Browsing by Author "Jissa, VT"

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    Circulating Thrombotic Risk Factors in Young Patients with Coronary Artery Disease Who Are on Statins and Antiplatelet Drugs
    (Ind J Clin Biochem, 2016-02) Reema, G; Harikrishnan, S; Jayakumari, N; Anugya, B; Jissa, VT; Tharakan, JA
    Thrombotic risk factors may contribute to premature coronary artery disease (CAD), in addition to the conventional risk factors. There is paucity of data on studies evaluating the role of thrombotic factors in premature CAD in Indian patients. Thus a case–control study was performed to evaluate the role of thrombotic and atherogenic factors in young patients with angiographically proven CAD who are on treatment with statins and antiplatelet drugs. 152 patients (B55 years) with angiographically proven CAD and 102 asymptomatic controls were recruited. Clinical and biochemical data were obtained in both groups. Blood levels of thrombotic factors-fibrinogen, antithrombin-III, tissue-plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), von-Willebrand factor (v-WF), lipoprotein(a) [Lp(a)] and homocysteine were analyzed. Patients had high levels of conventional CAD risk factors (diabetes mellitus, smoking, hypertension, dyslipidemia and positive family history) compared to controls. Logistic regression analysis revealed that low antithrombin-III (odds ratio/OR 11.2; 95 % confidence interval/CI 2.29–54.01), high fibrinogen (OR 6.04; 95 % CI 1.09–33.21) and high Lp(a) (OR 4.54; 95 % CI 0.92–22.56), as important, independent risk factors in patients. PAI-1(OR 0.15; 95 % CI 0.03–0.69) levels were significantly lower in patients. But other thrombotic risk factors studied (t-PA, v-WF and homocysteine) were comparable among patients and controls. The treatment using statins and anti-platelet drugs might be contributing to the control of some of the thrombotic risk factors. The strategies aiming at lowering the levels of thrombotic risk factors along with conventional risk factors may be useful in primary and secondary prevention of CAD
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    Demographic and Clinical Characteristics of Pandemic Influenza A (H1N1) 2009 Outbreak in Kerala, Southern India
    (British Microbiology Research Journal, 2014-04) Dhanya, VC; Sara, PJ; Sanjai, D; Amar, F; Deepa, PM; Santosh, GR; Jissa, VT; Pillai, MR
    Aims: To study the clinical and epidemiological features in the affected individuals from different areas of Kerala, India. Study design: Population based cross sectional study. Place and Duration of Study: Regional Facility for Molecular Diagnostics, Rajiv Gandhi Center for Biotechnology and Directorate of Health Services, Kerala, between August 2009 and September 2010. Methodology: We conducted active surveillance for referral hospitals with specialist in-patient care in Kerala during pandemic periods. Oropharyngeal or nasopharyngeal swabs were tested for influenza viruses by Real time reverse transcriptase PCR. Results: A total of 4252 samples were tested for H1N1 influenza virus, of which, 30.17% were positive for pandemic influenza A H1N1 and 10.49% were positive for Influenza A (seasonal flu). Severe disease and mortality in the pandemic influenza A (H1N1) 2009 infection predominantly affected relatively healthy adolescents and adults between the age of 10 and 50 years. Both Males (29.28%) and Females (31.15%) were equally effected even though we observed a significant difference (P=.02). 141 cases exhibited lower respiratory tract symptoms. Pneumonia alone accounted for 28% of complicated cases. It was observed that the majority of cases (29.28%) during the first outbreak season were imported from affected overseas regions. Conclusion: In this study, prevalence of Influenza A H1N1 was high in the healthy younger population and there wasn’t any sex related susceptibility for Influenza infection. Majority of districts showed a positivity of approximately 10-30%, few with high positivity of >30%. Our findings highlight the importance of regular influenza immunization as it is significant to understand that the H1N1 (2009) virus may still circulate for many years with similar high severity.
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    Effect of screening on the risk estimates of socio demographic factors on cervical cancer - a large cohort study from rural India
    (Asian Pac J Cancer Prev., 2013-08) Jissa, VT; Malila, N; Hakama, M; Esmy, PO; Cherian, M; Swaminathan, R; Muwonge, R; Sankaranarayanan, R
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    Forkhead box C2 Promoter Variant c.-512C.T Is Associated with Increased Susceptibility to Chronic Venous Diseases
    (PLoS ONE., 2014-03) Surendran, S; Girijamma, A; Nair, R; Ramegowda, KS; Nair, DH; Jissa, VT; Lakkappa, RB; Kamalapurkar, G; Kartha, CC
    Chronic venous disease (CVD) is one of the most prevalent yet underrated disorders worldwide. High heritability estimates of CVD indicate prominent genetic components in its etiology and pathology. Mutations in human forkhead box C2 (FoxC2) gene are strongly associated with valve failure in saphenous and deep veins of lower extremities. We explored the association of genetic variants of FoxC2 as well as FoxC2 mRNA and protein expression levels with CVD of lower limbs. We systematically sequenced the single coding exon, 59 and 39 flanking regions of FoxC2 gene in 754 study subjects which includes 382 patients with CVD and 372 healthy subjects. Four novel and three reported polymorphisms were identified in our cohort. Three variants in 59 flanking region and one in 39 flanking region of FoxC2 gene were significantly associated with CVD risk. FoxC2 mRNA in vein tissues from 22 patients was 461.42 fold increased compared to saphenous veins from 20 normal subjects (p,0.01). FoxC2 protein was also significantly upregulated in varicose veins compared to control samples. The c.-512C.T (rs34221221: C.T) variant which is located in the FoxC2 putative promoter region was further analyzed. Functional analysis of c.-512C.T revealed increased mRNA and protein expression in patients with homozygous TT genotype compared to heterozygous CT and wild CC genotypes. Luciferase assay indicated higher transcriptional activity of mutant compared to wild genotype of this variant. These findings suggested that c.-512C.T variant of FoxC2 was strongly associated with susceptibility to CVD and also that this variant resulted in FoxC2 overexpression. To obtain a mechanistic insight into the role of upregulated FoxC2 in varicosities, we overexpressed FoxC2 in venous endothelial cells and observed elevated expression of arterial markers Dll4 and Hey2 and downregulation of venous marker COUP-TFII. Our study indicates altered FoxC2-Notch signaling in saphenous vein wall remodeling in patients with varicose veins.
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    Nutritional Status of Mid Day Meal Programme Beneficiaries: A Cross sectional Study among Primary Schoolchildren in Kottayam District, Kerala, India
    (Indian J Public Health, 2017-08) Jayalakshmi, R; Jissa, VT
    Background: The efficiency of Mid‑Day Meal (MDM) Programme in India to ensure the optimum nutritional status of its beneficiaries is rarely studied. Objective: This study assessed the nutritional status of 6–10‑year‑old schoolchildren who were the beneficiaries of MDM and the child‑related factors affecting their nutritional status. Methods: A cross‑sectional study was performed among 322 children from 12 randomly selected primary schools in one block panchayat of Kerala state. The background information was collected from children and their parents, and anthropometric measurements of the children were observed. The prevalence of undernutrition was estimated using conventional indices (stunting, underweight, and wasting) and composite index of anthropometric failure (CIAF). Logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: The prevalence of CIAF was 45.7% (95% CI: 40.3%–51.1%) and that of stunting, underweight, and wasting were 13.4% (9.7%–17.1%), 38.8% (33.5%–44.1%), and 30.7% (25.7%–35.7%), respectively. The prevalence of wasting (42.6% vs. 28.4%, P = 0.039) and severe underweight (20.4% vs. 7.1%, P = 0.002) was statistically significantly high among occasional/never users compared to regular users of MDM Programme. Children born with <2.5 kg showed an OR of 1.76 (95% CI: 0.99–3.11) for being undernourished compared to children born with normal weight (≥2.5 kg) when adjusted for age, sex, birth order, and illness in the past 2 weeks. Conclusion: This study showed a higher prevalence of undernutrition among school‑age children who were the beneficiaries of MDM Programme, and this indicates the need for continuous nutritional interventions and surveillance among these children.
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    Over expression of cytosolic galectin-3 correlates with anti-apoptotic protein bcl-2: its significance in the differential diagnosis of follicular cell derived thyroid tumors in fnac
    (International Journal of Current Research, 2016-02) Shanone, CP; Jissa, VT; Shaji, T; Preethi, TR; Remani, P; Sujathan, K
    Fine Needle Aspiration Cytology is considered as a reliable and cost effective method for the initial evaluation of thyroid nodules. But it poses a diagnostic challenge in differentiating benign follicular adenoma from follicular carcinoma and follicular variant of papillary carcinoma as they have similar cytological appearance. Present study focused on the identification of an immuno marker for the differential diagnosis of thyroid malignancy and to compare the expression of Galectins and Bcl-2 to explain its role in apoptosis. We performed immunohistochemistry of galectin-1, galectin-3 and bcl-2 on cell block prepared from FNA material and corresponding tissue sections on 289 samples. Galectin-3 mRNA expression was quantified using Real time PCR. Western blotting was carried out in surgically excised fresh tissue specimens. Pap stained slides were also subjected to immunocytochemistry without de-staining. Galectin-3 was found to be highly significant (P<0.001) in the differential diagnosis of malignancy from adenoma with high diagnostic accuracy of 97.8%. All the samples of papillary carcinoma with distant metastasis showed intense expression of galectin-3 and bcl-2. A negative correlation in the expression pattern of galectin-3 and bcl-2 was observed in the case of thyroiditis. QRT- PCR revealed a significant over expression of galectin-3 (2.4 fold) in papillary carcinoma. The present study observed a correlation for the over expression of Galectin-3 with its anti-apoptotic activity and suggests galectin-3 immunohistochemistry along with morphological evaluation and quantitative assessment to eliminate unwanted thyroidectomies for benign nodules
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    Self-reported Physical Activity and its Correlates among Adult Women in the expanded part of Thiruvananthapuram City, India
    (Indian Journal of Public Health, 2015) Mathews, E; Pratt, M; Jissa, VT; Thankappan, KR
    Data on correlates of physical activity (PA) are limited in India. This study estimated the prevalence and correlates of PA among women. A cross-sectional survey was conducted among 1303 women (mean age 45 years) selected by multistage cluster sampling. Information was collected using a pretested interview schedule. Multivariate logistic regression analysis was used to determine the correlates of PA. Self-reported moderate or high level PA prevalence was 73.4% [95% confidence interval (CI); 71.1-75.9]. Women who perceived themselves as being underweight [odds ratio (OR) 3.68: 1.97-6.74]; had an exercising member in the household (OR 3.41: 2.52-4.66); had access to exercise facilities (OR 2.17: 1.63-2.95); were married (OR 2.14: 1.40-3.25), were in the age group of 35-54 years (OR 1.91: 1.32-2.63); reported having knowledge about the benefits of PA (OR 1.62: 1.13-2.25); and who reported having the support of friends and neighbors (OR 1.42: 1.05-2.01) were more likely to report PA than their counterparts.
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    Socio Demographic and Reproductive Risk Factors for Cervical Cancer – a Large Prospective Cohort Study from Rural India
    (Asian Pac J Cancer Prev., 2013-03) Jissa, VT; Nea, M; Matti, H; Pulikottil, OE; Mary, C; Rajaraman, S; Richard, M; Rengaswami Sankaranarayanan, R
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    Transesophageal echocardiographic evaluation of left ventricular systolic and diastolic function in response to 20% mannitol and 3% hypertonic saline infusion in neurosurgical patients undergoing cran
    (J Neurosurg Anesthesiol., 2014-07) Gayatri, P; Misra, S; Menon, G; Arulvelan, A; Jissa, VT
    BACKGROUND: Mannitol and hypertonic saline (HS) are routinely used during craniotomy. Both increase myocardial preload and reduce afterload, and may improve cardiac output. It is not currently known whether this results in an improvement in the global myocardial function. Thus, the aim of this study was to compare the effects of a single equiosmolar bolus of 20% mannitol (5 mL/kg) or 3% HS (5 mL/kg) on the global myocardial function by tissue Doppler-derived myocardial performance index (TD-MPI) in patients undergoing craniotomy. METHODS: Fifty adult patients were included and randomized to receive either mannitol or 3% HS. Transesophageal echocardiography was performed in all patients. Early (E) and late (A) peak mitral inflow velocity, early diastolic mitral annular velocity (E prime), isovolumetric relaxation time (IVRT), ejection time (ET), and isovolumetric contraction time (IVCT) were recorded at baseline and at 15, 30, 60, and 120 minutes after administration of the hyperosmolar solutions. TD-MPI was calculated as IVRT+IVCT/ET. RESULTS: There were no significant differences in the TD-MPI (HS vs. mannitol: 0.43 vs. 0.44 [baseline], 0.45 vs. 0.43 [15 min], 0.44 vs. 0.45 [30 min], 0.47 vs. 0.45 [60 min], 0.45 vs. 0.46 [120 min]), E/A ratio, IVCT, and E/E' either within or between the 2 groups at any time point. IVRT was prolonged in HS group as compared with baseline at 15, 30, and 60 minutes postinfusion. ET was decreased in both the groups at 120 minutes postinfusion. Neither of these altered the TD-MPI. CONCLUSIONS: Equiosmolar administration of 20% mannitol and 3% HS did not show any difference in global myocardial performance as measured by TD MPI.
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    Using opensource data to explore distribution of built environment characteristics across Kerala, India
    (Indian Journal of Public Health, 2020-10) Valson, JS; Kutty, VR; Soman, B; Jissa, VT
    Background: Built environment characteristics in the neighborhood are of utmost priority for a healthy lifestyle in the fast-urbanizing countries. These characteristics are closely linked to the disease burden and challenges in low- and middle-income countries (LMICs), which have been unexplored using open-source data. The present technology offers online resources and open source software that enable researchers to explore built environment characteristics with health and allied phenomena. Objectives: This article intends to delineate methods to capture available and accessible objective built environment variables for a state in India and determine their distribution across the state. Methods: Built environment variables such as population density and residential density were collated from the Census of India. Safety from crime and traffic were captured as crime rates and pedestrian accident rates, respectively, acquired from State Crime Records Bureau. Greenness, built-up density, and land slope were gathered from open-source satellite imagery repository. Road intersection density was derived from OpenStreetMap. Processing and analysis differed for each dataset depending on its source and nature. Results: Each variable showed a distinct pattern across the state. Population and residential density were found to be closely related to each other across both districts and subdistricts. They were both positively related to crime rates, pedestrian accident rates, built-up density, and intersection density, whereas negatively related to land slope and greenness across the subdistricts. Conclusion: Delineating the distribution of built environment variables using available and open-source data in resource-poor settings is a first in public health research among LMICs. Cost-effectiveness and reproducible nature of open-source solutions could equip researchers in resource-poor settings to identify built environment characteristics and patterns across regions.