Browsing by Author "Mathew, R"

Now showing 1 - 10 of 10
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    Adaptation of the ACE for a Malayalam speaking population in southern India
    (INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, 2004)
    Objective To adapt the Addenbrooke's Cognitive Examination (ACE) as a dementia-screening tool in a community in south India. To establish that items in the adapted version are equivalent to that in the original.Methods The ACE was adapted into the local language, Malayalam (m-ACE), following cultural/linguistic modifications. To establish equivalence, qualitative comparisons were made (on the distribution of scores, percentage scoring at ceiling, and relative difficulty across items) between a UK sample receiving the ACE (n = 50; mean age = 67.9 +/- 7.4; education greater than or equal to9, mean = 10.9 +/- 2.5) and a community-based educationally-stratified Indian sample receiving the m-ACE: 'India greater than or equal to9' (n = 50; mean age = 67.8 +/- 5.2; education greater than or equal to9, mean = 13.9 +/- 2.7) and 'India less than or equal to8' (n = 50; mean age = 67.1 +/- 5.3; education less than or equal to8, mean = 3.1 +/- 2.0).Results Most ACE items were retained. The score distribution (mean +/- ISD), percentage at ceiling, and relative difficulties across items is comparable between the UK and the educationally equivalent India greater than or equal to9 groups. Language, Naming, Attention and Orientation are relatively easy (greater than or equal to80% at ceiling) and Recall and Verbal fluency are relatively difficult (less than or equal to22% at ceiling). Although the percentage at ceiling were lower for the India less than or equal to8 group, the order of relative difficulty was similar and the percentage scoring at floor was less than or equal to10% on all except visuospatial item.Conclusions The m-ACE provides a culture-fair Malayalam adaptation of the ACE with component items of equivalent difficulty. Copyright (C) 2004 John Wiley Sons, Ltd.
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    Comparison of Risk Models to Predict In-Hospital Mortality for Patients With Acute Coronary Syndrome in India: The CSI-Kerala Risk Score
    (CIRCULATION, 2011) Huffman, MD; Mathew, R; Harikrishnan, S; Krishan, MN; Zachriah, G; Joseph, J; Prabhakaran, D; Faizal, A; Jayagopal, PB; Varghese, PK; Nambiar, A; Mohanan, PP
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    Complications in acute stroke in India (CAST-1): A multicenter study.
    (J Stroke Cerebrovasc Dis, 2012-12) Pandian, JD; Kaur, A; Jyotsna, R; Sylaja, PN; Vijaya, P; Padma, MV; Venkateswarlu, K; Sukumaran, S; Mathew, R; Kaur, P; Singh, YP; Radhakrishnan, K
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    Complications in acute stroke in India (CAST-1): A multicenter study.
    (J Stroke Cerebrovasc Dis, 2012-12) Pandian, JD; Kaur, A; Jyotsna, R; Sylaja, P N; Vijaya, P; Padma, MV; Venkateswarlu, K; Sukumaran, S; Mathew, R; Kaur, P; Singh, YP; Radhakrishnan, K
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    Complications in Acute Stroke in India (CAST-I): A Multicenter Study
    (JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, 2012) Pandian, JD; Kaur, A; Jyotsna, R; Sylaja, PN; Vijaya, P; Padma, MV; Venkateswaralu, K; Sukumaran, S; Mathew, R; Kaur, P; Singh, YP; Radhakrishnan, K
    The prognosis and final outcome in patients who sustain stroke are significantly affected by medical complications occurring during the acute phase of stroke. Only limited information is available from India and other developing countries regarding acute complications of stroke. This study examined the frequency of acute stroke and the factors associated with complications of stroke in India. In this prospective multicenter study, running from March 2008 to September 2009, 6 hospitals collected information on complications of first-ever stroke during admission. Complications were defined in accordance with standard criteria. Outcome at 30 days poststroke was assessed using the modified Rankin Scale. Stroke characteristics, length of hospital stay, and stroke severity (based on the National Institutes of Health Stroke Scale) were documented. Hematologic (ie, hemoglobin) and biochemical (ie, total proteins and albumin) parameters also were obtained. A total of 449 patients out of the recruited 476 completed follow-up. The mean age was 58.1 +/- 13.7 years (range, 16-96 years), and the majority were men (n=282; 62.8%). The mean National Institutes of Stroke Scale score was 10.2 +/- 5.3. Overall, 206 patients (45.9%) experienced complications during admission. In the logistic regression analysis, limb weakness (odds ratio [OR], 0.12; 95% confidence interval [CI], 0.02-0.67; P=.01), anemia (OR, 0.35; 95% CI, 0.15-0.81; P=.01), length of hospital stay (OR, 0.89; 95% CI, 0.85-0.94; P<.0001), and stroke severity (OR, 0.27; 95% CI, 0.10-0.72; P=.01) were the variables associated with complications. Such complications as urinary tract infection (OR, 0.31; 95% CI, 0.13-0.78; P=.01), chest infection (OR, 1.81; 95% CI, 1.12-2.93; P=.02), bedsores (OR, 3.52; 95% CI, 1.02-12.08; P=.05), other pain (OR, 0.21; 95% CI, 0.09-0.49; P<.0001), and depression (OR, 2.22; 95% CI, 1.30-3.80; P<.01) were associated with poor outcome. Our study shows high rates of complication in acute stroke. Limb weakness, stroke severity, length of hospital stay, and anemia were the factors associated with complications. Other complications, such as urinary tract infection, chest infection, bedsores, other pain, and depression, can lead to poor outcome.
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    Instrumental activities of daily living scale for dementia screening in elderly people
    (INTERNATIONAL PSYCHOGERIATRICS, 2005)
    Objective: To develop and validate an Instrumental Activities of Daily Living Scale for elderly people (IADL-E) to use in conjunction with cognitive screening tests for dementia in an educationally and socioculturally heterogeneous population.Method: Eleven IADL items were selected and weighted for major factors causing heterogeneity in the population-gender, education, social (rural/urban) setting and age. Each item was rated for its applicability (yes/no), degree of disability (scored from 0 to 2) and causative impairment (cognitive and/or physical). From this a composite index of cognitive (CDI) or physical (PDI) disability was derived. Validation was performed retrospectively on 240 subjects: 135 without and 105 with dementia by DSM-IV.Results: The IADL-E had a high internal consistency (alpha = 0.95). The area under the receiver operating characteristic (ROC) curve was 0.97 (CI = 0.94-0.99). A cutoff score of 16 on CDI provided a sensitivity of 0.91, specificity 0.99 and positive predictive value 0.76 (at 5% base rate). IADL-E correlated highly with clinical (DSM-IV, K = 0.89), functional (CDR, 0.82) and cognitive (Mini-mental Status Examination, MMSE, 0.74) diagnoses. It showed good responsiveness, with the change on CDI over a median of 23 months correlating significantly with that on MMSE (coefficient =-0.382, CI=-0.667 to -0.098; p=0.009). Individual items had good interrater and test-retest reliability.Conclusions: The IADL-E is a reliable, sensitive and responsive scale of functional abilities useful in dementia screening in a socioculturally heterogeneous population.
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    Premorbid nutrition and short term outcome of stroke: a multicentre study from India
    (JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2011) Pandian, JD; Jyotsna, R; Singh, R; Sylaja, PN; Vijaya, P; Padma, MV; Venkateswaralu, K; Sukumaran, S; Radhakrishnan, K; Sarma, PS; Mathew, R; Singh, Y
    Background Little is known about the impact of premorbid undernutrition on stroke outcome in developing countries. Aim To study the impact of premorbid undernutrition status, measured by the Subjective Global Assessment (SGA) tool, on short term stroke outcome. Methods First ever stroke patients admitted to six major hospitals in North and South India participated in this study from 1 March 2008 to 30 September 2009. The SGA tool was administered within 48 h of stroke onset, and 6 months premorbid nutritional status was rated as well nourished (A rating) and undernourished (B and C ratings) using this tool. Stroke outcome was assessed after 30 days using the modified Rankin scale (mRs), and a mRs score >3 was defined as a poor outcome. Statistical analyses were performed using SPSS Statistics V.17.0. Results Of 477 patients enrolled, 448 patients were included in the analyses. Mean age was 58.1 +/- 13.7 years (range 16-96) and 281 (62.7%) patients were men. At admission, premorbid undernutrition was found in 121 (27.2%) patients. Older age (OR 4.99, CI 1.26 to 19.64, p=0.021), hypertension (OR 1.99, CI 1.04 to 3.79, p=0.037) and patients from Andhra Pradesh State (OR 1.87, CI 1.05 to 3.32, p=0.032) were predictors of undernutrition in multiple logistic regression analysis. Premorbid undernutrition (OR 1.99, CI 1.20 to 3.31, p=0.007) and length of hospital stay (OR 3.41, CI 1.91 to 6.06, p<0.0001) were the independent predictors of poor outcome in the multiple logistic regression model. Conclusions High rates of premorbid undernutrition in stroke patients were found. Age, hypertension and patients from Andhra Pradesh State were predictors of premorbid undernutrition. Premorbid undernutrition was associated with poor stroke outcome. The results provide opportunities for primary prevention and improving stroke outcome.
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    Presentation, Management, and Outcomes of 25,748 Acute Coronary Syndrome Admissions in Kerala, India: Results from the Kerala ACS Registry
    (CIRCULATION, 2011) Mohanan, PP; Mathew, R; Harikrishnan, S; Krishan, MN; Zachriah, G; Joseph, J; Huffman, MD; Eapen, K; Abraham, M; Menon, J; Manoj, P; Jacob, S; Prabhakaran, D
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    Rural/Urban Differences in Hospital Characteristics, Patient Presentation, Process-of-Care Measures, and Outcomes of 25,748 Acute Coronary Syndrome Admissions in Kerala, India: Results From the Kerala ACS Registry
    (CIRCULATION, 2011) Mathew, R; Harikrishnan, S; Krishan, MN; Zachriah, G; Joseph, J; Huffman, MD; Prabhakaran, D; Cholakkal, M; Ponnouse, E; Govindannunni, U; Abraham, AK; Mohanan, PP