M. Kalaivani

• Ph.D Biostatistics
• Assistant Professor at All India Institute of Medical Sciences

Background Breast cancer is the most common malignancy diagnosed in women worldwide. Triple-negative breast cancer (TNBC) is the most aggressive subtype, accounting for nearly one third of all breast cancers in India. The addition of pembrolizumab to neoadjuvant chemotherapy improved the pathological response and event free survival in patients wit...

Background Anaemia is a serious public health problem. It is the second-commonest contributing factor to years lost by adolescents to disability and death. Targeting adolescent girls will allow a window of opportunity to correct their nutritional health and improve their obstetric outcomes. Studies in India have reported varying prevalence rates of...

Background Minimally invasive autopsy (MIA) using post‐mortem magnetic resonance imaging with ancillary investigations is reported as accurate as conventional autopsy. This study assesses MIA's feasibility and accuracy compared to conventional autopsy. Method MIA and/or conventional autopsy were performed on malformed fetuses (14–20 weeks gestatio...

Objectives: The 70% screening coverage target proposed in the global cervical cancer elimination strategy is not achieved even at tertiary centres in India. A situational analysis was done to assess the currently existing facilities and barriers in tertiary care institutes. Methods: This cross sectional multicentric study was conducted from Augu...

Metabolic syndrome (MetS) is a group of metabolic abnormalities that include disturbed glucose metabolism, dyslipidemia, abdominal obesity, and arterial hypertension. Nutritional and lifestyle modifications have increased the risk of cardiometabolic disorders among adolescents. Studies conducted in various parts of India have shown a wide range of...

Background The COVID-19 pandemic posed a challenge for the public health system, as all the health facilities and manpower were diverted for the delivery of COVID-19-related services. This affected the provision of routine health services, including maternal healthcare services. There is a paucity of data from rural and primary healthcare settings,...

Aim: In addition to the well-known toxicities of treatment, survivors of pediatric solid tumors can also develop other health-related conditions. They may either be an indirect consequence of therapy or could be unrelated to their prior history of malignancy. We aim to evaluate the nontoxicity related health conditions in survivors of pediatric sol...

Background and Aims Thyroid surgery maybe associated with mild-moderate pain, with 66-90% patients requiring opioids on the first postoperatively. This study compared superficial cervical plexus block (SCPB) [USG subcutaneous local anaesthetic (LA) injection at Erb’s point] and intermediate CPB (IMCPB) [USG LA injection below posterior SCM border]...

Background: Mild cognitive impairment (MCI) is a transitional state between normal cognition and clinical dementia. MCI is associated with an increased risk of dementia and mortality. Progression of MCI to dementia can be prevented by cognitive and lifestyle interventions. There is limited evidence on the burden and risk factors associated with MCI...

Background It is well documented that the utilization of maternal healthcare services during pregnancy and childbirth plays a significant role in reducing maternal morbidity and mortality. Disruptions in maternal healthcare services during the coronavirus disease 2019 (COVID-19) pandemic have been reported. However, there is a paucity of literature...

The management of the deep carious lesion with reversible pulpitis is a dilemma for the dentist. The current study compared selective removal of soft dentine (SRSD) to full pulpotomy for treating proximal deep carious lesions in teeth with reversible pulpitis. Visual-tactile examination and bitewing radiographs were used to determine the depth of c...

Objectives: Glasgow Coma Scale-Pupils (GCS-P) score has been found to be strongly related to in-hospital mortality in retrospective studies. We hypothesized that GCS-P would be better prognosticator than Glasgow Coma Scale (GCS) in patients with traumatic brain injury (TBI). Methods: In this prospective, multicentric, observational study, GCS an...

Adrenocortical neoplasms are rare in childhood. Their histopathological categorization into benign and malignant is often challenging, impacting further management. While the AFIP/Wieneke scoring system is widely used for the prognostic classification of these tumors, it has limitations. Few other tumor scoring systems have evolved over the past fe...

Background & objectives: Research studies in the 1970s reported that in pre-school children, undernutrition increased the risk of infections and infections aggravated undernutrition. Over decades, there has been a reduction in prevalence of undernutrition and improvement in access to healthcare for treatment of infections. A mixed longitudinal stu...

Background Yoga is an emerging intervention causing improvement in physical, mental, and spiritual well-being. Its role in improving outcomes in patients with amputation was investigated. Methodology Patients with traumatic lower limb amputation ( n = 50) were enrolled and randomized to the Yoga group ( n = 26) against control ( n = 24). Sociodemo...

Background: The purpose of the current study was to evaluate patient-oriented strategies encompassing individualized oocyte number (POSEIDON) criteria, validate stratification of low prognosis women, and prognosticate their reproductive potential in terms of cumulative live birth rate (CLBR) in Indian women. Methods: Out of 4048 women who underw...

Background and aims: Acute kidney injury (AKI) is a frequent complication of severe trauma associated with high mortality. The aim of this study was to evaluate the diagnostic ability of plasma and urine neutrophil gelatinase-associated lipocalin (NGAL) as an early marker of AKI assessed by RIFLE criteria as reference in trauma patients in intensi...

Objective: We carried out a secondary analysis of data of Comprehensive National Nutrition Survey 2016-18 to analyze the prevalence and predictors of vitamin D deficiency (VDD) among Indian children and adolescents. Results: The overall prevalence of VDD in preschool children (1-4 years), school age (5-9 years) children, and adolescents (10-19 y...

Background: Diabetes is a major contributor to hospital admissions, out‑of‑pocket expenditure, and premature mortality in India. Proper treatment and adequate control rates are needed to reduce the complications and deaths due to diabetes. Hence, we conducted a systematic review and meta‑analysis of community‑based studies to estimate the treatment...

The utility of telemedicine in healthcare has been brought to the forefront by the COVID-19 pandemic. ‘SwasthGarbh’ (Healthy Pregnancy) is a multi-functional, interactive smartphone application for providing antenatal care and real-time medical support to all pregnant women (especially those in rural areas and/or do not have easy access to doctors)...

Introduction: Abdominal bloating is a common complaint in patients with functional and organic bowel disease. Rifaximin, a non-absorbable antibiotic, has been tried for the treatment of this disease. We performed a systematic review and meta-analyses to study the efficacy of rifaximin in abdominal bloating and distension in patients with functional...

Background & objectives: Studies assessing the spatial and temporal association of ambient air pollution with emergency room visits of patients having acute respiratory symptoms in Delhi are lacking. Therefore, the present study explored the relationship between spatio-temporal variation of particulate matter (PM)2.5 concentrations and air quality...

IntroductionThe aim of the study was to evaluate the differences in the continuous glucose monitoring system (CGMS)-based glycemic parameters between women with normoglycemia and early gestational diabetes mellitus (GDM) identified on the basis of mild fasting plasma glucose elevation (FPG, 5.1–5.5 mmol/L) and/or post-load plasma glucose elevation...

Background: There is dearth of literature on impact of age - pediatric versus adult, Suzuki staging - early versus late, and revascularization type - indirect versus direct on clinical and angiographic outcome in moyamoya disease (MMD). Hence, we intend to comprehensively evaluate factors influencing outcome in MMD following surgical revasculariza...

Background: Systematic reviews conducted on sleep disturbances in attention deficit hyperactivity disorder (ADHD) have found inconsistent results due to the presence of several moderating variables which were not controlled for in previous studies. The aim of this study was to examine sleep disturbances in children with ADHD compared to their typic...

Abstract Introduction The COVID-19 pandemic has been a major public health threat for the past three years. The RNA virus has been constantly evolving, changing the manifestations and progression of the disease. Some factors which impact the progression to severe COVID-19 or mortality include comorbidities such as diabetes mellitus, hypertension, a...

Purpose The aim of the present study was to assess the effect of Bacillus coagulans Unique IS-2 supplementation on absorption and utilization of protein in resistance-trained males. Methods In this double blind, placebo-control trial, resistance-trained males (21.08 ± 2.84 years) were randomized to consume, either 20 g of whey protein powder {80%...

BACKGROUND There is an unmet need to evaluate the burden of cardiometabolic risk factors in young South Asian adults, who are not preselected for glycaemia. AIM To evaluate young North Indian men (aged 20-50 years) for burden of cardiometabolic risk factors, in relation to parameters of homeostatic model assessment for insulin resistance (HOMA-IR)...

Introduction: The etiopathogenesis of pelviureteric junction obstruction (PUJO) has been debated. Recently, the role of interstitial cells of Cajal-like cells (ICC-LC)has been studied and reported to be the cause of this functional obstruction. We studied the histopathology and ICC-LC density at PUJ and compared it with that of PUJ of the control...

Purpose: The aim of the study was to estimate centiles by using improved statistical smoothing procedure, the Box-Cox power-exponential (BCPE) method, in urban northern Indian adolescents aged 11-17 years. Materials and methods: Data were collected cross-sectionally by measuring specific anthropometric features such as height, weight, and mid-up...

There is a lack of national-level estimates on the magnitude of asthma among children in India. Hence, we undertook a systematic review and meta-analysis to estimate the prevalence of asthma among children in India. We searched PubMed, Embase, Cochrane Library, and Google Scholar, and included cross-sectional studies reporting data on the prevalenc...

Introduction: Nutritional deficiencies are common among elderly person aged 60 years or older. Elderly persons suffer the dual burden of overnutrition and undernutrition. These nutritional disorders can be corrected if diagnosed and managed at the earliest. Aim: To estimate the prevalence and factors associated with underweight, overweight, obesity...

Background: H. pylori-associated gastritis in patients from the high-altitude area of Ladakh showed severe gastritis, mucosal nodularity, atrophy, and cancer in comparison to those from North India. This study served to analyze if differences in the H. pylori virulence genotypes decide the extent of gastric mucosal inflammation. Methods: Fifty g...

Introduction: In elderly persons, due to physiological, anatomical, and functional changes, body mass index (BMI) may not be suitable for the assessment of nutritional status. Mid-upper arm circumference (MUAC) can be a proxy indicator to identify underweight and overweight/obesity among elderly persons. This study aimed to estimate the correlation...

Exploring the barriers and facilitators of cervical cancer screening (CCS) is essential to reduce the incidence and mortality, particularly in low and middle-income countries. The present study investigates the direct, indirect, and total effects of the barriers and facilitators on CCS in India through the generalized structural equation modeling u...

Aims/introduction: We aimed to evaluate and compare CGMS-based glycemic parameters in women in early pregnancy (<20 weeks of gestation) who were classified as: a) GDM by IADPSG but normoglycemia by alternate (UK NICE, CDA and DIPSI) criteria, and b) normoglycemia by both (IADPSG and alternate) criteria. Material and methods: In this cross-sectio...

Background Surge of SARS CoV-2 infections ascribed to omicron variant began in December 2021 in New Delhi. We determined the infection and reinfection density in a cohort of health care workers (HCWs) along with vaccine effectiveness (VE) against symptomatic infection within omicron transmission period (considered from December 01, 2021 to February...

Objective: This multi-center randomized controlled trial aims to evaluate the effectiveness of a context-specific transition intervention program to improve clinic visit adherence and clinical outcomes among emerging adults with type 1 diabetes mellitus (T1DM) in Delhi, India. Methods: We will recruit patients with T1DM of duration ≥1 year and a...

Background Progression in age causes gradual loss in height due to degenerative osteoporotic changes in bones and decrease in the disc space. Hence, proxy measures of height are required in elderly persons. Objective The objective of the study is to study the relationship between height and arm-span of elderly persons. Materials and Methods This...

The novel coronavirus (SARS‐CoV‐2) pandemic has emerged as a major public health challenge, affecting more than 380 million people globally and causing more than 5.6 million deaths This article is protected by copyright. All rights reserved.

Objective To evaluate the role of shear wave elastography (SWE) of suspicious axillary lymph nodes and its combination with B-mode USG in predicting nodal metastasis in breast cancer patients. Methods Prospective observational study was performed from June 2018-August 2020 on breast cancer patients with suspicious axillary nodes on USG. B-mode fea...

Purpose: To develop a new age-appropriate visual function questionnaire for visually impaired children. Methods: The study was conducted in north India in 20,955 (97.3%) children ≤15 years who underwent visual acuity examination. Of these 20,955 children, a total of 722 children were referred with unaided visual acuity less than 6/12 in any eye....

Background Anti‐tumor necrosis factor (anti‐TNF) therapy use in patients with inflammatory bowel disease (IBD) leads to an increased risk of tuberculosis (TB) reactivation despite latent tuberculosis (LTB) screening, especially in TB endemic regions. Aim We evaluated the effect of stringent screening strategy and LTB prophylaxis on TB reactivation...

Background: Differentiation of neonatal cholestasis into neonatal hepatitis (NH) and extrahepatic biliary atresia (EHBA) is essential to formulate the treatment plan; promptness is indispensable for optimal outcomes. The clinical and nonoperative algorithms lack precision; the gold standard investigations (liver biopsy or per-operative cholangiogr...

Background: Adrenocortical tumors are rare tumors in children with a paucity of outcome data, especially in a resource-challenged setting. Materials and methods: A retrospective study was conducted to evaluate the presentation, management, and outcomes of children with adrenocortical tumors who presented to our institute from January 1992 to Dec...

Nitric oxide (NO.) is critical for functionality of endothelial colony forming cells (ECFCs). Dimerization of endothelial nitric oxide synthase (eNOS) is must to produce NO. and tetrahydrobiopterin (BH4) plays a crucial role in stabilizing this state. We investigated BH4 level in ECFCs and its effect on ECFCs functionality in CAD patients. Intracel...

Introduction: Type 1 diabetes (T1DM) is associated with cognitive deficits, and age at diagnosis is thought to play a substantial role. However, there are limited data for the cognitive performance in young adults, in relation to the age of diabetes onset. The lack of information is particularly striking in the context of developing regions. Meth...

Introduction. Urinary tract infection (UTI) is one of the most common infections in clinical practice worldwide in both healthcare and community settings causing significant morbidity and mortality. It is one of the major conditions at the community level treated empirically and regarded as a potential cause of emergence of antimicrobial resistance...

The study aimed to document the method standardization and assessment of micronutrient and inflammatory markers in women from indigenous tribal communities of Jharkhand using a low volume, high throughput assay. This cross-sectional study was done among women of the reproductive age group from Sauria Paharia and Santhal tribal households in selecte...

Background: Presbyopia is a major cause for near visual impairment among adults. Presbyopia induced visual impairment can be corrected easily by spectacles. We aimed to study the prevalence of presbyopia among adults aged ≥35 years and spectacles coverage among them. We also studied the unmet need for presbyopia along with the barriers to uptake o...

Background Delta variant transmission resulted in surge of SARS CoV-2 cases in New Delhi, India during the early half of year 2021. Health Care Workers (HCWs) received vaccines on priority for prevention of infection. Real life effectiveness of BBV152 vaccine against severe disease including hospitalization and death was not known. Objective To es...

Background Anti-tumour necrosis factor (anti-TNF) therapy use in patients with inflammatory bowel disease (IBD) leads to increased risk of tuberculosis (TB) reactivation despite LTB screening, especially in TB endemic regions. We evaluated the effect of stringent screening strategy and latent tuberculosis (LTB) prophylaxis on TB reactivation. Meth...

Importance A surge of COVID-19 occurred from March to June 2021, in New Delhi, India, linked to the B.1.617.2 (Delta) variant of SARS-CoV-2. COVID-19 vaccines were rolled out for health care workers (HCWs) starting in January 2021. Objective To assess the incidence density of reinfection among a cohort of HCWs and estimate the effectiveness of the...

Background: Surge of SARS CoV-2 infections ascribed to omicron variant began in December 2021 in New Delhi. We determined the infection and reinfection density in a cohort of health care workers (HCWs) along with vaccine effectiveness (VE) against symptomatic infection within omicron transmission period (considered from December 01, 2021 to Februar...

Objective Data for association between diabetes and SARS-CoV-2 susceptibility are conflicting. We aimed to evaluate this association using an analytical cross-sectional study design. Methods Study participants were recruited from endocrine clinics of our hospital and belonged to three groups: group 1 (T1DM), group 2 (T2DM), and group 3 (controls)....

Objective The aim of this cross-sectional study was to comprehensively assess bone health in women with prior gestational diabetes mellitus, including bone microarchitecture (TBS), bone mineral density (BMD, DXA) and bone turnover (osteocalcin). Design, Patients and Measurements Study participants underwent a detailed anthropometric, biochemical a...

Background There is an increasing need for Mental Health Promotion (MHP) among adolescents, especially in developing countries with limited resources and rapid socio-demographic transition. With the growing burden of mental health problems among adolescents (suicide, depression) and their preferences to seek help from their peers, improving Mental...

Objectives To study the association of Candida and antifungal therapy with pro-inflammatory cytokines (PIC) in oral leukoplakia (OL).Materials and methodsA prospective observational study where immunocompetent adult subjects with OL (30 homogenous (HL), 30 non-homogenous (NHL)) and 30 age and sex-matched healthy controls (C) with no predisposing fa...

Background and objective: The prevalence of chronic obstructive pulmonary disease (COPD) is increasing worldwide. There is a lack of national-level estimates on the magnitude of COPD in India. Hence, we estimated the prevalence of COPD among adults in India. Methods: We searched PubMed, Embase, Cochrane Library, Google Scholar, and Scopus and in...

Background: Underweight, overweight, and anemia are common public health problems among elderly individuals. Objectives: The current study was conducted in a rural area of Ballabgarh, Haryana, to estimate the prevalence of underweight, overweight, and anemia among elderly persons and to find their association with sociodemographic variables. Ma...

Introduction: We aimed to evaluate whether SARS-CoV-2 infection is associated with beta cell dysfunction and progression of glycemic and cardiometabolic variables in an established cohort. Methods: Study participants (n = 352, 46.9% men) underwent a detailed evaluation at two time points: (a) pre-COVID (2016–19) and (b) peri-COVID (2020–21). At th...

Introduction: The estimates of prevalence of depression among adolescents in the Indian community are limited; most studies are institution-based. Early identification and management of depression can provide significant health dividends to the affected adolescents, and better health consequences in their adulthood. Objectives: To determine the pre...

Aim: We conducted this network meta-analysis to compare the efficacy and safety of targeted pharmacotherapies and fecal microbial transplantation (FMT). Patients & methods: Nineteen studies were included and there was only one head-to-head randomized controlled trial (adalimumab vs vedolizumab). Results: All interventions, including FMT, were super...

Objective To study the effects of myoinositol (Myo) in comparison to metformin (Met), in reducing the risk of OHSS and improving ART outcome in PCOS women undergoing IVF. Design Double-blinded randomized controlled trial (CTRI/2018/05/014196). Setting ART Clinic, AIIMS, New Delhi patients: 102 infertile PCOS women undergoing IVF cycles were enrol...

Background & objectives: In the current scenario, with availability of different surgical procedures for limbal stem cell deficiency (LSCD), there exists no common consensus as to the standardization of the management protocol for the same. In addition, there also exists diversity in the views about the clinical diagnosis, ancillary investigations...

Objective: To evaluate the efficacy of daily supplementation of 200 mL milk fortified with 240 IU of vitamin D2 (ergocalciferol). Design: Double-blind randomized controlled trial. Settings: School-based study in Delhi between October and December, 2019. Participants: 235 healthy children aged 10-14 years. Intervention: Daily supplementatio...

Objective To evaluate the role of axillary ultrasonography (axUS) and ultrasound-guided pre-operative wire localisation of pre-treatment positive clipped node (CN) for prediction of nodal response to neoadjuvant chemotherapy (NACT) in node positive breast carcinoma patients. Methods and materials A prospective study was conducted between June 2018...

The present study explored the association between daily ambient air pollution and daily emergency room (ER) visits due to acute respiratory symptoms in children of Delhi. The daily counts of ER visits (ERV) of children (≤15 years) having acute respiratory symptoms were obtained from two hospitals of Delhi for 21 months. Simultaneously, data on dai...

In chronic kidney disease (CKD) toxins accumulate in the muscles and cause fatigue, mental impairment, and muscle dysfunction (cramps). Exercise results in the opening of capillaries thereby increasing blood flow and allowing greater movement of urea and creatinine from the tissues to the vascular compartment and subsequent removal through dialysis...

Background: Preclinical studies have reported significant changes in the gut microbiome after traumatic brain injury (TBI). We hypothesized that TBI induces the growth of Proteobacteria in the human gut. Our primary outcome was to study the profile of the human fecal microbiome after TBI and the secondary outcome was to identify colonization with...

Background: COVID-19 pandemic has disrupted pediatric cardiac services across the globe. Limited data are available on the impact of COVID.19 on pediatric cardiac care in India. Aims: The aims are to study the impact of COVID-19 pandemic on the care of children with heart disease in India in terms of number of outpatient visits, hospitalizations...

Background: Outcome data of children with heart disease who acquired COVID-19 infection are limited. Aims: We sought to analyze outcome data and identify risk factors associated with mortality in children with heart disease and grown-ups with congenital heart disease (GUCH) who had a laboratory-confirmed COVID-19 infection. Settings and design:...

Aim. Studies on the changes in the presentation and management of acute myocardial infarction (AMI) during the COVID-19 pandemic from low- and middle-income countries are limited. We sought to determine the changes in the number of admissions, management practices, and outcomes of AMI during the pandemic period in India. Methods & Results. In this...

Background. Falls are one of the leading causes of death and disability among elderly persons. In India, there is paucity of data on the prevalence of falls, particularly among community-dwelling elderly persons. To estimate healthcare costs related to falls and formulation of fall prevention strategies, there is a need of reliable estimates of mag...

Aim The aim of this study was to evaluate the association of cognitive impairment with sleep quality, depression, and cardiometabolic risk factors among participants with type 2 diabetes mellitus. Methods Subjects underwent clinical interview to capture socio-demographic details, medical history, sleep quality, presence of depression, along with a...

Background & objectives: Chronic obstructive pulmonary disease (COPD) is a major public health problem in India. Its magnitude is particularly high among the elderly. Old age and comorbidity may lead to misdiagnosis and under treatment of this condition. COPD is not curable; however, various forms of treatment can help control symptoms and improve...

Objectives Chronic inflammation caused by infection may lead to the production of proinflammatory cytokines (PICs) that can cause DNA damage and cell proliferation, thus playing a role in carcinogenesis. Candida infection has been reported to be increased in oral leukoplakia (OL) and is associated with an increased rate of malignant transformation...

Background: Elective percutaneous tracheostomy [PCT] is the widely performed procedure in neurocritically ill patients as an airway management choice in neurocritical care unit [NICU]. Intracranial pressure [ICP] is a vital parameter to be monitored in these patients while undergoing any surgical procedure including PCT. Optic nerve sheath diamete...

Background & objectives: Uncorrected refractive error and cataract are the two most common causes of impairment of vision among elderly persons, and both are treatable. Treatment-seeking in patients is driven by symptom (decreased vision) rather than any anatomical or physiological measurement. The objective of this study was to evaluate the treat...

Background Methotrexate is the most commonly used drug in the treatment of psoriasis with good efficacy and safety. Recently, weekly azathioprine pulse has been shown to be effective in this disease. Aim The aim of this study is to compare the effectiveness and safety of weekly pulse doses of azathioprine and methotrexate for the treatment of chro...

Background: Acute lower respiratory tract infections (ALRI) are the major cause of morbidity and mortality in young children worldwide. Information on viral etiology in ALRI from India is limited. The aim of the present study was to develop a simple, sensitive, specific and cost effective multiplex PCR (mPCR) assay without post PCR hybridization or...

Background: There are few studies on basal cell carcinoma (BCC) from India. Long-term follow-up is available in only one study and the aesthetic outcome of treatment has not been evaluated in Indian patients. Aims: In this retrospective study on BCC, we compared treatment failure, recurrence rates and aesthetic outcomes on long-term follow-up be...

Background The decline in the diaphragm thickness is common among patients with sepsis. The purpose of this study is to examine the relationship between the decline in diaphragm thickness as assessed by ultrasonography and various outcomes in septic patients. Methods This prospective study included patients with sepsis whose diaphragm thickness wa...

Objectives To determine the association of Candida phenotypes, virulence factors, antifungal sensitivity and clinical response to Fluconazole in Oral leukoplakia (OL). Methods Sterile swabs were obtained from oral lesions in immunocompetent subjects [30 Homogenous (HOL), 31 Non- Homogenous (NHOL] and normal buccal mucosa in 30 age and sex-matched...

Background: Breast cancer is one of the most common cancers among women. Surgical removal of the cancer is the mainstay of treatment; however, tumour handling during surgery can cause microscopic dissemination of tumour cells and disease recurrence. The body's hormonal response to surgery (stress response) and general anaesthesia may suppress immu...