Richard Kirubakaran

• Master of Science
• Researcher at Christian Medical College & Hospital

Background Accurate and rapid diagnosis is crucial for ending the tuberculosis epidemic. Truenat assays are World Health Organization (WHO)- recommended rapid molecular diagnostic tests that detect Mycobacterium tuberculosis complex and rifampicin resistance. Objectives Primary objective To assess the diagnostic accuracy of Truenat assays (MTB, MT...

Background Abnormal coagulation and thrombotic complications prompted many guidelines to recommend thromboprophylaxis for patients hospitalised with COVID‐19, but the dose required for prophylaxis remains unclear. This systematic review (SR) analyses the safety and efficacy of therapeutic dose anticoagulation (TDA) versus non‐therapeutic dose antic...

The primary aim of this study was to evaluate the effectiveness of herbal mouthrinses (HMR) on caries prevention in children and adolescents. In addition, this systematic review assessed its effectiveness in remineralization of white spot lesions, reduction of halitosis, and improving gingival and periodontal health in orthodontic patients and pati...

The care of infants at risk of poor growth and development is a global priority. To inform new WHO guidelines update on prevention and management of growth faltering among infants under six months, we examined the effectiveness of postnatal maternal or caregiver interventions on outcomes among infants between 0 and 6 months. We searched nine electr...

Background The coronavirus disease 2019 (COVID‐19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) continues to challenge the health workforce and societies worldwide. Favipiravir was suggested by some experts to be effective and safe to use in COVID‐19. Although this drug has been evaluated in randomized controlled...

Despite a large number of trials conducted on the use of herbal oral care products to reduce dental plaque or gingivitis, the results are conflicting and inconclusive. This systematic review aimed to evaluate the effectiveness of herbal dentifrices in caries prevention in children and adolescents and to ascertain the potential of herbal dentifrices...

Aim: This study aims to (1) Describe a multi-ethnic cohort of PsA patients seen in rheumatology centers in UAE, in terms of socio-demographic features, clinical and disease characteristics, and treatment trends (2) Explore relationship between active combination (biologics and methotrexate (MTX)) or MTX users and achieving minimal disease activity...

Background Early childhood caries is a significant public health concern affecting about 600 million children globally. The etiology of early childhood caries can be explained as an interplay between genetic and environmental factors. Single nucleotide polymorphisms are the most common variations in the human genome. Genetic variations of immune re...

Background: Due to their chronicity, prolonged morbidity, and high mortality, chronic respiratory diseases (CRDs) pose a huge burden of disease globally, primarily among low- and middle-income countries. Most of these diseases can be controlled by early diagnosis and treatment, correct practice of medications, regular follow-up, and avoidance of r...

Title Mapping factors facilitating resilience in mothers - potential clinical relevance for children with ADHD Background: Maternal resilience has been linked to treatment outcomes in offspring with ADHD. However, not much is known about factors that may facilitate maternal resilience. Studies have pointed to a complicated and mutual relationship...

Background We aimed to determine the effectiveness and safety of the Levofloxacin-containing regimen that the World Health Organization is currently recommending for the treatment of Isoniazid mono-resistant pulmonary Tuberculosis. Methods Our eligible criteria for the studies to be included were; randomized controlled trials or cohort studies tha...

Introduction: Genetic polymorphisms of genes regulating amelogenesis can alter susceptibility to Early Childhood Caries (ECC). This systematic review aims to analyze associations between single-nucleotide polymorphisms of enamel formation genes and ECC. Methods: Search was conducted across PUBMED, CINAHL, LILACS, SCOPUS, EMBASE, Web of Science,...

Objectives: To compare efficacy of aloe vera and probiotic mouthwashes vs fluoride mouthwash on Streptococcus mutans (S. mutans) in the plaque of orthodontic patients and to assess patient-reported outcomes and compliance. Materials and methods: This prospective randomized clinical trial included 90 patients aged 12-35 years and in permanent den...

This systematic review aimed to assess bite force measurements in children and adolescents and to study the various devices that measure Maximum Voluntary Bite Force (MVBF). This systematic review included observational studies and experimental studies in children and adolescents (upto 19 years of age) which evaluated MVBF using a bite force measur...

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed and treated psychiatric disorders in childhood. Typically, children and adolescents with ADHD find it difficult to pay attention and they are hyperactive and impulsive. Methylphenidate is the psychostimulant most often prescribed, but the evidence on...

(1) Background: The current evidence on management of infants under six months (u6m) with growth faltering is limited and of low quality. This review aimed at updating an existing review to inform the WHO guideline update on prevention and management of growth faltering in infants u6m. The objective is to synthesise evidence on interventions to man...

A B S T R A C T Objectives This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To determine the diagnostic accuracy of Truenat assays (MTB, MTB Plus, and MTB RIF Dx) for detecting pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis. Secondary objectives 1. To compare t...

PURPOSE: The purpose of the study is to evaluate the safety and outcomes of corneal collagen cross-linking (CXL) and different CXL protocols in progressive keratoconus (PK) population at short and long-term. MATERIALS AND METHODS: A systematic review and meta-analysis was conducted. A total of eight literature databases were searched (up to Februa...

Background and Aim: While sedative drugs are not hepatotoxic, the use of sedative drugs in patients with acute liver dysfunction may lead to unrecognized sedative overdose, or trigger or aggravate encephalopathy. This study hopes to draw more attention to the need to correctly interpret and use the expert guidelines in this regard. The aim of this...

(Abstracted from Eur J Obstet Gynecol Reprod Biol 2022;271:235–244) Chromosomal aberrations occur at a frequency of approximately 1 in 150 to 200 live births and are one of the most important causes of congenital anomalies and miscarriages. The introduction of chromosomal microarray (CMA) in the 1990s advanced the detection of chromosomal aberratio...

Research question: To estimate the pooled prevalence of molar incisor hypomineralization (MIH) in children from India. Research protocol: The PRISMA guidelines were followed. Literature search: An electronic search of the databases was performed to find prevalence studies of MIH in children above age 6 years in India. Data extraction: Two au...

Objective To summarise latent tuberculosis infection (LTBI) management strategies among household contacts of bacteriologically confirmed pulmonary tuberculosis (TB) patients in high‐TB burden countries. Methods PubMed/MEDLINE (NCBI) and Scopus were searched (January 2006 to December 2021) for studies reporting primary data on LTBI management. Stu...

Background: The role of endogenous Matrix Metallo Proteinases in resin dentin bond deterioration over time has been well documented. The present study aimed to systematically review the literature; in vitro and ex vivo studies that assessed the outcomes of natural cross-linkers for immediate and long-term tensile bond strength were included. Method...

Purpose The present study examines the association between psychological violence and posttraumatic stress disorder (PTSD), depression, and anxiety, while comparing the specific subtypes of psychological violence and simultaneously focusing on methodological shortcomings. Method A systematic review and random-effects meta-analyses were applied on...

Introduction Obesity being a global epidemic, currently has several adverse health outcomes. Weight stigma is a significant barrier to delivering quality services and also impairs clinical progress. We intended to study the association of stigma with demographic and clinical variables in obese patients to identify the obstacles in treatment-seeking...

Background Health behaviour can change outcomes in both healthy and unhealthy populations and are particularly useful in promoting compliance to treatment and maintaining fidelity to care seeking and follow-up options in chronic diseases. Interventions to change health behaviour based on psychological theory are more often successful than those wit...

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the eEicacy and harms or adverse events of immunomodulatory therapies in people with ALS compared with a placebo, no additional treatment, or a standard-of-care protocol (with or without riluzole, edaravone, or both).

Background The World Health Organization has recommended Vitamin A supplementation for children in low- and middle-income countries for many years to reduce child mortality. Nepal still practices routine Vitamin A supplementation. We examined the potential current impact of these programs using national data in Nepal combined with an update of the...

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To determine the efficacy and safety of favipiravir in patients with COVID-19 as compared to standard of care without favipiravir. Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Background: Bacopa monnieri, a herb used extensively, has shown neuroprotective effects in animal and invitro studies; human studies on patients with Alzheimer's Disease (AD) have been inconclusive. Objective: The primary objective was to determine the clinical efficacy and safety of Bacopa monnieri (Brahmi) in persons with mild, moderate or sev...

Aim and objective: To assess the systematic reviews and meta-analyses investigating the dental caries experience in children with cleft lip and/or palate (CL/P). Study design and methodology: A systematic search was carried out from MEDLINE Via PubMed, JBI Database of Systematic Reviews and Implementation Reports, EMBASE, OVID, Cochrane Database...

Objective The aim of this systematic review and meta-analysis was to integrate the detection of second mesiobuccal (MB2) canals in maxillary first molars reported by different studies and methods on the Indian population. Methods This systematic review was conducted following Meta-analysis Of Observational Studies in Epidemiology (MOOSE) and PRISMA...

In people with COVID-19, the group recommends respiratory support measures targeting a peripheral oxygen saturation (SpO2) of 94-98%, and not a lower saturation target as there is insufficient evidence and potential harm (Conditional recommendation, very low certainty evidence). https://indiacovidguidelines.org/oxygen-saturation-targets/

The literature on the efficacy of erbium lasers for nonsurgical periodontal therapy is inconsistent. The objective of the umbrella review was to collate the information available in the systematic reviews to provide a comprehensive synthesis of clinical and patient reported outcomes following the use of erbium lasers for non-surgical periodontal th...

Objective To estimate the incremental yield of single nucleotide polymorphism (SNP) array over karyotype and to assess the diagnostic accuracy of SNP array as a stand-alone test versus SNP array with karyotype in detecting chromosomal abnormalities for prenatal diagnosis in women with an abnormal fetal ultrasound. Study design Studies in which SNP...

Background Studies have pointed to a complicated and mutual relationship between attention deficit hyperactivity disorder (ADHD) and attachment. In an observational follow-up study conducted in 2015 60 children from 7 years to 12 years recently diagnosed with ADHD were included and assessed according to attachment representation showing 85% of the...

Background: Resistance or susceptibility to caries is significantly correlated with the alterations in salivary proteins and cytokines, a useful biomarker in predicting caries' risk and prognosis. Bacteria colonize the oral cavity and lead to inflammation, which induces both innate and adaptive immune responses by the host. A predominant cell of in...

Study question Does Single nucleotide polymorphism (SNP) array provide a diagnostic advantage over conventional karyotype in prenatal diagnosis for fetuses with an abnormal ultrasound? Summary answer SNP array in the prenatal setting provides an incremental diagnostic yield over karyotype and the diagnostic accuracy is comparable with combined SNP...

https://indiacovidguidelines.org/niv-vs-hfno/ This link has the full evidence and the Recommendation.

Background Scrub typhus, a vector-borne zoonotic infection caused by the bacteria Orientia tsutsugamushi, is one of the most common and clinically important rickettsial infections worldwide. An estimated one million cases occur annually with a high case fatality rate. Although scrub typhus is a major public health threat in India, the burden and di...

Technology-assisted parent-mediated interventions improve accessibility and are acceptable but not proven to be effective. We conducted a systematic search of 6 databases. We included and analysed results from studies on social and communication outcomes. Sixteen Randomised-Controlled-Trials (RCTs) with 748 participants were included. Most studies...

https://indiacovidguidelines.org/inhaled-corticosteroids/ The full recommendation and Evidence summary is available in the above link.

Introduction The heterogeneity in people with borderline personality disorder (BPD) and the range of specialised psychotherapies means that people with certain BPD characteristics might benefit more or less from different types of psychotherapy. Identifying moderating characteristics of individuals is a key to refine and tailor standard treatments...

Background Health behaviour can change outcomes in both healthy and diseased populations and are particularly useful in promoting compliance to treatment and maintain fidelity to care seeking and follow-up options in chronic diseases. Interventions to change health behaviour based on psychological theory more often successful than those without any...

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary Objective: To assess the efficacy and safety of antibiotics in adults with irritable bowel syndrome compared to placebo or standard medical therapy alone. Secondary Objective: To determine the duration of response or time of recurrence following antibi...

Objective To assess the effect of different frequencies of ventilator circuit changes in neonates and children through a systematic review and meta‐analysis. Interventions (1) “No routine change of ventilator circuit (unless visibly soiled)” versus “routine change at any fixed interval”; (2) routine change of circuit at “less frequent” versus “mor...

STUDY QUESTION Are live birth (LB) and perinatal outcomes affected by the use of frozen own versus frozen donor oocytes? SUMMARY ANSWER Treatment cycles using frozen own oocytes have a lower LB rate but a lower risk of low birth weight (LBW) as compared with frozen donor oocytes. WHAT IS KNOWN ALREADY A rising trend of oocyte cryopreservation has...

Background Bacopa Monnieri or Brahmi is a herb belonging to plant family Scrophulariaceae whose medicinal properties have been reported in Indian traditional medicine (Ayurveda) literature for treatment of anxiety, intellect and memory disorders. Even though there is good quality preclinical evidence on utility of Brahmi, peer‐reviewed published da...

Introduction The heterogeneity in people with BPD and the range of specialised psychotherapies means that people with certain BPD characteristics might benefit more or less from different types of psychotherapy. Identifying moderating characteristics of individuals is a key to refine and tailor standard treatments so they match the specificities of...

Objectives: We sought to assess health literacy (HL) and its associated factors in the Bahraini community using a validated HL scale and address its deficient domains to inform policy. Methods: We carried out a conveniently sampled, cross-sectional survey using the All Aspects of Health Literacy Scale in the Bahraini community. The scale has thr...

Purpose: Although the use of steroids in the management of COVID-19 has been addressed by a few systematic review and meta-analysis, however, they also used data from "SARS-CoV" and "MERS-CoV." Again, most of these studies addressed only one severity category of patients or addressed only one efficacy endpoint (mortality). In this context, we cond...

Background: Virtual reality (VR) computer technology creates a simulated environment, perceived as comparable to the real world, with which users can actively interact. The effectiveness of VR distraction on acute pain intensity in children is uncertain. Objectives: To assess the effectiveness and adverse effects of virtual reality (VR) distract...

Objective: The aim of this systematic review and meta-analysis is to compare the outcomes of morphine vs. clonidine use as adjuvants in caudal anaesthesia. We are specifically focused on analgesic and side effect profiles. Methods: We searched databases and trial registration sites and include here randomised controlled trials that compare the a...

Introduction The association of Vitamin D and children with asthma is known and there are several individual studies on Vitamin D polymorphisms. However, systematic reviews on all vitamin D associated gene polymorphisms have not been done in children with asthma. Objective To investigate the association of Vitamin D associated gene polymorphisms a...

Background: Transfer of more than one embryo during in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) increases multiple pregnancy rates resulting in an increased risk of maternal and perinatal morbidity. Elective single embryo transfer offers a means of minimising this risk, but this potential gain needs to be balanced again...

Background: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurobiological disorders in childhood. Maternal resilience has been linked to treatment outcome in child ADHD. However, not much is known about factors that may facilitate maternal resilience. Aim: The aim of this study was to explore factors potentially facilita...

Background: Nutrition is an important aspect of management in severe acute pancreatitis. Enteral nutrition has advantages over parenteral nutrition and is the preferred method of feeding. Enteral feeding via nasojejunal tube is often recommended, but its benefits over nasogastric feeding are unclear. The placement of a nasogastric tube is technica...

Background: Granulocyte-colony stimulating factor (G-CSF) seems to play an important role in the process of embryo implantation and continuation of pregnancy. It has been used during in vitro fertilisation (IVF) treatment for subfertile women with chronically thin endometrium and those with previous multiple IVF failures. It is currently unknown w...

Background: Tuberculosis causes more deaths than any other infectious disease worldwide, with pulmonary tuberculosis being the most common form. Standard first-line treatment for drug-sensitive pulmonary tuberculosis for six months comprises isoniazid, rifampicin, pyrazinamide, and ethambutol (HRZE) for two months, followed by HRE (in areas of hig...

Background: Mammalian bites are a common presentation in emergency and primary healthcare facilities across the world. The World Health Organization recommends postponing the suturing of a bite wound but this has not been evaluated through a systematic review. Objectives: To assess the effects of primary closure compared with delayed closure or...

Evaluation of salivary interleukin‑6 in patients with caries before and after treatment in a tertiary care hospital - A cross sectional study Background: Human saliva is a protein rich easily accessible source of potential biomarkers for the diagnosis of oral and systemic diseases. Resistance or susceptibility to caries may be significantly correl...

In this systematic review, we aimed to assess role of plasma von-Willebrand factor (vWF), an endothelial activation marker, as prognostic marker in patients with chronc liver disease [cirrhosis and acute-on-chronic liver failure (ACLF)]. We searched published databases using predefined keywords to identify all studies up to June 2018, in which plas...

Aim: The objective of this cross sectional study was to estimate the prevalence of pulpitis among the adult population in the tertiary care hospital in south India. Methods: Enumerated the data from the hospital records in the march month. And also identified the individuals who visited the department of conservative dentistry and endodontics. To e...

Background In routine clinical care of Rheumatoid arthritis (RA) Spondyloarthritis(SPA) and Psoriatic arthritis (PSA) there is a high rate of discontinuation of biologic disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs) due to loss of efficacy, side effects or lack of adherence....

Purpose: The purpose of this study was to perform a systematic review to assess current evidence for association between various risk factors and the prevalence or incidence of early childhood caries (ECC). Methods: Two reviewers searched various databases until January 2019. The Newcastle-Ottawa scale was used to perform risk of bias assessment....

Atomoxetine is prescribed to children with autism spectrum disorder having symptoms of attention deficit hyperactivity disorder. We sought to examine the efficacy and safety of atomoxetine in this population. After screening for inclusion criteria, we identified three randomized placebo controlled trials involving 241 children. We assessed internal...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the effectiveness and safety of granulocyte-colony stimulating factor in women undergoing ART. Copyright © 2018 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.

Objective A systematic literature review was performed to document published MRI lesion definitions and scoring systems for enthesitis in SpA. Methods PubMed, EMBase and Cochrane library databases were searched for original publications involving adult SpA patients undergoing MRI of axial/peripheral joints. Selected articles were assessed for qual...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of extracorporeal shockwave therapy (ESWT) as a treatment option for men with erectile dysfunction (ED).

Background Early and accurate diagnosis of tuberculosis is a priority for TB programs globally to initiate treatment early and improve treatment outcomes. Currently, Ziehl–Neelsen (ZN) stain-based microscopy, GeneXpert and Light Emitting Diode-Fluorescence Microscopy (LED-FM) are used for diagnosing pulmonary drug sensitive tuberculosis. Published...

List of references excluded due to non-ZN comparator. (DOCX)

List of references excluded due to non-reporting of effectiveness indicator. (DOCX)

Search strategy used to search various databases (PubMed/MEDLINE/EMBASE/Cochran/CEA Registry). (DOCX)

Bronchoscopic lung volume reduction (BLVR) methods have emerged as a new treatment option for patients with severe emphysema. Endobronchial valves and coils have been extensively studied. This review assesses efficacy, safety, and cost effectiveness of the BLVR procedures (stent, valves, vapor ablation, endobronchial coils, lung sealant) in patient...

Early Childhood Caries (ECC) is a serious public health problem in developed as well as developing nations, with high prevalence among children around the world. This systematic review of the national literature was undertaken to document the prevalence of Early Childhood Caries. Studies evaluating the prevalence of Early Childhood Caries (ECC) in...

Background: There is little evidence in the literature on the association between methylphenidate treatment and psychotic symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Objective: We examine the occurrence of psychotic symptoms during methylphenidate treatment of children and adolescents with ADHD. The...

Study question: Do immune therapies improve live birth rate in women with a history of recurrent implantation failures (RIF), who are undergoing another cycle of assisted reproduction? Summary answer: There is some evidence that intralipid may improve live birth rate with PBMC,GCSF treatment conferring potential benefit with regards to clinical pr...

Background: Upper gastrointestinal (GI) bleeding due to stress ulcers contributes to increased morbidity and mortality in people admitted to intensive care units (ICUs). Stress ulceration refers to GI mucosal injury related to the stress of being critically ill. ICU patients with major bleeding as a result of stress ulceration might have mortality...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: This review aims to look at the benefits and harms of a drug or drug combination for the treatment of ABMR in kidney transplant recipients.

Background: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood. The psychostimulant methylphenidate is the most frequently used medication to treat it. Several studies have investigated the benefits of methylphenidate, showing possible favourable effects on ADHD symptoms, but the true magnitude of...

Background: Endentulism is relatively common and is often treated with the provision of complete or partial removable dentures. Clinicians make final impressions of complete dentures (CD) and removable partial dentures (RPD) using different techniques and materials. Applying the correct impression technique and material, based on an individual's o...

Background Preventive therapy for child contacts of multidrug-resistant tuberculosis (MDR-TB) patients is poorly studied, and no consensus about the role and the rationale of chemoprophylaxis has been reached. Objective To conduct systematic review with an aim to determine the effectiveness of TB preventive therapy in reducing the incidence of TB...

Background Cancer sufferers are amongst the most malnourished of all the patient groups. Studies have shown that ghrelin, a gut hormone can be a potential therapeutic agent for cachexia (wasting syndrome) associated with cancer. A variety of mechanisms of action of ghrelin in people with cancer cachexia have been proposed. However, safety and effic...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the efficacy and safety of shortened treatment regimens, versus the standard six-month treatment regimen, in individuals with drug-sensitive pulmonary tuberculosis.

Background: Gilles de la Tourette syndrome, or Tourette's syndrome, is defined as the presence of both motor and vocal (phonic) tics for more than 12 months, that manifest before the age of 18 years, in the absence of secondary causes. Treatment of motor and phonic tics is difficult and challenging. Objectives: To determine the safety and effect...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of occlusal interventions in people diagnosed with TMD, compared to other interventions or no treatment, for reduction in joint pain, muscle pain at rest and during mastication, quality of life, and discomfort. © 2017 The Cochrane Collabora...