Vivek Bhat | Rajiv Gandhi University of Health Sciences (original) (raw)
Papers by Vivek Bhat
Journal of clinical oncology, Jun 1, 2024
Acta Ophthalmologica Scandinavica, 2004
To assess the relationship between the use of angiotensin-converting enzyme inhibitors (ACEIs) an... more To assess the relationship between the use of angiotensin-converting enzyme inhibitors (ACEIs) and prevalence of age-related maculopathy (ARM). Eligible residents aged >/= 49 years were first examined in 1992-94 (Cross-section 1, n = 3654). Of these, 2335 were re-examined in 1997-99, together with an additional 1174 who became eligible after 1994 (Cross-section 2, n = 3509). Information regarding ACEI use was obtained and retinal photographs were graded using the Wisconsin ARM Grading System. In Cross-section 1, prevalence rates of late and early stage ARM were 1.3% and 4.3% among current ACEI users, and 2.0% and 4.8% among non-current users, respectively. In Cross-section 2, prevalence rates of late and early stage ARM were 2.3% and 11.3% among current ACEI users, and 1.3% and 9.3% among non-current users, respectively. After adjusting for age, sex and smoking, neither survey found any significant association between ACEI use and prevalence of either late or early ARM. No significant cross-sectional associations were found between ACEI use and ARM prevalence in this population.
Journal of Stroke and Cerebrovascular Diseases, 2022
Patients with polycythemia, either primary or secondary, are at elevated risk for thrombotic comp... more Patients with polycythemia, either primary or secondary, are at elevated risk for thrombotic complications, including stroke. We aimed to investigate the clinical and radiological characteristics of cerebrovascular disease (CVD) in polycythemia, and describe other neurologic manifestations. We conducted a cross-sectional study of patients diagnosed with polycythemia between 2014 and 2019 at a tertiary care center and collected relevant medical data with a special focus on cerebrovascular disease and neurologic manifestations. We performed descriptive and inferential analyses. We have also described and analyzed the available neuroimaging features. We analyzed data from 56 patients. 20 patients (35.7%) had ischemic stroke. The incidence of CVD was higher in those with primary polycythemia (43%) than in those with secondary polycythemia (8%). The most common subtype of stroke was large vessel disease, and the most common arterial territory was the anterior circulation. There was no statistically significant difference in the hematocrit level between those with or without CVD. Neuroimaging revealed multiple large vessel intracranial stenoses on MR Angiography, and hyperdense vessels on plain CT. Other neurologic manifestations included headache, seizures, dizziness, visual symptoms and papilledema, and these were significantly more common in primary polycythemia. CVD is common in patients with polycythemia. The most common type observed was large vessel occlusion, predominantly in the anterior circulation. In stroke patients, multiple vessel stenosis and hyperdense vessels may be clues to polycythemia.
JMIR medical education, Jun 19, 2023
Journal of family medicine and primary care, 2020
Scrub typhus (ST), a zoonotic disease, is currently being recognized as a significant contributor... more Scrub typhus (ST), a zoonotic disease, is currently being recognized as a significant contributor to the changing landscape of infectious diseases in India. As one of the important causes of febrile illness, in many parts of the country, general practitioners need to include it as part of the workup for cases of fever of unknown origin. While very amenable to early treatment with a simple regime of doxycycline, delayed diagnosis can result in a spectrum of complications. We report here one such complication of a case of ST manifesting with isolated lateral rectus palsy, which, to the best of our knowledge, has been reported only thrice in the world previously. Family physicians also need to be aware of the availability in India of affordable serological testing for ST that is useful for rapid and inexpensive diagnosis, leading to timely treatment.
Cancers, Feb 20, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
European Heart Journal, Mar 22, 2022
Journal of Neurosurgery, Apr 1, 2022
W omen have historically been poorly represented in neurosurgery. This is especially true in Sout... more W omen have historically been poorly represented in neurosurgery. This is especially true in South Asia, considering the added sociocultural barriers for women in surgery in the region. Yet, as Spetzler described in 2004, 1 the diminutive literature that exists on women in neurosurgery does not say that they have not contributed; rather, it suggests that their lives are yet to be fully recounted. One such life is that of Dr. T. S. Kanaka (1932-2018), Asia's first and the world's fifth fully qualified female neurosurgeon, after Sofia Ionescu, Diana Beck, Aysima Altinok, and Ruth Jakoby. 1 Kanaka was also one of the pioneers of stereotactic and functional neurosurgery in Asia, and paved the way for women neurosurgeons to follow (Fig. 1). 2,3 While previous biographies have covered her academic successes, including a brief description as part of a recent review on international women in neurosurgery, 2-4 this historical vignette narrates lessons to be learned from her life along with corresponding facets from her career. Emphasized below are the specific attributes that enabled her to succeed in a hostile world in which gender discrimination was present at every step. Several unique primary sources have been utilized to lend emphasis to how she conquered significant obstacles in light of the modern literature on grit, perseverance, and mentorship, among other themes. Finally, the circumstances that enabled her to "break the glass ceiling" have been recounted to shed light on ways in which modern neurosurgery may be made more diverse and inclusive. A Life Devoted to Neurosurgery Thanjavur Santhanakrishna Kanaka, more widely known as T. S. Kanaka, was born on March 31, 1932, in the city of Madras (currently called Chennai) in South India, to highly educated parents and siblings. Her father was the principal of Teachers' College of Madras, likely the oldest teacher training institute in India. She entered un-ABBREVIATIONS AWNA = Asian Women's Neurosurgical Association; CMC
The Cochrane library, May 2, 2021
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary O... more 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 antibiotics in adults with irritable bowel syndrome.
Journal of the American College of Cardiology
JMIR Medical Education, 2023
We appreciate the thoughtful correspondence by Sow et al [1] in response to our work [2] and disc... more We appreciate the thoughtful correspondence by Sow et al [1] in response to our work [2] and discuss further considerations below.
Sow et al [1] have highlighted the sociocultural and ethical challenges surrounding unpaid research fellowships, pursued not only by international medical graduates (IMGs) but increasingly by MD and DO students in the United States as well. We have discussed this issue before, highlighting that IMG aspiring for several competitive specialties pursue several postdoctoral research years, although quantitative data remain unavailable [3]. The USMLE (United States Medical Licensing Examination) Step 1 pass/fail change has occurred notwithstanding a substantial supply-demand mismatch in competitive specialties, which has historically warranted and continues to warrant measures (like USMLE scores) to facilitate the rank-ordering of applicants. Program rank lists require an ever-increasing number of applicants per position to be assessed and objectively ranked [4]. Therefore, research fellowships will likely be increasingly pursued to demonstrate academic accomplishment, given the loss of major objective metrics like the USMLE Step 1 score, which we have highlighted previously [3].
Several publications have indicated the presence of elements of socioeconomic disparity, racial and/or ethnic bias, or financial privilege in USMLE. We argue this is potentially true for nearly all other components of the residency evaluation process. It is contended that comprehensive USMLE preparation forces students to use expensive preparatory resources. What is frequently unstated here is the often exponentially greater cost of unpaid research years, unpaid volunteering, and away rotations, the latter typically unpaid.
World Neurosurgery, 2021
More than a year has elapsed since the United States Medical Licensing Examination (USMLE) Step 1... more More than a year has elapsed since the United States Medical Licensing Examination (USMLE) Step 1 was announced to be changing to a pass/fail examination in 2022, with a significant body of research having been published in the meanwhile. 1,2 Considering the long-standing value of Step 1 score in both screening and selection of candidates, this change has significantly impacted both residency programs and applicants. Several considerations for all stakeholders in the neurosurgery match can be found in the work of Kumar et al, which is a subgroup analysis of their landmark work published in the New England Journal of Medicine that looked at over 2000 program directors (PDs) of all specialties. 1,3 We add to considerations discussed by them below. Further Perspectives of Program Directors Firstly, their work needs to be put together with the quite similar work by Huq et al of the perspectives of neurosurgery PDs regarding the pass/fail change, which was published prior. This survey, which captured responses of 59 PDs and 16 associate PDs (APDs) in neurosurgical residencies, found that 77% of them have 'always' screened candidates using Step 1 scores and nearly 79% disagree with this change. 4 These findings are similar to those of Kumar et al. Of the 48 neurosurgery PDs who responded to the latter's survey, nearly 78.7% disagreed with the change, and 85% agreed that it would make objectively comparing applicants more difficult. 3
Journal of clinical oncology, Jun 1, 2024
Acta Ophthalmologica Scandinavica, 2004
To assess the relationship between the use of angiotensin-converting enzyme inhibitors (ACEIs) an... more To assess the relationship between the use of angiotensin-converting enzyme inhibitors (ACEIs) and prevalence of age-related maculopathy (ARM). Eligible residents aged >/= 49 years were first examined in 1992-94 (Cross-section 1, n = 3654). Of these, 2335 were re-examined in 1997-99, together with an additional 1174 who became eligible after 1994 (Cross-section 2, n = 3509). Information regarding ACEI use was obtained and retinal photographs were graded using the Wisconsin ARM Grading System. In Cross-section 1, prevalence rates of late and early stage ARM were 1.3% and 4.3% among current ACEI users, and 2.0% and 4.8% among non-current users, respectively. In Cross-section 2, prevalence rates of late and early stage ARM were 2.3% and 11.3% among current ACEI users, and 1.3% and 9.3% among non-current users, respectively. After adjusting for age, sex and smoking, neither survey found any significant association between ACEI use and prevalence of either late or early ARM. No significant cross-sectional associations were found between ACEI use and ARM prevalence in this population.
Journal of Stroke and Cerebrovascular Diseases, 2022
Patients with polycythemia, either primary or secondary, are at elevated risk for thrombotic comp... more Patients with polycythemia, either primary or secondary, are at elevated risk for thrombotic complications, including stroke. We aimed to investigate the clinical and radiological characteristics of cerebrovascular disease (CVD) in polycythemia, and describe other neurologic manifestations. We conducted a cross-sectional study of patients diagnosed with polycythemia between 2014 and 2019 at a tertiary care center and collected relevant medical data with a special focus on cerebrovascular disease and neurologic manifestations. We performed descriptive and inferential analyses. We have also described and analyzed the available neuroimaging features. We analyzed data from 56 patients. 20 patients (35.7%) had ischemic stroke. The incidence of CVD was higher in those with primary polycythemia (43%) than in those with secondary polycythemia (8%). The most common subtype of stroke was large vessel disease, and the most common arterial territory was the anterior circulation. There was no statistically significant difference in the hematocrit level between those with or without CVD. Neuroimaging revealed multiple large vessel intracranial stenoses on MR Angiography, and hyperdense vessels on plain CT. Other neurologic manifestations included headache, seizures, dizziness, visual symptoms and papilledema, and these were significantly more common in primary polycythemia. CVD is common in patients with polycythemia. The most common type observed was large vessel occlusion, predominantly in the anterior circulation. In stroke patients, multiple vessel stenosis and hyperdense vessels may be clues to polycythemia.
JMIR medical education, Jun 19, 2023
Journal of family medicine and primary care, 2020
Scrub typhus (ST), a zoonotic disease, is currently being recognized as a significant contributor... more Scrub typhus (ST), a zoonotic disease, is currently being recognized as a significant contributor to the changing landscape of infectious diseases in India. As one of the important causes of febrile illness, in many parts of the country, general practitioners need to include it as part of the workup for cases of fever of unknown origin. While very amenable to early treatment with a simple regime of doxycycline, delayed diagnosis can result in a spectrum of complications. We report here one such complication of a case of ST manifesting with isolated lateral rectus palsy, which, to the best of our knowledge, has been reported only thrice in the world previously. Family physicians also need to be aware of the availability in India of affordable serological testing for ST that is useful for rapid and inexpensive diagnosis, leading to timely treatment.
Cancers, Feb 20, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
European Heart Journal, Mar 22, 2022
Journal of Neurosurgery, Apr 1, 2022
W omen have historically been poorly represented in neurosurgery. This is especially true in Sout... more W omen have historically been poorly represented in neurosurgery. This is especially true in South Asia, considering the added sociocultural barriers for women in surgery in the region. Yet, as Spetzler described in 2004, 1 the diminutive literature that exists on women in neurosurgery does not say that they have not contributed; rather, it suggests that their lives are yet to be fully recounted. One such life is that of Dr. T. S. Kanaka (1932-2018), Asia's first and the world's fifth fully qualified female neurosurgeon, after Sofia Ionescu, Diana Beck, Aysima Altinok, and Ruth Jakoby. 1 Kanaka was also one of the pioneers of stereotactic and functional neurosurgery in Asia, and paved the way for women neurosurgeons to follow (Fig. 1). 2,3 While previous biographies have covered her academic successes, including a brief description as part of a recent review on international women in neurosurgery, 2-4 this historical vignette narrates lessons to be learned from her life along with corresponding facets from her career. Emphasized below are the specific attributes that enabled her to succeed in a hostile world in which gender discrimination was present at every step. Several unique primary sources have been utilized to lend emphasis to how she conquered significant obstacles in light of the modern literature on grit, perseverance, and mentorship, among other themes. Finally, the circumstances that enabled her to "break the glass ceiling" have been recounted to shed light on ways in which modern neurosurgery may be made more diverse and inclusive. A Life Devoted to Neurosurgery Thanjavur Santhanakrishna Kanaka, more widely known as T. S. Kanaka, was born on March 31, 1932, in the city of Madras (currently called Chennai) in South India, to highly educated parents and siblings. Her father was the principal of Teachers' College of Madras, likely the oldest teacher training institute in India. She entered un-ABBREVIATIONS AWNA = Asian Women's Neurosurgical Association; CMC
The Cochrane library, May 2, 2021
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary O... more 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 antibiotics in adults with irritable bowel syndrome.
Journal of the American College of Cardiology
JMIR Medical Education, 2023
We appreciate the thoughtful correspondence by Sow et al [1] in response to our work [2] and disc... more We appreciate the thoughtful correspondence by Sow et al [1] in response to our work [2] and discuss further considerations below.
Sow et al [1] have highlighted the sociocultural and ethical challenges surrounding unpaid research fellowships, pursued not only by international medical graduates (IMGs) but increasingly by MD and DO students in the United States as well. We have discussed this issue before, highlighting that IMG aspiring for several competitive specialties pursue several postdoctoral research years, although quantitative data remain unavailable [3]. The USMLE (United States Medical Licensing Examination) Step 1 pass/fail change has occurred notwithstanding a substantial supply-demand mismatch in competitive specialties, which has historically warranted and continues to warrant measures (like USMLE scores) to facilitate the rank-ordering of applicants. Program rank lists require an ever-increasing number of applicants per position to be assessed and objectively ranked [4]. Therefore, research fellowships will likely be increasingly pursued to demonstrate academic accomplishment, given the loss of major objective metrics like the USMLE Step 1 score, which we have highlighted previously [3].
Several publications have indicated the presence of elements of socioeconomic disparity, racial and/or ethnic bias, or financial privilege in USMLE. We argue this is potentially true for nearly all other components of the residency evaluation process. It is contended that comprehensive USMLE preparation forces students to use expensive preparatory resources. What is frequently unstated here is the often exponentially greater cost of unpaid research years, unpaid volunteering, and away rotations, the latter typically unpaid.
World Neurosurgery, 2021
More than a year has elapsed since the United States Medical Licensing Examination (USMLE) Step 1... more More than a year has elapsed since the United States Medical Licensing Examination (USMLE) Step 1 was announced to be changing to a pass/fail examination in 2022, with a significant body of research having been published in the meanwhile. 1,2 Considering the long-standing value of Step 1 score in both screening and selection of candidates, this change has significantly impacted both residency programs and applicants. Several considerations for all stakeholders in the neurosurgery match can be found in the work of Kumar et al, which is a subgroup analysis of their landmark work published in the New England Journal of Medicine that looked at over 2000 program directors (PDs) of all specialties. 1,3 We add to considerations discussed by them below. Further Perspectives of Program Directors Firstly, their work needs to be put together with the quite similar work by Huq et al of the perspectives of neurosurgery PDs regarding the pass/fail change, which was published prior. This survey, which captured responses of 59 PDs and 16 associate PDs (APDs) in neurosurgical residencies, found that 77% of them have 'always' screened candidates using Step 1 scores and nearly 79% disagree with this change. 4 These findings are similar to those of Kumar et al. Of the 48 neurosurgery PDs who responded to the latter's survey, nearly 78.7% disagreed with the change, and 85% agreed that it would make objectively comparing applicants more difficult. 3