Rishav Sinha

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Abstract 4146535: Prevalence and In-hospital Outcomes of Cardiac events in Women with underlying Infertility Condition:A National Inpatient Database Analysis

Circulation (2024)

Sujana Sanka Priya Hotwani Dhairya Nanavaty Rishav Sinha Himaja Dutt Chigurupati

Introduction: Cardiovascular(CV) disease is one of the leading cause of death in females in USA out of which 44% suffer. According to the latest CDC guidelines, 13.4 % are suffering from the infertility.It includes the most common conditions including endometriosis, poly cystic ovarian syndrome. Studies shows a mutlitude of factors including genetic abnormalities, hormonal imbalances like chronic anovulation or increased androgens predispose the women to subsequent health conditions.Literature review suggests that long term cv risks are less understood in the infertile women. Aim: The aim of the study is to identify the CV outcomes including coronary heart disease(CAD) , acute coronary syndrome(ACS), and heart failure in women with underlying infertility condition. Methods: The NIS 2020 was queried for the female adult population (age>18 years) with a primary or secondary diagnosis of infertility. Prevalence of CV risk factors were compared between females with and without infertility problem. The association of cardiac diagnoses including CAD, ACS and was analysed. Multivariate regression analysis was performed taking all-cause mortality as a primary outcome. Results: A total of 3870 adult patients with a primary or secondary diagnosis of infertility were identified and the mean age was 36 years.In adult population without infertility condition, patients with an underlying infertility were found to have an increased association with DM (48.16%vs 23.11%; P<0.001),HLD(56.14% vs 30.72%; P<0.001),hypothyroid(17.47% vs 10.47%; P<0.001),metabolic syndrome(0.23% vs 0.16%; P<0.001) while we found decreased association in tobacco abuse( 14.18% vs 17.12%; P<0.001),HTN(1.47% vs 37.95%; P<0.001). The prevalence of CAD(46.64% vs 12.59%; P<0.001), ACS(46.64% vs 12.59%; P<0.001) was also found to be significantly higher in women with infertility. In the female subpopulation with infertility, approximately 5.91% of patients died. However, the odds of mortality was significantly increased if patients had underlying ACS (OR- 2.77; C.I.-2.72 -2.87; P<0.001) or CAD (OR- 3.97; C.I.: -3.93-4.02; p<0.001). There was no statistically significant increased mortality with HF( OR:1). Conclusion: In our study, infertility in women was associated with higher prevalence of CAD and ACS. The odds of mortality also increased if women with infertility condition if they developed ACS or CAD. Further clinical research and studies are warranted to understand its CV outcomes.

National database

10.1161/circ.150.suppl_1.4146535

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S4396 Complexities of Managing Chronic Hepatitis B in HIV: A Case of Acute Liver Injury Post-Medication Change

The American Journal of Gastroenterology (2024)

Manasa Ginjupalli Hamsika Moparty Jayalekshmi Jayakumar Sweta Lohani Nishanth Moparty

Acute hepatitis

10.14309/01.ajg.0001046952.69321.81

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CASTING LIGHT ON THE UNFORESEEN: NEBULIZED IPRATROPIUM'S RARE TWIST--A CASE REPORT OF URINARY RETENTION IN A PATIENT WITHOUT BENIGN PROSTATIC HYPERPLASIA

CHEST Journal (2024)

PRAHASITH KAMANI Rishav Sinha BHAVYAKUMAR VACHHANI EI MYINT ISHWARI IYER

Urinary retention

Ipratropium

10.1016/j.chest.2024.06.1275

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HYDROPNEUMOTHORAX'S STEALTHY TWIST IN MILIARY TUBERCULOSIS

CHEST Journal (2024)

JAGAT RAM KUKKAR PRAHASITH KAMANI GIOVANNIE ISAAC-COSS BHAVYAKUMAR VACHHANI Rishav Sinha

Miliary tuberculosis

Hydropneumothorax

10.1016/j.chest.2024.06.2234

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RARE BUT NOT FORGOTTEN: A CASE OF ATYPICAL BACTERIA SPECIES IN LEMIERRE'S SYNDROME

CHEST Journal (2023)

SEUNGMO SUH KHOI PAUL DANG-HO Dhruv Patel DHAIRYA NANAVATY Rishav Sinha

Odynophagia

Chills

Acute Tonsillitis

Palpation

Fusobacterium necrophorum

Peritonsillar Abscess

10.1016/j.chest.2023.07.3645

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IMPACT OF CONGENITAL VENTRICULAR SEPTAL DEFECT IN ADULT CHRONIC HEART FAILURE HOSPITALIZATIONS: A NATIONWIDE ANALYSIS

Journal of the American College of Cardiology (2024)

Sohrab Singh Dhairya Nanavaty Sukrut Nanavaty Ankushi Sanghvi Anuj Thakre

Heart defect

10.1016/s0735-1097(24)03651-9

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Abstract Tu070: Impact of Hypertrophic Cardiomyopathy in Hospitalizations with Aortic Stenosis : A National Inpatient Sample survey

Circulation Research (2024)

Rohit Sekandlapuram Dhairya Nanavaty Hima Varsha Voruganti Bhavyakumar Vachhani Jayalekshmi Jayakumar

Background: The management of patients with combined aortic stenosis (AS) and hypertrophic cardiomyopathy (HCM) is tricky. HCM causes a dynamic obstruction, while AS causes a fixed obstruction, both causing a hindrance to left ventricular output. We aim to study the outcomes of hospitalizations with co-prevalent HCM and AS. Methods: We queried the National Inpatient Sample 2018-2020 for adult hospitalizations with AS. This sample was stratified based on the prevalence of HCM. Mortality, arrhythmia prevalence, and acute cardiac complications were compared in aortic stenosis hospitalizations with and without AS. A multivariate regression analysis was performed to study the impact of HCM on mortality, arrhythmias, and other complications in patients with AS. Results: In hospitalizations with aortic stenosis (n=2483854), a total of 11820 had underlying HCM (0.47%). The mean age was 76 years and 64% were females. Hospitalizations with AS and HCM as compared to those without HCM had a higher prevalence of arrhythmias including first degree AV block, atrial flutter, atrial fibrillation, ventricular tachycardia and ventricular fibrillation (Table 1). The occurence of cardiogenic shock was also higher in this subgroup. The difference in mortality, acute coronary syndrome, acute heart failure and cardiac arrest was not statistically significant in AS hospitalizations with and without HCM (Table 1). Multivariate regression analysis revealed a higher odds of arrhythmias (OR-1.44; C.I: 1.36-1.62; P<0.001) and cardiogenic shock (OR-1.58; C.I: 1.22-2.06; P<0.001) with HCM in AS hospitalizations. Conclusion: Prior studies have demonstrated worse outcomes in AS patients with pre-existing HCM, especially post TAVI. Our study concludes that HCM was associated with a higher odds of arrhythmias and cardiogenic shock in AS hospitalizations.

Sample (material)

10.1161/res.135.suppl_1.tu070

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LUNGING INTO THE UNKNOWN: A SEQUESTERED SAGA

CHEST Journal (2024)

PRAHASITH KAMANI Rishav Sinha Bhavyakumar Vachhani EI MYINT ISHWARI IYER

10.1016/j.chest.2024.06.2686

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MEDIASTINAL MASS: LUNG VS ESOPHAGUS, THE SEARCH FOR THE PRIMARY

CHEST Journal (2023)