Sheeba George

Chitwan Medical College

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Co-Authors

Kitty George

California Institute of Behavioral Neurosciences and Psychology (United States)

Roopa Chalasani

California Institute of Behavioral Neurosciences and Psychology (United States)

Feeba Sam Koshy

California Institute of Behavioral Neurosciences and Psychology (United States)

Sara Waqar

Geisinger Health System

Amina Yusuf Ali

California Institute of Behavioral Neurosciences and Psychology (United States)

Prakar Poudel

California Institute of Behavioral Neurosciences and Psychology (United States)

Bithaiah Inyang

California Institute of Behavioral Neurosciences and Psychology (United States)

Mastiyage R Goonathilake

California Institute of Behavioral Neurosciences and Psychology (United States)

Lubna Mohammed

California Institute of Behavioral Neurosciences and Psychology (United States)

Wilford Jean-Baptiste

California Institute of Behavioral Neurosciences and Psychology (United States)

Cooperative Institutions

California Institute of Behavioral Neurosciences and Psychology (United States)

Chitwan Medical College

Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences

Dr. Reddy's Laboratories (India)

Amrita Institute of Medical Sciences and Research Centre

Lilavati Hospital & Research Centre

Rawalpindi Medical University

Nizam's Institute of Medical Sciences

Post Graduate Institute of Medical Education and Research

Government Medical College

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Hyperuricaemia in acute heart failure among Indian population - More than an innocent bystander?

Indian Heart Journal (2018)

Sheeba George Prannoy George Mathen

Bystander effect

10.1016/j.ihj.2018.10.161

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Citations (0)

The Role of Type 2 Diabetes in Pancreatic Cancer

Cureus (2022)

Sheeba George Wilford Jean-Baptiste Amina Yusuf Ali Bithaiah Inyang Feeba Sam Koshy

The incidence of type 2 diabetes mellitus (T2DM) and its potential complications, such as cancers, are increasing worldwide at an astounding rate. There are many factors such as obesity, diabetes, alcohol consumption, and the adoption of sedentary lifestyles that are driving pancreatic cancer (PC) to become one of the leading causes of cancer mortality in the United States. PC is notorious for its generic symptoms and late-stage presentation with rapid metastasis. The connection between T2DM and the risk of PC development is multifaceted and complex. Some of the proposed theories reveal that chronic inflammation, insulin resistance, hyperinsulinemia, hyperglycemia, and abnormalities in the insulin and insulin-like growth factor axis (IGF) contribute to the disease association between these two conditions. This literature review aims to highlight relevant studies and explore the molecular mechanisms involved in the etiology of diabetes and its impact on PC development, as well as the role of anti-diabetic agents on PC. Despite extensive studies, the exact interaction between T2DM and PC remains obscure and will need further investigation. According to current knowledge, there is a substantial link between diabetes, obesity, and dietary patterns in the development and progression of PC. Consequently, focusing our efforts on preventive measures by reducing modifiable risk factors remains the most effective strategy to reduce the risk of PC at this time. Antidiabetic drugs can have various effects on the occurrence and prognosis of PC with metformin offering a clear benefit of inhibiting PC and insulin increasing the risk of PC. The development of future novel therapies will require a deeper knowledge of the triggering mechanisms and interplay between these two disease states.

Hyperinsulinemia

Etiology

10.7759/cureus.26288

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Citations (10)

Recognizing Histopathological Simulators of Melanoma to Avoid Misdiagnosis

Cureus (2022)

Sara Waqar Sheeba George Wilford Jean-Baptiste Amina Yusuf Ali Bithaiah Inyang

Melanocytic lesions have a wide morphological spectrum, ranging from benign nevi to malignant melanoma. In contrast to a diagnosis of a benign nevus, a diagnosis of melanoma could mean intensive treatment, lifetime monitoring, and a worse prognosis. Therefore, melanocytic tumors are notoriously challenging and associated with a high risk of litigation in surgical pathology. After describing the basic features of nevi and melanoma, this article describes the detailed clinical and histological features of those lesions that share many similar features with melanoma. The entities included are Spitz nevi and atypical Spitz tumors (AST), Reed nevus, dysplastic nevus, cellular blue nevus (CBN), deep penetrating nevus, combined nevus, recurrent nevus, irritated nevus, congenital pattern nevus, acral nevus, and nevi of special sites. Knowledge of these imitators can help pathologists distinguish between benign and malignant cases and avoid misdiagnosis.

Spitz nevus

Melanocytic nevus

Dysplastic nevus

Blue nevus

10.7759/cureus.26127

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Citations (7)

Effect of Thyroxine and Thyrotropin on Bone Mineral Density in Postmenopausal Women: A Systematic Review

Cureus (2022)

Prakar Poudel Roopa Chalasani Mastiyage R Goonathilake Sara Waqar Sheeba George

The effect of thyroid hormones on bone mineral density in postmenopausal women has been reported but is not completely established. To better understand this relationship, this systematic review of the reported association, differences, and effects of thyroxine and/or thyrotropin levels on bone mineral density was conducted. An electronic literature search was conducted on MEDLINE, PMC, Google Scholar, Cochrane Library, and Science Direct from inception to April 2022; 20 studies were identified which include five quasi-experimental studies, three community cohort studies, and 12 hospital-based cross-sectional studies. Following an extensive evaluation, it was difficult to conclusively determine the association or effect of thyroxine or thyrotropin levels on bone mineral density in postmenopausal women. It is therefore suggested to conduct additional non-randomized or randomized control studies on this topic for the benefit of postmenopausal women. Particular attention should be given to the adjustment of age, body mass index, smoking status, alcohol consumption, and dietary calcium in future research on this topic for rigorous analysis.

10.7759/cureus.26353

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Citations (1)

Elevated heart rate across cardiovascular continuum and its management

International Journal of Advances in Medicine (2021)

Ashok Punjabi Sheeba George Peyush Khera Sameer Srivastava

Elevated heart rate in both healthy individuals and patients with coronary artery disease (CAD), acute myocardial infarction (AMI) and heart failure poses a major risk factor for morbidity and mortality. This fact has further been supported by several studies pointing out to elevated resting heart rate as an important marker for this catastrophe necessitating a prompt therapeutic action plan, consisting of early detection and treatment of the risk factors, to achieve ideal heart rates (approximately 60 beats/minute) in patients which could stop or prevent the progression of the cardiovascular disease (CVD) continuum. Lowering heart rate by therapeutic interventions has shown favorable results, but most of the data so far is retrospective and limited to AMI and heart failure with beta-blocker treatment. Addition of newer drugs into the cardiac armamentarium, like ivabradine, a sinus node inhibitor acting by selective heart rate reduction, has shown several beneficial effects in a variety of conditions spanning from stable angina to heart failure. A consensus meeting was held at the national level wherein experts from various parts of the country discussed and reviewed the importance of heart rate lowering across CV continuum and addition of ivabradine for patients with chronic heart failure and chronic stable angina.

Ivabradine

Unstable angina

10.18203/2349-3933.ijam20214147

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Effectiveness of mirror therapy on upper and lower limb function among stroke patients with hemiparesis

C. Silpa Sheeba George

Introduction: The upper and lower limb function impairment remains an undesirable consequence followed by a stroke that increases activity limitation. Objective: To find the effectiveness of mirror therapy on upper and lower limb function among stroke patients with hemiparesis admitted at Govt Medical College, Kannur. Methods: Quasiexperimental, non-equivalent control group pre-test post-test research design was used among 24 stroke patients with hemiparesis who met inclusion criteria by using consecutive sampling technique and allotted to both experimental (n=12) and control group (n=12). Mirror therapy was administered to the experimental group daily for two weeks. A semi-structured interview schedule and Fugl-Meyer assessment scale were used to collect data. Results: The study showed a significant difference between pre-test and post-test scores of upper limb function (Z=3.064), lower limb function (Z=3.076) in the experimental group, and upper limb function (Z=3.064), lower limb function (Z=3.075) in the control group. A significant improvement in post-test score of upper limb function (Z=3.050) and lower limb function (Z=2.266) among the experimental group than the control group. Conclusion: This study concluded that mirror therapy was useful in improving upper and lower limb function among stroke patients with hemiparesis.

Hemiparesis

Stroke

Source

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Elements That Influence the Development of Attention Deficit Hyperactivity Disorder (ADHD) in Children

Cureus (2022)

Amina Yusuf Ali Bithaiah Inyang Feeba Sam Koshy Kitty George Prakar Poudel

Various factors may have a role in the development of attention deficit hyperactivity disorder (ADHD). Although the specific pathophysiology of this disease is still not entirely understood, it is believed to be caused by a mix of genetic, maternal, dietary, and environmental factors. The effect of these factors can determine the severity of ADHD; for example, some of them are dose-dependent, but there is a typical pattern that all are known to be associated with either early childhood exposure or maternal exposure during pregnancy. Some factors share a similar mechanism of affecting pathways and increasing the risk of ADHD. ADHD is not a disorder that can be detected before symptoms appear in a child, making it more challenging to anticipate even if a child has been exposed to a known trigger. Environmental pollutants were investigated, and it was shown that there was a link between ADHD in childhood and exposure to pollutants throughout childhood or during pregnancy. It is well known that maternal health is a significant factor in the unborn child's development in many health aspects. The central nervous system (CNS) is a primary system that can suffer irreversible damage from health conditions, stress, depression, or specific nutritional deficiency when the pregnant mother is subjected to these conditions. Even though numerous studies have been conducted to investigate the probable causes of ADHD, with some of them having robust findings, no conclusive explanation can be provided to identify a definitive cause or a risk factor.

Depression

Child Development

10.7759/cureus.27835

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Citations (12)

Expert Recommendations on the Usage of Non-vitamin K Antagonist Oral Anticoagulants (NOACs) from India: Current Perspective and Future Direction

Cardiology and Therapy (2022)

Balbir Singh Paresh Pai Harish Kumar Sheeba George Sandeep Mahapatra

Non-vitamin K antagonist oral anticoagulants (NOACs) are a new class of anticoagulant drugs used in the prevention and treatment of venous thromboembolism (VTE) and atrial fibrillation (AF). Anticoagulation requires the integration of the correct type and dose of oral anticoagulants based on patient characteristic, and therefore therapy needs to be individualized for each patient. Growing scientific evidence from studies on NOACs has led to a better understanding of their benefits and safety. A large amount of available data creates a necessity for an adaptable practical document for the usage of NOACs in India. The current consensus, developed by experts from India, aims to give recommendations on various frequently raised clinical questions with regards to NOACs and its usage. This practical document provides a platform upon which future guidelines, policies, training, and education for the use of NOACs can be tailored.

Vitamin K antagonist

10.1007/s40119-022-00254-w

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Citations (7)

Efficacy of Angiotensin Receptor Neprilysin Inhibitors in Indian Patients with Resistant Hypertension

Indian Heart Journal (2024)

Sheeba George Pratheesh George Mathen Prannoy George Mathen

10.1016/j.ihj.2024.11.226

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An Overview of Ascariasis Involvement in Gallbladder Disease: A Systematic Review of Case Reports

Cureus (2022)

Bithaiah Inyang Feeba Sam Koshy Kitty George Prakar Poudel Roopa Chalasani

Ascaris lumbricoides is the most common type of helminth infection in humans. It affects more than one billion of the world's population. Children living in developing nations are prone to ascariasis, presenting with obstructive biliary illnesses. Migration of Ascaris worms through the major duodenal papilla to the hepatobiliary system leads to symptoms of biliary colic and complications along the biliary tree. In April 2022, we performed a systematic review of case reports to identify and examine cases of gallbladder ascariasis worldwide. A methodical search using PubMed, Semantic Scholar, ScienceDirect, and Directory of Open Access Journals yielded 2773 studies. After duplicate removal, title, abstract, and content screening, retrieval, and quality assessment, 13 studies met the criteria for this systematic review of case reports. The cases and results from these 13 studies revealed gallbladder ascariasis in different age groups worldwide. This systematic review discusses ascariasis, explicitly highlighting its presence in the gallbladder, symptomatic presentation, laboratory/imaging findings, complications, and approach to management.

Ascaris

Biliary colic

Gallbladder disease

10.7759/cureus.32545

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Citations (9)