Publications by authors named "Joy John Mammen"

6 Publications

  • Page 1 of 1

A national level estimation of population need for blood in India.

Transfusion 2021 May 15. Epub 2021 May 15.

National AIDS Control Organization (NACO), New Delhi, India.

Background: The population need for blood is the total volume required to transfuse all the individuals who need transfusion in a defined population over a defined period. The clinical demand will arise when people with a disease or condition who require transfusion, access healthcare services, and subsequently the clinicians request blood. Essentially, the conversion of need to demand must be maximum to avoid preventable mortality and morbidity. The study estimated the population need for blood in India.

Methods: The methodology included a comprehensive literature review to determine the diseases and conditions requiring transfusion, the population at risk, and prevalence or incidence; and Delphi method to estimate the percentage of people requiring transfusion, and the quantum.

Results: The estimated annual population need was 26.2 million units (95% CI; 17.9-38.0) of whole blood to address the need for red cells and other components after the separation process. The need for medical conditions was 11.0 million units (95% CI:8.7-14.7), followed by surgery 6.6 million (95% CI:3.8-10.0), pediatrics 5.0 million (95% CI:3.5-7.0), and obstetrics and gynecology 3.6 million units (95% CI:1.9-6.2). The gap between need and demand which depends upon the access and efficiency of healthcare service provision was estimated at 13 million units.

Conclusion: The study brings evidence to highlight the gap between need and demand and the importance of addressing it. It cannot be just the responsibility of blood transfusion or health systems, it requires a multi-sectoral approach to address the barriers affecting the conversion of need to clinical demand for blood.
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http://dx.doi.org/10.1111/trf.16369DOI Listing
May 2021

Slow parasite clearance, absent K13-propeller gene polymorphisms and adequate artesunate levels among patients with malaria: A pilot study from southern India.

Natl Med J India 2019 Jul-Aug;32(4):200-206

Department of Medicine-I and Infectious Diseases, Christian Medical College Hospital, Ida Scudder Road, Vellore 632004, Tamil Nadu, India.

Background: Artemisinin-based combination therapy (ACT) is widely used in India and many generic preparations are available. Delayed response has been reported, suggesting inadequate response to artesunate (AS) or genotypic resistance. We designed a prospective observational study to assess the therapeutic response, elaborate pharmacokinetics of AS and identify Plasmodium falciparum kelch 13 (pfk13) propeller gene polymorphisms among hospitalized Indian patients with severe malaria.

Methods: We collected blood samples from adult patients with severe P. falciparum or mixed (P. falciparum and P. vivax) malaria on ACT. We calculated the parasite clearance (CL) half-life using the Worldwide Antimalarial Resistance Network (WWARN) online parasite clearance estimator (PCE). We used the liquid chromatography tandem mass spectrophoto-metry method for simultaneous quantification of AS and dihydroartemisinin. We genotyped longitudinally archived DNA samples obtained pre-treatment (day 0) to study the point mutations in the pfk13 propeller domain.

Results: A total of 54 patients with malaria were included, with a majority fulfilling the definitions of severe malaria. The median parasite CL slope half-life was estimated to be 6.44 hours (interquartile range 4.79-10.24). AS pharmacokinetics, assessed in 17 patients, were found to be similar in the groups with rapid (<48 hours) and slow CL (>48 hours) of parasites. No known mutations associated with artemisinin resistance in Southeast Asia were observed in our study participants.

Conclusions: Slow parasite CL was seen with a high parasite burden without genotypic evidence of AS resistance. There is a need to standardize definitions of therapeutic efficacy of AS in cases of severe malaria.
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http://dx.doi.org/10.4103/0970-258X.291292DOI Listing
August 2020

The demand and supply of blood in India.

Lancet Haematol 2020 02;7(2):e94

Christian Medical Association of India, New Delhi, India.

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http://dx.doi.org/10.1016/S2352-3026(19)30255-8DOI Listing
February 2020

Automated Segmentation of Nuclei in Breast Cancer Histopathology Images.

PLoS One 2016 20;11(9):e0162053. Epub 2016 Sep 20.

School of Mechanical and Materials Engineering, University College Dublin, Ireland.

The process of Nuclei detection in high-grade breast cancer images is quite challenging in the case of image processing techniques due to certain heterogeneous characteristics of cancer nuclei such as enlarged and irregularly shaped nuclei, highly coarse chromatin marginalized to the nuclei periphery and visible nucleoli. Recent reviews state that existing techniques show appreciable segmentation accuracy on breast histopathology images whose nuclei are dispersed and regular in texture and shape; however, typical cancer nuclei are often clustered and have irregular texture and shape properties. This paper proposes a novel segmentation algorithm for detecting individual nuclei from Hematoxylin and Eosin (H&E) stained breast histopathology images. This detection framework estimates a nuclei saliency map using tensor voting followed by boundary extraction of the nuclei on the saliency map using a Loopy Back Propagation (LBP) algorithm on a Markov Random Field (MRF). The method was tested on both whole-slide images and frames of breast cancer histopathology images. Experimental results demonstrate high segmentation performance with efficient precision, recall and dice-coefficient rates, upon testing high-grade breast cancer images containing several thousand nuclei. In addition to the optimal performance on the highly complex images presented in this paper, this method also gave appreciable results in comparison with two recently published methods-Wienert et al. (2012) and Veta et al. (2013), which were tested using their own datasets.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5029866PMC
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0162053PLOS
August 2017

Recruitment and retention of voluntary blood donors through electronic communication.

Acta Inform Med 2013 ;21(2):142

Department of Transfusiology Medicine and Immunohematology. Christian Medical College , Vellore, Tamilnadu, India.

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http://dx.doi.org/10.5455/aim.2013.21.142-142DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766533PMC
December 2013

Perspectives and attitudes to voluntary blood donation in a tertiary referral hospital blood bank.

Asian J Transfus Sci 2013 Jul;7(2):158-9

Department of Transfusion Medicine and Immunohaematology, John Scudder Memorial Blood Bank, Christian Medical College, Vellore - 632 004, Tamilnadu, India.

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http://dx.doi.org/10.4103/0973-6247.115589DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3757781PMC
July 2013