http://pucir.inflibnet.ac.in:8080/jspui/handle/123456789/730 Wed, 29 Apr 2026 14:34:54 GMT 2026-04-29T14:34:54Z http://pucir.inflibnet.ac.in:8080/jspui/handle/123456789/739 Title: Prevalence and predictors of tobacco use among currently married pregnant women in India Authors: Pasupuleti, Samba Siva Rao Abstract: Tobacco use during pregnancy has harmful consequences both to the women and their fetuses. There is a lack of national-level information on the prevalence and predictors of tobacco use among pregnant women in India. This study fills this gap by investigating the prevalence and predictors of tobacco use among currently married pregnant women in India. METHODS Unit level data from the fourth National Family Health Survey, conducted in India during 2015–2016, were used in this study. Logistic regression analyses were performed to identify independent factors associated with tobacco use. RESULTS Our results suggest the prevalence of tobacco use among currently married pregnant women in India is 4.6% (95% CI: 4.3–5.1), and more than 80% of pregnant tobacco users use tobacco in the smokeless form only. Age of woman, region of residence, education level, religion, caste, wealth quintile, frequency of watching television were the independent predictors of tobacco use among currently married pregnant women in India. In general, lower socioeconomic status is positively associated with tobacco use among them. CONCLUSIONS Around 4.6% of pregnant women in India use tobacco, and the smokeless form of tobacco use is predominant among pregnant tobacco users. Socioeconomic disadvantage is positively associated with tobacco use among pregnant women in India. The findings of the present study need to be used to reduce tobacco use among pregnant women in the country by identifying subpopulations at risk, and sensitizing them to the harmful consequences of tobacco use, by offering tobacco cessation services during prenatal checkups. Mon, 22 Mar 2021 00:00:00 GMT http://pucir.inflibnet.ac.in:8080/jspui/handle/123456789/739 2021-03-22T00:00:00Z http://pucir.inflibnet.ac.in:8080/jspui/handle/123456789/738 Title: Comparison of Prognostic Models in Acute Liver Failure: Decision is to be Dynamic Authors: Pasupuleti, Samba Siva Rao Abstract: Background and aims: Acute liver failure (ALF) is a rare disease entity with a high mortality. Management is dependent on accurate prognostication. Materials and methods: One hundred consecutive patients presenting with ALF were prospectively evaluated. The King’s college criteria (KCC), ALF early dynamic model (ALFED), sequential organ failure assessment (SOFA) score, and acute physiology and health evaluation II (APACHE II) scores were compared to predict mortality. Results: There were significant differences in means of all the scores between survivors and nonsurvivors. The SOFA 48 hours had the highest area under receiver operating characteristic curve (AUC) (0.857) closely followed by the ALFED score (0.844). The optimal cutoff for the SOFA score at 48 hours to predict subsequent survival outcome is ≥10 and for the ALFED score is ≥5. Sequential organ failure assessment 48 hours had a good sensitivity of 87%, and the ALFED score showed a good specificity of 84%. The decision curve analysis showed that between a threshold probability of 0.13 and 0.6, use of the SOFA score provided the maximum net benefit and at threshold probabilities of >0.6, the use of ALFED score provided the maximum clinical benefit. Conclusion: Dynamic scoring results in better prognostication in ALF. The SOFA 48 hours and ALFED score have good prognostication value in nonacetaminophen-induced liver failure. Tue, 01 Jan 2019 00:00:00 GMT http://pucir.inflibnet.ac.in:8080/jspui/handle/123456789/738 2019-01-01T00:00:00Z http://pucir.inflibnet.ac.in:8080/jspui/handle/123456789/732 Title: A randomised-controlled trial (TARGET-C) of high vs. low target mean arterial pressure in patients with cirrhosis and septic shock Authors: Pasupuleti, Samba Siva Rao Abstract: A target mean arterial pressure (MAP) of 65-70 mmHg has been suggested for patients with septic shock undergoing resuscitation, except for patients with chronic hypertension.1,2 In these patients, a higher target of 80-85 mmHg is a reasonable approximation that preserves the perfusion of kidneys.3 A high target strategy is associated with a higher risk of arrhythmias. Maintaining an appropriate organ perfusion pressure during sepsis is the ultimate goal of haemodynamic management.1,2 The surviving sepsis campaign recommends initial resuscitation with crystalloids at 30 ml/kg followed by the institution of vasoactive agents. Norepinephrine is usually considered the first-choice vasopressor to target a MAP of 65-70 mmHg.1 Despite this, the appropriate blood pressure target in patients with septic shock is controversial. Sun, 23 Apr 2023 00:00:00 GMT http://pucir.inflibnet.ac.in:8080/jspui/handle/123456789/732 2023-04-23T00:00:00Z http://pucir.inflibnet.ac.in:8080/jspui/handle/123456789/731 Title: A randomized-controlled trial comparing 20% albumin to plasmalyte in patients with cirrhosis and sepsisinduced hypotension [ALPS trial] Authors: Pasupuleti, Samba Siva Rao Abstract: Sepsis is an inflammatory response to severe infection characterized by hypovolemia and vasodilation.1 It is characterized by organ dysfunction secondary to a dysregulated immune response of the host to the microbial pathogen. Prompt identification, early institution of appropriate antibiotics, and fluid resuscitation can improve patient outcomes.1 Hypoperfusion is a hallmark in patients with sepsis-induced hypotension seen secondary to the increase in oxygen demand and decrease in oxygen delivery to the peripheral tissues causing organ dysfunction.2 Early and appropriate fluid resuscitation is crucial for improving patient outcomes in sepsis. Patients with cirrhosis and sepsis are a distinct group.1 The hemodynamic alterations are more profound in patients with cirrhosis with sepsis compared to those without cirrhosis. The choice of fluid, i.e. crystalloid vs. colloid and balanced vs. non-balanced, is controversial.3 Patients with advanced cirrhosis have effective hypovolemia, hypoalbuminemia, and splanchnic and systemic vasodilatation. These hemodynamic alterations get exacerbated with sepsis.1,3 Patients with cirrhosis, in addition, have impaired responsiveness to endogenous and exogenous vasoconstrictors. The resultant arterial pooling of blood increases blood volume in the splanchnic circulation. Reduced central blood volume is responsible for a decreased preload and less than expected cardiac output, which compromises renal perfusion and causes sodium and water retention. Sat, 01 Jan 2022 00:00:00 GMT http://pucir.inflibnet.ac.in:8080/jspui/handle/123456789/731 2022-01-01T00:00:00Z