Rajesh Nandy, Ph.D.

Permanent URI for this communityhttps://hdl.handle.net/20.500.12503/31200

Associate Professor, Biostatistics & Epidemiology

Email: Rajesh.Nandy@unthsc.edu

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Assessment of Knowledge, Attitudes, and Practices Regarding Dengue among Physicians: A Web-Based Cross-Sectional Survey
(MDPI, 2021-07-21) Koonisetty, Kranthi Swaroop; Aghamohammadi, Nasrin; Urmi, Tamanna; Yavasoglu, Sare Ilknur; Rahman, Md. Shahinur; Nandy, Rajesh; Haque, Ubydul
Dengue fever is one of the most important viral infections transmitted by Aedes mosquitoes and a major cause of morbidity and mortality globally. Accurate identification of cases and treatment of dengue patients at the early stages can reduce medical complications and dengue mortality rate. This survey aims to determine the knowledge, attitude, and practices (KAP) among physicians in dengue diagnosis and treatment. This study was conducted among physicians in Turkey as one nonendemic country and Bangladesh, India, and Malaysia as three dengue-endemic countries. The dosing frequencies, maximum doses, and contraindications in dengue fever were examined. The results found that physicians from Bangladesh, India, and Malaysia have higher KAP scores in dengue diagnosis and treatment compared to physicians in Turkey. This may be due to a lack of physician's exposure to a dengue patient as Turkey is considered a nonendemic country. This assessment may help establish a guideline for intervention strategies among physicians to have successful treatment outcomes and reduce dengue mortality.
Clinical Symptoms of Arboviruses in Mexico
(MDPI, 2020-11-19) Ananth, Sushmitha; Shrestha, Nistha; Treviño C., Jesús A.; Nguyen, Uyen-Sa; Haque, Ubydul; Angulo-Molina, Aracely; Lopez-Lemus, Uriel A.; Lubinda, Jailos; Sharif, Rashed Md; Zaki, Rafdzah Ahmad; Sánchez Casas, Rosa María; Cervantes, Diana; Nandy, Rajesh
Arboviruses such as Chikungunya (CHIKV), Dengue (DENV), and Zika virus (ZIKV) have emerged as a significant public health concern in Mexico. The existing literature lacks evidence regarding the dispersion of arboviruses, thereby limiting public health policy's ability to integrate the diagnosis, management, and prevention. This study seeks to reveal the clinical symptoms of CHIK, DENV, and ZIKV by age group, region, sex, and time across Mexico. The confirmed cases of CHIKV, DENV, and ZIKV were compiled from January 2012 to March 2020. Demographic characteristics analyzed significant clinical symptoms of confirmed cases. Multinomial logistic regression was used to assess the association between clinical symptoms and geographical regions. Females and individuals aged 15 and older had higher rates of reported significant symptoms across all three arboviruses. DENV showed a temporal variation of symptoms by regions 3 and 5, whereas ZIKV presented temporal variables in regions 2 and 4. This study revealed unique and overlapping symptoms between CHIKV, DENV, and ZIKV. However, the differentiation of CHIKV, DENV, and ZIKV is difficult, and diagnostic facilities are not available in rural areas. There is a need for adequately trained healthcare staff alongside well-equipped lab facilities, including hematological tests and imaging facilities.
Higher Expression of Annexin A2 in Metastatic Bladder Urothelial Carcinoma Promotes Migration and Invasion
(MDPI, 2022-11-27) Guo, Christina; Trivedi, Rucha; Tripathi, Amit K.; Nandy, Rajesh; Wagner, Diana C.; Narra, Kalyani; Chaudhary, Pankaj
In this study, we aim to evaluate the significance of AnxA2 in BLCA and establish its metastatic role in bladder cancer cells. Analysis of TCGA data showed that AnxA2 mRNA expression was significantly higher in BLCA tumors than in normal bladder tissues. High mRNA expression of AnxA2 in BLCA was significantly associated with high pathological grades and stages, non-papillary tumor histology, and poor overall survival (OS), progression-free survival (PFS), and diseases specific survival (DSS). Similarly, we found that AnxA2 expression was higher in bladder cancer cells derived from high-grade metastatic carcinoma than in cells derived from low-grade urothelial carcinoma. AnxA2 expression significantly mobilized to the surface of highly metastatic bladder cancer cells compared to cells derived from low-grade tumors and associated with high plasmin generation and AnxA2 secretion. In addition, the downregulation of AnxA2 cells significantly inhibited the proliferation, migration, and invasion in bladder cancer along with the reduction in proangiogenic factors and cytokines such as PDGF-BB, ANGPT1, ANGPT2, Tie-2, bFGF, GRO, IL-6, IL-8, and MMP-9. These findings suggest that AnxA2 could be a promising biomarker and therapeutic target for high-grade BLCA.
Longitudinal Changes in Cognitive Functioning and Brain Structure in Professional Boxers and Mixed Martial Artists After They Stop Fighting
(Wolters Kluwer Health, Inc., 2022-09-15) Zhuang, Xiaowei; Bennett, Lauren; Nandy, Rajesh; Cordes, Dietmar; Bernick, Charles; Ritter, Aaron
OBJECTIVE: This study compares longitudinal changes in cognitive functioning and brain structures in male fighters who transitioned to an inactive fighting status without any further exposure to repetitive head impacts (RHI) and fighters remaining active with continual exposure to RHI. METHODS: Participants were recruited from the Professional Fighters Brain Health Study. At time point 1 (TP1), all fighters were active, with continual exposure to RHI. At time point 2 (TP2), fighters were considered transitioned" if they had no sanctioned professional fights and had not been sparring for the past 2 years. Fighters were considered "active" if they continued to train and compete. All fighters underwent cognitive testing and 3T magnetic resonance imaging (MRI) at both TPs. A subset of our fighters (50%) underwent blood sampling for characterization of neurofilament light (NfL) levels at both TPs. Linear mixed effect models were applied to investigate the potentially different longitudinal trajectories (interaction effect between group and time) of cognitive function measures, NfL levels and regional thickness measures (derived from structural MRI) between transitioned and active fighters. RESULTS: 45 male transitioned fighters (31.69+/-6.27 years old (TP1), 22 boxers, 22 mixed martial artists, 1 martial artist) and 45 demographically matched male active fighters (30.24+/-5.44 years old (TP1); 17 boxers, 27 mixed martial artists, 1 martial artist) were included in the analyses. Significantly different longitudinal trajectories between transitioned and active fighters were observed in verbal memory (p (FDR) =4.73E-04), psychomotor speed (p (FDR) =4.73E-04), processing speed (p (FDR) =3.90E-02) and NfL levels (p=0.02). Transitioned fighters demonstrated longitudinally improved cognitive functioning and decreased NfL levels, and active fighters demonstrated declines in cognitive performance and stable NfL levels. Out of 68 cortical regions inspected, 54 regions demonstrated a consistently changing trajectory, with thickness measures stabilizing on a group level for transitioned fighters and subtly declining over time for active fighters. CONCLUSION: After fighters' cessation of RHI exposure, cognitive function and brain thickness measures may stabilize and blood NfL levels may decline. This study could be a starting point to identify potential predictors of individuals who are at a higher risk of RHI-related long-term neurological conditions."
Moderation effects of serotype on dengue severity across pregnancy status in Mexico
(BioMed Central Ltd., 2023-03-11) Annan, Esther; Nguyen, Uyen-Sa D. T.; Trevino, Jesus; Wan Yaacob, Wan F.; Mangla, Sherry; Pathak, Ashok K.; Nandy, Rajesh; Haque, Ubydul
BACKGROUND: Pregnancy increases a woman's risk of severe dengue. To the best of our knowledge, the moderation effect of the dengue serotype among pregnant women has not been studied in Mexico. This study explores how pregnancy interacted with the dengue serotype from 2012 to 2020 in Mexico. METHOD: Information from 2469 notifying health units in Mexican municipalities was used for this cross-sectional analysis. Multiple logistic regression with interaction effects was chosen as the final model and sensitivity analysis was done to assess potential exposure misclassification of pregnancy status. RESULTS: Pregnant women were found to have higher odds of severe dengue [1.50 (95% CI 1.41, 1.59)]. The odds of dengue severity varied for pregnant women with DENV-1 [1.45, (95% CI 1.21, 1.74)], DENV-2 [1.33, (95% CI 1.18, 1.53)] and DENV-4 [3.78, (95% CI 1.14, 12.59)]. While the odds of severe dengue were generally higher for pregnant women compared with non-pregnant women with DENV-1 and DENV-2, the odds of disease severity were much higher for those infected with the DENV-4 serotype. CONCLUSION: The effect of pregnancy on severe dengue is moderated by the dengue serotype. Future studies on genetic diversification may potentially elucidate this serotype-specific effect among pregnant women in Mexico.
The Health & Aging Brain among Latino Elders (HABLE) study methods and participant characteristics
(Wiley Periodicals, LLC, 2021-06-21) O'Bryant, Sid E.; Johnson, Leigh A.; Barber, Robert C.; Braskie, Meredith N.; Christian, Bradley; Hall, James R.; Hazra, Nalini; King, Kevin; Kothapalli, Deydeep; Large, Stephanie; Mason, David; Matsiyevskiy, Elizabeth; McColl, Roderick; Nandy, Rajesh; Palmer, Raymond; Petersen, Melissa E.; Philips, Nicole; Rissman, Robert A.; Shi, Yonggang; Toga, Arthur W.; Vintimilla, Raul; Vig, Rocky; Zhang, Fan; Yaffe, Kristine
Introduction: Mexican Americans remain severely underrepresented in Alzheimer's disease (AD) research. The Health & Aging Brain among Latino Elders (HABLE) study was created to fill important gaps in the existing literature. Methods: Community-dwelling Mexican Americans and non-Hispanic White adults and elders (age 50 and above) were recruited. All participants underwent comprehensive assessments including an interview, functional exam, clinical labs, informant interview, neuropsychological testing, and 3T magnetic resonance imaging (MRI) of the brain. Amyloid and tau positron emission tomography (PET) scans were added at visit 2. Blood samples were stored in the Biorepository. Results: Data was examined from n = 1705 participants. Significant group differences were found in medical, demographic, and sociocultural factors. Cerebral amyloid and neurodegeneration imaging markers were significantly different between Mexican Americans and non-Hispanic Whites. Discussion: The current data provide strong support for continued investigations that examine the risk factors for and biomarkers of AD among diverse populations.

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