As a practicing clinician focused on inflammatory bowel disease (IBD), a disease without medical cure and whose pathogenesis is incompletely understood, I am keenly aware of the limitations and risks of therapies for these patients. It is precisely this need—the need for improved treatment options by better understanding the pathogenesis of IBD—that motivates me and is the focus of my research. Leveraging my years of experience in translational research and assessing/developing technologies to improve health, I am interested in developing and applying innovations to alleviate intestinal inflammatory conditions. My research is focused on understanding microenvironment changes in the inflamed versus normal gut in order to identify better therapeutic targets for people with GI immune-mediated disorders. In addition, I have a longstanding research interest in applications of cost-effective technologies to improve health.
- Inflammatory Bowel Disease
- Ulcerative Colitis
- Crohn's Disease
- Microscopic Colitis
- Global Health
- Biodesign, Low-cost devices
Instructor, Medicine - Gastroenterology & Hepatology
Board Certification: Gastroenterology, American Board of Internal Medicine (2014)
Fellowship:Stanford Hospital and Clinics (2014) CA
Fellowship:Stanford Biodesign Program (2011) CA
Board Certification: Internal Medicine, American Board of Internal Medicine (2010)
Residency:Stanford University School of Medicine (2010) CA
Internship:Columbia University Medical Center (2008) NY
Medical Education:University of California San Francisco (2007) CA
Current Research and Scholarly Interests
Dr. Sinha is physician researcher interested in translating biomedical innovations into novel therapeutics and diagnostics. His research is focused on cost-effective technologies to improve health with a particular interest in targeted therapies for GI immune-mediated disorders. His clinical focus is in inflammatory bowel disease (IBD). He has formal training in biodesign (technology development to improve health) under the guidance of Dr. Paul Yock and in translational immunology in the lab of Dr. Aida Habtezion. In addition, he is interested in other applications of technology to improve health such as remote monitoring/mobile health. Realizing that such research requires experts across disciplines, his projects have included collaboration with individuals from various specialties of engineering, business, medicine/surgery, and computer sciences. He has been engaged in numerous multidisciplinary research projects at organizations such as the World Health Organization, Health Information and Technology Lab at Columbia University, and Stanford University/Stanford Biodesign.
Using Social Media to Characterize Public Sentiment Toward Medical Interventions Commonly Used for Cancer Screening: An Observational Study.
Journal of medical Internet research
2017; 19 (6)
Although cancer screening reduces morbidity and mortality, millions of people worldwide remain unscreened. Social media provide a unique platform to understand public sentiment toward tools that are commonly used for cancer screening.The objective of our study was to examine public sentiment toward colonoscopy, mammography, and Pap smear and how this sentiment spreads by analyzing discourse on Twitter.In this observational study, we classified 32,847 tweets (online postings on Twitter) related to colonoscopy, mammography, or Pap smears using a naive Bayes algorithm as containing positive, negative, or neutral sentiment. Additionally, we characterized the spread of sentiment on Twitter using an established model to study contagion.Colonoscopy-related tweets were more likely to express negative than positive sentiment (negative to positive ratio 1.65, 95% CI 1.51-1.80, P<.001), in contrast to the more positive sentiment expressed regarding mammography (negative to positive ratio 0.43, 95% CI 0.39-0.47, P<.001). The proportions of negative versus positive tweets about Pap smear were not significantly different (negative to positive ratio 0.95, 95% CI 0.87-1.04, P=.18). Positive and negative tweets tended to share lexical features across screening modalities. Positive tweets expressed resonance with the benefits of early detection. Fear and pain were the principal lexical features seen in negative tweets. Negative sentiment for colonoscopy and mammography spread more than positive sentiment; no correlation with sentiment and spread was seen for Pap smear.Analysis of social media data provides a unique, quantitative framework to better understand the public's perception of medical interventions that are commonly used for cancer screening. Given the growing use of social media, public health interventions to improve cancer screening should use the health perceptions of the population as expressed in social network postings about tests that are frequently used for cancer screening, as well as other people they may influence with such postings.
View details for DOI 10.2196/jmir.7485
View details for PubMedID 28592395
Use of Tumor Necrosis Factor Alpha Inhibitors for Inflammatory Bowel Disease Patients with Concurrent Heart Failure.
Digestive diseases and sciences
2017; 62 (6): 1597-1606
Prescribing information for tumor necrosis factor alpha (TNFα) inhibitors, a mainstay of treatment for moderate to severe inflammatory bowel disease (IBD), instructs cautious use in those with heart failure (HF). However, the limited data behind these warnings are inconclusive and should be weighed against mounting evidence demonstrating worse cardiac outcomes in active IBD.To assess whether TNFα inhibitor use is reduced in patients with IBD and HF by analyzing physician practice and prescription patterns.Using a Stanford University database, we queried TNFα inhibitor prescriptions in 8905 patients with an ICD-9 diagnosis of Crohn's disease or ulcerative colitis. Detailed chart review analysis was done for patients with a concurrent diagnosis of HF who were prescribed anti-TNFα agents. In addition, we collected survey data from 25 gastroenterologists on their usage of these drugs for patients with IBD and HF.TNFα inhibitors were prescribed to 10/455 (2.2%) IBD patients with HF compared to 1265/8450 (15.0%) in IBD patients without HF (p < 0.0001). Of those ten with HF prescribed TNFα inhibitors, only one had it discontinued because of HF exacerbation while on drug. Survey data indicated few (5/25) providers do not actively avoid TNFα inhibitors for those with HF.IBD patients with HF are prescribed significantly less TNFα inhibitors than those without HF. The majority of providers are either uncertain about or actively avoid use of anti-TNFα medications for those with HF. The risks and benefits of anti-TNFα use in HF patients must be investigated further.
View details for DOI 10.1007/s10620-017-4574-2
View details for PubMedID 28417241
A Thermo-Sensitive Delivery Platform for Topical Administration of Inflammatory Bowel Disease Therapies.
2015; 149 (1): 52-55 e2
Systemic therapies for inflammatory bowel disease are associated with increased risk of infections and malignancies. Topical therapies reduce systemic exposure, but can be difficult to retain or have limited proximal distribution. To mitigate these issues, we developed a thermo-sensitive platform, using a polymer-based system that is liquid at room temperature but turns into a viscous gel upon reaching body temperature. Following rectal administration to mice with dextran sulphate sodium-induced colitis, the platform carrying budesonide or mesalamine becomes more viscoelastic near body temperature. Mice given the drug-containing platform gained more weight and had reduced histologic and biologic features of colitis than mice given the platform alone or liquid drugs via enema. Image analysis showed that enemas delivered with and without the platform reached similar distances in the colons of mice, but greater colonic retention was achieved by using the platform.
View details for DOI 10.1053/j.gastro.2015.04.002
View details for PubMedID 25863215
- Effect of Intratonsillar Injection of Steroids on the Palatine Tonsils of Rabbits LARYNGOSCOPE 2014; 124 (12): 2811-2817
- Strategies for last mile implementation of global health technologies. The Lancet. Global health 2014; 2 (9): e497-8
Ethnic Disparities in the Association of Body Mass Index with the Risk of Hypertension and Diabetes
JOURNAL OF COMMUNITY HEALTH
2014; 39 (3): 437-445
Despite having lower body mass index (BMI) compared to other ethnic groups, Asians continue to develop significant metabolic diseases such as hypertension and diabetes. To evaluate the disparate association of BMI and risk of hypertension and diabetes in Asians. We retrospectively studied 150,753 adults from the 1985-2011 California Behavioral Risk Factor Survey. Trends in prevalence of obesity, hypertension, and diabetes were stratified by ethnicity. Multivariate logistic regression models evaluated the incremental effect of one unit BMI increase on risk of hypertension and diabetes and the disparate risks of hypertension and diabetes at different BMI thresholds. Asians had the lowest BMI among all groups. However, the impact of increasing BMI on risk of hypertension and diabetes was significantly greater in Asians. For each one unit increase in BMI, Asians were significantly more likely to have hypertension (OR 1.15; 95 % CI 1.13-1.18) compared to non-Hispanic whites, blacks, and Hispanics. Similar trends were seen for diabetes (Asians: OR 1.15; 95 % CI 1.13-1.18). The risk of hypertension in Asians with BMI ≥ 22 was similar to non-Hispanic whites with BMI ≥ 27 and blacks with BMI ≥ 28. The risk of diabetes in Asians with BMI ≥ 28 was similar to non-Hispanic whites with BMI ≥ 30. Despite lower overall BMI compared to other groups, weight gain in Asians is associated with significantly higher risks of hypertension and diabetes. Compared to other ethnic groups, similar risks of hypertension and diabetes are seen in Asians at much lower BMI.
View details for DOI 10.1007/s10900-013-9792-8
View details for Web of Science ID 000335392600005
View details for PubMedID 24276618
- Severe Iron Deficiency: Rare Etiology, Easy Treatment DIGESTIVE DISEASES AND SCIENCES 2014; 59 (3): 538-542
- Effect of intra-tonsillar injection of Steroids on the palatine tonsils of rabbits. Laryngoscope 2013
- Severe Iron Deficiency: Rare Etiology, Easy Treatment. Digestive Diseases and Sciences 2013
- Enhanced imaging technologies in detecting dysplasia in IBD: narrowing or widening our options? Gastroenterology 2012; 143 (4): 1108-1110
- Health Technologies and Innovation in the Global Health Arena NEW ENGLAND JOURNAL OF MEDICINE 2011; 365 (9): 779-782
- Protecting health: thinking small BULLETIN OF THE WORLD HEALTH ORGANIZATION 2010; 88 (9): 713-715
- Shaping National Health Financing Systems: How Can Micro-banking Contribute? World Health Organization Technical Brief 2009