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3. Mortality in Haemophilia Patients in India: A National Cohort Study.

Author

Shetty, Shrimati, Ross, Cecil, John, M. Joseph, Kshirsagar, Shrinath, Kulkarni, Nimish, Pavitra, D. S., Sarwan, Diksha, Misha, P. K., Paul, Antony, More, Apurva, Kaunchale, Nazish, D'silva, Magdalene, Masurkar, Shrushti, Kharat, Shruti, Patil, Kranti, Patel, Shalaka, Mehendale, Priti, Sarvaiya, Prachi, and Rangarajan, Savita

Subjects
*HEALTH facilities, *HEMOPHILIA treatment, *HEMOPHILIACS, *IMMUNOLOGICAL tolerance, *CAUSES of death, CAUSE of death statistics
Abstract

ABSTRACT Introduction Aim Methods Results Conclusion Mortality and morbidity in persons with haemophilia (PWH) have decreased due to improved diagnosis and treatment along with comprehensive population outreach efforts, but the impact is not uniform in different countries.The study aims to assess all‐cause and intracranial haemorrhage (ICH)‐specific mortality of PWH in India.This is a retrospective, observational, multi‐centric cohort study of 1020 haemophilia patients from three centres in India. The mortality data in the family was collected from personal interviews, and subsequently confirmed with the corresponding haemophilia treatment centres (HTCs). The demographic and clinical data, along with other comorbidities, were collected from the medical records.Among 170 reported deaths, 73 (42.9%) were caused by ICH, and 44 (25.9%) resulted from accidents or trauma. Gastrointestinal (GI) bleeding was the third most common cause of death, accounting for 27 cases (15.9%). The average and median ages at death were 27.7 and 26 years, respectively. None of the deceased cases were receiving any prophylactic or immune tolerance induction (ITI) therapy, and all had severe haemophilia. In addition, the prevalence of inhibitors and hypertension was significantly higher in deceased cases compared to that in the general haemophilia population (p < 0.05).Severity of haemophilia, episodic treatment, hypertension and inhibitors showed significant association with mortality. ICH continues to be the leading cause of death among haemophilia patients in the country. This underscores the challenges in managing haemophilia and the need for improved treatment strategies to increase the life expectancy of PWH. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Indian Society of Hematology and Blood Transfusion (ISHBT) Consensus Document on Hematological Practice During COVID-19 Pandemic

Author

Kar, Rakhee, Dolai, Tuphan Kanti, Shekhawat, Prakash Singh, Malhotra, Pankaj, Singh, Avinash, Naithani, Rahul, Mandal, Prakas Kumar, Ganesan, Prasanth, Manivannan, Prabhu, Basu, Debdatta, Srivastava, Alok, Das, Reena, Bhattacharya, Maitreyee, Mahapatra, Manoranjan, Dhawan, Rishi, Jain, Arihant, Bhandary, Chandni, Pati, Hara Prasad, Chatterjee, Tathagata, Tilak, Vijai, Chandra, Sarmila, Shetty, Shrimati Dharampal, and Jena, Rabindra Kumar

Published
2021
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17. Low dose emicizumab prophylaxis in haemophilia a patients: A pilot study from India

Author

Apotheek Veiligheid en Kwaliteit, Apotheek Onderzoek, Poli Van Creveldkliniek Medisch, Child Health, Circulatory Health, Bansal, Shweta, Donners, Anouk A.M.T., Fischer, Kathelijn, Kshirsagar, Shrinath, Rangarajan, Savita, Phadke, Varsha, Mhatre, Shrutika, Sontate, Bharati, silva, Magdelene D’, Ansari, Shahana, Shetty, Shrimati, Apotheek Veiligheid en Kwaliteit, Apotheek Onderzoek, Poli Van Creveldkliniek Medisch, Child Health, Circulatory Health, Bansal, Shweta, Donners, Anouk A.M.T., Fischer, Kathelijn, Kshirsagar, Shrinath, Rangarajan, Savita, Phadke, Varsha, Mhatre, Shrutika, Sontate, Bharati, silva, Magdelene D’, Ansari, Shahana, and Shetty, Shrimati

Published
2023

43. COVID‐19 and preeclampsia: The unique and the mutually nonexclusive clinical manifestations.

Author

Shetty, Shrimati, Kshirsagar, Shrinath, Bansal, Shweta, Rangarajan, Savita, and Phadke, Varsha

Subjects
*SYMPTOMS, *PREECLAMPSIA, *COVID-19, *PATHOGENESIS, *ENDOTHELIAL cells, *ENDOTHELIUM diseases
Abstract

Preeclampsia (PE) is a serious, unpredictable hypertensive disorder of pregnancy present in around 8–10% of all pregnancies resulting in high rate of maternal and fetal morbidity and mortality. With the pathophysiology partially known, delivery is the only cure for PE. The disease sets due to multiple pathologic processes involving endothelial cell activation, inflammation, multiorgan damage and syncytiotrophoblast stress. Though the primary target organ is lungs in COVID‐19, other systemic manifestations which include endothelial dysfunction, dysregulated angiogenesis, thrombosis, liver injury, thrombocytopenia, hypertension and kidney damage overlap with PE. COVID‐19 patients show a higher incidence of PE as compared to their noninfected counterparts and vice versa. Similar pathophysiology and clinical features make differential diagnosis challenging. For effective and specific management, it is important to differentiate actual PE from COVID‐19 with PE like features. There are contradictory reports about the accuracy of diagnostic tools in distinguishing PE from severe COVID‐19 with PE like features. With the available data, it can only be stated that PE is a common adverse pregnancy event, which may be exacerbated by, or may exacerbate, COVID‐19. Future research should focus on cohesive understanding of the pathophysiology of the clinical manifestations, and preventive strategies during pregnancy. [ABSTRACT FROM AUTHOR]

Published
2023
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