36 results on '"Sudha Sinha"'
Search Results
2. Acute perioperative hyperlactatemia in oncoplastic reconstructive surgeries: What is the significance?
- Author
-
Preety M Roy, Kamal Bharti, Sudha Sinha, Sangeeta Khanna, and Yatin Mehta
- Subjects
free flap surgery ,lactate ,oncoplastic surgery ,reconstructive ,Anesthesiology ,RD78.3-87.3 ,Pharmacy and materia medica ,RS1-441 - Abstract
Background and Aims: We aim to study the significance of intraoperative hyperlactatemia in reconstructive oncoplastic surgery. Material and Methods: A retrospective observational study was conducted on a cohort of patients who underwent reconstructive oncoplastic surgery with free flap for oral cancer over a 6-month period. The study population was divided into two groups based on peak lactate levels. Group N with peak lactate level less than 2 mmol/L and Group H peak lactate level more than 2 mmol/L. The various parameter studied were patient's comorbidities; intraoperative events (vasopressor requirement, blood transfusion, and duration of surgery); postoperative parameters including the need for re- exploration and duration of stay in hospital and intensive care unit. Results: The study demonstrates that intraoperative rise of lactate was not influenced by comorbidities. None of the intraoperative parameters studied influenced the lactate levels. Baseline lactate level was found to correlate with peak lactate level intraoperatively. But it was observed that there was normalization of lactate level within 24 hours postoperatively in both the groups. There was no difference in outcome parameters in the two groups. Conclusion: Intraoperative hyperlactatemia is not a significant prognostic factor for outcome in oncoplastic reconstructive surgery.
- Published
- 2021
- Full Text
- View/download PDF
3. Clinicopathological Study of Marrow Infiltration by Lymphoproliferative Disorders: A 2-year Experience from a Cancer Institute
- Author
-
Sai Mallikarjun, Abid Hussain, Triveni Bhopal, Sree Lakshmi, Sudha Sinha, and Fatima Farzeen Fameena
- Subjects
bone marrow involvement ,chronic lymphocytic lymphoma ,immunohistochemistry ,lymphoma ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Bone marrow (BM) examination is an essential tool in evaluation and staging of non-Hodgkin lymphoma (NHL). The aim of this study is to overview the approach to the use of unilateral versus bilateral BM sampling in lymphoproliferative disorders for diagnosis and staging. All cases diagnosed as lymphoproliferative disorders from January 2014 to January 2017 were studied. Bilateral trephine biopsy and aspiration of 414 cases were assessed for involvement patterns and presence/absence of background changes. Bone marrow involvement (BMI) was seen in 109 (26.3%) cases. The cases ranged from 2 to 80 years. BMI was more frequent in B-cell lymphomas than T-cell lymphomas as was the incidence (B-NHL= 87/109 [79.8%]; T-NHL=21/109 [19.1%]). Among B-cell lymphomas, BMI was most frequent in chronic lymphocytic lymphoma followed by B-lymphoblastic lymphoma (BLL) and mantle cell lymphoma. Among T-cell lymphomas, BMI was most frequent in T-lymphoblastic lymphoma (TLL). A single case of anaplastic large cell lymphoma (ALCL) had BMI. Bone marrow aspiration (BMA) and bone marrow trephine (BMT) agreed in 97% of cases (401 of 414: 308 both negative, 93 both positive). Additional 13 cases were diagnosed on BMT whereas BMA was negative for these cases. Background changes (fibrosis and necrosis) were common in TLL followed by BLL. Of the 109 positive cases, 4 were missed by unilateral BMT. Peripheral spill of lymphoma was seen in 14 of 109 cases. BMT involvement by lymphoma is more commonly seen in lymphoblastic lymphoma. Bilateral trephine biopsy remains gold standard to determine the marrow involvement and staging and assess the remission.
- Published
- 2018
- Full Text
- View/download PDF
4. A novel technique to prevent endobronchial spillage during video assisted thoracoscopic lobectomy
- Author
-
Anand Sharma, Sudha Sinha, Sangeeta Khanna, Yatin Mehta, Shaiwal Khandelwal, and Ali Zamir Khan
- Subjects
Aspergilloma ,Fogarty catheter ,Lung isolation ,Anesthesiology ,RD78.3-87.3 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Endobronchial spillage of fungal material into normal lung can infect it and the spillage of fungal material should be prevented during surgery. We report our experience of a patient who presented for right upper lobectomy with bronchiectasis, tubercular destruction and subsequent aspergilloma. A 4F Fogarty catheter was introduced through the tracheal lumen of the left sided endobronchial double lumen tube (DLT) to occlude the bronchus intermedius to prevent spillage of aspergilloma into the non-infected lower and middle lobes of the right lung. The Fogarty catheter was pulled into the trachea just before stapling the bronchus; thereafter, right upper lobectomy was completed successfully. The patient was extubated uneventfully and transferred to post-operative recovery ward. The endobronchial blockage of the intermediate bronchus of the operative lung by the Fogarty catheter and isolation of the left lung by the DLT prevented spillage of aspergilloma in both the operative right lung and the left lung.
- Published
- 2014
- Full Text
- View/download PDF
5. Airway management: Few more lessons to learn
- Author
-
Preety M Roy, Sudha Sinha, Sangeeta Khanna, and Yatin Mehta
- Subjects
Anesthesiology ,RD78.3-87.3 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2016
- Full Text
- View/download PDF
6. Complete Clinical Regression of Orocutaneous Fistula in Contralateral Relpased Oral Cavity Squamous Cell Carcinoma Patient Following Surgery and Adjuvant Radiotherapy
- Author
-
Bharat Patodiya, Shalini Patodiya, Shivam Shingla, and Sudha Sinha
- Subjects
General Earth and Planetary Sciences ,General Environmental Science - Published
- 2022
7. Exploring Non-users’ Perceptions Towards the College Library Services in Darjeeling Hill
- Author
-
Sudha Sinha, Krishnapada Majumder, and Prabin Karkee
- Subjects
General Agricultural and Biological Sciences - Published
- 2022
8. Acute perioperative hyperlactatemia in oncoplastic reconstructive surgeries: What is the significance?
- Author
-
Sudha Sinha, Kamal Bharti, Yatin Mehta, Sangeeta Khanna, and Preety Mittal Roy
- Subjects
Reconstructive surgery ,medicine.medical_specialty ,Blood transfusion ,medicine.medical_treatment ,Free flap ,law.invention ,Pharmacy and materia medica ,reconstructive ,Anesthesiology ,law ,medicine ,RD78.3-87.3 ,Pharmacology (medical) ,General Pharmacology, Toxicology and Pharmaceutics ,lactate ,business.industry ,oncoplastic surgery ,Retrospective cohort study ,Perioperative ,Intensive care unit ,RS1-441 ,Oncoplastic Surgery ,Anesthesiology and Pain Medicine ,Anesthesia ,Free flap surgery ,Hyperlactatemia ,Original Article ,business - Abstract
Background and Aims: We aim to study the significance of intraoperative hyperlactatemia in reconstructive oncoplastic surgery. Material and Methods: A retrospective observational study was conducted on a cohort of patients who underwent reconstructive oncoplastic surgery with free flap for oral cancer over a 6-month period. The study population was divided into two groups based on peak lactate levels. Group N with peak lactate level less than 2 mmol/L and Group H peak lactate level more than 2 mmol/L. The various parameter studied were patient's comorbidities; intraoperative events (vasopressor requirement, blood transfusion, and duration of surgery); postoperative parameters including the need for re- exploration and duration of stay in hospital and intensive care unit. Results: The study demonstrates that intraoperative rise of lactate was not influenced by comorbidities. None of the intraoperative parameters studied influenced the lactate levels. Baseline lactate level was found to correlate with peak lactate level intraoperatively. But it was observed that there was normalization of lactate level within 24 hours postoperatively in both the groups. There was no difference in outcome parameters in the two groups. Conclusion: Intraoperative hyperlactatemia is not a significant prognostic factor for outcome in oncoplastic reconstructive surgery.
- Published
- 2021
9. A health care labyrinth: perspectives of caregivers on the journey to accessing timely cancer diagnosis and treatment for children in India
- Author
-
Sarah Bernays, Sameer Bakhshi, Ayyagari Santa, Neha Faruqui, Rachna Seth, Huma Anis, Ananya Mishra, Rohina Joshi, Sudha Sinha, Ramandeep Singh Arora, Sirisharani Siddaiahgari, Jennifer Lowe, Manas Kalra, and Alexandra Martiniuk
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Referral ,Adolescent ,Psychological intervention ,India ,Health Services Accessibility ,Time-to-Treatment ,03 medical and health sciences ,Social support ,0302 clinical medicine ,Informed consent ,Neoplasms ,Health care ,medicine ,Humans ,030212 general & internal medicine ,Child ,Poverty ,Referral and Consultation ,Qualitative Research ,business.industry ,Public health ,lcsh:Public aspects of medicine ,Public Health, Environmental and Occupational Health ,Social Support ,Accessing care ,lcsh:RA1-1270 ,Patient Acceptance of Health Care ,Treatment delay ,Caregivers ,Socioeconomic Factors ,030220 oncology & carcinogenesis ,Family medicine ,Diagnosis delay ,Referral pathways ,Female ,Thematic analysis ,Qualitative study ,business ,Childhood cancer ,Qualitative research ,Research Article - Abstract
BackgroundCure rates for children with cancer in India lag behind that of high-income countries. Various disease, treatment and socio-economic related factors contribute to this gap including barriers in timely access of diagnostic and therapeutic care. This study investigated barriers to accessing care from symptom onset to beginning of treatment, from perspectives of caregivers of children with cancer in India.MethodsSemi-structured in-depth interviews were conducted with caregivers of children (ResultsThirty-nine caregivers were interviewed, where three key themes emerged from the narratives: time intervals to definitive diagnosis and treatment, the importance of social supportive care and the overall accumulative impacts of the journey. There were two phases encapsulating the experiences of the family: referral pathways taken to reach the hospital and after reaching the hospital. Most caregivers, especially those from distant geographical areas had variable and inconsistent referral pathways partly due to poor availability of specialist doctors and diagnostic facilities outside major cities, influence from family or friends, and long travel times. Upon reaching the hospital, families mostly from public hospitals faced challenges navigating the hospital facilities, finding accommodation, and comprehending the diagnosis and treatment pathway. Throughout both phases, financial constraint was a recurring issue amongst low-income families. The caregiver’s knowledge and awareness of the disease and health system, religious and social factors were also common barriers.ConclusionThis qualitative study highlights and explores some of the barriers to childhood cancer care in India. Our findings show that referral pathways are intrinsically linked to the treatment experience and there should be better recognition of the financial and emotional challenges faced by the family that occur prior to definitive diagnosis and treatment. This information would help inform various stakeholders and contribute to improved interventions addressing these barriers.
- Published
- 2019
10. A Scientometric Appraisal of IASLIC Bulletin (2013-2017)
- Author
-
Prabin Karkee and Sudha Sinha
- Subjects
Engineering ,business.industry ,Library science ,business - Abstract
This study aims to analyse the contributions in IASLIC Bulletin –an official organ or a leading library science journal published by IASLIC. The total 97 articles were published during the period 2013 – 2017. The study covers the year-wise, institutions-wise, state-wise distribution of contributions, authorship pattern, citation analysis, length of the contributions etc. The study shows that most of the contributions of this journal are contributed by joint authors and state-wise distribution shows that most of the contributions are contributed from West Bengal. Citation analysis of 1369 citations includes finding out number of citations per volume, types of publications cited and preparing of ranked list of cited journals in contributions of this journal. The study reveals that journals are the most cited publication amongst the library and information scientists. Annals of Library and Information Studies is the most cited journal in the contributions of this journal.
- Published
- 2021
11. Treatment Adherence and Abandonment in Acute Myeloid Leukemia in Pediatric Patients at a Low-Resource Cancer Center in India
- Author
-
Thomas Wiebe, Gayatri Palat, Eva Brun, Gustav Brattström, Vineela Rapelli, Sudha Sinha, and Mikael Segerlantz
- Subjects
Pediatrics ,medicine.medical_specialty ,Palliative care ,Childhood leukemia ,business.industry ,Concordance ,Medical record ,Myeloid leukemia ,Cancer ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,030225 pediatrics ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,medicine ,Abandonment (emotional) ,Stage (cooking) ,business - Abstract
Aim: One of the causes for lower cure rates in acute childhood leukemia in low- and middle- income countries (LMIC) compared to high-income countries is abandonment from treatment. The International Society of Pediatric Oncology (SIOP) defines abandonment as failure to begin treatment or an absence of 4 weeks during treatment. The aim of this study was to evaluate the extent of abandonment among patients diagnosed with acute myeloid leukemia (AML) at the pediatric ward at a low-resource cancer center in India. Methods: Medical records of all patients, aged 0–15 years, diagnosed with AML between January 1, 2014, and March 31, 2015, at the hospital were reviewed. Age, sex, date of diagnosis, and survival during the short follow-up time after completed treatment and information regarding abandonment were collected. SIOP definition of abandonment was used. Eight patients were diagnosed with AML at the hospital whereof 65 met the inclusion criteria of this study. Results: Of the included 65 patients, 6 died before treatment could be initiated and 3 were referred to palliative care upfront. Thus, 56 patients were offered curatively intended treatment. Of these patients, six refused treatment at this stage and another five abandoned during therapy. Altogether, 11 children abandoned treatment. Conclusion: In this study, the abandonment rate from treatment of childhood AML was 20%, which is in concordance from other studies conducted in India and other LMIC, stating that abandonment is a problem and hindrance when treating with a curative intent.
- Published
- 2019
12. Bone Marrow Infiltration by Nonhematopoetic Small Round Cell Tumors: A Clinicopathological Study from a Tertiary Care Centre in South India
- Author
-
Abid Hussain, Sai Mallikarjun, Sudha Sinha, Triveni Bhopal, and Sree Lakshmi
- Subjects
0301 basic medicine ,Pathology ,medicine.medical_specialty ,business.industry ,medicine.disease ,Metastasis ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Primitive neuroectodermal tumor ,Neuroblastoma ,Pediatrics, Perinatology and Child Health ,medicine ,Round cell ,Immunohistochemistry ,Bone marrow ,Sarcoma ,business ,Rhabdomyosarcoma - Abstract
Objectives: The objective of this study to comprehensively analyze bone marrow (BM) infiltration by nonhematological round cell tumors. Materials and Methods: A total of 206 diagnosed cases of small round blue cell tumors (excluding lymphomas) during a period of 2½ years, referred for BM examination were included in the study. Clinical details were obtained from medical records. BM aspiration (BMA) and BM biopsies (BMBx) were performed under local anesthesia for staging workup. BMBx were studied for cellularity, presence of infiltration by round cells (nonhematopoietic), histologic patterns (island/nests and diffuse sheets), fibrosis, necrosis and other secondary changes. Immunohistochemistry panel was used depending on the morphology. Results: The cases included age range from 45 days to 25 years with a median age of 12 years. There was a male predominance with male:female 1.5:1. Among these, 37/206 cases (17.9%) were positive for BM involvement (BMI) on BMBx. Of these, 24 cases were neuroblastoma (64.8%), 9 cases Ewing’s sarcoma/primitive neuroectodermal tumor (24.3%), and 4 Rhabdomyosarcoma (10.8). BMBx was done in all the 206 cases. Among these, 37/206 cases were positive for BMI on BMBx while 35/206 cases were positive on BM imprints and 33/206 cases were positive on BMA. Conclusion: Detection of metastasis in the BM has both therapeutic and prognostic significance. BMBx are complementary in the diagnosis of small round cell tumor.
- Published
- 2019
13. Procedural Pain in Lumbar Punctures and the Impact of Preparation in Pediatric Cancer Patients
- Author
-
Thomas Wiebe, Jean Jacob, Gayatri Palat, Tommy Schyman, Eva Brun, Magdalena Marczak, Mikael Segerlantz, and Sudha Sinha
- Subjects
medicine.medical_specialty ,Medical staff ,business.industry ,Childhood cancer ,Pain management ,Pediatric cancer ,Procedural Pain ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,Oncology ,030225 pediatrics ,Pediatrics, Perinatology and Child Health ,Physical therapy ,Pediatric oncology ,Medicine ,business ,Limited resources ,030217 neurology & neurosurgery - Abstract
Aim: Childhood cancer patients are subjected to recurring painful medical procedures. In low- and middle-income countries (LMIC), where the majority of the world’s childhood cancer patients live, pain management is often unsatisfactory due to limited resources. This study aimed to evaluate the possibility of conducting a preprocedural preparation for lumbar punctures (LPs) at a pediatric oncology unit in a LMIC and to assess whether this intervention would decrease procedural pain and fear. Methods: Patients aged 5–18 who underwent LPs between February 25, 2017, and April 12, 2017, were eligible and invited to participate. Included patients were interviewed to assess the procedural pain and fear in conjunction with the LP and the patients’ understanding of why an LP was done. Closest caregivers and the medical staff were interviewed to compare the perceptions of pain. The study was conducted in two separate phases; patients included in the period of February 25–March 9 underwent LP according to routines without preparation while patients included in the period of March 10–April 12 received procedural preparation with information. Results from the interviews from the two study groups were compared. Results: Out of 79 patients who met the inclusion criteria, 76 were included and preparation was successfully implemented for 25 of them. The pain decreased significantly (P = 0.022) after preparation. The physicians underestimated the patients’ pain (P < 0.0001). The understanding of the reason for the LP increased significantly among patients (P = 0.0081) and their caregivers (P < 0.0001). Conclusions: Preparation by preprocedural information, created to fit the situation at a state-run hospital in a LMIC, is feasible and efficient.
- Published
- 2019
14. End-of-Life Treatments in Pediatric Patients at a Government Tertiary Cancer Center in India
- Author
-
Thomas Wiebe, Gayatri Palat, Mikael Segerlantz, Eva Brun, Jaskirt Kaur Matharu, Sudha Sinha, and Jean Jacob
- Subjects
Male ,medicine.medical_specialty ,Palliative care ,Adolescent ,Demographics ,India ,Pediatrics ,Tertiary Care Centers ,03 medical and health sciences ,Government Agencies ,0302 clinical medicine ,Neoplasms ,medicine ,Humans ,Center (algebra and category theory) ,030212 general & internal medicine ,Child ,General Nursing ,Retrospective Studies ,Terminal Care ,Government ,business.industry ,Oncology Nursing ,Palliative Care ,Infant, Newborn ,Infant ,Cancer ,General Medicine ,medicine.disease ,Hospice Care ,Anesthesiology and Pain Medicine ,Child, Preschool ,030220 oncology & carcinogenesis ,Family medicine ,Female ,business ,End-of-life care - Abstract
The primary objective of this study was to describe demographics and end-of-life treatments of children with cancer at a government tertiary cancer center in India.A retrospective review was undertaken of medical charts of all children younger than 18 years, who died as inpatients while undergoing treatment at the pediatric oncology department between April and September 2016. Data were collected on demographics, diagnosis, treatments, survival, palliative care involvement, and symptoms at end of life.There were 44 pediatric oncology patients who died in the hospital during the study period. The most frequent diagnoses were hematological malignancies (n = 29). Tumor-specific treatment was given to 38/44 (86%) patients in the last 30 days of life, and 13 patients in the last day of life or 1 day before. Of all deaths, 23/44 (52%) occurred within 30 days of admission to the pediatric ward and 34/44 (77%) within 90 days. Of the 44 patients, 25 (57%) were referred to palliative care. The median number of days between referral and death was 14 (0-78) days. Frequent symptoms documented were bleeding (11/44), dyspnea (10/44), pain (7/44), seizures (7/44), and delirium (5/44), with each patient having one or more of these symptoms. Only patients with a palliative care referral received opioid analgesics or benzodiazepines at the end of life.This study highlights the demographics of suffering, death, and end-of-life care in children with cancer at a government tertiary cancer center in India.
- Published
- 2018
15. Clinicopathological Study of Marrow Infiltration by Lymphoproliferative Disorders: A 2-year Experience from a Cancer Institute
- Author
-
Abid Hussain, Triveni Bhopal, Sudha Sinha, Fatima Farzeen Fameena, Sree Lakshmi, and Sai Mallikarjun
- Subjects
medicine.medical_specialty ,business.industry ,Lymphoblastic lymphoma ,Lymphoproliferative disorders ,lymphoma ,chronic lymphocytic lymphoma ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Gastroenterology ,lcsh:RC254-282 ,Lymphoma ,medicine.anatomical_structure ,Fibrosis ,immune system diseases ,Internal medicine ,hemic and lymphatic diseases ,immunohistochemistry ,Medicine ,General Materials Science ,Mantle cell lymphoma ,Bone marrow ,bone marrow involvement ,business ,Infiltration (medical) ,Anaplastic large-cell lymphoma - Abstract
Bone marrow (BM) examination is an essential tool in evaluation and staging of non-Hodgkin lymphoma (NHL). The aim of this study is to overview the approach to the use of unilateral versus bilateral BM sampling in lymphoproliferative disorders for diagnosis and staging. All cases diagnosed as lymphoproliferative disorders from January 2014 to January 2017 were studied. Bilateral trephine biopsy and aspiration of 414 cases were assessed for involvement patterns and presence/absence of background changes. Bone marrow involvement (BMI) was seen in 109 (26.3%) cases. The cases ranged from 2 to 80 years. BMI was more frequent in B-cell lymphomas than T-cell lymphomas as was the incidence (B-NHL= 87/109 [79.8%]; T-NHL=21/109 [19.1%]). Among B-cell lymphomas, BMI was most frequent in chronic lymphocytic lymphoma followed by B-lymphoblastic lymphoma (BLL) and mantle cell lymphoma. Among T-cell lymphomas, BMI was most frequent in T-lymphoblastic lymphoma (TLL). A single case of anaplastic large cell lymphoma (ALCL) had BMI. Bone marrow aspiration (BMA) and bone marrow trephine (BMT) agreed in 97% of cases (401 of 414: 308 both negative, 93 both positive). Additional 13 cases were diagnosed on BMT whereas BMA was negative for these cases. Background changes (fibrosis and necrosis) were common in TLL followed by BLL. Of the 109 positive cases, 4 were missed by unilateral BMT. Peripheral spill of lymphoma was seen in 14 of 109 cases. BMT involvement by lymphoma is more commonly seen in lymphoblastic lymphoma. Bilateral trephine biopsy remains gold standard to determine the marrow involvement and staging and assess the remission.
- Published
- 2018
16. Specialized Palliative Care and the Quality of Life for Hospitalized Cancer Patients at a Low-Resource Hospital in India
- Author
-
Gayatri Palat, Caroline Stenlander, Jean Jacob, Sudha Sinha, Vineela Rapelli, Thomas Wiebe, Eva Brun, and Mikael Segerlantz
- Subjects
lcsh:R5-920 ,Hospital Anxiety and Depression Scale ,Eastern Cooperative Oncology Group ,palliative care ,quality of life ,Palliative Care Outcome Scale ,Original Article ,lcsh:Medicine (General) - Abstract
Aim: This study aimed to compare the quality of life (QoL) of cancer patients, with an Eastern Cooperative Oncology Group (ECOG) performance of 3–4, in contact with or without contact, with a specialized palliative care unit (PCU) at a low-resource governmental cancer hospital, as well as studying the impact of this contact on the QoL in their caregivers. Materials and Methods: Hospitalized patients with an ECOG performance of 3 or 4 and their primary caregiver were asked to participate in this observational study. Patients in contact with the specialized PCU and their closest caregivers formed Group A, while patients and families without this contact formed Group B. Contact was mainly one consultation. The patients were asked to complete the Palliative Care Outcome Scale (POS), and the caregivers were asked to complete the Hospital Anxiety and Depression Scale (HADS) and the distress thermometer (DT). Results: There was no statistically significant difference between the median POS values of the patient groups, neither regarding the total sum nor per any item. There were also no statistically significant differences between the median HADS values and median DT values when comparing the caregivers to Group A and B. Conclusion: Consultation with a specialized PCU at this tertiary referral center did not alter the QoL of patients with an ECOG performance of 3–4 nor did it affect the psychological well-being of their caregivers. We argue that monitoring prescribed treatment and follow-up is a necessary component of PC.
- Published
- 2018
17. Low-Dose Oral Ketamine for Procedural Analgesia in Pediatric Cancer Patients Undergoing Lumbar Puncture at a Resource-Limited Cancer Hospital in India
- Author
-
Mikael Segerlantz, Tim Bäckdahl, Jean Jacob, Naresh Reddy, Spandana Rayala, Eva Brun, Emil Karonen, Gayatri Palat, Erik Gebre-Medhin, Sudha Sinha, Tommy Schyman, and Thomas Wiebe
- Subjects
Adolescent ,Administration, Oral ,India ,Cancer Care Facilities ,Pediatrics ,Spinal Puncture ,03 medical and health sciences ,0302 clinical medicine ,030502 gerontology ,medicine ,Humans ,Pain Management ,Ketamine ,Child ,General Nursing ,Analgesics ,medicine.diagnostic_test ,business.industry ,Lumbar puncture ,Low dose ,Cancer ,General Medicine ,medicine.disease ,Placebo Effect ,Pediatric cancer ,Procedural Pain ,Safety profile ,Anesthesiology and Pain Medicine ,030220 oncology & carcinogenesis ,Anesthesia ,Child, Preschool ,0305 other medical science ,business ,Limited resources ,medicine.drug - Abstract
Aim: The aim of this study was to evaluate the therapeutic efficacy and safety profile of orally administered low-dose ketamine for procedural pain management in pediatric cancer patients ...
- Published
- 2019
18. Genetic Variants of ATM & Non-Homologous End Joining Pathway Genes in Acute Myeloid Leukemia: A South India Case-Control Study
- Author
-
Raghunadharao Digumarthi, Manjula Gorre, Sugunakar Vuree, Vishnupriya Satti, Dunna Nageswara Rao, Anuradha Cingeetham, Sadashivudu Gundeti, and Sudha Sinha
- Subjects
Genome instability ,Genetics ,DNA repair ,Immunology ,Myeloid leukemia ,Cell Biology ,Hematology ,Biology ,Biochemistry ,law.invention ,Non-homologous end joining ,law ,Genotype ,Allele ,Restriction fragment length polymorphism ,Polymerase chain reaction - Abstract
Purpose of the study: Deregulated DNA repair is one of the hallmarks of cancers including Acute Myeloid Leukemia (AML), as it results in genomic instability. ATM gene functions as a sensor, activates cascade of events leading to stimulation of multiple DNA damage- responsive signaling pathways. Principal DNA repair mechanism activated in the hematopoietic stem cells is the Non Homologous End Joining (NHEJ) pathway. However, this pathway was shown to be error prone. Functional SNPs in the genes involved in DNA repair might influence the gene expression leading to altered DNA repair which might confer the risk to AML. Materials & Methods: This hospital-based case-control study included 225 AML patients and 326 cancer-free controls from South Indian population. Six polymorphisms of XRCC5, XRCC6, XRCC7 and ATM were genotyped using polymerase chain reaction (PCR)-Restriction Fragment Length Polymorphism (PCR- RFLP) method. Statistical analyses were performed by using SPSS (version20v) and SNPSTAT online tool. Protein-Protein Interaction (PPI) analysis was also done to see the relationship between these genes. Results: We found that there was an elevated risk of AML associated with the XRCC5 VNTR 0R repeat and A allele of 2408G>A polymorphism (p-0.04 and pG and T allele (p-0.003) of ATM -5144A>T polymorphisms were also significantly increased in AML cases. Further, analyses of the variant genotypes with epidemiological and clinical variables revealed a significant association of the risk genotypes with development and progression of AML. Conclusion: The XRCC5 0R repeat, 2408G>A, XRCC6 -1310 C>G and ATM- 5144A>T polymorphisms, but not XRCC6 -61C>G and XRCC7 6721G>T polymorphisms, play an important role in the pathogenesis of AML. Figure Disclosures No relevant conflicts of interest to declare.
- Published
- 2019
19. Cancer Treatment and End-of-Life Care
- Author
-
Jaskirt Kaur Matharu, Mikael Segerlantz, Eva Brun, Thomas Wiebe, Gayatri Palat, Sudha Sinha, and Jean Jacob
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Palliative care ,Referral ,Adolescent ,medicine.medical_treatment ,Decision Making ,India ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Neoplasms ,medicine ,Humans ,030212 general & internal medicine ,Child ,Referral and Consultation ,General Nursing ,Aged ,Retrospective Studies ,Aged, 80 and over ,Terminal Care ,business.industry ,Medical record ,Palliative Care ,Cancer ,Infant ,General Medicine ,Middle Aged ,medicine.disease ,Pediatric cancer ,Cancer treatment ,Radiation therapy ,Anesthesiology and Pain Medicine ,030220 oncology & carcinogenesis ,Child, Preschool ,Practice Guidelines as Topic ,Female ,business ,End-of-life care - Abstract
To study to what extent tumor-specific treatment (chemo- or radiotherapy) was given during the last 30 days in life and to examine how many of the patients were referred to a specialized palliative care unit (PCU), at a low-resource governmental hospital in India.Medical records of adult cancer patients deceased between April 1 and May 31 in 2016, and pediatric cancer patients deceased between April 1 and September 30 in 2016 were collected. Data regarding gender, age at admission, cancer diagnosis, tumor-specific treatment received, referral to the PCU, and date of death, were sampled.A total of 96 patients (52 adults and 44 pediatric patients) were included in the study. In the last 30 days of life, tumor-specific treatment was given to 39 adult patients and 38 pediatric patients. During the last week in life, 26 adult and 25 pediatric patients, respectively, received tumor-specific treatment. Twenty-six adult and 25 pediatric patients, respectively, were referred to the PCU. End-of-life (EoL) tumor therapy was given to a lesser extent among referred patients.Eighty percent of the patients were given tumor-specific treatment near EoL. Half of the patients had been referred for specialized palliative care (SPC).
- Published
- 2018
20. Influence of BCL2-938C>A and BAX-248G>A promoter polymorphisms in the development of AML: case–control study from South India
- Author
-
Manjula Gorre, Sudha Sinha, Prajitha Mohandas Edathara, Sugunakar Vuree, Anuradha Cingeetham, Nageswara Rao Dunna, Sandhya Annamaneni, Santhoshi Rani Nanchari, Vishnupriya Satti, Raghunadharao Digumarthi, and Phannibhushann Meka
- Subjects
Adult ,Male ,Oncology ,medicine.medical_specialty ,Adolescent ,India ,Cellular homeostasis ,Biology ,Bioinformatics ,Polymerase Chain Reaction ,Polymorphism, Single Nucleotide ,Young Adult ,Bcl-2-associated X protein ,hemic and lymphatic diseases ,Internal medicine ,Genotype ,Biomarkers, Tumor ,medicine ,Humans ,Allele ,Child ,Promoter Regions, Genetic ,neoplasms ,Survival rate ,Survival analysis ,Aged ,Neoplasm Staging ,bcl-2-Associated X Protein ,Case-control study ,DNA ,General Medicine ,Middle Aged ,Prognosis ,Survival Rate ,Leukemia, Myeloid, Acute ,Proto-Oncogene Proteins c-bcl-2 ,Case-Control Studies ,Child, Preschool ,biology.protein ,Female ,Restriction fragment length polymorphism ,Polymorphism, Restriction Fragment Length ,Follow-Up Studies - Abstract
B-cell lymphoma 2 (BCL2) and BCL2-associated X protein (BAX) proteins are anti-apoptotic and pro-apoptotic determinants of mitochondrial-mediated apoptosis, and their relative expression determines the cell fate. The promoter polymorphisms in these genes were shown to alter the protein function or expression and exert an impact on apoptosis regulation. Deregulation in the expression of any of these genes leads to disruption of cellular homeostasis and malignant transformation. The present study was aimed to determine the association of BCL2-938C>A and BAX-248G>A promoter polymorphisms with origin and progression of acute myeloid leukemia (AML). We also have performed combined genotype analysis to evaluate the cumulative effect of risk genotypes in the AML development. These polymorphisms were genotyped by polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) in 221 AML patients and 305 age- and sex-matched healthy controls. Our study revealed that BCL2-938CA (p = 0.018) and BAX-248GG (0.043) genotypes were significantly associated with increased risk for AML occurrence. BAX-248A allele had shown decreased risk for AML. The combined analysis had shown that BCL2-938CA+AA-BAX-248GG group had a 1.63-fold (95 % CI: 1.08-2.45, p = 0.02) increased risk for AML. None of the clinical variables had shown any significant association with both polymorphisms. With respect to complete remission (CR) rate, BAX-248GG genotype (p = 0.002) and G allele (p = 0.009) had conferred significant risk for complete remission failure. Although the log rank test was not significant, survival analysis had shown a trend where BCL2-938CA genotype, and BAX-248GG had reduced median disease-free survival (DFS) of 9 and 10 months, respectively. In conclusion, BCL2-938C>A and BAX-248G>A gene polymorphisms might contribute to the origin of AML. Moreover, influence of BAX-248GG genotype on CR and DFS rate suggests that the BAX-248G>A polymorphism can serve as marker for poor prognosis in AML.
- Published
- 2015
21. Exploring Barriers To Accessing Care For Childhood Cancers In India: A Qualitative Study (Inpog-Acc-16-03)
- Author
-
Neha Faruqui, Ananya Mishra, Ramandeep Singh Arora, Sameer Bakhshi, Manas Kalra, Sudha Sinha, Jennifer Lowe, Alexandra Martiniuk, Rachna Seth, Ayyagari Santa, Sarah Bernays, Rohina Joshi, Sirisharani Siddaiahgari, and Huma Anis
- Subjects
03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Oncology ,business.industry ,030220 oncology & carcinogenesis ,Family medicine ,Pediatrics, Perinatology and Child Health ,medicine ,Hematology ,business ,030215 immunology ,Qualitative research - Published
- 2018
22. A novel technique to prevent endobronchial spillage during video assisted thoracoscopic lobectomy
- Author
-
Ali Zamir Khan, Sudha Sinha, Anand Sharma, Yatin Mehta, Shaiwal Khandelwal, and Sangeeta Khanna
- Subjects
Adult ,Novel technique ,Hemoptysis ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Antifungal Agents ,Aspergilloma ,Fogarty catheter ,Lung isolation ,Bronchi ,lcsh:RD78.3-87.3 ,Spillage ,Postoperative Complications ,medicine ,Aspergillosis ,Humans ,Tuberculosis ,Intraoperative Complications ,Lung ,Bronchus ,Bronchiectasis ,Lung Diseases, Fungal ,Thoracic Surgery, Video-Assisted ,business.industry ,General Medicine ,respiratory system ,medicine.disease ,Surgery ,respiratory tract diseases ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Cardiothoracic surgery ,lcsh:Anesthesiology ,lcsh:RC666-701 ,Catheter-Related Infections ,Female ,Voriconazole ,Cardiology and Cardiovascular Medicine ,business - Abstract
Endobronchial spillage of fungal material into normal lung can infect it and the spillage of fungal material should be prevented during surgery. We report our experience of a patient who presented for right upper lobectomy with bronchiectasis, tubercular destruction and subsequent aspergilloma. A 4F Fogarty catheter was introduced through the tracheal lumen of the left sided endobronchial double lumen tube (DLT) to occlude the bronchus intermedius to prevent spillage of aspergilloma into the non-infected lower and middle lobes of the right lung. The Fogarty catheter was pulled into the trachea just before stapling the bronchus; thereafter, right upper lobectomy was completed successfully. The patient was extubated uneventfully and transferred to post-operative recovery ward. The endobronchial blockage of the intermediate bronchus of the operative lung by the Fogarty catheter and isolation of the left lung by the DLT prevented spillage of aspergilloma in both the operative right lung and the left lung.
- Published
- 2014
23. Role of the MDM2 promoter polymorphism (-309TG) in acute myeloid leukemia development
- Author
-
Anuradha Cingeetham, Raghunadharao Digumarti, Manjula Gorre, Sangeeta Jiwatani, Sudha Sinha, Vishnupriya Satti, Sandhya Annamaneni, Sailaja Kagita, Phanni Bhushann Meka, Nageswara Rao Dunna, and Sugunakar Vuree
- Subjects
Adult ,Male ,Cancer Research ,Adolescent ,Epidemiology ,medicine.medical_treatment ,Biology ,Polymorphism, Single Nucleotide ,Disease-Free Survival ,Young Adult ,Risk Factors ,Genotype ,medicine ,SNP ,Humans ,Genetic Predisposition to Disease ,Child ,Promoter Regions, Genetic ,neoplasms ,Gene ,Aged ,Chemotherapy ,Public Health, Environmental and Occupational Health ,Induction chemotherapy ,Myeloid leukemia ,Proto-Oncogene Proteins c-mdm2 ,Middle Aged ,Molecular biology ,Leukemia, Myeloid, Acute ,Real-time polymerase chain reaction ,Cell Transformation, Neoplastic ,Oncology ,Case-Control Studies ,Child, Preschool ,Cancer research ,biology.protein ,Mdm2 ,Female ,Tumor Suppressor Protein p53 - Abstract
The human homologue of the mouse double minute 2 (MDM2) gene is a negative regulator of Tp53. MDM2-309TG a functional promoter polymorphism was found to be associated with overexpression thereby attenuation of Tp53 stress response and increased cancer susceptibility. We have planned to evaluate the possible role of MDM2-309TG polymorphism with risk and response to chemotherapy in AML.A total of 223 de novo AML cases and 304 age and sex matched healthy controls were genotyped for the MDM2-309TG polymorphism through the tetra-primer amplification refractory mutation system (ARMS)-PCR method. In order to assess the functional relationship of -309TG SNP with MDM2 expression level, we quantified MDM2 mRNA in 30 primary AML blood samples through quantitative RT-PCR. Both the (-309TG) genotypes and the MDM2 expression were correlated with disease free survival (DFS) rates among patients who have achieved complete remission (CR) after first induction chemotherapy.MDM2-309TG polymorphism was significantly associated with AML development (p0.0001). The presence of either GG genotype or G allele at MDM2-309 confered 1.79 (95% CI: 1.12-2.86; p0.001) and 1.46 fold (95%CI: 1.14-1.86; p=0.003) increased AML risk. Survival analysis revealed that CR+ve cases with GG genotype had significantly increased DFS rates (16months, p=0.05) compared to CR+ve TT (11 months) and TG (9 months) genotype groups. Further, MDM2 expression was also found to be significantly elevated in GG genotype patients (p=0.0039) and among CR+ve cases (p=0.0036).The MDM2-309TG polymorphism might be involved in AML development and also serve as a good prognostic indicator.
- Published
- 2015
24. Emp is a component of the nuclear matrix of mammalian cells and undergoes dynamic rearrangements during cell division
- Author
-
Shivani Soni, Manjit Hanspal, Sudha Sinha, Shashi Bala, and Ajay Kumar
- Subjects
Cell division ,Active Transport, Cell Nucleus ,Biophysics ,Biology ,Kidney ,Biochemistry ,Spindle pole body ,Cell Line ,Humans ,Nuclear Matrix ,Cytoskeleton ,Molecular Biology ,Mitosis ,Blood Proteins ,Cell Biology ,Nuclear matrix ,Actins ,Spindle apparatus ,Cell biology ,Cytoskeletal Proteins ,Interphase ,Cell Adhesion Molecules ,Cell Division ,Cytokinesis ,Subcellular Fractions - Abstract
Emp, originally detected in erythroblastic islands, is expressed in numerous cell types and tissues suggesting a functionality not limited to hematopoiesis. To study the function of Emp in non-hematopoietic cells, an epitope-tagged recombinant human Emp was expressed in HEK cells. Preliminary studies revealed that Emp partitioned into both the nuclear and Triton X-100-insoluble cytoskeletal fractions in approximately a 4:1 ratio. In this study, we report investigations of Emp in the nucleus. Sequential extractions of interphase nuclei showed that recombinant Emp was present predominantly in the nuclear matrix. Immunofluorescence microscopy showed that Emp was present in typical nuclear speckles enriched with the spliceosome assembly factor SC35 and partially co-localized with actin staining. Coimmunoprecipitation and GST-pull-down assays confirmed the apparent close association of Emp with nuclear actin. During mitosis, Emp was detected at the mitotic spindle/spindle poles, as well as in the contractile ring during cytokinesis. These results suggest that Emp undergoes dynamic rearrangements within the nuclear architecture that are correlated with cell division.
- Published
- 2006
25. Safety and efficacy of peripheral blood progenitor cell mobilization and collection in patients with advanced coronary heart disease
- Author
-
Sudha Sinha, Marianne Kearney, Donato Sodano, Janice Flanagan, Kian Keong Poh, Cindy Ouilette, Robert Weinstein, Douglas W. Losordo, Lindsay Heyd, and Jill Wollins
- Subjects
Male ,medicine.medical_specialty ,Myocardial Ischemia ,Neovascularization, Physiologic ,Pain ,Coronary Disease ,Transplantation, Autologous ,Angina Pectoris ,Angina ,Coronary artery disease ,Internal medicine ,Granulocyte Colony-Stimulating Factor ,medicine ,Humans ,Single-Blind Method ,Adverse effect ,Bone pain ,Aged ,Aged, 80 and over ,Salvage Therapy ,Peripheral Blood Stem Cell Transplantation ,business.industry ,Headache ,Hematology ,General Medicine ,Middle Aged ,medicine.disease ,Hematopoietic Stem Cell Mobilization ,Surgery ,Granulocyte colony-stimulating factor ,Transplantation ,Apheresis ,Heart failure ,Chronic Disease ,Female ,medicine.symptom ,business - Abstract
Information on the safety of mobilization and collection of peripheral blood progenitor cells (PBPC) in patients with advanced coronary heart disease (CHD) is limited. We report herein our early experience with patients participating in a Phase I trial of injection of autologous CD 34(+) cells into threatened, ischemic myocardium for neovascularization and symptom relief in patients with chronic refractory myocardial ischemia. All patients had advanced inoperable CHD despite the best medical therapy. Granulocyte colony stimulating factor (G-CSF, 5 microg/kg/day) was administered subcutaneously for 5 days for mobilization of CD34(+) cells into the peripheral blood. PBPCs were collected in the outpatient apheresis suite on day 5. Nine patients from our institution were evaluable. Adverse effects of mobilization included: increase in frequency and/or intensity of angina in 8 patients (88.8%); bone pain in 7 patients (77.7%); headaches in 4 patients (44.4%); 2 patients (22%) were hospitalized. Collection phase toxicities included: tingling in 5 patients (55.5%) and angina in 3 patients (33%). All procedures were completed without new myocardial infarction, congestive heart failure, or death. The median peripheral blood CD34(+) cell count on day 5 of G-CSF was 21 cells/microl (range 10-40 cells/microl). A median of 1.65 x 10(6) CD34(+) cells/kg (range: 0.13-3.0 x 10(6)/kg) were harvested. We conclude that mobilization and collection of PBPC in patients with advanced CHD can be safely performed as an outpatient procedure. Apheresis professionals should be aware of the intensity and frequency of angina in this patient population.
- Published
- 2006
26. Airway management: Few more lessons to learn
- Author
-
Sangeeta Khanna, Sudha Sinha, Preety Mittal Roy, and Yatin Mehta
- Subjects
medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,business.industry ,medicine.medical_treatment ,MEDLINE ,General Medicine ,030204 cardiovascular system & hematology ,lcsh:RD78.3-87.3 ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,Text mining ,lcsh:Anesthesiology ,lcsh:RC666-701 ,medicine ,030211 gastroenterology & hepatology ,Airway management ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business ,Letters to Editor - Published
- 2016
27. Recommendations to support nurses and improve the delivery of oncology and palliative care in India
- Author
-
Usha Lakshmi Pilla, Padma Vennela, Gayatri Palat, Beaulah John Battula Jamima, Yadamma Shapuram, Nireekshana Podduturi, Sudha Sinha, Vineela Rapelli, Zahra Lalani, Sanjeeva Kumari Chinta, Susan L. Beck, and Virginia T. LeBaron
- Subjects
District nurse ,Oncology ,medicine.medical_specialty ,Surgical nursing ,Palliative care ,media_common.quotation_subject ,Psychological intervention ,India ,Context (language use) ,Participant observation ,nurses ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Internal medicine ,Chemotherapy ,Medicine ,media_common ,lcsh:R5-920 ,Teamwork ,palliative care ,030504 nursing ,Social work ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,030220 oncology & carcinogenesis ,Family medicine ,oncology ,recommendations ,Original Article ,lcsh:Medicine (General) ,0305 other medical science ,business - Abstract
Context: Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training. Aim: The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care. Methods: Qualitative ethnography. Setting: The study was conducted at a government cancer hospital in urban South India. Sample: Thirty-seven oncology/palliative care nurses and 22 others (physicians, social workers, pharmacists, patients/family members) who interact closely with nurses were included in the study. Data Collection: Data were collected over 9 months (September 2011– June 2012). Key data sources included over 400 hours of participant observation and 54 audio-recorded semi-structured interviews. Analysis: Systematic qualitative analysis of field notes and interview transcripts identified key themes and patterns. Results: Key concerns of nurses included safety related to chemotherapy administration, workload and clerical responsibilities, patients who died on the wards, monitoring family attendants, and lack of supplies. Many participants verbalized distress that they received no formal oncology training. Conclusions: Recommendations to support nurses in India include: prioritize safety, optimize role of the nurse and explore innovative models of care delivery, empower staff nurses, strengthen nurse leadership, offer relevant educational programs, enhance teamwork, improve cancer pain management, and engage in research and quality improvement projects. Strong institutional commitment and leadership are required to implement interventions to support nurses. Successful interventions must account for existing cultural and professional norms and first address safety needs of nurses. Positive aspects from existing models of care delivery can be adapted and integrated into general nursing practice.
- Published
- 2017
28. Interpretation of PET scan results at varying degrees of blood glucose in diabetic patients with lymphoma: an experience of 25 cases of Non Hodgkin Lymphomas from southern India
- Author
-
Obula C. Reddy, Sudha Sinha, A. V. S. Suresh, and T. Mandapal
- Subjects
medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Disease ,medicine.disease ,Lymphoma ,Gestational diabetes ,Internal medicine ,Diabetes mellitus ,Immunology ,Internal Medicine ,Medicine ,Outpatient clinic ,Prediabetes ,Risk factor ,First-degree relatives ,business - Abstract
The objective of study was to determine the frequency of prediabetes and observe the influence of various risk factors on the development of prediabetes at Liaquat University Hospital, Hyderabad. Descriptive case series. Medical outpatient department Liaquat University Hospital, Hyderabad. From 01-03-2007 to 31-03-2008. Total 500 subjects with BMI>25 and aged either 45 year and above or BMI>25, with an additional risk factor were enrolled for the study.All diagnosed patients of diabetes were excluded from study. A well designed proforma included demographic information, history regarding first degree relative with diabetes, gestational diabetes, delivery of large baby and related investigations. Fasting blood glucose (FBG)≥100 mg/dl but
- Published
- 2011
29. Primary Thyroid Lymphoma Presenting With Stridor
- Author
-
Leo Aish, Sudha Sinha, and Thein Hlaing Oo
- Subjects
Male ,Cancer Research ,Pediatrics ,medicine.medical_specialty ,Lymphoma, B-Cell ,Primary (chemistry) ,business.industry ,Stridor ,medicine.disease ,Text mining ,Oncology ,Thyroid lymphoma ,Humans ,Medicine ,Thyroid Neoplasms ,medicine.symptom ,business ,Aged ,Respiratory Sounds - Published
- 2005
30. Palliative chemotherapy in head and neck squamous cell cancer - What is best in Indian population? A time without symptoms, treatment toxicity score based study
- Author
-
K Suresh, V. Anuradha, Sudha Sinha, S Chinna Babu, B.B. Anand, and A. V. S. Suresh
- Subjects
Oncology ,Cisplatin ,medicine.medical_specialty ,business.industry ,Head and neck cancer ,India ,medicine.disease ,Surgery ,Regimen ,Pharmacoeconomics ,Gefitinib ,Quality of life ,quality of life ,Internal medicine ,Pediatrics, Perinatology and Child Health ,time without symptoms treatment toxicity ,medicine ,Methotrexate ,Original Article ,Prospective cohort study ,business ,medicine.drug - Abstract
Background: Patients with recurrent and metastatic head and neck Squamous Cell Cancer (HNSCC) have poor prognosis with limited treatment options. In view of decimal prognosis, the treatment decision should include quality of life (QOL) issues, cost-effectiveness besides the response rates and survival. Aim: Present retrospective analysis was conducted to evaluate efficacy (disease-free survival), pharmacoeconomics, and toxicity profile of four (4) different regimens, viz. gefitinib alone, gefitinib with methotrexate, methotrexate alone, or 5-FU with cisplatin. Materials and Methods: Case records between 2007 September and 2008 September were analyzed, 68 patients were found suitable for analysis. Patients received gefitinib (250 mg/day), methotrexate as 50 mg intramuscular weekly or a combination of the same or 5-FU 750 mg/m 2 /day for 4 days along with cisplatin 75 mg/m 2 /day on day 1 in 21-day cycle. Results: A total of 68 patients received therapy. Fifty-one patients have clinically meaningful response (stable disease + complete + partial responses) (75%) and had symptomatic improvement. The median progression-free survival was significantly superior in responders (those who achieved partial or complete response) (8.4 months vs. 3.1 months, P=0.001). Methotrexate with gefitinib had maximum median survival and better overall QOL compared to the other treatment regimens. Weekly methotrexate is relatively cost-effective followed by methotrexate with gefitinib and gefitinib alone. 5-FU with cisplatin in our experience does not appear so attractive in view of high complication rates (when given in full doses) and prolonged hospital stay. Conclusion: Based on the results of this retrospective analysis, methotrexate weekly as single agent or in combination with gefitinib appears as an attractive alternative regimen for patients with metastatic HNSCC including those having poor performance status. A prospective study was planned and submitted to the local ethics committee based on above results to validate these results and compare methotrexate and gefitinib arm with 5-FU + cisplatin.
- Published
- 2013
31. Epidemiological profile of adolescent and young adults (AYA) with cancer: A decade long experience of a tertiary care centre from South India
- Author
-
Jayanthi Srirambhatla, Meher Lakshmi Konatam, Sudha Sinha, and Radhika Parimkayala
- Subjects
Cancer Research ,medicine.medical_specialty ,Pediatrics ,business.industry ,Cancer ,Special needs ,medicine.disease ,Tertiary care ,Oncology ,Family medicine ,Epidemiology ,medicine ,Young adult ,business - Abstract
e13102Background: Cancers in Adolescent and young adults is a variegated group with special needs which is an orphaned subject. Methods: to study the epidemiological profile of cancers in adolescen...
- Published
- 2016
32. Risk-scoring system for predicting mucositis in patients of head and neck cancer receiving concurrent chemoradiotherapy [rssm-hn]
- Author
-
P Pratap Varma, M.P. Srinivasan, B.B. Anand, Sudha Sinha, Raghu Raman, Satya Deepika, A. V. S. Suresh, T. Mandapal, and C Obula Reddy
- Subjects
Mucositis ,medicine.medical_specialty ,Antineoplastic Agents ,lcsh:RC254-282 ,Risk Assessment ,chemoradiotherapy ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Stage (cooking) ,Head and neck cancer ,Retrospective Studies ,Performance status ,Receiver operating characteristic ,Radiotherapy ,business.industry ,India ,scoring system ,Cancer ,Retrospective cohort study ,General Medicine ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Combined Modality Therapy ,Surgery ,Oncology ,ROC Curve ,Head and Neck Neoplasms ,business ,Chemoradiotherapy - Abstract
Background: One of the most distressing complications of head and neck cancer patients on chemoradiotherapy is mucositis. There is no proper tool to predict its occurrence in these patients. Aim: This study was conducted to develop a risk-scoring system to predict probable incidence and severity of mucositis in head and neck cancer patients on chemoradiotherapy. Materials and Methods: This is a retrospective analysis conducted at a tertiary care cancer center with approximately 2,000 new cases of head and neck cancer patients annually. We Hypothesized were age, comorbid conditions, leukocyte count, nutritional status, oral hygiene, tobacco use, erythrocyte sedimentation rate (ESR); Eastern cooperative oncology group (ECOG) performance status (PS) and TNM (tumor, node, metastasis) stage as possible risk factors. Receiver operating characteristic (ROC) curves were drawn to predict the cutoff values for risk factors, and a final scoring system was developed with sensitivity and specificity data. Results: A total of 218 patients on chemoradiation receiving cisplatin 40 mg/m 2 /week along with local radiation of 60-70 Gy depending on primary site were analyzed. Based on ROC analysis, the following cutoff values were selected: age > 40 years, ECOG PS > 2, WBC < 3000/μL, elevated ESR, albumin < 3 gm/dL and > stage III disease. The remaining factors were indicated as present or absent. A score of 1 was assigned for the above risk factors. For patients, the final score of 3 or less there is 17% probability of developing grade 3 or 4 mucositis, while patients having score of 6 or more have 76% probability. Conclusion: The current tool is fairly accurate in predicting development of mucositis in head and neck caner patients on chemoradiotherapy. This will further help clinicians to adopt preventive strategies as well as better counseling.
- Published
- 2011
33. Health-related quality of life among children with cancer in Hyderabad, India
- Author
-
Tim Eden, Senthil Rajappa, Susmitha Chirivella, Sudha Sinha, and Ronald D. Barr
- Subjects
Male ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Health Status ,Developing country ,India ,Proxy (climate) ,Neoplasms ,Medicine ,Humans ,Child ,Health related quality of life ,business.industry ,Cancer ,social sciences ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,humanities ,Cross-Sectional Studies ,El Niño ,Family medicine ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Tropical medicine ,Quality of Life ,Female ,business ,human activities - Abstract
Health-related quality of life (HRQL) experienced by children with cancer is more important than ever before as survival rates are increasing. The aim of this study was to assess the HRQL of children with cancer in a developing country, using physician proxy assessments.The Health Utilities Index (HUI) was chosen as the measurement tool and physicians' assessments were obtained using an HUI proxy-respondent interview-administered questionnaire.A total of 45 patients and their physicians (n=6) were recruited from 2 hospitals in Andhra Pradesh, India. Most of the children had acute lymphoblastic leukaemia. There were no differences in patterns observed between cancer types for the child's HRQL, but there was wide variation in the total HRQL scores among the children. This variation was more evident in certain aspects of children's life such as emotion and pain.This study has shown that HRQL as determined by physician proxy assessments in children with cancer in India is compromised, matching results in similar populations elsewhere.
- Published
- 2008
34. Abstract 4625: Influence of intrinsic apoptotic pathway gene polymorphisms on the development and progression of acute myeloid leukemia: Case-control study
- Author
-
Manjula Gorre, Sugunakar Vuree, Nageswara Rao Dunna, Anuradha Cingeetham, Sudha Sinha, Vishnupriya Satti, and Raghunadharao Digumarti
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,Case-control study ,Cancer ,Induction chemotherapy ,Myeloid leukemia ,Cellular homeostasis ,Single-nucleotide polymorphism ,medicine.disease ,Internal medicine ,Immunology ,medicine ,business ,Survival analysis ,SNP array - Abstract
Background: Apoptosis plays a pivotal role in maintaining cellular homeostasis mainly in rapidly proliferating tissue like hematopoietic tissue. Defective apoptosis is one of the hallmarks of cancer as it plays a crucial role in malignant transformation through disruption of homeostasis mechanism resulting in acquired chemo-resistance. Aim: The functional single nucleotide polymorphisms (SNPs) in apoptotic genes can influence the gene expression leading to altered apoptosis that may promote malignancy. Moreover, these SNPs might also influence the treatment outcome, since most of the chemotherapeutic drugs being used are aimed to induce apoptosis of malignant cells. The present study mainly aims to evaluate the role of SNPs in BCL2 (-938C>A (rs2279115); BAX (-248G>A (rs4645878), CASP9 [-1263A>G (rs4645978); -712C>T (rs4645981); -293del (rs4645982); Ex5+32G>A (rs1052576)] with development of acute myeloid leukemia (AML) and treatment outcome in terms of disease free survival (DFS) among patients who have achieved complete remission(CR) rates after first induction chemotherapy. Methods: The study includes 225 AML cases and 307 age-gender matched controls for case-control comparison. The study was approved by ethical committee of Osmania University. Before collecting 5ml of blood sample, each participant had provided written informed consent. Baseline line clinical characteristics and follow-up data were collected from the tumor registries with the help of oncologist. Genomic DNA was extracted and SNPs were genotyped using PCR, RFLP, Tetra primer techniques. The genotype data was subjected to various statistical analyses to correlate with disease occurrence and treatment outcome in terms of CR and DFS rates using SPSS Software. We have also performed non parametric analysis to know gene-gene interaction through Multi Dimensionality Reduction (MDR). Results: The single SNP analysis had revealed that BCL2 (rs2279115), BAX (rs4645878), CASP9 (rs4645978) and CASP9 (rs4645982) were significantly associated with the origin of AML. Survival analysis had shown that minor alleles of both CASP9 (rs4645978 and rs4645982) SNPs were associated with reduced DFS rates (log rank p = 0.02). Further, cox regression analysis had also confirmed these observations where CASP9 rs4645978 (HR = 1.91; 95%CI = 1.19-3.07; p = 0.008) and rs4645982 (HR = 1.88; 95%CI = 1.06-3.35; p = 0.03) had elevated risk for relapse and shorter DFS rates. The MDR analysis had revealed that CASP9 (rs4645981) is the highest predicting variable. The best interaction model was found to be CASP9 (-1263A>G (rs4645978); -712C>T (rs4645981); and BCL2 (rs2279115) with CVC = 8/10 and TAB = 0.604. Conclusion: Our results suggest that CASP9 (rs4645978 and rs4645982) SNPs might influence the AML development and DFS rates after first induction chemotherapy. Citation Format: Anuradha Cingeetham, Sugunakar Vuree, Nageswara Rao Dunna, Manjula Gorre, Raghunadharao Digumarti, Sudha Sinha, Vishnupriya Satti. Influence of intrinsic apoptotic pathway gene polymorphisms on the development and progression of acute myeloid leukemia: Case-control study. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4625. doi:10.1158/1538-7445.AM2015-4625
- Published
- 2015
35. On the Resurgence of the Hematologist as Consultant to Primary Care Practitioners
- Author
-
Brian Trainor, Robert Weinstein, and Sudha Sinha
- Subjects
Pediatrics ,medicine.medical_specialty ,Gestational thrombocytopenia ,Thrombocytosis ,Mononucleosis ,business.industry ,Anemia ,Myelodysplastic syndromes ,Immunology ,Hyperglobulinemia ,Cell Biology ,Hematology ,medicine.disease ,Biochemistry ,Hereditary hemochromatosis ,medicine ,Hematologist ,business - Abstract
The widespread use of “routine” automated blood testing in primary care practice appears to have increased the demand for consultative services by hematologists. To explore this hypothesis, we tracked consecutive first-time referrals to our university hospital hematology clinic retrospectively between July 2002 and June 2003 and prospectively from July 2003 to May 2004. Findings were similar in both time intervals and thus are combined for reporting. Of 557 consultative referrals, 326 patients (58.5 %) were referred for abnormalities of the peripheral blood counts, 209 (64%) of which were detected as incidental findings in asymptomatic patients. 144 (26%) of all referrals were for anemia and 79 (55%) of those proved to have primary medical conditions including active alcoholism, medication effects, chronic renal failure, iron deficiency, chronic inflammatory diseases or advanced liver disease. The rest had hematological disorders including, myelodysplastic syndromes, hemoglobinopathies, hemolytic anemias, and others. 66 (12%) of all referrals were for abnormalities of the white blood cell count and only 24 (36%) turned out to have a primary hematological disorder (e.g. CLL, CML or benign chronic leukopenia). The other 42 (64%) had primary medical disorders including leukocytosis of smoking or pregnancy, allergies, anti-convulsant-related leukopenia, etc. 50 patients were referred for thrombocytopenia or thrombocytosis, of which 29 (58%) had primary medical disorders including iron deficiency or inflammatory states, gestational thrombocytopenia, known hypersplenism, medication-related thrombocytopenia, or alcoholism. Similarly 20 of the 40 patients referred for bi- or pancytopenias had primary hematological disorders and 20 had medical disorders that included hypersplenism, drugs, or mild disorders that resolved by the time of referral. The remaining 231 patients (41.5%) included 69 who were referred for evaluation of, and counseling for, hypercoagulable disorders, 39 referred for presumed bleeding disorders (4 had senile purpura; 9 had storage pool disorders), 9 with hereditary hemochromatosis, 51 with hematological malignancies, 12 with unexplained lymphadenopathy (8 with infectious mononucleosis or other reactive lymphadenopathy, 1 with enlarged tonsils, 1 CLL, 1 T-cell lymphoma, 1 Kimura’s disease) and 9 patients with polyclonal hyperglobulinemia. Overall, only 45 % of the patients referred for consultation turned out to have a primary hematological disorder. The rest had conditions that are traditionally considered to be in the realm of internal medicine or primary care. Most consults were initiated based on incidental abnormalities of the CBC that were not, or could not be, worked up by the referring physician. Thus primary care practitioners are relying on hematologists to explain routine findings in often-asymptomatic patients with fortuitous abnormalities of the peripheral blood counts. Medical surveillance of asymptomatic patients is likely to result in progressively early detection of subtle changes in the CBC that internists and others will rely on hematologists to explain. Thus the hematologist’s role as consultant continues to expand.
- Published
- 2004
36. Primary Thyroid Lymphoma Presenting With Stridor.
- Author
-
Sudha Sinha
- Published
- 2005
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.