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Roy AS, Banerjee K, Roy P, Shil R, Ravishankar R, Datta R, Sen A, Manna S, Ghosh TK, Mukherjee G, Rana TK, Kundu S, Nayak SS, Pandey R, Paul D, Atreya K, Basu S, Mukhopadhyay S, Pandit D, Kulkarni MS, Bhattacharya C. Measurement of energy and directional distribution of neutron ambient dose equivalent for the 7Li(p,n) 7Be reaction. Appl Radiat Isot 2024; 204:111140. [PMID: 38070360 DOI: 10.1016/j.apradiso.2023.111140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 11/13/2023] [Accepted: 12/02/2023] [Indexed: 12/31/2023]
Abstract
Double differential neutron fluence distributions were measured in the 7Li(p,n)7Be reaction for proton beam energies 7, 9 and 12 MeV. Seven liquid scintillator based detectors were employed to measure neutron fluence distributions using the Time of Flight technique. Neutron ambient dose equivalents were determined from the measured fluence distribution using ICRP (International Commission on Radiological Protection) recommended fluence to dose equivalent conversion coefficients. Neutron dose equivalents were also measured using a conventional BF3 detector based REM counter. Ambient dose equivalent measured by the REM counter is found to be in agreement with that determined from the neutron fluence spectra within their uncertainties. Angular distributions of the ambient dose equivalents were also determined from the measured fluence distributions at different angles.
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Affiliation(s)
- A S Roy
- Health Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
| | - K Banerjee
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India.
| | - Pratap Roy
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - R Shil
- Visva Bharati University, Santiniketan, Bolpur, West Bengal 731235, India
| | - R Ravishankar
- Health Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - R Datta
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; RP&AD, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - A Sen
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - S Manna
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - T K Ghosh
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - G Mukherjee
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - T K Rana
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - S Kundu
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - S S Nayak
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - R Pandey
- Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - D Paul
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - K Atreya
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - S Basu
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - S Mukhopadhyay
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - Deepak Pandit
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - M S Kulkarni
- Health Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
| | - C Bhattacharya
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
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Sidhu MS, Paul D, Bhutani P, Kaur H. Primary squamous cell carcinoma of thyroid gland-First case report from state Punjab, India. J Cancer Res Ther 2024; 20:435-437. [PMID: 38554357 DOI: 10.4103/jcrt.jcrt_250_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 08/27/2022] [Indexed: 04/01/2024]
Abstract
Primary squamous cell carcinoma of the thyroid is a very rare thyroid malignancy. In addition, due to its presentation as a locally advanced disease with a high tendency to metastasize, it has a poor prognosis and outcome. We report a 60-year-old male patient with PSCC, which was confirmed by immunohistochemistry on biopsy. The patient was staged as T4N1M0 and was planned as per the multidisciplinary team approach. In sum, pathologic examination and IHC aid in distinguishing this lesion and help in differentiating it from other tumors of similar histology. Furthermore, it also aids in planning treatment.
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Affiliation(s)
- Manjinder S Sidhu
- Department of Radiation Oncology, DMCH Cancer Centre, Ludhiana, Punjab, India
| | - Davinder Paul
- Department of Medical Oncology, DMCH Cancer Centre, Ludhiana, Punjab, India
| | - Puneet Bhutani
- Department of Nuclear Medicine, DMCH Cancer Centre, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Pathology, DMCH, Ludhiana, Punjab, India
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Mahdi RA, Aggarwal P, Kumar S, Sood A, Paul D, Mittal BR. Excellent Response to Full-Dose 177 Lu-PSMA-617 RLT in Metastatic Castration-Resistant Prostate Cancer With Transplant Kidney : A Step Ahead. Clin Nucl Med 2023; 48:e470-e471. [PMID: 37566811 DOI: 10.1097/rlu.0000000000004781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
ABSTRACT 177 Lu-PSMA radioligand therapy (RLT) has shown very encouraging results in metastatic castrate-resistant prostate cancer (mCRPC) patients with acceptable adverse events. The adverse events of RLT are mainly limited to salivary glands and kidneys. However, there is dearth of available data of RLT in transplanted kidney patients with mCRPC. Here is a case of 68-year-old mCRPC patient with history of renal transplant who underwent 4 cycles of 177 Lu-PSMA-617 RLT (~7.4 GBq/cycle). Posttherapy serum creatinine and glomerular filtration rate remained stable along with excellent response and symptomatic improvement, thus demonstrating the safety of full dose of 177 Lu-PSMA in renal transplant patients.
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Affiliation(s)
- Raza Abbas Mahdi
- From the Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - Piyush Aggarwal
- From the Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - Suraj Kumar
- From the Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - Ashwani Sood
- From the Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh
| | - Davinder Paul
- Department of Medical Oncology, Fortis Hospital, Ludhiana, Punjab, India
| | - Bhagwant Rai Mittal
- From the Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh
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Arockiaraj M, Paul D, Clement J, Tigga S, Jacob K, Balasubramanian K. Novel molecular hybrid geometric-harmonic-Zagreb degree based descriptors and their efficacy in QSPR studies of polycyclic aromatic hydrocarbons. SAR QSAR Environ Res 2023; 34:569-589. [PMID: 37538006 DOI: 10.1080/1062936x.2023.2239149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/16/2023] [Indexed: 08/05/2023]
Abstract
The physicochemical characteristics of polycyclic aromatic compounds critical to environmental modelling such as octanol partition coefficients, solubility, lipophilicity, polarity and several equilibrium constants are functions of their underlying molecular structures, prompting the development of mathematical models to predict such characteristics for which experimental results are difficult to obtain. We propose twelve novel descriptors derived from geometric, harmonic and Zagreb degree-based descriptors and then test the effectiveness of these descriptors on a data set consisting of 55 benzenoid hydrocarbons of environmental importance. Our computations show that the proposed descriptors have a good linear correlation and predictive power when compared to the degree and distance type descriptors. We have also derived the QSPR expressions for four properties of a large series of polycyclic aromatics arising from circumscribing coronenes and show that a scaling factor can be deduced to derive physicochemical properties of such series up to 2D graphene sheets.
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Affiliation(s)
- M Arockiaraj
- Department of Mathematics, Loyola College, Chennai, India
| | - D Paul
- Department of Mathematics, Sri Sairam Institute of Technology, Chennai, India
| | - J Clement
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Vellore, India
| | - S Tigga
- Department of Mathematics, Loyola College, Chennai, India
| | - K Jacob
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Vellore, India
| | - K Balasubramanian
- School of Molecular Sciences, Arizona State University, Tempe, AZ, USA
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Bansal A, Singla A, Paul D, Kaur S. Pembrolizumab-Induced Lichen Planus: A Rare Immune-Related Adverse Side Effect. Indian Dermatol Online J 2023; 14:391-394. [PMID: 37266094 PMCID: PMC10231724 DOI: 10.4103/idoj.idoj_377_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/02/2022] [Accepted: 12/11/2022] [Indexed: 06/03/2023] Open
Abstract
Pembrolizumab is the first anti-programmed death protein-1 agent approved by the US Food and Drug Administration. It has demonstrated efficacy in melanoma, lung cancer, and other advanced solid tumours and hematologic malignancies. Various dermatological side effects including pruritus, maculopapular rash, vitiligo, lichenoid skin reactions, psoriasis, and rarely life-threatening conditions like bullous pemphigoid, Stevens-Johnson syndrome, and drug rash with eosinophilia and systemic symptoms have been reported. We report a case of pembrolizumab-induced lichen planus in a 54-year-old female who was receiving pembrolizumab for management of lung metastasis from squamous cell carcinoma of the buccal mucosa. The lichen planus responded to acitretin and pembrolizumab was continued safely.
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Affiliation(s)
- Aditi Bansal
- Department of Dermatology, Venereology and Leprology, Deep Hospital, Ludhiana, Punjab, India
| | - Ankur Singla
- Department of Dermatology, Venereology and Leprology, Ludhiana, Punjab, India
| | - Davinder Paul
- Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Sukhjot Kaur
- Department of Dermatology, Venereology and Leprology, Ludhiana, Punjab, India
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Parikh PM, Aggarwal S, Biswas G, Gulia S, Agarwala V, Basade M, Mohapatra P, Vamshi KM, Warrier A, Prasad K, Roy P, Chandrakant M, Malhotra H, Hingmire S, Paul D, Maniar V, Gupta A, Panda SS, Samar A, Rohatgi N, Dattatreya S, Krishnamurthy M, Thirumalairaj R. Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries. South Asian J Cancer 2023; 12:93-99. [PMID: 37969669 PMCID: PMC10635760 DOI: 10.1055/s-0043-1771445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
Purvish M. ParikhCancer-associated anemia (CAA) remains a major unmet need that compromises overall survival (OS) and quality of life (QoL). Currently, available guidelines do not take into consideration the unique challenges in low- and middle-income countries (LMIC). Our CAA patients have to battle preexisting impaired nutritional status, depleted body iron stores, financial limitations, and difficulty in having easily accessible affordable healthcare. Hence, we fulfilled the need of guidelines for LMIC. A group of subject experts were put together, given background literature, met in a face-to-face discussion, voted using Delphi process, and finally agreed on the contents of this guideline document. As many as 50% of cancer patients will have significant anemia (hemoglobin < 10 g/dL) at initial diagnosis. It is most commonly seen with gastrointestinal malignancies, head and neck cancers, and acute leukemias. The hemoglobin falls further after initiation of cancer directed therapy, due to chemotherapy itself or heightened nutritional deficiency. Its evaluation should include tests for complete blood count, red blood cell morphology, reticulocyte count, Coombs test, and levels of vitamin B12 and folic acid. Iron status should be monitored using test to measure serum iron, total iron binding capacity, transferring saturation, and serum ferritin levels. A minimum of 50% of cancer patients with anemia require iron supplements. The preferred mode of therapy is with intravenous (IV) iron using ferric carboxymaltose (FCM). Most patients respond satisfactorily to single dose of 1000 mg. It is also safe and does not require use of a test dose. Significant anemia is found in at least half of all cancer patients in India, South Asian Association for Regional Cooperation region, and other LMIC countries. Its awareness among healthcare professionals will prevent it from remaining undiagnosed (in up to 70% of all cancer patients) and adversely affecting OS and QoL. The benefits of treating them with IV iron therapy are quick replenishment of iron stores, hemoglobin returning to normal, better QoL, and avoiding risk of infections/reactions with blood transfusions. Many publications have proven the value of single-dose FCM in such clinical situations. CAA has been proven to be an independent prognostic factor that adversely affects both QoL and OS in cancer patients. Use of FCM as single IV dose of 1000 mg is safe and effective in the majority of patients with CAA.
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Affiliation(s)
- Purvish Mahendra Parikh
- Department of Clinical Hematology, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
| | - Shyam Aggarwal
- Department of Medical Oncology, Sir Gangaram Hospital, New Delhi, India
| | - Ghanashyam Biswas
- Department of Medical Oncology, Sparsh Hospitals and Critical Care Private Ltd., Bhubaneswar, Odisha, India
| | - Seema Gulia
- Department of Medical Oncology, Tata Memorial Center, Mumbai, Maharashtra, India
| | - Vivek Agarwala
- Department of Medical Oncology, Narayana Superspeciality Hospital and Cancer Institute, Kolkata, West Bengal, India
| | - Maheboob Basade
- Department of Medical Oncology, Saifee Hospital, Mumbai, Maharashtra, India
| | - P.N. Mohapatra
- Department of Medical Oncology, Apollo Cancer Center, Kolkata, West Bengal, India
| | | | - Arun Warrier
- Department of Medical Oncology, Aster Medicity, Cochin, Kerala, India
| | - Krishna Prasad
- Department of Medical Oncology, Mangalore Institute of Oncology, Mangalore, Karnataka, India
| | - Partha Roy
- Department of Medical Oncology, Dr. Bhubaneswar Borooah Cancer Institute, Guwahati, Assam, India
| | - M.V. Chandrakant
- Department of Medical Oncology, Narayana Hospital, Howrah, West Bengal, India
| | - Hemant Malhotra
- Department of Medical Oncology, Mahatma Gandhi Medical College Hospital, Jaipur, Rajasthan, India
| | - Sachin Hingmire
- Department of Medical Oncology, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India
| | - Davinder Paul
- Department of Medical Oncology, Fortis Hospital, Ludhiana, Punjab, India
| | - Vashista Maniar
- Department of Medical Oncology, Mumbai Oncocare Center, Mumbai, Maharashtra, India
| | - Alok Gupta
- Department of Medical Oncology, Medanta Hospital, Lucknow, Uttar Pradesh, India
| | - Soumya S. Panda
- Department of Medical Oncology, The Institute of Medical Sciences and Sum Hospital, Bhubaneswar, Odisha, India
| | - Aseem Samar
- Department of Medical Oncology, Bhagwan Mahavir Cancer Hospital & Research Center, Jaipur, Rajasthan, India
| | - Nitesh Rohatgi
- Department of Medical Oncology, Fortis Cancer Institute, Delhi, India
| | - Satya Dattatreya
- Department of Medical Oncology, Renova Soumya Hospital, Secundarabad, Telangana, India
| | | | - Raja Thirumalairaj
- Department of Medical Oncology, Apollo Cancer Center, Chennai, Tamil Nadu, India
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Singh S, Singh J, Mehta A, Sharma R, Joshi K, Jain K, Paul D, Oberoi G, Jindal N, Dhillon B, Narang V. Distinctive Attributes of Indian Patients With Classical BCR::ABL1 Negative Myeloproliferative Neoplasms: Unified Clinical and Laboratory Data. Clin Lymphoma Myeloma Leuk 2023; 23:360-369.e1. [PMID: 36849307 DOI: 10.1016/j.clml.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/29/2023]
Abstract
INTRODUCTION We report one of the largest single center data from a mixed referral setting in India describing baseline characteristics and outcomes of patients with classical BCR::ABL1 negative myeloproliferative neoplasms (MPNs). MATERIALS AND METHODS Patients diagnosed from June 2019 to 2022 were included. Workup and treatment was as per current guidelines. RESULTS Diagnosis comprised polycythemia vera (PV) in 51(49%), ET in 33(31.7%) and prefibrotic primary myelofibrosis (MF) pre fibrotic myelofibrosis (prePMF) and myelofibrosis in 10(9.6%) patients each. Median age at diagnosis was 52 years for PV and ET, 65.5 for MF and 79 years for prePMF. Diagnosis was incidental in 63(56.7%) and after thrombosis in 8(7.2%) patients. Baseline next generation sequencing (NGS) was available for 63(60.5%) patients. Driver mutations in PV: JAK2 in 80.3%; in ET: JAK2 in 41%, CALR in 26%, MPL in 2.9%; in prePMF JAK2 in 70%, CALR in 20%, MPL in 10%, and in MF: JAK2 in 10%, MPL in 30% and CALR in 40%. Seven novel mutations were detected of which 5 were potentially pathogenic on computational analysis. After median follow up of 30 months, 2 patients had disease transformation and none had new episodes of thrombosis. Ten patients died, most commonly with cardiovascular events(n = 5,50%). Median overall survival was not reached. Mean OS time was 10.19 years(95%CI, 8.6 to 11.74) and mean time to transformation was 12.2 years(95% CI,11.8 to 12.6). CONCLUSION Our data indicates comparatively indolent presentation of MPNs in India with younger age and lower risk of thrombosis. Further follow up will enable correlation with molecular data and guide modification of age based risk stratification models.
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Affiliation(s)
- Suvir Singh
- Department of Clinical Haematology and Stem Cell Transplantation, Dayanand Medical College and Hospital, Ludhiana, India.
| | - Jagdeep Singh
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Arpan Mehta
- Neuberg Supratech Reference Laboratories, Ahmedabad, India
| | - Rintu Sharma
- Department of Clinical Haematology and Stem Cell Transplantation, Dayanand Medical College and Hospital, Ludhiana, India
| | - Kaveri Joshi
- Department of Clinical Haematology and Stem Cell Transplantation, Dayanand Medical College and Hospital, Ludhiana, India
| | - Kunal Jain
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Davinder Paul
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Gurleen Oberoi
- Department of Hematopathology, All India Institute of Medical Sciences, New Delhi, India
| | - Nandita Jindal
- Department of Molecular Genetics, Dayanand Medical College and Hospital, Ludhiana, India
| | - Barjinderjit Dhillon
- Department of Molecular Genetics, Dayanand Medical College and Hospital, Ludhiana, India
| | - Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
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Tandon R, Sachdeva S, Gupta R, Paul D. Primary Cardiac Lymphoma: Case Series. J Indian Acad Echocardiogr Cardiovasc Imaging 2023. [DOI: 10.4103/jiae.jiae_49_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Jeklin A, Alamgeer M, Stirling R, Maccora J, Kumarahuru R, Paul D, Afsana A, Wiley J. P2.08-02 Burning the Candle at Both Ends-Sleep Quality Before and After Chemotherapy in Lung Cancer Patients - A Systematic Review and Meta-Analysis. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Soni A, Jindal S, Narang V, Singh A, Paul D, Kaur H. Isolated pancreatic myeloid sarcoma: A potential mimicker of pancreatic adenocarcinoma. INDIAN J PATHOL MICR 2022; 65:676-678. [PMID: 35900500 DOI: 10.4103/ijpm.ijpm_202_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Myeloid sarcoma (MS) is an extramedullary proliferation of immature myeloid cells which may occur as a progression of myelodysplastic syndrome (MDS), myeloproliferative neoplasm (MPN), or myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) and as acute myeloid leukemia (AML) relapse. Rarely may it be de novo. Lymph nodes, skin, lungs, intestine are the commonly involved sites. However, an isolated pancreatic MS is seldom reported in the literature. Herein, we report one such case which was misdiagnosed as pancreatic adenocarcinoma on the clinico-radiological examination which misled us away from preoperative diagnostic sampling, and a Whipple pancreaticoduodenectomy was performed. Histopathological examination in conjunction with immunohistochemistry revealed the final diagnosis of isolated MS of the pancreas. We emphasize that although rare, a clinical suspicion along with preoperative histopathological examination may lead to early diagnosis, targeted management, and a better clinical outcome in such cases.
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Affiliation(s)
- Ankita Soni
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Saveena Jindal
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Aminder Singh
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Davinder Paul
- Department of Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Paul D, Bhuiya MI, Paul UK, Dey B, Khan MK. Chest HRCT Severity Scores among Hospitalized Patients with COVID-19. Mymensingh Med J 2022; 31:819-825. [PMID: 35780369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Corona Virus Disease 2019 (COVID-19) was declared a pandemic in March 2020. This global health crisis caused thousands of pneumonia related death all over the world since December 2019. RT-PCR is the primary test for diagnosis of COVID-19, though its sensitivity and specificity is variable. Several studies revealed that chest HRCT complements RT-PCR in highly suspected cases or in false negative RT-PCR and helps to gauge disease severity. This study was carried out with an aim to find out the severity scores of chest HRCT in hospitalized patients with COVID-19. This cross sectional descriptive type of observational study was carried out at COVID-19 unit of Sylhet Women's Medical College Hospital, Bangladesh from April 2021 to September 2021. Data were collected from purposively selected 204 patients with COVID-19 by face to face interview, chest HRCT and necessary laboratory investigations. Informed written consent was taken from the participants of the study at the beginning of the interview. Data were analyzed by using SPSS version 21.0. The results of the study showed that mean age of the patients with COVID-19 was 57.9 years with a standard deviation of ±15.8 years. Majority of them (121, 59.3%) were female and the remaining (83, 40.7%) were male. Regarding co-morbidities it was found that each 115 (56.4%) patients were hypertensive and diabetic. Thirty five (16.2%) had ischemic heart disease; 3(1.5%) had congestive cardiac failure and 2(1.0%) had asthma. One (0.5%) patient has atrial fibrillation. In case of 160(78.4%) RT-PCR confirmed patients with COVID-19, chest HRCT was found positive and in 44(21.6%) it was found negative. Among the positive cases mild (7 or less) chest HRCT score was found in 26(12.7%) patients; moderate (8-17) score was found in highest number of patients (128, 62.7%) and severe (18 or more) chest HRCT score was found in 6(2.9%) patients with COVID-19. Chi-square test was carried out to assess the relation of chest HRCT scores with age group, sex, troponin-I, D-Dimer and clinical outcomes within CCU but statistically significant relation was not found (p>0.05). The negative scans were highest (20, 9.8%) in the age group of 41-60 years. Mild, moderate and severe chest HRCT scores was found highest in the age group of 61-80 years (13, 6.4%; 51, 25.0% and 5, 2.5% respectively) (p=0.508). Chest HRCT scans were negative in 18(8.8%) male and 26(12.7%) female. Mild scores were equally distributed between each sex i.e. male 13(6.4%) and female 13(6.4%). Both moderate and severe scores were found more in female (77, 37.7% and 5, 2.5% respectively) than male (51, 25.0% and 1, 0.5% respectively) (p=0.492). Negative chest HRCT scans, mild, moderate and severe scores-all were found more in patients with elevated D-Dimer (p=0.194). Among 204 patients one (0.5%) died in the CCU who had mild score of chest HRCT (p=0.076) but highly elevated Troponin-I (21.70ng/mL). Chest HRCT was found positive among 78.4% of patients with COVID-19 confirmed by RT-PCR. Chest HRCT can help physicians to detect suspected cases and to assess the severity and outcome of the disease. However, further research is recommended to clarify the role of chest HRCT in assessing severity of COVID-19 and prediction of prognosis.
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Affiliation(s)
- D Paul
- Dr Debashish Paul, Associate Professor, Department of Cardiology, Sylhet Women's Medical College, Bangladesh; E-mail:
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Burja B, Paul D, Gerber R, Edalat SG, Elhai M, Pachera E, Zingg RS, Pramotton FM, Madsen SF, Buerki K, Costanza G, Whitfield M, Bay-Jensen AC, Sodin-Šemrl S, Tomsic M, Kania G, Rehrauer H, Distler O, Rotar Z, Robinson M, Lakota K, Frank Bertoncelj M. OP0095 SINGLE-CELL RNA SEQUENCING REVEALS POTENT ANTI-INFLAMMATORY AND ANTIFIBROTIC ACTIVITIES OF DIMETHYL-ALPHA-KETOGLUTARATE ON EXPLANTED SKIN FROM PATIENTS WITH SYSTEMIC SCLEROSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundActivated fibroblasts are the main drivers of skin fibrosis in SSc. We have recently identified dimethyl alpha-ketoglutarate (dm-aKG) as a potential repressor of myofibroblast differentiation and profibrotic activity in cultured skin fibroblasts.ObjectivesTo further analyse the clinical translation of our findings by investigating the antifibrotic capacity of dm-aKG on explanted skin biopsies from SSc patients.MethodsWe cultured forearm punch skin biopsies from SSc patients (n=10) for 24h ex vivo in the presence/absence of 6 mM dm-aKG. Thereafter, skin biopsies (n=4) were dissociated into single cells using a combined mechanical-enzymatic dissociation protocol, followed by single cell (sc)RNA-seq library preparation (10x Genomics) and sequencing (Illumina, NovaSeq6000, 50,000 reads/cell). We mapped the scRNA-seq reads to the reference genome GRCh38.p13 and analysed the data with R/Bioconductor tools. We deconvoluted cell types in bulk skin transcriptomes from SSc cohorts (GSE: 45485, 59785, 9285, 32413) using human skin scRNA-seq data1. The secretion of IL-6, procollagen-1, PRO-C1 (N-terminal type I collagen pro-peptide), C1M (MMP-degradation fragment of type I collagen), and fibronectin (FBN-C) from cultured skin (n=10) was measured in supernatants by ELISA. We analysed gene and protein expression in TGFβ-activated healthy and SSc dermal fibroblasts (DF, n=10) treated or not with dm-aKG using qPCR, Western blot and ELISA. Contractile properties of DF were assessed by gel contraction assay. Traction forces generated by DF were determined by reference-free traction force microscopy.ResultsDissociated cultured SSc skin exhibited comparable cell yield and viability in the presence (20,203; 89%) and absence (25,280; 93%) of dm-aKG, respectively. scRNA-seq skin analysis included 20,869 high quality single cell profiles segregating into 10 distinct skin cell populations (Figure 1A). This analysis demonstrated decreased proportion of fibroblasts and increased proportion of keratinocytes in dm-aKG treated skin (p<0.05; Figure 1B). Among skin cell types, skin fibroblasts exhibited the largest amount of differentially expressed genes upon dm-aKG treatment (44%, n=779, x-fold>0.5, FDR<0.05), suggesting that these cells are key targets of dm-aKG therapy in SSc skin. We identified inflammatory/cytokine signalling (hub genes IL6, STAT1) and extracellular matrix (ECM) organization (hub genes MMP1, ITGB3) as top downregulated biological processes in fibroblasts in dm-aKG treated SSc skin (Figure 1C), coinciding with a decreased abundance of proinflammatory skin fibroblast subpopulation. Specifically, these cells were identified as the main source of IL6 (Figure 1D) and were enriched in SSc skin as revealed by deconvolution analysis of skin transcriptomes. Furthermore, dm-aKG reduced the secretion of IL-6, procollagen-1 and C1M, but not pro-C1 and FBN-C, from cultured skin explants. In cultured DF, dm-aKG blocked the inflammatory (IL-6, pSTAT3), profibrotic (aSMA, Fibronectin, Procollagen-1, Pro-C1) and contractile activities, and significantly diminished traction forces exerted by DF on the matrix substrate.Figure 1.scRNA-seq – comparison of untreated and dm-aKG treated paired skin biopsies. (A) UMAP plot with annotated skin cells, (B) differential abundance of main skin cell types, (C) volcano plot of DE genes with top downregulated gene ontology (GO) pathways in dm-aKG treated skin fibroblasts, (D) IL6 expression in untreated (blue) and treated (pink) skin fibroblasts.ConclusionDm-aKG broadly interferes with inflammatory and ECM organizational activities of skin fibroblasts in culture and in explanted skin from SSc patients. These results confirm that dm-aKG might represent a potential new therapeutic approach for efficient targeting of skin inflammation and fibrosis in SSc.References[1]He H et al. J Allergy Clin Immunol 2020AcknowledgementsThis work was supported by a research grant from FOREUM Foundation for Research in Rheumatology and University Medical Centre Ljubljana.Disclosure of InterestsBlaž Burja: None declared, Dominique Paul: None declared, Reto Gerber: None declared, Sam G. Edalat: None declared, Muriel Elhai Speakers bureau: BMS, Elena Pachera: None declared, Rahel S. Zingg: None declared, Francesca Michela Pramotton: None declared, Sofie Falkenløve Madsen: None declared, Kristina Buerki: None declared, Giampietro Costanza: None declared, Michael Whitfield: None declared, Anne-Christine Bay-Jensen: None declared, Snežna Sodin-Šemrl: None declared, Matija Tomsic: None declared, Gabriela Kania: None declared, Hubert Rehrauer: None declared, Oliver Distler Speakers bureau: Bayer, Boehringer Ingelheim, Janssen, Medscape, Consultant of: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, 4P Science, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur, Grant/research support from: Kymera, Mitsubishi Tanabe, Boehringer Ingelheim, Ziga Rotar: None declared, Mark Robinson: None declared, Katja Lakota: None declared, Mojca Frank Bertoncelj: None declared.
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Van Roekel D, LeBedis C, Santos J, Paul D, Qureshi M, Kasotakis G, Gupta A. Cholecystitis: association between ultrasound findings and surgical outcomes. Clin Radiol 2022; 77:360-367. [DOI: 10.1016/j.crad.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/01/2022] [Indexed: 12/07/2022]
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Singh S, Sharma R, Singh J, Jain K, Paul D. Autologous stem cell transplantation for multiple myeloma in the novel agent era: Systematic review of Indian data and implications for resource constrained settings. J Cancer Res Ther 2022; 19:S12-S19. [PMID: 37147978 DOI: 10.4103/jcrt.jcrt_503_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Treatment of multiple myeloma has undergone significant advances in the last two decades, leading to meaningful improvement in overall and progression free survival. The incurable nature of disease necessitates serial sequencing of treatment options and continuous therapy once disease remission is achieved. Autologous stem cell transplantation (ASCT) has continued to offer a meaningful survival advantage with a consistent reduction in toxicity and costs. Despite the advent of newer drugs leading to deeper and sustained responses, ASCT continues to be the standard of care for all eligible patients and is ostensibly more cost effective than continued treatment with newer agents. However, ASCT continues to be underutilized in India, due to concerns about cost, safety, and sporadic expertize. We present a systematic review of available data on ASCT for multiple myeloma from India to evaluate safety and efficacy of the procedure, and provide evidence re-affirming its utility in resource constrained settings.
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Singh S, Jain K, Sharma R, Singh J, Paul D. Epigenetic Modifications in Myeloma: Focused Review of Current Data and Potential Therapeutic Applications. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1732861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AbstractMultiple myeloma is a common hematologic malignancy with an incidence of 1 per 100,000 population and is characterized by a nearly 100% risk of relapse, necessitating treatment with newer therapeutic agents at each instance of progression. However, use of newer agents is often precluded by cost and accessibility in a resource-constrained setting. Description of newer pathways of disease pathogenesis potentially provides opportunities for identification of therapeutic targets and a better understanding of disease biology. Identification of epigenetic changes in myeloma is an emerging premise, with several pathways contributing to pathogenesis and progression of disease. Greater understanding of epigenetic alterations provides opportunities to detect several targetable enzymes or pathways that can be of clinical use.
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Affiliation(s)
- Suvir Singh
- Department of Clinical Hematology and Stem Cell Transplantation, Dayanand Medical College, Ludhiana, Punjab, India
| | - Kunal Jain
- Department of Medical Oncology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Rintu Sharma
- Department of Clinical Hematology and Stem Cell Transplantation, Dayanand Medical College, Ludhiana, Punjab, India
| | - Jagdeep Singh
- Department of Medical Oncology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Davinder Paul
- Department of Medical Oncology, Dayanand Medical College, Ludhiana, Punjab, India
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Popotte C, Devic C, Munier M, Moreno R, Rousseau H, Perlongo S, Pilleul F, Paul D. Multicentric comparative study of dose indexes using an “in vivo” optical fiber detection system. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00272-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Jain S, Narang V, Jain K, Paul D, Singh J, Sohi AS, Sood S, Aggarwal R, Sood N, Brar GS. Prevalence of Molecular Subtypes in Operated Cases of Breast Cancer and Its Clinicopathological Correlation: A Single Institute Study from a Tertiary Cancer Centre in North India. Indian J Surg Oncol 2021; 12:538-544. [PMID: 34658582 DOI: 10.1007/s13193-021-01374-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/12/2021] [Indexed: 12/24/2022] Open
Abstract
Breast cancer has emerged as a major health problem among women in India. There are few Indian studies which have looked at prevalence of molecular subtypes of breast cancer in Indian population. The primary objective of our study was to find out the prevalence of various molecular subtypes in operated cases of breast cancer patients presenting to us. Three hundred sixty patients who were operated in our department were analysed. Clinicopathological features of all cases were recorded. Classification into various molecular subtypes was done using St. Gallen 2013 criteria. Luminal B HER2 negative was the predominant molecular subtype in our study population constituting 30.3% of patients. The percentage of aggressive subtypes, viz. triple negative breast cancer and HER2 enriched, were 21.7% and 11.4% respectively. Only 19.4% of patients in our study population had tumour size ≤ 2 cm with nodes being positive in 56.9% of our patients at presentation. Data from our study and other studies published from India show that the two most aggressive subtypes of, viz. triple negative breast cancer and HER2 enriched, may be more prevalent in our population as compared to western population.
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Affiliation(s)
- Sumeet Jain
- Department of Surgical Oncology, DMCH Cancer Care Centre, Ludhiana, India
| | - Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital (DMCH), Ludhiana, India
| | - Kunal Jain
- Department of Medical Oncology, DMCH Cancer Care Centre, Ludhiana, India
| | - Davinder Paul
- Department of Medical Oncology, DMCH Cancer Care Centre, Ludhiana, India
| | - Jagdeep Singh
- Department of Medical Oncology, DMCH Cancer Care Centre, Ludhiana, India
| | | | - Sandhya Sood
- Department of Radiation Oncology, DMCH Cancer Care Centre, Ludhiana, India
| | - Ritu Aggarwal
- Department of Radiation Oncology, DMCH Cancer Care Centre, Ludhiana, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College and Hospital (DMCH), Ludhiana, India
| | - G S Brar
- Department of Surgical Oncology, DMCH Cancer Care Centre, Ludhiana, India
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Croitoru V, Cazacu I, Paul D, Colita A, Lungulescu C, Herlea V, Luca N, Bogdan D, Sandra I, Gramaticu IM, Buica F, Dinu M, Sorop A, Dima S, Popescu I, Croitoru A, Alina T. 83TiP Clinical implications of clonal hematopoiesis mutations in patients with solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Cazacu I, Filippi A, Croitoru V, Kitahara S, Matsui A, Lauwers G, Sorop A, Necula L, Matei L, Pechianu C, Croitoru A, Herlea V, Saftoiu A, Paul D, Chivu-Economescu M, Dima S, Duda D, Popescu I. 34P Validation of a new scoring system for molecular subtyping of gastric cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Cazacu I, Croitoru V, Paul D, Popa E, Matei I, Gheorghe C, Herlea V, Diculescu M, Bogdan D, Sandra I, Gramaticu IM, Luca N, Dinu I, Alexandrescu S, Sorop A, Croitoru A, Dima S, Popescu I, Lyden D. 84TiP Predictive value of exosomes for therapy response in resectable/borderline resectable pancreatic cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sidhu MS, Paul D, Jain S, Brar GS, Sood S, Jain K. Prognostic factor for recurrence in esophagus cancer patients who underwent surgery for curative intent: A single-institution analysis. J Cancer Res Ther 2021; 17:1376-1381. [PMID: 34596602 DOI: 10.4103/jcrt.jcrt_1702_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective The purpose of this study is to analyze predisposing factors for a higher risk of recurrence in esophageal cancer patient who underwent surgery for curative intent and to do survival analysis of prognostic factors. Materials and Methods Between February 2018 and March 2020, we retrospectively identified 28 cases staged T1b to T4a managed electively at our institute as per multidisciplinary management plan. Demographic, clinical, radiological, operative, histopathological parameters, upfront surgery done or not, type of preoperative, and adjuvant treatment used and whether neoadjuvant or adjuvant therapy was planned along with waiting time for surgery, were assessed as potential risk factors. End point of study was to find potential risk factors for recurrence and to do their subgroup survival analysis. Results The recurrence rate in our study was 25% with a mean follow-up of 24 months. The median time of recurrence was 8.5 months, all recurrence occurred within 1 year. Overall DFS at 2 years was 72%. On univariate analysis, following prognostic factors were associated with high risk of recurrence, male sex X2 (1) =4.42, p = 0.035; histology subtype of adenocarcinoma X2 (1) = 7.07, p = 0.008; margin positive X2 (1) =3.76, p = 0.05; presence of lymph vascular invasion (LVI) X2 (1) =7.88, p = 0.005; presence of perineural invasion (PNI) X2 (1) =5.97, p = 0.015; postoperative T size >4 cm X2 (1) =3.86, p = 0.049; and nodal positivity X2 (3) =13.47, p = 0.004. Conclusions Male sex, adenocarcinoma histological subtype, positive resected margin, presence of LVI and PNI, postoperative T size >4 cm, and high postoperative nodal positivity and whether neoadjuvant versus adjuvant therapy given (on K. M analysis) were the identified predictors of recurrence which compromised DFS.
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Affiliation(s)
- Manjinder S Sidhu
- Department of Radiation Oncology, DMCH cancer center, Ludhiana, Punjab, India
| | - Davinder Paul
- Department of Medical Oncology, DMCH cancer center, Ludhiana, Punjab, India
| | - Sumeet Jain
- Department of Surgical Oncology, DMCH cancer center, Ludhiana, Punjab, India
| | - Gurpreet S Brar
- Department of Surgical Oncology, DMCH cancer center, Ludhiana, Punjab, India
| | - Sandhya Sood
- Department of Radiation Oncology, DMCH cancer center, Ludhiana, Punjab, India
| | - Kunal Jain
- Department of Medical Oncology, DMCH cancer center, Ludhiana, Punjab, India
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Paul B, Paul D. Comparative Analysis of Municipal Solid Waste Management in Kochi and Indore. NEPT 2021. [DOI: 10.46488/nept.2021.v20i03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Conventionally, the general understanding of Municipal Solid Waste (MSW) management is collecting solid waste and its disposal through its developed channels or outside contracts. However, depending upon the situation and context, the definition of MSW varies between countries across the globe. For instance, in countries like Singapore and Japan, Municipal Solid Waste is defined as general waste. However, while categorizing the general waste, the industrial waste component is considered for Singapore and not for Japan. Similarly, different countries associate different definitions for MSW and it becomes a difficult challenge to suggest a single unified definition applicable for all countries. This paper aims to do a comparative analysis of Waste management in Tier-II cities of India, Kochi and Indore. Kochi is ranked 372nd and the latter 1st according to the latest Swachh Survekshan undertaken as part of the Swachh Bharat Abhiyan (Urban) by the Ministry of Housing and Urban Affairs. This paper highlights what the key elements missing out in the management of waste in Kochi from the reference perspective of Indore and identifying the measures Kochi needs to undertake to improve its ranking among the cleanest city in India are.
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Singh S, Paul D, Jain K, Singh J. Mitigation of in-hospital risk of coronavirus disease 2019: Experience from a haematology-oncology and stem cell transplant setting. Natl Med J India 2021; 34:10-14. [PMID: 34396997 DOI: 10.4103/0970-258x.315901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background . Coronavirus disease 2019 (Covid-19) was first described in December 2019 and has evolved into an ongoing global pandemic. Cancer patients on chemotherapy are immunocompromised and are at the highest risk of Covid-19-related complications. We describe our experience with the management of haematology-oncology and stem cell transplant (SCT) patients receiving curative chemotherapy in a hospital with a high influx of Covid-19 patients. Methods . We did a prospective observational study at a 99-bedded cancer centre of a tertiary care teaching hospital from April 2020 to September 2020. Preventive measures taken were categorized as follows: (i) staff: screening, mandatory use of personal protective equipment (PPE), risk stratification of potential exposure and testing and isolation as needed; (ii) patients: mandatory viral polymerase chain reaction testing, segregation of positive and untested patients and testing of family members; and (iii) environment: mandatory regular cleaning, visitor restriction, telemedicine services and reassignment of priority to clinic visits. Treatment of the underlying conditions was continued with added precautions. Results . A total of 54 patients were included in the analysis, including 48 with haematological malignancies and 6 for stem cell therapy. Preventive measures were universally applied, and chemotherapy with a curative intent was initiated as per protocol. Three patients were detected to have Covid-19 infection before admission and one after the institution of chemotherapy. Nine patients died after the first cycle of chemotherapy, 2 due to severe Covid-19-related illness and 7 due to complications of chemotherapy or disease progression. Conclusions . In the wake of the Covid-19 pandemic, treatment for haematological malignancies must continue while balancing the risk of Covid-19 infections. Our report emphasizes the effectiveness of measures such as hand hygiene, social isolation, patient segregation, use of masks and PPE and universal pre-treatment testing for Covid-19 in reducing the risk of infection in a high-risk clinical setting.
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Affiliation(s)
- Suvir Singh
- Clinical Haematology and Stem Cell Transplantation, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
| | - Davinder Paul
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
| | - Kunal Jain
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
| | - Jagdeep Singh
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
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Singh S, Jain K, Singh J, Paul D. Multidrug Resistant Infections in Paediatric AML: An Ominous Sign of the Times to Come. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1731842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Suvir Singh
- Department of Clinical Hematology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Kunal Jain
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Jagdeep Singh
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Davinder Paul
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Sidhu M, Paul D, Sood S, Jain K, Singh J, Aggarwal R, Sood D. Risk Factors of Biochemical Failure in Locally Advanced Carcinoma Prostate Treated With Definitive External Beam Radiotherapy and Androgen Deprivation Therapy: Experience From Tertiary Care Center in North India. Cureus 2021; 13:e16895. [PMID: 34513468 PMCID: PMC8412057 DOI: 10.7759/cureus.16895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2021] [Indexed: 11/05/2022] Open
Abstract
Background Locally advanced prostate cancer (LACAP), despite external beam radiotherapy (EBRT) along with antiandrogen therapy (ADT) has risk of prostate-specific antigen (PSA) progression. Furthermore, number of studies have emphasized on different prognostic factors. The purpose of our study is to analyze risk factors for biochemical failure (BF) in these patients treated at our institute. Methods Our study is a single-institution retrospective observational done at a tertiary care center in North India. Between January 2018 and December 2020, we retrospectively identified 34 patients managed at our institute as per multidisciplinary board (MBD). Demographic, clinical, radiological, pathological and treatment-related parameters were assessed as potential risk factors. End-point of the study was to find significant risk factors for BF. Statistical analysis was done on SPSS, version 20 (IBM Corp., Armonk, NY). Results All eligible patients received EBRT with ADT as per institution policy. Mean follow-up period was 20 months during which two (5.9%) patients had BF at a mean of 30 months after EBRT. Four-year PSA-progression-free survival rate was 73%. On univariate analysis, prognostic factors associated with high risk of BF were Gleason score and clinical T stage. Conclusion In summary, prognostic factors for high risk of BF leading to clinical progression are Gleason score 9 or 10 and clinical T3b stage.
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Affiliation(s)
- Manjinder Sidhu
- Radiation Oncology, Dayanand Medical College & Hospital (DMCH) Cancer Center, Ludhiana, IND
| | - Davinder Paul
- Medical Oncology, Dayanand Medical College & Hospital (DMCH) Cancer Center, Ludhiana, IND
| | - Sandhya Sood
- Radiation Oncology, Dayanand Medical College & Hospital (DMCH) Cancer Center, Ludhiana, IND
| | - Kunal Jain
- Medical Oncology, Dayanand Medical College & Hospital (DMCH) Cancer Center, Ludhiana, IND
| | - Jagdeep Singh
- Medical Oncology, Dayanand Medical College & Hospital (DMCH) Cancer Center, Ludhiana, IND
| | - Ritu Aggarwal
- Radiation Oncology, Dayanand Medical College & Hospital (DMCH) Cancer Center, Ludhiana, IND
| | - Divyaanshi Sood
- Oncology, Dayanand Medical College & Hospital (DMCH), Ludhiana, IND
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Sharma A, Tyagi R, Selhi PK, Paul D, Aslam N, Kaur H, Sood N. Lymphophagocytosis in Pleural and Pericardial Fluids: An Ominous Finding. J Lab Physicians 2021; 13:95-96. [PMID: 34054245 PMCID: PMC8154341 DOI: 10.1055/s-0041-1727582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Aastha Sharma
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Ruchita Tyagi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Pavneet Kaur Selhi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Davinder Paul
- Department of Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Naved Aslam
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Singh S, Kaur K, Paul D, Jain K, Singh J, Narang V, Garg B, Sood N, Dhillon B. Clinical and Molecular Attributes of Patients With BCR/ABL1-negative Myeloproliferative Neoplasms in India: Real-world Data and Challenges. Clin Lymphoma Myeloma Leuk 2021; 21:e569-e578. [PMID: 33757770 DOI: 10.1016/j.clml.2021.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Classic BCR/ABL1-negative myeloproliferative neoplasms (MPNs) are characterized by clinical and genetic heterogeneity and include 4 distinct constituents. Very little data on clinical presentation and epidemiology of the same is available from the Indian setting. PATIENTS AND METHODS Patients referred to Hematology-Oncology from January 2018 to August 2020 with suspected MPNs were included in the analysis and prospectively followed-up. All patients were initially screened, and only those meeting the updated World Health Organization 2016 criteria were included in the analysis. Epidemiologic, clinical, and molecular characteristics were documented, and patients were followed-up prospectively. RESULTS A total of 233 patients were referred for evaluation of MPN, of which 63 were included in the analysis, including 39 males and 24 females. The median age at diagnosis was 57 years (range, 28-82 years), and 38% patients were younger than 50 years of age. The most common presentations were incidental detection in 35 (55.5%), abdominal symptoms in 13 (20%), fatiguability in 7 (11%), and recent vascular events in 6 (9.5%) patients. Final diagnosis was polycythemia vera in 27, essential thrombocytosis (ET) in 21, prefibrotic myelofibrosis in 9, and myelofibrosis in 6 patients. The frequency of driver mutations in polycythemia vera included JAK2 in 75%; in ET, JAK2 in 33%, CALR in 33%, and MPL in 4%; and in prefibrotic myelofibrosis, JAK2 in 66% and CALR in 33%. Aspirin was used for all patients along with risk-adapted cytoreduction with hydroxyurea. Ruxolitinib was reserved for symptoms refractory to hydroxyurea. After a median follow-up of 15 months (interquartile range, 10-28 months) from diagnosis, disease progression was noted in 4 patients. Two patients died at the end of the follow-up period, including 1 with secondary acute myeloid leukemia post myelofibrosis and one with ET and coexistent oral malignancy. The remaining 61 patients are alive and on regular treatment. RESULTS This is one of the first systematic descriptions and prospective follow-up of patients with BCR/ABL-negative MPNs from India. Our study indicates a younger median age of presentation and higher proportion of JAK2-unmutated disease across all subtypes. The primary role of bone marrow morphology and supportive role of somatic mutations in differentiating MPN subtypes is indicated. CONCLUSIONS This study sets the stage for a collaborative registry for defining epidemiologic data and long-term outcomes with MPN in India.
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Affiliation(s)
- Suvir Singh
- Department of Clinical Haematology and Stem Cell Transplantation, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
| | - Komalpreet Kaur
- Department of Clinical Haematology and Stem Cell Transplantation, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Davinder Paul
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Kunal Jain
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Jagdeep Singh
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Barjinderjit Dhillon
- Molecular Genetics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Singh S, Singh J, Paul D, Jain K. Treatment of Acute Leukemia During COVID-19: Focused Review of Evidence. Clin Lymphoma Myeloma Leuk 2021; 21:289-294. [PMID: 33558204 PMCID: PMC7801183 DOI: 10.1016/j.clml.2021.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/02/2021] [Accepted: 01/06/2021] [Indexed: 01/28/2023]
Abstract
The Coronavirus disease-2019 (COVID-19) pandemic is an unprecedented health care crisis and has led to over 1.5 million deaths worldwide. The risk of severe COVID-19 and mortality is markedly raised in patients with cancer, prompting several collaborative groups to issue guidelines to mitigate the risk of infection by delaying or de-escalating immunosuppressive therapy. However, delayed therapy is often not feasible for patients requiring treatment for acute leukemia or stem cell transplantation. We provide a focused review of the recommendations and evidence for managing this high-risk group of patients while minimizing the risk of COVID-19 infection, and provide a small snapshot of treatment data from our center.
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Affiliation(s)
- Suvir Singh
- Department of Clinical Hematology and Stem Cell Transplantation, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
| | - Jagdeep Singh
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Davinder Paul
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Kunal Jain
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Surati U, Paul D. Animal genetic resources in Goa: an overview. Journal of Livestock Science 2021. [DOI: 10.33259/jlivestsci.2021.37-41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Singh S, Singh K, Singh J, Paul D, Jain K. Altered oral intake during hematopoietic stem cell transplantation: Patterns and countermeasures. Indian J Med Spec 2021. [DOI: 10.4103/injms.injms_173_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Singh S, Jain K, Paul D, Singh J. A review of the pathological mechanisms and clinical implications of coagulopathy in COVID-19. J Appl Hematol 2021. [DOI: 10.4103/joah.joah_19_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Singh S, Singh J, Paul D, Jain K. Efficacy of single-agent cytarabine in adult langerhans cell histiocytosis: Short report and summary of treatment data for a rare disease. J Appl Hematol 2021. [DOI: 10.4103/joah.joah_5_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Noronha V, Patil VM, Joshi A, Bhattacharjee A, Paul D, Dhumal S, Juvekar S, Arya S, Prabhash K. A tertiary care experience with paclitaxel and cetuximab as palliative chemotherapy in platinum sensitive and nonsensitive in head and neck cancers. South Asian J Cancer 2020; 6:11-14. [PMID: 28413788 PMCID: PMC5379885 DOI: 10.4103/2278-330x.202558] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: The combination of paclitaxel and cetuximab (PaCe) has led to an encouraging response rate in Phase 2 setting with limited toxicity. The aim of our study was to assess the efficacy of this regimen in our setting in platinum sensitive and nonsensitive patients. Methods: This was a retrospective analysis of head and neck cancer patients treated with weekly PaCe as palliative chemotherapy between May 2010 and August 2014. The standard schedule of cetuximab along with 80 mg/m2 of weekly paclitaxel was administered till either disease progression or withdrawal of patient's consent. The toxicity and response were noted in accordance with CTCAE version 4.02 and RECIST version 1.1 criteria, respectively. The response rates between platinum sensitive and nonsensitive patients were compared by Chi-square test. Overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan–Meier survival method and log-rank test was used for comparison. Cox proportional hazard model was used for identification of factors affecting PFS and OS. Results: One Hundred patients with a median age of 52 years (interquartile range: 46–56 years) were included. Forty-five patients (45%) were platinum insensitive, whereas 55 patients (55%) were platinum sensitive. In platinum insensitive patients and sensitive patients, the response rates were 38.5% and 22.2%, respectively (P = 0.104), whereas the symptomatic benefit in pain was seen in 89.5% and 71.7%, respectively (P = 0.044). The median PFS in platinum insensitive and sensitive patients were 150 and 152 days, respectively (P = 0.932), whereas the median OS was 256 days (95% confidence interval [95% CI]: 168.2–343.8 days) and 314 days (95% CI: 227.6–400.4 days), respectively (P = 0.23). Nineteen patients (19%) had grades 3–4 adverse events during chemotherapy. Conclusion: Weekly paclitaxel combined with cetuximab has promising efficacy and good tolerability in the palliative setting in advanced head and neck cancer in both platinum sensitive and insensitive patients.
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Affiliation(s)
- Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vijay M Patil
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Atanu Bhattacharjee
- Division of Clinical Research and Biostatistics, Malabar Cancer Centre, Kannur, Kerala, India
| | - Davinder Paul
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sachin Dhumal
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Shashikant Juvekar
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Supreeta Arya
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Dasgupta N, Paul D. Expansion and persistence of blaCTXM gene within clinical-environmental interface: A study from India. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Chowdhury P, Baidya S, Saikia G, Paul D, Karmakar S, Kalita B. Distribution and breeding habitats of Aedes: Implications for risk of potential arboviral outbreaks in urban Tripura, India. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Deshamukhya C, Bhattacharjee A, Das B, Paul D, Chanda DD. cupA1/cupA5 gene overexpressed at subinhibitory concentration of carbapenem in biofilm forming Pseudomonas aeruginosa: Transcriptomic study from India. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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37
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Crouthamel B, Dixit A, Pearson E, Menzel J, Paul D, Shakhider A, Silverman J, Averbach S. P14 Intimate partner violence is associated with self-managed abortion in Bangladesh. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Erickson ML, Mey JT, Axelrod CL, Paul D, Gordesky L, Russell K, Barkoukis H, O'Tierney-Ginn P, Fielding RA, Kirwan JP, Catalano PM. Rationale and study design for lifestyle intervention in preparation for pregnancy (LIPP): A randomized controlled trial. Contemp Clin Trials 2020; 94:106024. [PMID: 32389808 DOI: 10.1016/j.cct.2020.106024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Maternal obesity increases neonatal risk for obesity and metabolic syndrome later in life. Prior attempts to break this intergenerational obesity cycle by limiting excessive gestational weight gain have failed to reduce neonatal adiposity. Alternatively, pre-conception lifestyle interventions may improve the in utero metabolic milieu during early pregnancy leading to improved fetal outcomes. This randomized controlled trial (RCT) is evaluating whether a lifestyle intervention to reduce weight and improve maternal metabolism in preparation for pregnancy (LIPP) attenuates neonatal adiposity, compared to standard medical advice. MATERIAL AND METHODS Overweight/class 1 obese women after a previous pregnancy, ~12 weeks postpartum, preparing for a subsequent pregnancy, will be block randomized (1:1) to either LIPP or standard of care in a parallel design. Randomization is stratified by lactation status and overweight vs. class 1 obesity. The LIPP program consists of intensive short-term weight loss followed by weight maintenance until conception using supervised exercise and a low glycemic Mediterranean diet. PRIMARY OUTCOMES Group differences in neonatal adiposity at birth assessed by PEA POD and placental mitochondrial lipid metabolism. SECONDARY OUTCOMES Group differences in maternal pregravid and gestational body composition, insulin sensitivity, β-cell function, fasting metabolic and inflammatory biomarkers, and overall quality of life. Exploratory outcomes include umbilical cord blood insulin resistance, lipid profile and inflammation. DISCUSSION This RCT will determine the efficacy of maternal weight loss prior to pregnancy on reducing neonatal adiposity. Findings may change standard obstetrical care by providing Level 1 evidence on lifestyle interventions improving neonatal outcomes for women planning for pregnancy. CLINICAL TRIAL REGISTRATION NCT03146156.
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Affiliation(s)
- M L Erickson
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America
| | - J T Mey
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America
| | - C L Axelrod
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America; Department of Translational Services, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America
| | - D Paul
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America
| | - L Gordesky
- Department of Reproductive Biology, Center for Reproductive Health, MetroHealth Medical, 2500 MetroHealth Dr, Cleveland, OH 44109, United States of America
| | - K Russell
- Mother Infant Research Institute, Tufts Medical Center, 800 Washington St, Boston, MA 02111, United States of America
| | - H Barkoukis
- Department of Nutrition, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, United States of America
| | - P O'Tierney-Ginn
- Department of Reproductive Biology, Center for Reproductive Health, MetroHealth Medical, 2500 MetroHealth Dr, Cleveland, OH 44109, United States of America; Mother Infant Research Institute, Tufts Medical Center, 800 Washington St, Boston, MA 02111, United States of America
| | - R A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, 711 Washington St, Boston, MA 02111, United States of America
| | - J P Kirwan
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America.
| | - P M Catalano
- Department of Reproductive Biology, Center for Reproductive Health, MetroHealth Medical, 2500 MetroHealth Dr, Cleveland, OH 44109, United States of America; Mother Infant Research Institute, Tufts Medical Center, 800 Washington St, Boston, MA 02111, United States of America.
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Choudhury N, Paul D, Das B, (Chanda) DD, Bhattacharjee A. Real time PCR based detection of broadhost range plasmids and their potential use as biomarker in detection of multidrug resistant gram negative bacteria. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Lungulescu C, Croitoru VM, Lungulescu C, Croitoru A, Paul D. DURABLE RESPONSE IN A CASE OF METASTATIC ANAPLASTIC THYROID CANCER USING A COMBINATION OF TYROSINE KINASE INHIBITORS AND A CHECK POINT INHIBITOR. Acta Endocrinol (Buchar) 2020; 16:236-241. [PMID: 33029242 DOI: 10.4183/aeb.2020.236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Anaplastic thyroid cancer (ATC) is a highly uncommon (less than 2% of thyroid malignancies) and aggressive type of cancer, with aggressive behavior and, therefore, exhibiting poor prognosis. ATC tumors are automatically labeled as stage IV disease regardless of standard criteria such as tumor burden or metastasis. ATC tumors require a diversified treatment approach that includes surgical resection, followed by a complete an aggressive combination of radiation and chemotherapy and/or palliative care. Despite best efforts, 1-year overall survival of patients is 20% to 40% with nearly universal mortality rate. Consequently, novel approaches (targeted therapy, immunotherapy) have been studied, alone or in combination, to improve the dire prognosis of these patients. BRAF V600E mutation is the most common genetic mutation found in ATC. We report the case of a 57-year-old man diagnosed with stage IVc (undifferentiated) ATC with hepatic and osseous metastases. The molecular analysis of the tumor revealed a V600E BRAF-mutation. The patient was treated with Dabrafenib and Trametinib, and achieved remission 5 weeks after starting the treatment. Subsequently, he had a thyroidectomy, and pembrolizumab was added to the two tyrosine kinase inhibitors. 9 months later he is still in remission. This case illustrates the importance of obtaining molecular information in anaplastic thyroid cancer and the urgent need of studies investigating the combination of tyrosine kinase inhibitors and check-point inhibitors in patients with V600E BRAF- mutations.
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Affiliation(s)
- C Lungulescu
- University of Medicine and Pharmacy of Craiova - Oncology, Bucharest, Romania
| | - V M Croitoru
- University of Medicine and Pharmacy of Craiova - Fundeni Clinical Institute - Medical Oncology, Bucharest, Romania
| | - C Lungulescu
- University of Medicine and Pharmacy of Craiova - Doctoral School, Craiova, Bucharest, Romania
| | - A Croitoru
- University of Medicine and Pharmacy of Craiova - Fundeni Clinical Institute - Medical Oncology, Bucharest, Romania.,University of Medicine and Pharmacy of Craiova - "Titu Maiorescu" University - "Acad. Nicolae Cajal" Institute of Medical Scientific Research, Bucharest, Romania
| | - D Paul
- University of Medicine and Pharmacy of Craiova - New York-Presbyterian Hospital/Weill Cornell Medical Center - Department of Medicine, Division of Hematology/Oncology, New York, United States of America
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Kashyap P, Pegu AK, Paul D. Study of Lipid Abnormalities in Non Diabetic Chronic Kidney Disease Patients with Special Reference to Hemodialysis. J Assoc Physicians India 2020; 68:77. [PMID: 31979753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
| | - A K Pegu
- Assam Medical College and Hospital
| | - D Paul
- Assam Medical College and Hospital
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Sweetman A, Catcheside P, Lack L, Antic N, Smith S, Chai-Coetzer C, Douglas J, O'Grady M, Dunn N, Robinson J, Paul D, McEvoy D. The effect of cognitive and behavioural therapy for insomnia on changes in sleep architecture and AHI in patients with co-occurring insomnia and sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sweetman A, Lack L, Catcheside P, Antic N, Smith S, Chai-Coetzer C, Douglas J, O'Grady M, Dunn N, Robinson J, Paul D, McEvoy D. Changes in initial, middle and late insomnia subtypes during CBT-i and cpap therapy in co-morbid insomnia and sleep apnea (COMISA). Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gogineni E, Wotman M, Rana Z, Karten J, Riegel A, Maduro L, Marrero M, Kamdar D, Frank D, Paul D, Teckie S, Seetharamu N, Ghaly M. Impact of Stereotactic Body Radiation Therapy on Assessment and Management for Older Adults with Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gogineni E, Rana Z, Vempati P, Karten J, Sharma A, Taylor P, Pereira L, Gabalski E, Paul D, Seetharamu N, Teckie S, Ghaly M. Stereotactic Body Radiotherapy as Primary Treatment for Medically Unfit Patients with Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Taylor R, Valabhji J, Aveyard P, Paul D. Prevention and reversal of Type 2 diabetes: highlights from a symposium at the 2019 Diabetes UK Annual Professional Conference. Diabet Med 2019; 36:359-365. [PMID: 30597609 DOI: 10.1111/dme.13892] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 11/26/2022]
Abstract
AIM This symposium covers the gamut of Type 2 diabetes prevention, reversing established Type 2 diabetes, population-level delivery of weight loss programmes and personal insights into achieving and retaining substantial weight loss. RESULTS The NHS Diabetes Prevention Programme was launched in 2016 and rates of referral and attendance have both exceeded expectations. By March 2018, mean weight loss for completers (those attending more than 60% of sessions) was 3.2 kg reflecting considerable health benefits. Established Type 2 diabetes is now known to be a reversible condition in the early years, and the underlying mechanism is the removal of the excess fat from within liver and pancreas in these susceptible individuals. The Diabetes Remission Clinical Trial has shown that around half of a primary care population of people with Type 2 diabetes of less than 6 years' duration can be returned to non-diabetic blood glucose control which lasts at least 12 months. This raises the question of population-level intervention to achieve weight loss. The success of some mass weight loss programmes requires to be recognized. Reframing mass provision of weight loss support should be a vital part of our clinical strategy to prevent and treat Type 2 diabetes. However, the current obesogenic environment is a reality in which individuals must live. A personal account of achieving substantial and maintaining substantial weight loss provides an invaluable insight into practical problems encountered. All health professionals dealing with weight control should assimilate and reflect upon this understanding. CONCLUSIONS Effective prevention and long term reversal of Type 2 diabetes is feasible. The impact upon the individual must be considered during delivery of advice and support.
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Affiliation(s)
- R Taylor
- Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, UK
| | - J Valabhji
- Imperial College Healthcare NHS Trust and NHS England, Skipton House, London, UK
| | - P Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Khan S, Bal H, Khan ID, Paul D. PREVALENCE OF GESTATIONAL DIABETES MELLITUS IN AN URBAN INDIAN COHORT USING DIABETES IN PREGNANCY STUDY GROUP IN INDIA (DIPSI) CRITERIA – VALIDATING ONE-STEP APPROACH. IJMMR 2019. [DOI: 10.11603/ijmmr.2413-6077.2018.2.9317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background. India is the “World’s Diabetes capital”, with half the diabetic population being women. Early detection of glucose intolerance during pregnancy offers a timely opportunity for screening, management and prevention of gestational diabetes mellitus (GDM) and prevents fetal complications.
Objective. The study assessed the prevalence of GDM in an Indian cohort using the Diabetes in Pregnancy Study group of India (DIPSI) criteria.
Methods. 200 pregnant women underwent two-phase testing with non-fasting 75-gram glucose challenge under Diabetes in Pregnancy Study group of India (DIPSI) criteria at <20 weeks and between 24-28 weeks period of gestation. A 3-hour 100-gm oral glucose tolerance test (OGTT) was used for confirmation. Repeat testing was done for women negative during the first-phase.
Results. Mean age was 24.26±3.75 years with 52.5% multigravidas. Mean Body Mass Index (BMI) was 20.7±3.07 kg/m2. The prevalence of GDM in study cohort was found to be 15.5% using the DIPSI criteria while the prevalence of GDM after 100 g OGTT was 13.0%. GDM was mostly seen to occur in women of 26-30-year age group. Statistically significant associations for age and GDM, and BMI and GDM were evidenced.
Conclusions. Maternal age of ≥25 years should be adopted as a risk factor for the development of GDM. The DIPSI criteria offer a cost-effective and an evidence-based protocol for a single-step definitive glucose test for both screening and diagnosis of pregnant patients belonging to any socio-economic strata; furthering its implementation for public health obstetrics.
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Vempati P, Halthore A, Teckie S, Antone J, Zhang H, Marrero M, Cohen J, Beadle K, Frank D, Paul D, Ghaly M. Long Term Follow-Up from a Phase I/II Trial Utilizing a Dose-Escalated Stereotactic Radiosurgery (SRS) Boost for Unfavorable Locally Advanced Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Zhang I, Gill G, Marrero M, Sharma A, Riegel A, Paul D, Knisely J, Teckie S, Ghaly M. EP-1071: Organ-sparing SBRT in reirradiation of head and neck cancer: efficacy, toxicity, and quality of life. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31507-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sharma A, Paul D, Dhotre D, Jani K, Pandey A, Shouche YS. Deep sequencing analysis of bacterial community structure of Soldhar hot spring, India. Microbiology (Reading) 2017. [DOI: 10.1134/s0026261717010118] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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