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Madan K, Schmidt S, Chami RF, Ho R, Lewis JC, Apollonio DE. Reported exposures to derived cannabis products in California before and after the 2018 federal reclassification of hemp. Int J Drug Policy 2024; 124:104313. [PMID: 38194724 DOI: 10.1016/j.drugpo.2023.104313] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND As of June 2023, a majority of states had legalized the sale of cannabis, which past research has found to be associated with increased exposures. In 2018, a change in federal policy increased access to cannabidiol (CBD) and derived psychoactive cannabis products, but there has been limited study of reported exposures following this change. METHODS This observational retrospective study analyzed exposures involving synthetic cannabinoid receptor agonists (SCRAs) and derived cannabis products, including CBD, reported to the California Poison Control System (CPCS) from 2010 to 2022. We focused primarily on potential shifts in reported exposures before and after the implementation of the 2018 Farm Bill, which removed products derived from hemp from the Controlled Substances Act. We reviewed and hand-coded individual call records to assess reported exposures over time and their characteristics, and conducted interrupted time series analysis to assess whether exposure counts changed after policy interventions. RESULTS Reported CBD exposures significantly increased following the federal reclassification of hemp products. Exposure reports were most common among young children and for edibles. Exposure reports provided limited information about derived psychoactive cannabis products. CONCLUSIONS Our findings suggest a need for improved data collection regarding derived psychoactive cannabis products, as well as potential public health value in modifying packaging regulations and in providing additional guidance to parents to help prevent CBD exposures.
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Affiliation(s)
- Kunal Madan
- School of Pharmacy, University of California San Francisco, San Francisco, CA, USA
| | - Samantha Schmidt
- School of Pharmacy, University of California San Francisco, San Francisco, CA, USA
| | - Raeiti Fouladi Chami
- School of Pharmacy, University of California San Francisco, San Francisco, CA, USA
| | - Raymond Ho
- School of Pharmacy, University of California San Francisco, San Francisco, CA, USA; California Poison Control System, San Francisco and Sacramento, CA, USA
| | - Justin C Lewis
- School of Pharmacy, University of California San Francisco, San Francisco, CA, USA; California Poison Control System, San Francisco and Sacramento, CA, USA
| | - Dorie E Apollonio
- School of Pharmacy, University of California San Francisco, San Francisco, CA, USA.
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Shah B, Kajal S, Bhalla AS, Madan K, Viswanathan GK, Thakar A, Sikka K, Bairwa M, Verma H. Prolonged Itraconazole Therapy as Sole Treatment for Patients with Allergic Fungal Rhinosinusitis. Laryngoscope 2024; 134:545-551. [PMID: 37377280 DOI: 10.1002/lary.30841] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/31/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Currently, the mainstay of treatment for allergic fungal rhinosinusitis (AFRS) is surgical debridement along with topical or systemic steroids. However, prolonged systemic steroid therapy comes with side effects and is also sometimes contraindicated. Systemic antifungals have been used earlier as an adjunct to steroids or in refractory cases, but they have not been used as the sole primary treatment. OBJECTIVE To study the effectiveness of sole Itraconazole therapy in patients with AFRS by comparison of clinical, radiological, and biochemical parameters before and after treatment. METHODS Thirty-four patients diagnosed with localized sino-nasal AFRS were recruited and started on the tablet Itraconazole 200 mg orally twice daily for 3 months with q2weekly monitoring of liver function tests. The baseline clinical, radiological, and biochemical parameters were then compared with those after completion of 3 months of Itraconazole therapy. RESULTS There was significant difference between all the parameters-clinical: SNOT-22 score (p < 0.001) and Meltzer endoscopy score (p < 0.001), radiological: Lund-Mackay score (p = 0.004) and 20-point CT score (p = 0.002), and biochemical: serum total IgE (p < 0.001), Aspergillus-specific IgE (p < 0.001), and absolute eosinophil count (p < 0.001). The clearance of the disease was more in anterior sinuses than the posterior ones. CONCLUSION Prolonged Itraconazole can be given as sole therapy in AFRS, especially in patients for whom steroids are contraindicated or in those who are awaiting surgery. It can result in symptomatic and radiological improvement, but surgery still remains the definitive treatment option for AFRS for complete clearance of disease. LEVEL OF EVIDENCE 3 Laryngoscope, 134:545-551, 2024.
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Affiliation(s)
- B Shah
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - S Kajal
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - A S Bhalla
- Department of Radiodiagnosis, AIIMS, New Delhi, India
| | - K Madan
- Department of Pulmonary Medicine, AIIMS, New Delhi, India
| | - G K Viswanathan
- Department of Haematology and Oncology, AIIMS, New Delhi, India
| | - A Thakar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - K Sikka
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - M Bairwa
- Department of Community Medicine, AIIMS, New Delhi, India
| | - H Verma
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Mishra PP, Madan K, Biswas S, Kini Rao AC. Fibroblastic reticular cell tumor of eyelid: Rare case report and review of literature. INDIAN J PATHOL MICR 2024; 67:166-168. [PMID: 38358212 DOI: 10.4103/ijpm.ijpm_908_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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Fibroblastic reticular cell tumours (FRCT) originate from the fibroblastic reticular cells (FBRC) which are histiocytic cells, belonging to the dendritic cell family. These tumours are extremely rare, with only a few cases reported in literature. Histomorphologically, they resemble follicular dendritic cell sarcoma (FDCS); however, they differ immunophenotypically. Extranodal presentations are rare. We report a case of malignant FBRC tumour of the left eyelid, in a 23-year-old woman, who had presented with a recurrent swelling over left lower eyelid. Microscopy revealed an ill circumbscribed tumour composed of oval to spindle cells in storiform pattern, sprinkled with lymphocytes. Immunohistochemistry was performed and diagnosis of FRCT was offered. To the best of our knowledge, this is the first report of malignant FBRC tumour arising in the eyelid region. Here we present this extremely rare case with review of the available literature.
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Affiliation(s)
- Pragnya P Mishra
- Department of Oncopathology, Yenepoya Medical College, Mangalore, Karnataka, India
| | - K Madan
- Department of Oncopathology, Yenepoya Medical College, Mangalore, Karnataka, India
| | - Siddhartha Biswas
- Department of Oncopathology, Yenepoya Medical College, Mangalore, Karnataka, India
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Yadav R, Nagori A, Madan K, Lodha R, Kabra SK. Short-term exposure to air pollution and emergency room visits for acute respiratory symptoms among adults. Int J Tuberc Lung Dis 2023; 27:761-765. [PMID: 37749844 PMCID: PMC10519391 DOI: 10.5588/ijtld.23.0044] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/11/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE: To examine the short-term effect of ambient air pollution on daily acute respiratory emergency room visits among adults.METHODS: A time-series study (June 2017-February 2019) was carried out among adults (≥18 years) visiting a multi-specialty hospital in Delhi. We evaluated the association between the daily levels of particulate matter (PM) <2.5 μm in diameter (PM2.5) and PM <10 μm in diameter (PM10), ozone (O₃), nitrogen dioxide (NO₂), carbon monoxide (CO) and sulphur dioxide and daily count of emergency room (ER) visits for acute respiratory symptoms. Generalised additive model (GAM) was used with the Poisson link function to analyse the associations for 0-1 to 0-7 lag days.RESULTS: A total of 69,400 ER visits were recorded, of which 2,669 were by adults due to acute respiratory symptoms. At 0-7 lag days, an increment of 1 standard deviation in NO₂ and PM2.5 concentration was associated with a percentage increase in acute respiratory ER visits of respectively 53.0% (95% CI 30.84-78.97) and 19.5% (95% CI 4.53-36.65). During 0-7 lag days, a positive trend was observed at higher concentrations of CO (>1.86-3.28 mg/m³), while a negative significant association was observed at low concentrations of CO (<1.171 mg/m³).CONCLUSION: Short-term exposure to ambient NO2 and PM2.5 was associated with acute respiratory emergency visits of adults at lag 0-7 days.
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Affiliation(s)
- R. Yadav
- Department of Paediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi
| | - A. Nagori
- Institute of Genomics and Integrative Biology, Council of Scientific and Industrial Research, New Delhi
- Academy of Scientific and Innovative Research, Ghaziabad
| | - K. Madan
- Department of Pulmonary Critical Care and Sleep Disorders, AIIMS, New Delhi, India
| | - R. Lodha
- Department of Paediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi
| | - S. K. Kabra
- Department of Paediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi
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Gamit P, Saikia J, Malik P, Kumar S, Jain D, Madan K, Bharati S, Deo S, Kumar S. PP01.23 Outcomes of Stage IIIA Disease in NSCLC, Treated with Surgery - A Single Institution Experience. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.049] [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: 01/30/2023]
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Sryma PB, Mittal S, Madan NK, Tiwari P, Hadda V, Mohan A, Guleria R, Madan K. Efficacy of Radial Endobronchial Ultrasound (R-EBUS) guided transbronchial cryobiopsy for peripheral pulmonary lesions (PPL...s): A systematic review and meta-analysis. Pulmonology 2023; 29:50-64. [PMID: 33441246 DOI: 10.1016/j.pulmoe.2020.12.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [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: 10/27/2020] [Revised: 12/16/2020] [Accepted: 12/16/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Transbronchial lung cryobiopsy (TBLC) is frequently described for the diagnosis of diffuse parenchymal lung diseases (DPLD). A few studies have reported transbronchial cryobiopsy for the diagnosis of peripheral pulmonary lesions (PPL...s). We aimed to study the utility and safety of transbronchial cryobiopsy for the diagnosis of PPL...s. METHODS We performed a systematic search of the PubMed and Embase databases to extract the relevant studies. We then performed a meta-analysis to calculate the diagnostic yields of transbronchial cryobiopsy and bronchoscopic forceps biopsy. RESULTS Following a systematic search, we identified nine relevant studies (300 patients undergoing cryobiopsy). All used Radial Endobronchial Ultrasound (R-EBUS) for PPL localization. The pooled diagnostic yield of transbronchial cryobiopsy was 77% (95% CI, 71%...84%) (I^2=38.72%, p=0.11). The diagnostic yield of forceps biopsy was 72% (95% CI, 60%...83%) (I^2=78.56%, p<0.01). The diagnostic yield of cryobiopsy and forceps biopsy was similar (RR 1.05, 95% CI 0.96...1.15), with a 5% risk difference for diagnostic yield (95% CI, ...6% to 15%). There was significant heterogeneity (I^2=57.2%, p=0.017), and no significant publication bias. One severe bleeding and three pneumothoraxes requiring intercostal drain (ICD) placement (major complication rate 4/122, 1.8%) were reported with transbronchial cryobiopsy. CONCLUSIONS R-EBUS guided transbronchial cryobiopsy is a safe and efficacious modality. The diagnostic yields of TBLC and forceps biopsy are similar. More extensive multicentre randomized trials are required for the further evaluation and standardization of transbronchial cryobiopsy for PPL...s.
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Affiliation(s)
- P B Sryma
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - S Mittal
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - N K Madan
- Department of Pathology, VMMC and Safdarjung Hospital, New Delhi, India
| | - P Tiwari
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - V Hadda
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - A Mohan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - R Guleria
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - K Madan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
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Madan K, Rudresh HK, Rao A, Sandeep S, Monica N, Gupta A. Clues from the Pandora's Box: Frequency of Acute Abdominal Symptoms in COVID-19 and Its Association with Inflammatory Markers-a Cross-Sectional Study. Indian J Surg 2022; 85:1-6. [PMID: 36033378 PMCID: PMC9395837 DOI: 10.1007/s12262-022-03550-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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is primarily considered to be a respiratory ailment. Hitherto, abdominal symptoms have been reported with variable frequency in acute COVID-19. The purpose of this study was to estimate the frequency of abdominal symptoms at presentation among patients hospitalised with COVID-19 infection, and to determine their association with disease severity. This was a single-centre cross-sectional observational study conducted at a COVID-19 tertiary care hospital (CTRI/2021/10/037195, registered on 08/10/2021). Consecutive patients hospitalised with acute COVID-19 illness during the study period were included in the study. Their demographic information, abdominal symptoms, comorbidities and category of COVID-19 illness were elicited. All patients had serum inflammatory markers tested on the day of hospitalisation. Among the 685 participants, 214 patients had mild-to-moderate category illness whereas the rest 471 had severe COVID-19 illness. Abdominal complaints were present among 132/685 (18.3%) patients with distension of abdomen (8.03%) being the most common symptom, followed by vomiting (6.72%) and abdominal pain (3.94%). At admission to the hospital, abdominal complaints were commoner among patients with severe disease than in those with mild-to-moderate disease (101/471 vs. 31/214; p=0.029). Abdominal symptoms were associated with a higher neutrophil to lymphocyte ratio (p=0.029). The mortality among COVID-19 patients with abdominal symptoms was higher (9.09 vs. 3.25%; p = 0.007). This study demonstrates the spectrum of abdominal symptoms that can be a part of acute COVID-19 at hospitalisation and also highlights their prognostic potential in acute COVID-19 infection.
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Affiliation(s)
- K. Madan
- Department of General Surgery, Ramaiah Medical College, Bangalore, Karnataka India
| | - H. K. Rudresh
- Department of General Surgery, Ramaiah Medical College, Bangalore, Karnataka India
| | - Akshay Rao
- Department of General Medicine, Ramaiah Medical College, Bangalore, Karnataka India
| | - S. Sandeep
- Department of General Surgery, Ramaiah Medical College, Bangalore, Karnataka India
| | - N. Monica
- Department of General Surgery, Ramaiah Medical College, Bangalore, Karnataka India
| | - Anupam Gupta
- Department of General Surgery, Ramaiah Medical College, Bangalore, Karnataka India
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Sawhney J, Vanani J, Madan K, Sharma M, Tyagi K, Kandpal B, Mehta A. Achieving the LDL-C goal in Indian patients of acute coronary syndrome with high intensity statin. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.543] [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: 11/02/2022]
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Kumar TP, Madan K, Arjun AS, Monica N. Assessment of Potential Risk Factors, Characteristics, and Outcome of Pneumothorax and Pneumomediastinum in Patients with COVID-19: A Retrospective Case-control Study. J Clin Diagn Res 2022. [DOI: 10.7860/jcdr/2022/57842.17012] [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: 11/12/2022]
Abstract
Introduction: Pneumothorax (PTX) and/or pneumomediastinum (PMD) are rare complications of Coronavirus Disease-2019 (COVID-19) and are linked to high mortality. Incidence rates vary between 0.56-2.01% in the reported literature. With clinical examination being hampered in the current pandemic setting, there is a delay in the diagnosis. There is a need to identify and establish potential predictive factors, that may aid in identifying patients with a high-risk of developing PTX and/or PMD. Aim: To identify potential risk factors and thus, explore their association with PTX and/or PMD among patients with COVID-19. Materials and Methods: A retrospective case-control study was conducted at MS Ramaiah Medical College and Hospital, Bangalore, South India over a six-month period. A total of 130 patients diagnosed with COVID-19 were recruited in a 1:3 ratio as cases and controls respectively. Cases were patients, diagnosed radiologically with PTX and/or PMD, and controls were, matched individuals without PTX and/or PMD. Patient’s clinical and laboratory parameters (complete blood count, renal and liver function tests, serum levels of inflammatory markers such as C-reactive protein (CRP), lactate dehydrogenase (LDH), and D-Dimer were tested for potential association with PTX and/or PMD. Student’s t-test, Chi-square test, multivariate and univariate logistic regression analysis were performed. Results: During the study period, there was a total of 3,251 COVID-19 admissions at the centre with 976 patients requiring Intensive Care Unit (ICU) admission. The overall incidence of PTX and/or PMD during the study period was (31/3251) 0.95%. The previous history of COVID-19, non vaccination with COVID-19 vaccine, cough as a predominant symptom, high values of baseline CRP, total bilirubin, Aspartate Transaminase (AST), and total leukocyte counts had a positive association. In-hospital mortality (54.8% vs 33.30%) and mortality 28 days (35.7% vs 7.6%) following discharge, were higher among those with PTX and/or PMD. Conclusion: Patients with a history of previous infection with COVID-19, non vaccination /incomplete-vaccination with COVID-19 vaccines, and patients with increasing total leukocyte counts and AST levels, high baseline total serum bilirubin were at increased risk of a detrimental clinical course and may indicate, the possibility of development of PTX and/or PMD in COVID-19 disease.
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Saikia J, Malik P, Kumar S, Jain D, Madan K, Bharati S, Deo S, Kumar S. 7P Predictive and prognostic value of cell-free DNA in plasma and pleural lavage among surgically treated adenocarcinomas of the lung (ADCL). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2003] [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] Open
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Sawhney J, Tyagi K, Sharma M, Madan K, Vanani J, Kandpal B, Mehta A. Lipoprotein (a) in young coronary artery disease and its association with severity of coronary artery disease. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.346] [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: 10/20/2022]
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Mittal A, Malik PS, Kumar S, Saikia J, Chitikela S, Khurana S, Bharti S, Jain D, Pathy S, Thulkar S, Kumar R, Madan K, Mohan A. Dose-dense Paclitaxel and Carboplatin as Neoadjuvant Chemotherapy for Stage IIB/IIIA Non-small Cell Lung Cancer - A Phase II trial. Clin Oncol (R Coll Radiol) 2021; 33:e553-e560. [PMID: 34340919 DOI: 10.1016/j.clon.2021.07.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/02/2021] [Accepted: 07/14/2021] [Indexed: 12/25/2022]
Abstract
AIMS The approach to potentially resectable non-small cell lung cancer (NSCLC) remains controversial. There is a benefit of neoadjuvant chemotherapy (NACT), but the ideal regimen is unknown. We evaluated the efficacy and safety of dose-dense NACT in potentially resectable NSCLC in this phase II trial. MATERIALS AND METHODS Paclitaxel at 80 mg/m2 on days 1, 8 and 15 with AUC-6 carboplatin on day 1, 3 weekly for four cycles was evaluated as NACT. Patients with Eastern Cooperative Oncology Group performance status 0-2, stage IIB and IIIA (with only non-bulky N2 nodes) were included. The primary end point was the objective response rate. Secondary end points included toxicity, progression-free survival, recurrence-free survival, complete resection rate and overall survival. The relative dose intensity (RDI) was calculated to define tolerability (CTRI/2016/05/006916). RESULTS In total, 37 patients were enrolled (median age 55 years). Most (78.8%) were smokers. Most patients had adenocarcinoma (57.6%) and stage IIIA disease (81.0%) according to the seventh American Joint Committee on Cancer staging system. Seventy-eight per cent of patients completed four cycles. The objective response rate was 75.6% with a complete response in 10.8%. The mean RDI of paclitaxel was 88.61%, with 68.0% of patients able to maintain an RDI ≥85.0%. In total, 187 toxicity events were recorded (120 grade 1, 64 grade 2 and three grade 3 events). Common toxicities were peripheral neuropathy (20.3%), myalgia (19.8%), nausea (15.7%) and neutropenia (10.2%). There were no treatment-related deaths. Seventeen patients underwent surgery (lobectomy 82.4%). After a median follow-up of 47 months (95% confidence interval 27-50.7 months), the median progression-free survival was 9.6 months (7.4-17.4) and overall survival was 29.2 months (16.0-37.2). CONCLUSION Dose-dense paclitaxel-carboplatin is feasible, safe and efficacious and should be evaluated further in potentially resectable NSCLC.
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Affiliation(s)
- A Mittal
- Department of Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - P S Malik
- Department of Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
| | - S Kumar
- Department of Surgical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - J Saikia
- Department of Surgical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Chitikela
- Department of Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Khurana
- Department of Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Bharti
- Department of Oncoanaesthesia and Palliative Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - D Jain
- Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Pathy
- Department of Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Thulkar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - R Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - K Madan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - A Mohan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Saikia J, Malik P, Jain D, Kumar S, Bharati S, Madan K, Gamit P, Deo S, Kumar S. 23P Clinical utility of cell free DNA in pleural lavage and plasma in resectable NSCLC: A pilot study. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01865-7] [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: 10/21/2022]
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Sawhney J, Mori V, Sharma M, Madan K, Verma I. Coronary risk factors and arcus cornealis in young patients of coronary artery disease with and without familial hypercholestrolemia. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.666] [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: 11/27/2022]
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Jeyaprakash P, Khor L, Madan K, Sivapathan S, Hill L, Robledo K, Hallani H, Roy P, Ellenberger K, Jepson N, Roy J, Pressley L, Patal S, Thomas L, French J, Burgess S. 887 STEMI in the Time of COVID-19: NSW Data. Heart Lung Circ 2020. [PMCID: PMC8435296 DOI: 10.1016/j.hlc.2020.09.894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mittal S, Suri T, Hadda V, Madan K, Mohan A, PB S, Tiwari P, Guleria R. A comparison of a wrist worn portable device (watchpat)™ with in-lab polysomnography for the diagnosis of obstructive sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.726] [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: 11/16/2022]
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Jain A, Manchanda S, Madan K, Bhola S, Sawhney J. Effect of yoga in Heart Failure: randomized trial. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.074] [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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Saikia J, Malik P, Madan K, Jain D, Bharati S, Gowda M, Nandi S, Deo S, Kumar S. EP1.17-13 Operated Stages I-IIIB NSCLC Among Young Indian Cohorts - Clinical Profile and Outcomes. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2423] [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: 11/30/2022]
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Hadda V, Kumar R, Dhungana A, Khan MA, Madan K, Khilnani GC. Inter- and intra-observer variability of ultrasonographic arm muscle thickness measurement by critical care physicians. J Postgrad Med 2019; 63:157-161. [PMID: 28272064 PMCID: PMC5525479 DOI: 10.4103/0022-3859.201412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose: The aim of this study was to assess inter- and intra-observer variability of arm muscle thickness measured by critical care physicians using bedside ultrasonography (USG). Methodology: This prospective study included twenty patients admitted with sepsis. Three measurements of thickness of right arm muscles of each patient using B-mode USG were taken by two critical care fellows, independently. Intra- and inter-observer reliability was tested using intraclass correlation coefficient (ICC). Results: The mean 1st, 2nd, and 3rd measurements of muscle thickness recorded by observer 1 and 2 were 23.620 (±4.171) versus 23.840 (±3.849) mm, 23.235 (±3.620) versus 23.625 (±4.062) mm, and 24.125 (±4.098) versus 23.965 (±3.651) mm, respectively. The average muscle thickness measured by first and second observer was 23.660 (±3.834) mm and 23.810 (±3.674) mm, respectively. ICC for intra-observer variability for observer 1 and 2 was 0.964 (95% confidence interval [CI] 0.924–0.985) and 0.949 (95% CI 0.892–0.978), respectively. ICC for inter-observer variability was 0.995 (95% CI 0.988–0.998). Conclusions: USG is a reliable tool for assessment of arm muscle thickness by critical care physicians.
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Affiliation(s)
- V Hadda
- Department of Pulmonary Medicine and Sleep Disorders, All Institute of Medical Sciences, New Delhi, India
| | - R Kumar
- Department of Pulmonary Medicine and Sleep Disorders, All Institute of Medical Sciences, New Delhi, India
| | - A Dhungana
- Department of Pulmonary Medicine and Sleep Disorders, All Institute of Medical Sciences, New Delhi, India
| | - M A Khan
- Department of Biostatistics, All Institute of Medical Sciences, New Delhi, India
| | - K Madan
- Department of Pulmonary Medicine and Sleep Disorders, All Institute of Medical Sciences, New Delhi, India
| | - G C Khilnani
- Department of Pulmonary Medicine and Sleep Disorders, All Institute of Medical Sciences, New Delhi, India
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Sawhney J, Mori V, Prasad S, Sharma M, Madan K, Manchanda S, Verma I. Prevalence Of Familial Hypercholesterolemia In Young Coronary Artery Disease Patients Admitted To A Referral Hospital In North India. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.648] [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: 11/26/2022]
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Breta M, Arava S, Madan K, Singh A, Jain D, Guleria R. Endobronchial metastasis from extrathoracic malignancies : A clinicopathological study of 11 cases. Lung India 2019. [DOI: 10.4103/0970-2113.257715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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22
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Madan K, Mittal S, Hadda V, Mohan A. Cryoprobe transbronchial lung biopsy with flexible bronchoscope using Arndt endobronchial blocker. Lung India 2019. [DOI: 10.4103/0970-2113.257708] [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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Nambirajan A, Longchar M, Mallick S, Kakkar A, Madan K, Mathur S, Jain D. P1.05-11 Role of EBUS-TBNA in Evaluation of Mediastinal Lymphadenopathy and Masses in Patients with Known or Suspected Extra-Pulmonary Malignancies. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.763] [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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25
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Jain D, Jangra K, Malik PS, Arulselvi S, Madan K, Mathur S, Sharma MC. Anaplastic lymphoma kinase immunohistochemistry in lung adenocarcinomas: Evaluation of performance of standard manual method using D5F3 antibody. Indian J Cancer 2018; 54:209-213. [PMID: 29199692 DOI: 10.4103/0019-509x.219588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Immunohistochemistry (IHC) with anaplastic lymphoma kinase (ALK) antibodies is considered as an economical screening method in lung adenocarcinomas. Automated Ventana D5F3-IHC is approved by US Food and Drug Administration for targeted therapy; however, the automated IHC apparatus are not widely used in most laboratories. We evaluated the performance of ALK IHC using the manual semiquantitative method to assess the concordance with Ventana ALK IHC assay. MATERIALS AND METHODS We tested 156 cases of primary lung adenocarcinomas for ALK protein expression by D5F3-IHC. The intensity of cytoplasmic staining was classified as 0 or 1+/2+/3+ (weak/medium/strong). Binary score of positive and negative was used for Ventana assay. A comparison analysis and clinicopathological features were recorded. RESULTS ALK IHC was positive in 25 (16.02%) cases, of which 18 were men and mostly nonsmokers. The mean age for all patients was 55 years, and for ALK IHC-positive cases was 48 years. Nine of 25 (36%) ALK IHC-positive cases showed signet ring cell and mucinous morphology. On comparison, all, but one, cases positive by manual method showed positive results by automated assay. IHC negative cases by manual method were negative by Ventana assay. CONCLUSION Manual IHC is equally effective in the detection of ALK-rearranged cases as automated methods. It can be easily integrated as a screening method into routine practice thus reducing the cost of automated systems. However, equivocal cases should be tested by approved methods.
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Affiliation(s)
- D Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - K Jangra
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - P S Malik
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - S Arulselvi
- Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
| | - K Madan
- Department of Pulmonary Medicine and Sleep Disorder, All India Institute of Medical Sciences, New Delhi, India
| | - S Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - M C Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Nakra T, Jain D, Madan K, Mallick S, Mathur SR, Iyer VK, Ramteke P. Endobronchial ultrasound guided transbronchial needle aspirate from subcarinal lymph node: Mesothelial lesion, a diagnostic dilemma. Cytopathology 2018; 29:486-488. [PMID: 29797365 DOI: 10.1111/cyt.12547] [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] [Accepted: 01/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- T Nakra
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - D Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - K Madan
- Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - S Mallick
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - S R Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - V K Iyer
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - P Ramteke
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Vashistha V, Choudhari C, Garg A, Gupta A, Parthasarathy G, Mohan C, Madan K, Hadda V, Khilnani G, Mohan A. 41P Gender based variations in presentation and management of lung cancer at a south Asian tertiary referral centre. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30321-6] [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: 10/17/2022]
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Kumar N, Deo S, Shukla N, Boriwal S, Kumar V, Ramanathan P, Jain D, Madan K, Kumar S. 225P Surgical experience of advanced bronchopulmonary carcinoids: An analysis from a tertiary care hospital of North India. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30497-0] [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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Mohan A, Poulose R, Ansari A, Madan K, Hadda V, Khilnani GC, Guleria R. Novel use of bioelectric impedence technique to detect alterations in body composition in advanced small cell lung cancer. Indian J Cancer 2018; 54:478-480. [PMID: 29469082 DOI: 10.4103/ijc.ijc_497_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
BACKGROUND Malnutrition is frequent in lung cancer and is measured using various tools, including the novel bioelectric impedance technique for measuring body composition. However, the validation of this technique for assessing body composition in advanced small cell lung cancer (SCLC) is untested. METHODS Forty-one treatment naïve patients (all males) and an equal number of age- and sex-matched controls were evaluated by anthropometric measurements of skinfold thicknesses and body composition parameters such as body fat%, fat mass, fat-free mass (FFM), and total body water (TBW). RESULTS The mean (SD) age of the patient group was 55.7 (7.5) years, median pack-years was 20 (range, 0-80), and mean (SD) duration of symptoms was 152.6 (153.7) days. Median Karnofsky Performance Scale was 70 (range, 50-90). Majority of our patients (68.3%) were Stage IV followed by Stage III (31.7%). The percentage of patients with low, normal, and high body mass index (BMI) was 31.7%, 61%, and 7.3%, respectively. All components of body composition, i.e., body fat%, FFM, and TBW were significantly lower in patients compared to controls. However, the body composition in patients and controls with normal BMI was similar. The phenomenon of sarcopenia as a cause of cancer cachexia may explain these findings, whereas the combination of loss of body fat and lean body mass may lead to weight loss and reduced BMI. CONCLUSION Our results indicate that body composition is markedly altered in Indian patients with advanced SCLC. The impact of these parameters on clinically relevant outcomes needs further evaluation.
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Affiliation(s)
- A Mohan
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - R Poulose
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - A Ansari
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - K Madan
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - V Hadda
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - G C Khilnani
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - R Guleria
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
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Nambirajan A, Kaur H, Jangra K, Kaur K, Madan K, Mathur SR, Iyer VK, Jain D. Adenocarcinoma predominant pattern subtyping and nuclear grading in cytology: Is there a role in prognostication of advanced pulmonary adenocarcinomas? Cytopathology 2018; 29:163-171. [DOI: 10.1111/cyt.12519] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2017] [Indexed: 12/30/2022]
Affiliation(s)
- A. Nambirajan
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - H. Kaur
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - K. Jangra
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - K. Kaur
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - K. Madan
- Department of Pulmonary Medicine; All India Institute of Medical Sciences; New Delhi India
| | - S. R. Mathur
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - V. K. Iyer
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - D. Jain
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
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Shah SR, Chowdhury A, Mehta R, Kapoor D, Duseja A, Koshy A, Shukla A, Sood A, Madan K, Sud R, Nijhawan S, Pawan R, Prasad M, Kersey K, Jiang D, Svarovskaia E, Doehle B, Kanwar B, Subramanian M, Acharya SK, Sarin S. Sofosbuvir plus ribavirin in treatment-naïve patients with chronic hepatitis C virus genotype 1 or 3 infection in India. J Viral Hepat 2017; 24:371-379. [PMID: 27933698 DOI: 10.1111/jvh.12654] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 11/01/2016] [Indexed: 12/14/2022]
Abstract
Until 2014, pegylated interferon plus ribavirin was the recommended standard of care for the treatment of chronic hepatitis C virus (HCV) infection in India. This open-label phase 3b study, conducted across 14 sites in India between 31 March 2014 and 30 November 2015, evaluated the efficacy and safety of sofosbuvir plus ribavirin therapy among treatment-naïve patients with chronic genotype 1 or 3 HCV infection. A total of 117 patients with genotype 1 or 3 HCV infection were randomized 1:1 to receive sofosbuvir 400 mg and weight-based ribavirin (1000 or 1200 mg) daily for 16 or 24 weeks. Among those with genotype 1 infection, the primary efficacy endpoint of sustained virologic response at 12 weeks post-treatment (SVR12) was reported in 90% (95% confidence intervals [CI], 73-98) and 96% (95% CI, 82-100) of patients following 16 and 24 weeks of treatment, respectively. For patients with genotype 3 infection, SVR12 rates were 100% (95% CI, 88-100) and 93% (95% CI, 78-99) after 16 and 24 weeks of therapy, respectively. Adverse events, most of which were mild or moderate in severity, occurred in 69% and 57% of patients receiving 16 and 24 weeks of treatment, respectively. The most common treatment-emergent adverse events were asthenia, headache and cough. Only one patient in the 24-week group discontinued treatment with sofosbuvir during this study. Overall, sofosbuvir plus ribavirin therapy achieved SVR12 rates ≥90% and was well tolerated among treatment-naïve patients with chronic genotype 1 or 3 HCV infection in India.
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Affiliation(s)
- S R Shah
- Global Hospitals, Mumbai, Maharashtra, India
| | - A Chowdhury
- Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - R Mehta
- Nirmal Hospital Pvt Ltd, Surat, Gujarat, India
| | - D Kapoor
- Global Hospitals, Hyderabad, Andhra Pradesh, India
| | - A Duseja
- Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - A Koshy
- Lakeshore Hospital, Kochi, Kerala, India
| | - A Shukla
- Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - A Sood
- Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - K Madan
- Artemis Hospitals, Gurgaon, Haryana, India
| | - R Sud
- Medanta - The Medicity, Gurgaon, Haryana, India
| | - S Nijhawan
- Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
| | - R Pawan
- Fortis Memorial Research Institute, Gurgaon, Haryana, India
| | - M Prasad
- VGM Hospital, Coimbatore, Tamil Nadu, India
| | - K Kersey
- Gilead Sciences, Inc., Foster City, CA, USA
| | - D Jiang
- Gilead Sciences, Inc., Foster City, CA, USA
| | | | - B Doehle
- Gilead Sciences, Inc., Foster City, CA, USA
| | - B Kanwar
- Gilead Sciences, Inc., Foster City, CA, USA
| | | | - S K Acharya
- All India Institute of Medical Science, New Delhi, Delhi, India
| | - S Sarin
- Institute of Liver and Biliary Sciences, New Delhi, Delhi, India
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Bamania A, Sahni D, Mohan A, Malik P, Madan K, Hadda V, Khilnani G, Guleria R. P227 Comparison of clinical profile of patients with ALK-positive and EGFR-positive non- small cell lung adenocarcinoma in an indian population. Chest 2017. [DOI: 10.1016/j.chest.2017.04.133] [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: 11/25/2022] Open
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Salib M, Madan K, Chandrala P, Coulshed D. Safety of Early Emergency Discharge in High-Sensitivity-Troponin-I (HsTnI) Negative Chest Pain Patients. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.121] [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]
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Mohan A, Poulose R, Kulshreshtha I, Chautani AM, Madan K, Hadda V, Guleria R. High prevalence of malnutrition and deranged relationship between energy demands and food intake in advanced non-small cell lung cancer. Eur J Cancer Care (Engl) 2016; 26. [PMID: 27099023 DOI: 10.1111/ecc.12503] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2016] [Indexed: 12/01/2022]
Abstract
The relation between dietary intake and metabolic profile in non-small cell lung cancer (NSCLC) was evaluated. Patients with NSCLC were recruited and their caloric requirement and resting energy expenditure (REE) were calculated using the Harris-Benedict equation and Katch-McArdle formula respectively. Hypermetabolic state was defined as REE more than 10% above the basal metabolic rate (BMR). Body composition parameters were calculated by bioelectric impedance method. The 24-h dietary intake method and Malnutrition Universal Screening Tool assessed nutritional intake. One hundred and forty-eight subjects were included (87% males). Of these, 46.6% subjects were hypermetabolic and 31% cachexic, with lower calorie and protein intakes than recommended, although per cent of total energy derived from protein, fat and carbohydrates were similar. Hypermetabolic patients had lower BMI, though the per cent deficit in energy and protein consumption was similar. Cachexia was associated with lower BMR but not with deficit in energy or protein consumption. No correlation was seen between dietary intake and body composition parameters. The calorie and protein intake of NSCLC patients is lower than recommended. The discordance between elevated REE and dietary intake implies that the relationship between increased energy demands and food intake may be altered.
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Affiliation(s)
- A Mohan
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi
| | - R Poulose
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi
| | - I Kulshreshtha
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi
| | - A M Chautani
- Department of Dietitics and Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - K Madan
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi
| | - V Hadda
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi
| | - R Guleria
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi
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Madan K, Hadda V, Khilnani GC, Guleria R. Expectorating the diagnosis: ruptured hydatid cyst. Assoc Med J 2015. [DOI: 10.1136/bmj.h654] [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]
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36
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Vijaya Bharathi B, Jaya Prakash G, Krishna KM, Ravi Krishna CH, Sivanarayana T, Madan K, Rama Raju GA, Annapurna A. Protective effect of alpha glucosyl hesperidin (G-hesperidin) on chronic vanadium induced testicular toxicity and sperm nuclear DNA damage in male Sprague Dawley rats. Andrologia 2014; 47:568-78. [DOI: 10.1111/and.12304] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2014] [Indexed: 01/30/2023] Open
Affiliation(s)
- B. Vijaya Bharathi
- Pharmacology Division; University College of Pharmaceutical Sciences; Andhra University; Visakhapatnam India
| | - G. Jaya Prakash
- Embryology Research Group; Krishna IVF Clinic; Visakhapatnam India
| | - K. M. Krishna
- Embryology Research Group; Krishna IVF Clinic; Visakhapatnam India
| | | | | | - K. Madan
- Vijaya Medical Center; Visakhapatnam India
| | - G. A. Rama Raju
- Embryology Research Group; Krishna IVF Clinic; Visakhapatnam India
| | - A. Annapurna
- Pharmacology Division; University College of Pharmaceutical Sciences; Andhra University; Visakhapatnam India
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Purkait S, Jain D, Madan K, Mathur S, Iyer VK. Combined small cell carcinoma of the lung: a case diagnosed on bronchoscopic wash cytology and bronchial biopsy. Cytopathology 2014; 26:197-9. [PMID: 24734994 DOI: 10.1111/cyt.12145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Purkait
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - D Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - K Madan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - S Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - V K Iyer
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Hadda V, Madan K, Mohan A, Ayub II. Furosemide Nebulization in Patients With COPD Exacerbation. Respir Care 2014; 59:e41. [DOI: 10.4187/respcare.03034] [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: 11/05/2022]
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39
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40
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Madan K, Guleria R. Bamboo spine and the lungs. Case Reports 2013; 2013:bcr-2013-201006. [DOI: 10.1136/bcr-2013-201006] [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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41
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Affiliation(s)
- K Madan
- Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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Madan K, Agarwal R, Bal A, Gupta D. Bronchoscopic management of a rare benign endobronchial tumor. Rev Port Pneumol 2012; 18:251-4. [PMID: 22463875 DOI: 10.1016/j.rppneu.2012.02.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Accepted: 12/05/2011] [Indexed: 11/30/2022] Open
Abstract
Benign endobronchial tumors are uncommon. Bronchoscopic removal is the preferred modality of treatment although surgery may be required in some cases. Rigid bronchoscopy is usually recommended in the management of these tumors. However, flexible bronchoscopy is also used in many centers. We present a case of endobronchial lipoma, where an unusual complication during flexible bronchoscopic resection using snare forceps necessitated urgent rigid bronchoscopy. This case highlights the importance of rigid bronchoscopy in the management of endobronchial tumors. We believe that with a large benign endobronchial tumor in tracheal or main-stem bronchus, physicians should initially employ rigid bronchoscopy, switching to flexible if more peripheral treatment is required.
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Affiliation(s)
- K Madan
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abhishek A, Kataria T, Sharma K, Karrthick K, Madan K, Piplani T. 32 portal vein thrombus irradiation-an alternative in inoperable hepatocellular carcinoma. J Clin Exp Hepatol 2011; 1:147. [PMID: 25755362 PMCID: PMC3940407 DOI: 10.1016/s0973-6883(11)60169-2] [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: 12/12/2022] Open
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Rama Raju GA, Jaya Prakash G, Murali Krishna K, Madan K, Siva Narayana T, Ravi Krishna CH. Noninsulin-dependent diabetes mellitus: effects on sperm morphological and functional characteristics, nuclear DNA integrity and outcome of assisted reproductive technique. Andrologia 2011; 44 Suppl 1:490-8. [DOI: 10.1111/j.1439-0272.2011.01213.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Chalamalasetty SB, Madan K, Javvaji S, Singh KK, Vijayaraghavan M, Mathur S, Kumar L, Paul S, Acharya SK. Anaplastic large cell lymphoma presenting as liver abscess and portal vein thrombosis. Indian J Cancer 2009; 46:240-1. [PMID: 19574679 DOI: 10.4103/0019-509x.52961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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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Saini V, Madan K, Mittal VV, Sakhuja P, Sarin SK. Alpha-fetoprotein production by non-hepatocellular carcinoma, malignant liver tumor. Indian J Cancer 2009; 46:253-4. [PMID: 19574688 DOI: 10.4103/0019-509x.52970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Madan K, Batra Y, Jha JK, Kumar S, Kalra N, Paul SB, Singh R, Duttagupta S, Panda SK, Acharya SK. Clinical relevance of HBV DNA load in patients with chronic hepatitis B infection. Trop Gastroenterol 2008; 29:84-90. [PMID: 18972767] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Hepatitis B virus (HBV) DNA detection and quantification are now playing an increasing role in the assessment of disease activity and response to therapy. However, viraemia levels which define various stages of HBV infection have not yet been established. AIM To define viraemia levels which describe various stages of chronic hepatitis B virus infection. METHODS In a retrospective study, stored sera samples of chronic hepatitis B virus (CHB) infected patients registered at AIIMS liver clinic, from January 1996 to June 2005 were subjected to competitive, quantitative PCR analysis. RESULTS The median HBV DNA load was lowest among carriers and highest among patients with chronic hepatitis B [0 (0-8) vs. 7 (0-12) log10 copies/ml, respectively; p<0.05]. As compared to chronic hepatitis patients the DNA load was also lower among cirrhotics [7 (0-12) vs. 4.5 (0-8) log10 copies/ml, respectively; p<0.05] and hepatocellular cancer patients [ 7(0-12) vs. 0 (0-8) log10 copies/ml, respectively; p<0.05]. Patients with carriers had a DNA load which was significantly lower than e antigen negative CHB [0 (0-8) vs. 6 (0-10) log10 copies/ml; p<0.05] or e antigen positive CHB [0 (0-8) vs 8 (0-12) log10 copies/ml; p<0.05]. A threshold of 3.5 log10 copies/ml had sensitivity and specificity of 83% and 58% respectively in differentiating carriers from e antigen negative CHB. There was a strong positive correlation of HBV DNA load with inflammatory grade (R=0.334; p=0.0001), fibrosis stage (R=0.276; p=0.001) and ALT levels (R=0.378; p=0.0001). 82% (9/11) of those who lost e antigen had a decline in HBV DNA levels to <5 log10 copies/ml, whereas only 12.5% (1/8) of those who did not lose e antigen had a decline in DNA load below this level. CONCLUSIONS HBV DNA viraemia levels correlate positively with the inflammatory grade, fibrosis stage and ALT levels. Most patients who loose e antigen have a decline in DNA load to below 5 log10 copies/ml. Further prospective studies employing repeated measurements are required to define a threshold to differentiate between HBV carriers and e antigen negative CHB.
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Affiliation(s)
- K Madan
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
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Rama Raju GA, Prakash GJ, Krishna KM, Madan K. Meiotic spindle and zona pellucida characteristics as predictors of embryonic development: a preliminary study using PolScope imaging. Reprod Biomed Online 2007; 14:166-74. [PMID: 17298718 DOI: 10.1016/s1472-6483(10)60784-5] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [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: 10/19/2022]
Abstract
This study assesses meiotic spindle and zona pellucida characteristics using the PolScope, and analyses their relationship to embryonic development potential. A total of 205 matured oocytes retrieved from 25 patients undergoing ovarian stimulation were imaged for meiotic spindle and zona pellucida characteristics using the PolScope. After intracytoplasmic sperm injection, the oocytes were cultured and assessed for progression to blastocysts. Meiotic spindles were visualized in 78.0% of oocytes. Significantly more oocytes with visible spindles fertilized and progressed to blastocysts compared with oocytes without visible spindles. Oocytes with spindle retardance of >3 nm showed a greater progression to blastocysts compared with those with a retardance of 2-3 nm or <2 nm. More blastocysts were obtained from oocytes with spindle lengths of >12 nm than from oocytes with spindle lengths 10-12 nm or <10 nm. A difference in progression to blastocyst was observed in oocytes with a zona inner layer retardance of >3 nm compared with oocytes with retardance of 2-3 nm or <2 nm. Oocytes with an inner layer zona of 10-12 nm thickness showed better progression compared with those with a thickness of 8-10 nm or <8 nm. Quantitative measurement of length and retardance of the meiotic spindle and zona pellucida has a positive predictive value in relation to embryonic development.
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Affiliation(s)
- G A Rama Raju
- Embryology Division, Krishna IVF Clinic, Zillaparishad Junction, Visakhapatnam, Pincode 530 002, Andhra Pradesh, India
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Franssen MTM, Korevaar JC, Leschot NJ, Bossuyt PMM, Knegt AC, Gerssen-Schoorl KBJ, Wouters CH, Hansson KBM, Hochstenbach PFR, Madan K, van der Veen F, Goddijn M. [Risk factors for structural chromosomal abnormality in > or = 2 miscarriages, as an instrument for selective karyotyping]. Ned Tijdschr Geneeskd 2007; 151:863-7. [PMID: 17472118] [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] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To identify additional risk factors and the corresponding probability of carrying a chromosome abnormality in couples with two or more miscarriages. DESIGN Nested case-control study. METHOD In 6 centres for clinical genetics in the Netherlands, data were collected from couples referred for karyotyping after 2 2 miscarriages from 1992-2000. Factors influencing the probability of carrier status were examined. The corresponding probability of carrier status was calculated for the various combinations of these factors. RESULTS In total 279 carrier couples and 428 non-carrier couples were included. 4 independent factors influencing the probability of carrier status were identified: a younger maternal age at the time of second miscarriage, a history of > or = 3 miscarriages, a history of > 2 miscarriages in a brother or sister of either partner, and a history of> 2 miscarriages in parents of either partner. The calculated probability of carrier status in couples referred for chromosome analysis after two or more miscarriages, varied between 0.5-10.2%. In 18% of couples included, the risk was found to be so low (< 2.2%), that in couples with comparable risk factors, it may not be necessary to perform karyotyping. CONCLUSION This study demonstrated that the probability of carrier status in couples with > or = 2 miscarriages is modified by additional factors. Selective chromosome analysis would result in a more effective referral policy and therefore decrease the number of chromosome analyses and lower the costs.
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Affiliation(s)
- M T M Franssen
- Academisch Medisch Centrum/Universiteit van Amsterdam, Postbus 22.660, II00 DD Amsterdam.
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