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Jindal N, Saroha M, Mirgh S, Chichra A, Nayak L, Bonda A, Gokarn A, Punatar S, Bagal B, Chavan P, Mathew LJ, Kannan S, Khattry N. Relevance of vitamin D in patients undergoing HLA matched allogeneic stem cell transplant for acute leukemia. Transpl Immunol 2023; 81:101925. [PMID: 37648032 DOI: 10.1016/j.trim.2023.101925] [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: 07/02/2023] [Revised: 08/20/2023] [Accepted: 08/27/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND In hematopoietic stem cell transplant (HSCT), vitamin D deficiency has been variably associated with increased complications, primarily graft versus host disease (GvHD), with a potential impact on survival. Results from various studies however, have not been consistent. This analysis was conducted to study the impact of peri-transplant vitamin D levels on transplant outcomes in patients with acute leukemia (AL) who underwent HLA matched (related/unrelated) HSCT. METHODS This was a single center retrospective study. Patients of AL including Acute Lymphoblastic Leukemia (ALL), Acute Myeloid Leukemia (AML) or Mixed Phenotypic Acute Leukemia (MPAL) who underwent fully matched or 9/10 transplants (related/unrelated) between 2008 and 2019 were included. Vitamin D deficiency was defined as serum 25-hydroxy vitamin D3 levels ≤20 ng/ml. Those with deficiency received replacement with oral vitamin D at a dose of 60,000 IU weekly for 8 weeks followed by maintenance with daily vitamin D (800 IU/day). Vitamin D levels were repeated at 4 months from start of replacement. For patients who received correction, repeat levels >20 ng/ml were considered replete. Based on vitamin D levels in the peri-transplant period (within 120 days of transplant), patients were categorised as either vitamin D replete (> 20 ng/ml) or deplete (≤ 20 ng/ml). Peri-transplant vitamin D status was correlated with transplant outcomes. RESULTS Of the 133 patients included, 31 were deplete (median vitamin D 15.0 ng/ml) and 102 were replete (median vitamin D 34 ng/ml) at time of transplant. Both groups were matched for age, diagnosis, EBMT score and disease risk index (DRI). There were no differences in time to neutrophil or platelet engraftment, CMV reactivation, acute GvHD (aGvHD) or chronic GvHD (cGvHD) between the two groups. Relapse rate, Progression Free Survival (PFS) and Overall Survival (OS) were also comparable between the 2 groups. CONCLUSION The incidence of vitamin D deficiency was high in our patient cohort. Patients who were vitamin D deficient at the time of transplant did not have inferior outcomes, suggesting a limited role of vitamin D in influencing transplant outcomes.
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Affiliation(s)
- Nishant Jindal
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Megha Saroha
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Sumeet Mirgh
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Akanksha Chichra
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Lingaraj Nayak
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Avinash Bonda
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Anant Gokarn
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Sachin Punatar
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Bhausaheb Bagal
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Preeti Chavan
- Composite Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Libin Jacob Mathew
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Sadhana Kannan
- Department of Biostatistics, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Navin Khattry
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India.
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Madkaiker D, Hiregoudar SS, Chavan P, Ojha S, Mendes J, Shastry S. 'Ironing out the risk': Assessing the effect of plateletpheresis donation frequency on iron stores in South-Asian male donors. Vox Sang 2023; 118:921-929. [PMID: 37772675 DOI: 10.1111/vox.13525] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/12/2023] [Accepted: 08/17/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND AND OBJECTIVES Repeated blood donation is a well-known cause of iron deficiency among donors. However, present scientific literature lacks comprehensive evidence regarding the impact of regular plateletpheresis procedures on body iron reserves. In this study, we aimed to detect and correlate iron deficiency (using iron indices) with the frequency of platelet donations. Additionally, we also analysed the correlation between other iron and haematological indices with serum ferritin to determine cost-effective parameters that may serve as an initial screening approach to determine which donors should be subjected to serum ferritin testing. MATERIALS AND METHODS A total of 180 male participants from our platelet donor registry were enrolled in this observational cross-sectional study. Enrolment questionnaires were administered to eligible donors, and biological samples were collected during plateletpheresis donation. Biological tests such as complete blood count, reticulocyte indices, iron indices, vitamin B12 and folate were performed. RESULTS Donors with ≥12 donations per year showed the highest prevalence of low ferritin (serum ferritin: 15-30 ng/mL) and absent iron stores (serum ferritin <15 ng/mL) (41.3% and 26.7%, respectively). Ferritin showed a significant negative correlation with recent (r = -0.346) and lifetime donations (r = -0.196). The efficacy of other indices for identifying iron depletion was much better using a serum ferritin value <15 ng/mL. CONCLUSION Regular plateletpheresis donations can lead to varying severities of non-anaemic iron deficiency. Blood centres must regularly monitor frequent plateletpheresis donors (especially donors with more than 11 donations in a calendar year) and ideally maintain their serum ferritin above 30 ng/mL.
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Affiliation(s)
- Deep Madkaiker
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Transfusion Medicine, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Sumathi S Hiregoudar
- Department of Transfusion Medicine, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Preeti Chavan
- Composite Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Shashank Ojha
- Department of Transfusion Medicine, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Jennifer Mendes
- Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shamee Shastry
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Chavan P, Dey R, Castelino R, Kamble A, Poladia P, Bagal R, Jadhav M, Shirsat A, Chavan A, Dhumal S, Kumar S, Krishnamurty MN, Bhat V, Bhattacharjee A, Gota V. Safety, immunogenecity and effectiveness of ChAdOx1 nCoV-19 vaccine during the second wave of pandemic in India: a real-world study. Drug Metab Pers Ther 2023; 38:227-236. [PMID: 37098129 DOI: 10.1515/dmpt-2022-0150] [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: 06/30/2022] [Accepted: 01/23/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVES This real-world study was conducted to assess the adverse effects following immunization (AEFI) and immunogenicity of ChAdO×1 nCoV-19 vaccine in terms of neutralising antibody titers and to study the effects of covariates such as age, sex, comorbidities and prior COVID status on these outcomes. Also, the effectiveness of the vaccine based on interval between the two doses was also investigated. METHODS A total of 512 participants (M/F=274/238) aged 35(18-87) years comprising a mixed population of healthcare workers, other frontline workers and general public were enrolled between March and May 2021. Records for adverse events if any were collected telephonically by following up with participants up to 6 months post first dose and graded as per Common Terminology Criteria for Adverse Events (CTCAE) version 5. Blood samples for measuring antibody titers against the receptor binding domain (RBD) were collected serially using a convenient sampling strategy up to 6 months after the first dose. Data on breakthrough COVID infection was collected telephonically till December 2021. RESULTS Incidence of local reactions was higher after first dose at 33.4 % (171/512) compared to those after second dose at 12.9 % (66/512). Commonest side effect observed was injection site pain after the first (87.1 %; 149/171) and second (87.9 %; 56/66) dose respectively. Among systemic reactions, fever was the most common manifestation followed by myalgia and headache. Female sex (p<0⸱001) and age less than 60 years (p<0⸱001) had significantly higher predilection for systemic toxicities. Age ≤60 years (p=0.024) and prior-COVID (p<0.001) were found to be significantly associated with higher antibody titers, however, no association was found between these variables and breakthrough COVID infection. Longer spacing between the doses (≥6 weeks) was found to offer better protection against breakthrough infection compared to a spacing of 4 weeks. All breakthroughs were mild-moderate in severity, not requiring hospitalization. CONCLUSIONS The ChAdOx1 nCov-19 vaccine is apparently safe and effective against SARS-CoV-2 virus infection. Prior COVID infection and younger age group achieve higher antibody titers, but no additional protection. Delaying the second dose up to at least 6 weeks is more effective compared to shorter spacing between doses.
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Affiliation(s)
- Preeti Chavan
- Composite Lab, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
| | - Rajashree Dey
- Division of Biostatistics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
| | - Renita Castelino
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Akshay Kamble
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Pratik Poladia
- Composite Lab, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
| | - Rajani Bagal
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
- Department of Microbiology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Monica Jadhav
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Aditi Shirsat
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Ashish Chavan
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Sachin Dhumal
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
- Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Sharath Kumar
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Manjunath Nookala Krishnamurty
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Vivek Bhat
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
- Department of Microbiology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Atanu Bhattacharjee
- Division of Biostatistics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
| | - Vikram Gota
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
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Chavan P, Bhat V, Joshi A, Gupta T, Murthy V, Noronha V, Rathish D, Prabhash K. Salivary IgA as a Surrogate Biomarker for Microbial Infections in Postoperative Patients Receiving Chemo-Radio-Therapy for Head and Neck Cancer. J Lab Physicians 2023. [DOI: 10.1055/s-0042-1757720] [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: 02/03/2023] Open
Abstract
Abstract
Objective Radiotherapy (RT) and chemotherapy (CT) are important treatment options in patients with head and neck cancers. A common complication of this is microbial colonization or infection of mucosal surfaces. These infections may commonly be due to bacteria or yeasts. Salivary proteins with their buffering activity and immunoglobulin, especially immunoglobulin A (IgA), protect oral tissue, mucosal surfaces, and teeth from various microorganisms. This study characterizes the common microorganisms encountered and evaluates the role of salivary IgA in predicting microbial infections in this group of patients with mucositis.
Methods A total of 150 adult head and neck cancer patients on CTRT were evaluated at baseline and at the end of 3 and 6 weeks, respectively. Oral swabs collected from buccal mucosa were processed in the microbiology laboratory for the presence of microorganisms. Saliva was processed for IgA level estimation on Siemens Dimension Automated biochemistry analyzer.
Results Pseudomonas aeruginosa and Klebsiella pneumoniae were the most common organisms found in our patients, followed by Escherichia coli and group A beta-hemolytic Streptococci. A significant increase (p = 0.0203) in the incidence of bacterial infection was observed in post-CTRT patients (61%) compared to pre-CTRT patients (49.33%). There was significant increase in levels of salivary IgA (p = 0.003) in patients with bacterial and fungal infection (n = 135/267) when compared to those in samples showing no growth (n = 66/183).
Conclusion A significant increase in the incidence of bacterial infection in post-CTRT patients was observed in this study. This study also indicated that postoperative head and neck cancer patients with oral mucositis that developed an infection were associated with high salivary IgA levels, and it may serve as a surrogate biomarker of infection in these patients.
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Affiliation(s)
- Preeti Chavan
- Composite Laboratory, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra, India
| | - Vivek Bhat
- Department of Microbiology, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra, India
| | - Amit Joshi
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra, India
| | - Tejpal Gupta
- Department of Radiation Oncology, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra. India
| | - Vedang Murthy
- Department of Radiation Oncology, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra. India
| | - Vanita Noronha
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra, India
| | - Divya Rathish
- Department of Microbiology, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra, India
| | - Kumar Prabhash
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra, India
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Gohil D, Panigrahi GC, Gupta SK, Gandhi KA, Gera P, Chavan P, Sharma D, Sandur S, Gota V. Acute and sub-acute oral toxicity assessment of 5-hydroxy-1,4-naphthoquinone in mice. Drug Chem Toxicol 2022; 46:1-14. [PMID: 35899689 DOI: 10.1080/01480545.2022.2104306] [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: 02/21/2022] [Revised: 07/08/2022] [Accepted: 07/17/2022] [Indexed: 11/03/2022]
Abstract
5-hydroxy-1,4-naphthoquinone (5NQ) or juglone is a bioactive molecule found in walnuts and has shown therapeutic effects in various disease models. Limited information is available regarding the toxicity of 5NQ, thereby limiting the clinical development of this drug. In the present study, oral acute (50, 300 and 2000 mg/kg) and sub-acute toxicity (5, 15 and 50 mg/kg) was assessed in mice to evaluate the safety of 5NQ. The acute toxicity study identified 118 mg/kg as the point-of-departure dose (POD) for single oral administration of 5NQ using benchmark dose modeling (BMD). Repeated administration of 5NQ at doses of 15 and 50 mg/kg/day caused reduction in food consumption and body weight of mice along with alterations in liver and renal function. Histopathological assessment revealed significant damage to hepatic and renal tissues at all doses in the acute toxicity study, and at higher doses of 15 and 50 mg/kg in the sub-acute toxicity study. We observed dose dependent mortality in sub-acute toxicity study and the no observed adverse effect level (NOAEL) was established as < 5 mg/kg/day. Modeling the survival response in sub-acute toxicity study identified 1.74 mg/kg/day as the POD for repeated administration of 5NQ. Serum levels of aspartate aminotransferase (AST) were most sensitive to 5NQ administration with a lower limit of BMD interval (BMDL) of 1.1 × 10-3 mg/kg/day. The benchmark doses reported in the study can be further used to determine a reference dose of 5NQ for human risk assessment.
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Affiliation(s)
- Dievya Gohil
- Clinical Pharmacology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, India, Mumbai, India
| | - Girish Ch Panigrahi
- Clinical Pharmacology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, India, Mumbai, India
| | - Saurabh Kumar Gupta
- Clinical Pharmacology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, India, Mumbai, India
| | - Khushboo A Gandhi
- Clinical Pharmacology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Poonam Gera
- ICGC Lab, ACTERC, Tata Memorial Centre, Navi Mumbai, India
- Biorepository, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Preeti Chavan
- Department of Clinical Biochemistry, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Deepak Sharma
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, India, Mumbai, India
- Radiation Biology & Health Science Division, Bio-science Group, Bhabha Atomic Research Centre, Mumbai, India
| | - Santosh Sandur
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, India, Mumbai, India
- Radiation Biology & Health Science Division, Bio-science Group, Bhabha Atomic Research Centre, Mumbai, India
| | - Vikram Gota
- Clinical Pharmacology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, India, Mumbai, India
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Chavan P, Bhat V, Ojha S, Poojary M, Sharma N. M167 Establishing biological reference ranges for select biochemical parameters in adult Indian population. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.049] [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: 11/16/2022]
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Dhumal S, Patil A, More A, Kamtalwar S, Joshi A, Gokarn A, Mirgh S, Thatikonda P, Bhat P, Murthy V, Chavan P, Oak A, Gore S, Bhattacharjee A, Patkar N, Kannan S, Shetty N, Rawat A, Achrekar M, Trivedi B, Laskar S, Chaturvedi P, Badwe R, Khattry N, Gupta S. SARS-COV-2 reinfection after previous infection and vaccine breakthrough infection through the second wave of pandemic in India: An observational study. Int J Infect Dis 2022; 118:95-103. [PMID: 35192951 PMCID: PMC8857778 DOI: 10.1016/j.ijid.2022.02.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background There are sparse longitudinal data on SARS-CoV-2 infection after previous infection and after partial or full vaccination. Methods This study of a cohort of healthcare workers used Kaplan-Meier analysis with appropriate definition of events and censoring and used Cox models to assess outcomes, with data cut-off on June 18, 2021. Results A total of 1806 individuals with median age of 32 (18-64) years, 1483 (82.1%) with at least one vaccine dose, 1085 (60.1%) with 2 vaccine doses, 408 (22.6%) with at least one episode of SARS-CoV-2 infection, and 6 (1.47%) with 2 episodes of infection were included in the analysis. At median follow-up of 38.4 weeks after first SARS-CoV-2 infection (n=408), the 52-week probability of reinfection was 2.2% (95% CI, 1.0-4.91%); and at median follow-up of 13.3 weeks after second dose, the 16-week probability of breakthrough infection was 5.6% (95% CI, 4.33-7.23%), which was significantly higher among those without previous SARS-CoV-2 infection versus with previous infection (6.4% vs 1.8%, p=0.016, adjusted Cox HR=3.49, 95% CI, 1.09-11.20, p=0.036) and females versus males (7.9% vs 3.8%, p=0.007, adjusted Cox HR=2.06, 95% CI 1.19-3.56, p=0.01). Conclusions There was low probability of reinfection after previous SARS-CoV-2 infection and higher vaccine breakthrough infections among females and those without previous infection.
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Affiliation(s)
- Sachin Dhumal
- Department of Radiation Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Amar Patil
- Department of Medical Administration, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Ashwini More
- Department of Medicine, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Sujeet Kamtalwar
- Department of Medicine, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Amit Joshi
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, & Homi Bhabha National Institute, Mumbai, India
| | - Anant Gokarn
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, & Homi Bhabha National Institute, Mumbai, India
| | - Sumeet Mirgh
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, & Homi Bhabha National Institute, Mumbai, India
| | - Puneeth Thatikonda
- Department of Medical Administration, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Prasanth Bhat
- Department of Medical Administration, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Vedang Murthy
- Department of Radiation Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Preeti Chavan
- Department of Composite Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Amey Oak
- Centre for Cancer Epidemiology, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Suvarna Gore
- Centre for Cancer Epidemiology, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Atanu Bhattacharjee
- Centre for Cancer Epidemiology, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Nikhil Patkar
- Department of Hematopathology, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Sadhana Kannan
- Department of Biostatistics, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Nitin Shetty
- Department of Radiodiagnosis, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Anjali Rawat
- Department of Nursing, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, & Homi Bhabha National Institute, Mumbai, India
| | - Meera Achrekar
- Department of Nursing, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, & Homi Bhabha National Institute, Mumbai, India
| | - Bhakti Trivedi
- Department of Anaesthesiology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, & Homi Bhabha National Institute, Mumbai, India
| | - Siddhartha Laskar
- Department of Radiation Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India
| | - Pankaj Chaturvedi
- Centre for Cancer Epidemiology, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Tata Memorial Centre, Navi Mumbai, India; Department of Surgical Oncology, Tata Memorial Centre, & Homi Bhabha National Institute, Mumbai, India
| | - Rajendra Badwe
- Department of Surgical Oncology, Tata Memorial Centre, & Homi Bhabha National Institute, Mumbai, India
| | - Navin Khattry
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, & Homi Bhabha National Institute, Mumbai, India
| | - Sudeep Gupta
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, & Homi Bhabha National Institute, Mumbai, India.
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Shetty A, Chatterjee G, Rajpal S, Srivastava T, Gardi N, Mirgh S, Gokarn A, Punatar S, Shetty N, Joshi A, Nair S, Murthy V, Khattry N, Tembhare P, Dikshit R, Chaturvedi P, More A, Kamtalwar S, Chavan P, Bhat V, Patil A, Dhumal S, Bhat P, Subramanian P, Gujral S, Badwe R, Patkar N, Gupta S. Genomic Analysis of AZD1222 (ChAdOx1) Vaccine Breakthrough Infections in the City of Mumbai. Int J Clin Pract 2022; 2022:2449068. [PMID: 35685574 PMCID: PMC9159196 DOI: 10.1155/2022/2449068] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/22/2021] [Accepted: 12/01/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This manuscript describes the genetic features of SARS-CoV-2 mutations, prevalent phylogenetic lineages, and the disease severity amongst COVID-19-vaccinated individuals in a tertiary cancer hospital during the second wave of the pandemic in Mumbai, India. METHODS This observational study included 159 COVID-19 patients during the second wave of the pandemic from 17th March to 1st June 2021 at a tertiary cancer care centre in Mumbai. The cohort comprised of healthcare workers, staff relatives, cancer patients, and patient relatives. For comparison, 700 SARS-CoV-2 genomes sequenced during the first wave (23rd April to 25th September 2020) at the same centre were also analysed. Patients were assigned to nonvaccinated (no vaccination or <14 days from the 1st dose, n = 92), dose 1(≥14 days from the 1st dose to <14 days from the 2nd dose, n = 29), and dose 2 (≥14 days from the 2nd dose, n = 38) groups. Primary measure was the prevalence of SARS-CoV-2 genomic lineages among different groups. In addition, severity of COVID-19 was assessed according to clinical and genomic variables. RESULTS Kappa B.1.1671.1 and delta B.1.617.2 variants contributed to an overwhelming majority of sequenced genomes (unvaccinated: 40/92, 43.5% kappa, 46/92, 50% delta; dose 1: 14/29, 48.3% kappa, 15/29, 51.7% delta; and dose 2: 23/38, 60.5% kappa, 14/38 36.8% delta). The proportion of the kappa and delta variants did not differ significantly across the unvaccinated, dose 1, and dose 2 groups (p = 0.27). There was no occurrence of severe COVID-19 in the dose 2 group (0/38, 0% vs. 14/121, 11.6%; p = 0.02). SARS-CoV-2 genomes from all three severe COVID-19 patients in the vaccinated group belonged to the delta lineage (3/28, 10.7% vs. 0/39, 0.0%, p = 0.04). CONCLUSIONS Sequencing analysis of SARS-COV-2 genomes from Mumbai during the second wave of COVID-19 suggests the prevalence of the kappa B.1.617.1 and the delta B.1.627.2 variants among both vaccinated and unvaccinated individuals. Continued evaluation of genomic sequencing data from breakthrough COVID-19 is necessary for monitoring the properties of evolving variants of concern and formulating appropriate immune response boosting and therapeutic strategies.
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Affiliation(s)
- Arusha Shetty
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Gaurav Chatterjee
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sweta Rajpal
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Tuhina Srivastava
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Nilesh Gardi
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Sumeet Mirgh
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Anant Gokarn
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Sachin Punatar
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Nitin Shetty
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, India
| | - Amit Joshi
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Sudhir Nair
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India
| | - Vedang Murthy
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, India
| | - Navin Khattry
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Prashant Tembhare
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Rajesh Dikshit
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, India
| | - Pankaj Chaturvedi
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India
| | - Ashwini More
- Department of General Medicine, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Sujeet Kamtalwar
- Department of General Medicine, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Preeti Chavan
- Department of Laboratory Medicine, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Vivek Bhat
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Microbiology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Amar Patil
- Department of General Medicine, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Sachin Dhumal
- Department of General Medicine, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Prashant Bhat
- Department of General Medicine, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Papagudi Subramanian
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sumeet Gujral
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Rajendra Badwe
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India
| | - Nikhil Patkar
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sudeep Gupta
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
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9
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Bhat V, Chavan P, Bhat P. Recommendations for COVID-19-related biomedical waste management in health care facilities. Indian J Cancer 2022; 59:149-150. [PMID: 35645061 DOI: 10.4103/ijc.ijc_84_21] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Vivek Bhat
- Department of Microbiology, HBNI, Navi Mumbai, Maharashtra, India
| | - Preeti Chavan
- Composite Laboratory, HBNI, Navi Mumbai, Maharashtra, India
| | - Prashant Bhat
- Medical Administration, HBNI, ACTREC-TMC, Plot No. 1 and 2, Sector 22, Kharghar, Navi Mumbai, Maharashtra, India
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10
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Gupta SK, Gohil D, Panigrahi GC, Vaykar S, Rane P, Chavan P, Gota V. Comparison of different autoanalyzers for the determination of lymphocyte and neutrophil counts in mouse blood. Drug Metab Pers Ther 2021; 37:219-222. [PMID: 34854273 DOI: 10.1515/dmpt-2021-0156] [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: 07/08/2021] [Accepted: 07/27/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Autoanalyzers are used in clinical haematology for analysis of blood samples in clinical as well as in nonclinical studies. The results from these analyzers vary from machine to machine. In this study, we compared the lymphocyte and neutrophil count of mouse blood between ADVIA 2120i, Horiba Yumizen H2500 and CellaVision analyzers against manual counting as gold standard. METHODS Blood samples from 28 female BALB/c mice were collected and analyzed. Agreement between different autoanalyzers and manual counting were determined by Bland-Altman method. RESULTS A high level of agreement was found between CellaVision and manual technique for lymphocyte (Bias=4.75, 95% limits of agreement -14 to 24) and neutrophil count (Bias=0.68 (-17 to 19)). Agreement in lymphocyte count was also observed between ADVIA and manual counting, but to a lesser extent compared to CellaVision (Bias=13.9 (-10.45 to 38.27)). However, no agreement was observed for ADVIA (Neutrophils), Horiba (lymphocytes and neutrophils) with manual counting. CONCLUSIONS Our data suggests that CellaVision could be used for the differential counting of neutrophil and lymphocytes in mouse blood sample.
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Affiliation(s)
- Saurabh Kumar Gupta
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, India
| | - Dievya Gohil
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, India
| | - Girish Ch Panigrahi
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, India
| | - Swati Vaykar
- Composite Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Pallavi Rane
- Clinical Research Secretariat, ACTREC, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Preeti Chavan
- Homi Bhabha National Institute, Mumbai, India.,Composite Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Vikram Gota
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, India
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11
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Mirgh SP, Gokarn A, Rajendra A, More A, Kamtalwar S, Katti KS, Singh A, Goli VB, Ravind R, Madala R, Kakoti S, Maitre P, Punatar S, Chichra A, Patil A, Trivedi B, Joshi A, Patkar N, Tembhare P, Khanka T, Rajpal S, Chatterjee G, Kannan S, Subramanian P, Murthy V, Shetty N, Chavan P, Bhat V, Nair S, Khattry N, Gupta S. Clinical characteristics, laboratory parameters and outcomes of COVID-19 in cancer and non-cancer patients from a tertiary Cancer Centre in India. Cancer Med 2021; 10:8777-8788. [PMID: 34786866 PMCID: PMC8646792 DOI: 10.1002/cam4.4379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/12/2021] [Accepted: 09/23/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is paucity of data regarding clinical characteristics, laboratory parameters and outcomes of coronavirus disease (COVID-19) in cancer versus non-cancer patients, particularly from India. MATERIALS AND METHODS This was an observational, single-centre, retrospective analysis of patients with laboratory-confirmed COVID-19 hospitalised in our institution between 22 May 2020 and 1 December 2020. We compared baseline clinical characteristics, laboratory parameters and outcomes of COVID-19 (overall mortality, time to discharge) between cancer and non-cancer patients. RESULTS A total of 200 COVID-19 infection episodes were analysed of which 109 (54.5%) were patients with cancer and 91 (45.5%) were patients without cancer. The median age was 43 (interquartile range [IQR]:32-57), 51 (IQR: 33-62) and 38 (IQR: 31.5-49.3) years; of whole cohort, cancer and non-cancer patients, respectively. Comparison of outcomes showed that oxygen requirement (31.2% [95% CI: 22.6-40.7] vs. 17.6% [95% CI: 10.4-26.9]; p = 0.03), median time to discharge (11 days [IQR: 6.75-16] vs. 6 days [IQR: 3-9.75]; p < 0.001) and mortality (10.0% [95% CI: 5.2-17.3] vs. 1.1% [95% CI: 0.03-5.9]; p = 0.017) were significantly higher in patients with cancer. In univariable analysis, factors associated with higher mortality in the whole cohort included diagnosis of cancer (10.1% vs. 1.1%; p = 0.027; odds ratio [OR]: 7.04), age ≥60 (17.4% vs. 2.6%; p = 0.001; OR: 7.38), oxygen requirement (22% vs. 0.6%; p < 0.001; OR: 29.01), chest infiltrates (19.2% vs. 1.4%; p < 0.001; OR: 22.65), baseline absolute lymphocyte count <1 × 109 /L (10.8% vs. 1.9%; p = 0.023; OR:5.1), C-reactive protein >1 mg% (12.8% vs. 0%; p = 0.027; OR: 24.69), serum procalcitonin >0.05 ng/ml (22.65% vs. 0%; p = 0.004; OR: 4.49) and interleukin-6 >6 pg/ml (10.8% vs. 1.3%; p = 0.036; OR: 3.08). In multivariable logistic regression, factors significantly associated with mortality were oxygen requirement (p = 0.005; OR: 13.11) and high baseline procalcitonin level (p = 0.014; OR: 37.6). CONCLUSION Cancer patients with COVID-19 have higher mortality and require longer hospital stay. High procalcitonin levels and oxygen requirement during admission are other factors that affect outcomes adversely.
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12
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Tembhare PR, Sriram H, Chatterjee G, Khanka T, Gokarn A, Mirgh S, Rajendra A, Chaturvedi A, Ghogale SG, Deshpande N, Girase K, Dalvi K, Rajpal S, Patkar N, Trivedi B, Joshi A, Murthy V, Shetty N, Nair S, More A, Kamtalwar S, Chavan P, Bhat V, Bhat P, Subramanian PG, Gupta S, Khattry N. Comprehensive immune cell profiling depicts an early immune response associated with severe coronavirus disease 2019 in cancer patients. Immunol Cell Biol 2021; 100:61-73. [PMID: 34582592 PMCID: PMC8652640 DOI: 10.1111/imcb.12504] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 06/04/2021] [Revised: 08/22/2021] [Accepted: 09/27/2021] [Indexed: 12/12/2022]
Abstract
Recent studies have highlighted multiple immune perturbations related to severe acute respiratory syndrome coronavirus 2 infection-associated respiratory disease [coronavirus disease 2019 (COVID-19)]. Some of them were associated with immunopathogenesis of severe COVID-19. However, reports on immunological indicators of severe COVID-19 in the early phase of infection in patients with comorbidities such as cancer are scarce. We prospectively studied about 200 immune response parameters, including a comprehensive immune-cell profile, inflammatory cytokines and other parameters, in 95 patients with COVID-19 (37 cancer patients without active disease and intensive chemo/immunotherapy, 58 patients without cancer) and 21 healthy donors. Of 95 patients, 41 had severe disease, and the remaining 54 were categorized as having a nonsevere disease. We evaluated the association of immune response parameters with severe COVID-19. By principal component analysis, three immune signatures defining characteristic immune responses in COVID-19 patients were found. Immune cell perturbations, in particular, decreased levels of circulating dendritic cells (DCs) along with reduced levels of CD4 T-cell subsets such as regulatory T cells (Tregs ), type 1 T helper (Th1) and Th9; additionally, relative expansion of effector natural killer (NK) cells were significantly associated with severe COVID-19. Compared with patients without cancer, the levels of terminal effector CD4 T cells, Tregs , Th9, effector NK cells, B cells, intermediate-type monocytes and myeloid DCs were significantly lower in cancer patients with mild and severe COVID-19. We concluded that severely depleted circulating myeloid DCs and helper T subsets in the initial phase of infection were strongly associated with severe COVID-19 independent of age, type of comorbidity and other parameters. Thus, our study describes the early immune response associated with severe COVID-19 in cancer patients without intensive chemo/immunotherapy.
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Affiliation(s)
- Prashant R Tembhare
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Harshini Sriram
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Gaurav Chatterjee
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Twinkle Khanka
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Anant Gokarn
- Department of Medical Oncology, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Sumeet Mirgh
- Department of Medical Oncology, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Akhil Rajendra
- Department of Medical Oncology, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Anumeha Chaturvedi
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Sitaram G Ghogale
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Nilesh Deshpande
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Karishma Girase
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Kajal Dalvi
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Sweta Rajpal
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Nikhil Patkar
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Bhakti Trivedi
- Department of Anesthesiology, Critical Care and Pain, Tata Memorial Center, HBNI University, Mumbai, India
| | - Amit Joshi
- Department of Medical Oncology, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Vedang Murthy
- Department of Radiation Oncology, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Nitin Shetty
- Department of Radio-Diagnosis, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Sudhir Nair
- Department of Head and Neck Surgical Oncology, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Ashwini More
- Department of Medicine, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Sujeet Kamtalwar
- Department of Medicine, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Preeti Chavan
- Composite Laboratory and Microbiology, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Vivek Bhat
- Composite Laboratory and Microbiology, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Prashant Bhat
- Medical Administration, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Papagudi G Subramanian
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Sudeep Gupta
- Department of Medical Oncology, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
| | - Navin Khattry
- Department of Medical Oncology, ACTREC, Tata Memorial Center, HBNI University, Mumbai, India
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13
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Bhat V, Chavan P, Khattry N, Gupta S. Dynamics of viral RNA load, virus culture, seroconversion & infectivity in COVID-19 patients: Implications on isolation policy. Indian J Med Res 2021; 153:585-590. [PMID: 34414920 PMCID: PMC8555608 DOI: 10.4103/ijmr.ijmr_3564_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/23/2022] Open
Abstract
The ongoing SARS-CoV-2 pandemic has spread all over the world due to rapid person-to-person transmission. More information about viral load dynamics and replication is needed for clarity on duration of infectiousness of an individual, along with its implications on transmission. This is important to healthcare facilities and public health authorities in formulating guidance on the duration of isolation for patients and return to work criteria for healthcare workers. The duration of detection of viral RNA by molecular methods in the upper respiratory tract has ranged from 2 to 12 wk. Viral RNA detection by reverse transcription polymerase chain reaction (RT-PCR) does not necessarily mean that the individual is infectious to others, as the detected virus may not be replication competent. Infectious virus is generally not shed beyond 20 days of the onset of symptoms in most patients, including severely ill and immunocompromised, as indicated by failure to isolate replication-competent virus beyond this timeline in available studies. Further, detection of neutralizing antibodies in the serum, although associated with positive RT-PCR, is generally not associated with infectious virus shedding as indicated by negative viral cultures beyond this period. In this review, we analyze the current literature on the dynamics of viral load, culture, seroconversion and their implications on infectivity and the duration of isolation precautions for COVID-19 patients.
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Affiliation(s)
- Vivek Bhat
- Department of Microbiology, Advanced Centre for Treatment, Research & Education, Tata Memorial Centre, Homi Bhaba National Institute, Navi Mumbai, Maharashtra, India
| | - Preeti Chavan
- Department of Composite Laboratory, Advanced Centre for Treatment, Research & Education, Tata Memorial Centre, Homi Bhaba National Institute, Navi Mumbai, Maharashtra, India
| | - Navin Khattry
- Department of Medical Oncology, Advanced Centre for Treatment, Research & Education, Tata Memorial Centre, Homi Bhaba National Institute, Navi Mumbai, Maharashtra, India
| | - Sudeep Gupta
- Department of Medical Oncology, Advanced Centre for Treatment, Research & Education, Tata Memorial Centre, Homi Bhaba National Institute, Navi Mumbai, Maharashtra, India
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14
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Mirgh S, Gokarn A, Punatar S, Chichra A, Singh A, Rajendra A, Babu Goli V, Trivedi B, Joshi A, Patkar N, Tembhare P, Subramanian PG, Shetty N, Chavan P, Bhat V, Gupta S, Khattry N. Clinical course of severe COVID19 treated with tocilizumab and antivirals post-allogeneic stem cell transplant with extensive chronic GVHD. Transpl Infect Dis 2021; 23:e13576. [PMID: 33523551 PMCID: PMC7994986 DOI: 10.1111/tid.13576] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/30/2020] [Revised: 01/11/2021] [Accepted: 01/17/2021] [Indexed: 12/15/2022]
Abstract
Recipients of allogeneic hematopoietic stem cell transplantation (allo‐HSCT) are an immunocompromised group who are likely to develop severe complications and mortality because of coronavirus disease 2019 (COVID‐19). We report here a 61‐year‐old male patient of primary myelofibrosis who underwent an allo‐HSCT 6 years earlier, had chronic graft‐versus‐host disease (cGVHD) involving the liver, lung, eyes, and skin, (with recurrent episodes of pulmonary infections) who developed severe COVID‐19. The patient was treated with tocilizumab, and a combination of lopinavir/ritonavir, ribavirin, interferon‐β1b. He was discharged after 31 days with full recovery. Tocilizumab, a humanized monoclonal antibody against IL6, has been shown to benefit respiratory manifestations in severe COVID19. However, this is first report, to our knowledge, of its use and benefit in a post HSCT recipient.
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Affiliation(s)
- Sumeet Mirgh
- Department of Medical Oncology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Anant Gokarn
- Department of Medical Oncology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sachin Punatar
- Department of Medical Oncology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Akanksha Chichra
- Department of Medical Oncology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Anuj Singh
- Department of Medical Oncology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Akhil Rajendra
- Department of Medical Oncology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Vasu Babu Goli
- Department of Medical Oncology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Bhakti Trivedi
- Homi Bhabha National Institute, Mumbai, Maharashtra, India.,Department of Anaesthesiology, Pain and Critical Care Medicine, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Amit Joshi
- Department of Medical Oncology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Nikhil Patkar
- Homi Bhabha National Institute, Mumbai, Maharashtra, India.,Department of Hemato-Pathology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Prashant Tembhare
- Homi Bhabha National Institute, Mumbai, Maharashtra, India.,Department of Hemato-Pathology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - P G Subramanian
- Homi Bhabha National Institute, Mumbai, Maharashtra, India.,Department of Hemato-Pathology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Nitin Shetty
- Homi Bhabha National Institute, Mumbai, Maharashtra, India.,Department of Radiodiagnosis, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Preeti Chavan
- Homi Bhabha National Institute, Mumbai, Maharashtra, India.,Department of Laboratory Medicine, ACTREC - Tata Memorial Centre, ACTREC, Navi Mumbai, Maharashtra, India.,Department of Microbiology, ACTREC - Tata Memorial Centre, ACTREC, Navi Mumbai, Maharashtra, India
| | - Vivek Bhat
- Homi Bhabha National Institute, Mumbai, Maharashtra, India.,Department of Microbiology, ACTREC - Tata Memorial Centre, ACTREC, Navi Mumbai, Maharashtra, India
| | - Sudeep Gupta
- Department of Medical Oncology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Navin Khattry
- Department of Medical Oncology, ACTREC - Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
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15
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Abstract
AbstractThe outbreak of Novel Coronavirus Pneumonia SARS-CoV-2 has necessitated the reinforcement of infection control measures in the hospital and laboratory setting. Contact and droplet infection control measures are advised for handling patients diagnosed with COVID-19 and airborne precautions for procedures that generate aerosols.Risk assessment is conducted for all steps of laboratory processes viz. preanalytical, analytical and postanalytical. Standard Precautions must be followed at all times when laboratory staff handle clinical specimens that may contain infectious microorganism. Standard precautions must include hand hygiene along with the use of personal protective equipment (PPE). All samples are collected in appropriate containers and all containers are decontaminated by 62-71% ethanol (alcohol) before transporting them to the laboratory in triple packaging.All samples should undergo initial processing in a biosafety cabinet (BSC). It should be ensured while undertaking all technical procedures that there is minimal formation of aerosols and droplets.All biomedical waste should be disposed as per state and national guidelines. Decontamination includes use of 1% sodium hypochlorite, 62-71% ethanol for surface disinfection or Hydrogen peroxide (0.5%).These laboratory biosafety measures are important to minimise the risk of laboratory transmission of COVID-19 to health care workers.
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Affiliation(s)
- Vivek Bhat
- Department of Microbiology, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Preeti Chavan
- OIC, Composite Laboratory, ACTREC-Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Sanjay Biswas
- Department of Microbiology, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Navin Khattry
- Department of Medical Oncology, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Prafulla Thakkar
- Department of General Medicine, ACTREC-Tata Memorial Centre, Navi Mumbai, Maharashtra, India
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Chavan P, Bhat V, Karmore A, Mohite R, Waykar S, Kadu H. Establishing Syva Methotrexate Assay on Siemens Dimension RxL Analyzer: Experience in a Tertiary Cancer Care Laboratory. J Lab Physicians 2020; 9:67-68. [PMID: 28042223 PMCID: PMC5015505 DOI: 10.4103/0974-2727.187923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/25/2022] Open
Affiliation(s)
- Preeti Chavan
- Composite Laboratory, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Vivek Bhat
- Composite Laboratory, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Ashwadeep Karmore
- Composite Laboratory, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Rajani Mohite
- Composite Laboratory, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Swati Waykar
- Composite Laboratory, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Hemali Kadu
- Composite Laboratory, Advanced Centre for Treatment, Research and Education in Cancer-Tata Memorial Centre, Mumbai, Maharashtra, India
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Holmes L, Chavan P, Blake T, Dabney K. Unequal Cumulative Incidence and Mortality Outcome in Childhood Brain and Central Nervous System Malignancy in the USA. J Racial Ethn Health Disparities 2018. [PMID: 29516435 DOI: 10.1007/s40615-018-0462-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 12/14/2022]
Abstract
BACKGROUND While survival in overall pediatric malignancy has improved during recent decades, brain/central nervous system (CNS) tumors has not demonstrated comparable survival advantage. Incidence and mortality data in this malignancy continue to illustrate race and sex differences; however, there are few data in the pediatric setting. This study sought to characterize brain/CNS tumors by socio-demographic and assess racial and sex variances in both cumulative incidence and mortality. METHODS A retrospective cohort design with Surveillance, Epidemiology and End Results (SEER) 1973-2014 was used for the assessment of children aged < 1-19 years diagnosed with brain/CNS tumors. The age-adjusted incidence rates were used for temporal trends, percent change, and annual percent change. We utilized binomial regression model to determine the exposure effect of race and sex on cancer mortality, adjusting for potential confounders. RESULTS Childhood brain/CNS tumor cumulative incidence (CmI) continues to rise in annual percent change, and mortality varied by race, sex, and year of diagnosis. The CmI was highest among whites, intermediate among blacks, and lowest among Asians, as well as lower in females relative to that in males. Compared to whites, blacks were 21% more likely to die from brain/CNS tumors [risk ratio (RR) 1.21, 95% confidence interval (C.I.) 1.13-1.28], while males were 4% more likely to die relative to females (RR 1.04, 95% C.I. 1.00-1.08). After controlling for age, sex, and tumor grade, racial disparities persisted, with 16% increased risk of dying among blacks relative to whites [adjusted risk ratio 1.16, (99% C.I.) 1.08-1.25, p < 0.001]. CONCLUSION The cumulative incidence of brain/CNS malignancy is higher among whites relative to that in blacks; however, blacks experienced survival disadvantage even after adjustment for potential tumor prognostic and predisposing factors.
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Affiliation(s)
- L Holmes
- Health Disparities Science Research Program, Office of Health Equity & Inclusion, Nemours Healthcare System for Children, 2200 Concord Pike, 7th floor, Wilmington, DE, 19803, USA.
- Office of Health Equity and Inclusion, Health Disparities Science Research Section, Nemours/AIDHC, Wilmington, DE, 19803, USA.
- Biological Sciences Department, University of Delaware, Newark, DE, 19716, USA.
- Medical College of Wisconsin, Clinical & Translational Science Institute, Milwaukee, WI, 53226, USA.
| | - P Chavan
- Health Disparities Science Research Program, Office of Health Equity & Inclusion, Nemours Healthcare System for Children, 2200 Concord Pike, 7th floor, Wilmington, DE, 19803, USA
- Office of Health Equity and Inclusion, Health Disparities Science Research Section, Nemours/AIDHC, Wilmington, DE, 19803, USA
- Department of Epidemiology, Biostatistics and Environmental Health, University of Memphis School of Public Health, Memphis, TN, 38152, USA
| | - T Blake
- Health Disparities Science Research Program, Office of Health Equity & Inclusion, Nemours Healthcare System for Children, 2200 Concord Pike, 7th floor, Wilmington, DE, 19803, USA
- Office of Health Equity and Inclusion, Health Disparities Science Research Section, Nemours/AIDHC, Wilmington, DE, 19803, USA
- College of Health & Human Development, Penn State University, PA, 16802, State College, USA
| | - K Dabney
- Health Disparities Science Research Program, Office of Health Equity & Inclusion, Nemours Healthcare System for Children, 2200 Concord Pike, 7th floor, Wilmington, DE, 19803, USA
- Office of Health Equity and Inclusion, Health Disparities Science Research Section, Nemours/AIDHC, Wilmington, DE, 19803, USA
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Bhat V, Gupta S, Kelkar R, Biswas S, Khattry N, Moiyadi A, Bhat P, Ambulkar R, Chavan P, Chiplunkar S, Kotekar A, Gupta T. Bacteriological profile and antibiotic susceptibility patterns of clinical isolates in a tertiary care cancer center. Indian J Med Paediatr Oncol 2016; 37:20-4. [PMID: 27051152 PMCID: PMC4795369 DOI: 10.4103/0971-5851.177010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 01/12/2023] Open
Abstract
Introduction: This increased risk of bacterial infections in the cancer patient is further compounded by the rising trends of antibiotic resistance in commonly implicated organisms. In the Indian setting this is particularly true in case of Gram negative bacilli such as Escherichia coli, Klebsiella pneumoniae and Acinetobacter spp. Increasing resistance among Gram positive organisms is also a matter of concern. The aim of this study was to document the common organisms isolated from bacterial infections in cancer patients and describe their antibiotic susceptibilities. Methods: We conducted a 6 month study of all isolates from blood, urine, skin/soft tissue and respiratory samples of patients received from medical and surgical oncology units in our hospital. All samples were processed as per standard microbiology laboratory operating procedures. Isolates were identified to species level and susceptibility tests were performed as per Clinical Laboratory Standards Institute (CLSI) guidelines -2012. Results: A total of 285 specimens from medical oncology (114) and surgical oncology services (171) were cultured. Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter spp. were most commonly encountered. More than half of the Acinetobacter strains were resistant to carbapenems. Resistance in Klebsiella pneumoniae to cephalosporins, fluoroquinolones and carbapenems was >50%. Of the Staphylococcus aureus isolates 41.67% were methicillin resistant. Conclusion: There is, in general, a high level of antibiotic resistance among gram negative bacilli, particularly E. coli, Klebsiella pneumoniae and Acinetobacter spp. Resistance among Gram positives is not as acute, although the MRSA incidence is increasing.
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Affiliation(s)
- Vivek Bhat
- ACTREC, Tata Memorial Centre, Kharghar, Mumbai, Maharashtra, India
| | - Sudeep Gupta
- ACTREC, Tata Memorial Centre, Kharghar, Mumbai, Maharashtra, India
| | - Rohini Kelkar
- TMH, Tata Memorial Centre, Kharghar, Mumbai, Maharashtra, India
| | - Sanjay Biswas
- TMH, Tata Memorial Centre, Kharghar, Mumbai, Maharashtra, India
| | - Navin Khattry
- ACTREC, Tata Memorial Centre, Kharghar, Mumbai, Maharashtra, India
| | - Aliasgar Moiyadi
- ACTREC, Tata Memorial Centre, Kharghar, Mumbai, Maharashtra, India
| | - Prashant Bhat
- ACTREC, Tata Memorial Centre, Kharghar, Mumbai, Maharashtra, India
| | - Reshma Ambulkar
- ACTREC, Tata Memorial Centre, Kharghar, Mumbai, Maharashtra, India
| | - Preeti Chavan
- ACTREC, Tata Memorial Centre, Kharghar, Mumbai, Maharashtra, India
| | | | - Amol Kotekar
- ACTREC, Tata Memorial Centre, Kharghar, Mumbai, Maharashtra, India
| | - Tejpal Gupta
- ACTREC, Tata Memorial Centre, Kharghar, Mumbai, Maharashtra, India
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Chavan P, Bhat V, Tiwari M, Gavhane U, Pal SK. Comparison of Complete Blood Count Parameters between Venous and Capillary Blood in Oncology Patients. J Lab Physicians 2016; 8:65-6. [PMID: 27013818 PMCID: PMC4785771 DOI: 10.4103/0974-2727.176238] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 11/16/2022] Open
Affiliation(s)
- Preeti Chavan
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Vivek Bhat
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Manikchandra Tiwari
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Umakant Gavhane
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Sanjay Kumar Pal
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
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Bhat V, Joshi A, Sarode R, Chavan P. Cytomegalovirus infection in the bone marrow transplant patient. World J Transplant 2015; 5:287-291. [PMID: 26722656 PMCID: PMC4689939 DOI: 10.5500/wjt.v5.i4.287] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 09/09/2015] [Accepted: 11/17/2015] [Indexed: 02/05/2023] Open
Abstract
Cytomegalovirus (CMV) infection is an important contributor to the morbidity and mortality associated with bone marrow transplantation (BMT). Infection may lead to CMV disease involving multiple organs such as pneumonia, gastroenteritis, retinitis, central nervus system involvement and others. CMV seropositivity is an important risk factor and approximately half of BMT recipients will develop clinically significant infection most commonly in the first 100 d post-transplant. The commonly used tests to diagnose CMV infection in these patients include the pp65 antigenemia test and the CMV DNA polymerase chain reaction (PCR) assay. Because of its greater sensitivity and lesser turnaround time, the CMV PCR is nowadays the preferred test and serves as a main guide for pre-emptive therapy. Methods of CMV prevention include use of blood products from seronegative donors or leukodepleted products. Prophylaxis or pre-emptive therapy strategies for CMV prevention may be used post-transplant with the latter becoming more common. The commonly used antivirals for pre-emptive therapy and CMV disease management include intravenous gancyclovir and foscarnet. The role of intravenous immunoglobulin, although used commonly in CMV pneumonia is not clear.
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Affiliation(s)
- Preeti Chavan
- Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Navi Mumbai, Maharashtra, India
| | - Vivek Bhat
- Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Navi Mumbai, Maharashtra, India
| | - Ulka Gosavi
- Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Navi Mumbai, Maharashtra, India
| | - Babu Pillai
- Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Navi Mumbai, Maharashtra, India
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Bhat VG, Chavan P, Ojha S, Nair PK. Challenges in the Laboratory Diagnosis and Management of Dengue Infections. Open Microbiol J 2015; 9:33-7. [PMID: 26668659 PMCID: PMC4676044 DOI: 10.2174/1874285801509010033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [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: 01/18/2015] [Revised: 06/01/2015] [Accepted: 06/01/2015] [Indexed: 02/02/2023] Open
Abstract
Dengue fever is considered the most important arthropod-borne viral diseases in terms of morbidity and mortality. An accurate and efficient diagnosis of dengue plays an important role in case confirmation. The virus may be isolated during the viremic phase (within day 5 of illness), from serum, plasma and peripheral blood mononuclear cells. Enzyme linked immunoassay (ELISA) has demonstrated the presence of high levels of dengue NS1 antigen and tests may be performed by enzyme-immunoassays (EIAs) or immune-chromatographic (ICT) methods. These assays are specific with respect to different flaviviruses. Conventional and real time RT PCR, nested PCR, multiplex PCR and Nucleic acid sequence based amplification (NASBA) have been described as sensitive and relatively rapid method of detecting the virus during the early viremic phase. Other tests used include assay of anti-dengue specific IgM and IgG ELISA. Currently no curative treatment in terms of anti-viral drugs is available for dengue and patients are managed with rest and aggressive supportive therapy. Management may be done at home or in the hospital depending on the severity of the illness. Hospital management includes fluid therapy, blood component transfusion and other modalities of treatments like steroids, recombinant factor VII and management of complications. Various vaccines are in trial stages and may become available in the near future.
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Affiliation(s)
- Vivek G Bhat
- Department of Microbiology, ACTREC -Tata Memorial Center, Navi Mumbai- 410210
| | - Preeti Chavan
- Composite Laboratory, ACTREC -Tata Memorial Center, Navi Mumbai- 410210
| | - Shashank Ojha
- Department of Transfusion Medicine, ACTREC -Tata Memorial Center, Navi Mumbai- 410210
| | - Pravin K Nair
- Department of Microbiology, Holy Spirit Hospital, Andheri (E), Mumbai 400093, India
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Dhobale M, Chavan P, Mehendale S, Pisal H, Joshi S. WITHDRAWN: Maternal cortisol and cord brain derived neurotrophic factor in preterm pregnancy: implications for fetal neurodevelopment. Int J Dev Neurosci 2012:S0736-5748(12)00295-X. [PMID: 22543235 DOI: 10.1016/j.ijdevneu.2012.03.256] [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: 11/26/2022] Open
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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Affiliation(s)
- M Dhobale
- Department of Nutritional Medicine, Interactive Research School for Health Affairs, Bharati Vidyapeeth University,Pune 411043,India
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Joshi K, Chavan P. Development of sequence characterized amplified region from random amplified polymorphic DNA amplicons. Methods Mol Biol 2012; 862:123-134. [PMID: 22419493 DOI: 10.1007/978-1-61779-609-8_10] [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: 05/31/2023]
Abstract
Among the PCR-based markers that are most widely used in molecular genetic studies, SCARs (sequence characterized amplified regions) have the advantage of being less sensitive to the conditions of a standard PCR due to its primer size when compared to RAPD (random amplified polymorphic DNA) and hence are more specific and reproducible. Moreover, SCARs require no radioactive isotopes and detect only a single locus. Here, we describe the development of SCAR from RAPD amplicons.
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Affiliation(s)
- Kalpana Joshi
- Department of Biotechnology, Sinhgad College of Engineering, Pune, India.
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Dhobale M, Chavan P, Kulkarni A, Mehendale S, Pisal H, Joshi S. Reduced Folate, Increased Vitamin B12 and Homocysteine Concentrations in Women Delivering Preterm. Ann Nutr Metab 2012; 61:7-14. [DOI: 10.1159/000338473] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 04/01/2012] [Indexed: 12/14/2022]
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Nikam V, Chavan P. Influence of water deficit and waterlogging on the mineral status of a medicinal plantChlorophytum borivilianum. ACTA ACUST UNITED AC 2009. [DOI: 10.1556/abot.51.2009.1-2.13] [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: 11/19/2022]
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Chavan P, Warude D, Joshi K, Patwardhan B. Development of SCAR (sequence-characterized amplified region) markers as a complementary tool for identification of ginger (Zingiber officinale Roscoe) from crude drugs and multicomponent formulations. Biotechnol Appl Biochem 2008; 50:61-9. [PMID: 17868041 DOI: 10.1042/ba20070128] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [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: 11/17/2022]
Abstract
Zingiber officinale Roscoe (common or culinary ginger) is an official drug in Ayurvedic, Indian herbal, Chinese, Japanese, African and British Pharmacopoeias. The objective of the present study was to develop DNA-based markers that can be applied for the identification and differentiation of the commercially important plant Z. officinale Roscoe from the closely related species Zingiber zerumbet (pinecone, bitter or 'shampoo' ginger) and Zingiber cassumunar [cassumunar or plai (Thai) ginger]. The rhizomes of the other two Zingiber species used in the present study are morphologically similar to that of Z. officinale Roscoe and can be used as its adulterants or contaminants. Various methods, including macroscopy, microscopy and chemoprofiling, have been reported for the quality control of crude ginger and its products. These methods are reported to have limitations in distinguishing Z. officinale from closely related species. Hence, newer complementary methods for correct identification of ginger are useful. In the present study, RAPD (random amplification of polymorphic DNA) analysis was used to identify putative species-specific amplicons for Z. officinale. These were further cloned and sequenced to develop SCAR (sequence-characterized amplified region) markers. The developed SCAR markers were tested in several non-Zingiber species commonly used in ginger-containing formulations. One of the markers, P3, was found to be specific for Z. officinale and was successfully applied for detection of Z. officinale from Trikatu, a multicomponent formulation.
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Affiliation(s)
- Preeti Chavan
- Bioprospecting Laboratory, Interdisciplinary School of Health Sciences, University of Pune, Pune 411007, India
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Chavan P, Joshi K, Patwardhan B. DNA microarrays in herbal drug research. Evid Based Complement Alternat Med 2006; 3:447-57. [PMID: 17173108 PMCID: PMC1697755 DOI: 10.1093/ecam/nel075] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2006] [Accepted: 09/19/2006] [Indexed: 12/18/2022]
Abstract
Natural products are gaining increased applications in drug discovery and development. Being chemically diverse they are able to modulate several targets simultaneously in a complex system. Analysis of gene expression becomes necessary for better understanding of molecular mechanisms. Conventional strategies for expression profiling are optimized for single gene analysis. DNA microarrays serve as suitable high throughput tool for simultaneous analysis of multiple genes. Major practical applicability of DNA microarrays remains in DNA mutation and polymorphism analysis. This review highlights applications of DNA microarrays in pharmacodynamics, pharmacogenomics, toxicogenomics and quality control of herbal drugs and extracts.
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Millar CE, Gangler FA, Robinson WO, Dusserre C, Chavan P, Molinari, Bosworth AW, Neubauer H, Wolferts E, Incze G, Kroll P, Hartleb R, Wagner P, Robertson GS, Pranke EJ. Phosphors�ure. Anal Bioanal Chem 1918. [DOI: 10.1007/bf01452090] [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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