5 results on '"Badira Cheriyalinkal Parambil"'
Search Results
2. Pediatric cancer‐associated thrombosis: Analysis from a tertiary care cancer center in India
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Nidhi Dhariwal, Venkata Rama Mohan Gollamudi, K. P. Sangeetha, Badira Cheriyalinkal Parambil, Nirmalya Roy Moulik, Chetan Dhamne, Maya Prasad, Tushar Vora, Girish Chinnaswamy, Seema Kembhavi, Papagudi G. Subramanian, Sumeet Gujral, S. D. Banavali, and Gaurav Narula
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Oncology ,Pediatrics, Perinatology and Child Health ,Hematology - Abstract
Thrombotic events (TEs) have been extensively studied in adult cancer patients, but data in children are limited. We prospectively analyzed pediatric cancer-associated thrombosis (PCAT) in children with malignancies.Children below 15 years of age with confirmed malignancies, treated at a large tertiary cancer center in India from July 2015 to March 2020 developing any TE were eligible. A standardized approach for detection and management was followed. Data were collected after informed consent.Of 6132 eligible children, 150 (2.44%) had 152 TEs, with median age 8.5 years and male:female of 1.83:1. Most TEs occurred on chemotherapy: 111 (74.0%). The most common site was central nervous system (CNS) 59 (39.3%), followed by upper-limb venous system 37 (24.7%). Hemato-lymphoid (HL) malignancies were more prone to PCAT than solid tumors (ST) (incidence 3.23% vs. 1.58%; odds ratio [OR] = 2.06, 95% confidence interval [CI] [1.36-2.88]; p .001). Malignancies associated with PCAT were acute lymphoblastic leukemia (ALL) 2.94%, acute myeloid leukemia (AML) 6.66%, and non-Hodgkin lymphomas 5.35%. Response imaging done in 106 (70.7%) children showed complete to partial resolution in almost 90% children. Death was attributable to TE in seven (4.66%) children. Age above 10 years (OR 2.33, 95% CI [1.59-3.41]; p .001), AML (OR 4.62, 95% CI [1.98-10.74]; p = .0062), and non-Hodgkin lymphoma (OR 4.01, 95% CI [1.15-14.04]; p = .029) were significantly associated with TEs. In ALL, age more than 10 years (OR 1.86, 95% CI [1.06-3.24]; p .03), T-ALL (OR 3.32, 95% CI [1.69-6.54]; p = .001), and intermediate-risk group (OR 4.97, 95% CI [1.12-22.02]; p = .035) were significantly associated with thrombosis. The 2-year event-free survival (EFS) for HL malignancies with PCAT was 55.3% versus 72.1% in those without PCAT (p = .05), overall survival (OS) being 84.6% versus 80.0% (p = .32).Incidence of PCAT was 2.4%, and occurred predominantly in older children with hematolymphoid malignancies early in treatment. Most resolved completely with low molecular weight heparin (LMWH) and mortality was low. In hematolymphoid malignancies, PCAT reduce EFS, highlighting the need for prevention.
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- 2022
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3. Psychological distress in primary caregivers of children with cancer during COVID‐19 pandemic‐A single tertiary care center experience
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Girish Chinnaswamy, Gaurav Narula, Chetan Dhamne, Akanksha Chichra, Nirmalya Roy Moulik, Badira Cheriyalinkal Parambil, Harshita Sarda, Shalini Jatia, Amey Paradkar, Lekhika Sonkusare, Savita Goswami, Tushar Vora, Shripad Banavali, Jayita Deodhar, and Maya Prasad
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caregivers ,Pediatrics ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,children with cancer ,Psycho-oncology ,Experimental and Cognitive Psychology ,Psychological Distress ,Tertiary care ,Tertiary Care Centers ,COVID‐19 ,Neoplasms ,Pandemic ,Humans ,Medicine ,Child ,Pandemics ,Psychotherapeutic interventions ,SARS-CoV-2 ,business.industry ,pandemic ,COVID-19 ,Cancer ,Psychological distress ,medicine.disease ,Psychiatry and Mental health ,Oncology ,psycho‐oncology ,Cohort ,Original Article ,business - Abstract
Objective Families of children with cancer undergoing treatment during COVID‐19 pandemic represent a vulnerable population for psychological distress and early identification and remedial measures are imperative for wellbeing of both the children and the caregivers. This article reports the results of assessment of psychological distress in primary caregivers of children with cancer undergoing treatment at a tertiary care center. Methods Primary caregivers of children with cancer (≤15 years) taking treatment at our institute during the period of July 2020 to August 2020 were prospectively evaluated for psychological distress using Patient Health Questionnaire‐9 (PHQ‐9) and Generalized Anxiety Disorder‐7 (GAD‐7) tools over a telephonic call. There were 2 cohorts, A and B (50 participants each) depending on whether child was diagnosed with COVID‐19 or not respectively during the study period. Results The assessment tool, PHQ‐9 showed a score of ≥10 in 13% (n = 13) participants (95%CI:7.1%–21.2%) in the entire cohort and in 16% (n = 8, 95%CI:5.8%–26.2%) and 10% (n = 5, 95%CI:1.7%–18.3%) participants in cohort A and cohort B respectively. GAD‐7 showed a score of ≥8 in 18% (n = 18) participants (95%CI:11.0%–27.0%) in the entire cohort and in 20% (n = 10, 95%CI:8.9%–31.1%) and 16% (n = 8, 95%CI:5.8%–26.2%) participants in cohort A and cohort B respectively. All participants were assessed, and supportive psychotherapeutic interventions administered over telephonic call. Conclusions Primary caregivers should be assessed and followed up for psychological distress irrespective of other co‐existing factors. Robust support systems built over time could help withstand the exceptional strain of a major surge during a pandemic.
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- 2021
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4. COVID‐19 in cancer patients on active systemic therapy – Outcomes from LMIC scenario with an emphasis on need for active treatment
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Manju Sengar, Badira Cheriyalinkal Parambil, Jyoti Bajpai, Bhausaheb Bagal, Vanita Noronha, Shripad Banavali, Chetan Dhamne, Amit Kumar, Prabhat Bhargava, Amit Joshi, Vikas Ostwal, Kumar Prabhash, Sushmita Rath, Sudeep Gupta, Gaurav Narula, Hasmukh Jain, Minit Shah, Lingaraj Nayak, Tushar Vora, Kunal N. Jobanputra, Sachin Punatar, Nirmalya Roy Moulik, Sujay Srinivas, Nandini Menon, Vijay Patil, Girish Chinnaswamy, Jaya Ghosh, Avinash Bonda, Jayashree Thorat, Anant Ramaswamy, Navin Khattry, Seema Gulia, Anant Gokarn, Maya Prasad, and Akhil Kapoor
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Male ,0301 basic medicine ,Cancer Research ,Comorbidity ,LMICs ,systemic therapy ,0302 clinical medicine ,Interquartile range ,Neoplasms ,Outcome Assessment, Health Care ,Medicine ,Prospective Studies ,Young adult ,Child ,Prospective cohort study ,Original Research ,Mortality rate ,Middle Aged ,Survival Rate ,Oncology ,Radiology Nuclear Medicine and imaging ,Child, Preschool ,030220 oncology & carcinogenesis ,Cohort ,Female ,Adult ,medicine.medical_specialty ,Adolescent ,India ,Antiviral Agents ,Young Adult ,03 medical and health sciences ,COVID‐19 ,Internal medicine ,cancer ,Humans ,Radiology, Nuclear Medicine and imaging ,Pandemics ,Survival rate ,Aged ,SARS-CoV-2 ,business.industry ,Clinical Cancer Research ,COVID-19 ,Infant ,Cancer ,medicine.disease ,Pediatric cancer ,030104 developmental biology ,RT‐PCR negativity ,business - Abstract
Background There is limited data on outcomes in cancer patients with coronavirus disease 2019 (COVID‐19) from lower middle‐income countries (LMICs). Patients and Methods This was an observational study, conducted between 12 April and 10 June 2020 at Tata Memorial centre, Mumbai, in cancer patients undergoing systemic therapy with laboratory confirmed COVID‐19. The objectives were to evaluate cumulative 30‐day all‐cause mortality, COVID‐19 attributable mortality, factors predicting mortality, and time to viral negativity after initial diagnosis. Results Of the 24 660 footfalls and 7043 patients evaluated, 230 patients on active systemic therapy with a median age of 42 (1‐75) years were included. COVID‐19 infection severity, as per WHO criteria, was mild, moderate, and severe in 195 (85%), 11 (5%), and 24 (11%) patients, respectively. Twenty‐three patients (10%) expired during follow‐up, with COVID‐19 attributable mortality seen in 15 patients (6.5%). There were no mortalities in the pediatric cohort of 31 (14%) patients. Advanced stage cancer being treated with palliative intent vs others [30‐day mortality 24%% vs 5%, odds ratio (OR) 5.6, 95% CI 2.28‐13.78, P, COVID‐19 attributable mortality in cancer patients on systemic therapy in LMICs appears lower than published data and slightly more than an unselected patient's cohort. Delayed recovery in terms of SARS COV‐2 negativity is seen in these patients. Treating Cancer remains the priority.
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- 2020
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5. Clinical profile and outcome of classical Hodgkin lymphoma treated with a risk‐adapted approach in a tertiary cancer center in India
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Epari Shridhar, Gaurav Narula, Badira Cheriyalinkal Parambil, Sumeet Gujral, Shripad Banavali, Sneha Shah, Maya Prasad, Hari Sankaran, Siddhartha Laskar, Nehal Khanna, and Tanuja Shet
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Male ,medicine.medical_specialty ,Adolescent ,Cyclophosphamide ,medicine.medical_treatment ,Dacarbazine ,India ,Bleomycin ,Gastroenterology ,Tertiary Care Centers ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Child ,Etoposide ,Retrospective Studies ,Chemotherapy ,business.industry ,Infant ,Hematology ,Prognosis ,Hodgkin Disease ,Vinblastine ,Survival Rate ,Oncology ,chemistry ,ABVD ,Child, Preschool ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Prednisolone ,Female ,business ,Follow-Up Studies ,030215 immunology ,medicine.drug - Abstract
BACKGROUND Classical Hodgkin lymphoma (cHL) has excellent survival rates, but late effects are an issue and dictate modern approaches. We analyzed the clinical profile and outcome of cHL treated on a risk-adapted approach aimed at reducing late effects while improving historical outcomes at our center. PROCEDURE Children (≤15 years) consecutively treated for cHL from January 2013 through December 2016 were retrospectively analyzed. 18 FDG-PET-CT-based staging and response assessment was done after two cycles for early response (ERA) and end of chemotherapy (late-response assessment [LRA]) if not in complete response (CR; Deauville
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- 2019
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