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21. Survival outcomes of epithelial ovarian cancer treated at a tertiary-level hospital in India.

Author

Chandy, Rachel G., Thomas, Vinotha, Sebastian, Ajit, Mani, Thenmozhi, Thomas, Anitha, Joel, Anjana, Ram, Thomas S., and Peedicayil, Abraham

Subjects
*OVARIAN epithelial cancer, *SURVIVAL rate, *PROPORTIONAL hazards models, *ELECTRONIC health records, *CA 125 test, MORTALITY risk factors
Abstract

Background: One needs to choose wisely between primary neoadjuvant chemotherapy and primary cytoreductive surgery in ovarian cancer. The aim was to determine the recurrence free survival and overall survival after surgery for epithelial ovarian cancer and also the risk factors for recurrence and death. Methods: Electronic medical records of 322 women operated for ovarian, fallopian or primary peritoneal cancer between 2011 and 2015 were reviewed. Descriptive statistics were used to describe patients and their clinical outcomes. Cox proportional hazard models were used for risk factor analysis. Adjusted hazard ratios were obtained for recurrence and death, adjusted for stage, primary treatment modality, residual disease and histology. Kaplan-Meier curves were drawn for probability of recurrence-free survival and overall survival. The log rank test was used to compare survival probabilities. Results: The majority were stage III or stage IV (78%), serous histology (71%) and high grade (64%). Primary cytoreduction was done in 48% and interval cytoreduction in 52%. The median duration of follow up (survival) was 77 months (95% CI 72-82). There were 179 known recurrences (55.6 %). The estimated median time to recurrence was 22 (95% CI 14.5- 29.5) months. The independent risk factors for recurrence were neoadjuvant chemotherapy [HR 2.14, 95% CI 1.48-3.09], stage III/IV [HR 2.75; 95% CI 1.40-5.41], high grade serous histology [HR 1.69; 95% CI 1.12-2.54] and sub-optimal debulking [HR 3.15, 95% CI 2.19-4.55]. There were 78 known deaths (24.2 %) with a mean time to death of 24.3 (SD 16.1) months. The independent risk factors for death were sub-optimal debulking [HR 3.07; 95% CI 1.78-5.29] and stages III and IV cancer [HR 3.07; 95% CI 1.14-8.27]. Conclusions: Most ovarian cancers recur within 2 years. Risk factors for mortality are advanced stage and sub-optimal debulking. Maximal efforts at down staging and surgical resection will increase survival. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Ovarian Cancer in Young Women

Author

Lalrinpuii, Eileen, Bhageerathy, Pallipuram Seshadrinathan, Sebastian, Ajit, Jeyaseelan, Lakshmanan, VinothaThomas, Thomas, Anitha, Chandy, Rachel, and Peedicayil, Abraham

Published
2017
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26. A Pilot study of POLE mutations in endometrial cancer and its clinicopathological correlation with Microsatellite Instability and P53 mutations

Author

Dahiya, Alka, primary, Thomas, Anitha, additional, Pai, Rekha, additional, Rajadurai, Abarna, additional, Daniel, Sherin, additional, Sebastian, Ajit, additional, Thomas, Vinotha, additional, Sathyamurthy, Arvind, additional, Rebekah, Grace, additional, Chandy, Rachel, additional, Thomas, Dhanya, additional, Ram, Thomas, additional, and Peedicayil, Abraham, additional

Published
2022
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31. ERAS: An Audit of Existing Practices

Author

Bassetty, Karthik C., primary, Thomas, Dhanya Susan, additional, Sebastian, Ajit, additional, Thomas, Anitha, additional, Chandy, Rachel, additional, Peedicayil, Abraham, additional, and Thomas, Vinotha, additional

Published
2021
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46. In vitro Impact of Limited Exposure to Subtherapeutic Concentrations of Chlorhexidine Gluconate on the Adhesion-Associated Attributes of Oral CandidaSpecies

Author

Ellepola, Arjuna N.B., Chandy, Rachel, and Khan, Zia U.

Subjects
Buccal epithelial cells, Original Paper, Dose-Response Relationship, Drug, Chlorhexidine, Chlorhexidine gluconate, Mouth Mucosa, Kuwait, Candidiasis, Oral, Adhesion, Anti-Infective Agents, Local, Cell Adhesion, Humans, Denture acrylic, Candida, Cell surface hydrophobicity
Abstract

Objective Candida albicans and its non-albicans counterparts, such as C. tropicalis, C. krusei, C. glabrata and C. dubliniensis, are the major etiological agents of oral candidosis. Their adherence to buccal epithelial cells (BEC), denture acrylic surfaces (DAS) and cell surface hydrophobicity (CSH) are attributes associated with yeast colonization and infection. Chlorhexidine gluconate (CG) is a widely used antiseptic in dentistry. When administered, the diluent effect of saliva and the cleansing effect of the oral musculature reduce its bioavailability, compromising its efficacy. Hence, intraorally, Candida undergoes a transient exposure to high CG concentrations, and thereafter it is likely to be subtherapeutic. Therefore, the impact of CG on adhesion to BEC, DAS and CSH of different oral Candida species was investigated following brief exposure to three subtherapeutic concentrations of CG. Materials and Methods Ten oral isolates of each of the above five Candida species obtained in Kuwait from oral rinse samples were exposed to 0.00125, 0.0025 and 0.005% CG for 30 min. Subsequently, the yeast adhesion to BEC, DAS and CSH was determined. The data were analyzed using ANOVA Dunnett's t tests. Results Exposure to the lowest dilution (0.00125%) of CG did not elicit a noteworthy collective suppression on all three adhesion traits evaluated. Exposure to 0.0025% CG curtailed the adhesion to BEC, DAS and CSH of Candida species by 50.89, 40.79 and 24.58%, respectively (p < 0.001). Exposure to the highest concentration (0.005%) of CG reduced the adhesion to BEC, DAS and CSH of Candida species by 64.68, 54.59 and 50%, respectively (p < 0.001). Conclusions Brief exposure to subtherapeutic concentrations of CG suppressed the adhesion to BEC, DAS and CSH of oral Candida species, indicating probable pharmacodynamics that may potentiate its antiseptic properties.

Published
2016

47. Performance comparison of phenotypic and molecular methods for detection and differentiation of Candida albicans and Candida dubliniensis

Author

Ahmad Suhail, Khan Ziauddin, Asadzadeh Mohammad, Theyyathel Ajmal, and Chandy Rachel

Subjects
Candida albicans, Candida dubliniensis, Detection, Differentiation, Duplex PCR, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Candida albicans is the most pathogenic Candida species but shares many phenotypic features with Candida dubliniensis and may, therefore, be misidentified in clinical microbiology laboratories. Candidemia cases due to C. dubliniensis are increasingly being reported in recent years. Accurate identification is warranted since mortality rates are highest for C. albicans infections, however, C. dubliniensis has the propensity to develop resistance against azoles more easily. We developed a duplex PCR assay for rapid detection and differentiation of C. albicans from C. dubliniensis for resource-poor settings equipped with basic PCR technology and compared its performance with three phenotypic methods. Methods Duplex PCR was performed on 122 germ tube positive and 12 germ tube negative isolates of Candida species previously identified by assimilation profiles on Vitek 2 ID-YST system. Typical morphologic characteristics on simplified sunflower seed agar (SSA), and reaction with a commercial (Bichro-Dubli) latex agglutination test were also performed. The assay was further applied on 239 clinical yeast and yeast-like fungi and results were confirmed by DNA sequencing of internal transcribed spacer (ITS) region of rDNA. Results The results of duplex PCR assay for 122 germ tube positive and 12 germ tube negative isolates of Candida species were comparable to their identification by Vitek 2 ID-YST system, colony characteristics on SSA and latex agglutination test. Application of duplex PCR also correctly identified all 148 C. albicans and 50 C. dubliniensis strains among 239 yeast-like fungi. Conclusions The data show that both, duplex PCR and Bichro-Dubli are reliable tests for rapid (within few hours) identification of clinical yeast isolates as C. dubliniensis or C. albicans. However, duplex PCR may be applied directly on clinical yeast isolates for their identification as C. dubliniensis or C. albicans as it does not require prior testing for germ tube formation or latex Candida agglutination.

Published
2012
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48. STARTING A HIPEC PROGRAMME IN A LOW RESOURCE SETTING

Author

Peedicayil, Abraham, primary, Mittal, Rohin, primary, Joel, Anjana, primary, ['Ekta'], Anjana, primary, SUBRAMANI, KANDASWAMY, primary, Sebastian, Ajit, primary, Thomas, Vinotha, primary, ['Anitha'], Vinotha, primary, and Chandy, Rachel, primary

Published
2019
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