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  • 1
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2017
    In:  Journal of Clinical Oncology Vol. 35, No. 15_suppl ( 2017-05-20), p. 11064-11064
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. 11064-11064
    Abstract: 11064 Background: Reaching to the correct histo-pathological diagnosis of soft tissue sarcomas (STS) is a great challenge and is cornerstone for treatment planning. Need of expertise for diagnosis is limited by lack of expert pathologists and dedicated sarcoma oncologists in India. Through this study we highlight the pattern of pathological diagnosis and accuracy outside specialist centre. Methods: We did retrospective analysis of all patients referred to us with diagnosis of STS in the last 12 months (January 2016 to 2017). According to protocol, all patients had pathology review from our institute. If blocks were available then they were reviewed and if necessary, fresh biopsy was performed. Besides, pathological diagnosis was reviewed in joint clinic, giving clinico-radiological inputs to sarcoma pathologists. For patients diagnosed outside and had discordant report, we divided them into major discrepancy (including change of diagnosis of sarcoma to benign or other histological entity that could potentially change the treatment plan) or minor discrepancy (like mild change in grade or histopathological diagnosis not affecting the treatment plan). Results: There were 149 patients registered with median age of 36 years (14-77 years) and 93 patients (62.4%) were males. 85(57%) patients had localized disease. Most common subtypes were synovial sarcoma 16%, liposarcoma 9%, soft tissue ewings sarcoma 9%, MPNST 9%, leiomyosarcoma 8%, pleomorphic undifferentiated sarcoma 8% etc. Of 149 patients, 42 had not been worked up outside and thus comparison was not possible while 4 patients couldn’t retrieve blocks and repeat biopsy could not be performed. Of 97 patients (biopsy = 84, FNAC = 13) who had diagnosis from outside, 37% had major discrepancy and 24% had minor discrepancy compared with our biopsy review. Major discrepancy was more in non extremity than extremity STS (p = 0.003). Conclusions: Pathological diagnosis of more than half of patients referred from outside was discordant with respect to diagnosis of our centre with major implications on 37%. We believe this is due to lack of sarcoma pathology experts and virtually non-existent multidisciplinary clinics in set up outside tertiary care centres.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2017
    detail.hit.zdb_id: 2005181-5
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  • 2
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2019
    In:  Journal of Clinical Oncology Vol. 37, No. 15_suppl ( 2019-05-20), p. e18553-e18553
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 15_suppl ( 2019-05-20), p. e18553-e18553
    Abstract: e18553 Background: Philadelphia chromosome (Ph) negative Myeloproliferative neoplasm (MPN) is a rare heterogeneous group of clonal hematological malignancy. We aim to describe the clinico-pathological features, treatment, outcomes and complications of this disorder. Methods: It is an ambispective study. All Ph negative MPN patients registered during 2001 to 31st December 2015 at our institute were reviewed for demographic data, diagnosis based on WHO 2008 criteria, treatment, complications and outcomes. SPSS software was used. Results: There were 55 patients registered with PMF (37), ET (9), PV (7), CNL (1) and MPN-U (1). PMF showed median age 51.2 years (23-70), male: female ratio of 1.46, symptomatic (36), splenomegaly (29), mean hemoglobin 9.7 gm/dl (3-16), JAK2 mutation positive (14), CALR mutation positive (1). Most of the patients were DIPSS intermediate-1 risk 22 (59.4%) grouping. They received hydroxyurea (13), steroids (9), ruxolitinib (6), immunomodulators/steroids (4), aspirin (3), allogeneic stem cell transplantation (2), interferon (1), radiation (1), danazol (1) and observation (1). Median OS was not reached. OS at 5 years is 84% (95% CI 70% to 98%). Survival probability at 36 months is significant for circulating blasts 〈 1% and high bone marrow fibrosis but not significant on multivariate analysis. Progression probability at 36 months is significant for circulating blast 〈 1% and high DIPSS score but not significant in multivariate analysis. PV showed median age 58 years (23-70), male: female ratio 6:1, symptomatic (7), splenomegaly (6), mean hemoglobin 18.4 gm/dl (16.6-21.5), JAK2 mutation positivity (5), low risk (2), high risk (5). They received hydroxyurea (6), phlebotomy (3) and aspirin (1). Five out of 7 patients are in stable condition. ET showed median age 39 years (24-72), male: female ratio 2:1, symptomatic (4), splenomegaly (2), mean hemoglobin 12.2 gm/dl (7.5-15.4), JAK2 mutation positivity (4), low risk (7) and high risk (2). They received aspirin (6), hydroxyurea (5), and observation (1). Three patients are in stable condition. CNL (1) developed pneumothorax and was lost to follow up. MPN-U (1) received hydroxyuea. Seven died due to pneumonia (5), transfusion hypersensitivity (1) and AML transformation (1). Conclusions: PMF is the most common Ph negative MPN in our institute with DIPSS intermediate-1 being the most common risk group. At a median follow up of 36 months overall survival at 5 years is 84%.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2019
    detail.hit.zdb_id: 2005181-5
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  • 3
    In: Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 39, No. Supplement 1 ( 2021-04), p. e125-
    Type of Medium: Online Resource
    ISSN: 0263-6352 , 1473-5598
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2017684-3
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  • 4
    In: European Heart Journal Supplements, Oxford University Press (OUP), Vol. 23, No. Supplement_B ( 2021-05-20), p. B110-B113
    Abstract: May Measurement Month (MMM) is a global initiative to screen high blood pressure (BP) in the community and increase awareness at the population level. High BP is the leading risk factor for mortality worldwide and in Nepal. This study presents the results of the 2019 MMM in Nepal. Opportunistic BP screening was conducted in 30 out of 77 districts across Nepal and aged ≥18 years at the community and public places. BP was measured three times in a seated position. A total of 74 205 individuals participated in the study, mean age 39.9 years, and 58% were male. BP measurements for the second and third readings were available for 69 292 (93.3%) individuals. The proportion of the population that were hypertensive was 27.5% (n = 20 429). Among those hypertensives, 46.3% were aware of their hypertensive status and of these, 37.5% were on antihypertensive medication. Only 54.3% of those on antihypertensive medication had their BP controlled. Of the community screened, those self reporting to have diabetes, current tobacco users, and current alcohol drinkers were 6.7%, 23.6%, and 31.9%, respectively; 20.6% of the participants were overweight, and 6.5% were obese. Since the first BP screening campaign, MMM 2017 in Nepal, the number of participants screened has largely increased over the years. MMM’s success in Nepal is through a coordinated mobilization of trained health science students and volunteers in the communities. The Nepal MMM data demonstrates that large community-based BP screening campaigns are possible in low resource settings.
    Type of Medium: Online Resource
    ISSN: 1520-765X , 1554-2815
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2141255-8
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  • 5
    In: European Heart Journal Supplements, Oxford University Press (OUP), Vol. 22, No. Supplement_H ( 2020-08-01), p. H92-H95
    Abstract: Raised blood pressure (BP) is a leading risk factor for mortality globally and in Nepal. May Measurement Month (MMM) is a global initiative aimed at screening for hypertension and raising awareness on high BP worldwide. This study provides the results of the 2018 MMM (MMM18) in Nepal. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018 nationwide. The standard MMM protocol was followed for BP measurement, the definition of hypertension, and statistical analysis. The campaign was publicized through various social media for recruiting volunteers and inviting participation. A total of 15 561 (58.7% male) from 35 districts of Nepal were screened in MMM18, of which 4 321 (27.8%) had hypertension. A total of 2 633 (19.0%) of 13 873 individuals who were not on antihypertensive treatment were found to be hypertensive. Of those on medication, 799 (47.4%) had uncontrolled BP. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly higher in people on antihypertensive treatment, smokers, and alcohol drinkers compared with those who were not on antihypertensive treatment, smokers, and alcohol drinkers, respectively. Likewise, SBP and DBP steadily increased across increasing body mass index categories. MMM18 was the largest BP screening campaign undertaken in Nepal. MMM has highlighted the importance of a periodic public health program at the national level to increase awareness on hypertension detection and control rate, and thus, the prevention of cardiovascular diseases.
    Type of Medium: Online Resource
    ISSN: 1520-765X , 1554-2815
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2141255-8
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