Publications by authors named "A Sharma"

16,355 Publications

Risk classification at diagnosis predicts post-HCT outcomes in intermediate-, adverse-risk, and KMT2A-rearranged AML.

Blood Adv 2021 Sep 22. Epub 2021 Sep 22.

University of Texas Southwestern Medical Center, Dallas, Texas, United States.

Little is known about whether risk classification at diagnosis predicts post-hematopoietic cell transplantation (HCT) outcomes for acute myeloid leukemia (AML) patients. We evaluated 8709 AML patients from the CIBMTR database and, after selection and manual curation of cytogenetics data, 3779 patients in CR1 were included in the final analysis: 2384 with intermediate-risk, 969 with adverse-risk, and 426 with KMT2A-rearranged disease. An adjusted multivariable analysis compared to intermediate-risk patients detected an increased risk of relapse for KMT2A-rearranged and adverse-risk patients (HR 1.27, p = 0.01 and HR 1.71, p < 0.001, respectively). Leukemia-free survival (LFS) was similar for KMT2A and adverse-risk patients (HR 1.26, p = 0.002 and HR 1.47, p < 0.001), as was overall survival (OS) (HR 1.32, p < 0.001 and HR 1.45, p < 0.001). No differences in outcome could be detected when patients were stratified by KMT2A fusion partner. This is the largest study conducted to date on post-HCT outcomes in AML using manually curated cytogenetics for risk stratification. Our work demonstrates that risk classification at diagnosis remains predictive of post-HCT outcomes in AML. It also highlights the critical need to develop novel treatment strategies for patients with KMT2A rearrangements and adverse-risk disease.
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http://dx.doi.org/10.1182/bloodadvances.2021004881DOI Listing
September 2021

Evaluation and screening of elite wheat germplasm for salinity stress at the seedling phase.

Physiol Plant 2021 Sep 22. Epub 2021 Sep 22.

Department of Botany, Punjab Agricultural University Ludhiana, Punjab, India.

Salinity is one of the most important constraints for global cereal production, and breeding for salinity tolerance is a challenge. The limited gene pools, merged information regarding osmotic stress/tissue tolerance mechanism(s) including the accumulation of Na , over-stressed on the Na exclusion mechanism, and inadequate suitable screening methods further weaken the progress. In the present study, anwas made to evaluate the salt tolerance in Triticum aestivum lines using the membership function value (MFV) of certain traits viz., the root and shoot length (RL & SL), shoot and root fresh weight (SFW & RFW), shoot and root dry weight (SDW & RDW) and germination percentage (GP). This study screened 314 wheat lines (278 linked top cross population (LTPs) and 36 normal wheat cultivars) under lab conditions to evaluate their salt tolerance. A positive, and the highest, correlation coefficient was recorded between salt tolerance index (STI) of SL and the STI of RL..11 highly salt tolerant (HST), 59 salt tolerant (ST), 100 moderately salt tolerant (MST), 137 salt sensitive (SS), and 7 highly salt sensitive (HSS) were observed with a distance of 2.2 between each category. The R-square value was maximum (0.836) between the STI of SFW and the mean MFV,which can be used as the most reliable trait for the salinity tolerance in T. aestivum at the germination phase. Wheat tolerant lines had higher tolerance to salt stress in comparison with the used normal wheat cultivars were detected at the seedling stage. This article is protected by copyright. All rights reserved.
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http://dx.doi.org/10.1111/ppl.13571DOI Listing
September 2021

Poor Dietary Habits: A Function of Online Food Delivery Fad among Medical and Dental College Students in India.

J Lifestyle Med 2021 Jul;11(2):74-81

Centre for Scientific and Industrial Research, New Delhi, India.

Background: Globalization has impacted our food choice and the booming online food industry has made it available at the click of a button. Students staying away from home often fail to maintain a healthy diet and lifestyle, impacting their health.

Methods: A survey was conducted amongst interns of medical and dental colleges in Delhi. Simple Random Sampling was done to select every alternate intern as per the list provided by the colleges. The survey included questions on dietary, fitness and food hygiene habits and dental history. Demographic details such as height weight and living arrangements were collected. Dietary habits score and Fitness & Food hygiene score was calculated based on pre-set criteria. Association of poor dietary habits and hygiene with BMI, living conditions and dental history was determined.

Results: One-fourth of the population was either overweight or obese. Poor, fair and good dietary habits was seen in 8.9%, 69.8% and 21.4% respectively. Poor, fair and good fitness and food hygiene was seen in 56.3%, 39.6% and 4.2% respectively. Obesity was significantly associated with poor fitness scores and with tendency to order junk food. Consumption of sugary food was associated with positive dental history, and those living with parents displayed good dietary habit score.

Conclusion: Students with high stress levels and living away from home are susceptible to poor dietary routine which impacts both their health and academic performance. Identifying these problems and triggers which induce such unhealthy lifestyle behaviour can go a long way in controlling the resultant health problems.
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http://dx.doi.org/10.15280/jlm.2021.11.2.74DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8430309PMC
July 2021

Forearm hematoma as a complication of transradial coronary intervention: an Indian single-center experience.

Am J Cardiovasc Dis 2021 15;11(4):462-470. Epub 2021 Aug 15.

Department of Cardiology, King George's Medical University Lucknow, Uttar Pradesh 226003, India.

Background: Forearm hematomas are not uncommon after transradial coronary interventions. The present study describes the incidence and predictors of forearm hematoma formation after transradial coronary interventions.

Methods: This was a prospective study in 1754 patients undergoing angiography/angioplasty through transradial access. Each procedure was performed using optimum levels of anticoagulation, hydrophilic sheaths, and post-procedural patent hemostasis protocols. Patients were evaluated for forearm hematoma immediately after the procedure, after radial band removal, and on the next day of the procedure. Severity of hematomas was graded according to the Early Discharge after Transradial Stenting of Coronary Arteries Study scale. Univariate and multivariate logistic regression analyses were done to determine the predictors of hematoma formation.

Results: Mean age of the patients was 56.31 years and 82.2% were males. A total of 1374 (78.3%) patients underwent angioplasty while 380 (21.7%) underwent angiography. Forearm hematoma developed in 187 (10.7%) patients. Grade I hematoma was most common (3.53%) followed by Grade II (3.08%), Grade III (2.83%) and Grade IV (1.25%) hematoma. None of the patients required vascular or surgical interventions for this complication. Female gender, multiple puncture attempts, intensive antiplatelet therapy, complex procedure and longer hemostasis time were significant predictors of forearm hematoma formation post transradial coronary interventions.

Conclusions: Forearm hematoma developed in substantial proportion of patients undergoing transradial coronary interventions and interventional variables were predominantly associated with hematoma formation. Pre-emptive knowledge of modifiable interventional risk factors can help in reducing the burden of this complication.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449195PMC
August 2021

An Experience of Pediatric Upper and Lower Gastrointestinal Endoscopy in a Tertiary Center.

Authors:
S Upadhyay A Sharma

Kathmandu Univ Med J (KUMJ) 2017 Apr-Jun;17(58):142-145

Department of Pediatrics, Nepal Medical College Teaching Hospital, Jorpati, Kathmandu, Nepal.

Background Although upper gastrointestinal endoscopy and colonoscopy is considered to be a gold standard in the diagnosis of many pediatric gastrointestinal disorders, there is limited data about its utility from our country. This important diagnostic tool is underutilized. Objective The objective of this study is to report the common indications, endoscopic findings and complications of pediatric upper gastrointestinal endoscopy and colonoscopy in a tertiary center to increase awareness amongst pediatricians. Methods This descriptive cross-sectional study was conducted in children undergoing upper gastrointestinal endoscopy and colonoscopy for various indications in a tertiary center from November 2014 to October 2016 (24 months). Results We performed 192 endoscopies during this period. Upper gastrointestinal endoscopy 158 and Colonoscopy 34. Mean age of patients was 10.2 years (range 6 months to 16 years) and 140(72.9%) patients were under 10 years of age. Common indications of UGI endoscopy were recurrent abdominal pain (67%), acute abdominal pain (12.6%), recurrent vomiting (8.0%), upper GI bleed (4.4%), failure to thrive (3.1%) and caustic ingestion (2.5%). An abnormality was detected in 128(81%) patients. Antral gastritis (55%) was the most common diagnosis. Thirty two percent of children with RAP had chronic moderate to severe gastritis and were positive for H. pylori in Giemsa stain on histopathological examination. Common indications of colonoscopy were Lower GI bleed and chronic diarrhea. Out of 22 patients who underwent colonoscopy for lower GI bleed, 18(82%) patients had rectal polyp and underwent snare polypectomy. Out of 12 patients who were evaluated for chronic diarrhea, 7(20%) were diagnosed to have cow's milk protein allergy and 5(15%) patients had inflammatory bowel disease. An abnormality was detected in 30(88%) patients. All children received sedation/ analgesia and tolerated the procedure well. Conclusion Upper gastrointestinal endoscopy and colonoscopy are safe procedure in children. The awareness about its diagnostic and therapeutic role should be raised amongst pediatricians in developing countries. There is also a need to develop training programs of pediatric gastroenterology and pediatric endoscopic suites in developing countries so that children may benefit from this state of the art diagnostic modality.
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September 2021
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