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Chandigarh, India

Naseem S.,Advanced Pediatric Center
Indian Journal of Hematology and Blood Transfusion | Year: 2010

Visceral Leishmaniasis (VL) or Kala Azar is a chronic infectious disease caused by parasites of the Leishmania donovani complex that can cause various hematologic manifestations. It is characterized by fever, enlargement of liver and spleen, weight loss, pancytopenia and hypergammaglobinemia. It is endemic in the Indian subcontinent, mainly seen in the states of Bihar and West Bengal. Patients with VL can present to the haematologist for various haematological problems prior to receiving the diagnosis of VL. Anaemia is the most common haematological manifestation of VL. VL may also be associated with leucopenia, thrombocytopenia, pancytopenia, hemophagocytosis and disseminated intravascular coagulation. Hematological improvement is noted within a week and complete hematological response occurs in 4-6 weeks of treatment. Relapses are rare and increased risk of being diagnosed with hematolymphoid malignancies on long term follow up is not noted. © 2010 Indian Society of Haematology & Transfusion Medicine.

Although, a slight male preponderance has been reported in childhood acute lymphoblastic leukemia (ALL) from several developed nations, several Indian studies suggest a skewed gender ratio in ALL. To assess the gender ratio at presentation in ALL in India, we used a three-prong approach: (i) center audit, (ii) systematic review of published studies on ALL in India, and (iii) assessment of population based registry data. Data on gender at presentation in ALL were extracted from these multiple sources. In our center audit, we observed a significantly higher of male:female (M:F) ratio of 3.16:1 (P = .046) in ALL as compared to world literature. In the systematic review of all ALL studies from India, 367 articles were identified and reviewed. A total of 4230 and 1843 boys and girls in these studies were assessed and the M:F ratio was 2.503:1; much higher than the world ratio but not significantly different (P = .10). Population-based data obtained from the National Cancer Registry Program also depicted a male preponderance, especially from large cities in India in a consistent manner since 1984. There is also significant (P = .025) interregional variation in the gender ratio in India. Our study clearly demonstrates a consistent male preponderance in childhood ALL in India along with significant interregional variations over the last three decades. There is a clear need of prospective nationwide multicenter assessment of high-resolution data to confirm this important observation and assess its implications, especially on the health care system. © 2013 Informa Healthcare USA, Inc.

Sahu J.K.,Advanced Pediatric Center
Indian Journal of Pediatrics | Year: 2014

Infantile spasms constitute significant burden of refractory epilepsy in children. The first line treatment choice varies at different centres. The author presents concise evidence based update on medical management of infantile spasms. © 2014, Dr. K C Chaudhuri Foundation.

Kulkarni K.P.,University of Alberta | Kulkarni K.P.,Advanced Pediatric Center | Arora R.S.,Alder Hey Hospital | Marwaha R.K.,Advanced Pediatric Center
Journal of Pediatric Hematology/Oncology | Year: 2011

The outcome of childhood acute lymphoblastic leukemia in India has been inferior to more than 80% cure rates in developed nations. This study was done to analyze the outcome of acute lymphoblastic leukemia in India over 4 decades. There has been a gradual improvement in survival rates of up to >70% in some centers along with a decline in relapse and mortality. However, these Results cannot be generalized to the entire nation. There is a crying need to address treatment abandonment, take quality improvement, educational and financial initiatives; cooperative research into risk factors and disease biology, and the implementation of risk stratification along with the assessment of response to therapy. Copyright © 2011 by Lippincott Williams & Wilkins.

Kulkarni K.P.,Advanced Pediatric Center | Marwaha R.K.,Advanced Pediatric Center
Asian Pacific Journal of Cancer Prevention | Year: 2010

Abandonment of therapy is cited as an important factor contributory to inferior survival outcome in developing nations. In this communication we describe the pattern of therapy abandonment and its impact on survival of childhood acute lymphoblastic leukemia at a large tertiary care center in Northern India and discuss remedial measures.

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