18 research outputs found
Perovskite materials as superior and powerful platforms for energy conversion and storage applications
No full textAvailable online 1 November 2020In order to meet the continuously growing demand for clean energy, a plethora of advanced materials have been exploited for energy storage applications. Among these materials, perovskites belong to a relatively new family of compounds with the structural formula of ABX3. These compounds exhibit a variety of electrical, optical, and electronic properties to adopt them for a variety of energy conversion and storage applications. The present review highlights the multifaceted nature of perovskite materials by covering a brief background, common crystallographic structures, and the importance of doping with different elements. Our discussion is extended further on the strategic energy applications of perovskites in modern devices such as fuel cells, lithium batteries, supercapacitors, LEDs, and solar cells.Priyanshu Goel, Shashank Sundriyal, Vishal Shrivastav, Sunita Mishra, Deepak P. Dubal, Ki-Hyun Kim, Akash Dee
Audit of In-Hospital Mortality from a Medical Oncology and Hemato-Oncology Center with the Emphasis on Best Supportive Care
No full textAbstract
Deepak Sundriyal
Background and Objectives The newly established medical oncology and hemato-oncology center at the All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India, provided us an opportunity to audit in-hospital mortalities with a vision that the audit will serve as a standard for ceaseless improvement. Aim of the study was to initiate a vigorous process for the evaluation of all-cause mortality in patients suffering from cancer.
Methods An audit of all in-hospital deaths that occurred during the year 2019 was performed, and comprehensive scrutiny of various parameters (demographic, clinico-pathological, therapeutic, causes of death) was done. Reviews from two independent observers sharpened the infallibility of the audit. The lacunae in the existing practices and the scope for further improvement were noted.
Results Forty-five in-hospital deaths were registered during the study period (January–December 2019). The majority of the deaths occurred in patients with advanced stage of malignancy ([n = 31] 68.8%). Most common causes of death were progressive disease, neutropenic, and non-neutropenic sepsis. Chemotherapeutic agents, growth factors, blood components, and antibiotics were found to be used judiciously as per institutional policy. The reviewers emphasized on the use of comorbidity indexes in the treatment planning and avoiding intensive care unit referrals for patients receiving best supportive care (BSC). Emphasis was put on providing only BSC to the patients with a very limited life expectancy. Emphasis was also laid down on record of out of the hospital deaths.
Interpretation and Conclusion The audit disclosed areas of care which require further improvement. The mortality audit exercise should become a regular part of evaluation and training for the ongoing and future quality commitment. This should impact the clinical decision making in an oncology center providing quality care to the terminally ill patients
A Patient with Adenocarcinoma Stomach on FLOT (5-Fluorouracil/Leucovorin, Oxaliplatin, and Docetaxel) Chemotherapy Presents with Tooth Discoloration: Spot the Diagnosis
No full text
Hodgkin Lymphoma Presenting as Pel–Ebstein Fever: A Case Report
No full textABSTRACT Background Prolonged fever of more than a year duration can be a symptom of underlying malignancy. This article appreciates the need for diligent history taking and carefully performed clinical examination, which is fundamental to reaching an initial diagnosis. Case We report the case of a middle‐aged male who presented to us with a fever of more than a year duration. The patient's residence was located in a remote area where the nearby tertiary care center was almost 250 km away. He was empirically treated with antibiotics without any success by local physicians. After more than a year, he reported to us and was diagnosed with Hodgkin lymphoma with a characteristic Pel–Ebstein pattern of fever missed earlier by the local physicians. His fever resolved within 5 days of chemotherapy, and he achieved complete remission. Conclusion Meticulous history‐taking and clinical examination are essential for reaching a clinical diagnosis. Malignant causes should be considered in the differentials of prolonged fever
Factors Associated With Default of Treatment and Follow-Up Among Patients With Cancer: A Cross-Sectional Study From a Lower-Middle-Income Country
No full textPURPOSEDesirable outcomes during the treatment of patients with cancer require adherence to evaluation, treatment, and follow-up. This study aimed to evaluate the factors associated with default in patients with cancer.MATERIALS AND METHODSWe included patients with a histologically confirmed diagnosis of cancer who defaulted during evaluation, treatment, and follow-up. All patients’ detailed demographic and clinical data were recorded. Those lost to follow-up were interviewed telephonically. The factors associated with default were noted. Descriptive statistics were used to compute the demographic and clinical characteristics.RESULTSIn total, 172 patients were included. Geriatric and female patients were 38.9% and 37.2%, respectively. Fifty-eight percent of the patients lived in rural areas, whereas 45.9% were illiterate. More than one third (34.3%) of the patients who defaulted received the curative-intent treatment, whereas 62.1% of patients had a good performance status immediately before default. The average distance traveled by the patients to reach the cancer facility was 143 ± 13.15 km. The most common reasons for default were the lack of social support, financial constraints, difficulty in commuting, and too sick to come in 45 (26.2%), 35 (20.3%), 28 (16.3%), and 23 (13.4%) patients, respectively. Twenty-nine (16.9%) patients reported more than one reason for default.CONCLUSIONLack of social support, financial constraints, transportation barriers, and inadequate counseling by the health care provider serve as barriers to uninterrupted cancer care. These factors are often interrelated and can be attenuated by adopting the hub and spoke model. Simultaneously, a good relationship between the patient and the health care provider fostered by appropriate counseling is imperative to increase adherence to cancer treatment and improve the outcome
High Prevalence of Malnutrition in Geriatric Patients With Solid Organ Cancer—An Institutional Study
No full textPURPOSEThe demographic transition toward aging heralds an increase in the number of geriatric patients with cancer in India. Comprehensive geriatric assessment (CGA) is a sine qua non for treatment planning and shared decision making in these patients. We aimed to study the prevalence of malnutrition and the associated risk factors in geriatric patients with solid organ cancer.METHODSIn this observational study, treatment-naïve geriatric patients with cancer underwent CGA. We performed a Mini Nutritional Assessment (MNA) to diagnose malnutrition. Data analysis was done using descriptive statistics, Pearson’s chi-square, Spearman correlation, and multivariable regression analysis to assess the factors associated with malnutrition.RESULTSOne hundred forty-two patients were included in the analysis. The median age was 67 (range, 60-88) years, with a male preponderance of 73.2% (n = 104) and a stage IV disease of 75.4% (n = 107). Most patients, 91.6% (n = 130), had abnormal MNA scores. Nearly one third of the patients, 35.2% (n = 50), were underweight (BMI <18.5 kg/m2). Poor performance status (PS) was seen in 66.2% (n = 94) of the patients. Poor appetite 79.6% (n = 113) was the most common risk factor, followed by addictions (74.6%, n = 106), chronic constipation (35.9%, n = 51), and polypharmacy (21.8%, n = 31). Cognitive impairment and depression were seen in 35.2% (n = 50) and 57.1% (n = 81) of the patients, respectively. The study found a significant correlation of MNA with age (P = .048), depression (P < .001), PS (P < .001), functional decline (P < .001), and cognition (P < .001).CONCLUSIONThere exists a widespread prevalence of malnutrition and amenable risk factors in geriatric patients with cancer. Nutritional assessment is essential, and interventions should be implemented to improve clinical outcomes
Prevalence and impact of endocrine disorders in advanced metastatic cancer patients undergoing cancer‐directed therapy: A prospective observational study
No full textAbstract Background Noncommunicable diseases (NCDs) contribute significantly to global morbidity and mortality, with cancer being one of the leading causes. In this prospective observational study, we aimed to investigate the prevalence and impact of endocrine disorders, specifically diabetes and thyroid dysfunction, in patients with advanced metastatic cancer undergoing cancer‐directed therapy. Methods Over 15 months, we recruited 100 histologically proven advanced metastatic cancer patients from the Department of Medical Oncology Haematology, All India Institute of Medical Sciences, Rishikesh, and conducted institutional‐based prospective observational study. All participants over 18 years of age, treatment‐naive, and potential candidates for systemic chemotherapy with an expected clinical survival of at least 6 months were included in the study. Patients with prior therapy, secondary neoplasms, and those unable to complete 3 months of palliative chemotherapy were excluded. Patients were assessed for diabetes and thyroid function at presentation, after 3 and 6 months of cancer‐directed standard therapy. These data were analyzed, processed, and presented as results. Results The mean age of participants was 50.45 years, with a near‐equal distribution of males and females. At baseline, 10% of the study population had preexisting endocrine disorders (2% hypothyroidism, 8% diabetes). By the end of 6 months, the prevalence increased to 18%, with females being more affected. Notably, the prevalence of new‐onset endocrine disorders during cancer‐directed therapy was only 3% for diabetes and 4% for thyroid dysfunction. Conclusion Analysis of sociodemographic and cancer‐related characteristics showed no significant association with changes in diabetic and thyroid status at 3 and 6 months. However, substance use, particularly smoking, was associated with an increased risk of diabetes development (p < .05). Cancer type and treatment regimen did not show statistically significant correlations with endocrine dysfunction. Implications Our study highlights the importance of considering endocrine disorders in advanced metastatic cancer patients undergoing therapy. The prevalence of diabetes and thyroid dysfunction increased during cancer‐directed therapy, particularly in females. Careful monitoring and timely intervention are essential to improve the quality of life for these patients. Further research is warranted to explore the long‐term effects of cancer‐directed therapy on endocrine health and develop tailored management strategies for this vulnerable population
