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G.k. Rath - One of the best experts on this subject based on the ideXlab platform.
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518pmetabolic toxicity in patients undergoing radical anti cancer therapy a cross sectional analysis of patients in an Oncology Ward in india
Annals of Oncology, 2015Co-Authors: Subhash Gupta, Soumyajit Roy, Pramod Kumar Julka, D Sharma, G.k. RathAbstract:Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our Oncology Ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS <70, pancytopenia and artificial ventilation requirement were found to have a significant impact on death. Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.
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Hematologic Toxicity in Patients Undergoing Radical Anti- cancer Therapy: A Cross-Sectional Analysis of Patients in an Oncology Ward in India
Annals of Oncology, 2015Co-Authors: Soumyajit Roy, Supriya Mallick, Waseem Raza, Kunhi Parambath Haresh, Subhash Gupta, Daya Nand Sharma, Pramod Kumar Julka, G.k. RathAbstract:Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our Oncology Ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS
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hematologic toxicity in patients undergoing radical anti cancer therapy a cross sectional analysis of patients in an Oncology Ward in india
Asian Pacific Journal of Cancer Prevention, 2014Co-Authors: Soumyajit Roy, Supriya Mallick, Kunhi Parambath Haresh, Subhash Gupta, Daya Nand Sharma, Pramod Kumar Julka, Md Waseem Raza, G.k. RathAbstract:Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our Oncology Ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS <70, pancytopenia and artificial ventilation requirement were found to have a significant impact on death. Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.
Soumyajit Roy - One of the best experts on this subject based on the ideXlab platform.
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518pmetabolic toxicity in patients undergoing radical anti cancer therapy a cross sectional analysis of patients in an Oncology Ward in india
Annals of Oncology, 2015Co-Authors: Subhash Gupta, Soumyajit Roy, Pramod Kumar Julka, D Sharma, G.k. RathAbstract:Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our Oncology Ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS <70, pancytopenia and artificial ventilation requirement were found to have a significant impact on death. Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.
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Hematologic Toxicity in Patients Undergoing Radical Anti- cancer Therapy: A Cross-Sectional Analysis of Patients in an Oncology Ward in India
Annals of Oncology, 2015Co-Authors: Soumyajit Roy, Supriya Mallick, Waseem Raza, Kunhi Parambath Haresh, Subhash Gupta, Daya Nand Sharma, Pramod Kumar Julka, G.k. RathAbstract:Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our Oncology Ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS
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hematologic toxicity in patients undergoing radical anti cancer therapy a cross sectional analysis of patients in an Oncology Ward in india
Asian Pacific Journal of Cancer Prevention, 2014Co-Authors: Soumyajit Roy, Supriya Mallick, Kunhi Parambath Haresh, Subhash Gupta, Daya Nand Sharma, Pramod Kumar Julka, Md Waseem Raza, G.k. RathAbstract:Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our Oncology Ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS <70, pancytopenia and artificial ventilation requirement were found to have a significant impact on death. Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.
Subhash Gupta - One of the best experts on this subject based on the ideXlab platform.
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518pmetabolic toxicity in patients undergoing radical anti cancer therapy a cross sectional analysis of patients in an Oncology Ward in india
Annals of Oncology, 2015Co-Authors: Subhash Gupta, Soumyajit Roy, Pramod Kumar Julka, D Sharma, G.k. RathAbstract:Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our Oncology Ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS <70, pancytopenia and artificial ventilation requirement were found to have a significant impact on death. Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.
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Hematologic Toxicity in Patients Undergoing Radical Anti- cancer Therapy: A Cross-Sectional Analysis of Patients in an Oncology Ward in India
Annals of Oncology, 2015Co-Authors: Soumyajit Roy, Supriya Mallick, Waseem Raza, Kunhi Parambath Haresh, Subhash Gupta, Daya Nand Sharma, Pramod Kumar Julka, G.k. RathAbstract:Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our Oncology Ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS
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hematologic toxicity in patients undergoing radical anti cancer therapy a cross sectional analysis of patients in an Oncology Ward in india
Asian Pacific Journal of Cancer Prevention, 2014Co-Authors: Soumyajit Roy, Supriya Mallick, Kunhi Parambath Haresh, Subhash Gupta, Daya Nand Sharma, Pramod Kumar Julka, Md Waseem Raza, G.k. RathAbstract:Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our Oncology Ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS <70, pancytopenia and artificial ventilation requirement were found to have a significant impact on death. Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.
Daniel C. Mcfarland - One of the best experts on this subject based on the ideXlab platform.
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less direct patient care delivered by medical trainees by the end of a hematology Oncology Ward rotation association with empathy and related factors
Psycho-oncology, 2019Co-Authors: Daniel C. McfarlandAbstract:OBJECTIVE The education of trainee physicians in hematology-Oncology is challenged by inherent stressors of hematology-Oncology. Clinical work load, death and dying, and the known phenomenon of empathy decline during clinical education affect trainees. Time spent with patients or direct patient care time (DPCT) is influenced by many factors, which ultimately affect medical education. Therefore, DPCT may decrease by the end training on a busy hematology-Oncology Ward rotation. METHODS Internal medicine interns and residents (n = 64) rotating on a hematology-Oncology Ward rotation were consecutively selected to participate. Questionnaires containing Likert scale questions assessing time spent with patients before and after the rotation, empathy/resilience/distress measurements (Interpersonal Reactivity Index [IRI], Connors-Davidson Resilience Scale [CD-RISC], and Impact of Events Scale-Revised [IES-R], respectively), and demographic and situational information were collected at the beginning and end of the rotation RESULTS: DPCT decreased from over 10 to 15 minutes per patient to slightly over 1 to 5 minutes with over half of the trainees spending less than 1 minute per patient per day (P < .001, Cohen's d = 1.05). Empathy scores decreased 2.01 points from 58.9 to 56.8 (P = .018, Cohen's d = 0.33) during the rotation. DPCT decrease was associated mistreatment (P < .001) and lack of support (P = .001) while endorsing external issues (P = .002) and longer rotation time predicted for greater DPCT accounting for 67% of DPCT variance on multivariate analysis. CONCLUSION Medical trainees in Oncology who feel a lack of social/familial support and feel mistreated by mentors/superiors spend significantly less time with patients. Educational initiatives should replicate and utilize these associations to enhance patient-centric care in Oncology.
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Less direct patient care delivered by medical trainees by the end of a hematology-Oncology Ward rotation: Association with empathy and related factors.
Psycho-oncology, 2019Co-Authors: Daniel C. McfarlandAbstract:OBJECTIVE The education of trainee physicians in hematology-Oncology is challenged by inherent stressors of hematology-Oncology. Clinical work load, death and dying, and the known phenomenon of empathy decline during clinical education affect trainees. Time spent with patients or direct patient care time (DPCT) is influenced by many factors, which ultimately affect medical education. Therefore, DPCT may decrease by the end training on a busy hematology-Oncology Ward rotation. METHODS Internal medicine interns and residents (n = 64) rotating on a hematology-Oncology Ward rotation were consecutively selected to participate. Questionnaires containing Likert scale questions assessing time spent with patients before and after the rotation, empathy/resilience/distress measurements (Interpersonal Reactivity Index [IRI], Connors-Davidson Resilience Scale [CD-RISC], and Impact of Events Scale-Revised [IES-R], respectively), and demographic and situational information were collected at the beginning and end of the rotation RESULTS: DPCT decreased from over 10 to 15 minutes per patient to slightly over 1 to 5 minutes with over half of the trainees spending less than 1 minute per patient per day (P
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Is empathy associated with a derived sense of meaning among resident physicians working with patients nearing the end of life on a hematology-Oncology Ward?
Journal of Clinical Oncology, 2016Co-Authors: Daniel C. Mcfarland, Jonathan KomisarAbstract:28 Background: An association between empathy and physician-in-training based meaning derived from patient deaths has not been explored previously. If meaning is associated with empathy, an intervention to enhance meaning may counteract empathy decline and promote clinician resilience. This study sought to understand if empathy might be associated with the ability to find meaning in the clinical situations that residents face in Oncology. Methods: Internal Medicine residents rotating on a Hematology/Oncology Ward were asked “Do you derive a sense of meaning from working with dying patients? Yes or No.” The Interpersonal-Reactivity Index (IRI) was used to measure empathy and demographic information. Results: 64 responded (66.7% response rate). 43 (67.2%) derived a sense of meaning while 21 (32.8%) did not. The ‘meaning’ group empathy score (IRI) was 60.7 (SD 10.8) and the ‘no meaning’ group empathy score (IRI) was 51.7 (SD 11.5) (p < .01). Empathy subscale differences were notable for decreased cognitive e...
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Acute empathy decline among resident physician trainees on a hematology-Oncology Ward: an exploratory analysis of house staff empathy, distress, and patient death exposure.
Psycho-oncology, 2016Co-Authors: Daniel C. Mcfarland, Adriana K. Malone, Andrew J. RothAbstract:Objective A reason for empathy decline during medical training has not been fully elucidated. Empathy may decrease acutely during an inpatient hematology–Oncology rotation because of the acuity of death exposures. This study aimed to explore physician trainee empathy, distress, death exposures, and their attributed meaning for the trainee. Methods Internal medicine interns and residents at a single academic center were evaluated before and after hematology–Oncology Ward rotations using Interpersonal Reactivity Index for empathy, previously cited reasons for empathy decline, Impact of Event Scale-Revised for distress, death exposures (no. of dying patients cared for) and attributed sense of meaning (yes/no) (post-rotation). Results Fifty-six trainees completed both pre-rotation and post-rotation questionnaires (58% response). Empathy averaged 58.9 (SD 12.0) before and 56.8 (SD 11.1) after the rotation (2.1 point decrease) (p = 0.018). Distress was elevated but did not change significantly during the rotation. Residents cared for 4.28 dying patients. Seventy-three percent reported that death was the most stressful event during the rotation, yet 68% reported that they derived a sense of meaning from caring for dying patients. Empathy and distress scales were positively correlated before the rotation (r = 0.277, p = 0.041) but not after (r = .059, p = 0.69). Conclusion This study suggests that an acute drop in empathy can occur over several weeks in residents rotating through inpatient hematology–Oncology, similar to empathy decline associated with years of training in other studies. Empathy decline may be associated with elevated distress and death exposures on the hematology–Oncology Ward and should be explored further in other medical training environments. Copyright © 2016 John Wiley & Sons, Ltd.
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Psychological Distress of Internal Medicine Residents Rotating on a Hematology and Oncology Ward: An Exploratory Study of Patient Deaths, Personal Stress, and Attributed Meaning
Medical science educator, 2015Co-Authors: Daniel C. Mcfarland, Robert G. Maki, Jimmie C. HollandAbstract:Effectively managing patient distress in Oncology is challenging. Trainees in Oncology experience distress along with their patients and patients’ families, especially during an inpatient admission. This study evaluated the physician-in-training experience while working on an inpatient hematology-Oncology Ward. We collected a survey from internal medicine interns and residents at the end of a 2- or 4-week-long rotation on a hematology-Oncology Ward. It included the Impact of Events Scale-Revised (IES-R), a measure of distress, information about resident demography, rotation experiences with death, and personal circumstances that could affect distress levels. House officers were asked to provide comments regarding their most stressful experiences or how they were affected by dying patients. Fifty-six residents completed questionnaires (58 % overall response rate) and scored IES-R 18.7 (SD 14.2) indicating that the majority (80 %) experienced significant clinical distress (IES-R ≥8) and 20 % experienced posttraumatic stress disorder (PTSD) levels of distress (IES-R ≥33). Comment themes are highlighted and included general frustration and death-related events. Forty-one (73 %) reported that their IES-R event was a death-related experience, and 39 (69.6 %) reported that attending to dying patients was the most stressful part of the rotation. Residents cared for 4.28 patients at the end of life on average during the rotation, and 68 % derived a sense of meaning from such work. This study suggests that physician-trainee distress is significantly elevated while working on a hematology-Oncology Ward and may relate to general frustration and death-related events. Further study should evaluate the etiology of medical trainee distress in Oncology.
Pramod Kumar Julka - One of the best experts on this subject based on the ideXlab platform.
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518pmetabolic toxicity in patients undergoing radical anti cancer therapy a cross sectional analysis of patients in an Oncology Ward in india
Annals of Oncology, 2015Co-Authors: Subhash Gupta, Soumyajit Roy, Pramod Kumar Julka, D Sharma, G.k. RathAbstract:Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our Oncology Ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS <70, pancytopenia and artificial ventilation requirement were found to have a significant impact on death. Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.
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Hematologic Toxicity in Patients Undergoing Radical Anti- cancer Therapy: A Cross-Sectional Analysis of Patients in an Oncology Ward in India
Annals of Oncology, 2015Co-Authors: Soumyajit Roy, Supriya Mallick, Waseem Raza, Kunhi Parambath Haresh, Subhash Gupta, Daya Nand Sharma, Pramod Kumar Julka, G.k. RathAbstract:Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our Oncology Ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS
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hematologic toxicity in patients undergoing radical anti cancer therapy a cross sectional analysis of patients in an Oncology Ward in india
Asian Pacific Journal of Cancer Prevention, 2014Co-Authors: Soumyajit Roy, Supriya Mallick, Kunhi Parambath Haresh, Subhash Gupta, Daya Nand Sharma, Pramod Kumar Julka, Md Waseem Raza, G.k. RathAbstract:Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our Oncology Ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS <70, pancytopenia and artificial ventilation requirement were found to have a significant impact on death. Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.
