Tata Memorial Hospital

About: Tata Memorial Hospital is a healthcare organization based out in Mumbai, India. It is known for research contribution in the topics: Cancer & Breast cancer. The organization has 3187 authors who have published 4636 publications receiving 109143 citations.

Impact of COVID-19 on cancer care in India: a cohort study.

Abstract: BACKGROUND: The COVID-19 pandemic has disrupted health-care systems, leading to concerns about its subsequent impact on non-COVID disease conditions. The diagnosis and management of cancer is time sensitive and is likely to be substantially affected by these disruptions. We aimed to assess the impact of the COVID-19 pandemic on cancer care in India. METHODS: We did an ambidirectional cohort study at 41 cancer centres across India that were members of the National Cancer Grid of India to compare provision of oncology services between March 1 and May 31, 2020, with the same time period in 2019. We collected data on new patient registrations, number of patients visiting outpatient clinics, hospital admissions, day care admissions for chemotherapy, minor and major surgeries, patients accessing radiotherapy, diagnostic tests done (pathology reports, CT scans, MRI scans), and palliative care referrals. We also obtained estimates from participating centres on cancer screening, research, and educational activities (teaching of postgraduate students and trainees). We calculated proportional reductions in the provision of oncology services in 2020, compared with 2019. FINDINGS: Between March 1 and May 31, 2020, the number of new patients registered decreased from 112 270 to 51 760 (54% reduction), patients who had follow-up visits decreased from 634 745 to 340 984 (46% reduction), hospital admissions decreased from 88 801 to 56 885 (36% reduction), outpatient chemotherapy decreased from 173634 to 109 107 (37% reduction), the number of major surgeries decreased from 17 120 to 8677 (49% reduction), minor surgeries from 18 004 to 8630 (52% reduction), patients accessing radiotherapy from 51 142 to 39 365 (23% reduction), pathological diagnostic tests from 398 373 to 246 616 (38% reduction), number of radiological diagnostic tests from 93 449 to 53 560 (43% reduction), and palliative care referrals from 19 474 to 13 890 (29% reduction). These reductions were even more marked between April and May, 2020. Cancer screening was stopped completely or was functioning at less than 25% of usual capacity at more than 70% of centres during these months. Reductions in the provision of oncology services were higher for centres in tier 1 cities (larger cities) than tier 2 and 3 cities (smaller cities). INTERPRETATION: The COVID-19 pandemic has had considerable impact on the delivery of oncology services in India. The long-term impact of cessation of cancer screening and delayed hospital visits on cancer stage migration and outcomes are likely to be substantial. FUNDING: None. TRANSLATION: For the Hindi translation of the abstract see Supplementary Materials section.

Estimate of cancer incidence in india in 1991

Abstract: Cancer incidence and eighteen site-specific age standardised rates in India were estimated for the year 1991. With the establishment of National Cancer Registry Programme, incidence rates per 100,000 are available from six metropolitan registries and one rural registry. Using population census data for India in 1991, about 609,000 new cancer cases were estimated to have been diagnosed in the country in 1991. The estimated age standardised rates per 100,000 were 96.4 for males and 88.2 for females. The five most common cancers were lung (10.6%) pharynx (9.1%), oesophagus (6.7%), tongue (6.6%) and stomach (5.7%) among males and cervix (23.5%), breast (19.3%), ovary (5.5%) oesophagus (4.4%), and mouth (3.9%) among females. A comparison of estimated ASRs for two two largest countries in Asia (China and India) showed differences in the pattern of cancer.

Intensive Care in India: The Indian Intensive Care Case Mix and Practice Patterns Study.

Abstract: Aims To obtain information on organizational aspects, case mix and practices in Indian Intensive Care Units (ICUs). Patients and methods An observational, 4-day point prevalence study was performed between 2010 and 2011 in 4209 patients from 124 ICUs. ICU and patient characteristics, and interventions were recorded for 24 h of the study day, and outcomes till 30 days after the study day. Data were analyzed for 4038 adult patients from 120 ICUs. Results On the study day, mean age, Acute Physiology and Chronic Health Evaluation (APACHE II) and sequential organ failure assessment (SOFA) scores were 54.1 ± 17.1 years, 17.4 ± 9.2 and 3.8 ± 3.6, respectively. About 46.4% patients had ≥1 organ failure. Nearly, 37% and 22.2% patients received mechanical ventilation (MV) and vasopressors or inotropes, respectively. Nearly, 12.2% patients developed an infection in the ICU. About 28.3% patients had severe sepsis or septic shock (SvSpSS) during their ICU stay. About 60.7% patients without infection received antibiotics. There were 546 deaths and 183 terminal discharges (TDs) from ICU (including left against medical advice or discharged on request), with ICU mortality 729/4038 (18.1%). In 1627 patients admitted within 24 h of the study day, the standardized mortality ratio was 0.67. The APACHE II and SOFA scores, public hospital ICUs, medical ICUs, inadequately equipped ICUs, medical admission, self-paying patient, presence of SvSpSS, acute respiratory failure or cancer, need for a fluid bolus, and MV were independent predictors of mortality. Conclusions The high proportion of TDs and the association of public hospitals, self-paying patients, and inadequately equipped hospitals with mortality has important implications for critical care in India.

Pancreatic fistula after pancreaticoduodenectomy: the impact of a standardized technique of pancreaticojejunostomy

Abstract: The leading cause for morbidity and mortality after pancreaticoduodenectomy is a pancreatic anastomotic leak and fistula The two most commonly performed anastomoses after pancreaticoduodenectomy are pancreaticogastrostomy (PG) and pancreaticojejunostomy (PJ) The role of standardization on outcomes after pancreaticoduodenectomy has not been sufficiently addressed The goal is to study the impact of a standardized technique of pancreatic anastomosis (PJ) after pancreaticoduodenectomy in a tertiary referral cancer teaching hospital A single-institution database was analyzed over 15 years The entire data were subdivided into two periods, viz, period A (1992 to 2001), when PG (dunking) was predominantly used, and period B (2003–2007), when a standardized technique of PJ (duct to mucosa) was employed There were 144 pancreaticoduodenectomies performed during period A with a pancreatic fistula rate of 16% During period B, 123 pancreaticoduodenectomies were performed with a pancreatic fistula rate of 32% (p < 00005) It appears that a standardized approach to the pancreatic anastomosis and a consistent practice of a single technique can help to reduce the incidence of complications after pancreaticoduodenectomy