Shaunak Valame - Academia.edu (original) (raw)

Papers by Shaunak Valame

Journal of Clinical Oncology

e12533 Background: Age is an important risk factor for breast cancer (BC). The younger age (< ... more e12533 Background: Age is an important risk factor for breast cancer (BC). The younger age (< 40 years) is associated with unfavorable tumor biology. This is a retrospective analysis of young breast patients treated from 2012-2020 at a comprehensive cancer centre. Methods: Data regarding demography, clinical presentation, histopathological features, molecular profiling, treatment details, and outcomes were retrieved from medical records. All time-to event outcomes were analyzed using Kaplan-Meir method. Results: A total of 134 patients (< 40 years) with BC were included. Median age of the study cohort was 37 years (range: 22-40 years) with a female predominance (98.5%). Most of the patients presented with locally advanced BC (51%) followed by early BC (43%) and metastatic BC (6%). The mean tumor size and positivity lymph nodes of our non-metastatic patients were 3.86±1.90 cm and 3.3±3.98, respectively. The molecular classification revealed most of the patients were of Basal-li...

Indian Journal of Medical and Paediatric Oncology, 2020

Mucositis is a common complication of cancer treatment. Mucositis has varied etiology. Here, we d... more Mucositis is a common complication of cancer treatment. Mucositis has varied etiology. Here, we describe a case of 71-year-old male with metastatic castrate-resistant carcinoma prostate who developed mucositis with the use of targeted therapy, and this particular scenario led to the therapeutic dilemma.

Journal of Evolution of medical and Dental Sciences, 2015

CONTEXT: Although head and neck masses are fairly common clinical presentation, it may be the onl... more CONTEXT: Although head and neck masses are fairly common clinical presentation, it may be the only, or one of several nonspecific findings in serious illnesses like lymphoma or metastatic cancer. Thus, the need to efficiently differentiate patients with serious illness from those with self-limited disease arises. Fine Needle Aspiration Cytology (FNAC) helps in the early and accurate diagnosis especially where approach for interventional biopsy is limited. AIMS: To diagnose various head and neck mass lesions via FNAC and correlating the results with clinical and histo pathological diagnosis. SETTINGS & DESIGN: The study was conducted in Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa (MP), on 406 patients who presented with head and neck swellings. METHODS & MATERIAL: A complete general and systemic examination was carried out. FNAC was carried out on 406 subjects while biopsy was done for 123 lesions. The predictive value for FNAC was retrospectively ...

Context: Envenomation due to snake bites is one of the major Neglected Tropical Disease worldwide... more Context: Envenomation due to snake bites is one of the major Neglected Tropical Disease worldwide. In rural areas exposure to snake bite and reliance on traditional healing is high. Hence, there is a need to evaluate clinical characteristics to identify patients at high risk of developing fatal complications. Settings & design: This study was carried out on 160 patients who were admitted with history of snake bite in Department of Medicine, Shyam Shah Medical College and associated S.G.M. Hospital, Rewa (MP). Material & methods: Data was categorized into demographic characteristics, type of snake bite, history of self/home/ faith healer treatment, time lapse from the time of bite till hospital admission, clinical characteristics, severity, quantity of polyvalent antisnake venom used, duration of hospitalisation, and clinical status at discharge. Data was analysed using the Chi-square test. Results: The study of 160 snake bites revealed a significant demographic predilection to age (...

Context: Swellings of the thyroid are commonplace in day-to-day practice. Whether symptomatic or ... more Context: Swellings of the thyroid are commonplace in day-to-day practice. Whether symptomatic or not, the differentiation of a benign from malignant swelling is a primary objective for all physicians. In the recent past, Fine Needle Aspiration Cytology (FNAC) has emerged as the foremost application in the diagnosis of thyroid swellings. Through this study, we evaluated the accuracy of FNAC in our setting. Settings & design: The study was conducted in Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa (MP), on 86 patients who presented with thyroid swellings. Methods & material: 86 subjects presenting with thyroid swellings were included on whom FNAC was done whereas histopathology was carried out on 22. The predictive value for FNAC was retrospectively correlated clinically and with biopsy results, if available. Results: In the current study, 80 diagnoses clinically correlated to 86 cytological diagnoses. The most common thyroid swellings were benign ade...

CONTEXT: Patients with impaired glucose tolerance are diagnosed with difficulty in the clinical s... more CONTEXT: Patients with impaired glucose tolerance are diagnosed with difficulty in the clinical setting because of the absence of classical symptoms of the disease. Due to recent introduction of this class of glucose intolerance, and relative lack of knowledge of its clinical significance impaired glucose tolerance is still the subject of research to determine its course and prognostic implications. AIMS: To study the prevalence of impaired glucose tolerance in first degree relatives of type II diabetic patients, above 30 years of age. SETTINGS AND DESIGN: Inclusion of persons above the age of 30 years who are first degree relatives of type II diabetic, admitted in indoor or attending as outpatients in Department of Medicine, Sanjay Gandhi Memorial Hospital, Rewa, Madhya Pradesh. METHODS AND MATERIAL: A complete general and systemic examination and Oral GTT to be carried out on selected subjects. RESULTS: More than one-fourth of the subjects were found to have an impaired Oral Gluco...

Journal of Evolution of Medical and Dental Sciences, 2017

BACKGROUND India currently leads the world with largest number of diabetic subjects, earning the ... more BACKGROUND India currently leads the world with largest number of diabetic subjects, earning the ignominy of being the "Diabetes capital of the world." Diabetic foot ulcer is a rising health problem, being the most important cause of non-traumatic foot ischaemia. Ulceration, infection, gangrene and lower extremity amputation are complications often encountered in diabetics. Not all foot complications can be prevented, but it is possible to dramatically reduce their incidence through appropriate management and prevention programs. The aim of this study is to evaluate risk of development of diabetic foot among diabetics and to identify high risk features through Epidemiological variables, biochemical parameters and clinical findings of Ankle-Brachial Index, Monofilament testing and Durometer analysis. Settings and Design-Cross-sectional study with educational intervention on 350 Diabetics attending Outpatient Department of Medicine at a tertiary care hospital in Central India. MATERIALS AND METHODS Diabetic Foot Risk Assessment questionnaire will be filled out by patients. Clinical assessment of their feet using Monofilament, Ankle Brachial Index and Durometer analysis of footwear along with Epidemiological Profile and Biochemical Parameters shall be correlated with their risk profile. Statistical Analysis-Data analysis was done by calculating the p-value using the Chi-Square test using Microsoft Excel version 2016 (MS Office 365 Home). RESULTS Of 350 subjects 227 (64.86%) had moderate risk of developing diabetic foot, while 87 (24.86%) had high risk. Advanced age, rural lifestyle, low literacy, high body mass index, poor blood glucose control, longer duration of diabetes and addictions were significantly associated with a higher risk of developing diabetic foot. Ankle-Brachial Index, Monofilament Test and Durometer evaluation proved to be simple, cost-effective outpatient methods to evaluate risk profile. CONCLUSION Foot care assessment and inculcation of good foot care practices should be done at the outset of diagnosis of diabetes. Simple outpatient tests are sensitive enough to detect risk of developing diabetic foot. This approach may help reduce the incidence of diabetic foot.

Journal of Evolution of medical and Dental Sciences, Sep 9, 2014

Risk of Diabetic Foot in Diabetics With Micro and Macrovascular Complications, Feb 12, 2014

We consider the use of adaptive modulation scheme for multiple transmit and multiple receive ante... more We consider the use of adaptive modulation scheme for multiple transmit and multiple receive antenna system with instantaneous channel information known to both the receiver and the transmitter. We derive an efficient bit allocation algorithm which maximizes the transmission rate for a given transmit power. The algorithm is generally a greedy algorithm; however, we derive a sufficient condition for the bit allocation algorithm to be globally optimal, which is found to be satisfied in all digital modulation schemes. It is found that when uncoded M-ary QAM is used with a target symbol error probability of 10 −5 there is about 9 dB gap between the channel capacity and the throughput of adaptive modulation.

Clinical and Epidemiological Study on Atrial Fibrillation Original Report, Nov 9, 2014

CONTEXT: Foot complications are one of the most serious and costly complications of diabetes, but... more CONTEXT: Foot complications are one of the most serious and costly complications of diabetes, but are usually neglected. Since most Indians still walk barefoot and are ignorant of foot care, there is an urgent need for preventive clinical measures to reduce the impact of diabetic foot. AIMS: To evaluate micro and macro vascular complications in diabetics as predictors of diabetic foot risk. SETTINGS & DESIGN: The study was conducted in Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa (MP), in 2013 on 200 diabetics. METHODS & MATERIAL: A complete general and systemic examination to be carried out on diabetic subjects, analysing their micro and macrovascular complications and evaluating their risk of developing diabetic foot. Data analysis was done by calculating the p-value using the Chi Square Test. RESULTS: Out of 200 patients, 12 were at a high risk of developing diabetic foot, while 57 and 131 were at low and moderate risk respectively. Demographic ...

Journal of Clinical Oncology

349 Background: In a real-world scenario, Fluorouracil-based triplet combination chemotherapies h... more 349 Background: In a real-world scenario, Fluorouracil-based triplet combination chemotherapies have limited feasibility with regards to toxicity, need for central venous access, and hospitalization. The primary objective of this study was to assess pathological tumor regression to Capecitabine-based triplet regimes, with the additional possible benefit of overcoming the aforementioned barriers. Methods: This Single-Arm, Prospective study investigated the primary outcome of histopathologic regression to perioperative Docetaxel, Oxaliplatin, and Capecitabine (DOX) combination regime in histologically confirmed resectable Esophageal, Esophagogastric Junction, and Gastric Adenocarcinomas. Three preoperative and 3 postoperative cycles of Docetaxel 60mg/m2 plus Oxaliplatin 100mg/m2 on Day 1, with Capecitabine 500mg/m2 twice daily from Day 1 to Day 21 were administered, with cycles repeating every 21 days. Histopathologic regression was assessed by Modified Ryan’s Schema on surgical speci...

Journal of Clinical Oncology

e12533 Background: Age is an important risk factor for breast cancer (BC). The younger age (< ... more e12533 Background: Age is an important risk factor for breast cancer (BC). The younger age (< 40 years) is associated with unfavorable tumor biology. This is a retrospective analysis of young breast patients treated from 2012-2020 at a comprehensive cancer centre. Methods: Data regarding demography, clinical presentation, histopathological features, molecular profiling, treatment details, and outcomes were retrieved from medical records. All time-to event outcomes were analyzed using Kaplan-Meir method. Results: A total of 134 patients (< 40 years) with BC were included. Median age of the study cohort was 37 years (range: 22-40 years) with a female predominance (98.5%). Most of the patients presented with locally advanced BC (51%) followed by early BC (43%) and metastatic BC (6%). The mean tumor size and positivity lymph nodes of our non-metastatic patients were 3.86±1.90 cm and 3.3±3.98, respectively. The molecular classification revealed most of the patients were of Basal-li...

Indian Journal of Medical and Paediatric Oncology, 2020

Mucositis is a common complication of cancer treatment. Mucositis has varied etiology. Here, we d... more Mucositis is a common complication of cancer treatment. Mucositis has varied etiology. Here, we describe a case of 71-year-old male with metastatic castrate-resistant carcinoma prostate who developed mucositis with the use of targeted therapy, and this particular scenario led to the therapeutic dilemma.

Journal of Evolution of medical and Dental Sciences, 2015

CONTEXT: Although head and neck masses are fairly common clinical presentation, it may be the onl... more CONTEXT: Although head and neck masses are fairly common clinical presentation, it may be the only, or one of several nonspecific findings in serious illnesses like lymphoma or metastatic cancer. Thus, the need to efficiently differentiate patients with serious illness from those with self-limited disease arises. Fine Needle Aspiration Cytology (FNAC) helps in the early and accurate diagnosis especially where approach for interventional biopsy is limited. AIMS: To diagnose various head and neck mass lesions via FNAC and correlating the results with clinical and histo pathological diagnosis. SETTINGS & DESIGN: The study was conducted in Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa (MP), on 406 patients who presented with head and neck swellings. METHODS & MATERIAL: A complete general and systemic examination was carried out. FNAC was carried out on 406 subjects while biopsy was done for 123 lesions. The predictive value for FNAC was retrospectively ...

Context: Envenomation due to snake bites is one of the major Neglected Tropical Disease worldwide... more Context: Envenomation due to snake bites is one of the major Neglected Tropical Disease worldwide. In rural areas exposure to snake bite and reliance on traditional healing is high. Hence, there is a need to evaluate clinical characteristics to identify patients at high risk of developing fatal complications. Settings & design: This study was carried out on 160 patients who were admitted with history of snake bite in Department of Medicine, Shyam Shah Medical College and associated S.G.M. Hospital, Rewa (MP). Material & methods: Data was categorized into demographic characteristics, type of snake bite, history of self/home/ faith healer treatment, time lapse from the time of bite till hospital admission, clinical characteristics, severity, quantity of polyvalent antisnake venom used, duration of hospitalisation, and clinical status at discharge. Data was analysed using the Chi-square test. Results: The study of 160 snake bites revealed a significant demographic predilection to age (...

Context: Swellings of the thyroid are commonplace in day-to-day practice. Whether symptomatic or ... more Context: Swellings of the thyroid are commonplace in day-to-day practice. Whether symptomatic or not, the differentiation of a benign from malignant swelling is a primary objective for all physicians. In the recent past, Fine Needle Aspiration Cytology (FNAC) has emerged as the foremost application in the diagnosis of thyroid swellings. Through this study, we evaluated the accuracy of FNAC in our setting. Settings & design: The study was conducted in Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa (MP), on 86 patients who presented with thyroid swellings. Methods & material: 86 subjects presenting with thyroid swellings were included on whom FNAC was done whereas histopathology was carried out on 22. The predictive value for FNAC was retrospectively correlated clinically and with biopsy results, if available. Results: In the current study, 80 diagnoses clinically correlated to 86 cytological diagnoses. The most common thyroid swellings were benign ade...

CONTEXT: Patients with impaired glucose tolerance are diagnosed with difficulty in the clinical s... more CONTEXT: Patients with impaired glucose tolerance are diagnosed with difficulty in the clinical setting because of the absence of classical symptoms of the disease. Due to recent introduction of this class of glucose intolerance, and relative lack of knowledge of its clinical significance impaired glucose tolerance is still the subject of research to determine its course and prognostic implications. AIMS: To study the prevalence of impaired glucose tolerance in first degree relatives of type II diabetic patients, above 30 years of age. SETTINGS AND DESIGN: Inclusion of persons above the age of 30 years who are first degree relatives of type II diabetic, admitted in indoor or attending as outpatients in Department of Medicine, Sanjay Gandhi Memorial Hospital, Rewa, Madhya Pradesh. METHODS AND MATERIAL: A complete general and systemic examination and Oral GTT to be carried out on selected subjects. RESULTS: More than one-fourth of the subjects were found to have an impaired Oral Gluco...

Journal of Evolution of Medical and Dental Sciences, 2017

BACKGROUND India currently leads the world with largest number of diabetic subjects, earning the ... more BACKGROUND India currently leads the world with largest number of diabetic subjects, earning the ignominy of being the "Diabetes capital of the world." Diabetic foot ulcer is a rising health problem, being the most important cause of non-traumatic foot ischaemia. Ulceration, infection, gangrene and lower extremity amputation are complications often encountered in diabetics. Not all foot complications can be prevented, but it is possible to dramatically reduce their incidence through appropriate management and prevention programs. The aim of this study is to evaluate risk of development of diabetic foot among diabetics and to identify high risk features through Epidemiological variables, biochemical parameters and clinical findings of Ankle-Brachial Index, Monofilament testing and Durometer analysis. Settings and Design-Cross-sectional study with educational intervention on 350 Diabetics attending Outpatient Department of Medicine at a tertiary care hospital in Central India. MATERIALS AND METHODS Diabetic Foot Risk Assessment questionnaire will be filled out by patients. Clinical assessment of their feet using Monofilament, Ankle Brachial Index and Durometer analysis of footwear along with Epidemiological Profile and Biochemical Parameters shall be correlated with their risk profile. Statistical Analysis-Data analysis was done by calculating the p-value using the Chi-Square test using Microsoft Excel version 2016 (MS Office 365 Home). RESULTS Of 350 subjects 227 (64.86%) had moderate risk of developing diabetic foot, while 87 (24.86%) had high risk. Advanced age, rural lifestyle, low literacy, high body mass index, poor blood glucose control, longer duration of diabetes and addictions were significantly associated with a higher risk of developing diabetic foot. Ankle-Brachial Index, Monofilament Test and Durometer evaluation proved to be simple, cost-effective outpatient methods to evaluate risk profile. CONCLUSION Foot care assessment and inculcation of good foot care practices should be done at the outset of diagnosis of diabetes. Simple outpatient tests are sensitive enough to detect risk of developing diabetic foot. This approach may help reduce the incidence of diabetic foot.

Journal of Evolution of medical and Dental Sciences, Sep 9, 2014

Risk of Diabetic Foot in Diabetics With Micro and Macrovascular Complications, Feb 12, 2014

We consider the use of adaptive modulation scheme for multiple transmit and multiple receive ante... more We consider the use of adaptive modulation scheme for multiple transmit and multiple receive antenna system with instantaneous channel information known to both the receiver and the transmitter. We derive an efficient bit allocation algorithm which maximizes the transmission rate for a given transmit power. The algorithm is generally a greedy algorithm; however, we derive a sufficient condition for the bit allocation algorithm to be globally optimal, which is found to be satisfied in all digital modulation schemes. It is found that when uncoded M-ary QAM is used with a target symbol error probability of 10 −5 there is about 9 dB gap between the channel capacity and the throughput of adaptive modulation.

Clinical and Epidemiological Study on Atrial Fibrillation Original Report, Nov 9, 2014

CONTEXT: Foot complications are one of the most serious and costly complications of diabetes, but... more CONTEXT: Foot complications are one of the most serious and costly complications of diabetes, but are usually neglected. Since most Indians still walk barefoot and are ignorant of foot care, there is an urgent need for preventive clinical measures to reduce the impact of diabetic foot. AIMS: To evaluate micro and macro vascular complications in diabetics as predictors of diabetic foot risk. SETTINGS & DESIGN: The study was conducted in Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa (MP), in 2013 on 200 diabetics. METHODS & MATERIAL: A complete general and systemic examination to be carried out on diabetic subjects, analysing their micro and macrovascular complications and evaluating their risk of developing diabetic foot. Data analysis was done by calculating the p-value using the Chi Square Test. RESULTS: Out of 200 patients, 12 were at a high risk of developing diabetic foot, while 57 and 131 were at low and moderate risk respectively. Demographic ...

Journal of Clinical Oncology

349 Background: In a real-world scenario, Fluorouracil-based triplet combination chemotherapies h... more 349 Background: In a real-world scenario, Fluorouracil-based triplet combination chemotherapies have limited feasibility with regards to toxicity, need for central venous access, and hospitalization. The primary objective of this study was to assess pathological tumor regression to Capecitabine-based triplet regimes, with the additional possible benefit of overcoming the aforementioned barriers. Methods: This Single-Arm, Prospective study investigated the primary outcome of histopathologic regression to perioperative Docetaxel, Oxaliplatin, and Capecitabine (DOX) combination regime in histologically confirmed resectable Esophageal, Esophagogastric Junction, and Gastric Adenocarcinomas. Three preoperative and 3 postoperative cycles of Docetaxel 60mg/m2 plus Oxaliplatin 100mg/m2 on Day 1, with Capecitabine 500mg/m2 twice daily from Day 1 to Day 21 were administered, with cycles repeating every 21 days. Histopathologic regression was assessed by Modified Ryan’s Schema on surgical speci...