Subir Sinha - Academia.edu (original) (raw)

Papers by Subir Sinha

Indian Journal of Anaesthesia, 2016

Background and Aims: The use of ultrasound (US) scanning to assess the depth of epidural space to... more Background and Aims: The use of ultrasound (US) scanning to assess the depth of epidural space to prevent neurological complications is established in current practice. In this study, we hypothesised that pre-puncture US scanning for estimating the depth of epidural space for thoracic epidurals is comparable between transverse median (TM) and paramedian sagittal oblique (PSO) planes. Methods: We performed pre-puncture US scanning in 32 patients, posted for open abdominal surgeries. The imaging was done to detect the depth of epidural space from skin (ultrasound depth [UD]) and needle insertion point, in parasagittal oblique plane in PSO group and transverse median plane in TM group. Subsequently, epidural space was localised through the predetermined insertion point by 'loss of resistance' technique and needle depth (ND) to the epidural space was marked. Correlation between the UD and actual ND was calculated and concordance correlation coefficient (CCC) was used to determine the degree of agreement between UD and ND in both the planes. Results: The primary outcome, i.e., the comparison between UD and ND, done using Pearson correlation coefficient, was 0.99 in both PSO and TM groups, and the CCC was 0.93 (95% confidence interval [95% CI]: 0.81-0.97) and 0.90 (95% CI: 0.74-0.96) in PSO and TM groups respectively, which shows a strong positive association between UD and ND in both groups. Conclusion: The use of pre-puncture US scanning in both PSO and TM planes for estimating the depth of epidural space at the level of mid-and lower-thoracic spine is comparable.

Infection Control & Hospital Epidemiology

Background: The multidrug-resistant fungus Candida auris is emerging as a major cause of healthca... more Background: The multidrug-resistant fungus Candida auris is emerging as a major cause of healthcare-associated infection globally. Understanding the epidemiology of these infections in vulnerable groups such as cancer patients is important for hospital infection control and their effective management. In this report we present diagnostic, clinical, antifungal resistance and outcome data of 11 cases of C. auris infection from an oncology center in India. Methods:C. auris strains were identified by Sanger-based DNA sequencing of the internal transcriber spacer (ITS) gene. Antifungal susceptibility testing (AFST) was performed using the broth dilution method. Identification and AFST were checked by the WHO Collaborating Center for Reference & Research on Fungi of Medical Importance. Patients had both empirical as well as directed therapy with antifungal agents based on AFST results and clinical assessment. Results: Between November 2018 and March 2019, 11 cases of C. auris (8 from pati...

Society of Nuclear Medicine Annual Meeting Abstracts, May 1, 2010

Results: RR was found to be linearly related to the QDS. In general, decreases greater than 80% o... more Results: RR was found to be linearly related to the QDS. In general, decreases greater than 80% of maximum were read as 0, 70% to 80% as "1", 60% to 70% as "2", 50% to 60% as "3" and below 50% as "4". Analysis of RR indicated that greater than 1 unit change from the 2-...

Biostatistics is not universally available in colleges/universities and is thus an attractive cou... more Biostatistics is not universally available in colleges/universities and is thus an attractive course to offer via distance education. However, evaluation of the impact of distance education on course enrollment and student success is lacking. We evaluated an "Introduction to Biostatistics" course at Harvard University that offered the distance option (Spring 2005).We assessed the effect on course enrollment and compared the grades of traditional students with non-traditional students, as well as with historical traditional students (Fall 2004). We further compared course evaluations from the inaugural semester with the distance option to evaluations from the prior semester. No evidence of dissimilarities was noted with respect to overall course grade averages or course evaluations.

Breast Cancer: Targets and Therapy, 2015

Following neoadjuvant chemotherapy (NACT) for breast cancer, changes in estrogen receptor (ER), p... more Following neoadjuvant chemotherapy (NACT) for breast cancer, changes in estrogen receptor (ER), progesterone receptor (PR), HER2 status, and Ki-67 index (IHC4 status) and its correlation with pathological complete response (pCR) or relapse-free survival (RFS) rates could lead to better understanding of tumor management. Pre- and post-NACT IHC4 status and its changes were analyzed in 156 patients with breast cancer. Associations between pCR, RFS rates to IHC4 status pre- and post-NACT were investigated. pCR was found in 25.3% patients. Both ER and PR positive tumors had the lowest (14.3%) pCR compared to ER and PR negative (29%) or either ER-/PR-positive (38.6%) tumors. PR positivity was significantly associated with less likelihood of pCR (15% versus 34%). The pCR rate was low for luminal A subtype (13.68%) compared to 24.36%, 26.31%, and 33.33% for luminal B, HER2-enriched, and triple-negative subtypes, respectively. There was significant reduction in ER expression and Ki-67 index post-NACT. RFS of patients in whom the hormonal status changed from positive to negative was better compared to those of patients in whom the hormonal status changed from negative to positive. Although changes in IHC4 occurred post-NACT, pre-NACT hazard ratio status prognosticated RFS better. pCR and RFS rates were lower in PR-positive tumors.

Indian Journal of Anaesthesia, 2016

Background and Aims: The use of ultrasound (US) scanning to assess the depth of epidural space to... more Background and Aims: The use of ultrasound (US) scanning to assess the depth of epidural space to prevent neurological complications is established in current practice. In this study, we hypothesised that pre-puncture US scanning for estimating the depth of epidural space for thoracic epidurals is comparable between transverse median (TM) and paramedian sagittal oblique (PSO) planes. Methods: We performed pre-puncture US scanning in 32 patients, posted for open abdominal surgeries. The imaging was done to detect the depth of epidural space from skin (ultrasound depth [UD]) and needle insertion point, in parasagittal oblique plane in PSO group and transverse median plane in TM group. Subsequently, epidural space was localised through the predetermined insertion point by 'loss of resistance' technique and needle depth (ND) to the epidural space was marked. Correlation between the UD and actual ND was calculated and concordance correlation coefficient (CCC) was used to determine the degree of agreement between UD and ND in both the planes. Results: The primary outcome, i.e., the comparison between UD and ND, done using Pearson correlation coefficient, was 0.99 in both PSO and TM groups, and the CCC was 0.93 (95% confidence interval [95% CI]: 0.81-0.97) and 0.90 (95% CI: 0.74-0.96) in PSO and TM groups respectively, which shows a strong positive association between UD and ND in both groups. Conclusion: The use of pre-puncture US scanning in both PSO and TM planes for estimating the depth of epidural space at the level of mid-and lower-thoracic spine is comparable.

Infection Control & Hospital Epidemiology

Background: The multidrug-resistant fungus Candida auris is emerging as a major cause of healthca... more Background: The multidrug-resistant fungus Candida auris is emerging as a major cause of healthcare-associated infection globally. Understanding the epidemiology of these infections in vulnerable groups such as cancer patients is important for hospital infection control and their effective management. In this report we present diagnostic, clinical, antifungal resistance and outcome data of 11 cases of C. auris infection from an oncology center in India. Methods:C. auris strains were identified by Sanger-based DNA sequencing of the internal transcriber spacer (ITS) gene. Antifungal susceptibility testing (AFST) was performed using the broth dilution method. Identification and AFST were checked by the WHO Collaborating Center for Reference & Research on Fungi of Medical Importance. Patients had both empirical as well as directed therapy with antifungal agents based on AFST results and clinical assessment. Results: Between November 2018 and March 2019, 11 cases of C. auris (8 from pati...

Society of Nuclear Medicine Annual Meeting Abstracts, May 1, 2010

Results: RR was found to be linearly related to the QDS. In general, decreases greater than 80% o... more Results: RR was found to be linearly related to the QDS. In general, decreases greater than 80% of maximum were read as 0, 70% to 80% as "1", 60% to 70% as "2", 50% to 60% as "3" and below 50% as "4". Analysis of RR indicated that greater than 1 unit change from the 2-...

Biostatistics is not universally available in colleges/universities and is thus an attractive cou... more Biostatistics is not universally available in colleges/universities and is thus an attractive course to offer via distance education. However, evaluation of the impact of distance education on course enrollment and student success is lacking. We evaluated an "Introduction to Biostatistics" course at Harvard University that offered the distance option (Spring 2005).We assessed the effect on course enrollment and compared the grades of traditional students with non-traditional students, as well as with historical traditional students (Fall 2004). We further compared course evaluations from the inaugural semester with the distance option to evaluations from the prior semester. No evidence of dissimilarities was noted with respect to overall course grade averages or course evaluations.

Breast Cancer: Targets and Therapy, 2015

Following neoadjuvant chemotherapy (NACT) for breast cancer, changes in estrogen receptor (ER), p... more Following neoadjuvant chemotherapy (NACT) for breast cancer, changes in estrogen receptor (ER), progesterone receptor (PR), HER2 status, and Ki-67 index (IHC4 status) and its correlation with pathological complete response (pCR) or relapse-free survival (RFS) rates could lead to better understanding of tumor management. Pre- and post-NACT IHC4 status and its changes were analyzed in 156 patients with breast cancer. Associations between pCR, RFS rates to IHC4 status pre- and post-NACT were investigated. pCR was found in 25.3% patients. Both ER and PR positive tumors had the lowest (14.3%) pCR compared to ER and PR negative (29%) or either ER-/PR-positive (38.6%) tumors. PR positivity was significantly associated with less likelihood of pCR (15% versus 34%). The pCR rate was low for luminal A subtype (13.68%) compared to 24.36%, 26.31%, and 33.33% for luminal B, HER2-enriched, and triple-negative subtypes, respectively. There was significant reduction in ER expression and Ki-67 index post-NACT. RFS of patients in whom the hormonal status changed from positive to negative was better compared to those of patients in whom the hormonal status changed from negative to positive. Although changes in IHC4 occurred post-NACT, pre-NACT hazard ratio status prognosticated RFS better. pCR and RFS rates were lower in PR-positive tumors.