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Papers by shivshankar timmanpyati

Research paper thumbnail of Vulnerability Assessment and Decision-Making in Older Patients with Head and Neck Cancers Planned for Chemoradiation: Experience from a Tertiary Care Cancer Centre in India

Research paper thumbnail of Assessing frailty in older Indian patients before cancer treatment: Comparative analysis of three scales and their implications for overall survival

Journal of geriatric oncology/Journal of geriatric oncology (Online), Apr 1, 2024

Research paper thumbnail of Weight changes in head and neck cancer patients during their cancer treatment

Clinical Nutrition ESPEN, Nov 30, 2023

Research paper thumbnail of Correlation of the Geriatric Assessment with Overall Survival in Older Patients with Cancer

Clinical Oncology, Dec 31, 2023

Research paper thumbnail of Baseline assessment of cognitive functions in Indian elderly cancer patients

Journal of Geriatric Oncology

Research paper thumbnail of Dietary intake and nutritional status of patients with phenylketonuria in Taiwan

Scientific Reports, 2020

Phenylalanine hydroxylase (PAH) deficiency leads to phenylalanine accumulation and results in phe... more Phenylalanine hydroxylase (PAH) deficiency leads to phenylalanine accumulation and results in phenylketonuria (PKU). Phenylketonuria can contribute to severe inability such as mental impairment. Early diagnosis and dietary intervention can have beneficial effects on maintaining normal neural and cognitive function in patients with PKU. However, a long-term low phenylalanine diet may put children at risk of malnutrition. A food supplement was therefore used for children with PKU under dietician supervision according to dietary reference intakes (DRIs). In this cross-sectional study, we enrolled patients with PKU and age-matched controls to compare their anthropometry data [weight, height, body mass index (BMI), and body composition using bioelectrical impedance analysis (BIA)], and correlated it with their dietary intake based on 24-h dietary recall. For continuous parameters, the data were expressed as median ± standard deviation (SD), and the Mann–Whitney U test was used to test th...

Research paper thumbnail of Expert Panel Opinion on Nutritional Management of Sarcopenia in Cancer Patients

Journal of cancer research reviews & reports, Jun 30, 2024

Research paper thumbnail of Prevalence of Malnutrition and its contributing factors in Indian elderly cancer patients

Journal of Geriatric Oncology, 2023

Research paper thumbnail of The current status of geriatric oncology in India

Research paper thumbnail of Subjective vs objective nutritional assessment characteristics of female gynecological cancers

Clinical Nutrition, Sep 1, 2018

Rationale: Body weight loss is a common problem after gastrectomy, and body composition changes a... more Rationale: Body weight loss is a common problem after gastrectomy, and body composition changes are substantially affected by gastrectomy. The purpose of this study was to evaluate body composition changes of patients who underwent gastrectomy for gastric cancer Methods: We retrospectively collected and reviewed patients' data who underwent radical gastrectomy for gastric cancer between December 2015 and December 2016. Body composition was examined by segmental multifrequency bioelectrical impedance analysis. All measurements were obtained preoperatively and 1, 3, 6, 9, and 12 months after surgery Results: A total of 91 patients were included for analysis. Distal gastrectomy and total gastrectomy were performed 68 and 23 patients, respectively. Body weight loss at 1, 3, 6, 9, and 12 months was 3.2kg (4.9%), 5.0kg (7.6%), 5.5kg (8.3%), 5.6kg (8.3%), and 5.6kg (8.3%), respectively. Loss of fat mass was greater than loss of lean body mass (4.2kg vs. 0.8kg). Loss of lean body mass was There were no significant differences between distal gastrectomy and total gastrectomy, but loss of lean body mass at 3 months after surgery was significantly greater in total gastrectomy than distal gastrectomy (p¼0.005). There were no significant differences between partial omentectomy and total omentectomy. Conclusions: Body weight loss occurred during the first 6 months after surgery. Especially, loss of fat mass accounted for a significant part of body weight loss after gastrectomy. Loss of lean body mass was significantly greater in total gastrectomy than distal gastrectomy Disclosure of interest: None declared.

Research paper thumbnail of Prevalence and factors associated with frailty among older Indian adults with cancer: A single-center cross-sectional analytical study from a geriatric oncology clinic in India

Cancer Research, Statistics, and Treatment

Physical frailty and cognitive impairment are risk factors for adverse outcomes in older people w... more Physical frailty and cognitive impairment are risk factors for adverse outcomes in older people with osteoarthritis of the knee (knee OA). This cross-sectional study was conducted to determine the prevalence and associated factors of frailty and cognitive frailty among community-dwelling older patients with knee OA in four representative cities of Thailand. Data composed of three parts, Part 1: Demographic data, Part 2: The assessment of frailty by Fried phenotype and cognitive function by MiniCog and Part 3: The assessment of factors associated with frailty. Of 780 elders (mean age, 69.4 ± 6.9 years) screened, 101 (12.9%) were classified to be frail, 511 (65.6%) pre-frail and 168 (21.5%) non-frail. The prevalence of cognitive frailty was 2.44%. The correlation between physical activity rated by the Global Physical Activity Questionnaire (GPAQ) and self-rated methods was high (kappa 0.721; p < 0.001). Self-rated physical activity yielded similar prevalence of frail (9.4%), pre-frail (69.1%) and non-frail (21.5%). In multivariate analysis, aging (OR 3.42; 95% CI 1.16-10.11), severe knee OA symptoms (OR 18.96; 95% CI 3.53-101.65), malnutrition (OR 2.50; 95% CI 1.23-5.09), and functional dependence (OR 3.94; 95% CI 1.19-13.03) were associated with frailty. The prevalence of frailty and pre-frailty was high in knee OA and associated with aging, severe knee OA symptoms, malnutrition, and functional dependence, whereas the prevalence of cognitive frailty was not uncommon in community-dwelling elderly. Physical activity rated by the GPAQ and self-rated methods were highly correlated. Self-rated physical activity may be used in community surveys of frailty.

Research paper thumbnail of Survey of Nutritional Screening Status as Well as Dietitian to Patient Ratio in Various Healthcare Setups in India

Journal of Nutrition Research

It’s very well documented that malnutrition is an independent risk factor that has an impact on t... more It’s very well documented that malnutrition is an independent risk factor that has an impact on treatment outcomes and further influences the quality of life and survivorship. Nutritional attention with timely intervention is an integral component of patient care which corresponds to improved disease outcomes. Adequate nutrition not only provides economic and physiological benefits but also ensures psychological comfort throughout the patient’s journey and during and after treatment. Evaluation of the patient’s nutritional status is critical in determining the nutritional prescription for the patient. Several studies indicate early identification of malnourished patients or at risk of malnutrition is the key to begin timely and adequate nutrition attention. This multi-centre study attempted a nationwide online survey on malnutrition screening from 19th November to 18th December 2022. Out of 644 responses received, 443 were considered for analysis, and 201 were excluded. Responses fr...

Research paper thumbnail of Validation of the Onco-MPI in predicting short-term mortality in older Indian patients with cancer

Journal of Geriatric Oncology

Research paper thumbnail of A Panel Discussion in Nutritional Management in Cancer Care

Journal of nutrition research, Jan 15, 2023

Nutritional status plays an important role in cancer treatment. Several studies have strongly ind... more Nutritional status plays an important role in cancer treatment. Several studies have strongly indicated that malnutrition has a negative impact on the efficacy of cancer treatment. Nutritional negligence or poor nutrition may impede the progress in cancer care, rendering them a harder time with the toxic side effects. It is well documented that there is a high prevalence of cancer-related malnutrition ranging from 25% to 70% from various studies, and cancer patients are the most malnourished of all other patient groups. Escalation of nutrients, effective counseling, and consistent monitoring as an adjuvant to cancer treatment, not only improve nutrition parameters, and body composition but also help in managing toxic effects, thus enhancing the quality of life and ultimately better survival.

Research paper thumbnail of The IAPEN INDIA Association for Parenteral and Enteral Nutrition Chennai Declaration on the Fundamental Right to Nutritional Care of Patients Under Treatment

Journal of Nutrition Research

Malnutrition can be defined as a state of nutrition in which a deficiency or excess or imbalance ... more Malnutrition can be defined as a state of nutrition in which a deficiency or excess or imbalance of energy, protein, and other nutrients cause measurable adverse effects on body tissues, eventually affecting the quality of life and clinical outcome. Malnutrition is associated with many adverse outcomes both in the community as well as in clinical settings; including a suppressed immune system, impaired wound healing, muscle wasting, extended periods of hospital stay, and increased mortality. Undetected malnutrition not only enhances the risk of adverse complications for patients but impacts negatively with an increase in health care costs. This can be prevented if protocol prioritized attention is given to their nutritional care. Achievement of good nutrition is important and is a must in overall healthcare, hence, all stakeholders should be updated regarding the management of malnutrition and challenges encountered. It’s time we start, mobilize everyone and engage governments, poli...

Research paper thumbnail of IAPEN India : Nutrition Consensus Guidelines in Oncology Clinical Practice

Journal of Nutrition Research

Malnutrition is one of the most common and significant issue during the treatment of cancer. Poor... more Malnutrition is one of the most common and significant issue during the treatment of cancer. Poor nutritional management during the treatment may impede the progress in the treatment. Many international societies have nutritional recommendations published on their websites. India, being a multicultural population with varied nutritional habits and local beliefs have no cohesive evidence-based nutritional approach during and after treatment. The current guideline has been formulated jointly by oncologists, nutritionists, and multidisciplinary professionals with an aim to provide science based standard nutritional guidance to the community healthcare professionals across India. The committee referred to major international guidelines published in recent past. With intense deliberations adopted few selective recommendations which are compatible with Indian practice. Keywords: Cancer, Nutrition, Consensus guideline, nutrition in cancer, IAPEN guidelines, IAPEN cancer guidelines

Research paper thumbnail of IAPEN INDIA Consensus Statement on Nutritional Management in Head and Neck Cancers

Journal of Nutrition Research

Nutritional support is an integral component in the treatment of head and neck cancers (HNC). Stu... more Nutritional support is an integral component in the treatment of head and neck cancers (HNC). Studies indicate 90% of HNC patients are at high risk of developing malnutrition. Chemo-radiation and surgery, the three common treatments used to treat HNC are highly susceptible to toxic side effects. Dysphagia is often underestimated in HNC patients. A prolonged impaired swallowing process can lead to severe morbidities like malnutrition, dehydration, aspiration, pneumonia, and even death. These complications have adverse effects on patients' QoL (Quality of Life) and mental health. These adverse reactions further complicate the nutritional status of the patients and the final treatment outcome, increasing morbidity and mortality. The consensus statements try to address nutritional issues and provide practical recommendations for practicing dieticians and clinicians. Keywords: Head and neck cancer guidelines, Nutrition in head and neck cancers, Consensus statements in nutrition in He...

Research paper thumbnail of Vulnerability Assessment and Decision-Making in Older Patients with Head and Neck Cancers Planned for Chemoradiation: Experience from a Tertiary Care Cancer Centre in India

Research paper thumbnail of Assessing frailty in older Indian patients before cancer treatment: Comparative analysis of three scales and their implications for overall survival

Journal of geriatric oncology/Journal of geriatric oncology (Online), Apr 1, 2024

Research paper thumbnail of Weight changes in head and neck cancer patients during their cancer treatment

Clinical Nutrition ESPEN, Nov 30, 2023

Research paper thumbnail of Correlation of the Geriatric Assessment with Overall Survival in Older Patients with Cancer

Clinical Oncology, Dec 31, 2023

Research paper thumbnail of Baseline assessment of cognitive functions in Indian elderly cancer patients

Journal of Geriatric Oncology

Research paper thumbnail of Dietary intake and nutritional status of patients with phenylketonuria in Taiwan

Scientific Reports, 2020

Phenylalanine hydroxylase (PAH) deficiency leads to phenylalanine accumulation and results in phe... more Phenylalanine hydroxylase (PAH) deficiency leads to phenylalanine accumulation and results in phenylketonuria (PKU). Phenylketonuria can contribute to severe inability such as mental impairment. Early diagnosis and dietary intervention can have beneficial effects on maintaining normal neural and cognitive function in patients with PKU. However, a long-term low phenylalanine diet may put children at risk of malnutrition. A food supplement was therefore used for children with PKU under dietician supervision according to dietary reference intakes (DRIs). In this cross-sectional study, we enrolled patients with PKU and age-matched controls to compare their anthropometry data [weight, height, body mass index (BMI), and body composition using bioelectrical impedance analysis (BIA)], and correlated it with their dietary intake based on 24-h dietary recall. For continuous parameters, the data were expressed as median ± standard deviation (SD), and the Mann–Whitney U test was used to test th...

Research paper thumbnail of Expert Panel Opinion on Nutritional Management of Sarcopenia in Cancer Patients

Journal of cancer research reviews & reports, Jun 30, 2024

Research paper thumbnail of Prevalence of Malnutrition and its contributing factors in Indian elderly cancer patients

Journal of Geriatric Oncology, 2023

Research paper thumbnail of The current status of geriatric oncology in India

Research paper thumbnail of Subjective vs objective nutritional assessment characteristics of female gynecological cancers

Clinical Nutrition, Sep 1, 2018

Rationale: Body weight loss is a common problem after gastrectomy, and body composition changes a... more Rationale: Body weight loss is a common problem after gastrectomy, and body composition changes are substantially affected by gastrectomy. The purpose of this study was to evaluate body composition changes of patients who underwent gastrectomy for gastric cancer Methods: We retrospectively collected and reviewed patients' data who underwent radical gastrectomy for gastric cancer between December 2015 and December 2016. Body composition was examined by segmental multifrequency bioelectrical impedance analysis. All measurements were obtained preoperatively and 1, 3, 6, 9, and 12 months after surgery Results: A total of 91 patients were included for analysis. Distal gastrectomy and total gastrectomy were performed 68 and 23 patients, respectively. Body weight loss at 1, 3, 6, 9, and 12 months was 3.2kg (4.9%), 5.0kg (7.6%), 5.5kg (8.3%), 5.6kg (8.3%), and 5.6kg (8.3%), respectively. Loss of fat mass was greater than loss of lean body mass (4.2kg vs. 0.8kg). Loss of lean body mass was There were no significant differences between distal gastrectomy and total gastrectomy, but loss of lean body mass at 3 months after surgery was significantly greater in total gastrectomy than distal gastrectomy (p¼0.005). There were no significant differences between partial omentectomy and total omentectomy. Conclusions: Body weight loss occurred during the first 6 months after surgery. Especially, loss of fat mass accounted for a significant part of body weight loss after gastrectomy. Loss of lean body mass was significantly greater in total gastrectomy than distal gastrectomy Disclosure of interest: None declared.

Research paper thumbnail of Prevalence and factors associated with frailty among older Indian adults with cancer: A single-center cross-sectional analytical study from a geriatric oncology clinic in India

Cancer Research, Statistics, and Treatment

Physical frailty and cognitive impairment are risk factors for adverse outcomes in older people w... more Physical frailty and cognitive impairment are risk factors for adverse outcomes in older people with osteoarthritis of the knee (knee OA). This cross-sectional study was conducted to determine the prevalence and associated factors of frailty and cognitive frailty among community-dwelling older patients with knee OA in four representative cities of Thailand. Data composed of three parts, Part 1: Demographic data, Part 2: The assessment of frailty by Fried phenotype and cognitive function by MiniCog and Part 3: The assessment of factors associated with frailty. Of 780 elders (mean age, 69.4 ± 6.9 years) screened, 101 (12.9%) were classified to be frail, 511 (65.6%) pre-frail and 168 (21.5%) non-frail. The prevalence of cognitive frailty was 2.44%. The correlation between physical activity rated by the Global Physical Activity Questionnaire (GPAQ) and self-rated methods was high (kappa 0.721; p < 0.001). Self-rated physical activity yielded similar prevalence of frail (9.4%), pre-frail (69.1%) and non-frail (21.5%). In multivariate analysis, aging (OR 3.42; 95% CI 1.16-10.11), severe knee OA symptoms (OR 18.96; 95% CI 3.53-101.65), malnutrition (OR 2.50; 95% CI 1.23-5.09), and functional dependence (OR 3.94; 95% CI 1.19-13.03) were associated with frailty. The prevalence of frailty and pre-frailty was high in knee OA and associated with aging, severe knee OA symptoms, malnutrition, and functional dependence, whereas the prevalence of cognitive frailty was not uncommon in community-dwelling elderly. Physical activity rated by the GPAQ and self-rated methods were highly correlated. Self-rated physical activity may be used in community surveys of frailty.

Research paper thumbnail of Survey of Nutritional Screening Status as Well as Dietitian to Patient Ratio in Various Healthcare Setups in India

Journal of Nutrition Research

It’s very well documented that malnutrition is an independent risk factor that has an impact on t... more It’s very well documented that malnutrition is an independent risk factor that has an impact on treatment outcomes and further influences the quality of life and survivorship. Nutritional attention with timely intervention is an integral component of patient care which corresponds to improved disease outcomes. Adequate nutrition not only provides economic and physiological benefits but also ensures psychological comfort throughout the patient’s journey and during and after treatment. Evaluation of the patient’s nutritional status is critical in determining the nutritional prescription for the patient. Several studies indicate early identification of malnourished patients or at risk of malnutrition is the key to begin timely and adequate nutrition attention. This multi-centre study attempted a nationwide online survey on malnutrition screening from 19th November to 18th December 2022. Out of 644 responses received, 443 were considered for analysis, and 201 were excluded. Responses fr...

Research paper thumbnail of Validation of the Onco-MPI in predicting short-term mortality in older Indian patients with cancer

Journal of Geriatric Oncology

Research paper thumbnail of A Panel Discussion in Nutritional Management in Cancer Care

Journal of nutrition research, Jan 15, 2023

Nutritional status plays an important role in cancer treatment. Several studies have strongly ind... more Nutritional status plays an important role in cancer treatment. Several studies have strongly indicated that malnutrition has a negative impact on the efficacy of cancer treatment. Nutritional negligence or poor nutrition may impede the progress in cancer care, rendering them a harder time with the toxic side effects. It is well documented that there is a high prevalence of cancer-related malnutrition ranging from 25% to 70% from various studies, and cancer patients are the most malnourished of all other patient groups. Escalation of nutrients, effective counseling, and consistent monitoring as an adjuvant to cancer treatment, not only improve nutrition parameters, and body composition but also help in managing toxic effects, thus enhancing the quality of life and ultimately better survival.

Research paper thumbnail of The IAPEN INDIA Association for Parenteral and Enteral Nutrition Chennai Declaration on the Fundamental Right to Nutritional Care of Patients Under Treatment

Journal of Nutrition Research

Malnutrition can be defined as a state of nutrition in which a deficiency or excess or imbalance ... more Malnutrition can be defined as a state of nutrition in which a deficiency or excess or imbalance of energy, protein, and other nutrients cause measurable adverse effects on body tissues, eventually affecting the quality of life and clinical outcome. Malnutrition is associated with many adverse outcomes both in the community as well as in clinical settings; including a suppressed immune system, impaired wound healing, muscle wasting, extended periods of hospital stay, and increased mortality. Undetected malnutrition not only enhances the risk of adverse complications for patients but impacts negatively with an increase in health care costs. This can be prevented if protocol prioritized attention is given to their nutritional care. Achievement of good nutrition is important and is a must in overall healthcare, hence, all stakeholders should be updated regarding the management of malnutrition and challenges encountered. It’s time we start, mobilize everyone and engage governments, poli...

Research paper thumbnail of IAPEN India : Nutrition Consensus Guidelines in Oncology Clinical Practice

Journal of Nutrition Research

Malnutrition is one of the most common and significant issue during the treatment of cancer. Poor... more Malnutrition is one of the most common and significant issue during the treatment of cancer. Poor nutritional management during the treatment may impede the progress in the treatment. Many international societies have nutritional recommendations published on their websites. India, being a multicultural population with varied nutritional habits and local beliefs have no cohesive evidence-based nutritional approach during and after treatment. The current guideline has been formulated jointly by oncologists, nutritionists, and multidisciplinary professionals with an aim to provide science based standard nutritional guidance to the community healthcare professionals across India. The committee referred to major international guidelines published in recent past. With intense deliberations adopted few selective recommendations which are compatible with Indian practice. Keywords: Cancer, Nutrition, Consensus guideline, nutrition in cancer, IAPEN guidelines, IAPEN cancer guidelines

Research paper thumbnail of IAPEN INDIA Consensus Statement on Nutritional Management in Head and Neck Cancers

Journal of Nutrition Research

Nutritional support is an integral component in the treatment of head and neck cancers (HNC). Stu... more Nutritional support is an integral component in the treatment of head and neck cancers (HNC). Studies indicate 90% of HNC patients are at high risk of developing malnutrition. Chemo-radiation and surgery, the three common treatments used to treat HNC are highly susceptible to toxic side effects. Dysphagia is often underestimated in HNC patients. A prolonged impaired swallowing process can lead to severe morbidities like malnutrition, dehydration, aspiration, pneumonia, and even death. These complications have adverse effects on patients' QoL (Quality of Life) and mental health. These adverse reactions further complicate the nutritional status of the patients and the final treatment outcome, increasing morbidity and mortality. The consensus statements try to address nutritional issues and provide practical recommendations for practicing dieticians and clinicians. Keywords: Head and neck cancer guidelines, Nutrition in head and neck cancers, Consensus statements in nutrition in He...