Rashmi Shirali | Jawaharlal Nehru University (original) (raw)

Papers by Rashmi Shirali

Research paper thumbnail of Влияние ликопида и комплекса бифидои лактобактерий на активность лизоцима как фактора неспецифической иммунной защиты при хронической язвенной болезни желудка и двенадцатиперстной кишки

Современные технологии в медицине, 2012

В.В. Дугина, к.м.н., доцент кафедры общей и клинической фармакологии 1 ; Рашми Ширали, д.м.н., вр... more В.В. Дугина, к.м.н., доцент кафедры общей и клинической фармакологии 1 ; Рашми Ширали, д.м.н., врач, научный сотрудник 2 ; Н.В. Лебедева, аспирант кафедры общей и клинической фармакологии 1 ; С.Р. Бабаян, к.м.н., директор 3 ; Г.В. Рудакова, доцент кафедры общей и клинической фармакологии 1 ; Н.С. Хрулева, к.м.н., ассистент кафедры госпитальной терапии им. В.Г. Вогралика 1

Research paper thumbnail of Gemcitabine and cisplatin-based combination chemotherapy in advanced hepatocellular carcinoma: An Indian experience

Indian Journal of Medical and Paediatric Oncology, 2012

Background: Gemcitabine, an anti-metabolite, has some activity in hepatocellular carcinoma (HCC) ... more Background: Gemcitabine, an anti-metabolite, has some activity in hepatocellular carcinoma (HCC) in terms of responses and median survival. Aims: To analyze our experience with the use of gemcitabine in combination with cisplatin in HCC with respect to response, toxicity and survival. Materials and Methods: We studied the records of patients of HCC treated from January 2000 to December 2005 with gemcitabine and cisplatin, and found 24 of them to be evaluable for response, toxicity and survival. Results: Of 24 patients receiving three or more cycles of chemotherapy, six (25%) had a partial response and an additional 12 (50%) had stable disease. The median overall survival (OS) was 7.5 months (95% confidence interval, 4.5-10.5 months) and 1-year survival was 18%. Grade 3 and 4 anemia, thrombocytopenia and neutropenia were observed in, respectively, 17, 17 and 33% patients. The most frequent non-hematologic toxicities were nausea and vomiting and peripheral neuropathy. Conclusion: We report a partial response rate of 25% with stable disease in an additional 50% to three or more cycles of chemotherapy with gemcitabine and cisplatin, with a median OS of 7.5 months (95% confidence interval, 4.5-10.5) and acceptable toxicity profile from our single-center retrospective study of 24 patients of HCC. We trust that, in HCC, gemcitabine is a good drug to be the foundation to build the chemotherapeutic or targeted agents' combinations on.

Research paper thumbnail of Влияние иммуномодуляторов рибомунила и ликопида на показатели иммунитета при язвенной болезни желудка и двенадцатиперстной кишки

Современные технологии в медицине, 2012

Research paper thumbnail of 1028 Epidemiology, patterns of cancers and their outcomes amongst adolescents and young adults (AYA) from a tertiary cancer center in Delhi

European Journal of Cancer, 2015

AState as one ofInternational law subjects has rights and obligations based on interna tional law... more AState as one ofInternational law subjects has rights and obligations based on interna tional law. One ofthe international obligations of a State is to assist andprotect the right

Research paper thumbnail of Epidemiology of cancers among adolescents and young adults from a tertiary cancer center in Delhi

Indian Journal of Medical and Paediatric Oncology, 2016

One challenge has been the variable definitions for the age range of AYA. The World Health Organi... more One challenge has been the variable definitions for the age range of AYA. The World Health Organization defines adolescents as those aged 10-19, whereas youth as those aged 15-24 years. [3] The US Surveillance Epidemiology and End Results (SEER) program and few other international societies define the AYA cancer population as those aged between 15 and 29. [4,5] For the purpose of this study, we set the age range of 15-29 years as AYA. Our objective was to study the descriptive epidemiology of cancer in AYAs at our cancer center and to compare this with the available data in Indian and Western literature. MATERIALS AND METHODS All patients aged 15-29 years with a diagnosis of cancer who visited the outpatient or inpatient department at Max Cancer Centre, Saket (South Delhi), and Max Cancer Centre,

Research paper thumbnail of Post-trial access to treatment for patients participating in clinical trials

Perspectives in Clinical Research, 2015

Clinical trials are the mainstay for bringing out newer and better drugs to serve the mankind. By... more Clinical trials are the mainstay for bringing out newer and better drugs to serve the mankind. By virtue of participating in a clinical trial, a patient receives access to the newer drugs/therapies, but nothing is generally being offered to them once their participation in the study comes to an end. Though the issue of post-trial access to treatment by patients participating in a clinical trial is debatable, there is no compelling justification either for or against it. We examined a case study in order to evaluate the applicability of post-trial access to treatment for patients participating in clinical trials. The provision of post-trial access to treatment should also keep into consideration the compassionate use of drugs on humanitarian grounds, especially in cases of trial drugs that have offered significant benefit to the trial patients and whose termination would lead to deterioration in patient's overall condition. In the present era of personalized medicine, the incorporation of genetic testing into clinical practice further authenticates the rationale of compassionate use of drugs and post-trial access to treatment.

Research paper thumbnail of Chronic myeloid leukemia treatment with Imatinib: An experience from a private tertiary care hospital

Indian Journal of Medical and Paediatric Oncology, 2013

The data presents 75 chronic myeloid leukemia patients diagnosed over a period 6 years i.e. from ... more The data presents 75 chronic myeloid leukemia patients diagnosed over a period 6 years i.e. from 2002 to 2008. The most common presentation was splenomegaly and 97% achieved complete hematological response at median duration of 4.3 weeks. The uniqueness of this study is follow-up with molecular response monitoring. Nearly, 30% patients achieved major molecular response (MMoR) by 12 months. 70% of patients achieved MMoR by median time of 60 months. Only 10% of the patient who achieved MMoR by 18 months had lost their responses subsequently.

Research paper thumbnail of The Relationship Between Helicobacter Pylori and P53 Gene Mutation in Patients with Adenocarcinoma of Stomach

Research paper thumbnail of The Relationship Between Helicobacter Pylori and P53 Gene Mutation in Patients with Adenocarcinoma of Stomach

Research paper thumbnail of Indian Cancer Patients' use of Traditional, Complementary and Alternative Medicine (TCAM) and delays in presentation to Hospital

Research paper thumbnail of Gemcitabine and cisplatin-based combination chemotherapy in advanced hepatocellular carcinoma: An Indian experience

Indian Journal of …, Jan 1, 2012

Background:Gemcitabine, an anti-metabolite, has some activity in hepatocellular carcinoma (HCC) i... more Background:Gemcitabine, an anti-metabolite, has some activity in hepatocellular carcinoma (HCC) in terms of responses and median survival.Aims:To analyze our experience with the use of gemcitabine in combination with cisplatin in HCC with respect to response, toxicity and survival.Materials and Methods:We studied the records of patients of HCC treated from January 2000 to December 2005 with gemcitabine and cisplatin, and found 24 of them to be evaluable for response, toxicity and survival.Results:Of 24 patients receiving three or more cycles of chemotherapy, six (25%) had a partial response and an additional 12 (50%) had stable disease. The median overall survival (OS) was 7.5 months (95% confidence interval, 4.5–10.5 months) and 1-year survival was 18%. Grade 3 and 4 anemia, thrombocytopenia and neutropenia were observed in, respectively, 17, 17 and 33% patients. The most frequent non-hematologic toxicities were nausea and vomiting and peripheral neuropathy.Conclusion:We report a partial response rate of 25% with stable disease in an additional 50% to three or more cycles of chemotherapy with gemcitabine and cisplatin, with a median OS of 7.5 months (95% confidence interval, 4.5–10.5) and acceptable toxicity profile from our single-center retrospective study of 24 patients of HCC. We trust that, in HCC, gemcitabine is a good drug to be the foundation to build the chemotherapeutic or targeted agents’ combinations on.

Research paper thumbnail of The Effect of Licopid and Bifid and Lactic Acid Bacteria Complex on Lysozyme Activity as the Factor of Nonspecific Immune Protection in Chronic Gastric and …

… Tehnologii v Medicine

Abstract: The aim of the investigation is to study the effect of Licopid and bifid and lactic aci... more Abstract: The aim of the investigation is to study the effect of Licopid and bifid and lactic acid bacteria complex on Helicobacter pylori eradication and lysozyme activity as the factor of nonspecific immune protection in gastric and duodenal ulcer. Materials and methods. ...

Research paper thumbnail of The Effect of Ribomunyl and Licopid on Immunity Indexes in Gastric and Duodenal Ulcer

… Tehnologii v Medicine

Abstract: The aim of the investigation is to study the effect of immunomodulators Ribomunyl and L... more Abstract: The aim of the investigation is to study the effect of immunomodulators Ribomunyl and Licopidin on Helicobacter pylori eradication and cell-mediated immunity indexes in chronic gastric and duodenal ulcer. Materials and methods. 30 patients with Helicobacter ...

Research paper thumbnail of Indian Cancer Patients' use of Traditional, Complementary and Alternative Medicine (TCAM) and delays in presentation to Hospital

Oman medical …, Jan 1, 2009

ObjectivesA majority of Indian cancer patients are often presented with incurable diseases at the... more ObjectivesA majority of Indian cancer patients are often presented with incurable diseases at the latest phase of disease progression. The use of traditional, complementary and alternative medicine (TCAM) has been identified by Indian oncologists as a potential factor for the delay in seeking health from medical practitioners but no research has been conducted to verify such claims. The aim of this study is to identify socio-demographic and disease status differences between TCAM and non-TCAM users among cancer patients in India and associated patterns of seeking professional medical help.MethodsA random survey of 825 cancer patients in one public and one private hospital was conducted in Delhi, India. Using four interviewers, a list sampling technique was used to interview every patient over a four month period, with a response rate of 80%.ResultsThe results showed that 34.3% of cancer patients had used TCAM. The results also demonstrated a statistically significant relationship between the use of TCAM and reported delay in seeking help from clinical medicine (p<0.001). On the other hand, 35.2% of TCAM users reported seeking help immediately after onset of symptoms, whereas 50% of non-users immediately sought help from conventional medicine. Furthermore, 11.5% of TCAM users reported waiting for six months or more after noticing cancer-related symptoms, while only 2.1% of non-users waited this long.ConclusionOverall, early diagnosis and intervention is critical for effective treatment of many malignancies. Delays in presentation related to the use of TCAM may be an important factor relating to the high rates of advanced disease on presentation and low survival rates in the care of Indian cancer patients. Further research is needed to explore the reasons for using TCAM and to ensure existing issues of delays in help seeking are addressed.

Research paper thumbnail of Влияние ликопида и комплекса бифидои лактобактерий на активность лизоцима как фактора неспецифической иммунной защиты при хронической язвенной болезни желудка и двенадцатиперстной кишки

Современные технологии в медицине, 2012

В.В. Дугина, к.м.н., доцент кафедры общей и клинической фармакологии 1 ; Рашми Ширали, д.м.н., вр... more В.В. Дугина, к.м.н., доцент кафедры общей и клинической фармакологии 1 ; Рашми Ширали, д.м.н., врач, научный сотрудник 2 ; Н.В. Лебедева, аспирант кафедры общей и клинической фармакологии 1 ; С.Р. Бабаян, к.м.н., директор 3 ; Г.В. Рудакова, доцент кафедры общей и клинической фармакологии 1 ; Н.С. Хрулева, к.м.н., ассистент кафедры госпитальной терапии им. В.Г. Вогралика 1

Research paper thumbnail of Gemcitabine and cisplatin-based combination chemotherapy in advanced hepatocellular carcinoma: An Indian experience

Indian Journal of Medical and Paediatric Oncology, 2012

Background: Gemcitabine, an anti-metabolite, has some activity in hepatocellular carcinoma (HCC) ... more Background: Gemcitabine, an anti-metabolite, has some activity in hepatocellular carcinoma (HCC) in terms of responses and median survival. Aims: To analyze our experience with the use of gemcitabine in combination with cisplatin in HCC with respect to response, toxicity and survival. Materials and Methods: We studied the records of patients of HCC treated from January 2000 to December 2005 with gemcitabine and cisplatin, and found 24 of them to be evaluable for response, toxicity and survival. Results: Of 24 patients receiving three or more cycles of chemotherapy, six (25%) had a partial response and an additional 12 (50%) had stable disease. The median overall survival (OS) was 7.5 months (95% confidence interval, 4.5-10.5 months) and 1-year survival was 18%. Grade 3 and 4 anemia, thrombocytopenia and neutropenia were observed in, respectively, 17, 17 and 33% patients. The most frequent non-hematologic toxicities were nausea and vomiting and peripheral neuropathy. Conclusion: We report a partial response rate of 25% with stable disease in an additional 50% to three or more cycles of chemotherapy with gemcitabine and cisplatin, with a median OS of 7.5 months (95% confidence interval, 4.5-10.5) and acceptable toxicity profile from our single-center retrospective study of 24 patients of HCC. We trust that, in HCC, gemcitabine is a good drug to be the foundation to build the chemotherapeutic or targeted agents' combinations on.

Research paper thumbnail of Влияние иммуномодуляторов рибомунила и ликопида на показатели иммунитета при язвенной болезни желудка и двенадцатиперстной кишки

Современные технологии в медицине, 2012

Research paper thumbnail of 1028 Epidemiology, patterns of cancers and their outcomes amongst adolescents and young adults (AYA) from a tertiary cancer center in Delhi

European Journal of Cancer, 2015

AState as one ofInternational law subjects has rights and obligations based on interna tional law... more AState as one ofInternational law subjects has rights and obligations based on interna tional law. One ofthe international obligations of a State is to assist andprotect the right

Research paper thumbnail of Epidemiology of cancers among adolescents and young adults from a tertiary cancer center in Delhi

Indian Journal of Medical and Paediatric Oncology, 2016

One challenge has been the variable definitions for the age range of AYA. The World Health Organi... more One challenge has been the variable definitions for the age range of AYA. The World Health Organization defines adolescents as those aged 10-19, whereas youth as those aged 15-24 years. [3] The US Surveillance Epidemiology and End Results (SEER) program and few other international societies define the AYA cancer population as those aged between 15 and 29. [4,5] For the purpose of this study, we set the age range of 15-29 years as AYA. Our objective was to study the descriptive epidemiology of cancer in AYAs at our cancer center and to compare this with the available data in Indian and Western literature. MATERIALS AND METHODS All patients aged 15-29 years with a diagnosis of cancer who visited the outpatient or inpatient department at Max Cancer Centre, Saket (South Delhi), and Max Cancer Centre,

Research paper thumbnail of Post-trial access to treatment for patients participating in clinical trials

Perspectives in Clinical Research, 2015

Clinical trials are the mainstay for bringing out newer and better drugs to serve the mankind. By... more Clinical trials are the mainstay for bringing out newer and better drugs to serve the mankind. By virtue of participating in a clinical trial, a patient receives access to the newer drugs/therapies, but nothing is generally being offered to them once their participation in the study comes to an end. Though the issue of post-trial access to treatment by patients participating in a clinical trial is debatable, there is no compelling justification either for or against it. We examined a case study in order to evaluate the applicability of post-trial access to treatment for patients participating in clinical trials. The provision of post-trial access to treatment should also keep into consideration the compassionate use of drugs on humanitarian grounds, especially in cases of trial drugs that have offered significant benefit to the trial patients and whose termination would lead to deterioration in patient&amp;amp;amp;amp;#39;s overall condition. In the present era of personalized medicine, the incorporation of genetic testing into clinical practice further authenticates the rationale of compassionate use of drugs and post-trial access to treatment.

Research paper thumbnail of Chronic myeloid leukemia treatment with Imatinib: An experience from a private tertiary care hospital

Indian Journal of Medical and Paediatric Oncology, 2013

The data presents 75 chronic myeloid leukemia patients diagnosed over a period 6 years i.e. from ... more The data presents 75 chronic myeloid leukemia patients diagnosed over a period 6 years i.e. from 2002 to 2008. The most common presentation was splenomegaly and 97% achieved complete hematological response at median duration of 4.3 weeks. The uniqueness of this study is follow-up with molecular response monitoring. Nearly, 30% patients achieved major molecular response (MMoR) by 12 months. 70% of patients achieved MMoR by median time of 60 months. Only 10% of the patient who achieved MMoR by 18 months had lost their responses subsequently.

Research paper thumbnail of The Relationship Between Helicobacter Pylori and P53 Gene Mutation in Patients with Adenocarcinoma of Stomach

Research paper thumbnail of The Relationship Between Helicobacter Pylori and P53 Gene Mutation in Patients with Adenocarcinoma of Stomach

Research paper thumbnail of Indian Cancer Patients' use of Traditional, Complementary and Alternative Medicine (TCAM) and delays in presentation to Hospital

Research paper thumbnail of Gemcitabine and cisplatin-based combination chemotherapy in advanced hepatocellular carcinoma: An Indian experience

Indian Journal of …, Jan 1, 2012

Background:Gemcitabine, an anti-metabolite, has some activity in hepatocellular carcinoma (HCC) i... more Background:Gemcitabine, an anti-metabolite, has some activity in hepatocellular carcinoma (HCC) in terms of responses and median survival.Aims:To analyze our experience with the use of gemcitabine in combination with cisplatin in HCC with respect to response, toxicity and survival.Materials and Methods:We studied the records of patients of HCC treated from January 2000 to December 2005 with gemcitabine and cisplatin, and found 24 of them to be evaluable for response, toxicity and survival.Results:Of 24 patients receiving three or more cycles of chemotherapy, six (25%) had a partial response and an additional 12 (50%) had stable disease. The median overall survival (OS) was 7.5 months (95% confidence interval, 4.5–10.5 months) and 1-year survival was 18%. Grade 3 and 4 anemia, thrombocytopenia and neutropenia were observed in, respectively, 17, 17 and 33% patients. The most frequent non-hematologic toxicities were nausea and vomiting and peripheral neuropathy.Conclusion:We report a partial response rate of 25% with stable disease in an additional 50% to three or more cycles of chemotherapy with gemcitabine and cisplatin, with a median OS of 7.5 months (95% confidence interval, 4.5–10.5) and acceptable toxicity profile from our single-center retrospective study of 24 patients of HCC. We trust that, in HCC, gemcitabine is a good drug to be the foundation to build the chemotherapeutic or targeted agents’ combinations on.

Research paper thumbnail of The Effect of Licopid and Bifid and Lactic Acid Bacteria Complex on Lysozyme Activity as the Factor of Nonspecific Immune Protection in Chronic Gastric and …

… Tehnologii v Medicine

Abstract: The aim of the investigation is to study the effect of Licopid and bifid and lactic aci... more Abstract: The aim of the investigation is to study the effect of Licopid and bifid and lactic acid bacteria complex on Helicobacter pylori eradication and lysozyme activity as the factor of nonspecific immune protection in gastric and duodenal ulcer. Materials and methods. ...

Research paper thumbnail of The Effect of Ribomunyl and Licopid on Immunity Indexes in Gastric and Duodenal Ulcer

… Tehnologii v Medicine

Abstract: The aim of the investigation is to study the effect of immunomodulators Ribomunyl and L... more Abstract: The aim of the investigation is to study the effect of immunomodulators Ribomunyl and Licopidin on Helicobacter pylori eradication and cell-mediated immunity indexes in chronic gastric and duodenal ulcer. Materials and methods. 30 patients with Helicobacter ...

Research paper thumbnail of Indian Cancer Patients' use of Traditional, Complementary and Alternative Medicine (TCAM) and delays in presentation to Hospital

Oman medical …, Jan 1, 2009

ObjectivesA majority of Indian cancer patients are often presented with incurable diseases at the... more ObjectivesA majority of Indian cancer patients are often presented with incurable diseases at the latest phase of disease progression. The use of traditional, complementary and alternative medicine (TCAM) has been identified by Indian oncologists as a potential factor for the delay in seeking health from medical practitioners but no research has been conducted to verify such claims. The aim of this study is to identify socio-demographic and disease status differences between TCAM and non-TCAM users among cancer patients in India and associated patterns of seeking professional medical help.MethodsA random survey of 825 cancer patients in one public and one private hospital was conducted in Delhi, India. Using four interviewers, a list sampling technique was used to interview every patient over a four month period, with a response rate of 80%.ResultsThe results showed that 34.3% of cancer patients had used TCAM. The results also demonstrated a statistically significant relationship between the use of TCAM and reported delay in seeking help from clinical medicine (p<0.001). On the other hand, 35.2% of TCAM users reported seeking help immediately after onset of symptoms, whereas 50% of non-users immediately sought help from conventional medicine. Furthermore, 11.5% of TCAM users reported waiting for six months or more after noticing cancer-related symptoms, while only 2.1% of non-users waited this long.ConclusionOverall, early diagnosis and intervention is critical for effective treatment of many malignancies. Delays in presentation related to the use of TCAM may be an important factor relating to the high rates of advanced disease on presentation and low survival rates in the care of Indian cancer patients. Further research is needed to explore the reasons for using TCAM and to ensure existing issues of delays in help seeking are addressed.