Browsing by Author "Ganesan, P"
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Item Bloodstream infections in pediatric patients at cancer institute, Chennai.(2014-10) Radhakrishnan, V; Vijaykumar, V; Ganesan, P; Rajendranath, R; Trivadi, G; Tenali, SBACKGROUND: There is paucity of data on the epidemiology of bloodstream infections in pediatric cancer patients from India. Rationale use of antibiotics in febrile neutropenia is important for reducing morbidity and preventing the emergence of drug resistant bacteria. AIMS: The study was conducted to look at the prevalence of bloodstream bacterial infection and the antibiotic resistance profile at Cancer Institute, Chennai. SETTINGS AND DESIGN: This was a retrospective study. MATERIALS AND METHODS: Data on all blood cultures taken from pediatric cancer patients treated at Cancer Institute, Chennai, during the year 2013 were analyzed. The microbiological profile and sensitivity pattern were analyzed. RESULTS: A total of 1045 blood culture samples were taken, and there were 82/1045 (7.5%) positive blood cultures. Gram‑negative organisms accounted for 50/82 (61%) of all positive cultures. Klebsiella pneumoniae (32%) was the most common Gram‑negative isolate, and Staphylococcus aureus (93.5%) was the most common Gram‑positive. There was high resistance to aminoglycosides and beta‑lactam/beta‑lactamase inhibitor antibodies. CONCLUSION: Gram‑negative organisms are the predominant bacteria isolated. There is high resistance to first‑line combination antibiotics used as empiric therapy for treatment of febrile neutropenia.Item Chronic myeloid leukemia in acute lymphoblastic leukemia survivor: A case report.(2014-07) Cyriac, S; Philip, A; Ganesan, P; Kannan, K; Sagar, T GItem Factors predicting outcome in high risk febrile neutropenia in patients receiving intensive chemotherapy for acute sleukemia: A prospective, observational study from South India.(2014-10) Rajendranath, R; Balasubramaniyum, V K K; Vijayakumar, V; Ganesan, P; Tenali, G SBACKGROUND: Outcome of febrile neutropenia (FN) in acute leukemia patients undergoing intensive chemotherapy from India is scanty. MATERIALS AND METHODS: A prospective, observational, single institutional study was conducted to evaluate the clinical features, microbiological aspects, risk factors influencing the outcome of high risk FN during intensive therapy in acute leukemia. RESULTS: Among 115 febrile episodes, though 94 (81.7%) had indwelling central venous catheter (CVC) at the time of diagnosis of FN, infective foci clinically were identified in 70.4% of episodes, with lung as the major site (25.2%) followed by CVC (17.4%). Microbiological documentation was possible in 33% (n = 40) episodes. Gram‑negative bacteria isolates were 58.3% and Gram‑positive isolates were 41.7% of which Pseudomonas was the predominant Gram‑negative and Staphylococcus aureus was the most common Gram‑positive isolate. Piperacillin‑tazobactam + amikacin were used as first line antibiotic in 93% episodes and second line antibiotics were necessary in 73% episodes. Granulocyte colony stimulating factor was used in 60.9% episodes of high risk FN mostly in acute myeloid leukemia consolidation patients. Eighteen episodes (15.7%) were assigned to have invasive fungal disease. Eleven (9.6%) out of 115 high risk FN had a fatal outcome. Presence of pulmonary infection predicted for fatal outcome (P = 0.02). CONCLUSION: This study reports the outcome of high risk FN in patients with acute leukemia undergoing intensive chemotherapy. Gram‑negative isolates are highly sensitive to piperacillin‑tazobactum and hence in a cost restraint scenario, carbapenems needs to be judiciously used. Focus of Infection in lungs during FN predicted higher fatal outcomes.Item Nutritional profile of pediatric cancer patients at Cancer Institute, Chennai.(2015-04) Radhakrishnan, V; Ganesan, P; Rajendranath, R; Ganesan, T S; Sagar, T GBACKGROUND: Malnutrition is widely prevalent in the pediatric population in India. There is paucity of data on the prevalence of malnutrition in pediatric cancer patients and the impact of cancer treatment on nutritional status of Indian children. AIMS: The study was conducted to look at the prevalence of malnutrition and assess the impact of treatment on nutritional status of pediatric cancer patients. SETTINGS AND DESIGN: This was a retrospective study. MATERIALS AND METHODS: Data on the weight of pediatric cancer patients <16 years of age treated at Cancer Institute, Chennai, from January 2013 to May 2014 were analyzed at systematic time points in therapy. Patients’ weight were plotted on the Centre for Disease Control (CDC) growth charts. Patients were defined to be undernourished if their weight for age was ≤3rd centile in CDC growth charts and obese if their weight for age was ≥97th centile on CDC growth charts. RESULTS: A total of 295 patient case records were analyzed. Acute lymphoblastic leukemia was the most common malignancy. At diagnosis, under‑nutrition was seen in 44% patients, this increased to 46% midway during treatment (end of induction in acute leukemia and completion of 50% of planned treatment in solid tumors) and decreased to 27% at the end of treatment (beginning of maintenance in acute leukemia and completion of planned treatment in solid tumors) (P = 0.0005). There was no significant difference in nutritional status between patients with hematological malignancies and solid tumors (P = 0.8). CONCLUSION: Under‑nutrition is present in close to half of the pediatric cancer patients presenting to our institute. Active nutritional intervention and education were able to significantly reduce the prevalence of under‑nutrition in patients at the end of treatment.Item Protracted cisplatin-induced vomiting responding to mosapride.(2010-01) Ganesan, P; Sharma, A; Mohanti, B K; Gogia, A