Browsing by Author "Ishan Kumar"

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A case of rapidly progressive dementia: A diagnosis not to be missed
(Blackwell Publishing Ltd, 2019) Pritam Das; Saumya Gupta; Ishan Kumar; Indrajeet Singh Gambhir; Sankha Shubhra Chakrabarti
[No abstract available]
A prospective randomized comparison of simultaneous integrated boost with sequential boost intensity-modulated radiotherapy in locally advanced head and neck cancer
(Wolters Kluwer Medknow Publications, 2022) Nilesh Mani; Sushil K. Aggarwal; Ishan Kumar; Abhijit Mandal; Garima Jaiswal; Rakesh Ranjan; Anil K. Jaiswal; Neha Gupta; Ankita Singh; Ankur Mourya; Lalit M. Aggarwal; Sunil Choudhary
Purpose: A comparison of simultaneous integrated boost (SIB) with sequential boost (SEQ) using intensity-modulated radiotherapy along with concurrent cisplatin in locally advanced head and neck cancer (HNC) was made with regard to their survival outcomes and toxicity profile. Materials and Methods: A total of 34 patients were enrolled between October 2016 and March 2019. They were randomized into two arms, SIB and SEQB. All patients were treated with 6 MV photon beam on Linear Accelerator with weekly concurrent cisplatin at 35 mg/m 2. Overall survival (OS) and disease-free survival (DFS) were the primary end points and acute and late toxicities were the secondary end points. Results: The median follow-up period was 40.6 and 37.3 months for SIB and SEQB, respectively. At the end of 5 years, the median OS was 40.6 and 37.3 months (P = 0.947) and the median DFS was 35.1 and 37.3 months in the SIB and SEQB arms, respectively (P = 0.991).complete response at 3 months was 64.7% and 76.5% and partial response was 23.5% and 17.6%, whereas progressive disease was 11.8% and 5.9% in SIB and SEQB arms, respectively. Acute dermatitis, mucositis, dysphagia, and salivary gland toxicities were higher in the SIB arm compared to the SEQB arm. Conclusion: SIB and SEQ arms were comparable in terms of OS and DFS. However, the acute toxicities were higher in the SIB arm, although the difference was not significant, compared to the SEQB arm. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
A Rare Case of Multiple Intracranial Cysts
(Springer, 2019) Ishan Kumar; Srishti Sharma; Zeeshan Siddiqui; Priyanka Aggarwal; Ashish Verma
[No abstract available]
A Rare Cause of Acute Recurrent Pancreatitis in a Child
(Springer, 2024) Ishan Kumar; Sunil Meena; Pramod Kumar Singh; Priyanka Aggarwal; Ashish Verma
[No abstract available]
Acute Cardiac Events After ChAdOx1 nCoV-19 Corona Virus Vaccine: Report of Three Cases
(Lippincott Williams and Wilkins, 2022) Rohit Singh; Sankha Shubhra Chakrabarti; Indrajeet Singh Gambhir; Ashish Verma; Ishan Kumar; Soumik Ghosh; Ashutosh Tiwari; Gourav Chandan; Sasanka Chakrabarti; Upinder Kaur
[No abstract available]
Application of deep learning models for accurate classification of fluid collections in acute necrotizing pancreatitis on computed tomography: a multicenter study
(Springer, 2025) Pankaj Kumar Gupta; Ruby Siddiqui; Shravya Singh; Nikita Pradhan; Jimil Shah; Jayanta Samanta; Vaneet Jearth; Anupam Kumar Singh; Harshal Surendra Mandavdhare; Vishal Sharma; Amar Mukund; Chhagan Lal Birda; Ishan Kumar; N. Suresh Kumar; Yashwant Patidar; Ashish Agarwal; Taruna Yadav; Binit Sureka; Anurag Kumar Tiwari; Ashish Verma; Ashish Sravanth Kumar; Saroj Kant Sinha; Usha K. Dutta
Purpose: To apply CT-based deep learning (DL) models for accurate solid debris-based classification of pancreatic fluid collections (PFC) in acute pancreatitis (AP). Material and methods: This retrospective study comprised four tertiary care hospitals. Consecutive patients with AP and PFCs who had computed tomography (CT) prior to drainage were screened. Those who had magnetic resonance imaging (MRI) or endoscopic ultrasound (EUS) within 20 days of CT were considered for inclusion. Axial CT images were utilized for model training. Images were labelled as those with≤30% solid debris and >30% solid debris based on MRI or EUS. Single center data was used for model training and validation. Data from other three centers comprised the held out external test cohort. We experimented with ResNet 50, Vision transformer (ViT), and MedViT architectures. Results: Overall, we recruited 152 patients (129 training/validation and 23 testing). There were 1334, 334 and 512 images in the training, validation, and test cohorts, respectively. In the overall training and validation cohorts, ViT and MedVit models had high diagnostic performance (sensitivity 92.4–98.7%, specificity 89.7–98.4%, and AUC 0.908–0.980). The sensitivity (85.3–98.6%), specificity (69.4–99.4%), and AUC (0.779–0.984) of all the models was high in all the subgroups in the training and validation cohorts. In the overall external test cohort, MedViT had the best diagnostic performance (sensitivity 75.2%, specificity 75.3%, and AUC 0.753). MedVit had sensitivity, specificity, and AUC of 75.2%, 74.3%, and 0.748, in walled off necrosis and 79%, 74.2%, 75.3%, and 0.767 for collections >5 cm. Conclusion: DL-models have moderate diagnostic performance for solid-debris based classification of WON and collections greater than 5 cm on CT. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.
Application of deep learning models for accurate classification of fluid collections in acute necrotizing pancreatitis on computed tomography: a multicenter study
(Springer, 2024) Pankaj Gupta; Ruby Siddiqui; Shravya Singh; Nikita Pradhan; Jimil Shah; Jayanta Samanta; Vaneet Jearth; Anupam Singh; Harshal Mandavdhare; Vishal Sharma; Amar Mukund; Chhagan Lal Birda; Ishan Kumar; Niraj Kumar; Yashwant Patidar; Ashish Agarwal; Taruna Yadav; Binit Sureka; Anurag Tiwari; Ashish Verma; Ashish Kumar; Saroj K. Sinha; Usha Dutta
[No abstract available]
Approach to Acute Respiratory Illness in Children with Hematological Malignancy: A Prospective Study Evaluating Utility of CT Scan
(Georg Thieme Verlag, 2022) Priyanka Aggarwal; Tapish Raipa; Ishan Kumar; Ashish Verma; Ram Chandra Shukla; Vineeta Gupta
Introduction Various pulmonary complications can occur in children with hematological malignancies including both infection and malignant disease infiltration of pulmonary parenchyma. Objectives To assess the role of CT scan in determining the etiology of acute pulmonary complications in children with hematological malignancies. Materials and Methods All children < 17 years with newly diagnosed hematological malignancy with respiratory symptoms (Group A) along with children who developed fever with persistent respiratory symptoms as well as worsening chest radiographs during treatment (Group B) and underwent CECT thorax, from February 2019 to July 2020 were enrolled. The final diagnosis was made on the basis of clinical history, laboratory as well as radiological investigations and treatment response. Results Thirty-seven children with mean age of 7.5 ± 3.5 years and male to female ratio of 1.3:1 who underwent CECT thorax were included in our study. For newly diagnosed cases, i.e., Group A (n = 8), the most common cause of respiratory symptoms as identified on CECT thorax was pulmonary tumoral infiltration (n = 5) followed by tuberculosis (n = 3). However, in Group B (n = 29) the cause of persistent respiratory symptoms was identified as infection (n = 17) followed by leukemic infiltration (n = 12). Thus, chest CT could accurately identify pulmonary tuberculosis, fungal pneumonia, bacterial infection, and pulmonary tumoral infiltrates. Conclusion CT scan can be used as an adjunctive tool for prompt diagnosis and management of pulmonary complications in children with persistent respiratory symptoms as they are often non-specific. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Author's Reply
(Wolters Kluwer Medknow Publications, 2025) Ishan Kumar; Tulika Kumari Rai
[No abstract available]
Basic Principles of Pediatric Surgical Oncology: What Radiologist Should Know
(Springer Science+Business Media, 2025) K. Sharma; Sarita Chowdhary; Shiv Prasad Sharma; Ishan Kumar
Radiologists are integral members in the multidisciplinary care of pediatric oncology patients. Their expertise in diagnostic imaging, including X-rays, ultrasounds, MRIs, and CT scans, is essential for accurate diagnosis and treatment planning. Interpretation and diagnosis of pediatric surgical imaging require a comprehensive understanding of imaging algorithms to navigate between various tumors. The location, size, and characteristics of these abnormalities are crucial in determining the type and extent of the cancer. Surgical planning is predominantly guided by resectability and stage of tumor. Further, imaging plays a crucial role in assessing the treatment response as well as long-term surveillance of tumor. This review explores the treatment guidelines and protocols of common pediatric surgical tumors. A concise algorithms to various pediatric surgical tumors have been provided to give insight into the integrated treatment approach with approximate timelines. © 2025 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
Bone Mineral Metabolism during Chemotherapy in Childhood Acute Lymphoblastic Leukemia
(Lippincott Williams and Wilkins, 2021) Sonal Maddheshiya; Surya K. Singh; Ishan Kumar; Priyanka Aggarwal; Vineeta Gupta
Objective: The aim of this study was to evaluate levels of vitamin D, bone mineral density (BMD), and radiograph features at diagnosis and after 6 months of chemotherapy in patients with acute lymphoblastic leukemia (ALL). Vitamin D levels were also correlated with BMD and radiograph features. Materials and Methods: 25-Hydroxy vitamin D [25(OH)D] levels, BMD, and radiograph features were assessed in 50 newly diagnosed patients of ALL in the age group of 2 to 14 years. A total of 30 age-matched and sex-matched children were recruited as controls. Vitamin D deficiency was defined as 25(OH)D <10 ng/mL, Vitamin D insufficiency as 10 to 29 ng/mL, and Vitamin D sufficiency as =30 ng/mL. Enzyme immunoassay (EIA) was used for the quantitative measurement of 25(OH)D levels in plasma and a LUNAR DPX NT bone densitometer was used for the assessment of BMD. Results: The mean age of the patients was 6.3 years, with a male:female ratio of 1.38:1. The mean 25(OH)D levels were 31.90±16.90 ng/mL in patients at diagnosis against 41.63±20.50 ng/mL in controls (P=0.02). Levels were 18.50±11.10 ng/mL postchemotherapy (P=0.00). Female sex was a risk factor for deficient 25(OH)D levels. There was a significant decrease in BMD postchemotherapy in the age groups of 5 to 10 and above 10 years at the femoral neck. Osteopenic changes were observed in more number of patients after 6 months of chemotherapy. There was a significant correlation between vitamin D levels, BMD, and osteopenic changes. Conclusions: Vitamin D deficiency was common among ALL patients, which worsened after chemotherapy. This had a significant correlation with BMD and osteopenic changes in radiograph. © 2021 Lippincott Williams and Wilkins. All rights reserved.
Cardiac T2∗ magnetic resonance analysis of membranous interventricular septum in assessment of cardiac iron overload in pediatric thalassemia patients: A pilot study
(Wolters Kluwer Medknow Publications, 2019) Ishan Kumar; Priyanka Aggarwal; Vineeta Gupta; Ashish Verma; Suwen Kumar; Ram Shukla
Background: Cardiac iron deposition in transfusion-dependent thalassemia patients is patchy in distribution. Purpose: The purpose of this study is to assess the correlation between T2∗ matrices of membranous interventricular septum (MIVS) and T2∗ values of muscular interventricular septum (IVS) on magnetic resonance imaging (MRI) and to evaluate the relationship of myocardial T2∗ at these two locations with MRI-estimated liver iron concentrations (LIC) and electrocardiographic (ECG) parameters. Material and Methods: MRI of heart and liver was performed in 16 consecutive pediatric patients of transfusion-dependent thalassemia major to calculate liver iron concentration and T2∗ time of membranous and muscular IVS. ECG parameters of these patients were charted and correlated with MRI parameters. Results: No significant correlation between T2∗ values of muscular IVS and MIVS was observed. Mean T2∗ of MIVS (9.8 ms) was significantly lower than that of muscular IVS (26.9 ms). T2∗ of MIVS correlated strongly with LIC where as a weak correlation was observed between T2∗ of IVS and LIC. Significantly higher mean QTc (corrected QT interval) value (439.86 ms) was seen in patients with T2∗ IVS <20 ms. Conclusion: Addition of T2∗ analysis of MIVS to the existing MRI protocol, consisting of muscular IVS analysis, may offer a more sensitive estimation of cardiac iron overload. © 2019 Indian Journal of Radiology and Imaging | Published by Wolters Kluwer - Medknow.
Case Report: Nocardia amamiensis Infection Leading to Worsening of Chronic Obstructive Pulmonary Disease Symptoms in an Elderly Man
(American Society of Tropical Medicine and Hygiene, 2023) Ahalya Kanakan; Amit Kumar; Upinder Kaur; Prity Narwade; Zinnu Rain; Nidhi Yadav; Ishan Kumar; Deepak Kumar; Sankha Shubhra Chakrabarti
Nocardiosis is a rare opportunistic infection mostly affecting the lungs, brain, or skin of immunocompromised individuals. Most pulmonary nocardiosis patients present with nonspecific clinical features such as productive cough, exertional dyspnea, and fever. The disease is uncommonly suspected, especially in tuberculosis-endemic regions, and clinical diagnosis is often delayed, resulting in high mortality. Pulmonary nocardiosis in apparently immunocompetent individuals is uncommon. Here, we present the case of an elderly gentleman with a background history of poorly controlled diabetes but no history of systemic steroid use who presented with worsening symptoms of chronic obstructive pulmonary disease in the form of productive cough and dyspnea. The patient had diffuse crepitations in bilateral lung fields and an arterial oxygen saturation of 86% at admission. Sputum microscopy revealed gram-positive filamentous bacteria that could be successfully cultured and identified as Nocardia amamiensis on 16S ribosomal RNA sequencing. Contrast-enhanced computed tomography of the lungs revealed cavitary nodules and consolidation. The patient responded well to treatment with specific antibiotics based on sensitivity patterns. Because of the nonspecific clinical and radiological findings in pulmonary nocardiosis, a high index of suspicion is required, especially in tuberculosis-endemic regions. © 2023 American Society of Tropical Medicine and Hygiene. All rights reserved.
Cerebellar dysfunction in an elderly male after a brief course of metronidazole
(Bentham Science Publishers B.V., 2019) Upinder Kaur; Ishan Kumar; Anup Singh; Mukesh Kumar; Sankha Shubhra Chakrabarti
Background: Metronidazole, a widely used antibacterial and antiprotozoal drug, is often the drug of choice in amoebic liver abscess. The drug, otherwise safe, can cause serious central nervous disturbances in rare circumstances. Case Report: Here, we report a case of cerebellar dysfunction in the form of slurring of speech and episodes of falls, in an elderly male following a three-week course of metronidazole therapy. Results and Conclusion: The patient manifested classic radiologic features of metronidazole neurotoxicity. Marked improvement in clinical symptoms was seen following drug discontinuation. © 2019, Bentham Science Publishers B.V.. All rights reserved.
Chemical Shift Artifact on Steady-State MRI Sequences for Detection of Vesical Wall Invasion in Placenta Percreta
(Federation of Obstetric and Gynecologycal Societies of India, 2016) Ishan Kumar; Ashish Verma; Shivi Jain; Madhu Jain; R.C. Shukla; Arvind Srivastava
Background: Antenatal diagnosis of the invasiveness of a placenta percreta helps in planning the surgical approach, reducing blood loss and morbidity. Doppler sonography is the mainstay diagnostic modality with a sensitivity of 80–95 %. With the advent of high magnetic field MRI techniques, there has been recent interest in evaluation of placenta by MRI. On an extensive PUBMED search, we could not find any citations describing imaging, ultrasound, or MRI features to evaluate vesical wall invasion by placenta percreta. Purpose: We attempt to evaluate transmyometrial vesical wall invasion by placenta percreta using chemical shift artifact as a marker of intact bladder-myometrial interface on steady-state MRI sequences. Materials and Methods: This is a prospective observational study, conducted at a university hospital. We have compiled clinico-radiological criteria for diagnosis of invasive placentae based on the existing body of evidences, in four patients. We further go on to analyze a specific proposed sign on a newly introduced MR imaging sequence i.e., loss of chemical shift artifact (India ink line) on steady-state GRE sequence (TrueFISP), to diagnose transmyometrial vesical invasion in placenta percreta. Results: Though the sample size is small, the sensitivity, specificity, positive, and negative predictive value of the proposed sign for the purpose was 100 %. Conclusions(s): Loss of chemical shift artifact (India ink line) on steady-state GRE sequences at the vesico-myometrial junction in case of invasive placentae confirms vesical wall invasion, a prospective diagnoses of which can help in planning the surgical protocol and preventing potentially fatal blood loss. © 2015, Federation of Obstetric & Gynecological Societies of India.
Child with Intellectual Disability and Seizures
(Springer, 2022) Ishan Kumar; Manoj Ranjan; Ankur Singh; Priyanka Aggarwal; Ashish Verma
[No abstract available]
Comparative accuracy of magnetic resonance morphometry and sonography in assessment of post-cesarean uterine scar
(Wolters Kluwer Medknow Publications, 2018) Gayatri Satpathy; Ishan Kumar; Manjari Matah; Ashish Verma
Objective: To compare the diagnostic accuracy of magnetic resonance imaging (MRI) with that of ultrasonography (USG) for the measurement of lower segment cesarean scar during trial of labor after cesarean (TOLAC). Materials and Methods: This was a prospective case-control observational study conducted with a cohort of 30 participants being considered for TOLAC but eventually proceeding to lower segment cesarean section (LSCS) at a university-based teaching institute over a period of 2 years. Measurement of scar thicknesses were done by MRI and USG preoperatively and validated by surgical findings. Comparison of diagnostic accuracy as well as the cut-off values (to differentiate a normal scar from an abnormal scar) was done between the two modalities. Results: Insignificant systematic error between the measurements obtained by the two modalities was noted by a Bland-Altmann analysis. The diagnostic accuracy of USG for differentiating a normal from an abnormal uterine scar was 96.7% while that of MRI was at a slightly lower level of 90%. A strong level of agreement between the two modalities was observed. Conclusion: MRI offers no advantage in diagnostic accuracy for the measurement of LSCS scar thickness during consideration of TOLAC. Advances in Knowledge: Measurement of uterine scar by MRI has a good correlation with that done on USG in the setting of post-cesarean pregnancy. The results hold good both for normal (grades 1 and 2) and abnormal (grades 3) scars. MRI, however, does not offer any added advantage over sonographic scar thickness measurement for the differentiation of a normal (grades 1 and 2) from an abnormal (grade 3) scar. © 2018 Indian Journal of Radiology and Imaging | Published by Wolters Kluwer - Medknow.
Comparative analysis of transforaminal lumbar interbody fusion versus posterolateral instrumented fusion in degenerative lumbar spine disorders
(SAGE Publications Inc., 2020) Sanjay Yadav; Saurabh Singh; Raj Kumar Arya; Alok Kumar; Ishan Kumar; Abhinav Jha
Objectives: Spinal fusion is an effective treatment for degenerative lumbar spine; however, conflicting results exist regarding the best procedure. This study compares the clinical and radiological outcomes of transforaminal lumbar interbody fusion (TLIF) versus instrumented posterolateral fusion (PLF) in patients of degenerative lumbar spine disorders. Methods: Of the total 37 patients, 16 patients were operated with TLIF and 21 were operated with instrumented PLF with bone grafting. Duration of the study was from June 2017 to June 2019. Patients fulfilling the inclusion criteria were included in the study. Inclusion criteria were (1) age of patient ranging from 18 years to 70 years, (2) involvement of single level, (3) diagnosis of degenerative spine disease, and (4) minimum follow-up of 1 year. Radiographic parameters such as slippage of vertebrae, anterior and posterior disc heights, local disc lordosis, T12–S1 angle were measured, and fusion were assessed; comparison between preoperative and postoperative parameters was also done. Clinical outcome score was obtained using visual analog scale (VAS) and Oswestry disability index (ODI). Statistical analysis was done using SPSS software. Results: No significant difference was found in ODI and VAS between TLIF and PLF. Restoration of disc height and improvement of local disc lordosis was better in the TLIF group than in the PLF group. The fusion rate was 87.5% in the TLIF group and 81% in the instrumented PLF group. Amount of blood loss was slightly higher in the TLIF group (319.69 ± 53.8 mL) than in the instrumented PLF group (261.19 ± 34.9 mL). Operating time was also slightly higher in TLIF (133 ± 6.02 min) than in instrumented PLF (90.71 ± 6.3 min). Conclusion: TLIF is superior to instrumented PLF in terms of restoration of anterior and posterior disc heights and improvement in local disc lordosis and higher fusion rate, however it requires greater surgical expertise and more experience. Because of anterior cage support, early weight-bearing mobilization can be allowed in the TLIF group compared to the PLF group. Surgical time and blood loss were slightly higher in cases of TLIF than instrumented PLF. © The Author(s) 2020.
Comparison of T2-weighted and diffusion-weighted imaging for the diagnosis of placenta accreta spectrum abnormality
(SAGE Publications Inc., 2023) Adity Prakash; Ishan Kumar; Ashish Verma; Ram C Shukla
Background: Diffusion-weighted imaging (DWI) is feasible in prenatal imaging, and it exhibits better contrast between the placenta and the myometrium compared to T2-weighted (T2W) images. Purpose: To compare magnetic resonance imaging (MRI) features of placenta accreta on T2W and DW imaging. Material and Methods: In this retrospective study, 42 pregnant patients who underwent prenatal MRI were included. MRI was performed on a Siemens 1.5-T scanner. T2W and DWI sequences in the axial, sagittal, and/or coronal planes were compiled for review. Two radiologists independently interpreted T2W and DW images for placenta accreta. T2W and DWI scores were calculated based on the presence of features and graded as low, intermediate, and high risk. The association between imaging features and placental invasion on pathology was calculated using chi-square tests. Sensitivity, specificity, and positive and negative predictive values (NPV) were compared between T2W and DWI interpretations. Inter-reader agreement between the two radiologists for T2W and DWI scores was calculated using Cohen's kappa coefficient. Results: Out of 42 pregnant patients, 10 were pathologically/surgically proven to have placenta accreta. There were no significant differences between T2W and DWI interpretations. Considering a cutoff >6 as positive, the T2W score had higher sensitivity (90% vs. 80%) and NPV (96.9% vs. 94.1%) than the DWI score. The specificity and positive predictive value were 100% for both scores. The inter-reader agreement of T2W score was higher (k = 0.943 vs. 0.882). Conclusion: T2W and DWI are comparable in diagnosing placenta accreta spectrum. T2W sequences have higher sensitivity, NPV, and inter-reader agreement than DWI. © The Foundation Acta Radiologica 2022.
Comparison of the effects of calcium channel blockers plus iron chelation therapy versus chelation therapy only on iron overload in children and young adults with transfusion-dependent thalassemia: A randomized double-blind placebo-controlled trial
(John Wiley and Sons Inc, 2022) Vineeta Gupta; Ishan Kumar; Vibhesh Raj; Priyanka Aggarwal; Vikas Agrawal
Background: Myocardial iron deposition is a significant cause of morbidity and mortality in patients with transfusion-dependent thalassemia (TDT). Amlodipine, L-type calcium channel blocker with regular chelation therapy may reduce myocardial iron overload. Lack of randomized trials prompted this study to assess the effect of calcium channel blocker (amlodipine) in combination with iron chelation therapy on iron overload in patients with TDT. Methods: Sixty-four eligible patients were randomized to receive either amlodipine and chelation (group A) or chelation alone (group B) in double-blind placebo-controlled trial. Myocardial iron concentration (MIC) using T2* magnetic resonance imaging (MRI), liver iron concentration (LIC), left ventricular ejection fraction (LVEF), and serum ferritin were measured at baseline and 12 months. Results: In the amlodipine group, mean cardiac T2* value significantly increased from 18.11 ± 8.47 to 22.15 ± 7.61 (p =.002) at 12 months, whereas in control group, there was a nonsignificant increase (p =.62) in cardiac T2* value from 19.50 ± 8.84 to 20.03 ± 9.07. There was a significant decrease in MRI-derived MIC in the amlodipine group compared to control group (1.93 ± 1.61 to 1.29 ± 0.90, p =.01). Changes in the LVEF (p =.45), MRI-derived LIC (p =.09), and serum ferritin (p =.81) were not significant between the two groups. Conclusion: Amlodipine is safe and when combined with chelation therapy appears to be more effective in reducing cardiac iron overload than chelation only in children and young adults with TDT. © 2022 Wiley Periodicals LLC.