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  1. Home
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Browsing by Author "Pankaj Puri"

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    PublicationReview
    Consensus statement of HCV task force of the Indian National Association for Study of the Liver (INASL). Part I: Status report of HCV infection in India
    (Elsevier, 2014) Pankaj Puri; Anil C. Anand; Vivek A. Saraswat; Subrat K. Acharya; Radha K. Dhiman; Rakesh Aggarwal; Shivram P. Singh; Deepak Amarapurkar; Anil Arora; Mohinish Chhabra; Kamal Chetri; Gourdas Choudhuri; Vinod K. Dixit; Ajay Duseja; Ajay K. Jain; Dharmesh Kapoorz; Premashis Kar; Abraham Koshy; Ashish Kumar; Kaushal Madan; Sri P. Misra; Mohan V.G. Prasad; Aabha Nagral; Amarendra S. Puri; R. Jeyamani; Sanjiv Saigal; Shiv K. Sarin; Samir Shah; P.K. Sharma; Ajit Sood; Sandeep Thareja; Manav Wadhawan
    Globally, around 150 million people are infected with hepatitis C virus (HCV). India contributes a large proportion of this HCV burden. The prevalence of HCV infection in India is estimated at between 0.5% and 1.5%. It is higher in the northeastern part, tribal populations and Punjab, areas which may represent HCV hotspots, and is lower in western and eastern parts of the country. The predominant modes of HCV transmission in India are blood transfusion and unsafe therapeutic injections. There is a need for large field studies to better understand HCV epidemiology and identify high-prevalence areas, and to identify and spread awareness about the modes of transmission of this infection in an attempt to prevent disease transmission. © 2014 INASL.
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    PublicationReview
    Consensus statement of HCV task force of the Indian National Association for Study of the Liver (INASL). Part II: INASL recommendations for management of HCV in India
    (Elsevier, 2014) Pankaj Puri; Anil C. Anand; Vivek A. Saraswat; Subrat K. Acharya; Shiv K. Sarin; Radha K. Dhiman; Rakesh Aggarwal; Shivaram P. Singh; Deepak Amarapurkar; Anil Arora; Mohinish Chhabra; Kamal Chetri; Gourdas Choudhuri; Vinod K. Dixit; Ajay Duseja; Ajay K. Jain; Dharmesh Kapoor; Premashis Kar; Abraham Koshy; Ashish Kumar; Kaushal Madan; Sri P. Misra; Mohan V.G. Prasad; Aabha Nagral; Amarendra S. Puri; R. Jeyamani; Sanjiv Saigal; Samir Shah; Praveen K. Sharma; Ajit Sood; Sandeep Thareja; Manav Wadhawan
    The estimated prevalence of hepatitis C virus (HCV) infection in India is between 0.5 and 1.5% with hotspots showing much higher prevalence in some areas of northeast India, in some tribal populations and in certain parts of Punjab. Genotype 3 is the most prevalent type of infection. Recent years have seen development of a large number of new molecules that are revolutionizing the treatment of hepatitis C. Some of the new directly acting agents (DAAs) like sofosbuvir have been called game-changers because they offer the prospect of interferon-free regimens for the treatment of HCV infection. These new drugs have not yet been approved in India and their cost and availability is uncertain at present. Till these drugs become available at an affordable cost, the treatment that was standard of care for the whole world before these newer drugs were approved should continue to be recommended. For India, cheaper options, which are as effective as the standard-of-care (SOC) in carefully selected patients, are also explored to bring treatment within reach of poorer patients. It may be prudent to withhold treatment at present for selected patients with genotype 1 or 4 infection and low levels of fibrosis (F1 or F2), and for patients who are non-responders to initial therapy, interferon intolerant, those with decompensated liver disease, and patients in special populations such as stable patients after liver and kidney transplantation, HIV co-infected patients and those with cirrhosis of liver. © 2014 INASL.
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    PublicationErratum
    Corrigendum to “Joint Consensus Statement of the Indian National Association for Study of the Liver and Indian Radiological and Imaging Association for the Diagnosis and Imaging of Hepatocellular Carcinoma Incorporating Liver Imaging Reporting and Data System” [J Clin Expt Hepatol 9 (2019) 625–651] (Journal of Clinical and Experimental Hepatology (2019) 9(5) (625–651), (S0973688319301914), (10.1016/j.jceh.2019.07.005))
    (Elsevier B.V., 2020) Sonal Krishan; Radha K. Dhiman; Navin Kalra; Raju Sharma; Sanjay S. Baijal; Anil Arora; Ajay Gulati; Anu Eapan; Ashish Verma; Shyam Keshava; Amar Mukund; S. Deva; Ravi Chaudhary; Karthick Ganesan; Sunil Taneja; Ujjwal Gorsi; Shivanand Gamanagatti; Kumble S. Madhusudan; Pankaj Puri; Shalimar; Shallini Govil; Manav Wadhavan; Sanjiv Saigal; Ashish Kumar; Shallini Thapar; Ajay Duseja; Neeraj Saraf; Anubhav Khandelwal; Sumit Mukhopadyay; Nitin Shetty; Nipun Verma
    The authors regret that the affiliation of co-author. Nitin Shetty mentioned in the article is incorrect. The correct affiliation is as follows: Name: Nitin Sudhakar Shetty Affiliation: (a) Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India (b) Homi Bhabha National Institute (HBNI), Mumbai, India Address: Dr. E. Borges Road, Parel, Mumbai, 400012, India Email ID: drnsshetty@gmail.com Phone No: 9757092013 The authors would like to apologise for any inconvenience caused. © 2019
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    PublicationErratum
    Erratum: Corrigendum to “Indian National Association for Study of the Liver (INASL) guidance for antiviral therapy against HCV infection: Update 2016” (Journal of Clinical and Experimental Hepatology (2016) 6(2) (119–145) (S0973688316302584) (10.1016/j.jceh.2016.07.001))
    (Elsevier B.V., 2016) Pankaj Puri; Vivek A. Saraswat; Radha K. Dhiman; Anil C. Anand; Subrat K. Acharya; Shivaram P. Singh; Yogesh K. Chawla; Deepak N. Amarapurkar; Ajay Kumar; Anil Arora; Vinod K. Dixit; Abraham Koshy; Ajit Sood; Ajay Duseja; Dharmesh Kapoor; Kaushal Madan; Anshu Srivastava; Ashish Kumar; Manav Wadhawan; Amit Goel; Abhai Verma; Shalimar; Gaurav Pandey; Rohan Malik; Swastik Agrawal
    The authors regret for the typological error in Table 3 published in the original version of the article. The corrected version of Table 3 is given below: The authors would like to apologise for any inconvenience caused. © 2016
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    PublicationReview
    INASL-ISN Joint Position Statements on Management of Patients with Simultaneous Liver and Kidney Disease
    (Elsevier B.V., 2021) Anil Arora; Ashish Kumar; Narayan Prasad; Ajay Duseja; Subrat K. Acharya; Sanjay K. Agarwal; Rakesh Aggarwal; Anil C. Anand; Anil K. Bhalla; Narendra S. Choudhary; Yogesh K. Chawla; Radha K. Dhiman; Vinod K. Dixit; Natarajan Gopalakrishnan; Ashwani Gupta; Umapati N. Hegde; Sanjiv Jasuja; Vivek Jha; Vijay Kher; Ajay Kumar; Kaushal Madan; Rakhi Maiwall; Rajendra P. Mathur; Suman L. Nayak; Gaurav Pandey; Rajendra Pandey; Pankaj Puri; Ramesh R. Rai; Sree B. Raju; Devinder S. Rana; Padaki N. Rao; Manish Rathi; Vivek A. Saraswat; Sanjiv Saxena; Shalimar; Praveen Sharma; Shivaram P. Singh; Ashwani K. Singal; Arvinder S. Soin; Sunil Taneja; Santosh Varughese
    Renal dysfunction is very common among patients with chronic liver disease, and concomitant liver disease can occur among patients with chronic kidney disease. The spectrum of clinical presentation and underlying etiology is wide when concomitant kidney and liver disease occur in the same patient. Management of these patients with dual onslaught is challenging and requires a team approach of hepatologists and nephrologists. No recent guidelines exist on algorithmic approach toward diagnosis and management of these challenging patients. The Indian National Association for Study of Liver (INASL) in association with Indian Society of Nephrology (ISN) endeavored to develop joint guidelines on diagnosis and management of patients who have simultaneous liver and kidney disease. For generating these guidelines, an INASL-ISN Taskforce was constituted, which had members from both the societies. The taskforce first identified contentious issues on various aspects of simultaneous liver and kidney diseases, which were allotted to individual members of the taskforce who reviewed them in detail. A round-table meeting of the Taskforce was held on 20–21 October 2018 at New Delhi to discuss, debate, and finalize the consensus statements. The evidence and recommendations in these guidelines have been graded according to the Grading of Recommendations Assessment Development and Evaluation (GRADE) system with minor modifications. The strength of recommendations (strong and weak) thus reflects the quality (grade) of underlying evidence (I, II, III). We present here the INASL-ISN Joint Position Statements on Management of Patients with Simultaneous Liver and Kidney Disease. © 2020 Indian National Association for Study of the Liver
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    PublicationReview
    Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection in 2015
    (Elsevier B.V., 2015) Pankaj Puri; Anil C. Anand; Vivek A. Saraswat; Subrat K. Acharya; Radha K. Dhiman; Shiv K. Sarin; Shivaram P. Singh; Yogesh K. Chawla; Rakesh Aggarwal; Deepak Amarapurkar; Anil Arora; Vinod K. Dixit; Ajit Sood; Samir Shah; Ajay Duseja; Dharmesh Kapoor; Shalimar; Kaushal Madan; Gaurav Pande; Aabha Nagral; Premashis Kar; Abraham Koshy; Amarender S. Puri; C.E. Eapen; Sandeep Thareja
    Overall prevalence of HCV infection in India has been estimated to be approximately 1.3% in the general population. Recent introduction of sofosbuvir in India at a relatively affordable price has led to great optimism about prospects of cure for these patients. This drug is likely to form the backbone of current and future treatment regimes for HCV infection, displacing pegylated interferon. Availability of directly acting antiviral drugs (DAAs) has necessitated revision of INASL guidelines for the treatment of HCV published in 2014, as has happened across the world. Current considerations for the treatment of HCV in India include the poorer response of genotype 3, nonavailability of many of the DAAs recommended by other guidelines and the cost of therapy. Since only one DAA, sofosbuvir, is available in India, only two sofosbuvir-based regimes are possible: either dual drug therapy in combination with ribavirin alone for 6 months or triple drug therapy in combination with ribavirin and pegylated interferon for 3 months. The utility of these regimes in various situations has been discussed. Availability of a few other newer DAAs, expected in 2016, is expected to lead to more widespread use of these agents. Current guidance will be updated once newer DAAs, newer evidence with DAAs and 'real-life experience' with use of DAAs accumulate in India. © 2015 INASL.
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    PublicationReview
    Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016
    (Elsevier B.V., 2016) Pankaj Puri; Vivek A. Saraswat; Radha K. Dhiman; Anil C. Anand; Subrat K. Acharya; Shivaram P. Singh; Yogesh K. Chawla; Deepak N. Amarapurkar; Ajay Kumar; Anil Arora; Vinod K. Dixit; Abraham Koshy; Ajit Sood; Ajay Duseja; Dharmesh Kapoor; Kaushal Madan; Anshu Srivastava; Ashish Kumar; Manav Wadhawan; Amit Goel; Abhai Verma; Shalimar; Gaurav Pandey; Rohan Malik; Swastik Agrawal
    India contributes significantly to the global burden of HCV. While the nucleoside NS5B inhibitor sofosbuvir became available in the Indian market in March 2015, the other directly acting agents (DAAs), Ledipasvir and Daclatasvir, have only recently become available in the India. The introduction of these DAA in India at a relatively affordable price has led to great optimism about prospects of cure for these patients as not only will they provide higher efficacy, but combination DAAs as all-oral regimen will result in lower side effects than were seen with pegylated interferon alfa and ribavirin therapy. Availability of these newer DAAs has necessitated revision of INASL guidelines for the treatment of HCV published in 2015. Current considerations for the treatment of HCV in India include the poorer response of genotype 3, nonavailability of many of the DAAs recommended by other guidelines and the cost of therapy. The availability of combination DAA therapy has simplified therapy of HCV with decreased reliance of evaluation for monitoring viral kinetics or drug related side effects. © 2016 INASL
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    PublicationReview
    Indian National Association for the Study of the Liver—Federation of Obstetric and Gynaecological Societies of India Position Statement on Management of Liver Diseases in Pregnancy
    (Elsevier B.V., 2019) Anil Arora; Ashish Kumar; Anil C. Anand; Pankaj Puri; Radha K. Dhiman; Subrat K. Acharya; K. Aggarwal; Neelam Aggarwal; Rakesh Aggarwal; Yogesh K. Chawla; Vinod K. Dixit; Ajay Duseja; Chundamannil E. Eapen; Bhabadev Goswami; Kanwal Gujral; A. Gupta; A. Jindal; Premashish Kar; Krishna Kumari; Kaushal Madan; Jaideep Malhotra; Narendra Malhotra; Gaurav Pandey; Uma Pandey; Ratna D. Puri; Ramesh R. Rai; Padaki N. Rao; Shiv K. Sarin; Aparna Sharma; Praveen Sharma; Koticherry T. Shenoy; Karam R. Singh; Shivaram P. Singh; Vanita Suri; Nirupama Trehanpati; M. Wadhawan
    Liver diseases occurring during pregnancy can be serious and can progress rapidly, affecting outcomes for both the mother and fetus. They are a common cause of concern to an obstetrician and an important reason for referral to a hepatologist, gastroenterologist, or physician. Liver diseases during pregnancy can be divided into disorders unique to pregnancy, those coincidental with pregnancy, and preexisting liver diseases exacerbated by pregnancy. A rapid differential diagnosis between liver diseases related or unrelated to pregnancy is required so that specialist and urgent management of these conditions can be carried out. Specific Indian guidelines for the management of these patients are lacking. The Indian National Association for the Study of the Liver (INASL) in association with the Federation of Obstetric and Gynaecological Societies of India (FOGSI) had set up a taskforce for development of consensus guidelines for management of patients with liver diseases during pregnancy, relevant to India. For development of these guidelines, a two-day roundtable meeting was held on 26–27 May 2018 in New Delhi, to discuss, debate, and finalize the consensus statements. Only those statements that were unanimously approved by most members of the taskforce were accepted. The primary objective of this review is to present the consensus statements approved jointly by the INASL and FOGSI for diagnosing and managing pregnant women with liver diseases. This article provides an overview of liver diseases occurring in pregnancy, an update on the key mechanisms involved in its pathogenesis, and the recommended treatment options. © 2019
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    PublicationReview
    Joint Consensus Statement of the Indian National Association for Study of the Liver and Indian Radiological and Imaging Association for the Diagnosis and Imaging of Hepatocellular Carcinoma Incorporating Liver Imaging Reporting and Data System
    (Elsevier B.V., 2019) Sonal Krishan; Radha K. Dhiman; Navin Kalra; Raju Sharma; Sanjay S. Baijal; Anil Arora; Ajay Gulati; Anu Eapan; Ashish Verma; Shyam Keshava; Amar Mukund; S. Deva; Ravi Chaudhary; Karthick Ganesan; Sunil Taneja; Ujjwal Gorsi; Shivanand Gamanagatti; Kumble S. Madhusudan; Pankaj Puri; Shalimar; Shallini Govil; Manav Wadhavan; Sanjiv Saigal; Ashish Kumar; Shallini Thapar; Ajay Duseja; Neeraj Saraf; Anubhav Khandelwal; Sumit Mukhopadyay; Nitin Shetty; Nipun Verma
    Hepatocellular carcinoma (HCC) is the 6th most common cancer and the second most common cause of cancer-related mortality worldwide. There are currently no universally accepted practice guidelines for the diagnosis of HCC on imaging owing to the regional differences in epidemiology, target population, diagnostic imaging modalities, and staging and transplant eligibility. Currently available regional and national guidelines include those from the American Association for the Study of Liver Disease (AASLD), the European Association for the Study of the Liver (EASL), the Asian Pacific Association for the Study of the Liver, the Japan Society of Hepatology, the Korean Liver Cancer Study Group, Hong Kong, and the National Comprehensive Cancer Network in the United States. India with its large population and a diverse health infrastructure faces challenges unique to its population in diagnosing HCC. Recently, American Association have introduced a Liver Imaging Reporting and Data System (LIRADS, version 2017, 2018) as an attempt to standardize the acquisition, interpretation, and reporting of liver lesions on imaging and hence improve the coherence between radiologists and clinicians and provide guidance for the management of HCC. The aim of the present consensus was to find a common ground in reporting and interpreting liver lesions pertaining to HCC on imaging keeping LIRADSv2018 in mind. © 2019
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