Browsing by Author "S. P.V. Kumar"

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Building Palliative Care Capacity - A Rapid Evaluation of Services in Eleven Hospitals in Northern India
(2025) Komal Kashyap; Anjum Khan Joad; Brajesh Kumar Ratre; Suraj Pal Singh; Varun Shekhar; Surabhi Shekhar; Anshika Arora; Sweety Gupta; Kunal Jain; Rohit Lahori; Vanita Ahuja; Sukanya Mitra; Arshi Taj; Manoj Kamal; Nimisha Verma; Lalit Kumar Raiger; Seema Partani; Naveen Patidar; Anuja Pandit; Saurabh Vig; H. K.R. Sagiraju; Raghav Gupta; Prashant Sirohiya; S. P.V. Kumar; Neetu S. Mahajan; Sushma Bhatnagar
AIMS AND OBJECTIVES: This study aimed to evaluate palliative care capacity across eleven northern Indian hospitals whose physicians and nurses had undergone training as part of the Cancer Treatment Centers (CTC) program. An online rapid evaluation using The "Standards audit tool for Indian palliative care programs" developed by the Indian Association of Palliative Care (IAPC) was done to audit specific aspects of palliative care delivery including staff training, recordkeeping, availability of morphine, and continuing professional development programs. A descriptive analysis of the data was conducted. Additional information was obtained through surveys, site visits, document reviews, and interviews with program leaders. For each site, the researchers determined to what extent the program met the set IAPC of the Standards Audit Tool. The eleven centers satisfied most of the essential criteria and some of the desirable criteria. One center did not have an in-house access to oral morphine. Some of the lacunae were inadequate provision of home care, unavailability of care after business hours, place of multidisciplinary collaboration, and involvement of community and volunteers. There was evidence of teaching, training, team health, audit, and administrative support. These hospitals were delivering good quality palliative care as per IAPC standards in parts of northern India that are underserved. There is scope for improvement in the outreach to the community, and a more multidisciplinary approach is required. © © 2025 WHO South-East Asia Journal of Public Health.
Outcome of Cerebral Venous Thrombosis Requiring Mechanical Ventilation
(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Jayantee Kalita; Prakash Chandra Pandey; Nagendra Babu Gutti; Kuntal Kanti Das; S. P.V. Kumar; Varun Kumar Singh
Background: Patients with cerebral venous thrombosis (CVT) requiring mechanical ventilation (MV) may have a severe procoagulant state, extensive venous sinus thrombosis, and a worse outcome, but there is a paucity of studies on this topic. We compare the clinical risk factors, radiological findings, and outcomes between CVT patients requiring MV and the non-MV group. Methods: Consecutive CVT patients admitted to our service were included. Their clinical details, prothrombotic states and MRI and MRV findings were noted. The patients were admitted to the intensive care unit (ICU) if the Glasgow Coma Scale (GCS) score was below 14 and intubated if arterial blood gas analysis was abnormal. All the patients received heparin followed by an oral anticoagulant. In-hospital death was noted, and functional outcomes at 3 months were assessed using the modified Rankin Scale (mRS). Results: Ninety-eight patients with CVT were admitted during the study period; 45 (45.9%) required ICU care, and 18 of them required MV for a median of 6.5 (1–15) days. The MV patients had a shorter duration of illness, a lower GCS score, and protein C deficiency. Twelve (12.2%) patients died: five (27.8%) in the MV, four (14.8%) in the non-MV ICU, and three (5.7%) in the non-MV non-ICU groups. Poor outcomes were 5.5%, 14.8%, and 5.7%, respectively. On Cox regression analysis, the MV had an association with death [adjusted hazard ratio (AHR) 0.40, 95% confidence interval 0.21–0.77; p = 0.007] and poor outcome at 3 months (AHR 0.45, 95% CI 0.27–0.76; p = 0.003). Conclusions: About 18.4% of CVT patients require MV with a mortality of 27.8%. Amongst the survivors, 90.7% of patients have a good outcome at 3 months. © 2025 by the authors.