Browsing by Author "Saumya Srivastava"

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Developing Standard Treatment Workflows—way to universal healthcare in India
(Frontiers Media SA, 2023) Ashoo Grover; Balram Bhargava; Saumya Srivastava; Lokesh Kumar Sharma; Jerin Jose Cherian; Nikhil Tandon; Sudha Chandershekhar; Roderico H. Ofrin; Henk Bekedam; Deepika Pandhi; Aparna Mukherjee; Rupinder Singh Dhaliwal; Manjula Singh; Kavitha Rajshekhar; Sudipto Roy; Reeta Rasaily; Deepika Saraf; Dhiraj Kumar; Neeraj Parmar; Sushil Kumar Kabra; Dhruva Chaudhry; Ashok Deorari; Radhika Tandon; Rajdeep Singh; Binod Khaitan; Sandeep Agrawala; Sudeep Gupta; Satish Chandra Goel; Anil Bhansali; Usha Dutta; Tulika Seth; Neeta Singh; Shally Awasthi; Amlesh Seth; Jeyaraj Pandian; Vivekanand Jha; Sudhanshu Kumar Dwivedi; Reva Tripathi; Alok Thakar; Surinder Jindal; Banglore Nanjudaiah Gangadhar; Anjali Bajaj; Mohan Kant; Aniket Chatterjee
Primary healthcare caters to nearly 70% of the population in India and provides treatment for approximately 80–90% of common conditions. To achieve universal health coverage (UHC), the Indian healthcare system is gearing up by initiating several schemes such as National Health Protection Scheme, Ayushman Bharat, Nutrition Supplementation Schemes, and Inderdhanush Schemes. The healthcare delivery system is facing challenges such as irrational use of medicines, over- and under-diagnosis, high out-of-pocket expenditure, lack of targeted attention to preventive and promotive health services, and poor referral mechanisms. Healthcare providers are unable to keep pace with the volume of growing new scientific evidence and rising healthcare costs as the literature is not published at the same pace. In addition, there is a lack of common standard treatment guidelines, workflows, and reference manuals from the Government of India. Indian Council of Medical Research in collaboration with the National Health Authority, Govt. of India, and the WHO India country office has developed Standard Treatment Workflows (STWs) with the objective to be utilized at various levels of healthcare starting from primary to tertiary level care. A systematic approach was adopted to formulate the STWs. An advisory committee was constituted for planning and oversight of the process. Specialty experts' group for each specialty comprised of clinicians working at government and private medical colleges and hospitals. The expert groups prioritized the topics through extensive literature searches and meeting with different stakeholders. Then, the contents of each STW were finalized in the form of single-pager infographics. These STWs were further reviewed by an editorial committee before publication. Presently, 125 STWs pertaining to 23 specialties have been developed. It needs to be ensured that STWs are implemented effectively at all levels and ensure quality healthcare at an affordable cost as part of UHC. Copyright © 2023 Grover, Bhargava, Srivastava, Sharma, Cherian, Tandon, Chandershekhar, Ofrin, Bekedam, Pandhi, Mukherjee, Dhaliwal, Singh, Rajshekhar, Roy, Rasaily, Saraf, Kumar, Parmar, Kabra, Chaudhry, Deorari, Tandon, Singh, Khaitan, Agrawala, Gupta, Goel, Bhansali, Dutta, Seth, Singh, Awasthi, Seth, Pandian, Jha, Dwivedi, Tripathi, Thakar, Jindal, Gangadhar, Bajaj, Kant and Chatterjee.
Expression of Ki-67 and p53 in Triple-negative Breast Cancer: A Clinicopathological Study
(Wolters Kluwer Medknow Publications, 2025) Radhey Shyam Verma; Saumya Srivastava; Sushila Yadav; Rinki Kumari
Background: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype, categorized by a lack of expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2, associated with poor prognosis. Therefore, need to take reliable biomarkers are essential for prognostic stratification and guiding treatment decisions. This study evaluates the clinicopathological significance of Ki-67 and p53 expression in TNBC within an Indian cohort. Methods: A prospective observational study was conducted on 23 histologically confirmed TNBC cases diagnosed between January 2023 and June 2024. Consecutive sampling was used to include all eligible, treatment-naïve patients. Clinicopathological parameters were recorded, and immunohistochemistry (IHC) for Ki-67 and p53 was performed on formalin-fixed paraffin-embedded tissue. Associations between biomarker expression and tumor grade, size, and lymph node status were analyzed using Chi-square/Fisher’s exact test and binary logistic regression. Results: The mean patient age was 48.6 years (range: 32–68). Most tumors (69.6%) were >2 cm, 73.9% were Grade III, and 56.5% had lymph node metastasis. High Ki-67 expression (>20%) was observed in 78.3% of cases, showing a significant association with Grade III tumors (P = 0.01) and lymph node metastasis (P = 0.03). p53 positivity (>10%) occurred in 65.2% of cases, correlating significantly with tumor grade (P = 0.04) but not with nodal status. Binary logistic regression confirmed Ki-67 as an independent predictor of Grade III histology (odds ratio [OR] = 6.75, P = 0.04) and nodal metastasis (OR = 5.40, P = 0.047), whereas p53 did not retain independent prognostic significance. Conclusion: High Ki-67 expression is a robust and independent prognostic marker in TNBC, associated with high-grade histology and lymphatic spread, supporting its integration into routine pathological evaluation. p53 expression shows limited prognostic utility when used alone but may have value in multi-marker panels. Larger studies with long-term survival data are warranted to validate these findings and refine biomarker-guided management strategies in TNBC. © 2025 Biomedical and Biotechnology Research Journal (BBRJ)