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  1. Article: Identification of h-TERT Promoter Mutations in Germline DNA from North Indian Lung Carcinoma Patients.

    Prasad, Rajendra / Panchal, Sonia / Rani, Isha / Kishan, Jai / Parashar, Gaurav

    Indian journal of clinical biochemistry : IJCB

    2022  Volume 38, Issue 1, Page(s) 120–127

    Abstract: Lung cancer is a severe and the leading cause of cancer related deaths worldwide. The recurrent h-TERT promoter mutations have been implicated in various cancer types. Thus, the present study is extended to analyze h-TERT promoter mutations from the ... ...

    Abstract Lung cancer is a severe and the leading cause of cancer related deaths worldwide. The recurrent h-TERT promoter mutations have been implicated in various cancer types. Thus, the present study is extended to analyze h-TERT promoter mutations from the North Indian lung carcinoma patients. Total 20 histopathologically and clinically confirmed cases of lung cancer were enrolled in this study. The genomic DNA was extracted from venous blood and subjected to amplification using appropriate h-TERT promoter primers. Amplified PCR products were subjected for DNA Sanger sequencing for the identification of novel h-TERT mutations. Further, these identified h-TERT promoter mutations were analysed for the prediction of pathophysiological consequences using bioinformatics tools such as Tfsitescan and CIIDER. The average age of patients was 45 ± 8 years which was categorized in early onset of lung cancer with predominance of male patients by 5.6 fold. Interestingly, h-TERT promoter mutations were observed highly frequent in lung cancer. Identified mutations include c. G272A, c. T122A, c. C150A, c. 123 del C, c. C123T, c. G105A, c. 107 Ins A, c. 276 del C corresponding to -168 G>A, -18 T>A, -46 C>A, -19 del C, -19 C>T, -1 G>A, -3 Ins A, -172 del C respectively from the translation start site in the promoter of the telomerase reverse transcriptase gene which are the first time reported in germline genome from lung cancer. Strikingly, c. -18 T>A [C.T122A] was found the most prevalent variant with 75% frequency. Notwithstanding, other mutations viz c. -G168A [c. G272A] and c. -1 G>A [c. G105A] were found to be at 35% and 15% frequency respectively whilst the rest of the mutations were present at 10% and 5% frequency. Additionally, bioinformatics analysis revealed that these mutations can lead to either loss or gain of various transcription factor binding sites in the h-TERT promoter region. Henceforth, these mutations may play a pivotal role in h-TERT gene expression. Taken together, these identified novel promoter mutations may alter the epigenetics and subsequently various transcription factor binding sites which are of great functional significance. Thereby, it is plausible that these germline mutations may involve either as predisposing factor or direct participation in the pathophysiology of lung cancer through entangled molecular mechanisms.
    Language English
    Publishing date 2022-05-19
    Publishing country India
    Document type Journal Article
    ZDB-ID 1033583-3
    ISSN 0974-0422 ; 0970-1915
    ISSN (online) 0974-0422
    ISSN 0970-1915
    DOI 10.1007/s12291-022-01047-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Atypical Case of Highly Mutated h-TERT Promoter in Germline Genome from Buccal Mucosa Cancer.

    Prasad, Rajendra / Panchal, Sonia / Rani, Isha / Parashar, Gaurav / Kishan, Jai / Bhatnagar, Mini

    Indian journal of clinical biochemistry : IJCB

    2021  Volume 38, Issue 3, Page(s) 400–404

    Abstract: Buccal mucosa cancer has an aggressive nature as it rapidly grows and penetrates with high recurrence rate. Strikingly, carcinoma of buccal mucosa is the most common cancer of oral cavity in India. Recently, telomerase and telomere biology have been ... ...

    Abstract Buccal mucosa cancer has an aggressive nature as it rapidly grows and penetrates with high recurrence rate. Strikingly, carcinoma of buccal mucosa is the most common cancer of oral cavity in India. Recently, telomerase and telomere biology have been implicated in the pathogenesis and progression in various cancers via regulation of telomere maintenance by telomerase expression which is controlled by telomerase reverse transcriptase (TERT) promoter. Strikingly, h-TERT promoter mutations have been incriminated in regulation of telomerase gene expression. Here, we present a 35 years old male with intense coughing, short breathlessness and fever since 15 days, was admitted to the pulmonary unit. He was a chronic smoker and gutka user. The cytopathological analysis of gastric aspirate revealed buccal mucosa carcinoma of IV stage. We identified h-TERT promoter mutations in isolated genomic DNA from whole blood using DNA sequencer. Genetic analysis disclosed that h-TERT promoter region was highly mutated in this patient. Identified mutations include C.-248 del G, C.-272 del G, C.-279 del G, C.-331 del G, C.-349 del G, C.-351 del C, C.-360 G > A, C.-362 T > A, C.-371 del T and C.-372 del T. Further, all identified mutations were subjected to predict the pathologic functional consequences using bioinformatics tools viz TFsitescan and CiiiDER which showed either loss or gain of transcription factors binding sites in h-TERT promoter. This is a unique case in which total 9 mutations were observed in h-TERT promoter in a single case. In conclusion, all together these mutations in h-TERT promoter may alter the epigenetics and subsequently the tenacity of binding transcription factors which are of functional significance.
    Language English
    Publishing date 2021-10-04
    Publishing country India
    Document type Case Reports
    ZDB-ID 1033583-3
    ISSN 0974-0422 ; 0970-1915
    ISSN (online) 0974-0422
    ISSN 0970-1915
    DOI 10.1007/s12291-021-01006-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: MediDial cards: a quick win for service improvement.

    Davies, Mike / Panchal, Sonia

    BMJ quality improvement reports

    2014  Volume 3, Issue 1

    Abstract: One of the key roles of a junior doctor is co-ordinating the care of their patients and communicating with different departments or specialties within the hospital. To do this, junior doctors often spend a lot of time on a daily basis contacting the ... ...

    Abstract One of the key roles of a junior doctor is co-ordinating the care of their patients and communicating with different departments or specialties within the hospital. To do this, junior doctors often spend a lot of time on a daily basis contacting the hospital switchboard in order to locate a required bleep/extension/fax number, or trying to navigate an intranet based directory which can be difficult to use. We aimed to improve this task for junior doctors as a pilot project for engaging junior doctors in service improvement. Our multi-disciplinary team, led by junior doctors and with the support of the Trust, produced and implemented lanyard (MediDial) cards containing common and relevant (fax, bleep, and extension) numbers for use by junior doctors. Through the introduction of our MediDial cards we not only reduced the frequency junior doctors needed to contact the switchboard on a daily basis, but also the length of time spent waiting to speak to an operator. The MediDial cards were also found to be time saving and more useful than the previous intranet based database. Since the introduction of the MediDial cards, the project has been rolled out across the Trust and presented at Grand Rounds as an example of junior doctor led service improvement, aiming to encourage trainees to engage with quality improvement projects.
    Language English
    Publishing date 2014-10-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2677829-4
    ISSN 2050-1315
    ISSN 2050-1315
    DOI 10.1136/bmjquality.u203210.w1957
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: The Handbook: an end to 'I wish I had known that before I started'.

    Davies, Mike / Panchal, Sonia / Misra, Nikhil

    BMJ quality improvement reports

    2015  Volume 4, Issue 1

    Abstract: The importance of an effective handover between clinicians is vital, particularly for junior doctors when commencing a new clinical rotation. When junior doctors commence a new rotation there is often a significant amount of new information and tasks ... ...

    Abstract The importance of an effective handover between clinicians is vital, particularly for junior doctors when commencing a new clinical rotation. When junior doctors commence a new rotation there is often a significant amount of new information and tasks that they must learn, whilst also maintaining a high level of care for patients. However, very little information is formally passed from the outgoing junior doctor to the incoming junior doctor when changing rotations, resulting in a gap in knowledge and information having to be relearned by each junior doctor for each ward. Through a junior doctor led service improvement initiative we created an intranet-based, updateable, easily accessible, and secure resource to assist junior doctors during this transition period. Our project was not only beneficial to junior doctors when starting on a new rotation but also helped them understand their role within the ward environment and become more efficient in their clinical work. The project is an example of a sustainable service improvement project implemented with no cost that due to its format and low maintenance, could be easily adapted on a wider scale in other hospitals or Trusts.
    Language English
    Publishing date 2015-03-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2677829-4
    ISSN 2050-1315
    ISSN 2050-1315
    DOI 10.1136/bmjquality.u203210.w1579
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Confusion: delirium and dementia - a smartphone app to improve cognitive assessment.

    Sangha, Selina / George, J / Winthrop, Craig / Panchal, Sonia

    BMJ quality improvement reports

    2015  Volume 4, Issue 1

    Abstract: Older patients with dementia and delirium are more prone to adverse events in hospital, but formal cognitive assessment to identify these vulnerable patients on admission is often not carried out by junior doctors. A smartphone app was created and ... ...

    Abstract Older patients with dementia and delirium are more prone to adverse events in hospital, but formal cognitive assessment to identify these vulnerable patients on admission is often not carried out by junior doctors. A smartphone app was created and provided on hospital wards to facilitate the use of standard cognitive assessments for delirium and dementia. Before the introduction of the app, 36% of patients over 75 years old were assessed cognitively. After the app, the percentage of cognitive assessments improved to 63%. Improvements in cognitive assessments were most marked after individual teaching of the doctors on the wards in the use of the app and on making the app available on the ward tablets. The results of the study suggest that the introduction of a smartphone app for junior doctors can improve performance in cognitive assessment of older people.
    Language English
    Publishing date 2015-01-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2677829-4
    ISSN 2050-1315
    ISSN 2050-1315
    DOI 10.1136/bmjquality.u202580.w1592
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: British Society of Rheumatology guideline working group response to European Medicines Agency safety update on Hydroxychloroquine.

    Russell, Mark D / Dey, Mrinalini / Flint, Julia / Davie, Philippa / Allen, Alexander / Crossley, Amy / Frishman, Margreta / Gayed, Mary / Hodson, Kenneth / Khamashta, Munther / Moore, Louise / Panchal, Sonia / Piper, Madeleine / Reid, Clare / Saxby, Katherine / Schreiber, Karen / Senvar, Naz / Tosounidou, Sofia / van de Venne, Maud /
    Warburton, Louise / Williams, David / Yee, Chee-Seng / Gordon, Caroline / Giles, Ian

    Rheumatology (Oxford, England)

    2023  Volume 63, Issue 2, Page(s) e37–e38

    MeSH term(s) Humans ; Hydroxychloroquine/adverse effects ; Rheumatology
    Chemical Substances Hydroxychloroquine (4QWG6N8QKH)
    Language English
    Publishing date 2023-07-29
    Publishing country England
    Document type Letter
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/kead384
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: comorbidity medications used in rheumatology practice.

    Schreiber, Karen / Frishman, Margreta / Russell, Mark D / Dey, Mrinalini / Flint, Julia / Allen, Alexander / Crossley, Amy / Gayed, Mary / Hodson, Kenneth / Khamashta, Munther / Moore, Louise / Panchal, Sonia / Piper, Madeleine / Reid, Clare / Saxby, Katherine / Senvar, Naz / Tosounidou, Sofia / van de Venne, Maud / Warburton, Louise /
    Williams, David / Yee, Chee-Seng / Gordon, Caroline / Giles, Ian

    Rheumatology (Oxford, England)

    2023  Volume 62, Issue 4, Page(s) e89–e104

    MeSH term(s) Pregnancy ; Female ; Humans ; Rheumatology ; Breast Feeding ; Rheumatic Diseases/drug therapy ; Antirheumatic Agents/therapeutic use ; Comorbidity
    Chemical Substances Antirheumatic Agents
    Language English
    Publishing date 2023-04-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/keac552
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Catch me if you can: a national survey of rheumatologists and obstetricians on the use of DMARDs during pregnancy.

    Panchal, Sonia / Khare, Manjiri / Moorthy, Arumugam / Samanta, Ash

    Rheumatology international

    2012  Volume 33, Issue 2, Page(s) 347–353

    Abstract: The use of disease-modifying anti-rheumatic drugs and biological therapy is variable throughout pregnancy. This questionnaire-based study was undertaken to explore and compare the current practice amongst rheumatologists and obstetricians across the UK, ... ...

    Abstract The use of disease-modifying anti-rheumatic drugs and biological therapy is variable throughout pregnancy. This questionnaire-based study was undertaken to explore and compare the current practice amongst rheumatologists and obstetricians across the UK, regarding the use of drugs during pregnancy. A questionnaire was devised to address issues regarding individual drugs used during preconception, pregnancy and lactation. Members of the British Society of Rheumatology, Midlands Rheumatology Society and the British Maternal Fetal Medicine Society were emailed. Results were analysed by the online survey software and Fisher's exact testing. Our results show differences between rheumatologists and obstetricians. A total of 500 members of each society were emailed. There were 102 (20 %) versus 33 (7 %) respondents. With regard to medication, in relation to advice given before conception, hydroxychloroquine 80 versus 61 % continue, 19 versus 15 % discontinue (p = 1.0); sulphasalazine 59 versus 70 % continue, 41 versus 6 % discontinue (p = 0.002); azathioprine 62 versus 58 % continue, 36 versus 21 % discontinue (p = 0.37); methotrexate 0 versus 3 % continue, 100 versus 76 % discontinue (p = 0.2); leflunomide 0 versus 0 % continue, 98 versus 42 % discontinue (p = 1.0); anti-TNF therapy 7 versus 15 % continue, 54 versus 54 % discontinue (p = 0.05); and rituximab 2 versus 12 % continue, 95 versus 52 % (p = 0.01) would discontinue prior to conception. This survey is the first of its nature amongst rheumatologists and obstetricians. Most would give advice to continue with sulphasalazine, azathioprine and stop methotrexate and leflunomide. We observed no uniform practice and therefore recommend guidelines.
    MeSH term(s) Antirheumatic Agents/therapeutic use ; Counseling ; Drug Utilization ; Female ; Humans ; Obstetrics ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy Complications/drug therapy ; Rheumatology ; Surveys and Questionnaires
    Chemical Substances Antirheumatic Agents
    Language English
    Publishing date 2012-03-27
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 8286-7
    ISSN 1437-160X ; 0172-8172
    ISSN (online) 1437-160X
    ISSN 0172-8172
    DOI 10.1007/s00296-012-2418-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids.

    Russell, Mark D / Dey, Mrinalini / Flint, Julia / Davie, Philippa / Allen, Alexander / Crossley, Amy / Frishman, Margreta / Gayed, Mary / Hodson, Kenneth / Khamashta, Munther / Moore, Louise / Panchal, Sonia / Piper, Madeleine / Reid, Clare / Saxby, Katherine / Schreiber, Karen / Senvar, Naz / Tosounidou, Sofia / van de Venne, Maud /
    Warburton, Louise / Williams, David / Yee, Chee-Seng / Gordon, Caroline / Giles, Ian

    Rheumatology (Oxford, England)

    2022  Volume 62, Issue 4, Page(s) e48–e88

    MeSH term(s) Pregnancy ; Female ; Humans ; Rheumatology ; Breast Feeding ; Immunomodulating Agents ; Antirheumatic Agents/therapeutic use ; Rheumatic Diseases/drug therapy ; Adrenal Cortex Hormones/therapeutic use
    Chemical Substances Immunomodulating Agents ; Antirheumatic Agents ; Adrenal Cortex Hormones
    Language English
    Publishing date 2022-10-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/keac551
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Prescribing anti-rheumatic drugs in pregnancy and breastfeeding-the British Society for Rheumatology guideline scope.

    Giles, Ian / Allen, Alexander / Crossley, Amy / Flint, Julia / Frishman, Margreta / Gayed, Mary / Kamashta, Munther / Moore, Louise / Panchal, Sonia / Piper, Madeline / Reid, Clare / Saxby, Katherine / Schreiber, Karen / Senvar, Naz / Tosounidou, Sofia / van de Venne, Maud / Warburton, Louise / Wiliams, David / Yee, Chee-Seng /
    Gordon, Caroline

    Rheumatology (Oxford, England)

    2022  Volume 60, Issue 8, Page(s) 3565–3569

    MeSH term(s) Antirheumatic Agents/therapeutic use ; Breast Feeding ; Female ; Humans ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy Complications/drug therapy
    Chemical Substances Antirheumatic Agents
    Language English
    Publishing date 2022-08-04
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/keab334
    Database MEDical Literature Analysis and Retrieval System OnLINE

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