Sumedha Arya

• MD
• University of Toronto

Background and Objectives By optimizing erythropoiesis, patient blood management (PBM) programmes can reduce transfusions, lower mortality and provide cost‐effective care. While definitions of anaemia have historically varied by sex, for the purposes of PBM, anaemia is defined as a haemoglobin <130 g/L. Our objective was to describe whether periope...

The aim of this study was to describe the impact of marginalization on DLBCL overall survival (OS) within the Canadian setting. We conducted a population-based retrospective cohort study of adult patients with newly diagnosed DLBCL in Ontario between 1 January 2005 and 31 December 2017 receiving a rituximab-containing chemotherapy regimen with cura...

Background Autologous hematopoietic stem cell transplants (ASCT) are potentially life-saving interventions used to treat hematologic disorders. However, it is unclear if socioeconomic disparities impact the patient benefit from ASCT. Recent evidence suggests lower rates of ASCT for patients living in rural settings and for ethnic minority groups. F...

Background Allogeneic hematopoietic stem cell transplants (allo-SCT) are potentially life-saving interventions used to treat hematologic disorders. Recent studies have shown that living in rural areas may predict worse outcomes after allo-SCT. Marginalization, a term that encompasses social and health-related factors affecting individuals, is predi...

Background: While mental disorders have been reported in patients with diffuse large B-cell lymphoma (DLBCL), studies examining their association with mortality are lacking. Methods: We conducted a population-based study using linked administrative healthcare databases from Ontario, Canada. All patients with DLBCL aged ≥18 years treated with rit...

Background: Patient blood management (PBM) programs are effective at reducing transfusion-associated mortality and morbidity; however, patient engagement within the realm of PBM remains relatively unstudied. Our objectives were to develop a novel educational tool utilizing animation to educate preoperative patients about anemia and to evaluate the...

Von Willebrand disease (VWD), the most common inherited bleeding disorder (IBD), disproportionately affects females, given the hemostatic challenges they may encounter throughout their lifetimes. Despite this, research about VWD remains grossly underrepresented, particularly compared to hemophilia, which is historically diagnosed in males. Structur...

Guillain-Barré syndrome (GBS) is a rare condition caused by autoimmune damage of peripheral nerves. We describe a case where a man in his 80s presented with subacute, progressive fatigue and weakness. He had received an outpatient work-up for possible haematological malignancy, but eventually presented to the emergency department for worsening weak...

Fat embolism syndrome (FES) is a rare condition that can occur as a complication of sickle cell disease. We describe a case of a patient with sickle cell disease (homozygous Hb S or HBB: c.20A>T) presenting with initial signs and symptoms consistent with a vaso-occlusive crisis (VOC). Within 24 hours, the patient developed evidence of coagulopathy,...

Introduction While prior studies suggest that mental health complications are underdiagnosed and undertreated in patients with cancer, a paucity of data exists for patients with diffuse large B-cell lymphoma (DLBCL). Indeed, mental illness can impact the success of potentially curative treatment for DLBCL including delays in treatment initiation, p...

Introduction: While health disparities in diffuse large B-cell lymphoma (DLBCL) have been previously noted, literature systematically describing the impact of social determinants of health (SDOH) on DLBCL overall survival (OS) is sparse. Furthermore, existing data largely examine SDOH of health in isolation, not accounting for key covariates or dis...

Introduction Guidelines of the World Federation of Hemophilia support the provision of equitable, optimal care for people with hemophilia (PWH). However, limited research exists examining the lived experiences of PWH, or the barriers to care they may encounter. The primary objective of this exploratory study was to describe the experiences of men w...

Introduction Women with inherited bleeding disorders experience excessive bleeding that may impair their quality of life, making early diagnosis and treatment critical. However, the experiences of these women regarding access to care has been minimally described. The primary objective of this study was to evaluate and describe barriers to care for...

Introduction: Despite the many symptoms that women with inherited bleeding disorders experience, no study has specifically sought to explore and understand the lived experiences of these women, nor the barriers to care that they may encounter. The primary objective of this study was to describe the lived experiences of women with inherited bleedin...

Introduction The ways in which social determinants of health affect patients with inherited bleeding disorders remains unclear. The objective of this study was to understand healthcare provider perspectives regarding access to care and diagnostic delay amongst this patient population. Methods A healthcare provider survey comprising 24 questions wa...

Introduction: The literature surrounding inequity in healthcare is robust, with factors such as socioeconomic status (SES), race, immigration status, and geographic access being extensively documented as influencers of both healthcare access and healthcare outcomes. However, the ways in which social determinants of health (SDOH) affect patients wit...

Introduction: Despite the manifold symptoms that women with inherited bleeding disorders may experience, no study has specifically sought to understand the lived experiences of these women, nor the barriers to care that they may face. Indeed, the literature on this topic remains sparse. A MEDLINE search assessing literature on access to care for wo...

Introduction: Despite the manifold symptoms women with inherited bleeding disorders experience, whether they receive timely screening and specialist referral remains unclear. While literature on this topic is sparse, studies have found that, irrespective of the hemostatic challenges women face, they are often unlikely to be referred to hematologist...

Introduction The Lancet Commission on Global Surgery proposed the perioperative mortality rate (POMR) as one of the six key indicators of the strength of a country’s surgical system. Despite its widespread use in high-income settings, few studies have described procedure-specific POMR across low-income and middle-income countries (LMICs). We aimed...

Aims: Dysregulation of arginine metabolism, as evidenced by increased circulating levels of asymmetric dimethylarginine (ADMA), has been proposed as an early event in the natural history of cardiovascular disease. Since the diagnosis of gestational diabetes mellitus (GDM) identifies a patient population at increased future risk of cardiovascular d...

Study design: Cross-sectional, questionnaire-based study. Objectives: To test the hypothesis that self-perceived functional impairment and religiosity/spirituality (S/R) predict depression among traumatic spinal cord injury (SCI) patients in Sri Lanka. Setting: Ragama Rheumatology and Rehabilitation Hospital, Ragama, Sri Lanka. Methods: The...

Access to surgery remains inequitable worldwide with 5 billion people lacking safe and affordable surgical and anaesthesia care when needed. The Lancet Commission on Global Surgery was convened in 2013 to assess the state of surgery around the world provide recommendations for improving access and propose indicators for assessing national surgical...

Background: Charitable organizations may play a significant role in the delivery of surgical care in low- and middle-income countries (LMICs). However, in order to quantify their collective contribution, to account for the care they provide in national surgical plans, and to maximize coordination between organizations, a comprehensive database of...

Purpose: Psychosocial consequences of traumatic spinal cord injury (SCI) have been well documented in Western populations, but there is no published literature on such incidence in the Sri Lankan population. The purpose of this study was to explore the psychosocial impact of SCI in a Sri Lankan population and to examine this population's coping me...

I reek of salt water: the breath of the Indian Ocean lingers on my tanned skin and sweat trickles down my back, my legs, my nose. A bony elbow juts into my ribs and a stranger’s hand rests familiarly on my shoulder while another calloused hand overlaps my own on a sticky, metallic surface: an ordinary train pole suddenly transformed into a quasi-ar...

In the face of staggering global unmet need for surgical care, non-governmental organisations (NGOs) play a substantial part in the surgical workforce, providing surgical care for those who are without it. The number of NGOs providing surgical care in low-income and middle-income countries (LMICs) is unknown. This information is needed to determine...

Stress is known to contribute to overall health status. Many individuals in sub-Saharan Africa are believed to be stressed about their employment, income, and health. This study aimed to investigate hair cortisol as a biomarker of chronic stress in settlement communities in Kenya. Hair samples were collected from 108 volunteers from settlement comm...