“Oxygen Pheriwala: ” An Innovative Model for SARS-CoV-2 Screening in Resource-Limited Settings

The second wave of SARS?CoV?2 infection came as a hypoxic emergency and situation became worse in rural India, where undiagnosed COVID-19 patients died without any diagnosis or intervention. The primary aim of this innovative model was the early diagnosis of suspected SARS?CoV?2 cases, providing empirical treatment and timely referral to appropriate COVID care facilities. Fever was measured with infrared thermometer and oxygen saturation level with pulse oximeter. A total of 8203 people were screened, of which 274 persons were febrile and 69 (25%) were hypoxic too. Sixty?four out of 69 (93%) patients turned COVID?19 positive on reverse transcription?polymerase chain reaction. At the end of 3 weeks, 48/64 (75%) patients were successfully discharged. This model can be easily implemented in resource?limited regions to identify and prioritize the patients not only in this pandemic but also in outbreak of other communicable diseases.

A clinico-epidemiological, pathological, and molecular study of lung cancer in Northwestern India

Introduction: Lung cancer is the most common malignant disease and is the topmost cause of cancer deaths in the world across all age groups and in both sexes. It is the most common cause of cancer deaths in developed countries and is also rising at an alarming rate in the developing countries. Objective: The present study was undertaken to explore the clinicopathological and molecular profile of bronchogenic carcinoma in northwestern population of India. Materials and Methods: A total of 136 consecutive patients with histologically proven bronchogenic carcinoma, registered between May 2014 and April 2016 at a tertiary care hospital in New Delhi, India, were analyzed. Results: Out of a total of 136 diagnosed cases, 6% were in the third to fourth decade of life, 49% in the fifth to sixth decade, and 45% in the seventh decade and above. Seventy-one percent of patients were male. Smoking was the major risk factor in 65.40% of patients. About 33% of female patients were smokers with a significant overlap in the use of smoking objects. Twenty-one percent of patients had been initially empirically treated with antitubercular therapy. Most common symptoms at presentation were cough, dyspnea, weight loss, and chest pain. Pleural effusion, paraneoplastic phenomenon, clubbing, peripheral lymphadenopathy, and Pancoast syndrome were the major signs at presentation. Twenty-one percent of nonsmokers and 40% of smoker patients presented with ECOG Performance Status 3 or 4. Ninety-three percent of patients presented in stage III or IV. Metastases to skeleton, brain, liver, pleura, adrenals, lung, and distant lymph nodes were present in 30.8%, 16.9%, 15.4%, 15.4%, 14.7%, 13.2%, and 11.8%, respectively. Fiberoptic bronchoscopy was found to be the most efficient diagnostic procedure as compared to transthoracic and thoracoscopic methods. Histologically, squamous cell carcinoma, adenocarcinoma, and small cell carcinoma and its variants were seen in 35.30%, 44.9%, and 15.40% cases, respectively. Nearly 4.4% of patients were diagnosed as poorly differentiated carcinoma. Driver mutations (epidermal growth factor receptor or anaplastic lymphoma kinase) were detected in 48% (25 of 52 tested) of adenocarcinomas and 55.55% (5 of 9 tested) of young, nonsmoker, female squamous cell carcinoma patients. Conclusion: This study highlights that the adenocarcinoma incidence is surpassing squamous cell carcinoma in Indian lung cancer patients also, as observed in Western population. Mean age at diagnosis is about one decade earlier than in the Western population. Driver mutations are more common in India than in the West as also reported in other Asian studies

Clinical Correlates of Patients Attempting Suicide in North India: A Hospital based Retrospective Study.

Introuduction: Suicide has become one of major challenginghealth problem in developing country like India. It is oneof the leading causes of mortality in young adults. There iscomplex interplay of multiple factors influencing the outcomeof suicide. Additionally, there is significant variability inprevalence and pattern of suicide attempts across differentparts of India. Study aimed to assess the sociodemographicand clinical profile of patients attempting suicide.Material and Methods: The study included retrospective filereview of around 150 survivors of suicide attempts registeredover a period of 1 Year (July 2016 to July 2017) at UttarPradesh University of Medical Sciences (UPUMS), Saifai,Etawah. These patients were referred from emergency andmedicine department for psychiatric assessment.Results: Most of the survivors were of female gender(72%), most common mode of attempt was by ingestion ofpesticides (82%), followed by overdose of medications (9%),and followed by hanging (8%). Psychiatric morbidity wasdiagnosed in 70% of the cases. Most common diagnosis wasadjustment disorders and mood disorders.Conclusions: This study reiterated the fact that majorityof suicide attempts were carried out by young females,predominantly by poisoning and overwhelming number ofsuch patients had underlying psychiatric morbidity

Expression of Interleukin-1 Alpha and Interleukin-6 Expression in Keratocystic Odontogenic Tumors and Ameloblastomas

Both Ameloblastomas and odontogenic keratocysts share many clinical features in common such as local aggressiveness, high recurrence rates and radical management options. Understanding the pathogenesis and biological behavior of these would improve our success at diagnosis and treatment. Despite efforts focused on understanding the pathogenesis of these lesions still little is known about them. AIM: To evaluate the expression of IL-1α and IL-6 by immunohistochemistry in ameloblastomas and KCOTs and correlate their expression with with their increase in size and extent of bone destruction. Methods: A total of 25 cases of ameloblastomas and 25 cases of keratocystic odontogenic tumors were included in the study. All histological slides were stained immunohistochemically to show the expression of IL-1α and IL-6. Results: Immunohistochemical expressions of IL-1α and IL-6 in ameloblastoma was observed in only stellate reticulum-like cells While in KCOT the immonohistochemical expression of both the antibodies in comparision to ameloblastoma was observed only in the lining epithelial cells. The higher expression rates of IL-1α and IL-6 were associated with increases in tumor size in ameloblastomas and connective tissue cyst wall thickness in keratocystic odontogenic tumors. Conclusion: The higher expression rates of IL-1α and IL-6 were associated with increased tumor size in ameloblastomas and with connective tissue cyst wall thickness in KCOT. Thus we can suggest that the cytokines play a role on aggressive behaviour of ameloblastomas and keratocystic odontogenic tumors by facilitating increased bone resorption.