Mental Health in Non-Oncologic Urology Patients.

This article is a literature review of mental health concerns in non-oncologic urology patients. Pathologies represented in this review include Peyronie's Disease (PD), erectile dysfunction (ED), urinary incontinence and urinary tract infections (UTI), infertility, benign prostatic hyperplasia (BPH), kidney stones, and urinary retention. While there has been great interventional focus as of late for urogenitary malignancies (i.e. prostate cancer awareness with the Movember campaign), literature studies and intervention focused on non-oncologic urology patients has been limited. As such, we conducted a review on urology patients with non-oncologic pathologies as an effort to increase clinician awareness of mental health concerns among such patients, increase the comfort level for clinician communication on socially sensitive topics surrounding pathologies, and review ongoing interventions conducted within these pathologies. We outlined different ongoing Mental Health Illness (MHI) needs and treatments for various pathologies. Patients with non-cancerous urologic pathologies had lower quality of life and higher incidence of MHI than the general population. As such, in line with the American Urological Association recommendations, psychological and social support from peers, therapists, and healthcare providers further prove to be crucial for some subpopulations. The review also yielded pathology specific interventions such as group therapy for ED patients. Given the higher incidence of MHI in the patient population after the Covid-19 pandemic, MHI awareness in the sphere of non-oncologic urology treatment continues to be crucial when creating a collaborative treatment platform for patients.

Modelling supply chain viability during COVID-19 disruption: A case of an Indian automobile manufacturing supply chain

In recent years, supply chains seem to be moving more towards reconfiguring their networks to become more profitable. In the times of COVID-19, where the whole supply chains have been disrupted, suppliers are unable to supply, and manufacturers are unable to manufacture because of lockdowns in the various regions around the world. This pandemic can be compared to past earthquakes and tsunamis, as the coronavirus is also a natural disaster. Due to these past disruptions, organizations have taken many precautions and developed risk mitigation strategies to manage them. Because the COVID-19 outbreak shows the importance of new business perspectives like repurposing a viability strategy, that comes with sustainability and reconfigurability. Where reconfiguration focuses on adaptation, which directly means changes in resources and capabilities and repurposing focuses on a quick response solution to address the shortage. In this paper, a study has been done in two phases to model viability in an automobile supply chain during the COVID-19 times. In the first phase, a hybrid Multi-criteria Decision Making (MCDM) approach is used to get the best criteria and alternatives with sustainability and reconfigurability under consideration. The multi-objective mixed-integer linear programming (MOMILP) model has been developed in the second phase. Suppliers' weight that is obtained will be used to get the optimal order and allocation. This model will help develop supply chain strategies to cope with situations that hinder the firm's competitiveness. A case study of an Indian automobile manufacturer has been taken to show the applicability and effectiveness of the proposed methodology using GAMS/CPLEX solver.

Statin and aspirin as adjuvant therapy in hospitalised patients with SARS-CoV-2 infection: a randomised clinical trial (RESIST trial).

BACKGROUND: Statins and aspirin have been proposed for treatment of COVID-19 because of their anti-inflammatory and anti-thrombotic properties. Several observational studies have shown favourable results. There is a need for a randomised controlled trial. METHODS: In this single-center, open-label, randomised controlled trial, 900 RT-PCR positive COVID-19 patients requiring hospitalisation, were randomly assigned to receive either atorvastatin 40 mg (Group A, n = 224), aspirin 75 mg (Group B, n = 225), or both (Group C, n = 225) in addition to standard of care for 10 days or until discharge whichever was earlier or only standard of care (Group D, n = 226). The primary outcome variable was clinical deterioration to WHO Ordinal Scale for Clinical Improvement ≥ 6. The secondary outcome was change in serum C-reactive protein, interleukin-6, and troponin I. RESULTS: The primary outcome occurred in 25 (2.8%) patients: 7 (3.2%) in Group A, 3 (1.4%) in Group B, 8 (3.6%) in Group C, and 7 (3.2%) in Group D. There was no difference in primary outcome across the study groups (P = 0.463). Comparison of all patients who received atorvastatin or aspirin with the control group (Group D) also did not show any benefit [Atorvastatin: HR 1.0 (95% CI 0.41-2.46) P = 0.99; Aspirin: HR 0.7 (95% CI 0.27-1.81) P = 0.46]. The secondary outcomes revealed lower serum interleukin-6 levels among patients in Groups B and C. There was no excess of adverse events. CONCLUSIONS: Among patients admitted with mild to moderate COVID-19 infection, additional treatment with aspirin, atorvastatin, or a combination of the two does not prevent clinical deterioration. Trial Registry Number CTRI/2020/07/026791 ( http://ctri.nic.in ; registered on 25/07/2020).

Idiopathic brachial plexopathy after pacemaker implant.

A middle-aged woman presented with symptomatic complete heart block and underwent an uneventful dual chamber pacemaker implantation. Three weeks post procedure, she developed left arm pain and weakness, with neurological localization to the lower trunk of left brachial plexus. Possibilities of traumatic compression by the device/leads or postoperative idiopathic brachial plexopathy were considered. After ruling out traumatic causes, she was started on oral steroids, to which she responded remarkably. This case highlights the importance of recognizing this rare cause of brachial plexopathy following pacemaker implantation, because not only does an expedited diagnosis and medical treatment lead to prompt recovery with minimal neurological deficits, but it also circumvents an unnecessary surgical re-exploration.

Outcome of Pulmonary Hypertension in Pregnancy in Contemporary Era: A Case-Based Narrative Review

A 35-year-old female presented to us with a history of exertional dyspnea from the last 20 years and low oxygen saturation noticed from last 1 month during her COVID-19-related illness. The patient did not seek medical attention over these years as the degree of limitation of physical activity was modest. She had a bad obstetric history: five second trimester pregnancy losses and one early neonatal death. Her symptoms were worse during pregnancy and improved thereafter. Physical examination was notable of cyanosis and features of pulmonary hypertension (PH). Echocardiography was suggestive of double outlet right ventricle, large subaortic ventricular septal defect with bidirectional shunt, and severe PH. This case highlights a variable clinical outcome of Eisenmenger syndrome in pregnancy. We did a literature review for studies reporting the outcomes of PH in pregnancy. The overall mortality rates seem to have declined dramatically from as high as 56% reported in studies in the 1990s to < 5% in more contemporary studies. The common adverse obstetric outcomes include prematurity and growth restriction. [ABSTRACT FROM AUTHOR] Copyright of Journal of the Practice of Cardiovascular Sciences is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)