Rucabarib: A new lease of life for ovarian cancer patients.

BACKGROUND: Rucaparib is a drug with potential as maintenence monotherapy in ovarian cancers irrespective of genetic mutation. METHODS: The results of the ARIEL 3 trial were analysed for the drug's prospects towards cure in ovarian and other pelvic malignancies. RESULTS: Ovarian cancer patients with highly malignant tumors and relapses on platinum based chemotherapy exhibited statistically significant reductions in tumor size with maintenance Rucaparib therapy vis a vis placebo. CONCLUSION: Genetic heterogeneity of the tumor did not have an impact upon Rucaparib efficacy in ovarian carcinoma. More malignant and relapsed variants can effectively be treated with Rucaparib, thereby improving survival rates and quality of life.

Personality traits as a predictor of emotional intelligence among medical students.

INTRODUCTION: Emotional intelligence (EI) is the ability to understand and manage our own feelings and of others. It has emerged as one of the vital elements of success and interpersonal relations in everyday life. There are individual differences of EI depending on characteristics and behaviors of an individual, which determines their personality. AIMS AND OBJECTIVES: The present study assesses the EI and personality traits of medical students and determines the relationship of EI with personality traits of the medical students. MATERIALS AND METHODS: This was a cross-sectional study and was conducted among students of a government medical college, located in New Delhi. A total of 210 participants were included in the study. After obtaining written informed consent from all participants, a questionnaire consisting of demographic information, Ten-Item Personality Inventory and Schutte EI Scale, was administered. The means and proportions were calculated. Chi-square test and Pearson's correlation test were used to test significance. P < 0.05 was considered statistically significant. RESULTS: The mean (standard deviation) age of the study participants was 21.54 (±1.98) years. The majority (65.7%) of the students were male. 51% of the students had moderate EI, and high EI was seen in 49% of the students. A positive and significant relationship between personality traits and EI was found in the study. CONCLUSION: Personality traits and EI are related to one another and could influence student academic achievement. Since EI influences academic performance so personality trait assessment and empathic perceptions exploration can facilitate to aid the academic performance of the students.

Gender-based violence in New Delhi, India: forecast based on secondary data analysis.

BACKGROUND: Violence against women is a global phenomenon. AIMS: To estimate and forecast cognizable crime against women in New Delhi, India, from 2016 to 2020. METHODS: Reported cognizable crime against women in New Delhi for 2009-2015 was extracted for statistical analysis, synthesis and modelling. The cognizable crimes reported are rape, attempt to commit rape, kidnapping and abduction, dowry deaths, assault on women with intent to outrage her modesty, insult to modesty of women, cruelty by husband or his relative, importation of girls from foreign countries, abetment of suicide of women and indecent representation of women. RESULTS: The actual number of registered cases of crime against women ranged from 4251 (2009) to 17 104 (2015). The projected number of cases ranged between 18 991 [95% confidence interval (CI): 13 092-24 889) in 2016 to 28 663 (95% CI: 22 314-35 013)] in 2020. A rising trend in crime against women was noticed in New Delhi, ranging from 204.6 (2016) to 308.8 (2020) per 100 000 women. After witnessing a substantive increase (116.2%) in reported crime against women in New Delhi in 2013, the subsequent actual and projected rise appears to be incremental in nature, with an annual percentage point change ranging between 9% and 18%. CONCLUSION: Within limitations, it is concluded that the safety of women will continue to be a concern in the near future.

Primary acquired gastric outlet obstruction in children: A retrospective single center study.

BACKGROUND/ PURPOSE: Idiopathic hypertrophic pyloric stenosis is by far the most common cause of gastric outlet obstruction (GOO) in young infants, with more than 90% of cases presenting between 3 and 10 weeks after birth. While cases of late onset pyloric stenosis beyond infancy have been reported, the etiology is poorly understood. We report our experience of 5 cases, describing the similarities and differences in management of our patient population which happens to be the second largest reported in literature. METHODS: From July 2014 to June 2018 (4 years) a total of five patients of primary acquired GOO were encountered at our center. RESULTS: The age range was 3 to 6 years and only one of them was a female. All presented with characteristic nonbilious vomiting that was recurrent and episodic. Upper GI (gastrointestinal) contrast study series revealed a dilated stomach and delayed gastric emptying. Upper GI endoscopy also demonstrated a dilated stomach without any intraluminal polyp, ulcer or any other pathology. Intraoperatively the pylorus had no evidence of scarring, inflammation, external compression or any mass in and around the pylorus. A retrocolic gastrojejunostomy was curative in all patients. CONCLUSION: Though rare, one must maintain a high index of suspicion for primary acquired GOO in the differential diagnosis of older children with nonbilious vomiting and failure to thrive. Following appropriate diagnostic workup, surgical interventions should be performed expeditiously because adequate nutrition is key to proper physical and mental development of the child. Further research will hopefully elucidate the underlying pathophysiology in order to guide clinical options for both prevention and treatment. TYPE OF STUDY: Retrospective single center study. LEVEL OF EVIDENCE: Level 4.

Organ donation in India: Scarcity in abundance.

In modern era, India witnessed its first successful corneal, kidney and cardiac transplant in the year 1960, 1967 and 1994 though the reverberations for organ donation and transplantation (ODT) existed since time-memorial with roots existing in Hindu mythology along with vivid example of Guru Dadheech and lord Ganesha. No country in the world is able to meets its organ requirement. Government of India promulgated Transplantation of Human Organ and Tissues Act in 1994 and with the view to enlarge its scope and promote organ donation government has brought new amendments as of year 2014 and 2017. In the background of this journey many new developmental milestones have been achieved in the country however organ donation which has assumed public health significance has been consistently lower than expectations. This manuscript highlights the current status of ODT in the country; legislative environment, limitations, challenges, health education activities, and newer initiatives.

Hemorrhagic pleural effusion due to pseudo-pancreatic cyst.

Hemorrhagic pleural effusion is a common clinical entity still diagnosis is often missed. An unusual and often over-looked cause of pleural effusion is an intra-abdominal process including complication arising due to pancreatitis. We report a rare case of massive left sided hemorrhagic pleural effusion in a patient due to pancreatic pathology.

Hypertension in Pregnancy: A Community-Based Study.

BACKGROUND: Hypertensive disorders during pregnancy occur in women with preexisting primary or secondary chronic hypertension, and in women who develop new-onset hypertension in the second half of pregnancy. The present study was undertaken to study the prevalence and correlates of hypertension in pregnancy in a rural block of Haryana. MATERIALS AND METHODS: This cross-sectional study was carried out in the all 20 subcenters under Community Health Center (CHC) Chiri, Block Lakhanmajra. All the pregnant women registered at the particular subcenter at a point of time of visit were included in the study. Appropriate statistical tests were used for analysis. RESULTS: A total of 931 pregnant women were included in the present study. Prevalence of hypertension in pregnancy was found to be 6.9%. Maternal age ≥25 years, gestational period ≤20 weeks, history of cesarean section, history of preterm delivery, and history of hypertension in previous pregnancy were found to be significantly associated with prevalence of hypertension in pregnancy. CONCLUSION: Nearly one in 14 pregnant women in rural areas of Haryana suffers from a hypertensive disorder of pregnancy. Early diagnosis and treatment through regular antenatal checkup is a key factor to prevent hypertensive disorders of pregnancy and its complications.

Level of motivation amongst health personnel working in a tertiary care government hospital of new delhi, India.

AIMS: To assess the level and factors of motivation amongst permanent government employees working in a tertiary health care institution. MATERIAL AND METHODS: A sample of 200 health personnel (50 in each category) i.e. doctors, nurses, technician, and support staff were contacted through face to face interview. Motivation was measured as the degree to which an individual possessed various identified motivation domains like Drive, Control, Challenge, Relationship and Rewards. Each domain was represented by 4 dimensions- accordingly a closed-ended statement represented each of these dimensions and responses were assessed on a Likert based scale. Data management was done using SPSS, ver. 19. RESULTS: THE AVERAGE AGE FOR DIFFERENT HEALTH PERSONNEL WERE: Doctors 48.68 (±8.53), nurses 40.72 (±7.76), technician 38.4 (±10.65) and support staff 43.24 (±9.52) years. The average year of work experience was: Doctor 19.09 (±9.77), nurses 17.2 (±8.420), technician 14.84 (±10.45), support staff 18.24 (±10.28). A comparison of overall motivation index (mean score) revealed that nurse had highest level (3.47), followed by support staff (3.46), doctor (3.45) and technician (3.43). Based on their individual mean scores, the healthcare providers were categorised into three different levels of motivation and it was found that majority of the health personnel i.e.70% of support staff, 62% nurse, 56% doctor and technician, had high to very high level of motivation index. The mean scores for all the five factors as well as their respective ranks were also found out and it was deduced that "relationship" assumed first rank for doctors (mean score: 3.71) and technician (mean score: 3.75), whereas "control" assumed greatest significance for nurses (mean score, 3.62) and support staff (mean scores, 3.61). Based upon the mean scores, "reward" assumed third rank among all the four categories. Kruskal-Wallis test was applied to test if the different categories of health personnel varied with respect to five factors of motivation and it was found that their orientation towards the various motivational components differed significantly only with respect to Drive (P < 0.01). CONCLUSION: There is scope for enhancing staff motivation.

Gross congenital malformation at birth in a government hospital.

A hospital-based cross-sectional study was undertaken to determine proportion of gross congenital malformation (GCMF) occurring at intramural births. Rate of GCMF was found to be 16.4/1000 consecutive singleton births (>28 weeks) with three leading malformation as anencephaly (44.68%), talipes equinovarus (17.02%) and meningomyelocele (10.63%). Higher risk of malformed births were noticed amongst un-booked (2.07%) in-comparison to booked (1.01%) mothers; women with low level of education (up to 8 years [2.14%] vs. at least 9 years of schooling [0.82%]); gravida status of at least 3 (2.69%) followed by 1 (1.43%) and 2 (1.0%) respectively; pre-term (5.13%) vs. term (0.66%); cesarean section (4.36%) versus vaginal delivery (0.62%). Mortality was significantly higher among congenitally malformed (17.35%) than normal (0.34%) newborns. With-in study limitation, emergence of neural tube defect as the single largest category of congenital malformation indicates maternal malnutrition (especially folic acid) that needs appropriate attention and management.

Birth audit.

OBJECTIVE: To describe profile of births occurring in teaching institution on selected parameters. MATERIALS AND METHODS: Considering feasibility, four months were systematically chosen for two-year time frame over a decade to gather selected information of consecutive singleton intramural births from log books of labor room on structured pro-forma. Data management was done using software package and analysis carried out by computing descriptive statistics (%) and Chi-square test. RESULTS: It was observed that there were a total of 2862 and 1527 singleton births (>28 weeks) recorded for the sampled time-frame of 2009 and 1999 respectively reflecting increased quantum of institutional deliveries over time-span. Out of 2862 births, monthly distribution was 21.8% (Jan), 20% (Apr), 37.2% (July) and 21.1% (Oct) with similar picture for 1999. The birth according to 8-hourly timeframe was computed to be 31.6% (12 am-8 am), 34.3% (8 am-4 pm) and 34.0% (4 pm to 12 am) for 2009 while it was 28.6%, 38.6% and 32.8% for 1999 (P < 0.05). Births took place through-out seven days of week; however, Sunday (12.0%) was the least popular day while Thursday (18.7%) recorded maximum proportion of births during 2009. Slightly higher proportion of pre-term births were recorded during 2009 (21.76%) in comparison to 1999 (18.53%). The caesarian section rose to 26.1% from 20.2% (P < 0.05) while M:F ratio at birth was 1.28 and 1.17 with similar proportion (92.3%; 93.0%) of newborns being discharged live during 2009 and 1999 respectively. CONCLUSION: It provides snapshots of birth occurring in a teaching hospital and within study constraints finding could be utilized for improving quality of care, health communication, better utilization of human resource and logistics.

Early birth registration at a center in rural India.

BACKGROUND: Registration of birth is mandatory in India however due to various issues compliance for timely birth registration has been poor. OBJECTIVE: The objective of this study was to determine time elapsed between birth and registration and describe the socio-demographic profile of registered births at a rural center. MATERIALS AND METHODS: A cross-sectional descriptive study was undertaken and all births registered at a primary health center of a block during the period 2010 and 2011 were retrieved and data collection carried using structured proforma based on birth formats under civil registration system (CRS). House to house visit was undertaken to identify births without registration. RESULTS: A total of 340 and 276 births were registered during 2010 and 2011 respectively. Time elapsed between birth and registration was computed to be lower, i.e., 9.38 days (±7.46) during 2011 in-comparison with 10.52 days (±8.73) in 2010. On a positive note, higher level of education and marriage of women beyond legal age of 18 years was noticed in 2011 in comparison with 2010. Overall, institutional birth stood at a very encouraging note (66.2%). All (100%) births during the study period were registered at this (rural) or higher center (urban) depending on the place of delivery. An omission/commission of birth format is highlighted that needs urgent attention of the authorities. DISCUSSION: Majority (>92%) of birth registration occurred with-in the stipulated period of 21 days as prescribed under CRS and our study indicates early birth registration in a rural area of Haryana, India.

Solitary fibrous tumour of lung.

Fibrous tumours arising entirely within the substance of the lung are rare. We report one such rare case in whom the diagnosis was established after surgical removal.

All Slums are Not Equal: Maternal Health Conditions Among Two Urban Slum Dwellers.

BACKGROUND: Pregnant women inhabiting urban slums are a "high risk" group with limited access to health facilities. Hazardous maternal health practices are rampant in slum areas. Barriers to utilization of health services are well documented. Slums in the same city may differ from one another in their health indicators and service utilization rates. The study examines whether hazardous maternal care practices exist in and whether there are differences in the utilization rates of health services in two different slums. MATERIALS AND METHODS: A cross-sectional study was carried out in two urban slums of Aligarh city (Uttar Pradesh, India). House-to-house survey was conducted and 200 mothers having live births in the study period were interviewed. The outcome measures were utilization of antenatal care, natal care, postnatal care, and early infant feeding practices. Rates of hazardous health practices and reasons for these practices were elicited. RESULTS: Hazardous maternal health practices were common. At least one antenatal visit was accepted by a little more than half the mothers, but delivery was predominantly home based carried out under unsafe conditions. Important barriers to utilization included family tradition, financial constraints, and rude behavior of health personnel in hospitals. Significant differences existed between the two slums. CONCLUSION: The fact that barriers to utilization at a local level may differ significantly between slums must be recognized, identified, and addressed in the district level planning for health. Empowerment of slum communities as one of the stakeholders can lend them a stronger voice and help improve access to services.

Diffuse proliferative crescentic lupus nephritis with normal renal function.

Crescentic nephritis can be a manifestation of Lupus Nephritis. It usually presents with rapid deterioration of renal functions over days to weeks with an active urinary sediment and confers a poor prognosis. Nephrotic range proteinuria is rare in crescentic nephritis. We present an interesting case of (crescentic) Diffuse Proliferative Lupus Nephritis (DPLN) with remarkably preserved renal function and nephrotic range proteinuria. Also noteworthy was the patient's excellent response to immunosuppressive therapy despite the high frequency of cellular crescents on biopsy.