Three-Inflated Poisson Distribution and its Application in Suicide Cases of India During Covid-19 Pandemic.

Inflated models are generally used whenever there is an excess number of frequencies at particular count. In this study, a three-inflated Poisson (ThIP) distribution is proposed by mixing the Poisson distribution and a distribution to a point mass at three. Some of its distribution properties and reliability characteristics are studied. A simulation study is carried out to see the performance of the MLEs. In India Covid-19 implications on mental health have been abysmal. Covid-19 related suicide data of India during lockdown to the first gradual relaxation of the terms of the total lockdown (unlocking 1.0) are used to examine the appropriateness of the proposed distribution. Likelihood ratio test is used for discriminating between Poisson and the proposed distribution.

The Prognostic Impact of Epidermal Growth Factor Receptor (EGFR) in Patients with Acute Myeloid Leukaemia.

Expression of Epidermal Growth Factor Receptor (EGFR), an important proto-oncogene, regulates cell differentiation, proliferation, cell migration and survival in most of the cancer types. EGFR expression has been reported in Acute Myeloid Leukaemia (AML), however, many other reports nullified EGFR expression in AML. These contradictory data prompted us to reevaluate the expression of EGFR in AML and carry out a comparative survival analysis between EGFR expressing and non-expressing AML patients (Children and Acute Promyelocytic Leukaemia patients excluded). Bone marrow and/or peripheral blood samples were collected from 60 adult patients with AML with written informed consent. PCR, Real-Time Taqman gene expression assays were used for the detection of genetic alterations. Statistical analysis was conducted using SPSS software (IBM SPSS 20). In our study, EGFR expression was detected in 21 out of 60, in 35% (95% C.I. 23.45-48.48) AML patients. Overall survival was significantly shorter in patients with EGFR (p = < 0.01), with an average survival of 18.57 months (95% C.I. 12.42-24.73 months) compared with 31.27 months (95% C.I. 28.19-34.33 months) in patients without EGFR. EGFR expression was significantly higher in female patients compared to male (p = 0.037).This study confirms the presence of EGFR in AML and indicates that EGFR expression confers poor prognosis in AML. However, the underlying cause of this adverse prognostic effect has not been identified. Further clinical studies are warranted to determine the exact mechanism through which EGFR activity might contribute to AML progression and identify the potential therapeutic target for the reversal of resistance to conventional chemotherapeutics.

COVID-19 pandemic and its recovery time of patients in India: A pilot study.

BACKGROUND AND AIMS: Covid-19 virus started from Wuhan, China and has brought the world down to its knees. It has catapulted as a venomous global phenomenon. This study focuses on the Covid-19 situation in India and its recovery time. METHOD: The study period is from March 1, 2020 to April 25, 2020. A random sample of 221 individuals found positive with Covid-19 from March 1, 2020 to 31st March is included in the study which is followed up April 25, 2020. There is a male preponderance in the sample with 66% of the Covid-19 patients being male and about 34% being female. Kaplan-Meier Product limit estimator, Kaplan-Meier survival curve and Log-rank test are used to analyze the recovery time of Covid-19 patients. RESULT: From the results of the study, it is found that the average recovery time of Covid-19 patients in India is 25 days (95% C.I. 16 days to 34 days). Only 4% of the patients get cured after 10 days of treatment. The recovery time of male and female patients is not statistically different. Recovery time of patients belonging to different age groups is also not statistically significant. CONCLUSION: This information on recovery time of Covid-19 patients will help planners to chalk out effective strategies.

Prevalence and Clinical Significance of FLT3 and NPM1 Mutations in Acute Myeloid Leukaemia Patients of Assam, India.

Acute Myeloid Leukaemia (AML) is one of the common forms of haematological malignancy in adults. We analysed the prevalence and clinical significance of FMS-like tyrosine kinase 3 (FLT3) and Nucleophosmin 1 (NPM1) mutations in AML patients of North East India. Co-prevalence and clinical significance of three recurrent chromosomal translocations namely t(15; 17), t(8; 21), t(16; 16) and expression of epidermal growth factor receptor (EGFR), flow markers were also documented and co-related with disease progress. We analysed bone marrow aspirates or peripheral blood samples from 165 newly diagnosed AML patients. All clinical samples were analysed by Real Time PCR and DNA sequencing based assays. NPM1 was the most frequently detected mutation in the study population (46/165 = 27.90%, 95% CI 20.75-35.05). FLT3 mutations were detected in 27/165 (16.40%, 95% CI 10.45-22.35) patients with internal tandem duplication (FLT3-ITD) in 24/165 (14.60%, 95% CI 8.91-20.29) and FLT3-D835 in 3/165 (1.80%, 95% CI 0-4.13) patients. NPM1 mutations were associated with a higher complete remission rate and longer overall survival (P < 0.01) compared to FLT3-ITD whereas FLT3-ITD showed adverse impact with poor survival rate (P < 0.01), leukocytosis (P < 0.01) and a packed bone marrow. EGFR expression was more in patients with NPM1 mutation compared to FLT3 mutation (P = 0.09). Patients with FLT3 and NPM1 mutations uniformly expressed CD13 and CD33 whereas CD34 was associated with poor prognosis (P ≤ 0.01) in patients with NPM1 mutation. FLT3-ITD was associated with inferior overall survival. However the clinical significance of FLT3-D835 was not clear due to small number of samples. NPM1 mutation showed better prognosis with increased response to treatment in the absence of FLT3-ITD.

Factors associated with immunization coverage of children in Assam, India: over the first year of life.

The children of Assam in the North-East Region of India have consistently evidenced low rates for routine childhood immunizations. This study has been conducted to evaluate the factors affecting the immunization coverage in the first year of life of the children. About 62.2% of the children were fully immunized. Lack of information among the parents was one of the major causes of drop out of vaccinations. The children from urban areas and mother's education level showed significant role in immunization coverage. Improvement in female literacy coupled with the reduction in the drop out rate would add to achieve a higher target of immunization among children in the study area.