Simplifying synthesis of the expanding glioblastoma literature: a topic modeling approach.

PURPOSE: Our study aims to discover the leading topics within glioblastoma (GB) research, and to examine if these topics have "hot" or "cold" trends. Additionally, we aim to showcase the potential of natural language processing (NLP) in facilitating research syntheses, offering an efficient strategy to dissect the landscape of academic literature in the realm of GB research. METHODS: The Scopus database was queried using "glioblastoma" as the search term, in the "TITLE" and "KEY" fields. BERTopic, an NLP-based topic modeling (TM) method, was used for probabilistic TM. We specified a minimum topic size of 300 documents and 5% probability cutoff for outlier detection. We labeled topics based on keywords and representative documents and visualized them with word clouds. Linear regression models were utilized to identify "hot" and "cold" topic trends per decade. RESULTS: Our TM analysis categorized 43,329 articles into 15 distinct topics. The most common topics were Genomics, Survival, Drug Delivery, and Imaging, while the least common topics were Surgical Resection, MGMT Methylation, and Exosomes. The hottest topics over the 2020s were Viruses and Oncolytic Therapy, Anticancer Compounds, and Exosomes, while the cold topics were Surgical Resection, Angiogenesis, and Tumor Metabolism. CONCLUSION: Our NLP methodology provided an extensive analysis of GB literature, revealing valuable insights about historical and contemporary patterns difficult to discern with traditional techniques. The outcomes offer guidance for research directions, policy, and identifying emerging trends. Our approach could be applied across research disciplines to summarize and examine scholarly literature, guiding future exploration.

Exploiting Natural Language Processing to Unveil Topics and Trends of Traumatic Brain Injury Research.

Traumatic brain injury (TBI) has evolved from a topic of relative obscurity to one of widespread scientific and lay interest. The scope and focus of TBI research have shifted, and research trends have changed in response to public and scientific interest. This study has two primary goals: first, to identify the predominant themes in TBI research; and second, to delineate "hot" and "cold" areas of interest by evaluating the current popularity or decline of these topics. Hot topics may be dwarfed in absolute numbers by other, larger TBI research areas but are rapidly gaining interest. Likewise, cold topics may present opportunities for researchers to revisit unanswered questions. We utilized BERTopic, an advanced natural language processing (NLP)-based technique, to analyze TBI research articles published since 1990. This approach facilitated the identification of key topics by extracting sets of distinctive keywords representative of each article's core themes. Using these topics' probabilities, we trained linear regression models to detect trends over time, recognizing topics that were gaining (hot) or losing (cold) relevance. Additionally, we conducted a specific analysis focusing on the trends observed in TBI research in the current decade (the 2020s). Our topic modeling analysis categorized 42,422 articles into 27 distinct topics. The 10 most frequently occurring topics were: "Rehabilitation," "Molecular Mechanisms of TBI," "Concussion," "Repetitive Head Impacts," "Surgical Interventions," "Biomarkers," "Intracranial Pressure," "Posttraumatic Neurodegeneration," "Chronic Traumatic Encephalopathy," and "Blast Induced TBI," while our trend analysis indicated that the hottest topics of the current decade were "Genomics," "Sex Hormones," and "Diffusion Tensor Imaging," while the cooling topics were "Posttraumatic Sleep," "Sensory Functions," and "Hyperosmolar Therapies." This study highlights the dynamic nature of TBI research and underscores the shifting emphasis within the field. The findings from our analysis can aid in the identification of emerging topics of interest and areas where there is little new research reported. By utilizing NLP to effectively synthesize and analyze an extensive collection of TBI-related scholarly literature, we demonstrate the potential of machine learning techniques in understanding and guiding future research prospects. This approach sets the stage for similar analyses in other medical disciplines, offering profound insights and opportunities for further exploration.

Tracing topics and trends in drug-resistant epilepsy research using a natural language processing-based topic modeling approach.

Epilepsy is a common neurological disorder affecting over 70 million people worldwide. Although many patients achieve seizure control with anti-epileptic drugs (AEDs), 30%-40% develop drug-resistant epilepsy (DRE), where seizures persist despite adequate trials of AEDs. DRE is associated with reduced quality of life, increased mortality and morbidity, and greater socioeconomic challenges. The continued intractability of DRE has fueled exponential growth in research that aims to understand and treat this serious condition. However, synthesizing this vast and continuously expanding DRE literature to derive insights poses considerable difficulties for investigators and clinicians. Conventional review methods are often prolonged, hampering the timely application of findings. More-efficient approaches to analyze the voluminous research are needed. In this study, we utilize a natural language processing (NLP)-based topic modeling approach to examine the DRE publication landscape, uncovering key topics and trends. Documents were retrieved from Scopus, preprocessed, and modeled using BERTopic. This technique employs transformer models like BERT (Bidirectional Encoder Representations from Transformers) for contextual understanding, thereby enabling accurate topic categorization. Analysis revealed 18 distinct topics spanning various DRE research areas. The 10 most common topics, including "AEDs," "Neuromodulation Therapy," and "Genomics," were examined further. "Cannabidiol," "Functional Brain Mapping," and "Autoimmune Encephalitis" emerged as the hottest topics of the current decade, and were examined further. This NLP methodology provided valuable insights into the evolving DRE research landscape, revealing shifting priorities and declining interests. Moreover, we demonstrate an efficient approach to synthesizing and visualizing patterns within extensive literature that could be applied to other research fields.

Minimal Residual Disease in the Management of B-Cell Acute Lymphoblastic Leukemia: A Systematic Review of Studies from Indian Settings.

Minimal residual disease (MRD) has become an essential tool in the management of B-cell acute lymphoblastic leukemia (B-ALL) and aids in tailoring treatment strategies to suit specific patient needs. Although much progress has been made in this area, there is limited data on the use of MRD in the Indian context. Our objective was to identify relevant literature that discusses the utility of MRD in the management of B-cell ALL in adolescents and young adults (AYA) and adults in Indian settings. A systematic search and screening of articles were performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The primary data source was PubMed followed by Google Scholar for articles and conference proceedings. Of the 254 records screened, 24 records were retained for analysis. MRD monitoring had a significant role in the management of AYA/adult B-cell ALL patients. Variability of results was observed across these studies with respect to methods, techniques, and use. However, these studies evidenced and validated the importance of MRD assessment in risk-adapted management of B-cell ALL and highlighted the need for optimization. The advances in MRD diagnostics and applications are yet to be tested and adopted in Indian settings. Hence, there is a need for in-depth research to develop and optimize approaches for calibrating country-specific management strategies. The potential role of MRD assessments in anticipating relapse or treatment failures warrants more attention for the preemptive positioning of novel strategies involving immunotherapies.

Unraveling the mechanistic insights of sophorolipid-capped gold nanoparticle-induced cell death in Vibrio cholerae.

IMPORTANCE: Vibrio cholerae, a Gram-negative bacterium, is the causative agent of a fatal disease, "cholera." Prevention of cholera outbreak is possible by eliminating the bacteria from the environment. However, antimicrobial resistance developed in microorganisms has posed a threat and challenges to its treatment. Application of nanoparticles is a useful and effective option for the elimination of such microorganisms. Metal-based nanopaticles exhibit microbial toxicity through non-specific mechanisms. To prevent resistance development and increase antibacterial efficiency, rational designing of nanoparticles is required. Thus, knowledge on the exact mechanism of action of nanoparticles is highly essential. In this study, we explore the possible mechanisms of antibacterial activity of AuNPs-SL against V. cholerae. We show that the interaction of AuNPs-SL with V. cholerae enhances ROS production and membrane depolarization, change in permeability, and leakage of intracellular content. This action leads to the depletion of cellular ATP level, DNA damage, and subsequent cell death.

Exploring the Synergistic Association Between Oral Health Status and Oral Health Literacy Among College Students: A Cross-Sectional Study.

INTRODUCTION: Oral health is often viewed as a significant component for an indication of good general health or for good well-being together with a decent quality of life. Health literacy is considered a crucial factor in improvising a good life or excellent health. Oral health literacy (OHL) is the ability necessary for people to identify the factors that lead to poor oral health, learn and put into practice the essentials of effective oral self-care behaviors, and communicate with oral healthcare professionals in order to schedule appointments, put their names on waiting lists for dental care, and locate the dentist's office. AIM AND OBJECTIVES: To evaluate students' oral health, their OHL, to determine the relationship between their oral health status and OHL, and finally to suggest preventive measures for the benefit of public health. MATERIALS AND METHOD: At Teerthanker Mahaveer University, a cross-sectional study involving 1500 participants, ages 18 to 25, was conducted on students studying nursing, physiotherapy, paramedicine, engineering, and law. Their informed consent was obtained. The Rapid Estimate of Adult Literacy in Dentistry (REALD-99) was used to gauge OHL levels, and the WHO's 1997 Oral Health Survey was used for their clinical evaluation. RESULTS: The mean REALD score was significantly higher in nursing students (88.32±6.46), followed by physiotherapy college (82.46±9.11), paramedical college (70.54±10.95), law college (46.52±7.74), and least in engineering college (38.80±10.65). The difference in the REALD score based on college was statistically significant. Along with this, the REALD score showed a correlation with gender and location too. Except for fluorosis, all the clinical parameters of dental caries, gingival bleeding, and pockets, loss of attachment, dental fluorosis, and dental enamel were associated with OHL. CONCLUSION: The results of the current study showed a relationship between educational attainment, clinical parameters examined, and OHL, leading to the conclusion that higher OHL is related to better oral health. So, we can conclude that maintaining good oral health requires OHL.

Impact of Dental Treatment on Oral Health-Related Quality of Life of Patients.

OBJECTIVE: It is crucial to understand how individuals perceive the impact of oral disorders and the treatment associated with or received for those disorders on their quality of life. A relatively new but quickly spreading concept of oral health-related quality of life (OHRQoL) that notably affects three fields, clinical dental practice, dental research, and dental education makes it feasible to figure out the relationship between oral health and its impact on the quality of life of an individual. OHRQoL can be measured in various ways; the most well-liked method uses a multiple-item questionnaire. There haven't been any prior attempts to compare the effects of various invasive and non-invasive dental therapies on OHRQoL, even though few studies have been conducted to evaluate the OHRQoL among patients undergoing independent dental procedures. Such a comparison would aid in our understanding of not only how various dental conditions affect OHRQoL, but also whether or not a patient's OHRQoL has improved as a result of various therapies for these diseases. METHOD: A longitudinal study was conducted on patients receiving invasive and non-invasive dental treatment at Teerthanker Mahaveer Dental College and Research Centre, Moradabad. A two-part questionnaire, the first part of which consists of questions related to the demographic details of the patient and the second part consisting of a set of 14 questions of the oral health impact profile (OHIP)-14 for assessing the OHRQoL, was used in the study. Patients' baseline OHRQoL was assessed before the commencement of any treatment by the interview method and follow-up OHRQoL was assessed three days, seven days, one month, and six months post-treatment telephonically. The OHIP-14 contains 14 items on the frequency of adverse impacts caused by oral conditions and the patients were asked to rate each item on a 5-point Likert scale as 0=never; 1=hardly ever; 2=occasionally; 3=fairly often; 4=very often. RESULTS: The results obtained after compiling and analyzing the data from a total sample of 400 indicate that the mean difference in the OHIP score at different time intervals between the groups who undertook invasive and non-invasive treatment was significant as the p-value was less than 0.05. In addition, it was observed that the mean difference at baseline was statistically significant in the invasive and non-invasive groups as the p-value is less than 0.05. At the domain level, the mean score at each domain was higher in the invasive group as compared to the non-invasive treatment group after three days and seven days of treatment. The mean difference between the group treated with invasive treatment on day three and the group treated with non-invasive treatment on day seven was statistically significant as the p-value is less than 0.05. The mean score was high in the invasive group as compared to the non-invasive group after one month and six months of treatment. CONCLUSION: The present study was conducted to assess dental treatment's impact on oral health-related quality of life in patients attending Teerthanker Mahaveer Dental College and Research Centre, Moradabad. Results from this study indicated that both types of treatments either invasive or non-invasive have significantly influenced the OHRQoL. Post-treatment OHRQoL improved at different intervals after receiving either treatment.

Association between obesity and periodontal disease among 35 - 44 years old patients visiting Teerthanker Mahaveer Dental College and Research Centre, Moradabad: A cross sectional study.

Introduction: Obesity had been the most neglected public health problem increasing at an alarming rate affecting both the developed and developing countries. Periodontitis is a chronic inflammatory disease which is highly prevalent worldwide affecting 20-50% of the global population. Thus, a research was conducted to evaluate the relationship between obesity and periodontal disease among 35-44-year-old patients who were visiting the Oral Medicine and Radiology Department (OMDR) in TMDCRC, Moradabad. Objective: To know the prevalence of obesity and periodontal health. To record the body mass index (BMI) and to co-relate with periodontal disease. To recommend preventive measures for periodontitis and the obese population. Materials and Method: A cross-sectional study was conducted in the Department of OMDR, TMDCRC, Moradabad. A total of 566 subjects were examined aged 35-44 years visiting the out patient department (OPD) of the OMDR Department. Informed consent was obtained from the participants. Questionnaire-based proforma was used comprising information regarding oral hygiene practices, frequency of toothbrushing, and method of brushing. A World Health Organization (WHO)-modified 2013 assessment form was used to record the periodontal status of the participants. Results: The examination of 550 subjects was done. It was found that there is a significant association of periodontal disease in factors like BMI, age, gender, smoking status, and loss of attachment (LOA) is found in BMI, gender, smoking status, and smoking frequency. It was also found that there is a significant association of the community periodontal index (CPI) scores in obese individuals. Conclusion: The main aim is to find and control the risk factor and eliminate it. Our study confirms that obesity is one of the risk indicators of periodontitis. With the scope and limitations of the study, it has been concluded that obesity and periodontitis have a significant relationship with each other. This study states the importance of good oral hygiene maintenance in obese and normal patients.

2/1 dose schedule of sunitinib is superior than the 4/2 regimen for the first-line therapy of clear cell metastatic renal cell carcinoma - An Indian experience.

BACKGROUND: Sunitinib remains the first-line treatment for favorable risk metastatic clear cell renal cell cancer (mccRCC). It was conventionally given in the 4/2 schedule; however, toxicity necessitated trying the 2/1 regimen. Regional variations in treatment response and toxicity are known, and there is no data from the Indian subcontinent about the outcomes of the alternative dosing schedule. METHODS: Clinical records of all consecutive adult patients who received sunitinib as first-line therapy for histologically proven mccRCC following cytoreductive nephrectomy from 2010-2018 were reviewed. The primary objective was to determine the progression-free survival (PFS), and the secondary objectives were to evaluate the response rate (objective response rate and clinical benefit rate), toxicity, and overall survival. A list of variables having a biologically plausible association with outcome was drawn and multivariate inverse probability treatment weights (IPTW) analysis was done to determine the absolute effect size of dosing schedules on PFS in terms of "average treatment effect on the treated" and "potential outcome mean." RESULTS: We found 2/1 schedule to be independently associated with higher PFS on IPTW analysis such that if every patient in the subpopulation received sunitinib by the 2/1 schedule, the average time to progression was estimated to be higher by 6.1 months than the 4/2 schedule. We also found 2/1 group to have a lower incidence than the 4/2 group for nearly all ≥ grade 3 adverse effects. Other secondary outcomes were comparable between both treatment groups. CONCLUSION: Sunitinib should be given via the 2/1 schedule in Indian patients.

The Utility of Grip Strength as a Simplified Measure of Frailty in the Older Adult in the Preoperative Clinic.

Objective  The aim of this study was to compare the measure of grip strength against other validated methods of measuring frailty. Materials and methods This was a single-center, cross-sectional study that took place at the Westchester Medical Center Pre-Procedural Testing Clinic. The patient population included n = 73 patients ≥65 years of age evaluated for elective surgery. During the study, patients' grip strength, CFS-I (Clinical Frailty Score of Investigator), CFS-P (Clinical Frailty Score of Participant), and FRAIL (Fatigue, Resistance, Aerobic capacity, Illnesses, and Loss of weight) scores were measured. Results Grip strength correlated negatively with the CFS-I, CFS-P, and FRAIL scores for females. Reduced grip strength in females correlated with higher frailty scores and vice versa. Male grip strength showed no significant relationship with the frailty scales. In addition, multivariate linear regression analysis revealed that the independent measure that demonstrated a significant inverse association with grip strength was age (ß= -0.43, p = <0.001). Conclusions  There exists a difference in the utility of grip strength as a measure of frailty between males and females.

Antibacterial efficacy of manuka honey, ocimum sanctum, curcuma longa and 0.2% chlorhexidine mouthwash on the level of streptococcus mutans and lactobacillus acidophilus - A randomized controlled trial.

Objective: : To assess the effects of Manuka honey, Ocimum sanctum, Curcuma longa, and 0.2% chlorhexidine mouthwash on Streptococcus mutans and Lactobacillus acidophilus levels. Material and Methods: A randomized controlled trial will be conducted on dental students of Teerthanker Mahaveer Dental College and Research Centre, Moradabad. The study participants will be divided into four groups. Each group will have a total of 20 individuals. By using a lottery system, Group A (Manuka honey mouthrinse), Group B (Ocimum sanctum mouthrinse), Group C (Curcuma longa mouthrinse), and Group D (0.2% chlorhexidine mouthrinse) will be chosen. To match the circadian cycle, saliva will be collected at baseline and again after 2 weeks between 10 and 10.30 a.m. The sterile container will subsequently be delivered to the microbiological laboratory and processed as soon as possible to measure Streptococcus mutans and Lactobacillus acidophilus count. For 2 weeks, participants were told to use 10 mL of mouthrinse twice daily. Results: : The mean oral hygiene index-simplified (OHI-S) score of all the four groups showed reduction in their scores from baseline to after the study period. For both S. mutans and L. acidophilus, there was a substantial Percentage Reduction (PR) between the prerinse and postrinse samples in all four groups. Discussion: : Because quantitative actions play a crucial part in the caries disease process, the changes in microbial activity before and after administration of experimental mouthwashes were examined. Conclusion: : Essential oil aqueous extracts were as efficient antibacterial mouthwashes as chlorhexidine and iodine mouthwashes.

Diagnostic performance of patient self-collected oral swab (tongue and cheek) in comparison with healthcare worker-collected nasopharyngeal swab for severe acute respiratory syndrome coronavirus-2 detection.

The present study was conducted to compare the performance of patient self-collected oral swab (OS) with healthcare worker (HCW)-collected nasopharyngeal swab (NPS) for SARS-CoV-2 detection by reverse transcription polymerase chain reaction (RT-PCR) in real-world setting. Paired OS and NPS were collected from 485 consecutive individuals presenting with symptoms of coronavirus disease-19 (COVID-19) or asymptomatic contacts of COVID-19 cases. Both specimens were processed for RT-PCR and cycle threshold (Ct) value for each test was obtained. Positive percent agreement (PPA), negative percent agreement (NPA), overall percent agreement (OPA) and kappa were calculated for OS RT-PCR compared with NPS RT-PCR as reference. A total of 116/485 (23.9%) participants were positive by NPS RT-PCR. OS had PPA of 71.6%, NPA of 98.8%, OPA of 92.4% and kappa of 0.771. Almost all participants (483/485, 99.6%) reported OS as a convenient and comfortable sample for SARS-CoV-2 testing over NPS. All participants with Ct values <25 and majority (90.8%) with Ct values <30 were detected by OS. To conclude, OS self-sampling was preferred in comparison with NPS due the ease and comfort during collection. The performance of OS RT-PCR for SARS-CoV-2 detection, however, was sub-optimal in comparison with NPS RT-PCR.

Diagnostic performance of oral swab specimen for SARS-CoV-2 detection with rapid point-of-care lateral flow antigen test.

We evaluated the performance of oral swab specimen both health-care worker (HCW) collected and self-collected for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) detection with rapid antigen test (RAT) as compared to reverse transcriptase polymerase chain reaction (RT-PCR). Of the 529 participants enrolled, 121 (22.8%) were RT-PCR positive. Among the RT-PCR positives, 62 (51.2%) were RAT positive using oral swab. When compared with RT-PCR, RAT with oral swab had sensitivity and specificity of 63.3 and 96.8% respectively among symptomatic individuals. No statistically significant difference was observed in RAT positivity with HCW collection and self-collection, p = 0.606. Ct values were significantly lower in RT-PCR and RAT positive samples (ORF gene: 18.85 ± 4.36; E gene: 18.72 ± 4.84) as compared to RT-PCR positive and RAT negative samples (ORF gene: 26.98 ± 7.09; E gene: 26.97 ± 7.07), p < 0.0001. Our study demonstrated moderate sensitivity of RAT with oral swab in symptomatic individuals. Oral swab was the preferred sampling by almost all participants in terms of convenience and comfort as compared to nasopharyngeal swab. Oral swabs have utility for SARS-CoV-2 antigen detection among symptomatic individuals residing in remote rural areas and can serve as an initial screening tool during COVID-19 spikes when cases rise exponentially and laboratory capacities for RT-PCR testing become overwhelmed.

Stillbirth in COVID-19 Affected Pregnancies: A Double Whammy for the Mother.

Introduction Pregnant women represent a high-risk group especially during the COVID-19 pandemic, suffering at the expense of pandemic restrictions and landing up in adverse maternofetal outcomes including stillbirth. Fetal demise along with COVID-19 disease acts as a double blow to these mothers. Literature is still limited on its impact on maternofetal outcomes. Methods A prospective, observational study was conducted in a tertiary care hospital in Delhi, India from April 15, 2020 to April 14, 2021, wherein all pregnant mothers with SARS-CoV-2 infection in the hospital who delivered a stillborn baby were enrolled and analyzed for incidence of stillbirth. These women were evaluated for risk factors and causes for stillbirth. Results Out of 15859 deliveries in the institute, there were 330 viable births among COVID-19 affected pregnancies. The incidence of stillbirth was 7.2% (24/330). The institutional delivery rate fell by 43% during the pandemic. The majority of cases were unbooked, from rural areas and of low socioeconomic status (p<0.01). The most significant risk factor and cause for stillbirth was an associated comorbidity (75%, p<0.001), notably severe forms of hypertensive disorders of pregnancy (HDP, 41.6%, p=0.002), followed by preterm labour (58.3%) and preterm premature rupture of membranes (PPROM, 29.1%, p<0.001). HDP remained the main cause of macerated stillbirths while maternal fever (50%, p<0.001) was the main cause of fresh stillbirth. Major modifiable factors were lack of awareness of when to seek care (83.3%), financial reasons (75%), commutation problems (87.5%), distance to hospitals (50%) and delayed referral (41.6%). Conclusion Improved policy-making, with an emphasis on telemedicine, COVID-19 preparedness alongside amped up vaccination and healthcare workers training will help reduce adverse maternofetal outcomes.

Clinical Significance of Circulating Serum Levels of sCD95 and TNF-α in Cytoprotection of Cervical Cancer.

Background: This study correlates the serum levels of sCD95 & TNF-α with a simple cell-based assay to evaluate the capacity of the serum sample to induce apoptosis in Jurkat cells. Interlinking of these parameters can be explored to design a minimum invasive diagnostic strategy for cervical cancer (CC). Methods: Sera samples were assessed to induce apoptosis in Jurkat cells through FACS. Serum levels of sCD95 and TNF-α were measured by ELISA. JNK phosphorylation was evaluated in sera incubated Jurkat cells. Data was scrutinized through statistical analysis. Results: Significantly higher serum levels of sCD95 and lower TNF-α levels were observed in CC patients; their sera samples inhibited induction of apoptosis in Jurkat cells through reduced JNK phosphorylation. Statistical analysis linked these three parameters for the early screening of CC. Conclusion: Distinct sera levels of sCD95 & TNF-α in CC patients showed an anti-apoptotic effect, which can be considered for early detection of CC.

Reduced fetal urine production rate-An early marker of fetal inflammatory response syndrome in preterm premature rupture of membranes: Prospective cohort study.

OBJECTIVE: To find association between fetal urine production rate (FUPR) and fetal inflammatory response syndrome (FIRS) in preterm premature rupture of membranes (PPROM). METHODS: A prospective cohort study of 70 pregnant women with PPROM at 28-34 weeks of pregnancy was conducted. FUPR was calculated by performing serial fetal bladder volume measurements ultrasonographically and was repeated weekly until delivery. After delivery, cord blood interleukin-6 (IL-6) levels were measured. Placental tissue histopathology was performed and neonatal outcomes were noted. RESULTS: Out of 70 recruited patients with PPROM, 44 had evidence of FIRS (62.86%). Mean FUPR at the time of delivery was significantly reduced in neonates with evidence of FIRS compared with the Non-FIRS group (13.89 ± 8.06 ml/h vs. 25.89 ± 4.94 ml/h). Out of 41 patients with reduced FUPR, 39 neonates had FIRS whereas only five out of 29 neonates with normal FUPR had FIRS (P < 0.001). Severe neonatal morbidity was found in 24 out of 41 (58.54%) neonates with reduced FUPR prenatally. The occurrence of respiratory distress syndrome, necrotizing enterocolitis, and sepsis was significantly high in neonates with reduced FUPR. CONCLUSION: Reduced FUPR is strongly associated with FIRS in cases of PPROM and hence can be used as an early predictor of adverse neonatal outcomes.

Measuring the impact of a single dose of ChAdOx1 nCoV-19 (recombinant) coronavirus vaccine on hospital stay, ICU requirement, and mortality outcome in a tertiary care centre.

OBJECTIVE: To comparatively evaluate ICU requirement, length of stay, and mortality between single-dose vaccinated and non-vaccinated hospitalized COVID-19 patients. DESIGN: A retrospective observational study was carried out in a tertiary care hospital in western Indian, from April 1 to June 30, 2021. RESULTS: Of the 569 patients who fulfilled the eligibility criteria and were enrolled in the study, 137 (24.08%) patients had received a single dose of ChAdOx1 nCoV-19 vaccine, while 432 (75.92%) patients had not received any form of vaccination. The overall length of stay in hospital was similar for both groups; however, a significant difference was seen in length of stay in the ward and in the ICU. Vaccinated patients were admitted to the ward for 6.21 ± 3.204 days, while non-vaccinated patients were admitted for 5.56 ± 4.55 days (p < 0.001). The mean length of ICU stay for the 21 vaccinated patients requiring intensive care was 4.47 ± 2.3 days, while that for the 145 non-vaccinated patients was 6.29 ± 2.19 days (p < 0.001). Mortality was observed in four patients in the vaccinated group and in 95 patients in the non-vaccinated group. CONCLUSION: A single dose of ChAdOx1 nCoV-19 vaccine was associated with a significantly lower severity of SARS-CoV-2 infection compared with no vaccination.

Effectiveness of Manual Vacuum Aspiration (MVA) Device in the Management of Intrauterine Copper Devices (IUCD) with Missing Strings: A Prospective Interventional Study.

BACKGROUND: The cases of intrauterine contraceptive device (IUCD) with missing strings have risen due to increasing popularity of postpartum IUCD in Indian women. This has lead to increase in the burden of referral cases in tertiary care centres. Manual vacuum aspiration (MVA) device is a cheap and non-invasive method, well established for surgical abortion in first trimester of pregnancy. This study was undertaken to assess if MVA device can be used in retrieving IUCD in low resource setting, hence, reducing the need for referral or need of expensive and invasive techniques. METHOD: A prospective interventional study was conducted over a period of 6 months. A total of 50 women who were desirous of IUCD removal with non-visibility of strings at the external cervical os were included in the study. All cases were more than 12 weeks postpartum and had an ultrasound confirmed intrauterine location of IUCD. Women with pregnancy, extrauterine location of IUCD, active pelvic infection and cervical cancer were excluded. RESULTS: The incidence of IUCD with missing strings was 19.4%. Almost a third of the cases (36%) were referred from outside Delhi for IUCD removal to our centre. In 30% cases IUCD could successfully be removed using the MVA device. Majority of the IUCDs were inserted in hospital by a gynaecologist (90%), and most of the insertions were post-placental (62%). CONCLUSION: Retrieval of IUCD with missing strings with MVA device is a novel method and can be an initial approach in low resource setting before referral to a higher centre for management.

Giant coronary artery aneurysm as a feature of coronavirus-related inflammatory syndrome.

A 5-month-old female infant was admitted to hospital with a history of fever and rash during the recent coronavirus pandemic. She had significantly elevated inflammatory markers and the illness did not respond to first line broad spectrum antibiotics. The illness was later complicated by coronary artery aneurysms which were classified as giant despite treatment with intravenous immunoglobulin, steroids and immunomodulators. The infant had COVID-19 antibodies despite an initial negative COVID-19 PCR test. This case highlights the association of atypical Kawasaki like illness and paediatric multisystem inflammatory syndrome-temporarily associated with COVID-19 infection.

Educational needs, perception, and perspectives of oncologists regarding compassionate use programs in Asia.

OBJECTIVE: This study was conducted to capture the educational needs, perceptions, and perspectives of oncologists towards Compassionate Use Programs (CUPs) in Asia, with the aim of gathering insights related to unmet needs for physician and patient assistance. METHODS: The participants responded to a voluntary, self-administered, closed-ended questionnaire through an online platform between 29 April 2020 and 17 June 2020. RESULTS: A total of 111 oncologists provided informed consent to participate in the study. Of these, 102 respondents fully completed the questionnaire and were included in the analyses. Maximum respondents (35.3%) had 10-20 years of experience after specialization with 19.6, 23.5, and 21.6% respondents having <5, 5-10, and ≥20 years of experience, respectively. Practice type plays a statistically significant role in the awareness of the existing compassionate program (p = .0066). While many respondents seem clear on the application process for CUP set in place by pharmaceutical companies, a higher number of respondents are unclear about the country regulations and processes for applying to CUPs set in place by regulatory authorities. Most respondents (75.5%) reported that there are no resources or training provided to them regarding CUPs. There was a significant association between the clarity of the application process for CUP set in place by the sponsors and the number of applications submitted (p = .0321). CONCLUSIONS: Our study brings light on various issues faced by physicians in accessing CUPs especially related to the lack of education and training on utilizing CUPs. There are significant unmet needs related to improving the clarity for the application process, providing resources and related training, particularly for oncologists who do not have previous experience with CUPs.