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The article comments on the article "Ultrasonic Percutaneous Tenotomy for Recalcitrant Lateral Elbow Tendinopathy: Clinical and Sonographic Results at 90 Months," by B. F. H. Ang, P. C. Mohan and M. A. Png, which appeared in the 2021 issue. Topics covered include the extensor tenotomy with variations as a treatment for tennis elbow, the study of patients with recalcitrant tennis elbow in India and the how structured conservative therapy is an effective treatment modality.

The success of cancer chemotherapy has increased greatly the potential areas for its inclusion in clinical trials and therefore has made the experimental design considerations more complex in these trials. New drugs which are launched yet go through the three classic phases of clinical study beginning with clinical pharmacology (Phase I), efficacy screening (Phase 2) and role delineation (Phase 3). The Phase 2 and 3 trials now need to be considered within the overall therapeutic strategies which are required for each of the many diseases which are called cancer. Drugs consumed in chemotherapy, such as cytarabine, work in different ways to stop the growth of cancer cells, either by killing the cells or stopping them from increase exponentially. may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. It is not yet known whether cytarabine is more effective in treating acute myeloid leukemia. The motive of this study is to assess the efficacious and eternal side effects of using combined tretinoin and arsenic trioxide in treating patients with newly detection of acute promyelocytic leukemia. Chemotherapy was identical, except for the addition of DTIC (300 mg/m2) for each course. A new drug may have required a lot of Phase 2 and 3 trials in a variety of tumors before it can be considered appropriately estimated. Essential aspects of valid clinical trials include an adequate protocol which details the study which is viable not for the current status but also for the future aspects. [ABSTRACT FROM AUTHOR]

The article discusses the context of positioning and maximizing the output of district level health officers, rendering greater autonomy and streamlining their roles in department of public health in Maharashtra and attempts to articulate challenges faced by existing district level human resources for health (HRH) architecture and discussed possible changes to face these challenges. It cites recommendation for state health directorate to have a full-fledged HR department.

Tuberous sclerosis complex (TSC) is a disease of varying presentations characterised by the presence of multiple hamartomas in various organ systems in the body. This is an Autosomal dominant disease with damages in two suppressor genes namely TSC1 and TSC2 located on chromosome 9 (9q34-hamartin) and chromosome 16 (16p13.3-tuberin). It is a lifelong disease with neurological manifestations, for example, epilepsy, mental retardation and autism and major dermatological features like facial fibromas (adenoma sebaceum), periungual fibromas, shagreen patches and hypopigmented macules. Some conditions, for example, autosomal dominant polycystic kidney disease can co-exist with TSC as a result of concurrent deletion of both polycystic kidney disease 1 and TSC2 genes present on chromosome 16p13.3. We present a cluster of three families with TSC having varied presentations. [ABSTRACT FROM AUTHOR]

Introduction: To determine effectiveness and side effects of expectant care in first-trimester miscarriage. An increase in the spontaneous miscarriage rate and its associated complications exerts a burden on the overall health and quality of life of women. Expectant care in a first-trimester miscarriage has shown success ranging 75-80%. This study was designed to search the literature for information on the clinical safety and effectiveness of expectant management on spontaneous miscarriage during the first trimester. Material and methods: The review included studies that included women in expectant care for spontaneous miscarriage in the first trimester. Trial studies were recognized through a methodical and organized database search from PubMed, COCHRANE, MEDLINE, Embase, and bibliography from January 2000 until December 2022. The methodological assessment and risk of bias was assessed using the Joanna Briggs Institute criteria. Results: Eleven studies in systematic review and 7 studies in the meta-analysis were included. The included studies showed a low to moderate risk of bias. The odds of success in expectant intervention were low when compared with surgical intervention (odds ratio - OR: OR: 0.37 [0.28, 0.48]) and medical management (OR: 0.47 [0.36, 0.61]), and the need for surgical evacuation was high (OR: 2.59 [1.88, 3.59]). Conclusions: Future trials should consider women's opinions and the effect on quality of life along with clinical consequences, to provide improved suggestions on the efficiency and adverse effects. [ABSTRACT FROM AUTHOR]

Background: The Post-Graduate Diploma in Public Health Management, launched by the Govt. of India under the aegis of the National Rural Health Mission in 2008, aims to enhance the managerial capabilities of public health professionals to improve the public health system. The Govt. of India invested enormous resources into this programme and requested an evaluation to understand the current processes, assess the graduates' work performance and identify areas for improvement. Methods: Quantitative telephone surveys as well as qualitative in-depth interviews were used. Graduates from the first three batches, their supervisors, peers and subordinates and faculty members were interviewed. Quantitative data were analysed using proportions, means and interpretative descriptions. Qualitative analyses involved transcription, translation, sorting, coding and filing into domains. Results: Of the 363 graduates whose contact details were available, 138 could not be contacted. Two hundred twenty-three (223) graduates (61.43% of eligible participants) were interviewed by telephone; 52 in-depth interviews were conducted. Of the graduates who joined, 63.8% graduates were motivated to join the programme for career advancement and gaining public health knowledge. The content was theoretically good, informative and well-designed. Graduates expressed need for more practical and group work. After graduating, they reported being equipped with some new skills to implement programmes effectively. They reported that attitudes and healthcare delivery practices had improved; they had better self-esteem, increased confidence, better communication skills and implementation capacity. While they were able to apply some skills, they encountered some barriers, such as governance, placements, lack of support from the system and community, inadequate implementation authority and lack of planning by the state government. Incentives (both monetary and non-monetary) played a major role in motivating them to deliver public health services. They suggested that states should nominate candidates expected to make a significant contribution to the health system, recognition from a relevant authoritative national body and need for a placement cell, especially for the self-sponsored candidates. Conclusions: A continuous mechanism for interaction and dialogue with the graduates during and after completion of the programme should be designed. This evaluation helped by providing inputs for refining the programme. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 05-months-old female infant born of non-consanguineous marriage presented with complaints of not gaining weight. Topics include nervous system examination revealing profound muscle wasting in all 4 limbs generalised hypertonia with brisk deep tendon reflexes; and suprasellar region arising from hypothalamus with possibility of glioma.

Background: The Post-Graduate Diploma in Public Health Management, launched by the Govt. of India under the aegis of the National Rural Health Mission in 2008, aims to enhance the managerial capabilities of public health professionals to improve the public health system. The Govt. of India invested enormous resources into this programme and requested an evaluation to understand the current processes, assess the graduates' work performance and identify areas for improvement.Methods: Quantitative telephone surveys as well as qualitative in-depth interviews were used. Graduates from the first three batches, their supervisors, peers and subordinates and faculty members were interviewed. Quantitative data were analysed using proportions, means and interpretative descriptions. Qualitative analyses involved transcription, translation, sorting, coding and filing into domains.Results: Of the 363 graduates whose contact details were available, 138 could not be contacted. Two hundred twenty-three (223) graduates (61.43% of eligible participants) were interviewed by telephone; 52 in-depth interviews were conducted. Of the graduates who joined, 63.8% graduates were motivated to join the programme for career advancement and gaining public health knowledge. The content was theoretically good, informative and well-designed. Graduates expressed need for more practical and group work. After graduating, they reported being equipped with some new skills to implement programmes effectively. They reported that attitudes and healthcare delivery practices had improved; they had better self-esteem, increased confidence, better communication skills and implementation capacity. While they were able to apply some skills, they encountered some barriers, such as governance, placements, lack of support from the system and community, inadequate implementation authority and lack of planning by the state government. Incentives (both monetary and non-monetary) played a major role in motivating them to deliver public health services. They suggested that states should nominate candidates expected to make a significant contribution to the health system, recognition from a relevant authoritative national body and need for a placement cell, especially for the self-sponsored candidates.Conclusions: A continuous mechanism for interaction and dialogue with the graduates during and after completion of the programme should be designed. This evaluation helped by providing inputs for refining the programme. [ABSTRACT FROM AUTHOR]