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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.

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.

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.

Violence against women is a global phenomenon.To estimate and forecast cognizable crime against women in New Delhi, India, from 2016 to 2020.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.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%.Within limitations, it is concluded that the safety of women will continue to be a concern in the near future.العنف القائم على الجنس في نيودلهي، الهند: التوقعات القائمة على تحليل البيانات الثانوية.نيدي دويفيدي، سانديب ساشديفا.تُعَدُّ الجرائم المرتكبة ضد النساء ظاهرة عالمية تحتاج إلى معالجة مستمرة.تم تقدير نسبة الجرائم التي يعترف بها القانون المرتكبة ضد النساء وتوقعها في نيودلهي، الهند، بداية من عام 2016 حتى عام 2020.استُخرجت نسبة الجرائم التي يعترف بها القانون المرتكبة ضد النساء في نيودلهي للفترة بين عامي 2009 و 2015 من أجل تحليلها إحصائيًا وتجميعها ونمذجتها. وشملت الجرائم التي يعترف بها القانون والمُبلَّغ عنها المرتكبة ضد النساء: الاغتصاب، ومحاولة الاغتصاب، والاختطاف والأسر، وحالات الوفاة بسبب المهر، والاعتداء على النساء بنية خدش حيائهن، وخدش حياء المرأة، والتعرض للقسوة على يد الزوج أو أحد أقاربه، وجلب الفتيات من البلدان الأجنبية، والتحريض على انتحار النساء، والتصوير غير اللائق للمرأة.أشارت البيانات المتاحة إلى أن العدد الفعلي للحالات المسجلة للجرائم المرتكبة ضد النساء تراوحت بين 4251 (2009) ، و 17 104 (2015). وتتراوح عدد الحالات المتوقعة بين 18 991 (%95 :CI 13 092 - 24 889) في 2016 إلى 28 663 (%95 :CI 22 314 - 35 013) في عام 2020. ولُوحِظ تصاعد وتيرة الجرائم ضد النساء، حيث تراوح معدل الجرائم المرتكبة ضد النساء بين 204.6 (2016) و 308.8 (2020) لكل 100 ألف امرأة من سكان نيودلهي. بالإضافة إلى ذلك، لُوحِظ أنه بعد ملاحظة زيادة جوهرية (116.2 %) في الجرائم المُبلَّغ عنها ضد النساء في نيودلهي في عام 2013 ، بدا أن الارتفاع اللاحق الفعلي والمتوقع ذو طبيعة تزايدية حيث يتراوح التغيُّ بالنقاط المئوية السنوية بين 9% و 18 %.تم استنتاج أن سلامة النساء ستظل مصدر قلق بالغ في المستقبل القريب، وأنه يجب إعطاء مزيد من الاهتمام لهذه القضية على المستوى السياسي وفي المجتمع.Violence sexiste à l’encontre des femmes à New Delhi (Inde) : projections basées sur une analyse des données secondaires.La violence à l’encontre des femmes est un phénomène mondial qui nécessite une attention constante.Évaluer les délits caractérisés à l’encontre des femmes à New Delhi (Inde) entre 2016 et 2020 et établir des projections à cet égard.Les délits caractérisés à l’encontre les femmes, rapportés à la police, à New Delhi pour la période allant de 2009 à 2015 ont servi de base à un travail d’analyse statistique, de synthèse et de modélisation. Les délits caractérisés à l’encontre des femmes ayant fait l’objet d’un dépôt de plainte sont : le viol, la tentative de viol, l’enlèvement et le détournement de femmes, les meurtres liés à la question de la dot, les agressions sur les femmes avec intention d’attenter à leur pudeur, l’outrage à la pudeur, les actes de cruauté de la part du mari ou d’un parent, la traite de jeunes filles originaires de pays étrangers, l’incitation au suicide des femmes, la représentation obscène de la femme.Les données disponibles indiquent que le nombre véritable de délits enregistrés à l’encontre de femmes était compris entre 4251 (2009) et 17 104 (2015). Selon les projections, le nombre de cas varie entre 18 991 (IC à 95 % : 13 092– 24 889) en 2016 et 28 663 (IC à 95% : 22 314–35 013) en 2020. On a observé une tendance à la hausse des délits perpétrés contre des femmes, le taux allant de 204,6 (2016) à 308,8 (2020) pour 100 000 femmes à New Delhi. En outre, on a constaté qu’après avoir enregistré une augmentation importante (116,2 %) des délits à l’encontre des femmes à New Delhi en 2013, ayant fait l’objet d’un dépôt de plainte, la hausse réelle et prospective semble être progressive par nature, l’évolution en points de pourcentage allant de 9 à 18 %.Dans certaines limites, l’étude conclut que la sécurité des femmes restera une préoccupation sérieuse dans un avenir proche, exigeant une attention accrue à la fois au niveau politique et au sein de la communauté.

To estimate the prevalence of global developmental delay among children under 3 years of age and study the determinant factors. Cross sectional descriptive study was conducted in field practice areas of the Department of Community Medicine, JN Medical College, Aligarh, India. A total of 468 (243 boys and 225 girls) children aged 0–3 years were included. Developmental screening was performed for each child. A multitude of biological and environmental factors were analysed. As many as 7.1% of the children screened positive for global developmental delay. Maximum delay was observed in the 0–12 months age group (7.0%). Undernutrition and prematurity were the two most prevalent etiological diagnoses (21% each). Stunting and maternal illiteracy were the microenvironmental predictors on stepwise binary logistic regression while prematurity and a history of seizures emerged significant biological predictors. Developmental delay can be predicted by specific biological and environmental factors which would help in initiating appropriate interventions.

Only 1 of 8 stroke patients is managed exclusively by a neurologist. Furthermore, many stroke patients harbor other vascular comorbidities and are also at risk for developing general medical complications that can lead to death following stroke. With the growing hospitalist system, it is quite clear that hospitalists are, and will increasingly be, an integral part of the care team for many hospitalized stroke patients. Because prevention remains the mainstay of treatment for ischemic stroke and TIA, it would be useful for practicing hospitalists to know the scientific evidence behind recommended therapeutic approaches to reducing vascular risk following stroke, as well as strategies for bridging the prevailing evidence–practice gap for hospitalized stroke patients, which this review article presents. Journal of Hospital Medicine 2007;2:31–38. © 2007 Society of Hospital Medicine.

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.

Leprosy is a chronic disabling disease and there are areas of high endemicity in India. Case findings and management strategies suffer a setback when disease manifestations are not picked up in time by health-care providers. This article attempts to estimate the annual incidents of leprosy and to study the confounding factors which may potentially cause delays in diagnosis in an office-based, tertiary health-care setting.

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.

Leprosy remains an important public health and social issue in South Asia, particularly in India. Its presence in childhood is an immense social burden because of the associated disabilities and widely prevalent misconceptions regarding communicability and treatment potential. The prevalence of leprosy among children suggests a possible gap in the national programmes aimed at leprosy elimination. This article reports a 10-year retrospective study of childhood leprosy in a tertiary care hospital setting (2000–2009) along with an analysis of selected socio-epidemiologic correlates. We stress the importance of early detection and the application of appropriate prophylactic measures in susceptible children.

The objective of this study was to assess the various factors affecting endothelial function in essential hypertensives and to establish a relation between them in a regression model. Also, the micro-inflammatory state that is known to exist in essential hypertension was evaluated. Sixty newly detected patients of essential hypertension not on any prior treatment and classified into Stage-1 or Stage-2 hypertension according to the JNC-VII criteria were recruited in the study. After a detailed history and physical examination, investigations including blood urea, serum creatinine, blood sugar (F), S. lipid profile (F), urine for albumin, sugar and sediments, X-ray of the chest, ECG and fundus examination were carried out. Urine for microalbuminuria, Hs-CRP and brachial artery reactivity were tested as markers of endothelial dysfunction and inflammation. The CRP levels, taken as a marker of inflammation in hypertension, were significantly elevated in a majority of the study subjects. Endothelial dysfunction was significantly more quantified in Stage-2 hypertension as compared with Stage-1 hypertension (P < 0.01). The Hs-CRP levels were consistently found to be elevated in both the stages of hypertension in our study, with an insignificant difference between the two groups. A significant association was noted with the stage of hypertension, triglycerides, microalbuminuria, CRP, LDL cholesterol and age, with the stage of hypertension emerging as the most powerful predictor variable (P < 0.0001) followed closely by microalbuminuria (P < 0.0001) in a multiple regression analysis model. The present study reinforces the view that hypertension is in part an inflammatory disorder. Endothelial dysfunction is an important component of essential hypertension, the severity being determined by the stage of hypertension, microalbuminuria, LDL-cholesterol, triglycerides, age and Hs-CRP levels independently. The undesirable inflammatory response can be cost-effectively prevented at various levels by targeting the potentially modifiable risk factors elucidated in the study.

To determine the prevalence and determinants of xerophthalmia among children aged 0-60 months .This cross-sectional study included 3571 children under 5 years of age from six villages and four periurban areas. Children with xerophthalmia were identified and severity graded using the WHO classification. The main outcome measures were socio-demographic, nutritional and comorbidity related risk factors of xerophthalmia. A pretested questionnaire carrying information on the above factors was administered to the caregivers. Univariate and multivariate binary logistic regression analyses were performed to examine the association of each of these factors with xerophthalmia.The overall prevalence of xerophthalmia was of serious public health importance at 9.1%. Prevalence of both mild (night blindness, and Bitots spots) and severe forms (corneal changes) of xerophthalmia increased with age. Bitots spots and night blindness were the commonest manifestations. Rural dwelling, lower social class, maternal illiteracy and occupation outside home were significant antecedent socio-demographic risk factors on univariate analysis. Multivariate analysis revealed low intake of proteins and vitamin A containing foods as well as predominant maize diet to be significant dietary factors. Nutritional wasting and a preceding history of measles were significant comorbid determinants (P0.05). None of the socio-demographic variables emerged significant on multivariate analysis.Vitamin A deficiency remains a significant public health problem in Aligarh district. The proximal factors in a child's milieu viz nutrition and comorbidities were more significantly associated with xerophthalmia than the distal socio-demographic factors, thereby making a case for their cost effective prevention. The high magnitude of the problem calls for intensification of existing prophylactic measures in these areas.

Unintentional injuries accounted for 43% of adolescents (1091/2545) reporting to the emergency department of a tertiary care hospital in Delhi over 3 months.

Childhood blindness and visual impairment are as important and perhaps more devastating and disabling than adult onset blindness, because of the long span of life still remaining to be lived. Refractive errors and more particularly myopia, place a substantial burden on the individual and society. School-age children constitute a particularly vulnerable group where uncorrected refractive errors may have a dramatic impact on learning capability and educational potential. This article provides an overview of school eye screening from the perspective of National Program for Control of Blindness (NPCB), Government of India; and challenges, future directions and thrust area envisaged under the program for amelioration of childhood blindness.

Objective: To determine vitamin A-first dose supplement coverage in children aged 12-23 months and to find out its correlates with selected variables . Materials and Methods: The 30-cluster sampling technique based on probability proportional to size advocated by the World Health Organization was used to assess vitamin A-first dose supplement amongst 210 children in the age group of 12-23 months residing in slums of a randomly selected municipal zone of Delhi during October to November 2005. Results: Only 79 (37.6%) children out of 210 had received vitamin A-first dose supplement. Further analysis of 79 children was carried out with regard to selected variables like religion, gender, birth order, place of birth, immunization status and literacy of mother. These analyses showed that 71 (89.9%) were Hindu and eight (10.1%) were non-Hindu ( P = 0.04). Nearly 44 (55.7%) males and 35 (44.3%) females had received vitamin A ( P = 0.74). The proportion of children born in a health institution who received first dose (57%) of vitamin A supplementation was significantly higher than of those who were born at home (43%) ( P < 0.001). Similarly, higher proportion of children with birth order-one (48.1%) in comparison to birth order-three or above (26.6%) received vitamin A ( P < 0.001). Thirty children though fully immunized for vaccine-preventable disease up to the age-of-one year had not received vitamin A-first dose supplement, suggesting that an opportunity had been missed. The association between receipt of vitamin A by the child and literacy status of mother was found to be significant ( P < 0.001). Conclusion: The study reflects low coverage of Vitamin A supplement.