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ObjectiveTo determine the best possible value of pathological PCI (pPCI) as a prognostic marker for survival in high-grade serous epithelial ovarian cancer patients in patients treated with neoadjuvant chemotherapy and interval cytoreductive surgery.MethodsAll patients with FIGO stage IIIC high-grade serous ovarian carcinoma were included. Receiver operating curves (ROC) were used to determine the best possible score for pPCI in predicting survival. Survival curves were calculated using the Kaplan–Meier test, and factors affecting survival were compared using the log-rank test.ResultsFrom January 2018 to January 2024, 171 patients who underwent interval cytoreductive surgery were included. Complete cytoreduction was achieved in 88% of the patients. ROC curves determined a (pPCI) cut-off value of 8 as the best possible score for predicting survival with a sensitivity of 82% and specificity of 67% (Youden’s Index = 0.60). pPCI with a cut-off value of 8 showed improved OS (p = 0.002) and DFS, (p = 0.001) in both univariate and multivariate analyses.ConclusionFollowing interval cytoreductive surgery, despite optimal complete cytoreductive surgery, a pathological PCI of 8 is a poor prognostic indicator of survival and may serve as a surrogate clinical marker for guiding clinicians in adjuvant treatment, especially in resource-driven settings in the real world.

Abstract Background Sri Lanka after eliminating malaria in 2012, is in the prevention of re-establishment (POR) phase. Being a tropical country with high malariogenic potential, maintaining vigilance is important. All malaria cases are investigated epidemiologically and followed up by integrated drug efficacy surveillance (iDES). Occasionally, that alone is not adequate to differentiate Plasmodium falciparum reinfections from recrudescences. This study evaluated the World Health Organization and Medicines for Malaria Venture (MMV) recommended genotyping protocol for the merozoite surface proteins (msp1, msp2) and the glutamate-rich protein (glurp) to discriminate P. falciparum recrudescence from reinfection in POR phase. Methods All P. falciparum patients detected from April 2014 to December 2019 were included in this study. Patients were treated and followed up by iDES up to 28 days and were advised to get tested if they develop fever at any time over the following year. Basic socio-demographic information including history of travel was obtained. Details of the malariogenic potential and reactive entomological and parasitological surveillance carried out by the Anti Malaria Campaign to exclude the possibility of local transmission were also collected. The msp1, msp2, and glurp genotyping was performed for initial and any recurrent infections. Classification of recurrent infections as recrudescence or reinfection was done based on epidemiological findings and was compared with the genotyping outcome. Results Among 106 P. falciparum patients, six had recurrent infections. All the initial infections were imported, with a history of travel to malaria endemic countries. In all instances, the reactive entomological and parasitological surveillance had no evidence for local transmission. Five recurrences occurred within 28 days of follow-up and were classified as recrudescence. They have not travelled to malaria endemic countries between the initial and recurrent infections. The other had a recurrent infection after 105 days. It was assumed a reinfection, as he had travelled to the same malaria endemic country in between the two malaria attacks. Genotyping confirmed the recrudescence and the reinfection. Conclusions The msp1, msp2 and glurp genotyping method accurately differentiated reinfections from recrudescence. Since reinfection without a history of travel to a malaria endemic country would mean local transmission, combining genotyping outcome with epidemiological findings will assist classifying malaria cases without any ambiguity.

Parental bonding is a critical factor in personality, emotional, and behavior development. The objectives of the present research were to study the socio-demographic profile and parental bonding of the students in Madurai Corporation Schools. The design of the study is descriptive, and 115 samples were selected using stratified random sampling. The present research focuses on the socio-demographic profile and parental bonding of male students in the age group from 14 to 17 years. The study included other factors like religion, caste, education of father and mother, the employment status of father and mother, family income, family type, and birth order of respondents. Further parental bonding, which includes father bonding and mother bonding was studied. Parental bonding was the outcome variable which included four subtypes (viz) a) affectionate constraint b) optimal parenting, c) affectionless control and d) neglectful parenting 'The study results show that both fathers and mothers showed affectionless power. Following this, optimal parenting, affectionate constraint, and neglectful parenting occupied successive percentage for fathers as well as mothers.

Introduction: Pain or vaso-occlusive crisis is the hallmark of sickle cell disease (SCD). Standard treatment for SCD pain includes hydration, as well as nonsteroidal anti-inflammatory drugs and opioid pain medications. Although most studies show that opioids provide short-term relief, they are associated with side effects including constipation, opioid-induced hyperalgesia, and risk of dependence and addiction. The objectives of this study were to assess the prevalence of complementary and integrative medicine (CIM) use in a population of pediatric patients with SCD, the type of CIM used, and sociodemographic and health-related factors associated with their use of CIM. Methods: Parents of children with SCD were recruited to the study during clinic visits and hospitalizations. They were asked to complete a 22-item self-administered survey about their child's use of CIM. Descriptive statistics were used to generate frequencies or percentages for categorical variables. Chi square or Fisher's exact test was performed with a p-value

BackgroundCOVID-19 was declared a global pandemic in March 2020. Early reports were primarily in adults, and sickle cell disease (SCD) was classified as a risk factor for severe COVID-19 disease. However, there are a limited number of primarily multi-center studies reporting on the clinical course of pediatric patients with SCD and COVID-19.MethodsWe conducted an observational study of all patients with SCD diagnosed with COVID-19 at our institution between March 31, 2020, and February 12, 2021. Demographic and clinical characteristics of this group were collected by retrospective chart review.ResultsA total of 55 patients were studied, including 38 children and 17 adolescents. Demographics, acute COVID-19 clinical presentation, respiratory support, laboratory findings, healthcare utilization, and SCD modifying therapies were comparable between the children and adolescents. Seventy-three percent (N = 40) of all patients required emergency department care or hospitalization. While 47% (N = 26) were hospitalized, only 5% (N = 3) of all patients required intensive care unit admission. Patients frequently had concurrent vaso-occlusive pain crisis (VOC) (N = 17, 43%) and acute chest syndrome (ACS) (N = 14, 35%). Those with ACS or an oxygen requirement had significantly higher white blood cell count, lower nadir hemoglobin, and higher D-dimers, supporting a pro-inflammatory and coagulopathic picture. Non-hospitalized patients were more likely to be on hydroxyurea than hospitalized patients (79 vs. 50%, p = 0.023).ConclusionChildren and adolescent patients with SCD and acute COVID-19 often present with ACS and VOC pain requiring hospital-level care. Hydroxyurea treatment appears to be protective. We observed no mortality despite variable morbidity.

Gesture recognition integrated into Internet of Things (IoT) systems is an emerging area of research with significant potential for various applications. This system primarily focuses on recognizing hand gestures to facilitate communication, especially for individuals with speech impairments. The proposed hand gesture recognition system employs sensors, such as flex sensors and accelerometers, to accurately capture hand movements. These sensors are connected to an IoT device, which processes the data and translates gestures into meaningful commands or text. The system is designed to be cost-effective, making it accessible for users who require assistive technologies. One notable application of this technology is in aiding communication for speech-impaired individuals. By converting recognized gestures into text or speech, the system enables users to interact more effectively with their environment and with others. The integration of machine learning algorithms enhances the accuracy and efficiency of gesture recognition, allowing for real-time processing and feedback. Overall, the hand gesture recognition system using IoT aims to improve accessibility and communication for differently-abled individuals, showcasing the potential of combining hardware and software solutions to address real-world challenges in human-computer interaction. [ABSTRACT FROM AUTHOR]

Aim: The study was undertaken to evaluate the effect of instructed tooth brushing on plaque and oral hygiene among the visually impaired children from a residential blind school in Pune. Materials and Methods: An interventional study was conducted for 30 days at a residential Blind School for boys. Twenty-four blind children were recruited for the study. Baseline data were recorded using the modified patient hygiene performance (PHP) index and oral hygiene index-simplified (OHIS). Oral prophylaxis was undertaken. Oral health instruction pamphlet in Braille script was given to them. Supervised tooth brushing twice daily as per the musical audio instructions was performed for 30 days. Postintervention, the indices scores were recorded again. Paired t-test was used for comparison of pre and postintervention scores. Results: The modified PHP score pre and postintervention were 4.19 ± 0.54 and 1.81 ± 0.87, respectively, and the difference was statistically significant. The OHIS scores pre and postintervention were 3.31 ± 0.88 and 1.04 ± 0.54 and were also statistically significant. Conclusion: The present study revealed that the instructed tooth brushing program, along with oral prophylaxis and oral hygiene instructions in Braille for the visually impaired children for maintaining their oral hygiene is an effective method.