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Key Clinical Message: With increased complexity in both medical comorbidities and coronary anatomy, the proportion of surgically turndown patients and high‐risk PCI will continue to rise. Impella‐assisted complex PCI can be performed with high technical success and can improve quality of life, angina score, and potentially left ventricular ejection fraction. [ABSTRACT FROM AUTHOR]

BackgroundMicroRNA-21 is up-regulated in a variety of cancers like, breast, colorectal, lung, head and neck etc. However, the regulation of miR-21 in renal cell carcinoma (RCC) has not yet been studied systematically.Methods and resultsWe measured miR-21 levels in 54 pairs of kidney cancers and their normal matched tissues by real-time PCR. The expression level of miR-21 was correlated with 5 year survival and the pathological stage. Functional studies were done after inhibiting miR-21 in RCC cell lines. We studied in vitro and in vivo effects of the chemo preventive agent genistein on miR-21 expression. In 48 cases (90%), miR-21 was increased. All patients with low miR-21 expression survived 5 years, while with high miR-21 expression, only 50% survived. Higher expression of miR-21 is associated with an increase in the stage of renal cancer. Functional studies after inhibiting miRNA-21 in RCC cell lines show cell cycle arrest, induction of apoptosis and reduced invasive and migratory capabilities. Western blot analysis showed an increase in the expression of p21 and p38 MAP kinase genes and a reduction in cyclin E2. Genistein inhibited the expression of miR-21 in A-498 cells and in the tumors formed after injecting genistein treated A-498 cells in nude mice besides inhibiting tumor formation.ConclusionsThe current study shows a clear correlation between miR-21 expression and clinical characteristics of renal cancer. Thus we believe that miR-21 can be used as a tumor marker and its inhibition may prove to be useful in controlling cancers with up-regulated miR-21.

Background Hypertriglyceridemia is a common cause of acute pancreatitis (AP). This literature review compared the effectiveness and adverse events of insulin therapy, with or without heparin, and plasmapheresis, in reducing triglyceride levels in patients with hypertriglyceridemia-induced AP. Methods Systematic reviews, meta-analyses, evidence syntheses, editorials, commentaries, protocols, abstracts, theses and preprints were excluded. Review Manager was used to conduct the meta-analysis. The literature search yielded 2765 articles, but only 5 were included in the systematic review and meta-analysis and the total number of participants in the review was 269. Results From this study's analysis, insulin ± heparin was more successful in reducing triglyceride levels than plasmapheresis (standardized mean difference -0.37, 95% confidence interval [CI] 0.99 to 0.25; P=0.25). Insulin ± heparin therapy had a lower mortality rate than plasmapheresis (risk ratio [RR] 0.70, 95%CI 0.25-1.95). Hypotension, hypoglycemia, and acute renal failure were less common in the plasmapheresis therapy group than in insulin ± heparin therapy (RR 1.13, 95%CI 0.46-2.81, RR 3.90, 95%CI 0.45-33.78, and RR 0.48, 95%CI 0.02-13.98 for hypotension, hypoglycemia, and acute renal failure, respectively). Conclusions This study found no significant difference in mortality between insulin ± heparin therapy and plasmapheresis used for the reduction in triglyceride levels. It is notable that no substantial differences were observed in the most common side-effects encountered during these therapies, thus indicating non-inferiority. [ABSTRACT FROM AUTHOR]

Research Background: In this modern world, every person needs a specific medium of information in order to survive with the communication means which is effectively and easily answered by the means of telecommunication. In this fast and rapidly moving world, the telecommunication sector has become a main tool to share and communicate information from one end to another. It bridges the gap between people irrespective of cities, countries or continents. During such modern and fast paced telecommunication times, a well devised customer social responsibility is known as catalyst that can significantly elevate the business operations for any telecommunication organizations in this sector. In order to advance in this rapidly growing technical market every telecommunication company is trying to maintain strong relationships with the customers in order to provide better service quality and develop new market strategies. The author suggests that telecommunication service providers must work on customer social responsibility strategies and policies that immensely reflects a significant impact towards customer loyalty. Purpose of the article: To examine that how corporate social responsibility in lieu with service quality and customer satisfaction affects the customer loyalty in telecommunication sector. This article also highlights the customer behaviour towards CSR policies and what significance value added services have on the customer accordingly. Methods: The author used descriptive statistics employed to analyse survey. Based on the finding the author has prepared the analysis and result. Finding & Value added: Implementing the CSR practice that is corporate social responsibility and better customer service quality, a telecommunication company can increase customer loyalty.

Introduction: The treatment of childhood TB is based on the same principles as the treatment of adult TB. The standard treatment regimen for childhood TB consists of a combination of isoniazid, rifampicin, pyrazinamide, and ethambutol for two months, followed by isoniazid and rifampicin for four months. Children with TB are treated with weight-based dosages of anti-TB drugs. Aims: To investigate delays and barriers in treatment initiation in children with TB. Material and Methods: The Department of Pulmonary Medicine and Pediatrics at the Govt. Medical College in Patiala carried out this cross-sectional investigation. In the current investigation, 126 participants in total were included. The study comprised children who had been diagnosed with T.B. (Pulmonary or Extra Pulmonary TB) during the course of a year and were patients at the department of Pulmonary Medicine and Paediatrics, Govt. Medical College, Patiala. Result: Delay was seen in 48.41 percent of the patients. Reasons for delay in treatment initiation as per parents/caregivers was denial diagnosis, economic constraints, lack of understanding and transportation challenges found to be present in 10.32 percent, 7.14 percent, 15.08 percent and 15.08 percent of the patients respectively. Conclusion: Strengthening HCP awareness regarding the importance of TB symptom screening and encouraging early referrals are crucial for rapidly scaling up early treatment initiation in childhood TB. [ABSTRACT FROM AUTHOR]