Evaluation of safety and tolerability of iron amino acid chelate therapy in pregnant women

Background: Anemia is a major health problem. Iron deficiency is the most common cause of anemia during pregnancy. It can be associated with increased preterm labor, preeclampsia, and maternal sepsis. It can also lead to fetal loss or even perinatal deaths. The aim of the study was to monitor the oral iron therapy [Iron Amino Acid Chelate (IAAC) equivalent to elemental iron 30 mg] administered according to hospital practice and to determine the safety, and tolerability of IAAC in pregnant women.Methods: The data of pregnant women attending the outpatient department of the hospital for antenatal care between March 2020 and February 2021 and prescribed IAAC was retrospectively analyzed. It was of interest to note the changes in the Hemoglobin (Hb) levels and serum ferritin levels. These parameters were considered as the primary efficacy parameter and were analyzed by the paired t-test.Results: The data indicated very well tolerance to IAAC preparation with increase in Hb levels. After 12 week of treatment, there were significant increases in hemoglobin levels with mean rise in Hb level was 7 to 9 gm/dL. A statistically significant difference was observed at the 4th, 8th, and 12th weeks from the baseline value to each evaluation in the Hb level due to the supplementation of oral iron.  The change in the serum ferritin levels was found to be statistically significant at the 12th week from the baseline values. Most of the women tolerated the oral IAAC preparationConclusions: This retrospective analysis showcased a significant improvement in the Hb and serum ferritin levels of pregnant women after 12 weeks

An overview of treatment options for COVID-19

Severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2) which emerged in Wuhan initially as pneumonia of unknown origin in December 2019, later spread to whole world and became pandemic on 11th March, 2020. Many drugs have been proposed but are backed without clinical evidence. Scientific bodies are in the row to discover a reliable vaccine and effective drugs against the novel coronavirus. Many antiviral and anti-parasitic drugs which were thought to have some effect on Coronavirus disease 2019 (COVID-19) have been tried during the crisis but none have shown concrete evidence of action. Randomized clinical trials on the repurposed drugs are now registered under clinical trial registry to look at the safety profile and efficacy of the drugs to be used against SARS-CoV-2. Many meta-analyses are being conducted worldwide to frame evidence for the fight against this novel coronavirus. We are providing below a review of various drugs that have been tried for treatment of COVID-19 as well as different clinical trials which are underway

Mixed-layer characteristics as related to the monsoon climate of New Delhi, India

Annual variations of mixed-layer characteristics at New Delhi, India have been studied for a weak monsoon (1987) and a strong monsoon (1988) year. In the weak monsoon year (1987), the maximum mixing depthh max was found to have a value of around 3000 m during the pre-monsoon, less than 2000 m during the summer monsoon, around 2000 m during the post-monsoon, and less than 1000 m in the winter season. For the strong monsoon year (1988),h max values were less than 1987 values for comparable periods throughout the year. The seasonal and yearly differences ofh max were explained by the surface energy balance and potential temperature gradient γ at a time close to sunrise. According to the spatial patterns of γ obtained by an objective analysis of the 850 to 700 hPa layers. mixed-layer characteristics obtained at New Delhi are representative of the north and central regions of India

Clinical, Radiological and Bacteriological Profile of Lung Abscess - An Observational Hospital Based Study

BACKGROUND: The incidence of lung abscess acquired in the community is unknown, but this is a common clinical problem encountered in developing countries. The incidence of lung abscess was high in the pre-antibiotic era but the advent of susceptible antibiotics it has reduced with an equal fall in mortality to 8.7%. With the emerging antibiotic resistance and change in the trends of bacteriological profile causing lung abscess, it is the need of time to reevaluate lung abscess. AIM: The study aimed to determine the clinical, radiological and bacteriological profile of lung abscess. MATERIAL AND METHOD: The study was a non-randomized prospective observational study conducted in the department of pulmonary medicine for 18 months. In the study, patients > 15 years of age with clinical features of lung abscess were recruited and were subjected to chest X-ray, routine blood test. Sputum gram stain and culture, as well as antibiotic sensitivity according to the organism, were evaluated. Reports of all investigations along with patient characteristics and risk factors were analysed statistically using SPSS 20.0. RESULTS: Forty-six cases of lung abscess were included, and the majority of patients were found to be adults with a mean age of 42.9 years with a male to female ratio of 6.6:1. The most common predisposing factor was an unhygienic oral cavity in 28% of cases with alcohol ingestion being the most important risk factor in 22% of cases. The most common organism found in lung abscess cases was Klebsiella pneumoniae, and they were sensitive to ceftazidime. CONCLUSION: Our study shows that Klebsiella pneumoniae should be considered an important pathogen in community-acquired lung abscesses

HIV status among presumptive tuberculosis cases attending tertiary care centre in South India

Introduction: In India, to increase human immunodeficiency virus (HIV) case detection, the National Technical Working Group onTB /HIV had made it mandatory to screen for HIV infection among presumptive tuberculosis (TB) cases. Material and methods: Our study was a cross-sectional study, conducted between June 2015 and December 2016 in a tertiarycare institute (JIPMER), in South India, to estimate the prevalence of HIV among presumptive TB cases. Results: Among the 964 presumptive TB cases who attended pulmonary medicine OPD, 189 patients were sputum acid-fastbacilli (AFB) positive. Among the 189 sputum positive cases, 9 were HIV positive. Of the 964 presumptive TB cases, 879 gaveconsent for HIV testing and 33 (3.7%) turned out to be HIV positive. If only sputum positive cases had been screened for HIV,we would have missed 24 new HIV positive cases. The number needed to screen was 27 among presumptive TB cases and 18among TB patients. Conclusions: The uptake of HIV testing (91%) and the diagnostic yield of 3.7% of HIV positive cases among the presumptiveTB patients is quite high compared to that of the Revised National Tuberculosis Control Programme (RNTCP) mechanism of Puducherry.This reinforces the need to screen all the presumptive cases for HIV infection, to increase HIV case detection so thatanti-retroviral therapy (ART) can be initiated early

Fungal pneumonia concealing bacterial pneumonia: a diagnostic dilemma

We describe the case of a 61-year-old diabetic man affected by Achromobacter denitrificans. He was immunocompetent and did not have any past history of chronic lung disease. The patient was treated with sensitive antibiotic meropenem 1 g three times daily. To our knowledge, only one case of A. denitrificans pneumonia has been reported from the Indian subcontinent, in an individual with underlying lung disease, and none in a healthy person

MIXED-LAYER CHARACTERISTICS AS RELATED TO THE MONSOON CLIMATE OF NEW DELHI, INDIA

Abstract. Annual variations of mixed-layer characteristics at New Delhi, India have been studied for a weak monsoon (1987) and a strong monsoon (1988) year. In the weak monsoon year (1987), the maximum mixing depth hma x was found to have a value of around 3000 m during the pre-monsoon, less than 2000 m during the summer monsoon, around 2000 m during the post-monsoon, and less than 1000 m in the winter season. For the strong monsoon year (1988), hmax values were Jess than 1987 values for comparable periods throughout the year. The seasonal and yearly differences of h~ax were explained by the surface energy balance and potential temperature gradient y at a time close to sunrise. According to the spatial patterns of 7 obtained by an objective analysis of the 850 to 700 hPa layers, mixed-layer characteristics obtained at New Delhi are representative of the north and central regions of India

Zakażenie wirusem HIV u pacjentów z podejrzeniem gruźlicy diagnozowanych w ośrodku specjalistycznym w południowych Indiach

WSTĘP: W celu zwiększenia wykrywalności zakażenia wirusem HIV w Indiach narodowa grupa robocza ds. zakażenia wirusem HIV i gruźlicy wprowadziła obowiązek badań przesiewowych w kierunku zakażenia wirusem HIV u wszystkich chorych z podejrzeniem gruźlicy. MATERIAŁ I METODY: Badanie miało charakter przesiewowy i miało na celu ocenę występowania zakażenia wirusem HIV wśród chorych z podejrzeniem gruźlicy. Przeprowadzono je w okresie od czerwca 2015 do grudnia 2016 roku w trzeciorzędowym ośrodku referencyjnym JIPMER w południowych Indiach. WYNIKI: Spośród 964 chorych z podejrzeniem gruźlicy przyjętych w poradni pulmonologicznej, u 189 chorych stwierdzono dodatni wynik plwociny w kierunku prątków kwasoodpornych (AFB). Spośród 189 chorych z dodatnim wynikiem plwociny u 9 stwierdzono zakażenie wirusem HIV. Spośród 879 chorych, którzy wyrazili zgodę na badanie w kierunku zakażenia wirusem HIV, u 33 wynik był dodatni (3,7%). Gdyby zbadano jedynie chorych z dodatnim wynikiem plwociny, nie wykryto by 24 nowych przypadków zakażenia wirusem HIV. Liczba badań, które należałoby wykonać, aby wykryć jeden przypadek zakażenia wirusem HIV (number needed to screen), wynosi 27 dla chorych z podejrzeniem gruźlicy i 18 dla chorych z potwierdzoną gruźlicą. WNIOSKI: Wykrywalność zakażenia HIV (91%) i skuteczność diagnostyczna 3,7% w grupie chorych z domniemaną gruźlicą jest wysoka w porównaniu z danymi zaktualizowanego programu narodowego kontroli gruźlicy. W związku z tym w celu zwiększenia wykrywalności zakażenia wirusem HIV konieczne jest objęcie badaniami przesiewowymi również chorych z podejrzeniem gruźlicy, aby można było wcześnie wdrożyć leczenie anty-retrowirusowe.WSTĘP: W celu zwiększenia wykrywalności zakażenia wirusem HIV w Indiach narodowa grupa robocza ds. zakażenia wirusem HIV i gruźlicy wprowadziła obowiązek badań przesiewowych w kierunku zakażenia wirusem HIV u wszystkich chorych z podejrzeniem gruźlicy. MATERIAŁ I METODY: Badanie miało charakter przesiewowy i miało na celu ocenę występowania zakażenia wirusem HIV wśród chorych z podejrzeniem gruźlicy. Przeprowadzono je w okresie od czerwca 2015 do grudnia 2016 roku w trzeciorzędowym ośrodku referencyjnym JIPMER w południowych Indiach. WYNIKI: Spośród 964 chorych z podejrzeniem gruźlicy przyjętych w poradni pulmonologicznej, u 189 chorych stwierdzono dodatni wynik plwociny w kierunku prątków kwasoodpornych (AFB). Spośród 189 chorych z dodatnim wynikiem plwociny u 9 stwierdzono zakażenie wirusem HIV. Spośród 879 chorych, którzy wyrazili zgodę na badanie w kierunku zakażenia wirusem HIV, u 33 wynik był dodatni (3,7%). Gdyby zbadano jedynie chorych z dodatnim wynikiem plwociny, nie wykryto by 24 nowych przypadków zakażenia wirusem HIV. Liczba badań, które należałoby wykonać, aby wykryć jeden przypadek zakażenia wirusem HIV (number needed to screen), wynosi 27 dla chorych z podejrzeniem gruźlicy i 18 dla chorych z potwierdzoną gruźlicą. WNIOSKI: Wykrywalność zakażenia HIV (91%) i skuteczność diagnostyczna 3,7% w grupie chorych z domniemaną gruźlicą jest wysoka w porównaniu z danymi zaktualizowanego programu narodowego kontroli gruźlicy. W związku z tym w celu zwiększenia wykrywalności zakażenia wirusem HIV konieczne jest objęcie badaniami przesiewowymi również chorych z podejrzeniem gruźlicy, aby można było wcześnie wdrożyć leczenie anty-retrowirusowe

Reporting trends, practices, and resource utilization in neuroendocrine tumors of the prostate gland: a survey among thirty-nine genitourinary pathologists

Background: Neuroendocrine differentiation in the prostate gland ranges from clinically insignificant neuroendocrine differentiation detected with markers in an otherwise conventional prostatic adenocarcinoma to a lethal high-grade small/large cell neuroendocrine carcinoma. The concept of neuroendocrine differentiation in prostatic adenocarcinoma has gained considerable importance due to its prognostic and therapeutic ramifications and pathologists play a pivotal role in its recognition. However, its awareness, reporting, and resource utilization practice patterns among pathologists are largely unknown. Methods: Representative examples of different spectrums of neuroendocrine differentiation along with a detailed questionnaire were shared among 39 urologic pathologists using the survey monkey software. Participants were specifically questioned about the use and awareness of the 2016 WHO classification of neuroendocrine tumors of the prostate, understanding of the clinical significance of each entity, and use of different immunohistochemical (IHC) markers. De-identified respondent data were analyzed. Results: A vast majority (90%) of the participants utilize IHC markers to confirm the diagnosis of small cell neuroendocrine carcinoma. A majority (87%) of the respondents were in agreement regarding the utilization of type of IHC markers for small cell neuroendocrine carcinoma for which 85% of the pathologists agreed that determination of the site of origin of a high-grade neuroendocrine carcinoma is not critical, as these are treated similarly. In the setting of mixed carcinomas, 62% of respondents indicated that they provide quantification and grading of the acinar component. There were varied responses regarding the prognostic implication of focal neuroendocrine cells in an otherwise conventional acinar adenocarcinoma and for Paneth cell-like differentiation. The classification of large cell neuroendocrine carcinoma was highly varied, with only 38% agreement in the illustrated case. Finally, despite the recommendation not to perform neuroendocrine markers in the absence of morphologic evidence of neuroendocrine differentiation, 62% would routinely utilize IHC in the work-up of a Gleason score 5 + 5 = 10 acinar adenocarcinoma and its differentiation from high-grade neuroendocrine carcinoma. Conclusion: There is a disparity in the practice utilization patterns among the urologic pathologists with regard to diagnosing high-grade neuroendocrine carcinoma and in understanding the clinical significance of focal neuroendocrine cells in an otherwise conventional acinar adenocarcinoma and Paneth cell-like neuroendocrine differentiation. There seems to have a trend towards overutilization of IHC to determine neuroendocrine differentiation in the absence of neuroendocrine features on morphology. The survey results suggest a need for further refinement and development of standardized guidelines for the classification and reporting of neuroendocrine differentiation in the prostate gland