Utility of Papanicolaou’s smears in the diagnosis of premalignant and malignant lesions of the cervix in a tertiary care centre of South Gujarat, India

Background: "Preventable but not prevented", this is the reality of cervical cancer today, at least in developing countries. 80% of all the cases of cervical cancer occur in these developing countries. In India, cervical cancer is the leading cause of cancer related deaths in women. The Papanicolaou test is simple, quick, and painless. It is capable of detecting cervical cancer at an early stage and is used widely in developed countries, where it has decreased both the incidence and mortality of cervical cancer. Objective of the study was conducted to determine the importance of conventional Pap smears for the diagnosis of inflammatory, premalignant and malignant lesions of the cervix.Methods: This cross-sectional study was conducted from January 2017 to June 2018 on 2000 women coming for a Pap smear examination in Government Medical College attached to New Civil Hospital, Surat. After doing Pap stain, all cases were reported as per the 2014 Bethesda system.Results: A total of 2000 cases of Pap smears were received out of which 1914(95.7%) cases were satisfactory for evaluation, 86(4.3%) cases were unsatisfactory. The frequency of epithelial abnormalities was 3.66%. The age group of 51-60 years showed the highest epithelial abnormalities. The frequency of epithelial abnormalities in asymptomatic women was 2.3%. Out of the 1844 cases, 103(5.6%) showed changes of atrophy, 1011(54.8%) cases showed inflammatory/reactive changes, whereas organisms were seen in 558(30.3%) cases.Conclusions: Pap smear happens to be an economical, safe and pragmatic diagnostic tool for early detection of cervical cancer

Profile of patients with intellectual disability visiting a tertiary care center in western India

Background:Intellectual disability is commonly associated with variety of etio-pathological and co-morbid conditions influencing outcome of rehabilitative measures. Understanding of these factors helps in better management of disabled condition.Methods:A qualitative retrospective case record review, of patients with intellectual disability, visiting psychiatry department of a tertiary care hospital, within a period of one year, was conducted to assess their epidemiological and clinical profile.Results: Patients with Intellectual disability are brought to the hospital at all ages and commonly by their parents. Etiologically related various peri-natal factors (delayed birth cry and seizures being most common) as well as childhood medical conditions (epilepsy and recurrent respiratory/GI infections being most common) were commonly found in these patients. Milestones are delayed in almost 60-70% of cases whereas various physical and psychiatric conditions commonly co-existed with disability.Conclusion:Clinical profile of these patients demands a comprehensive evaluation and management apart from routine IQ assessment

The effectiveness of non-pharmaceutical interventions in reducing SARS-CoV-2 transmission and COVID-19 incidence and mortality:systematic review and meta-analysis

OBJECTIVE: To review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World Health Organization COVID-19 database (preprints). ELIGIBILITY CRITERIA FOR STUDY SELECTION: Observational and interventional studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality. MAIN OUTCOME MEASURES: The main outcome measure was incidence of covid-19. Secondary outcomes included SARS-CoV-2 transmission and covid-19 mortality. DATA SYNTHESIS: DerSimonian Laird random effects meta-analysis was performed to investigate the effect of mask wearing, handwashing, and physical distancing measures on incidence of covid-19. Pooled effect estimates with corresponding 95% confidence intervals were computed, and heterogeneity among studies was assessed using Cochran’s Q test and the I(2) metrics, with two tailed P values. RESULTS: 72 studies met the inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures as a “package of interventions.” Eight of 35 studies were included in the meta-analysis, which indicated a reduction in incidence of covid-19 associated with handwashing (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I(2)=12%), mask wearing (0.47, 0.29 to 0.75, I(2)=84%), and physical distancing (0.75, 0.59 to 0.95, I(2)=87%). Owing to heterogeneity of the studies, meta-analysis was not possible for the outcomes of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces. The effects of these interventions were synthesised descriptively. CONCLUSIONS: This systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of covid-19 vaccination. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020178692

Isolated angioedema of the bowel due to C1 esterase inhibitor deficiency: a case report and review of literature

<p>Abstract</p> <p>Introduction</p> <p>We report a rare, classic case of isolated angioedema of the bowel due to C1-esterase inhibitor deficiency. It is a rare presentation and very few cases have been reported worldwide. Angioedema has been classified into three categories.</p> <p>Case presentation</p> <p>A 66-year-old Caucasian man presented with a ten-month history of episodic severe cramping abdominal pain, associated with loose stools. A colonoscopy performed during an acute attack revealed nonspecific colitis. Computed tomography of the abdomen performed at the same time showed a thickened small bowel and ascending colon with a moderate amount of free fluid in the abdomen. Levels of C4 (< 8 mg/dL; reference range 15 to 50 mg/dL), CH50 (< 10 U/mL; reference range 29 to 45 U/ml) and C1 inhibitor (< 4 mg/dL; reference range 14 to 30 mg/dL) were all low, supporting a diagnosis of acquired angioedema with isolated bowel involvement. Our patient's symptoms improved with antihistamine and supportive treatment.</p> <p>Conclusion</p> <p>In addition to a detailed comprehensive medical history, laboratory data and imaging studies are required to confirm a diagnosis of angioedema due to C1 esterase inhibitor deficiency.</p

Mental health in Europe during the COVID-19 pandemic: a systematic review

The COVID-19 pandemic caused immediate and far-reaching disruption to society, the economy, and health-care services. We synthesised evidence on the effect of the pandemic on mental health and mental health care in high-income European countries. We included 177 longitudinal and repeated cross-sectional studies comparing prevalence or incidence of mental health problems, mental health symptom severity in people with pre-existing mental health conditions, or mental health service use before versus during the pandemic, or between different timepoints of the pandemic. We found that epidemiological studies reported higher prevalence of some mental health problems during the pandemic compared with before it, but that in most cases this increase reduced over time. Conversely, studies of health records showed reduced incidence of new diagnoses at the start of the pandemic, which further declined during 2020. Mental health service use also declined at the onset of the pandemic but increased later in 2020 and through 2021, although rates of use did not return to pre-pandemic levels for some services. We found mixed patterns of effects of the pandemic on mental health and social outcome for adults already living with mental health conditions

Mental health in Europe during the COVID-19 pandemic: a systematic review

The COVID-19 pandemic caused immediate and far-reaching disruption to society, the economy, and health-care services. We synthesised evidence on the effect of the pandemic on mental health and mental health care in high-income European countries. We included 177 longitudinal and repeated cross-sectional studies comparing prevalence or incidence of mental health problems, mental health symptom severity in people with pre-existing mental health conditions, or mental health service use before versus during the pandemic, or between different timepoints of the pandemic. We found that epidemiological studies reported higher prevalence of some mental health problems during the pandemic compared with before it, but that in most cases this increase reduced over time. Conversely, studies of health records showed reduced incidence of new diagnoses at the start of the pandemic, which further declined during 2020. Mental health service use also declined at the onset of the pandemic but increased later in 2020 and through 2021, although rates of use did not return to pre-pandemic levels for some services. We found mixed patterns of effects of the pandemic on mental health and social outcome for adults already living with mental health conditions

El impacto del entrenamiento en mindfulness para enfermeras en la reducción del estrés y la mejora del bienestar

Objective: This study aimed to determine that a short Mindfulness-Based (MB) training program could assist critical care nurses feel lowering stress and being more in control of their enhancing well-being (WB).Method: To assess the program's efficacy, a design consisting of a pre-post study with a single group and a quasi-experimental approach was used. This study was conducted in Malaysia at a tertiary referrals facility. The initiative included 40 nurses in critical care that volunteered as a part of a non-probability sample. With at least 79% attendance, 36 people finished the course.Results: The process is a condensed form of Mindfulness-Based Cognitive Therapy (b-MBCT), known locally as Mindful-Gym. The b-MBCT is a five-week based on groups course that meets once a week for two hours and includes practice sessions in between. It was distributed as a component of the hospital's ongoing training for nursing staff. The outcomes associated with stress were evaluated using the Perceived Stress Scale (PSS) and the Depression Anxiety Stress Scale (DASS). In requisites of the results of one's state of WB, the Mindfulness Attention and Awareness Scale and the Subjective Happiness Scale (SHS) were used.Conclusion: Participants said that their perception of stress had significantly decreased after finishing the session (PSS: q &lt; .001; s = 0.40), anxiety (DASS-B: q &lt; .001; s =0.33), stress (DASS-T: q = .001; e = 0.53), depression (DASS-E: q &lt; .001; s = 0.35), and happiness (SHS: q = .026; e = 0.53), having an impact magnitude ranging from mild to significant. The findings provide credence to the efficacy of b-MBCT in lowering stress and enhancing WB with nurses working in critical care settings.Objetivo: Este estudio pretendía determinar si un programa corto de entrenamiento en Mindfulness-Based (MB) podría ayudar a las enfermeras de cuidados críticos a sentir que disminuyen el estrés y a tener un mayor control de su bienestar (Bb).Método: Para evaluar la eficacia del programa, se utilizó un diseño consistente en un estudio pre-post con un único grupo y un enfoque cuasi-experimental. Este estudio se llevó a cabo en Malasia, en un centro de referencia terciario. La iniciativa incluyó a 40 enfermeras de cuidados críticos que se presentaron voluntarias como parte de una muestra no probabilística. Con al menos un 79% de asistencia, 36 personas terminaron el curso.Resultados: El proceso es una forma condensada de Terapia Cognitiva Basada en Mindfulness (b-MBCT), conocida localmente como Mindful-Gym. El b-MBCT es un curso de cinco semanas basado en grupos que se reúne una vez a la semana durante dos horas e incluye sesiones de práctica entre medias. Se distribuyó como componente de la formación continua del personal de enfermería del hospital. Los resultados asociados al estrés se evaluaron mediante la Escala de Estrés Percibido (PSS) y la Escala de Depresión, Ansiedad y Estrés (DASS). En cuanto a los resultados del estado de WB, se utilizaron la Escala de Atención y Conciencia Mindfulness y la Escala de Felicidad Subjetiva (SHS).Conclusiones: Los participantes afirmaron que su percepción del estrés había disminuido significativamente tras finalizar la sesión (PSS: q &lt; 0,001; s = 0,40), la ansiedad (DASS-B: q &lt; 0,001; s = 0,33), el estrés (DASS-T: q = 0,001; e = 0,53), la depresión (DASS-E: q &lt; 0,001; s = 0,35) y la felicidad (SHS: q = 0,026; e = 0,53), teniendo una magnitud de impacto que oscilaba entre leve y significativa. Los hallazgos proporcionan credibilidad a la eficacia de la b-MBCT para disminuir el estrés y mejorar el BM en enfermeras que trabajan en entornos de cuidados críticos

FactDrill: A Data Repository of Fact-Checked Social Media Content to Study Fake News Incidents in India

The production and circulation of fake content in India is a rising problem. There is a dire need to investigate the false claims made in public. This paper presents a dataset containing 22,435 fact-checked social media content to study fake news incidents in India. The dataset comprises news stories from 2013 to 2020, covering 13 different languages spoken in the country. We present a detailed description of the 14 different attributes present in the dataset. We also present the detailed characterisation of three M’s (multi-lingual, multi-media, multi-domain) in the FactDrill dataset. Lastly, we present some potential use cases of the dataset. We expect that the dataset will be a valuable resource to understand the dynamics of fake content in a multi-lingual setting in India

OCT4 and SOX2 Work as Transcriptional Activators in Reprogramming Human Fibroblasts

SOX2 and OCT4, in conjunction with KLF4 and cMYC, are sufficient to reprogram human fibroblasts to induced pluripotent stem cells (iPSCs), but it is unclear if they function as transcriptional activators or as repressors. We now show that, like OCT4, SOX2 functions as a transcriptional activator. We substituted SOX2-VP16 (a strong activator) for wild-type (WT) SOX2, and we saw an increase in the efficiency and rate of reprogramming, whereas the SOX2-HP1 fusion (a strong repressor) eliminated reprogramming. We report that, at an early stage of reprogramming, virtually all DNA-bound OCT4, SOX2, and SOX2-VP16 were embedded in putative enhancers, about half of which were created de novo. Those associated with SOX2-VP16 were, on average, stronger than those bearing WT SOX2. Many newly created putative enhancers were transient, and many transcription factor locations on DNA changed as reprogramming progressed. These results are consistent with the idea that, during reprogramming, there is an intermediate state that is distinct from both parental cells and iPSCs