Severe childhood SLE with refractory autoimmune hemolytic anemia-a therapeutic challenge.

Paediatric Systemic lupus erythematosus (SLE) constitutes 10 to 20% of cases of SLE with more severe disease and higher mortality. We report a case of an adolescent girl with SLE with multisystem involvement who was started on hydroxychloroquine and oral prednisolone. However, due to persistent worsening of skin lesions and falling cell counts, pulsed dexamethasone was initiated which showed improvement in the skin lesions, cell counts, proteinuria and pleural effusion but there was a persistent fall in the haemoglobin.

Unveiling the Burden of Sickle Cell Anemia: A Pilot Study Validating Dried Blood Spots for Newborn Screening.

This hospital-based cross-sectional study aimed to screen newborns for sickle cell anemia immediately after birth and validate dried blood spot (DBS) samples against conventional venous blood samples (CBS) for hemoglobin variant analysis by HPLC. Among 751 newborns, 2.93% were found to have sickle cell trait.

Safety and efficacy of CAR-T cell therapy in patients with autoimmune diseases: a systematic review.

Chimeric antigen receptor T-cell (CAR-T) therapy has revolutionized the treatment of various hematological malignancies. Recently, CAR-T has been used in refractory auto-immune diseases with initial encouraging results. In this systematic review, we examined the safety and efficacy of CAR-T in patients with refractory auto-immune diseases.

Nanotechnology and nanobots unleashed: pioneering a new era in gynecological cancer management - a comprehensive review.

Introduction: Gynecological cancers, such as ovarian, cervical, and endometrial malignancies, are notoriously challenging due to their intricate biology and the critical need for precise diagnostic and therapeutic approaches. In recent years, groundbreaking advances in nanotechnology and nanobots have emerged as game-changers in this arena, offering the promise of a new paradigm in cancer management. This comprehensive review delves into the revolutionary potential of these technologies, showcasing their ability to transform the landscape of gynecological oncology.

Clinical and Laboratory Characteristics and Comorbidities in Asthma Endotypes in Children.

Objective: To estimate the proportion of eosinophilic and non-eosinophilic (NEA) endotypes in pediatric asthma, and to compare the clinical, and laboratory characterisitics, and different comorbidities between the two endotypes in the children.

Methods: Children aged 5 to 14 years of age with clinical and/or laboratory-confirmed asthma attending the pediatric outpatient department of a tertiary care hospital in Eastern India between October 1, 2023 and March 31, 2024, were included in this cross-sectional study. Complete hemogram, absolute eosinophil count (AEC), IgE, and pulmonary function tests were performed in all patients.

Association of Specific Dietary Fatty Acids with Asthma in Urban School Children and Adolescents: Inferences from a Cross-Sectional Multicentric Study From India.

Objective: To assess the association of dietary fatty acids with asthma in Indian school children.

Methods: Children aged 6-16 years were enrolled from randomly selected urban schools in 10 cities. The International Study on Asthma and Allergies in Childhood Phase III Questionnaire was used to assess the prevalence of asthma.

Re-evaluating Presumptive Treatment with Doxycycline/ Azithromycin in Children With Acute Febrile Illness in a Scrub Typhus Endemic Region: A Cross-Sectional Study.

Objective: To estimate the proportion of children with acute febrile illness (AFI) attending the peripheral health facilities in Gorakhpur, Uttar Pradesh, India, due to Orientia tsutsugamushi (Ots) and re-evaluate the strategy of presumptive administration of doxycycline/azithromycin (PDA) to patients with AFI.

Methods: Children aged 2-18 years with AFI attending 16 peripheral health facilities in Gorakhpur, Uttar Pradesh, were enrolled in September 2023. Blood samples were tested for O.

Ketorolac vs Morphine for Severe Vaso-Occlusive Crisis in Sickle Cell Disease: An Open-Label Randomized Controlled Trial (KISS Study).

Objectives: To compare the efficacy and safety of intravenous (IV) ketorolac and IV morphine in the management of severe vaso-occlusive crisis (VOC) in children with sickle cell disease (SCD).

Method: An open-label, randomized controlled trial was conducted from January 2021 to July 2022 wherein children with SCD aged 3 to 15 years, presenting with severe VOC (score > 6 on the Wong-Baker Faces Pain scale) were included. Block randomization with minimization was done and participants received either IV ketorolac (intervention) or IV morphine infusion (standard).

User satisfaction and dissatisfaction with assistive technology devices and services in India.

User satisfaction with Assistive Technology (AT) is one of the crucial factors in the success of any AT service. The current study aimed to estimate satisfaction with AT and the reasons for dissatisfaction and unsuitability among persons with functional difficulties in India. Using the WHO Rapid Assistive Technology Assessment tool, a cross-sectional study was conducted in eight districts, representing four zones of India.

Indocyanine Green Fluorescence-Guided Surgery in Pediatric Hepatobiliary Procedures: A Feasibility Study for Improved Intraoperative Visualization.

Introduction Indocyanine Green (ICG) fluorescence guided surgery (FGS) is reported extensively in adult operations, but its safety and applications in Pediatric populations remain to be comprehensively understood. The dose, administration protocols and intraoperative imaging benefits in Pediatric hepatobiliary operations are not clear. Objectives To identify the feasibility and applications of ICG Fluorescence Guided Surgery (FGS) in hepatobiliary surgeries (for biliary atresia, choledochal cyst, and cholelithiasis) in children.

Novel Inherited N-terminus TAP1 Variants and Severe Clinical Manifestations- Are Genotype-Phenotype Correlations Emerging?

Major histocompatibility complex class I deficiency results from deleterious biallelic variants in TAP1, TAP2, TAPBP, and B2M genes. Only a few patients with variant-curated TAP1 deficiency (TAP1D) have been reported in the literature and the clinical phenotype has been variable with an emphasis on autoimmune and inflammatory complications. We report TAP1D in a Nepalese girl with a severe clinical phenotype with serious viral infections at a very young age.

Antibiotic prophylaxis to prevent infection in patients with Child-Pugh A cirrhosis with upper gastrointestinal bleed: an open label randomised controlled trial.

Background And Aims: Although beneficial in reducing the risk of bacterial infections in patients with advanced decompensated cirrhosis after upper gastrointestinal (GI) bleed, the utility of prophylactic antibiotics in those with Child-Pugh A cirrhosis is not known. We studied if prophylactic antibiotics can be withheld in this cohort.

Methods: This was a single-centre, open-label randomised-controlled-trial with non-inferiority design.

Recent Advancements and Applications of Nanosensors in Oral Health: Revolutionizing Diagnosis and Treatment.

Advances in the field of nanomaterials are laying the foundation for the fabrication of nanosensors that are sensitive, selective, specific, cost-effective, biocompatible, and versatile. Being highly sensitive and selective, nanosensors are crucial in detecting small quantities of analytes and early diagnosis of diseases. These devices, operating on the nanoscale, detect signals, such as physical, chemical, optical, electrochemical, or biological, and then transduce them into a readable form.

Ethical engagement with artificial intelligence in medical education.

The integration of large language models (LLMs) in medical education offers both opportunities and challenges. While these AI-driven tools can enhance access to information and support critical thinking, they also pose risks like potential overreliance and ethical concerns. To ensure ethical use, students and instructors must recognize the limitations of LLMs, maintain academic integrity, handle data cautiously, and instructors should prioritize content quality over AI detection methods.

Prevalence and predictors of suboptimal peak inspiratory flow rates in the management of chronic obstructive pulmonary disease.

This cross-sectional study aimed to investigate the role of peak inspiratory flow rate (PIFR) in the management of inhalation therapy for patients with chronic obstructive pulmonary disease (COPD). Conducted in the Department of Pulmonary Medicine at a tertiary care institute from July 2021 to January 2022, this study included a total of 351 patients who were clinically diagnosed with stable COPD and currently receiving inhaler therapy. Participants underwent comprehensive assessments that included demographic data collection, the use of the ABCD assessment tool to evaluate disease severity, the COPD Assessment Test (CAT) for quality of life measurement, and assessments for adherence to inhaler therapy and inhaler technique proficiency.

Antivenom ineffectiveness in Echis carinatus sochureki envenoming: a five-year, single-centre experience from India.

Background: Snakebite is a neglected tropical disease that causes significant morbidity and mortality in India. In this study, we describe the clinical characteristics and outcomes of Echis carinatus sochureki envenoming from Western Rajasthan. We document the clinical ineffectiveness of the currently available Indian polyvalent antivenom in managing E.

Breastfeeding Challenges Experienced by Mothers Following Multiple Births-a Systematic Review and Meta-Synthesis of Quantitative, Qualitative, and Mixed-Methods Studies.

Breastfeeding is vital for infant nutrition, especially for multiple babies (twins) born prematurely, yet breastfeeding rates among mothers of twins are lower compared with mothers of singleton babies. This review presents a synthesis of research findings on breastfeeding challenges experienced by mothers following twins' births. The electronic databases of CINAHL, MEDLINE, PsycINFO, EMBASE, and Web of Science were systematically searched in August 2023.

Introduction of an Online Mentoring Program for Final Professional MBBS Students.

Background: Mentoring helps in the personal and professional development of mentees and helps them develop self-confidence in their work. Final-year undergraduate medical students face many challenges but they also have to gain the confidence to start working independently and plan their careers in the near future. In the coronavirus disease scenario, many of these challenges were amplified, and final-year students were in greater need of mentoring.

A Combined Comprehensive Palliative and Rehabilitative Care Plan for a Child With Cerebral Palsy.

Cerebral palsy (CP) is a group of neurological disorders that affect movement, muscle tone, and motor skills. Here, we present a case of an 11-year-old female patient who presented with tightness in both lower limbs, since birth, and delayed walking, accompanied by difficulty walking due to spasticity. She was diagnosed with spastic diplegic cerebral palsy.

Real-World Evidence on the Effectiveness of Pembrolizumab in Patients With Recurrent/Metastatic/Unresectable Head and Neck Squamous Cell Cancer: A Systematic Review and Meta-Analysis.

The aim of the review was to systematically review real-world data on the effectiveness and safety of pembrolizumab in recurrent/metastatic/unresectable head and neck squamous cell cancer (HNSCC) patients. Two independent reviewers retrieved the studies separately and simultaneously. PubMed, Embase, Scopus, Web of Science, and Cochrane Central were searched for prospective and retrospective studies on recurrent/metastatic/unresectable HNSCC patients treated with either pembrolizumab monotherapy or pembrolizumab combination therapy published till November 2024.

Structure of the Complex of Lactoperoxidase With Nitric Oxide at 1.95 Å Resolution.

Lactoperoxidase (LPO) is a heme-containing mammalian enzyme that is found in the extracellular fluids of animals including plasma, saliva, airway epithelial and nasal lining fluids, milk, tears, and gastric juices. LPO uses hydrogen peroxide (HO) to convert substrates into oxidized products. Previous structural studies have shown that HO, CO, and CN are bound to LPO at the distal heme cavity by coordinating with heme iron.

Dermatologic Manifestations in Chronic Kidney Disease Patients.

Various specific and nonspecific dermatologic abnormalities are observed in chronic kidney disease (CKD). Dermatologic manifestations are observed at all stages of CKD and these increase with increasing duration and severity of the renal disease. Most of the studies in the literature have focussed mainly on dermatologic manifestations associated with dialysis and end-stage renal disease.