Talimogene Laherparepvec: An Oncolytic Virus Therapy for Melanoma.

OBJECTIVE: To review the efficacy and safety of talimogene laherparepvec (T-VEC) as well as its pharmacology, pharmacokinetics, drug-drug interactions, handling procedures, cost considerations, and place in therapy. DATA SOURCES: Searches of PubMed (1966 to February 2017) and Cochrane Library (1999 to February 2017) were conducted using the terms talimogene laherparepvec, T-VEC, OncoVEX, immunotherapy, melanoma, and oncolytic virus. Additional information was determined from bibliographies, manufacturer product labeling and website, meeting abstracts, Food and Drug Administration website, and clinicaltrials.gov. STUDY SELECTION AND DATA EXTRACTION: A total of 79 English-language publications were identified. Articles that assessed T-VEC's pharmacokinetics, pharmacodynamics, mechanism, dosing, safety, and efficacy were included as well as narrative reviews that provided practical information. DATA SYNTHESIS: Clinical trials have confirmed the safety and efficacy of T-VEC as monotherapy for the treatment of advanced melanoma, with an overall response rate (ORR) of 26%. Relative to granulocyte-macrophage colony-stimulating factor, T-VEC significantly increased durable response rate (DRR; 16.3% vs 2.1%, P < 0.001); however, median overall survival was not improved (23.3 vs 18.9 months, P = 0.051). Phase 1b trials have combined T-VEC and immunotherapies with promising results. T-VEC's adverse effects are generally considered mild to moderate in severity. CONCLUSION: T-VEC is the first approved oncolytic virus for local treatment of unresectable cutaneous, subcutaneous, and nodal lesions in melanoma recurrent after initial surgery. T-VEC improves ORR and DRR as a single agent, shows promise in combination therapy, and is well tolerated. Ongoing trials will determine if T-VEC has a role in early treatment or in combination therapy for melanoma or other malignancies.

Cultural practices and beliefs followed for new born care in Santhal pargana - A cross sectional study.

Introduction: Newborn care practices and beliefs vary word-wide, country to country and region to region. These care practices play a vital role in morbidity and mortality of newborn. A descriptive cross-sectional study was conducted to assess the newborn care practices and beliefs of newborn care. Methods: Data was collected from 429 post-natal mothers, who delivered in selected government hospitals of Santhal parganas, Deoghar, Jharkhand. Convenience sampling technique was used to collect the data from February 2023 to April 2023. Results: Findings of the study are, 86.9% mothers accepted that they massage the baby with oil before bath, 89.3% participants have given breastfeeding within one hour of delivery, 93.7% have given prelacteal feeds to the newborn. Applying Heeng (Asafoetida) over the umbilicus was found a common practice to cure the abdominal pain, 70.8% accepted that they apply ashes or powder or cow dung on the umbilical cord, and 88.3% rub the dough on baby's skin to remove excess hairs, 99.3% mothers had firm belief that hot and cold foods in their diet could harm the baby. In continuation 98.8% believed that tooth eruption is associated with diarrhoea, 95.6% are applying kajal in the eyes of new born. Majority 98.8% believed that baby's skin should be exposed to sunlight in case of jaundice and 94% avoid dressing of new born with yellow clothes. Conclusion: Continuous Health Education programs must be organized in Community to Educate the people about beneficial and harmful newborn care practices, which will help to reduce morbidity and mortality in newborn.

Prevalence of Moderate-to-Severe Premenstrual Syndrome or Premenstrual Dysphoric Disorder and Associated Variables Among Young Women in a Tertiary Health Care Center in Eastern India.

BACKGROUND: Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that is predominantly characterized by mood symptoms, and debilitating physical and cognitive symptoms, which have a direct or indirect impact on work efficiency, social and personal relationships, and overall quality of life. This study was conducted to determine the prevalence of moderate to severe PMS and PMDD among young women in India and investigate sociodemographic and other associated factors. MATERIALS AND METHODS: We conducted a cross-sectional study that included 198 young women between 17 and 30 years of age who were medical students or nursing staff from a medical college in Eastern India. Data were collected regarding sociodemographic information, menstrual patterns, age of menarche, sexually active status, body mass index, and level of physical activity, which were analyzed to find correlations with moderate to severe PMS or PMDD. The Premenstrual Symptoms Screening Tool was used for diagnosing moderate to severe PMS or PMDD. The data were analyzed using Statistical Product and Service Solutions (SPSS, version 24.0; IBM SPSS Statistics for Windows, Armonk, NY) software. RESULTS: Forty-six (23.5%) respondents were diagnosed with moderate-to-severe PMS, of which four (2%) were diagnosed with PMDD. Among those diagnosed with moderate-to-severe PMS/PMDD, 39 (27.3%) were of the age group 17-24 years, and seven (13.2%) were of the age group 25-30 years, which was a statistically significant difference (p=0.05). Thirty-eight (30.6%) students were diagnosed with moderate-to-severe PMS, as compared to eight (11.1%) working professionals, which was also a statistically significant difference. CONCLUSION: Moderate-to-severe PMS significantly impacts quality of life. Considering its prevalence among young subjects, it is important to make young girls aware of the condition and educate them regarding various ways to manage their symptoms.

Assessing the Impact of Uterine Artery Doppler and Low-Dose Aspirin on Fetomaternal Outcome: A Prospective Study in Low-Risk Pregnant Women in Western Part of India.

Introduction Fetal growth restriction (FGR) and pregnancy-induced hypertension (PIH) are significant and clinically relevant complications observed in many pregnancies. Early prediction of these complications may be possible through the assessment of the umbilical artery pulsatility index (UAPI). However, its utility in routine practice for otherwise normal pregnancy needs further exploration in India. Objectives This study aimed to evaluate the potential benefits of incorporating UAPI for the timely use of low-dose aspirin in preventing FGR and PIH in a tertiary care hospital in the western part of India. Methodology A prospective study was conducted involving 64 low-risk (i.e., not having any feature of high-risk pregnancy) pregnant women selected from routine antenatal care outpatient departments over a period of two years. All women underwent uterine artery Doppler examination during the 11-13+6 weeks of pregnancy and those who had high UAPI received low-dose (150 mg) aspirin till the 35th week. The incidence of FGR and PIH was analyzed and compared between high UAPI and normal UAPI pregnancy. Results A total of 64 pregnant women with a mean age of 27.11±4 years participated in the study. Among the women, eight (12.5%) were found to have high UAPI and were put on aspirin. Among those eight women, two developed PIH. In the normal UAPI group, nine (16.07%) developed PIH (p-value = 0.62). FGR was found in one case among the eight who received aspirin and in eight cases among the 56 who had normal UAPI (p-value > 0.99). Conclusion The study concluded that despite having normal UAPI, women categorized as low-risk may develop PIH and FGR. Hence, the routine use of UAPI should be investigated in further cohort studies using a large sample to draw a generalizable conclusion for the Indian population.