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2.
J Obstet Gynaecol India ; 74(4): 350-356, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39280205

RESUMO

Purpose: The prevalence of pre-invasive lesions (PIL) of cervix in human immunodeficiency virus (HIV)-seropositive women ranges from 12.5 to 69%. Although Papanicolaou (PAP) test is the recommended screening method, it has concerns owing to high false-negative cytology in HIV-infected women and is associated with high attrition rates. The current study aims to compare the role of routine colposcopy with PAP test at initial visit for screening of pre-invasive lesions of cervix in HIV-seropositive women. Methods: A cross-sectional study of 120 HIV-seropositive women aged 25-50 years and screened for PIL of cervix by PAP test and colposcopy simultaneously was conducted. Colposcopy-directed biopsy was taken if SWEDE score was ≥ 5, and the results were compared with PAP report as well as the histopathology findings. Results: Out of the 120 women screened, abnormal colposcopy was found in 22 women (18.3%) out of which 12 (54.54%) were positive for PIL of cervix on biopsy as well. Abnormal PAP test was found in 6 women (5%), and all had abnormal colposcopy and histopathological findings suggestive of PIL as well. There were 6 women with PIL of cervix who would have been missed if only PAP test was to be used as the screening modality. Conclusion: Colposcopy was superior in detection of PIL of cervix in HIV-seropositive women. Therefore, the authors conclude that colposcopy should be incorporated as a primary screening tool for pre-invasive lesions of cervix in HIV-seropositive women.

3.
Artigo em Inglês | MEDLINE | ID: mdl-39285657

RESUMO

ABSTRACT: Cryptococcal infection is less common in immunocompetent hosts and almost always occurs in the setting of HIV disease. Disseminated Cryptococcosis in a child is a fatal condition and often requires a prompt diagnosis and appropriate antifungal therapy to improve patient outcomes. Here, we present a case of bone marrow Cryptococcal infection in a 4-year-old female child. She presented clinically with fever, abdominal pain, and hepatosplenomegaly for a duration of two and a half months. A bone marrow aspiration and trephine biopsy was performed with a suspicion of haemato-lymphoid malignancy. However, bone marrow aspirate smears revealed bone marrow Cryptococcosis which was later confirmed by special stains. She was treated with liposomal amphotericin B (3 mg/kg) and flucytosine (100 mg/kg/day). A comprehensive approach including clinical symptoms, examination findings, imaging studies, and laboratory tests is crucial in establishing an early diagnosis of Cryptococcosis, particularly with atypical presentations.

4.
ACS Energy Lett ; 9(8): 3694-3718, 2024 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-39144813

RESUMO

High-entropy materials (HEMs) are typically crystalline, phase-pure and configurationally disordered materials that contain at least five elements evenly blended into a solid-solution framework. The discovery of high-entropy alloys (HEAs) and high-entropy oxides (HEOs) disrupted traditional notions in materials science, providing avenues for the exploration of new materials, property optimization, and the pursuit of advanced applications. While there has been significant research on HEAs, the creative breakthroughs in HEOs are still being revealed. This focus review aims at developing a structured framework for expressing the concept of HEM, with special emphasis on the crystal structure and functional properties of HEOs. Insights into the recent synthetic advances, that foster prospective outcomes and their current applications in electrocatalysis, and battery, are comprehensively discussed. Further, it sheds light on the existing constraints in HEOs, highlights the adoption of theoretical and experimental tools to tackle challenges, while delineates potential directions for exploration in energy application.

5.
Placenta ; 154: 153-159, 2024 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-39013215

RESUMO

INTRODUCTION: To assess the placental biometry, placental biomarkers and uterine artery Doppler in each trimester of pregnancy for prediction of early-onset fetal growth restriction (EO FGR). METHODS: In this prospective cohort study placental biometry; biomarkers PAPP-A, sFLT-1, and PlGF along with the uterine artery blood flow evaluation was done serially at 11-14, 20-24 and 28-32 weeks of gestation. The above parameters were compared between women with early onset FGR and controls. RESULTS: Out of 1008 fully followed cases, the small for gestational age fetuses were 227/1008 (22.5 %), and EO FGR were 84/1008(8.3 %).The placental length, volume, and PlGF levels were significantly lower, whereas the uterine artery PI(Ut PI) was significantly higher at all time points among cases. The sFLT-1 level showed a significant increase among cases, whereas it decreased among controls from the first to the second trimester. The detection rate using PV/UtA PI was 60 % in the first trimester and 66.7 % in the second trimester at 30 % FPR. CONCLUSION: The PV/Ut PI in first and the second trimester was a good marker for the prediction of pregnancies at increased risk of developing EO FGR.


Assuntos
Retardo do Crescimento Fetal , Placenta , Primeiro Trimestre da Gravidez , Segundo Trimestre da Gravidez , Artéria Uterina , Receptor 1 de Fatores de Crescimento do Endotélio Vascular , Humanos , Feminino , Gravidez , Retardo do Crescimento Fetal/diagnóstico por imagem , Estudos Prospectivos , Placenta/metabolismo , Placenta/diagnóstico por imagem , Adulto , Artéria Uterina/diagnóstico por imagem , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/sangue , Ultrassonografia Pré-Natal , Biomarcadores/sangue , Fator de Crescimento Placentário/sangue , Fator de Crescimento Placentário/metabolismo , Proteína Plasmática A Associada à Gravidez/metabolismo , Proteína Plasmática A Associada à Gravidez/análise , Estudos de Coortes , Adulto Jovem
6.
Cancer Pathog Ther ; 2(3): 187-194, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39027148

RESUMO

Background: Betel nut/areca nut/Areca catechu is one of the most commonly used psychoactive substance, and is also a major preventable cause of cancer. Unlike other psychoactive substances, such as nicotine, the mechanisms underlying addiction to areca nuts and related oncogenesis remain elusive. Recent reports suggest a possible overlap in the mechanisms of action of nicotine and areca nuts in the human body. Thus, this study aimed to investigate the interactome of human proteins associated with areca nut exposure and the intricate similarities and differences in the effects of the two psychoactive substances on humans. Methods: A list of proteins associated with areca nut use was obtained from the available literature using terms from Medical Subject Headings (MeSH). Protein-protein interaction (PPI) networks and functional enrichment were analyzed. The results obtained for both psychoactive substances were compared. Results: Given the limited number of common proteins (36/226, 16%) in the two sets, a substantial overlap (612/1176 nodes, 52%) was observed in the PPI networks, as well as in Gene Ontology. Areca nuts mainly affect signaling pathways through three hub proteins (alpha serine/threonine-protein kinase, tumor protein 53, and interleukin-6), which are common to both psychoactive substances, as well as two unique hub proteins (epidermal growth factor receptor and master regulator of cell cycle entry and proliferative metabolism). Areca nut-related proteins are associated with unique pathways, such as extracellular matrix organization, lipid storage, and metabolism, which are not found in nicotine-associated proteins. Conclusions: Areca nuts affect regulatory mechanisms, leading to systemic toxicity and oncogenesis. Areca nuts also affect unique pathways that can be studied as potential markers of exposure, as well as targets for anticancer therapeutic agents.

7.
Mater Today Bio ; 27: 101139, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39027679

RESUMO

The prevalence of polymer usage in everyday activities has emerged as a detriment to both human life and the environment. A large number of studies describe severe impacts of micropolymers (MP) and nanopolymers (NP) on various organ systems, including the endocrine system. Additionally, plasticizers utilized as additives have been identified as endocrine-disrupting chemicals (EDCs). MP/NP, along with associated plasticizers, affect principal signalling pathways of endocrine glands such as the pituitary, thyroid, adrenal, and gonads, thereby disrupting hormone function and metabolic processes crucial for maintaining homeostasis, fertility, neural development, and fetal growth. This review delves into the sources, distribution, and effects of micropolymers, nanopolymers, and associated plasticizers acting as EDCs. Furthermore, it provides a detailed review of the mechanisms underlying endocrine disruption in relation to different types of MP/NP.

8.
J Infect Dis ; 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39011957

RESUMO

Host metabolic dysregulation, especially in tryptophan metabolism, is intricately linked to COVID-19 severity and its post-acute sequelae (Long COVID). People living with HIV (PLWH) experience similar metabolic dysregulation and face an increased risk of developing Long COVID. However, whether pre-existing HIV-associated metabolic dysregulations contribute in predisposing PLWH to severe COVID-19 outcomes remains underexplored. Analyzing pre-pandemic samples from PLWH with documented post-infection outcomes, we found specific metabolic alterations, including increased tryptophan catabolism, predicting an elevated risk of severe COVID-19 and the incidence of Long COVID. These alterations warrant further investigation for their potential prognostic and mechanistic significance in determining COVID-19 complications.

9.
ACS Appl Mater Interfaces ; 16(27): 34809-34818, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38946438

RESUMO

Antimony has a high theoretical capacity and suitable alloying/dealloying potentials to make it a future anode for potassium-ion batteries (PIBs); however, substantial volumetric changes, severe pulverization, and active mass delamination from the Cu foil during potassiation/depotassiation need to be overcome. Herein, we present the use of electrophoretic deposition (EPD) to fabricate binder-free electrodes consisting of Sb nanoparticles (NPs) embedded in interconnected multiwalled carbon nanotubes (MWCNTs). The anode architecture allows volume changes to be accommodated and prevents Sb delamination within the binder-free electrodes. The Sb mass ratio of the Sb/CNT nanocomposites was varied, with the optimized Sb/CNT nanocomposite delivering a high reversible capacity of 341.30 mA h g-1 (∼90% of the initial charge capacity) after 300 cycles at C/5 and 185.69 mA h g-1 after 300 cycles at 1C. Postcycling investigations reveal that the stable performance is due to the unique Sb/CNT nanocomposite structure, which can be retained over extended cycling, protecting Sb NPs from volume changes and retaining the integrity of the electrode. Our findings not only suggest a facile fabrication method for high-performance alloy-based anodes in PIBs but also encourage the development of alloying-based anodes for next-generation PIBs.

10.
J Clin Oncol ; : JCO2302030, 2024 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-39083705

RESUMO

PURPOSE: High densities of tumor infiltrating CD3 and CD8 T-cells are associated with superior prognosis in colorectal cancer (CRC). Their value as predictors of benefit from adjuvant chemotherapy is uncertain. PATIENTS AND METHODS: Tumor tissue from 868 patients in the QUASAR trial (adjuvant fluorouracil/folinic acid v observation in stage II/III CRC) was analyzed by CD3 and CD8 immunohistochemistry. Pathologists, assisted by artificial intelligence, calculated CD3 and CD8 cell densities (cells/mm2) in the core tumor (CT) and invasive margin (IM). Participants were randomly partitioned into training and validation sets. The primary outcome was recurrence-free interval (RFI), 2-year RFI for assessment of biomarker-treatment interactions. Maximum-likelihood methods identified optimal high-risk/low-risk group cutpoints in the training set. Prognostic analyses were repeated in the validation set. RESULTS: In the training set, the recurrence rate in the high-risk group was twice that in the low-risk group for all measures (CD3-CT: rate ratio [RR], 2.00, P = .0008; CD3-IM: 2.38, P < .00001; CD8-CT: 2.17, P = .0001; CD8-IM: 2.13, P = .0001). This was closely replicated in the validation set (RR, 1.96, 1.79, 1.72, 1.72, respectively). In multivariate analyses, prognostic effects were similar in colon and rectal cancers, and in stage II and III disease. Proportional reductions in recurrence with adjuvant chemotherapy were of similar magnitude in the high- and low-recurrence risk groups. Combining information from CD3-IM and CD3-CT (CD3 Score) generated high-, intermediate-, and low-risk groups with numbers needed to treat (NNTs) to prevent one disease recurrence being 11, 21, and 36, respectively. CONCLUSION: Recurrence rates in the high-risk CD3/CD8 groups are twice those in the low-risk groups. Proportional reductions with chemotherapy are similar, allowing NNTs derived in QUASAR to be updated using contemporary, nonrandomized data sets.

11.
Langmuir ; 40(31): 16330-16337, 2024 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-39054764

RESUMO

Cyclic transparent optical polymer (CYTOP), a fluoropolymer, finds a plethora of applications in microelectronic devices for sustainable energy harvesting and memory devices. By and large, these devices demand high voltage breakdown, a high dielectric constant, transparency, charge storage, and retention capabilities. Despite many efforts, comprehensive investigation of the charge distribution, retention, and discharge studies conducted on the CYTOP film at the micro-scale remains elusive. Here, we present direct quantification and mapping of surface charge on the CYTOP surface at room temperature using two different modes of advanced surface probe microscopy i.e., Kelvin probe force microscopy (KPFM) and electrostatic force microscopy (EFM). We estimated that the surface charge densities of the CYTOP film using EFM are 1.4 and 3.3 µC/cm2 for the injection of positive and negative charges, respectively. Furthermore, we determined the charge retention time for both injected positive and negative charges. We found that the retention capacity of the negative charges on the CYTOP film is much higher as compared to the positive charges. Moreover, it is also observed that injected negative charges are strongly localized on the CYTOP surface compared to the positive counterpart. Additionally, we demonstrated that charge writing is possible on the CYTOP surface using the AFM conductive tip. These results may find potential applications in energy harvesting, sensing, memory devices, security, and surveillance.

12.
J Pharm Bioallied Sci ; 16(Suppl 2): S1420-S1422, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38882760

RESUMO

Aim: To assess clinically and histologically the efficacy of TheraCal LC and Biodentine as Direct Pulp Capping agents. Materials and Method: Sixty caries-free maxillary first premolar teeth which were scheduled for orthodontic extraction were selected for the study and were divided equally into Group 1 (Theracal LC) and Group 2 (Biodentine). Thermal and electric pulp testing was performed on the teeth to assess pulp vitality followed by tooth preparation to expose pulp horns under local anesthesia. After achieving hemostasis, the direct pulp capping agent was placed and composite restoration was done. All the teeth were evaluated and compared in terms of clinical and histological findings after 6 weeks. The statistical analysis used was the Kruskal-Wallis test. Results: Teeth with Theracal LC showed no sensitivity to heat, cold, or percussion, whereas sensitivity to heat, cold, or percussion was noted with Biodentine. Histological evaluation revealed that TheraCal LC has higher efficiency in complete dentin bridge formation, had maximum dentin thickness, and showed minimal or no pulpal disorganization and pulpal inflammation as compared to Biodentine. Conclusion: TheraCal LC proves to be a promising future as a direct pulp capping agent.

13.
Int J Gynaecol Obstet ; 167(1): 413-419, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38757568

RESUMO

OBJECTIVE: A pregnancy at the utero-tubal junction is a rare type of ectopic pregnancy and is associated with high maternal morbidity if it remains undetected. In the present study we discuss four cases of ectopic pregnancies at the utero-tubal junction which caused diagnostic and management dilemmas. METHODS: Four cases of early pregnancies with the gestational sac (G-sac) implanted near the utero-tubal junction are described. In case 1 this was suspected after a failed attempt at dilatation and curettage at our hospital, cases 2 and 3 presented with amenorrhea and pain abdomen and case 4 was diagnosed on first pregnancy documentation scan after frozen embryo transfer. RESULTS: As initial two-dimensional (2D) transvaginal scan (TVS) failed to diagnose the exact location of the G-sac, three-dimensional (3D) TVS helped to localize the exact location of pregnancy and subsequent individualized management. Case 1 had a partial intramural ectopic pregnancy managed by laparotomy and removal of the ectopic sac. The second and third cases were eccentric uterine pregnancies. The fourth was an interstitial ectopic pregnancy managed by a laparoscopic loop and stitch technique. CONCLUSION: This case series describes the role of 3D TVS for the evaluation of pregnancies implanted at the utero-tubal junction and individual management of eccentric intrauterine, interstitial ectopic and intramural ectopic pregnancies. A diagnostic algorithm for such types of cases and management options is discussed.


Assuntos
Algoritmos , Gravidez Ectópica , Humanos , Feminino , Gravidez , Adulto , Gravidez Ectópica/diagnóstico , Gravidez Ectópica/cirurgia , Gravidez Ectópica/diagnóstico por imagem , Gravidez Ectópica/terapia , Dilatação e Curetagem , Laparoscopia/métodos , Útero/diagnóstico por imagem , Útero/anormalidades , Saco Gestacional/diagnóstico por imagem , Ultrassonografia Pré-Natal , Transferência Embrionária/métodos
15.
BMC Cancer ; 24(1): 566, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38711004

RESUMO

BACKGROUND: Resveratrol has demonstrated its ability to regulate BRCA1 gene expression in breast cancer cells, and previous studies have established the binding of MBD proteins to BRCA1 gene promoter regions. However, the molecular mechanism underlying these interactions remains to be elucidated. The aimed to evaluate the impact of MBD proteins on the regulation of BRCA1, BRCA2, and p16 genes and their consequential effects on breast cancer cells. METHODS: Efficacy of resveratrol was assessed using the MTT assay. Binding interactions were investigated through EMSA, ChIP, & MeIP assay. Expression analyses of MBD genes and proteins were conducted using qRT-PCR and western blotting, respectively. Functional assays, including clonogenic, migratory, and sphere formation assays were used to assess cancer cells' colony-forming, metastatic, and tumor-forming abilities. The cytotoxicity of resveratrol on cancer cells was also tested using an apoptosis assay. RESULTS: The study determined an IC50 of 30µM for resveratrol. MBD proteins were found to bind to the BRCA1 gene promoter. Resveratrol exhibited regulatory effects on MBD gene expression, subsequently impacting BRCA1 gene expression and protein levels. Higher concentrations of resveratrol resulted in reduced colony and sphere formation, decreases migration of cancer cells, and an increases number of apoptotic cells in breast cancer cells. Impact Identification of MBD2-BRCA1 axis indicates their significant role in the induction of apoptosis and reduction of metastasis and proliferation in breast cancer cells. Further therapy can be designed to target these MBD proteins and resveratrol could be used along with other anticancer drugs to target breast cancer. CONCLUSIONS: In conclusion MBD2 protein interact to the BRCA1 gene promoter, and resveratrol modulates MBD2 gene expression, which in turn regulates BRCA1 gene expression, and inhibits cell proliferation, migration, and induces apoptosis in ER+, PR+ & Triple negative breast cancer cells.


Assuntos
Proteína BRCA1 , Proteínas de Ligação a DNA , Regulação Neoplásica da Expressão Gênica , Regiões Promotoras Genéticas , Resveratrol , Neoplasias de Mama Triplo Negativas , Resveratrol/farmacologia , Resveratrol/uso terapêutico , Humanos , Proteína BRCA1/genética , Proteína BRCA1/metabolismo , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Neoplasias de Mama Triplo Negativas/genética , Neoplasias de Mama Triplo Negativas/patologia , Neoplasias de Mama Triplo Negativas/metabolismo , Proteínas de Ligação a DNA/metabolismo , Proteínas de Ligação a DNA/genética , Linhagem Celular Tumoral , Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Movimento Celular/efeitos dos fármacos , Receptores de Estrogênio/metabolismo , Antineoplásicos Fitogênicos/farmacologia , Antineoplásicos Fitogênicos/uso terapêutico
16.
BMC Health Serv Res ; 24(1): 634, 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38755604

RESUMO

BACKGROUND: Multisectoral collaboration is essential for advancing primary health care (PHC). In low- and middle-income countries (LMICs), limited institutional capacities, governance issues, and inadequate stakeholder engagement impede multisectoral collaboration. India faces similar challenges, especially at the meso-level (districts and subdistricts). Owing to its dependence on context, and insufficient evidence, understanding "How" to improve multisectoral collaboration remains challenging. This study aims to elicit specific recommendations to strengthen meso-level stewardship in India for multisectoral collaboration. The findings from this study may offer lessons for other LMICs. METHODS: Using purposive, maximum variation sampling, the study team conducted semi-structured interviews with 20 diverse participants, including policymakers, implementers, development agency representatives, and academics experienced in multisectoral initiatives. The interviews delved into participants' experiences, the current situation, enablers, and recommendations for enhancing stakeholder engagement and capacities at the meso-level for multisectoral collaboration. RESULTS: Context and power are critical elements to consider in fostering effective collaboration. Multisectoral collaboration was particularly successful in three distinct governance contexts: the social-democratic context as in Kerala, the social governance context in Chhattisgarh, and the public health governance context in Tamil Nadu. Adequate health system input and timely guidance instil confidence among local implementers to collaborate. While power plays a role through local leadership's influence in setting agendas, convening stakeholders, and ensuring accountability. To nurture transformative local leaders for collaboration, holistic, equity-driven, community-informed approaches are essential. The study participants proposed several concrete steps: at the state level, establish "central management units" for supervising local implementers and ensuring bottom-up feedback; at the district level, rationalise committees and assign deliverables to stakeholders; and at the block level, expand convergence structures and involve local self-governments. Development partners can support data-driven priority setting, but local implementers with contextual familiarity should develop decentralised plans collaboratively, articulating rationales, activities, and resources. Finally, innovative training programs are required at all levels, fostering humility, motivation, equity awareness, leadership, problem- solving, and data use proficiency. CONCLUSION: This study offers multiple solutions to enhance local implementers' engagement in multisectoral efforts, advocating for the development, piloting, and evaluation of innovative approaches such as the block convergence model, locally-led collaboration efforts, and novel training methods for local implementers.


Assuntos
Atenção Primária à Saúde , Pesquisa Qualitativa , Índia , Atenção Primária à Saúde/organização & administração , Humanos , Participação dos Interessados , Entrevistas como Assunto , Comportamento Cooperativo , Colaboração Intersetorial , Política de Saúde
17.
BMC Med Educ ; 24(1): 493, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38702661

RESUMO

BACKGROUND: District Residency Programme (DRP) was introduced by National Medical Commission as mandatory three-months training program for postgraduate residents. The program was for the first time implemented in April 2023 in Rajasthan. However, it ran into several teething problems, especially for residents. With a lack of any precedence, this study was planned to explore experiences and challenges of residents posted in DRP. METHODS: Cross-sectional study was conducted at 12 DRP sites attached to SMS Medical College, Jaipur between August-October 2023. A self-administered questionnaire was used to collect information from residents who had completed DRP. Questions were scored on a five-point Likert scale. Mann-Whitney U test and Kruskal-Wallis H test was used to show association. RESULTS: Only around 17% residents felt that the learning objectives of DRP were fulfilled and nearly 60% residents felt isolated from academic activities and parent department. Over half of the residents were never posted with their concerned specialty services. Around four-fifth residents felt concerned about safety at least sometimes and more than three-fourth residents were dissatisfied with basic amenities. Kruskal-Wallis and Mann-Whitney tests showed significant association of gender and specialisation strata with multiple outcome variables. CONCLUSION: The study finds high degree of dissatisfaction among residents towards learning objectives, academic learning, and basic amenities during DRP. There was also a clear lack of specialty-exposure and high concerns of safety, especially for female residents. The study findings should alarm and inform policymakers and administrators to improve DRP implementation so as to better achieve laid objectives.


Assuntos
Internato e Residência , Humanos , Estudos Transversais , Índia , Feminino , Masculino , Inquéritos e Questionários , Adulto , Educação de Pós-Graduação em Medicina , Atitude do Pessoal de Saúde
18.
BMC Pregnancy Childbirth ; 24(1): 239, 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38575944

RESUMO

BACKGROUND: Poor intrapartum care in India contributes to high maternal and newborn mortality. India's Labor Room Quality Improvement Initiative (LaQshya) launched in 2017, aims to improve intrapartum care by minimizing complications, enforcing protocols, and promoting respectful maternity care (RMC). However, limited studies pose a challenge to fully examine its potential to assess quality of maternal and newborn care. This study aims to bridge this knowledge gap and reviews LaQshya's ability to assess maternal and newborn care quality. Findings will guide modifications for enhancing LaQshya's effectiveness. METHODS: We reviewed LaQshya's ability to assess the quality of care through a two-step approach: a comprehensive descriptive analysis using document reviews to highlight program attributes, enablers, and challenges affecting LaQshya's quality assessment capability, and a comparison of its measurement parameters with the 352 quality measures outlined in the WHO Standards for Maternal and Newborn Care. Comparing LaQshya with WHO standards offers insights into how its measurement criteria align with global standards for assessing maternity and newborn care quality. RESULTS: LaQshya utilizes several proven catalysts to enhance and measure quality- institutional structures, empirical measures, external validation, certification, and performance incentives for high-quality care. The program also embodies contemporary methods like quality circles, rapid improvement cycles, ongoing facility training, and plan-do-check, and act (PDCA) strategies for sustained quality enhancement. Key drivers of LaQshya's assessment are- leadership, staff mentoring, digital infrastructure and stakeholder engagement from certified facilities. However, governance issues, understaffing, unclear directives, competency gaps, staff reluctance towards new quality improvement approaches inhibit the program, and its capacity to enhance quality of care. LaQshya addresses 76% of WHO's 352 quality measures for maternal and newborn care but lacks comprehensive assessment of crucial elements: harmful labor practices, mistreatment of mothers or newborns, childbirth support, and effective clinical leadership and supervision. CONCLUSION: LaQshya is a powerful model for evaluating quality of care, surpassing other global assessment tools. To achieve its maximum potential, we suggest strengthening district governance structures and offering tailored training programs for RMC and other new quality processes. Furthermore, expanding its quality measurement metrics to effectively assess provider accountability, patient outcomes, rights, staff supervision, and health facility leadership will increase its ability to assess quality improvements.


Assuntos
Serviços de Saúde Materna , Melhoria de Qualidade , Feminino , Humanos , Recém-Nascido , Gravidez , Mães , Parto , Qualidade da Assistência à Saúde
19.
J Pharm Bioallied Sci ; 16(Suppl 1): S380-S382, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38595630

RESUMO

Objective: Using cone beam computed tomography (CBCT), this study compared three rotary file systems-XP Endoshaper, Hyflex CM, and K3 XF-for centering, canal transportation, and root canal area growth. Materials and Methods: The rotating file system randomly separated 60 removed human mandibular molars into three groups (n = 20). Manufacturer-recommended root canal instrumentation was done. Specialized software examined pre- and post-instrumentation CBCT scans. Centering ability was measured by canal transportation and root canal area expansion at different levels from the apex. Results: The Hyflex CM file system had the best centering and the least canal transit at all levels (P < 0.05). XP Endoshaper increased the root canal area the most (P < 0.05). The K3 XF file system had average centering and canal transfer results. Conclusion: The Hyflex CM system centered well, whereas the XP Endoshaper system increased the root canal area the most. The clinical context and therapeutic goals should determine the rotating file system.

20.
Indian J Palliat Care ; 30(1): 27-33, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38633685

RESUMO

Objectives: Pain is classified as nociceptive, neuropathic, or nociplastic. Neuropathic pain presents as variable phenotypes (characters) based on specific aetiology and pathophysiology. This study aimed to find out among cancer patients the incidence of different phenotypes of neuropathic pain and form specific phenotypic clusters based on the underlying neurophysiology and association of sensory profile with various organ systems - A prospective observational study. Materials and methods: The Institutional Ethical Committee clearance (IEC code: 2020-49-MD-EXP-15) https://ctri.nic.in/Clinicaltrials/showallp.php?mid1=44886&EncHid=88651.15716&userName=CTRI/2020/09/027964 approval was obtained. After written and informed consent, patients of age group 18-80 years, registering in the pain and palliative outpatient department or radiotherapy department with complaints of pain and not taking any anti-neuropathic pain medications, were enrolled. They were assessed using Leeds assessment of neuropathic symptoms and signs (LANSS) pain score, and a score of >12 was eligible for assessment of neuropathic pain phenotypes. Results: Out of 210 cancer patients complaining of pain, a neuropathic component with LANSS >12 was found in 73 (34.76%). The most predominant phenotypes, allodynia> tingling> pricking = burning, were found in 72.60%, 56.16%, and 43.84% of patients, respectively. Phenotypes were clustered into Nodes 1 and 2 based on clinically significant separation of phenotypes. Node 1 had neuropathic pain of spontaneous origin found predominantly in gastrointestinal tract (GIT) and genitourinary tract (GUT) cancers. Node 2 had stimulus-evoked negative and positive characters which occurred in head and neck, thoracic, and spinal metastatic cancers. Conclusion: Careful patient assessment reveals the incidence of neuropathic pain in 34.76%; allodynia and tingling astable the most prominent phenotypes. Broadly, sensory characters were clustered into spontaneous and stimulus-evoked sensations with GIT and GUT cancers presenting with Node 1 symptoms.

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