Decoding global reproductive health discourse on Reddit: themes, regions, and misinformation challenges.

This study explores dominant themes in global reproductive health discussions on Reddit over a 12-month period (January 2021 to December 2021). We collected and analyzed 50,000 posts and 100,000 comments from key subreddits, including "r/ReproductiveHealth" and "r/Parenting," using Python libraries like PRAW and BeautifulSoup for efficient data collection and preprocessing. Employing tools such as Latent Dirichlet Allocation (LDA) for topic modeling and VADER for sentiment analysis, we identified five major themes: Family Planning and Contraception, Pregnancy and Childbirth, Sexual Education and Awareness, Misinformation and Myths, and Support and Emotional Well-being. Geospatial analysis revealed regional variations, with North America and Europe emphasizing family planning, while Asia and Africa took the lead in discussions on pregnancy and childbirth. Our findings shed light on a global dispersion of misinformation discussions, emphasizing the challenges posed by misinformation in online reproductive health conversations. This research provides a nuanced understanding of prevalent themes and community engagement, contributing valuable insights to the dynamics of reproductive health discussions on Reddit.

Cette étude explore les thèmes dominants dans les discussions mondiales sur la santé reproductive sur Reddit sur une période de 12 mois (janvier 2021 à décembre 2021). Nous avons collecté et analysé 50 000 publications et 100 000 commentaires provenant de sous-reddits clés, notamment « r/ReproductiveHealth ¼ et « r/Parenting ¼, en utilisant des bibliothèques Python comme PRAW et BeautifulSoup pour une collecte et un prétraitement efficaces des données. En utilisant des outils tels que l'allocation de Dirichlet latente (LDA) pour la modélisation thématique et VADER pour l'analyse des sentiments, nous avons identifié cinq thèmes majeurs : planification familiale et contraception, grossesse et accouchement, éducation et sensibilisation sexuelles, désinformation et mythes, et soutien et bien-être émotionnel. . L'analyse géospatiale a révélé des variations régionales, l'Amérique du Nord et l'Europe mettant l'accent sur la planification familiale, tandis que l'Asie et l'Afrique prenaient la tête des discussions sur la grossesse et l'accouchement. Nos résultats mettent en lumière une dispersion mondiale des discussions sur la désinformation, soulignant les défis posés par la désinformation dans les conversations en ligne sur la santé reproductive. Cette recherche fournit une compréhension nuancée des thèmes dominants et de l'engagement communautaire, apportant des informations précieuses sur la dynamique des discussions sur la santé reproductive sur Reddit.

COVID-19 infection in patients with haematological disease - A tertiary centre experience from north India.

This retrospective study was aimed to understand the clinical, laboratory, radiological parameters and the outcome of COVID-19 patients with underlying haematological disease. All patients with known haematological disease admitted with COVID-19-positive status from April to August 2020 in the COVID-19 facility of a tertiary care centre in north India, were included. Their medical records were analyzed for outcome and mortality risk factors. Fifty four patients, 37 males, were included in the study. Of these, 36 patients had haematological malignancy and 18 had benign disorder. Fever (95.5%), cough (59.2%) and dyspnoea (31.4%) were the most common symptoms. Nine patients had severe disease at diagnosis, mostly malignant disorders. Overall mortality rate was 37.0 per cent, with high mortality seen in patients with aplastic anaemia (50.0%), acute myeloid (46.7%) and lymphoblastic leukaemia (40.0%). On univariate analysis, Eastern Cooperative Oncology Group performance status >2 [odd ratio (OR) 11.6], COVID-19 severity (OR 8.2), dyspnoea (OR 5.7) and blood product transfusion (OR 6.4) were the predictors of mortality. However, the presence of moderate or severe COVID-19 (OR 16.6, confidence interval 3.8-72.8) was found significant on multivariate analysis. The results showed that patients with haematological malignancies and aplastic anaemia might be at increased risk of getting severe COVID-19 infection and mortality as compared to the general population.

A randomized placebo-controlled trial of progesterone with or without hypothermia in patients with acute severe traumatic brain injury.

OBJECTIVE: Among newer neuroprotectant modalities, hypothermia and progesterone have shown a beneficial role in preliminary studies enrolling patients with severe traumatic brain injury (sTBI). The primary objective of this study was to evaluate the efficacy of progesterone with or without prophylactic hypothermia in acute sTBI patients. MATERIALS AND METHODS: This is a prospective, outcome assessor, statistician blinded, randomized, and placebo-controlled phase II trial of progesterone with or without hypothermia (factorial design). All adult patients (18-65 years) with acute sTBI (Glasgow coma score of 4-8) and presenting to trauma center within 8 h after injury were included in the trial. Computer-generated randomization was done after exclusion; sequentially numbered, opaque, sealed envelope technique was used for allocation concealment. The enrollment duration was from January 2012 to October 2014. The primary endpoint was dichotomized Glasgow outcome score (GOS) [poor recovery = GOS 1-3; good recovery = GOS 4-5], and secondary endpoints were functional independence measure (FIM) score and mortality rate at 6 and 12 months follow-up after recruitment. RESULTS: A total of 107 patients were randomized into four groups (placebo [n = 27], progesterone [n = 26], hypothermia alone [n = 27], and progesterone + hypothermia [n = 27]). The study groups were comparable in baseline parameters except for a higher incidence of decompressive craniectomy in the placebo group (P = 0.001). The analysis of GOS at 6 months revealed statistically significant better outcome in the hypothermia group (82%; P = 0.01) and a weaker evidence for progesterone group (74%; P = 0.07) as compared with the placebo group (44%). However, the outcome benefit was marginal at 1-year follow-up for the hypothermia group (82% vs. 58%, P = 0.17). The adjusted odds ratio of poor recovery at 6 months in the hypothermia group was 0.21 (confidence interval = 0.05-0.84, P = 0.03), as compared with the placebo group. Although mean FIM scores at 6 and 12 months respectively were marginally higher in the hypothermia and progesterone groups compared with the placebo group (P = 0.06 and 0.27), the proportion of functionally independent individuals were similar in all the groups (P = 0.79 and 0.51). The mortality rates were similar in all the groups at 6 and 12 months (P = 0.78 and 0.52 respectively). CONCLUSIONS: A strong evidence for prophylactic hypothermia and a weak evidence for progesterone therapy was observed for a better primary outcome at 6 months as compared to the placebo. A similar trend was observed at a 1-year follow-up. Contrary to our hypothesis, prophylactic hypothermia therapy suppressed the beneficial effects of progesterone therapy in sTBI patients. The complex cascades of factors responsible for such interactions are still unknown and need to be further determined.

Serum Vascular Endothelial Growth Factor and Endostatin as an adjunct to clinical decision making in managing radiation induced changes post Gamma Knife Radiosurgery in Spetzler Martin Grade 3 Arterio-venous Malformations patients: A pilot Study.

BACKGROUND: Radiation induced changes (RIC) are the most common complications observed post GKRS and may be observed within 6-18months post procedure. It has been observed that almost one third of RICs are symptomatic and half of them are persistent. There is no way to predict which patients will develop these changes and to what extent. This was a prospective analytical pilot study with the aim of understanding the role of Serum Vascular Endothelial Growth Factor and Endostatin as a predictive factor for clinically symptomatic RIC in intracranial AVMs Spetzler Martin (SM) grade 3 being managed with primary Gamma Knife radiosurgery. Total of 15 patients were analysed. 60% of them had a history of bleed. The median volume of AVM Nidus was 4.36 cc. One third of the patients had no imaging changes suggestive of RIC at 1 year follow up and 2 of the patients had symptomatic RIC needing intervention. Before Gamma Knife, the median values of serum concentration of Endostatin and VEGF are 34.98 ng/mL and 168.37 pg/mL respectively . The serum values of VEGF at 1 month post GKRS was much less than the pre GKRS values but not found to be predictive of RIC. No correlation could be observed with the levels of serum endostatin and RIC. Some patients may develop resistant oedema and necrosis post GKRS for intracranial AVMs which may warrant medical and surgical intervention. Serum biomarkers like VEGF and Endostatin may vary in post GKRS period fpo can be used to identify at risk cases, however more studies are needed to decide on appropriate time of sampling and identify clinically relevant predictive factors.

ALTERATION OF AKT1-GSK3Β SIGNALING PATHWAY IN TRAUMA HEMORRHAGIC SHOCK PATIENTS.

ABSTRACT: Trauma hemorrhagic shock (THS) is a major cause of death and disability worldwide. It is the leading cause of death with or without sepsis in approximately 50% of patients. In THS, there is an incidence of cellular apoptosis, which contributes majorly to cellular dysfunction, organ failure, and mortality. The Akt (protein kinase B) isoform, Akt1, and glycogen synthase kinase 3ß (Akt1-GSK3ß) signaling pathway controls cell survival and apoptosis. Deleterious consequences of alteration of this signaling system might lead to inflammation, cytokine storm, and other diseases. Hence, in the present study, we investigated the role of this signaling system by measuring the phosphorylation levels of Akt1-GSK3ß. Here, we demonstrated that the downregulation of pAkt1 and upregulation of pGSK3ß in THS were significantly associated with the severity of the shock, apoptosis of immune cells, altered glucose metabolism, inflammation, cytokine storm, hemostasis, and acidosis, causing mortality with or without sepsis. For the first time, this study shows that a dysregulated pAkt1-GSK3ß pathway causes contrasting cell fates in THS, leading to trauma pathology. Hence, the delineation and the implications of this signaling system may provide a new important target for the treatment of THS. In addition, Akt activation may become a potential strategy for increasing the survival rate following THS.

Blood mitochondrial enzymatic assay as a predictor of long-term outcome in severe traumatic brain injury.

Recent studies have observed the central role of mitochondrial dysfunction in severe traumatic brain injury (sTBI). One hundred and seven sTBI patients (18-65years old, presenting within 8hours of injury) were randomised for a placebo controlled phase II trial of progesterone with or without hypothermia. We serially analysed blood mitochondrial enzymes (Complex I [C1], Complex IV [C4] and pyruvate dehydrogenase complex [PDH]) using a dipstick assay at admission and 7days later for 37 patients, irrespective of assigned group. Favorable Glasgow Outcome Scale (GOS) at 1year was associated with admission C1 levels above 0.19µg, admission C4 levels above 0.19µg and day 7 C1 levels above 0.17µg, all per 25µl of blood. Unfavorable GOS at 1year was associated with admission serum PDH levels above 0.23µg/25µl of blood. Survivors at 1year had significantly higher admission serum C1 levels above 0.19µg/25µl and day 7 C1 levels above 0.17µg/25µl. To our knowledge this is the first clinical trial associating blood mitochondrial enzymes with long-term outcome in sTBI. Serial monitoring and optimisation of blood C1, C4 and PDH levels could aid in prognostication and potentially guide in using mitochondrial targeted therapies. Blood mitochondrial enzymatic assay might suggest global reduction-oxidation status.