Gender and Racial Profile of the Academic Pediatric Faculty Workforce in the United States.

Background Equity, diversity, and inclusion remain a challenge in the healthcare workforce. This study explored the current gender and racial/ethnic trends in academic pediatric positions across the United States. Methodology The pediatric faculty self-reported data by the American Association of Medical Colleges (AAMC) Faculty Roster from 2007 to 2020 were analyzed. The races were classified as White (non-Hispanic), Asian, Hispanic, Black (non-Hispanic), Multiple races (including both non-Hispanic and Hispanic), Others, and Unknown. Gender was categorized as male and female. Results The results showed that Asian, Black (non-Hispanic), and Hispanic academic pediatricians increased in full professor, associate professor, and assistant professor positions and decreased in instructor positions from 2007 to 2020. Black (non-Hispanic) academic pediatricians relatively decreased 5.5% in chairperson positions. Women increased in full professor, associate professor, instructor, and chairperson positions; however, relatively decreased 1.8% in assistant professor positions. Men and White (non-Hispanic) academic pediatricians relatively decreased 10.5% and 16%, respectively, in all academic ranks. Women, Asian, Black (non-Hispanic), Hispanic, and Other races were underrepresented in tenured, on-track (tenure-eligible), and not-on-track (tenure-eligible) positions. Conclusions Women and underrepresented minorities in medicine (URiM) physicians continue to remain significantly underrepresented in academic pediatric faculty positions and tenured track positions. There is a dire need to adapt multifaceted strategies to increase the engagement of women and URiM in academic pediatrics.

Neonatal haemolytic disease with co-existing Anti-D and Anti-C antibodies.

Neonatal haemolytic disease in the new-born remains of prime importance for paediatricians due to high perinatal morbidity and mortality rates. The Rh antigen family comprises several different antigens, out of which, D antigen incompatibility is well known for causing severe haemolytic disease in the foetus. Although the current literature shows anomalous cases where coexisting non-D-Rh and D-Rh antigens are the causative agents, there is very little information regarding post-natal outcomes in neonates bearing two different incompatibilities simultaneously. Herein, we discuss an unusual case of anti-D as well as anti-C antibodies (non-D-Rh) in a male neonate born to a Rh-negative mother, who developed jaundice and haemolysis in post-natal life. The neonate underwent exchange transfusion and photo therapy due to raised serum bilirubin levels, supplemented with repeated blood transfusions, intravenous immunoglobulin therapy, and immunosuppressive therapy. He responded well to the management and was later discharged from the hospital. Long-term follow-up revealed no side-effects.

Biosimilars as a Future, Promising Solution for Financial Toxicity: A Review with Emphasis on Bevacizumab.

A biosimilar is a biochemical product like another already approved biologic agent, known as the reference agent. To be endorsed by the Food and Drug Administration (FDA), biosimilars must demonstrate that they are as safe and effective as their reference item, with no clinical distinction. Humanized monoclonal antibodies (mAb) are revolutionizing the treatment of gastrointestinal and gynecologic malignancies. Bevacizumab, trastuzumab, cetuximab, rituximab, and pegfilgrastim are the most widely used mAb products with oncologic indications. Due to the complexities of the regulatory system, it may take time for anti-cancer biosimilars to play a significant game-changing role. Over the last decade, the use of generics has saved billions of dollars every year, and it is expected that biosimilars will soon prove to be a cost-effective alternative and can play an important role in driving down healthcare costs globally. In this review, we provide a critical appraisal of biosimilars with an emphasis on bevacizumab-awwb (Avastin) and its clinico-pharmacologic characteristics, safety, efficacy, interchangeability, regulatory and oncologic perspectives, and overall clinical perception.

Prevalence and Predictors of Blood Pressure Screening in Karachi: A Cross-sectional Study.

Background There is a lack of data about hypertension screening in low- to middle-income countries. The primary objective of this study was to determine the prevalence and predictors of blood pressure (BP) screening in Karachi, Pakistan. The secondary objective was to identify ways to improve effective BP screening practices among the population at risk. Methods This cross-sectional study was conducted from November 2016 to May 2017. The sample population consisted of 2039 residents of Karachi who were older than 18 years. A well-composed questionnaire was pilot tested and then used to assess their socio-demographic characteristics, personal attitude towards a healthy lifestyle, dietary habits, and BP screening practices. We used a chi-squared test as the primary statistical test. Results Of 2039 people, 1627 had their BP checked at least once in their lifetime. Approximately, half of the participants had their BP checked on a yearly basis. Women had a higher rate (83.6%, n = 989) of getting their BP checked than men (74.5%, n = 636). A significant relationship was observed between BP screening and lifestyle practices such as physical activity (p = 0.00), hours of sleep (p = 0.01), water intake (p = 0.01), and dining out (p = 0.03). Conclusion Current BP screening practices are inadequate amongst the urban population of Karachi. There is an urgent need for federal implementation of BP screening as well as awareness programs across the nation.

A Comparison of Visual Outcomes and Patient Satisfaction Between Photorefractive Keratectomy and Femtosecond Laser-Assisted In Situ Keratomileusis.

Purpose To compare visual outcomes and satisfaction among patients of photorefractive keratectomy (PRK; Wavelight EX 500, Alcon, Ft Worth, TX, USA) and femtosecond laser-assisted in situ keratomileusis (FAL; Wavelight FS 200 laser and Wavelight EX 500, Alcon, Ft Worth, TX, USA). Methods We performed a retrospective study of 409 eyes in 207 patients that underwent either PRK (n=90) or FAL (n=117) at the two centers of Hashmanis Hospital, Karachi, Pakistan. The included refractive outcomes were sphere diopters (D), cylinder D, and spherical equivalent D. Additionally, visual acuities were included. All of these were assessed preoperatively and at the one-month postoperative check-up. Patient satisfaction was gauged at the time of chart review by contacting the patient. Results When looking at the postoperative outcomes, we found all values to be statistically significant (p<0.001) with superior outcomes in the FAL cohort. Additionally, 90% and 15% of eyes achieved a postoperative uncorrected visual acuity (UCVA) of 20/20 in FAL and PRK, respectively. Furthermore, the efficacy indexes of the FAL and PRK arms were 1.00 and 0.82, respectively. The predictability of the procedures were 92.1% and 64.9%, respectively. Lastly, 93.3% of patients were satisfied with FAL and 95.7% with PRK. Conclusion Our study shows superior visual outcomes in patients undergoing FAL. However, we found a higher satisfaction rate in those that underwent PRK, perhaps due to the higher cost of FAL.