B. J. Medical College (Byramjee Jeejabhoy Medical College) (BJMC) is a medical college situated in Ahmedabad, Gujarat India. Dr. Jayesh Sachdev is the current dean of B.J. Medical College. BJMC is affiliated to Gujarat University and Ahmedabad Civil Hospital. The college has a modern library with around 500-600 students capacity. J. J.
An abdominal aortic aneurysm (AAA) is a potentially fatal vascular condition that often remains asymptomatic until rupture. Incidence of AAA remains higher among the elderly population, with smoking, hypertension, atherosclerosis and old age being the prominent risk factors. This disease tends to occur predominantly in males, but there are cases involving females. A 56-year-old female presented with the sudden onset of back pain and breathlessness and was declared dead shortly after hospital admission. Autopsy revealed a giant AAA measuring 17 × 9 cm with rupture and retroperitoneal haemorrhage. AAAs are established as one of the major catastrophes in older age group individuals and are found in 4%–7% of males and 1% of females aged 50 and above. As per the available literature, the present case appears to be very unusual in nature, considering the fact that it is more prevalent in males and rupture of the abdominal aorta is present only in 10% cases. A giant abdominal aneurysm amounts to a very rare entity. This case highlights the importance of early detection of AAA, especially in patients presenting with nonspecific symptoms such as abdominal or back pain.
e20733 Background: ROS1 rearrangements occur in approximately 1–2% of non–small cell lung cancers and define a clinically distinct subset responsive to tyrosine kinase inhibitors. Multiple ROS1 inhibitors are available; the recent 2025 approval of taletrectinib expands treatment options beyond crizotinib, repotrectinib, and entrectinib, yet the absence of head-to-head trials complicates selection. Methods: Databases and trial registries were systematically searched, followed by Bayesian network meta-analysis using R NetMeta and risk of bias assessment with RoB 2.0. Results: Ten studies comprising 1,246 patients with advanced ROS1-positive NSCLC were included. Patient numbers by treatment were crizotinib (n = 275), entrectinib (n = 247), repotrectinib (n = 127), and taletrectinib (n = 597). For overall response rate, taletrectinib showed superior efficacy (RR 1.24, 95% CI 1.14–1.35; SUCRA 92%), followed by repotrectinib (RR 1.10, 95% CI 1.01–1.20; SUCRA 71%), while entrectinib was comparable to crizotinib (SUCRA 41%). For progression-free survival, taletrectinib ranked highest (HR 0.45, 95% CI 0.32–0.63; SUCRA 95%), followed by repotrectinib (HR 0.54, 95% CI 0.40–0.74; SUCRA 82%), with entrectinib showing no benefit (SUCRA 29%). Regarding safety, taletrectinib demonstrated the most favorable profile, with a significantly lower risk of treatment discontinuation due to adverse events (HR 0.70, 95% CI 0.50–0.98; SUCRA 90%) and reduced neurologic toxicity. In contrast, repotrectinib showed a comparable risk of treatment discontinuation (HR 1.10, 95% CI 0.85–1.40; SUCRA 48%), alongside a higher incidence of neurologic adverse events, while entrectinib was associated with an increased risk of treatment discontinuation (HR 1.25, 95% CI 1.00–1.56; SUCRA 22%) and greater overall adverse-event burden. Conclusions: Taletrectinib demonstrated the most favorable overall efficacy and safety profile, repotrectinib showed strong efficacy with higher toxicity, and entrectinib provided comparable efficacy with less favorable safety; overall risk of bias across included studies was low.
Effective discharge plays an important role in the transport of suspended sediments in alluvial rivers. In the current study, the effective discharge of a large river is estimated using daily discharge and suspended sediment data for five gauging sites using streamflow and sediment data of 29 years. The empirical approach and analytical approach based on the Magnitude Frequency Approach (MFA) are used in the study to estimate the effective discharge on the regulated Upper Narmada River under pre- and post-dam scenarios and its inter-comparison was carried out. Different discharge class intervals were investigated in the first approach while in the second, log-normal probability distribution was used to estimate the effective discharge. The results depicted that empirical approach with the classes of equal arithmetic intervals and the classes in geometric progression showed similar trends of effective discharge for the various gauging sites for the pre- and post-dam scenarios. Regardless of the subdivision, the analytical approach significantly underestimated the effective discharge. There is a decrease in effective discharge in stations situated in the downstream of the dam in the post-dam scenario. The results of this investigation can be utilized for efficient planning and management of the Upper Narmada River.
Introduction: Maintaining quality within clinical laboratories is fundamental to patient safety and reliable diagnosis. Every stage of the Total Testing Process (TTP) from sample collection to result reporting, is prone to errors that can affect both clinical decisions and operational efficiency. Systematic identification and analysis of Non Conformances (NCs) form an integral part of accreditation and continual quality improvement. Aim: To analyse the nature, frequency, and underlying causes of NCs in a National Accreditation Board for Testing and Calibration Laboratories (NABL)-accredited, clinical biochemistry laboratory attached to a medical college Materials and Methods: An observational study was conducted in the Clinical Biochemistry Laboratory of a tertiary care teaching hospital located in rural Gujarat, India, over a 12-month period, from March 2023 to February 2024. All recorded NCs were reviewed and categorised according to seven domains, including type, recurrence, severity, root cause, and impact. Root Cause Analysis (RCA) was undertaken using the “5 Whys” and Fishbone (Ishikawa) diagram approaches. Data were analysed descriptively and expressed as frequencies and percentages. Results: A total of 439 NCs were documented. Pre-analytical errors were most frequent (53.30%), followed by analytical (43.51%) and post-analytical (3.19%) errors. Human error (62.18%) and technical factors (36.90%) were the main root causes. Most NCs were isolated (76.77%) and minor (70.16%), chiefly affecting resource utilisation (59.91%) and turnaround time (29.16%). Conclusion: Pre-analytical weaknesses and human-related factors remain the key contributors to laboratory NCs. Regular monitoring, structured RCA, and continuous staff training are essential to sustain accuracy, efficiency, and quality within clinical biochemistry laboratories.
Background: Ischemic heart disease (IHD) remains a leading cause of mortality globally. Given rising cardiovascular risk in younger populations, targeted surveillance in specific demographic subgroups is essential. This study examines IHD-related mortality trends among Asian adults aged 25–44 in the United States using CDC WONDER data from 2018 to 2023. Methods: We procured data from the CDC Multiple Cause of Death database. Age-adjusted mortality rates (AAMRs) for Asian males and females aged 25–44 years were calculated using ICD-10 codes for ischemic heart disease (I20–I25). Temporal trends in AAMRs were analyzed using Joinpoint regression to estimate average annual percent changes (APCs) by sex and overall. Piecewise linear regression was used to identify trend shifts, with a focus on changes before and after 2020. Results: From 2018–2023, 1,799 ischemic heart disease (IHD) deaths occurred among young Asian adults (271 females, 1,528 males). Age-adjusted mortality rates (AAMRs) ranged from 4.4–5.5 per 100,000, peaking in 2020. Males had consistently higher AAMRs (8.1–9.7) than females (1.1–1.9). Joinpoint regression showed a nonsignificant upward trend in females (APC +3.7%, p=0.09) and a stable trend in males (APC +0.0%, p=0.99). No significant change was seen overall (APC +0.7%, p=0.72). A significant decline in females was observed after 2020 (p=0.0408), followed by a nonsignificant rise post-2022 (p=0.3520). Significant post-2020 declines were also seen in males (p=0.0193) and the total population (p=0.0152) [Fig 1]. Conclusion: IHD mortality among young Asian adults remained largely unchanged, although slightly upward trend in females is observed at break points in 2022 which is non significant. Ongoing surveillance and research are needed to identify emerging sex-specific risk factors and inform early prevention strategies.
