GMERS Medical College and Hospital, Sola is a medical college located in Ahmedabad, Gujarat. It was established in the year 2012. The college imparts the degree Bachelor of Medicine and Surgery (MBBS). Nursing and para-medical courses are also offered. The college is affiliated to Gujarat University and is recognised by Medical Council of India. The selection to the college is done on the basis of merit through National Eligibility and Entrance Test. Yearly undergraduate student intake is 150..
The persistent challenge of temozolomide (TMZ) resistance and the eventual recurrence of tumors underscore the need for ongoing research and the development of novel therapeutic strategies. We aim to consolidate existing evidence related to the safety and efficacy of TMZ as adjuvant therapy to radiotherapy (RT). Various electronic platforms were used to conduct a systematic literature review, including PubMed, Europe PMC, SCOPUS, and clinicaltrials.gov. The approach aimed to identify all pertinent studies published up to July 25, 2024. The search incorporated terms such as “glioblastoma,” “temozolomide,” “monotherapy,” and “adjuvant” alongside relevant Medical Subject Headings (MeSH). The key metrics were overall and progression-free survival, while secondary measures concentrated on treatment-related adverse effects, notably hematological issues like anemia, leukopenia, thrombocytopenia, and neutropenia. The overall effect estimates from the forest plots show significant differences favoring TMZ + RT over RT alone. The HR for overall survival is 0.64 (95
Introduction Non-communicable diseases (NCDs) are responsible for 74% of global deaths annually, with significant issues including cardiovascular diseases, diabetes, stroke, and cancer. In India, the prevalence of hypertension is 74.7%, but only 12% have it under control. Known as the diabetes capital of the world, India has 77 million individuals affected by diabetes, with 57% undiagnosed. Cancer screening remains low despite its potential to reduce mortality. In response, the Indian government launched the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease, and Stroke (NPCDCS) in 2010, utilizing the Community-Based Assessment Checklist (CBAC) for ASHAs to screen for NCDs. Methods This mixed-methods study was carried out in a central district of Gujarat. Quantitative data were collected from 400 CBAC forms, while qualitative data were gathered through in-depth interviews with 10 ASHAs. The quantitative data were analyzed using records from the NCD portal, and qualitative data were examined thematically. Results ASHAs achieved 95% coverage of CBAC forms among the target population. Of those referred with a CBAC score greater than 4, 23% sought further medical attention at primary health centers (PHCs), and 21% were diagnosed with NCDs. Qualitative findings highlighted challenges such as workload, social stigma, and issues with the NCD portal. Discussion The study underscores the essential role of ASHAs in the early detection and management of NCDs while identifying the challenges they encounter. Recommendations include ongoing training, simplified CBAC forms, and localized content to enhance ASHA efficiency and improve community health outcomes.
RATIONALE:Idiopathic thrombocytopenic purpura (ITP) is a hematological disorder characterized by a decrease in platelet count due to increased destruction or decreased production. Although the pathophysiology and etiology remain largely unknown, understanding the typical and atypical presentations of ITP is crucial for early diagnosis and effective management. This case report highlights the rationale behind a comprehensive approach for the diagnosis and treatment of ITP, especially in cases with atypical presentations. PATIENT CONCERNS:A 45-year-old woman presented with a mucocutaneous petechial rash spreading over the ocular and oral areas of the face, accompanied by similar manifestations in the limbs. While petechiae are a hallmark of ITP, the initial widespread distribution and specific involvement of these extensive mucocutaneous areas were considered atypical presentation patterns in this case. She also reported moderate gum bleeding, epistaxis, and spontaneous ecchymosis of the oral mucosa. These symptoms suggested a potential platelet disorder. DIAGNOSES:Based on the clinical presentation and laboratory findings, the diagnosis of ITP was made. The patient's symptoms and laboratory results were consistent with the typical features of ITP, including a decreased platelet count, petechiae, and manifestations of bleeding. INTERVENTIONS:A thorough history and physical examination were conducted to rule out other potential causes of thrombocytopenia, including infections, medications, and underlying autoimmune diseases. Laboratory tests, including complete blood count, peripheral blood smear, and coagulation profile, were performed to assess platelet count, morphology, and clotting function. The diagnosis was initially followed by conservative management. Later on, the patient was also treated with corticosteroids and then intravenous immunoglobulin. OUTCOMES:The patient responded well to intravenous immunoglobulin, thereby demonstrating the effectiveness of the treatment. She was then discharged with maintenance doses of corticosteroids and a close follow-up schedule. LESSONS:This case report illustrates the importance of recognizing the diverse presentations of ITP, including its atypical manifestations. Early diagnosis and effective management are crucial for improving patient outcomes. A comprehensive approach, including thorough history, physical examination, and laboratory tests, is essential for the accurate diagnosis and effective treatment of ITP.
