Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS), also known as Rabindranath Tagore Hospital, in Mukundapur, Kolkata, West Bengal, India, is a multispeciality, tertiary care unit of Narayana Health group. It received accreditation from the NABH in 2014.
BACKGROUND:Trastuzumab emtansine (T-DM1) is widely regarded as a standard treatment for human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC), but its cost puts it beyond the reach of many patients in low- and middle-income countries. Ujvira® (ZRC-3256; Zydus Lifesciences, India), a biosimilar version, could offer a more affordable alternative, although real-world experience with it is still limited. METHODS:This retrospective, single-center study evaluated the efficacy and safety of Ujvira® in patients with HER2-positive MBC treated at a tertiary cancer center in India. All patients had prior trastuzumab exposure and received Ujvira® 3.6 mg/kg intravenously every 21 days until progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS), estimated by the Kaplan-Meier method. Secondary endpoints included objective response rate (ORR), safety (graded per CTCAE v5.0), and exploratory subgroup analyses based on ECOG performance status, hormone receptor expression, comorbidities, and metastatic pattern. RESULTS:Fifty-one patients were included (mean age 58.0 ± 8.4 years; 47 (92.2%) postmenopausal). Median PFS was 6.9 months (95% CI 6.2-9.0) overall, 7.7 months in the second-line setting, and 9.1 months in the third-line setting. The ORR was 35.3%. Treatment was well tolerated; the most common adverse events were thrombocytopenia in 17 patients (33.3%) and anemia in 10 patients (19.6%). Dose reductions occurred in eight patients (15.7%), which did not affect efficacy (PFS 6.8 vs 6.9 months; p = 0.25). CONCLUSIONS:In this real-world Indian cohort, Ujvira® demonstrated efficacy and safety consistent with innovator T-DM1, with preserved outcomes even among heavily pretreated and comorbid patients. These results support Ujvira® as an effective, tolerable, and accessible therapeutic option for HER2-positive MBC in resource-limited settings.
Saphenous vein graft (SVG) failure following coronary artery bypass grafting may require re-intervention, with current guidelines favoring percutaneous coronary intervention (PCI) of the bypassed native coronary artery over SVG-PCI. The Percutaneous Coronary Intervention of Native Coronary Artery versus Saphenous Vein Graft in Patients with Prior Coronary Artery Bypass Graft Surgery (PROCTOR) trial is the first randomized controlled trial comparing native coronary artery PCI with SVG-PCI. The study shows that at 1 year, SVG-PCI was associated with significantly lower major adverse cardiac events than native vessel PCI. These findings question existing guideline recommendations, although longer-term follow-up is required.
The growing need for real-time privacy-preserving health monitoring has driven the adoption of edge intelligence in biomedical sensing. Alcohol affects cardiovascular health. Detecting alcohol-related cardiac issues enables doctors to identify heart problems early and provide the right treatment. Many patients avoid sharing their drinking habits due to discomfort or social stigma. In this paper, we hypothesize and present a TinyML based system for detecting alcohol-induced abnormalities using raw ECG signals and subject metadata. For this pilot study, we collected raw ECG signals and metadata from hospitalized patients. ECG features were extracted and processed locally, reducing bandwidth and latency while ensuring data privacy. Machine learning models like Random Forest, XGBoost, Logistic Regression, and Linear Support Vector Classifier (SVC) were trained and deployed on Raspberry Pi and Arduino Nano ESP32. Linear SVC achieved the best results with 93% accuracy and F1-scores of 0.89 (Raspberry Pi) and 0.85 (ESP32). This work shows how Edge AI and TinyML can detect alcohol-induced abnormalities from ECG, which is practical, secure, and helps build smarter healthcare systems.
