Vivekanand Hospital and Research Center, first established in 1966, is a prominent hospital in the city of Latur, Maharashtra, India. It is a 300-bed hospital facility with a staff of 40 panel doctors and 400 paramedical staff. Vivekanand Hospital and Research Centre has facilities in cardiology, cardiac surgery, neurology and Cancer Treatment like Radiotherapy, chemotherapy and Cancer Surgery; it also has a nuclear science center, a diagnostic center, an intensive care units, a blood bank and a cancer unit..
OBJECTIVES:This study aimed to analyse the number of myocardial infarction (MI) admissions during the COVID-19 lockdown periods of 2020 and 2021 (March 15th to June 15th) and compare them with corresponding pre-pandemic period in 2019. The study also evaluated changes in critical treatment intervals: onset to door (O2D), door to balloon (D2B) and door to needle (D2N) and assessed 30-day clinical outcomes. This study examined MI care trends in India during the COVID-19 lockdown period, irrespective of patients' COVID-19 infection status. DESIGN:Multicentre retrospective cohort study SETTING: Twenty-three public and private hospitals across multiple Indian states, all with 24/7 interventional cardiology facilities. PARTICIPANTS:All adults (>18 years) admitted with acute myocardial infarction between March 15 and June 15 in 2019 (pre-pandemic), 2020 (first lockdown) and 2021 (second lockdown). A total of 3614 cases were analysed after excluding duplicates and incomplete data. PRIMARY OUTCOMES:Number of MI admissions, median O2D, D2B and D2N times. SECONDARY OUTCOMES:30-day outcomes including death, reinfarction and revascularisation. RESULTS:MI admissions dropped from 4470 in year 2019 to 2131 (2020) and 1483 (2021). The median O2D increased from 200 min (IQR 115-428) pre-COVID-19 to 390 min (IQR 165-796) in 2020 and 304 min (IQR 135-780) in 2021. The median D2B time reduced from 225 min (IQR 120-420) in 2019 to 100 min (IQR 53-510) in 2020 and 130 min (IQR 60-704) in 2021. Similarly, D2N time decreased from 240 min (IQR 120-840) to 35 min (IQR 25-69) and 45 min (IQR 24-75), respectively. The 30-day outcome of death, reinfarction and revascularisation was 4.25% in 2020 and 5.1% in 2021, comparable to 5.8% reported in the Acute Coronary Syndrome Quality Improvement in Kerala study. CONCLUSION:Despite the expansion of catheterisation facilities across India, the country continues to fall short of achieving international benchmarks for optimal MI care.
Context:: Head and neck squamous cell carcinomas (HNSCCs) are the sixth most frequent malignancy in the world. Epidermal growth factor receptors (EGFRs) are members of Erb B family of receptors. EGFR is known to act as a driver of tumorigenesis in various carcinomas. Over expression of EGFR in HNSCC is associated with poor prognosis and resistance to radiotherapy. It is a useful prognostic marker, marker for response to therapy, and also a therapeutic target. Aim:To study the association of the known prognostic variables with EGFR expression in HNSCCs and to correlate it with the clinical outcome. Settings and Design:Cross-sectional observational study. Materials and Methods:A total of 170 patients of HNSCC were evaluated for EGFR expression and followed up for at least two years, with correlation of EGFR expression with various histopathological factors and their clinical outcome. Statistical Analysis Used:: Chi-square test. Results:The expression of EGFR in HNSCC in this study population was 88.82%. Statistical significance was noted between EGFR reactivity and age of the patient, its histological grade and perineural invasion. Statistical significance was also noted between EGFR reactivity and recurrence of malignancy as well as the site of recurrence. Conclusion:EGFR expression in patients with HNSCC is a poor prognostic biomarker and has a comparatively lower survival outcome as compared to non-EGFR expressing HNSCC cases. Hence, it will be helpful for all those patients diagnosed with HNSCC to ideally undergo an additional EGFR immunohistochemical evaluation, which, in turn, will help the oncologists in management of the tumor with anti-EGFR therapy combined with radiotherapy, to obtain a better response and a survival outcome.
