Introduction: The duration of post-partum amenorrhea (PPA), a crucial aspect of reproductive health, re- mains a significant factor in family planning and maternal well-being. Understanding the distribution of this period provides valuable insights into fertility patterns and informs contraceptive strategies. However, this duration often involves current status data, presenting challenges in accurate estimation and analysis. This study aims to employ statistical modeling, specifically utilizing the Weibull distribution and the EM algorithm, to estimate parameters related to PPA duration. The primary objective is to develop a robust methodology for parameter estimation within current status data. Methods: The research employs the Weibull distribution, known for its applicability in current status data analyses, as a framework for modeling PPA duration. Leveraging the EM algorithm, the study develops an approach to estimate the Weibull distribution parameters from the current status data. This methodology focuses on overcoming the challenges posed by interval-censored observations, providing a more accurate understanding of the duration. Results: The application of the EM algorithm to estimate Weibull distribution parameters yields promising results. The methodology successfully addresses the complexities of current status data, offering estimates that enhance the understanding of PPA duration. The results highlight the efficacy of the proposed approach in handling such nuanced datasets. Conclusion:This study underscores the significance of statistical modeling techniques, particularly the Weibull distribution coupled with the EM algorithm, in estimating parameters for PPA duration analysis. The successful application of this methodology emphasizes its potential for furthering the understanding of fertility patterns and aiding in informed decisionmaking concerning reproductive health strategies.

Background:As serum ceruloplasmin has ferroxidase properties, we hypothesized that Wilson disease (WD) may have greater iron accumulation than other liver diseases. We aimed to assess liver iron overload in WD by evaluating the iron metabolism biomarkers and liver iron concentration (LIC). Methods:Compensated and recompensated WD patients with ≥3 years of chelation and serum exchangeable copper (ExCu) < 1.15 μmol/L were recruited and compared to controls. All patients underwent assessment of iron metabolism biomarkers and T2∗-weighted liver magnetic resonance imaging (MRI) for LIC. High LIC was defined as >1.5 mg/g dry weight (dw). Results:Thirty-seven WD patients were compared to age, sex, and liver disease score-matched controls (n = 10). High LIC was seen in 49% WD vs. 10% controls (P = 0.027). In those with a duration of chelation ≥6 years vs. <6 years, high LIC was found in 89% vs. 58% (P = 0.03). High LIC was seen in 3/9 (30%), 7/15 (47%), and 8/13 (62%) of the WD patients in 3-5 years, 6-9 years, and 10-12 years of chelation therapy, respectively. In those with LIC >1.5 mg/g dw (n = 18) and LIC >2.0 mg/g dw (n = 10), longer duration of chelation therapy inversely correlated with serum ferroxidase activity (r = -0.7, P < 0.001; r = -0.75, P = 0.01 respectively). Serum ferritin had poor correlation with LIC (r = 0.177, P = 0.3). Mean (standard deviation) ExCu in high vs. normal LIC were 0.66 (0.27) vs. 0.94 (0.33), P = 0.01. Conclusion:High LIC is found in approximately half of WD patients, especially in those with ≥6 years of chelation therapy and low ExCu. MRI is recommended as a screening tool for iron overload in WD.

BACKGROUND AND OBJECTIVE:Relapse after treatment discontinuation or reduction frequently occurs in pulmonary sarcoidosis (PS), but reported rates vary widely. We conducted a systematic review and meta-analysis to estimate relapse prevalence and evaluate risk factors. METHODS:We searched PubMed, Embase, Scopus, and Google Scholar from inception through January 2026 for studies reporting relapse prevalence in PS. Two reviewers independently extracted data on relapse prevalence, timing, definitions, and predictors, and assessed study quality using the Hoy et al. tool. We calculated pooled prevalence using random effects models, assessed heterogeneity using I2, and performed subgroup analyses and meta-regression. RESULTS:We included 51 studies comprising 6093 patients; 3682 were followed up, and 1442 relapsed. Pooled relapse prevalence was 0.39 (95% CI: 0.33-0.45) with substantial heterogeneity (I2 = 94%). Relapse prevalence was lower in prospective (0.31, 95% CI: 0.25-0.37) than retrospective (0.45, 95% CI: 0.36-0.54) studies. Only 23 (45%) studies provided explicit relapse definitions, which varied across clinical, radiological, functional, and biomarker criteria. Advanced radiographic stage was associated with higher relapse odds than stage I (log OR 0.55-1.04, corresponding OR 1.73-2.83; p < 0.05), and Black race with higher odds than White race (log OR 0.91, corresponding OR 2.48; p < 0.01). Relapse prevalence did not differ between clinical-only versus composite definitions. CONCLUSIONS:Approximately 39% of PS patients relapse after treatment reduction or discontinuation. Marked heterogeneity in relapse definitions and observational study designs underscores the need for standardized criteria. Clinical assessment appears comparable to complex definitions for assessing relapse. REGISTRATION:PROSPERO CRD420251075384.

BACKGROUND:The comparative sampling efficacy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) needles in mediastinal lymphadenopathy remains unclear. Would the fine needle biopsy (FNB), with its Franseen design, provide better results than the fine needle aspiration (FNA) during EBUS-TBNA? METHODS:We performed a single-center, investigator-initiated, single-blinded, randomized, parallel-group, superiority trial between August 2022 and July 2023. Consecutive patients were randomly assigned (1:1) to undergo EBUS-TBNA with either 19-gauge (G) FNA or 22-G FNB. The primary endpoint was the diagnostic yield, while the secondary endpoints were specimen adequacy and complication rates. RESULTS:The study included 150 patients with a mean age of 44.5±15.1 years (50.7% female patients). The diagnostic yield of FNB was not significantly different from FNA (94.7% vs. 89.3%; difference, 5.4%; 95% CI: -4.0% to 15.0%; P=0.23). Despite this, FNB had a higher rate of adequate tissue (98.6% vs. 86.7%; difference, 11.9%; 95% CI: 4.0%-22.0%; P<0.001) and larger core tissue (11.52 vs. 9.29 mm; mean difference, 2.23 mm; 95% CI: 1.4-3.1mm; P<0.001) than FNA. FNB showed a significantly higher diagnostic yield for histologic samples (90.7% vs. 76.0%; difference, 14.7%; 95% CI: 3.0-27.0; P=0.016) in post hoc analysis; however, this should be considered a hypothesis-generating finding. All procedures were well tolerated except for minor bleeding. CONCLUSION:Despite similar diagnostic yields, FNB was more effective than FNA in providing larger, adequate core tissue samples. This improvement in specimen quality may suggest a potential clinical benefit for comprehensive diagnosis and advanced pathologic work-up.

Chimeric antigen receptor (CAR) T-cell therapy has emerged as a potentially curative approach for hematological malignancies. The DNA transposon system represents a non-viral approach to CAR T-cell generation, offering several advantages including low immunogenicity, scalability, and cost-effectiveness over existing methods. Despite significant clinical advances, no meta-analysis has been conducted to evaluate the safety and efficacy of DNA transposon-generated CAR T-cells. This meta-analysis aims to evaluate the efficacy and safety of DNA transposon-generated CAR T-cell therapy across B-cell malignancies. A systematic literature search was conducted through databases, PubMed, Google Scholar, OpenAlex, and Semantic Scholar, from 2012 to January 2024. A total of seven studies encompassing 110 patients were found eligible. The pooled analysis demonstrated an overall response rate of 75%, with a complete response achieved in 66% of patients. Moreover, 49% of patients demonstrated progression-free survival (PFS) with a median follow-up of 30 months, and 53% of patients achieved negative measurable residual disease (NMRD) remission. Notably, few patients experienced cytokine release syndrome (CRS) of grades 1-2; however, neurotoxicity was not described as a prevalent side effect. DNA transposon-generated CD19 CAR T-cell therapy demonstrates promising efficacy in B-cell malignancies, with favorable safety profiles. However, the outcomes of this meta-analysis underscore the need for further clinical development.

Data regarding the efficacy and feasibility of telemedicine services in type 1 diabetes (T1D) are sparse in India. This study was planned to assess non-inferiority of glycemic control and diabetes knowledge score after outreach care via telemedicine. The study enrolled persons with T1D (age ≤ 25 years). The paramedical members of our multidisciplinary team (MDT) rendered their routine clinic care at the outreach center. The doctor’s consultation in each session was via Zoom platform. A change in HbA1c level and diabetes knowledge score was assessed at last visit (at 6 months). A total of 59 persons with T1D were included. The median, (IQR) HbA1c (

Background Interstitial Lung Disease (ILD) patients admitted to the ICU face a high risk of infections, especially fungal infections, due to factors such as impaired lung function and frequent immunosuppressive treatment. These infections pose significant mortality risks; however, there is limited literature specifically examining fungal infections in ILD patients who experience ICU mortality. This study aims to fill that gap by assessing the prevalence, species distribution, and treatment implications of fungal infections in this vulnerable patient group. Methodology We conducted a 12-year retrospective study analyzing fungal infections in ILD patients who died in the ICU. Data from the records of adult ILD patients admitted to the ICU during this period were reviewed. Information on patient demographics, fungal culture results, and sample sites was collected, with an emphasis on understanding the prevalence and distribution of fungal species and their potential impact on patient outcomes. Results Out of 2883 ICU admissions over the 12 years, 437 (15%) were ILD patients. Among these, 90 (20.59%) ILD patients died during their ICU stay, with ages ranging from 22 to 100 years. Of the deceased patients, 55 (61%) were male, and 35 (39%) were female. Fungal infections were confirmed in 46 (51%) of the 90 patients. Positive fungal cultures were obtained from several sites: 5.6% from blood samples, 17.8% from urine, 42% from sputum or tracheal aspirates, and 56% from bronchial lavage, indicating frequent respiratory involvement. Among the identified fungal species, 47 samples (62%) were positive for Candida species, 1 for Trichosporon species, 1 for Cryptococcus neoformans, and 9 (12%) for Aspergillus species. Additionally, 15 samples showed budding yeast or yeast-like cells without species identification. Notably, 34% (16 out of 46) of the patients had multiple-site fungal infections, and 12 patients exhibited co-infections with multiple fungal species, reflecting the complexity of these infections. Conclusion Fungal infections, predominantly due to Candida and Aspergillus species, were prevalent among ILD patients with high ICU mortality. These findings underscore the need for vigilant screening and early intervention in ILD patients at risk for fungal infections. Given the high mortality associated with these infections, timely diagnosis and targeted antifungal treatment are essential for improving outcomes. The study highlights the importance of multidisciplinary approaches in managing ILD patients with ICU admissions to mitigate the severe impacts of fungal infections.

Background Procalcitonin, a precursor hormone of calcitonin, represents a promising marker of bacterial infections. Research Question What is the accuracy of procalcitonin for the diagnosis of sepsis in adult patients in the emergency department (ED)? Study Design and Methods In this this systematic review and meta-analysis, we searched 5 databases (PubMed, Google Scholar, Science Direct, Wiley, and the Cochrane database) from the inception of the Third International Consensus Definitions for Sepsis and Septic Shock diagnostic criteria (January 1, 2016) through December 31, 2024. We included studies that assessed the accuracy of procalcitonin for sepsis in adult patients admitted in the ED. We performed a random-effects meta-analysis, evaluated individual study risk of bias using Quality Assessment of Diagnostic Accuracy Studies 2 criteria and certainty of evidence using Grading of Recommendations, Assessment, Development, and Evaluations methodology. Results We included 11 studies comprising 7,937 patients in the analysis. The pooled sensitivity of procalcitonin for sepsis in patients in the ED was 0.62 (95% CI, 0.60-0.64) and the pooled specificity was 0.80 (95% CI, 0.79-0.81); both were based on low certainty evidence. The pooled positive likelihood ratio was 2.80 (95% CI, 2.20-3.57), the negative likelihood ratio was 0.42 (95% CI, 0.32-0.55), and the pooled diagnostic OR was 6.83 (95% CI, 4.87-9.58). The area under the summary receiver operating characteristic curve for procalcitonin was 0.77 (95% CI, 0.7281-0.8309). Conclusions Based on pooled analysis, procalcitonin was shown to have reasonable specificity but poor sensitivity for diagnosis of sepsis in patients in the ED with suspected infection. Given that the results are based on low certainty of evidence, further high-quality data in this population are needed. Clinical Trial Registration International Prospective Register of Systematic Reviews; No.: CRD42024618786; URL: https://www.crd.york.ac.uk/prospero/

ABSTRACT Background and Aim: Relapses are known to adversely affect the prognosis of patients with pulmonary sarcoidosis (PS). However, a systematic review or meta-analysis on the subject is not yet available in the literature. Research question: What are the global prevalence and risk factors for relapse in PS patients? Methods: We systematically searched the PubMed, Google Scholar, Scopus, and Embase electronic databases to collect eligible PS studies published until 31 January 2025. Eligible studies were peer-reviewed, English-language studies reporting relapse and risk factors in PS patients. Prevalence and risk factors were analyzed using proportions and log odds ratios (LORs) with 95% confidence intervals (CIs). Quality was assessed by Hoy et al tool for prevalence studies Results: A total of 50 studies with 5978 patients were included in this meta-analysis. Among these patients, 3646 were followed up, and PS relapse was analyzed. Relapse prevalence heterogeneity was significant (Q test, p<0.01). The pooled prevalence of relapse was 0.40 (95% CI: 0.34, 0.46) in all included studies. Sensitivity analyses of the pooled prevalence estimate showed minimal variation, with estimates ranging from 35% to 41% across analyses removing outliers, performing leave-one-out, adjusting for study size, excluding lower-quality studies, and excluding studies without relapse definitions. The pooled prevalence of relapse in prospective vs. retrospective studies was 0.32 (95% CI: 0.26, 0.38) vs. 0.44 (95% CI: 0.36, 0.54), with a meta-regression coefficient of 0.14 (p = 0.02). The pooled LOR of relapse was greater for patients who were black [0.91 (95% CI: 0.44, 1.37); p<0.001], had stage II & III disease [0.55 (95% CI: 0.07, 1.03); p=0.02], and had stage IV disease [1.04 (95% CI: 0.25, 1.83); p=0.01], whereas it was comparable for age, sex, treatment type, and PS type (isolated or systemic PS). Conclusion: The pooled prevalence of PS relapse in all studies was 40%, but it was lower in prospective studies. A black race and higher-grade radiographic stages were the underlying risk factors for disease relapse. KEYWORDS: Pulmonary Sarcoidosis, Relapse, Risk Factors, Meta-analysis ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Protocols ### Funding Statement None ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Data is for metanalysis so was openly available from PubMed, Embase, SCOPUS, Google Scholar I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials

INTRODUCTION:Procalcitonin (PCT) has been a blue-eyed-boy in diagnosing sepsis in previous years. The aim of this systematic review and meta-analysis was to assess the accuracy of PCT for the diagnosis of sepsis, according to the recent Sepsis-3 criteria, in adult patients admitted to the intensive care unit (ICU). METHODS:We searched several electronic databases, including PubMed, Science Direct, Wiley, Cochrane, and Google Scholar from the inception of the Sepsis-3 diagnostic criteria (January 1, 2016) until May 31, 2025, for randomized controlled trials, cohort, and case-control studies that assessed the diagnostic accuracy of PCT for sepsis using the Sepsis-3 criteria among critically ill adult patients with suspected infection. We performed a random effect diagnostic meta-analysis, evaluated the risk of bias of individual studies using the QUADAS tool, and assessed certainty of evidence using GRADE methodology. RESULTS:We included 10 studies comprising 1098 patients. Of these, 635 patients were diagnosed with sepsis based on Sepsis-3 criteria, including 89 patients with septic shock. The pooled sensitivity of PCT for diagnosing sepsis was 0.72 (95 % CI [confidence interval], 0.68-0.75, low certainty) and the pooled specificity was 0.65 (95 % CI, 0.61-0.69, low certainty). The pooled positive likelihood ratio was 2.45 (95 % CI [confidence interval], 1.62-3.68), The negative likelihood ratio was 0.38 (95 % CI, 0.28-0.53), and the pooled diagnostic odds ratio was 7.08 (95 % CI, 3.69-13.58). The area under the summary receiver operating characteristic curve of PCT was 0.79 (95 % CI 0.73-0.86). CONCLUSION:Based on pooled analysis, PCT has a moderate sensitivity and specificity for diagnosis of sepsis in ICU patients with suspected infection. These results suggest clinicians should be cautious about using PCT to facilitate the diagnosis of sepsis in critically ill adults with suspected infection. Given the ongoing uncertainty, further high-quality data in this population is needed.

Introduction: Estimating the First Birth Interval (FBI) from cross-sectional data often presents challenges related to truncation effects. These challenges stem from the data’s inability to capture the enough exposure for an event, resulting in potential biases and inaccuracies in FBI estimates. Recognizing and addressing truncation effects is essential for obtaining more precise and meaningful fertility parameter estimates in a cross-sectional survey. This study seeks to mitigate truncation effects in the estimation of the FBI by utilizing the Current Status Data technique. This approach focuses on women with specific marital durations, providing a means to counteract the bias caused by truncation and thereby yielding more accurate and reliable FBI estimates. Methods: Data from the National Family Health Survey (NFHS-IV) are employed for this study. The Current Status Data Technique is applied to the dataset, considering exclusively those women with marital durations less than 120 months. This methodology enables the adjustment of truncation effects and facilitates a more precise estimation of the FBI. Statistical analysis is conducted to determine the FBI distribution and ascertain the necessary sample size. Results: The estimated First Birth Interval (FBI) without accounting for truncation is 27.85 months, while the estimate considering truncation is 31.70 months. When applying the Current Status Data technique, the estimated FBI is 30.70 months. To obtain reliable estimates of the FBI using Current Status techniques, a minimum sample size of over 5,000 observations is necessary. Conclusion: The truncation effect in FBI is addressed, and some non-parametric adjustments are used for estimating the duration of FBI. The Current Status Data technique emerges as a valuable tool for mitigating these effects and enhancing the precision of FBI estimates. This research contributes to an improved understanding of fertility dynamics and provides valuable insights for future studies on the First Birth Interva

Chimeric antigen receptor (CAR) T-cell therapy has emerged as a potentially curative approach for hematological malignancies. The sleeping beauty (SB) transposon system represents a non-viral approach to CAR T-cell generation offering several advantages including low immunogenicity, scalability, and cost-effectiveness over existing methods. Despite significant clinical advances, the efficacy and safety of SB-generated CAR T-cells have not been adequately addressed. This meta-analysis aims to evaluate the efficacy and safety of SB-generated CAR T-cell therapy across B-cell malignancies. A systematic literature search was conducted through databases, PubMed, Google Scholar, Open Alex, and Semantic scholar from 2012 to January 2024. A total of 10 studies encompassing 153 patients were found eligible. The pooled analysis demonstrated an overall response rate of 71%, with complete response achieved in 66% of patients. Moreover, 55% of patients demonstrated progression-free survival (PFS) with a median follow-up of 30 months and 55% of patients achieved measurable residual disease (MRD) negative remission. Notably, few patients experienced cytokine release syndrome (CRS) of grade 1-2; however, neurotoxicity were not described as prevalent side effects. SB-generated anti-CD19 CAR T-cell therapy demonstrates promising efficacy in B-cell malignancies, with favorable safety profiles. However, the outcomes of this meta-analysis underscore the need for further clinical development. PROSPERO registration No. CRD42024507597. Keywords: CD19, hematological malignancies, sleeping beauty chimeric antigen receptor, meta-analysis, clinical trial, non-viral gene transfer. PROSPERO registration No. CRD42024507597.

w i t h c o r t i c o s t e r o i d s o r o t h e r immunosuppressants.Data management Data will be entered into Excel.We will import all references to EndNote 21.0. Quality assessment / Risk of bias analysisVisual inspection of funnel plot.Egger's test, Begg and Mazumdar's test. Strategy of data synthesisWe will use STATA 18.0 for conducting metanalysis..We will extract information on relapse occurrence from all studies.Subgroup analysis If data on further subgroups like gender is available, then we will perform a sexbased subgroup analysis on relapse. Sensitivity analysisWe will perform sensitivity analysis if we have access to the data.

COVID-19-associated pulmonary aspergillosis (CAPA) remains a high mortality mycotic infection throughout the pandemic, and glucocorticoids (GC) may be its root cause. Our aim was to evaluate the effect of systemic GC treatment on the development of CAPA. We systematically searched the PubMed, Google Scholar, Scopus and Embase databases to collect eligible studies published until 31 December 2022. The pooled outcome of CAPA development was calculated as the log odds ratio (LOR) with 95% confidence intervals (CI) using a random effect model. A total of 21 studies with 5174 patients were included. Of these, 20 studies with 4675 patients consisting of 2565 treated with GC but without other immunomodulators (GC group) and 2110 treated without GC or other immunomodulators (controls) were analysed. The pooled LOR of CAPA development was higher for the GC group than for the controls (0.54; 95% CI: 0.22, 0.86; p < .01). In the subgroups, the pooled LOR was higher for high-dose GC (0.90; 95% CI: 0.17, 1.62: p = .01) and dexamethasone (0.71; 95% CI: 0.35, 1.07; p < .01) but had no significant difference for low-dose GC (0.41; 95% CI: -0.07, 0.89; p = .09), and non-dexamethasone GC (0.21; 95% CI: -0.36, 0.79; p = .47), treated patients versus controls. GC treatment increases the risk of CAPA development, and this risk is particularly associated with the use of high-dose GC or dexamethasone treatment.

Abstract Background and Aim: Relapses in pulmonary sarcoidosis (PS) adversely affect the clinical management and prognosis of the disease, but there is a paucity of data on their incidence and risks. We aimed to systemically review and meta-analyze the available studies for evaluating the pooled weighted incidence and risk factors for relapse in the disease. Methods: We systematically searched electronic databases, including PubMed, Google Scholar, Scopus and Embase, and performed a manual search to collect eligible studies published until 31 October 2023. The prevalence and risk factors for relapse of PS were analyzed by a random effect model using proportions with 95% confidence intervals (CIs). Results: Of the 1402 records retrieved, 26 studies met the inclusion criteria. All these studies were from tertiary centers. Mean age of the relapse groups was 45.94 years (SD 10.87). The prevalence of relapse in sarcoidosis (843 relapses in 2698 sarcoidosis subjects) varied from 11–67%, with a pooled prevalence of 0.34 [95% CI, 0.28–0.40]. Relapses were more common in blacks than in white individuals [0.72 (0.65–0.79) vs [0.27 (0.20–0.34), p = 0.00]. There were no significant differences in subgroups based on age, sex, location, or type of study. Although not reaching statistically significance, the number of relapses were higher in the female as compared to males [Risk difference 0.05(95% CI: -0.01-0.11, p = 0.09)]. Conclusion: Our study shows a pooled incidence of PS relapse of 34%, suggesting a regular follow-up of the patients for early detection of relapse and improved prognosis of the disease.

Background: The COVID-19-associated pulmonary aspergillosis (CAPA) remains a global cause of high mortality throughout the pandemic, but its root cause is still obscure. Our aim was to systematically synthesize the effect of glucocorticoids (GCs) on the development of CAPA.Methods: We conducted a meta-analysis by systematically searching the PubMed/MEDLINE, Google Scholar, Scopus, and Embase databases and citations to collect eligible studies published until October 10, 2022. The eligibility criteria included full-text English language cohort studies reporting CAPA in patients treated with GC or no GC (No-GC) therapy. The outcome measure of the study was the development of CAPA in GC-treated patients. The pooled outcome was calculated as the log odds ratio (LOR) with 95% confidence intervals (CI) using a random effect model. Publication bias, heterogeneity and quality were assessed using standard methods. The PROSPERO registration-ID of the study was CRD42022341633.Findings: Our database search identified a total of 2256 studies, of which 21 studies with 4972 patients met the eligibility criteria and were included in the meta-analysis. The GC vs No-GC therapy had a higher pooled LOR of the outcome [0.85 (95% CI: 0.44 to 1.26), Z=4.07, p=0.00]. The pooled LOR of high- vs low-dose GC had no difference [0.64 (95% CI: -0.08 to 1.35, Z=1.75; p=0.08), but it was higher for low-dose GC [0.71 (95% CI: 0.16 to 1.26, Z=2.55, p=0.01) and high-dose GC [0.92 (95% CI: 0.30 to 1.53), Z=2.94; p=0.00] as compared to No-GC therapy. The pooled LOR was higher for dexamethasone [0.80 (95% CI: 0.29 to 1.31), Z=3.09, p= 0.00], and prednisolone [1.28 (95% CI: 0.23 to 2.32), (z=2.39, p=0.02] but had no difference for methylprednisolone [0.44 (95% CI: -0.43 to 1.30), z =0.99, p=0.32] as compared to No-GC therapy. The studies were of high quality but had publication bias and heterogeneity.Interpretation: The GC therapy of COVID-19 increases the risk of CAPA development and this risk is more with high-dose as compared to low-dose therapy. Among common GC types, methylprednisolone therapy has no or minimal risk of CAPA. Our data collectively suggest the use of low-to-moderate doses of methylprednisolone as GC therapy of choice for COVID-19 to minimize or prevent the risk of CAPA development and improve the outcome of the disease.Funding: None.Declaration of Interests: The authors declare that there are no conflicts of interest.

Background: First birth is an important phenomenon in women life. It not only affects the duration of the rest of birth intervals but also affects the reproductive pattern of women. The study aims to explore the determinants of the duration of the first birth interval. Subjects dan Method: The cross-sectional study data of 33,275 women married between the years 2005-2021 aged (15-49) years from Uttar Pradesh, were selected from NFHS-5 data. The NFHS-5 sample is a stratified two-stage sample. Socio-demographic, socio-economic and cultural factors were taken as independent variables. The dependent variable was the first birth interval variable. Data analysis was performed on SPSS version 23 software and R Programming language for graphical representation. Cox proportional hazard models were applied for analysis. Results: The mean age of women at first marriage was 19.4; SD=3.26 years and the mean age of women at first birth was 21.39; SD=3.24 years. The median duration of the first birth interval was22 months with an IQR of 14 until 32 months. Cox hazard proportional analysis revealed that religion, residence, (ever) fetal loss, age at first birth, heard family planning, and women or husband education were found to be statistically significant factors associated with the duration of the first birth interval (p<0.001). Conclusion: There is a need to change the mindset of people towards the concept of the use of family planning methods to increase the length of the birth interval, regardless of various factors. This would help to increase the duration of the birth interval, improve the health of women and children, as well as help reduce population growth. Keywords: Uttar Pradesh, birth interval, semi-parametric, cox model, hazard plot. Correspondence: Jai Kishun, Department of Biostatistics and Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences. Lucknow – 226014, India; email: jaikishan.stat@gmail.com. Mobile: Journal of Epidemiology and Public Health (2023), 08(01): 1-14 https://doi.org/10.26911/jepublichealth.2023.08.01.01.

Hookworm (Necator americanus, Ancylostoma duodenale) infection are common in tropical and subtropical countries. These are still an neglected tropical disease in rural areas,leading to severe iron deficiency anemia and even mortality. Here we present a case from a tertiary care center in northern India of a 3 year old child with progressive complaint of pallor and generalised body swelling. On upper gastrointestinal gastroscopy hookworms were visualised and recovered. Patients stool sample was sent to lab in which egg of hookworm was also seen on microscopy. The child was treated with albendazole and anemia was also cured

Background & objectives: Due to lack of appropriate statistical knowledge, published research articles contain various errors related to the design, analysis and interpretation of results in the area of biomedical research. If research contains statistical error, however, costly, it may be of no use and the purpose of the investigation gets defeated. Many biomedical research articles published in different peer reviewed journals may retain several statistical errors and flaws in them. This study aimed to examine the trend and status of application of statistics in biomedical research articles. Study design, sample size estimation and statistical measures are crucial components of a study. These points were evaluated in published original research articles to understand the use or misuse of statistical tools. Methods: Three hundred original research articles from the latest issues of selected 37 journals were reviewed. These journals were from the five internationally recognized publication groups (CLINICAL KEY, BMJ Group, WILEY, CAMBRIDGE and OXFORD) accessible through the online library of SGPGI, Lucknow, India. Results: Among articles assessed under present investigation, 85.3 per cent (n=256) were observational, and 14.7 percent (n=44) were interventional studies. In 93 per cent (n=279) of research articles, sample size estimation was not reproducible. The simple random sampling was encountered rarely in biomedical studies even though none of the articles was adjusted by design effect and, only five articles had used randomized test. The testing of assumption of normality was mentioned in only four studies before applying parametric tests. Interpretation & conclusions: In order to present biomedical research results with reliable and precise estimates based on data, the role of engaging statistical experts need to be appreciated. Journals must have standard rules for reporting study design, sample size and data analysis tools. Careful attention is needed while applying any statistical procedure as, it will not only help readers to trust in the published articles, but also rely on the inferences the published articles draw.

Women between the ages of 20 and 35 are at high risk of Human Papillomavirus infection. Based on a systematic review of the literature, it was found that the prevalence of HPV in pregnant women varied from 5.5 to 65