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The covid-19 pandemic has impacted the management of non-covid-19 illnesses. Epithelial ovarian cancer (EOC) requires long-duration multidisciplinary treatment. Teleconsultation and shared care are suggested solutions to mitigate the consequences of the pandemic. However, these may be challenging to implement among patients who come from the lower economic strata. We report the disastrous impact of the pandemic on the care of EOC by comparing patients who were treated during the pandemic with those treated in the previous year. We collected the following data from newly diagnosed patients with EOC: time from diagnosis to treatment, time for completion of planned chemotherapy, and proportion of patients completing various components of therapy (surgery and chemotherapy). Patients treated between January 2019 and September 2019 (Group 1: Pre-covid) were compared with those treated between January 2020 and December 2020 (Group 2: During covid pandemic). A total of 82 patients were registered [Group 1: 43(51%) Group 2: 39(49)]. The median time from diagnosis to start of treatment was longer in group 2 when compared to group 1 [31(23–58) days versus 17(11–30) days ( p = 0.03)]. The proportion of patients who had surgery in group 2 was lower in comparison to group 1 [33(77%) versus 21(54%) ( p = 0.02)]. Proportion of patients who underwent neoadjuvant (NACT) and surgery were fewer in group 2 in comparison to group 1 [9(33%) versus 18(64%) p = 0.002]. Among patients planned for adjuvant chemotherapy, the median time from diagnosis to treatment was longer in group 2 [28(17–45) days, group 1 versus 49(26–78) days, group 2 ( p = 0.04)]. The treatment of patients with EOC was adversely impacted due to the COVID-19 pandemic. There was a compromise in the proportion of patients completing planned therapy. Even among those who completed the treatment, there were considerable delays when compared with the pre-covid period. The impact of these compromises on the outcomes will be known with longer follow-up.

Aims To perform network meta‐analysis for a head‐to‐head comparison of various interventions used in coronavirus disease 2019 (COVID‐19) on mortality, clinical recovery, time to clinical improvement and the occurrence of serious adverse events. Methods Systematic search was performed using online databases with suitable MeSH terms including coronavirus, COVID‐19, randomized controlled trial, hydroxychloroquine, lopinavir/ritonavir, tocilizumab, remdesivir, favipiravir, dexamethasone and interferon‐β. Data were independently extracted by 2 study investigators and analysed. Results Out of 1225 studies screened, 23 were included for qualitative and quantitative analysis. Among the drugs studied, dexamethasone reduces mortality by 10%, with a relative risk of 0.90 (95% confidence interval [0.82–0.97]) and increases clinical recovery by 6% (relative risk 1.06, 95% confidence interval [1.02–1.10]) compared to standard of care. Similarly, remdesivir administered for 10 days increased clinical recovery by 10%, reduced time to clinical improvement by 4 days and lowered the occurrence of serious adverse events by 27% as compared to standard of care. Conclusion In comparison to standard of care, dexamethasone was found to increase clinical recovery and lower mortality; remdesivir was significantly associated with a lower risk of mortality as compared to tocilizumab and higher clinical recovery and shorter time to clinical improvement as compared to hydroxychloroquine and tocilizumab; remdesivir followed by tocilizumab were found to have lesser occurrence of serious adverse events in patients with moderate to severe COVID‐19.

Context Treatment delays can compromise outcomes in aggressive hematological malignancies primarily treated with chemotherapy. Due to the burden of the COVID-19 pandemic on healthcare systems, there is a potential risk of delayed therapy of various diseases, including cancers. However, efforts were made in our center (despite being a COVID-19-designated hospital) to ensure that “curative-intent” treatment for cancers should not be affected, and hence, the diagnostic (pathology, imaging) and therapeutic services for hematological cancers were continued. In this study we analyzed the impact of the COVID-19 pandemic on diagnosis and treatment procedures and survival outcomes among patients with Diffuse Large B-Cell Lymphoma (DLBCL). Objective To compare treatment duration among patients with DLBCL during the COVID-19 period with those treated prior to the onset of the pandemic. Design Retrospective record-based study. Setting Regional cancer center, JIPMER, India. Patients or Other Participants The medical records of treatment naïve DLBCL patients registered between January 2019 and December 2019 (Group 1; pre-pandemic) and January 2020 until December 2020 (Group 2: during pandemic) were accessed, and the following data were collected: baseline characteristics, time from diagnosis to treatment, time for completion of planned chemotherapy, and proportion of patients defaulting treatment. Interventions Not applicable, as it is a retrospective record-based study. Main Outcome Measures Primary endpoint was treatment duration during the COVID-19 period with those treated prior to the onset of the pandemic. Results A total of 67 patients were identified (Group 1: 46 (69%) Group 2: 21 (31%). The median age of patients registered in 2019 and 2020 were 50 (39–64) years and 44 (34–62) years, respectively. The duration between diagnosis to start of treatment for patients in 2019 and 2020 was 28 (13–43) days and 19 (11-40) days respectively. The duration between start of treatment to end of treatment for patients in 2019 and 2020 was 119 (107–137) days and 121 (101–145) days, respectively. Conclusions There was no significant difference in treatment duration among DLBCL patients during the COVID-19 pandemic. Treatment completion rates were similar.

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Maternal intake of nut at higher levels in early pregnancy is associated with enhanced neuropsychological development in offsprings at 1.5, 5 and 8 years old. A diet deficient in nuts and seeds accounts to leading dietary risk for Disability-Adjusted Life Years (DALYs). [1] Depression and mild cognitive disorders are negatively correlated with dietary pattern with nuts as a primary component. The essential fatty acids or nutritional components like folic acid compose the healthful nut. During human gestation, the brain undergoes a number of puzzling process for which maternal nutrition appears to be the prime factor that contributes to an adequate foetal neurodevelopment with long-term effects. [2] The nut consumption in the Spanish population includes mostly almonds and walnuts (prime source of ALA-Alpha Lipoic Acid). [3] ALA-a widely distributed protein in the brain necessitates crucial number of functions such as neuronal maintenance and neurogenesis. In addition, the learning and memory, brain plasticity and brain-derived neurotrophic factor (BDNF) is elicited on ALA supplementation. [4] Thus, the reality of insufficient beneficial nutrients in pregnant woman will additionally have long-term functional consequences during child development.