ObjectiveSex-ratio at birth in families with previous girls is worse than those with a boy. Our aim was to prospectively study in a large maternal and child unit sex-ratio against previous birth sex and use of traditional medicines for sex selection.Main Outcome MeasuresSex-ratio among mothers in families with a previous girl and in those with a previous boy, prevalence of indigenous medicine use and sex-ratio in those using medicines for sex selection.ResultsOverall there were 806 girls to 1000 boys. The sex-ratio was 720∶1000 if there was one previous girl and 178∶1000 if there were two previous girls. In second children of families with a previous boy 1017 girls were born per 1000 boys. Sex-ratio in those with one previous girl, who were taking traditional medicines for sex selection, was 928∶1000.ConclusionEvidence from the second children clearly shows the sex-ratio is being manipulated by human interventions. More mothers with previous girls tend to use traditional medicines for sex selection, in their subsequent pregnancies. Those taking such medication do not seem to be helped according to expectations. They seem to rely on this method and so are less likely use more definitive methods like sex selective abortions. This is the first such prospective investigation of sex ratio in second children looked at against the sex of previous children. More studies are needed to confirm the findings.
Introduction: Refusal and abandonment of treatment is often considered as an important reason for poor survival of pediatric cancer patients in developing and underdeveloped countries. In this study we analyze the factors responsible for treatment abandonment and refusal in a Regional Cancer Centre (RCC) in North East India. Material and Methods: All histopathologically or cytologically confirmed cases of childhood cancer from below 15 years of age registered from 1st April, 2010 to 31st March, 2017 were included in this study. Parents or caregivers were interviewed thoroughly and a questionnaire was filled up for analysis of demographic and socioeconomic factors. Modified Kuppuswamy scale was used to measure socioeconomic status. Results: Of 592 patients 161 (27.1%) abandoned therapy and 23 (3.9%) refused treatment. Factors associated with abandonment of treatment included: lower risk if residing in urban areas (Odds ratio [OR] = 0.8333, 95% CI 0.565-1.228; P=0.36) and higher risk with maternal education less than secondary school (OR = 1.357; 95%CI: 0.553-3.326; P=0.505). Low socioeconomic status and age >5yrs were also associated with abandonment of treatment. In a binary logistic regression analysis, male sex [Odds Ratio (OR) = 0.701; 95% CI 0.48-1.01; P=0.062] have lowest risk of abandoning treatment with trend to statistical significance. Conclusion: There is a need for proper definition of the problem of childhood cancer patients so that appropriate policy can be introduced to improve survival by improving treatment compliance.
Gastric cancer is a leading health-care problem worldwide and is the fifth most common cancer in the world, with 952,000 new cases diagnosed in 2012 Worldwide 0.7 million people die of gastric cancer each year (accounts for 8.8% of all cancer-related deaths) [GLOBACON, 2012]. Gastric cancer is the second most common cancer among men and third-most among females in Asia (Rahman et al., 2014) and is the second most common cause of cancer-related deaths in India (Dikshit et al., 2012). A high incidence of gastric cancer has been reported from Southeast Asia, most commonly from Japan, China and South Korea (Ferlay et al., 2012).The age-adjusted rate (AAR) of gastric cancer among urban registries in India is (3.0-13.2) compared to the worldwide AAR (4.1-95.5) with China having the highest incidence of AAR. Amongst all the population based cancer registries in India, Papumpure district (Arunachal Abstract Objective: Human epidermal growth factor receptor 2 (erbb2/HER2) overexpression, has now been implicated in advanced gastric and gastroesophageal junction cancers. The study was conducted to determine the rate of HER2 positivity in patients with locally advanced or metastatic gastric and gastroesophageal adenocarcinoma in North-East India and to assess the impact of various demographic and clinical parameters on HER2 positivity. Methods: A total of 68 patients of age >18 years of gastric and gastroesophageal adenocarcinoma diagnosed on histopathological examination from September 2016 to February 2018 at Dr B Borooah Cancer Institute, Assam were enrolled for the observational (epidemiological) study. All patients were subjected to the HER2 immunohistochemistry test using a FDA-approved, standardized test kit. HER2 expression was correlated with various demographic and clinicopathological parameters. Results: The overall rate of HER2 positivity in the population studied was 56% (n=38). The rate was non-significantly higher in male, older age group (>60 years) and Hindu population. Similarly, HER2 positivity rate was higher in patients with well differentiated histology and was more common in patients with stage II and III diseases, but neither of the associations is statistically significant. HER2 positivity rate was significantly higher in proximal and in GEJ tumours (56% versus 44%, P=0.002). Conclusion: HER2 overexpression was evident in 56% of the North-East Indian patients with locally advanced and metastatic gastric and gastroesophageal adenocarcinoma. The overexpression correlated significantly with primary tumour site. Routine testing of gastric and gastroesophageal tumours for HER2 expression is recommended to provide a therapeutic advantage in Indian patients.
sonal fees from Thornton Ross, outside the submitted work. Simon Robinson reports that his brother works for Gilead, which produces Remdesivir; he has had no conversations with him with regards Remdesivir, nor discussion relating these 2 patients and his brother is unaware that Dr Robinson has written this article. For the remaining authors, none were declared. B.S. was involved in the management of patient, conceptualization, data curation, analysis, supervision, writing original draft, and writing review and editing. J.T. and S.B. were involved in management of patient providing expert support, review, and editing. S.N. and S.R. were involved in management of patient, analysis of data, review, and editing. K.B.L. and M.K. were
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