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Study Objective Iron deficiency anemia is the most common form of anemia, and parenteral iron therapy is necessary in select patients. The objective of this analysis was to assess the impact of initial complete parenteral iron repletion on serum hemoglobin (Hgb) level normalization and on health care resource utilization in real‐world practice. Design Retrospective observational study. Data Source Decision Resources Group Real‐World Data Repository (United States databases). Patients A total of 2966 patients who had a baseline Hgb level below normal (< 12 g/dl for females and < 13.5 g/dl for males) and were treated with parenteral iron between March 2015 and February 2017. Measurements and Main Results The effect of receiving the required parenteral iron dose to replete the deficit, calculated by a modified Ganzoni formula, within 3 weeks of the first parenteral iron therapy claim (index date) on the likelihood of Hgb level normalization, was estimated by using logistic regression. All analyses were adjusted for sex, age, comorbidities, and use of prescription oral iron therapy. The adjusted mean numbers of all‐cause inpatient admissions, outpatient visits, and emergency department (ED) visits within 6 months and 1 year after the index date were compared between patients with and without normalized Hgb levels by using negative binomial regression. Of the 2966 included patients, 33.9% received the required iron dose within 3 weeks of the index date, and 19.6%, 48.2%, and 53.9% had a normalized Hgb level within 8 weeks of the index date, within 1 year of the index date, and until the end of data availability, respectively. Patients who received the required iron dose within 3 weeks of the index date were significantly more likely to have a normalized Hgb level within 8 weeks of the index date and at any time during the study period than those who did not: adjusted odds ratio (OR) (95% confidence interval [CI]) 2.67 (2.20, 3.24) and 2.33 (1.96, 2.77), respectively. Hgb level normalization within 1 year of the index date was associated with fewer inpatient admissions and outpatient visits and a similar number of ED visits compared with no Hgb level normalization 1 year after the index date. Conclusion The results of these analyses underscore the importance of initial complete parenteral iron repletion for rapidly improving clinical outcomes. Prompt achievement of a normalized Hgb level may also provide an opportunity to reduce health care resource utilization in patients with iron deficiency anemia receiving parenteral iron therapy.

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The Indian Himalayas, being semi-isolated geographically, provide ideal conditions for population genetics investigations. The main aim of this study is to genetically characterize and analyze the genetic structure of the people of Uttarakhand, a newly created North Indian hill state in the Central Himalayas, using original phenotype and allele-frequency data on a battery of seven red cell enzyme polymorphisms. For this analysis, blood samples were collected from 3,222 unrelated subjects belonging to various endogamous caste populations (Brahmin, Rajput, and Shilpkar) and tribal Bhotia inhabiting seven different districts in the Garhwal (northern) and Kumaon (southern) regions of Uttarakhand. Hemolysates were typed for isozymes of ESD, PGM1, ADA, AK1, GLO1, ACP1, and GPI using standard electrophoretic techniques. The genetic structure of these regional caste and tribal population groups was investigated with the help of different statistical measures. The present biochemical marker results show that the overall genetic constitution of the different populations of Uttarakhand is rather heterogeneous but similar to that of various caste and tribal populations of the neighboring hill state of Himachal Pradesh, situated on Uttarakhand's western border. The extent of genic differentiation observed in different contemporary populations of Garhwal was twice as high as that of Kumaon. Interestingly, in genetic distance dendrograms of both the regions and of all of Uttarakhand, all the Shilpkar groups are differentiated from the remaining groups of Brahmin, Rajput, and Bhotia. The genetic constitution of the Shilpkar (a scheduled caste population of Uttarakhand) and to a lesser extent that of the Bhotia (a scheduled tribe population of Uttarakhand) are rather different from both the Brahmin and Rajput high-caste populations, which tend to show genetic similarities between them. These observations are corroborated by the known ethnohistory of different populations of Uttarakhand.

Standard evaluation of fetal well-being during labor includes the periodic assessment of the fetal heart rate (FHR), its pattern and response to intrapartum stimuli and events. Effective methods of evaluation and meaningful interpretation of FHR data range from non-invasive techniques like Intermittent Auscultation, continuous electronic fetal heart rate (FHR) monitoring to invasive techniques of fetal blood gas analysis and fetal ECG.

Fine needle aspiration cytology (FNAC) is themost sensitive, correct and priceeffective initial technique for the clinical management of patient with thyroid nodules. Majority of the thyroid nodules are benign, with cancer accounting for less than 1% of all the lesions. Surgeons should understand the type of lesion before operation. Follicular patterned lesions is a grey zone area. If uniform standards are applied while reporting thyroid FNAC, thyroid lesions can be accurately categorized. It is a retrospective observational, comparative hospital based study. Previous archived slides of thyroid FNAC ranging from a spectrum of benign to malignant lesions, belonging to different categories which can be classified according to Bethesda system over a period of 2 years. 20 FNA slides will be selected from different categories. The conventional system and the Bethesda system was used for reporting. Bethesda system clearly defines risk of malignancy. Good interobserver correlation is found in Cat I and Cat VII while category IV, V and VI shows poor correlation by conventional method. While good correlation is found by the observers in category I, II and VI, Moderate correlation is found in category V by Bethesda system. Bethesda system of reporting thyroid cytopathology has high sensitivity as compared to conventional method and by this technique the interobserver and intraobserver variability can be reduced.

This manuscript provides a practical and easy to use consensus recommendation to community oncologists on how to manage gestational breast cancer.