In this population-based study stillbirths account for a proportion of cases that are not routinely counted and represent a group for which intrapartum antibiotics would likely not be effective, but potentially preventable by vaccination. Inclusion of serotypes Ia, III and V in a conjugate vaccine or serotypes III and V conjugated with the C protein in a GBS vaccine could theoretically provide protection against the majority of GBS invasive disease in Alberta neonates.

The Covid-19 has shifted the face of many markets including e-commerce and online business with many bottlenecks to be cleared. The last-mile delivery project has the greatest effect on all types of e-commerce companies because it has many consumer touchpoints as well as the Covid-19 pain points. Due to these interconnected issues, the delivery projects itself requires modern solutions. The purpose of this paper is to identify, analyse and categorize the major factors that affect the last mile delivery projects in e-commerce, food sector, retail sector and so on using total ınterpretive structural modelling approach during the Covid-19. Ten major factors are identified from literature review, and expert opinions are collected from multiple organizations that are involved in the last mile delivery projects. The results indicate that types of goods, achieving routing efficiency and meeting fulfilment timeline are the key factors for last mile delivery projects during the time of Covid-19. This study helps the managers to identify the key factors and to focus on these factors for the successful implementation of last mile delivery project.

Background:Indo-Gangetic basin is known to have higher incidence of gallbladder cancer. Proximity to River Ganga and high heavy metal in soil exposure have been postulated as risk factors.Aim:This study aims to evaluate the geographical pattern of gallbladder cancer from consecutive patient database enrolled in hospital-based cancer registry (HBCR).Objectives:To evaluate demographic profile and districtwise/zonewise dispersion of gallbladder cancer cases registered in HBCR from year 2014 to 2016. To evaluate association of carcinoma gallbladder (CaGB) due to proximity of Ganges, districts of high soil arsenic levels and referral bias.Materials and Methods:Demographic profile and district-based location of individual consecutive gallbladder cancer patient registered in Regional Cancer Centre from the year 2014 till 2016 were analyzed. Population data from 2011 census and arsenic soil content data from central groundwater body were obtained. Frequency distribution, cross tabulation, and odds ratio were used to analyze risk of CaGB across population subsets in Bihar.Results:A total of 1291 consecutive patients of CaGB were registered from 2014 to 2016. Median age at diagnosis was 55 years (range 18–95 years). Male to female ratio was 0.6. Patna (16%) followed by Vaishali (5.8%), Sitamarhi (5%), Madhubani (4.7%), Gaya (4%), and Samastipur (4%) had highest cases. Districts along main central River Ganga (n = 12) and those exposed to high arsenic soil content (n = 15) had higher odds ratio for CaGB, 1.72 (95% confidence interval [CI]: 1.54–1.91, P = 0.001), and 1.45 (95% CI: 1.30–1.62, P = 0.001), respectively. Districts within 100 km radius of our institute had higher gallbladder cancer cases, odds ratio 1.81 (95% CI: 1.62–2.03, P = 0.001), suggesting significant referral bias predominantly contributed by cases registered under Patna and Vaishali districts.Conclusion:CaGB is major public health problem in Bihar. Exposure to high soil arsenic levels and proximity to River Ganga are strongly associated with gallbladder cancer. Systematic population-based longitudinal studies are needed to explore above hypothesis.

Prophylactic antifungal therapy in patients undergoing RT for head and neck malignancy is particularly important to prevent intraoral colonization and infection by Candida. Screening of such patients on RT for fungal infections can prevent fatal mold infections.

SPMs are not very rare. Hence, pretreatment and follow-up evaluation should be meticulous to rule out SPMs.

Background:Trends of cancer cases vary across several hospital-based cancer registries (HBCRs). There is a paucity of demographic data to evaluate trends of cancer in Eastern India.Aim:The aim of this study is to evaluate trends and pattern of cancer cases with respect to time from HBCR from Bihar.Objectives:The objective of this study is to evaluate the numbers of consecutive patients registered with eight most common type of cancer in our HBCR in Regional Cancer Centre, Bihar, and to evaluate trends of cancer cases registered with respect to time.Materials and Methods:Demographic profile of consecutive cancer patients registered from January 2014 to December 2016 (3 years) in HBCR was obtained. Patients diagnosed with common malignancies including head-and-neck cancer, gallbladder, breast, cervix, ovary, esophagus, stomach, hematolymphoid, and colorectal were analyzed. Frequency distribution, crosstabs, and line diagram were used to evaluate the trends of these common cancers with respect to time.Results:Sixty-six thousand and twenty-nine consecutive patients were registered between 2014 and 2016. Carcinoma gallbladder was the most common malignancy (21%), followed by head-and-neck cancer (19%) and breast cancer (15%). Median age at the diagnosis was 55 years for carcinoma gallbladder while 53 years and 46 years for head-and-neck and breast cancer, respectively. Male-to-female ratio was 0.6 for carcinoma gallbladder and 1.8 for head-and-neck cancer. A number of gallbladder and head-and-neck cancer registered increased by 36% (between 2014 and 2015) and 5% (between 2015 and 2016) and 24% (between 2014 and 2015) and 4% (between 2015 and 2016), respectively. Carcinoma breast and cervix showed decreasing trend with fall in registration up to 13% (between 2015 and 2016) and 27% (between 2015 and 2016), respectively.Conclusion:Carcinoma gallbladder is the most common cancer in Bihar. Head-and-neck cancer and carcinoma gallbladder are increasing while breast and cervical cancers are decreasing with respect to time.

No abstract

In May, Brain Tumor Awareness Month, we are facing challenges pertaining to brain cancer and coronavirus (COVID-19) pandemic. With no effective treatment and no vaccine currently available, the most effective means of slowing the dissemination of COVID-19 is through social distancing, crowd avoidance, appropriate quarantine, and other techniques intended to limit community exposure. However, in this ongoing pandemic era, timely treatment by surgery is critical to reduce the tumor mass inside a patient’s brain. By giving drug therapy to slow down the tumor’s progression and provide a longer survival time is utmost important. As hospitals across the country postpone elective procedures to increase the capacity for COVID-19 patients, there is a lot of uncertainty among the neuro-oncology community. Patient having multiple co-morbidities poses challenges for centers that may need access to ventilator care due to insufficient critical care facilities across the country. This crisis is straining our health care sy tem, as this viral infection continues to escalate. It is the time for the neuro-oncology team to develop a uniform and acceptable approach to the brain tumor patient. We present an approach developed by an international multidisciplinary group to provide them best possible care during this pandemic as well as reducing their chance of viral infection.