A community-based study on obstetric danger signs among pregnant women of Sivagangai district

Background Every pregnant woman faces the risk of pregnancy related morbidities. It Is better that pregnant women are aware of the pregnancy related symptoms and warning signs. Early intervention or referral to obstetric care facility can be made only if the pregnant woman has adequate knowledge in identifying danger signs. This study aimed to assess the knowledge of obstetric danger signs among pregnant women. Methods Community based cross sectional study was conducted from March 2019 to august 2019. 280 pregnant women were interviewed face to face using semi structured questionnaire. Results Only 86(30.7%) respondents were aware of at least more than four danger signs during antenatal period. Only 7.1% of the study participants were aware of the danger signs during post-partum. Maternal age, socioeconomic scale and parity had significant association with knowledge of obstetric danger signs. Conclusion Mother’s awareness on danger signs of pregnancy was poor during both antenatal and postpartum period. There is probably a need to enhance the health education sessions to all pregnant women irrespective of their demographic characteristics

Advancements in methanol poisoning management: Integrating traditional treatments, modern innovations, and artificial intelligence for optimal patient outcomes

Background. Methanol poisoning presents a serious medical emergency characterized by a high potential for morbidity and mortality. Effective management is crucial and traditionally involves the administration of antidotes like ethanol or fomepizole and supportive measures such as hemodialysis. Recent advances in treatment strategies and the integration of artificial intelligence (AI) into clinical decision-making have further evolved the management landscape. Objective. This review aims to provide a comprehensive analysis of current treatment modalities for methanol poisoning, compare traditional methods with newer advancements, and explore the role of AI in optimizing patient outcomes. Methods. A detailed review of literature and treatment guidelines was conducted, focusing on the use of ethanol, fomepizole, and hemodialysis. Advances in treatment strategies and the implementation of AI models in clinical settings were also examined. The review includes a flow chart depicting the treatment protocol and a comparison table highlighting the efficacy of various interventions. Results. Ethanol and fomepizole remain the primary antidotes for methanol poisoning, each with distinct advantages. Ethanol, a competitive inhibitor of alcohol dehydrogenase, is effective but requires careful dosing. Fomepizole, a more specific inhibitor, offers benefits in terms of safety and dosing ease. Hemodialysis is critical in severe cases to accelerate the removal of methanol and its toxic metabolites. Recent developments in AI have shown promise in enhancing diagnostic accuracy and personalizing treatment strategies. Conclusion. While traditional methods of treating methanol poisoning remain foundational, recent advancements and AI integration offer significant improvements. AI models can enhance early diagnosis, predict treatment outcomes, and support clinical decision-making. Continued research and development in these areas are essential for optimizing treatment protocols and improving patient outcomes

Comparison of architect assay and elecsys HBs Ag II assay in the quantification of hepatitis B surface antigen in chronic HBV patients

Background. Hepatitis B virus (HBV) infection is a global health concern, with an estimated 296 million chronic carriers worldwide. Quantification of hepatitis B surface antigen (HBsAg) is a crucial tool in HBV disease management, providing valuable insights into disease progression and treatment efficacy. Objective. To evaluate the comparative performance of the Abbott Architect HBsAg QT and Roche Elecsys HBsAg II assays in quantifying hepatitis B surface antigen (HBsAg) levels in patients with chronic hepatitis B (CHB). Methods. This prospective study enrolled 60 confirmed CHB patients between February 2021 and November 2021. HBsAg levels were measured using both assays and subsequently log-transformed (log10 IU/mL) for statistical analysis. Interclass correlation coefficient (ICC), Pearson correlation coefficient, and Bland-Altman analyses were employed to assess assay concordance and systematic bias. Results. A statistically significant positive correlation was observed between the Elecsys HBsAg II and Architect HBsAg QT assays for both untreated and treatment-receiving CHB patients (ICC values not specified, p <0.001). Notably, Architect consistently yielded higher HBsAg measurements compared to Elecsys. Conclusion. Both the Elecsys HBsAg II and Architect HBsAg QT assays demonstrate robust correlation in quantifying HBsAg levels in CHB patients. However, the Architect assay exhibits a systematic positive bias relative to Elecsys, which should be considered when interpreting results and making clinical decisions. Both tools provide reliable assessments for HBsAg quantification within CHB management strategies, but it is essential to be aware of potential assay-specific differences

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society