Investigating the benefits of molecular profiling of advanced non-small cell lung cancer tumors to guide treatments.

In this study we utilized data on patient responses to guided treatments, and we evaluated their benefit for a non-small cell lung cancer cohort. The recommended therapies used were predicted using tumor molecular profiles that involved a range of biomarkers but primarily used immunohistochemistry markers. A dataset describing 91 lung non-small cell lung cancer patients was retrospectively split into two. The first group's drugs were consistent with a treatment plan whereby all drugs received agreed with their tumor's molecular profile. The second group each received one or more drug that was expected to lack benefit. We found that there was no significant difference in overall survival or mortality between the two groups. Patients whose treatments were predicted to be of benefit survived for an average of 402 days, compared to 382 days for those that did not (P = 0.7934). In the matched treatment group, 48% of patients were deceased by the time monitoring had finished compared to 53% in the unmatched group (P = 0.6094). The immunohistochemistry biomarker for the ERCC1 receptor was found to be a marker that could be used to predict future survival; ERCC1 loss was found to be predictive of poor survival

A mediation approach to understanding socio-economic inequalities in maternal health-seeking behaviours in Egypt.

BACKGROUND: The levels and origins of socio-economic inequalities in health-seeking behaviours in Egypt are poorly understood. This paper assesses the levels of health-seeking behaviours related to maternal care (antenatal care [ANC] and facility delivery) and their accumulation during pregnancy and childbirth. Secondly, it explores the mechanisms underlying the association between socio-economic position (SEP) and maternal health-seeking behaviours. Thirdly, it examines the effectiveness of targeting of free public ANC and delivery care. METHODS: Data from the 2008 Demographic and Health Survey were used to capture two latent constructs of SEP: individual socio-cultural capital and household-level economic capital. These variables were entered into an adjusted mediation model, predicting twelve dimensions of maternal health-seeking; including any ANC, private ANC, first ANC visit in first trimester, regular ANC (four or more visits during pregnancy), facility delivery, and private delivery. ANC and delivery care costs were examined separately by provider type (public or private). RESULTS: While 74.2% of women with a birth in the 5-year recall period obtained any ANC and 72.4% delivered in a facility, only 48.8% obtained the complete maternal care package (timely and regular facility-based ANC as well as facility delivery) for their most recent live birth. Both socio-cultural capital and economic capital were independently positively associated with receiving any ANC and delivering in a facility. The strongest direct effect of socio-cultural capital was seen in models predicting private provider use of both ANC and delivery. Despite substantial proportions of women using public providers reporting receipt of free care (ANC: 38%, delivery: 24%), this free-of-charge public care was not effectively targeted to women with lowest economic resources. CONCLUSIONS: Socio-cultural capital is the primary mechanism leading to inequalities in maternal health-seeking in Egypt. Future studies should therefore examine the objective and perceived quality of care from different types of providers. Improvements in the targeting of free public care could help reduce the existing SEP-based inequalities in maternal care coverage in the short term

Validation of the WHO Disability Assessment Schedule (WHODAS 2.0) 12-item tool against the 36-item version for measuring functioning and disability associated with pregnancy and history of severe maternal morbidity.

OBJECTIVE: To validate the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) 12-item tool against the 36-item version for measuring functioning and disability associated with pregnancy and the occurrence of maternal morbidity. METHODS: This is a secondary analysis of the Brazilian retrospective cohort study on long-term repercussions of severe maternal morbidity (SMM) among women who delivered at a tertiary facility (COMMAG study). We compared WHODAS-12 and WHODAS-36 scores of women with and without SMM using measures of central tendency and variability, tests for instruments' agreement (Bland-Altman plot), confirmatory factor analysis (CFA), and Cronbach alpha coefficient for internal consistency. RESULTS: The COMMAG study enrolled 638 women up to 5 years postpartum. Although the median WHODAS-36 and -12 scores for all women were statistically different (13.04 and 11.76, respectively; P<0.001), there was a strong linear correlation between them. Furthermore, the mean difference and the differences in variance analyses demonstrated agreement of total scores between the two versions. CFA demonstrated how the WHODAS-12 questions are divided into six previously defined factors and Cronbach alpha showed good internal consistency. CONCLUSION: WHODAS-12 demonstrated agreement with WHODAS-36 for total score and was a good instrument for screening functioning and disability among postpartum women, with and without SMM

Rational prescribing practice assessment among resident doctors in a tertiary care teaching hospital: a questionnaire based observational study

Background: One of the important factors in health policy is recognised to be rational use of medicines (RUM). Physicians can influence the health and well-being of patients by prescribing appropriate drug in right doses and they should be taught to prescribe rationally at the earliest of their professional carrier.Methods: This cross-sectional, questionnaire-based study was carried out in SMHS hospital which is a tertiary-care teaching hospital associated with Government Medical College, Srinagar, Jammu and Kashmir, India.Results: Out of 106 resident doctors enrolled in the study, 96.2% respondents were aware about the term essential medicines of India, and 47.6% had National List of Essential Medicines of India available at their work place. When the participants were questioned about the term RUM only 17% of them responded positively, but majority of the resident doctors (88.67%) were aware about the ingredients of the drugs they use to prescribe. Though only 3.7% of our participating doctors always use essential medicines during their prescription writing but majority of them (96.22%) would always use to inform the patient regarding disease, drug therapy and monitoring of drug therapy.Conclusions: Considering the fact that respondents are future prescribers they should be aware of all aspects about RUM and improper knowledge in certain areas of RUM is a matter of concern that needs to be addressed

Cloudshield: The Future of Cloud Security

Cloud computing has become an integral part of modern IT infrastructure, enabling organizations to store, process, and manage data with unprecedented flexibility and scalability. However, as more critical and sensitive data moves to the cloud, the need for robust security mechanisms becomes increasingly vital. This paper introduces "CloudShield," a forward-thinking security framework designed to address the emerging challenges of cloud security. We explore the core components of this model, including AI-powered threat detection, enhanced encryption protocols, decentralized access management, and compliance automation. Additionally, we discuss how CloudShield integrates with existing cloud infrastructure and supports dynamic threat environments. Finally, the paper explores the role of AI, blockchain, and quantum computing in shaping the future of cloud security. The aim is to provide a comprehensive overview of how the CloudShield framework can serve as a blueprint for securing the next generation of cloud environments

Malignant ectopic thyroid tissue with distant metastasis: a case report

Introduction: Ectopic thyroid tissue is the most common form of thyroid dysgenesis. But primary malignant transformation in ectopic thyroid tissue is quite a rare entity, with follicular malignancy being the dominant form at ectopic sites. Very infrequently, malignant ectopic thyroid tissue can present with metastasis to lymph nodes. But we report a case of malignant ectopic thyroid tissue over manubrium sterni with distant metastasis. Case presentation: A 42-year-old Pakistani female presented with gradually increasing swelling on anterior aspect of manubrium sterni for last 6 months. She had no goitre and was clinically and biochemically euthyroid. Rest of systemic exam was also unremarkable. CT chest showed a circumscribed soft tissue density mass arising from sternum, measuring 3.9×3.9 cm, causing erosions of anterior, right lateral and posterior walls of sternum. Trucut biopsy of the sternal mass proved it to be thyroid tissue with follicular differentiation and occasional mitotic figures. Multiple nodules were also noted in thyroid gland in US neck. She underwent total thyroidectomy and excision of ectopic thyroid tissue over manubrium sterni. Extensive histopathological examination of primary thyroid gland showed benign nodular hyperplasia with no evidence of malignancy. Ectopic thyroid tissue showed minimally invasive follicular thyroid carcinoma with tumor size of 3.2×2.3 cm. Her postoperative 21-day biochemical profile showed TSH 22.345 μIU/ml (0.4–4.2), serum thyroglobulin 88.3 ng/ml, and anti-TG antibodies Conclusion: We describe the first case of its kind having malignant ectopic thyroid with metastasis to spine and ilium. Such cases may impose difficulties in their treatment decisions

Frequency and pattern of gynecological problems of adolescent girls attending outpatient department, department of obstetrics and gynecology, Bangabandhu Sheik Mujib Medical University, Bangladesh

Background: Adolescent is a stage of development tangent, like a bridge of childhood and adulthood. It is the healthiest age group of our society which is almost 20% of our total population. World health organization (WHO) defines adolescents are in the 10-19 year in age group. One of the major physiological changes that take place in adolescent girls is the onset of menarche, which is often associated with problems of irregular menstruation, excessive bleeding and dysmenorrhea.Methods: This cross-sectional observational study was carried out in 668 female adolescent aged 10-19 years irrespective of their marital status visiting the OPD of obstetrics and gynecology department of BSMMU. All data was analyzed using SPSS program version 22.0.Results: Results were expressed in frequencies or percentages. Of the 668 adolescent girls, 418 (62.6%) had different type of menstrual disorder. Of these 418 cases about 127 (30.38%) of them were a case of puberty menorrhagia, 109 (26.07%) cases were oligomenorrhoea and 91 (21.77%) were amenorrhea. Other presentations were pre-vaginal discharge, vulval itching, lower abdominal pain, dysuria, feeling lump in lower abdomen, mastalgia, feeling lump in the breast, discharge from breast, acne, hirsutism.Conclusions: This study shows more than half of adolescent girls are having menstrual disorder. Adolescent gynecology needs increased awareness and greater attention to improve the quality of their life. Setting up a separate adolescent clinic is necessary for efficient management of adolescent problem