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Patients with tuberculosis (TB) developing acute respiratory distress syndrome (ARDS) may have a higher mortality when compared with ARDS of other infectious etiology.In this single-centre retrospective cohort study spanning 5-years (2012 to 2016), TB-ARDS patients were age and gender matched (1:2) with non-TB infectious ARDS and followed up until death or hospital discharge. Clinical profile, treatment and outcomes were compared using t-test and Chi-square as appropriate. Mortality predictors were explored using Conditional Poisson regression analysis and expressed as relative risk (RR) with 95% confidence interval (CI).Of the 516 ARDS patients, 74 TB-ARDS and 148 non-TB infectious ARDS patients were included. Although admission APACHE-II (21.4 ± 7.1 vs. 17.6 ± 6.8, p 0.001), incidence of shock (36.5% vs. 19.1%, p = 0.005) and mortality (59.5% vs. 29.7%, p 0.001) were significantly higher in TB-ARDS than non-TB etiology, overall ICU length of stay and nosocomial infections were similar in both groups. On regression analysis, after adjusting for confounders, TB-ARDS (RR 1.82; 95% CI 1.13-2.92) and need for inotropes (RR 3.49; 95% CI 1.44-8.46) were independently associated with death.Patients with TB-ARDS presented sicker and had higher mortality when compared with ARDS due to non-TB infectious etiology.

Background ‘Emergency remote learning’ (ERL) has been undertaken as an emergency response globally to facilitate online shift of medical education due to COVID-19. Although medical students world-wide have reported an increased level of anxiety, factors in the academic setting during ERL that influenced anxiety levels have not been studied yet. The present study aimed to evaluate anxiety levels of first year medical students and its correlation with academic factors during ERL. Methods ERL for neuroanatomy was conducted for six weeks mainly by online small group teaching. At completion, feedback was collected from students (n = 97) which included a GAD-7 questionnaire for anxiety levels and a modified VARK analysis to record changes in learning styles. Results Of 97 students (M46, F51) 43.30% had minimal, 31.96% mild, 10.31% moderate and 14.43% severe anxiety. Academic exchanges such as student–teacher interaction (80.41%), tutor feedback (90.72%) and mentor meetings (81.44%) were reported to be advantageous. There was a significant (p = 0.0056) correlation between enjoyment of small group discussion and lower GAD-7 scores. There was significant change in perceived learning styles during ERL. Video calls (p = 0.018) and gaming (p = 0.022) were significant modes of stress relief. There was significant correlation (p = 0.022) between gaming and GAD-7 scores. Conclusion About one-fourth of the students faced anxiety issues during ERL period. Small group interactions with focus on promoting connectedness and interaction, augmented by feedback, mentorship, familial and social support are important in reducing anxiety which should be kept in mind by educators while delivering such learning experiences.

Objective To study influence of abstinence period on the live-birth rate after assisted reproductive technology (ART). Design Retrospective cohort study. Setting Reproductive medicine unit, university-level hospital. Patient(s) A total 1,030 ART cycles evaluated from 2011 to 2015. Intervention(s) Group I, abstinence period 2–7 days, and group II, abstinence period >7 days, were compared. Two subgroups Ia (2–4 days) and Ib (5–7 days) were also compared with group II. Main Outcome Measure(s) Primary outcome was live birth per ET. Secondary outcomes included implantation, clinical pregnancy, and miscarriage rates. Result(s) The live-birth rate (34.1 % vs. 24.1%; odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1–2.4), clinical pregnancy rate (44.4 % vs. 32.7%; OR, 1.6; 95% CI, 1.1–2.3), and implantation rate (26.4% vs. 18.2%) were significantly higher in group I compared with group II. Other secondary outcomes of fertilization rate and miscarriage rate did not differ between groups I and II. The adjusted odds ratio (aOR) for live birth (aOR, 1.6; 95% CI, 1.1–2.5) and clinical pregnancy rates (aOR, 1.7; 95% CI, 1.2–2.5) were significantly higher for group I compared with group II. The live-birth rate was significantly higher in group Ia (36.1% vs. 24.1%) compared with group II. Conclusion(s) An abstinence period of more than 7 days may impact ART outcomes adversely when compared with an abstinence period of 2–7 days.