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This article examines the outcomes of patients with Caesarean scar pregnancy (CSP) who were symptomatic at the time of diagnosis compared to those who were asymptomatic. The study found that symptomatic patients were less likely to have a successful CSP compared to asymptomatic patients. However, there were no significant differences in the rate of therapeutic interventions or the time it took for complete resolution between the two groups. The study also noted that symptomatic patients were more likely to be of Hispanic race. Overall, this research suggests that being symptomatic at the time of CSP diagnosis may increase the likelihood of a failed CSP, but further investigation is needed. [Extracted from the article]

This article, titled "Transvaginal ultrasound-guided feticide in the management of interstitial ectopic pregnancy," discusses the effectiveness and safety of using transvaginal ultrasound-guided feticide as a treatment for interstitial ectopic pregnancy (IEP). The study, conducted at a New York City academic institution between 2010 and 2023, included 23 patients with IEP. The primary outcome of the study was treatment success, defined as resolution without surgical intervention. The results showed that transvaginal ultrasound-guided feticide was highly effective and safe for managing live IEPs, with minimal complications. [Extracted from the article]

This article discusses the efficacy and safety of minimally invasive approaches in the treatment of cervical ectopic pregnancy (CEP). The study analyzed cases of CEP at a New York City medical center from 2010 to 2023. The primary treatment options included transvaginal ultrasound-guided feticide, transcervical balloon catheter insertion, and systemic methotrexate (MTX). The results showed that both transvaginal ultrasound-guided feticide and transcervical balloon catheter were effective in resolving live CEP without surgical intervention. Systemic MTX was used for non-live CEP cases, with some requiring additional interventions. Overall, the study suggests that minimally invasive management can successfully treat CEP. [Extracted from the article]

This article discusses the outcomes of expectant management in cases of live Caesarean scar pregnancies (CSP). The study, conducted at a New York City tertiary academic institution between 2010 and 2023, found that among 110 CSP diagnoses, 70 were viable and 19 patients chose expectant management. The average gestational age at diagnosis was 9.2 weeks. While expectant management presented considerable maternal risk, with a high rate of hysterectomy, three-quarters of patients achieved a live birth, albeit preterm. The study emphasizes the importance of rigorous clinical decision-making and patient education regarding the associated risks. [Extracted from the article]

This article compares the outcomes of first trimester non-viable Caesarean scar pregnancies (CSP) that were treated versus those managed expectantly. The study, conducted at a tertiary care institution in New York City between 2010 and 2023, included 40 patients diagnosed with non-viable CSP. The results showed that expectant management is a reasonable option for patients with non-viable CSP in the first trimester, as it does not increase the risk of complications or delay resolution. The study found no significant differences in outcomes between patients who received active intervention and those managed expectantly. [Extracted from the article]

An outbreak of acute hemorrhagic conjunctivitis occurred in Delhi, India, during August and September 1996, The etiologic agent was confirmed as enterovirus type 70 by a modified centrifugation-enhanced culture method [...]

Background and Objectives: There is need to promote professionalism in junior doctors. The big challenge for medical education is how we can teach and assess professionalism. The objective of the study is to find out-is work place based assessment is a valuable tool to assess professionalism? Methods: This was a cross sectional study conducted in Gynae/Obs department of Shalamar Medical and Dental college Lahore. Total 50 junior doctor were included in the study. Approval was taken from the ethical committee of hospital. After obtaining informed consent data was collected by direct observation of junior doctors at their place of work during routine working. Results: 50 junior doctors participated in the study. 25 were house officers and 25 were first year residents. The main traits which were found deficient were empathy in 30%, interpersonal skills in 35% and communication with the patients in 45%. Conclusion: Work place based assessment is a valuable tool for professionalism. Junior doctors should be assessed at their place of work and feedback provided will help them to identify areas of deficiencies and improvement for future. [ABSTRACT FROM AUTHOR]

The first major dengue outbreak in Delhi, India, is discussed. The outbreak of dengue hemorrhagic fever/dengue shock syndrome (DHS/DSS) was in 1996 in and near Delhi. The cause was seen to be dengue virus type 2. It was the largest such outbreak reported from India and showed serious resurgence of dengue virus infection. There is a seasonal pattern. All outbreaks are during the monsoon season, Aug-Nov. Table lists age distribution of those with culture-positive dengue., An outbreak of dengue hemorrhagic fever/dengue shock syndrome (DHS/DSS) occurred in 1996 in India in and near Delhi. The cause was confirmed as dengue virus type 2, by virus cultivation [...]

Studies on Pneumocystis jirovecii dihydropteroate synthase (DHPS) genotypes among non-HIV immunocompromised patients from developing countries are rare. In the present prospective investigation, 24 (11.8%) cases were found to be positive for Pneumocystis jirovecii out of 203 non-HIV patients with a clinical suspicion of Pneumocystis pneumonia (PCP). Dihydropteroate synthase (DHPS) genotype 1 (Thr55+Pro57) was noted in 95.8% P. jirovecii isolates in the present study in contrast to only 4.1% of patients with DHPS genotype 4 (Thr55Ala + Pro57Ser). [ABSTRACT FROM AUTHOR]

In 1990, we isolated 158 strains of Salmonella typhi from blood cultures of patients suffering from typhoid fever. Seventy nine (50%) of these isolates were found to be simultaneously resistant to chloramphenicol, ampicillin and cotrimoxazole. These strains were also resistant to streptomycin and tetracycline, but sensitive to gentamicin, amikacin and cephalexin. The minimum inhibitory concentrations of chloramphenicol and trimethoprim for a representative number of these strains were found to be greater than 1024 micrograms/ml and greater than 128 micrograms/ml respectively. Majority of the multidrug resistant (MDR) strains tested against cefotaxime (23/23), ciprofloxacin (38/38) and amoxycillin plus clavulanic acid (23/24) were sensitive to these drugs. [ABSTRACT FROM AUTHOR]

Abstract Background Acute lower respiratory tract infections (ALRI) are the major cause of morbidity and mortality in young children worldwide. Information on viral etiology in ALRI from India is limited. The aim of the present study was to develop a simple, sensitive, specific and cost effective multiplex PCR (mPCR) assay without post PCR hybridization or nested PCR steps for the detection of respiratory syncytial virus (RSV), influenza viruses, parainfluenza viruses (PIV1–3) and human metapneumovirus (hMPV). Nasopharyngeal aspirates (NPAs) were collected from children with ALRI ≤ 5 years of age. The sensitivity and specificity of mPCR was compared to virus isolation by centrifugation enhanced culture (CEC) followed by indirect immunofluorescence (IIF). Results From April 2005–March 2007, 301 NPAs were collected from children attending the outpatient department or admitted to the ward of All India Institute of Medical Sciences hospital at New Delhi, India. Multiplex PCR detected respiratory viruses in 106 (35.2%) of 301 samples with 130 viruses of which RSV was detected in 61, PIV3 in 22, PIV2 in 17, hMPV in 11, PIV1 in 10 and influenza A in 9 children. CEC-IIF detected 79 viruses only. The sensitivity of mPCR was 0.1TCID50 for RSV and influenza A and 1TCID50 for hMPV, PIV1, PIV2, PIV3 and Influenza B. Mixed infections were detected in 18.8% of the children with viral infections, none detected by CEC-IIF. Bronchiolitis was significantly associated with both total viral infections and RSV infection (p < 0.05). History of ARI in family predisposed children to acquire viral infection (p > 0.05). Conclusion Multiplex PCR offers a rapid, sensitive and reasonably priced diagnostic method for common respiratory viruses.

Abstract Background Co-circulation of multiple dengue virus serotypes has been reported from many parts of the world including India, however concurrent infection with more than one serotype of dengue viruses in the same individual is rarely documented. An outbreak of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) occurred in and around Delhi in 2006. This is the first report from India with high percentage of concurrent infections with different dengue virus serotypes circulating during one outbreak. Results Acute phase sera from patients were tested for the presence of dengue virus RNA by RT-PCR assay. Of the 69 samples tested for dengue virus RNA, 48 (69.5%) were found to be positive. All the four dengue virus serotypes were found to be co-circulating in this outbreak with DENV-3 being the predominant serotype. In addition in 9 of 48 (19%) dengue virus positive samples, concurrent infection with more than one dengue virus serotype were identified. Conclusion This is the first report in which concurrent infections with different dengue virus serotypes is being reported during an outbreak from India. Delhi is now truly hyperendemic for dengue.

Abstract Background A major DHF outbreak occurred in Delhi in 1996. Following this another outbreak was reported in the year 2003. In the years 2004 and 2005, though no outbreak was reported, a definitely higher number of samples were received in the virology laboratory of A.I.I.M.S. from suspected cases of dengue infection. This study was designed to compare the serological and virological profiles of confirmed dengue cases in the years 2003, 2004 and 2005. Results Out of 1820 serum samples received from suspected cases in all three years, 811 (44.56%) were confirmed as dengue infection serologically. Out of these confirmed dengue cases maximum cases, in all three years, were seen in the age group 21–30 years. There was an increase in the number of samples received in the post monsoon period (September to November) with a peak in the second and third week of October. More samples were received from DHF cases in the year 2005 than 2004 and 2003. All four dengue serotypes were seen co-circulating in the year 2003, followed by complete predominance of dengue serotype 3 in 2005. Conclusion Epidemiology of dengue is changing rapidly in Delhi. Dengue infections are seen every year thus making it an endemic disease. After co-circulation of all serotypes in 2003, now dengue serotype 3 is emerging as the predominant serotype.

Objective: To assess the performance of simultaneous endometrial aspiration and sonohysterography to screen for endometrial cancer or hyperplasia in women aged 50 years or older., Methods: We conducted a prospective study from February 2014 to October 2020 at the ultrasound unit of a large urban academic medical center. The study included 1,635 women aged 50 years or older referred for endometrial evaluation, with follow-up through January 2021. Participants underwent saline infusion sonohysterography combined with ultrasound-guided endometrial aspiration. The primary outcome measured was a diagnosis of endometrial cancer or hyperplasia within 1 year from screening. The diagnostic accuracy of the combined evaluation method, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), was assessed., Results: Of 1,170 women who completed the study protocol, 82 (7.0%) had endometrial cancer and 42 (3.6%) had endometrial hyperplasia. Of all patients who developed cancer during the follow-up period, 85.5% were diagnosed within 1 year after evaluation. The application of simultaneous endometrial aspiration and sonohysterography together demonstrated a sensitivity of 99.1%, specificity of 24.9%, PPV of 11.8%, and NPV of 99.6%. Using a theoretical sequential approach, assuming an endometrial aspiration is performed only in patients determined to be high risk by sonohysterography, demonstrated a sensitivity of 93.4%, specificity of 99.9%, PPV of 99.0%, and NPV of 99.3%., Conclusion: Simultaneous endometrial aspiration and sonohysterography is an effective one-stop outpatient screening tool for detecting endometrial cancer and hyperplasia in women aged 50 years or older. With the integration of two screening modalities into a single procedure, simultaneous endometrial aspiration and sonohysterography may overcome the limitations inherent in each of the currently recommended methods individually, potentially improving patient prognosis and streamlining the diagnostic process., Competing Interests: Financial Disclosure Haotian Wu disclosed receiving payments from Montefiore. The other authors did not report any potential conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)