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Abstract The Digital Personal Data Protection Act (DPDPA), 2023 of India provides a regulatory framework for use and security of personal digital data. However, instances, wherein the patients consult the clinicians via digital means of communication: the implications of DPDPA, 2023 for the medical personnel remain unclear. This paper critically discusses the gray areas encountered in the Indian medical ecosystem and DPDPA, 2023 and; lists the recommendations to address them.

Author(s): Leema P. Cornelius [1]; K. J. Venkateswaran [1]; K. Jered Livinston [1]; E. Neeraj [1]; S. Surya Kumar [1] Introduction Subacute sclerosing panencephalitis (SSPE) is a rare progressive demyelinating [...], Background: Subacute sclerosing panencephalitis (SSPE) is a progressive neurological disorder in children and young adults due to persistent infection caused by the defective measles virus. It is still common in developing countries such as India. Aim: The aim of this study was to describe the clinical and demographic neuroimaging features, and outcomes of SSPE. Materials and Methods: A retrospective chart review of children diagnosed with SSPE during 2016-2020 was performed and the data were analyzed. Results: Of the 32 patients, 28 (87.5%) were men and four (12.5%) were women. The mean age of onset was 7.28 ± 2.19 years. The initial symptom was myoclonic and generalized seizures in eight (25%) each, behavioral problems in seven (21.9%), frequent falls in six (18.8%), and poor scholastic performance in three (9.4%). One-half of the cohorts had measles in the past and 91% had received the vaccine. Atypical presentations such as akinetic rigid syndrome, and acute disseminated encephalomyelitis (ADEM) like presentations can occur. Magnetic resonance imaging (MRI) brain showed abnormalities in 14 (43.8%) and was normal in 10 (31.3%). The most common abnormality noted was hyperintensities in the frontoparietal region in six (18.8%). Electroencephalogram showed long interval periodic complexes in 21 (65.6%), burst suppression pattern in 7 (22%), and was normal in 4 (12.5%). At the time of diagnosis, 25 (78%) patients were in stage II, 5 (15.6%) in stage III, and 1 (3.1%) child in stage IV and stage I each. Five patients (15.6%) died, 10 (31.3%) lost follow-up, 12 (37.5%) were bedridden, and the disease was static in 5 children (15.6%). Conclusion: Myoclonic seizures and cognitive decline are the most common symptoms in children with SSPE. Knowledge about atypical presentations is essential to avoid unnecessary investigations. Keywords: Cognitive decline, myoclonic seizures, subacute sclerosing panencephalitis

The Digital Personal Data Protection Act (DPDPA), 2023 of India provides a regulatory framework for use and security of personal digital data. However, instances, wherein the patients consult the clinicians via digital means of communication: the implications of DPDPA, 2023 for the medical personnel remain unclear. This paper critically discusses the gray areas encountered in the Indian medical ecosystem and DPDPA, 2023 and; lists the recommendations to address them. [ABSTRACT FROM AUTHOR]

Background : Recent SIOPEL studies have shown cisplatin monotherapy to be equally effective in management of Standard risk Hepatoblastoma (SRHB)as compared to PLADO. Aims and Objectives: To study the chemotherapy, response and outcomes in children with SRHB. Material and Methods: A retrospective study was conducted and all children with SRHB who presented to us from June 2007 to December 2017 were included. All patients with standard risk hepatoblastoma who had received at least 2 cycles of chemotherapy were included. Data regarding the demographics, PRETEXT stage, chemotherapy, response to chemotherapy and outcomes were recorded. Kaplan Meier survival analysis was performed to calculate 5 year overall survival (OS) and event free survival (EFS). Results: Thirty two children were included in the study. The disease was PRETEXT I in 5 (15.6%), II in 9 (28.1%) and 18 (56.2%). Nineteen children (59.4%) received Cisplatin monotherapy and of these 6 patients (all PREXT III) had poor response and the chemotherapy was upgraded to PLADO. The remaining 13 (40.6%) received upfront PLADO chemotherapy. Only 31 patients could be operated. Tumor recurred in 5 patients, 2 who had upfront PLADO and 3 patients had been upgraded to PLADO. The 5 year OS and EFS was 100% in the monotherapy group (n=13), 92% and 69% in the upfront PLADO group (n=13), and 62% and 22% in the upgraded to PLADO group (n=6). Patients with PRETEXT III disease in whom chemotherapy was upgraded to PLADO had significantly lower survival (p=0.036) compared to those who received upfront PLADO chemotherapy. Conclusion: Two thirds of patients with PRETEXT stage III who received cisplatin monotherapy showed poor response and were upgraded to PLADO chemotherapy. These patients had a significantly poorer outcome compared to the rest of the cohort. PRETEXT stage III standard-risk hepatoblastoma may benefit from PLADO chemotherapy instead of cisplatin monotherapy.

Abstract This work is intended to understand the variation of pressure and flow at the pump inlet of liquid rocket engine. The opening and closure of the valve upstream of the pump features complex phenomenon. The opening and closing of the valve cause pressure and flow variations at the pump inlet which may lead to combustion instabilities in combustion chamber of engine, hydraulic transients in feedlines, and off-design operation of turbo-pumps which are fundamental to the efficient testing and operation of engine. A numerical model to predict the pressure and flow transients across a control valve for different rate of opening in fluid feed systems has been developed using first-order finite difference technique. In case of flow in pipes, the velocity and pressure is governed by momentum and continuity equations. A computer code for the prediction of fluid transients is developed based on method of characteristics for one-dimensional fluid flow in pipelines and compared with test data for validation. The control valve is considered to be in-line with the feed line and modeled based on the valve coefficient vs. percent opening of valve. This model can subsequently be used to predict the effect of opening/closing time of the valve on pressure surges across the control valve and corresponding flow rate in the feedline for different opening of the valve.

Background: Anaplastic large-cell lymphoma (ALCL) is a rare subtype of non-Hodgkin's lymphoma (NHL) characterized by the presence of unusual giant cells. It is a CD30+lymphoma of T-cells lineage, which shows anaplastic lymphoma kinase-nucleophosmin (ALK-NPM) rearrangement. ALCL on fine needle aspiration cytology (FNAC) shows unusually large and bizarre tumor cells. Materials and Methods: All aspirates seen over a 6-year period from November 2009 to November 2015 in which a diagnosis of ALCL or Hodgkin's lymphoma (HL) with bizarre giant cells were suspected on cytomorphology were prospectively selected. Twenty such aspirates were subjected to CD-30 and ALK-1 immunocytochemistry (ICC). Subsequent biopsy was available in all cases. Results: Out of 20 cases, seven cases, suspected to be ALCL on FNAC, were confirmed on biopsy. ALK-1 was positive in both cytology and biopsy of 6/7 of these. Two cases suspected to be ALCL on cytomorphology were HL (1) and diffuse large B-cell lymphoma (DLBCL) (1) on biopsy, both of which were ALK-1 negative on cytology. Eight cases of HL and three cases of large-cell NHL, which were all ALK negative on cytology, were confirmed on biopsy. Conclusion: ICC for ALK and CD30 is useful in aspiration cytodiagnosis of ALCL. One CD30 positive DLBCL and one ALK negative ALCL showed concordant results of ICC on cytology and histology.

Background: Conventional transbronchial needle aspiration (c-TBNA) is an underutilized bronchoscopic modality. Endobronchial ultrasound (EBUS) guided-TBNA though efficacious is an expensive modality, facilities of which are available at only limited centers. c-TBNA is cost-effective and has potential for wide utilization especially in resource-limited settings. Rapid on-site evaluation (ROSE) improves the yield of c-TBNA. Materials and Methods: A retrospective review of the bronchoscopy records (May 2012 to July 2014) was performed. The patients who underwent c-TBNA with ROSE were included in the study and their clinical details were extracted. Convex probe EBUS-TBNA was being regularly performed during the study period by the operators performing c-TBNA. Results: c-TBNA with ROSE was performed in 41 patients with mean age of 42.4 (16.2) years. The most frequently sampled node stations (>90% patients) were the subcarinal and lower right paratracheal. Representative samples could be obtained in 33 out of the 41 patients (80.4%). c-TBNA was diagnostic in 32 [tuberculosis (TB)-8, sarcoidosis-9, and malignancy-15] patients out of the 41 patients. The overall diagnostic yield (sensitivity) of c-TBNA with ROSE was 78%. Mean procedure duration was 18.4 (3.1) min and there were no procedural complications. Conclusion: c-TBNA with ROSE is a safe, efficacious, and cost-effective bronchoscopic modality. When it was performed by operators routinely performing EBUS-TBNA, diagnostic yields similar to that of EBUS-TBNA can be obtained. Even at the centers where EBUS facilities are available, c-TBNA should be routinely performed.

Introduction: Hepatocellular carcinoma (HCC) is a common primary malignancy of the liver but is rare in the paediatric age group; thus, it may be misdiagnosed as the more common tumour, hepatoblastoma. Management varies in both these tumours, and pathological diagnosis thus plays an important role for definitive therapy. Only a few case reports available in the literature have described the cytological characteristics of paediatric HCC. The present study was thus planned to evaluate the cytomorphological features of paediatric HCC. Methods: Cases diagnosed with HCC on ultrasound‐guided fine needle aspiration cytology over a period of 14 years were retrieved. The cases were evaluated for detailed cytological features including cellularity, architecture, sinusoidal wrapping, trabecular thickness, necrosis, anisonucleosis, chromatin, nucleoli, nuclear contours, bi‐ or multinucleation, intranuclear and intracytoplasmic inclusions, naked nuclei, extra‐medullary haematopoiesis, monomorphism, and nuclear overlapping. Results: Twelve cases of HCC were included in the study. The median age at diagnosis was 10 years. Serum alpha‐fetoprotein level was raised in most of them. Five of the 12 cases were characterised as moderately differentiated, three as poorly differentiated, two as well differentiated, and two as the fibrolamellar type of HCC. Cytohistological correlation was performed in seven cases. Conclusions: Ultrasound‐guided fine needle aspiration serves as a useful tool to diagnose paediatric HCC and differentiate it from other primary hepatic malignancies, especially hepatoblastoma which closely mimics HCC in this age group, as serum alpha protein levels and imaging findings are unable to distinguish these two tumours. [ABSTRACT FROM AUTHOR]