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A community-based cross-sectional study was undertaken by the Cardiology Society of India (Kerala Chapter) to determine the prevalence of coronary artery disease (CAD) and its risk factors. The periodontal health status of the rural and urban participants in the Thiruvananthapuram district of Kerala was evaluated to document any association between periodontal disease (PD) and CAD and to describe any shared risk factors. The participants were selected using a multistage cluster random sampling method. Socio-demographic data and personal histories were collected using a structured interview schedule and validated tools. Body mass index, blood pressure, electrocardiogram, and biochemical investigations were recorded and analyzed using standard protocols. A modification of the Ramfjord periodontal disease index was used to assess periodontal health. PD was more frequent among rural (61.4%) than in the urban population (35.5%). The frequencies of CAD associated with PD in the rural and urban populations were 82.6% and 40.5%, respectively. PD was not found to be a significant risk factor for CAD in the univariate regression analysis of urban populations. In the rural population, the odds of PD as a risk factor for CAD were found to be 3.08 (95% CI [1.38–8.38]) and significant ( P = .043) in univariate regression analysis and 1.54 (95% CI: 0.44–5.4) and non-significant ( P = .503) in the multivariate regression analysis. In rural areas, male sex and dyslipidemia demonstrated borderline significance as risk factors for CAD. PD was not found to be an independent risk factor after adjusting for age, sex, tobacco use, hypertension, sedentary lifestyle, and dyslipidemia. Male sex and dyslipidemia were identified as shared risk factors between PD and CAD, which could have confounded the significant association between the latter. In urban areas, age, male sex, and dyslipidemia demonstrated an independent association with CAD. This study could not establish an independent association between PD and CAD in either community. Future epidemiological studies should identify and recruit novel environmental factors to understand the interrelationships between PD and CAD and focus on the role of effect modifiers that may have a protective role against PD colluding with CAD.

Context: Tumor budding (TB), poorly differentiated clusters (PDCs), and Ki 67 index are proven adverse prognostic factors in breast carcinoma. Though the relation of Ki 67 index with molecular subtypes of breast carcinoma have been extensively studied, there is very limited information on the role of TB and PDCs. Aims: To grade TB, PDCs, and Ki 67 index and assess histological features and relationship of all these with molecular subtypes of invasive breast carcinoma of no special type. Methods and Material: Retrospective study of 148 cases from 1/1/2019 to 30/12/2019. Division of molecular groups – Luminal A, Luminal B, Her2 neu positive, and triple-negative breast carcinomas (TNBC), and Ki 67 index grades based on St Gallen criteria, intratumoral and peritumoral TB and PDC grades as per the International Tumor Budding Consensus Conference (ITBCC) criteria for colon and correlation between these and other histological features with the molecular subtypes were done. Statistical Analysis: Chi-square test, univariate and multivariate logistic regression models were used. Results: Significant correlation was seen between TB and lymphovascular emboli, Luminal B tumors with high-grade TB and PDCs, Her 2 neu positive and TNBC tumors with low-grade TB, circumscribed tumor margins, tumor necrosis, and Luminal B, Her 2 neu positive and TNBC tumors with larger tumor size and high nuclear grades. Conclusions: TB and PDCs are useful in the prognostication of Luminal A and B tumors when the Ki 67 index values are low/intermediate. Her 2 neu positive and TNBC tumors have a high nuclear grade with necrosis and no association with TB or PDCs.

Roghan Mālish is a cost effective topical application recommended for joint pain management. This prospective pilot study evaluated the safety, analgesic, and anti-inflammatory effect of Roghan Mālish in patients with arthralgia to validate the therapeutic claim and generate evidence for further studies. The study was conducted in patients with joint pain as chief complaint, with or without swelling and morning stiffness. The study was approved by Institutional ethic committee prior to initiation. Patients were advised to apply Roghan Mālish (2.5 mL/joint) followed by gentle massage in circular motion for 5 mins twice daily for 14 days. The efficacy was calculated from the reduction in Visual Analogue Scale (VAS), C-Reactive Protein (CRP) level and improvement in Quality of Life Scale (QOLS). Relevant pathological and biochemical indices and the observation of adverse events were used to evaluate the safety. A total number of 58 patients completed the trial with the mean age of 46.2 years and the majority (70.7%) being female. The overall therapeutic response was 93%. A significant (P<0.05) decrease in VAS score and CRP level, and significant improvement in QOLS was observed after treatment with Roghan Mālish. No significant difference in pathological and biochemical indices was observed before and after treatment. Roghan Mālish was well tolerated upon topical application with no any undesirable side effects. The study results indicate that the topical application of Roghan Mālish is safe and may be used successfully to treat arthralgia.

Background: Few studies have looked into the impact of hypoglobulinaemia on infectious complications in childhood acute lymphoblastic leukemia (ALL). We conducted this prospective study to analyse the profile of severe infections during maintenance chemotherapy in Indian children and their correlation with serum immunoglobulin levels. Methodology: Children [?]14 years with ALL on maintenance chemotherapy were recruited and serum immunoglobulin levels were measured at the time-of-recruitment in this study conducted between 1st April 2018 and 31st March 2019. Children were followed up for severe infection for a period of 6 months or till completion of treatment whichever was later. Statistical analysis was done to find out risk factors of severe infection including serum immunoglobulin status. Results: We recruited 199 children undergoing maintenance chemotherapy (58, 52, 47, and 42 children in 0-6, 7-12, 13-18 and 19-24 months of maintenance period) and followed them up for a mean (SD) 9.7(2.961) months. 56.8%, 80.4%, and 86.4% children had hypo-IgG, hypo-IgA, and hypo-IgM at the time-of-recruitment. Ninety-one (45.7%) children developed 147 episodes of severe infections of which 54 (59.3%) were respiratory. Univariate analysis showed younger age, female gender and normal IgG group had significantly increased risk of severe infection (P=0.024, 0.007, 0.049, respectively), in multivariate analysis female gender had significantly increased risk of severe infection (P=0.025). Conclusion: Significant proportion of Indian children on ALL maintenance chemotherapy developed severe infection and hypoglobulinaemia. However, hypoglobulinaemia did not significantly increase the risk of severe infection. Younger children and female gender had significantly increased risk of severe infection during maintenance.