The new A-B-C-D Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification of severity of chronic obstructive pulmonary disease (COPD) is based on combined symptoms and exacerbation risk assessment. The assumed equivalence between dyspnoea modified Medical Research Council (mMRC) grade ≥2 and COPD Assessment Test (CAT) score ≥ 10 to identify more symptoms has been questioned. Whether the exacerbation risk assessment criteria, old GOLD spirometry staging and frequency of exacerbations, are equivalent has not been examined. We evaluated the extent of agreement between these alternative criteria and whether it improved by redefining the equivalence between mMRC grade and CAT score. CAT scores, mMRC grades of dyspnoea, frequency of exacerbations and spirometry stages were computed in 400 patients with COPD. Receiver operating characteristic curve was analysed to determine the best CAT score to identify more symptoms. CAT scores across mMRC grades and the frequency of exacerbations across spirometry stages showed substantial overlaps. The symptoms criteria gave discordant classification in 88 (22%) patients (kappa 0.62) and the exacerbation risk assessment criteria in 181 (45%) patients (kappa 0.12). A CAT score of ≥10 had 82% sensitivity but 24% specificity to identify mMRC grade ≥ 2, while a score of 17 had 98% specificity but a low sensitivity of 52% and did not improve the agreement. We conclude that symptoms and exacerbation risk assessment criteria of the new GOLD classification yield discordant group categorisations. Lack of any satisfactory equivalence between CAT score and mMRC grades implies that the former cannot be used alone. Using the higher of mMRC ≥ 2 and CAT score ≥ 17 to identify more symptoms would avoid discordant categorisation.

This article deals with the problem of estimation of the population mean in presence of multi-auxiliary information in two occasion rotation sampling. A multivariate exponential ratio type estimator has been proposed to estimate population mean at current (second) occasion using information on p-additional auxiliary variates which are positively correlated to study variates. The theoretical properties of the proposed estimator are investigated along with the discussion of optimum replacement strategies. The worthiness of proposed estimator has been justified by comparing it to well-known recent estimators that exist in the literature of rotation sampling. Theoretical results are justified through empirical investigations and a detailed study has been done by taking different choices of the correlation coefficients. A simulation study has been conducted to show the practicability of the proposed estimator.

The present work deals with the problem of estimation of finite population median at current occasion, in two occasion successive (rotation) sampling. A class of estimators has been proposed for the estimation of population median at current occasion, which includes many existing estimators as a particular case. Asymptotic properties including the asymptotic convergence of proposed class of estimators are elaborated. Optimum replacement strategies are also discussed. The proposed class of estimators at optimum condition is compared with the sample median estimator when there is no matching from the previous occasion as well as with some other members of the class. Theoretical results have been justified through empirical interpretation with the help of some natural populations.

The prevalence of hepatitis C virus (HCV) infection in Pediatric patients with lymphoproliferative diseases has most commonly been reported with B cell Non-Hodgkin lymphoma. Case studies have reported the requirement of dose reduction or suspension of chemotherapy in 80% of Pediatric ALL cases who are anti-HCV positive owing to hepatotoxicity. The standard of care anti HCV therapy in children aged 3-17 years had been peginterferon and ribavirin for 48 weeks. FDA approved pan-genotypic, anti- HCV regimen, sofosbuvir/velpatasvir [SOF/VEL], for the Pediatric population >6yrs of age or >17 kg body weight in March 2020. We herein report a case of an HCV infected Pediatric B cell ALL patient who was treated with SOF/VEL concomitantly with an intensive chemotherapy regimen. Child tolerated the full dose chemotherapy along with antivirals for 12 weeks and was in morphological remission with sustained virological response.