Ministry Of Welfare Research Articles

Novel antioxidant protein target therapy to counter the prevalence and severity of SARS-CoV-2.

This review analyzed the magnitude of the COVID-19 pandemic globally and in India and the measures to counter its effect using natural and innate immune booster molecules. The study focuses on two phases: the first focuses on the magnitude, and the second on the effect of antioxidants (natural compounds) on SARS-CoV-2. The magnitude of the prevalence, mortality, and comorbidities was acquired from the World Health Organization (WHO) report, media, a report from the Ministry of Health and Family Welfare (MoHFW), newspapers, and the National Centre of Disease Control (NCDC). Research articles from PubMed as well as other sites/journals and databases were accessed to gather literature on the effect of antioxidants. In the elderly and any chronic diseases, the declined level of antioxidant molecules enhanced the reactive oxygen species, which in turn deprived the immune system. Innate antioxidant proteins like sirtuin and sestrin play a vital role in enhancing immunity. Herbal products and holistic approaches can also be alternative solutions for everyday life to boost the immune system by improving the redox balance in COVID-19 attack. This review analyzed the counteractive effect of alternative therapy to boost the immune system against the magnitude of the COVID-19 pandemic.

Brain tumor segmentation using U-Net in conjunction with EfficientNet.

According to the Ten Leading Causes of Death Statistics Report by the Ministry of Health and Welfare in 2021, cancer ranks as the leading cause of mortality. Among them, pleomorphic glioblastoma is a common type of brain cancer. Brain cancer often occurs in the brain with unclear boundaries from normal brain tissue, necessitating assistance from experienced doctors to distinguish brain tumors before surgical resection to avoid damaging critical neural structures. In recent years, with the advancement of deep learning (DL) technology, artificial intelligence (AI) plays a vital role in disease diagnosis, especially in the field of image segmentation. This technology can aid doctors in locating and measuring brain tumors, while significantly reducing manpower and time costs. Currently, U-Net is one of the primary image segmentation techniques. It utilizes skip connections to combine high-level and low-level feature information, leading to significant improvements in segmentation accuracy. To further enhance the model's performance, this study explores the feasibility of using EfficientNetV2 as an encoder in combination with U-net. Experimental results indicate that employing EfficientNetV2 as an encoder together with U-net can improve the segmentation model's Dice score (loss = 0.0866, accuracy = 0.9977, and Dice similarity coefficient (DSC) = 0.9133).

Who Are the Stakeholders in Promoting Mental Health?

It is now confirmed that mental health promotion policies need innovations beyond the scope of the health sector. In this study, an attempt was made to identify the most effective stakeholders of the public sector in the field of mental health promotion in Iran to help the policy-makers and to encourage inter-sectoral collaboration and further involvement of these effective sectors in mental health promotion plans. This was a mixed-methods study. From the first step (literature review and a survey), the names of public agencies affected by mental health promotion were extracted. In the next step, a checklist for identifying the main stakeholders was developed. The data of this step were analyzed by the simple additive weighting method. Ultimately, a table was plotted in the form of institutional mapping in order to summarize the organizations affecting each risk factor of mental health promotion. The Islamic Consultative Assembly, the Ministry of Interior, the Islamic Republic of Iran Broadcasting, the Ministry of Cooperatives, Labor, and Social Welfare, and the Ministry of Education were identified as the five institutions with the greatest impacts on the social determinants of mental health in Iran. Significant impacts can be exerted by institutions such as the Islamic Consultative Assembly (as the legislator), the Ministry of Interior, and its subsidiary entities such as municipalities and governors (as the administrators of homeland security and support for safe and appropriate urban and local facilities), the Islamic Republic of Iran Broadcasting (as the national media), the Ministry of Cooperatives, Labor, and Social Welfare (as the institution in charge of employment, job security, and social welfare), and the Ministry of Education (as the educational institution of the country).

Updated Information on NDB.

The Ministry of Health, Labour, and Welfare, Japan launched a national administrative claims database in 2009, which is called the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB). Detailed information on the NDB was reported in Annals of Clinical Epidemiology in 2019. The present report provides updated information on the NDB. In 2020, the provision of data to private companies, as well as public sectors and academic entities, was legislated. As of 2024, the Ministry of Health, Labour, and Welfare is planning linkage of NDB data with several other national databases. Our previous literature review identified a total of 126 original articles using the NDB and NDB Open Data published from 2013 to 2022. Our updated review identified 94 original articles using the NDB and NDB Open Data in the recent two years. Studies using the NDB are gradually increasing, but there is still room for enhancing NDB studies on various subject areas.

Analysis of African Adventist Theology of Mission in the 21st Century

Introduction: Analysis of African Adventist theology of mission in the 21st century highlights theological African Adventist issues of concern. As an Adventist researcher, one is challenged by the growing anticipations and expectations that arise or are questioned in certain areas and sectors, including doctrinal issues in some grey areas. This research article probes those challenges that may be tabled by higher organizations or are just difficult to handle. Problem: Analysis of African Adventist Theology of Mission in the 21st Century presents problematic, unresolved doctrinal issues and teachings upheld by the mother body, the General Conference of the Seventh-day Adventists. These issues are still debated in other circles and regions. Purpose: To analyze the Seventh-day Adventists’ beliefs as a lifestyle for the African Adventists in the 21st century and highlight some downsides that may hinder the mission’s progress among Africans. Old and New Testament Scriptures guide, teach, and instruct a person to the esteemed life of Christ-like character. However, some scholars still argue that Christians and Adventists teach Creation Week. To an African, the belief in a creator God who shares space with His people has brought doubts to the very God who created everything in one week. Discussions: An African Adventist Theology of Ministry for the 21st Century article presented communication, ways of ministry in diverse settings, the Biblical foundation for mission and ministry, and God’s purpose for ministry. The Seventh-day Adventist Church is a family of Christian believers united in mission, purpose, and belief. Adventists seek to follow Biblical principles of Christ-like living, communicating, disciplining, teaching, healing, and serving communities regardless of where they are. Since God is the creator and owner of the mission, He has a purpose for His ministry and creation, which includes human beings. The purpose of God for his church is being revealed amongst His people through the publishing of literature, public evangelism, the gospel ministry, and medical missionary. As the mission owner (Missio Dei), God chooses how to direct the mission using His created world. All the people of different cultures and traditions are part of God’s mission. There are diverse ways of ministry, including reaching people in their homes, welfare ministry, friendship evangelism, Adventism, and God’s mission. When spreading the gospel, theologians need to recognize different types of communication: secular, Christian, and Adventist approaches. Findings: An analysis of African Adventist theology of mission in the 21st century found that God’s purpose for the ministry is to involve all means and people, regardless of creed, race, or ethnicity. God would employ any method to spread the gospel all over the world. Finally, communication plays a significant role in God’s mission.

Clinical Utilization of Generic Drugs and Biosimilars for Ulcerative Colitis Treatment: Insights from a Nationwide Database Study in Japan

Introduction: Limited data exist regarding the prevalence and clinical practice involving generic drugs and biosimilars for treating ulcerative colitis (UC) in Japan. We aimed to clarify the clinical usage of these generic drugs and biosimilars for UC treatment in Japan using a nationwide database. Methods: We collected data from 30,675 UC cases, along with their prescriptions for both generic drugs or biosimilars and their original counterparts, using a medical claim database provided by DeSC Healthcare, Inc. We calculated the prescription and penetration rates of generic drugs and biosimilars and demonstrated the transition of these rates. Additionally, the cumulative retention rates between infliximab originator and biosimilar were compared using the Kaplan-Meier method. Results: The prescription rate of generic mesalazine increased from approximately 10% in 2015 to over 30% in 2021. Although the prescription rate of generic molecular targeting drugs (MTDs) also increased from approximately 0.15% in 2014 to 2.5% in 2021, the increment was lower than that of generic mesalazine. The penetration rates of generic 5-aminosalicylic acid and tacrolimus ranged from over 30% to approximately 50%. Infliximab biosimilar achieved an approximate 20% penetration rate, whereas adalimumab achieved <5%. The cumulative retention rates did not differ between infliximab originator and biosimilar. Conclusions: The penetration rates of generics and biosimilars for UC treatment are relatively low compared with those for treatment in other fields and the goal of the Ministry of Health, Labor, and Welfare. Several countermeasures are necessary for the widespread use of generics and biosimilars, ultimately contributing to cost-effective and sustainable healthcare delivery.

Construction of a Temporary Radiological Image Viewing Network for Large-scale Disasters

The Ministry of Health, Labor and Welfare mandated the creation of the business continuity plan (BCP) for disaster key hospitals on March 31, 2017. Supposing the hospital information system (HIS) failure occurred, the picture archiving and communication system (PACS) also suffers obstacles, we assumed building a new network was necessary for radiological examination images. The purpose of this study was to investigate whether building a new network for radiological examination images is necessary in an emergency. Using wireless fidelity (Wi-Fi), the new network consisting of one image server and two tablet terminals A and B was constructed. The study measured the portable image transfer time for various stages of the network. The results were as follows: Transfer time from the mobile X-ray unit to the image server was 4.12±0.86 s, that from the image server to the tablet device A was 5.14±0.71 s, and that from the image server to the tablet device B was 7.32±1.66 s. Therefore, the new network configuration can provide a reliable means of accessing radiological images during emergency situations when the HIS and PACS may experience obstacles or failures.

Changes in care managers' positive attitudes toward dying patients compared to that of nurses by one-day online advance care planning communication training.

Culturally appropriate communication training programs for a wide range of professions that can be used during infection epidemics are crucial for advance care planning implementation. Starting in 2018, the Japanese Ministry of Health, Labour and Welfare made a major policy change, and doctors, nurses, and social workers, and care managers were identified in the guidelines as the professions that promote advance care planning. Motivated by the lack of online programs for Japanese care managers, we proposed a new one-day program. This study aimed to determine the changes in the positive attitude of care managers toward dying patients compared to that of nurses, which has been used in past literature as an outcome of advance care planning educational interventions, after administering the program in Japan. Before-after comparison study. Care managers were recruited through our website, ACP-Piece, http://plaza.umin.ac.jp/~acp-piece/piece.html. A questionnaire survey concerning positive attitudes toward dying patients was administered before and after the program on 28 August 2021. Sixty-six subjects participated in the training and 60 participants, including 14 care managers, consented to the study and completed the questionnaire surveys before and after the program. The Frommelt attitude toward care of the dying scores for care managers increased after the program (p-values, confidence intervals, and effect sizes: p < 0.001, -11.90 to -4.388, -1.252). After training, care managers had a significantly higher maximum score occurrence than nurses. Older care managers with advance care planning experience may have had a higher maximum score occurrence compared to younger, inexperienced participants. To our knowledge, this is the first to demonstrate the increased positive attitude scores toward dying patients after online communication training for Japanese care managers. The limitations of this study include the lack of evidence regarding reasons for score changes, long-term score changes, and effectiveness for patients and their families.

The prevalence of post-COVID-19 vaccination syndrome and quality of life among COVID-19-vaccinated individuals

BackgroundThere were many studies conducted to determine how immunization affects people with long-term COVID. The results of those studies have caused debate as they gave rise to varying outcomes. Some evidence indicates a change in, an improvement in, a continuation of, or even a worsening of long-term COVID symptoms following vaccination. The ratio of change in antibody titers was noticeably larger in the group of people whose illnesses became worse. Hence, this study aimed to explore potential post-COVID-19 vaccination syndrome (PCVS) in vaccinated individuals and also to assess their quality of life (QoL). MethodologyBetween September 2021 and May 2023, an ambidirectional, descriptive, follow-up cohort study was conducted, enrolling participants who were 18 years of age or older, met the vaccination requirements established by the Ministry of Health and Family Welfare, Government of India, and had completed the primary immunization series with the AZD1222® or BBV152® vaccine. The prevalence of PCVS and the QoL measured using EQ-5D-5L were assessed at 1 month, 6 months, and 12 months post-COVID-19 vaccination. ResultsAZD1222® vaccine was received by 84.28% (343) of the participants, and BBV152® vaccine was received by 15.72% (64) of the study participants. A month after the primary vaccination series, 52.8% (215) of the total participants had at least 1 PCVS, 39.8% (162) at 6 months, and 64.6% (263) at 12 months. Among those who had received vaccinations, the QoL increased at 6 months to 0.975±0.08 and declined at 12 months to 0.94±0.13 from 0.949±0.13 at 1 month after receiving a primary immunization. The overall prevalence of PCVS between AZD1222®-vaccinated individuals and BBV152®-vaccinated individuals at a month post-vaccination was 54.5% vs. 43.8%, at 6 months it was 41.1% vs. 32.8%, and at 12 months it was 65.59% vs. 59.4%. The QoL between AZD1222®-vaccinated individuals and BBV152®-vaccinated individuals at a month post-vaccination was 0.95±0.13 vs. 0.95±0.126, at 6 months it was 0.98±0.08 vs. 0.97±0.07, and at 12 months it was 0.94±0.12 vs. 0.92±0.20. However, there was no statistically significant difference in the prevalence of PCVS and QoL between AZD1222® and BBV152®-vaccinated individuals.The percentage of participants who had at least one PCVS was 83.9% (146) in the group that got booster doses and 50.2% (117) in the group that did not. The QoL was 0.9±0.15 in the group receiving booster dosages and 0.96±0.11 in the group not receiving them. There was a statistically significant difference in the prevalence of PCVS and QoL between booster dose recipients and no booster dose recipients. ConclusionIn the study, we observed the prevalence of PCVS and was similar to long-term COVID; it declined over time and increased following booster immunization. Contrary to PCVS prevalence, QoL rises with time and falls after booster doses. There is no difference in the prevalence of PCVS and the quality of life among AZD1222® and BBV152®.

History of the Task Force for the Korean Clinical Guidelines of the Developmental Disorders.

Under the Ministry of Health and Welfare of the Republic of Korea, the National Autism and Developmental Disorder Centers for people with developmental disabilities are gradually expanding. The headquarters of the National Autism and Developmental Disorder Center provides support for education, training, and research, and several centers have been effectively operating since 2020. This study aimed to provide practical recommendations and guidelines for specialists such as clinical psychologists, child psychiatrists, allied professionals, community workers, and related administrators. It was developed as a guideline to promote early diagnosis, provide important information on integrated treatment, and assist people with developmental disabilities in Korea to make the best decisions for their quality of life.

Quality of life and neurological symptoms in patients with neurofibromatosis type 2: a national database study in Japan.

This study examined the association between neurological symptoms and quality of life (QoL) in patients with neurofibromatosis type 2 (NF2) using a national database of all patients who newly claimed for medical expense subsidies in Japan from 2015 to 2019. The Japanese Ministry of Health, Labour and Welfare provided access to the "National Database of Designated Intractable Diseases of Japan" containing the "Medical Certificates of Designated Intractable Diseases" of all patients with NF2. The database included information on five items of QoL: "mobility," "self-care," "usual activities," "pain/discomfort," and "anxiety/depression." To examine the association between the presence/absence of neurological symptoms and QoL, multivariable logistic regression analyses were performed, adjusted for potential confounders. Data from 187 patients (97 females and 90 males; mean (standard deviation) age, 43.1 (17.9) years) were analyzed. Overall, 31% to 55% of patients were recorded as having moderate/severe impairment of QoL. Spinal dysfunction was significantly associated with deterioration of all components of QoL, whereas speech dysfunction and hemiparesis were specifically associated with physical health-related components of QoL. Spinal dysfunction, facial nerve palsy, and age 25-64 years were significantly associated with "anxiety/depression." In the present epidemiological study using a national database of NF2 in Japan, spinal dysfunction was significantly associated with deterioration of all components of QoL, including subjective and mental health-related components of QoL, whereas speech dysfunction and hemiparesis were specifically associated with physical health-related components of QoL.

Activity of a Medical Relief Team from Shizuoka Hospital that was Dispatched to the Noto Peninsula Earthquake in Reiwa 6 (2024).

The present study aimed to report on the activity of a medical relief team from Juntendo Shizuoka Hospital that was dispatched to the Noto Peninsula Earthquake in Reiwa 6. Narrative report. The activities conducted on-site in the Noto Peninsula involved multiple deployments of the Juntendo University Shizuoka Hospital Disaster Medical Assistance Team (JS-DMAT). The first deployment from January 2nd to January 6th faced challenges due to damaged infrastructure, particularly roads, affecting mobility. The team focused on hospital medical support, patient transportation, and DMAT headquarters assistance. The second deployment, from January 8th to January 12th, encountered persistently damaged roads, leading to incidents but no significant vehicle damage. The team engaged in screening, zoning, medical examinations, and DMAT headquarters support in evacuation shelters. The third team's planned activities in early February were canceled by Shizuoka Prefecture.Additionally, on January 7, 2024, personnel from Juntendo Shizuoka Hospital participated in the Shizuoka Prefectural DMAT Coordination Headquarters activity, documenting DMAT activities and assessing team members' health. The Ministry of Health, Labour and Welfare's request for the fourth Shizuoka Prefecture DMAT dispatch led to the selection of the second JS-DMAT for deployment. The activities related to the Noto Peninsula earthquake by JS-DMAT were reported. Lessons from this disaster are being sought to guide future disaster response preparations.

Ethics Review Committees of Public Health Institutes in Japan

Recent legislative changes in the wake of the novel coronavirus pandemic have placed an increased emphasis on the research activities of Local Public Health Institutes (PHIs) in Japanese municipalities. However, few studies have examined the ethical review processes of these institutes. We analyzed information on (a) the status and year of establishment of "Ethics Review Committees" (and equivalent committees), (b) the number of review cases for each year, (c) the status of public disclosure of committee activities, and (d) the composition of committee members for 85 PHIs across Japan. Publicly available information from each PHI and the Ministry of Health, Labour and Welfare was used for the analysis. Out of 85 PHIs nationwide, about half of them publicly disclosed the establishment of their committees (41 committees, 48.2%). The number of review cases handled by the committees varied, with some committees having no cases or only one case. Among the committees, approximately 20% still maintained adherence to outdated national research ethics guidelines, and approximately 15% did not specify any guidelines they followed. Furthermore, we identified committees without external members (at least two committees) and those lacking public representation (four committees). There are differences in the operational performance of ethics review committees at PHIs, possibly owing to varying levels of understanding of the guidelines, the degree of proactive engagement in academic research, and the emphasis on human subject research. There is a crucial need to accumulate and share experiences that support the review functions of the committees.

Coronavirus disease appropriate behavior among medical representatives

Background: The coronavirus disease 2019 (COVID-19) crisis has brought many appropriate changes in the behavior of the people in India. It posed deleterious effects on nearly every industry and business sector and pharmaceutical industry is no exception. Medical representatives were facing challenges in contacting health-care providers and other concerned individuals for sales efforts during the pandemic affecting their work behaviors and outputs. Therefore, it is highly important that MRs have adequate knowledge about the COVID-19 appropriate behaviors (CABs). Aims and Objectives: The objective of our study was to assess the perception of COVID-19 appropriate behaviors (CAB), among medical representatives. Materials and Methods: The study was conducted during lockdown for a period of 3 months from May to July 2021. After obtaining Institutional approval using the CAB, published by the Ministry of Health and Family Welfare, a questionnaire was designed and along with the consent form was sent to Medical Representatives to collect the information on CAB. Data from all consented voluntary participants using self-administered Google forms were collected. The data collected were reversibly coded and confidentiality of participants was maintained. Results: A total of 88 number of medical representatives (n = 88) participated in the study. Of these, 96.50% were males and all were &lt;50 years. Graduated participants constituted 96.6% (n = 85). Only 67.10% perceived it as a serious disease. Greeting without physical contact was practiced by 57 (64.7%), Namaste, by 56 (63.3%). Avoiding touching hands, nose, and mouth was considered very important by 68.9%. Covering nose and mouth when you cough or sneeze with handkerchief was considered important for 96.6%. Avoiding touching eyes, nose, and mouth was considered “not important at all” and slightly important by 2.2% and 5.6%, respectively. Discourage and avoiding crowd was thought as not important at all by 3.4% and slightly important by 2.3%. Conclusion: The medical representatives are well informed about COVID-19 disease and it is spread but only 2/3rd of the participants regarded COVID-19 as a serious condition and practiced various CABs to prevent infection spread. They considered national news and doctors as the main source of information.

Risk Assessment for Non-Communicable Diseases among Adults of 18 to 29 years Age in a Rural Area of Madurai District, Tamil Nadu, India: A Cross-sectional Study

Introduction: Non-Communicable Diseases (NCDs) are the leading cause of morbidity and mortality globally. In India, the Ministry of Health and Family Welfare reported a rise in mortality rates from 37% in 1990 to 61% in 2016. Additionally, the prevalence of diabetes mellitus and hypertension among young adults was higher than estimated. As the behavioural risk factors are mainly established in adolescence, screening at an earlier age becomes essential. Aim: To estimate the risk for diabetes mellitus and hypertension among individuals aged 18-29 years and to assess the association between the risk factors and at-risk individuals. Materials and Methods: A community-based cross-sectional study was conducted in the field practice area of Madurai Medical College, Madurai, Tamil Nadu, India, to estimate the risk for diabetes mellitus and hypertension among individuals aged 18-29 years. The National Health Mission (NHM) protocol was used for risk assessment, based on American Diabetic Association (ADA) and Joint National Committee (JNC) 8 guidelines. Statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) 20.0 software. Results: A total of 154 residents were included in the study. The mean age of the study participants was 24.64±4.70 years. Approximately 60% of the study participants were males and 40% were females. A total of 54% of the participants were married. Most subjects had completed high school (33.8%), followed by 28.6% who completed postgraduation. Disease categorisation revealed that 54 (35%) were non-diabetics, 89 (58%) were pre-diabetics, and 11 (7%) had diabetes mellitus. Similarly, 24 (16%) were non-hypertensive, 115 (75%) had high normal values, and 15 (9%) had probable stage I hypertension. A statistically significant association was observed between hypertension and educational level, alcoholism, Systolic Blood Pressure (SBP), and Diastolic Blood Pressure (DBP), whereas diabetes mellitus was not significantly associated with any variables. The probabilistic prediction for hypertension using the logistic regression model included alcoholism and SBP, which contributed to 25.6% of the variations in prediction hypertension. Conclusion: The study results highlight a significant burden of undiagnosed cases of diabetes and hypertension in the community. This indicates the need for systematic screening, early lifestyle modifications, appropriate treatment, and regular follow-up for such individuals.

Adult Moyamoya Disease and Moyamoya Syndrome: What Is New?

Recent advances are in the genetics, diagnosis, pathophysiology, and management of moyamoya disease (MMD), and moyamoya syndrome (MMS), a term used to describe moyamoya-like vasculopathy associated with various systemic diseases or conditions. Ring finger protein (RNF213) has been reported to be a susceptibility gene not only for MMD but also for atherosclerotic intracranial arterial stenosis and ischemic stroke attributable to large artery atherosclerosis. The latest guidelines by the Research Committee on MMD of the Japanese Ministry of Health, Labor, and Welfare, removed limitations of the previous definition that required bilateral involvement of the intracranial carotid artery to make the diagnosis, given the increasing evidence of progression to bilateral involvement in unilateral MMD. 3-dimensional constructive interference in steady-state MRI is useful for the differential diagnosis of MMD from atherosclerosis. Recent advances in the pathophysiology of MMD suggest that genetic and environmental factors play important roles in vascular angiogenesis and remodeling via complex mechanisms. The latest Japanese Guidelines and American Scientific Statement described that antiplatelet therapy can be considered reasonable. Endovascular interventional stent placement fails to prevent ischemic events and does not halt MMD progression. In the Japan Adult Moyamoya trial, a randomized controlled trial for bilateral extracranial-intracranial direct bypass versus conservative therapy in patients with MMD, who had intracranial hemorrhage, recurrent bleeding, completed stroke, or crescendo transient ischemic attack was significantly fewer with direct bypass than with conservative care. This review presents updated information on genetics, diagnosis, pathophysiology, and treatment of adult MMD and MMS. Despite recent advances, many mysteries still exist in the etiologies of moyamoya vasculopathy. The diagnostic criteria and treatment guidelines have been updated but not yet been globally established. Ongoing and future studies investigating underlying pathophysiological mechanisms of MMD and MMS may clarify potentially effective medical, surgical, or endovascular treatments.

BRONCHOPULMONARY ASPERGILLOSIS WITH COMORBID GRANULOMATOUS POLYANGIITIS IN A PATIENT WHO PRESENTED WITH EXOPHTHALMOS: A CASE REPORT

There have been no reports of the coexistence of allergic bronchopulmonary aspergillosis (ABPA) and granulomatosis with polyangiitis (GPA). The first case of ABPA with comorbid GPA that developed exophthalmos is reported. A 69-year-old man was referred to our hospital for exophthalmos, fever, anorexia and weight loss. The patient had been diagnosed with ABPA six years earlier, which had been repeatedly treated but recurred with oral corticosteroids with or without antifungal therapy. The laboratory data on referral showed elevations of the white blood cell count, C-reactive protein and specific immunoglobulin E against Aspergillus fumigatus, but antineutrophil cytoplasmic antibody was not positive. Urinalysis showed proteinuria. Paranasal sinus and chest computed tomography showed sinusitis with osteochondral destruction, bronchiectasis, mucus plugging, and a pulmonary nodule. Orbital magnetic resonance imaging showed swelling of the medial rectus muscle and peripheral mass. The intraorbital tissue biopsy showed a necrotic granuloma and necrotizing vasculitis. The patient was diagnosed with GPA, on the basis of the Ministry of Health, Labour and Welfare's criteria of Japan. The patient was treated with induction therapy consisting of glucocorticoids and rituximab, and his symptoms improved. Though the pathogenesis common to ABPA and GPA remains unknown, neutrophilic inflammation induced by airway Aspergillus persistent infection might be involved. Study of further cases is needed.

Presenting a Pattern of Flexible working Hours in Government Organizations with an Emphasis on Increasing the Productivity Level of Academic Employees in the Ministry of Cooperation, Labor and Social Welfare

Presenting a Pattern of Flexible working Hours in Government Organizations with an Emphasis on Increasing the Productivity Level of Academic Employees in the Ministry of Cooperation, Labor and Social Welfare

The Essentiality of Effective Anticancer Drugs in the Essential Medicines Lists: A Comparative Analysis

ABSTRACT Background: Drugs for cancer management constitute a large part of essential medicine lists (EMLs) prepared by many countries globally. Here, we compared anticancer drugs suggested by the World Health Organization (WHO) as essential medicines and the extent to which Government of India (GOI) included them in the National list of essential medicines (NLEMs). Aim: The current study was carried out to reiterate the importance of effective alternatives listed in the WHO-EMLs to all the members of core committee under Ministry of Health and Family Welfare, GOI, and inclusion of cost-effective targeted anticancer drugs in the NLEMs at regular intervals. Materials and Methods: A descriptive, observational study was conducted to analyze the essential anticancer drugs included in the WHO-EMLs and NLEMs published during the period 2015–2023. A total of 7 EMLs (5 from WHO and 2 from India) were included in the study. The collected data were assessed for the number of cytotoxic drugs, targeted drugs, immunomodulators, and hormonal drugs recommended treating various types of cancers. Microsoft Office Excel 2007 was used for tabulation and analysis. Descriptive statistics were used for the analysis. Results: Compared with NLEMs, the WHO-EMLs included more number of cytotoxic drugs (33 vs. 29). Except for the year 2015, where more number of targeted anticancer drugs were designated as essential medicines by the GOI (6) compared to the WHO (4), subsequent EMLs from the WHO (2019–2023) included more targeted drugs (10 in 2019, 12 in 2021, and 2023 respectively). We also witnessed substantial increase in the number of immunomodulators and hormonal agents used for cancer management in the latest editions of WHO-EMLs (4,15) as compared to the NLEMs (2,8). Conclusion: Targeted anticancer drugs, including immunomodulators and hormonal agents, are more efficacious with high response rates compared to the conventional cytotoxic drugs. Efforts to include them in the Indian-EMLs must be enhanced to cope up with the pace of WHO-EMLs. Special emphasis must be given to the economical therapeutic substitutes such as dasatinib, included in the WHO-EMLs that are effective against resistant cancers.

Analysis of Blood Donor Deferral Pattern during COVID-19 Pandemic at a Tertiary Care Hospital-based Blood Centre, Jammu and Kashmir, India: A Cross-sectional Study

Introduction: Blood donor deferral is vital for ensuring safe blood transfusion. However, with the unfolding Coronavirus Disease-2019 (COVID-19) pandemic, significant changes were made in donor screening and blood donation criteria, resulting in a shift in the pattern of donor deferrals. Aim: To estimate the blood donor deferral patterns during the COVID-19 pandemic. Materials and Methods: A retrospective cross-sectional study was conducted in the Department of Transfusion Medicine at SMHS Hospital/GMC Srinagar, Jammu and Kashmir, India. The study spanned two years, from March 2020 to February 2022. All blood donors were screened in accordance with the Ministry of Health and Family Welfare (MOHFW), National Acquired Immune Deficiency Syndrome (AIDS) control organisation (National blood transfusion services) 2017 guidelines. The data was analysed in Microsoft Excel, considering factors such as age, gender, type of deferral, and reasons for deferral. Results: Deferred blood donors were most common in the age group of 18-33 years. During the study period, a total of 19,895 blood donors (19493 males and 402 females) were registered for blood donation. Out of these, 3441 donors (17.30%) were deferred, with a male donor deferral rate of 3258/19493 (16.71%) and a female donor deferral rate of 183/402 (45.52%). Temporary blood donor deferrals accounted for 3272 (95.09%) cases, while permanent deferrals were 169 (4.91%). The most common cause of deferral was low haemoglobin, accounting for 991/3441 (28.80%) cases, followed by deferrals due to reasons attributable to the COVID-19 pandemic (786/3441, 22.84%) and hypertension (653/3441, 18.98%). Conclusion: The study observed a substantial increase in the total donor deferral rate, as well as a change in the donor deferral pattern during the COVID-19 pandemic.