Sweta Soni

Upfront debulking surgery or delayed surgery after neoadjuvant chemotherapy for advanced-stage epithelial ovarian cancer: Comparison of survival from a noncancer center in India

Abstract Background: In advanced-stage epithelial ovarian cancer (EOC) standard of care is upfront debulking surgery (UDS) followed by adjuvant chemotherapy. Interval debulking surgery after neoadjuvant chemotherapy (NACT-IDS) is a reasonable alternative. Methods: This study was a retrospective review of patients of Stage III/IV EOC treated either by UDS or NACT-IDS between January 2016 and December 2018 to report the comparison of progression-free survival (PFS) and overall survival (OS) of patients with advanced-stage EOC treated with either UDS or NACT-IDS. Results: Out of 50 patients, 19 (38%) underwent UDS, and 31 (62%) received NACT. The mean follow-up duration was 27.7 months. No gross residual disease was achieved in 52.6% of the UDS group and in 70.4% of the NACT-IDS group. The median PFS of 20 and 30 months was observed in the UDS and NACT-IDS groups, respectively (log-rank P = 0.054). The median OS was 36 months in the NACT-IDS group and could not be reached in the UDS group (log-rank P = 0.329). Only residual disease was significantly associated with survival (hazards ratio 3.03, 95% confidence interval: 1.19–7.74) on multivariate Cox regression analysis. Conclusions: In advanced-stage EOC, the survival outcomes of NACT-IDS are comparable with those of UDS. Apart from the patient-specific parameters, the decision for UDS or NACT-IDS should take in account the expertise of the surgeon and the institutional capacity as a whole.

Assessment of 5A's of Human Papilloma Virus Vaccination: Awareness, Attitude, Apprehension, Action Expected and Acceptability Amongst Health Care Providers, Medical Students, Para‐Medical and Administration Staff in AIIMS Rajkot

ABSTRACTThe study aims to assess awareness, attitude, apprehension, action expected from policy makers, and acceptability towards HPV vaccination amongst health care providers (HCP), medical students, paramedical staff and administrative personnel. A cross‐sectional study was conducted with 501 participants, including HCP, medical students, paramedical and administrative staff. Their awareness, attitudes, apprehensions, actions expected from policymakers, and acceptability towards HPV vaccine were assessed through a Google Form survey. Of the 501 participants, 92.4% were aware of HPV vaccines, 24.6% had a thorough understanding of HPV, but only 5.8% had received the vaccine. Most participants held a positive attitude toward cervical cancer prevention and HPV vaccination, although 46.7% expressed apprehensions. Before viewing educational video, 278 participants (55.8%) were willing to receive the HPV vaccine, while 116 (44.2%) were not. After viewing the educational video, willingness increased to 394 participants (78.6%), and those unwilling decreased to 107 (21.4%). Factors such as age, gender, marital status, education, and professional role did not significantly predict knowledge or apprehension regarding HPV and the HPV vaccine. However, professional role and younger adult (20–39 years) groups were statistically significant predictors of a positive attitude as well as stronger expectations for action from policymakers towards HPV vaccine. The study reveals significant gaps in HPV vaccine awareness and uptake among medical professionals, paramedics, and administrative staff. It highlights the need for broad educational programs to address these knowledge gaps, emphasizing HPV's health impacts and preventive measures. Multimedia educational interventions effectively boost vaccine acceptance among the groups and the general public.