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Background & objectives: Artificial intelligence (AI) and machine learning (ML) have shown promising results in cancer diagnosis in validation tests involving retrospective patient databases. This study was aimed to explore the extent of actual use of AI/ML protocols for diagnosing cancer in prospective settings. Methods: PubMed was searched for studies reporting usage of AI/ML protocols for cancer diagnosis in prospective (clinical trial/real world) setting with the AI/ML diagnosis aiding clinical decision-making, from inception till May 17, 2021. Data pertaining to the cancer, patients and the AI/ML protocol were extracted. Comparison of AI/ML protocol diagnosis with human diagnosis was recorded. Through a post hoc analysis, data from studies describing validation of various AI/ML protocols were extracted. Results: Only 18/960 initial hits (1.88%) utilized AI/ML protocols for diagnostic decision-making. Most protocols used artificial neural network and deep learning. AI/ML protocols were utilized for cancer screening, pre-operative diagnosis and staging and intra-operative diagnosis of surgical specimens. The reference standard for 17/18 studies was histology. AI/ML protocols were used to diagnose cancers of the colorectum, skin, uterine cervix, oral cavity, ovaries, prostate, lungs and brain. AI/ML protocols were found to improve human diagnosis, and had either similar or better performance than the human diagnosis, especially made by the less experienced clinician. Validation of AI/ML protocols was described by 223 studies of which only four studies were from India. Also there was a huge variation in the number of items used for validation. Interpretation & conclusions: The findings of this review suggest that a meaningful translation from the validation of AI/ML protocols to their actual usage in cancer diagnosis is lacking. Development of regulatory framework specific for AI/ML usage in healthcare is essential.
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Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign proliferation of blood vessels of uncertain etiology. It primarily affects the head‑and‑neck region. Histologically, it is characterized by the prominent proliferation of plump endothelial cells, and accompanying eosinophilic and lymphocytic infiltration. Herein, we report the case of ALHE in a 65‑year‑old male.
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BackgroundThere is an increase in use of regional anaesthetic techniques in various surgeries.Steroids have anti inflammatory and analgesic properties. Hence , we decided to study the efficacy ofdexamethasone as an adjuvant to local anaesthetic agents in supraclavicular brachial plexus block vialandmark approach for upper limb orthopaedic surgeries.Materials and MethodsAfter ethical clearance, and informed written consent, this prospective randomised controlled clinical studywas carried out in 50 patients, aged 18-50 years, ASA grade I or II, scheduled for elective or emergencyorthopaedic upper limb surgeries.Patients were randomly divided into two groups,Group A- received Inj. Bupivacaine 0.5% 10 ml, Inj. Lignocaine + Adrenaline (1.5%) 20 ml and Inj..Normal saline (0.9%) 2 mlGroup B- received Inj. Bupivacaine 0.5% 10 ml, Inj. Lignocaine + Adrenaline (1.5%) 20 ml and Inj.Dexamethasone (8 mg) 2 mlAfter confirming complete motor and sensory blockade, surgery was commenced.VAS score was recorded for 18 hours postoperatively where 0 equals no pain and 10 as worst possible pain.Results-● The onset of sensory and motor block was significantly faster in patients who receivedcombination of local anaesthetic and dexamethasone.● The duration of motor and sensory block in dexamethasone group was significantly higher thancontrol group.● There was no significant difference in the hemodynamics found between the two groupsperioperatively.● The duration of post operative analgesia was prolonged in dexamethasone group as compared tocontrol group.● Postoperatively, no complications were observed in any group.ConclusionThe addition of dexamethasone to local anaesthetics in supraclavicular approach of brachial plexus blockproduces adequate anaesthesia with following advantage.• Dexamethasone hastens the time of onset of sensory and motor blockade.• It prolongs the duration of sensory and motor blockade.• It prolongs the duration of postoperative analgesia.• Dexamethasone provides stable haemodynamics without any unwanted side effects in perioperative
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Objectives: Family history is considered as an important predictor of cardiovascular diseases (CVDs) and diabetes. Available research findings suggest that family history of chronic diseases is associated with perceived risk of disease and adoption of healthy behaviours. We examined the association between family history of cardio-metabolic diseases (CMDs) and healthy behaviours among adults without selfreported CMDs. Methods: Cross-sectional data of 12,484 adults, without self-reported CMDs, from the baseline survey of Centre for cArdiometabolic Risk Reduction in South-Asia (CARRS) cohort study were analysed. Results: Family history was positively associated with non-smoking and high fruits & vegetables consumption in the age group of 45e64 years and moderate to high physical activity in the age group _x0001_65 years after adjusting for sex, education, wealth index, city and body mass index. Conclusions: Understanding perceived risks and cultural or psychological factors related to family history through ethnographic studies may deepen understanding of these associations.
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The aim of the study was to develop and assess the effect of supportive-educational intervention on perinatal outcome among primipara mothers with a fear of childbirth. This randomised controlled trial was conducted on 205 primipara mothers with a fear of childbirth attending a Gynae OPD. At 24-28 weeks of pregnancy primipara mothers were screened for fear of childbirth WDEQ-A and then randomly allocated to experimental and control group. Within one week of delivery perinatal outcome was assessed with help of self-made checklist. After the interventions, there were signi cant differences between groups on post-intervention scores for term of delivery and newborn birth weight at p'lt;0.001. Based on the results of the study it can be concluded that supportive educational intervention was effective in primipara mothers for positive birth outcome.
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Background: The main purpose of providing antenatal care is to identify women at risk ofcomplications as a result of impaired uteroplacental circulation such as pre-eclampsia.Aim: To describe practical application of Doppler ultrasound in obstetrics with analysis of bloodflow velocity waveform in pre-eclampsia and to examine perinatal outcome in pregnancies withaltered Doppler indices.Material and Method: This is a prospective study of 40 pregnant women with pre-eclampsiaevaluated sono-graphically with color Doppler and to be followed subsequently for any adverseperinatal outcome.Result: Out of 40 cases 45% of cases were found in 25-29 years age group. 25 cases had abnormaluterine artery Doppler indices accounting for 62.5%, while 15 cases had a normal doppler indicesaccounting for 37.5%. Out of 40 cases, 24 cases had abnormal Middle cerebral artery accounting for60%. In our study 14 cases had abnormal umbilical artery Doppler indices accounting for 35%,while 26 cases had a normal Doppler index accounting for 65%. In this study total 6 cases (15%) ofperinatal mortality were seen.Conclusion: The knowledge of Doppler arteries waveform may help to improve pregnancyoutcome and any permit identification and assessment of pre-eclampsia at earliest gestational age ascompared to other ante partum test modalities.
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Green nanoparticle synthesis is a promising, eco-friendly and safe approach. In the current study, Iron oxide nanoparticles (FeONPs) were synthesized using aqueous leaf extract of Coriandrum sativum L. Further, the characterization of synthesized FeONPs was performed using ultraviolet-visible spectroscopy, transmission electron microscopy (TEM), dynamic light scattering (DLS), vibrating sample magnetometer (VSM) and differential scanning colorimetry (DSC). The surface plasmon resonance effect confirmed the synthesis of FeONPs. Dynamic light scattering (DLS) revealed mean particle size of FeONPs around 163.5 and polydispersity index 0.091 with a zeta potential of ?13.8 mV. Differential scanning colorimetry (DSC) exhibited an endothermic peak at 176.91°C. Vibrating sample magnetometer (VSM) analysis showed superparamagnetic properties of iron nanoparticles with a magnetization value of 3.483 emu/g and the results indicated superparamagnetic behavior of prepared iron nanoparticles at room temperature, thus highlighting their potential as magnetically targeted drug delivery system. This biosynthetic method has been proven to be cost-effective, environment friendly and promising for use in biomedical sciences.
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Purpose: To compare the clinicomicrobiological features and outcomes in patients with infectious endophthalmitis caused by biofilm?positive (BP) and biofilm?negative (BN) bacteria. Methods: This was a prospective, interventional, comparative, nonrandomized, consecutive case series. Culture?positive bacterial endophthalmitis cases from August 1, 2018 to July 31st 31, 2019 were included. All vitreous samples were tested for biofilm using crystal violet plate and XTT (2,3?bis?(2?methoxy?4?nitro?5?sulfophenyl)?2H?tetrazolium?5?carboxanilide) methods and classified as BN and BP. The antibiotic susceptibility of all organisms was determined. Anatomic and functional success was defined as intraocular pressure >5 mm Hg and final best?corrected vision ?20/400, respectively, at last visit. Results: There were 50 eyes in the BN group and 33 eyes in the BP group. BN group eyes required 2.86 ± 1.45 surgical interventions, and BP group eyes needed surgical 6.36 ± 2.89 interventions, P < 0.0001, 95% Confidence Interval, CI: 2–4. Median follow?up was 6 and 5 months, respectively (P = 0.33). Final logMAR vision was a median of 1.2 and 1.9 respectively; P = 0.0005, 95% C.I.: 0.4–1.7. Functional success was achieved in 44% and 21.2% (P = 0.03, 95% C.I.: 1.86%–40.08%) and anatomic success was achieved in 68% and 42.42%, respectively (P = 0.02, 95% C.I.: 3.85%–45.47%). The antimicrobial resistance patterns between the two groups were comparable. Conclusion: Endophthalmitis caused by the biofilm?forming bacteria needs a greater number of surgical interventions. The anatomic and functional outcomes are poorer than non?biofilm?forming bacterial endophthalmitis. The increased virulence and poorer outcomes can be hypothesized to be due to the physical barrier effect of the biofilm on the antibiotics
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Background: The promising improvement in the clinical outcome of lung cancer can be possibly achieved by identification of the molecular events that underlie its pathogenesis. Cancer stem cell (CSC) being one of the subsets of tumor majorly participates in drug resistance and treatment failure because of the moderate cell cycle, lower proliferation, and increased expression of DNA repair and anti-apoptosis genes. Although many putative CSC markers exist, a precise characterization for non-small cell lung cancer is of utmost importance due to increased mortality rate and lack of targeted therapies. Hence, the article focuses on the expression of stemness-associated markers, namely octamer-binding transcription factor 4 (OCT4), NANOG, and sex-determining region Y-box 2 (SOX2) in non-small cell lung cancer (NSCLC) patients. Methods: The expression of OCT4, NANOG, and SOX2 were evaluated in 32 histopathologically confirmed NSCLC tissues using real-time polymerase chain reaction. The obtained expression was correlated with clinical and pathological manifestations using the statistical test such as Student's t-test and Pearson correlation in varied statistical software. Results: Results showed a significantly higher expression of OCT4 and NANOG compared to SOX2 in the tumor tissues. When the expression of these markers was correlated with the clinical parameters, higher expression was seen in males, patients with age above 60 years, and in adenocarcinoma subtype. In correlation with the habit, higher expression of OCT4 and SOX2 was observed in habituated patients. Expression of NANOG and OCT4 was higher even in patients with poor differentiation. Conclusion: The expression and prognostic significance of CSC markers obviously vary depending on histological NSCLC subtype. Importantly, our findings suggest that OCT4, SOX2, and NANOG network together may be promising for ongoing targeted therapies in specific NSCLC subgroups
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Tubal occlusion is one of the most frequent causes of infertility in women. The evaluation of the fallopian tube is necessary in female infertility. The two most important diagnostic procedures for evaluation of tubal patency are hysterosalpingography (HSG) and laparoscopy. We wanted to compare the diagnostic efficacy of HSG & diagnostic laparoscopy in evaluation of tubal patency in infertility.METHODSA hospital OPD based prospective study was conducted among fifty patients fulfilling the inclusion and exclusion criteria who attended the OPD for treatment of infertility in the Department of Obstetrics and Gynaecology, Medical College and Hospital, Kolkata from 1st January 2016 - 31st December 2017. After taking proper history, thorough examination and basic investigations for infertility work-up, HSG and Laparoscopy were performed.RESULTSAnalysis showed that most of the patients were in the age group of 30 to 35 years. Incidence of primary and secondary infertility was 64% and 36% respectively. Right proximal and distal blockage in HSG, and DL were 56% and 40% in HSG and 48% and 28% in DL respectively. p=0.0001. Left proximal and distal blockage in HSG and DL were 32% and 56 % in HSG and 40% and 28 % in DL. Right and left hydrosalpinx on HSG and DL were 32% and 12% in HSG and 40% and 16 % in DL. p<0.005. Right and left peri-tubal adhesions on HSG and DL were 36% and 20% at HSG and 52% and 28 % in DL. p<0.005. Thus, laparoscopy is superior in detection of hydrosalpinx and peritubal adhesions than HSG. In this analysis, the incidence of submucosal, intramural and subserous fibroids was 16%, 12% and 8 % respectively. Incidence of septate, unicornuate, bicornuate & arcuate uterus was 8%, 6%, 6%, 2% respectively. Intrauterine adhesions were detected in 12% and endometrial polyp in 4% of patients.CONCLUSIONSHSG is considered to have a high sensitivity and specificity to detect tubal block. HSG and laparoscopy are not alternative, but are complementary in the evaluation of tubal block.
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PURPOSE: This study aimed to investigate the clinical and metabolic determinants of circulating soluble leptin receptor (CSLR) and free leptin index (FLI) in pre-pubertal obese male children.METHODS: We conducted a preliminary cross-sectional study at three tertiary hospitals and one public primary school. Eighty obese male children without growth and developmental abnormalities aged 5–9 years were recruited. In these children, obesity was solely caused by excessive food intake, and not by acute illness, medications, endocrine abnormalities, or any syndrome. Body mass index (BMI), body fat mass, carbohydrate intake, fat intake, high density lipoprotein cholesterol level, low density lipoprotein cholesterol level, triglyceride level, and Homeostatic Model Assessment for Insulin Resistance are the potential determinants for leptin regulation, which is represented by CSLR level and FLI.RESULTS: Carbohydrate was the main source of energy. BMI and body fat mass had negative weak correlation with CSLR and positive weak correlation with FLI. Furthermore, carbohydrate intake was found to be independently associated with CSLR based on the results of the multiple linear regression analysis. Following an increase in carbohydrate intake, CSLR level decreased progressively without any negative peak.CONCLUSION: Leptin regulation in prepubertal obese male children is associated with body composition and dietary intake. Carbohydrate intake is useful for predicting CSLR. Lipid profiles and insulin resistance are not related to both CSLR and FLI. Treatment and prevention of leptin resistance in obese children should focus on reducing BMI, fat mass, and carbohydrate intake.
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Child , Humans , Male , Adipose Tissue , Body Composition , Body Mass Index , Cholesterol, HDL , Cholesterol, LDL , Cross-Sectional Studies , Diet , Eating , Growth and Development , Insulin Resistance , Leptin , Linear Models , Obesity , Receptors, Leptin , Tertiary Care Centers , TriglyceridesABSTRACT
Introduction: Sleep has become one of the most ignored factors today. More sleep or less sleep does not matter it is just compensated the next day. Importance of regular and timely sleep amongst the students and their correlation with blood pressure is necessary to be found out so that the students can be made aware of and can be provided treatment to prevent further complications. Method: Demographic profile was noted it includes name, age, gender, professional year of MBBS and residence. History of sleeping was noted and other factors which influences sleeping pattern (i.e, alcohol, smoking, an association of dreams with sleep, midnight awakenings with sleep, caffeine intake before bed and average stress levels) through a well-structured questionnaire. Blood pressures of all eligible students were recorded 3 times in a week at the same time by the principal investigator with the same instrument according to the JNC 7 classi-fication for hypertension. Results: Amongst all the medical students, 6% had systolic hypertension and 22.50% had diastolic hypertension. Comparing blood pressures according to sleeping patterns, amongst cases (less than 5 hours of sleep) 20.8% had systolic hypertension and 56.30% had diastolic hypertension. Whereas in controls (more than 5 hours of sleep) 1.40% had systolic hypertension and 11.90% had diastolic hypertension. Factors such as alcohol con-sumption, smoking, caffeine consumption before sleep, dreams, midnight awakenings and stress were found to be as-sociated with sleeping patterns and the results were found to be extremely significant (p<0.0001) statistically. Conclu-sion:Sleep duration of less than 5 hours was noted in 24% of the total population. The subjects with lesser number of sleeping hours had increased levels of blood pressure and a higher prevalence of hypertension. The average systolic blood pressure in subjects with less than 5 hours of sleep (cases) showed 48.50% pre-hypertensives and 20.80% hy-pertensives whereas in case of average diastolic blood pressure 18.50% were prehypertensive and 56.30% were hyper-tensive.
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Introduction: School children majorly face stress due to the pressure and expectations from their parents besides aca-demics, athletics, etc. It is known that depression, stress increases blood pressure. Such wide variations in blood pres-sure at such a young age can increase the incidence of cerebrovascular accidents, ischemic heart diseases, renal failure and preterm death in the adulthood of such children. This survey will guide the parents and teachers to the various problems student face and how can they help the student cope with it. Method: The blood pressure of each student was taken three times to reduce them to minimise the possibility of errors and the blood pressures of all the students were compared according to their age (13-16 years) and the schooling type (boarders and day scholars). Results:On comparing the prehypertensive stage, the numbers of pre-hypertensives are found to be greater in the age group of 15 years in both day scholars and boarders i.e. 14% and 8% respectively. The on comparing the schooling type the day scholars have a greater number of prehypertensive i.e. 25% than boarders which is 17%. Though pre-hypertensives are higher in the age group of 15 years, but the numbers of hypertensives are more in 14 years of age which is 7% (6% in hypertension stage I and 1% in hypertension stage II) in day scholars and 4% (3% in hypertension stage I and 1% in hypertension stage II) in boarders. In schooling type, a similar trend as that of prehypertension is seen i.e. in day schol-ars 14% students are in hypertension stage I and 3% students are in hypertension stage II making a total of 17% of hypertensive in day scholars. Similarly, in boarders there are 6% in hypertension stage I and 1% in hypertension stage II making 7% hypertensive in boarders, thereby showing a higher percentage of hypertensive in day scholars. Conclu-sion: The study revealed Percentage of students in hypertension stage I and hypertension stage II were found more in day scholars (14% HT STAGE I and 3% HT STAGE II) than boarders (6%HT STAGE I and 1% HT STAGE II) re-spectively. Thus, it can be very well concluded that 17% of day school children and 7% boarders were found to be in hypertensive.
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Eruptive pseudoangiomatosis is a rare viral exanthem characterized by acute onset of hemangiomata-like lesions, however, histological findings are distinct from that of true angiomas. This entity has been reported from Europe, North America, Japan, and Korea till date. Here, we report 12 cases of eruptive pseudoangiomatosis from a tertiary care hospital in Punjab.
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Eruptive pseudoangiomatosis is a rare viral exanthem characterized by acute onset of hemangiomata-like lesions, however, histological findings are distinct from that of true angiomas. This entity has been reported from Europe, North America, Japan, and Korea till date. Here, we report 12 cases of eruptive pseudoangiomatosis from a tertiary care hospital in Punjab.
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Aims:-To providea comprehensiveinformationaboutanalysisof activationof variousmuscles during Sit-to-Standinpatientswithstroke.Todetermineifthereexistsanycommonpatternof muscleactivation.Togivedirectiontofuturestudiesregarding themusclestobeinvestigated during Sit-to-Stand. Methods-A literature search was performed with help of the most commonlyuseddatabasei.e.PubMedtoselectthestudiesrelatedtoelectro-myographicactivities ofvariouslowerextremity,trunkandupperextremity musclesduringSit-to-Standactivity, publishedtill2016.TheInclusioncriteriaforthestudy wereProspectiveorretrospectivecohort studies,studiesthatincludedonly participantswithstrokeleadingtohemiparesisand/oralong withhealthy participants ascontrolgroupandstudiesthatmeasuredtheEMGactivity ineither trunkmusclesand/orlimbmusclesduring sittostand.Theexclusion criteriawere iftheir populationofinterestalsoincludedpatientswith otherneurologicalconditionsandstudiesinany language other than English.Twoindependentinvestigatorsassessedthe studiesbasedon inclu-sion and exclusion criteria. Keywordsused duringthesearch wereElectromyography, Stroke,Sit-to-Stand.Thestudieswerethoroughly evaluatedwithrespecttotheSit-to-Stand procedureandvariety ofmusclesthatwereinvestigatedthroughEMGanalysis. Results: Withthe helpof givenkeywords,abstracts/articlesof 21studieswereretrievedfromthedatabase.After initial screening oftheabstracts12studieswereselectedforindepthanalysis.Variouslowerextremity musclesincludingTibialisAnterior,Soleus,Quadriceps,Vastusmedialis,GluteusMaximus were investigatedinthe studies.In2studies,Trunkmuscleswereinvestigatedwhereasinone study Tricepsmuscleactivity wasanalyzedduring Sit-toStandactivity inpatientswith stroke. Conclusion:Fromthisstudy itcanbecon-cludedthattheactivityofTibialisAnterior musclewasinvestigatedmorefrequentlybyvariousresearchersfollowedbytheactivityof Soleus and Quadriceps muscle.
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Osteomyelitis is an acute and chronic inflammation of a medullary portion of bone along with cortex and periosteum. Osteomyelitis is more common in developing countries. Among the other bacterial infectious diseases, osteomyelitis is the most difficult to treat. We hereby report a rare case of osteomyelitis of maxilla in a middle-aged immunocompetent male patient who was treated with subtotal maxillectomy, and later, the defect was closed with split-thickness skin graft
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BACKGROUND AND AIMS : The use of Electroconvulsive therapy as a treatment modality has increased over the recent years. Electroconvulsive therapy (ECT) is associated with transient episodes of hypertension and tachycardia.Various agents like Beta-blocking agents, Opioids, Nitroglycerine and Clonidine are usedto prevent cardiovascular response.Aim of our study was to assess the efficacy of Fentanyl on cardiovascular response and seizure duration during ECT. MATERIAL AND METHOD :60 patients aged 18-60 years with ASA Grade I or II undergoing ECT were divided into Group A patients who received Inj.Fentanyl 1 mcg/kg intravenously and Group B patients who did not received Inj. Fentanyl 1 mcg/kg. The haemodynamic changes and seizure duration were recorded and tested by Mean, Standard deviation, Percentage, P value for significance. RESULTS :The haemodynamic changes after giving ECT were less in Fentanyl Group A (P<0.05) as compared to Nonfentanyl Group B and vitals came to baseline value earlier in Fentanyl group than Nonfentanyl group. Seizure duration was not affected by Fentanyl (P>0.05). CONCLUSION : Those patients receiving ECT when given Inj. Fentanyl 1 mcg/kg intravenously wereseen to be more haemodynamicaly stable as compared to those patients who did not received Inj.Fentanyl intravenously.
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AIMS AND OBJECTIVES:Comparison of efficacy of dexmedetomidine v/s combination of midazolam-fentanyl during monitored anaesthesia care in tympanoplasty with special emphasis on the sedative properties and the effectiveness of sedation, the number of doses of rescue analgesics given and the haemodynamic parameters measured.MATERIALS AND METHOD:60 patients aged between 15-60 years undergoing tympanoplasty under local anaesthesia were divided into Group A patients received intravenous dexmedatomidine in the dose of 1μg/kg over10 minutes and group B patients received combination of intravenous midazolam 0.02mg/kg and 1μg/kg fentanyl over 10 minutes. Sedation was titrated to Ramsay sedation score (RSS) of three. Vital parameters, intra operative pain intensity by visual analogue scale (VAS) >3, rescue analgesic given if required in the form of fentanyl 1μg/kg was recorded.RESULTS:The mean sedation score in group A is 3.18 ± 0.19 and in group B is 3.03 ± 0.21(p>0.05).Intra operative heart rate and mean arterial pressure in group A were lower than the base line values and the corresponding values in group B (p<0.05).Group A patients have less requirement of rescue analgesic as compared to the midazolam-fentanyl group (40%).CONCLUSION:Dexmedetomidine and combination of Midazolam fentanyl were comparable in the effectiveness of sedation. The lesser requirement of rescue analgesics and decrease in MAP facilitating improved surgical field makes Dexmedetomidine a better choice due to sedative effect and control over hemodynamics in ENT surgical procedures.