Google Search Trends Predicting Disease Outbreaks: An Analysis from India / 대한의료정보학회지

OBJECTIVES: Prompt detection is a cornerstone in the control and prevention of infectious diseases. The Integrated Disease Surveillance Project of India identifies outbreaks, but it does not exactly predict outbreaks. This study was conducted to assess temporal correlation between Google Trends and Integrated Disease Surveillance Programme (IDSP) data and to determine the feasibility of using Google Trends for the prediction of outbreaks or epidemics. METHODS: The Google search queries related to malaria, dengue fever, chikungunya, and enteric fever for Chandigarh union territory and Haryana state of India in 2016 were extracted and compared with presumptive form data of the IDSP. Spearman correlation and scatter plots were used to depict the statistical relationship between the two datasets. Time trend plots were constructed to assess the correlation between Google search trends and disease notification under the IDSP RESULTS: Temporal correlation was observed between the IDSP reporting and Google search trends. Time series analysis of the Google Trends showed strong correlation with the IDSP data with a lag of −2 to −3 weeks for chikungunya and dengue fever in Chandigarh (r > 0.80) and Haryana (r > 0.70). Malaria and enteric fever showed a lag period of −2 to −3 weeks with moderate correlation. CONCLUSIONS: Similar results were obtained when applying the results of previous studies to specific diseases, and it is considered that many other diseases should be studied at the national and sub-national levels.

Urogenital fistulae: a prospective study of 50 cases at a tertiary care hospital

The misfortunate incident of formation of a ureogenital fistula remains a major challenge for surgical urologists worldwide. Such fistulae may not be a life-threatening problem, but surely the women face demoralization, social boycott and even divorce and separation. The fistula may be vaginal, recto-vaginal or a combination of the two. The World Health Organization [WHO] has estimated that in the developing nations, nearly 5 million women annually suffer severe morbidity with obstetric fistulae being the foremost on the list. The objective of our study was to enunciate the patient demography, patient profile, incidence, type of surgery, as well as the long-term outcomes encountered in the management of all types of genital fistulae at a tertiary care centre. 50 consecutive patients, attending the outpatient department with urogenital fistulae, were studied during the period of 5 years from July 2009. All female patients with complaints of urinary incontinence and fecal incontinence and dribbling, patients having a history of obstructed labor, radiotherapy, instrumental delivery, foreign body or trauma and with a history of hysterectomy [abdominal/ vaginal] and lower segment caesarean section [LSCS] were included. A thorough urological examination included a dye study using methylene blue, Renal function tests, X-ray KUB nad intravenous urography [IVU]. Cystoscopy along with examination under anaesthesia [EUA] were done to assess the actual extent of injury. All patients were subjected to appropriate surgical interventions via the same combination of surgeons. Post operatively, prophylactic antibiotics were administered to all patients and patients were managed till discharge and followed thereafter via regular outpatient visits for a period of 3 years. Age of patients ranged from 21 to 40 years. 64% patients hailed from rural areas, 76% were from the lower socio-economic strata, 40% illiterate and 69% were short Statured. Vesico vaginal fistulae [VVF] was seen in 64% cases of which 50% were due to obstructed labor, 19% cases post LSCS and 31% cases post total abdominal hysterectomy [TAH]. 68% of urogenital fistulae were between 1 to 3 cms. We obtained a 75% cure rate in UVF, 87.5% cure rate in RVF while a 93.75% cure rate was observed in patients with VVF, 765 of all patients were cured while 8% had a recurrence, probably due to the large size of fistula. Genital fistula is preventable, yet it remains a significant cause of morbidity among females of reproductive age group. Despite facilities available, certain conditions like physical, social, economic, illiteracy, and a very casual attitude towards maternal health and children birth practices limit utilization of services for women. It is important that the modern health care providers should be aware of these aspects, so that they can recognize services that are appropriate and acceptable to the people. Thus, one must agree that in cases of urogenital fistulae, "prevention is better than cure"

Serum transferrin levels - a predictive marker of spontaneous closure and mortality in patients with enterocutaneous fistulae

A fistula is a communication between two epithelialised surfaces. Fistulae may be classified based on anatomic, physiologic or aetiologic criteria. Postoperative fistulae account for approximately 80% of enterocutaneous fistulae. There are numerous features including laboratory parameters that may enable the prediction of spontaneous closure in patients with enterocutaneous fistulae. The aim of this study was to determine whether serum transferring levels are a predictive marker for spontaneous closure of enterocutaneous fistulae, as well as for patients' morbidity and mortality. A prospective study including 92 patients with enterocutaneous fistulae [recruitment from March 2000 to February 2009] was done and serum transferring levels were assessed on the day of presentation with the enterocutaneous fistula. All patients were followed-up till their final out-come.statistical significance was determined by using the chi-square test. Spontaneous fistula closure rate was 66.67% in patients with serum transferin levels >140 mg dl[-1] and 18.33% in whom serum transferring levels were <140 mg dl[-1], and this was statistically highly significant. Mortality rate was 56.25% in patients with serum transferring levels <140 mg dl[-1] and 18.75% in whom serum transferring levels were >140 mg dl[-1] and the difference was statistically significant too. Short-turnover proteins, such as serum transferrin, are useful in predicting which patients with enterocutaneous fistulae should undergo surgery despite anatomic and physiological criteria favourable for spontaneous closure and which patients should not

Metastatic gastrointestinal stromal tumours of the stomach: a report on two cases and literature review

Gastrointestinal stromal tumours [GISTs] are mesenchymal tumours of the gastrointestinal tract, accounting for approximately 1% of gastric malignancies. We report on two cases of large malignant irresectable stromal tumours of the stomach with presence of concomitant distant metastases, treated palliatively, and followed by adjuvant imatinib therapy. The rarity lies in the presence of distant as well as lymph node metastases. The literature on this topic is reviewed