The Hyperledger fabric as a Blockchain framework preserves the security of electronic health records.

The Hyperledger Fabric (HF) framework is widely studied for securing electronic health records (EHRs) in the healthcare sector. Despite the various cross-domain blockchain technology (BCT) applications, little is known about the role of the HF framework in healthcare. The purpose of the systematic literature review (SLR) is to review the existing literature on the HF framework and its applications in healthcare. This SLR includes literature published between January 2015 and March 2023 in the ACM digital library, IEEE Xplore, SCOPUS, Springer, PubMed, and Google Scholar databases. Following the inclusion and exclusion criteria, a total of 57 articles emerged as eligible for this SLR. The HF framework was found to be useful in securing health records coming from the Internet of Medical Things (IoMT) and many other devices. The main causes behind using the HF framework were identified as privacy and security, integrity, traceability, and availability of health records. Additionally, storage issues with transactional data over the blockchain are reduced by the use of the HF framework. This SLR also highlights potential future research trends to ensure the high-level security of health records.

Intraoperative Neurophysiological Monitoring for Intradural Extramedullary Spinal Tumours.

STUDY DESIGN: Retrospective cohort study. OBJECTIVES: Intraoperative neurophysiological monitoring (IONM) is widely used in spinal neurosurgery, particularly for intramedullary tumours. However, its validity in intradural extramedullary (IDEM) spinal tumours is less clearly defined, this being the focus of this study. METHODS: We compared outcomes for patients that underwent resection of IDEM tumours with and without IONM between 2010 and 2020. Primary outcomes were postoperative American Spinal Injury Association (ASIA) scores. Other factors assessed were use of intraoperative ultrasound, drain placement, postoperative complications, postoperative Eastern Cooperative Oncology Group (ECOG) score, extent of resection, length of hospital stay, discharge location and recurrence. RESULTS: 163 patients were included, 71 patients in the IONM group and 92 in the non-IONM group. No significant differences were noted in baseline demographics. For preoperative ASIA D patients, 44.0% remained ASIA D and 49.9% improved to ASIA E in the IONM group, compared to 39.7% and 30.2% respectively in the non-IONM group. For preoperative ASIA E patients, 50.3% remained ASIA E and 44.0% deteriorated to ASIA D in the IONM group, compared to 30.2% and 39.7% respectively in the non-IONM group (all other patients deteriorated further). Length of inpatient stay was significantly shorter in the IONM group (P = .043). There were no significant differences in extent of resection, postoperative complications, discharge location or tumour recurrence. CONCLUSIONS: Research focusing on the use of IONM in IDEM tumour surgery remains scarce. Our study supports the use of IONM during surgical excision of IDEM tumours.

The COVID-19 impact on air condition usage: a shift towards residential energy saving.

The enforcement of the Movement Control Order to curtail the spread of COVID-19 has affected home energy consumption, especially HVAC systems. Occupancy detection and estimation have been recognized as key contributors to improving building energy efficiency. Several solutions have been proposed for the past decade to improve the precision performance of occupancy detection and estimation in the building. Environmental sensing is one of the practical solutions to detect and estimate occupants in the building during uncertain behavior. However, the literature reveals that the performance of environmental sensing is relatively poor due to the poor quality of the training dataset used in the model. This study proposed a smart sensing framework that combined camera-based and environmental sensing approaches using supervised learning to gather standard and robust datasets related to indoor occupancy that can be used for cross-validation of different machine learning algorithms in formal research. The proposed solution is tested in the living room with a prototype system integrated with various sensors using a random forest regressor, although other techniques could be easily integrated within the proposed framework. The primary implication of this study is to predict the room occupation through the use of sensors providing inputs into a model to lower energy consumption. The results indicate that the proposed solution can obtain data, process, and predict occupant presence and number with 99.3% accuracy. Additionally, to demonstrate the impact of occupant number in energy saving, one room with two zones is modeled each zone with air condition with different thermostat controller. The first zone uses IoFClime and the second zone uses modified IoFClime using a design-builder. The simulation is conducted using EnergyPlus software with the random simulation of 10 occupants and local climate data under three scenarios. The Fanger model's thermal comfort analysis shows that up to 50% and 25% energy can be saved under the first and third scenarios.

Case report: 'Photodynamics of Subependymal Giant Cell Astrocytoma with 5-Aminolevulinic acid'.

Subependymal Giant Cell Astrocytoma (SEGA) is a common diagnosis in patients with Tuberous Sclerosis. Although surgical treatment is often required, resection may entail a significant risk for cognitive function given the anatomical relation with critical structures such as the fornices and subgenual area. Therefore, target subtotal resections using minimal invasive approaches focused in the higher metabolic areas are valuable options to preserve quality of life while addressing specific problems caused by the tumor, such as hydrocephalus or progressive growth of a specific component of the tumor. In this report, the authors explore the potential role of 5-ALA in the identification of highly metabolic areas during SEGA resection in the context of minimal invasive approaches.

Protection challenges of pregnant women against vertical transmission during COVID-19 epidemic: A narrative review.

This paper presents a narrative review study of 5 popular data repositories focusing on challenges of pregnant women protection during the COVID-19 pandemic. The study concludes that the likelihood of a vertical transmission of COVID-19 infection from pregnant women to neonates was not observed. Nevertheless, it remains a serious risk for them during their earlier stage of pregnancy, thus, special attention from health professionals has been recommended.

Combined measures to control the COVID-19 pandemic in Wuhan, Hubei, China: A narrative review.

Coronavirus disease 2019 (COVID-19) is an emerging disease caused by the coronavirus, SARS-CoV-2, which leads to severe respiratory infections in humans. COVID-19 was first reported in December 2019 in Wuhan city, a populated area of the Hubei province in China. As of now, Wuhan and other cities nearby have become safe places for locals. The rapid control of the spread of COVID-19 infection was made possible due to several interventions and measures that were undertaken in Wuhan. This narrative review study was designed to evaluate the emerging literature on the combined measures taken to control the COVID-19 pandemic in Wuhan city. Science Direct, Springer, Web of Science, and the PubMed data repositories were searched for studies published between December 1, 2019, and June 07, 2020. The referred "preferred reporting items for systematic reviews and meta-analyses" (PRISMA) protocol was used to conduct this narrative review. A total of 330 research studies were found as a result of the initial search based on exclusion and inclusion criteria, and 30 articles were chosen on final evaluation. It was discovered that the combined measures to control the spread of COVID-19 in Wuhan included cordon sanitaire, social distancing, universal symptom surveys, quarantine strategies, and transport restrictions. Based on the recommendations presented in this review study, existing policies with regard to combined measures and public health policies can be enforced by other countries to implement a rapid control procedure to control the spread of the COVID-19 pandemic.

The Effect of Oral Propranolol versus Oral Corticosteroids in Management of Pediatric Hemangiomas.

BACKGROUND: Hemangiomas are the most common benign tumors of infancy. This study evaluated the efficacy of oral propranolol comparing to oral steroids in management of pediatric hemangiomas. METHODS: In North India from January 2012 to January 2015, sixty children <6 years old with superficial hemangiomas were divided into 2 groups; oral propranolol vs. oral prednisolone. All participants were assessed for electrocardiogram, heart rate, blood pressure and sugar and initial therapy was started using 1 mg/kg and in absence of adverse effects, 2 mg/kg was administered after 2 weeks. The hemangioma Activity Score (HAS) was used for scoring and patients were followed up for 6 months. RESULTS: The propranolol group mostly showed early response to the drug and needed the drug for less time compared to corticosteroid group. In propranolol group, 16.5%, 23% and 59% needed the drug to be continued for 8-12, 4-8 and 4 months. In corticosteroid group, the therapy was continued for 8-12, and 4-8 months in 76.8% and 16.5% and in 6.6% was stopped within 4 months. In propranolol group, the response was 70% compared to 40% in other group. The mean HAS decreased significantly in propranolol group when compared to steroid group. Three patients on prednisolone developed Cushingoid features, while 1 patient in propranolol group had mild flue like symptoms. CONCLUSION: Two mg/kg of oral propranolol significantly decreased HAS, when compared to oral prednisolone, with good parent satisfaction, minimal adverse effects and no recurrence/relapse of hemangiomas after a follow up period of 6 months.

Does diverting ileostomy improve the outcome in children with tuberculous small bowel obstruction requiring surgical intervention?

INTRODUCTION: Abdominal tuberculosis is fairly common in children. The most common clinical presentation is bowel obstruction. Depending upon the presentation, the intestinal obstruction can be either managed conservatively or by operative intervention. There are various options in patients who undergo operative treatment. This study was undertaken to analyze the results of operative intervention with and without ileostomy. MATERIALS AND METHODS: This is a retrospective study carried out over a period of 10 years on 32 children who were operated for small bowel obstruction due to abdominal tuberculosis. The patients were divided into two groups (A: with ileostomy and B: without ileostomy). The relevant data and the defined outcome measures were statistically analyzed. RESULTS: A total of 32 children with tuberculous bowel obstruction requiring surgical intervention were studied. The patient of group A had mean duration of postoperative ileus for 2.55 days, restoration of enteral feeding within mean period of 3.55 days and had a primary hospital stay for a mean period of 9.0 days. These outcomes when compared with group B patients were statistically significant. CONCLUSION: In children with bowel obstruction due to tuberculosis, diverting ileostomy decreases the morbidity by allowing early return of enteral motility, early institution of feeding and first-line ATT and decreasing the primary hospital stay.

Neonatal Intestinal Obstruction: When to Suspect Duplication Cyst of Bowel as the Cause.

BACKGROUND: Duplication cyst is a rare cause of neonatal intestinal obstruction. Their most common location is the small intestine. The clinical presentation is extremely variable depending upon its size, location and type and the age of the patient and are mainly encountered during infancy or early childhood. The diagnosis is very difficult in neonates. This study was undertaken to study their presentation, diagnostic modality of choice and further management in neonatal age group. MATERIALS AND METHODS: This was a retrospective study performed at the Department of Paediatric Surgery, J .N Medical College Hospital, AMU Aligarh from July 2008 to June 2014. The data was analyzed with respect to demographic profile of the neonates, their initial clinical presentation, radiological features and subsequent event leading to intervention, operative features and outcome. RESULTS: There were a total of seven neonates between ages of 3 days and 21 days who were diagnosed as cases of intestinal obstruction due to duplication cyst. The majority of the patients were having ileal duplication cyst (n=4). Ultrasonography played important role in majority of the cases for diagnosis. There was one patient in which the diagnosis was confused with ileal atresia. All the patients underwent excision with restoration of bowel continuity. CONCLUSION: The diagnosis of intestinal obstruction in neonate due to duplication cyst is difficult. It has varied presentation and preoperative diagnosis at times may be challenging. Surgery is the mainstay of the treatment.

Routine histopathological examination of appendectomy specimens in children: is there any rationale?

OBJECTIVE: Primary carcinoma of the bowel is a rare malignancy in pediatric age group. The aim of the study was to assess the incidence of appendicular malignancies in children and the possibility of reducing the need for routine histopathological examination of appendix. MATERIALS AND METHODS: In last 15 years, all the cases of appendectomies in children were analyzed. Retrospective analysis of the data was done to document the clinical presentation, diagnosis, outcome and histopathology reports of the specimen. The case files and operation notes were studied thoroughly in cases where HPR was positive for malignancy. RESULTS: From July 1995 to June 2010, 595 appendectomies were done in children. Three cases of carcinoid tumor were detected. All were less than 1 cm and were on the tip of the appendix. There was no preoperative or intraoperative suspicion. CONCLUSION: Routine histopathological analysis did not help in the management of any of the cases. Therefore, selective utilization of the already burdened histopathology section of the hospital would be more cost effective without affecting the patient outcome.

Perforation into gut by ventriculoperitoneal shunts: A report of two cases and review of the literature.

We report two cases of gastrointestinal perforation by ventriculoperitoneal (VP) shunts and review the literature on the topic. The time interval between shunt surgery and detection of bowel perforation is minimum in infants and increases with age. Sigmoid and transverse colon followed by stomach are the most frequent sites of gastrointestinal perforations by VP shunts.

Multicystic renal dysplasia: a diagnostic dilemma.

A 3-year-old male child had left-sided abdominal lump for 4 months. Radiological examination revealed a cystic mass in the left kidney. A tentative diagnosis of multicystic nephroma was made on clinical and radiological examination. Cytology was inconclusive. Nephrectomy was done. A final diagnosis of multicystic dysplasia was made on histological examination.