Unlocking Precision Medicine for Prognosis of Chronic Kidney Disease Using Machine Learning.

Chronic kidney disease (CKD) is a significant global health challenge that requires timely detection and accurate prognosis for effective treatment and management. The application of machine learning (ML) algorithms for CKD detection and prediction holds promising potential for improving patient outcomes. By incorporating key features which contribute to CKD, these algorithms enhance our ability to identify high-risk individuals and initiate timely interventions. This research highlights the importance of leveraging machine learning techniques to augment existing medical knowledge and improve the identification and management of kidney disease. In this paper, we explore the utilization of diverse ML algorithms, including gradient boost (GB), decision tree (DT), K-nearest neighbor (KNN), random forest (RF), histogram boost (HB), and XGBoost (XGB) to detect and predict chronic kidney disease (CKD). The aim is to improve early detection and prognosis, enhancing patient outcomes and reducing the burden on healthcare systems. We evaluated the performance of the ML algorithms using key metrics like accuracy, precision, recall, and F1 score. Additionally, we conducted feature significance analysis to identify the most influential characteristics in the detection and prediction of kidney disease. The dataset used for training and evaluation contained various clinical and demographic attributes of patients, including serum creatinine level, blood pressure, and age, among others. The proficiency analysis of the ML algorithms revealed consistent predictors across all models, with serum creatinine level, blood pressure, and age emerging as particularly effective in identifying individuals at risk of kidney disease. These findings align with established medical knowledge and emphasize the pivotal role of these attributes in early detection and prognosis. In conclusion, our study demonstrates the effectiveness of diverse machine learning algorithms in detecting and predicting kidney disease. The identification of influential predictors, such as serum creatinine level, blood pressure, and age, underscores their significance in early detection and prognosis. By leveraging machine learning techniques, we can enhance the accuracy and efficiency of kidney disease diagnosis and treatment, ultimately improving patient outcomes and healthcare system effectiveness.

A Rare Case of Infantile Cortical Hyperostosis (ICH) of the Bilateral Tibia or Caffey Disease.

An inflammatory collagenopathy of infancy characterized by subperiosteal bone hyperplasia is known as infantile cortical hyperostosis (ICH) or Caffey disease. A 10-day male infant presented to the hospital with leg swelling, excessive crying, and irritability since birth. He was born with the swallowed part of his tibia bone. The X-ray suggested hyperostosis of the bilateral tibia bone involving the anterior cortex, which is more prominent on the right side. The infant was clinically monitored and treated and discharged after the swelling was reduced. Again, he was admitted to the hospital at 10 weeks of life, and a similar thickening appeared on his left tibia. He was administered analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) and discharged under a follow-up schedule. The infant was monitored in the pediatric ward for the next seven days. The swelling and pain completely subsided one and a half weeks after hospitalization, and continued follow-up was suggested until the complete correction of the disease on an outpatient basis. This disease must be recognized and understood, and the clinical-radiological correlation is significant.

Rapid-cycle evaluation and learning for the effective delivery of integrated interventions in early childhood in rural India.

Background: Effective and real-time data analytics plays an essential role in understanding gaps and improving the quality and coverage of complex public health interventions. Studies of public health information systems identify problems with data quality, such as incomplete records and untimely reporting. Effective data collection and real-time analysis systems for rapid-cycle learning are necessary to monitor public health programs and take timely evidence-based decisions. Early childhood development (ECD) programs are very diverse. Rapid-cycle evaluation and learning (REAL) guides the implementation process of such complex interventions in real time. Stepping stones was one such early childhood development program implemented in Central India. Objective: The objective was to improve the delivery of complex, integrated public health interventions for early childhood development in remote areas of rural India. Methodology: The program was developed according to the principles of inclusion and community-centeredness, which can be tested quickly and iteratively. To enhance the decision-making process and improve delivery and coverage, the core team implemented an information system for rapid-cycle learning. We developed performance indicators and a performance measurement matrix after defining the specific needs. Following that, we trained staff to collect complete data using electronic data collection tools and transfer it the same day to the server for quality review and further analysis. A variety of data/information was triangulated to address the gaps in intervention delivery, and those decisions were subsequently implemented. Results: We observed that the quality of data collection improved, and errors were reduced by 50% in the third quarter. The quality of the narrative was also enhanced; it became more elaborate and reflective. Sharing their field output in meetings and improving the quality of the narrative enhanced the self-reflection skills of field staff and consequently improved the quality of the intervention delivery. Refresher training and mentoring by supervisors helped to improve the data quality over time. Conclusion: Rapid-cycle evaluation and learning (REAL) can be implemented in resource-limited settings to improve the quality and coverage of integrated intervention in early childhood. It nurtures a reinforcing ecosystem that integrates providers, community, and family perspectives and guides interactions among stakeholders by integrating data from all available sources.

A Case of Anesthetic Management of Arnold-Chiari Malformation I: A Contest to Anesthesiologists.

Arnold-Chiari malformation is a very uncommon array of deformities in the posterior part of the cranium and hindbrain caused due to abnormal extension of the posterior brain into the spinal canal. Chiari malformation is further divided into subtypes 1, 2, and 3. The latter two are more common in pediatric forms and present at birth. The severity of symptoms depends upon the extent of herniation of the hindbrain due to herniation of the cerebellum through the foramen of the cranium. Also, there have been instances of absence of cerebellum. Multiple associated disorders like hydrocephalus due to increased intracranial pressure, then encephalocele, syrinx, or spinal deformity in the form of scoliosis have been presented in many cases. All these factors thus become a challenge to anesthesiologists for such patients. Hence evidence-based knowledge along with multidisciplinary, well-planned approach is required for its management.

The Effect of Static Cupping Therapy in Non-specific Low Back Pain for Primary Dysmenorrhea.

Dysmenorrhea is often referred to as painful menstruation with cramping sensations in the lower abdomen, resulting in discomfort. This pain commonly radiates to both the thighs and lumbosacral regions. A 23-year-old female presented with a complaint of severe abdominal pain during menses, accompanied by low back pain (LBP) that typically started at the onset of menstrual flow and lasted for the first 24-48 hours for which no analgesics were taken by the patient. The pain intensity was recorded on a numerical pain rating scale (NPRS) that showed 6 out of 10 for abdominal and low back pain during activity and 4 out of 10 at rest, on account of which a two-day supervised static cupping therapy protocol was devised for the patient. After treatment, the NPRS recorded a remarkable decrease in pain intensity to 2 out of 10 for abdominal and low back pain during activity, as well as at rest. As static cupping therapy is used to target deeper muscles in the lower back and abdomen; this case report aims to highlight the beneficial effects of static cupping on primary dysmenorrhea and related non-specific low back pain.

Bibliometric Analysis on Bibliometric Studies of Case Reports in the Medical Field.

The studies on bibliometric analyses of case reports usually give valuable information regarding various aspects of case reports but lack investigation analysing these publications. This is the first-ever study to examine the bibliometric articles on case reports; hence, it is hypothesized to provide a valuable contribution to this gap. PubMed and SCOPUS databases were searched, and a total of 119 articles were obtained, but only five were analyzed matching the inclusion criteria. The keywords involved in the search were "Bibliometrics", "analysis", "case reports", "case series", and "articles" whereas, the time range in which the case reports were searched for was between 2011-2021. Common parameters from these five articles were employed for bibliometric analysis, which included publication year, publication type, the number of case reports per article, theme or subject of the article, citation, and impact factor (IF). Out of the five articles identified, four were published in 2021. One out of five was a case report, and the rest were review-type of articles. The overall citation number of these articles was less than 10, and the IF of these articles was between 0-0.007. The number of citations of the articles was in a period of one to two years or less than one year. A comprehensive overview of the parametrises, as well as the recent trends that are being used to conduct bibliometric analysis on case reports was acquired.

Post-operative Rehabilitation in Klatskin Tumor: A Rare Case Report.

Cholangiocarcinoma (CCA), commonly referred to as Klatskin tumor (KT), is a rare cancer that develops from the epithelium of the intra- or extrahepatic bile duct. This case outlines the impact of physiotherapy rehabilitation in a post-operative case of a KT in a 58-year-old male who presented with complaints of abdominal pain, nausea, constipation, and difficulty in urinating and reportedly exhibited generalized weakness, weight loss, and dyspnea. Following investigations such as computed tomography (CT) scan, the patient was diagnosed with a KT for which he underwent hepaticojejunostomy and was kept under observation, following which supervised physiotherapy intervention (PI) commenced from post-operative day (POD) 3. The outcome measure was peak expiratory flow rate (PEFR), whereas the intervention involved diaphragmatic breathing exercises (DBEs), thoracic expansion exercises (TEEs), incentive spirometry (IS), range of motion (ROM) exercises, active cycle of breathing technique (ACBT), and ambulation. After two weeks of treatment, there were an improvement in cough frequency and an appreciable change in vital capacity (VC), and a significant increase in PEFR values was observed.

A Pragmatic Comparison Between Aerobic Exercise and Suryanamaskar in Stress Management in Medical Professionals: A Quasi-experimental Study.

Background Stress is an episodic process in an individual's life that depends upon the circumstances that elicit this process, later jeopardizing an individual's mental balance and leading to depression and anxiety. Yoga is a traditional component of physical activity that contains three main domains, namely, maintaining the correct posture (asanas), control over one's breath (pranayama) and meditation with complete concentration (dhyana), which are proven to be effective in enhancing the psychological, physical, and spiritual wellbeing of an individual along with mindfulness. The purpose of the present study was to compare aerobic exercise (AE) and Suryanamaskar (SN) in terms of the best intervention in lowering the level of stress in medical professionals (MPs). Methods A quasi-experimental study including a pragmatic comparison was conducted involving 30 participants who were divided into two groups A and B. The participants in group A did treadmill walking and the participants in group B were made to perform the complete cycle of SN with all the 12 asanas for four weeks. Results The outcomes demonstrated that both AE and SN had significant statistical values in terms of pre- and post-intervention Perceived Stress Scale (PSS) scores, resting heart rate, and systolic and diastolic blood pressure. Also, when post-intervention mean values of both the groups were compared for all the parameters, only mean PSS values were found to be statistically significant. Conclusion The current study concluded that both AE and SN were beneficial in decreasing the level of stress in MPs with SN being statistically more significant in reducing stress levels than AE. Both interventions are safe to perform.

A Rare Incidence of Necrotizing Lesion of the Upper Arm Due to Pentazocine Injection Abuse: A Case Report.

A patient with a history of treated pain with intravenous drugs comes at high risk for drug abuse. Administration of intravenous pentazocine continuously for a long time in the same location affected the skin tissue. Pentazocine misuse is frequent among patients with chronic disease conditions and the easy availability of pentazocine injection can easily lead to significant consequences. We present a unique case of pentazocine misuse resulting in significant skin necrosis. We present a case of a 48-year-old male with a complaint of pain and wound with lesions over the arm due to the regular self-administered pentazocine in the same location. The therapeutic intervention given in this case is an opiate agonist to control the dependence on pentazocine.

Prevalence of thyroid disorder among young adults in the rural areas of Wardha district: A cross-sectional study.

Background and Aim: Recently, it has been revealed that most thyroid disorders occur among females and that the factors contributing to this are infertility and sex hormone imbalance. Other research studies showed both genders are equally affected. Therefore, this study aims to estimate the prevalence rate of thyroid disorder among young adults in the rural areas of Wardha district and correlate the results with demographic variables. Materials and Methods: A cross-sectional research design was used in this study. One thousand males and females were involved in the study. The Calbiotech Thyroxine Elisa kit was used to check the prevalence rate of thyroid disorder. Data were analysed using the Statistical Package for Social Sciences (SPSS) and released in 2016. Results: Among the rural villages of Wardha district, Seloo, Salod (Hirapur) and Kelzar were included in the study. It was found that in Seloo, 154 (49.04%) young adults had normal thyroid function, 105 (33.44%) had hyperthyroidism and 55 (17.52%) participants had hypothyroidism. Salod (Hirapur) showed 210 (47.95%) with normal thyroid function, 149 (34.02%) with hyperthyroidism and 79 (18.04%) with hypothyroidism. In Kelzar, there were 121 (48.79%) with normal thyroid function, 80 (32.26%) with hyperthyroidism and 47 (18.95%) with hypothyroidism. Conclusion: Prevalence of thyroid disorder revealed that majority of the thyroid problems were found among females in the rural areas of Wardha district. There are various problems in rural areas, such as lack of medical facilities and laboratory facilities to diagnose thyroid dysfunction early. It is recommended that health check-up camps be conducted in rural areas and health education be given to young adults about thyroid disorders and their prevention measures for promotion of health free from a thyroid disorder.

Effectiveness of Plyometrics Along With Pilates Exercises in Increasing Vertical Jump Performance Among Basketball Players.

Introduction Basketball is an athletic court game sport played by five players from two sports teams each. Therefore, the objective of this study is aimed at gauging the potential impact of the combination of plyometrics and Pilates training along with the efficacy of these exercise regimes individually on raising vertical jump performance in basketball players. Methodology For this study, 45 subjects were enrolled and assigned into groups A, B, and C. Group A was given a plyometric program, group B was given a Pilates program, and group C was given a combination of plyometrics and Pilates program. All were tested for vertical jump and muscle endurance prior to starting the plyometric and Pilates training and plyometrics with Pilates program. All the subjects passed through six weeks of the training program and were retested. The program was given three days a week for six weeks. Result The data collected were statistically analyzed by applying the Wilcoxon signed-rank test and the one-way analysis of variance test. The analysis of variance in vertical jump ability among three groups was assessed. The average value of vertical jump ability before training was 260.60 for group A, 243.47 for group B, and 263 for group C. Training group C had a higher mean vertical jump value. All groups showed improvement in vertical jump, but group C (plyometrics with Pilates) showed greater improvement in the vertical jump height and trunk flexor and trunk extensor endurance test. Conclusion The finding suggested that group C (plyometrics with Pilates) is more effective than group A (plyometrics) and B (Pilates) in improving the vertical jump height.