bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of performance in the pre-analytical phase of a clinical biochemistry laboratory in a Tertiary Medical College Hospital
Authors: Chaudhuri Sayani , Das Amitabha , Das Subir Kumar , Tanmay Saha
Published: June 2022

Background: Pre-analytical phase is the major source of errors in a clinical biochemistry laboratory.
Aims and Objectives: The study aims to determine the quality of laboratory performance in the pre-analytical phase using quality indicators (QI) specified by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Working Group on Laboratory Errors and Patient Safety and sigma metric scale for both the inpatient and outpatient samples received in the clinical biochemistry laboratory.
Materials and Methods: All samples and requisition forms received in the laboratory were examined before analysis. The percentages of the seven QI were calculated. The frequency, percentage, and defects per million rates of each pre-analytical error were calculated. Sigma value was obtained using an online sigma calculator. The laboratory performance was then categorized by the IFCC-based performance levels and sigma-based values.
Results: Out of 30,546 samples received during a period of 6 months, pre-analytical errors occurred in 2.8% of them. The highest number of pre-analytical errors was due to hemolysis (29.9%). The outpatient samples showed a desirable to optimum performance with a good sigma value. There were more errors and lower quality-based performance, in the case of inpatient samples. Errors were highest in September at the start of the study followed by a gradual decrease over the next 5 months.
Conclusion: The laboratory performance in the pre-analytical phase was found to be favorable and consistent with the international specifications.
Effect of pre-treatment with rocuronium and vecuronium on post succinylcholine fasciculations, serum potassium, and postoperative myalgia: A prospective, randomized, double-blind study
Authors: Kothari Dilip , Tripathi Sonali , Upadhyay Ritesh
Published: June 2022

Background: Succinylcholine with quick onset, ultra short duration of action, and complete predictable paralysis has been the best drug for endotracheal intubation but the occurrence of side effects such as muscle fasciculations, postoperative myalgia, rise in serum potassium levels and myoglobinuria limits its use in the full stomach, burns, massive trauma, metabolic acidosis, and few myopathies. For attenuation of these effects, many drugs have been studied but pre-treatment with non-depolarizing muscle relaxant found to be successful.
Aims and Objectives: This study was designed to assess the effect of Rocuronium and Vecuronium pre-treatment on post-succinylcholine fasciculations, rise in serum potassium levels, and postoperative myalgia.
Materials and Methods: 100 patients between the age of 20–50 years of either sex (American Society of Anaesthesiologists grade I and II) undergoing general anesthesia for various surgical procedures were randomly allocated into two groups according to pre-treatment with Rocuronium (Group R) and Vecuronium (Group V) before Succinylcholine administration. After Succinylcholine administration severity of fasciculations, rise in serum potassium after 5 min and myalgia on postoperative days 1, 2, and 3 were recorded.
Results: About 74% patients had no fasciculation in Group R as compared to 36% in group V. Statistically insignificant (P>0.05) rise in serum potassium level was observed in both groups. Higher number of patients had mild-to-moderate degree of myalgia with Vecuronium on postoperative days 2 and 3.
Conclusion: Pre-treatment with Rocuronium before Succinylcholine provided better attenuation of post-succinylcholine muscle fasciculations, postoperative myalgia with statistically insignificant rise in serum potassium levels.
A prospective randomized study to compare weekly versus tri-weekly cisplatin-based concurrent chemoradiation in the treatment of locally advanced carcinoma cervix
Authors: Arshad Mollah  , Shyam Sharma  , Koustav Biswas  , Linkon Biswas  , Srikrishna Mandal
Published: June 2022

Background: Concurrent chemoradiotherapy with cisplatin is the standard treatment for locally advanced carcinoma cervix. Cisplatin can be given either as weekly or a tri-weekly regimen with radiotherapy. However, there were few studies comparing both, so our study aimed at comparing weekly versus tri-weekly cisplatin-based chemoradiation in terms of loco-regional control and acute toxicity profile.
Aims and Objectives: To compare the treatment response and acute toxicity profile of thse two concurrent chemotherapy schedule.
Materials and Methods: Patients with non-metastatic, squamous cell carcinoma of uterine cervix International Federation of Gynecology and Obstetrics stage IB2-IVA were randomized into two arms-control arm patients received external beam radiotherapy (50Gy in 25 fractions over 5 weeks) with concurrent weekly cisplatin (40mg/m2), and study arm patients received radiotherapy with same dose, along with tri-weekly concurrent cisplatin (75 mg/m2) for two cycles. After that, all patients received brachytherapy 21 Gee/3 fractions, one fraction/week. All patients were followed up weekly during treatment and then monthly for at least a period of 6 months for evaluation of toxicity and treatment response.
Results: Six weeks after treatment completion, complete treatment response was comparable in both the arms(43.33% vs. 46.67%, P=0.35). Incidences of leucopenia were significantly high in weekly cisplatin arm (P=0.002).Nephrotoxicity of higher grade was also numerically more in control arm (P=0.654). However, treatment compliance was better in tri-weekly cisplatin arm, reflected by reduced treatment interruptions (46.67% vs. 53%).
Conclusion: Tri-weekly cisplatin-based concurrent chemoradiation is equally effective as weekly cisplatin-based approach with comparable acute toxicity in treatment of carcinoma cervix.
Knowledge, attitude, and practice about air-borne infection control guidelines: A cross-sectional study among residents doctors of tertiary care hospital in central India
Authors: Heyma Krishna  , Bhargava Jitendra K , Jain Avinash , Patel Vikas , Prakash Brahma
Published: June 2022

Background: Adherence to National Airborne Infection Control Guidelines (NAIC) by health-care facilities is an effective way of reducing the spread of air-borne infections such as H1N1, drug-resistant tuberculosis, and COVID-19 disease.
Aims and Objectives: This study aims to assess the gaps in knowledge, attitude, implementation, and satisfaction regarding resources availability of NAIC among postgraduate resident doctors.
Materials and Methods: Across-sectional study was conducted from December 2019 to February 2021 at a medical college in central India. Total 301 interns, postgraduates, and senior residents in surgery and medicine allied clinical departments were included by convenient sampling method. A pre-designed, self-administered questionnaire was used to assess knowledge, attitude, and practice (KAP) and their satisfaction with available resources regarding NAIC. The data collected were tabulated and were analyzed using descriptive test and comparison of means by Analysis of variance test.
Results: Almost 95%, 77%, and 74% of study participants were having adequate KAP on NAIC, respectively. Sixty-one percent participants were satisfied with the resources availability in their work area. Statistically significant association was observed between participants age, designation with their KAP score (P<0.05) and between gender and essential resources provided in the hospital. There was an existence of difference between study participants mean KAP score and essential resources score with statistically significance (P<0.05).
Conclusion: The overall KAP was adequate, but there was a gap that exists between knowledge, practice, and satisfaction for availability of essential resources. The study findings were useful for healthcare workers in designing interventions to improve the adherence toward the NAIC guidelines and also to benchmark evaluation of interventions.
Seroprevalence of antiSARS-CoV-2 IgG antibodies in children with household exposure to confirm cases of COVID-19 during the second wave of COVID-19 pandemic in Kota, Rajasthan
Authors: Sardana Vijay , Mittal Deepika , Sharma Saurabh , Sharma Ashutosh
Published: June 2022

Background: Weather and the susceptibility of children to SARS-CoV-2 infection is still a debated question particularly in view of important decisions regarding opening schools. Therefore, we planned this cross-sectional analysis of antiSARS-CoV-2 Immunoglobulin-G (IgG) antibodies in children with known household exposure to SARS-CoV-2. This serosurveillance, to find the presence of IgG antibodies among children of probable household exposure of confirmed COVID-19 cases will help in the better understanding of the immune response after COVID-19 infection/exposure.
Aims and Objectives: The aim of the study was to investigate the prevalence of anti-SARS-CoV-2 antibodies in children among the families who had confirm case/cases of COVID 19 during the second wave of the COVID-19 pandemic. This study is designed as a cross-sectional serosurveillance study in Kota, Rajasthan India.
Materials and Methods: Population-based serosurveillance among children with probable household exposure to confirmed COVID-19 cases who was admitted in Govt. Medical College attached COVID 19 dedicated hospital was carried out during October 2021 to December 2021 using the COVID IgG Antibody Detection Enzyme-Linked Immunosorbent Assay kits. Seropositivity among children was measured and with various other factors to understand the immunity status among COVID-19 cases. Descriptive statistical analysis done.
Results: 156/1285 eligible candidates (19.53%) having a total of 251 household contacts of <17 years age group agreed to participate in study while rest of them refused. Anti-SARS-CoV-2 IgG antibodies were present in 127/251 household contacts (50.59%). Among them maximum 28.68% of seropositive were from age group 11–17 years age, symptoms were observed in 29.13% IgG positive contacts, maximum seropositivity was seen when only one family member was hospitalized, 63% seropositivity was seen when primary relative of child was hospitalized as compared to secondary. Maximum seroreactivity (55.9%) was seen when the Chest CT score of index case was high, that is, 14–25. max reactivity was observed 76/127 (59.84%) when hospital duration of index case is <1 week. 118/127 (92.91%) of seroreactive children were found when the index case was unvaccinated or partially vaccinated.
Conclusion: Seropositivity of 50.59% suggests that all the cases may not have IgG antibodies. Among the seronegative cases, the antibodies either not developed, or are undetectable, or have disappeared during the post COVID period. Seropositivity based on gender difference is statistically not significant. Proportion of positivity shows an increasing trend with increasing age among pediatric household contacts. Complete COVID-19 vaccination is an effective tool to minimize the disease frequency/severity. Severe disease patients with high CT score transmits the infection to household contacts more efficiently.
Antibiotic susceptibility and prevalence of Methicillin-resistant Staphylococcus aureus in different clinical isolates in a tertiary care hospital
Authors: Chaudhury Nabamita , Biswas Tanusri , Mondal Raston , Aroni Chatterjee  , Saswati Chattopadhyay  , Nag Soumi
Published: June 2022

Background: Staphylococcus aureus is a Gram-positive cocci bacterium responsible for variety of infections. Emergence of Methicillin-resistant S. aureus (MRSA) strains has led to a greater threat in different clinical settings. Early identification of MRSA in different infections is an effective measure to prevent and treat such systemic infections.
Aims and Objectives: This study aims to isolate and identify MRSA with their antibiotic sensitivity in different clinical samples.
Materials and Methods: A total of 2041 clinical samples from January to June 2021were collected and processed at the Microbiology Department of Burdwan Medical College and Hospital. S. aureus was identified and their antibiotic susceptibility testing was determined. MRSA/methicillin-sensitive S. aureus (MSSA) were identified by cefoxitin disc (30 mcg/disc) and their susceptibility to vancomycin and MIC determined by Etest following British Society for Antimicrobial Chemotherapy (BSAC) guidelines.
Results: Of 2041 samples, 358 (13.36%) isolates were S. aureus, of which 207 (57.82 %) MRSA and 151 (42.18%) MSSA. Among the 207 MRSA isolates, 40% were from patients with sepsis, 18.36% from pyrexia of unknown origin, 12.56% from surgical site infection, and 10.62% from ventilator-associated events. The highest number (55.55%) of MRSA was isolated from blood followed by 27.05% of isolates were from pus. All the isolates were sensitive to vancomycin with MICs of 0.5 μg, 0.75 μg, 1.0 μg, and 1.5 μg according BSAC and also very good sensitivity to levofloxacin and piperacillin/tazobactam.
Conclusion: The increasing prevalence of MRSA is posing a real threat to the health-care system. Careful detection and judicious use of antibiotics are the only answer.
Dermatoglyphics - A predictor of disease
Authors: Tewari Jay , Tewari Vineeta , Munsif Tahsin , Kapoor Prince , Tewari Ajoy
Published: June 2022

Dermatoglyphics is the scientific study of the pattern of dermal ridges on the palmar surface of digits, palm and sole. Characteristically, hair does not grow in this area. These ridges serve well to enhance contact. The development of these ridges and the development of the nervous system occur simultaneously in the intrauterine period. The pattern of dermal ridges begins to develop around the 13th week and is completed by the 19th week of intrauterine life. Once the fingerprint pattern develops, it does not change and persists throughout life. Unusual dermatoglyphic patterns often relate to genetic disorders. Dermatoglyphics may be used as an additional screening tool to identify early risk factors that may help prevent additional complications of various diseases. In this review, we will be discussing dermatoglyphics and its important role in the diagnosis of diseases which have some genetic basis.
Recurrent granular myringitis: Medical management revisited
Authors: Surbhi  , Shaheen Zafar  , Rohit Kumar
Published: June 2022

Background: Granular myringitis (GM) is one of the rarer conditions reported in Indian literature. It is defined as a chronic inflammation limited to squamous layer of tympanic membrane. Several names have been given to it such as myringitis granulosa, acute granulomatous myringitis, and chronic myringitis.
Aims and Objectives: The objective of our study is to evaluate the results of topical antibiotic with steroids and topical antibiotic alone on disease pathology of GM and its outcome.
Materials and Methods: This study was conducted in the department of otorhinolaryngology on 80 patients from the period of September 2020–December 2021 on patients of GM after complete clinical evaluation. This is a prospective study made on two groups of patients. The results were analyzed by visual analog scale.
Results: Both the groups after a period of 6 months showed improved results. The outcome with antibiotic with steroid was comparatively faster and superior than antibiotic only ear drops.
Conclusion: The result of antibiotic with steroid ear drops is superior to antibiotic only ear drops in the treatment of recurrent GM.
Attenuation of metabolic stress response during spinal surgery under general anaesthesia - A comparison between preoperative carbohydrate drink or no carbohydrate load
Authors: Hossain Arif , Mandal Sangita , Chakrabarti Soumya , Mandal Mohanchandra , Acharjee Amita
Published: June 2022

Background: Surgery is a stress which stimulates the increase of counter regulatory hormones. Pre-operative prolonged fasting increases stress further. Although a pre-operative carbohydrate (CHO) drink has been variably reported to yield benefit in reducing the perioperative stress and is being used frequently for elective surgeries, some recent reports also reports that preoperative CHO loading did not result in increase or decrease in the post-operative complication rates when compared with placebo or fasting group.
Aims and Objectives: The present study was designed to determine the stress response in the postoperative period at 24 h in terms of changes in the levels of cortisol and other biomarkers.
Materials and Methods: This randomized, parallel group, and double-blind study was conducted in 75 patients aged 18–65 years, of American Society of Anesthesiologists Physical Status Classes I and II, scheduled for elective lumbar spine surgery under general anesthesia. The patients were randomly allocated to receive 300 ml plain water at 9 pm on the day before surgery and 2 h before operation (Group C, control, n=25), or 300 ml plain water at 9 pm on the day before surgery and solution containing 75 grams of glucose dissolved in 300 ml water in the morning 2 h before surgery (Group CHO-1, n=25), or to receive 75 grams of glucose dissolved in 300 ml water at 9 pm in the night before the surgery and again in the morning at 2 h before surgery (Group CHO-2, n=25). In all the three groups, the levels of insulin (C-peptide), lactate, glucose, and cortisol were determined preoperatively (before the induction of anesthesia) and 24 h postoperatively.
Results: There was considerable difference between post-operative blood cortisol level among the three groups (583.9 vs. 462.3 vs. 389.6 nMol/L, Control vs., CHO load once or twice, respectively, P<0.0001). A significant difference in post-operative values was also seen with other parameters such as serum lactate, glucose, and C-peptide. Considerable differences were seen in both preoperative and postoperative period in case of cortisol and lactate whereas it was limited to postoperative values in case of glucose and C-peptide.
Conclusion: Pre-operative glucose loading showed better efficacy in suppressing perioperative stress response in terms of less rise of serum cortisol and lactate as compared to no CHO load.
A 10-year experience of hydatid cysts of lung in association with other extrathoracic system involvement in a tertiary care hospital in Kolkata, India
Authors: Surendra Singh Yadav  , Ushnish Chakrabarty  , Swarnendu Datta  , Madhusudan Pal
Published: June 2022

Background: The metacystode of tapeworm Echinococcus causes hydatid disease. Infection in man is mainly caused by Echinococcus granulosus. Surgical intervention to treat complicated hydatid cyst (HC) is different from uncomplicated HC.
Aims and Objectives: The present study was performed with an aim to review 82 cases of pulmonary HCs and associated HCs in other locations. We analyze and evaluate our experience in the surgical treatment and complication.
Materials and Methods: In a 10-year period, from August 1, 2005, to July 31, 2015; 82 patients were operated on in our hospital for HCs in pulmonary as well as other associated extrapulmonary locations. The diagnosis was established on the basis of clinical features and imaging studies supplemented by serological test. Surgical approach consisted of a posterolateral thoracotomy in all cases of thoracic HCs. For cysts in extrathoracic locations, either laparotomy or local excisions were performed.
Results: Radical resections [lobectomy] were done in four cases, and conservative operations in the remaining. Post-operative complications occurred in 12 cases (14.63 %). We had two recurrences, three cases of prolonged air leak with bronchopleural fistula, two had atelectasis, and five wound infections. At 6 months follow-up, 97.56% of our patients were free of any recurrence.
Conclusion: HCs of the lung are best treated with surgery. Even when associated with HCs in other locations in the body, surgery is considered the treatment of choice. When supplemented with long-term perioperative Albendazole therapy, the chance of recurrence is practically negligible.
Examination of the primary fraction of hemoglobin in individuals having sickle cell disease using high-performance liquid chromatography
Authors: Manoj Kumar Mohapatra  , Bariha Prafulla Kumar , Tudu Kshetramohan , Jajodia Nawal Kishore
Published: June 2022

Background: Hemoglobinopathies refer to a range of diseases, in which the hemoglobin (Hb) molecule’s synthesis or structure is aberrant. It is passed down through the generations (inherited). Hb C illness, Hb S-C disease, sickle cell anemia, and thalassemia are all part of this group. Hemoglobinopathies are the most frequent genetically inherited red blood cell condition on the planet. Hb variant screening and precise identification have become more crucial in the antenatal diagnosis and prevention of Hb diseases.
Aims and Objectives: Hb analysis, cation exchange high-performance liquid chromatography (HPLC) has emerged as the method of choice. This research was brought up to diagnose numerous hemoglobinopathies and also to measure distinct Hb fractions.
Materials and Methods: Four hundred and seventy participants were examined for hemoglobinopathies in the investigation. Different fractions of Hb were compared to patients with normal Hb after diagnosis.
Results: Normal HPLC, SCA (Hb SS), sickle cell trait (SCT), and -thalassemia trait were discovered in 110 (23.4%), 130 (27.6%), 210 (44.6%), and 20 (4.2%) individuals, respectively, out of 470 patients. Rare hemoglobinopathies such as tenacious fetal Hb (PFH), Hb E, Hb D-Punjab, and Hb Q India accounted for 15 (3.1%) of the sufferers. Patients with SCA had a mean percent of Hb S, Hb F, Hb A, and Hb A2 of 81.6±74.6, 22.9±13.9, 3.1±6.1, and 2.5±1.02, respectively. Hb F was 22.9±13.9% on average, which was much higher than normal and SCT. A high HbA2 level (>3.5%) indicated the existence of the β-thalassemia trait.
Conclusion: In the included section of the population, SCD is the most common kind of hemoglobinopathy, both homozygous and heterozygous. Hb F concentrations are observed to be elevated in SCA patients, and it is thought to be a key element in protecting patients from problems. Raised Hb A2, which indicates the presence of the β-thalassemia trait, was also discovered in this area, and it is suspected when the value is >3.7%. Cation exchange HPLC is ideal for routine hemoglobinopathies research due to its high resolution, short test time, and precise quantification.
Chronic low back pain – its association with lumbar spinal canal diameter – a cross-sectional hospital-based study in a tertiary care hospital in North Bengal
Authors: Mandal Mahadeb , Chakraborty Durga Prasad , Chattopadhyay Aniruddha , Sarmah Pulakesh , Bera Nirmal Kumar
Published: June 2022

Background: Low back pain (LBP) is a very common cause of disability in working age adults, lumbar canal stenosis (LCS) being one of the chief anatomical correlates. However, number of studies seeking role of LCS in the origin of LBP are not many, particularly in India.
Aims and Objectives: The aims of this study were to investigate LBP and its relation to lumbar canal diameter (LCD), also to evaluate the impact of psychosomatic factors on LBP.
Materials and Methods: Eighty symptomatic (LBP) and 41 asymptomatic (without LBP) subjects were chosen and LCD for three lowest lumbar segments measured by 1.5 Tesla magnetic resonance imaging for both symptomatic and asymptomatic subjects was ascertained. Canal diameters of both groups were compared by Pearson’s Chi-square test. Pain intensity of patients was assessed using visual analog scale (VAS)-pain score. Using tests of normality and non-parametric test Spearman’s rank coefficient, correlation between VAS score (pain intensity) and lowest canal diameter of the cases was evaluated. To evaluate the role of psychosomatic factors in LBP, the number of subjects (LBP) with somatic symptoms disorder (SSD) score ≥8 was ascertained.
Results: The results were as follows: (1) Significant association between presence of LCS (diameter <10 mm) and LBP (P=0.015). (2) No significant correlation between intensity of LBP (VAS score) and LCD. (3) 13.75% of LBP patients had SSD (Male 8% and Female 23.33%).
Conclusion: LCS may be an important factor in the origin of LBP. More studies are needed in this regard and also seeking correlation between LBP and other anatomical factors. Psychosocial factors may play important role in the origin and maintenance of LBP.
Study of different type of the management of patients in cases of traumatic colorectal injury in tertiary hospital in West Bengal
Authors: Chandranath Banerjee  , Sajal Kumar Sarkar  , Shyamal Hansda  , Patra Kajal Kumar
Published: June 2022

Background: Although the treatment strategy for colorectal trauma has advanced during the last part of the 20th century and the result has improved and compared to other injuries and problems, such as high septic complication rates and mortality rates, still exist, so standard management for colorectal trauma is still a controversial issue.
Aims and Objectives: This study aims to determine the factors that affect morbidity and mortality in colon and rectum injuries.
Materials and Methods: This study was prospective cohort study. The study was conducted at Burdwan Medical College and Hospital, West Bengal from May 2019 to October 2020 including 80 patient of trauma over abdomen. Thorough history taking and clinical examination were done. Template was generated in MS Excel sheet and analysis was done on statistical package for the social sciences software.
Results: Among 80 patients, the majority of the patients were in the age group of 21–30 years (45%). Majority 69 patients (86.25%) were males and 11 patients (13.75%) were females. Gunshot wounds were found in maximum 41 (51.3%) and stab wounds in 27 (33.7%). Colon was injured in 68 (85%) patients and the rectum in 12 (15%) patients. CIS Grade 1, 2, and 3 was observed in 69 (86.3%) patients. Primary repair was performed in 45.0% (36) patients. Resection and anastomosis management was given to 32 (40.0%) patients.
Conclusions: If colorectal injuries are not treated appropriately, severe complications leading to death may be induced; nonetheless, controversy still exists concerning the standard treatment. In this regard, unnecessary proximal diversions should be avoided.
Role of C-reactive protein, lactate dehydrogenase, Vitamin D, and interleukin-6 in the prognosis of COVID-19 – A retrospective study in a tertiary care hospital in Tamil Nadu
Authors: Sivakumar J , Anitha G , Ponnazhagan K
Published: June 2022

Background: SARS-COV-2 is also known as coronavirus causes an infectious disease has caused a global concern due to its pandemic nature. In India, nearly 36 million cases and 5.1 lakh deaths have been recorded so far. Laboratory biomarkers play an important role in improving the clinical situational awareness by predicting risk stratification and by discriminating between severe and non-severe cases. There is no sufficient information available regarding the role of C-reactive protein (CRP), lactate dehydrogenase (LDH), Vitamin D, and interleukin-6 (IL-6) in the prognosis of COVID-19 patients in Southern part of India.
Aims and Objectives: We aim to retrospectively analyze CRP, LDH, Vitamin D, and IL-6 in COVID-19 patients.
Materials and Methods: The observational and retrospective study was carried out from the case records of 103 patients from November 2021 to February 2022 in which CRP, LDH, Vitamin D, IL-6, COVID-19 Reporting and Data System (CO-RADS), and CT sore were analyzed during admission and follow-up period in the hospital. Mean, mean difference, standard deviation, standard error difference, and P value were calculated. P<0.05 was considered to be significant.
Results: CRP, LDH, IL-6, Vitamin D, CO-RADS, and CT score were decreased during the follow-up period when these levels were compared at the time of admission in the hospital, while there is an increase in Vitamin D levels during the follow-up period.
Conclusion: The use of reliable and easy to use assays such as CRP, LDH, Vitamin D, and IL-6 plays an important role in the diagnosis and prognosis of COVID-19.
Pandenomics: Unmasking the Global Recovery Woes
Authors: Sthapit Arhan
Published: June 2022

The World Bank’s predictions of a strong rebound in the global economy, not seen in the last five decades, are mainly based on the assumption that the mass COVID-19 vaccinations and the government stimulus packages running into trillions of dollars in the rich countries will stimulate growth worldwide. Likewise, it is but natural that even a meagre economic rise this year will post a bigger figure against last year’s poor economic performance hit hard by the pandemic. However, ‘under-managed’ developing countries like Nepal that have neither been able to mass vaccinate their population nor roll out economic stimulus packages are unlikely to share the global growth and reap the growth dividends. Instead, the pandemic is expected to push millions of people into deeper poverty, exacerbated by higher food prices and agricultural commodities worldwide over the last year due to a supply-chain disruption. Adding to these woes, considerable chunks of the population in poor countries like Nepal have been unable to work to eke out a living due to the lockdown imposed to break the chain of infection. The economic recovery woes are most likely to persist.
Precise measurement on the binding energy of hypertriton from the nuclear emulsion data using analysis with machine learning
Authors: Kasagi Ayumi , Liu Enqiang , Nakagawa Manami , Ekawa Hiroyuki , Yoshida Junya , Dou Wenbo , Muneem Abdul , Nakazawa Kazuma , Rappold Christophe , Saito Nami , Saito Takehiko , Taki Masato , Tanaka Yoshiki , Wang He
Published: June 2022

A machine learning model has been developed to search events of production and decay of a hypertriton in nuclear emulsion data, which is used for measuring the binding energy of the hypertriton at the best precision. The developed model employs an established technique for object detection and is trained with surrogate images generated by Monte Carlo simulations and image transfer techniques. The first hypertriton event has already been detected with the developed method only with 10−4 of the total emulsion data. It implies that a sufficient number of hypertriton events will soon be detected for the precise measurement of the hypertriton binding energy.
Comparison of Automatic Sleep Stage Classification Methods for Clinical Use
Authors: Labrada Alexei , Santos Febles Elsa , Manuel Antelo José
Published: June 2022

Sleep stage scoring is necessary for diagnosing several sleep disorders. However, it is an intensive and repetitive task and a vital automation candidate. This work seeks to evaluate different kinds of Machine Learning based classification algorithms available in the scientific literature to determine which one fits better the clinical practice requirements. The comparison is made with a predefined experimental design, using electroencephalography, electrooculography, and electromyography signals from the polysomnographic records of the Sleep-EDFx dataset. The comparison considers the accuracy and speed of algorithms based on Linear Discriminate Analysis, Support Vector Machines, Random Forests, and Artificial Neural Networks. The latter group includes the Deep Neural Networks DeapFeatureNet, based on Convolutional Neural Networks, and DeepSleepNet, additionally based on Recurrent Neural Networks. It is determined that several of the tested algorithms boast high accuracy levels (85%). From them, DeepSleepNet is chosen as the fittest due to its considerable advantage in execution time. Nevertheless, the final result should always be reviewed by the experts.
COVID-19, a blessing in disguise: the experience of a Nigerian radiotherapy engineer
Authors: Adio Oluwasegun O. , Uwadiae Iyobosa B. , Adewumi Alaba O.
Published: June 2022

The health technology sector of low- and middle-income countries (LMICs) is bedeviled by performance failures that make it a significant obstacle to effective patient healthcare interventions. The predominant factors behind the sector’s poor performance have been identified as (a) inadequately trained technical personnel and (b) the unserviceable condition of medical equipment.
Past studies show that after adequate training, there is an increase in the proficiency of in-hospital biomedical engineers, but the studies have been limited to the maintenance job description of the engineers. We present a case study of the successful installation of sophisticated medical equipment by an in-hospital engineer to demonstrate that comprehensive training can also develop the installation expertise of local engineers. The installation, which is usually accomplished by the equipment manufacturer, was delegated to the trained in-hospital engineer due to the COVID-19 pandemic.
Furthermore, the bulk of medical equipment in LMICs is imported, which has led to an over-dependence of their health sectors on non-indigenous technology to the detriment of local alternatives and know-how. The World Health Organization estimates that 7 out of 10 sophisticated medical equipment imported by LMICs are unserviceable due to the issue of compatibility and adaptability with the setting. Previous research focuses on equipment subsidy, frugal innovation, and health technology management to better adapt foreign equipment to the environment. Still, this paper explores the option of indigenous technology and expertise to provide in-country development of suitable and sustainable medical equipment.
Book Review
Authors: Lilley Lloyd
Published: June 2022

This book review is about the Elsevier Academic Press newly published Cybersecurity for Connected Medical Devices by author Arnab Ray, Ph.D.
Becoming “Multilingual” Professional French Language Teachers in Transnational and Contemporary Times: Toward Transdisciplinary Approaches
Authors: Byrd Clark Julie S. , Roy Sylvie
Published: June 2022

Cet article présente de nouvelles façons de penser à « devenir multilingue » à l’ère transnationale en examinant l’importance du multilinguisme pour les étudiants multilingues inscrits à des programmes de formation en enseignement du français dans les provinces de l’Alberta et de l’Ontario. Comme la diversité est plus présente dans les classes d’enseignement en français, nous ne pouvons plus de considérer ce multilinguisme comme étant un objet figé ni continuer à considérer les identités linguistiques comme étant statiques. À partir d’une approche ethnographique et sociolinguistique et d’un cadre analytique du discours, nos résultats révèlent certaines des pratiques et représentations linguistiques complexes des futurs enseignants. Cet article s’appuie sur les données initiales recueillies à partir d’observations, de commentaires en ligne et d’entretiens en classe. Nos conclusions révèlent: (1) comment certaines représentations sont construites, valorisées, négociées et contestées; et (2) de quelle manière les normes linguistiques ont un impact (ou entravent) le développement de répertoires multilingues. Ces résultats nous fournissent des moyens essentiels d’observer ce que les futurs enseignants multilingues font avec la langue, mais aussi comment et pourquoi ils font ce qu’ils font, comment ils se présentent eux-mêmes dans des espaces différents, comment ils sont perçus par les autres dans certains contextes et comment certaines représentations deviennent significatives et incarnées. Cette étude peut aussi influencer les pratiques enseignantes dans les classes multilingues.
SENSITIZATION TO MOLECULAR COMPONENTS OF MALASSEZIA ALLERGENS IN CHILDREN WITH ATOPY
Authors: Mozyrska O.V.
Published: June 2022

The aim

Violation of the epidermal barrier can lead to percutaneous sensitization to microbial products or allergens. The interaction between the yeast Malassezia and the skin's immune system contributes to skin inflammation in patients with atopic dermatitis. The aim of this study was to determine the sensitization to the molecular components of the yeast Malassezia (Mala s 5, Mala s 6, Mala s 11) in children with atopy.

Methods

The study included 333 children aged 1 to 18 with atopy, with symptoms of bronchial obstruction, allergic rhinitis, atopic dermatitis or urticaria. All patients / parents gave informed consent to participate. Spearman's rank test (ρ) was used to assess the correlation between total sIgE, specific sIgE, and age.

Results

Among 333 children with atopy, specific IgE to Mala s 5 was detected in 20.1 % children, to Mala s 6 in 64.6 %, and to the allergen Mala s 11 in 23.1 % children. The level of antibodies to Mala s 5 and Mala s 6 correlate with total serum IgE (ρ = 0.161 and ρ = 0.112, respectively). The correlation was also found between the level of specific IgE to Mala s 11 and to Mala s 6 (ρ = -0.351), and Mala s 5 and Mala s 6 (ρ = -0.490). Correlation of specific IgE and age was detected for the molecular component Mala s 6 (ρ = -0.126).

Conclusions

Sensitization to the molecular components of yeast (Mala s 5, Mala s 6, Mala s 11) was quite common among children with allergic diseases. Sensitization to Mala s 6 was most common in children. The highest values of sIgE were observed for Mala s 11 ‒ in 23.9% of patients. For future clinical trials, it is important to consider intrapersonal anatomical variations in skin microbiota, individual susceptibility, sex, age, seasonality, and ethnicity.
À l’ère de l’euthanasie : la clinique du deuil en contexte de mort anticipée
Authors: Laperle P. , Achille M. , Ummel D.
Published: June 2022

Les soignants en oncologie et en soins palliatifs gagnent à considérer les effets de l’euthanasie sur leur pratique. Choisir les circonstances de sa mort est dans l’ère du temps, ce qui influence les trajectoires de soins. Ainsi, il devient pertinent de s’intéresser à l’impact du décès anticipé (euthanasique ou naturel) à la fois sur l’accompagnement du patient et sur celui des proches endeuillés. À cet égard, nous proposons une approche relationnelle et des pistes d’intervention fondées sur les empreintes laissées par la mort et le paysage relationnel du deuil.
Étude observationnelle des comportements familiaux durant la phase palliative terminale
Authors: Van Lander A. , Bioy A. , Guastella V.
Published: June 2022

Accompagner l’entourage d’un patient atteint de maladie grave, évolutive ou terminale est une obligation légale (loi 99, art. L. 1er B) et nécessite des professionnels éclairés sur les mécanismes spécifiques. Objectif : découvrir les mécanismes psychoadaptatifs familiaux lors de la phase terminale. Méthode : la méthode était qualitative avec une observation participante dans un service de soins palliatifs entre 2016 et 2020. Résultats : l’observation de 649 familles révèle des détresses spécifiques, une relation soignante et/ou fusionnelle et un pacte dénégatif sur le mourir. L’absence de communication familiale sur le mourir est protectrice. Conclusion : les accompagnements doivent s’adapter aux fonctionnements de la famille. Elle est le berceau de la vie psychique du patient.
Performative and Eidetic Simulations
Authors: Magomedov Elad
Published: June 2022

Different kinds of fakery and imposture can be differentiated by means of the imaginary regimes within which a performative simulation unfolds. Engaging with Sartre’s analysis of the imaginary, we will identify three such regimes, calling them the objective, the reflective, and the phantasmatic. Each of these regimes involves its own kind of image and accordingly a specific type of simulation. It is proper to the objective image to attain dissimulation of the self by replacing the real with fiction. In the reflective regime, the real is not substituted by the imaginary, but rather contaminated by it. Finally, whereas the objective and the reflective regimes operate within the sphere of intentional (dis)simulation, the phantasmatic image carries us beyond Sartre’s findings, as it shapes the very structure of pre-reflective disclosedness which provides the background for our projects.
Deconstructing Sartre
Authors: Betschart Alfred
Published: June 2022

François Noudelmann, Un tout autre Sartre (Paris: Gallimard, 2020), 206 pp. ISBN 978-2-07-288710-9. €18/e-book €13.
Book Reviews
Authors: Johns Charles William , Norris Marcos A.
Published: June 2022

Cox, Gary, How to Be an Existentialist: Or How to Get Real, Get a Grip and Stop Making Excuses, (London: Bloomsbury, 2020) 144 pp. ISBN 9781350068988 £9.99 (paperback).

Wicks, Robert L. Introduction to Existentialism: From Kierkegaard to The Seventh Seal. (London: Bloomsbury, 2020) 240 pp. ISBN 9781474272520 £21.59 (paperback).

French and Italian Stoicisms: From Sartre to Agamben. Edited by Kurt Lampe and Janae Sholtz. (London: Bloomsbury Academic, 2021), 237 pp. ISBN 978-1-3500-8203-8 (hardcover).
Digital cognitive testing using a tablet-based app in patients with brain tumors: a single-center feasibility study comparing the app to the gold standard
Authors: Butenschoen Vicki M. , Ahlfeld Jasmin , Meyer Bernhard , Krieg Sandro M.
Published: June 2022

OBJECTIVE

Healthcare digitization has led to increasing tablet-based apps to improve diagnostics, self-discipline, and well-being in patients. Moreover, patient-reported outcome measures are crucial for optimized treatment, with superior applicability if independent from patient visits. Whereas most uses cover health maintenance, only a few studies have focused on cognitive testing in neurosurgical patients despite its nature as one of the most integrative outcome measures in neurooncology.

METHODS

The authors performed a prospective single-center feasibility study including neurosurgical patients affected by intraaxial tumors and healthy subjects, testing cognitive function by using a digitized app-based approach and conventional paper-and-pencil (PP) tests. Healthy subjects underwent follow-up testing for retest reliability.

RESULTS

The authors included 24 patients with brain tumor and 10 healthy subjects, all of whom completed both tests. Equivalent mean performance results were found in the tablet-based digital app and PP counterparts; whereas the digital approach had shorter test duration in patients (29.9 minutes for PP vs 21.9 minutes for app, p = 0.019) and in the healthy cohort (23.2 minutes for PP vs 16.4 minutes for app, p = 0.003), patients with brain tumor scored lower when both test strategies were applied. Results were consistent in healthy subjects after a median of 3 months.

CONCLUSIONS

Cognitive function assessment is feasible using a digitized tablet-based app, with equivalent results to those of PP tests in healthy subjects and patients with brain tumor. Thus, this approach allows much closer follow-up independent of patient visits and might provide a viable option to improve patient follow-ups.
Family-acquired photographs for the evaluation of pediatric head shape via telemedicine: an analysis of photograph quality
Authors: Paro Mitch R. , Lambert William A. , Leclair Nathan K. , Chakraborty Arijit R. , Angelo Sophia , Pesante Benjamin , Stoltz Petronella , Martin Jonathan E. , Bookland Markus J. , Hersh David S.
Published: June 2022

OBJECTIVE

Telemedicine can be an effective tool for the evaluation of the pediatric patient with a cranial deformity, but it increases the reliance of neurosurgical providers on data provided by patients and families. Family-acquired photographs, in particular, can be used to augment the evaluation of pediatric head shape abnormalities via telemedicine, but photographs of sufficient quality are necessary. Here, the authors systematically reviewed the quality and utility of family-acquired photographs for patients referred to their pediatric neurosurgery clinic for telemedicine-based head shape evaluations.

METHODS

All telemedicine encounters that were completed for head shape abnormalities at the authors’ institution between May 2020 and December 2021 were retrospectively reviewed. Instructions were sent to families prior to each visit with examples of ideal photographs. Three orthogonal views of the patient’s head—frontal, lateral, and vertex—were requested. Data were collected regarding demographics, diagnosis, follow-up, and photograph quality. Quality variables included orthogonality of each requested view, appropriate distance, appropriate lighting, presence of distracting elements, and whether hair obscured the head shape.

RESULTS

Overall, 565 patients had 892 visits during the study period. A total of 1846 photograph requests were made, and 3335 photographs were received for 829 visits. Of 2676 requested orthogonal views, 1875 (70%) were received. Of these, 1826 (97%) had adequate lighting, 1801 (96%) had appropriate distance, and 1826 (97%) had no distracting features. Hair did not obscure the head shape on the vertex view in 557 visits with orthogonal vertex views (82%). In-person follow-up was requested for further medical evaluation in 40 visits (5%).

CONCLUSIONS

The family-acquired photographs in this series demonstrated high rates of adequate lighting and distance, without distracting features. Lack of orthogonality and obscuration of the head shape by hair, however, were more common issues. Family education prior to the visit may improve the quality of family-acquired photographs but requires an investment of time by medical staff. Efforts to further improve photographic quality will facilitate efforts to perform craniometric evaluations through telemedicine visits.
Feasibility of smart glasses in supporting spinal surgical procedures in low- and middle-income countries: experiences from East Africa
Authors: Sommer Fabian , Waterkeyn Francois , Hussain Ibrahim , Goldberg Jacob L. , Kirnaz Sertac , Navarro-Ramirez Rodrigo , Ahmad Alaaeldin Azmi , Balsano Massimo , Medary Branden , Shabani Hamisi , Ng Amanda , Gadjradj Pravesh Shankar , Härtl Roger
Published: June 2022

OBJECTIVE

Telemedicine technology has been developed to allow surgeons in countries with limited resources to access expert technical guidance during surgical procedures. The authors report their initial experience using state-of-the-art wearable smart glasses with wireless capability to transmit intraoperative video content during spine surgery from sub-Saharan Africa to experts in the US.

METHODS

A novel smart glasses system with integrated camera and microphone was worn by a spine surgeon in Dar es Salaam, Tanzania, during 3 scoliosis correction surgeries. The images were transmitted wirelessly through a compatible software system to a computer viewed by a group of fellowship-trained spine surgeons in New York City. Visual clarity was determined using a modified Snellen chart, and a percentage score was determined on the smallest line that could be read from the 8-line chart on white and black backgrounds. A 1- to 5-point scale (from 1 = unrecognizable to 5 = optimal clarity) was used to score other visual metrics assessed using a color test card including hue, contrast, and brightness. The same scoring system was used by the group to reach a consensus on visual quality of 3 intraoperative points including instruments, radiographs (ability to see pedicle screws relative to bony anatomy), and intraoperative surgical field (ability to identify bony landmarks such as transverse processes, pedicle screw starting point, laminar edge).

RESULTS

All surgeries accomplished the defined goals safely with no intraoperative complications. The average download and upload connection speeds achieved in Dar es Salaam were 45.21 and 58.89 Mbps, respectively. Visual clarity with the modified white and black Snellen chart was 70.8% and 62.5%, respectively. The average scores for hue, contrast, and brightness were 2.67, 3.33, and 2.67, respectively. Visualization quality of instruments, radiographs, and intraoperative surgical field were 3.67, 1, and 1, respectively.

CONCLUSIONS

Application of smart glasses for telemedicine offers a promising tool for surgical education and remote training, especially in low- and middle-income countries. However, this study highlights some limitations of this technology, including optical resolution, intraoperative lighting, and internet connection challenges. With continued collaboration between clinicians and industry, future iterations of smart glasses technology will need to address these issues to stimulate robust clinical utilization.