116 research outputs found

    New Recordkeeping on the Block: An Assessment of 2 Blockchain- Based Recordkeeping Systems

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    This study explores the application of blockchain technology to recordkeepingpractices. To that end, two blockchain-based recordkeeping platforms—ARCHANGEL and RecordsKeeper—were evaluated according to the three criteriaoutlined in T. D. Smith’s evaluation framework for blockchain-based recordkeepingplatforms—dependabilty, security, and trust.The results of these two evaluations demonstrate blockchain technology’s inability toprovide viable long-term solutions for sustainable records management as yet. Thisstudy also suggests supplementing Smith’s framework with more blockchain-specificquestions to ensure a more comprehensive evaluation of the use of blockchain in suchplatforms. Finally, this study recommends adding a fourth criteria, sustainability, tothe framework.Master of Science in Information Scienc

    Benign mixed epithelial stromal tumor of the renal pelvis with exophytic growth: case report

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    BACKGROUND: Mixed epithelial and stromal tumor (MEST) is a distinctive benign composite neoplasm of the kidney predominantly seen in females mostly in the perimenopausal period. Although these tumors are known to arise from renal pelvis, our case was distinct in that it had no intrapelvic component growing in exophytic fashion. CASE REPORT: A 35 year old female patient presented to us with vague abdominal pain. She had undergone excision of bilateral ovarian cystic masses for cystic teratoma twelve years earlier. A computed tomography scan of abdomen and pelvis showed a 9 Ă— 7 cm uniformly solid mass with poor contrast enhancement situated in the inferomedial aspect of the left kidney. On exploration, the mass was arising from the inferior and anterior aspect of left renal pelvis, and was attached to it with a narrow pedicle. There was no adherence or attachment to the renal parenchyma. The mass was excised preserving the kidney. Microscopically, the tumor was composed of large collagenized areas containing bundles of spindle cells and several 'microcysts' lined by cuboidal epithelium suggestive of a benign mixed epithelial stromal tumor. DISCUSSION: Mixed epithelial tumors usually present in perimenopausal women as a partially cystic mass. Tumors are composed of irregular mixtures of cystic and solid areas, glands with variable complexity and distribution and the stromal component is characterized by a spindle cell proliferation. Commonly, it arises from the renal parenchyma and pelvis and nephrectomy is advocated to manage these tumors. CONCLUSION: MEST is a distinctive benign tumor of the kidney that should be distinguished from other renal neoplasms. MEST arising from the renal pelvis and growing exophytically is a rare entity. The overall prognosis is favorable

    Etiological review and outcome of thrombocytopenia in pregnancy in the tertiary care centre

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    Background: Objective of the study was to identify and analyse the etiology of thrombocytopenia in pregnancy and review the evaluation of thrombocytopenia and its outcome in pregnancy. Methods: Retrospective study conducted at D. Y. Patil Hospital, Kolhapur, Maharashtra, India, from January 2021 to January 2023, in the Department of Obstetrics and Gynecology. All the antenatal women admitted in the ward of obstetrics and gynecology with platelet count less than 1 lakh/cubic cc were included in the study. Thorough evaluation for the cause of thrombocytopenia and outcome of the patient were collected and results were analyzed. Results: Out of 3319 deliveries, 100 patients had platelet counts less than 1 lakh. Overall, in the present study, Gestational thrombocytopenia (38%) is the most common cause of low platelets in pregnancy, followed by pre-eclampsia (20%) and DIC (16%). The rest of the etiologies rarely cause thrombocytopenia in pregnancy (<10%). Conclusions: Despite thrombocytopenia is a common abnormality in pregnancy, it seldom leads to life-threatening complications by itself. By contrast, a significant thrombocytopenia associated with medical conditions can have serious maternal-fetal consequences and requires appropriate management. The management of thrombocytopenia focuses on the underlying cause/etiology which is challenging because there are many potential causes, some directly related to the pregnancy and some unrelated. Cause directed therapies, if promptly administered, may significantly improve the maternal and fetal outcomes. Study intended to evaluate the wide spectrum of causes for thrombocytopenia in pregnancy and its outcome. Preeclampsia with or without HELLP syndrome is found to be very important cause of severe thrombocytopenia and attributed with maternal complications. while the perinatal outcome of gestational thrombocytopenia and immune thrombocytopenic purpura is basically favourable

    Circulating serum fatty acid synthase is elevated in patients with diabetes and carotid artery stenosis and is LDL-associated

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    BACKGROUND AND AIMS: Diabetes is an independent risk factor for carotid artery stenosis (CAS). Fatty acid synthase (FAS), an essential de novo lipogenesis enzyme, has increased activity in the setting of diabetes that leads to altered lipid metabolism. Circulating FAS (cFAS) was recently observed in the blood of patients with hyperinsulinemia and cancer. We thought to evaluate the origin of cFAS and its role in diabetes-associated CAS. METHODS: Patients with diabetes and no diabetes, undergoing carotid endarterectomy (CEA) for CAS, were prospectively enrolled for collection of plaque and fasting serum. FPLC was used to purify lipoprotein fractions, and ELISA was used to quantify cFAS content and activity. Immunoprecipitation (IP) was used to evaluate the affinity of cFAS to LDL-ApoB. RESULTS: Patients with CAS had higher cFAS activity (p \u3c 0.01), and patients with diabetes had higher cFAS activity than patients with no diabetes (p \u3c 0.05). cFAS activity correlated with serum glucose (p = 0.03, r CONCLUSIONS: Serum cFAS is higher in patients with diabetes and CAS, appears to originate from the liver, and is LDL cholesterol associated. We postulate that LDL may be serving as a carrier for cFAS that contributes to atheroprogression in carotid arteries of patients with diabetes

    Primary vaginal Ewing's sarcoma or primitive neuroectodermal tumor in a 17-year-old woman: a case report

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    <p>Abstract</p> <p>Introduction</p> <p>Primary Ewing's sarcoma or primitive neuroectodermal tumor of the genital tract of women is uncommon. Rarer still is its occurrence in the vagina, with only five cases described so far. Out of these, only one case was confirmed using molecular analysis.</p> <p>Case presentation</p> <p>We present an extremely rare case of Ewing's sarcoma or primitive neuroectodermal tumor in a 17-year-old Indian girl. She presented with a vaginal mass that was initially diagnosed as a malignant round cell tumor. Immunohistochemistry showed diffuse positivity for vimentin, membranous positivity for MIC2, and positivity for BCL2 and FLI-1. On the other hand, she was negative for cytokeratin, epithelial membrane antigen, desmin, Myo D-1, myogenin and smooth muscle actin. A diagnosis of primitive neuroectodermal tumor was thus offered. Furthermore, a molecular analysis of our patient using reverse transcription-polymerase chain reaction technique showed positivity for t(11; 22) (q24; q12) (EWSR1-FLI1), thus confirming the diagnosis of a Ewing's sarcoma/primitive neuroectodermal tumor. Our patient was offered chemotherapy on Institutional protocol EFT 2001.</p> <p>Conclusion</p> <p>This is a rare case of primary vaginal Ewing's sarcoma or primitive neuroectodermal tumor, which was confirmed with molecular analysis, in the youngest patient known so far. This study reinforces the value of integrating morphological features with membranous MIC2 positivity, along with application of molecular techniques in objective identification of an Ewing's sarcoma or primitive neuroectodermal tumor at uncommon sites.</p

    Using digital surveillance tools for near real-time mapping of the risk of infectious disease spread

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    Data from digital disease surveillance tools such as ProMED and HealthMap can complement the field surveillance during ongoing outbreaks. Our aim was to investigate the use of data collected through ProMED and HealthMap in real-time outbreak analysis. We developed a flexible statistical model to quantify spatial heterogeneity in the risk of spread of an outbreak and to forecast short term incidence trends. The model was applied retrospectively to data collected by ProMED and HealthMap during the 2013–2016 West African Ebola epidemic and for comparison, to WHO data. Using ProMED and HealthMap data, the model was able to robustly quantify the risk of disease spread 1–4 weeks in advance and for countries at risk of case importations, quantify where this risk comes from. Our study highlights that ProMED and HealthMap data could be used in real-time to quantify the spatial heterogeneity in risk of spread of an outbreak
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