Application of Data mining in Medical Applications

Abstract Data mining is a relatively new field of research whose major objective is to acquire knowledge from large amounts of data. In medical and health care areas, due to regulations and due to the availability of computers, a large amount of data is becoming available. On the one hand, practitioners are expected to use all this data in their work but, at the same time, such a large amount of data cannot be processed by humans in a short time to make diagnosis, prognosis and treatment schedules. A major objective of this thesis is to evaluate data mining tools in medical and health care applications to develop a tool that can help make timely and accurate decisions. Two medical databases are considered, one for describing the various tools and the other as the case study. The first database is related to breast cancer and the second is related to the minimum data set for mental health (MDS-MH). The breast cancer database consists of 10 attributes and the MDS-MH dataset consists of 455 attributes. As there are a number of data mining algorithms and tools available we consider only a few tools to evaluate on these applications and develop classification rules that can be used in prediction. Our results indicate that for the major case study, namely the mental health problem, over 70 to 80% accurate results are possible. A further extension of this work is to make available classification rules in mobile devices such as PDAs. Patient information is directly inputted onto the PDA and the classification of these inputted values takes place based on the rules stored on the PDA to provide real time assistance to practitioners

Case of left hip acute pediatric septic arthritis - polymicrobial etiology

Septic arthritis is a true orthopedic emergency, involving a severe bacterial, viral, or fungal joint infection that triggers inflammation and the degeneration of joint tissues. It typically affects joints such as the knee, hip, shoulder, or wrist. Early diagnosis and treatment are crucial to avoid long-term complications. Herein, we describe the case of an 8-year-old male patient who presented with complaints of spontaneous onset of hip pain and an abnormal gait. The patient was diagnosed with left hip septic arthritis and underwent a left hip arthrotomy under general anesthesia (GA). The patient was administered intravenous antibiotics for 21 days while being kept on non-weight-bearing mobilization. After 3 weeks, the patient's intravenous antibiotics were switched to oral antibiotics for the next 3 weeks. On the second follow-up visit, the patient showed significant improvement, with laboratory findings within normal limits

Assessment of myofascial pain syndrome among married female healthcare workers: a cross sectional comparative study in a tertiary care centre

Background: Myofascial pain syndrome (MPS) is common among females between ages 20-40 years. Psychosomatic and mechanical reasons are attributed as causative factors. Female health care workers (FHW) in hospitals with rapid patient turn over are vulnerable to develop MPS. Our aim was to ascertain the prevalence of MPS in married FHW working in various departments of the hospital and its association with poor sleep and work stress. Methods: We selected married FHWs in 20-50 years age group and divided them into two groups, medical and paramedical (those involved directly and indirectly with patient care respectively). MPS was diagnosed after detailed personal interview and clinical examination. Sleep duration was divided into less than 5 hours and more than 5hours. Presence of work-related stress and other medical parameters were also recorded. Results: A total of 150 medical and 150 paramedical FHWs were included in the study. Overall prevalence of MPS among FHWs was 42%, of which, medical group was 32% and paramedical was 52%. The paramedical group showed significantly higher prevalence of MPS (p: 0.02). Sleep was less than 5 hours in 29.3% of medical FHW and 13.3% of paramedical. This difference didn’t show any association to MPS (p=0.8). 38% FHW perceived excessive work stress, 40% were paramedical and 36% were medical. This didn’t correlate with prevalence of MPS (p=0.2) among them. Conclusions: Paramedical FHW experienced more MPS than medical and it was more of mechanical type and not due to work stress or sleep deprivation

Treatment of bronchial airway obstruction using a rotating tip microdebrider: a case report

BACKGROUND: Central airway obstruction is a common complication of lung cancer. The microdebrider is a new device available for treatment of central airway obstruction. CASE DESCRIPTION: We report a case a 59-yr-old male with T3N2M1 non-small cell lung cancer with malignant distal left mainstem obstruction treated successfully with a novel elongated rotating tip microdebrider via rigid bronchoscopy with sufficient length to reach distal bronchial lesions. DISCUSSION AND CONCLUSION: The microdebrider is an excellent addition to the spectrum of interventions available for the management of central airway obstruction with advantages including accuracy and immediate removal of debris without a need for separate suctioning or limitation in oxygenation

Arsenicosis, possibly from contaminated groundwater, associated with noncirrhotic intrahepatic portal hypertension.

BACKGROUND AND AIMS: Idiopathic noncirrhotic intrahepatic portal hypertension (NCIPH), a chronic microangiopathy of the liver caused by arsenicosis from use of contaminated groundwater, was reported from Asia. This study aimed to see, if in the twenty-first century, arsenicosis was present in NCIPH patients at our hospital and, if present, to look for groundwater contamination by arsenic in their residential locality. METHODS: Twenty-seven liver biopsy proven NCIPH patients, 25 portal hypertensive controls with hepatitis B or C related cirrhosis and 25 healthy controls, matched for residential locality, were studied. Eighty-four percent to 96 % of study subjects belonged to middle or lower socioeconomic category. Arsenicosis was looked for by estimation of arsenic levels in finger/toe nails and by skin examination. Arsenic levels in nails and in ground water (in NCIPH patients with arsenicosis) was estimated by mass spectrometry. RESULTS: Nail arsenic levels were raised in five (10 %) portal hypertensive study subjects [two NCIPH patients (both had skin arsenicosis) and three portal hypertensive controls]. All of these five patients were residents of West Bengal or Bangladesh. Skin arsenicosis was noted in three NCIPH patients (11 %) compared to none of disease/healthy controls. Ground water from residential locality of one NCIPH patient with arsenicosis (from Bangladesh) showed extremely high level of arsenic (79.5 μg/L). CONCLUSIONS: Arsenicosis and microangiopathy of liver, possibly caused by environmental contamination continues in parts of Asia. Further studies are needed to understand the mechanisms of such 'poverty-linked thrombophilia'

Three-Year Clinical Outcomes of the First South Asian Prospective Longitudinal Observational IgA Nephropathy Cohort

INTRODUCTION: Glomerular Research And Clinical Experiments—IgA Nephropathy in Indians (GRACE-IgANI) is the first prospective South Asian IgA nephropathy (IgAN) cohort with prespecified objectives, protocolized longitudinal follow-up, and extensive biosample collection. The baseline risk scores predicted high risk of kidney disease progression. METHODS: A total of 195 of 201 patients (97%) completed 3-year follow-up in September 2020. All patients received optimized supportive care, and those at high risk of progression were offered systemic corticosteroids. RESULTS: A total of 76 patients (76 of 193, 39.4%) had rapid progression in 3 years (≥5 ml/min per 1.73 m(2) decline in estimated glomerular filtration rate [eGFR] per year). A total of 72 patients (72 of 195, 36.9%) experienced the composite outcome (CO), defined as ≥50% fall in eGFR, eGFR < 15 ml/min per 1.73 m(2), commenced kidney replacement therapy or death, in 3 years. At each scheduled follow-up, achievement of proteinuria level < 1 g/d significantly delayed the time to the CO. The receiver operating characteristic curve of average annual decline in eGFR ≥ 5 ml/min per 1.73 m(2) had 86% sensitivity and 89% specificity for CO in 3 years and had good discrimination from 1 year onwards (area under the curve 0.8, SE 0.04, 95% CI 0.7–0.9, P < 0.0001). The significant predictors of CO by Cox proportional-hazards model were as follows: baseline MEST-T2 score (hazard ratio [HR] 3.3, 95% CI 1.7–6.5, P < 0.001), along with 24-hour urine protein level ≥ 1 g/d (HR 2.1, 95% CI 1.1–3.9, P = 0.02), eGFR < 60 ml/min per 1.73 m(2) (HR 2.9, 95% CI 1.1–7.6, P = 0.03), and rate of eGFR decline ≥ 5 ml/min per 1.73 m(2)/yr (HR 2.7, 95% CI 1.6–4.8, P < 0.001) all measured at 6 months. Mortality was 11 of 195 (5.6%). CONCLUSION: We identified longitudinal clinical variables measured at 6 months and ≥5 ml/min per 1.73 m(2) annual fall in eGFR after kidney biopsy as important predictors for composite outcome in addition to baseline histology

Clinical implications of granulomatous inflammation detected by endobronchial ultrasound transbronchial needle aspiration in patients with suspected cancer recurrence in the mediastinum.

Background: Granulomatous inflammation has been previously reported in association with cancer. Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is a new minimally invasive test for investigating mediastinal lymphadenopathy. The identification of granulomatous inflammation by EBUS-TBNA and the clinical implications of such detection in a series of patients with previously treated cancer and new mediastinal lymphadenopathy has not previously been performed. Methods: All 153 consecutive patients undergoing EBUS-TBNA in an academic cancer institution for suspected cancer in the mediastinum (mediastinal lymphadenopathy by CT imaging) were reviewed. Patients with non-caseating granuloma identified by EBUS-TBNA were included. Results: EBUS-TBNA identified non-caseating granuloma in 17/153 (11%) patients. A subset of 8/153 (5.2%) had sarcoid like lymphadenopathy mimicking cancer recurrence (5/5 PET positive). Another 8/153 (5.2%) patients with new mediastinal lymphadenopathy and no prior history of cancer had a clinical syndrome consistent with sarcoidosis. One other patient with a history of breast cancer was diagnosed with non-tuberculous mycobacteria infection. No patient required mediastinoscopy and there were no complications. Conclusion: In an academic cancer institute, at least 5% of patients undergoing EBUS-TBNA have sarcoid-like lymphadenopathy mimicking cancer recurrence. Further studies to define the precise etiology, natural history and prognosis of this phenomenon are warranted

IISR Mahima and IISR Rejatha - two high yielding and high quality ginger (Zingiber officinale Rosc.) varieties

IISR Mahima (Acc. 117) and IISR Rejatha (Acc. 35), developed through selection from germplasm at the Indian Institute of Spices Research, Calicut are good quality, high yielding ginger varieties. Maturing in 200 days, IISR Mahima has given an average yield of 23.2 t ha-1 (fresh) with a dry recovery of 23%, essential oil 1.72%, oleoresin 4.48% and fibre content 3.26%. Rhizomes of Mahima are bold and this variety is resistant to root-knot nematode also. IISR Rejatha is a medium duration, bold variety with an average yield of 22.4 t ha-1 (fresh), dry recovery 19%, essential oil 2.36%, oleoresin 6.34% and fibre content 4.0%. &nbsp

Contextualizing the Global Nursing Care Chain: International Migration and the Status of Nursing in Kerala, India

In this article I explore the issue of nursing status in Kerala, India and how over time a colonial discourse of caste‐based pollution has given way to a discourse of sexual pollution under expanding migratory opportunities. Based on survey and qualitative research findings, I caution that the improving occupational status of nursing in India is not directly mapped onto social status, and this is particularly evident in the matrimonial market. In the light of these findings I argue that global nursing care chain (GNCC) analysis must assess more than just workplace contexts in order to conceptualize how global care chains (GCCs) interlock, and how they are differentiated from each other

The Use of Bronchoscopy During the COVID-19 Pandemic: CHEST/AABIP Guideline and Expert Panel Report

BACKGROUND: The coronavirus disease 2019 (COVID-19) has swept the globe and is causing significant morbidity and mortality. Given that the virus is transmitted via droplets, open airway procedures such as bronchoscopy pose a significant risk to health-care workers (HCWs). The goal of this guideline was to examine the current evidence on the role of bronchoscopy during the COVID-19 pandemic and the optimal protection of patients and HCWs. RESEARCH QUESTION: ▪▪▪ STUDY DESIGN AND METHODS: A group of approved panelists developed key clinical questions by using the Population, Intervention, Comparator, and Outcome (PICO) format that addressed specific topics on bronchoscopy related to COVID-19 infection and transmission. MEDLINE (via PubMed) was systematically searched for relevant literature and references were screened for inclusion. Validated evaluation tools were used to assess the quality of studies and to grade the level of evidence to support each recommendation. When evidence did not exist, suggestions were developed based on consensus using the modified Delphi process. RESULTS: The systematic review and critical analysis of the literature based on six PICO questions resulted in six statements: one evidence-based graded recommendation and 5 ungraded consensus-based statements. INTERPRETATION: The evidence on the role of bronchoscopy during the COVID-19 pandemic is sparse. To maximize protection of patients and HCWs, bronchoscopy should be used sparingly in the evaluation and management of patients with suspected or confirmed COVID-19 infections. In an area where community transmission of COVID-19 infection is present, bronchoscopy should be deferred for nonurgent indications, and if necessary to perform, HCWs should wear personal protective equipment while performing the procedure even on asymptomatic patients