Long term follow-up study for abdominal sacrocolpopexy/sacrohysteropexy

Background: Pelvic organ prolapse is common in women and 7-9% undergo surgical repair. Abdominal sacrocolpopexy and sacrohysteropexy is the most durable operation for vault prolapse and Nulliparous prolapse respectively. The objectives of this study were to describe Anatomic and symptomatic outcomes up to 5 years after abdominal sacrocolpopexy or sacrohysteropexy.Methods: This study was conducted in ASCOMS hospital for a cohort of patients who underwent abdominal sacrocolpopexy (ASC) or sacrohysteropexy (ASH) in 2 years (2013-2015) and follow up done for a period of 5 years from 2015-2019. These patients were evaluated for subjective and objective outcomes following ASC and ASH. women completed questionnaires and were examined in gynaecology clinic. Prospective follow up study using standarised examination with pelvic organ prolapse quantification system (POP-Q) and questionnairesResults: In the present study, there was low incidence of intraoperative and postoperative complications as well as long term complications were significantly low. The anatomical cure rate and patient satisfaction rate was both 100%.Conclusions: Abdominal sacrocolpopexy for vault prolapse and sacrohysteropexy for Nulliparous prolapse is safe and effective method and is considered gold standard for treatment of Apical compartment prolapse

OpenXAI: Towards a Transparent Evaluation of Model Explanations

While several types of post hoc explanation methods (e.g., feature attribution methods) have been proposed in recent literature, there is little to no work on systematically benchmarking these methods in an efficient and transparent manner. Here, we introduce OpenXAI, a comprehensive and extensible open source framework for evaluating and benchmarking post hoc explanation methods. OpenXAI comprises of the following key components: (i) a flexible synthetic data generator and a collection of diverse real-world datasets, pre-trained models, and state-of-the-art feature attribution methods, (ii) open-source implementations of twenty-two quantitative metrics for evaluating faithfulness, stability (robustness), and fairness of explanation methods, and (iii) the first ever public XAI leaderboards to benchmark explanations. OpenXAI is easily extensible, as users can readily evaluate custom explanation methods and incorporate them into our leaderboards. Overall, OpenXAI provides an automated end-to-end pipeline that not only simplifies and standardizes the evaluation of post hoc explanation methods, but also promotes transparency and reproducibility in benchmarking these methods. OpenXAI datasets and data loaders, implementations of state-of-the-art explanation methods and evaluation metrics, as well as leaderboards are publicly available at https://open-xai.github.io/.Comment: 36th Conference on Neural Information Processing Systems (NeurIPS 2022) Track on Datasets and Benchmark

On Testing Dependence between Time to Failure and Cause of Failure when Causes of Failure Are Missing

The hypothesis of independence between the failure time and the cause of failure is studied by using the conditional probabilities of failure due to a specific cause given that there is no failure up to certain fixed time. In practice, there are situations when the failure times are available for all units but the causes of failures might be missing for some units. We propose tests based on U-statistics to test for independence of the failure time and the cause of failure in the competing risks model when all the causes of failure cannot be observed. The asymptotic distribution is normal in each case. Simulation studies look at power comparisons for the proposed tests for two families of distributions. The one-sided and the two-sided tests based on Kendall type statistic perform exceedingly well in detecting departures from independence

Post-implementation Review of the Himalaya Home Care Project for Home Isolated COVID-19 Patients in Nepal

Background: The emergence of coronavirus disease 2019 (COVID-19) has resulted in a pandemic that has significantly impacted healthcare systems at a global level. Health care facilities in Nepal, as in other low- and middle-income countries, have limited resources for the treatment and management of COVID-19 patients. Only critical cases are admitted to the hospital resulting in most patients in home isolation. Methods: Himalaya Home Care (HHC) was initiated to monitor and provide counseling to home isolated COVID-19 patients for disease prevention, control, and treatment. Counselors included one physician and four nurses. Lists of patients were obtained from district and municipal health facilities. HHC counselors called patients to provide basic counseling services. A follow-up check-in phone call was conducted 10 days later. During this second call, patients were asked about their perceptions of the HHC program. Project objects were: (1) To support treatment of home isolated persons with mild to moderate COVID-19, decrease burden of hospitalizations, and decrease risks for disease transmission; and, (2) To improve the health status of marginalized, remote, and vulnerable populations in Nepal during the COVID-19 pandemic. Results: Data from 5823 and 3988 patients from May 2021-February 2022 were entered in initial and follow-up forms on a REDCap database. The majority of patients who received counseling were satisfied. At follow-up, 98.4% of respondents reported that HHC prevented hospitalization, 76.5% reported they could manage their symptoms at home, and 69.5% reported that counseling helped to limit the spread of COVID-19 in their household. Conclusions: Telehealth can be an essential strategy for providing services while keeping patients and health providers safe during the COVID-19 pandemic

A study on role of front office administration in Max Super Speciality Hospital Bathinda

In Max Hospitals front office executive controls the flow of people through the organization and ensure that all receptionist are performing their task in a timely manner. Their works includes answering the calls, attending to the patients, overseeing the front office operation and maintaining the contact list of patients. Front Office Executive is a person who works in the hospital front office and manages a variety of tasks. The department keeps information and records of all the patients of the hospital. It also plays a key role in forming overall impressions of the services provided by the organization. A front office executive is the first point of contact at the office and is also an integral part of the administration team. They help to coordinate between the individuals visiting the office and the administrative team. They sometimes have to introduce the client to the higher management of the organization. It is necessary for a front office executive to possess a very pleasing personality and effective communication skills. The aims of this study to investigate service attributes in a hospital front office

A study on the role of Hospital in Disaster Management and its Palliative Approach

Hospitals play important roles in saving the lives and reducing the suffering of injured people during and after disasters. Disaster damage to health systems is a human and health tragedy, results in huge economic losses, deals devastating blows to development goals, and shakes social confidence. Hospital disaster preparedness presents complex clinical operation. It is difficult philosophical challenge. They should be ready to save lives and to continue providing essential emergencies. India has been traditionally vulnerable to the natural disasters on the account of its unique geo-climatic conditions. Floods, droughts, cyclones, earthquakes and landslides would have been recurrent phenomena. It is difficult to determine how much time, money, and effort should be spent in preparing for an event that may not occur. Health facilities whether hospitals or rural health clinics, should be a source of strength during emergencies and disasters. In India most of the disasters are caused by floods. About 60% of the landmass is prone to earthquakes of various intensities, over 40 million hectares is prone to floods, about 8% of the total area is prone to cyclones and 68% of the area is susceptible to drought. In this paper a review has been made to disaster reasons and their mitigation and the effect of disaster on the lives of human being and necessary steps taken to palliate the disaster. In this paper a review has been made to disaster reasons and their mitigation and the effect of disaster on the lives of human being and necessary steps taken to palliate the disaster

Biomedical Waste & Its Disposal in Ayurvedic Hospitals : Awareness and Practices

Since beginning, the Ayurvedic hospitals are known for the treatment of sick persons but now it is a well established fact that hospital waste is a potential health hazard to the health care workers, public and ecosystem of the area. Biomedical waste disposal is an integral part of health care. The paper focuses on the identification and classification of biomedical wastes in Ayurvedic hospitals and current practices of its management in Ayurveda hospitals. Biomedical waste  generated during Panchkarma procedures and making of Ayurvedic medicines in  Rasashastra  or in Ayurvedic hospitals includes discarded blood, sharps, body parts other human tissues, used bandages and dressings, discarded gloves, catheters, syringes and other medical supplies that may have been in contact with blood and body fluids, clotted blood, liquids like - oils, butter milk, plant decoction waste, waste milk, vomitus, fecal material, waste Kalka (Paste), dough, mud packs, fresh leaves, leaf extract, dead leech, Mansa Pinda (flesh), cloth, burnt ashes, heavy metals (Bhasma) like mercury, arsenic  etc. BMW management is compulsory for Ayurvedic hospitals/ Panchkarma setups as commendable treatment approach and patient’s reliability is increasing for emerging lifestyle disorders. Sixty percent of waste generated is biodegradable and environmentally accepted which can also be solved through deep burial method. Ten percent is recyclable. Only thirty percent requires management through other means. As per Ayurveda, on the basis upon its origin materials are obtained from Jangama, etc. Similarly, these are also the sources of waste substance. Likewise, Ayurvedic classics provide detailed knowledge of use of agro forestry waste, mining waste, and dairy industries wastes etc. to minimize the amount of waste sent to dumping grounds

A review on the role of NABH standards in Ayurvedic Hospital

Background - Demand for Ayurveda is gradually growing in medical tourism. The quality health care and cost-effective treatment gives Ayurveda advantages in modern health tourism.  People with uncontrolled medical neuro-muscular conditions such as Muscular dystrophy, myopathies, Multiple sclerosis, Myasthenia gravis, Parkinson’s disease and Autism are exploring possible Ayurvedic treatment globally. Panchakarma, Yoga, Marma Chikitsa, Ksharsutra, Rasaushadhi etc. are super specialities of Ayurveda, having no other alternative at all, are becoming attractions, raising medical tourism in India. Kerala is now the hub of Ayurvedic medical tourism in the country. In this era, evaluation of organization as per their performance & quality has become integral part of health sector of India. NABH has established standards by keeping in mind, enhancement of health system & promotion of continuous quality improvement & patient safety. Objective - To have a review on the of NABH standards in Ayurvedic hospitals. Design - NABH accreditation standards for Ayurveda hospitals second edition is referred to have review on the of NABH standards in Ayurvedic hospitals. Results - Ayurveda hospital accreditation standards consist of 10 chapters, further divided into 98 standards, incorporation of 590 objective elements. These standards are requirements led by NABH which facilitate safe high-quality care. Conclusion - Patients are well aware about quality health services, especially in terms of medical tourism expects standard & safety assurance. These NABH accreditation standards setting benchmark for AYUSH hospitals, helps in enhancing significance in health sector in India

A Prospective Comparative Study Of Efficacy of Olanzapine and Aprepitant in Prevention of Chemotherapy Induced Nausea and Vomiting in GMC, Jammu

Introduction:Breast cancer ranks first among all cancers in women globally as well as in India, with an incidence rate of 25.8 per 100,000.The combination of anthracyclines with cyclophosphamide forms the basis of many breast cancer treatment protocols. This combination is known to have a high potential for chemotherapy-induced nausea and vomiting (CINV).Materials and Methods:A comparative study conducted in all the patients attending outpatient and inpatient department for chemotherapy at Department of Radiotherapy, Govt Medical College, Jammu in 60 patients for a period of 12 months. All the patients, satisfying the inclusion criteria were enrolled into the study. The patients who satisfied the inclusion criteria for Department of Radiotherapy, Govt Medical College, Jammu were enrolled after written informed consent. A detailed medical history, general physical examination was done and findings were recorded at the time of screening. Results:Among Olanzapine group majority (25%) of the patients belonged to the age group of 41-45 years and 51-55 years each, followed by 46-50 years and 56-60 years each (16.66%). 8.33% belonged to the age group of <40 years and >60 years each. The mean age was 51.43±7.52 years.AmongAprepitant group majority (22.22%) of the patients belonged to the age group of 41-45 years and 51-55 years each, followed by 46-50 years and 56-60 years each (16.66%). 11.11% belonged to the age group of <40 years and >60 years each. The mean age was 53.47±8.33 years.Among Olanzapine group, 58.33% were females, 41.66% were males. Among Aprepitant group, 72.22% were females and 27.77% were males. Among Olanzapine group, 41.66% had co-morbidities. Among Aprepitant group, 33.33% had co-morbidities. Among Olanzapine group, 41.66% had co-morbidities, out of which 8.33% contributed to only diabetes and only hypertension. 25% had both. Among Aprepitant group, 33.33% had co-morbidities, out of which 11.11% contributed to only diabetes, only hypertension and both.Conclusion:The objective of the present study was to compare the efficacy of Olanzapine and Aprepitant in prevention of chemotherapy induced nausea and vomiting.Though there was no statistically significant association was derived between the drugs regarding superior efficacy, Aprepitant appears to be better than Olanzepine. However, keeping in view the cost of the drug, Olanzepine can be considered in Low and Middle Income settings. Olanzepine is the better, safe, cost effective alternative than Aprepitant

Role of AYUSH during Covid-19 crisis

The novel virus was first identified from an outbreak in the Chinese city of Wuhan in December 2019, and attempts to contain it there failed, allowing it to spread across the globe. The World Health Organization (WHO) declared a Public Health Emergency of International Concern on 30 January 2020 and a pandemic on 11 March 2020. As of 26 January 2022, the pandemic had caused more than 360 million cases and 5.62 million deaths, making it one of the histories. There is a lot of discussion on COVID-19 control plan from the mainstream approaches, but it is also necessary to focus on the contributions of the Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Riga and Homeopathy (AYUSH) sector, which is now being brought into public health interventions nationally. During the Covid crisis role of AYUSH was appreciated by whole world and the system of AYUSH played a crucial role in Covid 19 crisis. This paper will put light on the role of AYUSH and AYUSH healthcare workers during Covid 19 crisis