Common ECG Lead Placement Errors. Part II: Precordial Misplacements

Background: Electrocardiography is a very useful diagnostic tool. However, errors in placement of ECG leads can create artifacts, mimic pathologies, and hinder proper ECG interpretation. This is the second of a two-part series discussing how to recognize and avoid these errors. Methods: 12-lead ECGs were recorded in a single male healthy subject in his mid 20s. Various precordial lead misplacements were compared to ECG recordings from correct lead placement. Results: Precordial misplacements caused classical changes in ECG patterns. Techniques of differentiating these ECG patterns from true pathological findings were described. Conclusion: As in Part I of this series, recognition and interpretation of common ECG placement errors is critical in providing optimal patient care

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) in the International Journal of Medical Students

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Common ECG Lead Placement Errors. Part I: Limb lead Reversals

Background: Electrocardiography is a very useful diagnostic tool. However, errors in placement of ECG leads can create artifacts, mimic pathologies, and hinder proper ECG interpretation. This is the second of a two-part series discussing how to recognize and avoid these errors. Methods: 12-lead ECGs were recorded in a single male healthy subject in his mid 20s. Various precordial lead misplacements were compared to ECG recordings from correct lead placement. Results: Precordial misplacements caused classical changes in ECG patterns. Techniques of differentiating these ECG patterns from true pathological findings were described. Conclusion: As in Part I of this series, recognition and interpretation of common ECG placement errors is critical in providing optimal patient care

Toxicity to immune checkpoint inhibitors presenting as pulmonary arterial vasculopathy and rapidly progressing right ventricular dysfunction

Introduction: Immune Checkpoint Inhibitors (ICIs) are antitumor drugs associated with a number of serious immune-related adverse events (IRAEs). ICIs enhance anti-tumor immunity, thereby  energized  patient's immune system to fight cancer. IRAEs may affect functions of various organs, including heart, and may lead to morbidity and, to some  extent  mortality. Left ventricle (LV) myocarditis with dysfunction is a known side effect of this class of drugs. However, right ventricle (RV) myocarditis and pulmonary vasculitis are an unknown entity and has not been previously reported.  Here, we present the first case of  IRAEs causing selective RV involvement with dysfunctions, attributed to immune checkpoint inhibitors described till date in medical literature.Presentation of Case: A 58-year male presented  with history of low-grade fever and  weight loss. On palpation, he had diffuse cervical lymphadenopathy. Histopathology evaluation of  lymph node revealed  metastatic lesions of Renal Cell Carcinoma (RCC).Conclusion: Fatal cardiovascular adverse events can occur as a side effect of ICI. The combination of RV myocarditis with progressive pulmonary hypertension is fatal. Treatment with high dose corticosteroids and immunomodulators may help in patient survival. Physicians treating patients with ICIs should be aware of their lethal cardiotoxic side effects  to reduce adverse cardiac outcomes. Because the number of patients exposed to this new immune therapy is expected to increase remarkably in the near future, our study encourages further work to define guidelines for cardiovascular monitoring and management

Privacy Preserving EEG-based Authentication Using Perceptual Hashing

The use of electroencephalogram (EEG), an electrophysiological monitoring method for recording the brain activity, for authentication has attracted the interest of researchers for over a decade. In addition to exhibiting qualities of biometric-based authentication, they are revocable, impossible to mimic, and resistant to coercion attacks. However, EEG signals carry a wealth of information about an individual and can reveal private information about the user. This brings significant privacy issues to EEG-based authentication systems as they have access to raw EEG signals. This thesis proposes a privacy-preserving EEG-based authentication system that preserves the privacy of the user by not revealing the raw EEG signals while allowing the system to authenticate the user accurately. In that, perceptual hashing is utilized and instead of raw EEG signals, their perceptually hashed values are used in the authentication process. In addition to describing the authentication process, algorithms to compute the perceptual hash are developed based on two feature extraction techniques. Experimental results show that an authentication system using perceptual hashing can achieve performance comparable to a system that has access to raw EEG signals if enough EEG channels are used in the process. This thesis also presents a security analysis to show that perceptual hashing can prevent information leakage

DETERMINING THE EFFICACY OF ISOXYL, A MYCOLIC ACID INHIBITOR, IN VITRO AGAINST MYCOBACTERIA OTHER THAN MYCOBACTERIUM TUBERCULOSIS (MOTT) STRAINS

Mycobacteria other than Mycobacterium tuberculosis (MOTT) cause infections more commonly in the presence of predisposing factors and underlying diseases.They are also notably resistant to commonly used antituberculosis drugs. Total 11 clinical isolates MOTT were included in the study.Drug susceptibility testing of these isolates was performed by Resistant Ratio method. Minimum inhibitory concentration (MIC) pattern of these isolates of MOTT to mycelia acid synthesis inhibitors namely, Isoxyl(ISO) and Isoniazid (INH) were determined by agar dilution and broth dilution method. Minimum bactericidal concentration (MBC) pattern of these isolates to ISO and INH werealso determined. Out of 11 MOTT isolates, 3 isolates were characterized as Mycobacteriumscrofulaceum, 3 isolates as Mycobacteriumfortuitum, 2 isolates as Mycobacteriumflavescens, 1 isolates as Mycobacterium terrae and 2 isolates as Mycobacteriumkansasi depending upon the results of biochemical tests.The MBC range of INH was found to be 0.025 to 6.4 μg/ml and of ISO was found to be 0.6 to 20 μg/ml. Bactericidal activity of ISO was 7.25 times lower than the activity of INH. It is well known that most MOTT species are more resistant to chemotherapeutic agents other than tubercle bacilli.The inhibitory activity of ISO was more to MOTT strains than Mycobacterium tuberculosis strains.There was low bactericidal activity of ISO to MOTT strains, but better than for Mycobacterium tuberculosis strains.&nbsp

Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with endometrial cancer

Endometrial cancer; Guidelines; TreatmentCàncer d'endometri; Pautes; TractamentCáncer de endometrio; Pautas; TratamientoThe most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with endometrial cancer was published in 2022. It was therefore decided, by both the ESMO and the Indian Society of Medical and Paediatric Oncology (ISMPO), to convene a virtual meeting in July 2022 to adapt the ESMO 2022 guidelines to take into account the variations in the management of endometrial cancer in Asia. These guidelines represent the consensus opinion of a panel of Asian experts representing the oncological societies of China (CSCO), India (ISMPO), Indonesia (ISHMO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO). Voting was based on scientific evidence and was conducted independently of the current treatment practices and treatment access constraints in the different Asian countries, which were discussed when appropriate. The aim of this guideline manuscript is to provide guidance for the optimisation and harmonisation of the management of patients with endometrial cancer across the different regions of Asia, drawing on the evidence provided by Western and Asian trials whilst respecting the variations in clinical presentation, diagnostic practices including molecular profiling and disparities in access to therapeutic options, including drug approvals and reimbursement strategies.All costs relating to this consensus conference were covered by the ESMO and the ISMPO from central dedicated funds. There was no external funding of the event or the manuscript production