A Study of Sexual Dysfunction and Quality of Life in Female Patients on Selective Serotonin Reuptake Inhibitor (SSRI)

Context: Sexual dysfunction is one of the most common and disconcerting side effect during treatment with Selective serotonin reuptake inhibitors (SSRIs). Sexual side effects from these medications have significant impact on self esteem, quality of life and can lead to non compliance and relapse in long term treatment. Aims: To study prevalence, severity of sexual dysfunction and its possible association with quality of life in female patients on treatment with SSRI for depression and anxiety. Materials and Methods: This was an observational, cross sectional, single-centre study. Hundred consecutive female patients who were sexually active, on SSRIs for six weeks or more were recruited. Diagnosis of Major depressive disorder (MDD), Anxiety disorders and female sexual dysfunction was done by clinician administered interview as per Diagnostic and Statistical Manual of mental disorders (DSM 5). The patients were further assessed for demographic details, CSFQ-F-C, HAM-D, HAM-A and WHOQOL-BREF scales for sexual dysfunction, depression, anxiety and quality of life respectively. p value of <0.05 was considered to be statistically significant. Results: Prevalence of sexual dysfunction was 84%. Patients with sexual dysfunction scored significantly lower value in social relationships (p= 0.0002) and environment (p= 0.033) domains of quality of life. Frequency of sexual dysfunction among patients on fluoxetine was 86.20%, on escitalopram was 86.76% and on sertraline was 66.6%. Frequency of sexual dysfunction was more with higher dose of SSRIs. Conclusions: Patients on various SSRIs experienced sexual dysfunction and had poor quality of life. Frequency of sexual dysfunction was more with higher doses of SSRIs

Federated learning enables big data for rare cancer boundary detection.

Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing

Federated Learning Enables Big Data for Rare Cancer Boundary Detection

Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing

SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway

Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant

Contact Lens Induced Corneal Ulcer Management in a Tertiary Eye Unit in Oman - A descriptive study

Objectives: The corneal disease is a priority problem in Oman. We present patients with contact lens (CL) induced severe keratitis, admitted in the corneal unit of Al Nahdha Hospital in Oman. Methods: The study was conducted in 2005-2006. Ophthalmologists examined the eyes using slit lamp bio-microscope. Visual acuity was noted using Snellen’s distance vision chart. Specimens of corneal scraping and CLs were sent for culture and sensitivity tests. Patients with severe keratitis were admitted and treated with medicines. Corneal and visual statuses were noted at the time of discharge from hospital and after six weeks. Numbers, percentages and their 95% confidence intervals were calculated. Pre- and post-treatment vision were compared using a scattergram. Results: The 52 eyes of 15 males and 37 female patients with corneal ulcers were examined. Thirty-two patients were between 20 to 30 years of age. Only 13 (25%) patients had visited an ophthalmologist within 24 hours of developing severe keratitis. Seventeen (33%) had central ulcers and six (11.5%) had ulcer ≥5 mm in size. Pseudomonas was found in 29 (55.8%) of CL and corneal material scraped from the eyes of 15 (28.8%) patients. Vision was &lt;6/60 (legally blind) in 12 (23.1%) eyes before and in five (9.6%) eyes after treatment. Twenty-six (50%) patients were lost to follow up. Conclusion: CL related severe keratitis causes visual disabilities. Prevention and proper records are essential. Treatment improves vision and hence facilities for management should be strengthened

Geographical Variability in CYP1B1 Mutations in Primary Congenital Glaucoma

Primary congenital glaucoma (PCG) is a rare type of glaucoma that is inherited in an autosomal recessive manner. PCG can lead to blindness if not detected early in children aged 3 or younger. PCG varies in presentation among various populations, where disease presentation and disease severity vary by mutation. The most common gene implicated in PCG is cytochrome p450 1B1 (CYP1B1). Here, we sought to review the literature for mutations in CYP1B1 and their presentation among different populations. Areas of interest include recent findings on disease presentation and potential implications on our understanding of PCG pathophysiology

Leisure education for youth with a lived experience of mental illness, development of the FRESH [Fun Recreation Exercise and Skills for Health] program for a youth cohort in Western Sydney, Australia

Mental health disorders account for a significant percentage of disease around the world, with the majority of these disorders developed during adolescence and early adulthood, 12-24 years of age. This period is marked by significant changes in life and in many cases, symptoms of mental illness can go underdiagnosed or seen as a somewhat normal response to this period of development. Poor mental health impacts many aspects of one's life and can lead to lower educational performance, domestic violence, substance abuse, alcohol addiction, and poor reproductive and sexual health. Some feasible and accessible therapeutic recreation interventions have been developed to promote leisure education within the community for youth experiencing and at risk of mental illness. Engagement and education surrounding leisure activities, leisure attitudes and promotion of a healthy leisure lifestyle may create opportunities for young adults experiencing mental illness to further their recovery. The following chapter will discuss the development and recommendations related to an innovative leisure and recreation treatment program termed Fun Recreation Exercise and Skills for Health (FRESH). This innovative leisure practice highlights elements of co-design and peer-to-peer instruction for a youth cohort in Western Sydney, Australia, targeting boredom and the development of a healthy leisure lifestyle in a community youth mental health context. The value of this case study for academic audiences highlights the developing evidence base for leisure-based interventions such as therapeutic recreation and leisure education. This case study highlights the significant need for research within the intersections of mental health, leisure and leisure education. Non-academic audiences such as mental health service providers, recreation service providers, and leisure professionals will benefit from this case study as it highlights the possibility of an innovative area of service provision that could be integrated within both clinical and semi-clinical environments that service youth populations

Multidetector Computed Tomography (MDCT) in Gastrointestinal Obstruction: One Symptom Myriad Differentials

Introduction: Computed Tomography (CT) is a highly sensitive modality with its multi-planar capabilities, used in evaluation of acute cases of intestinal obstruction. It delineates the level and helps to identify various etiologies of obstruction, where plain radiographs can only suggest signs of obstruction. It has an added advantage of detecting further complications, thus framing appropriate surgical approach. Aim: Our study aims at delineating variable CT spectrum of intestinal obstruction with highlight on atypical presentation. Materials and Methods: Retrospective hospital data based study was conducted in the Radiology Department of Shree Krishna Hospital, Anand, Gujarat, India, between 2014-2017 including 40 patients with mechanical causes of obstruction and excluding patients with non-mechanical causes of obstruction. Statistical analysis was done using percentages and proportions using MedCalc software version 17.6. Results: The age range of patients was from 5 days to 83 years and the maximum number of patients i.e., 7 (17.5%) were in the age group of 41-50 years. Radiographic signs related to obstruction like air fluid levels, dilated bowel loops was seen in 26 out of 40 cases (sensitivity 60%). Small bowel obstruction dominated the case list with obstructed hernia as major causative factor. Conclusion: Study highlights the contribution of MDCT in early identification of underlying etiology and complications of obstruction with additional contribution in road mapping and framing appropriate and individualized treatment strategy for patients