Risk assessment and predicting outcomes in patients with depressive symptoms: a review of potential role of peripheral blood based biomarkers

Depression is one of the major global health challenges and a leading contributor of health related disability and costs. Depression is a heterogeneous disorder and current methods for assessing its severity in clinical practice rely on symptom count, however this approach is unreliable and inconsistent. The clinical evaluation of depressive symptoms is particularly challenging in primary care, where the majority of patients with depression are managed, due to the presence of co-morbidities. Current methods for risk assessment of depression do not accurately predict treatment response or clinical outcomes. Several biological pathways have been implicated in the pathophysiology of depression; however, accurate and predictive biomarkers remain elusive. We conducted a systematic review of the published evidence supporting the use of peripheral biomarkers to predict outcomes in depression, using Medline and Embase. Peripheral biomarkers in depression were found to be statistically significant predictors of mental health outcomes such as treatment response, poor outcome and symptom remission; and physical health outcomes such as increased incidence of cardiovascular events and deaths, and all-cause mortality. However, the available evidence has multiple methodological limitations which must be overcome to make any real clinical progress. Despite extensive research on the relationship of depression with peripheral biomarkers, its translational application in practice remains uncertain. In future, peripheral biomarkers identified with novel techniques and combining multiple biomarkers may have a potential role in depression risk assessment but further research is needed in this area

On Majorization for Matrices

In this paper, we give several results for majorized matrices by using continuous convex function and Green function. We obtain mean value theorems for majorized matrices and also give corresponding Cauchy means, as well as prove that these means are monotonic. We prove positive semi-definiteness of matrices generated by differences deduced from majorized matrices which implies exponential convexity and log-convexity of these differences and also obtain Lypunov's and Dresher's type inequalities for these differences

Remote Cerebellar Haemorrhage: A Potential Iatrogenic Complication of Spinal Surgery

We report the case of a 51-year-old man with no significant past medical history, who underwent elective revision spinal surgery and subsequently developed intracranial hypotension, remote cerebellar haemorrhage (RCH), and mild hydrocephalus on the fourth postoperative day. Remote cerebellar haemorrhage is a known complication of supratentorial surgery. This iatrogenic phenomenon may also occur following spinal surgery, due to dural tearing and rapid cerebral spinal fluid (CSF) leakage, resulting in intracranial hypotension and cerebellar haemorrhage. This complication may result in severe permanent neurologic sequelae; hence, it is of pertinence to diagnose and manage it rapidly in order to optimise patient outcome

Remote Cerebellar Haemorrhage: A Potential Iatrogenic Complication of Spinal Surgery

We report the case of a 51-year-old man with no significant past medical history, who underwent elective revision spinal surgery and subsequently developed intracranial hypotension, remote cerebellar haemorrhage (RCH), and mild hydrocephalus on the fourth postoperative day. Remote cerebellar haemorrhage is a known complication of supratentorial surgery. This iatrogenic phenomenon may also occur following spinal surgery, due to dural tearing and rapid cerebral spinal fluid (CSF) leakage, resulting in intracranial hypotension and cerebellar haemorrhage. This complication may result in severe permanent neurologic sequelae; hence, it is of pertinence to diagnose and manage it rapidly in order to optimise patient outcome

1.16 THE EFFECT OF QUARANTINE ON THE EMOTIONAL WELL-BEING OF KIDS: A SYSTEMATIC REVIEW

Objectives: COVID-19 has a significant impact on the mental health of children and adolescents including adverse consequences from quarantine or isolation. In this systematic review, we explore the impact of quarantine and isolation on psychological well-being of youth and propose a comprehensive strategy to reduce psychological burden. Methods: Three electronic databases including PubMed, Scopus, and Web of Science were searched for relevant articles by using the following search terms: (stigma OR stigmas OR stigmatization OR stigmatization) AND (psych* OR mental OR anxiety OR depression OR stress OR insomnia OR adjustment) AND (quarantin* OR patient isolation OR isolate* OR lockdown OR lock-down OR cordon) AND (child* OR adolescent OR adolescence OR youth). Two independent reviewers performed title and abstract screening followed by full-text screening by using predetermined eligibility criteria. Data were extracted for study population, country of study, scales used to measure for outcome, summary of results, and limitations. Results: The initial search found 530 unique citations, and 10 studies were included after thorough screening. Among the included studies, the study design was cohort in 4 studies, cross-sectional in 3, and descriptive qualitative in 3. The most common diagnoses were acute stress disorder, adjustment disorder, grief, and PTSD. There was also evidence for restlessness, irritability, anxiety, clinginess, and inattention with increased screen time in children during quarantine. Conclusions: This review helps in improving the understanding of quarantine\u27s effects on children and adolescents, such as mental health issues, stigma, physical health, education, socialization, and parental perception. We also propose interventions for quarantined children through education, information dissemination, behavioral activation, health care system response, school-based strategies, and other coping techniques

Protection of Records and Data Authentication based on Secret Shares and Watermarking

The rapid growth in communication technology facilitates the health industry in many aspects from transmission of sensor’s data to real-time diagnosis using cloud-based frameworks. However, the secure transmission of data and its authenticity become a challenging task, especially, for health-related applications. The medical information must be accessible to only the relevant healthcare staff to avoid any unfortunate circumstances for the patient as well as for the healthcare providers. Therefore, a method to protect the identity of a patient and authentication of transmitted data is proposed in this study. The proposed method provides dual protection. First, it encrypts the identity using Shamir’s secret sharing scheme without the increase in dimension of the original identity. Second, the identity is watermarked using zero-watermarking to avoid any distortion into the host signal. The experimental results show that the proposed method encrypts, embeds and extracts identities reliably. Moreover, in case of malicious attack, the method distorts the embedded identity which provides a clear indication of fabrication. An automatic disorder detection system using Mel-frequency cepstral coefficients and Gaussian mixture model is also implemented which concludes that malicious attacks greatly impact on the accurate diagnosis of disorders

Blinding Trachoma: A Disease of Poverty

Trachoma accounts for 15% of blindness worldwide, affecting the world's poorest communities. How can the disease be controlled

Ultrasound-guided Intralesional Bleomycin Injection (IBI) for Treatment of Cutaneous Hemangiomas and Vascular Malformations

Purpose: To report the therapeutic outcome of ultrasound-guided intralesional injection of bleomycin in the treatment of cutaneous hemangiomas and vascular malformations. Material & Methods: The medical records of patients with cutaneous hemangiomas and vascular malformations treated with the intralesional injection of bleomycin under ultrasound guidance between August 2009 and June 2013 at the Indus Hospital, Karachi were reviewed retrospectively using a computerized medical record information management system. Data were extracted using a pre-coded performa that included patient demographics, type and location of lesion, number of treatments, presenting/pre- and post-treatment clinical symptoms (pain, swelling, heaviness, size, discoloration), ultrasound appearance and vascularity, and post-treatment side effects. The dose range of bleomycin was 0.5-1.0 mg/kg, but not exceeding 15 mg in a single session. A maximum of four treatments were given in any given patient except for one, who presented with recurrence after a year of complete resolution. Therapeutic outcome was determined using review of ultrasound images and recorded clinical assessment. Treatment response was categorized as: (i) complete resolution [more than 90% reduction]; (ii) substantial reduction [more than 50% reduction]; (iii) mild reduction [25% reduction]; or, (iv) no improvement [ \u3c 10% reduction]. Results: A total of 30 patients (16 female, 14 male), ranging in age from 8 months to 48 years (mean age 10.2 years), were treated from 2009 to 2013. There were 23 hemangiomas. Seven were vascular malformations, of which five were lymphatic malformations and two were venous malformations. Twenty-eight lesions were located in the head and neck region, and two were peripheral.. In 24 of the 30 patients (76%), treatment had been completed. In six patients (21%) treatment was ongoing at the time of this report. Seventeen of the 23 hemangiomas (74%) were completely resolved clinically and on ultrasound, five (22%) showed substantial improvement and one (4%) showed mild improvement. In five of the seven vascular malformations (71%) lymphatic malformations resolved completely, and two (29%) venous malformations showed substantial improvement. Of the 13 patients presenting with discoloration, there was complete resolution in one (7.7%), marked reduction in 11 (84.6%) and mild reduction in one (7.7%). Of seven patients presenting with pain, there was complete resolution in two (28.6%), marked reduction in two (28.6%), mild reduction in two (28.6%), and no improvement in one (14.3%). There were no pulmonary complications. Conclusion: Ultrasound-guided intralesional injection of bleomycin is an option to consider for the treatment of certain types of cutaneous hemangiomas and vascular malformations. Prospective studies should be undertaken to understand the various factors contributing to therapeutic success