Non-contrast spiral computed tomography diagnosis of urolithiasis and associated features: hospital based study

Background: Urolithiasis is prevalent across the world and affects a diverse group of people, irrespective of culture, race or geographic location. Non-contrast computed tomography (CT), has been considered as gold standard for the initial as well as follow-up assessment of patients with suspected urolithiasis. Present study describes the findings on non-contrast spiral computed tomography in clinically suspected patients of urolithiasis visiting radiodiagnosis department of a tertiary care hospital.Methods: It is a descriptive observational study done at Department of Radiodiagnosis and Imaging at Shri Chhatrapati Shivaji Maharaj General Hospital in Solapur district of Maharashtra state in India. Study duration was Jan 2005 to Oct 2006. 120 patients who presented with symptoms and signs of urolithiasis for diagnosis and treatment in Department of Surgery and Medicine, including the referrals from other hospitals and institutes and referred to Department of Radiodiagnosis and Imaging of the institute for computerised tomography (CT) were enrolled. Detailed history and physical examination was done. The description of findings on non-contrast spiral CT study was done with respect to size and CT attenuation value of the calculus, secondary signs of obstruction, CT diagnosis of urolithiasis, genitourinary or other diseases.Results: In hundred patients diagnosed as urolithiasis on NCSCT, 140 calculi were found. The mean calculus size (breadth) was 4.65 mm ± 7.03 with a range of 1 to 70 mm. The mean calculus size (length) was 11.1±12.87 mm with a range of 2 to 110 mm. The range of CT attenuation value of calculus was from 60 to 1100 with median value of 311 HU.  Among the 100 patients of urolithiasis, hydronephrosis (84%) and hydroureter (82%) were the most common secondary signs of obstruction. Out of 120 patients suspected clinically with diagnosis of urolithiasis, 99 (82.5%) had obstruction with or without urolithiasis. In 86 (71.7%) patients, obstruction with urolithiasis was present. In 13(10.8%) patients, obstruction because of cause other than urolithiasis was present. We have observed additional diagnosis related to genito-urinary tract in 16 (13.5%) cases. We have observed additional diagnosis not related to genito-urinary tract in 6 (0.5%) cases.Conclusions: Non contrast spiral CT scan evaluation helped in diagnosis of urolithiasis and secondary obstruction. It also provided very useful information regarding genitourinary as well as other than genitourinary pathology

Significance of Effect of Metformin on Cancer Stem Cells – “Need of an Hour” in oral cancer

Oral cancer is a life-threatening disease. Advanced therapeutic approaches are still insufficient to improve the prognosis. Effect of Metformin on cancer stem cells (CSCs) provides promising future. Research on diverse molecular mechanisms involved in different kinds of cancers showed a definite correlation. The role in oral squamous cell carcinoma(OSCC) is not yet defines. So, it will be fruitful in future if the research on metformin and CSCs would be done in oral cancer. It would be helpful in improving the results of current antitumor treatment in oral cancer

Upright kneeling position during second stage of labor: a pilot study

Background: Women delivering in upright position have shorter labour due to efficient and stronger contractions with faster descent of foetal head. The present study aimed to find out effect of upright kneeling position in the second stage of labour on maternal and foetal outcome and assess patients’ satisfaction.Methods: The study was carried out in a tertiary care hospital of North India from October 2012 to February 2014. Low risk women admitted in early labour were divided into two groups, women delivering in kneeling position and in supine position. The outcome measures studied were, duration of second stage of labour, mode of delivery, 2nd degree perineal tears, Apgar scores at 5 minutes, NICU admission rate and patient satisfaction.Results: The mean duration of second stage of labour in kneeling group was shorter by 14.901 minutes. The rate of vaginal delivery was comparable for both primigravidas and multigravida in kneeling and supine groups, RR: 2.275, 95% CI (0.7872-6.5831) and RR: 1.633, 95% CI (0.393-6.775). Primigravidas had more 2nd degree perineal tears in kneeling group as compared to supine, RR 4.191, 95% CI (1.54 to 11.41). No difference in Apgar scores >7 at 5 minutes was observed in both groups, however, significantly lesser babies in kneeling group were admitted in NICU, RR 0.246, 95% CI (0.079 to 0.761). There was no difference on comparing satisfaction scores of primigravidas and multigravida in both supine and kneeling position.Conclusions: Kneeling position reduces the duration of second stage of labour and NICU admissions

Multivariate analysis of histopathological features as prognostic factors in fifty cases of thyroid neoplasm: a retrospective study done at tertiary care centre

Background: Number of prognostic factors for thyroid carcinoma have been identified including age, gender and tumor characteristics, such as histology and stage. The importance of these factors as independent predictors of survival for patients with differentiated thyroid carcinoma has been extensively studied but remains uncertain. Methods: A retrospective analysis of 50 thyroid carcinomas was made to assess prognostic factors including histological variants from September 2019 to February 2022 at our centre. The surgical and histopathological data were studied. Results: 72% patients had papillary thyroid cancer. Multivariate analysis was done and factors showing prognostic significance were tumour size, extrathyroid extension, extranodal extension, lymphovascular, perineural invasion, histological type, necrosis, focality, capsular invasion were found to have poor prognosis. Conclusions: There are histopathological factors which can modify the course and influence the line of treatment of thyroid neoplasms

Physiological and behavioral effects of animal-assisted interventions for therapy dogs in pediatric oncology settings

Over the past two decades, animal-assisted interventions (AAIs), defined as the purposeful incorporation of specially trained animals in services to improve human health, have become increasingly popular in clinical settings. However, to date, there have been few rigorously-designed studies aimed at examining the impact of AAIs on therapy animals, despite a notable potential for stress. The current study measured physiological and behavioral stress indicators in therapy dogs who participated in AAI sessions in pediatric oncology settings, while also examining the psychosocial effects for patients and their parents. This manuscript describes the study’s canine stress findings. Methods: A total of 26 therapy dog-handler teams were paired with newly diagnosed children with cancer at five children’s hospitals in the United States. These teams provided regular AAI visits to the child and his/her parent(s) for a period of four months. The teams completed a demographic form, the Canine Behavioral Assessment & Research Questionnaire (C-BARQ), and a self-report survey to document the types of activities that occurred during each session. Canine saliva was also collected at five baseline time points and 20 minutes after the start of study sessions for cortisol analysis, and all study sessions were video recorded to document the dog’s behavior via an ethogram measure. Results: Data showed no significant differences in salivary cortisol levels between baseline (0.51µg/dL) and AAI sessions (0.44µg/dL), p = 0.757. Higher salivary cortisol was significantly associated with a higher number of stress behaviors per session (p = 0.039). There was a significant relationship between stress and affiliative session behaviors (pConclusions:Results show that therapy dogs did not have significantly increased physiological stress responses, nor did they exhibit significantly more stress-related behaviors than affiliative-related behaviors, while participating in AAIs in pediatric oncology settings. The significant relationship between canine cortisol and behavior, thus strengthening the argument for the use of cortisol in canine well-being research. This study discusses the importance of further investigation to confirm these findings, which may lead to enhanced canine involvement in hospital settings

Laboratory misdiagnosis of von Willebrand disease in post- menarchal females: A multi- center study

Increased awareness of von Willebrand Disease (VWD) has led to more frequent diagnostic laboratory testing, which insurers often dictate be performed at a facility with off- site laboratory processing, instead of a coagulation facility with onsite processing. Off- site processing is more prone to preanalytical variables causing falsely low levels of von Willebrand Factor (VWF) due to the additional transport required. Our aim was to determine the percentage of discordance between off- site and onsite specimen processing for VWD in this multicenter, retrospective study. We enrolled females aged 12 to 50- years who had off- site specimen processing for VWF assays, and repeat testing performed at a consulting institution with onsite coagulation phlebotomy and processing. A total of 263 females from 17 institutions were included in the analysis. There were 251 subjects with both off- site and onsite VWF antigen (VWF:Ag) processing with 96 (38%) being low off- site and 56 (22%) low onsite; 223 subjects had VWF ristocetin co- factor (VWF:RCo), 122 (55%) were low off- site and 71 (32%) were low onsite. Similarly, 229 subjects had a Factor VIII (FVIII) assay, and 67 (29%) were low off- site with less than half, 29 (13%) confirmed low with onsite processing. Higher proportions of patients demonstrated low VWF:Ag, VWF:RCo, and/or FVIII with off- site processing compared to onsite (McNemarʼs test P- value <.0005, for all assays). These results emphasize the need to decrease delays from sample procurement to processing for VWF assays. The VWF assays should ideally be collected and processed at the same site under the guidance of a hematologist.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156476/2/ajh25869.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156476/1/ajh25869_am.pd

Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019

Background Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings An estimated 1·57 billion (95% uncertainty interval 1·51–1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5–21·1]). Of these, 403·3 million (357·3–449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7–479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3–142·6]). Of all people with a hearing impairment, 62·1% (60·2–63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35–2·56) people will have hearing loss, a 56·1% (47·3–65·2) increase from 2019, despite stable age-standardised prevalence. Interpretation As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings

A REVIEW OF EXISTING CLOUD AUTOMATION TOOLS

Many enterprises are running distributed applications on their on-premise servers. However, if load on those servers changes unexpectedly, then itbecomes tedious to scale the resources and requires skilled human power to manage such situations. It may increase the capital expenditure. Hence,many companies have started to migrate their on-premise applications to the cloud. This migration of the applications to the cloud is one of the majorchallenges. To setup and manage the growing complex infrastructure, after migrating these applications to the cloud are really a time-consuming andtedious process which results in downtime. Hence, we need to automate this environment. To achieve architecture for the distributed systems whichsupport security, repeatability, reliability, and scalability, we require some cloud automation tools. This paper summarizes tools such as Terraform andcloud formation for infrastructure automation and Docker and Habitat for application automation

Co-infection of Hepatitis A and Hepatitis E Viruses among the Acute Viral Hepatitis Cases in Tertiary Care Hospital –A Four Years Retrospective Study

Acute viral hepatitis(AVH) is caused by Hepatitis A (HAV) and Hepatitis E(HEV). It is major health burden in India. Both the viruses HAV and HEV are primarily transmitted via the faeco-oral course. Study was conducted to determine the seroprevalence of HAV, HEV and rate of co-infection in AVH patients attending rural tertiary care centre. A retrospective laboratory record based study was carried out in rural tertiary health care center located in Western Maharashtra. Laboratory and Medical records of suspected acute viral infection patients were analyzed during study. Study period was June 2014 to July 2018. Commercially available ELISA kits of IgM anti-HAV and IgM anti-HEV were used to analyze serum samples of suspected study participants. Tests were carried out as per the manufacturer’s instructions. A total of 778 acute viral hepatitis cases were included in the study from July 2014 to July 2018 among which 85/778 (10.9 %) detected positive for HAV and 121/778 (15.6%) detected positive for HEV. Co-infection was identified in 6/778(0.8 %). Jaundice, fever fatigue and hepatomegaly were common clinical presentation in HAV, HEV and confection with both viruses in acute viral hepatitis patients. Study indicated low exposure to HAV in childhood bellow 16 years. Co-infection rate was detected high in 16-25 years age group. Vaccination policy against HAV in adolescent age group needed as there is change epidemiological shift of HAV which has been observed in the current study. These data will helps for planning future vaccination strategies, better implementation sanitation program, and safe water supply in this geographic area