Level of satisfaction of patients attending out-patient department of radiotherapy department of a tertiary hospital in Raipur, Chhattisgarh, India

Background: Like any service organization, the main aim of the Health Service organization is creation of satisfaction among their service consumers. Patient satisfaction has been defined as the degree of congruency between a patient’s expectations of ideal case versus his perception of real care he or she receives. Mismatch between patient’s expectation of the service received is related to decreased satisfaction. Therefore, assessing patient perspective gives them a voice, which can make public health services more responsive to people’s needs and expectations.Methods: The study used IN-PATSAT32 questionnaire developed by the European Organization for Research and Treatment of Cancer (EORTC) with a few modifications to suit all the patients (in or out-patients). Sample size:200 patients.Results: Out of total patients assessed, 41.5% of patients were highly satisfied(excellent), 56% of patients were satisfied with the services provided by the radiotherapy department at Dr. B. R. A. M. hospital, Raipur and only 5% of patients rated the services as “poor” i.e. we’re not satisfied.Conclusions: The findings of the study will help us educate the prescribers about the various neglected areas of the consultation which will go a long way to develop a consistent relationship between the providers and the beneficiaries for the attainment of the “Health for all

Effect of Population Structures on Quantum-Inspired Evolutionary Algorithm

Quantum-inspired evolutionary algorithm (QEA) has been designed by integrating some quantum mechanical principles in the framework of evolutionary algorithms. They have been successfully employed as a computational technique in solving difficult optimization problems. It is well known that QEAs provide better balance between exploration and exploitation as compared to the conventional evolutionary algorithms. The population in QEA is evolved by variation operators, which move the Q-bit towards an attractor. A modification for improving the performance of QEA was proposed by changing the selection of attractors, namely, versatile QEA. The improvement attained by versatile QEA over QEA indicates the impact of population structure on the performance of QEA and motivates further investigation into employing fine-grained model. The QEA with fine-grained population model (FQEA) is similar to QEA with the exception that every individual is located in a unique position on a two-dimensional toroidal grid and has four neighbors amongst which it selects its attractor. Further, FQEA does not use migrations, which is employed by QEAs. This paper empirically investigates the effect of the three different population structures on the performance of QEA by solving well-known discrete benchmark optimization problems

Climate-driven differences in growth performance of cohabitant fir and birch in a subalpine forest in Dhorpatan Nepal

Himalayan Silver Fir (Abies spectabilis) and Himalayan Birch (Betula utilis) are tree species often found coexisting in sub-alpine forests of the Nepal Himalayas. To assess species-specific growth performances of these species, tree-ring samples were collected from the subalpine forest in the Dhorpatan Hunting Reserve, Nepal. Standard ring width chronologies of both species were correlated with climatic variables in both static and running windows. Differential and contrasting temporal responses of radial growth of these species to climate were found. Warmer and drier springs appeared to limit birch radial growth. Whereas radial growth of fir showed weakened climate sensitivity. Moving correlation analyses revealed divergent influences of spring climate on both fir and birch. Significant warming that occurred in the 1970s coincided with growth declines in birch and an increase in fir, as indicated by basal area increment. In summary, recent warming has been unfavorable for birch, and favorable to fir radial growth.publishedVersio

Prevalence of goitre, iodine uptake and salt iodization level in Mahasamund district of Chhattisgarh: a baseline study in Central India

Background: Iodine deficiency disorder (IDD) is the single most important preventable cause of brain damage. Iodine deficiency disorders (IDDs) refer to all of the consequences of iodine deficiency in a population, which can be prevented by taking adequate amount of Iodine.  The objectives was to ascertain the prevalence goitre among 6-12 year children by clinical examination in Mahasamund district; 2) to document the iodine uptake status reflected by random urinary excretion levels in a sub-sample of 6-12 year children covered for clinical examination, and 3) to evaluate the coverage of iodized salt at community level (i.e. at household and retail shop) on-the-spot test by using rapid salt testing kit.Methods: A cross sectional community based survey was done in Mahasamund district during April 2015 to September 2015. The study population was children in the age group of 6-12 years. 30 cluster sampling methodology was applied using PPS sampling technique, based on latest survey guidelines of NIDDCP of Govt. of India. The parameters studied were prevalence of goitre, urinary iodine excretion, and iodine content in salt at community level (i.e. household and shop).Results: A total of 2700 children aged from 6-12 years were assessed clinically for goitre. The total goitre prevalence was 4.29% (95% CI: 3.3-5.27). The median urinary iodine excretion (MUIE) was 106.67μg/L (range 11-216.7μg /L) among surveyed children.  37.4% of the urinary iodine excretion values were <100 μg/L. The households consuming inadequately iodized salt (i.e. iodine content ≤15 ppm) was 20% in the surveyed district.Conclusions: Although prevalence of goitre and median urinary iodine excretion among surveyed population was found satisfactory against the norms set by NIDDCP in surveyed district but universal salt iodization (USI) is yet to achieve in surveyed district.

Efficacious and Safe Tissue-Selective Controlled Gene Therapy Approaches for the Cornea

Untargeted and uncontrolled gene delivery is a major cause of gene therapy failure. This study aimed to define efficient and safe tissue-selective targeted gene therapy approaches for delivering genes into keratocytes of the cornea in vivo using a normal or diseased rabbit model. New Zealand White rabbits, adeno-associated virus serotype 5 (AAV5), and a minimally invasive hair-dryer based vector-delivery technique were used. Fifty microliters of AAV5 titer (6.5×1012 vg/ml) expressing green fluorescent protein gene (GFP) was topically applied onto normal or diseased (fibrotic or neovascularized) rabbit corneas for 2-minutes with a custom vector-delivery technique. Corneal fibrosis and neovascularization in rabbit eyes were induced with photorefractive keratectomy using excimer laser and VEGF (630 ng) using micropocket assay, respectively. Slit-lamp biomicroscopy and immunocytochemistry were used to confirm fibrosis and neovascularization in rabbit corneas. The levels, location and duration of delivered-GFP gene expression in the rabbit stroma were measured with immunocytochemistry and/or western blotting. Slot-blot measured delivered-GFP gene copy number. Confocal microscopy performed in whole-mounts of cornea and thick corneal sections determined geometric and spatial localization of delivered-GFP in three-dimensional arrangement. AAV5 toxicity and safety were evaluated with clinical eye exam, stereomicroscopy, slit-lamp biomicroscopy, and H&E staining. A single 2-minute AAV5 topical application via custom delivery-technique efficiently and selectively transduced keratocytes in the anterior stroma of normal and diseased rabbit corneas as evident from immunocytochemistry and confocal microscopy. Transgene expression was first detected at day 3, peaked at day 7, and was maintained up to 16 weeks (longest tested time point). Clinical and slit-lamp eye examination in live rabbits and H&E staining did not reveal any significant changes between AAV5-treated and untreated control corneas. These findings suggest that defined gene therapy approaches are safe for delivering genes into keratocytes in vivo and has potential for treating corneal disorders in human patients

In Memoriam: A Memoir for Our Fallen "Heroes"

This article is made available for unrestricted research re-use and secondary analysis in any form or be any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Even though neurosurgeons exercise these enormous and versatile skills, the COVID-19 pandemic has shaken the fabrics of the global neurosurgical family, jeopardizing human lives, and forcing the entire world to be locked down. We stand on the shoulders of the giants and will not forget their examples and their teachings. We will work to the best of our ability to honor their memory. Professor Harvey Cushing said: “When to take great risks; when to withdraw in the face of unexpected difficulties; whether to force an attempted enucleation of a pathologically favorable tumor to its completion with the prospect of an operative fatality, or to abandon the procedure short of completeness with the certainty that after months or years even greater risks may have to be faced at a subsequent session—all these require surgical judgment which is a matter of long experience.” It is up to us, therefore, to keep on the noble path that we have decided to undertake, to accumulate the surgical experience that these icons have shown us, the fruit of sacrifice and obstinacy. Our tribute goes to them; we will always remember their excellent work and their brilliant careers that will continue to enlighten all of us. This memorial is intended to commemorate our colleagues who succumbed during the first 4 months

Mapping disparities in education across low- and middle-income countries

Analyses of the proportions of individuals who have completed key levels of schooling across all low- and middle-income countries from 2000 to 2017 reveal inequalities across countries as well as within populations. Educational attainment is an important social determinant of maternal, newborn, and child health(1-3). As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting(4-6). The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness(7,8); however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health(9-11). Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but-to our knowledge-no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries(12-14). By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations.Peer reviewe