Magnetic Resonance (MR) Patterns of Brain Metastasis in Lung Cancer Patients: Correlation of Imaging Findings with Symptom

IntroductionAsymptomatic brain metastasis in lung cancer patients, if detected early have been reported to show survival benefit with treatment. These asymptomatic metastasis have been found to be smaller and less in number than those with symptoms. We however observed that many lung cancer patients bear a significant metastatic load in the brain irrespective of the stage or neurologic symptoms at the time of initial presentation.Material and MethodsA retrospective study was conducted on 175 patients of proven non-small cell lung cancer to assess the patterns of brain metastasis in the two groups of patients, with and without neurologic symptoms. All patients had undergone screening magnetic resonance imaging for brain metastasis as an initial staging protocol. The patients with brain metastasis were divided into two groups: asymptomatic (group I) and symptomatic (group II). The lesions were studied with regards to the number, size, site, nature (solid with and without necrosis), and presence of perilesional edema and intralesional hemorrhage in both the groups in various stages of disease.ResultsBrain metastasis was seen in 62 (31.3%) patients of whom 46.7% were neurologically asymptomatic. Patients (90.3%) with brain metastasis were in stage IV at the time of presentation. No statistically significant correlation was found between the two groups regarding the number of lesions (p = 0.554), size of lesion (p = 0.282), site of lesion (p = 0.344), nature of lesion (p = 0.280), presence of perilesional edema (p = 0.404), and presence or absence of intralesional hemorrhage (p = 0.09). In our study, brain metastases were present only in stages III and IV disease with no statistically significant difference in the lesion patterns.ConclusionThe study reveals almost equal number of patients with brain metastasis in the symptomatic and asymptomatic groups with no significant difference in lesion patterns. We therefore conclude that although imaging surveillance of the brain for metastasis will detect asymptomatic metastasis early for early institution of appropriate therapy the prognosis in these patients would not solely depend on the presence or absence of symptoms and the pattern of lesion may have an influence on the patients’ response to therapy and survival benefit specially for those asymptomatic patients with equally large metastatic load

Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility

Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm’s potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause

ChatGPT: An online cross-sectional descriptive survey comparing perceptions of healthcare workers to those of other professionals

Background: Chat Generative Pre-Trained Transformer (ChatGPT) is an artificial intelligence tool that interacts using natural human language. Its recent launch has generated immense interest and utilization. Objectives: Our primary aim was to document the early perceptions regarding ChatGPT and its potential impact on the lives of healthcare professionals. Our secondary aim was to compare the perceptions of healthcare professionals regarding ChatGPT with those of non-healthcare professionals. Materials and Methods: The survey questions were decided by all authors in consultation. Between February 6, 2023, and February 17, 2023, we conducted an anonymous survey using Google Forms. The survey comprised nine multiple-choice questions, related to perceptions about ChatGPT. The respondents were divided into two groups based on their profession (healthcare versus others). The survey results were analyzed using ChatGPT. Results: There were 210 participants; 157 (74.8%) were healthcare professionals, and 53 (25.2%) were from other fields. Less than half the respondents (n = 89, 42.4%) reported that they had already asked ChatGPT a question. Significantly fewer healthcare professionals (n = 63, 40.1%) than non-healthcare professionals (n = 25, 47.2%) had used ChatGPT; P = 0.01. Majority of respondents (161/210; 76.6%) expected ChatGPT to have less than 50% impact on them in the year 2023. However, significantly more healthcare professionals (n = 122, 77.7%) than non-healthcare professionals (n = 39, 73.6%) thought that the change would be less than 50%; P = 0.049. More healthcare professionals expected ChatGPT to positively impact their careers (n = 82, 52.2% versus n = 20, 37.7%; P < 0.001). More respondents from the healthcare sector (n = 32, 20.4%) planned to make changes in their career as a result of ChatGPT than respondents from other professions (n = 6, 11.3%); P = 0.008. Additionally, more healthcare professionals considered that the effect on the future of civilization and the human race (as predicted by Stephen Hawking) would be favorable (n = 113, 72%) as compared to non-healthcare professionals (n = 36, 67.9%); P = 0.019. Conclusions: Although fewer healthcare professionals have accessed and used ChatGPT than non-healthcare professionals,healthcare professionals' perception of ChatGPT is predominantly positive. Regardless of our professions, all of us will need to reinvent ourselves in the new era of artificial intelligence and chatbots

Grade IV myositis: A rare complication of docetaxel

An extremely rare case of acute inflammatory myopathy during combination chemotherapy with docetaxel and carboplatin for metastatic breast carcinoma in a 62-year-old diabetic female patient is reported. Despite the early clinical partial response of the underlying malignancy to the chemotherapeutic regimen, the patient developed symmetrical, painful, proximal muscle weakness in the lower limbs with peripheral edema after the administration of the third cycle of treatment. The syndrome regressed after the discontinuation of chemotherapy and the administration of corticosteroids

Psychological challenges encountered by health care professionals having a risk of accidental exposure and its impact on their wellbeing in a non-covid hospital during the prevailing pandemic

Health care professionals played and are still playing a crucial role in containing the spread of the coronavirus (SARS-CoV 2). While being a frontliner and saving the lives of patients, healthcare professionals (HCP’s) have encountered physical but varied levels and types of psychological challenges. Psychological challenges faced by HCP’s at covid care centres have been highlighted by many researches and publications. The purpose of this study was to highlight the psychological challenges encountered by HCP’s at a non-covid cancer care institute. A self-designed survey about psychological challenges (physical changes, anxiety, perceived fear, depression, awareness, and positivity) experienced by HCP’s with purposive sampling (Doctors) was conducted in a tertiary cancer care institute. Results revealed that fear and anxiety of getting infected and infecting their significant others was significantly high among HCP’s. To maintain an effective, encouraging, and motivating workforce, psychological interventions played a key role