Common sources of radiations in a medical environment

Use of radiation is now a days so common in most of the tertiary care hospitals for diagnostic and therapeutic purpose. The ionizing radiation provides many benefits in both diagnostic as well as therapeutic interventions, but they are also potential harmful. Radiation risks, exposure and mitigation strategies should always be in mind while using to an individual (public, radiation worker, and patient) and the environment should not exceed the prescribed safe limits. Regular monitoring of hospital area and radiation workers is mandatory to assess the quality of radiation safety. This review article emphasis on radiation risks, exposure and prevention and treatment strategies

Epidemiology of carbapenem-resistant Enterobacteriaceae colonization in ICU: a pilot study from a tertiary care hospital in Western Rajasthan, India

Background: Carbapenem-resistant Enterobacteriaceae (CRE) is a serious global public health threat. Antibiotic overuse, improper sanitation and unhygienic practices lead to large scale carriage and rapid spread.Methods: This is a prospective hospital based study planned for a period of 3 months including all patients admitted to 14 bedded Trauma ICU of a tertiary care hospital in Rajasthan. Rectal swabs were collected from admitted patients and carriage of carbapenem resistant Enterobacteriaceae looked for as per CDC guidelines. Screening of the Enterobacteriaceae colonies for carbapenemase production was done by Modified Hodge test. Carbapenem-resistant isolates were also tested for Metallo beta lactamase production by phenotypic disc confirmatory test.Results: A total of 73 patients were screened and 27 CRE isolates were obtained, carriage rate being 37%. A high level of resistance was seen to aminoglycosides, fluoroquinolones and cephalosporins. 100% sensitivity was however seen to Colistin, Tigecycline and Fosfomycin. 5 out of 27 strains showed a positive MHT test. Metallo beta lactamase (MBL) production was seen in 21/25 strains as tested by meropenem and Meropenem-EDTA discs.Conclusions: The current pilot study finds out the prevalence of CRE carriage among critically ill patients and stresses upon strong need for stringent infection control measures

Exploring Large Language Models for Code Explanation

Automating code documentation through explanatory text can prove highly beneficial in code understanding. Large Language Models (LLMs) have made remarkable strides in Natural Language Processing, especially within software engineering tasks such as code generation and code summarization. This study specifically delves into the task of generating natural-language summaries for code snippets, using various LLMs. The findings indicate that Code LLMs outperform their generic counterparts, and zero-shot methods yield superior results when dealing with datasets with dissimilar distributions between training and testing sets.Comment: Accepted at the Forum for Information Retrieval Evaluation 2023 (IRSE Track

GCS score and MRI grading does not predicts the outcome in dai patients: A prospective study

Diffuse axonal injury (DAI) is a type of brain injury due to extensive lesions in white matter tract occurring over a wide area. It is one of the most common and devastating types of traumatic brain injury and major cause of unconsciousness and persistent vegetative state after head trauma. DAI occurs in about half of all cases of severe head trauma. The study was undertaken to correlate the GCS at time of admission and Grade of DAI with the outcome. Aim: - To correlate GCS Score and MRI grading with the outcome in DAI patients. Setting and Design: - A 3 months prospective study was conducted in Department of Neurosurgery. Material and Method: - Sources of Data: - Patients admitted with clinical diagnosis of Diffuse Axonal Injury under Department of Neurosurgery. Sample size: - 50 cases of Diffuse Axonal Injury. Inclusion Criteria: - All traumatic DAI Patients requiring ICU care. Exclusion Criteria: - Head injury patients requiring Surgery. Patients other findings on imaging as contusion, EDH, SDH, IVH.Patients with Sepsis. Patients with other co morbid Illness as DM, Hypertension. Patients who were haemodynamically unstable at the time of admission. Patients with other systemic injuries. Statistical Analysis. Data so collected was analysed using IBM SPSS Statistics Windows, version 20.0 (Armonk, NY: IBM Corp) for the generation of descriptive and inferential statistics. The statistical significant difference among age groups was determined by Chi square test and one way analyses of variance. The level of significance was set at p?0.05. Results: Distribution of patients according to Gender and MRI Grading shown in Table 1. Total 50 patients were evaluated out of which 38 (76%) were male and 12 (24%) were female. Number of patients according to Grading [Table 2 and Fig. 1] Out of 50 patients admitted 10% (5) constitutes Grade 1 DAI, 28% (14) grade II, and 62% (31) Grade III. Grades of DAI according to age of patients [Table 3]. Mean age in Grade I patients was 20.83±3.63, Grade II 23.36±7.089 and in Grade III 22.32±11.38. Comparisons of Mean ICU stay Mean Hospital stay and Mortality in Different GCS Groups [Table 4]. In patients with GCS 3-8 the mean ICU stay was 18.48±14.53, mean hospital stay was 37.24±12.31 and Mortality was 15.21%, in patients with GCS 9-12, mean ICU stay was 10.5±4.12, Hospital stay 19.4±5.79 and mortality was 25%. Comparison of Mean ICU stay, and Ventilator stay in different MRI Grade [Table 5]. In patients with Grade I DAI Mean ICU stay was 17.13±14.65 and Mean Ventilator stay was 6.24±2.57, In Grade II DAI mean ICU stay was 20.57±15.45 and Ventilator stay was 12.01±3.82 and in Grade III mean ICU stay was 23.4±15.41 and mean Ventilator stay was 10.89±2.58. Mortality of patients in different Grades and GCS groups [Table 6 and Fig 2] In patients with GCS 9-12 and Grade III only 1 patient died, while in patients with GCS 3-8 total 7 died, 2 in Grade I, 2 in Grade II and 3 in Grade III. Complications [Table 7] Out of 5 patients in Grade I, electrolyte imbalance was seen in 1 patient in the form of hypernatraemia, 1 patient developed seizure, and septicaemia was seen in 1 and 1 patient developed shock. In patients with Grade II DAI out of 14 patients 1 had ventilator associated pneumonia, hypernatraemia was seen in 1, 1patient developed bed sore, seizures seen in 3, 2 had septicaemia & shock was seen in 2, and in 1drug reaction occurred. Out of 31 patients with Grade III DAI 2 developed ventilator associated pneumonia, hypernatraemia and hyponatraemia was seen in 2 & 1 patient respectively, 2 developed bedsore, seizure in 1 and septicaemia and shock was seen in 3-3 patients. Conclusion:-Diffuse axonal injury is a very common finding in traumatic head injury patients. Magnetic resonance imaging and GCS scoring does not have appropriate prognostic value in pure DAI patients and a better survival rate can be achieved with dedicated neurocritical care and neurosurgical management

Comparison of Ultrasound Guided Femoral Nerve Block And Parenteral Tramadol In Acute Trauma Patients With Fracture Femur: An Observational Study

Aim: The aim of present study is to compare the analgesic effects of USG guided femoral nerve block (FNB) with parenteral tramadol in patients with fractured femur shaft. Methodology: This prospective randomized observational study was carried out in the Department of Anaesthesiology and Critical care, Dr. S.N. Medical College, Jodhpur and associated group of hospitals after getting approval from ethical committee. In our study total 60 patients were enrolled and divided randomly into two groups. One group received Femoral Nerve Block (Group R- 0.5% ropivacaine) and other group received intravenous tramadol ( group T). A written and informed consent was taken from the patient after explaining the procedure to the patient. Patients were observed for onset and duration of analgesia, hemodynamic and respiratory parameters changes, side effects or complications of study drugs and block. Results: it was observed that FNB with ropivacaine provides earlier and prolonged duration of analgesia as compared to intravenous tramadol. The reduction in rescue analgesia might be due to prolonged and better analgesia provided by ropivacaine in R group. None of our patients in both the study groups experienced haemodynamic unstability. Conclusion: The USG guided Femoral nerve block with 0.5% ropivacaine is safe, simple and effective method for relieving intense pain due to femur shaft fracture. No systemic side effects were observed and haemodynamic stability was also well maintained in patients with moderate general condition

Comparison of Ultrasound Guided Femoral Nerve Block And Parenteral Tramadol In Acute Trauma Patients With Fracture Femur: An Observational Study

Aim: The aim of present study is to compare the analgesic effects of USG guided femoral nerve block (FNB) with parenteral tramadol in patients with fractured femur shaft. Methodology: This prospective randomized observational study was carried out in the Department of Anaesthesiology and Critical care, Dr. S.N. Medical College, Jodhpur and associated group of hospitals after getting approval from ethical committee. In our study total 60 patients were enrolled and divided randomly into two groups. One group received Femoral Nerve Block (Group R- 0.5% ropivacaine) and other group received intravenous tramadol ( group T). A written and informed consent was taken from the patient after explaining the procedure to the patient. Patients were observed for onset and duration of analgesia, hemodynamic and respiratory parameters changes, side effects or complications of study drugs and block. Results: it was observed that FNB with ropivacaine provides earlier and prolonged duration of analgesia as compared to intravenous tramadol. The reduction in rescue analgesia might be due to prolonged and better analgesia provided by ropivacaine in R group. None of our patients in both the study groups experienced haemodynamic unstability. Conclusion: The USG guided Femoral nerve block with 0.5% ropivacaine is safe, simple and effective method for relieving intense pain due to femur shaft fracture. No systemic side effects were observed and haemodynamic stability was also well maintained in patients with moderate general condition

Pill Esophagitis: Clinical and Endoscopic Profile

Background Medications can rarely cause esophageal injury and present with acute symptoms. Multiple factors, including the type of medication, comorbidity, and method of ingestion play a role in causing drug-induced or pill esophagitis (PE). We analyzed the clinical, endoscopic, and histopathological profiles of PE cases at our gastroenterology outpatient clinic

Вплив онлайн-занять віньяса-йогою на витривалість нижньої та верхньої частини тіла домогосподарок: рандомізоване дослідження в період після пандемії COVID-19

Study purpose. The COVID-19 pandemic has a considerable impact on social and financial factors in addition to health outcomes. There is, however, still little information available as to how Covid-19 actually impacted housewives. Consequently, this paper aims to provide a new dimension to the study of how vinyasa could support mothers’ fitness throughout the pandemic. This study sought to determine whether an online vinyasa programme for 8 weeks during Covid-19 pandemic could significantly influence housewives’ upper and lower body muscle endurance. Materials and methods. 24 housewives (between the ages of 26 and 36) from the NCR region of Delhi participated in the study. The participants were divided at random and put either into the experimental group (vinyasa) or the control group. Both upper and lower body muscular endurance was found to be the health-related variable. The longest-lasting bent knee push-ups were used to gauge upper body muscular endurance, while the longest-lasting bodyweight squat holds over a 90-degree angle were used to gauge lower body muscle endurance. Results. To analyse the findings, tests were run both prior to and following the training. A substantial difference between the experimental group and control group was found using ANCOVA to compare them to the baseline after 8 weeks. Conclusions. Thus, it was determined that the online/virtual vinyasa training programme was a successful way for housewives to increase  their body muscular endurance (health-related fitness).  Мета дослідження. Пандемія COVID-19 має значний вплив на соціальні та фінансові фактори, окрім наслідків для здоров’я. Однак поки що мало інформації про те, як Covid-19 насправді вплинув на домогосподарок. Отже, метою цієї статті є забезпечення нового виміру дослідженню того, як віньяса-йога могла підтримувати фізичну форму матерів протягом пандемії. Метою цього дослідження було визначити, чи могла онлайн-програма занять віньяса-йогою протягом 8 тижнів під час COVID-19 суттєво вплинути на витривалість м’язів верхньої та нижньої частини тіла домогосподарок. Матеріали та методи. У дослідженні взяли участь 24 домогосподарки (віком від 26 до 36 років) з Національносго столичного регіону Делі (Індія). Учасниць розподілили випадковим чином до експериментальної групи (віньяса-йога) або до контрольної групи. Установлено, що м’язова витривалість як верхньої, так і нижньої частини тіла є змінною, пов’язаною зі здоров’ям. Найтриваліші віджимання на колінах використовували для вимірювання витривалості м’язів верхньої частини тіла, тоді як найтриваліші утримання присіду із власною вагою під кутом 90 градусів використовували для вимірювання витривалості м’язів нижньої частини тіла. Результати. Для аналізу отриманих результатів були проведені тести до та після тренування. Між експериментальною та контрольною групою було виявлено значну різницю за допомогою коваріаційного аналізу, який використовували для їх порівняння із вихідним рівнем через 8 тижнів. Висновки. Таким чином, було визначено, що онлайн/віртуальна програма занять віньяса-йогою є успішним способом для домогосподарок підвищити м’язову витривалість свого тіла (фізичну витривалість)

Mortality predictors during the third wave of COVID-19 pandemic: A multicentric retrospective analysis from tertiary care centers of Western India

Background: The COVID-19 has a varied mode of presentation in different regions of the world. This multicentric study was planned to evaluate the survival outcomes in intensive care unit-admitted patients admitted during the third wave of the COVID-19 pandemic on the basis of clinicodemographic profile and vaccination status. Methodology: Data from 299 patients admitted to three tertiary care centers in Western India were collected and analyzed. Based on survival outcomes, all patients were divided into two groups: survivors and nonsurvivors. Univariate analysis of the demographic profile, comorbidities, vaccination status, and disease severity was performed, whereas multivariate analysis was performed to predict independent factors associated with mortality. Results: Among total 299 studied patients, 208 (69.5%) patients survived and 91 (30.4%) did not. The number of elderly patients and patients with comorbidities such as diabetes, tuberculosis, chronic obstructive pulmonary disease, cardiovascular and respiratory diseases, and malignancy were more prevalent among nonsurvivors. Patients who did not receive a single dose of vaccine were higher in the nonsurvivor group (P = 0.037); however, no significant difference in survival outcome was found if patients had received the first or both doses of vaccine. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score at 24 h after admission and Sequential Organ Failure Assessment (SOFA) score at admission were significantly higher in nonsurvivors compared to survivors (P < 0.0001). On multivariate analysis, APACHE II and SOFA scores were found to be independent predictors of outcome. Conclusions: Older age, presence of comorbidities, nonvaccination and higher disease severity scores affected mortality during the third wave of COVID-19