Publications by authors named "Harpreet Singh"

508 Publications

Structure-based study to identify alkaloids as promising cytochrome P450 (CYP1A1) inhibitors: An in silico approach using virtual screening, molecular dynamic simulations, and binding free energy calculation.

J Cell Biochem 2022 Jun 28. Epub 2022 Jun 28.

Division of Molecular Genetics and Biochemistry, Molecular Biology Group, ICMR-National Institute of Cancer Prevention and Research, Noida, India.

Carcinogens present in smokeless tobacco (SLT) like tobacco-specific nitrosamines can be metabolized by the cytochrome P450 (CYP450) enzyme. Functionally, the CYP450 enzyme resides in a heme pigment to perform the catalytic activity. The CYP1A1 is one of the main extrahepatic CYP450 enzymes known to detoxify toxic substances and activate carcinogens. The CYP1A1 inhibition by potential inhibitors reduce the chance of oral cancer. The current study aimed to explore more about the inhibitor binding site and identification of lead alkaloids, that could work as putative inhibitors against target CYP1A1. In respect, we have performed docking studies, virtual screening of alkaloids, and natural product libraries against CYP1A1 followed by molecular dynamic simulations and binding free energy calculations. Docking studies of tobacco-specific nitrosamine (TSNA) products and their similar carcinogen analogs revealed that the heme group is bound to the floor of the bowl-shaped cavity whereas carcinogens are bound to the roof of the rounded shape cavity. Furthermore, virtual screening and binding free energy calculations revealed Tomatidine as a putative inhibitor against CYP1A1. On the basis of altogether outcomes of the current study, we have concluded that the addition of lead-hit alkaloid Tomatidine and others in SLT products may be working as a supplement that could be able to reduce the expression of human CYP1A1 and suppresses carcinogenic by-products formations.
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http://dx.doi.org/10.1002/jcb.30302DOI Listing
June 2022

Analysis of the COVID-19 testing parameters and progression of the pandemic at the district level- findings from the ICMR- Hundred Million Test (HMT) database during the first wave in India.

Int J Infect Dis 2022 Jun 22. Epub 2022 Jun 22.

ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha, India. Electronic address:

Background: India had the second highest number of COVID-19 cases globally. We evaluated the progression of the pandemic across the lockdowns and phased reopening at the district level during the first wave (in India).

Methods: More than 100 million COVID-19 test results along with other parameters available in the Indian Council of Medical Research (ICMR) database during March-October, 2020, were used for the analysis. The districts were stratified as high, moderate, and low case load districts, and data analysis was done for each phase of lockdown.

Findings: Of the 110.5 million tests included in the analysis, 54.79 million tests were performed using molecular methods, 53.58 million by rapid antigen tests (RATs) and 2.13 million using the indigenous TruNat platform. The proportion of positives among symptomatic individuals (22.6%) was significantly higher than asymptomatic individuals (8.6%). The tests conducted, and proportions of positivity were significantly higher in high caseload districts and 58% of these tests were conducted using molecular methods as opposed to only one-third in low case load districts.

Interpretation: Laboratory parameters, along with other demographic information, can help us better understand the spread of the pandemic in a country. Such information can be crucial to formulate and implement public health policies in any future waves of the pandemic.
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http://dx.doi.org/10.1016/j.ijid.2022.06.027DOI Listing
June 2022

Composition and Ecological Functionality of Fungal Communities Associated with Smokeless Tobacco Products Mainly Consumed in India.

Microbiol Spectr 2022 Jun 13:e0227321. Epub 2022 Jun 13.

Division of Molecular Genetics and Biochemistry, Molecular Biology Group, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India.

The microbial communities present in smokeless tobacco products (STPs) perform critical steps in the synthesis of carcinogens, mainly tobacco-specific nitrosamines (TSNAs). Most studies emphasize the bacterial component, and the mycobiome of STPs has not been well characterized. In this study, we investigated the fungal communities in the different categories of STPs by sequencing the internal transcribed spacer (ITS) rRNA region of the fungal genome. The ecological character of the fungal community associated with STPs was determined by using FUNGuild. Our results indicated that and were the most abundant fungal phyla across all STPs. The predominant fungal genera in STPs were Pichia, Sterigmatomyces, and Mortierella. The α-diversity varied significantly across the STPs based on observed, Fisher, and Shannon indices. Using SparCC cooccurrence network analysis, significant positive correlations of 58.5% and negative connections of 41.5% were obtained among fungal genera identified in STPs. Furthermore, the functional predictions by FUNGuild determined that STPs possessed high abundances of saprotroph and pathotroph-saprotroph-symbiotroph fungal trophic groups. At the functional guild level, the qiwam samples contained high abundances of soil saprotrophs, while plant pathogens were prevalent in pan-masala samples. These results suggest that various fungal populations reside in STPs and interrelate with each other and can contribute to the synthesis of TSNAs. This study has established the basis for future large-scale investigations of STP-associated mycobiota and the impact of such mycobiota in oral carcinogenesis in STP users via inflammation and carcinogens (TSNAs and mycotoxins). Smokeless tobacco products (STPs) contain complex microbial communities that influence the synthesis of carcinogens, such as tobacco-specific nitrosamines (TSNAs). Research on STP-associated bacterial populations revealed connections between bacterial metabolism and TSNA synthesis. The abundance of the fungal population may also have an impact on the production of TSNAs. This study examined STPs popularly used in India, and diverse fungal communities were identified in these STPs. Pichia, Sterigmatomyces, and Mortierella were the predominant fungal genera in the STPs. High abundances of saprotroph and pathotroph-saprotroph-symbiotroph trophic groups in STPs could affect the degradation of tobacco products and the synthesis of TSNAs.
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http://dx.doi.org/10.1128/spectrum.02273-21DOI Listing
June 2022

FDA Approval Summary: Cabozantinib for Differentiated Thyroid Cancer.

Clin Cancer Res 2022 Jun 9. Epub 2022 Jun 9.

Food and Drug Administration, Silver Spring, United States.

On September 17, 2021, the U.S. Food and Drug Administration (FDA) approved cabozantinib (Cabometyx; Exelixis, Inc.) for the treatment of adult and pediatric patients 12 years of age and older with locally advanced or metastatic differentiated thyroid cancer (DTC) that has progressed following prior VEGFR-targeted therapy and who are radioactive iodine (RAI)-refractory or ineligible. This is the first approval for patients with RAI-refractory locally advanced or metastatic DTC who have progressed following prior therapy and the first approval in pediatric patients with DTC. The approval was based on data from COSMIC-311 (Study XL184-311, NCT03690388), an international, randomized, double-blind trial in which patients with locally advanced or metastatic RAI-refractory DTC that progressed during or following treatment with at least one VEGFR-targeting tyrosine kinase inhibitor (TKI) were treated with either cabozantinib 60 mg orally once daily (N=170) or placebo with best supportive care (N=88). The primary efficacy outcome measures were progression-free survival (PFS) and overall response rate (ORR) by blinded independent central review (BICR) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. The median PFS was 11.0 months (95% CI: 7.4, 13.8) in the cabozantinib arm compared to 1.9 months (95% CI 1.9, 3.7) in the control arm, with a hazard ratio (HR) of 0.22 (95% CI: 0.15, 0.31). The endpoint of ORR was not met. No new safety signals were identified with the exception of hypocalcemia which was added as a warning in the product labeling.
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http://dx.doi.org/10.1158/1078-0432.CCR-22-0873DOI Listing
June 2022

Topical non-aqueous nanoemulsion of Alpinia galanga extract for effective treatment in psoriasis: In vitro and in vivo evaluation.

Int J Pharm 2022 Jun 4:121882. Epub 2022 Jun 4.

Department of Life Sciences, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia.

Non-aqueous nanoemulsion (NANE) of Alpinia galanga extract (AGE) was prepared using Palmester 3595 (MCT oil) as oil phase, Cremophor RH 40-Transcutol P® as surfactant-co-surfactant (S), and glycerin as non-aqueous polar continuous phase. The composition was optimized by applying three-level, four factor Box-Behnken design (BBD). The mean droplet size and zeta potential of the optimized AGE NANE was found to be 60.81 ± 18.88 nm and -7.99 ± 4.14 mV, respectively. The ex vivo permeation studies of AGE NANE and AGE per se on porcine skin reported flux of 125.58 ± 8.36 µg/cm h and 12.02 ± 1.64 µg/cm h, respectively. Therefore, the enhancement ratio has shown 10-folds increase in the flux for AGE NANE when compared to extract per se. Later, confocal laser scanning microcopy confirmed that AGE NANE were able to penetrate into skin's stratum by trans-follicular transport mechanism. The stability studies of AGE NANE confirmed its stability at 30 ± 2 °C/75 ± 5 % RH and 5 ± 3 °C. The efficacy of AGE NANE was evaluated in vivo on imiquimod (IMQ) induced mouse model. The mice treated with low and high doses of AGE NANE (groups VI and VII) showed significant (p < 0.05) amelioration of psoriasis. Results of histopathology indicated reduction in psoriasis area severity index in AGE NANE treated mice (group VI and group VII).
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http://dx.doi.org/10.1016/j.ijpharm.2022.121882DOI Listing
June 2022

Development of carbon quantum dot-based lateral flow immunoassay for sensitive detection of aflatoxin M1 in milk.

Food Chem 2022 Nov 1;393:133374. Epub 2022 Jun 1.

Department of Biotechnology, University Institute of Engineering Technology (UIET), Panjab University, Chandigarh, India. Electronic address:

Currently, there is a great demand for simple, sensitive, and accurate sensors for aflatoxin M1 (AFM1) in dairy products. In the present research, a novel fluorescent immunosensor based on nitrogen-doped carbon quantum dots (CQDs) has been developed for AFM1 analysis. The N-doped CQDs were synthesized through the hydrothermal approach using citric acid and polyethyleneimine as precursors. The CQDs showed bright blue emission under ultraviolet light irradiation and a maximum emission was observed at 450 nm upon excitation at 350 nm. The anti-AFM1 antibody (Ab) was immobilized on the as-obtained amine-functionalized CQDs and the obtained CQDs/Ab probe was then directly used for developing the immunoassays for AFM1. The fluorescence of the CQDs/Ab solution was effectively quenched in the presence of increasing AFM1 concentrations. Under the optimized conditions, the fluorescent nanosensor exhibited high sensitivity towards AFM1 in the range of 0.2-0.8 ng/mL with low limit of detection i.e., 0.07 ng/mL in standard buffer. Furthermore, the CQDs/Ab immunosensor was developed as a lateral flow design for detecting the aflatoxin residues in milk. This strategy can be used for the development of low-cost, rapid, and highly sensitive sensor strips for the detection of AFM1 in dairy products.
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http://dx.doi.org/10.1016/j.foodchem.2022.133374DOI Listing
November 2022

A wolf in sheep's clothing: Dogs confer an unrecognized risk for their immunocompromised master.

Respir Med Case Rep 2022 25;38:101672. Epub 2022 May 25.

Department of Medicine, Division of Pulmonary and Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA.

Bordetella bronchiseptica is a pleomorphic gram-negative coccobacillus that commonly causes respiratory tract infections in canines, felines, and swine. Human infections are rare. We report a case of Bordetella bronchiseptica pneumonia in a 67-year-old immunocompromised host. His past medical history included multiple myeloma treated with autologous bone marrow transplant followed by a chimeric antigen receptor cell therapy for relapse. He was admitted with unrelenting diarrhea due to HHV-6 pancolitis. During the hospital course he developed high-grade fever (102.3°F), cough and respiratory failure requiring mechanical ventilation. Chest imaging demonstrated bilateral opacities most pronounced at lung bases and worsening mediastinal lymphadenopathy. Bronchoalveolar lavage cultures grew Bordetella bronchiseptica. He was treated with piperacillin/tazobactam, but developed progressive multiorgan failure, transitioned to comfort care, and expired in the hospital. Bordetella bronchiseptica is an organism that do not cause serious infection in immunocompetent persons but can sometimes cause serious illness in immunocompromised populations. It causes "kennel cough" in dogs and spready by respiratory droplets. Dogs and cats are not uniformly vaccinated against this pathogen. Therefore, transmission through animal contact is becoming increasingly common. Realize that unlike other Bordetella spp, this pathogen is not typically responsive to erythromycin and is often resistant to ampicillin and cephalosporins so the typical neutropenic fever coverage with an antipseudomonal cephalosporin and azithromycin might not be effective. Given the increasing recognition of this zoonosis as a threat to the immunocompromised, it is essential to educate immunocompromised patients to minimize zoonotic exposure, as immunization of pets might not confer protection to humans.
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http://dx.doi.org/10.1016/j.rmcr.2022.101672DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9149181PMC
May 2022

Exploring the molecular interaction of pheniramine with Enterococcus faecalis homoserine kinase: In-silico studies.

J Mol Recognit 2022 May 31:e2979. Epub 2022 May 31.

Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India.

Infections caused by the bacteria Enterococcus faecalis (also known as E. faecalis) are common in hospitals. This bacterium is resistant to a wide range of medicines and causes a variety of nosocomial infections. An increase in the number of infections caused by multidrug-resistant (MDR) bacteria is causing substantial economic and health issues around the world. Consequently, new therapeutic techniques to tackle the growing threat of E. faecalis infections must be developed as soon as possible. In this regard, we have targeted a protein that is regarded to be critical for the survival of bacteria in this experiment. Homoserine kinase (HSK) is a threonine metabolism enzyme that belongs to the GHMP kinase superfamily. It is a crucial enzyme in threonine metabolism. This enzyme is responsible for a critical step in the threonine biosynthesis pathway. Given the important function that E. faecalis Homoserine Kinase (ESK) plays in bacterial metabolism, we report here cloning, expression, purification and structural studies of E. faecalis HSK using homology modelling. In addition, we have reported on the model's molecular docking and Molecular Dynamic Stimulation (MD Stimulation) investigations to validate the results of the docking experiments. The results were promising. In silico investigations came up with the conclusion: pheniramine has good binding affinity for the E. faecalis HSK.
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http://dx.doi.org/10.1002/jmr.2979DOI Listing
May 2022

Delineating the Bacteriome of Packaged and Loose Smokeless Tobacco Products Available in North India.

Appl Microbiol Biotechnol 2022 Jun 23;106(11):4129-4144. Epub 2022 May 23.

Division of Molecular Genetics and Biochemistry, Molecular Biology Group, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India.

Smokeless tobacco product (STP) consumption is a significant public health threat across the globe. STPs are not only a storehouse of carcinogens and toxicants but also harbor microbes that aid in the conversion of tobacco alkaloids to carcinogenic tobacco-specific nitrosamines (TSNAs), thereby posing a further threat to the health of its consumers. The present study analyzed the bacterial diversity of popular dry and loose STPs by 16S rRNA gene sequencing. This NGS-based investigation revealed four dominant phyla Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria and identified 549 genera, Prevotella, Bacteroides, and Lactobacillus constituting the core bacteriome of these STPs. The most significantly diverse bacteriome profile was displayed by the loose STP Mainpuri kapoori. The study further predicted the functional attributes of the prevalent genera by Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) algorithm. Genes encoding for nitrate and nitrite reduction and transport enzymes, antibiotic resistance, multi-drug transporters and efflux pumps, secretion of endo- and exotoxin, and other pro-inflammatory molecules were identified. The loose STPs showed the highest level of nitrogen metabolism genes which can contribute to the synthesis of TSNAs. This study reveals the bacteriome of Indian domestic loose STPs that stagger behind in manufacturing and storage stringencies. Our results raise an alarm that the consumption of STPs harboring pathogenic genera can potentially lead to the onset of several oral and systemic diseases. Nevertheless, an in-depth correlation analysis of the microbial diversity of STPs and their elicit impact on consumer health is warranted. KEY POINTS: • Smokeless tobacco harbors bacteria that aid in synthesis of carcinogenic nitrosamines. • Most diverse bacteriome profile was displayed by loose smokeless tobacco products. • Pathogenic genera in these products can harm the oral and systemic health of users.
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http://dx.doi.org/10.1007/s00253-022-11979-yDOI Listing
June 2022

Identifying the Novel Inhibitors Against the Mycolic Acid Biosynthesis Pathway Target "mtFabH" of .

Front Microbiol 2022 6;13:818714. Epub 2022 May 6.

Amity Institute of Integrative Sciences and Health, Amity University, Gurugram, India.

Mycolic acids are the key constituents of mycobacterial cell wall, which protect the bacteria from antibiotic susceptibility, helping to subvert and escape from the host immune system. Thus, the enzymes involved in regulating and biosynthesis of mycolic acids can be explored as potential drug targets to kill (Mtb). Herein, Kyoto Encyclopedia of Genes and Genomes is used to understand the fatty acid metabolism signaling pathway and integrative computational approach to identify the novel lead molecules against the mtFabH (β-ketoacyl-acyl carrier protein synthase III), the key regulatory enzyme of the mycolic acid pathway. The structure-based virtual screening of antimycobacterial compounds from ChEMBL library against mtFabH results in the selection of 10 lead molecules. Molecular binding and drug-likeness properties of lead molecules compared with mtFabH inhibitor suggest that only two compounds, ChEMBL414848 (C1) and ChEMBL363794 (C2), may be explored as potential lead molecules. However, the spatial stability and binding free energy estimation of thiolactomycin (TLM) and compounds C1 and C2 with mtFabH using molecular dynamics simulation, followed by molecular mechanics Poisson-Boltzmann surface area (MM/PBSA) indicate the better activity of C2 (ΔG = -14.18 kcal/mol) as compared with TLM (ΔG = -9.21 kcal/mol) and C1 (ΔG = -13.50 kcal/mol). Thus, compound C1 may be explored as promising drug candidate for the structure-based drug designing of mtFabH inhibitors in the therapy of Mtb.
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http://dx.doi.org/10.3389/fmicb.2022.818714DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9121832PMC
May 2022

Therapeutic natural compounds Enzastaurin and Palbociclib inhibit MASTL kinase activity preventing breast cancer cell proliferation.

Med Oncol 2022 May 23;39(5):100. Epub 2022 May 23.

Division of Radiation Biosciences, Institute of Nuclear Medicine and Allied Sciences, Delhi, India.

Microtubule-associated serine/threonine kinase-like (MASTL) regulates mitotic progression and is an attractive target for the development of new anticancer drugs. In this study, novel inhibitory molecules were screened against MASTL kinase, a protein involved in cell proliferation in breast cancer. Natural source-derived drugs Enzastaurin and Palbociclib were selected to identify their role as MASTL kinase inhibitors. Cytotoxic activity, kinase activity, and other cell-based assays of Enzastaurin and Palbociclib were evaluated on human breast cancer (MCF-7) cells. The potential natural compounds caused cytotoxicity in MCF-7 cells in a dose- and time-dependent manner. Further analysis by Annexin V and PI staining indicated that both drugs are potent inducers of apoptosis. Enzastaurin induced G2/M phase arrest, while Palbociclib caused G1 arrest. MASTL kinase activity was significantly abrogated with both the compounds showing EC values of 17.13 µM and 10.51 µM, respectively. Taken together, these data strongly suggest that Enzastaurin and Palbociclib possess the ability to inhibit MASTL kinase activity and induce cell death in breast cancer cells, thus exhibiting significant therapeutic potential.
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http://dx.doi.org/10.1007/s12032-022-01701-3DOI Listing
May 2022

A Case Control Study of Risk Assessment of Diabetes and Nephropathy with eNOS (T786C and 27bp VNTR) Gene Polymorphisms.

J Assoc Physicians India 2022 May;70(5):11-12

Assistant Professor, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana.

Objectives: To determine the association of eNOS (T786C and 27bp VNTR) gene polymorphism with the risk of type II diabetes mellitus and diabetic nephropathy in North India.

Methods: The prospective case control study was conducted over a period of 18 months. A total of 100 patients of Type 2 Diabetes Mellitus (A1: 50 cases without Diabetic nephropathy-DN and 50 cases with DN) aged 18-75 years and 50 healthy adults as control (Group B) were included. The endothelial nitric oxide gene variant (T786C and 27bp VNTR) genotypes and alleles were studied. Odds ratio with 95% CI was calculated for genotype and alleles for the occurrence of diabetes and DN. p value of less than 0.05 was considered as significant.

Results: With Bb as reference(27bp VNTR), the odds ratio for Ab in the three groups (A1,A2,B) was 2.243, 1.545 and 0.746 respectively; and for Aa was 3.043, 3.058 and 1.878 respectively; with TT as reference (T786C), it was 1.573, 1.55 and 1.055 respectively for TC; and for CC it was 2.121, 2.063 and 2.348 respectively. The OR was comparable among the study groups and control for all genotypes and alleles (p>0.05).

Conclusion: In conclusion, there was a trend towards higher predilection of DN with aa genotype and a allele in 27 VNTR, CC genotype and C allele of -786T>C polymorphism however it was not found to be statistically significant. Future large sample studies are required to account for the ethnic variation for a clearer association of the genes and their associated risk with Diabetes and its complications.
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May 2022

The effect of combined magnesium and vitamin D supplementation on vitamin D status, systemic inflammation, and blood pressure: A randomized double-blinded controlled trial.

Nutrition 2022 Jul-Aug;99-100:111674. Epub 2022 Apr 1.

Department of Nutrition Sciences, Drexel University, Philadelphia, Pennsylvania. Electronic address:

Objective: Poor vitamin D and magnesium status is observed in individuals who are overweight and obese (Owt/Ob) and is often associated with a heightened risk of cardiovascular disease. Magnesium is a cofactor that assists vitamin D metabolism. We aimed to determine the efficacy of a combined magnesium and vitamin D regimen compared with vitamin D only on increasing serum 25-hydroxyvitamin D (25OHD) concentrations and the effects of these supplements on cardiometabolic outcomes.

Methods: This 12-week double-blinded randomized controlled trial had three treatment arms: magnesium + vitamin D (MagD; 360 mg magnesium glycinate + 1000 IU vitamin D 3 × daily), vitamin D only (VitD; 1000 IU vitamin D 3 × daily), and placebo. A total of 95 Owt/Ob participants were randomized into one of these three study arms. Anthropometry, dietary intake, concentrations of serum 25OHD, serum parathyroid hormone (PTH), serum inflammatory markers, and blood pressure were obtained at baseline and week 12.

Results: The MagD group experienced the greatest increase in serum 25OHD concentrations (6.3 ± 8.36 ng/mL; P < 0.05). There was a decrease in systolic blood pressure (7.5 ± 8.26 mmHg; P < 0.05) for individuals who had a baseline systolic blood pressure of >132 mmHg in the MagD group. There were no statistically significant treatment effects on serum PTH concentrations and markers of inflammation.

Conclusions: A combined MagD treatment may be more effective in increasing serum 25OHD concentrations compared with VitD supplementation alone in Owt/Ob individuals.
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http://dx.doi.org/10.1016/j.nut.2022.111674DOI Listing
June 2022

Predicting clinical outcomes using artificial intelligence and machine learning in neonatal intensive care units: a systematic review.

J Perinatol 2022 May 13. Epub 2022 May 13.

Child Health Imprints (CHIL) USA Inc, Madison, WI, USA.

Background: Advances in technology, data availability, and analytics have helped improve quality of care in the neonatal intensive care unit.

Objective: To provide an in-depth review of artificial intelligence (AI) and machine learning techniques being utilized to predict neonatal outcomes.

Methods: The PRISMA protocol was followed that considered articles from established digital repositories. Included articles were categorized based on predictions of: (a) major neonatal morbidities such as sepsis, bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity; (b) mortality; and (c) length of stay.

Results: A total of 366 studies were considered; 68 studies were eligible for inclusion in the review. The current set of predictor models are primarily built on supervised learning and mostly used regression models built on retrospective data.

Conclusion: With the availability of EMR data and data-sharing of NICU outcomes across neonatal research networks, machine learning algorithms have shown breakthrough performance in predicting neonatal disease.
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http://dx.doi.org/10.1038/s41372-022-01392-8DOI Listing
May 2022

Nuclear cardiology for a cardiothoracic surgeon.

Indian J Thorac Cardiovasc Surg 2022 May 1;38(3):268-282. Epub 2022 Mar 1.

Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Cardiac surgeons are commonly faced with issues regarding the balance between the potential risk and the potential benefit of a surgical procedure. Nuclear cardiology procedures such as single-photon emission computed tomography and positron emission tomography provide the surgeon with objective information that augments standard clinical and angiographic assessments related to the diagnosis, prognosis, and potential benefit from any intervention. Myocardial perfusion is imaged with the use of radiopharmaceuticals that accumulate rapidly in the myocardium in proportion to the myocardial blood flow. Radionuclide lung imaging most commonly involves the demonstration of pulmonary perfusion using technetium-99 m macro aggregate albumin (Tc-99 m MAA), as well as the assessment of ventilation using inspired inert gas, usually xenon, or Tc-99 m-labelled aerosols. Nuclear cardiology is extensively used as a part of the work-up of ischemic heart disease and cardiac failure in deciding the optimal therapeutic strategy with its ability to predict the severity of the disease. It has also proved extremely useful in the management of congenital heart disease and the diagnosis of pulmonary embolism, among many other applications. Myocardial perfusion imaging is a basic adjunct to the noninvasive assessment of patients with stable angina, baseline electrocardiogram (ECG) abnormalities, post-revascularisation assessment, and heart failure. This review article covers a summary of basic concepts of nuclear cardiology about what a cardiac surgeon should be aware of. To many, it is just a perfusion test, but the versatility, reliability, and future of the technology are without a doubt.
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http://dx.doi.org/10.1007/s12055-021-01311-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9023643PMC
May 2022

Face mask detection in COVID-19: a strategic review.

Multimed Tools Appl 2022 May 5:1-30. Epub 2022 May 5.

Faculty, CSED, Thapar Institute of Engineering and Technology, Patiala, Punjab India.

With the outbreak of the Coronavirus Disease in 2019, life seemed to be had come to a standstill. To combat the transmission of the virus, World Health Organization (WHO) announced wearing of face mask as an imperative way to limit the spread of the virus. However, manually ensuring whether people are wearing face masks or not in a public area is a cumbersome task. The exigency of monitoring people wearing face masks necessitated building an automatic system. Currently, distinct methods using machine learning and deep learning can be used effectively. In this paper, all the essential requirements for such a model have been reviewed. The need and the structural outline of the proposed model have been discussed extensively, followed by a comprehensive study of various available techniques and their respective comparative performance analysis. Further, the pros and cons of each method have been analyzed in depth. Subsequently, sources to multiple datasets are mentioned. The several software needed for the implementation are also discussed. And discussions have been organized on the various use cases, limitations, and observations for the system, and the conclusion of this paper with several directions for future research.
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http://dx.doi.org/10.1007/s11042-022-12999-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9069221PMC
May 2022

A 31-Year-Old Man With Fever, Atypical Chest Pain, and Mediastinal Mass.

Chest 2022 May;161(5):e299-e304

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.

Case Presentation: A 31-year-old Asian male never-smoker living in the upper Midwest with a past medical history of congenital bilateral hearing loss sought treatment with a 1-week history of fever, fatigue, right-sided pleuritic chest pain, shortness of breath, productive cough with mild intermittent hemoptysis, night sweats, and unintentional 10-lb weight loss over 4 weeks. He was adopted from South Korea as an infant, and thus the family history was unknown. He worked in the heating, ventilation, and air conditioning business, performing installations and repairs. There was no known exposure to animals, caves, rivers, lakes, or wooded areas. He travelled to South Korea and New Hampshire approximately 9 months previously. He did not take any medication.
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http://dx.doi.org/10.1016/j.chest.2021.12.644DOI Listing
May 2022

Comparison of clinical with CT based evaluation for tibial torsion.

J Clin Orthop Trauma 2022 Jun 22;29:101875. Epub 2022 Apr 22.

Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.

Purpose: Tibial torsion is important to be factored in during calculations of angular deformities of the lower extremity. Three methods are commonly used, thigh foot angle, measurement of transmalleolar axis with proximal tibia or knee as a reference, and Computerized tomography. The purpose of the current study was to find out the effectiveness of clinical methods and compare CT based method for tibial torsion.

Methods: A total of 68 limbs (34 subjects) were included. Tibial torsion was measured using thigh foot angle, transmalleolar axis in relation to knee forward position (Knee ankle axis) and CT based evaluation using Jend method.

Results: Pearson correlation coefficient showed strong correlation between CT values and thigh foot angle (r = 0.848) as well as between CT values and Knee ankle axis (r = 0.889). Scatter plots also showed a linear distribution.

Conclusion: Both thigh foot angle and Knee ankle axis provide reliable alternative to ionizing CT in measuring tibial torsion.
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http://dx.doi.org/10.1016/j.jcot.2022.101875DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9058954PMC
June 2022

Ocular sequelae in severe COVID-19 recovered patients of second wave.

Indian J Ophthalmol 2022 05;70(5):1780-1786

Society for Health Education and Allied Research, New Delhi, India.

Purpose: To evaluate the retinal microvascular changes in patients, recovered from severe COVID-19 during the second wave of the pandemic in North India.

Methods: In this observational cross-sectional study, 70 eyes of 35 patients who recovered from severe COVID-19 during the second wave underwent detailed ophthalmic evaluation 4-6 weeks after discharge. Twelve controls were also enrolled, and the difference in the findings between the case and control groups on optical coherence tomography (OCTA) were studied.

Result: The ages of study participants ranged from 27 to 60 years with the male:female ratio being 1.05:1. The fundus changes suggestive of ischemia in the form of cotton wool spots and vascular tortuosity were seen in 25 eyes (35.71%). Increased venous tortuosity was the most common finding seen in 23 eyes (32.85%), of which 10 eyes (28.57%) had concurrent hypertensive retinopathy (HTR) changes. There was a significant reduction in the mean vascular density (VD) and perfusion density (PD) for both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) at inner, outer ring, and whole (P < 0.05). Foveal avascular zone was significantly enlarged in both the SCP (P = 0.01) and the DCP (P = 0.03). The mean ganglion cell-inner plexiform layer (GC-IPL) was significantly reduced in comparison to controls (P < 0.001).

Conclusion: Severe COVID-19 can result in microvascular changes at the macula in the form of reduction in vascular and perfusion density, which can be evaluated using OCTA. As structural changes precede functional changes, a close watch is recommended in patients showing compromise in retinal microvasculature.
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http://dx.doi.org/10.4103/ijo.IJO_2882_21DOI Listing
May 2022

Peroperative Intra-Articular Infiltration of Tranexamic Acid and Ropivacaine Cocktail in Patients Undergoing Total Knee Arthroplasty: A Randomized Controlled Trial.

Cureus 2022 Mar 12;14(3):e23091. Epub 2022 Mar 12.

Department of Orthopaedics, Geetanjali Medical College and Hospital, Udaipur, IND.

Background Total knee arthroplasty (TKA) is a procedure that has improved the quality of life of patients with knee arthritis. Postoperative pain and blood loss are the two major drawbacks of TKA which affect patient satisfaction and delay recovery and rehabilitation. Local infiltration analgesia has shown better results in controlling immediate postoperative pain, thus enabling early rehabilitation and mobilization, while local infiltration of antifibrinolytic agents has shown impressive results in controlling blood loss. In this study, we evaluate the effect of a combination of intra-articular infiltration of ropivacaine cocktail along with intra-articular instillation of tranexamic acid in reducing patient-reported postoperative pain and the level of blood loss control after TKA. Methodology Patients presenting with high-grade osteoarthritis and undergoing TKA were included and randomly allocated to two groups: one receiving the intra-articular infiltration (group A), and the other not receiving any infiltration (group B). Postoperative pain was measured through the Visual Analog Scale (VAS) every three hours for the first 24 hours, and then at 48 hours and 72 hours postoperatively. The need for additional analgesia, in the form of a slow epidural infusion, in patients experiencing severe postoperative pain was evaluated in both groups. Postoperative blood loss was assessed by measuring total drain output (in mL) and by comparing preoperative and postoperative (at 24 hours) hemoglobin, hematocrit drift, and blood transfusion rates. The duration of the postoperative hospital stay and the time taken to start postoperative knee mobilization exercises and weight-bearing were noted to assess the recovery and rehabilitation of the patients in the two groups. Results The study included 42 patients (group A, 22 patients; group B, 20 patients) with 28 knees in each group. Patients with intra-articular infiltration using ropivacaine cocktail with tranexamic acid showed excellent pain control compared to the non-infiltrated patients in the early 48 hours postoperatively. There was a significant drop in postoperative hemoglobin and hematocrit values in the non-infiltrated patients compared to the other group. Further, the intra-articular infiltration-instillation significantly reduced blood loss through the drain, the requirement of postoperative blood transfusions, and the duration of hospital stay. Conclusions It can be safely concluded that ropivacaine cocktail and tranexamic acid instillation postoperatively in knee arthroplasty patients is a very useful and effective technique to reduce postoperative pain and blood loss.
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http://dx.doi.org/10.7759/cureus.23091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8996435PMC
March 2022

Outbreak control of hospital acquired varicella infection amongst health care workers in a tertiary care hospital.

Med J Armed Forces India 2022 Apr 23;78(2):136-139. Epub 2020 Mar 23.

Professor (Pathology & Microbiology), Bharati Vidyapeeth Medical College. Pune 411043, India.

Background: Adult and immunocompromised patients suffering from varicella (chicken pox) are potential source of infection to healthcare workers. An outbreak of varicella among healthcare workers in a tertiary care centre was investigated, and preventive measures were implemented.

Methods: Cases of chicken pox between 05 Feb 2017 and 11 Feb 2017 in a tertiary healthcare establishment were investigated. An epidemiological investigation by developing case definitions, spot map and contact tracing was conducted. Eight cases were identified among healthcare workers. Suitable preventive measures including identification of susceptible contacts and vaccination of susceptible ones with two doses of varicella vaccine was undertaken.

Results: Index case was a 21-year-old nurse who was exposed to a 34-year-old male patient transferred from a secondary care hospital on 24 Jan 2017 as a case of acute liver failure and coagulopathy. Primary case was later diagnosed as case of varicella based on serological and clinical evidence. Among a total of 8 cases identified in the outbreak, the cases occurred among healthcare workers of secondary care centre, healthcare workers managing the primary case in the intensive care unit and who conducted the autopsy. A total of 181 contacts were identified in the epidemiological investigation, and 54 were susceptible to chicken pox. Two-dose immunization with varicella vaccination of susceptible ones was found to be effective in preventing further cases.

Conclusion: Two-dose vaccination of healthcare workers with varicella vaccine is an effective strategy to prevent nosocomial varicella among healthcare workers.
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http://dx.doi.org/10.1016/j.mjafi.2019.12.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9023553PMC
April 2022

Outcomes of patients presenting with Guillain-Barre Syndrome at a tertiary care center in India.

BMC Neurol 2022 Apr 22;22(1):151. Epub 2022 Apr 22.

Department of Medicine, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India.

Background: The Guillain-Barre Syndrome (GBS), also known as acute idiopathic polyneuritis, is a critical acquired condition associated with preceding nonspecific infection or triggering factors like trauma, surgery, or vaccination. GBS is currently the most frequent cause of acute flaccid paralysis in India. This study evaluates the short-term and in-hospital outcomes in different subtypes of GBS.

Methods: A prospective observational study was conducted at V.S. Hospital, Ahmedabad, from September 2015 to December 2017. Patients above the age of 12 were included. Patients having other underlying neurological conditions, as well as immunodeficiency disorders, were excluded. The patients were classified into different subtypes of GBS, and functional outcomes were recorded on admission and discharge according to Hughes Scoring System. All statistical analyses were performed by using SPSS software.

Results: Out of 50 patients, 35 (70%) were males. The mean age was of 37.18 +/- 18.35 years. 25 (50%) patients had a preceding infection. 88% of patients presented with cranial nerve (CN) involvement had a Hughes Score of >/= 3 (p = 0.0087). They had less improvement of Hughes Score on discharge (0.13 +/- 0.04) as compared to the patients without cranial nerve involvement (0.38 +/- 0.08) (p = 0.008). Respiratory involvement was associated with a higher Hughes Score (p = 0.005) on admission. 85% of patients diagnosed with an axonal subtype of GBS had a Hughes Score of >/= 3 (p = 0.06) compared to 74% patients with demyelinating subtype. Axonal subtype required double period (11 +/- 2.34) to show improvement as compared to demyelinating subtype (6 +/- 1.2) (p = 0.020). Irrespective of the subtypes, in two different treatment cohorts (PLEX vs IVIG), there was no difference in short term functional outcomes measured by improvement in the Hughes scores (p = 0.89).

Conclusions: Early cranial nerve and respiratory involvement in patients presenting with GBS are associated with poor outcomes warranting immediate critical care involvement. In our study, amongst all the subtypes, axonal had poor clinical outcomes. Further clinical trials on the Indian subpopulation will help us evaluate the impact of different treatment modalities on this disease.
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http://dx.doi.org/10.1186/s12883-022-02676-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9027043PMC
April 2022

Strengthening the Surveillance of Antimicrobial Resistance in India Using Integrative Technologies.

Front Public Health 2022 4;10:861888. Epub 2022 Apr 4.

Division of Biomedical Informatics, Indian Council of Medical Research, New Delhi, India.

Background: The antimicrobial resistance (AMR) situation in India is alarming. In the absence of newer antibiotics, the best possible approach is to efficiently use the existing antimicrobials through surveillance of resistance. The data generated by AMR surveillance across the country has immense potential to drive policy decisions. However, this data is available in a variety of sources. It is imperative to have tools to integrate the data generated across the country into a single data repository.

Methods: An ensemble of tools (-AMRSS, -DIA, and -AMRIT) have been designed and developed by the data management team at the Indian Council of Medical Research (ICMR) to strengthen surveillance of antimicrobial resistance in India.

Results: The -AMRSS is a web-based ICMR's AMR surveillance system, collecting data from tertiary care centers across the country and sending it to the one-stop data repository. The -DIA is a web-based API that simplifies the AMR data interoperability by seamlessly importing most of the LIS / HIS data from CSV files into a central, one-stop data repository. The -AMRIT is a standalone ICMR's AMR surveillance system using integrative technologies, collecting data from all the labs across the country and sending the lab-specific cumulative data to the one-stop data repository.

Discussion: The tools are being used in ICMR's AMR Network and have collected over 0.4 million patient records to date. The complete system is presently being used to capture human susceptibility testing data and can be extended for capturing data using the 'One Health' approach. The authors plan to make the system compliant with FHIR standards to enable interoperability with other countries.
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http://dx.doi.org/10.3389/fpubh.2022.861888DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013893PMC
April 2022

Inhibition of BK channels protects neonatal hearts against myocardial ischemia and reperfusion injury.

Cell Death Discov 2022 Apr 7;8(1):175. Epub 2022 Apr 7.

Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

BK channels are large-conductance calcium and voltage-activated potassium channels that are heterogeneously expressed in a wide array of cells. Activation of BK channels present in mitochondria of adult ventricular cardiomyocytes is implicated in cardioprotection against ischemia-reperfusion (IR) injury. However, the BK channel's activity has never been detected in the plasma membrane of adult ventricular cardiomyocytes. In this study, we report the presence of the BK channel in the plasma membrane and mitochondria of neonatal murine and rodent cardiomyocytes, which protects the heart on inhibition but not activation. Furthermore, K currents measured in neonatal cardiomyocyte (NCM) was sensitive to iberiotoxin (IbTx), suggesting the presence of BK channels in the plasma membrane. Neonatal hearts subjected to IR when post-conditioned with NS1619 during reoxygenation increased the myocardial infarction whereas IbTx reduced the infarct size. In agreement, isolated NCM also presented increased apoptosis on treatment with NS1619 during hypoxia and reoxygenation, whereas IbTx reduced TUNEL-positive cells. In NCMs, activation of BK channels increased the intracellular reactive oxygen species post HR injury. Electrophysiological characterization of NCMs indicated that NS1619 increased the beat period, field, and action potential duration, and decreased the conduction velocity and spike amplitude. In contrast, IbTx had no impact on the electrophysiological properties of NCMs. Taken together, our data established that inhibition of plasma membrane BK channels in the NCM protects neonatal heart/cardiomyocytes from IR injury. Furthermore, the functional disparity observed towards the cardioprotective activity of BK channels in adults compared to neonatal heart could be attributed to their differential localization.
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http://dx.doi.org/10.1038/s41420-022-00980-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8989942PMC
April 2022

Residual effect of defeated stripe rust resistance genes/QTLs in bread wheat against prevalent pathotypes of Puccinia striiformis f. sp. tritici.

PLoS One 2022 1;17(4):e0266482. Epub 2022 Apr 1.

Department of Plant Breeding & Genetics, PAU, Ludhiana, India.

The periodic breakdowns of stripe rust resistance due to emergence of new virulent and more aggressive pathotypes of Puccinia striiformis f. sp. tritici have resulted in severe epidemics in India. This necessitates the search for new and more durable resistance sources against stripe rust. The three bread wheat cultivars PBW 343 (carries Yr9 and Yr27), PBW 621 (carries Yr17) and HD 2967 (gene not known) were highly popular among the farmers after their release in 2011. But presently all three cultivars are highly susceptible to stripe rust at seedling as well as at adult plant stages as their resistance has been broken down due to emergence of new pathotypes of the pathogen (110S119, 238S119). In previous study, the crosses of PBW 621 with PBW 343 and HD 2967 and evaluation of further generations (up to F4) against pathotype 78S84 resulted in resistant segregants. In the present study, the F5 and F6 RIL populations have been evaluated against new pathotypes of Pst. The RILs categorized based on the disease severity on the P (Penultimate leaf) and F (flag) leaf into three categories i.e., high, moderate and low level of APR (adult plant resistance) having 1-200, 201-400 and >400 values of AUDPC, respectively, upon infection with stripe rust. The various APR components (latent period, lesion growth rate, spore production and uredial density) were studied on each category, i.e., resistant, moderately resistant and susceptible. The values of APR parameters decreased as the level of resistance increased. Based on molecular analysis, the lines (representing different categories of cross PBW 621 X PBW 343) containing the genes Yr9 and Yr17 due to their interactive effect provide resistance. Based on BSA using 35k SNPs and KASP markers association with phenotypic data of the RIL population (PBW 621 X HD 2967) showed the presence of two QTLs (Q.Pst.pau-6B, Q.Pst.pau-5B) responsible for the residual resistance and two SNPs AX-94891670 and AX-94454107 were found to be associated with the trait of interest on chromosome 6B and 5B respectively. The present study concludes that in the population of both the crosses (PBW 621 X PBW 343 and PBW 621 X HD 2967) major defeated gene contributed towards residual resistance by interacting with minor gene/QTLs.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266482PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8975100PMC
April 2022

Role of Microglia and Astrocytes in Spinal Cord Injury Induced Neuropathic Pain.

Ann Neurosci 2021 Jul 18;28(3-4):219-228. Epub 2021 Oct 18.

Neuroscience research lab, Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Background: Spinal cord injuries incite varying degrees of symptoms in patients, ranging from weakness and incoordination to paralysis. Common amongst spinal cord injury (SCI) patients, neuropathic pain (NP) is a debilitating medical condition. Unfortunately, there remain many clinical impediments in treating NP because there is a lack of understanding regarding the mechanisms behind SCI-induced NP (SCINP). Given that more than 450,000 people in the United States alone suffer from SCI, it is unsatisfactory that current treatments yield poor results in alleviating and treating NP.

Summary: In this review, we briefly discussed the models of SCINP along with the mechanisms of NP progression. Further, current treatment modalities are herein explored for SCINP involving pharmacological interventions targeting glia cells and astrocytes.

Key Message: The studies presented in this review provide insight for new directions regarding SCINP alleviation. Given the severity and incapacitating effects of SCINP, it is imperative to study the pathways involved and find new therapeutic targets in coordination with stem cell research, and to develop a new gold-standard in SCINP treatment.
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http://dx.doi.org/10.1177/09727531211046367DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8948321PMC
July 2021

Photodynamic therapy for treatment of recurrent adenocarcinoma of the lung with tracheal oligometastasis.

Respir Med Case Rep 2022 10;37:101620. Epub 2022 Mar 10.

Department of Pulmonary and Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA.

Introduction: Tracheal neoplasms account for less than 0.1% of all malignancies. The majority of tracheal malignancies are secondary neoplasms from direct tracheal invasion from adjacent structures and less commonly from hematogenous or lymphatic spread from distal malignancies. Evidence-based guidelines for management are lacking. Less invasive bronchoscopic ablation modalities are an option for non-operable patients. We report a case of endotracheal oligometastatic adenocarcinoma successfully treated with photodynamic therapy.

Case: A 59-year-old man with past medical history of stage 1 right upper and left upper lobe neoplasm treated with right lobectomy 2 years ago and wedge resection of the lingula ten months ago presented with cough and hemoptysis. Flexible bronchoscopy revealed a 10 mm endoluminal exophytic lesion of the mid-trachea confirmed as lung adenocarcinoma on biopsy. Considering the lack of extra-cartilaginous spread and the small size, a multidisciplinary team recommended local treatment using photodynamic therapy. Surveillance biopsies out to 2 years confirmed lack of disease recurrence. The patient did not experience any adverse effects.

Conclusion: PDT as first line therapy for a 10 mm oligometastatic endotracheal adenocarcinoma from recurrent pulmonary malignancy with no extra-cartilaginous spread is an effective modality that is well tolerated and produces a durable response, which in our patient led to complete response without recurrence at 24 months and with no adverse effects or complications. Determining depth of tumor penetration is paramount if the treatment is with curative intent. PDT should be considered as part of a multidisciplinary approach for endotracheal malignant disease.
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http://dx.doi.org/10.1016/j.rmcr.2022.101620DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938912PMC
March 2022

Quantifying prognosis severity of COVID-19 patients from deep learning based analysis of CT chest images.

Multimed Tools Appl 2022 8;81(13):18129-18153. Epub 2022 Mar 8.

Department of Computer Science and Engineering, TIET, Patiala, Punjab India.

The COVID-19 pandemic has affected all the countries in the world with its droplet spread mode. The colossal amount of cases has strained all the healthcare systems due to the serious nature of infections especially for people with comorbidities. A very high specificity Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) test is the principal technique in use for diagnosing the COVID-19 patients. Also, CT scans have helped medical professionals in patient severity estimation & progression tracking of COVID-19 virus. In study we present our own extensible COVID-19 viral infection tracking prognosis technique. It uses annotated dataset of CT chest scan slice images created with the help of medical professionals. The annotated dataset contains bounding box coordinates of different features for COVID-19 detection like ground glass opacities, crazy paving pattern, consolidations, lesions etc. We qualitatively identify the severity of the patient for later prognosis stages in our study to assist medical staff for patient prioritization. First we detected COVID-19 positive patients with pre-trained Siamese Neural Network (SNN) which obtained 87.6% accuracy, 87.1% F1-Score & 95.1% AUC scores. These metrics were achieved after removal of 40% quantitatively highly similar images from the COVID-CT dataset. This reduced dataset was further medically annotated with COVID-19 features for bounding box detection. After this we assigned severity scores to detected COVID-19 features and calculated the cumulative severity score for COVID-19 patients. For qualitative patient prioritization with prognosis clinical assistance information, we finally converted this score into a multi-classification problem which obtained 47% weighted-average F1-score.
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http://dx.doi.org/10.1007/s11042-022-12214-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901869PMC
March 2022

Applications and Challenges in Healthcare Big data: A Strategic Review.

Curr Med Imaging 2022 Mar 8. Epub 2022 Mar 8.

Computer Science Engineering Department, Thapar University, Patiala, India.

Big data has been a topic of interest for many researchers and industries for the past few decades. Due to the exponential growth of technology today, a tremendous amount of data is generated every minute. This article provides a strategic review study on Big data in the healthcare sector. In particular, this article highlights various applications and issues faced by the healthcare industry using Big data by evaluating various journal articles between 2016-2021. Multiple issues related to data mining, storing, analyzing, and sharing of Healthcare Big data, briefly summarizing deep-learning-based tools available for Big data analytics, have been covered in this article. This article aims to benefit the research community by understanding various research tools and processes available today to manage Healthcare Big data.
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http://dx.doi.org/10.2174/1573405618666220308113707DOI Listing
March 2022

Enablers and barriers towards ensuring routine immunization services during the COVID-19 pandemic: findings from a qualitative study across five different states in India.

Trans R Soc Trop Med Hyg 2022 Mar 2. Epub 2022 Mar 2.

Regional Medical Research Centre, Department of Epidemiology, Odisha 751023, India.

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to disruption in delivering routine healthcare services including routine immunization (RI) worldwide. Understanding the enablers and barriers for RI services during a pandemic is critically important to develop context-appropriate strategies to ensure uninterrupted routine services.

Methods: A community-based, cross-sectional descriptive study was conducted in five different states of India, nested within an ongoing multicentric study on RI. Telephone in-depth interviews among 56 health workers were carried out and the data were analyzed using a content analysis method.

Results: During the COVID-19 pandemic, healthcare providers encountered many challenges at the health system, community and individual level when rendering RI services. Challenges like the limited availability of personal protective equipment and vaccines, deployment for COVID-19 duty at system level, the difficulty in mobilizing people in the community, fear among people at community level, mobility restrictions and limited family support, as well as the stress and stigma at individual level, were barriers to providing RI services. By contrast, the issuing of identification cards to health staff, engaging community volunteers, the support given to health workers by their families and training on COVID-19, were factors that enabled health workers to maintain RI services during the pandemic.

Conclusions: When addressing the COVID-19-related public health emergency, we should not lose sight of the importance of services like RI.
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http://dx.doi.org/10.1093/trstmh/trac011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8903434PMC
March 2022
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