Publications by authors named "R Jayachandra Babu"

539 Publications

A systematic review and meta-analysis of conventional laparoscopic versus robot-assisted laparoscopic pyeloplasty in infants.

J Pediatr Urol 2021 Mar 19. Epub 2021 Mar 19.

Pediatric Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

Objective: While there are several reports confirming the safety and efficacy of laparoscopic pyeloplasty (LP) and robot-assisted laparoscopic pyeloplasty (RALP) in children there have been none comparing LP and RALP specifically in infants. In this meta-analysis, we have compared the outcomes of LP and RALP in infants.

Methods: Pubmed (Medline), Publon, Index Medicus and Embase were searched using the search terms: pyeloplasty (laparoscopic OR robot-assisted) AND (infant), to identify all papers pertaining to LP and RALP. Systematic review was performed to identify information regarding number of patients/renal units, age, body weight, operating time, hospital stay, success and complications. Meta-analysis of heterogeneity was reported with I2statistics. Once heterogeneity was found low, the pooled outcomes were compared with student's t test and Fishers exact test, wherever appropriate.

Results: After screening a total of 267 articles, 18 articles were included (10 articles on LP, 7 on RALP, 1 reporting both), comprising 323 renal units for LP and 173 renal units for RALP. With low heterogeneity (I2: 0%) both groups were considered to have been conducted under similar conditions for fixed effect model. There was no significant difference between the success rates of LP or RALP (97.5% vs 94.8%; p = 0.21). The mean age at operation was significantly lower for LP (5.6 ± 1.8 months) than RALP (7.2 ± 1.2 months, P = 0.0001). The duration of surgery was 137 ± 45 min for LP while significantly higher at 179 ± 49 min for RALP (p = 0.0001). The mean (s.d) time to discharge was 2.0 (1.9) days for LP while 1.3 (0.4) days for RALP. The overall complication rate was significantly higher (summary table) for RALP than LP (p = 0.03), mainly due to more port-site hernias in RALP.

Discussion: In the present study, we found that the success of LP and RALP in infants was similar. RALP in infants had longer duration of surgery, similar hospital stay and higher Clavien-3 complications than LP. While several studies have reported favorable outcomes for RALP over LP in children, this was not the case in infants. The smaller workspace, in an infant, can significantly limit the mobility of robotic instruments and increase the chance of port-site conflicts or trocar collisions. The use of larger robotic ports and instruments in the small space of infant abdomen might have been responsible for higher complications in RALP, including significantly larger number of port-site hernias. This meta-analysis represents the early experience of most RALP in infants, and it is possible that with experience RALP outcomes in infants also will catch up with LP. Miniaturization of robotic instruments might render RALP the future standard of care for pyeloplasty in infants.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jpurol.2021.03.009DOI Listing
March 2021

Adherence to home-based videogame treatment for amblyopia in children and adults.

Clin Exp Optom 2021 Mar 1:1-7. Epub 2021 Mar 1.

School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.

: Home-based videogame treatments are increasingly popular for amblyopia treatment. However, at-home treatments tend to be done in short sessions and with frequent disruptions, which may reduce the effectiveness of binocular visual stimulation. These treatment adherence patterns need to be accounted for when considering dose-response relationships and treatment effectiveness.: Home-based videogame treatments are increasingly being used for various sensory conditions, including amblyopia ('lazy eye'), but treatment adherence continues to limit success. To examine detailed behavioural patterns associated with home-based videogame treatment, we analysed in detail the videogame adherence data from the Binocular tReatment of Amblyopia with VideOgames (BRAVO) clinical trial (ACTRN12613001004752).: Children (7-12 years), teenagers (13-17 years) and adults (≥ 18 years) with unilateral amblyopia were loaned iPod Touch devices with either an active treatment or placebo videogame and instructed to play for a total of 1-2 hours/day for six weeks at home. Objectively-recorded adherence data from device software were used to analyse adherence patterns such as session length, daily distribution of gameplay, use of the pause function, and differences between age groups. Objectively-recorded adherence was also compared to subjectively-reported adherence from paper-based diaries.: One hundred and five of the 115 randomised participants completed six weeks of videogame training. Average adherence was 65% (SD 37%) of the minimum hours prescribed. Game training was generally performed in short sessions (mean 21.5, SD 11.2 minutes), mostly in the evening, with frequent pauses (median every 4.1 minutes, IQR 6.1). Children played in significantly shorter sessions and paused more frequently than older age groups (p < 0.0001). Participants tended to over-report adherence in subjective diaries compared to objectively-recorded gameplay time.: Adherence to home-based videogame treatment was characterised by short sessions interspersed with frequent pauses, suggesting regular disengagement. This complicates dose-response calculations and may interfere with the effectiveness of treatments like binocular treatments for amblyopia, which require sustained visual stimulation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08164622.2021.1878834DOI Listing
March 2021

Clinical Outcomes in Carbapenem-Resistant Enterobacteriaceae Infections Treated With Ceftazidime-Avibactam: A Single-Center Observational Study.

Cureus 2021 Feb 2;13(2):e13081. Epub 2021 Feb 2.

Clinical Microbiology, Aster Medcity, Kochi, IND.

Introduction Among the several newer beta lactam+beta lactase inhibitors (BL/BLI), ceftazidime-avibactam is the only drug showing activity against OXA-48-like producers. Hence, it is being increasingly used in India to treat infections caused by carbapenem-resistant Enterobacteriaceae (CRE), especially as a colistin-sparing agent. We have used ceftazidime-avibactam in patients suspected and confirmed to have CRE infections in our center, and present a retrospective analysis of our experience. Methods We conducted a single-center, retrospective study involving all patients who were treated with ceftazidime-avibactam for suspected and proven CRE infections during a one-year period at our 500-bedded hospital. Our primary objective for this study was taken as all-cause mortality. The secondary objectives were to determine the clinical cure, defined as the end of the treatment regimen with a resolution of primary infection and resistance to ceftazidime-avibactam in patients who underwent the Epsilometer test (E-test). Results  A total of 103 patients who received ceftazidime-avibactam were identified. The all-cause mortality was 27% while a clinical cure was achieved in 73%. Fifty-two patients received empirical therapy and 51 patients received ceftazidime-avibactam for confirmed CRE infection. Forty-eight patients had an E-test done, out of which 79% of patients had CREs sensitive to ceftazidime-avibactam, and 21% of patients had ceftazidime-avibactam resistant CREs. A higher Sequential Organ Failure Assessment (SOFA) score, Charlson comorbidity index (CCI) score, intensive care unit (ICU) admission, inotrope requirement, and lower days of therapy (DOT) with ceftazidime-avibactam were found to be associated with increased mortality. Conclusion Colistin has been considered to be the last-line agent in CRE infections, but there are concerns about its adverse effects and the emergence of resistance. Given our relatively low mortality of 27% in CRE infections treated with ceftazidime-avibactam, coupled with the high susceptibility of the tested isolates, there may be a role for the empirical use of this drug in infections caused by CRE, especially in a setting where colistin may not be ideal.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.13081DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931974PMC
February 2021

Resveratrol-loaded nanomedicines for cancer applications.

Cancer Rep (Hoboken) 2021 Mar 2:e1353. Epub 2021 Mar 2.

Department of Drug Discovery and Development, Auburn University, Auburn, Alabama, USA.

Background: Resveratrol (3, 5, 4 -trihydroxystilbene), a natural polyphenol and phytoalexin, has drawn considerable attention in the past decade due to its wide variety of therapeutic activities such as anticancer, anti-inflammatory, and antioxidant properties. However, its poor water solubility, low chemical stability, and short biological half-life limit its clinical utility.

Recent Findings: Nanoparticles overcome the limitations associated with conventional chemotherapeutic drugs, such as limited availability of drugs to the tumor tissues, high systemic exposures, and consequent toxicity to healthy tissues. This review focuses on the physicochemical properties of resveratrol, the therapeutic potential of resveratrol nano-formulations, and the anticancer activity of resveratrol encapsulated nanoparticles on various malignancies such as skin, breast, prostate, colon, liver, ovarian, and lung cancers (focusing on both in vitro and in vivo studies).

Conclusions: Nanotechnology approaches have been extensively utilized to achieve higher solubility, improved oral bioavailability, enhanced stability, and controlled release of resveratrol. The resveratrol nanoparticles have markedly enhanced its anticancer activity both in vitro and in vivo, thus considering it as a potential strategy to fight various cancers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/cnr2.1353DOI Listing
March 2021

COVIDScreen: explainable deep learning framework for differential diagnosis of COVID-19 using chest X-rays.

Neural Comput Appl 2021 Jan 8:1-22. Epub 2021 Jan 8.

Shiv Nadar University, NCR, Gautam Budh Nagar, India.

COVID-19 has emerged as a global crisis with unprecedented socio-economic challenges, jeopardizing our lives and livelihoods for years to come. The unavailability of vaccines for COVID-19 has rendered rapid testing of the population instrumental in order to contain the exponential rise in cases of infection. Shortage of RT-PCR test kits and delays in obtaining test results calls for alternative methods of rapid and reliable diagnosis. In this article, we propose a novel deep learning-based solution using chest X-rays which can help in rapid triaging of COVID-19 patients. The proposed solution uses image enhancement, image segmentation, and employs a modified stacked ensemble model consisting of four CNN base-learners along with Naive Bayes as meta-learner to classify chest X-rays into three classes viz. COVID-19, pneumonia, and normal. An effective pruning strategy as introduced in the proposed framework results in increased model performance, generalizability, and decreased model complexity. We incorporate explainability in our article by using Grad-CAM visualization in order to establish trust in the medical AI system. Furthermore, we evaluate multiple state-of-the-art GAN architectures and their ability to generate realistic synthetic samples of COVID-19 chest X-rays to deal with limited numbers of training samples. The proposed solution significantly outperforms existing methods, with 98.67% accuracy, 0.98 Kappa score, and F-1 scores of 100, 98, and 98 for COVID-19, normal, and pneumonia classes, respectively, on standard datasets. The proposed solution can be used as one element of patient evaluation along with gold-standard clinical and laboratory testing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00521-020-05636-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791540PMC
January 2021

Genome wide association study and genomic prediction for stover quality traits in tropical maize (Zea mays L.).

Sci Rep 2021 Jan 12;11(1):686. Epub 2021 Jan 12.

Centro Internacional de Mejoramiento de Maíz y Trigo (CIMMYT), c/o ICRISAT, Patancheru, 502324, India.

Maize is rapidly replacing traditionally cultivated dual purpose crops of South Asia, primarily due to the better economic remuneration. This has created an impetus for improving maize for both grain productivity and stover traits. Molecular techniques can largely assist breeders in determining approaches for effectively integrating stover trait improvement in their existing breeding pipeline. In the current study we identified a suite of potential genomic regions associated to the two major stover quality traits-in-vitro organic matter digestibility (IVOMD) and metabolizable energy (ME) through genome wide association study. However, considering the fact that the loci identified for these complex traits all had smaller effects and accounted only a small portion of phenotypic variation, the effectiveness of following a genomic selection approach for these traits was evaluated. The testing set consists of breeding lines recently developed within the program and the training set consists of a panel of lines from the working germplasm comprising the founder lines of the newly developed breeding lines and also an unrelated diversity set. The prediction accuracy as determined by the Pearson's correlation coefficient between observed and predicted values of these breeding lines were high even at lower marker density (200 random SNPs), when the training and testing set were related. However, the accuracies were dismal, when there was no relationship between the training and the testing set.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-020-80118-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7804097PMC
January 2021

Enhanced Bioavailability of Boswellic Acid by : A Computational and Pharmacokinetic Study.

Front Pharmacol 2020 15;11:551911. Epub 2020 Dec 15.

Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, United States.

Chronic inflammation is a key culprit factor in the onset and progression of several diseases. Novel and pharmacologically effective therapeutic approaches are needed for new treatment remedy or improved pharmacokinetics and pharmacodynamics for existing synthetic drugs, in particular natural products. Boswellic acids are well-known natural products, with capacity to effectively retard inflammation without severe adverse effects. However, the therapeutic use of Boswellic acids are greatly hindered by its poor pharmacokinetic properties. Co-administration strategies that facilitate the oral absorption and distribution of Boswellic acids should lead to a safe and more effective use of this product prophylactically and therapeutically in inflammatory disorders. In this study, we examined the effect of extract on the absorption and bioavailability of Boswellic acid in rabbits. In addition, we further explored computational pharmacodynamic interactions between and Boswellic acid. extract at 2.5 and 10 mg/kg, increased the bioavailability of Boswellic acid ( < 0.05). Based on our drug-based computational modeling, cytochrome P450 (CYP450)-mediated mechanism was involved in increased bioavailability. These findings confirmed that with Boswellic acid may be administered orally together for effective therapeutic efficacy. Thus, our studies support the application of with Boswellic acid as a novel therapeutic avenue in diseases associated with inflammation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fphar.2020.551911DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7770183PMC
December 2020

Postnatal management of bilateral Grade 3-4 ureteropelvic junction obstruction.

Indian J Urol 2020 Oct-Dec;36(4):288-294. Epub 2020 Oct 1.

Department of Pediatric Urology, Sri Ramachandra Institute of Higher Education and Research. Chennai, Tamil Nadu, India.

Introduction: Bilateral hydronephrosis on prenatal ultrasound can be managed expectantly or with surgical intervention. The treatment strategies and outcomes are not clearly defined.

Methods: We conducted a retrospectively audit of outcomes of management of prenatally detected severe bilateral ureteropelvic junction obstruction (UPJO) in our institution.Patients with bilateral Grade 3-4 hydronephrosis were included. Those with complications like rupture, underwent bilateral intervention within 4 weeks; in the remaining, unilateral pyeloplasty was performed at 4-12 weeks. The contralateral renal unit was re-evaluated at a later date for further improvement or deterioration. All the patients were followed up with ultrasonography and renogram at 3 months, 6 months, and 1-year post operatively. The case records were analyzed for the resolution of antero-posterior diameter (APD) or the improvement in single-kidney glomerular filtration rate (s-GFR) in the operated units.

Results: Over 15 years, 28 patients (56 renal units) had bilateral UPJO (male-to-female ratio = 13:1). Twelve units underwent neonatal intervention to tackle the complications (6 bilateral pyeloplasty), 17 units underwent early pyeloplasty, and 15 underwent late pyeloplasty. Twelve of the twenty-two (54%) contralateral units, which were stented/observed, resolved spontaneously. Receiver operating characteristics analysis revealed that those with initial APD <25 mm and initial s-GFR >35 ml/m were more likely to improve during the observation. Ten of the forty-four operated units (22%) failed to show an improvement. Units with initial s-GFR <10 ml/m had poor chance of postoperative functional recovery.

Conclusions: In neonates with bilateral UPJO, the worse affected kidney is operated first, as it still has the potential to recover. The contralateral milder UPJO unit is known to recover spontaneously following unilateral pyeloplasty. In those with bilateral Grade 4 UPJO and mass, bilateral pyeloplasty is feasible. Alternatively, unilateral pyeloplasty + contralateral cystoscopic retrograde stenting may prevent rupture or functional deterioration in the opposite kidney.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/iju.IJU_231_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759160PMC
October 2020

Why Is Clinical Research Important for a Pediatric Surgeon?

Authors:
Ramesh Babu

J Indian Assoc Pediatr Surg 2020 Sep-Oct;25(5):263-264. Epub 2020 Sep 1.

Department of Pediatric Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jiaps.JIAPS_182_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732012PMC
September 2020

Orthetrum erythronigrum sp. nov. (Odonata: Libellulidae) from the Great Nicobar Island, India.

Zootaxa 2020 Nov 2;4869(2):zootaxa.4869.2.4. Epub 2020 Nov 2.

Zoological Survey of India, Southern Regional Centre, Santhome High Road, Chennai-600 028, Tamil Nadu, India..

The male and female of Orthetrum erythronigrum sp. nov. are described from Great Nicobar Island and are believed to be endemic to the Nicobar Islands archipelago (holotype ♂, India, Andaman and Nicobar Islands, Great Nicobar Island, Great Nicobar Biosphere Reserve, N 6.99067, E 93.871363; 01-xii-2018; deposited in ZSI, SRC, Chennai, India). The male of this new species is easily distinguished from other known Orthetrum species by its black abdomen with contrasting crimson belly. Female is distinguished by its large size, the black non-metallic head, black thorax and the red abdomen with a distinct black pattern. Based on field observations and photographs, notes on the life colouration of the mature male and information on the distribution and habitat of this Great Nicobar endemic are provided.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11646/zootaxa.4869.2.4DOI Listing
November 2020

New species of Soa Enderlein, 1904 (Psocodea: 'Psocoptera': Lepidopsocidae) from the Western Ghats of India.

Zootaxa 2020 Nov 19;4881(2):zootaxa.4881.2.11. Epub 2020 Nov 19.

Southern Regional Centre, Zoological Survey of India, 130, Santhome High Road, Chennai- 600 028, Tamil Nadu, India. University of Madras, Chennai-600 005, Tamil Nadu India..

Soa papanasam sp. nov. is described and illustrated based on both sexes from Kalakkad Mundanthurai Tiger Reserve and Meghamalai Wildlife Sanctuary, Tamil Nadu, India. It differs from all other known species of Soa, by hindwing vein R1 originating proximal to vein M1 and distal to M2. This is the first species of the genus Soa described from India.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11646/zootaxa.4881.2.11DOI Listing
November 2020

Gender identity disorder (GID) in adolescents and adults with differences of sex development (DSD): A systematic review and meta-analysis.

J Pediatr Urol 2021 02 12;17(1):39-47. Epub 2020 Nov 12.

Department of Pediatric Urology, Sri Ramachandra Institute of Higher Education & Research, Chennai, 600116, India.

Gender assignment in infants born with a difference in sexual development (DSD) remains one of the many difficult decisions faced by the multi-disciplinary treatment team as some of these children develop gender identity disorder (GID) when they become adults. In this systematic review and meta-analysis we have analyzed the prevalence of GID in adolescent and adults with DSD. The secondary outcome of this review is to help physicians in appropriate sex assignment of DSD children so that development of GID in later life can be reduced.

Methods: Pubmed/Index medicus were searched for "intersex" [All fields] OR "disorders of sexual differentiation AND "gender identity disorder OR gender dysphoria" [MeSH] for articles published between 2005 and 2020. Typical diagnoses included were congenital adrenal hyperplasia (CAH); complete androgen insensitivity syndrome (CAIS); partial androgen insensitivity syndrome (PAIS); 5 alpha reductase deficiency (5ARD); 17-hydroxysteroid dehydrogenase deficiency (17HSD); mixed gonadal dysgenesis (MGD) and complete gonadal dysgenesis (CGD). GID or gender dysphoria (a strong feeling of dissatisfaction about oneself as male or female) prevalence in DSD patients older than 12 years of age was extracted. Within each condition, GID percentage was compared between female and male rearing.

Results: The I2statistics for prevalence of GID in DSD showed high heterogeneity with I2 of 93% (95% C.I 90-95%) among the 20 articles included. The overall prevalence of GID among those with DSD was 15% (95% C.I 13-17%). CAH reared females had 4% GID while CAH reared males had significantly higher GID at 15% (p = 0.0056). All CAIS patients were raised as females and the prevalence of GID was 1.7%. GID prevalence was 12% in PAIS raised as females while 25% in those raised as males with no significant difference (p = 0.134). GID was significantly high in 5ARD (53%) and 17HSD (53%) reared as females with half of them virilizing at puberty forcing a gender change. Among sex chromosome DSD 22% of those reared as females had GID while none in those raised as male with no significant difference.

Conclusions: GID is low in women with CAH, CAIS and CGD favoring female sex of rearing in these conditions. GID is high in women with 5ARD/17HSD favoring male sex of rearing in these conditions. GID is variable in PAIS or MGD and no recommendations on sex of rearing could be made in these conditions. Each DSD patient is unique and they warrant multi-disciplinary care and long term psycho sexual support.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jpurol.2020.11.017DOI Listing
February 2021

Genetic gains with rapid-cycle genomic selection for combined drought and waterlogging tolerance in tropical maize (Zea mays L.).

Plant Genome 2020 11 20;13(3):e20035. Epub 2020 Jul 20.

CIMMYT Asia Maize Program, ICRISAT Campus, Hyderabad, 502324, India.

Rapid cycle genomic selection (RC-GS) helps to shorten the breeding cycle and reduce the costs of phenotyping, thereby increasing genetic gains in terms of both cost and time. We implemented RC-GS on two multi-parent yellow synthetic (MYS) populations constituted by intermating ten elite lines involved in each population, including four each of drought and waterlogging tolerant donors and two commercial lines, with proven commercial value. Cycle 1 (C ) was constituted based on phenotypic selection and intermating of the top 5% of 500 S families derived from each MYS population, test-crossed and evaluated across moisture regimes. C was advanced to the next two cycles (C and C ) by intermating the top 5% selected individuals with high genomic estimated breeding values (GEBVs) for grain yield under drought and waterlogging stress. To estimate genetic gains, population bulks from each cycle were test-crossed and evaluated across locations under different moisture regimes. Results indicated that the realised genetic gain under drought stress was 0.110 t ha yr and 0.135 t ha yr , respectively, for MYS-1 and MYS-2. The gain was less under waterlogging stress, where MYS-1 showed 0.038 t ha yr and MYS-2 reached 0.113 t ha yr . Genomic selection for drought and waterlogging tolerance resulted in no yield penalty under optimal moisture conditions. The genetic diversity of the two populations did not change significantly after two cycles of GS, suggesting that RC-GS can be an effective breeding strategy to achieve high genetic gains without losing genetic diversity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/tpg2.20035DOI Listing
November 2020

Foundations and affordances of workplace assistive technology: The case of mobile and enabling IT for workers with visual impairments.

Assist Technol 2020 Nov 13:1-8. Epub 2020 Nov 13.

Envision Research Institute, Lead Accessibility Scientist, Envision, Inc , Wichita, Kansas, USA.

Smartphones, with their built-in cameras, speech synthesizers, processing power, sensors, and network connectivity have established themselves as a fertile and ubiquitous platform for software developers interested in augmenting the capabilities of users with visual impairments. When fitted with readily available nonvisual apps, they comprise a mobile and enabling IT bundle (ME-IT) which can afford users new capabilities to interact with visual aspects of their environment. In this study, we investigated the potential of ME-IT as a workplace enabler for workers with visual impairments (WVI). Adopting a Delphi approach, this study contributes five categories of extended capabilities afforded by ME-IT deemed highly relevant to WVI and their employers: , and . Two characteristics of the ME-IT bundle emerged as the basis for these extended capabilities: portable computer vision and context awareness. Findings extend literature on the use of mobile technology in the workplace, contextually aware computing, and assistive technology, and invites additional work to calibrate ME-IT to specific jobs, job contexts, and the needs of users.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/10400435.2020.1812764DOI Listing
November 2020

Co-Delivery of Hispolon and Doxorubicin Liposomes Improves Efficacy Against Melanoma Cells.

AAPS PharmSciTech 2020 Nov 4;21(8):304. Epub 2020 Nov 4.

Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, Alabama, 36849, USA.

Hispolon is a small molecular weight polyphenol that has antioxidant, anti-inflammatory, and anti-proliferative activities. Our recent study has demonstrated hispolon as a potent apoptosis inducer in melanoma cell lines. Doxorubicin is a broad spectrum first-line treatment for various kinds of cancers. In this study, co-delivery of doxorubicin and hispolon using a liposomal system in B16BL6 melanoma cell lines for synergistic cytotoxic effects was investigated. Liposomes were prepared using a lipid film hydration method and loaded with doxorubicin or hispolon. The formulations were characterized for particle size distribution, release profile, and encapsulation efficiency (EE). In addition, in vitro cytotoxicity, in vitro cell apoptosis, and cellular uptake were evaluated. Liposomes exhibited small particle size (mean diameter ~ 100 nm) and narrow size distribution (polydispersity index (< 0.2) and high drug EE% (> 90%). The release from liposomes showed slower release compared to free drug solution as an additional time required for the release of drug from the liposome lipid bilayer. Liposome loaded with doxorubicin or hispolon exhibited significantly higher cytotoxicity against B16BL6 melanoma cells as compared to doxorubicin solution or hispolon solution. Likewise, co-delivery of hispolon and doxorubicin liposomes showed two-fold and three-fold higher cytotoxicity, as compared to hispolon liposomes or doxorubicin liposomes, respectively. In addition, co-delivery of doxorubicin and hispolon in liposomes enhanced apoptosis more than the individual drugs in the liposome formulation. In conclusion, the co-delivery of hispolon and doxorubicin could be a promising therapeutic approach to improve clinical outcomes against melanoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1208/s12249-020-01846-2DOI Listing
November 2020

Evaluation of Cytotoxicity and Taste-Masking Effect of Selected Flavors on Dental Lidocaine HCl Injection.

Pharmaceuticals (Basel) 2020 Oct 29;13(11). Epub 2020 Oct 29.

Department of Pharmacology and Experimental Therapeutics, The University of Toledo, Health Science Campus, 3000 Arlington Ave, Toledo, OH 43614, USA.

Aim: Anxiety and intolerance to dental local anesthetic injections are common in patients undergoing dental procedures. This work was designed to study cytotoxicity of selected flavors in primary gingival keratinocytes (PGK), to acquire information on their suitability for use in dental lidocaine hydrochloride (LID) injection. We also evaluated the bio-mimetic taste of LID dental injection in the presence of selected flavors and sweetener using an Astree electronic tongue (ETongue).

Methods: The cytotoxicity of chocolate natural and artificial flavor (CTE), raspberry flavor artificial (RAS), cherry flavor (CHR), bitterness suppressor flavor (BSF) and lemon flavor extract (LFE) at various dilutions (0.16-10% /) was carried out in PGK using the live cell morphological analysis and MTT cell cytotoxicity assay. Based on the cytotoxicity data, CTE and RAS were added to Xylocaine (2%) along with 0.09% sodium saccharin and taste was assessed using an ETongue.

Results: After three hours of treatment, a dose-dependent cell death was induced by all flavors compared to the untreated control. BSF was found to be more toxic when compared to other flavors. CTE was found to be less toxic. The mean IC50 values of CTE, RAS, CHR, BSF and LFE in PGK were found to be 9.54, 8.43, 2.21, 0.38 and 4.01 mg/mL. Taste analysis with the ETongue showed a clear taste difference between the control and test formulations containing CTE and RAS flavors along with sodium saccharin.

Conclusion: CTE and RAS flavors in combination with 0.09% sodium saccharin can achieve a significant taste-masking effect in the dental LID injection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ph13110353DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7693877PMC
October 2020

Checklist of the dragonflies and damselflies (Insecta: Odonata) of Bangladesh, Bhutan, India, Nepal, Pakistan and Sri Lanka.

Zootaxa 2020 Sep 8;4849(1):zootaxa.4849.1.1. Epub 2020 Sep 8.

Naturalis Biodiversity Center, P.O. Box 9517, 2300 RA Leiden, The Netherlands..

A checklist of the dragonflies and damselflies occurring in Bangladesh, Bhutan, India (including Andaman and Nicobar Islands), Nepal, Pakistan and Sri Lanka is presented. In total 588 (including 559 full species) taxa are known to occur in the region of which 251 taxa (species subspecies) are single country endemics. Recent taxonomic changes relevant to the area are summarized. Sixteen taxa are synonymized and a checklist of all synonyms established since 1950 is provided. Information is given on available larval descriptions including a list of genera present in the region for which no larvae have yet been described. Numerous species occurring in the area are still poorly known and a list of genera for which a revision is urgently needed is provided.                The following new synonyms are established: Calicnemia sudhaae Mitra, 1994 = Calicnemia imitans Lieftinck, 1948 syn. nov.; Ceriagrion fallax cerinomelas Lieftinck, 1927 = Ceriagrion fallax Ris, 1914 syn. nov.; Ceriagrion fallax pendleburyi Laidlaw, 1931 = Ceriagrion fallax Ris, 1914 syn. nov.; Coenagrion kashmirus Chowdhary Das, 1975 = Ischnura forcipata Morton, 1907 syn. nov.; Enallagma insula Fraser, 1920 = Aciagrion occidentale Laidlaw, 1919 syn. nov.; Himalagrion pithoragarhicum Sahni, 1964 = Ceriagrion fallax Ris, 1914 syn. nov.; Ischnura bhimtalensis Sahni, 1965 = Ischnura rubilio Selys, 1876 syn. nov.; Onychargia indica Sahni, 1964 = Paracercion calamorum (Ris, 1916) syn. nov.; Anaciaeschna kashmirense Singh Baijal, 1954 = Anaciaeschna martini (Selys, 1897) syn. nov.; Cyclogomphus vesiculosus Selys, 1854 = Cyclogomphus ypsilon Selys, 1954 syn. nov.; Chlorogomphus brittoi Navás, 1934 = Chlorogomphus xanthoptera (Fraser, 1919) syn. nov.; Hylaeothemis indica Fraser, 1946 = Hylaeothemis apicalis Fraser, 1924 syn. nov.; Sympetrum durum Bartenef, 1916 = Sympetrum striolatum commixtum Selys, 1884 syn. nov.; Sympetrum himalayanum Navás, 1934 = Sympetrum hypomelas (Selys, 1884) syn. nov.; Sympetrum haematoneura Fraser, 1924 = Sympetrum speciosum Oguma, 1915 syn. nov.; Sympetrum speciosum taiwanum Asahina, 1951 = Sympetrum speciosum Oguma, 1915 syn. nov.                In addition, Periaeschna lebasi Navás, 1930 is regarded a nomen nudum. The following new combinations are proposed: Onychogomphus acinaces Laidlaw, 1922 is transferred to the genus Melligomphus Chao, 1990 resulting in Melligomphus acinaces (Laidlaw, 1922) comb. nov. Onychogomphus saundersii Selys, 1854 is transferred to the genus Nychogomphus Carle, 1986 resulting in Nychogomphus saundersii (Selys, 1854) comb. nov..
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11646/zootaxa.4849.1.1DOI Listing
September 2020

Three new species of Protosticta Selys, 1885 (Odonata: Zygoptera: Platystictidae) from the Western Ghats, India, with taxonomic notes on P. mortoni Fraser, 1922 and rediscovery of P. rufostigma Kimmins, 1958.

Zootaxa 2020 Sep 30;4858(2):zootaxa.4858.2.1. Epub 2020 Sep 30.

National Centre for Biological Sciences, GKVK Campus, Bellary Rd, Bengaluru, 560065, Karnataka, India.

Three new species of Protosticta Selys, 1885 (Odonata: Zygoptera: Platystictidae) from the Western Ghats biodiversity hotspot in India: P. cyanofemora sp. nov. (wet evergreen forests in Shendurney Wildlife Sanctuary, Kollam, Kerala and Kalakkad Mundanthurai Tiger Reserve, Tirunelveli, Tamil Nadu), P. myristicaensis sp. nov. (Myristica swamp at Kathalekan, Shivamogga, Karnataka) and P. sholai sp. nov. (montane sholas of Upper Manalar, Meghamalai Wildlife Sanctuary, Theni, Tamil Nadu) are described and illustrated. We compare these three new species with other Protosticta spp. from the Western Ghats based on new material and provide comprehensive differential diagnoses with determination key for males of all species occurring in the Western Ghats. The taxonomic validity of P. mortoni Fraser, 1922 is established with fresh specimens from Hassan, Karnataka, and rediscovery of P. rufostigma Kimmins, 1958 is reported from Kanyakumari Wildlife Sanctuary, Tamil Nadu.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11646/zootaxa.4858.2.1DOI Listing
September 2020

Application of Extrusion-Based 3D Printed Dosage Forms in the Treatment of Chronic Diseases.

J Pharm Sci 2020 12 6;109(12):3551-3568. Epub 2020 Oct 6.

Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, AL 36849, USA. Electronic address:

Chronic disease management has been a significant burden in many countries. As most treatment options involve long-term pharmacotherapy, patient compliance has been a challenge, as patients have to remember taking medications on time at the prescribed dose for each disease state. Patients are often required to split the dosage unit, which may lead to under- or over-dose and dose-related adverse effects. However, 3D printing technologies have been used for fabricating personalized medications and multiple drugs in a single dose unit (polypills), which might greatly reduce treatment monitoring, dosing errors, and follow-ups with the health care providers. Extrusion-based 3D printing is the most used technology to fabricate polypills and to customize the dose, dosage form, and release kinetics, which might potentially reduce the risk of patient non-compliance. Although extrusion-based 3D printing has existed for some time, interest in its potential to fabricate dosage forms for treating chronic diseases is still in its infancy. This review focuses on the various extrusion-based 3D printing technologies such as fused deposition modeling, pressure-assisted microsyringe, and direct powder extrusion 3D printing in the preparation of customizable, multi-drug dosage forms for treating chronic diseases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.xphs.2020.09.042DOI Listing
December 2020

A systematic review and meta-analysis comparing outcomes of laparoscopic extravesical versus trans vesicoscopic ureteric reimplantation.

J Pediatr Urol 2020 Dec 16;16(6):783-789. Epub 2020 Sep 16.

Department of Pediatric Surgery, Pediatric Urology & MAS, Ankura Children's Hospital, Hyderabad, India.

Objective: When considering treatment for vesico ureteric reflux via inimally invasive surgery there is a dilemma to choose between laparoscopic extravesical (LEVUR) and transvesicoscopic (TVUR) ureteric reimplantation. In this systematic review and meta-analysis we have analyzed the articles on LEVUR and TVUR and compared the outcomes.

Methods: We searched the databases to identify all papers pertaining to TVUR and LEVUR in the pediatric population. Duplicate publications, review articles, incomplete articles and robotic assistance were excluded. Systematic review was performed to identify patient data, reflux grades, laterality, duration of surgery, time to discharge, success rate and complications. Meta-analysis of heterogeneity was reported with I 2 statistics. Once heterogeneity was found low, the pooled outcomes were compared with students t test and Fishers exact test, wherever appropriate.

Results: After screening a total of 45 articles, 23 articles were included (13 articles on TVUR and 10 articles on LEVUR). The I 2 statistics for TVUR and LEVUR showed low heterogeneity with I 2 of 0% (95% C.I 0-37%) and 25% (95% C.I 0-64%) respectively. With low heterogeneity both were suitable to be considered to have been conducted under similar conditions with possibility of using fixed effect model. The percentage of Grade 5 VUR was significantly higher (p = 0.001; X 2) in TVUR (11.9%) compared to LEVUR (2.2%). The proportion of bilateral reimplantation was significantly higher (p = 0.001; X 2) in TVUR compared to LEVUR (summary table). The success rate of LEVUR was significantly higher at 96.7% compared to TVUR at 93.7% (p = 0.007 X 2). Unilateral/Bilateral TVUR took significantly longer duration of surgery (155/194 min vs 107/161 min) compared to LEVUR (p = 0.001; Fishers). The mean (s.d) time to discharge was longer at 3.2 (1.6) days for TVUR compared to 1.6 (0.4) days for LEVUR (p = 0.001; Fishers). The complication rate was comparable, 7.35% for TVUR and 5.35% for LEVUR (p = 0.167; X 2).

Discussion: In this meta-analysis we found that LEVUR had shorter operating time, higher success, and shorter hospital stay compared to TVUR. A probable explanation could be higher number unilateral VURs and lower number of grade 5 VUR cases in LEVUR group. Both the techniques had comparable overall complication rate: LEVUR had more post-operative urinary retention while TVUR had more port-related problems.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jpurol.2020.09.006DOI Listing
December 2020

Robot-assisted laparoscopic extravesical versus conventional laparoscopic extravesical ureteric reimplantation for pediatric primary vesicoureteric reflux: a systematic review and meta-analysis.

Pediatr Surg Int 2020 Nov 27;36(11):1371-1378. Epub 2020 Sep 27.

Pediatric Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

To perform a systematic review and meta-analysis comparing the outcomes of robotic-assisted laparoscopic extravesical ureteric reimplantation (RALUR) with conventional laparoscopic extravesical ureteric reimplantation (LEVUR) for primary vesicoureteric reflux in children. We searched the databases to identify all papers of RALUR and LEVUR between 2001 and 2020. Systematic review was performed to identify patient data, age, reflux grades, laterality, duration of surgery, time to discharge, success rate and complications. Heterogeneity was reported with I statistics and publication bias was assessed by Doi curve and Luis Furuya-Kanamori index. Pooled data from both groups were compared with Student's t test and Fisher's exact test, wherever appropriate. From a total of 43 articles screened, 28 articles were included (18 RALUR and 10 LEVUR). The I statistics for RALUR and LEVUR showed heterogeneity of 86% and 25%, respectively. Both groups had comparable minor publication bias. RALUR had higher proportion of grade 5 VUR (p < 0.001) and bilateral reimplantations (p < 0.001). The success rate of RALUR was significantly lower than that of LEVUR (97.6% vs. 93.4%, p = 0.0018). RALUR took a significantly longer duration for surgery compared to LEVUR, both for unilateral and bilateral cases (p < 0.001). The complication rate was not significantly different: 6.6% for RALUR and 5.35% for LEVUR (p = 0.32). The most common complication in both groups was post-operative urinary retention in bilateral cases. Articles on LEVUR reported more consistent success. RALUR series had higher proportion of grade 5 cases and bilateral reimplantations. RALUR reported longer operative time and lower success compared to LEVUR, with a complication rate comparable to LEVUR.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00383-020-04749-2DOI Listing
November 2020

Cystoscopic Management of Prostatic Utricles.

Urology 2021 Mar 17;149:e52-e55. Epub 2020 Sep 17.

Department of Pediatric Surgery, Pediatric Urology & MAS, Ankura Children's Hospital, Hyderabad, India.

In this case series (n = 7) on prostatic utricles (PU), retention of urine was seen in 5 of 7, urinary tract infection (4 of 7), recurrent epidydymo-orchitis (3 of 7), and scrotal sinus (1 of 7). Voiding cystourethrogram established diagnosis in 3 of 7 patients while CT/MRI in 4 of 7 patients. Four patients were primarily managed by cystoscopic widening of mouth of PU. Three with large PU underwent initial open (2) or laparoscopic (1) excision but later warranted cystoscopic widening for residual PU. Excision (open/laparoscopic) has risk of damage to adjacent structures (nerves/vas/seminal vesicles) or leaving behind a residual PU. Cystoscopic management (primary/salvage) has less morbidity and relieves recurrent symptoms due to stasis of urine in PU.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.urology.2020.09.005DOI Listing
March 2021

Spinal Metastasis of Cerebral Glioblastoma with Genetic Profile: Case Report and Review of Literature.

World Neurosurg 2020 Nov 31;143:480-489. Epub 2020 Jul 31.

Department of Neurosurgery, Hamad Medical Corporation, Doha, Qatar; Department of Neurosurgery, Weill Cornell Medical College, Doha, Qatar; Department of Surgery, Michigan State University, Lansing, Michigan, USA.

Background: Spinal metastasis of cerebral glioblastoma (GBM) is rare, with some reports suggesting a prevalence of 1%-2%.

Case Description: Herein, we present 2 unique cases of spinal metastasis of cerebral GBM, 1 of which was histologically proven to be a drop spinal GBM metastasis. The first case was a 25-year-old female who presented with a spinal intradural intramedullary spinal lesion a few months after resection of a left temporal lobe GBM (isocitrate dehydrogenase wild type). The patient underwent surgical resection of the new lesion, and subsequent histopathologic examination proved that the intramedullary spinal lesion was GBM. The patient experienced full recovery postoperatively, and then a few months later, she presented again with widespread drop metastasis of the spinal cord. The second case is a middle-aged male with right temporal GBM who developed spinal metastasis 10 months after his diagnosis.

Conclusions: We are reporting these 2 cases due to the rarity of spinal metastasis in GBM. We reviewed the current literature and included genetic and molecular profiles in the discussion. Currently, there are no established treatment guidelines for GBM spinal metastasis. The Stupp protocol after initial brain surgery for GBM did not appear to have beneficial effects on prolonging survival in these patients with spinal metastasis. The goal of treatment was primarily to alleviate pain and neurologic deficits with no effect on overall outcome. Prognosis following the diagnosis of spinal metastasis is poor.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.wneu.2020.07.163DOI Listing
November 2020

Perspectives of Healthcare Providers and the General Population on a Cancer Awareness Portal: a Qualitative Study.

J Cancer Educ 2020 Aug 1. Epub 2020 Aug 1.

ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India.

This study was aimed at a qualitative assessment of a cancer informational website, "India Against Cancer," developed by the ICMR-National Institute of Cancer Prevention and Research with the dual purpose of promoting cancer awareness among the general population and providing comprehensive information to healthcare providers. We used the narrative qualitative approach (data collection using in-depth interviews (IDIs) and focused group discussions (FGDs)) and content analysis. Purposive sampling was undertaken for both IDIs and FGDs. Thematic analysis was done on four themes: general cancer awareness, ease of comprehension of the Web portal, the relevance of the website content, and general comments and suggestions. Readability assessment of content of the website was conducted using Flesch-Kincaid Readability methodology. The general cancer awareness was enhanced among the participants after visiting the website. Ease of comprehension of the Web portal content was reported to fare well. The sections on "risk factors," "warning signs," and "diet and cancer" were mentioned as most relevant by the general population, whereas "myths and facts" and "screening guidelines" were most relevant for the healthcare workers. Similarly, references and epidemiology sections were most useful for healthcare researchers/professionals. Readability scores of content in English were appropriate for high school pass audience. The content on "India Against Cancer" website was found to serve its intended purpose of promoting cancer awareness among the general population and providing authentic cancer-related information to the healthcare providers. The suggestions received would enable us to enhance the utility of our website by tailoring it to the needs of the target audience.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s13187-020-01846-7DOI Listing
August 2020

Components of complex movement that can be best studied using the sequence learning paradigm.

Authors:
Reshma Babu

J Neurophysiol 2020 09 29;124(3):645-647. Epub 2020 Jul 29.

Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana.

The sequence learning paradigm has been used extensively to study motor skill acquisition. Skilled movement involves combining smaller elements of the movement in a particular order with certain timing; in sequence learning these are typically button presses, but other motor skills may include more complex elements. This paper reviews recent evidence suggesting the sequence learning paradigm can be used to understand how the brain abstractly represents the ordering of discrete actions in a complex movement.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1152/jn.00769.2019DOI Listing
September 2020

Lead-Free, Water-Stable A Bi I Perovskites: Crystal Growth and Blue-Emitting Quantum Dots [A=CH NH , Cs , and (Rb Cs ) ].

Chemistry 2020 Aug 27;26(46):10519-10527. Epub 2020 Jul 27.

Polymers and Functional Materials Division, CSIR-Indian Institute of Chemical Technology (IICT), Uppal Road, Tarnaka, Hyderabad, 500007, India.

Despite the great success in the increase in the power conversion efficiency of lead halide perovskite solar cells, the toxicity of lead and the unstable nature of the materials are still major concerns for their wider implementation at the industrial level. Herein, large-size single crystals (SCs) are developed in HI solution by using a temperature lowering method and nanocrystals (NCs) of A Bi I perovskites [where A=CH NH (MA) , Cs , and (Rb Cs ) ] are formed in ethanol (EtOH) and toluene (TOL). The stability of A Bi I perovskite is investigated by immersing the SCs for 24 h and pellets for 12 h in water. Moreover, the A Bi I perovskite NCs displays a promising photoluminescence quantum yield of 17.63 % and a long lifetime of 8.20 ns.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/chem.202000506DOI Listing
August 2020

Evaluation of a Chip-Based, Point-of-Care, Portable, Real-Time Micro PCR Analyzer for the Detection of High-Risk Human Papillomavirus in Uterine Cervix in India.

JCO Glob Oncol 2020 07;6:1147-1154

Indian Council of Medical Research-Indian Cancer Research Consortium, New Delhi, India.

Purpose: Currently available human papillomavirus (HPV) detection devices are expensive, requiring a continuous power supply, high-priced reagents, skilled laboratory personnel, and infrastructure. These make it difficult to implement primary HPV screening in high-risk (HR) populations, particularly in low-income settings such as in India. The objective of our study was to evaluate the diagnostic performance of a point-of-care, portable, battery-operated device called Truenat, which detects 4 HR HPV genotypes (16, 18, 31, and 45), as a potentially cost-effective alternative to conventional HPV diagnostic tests.

Patients And Methods: This was a single-site, blinded, cross-sectional study that evaluated the performance of the Trunat HPV-HR using cervical samples collected from nonpregnant women > 30 years old via consecutive sampling. The comparison was conducted against the Hybrid Capture 2 (HC2) method. All the positive samples were validated by 14 Real-TM Quant Kit.

Results: Of 615 cervical samples, the HR-HPV DNA test was positive in 78 women (12.7%) by HC2 and in 49 (8%) by Truenat. With the consideration of limited genotype inclusivity, the sensitivity and specificity of Truenat HPV-HR were 97.7% and 98.9%, respectively.

Conclusion: The performance of Truenat HPV-HR test was comparable to that of HC2 in the 4 HPV genotypes and would be appropriate to consider for use in primary HR cervical cancer screening and particularly in low-income settings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1200/GO.20.00024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392761PMC
July 2020

Factors influencing the retention of participants in online cancer screening training programs in India.

BMC Med Educ 2020 Jul 13;20(1):220. Epub 2020 Jul 13.

Department of Clinical Oncology, ICMR- National Institute of Cancer Prevention and Research, I-7, Sector 39, Noida, Uttar Pradesh, 201301, India.

Background: Online courses have broken the boundaries in imparting knowledge. While in western countries e-learning in medical education is well accepted, it is still an upcoming field in low- and middle-income countries like India. Attrition is a major threat to online courses world-wide. The objective of this article is to share the experiences in conducting online cancer screening courses, reasons for attrition and ways to improve retention.

Methods: Online training program in preventive oncology for medical professionals is being conducted since 2017, which is 14-week long with weekly one-hour sessions and specific curriculum for healthcare professionals. Since the retention of participants was a major challenge in all the courses, a short online survey was conducted to identify the reason behind quitting the course and suggestions to improve retention. The data was analyzed in November 2019.

Results: Among 614 enrolments, 26% (159/614) refused to attend the course and only 55% (252/455) completed the course successfully. Among the attendees 52% (238/455) were females, 71% (325/455) were from the public sector and 71% (324/455) were non-specialists. The attrition was high among non-specialists 49% (160/324), male participants 57% (124/217) and public sector doctors 52% (170/325). The main reasons for quitting the course were high workload in the health facilities 75% (52/69) and poor internet connectivity 12% (8/69).

Conclusion: The internet connectivity should be strengthened in all the healthcare centers to facilitate e-learning. A dedicated time-slot should be allotted to the providers for e-learning and updating their knowledge in addition to their routine work.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12909-020-02144-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359595PMC
July 2020

Cervical Epidural Abscess due to Treated with Decompression and Instrumentation: A Case Report and Review of Literature.

Asian J Neurosurg 2020 Apr-Jun;15(2):440-444. Epub 2020 May 29.

Department of Neurosurgery, Hamad Medical Corporation, Doha, Qatar.

is caused by a Gram-negative bacillus and is a common disease in endemic areas where people are in close contact with animals and dairy products, but brucellar cervical epidural abscess is rare. We describe a rare case of a C5-6 brucellar epidural abscess in a veterinary doctor who was treated with decompression and instrumentation. We also review the cases of cervical brucellar epidural abscess treated with instrumentation in the literature.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ajns.AJNS_358_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335118PMC
May 2020