Detection

Factors influencing referral delay of cancer patients to an oncology unit in the Southern Region of Saudi Arabia

Published on: 20th August, 2021

OCLC Number/Unique Identifier: 9194011239

Introduction: Cancer treatment and prognosis depend heavily on early detection. Survival in the early stages is excellent for almost all types of cancer. Unfortunately, in Saudi Arabia, a large number of cancer patients present with advanced disease, resulting in a poor prognosis. There are three levels of delay in the management of cancer patients. The first level is the time between the first cancer-related symptoms and the presentation to the health facility, the second level is from the presentation to the diagnosis, and the third level is between the diagnosis and the treatment. This study aims to determine if there is a delay, at what level and to study the factors causing such delays.Materials and methods: Two hundred cancer patients who presented to the Armed Forces Hospital Southern Region, Oncology Department, were interviewed from January 1st to June 30th, 2018. The interviews were conducted by trained physicians familiar with the questionnaire’s contents. The questionnaire consisted of four sections: a demographic section and three more sections to identify factors causing the delay at the three levels from the patients’ perspectives. All data were analyzed using the SPSS version 20.0.Results: The mean patient age was 63 years. A total of 112 patients were female and 88 were male. The most common cancer type was breast cancer (27.5%). Among the patients, 61% were illiterate and 25.5% had elementary school degrees, 86% expressed little or no general medical knowledge about cancer. More women than men paid attention to cancer symptoms (70% vs. 54%). 75% of the patients presented to the first health facility after 2 months from the first appearance of symptoms (level 1 delay). Only 2% of the patients presented within one week. 50% of the patients received a diagnosis after visiting two health facilities. All patients were diagnosed at hospitals. 40% of patients used alternative medicines, 70% of whom thought this was the cause of their delayed presentations. 67% had their diagnosis confirmed within one month (level 2 delay), and 66% started their definitive treatment within one month (level 3 delay). 75% of the patients blame themselves for the delay. Educational level (p = 0.03), knowledge about cancer (p < 0.01), and the use of complementary and alternative medicines (CAM) (p = 0.01) were significantly associated with delayed presentation of patients to the health facility. Conclusion: There is a delay in the presentation of cancer patients (level 1) in the southern part of Saudi Arabia. Educational level, knowledge of cancer symptoms, and use of complementary and alternative medicines are the main causes. There were no delays in diagnosis and start of treatment (level 2,3).
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MALDI-MSI method for the detection of large biomolecules in plant leaf tissue

Published on: 6th August, 2021

OCLC Number/Unique Identifier: 9204611613

In this study we describe a method for the detection of biomolecules (in the polypeptide m/z range) directly from the surface of plant leaves by using Mass Spectrometry Imaging. The plant-pathogen interaction between Arabidopsis thaliana and the bacterium Xanthomonas campestris pv. campestris was analyzed by comparing infected and non-infected leaf discs submitted to mass spectrometry. The total surface area of ion distribution was calculated for both samples, revealing 23 ions, out of which 3 showed statistical significance. Although these ions were not identified, the results showed that this approach can be successfully applied for the detection of potential polypeptide biomarkers directly on leaf tissue, which is a major challenge in MALDI-Imaging studies.
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Perception of Brazilian adolescents about cancer prevention

Published on: 31st December, 2021

OCLC Number/Unique Identifier: 9382541827

Cancer, as a disease, has found a place in the social imaginary. Individuals construct ideas based on pre-established discourses—be they medical, media, or popular—which often hinder its prevention. Educational interventions have tended to focus on spreading information about the disease, ignoring its social connotations. The objective of the present study is to investigate the concept of cancer prevention in 980 adolescents, aged between 12 and 18 years, attending primary and secondary school in three public schools and one private school in the metropolitan region of São Paulo and the municipality of Dom Viçoso, Minas Gerais. The notion of prevention implies the dominant feeling of performing medical examinations from a symptom, against the idea of preventing, even when there is no clinical manifestation of the body. The majority of students emphasize the advantages of early diagnosis and that the decisive factor for the cure corresponds to the moment of detection: "cancer must be discovered in time". This is a solid belief within the body of knowledge about the disease that can be used as a starting point in prevention messages.However, even when the importance of early detection of cancer is understood as an essential element for its cure, care practices do not accompany the set of principles that regulate prevention or its demands.
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Rapid and sensitive identification of cow and buffalo species and gender in tissue/meat samples impounded from different spots in Delhi NCR India by Real Time PCR

Published on: 12th January, 2022

OCLC Number/Unique Identifier: 9395225158

The objective of this study was to obtain a fast, accurate and reliable method of species identification of unknown biological samples for forensic applications, especially in illegal trade of animals as well as meat fraud. Meat fraud and adulteration not only affects the market but also increases the risk of religious and ethnic conflicts around the world [1]. In this study, species-specific and gender differentiating Real time PCR technique was employed to analyse 15 meat samples collected from a suspected site. Out of 15 samples collected from suspected site, 54% and 13% samples were of Cow and buffalo origin respectively. All 54% cow samples were of male while one each of buffalo were of male and female origin. Two samples were inconclusive. These findings indicated that species and gender-specific PCR is very sensitive and can be used for forensic species identification and the detection of meat fraud and adulteration.
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Applications of convolutional neural networks in chest X-ray analyses for the detection of COVID-19

Published on: 20th January, 2022

OCLC Number/Unique Identifier: 9391752257

Throughout global efforts to defend against the spread of COVID-19 from late 2019 up until now, one of the most crucial factors that has helped combat the pandemic is the development of various screening methods to detect the presence of COVID-19 as conveniently and accurately as possible. One of such methods is the utilization of chest X-Rays (CXRs) to detect anomalies that are concurrent with a patient infected with COVID-19. While yielding results much faster than the traditional RT-PCR test, CXRs tend to be less accurate. Realizing this issue, in our research, we investigated the applications of computer vision in order to better detect COVID-19 from CXRs. Coupled with an extensive image database of CXRs of healthy patients, patients with non-COVID-19 induced pneumonia, and patients positive with COVID-19, convolutional neural networks (CNNs) prove to possess the ability to easily and accurately identify whether or not a patient is infected with COVID-19 in a matter of seconds. Borrowing and adjusting the architectures of three well-tested CNNs: VGG-16, ResNet50, and MobileNetV2, we performed transfer learning and trained three of our own models, then compared and contrasted their differing precisions, accuracies, and efficiencies in correctly labeling patients with and without COVID-19. In the end, all of our models were able to accurately categorize at least 94% of the CXRs, with some performing better than the others; these differences in performance were largely due to the contrasting architectures each of our models borrowed from the three respective CNNs.
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To compare serum Vitamin D status in pre-eclamptic and non-preeclamptic pregnant women in labour: A tertiary care centre study of Northern India

Published on: 28th January, 2022

OCLC Number/Unique Identifier: 9406533422

Background: Pre-eclampsia and eclampsia have remained a major global public health threat in contributing significantly to maternal and perinatal morbidity and mortality. Based on the inverse relationship between serum 1,25(OH)2D3 levels and plasma renin activity found previously, it is speculated that 1,25(OH)2D3 might be a negative endocrine regulator of renin production in vivo. During pregnancy, vitamin D may play a role in implantation and placental function potentially due to angiogenic, immunomodulatory, and antiinflammatory effects. Vitamin Ddeficiency can affect the health of both mother and fetus by increasing the production of inflammatory cytokines and stimulating the activity of T-regulating cells. Vitamin D is emerging as a promising agent for pre-eclampsia prevention. Aims and objectives: The objective of this study is to compare the vitamin D levels in pre-eclamptic and healthy non-pre-eclamptic pregnant women in labor and find out the relationship between vitamin D levels and pre-eclampsia. Methodology: The present cross-sectional study was carried out on pregnant women with pre-eclampsia in labor. For each case with pre-eclampsia, one uncomplicated, normotensive pregnant woman in labor was taken as control. On admission to the labor room detailed history, physical examination followed by thorough obstetrics and systemic examination was done. Required investigations were done including vitamin D and calcium levels. Maternal and fetal condition was monitored during labor/cesarean section, mode of delivery, maternal and fetal outcomes were recorded. After delivery, 2cc of cord blood was collected in a serum tube and sent for vitamin D levels. Data was collected and analyzed statistically using Epi-info version 7.1.Results: It was observed that the patients in both groups were comparable with respect to demographic and obstetrics characteristics except for significantly high BP in group I. Vitamin Ddeficiency (i.e. < 20 ng/ml) was significantly more in group I as compared to group II and the difference was highly significant (p < 0.0001). Similarly, the mean maternal calcium levels were significantly lower in group I in comparison to group II (p < 0.0001) i.e. the mean maternal calcium level in group I and group II were 8.03 ± 0.94 and 9.19 ± 0.67 respectively. It was also observed that the level of 25-OH-D in neonates of preeclamptic women was significantly lower than for those of the normal pregnant women (p < 0.0001). Conclusion: Vitamin D deficiency is highly prevalent in all parts of the world. Pregnant women and neonates are highly vulnerable to vitamin D deficiency. Preeclampsia is indeed associated with lower vitamin D levels and the pathophysiology of pre-eclampsia involves vitamin D and calcium metabolism through their role in immunomodulation, angiogenesis and anti-inflammatory effects. From the present study, it was observed that vitamin D and calcium levels were significantly lowered in women with pre-eclampsia as compared to those of the normotensive pregnant women. So early detection of vitamin D and calcium deficiencies may be helpful in preventing occurrence of PET and its complications.
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Journey with a 21 weeks primi with acute massive pulmonary thromboembolism secondary to possible “Latent Lupus”: an audacious ride

Published on: 9th March, 2022

OCLC Number/Unique Identifier: 9445952693

In pregnancy, the incidence of pulmonary embolism (PE) is increased fivefold when compared to nonpregnant women of the same age, and PE is one of the leading causes of death during pregnancy.However, the diagnosis of PE among pregnant women is complicated by concerns regarding radiation exposure. Systemic lupus erythematosus (SLE) is an autoimmune disorder with a wide array of presentations and a predilection to affect women of certain ethnic backgrounds. The hallmark of the disease is multisystem involvement, dispersed in time and severity. Usual pulmonary involvement includes pleuritis, pleural effusions, pneumonitis, shrinking lung syndrome, pulmonary hypertension, and alveolar hemorrhage. Pulmonary embolism (PE) is a relatively unusual presentation of SLE. We report the case of a 20-year-old primi at 21 weeks gestation with an acute PE with central chest pain and shortness of breath. The absence of overt signs and symptoms and traditional risk factors prompted a fragmentary workup. This led to the detection of antibodies sensitive for SLE, in the absence of overt signs and symptoms. We revive the concept of latent lupus, a condition construed as early lupus. We firmly suspect direct causation between SLE and PE. Further studies are needed to establish pathogenesis to facilitate early diagnosis and prevent morbidity and mortality from PE. Due to persistent hypotension, thrombolytic therapy with streptokinase was administered and the clinical and hemodynamic response was excellent, with no maternal or fetal hemorrhagic complications. The clinical presentation of pulmonary embolism is sometimes camouflaged by the physiological changes that occur in pregnancy and diagnosis is often delayed by a reluctance to expose the fetus to ionizing radiation. 
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Spinal cord involvement in tuberculous meningitis: a case report and brief review of literature

Published on: 15th March, 2022

Introduction: Tuberculosis (TB) continues to pose a significant public health problem worldwide. Tuberculous meningitis (TBM) is the most devastating form of extrapulmonary TB however other forms of central nervous system (CNS) disease include tuberculoma and spinal arachnoiditis. TBM carries high mortality even for a patient who is already receiving treatment. The difficulty in diagnosis often leads to a delay in treatment and subsequent mortality. The emergence of Xpert ultra has improved the rapid detection of MTB and rifampicin resistance in CSF and is the preferred diagnostic tool in TBM.Case: In this case report we present a 33 years patient of concern who presented with progressive lower limb weakness associated with pain and paresthesia for 4 months, admitted via the Orthopedic unit with a diagnosis of spinal mass (meningioma, neurofibroma, or nerve sheath tumor) for which biopsy was done and revealed a chronic inflammatory process, necrotic bone lesions with no granulomas and no malignancy, he was later diagnosed with tuberculous meningitis and promptly started anti-tuberculous therapy with a dramatic recovery and improvement in neurological function.Conclusion: Tuberculous meningitis conditions have high morbidity and mortality yet diagnosis and start of treatment continue to experience an important delay. Clinicians should keep in mind the limitations of clinical presentation due to pleiotropy and current diagnostics and should employ a combination of diagnostic modalities in addition to a high index of suspicion to prevent morbidity in patients with TBM.
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Assessment of knowledge on breast self-examination among female adolescent: a cross-sectional study

Published on: 23rd March, 2022

OCLC Number/Unique Identifier: 9457394403

Background: Breast self-examination is the most important screening method for early detection and diagnosis of Breast cancer. Females assess their breasts regularly to detect any abnormalities to seek instant medical attention. Objectives: The main objective of the study was to assess the knowledge on breast self-examination among female adolescents of Nepal.Method: A cross-sectional study was conducted using self-structured questionnaires among female adolescents of Model Multiple College, Dhanusha. The sample size was 120 participants. Probability proportionate stratified sampling technique was used to collect the data from October 28th to November 12th, 2013. Data were processed through Statistical Package for Social Sciences version 16 and analyzed using descriptive statistics.Results: Out of 120 participants 67.5% participants had knowledge about breast cancer and 40% had knowledge of breast self-examination (BSE). Most of them (94.2%) had a poor knowledge of BSE followed by 5.8% of participants with a moderate level of knowledge of BSE. The mean knowledge score was 18.7 ± 3.5. The majority (66.7%) of participants were from science faculties. More than half (51.7%) of participants stated source of information on BSE was health personnel. Only 25% of the respondent had a family history of breast cancer. Conclusion: The study revealed that most (94.2%) of the participants had poor knowledge of breast self-examination. There is further need for awareness and health education on breast self-examination. 
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Associations of arterial stiffness with left ventricular mass index and carotid intima-media thickness in the hypertensives

Published on: 5th May, 2022

Background: Arterial stiffness has been considered an independent predictor of cardiovascular disease in addition to the traditionally known cardiovascular risk factors. Objectives: This study aimed to investigate the associations between arterial stiffness with left ventricular mass index and carotid intima-media thickness in the hypertensives. Methods: A descriptive cross-sectional study compared a control group in 210 study subjects (105 hypertensives and 105 normotensives). Measuring left ventricular mass index by echocardiography and carotid intima-media thickness by carotid doppler ultrasonography. Pulse wave velocity was measured using the Agedio B900 device and the Agedio K520 application. The manual method was measured by the ankle-brachial index.Results: There was a statistically significant positive correlation between pulse wave velocity and age (r = 0.922, p < 0.001). The ankle-brachial index had a statistically significant positive correlation at a weak level with left ventricular mass index and carotid intima-media thickness, in which the coefficient r was equal to 0.219 (p < 0.05) and 0.250 (p < 0,001), respectively. Pulse wave velocity also had a statistically significant positive correlation at a weak level with left ventricular mass index and carotid intima-media thickness, in which the coefficient r was equal to 0.188 (p < 0.05) and 0.289 (p < 0,001), respectively. Pulse wave velocity had a multivariable linear correlation with gender, pulse, mean blood pressure, and ankle-brachial index with statistical significance; and they were written in the form of the following equation: Pulse wave velocity (R2: 41.3%) = 0.641*(Gender) – 0.027*(Pulse) + 0.043*(Mean blood pressure) + 8.378*(Ankle-brachial index) – 3.254.Conclusion: Arterial stiffness was statistically correlated with left ventricular mass index and carotid intima-media thickness in the hypertensives. Through the above research results, we suggest that the hypertensives should be combined with the evaluation of hemodynamic parameters and arterial stiffness for contributing to the diagnosis and detection of cardiovascular complications, thereby improving the quality of monitoring and treatment in hypertensive patients.
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Chemical composition of olive stems essential oil from Ethiopia

Published on: 14th June, 2022

OCLC Number/Unique Identifier: 9538009406

In this article, the chemical compounds, antimicrobial and antioxidant activity of the volatile oil from leaves of Olea Europaea L. cultivar from Ethiopia has been studied. The essential oil was provided with a dry distillation apparatus and analyzed by GC-MS/FID. This analysis leads to the detection of 128 compounds representing 89.4% of the total oil. The major constituents were methyl ester hexadecanoic acid (4.10%), 2,4-dimethoxyphenolAa (4.05%), 2-methoxy-phenol (3.25%), 3,5-dimethoxy-4-hydroxytoluene (3.20%), 2-methoxy-5-methyl phenol (3.19%), 1,2,3-trimethoxy-5-methyl benzene (2.93%), 2-methoxy-4-vinyl phenol (2.70%), 2-hydroxy-3-methyl-2-cyclopenten-1-one (2.60%), trans-Isoeugenol (2.45%) and (E) -2,6-dimethoxy-4- (prop-1-en-1-yl) phenol (2.25%). The composition of essential oils was dominated by phenolic compounds.
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Incidence, risk factors, and outcomes of acute kidney injury among hiv positive medical admissions at the Bamenda Regional Hospital

Published on: 16th June, 2022

OCLC Number/Unique Identifier: 9538011570

Background: There is a paucity of data on the burden of acute kidney injury (AKI) in hospitalized HIV-infected patients in Sub-Saharan Africa in the “test and treat” era.Objectives: To study the incidence, risk factors, and outcomes of AKI among HIV-positive medical admissions in a secondary hospital.Materials and methods: We prospectively screened adult HIV-positive patients who gave their informed consent and were admitted to the Bamenda Regional Hospital for AKI from February to June 2020. We excluded participants with Chronic Kidney Disease (CKD) Stage 5 and those with confounders of serum creatinine. On admission and after 2-7 days, we extracted a venous blood sample from each participant to evaluate serum creatinine and diagnose AKI. The participants were then followed up on until they were discharged or died. We measured the need for dialysis, access to dialysis, and renal recovery at three months for patients with AKI. The amended KDIGO 2012 criteria were used to define and classify AKI. The University of Bamenda’s institutional review board provided ethical approval.Results: A total of 206 participants (39.8% men) were enrolled, with a mean (SD) age of 45.71(13.13) years. On enrolment, 89.8% (n = 185) of the participants were on combination antiretroviral therapy (c-ART), with 81.6% (n = 151) on tenofovir-containing regimens. The WHO HIV clinical stages 3 and 4 were present in 81.5% (n = 168) of the individuals. The most common reason for hospitalization was opportunistic infections (69.8%; n = 142). AKI was found in 30.6% (n = 63) of the patients, with 58.7% (n = 37) of them being classified as KDIGO stage 3. A total of 12 (42.9%) participants out of the 28 in need, were dialyzed. AKI was independently associated with use of traditional medicines (aOR = 2.9; 95% CI 1.4-6.3; p = 0.006), WHO HIV stages 3 and 4 (aOR = 4.1; 95% CI 1.1-15.7; p = 0.038), hypotension (aOR = 3.3; 95% CI 1.4-7.8; p = 0.008) and low haemoglobin level ≤ 8.0 g/dl (aOR = 3.5; 95% CI 1.7-7.4; p = 0.001). The AKI group used to have a significantly higher mortality rate (42.9% vs. 16.1%; p < 0.001). Renal recovery was complete in 66.7% of the 30 survivors at three months, partial in 13.3%, and no recovery in 20% of the survivors.Conclusion: Despite the growing use of combination antiretroviral medication, significant immunosuppression is still common in hospitalized HIV-positive patients, increasing the risk of AKI and worsening prognosis. In this high-risk population, early detection of AKI with renal function monitoring may improve results.
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Patient, disease and surgeon predictors of successful bilateral sentinel lymph node mapping for endometrial cancer: A retrospective, multicenter analysis

Published on: 14th July, 2022

Objective: Sentinel lymph node mapping is an acceptable standard for lymph node evaluation in patients with endometrial cancer. The purpose of this study was to evaluate the adoption of this technique at two academic institutions, including which patient and disease features are associated with rates of successfully identifying sentinel lymph nodes with fluorescent mapping. In addition, we sought to characterize if and how surgeons experience the technique related to successful bilateral sentinel lymph node mapping. Methods: A retrospective chart review was performed of patients at two academic institutions who underwent sentinel lymph node mapping prior to a minimally invasive hysterectomy for endometrial cancer over the first 30 months during which the technique was adopted at each institution. A modified Poisson regression model was used to determine the relationships between patient, disease, and surgeon factors on outcomes of sentinel lymph node mapping. Results: A total of 460 charts were reviewed. The mean age was 64 and the median body mass index was 34.2. The most disease was stage I (83%), endometrioid (89%), and Grade I (64%). The bilateral sentinel lymph node mapping success rate was 65%, while unilateral or bilateral success occurred in 91% of cases. Sentinel lymph node mapping was significantly more likely to be successful in premenopausal women (RR 1.25; 95% CI 1.07 - 1.46; p = 0.005) and Asian women (RR 1.48; 95% CI 1.3-1.68; p < 0.001). BMI was not significantly predictive of mapping success (RR 1.03; 95% CI 1.00 - 1.07; p = 0.05). Increasing surgeon experience with the technique did predict successful bilateral sentinel lymph node mapping (RR 1.02; 95% CI 1.00 - 1.03; p = 0.02).Conclusion: Premenopausal status and surgeon experience with the technique increases the likelihood of bilateral sentinel lymph node detection for endometrial cancer.
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Association between clinical forms of Leprosy and contacts with the vaccination state with BCG in five endemic municipalities in the Brazilian Amazon

Published on: 19th July, 2022

OCLC Number/Unique Identifier: 9575035083

Introduction: The World Health Organization (WHO) strategy for leprosy control from 2021 to 2030 focuses on interrupting transmission, reducing autochthonous cases to zero, and using a safe and effective vaccine and chemoprophylaxis. In 2020, 127,396 new cases were registered in the world, 19,195 new cases in the Americas, and, of these, 17,979 cases in Brazil, about 93.66% of the total in the Americas. Brazil is classified as a country with a high burden of the disease, occupying the 2nd place in the world, behind only India (WHO, 2020). Análise do período de 2010-2015 em publicação recente9, apresenta as seguintes cidades no estado do Pará nas quais se observou maiores taxas de incidência (detecção): Marituba, Belém, Marabá, Parauapebas e Altamira [9]. Material and method: This is an analytical retrospective study carried out in a database - Epi-Info resulting from records of Surveillance and Seroprevalence actions in five endemic municipalities for leprosy located in the Southeast and West of Pará. The following variables were analyzed: age, sex, Clinical Classification, vaccination status with BCG, and the result of the search for IgM antibodies against PGL-1 of Mycobacterium leprae by the “In house” ELISA technique. Results: We evaluated 1551 records examined in the laboratory from 2014 to 2016, which were classified into 123 Multibacillary -MB patients (123/1551 = 7.93%); 71 Paucibacillary-PB patients (71/1551 = 4.57%); 451 Intradomicilliary Consanguineous Contacts - CCOSI (451/1551 = 29.07%) and 906 Non Consanguineous Contacts - CNCOS (906/1551 = 58.41%). 57 MB patients (13.47%), 13 PB patients (3.07%), 133 CCOSI (31.44%) and 220 CNCOS (52.00%) were positive for PGL-1. The correlation of the Classification with the vaccination status showed 57 MB patients without any BCG (57/125 = 45.6%) and only 3 patients with two doses of BCG (3/125 = 2.4%); 17 PB patients without any dose of BCG (17/69 = 24.63%); 80 CCOSI without any BCG (80/455 = 17.58%) and 171 CNCOS (171/906 = 18.87%). The odds ratio (OR) in the analysis between unvaccinated MB patients compared to CCOSI was statistically significant (OR = 14.25; p ˂ 0.0001). The study shows the importance of using the BCG vaccine in healthy contacts of patients with leprosy, as it shows the probability of unvaccinated individuals being 14.25 times more likely to become ill with Multibacillary forms compared to CCOSI. In addition, the BCG vaccine has been in use for 80 years and is the only vaccine that we can use in leprosy control programs. Conclusion: Although the leprosy epidemiological data analyzed recently (2010 - 2015) show a downward trend in the main indicators in Pará, such as the detection of new cases and prevalence, the endemic municipalities are still classified as hyperendemic for the population under 15 years of age and This proves that Surveillance is essential, as well as BCG vaccination according to the Ministry of Health Standards.
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Cost-analysis comparison of clinical risk assessment with and without ROMA for the management of women with pelvic masses

Published on: 17th August, 2022

Objective: Pelvic masses can be classified as low risk (likely benign) and high risk (likely malignant) based on an initial clinical risk assessment, which involves a detailed history, physical exam, basic laboratory tests, and imaging. In recent years, the Risk of Ovarian Malignancy Algorithm (ROMA), which combines CA125, HE4 and menopausal status, has emerged as a powerful tool in the classification of pelvic masses and triage of patients to either a generalist gynecologist or a gynecologic oncologist for management. The objective of this study was to evaluate whether the use of ROMA, alone or in combination with Initial Clinical Risk Assessment (ICRA), provides cost savings compared to triage based on ICRA alone.Methods: A health-economic decision model was developed to assess clinical and cost differences associated with three different clinical pathways of risk assessment for a pelvic mass: ICRA alone, ROMA alone, or ICRA + ROMA in combination. Using previously reported accuracy rates and patient characteristics from a prospective, multicenter, blinded clinical trial, total healthcare costs were modeled for each clinical pathway using the Medicare 2020 reimbursement rates.Results: A total of 461 patients with pelvic masses were included with 10.4% ultimately diagnosed with epithelial ovarian cancer. Total healthcare costs for patients with benign disease, EOC, or low malignant potential tumors (LMP) (n = 441) triaged using ROMA alone were 3.3% lower than when triaged using ICRA alone. While lab costs increased 55% using ROMA, the use of ROMA alone resulted in a 4% decrease in laparoscopy costs and a 3.1% decrease in laparotomy costs compared with ICRA alone. Similarly, total costs associated with a combination of ICRA + ROMA were 3.9% lower than total costs associated with ICRA alone. The model also predicted a 63% reduction in repeat surgeries resulting from false negative ICRA when using ROMA to triage patients.Conclusion: Triage of women with pelvic masses using the more sensitive ROMA score lowers overall healthcare costs compared to ICRA alone. With fewer false negative results than ICRA alone, the ROMA score improves initial detection of malignancy and reduces second surgical treatments in women with pelvic masses.
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Ultraviolet fluorescent detection of elevated bilirubin in dried blood serum

Published on: 23rd September, 2022

Increased levels of bilirubin in blood serum may result from numerous physical conditions including hepatitis, cirrhosis, enzyme deficiency, drug reactions, autoimmune disorders and physiological trauma. No presumptive test for high bilirubin levels in blood serum stains currently exists, which could prove useful in the assessment of crime scenes involving victims with one of the above disorders. Here, the use of ultraviolet 365 (UV 365) is described as a simple, nondestructive method for the detection of blood serum containing elevated levels of bilirubin.
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Monkeypox virus outbreak: A new threat of virus to mankind

Published on: 27th September, 2022

Viruses becoming day by day dominate over humans, as a covid-19 pandemic is not jet over, new monkeypox virus infection cases emerged in the month of May 2020. On 13th May 2020 WHO reported monkeypox virus cases from 12 member states that are epidemic for this virus. In the past monkeypox virus are rarely seen outside of west and central Africa. Investigations are going to establish a travel link between reported cases and epidemic areas. There are very little data regarding viral mechanism or time of shading and still, we have no licensed treatment. Two smallpox-approved drugs brincidofovir and tecovirimat have efficacy against monkeypox shown in animals. Now two smallpox-recommended vaccinations JYNNEOS and ACAM2000 are also available and are efficient to prevent the monkeypox virus. Two second- and third-generation Vaccinations are recommended by WHO for people that are immunocompromised and children’s MVA-BN, LC16. This article aims to raise awareness of virus spread, providing information regarding virus detail, severity, precautions, and detection.
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Diagnostic evaluation of nasopharyngeal swab and saliva kits against SARS-CoV-2: Adequate rapid screening is deemed necessary to overcome COVID-19 Pandemic

Published on: 16th September, 2022

OCLC Number/Unique Identifier: 9625089265

SARS-CoV-2 is the virus associated with the disease called COVID-19 and become a global pandemic. The only way to prevent its severe scenarios is through timely and rapid testing. In comparison to more time taking gold-standard RT-PCR testing, rapid diagnostic kits are used. For better prevention and diagnosis of SARS-CoV-2, the analysis of rapid diagnostic kits' accuracy and specificity is necessary. This study is meant to assess and examine the viability, responsiveness, and explicitness of quick antigen distinguishing nasopharyngeal swabs (NPS), and saliva-based units. The study was conducted on 200 suspected COVID-19 patients from Islamabad, 100 of which were RT-PCR positive while 100 were RT-PCR negative. For the analysis of Rapid diagnostic COVID-19 kits (RDT), nasopharyngeal swabs (NPS) and saliva samples were taken from the RT-PCR positive and negative patients. Among 100 RT-PCR positive patients, 62% were males (19 - 91 years), 34% were females (20 - 78 years) and 4% were children (6 - 17 years). False-negative results were significantly more observed in saliva-based RDTs of the sample (49%) as compared to nasopharyngeal swab RDT (38%). There were 2% invalid results in saliva-based RDT and 3% invalid results in Nasopharyngeal swab RDT. While among 100 RT-PCR negative patients 69% were males (19 - 80 yrs), 27% were females (18 - 77 yrs) and 4% were children (12 - 16 yrs.). False positive results were significantly more in saliva-based RDT (22%) as compared to Nasopharyngeal swab RDT (13%). The sensitivity and specificity of saliva-based RDT were 67% and 87% respectively while that of Nasopharyngeal swab (NPS) was 72% and 82% respectively, both of which were less than the gold standard RT-PCR sensitivity demanding the introduction of more sensitive RDT kits in Pakistan for accurate detection of COVID-19.
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The modified star excursion balance test for the detection of the risk of injury in elite handball female players

Published on: 25th November, 2022

Background: Elite handball female players are at high risk of injury to the lower limbs. The modified Star Excursion Balance Test (mSEBT) is efficient in detecting players with a risk of injury. However, performed once before the season, the mSEBT cannot determine with precision when the injury will occur. Purpose: The objective of the study was to investigate if a repeated measure of mSEBT across the season would help in identifying with precision the period at risk of injury for each player.Methods: Eleven elite female handball players took part in the study. The mSEBT was measured weekly for 25 weeks and the injuries were recorded. Composite Scores (CS) and distances on each axis were computed for both legs of each player. The 94% cut-off on the composite score and the 4 cm difference between the right and left leg on the anteroposterior axis (ANT) was investigated for each player.Results: Five players reported injury. The 94% cut-off on the CS and the 4 cm difference on ANT were not significant indicators of risk of injury in our study. However, for each injured player, a drop in the composite score was noticed the week before the injury.Conclusion: We propose the drop of CS as an indicator for the detection of the risk of injury in a follow-up of elite athletes using repeated mSEBT. This indicator allows the detection of injury a week before it occurs. Further work is needed to confirm, investigate and validate this indicator.
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Forensic analysis of raw meat adulteration using mtDNA

Published on: 29th December, 2022

Meat species identification has become essential with the increasing events of frauds like the illegal slaughter of cows, meat adulteration, and substitution. Food scam directly influences public well-being, trade, and wildlife. In Pakistan, donkey meat is used as adulterants for cow meat and is considered Haram in Islamic concepts. In this study PCR, based detection methods are used for identification purposes. The mitochondrial gene cytochrome b has been used in this study to identify the origin of meat specie. Specie-specific primers of cyt b of cow and donkey were used for identification. DNA from different binary ratios of cow and donkey meat was extracted by the phenol-chloroform method. Ratios were made from 1-10 and extracted DNA was subjected to PCR to amplify the target fragment of the cyt b gene. Primers were sensitive to identifying species origin in all meat ratios. Multiplex PCR was designed to identify both species and the results were analyzed by gel electrophoresis. Fragment size of 309bp for cow and 475bp for donkey was observed.Results of the current study conclude that PCR assays, including multiplex PCR, is efficient and has a high sensitivity for even small amount of meat. It is concluded that multiplex PCR is useful and reliable for adulterated meat detection.
Cite this ArticleCrossMarkPublonsHarvard Library HOLLISGrowKudosResearchGateBase SearchOAI PMHAcademic MicrosoftScilitSemantic ScholarUniversite de ParisUW LibrariesSJSU King LibrarySJSU King LibraryNUS LibraryMcGillDET KGL BIBLiOTEKJCU DiscoveryUniversidad De LimaWorldCatVU on WorldCat
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