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1. Intraoperative Ocular Decompression Retinopathy During 23 Gauge Transconjunctival Vitrectomy: A Case Report

Author

Agarwal L, Pradhan D, Agrawal N, Joshi I, Kumari A, and Kushwaha A

Subjects
pars plana vitrectomy, intraoperative complication, preoperative raised intraocular pressure, retinal hemorrhages, decompression retinopathy, Medicine (General), R5-920
Abstract

Lalit Agarwal,1 Deepti Pradhan,1 Nisha Agrawal,2 Ichhya Joshi,1 Archana Kumari,1 Anamika Kushwaha1 1Biratnagar Eye Hospital, Biratnagar, Nepal; 2Taparia Eye Care, Biratnagar, NepalCorrespondence: Deepti PradhanBiratnagar Eye Hospital, Rani, Biratnagar, NepalTel +977 9808119112Email deeptiprdhn@gmail.comPurpose: To report an uncommon case of intraoperative ocular decompression retinopathy (ODR).Case report: A 48-year-old man presented with decreased vision and pain in the left eye (LE) for 10 days following trauma with a bamboo stick. He had visual acuity of counting finger close to face in the same eye, along with corneal edema, dilated pupil and posteriorly dislocated lens. Intraocular pressure (IOP) was 42 mm of mercury (Hg). He underwent 23-gauge pars plana vitrectomy with removal of the dislocated lens. Towards the end of otherwise uneventful surgery, blot hemorrhages appeared over the posterior pole and equator. The following day, his vision was counting finger close to face and IOP was 16 mm of Hg. Fundus examination revealed large blotches of hemorrhages at different levels of the retina, later confirmed by optical coherence tomography. Disc hyperfluorescence and blocked fluorescence corresponding to blot hemorrhages were seen on fundus fluorescein angiography. Blood investigations to rule out blood dyscrasias were within normal limits.Conclusion: Ocular decompression retinopathy, though not common, has been reported to occur following various types of surgeries, especially if associated with preoperatively raised IOP. The event can also occur intraoperatively and the preoperative control of IOP is of paramount importance in the prevention of ODR.Keywords: pars plana vitrectomy, intraoperative complication, preoperative raised intraocular pressure, retinal hemorrhages, decompression retinopathy

Published
2019

6. Predicting Riverbed Deformation During Floods for a Sustainable Design of Headworks Structures

Author

Joshi, I., Singh, U., Bishwakarma, M. B., Kitamura, Y., and Lia, L.

Subjects
Numerical modeling, Sediment transport, Floods, Maximum scour
Abstract

Understanding and predicting riverbed deformation during floods is important for the proper and sustainable design of headworks structures. Field-scale study of floods is challenging, and existing literature shows that mainly qualitative data (Photographic and Videographic) have been used in riverbed deformation studies. On the other hand, laboratory experiments allow studying floods in more detail and under a controlled environment. In this research, bed deformation of river channel during floods was investigated by conducting experiments in a curved flume. Parameters of the experiments were chosen with respect to gravel-cobbled River in Nepal. Four different floods with different magnitudes and durations were investigated in the experiments. Riverbed deformation was quantified by differencing pre and post-flood DEMs obtained using Structure from Motion (SfM) technology. The maximum scour during the floods was measured by scour chains made with light beads in a thread. The results showed that the magnitude and duration of floods are both important factors for riverbed deformation. The volume of channel bed erosion increased with the increase in flood magnitude. However, the total volume of sediment reworked was higher in the case of floods which are of lower magnitude but occur frequently in multiple cycles. The depth of maximum bed scour during the floods was observed much higher than the channel bed resulted at the end of the floods. The difference was more prominent along the bends where the secondary currents are stronger. The understanding could be used to better validate sediment transport models, and thus predict riverbed deformation more accurately for sustainable design of headworks structures.

Published
2022

7. Effectiveness of initiating biologics in severe asthma patients with high steroid exposure

Author

Chen, W, primary, N Tran, T, additional, Sadatsafavi, M, additional, Garcia Gil, E, additional, Alacqua, M, additional, Menzies Gow, A, additional, G Heaney, L, additional, E.Pfeffer, P, additional, Maspero, J, additional, Peters, M, additional, C Christoff, G, additional, Bhutani, M, additional, A.Torres-Duque, C, additional, Ulrik, C, additional, Altraja, A, additional, Lehtimaki, L, additional, Taille, C, additional, I.Papaioannou, A, additional, Salvi, S, additional, W Costello, R, additional, Walter Canonica, G, additional, Iwanaga, T, additional, Al-Ahmad, M, additional, Larenas-Linnemann, D, additional, Kuna, P, additional, A.Fonseca, J, additional, Al-Lehebi, R, additional, Koh Siyue, M, additional, Rhee, C K, additional, Perez-De-Llano, L, additional, C Jones, R, additional, Perng, D, additional, Wang, E, additional, Hoyte, F, additional, Wong Chong Boon, N, additional, Lyu, J, additional, Ariti, C, additional, Murray, R, additional, Goh, C, additional, Joshi, I, additional, Eleangovan, N, additional, and Price, D, additional

Published
2022
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8. Internal Limiting Membrane Peeling in der Makulaforamen-Operation

Author

Pradhan, D, Agarwal, L, Joshi, I, Kushwaha, A, Aditya, K, and Kumari, A

Subjects
adverse effects of ILM peeling, temporärer ILM Flap, DONFL, ddc: 610, Ocriplasmin, vital dye staining, unerwünschte Wirkungen des ILM-Peelings, temporal ILM flap, Vitalfarbstofffärbung
Abstract

Since the era when macular hole was considered untreatable, macular hole surgery has come a long way to being one of the most successful surgeries. Internal limiting membrane (ILM) peeling has been an essential step of macular hole surgery since the establishment of the role of ILM in the aetiopathogenesis and progression of macular hole. However, the novel technique was not all virtuous. It had some vices which were not evident immediately. With the advent of spectral domain optical coherence tomography, short- and long-term effects of ILM peeling on macular structures were known; and with microperimetry, its effect on the function of macula could be evaluated. The technique has evolved with time from total peeling to inverted flap to just temporal peeling and temporal flap in an attempt to mitigate its adverse effects and to improve its surgical outcome. ILM abrasion technique and Ocriplasmin may eliminate the need of ILM peeling in selected cases, but they have their own limitations. We here discuss the role of ILM in the pathogenesis of macular hole, the benefits and adverse effects of ILM peeling, and the various modifications of the procedure, to then explore the alternatives. Seit der Ära, in der das Makulaforamen als unbehandelbar galt, hat die Makulaforamenchirurgie einen weiten Weg zurückgelegt und ist heute eine der erfolgreichsten Operationen. Das Peeling der Internal Limiting Membrane (ILM) ist ein wesentlicher Schritt der Makulaforamenchirurgie, seit die Rolle der ILM in der Ätiopathogenese und Progression des Makulaforamens bekannt ist. Jedoch brachte die neue Technik nicht nur Vorteile, sondern auch einige Nachteile, die nicht sofort ersichtlich waren. Mit dem Aufkommen der optischen Spektraldomänen-Kohärenztomographie wurden die kurz- und langfristigen Auswirkungen des ILM-Peelings auf die Makulastrukturen bekannt, und mit der Mikroperimetrie konnte die Auswirkung auf die Funktion der Makula bewertet werden. Die Technik hat sich im Laufe der Zeit vom totalen Peeling über den invertierten Flap bis hin zum nur temporären Peeling und dem temporären Flap weiterentwickelt, um die negativen Auswirkungen zu mildern und das chirurgische Ergebnis zu verbessern. Die ILM-Abrasionstechnik und Ocriplasmin können in bestimmten Fällen ein ILM-Peeling überflüssig machen, sie haben aber ihre eigenen Einschränkungen. Wir diskutieren hier die Rolle der ILM in der Pathogenese des Makulaforamens, die Vorteile und unerwünschten Wirkungen des ILM-Peelings sowie die verschiedenen Modifikationen des Verfahrens, um anschließend die Alternativen zu untersuchen.

Published
2022
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9. Internal limiting membrane peeling in macular hole surgery

Author

Pradhan, D, Agarwal, L, Joshi, I, Kushwaha, A, Aditya, K, Kumari, A, Pradhan, D, Agarwal, L, Joshi, I, Kushwaha, A, Aditya, K, and Kumari, A

Abstract

Since the era when macular hole was considered untreatable, macular hole surgery has come a long way to being one of the most successful surgeries. Internal limiting membrane (ILM) peeling has been an essential step of macular hole surgery since the establishment of the role of ILM in the aetiopathogenesis and progression of macular hole. However, the novel technique was not all virtuous. It had some vices which were not evident immediately. With the advent of spectral domain optical coherence tomography, short- and long-term effects of ILM peeling on macular structures were known; and with microperimetry, its effect on the function of macula could be evaluated. The technique has evolved with time from total peeling to inverted flap to just temporal peeling and temporal flap in an attempt to mitigate its adverse effects and to improve its surgical outcome. ILM abrasion technique and Ocriplasmin may eliminate the need of ILM peeling in selected cases, but they have their own limitations. We here discuss the role of ILM in the pathogenesis of macular hole, the benefits and adverse effects of ILM peeling, and the various modifications of the procedure, to then explore the alternatives., Seit der Ära, in der das Makulaforamen als unbehandelbar galt, hat die Makulaforamenchirurgie einen weiten Weg zurückgelegt und ist heute eine der erfolgreichsten Operationen. Das Peeling der Internal Limiting Membrane (ILM) ist ein wesentlicher Schritt der Makulaforamenchirurgie, seit die Rolle der ILM in der Ätiopathogenese und Progression des Makulaforamens bekannt ist. Jedoch brachte die neue Technik nicht nur Vorteile, sondern auch einige Nachteile, die nicht sofort ersichtlich waren. Mit dem Aufkommen der optischen Spektraldomänen-Kohärenztomographie wurden die kurz- und langfristigen Auswirkungen des ILM-Peelings auf die Makulastrukturen bekannt, und mit der Mikroperimetrie konnte die Auswirkung auf die Funktion der Makula bewertet werden. Die Technik hat sich im Laufe der Zeit vom totalen Peeling über den invertierten Flap bis hin zum nur temporären Peeling und dem temporären Flap weiterentwickelt, um die negativen Auswirkungen zu mildern und das chirurgische Ergebnis zu verbessern. Die ILM-Abrasionstechnik und Ocriplasmin können in bestimmten Fällen ein ILM-Peeling überflüssig machen, sie haben aber ihre eigenen Einschränkungen. Wir diskutieren hier die Rolle der ILM in der Pathogenese des Makulaforamens, die Vorteile und unerwünschten Wirkungen des ILM-Peelings sowie die verschiedenen Modifikationen des Verfahrens, um anschließend die Alternativen zu untersuchen.

Published
2022

10. Improved Techniques for the Conditional Generative Augmentation of Clinical Audio Data

Author

Margaryan, Mane, Seibold, Matthias; https://orcid.org/0000-0002-9960-3244, Joshi, I, Farshad, M, Fürnstahl, P, Navab, Nassir, Margaryan, Mane, Seibold, Matthias; https://orcid.org/0000-0002-9960-3244, Joshi, I, Farshad, M, Fürnstahl, P, and Navab, Nassir

Abstract

Data augmentation is a valuable tool for the design of deep learning systems to overcome data limitations and stabilize the training process. Especially in the medical domain, where the collection of large-scale data sets is challenging and expensive due to limited access to patient data, relevant environments, as well as strict regulations, community-curated large-scale public datasets, pretrained models, and advanced data augmentation methods are the main factors for developing reliable systems to improve patient care. However, for the development of medical acoustic sensing systems, an emerging field of research, the community lacks large-scale publicly available data sets and pretrained models. To address the problem of limited data, we propose a conditional generative adversarial neural network-based augmentation method which is able to synthesize mel spectrograms from a learned data distribution of a source data set. In contrast to previously proposed fully convolutional models, the proposed model implements residual Squeeze and Excitation modules in the generator architecture. We show that our method outperforms all classical audio augmentation techniques and previously published generative methods in terms of generated sample quality and a performance improvement of 2.84% of Macro F1-Score for a classifier trained on the augmented data set, an enhancement of 1.14% in relation to previous work. By analyzing the correlation of intermediate feature spaces, we show that the residual Squeeze and Excitation modules help the model to reduce redundancy in the latent features. Therefore, the proposed model advances the state-of-the-art in the augmentation of clinical audio data and improves the data bottleneck for the design of clinical acoustic sensing systems.

Published
2022

12. A Systematic Review and Meta-analysis of Clinical Characteristics and Outcomes in Lung Cancer Patients with COVID-19

Author

Peravali, M., Joshi, I., Ahn, J., and Kim, C.

Subjects
Mortality, Lung, Article, COVID, Cancer
Abstract

Background Cancer is considered to be an independent risk factor for severe illness and higher mortality in patients with Coronavirus disease 2019 (COVID-19). These adverse outcomes have been suspected to be more severe in lung cancer patients. The objective of this systematic review and meta-analysis is to outline patient characteristics, challenges in diagnosis and treatment, and outcomes of lung cancer patients with COVID-19. Methods A comprehensive search was conducted using EMBASE and PUBMED databases using the terms “COVID” and “cancer.” Studies that reported clinical characteristics and/or outcomes of lung cancer patients with COVID-19 were then systematically identified. Meta-analysis for COVID-19 related mortality associated with lung cancer compared to other cancer types was conducted. The results were reported as odds ratio (OR) and confidence intervals (CI) using mixed-effects logistic regression model. Results The most commonly reported clinical findings in lung cancer patients with COVID-19 were fever and cough, with 68% and 61%, respectively. Laboratory and radiographic findings were consistent with broadly reported data. The meta-analysis noted a statistically significant increase in mortality rate in lung cancer patients compared to other cancer patients, OR 1.62 (95% CI: 1.06-2.48). Lung cancer patients with COVID-19 also reflected greater severity of illness and higher rates of ICU admissions and mechanical ventilation. Conclusions COVID-19 in lung cancer patients is associated with severe disease and increased mortality relative to patients with other malignancies and the general population. There is conflicting evidence on the effect of specific lung cancer treatments on outcomes. Until more definitive data is available, lung cancer directed treatment should be continued or restarted as early as possible in mild to moderate cases to prevent worsening cancer-related mortality., HIGHLIGHTS • Patients with lung cancer and COVID-19 infection have higher mortality rates compared to patients with other cancer types. • Rates of severe illness, ICU admissions and mechanical ventilation are also higher in lung cancer patients. • Clinical, laboratory and radiographic characteristics are similar to reports in the general population. • There is conflicting data regarding the effect of specific lung cancer treatments on outcomes.

Published
2021

13. Short-term forecasts to inform the response to the Covid-19 epidemic in the UK

Author

Funk, S, Abbott, S, Atkins, BD, Baguelin, M, Baillie, JK, Birrell, P, Blake, J, Bosse, NI, Burton, J, Carruthers, J, Davies, NG, De Angelis, D, Dyson, L, Edmunds, WJ, Eggo, RM, Ferguson, NM, Gaythorpe, K, Gorsich, E, Guyver-Fletcher, G, Hellewell, J, Hill, EM, Holmes, A, House, TA, Jewell, C, Jit, M, Jombart, T, Joshi, I, Keeling, MJ, Kendall, E, Knock, ES, Kucharski, AJ, Lythgoe, KA, Meakin, SR, Munday, JD, Openshaw, PJM, Overton, CE, Pagani, F, Pearson, J, Perez-Guzman, PN, Pellis, L, Scarabel, F, Semple, MG, Sherratt, K, Tang, M, Tildesley, MJ, Van Leeuwen, E, and Whittles, LK

Abstract

BackgroundShort-term forecasts of infectious disease can aid situational awareness and planning for outbreak response. Here, we report on multi-model forecasts of Covid-19 in the UK that were generated at regular intervals starting at the end of March 2020, in order to monitor expected healthcare utilisation and population impacts in real time.MethodsWe evaluated the performance of individual model forecasts generated between 24 March and 14 July 2020, using a variety of metrics including the weighted interval score as well as metrics that assess the calibration, sharpness, bias and absolute error of forecasts separately. We further combined the predictions from individual models into ensemble forecasts using a simple mean as well as a quantile regression average that aimed to maximise performance. We compared model performance to a null model of no change.ResultsIn most cases, individual models performed better than the null model, and ensembles models were well calibrated and performed comparatively to the best individual models. The quantile regression average did not noticeably outperform the mean ensemble.ConclusionsEnsembles of multi-model forecasts can inform the policy response to the Covid-19 pandemic by assessing future resource needs and expected population impact of morbidity and mortality.

Published
2020

18. Nematode Genome Announcement: A Draft Genome of Seed Gall Nematode, Anguina tritici

Author

Singh Ashish Kumar, Das Antara, Joshi Ila, Kumar Manish, Kohli Deshika, Pankaj, Gaikwad Kishor, Jain Pradeep Kumar, and Sirohi Anil

Subjects
anguina tritici, earcockle, tundu disease, genome sequence, illumina miseq, Biology (General), QH301-705.5
Abstract

Anguina tritici is the first plant-parasitic nematode described in literature, dating back to the year 1743. It is responsible for causing earcockle (seed gall) and tundu diseases in wheat and rye. Notably, this nematode has been observed to survive in an anhydrobiotic state for up to 32 years within wheat seed galls. These exceptional characteristics have inspired the sequencing of the A. tritici genome. In this study, we present the initial draft genome of A. tritici, obtained using the Illumina MiSeq platform with coverage of 60-fold. The genome is estimated to have a size of 164 Mb and comprises 39,965 protein-coding genes, exhibiting a GC content of 39.1%. The availability of this genome data will serve as a foundation for future functional biological investigations, particularly for genes whose functions remain unknown to this day.

Published
2023
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33. Undifferentiated embryonic stem cells express ionotropic glutamate receptor mRNAs

Author

Pachernegg, S, Joshi, I, Muth-Koehne, E, Pahl, S, Muenster, Y, Terhag, J, Karus, M, Werner, M, Ma-Hoegemeier, Z-L, Koerber, C, Grunwald, T, Faissner, A, Wiese, S, Hollmann, M, Pachernegg, S, Joshi, I, Muth-Koehne, E, Pahl, S, Muenster, Y, Terhag, J, Karus, M, Werner, M, Ma-Hoegemeier, Z-L, Koerber, C, Grunwald, T, Faissner, A, Wiese, S, and Hollmann, M

Abstract

Ionotropic glutamate receptors (iGluRs) do not only mediate the majority of excitatory neurotransmission in the vertebrate CNS, but also modulate pre- and postnatal neurogenesis. Most of the studies on the developmental role of iGluRs are performed on neural progenitors and neural stem cells (NSCs). We took a step back in our study by examining the role of iGluRs in the earliest possible cell type, embryonic stem cells (ESCs), by looking at the mRNA expression of the major iGluR subfamilies in undifferentiated mouse ESCs. For that, we used two distinct murine ES cell lines, 46C ESCs and J1 ESCs. Regarding 46C ESCs, we found transcripts of kainate receptors (KARs) (GluK2 to GluK5), AMPA receptors (AMPARs) (GluA1, GluA3, and GluA4), and NMDA receptors (NMDARs) (GluN1, and GluN2A to GluN2D). Analysis of 46C-derived cells of later developmental stages, namely neuroepithelial precursor cells (NEPs) and NSCs, revealed that the mRNA expression of KARs is significantly upregulated in NEPs and, subsequently, downregulated in NSCs. However, we could not detect any protein expression of any of the KAR subunits present on the mRNA level either in ESCs, NEPs, or NSCs. Regarding AMPARs and NMDARs, GluN2A is weakly expressed at the protein level only in NSCs. Matching our findings for iGluRs, all three cell types were found to weakly express pre- and postsynaptic markers of glutamatergic synapses only at the mRNA level. Finally, we performed patch-clamp recordings of 46C ESCs and could not detect any current upon iGluR agonist application. Similar to 46C ESCs, J1 ESCs express KARs (GluK2 to GluK5), AMPARs (GluA3), and NMDARs (GluN1, and GluN2A to GluN2D) at the mRNA level, but these transcripts are not translated into receptor proteins either. Thus, we conclude that ESCs do not contain functional iGluRs, although they do express an almost complete set of iGluR subunit mRNAs.

Published
2013

43. The storage and synthetic pools of heparin-releasable lipoprotein lipase and hepatic triacylglycerol lipase in the growing puppy

Author

Das, J B, Joshi, I D, and Philippart, A I

Abstract

Age-related changes in the activities of extrahepatic lipoprotein lipase and hepatic triacylglycerol lipase were determined during a primed/constant-rate infusion of heparin for 2 h in puppies between birth and 18 weeks of age. The early (storage) and late (synthetic) phases were measured. Both phases of hepatic triacylglycerol lipase activity were well developed in the first week, reflecting the metabolic maturity of the liver at birth. During the 18 weeks of study, the activity remained relatively unchanged except for a sharp peak at 12 weeks. Extrahepatic lipoprotein lipase activity was low in the first 4 weeks of suckling. Its storage pool increased 6-fold in the next 14 weeks, with a less marked rise in its late (synthetic) pool. Sustained increases in the activity of this enzyme were first noticed during weaning, when the insulin-secretory response matured. Endogenous insulin-secretory capacity rather than the fat content of the feed appeared significant in the postnatal development of lipoprotein lipase (Clearing-factor lipase) activity.

Published
1982
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44. Excess molar volumes of (dibutyl ether + trichloromethane or tetrachloromethane or 1,2-dichloroethane or 1,1,2-trichloroethane or 1,1,2,2-tetrachloroethane or pentachloroethane) at the temperature 303.15 K

Author

Singh, Jasbir, Joshi, I. M., and Sharma, S. C.

Abstract

Excess molar volumes VEm are reported for (dibutyl ether + trichloromethane or tetrachloromethane or 1,2-dichloroethane or 1,1,2-trichloroethane or 1,1,2,2-tetrachloroethane or pentachloroethane) at the temperature 303.15 K over the entire composition range by direct dilatometry. The curves of VEm against mole fraction x are negative at all x for all the mixtures except for that with 1,2-dichloroethane in which case VEm is positive. The excess volumes decrease in the sequences: 1,2-dichloroethane > tetrachloromethane > 1,1,2-trichloroethane > trichloromethane > 1,1,2,2-tetrachloroethane > pentachloroethane. Copyright 1993, 1999 Academic Press

Published
1993
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46. Enhanced efficacy of gemcitabine in combination with anti-CD20 monoclonal antibody against CD20+ non-Hodgkin's lymphoma cell lines in vitro and in scid mice

Author

Jin Fang, Joshi Indira, Smith Mitchell R, and Obasaju Coleman

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Despite exciting new targeted therapeutics against non-Hodgkin's lymphoma (NHL), chemotherapy remains a cornerstone of therapy. While purine nucleoside analogs have significant activity in low grade NHL, the pyrimidine nucleoside analog gemcitabine has been less extensively studied, but has important activity. Use of the anti-CD20 monoclonal antibody rituximab in combination with chemotherapy for B-NHL is becoming prevalent in clinical practice, but has not been extensively studied in pre-clinical models. Methods We have tested the activity of gemcitabine ± rituximab in vitro and in scid/human NHL xenograft models. We used two t(14;18)+, CD20+ follicular B cell NHL cell lines, DoHH2 a transformed NHL line and WSU-FSCCL isolated from pleural fluid of a patient with indolent NHL. Results Gemcitabine is cytotoxic to DoHH2 and WSU-FSCCL cells in vitro, and the IC50 is 2–3 fold lower in the presence of rituximab. Apoptosis is also enhanced in the presence of rituximab. Clearance of NHL cells from ascites in scid mice is prolonged by the combination, as compared with either agent alone. Most importantly, survival of scid mice bearing human NHL cells is significantly prolonged by the combination of gemcitabine + rituximab. Conclusion Based on our pre-clinical data showing prolonged survival of mice bearing human lymphoma cell line xenografts after treatment with gemcitabine + anti-CD20 antibody, this combination, expected to have non-overlapping toxicity profiles, should be explored in clinical trials.

Published
2005
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47. Health 2.0 and Medicine 2.0: tensions and controversies in the field.

Author

Hughes B, Joshi I, Wareham J, Hughes, Benjamin, Joshi, Indra, and Wareham, Jonathan

Abstract

Background: The term Web 2.0 became popular following the O'Reilly Media Web 2.0 conference in 2004; however, there are difficulties in its application to health and medicine. Principally, the definition published by O'Reilly is criticized for being too amorphous, where other authors claim that Web 2.0 does not really exist. Despite this skepticism, the online community using Web 2.0 tools for health continues to grow, and the term Medicine 2.0 has entered popular nomenclature.Objective: This paper aims to establish a clear definition for Medicine 2.0 and delineate literature that is specific to the field. In addition, we propose a framework for categorizing the existing Medicine 2.0 literature and identify key research themes, underdeveloped research areas, as well as the underlying tensions or controversies in Medicine 2.0's diverse interest groups.Methods: In the first phase, we employ a thematic analysis of online definitions, that is, the most important linked papers, websites, or blogs in the Medicine 2.0 community itself. In a second phase, this definition is then applied across a series of academic papers to review Medicine 2.0's core literature base, delineating it from a wider concept of eHealth.Results: The terms Medicine 2.0 and Health 2.0 were found to be very similar and subsume five major salient themes: (1) the participants involved (doctors, patients, etc); (2) its impact on both traditional and collaborative practices in medicine; (3) its ability to provide personalized health care; (4) its ability to promote ongoing medical education; and (5) its associated method- and tool-related issues, such as potential inaccuracy in enduser-generated content. In comparing definitions of Medicine 2.0 to eHealth, key distinctions are made by the collaborative nature of Medicine 2.0 and its emphasis on personalized health care. However, other elements such as health or medical education remain common for both categories. In addition, this emphasis on personalized health care is not a salient theme within the academic literature. Of 2405 papers originally identified as potentially relevant, we found 56 articles that were exclusively focused on Medicine 2.0 as opposed to wider eHealth discussions. Four major tensions or debates between stakeholders were found in this literature, including (1) the lack of clear Medicine 2.0 definitions, (2) tension due to the loss of control over information as perceived by doctors, (3) the safety issues of inaccurate information, and (4) ownership and privacy issues with the growing body of information created by Medicine 2.0.Conclusion: This paper is distinguished from previous reviews in that earlier studies mainly introduced specific Medicine 2.0 tools. In addressing the field's definition via empirical online data, it establishes a literature base and delineates key topics for future research into Medicine 2.0, distinct to that of eHealth. [ABSTRACT FROM AUTHOR]

Published
2008
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50. Prevalence of Co-infection of Culture-Proven Bacterial Pathogens in Microbiologically Confirmed Pulmonary Tuberculosis Patients From a Tertiary Care Center.

Author

Bir R, Ranjan R, Gunasekaran J, Chatterjee K, Karteeka D, Rai A, Gupta S, Karlapudi P, Joshi I, and Gupta RM

Abstract

Tuberculosis (TB) is a chronic condition that weakens the immune system, causes structural changes in the lungs, and can lead to infections by other bacterial pathogens. Very few studies have been done to understand the magnitude of co-infection with other bacterial pathogens, so this study was conducted to understand the co-infection pattern and burden. A total of 174 microbiologically confirmed pulmonary TB patients' samples, identified by cartridge-based nucleic acid amplification test, were further tested for other bacterial pathogens by culture over a period of five months from May 2023 to September 2023. The isolates' identification and drug susceptibility were performed using the VITEK 2 system (bioMérieux, Marcy-l'Étoile, France). Of the 174 pulmonary samples tested, 19 samples grew a significant amount of other bacterial pathogens, making the prevalence 10.91% (19/174). Among the pulmonary samples tested, 54.59% were sputum, 38.5% were bronchoalveolar lavage, and 6.89% were endotracheal aspirate. Additionally, 70.11% of the patients tested were in the age group of 19-60 years. Of the patients who had co-infection, 94.73% (18/19) were male. The most common bacterial infection was caused by Pseudomonas aeruginosa , which was identified in 36.84% of the co-infection cases (7/19). This was followed by Acinetobacter baumannii in 31.57% (6/19), Klebsiella pneumoniae in 26.31% (5/19), and Stenotrophomonas maltophilia in 5.28% (1/19). Acinetobacter baumannii and Klebsiella pneumoniae showed high drug resistance, ranging from 60% to 100% against various groups of drugs tested. None of the patient samples with co-infection showed rifampicin resistance. Among all the samples with co-infection, the majority (42.10%, or 8/19) had a high load of Mycobacterium tuberculosis complex detected by CBNAAT Ultra (Cepheid, Sunnyvale, California). Pseudomonas aeruginosa , Acinetobacter baumannii , and Klebsiella pneumoniae are unusual pathogens causing infection in community patients and are known to cause illness in hospitalized patients. These organisms' resistance was also similar to the resistance shown by hospital-acquired infections. This indicates that bacterial co-infection in pulmonary TB patients will be similar to the pattern of hospital-acquired infections. The high prevalence of bacterial co-infections (10.91%) in patients with pulmonary TB poses a significant challenge as these bacterial pathogens are not susceptible to anti-tubercular drugs. Therefore, comprehensive screening for other bacterial infections in all pulmonary TB patients is crucial for effective treatment and outcomes., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee of ESIC MC&H, Faridabad issued approval 134 X/11/13/2024- IEC/DHR/04. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bir et al.)

Published
2024
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