Direct digital photography for lip print recording is a recent trend, and there is a dearth of systematic research on the analysis of the recorded prints with existing clip print classification ...systems.
This study aims to compare the accuracy of the digital photographic method in lip print recording, comparing it with traditional methods, and assessing the suitability of commonly used lip print classification for analyzing lip prints recorded by photographic method.
A total of 72 participants aged between 20 and 26 were included. The lip print recording process involved photographing the lips without and with lipstick, followed by recording the lip print with cellophane tape on bond paper. The prints collected using the different methods were analyzed and compared for agreement, and the data were analyzed statistically.
Inter-observer reliability was high for all methods (>0.800). The distribution of lip print patterns differed across the methods, suggesting a potential influence of the recording technique. The agreement between the conventional method and both digital methods was moderate (kappa=0.449-0.517). The agreement between digital methods with and without enhancement was also moderate (kappa=0.718). Notably, digital photographs with enhancement tend to have a higher positive agreement for several lip print types.
Digital photography is a potential method for lip print recording. However, this study highlights the need for the calibration of lip print classification systems for digitally recorded lip prints. Further research is needed to refine the use of digital photography in forensic lip print analysis and to explore its integration with artificial intelligence for biometric identification.
Prior reports have documented extremely poor adherence to evidence-based medications among South Asian patients with established chronic cardiovascular diseases. Treatment adherence is now considered ...a part of the 'self-care' process, the determinants of which have not been adequately explored or explained among South Asian patients with chronic heart failure (CHF). Our objective was to qualitatively ascertain the determinants of the self-care process among Indian patients with a lived experience of heart failure.
We conducted in-depth interviews (audio-recorded) among 22 purposively sampled patients living with chronic heart failure, diagnosed at least 4 weeks prior to the interview and 17 caregivers (n = 39) in a tertiary care teaching hospital in Southern India. We employed an inductive analytical approach using Charmaz's constructivist grounded theory. Initial line-by-line coding and categorization was followed by memo writing, reflexive analysis after interviewing and analyzing four, eight and twelve patients, and at each stage further theoretical sampling was carried out until we reached thematic saturation. We used NVivo ver. 12 to analyze and organize data.
The mean age of our patients was 61 years and they represented 5 Indian states and spoke seven languages, distributed across socio-economic strata and literacy levels. We classified self-care determinants into 3 broad, simple categories and defined underlying themes namely, negative determinants (passivity, entrenched beliefs, negative affect, lack of knowledge, financial difficulties, and fatalism), intermediate factors (patient expectations, provider/hospital hopping) and facilitators or positive self-care determinants (intrinsic and extrinsic facilitators). Gender and the cultural background of patients' upbringing appear to shape these determinants, thereby affecting self-care decision making in chronic heart failure.
We have empirically described a unique set of self-care determinants among Indian chronic heart failure patients, which in turn are shaped by economic and socio-cultural factors. Assessing for and addressing these determinants during clinical interactions through multi-factorial approaches may help improve self-care among Indian CHF patients, thus improving treatment adherence and clinical outcomes.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We developed a three-pronged complex intervention to improve selfcare and deliver whole person care for patients with heart failure, underpinned by the ‘extant cycle’ theory – a theory based on our ...formative work.
This is a 3 centre, 2-arm, 1:1, open, adaptive stratified, randomized controlled trial. We included patients aged ≥ 18 years with heart failure, taking any of the key guideline directed medical treatments, with a history of or currently on a high ceiling diuretic. We excluded end stage renal disease, clinically diagnosed severe mental illness or cognitive dysfunction and having no caregivers. Interventions included, (i) trained hospital based lay health worker mediated assessment of patients' current selfcare behaviour, documenting barriers and facilitators and implementing a plan to ‘transition’ the patient toward optimal selfcare. (ii) m-health mediated remote monitoring and (iii) dose optimization through a ‘physician supervisor’.
We recruited 301 patients between Jan 2021 and Jan 2022. Mean age was 59.8 (±11.7) years, with 195 (64.8 %) from rural or semi-urban areas and 67.1 % having intermediate to low health literacy. 190 (63.1 %) had an underlying ischemic cardiomyopathy. In the intervention arm, 142 (94.1 %) had a Selfcare in Heart Failure Index (SCHFI) score of ≤70, with significant barriers being ‘lack of knowledge’ 105 (34.5 %) and ‘behavioural passivity’ 23 (7.5 %).
This is the first South Asian trial evaluating a complex intervention underpinned by behaviour change theory for whole person heart failure care. These learnings can be applied to heart failure patient care in other resource constrained health systems.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Thyroid dysfunction has been reported following COVID-19 infection in the recent past. A 50 year old hypertensive female with no previous thyroid illness, developed features of thyrotoxicosis two ...weeks after a COVID-19 infection. There was no thyromegaly, neck pain or fever and her ESR was 15 mm/hour. She was initiated on propranolol and methimazole in an outside hospital. Ten days later, she presented to our hospital with fever, sore throat, cough and breathing difficulty. On evaluation she was found to be in neutropenic sepsis (WBC -820 cells/mm3, ANC-6 cells/mm3). Evaluation of thyroid functions showed: TSH- <0.00025 IU/ml, free T3 - 4.17 pg/ml, free T4- 3.59 ng/ml and Thyroid Receptor Antibody Levels (TRAb)- 2.53 IU/L. Following treatment with colony stimulating factors and antibiotics she recovered. The patient was commenced on lithium bicarbonate and cholestyramine, along with propranolol. On follow up in the OPD she is euthyroid with free T4 1.43 ng/ml (normal) levels. Post COVID-19 thyrotoxicosis in this case is likely due to Graves’ disease. Thyrotoxicosis following COVID-19 is now being recognised and is possibly due to infection induced molecular mimicry with activation of immune pathways causing autoimmune disorders.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Network theoretic approach has been used to model and study the flow of ecological information, growth and connectivity on landscape level of anemochory (wind dispersal) of Himalayan moist temperate ...forest species in the Western Himalaya region. A network is formally defined and derived for seed dispersion model of target floral species where vertices represent habitat patches which are connected by an edge if the distance between the patches is less than a threshold distance. We define centrality of a network and computationally identify the habitat patches that are central to the process of seed dispersion to occur across the network. These central patches are located on map and geographical regions critically important for the flow of ecological information across the network are identified as Gharwal region and eastern Himachal Pradesh of Indian Himalaya. We find that the network of habitat patches is a scale-free network and at the same time it also displays small-world property characterized by high clustering and low average shortest path length. As a result, ecological information propagates rapidly and evenly on a local scale. Hubs in the network are identified as important centres for dissemination of ecological information (seeds) and need to be conserved against a potential attack by malicious agents and also ecological shocks. The network showcase a well-formed community structure. As a consequence of these structural properties of the network, anemochory floral species studied in this work are likely to thrive across the ecological network of forest patches in the Western Himalaya region over time.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Abstract
Background:
Advancing age and multimorbidity are well-established risk factors for the incidence and severity of coronavirus disease 2019 (COVID-19) infection.
Aims:
To describe the clinical ...profile of hospitalized elderly patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to assess the risk factors for mortality.
Methodology:
Data on 465 consecutive patients aged 60 years and above admitted with COVID-19 at St John’s Medical College Hospital, Bangalore, were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0 software (SPSS Inc., Chicago, IL, USA).
Results:
A total of 465 patients were included for the analysis. The overall mean age of the study group was 67 ± 4 years with 315 (67.9%) male patients. Eighty-one patients had mild, 117 had moderate, and 267 had severe COVID-19. After adjusting for age, gender, glycemic status, and COVID severity in the multivariate logistic regression analysis, elevated neutrophil-to-lymphocyte ratio (adjusted odds ratio aOR 1.93 95% confidence interval CI 1.14–3.29), end stage renal disease (aOR 3.49, 95% CI 1.34–9.06), acute kidney injury (aOR 3.25, 95% CI 1.94–5.41), shock (aOR 13.53 95% CI 6.35–28.82), mechanical ventilation (aOR 8.53, 95% CI 4.85–15.00), and intensive care unit care (aOR 14.5 95% CI 7.42–28.38) were the independent predictors of mortality.
Conclusion:
COVID-19 is characterized by poor outcomes and mortality, especially among older patients who have multiple comorbid illness.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Introduction
Blunt trauma to the neck may result in life threatening injuries due to airway compromise. Thyroid Injury in a previously normal gland is rare, so is Isolated Cricoid Fracture. The ...expanding thyroid hematoma and an unstable larynx compound the effects of compression and lead to sudden deterioration of the patient.
Case Report
We report the case of young male, who sustained a blunt injury in front of the neck. He developed a swelling in the front of his neck and suddenly deteriorated, needing intubation and airway management. Computed Tomographic imaging of the neck showed thyroid hematoma and fracture of the cricoid ring requiring an emergency hemi thyroidectomy and fixation of the cricoid fracture.
Discussion
This case brings forth the occurrence of two rare entities, Thyroid hematoma and Isolated Cricoid fracture in the same patient needing expert airway management and exploration.
Bouveret syndrome is a very rare form of gastric outlet obstruction following the passage of a gallstone from the gallbladder to the duodenum or pylorus through a bilioenteric fistula. We present a ...unique case of a 78-year-old male complaining of right upper quadrant abdominal pain and who was found to have a gallstone in the proximal duodenum along with pneumobilia and cholecysto-duodenal fistula suggestive of Bouveret's syndrome.
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