Neighbourhood characteristics influence infant mortality above and beyond individual/household factors. In India, there are very few studies discussing the effects of neighbourhood characteristics on infant mortality....Neighbourhood characteristics influence infant mortality above and beyond individual/household factors. In India, there are very few studies discussing the effects of neighbourhood characteristics on infant mortality. This study examined the effect of neighbourhood socioeconomic characteristics on infant mortality using data from the India’s Third District Level Household Survey conducted in 2007-2008. Multilevel analyses applied on the representative sample of 168,625 nested within 14,193 communities using MCMC procedure. Results established that place of residence, neighbourhood socio-economic factors as important determinants of infant mortality. Overall, being born in affluent (OR: 0.79, p < 0.01), more educated (OR: 0.86, p < 0.01) and socially disadvantaged caste (OR: 0.83, p < 0.01) neighbourhood was associated with the significant reduction in hazards of infant death. The finding of this study suggests that effort should be made to reduce infant mortality in these high focus states by including policies which aim at improving infant survival in the neighbourhood that is economically and socially deprived.展开更多
Upper tract urothelial cell carcinoma(UTUCC),formerly known as transitional cell carcinoma of the upper urinary tract,is a rare oncologic disease in Western countries.Thus its disease process and its management are no...Upper tract urothelial cell carcinoma(UTUCC),formerly known as transitional cell carcinoma of the upper urinary tract,is a rare oncologic disease in Western countries.Thus its disease process and its management are not as well defined as other urologic cancers. We are reviewing the current evidence based literature available to develop a plan for the treatment of UTUCC. A Pub Med search was completed using the key words "upper tract urothelial cell carcinoma","epidemiology","risk factor","treatment" and "prognosis". Six hundred fifty two articles were found. We narrowed our search to articles published between January 2004 and June 2016 for a more contemporary review of the topic. Four hundred seventy articles were then available for review. Further detailed search was performed for relevance on the topic and hundred one articles were selected for the review. Many risk factors have been found to be associated with the development of UTUCC,including tobacco use. Patients are often asymptomatic and may only present with microscopic or gross hematuria. Tumor grade and stage are pivotal in determining the treatment options for UTUCC. Advancements in endoscopic techniques have aided in the diagnosis,grading and treatment of this disease. Treatment options include topical therapy,with combinations of methotrexate,vinblastine,doxorubicin and cisplatin or gemcitibine or cisplatin,endoscopic resection,segmental ureterectomy and ureteral implantation,and nephroureterectomy,including bladder cuff. Treatment recommendations depend on tumor grade and stage,renal function,tumor location and the patient's prognosis. There are currently no tissue or blood-based biomarkers available to accurately monitor the disease. Further studies of gene expression and biomarkers may hopefully improve the management of this disease. Although rare in many countries,UTUCC is becoming more prevalent due to exposure to carcinogenic herbal remedies and other identifiable risk factors. Numerous treatment modalities,both surgical and chemotherapeutic,have been utilized to treat both low and high grade UTUCC tumors. Additional clinical trials are necessary to further develop methods for screening,treatment,and surveillance to improve management.展开更多
SUMMARY Linear regression is widely used in biomedical and psychosocial research.A critical assumption that is often overlooked is homoscedasticity.Unlike normality,the other assumption on data distribution,homoscedas...SUMMARY Linear regression is widely used in biomedical and psychosocial research.A critical assumption that is often overlooked is homoscedasticity.Unlike normality,the other assumption on data distribution,homoscedasticity is often taken for granted when fitting linear regression models.However,contrary to popular belief,this assumption actually has a bigger impact on validity of linear regression results than normality.In this report,we use Monte Carlo simulation studies to investigate and compare their effects on validity of inference.展开更多
Background: Ovarian remnant syndrome (ORS) is characterized by functional ovarian tissue following bilateral salpingo-oophorectomy. ORS presents with pelvic pain or mass, but may also present with urinary tract sympto...Background: Ovarian remnant syndrome (ORS) is characterized by functional ovarian tissue following bilateral salpingo-oophorectomy. ORS presents with pelvic pain or mass, but may also present with urinary tract symptoms resulting from enlarging residual tissue. Case: A 37 year old woman presented with pelvic pain radiating to her flank due to ureteral obstruction from an enlarging ovarian cyst in ORS. Transvaginal ultrasound guided, ovarian cyst aspiration accompanied by leuprolide acetate gonadotropin suppression resulted in acute and chronic relief of ureteral obstruction. Conclusion: This case demonstrated successful treatment of ureteral obstruction caused by an ovarian cyst in a patient with ORS via cyst aspiration and leuprolide acetate gonadotropin suppression. This treatment is a viable alternative for management of ORS, but sacrifices pathologic diagnosis when compared to traditional surgical resection.展开更多
Hairy polyp is an unusual, rare benign developmental malformation of neonates and infants. Embryologically, they are benign lesions containing of both ectodermal and mesodermal origin. Based on size, location of the l...Hairy polyp is an unusual, rare benign developmental malformation of neonates and infants. Embryologically, they are benign lesions containing of both ectodermal and mesodermal origin. Based on size, location of the lesion, they can produce symptoms such as feeding difficulties, airway obstructions, apneic episodes. We present a case of hairy polyp at Oro/Nasopharynx causing feeding difficulties immediately after birth. We explained the mode of presentation, imaging studies, treatment, and review of literature of congenital hairy polyp/choristoma.展开更多
Purpose:To investigate the orthopedic injuries sustained while driving and using social media on cellular phones from an orthopedic resident's perspective.Methods:A total of 118 patients who presented with a histo...Purpose:To investigate the orthopedic injuries sustained while driving and using social media on cellular phones from an orthopedic resident's perspective.Methods:A total of 118 patients who presented with a history of road traffic accident secondary to social media usage and suffered from fractures were included in this cross-sectional study.These patients were reported from October 2018 to April 2019.We collected the data including the type of collision,type of social media usage during driving,location of injury,wearing of safety equipment's such as helmet and seat belt during driving.Results:The mean age of patients was(34.86±12.73)(range 15-71)years.The common types of accident on the basis of collision of vehicles were:car versus motorbike 45(38.1%),motorbike versus motorbike 28(23.7%),and motorbike versus pedestrian 22(18.6%).Most of the accidents(61,51.7%)occurred due to mistake of motor-bikers.Out of them,44(37.3%)occurred on traffic signals,followed by 29(24.6%)while driving on main roads.The common timing of accident was normal hours with frequency of 44(37.3%),followed by 39(33.1%)at late night.According to fracture type,closed injuries were 98(83.1%)and open fractures were 20(16.9%).The most common fracture was clavicular fracture(21,22.5%)followed by soft tissue injury in 19(16.1%)patients.The most common social media application usage during driving was Facebook 43(36.4%),followed by Whatsapp 24(20.3%),Google 19(16.1%),and Instagram 15(12.7%).Conclusion:This study provides evidence that social media usage while driving put the drivers and other road users'lives at high risk.The most common social media addiction while driving is Facebook and Whatsapp.So there is a need to make strict rules and penalties for using cell phone during driving so as to save the lives of drivers and other people using road.展开更多
文摘Neighbourhood characteristics influence infant mortality above and beyond individual/household factors. In India, there are very few studies discussing the effects of neighbourhood characteristics on infant mortality. This study examined the effect of neighbourhood socioeconomic characteristics on infant mortality using data from the India’s Third District Level Household Survey conducted in 2007-2008. Multilevel analyses applied on the representative sample of 168,625 nested within 14,193 communities using MCMC procedure. Results established that place of residence, neighbourhood socio-economic factors as important determinants of infant mortality. Overall, being born in affluent (OR: 0.79, p < 0.01), more educated (OR: 0.86, p < 0.01) and socially disadvantaged caste (OR: 0.83, p < 0.01) neighbourhood was associated with the significant reduction in hazards of infant death. The finding of this study suggests that effort should be made to reduce infant mortality in these high focus states by including policies which aim at improving infant survival in the neighbourhood that is economically and socially deprived.
文摘Upper tract urothelial cell carcinoma(UTUCC),formerly known as transitional cell carcinoma of the upper urinary tract,is a rare oncologic disease in Western countries.Thus its disease process and its management are not as well defined as other urologic cancers. We are reviewing the current evidence based literature available to develop a plan for the treatment of UTUCC. A Pub Med search was completed using the key words "upper tract urothelial cell carcinoma","epidemiology","risk factor","treatment" and "prognosis". Six hundred fifty two articles were found. We narrowed our search to articles published between January 2004 and June 2016 for a more contemporary review of the topic. Four hundred seventy articles were then available for review. Further detailed search was performed for relevance on the topic and hundred one articles were selected for the review. Many risk factors have been found to be associated with the development of UTUCC,including tobacco use. Patients are often asymptomatic and may only present with microscopic or gross hematuria. Tumor grade and stage are pivotal in determining the treatment options for UTUCC. Advancements in endoscopic techniques have aided in the diagnosis,grading and treatment of this disease. Treatment options include topical therapy,with combinations of methotrexate,vinblastine,doxorubicin and cisplatin or gemcitibine or cisplatin,endoscopic resection,segmental ureterectomy and ureteral implantation,and nephroureterectomy,including bladder cuff. Treatment recommendations depend on tumor grade and stage,renal function,tumor location and the patient's prognosis. There are currently no tissue or blood-based biomarkers available to accurately monitor the disease. Further studies of gene expression and biomarkers may hopefully improve the management of this disease. Although rare in many countries,UTUCC is becoming more prevalent due to exposure to carcinogenic herbal remedies and other identifiable risk factors. Numerous treatment modalities,both surgical and chemotherapeutic,have been utilized to treat both low and high grade UTUCC tumors. Additional clinical trials are necessary to further develop methods for screening,treatment,and surveillance to improve management.
文摘SUMMARY Linear regression is widely used in biomedical and psychosocial research.A critical assumption that is often overlooked is homoscedasticity.Unlike normality,the other assumption on data distribution,homoscedasticity is often taken for granted when fitting linear regression models.However,contrary to popular belief,this assumption actually has a bigger impact on validity of linear regression results than normality.In this report,we use Monte Carlo simulation studies to investigate and compare their effects on validity of inference.
文摘Background: Ovarian remnant syndrome (ORS) is characterized by functional ovarian tissue following bilateral salpingo-oophorectomy. ORS presents with pelvic pain or mass, but may also present with urinary tract symptoms resulting from enlarging residual tissue. Case: A 37 year old woman presented with pelvic pain radiating to her flank due to ureteral obstruction from an enlarging ovarian cyst in ORS. Transvaginal ultrasound guided, ovarian cyst aspiration accompanied by leuprolide acetate gonadotropin suppression resulted in acute and chronic relief of ureteral obstruction. Conclusion: This case demonstrated successful treatment of ureteral obstruction caused by an ovarian cyst in a patient with ORS via cyst aspiration and leuprolide acetate gonadotropin suppression. This treatment is a viable alternative for management of ORS, but sacrifices pathologic diagnosis when compared to traditional surgical resection.
文摘Hairy polyp is an unusual, rare benign developmental malformation of neonates and infants. Embryologically, they are benign lesions containing of both ectodermal and mesodermal origin. Based on size, location of the lesion, they can produce symptoms such as feeding difficulties, airway obstructions, apneic episodes. We present a case of hairy polyp at Oro/Nasopharynx causing feeding difficulties immediately after birth. We explained the mode of presentation, imaging studies, treatment, and review of literature of congenital hairy polyp/choristoma.
文摘Purpose:To investigate the orthopedic injuries sustained while driving and using social media on cellular phones from an orthopedic resident's perspective.Methods:A total of 118 patients who presented with a history of road traffic accident secondary to social media usage and suffered from fractures were included in this cross-sectional study.These patients were reported from October 2018 to April 2019.We collected the data including the type of collision,type of social media usage during driving,location of injury,wearing of safety equipment's such as helmet and seat belt during driving.Results:The mean age of patients was(34.86±12.73)(range 15-71)years.The common types of accident on the basis of collision of vehicles were:car versus motorbike 45(38.1%),motorbike versus motorbike 28(23.7%),and motorbike versus pedestrian 22(18.6%).Most of the accidents(61,51.7%)occurred due to mistake of motor-bikers.Out of them,44(37.3%)occurred on traffic signals,followed by 29(24.6%)while driving on main roads.The common timing of accident was normal hours with frequency of 44(37.3%),followed by 39(33.1%)at late night.According to fracture type,closed injuries were 98(83.1%)and open fractures were 20(16.9%).The most common fracture was clavicular fracture(21,22.5%)followed by soft tissue injury in 19(16.1%)patients.The most common social media application usage during driving was Facebook 43(36.4%),followed by Whatsapp 24(20.3%),Google 19(16.1%),and Instagram 15(12.7%).Conclusion:This study provides evidence that social media usage while driving put the drivers and other road users'lives at high risk.The most common social media addiction while driving is Facebook and Whatsapp.So there is a need to make strict rules and penalties for using cell phone during driving so as to save the lives of drivers and other people using road.
