Connectivity Strategies in Managing a POCT Service.

Point of Care Testing is increasingly being used for diagnosis and management of various disease states. Management of different Point of Care instruments at multiple sites can be challenging, particularly when such instruments are operated by non technical staff. Connectivity is critical for optimal management of these services which are intimately linked to operator training and competency and are important in minimising harm to the patient by reducing analytical errors. Furthermore, connectivity improves turn around time leading to faster decision making by physicians. Recent advances in technology such as 5G and artificial intelligence are likely to lead to a greater focus on personalized care as a result of big data analysis and development of algorithms.

Web-based Radiology Subspecialty Training Program: Pilot Feasibility and Effectiveness Analysis on Ethiopian Radiologists.

RATIONALE AND OBJECTIVES: To investigate the feasibility and effectiveness of a novel web-based radiology subspecialty training program. MATERIALS AND METHODS: Ten Ethiopian general radiologists were enrolled; each participant selected two out of four available subspecialty training programs including abdominal imaging, neuroradiology, chest imaging, and musculoskeletal imaging. Participants were trained simultaneously in 4-stages over 20-months remotely. The program contains online lectures (previously recorded), online interactive case reviews, learning modules, and one-month observership at Johns Hopkins University. Each subspecialty training program consisted of nearly 50 recorded lectures, 26 case reviews, and 40 modules, all provided by subspecialty-trained radiology faculty. Trainees were evaluated using pre- and postcourse multiple choice questions, and the effectiveness of the program was assessed by comparing pre- and postcourse performances using paired t test or Wilcoxon signed-rank test. Regression analysis was conducted to determine the association between the magnitude of score change and trainees' age and years after graduation. RESULTS: All programs including abdominal imaging (p < 0.001), neuroradiology (p < 0.001), chest imaging (p: 0.001), and musculoskeletal imagining (p = 0.001) led to significant improvements in participants' knowledge (overall mean ± standard deviation of score change: +18.4% ± 11.4%). All stages of training including stage-1 (+29.3% ± 8.4%), stage-2 (+21.0% ± 8.0%), stage-3 (+15.0% ± 13.7%), and stage-4 (+17.0% ± 7.9%) significantly improved trainees' scores; and the percent score change decreased with each stage. Regression analysis revealed that score improvement was not associated with age and years after residency training. CONCLUSION: Our newly developed web-based radiology subspecialty training program results in improved knowledge of radiologists. Implementation of web-based subspecialty training could be an effective and feasible method for institutions without subspecialty faculty and programs.

Age, sex, and HIV seroprevalence among individuals from different parts of India tested for HIV infection in a nongovernmental setting.

India has a large population of HIV-infected individuals, but the amount of information available about this population is small and not commensurate with the population's size. Here, we report the age and sex for 11,925 individuals tested for HIV infection in a nongovernmental setting over a 36-month period. The samples were derived from 161 sites located in different parts of the country and the odds of HIV infection among males was 2.27 times that for females. Of the samples from males and females tested, 50 and 65%, respectively, were in the 16-35 year age group. Of the seropositive samples excluding less than 1 year of age, 92% were in the 16-50 year age group. Analysis of this testing data provides limited but valuable information on the HIV epidemic in India.

Geographical distribution of hepatitis C virus genotypes in India.

HCV isolates from around the world show substantial nucleotide sequence variability throughout the viral genome. Based on the identification of these genome differences various genotypes and subtypes have been described from different geographical regions. They have been tentatively classified into six major genotypes and more than 30 subtypes, but new subtypes are continually being discovered. In recent years, substantial evidence has emerged indicating that typing and subtyping for HCV is clinically important. The present study aims at determining and comparing the prevalence of different genotypes from different parts of India (North, South, East and West). A total of 153 samples representing different regions have been genotyped in our lab. Our studies document a high prevalence of genotype 3 (> 76%) and very low prevalence of genotype 2 (< 2%), as a whole. However, genotype 3a has been found to be the highest (50%) with a decreased frequency of approximately 25% in the case of 3b, approximately 14% in 1b and approximately 10% in 1a, whereas a minimal number (approximately 4%) of genotype 4 has been found only in Southern and Western India.

X chromosomal abnormalities in Indian adolescent girls.

In girls of adolescent age, primary amenorrhea is a major problem and it is often suspected as Turner syndrome (TS), with complete or partial absence of one of the two X chromosomes. The girls who are unable to menstruate are primarily investigated by the gynecologists with the help of a physical examination, sonogram of the pelvis, endocrinologic tests, and ultimately cytogenetic analysis. Chromosomal analyses have been carried out in 280 such cases that were referred from different parts of the country. The standard protocol for peripheral blood lymphocyte culture was followed for metaphase chromosome preparation and conventional analysis of G-banded chromosomes. A total of 29% cases were found to have some chromosomal abnormality, including TS and testicular feminization syndrome involving sex chromosomes. Amongst those with sex chromosomal anomaly, 34% had evidence of a 46,XY karyotype in phenotypic females and 51% had pure line 45,X or mosaic with normal XX or other aberrations in X. The classification of the TS group further showed the spectrum of variant TS in Indian adolescent girls who suffered from absence or delayed menarche to correspond well with the Belgian, Danish, or Russian population. However, it has been reported that only 1% of the pure line 45,X conception is viable, indicating the necessity of mosaicism with X or Y chromosome. It has been understood that conventional banding analysis is absolutely necessary for segregating the variant nature of TS. In addition, molecular genetic or molecular cytogenetic investigations can determine the nature of mosaicism. The present study further indicated the involvement of autosomes in causing improper sexual development in girls of adolescent age.