Correlation between scientometrics and altmetrics score of scholarly literature of Medical Journal Armed Forces India.

Background: Present article was an attempt to study correlation of scientometrics and altmetrics of scholarly output of Medical Journal Armed Forces India (MJAFI) during the period from 2010 to 2018. Methods: The study was carried out by "DIMENSIONS", Webometric Analyst 4.1, VOSviewer, version 1.6.10, database to identify year-wise number of publications, their accessibility, altmetric attention, field citation ratio, and relative citation ratio of top 100 articles between 2010 and 2018. Pearson correlation test was used to assess data statistically using SPSS software, version 21. Results: The study found that maximum publications were in 2015, i.e. 21.44% followed by 2018, i.e. 11.52% with 1053 articles open access and 318 articles closed access (1371). Total 317 altmetric attention received by total 1371 articles, and "Clinical Sciences" category published most of publications with 0.55 mean field citation ratio (FCR) and 0.31 mean relative citation ratio (RCR). The positive correlation value between citations and altmetric scores obtained was 0.88. It was also observed that the topmost article among the top 100 has a maximum RCR (8.24) and FCR (19.3). Conclusion: Present study found that articles published in MJAFI are getting favorable attention at both academic as well as social platform; however, the constant improvement and rigorous maintenance of standards is utmost important by publishing high-quality evidence-based studies and its subsequent dissemination at both academic and non-academic platform, which might be beneficial to not only medical field but also well-being of entire human race.

Potential for differentiation of glioma recurrence from radionecrosis using integrated 18F-fluoroethyl-L-tyrosine (FET) positron emission tomography/magnetic resonance imaging: A prospective evaluation.

PURPOSE: To assess the utility of 18F-fluoroethyl-L-tyrosine (FET) positron emission tomography/magnetic resonance imaging (PET/MRI) in distinguishing recurrence from radionecrosis. MATERIALS AND METHODS: Thirty-two patients (25 males, 7 females) of glioma who had already undergone surgery/chemoradiotherapy and had enhancing brain lesions suspicious of recurrence were evaluated using integrated 18F-FET PET/MRI, and followed up with histopathology or clinical follow-up and/or MRI/PET/MRI imaging. Manually drawn regions of interest over areas of maximal enhancement or FET uptake were used to calculate tumor to background ratios [TBRmax, TBRmean], choline: creatine ratio [Cho: Cr ratio], normalized relative cerebral blood volume [N rCBVmean] and apparent diffusion coefficient [ADCmean]. Correlations were evaluated using Pearson's coefficient. Accuracy of each parameter was calculated using independent t-test and receiver operator curve (ROC) analysis while utility of all four parameters together using multivariate analysis of variance (MANOVA) for differentiating recurrence vs. radionecrosis was evaluated. Positive histopathology and imaging/clinical follow up served as the gold standard. RESULTS: Twenty-four of the 32 patients were diagnosed with recurrent disease and 8 with radiation necrosis. Significant correlations were observed between TBRmaxand N rCBVmean (ρ =0.503; P = 0.003), TBRmean, and N rCBVmean (ρ =0.414; P = 0.018), TBRmaxand ADCmean (ρ = -0.52; P = 0.002), and TBRmeanand ADCmean(ρ = -0.518; P = 0.002). TBRmax, TBRmean, ADCmean, Cho: Cr ratios, and N rCBVmeanwere significant in differentiating recurrence from radiation necrosis with an accuracy of 94.1%, 88.2%, 80.4%, 96.4%, and 89.9%, respectively. MANOVA indicated that combination of all parameters demonstrated better evaluation of recurrence vs. necrosis than any single parameter. The diagnostic accuracy, sensitivity, and specificity using all MRI parameters were 93.75%, 96%, and 85.7%, and using all FET PET/MRI parameters was 96.87%, 100%, and 85.7%, respectively. CONCLUSIONS: Synergetic effect of multiple MR parameters evaluated together in addition to FET PET uptake highlights the fact that integrated 18F-FET PET/MRI might have the potential to impact management of patients with glioma by timely and conclusive recognition of true recurrence from radiation necrosis.

Glioma Recurrence Versus Radiation Necrosis: Single-Session Multiparametric Approach Using Simultaneous O-(2-18F-Fluoroethyl)-L-Tyrosine PET/MRI.

PURPOSE: This study aimed to investigate the potential of hybrid gadolinium (Gd)-enhanced F-fluoroethyl-L-tyrosine (F-FET) PET/MRI in distinguishing recurrence from radiation necrosis using simultaneously acquired multiple structural and functional parameters. METHODS: Twenty-six patients (5 female and 21 male patients; mean ± SD age, 51.58 ± 15.97 years) with single or multiple contrast-enhancing brain lesions (n = 32) on MRI after surgery and radiation therapy were evaluated with simultaneously acquired Gd-enhanced F-FET PET/MRI. They were then followed up with resurgery and histopathological diagnosis (n = 9) and/or clinical/MRI- or PET/MRI-based imaging follow-up (n = 17). PET/MR images were analyzed using manually drawn regions of interest over areas of maximal contrast enhancement and/or FET uptake. Maximum target-to-background ratio (TBRmax), mean target-to-background ratio (TBRmean), and choline-to-creatine (Cho/Cr) ratios as well as normalized mean relative cerebral blood volume (rCBVmean) and mean apparent diffusion coefficient (ADCmean) were determined. The accuracy of each parameter individually and in various possible combinations for differentiating recurrence versus radiation necrosis was evaluated using 2-tailed independent samples Student t test, multivariate analysis of variance, and multivariate receiver operating characteristic analysis. Positive histopathological finding and long-term imaging/clinical follow-up suggestive of disease progression served as criterion standard. RESULTS: Of 26 patients, 19 were classified as recurrence, with 7 patients showing radiation necrosis. Individually, TBRmax, TBRmean, ADCmean, and Cho/Cr ratios as well as normalized rCBVmean was significant in differentiating recurrence from radiation necrosis, with an accuracy of 93.8% for TBRmax, 87.5% for TBRmean, 81.3% for ADCmean, 96.9% for Cho/Cr ratio, and 90.6% for normalized rCBVmean. The accuracy of both normalized rCBVmean and ADCmean was improved in combination with TBRmax or Cho/Cr ratio. However, TBRmax (or TBRmean) with Cho/Cr ratio yielded the highest accuracy, approaching up to 97%. Furthermore, maximum area under the curve is achieved with the combination of TBRmean, CBV, and Cho/Cr values. CONCLUSIONS: Our findings suggest that FET uptake with Cho/Cr ratio and normalized rCBVmean could be most useful to distinguish primary glioma recurrence from radiation necrosis. Hybrid simultaneous multiparametric F-FET PET/MRI might play a significant role in the evaluation of patients with suspected glioma recurrence.

Vitamin D deficiency in children presenting to the emergency department: a growing concern. Vitamin D deficiency in Birmingham's children: presentation to the emergency department.

INTRODUCTION: The increase in detected vitamin D deficiency appears to be multifactorial: an increasingly multicultural society, reduced exposure to sunlight due to concern about skin cancer and a more sedentary lifestyle and dietary changes within the population. METHODS: This was a retrospective survey of children found to be vitamin D deficient after attending the emergency department from March 2009 until March 2010. These data were then subdivided according to their age, ethnic origin, presenting complaint and biochemical associated features. RESULTS: We identified 89 patients with a low vitamin D level (total vitamin D levels less than 50 nmol/l), with 83% of those having very low vitamin D levels (less than 25 nmol/l). The most common presenting features were abdominal pain (19%), a seizure (17%) and limb pain (15%). The most common ethnic origins in our series were Pakistani (37%) followed by black African (11.2%). CONCLUSIONS: Vitamin D deficiency should be considered in children with pigmented skin presenting with a range of symptoms. The detected vitamin D deficiency probably represents only a very small proportion of the vitamin D deficiency in children in Birmingham.

A retrospective study of outcomes in subjects of head and neck cancer treated with hyperbaric oxygen therapy for radiation induced osteoradionecrosis of mandible at a tertiary care centre: an Indian experience.

Osteoradionecrosis (ORN) of the mandible is a rare complication of radiation therapy for head and neck cancer. It manifests as an area of exposed necrotic bone failing to heal for at least 3 months. Our study aims to determine the effectiveness of HBO in management of radiation induced mandibular ORN. A retrospective study of 33 subjects of mandibular ORN treated with HBOT during period 2009-2011 was carried out. The mean patient age was 60 years (range 41-80).They were treated in a multiplace hyperbaric chamber at 2.4 ATA, for 90 min once a day for up to 30 sessions. Pre and post treatment improvement in relation to symptoms, healing of intraoral wound and overall wellbeing were evaluated. Out of 33 Subjects, 48 % (n = 16) cases showed complete healing of wound, 18 % (n = 6) had marked healing, slight healing in 24 % (n = 8) cases and 9 % (n = 3) cases had no change in healing. 70 % (23 of 33) cases had significant reduction in pain, 62 % (18 of 29) cases had improved jaw opening, 41 % (11 of 27) cases and 71 % (20 of 28) cases showed improvement in ability to talk and mouth dryness respectively. Overall 85 % (28 of 30) cases showed improvement. Our clinical experience supports the efficacy of HBO treatment for radiation induced mandibular ORN and we recommend additional multicentric, prospective studies to be carried out defining the role of HBOT using at least 30 sessions in such cases.

Transdermal fentanyl in deliberate overdose in pediatrics.

The use of the fentanyl skin patch to provide pain relief in chronic pain conditions and oncology in adult practice has been common for several years, and an increase in use is now being seen in pediatric practice. Its use in drug misuse and suicide has also increased in recent years. We present the case of an adolescent who deliberately overdosed using fentanyl skin patches and describe the implications for management. This report serves to remind clinicians to consider this method of drug administration in children who display signs of opioid toxicity, where overdose may be subsequent to its use in therapy, recreation, or deliberate self-harm.

Not fun in the sun: playground safety in a heatwave.

Two patients with severe palmar burns sustained from hot playground equipment during a heatwave are presented here, with a review of the management of palmar burn injuries.