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BACKGROUND: Femoral derotation osteotomy is treatment of choice in intoeing gait secondary to cerebral palsy (CP). RESEARCH QUESTION: The aim of this study was to critically appraise the literature regarding the long-term outcomes of femoral derotation surgery in CP. METHODS: Electronic databases of PubMed and Scopus was used for the literature review by two researchers independently (SB, SC). The study population included patients of cerebral palsy undergoing femoral derotation surgery. The keywords used were "cerebral palsy", "intoeing gait", "femur anteversion", "hip anteversion", "femur derotation" and "femur osteotomy". RESULTS: Nine studies which included 657 limbs in 407 patients were selected for this study of which eight were retrospective in nature. The improvement in hip rotation at stance at last follow up (more than five years) maintained a statistical significance (SMD 1.67 95 %CI 1.12-2.22). Similar statistically significant outcomes were noted for foot progression angle (SMD 1.19 95 %CI 0.92-1.47), anteversion (SMD 2.75 95 %CI 1.49-4.01) and total passive internal rotation (SMD 1.71 95 %CI 1.19-2.22). SIGNIFICANCE: Femoral derotation surgery is the procedure of choice for correction of intoeing gait in CP. Even though, there is deterioration of results on long-term as compared to short term, majority of the patients shall maintain overall correction without recurrence of an intoeing gait. Future studies with uniform criteria for defining recurrence on the basis of functional limitations shall provide better idea about the natural course of this procedure.
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Lung diseases represent a significant global health threat, impacting both well-being and mortality rates. Diagnostic procedures such as Computed Tomography (CT) scans and X-ray imaging play a pivotal role in identifying these conditions. X-rays, due to their easy accessibility and affordability, serve as a convenient and cost-effective option for diagnosing lung diseases. Our proposed method utilized the Contrast-Limited Adaptive Histogram Equalization (CLAHE) enhancement technique on X-ray images to highlight the key feature maps related to lung diseases using DenseNet201. We have augmented the existing Densenet201 model with a hybrid pooling and channel attention mechanism. The experimental results demonstrate the superiority of our model over well-known pre-trained models, such as VGG16, VGG19, InceptionV3, Xception, ResNet50, ResNet152, ResNet50V2, ResNet152V2, MobileNetV2, DenseNet121, DenseNet169, and DenseNet201. Our model achieves impressive accuracy, precision, recall, and F1-scores of 95.34%, 97%, 96%, and 96%, respectively. We also provide visual insights into our model's decision-making process using Gradient-weighted Class Activation Mapping (Grad-CAM) to identify normal, pneumothorax, and atelectasis cases. The experimental results of our model in terms of heatmap may help radiologists improve their diagnostic abilities and labelling processes.
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Artificial intelligence (AI) driven solutions have the potential to significantly impact individuals with disabilities by providing assistance in their daily activities and facilitating the acquisition of new abilities. The utilisation of AI technology in assisting individuals with disabilities has novel prospects for enhancing accessibility, fostering inclusivity throughout society, and enabling autonomous living, which would otherwise pose considerable challenges or remain unattainable. As the field of AI continues to progress, it holds the potential to facilitate the development of increasingly sophisticated and groundbreaking approaches to tackle the multifaceted obstacles encountered by individuals with disabilities. Consequently, AI has the capacity to foster greater inclusivity for this population.
AI driven solutions have the potential to significantly impact individuals with disabilities by providing assistance in their daily activities and facilitating the acquisition of new abilities.Several solutions are being currently developed by numerous startups as well as corporate conglomerates like Google, Microsoft and Apple.An independent and self-sustaining life will be the future normal for persons with disability (PwD) with these rapidly progressing developments.
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Background Patients with type 2 Diabetes Mellitus (DM) have a poor quality of life because of various clinical effects. The sleep quality among these patients is affected and they encounter challenges to sleep and wakefulness due to physiological imbalance and co-morbid sleep pathologies. The present study was conducted to ascertain the sleep quality in type 2 DM patients attending a tertiary center in West Bengal. Methodology It was a hospital-based cross-sectional study that was conducted among old/follow-up patients who were suffering from DM. The eligible subjects were selected by systematic random sampling and were interviewed using a semi-structured and pre-tested questionnaire. Information pertaining to socio-demographic characteristics and sleep quality was ascertained. The sleep quality was assessed by using the Pittsburgh Sleep Quality Index (PSQI). Data was analyzed using Statistical Package for Social Sciences (SPSS) version 20 and statistical association of different parameters was tested using Chi-Square test. Results A total of 192 subjects were selected for study. Maximum subjects were above 50 years. A total of 102 males and 90 females participated in the study. A total of 110 subjects were poor sleepers (i.e. PSQI score ≥5) while 82 were good sleepers(PSQI<5). Poor sleepers were maximum in the 20-35 years age group, more in females and unemployed individuals. Subjects with poor diabetes control, i.e. HbA1C more than 7gm/dl were poor sleepers. Conclusions A higher proportion of patients with type 2 DM had poor quality of sleep. It is important on the part of the health personnel to attend to the sleep issues and impaired quality of life due to sleep inadequacy in DM patients.
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Road traffic injuries remain one of the common and leading causes of death among children and adolescents till the age of 19 years. Road safety is important for children since their physical activity, active travel, independence and development are largely affected by it. Solutions for road safety with benefits for people as well as an economy exist which should be implemented effectively and efficiently. These solutions which combine engineering, legislation and behavioural interventions should be implemented in an integrated Safe Systems Approach. The future of the children must be safeguarded from these injuries and every effort towards it being converted into "bygone figures" must be done diligently and honestly. The various risk factors and interventions possibly explained in this review article shall help in better understanding of the causes and possible guidelines at a policy level to prevent road traffic injuries in children.
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Objective: The aim of this pilot study was to analyze the need and feasibility of conducting prospective research on the epidemiological factors of bone mineral density (BMD) in the at-risk population in a rural and tribal-dominated area based on a screening test. Methods: This community-based retrospective cross-sectional study was based on data from the medical records from July 2021 to September 2021 at community camps organized in a rural area of Deoghar district of Jharkhand, India, and the at-risk patients who had undergone ultrasound-based BMD measurement were included in this study. Results: The mean age of the patients (N = 216) was 68.2 ± 10.2 years (range 35-73 years) with a mean T-score of -0.83 ± 0.09 (range -2.78-0.3, 95% CI 0.19). 70.3% (n = 152) of the patients were diagnosed as either osteopenic or osteoporotic based on the T-score. 14.8% (n = 32) of the patients had a comorbidity making them susceptible for low BMD. BMD was significantly low in patients above 60 years of age (t - 3.36, P - 0.0005), presence of comorbidity (t - 3.12, P - 0.001), and urban population (t - -1.93, P - 0.02). Conclusion: Although DEXA remains the study of choice, QUS can be used in primary healthcare systems in the developing world for the purposes of screening. Females, elderly, and urban residence have an increased chance of low BMD. This pilot study shows that a large-scale prospective study analyzing various aspects of bone health including dietary and lifestyle practices is the need of the hour.
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The aim of this review is to conduct an analysis of existing literature on outcomes of application of various methods of joint decompression in management of septic arthritis of the hip in children. A search of literature in PubMed, Embase, and Google Scholar was conducted for identification of studies reporting on the outcomes of intervention for septic arthritis of the hip in children. Of the 17 articles selected, four were comparative studies; two of these were randomized controlled trials while the rest were single arm studies. Statistical difference was observed between the proportion of excellent clinical and radiological outcomes in arthrotomy (90%, 95% confidence interval [CI] 81-98%; 89%, 95% CI 80-98%), arthroscopy (95%, 95% CI 91-100%; 95%, 95% CI 90-99%), and arthrocentesis (98%, 95% CI 97-100%; 99%, 95% CI 97-100%), respectively. The highest overall rate of additional unplanned procedures was observed in the arthrocentesis group (24/207, 11.6%). Patients who underwent arthrocentesis had a statistically greater chance of excellent clinical and radiological outcomes, although the highest level of need for additional unplanned surgical intervention was observed in the arthrocentesis group, followed by the arthroscopy group and the arthrotomy group. Future conduct of a prospective multicentric study focusing on the developed and developing world, along with acquisition of data. such as delay of treatment and severity of disease will enable assessment of the efficacy of one technique over the other by surgeons worldwide.
