Building on Trends of Bibliometric Analysis for Fixing Priorities for Research on Himalayan Biosphere Reserves

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - A bibliometric assessment of scientific research outputs (N = 676) on Himalayan Biosphere...     

Comparative cardiovascular safety of risperidone and olanzapine,based on electrocardiographic parameters and blood pressure: A prospective open label observational study

Objective:

To assess the cardiovascular safety of two commonly prescribed atypical antipsychotics risperidone (RSP) and olanzapine (OZP) in schizophrenic patients, using electrocardiography (ECG) and Blood Pressure (BP).

Materials and Methods:

This was a 10-week prospective open label, observational study, carried out in a newly diagnosed 64 schizophrenic patients receiving either RSP or OZP. RSP (n = 32) was started with dose of 2 mg/day and increased to 4 mg/day after 2 weeks, whereas OZP (n = 32) was started at a dose of 5 mg/day and was increased to 10 mg/day after 2 weeks. Heart rate (HR), ECG parameters (PR, RR, QRS, QT intervals and QTc and QTd) and BP (systolic and diastolic in supine and standing position) were recorded at baseline (before drug therapy)) and during follow-up visits at 2(I), 6(II) and 10(III) weeks.

Results:

In the RSP group, at II and III follow-ups, a significant increase in the HR (P = 0.018, P = 0.011 respectively) as well as in QTc (P = 0.025, P = 0.015, respectively) was observed when compared to the basal values. In the OZP group, diastolic BP was significantly decreased in standing position at II and III follow-ups (P = 0.045 and P = 0.024, respectively) compared to the basal values. When the two groups were compared with each other, no significant differences were observed in the changes of HR, PR, QRS, QT, RR, QT, QTd and SBP (supine and standing position); and DBP (supine position). However, DBP in standing position showed a significant decrease in the OZP group at II and III follow-up (P = 0.036 and P = 0.016, respectively) compared to the RSP group.

Conclusions:

Patients treated with OZP are at higher risk to develop postural hypotension as compared with RSP; hence RSP could be better tolerated by patients taking antihypertensive drugs as compared with OZP whereas OZP would have a safer cardiac profile.KEY WORDS: ECG changes, heart rate, olanzapine, QTc, QTd, risperidone     

The effects of cadmium, copper, lead, and zinc on the growth and reproduction of Proisotoma minuta Tullberg (Collembola)

Laboratory studies were conducted to evaluate Proisotoma minuta sensitivity toward selected heavy metals (Cd, Cu, Pb, and Zn). The experimental results showed a reduction in adult survival and no reproduction at the highest concentrations of Cd and Zn. Application of Pb at all levels resulted in large numbers of progeny and no significant mortality compared to controls. EC50 reproduction values for Cd, Cu, and Zn were 125, 696, and 283 microg g(-1), respectively. No significant difference in time from the introduction of adults into the test soils to the appearance of the first-instar animals was observed between different metal treatments. The growth rate of adults decreased for all metal treatments compared to the controls. It is suggested that the accumulation of metals in P. minuta affects metabolism and results in a slower growth rate. The absence of any statistically significant effect on mortality at all concentrations of Pb may be due to greater tolerance of P. minuta to Pb than to other metals.     

Intraductal hepatocellular carcinoma with normal liver--case report.

Hepatocellular carcinoma commonly invades the portal vein but is rarely seen in the bile duct. When seen, a minor intraductal component usually accompanies a prominent hepatic involvement. We report a case of hepatocellular carcinoma that entirely involved the common bile duct, the hepatic involvement was undiscernible at operation or ultrasonography. The patient had obstructive jaundice both at first presentation and at recurrence. The liver was normal at both explorations. The elevated AFP levels returned to normal after second resection. The diagnosis was confirmed by electron microscopy.     

Clinical decision support with automated text processing for cervical cancer screening

Objective

To develop a computerized clinical decision support system (CDSS) for cervical cancer screening that can interpret free-text Papanicolaou (Pap) reports.

Materials and Methods

The CDSS was constituted by two rulebases: the free-text rulebase for interpreting Pap reports and a guideline rulebase. The free-text rulebase was developed by analyzing a corpus of 49 293 Pap reports. The guideline rulebase was constructed using national cervical cancer screening guidelines. The CDSS accesses the electronic medical record (EMR) system to generate patient-specific recommendations. For evaluation, the screening recommendations made by the CDSS for 74 patients were reviewed by a physician.

Results and Discussion

Evaluation revealed that the CDSS outputs the optimal screening recommendations for 73 out of 74 test patients and it identified two cases for gynecology referral that were missed by the physician. The CDSS aided the physician to amend recommendations in six cases. The failure case was because human papillomavirus (HPV) testing was sometimes performed separately from the Pap test and these results were reported by a laboratory system that was not queried by the CDSS. Subsequently, the CDSS was upgraded to look up the HPV results missed earlier and it generated the optimal recommendations for all 74 test cases.

Limitations

Single institution and single expert study.

Conclusion

An accurate CDSS system could be constructed for cervical cancer screening given the standardized reporting of Pap tests and the availability of explicit guidelines. Overall, the study demonstrates that free text in the EMR can be effectively utilized through natural language processing to develop clinical decision support tools.     

Oesophageal dilatation on high‐resolution CT chest in systemic sclerosis: What does it signify?

Objective: To evaluate the significance of oesophageal dilatation on high‐resolution CT (HRCT) chest in patients with systemic sclerosis. Methods: We retrospectively retrieved the database of patients with systemic sclerosis seen at our hospital between January 2008 and January 2009. A total of 50 patients (46 women and four men) who had HRCT chest, pulmonary function testing and echocardiography within 1 month were included in the study. Peak pulmonary artery (PA) pressures and pulmonary function testing were charted. The HRCT chest was interpreted by a chest radiologist. Oesophageal dilatation was defined as a luminal coronal diameter of ≥9 mm in infra‐aortic oesophagus. Extent of ground glass, reticulation and honeycombing was objectively scored. Results: Statistical analysis using independent t‐test showed that diffusion capacity of carbon monoxide was significantly lower (P = 0.042) and peak PA pressures were significantly higher (P = 0.045) in patients with oesophageal dilatation (n = 29) as compared with those without oesophageal dilatation (n = 21). The two cohorts had no significant difference in their total lung capacity and HRCT determined extent of interstitial lung disease. Conclusion: Patients with oesophageal dilatation on HRCT chest had significantly lower diffusion capacity of carbon monoxide and higher peak PA pressures, which suggest that these patients tend to have more severe pulmonary vascular disease.