An investigation of basic science and clinical research methodologies to benefit clinical practice

The aim of this PhD thesis was to produce research that could inform and benefit clinical practice by exploring the application of basic science and clinical research methodologies to disorders in obstetrics and gynaecology. Chapter 1’s investigation of endometriosis is the first to 1) report detailed genetic mapping of endometriosis-associated ovarian cancer, 2) report the existence of micro-LOH (loss of heterozygosity) in ovarian endometriosis through a SNP 100K DNA array. Chapter 2 explores the efficacy of interventions to treat menstrual abnormalities using clinical cohort studies. Furthermore, Chapter 2 highlights how negligence in female sterilization failure may be mathematically (Bayesian) modelled. Chapter 3 explores the value of systematic reviews for preventing preterm delivery and use of LNG-IUS (Mirena coil). The clinical guidelines published in Chapter 4 include: vaginal birth after previous caesarean, ectopic pregnancy, safe laparoscopic entry and minimising risk of sterilisation failure. The thesis concludes (Chapter 5) by suggesting strategies to augment the research methodological approaches evaluated in this thesis in order fulfill the aim of benefitting clinical practice. Work included in this PhD thesis has been orally presented at international conferences, published in peer-reviewed journals, and published as a national clinical guideline by the Royal College of Obstetricians and Gynaecologists, UK (RCOG)

Analyzing the Influence of Health-Related Factors on Quality of Life among Elderly Populations

The impact of health-related issues on elder individuals\u27 quality of life (QoL) is examined, and understanding the factors influencing older people\u27s well-being is crucial as the world\u27s population ages. Research looks at social, mental, and physical health indicators and how it affect various aspects of QoL, such as social interaction, emotional stability, and physical functioning. Standardized health evaluations and structured interviews were used to gather information from a sample of 850 senior citizens. The data include chronic illnesses, mobility issues, cognitive decline, physical health, and mental health conditions (anxiety and depression), which are important health-related considerations taken into account. Community involvement and social support systems were also assessed in connection with QoL. The IBM SPSS software version of 30 was utilized. The descriptive statistics were implemented to connect the participant characteristics, multiple regression analysis was employed to ascertain the fostering power of health-related factors on QoL, and multivariate analysis of variance (MANOVA) was utilized to estimate the overall effect of health-related factors on several QoL dimensions. The findings show that whereas cognitive impairments are substantially associated with decreased social engagement and overall life satisfaction, health issues and mobility limits considerably impact physical and emotional well-being. To improve elder people\u27s QoL, these findings highlight the necessity of comprehensive healthcare strategies that address social, emotional, and physical well-being. Further research should explore interventions aimed at minimizing the impact of health-related factors on QoL in elderly populations

Region-based Convolutional Neural Network Driven Alzheimer’s Severity Prediction

It's important to note that Alzheimer's disease can also affect individuals over the age of 60, and in fact, the risk of developing Alzheimer's increases with age. Additionally, while deep learning approaches have shown promising results in detecting Alzheimer's disease, they are not the only techniques available for diagnosis and treatment. That being said, using Region-based Convolutional Neural Network (RCNN) for efficient feature extraction and classification can be a valuable tool in detecting Alzheimer's disease. This new approach to identifying Alzheimer's disease could lead to a more accurate and personalized diagnosis. It can also help in early treatment and intervention. However, it's still important to continue developing new methods and techniques for this disorder. Considering this our work proposes an innovative Region-based Convolutional Neural Network Driven Alzheimer’s Severity Prediction approach in this paper. The exhaustive experimental result carried out, which proves the efficacy of our Alzheimer prediction system

Autoimmune Parkinsonism: A Newer Manifestation of Contactin-Associated Protein-Like 2 Autoimmunity: A Case Report

Contactin-associated protein-like 2 (CASPR2) antibodies are part of an expanding spectrum of disorders. Although they were initially associated with Morvan’s syndrome and peripheral nerve hyperexcitability, their clinical manifestations are more varied than previously recognized. In this report, we present a rare case of a middle-aged woman who experienced gait disturbances, sleep disturbances, behavioral changes, and postural abnormalities over a period of five months. A thorough examination revealed a Parkinsonian phenotype. Considering the timeline and symptomatology, an autoimmune work-up was conducted, which detected CASPR2 antibodies in the patient’s serum. Treatment with high-dose intravenous Methylprednisolone followed by rituximab effectively reversed her clinical manifestations without residual neurological deficits

A Rare Case Of Bilateral Unicameral Bone Cyst In An Adult

Introduction: Unicameral bone cysts (UBCs) are benign cavities in immature bones, affecting 3% of bone tumors. They can weaken surrounding bones and increase fracture risk. Management varies, especially in children and adolescents. Several hypotheses exist, but cause remains elusive. Aims: The study investigates the outcomes of operative management of a pathological fracture caused by a Unicameral Bone Cyst in the proximal femur, along with the discovery of the same tumor. Methodology: A 27-year-old male patient with minor injury was diagnosed with a comminuted pathological fracture in the left intertrochanteric femur, requiring bilateral surgery to prevent future fractures. Results: The patient\u27s suture lines healed and suture removal was performed, and after 1.5 months of partial weight bearing, they were allowed full weight bearing walking by 3 months. Discussion: A 27-year-old patient with a comminuted femur fracture was found to have a bilateral unicameral bone cyst, a rare occurrence in adults, potentially contributing to structural weakness. Conclusion: This case report discusses the clinical manifestations of bilateral unicameral bone cysts, emphasizing the importance of thorough examination, MRI scans, and prophylactic surgery for accurate diagnosis

Self-regulation and expatriate adjustment:The role of regulatory fit

In this paper, we draw on the construct of regulatory fit in explaining how expatriates manage interactional and work-related discrepancies in diverse cultural contexts. When expatriates go overseas, they are often faced with a set of expectations that are at variance with their home country norms and these differences in expectations generate discrepancies. The emergence of discrepancies in an alien cultural context exacerbates the uncertainties facing the expatriate, though the response to uncertainty varies between expatriates. We posit that expatriates with a promotion-focused self-regulatory system are focused on maximizing gains leading them to manage uncertainty through experimentation whereas expatriates with a prevention-focused self-regulatory system are oriented to minimizing losses leading them to manage uncertainty by persisting with the status-quo. Utilizing insights from motivational science and by linking the self-regulatory processes to the cultural context, we develop a framework and propositions for expatriate adaptation in loose and tight cultures. We present managerial implications of our model and offer guidance for testing the framework

Co-cultivation of Curcuma longa with Piriformospora indica Enhances the Yield and Active Ingredients

The rhizome of Curcuma longa is used in the traditional medicinal system. Its secondary metabolites curcumin and the volatile oil possess wound-healing properties and inhibitory activities against certain pathogenic fungi and bacteria. Piriformospora indica is a root endophytic fungus that colonizes many plant roots and promotes the growth. P. indica was cultivated in the 5 litre capacity fermentor under standard conditions. The filtered biomass was then mixed with raw talcum powder. The propagative buds were treated with this formulation containing both sterile and inoculated fungus. We demonstrated that co- cultivation of C. longa and P. indica resulted in pronounced productivity and enhanced secondary metabolites- curcumin and volatile oil in farmers’ field. To the authors best of knowledge this is the first report where symbiotic fungus has added value to this medicinal plant in the agricultural field

Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis

Background: Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment. Methods: We did a systematic review and meta-analysis of population-based datasets relevant to global vision impairment and blindness that were published between 1980 and 2015. We fitted hierarchical models to estimate the prevalence (by age, country, and sex), in 2015, of mild visual impairment (presenting visual acuity worse than 6/12 to 6/18 inclusive), moderate to severe visual impairment (presenting visual acuity worse than 6/18 to 3/60 inclusive), blindness (presenting visual acuity worse than 3/60), and functional presbyopia (defined as presenting near vision worse than N6 or N8 at 40 cm when best-corrected distance visual acuity was better than 6/12). Findings: Globally, of the 7·33 billion people alive in 2015, an estimated 36·0 million (80% uncertainty interval [UI] 12·9–65·4) were blind (crude prevalence 0·48%; 80% UI 0·17–0·87; 56% female), 216·6 million (80% UI 98·5–359·1) people had moderate to severe visual impairment (2·95%, 80% UI 1·34–4·89; 55% female), and 188·5 million (80% UI 64·5–350·2) had mild visual impairment (2·57%, 80% UI 0·88–4·77; 54% female). Functional presbyopia affected an estimated 1094·7 million (80% UI 581·1–1686·5) people aged 35 years and older, with 666·7 million (80% UI 364·9–997·6) being aged 50 years or older. The estimated number of blind people increased by 17·6%, from 30·6 million (80% UI 9·9–57·3) in 1990 to 36·0 million (80% UI 12·9–65·4) in 2015. This change was attributable to three factors, namely an increase because of population growth (38·4%), population ageing after accounting for population growth (34·6%), and reduction in age-specific prevalence (–36·7%). The number of people with moderate and severe visual impairment also increased, from 159·9 million (80% UI 68·3–270·0) in 1990 to 216·6 million (80% UI 98·5–359·1) in 2015. Interpretation: There is an ongoing reduction in the age-standardised prevalence of blindness and visual impairment, yet the growth and ageing of the world’s population is causing a substantial increase in number of people affected. These observations, plus a very large contribution from uncorrected presbyopia, highlight the need to scale up vision impairment alleviation efforts at all levels