Diagnostic Services Research Articles

Root Cause Analysis of Increased Referral Rates in a Sub-district Hospital, Tamil Nadu: A Quality Improvement Initiative.

Background Sub-district hospitals in Tamil Nadu are critical in providing essential healthcare services, but they face significant challenges that can lead to increased patient referrals to higher-level facilities. High referral rates can overburden tertiary care centers, delay specialized treatment, and affect patient outcomes. This study aims to identify the root causes of increased referral rates in a sub-district hospital and implement targeted interventions to reduce unnecessary referrals. Methods A descriptive study was conducted at Sriperumbudur sub-district hospital in Tamil Nadu from May to August 2023. The study utilized a root cause analysis (RCA) approach, incorporating qualitative data from brainstorming sessions with healthcare providers and administrative staff, and quantitative data from hospital records on referral rates. A fishbone (Ishikawa) diagram was employed to map causal factors, and Pareto and bar charts were used to analyze and present referral trends. Interventions were implemented using the Plan-Do-Study-Act (PDSA) cycle. Results The analysis identified several key factors contributing to high referral rates, including inadequate diagnostic services, insufficient staffing, and lack of essential resources such as CT scans and blood components. Following targeted interventions, referral rates decreased significantly from 101 cases in May-June 2023 to 52 cases in July-August 2023 highlighting a reduction of over 48%. The most notable reductions were seen in referrals for road traffic accidents with head injury (38.7%) reduction, chronic kidney disease (CKD)/hypertension (HT)/diabetes mellitus (DM) (46.2%) reduction, and crush injuries (45.5%) reduction. Conclusions The RCA revealed systemic issues that were contributing to increased referral rates at the sub-district hospital. Implementing targeted interventions based on the RCA findings led to a significant reduction in referrals, improving patient care at the local level and alleviating the burden on tertiary care centers. This study underscores the importance of continuous quality improvement initiatives in strengthening healthcare delivery at the sub-district level.

Australian SLPs’ knowledge and actions regarding the early signs of autism: When does caution become gatekeeping?

Purpose Speech-language pathologists (SLPs) are often the first point of contact for families of children with autism. Despite this, little is known about SLPs’ understanding of autism and its early indicators. This study sought to investigate what Australian SLPs know about autism, the early indicators, and the actions they take when they identify these characteristics. Method A 34 question cross-sectional online survey was distributed through professional networks, social media channels, and industry contacts to Australian SLPs. Quantitative and qualitative data were analysed. Result The 70 participants worked in various contexts around the country. The majority of participants demonstrated sound knowledge of the main characteristics of autism, and some early indicators. Quantitative analysis identified a significant correlation between participant age and confidence talking to parents about possible autism. Overarching themes were identified: (a) caution may delay or prevent SLPs from taking action, (b) some factors may influence SLPs’ action, and (c) SLPs take action. Conclusion Australian SLPs working with children have the knowledge and understanding of the main characteristics of autism and some early indicators. However, they demonstrate a cautious approach around the subject of autism, and this caution may cause delays for children requiring diagnostic services.

Comparative treatment of homeless persons with an infectious disease in the US emergency department setting: a retrospective approach

BackgroundResearch has long documented the increased emergency department usage by persons who are homeless compared with their housed counterparts, as well as an increased prevalence of infectious diseases. However, there...

Health disparities among incarcerated populations: a crucial laboratory and pathology review.

The United States notoriously has one of the highest rates of incarceration in the world, yet scant attention to the health care needs of those incarcerated exists within laboratory medicine and pathology training and education. This article explores health disparities among incarcerated and released individuals regarding diagnostic laboratory testing and pathology services. A literature search was conducted for articles published between 2002 and 2023 using keywords including "healthcare," "incarcerated," "laboratory services," "pathology services," and "health insurance for prisoners." Central themes were extracted and discussed to reveal the realities of health care during and after release from incarceration. Excluded from the analysis were articles about the immediate or extended family of incarcerated persons. Incarcerated individuals have an increased risk for the development and exacerbation of communicable and noncommunicable diseases and mental health disorders, which results in exceedingly high morbidity and mortality rates. Policy changes are needed to mitigate disparities and improve health outcomes for incarcerated and released persons. Central to these disparities is decreased access to laboratory and pathology services, impeded by inadequate health care funding for these carceral institutions. Providing additional funding to the carceral system's health care budget is necessary to improve access to pathology and laboratory services.

Oral fibrolipoma in dogs: Retrospective case series study and comparative review.

Fibrolipoma is defined as a typical lipoma transected by variable amounts of paucicellular and collagenous fibrous components. Oral and lingual fibrolipomas are well-recognized histological entities in human medicine that are slightly more prevalent in females, occur most commonly after the fourth decade, and arise from the buccal mucosa. The documentation of this neoplasm in the oral cavity is lacking in veterinary medicine. Through a multi-institutional retrospective compilation of cases submitted to diagnostic pathology services, here we describe the clinical and pathologic features of oral fibrolipomas in dogs. A total of 112 cases of oral fibrolipomas in dogs were retrieved. The mean age was 10.1 years (range 2-16 years, ±2.63 years standard deviation), with an average tumor size of 1.7 cm (range 0.2-8 cm, ±1.1 cm standard deviation). The most common location was the tongue (57.1%, 64/112), followed by the buccal mucosa (15.2%, 16/112), sublingual area (8.0%, 9/112), gingiva and lip (4.5%, 5/112 each), and palate (1 case). The anatomical location of oral fibrolipomas only differed significantly among the dog breeds (P < .001) but not among sex, age, anamnesis, or reason for submission. The tumor was most commonly reported in males (69.7%, 78/112), and in 62.5% (70/112) of the cases, the tumor was an incidental finding. Fibrolipoma should be considered a differential diagnosis when considering benign lingual and other oral soft tissue masses in dogs.

Detection of pulmonary tuberculosis in the republic of Tajikistan

Objective: To study the dynamics and main reasons for the significant detection of pulmonary tuberculosis with a negative sputum test result in the Republic of Tajikistan over the past 5 years. Material and methods: An analysis of the estimated data of the WHO, as well as official statistics on TB incidence using the National TB Data Registry for 2019-2023, was carried out. Definitions of clinically established cases of pulmonary TB are noted. Information is presented on the introduction of the express PCR method of bacteriological verification of TB diagnosis in all regions of the country. Results: Over the past 5 years (2019-2023), WHO estimates on TB incidence in the Republic of Tajikistan have significantly decreased, indicating improved accessibility of the population to specialized anti-TB services. At the same time, during the COVID period (2019-2020), the prognosis was more unfavorable due to deteriorating accessibility to medical and social services than in the post-COVID period (2021-2023). At the same time, official statistics on the detection of new TB cases indicate the opposite dynamics: during the COVID period, the number of TB patients sharply decreased from 5976 to 4299 cases that is, by 1677 cases (more than 28%) and began to gradually increase in subsequent years, but has not yet reached the pre-COVID level. At the same time, in proportion to the indicated data, the number of clinically established cases of pulmonary TB decreased during the COVID period from 1422 to 720 cases (2019-2021), that is, almost twofold, and in the following years (2022-2023) began to gradually increase, still not reaching the pre-COVID period. Conclusion: Thus, despite the active introduction of new innovative methods for verifying the diagnosis of TB and improving the population's access to diagnostic services, including molecular genetic methods for rapid diagnostics of both sensitive and drug-resistant forms of TB, the proportion of clinically established cases of pulmonary TB remains high (34% of all pulmonary forms of TB) and tends to increase.

Prediction of Hearing Help Seeking to Design a Recommendation Module of an mHealth Hearing App: Intensive Longitudinal Study of Feature Importance Assessment.

Mobile health (mHealth) solutions can improve the quality, accessibility, and equity of health services, fostering early rehabilitation. For individuals with hearing loss, mHealth apps might be designed to support the decision-making processes in auditory diagnostics and provide treatment recommendations to the user (eg, hearing aid need). For some individuals, such an mHealth app might be the first contact with a hearing diagnostic service and should motivate users with hearing loss to seek professional help in a targeted manner. However, personalizing treatment recommendations is only possible by knowing the individual's profile regarding the outcome of interest. This study aims to characterize individuals who are more or less prone to seeking professional help after the repeated use of an app-based hearing test. The goal was to derive relevant hearing-related traits and personality characteristics for personalized treatment recommendations for users of mHealth hearing solutions. In total, 185 (n=106, 57.3% female) nonaided older individuals (mean age 63.8, SD 6.6 y) with subjective hearing loss participated in a mobile study. We collected cross-sectional and longitudinal data on a comprehensive set of 83 hearing-related and psychological measures among those previously found to predict hearing help seeking. Readiness to seek help was assessed as the outcome variable at study end and after 2 months. Participants were classified into help seekers and nonseekers using several supervised machine learning algorithms (random forest, naïve Bayes, and support vector machine). The most relevant features for prediction were identified using feature importance analysis. The algorithms correctly predicted action to seek help at study end in 65.9% (122/185) to 70.3% (130/185) of cases, reaching 74.8% (98/131) classification accuracy at follow-up. Among the most important features for classification beyond hearing performance were the perceived consequences of hearing loss in daily life, attitude toward hearing aids, motivation to seek help, physical health, sensory sensitivity personality trait, neuroticism, and income. This study contributes to the identification of individual characteristics that predict help seeking in older individuals with self-reported hearing loss. Suggestions are made for their implementation in an individual-profiling algorithm and for deriving targeted recommendations in mHealth hearing apps.

Multimorbidity patterns and the risk of falls among older adults: a community-based study in China

BackgroundDue to the high prevalence of multimorbidity and realistic health service demands for fall prevention, there is growing interest in the association between multimorbidity and falls. Our study aimed to identify multimorbidity patterns among Chinese older adults and explore the association between multimorbidity patterns and falls.MethodsData from 4,579 Chinese community-dwelling older adults was included in this analysis. Information regarding falls and 10 chronic conditions was collected. An exploratory factor analysis was performed to determine multimorbidity patterns. Regression models were fitted to explore the associations of individual chronic disease or multimorbidity patterns with falls.ResultsAmong 4,579 participants, 368 (8.0%) were defined as fallers, including 92 (2.0%) frequent fallers, and multimorbidity affected 2,503 (54.7%) participants. Older adults with multimorbidity were more likely to be fallers [odds ratio (OR) = 1.3, P = 0.02] and frequent fallers (OR = 1.7, P = 0.04). Three multimorbidity patterns were identified (i.e., cardiovascular-metabolic diseases, psycho-cognitive diseases and organic diseases), and the associations between psycho-cognitive diseases/organic diseases and prevalent falls or frequent falls were found to be significant.ConclusionsThe psycho-cognitive disease pattern and organic disease pattern are significantly associated with falls. Therefore, more attention should be paid to patients with psycho-cognitive diseases and timely, targeted diagnostic and treatment services should be provided in fall prevention.

Catastrophic out-of-pocket payments related to non-communicable disease multimorbidity and associated factors, evidence from a public referral hospital in Addis Ababa Ethiopia

BackgroundIn low and middle-income countries (LMICs), non-communicable diseases (NCDs) are on the rise and have become a significant cause of mortality. Unfortunately, accessing affordable healthcare services can prove to be challenging for individuals who are unable to bear the expenses out of their pockets. For NCDs, the treatment costs are already high, and being multimorbid further amplifies the economic burden on patients and their families. The present study seeks to bridge the gap in knowledge regarding the financial risks that come with NCD multimorbidity. It accomplishes this by examining the catastrophic out-of-pocket (OOP) expenditure levels and the factors that contribute to it at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia.MethodsA facility-based cross-sectional study was conducted at Tikur Anbesa Specialized Hospital between May 18 and July 22, 2020 and 392 multimorbid patients participated. The study participants were selected from the hospital’s four NCD clinics using systematic random sampling. Patients’ direct medical and non-medical out-of-pocket (OOP) expenditures were recorded, and the catastrophic OOP health expenditure for NCD care was estimated using various thresholds as cutoff points (5%, 10%, 15%, 20%, 25%, and 40% of both total household consumption expenditure and non-food expenditure). The collected data was entered into Epi Data version 3.1 and analyzed using STATA V 14. Descriptive statistics were utilized to present the study’s findings, while logistic regression was used to examine the associations between variables.ResultsA study was conducted on a sample of 392 patients who exhibited a range of socio-demographic and economic backgrounds. The annual out-of-pocket spending for the treatment of non-communicable disease multimorbidity was found to be $499.7 (95% CI: $440.9, $558.6) per patient. The majority of these expenses were allocated towards medical costs such as medication, diagnosis, and hospital beds. It was found that as the threshold for spending increased from 5 to 40% of total household consumption expenditure, the percentage of households facing catastrophic health expenditures (CHE) decreased from 77.55 to 10.46%. Similarly, the proportion of CHE as a percentage of non-food household expenditure decreased from 91.84 to 28.32% as the threshold increased from 5 to 40%. The study also revealed that patients who traveled to Addis Ababa for healthcare services (AOR = 7.45, 95% CI: 3.41–16.27), who were not enrolled in an insurance scheme (AOR = 4.97, 95% CI: 2.37, 10.4), who had more non-communicable diseases (AOR = 2.05, 95% CI: 1.40, 3.01), or who had more outpatient visits (AOR = 1.46, 95%CI: 1.31, 1.63) had a higher likelihood of incurring catastrophic out-of-pocket health expenditures at the 40% threshold.Conclusion and recommendationThis study has revealed that patients with multiple non-communicable diseases (NCDs) frequently face substantial out-of-pocket health expenditures (CHE) due to both medical and non-medical costs. Various factors, including absence from an insurance scheme, medical follow-ups necessitating travel to Addis Ababa, multiple NCDs and outpatient visits, and utilization of both public and private facilities, increase the likelihood of incurring CHE. To mitigate the incidence of CHE for individuals with NCD multimorbidity, an integrated NCD care service delivery approach, access to affordable medications and diagnostic services in public facilities, expanded insurance coverage, and fee waiver or service exemption systems should be explored.

Clinicopathologic findings and causes of mortality in 100 pet rabbits from the Canary Islands, Spain, 2011-2022.

The European domestic rabbit (Oryctolagus cuniculus domesticus) is commonly kept as a pet, with increasing popularity among pet owners. Despite the increasing body of information on lagomorph medicine and pathology, comprehensive published compilations of causes of mortality in pet rabbits are limited. We analyzed health disorders, pathology findings, and most probable causes of death in 100 pet rabbits submitted to the Anatomopathological Diagnostic Service of the Veterinary School of the University of Las Palmas de Gran Canaria, Canary Islands, Spain, from 2011 to 2022. We reviewed clinical data and gross and histopathologic findings to classify the various disorders into infectious (n = 39), noninfectious (n = 45), and idiopathic conditions (n = 16). Within infectious disease processes, Encephalitozoon cuniculi infection (n = 14) and rabbit hemorrhagic viral disease (n = 14) had the highest prevalence. Regarding the noninfectious conditions, perioperative mortality (n = 10), gastrointestinal syndrome (n = 7), and trauma (n = 6) were the most common clinicopathologic entities observed.

Specialty economies of scope in English hospitals: Cost Arguments for colocation

ObjectiveCurrent policy responses to COVID-19 disruption and care backlogs suggest potential changes to the location and structure of hospital healthcare supply. However, few studies investigating the cost effects of hospital reorganisation consider changes in the mix of outputs or test for the existence of economies of scope in hospital healthcare. Attempts to create dedicated hubs to address healthcare demand backlogs could have unintended adverse cost effects where these are provided outside existing hospital arrangements. To evaluate this, we investigate the existence and size of economies of scope in English hospital healthcare. DataWe use cost and activity data from the English NHS, linked to aggregated staff wage information and information taken from hospital financial statements. Cost and activity data was obtained from NHS England's Costing Publications. Wage data was extracted from the NHS's Electronic Staff Record via the NHS England Workforce Statistics Team, and published hospital financial accounts were aggregated and linked together at the organisation level. ResultsGeneral Surgery exhibited positive economies of scope when provided alongside other healthcare, as to a lesser extent did General Medicine and Obstetric/Gynaecology healthcare. There was little evidence for economies of scope in Diagnostic and Pathology services, Orthopaedics, or Emergency Care. Few (2/28) output cross-products (cost complementarities) were statistically significant, but Baumol's wider definition of scope economies demonstrates that scope economies are present in some specialties. ConclusionPolicymakers seeking to maximise the amount of healthcare provided and minimise the costs of doing so may wish to consider retaining General Surgery, General Medicine and Obstetric/Gynaecology healthcare supply alongside the provision of other clinical specialties. There is limited evidence that reconfiguring supply by centralizing other specialty groups into fewer providers would increase costs.

Status and future prospects for mobile phone-enabled diagnostics in Tanzania.

Diagnosis is a key step towards the provision of medical intervention and saving lives. However, in low- and middle-income countries, diagnostic services are mainly centralized in large cities and are costly. Point of care (POC) diagnostic technologies have been developed to fill the diagnostic gap for remote areas. The linkage of POC testing onto smartphones has leveraged the ever-expanding coverage of mobile phones to enhance health services in low- and middle-income countries. Tanzania, like most other middle-income countries, is poised to adopt and deploy the use of mobile phone-enabled diagnostic devices. However, there is limited information on the situation on the ground with regard to readiness and capabilities of the veterinary and medical professionals to make use of this technology. In this study we survey awareness, digital literacy and prevalent health condition to focus on in Tanzania to guide development and future implementation of mobile phoned-enable diagnostic tools by veterinary and medical professionals. Data was collected using semi-structured questionnaire with closed and open-ended questions, guided in-depth interviews and focus group discussion administered to the participants after informed consent was obtained. A total of 305 participants from six regions of Tanzania were recruited in the study. The distribution of participants across the six regions was as follows: Kilimanjaro (37), Arusha (31), Tabora (68), Dodoma (61), Mwanza (58), and Iringa (50). Our analysis reveals that only 48.2% (126/255) of participants demonstrated significant awareness of mobile phone-enabled diagnostics. This awareness varies significantly across age groups, professions and geographical locations. Interestingly, while 97.4% of participants own and can operate a smartphone, 62% have never utilized their smartphones for health services, including disease diagnosis. Regarding prevalent health condition to focus on when developing mobile phone -enabled diagnostics tools for Tanzania; there was disparity between medical and veterinary professionals. For medical professionals the top 4 priority diseases were Malaria, Urinary Tract Infections, HIV and Diabetes, while for veterinary professionals they were Brucellosis, Anthrax, Newcastle disease and Rabies. Despite the widespread ownership of smartphones among healthcare providers (both human and animal), only a small proportion have utilized these devices for healthcare practices, with none reported for diagnostic purposes. This limited utilization may be attributed to factors such as a lack of awareness, absence of policy guidelines, limited promotion, challenges related to mobile data connectivity, and adherence to cultural practices. The majority of medical and veterinary professionals in Tanzania possess the necessary digital literacy to utilize mobile phone-enabled diagnostics and demonstrate readiness to adopt digital technologies and innovations to enhance diagnosis. However, effective implementation will require targeted training and interventions to empower them to effectively apply such innovations for disease diagnosis and other healthcare applications.

Colorectal cancer risk stratification using a polygenic risk score in symptomatic primary care patients-a UK Biobank retrospective cohort study.

Colorectal cancer (CRC) is a leading cause of cancer mortality worldwide. Accurate cancer risk assessment approaches could increase rates of early CRC diagnosis, improve health outcomes for patients and reduce pressure on diagnostic services. The faecal immunochemical test (FIT) for blood in stool is widely used in primary care to identify symptomatic patients with likely CRC. However, there is a 6-16% noncompliance rate with FIT in clinic and ~90% of patients over the symptomatic 10 µg/g test threshold do not have CRC. A polygenic risk score (PRS) quantifies an individual's genetic risk of a condition based on many common variants. Existing PRS for CRC have so far been used to stratify asymptomatic populations. We conducted a retrospective cohort study of 50,387 UK Biobank participants with a CRC symptom in their primary care record at age 40+. A PRS based on 201 variants, 5 genetic principal components and 22 other risk factors and markers for CRC were assessed for association with CRC diagnosis within 2 years of first symptom presentation using logistic regression. Associated variables were included in an integrated risk model and trained in 80% of the cohort to predict CRC diagnosis within 2 years. An integrated risk model combining PRS, age, sex, and patient-reported symptoms was predictive of CRC development in a testing cohort (receiver operating characteristic area under the curve, ROCAUC: 0.76, 95% confidence interval: 0.71-0.81). This model has the potential to improve early diagnosis of CRC, particularly in cases of patient noncompliance with FIT.

An App for Navigating Patient Transportation and Acute Stroke Care in Northwestern Ontario Using Machine Learning: Retrospective Study.

A coordinated care system helps provide timely access to treatment for suspected acute stroke. In Northwestern Ontario (NWO), Canada, communities are widespread with several hospitals offering various diagnostic equipment and services. Thus, resources are limited, and health care providers must often transfer patients with stroke to different hospital locations to ensure the most appropriate care access within recommended time frames. However, health care providers frequently situated temporarily (locum) in NWO or providing care remotely from other areas of Ontario may lack sufficient information and experience in the region to access care for a patient with a time-sensitive condition. Suboptimal decision-making may lead to multiple transfers before definitive stroke care is obtained, resulting in poor outcomes and additional health care system costs. We aimed to develop a tool to inform and assist NWO health care providers in determining the best transfer options for patients with stroke to provide the most efficient care access. We aimed to develop an app using a comprehensive geomapping navigation and estimation system based on machine learning algorithms. This app uses key stroke-related timelines including the last time the patient was known to be well, patient location, treatment options, and imaging availability at different health care facilities. Using historical data (2008-2020), an accurate prediction model using machine learning methods was developed and incorporated into a mobile app. These data contained parameters regarding air (Ornge) and land medical transport (3 services), which were preprocessed and cleaned. For cases in which Ornge air services and land ambulance medical transport were both involved in a patient transport process, data were merged and time intervals of the transport journey were determined. The data were distributed for training (35%), testing (35%), and validation (30%) of the prediction model. In total, 70,623 records were collected in the data set from Ornge and land medical transport services to develop a prediction model. Various learning models were analyzed; all learning models perform better than the simple average of all points in predicting output variables. The decision tree model provided more accurate results than the other models. The decision tree model performed remarkably well, with the values from testing, validation, and the model within a close range. This model was used to develop the "NWO Navigate Stroke" system. The system provides accurate results and demonstrates that a mobile app can be a significant tool for health care providers navigating stroke care in NWO, potentially impacting patient care and outcomes. The NWO Navigate Stroke system uses a data-driven, reliable, accurate prediction model while considering all variations and is simultaneously linked to all required acute stroke management pathways and tools. It was tested using historical data, and the next step will to involve usability testing with end users.

Study of Inflammatory Bowel Disease in Patients Undergoing Colonoscopy at a Tertiary Center of Nepal.

Introduction Inflammatory bowel disease (IBD) is a chronic inflammatory condition of thegastrointestinal tract that includes ulcerative colitis (UC) and Crohn's disease (CD). The incidence and prevalence ofdisease are on a rising trend. Increasedcase detection is related tobetterhealth awareness andimprovedavailability of diagnostic services in the community. This articleaims to calculate the incidence of IBD per 1,000 colonoscopies per yearandto study the clinical and demographic characteristics of patients with IBD. Methodology It was a prospective observational study done at the National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal, from March 2023 to February 2024.All the patients who underwent colonoscopy during the study period were assessed for possible diagnosis of IBD. TheIncidence rate was calculated as new IBD cases per 1,000 colonoscopies per year. Demographic and clinical profiles of the patients were collected. Results Among 1,248 patients who underwent colonoscopy during the study period, IBD was detected in 52 patients (4.16%). UC was diagnosed in 43 patients and the incidence rate of it was calculated to be 34.4 casesper 1,000 colonoscopies per year. Similarly, CD was diagnosed in nine patients with its incidence rate being 7.2 cases per 1,000 colonoscopies per year. Disease was predominantly seen in females (F:M ratio - 1.36:1). The mean age at diagnosis of IBD was 39.67 ± 14.53 years, with patients with CD being slightly younger than those with UC. The majority of patients with UC had pancolitis. The median time todiagnosis from symptom onset was three years (range: 6 months to 7 years) for CD and 10 months for patients with UC (range: 2 months to 5 years). The most common extra-intestinal manifestations were arthralgia (11, 21.15%) and arthritis (7, 13.46%). Traditional drugs like mesalamine, prednisolone, and azathioprine were commonly prescribed. Biologics were used only in two (3.84%) patients, including infliximab and adalimumab. Janus kinase inhibitor (tofacitinib) was used in three(5.76%) patients in cases of acute severe UC. Conclusions Due to the rising trend of awareness in health and availability of colonoscopyservices in our country like Nepal, the incidence of IBD is seen to be quite high. UC was seen more commonly than CD, and females were predominantly involved. The majority of patients belonged to the young and middle-aged population.The majority of patients with UC had extensive colitis, while patients with CD had ileo-colonic disease with non-stricturing, non-penetrating phenotypes. Arthralgia and arthritis were the most common extra-intestinal manifestations. Conventional drugs like mesalamine, prednisolone, and immunomodulators such as azathioprine were mostly used. The use of biologics was fairly low. This study certainly contributes to the existing literature from Nepal regarding IBD.

Towards improving stroke services in Africa: Results from the Africa-UK Stroke Partnership [AUKSP] surveys

BackgroundThe African Stroke Organization (ASO) in partnership with the University of Central Lancashire's Stroke Research Team launched the Africa-UK Stroke Partnership (AUKSP). AUKSP undertook two (stroke expert and hospital Stroke Unit (SU)) on-line surveys mapping existing capacity and capability to deliver African stroke care. MethodsAn on-line expert survey tool was sent to 139 stroke experts in 54 African countries October 2021-March 2022 and the hospital SU survey to 120 hospital SUs (identified from the expert survey) June-October 2022. Both survey tools were prepared according to the World Stroke Organisation's Roadmap for Delivering Quality Stroke Care. Completed responses were exported from Qualtrics into Microsoft excel and were analysed descriptively. ResultsForty-five expert responses and 62 hospital SU responses were analysed, representing 54(87%) public hospitals, 7(11%) private and 1(2%) charitable organization. In both surveys, three main priorities for improvement of stroke services were: a rapid and prompt stroke diagnosis; effective primary and secondary stroke prevention, and acute stroke management. Survey findings suggest that there is a low presence of national stroke surveillance systems and registries, and heterogeneity in availability of diagnostic services, SUs, endovascular treatments, and rehabilitation. ConclusionSignificant gaps exist in Africa's capacity and capability to deliver essential elements of effective and quality stroke care. Tackling these challenges requires urgent and sustained multi-stakeholder action including: government, administrators, policy makers and other partners. Our survey findings highlight key priority areas for multi-stakeholder engagement and crafting of a pragmatic, prioritized and context-sensitive African Stroke Action Plan.

Evaluating the gap in rapid diagnostic testing: insights from subnational Kenyan routine health data

BackgroundUnderstanding diagnostic capacities is essential to addressing healthcare provision and inequity, particularly in low-income and middle-income countries. This study used routine data to assess trends in rapid diagnostic test (RDT)...

Research on the application of statistical methods based on big data in the medical and health field

In the current era of information, the rise of big data technology has become a key force driving the development of the medical and health field. Statistical methods, as core tools for data analysis, have demonstrated unique advantages in processing vast medical datasets. This paper comprehensively analyzes the various applications of big data statistical methods in the medical and health field, focusing particularly on their practical effects and potential value in disease prediction, epidemiological research, medical resource optimization, and personalized medical services. Through a review of relevant literature and in-depth discussions of multiple cases, this paper reveals how statistical methods play a crucial role in improving diagnostic accuracy and medical service efficiency. It also addresses the challenges faced in actual applications, such as data privacy protection and technical standardization.

Health2Home – Mapping home-based diagnostic imaging services around the world: A market research

Health2Home – Mapping home-based diagnostic imaging services around the world: A market research

User satisfaction with an imaging diagnostic service performed at home

User satisfaction with an imaging diagnostic service performed at home