Medical Disability Research Articles

Using Brain Waves and Computer Interface Technology as a Communication System

ABSTRACT Introduction The existing methods for individual emergency alert systems often rely on physical or voice-based human intervention, which may not be practical or safe in certain emergency situations or for people with certain rare medical conditions or disabilities. Popular voice command programs such as Siri and Alexa can be loud, drawing unwanted attention. Additionally, existing devices are limited to indoor usage, lack portability, involve multiple wires, have low noise tolerance, and offer limited customization options. This study introduces a novel method for emergency alert using brain waves. Method An electroencephalography (EEG) headset device was used to capture the user’s brain waves. After calibration, the device identifies peak brain signals and stores them for future use. When a command is triggered, the device’s Bluetooth functionality communicates with a dedicated application installed on any digital device. The user can use their thoughts to select a predefined command within the application, which is then transmitted to any local WiFi network or internet connection. Results Overall, this pilot study achieved a success rate of 96–98% for receiving the brain-computer interface (BCI) commands and sending the appropriate SMS text messages. Conclusion By leveraging these technologies, disabled individuals may access and use new technologies, starting with the ability to text message using their mind.

INNV-03. BEYOND ANALGESICS: PHOTOBIOMODULATION THERAPY AS A PARADIGM SHIFT IN PAIN MANAGEMENT

Abstract BACKGROUND Pain constitutes a primary cause of medical care demand and disability among patients. The predominant method employed for pain management entails analgesic administration. Nonetheless, prolonged use of analgesics may lead to adverse effects, including cardiovascular and gastrointestinal complications. Photobiomodulation therapy (PBMT) emerges as a novel approach to pain treatment, demonstrating effective pain reduction and anti-inflammatory properties. This systematic review aims to elucidate the impacts of PBMT on pain modulation and assess its potential for widespread application. METHODS A systematic review was conducted utilizing Boolean operators combining terms such as “Photobiomodulation” AND “Pain Management”; “Photobiomodulation therapy” AND “pain”; “PBMT” AND “Pain”. Electronic databases including Cochrane Library, PubMed, and Scopus were searched. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement. RESULTS The systematic review revealed that PBMT is a non-invasive, safe, and cost-effective technique for pain management. It has demonstrated efficacy across various conditions, encompassing neurological and musculoskeletal disorders. PBMT can complement existing interventions such as exercise programs, transcutaneous electrical nerve stimulation (TENS), or surgical procedures. However, further research with long-term follow-up is warranted to validate these findings. CONCLUSIONS PBMT emerges as a promising modality for pain management, offering a non-invasive alternative with favorable safety profiles. Its efficacy in diverse conditions underscores its potential utility as an adjunctive or standalone treatment option. Nonetheless, additional studies with extended follow-up periods are necessary to confirm and further elucidate its therapeutic benefits.

QOL-03. CAREGIVER PROGRAM IN NEURO-ONCOLOGY: UCSF EXPERIENCE CARING FOR MORE THAN 4,000 CAREGIVERS OVER THE LAST 10 YEARS

Abstract BACKGROUND Caregivers of patients with primary brain tumors are at high risk for distress as they navigate caring for their loved one with both a cancer diagnosis and neurologic disorder. The UCSF Gordon Murray Neuro-Oncology Program, the first of its kind, addresses caregiver needs and is fully integrated into clinical care, providing personalized care and programming to address common challenges and foster resilience. The Program includes a nurse, administrator, and social worker. Referrals occur at the initial clinic appointment; from clinical staff; and caregivers of patients with GBM receive proactive outreach. Dedicated programming provides educational materials around common concerns and building community through support groups, annual retreats and family camp. We report our practical experience of the Program serving over 4,000 caregivers. METHODS Total number of individual caregivers were included from 01/2014 – 12/2023. Detailed demographics were extrapolated during clinical interviews from a subset. Caregiver concerns and interventions were extracted from the medical records between 01/2017 – 12/2023. RESULTS The Program serves an average of 400 caregivers and 800 encounters annually. Demographics revealed 66% females; 77% between 41-64 years of age; 60% spouse; 89% working full time; and 30% with children at home. The most common concerns were informational (42%), followed by emotional (25%), and practical (23%). Examples of informational concerns included desire for resources, understanding treatment plan/side effects, and patient behavioral changes. Emotionally, they feel overwhelmed, uncertain, and sad. Practical concerns included physically caring for patients and issues around medical insurance, disability, and finances. Most common intervention was providing emotional support (40%). CONCLUSIONS Caregivers of patients with primary brain tumors are at high risk of distress and have unique needs. Our practical 10 year experience of a dedicated, fully integrated, caregiver program highlights real world concerns of caregivers and identifies opportunities to develop tailored interventions to address these needs.

OS02.4.A CAREGIVER PROGRAM IN NEURO-ONCOLOGY: UCSF EXPERIENCE CARING FOR MORE THAN 4,000 CAREGIVERS OVER THE LAST 10 YEARS

Abstract BACKGROUND Caregivers of patients with primary brain tumors are at high risk for distress and as they navigate caring for their loved one with both a cancer diagnosis and neurologic disorder. The last decade has seen growth of caregiver research in the brain tumor community, with evidence that caregiver mastery may correlate with survival in patients with glioblastoma (GBM). The UCSF Gordon Murray Neuro-Oncology Program, the first of its kind, launched in 2014 with a mission to address their unique needs. Caregiver care is now fully integrated into the clinical care of patients with brain tumors at UCSF, providing personalized care across the disease trajectory and programming to address common challenges and foster resilience. The Program includes a nurse, administrator, and social worker. Referrals occur 1) at first clinic appointment; 2) from clinical staff; and 3) caregivers of patients with GBM receive proactive outreach over the first 6 months after diagnosis. Caregivers are also contacted for bereavement support. Dedicated programming provides educational materials focusing on common concerns and building community through monthly support groups, educational webinars, annual retreats and family camp. We report our practical experience of the Program serving over 4,000 caregivers since its inception. MATERIAL AND METHODS Total number of individual caregivers were included from 01/2014 - 12/2023. Detailed demographic information was extrapolated during clinical interviews from a subset. Information regarding caregiver concerns and interventions was extracted from the medical records between 01/2017 - 12/2023. RESULTS The UCSF Gordon Murray Caregiver serves an annual average of 400 caregivers and over 800 encounters. Demographic information obtained from a subset revealed 66% females; 77% between 41-64 years of age; 60% a spouse; 89% working full time; and 30% had children in the home. The most common concerns for caregivers were informational (42%), followed by emotional (25%), and practical (23%). Examples of informational concerns included desire for informational resources, understanding the treatment plan/side effects, and understanding patient behavioral changes. Emotionally, they feel overwhelmed, uncertain, and sad. Practical concerns included physically caring for patients and issues around medical insurance, disability, and finances. Caregivers also expressed frequent concerns around talking with children/family members and feelings of isolation. CONCLUSION Caregivers of patients with primary brain tumors are at high risk of distress and have unique needs based on the tumor location and symptoms from treatment. Our practical 10 year experience of a dedicated, fully integrated, caregiver program highlights real world concerns of caregivers and identifies opportunities to develop tailored interventions to address these needs.

The Absence of Typical Stroke Symptoms and Risk Factors Represents the Greatest Risk of an Incorrect Diagnosis in Stroke Patients.

Stroke is one of the most misdiagnosed conditions that causes serious medical disabilities. Its early and accurate diagnosis by the emergency team is crucial for the patient's survival. This study aimed to determine the percentage of brain strokes incorrectly diagnosed by paramedic teams and to analyze the factors influencing incorrect diagnoses. The data of 103 patients, mean age of 68.4 ± 14.96 years, admitted in 2019 to hospital emergency departments of the two hospitals in Olsztyn, Poland, were analyzed retrospectively. All patient data were obtained from their information cards. The parameters of the patients misdiagnosed and accurately diagnosed by paramedics were analyzed with Odds Ratio (OR) calculations using IBM SPSS version 23 software. Stroke and transient ischemic attack were recognized in 77 cases (74.8%). In 26 patients (25.2%), the diagnosis made in the ambulance differed from that made in the hospital ward. The analysis of the Odds Ratio (OR) has shown that typical stroke risk factors, if present in a patient, facilitate the correct diagnosis. The greatest source of misdiagnosis of stroke by the paramedic team was the lack of hemiplegia (OR = 6.0). The absence of typical stroke risk factors and neurological stroke symptoms, such as smoking, hemiplegia, aphasia, hypercholesterolemia, arrhythmia, diabetes or a drooping corner of the mouth, constitutes a high risk of misdiagnosing stroke by the paramedic team.

Evaluating Joint Angle Data for Clinical Assessment Using Multidimensional Inverse Kinematics with Average Segment Morphometry.

Movement analysis is a critical tool in understanding and addressing various disabilities associated with movement deficits. By analyzing movement patterns, healthcare professionals can identify the root causes of these alterations, which is essential for preventing, diagnosing, and rehabilitating a broad spectrum of medical conditions, disabilities, and injuries. With the advent of affordable motion capture technologies, quantitative data on patient movement is more accessible to clinicians, enhancing the quality of care. Nonetheless, it is crucial that these technologies undergo rigorous validation to ensure their accuracy in collecting and monitoring patient movements, particularly for remote healthcare services where direct patient observation is not possible. In this study, motion capture technology was used to track upper extremity movements during a reaching task presented in virtual reality. Kinematic data was then calculated for each participant using a scaled dynamic inertial model. The goal was to evaluate the accuracy of joint angle calculations using inverse kinematics from motion capture relative to the typical movement redundancy. Shoulder, elbow, radioulnar, and wrist joint angles were calculated with models scaled using either direct measurements of each individual's arm segment lengths or those lengths were calculated from individual height using published average proportions. The errors in joint angle trajectories calculated using the two methods of model scaling were compared to the inter-trial variability of those trajectories. The variance of this error was primarily within the normal range of variability between repetitions of the same movements. This suggests that arm joint angles can be inferred with good enough accuracy from motion capture data and individual height to be useful for the clinical assessment of motor deficits.

Differences in the Oral Health of Children With Medical Complexity

ObjectiveChildren with medical complexity (CMC), a subgroup of children with special health care needs (CSHCN) with the most serious medical conditions and disabilities, are at risk for negative effects from poor oral health. CSHCN have high rates of poor oral health, including cavities. This study aimed to compare oral health status between CMC and CSHCN. MethodsThis was a cross-sectional analysis of the 2016–17 National Survey of Child Health data. CMC and CSHCN were identified using validated algorithms. The primary outcome was oral health status; secondary outcomes included dental service use. Bivariate analyses compared the prevalence and service use by medical complexity status. Multivariable logistic regression assessed oral health outcomes by complexity, adjusting for influencing variables. ResultsOf 16,178 CSHCN ages 1 to 17 years, 6% were CMC and 94% were non-CMC CSHCN. Compared to CSHCN, CMC had a higher prevalence of fair/poor teeth conditions (19% vs 9%; P < 0.001) and higher odds for fair/poor teeth conditions after adjusting for socioeconomic factors (aOR: 1.54; 95% CI: 1.01–2.34). There was no statistically significant difference between groups when assessing cavities, toothache, or receipt of most preventive dental services. ConclusionsOne in 5 CMC are reported by caregivers as having poor oral health, including cavities, despite high rates of receiving preventive dental services. After adjusting for socioeconomic factors, medical complexity remained associated with fair or poor teeth conditions. Understanding potentially modifiable targets could further help families of CMC prioritize dental needs and potentially reduce negative effects on overall health.

Recent Advances In Interventional Pain Management

Introduction: Due to limited access to therapy, 60 million individuals worldwide suffer from chronic pain, with a frequency of 20–25% in some nations. Low- and middle-income countries (LMICs) are disproportionately affected by this condition. The yearly cost of diabetes, cancer, and heart disease—including medical expenses, lost productivity, and disability programs—is less than that of pain complaints. Pain management techniques, the most recent discoveries in pain research, and the most recent advancements in pain therapy technology can work together to reduce the prevalence of chronic pain and lessen the financial burden that comes with pain syndrome. Objective: To determine the extent to which the latest technological developments in interventional pain management to personalized treatment techniques according to patient complaints and conditions. The scope of technological development here is not only pain intervention techniques but also advances in understanding the pathophysiology of pain, nerve and tissue regeneration, as well as the modalities of technology used for pain interventions. Review: By conducting literature searches including journals, systematic reviews, library surveys, and case reports from the last 10 years on the latest interventional pain management techniques and serial cases. Summary: Many new minimally invasive pain intervention techniques have been developed and used in the treatment of chronic pain within the past 10 years. The necessity for standardization of processes, safety, efficacy, cost, and accessibility to new technology and techniques are among the issues and debates surrounding technical advancements and strategies for managing chronic pain. Intervention pain management techniques have grown in importance as a less intrusive method of treating chronic pain. For optimal outcomes, used in conjunction with other pain management modalities such as medication, physical therapy, cognitive behavioral change therapy, and others.

Exploring Outcomes and Mediating Factors Following Supercharged End-to-Side Anterior Interosseous Nerve to Ulnar Nerve Transfer: A Scoping Review With Expert Insight

This scoping review with expert insight aims to map outcome measures following supercharged end-to-side anterior interosseous nerve to ulnar nerve transfer procedures, integrating clinical, patient-reported, and electrodiagnostic measures. It also explores surgical rationale and recovery trajectories, aiming to standardize methodologies and enhance patient care in nerve transfer surgeries. Our search encompassed multiple online databases, including MEDLINE, Embase, PubMed, and Google Scholar, ensuring rigor and comprehensiveness in identifying relevant literature. Through scrutiny of 17 studies involving 300 patients from 300 articles, along with expert consultations on supercharged end-to-side nerve transfer for ulnar nerve entrapment, promising outcomes emerge, particularly in cubital tunnel syndrome. Primary measures such as Medical Research Council scale assessments and Disabilities of the Arm, Shoulder, and Hand scores demonstrate notable postsurgery improvements, with minor complications noted. Factors influencing recovery include preoperative dysfunction duration and surgical technique. Surgery indications prioritize high ulnar nerve injuries and severe cubital tunnel syndrome. The review highlights the importance of standardized outcome measures, early intervention, and comprehensive rehabilitation for optimizing supercharged end-to-side anterior interosseous nerve to ulnar nerve transfer outcomes. Therapeutic IIIa.

Medical traumatic stress: Integrating evidence-based clinical applications from health and trauma psychology.

Medical events in both childhood and adulthood, including components of the illness or injury and subsequent medical intervention, recovery, and disability, are increasingly being recognized as potentially traumatic. There has been an increased focus on scholarly work related to medical trauma and medically induced posttraumatic stress disorder (PTSD). Existing evidence suggests that trauma-focused treatment can promote both physical and psychological recovery. However, there continues to be a dearth of clinical guidance on how to (a) best identify and treat prior trauma exposure that complicates adjustment to illness and increases the risk for medically induced PTSD and (b) address medically induced PTSD while concurrently targeting health-related concerns (e.g., pain, adjustment to illness, acquired disability) that may negatively impact recovery. Originally presented as a premeeting institute at the 2023 Annual Meeting of the International Society for Traumatic Stress Studies, this paper describes the biopsychosocial impacts of medical trauma on adults and considerations for assessment and intervention in both traditional trauma and integrated care settings. This includes clinical applications, including assessment, case conceptualization, and health and rehabilitation interventions, that can promote health-related adjustment and coping within the context of trauma-focused treatment.

Parents’ experiences of family and daily life after their child’s stay in the pediatric intensive care unit: a qualitative descriptive study

IntroductionThe stay of a critically ill child in a pediatric intensive care unit (PICU) is a significant experience for the family. Thus far, little is known regarding the impact of this stay on parents and their healthy children for whom no continuous aftercare services are offered. This study aimed to capture the post-stay experience and needs of parents after this traumatic event so that they could return to family and everyday life.MethodsThis qualitative descriptive study was conducted in collaboration with four pediatric intensive care units in Switzerland. It included parents whose children had fully recovered after a stay and who did not require continuous medical follow-up. All children were hospitalized in the PICU for at least 48 h. Data were collected through narrative pairs (n = 6) and individual interviews (n = 8). Interviews were audio recorded, transcribed, coded inductively according to Saldaña, and analyzed.ResultsThe results showed three related phases that influence each other to restore normality in daily life: Trust and inclusion in the treatment process during the stay (1), processing after the stay (2), and returning to everyday life (3).ConclusionFollow-up meetings should be available to all parents whose children have been hospitalized in the PICU. In particular, it should also be available to parents whose children have fully recovered and no longer have any medical disabilities.

Walking Activity and Physical Function Among Mexican American Older Adults Over 9Years of Follow Up.

Walking activity has been associated with reduction in the development of chronic disease, cognitive and physical function impairment, disability, and mortality. The objective of this study was to examine the relationship between walking activity and physical function over 9years of follow-up among Mexican Americans aged 78years and older. Participants (N = 998) were from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2007-2016). Measures included walking activity duration and frequency, socio-demographics, body mass index, medical conditions, pain, depressive symptoms, limitation in activities of daily living, and the Mini-Mental State Examination. Low physical function was defined as scoring <7 on the Short Physical Performance Battery. At baseline, participants were grouped into nonwalkers (n = 653), walked <150minutes/week (n = 144), and walked 150minutes/week or more (n = 201). A Generalized Estimating Equation model was used to estimate the odds ratio and 95% CI of low physical performance as a function of walking activity status. Compared with nonwalkers, participants walking < 150minutes/week had lower odds (odds ratio = 0.66, 95% CI, 0.51-0.86) of low physical function over time, after controlling for all covariates, as did those walking ≥ 150minutes/week (odds ratio = 0.54, 95% CI, 0.41-0.71). Mexican American older adults who engage in any walking activity are at reduced risk of low physical function, even those with disability. Interventions at the individual and community level are recommended to reduce physical function impairment, even in those with preexisting medical conditions or disability.

Measuring lung diffusing capacity: an opportunity for improved medical surveillance and disability evaluation of coal miners

ObjectivesSpirometry is the primary lung function test utilised for medical surveillance and disability examination for coal mine dust lung disease. However, spirometry likely underestimates physiologic impairment. We sought to characterise...

Fitness to Work in a Hansen's Disease Worker With a Disability: A Case Report.

Hansen's disease not only causes problems for patients in the workplace, but also increases the possibility of transmission to other workers. This case report discusses the fitness-to-work assessment for a Hansen's disease patient with a disability. A 19-year-old female, who worked as an online shop warehouse staff, presented at our hospital with a wound on her left hand accompanied by numbness. The patient's activity indicated mild limitations with a SALSA score of 25. A seven-step process for evaluating fitness to work was conducted. These steps involved assessing the patient's medical condition, disability, job demands, risks, and tolerance to determine the appropriate work status. This patient was declared fit to work with a note as online shop warehouse staff. She must take care of herself by maintaining good personal hygiene and consulting a doctor regularly, in addition to educating other workers about her condition and avoiding stigma. Routine examinations are also an important part of treating leprosy in the workplace.

Depression and anxiety in Greek heart failure patients who received a cardiac resynchronization therapy device and did not receive shock therapy during a 12-month follow-up

Abstract Background/Introduction Cardiac resynchronization therapy (CRT) represents an effective therapy in selected heart failure with reduced ejection fraction (HFrEF) patients. There are racial, social, geographical, and ethnic differences in the perception of cardiac device therapies as well as in the associated depression and anxiety status. Regarding psychological status indexes in CRT patients, heterogenous results have been reported while data on their variation over time are limited. No relative data regarding Greek patients have been published in the literature. Purpose We aimed to study psychological status and quality of life validated parameters at baseline as well as their variation at 6 and 12 months after implantation of a CRT device in Greek adult patients with HFrEF. Methods We recruited consecutive HFrEF adult patients who were implanted a CRT device (defibrillator or pacemaker). From the present analysis we excluded patients who suffered defibrillator shocks, those with neuropsychiatric disorders, and those with severe chronic medical illnesses or disabilities. Baseline demographic, clinical, laboratory, electrocardiographic, and echocardiographic parameters were carefully recorded. The following scores were assessed at baseline as well as 6 and 12 months after implantation: Minnesota Living with Heart Failure (MLHF), GAD-7 Anxiety, and PHQ-9 Depression. The variation of these scores over time was examined using the non-parametric Friedman’s test. Potential correlations of the baseline scores with other parameters were examined using the Spearman rank test. Comparison of these scores between different groups of patients was examined using the Mann-Whitney U test. Results The initial study population consisted of 105 patients, but after excluding 8 patients who experienced defibrillator shocks, we finally analyzed 97 patients (median age: 72 [64-76.5] years, 76% men). Six patients died during the 12-month follow-up. At baseline the MLHF score was 37 [20 - 56], at 6 months it was 1 [0 – 8], and at 12 months 0.5 [0-10]. The PHQ-9 score for depression at baseline was 9 [3.75 – 14.25], at 6 months it was 0.5 [0 – 2], and at 12 months it was 0.25 [0 – 1.5]; p &amp;lt;0.01. The GAD-7 anxiety score at baseline was 8 [2 – 16], at 6 months it was 0.5 [0 – 2], and at 12 months it was 0.5 [0 – 2.5]; p &amp;lt;0.01. At baseline 29% of patients had PHQ-9 score &amp;lt;5, namely minimal depression; and 35% had GAD-7 score &amp;lt;5, namely minimal anxiety. The baseline PHQ-9 and GAD-7 scores did not correlate to any other parameter while there were no differences between different patient groups. Baseline PHQ-9 and GAD-7 scores demonstrated strong correlation with the baseline MLHF score (p &amp;lt;0.01). Conclusions In Greek patients with HFrEF who were implanted a CRT device, depression was present in 71% and anxiety in 65% of them. The indexes of quality of life, anxiety, and depression were markedly reduced during the 12-month follow-up.

Effects of different mylohyoid muscle stimulations on swallowing cortex excitability in healthy subjects

BackgroundDysphagia has been recognized by the World Health Organization as a medical disability. Improving mylohyoid muscle function plays an important role in pharyngeal dysphagia. The aim of this study was to evaluate the treatment of transcranial magnetic stimulation (TMS), peripheral magnetic stimulation (PMS), and electrical stimulation (ES) for dysphagia. MethodsForty healthy subjects were randomly divided into four groups: TMS+PMS, TMS, PMS, and ES. TMS stimulated the cortical representative area of the mylohyoid muscle and the PMS was directly stimulating the mylohyoid muscle, both of them at a frequency of 10 Hz for a total of 1,800 pulses. The intensity of ES was based on the subject’s tolerance level, usually 2–5 mA. Functional near infrared spectroscopy (fNIRS) and motor evoked potential (MEP) of the mylohyoid muscle were used to evaluate the immediate effects of stimulation on swallowing cortex excitability of healthy subjects before and after intervention. ResultsThe fNIRS results revealed notable activation across multiple channels in the four groups of healthy subjects both pre- and post- the intervention. Among these channels, the activation levels were most pronounced in the TMS+PMS group, followed by the TMS, PMS, and ES groups, respectively. Regarding the MEP results, post-intervention observations indicated a reduction in bilateral latency and an increase in bilateral amplitude in the TMS+PMS group. Additionally, the left amplitude exhibited an increase in the TMS group. ConclusionsIn fNIRS, all four stimulation methods significantly activated the swallowing cortex of healthy subjects, and the activation of TMS+PMS was the most obvious, followed by TMS, PMS, and ES.

Health status and visit reasons for children attending the Pediatric Dentistry department in damascus university, damascus, Syria: A retrospective study

ObjectivesThis study aimed to discuss the health status and treatment requirements of children visiting the Department of Pediatric Dentistry at the Faculty of Dentistry. Materials and MethodsA retrospective study included the records of patients attending the Department of Pediatric Dentistry, from November 29, 2021, to December 14, 2023. ResultsThe study reviewed 2417 patient records, excluding 312. The majority of patients were primary school children aged 6 − <12, primarily from Rif-Dimashq governorate. About 18 % displayed negative behavior during examinations, and 8 % had special health care needs. The most frequent type of disability was medical disabilities, followed by neurological disorders, with percentages of 40.2 % and 28.9 %, respectively. Dental caries were the primary reason for visits, with a mean of 3.94 ± 3.13. A negative association was found between the number of decayed teeth and the following: age classification, visit year, and Salviov-Tinawi scale. The percentage of males who came for cosmetic problems was higher than females at 57.2 % and 42.8 %, respectively. ConclusionsThe Department of Pediatric Dentistry at the Faculty of Dentistry, Damascus University, is a public dental clinic that is visited by patients from all governorates, providing free specialized treatments. Clinical relevanceUnmet dental needs are a significant issue for both healthy children and those with special health care needs. The Department of Pediatric Dentistry serves as a research and educational center, offering comprehensive dental treatments to children from all socioeconomic backgrounds. Therefore, understanding the dental needs of children is crucial for providing effective support.

Medical Humanities and Disability Studies: In/Disciplines, by Stuart Murray. London: Bloomsbury Academic, 2023.

Medical Humanities and Disability Studies: In/Disciplines, by Stuart Murray. London: Bloomsbury Academic, 2023.

Which is Better in Predicting CT Scores in Patients with Chronic Rhinosinusitis after Medical treatment-Baseline Rhinosinusitis Disability Index (RSDI) or Endoscopic Score?

Rhinosinusitis disability index (RSDI) questionnaire is used to assess the severity of chronic rhinosinusitis (CRS) from the patient's perspective. The severity of CRS can be measured objectively with the endoscope and computed tomogram (CT) using the Lund-Kennedy endoscopic score and Mackay-Lund scores respectively. The objective of the study is to evaluate whether baseline RSDI and Lund-Kennedy (LK) endoscopy scoring can help predict the Mackay-Lund CT (MKLCT) scores after medical treatment in patients with CRS. This is a prospective, observational study, carried out from 1st October 2017 to 30th September 2019 in the ENT out- patient department at a tertiary hospital in Northern India. 90 patients diagnosed with CRS were enrolled consecutively in the study. RSDI questionnaire was filled out for all the participants. They all underwent a diagnostic endoscopy and CRS was graded according to the Lund-Kennedy endoscopic scores. All participants were given medical treatment. Patients underwent CT of the paranasal sinuses after medical treatment and the MLKCT scores were calculated. The baseline RSDI and Lund-Kennedy scores were correlated with the MKLCT scores using Spearman's Rank correlation tests. The diagnostic ability of the RSDI and LK endoscopy scores to predict the least MKLCT scores was compared using the receiver operator characteristics curves (ROC). A statistically significant correlation was seen with LK endoscopy scores and MKLCT scores (r = 0.396, p < 0.001) Among the individual parameters of the LK endoscopy scores only the polyp score had a statistically significant correlation with MKLCT scores (r = 0.593, p < 0.001). A weak negative correlation (r = - 0.058, p = 0.586) was seen between the RSDI scores and MKLCT scores. AUC in ROC curves for a LK endoscopy scores and RSDI scores were 0.690 and 0.462 respectively. Cut-off for predicting a MKLCT score of one or more for RSDI score was 25, with a sensitivity of 61% and specificity of 38.5%. Similarly, the cut-off for LK endoscopic score was 4.5, with a sensitivity of 68.8% and specificity of 61.5%. Statistically significant (p < 0.001) association was found between baseline Lund-Kennedy endoscopic scores and Mackay-Lund CT scores post medical treatment. No significant association was found between RSDI scores and Mackay-Lund CT scores. ROC analysis indicated that Lund- Kennedy endoscopy score is a more accurate tool than RSDI score to predict a Mackay-Lund CT scores after medical treatment. The online version contains supplementary material available at 10.1007/s12070-024-04708-6.

Medical humanities and disability studies: In/disciplines. Series: Critical interventions in the medical and health humanities. By S.Murray, London: Bloomsbury Academic. 2023. pp. 134. £45.00 (hbk); £14.99 (pbk); £13.49 (ebk). ISBN: 978‐1‐3501‐7217‐3

Medical humanities and disability studies: In/disciplines. <i>Series: Critical interventions in the medical and health humanities</i>. By S.Murray, London: Bloomsbury Academic. 2023. pp. 134. £45.00 (hbk); £14.99 (pbk); £13.49 (ebk). ISBN: 978‐1‐3501‐7217‐3