British Journal of Healthcare and Medical Research <p>British Journal of Healthcare &amp; Medical Research (<strong>BJHR</strong>) is an international, peer-reviewed, open access journal that provides an easy access to high quality manuscripts in all related aspects of diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings. The journal also focuses upon the challenges and opportunities and how healthcare can benefit from it in terms of reduced costs and improved diagnosis, therapy, and care. Access to health care manuscripts provides an insight that varies across countries, groups, and individuals, largely influenced by social and economic conditions as well as the health policies in place.</p> <p>The journal brings professionals in medicine, psychology, physiotherapy, nursing, dentistry, midwifery (obstetrics) and allied health, plus many other disciplines such as public health practitioners, community health workers and assistive personnel, who systematically provide personal and population-based preventive, curative and rehabilitative care services in health care under single roof.</p> Services for Science and Education, United Kingdom en-US British Journal of Healthcare and Medical Research 2055-1266 Management of Avascular necrosis of femur head with the help of Arthrox- A case study. <p>Osteonecrosis or bone infarction, which is a death of bone tissue due to interruption of the blood supply, is also called as avascular necrosis (AVN) and the most commonly affected bone is femur. Line of treatment may include some medication, bed rest, stretching, physiotherapy and surgery. As many as 20,000 people develop AVN each year, most ages between 20 and 50 commonest being in male then in female. Due to lack of promising results patient search for alternative therapies and remedies. We can apply basic principles of Ayurveda to treat any modern disease like AVN. This disease can be correlated with <em>Asthi majja gata vata</em> described in the Samhitas and <em>Asthivaha srotodushti vikaras. ).</em> In this article a male patient diagnosed as Asthi Majja gata vata is treated with Arthrox treatment which includes Virechana, Karma Basti and Hip dhara. His symptoms were assessed by two methods: Visual Analog Scale (VAS) change in pain and Harris Hip Score. Both help to ascertain overall quality of life. The patient was also given customized herbal remedies, manufactured by Ayushakti Ayurveda. With the help of this we can avoid the surgery, we can reduce the pain and we can serve a better quality of life for the patients with avascular necrosis of femur head. The recovery in this case was promising and was worth for documentation.</p> Deepak Mahajan Smita Naram Hemang Parekh Copyright (c) 2021 Deepak Mahajan, Smita Naram, Hemang Parekh 2021-11-16 2021-11-16 8 6 1 7 10.14738/jbemi.86.11154 Diameter measurements in three-dimensional printed flow phantom model of the carotid artery in preterm infants <p>Diameter form an integral part of blood flow measurement. This study aimed to explore different three-dimensional (3D) printed materials to develop flow phantom models of the carotid artery in preterm newborn infants and to investigate ideal diameter measurement points using ultrasound that reflected accurate lumen diameter measurement.</p> <p>Cerebral blood flow measurements data using Doppler ultrasound of the right common carotid artery from 21 randomly selected preterm infants were used to produce a 3D printed Doppler flow phantom model with three different vessel diameters. Diameters were measured by multiple observers blinded to phantom vessel characteristics and each other’s measurements. 9 measurement points were studied. Agreement between observers, inter and intra observer reliability and coefficient of variation (CoV) was examined.</p> <p>Of the 63 diameter measurements, 45 (71%) were performed on flow phantoms with vessel diameter of 0.196 cm. Bland-Altman plots revealed that measurement performed using leading edge to centre (mean bias 1.8% {95%LOA -4.1% to 7.7%}) and centre to trailing edge (mean bias 1.1% {95%LOA -5.4% to 7.8%}) resulted in the most accurate lumen diameter measurements. Inter and intra-observer reliability was excellent. The mean CoV for inter observer measurements was 1.7% and intra observer measurements was 1.6% and 1.8% for each observer.</p> <p>We successfully produced a 3D printed flow phantom model of the carotid artery in preterm infants and identified two measurement methods that result in reliable and accurate lumen diameter measurement. Researchers and clinicians can use this information for further studies involving ultrasound diameter measurements in small calibre vessels.</p> Sujith Pereira Jonathan Reeves Malcolm Birch Ahmed Ali Ajay Sinha Stephen Kempley Copyright (c) 2021 Sujith Pereira, Jonathan Reeves, Malcolm Birch, Ahmed Ali, Ajay Sinha, Stephen Kempley 2021-11-26 2021-11-26 8 6 8 21 10.14738/jbemi.86.11166 One-Time Cortical Lamina: A New Technique for Horizontal Ridge Augmentation. A Case Series <p><em>The aim of this case series is to introduce the One-Time Cortical Lamina Technique, a simplification of the F.I.R.S.T. (Fibrinogen-Induced Regeneration Sealing Technique) in cases where only horizontal augmentation is needed. The indications for this technique are ASA2 and ASA1 anxious patients. Pre-requisites for this surgical technique are: a good amount of keratinized tissue, sufficient alveolar ridge width for placement of implants, thickness of vestibular bone at CBCT planning less than 1 mm with risk of threads exposure. Five patients with horizontal deficiencies were selected to test the efficacy of this approach. The defects were augmented using a porcine cortical bone lamina in combination with collagenated porcine bone mixed with fibrin sealant. The cortical lamina was placed only buccal to the implants and stabilized with fibrin sealant, without pins or screws. Upon completion of the implant surgery, healing abutments were connected to the implants and the soft tissue sutured around them. The healing was uneventful in all cases. Six months after surgery impressions for final restorations were taken and screwed crowns delivered. The new volume had hard consistency and the follow-up CBCT measured an average of 4.17 mm of horizontal bone augmentation.&nbsp;One to three years of follow up demonstrated the maintenance of vestibular volume, hard consistency and clinical stability. Intraoral X-rays showed no marginal bone loss. An advantage of this technique could be the one stage surgery that creates a stable environment for regeneration from day one.</em></p> Vincenzo Foti Davide Savio Roberto Rossi Copyright (c) 2021 Vincenzo Foti, Davide Savio, Roberto Rossi 2021-12-05 2021-12-05 8 6 22 30 10.14738/jbemi.86.11270 ‘’An update on Brain organoids Generation and the Advancements made in the Context of a Human Model of Neurological Disorders-A systematic review’’ <p>Neurological conditions , represent a group of disorders that are responsible for&nbsp; &nbsp;the commonest etiologies of death all over&nbsp; the world&nbsp; which account practically for&nbsp; total cases of initiation of dementia in the&nbsp;&nbsp; aged ,besides their capacity ofhavinga negative impact&nbsp; on the motor capacity,mental&nbsp; and cognitive&nbsp; abilities andhaving a sense of total well being, besides happiness.At present maximum Neurological&nbsp; disorders(ND) remain without any appropriate treatment. In view of the absence of any&nbsp; effectivetherapeutic&nbsp;&nbsp; method.The cause for this is the existence&nbsp; of lack of insight with regards to the disorders,mainly&nbsp; due to thepresence of&nbsp; research models which do not possessthe capacity of translation&nbsp;&nbsp; into the human&nbsp; in vivo system.Thus here we conducted a systematic review utilizing search engine pubmed,google scholar ;web of science &amp;others utilizing&nbsp; the MeSH terms&nbsp; like ND; NDG ;NDD; Alzheimer’s disease; Parkinson’s&nbsp; diseases; ASD ;TTH; viral infections; Induced&nbsp; pluripotent Stem Cells(iPSCs); Crisper/Cas genetic &nbsp;editing methods; 2D mono cell layer models&nbsp;&nbsp; ;3D organoid models; embryonic Stem Cells(ESCs);vascularization;neuroectodermal constituents;gas exchange;microglia role;mesodermal parts;cellular&nbsp; diversity; cellular interconnectivity;assembloids;cerebral organoids;evolutionary study;consciousness study; role in traumatic brain injury from&nbsp; 1980 till 2021 till date.We found a total of 1500 articles out of which we selected&nbsp; 102 articles for this review.No meta-analysis was done. The existent models for investigation of ND, Neurodevelopment(NDD) and drug crosstalk in the central&nbsp; nervous system(CNS), are inclusive of in vitro mono cell layer culture and &nbsp;in vivo&nbsp; animal models.There are limitations&nbsp;&nbsp; of these&nbsp; models with regards to&nbsp; translation of the research in the context of pathology of thedisorder, generation and treatment to humans. Brain organoids represent three dimensional(3D) cultures of&nbsp; Stem Cell obtained&nbsp; neural cells&nbsp; which simulate the generation of&nbsp; the in vivo&nbsp; humans brain,possessing high precision.Already the investigators have started the construction&nbsp; of these mini brains with the idea of modeling&nbsp; &nbsp;&nbsp;a wide variety of ND that are inclusive of the complicatedNDD, NDG.Here we have tried to detail the generation and&nbsp;&nbsp; theadvancements in this field.</p> Kulvinder Kochar Kaur Gautam Allahbadia Mandeep Singh Copyright (c) 2021 Kulvinder Kochar Kaur, Gautam Allahbadia, Mandeep Singh 2021-12-05 2021-12-05 8 6 31 63 10.14738/jbemi.86.11266 Multidrug-resistant tuberculosis in childhood: A case report <p><strong>&nbsp;</strong><strong>Introduction</strong></p> <p>&nbsp;Multi-resistant tuberculosis is a major problem of public health concern and an endless cycle that ravages the population, particularly children because of the difficulty of controlling the disease. Thus, early detection of cases helps ensure adequate treatment and prevent the spread of the strain in the community.</p> <p><strong>&nbsp;Methods </strong></p> <p>We present here the case of a child with multidrug-resistant tuberculosis monitored at the Medical Center of Medical Center of the company RVA.</p> <p><strong>Results</strong></p> <p>It is a case of 4-year-old patient with general signs and had an aunt who died of multidrug-resistant tuberculosis. On admission, the child was in good general condition, weighing 14 kg and 90 Cm height. The clinical examination noted crackling rales at the level of two pulmonary bases and the chest x-ray showed multiple confluent nodular opacities in places with excavations. Laboratory workup showed 8.5 mg% microcytic hypochromic anemia and inflammatory syndrome. Sputum was tested for Koch's Bacillus on direct examination and both smears were positive. The <em>Mycobacterium tuberculosis</em> strain was isolated on Lowenstein Jenssen's medium. The Gen-Xpert MTB / RIF detected resistance to rifampicin and the Hain test performed showed resistance to rifampicin and Isoniazid. The child was put on ethambutol, ciprofloxacin, kanamycin, ethionamide, cycloserine, pyrazinamide and Vitamin B6 with good tolerability. The course was marked by weight gain (2 kg) and BK negativation in the second month of treatment.</p> <p><strong>Conclusion </strong></p> <p>Early detection of tuberculosis, especially multidrug-resistant tuberculosis is a crucial element in ensuring adequate treatment of cases and preventing the spread of germs in the population.</p> M. J. Kabedi P. Mbaya B. Lelo M. Tshibangu K. Taba L. Nkuku M. Mintsey S. Kibonza J. M. Kayembe S. Bisuta O. Lunguya J. J. Muyembe Copyright (c) 2021 M. J. Kabedi, P. Mbaya, B. Lelo, M. Tshibangu, K. Taba, L. Nkuku, M. Mintsey, S. Kibonza, J. M. Kayembe, S. Bisuta, O. Lunguya, J. J. Muyembe 2021-12-06 2021-12-06 8 6 64 69 10.14738/jbemi.86.11236 Role of fine needle aspiration cytology (FNAC) in diagnosing Pancreatic lesions in a tertiary care institution <p>OBJECTIVE- FNAC is an accurate and rapid technique for diagnosing pancreatic masses. <a href="">Pancreatic carcinoma</a>&nbsp;represents the seventh leading cause of cancer death in the world, responsible for more than 300,000 deaths per year.<sup>[1]</sup> Worldwide, both the incidence and death rates of pancreatic cancer are increasing. The aim of this study was early diagnosis of these lesions and to evaluate its burden and study the global, regional, and national patterns. These would further aid in policy making , better resource allocation for controlling pancreatic cancer risk factors and formulating more effective treatments.<sup>[2]</sup></p> <p>METHODS- This was a retrospective observational study performed at a tertiary care hospital over a period of one and a half year. A total of 86 patients with pancreatic lesions were subjected to image guided FNA . 35 of these patients underwent diagnostic histopathology in addition to FNA.</p> <p>RESULTS- The 86 cases analyzed were in the age group of 61-70 years with mean age distribution of 57.34 years. Male predominance was seen with M:F ratio of 2.18:1. Head was the most common area to be aspirated followed by tail and least number of lesions were in body of pancreas. Maximum cases were found to be malignant (55) in etiology. Only 2 were non diagnostic because one of them had insufficient cellularity and other had necrosis mainly on histopathology. Adenocarcinoma was the most common malignancy found followed by one case each of lymphoma and solid pseudo papillary neoplasm of pancreas. Histo pathological correlation was obtained in 91.42% cases proving that FNA is a very useful tool in early diagnosing pancreatic lesions.</p> Sonia Jain Pavneet Kaur Selhi Harpreet Kaur Ajay Gupta Siddharth Prakash Copyright (c) 2021 Sonia Jain, Pavneet Kaur Selhi, Harpreet Kaur, Ajay Gupta, Siddharth Prakash 2021-12-06 2021-12-06 8 6 70 76 10.14738/jbemi.86.11259 Evaluation of Eye Lens Dose Reduction Technics in Head CT <p><em>The purpose of this study is to find the best protocol to reduce the X-ray dose to the eye lens during head diagnostic computed tomography (CT) without decreasing image quality in the organs of interest according to</em> <em>the type of scanner. The lens of the eye is one of radiosensitive tissues in the body. Radiation induced cataract has been demonstrated among staff involved in interventional procedures using X-rays. This study compares the absorbed dose and image quality of several dose reduction technics to the eye lens during head CT exam namely bismuth shielding, organ-based dose modulation, tube current modulation, tube voltage modulation and the combination of a number of these techniques. Compared to the reference scan (Fixed tube current without bismuth shielding), the dose to the eye lens was reduced by 29.91% with bismuth shield, 14.55% with tube current modulation, 37.76% with tube current modulation and bismuth shield. The combination of organ-based dose modulation with tube voltage modulation reduced the dose by 44.93% that of tube current modulation with tube voltage modulation reduced by 19.03% and that of tube current modulation with tube voltage modulation and shield by 46.73%.</em></p> <p><em>The combination of organ-based dose with tube voltage modulation provided superior image quality than that of tube current modulation with tube voltage modulation and shield while similarly reducing dose to the eye lens.</em></p> Thierry Narcisse Kouagou Bangassi Odette Ngano Samba Hubert Thierens Moïse Godfroy Kwato Njock Copyright (c) 2021 Thierry Narcisse Kouagou Bangassi, Odette Ngano Samba, Hubert Thierens, Moïse Godfroy Kwato Njock 2021-12-14 2021-12-14 8 6 77 88 10.14738/jbemi.86.11218 TOWARDS GLOBAL OPTIMIZATION OF NEURAL NETWORK: A COMPARATIVE ANALYSIS USING GENETIC AND WHALE OPTIMIZATION ALGORITHMS <p>The intelligence and adaptability features of the neural network has made it a technique that is widely used to solve problems in diverse areas such as; detection, monitoring, prediction, diagnostics, data mining, classification, recognition, robotics, biomedicine, etc. However, determination of the optimal number of hidden layers of neural network and other parameters are still a difficult task. Usually, these parameters are decided by trial-and-error which increases the computational complexity and it is human dependent in obtaining the optimal model and parameters alike for any particular task. Optimization has received enormous attention in recent years, primarily because of the rapid progress in computer technology, including the development and availability of user-friendly software, high-speed and parallel processors, and artificial neural networks. This research work is to propose a neuro-evolutionary model using the computational intelligence techniques by combining ANN, GA and WOA for binary classification problems. The proposed optimized ANN-GA and WOA models is to circumvent the problem that is characterized in the trade-off between smoothness and accuracies in selecting the models and optimal parameters of neural network.</p> E. C. Igodan K. C. Ukaoha S. O. P. Oliomogbe Copyright (c) 2021 Kingsley Ukaoha, Igodan, E. C., Oliomogbe, S. O. 2021-12-14 2021-12-14 8 6 89 101 10.14738/jbemi.86.11004 Three-dimensional printed flow phantom model of the carotid artery in preterm infants for training and research <p>The aim of this study was to perform flow volume measurements with Doppler ultrasound using novel 3D printed flow phantom models of carotid artery in preterm infants with varying characteristics.</p> <p>Clinical data from cerebral blood flow measurements using Doppler ultrasound of the right common carotid artery from premature newborn infants were used to produce a 3D printed Doppler flow phantom model with three different vessel diameters; 0.158 cm, 0.196 cm and 0.244 cm. Leading edge to centre was used to measure vessel diameter. Two observers performed flow volume measurements using continuous and pulsatile flow. Agreement between observers was examined using Bland-Altman plots.</p> <p>24 measurements were performed. 18 (75%) measurements were performed using continuous flow. Pulsatile flow measurements were performed on lumen diameter of 0.244 cm only using physiological rates. Bland-Altman analysis for continuous flow measurements for observer 1 and 2 were -0.007 (95%LOA -4.3 to 4.3) ml/min and 3.2 (95%LOA -2.7 to 9.1) ml/min. Bias for pulsatile flow measurements for observer 1 and 2 were 1.5 (95%LOA -0.8 to 3.8) ml/min and 4.6 (0.7 to 8.5) ml/min respectively. Inter and intra-observer reliability was excellent for majority of measurements. The mean coefficient of variation for inter observer diameter measurements was 1.2% and intra observer measurements were between 1.5% to 3.9% for both observers.</p> <p>Flow volume measurements performed using 3D printed materials resulted in realistic echogenicities mimicking biological tissues. Validity and reliability studies, within and between, observers showed acceptable results. Researchers and clinicians can use this model for further training and simulation.</p> Sujith Pereira Jonathan Reeves Malcolm Birch Ahmed Ali Ajay Sinha Stephen Kempley Copyright (c) 2021 Sujith Pereira, Jonathan Reeves, Malcolm Birch, Ahmed Ali, Ajay Sinha, Stephen Kempley 2021-12-29 2021-12-29 8 6 102 114 10.14738/jbemi.86.11434