Hearing loss (HL) and chronic kidney disease (CKD) are conditions with high prevalence worldwide. Patients with oto-renal disorders are reported to have both syndromic forms of HL and kidney dysfunction due to common molecular signaling pathways. The major shared genetic factors, common developmental pathways, and physiological mechanisms adversely affect the auditory and kidney systems. This review consolidates the common morphogenic origins of the kidney and the cochlea, which focus on the major shared genes, networks, and oto-renal disorders that affect the cilia, collagen networks, and transport channels in both systems. This article shines a spotlight on mechanisms and pathophysiology of the major congenital disorders causing HL and kidney diseases. In addition to this, other risk factors including hemodialysis and certain drugs increase the risk of HL in patients with CKD. This review can help clinicians navigate options for differential diagnosis of oto-renal disorders. An interdisciplinary approach across nephrologists, audiologists, pediatricians, and geneticists can pave the way for effective screening, diagnosis, and treatment interventions. This also underscores the importance of future research on the ear–kidney axis to understand molecular signaling, biomarker discovery, and clinical management.
Disease severity in acute pancreatitis requires proper assessment at an early stage to ensure proper triage, management, and prognostication. Various clinical scoring systems that are based on laboratories are highly used in severity stratification, such as Ranson criteria, Bedside Index of Severity in Acute Pancreatitis (BISAP), and Acute Physiology and Chronic Health Evaluation II (APACHE II). Nonetheless, the scores depend on indirect physiological and biochemical parameters and can not be predictive of the degree of local pancreatic damage. The CT Severity Index (CTSI) using Balthazar scoring, which is a direct anatomical evaluation tool, is specifically used to evaluate the disease with contrast-enhanced computer tomography (CECT) and can be a better prognostic tool. The proposed research project is observational in nature, and the proposed tertiary care teaching hospital will be used to identify 100 adult patients who presented with acute pancreatitis. Clinical assessment, lab tests, Ranson, BISAP, APACHE II scores, and CECT abdomen to evaluate CTSI were done in all patients. Follow-up of patients during hospital stay was done to record local and systemic complications, intensive care unit (ICU) admission, length of stay in the hospital and death. The comparison between clinical scoring systems and CTSI was conducted through statistical analysis to determine the predictive performance of the system. The most prevalent aetiology was the alcohol, and then the gallstone disease. Clinical scoring systems diagnosed most of the patients with mild to moderate disease, but CTSI diagnosed more patients with moderate to severe pancreatitis. CTSI showed high correlation with local complications, ICU hospitalisation, extended hospitalisation, and death, in contrast with the laboratory-based scoring systems. Irrationalities were also noted where the clinical scores of the patient deemed mild had a severe disease severity on the CECT. The CT Severity Index based on CECT proved to be more accurate in determining the severity of the disease and prognosis in cases of acute pancreatitis than the traditional clinical scoring systems based on laboratory. Imaging severity assessment must be regarded as a part and parcel of the entire assessment in patients with acute pancreatitis.
Background: Magnetic Resonance Imaging (MRI) is regarded as the gold standard for musculoskeletal imaging due to its excellent soft-tissue contrast and multiplanar capabilities. Nevertheless, the high signal intensity of fat often obscures important anatomical and pathological details, underscoring the need for robust fat suppression techniques. Spectral Pre-saturation with Inversion Recovery (SPIR) and Spectral Adiabatic Inversion Recovery (SPAIR) are widely applied frequency-selective inversion recovery methods. Objective: This study aims to compare SPIR and SPAIR fat suppression techniques in MRI of the knee joint to determine which provides superior overall image quality for clinical application. Materials and methods: This cross-sectional study was conducted in the Department of Radiodiagnosis, Aarupadai Veedu Medical College and Hospital, Puducherry. A total of 72 patients referred for knee MRI were included using purposive sampling. Imaging was performed on a 1.5T MRI system with a dedicated knee coil, and both PDW-SPIR and PDW-SPAIR fat suppression sequences were obtained under identical parameters. Images were anonymized and independently reviewed by two experienced radiologists. Descriptive and inferential Statistical analysis was performed using the SPSS software. Results: SPAIR sequences consistently outperformed SPIR in terms of fat suppression homogeneity, reduction of artifacts, and visualization of key anatomical structures. Structures such as the cruciate ligaments, menisci, articular cartilage, and periarticular soft tissues were more distinctly delineated on PDW - SPAIR images. The differences in image quality were statistically significant (p < 0.05). Inter-observer reliability was excellent (κ = 0.88–1.00), confirming consistent evaluations across readers. Conclusion: SPAIR provides superior fat suppression and overall image quality compared to SPIR in knee MRI. SPAIR enhances diagnostic confidence in musculoskeletal imaging. Its routine incorporation into knee MRI protocols is recommended to improve the detection and assessment of subtle joint pathologies.
This study introduces an extensive framework for a cooperative privacy-preserving cloud intrusion detection system designed to enhance the security of Internet of Things ecosystems. The study presents a hierarchical architecture that integrates edge, fog and cloud layers to facilitate scalable performance, employing lightweight detection methods underpinned by blockchain-based trust management to guarantee transparent and dependable communication across diverse devices. During the methods phase, the system implements preprocessing and feature selection before classification, utilising various techniques such as the C4.5 decision tree, Support Vector Machine, traditional decision tree, Convolutional Neural Network, ConvNet, and Fully Convolutional Network, while maintaining privacy in distributed cloud analytics and collaborative decision-making. The experimental assessment demonstrates that integrating preprocessing with the Synthetic Minority Oversampling Technique enhances threat detection, while the C4.5 decision tree attains approximately 96.33 percent accuracy on the CES CICIDS2018 dataset using a diminished set of flow-based features, enabling real-time functionality under high-speed network conditions. The final remarks highlight that the incorporation of blockchain technology, tiered computing resources, and efficient classification methods facilitates a more reliable, scalable, and adaptable intrusion detection system, offering a feasible pathway for robust security in dynamic IoT environments.
Background: Erectile dysfunction (ED) refers to the ongoing difficulty in achieving and sustaining an erection adequate for satisfying sexual activity. Globally, a key concern involves individuals bypassing medical professionals to acquire ED medications (EDMs) without prescriptions. Objective: This study evaluates erectile function in a sample of local physicians, examines the psychological consequences of recreational EDM use, and compares erectile function across user categories. Methods: We conducted a cross-sectional survey exclusively among physicians at various hospital around Pondicherry. Participants completed a custom questionnaire covering demographics, sexual history, EDM usage, sexual satisfaction levels, and the validated International Index of Erectile Function (IIEF). Results: The study of 400 physicians showed 75.5% were non-users of oral erectile dysfunction medications (EDMs), with 19.5% using them recreationally. Recreational use was more common in younger and mid-career physicians, predominantly acquired over-the-counter, and mainly for enhancing erection strength, self-confidence, or partner satisfaction. Cialis (Tadalafil) and Snafi were the most commonly used brands. Most users reported occasional use and minor adverse effects, with post-use satisfaction notably higher than pre-use. Overall, recreational EDM use did not significantly impair erectile function compared to non-users, though prescribed users had lower IIEF scores. Conclusion: A substantial number of healthy, sexually active men turn to EDMs recreationally to enhance performance. Recreational EDM use can negatively affect psychological dimensions of sexual health. Our findings reveal EDM misuse among physicians, supporting the need to classify these drugs as prescription-only, dispensed by licensed healthcare providers.
