Government Mohan Kumaramangalam Medical College

Introduction: Contrast-Enhanced Mammography (CEM) is an emerging functional breast imaging technique that integrates digital mammography with intravenous iodinated contrast administration. Following the introduction of a dedicated Breast Imaging-Reporting and Data System (BI-RADS) lexicon for CEM in 2022, validation of individual Recombined (RC) image descriptors has become essential for standardised interpretation. Aim: To evaluate the distribution of CEM BI-RADS recombined image descriptors in malignant and non-malignant breast lesions. Materials and Methods: The present prospective observational study was conducted between July 2019 and March 2023 at the Institute of Radiodiagnosis, Government Kilpauk Medical College and hospital, Chennai, Tamil Nadu, India, and evaluated 802 breast lesions (327 malignant and 475 non-malignant) from 769 participants using CEM. RC image descriptors- including enhancement presence, morphology, margins, internal enhancement characteristics, distribution patterns, lesion conspicuity, and contrast kinetics- were assessed according to the 2022 American College of Radiology Breast Imaging-Reporting and Data System (ACR CEM BI-RADS) lexicon. Statistical analysis was performed using the Chi-square test, with p<0.05 considered statistically significant. Results: The study population comprised women, with malignant lesions predominantly observed in patients aged over 40 years (mean age: 52.68±10.61 years), while non-malignant lesions were more common in younger patients (mean age: 48.78±9.64 years). Absent enhancement was identified exclusively in non-malignant lesions (57.9%). A higher frequency of mass enhancement was observed in malignant lesions (83.5%) compared with non-malignant lesions (36.2%). With respect to mass enhancement patterns, non-circumscribed margins (86.4% vs. 12.2%), heterogeneous internal enhancement (74.7% vs. 25.6%) were observed in a significantly higher proportion of malignant lesions than non-malignant lesions. Similarly, malignant lesions demonstrated higher lesion conspicuity and predominantly washout (82.4%) or plateau (16%) contrast kinetics. Conclusion: According to the findings of the present study, distinct CEM BI-RADS recombined image descriptors demonstrate significant associations with malignant and non-malignant breast lesions.

Background: Odontoid fractures are the most common neck bone fractures in elderly patients and form about 10–15% of all cervical spine injuries. There is still no clear agreement on the best treatment — whether to treat with immobilisation (conservative) or surgery, especially in older patients. This study aimed to compare the outcomes of these two treatment methods. Methods: This was a bidirectional comparative study conducted at a tertiary care hospital in Chennai, including 76 patients with confirmed odontoid fractures. Patients who underwent conservative treatment (38 patients, using cervical collar or halo) and surgical treatment (38 patients, treated with anterior screw fixation or posterior C1–C2 fusion) were followed up and compared for Outcomes such as fracture healing, new neurological problems, complications, death, hospital and ICU stay, and functional recovery using Neck Disability Index (NDI) and Visual Analogue Scale (VAS). Statistical tests were applied, and p < 0.05 was considered significant. Results: Fracture healing was much higher in the surgical group (73.3% compared to 26.7%). New neurological problems occurred only in the conservative group. Patients who underwent surgery had longer hospital stay (28.08 ± 9.27 days vs 14.87 ± 4.39 days) and ICU stay (12.95 ± 3.74 days vs 5.18 ± 2.57 days). Complications were more common in the surgical group (75% vs 25%). Death was higher in the conservative group, but this was not statistically significant. Both groups showed improvement in NDI and VAS scores, with slightly better results in the surgical group at one year. Logistic regression did not show any independent factors predicting outcomes. Conclusion: Surgical treatment gives better fracture healing and prevents neurological problems, but it has more complications and requires longer hospital stay. Conservative treatment has fewer complications and shorter hospital stay. Treatment should be decided based on patient condition, fracture type, neurological status, and fitness for surgery.

Abstract Background Health systems in low- and middle-income countries are frequently described as “data rich, information poor,” collecting substantial data that rarely informs local decision-making. In tribal settings, this challenge is compounded by geographic isolation, fragmented governance, and the absence of disaggregated tribal health data within routine systems. We conducted a systematic mapping of data sources available for maternal and child health (MCH) decision-making at tribal Primary Health Centres (PHCs) in Andhra Pradesh, India. Methods Using a participatory data discovery approach embedded within an action research project, we mapped data sources across three PHCs under the Integrated Tribal Development Agency (ITDA) Rampachodavaram, Alluri Sitarama Raju District. Data discovery proceeded through three phases: document review, key informant interviews with Medical Officers and frontline health workers, and stakeholder validation. Sources were classified using the HEALTHY framework (Healthcare, Education, Access, Labour, Transportation, Housing, Income) and the Keller data discovery typology (Designed, Administrative, Opportunity, Procedural). Accessibility was assessed based on whether Medical Officers could retrieve data for local planning. Results We identified 28 distinct data sources relevant to MCH decision-making. Healthcare dominated (57.1%), while determinant domains remained underrepresented: Housing (10.7%), Income (10.7%), Education (7.1%), Labour (7.1%), Transportation (3.6%), and Access to healthy choices (3.6%). By data origin, Administrative sources predominated (46.4%), followed by Opportunity (21.4%), Procedural (17.9%), and Designed (14.3%). Despite 67.9% of sources having digital components, only 32.1% were fully accessible to Medical Officers, with 10.7% partially accessible and 57.1% inaccessible at the PHC level. Accessibility barriers were consistent across data categories, ranging from 50.0% to 66.7% inaccessibility. Conclusions The tribal PHC data ecosystem exhibits a fundamental mismatch between data generation and local utility. Data flows predominantly upward for administrative reporting rather than laterally for local decision-making. Addressing MCH outcomes in tribal populations requires reorienting health information systems toward local actionability.

Solar desalination systems offer a sustainable solution for potable water production in regions with abundant sunlight. This study investigates the performance of a double-slope solar desalination system (DSSDS) by incorporating a novel floating wick material with enhanced thermal conductivity. The data were collected from conventional DSSDS (CDSSDS) and modified DSSDS (MDSSDS) with three distinct floating wick conditions, namely, the floating cotton wick without nanoparticles (MDSSDS1), with aluminum nanoparticles (MDSSDS2), and with Copper nanoparticles (MDSSDS3). The experimental trials were conducted on four clear sunny days for each condition at Surampalem (latitude 17.0895 ° N, and longitude 82.0667 ° E), Andhra Pradesh, India, between April 2024 and June 2024. To ensure the reliability of data collection, these 4 days of data were averaged, and the average values were used for further calculations. The hourly freshwater production of CDSSDS has been compared with the standard reference equation and found well-accepted range of ±10.23% deviations between them. The average increase in Nu values of MDSSDS3, MDSSDS2, and MDSSDS1 is 49.12%, 40.11%, and 35.06% higher than the Nu value of CDSSDS, respectively, demonstrating that the inclusion of metal particles in cotton cloth improves heat transfer. The average increase in the value of Sh by 49.35%, 38.56%, and 15.62% compared to CDSSDS for MDSSDS3, MDSSDS2, and MDSSDS1, respectively, indicates that the inclusion of metal particles also improves mass transfer.

Background: Semi-structured programmes are available to promote knowledge of lung ultrasound (LUS) among intensivists, and in many neonatal units, LUS is increasingly utilised in the diagnosis of Respiratory Distress Syndrome (RDS). Aims and Objectives: This study seeks to qualitatively evaluate the LUS performed by sonographers of varying experience levels, while quantitatively assessing the agreement in LUS scores between an expert and them in Neonates with RDS. Methods: This is a single-centre, mixed-methods study with 10 participants who conducted LUS scans on 61 neonates less than 34 weeks of gestation diagnosed with RDS. The LUS scans were qualitatively and quantitatively assessed by a non-participant expert using a scoring system that included six zones and a total score. Results: The mean birth weight was 1.3 ± 0.2 kg. The mean gestational age was 31.1 ± 1.6 weeks. Qualitative analysis revealed that all participants demonstrated adequate image quality in LUS imaging. The ICC between the expert and other sonographers for the total scores ranged from 0.98 to 0.99, indicating excellent reliability. The kappa values for zone-wise interrater agreement demonstrated almost perfect agreement (0.81 to 1) in 60% of measurements and substantial interrater agreement (0.61 to 0.8) in 36.66% of measurements. Conclusion: This study has demonstrated adequate quality of LUS scans conducted by sonographers of varying experience levels. This study has demonstrated that neonatal LUS is easy to learn, simple to practice, and consistent with sonographers of varying experience levels.