Journal Issue: Vol. 22 No. 03 (2024): Issue 64 July-Sep
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1999-6217
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The Future of Artificial Intelligence in Healthcare
(Nepal Health Research Council, 2024) Dangal, Ganesh; Dangal, Ojash
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Incidence, Clinical Characteristics and Outcomes Associated with Acute Kidney Injury in Patients Hospitalized with COVID-19
(Nepal Health Research Council, 2024) Shrestha, Sanjay; Maharjan, Kijan; Bajracharya, Milan; Chalise, Bimal Sharma; Balla, Pujan; Adhikari, Shambhu; Shrestha, Soni; Baral, Bishwodip; Neupane, Jenish; Poudel, Manu; Bastola, Anup
Background: Acute kidney Injury associated with Coronavirus disease COVID-19 appeared to negatively influence clinical outcomes and is found to be associated with significant risk of death. This retrospective study aimed to describe the incidence of Acute Kidney Injury, its associations with clinical characteristics and outcomes among COVID-19 patients in Sukraraj Tropical and Infectious Disease Hospital, a tertiary infectious disease hospital in Nepal.
Methods: A cross-sectional study was done where. Medical and lab records of reverse transcriptase Polymerase chain reaction positive COVID-19 inpatients, admitted between April 2021 to July 2021 were reviewed. It represented the second wave of wave of coronavirus pandemic caused by the delta strain. Patients aged less than 18 years, pregnant females and patients with known chronic kidney disease were excluded
Results: Of 393 admissions, 83 (21.1%) patients developed Acute Kidney Injury. Characteristics found to have significant association with development of AKI was age (p <0.001), multiple co morbidities (2 or more) (p <0.001), use of mechanical ventilation (p <0.001), lymphopenia (p<0.001), Neutrophil to Lymphocyte Ratio (p =0.001) and d-dimer levels (p <0.001). Mortality was found to be significantly higher in COVID-19 patients with AKI compared to COVID-19 patients without AKI ((36.14% vs 15.8%, p value <0.01)). The median duration of hospital stay for patients with AKI was higher than for patients without AKI (10 days vs 6 days,p <0.01).
Conclusions: AKI develops in a sizeable percentage of patients with COVID-19 and is significantly associated with increasing age, multiple comorbidities, increased biomarkers, use of mechanical ventilation and is associated with poor outcome in terms of mortality and morbidity.
Keywords: AKI; COVID-19; Nepal; outcomes.
Diagnostic Accuracy of Artificial Intelligence-Based Chest X-Ray reading for screening of Tuberculosis
(Nepal Health Research Council, 2024) Shrestha, Ruby Maka; Paudel, Ram Chandra; Adhikari, Puspanjali; Ghimire, Ram Hari; Gurung, Karma; Shrestha, Rajeev
Background: Tuberculosis remains a public health challenge in Nepal and ranks as the seventh leading cause of death in the country. The END Tuberculosis strategy stresses - the screening for symptoms alone may not suffice; additional screening tools such as a chest radiograph may facilitate referral for diagnosis of tuberculosis. The study aims to evaluate the diagnostic accuracy of artificial intelligence (AI) based Chest X-ray and compare it with the human reading (radiologist), using GeneXpert-MTB RIF Assay for tuberculosis case detection.
Methods: Tuberculosis-suspected patients with a history of cough were screened using chest X-rays at two study sites (Dhulikhel Hospital and Nobel Medical College). The reading of AI qXR software was compared with radiologists reading who were blinded of the results generated by the software.
Results: The sensitivity of the test by qXR-based AI reading was 100%, (95% CI: 40 – 100%) and specificity 80% (95% CI: 73 – 87%), whereas the sensitivity of the test by the radiologist was 100%, (95% CI: 40 – 100%); and specificity 62% (95% CI: 53 – 70%).
Conclusions: Higher sensitivity and specificity were observed for both qXR-based AI and Radiographer readings for the diagnosis of TB.
Keywords: Artificial Intelligence; chest X-ray; diagnostic accuracy; screening; tuberculosis.
Junk Food Consumption Behavior among Young Children
(Nepal Health Research Council, 2024) Banstola, Sanju; Shrestha, Nirmala; Sharma, Bimala
Background: Consumption of junk food degrades the health status of people and is associated with low consumption of nutritious foods, which are essential for physical and mental growth. This study was carried out to find out the junk food consumption and its associated factors among young children.
Methods: A cross-sectional study was conducted among 352 school going children aged 5 to 9 years in Pokhara Metropolitan. Face to face interviews were done with one of the parents of the selected children with the help of a structured questionnaire. The study was done from March to October, 2020. Three or more consumption per week was categorized as high consumption of junk food. A descriptive and multivariate statistical analysis was performed. All inferential analyses were conducted at a 5% level of significance. Ethical approval was taken from the Nepal Health Research Council.
Results: Among the study participants, 70.7% consumed junk food three or more times per week; 66.5% energy dense food, 20.7% consumed noodles; and 9.7% sugary drinks. Consumption of junk food was associated with presence of conventional shop near home,ways type of food provision at school and, food at home after school. Consumption of junk food was found higher among those who got money for food at school (AOR, 2.31), and those who took snacks at home after school (AOR, 12.86).
Conclusions: Consumption of junk food among young children was remarkably high in the study area; concerned authorities should pay attention to dissociating such foods through policies and programs.
Keywords: Children; junk food; Pokhara.
Prediction and Estimation of Postoperative Refractive Error in Phacoemulsification: Using Ultrasound A-Scan and Intra Ocular Lens Master
(Nepal Health Research Council, 2024) Bhatta, Sabitri; Joshi, Sagun Narayan; Thapa, Madhu; Awasthi, Suresh; Shrestha, Gauri Shankar; Joshi, Niraj Dev
Background: This study aims to predict and estimate the postoperative refractive outcome in participants undergoing phacoemulsification using IOL Master and A-scan biometry.
Methods: A cross-sectional study was done where ninety eyes of 90 participants undergone phacoemulsification using SRK/T formula were included in longitudinal research. Each participant underwent axial length (AL) measurement by IOL Master and A-scan, and keratometry reading (k- reading) by manual TOPCON keratometer and automated keratometer on IOL master for IOL power calculation. All the pre-operative measurements between A-scan and IOL master and two keratometers were compared using paired-t tests. The four-week postoperative refractive error was estimated using univariate analysis and its prediction was compared with the ocular biometry parameters using quadratic regression.
Results: Preoperative findings were higher for AL and ACD by IOL master and A-scan (0.27±0.14mm; p<0.001, 0.14±0.31mm, p<0.001) respectively. The AL and K-reading were found to be strong predictors of IOL power calculation (? = -1.07; p<0.001, ? = 0.75; p<0.001), respectively. The AL, K-reading were found to be strong predictors for four-week postoperative refractive error (? = -1.563; p = 0.012, ? = 1.052; p = 0.012) where postoperative error was found to be higher (F = 7.521, p<0.001) in A-scan than IOL Master. For K-reading, the two keratometer’s and for AL by A-scan and IOL Master’s level of agreement (95% LoA) was comparable (-0.15 to 0.12mm and -0.01 to 0.54mm).
Conclusions: IOL Master is more reliable for ocular biometry and minimizes postoperative refractive error.
Keywords: Axial length; intraocular lens power; keratometry-reading; refractive error estimation; postoperative refractive error.