Medical Specialties Commons^™

Registration Of Hyperspectral Images And Mass Spectrometry Data For The Correlation Of Tissue Optical Spectra And Molecular Profiles, Angie T Fei, Douglas W Strand, Jing Wang

Faculty, Staff and Student Publications

Hyperspectral imaging (HSI) is a label-free imaging modality that is emerging for non-invasive detection of various diseases including cancers. HSI provides high-resolution spatial images where each pixel has a spectral curve with numerous wavelength bands from the visible to infrared ranges. The rich spatial and spectral information can be used to discriminate various types of tissues and pathophysiological conditions. However, it can be difficult to explain spectral data with respect to the underline cellular and molecular mechanism. In this study, we developed an approach that registers hyperspectral images and mass spectrometry (MS) data where MS provides tissue molecular profiles. Human …

Refinement Of An Emergency Department-Based, Advance Care Planning Intervention For Patients With Cognitive Impairment And Their Caregivers, Kei Ouchi, Christopher Joshi, Jenson Kaithamattam, Seth A Gale, Gad A Marshall, Alison Pietras, Wei Wang, Edward W Boyer, James A Tulsky, Susan D Block, Dorene Rentz, Mara A Schonberg

Faculty, Staff and Student Publications

Background and objectives: Advance care planning (ACP) conversations are important to provide goal-concordant care (i.e., the care that matches the patient's previously stated goals) near end of life. While 31% of older adults presenting to the emergency department (ED) have dementia, only 39% have previously had ACP conversations. We refined and piloted an ED-based, motivational interview designed to stimulate ACP conversations (ED GOAL) for patients living with cognitive impairment and their caregivers.

Research design and methods: We systematically refined ED GOAL and then conducted an acceptability study in an urban, academic medical center. We prospectively enrolled adults aged 50+ with …

Editorial: Immunological Aspects Of Emerging And Re-Emerging Zoonoses, Wei Wang, Jingxin Li, Yuejin Liang, Wenping Gong

Faculty, Staff and Student Publications

No abstract provided.

Unicentric Castleman Disease: Illustration Of Its Morphologic Spectrum And Review Of The Differential Diagnosis, Siba El Hussein, Andrew G Evans, Hong Fang, Wei Wang, L Jeffrey Medeiros

Faculty, Staff and Student Publications

Context: Unicentric Castleman disease (UCD) is a dynamic entity with a wide spectrum of morphologic findings. UCD can be further subdivided into hyaline-vascular and mixed/plasmacytic variants. Hyaline-vascular UCD has both follicular and interfollicular (stromal) changes, and occasionally these lesions show a skewed representation of either the follicular or stromal compartments. Plasmacytosis is usually minimal in the hyaline-vascular variant. The mixed/plasmacytic variant of UCD is composed of sheets of plasma cells often associated with a variable number of follicles with regressive changes.

Objective: To illustrate the differential diagnosis of UCD, as it is quite broad and includes lymphomas, plasma cell neoplasms, …

Highly Variable Timing Renders Immunotherapy Efficacy And Toxicity Impractical Biomarkers Of One Another In Clinical Practice, Mitchell S Von Itzstein, Yuqiu Yang, Yiqing Wang, David Hsiehchen, Thomas Y Sheffield, Farjana Fattah, Vinita Popat, Murtaza Ahmed, Jade Homsi, Jonathan E Dowell, Sawsan Rashdan, Jay Lohrey, Hans J Hammers, Randall S Hughes, Tao Wang, Yang Xie, David E Gerber

Faculty, Staff and Student Publications

Background: A useful clinical biomarker requires not only association but also a consistent temporal relationship. For instance, chemotherapy-induced neutropenia and epidermal growth-factor inhibitor-related acneiform rash both occur within weeks of treatment initiation, thereby providing information prior to efficacy assessment. Although immune checkpoint inhibitor (ICI)-associated immune-related adverse events (irAE) have been associated with therapeutic benefit, irAE may have delayed and highly variable onset. To determine whether ICI efficacy and irAE could serve as clinically useful biomarkers for predicting each other, we determined the temporal relationship between initial efficacy assessment and irAE onset in a diverse population treated with ICI.

Methods: Using …

Foxp1 And Klf2 Reciprocally Regulate Checkpoints Of Stem-Like To Effector Transition In Car T Cells, Ziang Zhu, Guohua Lou, Xiao-Lu Teng, Haixia Wang, Ying Luo, Wangke Shi, Kiddist Yihunie, Shumeng Hao, Kole Degolier, Chengheng Liao, Huocong Huang, Qing Zhang, Terry Fry, Tao Wang, Chen Yao, Tuoqi Wu

Faculty, Staff and Student Publications

During cancers and infections, self-renewing stem-like CD8+ T cells mediate the response of immunotherapies and replenish terminally exhausted T cells and effector-like T cells. However, the programs governing the lineage choice in chimeric antigen receptor (CAR) T cells are unclear. Here, by simultaneously profiling single-cell chromatin accessibility and transcriptome in the same CAR T cells, we identified heterogeneous chromatin states within CD8+ T cell subsets that foreshadowed transcriptional changes and were primed for regulation by distinct transcription factors. Transcription factors that controlled each CD8+ T cell subset were regulated by high numbers of enhancers and positioned as hubs of gene …

A Reinforcement Learning (Rl)-Motivated Simulation Framework For Evaluating Vancomycin Dosing Strategies, Bingyu Mao, Ziqian Xie, Laila Rasmy, Masayuki Nigo, Degui Zhi

Faculty, Staff and Student Publications

Achieving and maintaining the therapeutic range in vancomycin treatment is important for optimal outcomes. While guidelines and best practices based on empirical studies exist, the theoretical best dosing strategies under various conditions remain illusive. We developed an RL-based simulation framework using a deep learning two-compartment pharmacokinetic model (PK-RNN-2CM) and introduced the area under the time-concentration curve (AUC) reward score, which translates clinical guidelines into an RL reward. Ground truth time-concentration curves were generated from patient-specific data, and simulated curves were produced under different dosing strategies with optional noise perturbations to mimic real-world settings. Evaluation metrics included 24-hour AUC assessments and …

Author Correction: Neoadjuvant Atezolizumab For Resectable Non-Small Cell Lung Cancer: An Open-Label, Single-Arm Phase Ii Trial, Jamie E Chaft, Filiz Oezkan, Mark G Kris, Paul A Bunn, Ignacio I Wistuba, David J Kwiatkowski, Dwight H Owen, Yan Tang, Bruce E Johnson, Jay M Lee, Gerard Lozanski, Maciej Pietrzak, Michal Seweryn, Woo Yul Byun, Katja Schulze, Alan Nicholas, Ann Johnson, Jessica Grindheim, Stephanie Hilz, David S Shames, Chris Rivard, Eric Toloza, Eric B Haura, Ciaran J Mcnamee, G Alexander Patterson, Saiama N Waqar, Valerie W Rusch, David P Carbone

Faculty, Staff and Student Publications

No abstract provided.

Lights And Shadows On Local Recurrence After Renal Surgery: When, Why And How To Manage, Luca Di Gianfrancesco, Alessandro Crestani, Antonio Amodeo, Paolo Corsi, Davide De Marchi, Eugenio Miglioranza, Giuliana Lista, Ferdinando Daniele Vitelli, Francesca Simonetti, Gian Maria Busetto, Ugo Giovanni Falagario, Martina Maggi, Filippo Marino, Giannicola Genovese, Roberto Falabella, Angelo Porreca

Faculty, Staff and Student Publications

Introduction: This review aims to analyze the existing literature on local recurrence (LR) in patients undergoing partial nephrectomy (PN) for renal cell carcinoma, identifying relative risk factors, and exploring optimal clinical management strategies.

Methods: A comprehensive literature search was conducted across bibliographic databases, primarily focusing on LR rates. Secondary outcomes included evaluation of positive surgical margins (PSM), nephrometry scores, pathological stage (T and grading), perioperative outcomes, time-to-LR, overall survival, and cancer-specific survival.

Results: Due to the heterogeneity, a narrative synthesis was performed. LR rates after PN varied in the literature; with PSM emerging as a significant risk factor. Other LR …

Enhanced Tumor Control And Survival In Preclinical Models With Adoptive Cell Therapy Preceded By Low-Dose Radiotherapy, Nahum Puebla-Osorio, Natalie Wall Fowlkes, Hampartsoum B Barsoumian, Kristina Xega, Gitika Srivastava, Claudia Kettlun-Leyton, Sara Nizzero, Tiffany Voss, Thomas S Riad, Christina Wong, Ailing Huang, Yun Hu, Joylise Mitchell, Mingee Kim, Zahid Rafiq, Kewen He, Duygu Sezen, Ethan Hsu, Fatemeh Masrorpour, Aurian Maleki, Carola Leuschner, Maria Angelica Cortez, Philipp Oertle, Marko Loparic, Marija Plodinec, Janet L Markman, James W Welsh

Faculty, Staff and Student Publications

Introduction: Effective infiltration of chimeric antigen receptor T (CAR-T) cells into solid tumors is critical for achieving a robust antitumor response and improving therapeutic outcomes. While CAR-T cell therapies have succeeded in hematologic malignancies, their efficacy in solid tumors remains limited due to poor tumor penetration and an immunosuppressive tumor microenvironment. This study aimed to evaluate the potential of low-dose radiotherapy (LDRT) administered before T-cell therapy to enhance the antitumor effect by promoting CAR-T cell infiltration. We hypothesized that combining LDRT with T-cell therapy would improve tumor control and survival compared to either treatment alone.

Methods: We investigated this hypothesis …

Combination Chemotherapy Optimization With Discrete Dosing, Temitayo Ajayi, Seyedmohammadhossein Hosseinian, Andrew J Schaefer, Clifton D Fuller

Faculty, Staff and Student Publications

Chemotherapy drug administration is a complex problem that often requires expensive clinical trials to evaluate potential regimens; one way to alleviate this burden and better inform future trials is to build reliable models for drug administration. This paper presents a mixed-integer program for combination chemotherapy (utilization of multiple drugs) optimization that incorporates various important operational constraints and, besides dose and concentration limits, controls treatment toxicity based on its effect on the count of white blood cells. To address the uncertainty of tumor heterogeneity, we also propose chance constraints that guarantee reaching an operable tumor size with a high probability in …

Monitoring Variations In The Use Of Automated Contouring Software, Kelly A Nealon, Eun Young Han, Stephen F Kry, Callistus Nguyen, Mary Pham, Valerie K Reed, David Rosenthal, Samantha Simiele, Laurence E Court

Faculty, Staff and Student Publications

PURPOSE: Our purpose was to identify variations in the clinical use of automatically generated contours that could be attributed to software error, off-label use, or automation bias.

METHODS AND MATERIALS: For 500 head and neck patients who were contoured by an in-house automated contouring system, Dice similarity coefficient and added path length were calculated between the contours generated by the automated system and the final contours after editing for clinical use. Statistical process control was used and control charts were generated with control limits at 3 standard deviations. Contours that exceeded the thresholds were investigated to determine the cause. Moving …

Nontuberculosis Mycobacteria (Ntm) Infections In Patients With Leukemia: A Single Center Case Series, Jennifer Marvin-Peek, Koji Sasaki, Dimitrios P Kontoyiannis, Javier Adachi, Maro Ohanian, Koichi Takahashi, Ghayas C Issa, Steven Kornblau, Hussein A Abbas

Faculty, Staff and Student Publications

Patients with leukemia experience profound immunosuppression both from their underlying disease as well as chemotherapeutic treatment. Little is known about the prevalence and clinical presentation of nontuberculous mycobacteria (NTM) in this patient population. We identified six cases of NTM infection from 29,743 leukemia patients who had acid-fast bacilli (AFB) cultures. Four cases had bloodstream infections and five had disseminated disease, including one who presented with an unusual case of diffuse cellulitis/myositis. All patients were lymphopenic at time of diagnosis, and two patients ultimately died from their NTM infection. NTM infections are a rare, but potentially life-threatening infection in patients with …

Emerging Therapeutic Options For Follicular-Derived Thyroid Cancer In The Era Of Immunotherapy, Naimah Turner, Sarah Hamidi, Rim Ouni, Rene Rico, Ying C Henderson, Maria Puche, Sayan Alekseev, Jocelynn G Colunga-Minutti, Mark E Zafereo, Stephen Y Lai, Sang T Kim, Maria E Cabanillas, Roza Nurieva

Faculty, Staff and Student Publications

Although most follicular-derived thyroid cancers are well differentiated and have an overall excellent prognosis following treatment with surgery and radioiodine, management of advanced thyroid cancers, including iodine refractory disease and poorly differentiated/undifferentiated subtypes, is more challenging. Over the past decade, better understanding of the genetic drivers and immune milieu of advanced thyroid cancers has led to significant progress in the management of these patients. Numerous targeted kinase inhibitors are now approved by the U.S Food and Drug administration (FDA) for the treatment of advanced, radioiodine refractory differentiated thyroid cancers (DTC) as well as anaplastic thyroid cancer (ATC). Immunotherapy has also …

Canadian French Translation And Validation Of The Neck Dissection Impairment Index: A Quality Of Life Measure For The Surgical Oncology Population, Michel Khoury, William Guertin, Cameo Hao, Mikhail Saltychev, Tareck Ayad, Eric Bissada, Apostolos Christopoulos, Sami Moubayed, Marie-Jo Olivier, Douglas Chepeha, Stephen Y Lai, Anastasios Maniakas

Faculty, Staff and Student Publications

BACKGROUND: Neck dissections (ND) are a routine procedure in head and neck oncology. Given the postoperative functional impact that some patients experience, it is imperative to identify and track quality of life (QoL) symptomatology to tailor each patient's therapeutic needs. To date, there is no validated French-Canadian questionnaire for this patient-population. We therefore sought to translate and validate the Neck Dissection Impairment Index (NDII) in Canadian French.

METHODS: A 3-phased approach was used. Phase 1: The NDII was translated from English to Canadian French using a "forward and backward" translational technique following international guidelines. Phase 2: A cognitive debriefing session …

Quantification Of Gastric Muscle Interstitial Cells Of Cajal In Individuals With And Without Gastroparesis: A Pilot Study, Shazia Rashid, Michelle Neice, Hailey Canezaro, Victoria Andrus, Maryam Mubashir, Syed Musa Raza, James Traylor, Hidehiro Takei, Qiang Cai

Faculty, Staff and Student Publications

No abstract provided.

Rising Prevalence Of Mild Chronic Gastritis In Children: A Single Center Experience, Rohit Josyabhatla, Mary Lauren Wood, Amber Gafur, Nina Tatevian, Amanda S Tchakarov, Syed Shahrukh Hashmi, Jon Marc Rhoads, Melissa Renee Van Arsdall

Faculty, Staff and Student Publications

OBJECTIVES AND METHODS: We analyzed upper endoscopic and histological findings in 3 cohorts of children undergoing upper gastrointestinal endoscopy over a 10-year period. Five hundred seventy-nine patients were identified, with 244 (42%), 199 (35%), and 136 (23%) in the 2011, 2015, and 2019 cohorts, respectively. The most common symptoms and signs were abdominal pain, vomiting, failure to thrive, and diarrhea.

RESULTS: The number of patients who had histological evidence of chronic gastritis increased from 2011 (n = 70, 29%) to 2015 (n = 106, 53%) and 2019 (n = 92, 68%;

CONCLUSIONS: There has been a significant rise in the …

Rapid Detection Of Mutations In Csf-Cftna With The Genexus Integrated Sequencer, Srividya Arjuna, Mauli Shah, Antonio Dono, Luis Nunez-Rubiano, Pavel S Pichardo-Rojas, Jay-Jiguang Zhu, Roy F Riascos, Rajyalakshmi Luthra, Sinchita Roy-Chowdhuri, Dzifa Duose, Daniel H Wang, Frederick F Lang, Yoshua Esquenazi, Leomar Y Ballester

Faculty, Staff and Student Publications

PURPOSE: Genomic alterations are fundamental for molecular-guided therapy in patients with breast and lung cancer. However, the turn-around time of standard next-generation sequencing assays is a limiting factor in the timely delivery of genomic information for clinical decision-making.

METHODS: In this study, we evaluated genomic alterations in 54 cerebrospinal fluid samples from 33 patients with metastatic lung cancer and metastatic breast cancer to the brain using the Oncomine Precision Assay on the Genexus sequencer. There were nine patients with samples collected at multiple time points.

RESULTS: Cell-free total nucleic acids (cfTNA) were extracted from CSF (0.1-11.2 ng/μl). Median base coverage …

The Impact Of Covid-19 Pandemic On Global Neurosurgery Collaborations., Alvan Emeka Ukachukwu, Nancy Abu Bonsrah, Andreas Seas, Zoey Petitt, Romaric Waguia Kouam, Samantha Ramos, Alyssa Edwards, Di Deng, Michael Haglund, Mahmood Qureshi

General Surgery, East Africa

No abstract provided.

Feasibility And Safety Of Early Post-Covid-19 High-Intensity Gait Training: A Pilot Study, Joakim Halvorsen, Christopher Henderson, Wendy Romney, Magnus Hågå, Tonje Barkenæs Eggen, Jan Egil Nordvik, Ingvild Rosseland, Jennifer Moore

Physical Therapy Faculty Publications

Background: The feasibility and safety of rehabilitation interventions for individuals recovering from COVID-19 after the acute stage is not well understood. This pilot study aims to provide a preliminary investigation of the feasibility and safety of providing high-intensity gait training (HIT) with a targeted cardiovascular intensity of 70–85% of the age-predicted maximum heart rate (HRmax) for individuals undergoing rehabilitation post-COVID-19. Methods: Consecutive patients who were medically cleared for HIT were invited to participate in the study. Participants practiced walking in varied contexts (treadmill, overground, and stairs), aiming to spend as much time as possible within their target cardiovascular intensity zone …

Successful Management Of Spontaneous Unilateral Twin Ectopic Pregnancy With Two-Step Dose Of Methotrexate, Lauren A. Forbes, Navya Nuthivana, Renee Morales

Department of Obstetrics & Gynecology Faculty Publications

The incidence of unilateral tubal twin pregnancy is 1/20,000–1/250,000 with about 100 reported cases. Four of the six cases that were medically managed were successful. A 24-year-old female presented to the emergency department (ED) with vaginal bleeding and abdominal cramping. She was hemodynamically stable without signs of an acute abdomen. Laboratory evaluation revealed she was pregnant with a serum beta-human chorionic gonadotropin (b-hCG) of 798 mIU/mL. Transvaginal ultrasound (TVUS) revealed a single left tubal pregnancy with a yolk sac. The patient elected medical management with body surface area (BSA)–based intramuscular (IM) methotrexate (MTX). On Day 4, the patient returned to …

Sociodemographic Correlates Of Low Health Literacy Skills Among Cancer Survivors: National Findings From Brfss 2016 And Implications For Precision Survivorship Care, Qi Chen, John Moore, Lailea Noel, Kirk Von Sternberg, Barbara Jones

Publications and Research

Purpose: This study aimed to explore associations of sociodemographic factors with difficulties in three health literacy (HL) skills and the severity of low HL skills.

Design: Cross-sectional secondary data analysis. Subjects: Data came from 17,834 adults who responded to the HL module with a response rate of 47% in the 2016 Behavioral Risk Factor Surveillance System.

Measures: Independent variables included sex, age, race/ethnicity, education, employment and income. Dependent variables are three HL skills: obtaining, understanding oral, and understanding written health information.

Analysis: We conducted weighted Chi-square tests and multinominal logistic regressions.

Results: Cancer survivors younger than 65 (aged 18-39: AOR=4.46, …

Alopecia As An Early Clinical Marker For Azathioprine Induced Myelosuppression: A Case Report, Nilanjana Dutta , Final Year Mbbs, Dr. M Suresh Babu , Professor, Dr. Subramanian Ramaswamy , Professor, Dr. Mahabaleshwar Mamadapur , Assistant Professor

Digital Journal of Clinical Medicine

Azathioprine is a pro-drug and is metabolized by the TPMT enzyme in the body. In South Asians, Azathioprine is known to cause alopecia and bone marrow suppression in patients with TPMT enzyme deficiency. In India, the prevalence of TPMT mutation varies from 1.2- 10%. A new mutation was detected in 2014, NUDT15 whose incidence varies from 8.5-16%. Patients with mutation in both TPMT and NUDT15 develop myelosuppression faster. In our case, alopecia manifested as the first clinical feature of Azathioprine myelosuppression. Physicians need to recognize early clinical clues (alopecia) to avoid the impending development of myelosuppression and to look for …

Management Of Extracranial Schwannomas In Head And Neck Region - An Observational Study, Sambit Shubham Behera, Krishna Arpita Sahoo, Chinmaya Sundar Ray, Shreyas V, Nandigam Nithin Kumar

Digital Journal of Clinical Medicine

ABSTRACT

Background: Schwannomas, benign tumors arising from Schwann cells, often manifest as slow-growing lesions in the peripheral nerve sheath. While typically asymptomatic, they can affect cranial and peripheral nerves. Surgical excision is the primary treatment, but preserving nerve function poses challenges.

Methods: This retrospective study analyzed 12 cases of benign head and neck schwannomas diagnosed at Department of ENT, SCB Medical College, Orissa, India between 2021 and 2023. Data encompassed patient demographics, tumor characteristics, diagnostic methods, surgical approaches, histopathology, and follow-up outcomes. Pre-operative investigations included Fine Needle Aspiration Cytology, Ultrasonography, and imaging.

Results: Predominantly middle-aged and male patients presented with …

To Compare The Efficacy Of Oral Deflazacort, Oral Prednisolone And Inhaled Budesonide In The Treatment Of Salbutamol Refractory Acute Asthma In Children, Santosh Kondekar, Unmesh Dev M, Surbhi Rathi, Gulrej N. Shaikh

Digital Journal of Clinical Medicine

Abstract

Background: A 22-month open-label randomized comparative study was conducted at tertiary care centre attached to medical college in metropolitan city in Maharashtra from Dec 2011 to Oct 2013, aiming to compare the effectiveness of three corticosteroid treatments - oral deflazacort, oral prednisolone, and inhaled budesonide in managing salbutamol-refractory asthma in children aged 1-14 years.

Methods: 90 afebrile children were equally allocated to the different treatment arms. Treatment arm A received oral Deflazacort (1mg/kg/day alternate day), treatment arm B received oral prednisolone (1mg/kg/day), and treatment arm C received budesonide inhaler (100 mcg/puff twice a day) for seven days, along with …

A Real World Study Of Adherence To Insulin In Diabetic Humans-Stadium Study, Dipsanker Chatterjee, Subham Das

Digital Journal of Clinical Medicine

Background:

With an ever-increasing prevalence of diabetes, lack of adherence to insulin treatment in even a small percentage of patients is a major issue and can lead to significant burden on the healthcare system. This survey analysis seeks to investigate the insulin adherence patterns to identify the factors associated with medication adherence.

Methodology:

The current cross-sectional survey was conducted among diabetes patients on insulin treatment. A list of questions about insulin adherence was provided to the participants in the study and the responses were recorded. The data was analysed using Graph Pad Prism.

Results:

Around 23.2 and 18.6 % of …

Internet Addiction: A Growing Threat: A Cross-Sectional Among The Undergraduate Medical Students Of Tertiary Care Hospital, Mysuru, Rakesh M, Diksha Goswami, Sunil Kumar D, Shwethashree M

Digital Journal of Clinical Medicine

Background: The internet has quickly become a part of our lives, impacting every part of our existence. Its use has expanded beyond simply being a communication tool and a source of information. The objective of the study is to assess the prevalence of Internet addiction among the Undergraduate medical students of Mysuru.

Methods: This cross-sectional study was conducted among 255 medical students of a Tertiary care Hospital, Mysuru for three months from September 1^st to November 30^th,2023. Data was collected using a semi-structured questionnaire. The semi-structured questionnaire covered details of demographic data and twenty questions of the …

Placenta Accreta Spectrum Disorder As First Trimester Pregnancy Termination Complication; Case Series, Sindhu Kumari, Poornima M

Digital Journal of Clinical Medicine

Placenta Accreta Spectrum (PAS) disorder is rare (2% according to ACOG) condition of pregnancy when the placenta grows deeply into myometrium. This leads to failure of placenta to separate normally from myometrium after delivery and leads to massive hemorrhage. The PAS is classified as PA (Placenta Accreta), PI (Placenta Increta) and PP ( Placenta Percreta), on basis of depth of trophoblastic invasion. Increase in no. of cesarean sections, increasing the incidence of PAS. Cesarean scar on uterus promotes placental tissue to invade deeply in subsequent pregnancy. Antenatal scanning and color imaging can detect PAS, at a very early stage. Here …

Gender Equality– A Sustainable Development Goal In Progress At A Medical College And Hospital In South India, Mr. Manoj S M, Kusuma Kasapura Shivashankar, Suma M. Natraj, Praveen Kulkarni

Digital Journal of Clinical Medicine

Background: Gender Equality is one of the most important SDG and attaining it will ensure a peaceful, prosperous and a balanced world with equal opportunities for both women and men. The Indian scenario in the field of women education has changed with mindset of most parents undergoing a paradigm shift and many girls are encouraged to attend schools, colleges and women are allowed to work. Considering the above shift, our study intended to find out if the same was true and SDG-5, Gender Equality was attained or in progress at our medical college and hospital and hence the study.

Methods: …

The Balm Framework Of Clinical Excellence: An Adoptable Model For Sub-Saharan Africa., Taoreed Adegoke Azeez

Digital Journal of Clinical Medicine

Clinical excellence is the ability to provide rigorous, evidence-based, and rewarding care to the right patients. The BALM (brilliance, attitude, leadership, and materials) framework is a novel model for adjudicating clinical excellence. There are a few models and frameworks for evaluating clinical excellence, but each has its flaws and does not consider the peculiarities of economically-challenged regions such as sub-Saharan Africa. Coincidentally, such low-resource areas have an urgent need for a framework to assess clinical excellence because of their low health-related indices. The five-step mode of professional excellence is a well-recognised tool and was the model upon which the BALM …