scholarly journals Pharmacogenomics to Drive COVID-19 Therapy for Best Outcome in a Low Resource Setting

2020 ◽  
Author(s):  
Gayatri Iyer ◽  
Syeda Zubeda ◽  
Aruna Priya Kamireddy ◽  
Qurratulain Hasan
Keyword(s):  
Virus Disease ◽  
Standard Dose ◽  
Specific Treatment ◽  
Key Factors ◽  
Viral Binding ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Indispensable Tool ◽  
Line Of Therapy ◽  
Require Dose

Corona virus disease 2019 (COVID-19) has taken the world by storm with global infectivity and mortality of 3.5%. Since there is no specific treatment for COVID-19, several drugs have been repurposed to combat infection, these include drugs like anti-malarial – chloroquine, hydroxychloroquine, anti- diarrheal– loperamide and antipsychotic-promazine, which have been considered to be effective inhibitors as of viral binding to ACE2 receptor. The administration of these drugs is currently random and is the key factors responsible for varied treatment response, hence genes involved in drug metabolism should be analysed before planning therapy. Genes involved in metabolism of the listed drugs are ABCB1, CYP1A2, CYP2C8, CYP2C19, CYP3A4 and CYP2D6. Unpublished pharmacogenomic data from our internal cohort (75 cases) was analyzed to predict likely-responders and non-responders to propose drugs for COVID-19 drug therapy in our population. Preliminary data from random individuals without bias indicates that both anti-malarials at standard dose will benefit 98% of our cases (in absence of co-morbidities), while 11-85% of individuals would require dose reduction/alternatives for loperamide and promazine. Anti-malarials like chloroquine, hydroxychroloquine can be prescribed for prophylaxis and as first line of therapy in absence of comorbidities.  Simple genotype testing of ABCB1, CYP1A2, CYP2C19 and CYP2D6 is an indispensable tool to predict treatment outcomes of loperamide and promazine for COVID-19 patients.

Evaluation of a New Protocol of Insulin Dose Adjustment in a Low-Resource Setting

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 93-LB
Author(s):  
EDDY JEAN BAPTISTE ◽  
PHILIPPE LARCO ◽  
MARIE-NANCY CHARLES LARCO ◽  
JULIA E. VON OETTINGEN ◽  
EDDLYS DUBOIS ◽  
...  
Keyword(s):  
Dose Adjustment ◽  
Insulin Dose ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting

scholarly journals Right paraduodenal hernia with extensive bowel gangrene treated with staged surgery: a Bogota bag followed by resection in a low-resource setting

2021 ◽  
Vol 14 (4) ◽  
pp. e239250
Author(s):  
Vijay Anand Ismavel ◽  
Moloti Kichu ◽  
David Paul Hechhula ◽  
Rebecca Yanadi
Keyword(s):  
Plastic Material ◽  
Successful Outcome ◽  
Paraduodenal Hernia ◽  
Transparent Plastic ◽  
Low Resource ◽  
Entire Small Bowel ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Right Paraduodenal Hernia ◽  
Bowel Gangrene

We report a case of right paraduodenal hernia with strangulation of almost the entire small bowel at presentation. Since resection of all bowel of doubtful viability would have resulted in too little residual length to sustain life, a Bogota bag was fashioned using transparent plastic material from an urine drainage bag and the patient monitored intensively for 18 hours. At re-laparotomy, clear demarcation lines had formed with adequate length of viable bowel (100 cm) and resection with anastomosis was done with a good outcome on follow-up, 9 months after surgery. Our description of a rare cause of strangulated intestinal obstruction and a novel method of maximising length of viable bowel is reported for its successful outcome in a low-resource setting.

scholarly journals Humanitarian Surgical Missions in Times of COVID-19: Recommendations to Safely Return to a Sub-Saharan Africa Low-Resource Setting

2021 ◽  
Author(s):  
Víctor Lopez-Lopez ◽  
Ana Morales ◽  
Elisa García-Vazquez ◽  
Miguel González ◽  
Quiteria Hernandez ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Sub Saharan

scholarly journals Vulvar cancer: surgical management and survival trends in a low resource setting

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Navin Kumar ◽  
Mukur Dipi Ray ◽  
D. N. Sharma ◽  
Rambha Pandey ◽  
Kanak Lata ◽  
...  
Keyword(s):  
Surgical Management ◽  
Vulvar Cancer ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting

scholarly journals Lung ultrasound training and evaluation for proficiency among physicians in a low-resource setting

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Darlene R. House ◽  
Yogendra Amatya ◽  
Benjamin Nti ◽  
Frances M. Russell
Keyword(s):  
Lung Ultrasound ◽  
Cumulative Sum Analysis ◽  
Resource Setting ◽  
Individual Zone ◽  
Low Resource Setting ◽  
Hands On ◽  
Level Of Training ◽  
A Prospective Study ◽  
Training Physicians ◽  
Study Physician

Abstract Background Lung ultrasound (LUS) is helpful for the evaluation of patients with dyspnea in the emergency department (ED). However, it remains unclear how much training and how many LUS examinations are needed for ED physicians to obtain proficiency. The objective of this study was to determine the threshold number of LUS physicians need to perform to achieve proficiency for interpreting LUS on ED patients with dyspnea. Methods A prospective study was performed at Patan Hospital in Nepal, evaluating proficiency of physicians novice to LUS. After eight hours of didactics and hands-on training, physicians independently performed and interpreted ultrasounds on patients presenting to the ED with dyspnea. An expert sonographer blinded to patient data and LUS interpretation reviewed images and provided an expert interpretation. Interobserver agreement was performed between the study physician and expert physician interpretation. Cumulative sum analysis was used to determine the number of scans required to attain an acceptable level of training. Results Nineteen physicians were included in the study, submitting 330 LUS examinations with 3288 lung zones. Eighteen physicians (95%) reached proficiency. Physicians reached proficiency for interpreting LUS accurately when compared to an expert after 4.4 (SD 2.2) LUS studies for individual zone interpretation and 4.8 (SD 2.3) studies for overall interpretation, respectively. Conclusions Following 1 day of training, the majority of physicians novice to LUS achieved proficiency with interpretation of lung ultrasound after less than five ultrasound examinations performed independently.

Multi-level Chunk-based Constituent-to-Dependency Treebank Transformation for Tibetan Dependency Parsing

2021 ◽  
Vol 20 (2) ◽  
pp. 1-12
Author(s):  
Shumin Shi ◽  
Dan Luo ◽  
Xing Wu ◽  
Congjun Long ◽  
Heyan Huang
Keyword(s):  
Language Processing ◽  
Manual Annotation ◽  
Syntactic Parsing ◽  
Dependency Parsing ◽  
Low Resource ◽  
Resource Setting ◽  
Dependency Tree ◽  
Low Resource Setting ◽  
Novel Method ◽  
Multi Level

Dependency parsing is an important task for Natural Language Processing (NLP). However, a mature parser requires a large treebank for training, which is still extremely costly to create. Tibetan is a kind of extremely low-resource language for NLP, there is no available Tibetan dependency treebank, which is currently obtained by manual annotation. Furthermore, there are few related kinds of research on the construction of treebank. We propose a novel method of multi-level chunk-based syntactic parsing to complete constituent-to-dependency treebank conversion for Tibetan under scarce conditions. Our method mines more dependencies of Tibetan sentences, builds a high-quality Tibetan dependency tree corpus, and makes fuller use of the inherent laws of the language itself. We train the dependency parsing models on the dependency treebank obtained by the preliminary transformation. The model achieves 86.5% accuracy, 96% LAS, and 97.85% UAS, which exceeds the optimal results of existing conversion methods. The experimental results show that our method has the potential to use a low-resource setting, which means we not only solve the problem of scarce Tibetan dependency treebank but also avoid needless manual annotation. The method embodies the regularity of strong knowledge-guided linguistic analysis methods, which is of great significance to promote the research of Tibetan information processing.

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