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Introduction: Orthopaedic surgeons are among the most frequent users of radiation and are often exposed to X-Ray radiation regularly. There is an overall unsatisfactory level of knowledge, attitude, and practices regarding the same among surgeons. This study aimed to assess the practices among orthopaedic surgeons regarding radiation and its hazards in India. Methodology: This questionnaire-based survey was conducted between March and September 2022. The questionnaire broadly assessed the knowledge, awareness, and practices among orthopaedic surgeons regularly exposed to X-ray radiation. The questionnaire consisted of objective and Likert scale questions which were distributed to the respondents electronically using publicly available contact information. A qualitative review of interpretations obtained from the responses and available evidence in the literature was then performed. Results: The response rate for the survey was 36.4%. 65.9% reported using trunk protection all the time during procedures. 57.1% of respondents reported not using thyroid protection during procedures. 92.3% reported not using protective goggles and 100% did not use appropriate gloves. 76.9% were not issued dosimeters, and only 5.5% of those who had been issued one wore it during radiation procedures. 58.2% reported having a dedicated employee to operate the machine. 86.8% of respondents did not have formal training and 81.3% were not aware of institutes offering formal training. Conclusion: There is very high compliance with the use of protection aprons among the respondents however, the use of other apparel like thyroid shields, protection goggles and gloves was poor. The awareness regarding radiation exposure was also poor as most respondents were not issued dosimeters, however, those issued with one were well aware of their exposure. It is imperative to prioritize both surgeons' and patients' safety where radiation exposure is concerned. [ABSTRACT FROM AUTHOR]

Introduction: Spinopelvic malalignment causes continual backache. Intervertebral Disc Degeneration (IDD) is a leading cause of low backache. Understanding the relationship between spinopelvic parameters and IDD can help with better diagnosis and treatment and avoid unnecessary investigations. Aim: To measure radiographic spinopelvic parameters of patients diagnosed with varying grades of IDD in the lumbosacral spine on Magnetic Resonance Imaging (MRI), and to compare them with radiographs of the asymptomatic population (controls). Materials and Methods: A hospital-based retrospective observational study was done from January 2021 to August 2022 at a tertiary care hospital in Uttar Pradesh, India with 80 patients diagnosed with IDD on MRI and 80 controls. Cases were defined as patients diagnosed to have IDD on MRI and controls were those individuals who did not have disc degeneration on MRI. Lateral lumbosacral spine radiographs were taken, and spinopelvic parameters {Pelvic Tilt (PT), Sacral Slope (SS), Pelvic Incidence (PI), Lumbar Lordosis (LL), lumbo-sacral angle, and sacral horizontal angle} were measured using Surgimap Spine Software. T-test and Chi-square test were used for comparison between cases and controls. Results: Six patients had asymmetric disc bulge, 11 had symmetric disc bulge, 18 had disc extrusion and 45 had disc protrusion. Mean PT in patients with IDD was 11.05±3.84°, and control was 8.65±3.19°, p-value=0.009. Mean SS in case group was 38.38±3.03° and control was 36.56±3.43°, p-value=0.031. The mean PI of cases was 49.44±8.39° and control 46.19±9.01°, p-value=0.02. LL angle was higher in IDD at 46.34°, and was 45.36° in healthy individuals, without statistically significant difference. The mean lumbo-sacral angle in both study groups was similar. The mean Sacral Inclination Angle (SIA) was found to be 43.99° and 44.96° in the case and control group respectively without showing significant differences. A statistically significant difference was found only for the comparison of PT between different grades of IDD (p-value=0.039). Conclusion: Using Surgimap Spine Software, one can predict the individuals that possess a greater propensity of developing degeneration of disc and chronic low back pain in a more costeffective manner. [ABSTRACT FROM AUTHOR]

X-class solar flares, which occurred in the daytime from 2008 to 2016 during solar cycle 24, were studied for their influence on the lower ionosphere over the lowequatorial Indian region. To understand the D-region behaviour during flare events, we used the very low frequency (VLF) navigational transmitter NWC (19.8 kHz) signal recorded at Pryagraj, Uttar Pradesh, India. A total of seven parameters were estimated: (i) the magnitude of X-ray flux, (ii) VLF signal rising amplitude perturbation (SRAP), (iii) X-ray flux and NWC signal start time difference (STD), (iv) peak time difference (PTD), (v) Wait’s ionospheric parameters h′ (reference height), (vi) β (sharpness factor) and (vii) D-region electron density difference (EDD) to determine the overall effect of solar flares on the D-region. The results suggest that three parameters (X-ray flux, SRAP and h′) show a decreasing trend through the linear fit line, two parameters (β and EDD) show an increasing trend, while the remaining two parameters show a mixed trend (decrease during low activity and increase during high activity). Further, the trend line during the diurnal variation shows an increasing trend for X-ray flux, PTD and h′, and a decreasing trend for SRAP, STD, β and EDD. Deviation in the case of individual events may indicate the dependence of these parameters on the seasons as well. The present study will provide the base for more robust analysis and modelling work in the future to understand the complexity of ionospheric change during flare events, and to develop a predictive model for space weather mitigation. [ABSTRACT FROM AUTHOR]

Introduction: The Posterior Tibial Slope (PTS) is an angle formed by the tibial plateau and supports the biomechanics of the knee joint. This slope is found to be a factor in differentiating ACL tear injuries. Earlier studies have shown the association of PTS with Anterior Cruciate Ligament (ACL) tears but have not evaluated the PTS values for different gradings. Aim: To evaluate the PTS on X-ray and Magnetic Resonance Imaging (MRI), for patients with different grades of ACL tears, and patients identified with meniscal tears. Materials and Methods: This cross-sectional study was conducted from April 2020 to March 2021 at the Department of Radiodiagnosis and Imaging, KS Hegde hospital, Mangaluru, Karnataka, India. A total of 30 patients were studied, in which 20 patients with ACL tears underwent both X-ray and MRI, while the 10 patients with meniscal tears were only subjected to MRI. The PTS was evaluated for different grades of ACL tears on X-ray and MRI by an experienced Radiologist. The number of patients with grade I, grade II, and grade III ACL tears were 7, 6 and 7, respectively. Paired t-test was used to evaluate the mean PTS for the identified grade of the ACL tear. One-way Analysis of Variance (ANOVA) and Bonferroni post hoc test was used to analyse the difference between grades of the ACL tear. Results: The mean age of the study population was 32.50±16.363 years, and the male-to-female ratio was 4:1. Both right, as well as the left knee, were included in the study, and the left-to-right knee ratio was 3:2. There was a significant difference in PTS between Grades of ACL tears (p-value-0.001). The PTS was observed to increase as the severity of the ACL injury increased. The mean PTS value obtained on x-ray for grade I, grade II, and grade III ACL tears were 10.85±0.54, 14.18±0.62, and 16.46±1.56, respectively. While the mean PTS value obtained on MRI for grade I, grade II, and grade III ACL tears were 10.85±0.53, 14.19±0.60, and 16.47±1.55, respectively. There was no significant difference in the PTS measured for ACL tears between the X-ray and MRI (p-value>0.05). Further, the results did not show any difference of significance in the PTS measured on MRI between ACL tears and meniscal tears (p-value>0.05). Conclusion: The PTS can be used as an aid in the identification of the severity of the ACL injury. The PTS could also be used as a tool to recognise the presence of ACL tears on X-ray and this could be an important prognostic factor towards the functional outcome. [ABSTRACT FROM AUTHOR]

X-rays are the primary tools in examining the suspected fractures in humans in this era. Manual examination of X rays is a time-consuming process, which requires expert radiologists or trained orthopaedic surgeons. The demanding workloads, unavailability of radiologists in small setups and at primary/community health centres results in the inability to diagnose and delay in the treatment due to unnecessary referrals by the primary care clinicians. Moreover, the shortage of expert radiologists and orthopaedic surgeons in medically under-resourced areas such as rural areas in India have motivated us to develop an automated fracture detection model. We have developed a deep neural network to detect, localize and divide the wrist region into segments to identify fractures around wrist joint in radiographs. The orthopaedic surgeon has manually annotated the fractures by drawing a bounding box and segmented mask. We have utilized two different domains of datasets for the better convergence of the model. There is a similarity in the crack patterns of the surface crack image dataset and the wrist fracture dataset, which consists of 3000 and 315 images. A part of the dataset is made publicly available for research purposes to overcome data collection and labelling barriers for identifying wrist fractures. The crack patterns in the wrist bone samples are learned by effectively transferring the knowledge or weights obtained from surface crack datasets. The proposed architecture utilizes Feature Pyramid Network as the backbone architecture where the last-level max pool layer of the architecture is replaced with the concatenation of AdaptiveConcatPool, AdaptiveAvgPool, AdaptiveMaxPool layers. Additionally, the concept of freezing and unfreezing the network during two phases of transfer learning is utilized for better model convergence. Every radiograph is assigned a ground truth label for evaluating the accuracy of the model. The performance measure for fracture detection and localization is evaluated using the Average precision value using the concept of Intersection over Union. The result of the proposed model is compared against the ground truth label annotated by the radiologists and related studies. The average precision of 92.278 on 50° and 79.003 on a strict scale of 75° was reported for fracture detection. Similarly, the average precision of 77.445 on 50° and 52.156 on a strict scale of 75° was reported for fracture segmentation. [ABSTRACT FROM AUTHOR]

Background: In India, raw peanuts are obtained by aggregators from smallholder farms in the form of whole pods and the price is based on a manual estimation of basic peanut pod and kernel characteristics. These methods of raw produce evaluation are slow and can result in procurement irregularities. The procurement delays combined with the lack of storage facilities lead to fungal contaminations and pose a serious threat to food safety in many regions. To address this gap, we investigated whether X-ray technology could be used for the rapid assessment of the key peanut qualities that are important for price estimation. Results: We generated 1752 individual peanut pod 2D X-ray projections using a computed tomography (CT) system (CTportable160.90). Out of these projections we predicted the kernel weight and shell weight, which are important indicators of the produce price. Two methods for the feature prediction were tested: (i) X-ray image transformation (XRT) and (ii) a trained convolutional neural network (CNN). The prediction power of these methods was tested against the gravimetric measurements of kernel weight and shell weight in diverse peanut pod varieties1. Both methods predicted the kernel mass with R2 > 0.93 (XRT: R2 = 0.93 and mean error estimate (MAE) = 0.17, CNN: R2 = 0.95 and MAE = 0.14). While the shell weight was predicted more accurately by CNN (R2 = 0.91, MAE = 0.09) compared to XRT (R2 = 0.78; MAE = 0.08). Conclusion: Our study demonstrated that the X-ray based system is a relevant technology option for the estimation of key peanut produce indicators (Figure 1). The obtained results justify further research to adapt the existing X-ray system for the rapid, accurate and objective peanut procurement process. Fast and accurate estimates of produce value are a necessary pre-requisite to avoid post-harvest losses due to fungal contamination and, at the same time, allow the fair payment to farmers. Additionally, the same technology could also assist crop improvement programs in selecting and developing peanut cultivars with enhanced economic value in a high-throughput manner by skipping the shelling of the pods completely. This study demonstrated the technical feasibility of the approach and is a first step to realize a technology-driven peanut production system transformation of the future. [ABSTRACT FROM AUTHOR]

Background: Drug resistant tuberculosis is a major public health threat that hinders progress in tuberculosis control worldwide. In 2019, India contributed highest cases of TB (27%) Worldwide. In 2019, 3.3% of new TB cases and 18% of previously treated cases had MDR/RRTB worldwide and India (27%) had the largest share of the global burden. This study was done to find out the sociodemographic and clinical profile of drug resistant TB patients. Methodology: It is an observational descriptive study with cross-sectional design, conducted at the drug resistant tuberculosis centre of R. G. Kar Medical College of Kolkata, West Bengal. Study Population consisted of the patients who were registered for the DR-TB regimen. Study duration was July 2016-March 2017. Pre-tested, semi-structured schedule was designed to capture their sociodemographic profile, treatment history, clinical findings and available medical records. Data were compiled in MS Excel and analyzed in IBM SPSS 23.0. Results: Out of 159 cases, 27% patients were between 21-30 years. Males were predominant (68.6%). Most patients (56.6%) were underweight (BMI<18.5kg/m2). HIV seropositivity was found in 4 (2.5%) cases. Among all cases, 81.1% had history of taking ATD and 34.4% was cured in previous episode of treatment. The commonest associated comorbidity was DM (15.7%). Rifampicin resistance (93.1%) was most common followed by Isoniazid (8.2%). Pallor was found among 94.3% patients. Most patients had bilateral (62.3%) and moderately extensive (57.2%) lesions in chest x-ray. Conclusion: DR-TB control should focus adequately on younger age group as numbers of resistance is increasing among them. Relapse in previously cured cases was found to be major contributor of DR-TB suspect cases. Though, Rifampicin resistance was so common but prevalence of resistance to 2nd line drugs is still low. Focus should be given on early detection of drug resistance in all TB cases and improvement of nutritional status of the TB patient. [ABSTRACT FROM AUTHOR]

The Mα and Mβ X-ray fluorescence cross sections, IMα/IMβ intensity ratio, M5 subshell fluorescence yield and M5 subshell Auger yield for gold, lead and bismuth elements were determined using Indus-2 synchrotron radiation available at the Raja Ramanna Center for Advanced Technology, India. A 7 keV synchrotron radiation was used to generate the characteristic M X-ray photons in gold, lead and bismuth and consequent X-ray photons were detected with Amptek silicon drift detector which has energy resolution of 129 eV at 5.9 keV. By measuring the area under Mα and Mβ X-ray peaks, Mα and Mβ X-ray fluorescence cross sections, IMα/IMβ intensity ratio, M5 subshell fluorescence yield and M5 subshell Auger yield were determined for gold, lead and bismuth. Experimentally determined values were compared with the theoretical and other experimental values available in the literature. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common cancer in urban and second common in rural Indian women. In India, in spite of the best treatment available being given to the patients they lose their lives because of paucity of diagnostic aids and lack of an organized breast cancer screening program. Early detection, accurate staging, and initiation of appropriate therapy are the key factors for improving the treatment outcome and prognosis of the disease for the patients. Traditional staging methods include clinical examination, blood tests, chest X-ray, ultrasound of the abdomen, and/or skeletal survey. As these tests lack sensitivity and specificity, these are being scaled down. The hybrid positron emission tomography-computerized tomography (PET-CT) is a unique tool in the field of imaging modalities that combines the effectiveness of PET and CT. This study was undertaken to assess the efficacy and accuracy of PET-CT as a single-session staging modality in the very initial stage itself and if it can replace the conventional means of staging. Methods: This was a cross-sectional study conducted in the Radiotherapy department at GGS Medical College and Hospital Faridkot from March 2014 to October 2015. 52 patients with newly diagnosed and histopathologically proven carcinoma breast were staged by conventional modalities (clinical examination, blood tests, X-ray chest, mammography, ultrasonography abdomen, skeletal survey) and by 18F-fluorodeoxyglucose (18F FDG) PET/CT. PET-CT images were used for the detection, localization, staging of tumors and detection, evaluation, and diagnosis of metastatic lesions, disease burden and organ function along with treatment planning and planning therapeutic procedures. Following the completion of initial study, the results of 18F FDG PET-CT staging in comparison with conventional staging method were assessed. Along with this, the accuracy, changes in staging of cases of carcinoma breast and cost-effectiveness of 18F-FDG PET-CT were also studied. Results: All the pathologic entities identified by conventional imaging were also perceived with 18F-FDG PET/CT. Therefore, we recommend the use of PET/CT as an important imaging modality for initial diagnosis of carcinoma breast. [ABSTRACT FROM AUTHOR]

Introduction: In early stage of disease of Corona Virus Disease 2019 (COVID-19) infection chest Computed Tomography (CT) imaging is considered as the most effective method for detecting lung abnormalities. A Brixia Chest X-ray (CXR) scoring system which uses an 18-point severity scale to grade lung abnormalities due to COVID-19 was developed to improve the risk stratification for infected patients. Aim: To ascertain the validity of Brixia scoring system and to measure the outcome in COVID-19 patients. Materials and Methods: A retrospective study was conducted from 1st April 2020 to 31st July 2020, at a tertiary care hospital in India. Baseline CXR of COVID-19 patients were scored based on Brixia scoring system. The lungs were divided into six equal zones. Subsequently, scores (from 0 to 3) were assigned to each zone, based on lung abnormalities. A group comparison was implemented using Chi-Square test for categorical variables. Whereas an independent t-test was applied for continuous variables that followed normal distribution. Results: The study included 130 patients. The mean age was 57.09±13.73 years, 70.8% patients included were males. Out of 130 patients, 79 patients died. Among patients who died the mean CXR score was calculated to be 12.13±2.50. The mean CXR score was calculated to be 11.18±2.30 in patients who recovered and got discharged. During the process of comparison of CXR scores with the outcomes, the t-value came out to be 2.20 and the resulting p-value was 0.03 (statistically significant). Conclusion: Brixia score more than 12 was associated with increased mortality due to COVID-19, with p-value of 0.03. [ABSTRACT FROM AUTHOR]