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Beyond statistical significance:Embracing minimal clinically important difference for better patient care

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World Journal of Methodology 2025年第1期15卷 33-41页

作者： Naveen Jeyaraman Madhan Jeyaraman Swaminathan Ramasubramanian Sangeetha Balaji Sathish Muthu department of Orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia department of Research Methods Orthopaedic Research GroupCoimbatore 641045Tamil NaduIndia department of Orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia department of Biotechnology Faculty of EngineeringKarpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia department of Orthopaedics Government Medical CollegeKarur 639004Tamil NaduIndia

The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the patient's *** comprehensive review analyzes the evolution,applications,and challenges of MCID across medical specialties,emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and *** discuss the evolution of MCID since its inception in the 1980s,its current applications across various medical specialties,and the methodologies used in its calculation,highlighting both anchor-based and distribution-based ***,the paper delves into the challenges associated with the application of MCID,such as methodological variability and the interpretation difficulties that arise in clinical *** for the future include standardizing MCID calculation methods,enhancing patient involvement in setting MCID thresholds,and extending research to incorporate diverse global *** steps are critical to refining the role of MCID in patient-centered healthcare,addressing existing gaps in methodology and interpretation,and ensuring that medical interventions lead to significant,patient-perceived improvements.

关键词： Minimal clinically important difference Patient-centered care Clinical relevance Global health

Malpractice or masterful practice?Navigating vicarious liability in healthcare

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World Journal of Clinical Cases 2025年第2期13卷 10-13页

作者： Satvik N Pai Naveen Jeyaraman Madhan Jeyaraman Swaminathan Ramasubramanian department of Orthopaedics PES University Institute of Medical Sciences and ResearchBengaluru 560100KarnatakaIndia department of Orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia department of Orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia

In the intricate landscape of healthcare,vicarious liability looms large,shaping the responsibilities and actions of healthcare practitioners and administrators *** by a poignant scenario of a medication error,this article navigates the complexities of vicarious liability in *** explains the legal basis and ramifications of this theory,emphasizing its importance in fostering responsibility,protecting patient welfare,and easing access to *** paper explores the practical effects of vicarious responsibility on day-to-day operations,leadership practices,and decision-making processes via the eyes of senior consultants,junior doctors,and hospital *** comprehensive insights and real-world examples,it underscores the imperative of fostering a culture of accountability,communication,and quality care to navigate the intricate web of liabilities inherent in modern healthcare.

关键词： Vicarious liability Healthcare Responsibility Litigation Patient welfare

Parallel propagating modes and anomalous spatial damping in the ultra-relativistic electron plasma with arbitrary degeneracy

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Chinese Physics B 2017年第11期26卷 76-82页

作者： H Farooq M Sarfraz Z Iqbal G Abbas H A Shah department of Physics Government College University government College University

The dispersion relations of parallel propagating modes（Langmuir mode, right and left handed circular polarized waves） in the weak magnetic field limit ｜ω-k·v｜〉〉？ are considered for ultra-relativistic arbitrary degenerate electron plasma. The results are presented in terms of moments of Fermi-Dirac distribution. The increase in the electron equilibrium number density from negative large（weakly degenerate） to positive large（highly degenerate） values of μ/Te is observed（where μ is the electron chemical potential and Te is the electron thermal energy）. As a result, shifting of the cutoff points in all the real dispersion branches towards the higher values and increasing in the band gap between unmagnetized longitudinal and transverse modes in k-space are examined. Also, the suppression of the weak magnetic field effects in weakly magnetized right handed and left handed circular polarized waves and a decrease in the longitudinal and transverse screening effects are observed in the graphical patterns due to an increase in the equilibrium number density.

关键词： degenerate Fermi gases relativistic plasmas electromagnetic waves

Theoretical Study of Screening Dependence of Aluminium Doped MgB_2

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Chinese Physics Letters 2018年第3期35卷 79-83页

作者： Gargee Sharma Smita Sharma department of Physics Government Dungar College

The screening dependence of superconducting state parameters （λ, μ＊, Tc, α and NoV） of six alloys of aluminium doped MgB2 systems are studied in the BCS-Eliashberg-MeMillan framework by employing five forms of dielectric screening function, viz. random phase approximation （RPA）, Harrison, Geldart and Vosko （GV）, Hubbard and Overhauser in conjunction with Ashcroft＇s potential. It is observed that electron-phonon coupling strength and Coulomb pseudopotential μ＊ are quite sensitive to the form of dielectric screening, whereas transition temperature Tc, isotope effect exponent α and effective interaction strength NoV show weak dependence on the form of dielectric screening function. It is found that the RPA form of dielectric screening function yields the best results for transition temperature Tc for all alloys of the Mg-Al-B system. The results obtained using GV screening are much higher than the experimental results. This shows that all the four dielectric screenings used here almost describe superconductivity in all the alloys of the Mg-Al-B system, but the GV screening is not suitable for such an alloy system.

关键词： Theoretical Study of Screening Dependence of Aluminium Doped MgB2 Al

Numerical and analytical investigations of thermosolutal instability in rotating Rivlin-Ericksen fluid in porous medium with Hall current

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Applied Mathematics and Mechanics(English Edition) 2013年第4期34卷 501-522页

作者： S.KUMAR V.SHARMA K.KISHOR department of Mathematics Government College department of Mathematics Himachal Pradesh University department of Mathematics Government Senior Secondary School

Numerical and analytical investigations of the thermosolutal instability in a viscoelastic Rivlin-Ericksen fluid are carried out in the presence of a uniform vertical magnetic field to include the Hall current with a uniform angular velocity in a porous medium. For stationary convection, the stable solute gradient parameter and the rota- tion have stabilizing effects on the system, whereas the magnetic field and the medium permeability have stabilizing or destabilizing effects on the system under certain condi- tions. The Hall current in the presence of rotation has stabilizing effects for sufficiently large Taylor numbers, whereas in the absence of rotation, the Hall current always has destabilizing effects. These effects have also been shown graphically. The viscoelastic effects disappear for stationary convection. The stable solute parameter, the rotation, the medium permeability, the magnetic field parameter, the Hall current, and the vis- coelasticity introduce oscillatory modes into the system, which are non-existent in their absence. The sufficient conditions for the non-existence of overstability are also obtained.

关键词： magnetic field thermosolutal instability Rivlin-Ericksen rotating fluid Hall current porous medium

Pocket formula for mass attenuation coefficient, effective atomic number, and electron density of human tissues

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Nuclear Science and Techniques 2019年第3期30卷 1-8页

作者： H.C.Manjunatha L.Seenappa department of Physics Government College for Women

We have proposed a pocket formula for mass attenuation coefficient(μ/ρ), mass energy absorption coefficient(μ_(en)/ρ), and effective atomic number(Z_(eff)) in different tissues of human organs. We have also assigned a new chemical formula for all studied tissues based on their composition. We have introduced a new parameter called effective composition index(C_(eff)). Based on this, we have introduced a new method to compute the effective atomic number. The evaluated photon interaction parameters are graphically represented. The evaluated average, maximum,minimum, and standard deviations of effective atomic number are tabulated. The proposed formula produces a mass attenuation coefficient, mass energy absorption coefficient, and effective atomic number from their

关键词： Effective atomic number Mass attenuation coefficient Tissues

Effect of pH on Crystal Size and Photoluminescence Property of ZnO Nanoparticles Prepared by Chemical Precipitation Method

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Acta Metallurgica Sinica(English Letters) 2015年第3期28卷 394-404页

作者： M.Jay Chithra M.Sathya K.Pushpanathan PG & Research department of Physics Government Arts College

The effects of pH value on crystal size and optical property of zinc oxide nanoparticles prepared by chemical precipitation method were *** samples have been characterized by means of X-ray diffraction,scanning electron microscopy,ultraviolet-visible spectrometer and photoluminescence *** X-ray diffraction profile,it is found that the particle size of sample increases from 13.8 to 33 nm when the pH value of the solution was increased from 6 to *** study also shows that the particle size increases with pH *** shape of the zinc oxide nanoparticle has been confirmed by the scanning electron microscopy *** recorded ultraviolet-visible spectrum shows excitonic absorption peaks around 381 *** energy gap of the prepared samples has been determined from the ultraviolet-visible absorption spectrum,effective mass model equation and Tauc＇s *** was found that the energy gap of the prepared samples decreases with increase in pH *** recorded blue shift confirmed the quantum confinement effect in the prepared zinc oxide *** spectrum infers that the increase in pH value shifts the ultraviolet-visible emission but not the violet and green emissions.

关键词： Zinc oxide nanoparticles pH value Crystal structure Microstructure Energy gap Photoluminescence

Spectrum of fungal keratitis: clinicopathologic study of 44 cases

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International Journal of Ophthalmology(English edition) 2014年第1期7卷 114-117页

作者： Rajpal Singh Punia Reetu Kundu Jagdish Chander Sudesh Kumar Arya Uma Handa Harsh Mohan department of Pathology Government Medical College and Hospital department of Microbiology Government Medical College and Hospital department of Ophthalmology Government Medical College and Hospital

AIM: To determine the causative agents of fungal keratitis and study the predisposing factors over a period of ten years in a single tertiary care hospital. ·METHODS: A retrospective analysis of fungal corneal ulcers was done from 2003-2012. Patients’ clinical data were noted from the file records. Correlation of histopathological diagnosis was done with the report on fungal culture. · RESULTS: Mycotic keratitis was established in 44 cases by a positive fungal culture. Direct microscopic examination of potassium hydroxide(KOH) mounts revealed fungal elements in 39 cases while 40 cases showed fungus on Gram stained smears. Males(54.55%) were more commonly affected than the females(45.45%). The age ranged from 18 to 82 years. Most common age group to be involved was 41-60 years. Predisposing risk factors were seen in 34(77.27%) cases. Most common findings on clinical examination were anterior chamber reaction and conjunctival injection seen in all the cases. Other common findings were stromal infiltration and hypopyon seen in 20(45.45%) and 18(40.91%) cases respectively. On histopathological examination the fungus was typed,as aspergillus in 34 cases while no definite typing was possible in 10 cases. The predominant isolate was aspergillus flavus(59.09%) followed by fusarium(15.91%). Mixed fungal and bacterial infection was seen in 3(6.82%) cases. ·CONCLUSION: Although culture is the gold standard for definitive diagnosis of fungal keratitis,direct microscopic examination of corneal scrapings or histomorphological evaluation of biopsies allow a rapidpreliminary diagnosis. Early administration of antifungal treatment helps in preventing dreadful complications.

关键词： mycotic keratitis fungal culture infection cornea

Nonsurgical periodontal-therapy improves glycosylated hemoglobin levels in pre-diabetic patients with chronic periodontitis

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World Journal of Diabetes 2017年第5期8卷 213-221页

作者： Rosamma Joseph Meera Sasikumar Jerry Mammen M G Joseraj Chandni Radhakrishnan department of Periodontics Government Dental College department of Biochemistry Government Medical College department of Internal Medicine Government Medical College

AIM To evaluate the effect of nonsurgical periodontal therapy on glycosylated haemoglobin levels in pre-diabetic patients with chronic periodontitis(CHP).METHODS Sixty pre-diabetic patients with CHP were selected and equally allocated to case and control group. All subjects were evaluated at base line for periodontal parameters(plaque index, oral hygiene index, modified gingival index, probing pocket depth, clinical attachment level) and systemic parameters [glycosylated hemoglobin(HbA1c), fasting lipid profile, and fasting blood glucose]. The case group received non-surgical periodontal therapy. Subjects were re-evaluated for periodontal and systemic parameters after three *** Both groups were comparable at baseline. Three months after non surgical periodontal therapy(NSPT), there was significant improvement in periodontal parameters in case group. The mean difference in systemic parameters like HbA1c and fasting plasma glucose from baseline to fourth month for case group was 0.22 ± 0.11 and 3.90 ± 8.48 respectively and control group was-0.056 ± 0.10 and-1.66 ± 6.04 respectively, which was significant between case and control group(P < 0.05). In the case group there was a significant decrease in HbA1c from baseline to three months following NSPT(P < 0.05).CONCLUSION This study showed that periodontal inflammation could affect the glycemic control in otherwise systemically healthy individuals. Periodontal therapy improved periodontal health status and decreased glycosylated haemoglobin levels, thus reducing the probability of occurrence of inflammation induced prediabetes in patients with CHP.

关键词： Prediabetes Chronic periodontitis Non surgical periodontal therapy