Archive for month: May, 2024

A UCL-developed app that provides speech therapy for people with the language disorder aphasia has been found to significantly improve their ability to talk.

iTalkBetter, developed by the Neurotherapeutics Group at the UCL Queen Square Institute of Neurology, provides users the digital platform to practice over 200 commonly used words, in their own time and without any limits on the amount of therapy they receive.

While employing games to maintain engagement, the app’s integrated speech recogniser analyses speech in real time to give the user feedback on whether they have named the displayed item correctly.

A new study, published in eClinicalMedicine, found that when used over a six-week period for around 90 minutes per day, iTalkBetter significantly improved patients’ ability to name items by 13% for the 200 commonly used words. Importantly, spontaneous speech was also found to improve.

Aphasia occurs when a person suffers brain damage, usually to the organ’s left side, leading to difficulties with speech or language. The most common causes are stroke, severe head injury and brain tumours.

Symptoms can vary widely from person to person. However, most people with aphasia have some trouble with their speaking, and may also experience issues with writing, reading and listening.

Currently, the NHS provides around 12 hours of speech and language therapy with further face-to-face therapy available via some charities or privately.

Corresponding author, Professor Alex Leff (UCL Institute of Cognitive Neuroscience and UCL Queen Square Institute of Neurology), said: “Most health care systems massively under dose people with aphasia in terms of the hours of speech language therapy that they are provided with. App delivered therapy is one solution to this problem.

“This is the first randomised controlled trial of an app designed to improve speaking that transfers to a naturalistic speaking task and show an effect on connected speech.”

The researchers tested the app in a phase II randomised clinical trial on 27 people with aphasia as a result of a stroke, between September 2020 and March 2022.

Researchers also used structural and functional magnetic resonance imaging (MRI) to see what happened in the brains of participants when using the app.

Structurally, they found that brain regions related to language perception, production and control increased in volume after practice with iTalkBetter.

Professor Leff added: “This is the first task-based fMRI study in people with aphasia to identify dose-related changes in brain function. The more people with aphasia practiced, the more they were able to activate key auditory processing areas in the undamaged hemisphere.”

iTalkBetter will soon be rolled out as an app available to all suitable patients to use.

Reference:

Catherine Doogan, Victoria Fleming, Pedro Quijada Leyton, David Barbera, Peter Zeidman, Efficacy of a gamified digital therapy for speech production in people with chronic aphasia (iTalkBetter): behavioural and imaging outcomes of a phase II item-randomised clinical trial, EClinicalMedicine, https://doi.org/10.1016/j.eclinm.2024.102483.

General or regional anesthesia’s effect on colorectal cancer recurrence after surgery

The research study evaluated the recurrence of colorectal cancer (CRC) under general anaesthesia (GA) or regional anaesthesia (RA) in patients undergoing CRC surgery, along with the impact of anaesthetic agents on the immune system, neuroendocrine response, and the metastatic process. The study also discussed the implications of primary tumour location and tumour stage on the recurrence rate and the overall survival of patients with early-stage CRC.

Systematic Review Methodology

The authors performed a systematic review following PRISMA and SWiM guidelines, including studies that evaluated the effects of GA or RA on CRC recurrence. They conducted an electronic literature search and selected six studies for the review, with a total of 58,075 patients undergoing CRC surgery. The included studies utilized various anaesthetic agents and techniques, such as total intravenous anaesthesia (TIVA), inhalational anaesthesia, epidural anaesthesia, and spinal anaesthesia. The risk of bias and quality assessment for the included studies were evaluated using the Newcastle-Ottawa Scale (NOS).

Primary and Secondary Outcomes

The primary outcome of interest was cancer recurrence after surgery, while secondary outcomes included disease-free survival (DFS), overall survival, and mortality. The review revealed no significant association between anaesthesia type and CRC recurrence. Additionally, no conclusive improvement was found in DFS. The evidence quality was deemed very low for cancer recurrence and low for DFS, thus leaving scope for further studies with larger sample sizes and longer follow-up periods to determine the association between CRC recurrence and anaesthesia.

Factors Contributing to Recurrence

The authors discussed the potential factors contributing to recurrence or metastasis after cancer surgery, including minimal residual disease, surgical stress, and the use of anaesthetic agents and techniques, which may affect the immune and inflammatory responses. Furthermore, they highlighted the conflicting findings on the impact of different anaesthetic agents on cancer recurrence in various types of cancer and the need for further prospective clinical trials to elucidate the role of anaesthetic agents on cancer recurrence and prognosis.

Concluding Remarks on CRC Recurrence

In conclusion, the review found no significant association between regional anaesthesia and CRC recurrence. However, the authors emphasized the limitations of the existing studies, including various confounding factors, and highlighted the need for further well-designed randomized controlled trials to establish the relationship between CRC recurrence and anaesthesia.

The study identified limitations in the existing literature and suggested the need for larger prospective clinical trials to address these limitations and provide clearer insights into the impact of anaesthesia on CRC recurrence.

Reference –

Chachra, Alisha; Gunashekar, Satheesh; Kumar, Ajit; Thakur, Nitish; Jagath, Arun. Impact of general or regional anaesthesia on recurrence of colorectal cancer after surgery: Systematic review. Indian Journal of Anaesthesia 67(12):p 1061-1070, December 2023. | DOI: 10.4103/ija.ija_478_23

Vadodara- The Panchmahal police have recently arrested two more accused in the ongoing investigation into the National Eligibility cum Entrance Test (NEET) 2024 exam scam at a School in Godhra. The said School was one of the NEET 2024 exam centres in Vadodara.

According to a recent report by Indian Express, the police have arrested the Jai Jalaram School principal Sharma, who was also the NEET coordinator for the Godhra centre, and a Godhra resident Vohra. 

Tthe Indian Express has reported that Sharma has been arrested for allegedly being in connivance with prime accused  Bhatt. Consequently, Vohra, who had been arrested for allegedly paying Rs 7 lakh to Bhatt, which was recovered from his vehicle during a raid by the education department on May 5 to thwart the alleged plan to tamper with the NEET answer sheets.

After the matter came to light, on the complaint of Panchmahal district education officer Kirit Kumar Patel, an FIR was lodged at the Godhra taluka police station on May 8 against Tushar Bhatt, Parshuram Roy and Aarif Vohra for allegedly playing a criminal conspiracy to help at least 26 students pass the NEET exam “with meritorious ranks through unfair means”.

The FIR stated that the attempted malpractice was “foiled” on May 5 during a raid at the NEET centre by an inspection squad of the education department. The raid was conducted following input received by the Panchmahal collector. Typically, the Panchmahal collector had a tip-off that Bhatt was planning to commit irregularities during the NEET 2024 exam and help some students.

According to the FIR, it had been decided that the students would appear for the exam and allegedly “only attempt the questions, which they could solve” while leaving the “rest of the answer book blank to be filled up by the agents after the exam when the answer book is submitted to the exam supervisor”, reports Indian Express.

Speaking to the Indian Express, investigating Officer, Godhra Deputy Superintendent of Police N V Patel, said “Sharma and Bhatt were in connivance to tamper with the OMR answer sheets that were to be left blank by the students involved in this scam… The investigation has revealed that Sharma was in the know and supportive of Bhatt’s plan to tamper with the OMR sheets. His name had cropped up during the interrogation of the accused, especially Bhatt”.

So far, five people have been arrested in this case they are Anand, Roy, Bhatt,  Sharma and Vohra.

Talking about Anand, he is based in Maneja, Vadodara but hails from Bihar. He is an education consultant, who put students in touch with Parshuram Roy of Roy Overseas (Vadodara-based immigration agency)… Students from the other states had also contacted Anand through his ads on social media and he had referred some students to Roy. We have recovered a list of students from Anand. He used to bring medical aspirants and connect them with a person named Parshuram Roy, who runs a visa and overseas education consultancy firm in Vadodara. Bhatt, a Geography teacher at Jai Jalaram School and the superintending officer of the NEET exam. However, he was arrested on Saturday, a day before the arrest of Purushottam Sharma.

However, “Anand has been sent to police custody till May 23 by a local court while Sharma will soon be produced in court”, informed N V Patel. Meanwhile, the local court has extended the police custody of Parshuram Roy, from whose office the police have recovered cheques signed by NEET aspirants involved in the fraud.

Also, Patel informed that an investigation is also being conducted to ascertain the identity of the students who had approached the accused to commit malpractices to pass NEET with good rank in merit.

Rajkot: Taking action against a paediatrician for allegedly manipulating the reports of newborns to extract a huge sum of money from the Government’s Ayushman Bharat Scheme, the State health department recently expelled him from the Ayushman Card scheme of health insurance.  

This comes after the insurance company and the health department found that the doctor had been involved in unethical behaviour. This included tampering with medical records to portray patients’ conditions negatively, thus exaggerating the severity of their health issues.  

The doctor running Nihit Babycare Hospital at Rajkot in Gujarat was accused of having admitted perfectly healthy children to the Intensive Care Unit (ICU) to fraudulently obtain funds from the Ayushman scheme.

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As per the Desh Gujarat news report, the doctor will first verify if the patient’s family is covered by the Ayushman card scheme. Once it is confirmed that the family is a beneficiary of the scheme, he will gather samples from the child and send them to the Mangalam laboratory.

Subsequently, the reports will be reviewed and the child will be admitted to the NICU for 7-10 days. The information would be uploaded to the government portal of the Ayushman scheme, and a claim of Rs. 9,000 to Rs. 10,000 per day would be made under the scheme.

So far, a total of 1483 children have been admitted to his hospital under the scheme which was linked with his hospital two years ago. However, the doctor had shown a record of 523 admissions, for which he has claimed Rs. 2.53 crore.

It is estimated that he obtained the amount in a short period of only 8 months by providing unnecessary medical treatment to the infants using this method, according to VOI. 

His attempt to continuously deceive the government failed when Mr Imran Houthi of Divya Bhaskar brought the incident to light. This ex-employee revealed how the accused doctor admitted children into the hospital by intentionally creating falsified negative reports.

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