Biomedical subjects

Ashok Kothari

Publications and source records attributed to Ashok Kothari.

5 recordsLinked to original sources

PubMed2006

An analysis of 46 static telecytology cases over a period of two years.

We analysed 46 telecytology cases sent from two rural hospitals about 500 km from a tertiary cancer centre. The cases were submitted for second opinion over a period of two years and evaluated using a static store and forward telecytology approach. A total of 715 digital images were studied (average 15 per case). Forty-one of the 46 cases (89%) were reported within 3 days and 54% of cases were reported within one working day. The aspiration smears and images were found to be of diagnosable quality in 89 and 93% of the cases, respectively. The diagnostic concordance was assessed by comparing the telecytology diagnosis, glass slide diagnosis and final histopathology diagnosis (when available). A clinically useful diagnosis was rendered in 91% cases with 74% complete concordance. Five out of 46 cases (11%) were deferred for glass slide review. Store and forward telecytology using the Internet is a rapid and effective method of providing expert diagnosis in cytology.

Cytodiagnosis↗

PubMed2006

Indirect bonding technique.

Accurate bracket placement is the key for the successful treatment of an orthodontic case. With indirect bonding, not only is the bracket placement more accurate but this technique also significantly reduces chairtime. In this article, the author explains use of thermal glue in an indirect bonding technique. In cases of constricted arches, a modified rapid maxillary expander can be used along with indirect bonding to reduce overall treatment time.

Adolescent↗

PubMed2005

A cluster randomized controlled trial of visual, cytology and human papillomavirus screening for cancer of the cervix in rural India.

The impact of screening by visual inspection with acetic acid (VIA), cytology or HPV testing on cervical cancer incidence and mortality is investigated in a cluster randomized controlled trial in India. We report findings after the screening phase, when 52 clusters, with a total of 142,701 women aged 30-59 years in Osmanabad District, India, were randomized into 4 arms for a single round of screening by trained midwives with either VIA, cytology or HPV testing as well as a control group. All laboratory tests were done locally. Test-positive women underwent investigations (colposcopy/biopsy) and treatment in the base hospital. Data on participation, test positivity, positive predictive value and detection rates of cervical neoplasia were analyzed using cluster design methodology. Of the eligible women, 72-74% were screened. Test positivity rates were 14.0% for VIA, 7.0% for cytology and 10.3% for HPV. The detection rate of high-grade lesions was similar in all intervention arms (0.7% for VIA, 1.0% for cytology and 0.9% for HPV testing) (p = 0.06, Mann-Whitney test). While the detection rate for VIA dropped to 0.5% with declining test positivity during the course of the study, it remained constant for cytology and HPV testing. Over 85% of women with high-grade lesions received treatment. Our results show that a high level of participation and good-quality cytology can be achieved in low-resource settings. VIA is a useful alternative but requires careful monitoring. Detection rates obtained by HPV testing were similar to cytology, despite higher investments.

Acetic Acid↗

PubMed2004

Static telepathology consultation service between Tata Memorial Centre, Mumbai and Nargis Dutt Memorial Charitable Hospital, Barshi, Solapur, Maharashtra: an analysis of the first 100 cases.

Telepathology is the practice of pathology at a distance. Static telepathology is employed to achieve teleconsultation between a tertiary cancer referral centre, Tata Memorial Centre and a sister concern in rural area viz. Nargis Dutt Memorial Cancer Hospital, Barshi, Solapur. This is an analysis of the first 102 cases. Two transcontinental consultations have not been included in statistical analysis. A diagnosis was offered in 99 (99%) cases; whereas it was deferred in only I (1%) case. Clinically important or relevant diagnosis were achieved in 93/ 99 (93.93%) of cases. Major discrepancies were encountered in 6/99 (6.06%) of cases. A total of 79% of cases were reported within 3 days, of which 32% were reported within 8 hours (a single working day) and 47% within 1-3 days. Telemedicine can be used effectively to bridge the gap between medically underprivileged, geographically distant rural areas and advanced centers with technical expertise using cheaper static store and forward methodology.

Cancer Care Facilities↗

PubMedDate not supplied

Experience with telepathology at a tertiary cancer centre and a rural cancer hospital.

BACKGROUND: Telepathology allows quick and timely access to an expert opinion, no matter where the patient is located. We analysed the experience with the use of telepathology between a tertiary cancer centre and a rural cancer hospital. METHODS: Ninety-three cases were analysed in which static telepathology was used to obtain a consultation between Tata Memorial Centre and Nargis Dutt Memorial Cancer Hospital at Barshi, a rural area. RESULTS: Successful teleconsultation was achieved in all cases. A diagnosis was offered in 92 cases (98.9%) and was deferred in 1 case (1.1%). Complete concordance, clinically unimportant minor discrepancy and hedged diagnosis were obtained in 83 cases (90.2%). Major discrepancies were encountered in 9 cases (9.7%). The number of images per case ranged from 3 to 27 (average: 7 images). Images were of diagnosable quality in 89.2% of cases. Most of the cases (77.4%) were reported within 3 days; 32.2% were reported within 8 hours (a single working day) and 45.1% within 1-3 days. CONCLUSION: Telemedicine can be effectively used to bridge the gap between medically underprivileged, geographically distant rural areas and advanced centres using the static store and forward methodology.

Adolescent↗