Medical Disorders Research Articles

Tanshinone Alleviates UVA-induced Melanogenesis in Melanocytes via the Nrf2-regulated Antioxidant Defense Signaling Pathway.

As a complex of natural plant compounds, tanshinone is renowned for its remarkable antioxidant properties. However, the potential impact of tanshinone on melanocyte pigmentation regulation has yet to be elucidated. This study aimed to explore the protective effects of tanshinone I (T-I) and dihydrotanshinone (DHT) on melanogenesis by modulating nuclear factor E2-related factor 2 (Nrf2) signaling and antioxidant defenses in human epidermal melanocyte (HEM) cells. HEM cells and Nrf2 knockdown HEM cells were subjected to ultraviolet A (UVA) and treated with T-I and/or DHT. Then, the anti-melanogenic properties of T-I and DHT were examined by assessing tyrosinase activity, melanogenesis-related proteins, and melanin content in UVA-irradiated HEM cells. Furthermore, the antioxidant activities of T-I and DHT were evaluated by assessing oxidant formation and modulation of Nrf2-related antioxidant defenses, including reactive oxygen species (ROS), glutathione (GSH) content, and the activity and expression of antioxidant enzymes, such as catalase (CAT), heme oxygenase-1 (HO-1), and superoxide dismutase (SOD). Our findings revealed that T-I and DHT diminished melanogenesis in UVAirradiated HEM cells, activated Nrf2-antioxidant response element signaling, and enhanced antioxidant defenses in the irradiated cells. Furthermore, Nrf2 knockdown by shRNA abolished the anti-melanogenesis effects of T-I and DHT on HEM cells against oxidative damage. These results suggest that T-I and DHT inhibit UVA-induced melanogenesis in HEM cells, possibly through redox mechanisms involving Nrf2 signaling activation and increased antioxidant defenses. This indicates that T-I and DHT have potential as whitening agents in cosmetics and medical treatments for hyperpigmentation disorders.

Enhanced Brain Tumor Detection and Privacy Preserving Using Federated Learning

Brain cancers pose significant difficulties for both diagnosis and treatment, underscoring the necessity for precise and private-protecting detection techniques. Federated learning is used to solve this, allowing several healthcare facilities to work together to train detection models without jeopardizing patient privacy. This paper presents an approach called federated learning that may be used to improve brain tumor identification while protecting patient privacy. Brain tumors are dangerous medical disorders that need to be accurately diagnosed in order to be effectively treated. However, sharing private patient information is a common practice in traditional medical data analysis methodologies, which raises privacy issues. Federated learning helps with this by enabling cooperative training of a common model amongst several hospitals or institutions without requiring the exchange of raw data. This method protects patient privacy by having each institution train the model using its own local data and only sharing model updates. We show through trials that our method is efficient in reliably identifying brain tumors while upholding privacy norms, presenting a viable option for improving medical diagnosis without jeopardizing patient privacy.

Increased risk of breast cancer among premenopausal women with pituitary gland disorders in Taiwan: a population-based matched-cohort study.

An association between pituitary gland disorders and breast cancer remains controversial. We examined the prevalence and risk of breast cancer over a 15-year follow-up period or until diagnosed as breast cancer among premenopausal women (12-49 years old) with pituitary gland disorders in Taiwan. This retrospective matched-cohort study included 52,265 individuals each in the study group (women with pituitary gland disorders) and the matched control group from 2000 to 2004 identified using Taiwan's National Health Insurance Research Database. We compared sociodemographic characteristics and medical disorders between the two groups and examined the differences in clinicopathological characteristics of breast cancer. We also estimated the risk of breast cancer over 15 years of follow-up (median follow-up time = 11.2 years). Overall, 924 (1.8%) and 734 (1.4%) patients in the study and control groups, respectively, were diagnosed as having breast cancer (p < 0.001). Over the 15-year follow-up period, the study group had a 1.16-fold (95% confidence interval [CI] = 1.04-1.29, p < 0.05) increased risk of breast cancer compared with the control group. This risk was particularly pronounced in the 20-29 and 30-39 age groups (adjusted hazard ratio = 1.46 and 1.25, respectively; 95% CI = 1.15-1.86 and 1.07-1.44, p value < 0.01, respectively). Our findings reveal a relationship between pituitary gland disorders and breast cancer among premenopausal women in an Asian country. Physicians should check for signs of breast cancer in premenopausal women with pituitary gland disorders for early detection and treatment. Future studies should confirm our findings and clarify the causal relationship.

Snake Venom in Anticancer Drug Development: Potential Targets and Current Perspectives

Many animals active secretions have been used to create novel medications to treat ailments such as hypertension and cancer. Snake venom toxins have made major contributions to treating various medical disorders. There have been several research studies that have been published characterizing and clarifying snake venom's anti-cancer potential. Cancer treatment is one of the primary applications for protein peptides and enzymes derived from various animal species. When separated, several of these proteins, peptides, and enzymes from snake venom and assessed may bind selectively to cancer cell membranes, influencing migration and invasion. These cells proliferation Some of the chemicals discovered in snake venom have a high potential. Cystatin-rich snake venom influences tumor invasion and metastasis. A non-cholinesterase Arginine ester hydrolase enzyme in snake venom reported to have increased sensitivity to chemotherapy and radiotherapy in animal models. Snake thrombin-like enzymes, are serine proteases found in snake venom that causes haemostasis and hypofibrinogenemia. Cancer-associated fibroblasts was reported to have role in quiescence and also prevents cancer cell migration, in addition to downregulating the epithelial-mesenchymal transitioning. Collagen Tumor-associated hyaluronic acid (HA) and hyaluronidase (HAase) was crucial for tumor growth and metastasis promotion. Phospholipases are enzymes that break down phospholipids, which are key components of cell membranes are involved in cancer cell migration, invasion and metastasis. AMP-activated protein kinase (AMPK), a metabolic protein plays a crucial role in energy regulation and cell survival and studies reported its role in tumour suppression. The components of snake venom and its potential as a cancer-fighting agent, we summarised the key findings in this review.

Revolutionizing medicine: Recent developments and future prospects in stem-cell therapy.

Stem-cell therapy is a revolutionary frontier in modern medicine, offering enormous capacity to transform the treatment landscape of numerous debilitating illnesses and injuries. This review examines the revolutionary frontier of treatments utilizing stem cells, highlighting the distinctive abilities of stem cells to undergo regeneration and specialized cell differentiation into a wide variety of phenotypes. This paper aims to guide researchers, physicians, and stakeholders through the intricate terrain of stem-cell therapy, examining the processes, applications, and challenges inherent in utilizing stem cells across diverse medical disciplines. The historical journey from foundational contributions in the late 19th and early 20th centuries to recent breakthroughs, including ESC isolation and iPSC discovery, has set the stage for monumental leaps in medical science. Stem cells' regenerative potential spans embryonic, adult, induced pluripotent, and perinatal stages, offering unprecedented therapeutic opportunities in cancer, neurodegenerative disorders, cardiovascular ailments, spinal cord injuries, diabetes, and tissue damage. However, difficulties, such as immunological rejection, tumorigenesis, and precise manipulation of stem-cell behavior, necessitate comprehensive exploration and innovative solutions. This manuscript summarizes recent biotechnological advancements, critical trial evaluations, and emerging technologies, providing a nuanced understanding of the triumphs, difficulties, and future trajectories in stem cell-based regenerative medicine. Future directions, including precision medicine integration, immune modulation strategies, advancements in gene-editing technologies, and bioengineering synergy, offer a roadmap in stem cell treatment. The focus on stem-cell therapy's potential highlights its significant influence on contemporary medicine and points to a future in which individualized regenerative therapies will alleviate various medical disorders.

Impact of hyponatraemia during exacerbation on clinical outcomes in patients with bronchiectasis.

<sec><title>INTRODUCTION</title>Hyponatraemia is associated with morbidity and mortality among various medical disorders. Evidence on the association between hyponatraemia at the time of exacerbation and the prognosis in patients with bronchiectasis is lacking.</sec><sec><title>METHODS</title>This was a single-centre retrospective study. We included all bronchiectasis patients who were hospitalised in a regional hospital in Hong Kong for exacerbation from 1 January 2019 to 30 June 2022, to assess the association between hyponatraemia during hospitalised exacerbation and the subsequent outcomes.</sec><sec><title>RESULTS</title>169 patients were included in this study, of which 46 (27.2%) had hyponatraemia upon admission. Patients in the hyponatraemia group had shorter overall survival (OS) with a median OS of 31.3 months (95% CI 0.76-717.0) in the hyponatraemia group and 104.4 months (95% CI 0.82-1208.3) in the non-hyponatraemia group, adjusted hazard ratio (aHR) of 1.87 (95% CI 1.09-3.20; P = 0.023). Patients in the hyponatraemia group also had shorter time-to-next hospitalised bronchiectasis exacerbation with a median time-to-next hospitalised bronchiectasis exacerbation of 72.1 months (95% CI 0.25-362.1) in the hyponatraemia group and 144.6 months (95% CI 1.53-1437.8) in the non-hyponatraemia group, aHR of 2.04 (95% CI 1.07-3.88; P = 0.030).</sec><sec><title>CONCLUSIONS</title>This is the first report on the incidence and prognostic value of hyponatraemia in hospitalised bronchiectasis exacerbation, which was observed in 27.2% of patients. It was associated with significantly increased mortality and shorter time-to-next hospitalised bronchiectasis exacerbation when compared with the non-hyponatraemia group.</sec>.

A rare case of Guillain–Barre syndrome after snakebite in young male and review of literature

ABSTRACT Guillain–Barre syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system, often triggered by infections. This important medical emergency can also have noninfectious causes, such as trauma, surgery, medication (including vaccinations), and other systemic disorders. Here, we present a rare case of GBS following a snakebite. A 19-year-old man presented to the emergency department with quadriparesis and areflexia after showing initial recovery from a snakebite. Nerve conduction studies revealed motor axonal polyneuropathy. He was treated with intravenous immunoglobulin, which improved his clinical condition. This case report highlights a rare cause of GBS and emphasizes that timely recognition and treatment can significantly reduce morbidity and mortality. Additionally, we reviewed past literature of this rare association.

Gabapentin and pregabalin exposures reported to United States poison centers, 2012–2022

BackgroundGabapentin and pregabalin were originally introduced as anticonvulsant medications but are now also prescribed on- and off-label for multiple medical disorders, especially for pain management. The national opioid crisis has led to increased use of non-opioid pain medications, including gabapentinoids, which has been associated with changing patterns of adverse events associated with these medications. This study investigated the characteristics and trends of gabapentin and pregabalin exposures reported to US poison centers from 2012 to 2022.MethodsNational Poison Data System data involving gabapentin and pregabalin exposures for 2012 to 2022 were analyzed.ResultsThere were 124,161 exposures involving gabapentin and pregabalin as the primary substance reported to US poison centers during the study period. Most exposures involved gabapentin (85.9%), females (59.4%), single-substance exposures (62.9%), or occurred at a residence (97.2%). Suspected suicides accounted for 45.2% of exposures. Most exposures were associated with a minor effect (27.4%) or no effect (34.0%), while 22.1% experienced a serious medical outcome, including 96 fatalities. The rate of gabapentin and pregabalin exposures per one million US population increased by 236.1% from 22.7 in 2012 to 76.5 in 2019 (P < 0.001), followed by a non-significant decrease to 68.5 in 2022 (P = 0.068).ConclusionsThe rate of gabapentin and pregabalin exposures reported to US poison centers increased by more than 230% from 2012 to 2019 before plateauing from 2019 to 2022. The observed rate trend was driven primarily by gabapentin exposures and by cases associated with suspected suicide. Although most exposures were associated with a minor or no effect, 22% of individuals experienced a serious medical outcome, including 96 fatalities. These findings contribute to the discussion of rescheduling gabapentin as a federally controlled substance, which is the current status of pregabalin. Prevention of suicide associated with gabapentin and pregabalin merits special attention.

A clinical algorithm for diagnosis and treatment of insomnia in adults: an updated review.

Difficulty falling asleep and/or maintaining sleep are common complaints in patients visiting medical clinics. Insomnia can occur alone or in combination with other medical or psychiatric disorders. Diagnosis and management of insomnia at times are perplexing. This updated study review aimed at a clinical algorithm for diagnosis and treatment of insomnia in adults. We developed an easy-to-apply algorithm to diagnose and manage insomnia that can be used by general practitioners and non-sleep specialists. To this end, our team reviewed the previous studies to determine the prevalence, evaluation, and treatment of insomnia. We used the results to develop a clinical algorithm for diagnosing and managing insomnia.Insomnia occurs in a short (less than 3months duration) or chronic form (≥3months duration). Insomnia management includes both pharmacological and non-pharmacological interventions. There is ample research evidence for the impact of a variety of non-pharmacological treatments, but both types of treatments can be used for each patient. If there are any contradictions in the diagnosis process, therapists should use objective instruments, such as polysomnography, but they should not be in a hurry to use these instruments.

Hypersomnia secondary to severe acute respiratory syndrome coronavirus-2 infection

Excessive daytime sleepiness (EDS), with or without an excessive need for sleep, is a primary reason for patients seeking consultation at the sleep unit. EDS is observed in ~5% of the general population. Common causes of EDS include obstructive sleep apnea, sleep deprivation, effects of medication, psychiatric disease (especially depression), and circadian rhythm disorders. Coronavirus disease 2019 (COVID-19) infection is a rare cause of EDS. We present a case of mild COVID-19 infection as an unusual cause of hypersomnolence.

Delirium and risk of incident cardiovascular events in elderly: data from a global health research network

Abstract Introduction Delirium is a common complication of acute medical disorders. A strong association between cardiovascular events and the occurrence of delirium has been recorded. Thus far, no data are available regarding the risk of incident cardiovascular events after delirium onset in older adults. Methods Using data from TriNetX, a global health federated research network, we performed a propensity score matched (PSM) analysis of older adults (age ≥65 years) admitted to the emergency department (ED) reporting delirium within two weeks, who were compared with those without delirium. We evaluated the occurrence of a composite outcome of cardiovascular events (myocardial infarction, ischemic stroke, heart failure, intracranial haemorrhage, ventricular arrhythmias, takotsubo syndrome, and atrial fibrillation) at 30 days and 1 and 3 years of follow-up. Results 4,480,229 patients were retrieved for the analysis, and 82,693 (1.8%) reported delirium. Before PSM, patients reporting delirium were older, with more prevalent comorbidities. After PSM, a total of 165,386 patients were included in the analysis (mean (SD) age 76.6 (9.0) years, 51.1% females). Throughout the entire follow-up period, the cumulative composite cardiovascular events outcome was significantly higher in patients which reported delirium [Red Line, Figure 1]. Delirium was associated with cardiovascular events at 30 days (HR 1.96, 95% CI 1.92-2.00) ,1 year (HR 1.75, 95% CI 1.72-1.78) and 3 years (HR 1.67, 95% CI 1.64-1.69) of follow-up, as well as for each of its components (Table 1). The presence of delirium was also associated with a higher risk of all-cause death and hospital access (Table 1), evaluated as secondary outcomes. In patients with delirium associated with the occurrence of incident cardiovascular events, there was a higher risk of recurrent cardiovascular events at 1 year (HR 3.11, 95% CI 2.92-3.31) and 3 years (HR 2.84, 95% CI 2.67-3.01) of follow-up. Conclusions In a large, unselected cohort of older adults admitted to ED, occurrence of delirium was associated with a higher risk of cardiovascular events, both in the short and long-term follow-up.Figure 1:Delirium and CV EventsTable 1:Cox Regression Analysis

Trust, belief and transitions: people’s experiences of multidisciplinary inpatient treatment for persistent physical symptoms. A qualitative study

Purpose People with Persistent Physical Symptoms experience physical symptoms that are not wholly explained by a medical disorder or disease. Multidisciplinary treatment is recommended for people with severe difficulties and is provided in a small number of specialist centres in the UK. Only brief descriptions of this treatment are available, and the experiences of people receiving this treatment as an inpatient have not been explored. This study aimed to explore how people with persistent physical symptoms experience inpatient treatment from a specialist multidisciplinary team, and to identify which factors facilitated their engagement in the rehabilitation. Materials and Methods 18 people who had received inpatient multidisciplinary treatment for persistent physical symptoms participated in semi-structured interviews. The transcripts were analysed using reflexive thematic analysis. Results Participants’ experiences were influenced by whether they felt believed by the healthcare team, and whether they could place their own trust and belief in the staff team and the treatment approach. Their experiences involved a series of transitions; both in environment and understanding. Conclusions Improvements are possible for people receiving inpatient multidisciplinary treatment for severe PPS. Trusting relationships between patients and staff members take time to develop but play a major role in patients’ experiences of treatment.

Insights into the Therapeutic Potential of Active Ingredients of Citri Reticulatae Pericarpium in Combatting Sarcopenia: An In Silico Approach.

Sarcopenia is a systemic medical disorder characterized by a gradual decline in muscular strength, function, and skeletal muscle mass. Currently, there is no medication specifically approved for the treatment of this condition. Therefore, the identification of new pharmacological targets may offer opportunities for the development of novel therapeutic strategies. The current in silico study investigated the active ingredients and the mode of action of Citri Reticulatae Pericarpium (CRP) in addressing sarcopenia. The active ingredients of CRP and the potential targets of CRP and sarcopenia were determined using various databases. The STRING platform was utilized to construct a protein-protein interaction network, and the key intersecting targets were enriched through the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) analyses. Molecular docking was used to determine the binding interactions of the active ingredients with the hub targets. The binding affinities obtained from molecular docking were subsequently validated through molecular dynamics simulation analyses. Five active ingredients and 45 key intersecting targets between CRP and sarcopenia were identified. AKT1, IL6, TP53, MMP9, ESR1, NFKB1, MTOR, IGF1R, ALB, and NFE2L2 were identified as the hub targets with the highest degree node in the protein-protein interaction network. The results indicated that the targets were mainly enriched in PIK3-AKT, HIF-1, and longevity-regulating pathways. The active ingredients showed a greater interaction affinity with the hub targets, as indicated by the results of molecular docking and molecular dynamics simulations. Our findings suggest that the active ingredients of Citri Reticulatae Pericarpium, particularly Sitosterol and Hesperetin, have the potential to improve sarcopenia by interacting with AKT1 and MTOR proteins through the PI3K-AKT signaling pathway.

Strategic Aeromedical Evacuations of the French Armed Forces in French Guiana From 2018 to 2020.

The French Armed Forces are deployed in French Guiana (FG) to protect national territory and ensure the security of strategically important sites. Military health support (MHS) provides medical support for missions in this tropical environment, which is hazardous and where confrontations are possible. MHS must organize tactical and strategic evacuations (Strat-AEs), so that an optimal level of care can be delivered. Overall, Strat-AE activity has been described previously but no specific data related to FG has been reported. The main objective of this study was to provide an overview of military Strat-AEs from FG. We conducted a retrospective cohort study from January 01, 2018 through 31 December, 2020. All patients who required a military Strat-AE were included, and we collected sociodemographic characteristics, medical information, service-related injuries and illnesses, and the reason for and conditions of evacuation. We analyzed 210 patients and 199 were included. Most were noncommissioned members (63.3%) and belonged to the Army (75.4%) and the Gendarmerie (15.6%). Injury or illness was duty-related in 66.2% of patients. The main cause for evacuation was nonbattle injury (63.3%), followed by illness (27.1%). Battle stress and injury accounted for 9.5%. The main reasons for evacuation were surgical conditions (58.3%), particularly orthopedic (47.2%). Medical (22.1%), psychiatric (18.6%), and dental (1.0%) disorders followed. Most patients were categorized by the flight surgeon as P3 (98.5%), the lowest level of priority, and D4 (82.9%), the lowest level of dependency. The escort used during evacuation was identical to that recommended by the requester in 83.5% of cases. The final destination was mainly a hospital (89.9%). The time lag between injury or onset of illness and the request for evacuation was significantly longer when local health resources were insufficient. The particularity of FG is a local health care system that provided initial care before the evacuation. To reduce the number of Strat-AEs in FG, the risk of nonbattle injury must be lessened and improvements must be made to the local health care system and to the partnership between civilian and military health services.

Quality of Life of Pregnant Women With Medical Disorders in Ibadan, Nigeria

Quality of Life of Pregnant Women With Medical Disorders in Ibadan, Nigeria

Brine shrimp lethality and antioxidant property of &lt;i&gt;Lagenaria breviflora&lt;/i&gt; (Benth.) Roberty fruit crude extract and fractions

Background: Oxidative injury plays a pivotal impact in the development of human diseases, and it is a major component of the pathophysiology of several inflammation-linked human medical disorders. Objective: The focus of this study was to evaluate the cytotoxicity and antioxidant potential of the fruit of Lagenaria breviflora (Benth.) Roberty (LB). Methods: The antioxidant capacity of L. breviflora's crude and solvent fractions was assessed using standard techniques by measuring the total phenolic content, total flavonoid content, and DPPH radical scavenging activity. The data we0re analyzed using One-way ANOVA, and Dunnett's Multiple Comparison was used to establish the threshold. Results: The total flavonoid contents of fruit methanol extract, LB hexane, chloroform, and ethyl acetate fractions were 32.00 ± 0.94, 224.32 ±0.05, 224.06 ±0.14, and 2615.67 ± 13.20 mg gallic acid equivalent/g of extract, respectively. In contrast, the total phenolic contents were 5218.83 ± 3.18, 2615.67 ± 13.20, and 4553.00 ± 24.27 mg gallic acid equivalent/g of extract, respectively. The crude extract of LB, hexane fraction, chloroform, and ethyl acetate fraction displayed IC50 values of 242.57 ± 8.90, 262.91 ± 6.49, 96.17 ± 2.74, and 221.45 ± 0.83 μg/mL, respectively, for their ability to scavenge DPPH radicals. Ascorbic acid and rutin had IC50 values of 2.76 ± 0.01 and 20.6 ± 9.26 μg/mL, respectively. Conclusions: Fruit from L. breviflora (LB) exhibited strong antioxidant potential, which may have resulted from the fruit's phenolic and flavonoid content. This demonstrates the reason this herb is used in traditional medicine. Keywords: Oxidative stress, brine shrimp lethality assay, total phenolic contents, total flavonoid contents, DPPH, Lagenaria breviflora fruit.

Inpatient hospitalisations for patients with Prader-Willi syndrome: a 2019-2021 National Inpatient Sample analysis.

Prader-Willi syndrome (PWS) is a genetic disorder characterised by hyperphagia, intellectual disability and increased propensity to a range of medical disorders. To better characterise the clinical presentation of PWS across the lifespan, this study reports on the demographics and clinical diagnosis of individuals with PWS hospitalised in the United States. The National Inpatient Sample, an all-payor administrative claims database of hospitalisations in the United States, was queried for patients with a coded diagnosis of PWS from October 2019 through December 2021. Hospitalisations for patients with PWS were matched to five non-PWS hospitalisations based on age, sex, year and hospital characteristics. There were 4400 (95% CI: 3,885 to 4,915) PWS hospitalisations, with a median age of 24. Compared to controls, PWS hospitalisations had longer hospital stays (median 5 vs. 3days) and higher in-hospital mortality (2.2% vs. 1.3%). Infectious (19.0%) and respiratory (16.2%) diagnoses were most common for PWS patients. Codes for overweight or obesity were present in 38.1% of PWS hospitalisations, with Hispanic ethnicity was associated with a higher odds of overweight/obesity in PWS patients (aOR 1.73; 95% CI: 1.11-2.71). PWS hospitalisations are characterised by higher healthcare utilisation and complexity compared to matched controls. The high prevalence of obesity and significant rates of infectious and respiratory conditions highlight specific health challenges for PWS patients. Validation of the Q87.11 administrative claims code is an essential step for ongoing health services research in this condition.

Medical diagnosis based on artificial intelligence and decision support system in the management of health development.

Medical diagnosis plays a critical role in our daily lives. Every day, over 10 billion cases of both mental and physical health disorders are diagnosed and reported worldwide. To diagnose these disorders, medical practitioners and health professionals employ various assessment tools. However, these tools often face scrutiny due to their complexity, prompting researchers to increase their experimental parameters to provide accurate justifications. Additionally, it is essential for professionals to properly justify, interpret, and analyse the results from these prediction tools. This research paper explores the use of artificial intelligence and advanced analytics in developing Clinical Decision Support Systems (CDSS). These systems are capable of diagnosing and detecting patterns of various medical disorders. Various machine learning algorithms contribute to building these assessment tools, with the Network Pattern Recognition (NEPAR) algorithm being the first to aid in developing CDSS. Over time, researchers have recognised the value of machine learning-based prediction models in successfully justifying medical diagnoses. The proposed CDSS models have demonstrated the ability to diagnose mental disorders with an accuracy of up to 89% using only 28 questions, without requiring human input. For physical health issues, additional parameters are used to enhance the accuracy of CDSS models. Consequently, medical professionals are increasingly relying on these machine learning-based CDSS models, utilising these tools to improve medical diagnosis and assist in decision-making. The different cross-validation values are considered to remove the data biasness.

Deep learning to combat knee osteoarthritis and severity assessment by using CNN-based classification

BackgroundIn today’s digital age, various diseases drastically reduce people’s quality of life. Arthritis is one amongst the most common and debilitating maladies. Osteoarthritis affects several joints, including the hands, knees, spine, and hips. This study focuses on the medical disorder underlying Knee Osteoarthritis (KOA) which severely impairs people’s quality of life. KOA is characterised by restricted mobility, stiffness, and terrible pain and can be caused by a range of factors such as ageing, obesity, and traumas. This degenerative disorder leads to progressive wear and tear of the knee joint.MethodsTo combat arthritis in the kneecap, this study employs a 12-layer Convolutional Neural Network (CNN) to reach deep learning capabilities. A collection of data from the Osteoarthritis Initiative (OAI) is used to classify KOA. Through the use of medical image processing; the study ascertains whether an individual has this ailment. A sophisticated CNN architecture created especially for binary classification and KOA severity utilising deep learning algorithms is the main component of this work.ResultsThe cross-entropy loss function is an important component of the model’s laborious design that classifies data into two groups. The remaining section uses the Kellgren-Lawrence (KL) grade to classify the disease’s severity. In the binary classification, the proposed algorithm outperforms previous methods with an accuracy rate of 92.3%, and in the multiclassification, its accuracy rate is 78.4% which is superior to the previous findings.ConclusionLooking ahead, the research broadens the scope of this work by gathering information from various sources and using these methods on a wider range of datasets and situations. The potential for major advancements in the field of osteoarthritis detection and classification is highlighted by this forward-looking approach. Furthermore, this method reduces the intervention of medical practitioners and ultimately results in accurate diagnosis.Clinical trial numberNot applicable.

7289 An interesting case of Diabetes Mellitus Type 1 induced Renal Tubal Acidosis Type 1

Abstract Disclosure: R. Ripa: None. A. Itani: None. S.K. Patel: None. Introduction: Renal Tubular Acidosis (RTA) are a group of disorders that involve dysfunctional transporters and channels in the renal system. These disorders can be acquired (idiopathic, medication side effects, and medical disorders) or inherited. The most common type worldwide is type 4 RTA, the main cause is diabetic nephropathy leading to hypoaldosteronism. The association of type 1 RTA with diabetes has rarely been reported in studies. Here, we report the presentation, diagnosis and management of a rare case of type 1 RTA in a patient with a history of diabetes mellitus type 1. Case: A male in his 50s with a 30-year history of uncontrolled type 1 diabetes mellitus on insulin pump and coronary artery disease presented to his cardiologist with worsening chest pain, fatigue, polyuria, weight loss of 15 lbs, and recent insulin pump change. Blood tests revealed serum bicarbonate of 10 mmol/L and he was sent to the hospital. On examination, he was hypotensive and bradycardic with dry mouth and decreased skin turgor. His blood tests were consistent with type 1 RTA, he was treated with intravenous fluids containing bicarbonate plus potassium and transitioned to oral potassium citrate on discharge. He underwent renal biopsy as work up was unrevealing for a cause of type 1 RTA. Biopsy revealed normal glomeruli with negative immunofluorescence and Congo red stain. The biopsy, however, did show mild patchy chronic interstitial fibrosis with lymphocytes and mild tubular atrophy. At one year follow up, he remained on oral potassium citrate with resulting serum bicarbonate of 26 mmol/L and a normal renal function. Discussion: Diabetes mellitus can lead to a variety of renal pathologies, specifically metabolic acidosis that can be either seen as diabetic ketoacidosis or hyporeninemic hypoaldosteronism (Type 4 RTA). In our patient, despite being a diabetic, he did not present with either elevated anion gap, ketonuria or hyperkalemic hyperchloremic acidosis typical of type 4 RTA. He was noted to have hypokalemic hyperchloremic acidosis, with a positive urine anion gap, and an alkaline urine, all characteristic of type 1 RTA. Acquired distal RTA occurs more commonly due to certain medications or autoimmune diseases as in Sjögren’s syndrome. The relationship between distal RTA and Sjögren’s syndrome has already been established, unlike the relationship with type 1 diabetes. There have been few case reports of distal RTA in association with type 1 diabetes mellitus, implying a possible autoimmune pathology. Prior case reports also not only had patients who were insulin dependent, but diabetes was present for more than a decade at least suggesting chronicity of disease is needed. Traditional management consists of alkaline therapy and treatment of the underlying disease, or removal of offending medication. In this case, we hope to highlight distal RTA in a diabetic who doesn’t meet criteria for DKA or type 4 RTA. Presentation: 6/1/2024