Normal Segments Research Articles

A machine learning algorithm for detecting abnormal patterns in continuous capnography and pulse oximetry monitoring

Continuous capnography monitors patient ventilation but can be susceptible to artifact, resulting in alarm fatigue. Development of smart algorithms may facilitate accurate detection of abnormal ventilation, allowing intervention before patient deterioration. The objective of this analysis was to use machine learning (ML) to classify combined waveforms of continuous capnography and pulse oximetry as normal or abnormal. We used data collected during the observational, prospective PRODIGY trial, in which patients receiving parenteral opioids underwent continuous capnography and pulse oximetry monitoring while on the general care floor [1]. Abnormal ventilation segments in the data stream were reviewed by nine experts and inter-rater agreement was assessed. Abnormal segments were defined as the time series 60s before and 30s after an abnormal pattern was detected. Normal segments (90s continuous monitoring) were randomly sampled and filtered to discard sequences with missing values. Five ML models were trained on extracted features and optimized towards an Fβ score with β = 2. The results show a high inter-rater agreement (> 87%), allowing 7,858 sequences (2,944 abnormal) to be used for model development. Data were divided into 80% training and 20% test sequences. The XGBoost model had the highest Fβ score of 0.94 (with β = 2), showcasing an impressive recall of 0.98 against a precision of 0.83. This study presents a promising advancement in respiratory monitoring, focusing on reducing false alarms and enhancing accuracy of alarm systems. Our algorithm reliably distinguishes normal from abnormal waveforms. More research is needed to define patterns to distinguish abnormal ventilation from artifacts.

Can caterpillar cilia penetrate the retina

A 36-year-old male presented with recurrent episodes of redness in the right eye following vigorous eye rubbing since 3 months, treated with on and off steroid eyedrops elsewhere. On examination, his best corrected visual acuity was 6/6 in both eyes with normal anterior segment. A cilia-like structure was noted on fundoscopy along the temporal periphery with clumps of vitreous exudates surrounding it. Pars plana vitrectomy was performed to remove the hair, which was seen adherent to and penetrating through the retina. On follow-up at 3 months, there were no episodes of inflammation noted.

Novel pathogenic variants of SLC38A8 gene and literature review.

This study aimed to analyze the clinical and genetic characteristics of 6 Chinese patients with foveal hypoplasia (FH) caused by the variants of solute carrier family 38 member 8 (SLC38A8), and to describe the genotype and phenotype of SLC38A8 variants from previous literature. All subjects underwent comprehensive ophthalmic examinations. Optical coherence tomography (OCT) was performed to evaluate the structural grade of FH. Pathogenic variants of SLC38A8 gene were identified using panel-based next-generation sequencing and direct Sanger sequencing techniques. Further, all previously reported cases of SLC38A8 variants were re-analyzed together with the novel ones identified in this study. Nystagmus and FH were present in 6 patients with variants of SLC38A8 gene, accompanied by a normal anterior segment. Grade 4 FH was identified in 4 patients. A total of 12 variants of SLC38A8 gene were identified, including 9 novel variants. Systematical analysis revealed that half of the variants (30/60) were missense, the majority of which (23/30) were distributed in the transmembrane (TM) domains. Grade 4 FH was detected in the majority of patients (66%, 23/35). There was no statistical difference in the clinical features between the subgroups of patients with 0, 1 and 2 missense variants. Severe arrest of foveal development was identified in patients with variants of SLC38A8. This study provides a brief summary of the clinical and genetic characteristics of the pathogenic SLC38A8 variants, which is helpful in the differentiation diagnosis of FH.

Quantitative Proteomic Analysis Identifying and Evaluating TRAF6 and IL-8 as Potential Diagnostic Biomarkers in Neonatal Patients with Necrotizing Enterocolitis.

Necrotizing enterocolitis (NEC) is a common gastrointestinal complication in premature infants, resulting in high morbidity and mortality, and its early detection is crucial for accurate treatment and outcome prediction. Extensive research has demonstrated a clear correlation between NEC and extremely low birth weight, degree of preterm, formula feeding, infection, hypoxic/ischemic damage, and intestinal dysbiosis. The development of noninvasive biomarkers of NEC from stool, urine, and serum has attracted a great deal of interest because to these clinical connections and the quest for a deeper knowledge of disease pathophysiology. Therefore, this study aims to identify protein expression patterns in NEC and discover innovative diagnostic biomarkers. In this study, we recruited five patients diagnosed with NEC and paired necrotic segments of intestinal tissue with adjacent normal segments of intestine to form experimental and control groups. Quantitative proteomics tandem mass tagging (TMT) labeling technique was used to detect and quantify the proteins, and the expression levels of the candidate biomarkers in the intestinal tissues were further determined by quantitative polymerase chain reaction (RT-qPCR), Western blot analysis, Immunofluorescence methods and enzyme-linked immunosorbent assay (ELISA). A total of 6880 proteins were identified and quantified in patients with NEC. A significant disparity in protein expression was observed between necrotic and normal segments of intestinal tissue in NEC patients. A total of 55 proteins were found to be upregulated, and 40 proteins were found to be downregulated in NEC patients when using a p-value of < 0.05, and an absolute fold change of > 1.2 for analysis. GO function enrichment analysis showed the positive regulation of significant biological processes such as mitochondrial organization, vasoconstriction, rRNA catabolism, fluid shear stress response, and glycerol ether biosynthesis processes. Enrichment analysis also revealed essential functions such as ligand-gated ion channel activity, potassium channel activity, ligand-gated cation channel activity, ligand-gated ion channel activity, and ligand-gated channel activity, including molecular functions such as ligand-gated ion channel activity and mitotic events in this comparative group. Significant changes were found in endomembrane protein complex, membrane fraction, mitochondrial membrane fraction, membrane components, membrane intrinsic components, and other localized proteins. Additional validation of intestinal tissue and serum revealed a substantial increase in TRAF6 (tumor necrosis factor receptor-associated factor 6) and IL-8(Interleukin-8, CXCL8). The quantitative proteomic TMT method can effectively detect proteins with differential expression in the intestinal tissues of NEC patients. Proteins TRAF6 and CXCL8/IL-8 are significantly upregulated in the intestinal tissues and serum samples of patients and may serve as valuable predictor factors for NEC's early diagnosis.

Systemic steroids in pediatric pseudotumor cerebri - A case report

Study design: Case report. Purpose: To study the efficacy of systemic steroids in pediatric pseudotumor cerebri. Introduction: Pseudotumor cerebri is a condition caused by elevated intracranial pressure presenting most commonly with headache. It is a diagnosis of exclusion. Methods: A 15-year-old girl presented in our outpatient department with a headache for 3 months, more in the posterior aspect, continuous type with severe intensity, non-radiating. On examination, the best corrected visual acuity in her right eye was 6/9, and her left eye was 6/6 parts. She had a normal anterior segment and normal Intraocular Pressure (IOP). Fundoscopy showed both optic discs edematous, pink in color with blurry disc margins, tortuous disc vessels, and edematous peripapillary area. The rest of the retina was normal. Lumbar puncture showed elevated opening CSF pressure and normal CSF composition. Hence she was diagnosed with IIH. She was started on oral prednisolone 1mg/kgbw once a day dosage, oral acetazolamide 250 mg once a day, topical nepafenac 0.1% one drop thrice a day and timolol 0.5% eye drops twice a day. Discussion: The main goals of treatment are alleviation of symptoms, including headache, and preservation of vision. Steroids were commonly used for treating IIH in the past, but cause significant long-term side effects, such as weight gain, that are undesirable in IIH patients. Furthermore, withdrawal of steroids can cause rebound intracranial hypertension. Thus, steroids should not be used routinely for IIH treatment. Results: By the end of one month, the patient was relieved of symptoms, best corrected visual acuity was 6/6 in both eyes with normal IOP, normal optic disc in both eyes. Conclusion: Steroids are an effective way of managing idiopathic intracranial hypertension in pediatric patients.

Improvement in the estimation of perfusable tissue fraction and myocardial flow reserve in the ischemic myocardial lesions using ECG-gated dynamic myocardial PET with 15O-water.

Perfusable tissue fraction (PTF) and myocardial flow reserve (MFR) from 15O-water dynamic positron emission tomography (PET) are parameters of myocardial viability. However, myocardial motion causes errors in these values. We aimed to develop accurate estimation of PTF and MFR in ischemic lesions using an electro-cardiogram (ECG)-gated dynamic myocardial PET with 15O-water. Twenty-seven patients with ischemic heart disease were enrolled. All patients underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). List mode 3D PET data and ECG signals were acquired using Philips Gemini TF64 instrument. For each scan, 500MBq of 15O-water was infused slowly for 2min, and the dynamic data were scanned for 6min. Both non-gated dynamic images and ECG-gated diastolic dynamic images were reconstructed. On the myocardial PET images of each patient, the entire myocardial region of interest (ROI) was set and divided into 17 segments. Myocardial blood flow in the resting state (rest MBF), hyperemic state (stress MBF), PTF, and MFR in each segment were estimated from both non-gated and ECG-gated dynamic PET images. Coronary arteriograms were obtained for all patients. In total, 128 normal segments without stenosis and 50 ischemic segments with > 90% stenosis were evaluated. In the ischemic myocardial segments, the PTF with ECG-gated PET was estimated as significantly lower than that with non-gated PET (0.63 ± 0.09 vs. 0.72 ± 0.08 [mL/mL], p < 0.001). The ECG-gated PET estimated a significantly lower PTF in the ischemic segments than in the normal segments (0.63 ± 0.09 vs. 0.67 ± 0.07 [mL/mL], p < 0.01). In the normal segments, the ECG-gated PET detected no significant difference in MFR compared with those from the non-gated PET (2.15 ± 0.76 vs. 2.24 ± 0.79, p = 0.28). However, in the ischemic myocardial segments, the MFR with ECG-gated PET was estimated as significantly lower than that with the non-gated PET (1.23 ± 0.29 vs. 1.69 ± 0.71, p < 0.001). The ECG-gated PET presented a significantly higher inter-observer reproducibility of PTF and rest MBF than the non-gated PET (p < 0.01). Neither stress MBF nor MFR yielded significant differences in inter-observer reproducibility between the ECG-gated and non-gated PET. The ECG-gated dynamic 15O-water PET suppressed the myocardial motion effect and resulted in a lower PTF and MFR in ischemic myocardial lesions than the non-gated PET. The ECG-gated PET seemed to be better than the conventional non-gated dynamic PET for the detection of ischemic myocardial lesion.

New model of linkage evolution for the transtensional fault systems in the Nanpu Sag of Bohai Bay Basin: Insight from seismic interpretation and analogue modelling

The evolution of faults within the same stress field is frequently influenced by numerous factors, involving the reactivation of pre-existing structures, stress transmission through ductile detachment layers, and the growth, interaction, as well as linkage of new fault segments. This study analyses a complex multi-phase oblique extension fault system in the Nanpu Sag (NPS) of the Bohai Bay Basin (BBB), China. High-resolution three-dimensional (3D) seismic data and analogue modelling indicate that the oblique extensional reactivation of pre-existing structures governs the sequential arrangement of fault segments in the caprock, and they dip synthetically to the reactivated fault at depth. During the NW–SE extension in the Eocene, the predominant movement of the pre-existing fault is strike-slip. Subsequently, during the N–S extension since the Oligocene, inclined at 20° to the pre-existing fault, forming splay fault segments and ultimately creating large en-échelon arcuate faults linked by relay ramps. Using fault throw-distance (T-D) and laser scanning, we reconstructed the fault evolution model of oblique extension reactivation in the presence of a ductile detachment basement. Our study illustrates that the arcuate faults can be categorized into linear master fault segments controlled by pre-existing structures, bending splay faults in the termination zone, and normal fault segments responding to the regional stress field. The interaction between faults occurs among normal faults and strike-slip faults, and the kinematic unification of the two fault systems is accomplished in the intersection zone. As the faults continue to evolve, the new fault segments tend to relinquish the control of pre-existing structures and concentrate more on the development of planar and continuous major faults. The ductile detachment layer significantly contributes to the uniform distribution of strain, resulting in narrow shear zones and discontinuous normal faults in its absence.

Anomaly Detection in Heterogeneous Data Using Graph Convolutional Networks

Closed-circuit television (CCTV) surveillance systems are ubiquitous tools for ensuring public and private safety. However, manual monitoring of surveillance footage is arduous and time-consuming, often resulting in delayed identification and response to potential threats. In this paper, we present a novel real-time threat detection system tailored for CCTV surveillance, employing cutting-edge deep learning methodologies, particularly graph convolutional networks (GCNs), to detect and classify high-movement levels within video frames. By treating videos as segments and delineating between anomalous (potentially threatening) and normal (safe) segments, our system facilitates continuous real-time monitoring of surveillance footage, enabling the timely identification of potential threats such as abuse, burglaries, explosions, shootings, fighting, shoplifting, road accidents, arson, robbery, stealing, assault, and vandalism. To assess the efficacy of our system, we conducted extensive experiments on a large-scale dataset comprising CCTV footage, yielding promising results. Additionally, we introduce a novel, comprehensive dataset comprising 128 hours of real-world surveillance videos, encompassing various anomalies and normal activities. This dataset serves dual purposes: general anomaly detection, and the recognition of specific anomalous activities. Our experimental findings demonstrate the superior performance of our method in anomaly detection compared to state-of-the-art approaches. Furthermore, we provide an analysis of several recent deep learning baselines for anomalous activity recognition, revealing the challenging nature of our dataset and the potential it holds for future research endeavors. Through the integration of advanced deep learning techniques and comprehensive dataset creation, our proposed system stands to significantly enhance the efficiency and effectiveness of CCTV surveillance, facilitating faster response times and bolstering security for individuals in diverse environments.

Comparative study of respiratory sounds classification methods based on cepstral analysis and artificial neural networks

In this paper, we investigated and evaluated various machine learning-based approaches for automatically detecting wheezing sounds. We conducted a comprehensive comparison of these proposed systems, assessing their classification performance through metrics such as Sensitivity, Specificity, and Accuracy. The main approach to developing a machine learning-based system for classifying respiratory sounds involved the combination of a technique for extracting features from an unknown input sound with a classification method to determine its belonging class. The characterization techniques used in this study are based on the cepstral analysis, which was extensively employed in the automatic speech recognition field. While MFCC (Mel-Frequency Cepstral Coefficients) feature extraction methods are commonly used in respiratory sounds classification, our study introduces a novelty by employing GFCC (Gammatone-Frequency Cepstral Coefficients) and BFCC (Bark-Frequency Cepstral Coefficients) for this purpose. For the classification task, we employed two types of neural networks: the MLP (Multilayer Perceptron), a feedforward neural network, and a variant of the LSTM (Long Short-Term Memory) recurrent neural network called BiLSTM (Bidirectional LSTM). The proposed classification systems are evaluated using a database consisting of 497 wheezing segments and 915 normal respiratory segments, which are recorded from individuals diagnosticated with asthma and individuals without any respiratory issues, respectively. The highest classification performance was achieved by the BFCC-BiLSTM model, which demonstrated an exceptional accuracy rate of 99.8%.

Unusual Presentation of Lipemia Retinalis Presented with Visual Field Defect

Introduction : Lipemia retinalis is an ocular presentation that associated to hypertriglyceridemia. Most cases are usually asymptomatic, with changes detected only from fundus examination. This case report highlights a case of lipemia retinalis with decreased peripheral visual field.&#x0D; Case Illustration : Thirty four year-old female came with complaint of blurry right eye (RE) 3 months before hospital visit, especially on inferotemporal part of her right eye. She had history of diabetes mellitus and hypertriglyceridemia. Her sister also has known history of hypertriglyceridemia. Ophthalmological examination revealed 6/6 visual acuity on both eyes, with normal anterior segment of both eyes. Fundus examination showed creamy retinal vessels on both eyes. Humphrey perimetry result showed inferotemporal visual field defect of RE. At time of visit, triglyceride level was 1440 mg/dL. Patient was prescribed fenofibrate 1x300 mg daily by Endocrinology Department. After 6 months of fenofibrate therapy, serum triglyceride level was decreasing to 185 mg/dL. Ophthalmology exam revealed a significant decrease of creamy white vessel on right eye and normal vessel of left eye. Humphrey perimetry showed decreased visual field defect&#x0D; Discussion : Hypertriglyceridemia can result from familial or secondary to systemic diseases. Creamy vessel appearance in lipemia retinalis is resulted from presence of triglyceride-laden chylomicrons in the plasma. Lipemia retinalis rarely manifests with reduced peripheral vision, which is presented in this case.&#x0D; Conclusion : Lipemia retinalis is often overlooked due to its asymptomatic nature. Prompt recognition might be live saving from life-threatening condition resulting from hypertriglyceridemia. Triglyceride- lowering drug therapy is very useful in improving peripheral field defect as presented in our case report.

SURGICAL OUTCOME OF MUSCLE TRANSPLANTATION AS A MONOCULAR SURGERY FOR LARGE ANGLE STRABISMUS

Introduction: The management of large-angle strabismus can be difficult for surgeons, and successful outcomes may require multiple surgeries. However, modern surgical techniques aim to achieve desired results with a single operation. Muscle transplantation is one such technique that increases the effective muscle length, allowing for a large correction in a one-stage surgery. Objective: To report the outcome of muscle transplantation surgery in large-angle strabismus. Case Illustration: Three patients presented with large-angle strabismus, of which two cases showed &gt;50∆ ET and one case had &gt;50∆XT. All patients had normal anterior and posterior segment findings and underwent muscle transplantation under general anaesthesia. The first and second cases showed good alignment post-surgery, with no limitations in ocular motility in all gaze directions and improved visual acuity. However, none of the cases achieved stereoscopic vision due to chronic strabismus. In the third case, improvement in the primary position was observed two weeks post-operative, but ocular motility still had limitations. Conclusion: Muscle transplantation is a good option to correct large-angle strabismus, specifically in the unilateral case in a single procedure.

Management of Iatrogenic Iridodialysis with Single-pass Four-Throw (SFT) Pupilloplasty : A Case Report

Introduction : Iridodialysis is a localized separation or tearing away of the iris from its attachment to the ciliary body. It occurs most commonly secondary to trauma, and it is more frequently associated with blunt traumas compared to penetrating eye injuries. Iridodialysis can also occur due to intraocular surgeries. The prevalence of iridodialysis secondary to blunt trauma was reported to be 9.3-14% as compared to 0.2% caused by cataract surgeries. Small and superiorly located iridodialysis may be left untreated. However, a more inferiorly placed, larger, or symptomatic iridodialysis warrants surgical repair.&#x0D; Case Illustration : A Male 62 years old came with chief complaint Glare on right eye after complicated cataract surgery 2 months before.Patient also complained blurry vison without redness. Examination found visual acuity 6/60 UCVA RE, iridodialysis at superior region from 10 o’clock until 1 o’clock, IOL (+) with good central, Normal Posterior Segment. Patient was treated with Single-pass Four-Throw (SFT) Pupilloplasty with local anesthesia and 1-month after Pupilloplasty we found visual acuity 6/30 UCVA RE and without any glare complaint anymore.&#x0D; Discussion : Management of this patient is a challenging case. The treatment og Single-pass Four-Throw (SFT) Pupilloplasty can give great outcome for visual acuity and glare symptom. SFT Pupilloplasty is also great and easy technique for beginner eye surgeon but for anesthesia, general anesthesia is more convenience than local ones.&#x0D; Conclusion : SFT Pupilloplasty is also great and easy techinique for iatrogenic iridodialysis.

An Alternative in Managing Duane Retraction Syndrome Type I Using Modified Nishida Procedure: A Case Report

Introduction : Various surgical approaches have been proposed to address the challenge in managing abduction deficit in Duane Retraction Syndrome (DRS) Type I, with no clear guidelines to achieve optimal result. This report aims to describe the outcome of combining medial rectus (MR) recession and modified Nishida procedure to improve abduction in DRS Type I.&#x0D; Case Illustration : Twenty six year-old female came with inability to abduct her left eye (LE) since early childhood and an abnormal left head turn. No complaints of double vision nor visual impairment. There was -5 abduction on LE with a noticeable narrowing of vertical palpebral fissure during adduction. Prism alternate prism cover test shared a 30 PD esotropia with normal anterior and posterior segment. Patient was assessed with DRS Type I of LE and managed with 5mm MR recession combined with modified Nishida procedure (vertical rectus transposition without tenotomy and muscle splitting). On postoperative day 1 and last follow-up (1 year), the alignment was ortophoric, abduction improvement of -2, and diminished anomalous head posture.&#x0D; Discussion : Although studies have only reported successful cases of modified Nishida procedure in CN VI palsy, it can be assumed that the procedure can also be implemented to treat lateral rectus muscle innervation abnormality such as in DRS type I. Surgical intervention may not normalize abduction deficit. However, the procedure successfully corrects ocular alignment, eliminates anomalous head posture, and able to improve abduction with no complications.&#x0D; Conclusion : Modified Nishida procedure can be implemented as an alternative in managing DRS type I with relatively satisfactory result.

Navigating Through The Diagnostic and Management Maze of Atypical Optic Neuritis Due To Autoimmune

Abstract&#x0D; Introduction : Typical and atypical optic neuritis (ON) have many overlapping characteristics; however, atypical ON have different features, with more lasting visual impairment and devastating prognosis. This paper describes a challenging case of recurrent, atypical ON due to autoimmune.&#x0D; Case Illustration : 42-year-old female complained of recurrent attacks of bilateral blurry vision, eye pain, and headachefor the past two years. Patient had been on multiple rounds of high-dose oral methylprednisolone, but symptoms reappeared every time it was tapered down. Visual acuity of both eyes was 3/60 and 6/45 (without and with correction, respectively), with normal intraocular pressure, anterior and posterior segment, and cranial nerves. No relative afferent pupillary defect was present. Brain magnetic resonance imaging (MRI) revealed intracerebral chronic small vessels; with no lesion in both optic nerves nor signs of neuromyelitis optica. Blood work-up showed elevated C-reactive protein, platelet aggregation, fibrinogen, D-dimer; positive rheumatoid factor, antinuclear antibody, and lupus anticoagulant; and negative Aquaporin-4 IgG. Diagnosis of atypical ON was established. Internal medicine and neurology departments diagnosed her with non-radiographic axial spondyloarthritis and migraine due to attributed autoimmune, respectively. After administration of intravenous pulse dose of methylprednisolone, her vision recovered to 6/7,5 of both eyes and symptoms alleviated.&#x0D; Discussion : Atypical features usually give hints for atypical ON, while laboratory examination and imaging modalities may aid in etiology identification. Early immunosuppressant therapy is commonly required.&#x0D; Conclusion : Recognizing symptoms of ON and necessitating further evaluation through ancillary tests, and collaborations with other specialties can minimize long-lived ailment and improve patients’ quality of life.

Anomaly Detection in CCTV Surveillance

CCTV surveillance systems are routinely utilized to maintain the safety and security of public and private locations. However, manually watching surveillance footage may be tiresome and time-consuming, making it difficult to recognize and respond to possible threats quickly. In this research, we offer a real-time danger detection system for CCTV monitoring that uses deep learning models to identify and categorize degrees of high movement in video frames. Our system is able to continuously monitor surveillance footage in real-time and identify potential threats such as abuse, burglaries, explosions, shootings, fighting, shoplifting, road accidents, arson, robbery, stealing, assault, and vandalism by treating videos as segments and defining anomalous (threatening) and normal (safe) segments. We conducted extensive tests on a huge collection of CCTV video to evaluate the effectiveness of our system and obtained encouraging findings. Our solution has the potential to greatly increase the efficiency and efficacy of CCTV surveillance, allowing for faster reaction times and improved individual security. We use multiple instance learning (MIL) to automatically develop a deep anomaly ranking model that predicts high anomaly scores for anomalous video segments by treating normal and anomalous films as bags and video segments as instances. In addition, we apply sparsity and temporal smoothness requirements in the ranking loss function to improve anomaly localization during training. In addition, we present a novel large-scale, first-of-its-kind dataset comprising 128 hours of video. It comprises of 1900 uncut real-world surveillance movies with 13 actual anomalies such as fights, car accidents, burglary, robbery, and so on, as well as typical activities. This dataset may be used for two different purposes. First, global anomaly detection, which takes into account all abnormalities in one group and all normal activity in another. Secondly, for identifying every one of the thirteen unusual actions. Comparing our experimental results to state-of-the-art methodologies, we find that our MIL method for anomaly detection produces a considerable increase on anomaly detection performance. We provide the findings from many recent deep learning baselines concerning the identification of aberrant behavior. These baselines' poor recognition performance indicates how difficult our dataset is, and it also provides additional room for investigation in the future.

A study on hearing screening using oto-acoustic emissions in newborns delivered by normal vaginal delivery and lower segment caesarean section

Background: Hearing is one of the most complex systems of the human body and is a skill involved in the human social evolution. It has been estimated that around 900 million people by the end of 2050, will probably suffer from hearing loss. Our study aims to find out the correlation between the mode of delivery and the effect it has on newborn hearing screening. Methods: The Prospective study on 136 Newborn babies who were delivered in JLN Hospital &amp; Research Centre, Bhilai, Chhattisgarh during October 2020 to August 2021. After obtaining detailed history all newborns underwent TEOAE screening and the data were then compared with the available literature. Results: We observed normal vaginal delivery newborns have passed the test by 97.91% and 89.58% when compared to LSCS delivered infants 97.15% and 86.36% in screening and diagnostic frequency respectively. COVID-19 infection was seen in 2.94% of pregnant mothers in the 3rd trimester. There were no babies who required BERA in our study Conclusions: Normal vaginally delivered newborns have higher pass rate in TEOAE test when compared with LSCS delivered babies. Covid-19 infection in antenatal mother can influence the outcome in 1st TEOAE tests. The pass rate in TEOAE hearing test in the screening frequency is found to be greater when compared with diagnostic frequencies. In a developing country like India, Universal hearing screening programs needs to be reached out to the most remote parts of the country, in order to identify at risk infants for hearing loss.

Single Sequence Whole-Spine Screening Magnetic Resonance Imaging: Diagnostic and Therapeutic Role in Multiple-Level Spinal Tuberculosis.

Spinal tuberculosis (TB) is the most common form of skeletal tuberculosis. Paradiscal continuous vertebral involvement at a single level is the most prevalent pattern among all forms of spinal TB. There is a wide range of reported incidences of multiple-level non-contiguous spinal TB in the literature. We would like to discuss on the utility of single whole spine screening T2-weighted (T2W) mid-sagittal magnetic resonance imaging (MRI) film in diagnosing multiple-level spinal TB and therapeutic benefits it can provide. We have done a retrospective review of the collected data of patients in Vardhman Mahavir Medical College and Safdarjung Hospital from August 2017 to October 2021 to find the incidence of multiple-level spinal TB and possible factors attributed to this specific disease pattern. All the patients who had been diagnosed of spinal TB either microbiologically or histopathologically or by a good clinical response to anti-tubercular treatment (ATT) and had a whole spine screening MRI film, were included. Patients of spinal TB who did not have a whole spine screening MRI were excluded from the study. Multiple-level spinal TB was diagnosed when lesions were identified in vertebral levels other than a typical paradiscal lesion, and additional lesions were separated from the primary disease by at least one normal spinal segment. Among the patients, 242 met the inclusion criteria, and 76 showed multiple-level non-contiguous spinal TB on MRI, incidence being 31.4%. The rest of the 166 patients showed typical single-segment contiguous lesions. By doing multivariate analysis to determine the independent risk factors for multiple-level spinal TB, extremes of age (<20 years and >50 years) have been found to be a significant factor with p value of 0.0001. Though drug resistance was not found to be a significant risk factor (p value 0.051), the proportion of patients having multiple-level TB was far more in the drug-resistant group (13/76). Single sequence whole spine screening MRI film is an effective, economical, and time-saving tool to detect multiple-level spinal TB. Along with its diagnostic accuracy, it also provides therapeutic benefits like access to a more approachable site for biopsy.

Anomalous systemic arterial supply to normal basal segments of lung with anomalous V6

Anomalous systemic arterial supply to normal basal segments of lung with anomalous V6

Progress in the nerve ultrasound of inflammatory peripheral neuropathies

Objective: In recent years, high-resolution nerve ultrasound has been increasingly used as a complementary tool to nerve conduction studies in the diagnosis of peripheral neuropathies. Inflammatory peripheral neuropathies include a heterogeneous group of neuropathies mainly including chronic inflammatory demyelinating polyneuropathies (CIDP), multifocal motor neuropathy (MMN), systemic vasculitic neuropathy (SVN), and Guillain-Barre syndrome (GBS). We describe the ultrasonic characteristics of different inflammatory neuropathies.&#x0D; Data sources and study selection: The MEDLINE database was searched to find studies on nerve sonography in inflammatory peripheral neuropathies. Reported studies up to December 2022 were included in this review.&#x0D; Results: In neuropathies, the changes in ultrasound include enlarged nerve size, nerve echo-intensity, fascicle diameter and vascularity. Most CIDP patients have moderately enlarged CSA, some have dramatically enlarged CSA, and few have CSA within the normal range. Since the enlargement patterns are different, ultrasound is useful to help differentiate CIDP from CMT1. In follow-ups after immune treatment, nerve CSAs in CIDP could decrease, increase, or remain unchanged. Regional enlargement next to normal segments predominated in MMN. Nerve enlargement and hyper vascularization were found in vasculitic neuropathy. In GBS patients, there were enlarged peripheral nerve and nerve roots, which became normal at follow-up.&#x0D; Conclusions: High-resolution nerve ultrasound is complementary to the diagnosis of inflammatory peripheral neuropathies. CSA enlargement and its distribution are the most useful and quantifiable parameters in the evaluation of peripheral nerves. For patients suspected to have inflammatory neuropathies, we advise measuring the CSA of several pre-determined sites in the median, ulnar nerve, C5-8 cervical roots, and brachial plexus.

3D TUMOR SEGMENTATION AND DIAGNOSIS SYSTEM OF LUNG CANCER USING MULTISCALE APPROACHES

A deadly disease that affects people in various countries in the world is lung cancer (LC). The rate at which people die due to LC is high because it cannot be detected easily at its initial stage of tumor development. The lives of many people who are affected by LC are assured if it is detected in the initial stage. The diagnosis of LC is possible with conventional computer-aided diagnosis (CAD). The process of diagnosis can be improved by providing the associated evaluation outcomes to the radiologists. Since the results from the process of extraction of features and segmentation of lung nodule are crucial in determining the operation of the traditional CAD system, the results from the CAD system highly depend on these processes. The LC classification from computed tomography (CT) images of three dimensions (3D) using a CAD system is the key aspect of this paper. The collection of the 3D-CT images from the standard data source takes place in the first stage. The obtained images are provided as input for the segmentation stage, in which a multi-scale 3D TransUNet (M-3D-TUNet) is adopted to get the precise segmentation of the LC images. A multi-cascaded model that incorporates residual network (ResNet), visual geometry group (VGG)-19, and DenseNet models is utilized to obtain the deep features from the segmented images. The segmented image from the M-3D-TUNet model is given as input to this multi-cascaded network. The features are obtained and fused to form the feature pool. The feature-pool features are provided to the enhanced long short-term memory with attention mechanism (ELSTM-AM) for classification of the LC. The ELSTM-AM classifies the images as normal or healthy segments. The classifier's parameters are optimized with the help of the modified fluctuation-based queuing search algorithm (MF-QSA). The output from implementing the suggested model on 3D-CT images from Lung Nodule Analysis of 2016, with a sample of 888 CT scans with 1186 nodules dataset, achieved; Accuracy 90.9&amp;#37;, Precision 91.1&amp;#37;, Sensitivity 91&amp;#37;, Specificity 90.8&amp;#37;, and F-Score 91&amp;#37;, which shows that the generated framework for LC detection is better than existing models for LC classification.