Development of fuzzy logic-base diagnosis expert system for typhoid fever

Typhoid fever (TyF), caused by salmonella typhoid bacteria, represents one of the main public health challenge in various parts of the world. It is often treatable when diagnosed early, but if left untreated could lead to other medical complications. This study proposed an artificial intelligence means (arim) for diagnosis of TyF. The objectives are to find out the leading risk factors for TyF, develop fuzzy logic base-expert system, called Typhoid Responsive Expert System (TyRes), that can predict the ailment from symptoms and use TyRes to predict TyF in patients. Two sets of questionnaires were used for data collection. 325 copies were administered to the patients in 25 hospitals in Lagos, Abeokuta and Ifo, South-west Nigeria. Another set of 200 copies were administered to human medical experts (hme), 70 doctors and 140 qualified nurses, to capture hme knowledge about TyF and its symptoms. The data was analysed using Chi-Square to identify the main symptoms spotted by most of the hme. TyRes was implemented in Matlab 2015a using the main factors as input variables. Vomiting, high-temperature, weakness, abdominal-pains and loss-of-appetite were the input variables used to develop TyRes. When tested to predict TyF in 25 patients, 76% accuracy was derived when comparing hme predictions with TyRes results. It can be concluded that TyRes can mimic hme by 76% of all TyF predictions. The arim is considered reliable and can be used at home, school and health centres where hme are scarce

Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial

Background: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy.Methods: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset. Participants were assigned in a 1:1 ratio using computer randomisation to receive loading doses and then 30 days of intensive antiplatelet therapy (combined aspirin 75 mg, clopidogrel 75 mg, and dipyridamole 200 mg twice daily) or guideline-based therapy (comprising either clopidogrel alone or combined aspirin and dipyridamole). Randomisation was stratified by country and index event, and minimised with prognostic baseline factors, medication use, time to randomisation, stroke-related factors, and thrombolysis. The ordinal primary outcome was the combined incidence and severity of any recurrent stroke (ischaemic or haemorrhagic; assessed using the modified Rankin Scale) or TIA within 90 days, as assessed by central telephone follow-up with masking to treatment assignment, and analysed by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN47823388.Findings: 3096 participants (1556 in the intensive antiplatelet therapy group, 1540 in the guideline antiplatelet therapy group) were recruited from 106 hospitals in four countries between April 7, 2009, and March 18, 2016. The trial was stopped early on the recommendation of the data monitoring committee. The incidence and severity of recurrent stroke or TIA did not differ between intensive and guideline therapy (93 [6%] participants vs 105 [7%]; adjusted common odds ratio [cOR] 0·90, 95% CI 0·67–1·20, p=0·47). By contrast, intensive antiplatelet therapy was associated with more, and more severe, bleeding (adjusted cOR 2·54, 95% CI 2·05–3·16,