Phase Aberration Correction without Reference Data: An Adaptive Mixed Loss Deep Learning Approach

Phase aberration is one of the primary sources of image quality degradation in ultrasound, which is induced by spatial variations in sound speed across the heterogeneous medium. This effect disrupts transmitted waves and prevents coherent summation of echo signals, resulting in suboptimal image quality. In real experiments, obtaining non-aberrated ground truths can be extremely challenging, if not infeasible. It hinders the performance of deep learning-based phase aberration correction techniques due to sole reliance on simulated data and the presence of domain shift between simulated and experimental data. Here, for the first time, we propose a deep learning-based method that does not require reference data to compensate for the phase aberration effect. We train a network wherein both input and target output are randomly aberrated radio frequency (RF) data. Moreover, we demonstrate that a conventional loss function such as mean square error is inadequate for training the network to achieve optimal performance. Instead, we propose an adaptive mixed loss function that employs both B-mode and RF data, resulting in more efficient convergence and enhanced performance. Source code is available at \url{http://code.sonography.ai}

Variations in Serum Ferritin in Different Professionals of Mirpurkhas.

Introduction: Serum ferritin has been shown to be a good biomarker of body iron stores. Iron is essential mineral that functions to bind oxygen as a part of Heme in Hemoglobin and Myoglobin1. Ferritin, a major protein regulating iron homeostasis, is used as a biomarker for iron status and low grade inflammation, which results in free radical damage to cells and tissues18-19. Accordingly, recent studies demonstrated that serum ferritin concentrations are correlated with diabetes mellitus, insulin resistance, metabolic syndrome, ischemic heart disease, cardiovascular disease, and nonalcoholic fatty liver disease (NAFLD) in healthy men and obese patients. Objective: The study was aimed to evaluate possible variations in serum ferritin levels in different professional of Mirpurkhas. Methodology: 250 subjects were randomly selected from the local community of Mirpurkhas from OPDs of Civil Hospital Mirpurkhas and Muhammad Medical College Mirpurkhas. Their Serum ferritin was determined by ELISA. And the data was analyzed by SPSS 15. Results: This was a cross-sectional study. Out of 250 subjects 170 (68%) were male and 80 (32%) were female. The mean age was 55.20 ± 11.046 year the mean height of subjects was 1.6732 ±.09637 meters while the mean weight was estimated as 65.50 ±11.589 kgs. The mean BMI was calculated as 24.2772 ±3.34493 kgs/m2. Serum ferritin was ranged between 46-450 ng/ml of blood with mean serum ferritin 226.32 ± 99.027 ng/ml of blood. Serum Ferritin in male was found 233.59 ±98.366 ng/ml of blood and in female was found to be 210.88 ± 99.268 ng/ml of blood. It was found that the mean serum ferritin in teachers was 181.00 ± 42.312 ng/ml, in doctors 286.67 ±67.788 ng/ml, in farmers 267.91 ±78.188 ng/ml, in laborers 174.40 ±108.939 ng/ml, in house wives 201.14 ±112.797 ng/ml, in Clerks office superintendents 205.50 ±16.338 ng/ml, in peon/ masi/ attendants 233.00 ± 135.262 ng/ml, in unemployed 120.00 ± .000 ng/ml, in retired 304.20 ± 89.084 ng/ml and in Businessmen 193.17 ±89.084 ng/ml. A comparison was made between serum ferritin values of different professionals by applying ANOVA test and found that there is a significant difference between serum ferritin values of different professional with highly significant p=.000 value. Conclusion: It was found that serum ferritin level was not similar in all profession and different type of work do affect its level inside the body

Overconfidence and Loss Aversion in Investment Decisions: A Study of the Impact of Gender and Age in Pakistani Perspective

This study investigates the impacts of gender and age on two of the behavioral biases i.e. over confidence and loss aversion with reference to Pakistan. We used questionnaire based survey method to collect data from a sample amounting to 391 individuals. Chi-sguare analysis, OLS and correlation analysis have been used to estimate the models under study. The findings revealed men and older investors to be more overconfident whereas women and older investors to be more loss averse. Similarly, the results indicate that those who prefer risk are likely to be more over confident. The limitations include time and geographical constraints as well as unavailability of data. In the add, some recommendations have been made that could help researchers in their future works. Keywords: Behavioral biases, Gender and Overconfidence, Loss Aversion and Behavioral Finance Micro (BFMI)

DIABETES AS A RISK FACTOR OF IN – HOSPITAL MORTALITY IN PATIENTS WITH PREMATURE CORONAY DISEASE PRESENTING WITH ACUTE MYOCARDIAL INFARCTION.

Background; Recent data from various parts of the world have led to the conclusion that more than 80 % of CVD deaths occur in developing countries like Pakistan. This high burden of heart diseases is largely attributed to the industrial and technological progress which is associated with economic and social transformations which have lead to life style modification and sedentary life style. This study was planned to ascertain mortality rate of premature coronary artery disease in patients with AMI as it directly affects main workforce of our national economy. Objective; To determine role of diabetes with mortality in premature coronary artery disease patients with acute myocardial infarction.  Material and methods; A total of 145 patients having premature coronary artery disease presenting with acute myocardial infarction were included in this descriptive study. This study was conducted in the department of medicine, Nishtar Hospital, Multan from June 2018 to May 2019. These patients were followed during current hospitalization to see mortality in these patients and all the findings were noted in the proforma. Results; Of these 145 study cases, 96 (66.2%) were male patients and 49 (33.8%) were female patients. Mean age of our study cases was noted to be 47.67 ± 7.59 years. Mean time taken before presentation at hospital was 113.79 ± 54.36 minutes. Hypertension was present in 58 (40%), smoking in 39 (26.9%), family history of IHD in 67 (46.2%) and obesity in 49 (33.8%) of our study cases. Mortality was noted to be in 19 (13.1%) of our study cases, post MI angina was seen in 36 (24.8%) and cardiogenic shock was noted in 29 (20%). Diabetes was present in 48 (33.1%) of our study cases while in – hospital mortality among diabetic patients was 18 /48 (37.5%) (p=0.001). Conclusion; Our study results indicate that diabetic patients with premature coronary artery disease having acute myocardial infarction (AMI) have high rates of mortality. Positive family history, hypertension, obesity and diabetes were major risk factors noted in our study. Life style modification and early screening of the cases with positive family history in first degree relatives can help prevent heart diseases in our population as it hits main workforce and has negative impact on national productivity. Keywords; Premature coronary artery disease, mortality, diabetes, Myocardial infarction. DOI: 10.7176/JMPB/55-14 Publication date:May 31st 201

OUTCOME OF VAGINAL VERSUS ABDOMINAL ROUTE OF HYSTERECTOMY

Background; Hysterectomy is “Surgical removal of all or part of uterus”. Abdominal and vaginal route of hysterectomies are both predominant operative techniques being employed by the gynecologists all the world for various uterine conditions. Indications to select any particular technique in any of the hospital setting might not be optimally defined. This study was planned to evaluate particular route of hysterectomy (vaginal hysterectomy and abdominal hysterectomy) as there was no such study available which could document the data of our local population so this study was planned to be conducted to determine burden of problem and deficiencies for clinicians to opt better treatment options among targeted population. The results of this study will not only add in national data but will also be comparable with other international studies. Objective; To determine outcome of vaginal versus abdominal route of hysterectomy at a tertiary care hospital. Material and methods: A total of 240 women meeting inclusion and exclusion criteria of this study were registered in this study. Informed consent was taken from each patient. All the relevant data were recorded on pre-designed proforma. Data were entered and analyzed using SPSS-17. Results: A total of 240 subjects fulfilling the inclusion and exclusion criteria were registered in this study for abdominal hysterectomy and vaginal hysterectomy. Out of these 240 cases, 79 (32.9%) had undergone vaginal hysterectomy and 161 (67.1%) underwent through abdominal hysterectomy. Mean age of the study cases was 42.72±5.18 years (minimum age was 31 years while maximum age was up to 50 years). Mean parity of the study cases was 5.67±2.08 (minimum para 1 and maximum para 10). Pyrexia was seen in 90 (37.5%) of the study cases, of these 27 (30%) had undergone through vaginal hysterectomy and 63 (70%) underwent abdominal hysterectomy. Minimum duration of the surgery was 45 minutes and maximum duration of the surgery was 90 minutes, mean duration of the surgery was 69.75±14.92 minutes. Minimum Hospital stay was 3 days ranging to maximum hospital stay being 10 days, mean hospital stay in these study cases was observed to be 4.42±1.65 days. Conclusion; Vaginal route of hysterectomy is associated with lesser postoperative complications in terms short duration surgery, significantly short hospital stays and lower rates of postoperative pyrexia than that of abdominal route of hysterectomy. Keywords; Abdominal Hysterectomy, Vaginal hysterectomy, Uterovaginal prolapse. DOI: 10.7176/JMPB/55-05 Publication date:May 31st 201

Avoidable Mortality Differences between Rural and Urban Residents During 2004–2011: A Case Study in Iran

Background: Avoidable mortality as an indicator for assessing the health system performance has caught the attention of researchers for a long time. In this study we aimed to compare the health system performance using this indicator in rural and urban areas of one of Iran’s southern provinces. Methods: All deaths (29916) which happened during 2004–2011 in Bushehr province were assessed. Nolte and McKee’s avoidable deaths model was used to distinguish avoidable and unavoidable conditions. Accordingly, all deaths were classified into four categories including three avoidable death categories and one unavoidable death category. STATA software was used to conduct Poisson Regression Test and age-standardized death rate. Results: Findings showed that avoidable mortality rates declined in both urban and rural areas at 3.33% per year, but decline rates were influenced by Ischemic Heart Disease (IHD) and preventable death categories to treatable death category. Annual decline rate for IHD category in rural and urban areas was nearly the same as 8%, but in preventable death category, rural areas experienced more decreases than urban ones (7% vs 5% respectively). However, decline rate in treatable mortality neither in urban and nor in rural areas was statistically significant. Conclusion: Despite the annual decline in the rate of avoidable deaths, policy making initiatives especially screening and inter-sectoral measures targeting cause of deaths such as colon and breast cancers, hypertension, lung cancer and traffic accidents, can still further decrease avoidable deaths in both areas

Criteria and Practices of Various States for the Design of Jointless and Integral Abutment Bridges

The design of integral abutment bridges is not explicitly addressed in the U.S. bridge design specifications. Despite the lack of a specific national design standard for such bridges, their usage has grown steadily since several states began experimenting with this type of structure in the 1980s. The primary objective of the work reported here was to understand and compare the current (2017) design criteria and parameters that are being utilized by various states for the design of jointless and integral abutment bridges. In this paper, the required information was sought by obtaining all publicly-available “bridge design manuals” that are commonly (but not universally) published by state departments of transportation. Furthermore, when such information was not available online, direct contacts were made to obtain the necessary information. Data on each state’s integral abutment preferences, pile types, pile orientation and embedment, skew angle, maximum permissible length, etc. are provided and compared

Structural uterine anomalies in recurrent pregnancy loss

Background: To determine frequency of different structural uterine anomalies in patients with recurrent pregnancy loss.Methods: This observational study was conducted over a period of one and half year at a tertiary care Hospital, included 40 women with recurrent pregnancy loss who underwent combined laparoscopy and hysteroscopy.Results: Twenty-eight patients (70%) had 3 episodes of miscarriage, eight patients (20%) had experienced 4 abortions and three patients (7.5%) had five abortions. Only one patient (2.5%) had six abortions. 32.5% patients had normal hysteroscopy while as 65% patients had no abnormal finding on laparoscopy. Hysteroscopy was abnormal in 67.5% patients with uterine septum (25%) being the most common finding followed by submucous myoma(20%), polyp (12.5%), cervical incompetence (7.5%) and intra uterine adhesions (2.5%). Laparoscopy was abnormal in 35% patients with endometriosis(17.5%) being the most common finding followed by intra pelvic adhesions (15%) and bicornuate uterus (2.5%).Conclusions: Women with recurrent pregnancy loss have increased association with structural uterine anomalies than general population. Both congenital and acquired uterine anomalies are associated with recurrent abortions