An Ensemble Model for Detection of Adverse Drug Reactions

The detection of adverse drug reactions (ADRs) plays a necessary role in comprehending the safety and benefit profiles of medicines. Although spontaneous reporting stays the standard approach for ADR documents, it suffers from significant under reporting rates and limitations in terms of treatment inspection. This study proposes an ensemble model that combines decision trees, support vector machines, random forests, and adaptive boosting (ADA-boost) to improve ADR detection. The experimental evaluation applied the benchmark data set and many preprocessing techniques such as tokenization, stop-word removal, stemming, and utilization of Point-wise Mutual Information. In addition, two term representations, namely, term frequency-inverse document frequency and term frequency, are utilized. The proposed ensemble model achieves an F-measure of 89% on the dataset. The proposed ensemble model shows its ability in detecting ADR to be a favored option in achieving both accuracy and clarity

Prevalence and Pattern of Cerebral Variations during Endovascular Diagnostic Angiography in Saudi Patients: A Retrospective Observational Study

Background:  Previous studies detected large number of variations in circle of Willis in normal populations. There is limited data for the effect and correlation of normal varieties and pathologic vascular anomalies Purpose:  Prevalence of normal variants and impact of its presence in decision making process. Patients and methods: Ninety patients\u27 records underwent therapeutic angiography were retrospectively reviewed and reallocated into two equal groups according to pathology (group 1=vascular malformation group, group 2= ischemic insults). Age, sex, type of pathology, site of normal variants and finally their impact on decision making process were calculated.    Results: The mean and standard deviation of age in our study was found to be (40.18 years ± 15.6), most of patients were between 30-40 years old. The total number of normal variants that were detected in our study either at extra- or intracranial vascular tree was 46 variants. Forty-nine cases were "ignored" or added no impact on the proposed plan during neurointervention. The sensitivity of normal variants in changing decision making process was seen in 15% of cases while the specificity was 100%. Conclusion:  Normal variants were detected accidently through DSA for therapeutic purposes in 47% of cases. The term normal vascular variation is simple to be defined per se. However, when additional vascular event (aneurysm or AVM) was detected, the neurointerventionist should be aware of its presence, possible complications and how to proceed to the target without additional damage. These variations should be reported and explained to the patient and/or family especially when they interfere with operative plan or decision to avoid medicolegal consequences

A Deep Learning Algorithm for Lung Cancer Detection Using EfficientNet-B3

Lung carcinoma is one of the main causes of deaths over the whole world, causing a global burden of morbidity and mortality. Detecting lung tumors at their early stages can help reducing the risk of having lung cancer. This paper proposes a deep learning algorithm using EfficientNet B3 for lung cancer detection. The purpose is to improve detection accuracy highlighting potential to revolutionize the field of medical imaging and improve patient care. The proposed approach is build based on EfficientNet B3 model to classify four different types of lung cancer. The approach used CT scan images labeled into Normal, Squamous.cell.carcinoma, Large.cell.carcinoma, and Adenocarcinoma for the purpose of lung cancer detection. The results showed that the proposed model provided an improvement rate of 2.13% compared with the best-trained classifier with accuracy of 96%. This model can be generalized to improve lung cancer detection. The finding of deep neural networks, particularly EfficientNet B3, in supporting the diagnosis and detection of the lung disease, particularly in its early times

Dapagliflozin effects on hospitalization for heart failure reduction, and major adverse cardiovascular events

BackgroundUntil recently, there are no available preventive measures for macrovascular complications of diabetes mellitus (DM). Sodium-glucose co-transporter inhibitors (SGLT-2i) are a relatively new class of medications with cardio-renal protection. However, it is unknown, whether this is a class effect. Also, the exact mechanisms of action are not fully understood.AimsThe current review aimed to assess dapagliflozin effects on the major cardiovascular adverse events (MACE) and heart failure hospitalization rate (HHF) and its mechanisms of action.Methods The Pub Med, MEDLINE, and Google Scholar databases were systematically searched for relevant articles. Articles published in the English language from the first available article up to November 2019 were approached. The terms dapagliflozin, SGLT-2i, MACE, HHF, and mechanisms of action were used with proteans AND or OR. Out of two hundred-ten articles retrieved, only twenty-nine fulfilled the inclusion and exclusion criteria.Results Dapagliflozin reduced HHF, all-cause mortality, bumetanide induced hyperuricemia, and interstitial fluid volume with a lower rate of diuretic use. Possible mechanisms of action were: a reduction of oxidative stress, lowering of cardiac hexosamine biosynthetic pathway activation, reduced cytosolic sodium and calcium, and increased serum magnesium. Dapagliflozin effects on MACE are mixed. The above effects seem to be a class character across various population including normal people without diabetes with no differences across gender.ConclusionDapagliflozin reduced HHF (superior to empagliflozin) and all-cause mortality. The drug acts at cellular levels and not simple diuresis and haemoconcentration

Paediatrics Neurodegenerative Diseases, Roles Of Healthcare Administration, Secretary, Anesthesia And Nurses In Delivering Proper Care: Review

Neurodegenerative illnesses are becoming more prevalent in older individuals, posing a specific challenge for anesthesia. Neurodegenerative diseases occur as a result of changes in the transportation, breakdown, and accumulation of proteins. The physiological changes that occur as one ages have an impact on both the way medications are processed and the way they interact with the body in youngsters. Every day, numerous mothers and children die due to insufficient healthcare systems, where the lack of proper anesthetic and critical care services is a significant contributing factor. Pediatric nursing practitioners, particularly those specializing in caring for young adults with chronic and intellectual disabilities, are well-suited to actively engage in, initiate, and take charge of evidence-based transition planning. Pediatric-registered and advanced practice nurses have already taken on the responsibility of guiding the transition and transfer of vulnerable youths due to their extensive experience working with families, coordinating care with educational and social agencies, and their expertise in disease-specific care and self-management requirements

The nutritional status of mycetoma affected patients seen at the Mycetoma Research Center, Sudan.

Nutrition plays a critical and crucial role in addressing neglected tropical diseases (NTDs) and their complications, as they often contribute to malnutrition, which can worsen the impact of these conditions. Therefore, it is necessary to investigate the nutritional status of mycetoma patients, which has not been explored previously. This descriptive cross-sectional hospital-based study was conducted at the Mycetoma Research Center (MRC), University of Khartoum, Sudan. The study included 179 confirmed mycetoma patients and an equal number of age- and sex-matched normal controls. The nutritional status of the mycetoma patients was assessed and compared with that of the control group. The majority of the patients were young adults with varying educational levels, predominantly from Central Sudan. The foot was the most commonly affected part; most patients had lesions more than 10 cm in diameter. The Body Mass Index (BMI) was calculated for both study groups, revealing that 43.5% of the patients and 53.6% of controls had a normal BMI. Furthermore, 36% of patients were underweight, contrasting with only 11% in the control group. Correlation analyses indicated no significant associations between BMI and age groups, educational levels, daily meals, food quantity, and appetite in the study population (p > 0.05). Similarly, no significant differences were observed in BMI concerning disease duration and affected sites (p = 0.0577). The Kruskal-Wallis test did not reveal significant differences in BMI means among the groups. The study revealed that most participants consumed three meals daily, and the control group showed a more robust appetite and consumed more food than the patient group (p = 0.005). Nevertheless, there were no significant differences in the consumption of different food types between the patient and control groups and among different BMI categories (p = 0.025 and 0.040, respectively)

Biliary fistula and late recurrence of liver hydatid cyst: Role of cysto-biliary communication: A prospective multicenter study

Background: Hydatid cyst disease (HCD) is common in certain locations. Surgery is associated with postoperative biliary fistula (POBF) and recurrence. The primary aim of this study was to identify whether occult cysto-biliary communication (CBC) can predict recurrent HCD. The secondary aim was to assess the role of cystic fluid bilirubin and alkaline phosphatase (ALP) levels in predicting POBF and recurrent HCD. Aim: To identify whether occult CBC can predict recurrent HCD. The secondary aim was to assess the role of cystic fluid bilirubin and ALP levels in predicting POBF and recurrent HCD. Methods: From September 2010 to September 2016, a prospective multicenter study was undertaken involving 244 patients with solitary primary superficial stage cystic echinococcosis 2 and cystic echinococcosis 3b HCD who underwent laparoscopic partial cystectomy with omentoplasty. Univariable logistic regression analysis assessed independent factors determining biliary complications and recurrence. Results: There was a highly statistically significant association (P ≤ 0.001) between cystic fluid biochemical indices and the development of biliary complications (of 16 patients with POBF, 15 patients had high cyst fluid bilirubin and ALP levels), where patients with high bilirubin-ALP levels were 3405 times more likely to have biliary complications. There was a highly statistically significant association (P ≤ 0.001) between biliary complications, biochemical indices, and the occurrence of recurrent HCD (of 30 patients with recurrent HCD, 15 patients had high cyst fluid bilirubin and ALP; all 16 patients who had POBF later developed recurrent HCD), where patients who developed biliary complications and high bilirubin-ALP were 244.6 and 214 times more likely to have recurrent hydatid cysts, respectively. Conclusion: Occult CBC can predict recurrent HCD. Elevated cyst fluid bilirubin and ALP levels predicted POBF and recurrent HCD

Hepatobiliary manifestations following two-stages elective laparoscopic restorative proctocolectomy for patients with ulcerative colitis: A prospective observational study

BACKGROUNDHepatobiliary manifestations occur in ulcerative colitis (UC) patients. The effect of laparoscopic restorative proctocolectomy (LRP) with ileal pouch anal anastomosis (IPAA) on hepatobiliary manifestations is debated.AIMTo evaluate hepatobiliary changes after two-stages elective laparoscopic restorative proctocolectomy for patients with UC.METHODSBetween June 2013 and June 2018, 167 patients with hepatobiliary symptoms underwent two-stage elective LRP for UC in a prospective observational study. Patients with UC and having at least one hepatobiliary manifestation who underwent LRP with IPAA were included in the study. The patients were followed up for four years to assess the outcomes of hepatobiliary manifestations.RESULTSThe patients' mean age was 36 +/- 8 years, and males predominated (67.1%). The most common hepatobiliary diagnostic method was liver biopsy (85.6%), followed by Magnetic resonance cholangiopancreatography (63.5%), Antineutrophil cytoplasmic antibodies (62.5%), abdominal ultrasonography (35.9%), and Endoscopic retrograde cholangiopancreatography (6%). The most common hepatobiliary symptom was Primary sclerosing cholangitis (PSC) (62.3%), followed by fatty liver (16.8%) and gallbladder stone (10.2%). 66.4% of patients showed a stable course after surgery. Progressive or regressive courses occurred in 16.8% of each. Mortality was 6%, and recurrence or progression of symptoms required surgery for 15%. Most PSC patients (87.5%) had a stable course, and only 12.5% became worse. Two-thirds (64.3%) of fatty liver patients showed a regressive course, while one-third (35.7%) showed a stable course. Survival rates were 98.8%, 97%, 95.8%, and 94% at 12 mo, 24 mo, 36 mo, and at the end of the follow-up.CONCLUSIONIn patients with UC who had LRP, there is a positive impact on hepatobiliary disease. It caused an improvement in PSC and fatty liver disease. The most prevalent unchanged course was PSC, while the most common improvement was fatty liver disease

COVID-19 Vaccination Among Diverse Population Groups in the Northern Governorates of Iraq

Objectives: The present study was carried out to investigate COVID-19 vaccination coverage among populations of internally displaced persons (IDPs), refugees, and host communities in northern Iraq and the related underlying factors.Methods: Through a cross-sectional study conducted in five governorates in April–May 2022, 4,564 individuals were surveyed. Data were collected through an adapted questionnaire designed to gather data on participants.Results: 4,564 subjects were included (59.55% were 19–45 years old; 54.51% male). 50.48% of the participants (51.49% of host communities, 48.83% of IDPs, and 45.87% of refugees) had been vaccinated with at least one dose of COVID-19 vaccine. 40.84% of participants (42.28% of host communities, 35.75% of IDPs, and 36.14% of refugees) had been vaccinated by two doses, and 1.56% (1.65% of host communities, 0.93% of IDPs, and 1.46% of refugees) were vaccinated with three doses.Conclusion: Sociodemographic factors including age, gender, education, occupation, and nationality could affect vaccination coverage. Moreover, higher acceptance rate of vaccination is associated with belief in vaccine safety and effectiveness and trust in the ability of the vaccine to prevent complications

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020