Beyond the commonest: right lower quadrant abdominal pain is not always appendicitis

Background: Despite acute appendicitis is the most common underlying etiology of the acute abdomen, a considerable list of other pathologies should be considered; despite sharing almost the same clinical presentation. This study aimed to re-enhance the importance and sensitivity of CT scan as a solitary imaging tool, in the evaluation of patients with acute right lower abdominal pain. Patients and methods: It is a retrospective study of the last 1000 patients, referred with acute right lower abdominal pain for CT scan examination. Biphasic CT scan abdomen protocol was applied for all. Results: Cecal carcinoma was detected in three patients (0.3%), epiploic appendicitis in five (0.5%), omental infarct in two (0.2%), appendicular mucocele in two (0.2%), appendicular NET in one (0.1%), cecal diverticulitis in four (0.4%), Chron’s disease in six (0.6%), intussusception in one (0.1%) and FB in one (0.1%) and appendicular perforation in one (0.1%), acute simple appendicitis 398 (39.8%) and 577 (57.7%) were unremarkable. Conclusion: Despite acute appendicitis is the most common cause of the acute abdomen, many other surgical and non-surgical etiologies should also be considered, with a higher sensitivity of CT as a solitary diagnostic tool of imaging

Improving collaborative filtering using lexicon-based sentiment analysis

Since data is available increasingly on the Internet, efforts are needed to develop and improve recommender systems to produce a list of possible favorite items. In this paper, we expand our work to enhance the accuracy of Arabic collaborative filtering by applying sentiment analysis to user reviews, we also addressed major problems of the current work by applying effective techniques to handle the scalability and sparsity problems. The proposed approach consists of two phases: the sentiment analysis and the recommendation phase. The sentiment analysis phase estimates sentiment scores using a special lexicon for the Arabic dataset. The item-based and singular value decomposition-based collaborative filtering are used in the second phase. Overall, our proposed approach improves the experiments’ results by reducing average of mean absolute and root mean squared errors using a large Arabic dataset consisting of 63,000 book reviews

Effect of zinc supplementation on growth Hormone Insulin growth factor axis in short Egyptian children with zinc deficiency

BACKGROUND: The relationship between zinc (Zn) and growth hormone-insulin growth factor (GH-IGF) system and how Zn therapy stimulates growth in children has not been clearly defined in humans. Thus, we aimed to assess GH-IGF axis in short children with Zn deficiency and to investigate the effect of Zn supplementation on these parameters. METHODS: Fifty pre-pubertal Egyptian children with short stature and Zn deficiency were compared to 50 age-, sex-, and pubertal stage- matched controls. All subjects were subjected to history, auxological assessment and measurement of serum Zn, IGF-1, insulin growth factor binding protein-3 (IGFBP-3); and basal and stimulated GH before and 3 months after Zn supplementation (50 mg/day). RESULTS: After 3 months of Zn supplementation in Zn-deficient patients, there were significant increases in height standard deviation score (SDS, P = 0.033), serum Zn (P < 0.001), IGF-1 (P < 0.01), IGF-1 standard deviation score (SDS,P < 0.01) and IGFBP-3 (P = 0.042). Zn rose in all patients but reached normal ranges in 64 %, IGF-1 levels rose in 60 % but reached normal ranges in 40 % and IGFBP-3 levels rose in 40 % but reached reference ranges in 22 %. Growth velocity (GV) SDS did not differ between cases and controls (p = 0.15) but was higher in GH-deficient patients than non-deficient ones, both having Zn deficiency (p = 0.03). CONCLUSION: Serum IGF-1 and IGFBP-3 levels were low in short children with Zn deficiency, and increased after Zn supplementation for 3 months but their levels were still lower than the normal reference ranges in most children; therefore, Zn supplementation may be necessary for longer periods

Modelling Multilayer Communication Channel in Terahertz Band for Medical Applications

In this work we present a multi-layer channel model for terahertz communication that incorporates both layers of human body tissues and textile layers. Many research works tackled communication channel modelling in human body alone while some other research focused on textile characterization/modelling alone. There is a real gap in connecting these different models. To investigate this, a multi-layer channel model for terahertz communication is developed, this model assumes external textile layer stacked over layers of human body tissues. The electromagnetic properties of the different layers are extracted from previous works that used time domain spectroscopy (TDS) in the terahertz band to characterize each of the considered layers. The model is implemented as a flexible MATLAB/Octave program that enables the simulation of layers with either fixed or random depths. This paper aims to pave the way to connecting patients’ in-body nano-nodes with off-body (on-cloth) nano-nodes by building such a combined channel model. This helps in many applications especially in the medical field. For example, having connected nano-nodes can help in diagnosing diseases, monitoring health by sending information to the external environment, treatment (e.g., increasing or decreasing a certain dose depending on the monitoring), etc. The obtained results show how the THz signal can be affected when it propagates through heterogeneous mediums (i.e., human body tissues and textile). Various types of path-loss has been calculated for this purpose and verified by comparison with results from previous research on separate models of human body and textile

Performance Comparison of Several Control Algorithms for Tracking Control of Pantograph Mechanism

A sort of parallel manipulator known as a pantograph robot mechanism was created primarily for industrial requests that required high precision and satisfied speed. While tracking a chosen trajectory profile requires a powerful controller. Because it has four active robot links and one robot passive link in place of just two links like the open chain does, it can carry more loads than the open chain robot mechanism while maintaining accuracy and stability. The calculated model for a closed chain pantograph robot mechanism presented in this paper takes into account the boundary conditions. For the purpose of simulating the dynamics of the pantograph robot mechanism, an entire MATLAB Simulink has been created. The related Simscape model had been created to verify the pantograph mathematical model that had been provided. Five alternative tracking controllers were also created and improved using the Flower Pollination (FP) algorithm. The PID controller, which is used in many engineering applications, is the first control. An enriched Fractional Order PID (FOPID) controller is the second control. The third control considers an improved Nonlinear conventional PID (NLPID) controller, and the parameters for this controller were likewise determined using (FP) optimization using the useful objective function. Model Reference Adaptive Control (MRAC) with PID Compensator is the fourth control. The Fuzzy PD+I Control is the last and final controller. A comparison of the different control methods was completed. A rectangular trajectory was chosen as the end effector of the pantograph robot\u27s position reference because it displays performance during sharp edges and provides a more accurate study. The proposed controllers were used for this task to analyse the performance. The outcomes demonstrate that the Fuzzy PD+I control outperforms the PID, FOPID, NLPID, and MRAC with PID Compensator controllers in terms of performance. In the case of the Fuzzy PD+I control, the angles end effector has a lower rise time, a satisfied settling time, and low overshoot with good precision

Sickle cell anemia: Imaging from head to toe

AbstractSCA is hemolytic anemia with deformed RBCs leading to frequent hemolytic crisis, extramedullary hematopoiesis and multisystem repeated emboli.AimTo emphasize the role of different imaging modalities in early accurate diagnosis.Patients and methodsWe present different types of complications of SCA, encountered in patients of Eastern Province-KSA, between 2009 and 2013.ResultsComplication may involve any system of the body, thus different types of imaging modalities are needed for correct diagnosis.ConclusionBeing familiar with radiological signs of expected complications of SCA in different systems, helps much to control advance of the disease and protect against early organ damage

A quality assurance technique for the static multileaf collimator mode based on intrinsic base lines

AbstractThe inspection of the static leaf positions of Multileaf Collimator (MLC) devices is essential for safe radiotherapy deliveries in both static and dynamic modes. The purpose of this study was to develop a robust, accurate and generic algorithm to measure the individual static MLC leaf positions. This was performed by extracting leaf tip locations from the radiographic film image and measuring their relative distance from a reference line on the film. The reference line was created with a selected set of MLC leaf sides. The film scaling was created and verified using the physical leaf width. The average measured distance corresponds to a leaf width of 10 mm was 9.95 ± 0.09 mm. The estimated reproducibility of the leaf tips location was ±0.26 mm. The code accuracy was checked by intentionally positioning set of leaves with small errors (1 mm), and the detected deviations from the expected positions ranged from −0.25 mm and +0.32 mm. The algorithm includes two self testing functions in order to detect failures of leaf positioning due to poor film quality and to avoid the potential systematic errors attributable to the improper collimator setting. The code is promising to be more efficient with Gafchromic and Electronic Portal Imaging Device (EPID)

A proposed difficulty grading system for laparoscopic bile duct exploration: benefits to clinical practice, training and research

Background: A gap remains between the mounting evidence for single session management of bile duct stones and the adoption of this approach. Laparoscopic bile duct exploration (LBDE) is limited by the scarcity of training opportunities and adequate equipment and by the perception that the technique requires a high skill-set. The aim of this study was to create a new classification of difficulty based on operative characteristics and to stratify postoperative outcomes of easy vs. difficult LBDE irrespective of the surgeon’s experience. Methods: A cohort of 1335 LBDEs was classified according to the location, number and size of ductal stones, the retrieval technique, utilisation of choledochoscopy and specific biliary pathologies encountered. A combination of features indicated easy (Grades I and II A &amp; B) or difficult (Grades III A and B, IV and V) transcystic or transcholedochal explorations. Results: 78.3% of patients with acute cholecystitis or pancreatitis, 37% with jaundice and 46% with cholangitis had easy explorations. Difficult explorations were more likely to present as emergencies, with obstructive jaundice, previous sphincterotomy and dilated bile ducts on ultrasound scans. 77.7% of easy explorations were transcystic and 62.3% of difficult explorations transductal. Choledochoscopy was utilised in 23.4% of easy vs. 98% of difficult explorations. The use of biliary drains, open conversions, median operative time, biliary-related complications, hospital stay, readmissions, and retained stones increased with the difficulty grade. Grades I and II patients had 2 or more hospital episodes in 26.5% vs. 41.2% for grades III to V. There were 2 deaths in difficulty Grade V and one in Grade IIB. Conclusion: Difficulty grading of LBDE is useful in predicting outcomes and facilitating comparison between studies. It ensures fair structuring and assessment of training and progress of the learning curve. LBDEs were easy in 72% with 77% completed transcystically. This may encourage more units to adopt this approach