Lumbar Scoliosis Analysis Using Deep Learning Based Technique

Medical image interpretation automation saves physicians time and boosts diagnostic confidence. Most medical imaging diagnosis is done manually or semi-automatically. These methods vary when performed by several physicians. This thesis includes mid- sagittal lumbar spine magnetic resonance imaging (MRI) images with labeling and spinal metrics. Two pieces were marked. Professional radiologists created pixel-wise masks to detect vertebral bodies (VBs) in each picture, which a panel of spine surgeons subsequently examined. An enhanced method (VBSeg) compares the segmentation work of traditional and deep-learning architectural techniques. A novel computerized spinal misalignment evaluation method may help spine surgeons make objective decisions about critical surgeries. Angular deviation classifies spondylolisthesis 89% accurately, whereas the area inside the enclosed lumbar curve zone classifies LL adequacy/inadequacy 93%   accurately

Histopathological study of precursor and neoplastic lesions of endometrium in endometrial samplings

Background: Endometrial lesion presenting as abnormal uterine bleeding, abdominal pain and menstrual irregularities form most common presenting complaint in women of reproductive age group and in premenopausal women. Endometrial sampling is a safe and effective diagnostic step in evaluation of abnormal uterine bleeding (AUB). The present study was carried out to establish histopathological diagnosis of precursor and neoplastic lesions of endometrial samplings in correlation with clinical details and other investigations.Methods: A two-year prospective study was carried out in the department of pathology in a tertiary care hospital from June 2013-May 2015 which included endometrial samplings of precursor and neoplastic lesions. All cases were analyzed histopathologically.Results: The study included 46 cases comprising 30% of total 153 endometrial samplings. Out of these, precursor lesions were 36 cases (23.6%) and malignant were 10 case (5.8%). The highest incidence of precursor lesions (endometrial hyperplasia) was in the age group of 41- 50 years. Among the precursor lesions, endometrial hyperplasia without atypia (86%) was the commonest observation followed by atypical hyperplasia (14%).Conclusions: For the correct evaluation of cases presenting with AUB, histopathological evaluation of endometrial samplings is the gold standard method

A clinical study of elective hysterectomies for benign lesions

Background: Hysterectomy is widely used for treating a variety of gynecologic conditions. Most hysterectomies are elective and are performed to treat benign indications. Hence the present study was undertaken to determine the benign indication of hysterectomy, choice of surgical approach, safety and clinical aspect of hysterectomy as a surgical procedure and to correlate the findings with histopathological reports of the specimen.Methods: The present series represents a clinical study of 120 cases of elective hysterectomies for benign lesions. Out of which 73 were done by abdominal and 47 by vaginal route. Finally, all operated specimen were subjected to histological examination.Results: The main indications for elective hysterectomy were leiomyoma 53 (44.2%), prolapse 47 (39.2%) and dysfunctional uterine bleeding 11 (9.2%). Type of operation performed were mainly total abdominal hysterectomy with bilateral salphingo-oophorectomy in 60% cases and vaginal hysterectomy with anterior and posterior repair in 38.3% cases. The mean duration of surgery and average blood loss was more in vaginal procedure (90 min and 100ml) compared to abdominal (70 min and 80ml) respectively. Vaginal hysterectomy was associated with less morbidity and a smoother convalescence than abdominal hysterectomy. In 81.2% cases of abdominal hysterectomies correspondence of indication with histopathological report (HPR) were found, in vaginal 74.5% cases corresponded their histopathological report with their symptoms and investigations. Associated adnexal pathology was found in 8.3% cases. There was no mortality during the whole study period.Conclusions: Hysterectomy for benign pelvic lesions is a safe procedure and an important component of health care for women

Spectrum of morbid anatomy of liver in autopsy cases

Background: Purpose of autopsy is to learn the truth about the person’s health during and how the person died. Thus, autopsy study provides valuable information about the disease. The main aim of the study was to know the spectrum of morbid anatomical changes in liver autopsy.Methods: A prospective study was carried out on 100 liver specimens of autopsy cases comprising of 37 cases of roadside accidents, 17 of poisoning, 13 of burns, 10 of chronic illness, 7 each of hanging and head injury, 4 of myocardial infarction and 5 of death due to miscellaneous causes. Representative microsections of liver were evaluated for histopathological parameters like congestion, ballooning degeneration, hepatocellular necrosis, sinusoidal dilation, fatty change, bile stasis, fibrosis, lobular inflammation and portal inflammation.Results: Out of total 100 cases, 77 were males and 23 females. Male to female ratio was 3.34:1. Hepatomegaly was seen in 15% of cases. Chronic venous congestion was the main histopathological diagnosis seen in 61% of the cases followed by chronic hepatitis in 12%, normal liver histology in 9%, hepatic steatosis and cirrhosis in 6%, granulomatous hepatitis in 2%, and sinusoidal congestion, portal triaditis and secondary neoplasm in 1% each.Conclusions: Chronic venous congestion, chronic hepatitis, cirrhosis and hepatic steatosis were the common liver diseases identified. Autopsy study is useful to monitor the cause of death and to plan medical strategy. Histopathological examination of the liver is specialized learning tool to study the various diseases of liver which is a great value in improving the diagnosis

Avoiding Fire in the Operating Suite: An Intersection of Prevention and Common Sense

The operating room (OR) is a complex environment that involves large teams and multiple competing priorities, dynamically interacting throughout the entire course of a surgical procedure. The simultaneous presence of flammable substances, volatile gases, and the frequent use of electrical current results in a potentially dangerous combination. Operating room fire (ORF) is a rare but potentially devastating occurrence. To prevent this “never event”, it is critical for institutions to establish and follow proper fire safety protocols. Adherence to proven prevention strategies and awareness of associated risk factors will help reduce the incidence of this dreaded safety event. When ORF does occur despite strict adherence to established safety protocols, the entire OR team should know the steps required to contain and extinguish the fire as well as essential measures to minimize or avoid thermal injury. If injury does occur, it is important to recognize and treat it promptly. Appropriate and honest disclosure to all injured persons and their families should be made without delay. As with all serious patient safety events, regulatory reporting and root cause determinations must take place in accordance with applicable laws and regulations. The goal of patient safety champions at each institution should be the attainment of zero incidence of ORF

Long Non-Coding RNA Profile in Mantle Cell Lymphoma Identifies a Functional lncRNA ROR1-AS1 Associated With EZH2/PRC2 Complex.

Mantle cell lymphoma (MCL) is an aggressive B-cell lymphoma characterized by rapid disease progression. The needs for new therapeutic strategies for MCL patients call for further understanding on the molecular mechanisms of pathogenesis of MCL. Recently, long noncoding RNAs (lncRNAs) have been recognized as key regulators of gene expression and disease development, however, the role of lncRNAs in non-Hodgkin lymphoma and specifically in MCL is still unknown. Next generation RNA-sequencing was carried out on MCL patient samples along with normal controls and data was analyzed. As a result, several novel lncRNAs were found significantly overexpressed in the MCL samples with lncRNA ROR1-AS1 the most significant one. We cloned the ROR1-AS1 lncRNA in expression vector and ectopically transfected in MCL cell lines. Results showed that overexpression of ROR1-AS1 lncRNA promoted growth of MCL cells while decreased sensitivity to the treatment with drugs ibrutinib and dexamethasone. ROR-AS1 overexpression also decreased the mRNA expression of P16 (P = 0.21), and SOX11 (p = 0.017), without much effect on P53, ATM and P14 mRNA. RNA-immunoprecipitation assays demonstrated high affinity binding of lncRNA ROR1-AS1 with EZH2 and SUZ12 proteins of the polycomb repressive complex-2 (PRC2). Suppressing EZH2 activity with pharmacological inhibitor GSK343 abolished binding of ROR1-AS1 with EZH2. Taken together, this study identified a functional lncRNA ROR-AS1 involved with regulation of gene transcription via associating with PRC2 complex, and may serve as a novel biomarker in MCL patients

Genome analysis of amaranths: determination of inter- and intra-species variations

Amaranths are an important group of plants and include grain, vegetable and ornamental types. Despite the economic importance of the amaranths, there is very little information available about the extent and nature of genetic diversity present in the genus Amaranthus at molecular level. We now report the randomly amplified polymorphic DNA (RAPD) profiles of different species of Amaranthus as well as different accessions of the species. These RAPD analyses have been carried out using 65 arbitrary sequence decamer primers. From the RAPD data, an UPGMA dendrogram illustrating the inter-as well as intra-species relationships has been computed. The putative hybrid origin of A.dubious from A. hybridus and A. spinosus is also ruled out by the RAPD data. The trends of species relationships amongst the amaranths determined by RAPDs is consistent with their cytogenetic and evolutionary relationships that have already been determined

Fact versus Conjecture: Exploring Levels of Evidence in the Context of Patient Safety and Care Quality

Evidence-based medicine (EBM) can be defined as the integration of optimized clinical judgment, patient values, and available evidence. It is a philosophical approach to making the best possible clinical decisions for individual patients. Based on objective evaluation and categorization of methodological design and data quality, all existing literature can be organized according to a hierarchy of “evidence quality” that helps determine the applicability and value of scientific findings in terms of clinical implementation and the potential to change existing patterns of practice. In terms of general categorization of scientific impact, randomized controlled trials (RCTs) are placed on top of the hierarchy, followed by systematic reviews of randomized controlled trials (RCTs), quasi-randomized designs, observational studies including retrospective case series, and finally case reports and expert opinion. Each study design is susceptible to certain limitations and biases, highlighting the importance of both clinical and scientific acumen of the interpreting provider. Such approach is critical to determining the value and the applicability of study recommendations in everyday practice. Evidence-based practice (EBP) has become one of the fundamental components of modern medicine and plays an indispensible role in the development (and improvement) of patient care and safety worldwide. Furthermore, organizations that create guidelines and policies for the management of specific conditions, often base the content and strength of their recommendations on the quality of evidence available to expert decision-makers. Therefore, understanding the “state of the science” upon which those recommendations are based will help guide the medical practitioner on “if, when and how” to apply evidence-based guidelines in his or her everyday medical or surgical practice. This chapter focuses on clinically relevant application of levels of scientific evidence (LSE) and the corresponding levels of clinical recommendation (LCR) in the context of care quality and safety