New Method to Implement and Analysis of Medical System in Real Time

The use of information technology and technological medical devices has contributed significantly to the transformation of healthcare. Despite that, many problems have arisen in diagnosing or predicting diseases, either as a result of human errors or lack of accuracy of measurements. Therefore, this paper aims to provide an integrated health monitoring system to measure vital parameters and diagnose or predict disease. Through this work, the percentage of various gases in the blood through breathing is determined, vital parameters are measured and their effect on feelings is analyzed. A supervised learning model is configured to predict and diagnose based on biometric measurements. All results were compared with the results of the Omron device as a reference device. The results proved that the proposed design overcame many problems as it contributed to expanding the database of vital parameters and providing analysis on the effect of emotions on vital indicators. The accuracy of the measurements also reached 98.8% and the accuracy of diagnosing COVID-19 was 64%. The work also presents a user interface model for clinicians as well as for smartphones using the Internet of things

Architecture séquentielle des dépôts marins à continentaux sur une marge passive (Cénomanien, marge Atlantique marocaine, transversale d'Agadir)

Seven sections, covering the upper Albian to lowermost Turonian, have been correlated from full-marine to continental-dominated deposits across a passive margin, along a transect 425 km long, from the present-day Atlantic coast to the "Pre-African Trough" between the Anti-Atlas and the High-Atlas. The thickness of the Cenomanian succession changes from around 500 metres in the fully marine sections to 250 metres in mostly continental facies in the western High-Atlas, about 150 km updip, to a few tens of metres in the Bou Tazoult area. The strata thicken again eastwards into the Pre-African Trough where they can be traced without major facies changes to the Kem Kem embayment and to the Bechar area in Algeria. Over all this eastern area, continental facies are overlain by the fully-marine shallow-water deposits of the Cenomanian-Turonian boundary interval. A first major conclusion is that fluvial aggradation in high-frequency transgressive-regressive sequences is coeval with the seaward-shift of the shoreline, in accordance with the genetic sequence stratigraphic model of Galloway (1989). Both the flatness of the depositional profile and the corresponding very low energy of the marine environment during the transgressions account for the blanket of red continental clays on top of marine facies in updip depositional sequences, which is then preserved under the marine transgressive surface of the next sequence. A second major conclusion is that the high-frequency transgressive-regressive (T-R) sequences do not look like classical parasequences bounded by transgression surfaces. They usually exhibit a surface created by a sea-level fall within the regressive half-cycle. This is interpreted in the following way: regressions did not operate through a regular seaward-shift of the shoreline, but through stepped sea-level falls. The very low slope of the depositional ramp is thought to have enhanced the sequence stratigraphic record of such stepped regressions. Short-term, high-frequency sequences are organized into medium-frequency T-R sequences (seven in the Cenomanian) which show an overall aggrading and slowly retrograding pattern along the whole transect. Comparisons with other basins show that medium-frequency sequences do not fit the third-order depositional sequences described elsewhere, casting doubts about a eustatic mechanism for their deposition.Sept coupes couvrant l'intervalle Albien supérieur-Turonien inférieur ont été corrélées sur plus de 400 km, des faciès entièrement marins jusqu'aux dépôts presque exclusivement continentaux, depuis la côte atlantique et le sillon pré-africain, entre le Haut-Atlas et l'Anti-Atlas marocains. L'épaisseur des dépôts cénomaniens varie d'environ 500 m dans les séries entièrement marines de la côte actuelle, à 250 m dans les séries principalement continentales du Haut-Atlas, pour s'amincir à quelques dizaines de mètres (Bou Tazoult), sur environ 250 km. La série s'épaissit à nouveau vers l'est dans le sillon pré-africain où elle peut être suivie sans changements notables vers le golfe des Kem-Kem et le secteur de Béchar en Algérie. Sur toute la partie orientale de la transversale, les faciès continentaux ou mixtes sont recouverts par les dolomies marines du passage Cénomanien-Turonien. Une première conclusion majeure est que, dans les séquences transgression-régression (T-R) à haute fréquence, l'aggradation fluviatile accompagne sans hiatus le déplacement de la ligne de rivage au cours du demi-cycle régressif, en accord avec le modèle génétique de Galloway (1989). La platitude extrême du profil de dépôt ainsi que la faible énergie correspondante de l'environnement marin expliquent la préservation de la faible couche de dépôts continentaux rouges de fin de séquence au cours de la transgression suivante. Une seconde observation majeure est que ces séquences T-R à haute fréquence ne sont pas organisées comme les "paraséquences" du modèle de stratigraphie séquentielle "d'Exxon", en principe limitées les unes des autres par des surfaces de transgression. Elles comportent toutes en plus une surface de chute du niveau marin relatif dans le demi-cycle régressif. Ceci est interprété de la façon suivante : les régressions de la ligne de rivage ne sont jamais régulières, elles s'effectuent par l'intermédiaire de chutes étagées qui emboîtent vers l'aval les prismes côtiers successifs. Là encore, la pente extrêmement faible du profil de dépôt explique la distorsion géométrique de l'enregistrement stratigraphique du demi-cycle régressif. Les séquences à haute fréquence sont organisées en séquences T-R à moyenne fréquence dont l'empilement au cours du Cénomanien est globalement aggradant-lentement rétrogradant sur la transversale. La comparaison avec d'autres bassins montre que les séquences à moyenne fréquence ne correspondent pas aux séquences de 3º ordre décrites ailleurs, mettant ainsi en doute un mécanisme eustatique pour leur mise en place

Acute myocardial infarction in a patient with hypofibrinogenemia: a case report

<p>Abstract</p> <p>Introduction</p> <p>Congenital fibrinogen deficiency is a rare coagulation disorder usually responsible for hemorrhagic diathesis. However, it can be associated with thrombosis and there have been limited reports of arterial thrombotic complications in these patients.</p> <p>Case presentation</p> <p>A 42-year-old Tunisian man with congenital hypofibrinogenemia and no cardiovascular risk factors presented with new onset prolonged angina pectoris. An electrocardiogram showed features of inferior acute myocardial infarction. His troponin levels had reached 17 ng/L. Laboratory findings confirmed hypofibrinogenemia and ruled out thrombophilia. Echocardiography was not useful in providing diagnostic elements but did show preserved left ventricular function. Coronary angiography was not performed and our patient did not receive any anticoagulant treatment due to the major risk of bleeding. Magnetic resonance imaging confirmed myocardial necrosis. Our patient was managed with aspirin, a beta-blocker, an angiotensin-converting enzyme inhibitor and statin medication. The treatment was well tolerated and no ischemic recurrence was detected.</p> <p>Conclusion</p> <p>Although coronary thrombosis is a rare event in patients with fibrinogen deficiency, this condition is of major interest in view of the difficulties observed in managing these patients.</p

Declines in Pediatric Bacterial Meningitis in the Republic of Benin Following Introduction of Pneumococcal Conjugate Vaccine: Epidemiological and Etiological Findings, 2011-2016.

BACKGROUND: Pediatric bacterial meningitis (PBM) remains an important cause of disease in children in Africa. We describe findings from sentinel site bacterial meningitis surveillance in children <5 years of age in the Republic of Benin, 2011-2016. METHODS: Cerebrospinal fluid (CSF) was collected from children admitted to Parakou, Natitingou, and Tanguieta sentinel hospitals with suspected meningitis. Identification of Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae, and Neisseria meningitidis (meningococcus) was performed by rapid diagnostic tests, microbiological culture, and/or polymerase chain reaction; where possible, serotyping/grouping was performed. RESULTS: A total of 10 919 suspected cases of meningitis were admitted to the sentinel hospitals. Most patients were 0-11 months old (4863 [44.5%]) and there were 542 (5.0%) in-hospital deaths. Overall, 4168 CSF samples were screened for pathogens and a total of 194 (4.7%) PBM cases were confirmed, predominantly caused by pneumococcus (98 [50.5%]). Following pneumococcal conjugate vaccine (PCV) introduction in 2011, annual suspected meningitis cases and deaths (case fatality rate) progressively declined from 2534 to 1359 and from 164 (6.5%) to 14 (1.0%) in 2012 and 2016, respectively (P < .001). Additionally, there was a gradual decline in the proportion of meningitis cases caused by pneumococcus, from 77.3% (17/22) in 2011 to 32.4% (11/34) in 2016 (odds ratio, 7.11 [95% confidence interval, 2.08-24.30]). Haemophilus influenzae meningitis fluctuated over the surveillance period and was the predominant pathogen (16/34 [47.1%]) by 2016. CONCLUSIONS: The observed decrease in pneumococcal meningitis after PCV introduction may be indicative of changing patterns of PBM etiology in Benin. Maintaining vigilant and effective surveillance is critical for understanding these changes and their wider public health implications

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Antioxidant properties and subchronic toxicity of the standardized extract of LAMIC, a phytomedicine prototype based on aqueous extracts from trunk bark of Lannea microcarpa Engl and K. Krause

Aims: This study investigated the antioxidant activity and the 90 days subchronic toxicity of the standardized LAMIC phytomedicine prototype based on aqueous extracts from Lannea microcarpa trunk bark. Methods: Three spectrophotometric methods were used to evaluated the antioxidant activity of LAMIC which were 2,2-Diphenyl-1-picrylhydrazyl (DPPH) free radical, 2,2’-azinobis(3-ethylbenzolin-6-sulphonate) (ABTS) radical scavenging assays and ferric reducing antioxidant power (FRAP) assays. For the standardized LAMIC subchronic toxicity study, male and female Wistar rats were used by daily oral administration at doses of 500, 1000 and 1500 mg/kg bw consecutively for 90 days. Results: The LAMIC extract exhibit better inhibitory activity against DPPH radical than ABTS radical with respective IC50 values of 45.38±3.21 µg/mL and 66.45±18.76 µg/mL, while FRAP assay exhibit antioxidant activity of 211.34±15.92 mmol EAA/g. Subchronic oral administration of LAMIC was well-tolerated at all tested doses. No behavioral and physiological changes and mortality were observed. The LAMIC extract did not present any impact on general hematological parameters and biochemical parameters. Moreover, no significant changes were raised in organ and body weight of treated groups compared to the Control group. Conclusion: These results support that LAMIC prototype was a valuable source of natural antioxidants and no toxicity was associated to its long terms oral consumption in rats indicating a potential application as a cardiovascular protective formulation. Keywords: LAMIC–Lannea microcarpa–Standardization–Antioxidant–Subchronic toxicity. &nbsp

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication