Data Mining Technique to Interpret Lung Nodule for Computer Aided Diagnosis

Diagnostic decision-making in pulmonary medical imaging has been improved by computer-aided diagnosis (CAD) systems, serving as second readers to detect suspicious nodules for diagnosis by a radiologist. Though increasing the accuracy, these CAD systems rarely offer useful descriptions of the suspected nodule or their decision criteria, mainly due to lack of nodule data. In this paper, we present a framework for mapping image features to radiologist-defined diagnostic criteria based on the newly available data). Using data mining, we found promising mappings to clinically relevant, human-interpretable nodule characteristics such as malignancy, margin, spiculation, subtlety, and texture. Bridging the semantic gap between computed image features and radiologist defined diagnostic criteria allows CAD systems to offer not only a second opinion but also decision-support criteria usable by radiologists. Presenting transparent decisions will improve the clinical acceptance of CAD

Bridging the Gap of Skilled Surgeons in Low and Middle Income Countries Using ICT Based Tools : A Case Study in Super-Speciality Training

Introduction: Over the last two decades, advancement of super specialised surgical disciplines has shown improved health outcome, in particular quality and safety. Although medical technology has developed to meet diagnostics and therapeutic needs, there is a scarcity of trained human resources in advanced specialities in low and middle income countries (LMICs). Innovative methods are needed to educate and train people at their workplaces using collaborative technologies and networks. Methods: Over the last 15 years, two general surgeons in Cuttack have been telementored from Lucknow 1,163 km away, using collaborative technologies to develop Endocrine Surgery. This study reviews the last 11 years of the service which includes a clinical decision support system and treatment planning advice using real time videoconferencing. Results: Over the last 11 years, 199 endocrine surgeries per annum were performed with most being thyroid cases as compared with 119 surgeries per annum during the previous five years. Parathyroid and adrenal cases increased significantly during this period (p <0.001). Rates of temporary and permanent vocal cord palsy (1.7% and 0%), hypocalcaemia (5.9% and 1.1%) were comparable with high volume centres. Based on the quantum, safety and quality outcome of endocrine surgery the provincial government has approved creation of a super-speciality department of endocrine surgery in Cuttack. Conclusion: Sustained engagement using telementoring can transfer surgical skills to needy surgeons and enable them to match the expertise of mentors. This model can be replicated in other specialities in a cost effective way to develop specialised human resources for healthcare, in particular in LMICs

Timing of anterior cruciate ligament reconstruction and its effect on associated chondral damage and meniscal injury: a prospective observational study

Background: Following an anterior cruciate ligament (ACL) tear, associated injuries in the knee involving menisci and articular cartilage increase with time. This study was performed to assess the distribution of secondary injuries after an ACL tear with time and identify a suitable timing for the reconstruction surgery. Methods: 74 patients with an ACL tear were divided into three groups based on time since injury- less than six months, six months to one year, and greater than one year. The odds of finding each lesion in every group were calculated and tested for statistical significance. Receiver operating characteristic curves (ROC) were drawn to predict individual lesions with time since injury. The diagnostic performance and statistical significance of these tests were identified. Results: The odds of finding all lesions were greater than one after a year of ACL tear but only chondral damage was statistically significant (p=0.025). Poor diagnostic accuracy was observed for medial meniscal injury even after three years of an ACL tear. Chondral injury showed a good area under the curve (0.817) which predicted chondral damage with a sensitivity of 62% at a cut-off of three years after the ACL injury. Conclusions: After three years of ACL tear, meniscal injuries could not be accurately predicted. However, a significant rise in chondral injuries could be seen and predicted accurately with good sensitivity. There could be a role of MRI or arthroscopy to assess the extent of injury of articular cartilage in patients who do not undergo ACL reconstruction after this time.

A CROSS-SECTIONAL STUDY EVALUATION OF DIAGNOSTIC IMPLICATIONS OF PLATELET INDICES IN THROMBOCYTOPENIA.

Introduction: Thrombocytopenia (TCP) refers to a reduction of platelet count below 150 x 109/ L; it’s not a disease entity by itself, but a finding that may result from a number of disease processes. Automated hematology analyzers that determine the Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Plateletcrit (PCT), and Platelet Large Cell Ratio (P-LCR), could be very helpful to facilitate the differential diagnosis of thrombocytopenia and to monitor thrombocytopenic conditions. Materials and methods: A cross-sectional study of platelet indices of 512 thrombocytopenic samples by automated hematology analyzers was done. Results: The cases of thrombocytopenia were classified into hypo-productive (362 cases) and hyper-destructive (150) groups. A most common cause of hypo-productive and hyper-destructive thrombocytopenia was Aplastic anemia and ITP, respectively. All the indices were significantly higher (p-value < 0.05) in hyper-destructive TCP compared to hypo-productive TCP, except Plateletcrit. Conclusion: The results of the present study show platelet indices to be a useful and reliable test to differentiate between hyper-destructive thrombocytopenia from the hypo-productive type with statistically significant differences

Hybrid Image Mining Methods to Classify the Abnormality in Complete Field Image Mammograms Based on Normal Regions

Breast Cancer now becomes a common disease among woman in developing as well as developed countries. Many noninvasive methodologies have been used to detect breast cancer. Computer Aided diagnosis through, Mammography is a widely used as a screening tool and is the gold standard for the early detection of breast cancer. The classification of breast masses into the benign and malignant categories is an important problem in the area of computer-aided diagnosis of breast cancer. We present a new method for complete total image of mammogram analysis. A mammogram is analyzed region by region and is classified as normal or abnormal. We present a hybrid technique for extracting features that can be used to distinguish normal and abnormal regions of a mammogram. We describe our classifier technique that uses a unique re-classification method to boost the classification performance. Our proposed hybrid technique comprises decision tree followed by association rule miner shows most proficient and promising performance with high classification rate compared to many other classifiers. We have tested this technique on a set of ground-truth complete total image of mammograms and the result was quite effective

Microscopic evaluation of coal and coke for metallurgical usage : A case study

The growing demands of the steel industry to import coking coals necessitates their optimal use by proper blending with indigenous coals. Petrographic assessment depicts the heterogeneity of the coals. Maceral composition and vitrinite reflectance per cent as a rank parameter are the basic outcomes of coal petrographic studies that are in frequent use for categorizing coals. The present study also gives an idea about the potentialities of petrographic techniques to decide the optimum blend proportion from coal type, rank and Vstep distribution pattern. Apart from this, coke microtextural studies can be used as an efficient tool not only to cross-check the predicted quality of the coke, but also to predict its behaviour during metallurgical operations. Attempts have been made here to predict coke quality from the microtextural study. Three indigenous coals and four imported coals with reflectance ranging from 0.81 to 1.23% have been used in the present study to illustrate the potentialities of microscopic techniques for the assessment of coal and coke for metallurgical usage

Magnetic resonance imaging during life: the key to unlock cerebral malaria pathogenesis?

Understanding the mechanisms underlying the pathophysiology of cerebral malaria in patients with Plasmodium falciparum infection is necessary to implement new curative interventions. While autopsy-based studies shed some light on several pathological events that are believed to be crucial in the development of this neurologic syndrome, their investigative potential is limited and has not allowed the identification of causes of death in patients who succumb to it. This can only be achieved by comparing features between patients who die from cerebral malaria and those who survive. In this review, several alternative approaches recently developed to facilitate the comparison of specific parameters between fatal, non-fatal cerebral malaria and uncomplicated malaria patients are described, as well as their limitations. The emergence of neuroimaging as a revolutionary tool in identifying critical structural and functional modifications of the brain during cerebral malaria is discussed and highly promising areas of clinical research using magnetic resonance imaging are highlighted

Investigating the Pathogenesis of Severe Malaria: A Multidisciplinary and Cross-Geographical Approach.

More than a century after the discovery of Plasmodium spp. parasites, the pathogenesis of severe malaria is still not well understood. The majority of malaria cases are caused by Plasmodium falciparum and Plasmodium vivax, which differ in virulence, red blood cell tropism, cytoadhesion of infected erythrocytes, and dormant liver hypnozoite stages. Cerebral malaria coma is one of the most severe manifestations of P. falciparum infection. Insights into its complex pathophysiology are emerging through a combination of autopsy, neuroimaging, parasite binding, and endothelial characterizations. Nevertheless, important questions remain regarding why some patients develop life-threatening conditions while the majority of P. falciparum-infected individuals do not, and why clinical presentations differ between children and adults. For P. vivax, there is renewed recognition of severe malaria, but an understanding of the factors influencing disease severity is limited and remains an important research topic. Shedding light on the underlying disease mechanisms will be necessary to implement effective diagnostic tools for identifying and classifying severe malaria syndromes and developing new therapeutic approaches for severe disease. This review highlights progress and outstanding questions in severe malaria pathophysiology and summarizes key areas of pathogenesis research within the International Centers of Excellence for Malaria Research program

Gender Differences in Perception and Care-seeking for Illness of Newborns in Rural Uttar Pradesh, India

Although gender-based health disparities are prevalent in India, very little data are available on care-seeking patterns for newborns. In total, 255 mothers were prospectively interviewed about their perceptions and action surrounding the health of their newborns in rural Uttar Pradesh, India. Perception of illness was significantly lower in incidence (adjusted odds ratio=0.56, 95% confidence interval 0.33-0.94) among households with female versus male newborns. While the overall use of healthcare providers was similar across gender, the average expenditure for healthcare during the neonatal period was nearly four-fold higher in households with males (Rs 243.3±537.2) compared to females (Rs 65.7±100.7) (p=0.07). Households with female newborns used cheaper public care providers whereas those with males preferred to use private unqualified providers perceived to deliver more satisfactory care. These results suggest that, during the neonatal period, care-seeking for girls is neglected compared to boys, laying a foundation for programmes and further research to address gender differences in neonatal health in India