Multi-view convolutional recurrent neural networks for lung cancer nodule identification

Screening via low-dose Computer Tomography (CT) has been shown to reduce lung cancer mortality rates by at least 20%. However, the assessment of large numbers of CT scans by radiologists is cost intensive, and potentially produces varying and inconsistent results for differing radiologists (and also for temporally-separated assessments by the same radiologist). To overcome these challenges, computer aided diagnosis systems based on deep learning methods have proved an effective in automatic detection and classification of lung cancer. Latterly, interest has focused on the full utilization of the 3D information in CT scans using 3D-CNNs and related approaches. However, such approaches do not intrinsically correlate size and shape information between slices. In this work, an innovative approach to Multi-view Convolutional Recurrent Neural Networks (MV-CRecNet) is proposed that exploits shape, size and cross-slice variations while learning to identify lung cancer nodules from CT scans. The multiple-views that are passed to the model ensure better generalization and the learning of robust features. We evaluate the proposed MV-CRecNet model on the reference Lung Image Database Consortium and Image Database Resource Initiative and Early Lung Cancer Action Program datasets; six evaluation metrics are applied to eleven comparison models for testing. Results demonstrate that proposed methodology outperforms all of the models against all of the evaluation metrics

Mass in Right Iliac Fossa- Clinicopathogical Evaluation

To identify clinico-pathologicalentities presenting as mass in right iliac fossa.Methods: In this observational study patients ofmass in right iliac fossa were recruited. All patientswho presented with sign and symptoms of mass inright iliac fossa were investigated and subjected toconservative or operative managements dependingupon the cause and response to conservativemanagement.Results: Appendicular mass (33.7%) was thecommonest finding, followed by cecalcarcinoma(9.8%), ileocecal tuberculosis(9.8%), psoasabcess (7.6%), retroperitoneal dermoid(3.3%), worminfestation (3.3%) and lymphoma (3.3%).Conclusion: Appendicular mass is the main causeof mass in right iliac fossa, with a wide range ofother causes

Surgical site infection; effect of contamination and duration of surgical procedure

Introduction: Surgical site infections are responsible for increased treatment cost, prolonged hospital stay and increased morbidity on surgical floor. Increased level of per operative contamination and prolonged surgery increases the incidence of surgical site infections.Objective: To know the effect of contamination and duration of surgery on the incidence of surgical site infections in emergency surgical patients so that specific strategies can be developed to decrease the morbidity and mortality caused by these infections.Materials and Methods: All the patients who underwent general surgical operations on an emergency basis at the surgical unit-1 of the Benazir Bhutto Hospital Rawalpindi from 01-01-2019 to 31-12-2020 were evaluated for surgical site infections. The level of contamination per operatively and duration of surgery were documented. Surgical site infections suspected clinically were confirmed by culture and sensitivity.Results: Among 2202 emergency-operated patients, two hundred and thirty-seven patients (10.76%) had surgical site infection confirmed on culture and sensitivity (C/S) report. About sixty-five percent of patients were male. Of two hundred and thirty-seven positive patients, seventy (29.09%) patients underwent laparotomy for penetrating and blunt abdominal trauma. About fifty-eight percent of SSI patients had contaminated wounds per operatively. Operative time was one to three hours in about sixty-seven percent of SSI-positive patients. Staph aureus was present in one hundred and forty-five (79.67%) patients. E.coli was the most commonest Gram-ve micro-organism (70.95%).Conclusion: Surgical site infection causes a significant rise in morbidity on the surgical floor. Increased levels of contamination per operatively and prolonged operative time increase the incidence of SSI in emergency surgical operations

Surgical site infection; effect of contamination and duration of surgical procedure

Introduction: Surgical site infections are responsible for increased treatment cost, prolonged hospital stay and increased morbidity on surgical floor. Increased level of per operative contamination and prolonged surgery increases the incidence of surgical site infections.Objective: To know the effect of contamination and duration of surgery on the incidence of surgical site infections in emergency surgical patients so that specific strategies can be developed to decrease the morbidity and mortality caused by these infections.Materials and Methods: All the patients who underwent general surgical operations on an emergency basis at the surgical unit-1 of the Benazir Bhutto Hospital Rawalpindi from 01-01-2019 to 31-12-2020 were evaluated for surgical site infections. The level of contamination per operatively and duration of surgery were documented. Surgical site infections suspected clinically were confirmed by culture and sensitivity.Results: Among 2202 emergency-operated patients, two hundred and thirty-seven patients (10.76%) had surgical site infection confirmed on culture and sensitivity (C/S) report. About sixty-five percent of patients were male. Of two hundred and thirty-seven positive patients, seventy (29.09%) patients underwent laparotomy for penetrating and blunt abdominal trauma. About fifty-eight percent of SSI patients had contaminated wounds per operatively. Operative time was one to three hours in about sixty-seven percent of SSI-positive patients. Staph aureus was present in one hundred and forty-five (79.67%) patients. E.coli was the most commonest Gram-ve micro-organism (70.95%).Conclusion: Surgical site infection causes a significant rise in morbidity on the surgical floor. Increased levels of contamination per operatively and prolonged operative time increase the incidence of SSI in emergency surgical operations

Peripheral Vascular Disease “A Spectrum”

Background: To observe the spectrum of peripheralvascular disease presenting in a tertiary care hospital.Method: This observational, descriptive study wascarried out in Surgical Unit –I at Holy Family Hospital,Rawalpindi over a period of two years. All the patientspresenting with peripheral vascular disorders excludingacute vascular trauma patients, diabetics and varicoseveins patients were included in the study.Results: A total of 49 patients presented to the hospital.The male to female ratio was 2:1.The average age ofpresentation was 50.2 years. About 35% patients presentedwith occlusive disease, 18% with autoimmune disease and14% with embolism. The less common causes of peripheralvascular disorders included femoral pseudoaneurysms in8% patients and true aneurysms of iliac, popliteal andsubclavian arteries in 12% patients. Bilateral gangrene ofboth lower limbs was seen in 4% patients.Conclusion: Peripheral vascular disease is commonerin males and is mostly seen in the sixth decade of life.Atherosclerotic occlusive disease is the commonest causeof peripheral vascular disease followed by vasculitis,embolisms and aneurysms

Impact of Corporate Governance on Firm Performance: Evidence from Sugar Mills of Pakistan

This paper examines the impact of corporate governance mechanisms (Board Size, Board Composition, and CEO/Chairman Duality) on firm performance (Return on Asset) in sugar industry of Pakistan. The data of corporate governance mechanisms (Board Size, Board Composition, and CEO/Chairman Duality) collected from 12 listed sugar mills of Pakistan from 2005 to 2010. Using panel data methodology as a method of estimation Arithmetic mean, ANOVA and t-test applied on data by using SPSS. The results raveled that there is a significant impact of corporate governance on firm performance. Results further reveal that there is a significant impact of board size, CEO/Chairman Duality on ROA, and there is insignificant impact of Board Composition on ROA. Keywords: Corporate governance, Board of director, firm performanc

Teaching children road safety through storybooks: an approach to child health literacy in Pakistan

Background: Road traffic injuries (RTIs) commonly affect the younger population in low- and-middle-income countries. School children may be educated about road safety using storybooks with colorful pictures, which tends to increase the child’s interest in the text. Therefore, this study assessed the use of bilingual pictorial storybooks to improve RTI prevention knowledge among school children.Methods: This pretest-posttest study was conducted in eight public and nine private schools of Karachi, Pakistan, between February to May 2015. Children in grades four and five were enrolled at baseline (n = 410). The intervention was an interactive discussion about RTI prevention using a bilingual (Urdu and English) pictorial storybook. A baseline test was conducted to assess children’s pre-existing knowledge about RTI prevention followed by administration of the intervention. Two posttests were conducted: first immediately after the intervention, and second after 2 months. Test scores were analyzed using McNemar test and paired sample t-test. Results: There were 57% girls and 55% public school students; age range 8–16 years. Compared to the overall baseline score (5.1 ± 1.4), the number of correct answers increased in both subsequent tests (5.9 ± 1.2 and 6.1 ± 1.1 respectively, p-value \u3c 0.001). Statistically significant improvement in mean scores was observed based on gender, grades and school type over time (p-value \u3c 0.001).Conclusion: Discussions using bilingual pictorial storybooks helped primary school children in Pakistan grasp knowledge of RTI prevention. RTI education sessions may be incorporated into school curricula using storybooks as teaching tools. Potential exists to create similar models for other developing countries by translating the storybooks into local languages