Infant’s MRI Brain Tissue Segmentation using Integrated CNN Feature Extractor and Random Forest

Infant MRI brain soft tissue segmentation become more difficult task compare with adult MRI brain tissue segmentation, due to Infant’s brain have a very low Signal to noise ratio among the white matter_WM and the gray matter _GM. Due the fast improvement of the overall brain at this time , the overall shape and appearance of the brain differs significantly. Manual segmentation of anomalous tissues is time-consuming and unpleasant. Essential Feature extraction in traditional machine algorithm is based on experts, required prior knowledge and also system sensitivity has change. Recently, bio-medical image segmentation based on deep learning has presented significant potential in becoming an important element of the clinical assessment process. Inspired by the mentioned objective, we introduce a methodology for analysing infant image in order to appropriately segment tissue of infant MRI images. In this paper, we integrated random forest classifier along with deep convolutional neural networks (CNN) for segmentation of infants MRI of Iseg 2017 dataset. We segmented infants MRI brain images into such as WM- white matter, GM-gray matter and CSF-cerebrospinal fluid tissues, the obtained result show that the recommended integrated CNN-RF method outperforms and archives a superior DSC-Dice similarity coefficient, MHD-Modified Hausdorff distance and ASD-Average surface distance for respective segmented tissue of infants brain MRI

A prospective and observational study to assess the efficacy of pregabalin versus Gabapentin in relieving early post operative neuropathic pain with respect to clinical and functional outcomes in patients undergoing open lumbar discectomy surgery

Background: Post-operative neuropathic pain is one of the most dreadful complications following lumbar spine surgeries. Owing to the similarities in the pathophysiological and biochemical mechanisms underlying epilepsy and neuropathic pain, many anti-epileptic drugs (AEDs) like pregabalin and gabapentin are being used in the treatment of post-operative neuropathic pain. Methods: This prospective and observational study included a total of 60 patients out of 261 patients undergoing lumbar discectomy surgery, who postoperatively had neuropathic pain as diagnosed with LANSS score; and were randomly divided into pregabalin (n=30) and gabapentin (n=30) supplementation groups, and the efficacy was compared with respect to visual analog scale (VAS) score (clinically) and Oswestry disability index (ODI) score (functionally) at pre-operative and post-operative follow-ups; and also, total analgesia consumed. Results: No statistical differences were observed between any of the demographic variables and surgical levels operated upon between the two groups. Both the groups showed significant improvements in clinical (VAS) and functional (ODI) outcome as compared to pre-operative status. Leeds assessment of neuropathic symptoms and signs scale (LANSS) score was significantly increased in both the groups postoperatively till the 3rdmonthfollow-up, after which there was a significant decrease in the score. The Pregabalin group showed significant (p<0.05) improvement in VAS and ODI scores at the post operative 1st, 3rd, and 6th month, as compared to the gabapentin group; however, at other follow-ups the difference was insignificant. Total analgesia consumed was significantly higher in the gabapentin group. Conclusions: Our study concluded that both pregabalin and gabapentin are highly effective in the treatment of early post-operative neuropathic pain; showing encouraging clinical and functional improvements. Pregabalin had significantly better outcomes on short-term follow-ups; however, on longer follow-ups, both had similar beneficial outcomes. Pregabalin supplementation showed a significant analgesia-sparing effect as compared to gabapentin

Assessment of clinical and functional outcomes after single dose injection of autologous platelet rich plasma in patients with chronic lateral epicondylitis: a prospective and brief follow up study

Background: Lateral epicondylitis is a chronic, painful, and debilitating elbow condition. The introduction of platelet-rich plasma as an adjunct to the conservative and operative treatment has revolutionized the research in this topic. PRP is considered to be the ideal autologous biological blood-derived product which helps in regenerating the degenerated tissue rather than just repairing it and helps in relieving pain and improving function. Methods: This is a prospective study where 40 patients diagnosed with tennis elbow, failing other conservative treatment modalities were enrolled; and treated with single dose injection of autologous PRP; and were evaluated for clinical and functional outcomes using the visual analogue scale and disabilities of arm, shoulder, and hand scores on the follow-ups. Results: Out of the 40 patients enrolled, there were 15 males and 25 females. The mean age of the population was 45.88±8.87 years. All the patients had improved statistically significant differences in mean VAS and DASH scores (p value<0.001) on each follow-up as compared to the baseline score with VAS score and DASH score improvement being more than 77% and 65% respectively at final follow up. Conclusion: Our study concludes that a single local injection of autologous PRP appears to be the promising and safe modality of treatment in lateral epicondylitis, helping to improve the pain as well as the clinical and functional outcomes

A prospective and comparative study to evaluate the efficacy of oral pregabalin vs gabapentin combined with IV paracetamol as preemptive analgesic for post-operative pain in patients undergoing single level open lumbar spine decompression surgery in a tertiary health care center

Background: Post-operative pain in spine surgery, whether neuropathic or nociceptive, presents a significant challenge for both surgeons and patients. Previous research has demonstrated the effectiveness of pre-operative oral gabapentinoids in reducing postoperative pain, extending the time to first rescue analgesia, and diminishing overall analgesic requirements. Methods: This study involved 120 patients undergoing lumbar discectomy for disc herniation. They were randomly assigned to receive pre-operative oral pregabalin, gabapentin, or a placebo, along with IV paracetamol as preemptive analgesia. The study assessed their efficacy through post-operative pain scores (VAS), and sedation scores (Ramsay sedation score) at various intervals, time to first rescue analgesia, and total analgesia consumption. Results: No significant differences were found in demographic variables, surgical levels, or duration among the groups. The placebo group had the shortest time to first rescue analgesia, while the pregabalin group showed the longest, with a notable difference. Across most time frames, the pregabalin group reported the lowest mean postoperative VAS scores, whereas the placebo group had the highest. Initial variations in sedation scores converged in later time frames, with the placebo group consistently recording the lowest scores. Total rescue analgesia (tramadol) in the initial 24 hours was highest in the placebo group, followed by the gabapentin group, and lowest in the pregabalin group, with no significant variance. Conclusions: This study affirms the superiority of pre-operative oral pregabalin with IV paracetamol. It effectively prolongs the time to first rescue analgesia and reduces overall analgesic consumption post-lumbar spine surgery, compared to pre-operative oral gabapentin with IV paracetamol

Assessment of vitamin C supplementation as an adjuvant analgesic therapy and evaluating its efficacy in terms of clinical and functional outcomes in post-operative patients undergoing surgical decompression for prolapsed intervertebral lumbar disc

Background: Post-operative pain is one of the most debilitating condition following lumbar spine surgery, which negates the clinical and functional outcomes. Vitamin C (ascorbic acid) due to its anti-oxidant, neuroprotective and neuromodulating properties; was evaluated to have adjuvant analgesic effects in these patients. Methods: This prospective study included 50 patients undergoing single level lumbar disectomy; randomly divided into group A (vitamin supplementation, n=25) and group B (no supplementation, n=25). Both the groups were evaluated on the follow ups for the clinical outcomes (visual analog scale-VAS score), functional outcomes (Oswestry disability index-ODI score) and total analgesia consumed. Results: Both the groups showed statistically significant improvements in clinical and functional outcomes with respect to pre-operative status. Group A showed statistically significant (p<0.05) improvement in VAS and ODI scores as compared to group B at 4th, 6th and 8th week follow up, however at 2nd and 12th week follow up the difference was found to be insignificant. Total analgesia consumed by group A patients was statistically lower than that consumed by group B patients. Conclusions: Vitamin C has analgesic effects in certain clinical conditions, thus reducing post-operative pain and improving the overall satisfaction and outcome of the surgery. It helps in bringing about the improvement in clinical as well as the functional outcome of the spine surgery and has an effective dose-sparing and adjuvant effect on the post-operative analgesia

MR Damper Modeling Performance Comparison Including Hysteresis and Damper Optimization

This research paper represents the analysis and simulation of semi-active suspension using non-linear modeling of the Magneto-Rheological (MR) suspension with consideration of the hysteresis behavior for a quarter car model. The research is based on the assumption that each wheel experiences the same disturbance excitation. Hysteresis is analyzed using Bingham, Dahl's, and Bouc-Wen models. This research focuses on simulation of passive, Bingham, Dahl, and Bouc-Wen models and analysis for the five road profiles. The desired damping force determines the optimum working conditions based on optimized critical design parameters. An integrated approach towards the numeric design optimization by computational methods has been used to find the optimum working conditions. The critical parameters of MR damper are determined, and multi-objective optimization is performed considering the pole length, piston radius, gap thickness, piston internal radius, piston velocity and coil current. Sensitivity analysis also is performed to identify the sensitive parameter in the MR damper geometry towards the damping force. Analysis shows that gap thickness is the most sensitive geometric parameter of the MR damper. Furthermore, the comparative study of the models for the highest comfort with less overshoot and settling time are executed. The Bouc-Wen model is 36.91% more accurate than passive suspension in terms of damping force requirements, has a 26.16% less overshoot, and 88.31% less settling time. The simulation of the Bouc-Wen model yields the damping force requirement to be 2150N which is 91% of the analytical results

Surfactant protein D inhibits HIV-1 infection of target cells via interference with gp120-CD4 interaction and modulates pro-inflammatory cytokine production

© 2014 Pandit et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Surfactant Protein SP-D, a member of the collectin family, is a pattern recognition protein, secreted by mucosal epithelial cells and has an important role in innate immunity against various pathogens. In this study, we confirm that native human SP-D and a recombinant fragment of human SP-D (rhSP-D) bind to gp120 of HIV-1 and significantly inhibit viral replication in vitro in a calcium and dose-dependent manner. We show, for the first time, that SP-D and rhSP-D act as potent inhibitors of HIV-1 entry in to target cells and block the interaction between CD4 and gp120 in a dose-dependent manner. The rhSP-D-mediated inhibition of viral replication was examined using three clinical isolates of HIV-1 and three target cells: Jurkat T cells, U937 monocytic cells and PBMCs. HIV-1 induced cytokine storm in the three target cells was significantly suppressed by rhSP-D. Phosphorylation of key kinases p38, Erk1/2 and AKT, which contribute to HIV-1 induced immune activation, was significantly reduced in vitro in the presence of rhSP-D. Notably, anti-HIV-1 activity of rhSP-D was retained in the presence of biological fluids such as cervico-vaginal lavage and seminal plasma. Our study illustrates the multi-faceted role of human SPD against HIV-1 and potential of rhSP-D for immunotherapy to inhibit viral entry and immune activation in acute HIV infection. © 2014 Pandit et al.The work (Project no. 2011-16850) was supported by Medical Innovation Fund of Indian Council of Medical Research, New Delhi, India (www.icmr.nic.in/)

Surfactant protein D induces immune quiescence and apoptosis of mitogen-activated peripheral blood mononuclear cells

Surfactant Protein D (SP-D) is an integral molecule of the innate immunity secreted by the epithelial cells lining the mucosal surfaces. Its C-type lectin domain offers pattern recognition functions while it binds to putative receptors on immune cells to modify cellular functions. Activated PBMCs and increased serum levels of SP-D are observed under a range of pathophysiological conditions including infections. Thus, we speculated if SP-D can modulate systemic immune response via direct interaction with activated PBMCs. Here, we have examined interaction of a recombinant fragment of human SP-D (rhSP-D) on PHA-activated PBMCs. We observed a significant downregulation of TLR2, TLR4, CD11c and CD69 upon rhSP-D treatment. rhSP-D inhibited production of Th1 (TNF-α and IFN-γ) and Th17 (IL-17) cytokines along with IL-6. Interestingly, levels of IL-2, Th2 (IL-4) and regulatory (IL-10 and TGF-β) cytokines were unaltered. Differential expression of co-stimulatory CD28 and co-inhibitory CTLA4 expression along with their ligands CD80 and CD86 revealed selective up-regulation of CTLA4 at both mRNA and protein level. In addition, rhSP-D induced apoptosis only in the activated but not in non-activated PBMCs. Blockade of CTLA4 inhibited rhSP-D mediated apoptosis, confirming an involvement of CTLA4 in induction of apoptosis. We conclude that SP-D restores immune homeostasis: it regulates expression of immunomodulatory receptors and cytokines, which is followed by apoptosis induction of immune-activated cells. These findings appear to suggest a general role for SPD in immune surveillance against activated immune cells