A fused lightweight CNN model for the diagnosis of COVID-19 using CT scan images

Computed tomography is an effective tool that can be used for the fast diagnosis of COVID-19. However, in high case-load scenarios, there are chances of delay and human error in interpreting the scan images manually by an expert. An artificial intelligence (AI) based automated tool can be employed for fast and efficient diagnosis of this disease. For image-based diagnosis, convolutional neural networks (CNN) which is a subcategory of AI has been widely explored. However, these CNN models require significant computational resources for processing. Hence in this work, the performance of two lightweight least explored CNN models, namely SqueezeNet and ShuffleNet have been evaluated with CT scan images. While SqueezeNet produced an accuracy of 86.4%, ShuffleNet was able to provide an accuracy of 95.8%. Later, in order to improve the accuracy, a novel fused-model combining these two models has been developed and its performance has been evaluated. The fused-model outperformed the two base models with an overall accuracy of 97%. The analysis of the confusion matrix revealed an improved specificity of 96.08% and precision of 96.15% with a better fallout and false discovery rate of 3.91% and 3.84%, respectively

Maternal near miss review from a tertiary care center in South India

Background: Maternal near miss review acts as complimentary for mortality audits. It indicates the quality of obstetric care and helps obstetricians to revise policies and practices.Methods: A retrospective observational study was carried out at institute of maternal and child health, Government Medical College Kozhikode from January to December 2014. Cases were defined based on WHO criteria 2009.Results: Total live births during the study period were 15604 and there were 24 maternal deaths. Near Miss cases were 267. Maternal mortality rate was 153.5/lakh live births and maternal near miss incidence ratio was 17.03/1000 live births. Maternal near miss to mortality ratio was 11.1 and mortality index was 8.2%. Hypertensive disorders comprised 46%, followed by haemorrhage 36%, sepsis 7% and other causes 10%.Conclusions: Even with improving care, maternal near miss incidence (17.03 per 1000 live births) is found to be higher in our institution compared to developed nations. However high maternal near miss to mortality ratio (11.1) and low mortality index (8.2%) shows good quality of obstetric care in our institution

Allergic contact stomatitis (stomatitis venenata): A case report of oral hypersensitivity reaction to toothpaste

Allergic contact stomatitis (stomatitis venenata) might resemble oral lichen planus or oral lichenoid lesion clinically which can be acute or chronic in nature. Many offending agents have been attributed to their development and the most common being dental restorative materials, lipstick or flavouring agents in toothpaste or chewing gums. Allergic reactions can be in mild form to life-threatening anaphylaxis. The identification of the exact cause for allergy is difficult. Here, we report the case of a 37-year-old patient who presented with allergic contact stomatitis to a conventional daily routine product. Importance of history taking and awareness by the clinician about the contents of any new products being prescribed to the patient are emphasized by this case report

Barriers to Changing Dietary Behavior

Abstract Dietary change requires giving up long established patterns of eating behavior and acquiring new habits. ‘Noncompliance’ to diet advice may be a result of inability to provide diet self-management training and getting the right messages across to change eating behavior. Using a pre-tested questionnaire based interview, we carried out a study amongst 350 adults (> 20 years) with type 2 diabetes from two metro cities in South India, who had previously received diet advice with the objective to understand perceptions, attitudes and practices, as well as study factors that enhance or reduce compliance to diet advice. Ninety six patients (28%) followed diet for the full duration of diabetes (Group1), 131 (38%) followed diet for a partial duration varying between more than a quarter to three quarters of the total diabetes duration (Group 2) and 115 (34%) did not follow diet advice (Group 3) – followed for a duration less than a quarter of their diabetes duration. Study results show that many factors both patient and health care provider related influence outcomes of dietary advice. Factors that have a positive impact on compliance are – older age, shorter duration, nuclear family, good family support, less busy work life, higher health consciousness, advice given by dietician, more frequent visits to dietician, advice that includes elements to promote overall health not merely control of blood sugar, diet counseling that is easy to understand and use and includes healthy food options, cooking methods, practical guidance to deal with lifestyle issues. We conclude that patient barriers related to life circumstance are mostly non-modifiable, most modifiable barriers are related to behavioural aspect and the inability of the health care provider to provide individualized diet advice and self management training. Efforts must be made to improve counseling skills

Effect of Haemoglobin and Iron Status of the Antenatal Mothers on their Newborns at Birth: A Cross-sectional Study

Introduction: Iron deficiency (ID) anaemia in pregnant mothers can affect the iron reserves of their newborns and lead to anaemia later. The haematological indices and iron status of pregnant women and its correlation with their neonates is still unclear. Aim: To assess the correlation between maternal and cord blood Hb and iron status. Materials and Methods: The present cross-sectional study included 134 antenatal mothers, at term gestation without any significant antenatal complications. Complete haemogram, serum iron, ferritin, and iron binding capacity were assessed for these mothers before delivery and also from the cord blood samples of their newborns at birth. Statistical difference and correlation were observed using Chi-square test and Pearson’s correlation coefficient. Results: Maternal anaemia Hb <11 gm/dL) was observed in 62 (46.3%). The mean Hb and ferritin of the mothers were 11.06±1.02 gm/dL and 113.3±7.1 μg/L, respectively. The mean Hb and ferritin levels of the cord blood samples were 12.24±0.17 gm/dL and 214.3±20.1 μg/L, respectively. In univariate analysis, maternal Hb showed a significant correlation with cord blood Hb with Odds Ratio (OR) 0.508 and 95% Confidence Interval (CI): 0.428-0.603. The Pearson’s correlation showed a moderate correlation between mother and cord blood Packed Cell Volume (PCV) (r=0.344, p<0.001) and weak correlation between other maternal and cord blood iron indices and serum ferritin (r=0.191, p=0.027 and r=0.203, p=0.019). Conclusion: There is a significant correlation between maternal and cord blood Hb in term neonates. The study indicates that the haematological indices of pregnant women determine the neonatal Hb in term babies

Novel protein fold discovered in the PabI family of restriction enzymes

Although structures of many DNA-binding proteins have been solved, they fall into a limited number of folds. Here, we describe an approach that led to the finding of a novel DNA-binding fold. Based on the behavior of Type II restriction–modification gene complexes as mobile elements, our earlier work identified a restriction enzyme, R.PabI, and its cognate modification enzyme in Pyrococcus abyssi through comparison of closely related genomes. While the modification methyltransferase was easily recognized, R.PabI was predicted to have a novel 3D structure. We expressed cytotoxic R.PabI in a wheat-germ-based cell-free translation system and determined its crystal structure. R.PabI turned out to adopt a novel protein fold. Homodimeric R.PabI has a curved anti-parallel β-sheet that forms a ‘half pipe’. Mutational and in silico DNA-binding analyses have assigned it as the double-strand DNA-binding site. Unlike most restriction enzymes analyzed, R.PabI is able to cleave DNA in the absence of Mg2+. These results demonstrate the value of genome comparison and the wheat-germ-based system in finding a novel DNA-binding motif in mobile DNases and, in general, a novel protein fold in horizontally transferred genes

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention