Automated quantification of non-calcified coronary plaques in cardiac CT angiographic imagery

The high mortality rate associated with coronary heart disease (CHD) has driven intensive research in cardiac image analysis. The advent of computed tomography angiography (CTA) has turned non-invasive diagnosis of cardiovascular anomalies into reality as calcified coronary plaques can be easily identified due to high intensity values. However, detection and quantification of the non-calcified plaques in CTA is still a challenging problem because of their lower intensity values, which are often similar to the nearby blood and muscle tissues. In this work, we propose Bayesian posterior based model for precise quantification of the non-calcified plaques in CTA imagery. The only indicator of non-calcified plaques in CTA is relatively lower intensity. Hence, we exploited intensity variations to discriminate voxels into lumen and plaque classes. Based on the normal coronary segments, we computed the vessel-wall thickness in first step. In the subsequent step, we removed vessel wall from the segmented tree and employed Gaussian Mixture Model to compute optimal distribution parameters. In the final step, distribution parameters were employed in Bayesian posterior model to classify voxels into lumen or plaque. A total of 18 CTA volumes were analyzed in this work using two different approaches. According to the experimental results, mean Jaccard overlap is around 88% with respect to the manual expert. In terms of sensitivity, specificity and accuracy, the proposed method achieves 84.13%, 79.15% and 82.02% success, respectively. Conclusion: According to the experimental results, it is shown that the proposed plaque quantification method achieves accuracy equivalent to human experts

Economic analysis of Barramundi (Lates calcarifer) (Bloch 1790), in Pakistan and opportunities for its aquaculture development

1425-1434Barramundi, (Lates calcarifer) is one of the most commercially important fish species. In Pakistan, farming of this species is relatively new. Article delivers the economic analysis of Barramundi and its fishery resources in Pakistan. The analysis includes the capture production, aquaculture production and market price. The Capture production of Barramundi in Pakistan has shown a declining trend by average at 18 t y-1 from 605 t in 1986 to 121.2 t in 2018. Similarly, wholesale and retail market prices witnessed an increase from 2003 to 2018. During this period, the wholesale price rose to 384.3 PKR/kg from 69 PKR/kg, while the retail price surged to 395.2 PKR/kg from 97 PKR/kg. On the other hand, the increasing operational fishing fleets from 15513 (1990) to 30000 (2018) has reduced Fishery resources of barramundi i.e. from 312 ton to 130 and its body weight from 13.42 kg to 3.5 kg during the period from 1990 to 2018. On the contrary, aquaculture production registered a rising trend by average of 0.5 t y-1 from 05 t in 2009 to 8.2 t in 2018. The rise in aquaculture production of Barramundi is not satisfactory when compared to its growth rate in other countries like Bangladesh, Thailand, Australia, China, India etc. In this study, we find out the major causes of non-satisfactory rise in aquaculture production by the using AGR model. Results show that the main reasons beyond decline in the growth included inaccessibility of Barramundi Seed, unavailability of Barramundi Hatcheries and lack of government Support

Epidermólisis ampollosa, reporte de un caso

Introduction: epidermolysis bullosa refers to a heterogeneous group of chronic hereditary pimple-like diseases affecting the skin and mucosae with blisters and vesicles after minimal injury, with variable involvement of other organs.Case report: 3-year-old female patient with exulcerated skin lesions and some erythema crust-plaques, with scaling at exposure sites such as hands, knees, feet, back of the neck and genitals. She was admitted to “Hermanos Cordové” Pediatric Teaching Hospital in Manzanillo. The medical care was based on maintaining the integrity of the skin avoiding trauma, temperature control, nutrition and prevention of secondary infections. A simple epidermolysis bullosa is diagnosed by skin biopsy.Conclusions: the disease is scarcely known with low incidence and prevalence. It is a major problem in the family and social environment, as parents are dealing with a rare disease of genetic origin and poor prognosis. Medical-social support helps to minimize the problems by means of information and coordination. Treatment requires the care of a multidisciplinary and specialized team.Introducción: la epidermólisis bulosa se refiere a un grupo heterogéneo de enfermedades hereditarias ampulosas crónicas, que afectan a la piel y las mucosas con formación de ampollas y vesículas tras mínimos traumatismos, con afectación variable de otros órganos.Presentación de caso: paciente femenina de 3 años de edad con lesiones de piel exulceradas y algunas eritematocostrosas en placas, con descamación en sitios de exposición como manos, rodillas, pies, parte posterior del cuello y genitales. Se encontraba ingresada en el Hospital Pediátrico Docente “Hermanos Cordové", de Manzanillo. Los cuidados médicos se basaron en mantener la entereza de la piel evitando traumatismo, control de la temperatura, nutrición y prevención de infecciones secundarias. Se diagnostica por biopsia de piel una epidermólisis bulosa simple. Conclusiones: la enfermedad es poco conocida con baja incidencia y prevalencia. Supone un problema de gran magnitud en el entorno familiar y social, al enfrentarse los padres a una enfermedad rara con origen genético y de mal pronóstico. El apoyo médico-social ayuda a minimizar los problemas, a través de la información y coordinación. Para su tratamiento es necesaria la atención de un equipo multidisciplinario y especializado.

Anesthetic consideration in dystrophic epidermolysis bullosa

Epidermolysis bullosa is a group of inherited rare skin disease, characterized by bullae formation in the skin or mucous membranes. The fundamental abnormality is collagen degeneration leads to splitting of various epidermal layers. Dystrophic epidermolysis bullosa (DEB) is one of the major forms of epidermolysis bullosa. These patients often admitted to the hospital for corrective surgeries, change of dressing, contracture release, and skin grafting. Anesthetic management of these cases is always a challenge. We are reporting a case of 5-year-old boy diagnosed as a case of DEB scheduled for upper lip contracture release, skin grafting and debridement of nonhealing scars under anesthesia. In this case, we have focused mainly on the anesthetic management, preparation of the monitoring, transportation, difficulties in establishing the venous accesses, and airway management

Non-calcified plaque-based coronary stenosis grading in contrast enhanced CT

Background: The high mortality rate associated with coronary heart disease has led to state-of-the-art non-invasive methods for cardiac diagnosis including computed tomography and magnetic resonance imaging. However, stenosis computation and clinical assessment of non-calcified plaques has been very challenging due to their ambiguous intensity response in CT i.e. a significant overlap with surrounding muscle tissues and blood. Accordingly, this research presents an approach for computation of coronary stenosis by investigating cross-sectional lumen behaviour along the length of 3D coronary segments. Methods: Non-calcified plaques are characterized by comparatively lower-intensity values with respect to the surrounding. Accordingly, segment-wise orthogonal volume was reconstructed in 3D space using the segmented coronary tree. Subsequently, the cross sectional volumetric data was investigated using proposed CNN-based plaque quantification model and subsequent stenosis grading in clinical context was performed. In the last step, plaque-affected orthogonal volume was further investigated by comparing vessel-wall thickness and lumen area obstruction w.r.t. expert-based annotations to validate the stenosis grading performance of model. Results: The experimental data consists of clinical CT images obtained from the Rotterdam CT repository leading to 600 coronary segments and subsequent 15786 cross-sectional images. According to the results, the proposed method quantified coronary vessel stenosis i.e. severity of the non-calcified plaque with an overall accuracy of 83%. Moreover, for individual grading, the proposed model show promising results with accuracy equal to 86%, 90% and 79% respectively for severe, moderate and mild stenosis. The stenosis grading performance of the proposed model was further validated by performing lumen-area versus wall-thickness analysis as per annotations of manual experts. The statistical results for lumen area analysis precisely correlates with the quantification performance of the model with a mean deviation of 5% only. Conclusion: The overall results demonstrates capability of the proposed model to grade the vessel stenosis with reasonable accuracy and precision equivalent to human experts

Non-calcified plaque-based coronary stenosis grading in contrast enhanced CT

Background The high mortality rate associated with coronary heart disease has led to state-of-the-art non-invasive methods for cardiac diagnosis including computed tomography and magnetic resonance imaging. However, stenosis computation and clinical assessment of non-calcified plaques has been very challenging due to their ambiguous intensity response in CT i.e. a significant overlap with surrounding muscle tissues and blood. Accordingly, this research presents an approach for computation of coronary stenosis by investigating cross-sectional lumen behaviour along the length of 3D coronary segments. Methods Non-calcified plaques are characterized by comparatively lower-intensity values with respect to the surrounding. Accordingly, segment-wise orthogonal volume was reconstructed in 3D space using the segmented coronary tree. Subsequently, the cross sectional volumetric data was investigated using proposed CNN-based plaque quantification model and subsequent stenosis grading in clinical context was performed. In the last step, plaque-affected orthogonal volume was further investigated by comparing vessel-wall thickness and lumen area obstruction w.r.t. expert-based annotations to validate the stenosis grading performance of model. Results The experimental data consists of clinical CT images obtained from the Rotterdam CT repository leading to 600 coronary segments and subsequent 15786 cross-sectional images. According to the results, the proposed method quantified coronary vessel stenosis i.e. severity of the non-calcified plaque with an overall accuracy of 83%. Moreover, for individual grading, the proposed model show promising results with accuracy equal to 86%, 90% and 79% respectively for severe, moderate and mild stenosis. The stenosis grading performance of the proposed model was further validated by performing lumen-area versus wall-thickness analysis as per annotations of manual experts. The statistical results for lumen area analysis precisely correlates with the quantification performance of the model with a mean deviation of 5% only. Conclusion The overall results demonstrates capability of the proposed model to grade the vessel stenosis with reasonable accuracy and precision equivalent to human experts

Diversity of freshwater fish in the lower reach of indus river, sindh province section, pakistan

According to reports, the last comprehensive fish records from the Indus River were published in 1977. Although few recent studies have been conducted, they are limited to some confined localities, and hence there was a gap of comprehensive fish diversity analysis of the Indus River in Sindh province section. Therefore, the present investigation was performed to describe the fish fauna of the Indus River from its northern to its southern extremities. In order to establish fish diversity and distribution, the study was accomplished from June 2016 to May 2017 covering 8 sampling locations across the river. A total of 44 fish species, belonging to 35 genera, included in 18 families, and 9 orders were recorded. Family Cyprinidae was the most specious with 13 species followed by Bagridae and Cichlidae with 4 species each, and Siluridae with3 species. Alpha Diversity Indices study showed that the ichthyofauna diversity of the River was not high in comparison with previous studies. Shannon\u2019s index for the whole Indus River locations was 0.95 and the evenness index was 0.77. Sustained populations of exotic fish species were shown to have established in the Indus River