Estimation of organ absorbed dose in pediatric chest X-ray examination: a phantom study

Children have a greater risk of developing lifetime cancer and other biological effects from ionizing radiation exposure than adults. The aim of this study was to measure the absorbed dose received by lungs and heart in pediatric chest X-ray examination using nanoDot optically stimulated luminescent dosimeter (OSLD). The X-ray system, Siemens Multix Top was used. A pediatric phantom developed by using beeswax and polyurethane foam was exposed at 50 kVp, 52 kVp, 55 kVp, 57 kVp and 60 kVp, with fixed tube current-exposure time (3 mAs), which is normally used in pediatric clinical chest X-ray examinations. The nanoDot OSLDs were placed in different parts in the thorax of the phantom according to the position of organs in the chest area, which are lungs and heart. For lungs, absorbed dose measurement nanoDot OSLDs were placed in the apex and base at three different depths. The phantom was exposed three times for each kVp value, and the absorbed doses were measured in mGy. The findings show that the measured absorbed dose to the heart increased with the increase in kVp. Overall, a 22% increase in absorbed dose to heart and a 29% increase in lungs with the increase in kVp was recorded. In addition, absorbed dose to the base of left and right lungs was recorded higher up to 9% as compared to the apex of lungs. In conclusion, the absorbed dosage increases with exposure, while the absorbed dose decreases with depth. It is necessary for the radiographer to select an appropriate exposure setting based on the physical characteristics of the pediatric patient

Cognitive healthcare system and its application in pill-rolling assessment

Directional antennas have been extensively used in wireless sensor networks (WSNs) for various applications. This work presents the application of a four‐beam patch antenna as a sensor node to assess the pill‐rolling effect in Parkinson disease. The four‐beam patch is small in size, highly directive, and can suppress the multipath fading encountered in indoor settings that adversely affects the measurements. The pill‐rolling effect refers to tremors in the hands, particularly in the forefinger and the thumb, which the patient involuntary rubs together. The core idea is to develop a low‐cost framework that effectively evaluates the particular movement disorder to assist doctors or clinicians in carrying out an objective assessment using the S‐band sensing technique leveraging small wireless devices operating at 2.4 GHz. The proposed framework uses the perturbations in amplitude and phase information to efficiently identify tremors and nontremors experienced in the fingers. The unique imprint induced by each body motion is used to determine the particular body motion disorder. The performance of the framework is evaluated using the support vector machine algorithm. The results indicate that the framework provides high classification accuracy (higher than 90%)

Portable UWB RADAR Sensing System for Transforming Subtle Chest Movement into Actionable Micro-Doppler Signatures to Extract Respiratory Rate Exploiting ResNet Algorithm

Contactless or non-invasive technology for the monitoring of anomalies in an inconspicuous and distant environment has immense significance in health-related applications, in particular COVID-19 symptoms detection, diagnosis, and monitoring. Contactless methods are crucial specifically during the COVID-19 epidemic as they require the least amount of involvement from infected individuals as well as healthcare personnel. According to recent medical research studies regarding coronavirus, individuals infected with novel COVID-19-Delta variant undergo elevated respiratory rates due to extensive infection in the lungs. This appalling situation demands constant real-time monitoring of respiratory patterns, which can help in avoiding any pernicious circumstances. In this paper, an Ultra-Wideband RADAR sensor “XeThru X4M200” is exploited to capture vital respiratory patterns. In the low and high frequency band, X4M200 operates within the 6.0-8.5 GHz and 7.25-10.20 GHz band, respectively. The experimentation is conducted on six distinct individuals to replicate a realistic scenario of irregular respiratory rates. The data is obtained in the form of spectrograms by carrying out normal (eupnea) and abnormal (tachypnea) respiratory. The collected spectrogram data is trained, validated, and tested using a cutting-edge deep learning technique called Residual Neural Network or ResNet. The trained ResNet model’s performance is assessed using the confusion matrix, precision, recall, F1-score, and classification accuracy. The unordinary skip connection process of the deep ResNet algorithm significantly reduces the underfitting and overfitting problem, resulting in a classification accuracy rate of up to 90%

Near complete aortic transection and its successful repair using a novel cardiopulmonary bypass technique

Abstract The case of a 38-year old female, victim of a road traffic accident who presented with a near complete aortic transection is presented. An emergent repair employing cardiopulmonary bypass was attempted in the operating room. Anticipating a high-risk of compromise to cerebral perfusion from air micro-emboli, the bypass was attempted with an innovative approach involving the successful cannulation of the pulmonary artery and descending aorta. The patient survived and was found to be doing well on subsequent post-operative visits

Search for magnetoelectric monopole response in Cr\u3csub\u3e2\u3c/sub\u3eO\u3csub\u3e3\u3c/sub\u3e powder

Powder samples have been suggested as a pathway to fabricate isotropic magnetoelectric (ME) materials which effectively only have a pseudoscalar or monopole ME response. We demonstrate that random distribution of ME grains alone does not warrant isotropic ME response because the activation of a nonvanishing ME response requires a ME field cooling protocol which tends to induce preferred axes.We investigate the evolution of ME susceptibility in powder chromia samples for various ME field cooling protocols both theoretically and experimentally. In particular, we work out the theoretical expressions for ME susceptibility for powder chromia in the framework of statistical mechanics where Boltzmann factors weigh the orientation of the Néel vector relative to the local orientation of the c axis of a grain. Previous approximations oversimplified the thermodynamic nature of the annealing process giving rise to misleading conclusions on the role of the magnitude of the applied product of electric and magnetic fields on the ME response. In accordance with our refined theory, a strong dependence of the functional form of α vs T of chromia powders on the ME field cooling protocol is observed. It shows that chromia powder is not generically an isotropic ME effective medium but provides a pathway to realize the elusive isotropic ME response

Wilson\u27s disease: experience at a tertiary care hospital.

Wilson\u27s disease (WD) is a rare autosomal recessive disorder of copper metabolism. Data regarding WD is not available from Pakistan. A cross-sectional study was conducted at The Aga Khan University Hospital, Karachi, and all patients admitted with primary and secondary diagnosis of Wilson\u27s disease were added. A total of 47 patients were seen; 68% (n = 32) were male. The mean age was 26.6 ± 9.97 years. Most of the patients presented with hepatic, (n = 22, 46.8%), neurological, (n = 17, 36.2%) and psychiatric (n = 8, 17%) symptoms. Mean ceruloplasmin level was 0.17 ± 0.13 g/dl; it was \u3c 0.25 g/dl in 39 (86.6%) patients. Serum copper (Cu) was reduced in 32 (68.1%) patients and 24-hr-urinary Cu was raised in 22 (47.6%) patients. Slit lamp examination for Kayser-Fleischer (KF) rings was done on 15 (31.9%) patients and 9 (60%) of them had KF rings. Mean serum aspartate transaminase (AST) / alanine transaminases (ALT) ratio was 1.92 and median alkaline phosphatase / total bilirubin ratio was 79.30 (IQR 35.05; 166.50)

Low dose albumin for the prevention of renal impairment following large volume paracentesis in cirrhosis.

OBJECTIVES: To evaluate the effect of low dose Albumin i.e. 4 grams per litre of ascitic fluid after large volume paracentesis (LVP) for the prevention of paracentesis induced circulatory dysfunction (PICD) related renal impairment in cirrhosis. METHODS: Case records of all patients with cirrhosis who underwent LVP from January 12(th), 2011 till December 29(th), 2013 were reviewed. Patients were excluded if they had spontaneous bacterial peritonitis, creatinine \u3e1.5 mg/dl, hepatoma or if volume of ascitic fluid removed was \u3c5 litres. Data including age, gender, cause of cirrhosis, CTP score and volume of ascitic fluid drained were noted. In addition serum creatinine and serum sodium at baseline and one week post paracentesis were recorded. RESULTS: Two hundred and fourteen patients with cirrhosis underwent LVP during the study period. One hundred and thirty nine patients met the inclusion criteria and were analyzed. Patients were divided into two groups based on the amount of albumin given. The amount of albumin given was 25 grams and 50 grams while the volume of ascitic fluid removed were 6.2±1 litres and 10.4±1.5 litres in groups A and B respectively. One hundred and eight patients were in group A while thirty one patients were in group B respectively. Both groups received albumin at a dose of 4 grams per litre of ascitic fluid removed. Mean age in both groups were 53 years. Hepatitis C was the commonest etiology in both the groups, followed by Hepatitis B. More than 70% patients in both the groups were in child class C. Serum creatinine at baseline and one week post LVP was 1.04±0.24 mg/dl and 1.07±0.35 mg/dl in GROUP A while 1.11±0.23 mg/dl and 1.41±0.94 mg/dl in GROUP B. (P value 0.35). Similarly, serum sodium at baseline and one week post LVP was 130 ±5.6 meq/lit and 129.6±5.9 meq/lit in GROUP A while 127.6±5.8 meq/lit and 128±6.2 meq/lit in GROUP B respectively. (P value 0.14). CONCLUSION: This study suggests that 4 grams of albumin per litre of ascitic fluid drained is effective in preventing the PICD related renal impairment following large volume paracentesis in cirrhosis

LAPAROSCOPIC CHOLECYSTECTOMY: OUTCOME OF FIRST 202 CASES IN A DISTRICT HOSPITAL IN GILGIT

BACKGROUND: The incidence of gall stone disease is on the rise in Gilgit Baltistan. The objectives of the study were to assess the outcome of laparoscopic cholecystectomy in terms of conversion rate and postoperative morbidity, in The Aga Khan Medical Centre Gilgit. METHODS: It was descriptive case series. All patients that underwent laparoscopic cholecystectomy between June 2009 to May 2014 were included. The data was collected prospectively. Demographic features, operative time, and hospital stay were studied. Postoperative complications were documented and evaluated according to outcome measures (bile duct injuries, morbidity, mortality, conversion rates, wound infections). RESULTS: A total of 202 consecutive patients were enrolled with a mean age of 49±15 years. There were 164 (81%) female and 38(19%.) male patients. Twenty nine (15%) patients had hypertension, 51 (25%) patients had diabetes mellitus as comorbid conditions. The mean operative time was 54±21 minutes. The operative time was longer in 52 (26%) patients. Three patients (1.5%) required conversion to open cholecystectomy due to obscured anatomy in the area of Calot\u27s triangle, and empyema gallbladder. The mean hospital stay was 2±0.7 days. No common bile duct injury, solid organ or bowel injury occurred in this study. The mean follow up duration was 30±15 months. Postoperative complications include, port site infection in 8 (2%) patient, chest infection in 5 (2.4%) patients, and one (0.5%) patient had myocardial infarction. There was no mortality reported in this group of patients. CONCLUSION: Laparoscopic cholecystectomy is a safe procedure with advantages of decreased wound infection, less pain, decreased hospital stay, and early recovery

catena-Poly[[diaqua­calcium]bis­[μ-2-(1,3-dioxoisoindolin-2-yl)acetato]-κ3 O,O′:O;κ3 O:O,O′]

In the title complex, [Ca(C10H6NO4)2(H2O)2]n, the CaII atom lies on a twofold rotation axis and adopts a dodeca­hedral geometry. The CaII atom is octa­coordinated by two O atoms from two water mol­ecules and six O atoms from four acetate ligands. Each acetate acts as a tridentate ligand bridging two CaII atoms, resulting in a chain running along the c axis. O—H⋯O and C—H⋯O hydrogen bonds connect the chains into a two-dimensional network parallel to [011]. π–π inter­actions between adjacent isoindoline-1,3-dione rings [centroid–centroid distance = 3.4096 (11) Å] further consolidate the structure. One of the carboxylate O atoms is disordered over two sites in a 0.879 (12):0.121 (12) ratio