Empirical Evaluation of Pre-Trained Deep Learning Networks for Pneumonia Detection

Pneumonia is a significant global health issue, characterized by a substantial mortality risk, impacting a vast number of individuals on a global scale. The quick and precise identification of pneumonia is crucial for the optimal treatment and management of this condition. This research work aims to answer the pressing need for precise diagnostic methods by using two advanced deep learning models, namely VGG19 and ResNet50, for the purpose of pneumonia detection in chest X-ray pictures. Furthermore, the present area of research is on the use of deep learning methodologies in the domain of medical image analysis, namely in the identification of pneumonia cases via the examination of chest X-ray images. The study challenge pertains to the pressing need for accurate and automated pneumonia diagnosis to assist healthcare professionals in making timely and educated judgements. The VGG19 and ResNet50 models were trained and assessed using the comprehensive RSNA Pneumonia dataset. In order to enhance their performance in the classification of chest X-ray pictures as either normal or pneumonia-affected, the models underwent rigorous training and meticulous fine-tuning. Based on the results obtained from our investigation, it was seen that the VGG19 model exhibited a notable accuracy rate of 93\%, surpassing the ResNet50 model's accuracy of 84\%. Furthermore, it is worth noting that both models demonstrated a notable level of precision, recall, and f1-scores in the identification of normal and pneumonia patients. This indicates their potential for accurately classifying such instances. Furthermore, our research findings indicate that deep learning models, namely VGG19, have a high level of efficacy in reliably detecting pneumonia via the analysis of chest X-ray pictures. These models has the capacity to function as helpful tools for expediting and ensuring the precise identification of pneumonia by healthcare practitioners

Relationship between vitamin B12, folate and homocysteine levels and H. Pylori infection in patients with functional dyspepsia: a cross-section study

Background H. pylori infection has been associated with many micronutrient deficiencies. There is a dearth of data from communities with nutritional deficiencies and high prevalence of H. pylori infection. The aim of this study was to determine the impact of H. pylori infection on serum levels of vitamin B12, folate and homocysteine in patients with functional dyspepsia (FD). Methods One hundred and thirty-two patients with FD undergoing gastroscopy were enrolled. The serum was analyzed for B12, folate and homocysteine levels before gastroscopy. H. pylori infection was diagnosed by histopathological examination of gastric biopsies and urea breath test. An independent sample t-test and the Mann–Whitney test were used to compare mean serum concentrations of biomarkers between H. pylori-positive and H. pylori-negative groups of patients. A Chi-square test was performed to assess the differences among proportions, while Spearman’s rho was used for correlation analysis between levels of B12 and homocysteine. Results The mean age of the group was 40.3 ± 11.5 (19–72) years. Folate deficiency was seen in 43 (34.6%), B12 deficiency in 30 (23.1%) and hyperhomocysteinemia in 60 (46.2%) patients. H. pylori was present in 80 (61.5%) patients with FD while it was absent in 50 (38.5%). Mean serum levels of B12, folate and homocysteine in the H. pylori-positive group of patients were not significantly different from the levels in the H. pylori-negative group (357 ± 170 vs. 313 ± 136 pg/mL; p = 0.13), (4.35 ± 1.89 vs. 4.42 ± 1.93 ng/mL; p = 0.84); (15.88 ± 8.97 vs. 16.62 ± 7.82 μmol/L; p = 0.24); respectively. B12 deficiency (≤200 pg/mL) was 23.8% in the H. pylori-positive patients versus 22.0% in the H. pylori-negative patients. Folate deficiency (≤3.5 ng/mL) was 33.8% in the H. pylori-positive group versus 36% in the H. pylori-negative group. Hyperhomocysteinemia (\u3e15 μmol/L) was present in 46.2% of H. pylori-positive patients compared to 44% in the H. pylori-negative group. Correlation analysis indicated that serum B12 levels were inversely associated with serum levels of homocysteine in patients with FD (rho = −0.192; p = 0.028). Conclusions This study demonstrated an inverse relationship between serum levels of B12 and homocysteine in patients with FD. Moreover, no impact of the presence of H. pylori was found on B12, folate and homocysteine levels in such patients

Model for end-stage liver disease (MELD) score as a useful prognostic marker in cirrhotic patients with infection

OBJECTIVE: To determine the association of Model for End stage liver disease (MELD) score to the outcome of cirrhotic patients with bacterial infection and to compare it with Child-Turcott-Pugh (CTP) score. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, from January 2005 to December 2007. METHODOLOGY: Patients with diagnosis of liver cirrhosis and bacterial infection were included. Demographic features, laboratory data and type of infection were recorded. Multiple logistic regression assays were applied to determine the factors associated with poor outcome in cirrhotics with infection. Receiver-Operating Characteristics (ROC) were used to determine the cut-off values of CTP score and MELD score with the best sensitivity and specificity. RESULTS: A total of 530 patients, 313 male (59%) with a mean age of 53 +/- 13 years were analyzed. Spontaneous bacterial peritonitis was the predominant infection seen in 369 (69%) patients. One hundred and eighty six (35%) patients died. Factors associated with poor outcome were a CTP score of more than 11 (p=0.001), raised blood urea nitrogen (p=0.020), raised creatinine (p=0.004), shock (p=0.002), and MELD score \u3e 22 (p=0.03). An eight percent increase in mortality rate was noticed with every one point rise in MELD score above 22. ROC curve showed that the specificity of CTP and MELD score to predict poor outcome in these patients was 36% and 59% respectively. CONCLUSION: Child-Turcott-Pugh score more than 11, raised BUN and creatinine, shock and high MELD score were poor prognostic markers in cirrhotic patients with infection. MELD score had better specificity than CTP score in determining outcome

Frequency and characteristic features of portal hypertensive gastropathy in patients with viral cirrhosis.

To determine the frequency and specific characteristic features of portal hypertensive gastropathy (PHG) in cirrhosis due to viral etiology. Cross-sectional descriptive study. The Aga Khan University Hospital, Karachi, from June 2006 till June 2008. Patients with hepatitis B and C cirrhosis were included who underwent screening esophago-gastroduodenoscopy (EGD) for varices. Baveno III consensus statement was used for diagnosing PHG on endoscopy and divided them into two subgroups i.e. mild and severe. Data related to platelet/spleen ratio, MELD score and Child Turcotte Pugh (CTP) score indicating severity of cirrhosis were recorded in all patients. Findings were compared by using independent sample t-test. Out of 360 patients who underwent screening EGD, 226 (62.8%) were males. Two hundred and eighty one (78%) had hepatitis C while 79 (22%) suffered from hepatitis B related cirrhosis. Three hundred patients (83.3%) had PHG while 71 (24%) had severe PHG. Higher proportion of esophageal varices (89.7%) was present among those who had PHG (p \u3c 0.001). On univariate analysis lower platelet counts (11755 vs. 16790; p \u3c 0.001), increased spleen size (14.12.9 cm vs. 122.4cm; p \u3c 0.001) were found in PHG patients as compared to those without it. Similarly, lower platelet/spleen ratio was noted in patients with severe PHG (916400 vs. 1477899; p \u3c 0.001). Furthermore, on multivariate analysis CTP score \u3e 8 MELD score \u3e 12 and platelets/spleen ratio \u3c 900 were significantly associated factors with severe PHG. Frequency of PHG was 83% while severe PHG was seen in 24% cases of viral hepatic cirrhosis. MELD score \u3e 12, CTP score 8 and platelets/spleen ratio \u3c 900 were significant factors of severe PHG

Flipped Publishing: A New Paradigm for Medical Textbooks

Medical textbooks remain an integral component of the undergraduate education pathway. These texts are traditionally prepared by senior clinicians or academics, based on their long experience of the subject matter. Medical students and junior doctors are commonly asked to review these books, but often have little role in influencing the content. This article will discuss the opening of a new paradigm in medical publishing, whereby students and junior doctors (juniors) take the lead in planning and producing the content of their textbooks with senior clinicians taking the role of reviewer.

Prevalence and type distribution of high-risk Human Papillomavirus (HPV) in breast cancer : a Qatar based study

Human papillomavirus (HPV) has been implicated in the etiology of a variety of human cancers. Studies investigating the presence of high-risk (HR) HPV in breast tissue have generated considerable controversy over its role as a potential risk factor for breast cancer (BC). This is the first investigation reporting the prevalence and type distribution of high-risk HPV infection in breast tissue in the population of Qatar. A prospective comparison blind research study herein reconnoitered the presence of twelve HR-HPV types’ DNA using multiplex PCR by screening a total of 150 fresh breast tissue specimens. Data obtained shows that HR-HPV types were found in 10% of subjects with breast cancer; of which the presence of HPV was confirmed in 4/33 (12.12%) of invasive carcinomas. These findings, the first reported from the population of Qatar, suggest that the selective presence of HPV in breast tissue is likely to be a related factor in the progression of certain cases of breast cancer

Targeting cancer signaling pathways by natural products: Exploring promising anti-cancer agents

Cancer is one of the leading causes of death and significantly burdens the healthcare system. Due to its prevalence, there is undoubtedly an unmet need to discover novel anticancer drugs. The use of natural products as anticancer agents is an acceptable therapeutic approach due to accessibility, applicability, and reduced cytotoxicity. Natural products have been an incomparable source of anticancer drugs in the modern era of drug discovery. Along with their derivatives and analogs, natural products play a major role in cancer treatment by modulating the cancer microenvironment and different signaling pathways. These compounds are effective against several signaling pathways, mainly cell death pathways (apoptosis and autophagy) and embryonic developmental pathways (Notch pathway, Wnt pathway, and Hedgehog pathway). The historical record of natural products is strong, but there is a need to investigate the current role of natural products in the discovery and development of cancer drugs and determine the possibility of natural products being an important source of future therapeutic agents. Many target-specific anticancer drugs failed to provide successful results, which accounts for a need to investigate natural products with multi-target characteristics to achieve better outcomes. The potential of natural products to be promising novel compounds for cancer treatment makes them an important area of research. This review explores the significance of natural products in inhibiting the various signaling pathways that serve as drivers of carcinogenesis and thus pave the way for developing and discovering anticancer drugs.This study was supported by Sidra Medicine Precision Program funding to Ajaz A. Bhat (5081012003) and Mohammad Haris (5081012002)

Salvage of failed Swanson’s arthroplasty of the distal interphalangeal joint

Dear Editor, Silicone  interposition arthroplasty may provide pain relief for patients with  distal interphalangeal joint (DIPJ) arthritis who wish to preserve joint  movement (Neukom et al., 2020), with reported failure rates ranging from 4.7% to 9.6% (Sierakowski et al., 2012).  Conversion to arthrodesis after failed DIPJ arthroplasty has been  reported in 5% to 13% of patients. There is no established technique for  DIPJ arthrodesis in such cases (Neukom et al., 2020; Sierakowski et al., 2012). We present our approach and the results in six patients. Access to the DIPJ is achieved using a dorsal H-shaped incision (Figure 1).  Preparation of the middle and distal phalangeal canals using a Mitchell  trimmer (Orthocare, Shipley, UK) provides healthy bone for the  structural corticocancellous distal radial bone graft; this is harvested  from the distal radius via the third extensor compartment, preserving  the distal extensor retinaculum. The bone graft is designed as a block  with proximal and distal triangular extensions (Figure 1).  A 0.9 mm Kirschner wire is used to create multiple holes around the  marked bone graft, followed by completion using a sagittal bone saw. The  bone graft can be elevated using a Mitchell trimmer. Further cancellous  bone graft is then harvested. The proximal extension of the  corticocancellous bone graft is inserted into the middle phalanx, and  the distal phalanx is then distracted to facilitate insertion of the  distal extension; bony compression is achieved as the distal phalanx is  released. Fixation is achieved using an axial 1.0 mm Kirschner wire,  supplemented with a 0.4 mm cerclage wire loop with the ends folded down  onto the dorsum of the graft; this prevents cerclage wire protrusion (Figure 2).  Cancellous graft may then be packed over the dorsum of the structural  bone graft and the extensor tendon repaired to cover the cerclage wire  ends. The longitudinal Kirschner wire is cut below the surface of the  skin (Figure 2)...</p