Residual balanced attention network for real-time traffic scene semantic segmentation

Intelligent transportation systems (ITS) are among the most focused research in this century. Actually, autonomous driving provides very advanced tasks in terms of road safety monitoring which include identifying dangers on the road and protecting pedestrians. In the last few years, deep learning (DL) approaches and especially convolutional neural networks (CNNs) have been extensively used to solve ITS problems such as traffic scene semantic segmentation and traffic signs classification. Semantic segmentation is an important task that has been addressed in computer vision (CV). Indeed, traffic scene semantic segmentation using CNNs requires high precision with few computational resources to perceive and segment the scene in real-time. However, we often find related work focusing only on one aspect, the precision, or the number of computational parameters. In this regard, we propose RBANet, a robust and lightweight CNN which uses a new proposed balanced attention module, and a new proposed residual module. Afterward, we have simulated our proposed RBANet using three loss functions to get the best combination using only 0.74M parameters. The RBANet has been evaluated on CamVid, the most used dataset in semantic segmentation, and it has performed well in terms of parameters’ requirements and precision compared to related work

The Prevalence of Hypomagnesemia in Critically Ill Patients Admitted in Medically Intensive Care Unit

Background Magnesium is the fourth most abundant cation in the human body. Hypomagnesemia can result from decreased intake, redistribution of magnesium from the extracellular to the intracellular space, or increased renal or gastrointestinal loss. Hypomagnesemia can cause severe outcomes in ill patients. So, we conducted this study to determine the frequency of hypomagnesemia in critically ill medical patients. Methods This is a Descriptive cross-sectional study involving 120 patients admitted in the medical intensive care unit (MICU) of the Holy Family Hospital, Rawalpindi, Pakistan. The study was conducted from July 2020 to September 2021. About 1 ml sample of blood was taken from each patient included and sent to the hospital laboratory for evaluation of serum magnesium levels. All the collected data was entered and analyzed on SPSS v. 23. A p-value of ≤ 0.05 was taken significant. Results In our study, the mean age of the patients was 42.76±12.77 years, and the male-to-female ratio of the patients was 1:1. The mean value of the APACHE II score of the patients was 29.68±2.571. Hypomagnesemia was found in 28 (23.33%) patients. Conclusion According to our study, the frequency of hypomagnesemia in critically ill medical patients was 23.33% (28 patients)

Short-term adverse effects of COVID-19 vaccines after the first, second, and booster doses : a cross-sectional survey from Punjab, Pakistan, and the implications

Safety and efficacy concerns regarding coronavirus disease 2019 (COVID-19) vaccines are common among the public and have a negative impact on their uptake. We aimed to report the adverse effects currently associated with the vaccine in Pakistan to build confidence among the population for its adoption. A cross-sectional study was conducted in five districts of the Punjab province of Pakistan between January and March 2022. The participants were recruited using convenience sampling. All data were analyzed using SPSS 22. We recruited 1622 people with the majority aged between 25-45 years. Of these, 51% were female, including 27 pregnant women and 42 lactating mothers. Most participants had received the Sinopharm (62.6%) or Sinovac (17.8%) vaccines. The incidences of at least one side effect after the first (N = 1622), second (N = 1484), and booster doses (N = 219) of the COVID-19 vaccine were 16.5%, 20.1%, and 32%, respectively. Inflammation/erythema at the injection site, pain at the injection site, fever, and bone/muscle pain were common side effects of vaccination. No significant differences were observed in the adverse effect scores between all demographic variables except for pregnancy (P = 0.012) after the initial dose. No significant association was observed between any variable and the side effect scores of the second and booster doses of the vaccine. Our study showed a 16-32% prevalence of self-reported side effects after the first, second, and booster COVID-19 vaccinations. Most adverse effects were mild and transient, indicating the safety of different COVID-19 vaccines

Rectovaginal Fistula Due to an Erosive Pessary: A Case Report

Background: Pelvic organ prolapse (POP) occurs when pelvic organs protrude through the vagina due to displacement from their normal anatomic position, as a result of a weakening of the pelvic muscles. Pessaries have long been used to treat POP, but they may result in rectovaginal fistulas as a rare complication. The Case: We report a rare case of a rectovaginal fistula following vaginal ring pessary use in an 82-year-old G7P7 woman. She had a past medical history of bipolar disorder, and initially presented for nursing care and psychiatric support. A trained psychologist evaluated her, and found no psychological morbidity. A two-day history of a fall, diffuse abdominal pain, and chronic urinary incontinence were rather identified. Gynecological pelvic examination revealed a rectovaginal fistula and impacted stools in the vagina. Conclusion: The use of ring pessaries, though a conservative management option for POP, may lead to a rectovaginal fistula, a rare but severe complication

National hepatitis registry in Pakistan: a dire need for hepatitis surveillance and control

Abstract Hepatitis is a major public health issue in Pakistan, with an estimated 11.55% prevalence of HCV infection in the adult population. The country ranks second globally in terms of hepatitis C virus (HCV) infections, with approximately one in every 20 Pakistanis already infected. The mortality rates due to HBV and HCV stand at 563,000 and 366,000 annually, respectively. However, the absence of a national registry or database system and the lack of coordination among provinces pose significant obstacles in combating this disease effectively. To address this issue, the establishment of a centralized national database registry is crucial, allowing comprehensive analysis, tracking of hepatitis prevalence, and identification of high-risk areas for targeted interventions. By fostering collaboration among provinces, the government, and non-governmental organizations, the registry would facilitate joint decision-making, minimize duplication of efforts, and address inconsistencies in diagnosis and treatment. Collaborating with student-run organizations and leveraging enhanced laboratory capacities post-COVID era can strengthen the hepatitis control program. The centralized approach and unified efforts are necessary to achieve the goal of a hepatitis-free Pakistan, where a healthier future can be realized

Comparison of Primary Simple Closure and Limberg Flap Technique in Pilonidal Sinus

Introduction Pilonidal sinus is a disease affecting the intergluteal region. Many surgical techniques have been described for the treatment of this condition. The objective of this study was to compare Limberg flap technique and primary simple closure in terms of postoperative discharge. Materials and methods It was a randomized prospective study conducted at the Department of Surgery—removed for blind review-- from December 2018 to June 2021. Sixty male patients aged 15-30 years presenting with pilonidal sinus for the first time were included in the study. Patients with comorbidities and the American Society of Anesthesiologists (ASA) class three and above were excluded from the study. Patients were divided into two groups by lottery method. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 23.0. Chi-square tests were applied. A p-value of ≤ 0.05 was considered significant. Results The postoperative discharge was found in just five (16.3%) of the patients in group A (Limberg flap technique), while the discharge was present in 12 (40%) of the patients in group B (primary simple closure; p = 0.045). Conclusion Limberg flap technique is superior to primary simple closure in terms of postoperative discharge

Psychological factors related to professional examinations and their association with sleep quality among Medical students

Background: In our country, medical education is considered a challenging, tough, and stressful process, which is significantly associated with depression, anxiety, and stress, particularly during exam seasons, adversely affecting the sleep quality of medical students. The objective of our study is to evaluate the depression, anxiety and stress levels, and determine their impact on sleep quality of medical students during exams. Materials and Methods: It was a descriptive cross-sectional study involving 391 students of Rawalpindi Medical University. Data was collected through a questionnaire. The questionnaire consisted of (1) socio-demographic details, (2) Depression, Anxiety and Stress Scale-21(DASS-21), (3) The Pittsburgh Sleep Quality Index (PSQI). Chi-square and t-tests were applied taking P<0.05 as significant. Spearman rho test was applied to measure the strength of association. Data analysis was done via (SPSS) v.23.0. Results: Out of 391 students, 197 (50.4%) were female while 194 (49.6%) were male. The mean age was 21.63 years (SD=1.59). Fourth-year students (n=117, 29.9%) formed the majority of the participants followed by final-year 108(27.6%), second-year 94 (24%), and third-year 72 (18.4%). 167(42.71%) students suffered from depression, 50.4% from anxiety and 351(89.8%) from stress. Quality of sleep was poorest (PSQI>5) in second-year students with a mean value of 9.72 for global sleep quality. Quality of sleep was significantly associated with anxiety and depression. Conclusion: Depression, anxiety, and stress are common among second as well as third-year students. Second-year students have the poorest quality of sleep. The sleep quality is significantly associated with anxiety and depression

Analysis of risk factors and prognostic factors of brain metastasis in gastric cancer: a surveillance, epidemiology and end-results database study

Abstract Brain metastasis in gastric cancer (GC) patients is a rare phenomenon that is associated with adverse clinical outcomes and poor survival rates. We conducted a retrospective cohort study to investigate the incidence, risk factors and prognostic factors of brain metastasis in GC patients. Data on sociodemographic and tumor characteristics of GC patients from 2010 to 2019 was extracted from the Surveillance, Epidemiology and End-Results (SEER) database. Descriptive statistics, multivariable logistic and Cox regression were applied on SPSS. Kaplan–Meier-Survival curves and ROC curves were constructed. A total of 59,231 GC patients, aged 66.65 ± 13.410 years were included. Brain metastasis was reported in 368 (0.62%) patients. On logistic regression, the risk of brain metastasis was significantly greater in males, patients aged < 60 years and patients having concurrent bone and lung metastasis. High grade and high N stage were significant risk factors for development of brain metastasis. Patients who had undergone surgery for the primary tumor were at reduced risk for brain metastasis (adjusted odds ratio 0.210, 95% CI 0.131–0.337). The median OS was 3 months in patients with brain metastasis and 17 months in patients without brain metastasis (p < 0.05). On Cox regression, Grade IV tumors and primary antral tumors were significant predictable parameters for poor prognosis. Overall Survival (OS) and Cancer-Specific Survival (CSS) were prolonged in patients who had undergone surgery. Brain metastasis in gastric cancer is associated with significantly worse survival. Employing large-scale screening for high-risk patients holds a promising impact to improve survival rates, but it must be accurately balanced with a comprehensive understanding of clinicopathological aspects for accurate diagnosis and treatment