Improving radiologists’ and orthopedists’ QoE in diagnosing lumbar disk herniation using 3D modeling

This article studies and analyzes the use of 3D models, built from magnetic resonance imaging (MRI) axial scans of the lumbar intervertebral disk, that are needed for the diagnosis of disk herniation. We study the possibility of assisting radiologists and orthopedists and increasing their quality of experience (QoE) during the diagnosis process. The main aim is to build a 3D model for the desired area of interest and ask the specialists to consider the 3D models in the diagnosis process instead of considering multiple axial MRI scans. We further propose an automated framework to diagnose the lumber disk herniation using the constructed 3D models. We evaluate the effectiveness of increasing the specialists QoE by conducting a questionnaire on 14 specialists with different experiences ranging from residents to consultants. We then evaluate the effectiveness of the automated diagnosis framework by training it with a set of 83 cases and then testing it on an unseen test set. The results show that the the use of 3D models increases doctors QoE and the automated framework gets 90% of diagnosis accuracy

Lumbar disk 3D modeling from limited number of MRI axial slices

This paper studies the problem of clinical MRI analysis in the field of lumbar intervertebral disk herniation diagnosis. It discusses the possibility of assisting radiologists in reading the patients MRI images by constructing a 3D model for the region of interest using simple computer vision methods. We use axial MRI slices of the lumbar area. The proposed framework works with a very small number of MRI slices and goes through three main stages. Namely, the region of interest extraction and enhancement, inter-slice interpolation, and 3D model construction. We use the Marching Cubes algorithm to construct the 3D model of the the region of interest. The validation of our 3D models is based on a radiologist’s analysis of the models. We tested the proposed 3D model construction on 83 cases and We have a 95% accuracy according to the radiologist evaluation. This study shows that 3D model construction can greatly ease the task of the radiologist which enhances the working experience. This leads eventually to more accurate and easy diagnosis process

Azygos Lobe: Prevalence of an Anatomical Variant and Its Recognition among Postgraduate Physicians

The right azygos lobe is a rare anatomical variant of the upper lung lobe that can be misdiagnosed as a neoplasm, a lung abscess, or a bulla. The aim of this study was to assess the prevalence of right azygos lobe and to evaluate the ability of postgraduate doctors to correctly identify right azygos lobe. We analyzed a total of 1709 axial thoracic multi-detector computed tomography (CT) images for the presence of an azygos lobe. Additionally, a paper-based survey was distributed among a sample of intern doctors and radiology and surgery residents, asking them to identify the right azygos lobe in a CT image and in an anatomy figure. Results showed that the prevalence of the right azygos lobe in the study sample was 0.88%. Men have more right azygos lobes than women. None of the intern doctors or surgery residents identified the right azygos lobe correctly, whereas more than half (57.1%) of the radiology residents did. Most of the incorrect answers about the CT scan were related to the bronchi (25.0%). The apex of the lung (17.7%) and the superior vena cava (17.7%) were the most common incorrect answers about the anatomy figure. In conclusion, the prevalence of the right azygos lobe in the current study is within the range of previously published literature. More education should be given for the identification of the right azygos lobe during anatomy and clinical teaching

COVID-19 - Knowledge, Attitude and Practice among Medical and Non-Medical University Students in Jordan

The World Health Organization declared COVID-19 as a pandemic on the 11th of March 2020. Since then, many efforts are being carried out to contain the virus. Knowledge and attitude of people should be directed towards strict preventive practices in order to halt the spread of the virus. The aim of the current cross-sectional study is to assess the knowledge, practice and attitude of university students from medical and non-medical colleges in Jordan using a structured questionnaire involving a total number of 592 students. A positive response regarding the overall knowledge about the symptoms of COVID-19 was observed in more than 90% of the students. In response to the attitude and practice, a good number of students nearly 99.7% agreed that hand washing is necessary for prevention of infection whereas 68.4% believed that mask wearing would prevent the infection. Around 6-7% students considered the virus as a stigma hence would not visit hospital. Also, around 10% students believed that their religious beliefs and body immunity might protect them from infection. More dangerously, 20.6% and 19.2% students believed antibiotics and smoking to be a protective measure against the infection respectively. Also, 96.8% do avoid hand shaking, 98.8% wash their hands and 93.3% use alcoholic rub, 95.8% cough or sneeze in a tissue and dispose it in waste bin, 51% will drink ginger with honey and 42.7% eat garlic for infection prevention. The main sources of knowledge were social media, internet and television. No significant difference was noticed between medical and non medical colleges. Thus, there is a need for more detailed and directed measures and awareness campaigns to improve the knowledge, attitude and practice in some critical aspects to contain the virus

The Use of 13C-Urea Breath Test for Non-Invasive Diagnosis of Helicobacter pylori Infection in Comparison to Endoscopy and Stool Antigen Test

Helicobacter pylori (H. pylori) can cause gastritis, peptic ulcer diseases and gastric carcinoma. Endoscopy as the gold standard method of diagnosis is an invasive procedure that might not be suitable in all scenarios. Therefore, this first study in Jordan aimed to assess the non-invasive 13C urea breath test (UBT) and stool antigen test for diagnosis of H. pylori infection and the successfulness of eradication therapy as alternatives for endoscopy. Hence, a total of 30 patients attending the endoscopy units at Alkarak teaching hospital were asked to complete a questionnaire with demographic and clinical data. They were then tested for H. pylori using 13C UBT and H. pylori stool antigen before having endoscopy. Another 30 patients who were positive for H. pylori by endoscopy were tested using both tests 6 weeks post eradication therapy. Results showed that the rate of H. pylori detection using endoscopy was 56.7% (17/30). Heartburns (82.3%, p value = 0.019), epigastric pain (88.2%, p value = 0.007) and vomiting (70.5%, p value = 0.02) were the most significant symptoms. Family history of peptic ulcer diseases was significantly associated with an increased risk for having a H. pylori positive result (p value = 0.02). Compared to endoscopy, the sensitivity of 13C UBT for the diagnosis of H. pylori was 94.1% (16/17), while it was 76.5% (13/17) for the stool antigen test. The specificity of both tests was equal (76.9%). However, the positive predictive and negative predictive values (84.2% and 90.9%) for 13C UBT were higher than those (81.3% and 71.4%) for the stool antigen test. The accuracy of 13C UBT was 86.7% compared to 76.7% for the stool antigen test. There was an 87% agreement (20 patients out of 23) between both tests when used to assess success of the eradication therapy. In conclusion, the 13C UBT was found to be more sensitive and accurate than the stool antigen test when used for diagnosis; furthermore, it has a comparable outcome to the stool antigen test in assessing the successfulness of the eradication treatment

Epidemiology of <i>Streptococcus pneumoniae</i> Serotypes in Jordan Amongst Children Younger than the Age of 5: A National Cross-Sectional Study

Introduction: Streptococcus pneumoniae infections are a major cause of mortality and morbidity worldwide. In Jordan, pneumococcal conjugate vaccines (PCVs) are not included in the national vaccination program. Due to the current availability of several PCVs, including PCV-10, PCV-13, and PCV-15, along with PCV-20, currently undergoing pediatric approvals globally, the decision to introduce PCVs and their selection should be based on valid local data on the common serotypes of Streptococcus pneumoniae. Methods: This cross-sectional study aimed to identify the frequency of serotypes of Streptococcus pneumoniae in children aged below 5 years hospitalized with invasive pneumococcal diseases (IPDs), including pneumonia, septicemia, and meningitis, during the study’s duration in representative areas of Jordan. Serotyping for culture-positive cases was based on the capsular reaction test, known as the Quellung reaction. qPCR was conducted on the blood samples of patients with lobar pneumonia identified via X-ray or on cerebrospinal fluid for those with a positive latex agglutination test for Streptococcus pneumoniae. Results: This study was based on the analysis of the serotypes of 1015 Streptococcus pneumoniae cases among children younger than the age of 5: 1006 cases with pneumonia, 6 cases with meningitis, and 3 cases with septicemia. Only 23 culture-positive cases were identified in comparison to 992 lobar pneumonia cases, which were PCR-positive but culture-negative, with a PCR positivity rate of 92%. Serotypes 6B, 6A, 14, and 19F were the most common serotypes identified in this study, with prevalence rates of 16.45%, 13.60%, 12.12%, and 8.18%, respectively. PCV-10, PCV-13, PCV-15, and PCV-20 coverage rates were 45.32%, 61.87%, 64.14%, and 68.47%, respectively. Discussion: To the best of our knowledge, this is the largest prospective study from the Middle East and one of the largest studies worldwide showing the serotypes of Streptococcus pneumoniae. It reveals the urgency for the introduction of a PCV vaccination in Jordan, utilizing recently developed vaccines with a broader serotype coverage