Comparison of Surgical and Medical Treatment in Patients with Haemorrhagic Stroke

Optimal management of spontaneous intracerebral haemorrhage (ICH) remains one of the highly debated areas in the fields of neurosurgery. Earlier studies comparing open surgical intervention with best medical management failed to show a clear benefit. More recent experience minimally invasive techniques have shown greater promise. We present our experience of 46 patients who presented to neurosurgery, neurology, Medical, Surgical and allied specialities at SIMS / Services Hospital Lahore with clinical and CT scan Brain based diagnosis of Haemorrhagic Stroke and comparison as per outcome between Surgical and Medically treated patients. This is an ongoing study.Objective: To compare the outcome results of surgical and medical management of the Haemorrhagic Stroke patients.Study Design: A prospective ongoing study.Place and Duration of Study: SIMS / Services Hospital, Lahore December 2013 until July 2015.Materials and Methods: 46 patients who presented to neurosurgery, neurology, Medical, Surgical and allied specialities at SIMS/ Services Hospital Lahore with clinical and CT scan Brain based diagnosis of Haemorrhagic Stroke.Results: Surgical treatment of patients with haemorrhagic Stroke fulfilling the inclusion criteria carries a little Edge over the patients undergoing medical treatment for the haemorrhagic stroke as per our ongoing study.Conclusion: Treatment of spontaneous haemorrhagic stroke although debateable but still the surgical treatment specially minimal invasive techniques have favourable prognosis

Comparison of Surgical and Medical Treatment in Patients with Haemorrhagic Stroke

Optimal management of spontaneous intracerebral haemorrhage (ICH) remains one of the highly debated areas in the fields of neurosurgery. Earlier studies comparing open surgical intervention with best medical management failed to show a clear benefit. More recent experience minimally invasive techniques have shown greater promise. We present our experience of 46 patients who presented to neurosurgery, neurology, Medical, Surgical and allied specialties at SIMS/ Services Hospital Lahore with clinical and CT scan Brain based diagnosis of Haemorrhagic Stroke and comparison as per outcome between Surgical and Medically treated patients. This is an ongoing study. Objective: To compare the outcome results of surgical and medical management of the Haemorrhagic Stroke patients. Study Design: A prospective ongoing study. Place and Duration of Study: SIMS / Services Hospital, Lahore December 2013 until July 2015. Materials and Methods: 46 patients who presented to neurosurgery, neurology Medical Surgical and allied specialties at SIMS/ Services Hospital Lahore with clinical and CT scan Brain based diagnosis of Haemorrhagic Stroke. Results: 46 Adults patients meeting the inclusive criteria were included in our ongoing study, 26 patients in surgical group and 20 patients in medical group as already described in Pie Diagram 1. Out of 26 patients in surgical group 5 patients expired (19%) and 21 survived (81%). Conclusion: Optimal cure of spontaneous intracerebral haemorrhage (ICH) is highly debatable neurosurgical problem. Past studies on comparison between surgical intervention with best medical management failed to show a clear improvement. However recent studies of minimally invasive techniques have shown greater promise5 . There is at present no clear indication for the surgical removal of ICH in the majority of the patients, but with deteriorating level of consciousness, many surgeons would agree surgical removal as a life saving procedure. Abbreviations: AHA (American Heart Society), AVM (ArterioVenous Malformation), GCS (Glasgow Coma Scale), ICH (Intracerebral Hematoma), IVD (IntraVentricular Drainage), SAH (Subarachnoid Haemorrhage), HTN (Hypertension), DM (Diabetes Mellitus, STICH (supratentorial intracerebral haemorrhage)

Object Oriented Model for Evaluation of On-Chip Networks

Abstract: The Network on Chip (NoC) paradigm is rapidly replacing bus based System on Chip (SoC) designs due to their inherent disadvantages such as non-scalability, saturation and congestion. Currently very few tools are available for the simulation and evaluation of on-chip architectures. This study proposes a generic object oriented model for performance evaluation of on-chip interconnect architectures and algorithms. The generic nature of the proposed model can help the researchers in evaluation of any kind of on-chip switching networks. The model was applied on 2D-Mesh and 2D-Diagonal-Mesh on-chip switching networks for verification and selection of best out of both the analyzed architectures. The results show the superiority of 2D-Diagonal-Mesh over 2D-Mesh in terms of average packet delay

Silent Secretory Otitis Media in Cases with Adenoid Hypertrophy

Objective: to determine the cases brought to the Otolaryngology Department with adenoidal hyperplasia. Study Design: Cross-sectional study. Place and Duration of Study: ENT Department, Combined Military Hospital, Multan Pakistan from Jan to May 2022. Methodology: The study was conducted on children of age more than 2.5 years having adenoid hypertrophy that was confirmed by an X-Ray lateral view of the nasopharynx for adenoids. Their tympanogram was obtained. Results: The study showed that 2(2%) cases had a Type-B curve in a single ear, and 14(14.3%) had a Type-B curve in both ears.PTA was normal in 32(32.7%) cases. Up to 25 decibels (dB) of hearing loss was seen in 6(6.1%) cases. In 8(8.2%) cases, hearing loss, was more than 25Db. Conclusion: The tympanometry test is an objective test which is very easy to carry out and can very easily detect patients having glued ears which can be managed, and possible complications of the disease can be avoided

Deep Semantic Segmentation and Multi-Class Skin Lesion Classification Based on Convolutional Neural Network

Skin cancer is developed due to abnormal cell growth. These cells are grown rapidly and destroy the normal skin cells. However, it's curable at an initial stage to reduce the patient's mortality rate. In this article, the method is proposed for localization, segmentation and classification of the skin lesion at an early stage. The proposed method contains three phases. In phase I, different types of the skin lesion are localized using tinyYOLOv2 model in which open neural network (ONNX) and squeeze Net model are used as a backbone. The features are extracted from depthconcat7 layer of squeeze Net and passed as an input to the tinyYOLOv2. The propose model accurately localize the affected part of the skin. In Phase II, 13-layer 3D-semantic segmentation model (01 input, 04 convolutional, 03 batch-normalization, 03 ReLU, softmax and pixel classification) is used for segmentation. In the proposed segmentation model, pixel classification layer is used for computing the overlap region between the segmented and ground truth images. Later in Phase III, extract deep features using ResNet-18 model and optimized features are selected using ant colony optimization (ACO) method. The optimized features vector is passed to the classifiers such as optimized (O)-SVM and O-NB. The proposed method is evaluated on the top MICCAI ISIC challenging 2017, 2018 and 2019 datasets. The proposed method accurately localized, segmented and classified the skin lesion at an early stage.Qatar University [IRCC-2020-009]

An Integrated Design for Classification and Localization of Diabetic Foot Ulcer based on CNN and YOLOv2-DFU Models

Diabetes is a chronic disease, if not treated in time may lead to many complications including diabetic foot ulcers (DFU). DFU is a dangerous disease, it needs regular treatment otherwise it may lead towards foot amputation. The DFU is classified into two categories such as infection (bacteria) and the ischaemia (inadequate supply of the blood). The DFU detection at an initial phase is a tough procedure. Therefore in this research work 16 layers convolutional neural network (CNN) for example 01 input, 03 convolutional, 03 batch-normalization, 01 average pooling, 01 skips convolutional, 03 ReLU, 01 add (element-wise addition of two inputs), fully connected, softmax and classification output layers for classification and YOLOv2-DFU for localization of infection/ischaemia models are proposed. In the classification phase, deep features are extracted and supplied to the number of classifiers such as KNN, DT, Ensemble, softmax, and NB to analyze the classification results for the selection of best classifiers. After the experimentation, we observed that DT and softmax achieved consistent results for the detection of ischaemia/infection in all performance metrics such as sensitivity, specificity, and accuracy as compared with other classifiers. In addition, after the classification, the Gradient-weighted class activation mapping (Grad-Cam) model is used to visualize the high-level features of the infected region for better understanding. The classified images are passed to the YOLOv2-DFU network for infected region localization. The Shuffle network is utilized as a mainstay of the YOLOv2 model in which bottleneck extracted features through ReLU node-199 layer and passed to the YOLOv2 model. The proposed method is validated on the newly developed DFU-Part (B) dataset and the results are compared with the latest published work using the same dataset

Recognition of different types of leukocytes using YOLoV2 and optimized bag-of-features

White blood cells (WBCs) protect human body against different types of infections including fungal, parasitic, viral, and bacterial. The detection of abnormal regions in WBCs is a difficult task. Therefore a method is proposed for the localization of WBCs based on YOLOv2-Nucleus-Cytoplasm, which contains darkNet-19 as a basenetwork of the YOLOv2 model. In this model features are extracted from LeakyReLU-18 of darkNet-19 and supplied as an input to the YOLOv2 model. The YOLOv2-Nucleus-Cytoplasm model localizes and classifies the WBCs with maximum score labels. It also localize the WBCs into the blast and non-blast cells. After localization, the bag-of-features are extracted and optimized by using particle swarm optimization(PSO). The improved feature vector is fed to classifiers i.e., optimized naïve Bayes (O-NB) & optimized discriminant analysis (O-DA) for WBCs classification. The experiments are performed on LISC, ALL-IDB1, and ALL-IDB2 datasets

Genetics of the thrombomodulin-endothelial cell protein C receptor system and the risk of early-onset ischemic stroke

Background and purpose Polymorphisms in coagulation genes have been associated with early-onset ischemic stroke. Here we pursue an a priori hypothesis that genetic variation in the endothelial-based receptors of the thrombomodulin-protein C system (THBD and PROCR) may similarly be associated with early-onset ischemic stroke. We explored this hypothesis utilizing a multi-tage design of discovery and replication. Methods Discovery was performed in the Genetics-of-Early-Onset Stroke (GEOS) Study, a biracial population-based case-control study of ischemic stroke among men and women aged 1549 including 829 cases of first ischemic stroke (42.2% African-American) and 850 age-comparable stroke-free controls (38.1% African-American). Twenty-four single-nucleotide-polymorphisms (SNPs) in THBD and 22 SNPs in PROCR were evaluated. Following LD pruning (r(2)>= 0.8), we advanced uncorrelated SNPs forward for association analyses. Associated SNPs were evaluated for replication in an early-onset ischemic stroke population (onset-ge Results Among GEOS Caucasians, PROCR rs9574, which was in strong LD with 8 other SNPs, and one additional independent SNP rs2069951, were significantly associated with ischemic stroke (rs9574, OR = 1.33, p = 0.003; rs2069951, OR = 1.80, p = 0.006) using an additive-model adjusting for age, gender and population-structure. Adjusting for risk factors did not change the associations; however, associations were strengthened among those without risk factors. PROCR rs9574 also associated with early-onset ischemic stroke in the replication sample (OR = 1.08, p = 0.015), but not older-onset stroke. There were no PROCR associations in African-Americans, nor were there any THBD associations in either ethnicity. Conclusion PROCR polymorphisms are associated with early-onset ischemic stroke in Caucasians.Peer reviewe

Ariadne: Evolving test data using grammatical evolution

Heuristic-based optimization techniques have been increasingly used to automate different types of code coverage analysis. Several studies suggest that interdependencies (in the form of comparisons) may exist between the condition constructs of variables and constant values in the different branching conditions of real-world programs e.g. while(i  We propose a Grammatical Evolution (GE)-based test data generator, Ariadne, which employs a novel seeding strategy. Our proposed system employs a simple attribute grammar to exploit different kinds of existing interdependencies (involving both variables and constant values) throughout the search process, which enables it to efficiently evolve complex test data. Our results demonstrate that Ariadne dramatically improves both effectiveness and efficiency when compared with existing GA-based techniques, based upon well-established criteria, attaining high levels of coverage (the standard software testing success metric for these sorts of problems) with far fewer fitness evaluations. Moreover, we also performed rigorous performance and scalability analyses to gain better insights about the working and performance of Ariadne and to examine its scalability, respectively. Our results suggest that the improvements achieved by Ariadne are highly cost-effective and that it remains highly scalable when compared to GA-based test data generation approach. </p

Acute mitral regurgitation with unilateral left-sided pulmonary edema: A complication of stemi treated successfully with a mitraclip procedure

A 67-year-old man with inferior wall ST-segment elevation myocardial infarction underwent Impella-assisted percutaneous coronary intervention complicated by unilateral left-sided pulmonary edema and cardiogenic shock due to severe mitral valve regurgitation. Surgery was deferred due to hemodynamic instability and a high risk of mortality, so he underwent a MitraClip procedure. Mitral regurgitation (MR) is a catastrophic mechanical complication of myocardial infarction that leads to the development of pulmonary edema, cardiogenic shock, and death. After the procedure, the patient significantly reduces MR with a resolution of pulmonary edema. Acute MR can rarely present as a unilateral left-sided pulmonary edema delaying diagnosis and treatment. Transcatheter edge-to-edge repair can be a safe alternative for patients who are at high risk for surgery