Torsion of wandering spleen with Infarction.

Wandering spleen is a rare entity that results from the absence or maldevelopment of the ligaments that support the spleen in its normal location. As a result, the spleen is hypermobile and may be predisposed to hilar torsion and subsequent infarction, making it a potentially fatal abdominal emergency. We present a case of a 36-year-old Afghan female who presented with an acute abdomen, and was radiologically and surgically confirmed to have a wandering spleen with torsion and complete infarction. Knowledge of this condition and its radiological findings can play a crucial role in making a correct and timely diagnosis

Graphical Password Scheme Using Cued Click Point and Persuasion with Multiple Images

There are three main categories of authentication system – token-based (what you have), biometric-based (who you are) and knowledge-based (what you know). Cued Click Point is a graphical password scheme which is a type of knowledge based authentication. In CCP, user clicks on one point per picture for an arrangement of pictures.CCP gives more prominent security than PassPoints in light of the fact that the quantity of pictures builds the workload for attackers. The proposed system uses persuasion allowing user’s choice to a certain extent while encouraging users towards stronger and less-vulnerable passwords.In the proposed system, the undertaking of choosing less secure passwords (which are simple for attackers to hack) is more monotonous, disheartening users from settling on such decisions.In actuality, this approach makes picking a more secure secret key less weight on clients, it is less demanding to take after the framework's recommendations for a protected password—an element lacking in many systems. CCP is an effective alternative to text-based passwords and other forms of traditional authentication system. Psychological studies have also revealed that human mind can recognize images faster than text and numbers. CCP can be applied to a system front-end which requires high level of security.This paper presents implementation of Cued Click Point (CCP) graphical password which uses persuasion along with multiple images

Hemoptysis secondary to rupture of infected aortic aneurysm- a case report

BACKGROUND: Massive hemoptysis is a life-threatening condition and can arise as a complication of various conditions. It rarely occurs as a complication of a ruptured thoracic aortic aneurysm. Even rarer are conditions where pseudoanurysms of aorta result due to infection. CASE PRESENTATION: A 30 year-old female patient presented with left sided chest pain, intermittent fever, cough and massive hemoptysis. A pseudo-aneurysm of proximal descending thoracic aorta at the level of the left Subclavian artery was noted over CT scan. Upon performing a left posterolateral thoracotomy, the aneurysm was seen to have ruptured into the apical segment of left upper lobe, contained mainly by a thrombus. The anterior wall of the pseudoaneurysm was debrided and a bovine pericardial patch was used to repair the aortic defect. Cultures of the tissue obtained showed Enterobacter species, therefore the patient was prescribed 6 weeks of IV antibiotics following surgery. Post-operative CT scan revealed reduced diameter of the aorta. She was discharged in good health and remains well at follow up evaluation. CONCLUSIONS: We present a case of hemoptysis caused by a ruptured descending aorta aneurysm into left lung. The aneurysm was secondary to infection by Enterobacter. Surgical repair of the concerned region of aorta was effective, without any major sequelae. To the best of our knowledge, no such cases have been reported previousl

Comparative analysis of Desarda and Lichtenstein Inguinal Hernia Repair Techniques

Background: Inguinal hernia repair is the most commonly done procedure on the surgical floor these days. Objective: The study aims to evaluate and compare two different inguinal hernia repair techniques in terms of preoperative and postoperative measures. Methods: A comparative cross-sectional study was conducted in the department of Surgery, Aziz Fatimah Hospital from June 27, 2021, to March 02, 2022, using a consecutive sampling non-probability sampling technique. The demographic profile and characteristics of the hernia along with per operative and post-operative variables were collected and analyzed in SPSS 25 using the independent t-test. Results: The patients admitted for the elective inguinal hernia procedure in the ward underwent two routinely done surgical procedures. The mean age of the study population was 37±11 years. The mean age and standard deviation of patients in Group A (Desarda repair) were 36.43±11.01 years and 37.43±11.05 years of patients in Group B (Lichtenstein repair). Less mean operative time and days to return to daily life activities were seen in Group A (Desarda repair) patients compared to Group B (Lichtenstein repair) patients. Moreover, the estimated cost of the Desarda operative procedure was also much less compared to the Lichtenstein repair. Conclusion: The inguinal hernia repair technique Desarda is considered to be more effective and economical than the Lichtenstein repair in terms of per-operative and post-operative measures with less mean operative time, early return to normal activities, and cost-effectiveness

AI assisted reader evaluation in acute CT head interpretation (AI-REACT): protocol for a multireader multicase study

Introduction A non-contrast CT head scan (NCCTH) is the most common cross-sectional imaging investigation requested in the emergency department. Advances in computer vision have led to development of several artificial intelligence (AI) tools to detect abnormalities on NCCTH. These tools are intended to provide clinical decision support for clinicians, rather than stand-alone diagnostic devices. However, validation studies mostly compare AI performance against radiologists, and there is relative paucity of evidence on the impact of AI assistance on other healthcare staff who review NCCTH in their daily clinical practice. Methods and analysis A retrospective data set of 150 NCCTH will be compiled, to include 60 control cases and 90 cases with intracranial haemorrhage, hypodensities suggestive of infarct, midline shift, mass effect or skull fracture. The intracranial haemorrhage cases will be subclassified into extradural, subdural, subarachnoid, intraparenchymal and intraventricular. 30 readers will be recruited across four National Health Service (NHS) trusts including 10 general radiologists, 15 emergency medicine clinicians and 5 CT radiographers of varying experience. Readers will interpret each scan first without, then with, the assistance of the qER EU 2.0 AI tool, with an intervening 2-week washout period. Using a panel of neuroradiologists as ground truth, the stand-alone performance of qER will be assessed, and its impact on the readers’ performance will be analysed as change in accuracy (area under the curve), median review time per scan and self-reported diagnostic confidence. Subgroup analyses will be performed by reader professional group, reader seniority, pathological finding, and neuroradiologist-rated difficulty. Ethics and dissemination The study has been approved by the UK Healthcare Research Authority (IRAS 310995, approved 13 December 2022). The use of anonymised retrospective NCCTH has been authorised by Oxford University Hospitals. The results will be presented at relevant conferences and published in a peer-reviewed journal

AI assisted reader evaluation in acute CT head interpretation (AI-REACT): protocol for a multireader multicase study.

Introduction: A non-contrast CT head scan (NCCTH) is the most common cross-sectional imaging investigation requested in the emergency department. Advances in computer vision have led to development of several artificial intelligence (AI) tools to detect abnormalities on NCCTH. These tools are intended to provide clinical decision support for clinicians, rather than stand-alone diagnostic devices. However, validation studies mostly compare AI performance against radiologists, and there is relative paucity of evidence on the impact of AI assistance on other healthcare staff who review NCCTH in their daily clinical practice. Methods and analysis: A retrospective data set of 150 NCCTH will be compiled, to include 60 control cases and 90 cases with intracranial haemorrhage, hypodensities suggestive of infarct, midline shift, mass effect or skull fracture. The intracranial haemorrhage cases will be subclassified into extradural, subdural, subarachnoid, intraparenchymal and intraventricular. 30 readers will be recruited across four National Health Service (NHS) trusts including 10 general radiologists, 15 emergency medicine clinicians and 5 CT radiographers of varying experience. Readers will interpret each scan first without, then with, the assistance of the qER EU 2.0 AI tool, with an intervening 2-week washout period. Using a panel of neuroradiologists as ground truth, the stand-alone performance of qER will be assessed, and its impact on the readers’ performance will be analysed as change in accuracy (area under the curve), median review time per scan and self-reported diagnostic confidence. Subgroup analyses will be performed by reader professional group, reader seniority, pathological finding, and neuroradiologist-rated difficulty. Ethics and dissemination: The study has been approved by the UK Healthcare Research Authority (IRAS 310995, approved 13 December 2022). The use of anonymised retrospective NCCTH has been authorised by Oxford University Hospitals. The results will be presented at relevant conferences and published in a peer-reviewed journal. Trial registration number NCT06018545