Development and validation of an offline deep learning algorithm to detect vitreoretinal abnormalities on ocular ultrasound

Purpose: We describe our offline deep learning algorithm (DLA) and validation of its diagnostic ability to identify vitreoretinal abnormalities (VRA) on ocular ultrasound (OUS). Methods: Enrolled participants underwent OUS. All images were classified as normal or abnormal by two masked vitreoretinal specialists (AS, AM). A data set of 4902 OUS images was collected, and 4740 images of satisfactory quality were used. Of this, 4319 were processed for further training and development of DLA, and 421 images were graded by vitreoretinal specialists (AS and AM) to obtain ground truth. The main outcome measures were sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under receiver operating characteristic (AUROC). Results: Our algorithm demonstrated high sensitivity and specificity in identifying VRA on OUS ([90.8%; 95% confidence interval (CI): 86.1�.3%] and [97.1% (95% CI: 93.7�.9%], respectively). PPV and NPV of the algorithm were also high ([97.0%; 95% CI: 93.7�.9%] and [90.8%; 95% CI: 86.2�.3%], respectively). The AUROC was high at 0.939, and the intergrader agreement was nearly perfect with Cohen抯 kappa of 0.938. The model demonstrated high sensitivity in predicting vitreous hemorrhage (100%), retinal detachment (97.4%), and choroidal detachment (100%). Conclusion: Our offline DLA software demonstrated reliable performance (high sensitivity, specificity, AUROC, PPV, NPV, and intergrader agreement) for predicting VRA on OUS. This might serve as an important tool for the ophthalmic technicians who are involved in community eye screening at rural settings where trained ophthalmologists are not available

Second Trimester Uterine Rupture: A Rare Case Report.

Second trimester abortions constitute 10-15% of all induced abortions worldwide but are responsible for two-thirds of major abortionrelated complications. Although spontaneous fundal rupture is very rare in the early second trimester of pregnancy, it should be taken into consideration in the differential diagnosis of per vaginal bleeding with acute abdominal pain in pregnancy if there are predisposing factors. Uterine rupture in pregnancy is rare with a high incidence of fetal and maternal morbidity. Here, we report one of the rare cases of 32-yearold women presenting with per vaginal bleeding and acute abdominal pain with second trimester uterine rupture.

UTERINE ARTERIOVENOUS MALFORMATION TRANSVAGINAL DOPPLER ULTRASONOGRAPHY: CASE REPORT

Uterine arteriovenous malformation (AVM) is a rare condition, with fewer than 100 cases reported in the literature. Despite it being rare, it is a potentially life-threatening condition. This case report describes a healthy 29-year-old patient, nulligravida, with an unremarkable medical history, came from gynaecologist for ultrasaound due to complain of irregular heavy PV bleeding. Transvaginal Doppler ultrasonography is a widely available, noninvasive and excellent diagnostic method. Transvaginal ultrasound (TVS) of the pelvis showed increased vascularity with multidirectional flow of the uterus and a prominent vessel, located on the posterior wall.

The effect of remelting various combinations of new and used cobalt-chromium alloy on the mechanical properties and microstructure of the alloy.

Context: Remelting previously cast base metal alloy can adversely affect the mechanical properties of the alloy and necessitates addition of new alloy. Aims: To study the effect of remelting different combinations of new and used cobalt-chromium (Co-Cr) alloy on its mechanical properties and microstructure. Materials and Methods: Using induction casting, 24 tensile test specimens were prepared for eight different combinations of new and used Co-Cr alloy. The test specimens were assessed for yield strength and percentage elongation. Microhardness was evaluated using Vickers's hardness tester. The tensile testing was carried out on a 50 kN servo-hydraulic universal testing machine. Microstructure analysis was done using an optical photomicroscope on the fractured samples after acid etching. Statistical Analysis: The mean values (±standard deviation) and coefficient of variation were calculated. Student's 't' test was used for statistical analysis. Statistical significance was assumed at P=.05. Results: The mean yield strength of eight different combination groups were as follows: group A: 849 MPa, group B 1 : 834 MPa, group B 2 : 915 MPa, group B 3 : 897 MPa, group C 1 : 874 MPa, group C 2 : 859 MPa, group D 1 : 845 MPa, and group D 2 : 834 MPa. The mean percentage elongation for the different groups were as follows: group A: 7%, group B 1 : 7%, group B 2 : 8%, group B 3 : 7%, group C 1 : 8%, group C 2 : 7%, group D 1 : 7%, and group D 2 : 8%. The mean hardness values were as follows: group A: 373 VHN, group B 1 : 373 VHN, group B 2 : 346 VHN, group B 3 : 346 VHN, group C 1 : 364 VHN, group C 2 : 343 VHN, group D 1 : 376 VHN, and group D 2 : 373 VHN. Conclusion: Repeated remelting of base metal alloy for dental casting without addition of new alloy can affect the mechanical properties of the alloy. Microstructure analysis shows deterioration upon remelting. However, the addition of 25% and 50% (by weight) of new alloy to the remelted alloy can bring about improvement both in mechanical properties and in microstructure.

Protective Effect of Ethyl Acetate Extract of Acacia Catechu in Carbon Tetrachloride Induced Hepatotoxicity.

Objective: To study the protective effect of ethyl acetate extract of Acacia catechu in carbon tetrachloride induced hepatotoxicity in albino rats. Methods: The liver damage in albino rat was induced by a subcutaneous injection of 50%v/ v carbon tetrachloride in olive oil at the dose of 2ml/kg twice a week for 14days. The hepatoprotective activity was monitored biochemically by estimating serum transaminases, serum alkaline phosphatase, serum bilirubin and serum protein after intraperitoneal injection of ethyl acetate extract of Katha(250mg/kg). Silymarin(5mg/kg.I.P) was given as a reference drug. The histopathological changes of liver samples were compared with that of control. Results: Ethyl acetate extract of Acacia catechu inhibited carbon tetrachloride induced liver toxicity in albino rats at 250mg/kg body weight as assessed by the biochemical and histological examination. Conclusion: Ethyl acetate extract of “Katha” exhibited significant hepatoprotective activity.

Introgressive hybridization and evolution of a novel protein phenotype: glue protein profiles in the nasuta-albomicans complex of Drosophila.

Glue proteins are tissue-specific proteins synthesized by larval salivary gland cells of Drosophila. In Drosophila nasuta nasuta and D. n. albomicans of the nasuta subgroup, the genes that encode the major glue protein fractions are X-linked. In the present study, these X-linked markers have been employed to trace the pattern of introgression of D. n. nasuta and D. n. albomicans genomes with respect to the major glue protein fractions in their interracial hybrids, called cytoraces. These cytoraces have inherited the chromosomes of both parents and have been maintained in the laboratory for over 400-550 generations. The analysis has revealed that cytoraces with D. n. albomicans X chromosome show either D. n. nasuta pattern or a completely novel pattern of glue protein fractions. Further, quantitative analysis also shows lack of correlation between the chromosomal pattern of inheritance and overall quantity of the major glue protein fractions in the cytoraces. Thus, in cytoraces the parental chromosomes are not just differentially represented but there is evidence for introgression even at the gene level.

evaluation of the latest ADA criteria for screening and diagnosing gestational diabetes at a tertiary care hospital in the United Arab Emirates

The American Diabetic Association [ADA] has recently recommended lowering the cut-off values for the two-step oral glucose tolerance test [OGTT] used for screening of gestational diabetes. This study reports on the appropriateness of applying the latest ADA diagnostic criteria when screening for gestational diabetes mellitus [GDM] in a tertiary care facility in the United Arab Emirates. The study was carried out at Mafraq Hospital, Abu Dhabi, United Arab Emirates [UAE] between November 1999 and April 2001. A total of 889 pregnant women who underwent at least one test of the two-step OGTT were studied retrospectively for adverse maternal and fetal outcomes. Subjects were classified as GDM positive or negative by applying the old and the latest ADA criteria and the occurrence of adverse outcomes in the various groups was compared. Applying the latest ADA criteria with the two-step OGTT identified 11% and 17% more patients at risk for fetal and maternal adverse outcomes respectively. Advanced maternal age [> 30 years in our population], multi-parity [> 4] and obesity [BMI > 30] were associated with increased risk of being diagnosed as having GDM. Application of the latest ADA criteria to the two-step OGTT was determined to be appropriate for UAE pregnant women tested for GDM in the tertiary care setting. Older [age > 30 years], multiparous [parity > 4], and obese women [BMI > 30] were at greater risk of GDM diagnosis by the latest ADA criteria

Hybridization, transgressive segregation and evolution of new genetic systems in Drosophila.

Introgressive hybridization facilitates incorporation of genes from one species into the gene pool of another. Studies on long-term effects of introgressive hybridization in animal systems are sparse. Drosophila nasuta (2n = 8) and D. albomicans (2n = 6)-a pair of allopatric, morphologically almost identical, cross-fertile members of the nasuta subgroup of the immigrans species group-constitute an excellent system to analyse the impact of hybridization followed by transgressive segregation of parental characters in the hybrid progeny. Hybrid populations of D. nasuta and D. albomicans maintained for over 500 generations in the laboratory constitute new recombinant hybrid genomes, here termed cytoraces. The impact of hybridization, followed by introgression and transgressive segregation, on chromosomal constitution and karyotypes, some fitness parameters, isozymes, components of mating behaviour and mating preference reveals a complex pattern of interracial divergence among parental species and cytoraces. This assemblage of characters in different combinations in a laboratory hybrid zone allows us to study the emergence of new genetic systems. Here, we summarize results from our ongoing studies comparing these hybrid cytoraces with the parental species, and discuss the implications of these findings for our understanding of the evolution of new genetic systems.

Comparative evaluation of bone marrow aspirate particle smears, imprints and biopsy sections.

Comparative evaluation of bone marrow aspirate particle smears, imprints and biopsy sections was done on 30 haematological problems. Core needle biopsy of the bone marrow is a safe and useful procedure. It is a valuable diagnostic aid for measurement of marrow cellularity, metastatic tumours and fibrosis. It should not be taken as a substitute for examination of the marrow by aspiration smear but is a complementary procedure which affords several advantages. Bone marrow biopsy was of maximum utility in myelofibrosis which was diagnosed on biopsy alone. There were three additional cases with normal bone marrow aspiration in which specific diagnosis could only be made from bone marrow biopsy sections. New methodologies i.e. plastic embedding and semi thin sections of undecalcified bone marrow, can be expected to improve the cytological details of tissue obtained by biopsy. Imprint preparations obtained from biopsy can be useful in patients of malignancy but we have found them to be of limited value except in cases of dry tap.