Prediction and Staging of Hepatic Fibrosis in Children with Hepatitis C Virus: A Machine Learning Approach / 대한의료정보학회지

OBJECTIVES: The aim of this study is to develop an intelligent diagnostic system utilizing machine learning for data cleansing, then build an intelligent model and obtain new cutoff values for APRI (aspartate aminotransferase-to-platelet ratio) and FIB-4 (fibrosis score) for the prediction and staging of fibrosis in children with chronic hepatitis C (CHC). METHODS: Random forest (RF) was utilized in this study for data cleansing; then, prediction and staging of fibrosis, APRI and FIB-4 scores and their areas under the ROC curve (AUC) have been obtained on the cleaned dataset. A cohort of 166 Egyptian children with CHC was studied. RESULTS: RF, APRI, and FIB-4 achieved high AUCs; where APRI had AUCs of 0.78, 0.816, and 0.77; FIB-4 had AUCs of 0.74, 0.828, and 0.78; and RF had AUCs of 0.903, 0.894, and 0.822, for the prediction of any type of fibrosis, advanced fibrosis, and differentiating between mild and advanced fibrosis, respectively. CONCLUSIONS: Machine learning is a valuable addition to non-invasive methods of liver fibrosis prediction and staging in pediatrics. Furthermore, the obtained cutoff values for APRI and FIB-4 showed good performance and are consistent with some previously obtained cutoff values. There was some agreement between the predictions of RF, APRI and FIB-4 for the prediction and staging of fibrosis.

Nine months versus 12 months of adjuvant trastuzumab for patients with HER2-positive breast cancer

PURPOSE: This study aimed to compare the results of treatment with adjuvant trastuzumab for 9 months versus 12 months in human epidermal growth factor 2 (HER2)-positive breast cancer patients. The primary endpoint was disease-free survival. Secondary endpoints included cardiac safety, tolerability, and overall survival.METHODS: The study included 60 non-metastatic HER2-positive breast cancer patients. All study patients underwent surgery, received adjuvant chemotherapy, radiotherapy and hormonal therapy if indicated. Thirty patients were randomized in each group. Group I patients received adjuvant trastuzumab for 12 months, while group II patients received adjuvant trastuzumab for 9 months. Patients were assessed by clinical examination and Echocardiography during treatment.RESULTS: After median follow-up of 12 months, 90% of the patients in group I were disease free and 83.3% of patients in group II were disease free (P=0.402). All studied population in both groups I and II were alive at the end of the 1-year follow-up period after the completion of adjuvant trastuzumab treatment thus overall survival is 100%.CONCLUSION: Trastuzumab is tolerable and its side effects are reversible. Nine months of adjuvant trastuzumab treatment is more cost effective than the standard 12 months.

Knowledge and attitude practice [KAP] of rickets disease among mothers in KSA

Background: Rickets is one of the emerging diseases around the world and its records have been frequently increased among Saudi children

Objective: Our aim of the study was to discuss and improve the knowledge and the awareness of mothers in the Kingdom of Saudi Arabia about rickets disease and its environmental and nutritional risk factors

Methods: We conducted this cross-sectional retrospective Study at the maternal Children Hospital in Taif, Saudi Arabia. Data were collected using a pre-specified questionnaire after obtaining the patients consent. SPSS software was used to analyze the data

Results: We included 150 mothers with their children. There were 146 [97.3%] of the children with vitamin D deficiency

Conclusion: In Saudi Arabia, there is a need for campaigns that spread awareness among mothers and young adult females about the importance of vitamin D, diets containing adequate levels of it as well the risk factors that cause its deficiency

Inhibition of quorum sensing character in Pseudomonas aeruginosa isolates and its effect on biofilm formation and anti-microbial susceptibility profile

Quorum sensing [QS] plays a very important role in virulence and biofilm formation of Pseudomonas aeruginosa. We tested the effect of the aqueous garlic extract [AGE] on QS regulated biofilm formation and on antimicrobial susceptibility profile of P. aeruginosa isolates. One hundred P. aeruginosa isolates from patients with nosocomial infections from different departments of Sohag University Hospitals were collected during the period from April 2016 to April 2017. These isolates were tested for antibiotic sensitivity by the disc diffusion method and were screened phenotypically for biofilm formation by the Congo Red Agar [CRA] method and Tissue Culture Plate [TCP] technique. The presence of LasI, LasR, Rh1I and Rh1R genes in biofilm forming P. aeruginosa isolates was tested by using polymerase chain reaction [PCR]. Biofilm producing strains were investigated by exposure to sub-inhibitory concentration of AGE as a quorum-sensing inhibitory agent. P. aeruginosa showed the highest antibiotic resistance rate to Piperacillin [85%], followed by Ticarcillin-Clavulanate [84%], while the highest sensitivity was to Colistin [73%], followed by Polymyxin B [64%], and lastly to Meropenem [56%]. Eighty % of the isolated samples were biofilm producers, and most of these were from ICU patients.Strains were found to have different distribution of individual QS genes. LasI gene was present in 74% of isolates, LasR gene was present in 58% of isolates, Rh1I gene was present in 43% of isolates and Rh1R gene was present in 36% of isolates. On exposure of biofilm producing strains to the AGE there was significant improvement of the antibiotic sensitivity profile and significant decrease of biofilm formation. This work highlighted the bioactivity of garlic extract, as a Quorum Sensing inhibitory agent, in effectively inhibiting biofilm formation and increasing the sensitivity of the pathogens to antibiotics

Coronal microleakage for readymade and hand mixed temporary filling materials

The purpose of this in vitro study was to evaluate the sealing ability of the readymade temporary filling and hand mixed materials by assessing coronal microleakage. Standardized access cavities were prepared in 80 intact human permanent premolar teeth. They were divided randomly into four experimental groups [n=20]. The teeth were restored using one of the temporary materials including Cavisol, Litrak, Zinc phosphate cement, Zinconol [IRM]. Thermocycling was applied on the specimens. Methylene blue dye was applied and penetration was evaluated under stereomicroscope. Grading of the microleakage pattern was from 1 to 3, with 3 providing the best seal. Results were analyzed using one-way ANOVA test [P<0.05]. Microleakage of Cavisol and Litrak samples achieved grade 3; whereas zinc phosphate cement and Zinconol samples absorbed the dye into the bulk of the materials. Cavisol was found to exhibit the best seal amongst the four tested materials followed by Litrak, zinc phosphate cement, and Zinconol. There was a statistically significant difference in the microleakage scores obtained between the materials [P<0.01]. Among the four materials tested, readymade temporary filling provided the best sealing ability over hand-mixed. This study emphasizes the importance of correct placement and sufficient thickness of temporary filling materials in endodontic access cavities to ensure a tight seal

prophylactic effect of some natural antioxidant sources against hyperlipidemia in albino rats

The aim of this investigation was to study the effect of different natural antioxidants on hyperlipaemia in albino rats. To achieve this goal, 112 rats were used in order to study the prophylactic effect of wheat germ oil [W. G.O], rosemary [RM] and evening primrose oil [E.P.R] against hyperlipaemia. Rats were randomly divided into equal 7 groups [16 rats per each]. The first group was fed on standard normal diet, the second on hyperlipaemic diet [10% hydrogenated fat and 1% cholesterol] and the other groups [from the third to the seventh] received hyperlipaemic diet plus the following antioxidants W.G.O, RM, E.P.R, [W.G.O + E.P.R] and [RM + E.P.R], respectively. The experiment lasted for 8 weeks through which blood were collected at 0 time, 4 and 8 weeks. Every two samples were pooled together and served as one sample. W.G.O was administered to rats in a dose equivalent to 90 mg/kg b.w and added to the diet. RM and EPR were added in doses equivalent to 550 mg/kg b.w, and 360 mg/kg b.w., respectively. In general, the serum level of total lipids, triglycerides, cholesterol, malondialdehyde and the activities of alanine and aspartate aminotransferases, alkaline phosphatase and superoxide dismutase were significantly [P <0.01] increased in rats fed on hyperlipaemic diet. On the contrary, total proteins, globulin and reduced glutathione [GSH] were significantly [P < 0.01] decreased compared with the rat control group. From the data obtained, it could be deduced that all of the three antioxidants and their mixture had a remarkable ameliorative effect against hyperlipaemia. The effect of E.P.R was more pronounced than W.G.O and RM

Serum testosterone and aggression in schizophrenics and substance abusing subjects

This study had been carried out in psychiatric department of Zagazig University Hospital and Al Azazy Mental Hospital with the aim of studying the association between serum testosterone levels and aggression in some psychiatric disorders. 24 schizophrenics and Substance abusing who presented to the outpatient clinic with aggressire behaviour were subjected to the following; DSMII, R and clinical diagnosis, Brown aggressive scale and also measurement of free and total testosterone and sexhormone binding globulin [SHBG] by radioimmuno- assay and Enzyme immuno- assay teahniques. The results showed that substance abusing males had significautly higher serum levels of total and free testosterone than schizophrenics and controls. Also among schizophrenics the serum level of this hormone decreased significantly more with age compared to the other two groups, and correlated negatively with the duration of neuropleptic drug usage. The results also showed that the aggressive behavior of the schizophrenics were significantly lower than that of the drug abusing subjects, however there was no significant correlations between serum testosterone levels and the intenesity of aggression in either the schizophrenics or the substance abusing subjects

Antioxidants in children with protein energy malnutrition

The activity of erythrocytes antioxidant enzymes superoxide dismutase [SOD], glutathione peroxidase [GPX], blood glutathione [GSH] and the concentrations of non enzymatic antioxidants [plasma ceruloplasmin, vitamin E and C, serum Beta carotene, albumin, uric acid and TIBC] were measured in 15 children with kwashiorkor. These data were compared with those of 15 children with marasmus and 10 children who were normally nourished as control. SOD was similar in all groups. GSH and plasma ceruloplasmin were significantly lower in kwashiorkor than in the other two groups. GPX, plasma vitamin E, and serum albumin and uric acid were significantly lower in children with kwashiorkor than those with marasmus and both were lower than in controls. Serum TIBC, Beta carotene and plasma vitamin C were significantly lower in children with kwashiorkor and marasmus than in the control group. Concentration of serum malondialdehyde [MDA], a maker of lipid peroxidation was significantly elevated in children with kwashiorkor and marasmus than in the control group [P<0.05]. The elevated MDA in malnourished group of children who had decreased concentrations of antioxidants suggested that there were increased oxidative damage and lipid peroxidation in those children. A therapy directed to the restoration of antioxidant capacity might be beneficial for children with malnutrition, especially kwashiorkor

Changes in lipids, amino acids and enzymes activity during salting of sardine [sardinella aurita]

Changes in lipids, fatty acids composition, phospholipid fractions, amino acids composition and enzymes activity of sardine [Sardinella aurita] during salting by different techniques were investigated. Oxidation and hydrolysis of lipids caused a marked reduction in the content of the polyunsaturated fatty acids, triglycerides, phosphatidyl choline, phosphatidyl ethanol amine, phosphatidyl inositol and phosphatidyl serine and an observed increase in the total saturated fatty acids, free fatty acids, mono and diglycerides, lysoforms and phosphatidic acid. Among the amino acids, lysine and leucine were decreased, while aspartic, glutamic and alanine were increased, especially in the product treated with pancreatin enzyme. Activity of lipases and alkaline cathepsins enzymes increased only during the first four weeks of salting. They were higher in pickling than in Kench salting. Addition of the commercial enzymes preparation [pancreatin] led to increase the activity of such enzymes during the salting process

Comparative study of staphylococcal co-agglutination and latex agglutination for detection of enterotoxigenic escherichia coli

Several biological and immunological methods have been used for detection of ETEC. In this work a comparative study was done between staph-co- agglutination and latex agglutination. From the 75 faecal samples collected from infants and children having acute diarrhea, the total number of E. Coli strains isolated were 64. Out of these 64 strains, 6 strains were found to be positive for Labile Toxin [LT] production by both latex agglutination and staphylococcal co-agglutination test. However, another 3 strains which were negative by latex agglutination were found to be positive by staph co-agglutination test. The latex agglutination test was found to be simple, easy and rapid However this test was less sensitive in detection of ETEC. The staph-co-agglutination was also found to be simple, easy but it takes longer time [14 days]. It was concluded that both tests are simple, inexpensive to perform and can be used for rapid detection of ETEC