ABSTRACT
Patients who undergo heart valve replacements with mechanical valves need to take Vitamin K Antagonists (VKA) drugs (Warfarin, Nicoumalone) which has got a very narrow therapeutic range and needs very close monitoring using PT-INR. Accessibility to physicians to titrate drugs doses is a major problem in low-middle income countries (LMIC) like India. Our work was aimed at predicting the maintenance dosage of these drugs, using the de-identified medical data collected from patients attending an INR Clinic in South India. We used artificial intelligence (AI) - machine learning to develop the algorithm. A Support Vector Machine (SVM) regression model was built to predict the maintenance dosage of warfarin, who have stable INR values between 2.0 and 4.0. We developed a simple user friendly android mobile application for patients to use the algorithm to predict the doses. The algorithm generated drug doses in 1100 patients were compared to cardiologist prescribed doses and found to have an excellent correlation.
ABSTRACT
An enterolith is a mixed concretion formed in GIT, usually rare in humans. Primary enteroliths are formed in small bowel, typically within a diverticulum and secondary enteroliths in gallbladder. This case report highlights the presence of an enterocolic fistula; probably a postradiotherapy complication; and an enterolith without associated small bowel or colonic diverticuli. We have discussed the various diagnostic modalities used to reach a preoperative diagnosis of this rare condition. Imaging plays an important role in the detection and management of acquired gastrointestinal fistulas. The more routine use of cross-sectional imaging [especially computed tomography and magnetic resonance imaging] has altered the standard sequence of radiologic evaluation for possible fistulas, but fluoroscopic studies remain a valuable complement, especially for confirming and defining the anomalous communications
ABSTRACT
Myelodysplastic syndrome (MDS) is a clonal disorder of pluripotential stem cells of the bone marrow. The purpose of the study was to obtain epidemiological data of MDS. Thirty cases of MDS presented from April 1998 to May 2006 are included in this study. Complete blood counts were performed in an automated cell counter. Bone marrow aspiration, trephine biopsy and chromosomal study were carried out. The dry film was stained using a Romanwasky stain and Perl's stain. Fifteen cases were male and 15 cases were female. The mean age at presentation was 55 years (range 8-73 years). A majority of the patients presented with weakness (63.33%). Autoimmune manifestations in the form of joint pain were present in 13.33%. Patients were symptomatic for a prolonged period before diagnosis could be reached (average 358.8 days). A majority of the patients had MDS-refractory anemia (MDS-RA) or MDS-RA with excess blasts (MDS-RAEB-2) at presentation. Three patients had chromosomal abnormalities (27.27%). Eight patients (26.7%) were relatively young at presentation, less than 50 years of age. Three (10%) were children. A majority of the patients opted for symptomatic treatment only.
ABSTRACT
Traumatic brain injury following birth is common in newborn but significant intracranial haematoma following birth injury is not that usual. Even busy pediatric trauma center have about only 1 to 3 % of admission that require neurosurgical care. Extradural haematoma (EDH) associated with intracerebral and subdural haematoma (SDH) is even more rare in newborn. If this is not detected and treated in time, the outcome may be fatal. A case of EDH with subdural and intracerebral haematoma in a 3 days old neonate is presented. Etiology and problems in diagnosis and management are discussed.