Estimation of Aminophylline effectiveness at Neonatal Intensive Care Unit (NICU) using Artificial Intelligence

@#Introduction: The estimation of drug competence using Artificial Intelligence is presented in various literature for the adult population, but it is still new for drug dosage optimization in neonates. Aminophylline, a methylxanthine is administered as central nervous system stimulant for reducing Apnea episodes in neonates. Methods: The paper describes comparative evaluation of Support Vector Machine (SVM), K Nearest Neighbour (KNN), Decision Tree (DT) and Artificial Neural Network (ANN) for predicting drug effectiveness of Aminophylline. The models were evaluated using 100 Aminophylline cases based on various metrics such as sensitivity, specificity, and accuracy. The data used for the analysis was collected from the population pharmacokinetic study conducted at Kasturba Medical College, Neonatal Intensive Care Unit (NICU). Results: The evaluation result seemed to favour Multi-Layer Perceptron (MLP) with accuracy of 0.92 Area Under the Curve (AUC) followed by 0.85 (AUC) for Support Vector Machine (SVM). The input parameters in particular maternal, pharmacokinetics, demographic and physiological that were identified in literature as predictor variable played an important role in estimating effectiveness of Aminophylline regimens. Conclusion: Artificial Intelligence approach was potentially helpful in analysing drug dosage of Aminophylline and its effectiveness in diagnosing neonatal Apnea.

Gynecologic-tract sparing extra peritoneal retrograde radical cystectomy with neobladder

OBJECTIVE: We report on a series of female patients with transitional cell carcinoma of the bladder who underwent extraperitoneal retrograde radical cystectomy sparing the female reproductive organs with neobladder creation. MATERIALS AND METHODS: 14 female patients between the ages of 45 and 72 years who underwent gynecologic-tract sparing cystectomy (GTSC) with neobladder between 1997 and 2002 were retrospectively reviewed. Our surgical technique is also described. Radical cystectomy is accomplished by a retrograde method sparing the uterus, adnexa, vagina and distal urethra. An orthotopic neobladder was constructed using small bowel or sigmoid colon, brought extraperitoneally, and anastomosed to the distal urethra. RESULTS: Operating time ranged from 4.5 to six hours with a mean of 5.3 hours. Ten patients were able to void satisfactorily while four required self-catheterization for complete emptying of the bladder. Seven patients were continent day and night and another 7 reported varying degrees of daytime and nighttime incontinence. One patient died of metastases and another of pelvic recurrence. There were no urethral recurrences. Patient satisfaction with the procedure was high. CONCLUSIONS: Gynecologic-tract sparing cystectomy with orthotopic neobladder is a viable alternative in female patients with muscle invasive traditional cell carcinoma of the bladder, providing oncological safety with improved quality of life. Our extraperitoneal technique, which is an extension of our successful experience with retrograde extraperitoneal radical cystectomy in men, minimizes intraoperative complications and simplifies the management of post-operative morbidity with the neobladder.

Serum-ascites albumin gradient: a predictor of esophageal varices with ascites.

Other investigators have found that in adults the Serum-Ascites Albumin Gradient (SAAG) to be 1.1 g/dl or greater in the presence of portal hypertension (PTHN) and less than that in its absence. We sought to determine the correlation between the level of SAAG and the complications of PTHN, manifested by the presence of esophageal varices in children with ascites. Our study included 26 patients with cirrhosis, diagnosed by liver biopsy and 14 patients with nephrotic syndrome (NS) diagnosed by established criteria. The SAAG was measured in all patients. The patients with cirrhosis had upper gastrointestinal (GI) endoscopy for assessment of esophageal varices (EV). We found that 84.6% (22 of 26) patients with cirrhosis had High SAAG (> or = 1.1 g/dl) and 15.4% (4 of 26) had low SAAG (< 1.1 g/dl) (p < 0.001). EV was found in 91% (20 of 22) patients with high SAAG and in 50% (2 of 4) patients with low SAAG (p = 0.013). The SAAG differentiated cirrhosis with EV from those without EV (sensitivity = 91%, specificity = 50%, positive predictive value = 91%, negative predictive value = 50% and efficacy = 85%). The high SAAG is a useful means to predict the presence of EV in children with ascites.

Impact of television on children.

Television viewing has a great impact on various aspects of child's life. This study was carried out at Sir Padampat Mother & Child Health Institute, Jaipur (Rajasthan). The aim was to study the effects of television viewing on a child's eating habits, general physical health, physical activities, interest in study and school performance. Only 250 children of 3-10 years age groups were studied for a period of nine months (January 1992 to September 1992). Average duration of television exposure to an individual child was 18.5 hours per week in the study. Significant changes were observed in a childs' eating habits, weight, physical activity, sleep pattern, interest in study and general physical health. Increase in weight was observed in 19.6% children suggesting that the television viewing may predispose to childhood obesity. In 30.4% cases decrease in physical activity was found, 18.4% children showed decreased interest in study, while 10% children showed decrease in school performance, and sleep pattern was disturbed in 24% children. Medical problems were found in 11.6% children. Significantly two children had precipitation of fits on television viewing.

Precipitation test--a rapid method for diagnosis of tuberculous meningitis.

Precipitation test (modified Lavinson's test) was conducted in 125 cases of meningitis. Of these, 50 cases (proved cases of tuberculous meningitis) who served as positive controls showed positive response for the precipitation test in 96% and in 25 cases of negative control group (cases of meningitis other than TBM), it showed only 4% positivity. The remaining 50 cases of TBM where the cytological and biochemical findings were not in correlation with clinical diagnosis of TBM, showed 92% positivity for early diagnosis of TBM.