Application of Receiver Operating Characteristics (ROC) on the Prediction of Obesity

Abstract Obesity is the most common chronic disease, due to its ignorance in society. It gives birth to other diseases such as endocrine. The objective of this research is to analyze the different trends of each BMI category and predict its related serious consequences. Data mining based Support Vector Machine (SVM) technique has been applied for this and the accuracy of each BMI category has been calculated using Receiver Operating Characteristics (ROC), which is an effective method and potentially applied to medical data sets. The Area Under Curve (AUC) of ROC and predictive accuracy have been calculated for each classified BMI category. Our analysis shows interesting results and it is found that BMI ≥ 25 has the highest AUC and Predictive accuracy compares to other BMI, which claims a good rank of performance. From our trends, it has been explored that at each BMI precaution is mandatory even if the BMI < 18.5 and at ideal BMI too. Development of effective awareness, early monitoring and interventions can prevent its harmful effects on health.

Orthopedic injuries in poly- traumatized patients in age group of 15-45 years

Background: Orthopedic injuries in polytraumatised patient are common and affect the management in such patients

Aim of the Work: The purpose of this study was to assess the pattern and nature of orthopedic injuries in polytraumatised patient who sustain different mechanism of injury and to analyze the management of these injuries in the E.D. It is a descriptive study carried out at E.D. of Al-Jamhory teaching hospital

Patients and Methods: The study included all polytraumatised patient aged 15-45 years admitted to the E.D. OF Al-Jamhory teaching hospital after being injured in different mechanism of injury [MCV, FFH, Bullet injury, … etc]. Management carried out according to ATLS and to specific patient needs, 64 patient included in this study by using a special form for the study, patients ages were ranging from 15-45 years with subdivided to subgroups [15-25], [26-35], [36-45] and studied separately from the mechanism of injury and injured part of the body point of view

Results: Total number of causalities was 64 their mean age was 20 years, out of them 59 were male and 5 females, the most mechanism of injury were MVC 32[50%], transportation time was with average of 30 minutes, upper limbs affected equally to lower limbs, closed orthopedic injuries were common than open injuries, head injuries were noted to be the bulk associated injuries with the most serious and fatal outcome

Conclusions: Orthopedic injuries have a major impact on the management of polytraumatized patients. Males were the active sex group in our society and had much more affected in polytrauma than females with the main mechanism of injury of MVC

Predictors of admission in patients with acute bronchiolitis

Background: Acute viral bronchiolitis represents the most common lower respiratory tract infection in infants and young children less than 24 months and is associated with substantial morbidity and mortality. Respiratory syncytial virus is the most frequently identified virus, but many other viruses may also cause acute bronchiolitis. Most children with bronchiolitis have a self-limiting mild disease and can be safely managed at home with careful attention to feeding and respiratory status. Criteria for referral and admission vary between hospitals as do clinical practice in the management of acute viral bronchiolitis, Supportive care, including administration of oxygen and fluids, is the cornerstone of current treatment

Aim: To identify the epidemiological profile of babies less than 2 years with bronchiolitis, clinical characteristics of babies with bronchiolitis in respect to the main symptoms, signs and clinical presentations and the factors that affect disposition of the patient with acute bronchiolitis

Patient and Method: Design: A prospective observational case series study. Setting: Emergency unit in Al-Khansaa Teaching Hospital. Study period: one year [1/October/ 2012 - 30/September/ 2013] Sample size: 84 patients were enrolled in this study. Inclusion criteria: 1-first attack of acute wheeze due to bronchiolitis. 2-age 2 years or younger. Exclusion criteria: 1. patients with more than one attack wheezes. 2. wheezes due to other cause [pneumonia]. 3. age more than 2 years

Result: A Total of 84 patients with 1[st] attack wheeze in less than 2 years identified. The main age was 8.2+/-5.77 months, and the peak age was 6 months. 53 [63.1%] male, and 31[36.9%] female and ratio of 1.7:1. and the majority were mature babies, came from urban area more than rural area. The comparison done concentrated on symptoms, signs, and radiological findings between babies younger and older than 6 months age, and studied either to hospital or not and concentrated these findings had role as an indicator for admission on heart rate, respiratory rate and SPO2, The results indicated that poor feeding, irritability, runny nose, cough and shortness of breath all of these symptoms consider a good indicators for admission in both age groups. Severe retraction, rhonchi, and temperature more than 38.1 C, all of these physical findings consider good indicators of admission in both age groups. While fine rales and cyanosis are good indicators in babies younger than 6 months only. Radiological findings had no role in assessing admission of the patients to hospital. Respiratory rate [tachypnea]>60 bpm, and SPO2160 BPM consider significant indicator only in babies older than 6 months of age. Of all 84 patients admitted to emergency unit, only 63[75%] of them were admitted to hospital and the remaining were discharged

Conclusion: Indications of admission can be assessed by many symptoms [poor feeding, irritability, runny nose, cough, and SOB] and physical signs [Rhonchi, severe retraction, temperature >38.1 c, RR>60bpm, and SPO2<94], so We recommended carrying out serial checking SPO2 by pulse oximetry, and to conduct arterial or capillary blood gas analysis for the severely ill patients to assess the severity of the disease and its complications and treatment procedures

Accuracy of diagnosis of distal radial fractures by ultrasound

Background: although distal radial fracture account up to 20% of all fractures, it forms the most common fracture in upper extremities. Distal radial fracture has six types the most common one is Colle's fracture. The gold standard for diagnosis of distal radial fracture is conventional radiograph. Despite using ultrasound in tendon rupture, localizing foreign bodies, ultrasound started to be used for diagnosing bone fracture especially distal radius

Aim of the work: this study aimed to detect the accuracy of ultrasound in the diagnosis of distal radial fracture

Patients and methods: this was a selective prospective case series study in the Emergency Department, Al-Jumhoori Teaching Hospital, 78 patients were included in this study, their age ranged between 6-45 years with mean age 17.1. 59 were males and 19 females. Duration of the study was one year [January2013 - January 2014]

Results: by analyzing data of 78 patients for distal radial fracture ultrasound and comparing the results with the gold standard conventional radiograph we found that sensitivity of ultrasound in detecting fracture was 95.5%, specificity 100%, accuracy 96.15%, positive predictive value 100% and negative predictive value 80%

Conclusion: results of the current work demonstrated that ultrasound can be considered as a promising alternative to routine radiograph in diagnosis of the distal radial fractures and the horizon still open for further studies of use of ultrasound in diagnosis of other types of fractures

Predictors of hepatitis C virus recurrence after living donor liver transplantation: Mansoura experience

Background and Study Aims: Hepatitis C virus [HCV]-related cirrhosis is the leading cause of liver transplantation[LT]. All patients who undergo LT with detectable serum HCV-RNA experience graftreinfection, which is the most frequent cause of graft loss and death in these patients. We estimated the rate of HCV recurrence and evaluated the current therapeutic regimens

Patients and Methods: The records of consecutive 325 living donor LT [LDLT] surgeries performed between May 2004 and August 2014 were retrospectively analysed; 207 of them were followed-up throughout the study. Clinical, laboratory, radiological and histopathological examinations were performed thoroughly. Patients received treatment in the form of either pegylated interferon [PEG-IFN] or sofosbuvir, both in combination with ribavirin

Results: In total, 90.3% of recipients who were transplanted because of HCV-related end-stage liver disease experienced recurrence due to the virus. The donor age was older in the HCV recurrent group versus the non-recurrence group [28.7 +/- 7.1 versus 22.6 +/- 2.6 years: p

Conclusions: Older donor age and prolonged warm ischaemia time are independent predictors of HCV recurrence after LDLT, and early treatment with the direct-acting sofosbuvir is helpful in resolving the problem of post-LT HCV recurrence

Role of diagnostic laparoscopy in recurrent vague abdominal pain

To determine the role of laparoscopy in the management of recurrent vague abdominal pain. Descriptive case series. Surgical Unit 1, Civil Hospital Karachi, from January 2005 to June 2007. All patients who presented with vague recurrent abdominal pain and underwent laparoscopic surgery to make a definitive diagnosis were included in the study. A total of 60 patients were managed. There were 36 [60%] females and 24 [40%] males. The mean age was 26 year [range 18-58 year]. The common mode of admission was out patient department [73.3%]. Fourteen [23.3%] patients presented with vague abdominal pain in lower Abdomen, followed by 12 [20%] with right lower abdominal pain and 12 [20%] with central pain radiating to right lower abdomen. Diagnosis was established in 56 [93.3%] patients. In 4 [6.6%] patients no pathology was found. The most common diagnosis was inflamed appendix in 18 [30%] patients followed by abdominal tuberculosis in 16 [26.6%] patients. Most [36.6%] of the patients stayed in hospital for 24 hours. There was no readmission and no major postoperative complications. Diagnostic laparoscopy in vague abdominal pain provided a higher diagnostic accuracy and improved treatment. It may be considered as first line operative investigation for undiagnosed vague abdominal pain

Pelvic floor dyssynergia: Efficacy of biofeedback training

Paradoxical contraction of the pelvic floor during attempts to defaecate is described as pelvic floor dyssynergia [anismus]. It is a behavioural disorder [no associated morphological or neurological abnormalities]; consequently, biofeedback training has been recommended as a behavioural therapy for such a disorder. The aim of the present study was to evaluate long-term satisfaction of patients diagnosed with pelvic floor dyssynergia after biofeedback. Sixty patients [35 females and 25 males] with a mean age of 30 +/- 12 years and a 4 year duration of constipation were included. Forty-five patients had normal colonic transit and 15 patients had slow colonic transit. History, physical examination and barium enema were done to exclude constipation secondary to organic causes. Colonic and pelvic floor functions [colon-transit time, anorectal manometry, EMG and defaecography] were performed before and after biofeedback treatments. Patients were treated on a weekly basis with an average of [6 +/- 2] sessions. At the end of sessions, 55 out of 60 patients [91.6%] reported a subjectively overall improvement. Symptoms of dyschezia were reported less frequently after biofeedback. Age and gender were not predictive factors of outcome. No symptoms at initial assessment were predictive for patient's satisfaction but the only factor of predictive value was the diagnosis of anismus and the motivated patient who wanted to continue the sessions. Biofeedback remains a morbidity free, low-cost and effective outpatient therapy for well-motivated patients complaining of functional constipation and diagnosed as pelvic floor dyssynergia