Résumé
Objective@#This study aimed to present and evaluate a new deep learning model for determining cervical vertebral maturation (CVM) degree and growth spurts by analyzing lateral cephalometric radiographs. @*Methods@#The study sample included 890 cephalograms. The images were classified into six cervical stages independently by two orthodontists. The images were also categorized into three degrees on the basis of the growth spurt: pre-pubertal, growth spurt, and post-pubertal. Subsequently, the samples were fed to a transfer learning model implemented using the Python programming language and PyTorch library. In the last step, the test set of cephalograms was randomly coded and provided to two new orthodontists in order to compare their diagnosis to the artificial intelligence (AI) model’s performance using weighted kappa and Cohen’s kappa statistical analyses. @*Results@#The model’s validation and test accuracy for the six-class CVM diagnosis were 62.63% and 61.62%, respectively. Moreover, the model’s validation and test accuracy for the three-class classification were 75.76% and 82.83%, respectively. Furthermore, substantial agreements were observed between the two orthodontists as well as one of them and the AI model. @*Conclusions@#The newly developed AI model had reasonable accuracy in detecting the CVM stage and high reliability in detecting the pubertal stage. However, its accuracy was still less than that of human observers. With further improvements in data quality, this model should be able to provide practical assistance to practicing dentists in the future.
Résumé
To detect the nature and frequency of short and long term side effects of Methylprednisolone pulse therapy in patients with multiple sclerosis. sixty three patients with multiple sclerosis treated in multiple sclerosis clinic in Baghdad teaching hospital from April 2001 till December 2002 with one gram methylprednisolone [MPN] succinate pulse therapy were studied for short term side effects; forty six patients who received more than six doses were studied for short and long term side effects including serum lipid profile, ophthalmological complications, vascular necrosis of head of femur and osteoporosis by Achilles express device. body weight studied cross sectional at the start and after six months showed no significant changes; short term symptoms that occurred during and after pulse therapy were transient and occurred infrequently apart from taste changes in form of bitter sensation in 420 [60.87%] out of 690 pulses. There was no anaphylactic reactions, no cardiac dysrrhythmias and no deep venous thrombosis nor serious infections or septicemic complications during follow up. Blood pressure changes were not significant. Hematological investigation including hemoglobin, white blood cell count, platelets count changed within normal values after one week of pulse therapy. None of the patients developed diabetes mellitus at the end of the study. Among the 46 patients studied for long term side effects, one developed post subcapsular cataract non developed glaucoma, two showed increment in serum triglyceride, and one developed a vascular necrosis of the neck or the femur. Eighteen women receiving more than six pulses were evaluated for osteoporosis by Achellis express at the end of the study. Of them, 7 [38.88%] showed osteoporosis, 7 [38.88%] osteopenia, and 4 [22.22%] normal readings. methylprednisolone, when used on our therapeutic protocol, was a safe drug; there was a risk of developing osteoporosis for patients receiving more than 6 pulses