Typical and Atypical Presentations of Appendicitis and Their Implications for Diagnosis and Treatment: A Literature Review.

Appendicitis, an acute inflammation of the appendix, affects all demographic groups and exhibits various incidences and clinical manifestations. While acute appendicitis typically presents with colicky periumbilical abdominal pain that localizes to the right lower quadrant, atypical presentations are more common in children, geriatric, and pregnant patient populations, leading to delays in diagnosis. Clinical evaluation, clinical scoring systems, and inflammatory markers are commonly used, but their limitations have led to the increased use of diagnostic imaging in patients suspected of appendicitis. Acute appendicitis is managed by non-operative and operative management, depending on whether it is uncomplicated or complicated. Developing diagnostic pathways to improve outcomes and reduce complications is crucial. Although medical advancements have been made, diagnosing and managing appendicitis can be challenging, mainly when patients are present atypically. This literature review aims to comprehensively review typical and atypical presentations of appendicitis and their current implications for diagnosis and treatment modalities in pediatric, adult, pregnant, and geriatric patient populations.

Automated deep bottleneck residual 82-layered architecture with Bayesian optimization for the classification of brain and common maternal fetal ultrasound planes.

Despite a worldwide decline in maternal mortality over the past two decades, a significant gap persists between low- and high-income countries, with 94% of maternal mortality concentrated in low and middle-income nations. Ultrasound serves as a prevalent diagnostic tool in prenatal care for monitoring fetal growth and development. Nevertheless, acquiring standard fetal ultrasound planes with accurate anatomical structures proves challenging and time-intensive, even for skilled sonographers. Therefore, for determining common maternal fetuses from ultrasound images, an automated computer-aided diagnostic (CAD) system is required. A new residual bottleneck mechanism-based deep learning architecture has been proposed that includes 82 layers deep. The proposed architecture has added three residual blocks, each including two highway paths and one skip connection. In addition, a convolutional layer has been added of size 3 × 3 before each residual block. In the training process, several hyper parameters have been initialized using Bayesian optimization (BO) rather than manual initialization. Deep features are extracted from the average pooling layer and performed the classification. In the classification process, an increase occurred in the computational time; therefore, we proposed an improved search-based moth flame optimization algorithm for optimal feature selection. The data is then classified using neural network classifiers based on the selected features. The experimental phase involved the analysis of ultrasound images, specifically focusing on fetal brain and common maternal fetal images. The proposed method achieved 78.5% and 79.4% accuracy for brain fetal planes and common maternal fetal planes. Comparison with several pre-trained neural nets and state-of-the-art (SOTA) optimization algorithms shows improved accuracy.