Res-SE-ConvNet: A Deep Neural Network for Hypoxemia Severity Prediction for Hospital In-Patients Using Photoplethysmograph Signal.

Determining the severity level of hypoxemia, the scarcity of saturated oxygen (SpO2) in the human body, is very important for the patients, a matter which has become even more significant during the outbreak of Covid-19 variants. Although the widespread usage of Pulse Oximeter has helped the doctors aware of the current level of SpO2 and thereby determine the hypoxemia severity of a particular patient, the high sensitivity of the device can lead to the desensitization of the care-givers, resulting in slower response to actual hypoxemia event. There has been research conducted for the detection of severity level using various parameters and bio-signals and feeding them in a machine learning algorithm. However, in this paper, we have proposed a new residual-squeeze-excitation-attention based convolutional network (Res-SE-ConvNet) using only Photoplethysmography (PPG) signal for the comfortability of the patient. Unlike the other methods, the proposed method has outperformed the standard state-of-art methods as the result shows 96.5% accuracy in determining 3 class severity problems with 0.79 Cohen Kappa score. This method has the potential to aid the patients in receiving the benefit of an automatic and faster clinical decision support system, thus handling the severity of hypoxemia.

Role of Helicobacter pylori Eradication Therapy on Platelet Recovery in Chronic Immune Thrombocytopenic Purpura.

Background. Idiopathic thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys native platelets. In this condition an autoantibody is generated against a platelet antigen. ITP affects women more often than men and is more common in children than adults. Objective. To assess the effect of Helicobacter pylori eradication therapy (HPET) on platelet count in Helicobacter pylori associated chronic immune thrombocytopenic purpura (chronic ITP) in adult. Materials and Methods. It is an interventional prospective study conducted at Liaquat University of Medical and Health Sciences, Jamshoro, from 2014 to 2015. A set of 85 patients diagnosed with chronic ITP were included in the study via convenient sampling. Patients with platelets count < 100 × 109/L for >3 months were selected. They were posed to first-line investigations which comprised complete blood count (CBC) and peripheral blood smear examination followed by second-line tests including bone marrow examination and Helicobacter pylori stool specific antigen (HpSA-EIA). Standard H. pylori eradication therapy was offered and the patients were assessed at regular intervals for 6 months. Results. Of the 85 study patients, 32 (37.6%) were male and 53 (62.3%) were female. Mean ages of H. pylori positive and negative subjects were 43.89 ± 7.06 and 44.75 ± 7.91 years, respectively. Bone marrow examination confirmed the diagnosis and excluded other related BM disorders. H. pylori stool antigen (HpSA) was detected in 34 (40%) patients and hence regarded as H. pylori positive; the rest were negative. Treatment with eradication therapy significantly improved the mean platelet counts from 48.56 ± 21.7 × 109/l to 94.2 ± 26.8 × 109/l. Conclusion. We concluded that the anti-H. pylori eradication therapy improves blood platelet counts in chronic immune thrombocytopenia.

Ultrasonographic imaging of normal and impacted omasum in Indian crossbred cows.

Omasal impaction is a serious disease problem in cattle in India, but it is difficult to diagnose clinically. Ultrasonography has been proposed for the noninvasive evaluation of omasal disease. The objectives of this study were to compare the in vitro and in vivo ultrasonographic appearance of the omasum and to compare omasal appearance, limits, and size in clinically healthy cows with those in cows having confirmed omasal impaction. A 3.5 MHz curvilinear transducer was used to image and record the appearance of the omasum in vitro in a water bath, and its appearance, dorsal and ventral limits, and size in 10 healthy Indian Jersey/Red Sindhi crossbred cows. The results were compared with the ultrasonographic data collected from 5 cows with omasal impaction, as confirmed at necropsy. On moving the transducer dorsoventrally in each intercostal space and below the costal arch, the wall of omasum could be seen as an echogenic arc-like structure. The difference between mean dorsoventral extents of the normal and impacted omasums was statistically insignificant. These results suggest that ultrasonographic imaging may not be useful in the diagnosis of omasal impaction in Indian crossbred cows, however, additional studies may be warranted.

Usefulness and limitation of ultrasonography in the diagnosis of intestinal intussusception in cows.

The present study was conducted on 6 chronically ill Jersey/Red Sindhi cross-bred cows, which were suspected for intestinal obstruction on the basis of history and clinical signs. These cows were ultimately diagnosed with intestinal intussusception based on a combination of clinical, ultrasonographic and surgical examinations. "Bull's eye lesion" was the most prominent ultrasonographic finding, diagnostic for intussusception either trans-abdominally or transrectally. Dilated intestinal loops greater than 3.1 cm (mean ± SE, 4.41 ± 0.25) were imaged in the lower flank and the 12th intercostal space on the right side. Ultrasonography proved to be a useful tool in supplementing and substantiating the transrectal findings in cases of the bovine intestinal intussusception. However, ultrasonography was not significantly helpful where transrectal examination of the cows did not reveal any suspected intestinal mass.

Ultrasonographic examination of the rumen in healthy cows.

10 healthy Indian Jersey/Red Sindhi crossbred nonpregnant cows were subjected to transabdominal ultrasonography to develop baseline topographical data of the rumen. The wall of the rumen could be identified as a thick echogenic line adjacent to the left abdominal wall from left flank to 8th intercostal space. The motility pattern of rumen was characterized by approximately 1 contraction every minute. The mean amplitude of the ruminal contraction was 3.2 cm. Ultrasonography of the rumen in healthy cows is a useful adjunct to the noninvasive diagnostic investigation of the rumen.

Ultrasonographic application in the diagnosis and prognosis of pericarditis in cows.

The present study was conducted on 5 cows diagnosed with late-stage pericarditis based on a combination of clinical, radiographic, ultrasonographic, and postmortem examinations. On clinical examination, all the cows were found to be depressed, dyspnoeic, and moderately to severely tachycardic. The main radiographic findings were poor thoracic details and indistinguishable cardiophrenic silhouette. Ultrasonographically, the pericardial sac contained varying quantities of hypoechogenic exudate and echogenic fibrin shreds, which had caused physical compression of the cardiac chambers. The clinical and radiographic findings did not allow a definitive diagnosis of pericarditis, because all of the characteristic signs were not present in every case. Thoracic and abdominal ultrasonography played an important role in the early diagnosis and prognosis of the disease.

Antifungal activity of α-methyl trans cinnamaldehyde, its ligand and metal complexes: promising growth and ergosterol inhibitors.

Antifungal effectivity and utility of cinnamaldehyde is limited because of its high MIC and skin sensitivity. In this study, α-methyl trans cinnamaldehyde, a less irritating derivative, have been self coupled and complexed with Co(II) and Ni(II) to generate N, N'-Bis (α-methyl trans cinnamadehyde) ethylenediimine [C(22)H(24)N(2)], [Co(C(44)H(48)N(4))Cl(2)] and [Ni(C(44)H(48)N(4))Cl(2)]. Ligand and complexes were characterized on the basis of FTIR, ESI-MS, IR and (1)HNMR techniques. Synthesized ligand [L] and complexes were investigated for their MICs, inhibition of ergosterol biosynthesis and H(+) extrusion against three strains of Candida: C. albicans 44829, C. tropicalis 750 and C. krusei 6258. Average of three species MIC of methyl cinnamaldehyde is 317 µg/ml (2168 µM). Compared to methyl cinnamaldehyde ligand [L], Co(II) and Ni(II) complex are found to be 4.48, 17.78 and 21.46 times more effective in liquid medium and 2.73, 8.93 and 10.38 times more effective in solid medium. At their respective MIC(90) average inhibition of ergosterol biosynthesis caused by methyl cinnamaldehyde, ligand [L], Co(II) and Ni(II) complex, respectively was 80, 78, 90 and 93%. H(+) extrusion was also significantly inhibited but did not co-relate well with MIC(90). Results indicate ergosterol biosynthesis as site of action of α-methyl cinnamaldehyde, synthesized ligand and complexes. α-methyl cinnamaldehyde and ligand did not show any toxicity against H9c2 rat cardiac myoblast cell, whereas Co(II) and Ni(II) complexes on an average produced 19% cellular toxicity.

Comparative ultrasonographic imaging of spleen and liver in healthy crossbred cows.

The present study was undertaken to conduct a comparative ultrasonographic study of the normal bovine spleen and liver. This study was carried out in two phases using 3.5 MHz curvilinear transducer. In first phase of water bath study, bovine spleens and livers were obtained from 3 healthy cadavers and subjected to repeated ultrasonography to study the echotexture. The splenic parenchyma was isoechogenic with greater echogenicity as compared to the liver. Water bath study provided a good learning experience for the comparative analysis of echotexture of the spleen and liver. In second phase, 10 healthy Jersey/Red Sindhi adult nonpregnant cows were subjected to detailed abdominal ultrasonography a number of times to develop the baseline topographical data of the spleen and liver. The dorsal end of the spleen in the cranial intercostal spaces could be clearly seen at the peak of inspiration when the lungs retracted to uncover the parietal surface of the spleen. The ventral end of the spleen, portion of the left lung, and the reticular wall could be scanned in the left 7th to 6th ICS in all the cows, and in the left 5th ICS in 5 cows. The liver was imaged from just behind the 12th to 6th ICS in all the cows easily. The gallbladder was imaged as a tear drop or pear shaped anechogenic structure with a hyperechogenic wall. The location of the gallbladder varied from the 12th to 9th ICS. It was most consistently observed in the 11th ICS (in 7 cows) at a mean distance of 46.3 cm from the dorsal midline. In 3 cows, the gallbladder was also seen ventral to the costal arch. The caudal vena cava was imaged as a triangular anechogenic structure on the dorsal border of the liver in the last 2 intercostal spaces in all the cows. The portal vein was imaged characteristically as a star shaped anechogenic structure with a hyperechogenic wall, ventral to the caudal vena cava, in the last 2 intercostal spaces in all the cows and in the 10th ICS in only 8 cows. It was concluded that a systematic ultrasonography formed a basis for a reliable noninvasive determination of positions and sizes of the normal spleen and liver and their vessels in the bovines.