Unsupervised local center of mass based scoliosis spinal segmentation and Cobb angle measurement.

Scoliosis is a medical condition in which a person's spine has an abnormal curvature and Cobb angle is a measurement used to evaluate the severity of a spinal curvature. Presently, automatic Existing Cobb angle measurement techniques require huge dataset, time-consuming, and needs significant effort. So, it is important to develop an unsupervised method for the measurement of Cobb angle with good accuracy. In this work, an unsupervised local center of mass (LCM) technique is proposed to segment the spine region and further novel Cobb angle measurement method is proposed for accurate measurement. Validation of the proposed method was carried out on 2D X-ray images from the Saudi Arabian population. Segmentation results were compared with GMM-Based Hidden Markov Random Field (GMM-HMRF) segmentation method based on sensitivity, specificity, and dice score. Based on the findings, it can be observed that our proposed segmentation method provides an overall accuracy of 97.3% whereas GMM-HMRF has an accuracy of 89.19%. Also, the proposed method has a higher dice score of 0.54 compared to GMM-HMRF. To further evaluate the effectiveness of the approach in the Cobb angle measurement, the results were compared with Senior Scoliosis Surgeon at Multispecialty Hospital in Saudi Arabia. The findings indicated that the segmentation of the scoliotic spine was nearly flawless, and the Cobb angle measurements obtained through manual examination by the expert and the algorithm were nearly identical, with a discrepancy of only ± 3 degrees. Our proposed method can pave the way for accurate spinal segmentation and Cobb angle measurement among scoliosis patients by reducing observers' variability.

Systemic Immune-Inflammation Index in Relation to Diabetes Markers in Saudi Adults: A Retrospective Study.

Background and objectives: Low-grade inflammation is associated with metabolic disturbances like diabetes. The systemic immune-inflammation index (SII) has been proposed as a predictive tool to identify individuals at a greater risk of diabetes. This study aims to examine the association between SII and diabetes markers. Method and materials: We used retrospective data from a large cohort of adults (n = 3895) aged ≥18 in Saudi Arabia. The SII was calculated, and the markers of diabetes such as fasting blood glucose (FBG), insulin, and hemoglobin A1c (HbA1c) were included. Results: Across the quartiles of SII, FBG, insulin, and HbA1c were significantly higher in adults with higher compared to lower SII (p < 0.0001, p = 0.04, p < 0.0001, respectively). A two SD higher FBG was significantly associated with an SII difference of 47.7 (95% CI: (15.5, 91.9)). In subgroup analysis, this relationship prevailed in normal-weight participants and among those with normoglycemia and prediabetes but was attenuated in participants with diabetes. The association also prevailed in separate analyses for males and females but was stronger among females. Linear regression models showed no significant association between insulin, HbA1c, and SII. Conclusions: SII was associated with the markers of diabetes. The utility of SII for predicting diabetes can be confirmed with prospective cohort studies.

Revolutionizing chronic lymphocytic leukemia diagnosis: A deep dive into the diverse applications of machine learning.

Chronic lymphocytic leukemia (CLL) is a B cell neoplasm characterized by the accumulation of aberrant monoclonal B lymphocytes. CLL is the predominant type of leukemia in Western countries, accounting for 25% of cases. Although many patients remain asymptomatic, a subset may exhibit typical lymphoma symptoms, acquired immunodeficiency disorders, or autoimmune complications. Diagnosis involves blood tests showing increased lymphocytes and further examination using peripheral blood smear and flow cytometry to confirm the disease. With the significant advancements in machine learning (ML) and artificial intelligence (AI) in recent years, numerous models and algorithms have been proposed to support the diagnosis and classification of CLL. In this review, we discuss the benefits and drawbacks of recent applications of ML algorithms in the diagnosis and evaluation of patients diagnosed with CLL.

Common Resistance Patterns in the Burn Unit of a Tertiary Care Center: A Retrospective Observational Study.

Background Nosocomial bacterial infections have been one of the major concerns in the healthcare system. Burn patients, specifically severe cases, are at a high risk of developing bacterial infections compared to others. The most frequent cultures among burn patients are Staphylococcus aureus, Pseudomonas aeruginosa,and Acinetobacter baumannii. There is a scarcity of local data showing the most common infections in burn patients. This research aimed to determine the most common organisms that cause infections in burn unit patients and the antibiotic sensitivity and resistance patterns in King Abdulaziz Medical City (KAMC) in Jeddah. Methodology In this cross-sectional study, data were collected from patients' files into a data collection sheet. All patients in the burn unit with a positive culture were included in the study using a convenient sampling technique from Best-Care, KAMC electronic medical records. Burn patients with negative culture results and patients who were admitted to the plastic surgery ward for reasons other than burns were excluded. For sample size calculation, convenience sampling of 109 patient medical charts, over the study period from June 2016 to November 2021, was selected for data extraction, analysis, and reporting. Results Pseudomonas aeruginosa was the leading cause of infection in burn patients comprising 33.9% of the cases. Enterobacter cloacae was the second most frequent cause of infection among burn patients (27.5%). Klebsiella pneumoniae was the third most frequent cause of infection (26.6%) while Acinetobacter baumannii was the fourth most frequent cause of infection in burn patients (22.9%). Conclusions Understanding the local epidemiology of bacterial infections will be crucial for the development of treatment guidelines designed to standardize initial antibiotic use, reduce hospital-acquired infections, and reduce drug resistance. More attention should be paid to gram-negative bacteria, specifically Pseudomonas aeruginosa and Enterobacter Cloacae.

Types of fiber and gut microbiota composition and diversity among arab females.

Objectives: Dietary fiber is recognized as an important nutrient for gut health. However, research on the relations of different types of fibers (soluble and insoluble) to the human microbiota health is limited. This study aimed to identify whether higher habitual intake of soluble and/or insoluble fiber have a different influence on the composition, diversity, and abundance of microbiota. Methods: We examined the fecal microbial composition of 92 healthy females aged 18 and above using the novel shotgun metagenomics sequencing technique. The habitual fiber intake was determined using the Saudi food frequency questionnaire. Pearson's correlation was used for the correlations between total, soluble, and insoluble fiber and gut microbiota. α- and ß-diversities were applied to acquire the distinctions in the relative abundances of bacterial taxa. Results: Our findings show that higher dietary fiber, particularly insoluble fiber, was significantly correlated with the abundances of Bacteroides_u_s, Bacteroides uniformis, and Lactobacillus acidophilus (r = 0.26, 0.29, 0.26, p-value < 0.05, respectively). Non-significant difference was noted in the microbial α-diversity and ß-diversity in low and high soluble/insoluble dietary fiber. Conclusions: Current findings suggest that insoluble dietary-fiber intake is favorably correlated with the health of the human gut microbiota. However, further investigations are necessary to identify the effect of types of fiber on the specific species identified in this study.

Mortality and Survival Analysis of Burn Patients Admitted in a Critical Care Burn Unit, Saudi Arabia.

Background: Burn injury is associated with a high mortality risk. Recent epidemiological data on burn injury and mortality rate from Saudi Arabia is lacking. Objective: This study aimed to analyze the survival rates and its predictability using the Baux score in patients with burn injury at a tertiary care hospital in Saudi Arabia. Materials and Methods: This retrospective study included all patients admitted to the burn unit at King Fahd Hospital of the University, Al Khobar, between March 2014 and February 2020. Patients' burn characteristics and calculated revised Baux scores were collected. The age, burn wound size, type of burn, burn extension, and Baux score of the survivors and non-survivors were compared. Results: A total number of 102 patients were included, and their mean age was 24.2 years (range: 9 months to 78 years). The mean affected total body surface area was 26.4%. Ninety patients (88%) suffered from flame/scald burn. The mortality rate was 17.6% (18 patients); all these patients had flame burns. No patient with a revised Baux score ≥110 survived (n = 14; 77% of the total deaths), while there was no mortality at score <36. Inhalational injuries were reported in 18 patients, of which 13 (72%) died. Patients with patent airway and no inhalation injury were 19 times more likely to survive than those with a compromised airway (P < 0.001). In terms of the depth of burn, partial thickness increased the likeliness of survival by 10 times compared with full thickness (P < 0.003). Conclusion: Inhalational injury and burn size were the most prognostic factors of burn injury in this study. As all cases of mortality were from flame burns, regulation on flammable materials and safety measures should be promoted to the public.

Nanoplatform for the Delivery of Topotecan in the Cancer Milieu: An Appraisal of its Therapeutic Efficacy.

Chemotherapy has been the predominant treatment modality for cancer patients, but its overall performance is still modest. Difficulty in penetration of tumor tissues, a toxic profile in high doses, multidrug resistance in an array of tumor types, and the differential architecture of tumor cells as they grow are some of the bottlenecks associated with the clinical usage of chemotherapeutics. Recent advances in tumor biology understanding and the emergence of novel targeted drug delivery tools leveraging various nanosystems offer hope for developing effective cancer treatments. Topotecan is a topoisomerase I inhibitor that stabilizes the transient TOPO I-DNA cleavable complex, leading to single-stranded breaks in DNA. Due to its novel mechanism of action, TOPO is reported to be active against various carcinomas, namely small cell lung cancer, cervical cancer, breast cancer, and ovarian cancer. Issues of cross-resistance with numerous drugs, rapid conversion to its inactive form in biological systems, appended adverse effects, and higher water solubility limit its therapeutic efficacy in clinical settings. Topotecan nanoformulations offer several benefits for enhancing the therapeutic action of this significant class of chemotherapeutics. The likelihood that the target cancer cells will be exposed to the chemotherapeutic drug while in the drug-sensitive s-phase is increased due to the slow and sustained release of the chemotherapeutic, which could provide for a sustained duration of exposure of the target cancer cells to the bioavailable drug and result in the desired therapeutic outcome. This article explores nanoenabled active and passive targeting strategies and combinatorial therapy employing topotecan to ameliorate various cancers, along with a glimpse of the clinical studies utilizing the said molecule.

Successful Elbow Flexion Reconstruction Using Latissimus Dorsi Muscle Transfer Following a Road Traffic Accident and Upper Limb Trauma.

BACKGROUND Several surgical procedures to restore elbow flexion have been reported in the literature. Multiple factors direct the selection of appropriate procedures for each patient, including hand dominance, neurovascular injury, and comorbidities. Traumatic damage to the anterior compartment of the arm is an indication for latissimus dorsi transfer, which can restore elbow flexion. Bipolar pedicled latissimus dorsi (LD) flap is a design used very rarely to simultaneously reconstruct biceps brachii soft-tissue defects and regain complete flexion function. We report the case of a 30-year-old man who underwent successful elbow flexion reconstruction using latissimus dorsi muscle transfer following a road traffic accident and upper limb trauma. CASE REPORT A 30-year-old man presented with acute compartment syndrome caused by a road traffic accident and impact trauma to the left arm. The surgical evaluation revealed proximal biceps tendons rapture; therefore, immediate repair and therapeutic fasciotomy were done. Subsequently, unsuccessful repair resulted in total necrosis of the biceps muscle, which necessitated debridement of the biceps muscle. Delayed reconstruction with an LD flap was successfully done after stabilization of the patient's condition. The flap was harvested as free-pedicled, then modified into a tube-like shape to resemble the biceps muscle. CONCLUSIONS This report has shown that the surgical procedure of latissimus dorsi muscle transfer can successfully restore elbow function following upper limb trauma; however, preoperative planning and postoperative follow-up are crucial for functional reconstruction of the upper extremity. In addition, carefully selecting reconstructive surgery considering patient factors, degree of injury, and the institution's capacity are essential factors in achieving optimal function restoration with minimal complications.

General population knowledge about osteoarthritis and its related risk factors in Jeddah Saudi Arabia.

OBJECTIVES: To identify the knowledge gap and misconceptions about osteoarthritis (OA) and its risk factors among the general population of Jeddah, Saudi Arabia. METHODS: This is a cross-sectional study conducted Jeddah, Saudi Arabia, between 11-13 April, 2019. The study was approved by King Abdullah International Medical Research Center. A representative sample of the public in well-known mall was asked to complete the questionnaire to assess their knowledge regarding OA. The questionnaire consisted of 3 parts: 1) demographic data, 2) general knowledge regarding OA, and 3) a quiz of 20 questions. A descriptive analysis was carried out with t-test and F-test-based method. RESULTS: The study had 1238 respondents. Approximately 55% of them were females, with 51.8% between the ages of 18 to 29. Approximately 62% held a bachelor's degree and 63% had a family member or a friend afflicted with OA. Relatives and friends were the main source of information regarding OA. Only 37% correctly identified the mechanism behind OA. The mean score for the 20-item quiz was 9.84. No significant differences were found when comparing scores of males and females or those of age groups. However, significant differences in scores were identified between respondents of varying educational levels (p less than 0.001), participants' knowledge of the mechanism leading to OA (p less than 0.001), information sources (p less than 0.001), and knowing someone with it (p less than 0.001). CONCLUSION: The results of our study suggest a low level of knowledge regarding OA among Jeddah population. Many misconceptions regarding OA were identified, so more information be brought to the public.

Patient-reported outcomes after breast reconstructive surgery: A prospective cross-sectional study.

BACKGROUND: With advancements in and the evolution of the medical field, several methods and surgical techniques have been developed for breast reconstruction after mastectomy. Generally, we can categorize these strategies into two broad groups: autologous reconstruction and implant-based reconstruction. This study aimed to analyze the satisfaction rate between these groups, considering age, timing of breast reconstruction, body mass index (BMI), major complications, and the need for radiotherapy or chemotherapy. MATERIALS AND METHODS: All the patients who underwent a mastectomy and subsequent breast reconstruction surgery at our institution between August 1, 2013, and August 31, 2017, were invited to complete a BREAST-Q questionnaire. To compare the quality of life and complication rate between the autologous and implant-based reconstruction groups, data were collected from specific patients. All participants completed the Arabic version of the postoperative reconstruction module. RESULTS: Among 61 patients, 43 (70.5%) completed the two domains of the BREAST-Q questionnaire, about the satisfaction with the implanted breast and satisfaction with the surgical outcome. These patients were divided into two groups: autologous (n = 21) and implant-based (n = 22) groups. The mean score of satisfaction with the implanted breast was 43.5 for the autologous group and 39.6 for the implant-based group. For the surgical outcome, the scores for the autologous and implant-based groups were 45.4 and 56.0, respectively. However, there was neither a statistical significance in the satisfaction with the implanted breast nor the surgical outcome between the two groups. CONCLUSION: Although there are many different surgical techniques to reconstruct a breast after mastectomy, there is still no specific surgical method that is perfect or well-suited for all patients undergoing breast reconstruction surgery. In our study, we found that there was no significant difference in satisfaction between the ABR and IBR group.