Prescription eyeglasses as a forensic physical evidence: Prediction of age based on refractive error measures using machine learning algorithm.

Refractive errors (RE) are commonly reported visual impairment problems worldwide. Previous clinical studies demonstrated age-related changes in human eyes. We hypothesized that the binocular RE metrics including sphere and cylinder power, axis orientation, and interpupillary distance (IPD) can be used for forensic age estimation of an unknown individual. RE data of both eyes were collected from the clinical optometric exams and prescription glasses of 2027 Egyptian individuals aged between 2 to 93 years. The differences between age groups as well as sides, and sexual dimorphism were explored. Two modeling methods were compared: multiple and stepwise linear regression (LR) versus machine learning Regression Forest (RFM). Data were apportioned into training and test datasets with a ratio of 80/20. The results showed significant differences among the age groups in each eye for all variables. Stepwise LR improved the results over models based on the one-sided lens due to selection of IPD in addition to the left and right axis, and left sphere as independent variables. For the RFM, the left axis and IPD were the most important features. RFM outperformed LR in terms of accuracy and root mean squared error (RMSE). The estimated age within ±10 years showed 81.4% accuracy rate and RMSE = 8.9 years versus 38.5% accuracy rate and RMSE = 17.99 years using RFM and stepwise LR, respectively, in the test set. The current study upholds the significance of the age-related changes of refractive error in formulating alternative forensic age estimation models when standard methods are unavailable.

Kounis syndrome after anti-snake venom intradermal skin test: A case report.

Snake bites are a concerning health problem in Egypt and other tropical countries that are effectively managed with anti-snake venom (ASV). ASV has common reactive complications that are usually mild. Rarely, anaphylaxis and severe systemic reactions may occur following ASV. In this case report, we present a rare condition of Kounis syndrome, acute allergic myocardial infarction, in a young man during anaphylaxis following an allergic intradermal test of VACSERA snake antivenom.