Early diagnosis of Parkinson's disease: A combined method using deep learning and neuro-fuzzy techniques.

Predicting Unified Parkinson's Disease Rating Scale (UPDRS) in Total- UPDRS and Motor-UPDRS clinical scales is an important part of controlling PD. Computational intelligence approaches have been used effectively in the early diagnosis of PD by predicting UPDRS. In this research, we target to present a combined approach for PD diagnosis using an ensemble learning approach with the ability of online learning from clinical large datasets. The method is developed using Deep Belief Network (DBN) and Neuro-Fuzzy approaches. A clustering approach, Expectation-Maximization (EM), is used to handle large datasets. The Principle Component Analysis (PCA) technique is employed for noise removal from the data. The UPDRS prediction models are constructed for PD diagnosis. To handle the missing data, K-NN is used in the proposed method. We use incremental machine learning approaches to improve the efficiency of the proposed method. We assess our approach on a real-world PD dataset and the findings are assessed compared to other PD diagnosis approaches developed by machine learning techniques. The findings revealed that the approach can improve the UPDRS prediction accuracy and the time complexity of previous methods in handling large datasets.

Isolated Bilateral Pinna Swelling: A Rare Initial Presentation of Leprosy.

BACKGROUND: Leprosy or Hansen disease is a chronic infectious disease that causes social stigma due to its deforming bodily appearance and physical disability. It has a wide spectrum of presentation affecting diagnosis. CASE REPORT: A 21-year-old man who presented with chronic isolated bilateral pinna swelling as a result of leprosy is reported. The bilateral pinna swelling started as multiple shiny papules with an erythematous background and progressively became hyperpigmented and lobular over two years. This rare presentation of leprosy poses initial diagnostic difficulties, leading to misdiagnoses by various health care professionals. Diagnoses ascribed include eczema, insect bite and perichondritis. A suspicion of leprosy was raised when hyperaesthetic hypopigmentation of skin started to appear on the body after two years, with worsening of the pinna swellings. This was confirmed by identification of Mycobacterium leprae in slit skin smear test and skin biopsy. CONCLUSION: Isolated involvement of pinna in a patient without lesions in other body parts is an unusual initial presentation of leprosy. However, leprosy should be kept as a rare differential diagnosis of isolated lesions on the ear in patients not responding to conventional treatment.