This is a prospective study with the objective of comparing Three Dimensional (3D) Dynamic Subtraction Contrast Enhanced Magnetic Resonance Angiography (3DDSCEMRA) with Conventional Catheter Arteriography (CCA) as the gold standard, in the diagnosis of peripheral occlusive disease. Three patients scheduled for CCA in this hospital in between September and October 2000 were included in this study. Patients underwent 3DDSCEMRA before proceeding to CCA on the same day. The 3DDSCEMRA reader was blinded to the CCA results. The results showed good correlation in iliofemoral segment and poor correlation in the infrapopliteal segment due to artifacts in 3DDSCEMRA images. 3DDSCEMRA is a new, non-invasive and promising technique in the diagnosis of peripheral occlusive disease.
Intestinal obstruction in infancy due to duplication cyst is rare. This is a case of a three-month old boy presented to the hospital with symptoms and signs of intermittent intestinal obstruction for three-week duration. Investigation with ultrasound revealed a small bowel duplication cyst. Patient underwent successful segmental jejunal resection and made an uneventful recovery. He made significant weight gain at one-year follow-up. The diagnostic approach to infant with intestinal obstruction is described with special emphasis on ultrasonographic features of jejunal duplication cyst.
The number of requests for testosterone testing in adult males has been increasing in recent years. In this review, the biochemistry and physiology of testosterone in males relevant to the chemical pathologist or clinical biochemist is outlined. The methodology for total testosterone and various laboratory tests associated with the assessment of testosterone status including free testosterone, calculated free testosterone (CFT), bioavailable testosterone (BAT) and free androgen index (FAI) is then summarised. Clinical and laboratory criteria for the diagnosis of late-onset hypogonadism (LOH) in men are critically discussed with particular emphasis on the interpretation of laboratory test results. Finally, other indications for testosterone testing in adult men such as infertility are also reviewed.
Clustering is a key step in the processing of Expressed Sequence Tags (ESTs). The primary goal of clustering is to put ESTs from the same transcript of a single gene into a unique cluster. Recent EST clustering algorithms mostly adopt the alignment-free distance measures, where they tend to yield acceptable clustering accuracies with reasonable computational time. Despite the fact that these clustering methods work satisfactorily on a majority of the EST datasets, they have a common weakness. They are prone to deliver unsatisfactory clustering results when dealing with ESTs from the genes derived from the same family. The root cause is the distance measures applied on them are not sensitive enough to separate these closely related genes.
A 43 year-old woman presented with severe non-specific abdominal pain of 1-week duration. She was on oral contraceptive pills for the past 6 years. Clinically patient appeared ill with no specific abnormal physical sign. Moderate amount of free fluid in the peritoneal cavity on ultrasound prompted an urgent abdominal computed tomography (CT) scan, which revealed thrombosis of the superior mesenteric vein. Further investigations revealed a hypercoagulable state with protein C deficiency. Patient responded well to anticoagulation and supportive therapy. One month later patient readmitted with vomiting and signs of intestinal obstruction. Barium study revealed a moderately long tight stricture at mid jejunum with proximal dilation. A by-pass surgery was carried out. She was well at 3 months follow-up.
A descriptive study of 143 cases of clinically diagnosed measles in patients under the age of 12 years admitted to the Duchess of Kent Hospital, Sandakan, Sabah, during the year 1990 was carried out. The median age of the patients was one year and 13.3% of the cases were between the ages of 6 and 9 months. The male to female ratio was 1.3:1. The majority of the cases (85.3%) were not immunised against measles while 60.0% of the cases were malnourished. Most of the cases (86.0%) had at least one complication with 32.9% of the cases having more than one complications. The main complications were pneumonia (74.1%) and diarrhea (38.5%). Other complications were convulsions, otitis media and corneal ulceration/scarring. A case of pneumonia with mediastinal emphysema and subcutaneous emphysema was noted. The case fatality rate was 1.4% while blindness was the long term morbidity in 1.4% of the cases. Measles remains an important cause of morbidity in children in Sabah.
A cross sectional nationally representative survey of 33,110 school-going children in Singapore aged between 9 and 20 years was carried out to obtain, for the first time, baseline information on smoking among the school-going population in Singapore. The survey was carried out among students attending vocational institutes and public sector schools in Singapore in 1987. The overall smoking prevalence was found to be 2% (3% among boys and 0.2% among girls). Ex-smokers comprised 2% of respondents whilst those who had only experimented with smoking made up 9% of the respondents. Analyses of the data showed that cigarette smoking was more prevalent among Malays, among boys, among older children, and among the less academically inclined. On average, boys smoked a median of 20 cigarettes a week and girls, 12 cigarettes a week. On an international basis, the smoking prevalence among the school-going population in Singapore is significantly lower than that of developed countries like Australia, England and Wales and neighbouring countries such as Malaysia.
Machine learning and deep learning models are commonly developed using programming languages such as Python, C++, or R and deployed as web apps delivered from a back-end server or as mobile apps installed from an app store. However, recently front-end technologies and JavaScript libraries, such as TensorFlow.js, have been introduced to make machine learning more accessible to researchers and end-users. Using JavaScript, TensorFlow.js can define, train, and run new or existing, pre-trained machine learning models entirely in the browser from the client-side, which improves the user experience through interaction while preserving privacy. Deep learning models deployed on front-end browsers must be small, have fast inference, and ideally be interactive in real-time. Therefore, the emphasis on development and deployment is different. This paper aims to review the development and deployment of these deep-learning web apps to raise awareness of the recent advancements and encourage more researchers to take advantage of this technology for their own work. First, the rationale behind the deployment stack (front-end, JavaScript, and TensorFlow.js) is discussed. Then, the development approach for obtaining deep learning models that are optimized and suitable for front-end deployment is then described. The article also provides current web applications divided into seven categories to show deep learning potential on the front end. These include web apps for deep learning playground, pose detection and gesture tracking, music and art creation, expression detection and facial recognition, video segmentation, image and signal analysis, healthcare diagnosis, recognition, and identification.
A 16 year-old man presented with fracture of both his femurs after a road traffic accident. Chest radiograph revealed mediastinal widening. Subsequent CT scan and arch aortogram confirmed the findings of traumatic aortic arch transection at the isthmus. He underwent successful surgical repair. High index of suspicion and prompt actions are important in managing this potentially fatal but treatable condition.
We present a case of cervical necrotising fasciitis in a 56 year old man, secondary to a rare mastoid infection. The patient had coexisting diabetes mellitus and hypertension. He was treated with early surgical debridement followed by neck and chest reconstruction and radical mastoidectomy. Aggressive antibiotic therapy and supportive care was given. He recovered well with minimal residual functional deficit.
Both community composition changes due to species redistribution and within-species size shifts may alter body-size structures under climate warming. Here we assess the relative contribution of these processes in community-level body-size changes in tropical moth assemblages that moved uphill during a period of warming. Based on resurvey data for seven assemblages of geometrid moths (>8000 individuals) on Mt. Kinabalu, Borneo, in 1965 and 2007, we show significant wing-length reduction (mean shrinkage of 1.3% per species). Range shifts explain most size restructuring, due to uphill shifts of relatively small species, especially at high elevations. Overall, mean forewing length shrank by ca. 5%, much of which is accounted for by species range boundary shifts (3.9%), followed by within-boundary distribution changes (0.5%), and within-species size shrinkage (0.6%). We conclude that the effects of range shifting predominate, but considering species physiological responses is also important for understanding community size reorganization under climate warming.