Traditionally,pre-operative biliary drainage(PBD) was believed to improve multi-organ dysfunction,and for this reason,was practiced worldwide.Over the last decade,this concept was challenged by many reports,including ...Traditionally,pre-operative biliary drainage(PBD) was believed to improve multi-organ dysfunction,and for this reason,was practiced worldwide.Over the last decade,this concept was challenged by many reports,including meta-analyses that showed no difference in morbidity and mortality between surgery with,and surgery without PBD,in operable malignant jaundice.The main disadvantages of PBD are seen to be the additional cost of the procedure itself,and the need for longer hospitalization.In addition,many studies showed the significance of specific complications resulting from PBD,such as recurrent jaundice,cholangitis,pancreatitis,cutaneous fistula,and bleeding.However,the results of these studies remain inconclusive as to date there has been no perfect study that equally randomized comparable patients according to the level of obstruction and technique used for PBD.Generally,endoscopic stent insertion(ES) is preferred for common duct obstruction,whereas endoscopic nasobiliary drainage and percutaneous biliary drainage is reserved for hilar obstruction,since ES in hilar block confers a high rate of cholangitis.Although,there is no guideline which either supports or refutes this approach,certain subgroups of patients,including those with symptomatic jaundice,cholangitis,impending renal failure,hilar block requiring preoperative portal vein embolization,and those who need pre-operative neoadjuvant therapy,are suitable candidates for PBD.展开更多
Malaria is the leading cause of morbidity and mortality in tropical and subtropical countries. Conventional microscopy is the Gold standard in the diagnosis of the disease. However, it is prone to some shortcomings wh...Malaria is the leading cause of morbidity and mortality in tropical and subtropical countries. Conventional microscopy is the Gold standard in the diagnosis of the disease. However, it is prone to some shortcomings which include time consumption and difficultness in reproducing results. Alternative diagnosis techniques which yield superior results are quite expensive and hence inaccessible to developing countries where the disease is prevalent. Thus in this work, an accurate, speedy and affordable system of malaria detection using stained thin blood smear images was developed. The method uses Artificial Neural Network (ANN) to test for the presence of plasmodium parasites in thin blood smear images. Images of infected and non-infected erythrocytes were acquired, pre-processed, relevant features extracted from them and eventually diagnosis was made based on the features extracted from the images. Diagnosis entailed detection of plasmodium parasites. Classification accuracy of 95.0% in detection of infected erythrocyte was achieved with respect to results obtained by expert microscopists. The study revealed that artificial neural network (ANN) classifiers trained with colour features of infected stained thin blood smear images are suitable for detection. It was further shown that ANN classifiers can be trained to perform image segmentation.展开更多
文摘Traditionally,pre-operative biliary drainage(PBD) was believed to improve multi-organ dysfunction,and for this reason,was practiced worldwide.Over the last decade,this concept was challenged by many reports,including meta-analyses that showed no difference in morbidity and mortality between surgery with,and surgery without PBD,in operable malignant jaundice.The main disadvantages of PBD are seen to be the additional cost of the procedure itself,and the need for longer hospitalization.In addition,many studies showed the significance of specific complications resulting from PBD,such as recurrent jaundice,cholangitis,pancreatitis,cutaneous fistula,and bleeding.However,the results of these studies remain inconclusive as to date there has been no perfect study that equally randomized comparable patients according to the level of obstruction and technique used for PBD.Generally,endoscopic stent insertion(ES) is preferred for common duct obstruction,whereas endoscopic nasobiliary drainage and percutaneous biliary drainage is reserved for hilar obstruction,since ES in hilar block confers a high rate of cholangitis.Although,there is no guideline which either supports or refutes this approach,certain subgroups of patients,including those with symptomatic jaundice,cholangitis,impending renal failure,hilar block requiring preoperative portal vein embolization,and those who need pre-operative neoadjuvant therapy,are suitable candidates for PBD.
文摘Malaria is the leading cause of morbidity and mortality in tropical and subtropical countries. Conventional microscopy is the Gold standard in the diagnosis of the disease. However, it is prone to some shortcomings which include time consumption and difficultness in reproducing results. Alternative diagnosis techniques which yield superior results are quite expensive and hence inaccessible to developing countries where the disease is prevalent. Thus in this work, an accurate, speedy and affordable system of malaria detection using stained thin blood smear images was developed. The method uses Artificial Neural Network (ANN) to test for the presence of plasmodium parasites in thin blood smear images. Images of infected and non-infected erythrocytes were acquired, pre-processed, relevant features extracted from them and eventually diagnosis was made based on the features extracted from the images. Diagnosis entailed detection of plasmodium parasites. Classification accuracy of 95.0% in detection of infected erythrocyte was achieved with respect to results obtained by expert microscopists. The study revealed that artificial neural network (ANN) classifiers trained with colour features of infected stained thin blood smear images are suitable for detection. It was further shown that ANN classifiers can be trained to perform image segmentation.
