Acta Informatica Medica最新文献

Background: Compression of the ulnar nerve at the level of Guyon's canal is a very rare compressive neuropathy. Due to the vast range of symptoms that can manifest depending on the degree of ulnar nerve compression, the clinical picture is not consistent.

Objective: The aim of the study is to outline the diagnostic techniques and therapeutic options.

Case report: We reported a case of ganglion cyst-induced compression of the ulnar nerve in Guyon's canal. A 45-year-old female patient underwent surgical ulnar nerve release in Guyon's canal at the Clinic for Plastic and Reconstructive Surgery.

Discussion: After a thorough medical history and physical examination, the diagnosis of the syndrome is made, and ultrasound and magnetic resonance imaging (MRI) testing are used to determine the origin of the neuropathy. A ganglion cyst was identified pathohistological one month following the surgical excision of the soft tissue tumor. In order to hasten the patient's nerve recovery, physical therapy was recommended, and the patient was monitored for the following two years. After two years of treatment, the patient has made a very good recovery of the functionally damaged hand, as determined by a modified Bishop scoring method for evaluating functional ulnar nerve recovery.

Conclusion: In virtually all cases, early surgical intervention can lead to an outstanding functional recovery. If the symptoms are more severe and continue or get worse for more than three months, early surgical intervention is the gold standard for treating Guyon's canal syndrome. If soft tissue formations are compressing the ulnar nerve in Guyon's canal, MRI is thought to be the gold standard for diagnosis.

Background: Internal diseases pose a significant public health concern due to their prevalence and impact on premature mortality and disability. This study investigates the role of internal diseases in the morbidity structure of the Republic of Kazakhstan's population, focusing on the period from 2019 to 2021.

Objective: The primary objective of this study is to assess the prevalence and dynamics of internal diseases among the adult population of the Republic of Kazakhstan during 2019-2021.

Methods: We conducted a comprehensive analysis of medical records from healthcare facilities across the Republic of Kazakhstan for the years 2019 to 2021. The study focused on diseases of the cardiovascular system, endocrine system, metabolic disorders, respiratory system, gastrointestinal tract, and urinary system. Epidemiological indicators, including prevalence rates and morbidity, were calculated for each disease category using official population data for the same period.

Results: Our findings indicate a noteworthy increase in the prevalence rates of internal diseases among the adult population of the Republic of Kazakhstan from 2019 to 2021. Diseases of the cardiovascular system were the most prevalent, with arterial hypertension and coronary heart disease being particularly pressing concerns. Diabetes mellitus and thyroid abnormalities were the most common endocrine organ diseases. Among respiratory diseases, bronchitis had the highest prevalence, followed by tracheitis, bronchial asthma, and pneumonia. Additionally, the prevalence of gastrointestinal tract diseases increased by 3% over two years.

Conclusion: This study underscores the urgent need for effective prevention and management of internal diseases in the Republic of Kazakhstan. The increasing prevalence rates across all leading categories of diseases highlight significant public health concerns.

Objective: Dark Triad Traits, Adverse Childhood Experiences, impulsivity and sensation seeking significantly influence whether one engages in or avoids various risk behaviours and personality throughout life.

Objective: The present study aimed to investigate how Dark Triad Traits, Adverse Childhood Experience and impulsivity sensation influence risk taking behaviour personality throughout life.

Methods: The sample included 222 university students from four universities, 82 males (36.9%) and 140 females (63.1%), and aged between 18 and 51 years.

Results: The results showed that adverse childhood experiences, psychopathy, narcissism, impulsivity and sensation-seeking predicted risk taking. Machiavellianism, on the other hand, did not significantly predict risk taking. Based on results, adverse childhood experiences predicted risk-taking directly and indirectly through psychopathy, narcissism, impulsivity and sensation seeking.

Conclusion: The results indicate that early childhood experiences are a significant factor in personality traits and that positive early experiences could lead to minimising risk taking and reducing levels of impulsivity, sensation-seeking and dark triad traits.

Background: Amblyopia affects 1-3% of the population, leading to irreversible vision loss in children and adults. Treatment options include refractive correction, occlusion therapy, and atropine penalization. Anisometropic amblyopia, caused by a difference in refractive status between the eyes, can be treated using contact lenses, glasses, ICL implantation, or cataract surgery with intraocular lens implantation. Tecnis Eyhance IOL is a superior solution, improving vision after eye surgery with a low incidence of halo, glare, or starburst.

Objective: The aim is to present the case of a patient with anisometropic amblyopia, in whom Eyhance IOL was implanted in both eyes as a solution to refractive error and initial cataract due to intolerance for contact lenses.

Case report: A 58-year-old female patient presented to our clinic complaining of blurry vision in her left eye that had persisted for a year. The patient reported intolerance to contact lenses and a history of amblyopia in her right eye. CDVA was 0.20 with -9.00/-1.50 x 25◦ in her right and 0.80 with +4.00 sphere correction in her left eye, while her CNVA was J9 with +2.50 and J1 with +2.50. Slit-lamp examination revealed early cataracts in both eyes, with otherwise normal findings. A dilated fundus examination showed vitreous liquefaction and myopic macula in the right eye but normal results in both eyes' posterior segments. The IOP was within normal limits, and the eye's axial length was measured. Considering the patient's intolerance to contact lenses, cataract surgery with intraocular lens implantation was deemed appropriate. Given the anisometropic amblyopia, the Eyhance lens was selected to optimize the patient's visual acuity. Following the procedure, the patient's visual acuity improved significantly, with her best CDVA at 0.35 in the right eye and 0.95 in the left eye. With +1.50 sphere correction, the CNVA was also enhanced, with the patient reading at J4 and J1 for her right and left eye, respectively. These improvements may have positively impacted the patient's quality of life and ability to perform daily activities.

Conclusion: Anisometropic amblyopia in 58-year-old women was treated successfully with cataract surgery and implantation of Eyhance IOL.

Background: Assessment of thyroid nodules histopathology using AI is crucial for an accurate diagnosis. This systematic review analyzes recent works employing deep learning approaches for classifying thyroid nodules based on histopathology images, evaluating their performance, and identifying limitations.

Methods: Eligibility criteria focused on peer-reviewed English papers published in the last 5 years, applying deep learning to categorize thyroid histopathology images. The PubMed database was searched using relevant keyword combinations.

Results: Out of 103 articles, 11 studies met inclusion criteria. They used convolutional neural networks to classify thyroid neoplasm. Most studies aimed for basic tumor subtyping; however, 3 studies targeted the prediction of tumor-associated mutation. Accuracy ranged from 77% to 100%, with most over 90%.

Discussion: The findings from our analysis reveal the effectiveness of deep learning in identifying discriminative morphological patterns from histopathology images, thus enhancing the accuracy of thyroid nodule histopathological classification. Key limitations were small sample sizes, subjective annotation, and limited dataset diversity. Further research with larger diverse datasets, model optimization, and real-world validation is essential to translate these tools into clinical practice.

Background: Cardiovascular complications are the leading cause of death in diabetic patients. Speckle tracking echocardiography can early detect left ventricular systolic dysfunction even when normal ejection fraction.

Objective: The study aims to evaluate left ventricular systolic function by Speckle tracking echocardiography and its relation with cardiovascular risk factors in type 2 diabetic patients.

Methods: A controlled cross-sectional descriptive study was conducted on 150 patients (75 type 2 diabetic patients and 75 controls).

Results: Type 2 diabetic patients had global longitudinal strain (-17.02±3.06%), global circumferential strain (-29.04±6.39%) were lower than the control group (p<0.05). Global longitudinal strain was correlated with systolic blood pressure (r=0.3), diastolic blood pressure (r=0.2), fasting plasma glucose (r=0.5), HbA1c (r=0.2), total cholesterol (r=-0.25), (p<0.05). Global circumferential strain was correlated with systolic blood pressure (r=0.2), diastolic blood pressure (r=0.2), HDL (r=-0.3), (p<0.05).

Conclusion: Type 2 diabetic patients have reduced global longitudinal strain and global circumferential strain. The reduction of global longitudinal strain, global circumferential strain was correlated with cardiovascular risk factors (hypertension, not good glycemia control, increasing BMI, dyslipidemia).

Background: COVID-19 is a virulent viral infection by SARS-CoV-2 which caused pandemic and high mortality. One of the numerous risk factors for worse clinical outcomes in COVID-19 patients is the presence of comorbidity. Diabetes Mellitus is a chronic metabolic disease frequently in COVID-19 patients. Insulin resistance, causes chronic inflammation in the body, may aggravate the clinical outcome COVID-19 patients.

Objective: The aim of the study was to examine factors that impact clinical outcomes in COVID-19 T2DM patients.

Methods: The method used an analytical method with cross sectional design. Population is inpatients in Haji Adam Malik Hospital diagnosed with COVID-19 and Diabetes Mellitus Type 2 with 99 inpatients as sample. The data used are secondary data obtained through medical records from a hospital covering patients characteristics and laboratory result The data was analyzed using t-independent and chi square test with SPSS program.

Results: Clinical outcomes for 99 patients are 60 patients are cured and 39 patients are dead. analytical study found a significant correlation between factors impacting clinical outcomes on COVID-19 patients with T2DM that are HbA1c level, D-dimer, cholesterol total and COVID-19 degree of severity and the clinical outcomes (p<0,05).

Conclusion: HbA1c level, D-dimer, total cholesterol and the infection degree of severity affects the clinical outcomes on COVID-19 with T2DM (p<0,05).

Background: Anemia is one of the major global problems that continues to this day. According to World Health Organization (WHO) data, anemia is found in 1.62 billion people or equivalent to 24.8% of the world's population while, the prevalence of anemia in children under 6 years of age in Indonesia reached 38.4%. Anemia, if undiagnosed or untreated for a long period of time can lead to multiorgan failure. The cardiovascular system is the most commonly affected system in chronic anemia. Between one-third and two-thirds of patients with severe anemia have cardiomegaly and this will return to normal within a few weeks after the anemia is well managed. This abnormality can be evaluated on chest radiograph or echocardiography.

Objective: This study aims to evaluate the association between anemia and cardiomegaly.

Methods: This was a cross-sectional which was carried out in the pediatric ward and pediatric cardiology outpatient clinic in the year 2022. The research subjects were children diagnosed with anemia, then they would undergo chest radiograph and echocardiography to assess whether there is cardiomegaly or not.

Results: Eighty one children were included in this study. The majority of them were girl, with a total of 43 people (53.1%). The median age of patients in this study was 7.75 years old. In addition, this study also found that the median of patients' body weight and height were 18.3 kg and 116 cm. In this study, the median hemoglobin level was 10.3 g/dL. For the echocardiography parameters in this study, the median of LA/Ao, EF and FS were 1.24, 65% and 35% respectively.Conclusion There is no association beteween anemia and cardiomegaly based on chest radiograph or echocardiography.

Background: The electrocardiograph (ECG) is efficient method for the accurate assessment of fetal heart rate. The barriers for accurate assessment are maternal heart rate, uterine contractions and abdominal muscles. Although previous monitoring methods have struggled to overcome these barriers, recent advances have led to a greater degree of success for listening and recording pulse-by-pulse fetal heart rate.

Objectives: A prospective cohort study evaluating the use, reliability and safety of non-invasive electrocardiography, in conjunction with Fetal Heart Rate parameters such as, Short Term Variability (STV) together with umbilical cord PH and Apgar score, during the active phase of childbirth.

Methods: A total of 41 women with single, normal, full-term pregnancies had systematic obstetric monitoring with Monica AN24. 20 had only monitoring and 21 also had and arterial blood flow measurements. pH was measured and correlated with neonatal Apgar score at 1 and 5 min. The study also included a questionnaire about the safety and usability of obstetric monitoring. Statistical analysis was done using IBM SPSS v. 26.0.

Results: Mean age was 28.8 years, (SD ± 6.153). Electrocardiogram recordings (ECG) were classified as normal (71%) and suspicious (29%). Baseline between ECGs was different (p = 0.025) similarly for Short term variability (STV) (p <0.0001). BMI did not differentiate SVT rates. Only high acceleration (p <0.029) and small slowdowns had a statistically significant difference between normal and suspected cardiographs (p <0.029). APGAR score did not differ, whereas the umbilical cord pH was different in normal ECGs compared to the suspect (p = 0.012) and STV was also differentiated. A usability and safety survey was conducted after recording with MONIKA AN24, and the response to whether they would accept recording with the device again, was positive for 96% of the 30 responders.

Conclusion: The present study shows that the use of electrocardiography in obstetrics allows to draw conclusions about the fetal hematopoiesis and oxygenation status. This method could be clinically applied and be an important tool for further screening in embryos that may be hypoxic and to decide whether to continue with a vaginal or cesarean delivery, thereby achieving the goal of reducing perinatal morbidity and mortality.

Background: Tamoxifen has been successfully administered as adjunctive therapy for breast cancer. However, the effect of tamoxifen as an estrogen agonist and antagonist can cause pathological changes in the uterus. The agonist effect may stimulate endometrial proliferation leading to endometrial polyps, hyperplasia, and, rarely, endometrial cancer.

Objective: We present the case of tamoxifen-treated breast cancer case to better understand one of the most serious consequences, endometrial cancer.

Case presentation: A 37-year-old woman came to our centre with complaints of abnormal vaginal bleeding. She has diagnosed with grade I infiltrative ductal carcinoma in 2018, with primary complaints of right breast mass and axillary lymphadenopathy. During this period, adjuvant chemotherapy was given tamoxifen 20 mg once daily. There were no complaints or relapses at a six-month follow-up over three years. In the fourth year, the patient complained of vaginal bleeding. A vaginal biopsy was performed, and the results showed low-grade endometrioid-type endometrial carcinoma. Total hysterectomy and bilateral salpingo-oophorectomy were performed with the resultant mass of up to half of the myometrial lining with metastatic negative parallax lymph nodes.

Conclusion: Following tamoxifen therapy, endometrial cancer is more likely to occur in patients. Patients who experience irregular vaginal hemorrhage should have hysteroscopy or uterine ultrasound performed, and if the cause is unknown, a biopsy should be performed.