Diabetic Retinopathy (DR) is the most common complication that arises due to diabetes, and it affects the retina. It is the leading cause of blindness globally, and early detection can protect patients from losing sight. However, the early detection of Diabetic Retinopathy is an difficult task that needs clinical experts’ interpretation of fundus images. In this study, a deep learning model was trained and validated on a private dataset and tested in real time at the Sindh Institute of Ophthalmology & Visual Sciences (SIOVS). The intelligent model evaluated the quality of the test images. The implemented model classified the test images into DR-Positive and DR-Negative ones. Furthermore, the results were reviewed by clinical experts to assess the model’s performance. A total number of 398 patients, including 232 male and 166 female patients, were screened for five weeks. The model achieves 92.71% accuracy, 91.89% sensitivity, and 92.90% specificity on the test data as labelled by clinical experts on Diabetic Retinopathy.
Anterior-lateral Vs Anterior-posterior Electrode Positioning for Cardioversion of Atrial Fibrillation and Atrial Arrhythmias: A Systematic Review and Meta-analysis
Introduction:
Multiple randomized controlled trials (RCTs) have compared the efficacy of anterolateral (AL) and anteroposterior (AP) electrode positioning for cardioversion of atrial fibrillation and other atrial arrhythmias with conflicting results. We hypothesized that AP electrode positioning will have a superior efficacy for cardioversion due to better alignment of the energy vector with the atria.
Methods:
A systematic search was conducted in the MEDLINE and Embase databases utilizing the Ovid interface. Results were screened to identify RCTs comparing AL and AP position of electrodes for cardioversion for atrial arrhythmias. Studied outcomes included the success of cardioversion, number of shocks, and mean shock energy required for successful cardioversion to sinus rhythm. Mantel-Haenszel aggregated risk ratios (RR) with 95% CIs were calculated.
Results:
A total of 14 RCTs were included comprising 2445 patients (1329 AL, 1116 AP). There was no statistically significant difference between the two groups with respect to successful cardioversion (RR 1.02 [0.97-1.06]; p = 0.43), first shock success (RR 1.14 [0.99-1.32]; p = 0.06), second shock success (RR1.08 [0.94-1.23]; p = 0.29), mean shock energies (mean difference 6.49 [17.33-30.31]; p = 0.59). We additionally compared success at high; >150 J (RR 1.02 [0.92-1.14] and low; <150 J (RR 1.09 [0.97-1.22]; p = 0.64) cardioversion energies which also did not show any significant difference.
Conclusions:
There is no significant difference in the efficacy between AL vs. AP electrode position for cardioversion of atrial arrhythmias.
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