Artificial intelligence (AI) is a computer system that is able to perform tasks which normally require human intelligence. The role of AI in the field of gastroenterology has been gradually evolving since its inception in the 1950s. Discovery of wireless capsule endoscopy (WCE) and balloon enteroscopy (BE) has revolutionized small gut imaging. While WCE is a relatively patient-friendly and noninvasive mode to examine the nonobstructed small gut, it is limited by a lengthy examination time and the need for expertise in reading images acquired by the capsule. Similarly, BE, despite having the advantage of therapeutic intervention, is costly, invasive, and requires general sedation. Incorporation of concepts like machine learning and deep learning has been used to handle large amounts of data and images in gastroenterology. Interestingly, in small gut imaging, the application of AI has been limited to WCE only. This review was planned to examine and summarize available published data on various AI-based approaches applied to small bowel disease.
We conducted an extensive literature search using Google search engine, Google Scholar, and PubMed database for published literature in English on the application of different AI techniques in small bowel endoscopy, and have summarized the outcome and benefits of these applications of AI in small bowel endoscopy. Incorporation of AI in WCE has resulted in significant advancements in the detection of various lesions starting from dysplastic mucosa, inflammatory and nonmalignant lesions to the detection of bleeding with increasing accuracy and has shortened the lengthy review time in image analysis. As most of the studies to evaluate AI are retrospective, the presence of inherent selection bias cannot be excluded. Besides, the interpretability (black-box nature) of AI models remains a cause for concern. Finally, issues related to medical ethics and AI need to be judiciously addressed to enable its seamless use in future.
Introduction: Bacterial infections represents one of the most important precipitating event for acute decompensation and mortality in a case of cirrhosis of liver. Patients with cirrhosis are highly susceptible for bacterial infections and their severe courses. Infections occur more often in advanced stage of liver disease, impair hepatic function, trigger the onset of complications, and are significant factors of mortality as well. Gastrointestinal hemorrhage confers a higher risk for infections and infections play important role in provoking of variceal bleeding episodes and can also be associated with the failure to control bleeding. The incidence and severity of infection in cirrhosis is greater than in the population without cirrhosis. Infection with multi resistant organisms is common in cirrhosis and its occurrence is associated with higher mortality rates than in patients without cirrhosis. The endorgan damaging effect of bacterial infection is greater in patients with cirrhosis due to altered sensitivity, which often culminates in acute-on-chronic liver failure. Delays in the diagnosis and start of treatment results in higher mortality particularly in hypotensive patients with cirrhosis. Materials and methods: This was a hospital based observational, descriptive study to find data on bacterial infection in 123 cirrhotic patients. Results: Bacterial infection was present in 41(33.33%) patients of study population. SBP was the most common (39.02%) bacterial infection documented. In hospital mortality was highest with Child Pugh Class C (50%). Conclusion: With increase in Child Pugh Class, bacterial infections and in hospital mortality increases.
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