Although factors influencing sputum smear conversion in tuberculosis have been studied well, the effect of smoking is largely unknown. Excluding those with incomplete history or drug resistant isolates, 339 patients out of the 526 sputum positive patients registered between 1998 and 2000 were studied. At the end of 2 months, smokers and non-smokers converted with almost the same frequency to a negative sputum status {P=0.065, OR (95%CI) 0.47 (0.21-1.06)}. Although gender or age had no effect on sputum conversion with respect to smoking status, expatriate smokers as a whole showed a significant difference. (P=0.039). On applying logistic regression model, smokers with far advanced radiographic abnormalities (P<0.038) or with 3+ smear status (P=0.011), were found to have a less chance of an early smear conversion. In conclusion smoking did not influence sputum smear conversion in tuberculosis. However, as expatriate smokers and smokers with advanced disease showed a delay in smear conversion, smoking should be discouraged in patients with pulmonary tuberculosis.
We present the rare case of a primary gastro-aortic fistula involving the native aorta and proximal stomach in a patient with a chronic gastric ulcer and prior history of Nissen fundoplication. Our case highlights the importance of keeping this rare and fatal condition as a differential diagnosis in patients with prior history of Nissen fundoplication surgery.
Patients with laryngeal cancer have a high risk of developing lung cancer in the future. A patient presented with a complaint of left-sided chest pain for the last 3 months. Chest X-ray posterior-anterior view showed a homogeneous opacity in the left upper lung field with elevation of the diaphragm on the left side. CECT thorax revealed a heterogeneously enhancing soft tissue density mass lesion in the superior segment of the lingular lobe. On histopathological examination of the mass lesion, it was diagnosed as adenocarcinoma of the lung. About 10 months previously, the patient was treated for a laryngeal squamous cell carcinoma. Patients with laryngeal cancer should be routinely screened during follow-up with chest X-ray or CT scan for the early detection of lung cancer.
Most research on question answering focuses on the pre-deployment stage; i.e., building an accurate model for deployment. In this paper, we ask the question: Can we improve QA systems further post-deployment based on user interactions? We focus on two kinds of improvements: 1) improving the QA system's performance itself, and 2) providing the model with the ability to explain the correctness or incorrectness of an answer. We collect a retrievalbased QA dataset, FEEDBACKQA, which contains interactive feedback from users. We collect this dataset by deploying a base QA system to crowdworkers who then engage with the system and provide feedback on the quality of its answers. The feedback contains both structured ratings and unstructured natural language explanations. We train a neural model with this feedback data that can generate explanations and re-score answer candidates. We show that feedback data not only improves the accuracy of the deployed QA system but also other stronger non-deployed systems. The generated explanations also help users make informed decisions about the correctness of answers. 1
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