amorphous, acellular, eosinophilic amyloid deposits within portal vessels and hepatic sinusoids leading to hepatocyte atrophy. C. Trichrome stain 203 (2022): gray blue amyloid deposits within sinusoidal spaces and within portal tracts. Bright blue collagen deposition is minimal. D, Congo red stain 103 (2022): Apple-green birefringence under polarized light within sinusoids and portal tracts.
Introduction: Colonoscopy is operator-dependent and missed lesions contribute to interval colorectal cancer (CRC). Previous research shows at least 8.6% of CRC cases occur within the three years following a negative screening colonoscopy. With recent developments in the field of artificial intelligence (AI) with deep learning techniques, especially convolutional neural networks (CNN), AI assisted colonoscopy was invented with real time automated polyp detection. Many studies have shown improved polyp detection rate with AI assisted colonoscopy. As this is a novel technique used by endoscopists, the aim of our study was to assess the impact of AI assisted colonoscopy on the mental workload of endoscopists. Methods: We conducted single center randomized controlled trial with gastroenterologists and fellows from Feb 2022-April 2022 with Medtronic GI genius system. Blocked randomization was performed depending on the number of procedures in a day. Gastroenterologists were randomized to perform procedure with AI assisted colonoscopy (AIC) or conventional colonoscopy (CC). The NASA task load index (TLX) score measures and conducts subjective mental workload (MWL) assessment while a subject is performing a certain task. This was completed by the endoscopist after each procedure. Primary outcome was MWL measured with NASA TLX, and secondary outcomes were total procedure time, withdrawal time, cecal intubation rate and polyp detection rate. Results: A total of 290 procedures were included in our study with 146 in AIC and 144 in CC group. AIC group had 58.22% females with mean age 56.66 (54.32-59.00) and mean . This was comparable to patients in CC group. Location of procedure (at hospital versus ambulatory endoscopy center), session time (AM versus PM), fellow participation, patients with history of diabetes, opioid use, tricyclic antidepressants, history of abdominal surgeries, history of constipation, bowel prep quality, type of sedation were similar between the two groups. Mean NASA TLX scores were ) in CC groups, P50.49. There is a trend towards increased withdrawal time in AIC compared to CC (mean 18.05 minutes vs 16.96 minutes; P50.29). A trend towards increased polyp detection was noted in the AIC group (76.03% vs 66.67%; P50.07). (Table ) Conclusion: Endoscopist mental workload during AI-assisted colonoscopy was comparable to conventional colonoscopy with a trend towards increased withdrawal time and polyp detection rate with AI.
Background Diabetic foot ulcer infection cause great morbidity and mortality among diabetic patients and is a major cause of lower extremity amputation worldwide. This study aimed to determine the profile of aerobic bacteria and their antibiotic sensitivity patterns in diabetic foot infections (DFI) among different Wagner's grades. Methods This study was conducted during December 2017 - March 2018 in a Diabetic Center, Sudan. A total of 152 diabetic patients with different grades of foot ulcers were randomly enrolled in the study. The patients were grouped using Wagner's classification. Tissue biopsies and deep swabs were collected from the ulcers for aerobic cultures. The cultured isolates were identified using phenotypic and biochemical properties and their sensitivity to commonly used antibiotics, Colistin, Aikacin, Ciprofloxacin, Augmentin, Ceftazideme, Gentamicin, Clindamycin, Ceftriaxone Meropenum. Cotrimoxazole, Erythomycin, Oxacillin and Vancomycin. Fusidic acid, Imepenem, and Piperacillin was tested using the Kirby Bauer disk diffusion method. Results The mean age of the patients was 54.31 (SD ± 12.1) years, male to female ratio of 8: 1. The mean duration of diabetes was 14 (SD ± 8) years. The ulcers varied in duration from 1 day to 10 years. of 152 samples 181 aerobic bacteria were isolated. Cultures yielded 1-3 isolate per culture. The maximum number was isolated from grade 3 group followed by long standing ulcer LSU group 50.8% and 28% respectively. Polymicrobial infection was higher in LSU (30.4%). The isolates were mostly Gram-negative bacteria. The most frequent were proteus spp. (35.3%), S. aureus MRSA 14.4% and Coliform 12.2% respectively. The most common isolates in grade 3 were P. Mirablis, Staphylococcus and Coliform and in long standing ulcers were P. Mirablis, S. aureus MRSA and Coagulase negative staphylococcus respectively. Conclusion Gram-negative bacteria were more prevalent and the most frequent pathogens were Proteus spp. The most common polymicrobial infections were due to P. mirablis with; P. aerginosa, S. MRSA and Coliform respectively . Gram negative rods were sensitive to Amikacin, (80.6) %) while the highest sensitivity of Gram positive was to Imepnem (85%). Most of the isolates were sensitive to Meropenem. No significant relation between Wagner grades and neuropathy was detected.
Objective: 1) Evaluate the role of clarithromycin in recurrent CRSwNP. 2) Evaluate the factors related to clinical improvement after clarithromycin in recurrent CRSwNP.
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