Ahmed Aber

A review on gastric diverticulum

The gastric fundal diverticulae are rare. They can present with variable symptoms. We are enclosing a literature review on gastric fundal diverticulum. Lessons have emerged which may help in the management of this rare condition in future.

An Unusual Case of Spontaneous Bladder Perforation with Associated Autodialysis of the Ensuing Urinary Ascites

Spontaneous rupture of the urinary bladder is a rare occurrence, and when encountered it is a diagnostic challenge. We present an unusual case of urinary bladder rupture in a patient with severe cerebral palsy who initially presented with localized abdominal pain and during admission developed generalized peritonitis caused by bladder rupture. In this case, the patient had none of risk factors associated with urinary bladder.

Utilising Stochastic Diffusion Search to identify metastasis in bone scans and microcalcifications on mammographs

This paper introduces a novel approach in using a swarm intelligence algorithm - Stochastic Diffusion Search - as a tool to identify metastasis in bone scans and micro-calcifications on the mammographs. This algorithm is adapted for this particular purpose and its performance is investigated by running the agents of the swarm intelligence algorithm on sample bone scans whose status have been determined by the experts. The result of a statistical analysis is also reported, highlighting the behaviour of the algorithm when presented with different samples. Additionally a mathematical approach is presented, providing guideline for estimating the number of iterations required before the swarm intelligence algorithm terminates.

Acute mesenteric ischemia and duodenal ulcer perforation: a unique double pathology

BackgroundAcute mesenteric ischaemia and duodenal perforation are surgical emergencies with serious consequences. Patients presenting with acute mesenteric ischaemia alone face a high mortality rate as high as 60% whereas those presenting with peptic ulcer perforation the mortality rates range from 6-14%. There are very few reported cases of patients presenting with this dual pathology.Case presentationWe report a unique case of a 53 year old Italian lady who presented with acute mesenteric ischaemia and duodenal perforation. This is the first report of massive bowel ischaemia and duodenal perforation with no apparent underlying common pathophysiology leading to this presentation.ConclusionEarly management in the intensive care unit and appropriate surgical intervention maximised the patient’s chances of survival despite the poor prognosis associated with her dual pathology. The rare pathology of the patient described can be explained by two possible hypotheses: peptic ulcer disease causing duodenal ulceration, which precipitated ischaemic infarction of the small bowel. The second hypothesis is the patient developed a stress related ulcer following ischaemic bowel infarction secondary to arterial thrombosis.

Dispersive Flies Optimisation and Medical Imaging

One of the main sources of inspiration for techniques applicable to complex search space and optimisation problems is nature. This paper introduces a new metaheuristic—Dispersive Flies Optimisation (DFO)—whose inspiration is beckoned from the swarming behaviour of flies over food sources in nature. The simplicity of the algorithm facilitates the analysis of its behaviour. A series of experimental trials confirms the promising performance of the optimiser over a set of benchmarks, as well as its competitiveness when compared against three other well-known population based algorithms. The convergence-independent diversity of DFO algorithm makes it a potentially suitable candidate for dynamically changing environment. In addition to diversity, the performance of the newly introduced algorithm is investigated using the three performance measures of accuracy, efficiency and reliability and its outperformance is demonstrated in the paper. Then the proposed swarm intelligence algorithm is used as a tool to identify microcalcifications on the mammographs. This algorithm is adapted for this particular purpose and its performance is investigated by running the agents of the swarm intelligence algorithm on sample mammographs whose status have been determined by the experts. Two modes of the algorithms are introduced in the paper, each providing the clinicians with a different set of outputs, highlighting the areas of interest where more attention should be given by those in charge of the care of the patients.

Dynamic focus optical coherence tomography: feasibility for improved basal cell carcinoma investigation

Basal cell carcinoma (BCC) is the most common form of skin cancer. To improve the diagnostic accuracy, additional non-invasive methods of making a preliminary diagnosis have been sought. We have implemented an En-Face optical coherence tomography (OCT) for this study in which the dynamic focus was integrated into it. With the dynamic focus scheme, the coherence gate moves synchronously with the peak of confocal gate determined by the confocal interface optics. The transversal resolution is then conserved throughout the depth range and an enhanced signal is returned from all depths. The Basal Cell Carcinoma specimens were obtained from the eyelid a patient. The specimens under went analysis by DF-OCT imaging. We searched for remarkable features that were visualized by OCT and compared these findings with features presented in the histology slices.

Benign cystic mesothelioma: a rare cause for scrotal swelling.

Benign cystic mesothelioma of the tunica vaginalis is a rare occurrence. It usually presents with painless gradual swelling in the scrotum. These types of benign mesotheliomas typically occur in the peritoneum and usually affect young to middle-aged patients. We present in this case an unusual case of benign cystic mesothelioma of the tunica vaginalis in a 77-year-old male patient.

Deploying swarm intelligence in medical imaging identifying metastasis, micro-calcifications and brain image segmentation.

This study proposes an umbrella deployment of swarm intelligence algorithm, such as stochastic diffusion search for medical imaging applications. After summarising the results of some previous works which shows how the algorithm assists in the identification of metastasis in bone scans and microcalcifications on mammographs, for the first time, the use of the algorithm in assessing the CT images of the aorta is demonstrated along with its performance in detecting the nasogastric tube in chest X-ray. The swarm intelligence algorithm presented in this study is adapted to address these particular tasks and its functionality is investigated by running the swarms on sample CT images and X-rays whose status have been determined by senior radiologists. In addition, a hybrid swarm intelligence-learning vector quantisation (LVQ) approach is proposed in the context of magnetic resonance (MR) brain image segmentation. The particle swarm optimisation is used to train the LVQ which eliminates the iteration-dependent nature of LVQ. The proposed methodology is used to detect the tumour regions in the abnormal MR brain images.

Themes that Determine Quality of Life in Patients with Peripheral Arterial Disease: A Systematic Review

ObjectivesThe aim of this study was to identify domains that determine quality of life in patients with peripheral arterial disease and find the patient-reported outcome measures that can examine the identified themes.MethodsA systematic review of all the main six databases was undertaken to identify primary qualitative studies reporting on the health and/or quality of life of patients with peripheral arterial disease. The quality of studies was assessed using the Critical Appraisal Skills Program criteria. Findings from the included studies were analysed using framework analysis methodology. The identified themes were mapped against the items/domains of validated patient-reported outcome measures used in patients with peripheral arterial disease.ResultsThe systematic review identified eight papers that fulfilled the inclusion criteria. The included papers reported the views of 186 patients with peripheral arterial disease including patients with intermittent claudication, critical ischaemia and amputation secondary to peripheral arterial disease. The overall quality of the included studies was good based on Critical Appraisal Skills Program criteria. Framework analysis identified 35 themes that were divided into six main groups: symptoms, impact on physical functioning, impact on social functioning, psychological impact, financial impact and process of care. The best-fit generic and disease-specific patient-reported outcome measures were the Nottingham Health Profile and the Vascular Quality of Life Questionnaire, respectively. None of the patient-reported outcome measures covered all the themes important to patients with peripheral arterial disease.DiscussionThe findings from the review identified the important domains that affect patients living with peripheral arterial disease. None of the current generic and disease-specific patient-reported outcome measures provide a comprehensive measure for all themes that impact the daily living of patients with peripheral arterial disease.

A systematic review of qualitative research into people's experiences of living with venous leg ulcers

AIM To systematically identify, evaluate and synthesize qualitative research that examined the symptoms and health-related quality of life themes that are important from the perspective of patients with venous leg ulceration. BACKGROUND Venous leg ulceration is a common chronic condition; the symptoms and associated treatments have a negative effect on health-related quality of life. Qualitative research methods can provide insight into the personal experiences of patients with venous leg ulceration. DESIGN Qualitative evidence synthesis (using framework synthesis). DATA SOURCES Multiple electronic databases including MEDLINE, EMBASE, PsycINFO and CINAHL were comprehensively searched from inception to November 2015. REVIEW METHODS Systematic identification, quality assessment and synthesis of existing qualitative research were performed; framework synthesis was conducted on included studies. An inductive approach was used and emergent themes were identified. The final stage in the synthesis involved the development of new interpretations. RESULTS Thirteen studies met the inclusion criteria; the overall quality of the included studies was good. Four overarching themes were identified; physical impact, psychological impact, social impact and treatment and, in these, further subthemes were identified. Ulcer and treatment-related pain, as well as odour and exudate appeared to have significant and direct negative effects on quality of life, with additional and cumulative effects on sleep, mobility and mood. CONCLUSION The themes identified in this review should be considered by professionals providing services, care and treatment for venous leg ulcer patients and in the selection, or development, of patient-reported outcome measures for use with this population.