African Journal of Medicine and Surgery

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 11 (7), pp. 001-023, July, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper
    
Automated Segmentation and Extraction of Coronary Artery Tree Structures from Angiograms Using Gaussian Filtering and Thresholding

Hasan H. Khaleel¹*, Rahmita O. K. Rahmat¹, D. M. Zamrin², Ramlan Mahmod¹ and Norwati Mustapha^1
1Department of Multimedia, Faculty of Computer Science and Information Technology, UPM, 43400, Serdang, Malaysia.
²Heart and Lung Centre, National University of Malaysia Medical Centre, HUKM, 56000 Cheras, Kuala Lumpur, Malaysia. 

Accepted 24 April, 2024

Abstract

Dynamic variations in the curvilinearity of coronary arteries pose significant challenges for study using current angiograms. Nonetheless, both experimental and clinical evidence indicates that vessel extraction is valuable for surgical treatment and clinical research. In this paper, we present an automated algorithm designed to identify the outlines of coronary artery tree blood vessels in angiograms. This approach serves as a practical tool for physicians. The algorithm automates the segmentation of coronary arteries from cineangiograms, followed by precise extraction of vessel features. Such preprocessing, in conjunction with a matched Gaussian filter, can significantly enhance results. The segmentation algorithm comprises two key processes: (1) Gaussian filtering of blood vessels and (2) thresholding. We evaluated the algorithm using a raw dataset of 100 angiogram images, validating the results through two methods. First, hand-labeled annotations provided ground truth segmentation for 20 images, revealing that our algorithm outperformed manual detection, even in cases of poor contrast that the naked eye could not recognize. Second, we employed a questionnaire to assess the effectiveness of the illustrated output. The hand-labeling matched our results with an accuracy of 98%, while the questionnaire validation rate was 90.84%. We conclude that our enhanced algorithm is effective for extracting coronary artery tree vessels, including smaller branches. Additionally, the algorithm operates efficiently, completing vessel extraction in approximately 14 to 15 seconds per image.

Key words: Angiocardiography, coronary artery segmentation, matched filter, adaptive thresholding, vessel extraction.

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 11 (6), pp. 001-007, June, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Simulation of Living Intra-Epidermal Micro Patterns to Facilitate Guided Tissue Regeneration of the Human Skin

Denis E. Solomon

96 Standishgate, Wigan WN1 1XA, England. E-mail: [email protected].

Accepted February 26, 2024

Abstract

The methodology for isolating living intra-epidermal micro patterns using a tissue culture technique is detailed. The disassembly of the stripped epidermis (after Dispase digestion at 37°C) into epidermal brown rosettes (observed under a phase contrast microscope) forms intra-epidermal micro patterns. The stepwise reasoning for identifying epidermal basal layer rosettes and the distinction between attached upright and inverted brown rosettes spreading their epidermal cell contents onto a prepared extracellular matrix is explained. Mimicking the circular shape of brown rosette layers using a microscopic sterile cornstarch granule (appearing donut-shaped under the microscope) as a biodegradable nutritional scaffold is proposed. A lightweight antibiotic ointment combined with the cornstarch granules was utilized, and the significance of this mixture in guided tissue regeneration of the epidermis after Mohs surgery for basal cell carcinomas, as a treatment for second-degree burns, and for potential healing of donor sites after skin biopsies is discussed.

Key words: Natural micro patterns, Mohs surgery, basal layer, tissue repair, epidermal-melanin unit, human epidermis, Cellular Potts Model, microscopic nutritional cell scaffold.

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 11 (5), pp. 001-004, May, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Impact of Dexmedetomidine on Hemodynamic Stability, Cerebral State Index, and Postoperative Wakefulness in Geriatric Patients Undergoing Total Hip Replacement with General Anesthesia

Jun Zhou, Jie Wang and Fanmin Meng*

Department of Anesthesiology, Renmin Hospital, He Nan, China.

Accepted 7 March, 2024

Abstract

This study aimed to investigate how dexmedetomidine (Dex) administration influences hemodynamics [systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR)] and cerebral state index (CSI) in elderly patients undergoing total hip replacement (THR) surgery with general anesthesia. Patients aged sixty (60) years undergoing THR surgery and general anesthesia were recruited and randomly divided into an observation and a control group. The 30 patients in the observation group received intravenous 0.3 µg/kg Dex via an implanted minipump, while the control group received saline. Hemodynamic parameters including SBP, DBP, HR, and CSI were recorded at various time points: start of surgery (T0), start of drug administration (T1), 10 minutes post-drug (T2), skin incision (T3), 30 minutes post-incision (T4), extubation (T5), and 30 minutes after extubation (T6). Additionally, wakening time, extubation time, and vigilance/sedation (OAA/S) scores 30 minutes post-surgery were documented. In both groups, SBP, DBP, and HR decreased at T2 and increased at T5, showing significant differences from T0 (P<0.05). The observation group exhibited lower SBP, DBP, and HR at T5 and T6 compared to the control group (P<0.05). CSI decreased at T2 and increased at T5 in both groups, with significant differences from T0 (P<0.05). The observation group also had lower CSI values at T5 and T6 relative to the control group (P<0.05). Furthermore, the observation group had shorter extubation and wakening times, along with higher vigilance/sedation (OAA/S) scores compared to the control group (P<0.05). Dex administration stabilizes hemodynamics (SBP, DBP, and HR) and reduces CSI in elderly patients undergoing THR surgery with general anesthesia, also decreasing extubation and wakening times post-surgery.

Key words: Dexmedetomidine, aged patients, total hip replacement, general anesthesia, hemodynamics, cerebral function index, extubation time, wakening time.
 

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 11 (4), pp. 001-005, April, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Open Prostatectomy for the Treatment of Extensive Benign Prostatic Hyperplasia

Long Zhi, He Le-Ye*, Zhang Yi-Chuan, Huang Kai, Shi Xuan-Yan, Sun Xiao-Hui and Peng Dong-Yi

Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, PR China.

Accepted 25 January, 2024

Abstract

The objective of this study is to assess the efficacy and safety of open surgical intervention for large volume (> 150 ml) benign prostatic hyperplasia while summarizing our clinical findings. From January 2001 to September 2010, surgeries were performed on 15 patients diagnosed with significant volume benign prostatic hyperplasia. The average age of these individuals was 71.8 ± 6.1 years. The average prostate volume measured 217.2 ± 90.6 ml (range: 150.1 to 471.7 ml). Follow-up assessments occurred at one, three, six, and twelve months post-surgery. Evaluation metrics included maximum urinary flow rate (Qmax), international prostate symptom score (IPSS), and quality of life (QoL). The findings are as follows: the average weight of the excised glands was 201.3 ± 87.5 g; the average surgical duration was 65 ± 20.4 min; and mean hemoglobin loss during surgery was 1.4 ± 1.3 g/dl. A single case of blood transfusion occurred. Post-catheter removal, all patients were able to urinate independently. One month post-surgery, Qmax improved to 21.5 ± 4.6 ml/s (P < 0.001), while IPSS and QoL scores decreased to 7.3 ± 2.5 and 2.4 ± 0.3 (P < 0.05), respectively. All patients with lower urinary tract symptoms showed significant improvement by the 12-month follow-up. Two patients experienced mild incontinence initially; however, their symptoms resolved within three months. In conclusion, open suprapubic transvesical prostatectomy proves to be a safe and effective option for treating patients with large volume benign prostatic hyperplasia, with adequate preoperative preparation being crucial for ensuring patient safety and minimizing postoperative complications.

Key words: Benign prostatic hyperplasia, huge volume prostate, surgical treatment.
 

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 11 (3), pp. 001-004, March, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Case Report

Surgical management of acquired anterior diaphragmatic hernia via laparoscopy

Abdullah Alwabari, Lalit Parida and Ahmed H. Al-Salem*

Division of Pediatric Surgery, Department of Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia.

Accepted 25 November, 2023

Abstract

Congenital diaphragmatic hernia is a relatively common condition with an incidence of about 1 in 2000 to 1 in 5000 live births. Most cases occur posterolaterally through the foramen of Bochdalek and usually present immediately after birth with respiratory distress. Congenital anterior diaphragmatic hernia (Morgagni's hernia) is rare, accounting for less than 5% of all types of congenital diaphragmatic hernias. Most of these cases are seen in older children and are usually asymptomatically discovered incidentally or during investigations for some other unrelated condition. Iatrogenic anterior diaphragmatic hernia on the other hand is extremely rare. This report describes an iatrogenic anterior diaphragmatic hernia in a 6-month-old child following cardiac surgery that was repaired laparoscopically. The literature on the subject is also reviewed.

Keywords: Anterior diaphragmatic hernia, Iatrogenic, laparoscopic repair.

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 11 (2), pp. 001-004, February, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Efficacy of carbetocin in hemorrhage prevention during laparoscopic myomectomy

Man Yang, Chengyong Wu*, Xuezhen Wen, Mei Lin and Liping Li

Meizhou People’s Hospital, Mei Zhou, 514003, China.

Accepted 2 September, 2023

Abstract

The objective of this study was to evaluate the clinical effect and safety of carbetocin administered to prevent bleeding in laparoscopic myomectomy. A retrospective analysis of April, 2006 to April, 2011 laparoscopic myomectomy hand clinical data of 70 patients was carried out. The 70 patients were divided into treatment group and control group; the treatment group was given preoperative carbetocin, while the control group was given preoperative beta oxytocin after giving them oxytocin, which was administered in the same way as in the treatment group. Blood loss, operative time, postoperative hemoglobin (Hb) values, decrease exhaust time, and postoperative hospital stay were observed. All the patients were operated on successfully with no conversion to open surgery; 100% success rate was recorded in the treatment group as blood loss and operative time were lower in that group than in the control group, showing a significant difference (t = 5.31, 3.661; P < 0.05). After twenty-four hours, Hb decreased in the two groups; however, the value of the difference in the decrease was not statistically significant (t = 2.802; P > 0.05). In the treatment group, Hb value decreased after 72 h and hospital stay and discharge time after were significantly lower compared to the control group; the difference was significant (t = 4.902, 4.052, 4.088; P < 0.05). In both groups, no serious adverse reactions and occurrence of postoperative morbidity were observed. Carbetocin showed good clinical efficacy when given to laparoscopic myomectomy patients, causing less blood loss, shorter operative time, and rapid postoperative recovery; therefore, it is safe, reliable, and worthy of clinical application.

Keywords: Laparoscopy, myomectomy, bleeding, carbetocin.