Atrial fibrillation (AF) is a life-threatening cardiac condition caused by inadequate blood flow, resulting in abnormal ECG records, blood clotting, and cardioembolic strokes. In recent years, physicians have been particularly concerned with early detection and diagnosis to overcome cardiogenic stroke. AF can be easily identified at the initial stages due to the development in computer-aided diagnosis. The performance of this method is affected by noise and the variations in pattern of the ECG, which leads to false diagnosis. Current signal processing and shallow machine learning (ML) approaches are severely limited in their ability to detect this condition accurately. Deep neural networks have been shown to be extremely effective at learning nonlinear patterns in a wide variety of problems, which include computer vision tasks. Deep learning models are computationally costly, non-explainable, and require a large quantity of data to discover characteristics. In contrast, ML approaches are explainable and require good feature extraction. In this manuscript, ML based supervised classification method is developed based on feature ensembling. ECG signals are preprocessed (mean subtraction followed by Butterworth filtering and computation of RR intervals) and subjected to feature extraction (by entropy-, wavelets-, statistical-features). The variations due to AF are effectively captured and selective features are ensembled to perform classification by SVM and KNN. This method is experimented on five different databases (such as: PAF prediction Challenge, Long-Term AF, Intracardiac, AF termination Challenge, and MIT-BIH atrial fibrillation) and the classification performance is found to be the highest compared to the state of art. To evaluate the effectiveness of the proposed technique, AF-specific characteristics are retrieved from the ECG signal in the presence of artificially added noise and the features are fed to classifiers for classification. Performance of the proposed method is compared with the deep learning based approaches. The graphical abstract of the proposed atrial fibrillation detection method is presented. The overall accuracy of the proposed method was found to be 91.88 % and 91.99 % for wavelets-SVM and ensemble wavelet-SVM, respectively. This model attained 100 % accuracy for entropy and statistical features with SVM and KNN, respectively.
Primary cutaneous adnexal adenocarcinoma not otherwise specified (PCAANOS) is a rare malignant neoplasm derived from adnexal structures, often posing diagnostic challenges due to nonspecific morphology and immunohistochemical overlap with metastatic adenocarcinomas. We describe a case of PCAANOS and review key diagnostic considerations, including histopathology, immunohistochemistry, and radiologic evaluation, emphasizing the necessity of excluding cutaneous metastasis. PCAANOS commonly affects older adults and may recur or metastasize. Accurate diagnosis requires comprehensive evaluation. Therapeutic guidelines remain undefined; management typically involves complete surgical excision. Multidisciplinary management is essential given the rarity and therapeutic complexity of PCAANOS.
Tropical acute febrile illness often causes AKI in India and outcome linkage with AKIN staging is still limited. Hence, we studied 150 adults with tropical infection related AKI staged by AKIN at 48 hours and followed till discharge or death. Leptospirosis was the main cause and higher AKIN stage showed more oliguria organ dysfunction longer stay higher dialysis need with mortality rising to 40.9% in stage III. This study adds a clear stage based risk gradient plus simple bedside red flags and basic labs for early triage and it supports timely aggressive support and dialysis referral to reduce avoidable deaths.
Background: Adolescence is a critical stage where nutrition supports growth and lifelong health. Undernutrition impairs pulmonary function by reducing skeletal muscle mass, including the diaphragm, weakening respiratory mechanics and lowering Peak Expiratory Flow Rate (PEFR). Malnourished children often show reduced FVC and FEV1, likely from delayed airway growth. Recognizing the link between nutrition and PEFR highlights how deficiencies extend beyond stunted growth to compromise lung function. PEFR, as a simple non-invasive measure, can aid early detection and guide targeted nutritional and respiratory interventions for adolescents. Materials and Methods: This cross-sectional study was carried out to ascertain the relationship between undernutrition and peak expiratory flow rate in Puducherry's school-age adolescents (10–19 years). The height and BMI Z scores were calculated using the WHO growth chart. The peak expiratory flow rate is measured using peak flow meters. Results: The study included 540 adolescents (48.7% males, 51.3% females) with a balanced age distribution across 10– 18 years. PEFR was found to correlate positively with age and gender, increasing steadily with age and consistently higher in males. Undernutrition, particularly stunting and thinness, showed a significant negative impact on PEFR, underscoring how nutritional deficiencies impair lung function. Overnutrition also demonstrated a negative association, though not statistically significant, suggesting a possible double burden of malnutrition. Stunting exerted a stronger effect than thinness, reflecting the irreversible impact of chronic malnutrition compared to the potentially reversible effects of acute muscle wasting. Conclusion: Timely diagnosis and intervention during adolescence are crucial to enable catch-up growth and preserve lung function. Periodic nutritional assessments can help detect stunting early and prevent long-term pulmonary complications. Undernourished adolescents presenting with respiratory illness require heightened clinical care to reduce morbidity and mortality, emphasizing the importance of integrated nutritional and respiratory health strategies.
Abstract Piezogenic pedal papules (PPPs) are benign herniations of subcutaneous fat induced by pressure, commonly observed in individuals with prolonged standing, athletes, or those with connective tissue disorders. Although typically associated with identifiable mechanical or systemic factors, idiopathic presentations in otherwise healthy individuals are uncommon. We report the case of a 21-year-old healthy male who presented with asymptomatic, skin-colored, compressible papules over both heels for 6 months. The lesions appeared on standing and regressed upon elevation. Clinical examination revealed multiple soft papules over the posterior and lateral aspects of both heels without tenderness or overlying skin changes. Routine investigations were normal. Based on characteristic clinical features, a diagnosis of PPPs was made. No intervention was required apart from reassurance and advice to avoid prolonged standing and use cushioned footwear.
