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The Swiss Medicine & Pharmaceuticals,

Consultation In Applied Research Using Ai & ML @ Institute Of Bio Medical Engineering, Applied Research Using BigData in Public Health




    Non Prejudicial Disclosure, Intellectual Property: Solution Design Using Ai in Bio Medical Engineering,
    Date: Jun 14, 2024
    Thretre: Development Country Applied Research: Ai in Public Health Care

    Contagious and Infectious Disease
    Laboratory Medical Science & Engineering - Cancer, HIV, Diabetes, HPV Research and Heredity Blood, Water Borne Diseases


    Case 31:Dengu Death - Diagnosis:



    Our Patient is a 60 yr old female who possessed Dengu symptoms. Weakness, unable swollen throat. We conducted the following diagnostics, of her 5 living years (1997-2023 from 55-60 of her age) haematology and pathology tests that show gradual from excellent to disease vulnerability , to sinus infection , diabetes, kidney disease, heart disease, asthma, liver disease finally to Dengu and sudden decrease of platelets due to malfunction of kidney from diabetes, infection in thyroid , designated by TSH reading, sudden overnight abrupt decrease in platelet to 40,000/Cmm within moments before beiing able to replenish with blood platelets, and towards heart-brain communication loss plunging in to death , with an unsustainable bio-physical system of a Human Being exposed to sudden unpredictable mosquito bites.


    Status: Deceased due to Dengu infection. we adopt the following tests:

    .

    We used

  • Vitors 5600/Advia Centaur Xpt/Immulite 2000 XPi/Liaison / Maglumi 2000 Plus Random Access Immunoassay Analyzer,
  • Urised 3 and Labumat Urine Analyzer
  • Atellica Siemens Automated Analyzer

  • Vitros ECI /Advia Centaur XP/Architect I 1000 SR/Liaison Random Access
  • Checked Manually
    Digital X-Ray of P.N.S O/M view


    PNS OM View:

    Air fluid levels are noted in both maxillary sinuses.
    Rests of the paranasal sinus are o formal radiology
    Nasal septum is central
    No bony erosion is seen
    With above these we conclude acute maxillary sinusitis (Bil)


    X-Ray 1 film 100% CXR PA Digital

    Chest P/A View

    Lings: Ling marking are accentuated
    Hilar Shadow: Normal
    Diaphragm: Normal in position and contour Basal Angle: Clear
    Heart: Mildly enlarged in transverse diameter .Aorta is unfolded.
    Trachea: Appears central in position
    Bony Thorax : Reveals no abnormality
    Impression: Mild Cardiomegaly.

    X-Ray of Nasopharynx –Lateral View

    Normal thinness of the nasopharyngeal tonsil noted
    No abnormal pre-vertical soft tissue shadow seen
    Air way is clear
    Soft tissue swelling is notice on the nose

    ICT For Dengu Antibodies (IgG and IgM)

    IgG positive
    IgM Negative
    Comments: probably indicative of secondary dengu infection .please correlated the result with clinical condition.



    Prothrombin Time

    Estimation are carried out by Sysmex CA-104/Sysmex CS-1600 /STA Compact Max (Stago) Fully Automated Coagulation Analyzer


    Control 12 second ref value 12-17
    Patient 14 second
    Prothrombin Index 85.71 %
    Ration 1.16
    INR 1.17


    Creatinine Serum 151 micro mol./ liter ref value M:60-130 F :53-120 micro mol/Liter

    Urine Examination


    Physical Examination:


    Quantity a Few Mil
    Color Straw
    Appearance Clear
    Sediments Nil


    Chemical Examination


    Reaction pH Acidic
    Sugar (reducing Substances) Nil
    Albumin Nil
    Excess of Phosphates Nil




    Microscopic Examination

    Pus Cells 1-2 /hpf
    RBC (Red blood cells) Nil
    Epithelial Cell few,++

    Serum Crematine 1.3 mg/dl Male -07-1.4 mg/dl

    Female- 0.7-1.2 mg/dl

    TSH 50.5 microIU/ml Adult 0.35-5.50
    Child 0.70-5.70
    Infant 0.80-9.10
    Newborn 1.00-39.0
    Urine for Ketone Bodies Absent




    Immunochemistry –Diabetes Test

    HbA1c 11.30 % 4.40 – 6.49%

    Biochemistry

    Serum Creatinine 1.09 mg/dl Male 07-1.4 mg/dl

    Female: 07-1.2 mg/dl
    Lipid Profile


    Serum Cholesterol (total 193.0 mg/dl 40-200 mg/dl
    S.HDL –cholesterol 45.0 mg/dl Woman >65 mg/dl, Men >555 mg/dl
    S. LDL-Cholesterol 111.8 mg/dl <150 mg/dl
    S. Triglyceride 181.0 mg/dl Woman : 40 -140 mg/dl ; Men 60- 165 mg/dl


    Biochemistry

    Serum Creatinine 1.6 mg/dl Male 07-1.4 mg/dl
    Female: 07-1.2 mg/dl
    TSH(6/4/22) 0.3micro IU/ml adult 0.4-5.5
    Child 0.70- 5.70
    Infant 0.8-9.10
    New born 1.0 – 39.0


    Serum Uric Acid 4.3 mg/dl Male 3.4-7.0 mg/dl
    Female 2.4-5.7 mg/dl
    TSH 14.40 Adult 0.35-5.50
    Child 0.70-5.70
    Infant 0.80-9.10
    Newborn 1.0-39.0


    Troponin Test Heart Muscle Damage

    This rest is performed by Access2 of Bachman Coulter
    Glucose

    RBS (mmol/L) 18.1 [ <7.8]

    Kidney Function

    Creamtinine (mg/dl) 1.1 [ 0.4 to 1.4 ]


    Electrolytes

    Na+(mEq/l) 145.0 [135 to 145 ]
    K+ (mEq/l) 4.2 [3.52 to 5.0 ]
    Cl- (m eq/l) 107.0 {95 to 105 ]


    Biochemistry:

    Estimation carried out by Vitros 5600 /Seimens Advia 1800/Dimension ExL-LM system And Checked manually.

    S. creatinine 1.25 mg/dl adult male 0.70-1.30
    Female 0.50-1.10

    S.ALT(SGPT) 18 U/L Male 16-63
    Female 14-59
    Lipid Profile

    S. Cholesterol 181 mg/dl <200
    HDL 36 mg/dl >35
    LDL 112 mg/dl <130
    TG 150 mg/dl <150
    T. Cholesterol-HDL Ratio 5.03 Normal <4.5
    Moderate 4.5-8.5
    High Risk > 8.5


    Chest PA View

    Lung fields are clear
    Basal angels are clear
    Heat : Normal in TD
    Diaphragm : Normal in contour and level
    Thoracic Skeleton and the Soft tissue are normal

    Comment: Normal skigram of chest.








 

 


    Application of ML, Ai Research Bio Medical Engineering, Case Study Analysis:



    Hematology 12/01/2021:


    Test carried out by Ves-Matic Analyzer , Sysmax-XN-1000 AL Random Access Haematology And Checked manually. Red Blood Cell:

    Haemoglobin 10.0 g/dl Adult Men 15.0+-2.0 Women :13.5+- 1.5
    At birth 13.5=-19.5 Days 14.5-22.5
    1 month: 11-17, 2-5, Months:9.5-13.5

    Total RBC 3.41 million/Cm Men: 5+-0.5, Women 4.3+-0.5

    ESR 64 mm (auto analyzer) Men:0.45+- 0.05 Woman 0.41-= 0.05
    PCV/HCT 0.31/l Men: .45+-0.05 Woman 0.41+- 0.05
    MCV 89.7 fl 92+-9
    MCH 29.3 pg 29.5+-2.5
    MCHC 32.7 g/dl 33.0+-1.5
    RDW-CV 13.2% 12.8+-1.2



    WHITE BLOOD CELLS:

    Total WBC 9000/Cmm Child: 5000-15000,adult 4000-11000
    Infant 6000-18000 At Birth 10000-25000
    Circulating Eosinophils 90/Cmm 50-5000


    Differential Count


    Neutrophis 70% child 20-50 Adult 40-75
    Lymphocytes 25% Child 40-75 Adult: 20-40
    Monocytes 04% 2-10
    Eosinophis 01% 2-6
    Basophis 00% <1.0
    Others 00%


    Platelet Count

    Total Platelet count 2,75,000/Cmm 1,50,000- 4,50,000
    MPV 11.6 fl 8.0-9.5



    Hematology Date: 12/4/2021


    Tests: TC/DC/HB%/ESR/PLATELES COUNT /PMCT

    Haemoglobin 10.1 g/dl Adult Men 15.0+-2.0 Women :11.5+- 1.5
    At birth 13.5=-19.5 Days 14.5-22.5
    1 month: 11-17, 2-5, Months:9.5-13.5
    Total RBC 3.3 million/Cm Men: 5+-0.5, Women 4.3+-0.5
    Platelets 246x10^9/L F 3.8-4.8 M 4.5-5.5 X 10^12/L
    White Blood Cells 9.7x10^9/L 150-450 x10^9/L
    ESR(capillary method) 21 mm in 1st hr
    (auto analyzer) Men: < 29mm ,F< 38 mm


    PCV/HCT 29% F: 36-46 % . M 0.40+- 50
    MCV 88.7 fl 82-100
    MCH 31 pg 27-32
    MCHC 35 g/dl 33.0+-1.5
    RDW-CV 12.8% 11.6-14%



    WHITE BLOOD CELLS:


    Total WBC 9.7x10^9/L Child: 5000-15000,adult 4-11x10^9/L
    Infant 6000-18000 At Birth 10000-25000
    Circulating Eosinophils 90/Cmm 50-5000


    Differential Count


    Neutrophis 63% child 20-50 Adult 40-75
    Lymphocytes 31% Child 40-75 Adult: 20-40
    Monocytes 04% 2-10
    Eosinophis 02% 2-6
    Basophis 00% <1.0





    Hematology 15/12/2022:



    Test carried out by Hemax-330 Automated Hematology Analyzer ,

    . Red Blood Cell:


    Haemoglobin 9.3 g/dl Adult Men 15.0+-2.0 Women :13.5+- 1.5
    At birth 13.5=-19.5 Days 14.5-22.5
    1 month: 11-17, 2-5, Months:9.5-13.5

    Total RBC 2.8 million/ul Men: 4.5-6.5, Women 3.8-5.8 m/ul

    ESR(westergreen) 52 mm ( 1st hr) Men:0-10 . F 0-20 .mm/ist hr

    PCV/HCT 24.6 % Men: .40-54 Woman 37-47%

    MCV 86.8 fl 76-94fL
    MCH 33.0 pg 29.5+-2.5
    MCHC 38.0 g/dl 29-34 g/dL
    RDW-CV 45.9 fL 35.0-56fL



    WHITE BLOOD CELLS:


    Total WBC 6,600/Cmm Child: 5000-15000,adult 4000-11000
    Infant 6000-18000 At Birth 10000-25000
    Circulating Eosinophils 330/Cmm 50-450


    Differential Count

    Neutrophis 73% child 20-50 Adult 40-75
    Lymphocytes 18% Child 40-75 Adult: 20-40
    Monocytes 04% 2-10
    Eosinophis 05% 2-6
    Basophis 00% <1.0
    Total Cir. Eosinophils 330/cumm 50-450/cumm


    Platelet Count

    Total Platelet count 1,99,800/Cmm 1,50,000- 4,00,000
    MPV 8.8 fL 7.0-11.0
    PCT 0.1% 01.-0.2%
    P-LCR 30.2% 13.0-43.0%




    At Normal Heath condition of the same patient earlier while alive, Haematology Report Date: 09/12/2017

    Test carried out by Sysmex XT-2000i Hematology Analyzer ,


    . Red Blood Cell:


    Haemoglobin 13.0 g/dl Adult Men 15.0+-2.0 Women :13.5+- 1.5
    At birth 13.5=-19.5 Days 14.5-22.5
    1 month: 11-17, 2-5, Months:9.5-13.5



    ESR(westergreen) 26 mm ( 1st hr) Men:0-12 . F 0-20 .mm/ist hr
    PCV/HCT 38 % Men: .40-54 Woman 37-47%
    MCV 83.20 fl 76-94fL
    MCH 28.4. pg 29.5+-2.5
    MCHC 34.2 g/dl 29-34 g/dL
    RDW-CV 12.80 fL 11.60-14.80%



    WHITE BLOOD CELLS:


    WBC 10.80 K/microL Child: 5000-15000,adult 4000-11000
    Infant 6000-18000 At Birth 10000-25000


    Neutrophil 7.78 K/microL 1.56-6.00 K/microL
    Lymphocyte 2.59 K/microL 1.18-3.74 K/microL
    Monocyte 0.22 K/microL 0.24-0.36 K/microL
    Eosinophil 0.22 K/microL 0.04-0.36 K/microL
    Basophil 0.00 K/microsL 0.01-0.08 K/microL


    Differential Leucocyte Count


    Neutrophis 72% child 20-50 Adult 40-75
    Lymphocytes 24% Child 40-75 Adult: 20-40
    Monocytes 2.0% 2-10
    Eosinophis 2.0% 2-6
    Basophis 00% <1.0


    Platelet Count


    Total Platelet count 2,80,000/Cmm 1,50,000- 4,00,000
    MPV 11.20 fL 7.0-11.0
    PCT 0.31% 01.-0.2%
    PDW 14.60 10(GSD) 0.01-99.99 10(GSD)

    P-LCR 30.2% 13.0-43.0%

    B.T = 2mins 45 sec
    C..T = 6 mins





    Urine Test: Carried out by Urised Mini DocUrender Hungary) and checked manually

    Specimen: Urine

    Physical Examination:

    Quantity Sufficient Reference Value
    Color Yellow Pale Yellow /Straw
    Appearance Clear Clear
    Specific Gravity 1.022 1.010 - 1.022



    CHEMICAL EXAMINATION


    Reaction (PH) 5 4.5-8.0
    Protein Trace Nil
    Glucose Nil Nil
    Acetone (ketone body) Nil Nil
    Bilirubin Absent 0.2 mg/dL
    Urobilinogen Nil 0.1-1.8 mg/dL
    Nitrite Negative Nil


    MICROSCOPEIC EXAMINATION


    Epithelial Cells 15-18/HPF 0-5 /HPF
    Pus Cells 6-8 /HPF 1-5 /HPF
    RBC Nil 0-2 /HPF
    Yeast Cells Nil Nil
    Trichomonas Nil Nil
    Fungus Nil Nil
    Spermatozoa Nil Nil
    CAST


    Hyaline Nil Nil
    Granular Nil Nil
    Cellular Nil Nil
    RBC cast Nil Nil
    WBC cast Few Nil
    Waxy Cast Nil Nil



    Crystal


    Cal.Oxalate Nil Nil
    Amorphous phosphate Nil Nil
    Uric Acid Nil Nil
    Urates Nil Nil
    Triple Phosphate Nil Nil
    Sulphonamide Nil Nil















 




 

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