|Commenced in January 1999||Frequency: Monthly||Edition: International||Paper Count: 9|
Upper gastrointestinal endoscopy is a commonly performed diagnostic and therapeutic procedure and has many adverse effects like cardiopulmonary complications, complications related to sedation, infectious complications, bleeding and perforation. So this study was undertaken to evaluate important variables like patient’s age, gender and stage of the procedure in relation to the cardiopulmonary changes during diagnostic upper gastrointestinal endoscopy by monitoring oxygen saturation, blood pressure, heart rate and electrocardiogram. This is a prospective longitudinal hospital based study involving a total of 140 consecutive patients, at Sri. B. M. Patil Medical College, Hospital and Research Centre. Cardiopulmonary changes during upper gastrointestinal endoscopy are more common in the age groups of 51-60 years, with equal frequency in both male and female. Oxygen saturation levels decreased by about 4% in both sexes during introduction of endoscopy. Mild to moderate hypoxia was found in 32% of the study group. Severe hypoxia was found in 5% of the patients, mostly in those patients who are above 50 years of age. Tachycardia was noted in 88% of the study group patients. Blood pressure increased to hypertension levels in 22 patients (15.7%) which returned to normal within few minutes after the procedure. S-T depression was noticed in 4% of patients and T wave inversion in 8% of patients during upper gastrointestinal endoscopy. All these changes disappeared after 10 minutes after the endoscopy. Cardiopulmonary changes are common during upper gastrointestinal endoscopy. Maximum changes in oxygen saturation, heart rate and blood pressure occurred immediately after the introduction of endoscope. The cardiopulmonary changes did not manifest into any identifiable clinical symptoms. The rate of recovery was faster in younger age groups and women.
Wireless capsule endoscopy provides real-time images in the digestive tract. Capsule images are usually low resolution and are diverse images due to travel through various regions of human body. Color information has been a primary reference in predicting abnormalities such as bleeding. Often color is not sufficient for this purpose. In this study, we took morphological shapes into account as additional, but important criterion. First, we processed gastric images in order to indentify various objects in the image. Then, we analyzed color information in the object. In this way, we could remove unnecessary information and increase the accuracy. Compared to our previous investigations, we could handle images of various degrees of brightness and improve our diagnostic algorithm.
Bleeding in the digestive duct is an important diagnostic parameter for patients. Blood in the endoscopic image can be determined by investigating the color tone of blood due to the degree of oxygenation, under- or over- illumination, food debris and secretions, etc. However, we found that how to pre-process raw images obtained from the capsule detectors was very important. We applied various image process methods suitable for the capsule endoscopic image in order to remove noises and unbalanced sensitivities for the image pixels. The results showed that much improvement was achieved by additional pre-processing techniques on the algorithm of determining bleeding areas.