Search

This section presents synopses of poster papers presented at the 27th Annual Conference of the Association of Medical Physicists of India 2006. They include "Effect of Number of Iterations on Treatment Time Monitoring Units, Number of Segments and Dose to Target and Normal Structures in IMRT," and "Comparative Study of Superposition, Fast Superposition and Convolution Algorithms in Open, 3DCRT and IMRT Techniques for Various Diagnosis."

The article presents abstracts on neuroscience including the revisit rate in hospital after the diagnosis of conversion disorder, the assessment of the disturbance of eating behaviour, and the enhancement of the treatment outcome through the motor cortex electrical simulation.

Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry "Dentin Hypersensitivity," based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach. [ABSTRACT FROM AUTHOR]

Early physicians were taught with immediate auscultation, placing the ear directly on the patient's chest. They showed reluctance because it was questionable when the patient is obese, nonhygiene, and modesty, especially in cases of females. In 1816, when the freshly graduated physician René-Théophile-Hyacinthe Laënnec had a consultation with a young obese woman with the symptoms of underlying heart disease, he recalled an acoustic phenomenon which is known very well beforehand for him. He rolled up a sheet of paper and placed one end to her chest and another to his ear to listen. Rest is history. He presented his invention to the world and made revolutionary changes in the art of patient care, which is valuable even nowadays. After his discovery, several scientists contributed their works to make this crucial device achieve more potential. Through many years, Laennac's device became the stethoscope that we have today. Now, the stethoscope has become the symbol of the medical profession. [ABSTRACT FROM AUTHOR]

Ancient science of pulse reading had existed from antiquity and still being practiced in some traditional medicine systems like Unani, Ayurveda and Chinese medicine etc. Examination of pulse still remains an integral part of these systems of medicine in disease diagnosis and monitoring the disease treatment. An experienced Unani physician can easily differentiate between normal and deranged temperament pulse through Unani metaphysics. As whole concept of disease and its management is based on temperament and its deviation under Unani system of medicine, therefore this unique and simple technique of pulse examination makes it easier to diagnose and treat any disease. In this article, it was tried to explore ancient history regarding knowledge base and practice of pulse reading and present various aspects of pulse examination described in Unani system of medicine and its interpretation through Unani metaphysics. This paper will be useful in generalizing the concept of pulse for better understanding. [ABSTRACT FROM AUTHOR]

Background: Toward improving the reporting quality of clinical case reports in the Saudi Journal of Anaesthesia, we conducted this audit. The aim of this paper is to provide an overview of the different objectives for clinical case reports and to identify those subordinate items which seem most relevant from the CAse REport (CARE) checklist. Methods: We performed this pilot study on clinical case reports published in the Saudi Journal of Anaesthesia (SJA) in the past 5 years from 2013 to 2017. The journal publishes 4 issues/year that means 20 issues were studied. We used one online source to gather the clinical case reports which is the SJA website. A total of 84 case reports were studied. We have applied the 13th items in the CARE checklist on the case reports to determine their representations. Two reviewers abstracted data from all included papers to determine the adaptation of the CARE checklist. Data are presented as percentages of different subordinate items of the CARE guidelines. Results: None of the 84 case reports met all subordinate items of CARE guidelines, and only 5 subordinate items were reported fully met (100%). Patient perspective subordinate item was not mentioned in our series due to lack of data in the studied case reports. Therefore, only 12 subordinate items were included. We reported those adaptation percentages of the 12th subordinate items of the CARE checklist as follows: (a) title, keywords, abstract patient's biodata, and conclusion 100%; (b) main symptoms of the patients 97.6%; (c) timeline 78.5%; (d) diagnosis 94.0%; (e) treatment 97.6%; (f) strengths 85.7%; (g) literature review 94.0%; and (h) patient consent 33.4%. Conclusion: We believe that the CAse REport guidelines can provide an international framework for the authors to follow in writing their case reports and for the editors to use to ensure the completeness and readiness of the peer-reviewed case reports for publication. For the SJA, we have to apply the CARE checklist and to ensure all subordinate items are adapted including the patient's perspective subordinate item and to make sure that the consent form obtained and accompanied each submitted case reports. [ABSTRACT FROM AUTHOR]

Introduction: Peripheral odontogenic fibroma is a benign mesenchymal odontogenic tumor that presents as a relatively solid, fixed gingival mass and shows similar color to the surrounding gingiva. It morphologically mimics exophytic gingival mass, such as pyogenic granuloma, peripheral ameloblastoma, peripheral giant cell granuloma, and peripheral ossifying fibroma. Despite similarities, all reactive gingival lesions show some differences. Therefore, the purpose of this paper is to have an in-depth discussion on the pathway of diagnosis of reactive gingival lesions. Case Report: An 11-year-old boy reported to the Department of Pediatric and Preventive Dentistry with an asymptomatic firm gingival mass (2 cm × 2.5 cm) on the palatal surface in between #11 and #12 for the past 1 year. The swelling had remained consistent in size with no history of bleeding or pus discharge. A step-by-step diagnosis was followed; an aspiration test was negative and no significant radiographic findings were reported. A provisional diagnosis of fibroma was made. An excisional biopsy ruled out other reactive lesions and confirmed the diagnosis of peripheral odontogenic fibroma. Clinical Significance: Recognizing and diagnosing reactive gingival lesions in pediatric dental patients is essential for early intervention and management. As the clinical presentation is nonspecific for most of these lesions, a precise diagnostic pathway serves is an essential tool for adequate treatment. [ABSTRACT FROM AUTHOR]

This paper presents a case with dentinogenesis imperfecta (DI) associated with osteogenesis imperfecta. Systemic and dental manifestations of OI and its medical and dental treatments are discussed in this paper. A 5-year-old child with the diagnosis of OI was referred to the Dental School of Shaid Beheshti University of Medical Sciences. On clinical examination yellow/brown discoloration of primary teeth with the attrition of the exposed dentin and class III malocclusion was observed. Enamel of first permanent molars was hypoplastic. Radiographic examinations confirmed the diagnosis of DI. A histological study was performed on one of the exfoliating teeth, which showed abnormal dentin. Primary teeth with DI were more severely affected compared to permanent teeth; enamel disintegration occurred in teeth with DI, demonstrating the need for restricts recalls for these patients. [ABSTRACT FROM AUTHOR]

The article presents a study which evaluates the use of dried blood spot (DBS) on the diagnosis of hepatitis B infection (HBV). Researchers tested three hundred males who are 18 to 45 years of age. The samples are incubated and stored based on a modified temperature. Researchers found out that the use of DBS in filter papers does not exhibit consistent sensitivity and specificity. The researchers also add that the type of filter paper could have altered the results hence reserve the conclusion that DBS when applied in filter papers is not as optimal as other methods.

Dermatology, as a highly intuitive clinical discipline, requires dermatologists to apply their own knowledge and clinical experience to make a reasonable diagnosis for various skin diseases. However, the diagnosis results are largely affected by the subjective consciousness of dermatologists, and there is a certain misdiagnosis rate, especially in areas with low medical levels. Therefore, there is an urgent need for more accurate, objective, and efficient auxiliary diagnostic tools to improve the diagnostic level of skin diseases. Facing an increasing number of patients and higher requirements for accurate diagnosis of diseases, Artificial Intelligence (AI) technology has attracted considerable attention in the field of dermatology. As a nonorganism, the computer is not affected by subjective consciousness, emotion, fatigue, and other factors in the recognition process. It helps to improve the efficiency of diagnosis and assists human doctors to provide objective and accurate diagnosis results. This paper systematically summarizes the research progress of AI in the diagnosis and application of skin cancers, acne, rosacea, onychomycosis, psoriasis, vitiligo, atopic dermatitis, and eczema diseases at home and abroad in recent years, hoping to help dermatologists have a deeper understanding of AI. [ABSTRACT FROM AUTHOR]

Solitary median maxillary central incisor (SMMCI) is a rare dental anomaly that may occur alone or be associated with other systemic conditions. Most common association is with holoprosencephaly. It can easily be misdiagnosed as a simple case of hypodontia due to either traumatic dental injury or fusion of two central incisors or a mesiodens developing to the one side of midline or any other condition that may lead to growth termination of central incisor at the cellular level. Every dentist needs to be aware of oral manifestations of this anomaly, thereby facilitating an early diagnosis of SMMCI, as it may be a sign of other severe congenital or developmental anomalies. Proper follow-up and close monitoring of the growth and development of SMMCI patients are of critical importance. The aim of this paper was to report a case of a 12-year-old female child with an SMMCI and describe important symptoms of this syndrome. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the first cause of world death, and myocardial infarction (MI) is one of the five primary disorders of CVDs which the patient electrocardiogram (ECG) analysis plays a dominant role in MI diagnosis. This research aims to evaluate some extracted features of ECG data to diagnose MI. Methods: In this paper, we used the Physikalisch-Technische Bundesanstalt database and extracted some morphological features, such as total integral of ECG, integral of the T-wave section, integral of the QRS complex, and J-point elevation from a cycle of normal and abnormal ECG waveforms. Since the morphology of healthy and abnormal ECG signals is different, we applied integral to different ECG cycles and intervals. We executed 100 of iterations on a 10-fold and 5-fold cross-validation method and calculated the average of statistical parameters to show the performance and stability of four classifiers, namely logistic regression (LR), simple decision tree, weighted K-nearest neighbor, and linear support vector machine. Furthermore, different combinations of proposed features were employed as a feature selection procedure based on classifier's performance using the aforementioned trained classifiers. Results: The results of our proposed method to diagnose MI utilizing all the proposed features with an LR classifier include 90.37%, 94.87%, and 86.44% for accuracy, sensitivity, specificity, respectively. Also, we calculated the standard deviation value for the accuracy of 0.006. Conclusion: Our proposed classification-based method successfully classified and diagnosed MI using different combinations of presented features. Consequently, all proposed features are valuable in MI diagnosis and are praiseworthy for future works. [ABSTRACT FROM AUTHOR]

Background: Greater and lesser occipital neuralgias are primary neuralgias that are relatively uncommon, where the pain is felt in the distribution of these nerves.Objective: This review paper was intended to describe the features and management of occipital neuralgia in the context of a challenging case.Material and Methods: We looked at succinct literature from the past 30 years. We compared the features of our challenging case given in the current literature. In addition, an overview of the current literature is provided.Results: The case, although proved to be a diagnostic challenge, we were able to reach a conclusion and render the patient almost complete pain relief by conservative management modalities. It proved to be a rare presentation of occipital neuralgia with unusual pain distribution, and we are able to describe a literature-based explanation for this entity to be a diagnostic and management challenge.Conclusion: Primary headaches, i'n general, are a group of headache disorders that require exquisite diagnostic skills. The clinical history is a key factor when making an accurate diagnosis, and to establish an appropriate management plan. [ABSTRACT FROM AUTHOR]

This paper comes with a purpose to help the clinician as how to arrive at a logical differential diagnosis when an upper lip mass is encountered in day-to-day practice. The labial mucosa is commonly traumatized. One must be aware of the type of structures contained in the mucosa of the area of a lesion as well as the patients habits since they may relate to a lesion presented for diagnosis. It also helps them to procure a sound knowledge of the lesions by describing the lesions according to their clinical appearance and to aid the clinician in arriving at a differential diagnosis by considering that certain lesions have a predilection for the upper lip. All clinically similar appearing lesions are discussed according to their relative frequency of occurrence. This paper covers only a minority of plethora of elevated lesions that may appear on the upper lip since almost any soft tissue lesion or neoplasm (benign and malignant) may occur here. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is one of the most common cancers worldwide, CRC is the third furthermost common cancer and the fourth principal reason of cancer-related death. Colorectal cancer incidence varies globally, with developed countries having higher rates than developing countries. Colorectal cancer is associated with a lower socioeconomic status The following databases were searched: PubMed, Science Direct, Web of Science, EBSCO, and the Cochrane Library. Using Rayyan QCRI, included studies were screened by heading and abstract before being subjected to a full-text evaluation. This review investigates the published literature regarding the causes, diagnosis, and management of Colorectal cancer. This study comprised 7 trials with a total of 3,134,223 colorectal cancer patients, Most cases were diagnosed by computed tomography and only one study depended on surgery. The included studies used MRI also. CT defines the staging of CRC as the TNM staging [tumor, nodal, and metastases staging. Understanding the unique gene modifications is widely expected to lead to more accurate and tailored care for persons with polyps and malignancies, driven by molecular characterisation of the individual's colon tumour. [ABSTRACT FROM AUTHOR]

Vare et al. in their manuscript reported the incidence, cumulative mortality, and factors affecting the outcome of COVID-19-associated mucormycosis (CAM) from western India. The reported incidence of CAM in this report, that is, 13.6 cases per 1000 cases of moderate-severe COVID-19 infection, is a debatable figure as the paper does not specify if the 67 CAM patients belonged to the same pool of the 4910 COVID-19 patients treated at the same hospital. It is alarming to note that there were patients in this cohort who despite having a confirmed diagnosis of mucormycosis were unable to receive the drug of choice (amphotericin-B), most likely due to unavailability of the drug. [Extracted from the article]

Background: Primary care serves as an integral part of the health systems of nations especially the African continent. It is the portal of entry for nearly all patients into the health care system. Paucity of accurate data for health statistics remains a challenge in the most parts of Africa because of inadequate technical manpower and infrastructure. Inadequate quality of data systems contributes to inaccurate data. A simple-to-use classification system such as the International Classification of Primary Care (ICPC) may be a solution to this problem at the primary care level. Objectives: To apply ICPC-2 for secondary coding of reasons for encounter (RfE), problems managed and processes of care in a Nigerian primary care setting. Furthermore, to analyze the value of selected presented symptoms as predictors of the most common diagnoses encountered in the study setting. Materials and Methods: Content analysis of randomly selected patients' paper records for data collection at the end of clinic sessions conducted by family physicians at the general out-patients' clinics. Contents of clinical consultations were secondarily coded with the ICPC-2 and recorded into excel spreadsheets with fields for sociodemographic data such as age, sex, occupation, religion, and ICPC elements of an encounter: RfE/complaints, diagnoses/problems, and interventions/processes of care. Results: Four hundred and one encounters considered in this study yielded 915 RfEs, 546 diagnoses, and 1221 processes. This implies an average of 2.3 RfE, 1.4 diagnoses, and 3.0 processes per encounter. The top 10 RfE, diagnoses/common illnesses, and processes were determined. Through the determination of the probability of the occurrence of certain diseases beginning with a RfE/complaint, the top five diagnoses that resulted from each of the top five RfE were also obtained. The top five RfE were: headache, fever, pain general/multiple sites, visual disturbance other and abdominal pain/cramps general. The top five diagnoses were: Malaria, hypertension uncomplicated, visual disturbance other, peptic ulcer, and upper respiratory infection. From the determination of the posterior probability given the top five RfE, malaria, hypertension, upper respiratory infection, refractive error, and conjuctivitis were the five most frequent diagnoses that resulted from a complaint of a headache. Conclusion: The study demonstrated that ICPC-2 can be applied to primary care data in the Nigerian context to generate information about morbidity and services provided. It also provided an empirical basis to support diagnosis and prognostication in a primary care setting. In developing countries where the transition to electronic health records is still evolving and fraught with limitations, more reliable data collection can be achieved from paper records through the application of the ICPC-2. [ABSTRACT FROM AUTHOR]

In this paper, an efficient algorithm is proposed for detection of vertical root fractures (VRFs) in periapical (PA), and cone-beam computed tomography (CBCT) radiographs of nonendodontically treated premolar teeth. PA and CBCT images are divided into some sub-categories based on the fracture space between the two fragments as small, medium, and large for PAs and large for CBCTs. These graphics are first denoised using the combination of block matching 3-D filtering, and principle component analysis model. Then, we proposed an adaptive thresholding algorithm based on the modified Wellner model to segment the fracture and canal. Finally, VRFs are identified with a high accuracy through applying continuous wavelet transform on the segmented radiographs and choosing the most optimal value for sub-images based on the lowest interclass variance. Performance of the proposed algorithm is evaluated utilizing the different tested criteria. Results illustrate that the range of specificity deviations for PA and CBCT radiographs are 99.69 ± 0.22 and 99.02 ± 0.77, respectively. Furthermore, the sensitivity changes from 61.90 to 77.39 in the case of PA and from 79.54 to 100 in the case of CBCT. Based on our statistical evaluation, the CBCT imaging has the better performance in comparison with PA ones, so this technique could be a useful tool for clinical applications in determining the VRFs. [ABSTRACT FROM AUTHOR]

Background: Different viewpoints exist about lipid screening in all children or only in children with positive family history (FH) of premature cardiovascular diseases (CVDs) or hypercholesterolemia. This systematic review and meta-analysis aim to assess the effectiveness of lipid screening in children and adolescents according to the existence of positive FH of CVD risk factors. Materials and Methods: PubMed, Scopus, and Google scholar were searched to identify relevant papers that were published from November 1980 until 30 November 2013. Irrelevant studies were set aside after studying their title, abstract, and full text. Then, the relevant studies were assessed by using a quality appraisal checklist. We used random effect model for meta-analysis and calculating the total estimation of sensitivity, specificity, and the positive predictive value (PPV) of FH in predicting dyslipidemia among children and adolescents. Results: Overall, 17,214 studies were identified in the primary search, out of which 19 primary studies were qualified for study entry. The sensitivity of positive FH of premature CVD or dyslipidemia for predicting dyslipidemia among children varied between 15 and 93. Moreover, the effectiveness of screening children for dyslipidemia according to premature CVD or dyslipidemia in their relatives was low in 86.9% of the primary studies. The total estimation of sensitivity, specificity, and predictive value was 42.6, 59, and 20.7, respectively, according to the meta-analysis results. Conclusion: The present meta-analysis indicated that selecting target population for screening children and adolescents for dyslipidemia according to their FH has low sensitivity. [ABSTRACT FROM AUTHOR]

Vital pulp therapy (VPT) is a biologic and conservative treatment modality to preserve the vitality and function of the coronal or remaining radicular pulp tissue in vital permanent teeth. A search was conducted via the Cochrane database, PubMed, MEDLINE, and Ovid for any articles with the criteria for “pulp-capping,” or “pulp-capping materials” and “VPT outcomes” from 1978 to mid 2014. All articles were evaluated and the valid papers were selected. The outcomes of various VPT techniques, including indirect pulp treatment, direct pulp treatment, partial pulpotomy, and complete pulpotomy in vital permanent teeth were extracted. Although various studies have different research approach, most studies noted a favorable treatment outcome. Mineral trioxide aggregate (MTA) appears to be more effective than calcium hydroxide (Ca(OH)2) for maintaining long-term pulp vitality after indirect and direct pulpcapping. However, it seems that the success rate for partial pulpotomy and pulpotomy with Ca(OH)2 is similar to MTA. [ABSTRACT FROM AUTHOR]

In comparison to the worldwide burden of asthma, although India contributes to 13% of the total asthma prevalence, it has a threefold higher mortality rate and more than twofold higher DALYs, indicating a substantial gap in asthma diagnosis and treatment. Asthma causes significant suffering, affecting people's quality of life and draining the country's resources; therefore, we must devise ways and means to fill these gaps. The most successful and cost-efficient strategy to battle asthma is to form strong partnerships between patients, the general public, the government, the pharmaceutical industry and non-governmental organisations. This necessitates a comprehensive approach that involves raising awareness, developing universally applicable recommendations, increasing access to high-quality asthma care, and other measures. The purpose of this article was to review the existing scenario of asthma management in India and the factors that contribute to it and devise unique and all-encompassing strategies to fill these gaps. [ABSTRACT FROM AUTHOR]

Meandering pulmonary vein (MPV) is a rarely seen pulmonary vascular anomaly and confused with the scimitar syndrome which is more commonly seen. In this paper, we presented a case of left MPV which mimes arteriovenous malformation. A 30-year-old man was referred to our clinic for pulmonary nodule detected in routine evaluation before employment examination. Diagnosis of MPV was made by Pulmonary CT angiography. It showed abnormal drainage of upper lob pulmonary vein to the inferior pulmonary vein and form abnormal common pulmonary vein which shouldn't be exist. Because of any symptoms no further examination was recommended. According to our best knowledge to date only 17 cases reported in the literature. MPV diagnosis has been significantly changed by the means of advances in CT technology. Non-invasive diagnosis is possible with modern multisectional CT that clearly shows the anatomy of veins and enables the detailed MPV examination. Hereby, unnecessary radiological examination or surgery can be prevented.f veins and enables the detailed MPV examination. [ABSTRACT FROM AUTHOR]

Paresthesia is a burning or prickling sensation or partial numbness, resulting from neural injury. The symptoms can vary from mild neurosensory dysfunction to total loss of sensation in the innervated area. Only a few cases have described apical periodontitis to be the etiological factor of impaired sensation in the area innervated by the inferior alveolar and mental nerves. The aim of the present paper is to report a case of periapical lesion-induced paresthesia in the innervation area of the mental nerve, which was successfully treated with endodontic retreatment. [ABSTRACT FROM AUTHOR]

Objective: The objective of this paper was to investigate differential pathways in sporadic amyotrophic lateral sclerosis (SALS) based on pathway network analysis.Materials and Methods: To achieve this goal, first, differentially expressed genes (DEGs) between SALS and normal controls were identified, and a target network was defined as DEGs correlated interactions from the search tool for the retrieval of interacting genes/proteins (STRING). Second, topological centrality analysis was conducted on the target network to identify hub genes and hub network. Third, pathway network was constructed by taking intersections of Reactome database and STRING protein-protein interaction network. Finally, based on extracting the common interactions between target network, hub network and pathway network, we built randomized network, performed randomization test, and denoted differential pathways and hub differential pathways with P < 0.05.Results: There were 485 DEGs and 627 interactions in the target network. The pathway network was comprised 117,370 interactions. What was more, we found that 217 pathways had intersections with the target network. By accessing randomization test and removing the intersected count <10, 21 differential pathways with P values were nearly to be 0 were obtained, of which 6 rightly were the hub differential pathways, such as gene expression, mRNA Splicing, and mRNA splicing-major pathway.Conclusion: We have investigated 217 differential pathways and 21 significant differential pathways between SALS and normal controls based on network strategy. The findings might provide potential biomarkers for detection and therapy of SALS clinically and give great insights to reveal molecular mechanism underlying this disease. However, how these pathways cooperated with each other is still not clear, and future study should focus on this aspect. [ABSTRACT FROM AUTHOR]

Objective: The objective of this paper was to identify the disrupted pathways associated with colon cancer at a network level based on protein-protein interaction (PPI) network and pathway analysis.Materials and Methods: First of all, the Affymetrix microarray data of colon cancer, human PPIs relationships, and human pathways existed in the database were recruited and preprocessed. Second, differentially expressed genes (DEGs) between colon cancer and normal controls were identified. In the following, an objective PPI network was constructed using these DEGs. Ultimately, we calculated the disrupted pathways based on the intersection between pathway network and the objective network. Meanwhile, the topological centrality (degree) analysis was performed to explore the hub genes in the objective network.Results: In our study, an objective network consisted of 2288 PPI pairs by 574 DEGs were constructed. In addition, ten disrupted pathways whose number of intersection was not <22 between objective network and each pathway, as well as P < 0.05, was selected. Furthermore, a total of 22 hub genes in the objective network were selected based on degree >30. Last, seven out of the above ten pathways were validated to involve in the intersections of pathway network and objective network. Moreover, cell cycle was the most significant disrupted pathway.Conclusions: We successfully identified several biologically disrupted pathways, and these pathways might be potential biomarkers in detection and treatment for colon cancer. [ABSTRACT FROM AUTHOR]

Chest pain accounts for approximately 6% of Emergency Department (ED) attendances and is the most common reason for emergency hospital admission. For many years, our approach to diagnosis has required patients to stay in hospital for at least 6e12 h to undergo serial biomarker testing. As less than one fifth of the patients undergoing investigation actually has an acute coronary syndrome (ACS), there is tremendous potential to reduce unnecessary hospital admissions. Recent advances in diagnostic technology have improved the efficiency of care pathways. Decision aids such as the Thrombolysis in Myocardial Infarction (TIMI) risk score and the History, Electrocardiogram, Age, Risk factors and Troponin (HEART) score enable rapid 'rule out' of ACS within hours of patients arriving in the ED. With high sensitivity cardiac troponin (hs-cTn) assays, approximately one third of patients can have ACS 'ruled out' with a single blood test, and up to two thirds could have an acute myocardial infarction 'ruled out' with a second sample taken after as little as 1 h. Building on those recent advances, this paper presents an overview of the principles behind the development of the Troponin-only Manchester Acute Coronary Syndromes (T-MACS) decision aid. This clinical prediction model could be used to 'rule out' and 'rule in' ACS following a single blood test and to calculate the probability of ACS for every patient. The future potential of this approach is then addressed, including practical applications of artificial intelligence, shared decision making, near-patient testing and personalized medicine. [ABSTRACT FROM AUTHOR]

Current corneal assessment technologies make the process of corneal evaluation extremely fast and simple. Several devices and technologies allow to explore and manage patients better. Optical coherence tomography (OCT) technology has evolved over the years, and hence a detailed evaluation of anterior segment (AS) structures such as cornea, conjunctiva, tear meniscus, anterior chamber, iris, and crystalline lens has been possible in a noncontact and safe procedure. The purpose of this special issue is to present and update in the evaluation of cornea and ocular surface, and this paper reviews a description of the AS-OCT, presenting the technology and common clinical uses of OCT in the management of diseases involving cornea and ocular surface to provide an updated information of the clinical recommendations of this technique in eye care practice. [ABSTRACT FROM AUTHOR]

Cancer-related fatigue is a symptom of cancer where most patients or the general practitioners tend to misinterpret due to the insufficient understanding or knowledge of cancer-related fatigue (CRF). This paper will provide a better perspective for the patients and the health professionals on how to manage and handle CRF for both mild and severe fatigue patients. Articles were selected from the searches of PubMed database that had the terms "randomized controlled trials," "cancer," "fatigue," "pharmacologic treatment," and "nonpharmacologic treatment" using both Mesh terms and keywords. The authors have reviewed the current hypothesis and evidence of the detailed etiology of the CRF present in the literature for healthier management, directives, and strategies to improve the treatment of cancer-related fatigue. An algorithm has been blueprinted on screening, and management, of the CRF, and various kinds of effective treatments and assessment tools have been briefly studied and explained. Although many strategies seemed promising, the quality of randomized controlled trials is generally quite low in studies, making it difficult to draw conclusions about the effectiveness of each self-care strategies. Therefore, future studies require better design and reporting of methodological issues to ensure evidence-based self-care recommendations for people receiving cancer treatment. [ABSTRACT FROM AUTHOR]

Necrotizing fasciitis (NF) is a surgical emergency. It is often aggressive and characterized by the rapidly progressive inflammatory infection of the fascia that causes extensive necrosis of the subcutaneous tissue and fascia, relatively sparing the muscle and skin tissue. As the disease progresses, thrombosis of the affected cutaneous perforators subsequently devascularizes the overlying skin. The course indeed can be a fulminant one. The diagnosis of NF, especially in the early stages, is extremely challenging, and it can be very close in presentation to other skin and subcutaneous tissue infections. The primary site of the pathology is the deep fascia. Necrosis of the tissues and fascia may manifest as erythema without sharp margins, swelling, warmth, shiny, and exquisitely tender areas. Pain out of proportion to physical examination findings may be observed. The subcutaneous tissue may be firm and indurated such that the underlying muscle groups cannot be distinctly palpated. Eventually, as the overlying skin is stripped of its blood supply, skin necrosis ensues and hemorrhagic bullae form. Bacteremia and sepsis invariably develop when the infection is well established. This paper discusses some of issues related to the cutaneous signs found in NF and also provides a review the current, available literature on the subject matter. [ABSTRACT FROM AUTHOR]

This is a comprehensive review after a thorough literature search in PubMed-indexed journals, incorporating current information on the pathophysiology, clinical features, diagnosis, medical and surgical therapy, as well as outcomes of Acanthamoeba keratitis (AK). AK is a significant cause of ocular morbidity, and early diagnosis with timely institution of appropriate therapy is the key to obtaining good outcomes. The varied presentations result in frequent misdiagnosis, and co-infections can increase the morbidity of the disease. The first line of therapy continues to be biguanides and diamidines, with surgery as a last resort. [ABSTRACT FROM AUTHOR]

Prediction of the progression of knee osteoarthritis (KOA) is a very challenging task. Early identification of risk factors plays a vital role in diagnosing KOA. Thus, machine learning models are used to predict the progression of KOA. The purpose of the present study is to find out the efficacy of various machine learning models to identify the progression of KOA. A comprehensive literature search was conducted in international databases like Google Scholar, PubMed, Web of Science, and Scopus. Studies published from the year 2010 to May 2023 on the machine learning approach to diagnose KOA were included in the study. A total of 15 studies were selected and analyzed which included machine learning as an approach to diagnose KOA. The present study found that machine learning methods are the best methods to diagnose KOA early. Various methods like deep learning, machine learning, convolutional neural network (CNN), and multi-layer perceptron showed good accuracy in diagnosing its progression. The machine learning approach has attracted significant interest from scientists and researchers and has led to a new automated approach to diagnose KOA, which will help in designing treatment approaches. [ABSTRACT FROM AUTHOR]

Context: Urodynamic evaluation in the assessment of women complaining of urinary incontinence remains controversial with recent UK National Institute of Health and Clinical Excellence guidance maintaining that it is unnecessary prior to surgery for women with a primarily stress leakage. Other experts contend it should be part of routine preoperative assessment since it establishes a diagnosis, allows more careful patient counseling and predicts surgical outcome. Objectives: To summarize current literature to define the evidence level on which these conflicting opinions are based. Materials and Methods: A systematic literature search was performed and retrieved publications summarized in a narrative evidence review using both original papers and previous reviews. Results: Five hundred and one primary research papers and 65 previous reviews were retrieved. The findings were summarized in a narrative comprising overview, description of methods of bladder and urethral pressure measurement, and a summary of the literature concerning four key questions. Conclusion: The level of evidence was low regarding answering each of the questions posed, preventing firm conclusions. Urodynamic findings do correlate with relevant symptoms and, to some extent, with symptom severity, giving reasonable diagnostic accuracy. There is no reliable evidence that preoperative urodynamic diagnosis improves outcome from surgery for stress incontinence although it is likely to facilitate preoperative discussion. Tests to differentiate sphincter deficiency and urethral hypermobility are not currently recommended due to poor validity and reproducibility. This along with the current use of mid-urethral tapes as the universal primary surgical procedure means differentiation is not a necessity. Preoperative diagnosis of detrusor overactivity does not appear to worsen surgical outcome in women with a primary symptom of stress leakage. Large, well-designed prospective studies are now underway to provide a definitive answer to these questions. [ABSTRACT FROM AUTHOR]

Introduction Thyroglossal duct cyst and/or fistula represent the most common congenital anomalies of the neck. Many procedures have been described for excising thyroglossal cysts. These procedures vary from simple cyst excision to anterior block neck dissection. Objective The aim of the paper was to evaluate the concept of posterior hyoid space according to the Maddalozzo modification of the Sistrunk operation. Patients and methods This prospective study was carried out at the general surgery departments of Benha and Zagazig University Hospitals. Twenty-eight patients diagnosed with primary thyroglossal duct cyst were included in this study. The surgical technique used was that described by Maddalozzo et al. Results Twenty (71%) patients had anterior neck cystic swelling and eight (29%) patients had neck fistula. After histopathological examination, the tract passed in front of the hyoid bone in all cases (100%), whereas ectopic thyroid follicles were detected ventral to the hyoid bone in 11 (39%) cases, behind the hyoid bone in three (11%) cases, and in four (14%) cases, it was found in both the ventral and the dorsal position. Conclusion Our results were promising, and this approach of posterior hyoid space should be studied more extensively for assessment of its efficacy and benefits. This method should also be used to evaluate the possible role of ectopic thyroid tissues in recurrence with the use of the classic Sistrunk procedure. [ABSTRACT FROM AUTHOR]

Aims: Bioactive compounds existing in crustacean shells have the potential to inhibit the growth of some pathogenic microorganism. The purpose of this study is to evaluate the antibacterial effects of different extracts of prawn shells (Macrobrachium nipponense) on some human pathogenic bacteria. Materials and Methods: Sampling (prawn) was conducted in summer 2014 from Anzali wetland in southern coast of Caspian Sea. Then, the hydroalcoholic, methanolic, and acetone extracts of prawn shells were applied for this purpose. Two Gram-positive (Bacillus subtilis Staphylococcus aureus) and three Gram-negative (Klebsiella pneumoniae, Vibrio cholerae, and Escherichia coli) were used as test organisms. The antibacterial activity was determined by paper disk diffusion. Results: The prawn shell extracts showed activity against pathogenic bacteria. The highest antibacterial activities were measured in B. subtilis, S. aureus, and V. cholerae with the zone of inhibition being 12.12 ± 0.32 mm, 12.51 ± 0.14 mm, and 12.35 ± 0.27 mm, respectively. Among all the strains, S. aureus exhibits a significant zone of inhibition against all extracts (P < 0.05). Conclusion: The findings of this research showed that different prawn shell extracts, particularly hydroalcoholic, have bactericidal effect on B. subtilis, S. aureus, and V. cholerae species. [ABSTRACT FROM AUTHOR]

Background In many nodular thyroid cases, fine-needle biopsy (FNB) under the guidance of ultrasound (US) has been a primary diagnostic test as it is a safe, minimally invasive method with a low cost. However, it may have "nondiagnostic" aspirates because of the sampling difficulties. On the other hand, a bigger tissue sample is obtained by core-needle biopsy (CNB), which can promote more precise diagnostic results with a reduction of the need for repeated aspiration. Methods In a case-series study, adult patients with suspicious thyroid nodules were assigned to a preoperative diagnosis by both US-guided FNB and CNB with correlation to the final postoperative pathology diagnosis. Results CNB had more accuracy in thyroid malignancy diagnosis (95.8%) than FNB (75%). Nondiagnostic results could be lessened by CNB more than FNB with calculated sensitivities of 70% and 90% and specificities of 80% and 100% for FNB and CNB, respectively. No significant complications resulted while acquiring the samples for both modalities. Conclusion US-guided CNB was more specific than FNB in the diagnosis of thyroid malignancy. A combination of FNB/CNB would be more precise than performing CNB only or FNB in nodular thyroid disease. [ABSTRACT FROM AUTHOR]

The article discusses the case of a 70-year-old woman in whom tinea corporis was limited to the patch of vitiligo. Topics covered include the absence of epidermal dendritic cells in patients with vitiligo, the positive response of the patient to clotrimazole cream and griseofulvin and the possible role of altered T-cells in delimiting the extent of dermatophyte infection within the vitiliginous patch.

Background: Organic aciduria diseases (OADs) occur worldwide, with differences in prevalence and patterns between populations. Objectives: To describe the spectrum of OADs identified in Tunisia over a 35-years period. Materials and Methods: This retrospective study included patients who were diagnosed with OADs between 1987 and 2022 in the Laboratory of Biochemistry, Rabta Hospital, Tunisia. Organic acids were analyzed using gas chromatography-mass spectrometry. Results: A total of 30,670 urine samples were analyzed for OADs, of which 471 were positive for OADs. The estimated incidence of OADs in Tunisia was 6.78 per 100,000 live births. Methylmalonic (n = 146) and propionic (n = 90) acidurias were the most common OADs (estimated incidence: 2.10 and 1.30 per 100,000 live births, respectively). There were 54 cases of L-2-hydroxyglutatric acidurias and 30 cases of pyroglutamic acidurias, which makes it one of the highest in the world. The main clinical features were hypotonia (65%) and feeding difficulties (41%). Age at diagnosis was highly variable, ranging from 1 day to 49 years. Only 27% of the patients were diagnosed within the first month of life. The prevalence of OADs was highest in the Center-East and Southeast regions. Conclusions: In Tunisia, OADs are relatively frequent, but there are shortcomings regarding the diagnosis of these disorders. The frequency and health/social impact of these disorders warrant the need for implementing newborn screening programs and suitable patient management. [ABSTRACT FROM AUTHOR]

Zoon's balanitis or balanitis plasmacellularis circumscripta is a chronic inflammatory disorder of the genital mucosa that can affect both males and females (Zoon's vulvitis). It is not a sexually transmitted disease but can still cause anxiety to the patients because of its chronic nature. Hence, proper diagnosis and early management are necessary. It is a clinical mimicker of other commoner genital dermatoses and is mostly a diagnosis of exclusion when other diseases have been ruled out. It is characterised by a well-demarcated shiny erythematous patch or plaque over the genital mucosa. Histopathological examination becomes necessary when we are unable to differentiate it from premalignant lesions. It reveals lozenge-shaped keratinocytes with siderophages, haemorrhages and variable plasma cell infiltrate in the dermis. Dermoscopy shows spermatozoa-like, convoluted vessels with structureless red orange areas. Response to topical therapy alone is not always satisfactory. However, lasers and surgical management can provide long-term remission. [ABSTRACT FROM AUTHOR]

The application of artificial intelligence (AI) in the field of ophthalmology has garnered significant attention for its potential to enhance the accuracy of eye disease diagnosis. This systematic review and meta-analysis aimed to comprehensively assess the impact of AI on diagnosing eye diseases through the synthesis of existing research. A systematic search of electronic databases was conducted to identify relevant studies in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Eligible studies were those that reported the diagnostic accuracy of AI in ophthalmic image diagnosis. The standardized mean difference (SMD) and mean difference (MD) were utilised as the effect size measures to evaluate AI performance. A total of 18 studies meeting the inclusion criteria were selected for the quantitative synthesis. Further, the meta-analysis revealed that AI exhibited a substantial positive impact on the accuracy of diagnosing eye diseases. The overall SMD across various diagnostic parameters indicated a statistically significant improvement (SMD = 0.88, 95% confidence interval [CI]: 0.71–1.05). Moreover, the MD of diagnostic values demonstrated significant enhancements, with an overall MD of −10.2 (95% CI: −12.1 to −8.3). The selected studies consistently demonstrated that AI achieved high accuracy levels, reinforcing its potential as a valuable tool in ophthalmic diagnosis. This study provides significant evidence supporting the significant positive impact of AI on diagnosing eye diseases. The synthesis of the selected studies underscores the high accuracy achieved by AI in ophthalmic image diagnosis, as indicated by the substantial SMD and MD improvements. These findings highlight the promising role of AI in ophthalmology, offering the potential to revolutionise the field and improve patient care through enhanced diagnostic precision. [ABSTRACT FROM AUTHOR]

Artificial Intelligence (AI) has emerged as a transformative force in the field of diagnostic dermatology, offering unprecedented capabilities in image recognition and data analysis. Despite its promise, the integration of AI into clinical practice faces multifaceted challenges that span technical, ethical, and regulatory domains. This article provides a narrative overview of the current state of AI in dermatology, tracing its historical evolution from early diagnostic tools to contemporary hybrid supervised models. We identify and categorize six critical challenges: data quality and quantity, algorithmic development and explainability, ethical considerations, clinical workflow integration, regulatory frameworks, and stakeholder collaboration. Each challenge is dissected from the perspectives of academia, industry, and healthcare providers, offering actionable recommendations for future research and implementation. We also highlight the paradigm shift in AI research, emphasizing the potential of transformer architectures in revolutionizing diagnostic methodologies. By addressing the challenges and harnessing the latest advancements, AI has the potential to significantly impact diagnostic accuracy and patient outcomes in dermatology. [ABSTRACT FROM AUTHOR]

The article discusses idiopathic cutaneous pseudolymphoma in a male patient. Topics discussed include the patient's medical history, results of the patient's medical examinations, characterization and classification of pseudolymphoma, and the challenges posed by the diagnosis of pseudolymphoma to pathologists.

Context: Mādhava is regarded as a 7th century Indian Physician who composed two treatises (in Sanskrit) on Ayurveda, the Mādhava Nidāna and Mādhava Cikitsā. The former treatise deals with the diagnosis of diseases while the latter with the treatment using medicinal plants and other recipes. In Mādhava Cikitsā, a common Sanskrit name is found to describe two or more totally different botanical plant species (thus leading to ambiguity) and a distinct botanical species is also found to represent two or more Sanskrit names at several instances. Aims: The present paper deals with the correct botanical identification (most probable) of Sanskrit named plants described in Mādhava Cikitsā for the treatment of Diarrhoea (Atisāra Cikitsā). Subjects and Methods: The authentic manuscripts of ‘Mādhava Cikitsā' were critically studied for the present research outcome. A detailed literature survey is carried out from various references and texts. Results: The list of Sanskrit named plants contains 103 names, while after the critical study and assigning the most probable botanical identification as per ICBN, the list of plant species described in the text for the treatment of Diarrhoea is found to contain 73 names. Conclusions: The present study will certainly benefit Ayurvedic medical practitioners and pharmaceutical companies in selection of proper plant species avoiding substitutions for drug formulation. [ABSTRACT FROM AUTHOR]

The purpose of this report is to present a rare case of a fused mandibular lateral incisor with supernumerary tooth with a follow-up for 18-months. A 35-year-old female patient was referred to our clinic with an extraoral sinus tract in the chin. The intraoral diagnosis revealed the fusion of her mandibular lateral incisors. Vitality pulp tests were negative for mandibular right central and lateral incisors. Radiographic examinations showed a fused tooth with two separate pulp chambers, two distinct roots, and two separate root canals. There were also periapical lesion of fused teeth and mandibular right central incisor, so endodontic treatment was carried out the related teeth. Radiographic examination revealed a complete healing of the lesion postoperatively at the end of 18-months. This paper reports the successful endodontic and restorative treatment of unilateral fused incisors. Because of the abnormal morphology of the crown and the complexity of the root canal system in fused teeth, treatment protocols require special attention. [ABSTRACT FROM AUTHOR]

Background: Aneurysms arising in relation to perforators of the basilar artery (basilar perforator aneurysms or BPA) are very rare. Prior literature indicates the need for typically more than one angiogram for diagnosis, and argues for the utility of delayed angiograms in cases of subarachnoid hemorrhage (SAH) with initial negative studies. Different treatment modalities for BPA including endovascular, microsurgical, and conservative management have been described. Contemporary management appears to favor endovascular therapy. We discuss the topic by presenting a case which represents the first instance of BPA diagnosis after a fourth angiogram and subsequent successful endovascular occlusion. A literature review is provided.Objective: To discuss the unique presentation and management dilemmas in the rare entity of basilar artery perforator aneurysms by presentation of a case that was managed successfully by endovascular means. We also indirectly highlight the need for multiple follow-up angiograms in initial angiographically negative subarachnoid hemorrhage.Methods and Materials: We describe a 62-year-old male presenting with good clinical grade SAH and three negative angiograms, whose hospital course was complicated by repeat intraventricular hemorrhage. A fourth angiogram revealed a BPA. Multiple overlapping stents placed in the basilar artery achieved successful aneurysm exclusion. A comprehensive review of the literature was performed on PubMed.Results and Conclusions: Only 57 cases of BPAs have been described in literature. Multiple angiograms may be necessary for diagnosis. These aneurysms present with SAH. Endovascular flow modification is the current treatment of choice by means of overlapping stents or flow diversion. [ABSTRACT FROM AUTHOR]

Copyright of Annals of African Medicine is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Aims: A meta-analysis was performed to explore the role of the D-dimer in the development of portal vein thrombosis (PVT) in liver cirrhosis. Methods: All papers were searched via PubMed, EMBASE, China National Knowledge Infrastructure, Wan Fang, and VIP databases. A standardized mean difference (SMD) with 95% confidence interval (CI) was pooled. Results: Overall, 284 studies were initially identified, of which 21 were included. Cirrhotic patients with PVT had a significantly higher D-dimer concentration than those without PVT (pooledSMD = 1.249,95%CI = 0.740-1.758). After the portal hypertension-related surgery, cirrhotic patients with PVT had a similar preoperative D-dimer concentration to those without PVT (pooled SMD = 0.820, 95%CI = -0.122-0.286), but a higher postoperative value of D-dimer concentration than those without PVT (pooled SMD = 2.505, 95%CI = 0.975-4.036). Notably, the D-dimer concentration at the 1st postoperative day was similar between cirrhotic patients with and without PVT (pooled SMD = 0.137,95%CI = -0.827-1.101), but that at the 7th post-operative day was higher in cirrhotic patients with PVT than in those without PVT (pooled SMD = 1.224, 95%CI = 0.277-2.171). Conclusion: D-dimer might be regarded as a diagnostic marker for PVT in liver cirrhosis. In addition, postoperative D-dimer testing is worthwhile for the diagnosis of PVT after portal hypertension-related surgery. [ABSTRACT FROM AUTHOR]

Congenital triangular alopecia (CTA) also known as temporal triangular alopecia is a benign noncicatricial pattern of hair loss. It typically affects the frontotemporal region and rarely involves the temporoparietal or occipital scalp. It is a nonprogressive disorder that presents as a triangular, oval or lancet-shaped patch of alopecia. CTA can manifest at birth or develop later in life. The exact etiology of this condition remains unknown. Rarely, it may be associated with other disorders such as Down's syndrome and phakomatosis pigmentovascularis. The diagnosis is based on its distinct clinical appearance. Histologically, hair follicles are miniaturized and replaced by sparse vellus hair follicles. Tricoscopy using a polarized light handheld dermatoscope can be a useful diagnostic tool. CTA is often asymptomatic and remains unchanged throughout the life. No treatment is required. Surgical intervention with follicular unit hair transplantation can provide a satisfactory cosmetic result. In this paper, we have identified 126 cases of CTA in the published literature cited on PubMed between 1905 and 2015. From the available evidence, 79% of patients with CTA presented with unilateral hair loss, 18.5% with bilateral involvement and rarely, with occipital alopecia (2.5%). There was no gender predilection. These figures are entirely consistent with previously published data. Physicians should remember to consider CTA as a potential diagnosis in any patient presenting with a nonscarring alopecia in order to avoid unnecessary investigations and treatments. [ABSTRACT FROM AUTHOR]