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Background and Aim Methods Results Conclusion The implementation of computer‐aided detection (CAD) devices in esophagogastroduodenoscopy (EGD) could autonomously identify gastric precancerous lesions and neoplasms and reduce the miss rate of gastric neoplasms in prospective trials. However, there is still insufficient evidence of their use in real‐life clinical practice.A real‐world, two‐center study was conducted at Wenzhou Central Hospital (WCH) and Renmin Hospital of Wuhan University (RHWU). High biopsy rate and low biopsy rate strategies were adopted, and CAD devices were applied in 2019 and 2021 at WCH and RHWU, respectively. We compared differences in gastric precancerous and neoplasm detection of EGD before and after the use of CAD devices in the first half of the year.A total of 33 885 patients were included and 32 886 patients were ultimately analyzed. In WCH of which biopsy rate >95%, with the implementation of CAD, more the number of early gastric cancer divided by all gastric neoplasm (EGC/GN) (0.35% vs 0.59%, P = 0.028, OR [95% CI] = 1.65 [1.0–2.60]) was found, while gastric neoplasm detection rate (1.39% vs 1.36%, P = 0.897, OR [95% CI] = 0.98 [0.76–1.26]) remained stable. In RHWU of which biopsy rate <20%, the gastric neoplasm detection rate (1.78% vs 3.23%, P < 0.001, OR [95% CI] = 1.84 [1.33–2.54]) nearly doubled after the implementation of CAD, while there was no significant change in the EGC/GN.The application of CAD devices devoted to distinct increases in gastric neoplasm detection according to different biopsy strategies, which implied that CAD devices demonstrated assistance on gastric neoplasm detection while varied effectiveness according to different implementation scenarios. [ABSTRACT FROM AUTHOR]

Background: The giant cell tumor of the tendon pod is a benign neoplasia that can be present in any bone or tendon pod. Its etiology is unknown. Nevertheless, it is related to a chronic inflammatory process. It usually occurs in women between the third and fifth decade as a palpable and painless mass and slow growth, although it can be deformed and lead to limb loss. Case presentation: In this report, we present the case of an 11-year-old male patient, which began on June 21, 2020, with a blunt trauma. An ultrasound was performed, reporting compatible data with synovial sarcoma. Magnetic resonance was requested, with mass evidence in soft tissues in central and planting portions. A surgical procedure with a split and biopsy of the mass was carried out. The specimen was sent to the Pathology Department, leading to a diagnosis of a giant cell tumor of the tendon pod. Conclusions: The giant cell tumor of the tendon pod is rare. However, in some cases, it is crucial to consider it as a differential diagnosis. The surgical management of this entity has proven to reduce recurrence rates. [ABSTRACT FROM AUTHOR]

Distinguishing key morphologic features and understanding the pathophysiology of common cutaneous manifestations of hematologic disorders is essential to ensure prompt and appropriate treatment. In fact, classic cutaneous signs may provide the first clue to the diagnosis of an underlying hematologic disease. Disorders of coagulation, vascular abnormalities, or cutaneous infiltration and deposition are responsible for the underlying pathophysiology of cutaneous manifestations in the majority of cases. Hematologists often feel ill-equipped in identifying morphologic changes in the skin. Thus, the purpose of this review is to provide a comprehensive overview of classic cutaneous manifestations and diagnostic considerations of the associated hematologic conditions. Though there is a specific focus on non-malignant disorders, those straddling the spectrum of malignancy are also discussed. In many disease states, the skin may serve as an important marker of an emerging hematologic disorder, so close collaboration and multidisciplinary input remain essential to provide optimal and timely care for these patients. [ABSTRACT FROM AUTHOR]

Introduction: Thyroid disorders are common in Indian adult population. Current management guidelines from the American Thyroid Association (ATA) recommend diagnostic ultrasonography for all patients with thyroid nodules. However, suspicious and few overlapping characteristics of benign and malignant thyroid nodules makes FNAC unquestionable. Unwanted suspicion leads to excessive unnecessary biopsies and insufficient lower suspicion leads to under-diagnosis or missing of thyroid malignancies. Hence, making accurate decision of whether a nodule is potentially malignant or not is crucial. Aims and objectives: To study the USG features of thyroid lesions in patients with thyroid disorders and correlate these USG findings with FNAC in the diagnosis of thyroid lesions. Methods: The cross-sectional study was done for 18 months among patients of thyroid disorders coming to the Radio-diagnosis department of Muzaffarnagar Medical College for routine USG scan for thyroid lesions. A sample of 50 patients was taken among the age group of 10-75years who gave consent for FNAC and did not have any bleeding disorders. Sonographic evaluation of the thyroid gland was done by characterising its size, shape, echogenicity, vascularity and presence or absence of nodules. The respective nodules were assed for suspicious patterns and FNAC of the nodules was done to correlate the radiological with pathological diagnosis. Results: As per the study, with good sensitivity and specificity, radiological examination of thyroid lesions by USG showed significant correlation with pathological evaluation of thyroid lesions by FNAC examination. A strong positive correlation between the two diagnostic procedures was seen. The correlation was statistically significant, with a P < 0.05. Conclusion: Thyroid gland ultrasound is a non-invasive, cost-effective and patient compliant technique in assessing and diagnosing thyroid swellings which can be performed as the initial investigation before FNAC examination for quickly assessing thyroid nodules, their vascularity and identifying benign from malignant lesions. This would avoid unnecessary invasion and its related complications like puncturing an highly vascular nodule which could be determined on USG itself. [ABSTRACT FROM AUTHOR]

Background: In India, breast carcinoma is the 2nd most common malignancy in women. Incidence increases every year which ranges approximately 20-32%. Incidence of breast cancer shows "AGE SHIFT" over the past twenty years in India that is incidence increased from 6 to 17% in the age group of 30-40 years. The 'Modified Triple Test' utilizes-Physical Examination, Ultrasonography of the breast as the radiological method, and FNAC for the diagnosis of palpable breast lumps. It is gaining acceptance with the recent advances in technology and refinements in the interpretative criteria of sonographically characterized masses. Methods A prospective cross sectional study of 50 female patients attending the out patient department of General Surgery, K.R. Hospital, Mysore, between March 2022 to January 2024, with the complaint of a palpable lump/lumps in the breast was undertaken. Results Most commonly affected age group being 30-39 years. Incidence increased from 7 to 16% between the age group of 30 and 40 years. The calculated P - value for parity study is 0.017 and it is shown that malignancy is common among nulliparous. For the menstrual status, the calculated p-value is 0.044 is significant. The breast tumor is common at left side account for about overall 54% age. Fibroadenoma is the most common benign tumor. It was inferred from the study that clinical examination has a sensitivity of 87.5% which means that around 12.5% of the breast carcinoma cases are missed clinically. Results of Modified Triple Test were Sensitivity: 100%, Specificity: 97.37%, PPV: 91.67%, NPV: 100%. Hence the modified triple test can be used as a reliable and fairly accurate means of diagnosis of breast carcinoma. Conclusion Our results show that the diagnostic accuracy of physical examination breast USG and FNA/CNB combined is comparable to that of histological examination. Ultrasound replacing mammography serve as an effective imaging modality in palpable breast lumps and is also more comprehensive. CNB is a suitable alternative when FNA is inconclusive, also offers additional information. Thus the use of MTT to complement findings in differential diagnosis of a lesion in a symptomatic women seeking medical care deserves acceptance and further evalution. [ABSTRACT FROM AUTHOR]

Objective: To assess the appropriateness of hysterectomies performed at a large tertiary health system using the 1997 RAND appropriateness classification system and an updated algorithm. Design: We abstracted structured and unstructured data from electronic medical records on patient demographics, primary indication(s) for hysterectomy, diagnosis codes associated with the hysterectomy, previous treatments, and laboratory results. Subjects: Patients aged 18–44 years. Exposure: Receipt of hysterectomy for benign and nonobstetric conditions from October 2014 to December 2017. Main Outcome Measures: Using these data, we provided a RAND-based (dichotomous: inappropriate/appropriate) and Wright-based (3-level: inappropriate/ambiguous/appropriate) appropriateness rating and characterized missing information patterns associated with inappropriate ratings. Results: We analyzed 1,829 hysterectomies across 30 nonmutually exclusive primary indications for surgery. Nearly a third (32.8%) of surgeries had only one primary indication for surgery. Using the RAND-based classifier, 31.3% of hysterectomies were rated as appropriate and 68.7% as inappropriate. Using the Wright-based algorithm, 58.1% of hysterectomies were rated as appropriate, 15.7% as ambiguous, and 26.2% as inappropriate. Missing information on diagnostic procedures was the most common characteristic related to both RAND-based (46.1%) and Wright-based (51.2%) inappropriate ratings. Conclusions: The 1997 RAND classification lacked guidance for several contemporary indications, including gender-affirming care. RAND also has an outdated requirement for diagnostic surgeries such as laparoscopies, which have decreased in practice as diagnostic imaging has improved. Sensitivity analyses suggest that inappropriate surgeries cannot all be attributed to bias from missing electronic medical record data. Accurately documenting care delivery for benign gynecological conditions is key to ensuring quality and equity in gynecological care. [ABSTRACT FROM AUTHOR]

The leading cause of cancer-related deaths worldwide is skin cancer. Effective therapy depends on the early diagnosis of skin cancer through the precise classification of skin lesions. However, dermatologists may find it difficult and time-consuming to accurately classify skin lesions. The use of transfer learning to boost skin cancer classification model precision is a promising strategy. In this work, we proposed a hybrid CNN with a transfer learning model and a random forest classifier for skin cancer disease detection. To evaluate the efficacy of the proposed model, it was verified over two datasets of benign skin moles and malignant skin moles. The proposed model is able to classify images with an accuracy of up to 90.11%. The empirical results and analysis assure the feasibility and effectiveness of the proposed model for skin cancer classification. [ABSTRACT FROM AUTHOR]

To provide available evidence comparing surgical outcomes of different vaginal hysterectomy (VH) techniques and devices. PubMed, Embase, and ClinicalTrials.gov databases were searched from inception to December 1, 2023, using relevant keywords. Studies comparing at least 2 surgical techniques and devices for VH were included. An arm-based random effect frequentist network meta-analysis was performed. All available surgical outcomes were evaluated. Ten randomized controlled trials and 7 observational studies were eligible reporting on 1577 women undergoing VH with different techniques and devices (50% conventional, 22.5% Ligasure, 17.3% BiClamp, and 9.2% transvaginal natural orifice transluminal endoscopic surgery [vNOTES]). All surgical techniques/devices had a comparable risk ratio (RR) in terms of intraoperative complications, but Clavien-Dindo grade III postoperative complications were significantly reduced in the vNOTES group (RR, 0.15; 95% confidence interval [CI], 0.03–0.82; I2 = 0%) compared with conventional VH. The pooled network analysis showed a lower standard mean deviation for blood loss when comparing energy-based vessel sealing technologies (Ligasure: standard mean deviation, −0.92; 95% CI, −1.47 to −0.37; BiClamp: standard mean deviation, −1.66; 95% CI, −2.77 to −0.55) with conventional VH. Total operative time, postoperative hemoglobin variation, and pain were significantly reduced only in the Ligasure group compared with conventional VH. Bilateral salpingectomy or bilateral salpingo-oophorectomy was most commonly performed in the vNOTES group (RR, 1.9; 95% CI, 1.17–3.10) compared with the conventional VH group. Modern surgical techniques/devices have the potential to improve anatomic exposure and to reduce morbidity of VH. This may drive resurgence of vaginal approach to hysterectomy. [ABSTRACT FROM AUTHOR]

Skin cancer (SC) is a lethal disease not only in India but also in the world; there are more than a million cases of melanoma per year in India. Early detection of skin cancer through accurate classification of skin lesions is essential for effective treatment. Visual inspection by clinical screening, dermoscopy, or histological tests is strongly emphasised in today's skin cancer diagnosis. It can be challenging to determine the kind of skin cancer, especially in the early stages, due to the resemblance among cancer types. However, the precise classification of skin lesions could be time-consuming and challenging for dermatologists. To address these issues, we propose transfer learning to accurately classify skin lesions into several forms of skin cancer using a lightweight B-16 Vision Image Transformer model (LViT). An extensive dataset is used in the experiment to verify the efficiency of the proposed LViT model. The LViT model can classify skin cancer with high accuracy, sensitivity, and specificity and generalise favourably to new images. The proposed model has a 93.17% accuracy rating for classifying SC images over 25 epochs and a remarkable accuracy of 95.82% over 100 epochs. The proposed LViT model is lightweight, requires minimal processing resources, and achieves good accuracy on small and enormous data sets. [ABSTRACT FROM AUTHOR]

Globally, breast cancer is the leading cause of mortality for women. It has had an impact on the lives of all individuals, regardless of gender—males, females, and transgender people. However, it is more common among women. Its fatality rate can be decreased with early discovery and treatment. Machine Learning (ML) is critical to the early detection of breast cancer. ML's use has grown in a variety of fields during the last decade. Analytical modelling with ML is mostly restricted to statistical approaches such as image recognition, resonance spectroscopy, and mass spectrometry. This study gives an in-depth look at breast cancer and the many ML approaches used to identify it. A thorough examination of breast cancer diagnosis using machine learning is provided, comprising classification, prediction, and detection. Technical concerns with present prediction models and measuring methods (used to determine how active malignant and healthy tissues are) are highlighted to make future recommendations. [ABSTRACT FROM AUTHOR]

Summary: Breast cancer is the most prevalent kind of tumor to occur in females and the primary cause of death for women. Early detection is perhaps the most successful strategy to minimize breast cancer mortality. Early diagnosis necessitates a consistent and efficient diagnostics method that allows doctors to differentiate benign from malignant breast cancers without a surgical sample. The goal of this endeavor is to develop a sophisticated breast cancer diagnosis method. The primary goal of the paper is to reduce the death rate among women by promoting early detection of breast cancer. First, pre‐processing techniques such as median filtering and contrast limiting adaptive histogram equalization are used to the obtained raw images. By doing this, the machine‐learning model's computational complexity is decreased and the image quality is enhanced. K‐means clustering is used to segregate the pre‐processed image. Additionally, features including the enhanced local vector pattern, grey‐level co‐occurrence matrix and local vector patterns are produced in the course of the feature extraction stage. Finally, an optimized deep belief network (DBN) is carrying out the classification process. To boosts the classification accuracy, activation function of DBN (tanh, softmax, ReLu) as well as its weight function is optimized by the proposed grey wolf updated whale optimization algorithm The accuracy of the greywolf updated whale optimization algorithm+DBN is above 93% for datasets 1 and 2 when compared to extant models. Finally, calculation of the performance validates the proposed model's performance. [ABSTRACT FROM AUTHOR]

Background: Lipomas are the most frequent neoplasm of mesenchymal origin in the head-and-neck region. Around 15% of lipomas are found in the head-and-neck region. The usual site where lipomas can be found in the head-and-neck region is in the posterior triangle of the neck but they can also be found in the anterior neck, infratemporal fossa, submandibular space, larynx, pharynx, and parotid gland. The incidence of parotid lipoma ranges from 0.6% to 4.4% of all parotid neoplasms. There are two histological variants, focal lipoma and diffuse infiltrating variant. We describe two cases of rare focal lipoma of the parotid gland, therefore, must be reported. As rare as it may appear, existing relevant literature suggest management to includes definitive radiological investigations such as magnetic resonance imaging (MRI) and complete removal of lipoma with or without a cuff of parotid tissue. Case Report: Two cases were identified with a parotid lipoma on final histology. Case 1 is a 57-year-old male with a history of painless left parotid swelling for 2 years, reported to be 5 cm × 4 cm size on ultrasound, therefore, underwent superficial parotidectomy. Case 2 is a 67-year-old male who presented with right parotid swelling for 15 years, reported on ultrasound to be 5 cm × 5 cm, and underwent excision of intraparotid tumor. He later went on to develop breast carcinoma. The facial nerve was intact of both patients. Conclusion: Parotid lipomas are rare entities that should be a differential for clinically soft parotid swellings. Management includes definitive radiological investigations such as MRI and complete removal of lipoma with or without a cuff of parotid tissue instead of regular ultrasound followed by fine-needle aspiration cytology. Although our cases were managed on the same regular outlines, but reporting these cases would suffice the potential role of MRI and computed tomography scan for parotid swelling as per existing literature. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to compare shear wave elastography (SWE) of benign and malignant breast lesions, evaluate the sensitivity and specificity of previously suggested thresholds for identifying malignant breast lesions, and compare SWE measures across histopathological type and grade. Methods: This single‐centre study included 303 patients, and 405 solid breast lesions were biopsied and evaluated by mammography, which may have included contrast‐enhanced mammography, conventional B‐mode ultrasound, and SWE. Following this, elastography mean (Emean), maximum (Emax), and ratio (Eratio) variables were calculated for elasticity in kilopascals (kPa) and speed in metres per second (m/s). Results: Malignant (n = 113) samples were significantly higher than benign (n = 267) across all SWE variables [median (interquartile range)]; Emean (kPa) [132.8 (34), vs. 41.9 (53.6), p <.001], Emean (m/s) [6.9 (1), vs. 3.7 (2.2), p <.001]. The highest combined sensitivity and specificity were for Emax (97%, 73%) at >80 kPa, and Emean (96%, 76%) at >5.2 m/s. Histopathological grade 3 (kPa), Emean [145.8 (22.5), p =.012], Emax [147.8 (19.4), p =.009], and Eratio [11.7 (6.6), p =.006] were significantly higher than grades 1 [129.2 (37.3), 133.2 (35.9), 7.53 (4.7)] and 2 [127.3 (36.4), 133.3 (34.2), 8.3 (6.1)]. Conclusion: Breast elastography is a sensitive complementary technique that can distinguish between malignant and benign lesions and help characterise histological profile and grade. [ABSTRACT FROM AUTHOR]

Background & Objective: Endometrial carcinoma (EC) is one of the most common cancers and the fourth most common cancer affecting females, mostly affecting postmenopausal women. EC originates from the endometrium and is further subdivided into two types that are estrogen dependent; type 1 and type 2 with different gene expression patterns. Materials & Methods: This research was carried out between December 2021 and August 2022 in the Laboratories of the College of Science/Department of Biology and the other local lab and PCR was employed to establish HOXA11 presence. The aims of the study were to reveal the histological alterations in malignant and benign tumors and normal endometrium and to examine the relationship between HOXA11 levels and clinicopathological parameters including stage, grade, muscle and lymph node invasion, and histological type. Results: The mean HOXA11 expression values were compared in cancer, benign, and control endometrial patients' groups. The mean HOXA11 expression level was the lowest in endometrial cancer patients; they had a mean of 0. 24±0. 03, those with benign endometrial tumors had the second lowest with a mean of 0. 94±0. 06, while the control patients had the highest mean expression with 1. 00±0. 07. The comparison of the HOXA11 expression between the endometrial cancer patients and the control group showed a statistically significant difference (P-value >0. 001), thus underlining its diagnostic value. Also, there was a significant difference in the HOXA11 expression means between patients with benign tumors and control patients (P-value = 0. 021). As for HOXA11, the mean expression was relatively lower in the patients with benign endometrial tumors, 0. 94±0. 06 as compared to the control group 1. 00±0. 07. In addition, the mean HOXA11 expression in endometrial cancer patients was 0. 24±0. 03 which was significantly (P-value >0. 001) less than that in benign endometrial tumor patients. Conclusion: These results stress the importance of HOXA11 expression as a diagnostic marker and its possible application in differential diagnosis between endometrial cancer and benign neoplasms and normal tissues. [ABSTRACT FROM AUTHOR]

Background: Partial nephrectomy (PN) has become the dominant treatment modality for cT1 renal tumor lesions. Tumors suspected of malignant potential are indicated for surgery, but some are histologically classified as benign lesions after surgery. This study aims to analyze the number of benign findings after PN according to definitive histology and to evaluate whether there is an association between malignant tumor findings and individual factors. Methods: The retrospective study included 555 patients who underwent open or robotic-assisted PN for a tumor in our clinic from January 2013 to December 2020. The cohort was divided into groups according to definitive tumor histology (malignant tumors vs. benign lesions). The association of factors (age, sex, tumor size, R.E.N.A.L.) with the malignant potential of the tumor was further evaluated. Results: In total, 462 tumors were malignant (83%) and 93 benign (17%). Of the malignant tumors, 66% were clear-cell RCC (renal cell carcinoma), 12% papillary RCC, and 6% chromophobe RCC. The most common benign tumor was oncocytoma in 10% of patients, angiomyolipoma in 2%, and papillary adenoma in 1%. In univariate analysis, there was a higher risk of malignant tumor in males (OR 2.13, 95% CI 1.36–3.36, p = 0.001), a higher risk of malignancy in tumors larger than 20 mm (OR 2.32, 95% CI 1.43–3.74, p < 0.001), and a higher risk of malignancy in tumors evaluated by R.E.N.A.L. as tumors of intermediate or high complexity (OR 2.8, 95% CI 1.76–4.47, p < 0.001). In contrast, there was no association between older age and the risk of malignant renal tumor (p = 0.878). Conclusions: In this group, 17% of tumors had benign histology. Male sex, tumor size greater than 20 mm, and intermediate or high R.E.N.A.L. complexity were statistically significant predictors of malignant tumor findings. [ABSTRACT FROM AUTHOR]

Introduction: Thyroid nodules are extremely common being detected by ultrasonography in up to 67% of the population, with current surgical tenet maintaining that lobectomy is required for large symptomatic benign nodules or autonomously functionally nodules resulting in a risk of hypothyroidism or recurrent laryngeal nerve injury even in high volume centres. The introduction of radiofrequency ablation (RFA) has allowed thermal ablation of both benign and autonomously functioning thyroid nodules with minimal morbidity. The moving shot technique is the most well-established technique in performing RFA of thyroid nodules, and has proven to be safe, efficacious, accurate and successful amongst experienced clinicians. The purpose of this article to propose the use of a novel guide when performing RFA of thyroid nodules in clinical practice utilizing the moving shot technique. Methods: The technique proposed of RFA involves the use of a 10MHz linear ultrasound probe attached to an 18G guide which provides robust in line visualisation of a 7cm or 10cm radiofrequency probe tip (STARmed, Seoul, Korea) utilizing the trans isthmic moving shot technique. A geometric analysis of the guide has been illustrated diagrammatically. Results: The use of an 18G radiofrequency probe guide (CIVCO Infiniti Plus™ Needle Guide) maintains in line visualisation of the radiofrequency probe over a cross-sectional area up to 28cm2, facilitating efficient and complete ablation of conceptual subunits during RFA of thyroid nodules. Discussion: Radiofrequency ablation of thyroid nodules can be performed safely and effectively using the novel radiofrequency probe guide proposed which we believe potentially improves both accuracy and overall efficiency, along with operator confidence in maintaining visualisation of the probe tip, and hence we believe provides a valuable addition to the armamentarium of clinicians wishing to embark on performing RFA of thyroid nodules. [ABSTRACT FROM AUTHOR]

Background: Due to a lack of routine, there is often uncertainty regarding diagnostics of tumours around the knee joint. This study aimed to provide knowledge about the frequency, distribution and diagnostic algorithm of different bone and soft tissue tumour entities of the knee at a large referral university hospital in Germany. Methods: Retrospective, longitudinal, single-centre study that reviewed adult patients from 2010 until 2020 with a suspected tumours diagnosis around the knee at a university cancer centre. Inclusion criteria were adults with true bone or soft-tissue tumours in the knee joint and in its adjacent compartments. Suspected diagnosis, histological tumour entity, localization and its surgical treatment by biopsy, resection, osteosynthesis or tumour endoprosthesis were investigated. Results: A total number of 310 adult patients were included with a mean age of 54.2 ± 18.8 years. In total 160 (51.6%) soft-tissue tumours (69/43.1% benign; 74/46.2% malignant; 17/10.6% intermediate), 92 (29.6%) primary bone tumours (46/50% benign; 39/42.3% malignant; 7/7.6% intermediate), 36 (11.6%) metastases and 22 (7.1%) lymphomas were detected. 171 (55.1%) tumours were classified as malignant. Suspected diagnosis was matched with histology in 74.5% (231/310) of all cases. In 6 cases a primarily suspected benign diagnosis turned out to be malignant. The majority of primary bone tumours was cartilage derived (63.1%;58/92) and located in the distal 2/3 of the femur, whereas intracapsular tumours of the knee joint were rare (13.0%). Soft-tissue tumours were located primarily in the middle third of the thigh (36.8%). The MRI was the diagnostic tool of choice in 98.1% of soft tissue tumours and 82.6% bone tumours. Conclusion: Awareness is crucial for detecting rare and malignant tumours around the knee, with adipocytic tumours being the most common soft tissue tumour and chondrogenic tumours as the most prevalent malignant bone tumour. Accurate diagnosis of bone tumours necessitates radiographs and frequently an additional MRI scan, while soft tissue tumours require mandatory MRI scans. Incorrectly diagnosing a tumour can have severe consequences, emphasizing the need for histological confirmation in all cases. Additionally, malignant tumours within joint capsules in adults are infrequent. [ABSTRACT FROM AUTHOR]

Objective. Differentiation of benign from malignant liver lesions. Methods: The main sources of data for the study are patients from the following teaching Hospitals attached to Bapuji Education Association, J.J.M. Medical College, Davangere. 30 patients with focal liver lesions and additional 10 healthy volunteers with no focal liver lesion were studied to know to know normal ADC of liver Result: Out of the total 85 focal liver lesions seen in 30 patients there were 63(74.1%) were malignant and 22(25.9%) were benign lesions. The number of malignant FLLs detected with DWI (62 out of 63 - 98.4%) was highly significant than that detected with T2 WI (P <0.001). However there was significant difference between the T2 weighted imaging and DWI for the detection of HCCs alone. This may be due most of HCCs were more than 2cm in size. However, there was no difference determined between T2 weighted imaging and DWI for the detection of benign hepatic lesions in our study. Mean ADC values obtained from normal liver parenchyma in benign and malignant group 1.25±0.04 x 10-3 mm² /s. and 1.23±0.06 x 10-3 mm² /s. respectively. Mean ADC of normal liver parenchyma (both benign and malignant group) was 1.24± 0.06 x 10-3 mm2 /s were not significant (ANOVA p=0.20). Conclusion: Cysts and hemangiomas had the highest ADC values while malignant masses had the lowest. The lowest ADC values among the malignant masses belonged to metastases. Mean ADC values of malignant lesions were significantly lower than those of benign lesions: 0.92 x 10-3 mm² /s V/s 2.68 x 10-3 mm² /s respectively (P< .001). The Sensitivity of 98 %( 61/62), Specificity of 100% with the ADC cutoff value 1.26 x 10-3 mm² /s was obtained by normal distribution (mean ± 2SD) for differentiating between benign and malignant liver lesions. [ABSTRACT FROM AUTHOR]

Background: Primary bone tumors are relatively uncommon and constitute only 0.2-0.5% of all tumors in all ages in most series reported worldwide. Benign bone tumors are more common than the malignant bone tumors. Not many studies on benign bone tumors in the North Eastern Indian population are published in the available literature. Aims and Objectives: The current study was done with the aim to find out the epidemiological data on benign bone tumors in patients of the North-East Indian population who were admitted to the orthopedic department of a teaching institute. Materials and Methods: A hospital-based retrospective study with prospective effect was conducted on benign bone tumors in patients admitted to the Department of Orthopedics at our teaching institute from 2016 to 2020. Patients of all ages and both sexes with suspicion of bone tumors based on history and clinical examination were subjected to roentgenographic evaluation, including computed tomography (CT) scan and/or magnetic resonance imaging. Pre-operative core needle biopsy under C-arm/CT guidance or incisional biopsy was done for histological diagnosis, followed by appropriate intervention. Soft-tissue tumors and malignant bone tumors were excluded. Patients were followed up for recurrence, complications, and functional recovery. Results: Forty patients of bone tumors were treated out of 2288 patients admitted to the department (incidence of 1.75%). 29 were benign bone tumors with an incidence of 1.27%. Of 10-20 years age group was most commonly affected. Male preponderance with M: F=6.25:1. Femur (n=16) was the most commonly affected bone. Presenting features were swelling (n=18), pain (n=11), and pathological fracture (n=5). osteochondroma (n=15) was most common followed by giant cell tumor of bone (n=6). Treatment ranged from intralesional steroid to wide marginal excision based on histopathological diagnosis, the extent of tumor, anatomical location, and presenting symptoms. All patients were rehabilitated to activities of daily living at the final follow-up. No recurrence or any long-term complications were reported. Conclusion: This study gives epidemiological data on benign bone tumors, which can be used for setting up or upgrading dedicated oncological or oncosurgery institutes. A multicentric study on a large population in the future is suggested to obtain a larger data bank. [ABSTRACT FROM AUTHOR]

Introduction: The thyroid gland is a crucial endocrine organ that can be susceptible to various pathological conditions, often necessitating total thyroidectomy or lobectomy. It is a common surgical procedure in Saudi Arabia. Thus, it is essential to recognize the impact of thyroid surgery on patients' health-related quality of life (HRQoL). Aim: The aim of this study was to evaluate HRQoL among patients with benign and malignant thyroid diseases who underwent thyroidectomy in the eastern region of Saudi Arabia. Methods: This cross-sectional study was conducted at King Fahad Hospital of University in Khobar, Kingdom of Saudi Arabia from January 2018 to May 2018. The data collection method used was divided into two parts. Part I included the patients' socio-demographic characteristics and the clinical characteristics of their thyroid surgery. Part II was a HRQoL questionnaire (SF-36, version 1.0). Results: The sample included 100 thyroidectomy patients ≥18 years. The study findings revealed that the overall scores for post-thyroidectomy patients showed a significant improvement in HRQoL, and HRQoL was not significantly associated with benign or malignant thyroid diseases. Conclusion: Especially when the surgery is performed by a high-volume endocrine surgeon, thyroidectomy may lead to significant improvements in HRQoL among patients, including the elderly and younger adults, with benign and malignant thyroid disorders. There was no difference in HRQoL between patients who underwent total thyroidectomy or thyroid lobectomy. Also, HRQol among thyroidectomy patients is associated with their educational and occupational statuses. [ABSTRACT FROM AUTHOR]

We recently characterized the clinical performance of a multivariate index assay (MIA3G) to assess ovarian cancer risk for adnexal masses at initial presentation. This study evaluated how MIA3G varies when applied longitudinally to monitor risk during clinical follow-up. The study evaluated women presenting with adnexal masses from eleven centers across the US. Patients received an initial blood draw at enrollment and at the standard-of-care follow-up visits. MIA3G was determined for all visits but physicians did not have access to MIA3G scores to determine clinical management. The primary outcome was the relative change value (RCV) of MIA3G over the period of clinical observation. A total of 510 patients of 785 enrolled met study criteria. Of these, 30.8% had a second, 25.4% a third and 22.2% a fourth blood draw following initial collection. The median duration from initial draw was 131 d to second draw, 301.5 d to the third draw and 365.5 d to the fourth draw. MIA3G RCV of >50% was observed in 22–26% patients, whereas 70–75% patients had MIA3G RCV >5%. An empirical baseline RCV of 56% – transformed to 1 in logarithmic scale – was calculated from averaging RCVs of all patients who had no malignancy risk after 210 days. RCV > 1 log was associated with higher incidence of surgical intervention (29.6%) compared to RCV < 1 log (16.9%). Variation in MI3AG does not change the accuracy of the test for excluding malignancy, while marked changes may be associated with a slightly higher likelihood of surgical intervention. In addition to MIA3G score itself, the MIA3G RCV may be important for clinical management. • This study examined a novel application of multivariate index assay for longitudinal monitoring of ovarian cancer risk. • Relative change value of the MIA score post follow-up was associated with a higher incidence of surgical intervention. • The findings indicated the MIA relative change value is a useful clinical tool to monitor cancer risk for adnexal mass. [ABSTRACT FROM AUTHOR]

Background: Despite the rising rates of opportunistic salpingectomy at the time of surgery for non‐malignant conditions, salpingectomy is not widely adopted during vaginal hysterectomy (VH) and has not been extensively investigated. Objectives: The aim of the primary study was to determine the feasibility of bilateral opportunistic salpingectomy at the time of VH. Secondary aims included surgical outcomes, factors associated with patient selection, and the prevalence of incidental tubal malignancies. Search Strategy: In this systematic review and meta‐analysis we searched Pubmed, Embase and ClinicalTrials.gov databases from inception to September 1, 2023, using relevant keywords. Selection Criteria: Original articles with no language restriction reporting outcomes of women undergoing planned VH with opportunistic salpingectomy, were considered eligible. Studies including patients undergoing VH with and without opportunistic salpingectomy were also included. Data Collection and Analysis: The Newcastle‐Ottawa scale was used to assess quality of observational studies. DerSimonian–Laird random effects meta‐analysis was performed and pooled effect estimates and proportions with corresponding 95% confidence intervals were computed. Heterogeneity was assessed using the I2 statistic. Results: Seven observational cohort studies including 4808 women undergoing opportunistic salpingectomy at the time of VH and 10 295 patients undergoing VH alone were selected. The pooled proportion of success was 81.83 per 100 observations (95% CI: 75.35–87.54). Opportunistic salpingectomy at the time of VH, when feasible, was associated with a significant reduction in intraoperative complications (OR 0.06, 95% CI: 0.01, −0.37, P = 0.03) and total operative time (95% CI: −17.80, −1.07, P = 0.03) compared to those where it failed. Successful salpingectomy was significantly hindered by nulliparity (OR 0.12, 95% CI: −17.69, −1.21, P < 0.001) and favored by pelvic organ prolapse (OR 3.20, 95% CI: 1.35, 7.55, P = 0.008). Immunohistochemical tubal abnormalities were found in 13/579 (2.1%) patients. The overall quality of the evidence, according to the GRADE assessment, was low. Conclusion: Opportunistic salpingectomy is safe, effective, and feasible at the time of VH. Nulliparity and pelvic organ prolapse are factors potentially influencing surgical outcomes. Synopsis: Opportunistic salpingectomy is safe, effective, and feasible at the time of VH. Nulliparity and pelvic organ prolapse are factors potentially influencing surgical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: A skin lesion refers to an area of the skin that exhibits anomalous growth or distinctive visual characteristics compared to the surrounding skin. Benign skin lesions are noncancerous and generally pose no threat. These irregular skin growths can vary in appearance. On the other hand, malignant skin lesions correspond to skin cancer, which happens to be the most prevalent form of cancer in the United States. Skin cancer involves the unusual proliferation of skin cells anywhere on the body. The conventional method for detecting skin cancer is relatively more painful. Methods: This work involves the automated prediction of skin cancer and its types using two stage Convolutional Neural Network (CNN). The first stage of CNN extracts low level features and second stage extracts high level features. Feature selection is done using these two CNN and ABCD (Asymmetry, Border irregularity, Colour variation, and Diameter) technique. The features extracted from the two CNNs are fused with ABCD features and fed into classifiers for the final prediction. The classifiers employed in this work include ensemble learning methods such as gradient boosting and XG boost, as well as machine learning classifiers like decision trees and logistic regression. This methodology is evaluated using the International Skin Imaging Collaboration (ISIC) 2018 and 2019 dataset. Results: As a result, the first stage CNN which is used for creation of new dataset achieved an accuracy of 97.92%. Second stage CNN which is used for feature selection achieved an accuracy of 98.86%. Classification results are obtained for both with and without fusion of features. Conclusion: Therefore, two stage prediction model achieved better results with feature fusion. [ABSTRACT FROM AUTHOR]

Aim: In cases where standardized maximum uptake (SUVmax) values in positron emission tomography (PET-CT) were not sufficient to differentiate mediastinal lymphadenopathy and masses from malignant or benign, the contribution of Hounsfield unit (HU) values in thorax computed tomography to the diagnosis was evaluated. Material Method: The study was conducted by evaluating the data of 182 patients between 2019 and 2023. HU values on non-contrast thorax computed tomography and PET-CT SUVmax values of biopsied masses and lymph nodes were compared with histopathological diagnoses. Results: Patients, 58 females (31.9%) and 124 males (68.1%), who underwent EBUS were included in the study. Biopsies were taken from 233 stations (199 lymph nodes, 34 masses) from 182 patients. A total of 135 of the biopsies taken from 233 stations were histopathologically malignant and 98 were benign. While PET-CT SUVmax values of cases with benign histopathology were 4.5 ± 3.5, it was 7.6 ± 4.2 in patients with malignant pathology (p< 0.05). The HU value on non-contrast thorax tomography in patients with benign histopathology was 43.1 ± 15.7, and in patients with malignant histopathology it was 40.5 ± 13.7 (p> 0.05). When HU was compared according to lung cancer type, it was found to be significantly higher in non-small cell lung cancer (p=0.035). A weak (r=0.182) positive and significant relationship (p< 0.01) was found between PET-CT values and HU values in thorax computed tomography. Conclusion: While positron emission tomography maintains its importance in the differentiation of mediastinal lymphadenopathy and masses from malignant to non-malignant, it was concluded that HU values in computed tomography are not sufficient to distinguish malignant/non-malignant. [ABSTRACT FROM AUTHOR]

Although lung cancer has been recognized to be the deadliest type of cancer, a good prognosis and efficient treatment depend on early detection. Medical practitioners’ burden is reduced by deep learning techniques, especially Deep Convolutional Neural Networks (DCNN), which are essential in automating the diagnosis and classification of diseases. In this study, we use a variety of medical imaging modalities, including X-rays, WSI, CT scans, and MRI, to thoroughly investigate the use of deep learning techniques in the field of lung cancer diagnosis and classification. This study conducts a comprehensive Systematic Literature Review (SLR) using deep learning techniques for lung cancer research, providing a comprehensive overview of the methodology, cutting-edge developments, quality assessments, and customized deep learning approaches. It presents data from reputable journals and concentrates on the years 2015–2024. Deep learning techniques solve the difficulty of manually identifying and selecting abstract features from lung cancer images. This study includes a wide range of deep learning methods for classifying lung cancer but focuses especially on the most popular method, the Convolutional Neural Network (CNN). CNN can achieve maximum accuracy because of its multi-layer structure, automatic learning of weights, and capacity to communicate local weights. Various algorithms are shown with performance measures like precision, accuracy, specificity, sensitivity, and AUC; CNN consistently shows the greatest accuracy. The findings highlight the important contributions of DCNN in improving lung cancer detection and classification, making them an invaluable resource for researchers looking to gain a greater knowledge of deep learning’s function in medical applications. [ABSTRACT FROM AUTHOR]

This study investigated the relationship between mediastinal fat and pulmonary nodule status, aiming to develop a deep learning-based radiomics model for diagnosing benign and malignant pulmonary nodules. We proposed a combined model using CT images of both pulmonary nodules and the fat around the chest (mediastinal fat). Patients from three centers were divided into training, validation, internal testing, and external testing sets. Quantitative radiomics and deep learning features from CT images served as predictive factors. A logistic regression model was used to combine data from both pulmonary nodules and mediastinal adipose regions, and personalized nomograms were created to evaluate the predictive performance. The model incorporating mediastinal fat outperformed the nodule-only model, with C-indexes of 0.917 (training), 0.903 (internal testing), 0.942 (external testing set 1), and 0.880 (external testing set 2). The inclusion of mediastinal fat significantly improved predictive performance (NRI = 0.243, p < 0.05). A decision curve analysis indicated that incorporating mediastinal fat features provided greater patient benefits. Mediastinal fat offered complementary information for distinguishing benign from malignant nodules, enhancing the diagnostic capability of this deep learning-based radiomics model. This model demonstrated strong diagnostic ability for benign and malignant pulmonary nodules, providing a more accurate and beneficial approach for patient care. [ABSTRACT FROM AUTHOR]

Ayurveda, the ancient Indian system of medicine, offers a unique perspective on Arbuda, correlating them with the condition known as tumours. According to Ayurveda, Arbuda arise due to the vitiation of the three doshas: Vata (the dosha responsible for movement and cognition), Pitta (the dosha responsible for regulating body temperature and metabolic activities), and Kapha (the dosha responsible for regulating body fluids and maintaining the cohesion of body constituents). This vitiation disrupts the Dhatu Pariposhana, which refers to the body’s metabolic and nutritional balance. The concept of Arbuda, as detailed in classical Ayurvedic texts, describes as progressively enlarging, globular masses that are fixed to deeper structures, usually non suppurative, and occasionally painful. They can occur in any part of the body, involving the Mamsa (muscle) and Rakta (blood) Dhatus due to the disturbance of the tridosha. Factors such as Mithya Ahara (improper diet) and Vihara (lifestyle) contribute to the vitiation of doshas and the subsequent formation of Arbuda. The ancient texts also classify Arbuda into various types, though there is limited evidence linking Ayurveda’s understanding to modern medical concepts of non tumour-forming cancers. However, descriptions of other diseases in Ayurvedic literature bear resemblance to cancer, suggesting that ancient physicians may have recognised the link between shotha (chronic inflammation) and malignant tumours. This review presents the existing literature on Arbuda, aiming to provide a comprehensive understanding of tumours from an Ayurvedic perspective and to offer integrative approaches for their management and eradication.

Background and Objective: Surgical treatment is an effective option for symptomatic benign prostatic hyperplasia (BPH), after failed conservative therapy. Transurethral resection of the prostate (TURP) is considered as a standard treatment method for the management of the small to medium prostate while transvesical open prostatectomy (OP) is a standard option for great prostate. The objective of this study is to evaluate the efficacy and safety of both (B-TURP) and (OP). Methods: The present study included 73 patients underwent either transvesical open prostatectomy (31 patients) or bipolar transurethral resection of the prostate (42 patients) between May 2019 to May 2021, in Erbil-city. The baseline characteristics, intraoperative and postoperative characteristics plus early and late adverse effects were obtained from medical records for all patients in both groups, retrospectively. The data analyzed and compared statistically. Results: The baseline characteristics in the studied groups showed no significant differences except for the prostate size which was more on the OP group. According to the results, operative time was significantly (P

Abstract Background Partial nephrectomy (PN) has become the dominant treatment modality for cT1 renal tumor lesions. Tumors suspected of malignant potential are indicated for surgery, but some are histologically classified as benign lesions after surgery. This study aims to analyze the number of benign findings after PN according to definitive histology and to evaluate whether there is an association between malignant tumor findings and individual factors. Methods The retrospective study included 555 patients who underwent open or robotic-assisted PN for a tumor in our clinic from January 2013 to December 2020. The cohort was divided into groups according to definitive tumor histology (malignant tumors vs. benign lesions). The association of factors (age, sex, tumor size, R.E.N.A.L.) with the malignant potential of the tumor was further evaluated. Results In total, 462 tumors were malignant (83%) and 93 benign (17%). Of the malignant tumors, 66% were clear-cell RCC (renal cell carcinoma), 12% papillary RCC, and 6% chromophobe RCC. The most common benign tumor was oncocytoma in 10% of patients, angiomyolipoma in 2%, and papillary adenoma in 1%. In univariate analysis, there was a higher risk of malignant tumor in males (OR 2.13, 95% CI 1.36–3.36, p = 0.001), a higher risk of malignancy in tumors larger than 20 mm (OR 2.32, 95% CI 1.43–3.74, p

Background: Primary bone tumors are relatively uncommon and constitute only 0.2–0.5% of all tumors in all ages in most series reported worldwide. Benign bone tumors are more common than the malignant bone tumors. Not many studies on benign bone tumors in the North Eastern Indian population are published in the available literature. Aims and Objectives: The current study was done with the aim to find out the epidemiological data on benign bone tumors in patients of the North-East Indian population who were admitted to the orthopedic department of a teaching institute. Materials and Methods: A hospital-based retrospective study with prospective effect was conducted on benign bone tumors in patients admitted to the Department of Orthopedics at our teaching institute from 2016 to 2020. Patients of all ages and both sexes with suspicion of bone tumors based on history and clinical examination were subjected to roentgenographic evaluation, including computed tomography (CT) scan and/or magnetic resonance imaging. Pre-operative core needle biopsy under C-arm/CT guidance or incisional biopsy was done for histological diagnosis, followed by appropriate intervention. Soft-tissue tumors and malignant bone tumors were excluded. Patients were followed up for recurrence, complications, and functional recovery. Results: Forty patients of bone tumors were treated out of 2288 patients admitted to the department (incidence of 1.75%). 29 were benign bone tumors with an incidence of 1.27%. Of 10–20 years age group was most commonly affected. Male preponderance with M: F=6.25:1. Femur (n=16) was the most commonly affected bone. Presenting features were swelling (n=18), pain (n=11), and pathological fracture (n=5). osteochondroma (n=15) was most common followed by giant cell tumor of bone (n=6). Treatment ranged from intralesional steroid to wide marginal excision based on histopathological diagnosis, the extent of tumor, anatomical location, and presenting symptoms. All patients were rehabilitated to activities of daily living at the final follow-up. No recurrence or any long-term complications were reported. Conclusion: This study gives epidemiological data on benign bone tumors, which can be used for setting up or upgrading dedicated oncological or oncosurgery institutes. A multicentric study on a large population in the future is suggested to obtain a larger data bank.

Introduction: The ovaries, fallopian tubes, and the broad ligament make up the anatomical adnexa. Adnexal masses represent a commonly occurring issue in gynaecology. The majority of ovarian malignancies are detected at advanced stages. The clinical manifestations of adnexal masses vary, with many cancers either showing no symptoms or presenting with vague signs. In the reproductive age group, the most typical manifestation is a benign functional cyst. Aim: To conduct a clinico-pathological analysis of adnexal masses among women presenting at a tertiary healthcare centre. Materials and Methods: A retrospective observational study was conducted in the Department of Obstetrics and Gynaecology at Akash Institute of Medical Science and Research Centre, Devanahalli, Karnataka, India, from November 2022 to April 2024. The diagnosis of adnexal mass was based on clinical symptoms, abdominal examination, bimanual examination, and trans-abdominal ultrasound. The CA-125 and other tumour markers were sent depending on the risk of malignancy. All tissues were sent for histopathological examination. The data were collected and tabulated in a Microsoft excel sheet, and percentages were calculated. Results: This study included 38 cases, in which benign ovarian and para-ovarian cysts were the most common findings, observed in 21 cases (55.3%). There were six cases of benign serous cystadenoma (15.8%), three cases of teratoma (7.9%), two cases of high-grade serous carcinoma (5.3%), one case of germ cell tumour (2.6%), one case of mucinous cystadenoma (2.6%), two cases of endometriotic cysts (5.3%), one case of adnexal cystic degeneration of a fibroid (2.6%), and one rare case of primary fallopian tube carcinoma (2.6%). The most common presenting complaint was abdominal pain, reported in 21 cases (55.3%). Conclusion: Adnexal masses can present in a variety of forms, ranging from benign cysts to infections and cancers. A thorough history and clinical examination are essential for accurate diagnosis. Investigations support the diagnosis, and histology confirms it.

Background: Neck swellings are frequently found and can present the vast pathological spectrum from simple benign to highly malignant, which sometimes can pose a diagnostic dilemma. They are broadly classified as developmental, inflammatory, and neoplastic on the basis of etiology. The aim of the study is to assess the distribution of neck swelling according to etiology and its relation to age groups, as well as to assess their clinicopathological correlation as benign and malignant. Materials and Methods: The study was conducted from January 2020 to February 2023 on the basis of retrospective and prospective sampling. All the patients with neck swellings, except thyroid, who had undergone an excisional or incisional biopsy, were included in this study. Data was collected from in-patient records for retrospective sampling, and fine-needle aspiration cytology (FNAC), radiological investigation, and excisional or incisional biopsy were performed for prospective sampling after proper history and examination. Cytological and pathological correlation was analyzed as benign and malignant. Sensitivity and specificity were calculated. (P value

To evaluate the efficacy of radiomics features extracted from preoperative high-resolution computed tomography (HRCT) scans in distinguishing benign and malignant pulmonary pure ground-glass nodules (pGGNs), a retrospective study of 395 patients from 2016 to 2020 was conducted. All nodules were randomly divided into the training and validation sets in the ratio of 7:3. Radiomics features were extracted using MaZda software (version 4.6), and the least absolute shrinkage and selection operator (LASSO) was employed for feature selection. Significant differences were observed in the training set between benign and malignant pGGNs in sex, mean CT value, margin, pleural retraction, tumor–lung interface, and internal vascular change, and then the mean CT value and the morphological features model were constructed. Fourteen radiomics features were selected by LASSO for the radiomics model. The combined model was developed by integrating all selected radiographic and radiomics features using logistic regression. The AUCs in the training set were 0.606 for the mean CT value, 0.718 for morphological features, 0.756 for radiomics features, and 0.808 for the combined model. In the validation set, AUCs were 0.601, 0.692, 0.696, and 0.738, respectively. The decision curves showed that the combined model demonstrated the highest net benefit.

Objective: Breast abscesses are localized purulent collections, often arising from bacterial mastitis, and pose significant health risks, especially for lactating women. The aim of this study was to compare the efficacy and outcomes of two different treatment approaches: Traditional incision and drainage (I&D) versus ultrasound (USG)-guided aspiration in breast abscess management. Materials and Methods: Fifty female patients with breast abscesses were enrolled and divided into two groups: Group A (n = 25, I&D) and group B (n = 25, USG-guided aspiration). Group A underwent I&D under general anaesthesia and group B underwent USG-guided aspiration under local anaesthesia. The patients were followed up for two weeks after the procedure. Patient demographics, abscess characteristics, treatment outcomes, and complications were analyzed. Results: The mean age of patients was 36.4 and 31.8 in group A and B, respectively and the mean abscess size was 5.7 cm. The study found that USG-guided aspiration was associated with several advantages over I&D. Patients in group B experienced shorter healing times (5 days vs. 13 days, p = 0.001), lower rates of residual abscesses (12% vs. 36%, p = 0.047), and no recurrence after two weeks vs. 28% in group A (p = 0.012). Notably, the resumption of lactation was significantly greater in group B (91.67% vs. 20%). Importantly, patients in group B had no scarring, while 37% in group A healed with scars. Conclusion: These results highlight that USG-guided aspiration offers a minimally invasive and effective method for managing breast abscesses, leading to quicker recovery, better cosmetic outcomes, and higher patient satisfaction compared to the traditional I&D approach. Early diagnosis and intervention with USG-guided aspiration can prevent complications and reduce the need for open surgery. Based on these findings, USG-guided aspiration is a safer and more efficient method for treating breast abscesses, particularly when initiated promptly after diagnosis.

Introduction: The thyroid gland is a crucial endocrine organ that can be susceptible to various pathological conditions, often necessitating total thyroidectomy or lobectomy. It is a common surgical procedure in Saudi Arabia. Thus, it is essential to recognize the impact of thyroid surgery on patients’ health-related quality of life (HRQoL). Aim: The aim of this study was to evaluate HRQoL among patients with benign and malignant thyroid diseases who underwent thyroidectomy in the eastern region of Saudi Arabia. Methods: This cross-sectional study was conducted at King Fahad Hospital of University in Khobar, Kingdom of Saudi Arabia from January 2018 to May 2018. The data collection method used was divided into two parts. Part I included the patients’ socio-demographic characteristics and the clinical characteristics of their thyroid surgery. Part II was a HRQoL questionnaire (SF-36, version 1.0). Results: The sample included 100 thyroidectomy patients ≥18 years. The study findings revealed that the overall scores for post-thyroidectomy patients showed a significant improvement in HRQoL, and HRQoL was not significantly associated with benign or malignant thyroid diseases. Conclusion: Especially when the surgery is performed by a high-volume endocrine surgeon, thyroidectomy may lead to significant improvements in HRQoL among patients, including the elderly and younger adults, with benign and malignant thyroid disorders. There was no difference in HRQoL between patients who underwent total thyroidectomy or thyroid lobectomy. Also, HRQol among thyroidectomy patients is associated with their educational and occupational statuses.

Introduction: Breast fibroadenoma in the axilla is a rare manifestation that consists of biphasic proliferation of fibromyxoid stroma without atypia or mitosis, with a glandular component consisting of two luminal and myoepithelial layers. In this study, breast fibroadenoma in the left axilla of a 45-year-old woman is presented. Case presentation: The patient was a 45-year-old woman complaining palpation of a mass in the left axilla that underwent a needle biopsy, but in the ultrasound and mammography examination, both breasts were normal and without mass. In the pathology examination of the needle biopsy specimen of the axillary mass, biphasic proliferation of fibromyxoid stroma without atypia or mitosis, along with a glandular component consisting of two layers of luminal and myoepithelial tuberculosis was observed, and after the pathological examination of the surgical specimen, the diagnosis of fibroadenoma was confirmed. During the one year follow-up, the patient was alive with good general condition. Conclusion: A careful examination of any swelling in the axilla area of a woman should be considered, because even though the main breast tissue is normal, it may be caused by benign or even malignant neoplasms from the accessory breast.

Abstract Background Benign peripheral nerve sheath tumors (BPNSTs) include schwannomas and neurofibromas. About 10% of soft tissue sarcomas are malignant peripheral nerve sheath tumors (MPNSTs), which are invasive and aggressive tumors. These can happen occasionally or after radiation exposure. Up to 90% of schwannomas are made up of differentiated neoplastic Schwann cells. Malignant transformation of schwannomas is rare. Methods We collected the medical records of all patients (including their family histories), performed comprehensive physical and neurological assessments, and checked for the presence of a Tinel-like sign, as well as screening for neurofibromatosis (NF) signs. Magnetic resonance imaging (MRI), nerve conduction studies, and ultrasound were done for all cases. Results We have operated on 21 patients with age range 29–52 years. The mean age was 39.4 years. 14 of these patients were females and 7 were males. The presenting symptoms were just swelling at nerve site in 14 patients, spontaneous pain at the nerve sites in 7 patients, and sensory deficit at the nerve distribution sites in 9 patients. The other 12 patients were sensory intact and only 7 patients had motor deficit. Postoperatively all patients had improved motor and sensory deficit and none of intact patients were worsened. Preoperatively we did MRI to show important nearby vascular structure anatomical abnormalities and we ordered nerve studies to all patients that showed abnormalities, which was only in 9 patients. Gross total resection was done in 18 patients and other 3 cases had partial resection to avoid sensory and motor deficits. The pathological analysis revealed 11 schwannomas and 10 neurofibromas. With 1 year follow up there was no recurrence in any patients. Conclusion Benign pheripheral nerve sheath tumours are safely resected without increased sensory and motor deficits after surgery and with improve clinical outcome with no recurrence on follow up.

Non-malignant conditions of the prostate and seminal vesicles are much more common in imaging practice than prostate cancer. They include benign prostatic hyperplasia, infective and inflammatory prostatitis, prostatic and periprostatic cysts, and benign tumors. The advances in magnetic resonance imaging (MRI) of the prostate gland have dramatically improved the ability to identify these entities, many of them being identified incidentally in patients evaluated for other indications. Good knowledge of these conditions can aid in precise diagnosis and avoid interpretation pitfalls. In this article, we present non-malignant conditions of the prostate gland using several imaging modalities, including transrectal ultrasound, MRI, and computed tomography. We also present the pathological correlation for benign tumors.

Introduction: Patients presenting with large bowel obstruction (LBO) frequently undergo emergency surgery that is associated with significant morbidity. In malignant LBO, endoscopic approaches with placement is a self-expanding metal stent (SEMS), have been proposed to prevent emergency surgery and act as a bridge to an elective procedure—with the intention of avoiding a stoma and reducing morbidity. This systematic review aims to assess the quality and outcomes of data available on the use of SEMS in benign causes of colonic obstruction. Methods: This systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the protocol was registered on Prospero (ID: CRD42021239363). PUBMED, MEDLINE, HMIC, CINAHL, AMED, EMBASE, APA and Cochrane databases were searched. Studies were assessed for quality utilising the MINORS criteria. Pooled odds ratios with 95% confidence intervals (95% CI) were calculated using random effects models. Results: Sixteen studies were included for analysis. 300 patients were included with an average age of 68, and a male predominance of 57%. The quality of the papers included were at risk of bias. The pooled rate of technical success of procedure was 94.4% (95% CI 90.5–96.8%) The pooled rate of clinical success was 77.6% (95% CI: 66.6–85.7%). Adverse effects were low, with perforation 8.8% (4.5–16.6%), recurrence 26.5% (17.2–38.5%) and stent migration 22.5% (14.1–33.8%). Discussion: This systematic review demonstrated that SEMS for benign colonic obstruction can be a safe and successful procedure. The utilisation of SEMS in malignant disease as a bridge to surgery has been well documented. Whilst the limitations of the data interpreted are appreciated, we postulate that SEMS could be utilised to decompress patients acutely and allow pre-operative optimisation, leading to a more elective surgery with less subsequent morbidity. [ABSTRACT FROM AUTHOR]

Ovarian tumors can be challenging to diagnose and treat, especially in areas with limited access to advanced medical care. During routine prenatal ultrasounds, abnormal growths in the ovaries can be unexpectedly discovered. In clinical practice, it is essential to accurately differentiate between benign and malignant ovarian tumors in order to develop appropriate treatment plans. Ultrasound imaging has become the preferred diagnostic tool. The aim of this article is to examine the ultrasound characteristics of ovarian and adnexal growths and to explore how these characteristics, along with other clinical factors, can aid in predicting the likelihood of ovarian cancer. [ABSTRACT FROM AUTHOR]

The aim of this study is to determine and compare the distribution, localization, breed, age and gender incidences of head and neck region tumors by years, by evaluating the results of dog-cat biopsies and/or operation material brought to Ankara University, Faculty of Veterinary Medicine, Department of Pathology between the years 2011 and 2021. In the study, 244 (15.9%) of 1533 tumors diagnosed in dogs and cats between 2011 and 2021 belonged to the head and neck region, of which 159 were in dogs and 85 in cats. Dogs with tumors were generally more than 6 years old (n=108) and cats were mostly 1 year old and older (n=75). In the head and neck region tumors observed in dogs, malignant and benign tumors of epithelial origin were most common (n=81; 50.9%), with sebaceous tumors (n=22) being the most common, and mostly observed around the eyes (n=26), while malignant and benign tumors of mesenchymal origin were most commonly found in the mouth region. Among the tumors of this region, epithelial tumors were mostly encountered in cats (n=39, 45.8%), and 51.2% of the epithelial tumors were squamous cell cancer (n=20), with epithelial tumors being the most common in the mouth (n=12) and nose (n=9). As a result, epithelial malignant and benign tumors were mostly seen in the eyes, and mesenchymal malignant and benign tumors were detected in the mouth. Among tumor types, papilloma in benign tumors and squamous cell carcinoma in malignant tumors were noted. [ABSTRACT FROM AUTHOR]

Objective: Breast abscesses are localized purulent collections, often arising from bacterial mastitis, and pose significant health risks, especially for lactating women. The aim of this study was to compare the efficacy and outcomes of two different treatment approaches: Traditional incision and drainage (I&D) versus ultrasound (USG)-guided aspiration in breast abscess management. Materials and Methods: Fifty female patients with breast abscesses were enrolled and divided into two groups: Group A (n = 25, I&D) and group B (n = 25, USG-guided aspiration). Group A underwent I&D under general anaesthesia and group B underwent USG-guided aspiration under local anaesthesia. The patients were followed up for two weeks after the procedure. Patient demographics, abscess characteristics, treatment outcomes, and complications were analyzed. Results: The mean age of patients was 36.4 and 31.8 in group A and B, respectively and the mean abscess size was 5.7 cm. The study found that USG-guided aspiration was associated with several advantages over I&D. Patients in group B experienced shorter healing times (5 days vs. 13 days, p = 0.001), lower rates of residual abscesses (12% vs. 36%, p = 0.047), and no recurrence after two weeks vs. 28% in group A (p = 0.012). Notably, the resumption of lactation was significantly greater in group B (91.67% vs. 20%). Importantly, patients in group B had no scarring, while 37% in group A healed with scars. Conclusion: These results highlight that USG-guided aspiration offers a minimally invasive and effective method for managing breast abscesses, leading to quicker recovery, better cosmetic outcomes, and higher patient satisfaction compared to the traditional I&D approach. Early diagnosis and intervention with USG-guided aspiration can prevent complications and reduce the need for open surgery. Based on these findings, USG-guided aspiration is a safer and more efficient method for treating breast abscesses, particularly when initiated promptly after diagnosis. [ABSTRACT FROM AUTHOR]

To evaluate the efficacy of radiomics features extracted from preoperative high-resolution computed tomography (HRCT) scans in distinguishing benign and malignant pulmonary pure ground-glass nodules (pGGNs), a retrospective study of 395 patients from 2016 to 2020 was conducted. All nodules were randomly divided into the training and validation sets in the ratio of 7:3. Radiomics features were extracted using MaZda software (version 4.6), and the least absolute shrinkage and selection operator (LASSO) was employed for feature selection. Significant differences were observed in the training set between benign and malignant pGGNs in sex, mean CT value, margin, pleural retraction, tumor–lung interface, and internal vascular change, and then the mean CT value and the morphological features model were constructed. Fourteen radiomics features were selected by LASSO for the radiomics model. The combined model was developed by integrating all selected radiographic and radiomics features using logistic regression. The AUCs in the training set were 0.606 for the mean CT value, 0.718 for morphological features, 0.756 for radiomics features, and 0.808 for the combined model. In the validation set, AUCs were 0.601, 0.692, 0.696, and 0.738, respectively. The decision curves showed that the combined model demonstrated the highest net benefit. [ABSTRACT FROM AUTHOR]

Objective: Radiofrequency ablation (RFA) is an emerging non-surgical treatment for benign thyroid nodules (BTN). Despite its proven safety profile, data on the learning curve (LC) required to achieve proficiency are still lacking. Materials and methods: The first 179 RFA procedures performed by a single operator in patients with non-functioning BTN were retrospectively analyzed. Six-month nodule volume reduction rate (VRR) ≥ 50% was regarded as reflection of proficiency. Multiple linear regression analysis has been performed to determine the relationship between the VRR and clinical variables. Cumulative sum (CUSUM) charts were plotted to assess LCs for all consecutive procedures and in relation to basal nodule size. In details, Group 1 (G1): 57 patients with small nodules (<10 ml); Group 2 (G2): 87 patients with intermediate nodules (10 – 25 ml); Group 3 (G3): 35 patients with large size (> 25 ml). Results: LC of all 179 procedures showed 3 phases: initial learning (1–39 procedures); consolidation (40–145 procedures); and experienced period (146–179 procedures). For G1 and G2 proficiency is achieved starting from the 10th procedure within the group (or 37th considering consecutively all procedures) and from the 59th procedure within the group (or 116th considering consecutively all procedures), respectively. LC of G3 did not detect operator proficiency. Conclusion: Specific LCs exist concerning the basal size of the nodule treated with RFA. In nodules with baseline volume > 25 ml suboptimal VRR has to be expected. Previously achieved experience on small-intermediate nodules does not seem to provide advantages in terms of higher VRR in the treatment of large nodules. Other potential and non-modifiable factors likely play a key role in the final volume reduction independently from the increased skill of the operator. [ABSTRACT FROM AUTHOR]

Simple Summary: Pre-surgical evaluation of a sonographically indeterminate adnexal mass is a complex process, and surgical referral relies on subjective evaluation of multiple clinical parameters. The requirement to mitigate malignancy risk means that the vast majority of post-surgical diagnoses are ultimately benign. Conversely, less than half of cancer patients receive a primary referral to an oncology expert, which can adversely affect their long-term outcome. In this study, we highlight the combination of transvaginal ultrasound with a multi-biomarker panel (MMP) to accurately identify and differentiate benign from all stages of malignant disease. The MMP index combined with transvaginal ultrasound (TVU) was superior to TVU plus CA125, particularly for the identification of early-stage malignancies. Incorporation of the MMP index into TVU-driven workflows can provide improved accuracy for the pre-surgical assessment of an adnexal mass, enabling greater confidence for subsequent patient triage. Pre-surgical clinical assessment of an adnexal mass typically relies on transvaginal ultrasound for comprehensive morphological assessment, with further support provided by biomarker measurements and clinical evaluation. Whilst effective for masses that are obviously benign or malignant, a large proportion of masses remain sonographically indeterminate at surgical referral. As a consequence, post-surgical diagnoses of benign disease can outnumber malignancies up to 9-fold, while less than 50% of cancer cases receive a primary referral to a gynecological oncology specialist. We recently described a blood biomarker signature (multi-marker panel—MMP) that differentiated patients with benign from malignant ovarian disease with high accuracy. In this study, we have examined the use of the MMP, both individually and in combination with transvaginal ultrasound, as an alternative tool to CA-125 for enhanced decision making in the pre-surgical referral process. [ABSTRACT FROM AUTHOR]

Background & Aims: Early gastric cancers (EGCs) after Helicobacter pylori (H. pylori) eradication often appear as reddish depressed lesions (RDLs); the same features are also appeared in benign stomachs after eradication. We compared clinic-pathological and endoscopic features of benign and neoplastic RDLs after H. pylori eradication. Methods: 228 neoplastic RDLs after H. pylori eradication were studied. All lesions were divided into neoplastic RDLs (differentiated carcinoma or adenoma, n=114) and benign RDLs (n=114) according to the histology. Clinical and pathological characteristics were compared in neoplastic and benign groups. Endoscopic diagnostic yields using the white light (WL) endoscopy, chromoendoscopy (CE) using indigo carmine dye and the magnifying endoscopy with narrow-band imaging (ME-NBI) were also evaluated in relation to the pathological diagnosis. Results: Size of neoplastic RDLs was larger than that of benign RDLs (p<0.01). Sensitivity, specificity and accuracy for predicting pathological types of RDLs was 70.1%, 52.6% and 61.4% for the WL, 65.8%, 63.1% and 65.4% for the CE, while the ME-NBI scored better with the 88.6%, 88.6%, 99.1% and 93.9% of sensitivity, specificity and accuracy. The accuracy of the ME-NBI was 99.9% (113/114) in the benign RDLs and 89.4% (101/114) for the neoplastic RDLs. Undiagnosed neoplastic RDLs using the ME-NBI were associated with more differentiated tumors such as adenoma and well-differentiated adenocarcinoma (tub1) and the presence of an unclear demarcation line. Conclusions: ME-NBI is useful to diagnose RDLs after H. pylori eradiation, while some of neoplastic lesions are difficult to diagnose using the ME-NBI. [ABSTRACT FROM AUTHOR]

Nowadays, breast cancer is the most prevalent and jeopardous disease in women after lung cancer. During the past few decades, a substantial amount of cancer cases have been reported throughout the world. Breast cancer has been a widely acknowledged category of cancer disease in women due to the lack of awareness. According to the world cancer survey report 2020, about 2.3 million cases and 685,000 deaths have been reported worldwide. As, the patient-doctor ratio (PDR) is very high; consequently, there is an utmost need for a machine-based intelligent breast cancer diagnosis system that can detect cancer at its early stage and cure it more efficiently. The plan is to assemble scientists in both the restorative and the machine learning fields to progress toward this clinical application. This paper presents SELF, a stacked-based ensemble learning framework, to classify breast cancer at an early stage from the histopathological images of tumor cells with computer-aided diagnosis tools. In this work, we use the BreakHis dataset with 7909 histopathological images and Wisconsin Breast Cancer Database (WBCD) with 569 instances for the performance evaluation of our proposed framework. We have trained several distinct classifiers on both datasets and selected the best five classifiers on the basis of their accuracy measure to create our ensemble model. We use the stacking ensemble technique and consider the Extra tree, Random Forest, AdaBoost, Gradient Boosting, and KNN9 classifiers as the base learners, and the logistic regression model as a final estimator. We have evaluated the performance of SELF on the BreakHis dataset and WBCD datasets and achieved testing accuracy of approximately 95% and 99% respectively. The result of the other performance parameters on the BreakHis and the WBCD datasets also showed that our proposed framework outperforms with F1-Score, ROC, and MCC scores. [ABSTRACT FROM AUTHOR]

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