FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) IN DIAGNOSIS OF TUMORAL CALCINOSIS, A REPORT OF THREE CASES

Introduction: Tumoral calcinosis (T.C.) is very rare and generally of unknown aetiology characterized by calcific deposits in the soft tissues. Commonly seen in the second decade of life (reported age range 15 months to 83 years). We are reporting 3 cases of T. C. who were initially diagnosed by FNAC. Two of the 3 cases were female siblings who were referred to us as possible cases of recurrent fibrosarcomas following surgical excision. Case reports:  (1) Two female siblings aged 17 and 14 years  complaining of large swelling in the upper   outer right thigh and the left outer upper thigh around the hip joints respectively. There was no limitation of movement. The masses recurred within a short period after total excision. Neither specimen was subjected to histopathology. Clinical examination showed two masses each approximately 30cm maximum diameter and 10 cm width. In addition the younger sister showed an additional mass 4.5 cm in the outer aspect of her right elbow. (2) 18 months old female child, unrelated to the above two cases, presented with an egg-sized mass in the mid-lateral aspect of her right thigh  cystic and mobile.There is a history of quinine injection in the same area. No positive family history of a similar condition. All three cases showed normocalcaemia and hyperphosphataemia with specks of calcification on x - ray and cysts in ultrasound. FNAC showed structureless gung , calcium granules and inflammatory cells including foreign body type multinucleated giant cells. Histopathology confirmed the diagnosis of T. C. Discussion: Described the three types of T. C. (familial, idiopathic, and that in patients of chronic renal failure on dialysis). The differential diagnoses were also discussed as well as lines of management such as Ca++ supplementation, phosphate restriction, acetazolamide, parathyroidectomy and the treatment of choice is total surgical excision. To our best knowledge this is the first time to report the use of fine needle aspiration cytology in the diagnosis of T. C. in Sudan.&nbsp

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

A Survey in Modern Techniques in Digital Forensic Evidence in Graphics Design Applications

Digital forensics syndicates computer science theories, including computer architecture, applications, operating systems, file systems, software engineering, and computer networking as well as legal procedures that describe criminal and civil litigation, cyberlaw, and rules of evidence. This paper explores the modern techniques innovated in gathering digital forensic evidence from certain design application that proof counterfeit image or document was formed. The extrapolation is created by linking  digital forensic information gathered with the imaginable deeds established such as scanning, printing, editing, saving, importing, exporting the fake documents or images. The file generated by the particular graphic application is analyzed to accumulate the digital forensic information that concludes if the system is used for designing counterfeit document or image

Hybrid Framework Human Computer Interaction Art and Experiences

The expansion in Human-Computer Interaction (HCI) field has not only been in excellence of interaction, it has also experienced different branching in computer arts. Instead of designing regular interfaces, the different research branches have had different focus on the concepts of multi-modality rather than uni-modality, pleasure, intelligent adaptive interfaces rather than command/action based ones, and finally active with human engagement rather than passive interfaces. One important area that contributes to creative practice in art is HCI, or interaction design in particular. An innovated framework for human computer interaction based on both pleasure and human engagement that exploit modern computer arts components and technologies is introduced. In designing for engagement, the artist needs to consider where they sit in this space and what kind of engagement or engagement process they are concerned with. On other designing issue many artwork consider pleasure as form of interaction with specific characteristics. Providing a context in which appropriate interaction design decisions can be made and the nature of the interactive experience must be addressed.&nbsp