Value of elastography in differentiating benign from malignant breast lesions keeping histopathology as gold standard

Background: Breast cancer is the most common cancer in females, both in developed and developing countries. Pakistan has the highest breast cancer incidence rate in Asia. Guidelines recommend screening for detecting breast cancer with mammography and ultrasonography (US). Shear-wave elastography (SWE) is a newer technique that can aid additional characterization of breast lesions. Objective: The aim of this study was to determine the diagnostic accuracy of breast ultrasound elastography in differentiating benign from malignant breast lesions using histology diagnosis as the gold standard.Materials and methods: The study was conducted at the Abbasi Shaheed Hospital and Jinnah Post Graduate Medical Centre, Karachi. All consecutive patients undergoing breast biopsy and elastography of breast lesions were enlisted; 2 x 2 tables were used to measure the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of breast ultrasound elastography for differentiation of benign from malignant breast masses.Results: A total of 155 female patients were included with a mean age of 45.41 ± 14.24 years (range 20-70 years). On histological evaluation, 115 (74.2%) lesions were malignant and 40 (25.8%) were benign. The overall average mean elastography value was 108.45 kPa ± 52.75. The mean elastography (EMean) value for benign breast lesions was 48.96 kPa ± 42.32 and 132.78 kPa ± 42.32 for malignant lesions. The difference in mean elastography values of benign and malignant breast lesions was statistically significant (48.96 kPa ± 42.32 vs 32.78 kPa ± 42.32, P \u3c0.001). The area under the curve (AUC) was 0.952, optimal cutoff EMean value of 72 kPa and higher likelihood ratio was 9.41. A cutoff mean elastography (EMean) value of ≤ 72 kilopascal (kPa) for benign lesions had sensitivity 92.17%, specificity 90.4%, PPV 96.36%, NPV 80.0% and diagnostic accuracy 91.61%. Conclusion: Ultrasound elastography was found to have high sensitivity and specificity and diagnostic accuracy for differentiating benign from malignant breast lesions. Use of shear-wave elastography may increase malignancy detection rate by reducing the need for biopsy in benign breast lesions

The Natural Cryoprotectant Honey for Fertility Cryopreservation

Honey is a mixture of 25 sugars with other bioactive substances (i.e., organic acids, enzymes, antioxidants, and vitamins) and has been known as a highly nutritious functional food. Traditionally, it has been widely used in medicinal applications to cure various diseases. The effectiveness of honey in different applications has been used for its antimicrobial activity, absorption of hydrops, cleansing, removing odor, assisting granulation, recovery of nutrition, and formation of tissue and epithelium, which proved that honey has dehydrating and preserving properties to make it ideal for the cryopreservation of cells and tissues. Cryopreservation is an advanced preservation technique for tissue, cells, organelles, or other biological specimen storage, performed by cooling the sample at a very low temperature. It is the most common approach to improved preserving fertility (sperm, embryos, and oocytes) in different species that may undergo various life-threatening illnesses and allows for the genetic screening of these cells to test the sample for diseases before use. However, with toxic cryoprotectant (CPA), cryopreservation of fertility has been challenging because of their particular structure and sensitivity to chilling. Honey’s unique composition, as well as its dehydrating and preserving properties, qualify it to be used as a natural cryoprotectant. The aim of this study is to emphasize the ability of honey as a natural cryoprotectant in cryopreservation. The articles for this review were searched from Google Scholar, PubMed, Science Direct, Web of Science, and Scopus, using the keywords, honey, cryopreservation, natural cryoprotectant/CPAs, extenders, and fertility. Honey, as a natural cryoprotectant in fertility cryopreservation, yielded satisfactory results, with respect to improved post-thaw quality and viability. It is now proved as a non-toxic and highly efficient natural cryoprotectant in fertility preservation because its increasing viscosity at low temperature can provide a protective barrier to cells by reducing ice formation. Furthermore, its antioxidant property plays a vital role in protecting the cells from thermal damage by reducing the reactive oxygen species (ROS). This review provides a road map for future studies to investigate the potential of honey in the cryopreservation of other cells and tissue and contribute to the scientific research, regarding this remarkable natural product

Trans-Arterial Chemoembolization for the Treatment of Hepatocellular Carcinoma: A Single Tertiary Care Institute Experience

Introduction: Trans-arterial chemoembolization (TACE) is a mainstay therapeutic option indicated in early-stage non- resectable hepatocellular carcinoma (HCC) and has been shown to be associated with survival improvements. This study aimed to evaluate the radiological and clinical response of those who underwent TACE. Aims & Objectives: We aimed to evaluate the radiological and clinical response in patients who underwent Trans- arterial chemoembolization. Place and Duration of Study: This study was conducted in the Vascular Interventional Radiology Department, Dow Institute of Radiology, Dow University of Health Sciences, Ojha Campus Karachi for a period of 18 months between January 2021 and June 2022. Material & Methods: HCC patients (n=181) who underwent TACE as their primary treatment at Dow Hospital Ojha Campus Karachi between January 1st, 2021, and June 30th, 2022 were included. Inclusion criteria followed the Barcelona Clinic Liver Cancer (BCLC) and Child-Pugh staging systems. Tumor response was evaluated using “modified Response Evaluation Criteria in Solid Tumors (mRECIST)”, and patients were categorized into complete response (CR) or partial response (PR) groups. The study compared background, clinico-laboratory, and radiological features between these groups, including HCC sizes and CT scan findings before and after TACE. The retrieved data was entered and analyzed using SPSS version.21. Results: Of the total 118 patients, 51.70% showed CR to the TACE, while PR was noted in 48.30%. Age, sex, viral hepatitis, and co-morbids showed no intergroup differences. However, Child-Pugh stage and BCLC were significantly associated with tumor response. Similarly, laboratory parameters revealed significant mean differences between the two groups (p<0.001), except international normalized ratio and alanine transaminase. Those who had achieved CR had a mean number of tumor less than that of PR. Similarly, tumor size significantly decreased post-TACE (p<0.0001). Moreover, arterial-phase enhancement and portal venous and delayed phases washout tumors before TACE were reported in 76.30%. Over half of the patients had no residual tumor tissue after TACE. Tumors with arterial-phase enhancement and portal venous and delayed phases washout were highly susceptible to TACE.Furthermore, Child-Pugh classA had a greater estimated mean survival than class B (p<0.001). Conclusion: Over half of the patients showed complete response to the TACE. BCLC staging (B), Child-Pugh (stage A), and small tumors had a favourable effect on the radiological and clinical response in the early-stages of HCC. Tumors with an arterial-phase enhancement and portal venous and delayed phases washout were more susceptible to TACE

Interfacial polymerization synthesis of polypyrrole and sodium metavanadate (PPy/NaVO3) composite as an excellent performance electrode for supercapacitors

Herein, the interfacial polymerization method has been used for the synthesis of PPy/NaVO3 composites with different compositions of NaVO3 (10 %, 20 %, 30 %, 40 % and 50 %) as an efficient electrode material for supercapacitors. The successful formation and composition of the as-prepared composites (PV1-PV5) were confirmed by FTIR, XRD, EDX, and SEM analysis. The electrochemical properties were investigated by cyclic voltammetry (CV), galvanometric charge–discharge measurement (GCD), and electrochemical impedance spectroscopy (EIS) in 0.5 M H2SO4 electrolyte. As compared to other, the PV4 composite exhibit excellent specific capacitance of 391 F g−1 at a current density of 0.75 A/g with good cycling stability of ∼59 % after 1000 cycles. Furthermore, the PV4 composite also shows a high specific energy density of 14 Wh kg−1 and a specific power density of 150 W kg−1. The excellent electrochemical performance of PPy/NaVO3 composites (PV1-PV5) was attributed to the synergistic effect of conducting PPy and NaVO3 which provides the effective surface area for the efficient storage of ions and transfer of electrons and ions on the surface of the electrode. Thus, these excellent electrochemical performances reflect and suggest the practical application of PV4 electrode material for future high-energy–density supercapacitors

Diaryl pyrazole-4-carbaldehyde benzoylhydrazones metal complexes: synthesis and their antibacterial and antioxidant screening

Various heterocyclic ligands [1,3-diarylpyrazole-4-carbaldehyde benzoyl-hydrazones] and their metal complexes with Cu2+, Ni2+, Co2+, Pb 2+, Zn2+ and Fe2+ have been synthesized, characterized and screened for their antibacterial and antioxidant activities. The synthesized compounds were characterized through elemental analysis and spectroscopic techniques (FTIR, 1H NMR and Mass)