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

Application of chitosan‐based chickpea (Cicer arietinum L.) hull polysaccharides edible coating on cherry tomatoes preservation

Abstract Bio‐active food coating having natural antioxidants has attained great attention these days. Polysaccharides extracted from bacteria, fungi, and plants are considered rich in antioxidant biomolecules. Chickpea hull which is a food waste material contains a substantial quantity of antioxidants and bioactive compounds. In this study, chitosan (CS)‐based chickpea hull polysaccharides (CHPS) edible coating of cherry tomatoes was successfully fabricated. Cherry tomatoes were characterized in terms of physico‐chemical characteristics and shelf life. In comparison to the control, it was discovered that the CS‐incorporated CHPS coatings were successful at lowering the respiratory activity, total soluble solids, total polyphenols, firmness, weight loss, lycopene content, and vitamin C as well as improving the fruit's overall acceptability. The dose dependence of each of these effects was noticed. Conclusively, using CS‐incorporated CHPS coatings could preserve the shelf life of cherry tomatoes. A useful and different approach to enhance the postharvest quality of cherry tomatoes is to utilize CS‐CHPS composite coatings

Additional file 2: Table S1. of Preliminary Seroepidemiological survey of dengue infections in Pakistan, 2009-2014

Province wise, annual patient incidence of dengue fever cases during 2009–2014 in Pakistan. (DOCX 19 kb