A Comparative study of Palpatory Versus Image Guided Core Needle Biopsy in Breast Masses in Government Rajaji Hospital, Madurai

OBJECTIVES: Biopsy of palpable breast masses can be performed manually by palpation guidance or under imaging guidance. We conducted this prospective study to verify the superiority and determine the size of beneficial effect of image guided biopsy over palpation guided biopsy. METHODOLOGY: This is a prospective study comprising 60 patients with breast masses over a period from September 2018 to September 2019. In this present study, the clinical material consists of adult female patients attending out-patient department with palpable breast masses on examination and on radiological investigation usg showing BIRADS 4, 5 and patient with BIRADS 3 high risk, difficult to follow or patient anxious are included in the study. During this period 60 female patient agreed to participate in study and gave informed consent.21 patients reported as Birads IV,26 patients reported as Birads V,13 patients with Birads III who satisfy inclusion criteria are taken to study. Patients are randomised into two arms 30 each to image guided and palpatory guided biopsy with ratio of 1:1. RESULTS: Malignancy was found in 24 of 30 women in palpation guided biopsy arm and 20 of 30 women in image guided biopsy arm. Palpation guided biopsy had sensitivity, and negative predictive value (NPV) of 48, 100, 100, 27.8 per cent, respectively, for diagnosing breast cancer. Palpation guided biopsy group had a high repeat biopsy rate. Image guided biopsy had 85 per cent sensitivity and 100 per cent specificity. CONCLUSION: Our results showed that in palpable breast masses, image guided biopsy was superior to palpation guided biopsy in terms of sensitivity, false negative rate and repeat biopsy rates

Klippel trenaunay syndrome-an obstetric challenge

Klippel Trenaunay Syndrome is a rare congenital disease characterized by triad of extensive cutaneous haemangiomas (most common), venous varicosities and hypertrophy affecting a leg and/or arm on one side. We report two cases of pregnant women with Klippel Trenaunay syndrome of which one patient presented with Kasabach Merritt Syndrome (refractory coagulopathy). 24-year-old primigravida of 29 weeks with KTS presented with bleeding gums for two days. Known case of diabetes, hypothyroid on treatment and treated TB lymphadenopathy. She had hypertrophy with varicosities and haemangiomas on left lower limb and vulvar region. She was treated for thrombocytopenia at 19 weeks gestation with steroids. Laboratory studies revealed thrombocytopenia. Steroids were given as per haematologist opinion for thrombocytopenia. She had emergency caesarean section with platelet transfusion at 35 weeks as per vascular surgeon opinion. Postoperatively she was given anticoagulants and steroids. 28-year-old primigravida of 39 weeks with KTS admitted for safe confinement. She had surgery for haemorrhoids at 14 years of age and had bleeding per rectum two years back. She had hypertrophy of left lower limb and cutaneous nevus in multiple dermatomes on left half of body. Doppler left lower limb shows superficial varicosities. Laboratory studies revealed normal. With multidisciplinary approach, she had elective caesarean in view of primigravida/breech-footling presentation. Post operatively she was given anticoagulants. The success in the management of these patients requires the participation of multidisciplinary approach. The use of prophylactic anticoagulant is generally advised during the pregnancy and postpartum period

Focal Epithelial Hyperplasia: A Rare Case Report

Focal epithelial hyperplasia is a rare entity of oral mucosa induced by Human Papilloma virus type 13 and 32. It was described by Estrada in 1956 within a group of Colombian Caramanda Indians. In Latin America it is called Multifocal Papilloma virus induced epithelial hyperplasia. It is common in younger age groups. Generally it is very rare in Asia. Here we report a case of 32 year old male who came with a complaint of burning sensation for past 6 months. The lesion was diagnosed as Focal epithelial hyperplasia according to clinical and Histopathological features. Dental clinicians should be aware of these lesions with a careful clinical and Histopathological observation under definitive diagnosis

Comparative Analysis of Integrated Wideband/Narrow Band Antenna for Cognitive Radio Applications

Cognitive radio is an inventive system to wireless technologies in which radios are designed with an astonishing level of intelligence and agility. This handles the available spectrum in an expedient manner to avoid spectrum scarcity. The cognitive radio antenna consists of integrated wideband and narrow band antenna in same substrate which is taxing task. A UWB antenna is pondered for the wide band operation which has the bandwidth of 7.5 GHz respectively is used for sensing vacant slots in the spectrum. For narrowband antenna the frequency and pattern reconfigurable antenna is usually suggested which is used for transmission of data through the vacant slots from the outcomes of sensing antenna. In this paper the various cognitive radio antennas are investigated in tremendously

Clone Detection using Textual and Metric Analysis to figure out all Types of Clones

Abstract -A Clone Detection approach is to find out the reused fragment of code in any application to maintain .Various types of clones are being identified by clone detection techniques. Since clone detection was evolved, it provides better results and reduces the complexity. A different clone detection tool makes the detection process easier and efficiently produces the results. In many existing system, it mainly focuses on line by line detection or token based detection to find out the clone in the system. So it makes the system to take long time to process the entire system. If the fragment of code are not at exact code but the functionalities makes it similar to each other. Then existing system doesn't figure out the clone of that type of clones in it. This paper proposes combination of textual and metric analysis of a source code for the detection of all types of clone in a given set of fragment of java source code. Various semantics had been formulated and their values were used during the detection process. This metrics with textual analysis provides less complexity in finding the clones and gives accurate result

2-Bromo-4-chloro-6-[(2,6-diisopropyl­phen­yl)imino­meth­yl]phenol

There are two molecules in the asymmetric unit of the title compound, C19H21BrClNO, with dihedral angles between the aromatic rings of 70.0 (2) and 81.9 (3)°. The crystal structure is stabilized by inter­molecular C—H⋯π and C—Br⋯π inter­actions. In additional, the stacked mol­ecules exhibit intra­molecular O—H⋯N hydrogen bonds

Peptidoglycan from Immunobiotic Lactobacillus rhamnosus Improves Resistance of Infant Mice to Respiratory Syncytial Viral Infection and Secondary Pneumococcal Pneumonia

Several research works have demonstrated that beneficial microbes with the capacity to modulate the mucosal immune system (immunobiotics) are an interesting alternative to improve the outcome of bacterial and viral respiratory infections. Among the immunobiotic strains with the capacity to beneficially modulate respiratory immunity, Lactobacillus rhamnosus CRL1505 has outstanding properties. Although we have significantly advanced in demonstrating the capacity of L. rhamnosus CRL1505 to improve resistance against respiratory infections as well as in the cellular and molecular mechanisms involved in its beneficial activities, the potential protective ability of this strain or its immunomodulatory cellular fractions in the context of a secondary bacterial pneumonia has not been addressed before. In this work, we demonstrated that the nasal priming with non-viable L. rhamnosus CRL1505 or its purified peptidoglycan differentially modulated the respiratory innate antiviral immune response triggered by toll-like receptor 3 activation in infant mice, improving the resistance to primary respiratory syncytial virus (RSV) infection, and secondary pneumococcal pneumonia. In association with the protection against RSV-pneumococcal superinfection, we found that peptidoglycan from L. rhamnosus CRL1505 significantly improved lung CD3+CD4+IFN-γ+, and CD3+CD4+IL-10+ T cells as well as CD11c+SiglecF+IFN-β+ alveolar macrophages with the consequent increases of IFN-γ, IL-10, and IFN-β in the respiratory tract. Our results also showed that the increase of these three cytokines is necessary to achieve protection against respiratory superinfection since each of them are involved in different aspect of the secondary pneumococcal pneumonia that have to be controlled in order to reduce the severity of the infectious disease: lung pneumococcal colonization, bacteremia, and inflammatory-mediated lung tissue injury

Active Whey Protein Edible Films and Coatings Incorporating Lactobacillus buchneri for Penicillium nordicum Control in Cheese

Fungal contamination of food is responsible for health issues and food waste. In this work, the incorporation of a lactic acid bacteria (LAB) with antifungal properties (Lactobacillus buchneri UTAD104) into whey protein-based films and coatings was tested for the control of an ochratoxigenic fungi (Penicillium nordicum) in a cheese matrix. The incorporation of L. buchneri cells resulted in thicker films with less luminosity than control films and colour alteration. Nevertheless, cells inclusion did not alter moisture content, water vapour permeability, mechanical properties, hydrophobicity and chemical structure of the films. Whey protein films were able to maintain the viability of L. buchneri UTAD104 cells in 105 CFU/mL after 30 days of storage at 25 \textdegreeC. When applied in cheese, films and coatings containing L. buchneri cells prevented fungal contamination for at least 30 days, while control cheeses with films and coatings either without LAB or with Lactobacillus casei UM3 (a strain without antifungal ability) showed fungal contamination during that period. Ochratoxin A was not found in cheeses treated with films and coatings containing L. buchneri UTAD104. Results showed that the inclusion of a LAB with antifungal properties in edible films and coatings can help to reduce or eliminate P. nordicum contamination in cheeses.This study was supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UIDB/04469/2020 unit and BioTecNorte operation (NORTE-01-0145-FEDER-000004) funded by the European Regional Development Fund under the scope of Norte2020 - Programa Operacional Regional do Norte. Ana Guimarães received support through grant SFRH/BD/103245/2014 from the Portuguese FCT.info:eu-repo/semantics/publishedVersio