Needle localization of non-palpable breast lesions

Screening mammography identifies suspicious, non palpable mammary lesions. Mammographic needle localization (MNL) is currently being used to facilitate excision biopsy of these lesions. Thirty-two patients underwent biopsies of the breast after MNL for non-palpable lesions. Mammographic indications for biopsy consisted of microcalcifications (48%), mass or abnormal density (21%) or mass+abnormal density (24%). The carcinoma was identified in four cases (12%). Two of these were in situ, one was microinvasive and one was frankly invasive. Three were treated with a modified radical mastectomy. One of these non palpable lesion demonstrated nodal metastasis but none showed distant metastasis. All radiologically detected abnormalities were removed and confirmed with repeat radiology. No complications were identified. MNL effectively localizes non-palpable lesion of the breast and compliments accurate diagnosis and treatment of early carcinoma of the breast

Differentiable Graph Module (DGM) for Graph Convolutional Networks

Graph deep learning has recently emerged as a powerful ML concept allowing to generalize successful deep neural architectures to non-Euclidean structured data. One of the limitations of the majority of current graph neural network architectures is that they are often restricted to the transductive setting and rely on the assumption that the underlying graph is known and fixed. Often, this assumption is not true since the graph may be noisy, or partially and even completely unknown. In such cases, it would be helpful to infer the graph directly from the data, especially in inductive settings where some nodes were not present in the graph at training time. Furthermore, learning a graph may become an end in itself, as the inferred structure may provide complementary insights next to the downstream task. In this paper, we introduce Differentiable Graph Module (DGM), a learnable function that predicts edge probabilities in the graph which are optimal for the downstream task. DGM can be combined with convolutional graph neural network layers and trained in an end-to-end fashion. We provide an extensive evaluation on applications in healthcare, brain imaging, computer graphics, and computer vision showing a significant improvement over baselines both in transductive and inductive settings

Tuberculosis diagnosis and treatment practices of private physicians in Karachi, Pakistan

In a densely populated urban area of Karachi, Pakistan, a questionnaire survey was made of the knowledge and practices of 120 private general practitioners about the diagnosis and treatment of tuberculosis (TB). The majority knew that cough, fever and weight loss were the main symptoms of TB, but less than half knew that blood in sputum, poor appetite and chest pain were associated with the disease. Only 58.3% of physicians used sputum microscopy for diagnosing TB and 35.0% used it as a follow-up test. Only 41.7% treated TB patients themselves, the remaining referring their patients to specialists. Around 73.3% of the doctors were aware of the 4 first-line anti-TB drugs. Efforts to improve the knowledge of private practitioners, and strategies to enhance public-private collaboration forTB control in urban areas are urgently required

Root cause analysis (RCA) of fractured ASTM A53 carbon steel pipe at oil & gas company

Incident involving failures of ASTM A53 carbon steel (CS) pipe, connected to pressure safety valve (PSV) and carrying raw gas has caused serious supply disruption. This study was performed to identify the most probable cause of the pipe failure. It was conducted by reviewing the existing design, construction data and pipe material analysis using non-destructive techniques such as VT, PT, MT and UT along with metallographic, hardness and microscopic analysis. The investigation revealed that excessive material loss has occurred in both failure and its adjacent regions due to abrasive grinding, resulting in the formation of a through thickness flaw. These grindings were performed to accommodate the pre-installed piping spool to avoid alteration in the pipe position. RCA demonstrated that this rapid thinning of the steel pipe body later led to its failure. Metallurgical study using photomicrograph shows that the morphology of the steel material was consistent and did not show any evidence of internal corrosion or micro fractures. Further damage to the surface of already excessively reduced thickness occurred due to nominal pipe vibration and atmospheric effect during service. The research work described in the paper has a significant meaning to recognize the root cause of such failures in CS pipes and through given recommendations to eliminate future such happenings

Essential medicines management during emergencies in Pakistan

This paper illustrates the experiences of essential medicine management in providing cure and care to victims of Pakistan\u27s 2005 earthquake in a safe, rational and effective mode. The health interventions assured access to essential medicine, sustained supply, inventory control through a computerized logistic support system and rational use of medicines. World Health Organization Pakistan outlined modalities for acceptance of donated medicines, assisted in speedy procurement of medicines and designed customized kits. Proper storage of medicines at controlled temperature was ensured in warehousing facilities in 12 locations. A steady supply of medicines and their consumption without stock-outs in the 56 first-level care facilities of calamity-hit areas helped to ascertain the average consumption and cost of essential medicines and supplies for the catchment population. Tools for quantification and forecasting of medicines and supplies were developed and shared. Medicines and medical supplies were efficiently used resulting in minimum wastage

Human papillomavirus genotype distribution among colposcopy diagnosed cervical precancerous lesions

Background: Cervical cancer (CC) is one of the primary causes of gynaecological cancer death. Cervical cancer is the fourth most frequent cancer worldwide, and it is the second most common cancer in Bangladesh. The stage of cervical cancer at diagnosis has a significant impact on survival. Cervical cancer mortality is high in Bangladesh due to late detection and limited management facilities. The aim of the study was to determine the pattern of human papillomavirus (HPV) genotype among colposcopy diagnosed cervical precancerous lesions. Methods: This cross-sectional study was conducted in the department of gynecological oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka. Total of 142 women attending the colposcopy clinic of BSMMU. Results: The mean age was found 38.7±7.3 years with a range from 30 to 60 years. 10 (7.0%) patients were found HPV 16 positive followed by 1 (0.7%) HPV 18, another hr-HPV 3 (2.1%), HPV 16 and other hr-HPV 3 (2.1%) and HPV 16, HPV 18 and other hr-HPV 1 (0.7%). Regarding colposcopy reports 99 (69.7%) patients had CIN I, 33 (23.7%) had CIN II and 10 (7.0%) had CIN III identification by colposcopy reports. 61 (43.0%) patients had CIN I followed by 15 (10.6%) had CIN II, 11 (7.7%) had CIN III, 7 (4.9%) had CIS, and 48 (33.8%) had normal or squamous metaplasia by histopathological reports. Conclusions: It can be concluded that among all the 14 hr-HPV genotype HPV 16 is more prevalent while HPV18 prevalence was very low in colposcopy diagnosed cervical precancer cases. The study revealed HPV16 was more common among high grade lesions

Cancer Esophagus Karachi 1995-2002:Epidemiology, Risk Factors and Trends

Objective: To study the trends of cancer esophagus in Karachi South during 1995-2002 and identify risk factors. Methods: Incident esophageal cancer cases recorded at the Karachi Cancer Registry for Karachi South, during 1st January 1995 to 31st December 2003 were reviewed. For maximum completion of data, incident cases registered from 1st January 1995 to 31st December 2002 were included for final analyses. Results: The Age Standardized Incidence Rates (ASIRs) of cancer esophagus in Karachi South for males were 6.5/100,000 (1995-1997) and 6.4/100,000 (1998-2002). In females the observed rates were 7.0/100,000 (1995-1997) and 8.6/100,000 (1998-2002). Conclusion: In the moderately high incidence, cancer esophagus zone of Karachi, the ASIRs in males remained stable during the last decade, but in females, an upward trend was observed suggesting a progressively higher exposure to risk factors in the latter. The potential risk factors in Karachi are use of all forms of tobacco, areca nut, infrequent consumption of raw fruits and vegetables and diet deficiencies. There is a necessity to actively control the proven risk factors and address the existence of other risk factors. The primary recommended strategy for the control of cancer esophagus would therefore be legislation against tobacco and areca nut in Pakistan and public health education. The risk factors of cancer esophagus identified in this article need to be further confirmed