To evaluate the role of sonography as an adjunct to mammography in women with dense breasts

OBJECTIVE: To assess the role of sonography as an adjunct to mammography in women with dense breast tissue by determining yield and validity of sonography using histopathology/follow-up mammography as gold standard. METHODS: It was a descriptive analytical study conducted at the Radiology Department of Aga Khan University Hospital, from September 2005 to April 2007. A total of 76, mammographically dense breasts were evaluated with ultrasound. Of these 32 had palpable lumps on mammography, and were excluded from the study. A total of 44 patients had either symptoms of vague nodularity, nipple discharge, mastalgia or had no symptoms and the mammograms showed dense breast parenchyma without any focal abnormality. All these patients underwent whole breast ultrasound. The findings on ultrasound and subsequent histopathology and follow-up mammography were used to calculate the sensitivity, specificity, positive and negative predictive value of whole breast ultrasound as an adjunct to mammography. RESULTS: The age range of patients was 35 to 56 years, mean age was 42 +/- 7.33 years. Of the 44 patients included, 37 had normal ultrasound examinations and had the same findings on one year follow-up mammograms and ultrasound examinations. The remaining, seven patients were categorized as BI RADS category 4 due to presence of suspicious findings on ultrasound examination. They underwent ultrasound guided biopsy of the detected lesions. Out of seven solid lesions biopsied six were benign and one was reported malignant on histopathological examination. The sensitivity, specificity, positive and negative predictive values were 100%, 85%, 14% and 86% respectively. CONCLUSION: Breast ultrasound can be a useful adjunct to mammography in women with dense breast by detecting small cancers not identified on mammography or clinical breast examination. Larger studies will be required to suggest that ultrasound could be used as an adjunct

Hybridizing Micro - B4C with Carbon nanotubes to Enhance the Mechanical Properties of Aluminium Matrix Composites

In present work, the effects of hybridizing micron sized B4C particles with multi walled carbon nanotubes on the microstructural and mechanical properties of Al - B4C composite were investigated. Microstructure reveals grain refinement ascribed to the presence of uniformly distributed micron sized B4C particles with multi walled carbon nanotubes. The Al - (B4C + MWCNT) hybrid composite indicates the alliance of mechanical properties such as hardness, tensile strength and ductility. The enhanced attribute of Al - (B4C + MWCNT) hybrid composite when compared to Al - B4C is the increased content and uniform distribution of MWCNTs. © Published under licence by IOP Publishing Ltd

Online assessments during COVID-19 pandemic - A paradigm shift in educational strategy

Objectives: Covid-19 pandemic has instigated changes in the teaching and assessment practices of institutions in many parts of the world, resulting not only in online teaching but also online assessments. The present study analyzes the perceptions of students regarding the first online assessments conducted at a medical college in Pakistan. Methodology: This Mixed method cross-sectional study was conducted in Wah Medical College, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan from July to November 2020. The questionnaire was developed after collaboration of the authors and review of the pertinent literature on online examinations. Universal sampling was done and all students of WMC were invited to participate in the study. Data collection was done by google forms and analysis was performed on SPSS. Results: Students from all five years of the MBBS program participated almost equally in the study. Students of 1st, 3rd and 4th year were not contented with their performance in online exams whereas students of 2nd and 5th year were satisfied. Most students considered technological issues as a basis of their poor performance and proposed technical training before online exams. They also provided suggestions related to improvement of examination formats and tools. Conclusion: Majority of the students found the online assessment more effective and helpful in improving their performance in exams. Student perceptions provided valuable insights for improving the online examinations system at Wah Medical College. Key words: Online Assessments, Medical education, e-assessments, student perceptions, Higher Education institute

Online assessments during COVID-19 pandemic - A paradigm shift in educational strategy

Objectives: Covid-19 pandemic has instigated changes in the teaching and assessment practices of institutions in many parts of the world, resulting not only in online teaching but also online assessments. The present study analyzes the perceptions of students regarding the first online assessments conducted at a medical college in Pakistan. Methodology: This Mixed method cross-sectional study was conducted in Wah Medical College, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan from July to November 2020. The questionnaire was developed after collaboration of the authors and review of the pertinent literature on online examinations. Universal sampling was done and all students of WMC were invited to participate in the study. Data collection was done by google forms and analysis was performed on SPSS. Results: Students from all five years of the MBBS program participated almost equally in the study. Students of 1st, 3rd and 4th year were not contented with their performance in online exams whereas students of 2nd and 5th year were satisfied. Most students considered technological issues as a basis of their poor performance and proposed technical training before online exams. They also provided suggestions related to improvement of examination formats and tools. Conclusion: Majority of the students found the online assessment more effective and helpful in improving their performance in exams. Student perceptions provided valuable insights for improving the online examinations system at Wah Medical College. Key words: Online Assessments, Medical education, e-assessments, student perceptions, Higher Education institute

The outcomes measure of wide awake hand surgery

Objective: To measure the effects of WAHS intra-operatively with respect to subject’s well-being, pain and choice for wide awake surgery. Methodology: A cross sectional study of seventy patients with age range from 15-65 years, who underwent hand surgery in Jinnah Burn and Reconstructive Surgery Center, Lahore, between January 2019 to August 2019. The effectiveness of anesthesia was measured by pain, well-being and patient preferences. Pain was rated using the visual analogue scale (VAS). Patient well-being was tested depending on how they felt with respect to options on the Likert scale depicting in terms of extremely well, well, less well and extremely less well on VAS scoring. The preference of the subject was assessed by his experience in the surgery and the anesthesia they chose. Results: The total number of patients was 70, whose age was 33.63±6.94 in the range of 15 to 65 years. The average pain score on the VAS was 0.51±1.38 and the duration of surgery was 1.43±0.35 hours. Pain was a variation in the outcome observed in operation during surgery. There were 84.3% of patients who did not experience any pain during their surgery. The remaining patients showed various levels of pain on VAS. Conclusion: The benefits of WAHS are that short duration hand surgery procedures can be done using local anesthesia containing epinephrine. It is cost effective, avoids the side effects of general anesthesia, avoids the use of a tourniquet and reduces the burden of surgical patients requiring general or regional anesthesia procedure. It also avoids patient admission in to the hospital thus sparing hospital beds

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Survey of Applications of Complex Event Processing (CEP) in Health Domain

It is always difficult to manipulate the production of huge amount of data which comes from multiple sources and to extract meaningful information to make appropriate decisions. When data comes from various input resources, to get required streams of events form this complex input network, the one of the strong functionality of Business Intelligence (BI) the Complex Event Processing (CEP) is the appropriate solution for the above mention problems. Real time processing, pattern matching, stream processing, big data management, sensor data processing and many more are the application areas of CEP. Health domain itself is a multi-dimension domain such as hospital supply chain, OPD management, disease diagnostic, In-patient, out-patient management, and emergency care etc. In this paper, the main focus is to discuss the application areas of Complex Event Processing (CEP) in health domain by using sensor device, such that how CEP manipulate health data set events coming from sensor devices such as blood pressure, heart rate, fall detection, sugar level, temperature or any other vital signs and how this systems respond to these events as quickly as possible. Different existing models and application using CEP are discussed and summarized according to different characteristics

IBA: Intelligent bug algorithm – a novel strategy to navigate mobile robots autonomously

This research proposes an intelligent obstacle avoidance algorithm to navigate an autonomous mobile robot. The presented Intelligent Bug Algorithm (IBA) over performs and reaches the goal in relatively less time as compared to existing Bug algorithms. The improved algorithm offers a goal oriented strategy by following smooth and short trajectory. This has been achieved by continuously considering the goal position during obstacle avoidance. The proposed algorithm is computationally inexpensive and is easy to tune. The paper also presents the performance comparison of IBA and reported Bug algorithms. Simulation results of the robot navigation in an environment with obstacles demonstrate efficacy and performance of the improved algorithm