Mixed epithelial and stromal tumour of kidney

Mixed epithelial and stromal tumour of kidney is a recently described, rare entity and includes cases previously termed as cystic hamartoma of renal pelvis and adult mesoblastic nephroma. We report a case of 36 years old female who presented with a history of recurrent loose stools for 5 years. During ultrasound abdomen, a solid right renal mass was incidentally found in upper pole of right kidney. On gross examination it was a 3.5 cm diameter mass which was microscopically composed of both epithelial and stromal components in the form of cystically dilated tubules and fascicles of spindle shaped cells. These cells stained positive for alpha smooth muscle actin, desmin, progesterone receptors and negative for estrogen receptors

Metaplastic carcinoma of the breast, an intriguing rarity.

Abstract Metaplastic carcinoma breast is categorized as a rare heterogenous neoplasm generally characterized by a mixtureof adenocarcinoma with dominant areas of spindle cell, squamous and/or other mesenchymal differentiation. Todetermine the epidemio-demographic and histopathologic characteristics of this rare entity a retrospective studywas conducted to review all cases at the Aga Khan University Hospital (AKUH) Karachi, received during 1st January2000 to 31st August 2005. Twenty-four patients were identified with a mean age at diagnosis of 46.4 (±SD 3.8) years,and an age range of 28-68 years. The mean tumor size was 7.9 cm, range 2.0–17.0 cms (±SD 4.77). The specimenswere mostly obtained by modified radical mastectomy(54.2%) followed by biopsy (29.2%), lumpectomy (8.3%),and total mastectomy (4.2%). Skin ulceration was found in 37.5% cases. Component sub-categorization showed 13(54.2%) cases of infiltrating ductal carcinoma with squamous metaplasia, followed by 2 (8.3 %) cases with heterologouselements, 4 (16.7%) cases with spindle cell component, 2 cases of matrix producing carcinoma and one case ofsquamous cell carcinoma. The malignancy was high grade, modified Bloom Richardson’s grade III (54.2 %) andgrade II (12.5%). Such grading was not applicable to 4 cases of spindle cell component and 1 case with extensivechondroid areas. Twelve patients had information available on the nodal status. Five (41.6%) were node-negative,four (33.33%) had 1-3 lymph node involvement positive, and three (12.5%) had more than 3 lymph nodes positive.The median 3 year Event Free Survival (EFS) was 10% and overall survival was 30%. MCB is an aggressive diseasewith a poor prognosis. This aspect appears bleaker in our population either due to the biological characteristic of themalignancy in a high risk group or the lack of availability and accessibility of health coverage, resulting in a delayedpresentation. MCB is an uncommon breast malignancy and due to the lack of sufficiently large studies there islimited knowledge as to the pathogenesis, progress, best treatment protocols and prognosis. Collaborative studiesare therefore recommended to allow for better understanding of this intriguing neoplasm

Situs inversus totalis with perforated duodenal ulcer: a case report

<p>Abstract</p> <p>Introduction</p> <p>Situs inversus is an uncommon anomaly. Situs inversus viscerum can be either total or partial. Total situs inversus, also termed as mirror image dextrocardia, is characterized by a heart on the right side of the midline while the liver and the gall bladder are on the left side. Patients are usually asymptomatic and have a normal lifespan. The exact etiology is unknown but an autosomal recessive mode of inheritance has been speculated. The first case of perforated duodenal ulcer with situs inversus was reported in 1986; here, we report the second case of this nature in the medical literature.</p> <p>Case presentation</p> <p>A 22-year-old Pakistani man presented with severe epigastric and left hypochondrial pain. Examination and investigations (chest X-ray and ultrasonography) confirm peritonitis in a case of situs inversus totalis. On exploratory laparotomy, a diagnosis of situs inversus totalis with perforated duodenal ulcer was confirmed. Graham's patch closure of the duodenal ulcer was performed with absorbable sutures, and a thorough peritoneal lavage was also performed; an incidental appendectomy was also performed to avoid further diagnostic problems. Our patient had an uneventful recovery.</p> <p>Conclusions</p> <p>A diagnostic dilemma arises whenever abdominal pathology occurs in patients with situs inversus. Although an uncommon anomaly, to choose a proper surgical incision site for abdominal exploration pre-operative recognition of the condition is important.</p

Video Surveillance-Based Intelligent Traffic Management in Smart Cities

Visualization of video is considered as important part of visual analytics. Several challenges arise from massive video contents that can be resolved by using data analytics and consequently gaining significance. Though rapid progression in digital technologies resulted in videos data explosion that incites the requirements to create visualization and computer graphics from videos, a state-of-the-art algorithm has been proposed in this chapter for 3D conversion of traffic video contents and displaying on Google Maps. Time stamped visualization based on glyph is employed efficiently in surveillance videos and utilized for event detection. This method of visualization can possibly decrease the complexity of data, having complete view of videos from video collection. The effectiveness of proposed system has shown by obtaining numerous unprocessed videos and algorithm is tested on these videos without concerning field conditions. The proposed visualization technique produces promising results and found effective in conveying meaningful information while alleviating the need of searching exhaustively colossal amount of video data

Towards Robust Diagnosis of COVID-19 using Vision Self-attention Transformer

The outbreak of COVID-19, since its appearance, has affected about 200 countries and endangered millions of lives. COVID-19 is extremely contagious disease, and it can quickly incapacitate the healthcare systems if infected cases are not handled timely. Several Conventional Neural Networks (CNN) based techniques have been developed to diagnose the COVID-19. These techniques require a large, labelled dataset to train the algorithm fully, but there are not too many labelled datasets. To mitigate this problem and facilitate the diagnosis of COVID-19, we developed a self-attention transformer-based approach having self-attention mechanism using CT slices. The architecture of transformer can exploit the ample unlabelled datasets using pre-training. The paper aims to compare the performances of self-attention transformer-based approach with CNN and Ensemble classifiers for diagnosis of COVID-19 using binary Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and multi-class Hybrid-learning for UnbiaSed predicTion of COVID-19 (HUST-19) CT scan dataset. To perform this comparison, we have tested Deep learning-based classifiers and ensemble classifiers with proposed approach using CT scan images. Proposed approach is more effective in detection of COVID-19 with an accuracy of 99.7% on multi-class HUST-19, whereas 98% on binary class SARS-CoV-2 dataset. Cross corpus evaluation achieves accuracy of 93% by training the model with Hust19 dataset and testing using Brazilian COVID datase

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity &gt; 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Identifying Professional Attributes and Behaviors of Healthcare Educators in Distance Learning Programs

The main purpose of this study was to identify professional attributes and behaviors of healthcare educators in distance learning programs. A qualitative exploratory study was conducted. The population of this study was intended to consist of all students from a variety of locations and specialties in the certification program in health professions education (CHPE Fall-2020). There were 15 focus group discussions. Professional attribute and behaviors of healthcare educators based on their personal and social characteristics and actions. The prerequisite of an effective teacher was a part of the character of health care educators, and the teacher's personality is seen as a personal quality that lead to their obligations, topic expertise, pedagogical understanding, and dedication to change and continual improvement were all regarded as professional conduct of healthcare educators. Working interactions outside of the classroom, including social adaptability and flexibility, are regarded as social qualities and conduct of health care educators

Correlation of serum CA 15-3 with histological types of breast cancer

Background: The incidence of breast cancer and its fatal effects are constantly on a rise across the globe. Breast cancer is the most common cancer in Pakistan with approximately 1 in every 9 Pakistani women developing breast cancer at some stage of their life. There is a constant search for better screening methods which help in early detection and also reflect upon the prognosis of the tumor. CA 15-3 is a reliable serum marker that also helps in identifying patients who would benefit most from adjuvant therapy. Objective: To determine the correlation of serum CA 15-3 with histological types of breast cancer. Methodology: This prospective cross sectional study was conducted on 51 cases of female carcinoma breast from December 2015 to August 2016. The specimens were collected after mastectomy or lumpectomy and then transported to collection Shaukat Khanum Lab and city lab for chemical analysis and histopathological analysis. All the data was analyzed by using SPSS version 17. Results: In the current study, a total of 51 patients were included. Results of serum CA 15-3 level ranged from 3 to 743.2 U/ml (with mean of 40.62).&nbsp

Trajectory based vehicle counting and anomalous event visualization in smart cities

Motion pattern analysis can be performed automatically on the basis of object trajectories by means of tracking videos; an effective approach to analyse and to model the traffic behaviour; is important to describe motion by taking the whole trajectory whereas it’s more essential to identify and evaluate object behaviour online. In this paper, pattern detection approach is presented which takes spatio-temporal characteristic of vehicle trajectories. A real time system is built to infer and track the object behaviour quickly by online performing trajectory analysis. Every independent vehicle in the video frame is tracked over time. As the anomaly behaviour occurs, glyph is generated to show it occurrences. Vehicle counting is done by estimating the trajectories and compared with Hungarian tracker. Several surveillance videos are taken into account for the performance checking of system. Experimental results demonstrated that proposed method in comparison with the state of the art algorithms, provides robust vehicle density estimation and event information i.e., lane change information

Omega, Sadhana, and PI Polynomials of Quasi-Hexagonal Benzenoid Chain

Counting polynomials are important graph invariants whose coefficients and exponents are related to different properties of chemical graphs. Three closely related polynomials, i.e., Omega, Sadhana, and PI polynomials, dependent upon the equidistant edges and nonequidistant edges of graphs, are studied for quasi-hexagonal benzenoid chains. Analytical closed expressions for these polynomials are derived. Moreover, relation between Padmakar–Ivan (PI) index of quasi-hexagonal chain and that of corresponding linear chain is also established