Mastalgia: A narrative literature review of current understanding and management

Mastalgia, or breast pain, is one of the most common breast symptoms experienced by women of reproductive age. The cyclical variant of mastalgia is predominant, and patients need proper assessment and management to allay their 2 chief concerns: (1) the severity of pain negatively impacting daily life and (2) the fear of harbouring malignancy. This article presents a brief review of various modalities of management for cyclical mastalgia and emphasizes data collected from peer-reviewed literature published in the last decade. Keywords: mastalgia; breast pain; mastodynia; mammalgia; cyclic mastalgia; noncyclic mastalgia; danazol; tamoxifen; reassurance; visual analogue scale

Prevalence of Helicobacter Pylori in Type II Diabetes Mellitus

Objective: To determine the prevalence of Helicobacter pylori infection in type 2 diabetes and non-diabetes patients.Methodology: This case control study was conducted in Microbiology Department, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre Karachi with collaboration of diabetic clinic of medical and gastroenterology OPD, from June 2019 to November 2019.  Known cases of type 2 diabetes mellitus, irrespective of gender, above 30 years of age and in equal number non-diabetic patients with history of epigastric burning, epigastric pain, belching, bloating, nausea, vomiting for >1 month were included. Three ml venous blood was taken from antecubital vein after overnight fasting of 8-12 hours for blood sugar fasting. Patients underwent H. pylori Antigen Rapid Test Cassette (Stool). All the data was recorded on self-made proforma. Data was analyzed by using SPSS version 20.Results: In diabetic group most of the cases 35.2% were more than 60 years old and in non-diabetic group majority of the cases 44.8% were <50 years. Females were most common in both diabetes non-diabetes groups. Total of 83(79%) of diabetic group and 54 (51.4%) of non-diabetic were labeled as positive for H. pylori infection (p=0.001). Diabetic patients >50 years of age, were significantly associated with h-pylori infection, (p-0.001), while there was no significant impact found of gender on H-pylori infection (p-0.330).Conclusion: H. pylori infection in diabetic patients was higher as compared to non-diabetes. Effectiveness of stool antigen method is the best diagnostic tool for the detection of H. pylori infection in diabetic subjects

Device-Agnostic Millimeter Wave Beam Selection using Machine Learning

Most research in the area of machine learning-based user beam selection considers a structure where the model proposes appropriate user beams. However, this design requires a specific model for each user-device beam codebook, where a model learned for a device with a particular codebook can not be reused for another device with a different codebook. Moreover, this design requires training and test samples for each antenna placement configuration/codebook. This paper proposes a device-agnostic beam selection framework that leverages context information to propose appropriate user beams using a generic model and a post processing unit. The generic neural network predicts the potential angles of arrival, and the post processing unit maps these directions to beams based on the specific device's codebook. The proposed beam selection framework works well for user devices with antenna configuration/codebook unseen in the training dataset. Also, the proposed generic network has the option to be trained with a dataset mixed of samples with different antenna configurations/codebooks, which significantly eases the burden of effective model training.Comment: 30 pages, 19 figures. This article was submitted to IEEE Trans. Wirel. Commun. on Nov 14 202

CLINICAL PROFILE OF INTRA-CEREBRAL HAEMORRHAGIC STROKE PATIENTS IN AN ETHNIC POPULATION OF NORTH INDIA.

Introduction:Given the high prevalence of Intra Cerebral Haemorrhage (ICH) in the Kashmir Valley, an associated very high morbidity and mortality and the scarcity of studies from our part of the world, it becomes relevant and prudent to study the clinical parameters of ICH in our Valley which in turn would potentially be translated into preventive measures. Aim: We aimed to study various clinico-biochemical parameters of the ICH patients in our region. Methodology: We studied 150 consecutive ICH patients admitted to our hospital, including their age, gender, blood pressures, NCCTs and ICH scores, using a pretested, semi-structured questionnaire to collect the information. Statistical analysis was performed by using SPSS software (V.11.5). Results:The majority of ICH patients belonged to a higher age group (46% above age > 60 years and 38.6% in age range 40-60 years). There was no significant difference between the occurrence of ICH in males vs females (p value < 0.05). Hypertension was a major association of ICH with more than two-thirds of patients being hypertensive (75.33%). Non- Lobar ICH (72%) was much more common than the Lobar ICH (28%), with former being more significantly associated with underlying Hypertension and later with advancing age. Conclusion:ICH, a major health burden in our community is highly associated with Hypertension. Since Hypertension in itself has an unusually high prevalence in the Valley, so a relevant intervention would provide potential primary preventive measure to decrease the burden of ICH in our community

Spectrum of neurological disorders in neurology outpatients clinics in urban and rural Sindh, Pakistan: a cross sectional study

Background: Neurological disorders are the most common cause of morbidity and mortality in developing countries. Available evidence on urban–rural differences on neurological diseases is scare in such countries. Our study objective was to determine the prevalence of neurological diseases in urban and rural tertiary care hospitals of Sindh, Pakistan. Methods: This was a cross sectional study conducted in selected urban and rural region of tertiary care hospitals of Sindh, Pakistan. The outpatients medical records of adults (18 years and above) was obtained from January 1st, 2014 to December 31st, 2014. Results: A total of 10,786 outpatients visit were recorded in this period. Mean age of the participants was 40.6 ± 15 years; majority was females 6104 (56.6%). About three-fourth of the patients were from rural hospital 7828 (72.6%). Common neurological diseases were headache disorders 3613 (33.4%), nerve and root lesion 2928 (27.1%), vascular diseases 1440 (13.3%), epilepsies 566 (5.2%), muscle disorders 424 (3.9%), psychiatric disorders 340 (3.1%) and CNS infection 303 (2.8%). Comparison between the urban and rural samples showed that ischaemic stroke (72.7% vs. 82%) and psychiatric disorders (2.1% vs. 3.5%) were more prevalent in rural area as compared to urban setting. Conclusion: Stroke, headache and nerve and root lesion are major causes of neurological disorders in urban and rural settings of Sindh, Pakistan. The policy and planning must be focus on primary care, preventive measures and the promotion of health

Pulmonary placental transmogrification associated with adenocarcinoma of the lung: a case report with a comprehensive review of the literature

Pulmonary placental transmogrification (PT) is a rare entity with less than 40 cases reported in the literature. Most reported cases are associated with either bullous emphysema or with pulmonary fibrochondromatous hamartomas. We present only the second case of PT associated with adenocarcinoma of the lung. A 67-year-old female with multiple chronic medical ailments presented with shortness of breath and was found to have a 6-cm mass in the upper lobe of her right lung. A computed tomography (CT) guided core biopsy was performed that showed a well-differentiated adenocarcinoma. Interestingly the normal lung tissue showed placental villous architecture. A unique feature of our case is that the diagnosis was made on a needle core biopsy, unlike all the other cases in the literature. We also provide a comprehensive review of this rare entit

MALE INFLAMMATORY BREAST CANCER-AN ANALYSIS

Inflammatory breast cancer in males is an uncommon but extremely aggressive form of the disease. It is often misdiagnosed as a benign skin disease since it manifests as erythema along the chest wall. The management guidelines are not specific, and treatment is based on the experiences of female cancer patients. Since there is limited information available about this illness, this review aims to fill that gap by conducting a thorough analysis of case reports published in peer-reviewed journals since 2000

CLINICAL PROFILE AND THE OUTCOME OF COVID-19 IN PATIENTS WITH HEMATOLOGICAL MALIGNANCY: A SINGLE CENTRE EXPERIENCE

Objective: In the present study, we are reporting the clinical profile; and outcomes of COVID-19 in patients with hematological malignancy at tertiary care hospitals. Methods: Data from laboratory-confirmed 40 COVID-19 patients diagnosed between January 1, 2021 and July 31, 2021, were analyzed retrospectively. All COVID-19 patients with hematological malignancy (n=40) were included in the study. Results: In the present study, a total of 40 patients were included. Of 40, 25 (62.5%) were males, and 15 (37.5%) were females. The median age in this study was 43 years (Range, 8–70). Of these 40 patients, acute myeloid leukemia was the most common malignancy 11 (27.5%), followed by acute lymphoblastic leukemia 9 (22.5%) than non-Hodgkin lymphoma 5 (12.5%), plasma cell dyscrasia 4 (10%), chronic myeloid leukemia 4 (10%), chronic lymphocytic leukemia 3 (7.5%), acute promyelocytic leukemia 2 (5%), chronic myelomonocytic leukemia 2 (5%). Mean hemoglobin was (8.04 g/dl), white blood cell count was (10.14×109/l), platelet count was (77.7×109/l) creatinine was (0.86 mg/dl), bilirubin was (1.24 mg/dl). The overall case-fatality rate was 8 (22.5%). Conclusion: Patients with hematological malignancy are immunocompromised, and our study reveals that there is an increased case fatality rate among these patients. Hence, physicians should be aggressive in the management of COVID‐19 patients with hematological malignancy

Pulmonary placental transmogrification associated with adenocarcinoma of the lung: a case report with a comprehensive review of the literature

Pulmonary placental transmogrification (PT) is a rare entity with less than 40 cases reported in the literature. Most reported cases are associated with either bullous emphysema or with pulmonary fibrochondromatous hamartomas. We present only the second case of PT associated with adenocarcinoma of the lung. A 67-year-old female with multiple chronic medical ailments presented with shortness of breath and was found to have a 6-cm mass in the upper lobe of her right lung. A computed tomography (CT) guided core biopsy was performed that showed a well-differentiated adenocarcinoma. Interestingly the normal lung tissue showed placental villous architecture. A unique feature of our case is that the diagnosis was made on a needle core biopsy, unlike all the other cases in the literature. We also provide a comprehensive review of this rare entit