Breast cancer detection using deep learning: Datasets, methods, and challenges ahead.

Breast Cancer (BC) is the most commonly diagnosed cancer and second leading cause of mortality among women. About 1 in 8 US women (about 13%) will develop invasive BC throughout their lifetime. Early detection of this life-threatening disease not only increases the survival rate but also reduces the treatment cost. Fortunately, advancements in radiographic imaging like "Mammograms", "Computed Tomography (CT)", "Magnetic Resonance Imaging (MRI)", "3D Mammography", and "Histopathological Imaging (HI)" have made it feasible to diagnose this life-taking disease at an early stage. However, the analysis of radiographic images and Histopathological images is done by experienced radiologists and pathologists, respectively. The process is not only costly but also error-prone. Over the last ten years, Computer Vision and Machine Learning (ML) have transformed the world in every way possible. Deep learning (DL), a subfield of ML has shown outstanding results in a variety of fields, particularly in the biomedical industry, because of its ability to handle large amounts of data. DL techniques automatically extract the features by analyzing the high dimensional and correlated data efficiently. The potential and ability of DL models have also been utilized and evaluated in the identification and prognosis of BC, utilizing radiographic and Histopathological images, and have performed admirably. However, AI has shown good claims in retrospective studies only. External validations are needed for translating these cutting-edge AI tools as a clinical decision maker. The main aim of this research work is to present the critical analysis of the research and findings already done to detect and classify BC using various imaging modalities including "Mammography", "Histopathology", "Ultrasound", "PET/CT", "MRI", and "Thermography". At first, a detailed review of the past research papers using Machine Learning, Deep Learning and Deep Reinforcement Learning for BC classification and detection is carried out. We also review the publicly available datasets for the above-mentioned imaging modalities to make future research more accessible. Finally, a critical discussion section has been included to elaborate open research difficulties and prospects for future study in this emerging area, demonstrating the limitations of Deep Learning approaches.

Sero-epidemiological survey of human cystic echinococcosis in Kashmir, North India.

BACKGROUND: Echinococcosis is a human and animal health problem in many endemic areas worldwide. There are numerous reports and hospital-based studies from Kashmir, North India, yet there has been no epidemiological study conducted in Kashmir, the apparently endemic area for human hydatidosis. This study was designed to determine the seroprevalence of hydatid infection in Kashmir Valley and to find out association of risk factors for acquisition of this infection. METHODOLOGY: Fourteen hundred and twenty-nine samples were collected from different districts in the Kashmir region (North India) using systematic random sampling. The 130 control samples included were from apparently healthy blood donors (100), patients with other parasitic infections (20), surgically confirmed hydatidosis patients (5), and apparently healthy subjects excluded for hydatidosis and intestinal parasitic infections (5). Hydatid-specific IgG antibody was detected by enzyme-linked immunosorbent assay, and seropositive samples were analysed further by Western blotting. RESULTS: Out of 1,429 samples, 72 (5.03%) were IgG positive by ELISA. The percentage occurrence of the highly immunoreactive antigenic fractions in IgG ELISA positive samples was 57 kDa (72.2%) followed by 70 kDa (66.7%) and 39 kDa (58.3%) by immunoblotting. Samples with other parasitic infections were reactive with the cluster of 54-59 kDa antigenic fractions. Age <15 years, male gender, contact with dog, and rural residence were the most significant factors associated with the seropositivity. CONCLUSION: The study revealed that 72 (5.03%) out of 1,429 subjects asymptomatic for hydatidosis were seropositve to E.granulosus antigen by ELISA. Western blot analysis of 72 ELISA seropositive samples showed that 66.7% and 58.3% of samples were immunoreactive with 70 and 39 kDa specific antigenic fractions, respectively. The seropositivity was significantly higher (5.79%) in the younger age group (<15 years) as compared to the 16-55 years (4.07%) and > 55 years (3.05%) age groups, suggesting ongoing transmission of this infection in the younger age group. The number of seropositive males was significantly higher as compared to females. The risk factors identified were rural residence and contact with dogs. The study suggests the presence of asymptomatic infection in subjects in Kashmir, North India, and efforts need to be made for implementation of effective prevention measures to reduce the infection burden, which may otherwise lead to symptomatology and complications in the infected subjects.

Comparison of early and delayed laparoscopic cholecystectomy for acute cholecystitis: experience from a single center.

BACKGROUND: Cholecystectomy for symptomatic gallstones is mainly performed after the acute cholecystitis episode settles because of the fear of higher morbidity and conversion from laparoscopic cholecystectomy to open cholecystectomy during acute cholecystitis. AIMS: To evaluate the safety and feasibility of laparoscopic cholecystectomy for acute cholecystitis and to compare the results with delayed cholecystectomy. MATERIALS AND METHODS: This was a prospective and randomized study. For patients assigned to early group, laparoscopic cholecystectomy was performed as soon as possible within 72 hours of admission. Patients in the delayed group were treated conservatively and discharged as soon as the acute attack subsided. They were subsequently readmitted for elective laparoscopic cholecystectomy 6-12 weeks later. RESULTS: There was no significant difference in the conversion rates, postoperative analgesia requirements, or postoperative complications. However, the early group had significantly more blood loss, more operating time, and shorter hospital stay. CONCLUSION: Early laparoscopic cholecystectomy within 72 hours of onset of symptoms has both medical as well as socioeconomic benefits and should be the preferred approach for patients managed by surgeons with adequate experience in laparoscopic cholecystectomy.

Spontaneous hemo-pneumothorax in a patient with Ehlers-Danlos syndrome.

Spontaneous hemo-pneumothorax is one of the pulmonary complications of connective tissue disorders such as Ehlers-Danlos syndrome (EDS). Most thoracic surgeons overlook this fact and they consider it as primary. In the following report, we describe a unique case of spontaneous recurrent hemo-pneumothorax in a young patient with undiagnosed EDS. The aim of this presentation is to raise a high index of suspicion of every thoracic surgeon to include in his differential diagnosis, the connective tissue disorders in any case of spontaneous hemo-pneumothorax.

An Unusual Case of Hashimoto's Thyroiditis with Four Lobed Thyroid Gland.

Hashimoto's thyroiditis (HT), an autoimmune disorder, is the most prevalent cause of subclinical or overt hypothyroidism in areas with sufficient iodine intake. The gland is often diffusely enlarged, and the parenchyma is coarsened, hypoechoic, and often hypervascular on ultrasonograpy. Histopathologic appearance of HT includes lymphocyte aggregates with germinal centers, small thyroid follicles, presence of Hurthle cells, and variable fibrosis. We present a case of a 40-year-old female with suspected follicular neoplasm on fine-needle aspiration cytology of neck swelling. Intraoperatively, thyroid gland was found having four lobes separated from each other. Total thyroidectomy was done and histopathology from all four lobes revealed HT. At present, there is no literature to support the fact that such distorted thyroid anatomy may be due to the underlying disease. If we consider it as thyroid gland anomaly, no such anomaly has been mentioned in the literature till date.

Giant intrapulmonary teratoma: a rare case.

Teratomas are tumors composed of tissues derived from more than one germ cell line. Pulmonary teratomas are rare and commonly involve the upper lobe of the left lung. Criteria for pulmonary origin are the exclusion of a gonadal or other extragonadal primary site and origin entirely within the lung. We report a case of a giant pulmonary teratoma in a 2-year-old male child and review the relevant literature.

Isolated cervical rib fracture: a rare etiology of thoracic outlet syndrome.

Isolated fracture of a cervical rib is a very rare entity and usually presents as a painless swelling or as thoracic outlet syndrome. We describe a case of a 45-year-old woman with history of fall two months back. She presented with symptoms of neurogenic thoracic outlet syndrome for one month. Isolated left cervical rib fracture was documented on X-ray cervical spine. Her fractured cervical rib was resected through a supraclavicular approach, and symptoms resolved completely in the postoperative period.

Liposarcoma of the spermatic cord: a rare entity.

Primary malignant tumours of spermatic cord are rare. The liposarcoma of spermatic cord is a rare entity and only a few cases have been reported in the literature. We report a case of forty five-year-old male with huge left inguinoscrotal swelling. Fine needle aspiration cytology (FNAC) of swelling revealed the diagnosis of a liposarcoma. The patient was subjected to radical orchidectomy and wide excision. Histopathological examination (HPE) of the resected specimen reported a well-differentiated liposarcoma of the spermatic cord and confirmed the diagnosis.