Mask region-based CNNs for cervical cancer progression diagnosis on pap smear examinations.

This research presents a novel approach for cervical cancer detection and segmentation using tissue images with multiple cells. The study employs a novel deep learning architecture based on Mask Region-Based Convolutional Neural Network (RCNN) and statistical analysis. This new architecture enables us to achieve a high percentage of detection and pix-to-pix area segmentation. A mean Average Precision (mAP) higher than 60% for 3-class and 5-class was achieved. In addition, higher F1-scores of 70% for 3-class and 5-class were obtained. This investigation is a collaborative work, where a medical consultant collected the samples from the Papanicolaou (Pap) Smear examination and labeled the cells presented to the liquid-based cytology (LBC). Furthermore, the online available benchmark data set, SIPaKMeD, was also utilized. Additionally, sample images from the Mendeley data set were also labeled by the trained medical consultant for comparison. The proposed scheme automatically generates a full report for a medical consultant to identify the location of the malicious cells in the given images and expedite the diagnosis and treatment process.

A Clinical Audit of Operation Notes Documentation and the Impact of Introducing an Improved Proforma: An Audit Cycle.

Introduction Accurate and comprehensive documentation of surgical procedures is vital in healthcare for both medical and legal purposes. This audit assessed adherence to international guidelines for operative note documentation in a general surgery department and the impact of introducing educational initiatives and an enhanced proforma. Methods A retrospective audit of 100 operative notes was conducted in April 2023, followed by a prospective re-audit of another 100 notes in October-November 2023. A checklist based on Royal College of Surgeons (RCS) guidelines assessed 20 parameters. An improved proforma and an awareness session for surgeons were implemented between audits. Data analysis utilized the IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). A paired-sample t-test was used, and a p-value < 0.001 was considered statistically significant. Results The initial audit revealed discrepancies in documentation, with missing information on deep vein thrombosis (DVT) prophylaxis, elective/emergency settings, anticipated blood loss, closure technique specifics, and prosthesis/mesh details. Legibility was satisfactory in 88% of notes. After implementing the proforma and awareness session, significant improvements were observed in all parameters, with documentation rates exceeding 91%. Overall documentation completeness increased from 65.2% to 95.2%. Results of the paired-sample t-test indicated a significant difference before and after the introduction of the new proforma (Mean (M) = 65.2, standard deviation (SD) = 34.3 versus M = 95.2, SD = 4.3) with a p-value of 0.0005. Conclusion Regular audits, surgeon education, and standardized proformas are essential for maintaining high standards in operative note documentation, contributing to improved patient care and safety.

Possible molecular targets for therapeutic applications of caffeic acid phenethyl ester in inflammation and cancer.

Of the various derivatives of caffeic acid, caffeic acid phenethyl ester (CAPE) is a hydrophobic, bioactive polyphenolic ester obtained from propolis extract. The objective in writing this review article was to summarize all published studies on therapeutics of CAPE in inflammation and cancer to extract direction for future research. The possible molecular targets for the action of CAPE, include various transcription factors such as nuclear factor-κB, tissue necrosis factor-α, interleukin-6, cyclooxygenase-2, Nrf2, inducible nitric oxide synthase, nuclear factor of activated T cells, hypoxia-inducible factor-1α, and signal transducers and activators of transcription. Based on the valuable data on its therapeutics in inflammation and cancer, clinical studies of CAPE should also be conducted to explore its toxicities, if any.

Idiopathic adult ileoileal and ileocolic intussusception in situs inversus totalis: a rare coincidence.

Situs inversus totalis is a rare autosomal recessive congenital anomaly that is characterized by mirror image anatomy of the abdominal and thoracic organs. We report a case of a 28-year-old male with situs inversus totalis, who developed an idiopathic ileoileal and ileocolic intussusception, which was diagnosed on computed tomography scan. Patient underwent successfully ileal resection and side-to-side functional anastomosis of ileum 12 cms from ileocecal junction. Postoperative course was uneventful. To the best of our knowledge, this is the first case of idiopathic adult intussusception with situs inversus totalis in the literature.

Practical perioperative pinnaplasty preparation.

Creating and maintaining a sterile operative field for pinnaplasty can be difficult. Drapes can slip, and stray hairs can interfere with delicate dissection and suturing. Methods to combat this have been suggested in the literature, but each has disadvantages, either in cost or in adequacy of surgical access. This report describes a practical and prudent technique for reducing contamination and obstruction by stray hairs in the operative field during performance of a pinnaplasty while maintaining adequate access at no added cost.

CASE REPORT Playing Football Burns More Than Just Calories.

OBJECTIVE: To highlight the case of a sports-related alkali burn due to a common household chemical and emphasize the importance of a detailed medical history in chemical burns patients. METHODS: A single-patient case study is presented along with references from existing literature. RESULTS: Alkaline burn injuries associated with sports have previously been described in the literature; however, this case demonstrates an unusual presentation of a chemical burn with a readily available household substance. CONCLUSION: Chemical burns can present in atypical ways. Detailed history and thorough clinical examination is essential in determining the correct diagnosis and therefore implementing the most appropriate management plan.

Mastectomy scar histopathology of limited clinical value.

This study assesses whether the routine submission of mastectomy scars for histologic examination at the time of delayed breast reconstruction is useful. A retrospective review was performed of all delayed breast reconstructions for breast cancer performed by a single surgeon over a 5-year period from January 2000 to December 2004. One hundred eighty-eight patients underwent delayed breast reconstruction during this period, and of these, 133 scars (1 patient had bilateral scars excised) were submitted for histology where the reconstruction was performed by either transversus rectus abdominus muscle flap (TRAM) or latissimus dorsi myocutaneous flap (LDF) +/- implant. Fifty-six patients had reconstruction performed by tissue expander through the inframammary crease where the original mastectomy scar was not excised and were excluded from the study. One mastectomy scar specimen showed a 2-mm suspicious area of invasive ductal carcinoma consistent with same histopathology at the time of mastectomy. This study corroborates evidence that it is questionable whether routine histopathology of mastectomy scar at the time of delayed breast reconstruction should not be a standard practice.

Liver derived pro-inflammatory cytokines may be important in producing intracranial hypertension in acute liver failure.

We describe a patient with paracetamol induced acute liver failure (ALF) who fulfilled criteria for poor prognosis and was waiting for a liver to become available for transplantation. Because of severe uncontrolled intracranial hypertension she underwent a hepatectomy that resulted in stabilization of her systemic and cerebral hemodynamics. She remained anhepatic for 14 h and was successfully bridged to liver transplantation. The removal of the liver was associated with a sharp and sustained reduction in the circulating pro-inflammatory cytokine concentration suggesting that liver derived pro-inflammatory cytokines may be important in the pathogenesis of intracranial hypertension in patients with ALF.