Objectives: The purpose of this article was to familiarize pediatricians with the diagnosis and management of pinworm infestation.

Methods: A search was conducted in August 2023 in PubMed Clinical Queries using the key terms “Enterobius vermicularis,” OR “enterobiasis,” OR “pinworm.” The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article.

Results: Enterobiasis is a cosmopolitan parasitosis caused by Enterobius vermicularis. It affects approximately 30% of children worldwide and up to 60% of children in some developing countries. Predisposing factors include poor socioeconomic conditions, inadequate sanitation, poor personal hygiene, and overcrowding. Children aged 5 to 14 years have shown the highest prevalence of enterobiasis.. Egg transmission is mainly by the fecal-oral route. Approximately 30 to 40% of infested patients do not show any clinical symptoms of the disease. For symptomatic patients, the most common presenting symptom is nocturnal pruritus ani. The diagnosis of E. vermicularis infection is best established by the cellophane tape test. The sensitivity of one single test is around 50%; however, the sensitivity increases to approximately 90% with tests performed on three different mornings. If a worm is visualized in the perianal area or the stool, a pathological examination of the worm will yield a definitive diagnosis. As pinworms and eggs are not usually passed in the stool, examination of the stool is not recommended. The drugs of choice for the treatment of pinworm infestation are mebendazole (100 mg), pyrantel pamoate (11 mg/kg, maximum 1 g), and albendazole (400 mg), all of the above-mentioned drugs are given in a single dose and repeated in two weeks. Mebendazole and albendazole are both adulticidal and ovicidal, whereas pyrantel pamoate is only adulticidal. Given their safety and effectiveness, mebendazole and albendazole are currently the best available drugs for the treatment of pinworm infestation. For pregnant women, pyrantel is preferred to mebendazole and albendazole. Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections because reinfection is common even when effective medication is given.

Conclusion: In spite of effective treatment of pinworm infestation, recurrences are common. Recurrences are likely due to repeated cycles of reinfection (particularly, autoinfection) because of the short life span of adult pinworms. Good personal hygiene, such as frequent handwashing, especially after bowel movements and before meals, clipping of fingernails, avoidance of finger-sucking, nail-biting, and scratching in the anogenital area, are important preventive measures. Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections.

Objectives: Despite advancements in biological therapies, significant clinical needs persist. This review aims to discuss novel treatments, guiding future guidelines and drug discoveries for rheumatoid arthritis.

Methods: This review follows the 2020 PRISMA statement, utilising PubMed and Google Scholar for literature search and emphasizing recent meta-analyses on the safety and efficacy of targeted immunobiological medications.

Results: Small molecule inhibitors, whether utilised independently or in conjunction with Methotrexate, have been shown to contribute to effective disease management and have the potential for better adherence to the American College of Rheumatology criteria. Tocilizumab therapy demonstrates a significant reduction in disease activity and improves rates of disease remission when combined with Methotrexate. Investigations of mesenchymal stromal cell therapies have had promising outcomes, improving both cartilage quality (as evaluated by Macroscopic Cartilage Repair Assessment) and joint tenderness and swelling in clinical joint counts. Intra-articular administration of tolerogenic dendritic cells has displayed a capacity to alleviate pain, as measured by Visual Analog Scale scores, and enhance the Disease Activity Score across 28 joints. Resveratrol capsules supplemented with allopathic therapy show potential in reducing TNF-α and interleukin-6 serum levels.

Conclusion: More investigations and their analysis will improve patient outcomes and reduce adverse effects and the costs involved in developing and obtaining immunobiological drugs. Moreover, assessing the safety and efficacy of anti-RA properties of the bioactive compounds could offer less toxic and more cost-effective natural treatment options.

This study aimed to investigate the recorded cancer frequency in children and adolescents in Isfahan Province, Iran.

As one of the main reasons for death among children and adolescents is reported as cancer with different prevalence worldwide, therefore, reporting the occurrence of cancers in this population is crucial.

Methods: Information from the years between 2013 to 2015 related to the Surveillance, Epidemiology, and End Results; (SEER) was collected from the Isfahan Cancer Registry. The cancer sites studied were defined according to the International Classification of Diseases and recorded by related topography codes.

Results: Among all 30,465 registered cancers, there were 582 cases (2%) of cancer, including 57% of children and 43% of adolescents. The mean ± SD age of patients was 11.5 ± 5.9 years (Min; 1, Max 19). The top four ranked cancers were (n=264; 45%) comprised of; 1) hematopoietic and reticuloendothelial system (n= 122), 2) secondary and unspecified malignant neoplasm of lymph nodes (n=56), 3) malignant neoplasm of the brain (n=43) 4), thyroid gland (n=43). Death-reported data was associated with 32% of the total population studied. The neoplasm was reported in 174 cases, which was associated with 95% death.

Conclusion: This frequency source of children and adolescents cancers could be used for health strategy. The observed variations in the frequency of different cancers require continuous monitoring and investigation. Therefore, plan of health-system should focus based on greater efforts toward advanced evidence-based drug therapy in Isfahan, Iran.

Objective: The aim of this study is to investigate the clinical presentation, laboratory findings, and comorbidity factors involved in autoimmune thyroid disease among Emirati citizens in the UAE.

Methods: Medical records from Advanced Cure Diagnostic Centers were reviewed in a retrospective study over the period of four years from 2018 to 2022. The patients population included those who attended the Endocrinology Unit and others seen by the rest of the medical staff. Patients were considered to have AITD if they tested positive for thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb), or both. The data collected was evaluated using descriptive analysis to provide a basic summary of the patients sample and dataset. Unpaired t-test was used to compare the mean value of elevated autoantibodies in males and females.

Results: Of the 366 Emirati nationals who were tested for autoimmune thyroiditis, 220 (60%) had an abnormal result for TPOAb and/or TgAb. Among the 220 patients who had an abnormal result for TPOAb and/or TgAb, 188 (85.5%) were females, and 100 patients (45.5%) were in the age group between 31 and 40 years. 42% were in a euthyroid state and 42% presented with hypothyroidism. Only 7% presented with hyperthyroidism, 5% with subclinical hypothyroidism, and 2% with subclinical hyperthyroidism. An analysis of the comorbidity factors revealed 142 (65%) patients with obesity, 82 (37%) with a family history of thyroid disease, 77 (35%) with hyperlipidemia, 14 (6%) with hypertension, and 11 (5%) with diabetes.

Conclusion: This is the first publication intended to address AITD in Emirati citizens. Our findings concur with the international data regarding the prevalence among middle-aged females. Eighty-four percent of the positive patients either presented with no abnormality of their thyroid gland function or with hypothyroidism. With the alarming increase of obesity in the UAE, we found it to be the single most important and preventable comorbidity factor present in 65% of the studied population. This is followed by a family history of first-degree relatives with thyroid disease in 37% of the participants, due to the high rate of consanguineous marriages in the UAE.

Objective: This study aimed to investigate the effect of CD73 targeting inhibition on liver fibrosis.

Methods: Intraperitoneal injection of CCl4 was used to induce liver fibrosis in mice models. Adenosine 5′-(α, β-methylene) diphosphate sodium salt (APCP) was used for CD73 blockade. The siRNA was used to induce CD73 knockdown in HSCs. LX2 and HSC-T6 were used to investigate the role of CD73 in HSCs activation in vitro.

Results: The results showed that APCP treatment could alleviate hepatic fibrosis. In fibrotic liver tissues, CD73 exhibited a positive correlation with markers of HSCs activation. Furthermore, APCP treatment and CD73 knockdown could inhibit HSCs (LX2 and HSC-T6) activation and proliferation. By using RNA sequencing of liver tissues from control, CCl4-mice, and APCP-treated mice, 851 genes that were significantly changed in CCl4 mice (vs. control) were reversed by APCP treatment. These genes were mainly enriched in cell division-associated biological processes. Moreover, we found that CD73 might be associated with autophagy in HSCs. In fibrotic liver tissues and HSCs, ATG5 and Beclin1 expression could be downregulated by CD73 knockdown and APCP treatment.

Conclusion: This study demonstrated the effects and mechanism of CD73 in HSCs activation and proliferation, which presents the therapeutical potential of CD73 blockage for liver fibrosis.

Objective: This paper aims to discuss the mechanism of actions, pathways, and metabolites triggered due to the development of neuropathy and nephropathy post-long-haul diabetes in patients. The therapeutic targets are also highlighted, proving to be a potential cure for such conditions.

Methods: Research works were searched from international and national databases with keywords like “diabetes,” “diabetic nephropathy,” “NADPH,” “oxidative stress,” “PKC,” “Molecular mechanisms,” “ cellular mechanisms,” “complications of diabetes,” and “factors.” The databases searched were PubMed, Scopus, Directory of open access journals, Semantic Scholar, Core, Europe PMC, EMBASE, Nutrition, FSTA- Food Science and Technology, Merck Index, Google Scholar, PubMed, Science Open, MedlinePlus, Indian citation index, World Wide Science, and Shodhganga.

Results: Pathways causing protein kinase C (PKC) activation, free radical injury, oxidative stress, and aggravating the conditions of neuropathy and nephropathy were discussed. In diabetic neuropathy and nephropathy, neurons and nephrons are affected to the extent that their normal physiology is disturbed, thus leading to further complications and conditions of loss of nerve sensation in diabetic neuropathy and kidney failure in diabetic nephropathy.

Current treatment options available for the management of diabetic neuropathy are anticonvulsants, antidepressants, and topical medications, including capsaicin. According to AAN guidelines, pregabalin is recommended as the first line of therapy, whereas other drugs currently used for treatment are gabapentin, venlafaxine, opioids, amitriptyline, and valproate.

Drug targets for treating diabetic neuropathy must suppress the activated polyol pathways, kinase C, hexosamine, and other pathways, which amplify neuroinflammation. Targeted therapy must focus on the reduction of oxidative stress and proinflammatory cytokines and suppression of neuroinflammation, NF-κB, AP-1, etc.

Conclusion: Potential drug targets must be considered for new research on the treatment of neuropathy and nephropathy conditions.]]> https://www.benthamscience.comarticle/135619 https://www.benthamscience.comarticle/137402Mitosis of somatic cells produces a daughter cell. Apoptosis, a naturally programmed cellular death mechanism, kills abnormal cells produced by mitosis. Cancer can develop when this equilibrium is disrupted, either by an upsurge in cell propagation or a reduction in tissue demise. Cancer therapy aims to cause cancer cells to die while inflicting little harm to healthy cells. This review of apoptotic mechanism processes improves our understanding of how certain malignancies begin and develop. The current cancer treatments can operate either by inducing apoptosis or causing direct cell damage. An insight into the resistance to apoptosis may explicate why malignancy treatments fail in some situations. New therapies grounded on our understanding of apoptotic processes are being developed to induce apoptosis of cancer cells while limiting the simultaneous death of normal cells. Various biological activities require redox equilibrium to function properly.

Antineoplastic medications that cause oxidative stress by raising ROS and blocking antioxidant mechanisms have recently attracted much interest. The rapid accumulation of ROS impairs redox balance and damages cancer cells severely. Here, we discuss ROS-instigating malignancy therapy and the antineoplastic mechanism used by prooxidative drugs.

Methods: In this study, we have studied the anti-tumor properties and potential mechanisms of PF-04449913. Colorectal cancer cell viability was reduced by PF-04449913 in a dose-dependent manner. The migration and invasion ability of malignant colon cells were attenuated by the drug, as demonstrated by the Transwell test. Moreover, PF-04449913 repressed the phosphorylation levels of ERK and other proteins, and the expression levels of MMP9. The anti-tumor effects of the drug in vivo were demonstrated in BALB/c-nude mice models, and PF-04449913 inhibited the malignant phenotype of colorectal cancer cells, including reduction of tumor size and promotion of apoptosis. At the molecular level, PF-04449913 induced a significant decrease in ERK and p65 protein phosphorylation levels and inhibited MMP9 protein expression.

Results: Both in vivo and in vitro results showed PF-04449913 to demonstrate antitumor effects, which have been proposed to be mediated through blockade of the ERK/p65 signaling pathway, and subsequent repression of MMP9 expression.

Conclusion: Our study provides a new perspective on the potential clinical application of PF-04449913 in the treatment of colorectal cancer.

Methods: An imiquimod (IMQ)-induced psoriasis-like dermatitis mouse model was generated to evaluate the anti-inflammatory effect of GCK. Hematoxylin and eosin (H&E) staining was used to assess skin pathological changes. Protein expression of K17 and p-p65 in mice skin was assayed by immunohistochemical. Protein expression and phosphorylation of p65 IκB were assayed by Western blot. Protein expression of K1, K6, K10, K16, K17, and GR were assayed by Western blot and immunofluorescence. Enzyme-linked immunosorbent assay (ELISA) was used to determine cytokine levels of TNF-α, IL-6, CXCL-8, and ICAM-1. Real-time polymerase chain reaction (RT-PCR) was used to quantify TNF-α, IL-6, IL-8, and ICAM-1 mRNA expression. Cell viability was determined by Cell Counting Kit-8(CCK-8) assay. A high-content cell-imaging system was used to assay cell proliferation. Nuclear translocation of p65 and GR was assayed by imaging flow cytometry and immunofluorescence microscopy. Small interfering RNA was used to confirm the role of GR in the anti-inflammatory and immunoregulatory effect of GCK in normal human epidermal keratinecytes (NHEKs).

Results: GCK reduced the psoriasis area, severity index, and epidermal thickening in IMQ-induced mice. GCK significantly attenuated the mRNA levels of IL-6, IL-8, TNF-α, and ICAM-1 and reduced epidermal hyperproliferation in the skin of IMQ-induced mice. GCK inhibited in vitro activation of NF-κB, leading to attenuated release of inflammatory mediators (IL-6, IL-8, TNF-α, and ICAM-1) and suppression of NHEK hyperproliferation and abnormal differentiation. These inhibitory effects of GCK were diminished by GR silencing in NHEKs.

Conclusion: GCK suppressed psoriasis-related inflammation by suppressing keratinocyte activation, which may be related to promoting GR nuclear translocation and inhibiting NF-κB activation. In summary, GCK appears to be a GR activator and a promising therapeutic candidate for antipsoriatic agents.

Objectives: This review aims to cover the natural excipients’ role in nanoformulations and associated prospects.

Methods: More than 500 manuscripts were collected from ScienceDirect, PubMed, google, and other sources; however the manuscripts were excluded based on their relevance to the subject and finally 80 manuscripts were analyzed for the data.

Results: The substation of synthetic lipids with natural and semisynthetic for developing lipid-based nano drug delivery, and the use of gelatin and chitosan in developing encapsulated and nano particulates are a few examples to understand the above-mentioned transition.

Conclusion: This review provides an overview of the types of excipients used in the formulation of novel drug delivery systems with special emphasis on their characteristics, safety aspects, benefits associated, and common methods through, which they are employed in nanoformulations.

Objective: The goal of the current research was to create a biocompatible GSH-depleting and tumor- targeting nanoparticle (denoted as DOX/CA@PCN-224@HA) for the combined photodynamic and chemo photo-chemo) therapy.

Methods: The nanoparticles were characterized by transmission electron microscopy (TEM). A UV-vis spectrophotometer was used to measure the drug loading efficiency (DE) and encapsulation efficiency (EE). The GSH-depleting ability was measured using Ellman's test. Confocal laser scan microscopy (CLSM) was used to assess the cellular uptake. MTT was adopted to evaluate the cytotoxicity of DOX/CA@PCN-224@HA against 4T1 cells.

Results: The altered PCN-224 showed excellent monodispersing with a dimension of approximately 193 nm ± 2 nm in length and 79 nm ± 3 nm in width. The larger and spindle grid-like structure of PCN-224 obtains better dual-drug loading ability (DOX: 20.58% ± 2.60%, CA: 21.81% ± 1.98%) compared with other spherical PCN-224 nanoparticles. The ultimate cumulative drug release rates with hyaluronidase (HAase) were 74% ± 1% (DOX) and 45% ± 2% (CA) after 72 h. DOX/CA@PCN-224@HA showed GSH-consuming capability, which could improve the PDT effect. The drug-loaded nanoparticles could accurately target 4T1 cells through biological evaluations. Moreover, the released DOX and CA display cooperative effects on 4T1 cells in vitro. DOX/CA@PCN-224@HA nanoparticles showed inhibition against 4T1 cells with an IC₅₀ value of 2.71 μg mL^-1.

Conclusion: This nanosystem displays great potential for tumor-targeted enhanced (photo-chemo) therapy.

Objective: In this research, we have examined the anti - Alzheimer’s effect of ethanolic extract from roots of Cassia occidentalis L. on colchicine-induced Alzheimer’s in Wistar rats.

Methods: Ethanolic extract was obtained and spectroscopic, chromatography analysis was performed. Acute toxicity studies using Organization of Economic Co-operation and Development (OECD) Guidelines 423 were performed to examine and make sure that there were no signs of toxic effects. The induction of AD was done using colchicine which leads to symptoms like neurotoxicity, neuroinflammation, and neurodegeneration. In this experiment, a thorough analysis of body weight, behavioral parameters, locomotor activity, and biochemical evaluation was performed to estimate the medicinal properties of Cassia occidentalis L in treating Alzheimer’s disease.

Results: Pharmacognostic analysis showed the presence of vascular bundles, starch grains, fibers, calcium oxalate crystals, elongated parenchyma, and collenchyma mucilage as shown in the supplementary files. Locomotor activity, Escape latency time, Conditioned avoidance response, and Transfer latency were improved with treatment. Interleukin- 6 (IL - 6) levels were reduced significantly in the Colchicine + 200 Cassia mg/kg group (739.2 ± 0.37 pg/ml) than in the Colchicine Group (850.6 ± 0.40 pg/ml). Tumor necrosis factor (TNF-α) was decreased in the Colchicine + 200 Cassia mg/kg Group (1030.93 ± 0.51 pg/ml) than in the Colchicine Group (1455.06 ± 1.25 pg/ml). A significant decrease in total protein level was observed in the Colchicine Group (2.52 ± 0.10 mg/ml), (3.33 ± 0.90 mg/ml) as compared to Colchicine + 200 Cassia mg/kg Group (5.27 ± 0.09 mg/ml, (5.01 ± 0.10 mg/ml) respectively, in the Hippocampus and Entorhinal cortex. The levels of antioxidant enzymes such as Catalase (CAT), Serum superoxide dismutase (SOD), Reduced glutathione (GSH) and Malondialdehyde (MDA) were measured. When compared to the Colchicine Group (7.33 ± 0.16 nM/ mg, the MDA level was lower in the Colchicine + 100 Cassia mg/kg Group (3.20 ± 0.01 nM/ mg). The level of CAT in Colchicine + 200 Cassia mg/kg Group (7.01 ± 0.03 μmoles of H₂O₂/mg of protein) was seen to be increased when compared to Colchicine Group (3.32 ± 0.17 μmoles of H₂O₂/mg of protein). The level of SOD in Colchicine + 200 Cassia mg/kg Group (7.43 ± 0.02 U mg -1 of protein) was seen to be increased when compared with Colchicine Group (4.55 ± 0.03 U mg -1 of protein). The level of GSH in Colchicine + 200 Cassia mg/kg Group (10.07 ± 0.19 nM/mg -1 of protein) was increased when compared with the Colchicine Group (5.82 ± 0.11nM/mg -1 of protein). Histopathology of the Hippocampus and Entorhinal cortex showed diminished amyloid plaques, and neurodegeneration in the treatment groups.

Conclusion: The present study showed that ethanolic extract from the roots of Cassia occidentalis L. At 100 and 200 mg/kg doses in Wistar rats improved memory damage, by reducing oxidative stress. Levels of the antioxidant enzymes as CAT, and SOD, GSH were increased and MDA was decreased. The cytokine levels in the serum of Wistar rats of IL-6 level and TNF-α level were reduced significantly. Estimation of total protein level was found to be increased. It restored neuronal degeneration in the Hippocampus, and Entorhinal cortex and reduced oxidative stress. This suggests that the ethanolic extract of Cassia occidentalis L. could be an effective therapeutic treatment for neurodegenerative diseases like AD.

On the other hand, the portal vein carries microbial-produced endogenous compounds from the colon to the liver, where they might disrupt liver function. Acetyl-aldehyde and butyrate are two of the many byproducts produced by the microbiota in the human gut in response to indigestible food. In addition, these two waste products alter liver function and play an important role in maintaining intestinal health in humans. This paper reviews the literature on the link between butyrate and acetyl-aldehyde production in the human gut and the organ's role in the development of liver disease. Butyrate, acetyl-aldehyde, and liver disease all play roles in the gut-liver axis.

Case Presentation: An induration with mild discomfort was detected in the upper inner quadrant of the right breast of a 27-year-old Chinese woman with regular menstrual cycles. The patient is currently unmarried and has no previous history of full-term pregnancies or lactation. An ill-defined, subcutaneous, hyperechoic lesion with no calcification was visualized on breast ultrasound. Peripheral and internal blood flow signals demonstrated high intensity. Pathological analysis of a breast needle biopsy revealed fat lobule necrosis accompanied by mixed lymphoplasmacytic and histiocytic aggregates.

Conclusion: The diagnosis of lupus mastitis necessitates a comprehensive evaluation of the patient's medical history, serological testing, imaging studies, and histopathological analysis.

Case Presentation: A 17-year-old girl initially presented with enlarged lymph nodes near the main portal vein of the liver and a large liver tumour. Lesions were identified on the imaging findings obtained via positron emission tomography–computed tomography (CT) scanning, including an abnormal increase of heterogeneous glucose metabolism in the intrahepatic mass, with a maximum standardised uptake value of around 3.2. The CT imaging showed multiple dense shadows in the lesion, while the magnetic resonance imaging indicated a long T1 and a slightly longer T2.

Conclusions: This study summarises the imaging features of CNSETs to provide a reference for diagnosing liver tumours. In addition, the literature on the topics covered was systematically reviewed.

Objective: This study aims to design a model to classify BC Histopathology images accurately by leveraging segmentation techniques.

Methods: This work proposes a combined segmentation and classification approach for classifying BC using histopathology images to address these issues. Chan-Vese algorithm is used for segmentation to accurately delineate regions of interest within the histopathology images, followed by the proposed SegEIR-Net (Segmentation using EfficientNet, InceptionNet, and ResNet) for classification. Bilateral Filtering is also employed for noise reduction. The proposed model uses three significant networks, ResNet, InceptionNet, and EfficientNet, concatenates the outputs from each block followed by Dense and Dropout layers. The model is trained on the breakHis dataset for four different magnifications and tested on BACH (BreAst Cancer Histology) and UCSB (University of California, Santa Barbara) datasets.

Results: SegEIR-Net performs better than the existing State-of-the-Art (SOTA) methods in terms of accuracy on all three datasets, proving the robustness of the proposed model. The accuracy achieved on breakHis dataset are 98.66%, 98.39%, 97.52%, 95.22% on different magnifications, and 93.33% and 96.55% on BACH and UCSB datasets.

Conclusion: These performance results indicate the robustness of the proposed SegEIR-Net framework in accurately classifying BC from histopathology images.

Objective: The study aimed to explore the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with shear wave elastography (SWE) in the diagnosis of benign and malignant breast masses in BI-RADS (Breast Imaging Reporting and Data System) 4.

Methods: Examination outcomes and clinical information of 83 patients with BI-RADS 4 breast masses were analyzed retrospectively. These included patients who received CEUS, SWE, and pathological examinations. The difference of CEUS in determining the classification of BI-RADS 4 breast masses was evaluated using histopathological outcomes of breast masses as a reference standard. The diagnostic value of CEUS, SWE, and CEUS combined with SWE in the diagnosis of benign and malignant breast masses in BI-RADS 4 was also explored.

Results: Pathological biopsy results revealed 63 malignant masses and 20 benign masses among 83 BI-RADS 4 breast masses, with a 75.9% incidence of malignant masses. After the diagnosis of BI-RADS 4 breast masses with CEUS, SWE, and CEUS+SWE, the incidence of malignancy was 56.6%, 78.3%, and 73.5%, respectively. CEUS+SWE showed higher sensitivity (93.7% vs. 81% and 68.3%), specificity (90% vs. 30% and 80%), positive predictive value (96.7% vs. 78.5% and 91.5%), negative predictive value (81.8% vs. 33.3% and 44.4%), and diagnostic coincidence rate (92.8% vs. 68.7% and 71.1%) than SWE and CEUS alone in diagnosing pathological type of breast masses. Moreover, CEUS combined with SWE exhibited a larger area under the receiver operating characteristic (ROC) curve (0.918) than SWE (0.741, p = 0.028) and CEUS (0.555, p < 0.001) alone in the diagnosis of BI-RADS 4 breast masses.

Conclusion: Overall, the diagnostic value of CEUS+SWE for the pathological type of BI-RADS is preferred over CEUS and SWE alone. CEUS+SWE showed higher values than CEUS and SWE alone in diagnosing BI-RADS 4 breast masses. Specifically, CEUS+SWE can correctly identify benign and malignant masses, reduce unnecessary trauma, and avoid misdiagnosis. In summary, CEUS combined with SWE can serve as an effective diagnostic method and avoid delaying the best treatment opportunity for some malignant lesions.

Objective: To assess the clinical application of the three-dimensional (3D)-printed chest wall conformal device for breast cancer patients who need to be treated by chest wall intensity modulated radiotherapy (IMRT) after radical mastectomy.

Methods: The 24 patients were divided into three groups. During a computed tomography (CT) scan, patients in the study group were fixed by a 3D-printed chest wall conformal device, nothing in control group A, and a traditional 1-cm thick silica gel compensatory pad on the chest wall in control group B. The parameters of mean Dmax, Dmean, D2%, D50%, D98%, the conformity index (CI), and the homogeneity index (HI) of the planning target volume (PTV) are compared.

Results: The study group had the best dose uniformity (HI = 0.092) and the highest conformation (CI = 0.97), the worst in control group A (HI = 0.304, CI = 0.84). The mean Dmax, Dmean, and D2% of the study group were lower than control groups A and B (p<0.05). The mean D50% was higher than control group B (p<0.05), while the mean D98% was higher than control groups A and B (p<0.05). The mean Dmax, Dmean, D2%, and HI of control group A were higher than control group B (p<0.05), whereas the mean D98% and CI were lower than control group B (p<0.05).

Conclusion: By improving the efficacy of postoperative radiotherapy for breast cancer, using 3D-printed chest wall conformal devices may greatly improve the accuracy of repeating position fixation, increase the dose on the skin surface of the chest wall, optimise the dose distribution of the target area, and thus further reduce tumour recurrence and prolong patients' survival.

Objective: Describe the multidisciplinary approach and the benefits of quality of life and functionality in this diagnosis.

Case presentation: A paediatric patient was diagnosed with an aneurysmal bone cyst located in the cervical spine, which initially manifested with muscle pain, enlargement of the posterior cervical region, and difficulty in performing arcs of movement. He was treated with multidisciplinary management with surgery, embolisation, radiation, and bisphosphonate support.

Conclusion: The purpose of approaching multidisciplinary management helped to improve the accompanying symptoms that prevented our patient from having an active and quality life. However, more successful cases have not been reported to establish the best therapeutic protocol.

This review begins by discussing the regulatory landscape surrounding complex generic products in various regions, including the United States and Europe. It examines the specific guidelines and requirements set forth by regulatory authorities to ensure the safety, efficacy, and quality of these products. Additionally, the review explores the differences in terminology and definitions used to classify complex generics across different jurisdictions. Furthermore, it delves into the challenges faced by both regulatory agencies and pharmaceutical companies in evaluating and approving complex generic products. These challenges include establishing appropriate bioequivalence criteria, determining interchangeability with the reference product, addressing patent and exclusivity issues, and ensuring consistent quality throughout the product lifecycle. The impact of these challenges on market entry and competition is also discussed. The review highlights the need for harmonization and streamlining of regulations for complex generic products worldwide. It emphasizes the importance of clear and consistent guidelines to enable timely approvals, foster innovation, and facilitate patient access to affordable alternatives.

Objective: The aim of this study was to evaluate the efficiency of the sentinel node and occult lesion localization (SNOLL) technique in localizing nonpalpable breast lesions together with sentinel lymph node (SLN) using a single radiotracer, that is, nanocolloid particles of human serum albumin (NC) labeled with technetium-99m (^99mTc).

Methods: 39 patients were included, each having a single non-palpable breast lesion and clinically no evidence of axillary disease. Patients received ^99mTc- NC intratumorally on the same day as surgery under the guidance of ultrasound. Planar and single-photon emission computed tomography/computed tomography lymphoscintigraphy were performed to localize the breast lesion and the SLN. The occult breast lesion and SLN were both localized using a hand-held gamma-probe, which was also utilized to determine the optimal access pathway for surgery. In order to ensure a radical treatment in a single surgical session and reduce the amount of normal tissue that would need to be removed, the surgical field was checked with the gamma probe after the specimen was removed to confirm the lack of residual sources of considerable radioactivity.

Results: Breast lesions were successfully localized and removed in all patients. Pathological findings revealed breast carcinoma in 11/39 patients (28%) and benign lesions in 28 (72%). Axillary SLNs were detected in 31/39 (79.5%) patients. The metastatic involvement of SLN was only seen in two cases.

Conclusion: While the identification rate of the SNOLL technique performed with an intratumoral injection of ^99mTc-NC as the sole radiotracer in non-palpable breast lesions was great, it was not fully satisfactory in SLNs.

Objective: The objective of this research was to present a deep learning-based approach that can detect knee joint regions in medical images. By addressing the limitations of traditional methods, the aim was to develop a more efficient and automated approach for knee joint analysis.

Methods: The proposed method utilizes the Faster R-CNN model, which consists of a region proposal network (RPN) and Fast R-CNN. The RPN generates region proposals that potentially contain knee joint regions, while the Fast R-CNN network categorizes and extracts features from these proposals. To train the model, a dataset of knee joint images was employed. The performance of the model was evaluated using metrics, such as accuracy, precision, recall, F1-score, and mean IoU (Intersection Over Union).

Results: The results demonstrated the high accuracy of the proposed method in detecting knee joint regions. The model achieved a mean IoU of 94.5, indicating a strong overlap between the predicted and ground truth regions. These findings highlight the potential of deep learning-based approaches in automating medical image analysis, specifically in the diagnosis and management of knee joint disorders.

Conclusion: This study emphasizes the significance of leveraging advanced technologies, such as deep learning, in medical imaging. By developing more efficient and accurate methods for identifying knee joint regions in medical images, it becomes feasible to enhance patient outcomes and healthcare delivery. The proposed deep learning-based approach showcases promising results, paving the way for further advancements in the field of medical image analysis and contributing to improved diagnostic capabilities for knee joint disorders.

Case Report: A 44-year-old female presented with left heel pain that had persisted for over a year and had worsened over the past six months. A mass was found on the Lateral radiograph of the calcaneus, which was diagnosed as an aneurysmal bone cyst. Non-contrast computed tomography (CT) and magnetic resonance imaging (MRI)diagnosed a benign tumor. Based on light microscopy, special stains, and immunohistochemistry, a final diagnosis of diffuse tenosynovial giant cell tumor (D-TGCT) was rendered.

Results: D-TGCT is a slow-growing, infiltrative tumor that can form single or multiple masses outside the joint, and can also involve adjacent jointsmainly affects weight-bearing joints such as the knee, hip, and ankle. However, D-TGCT presents as a calcaneal mass, which poses a diagnostic challenge for all radiologists.

Conclusion: A calcaneal mass exhibiting well-defined borders, focal cortical destruction, a sclerotic rim, and T2WI hypointensity, the possibility of D-TGCT should be considered.

Objective: The objective of this study is to interpret the radiological findings of GCL and address the differential diagnosis between GCL and other lymphatic malformations in light of the relevant literature data.

Methods: The sample of this retrospective study consisted of six pediatric patients, four males and two females, diagnosed with GCL based on clinical, radiological, and histopathological findings between 2015 and 2022. The age of the patients at the time of diagnosis and their symptoms at admission were obtained from the hospital database. Radiological imaging findings were evaluated in detail based on the involved systems (thorax, abdomen, and musculoskeletal).

Results: The median age of the sample, 4/6 were male, was 9 years at admission (min. 3, max. 12). The most common symptom at admission was dyspnea, often accompanied by pleural effusion. Bone involvement was the most common extrathoracic finding. Abdominal involvement was primarily asymptomatic, and the spleen was the most frequently involved organ in the abdomen.

Conclusion: The diagnosis of GCL is challenging because of its rarity and overlapping diseases. Whole-body magnetic resonance imaging is a valuable tool as it reveals the typical radiological features of GCL and how far it has spread throughout the body.

Case Presentation: We report a 53-year-old female patient with sigmoid colon cancer and perforation who underwent a surgical operation. Three years after the operation, reexamination of the liver through computed tomography and magnetic resonance imagery scanning revealed multiple progressive liver lesions. However, the liver biopsy did not show malignant changes. Repeated analysis of the patient's liver magnetic resonance imaging revealed that multiple liver nodules were significantly enhanced in the arterial phase and that the portal vein density/signal ratio was higher than that of the liver parenchyma. The coincidence of doughnut-shaped nodules and high signal in the hepatobiliary phase, combined with the results of pathological liver puncture examination, led to nodular regenerative hyperplasia being considered as a possible diagnosis.

Conclusion: A review of the relevant literature showed that following oxaliplatin chemotherapy for colorectal cancer, it is not uncommon for doughnut-shaped nodules with obvious enhancement in the middle hepatic artery phase and high signal intensity in the hepatobiliary phase to develop. Such changes should be paid sufficient attention by radiologists.

Objective: To evaluate the relationship between the imaging and histopathological features of breast cancer in women aged under 40 years.

Methods: In our center, 537 suspicious lesions were detected in a total of 15,223 adult female patients under 40 years who were evaluated by breast ultrasonography (US). As a result of the mammographic, histopathological, and immunohistochemical analysis, 101 lesions meeting the study criteria were included in the sample.

Results: The luminal subtypes of breast cancer mostly visualized as irregularly shaped spiculated lesions with calcification and architectural distortion mammography and presented as masses that were sometimes accompanied by increased echogenicity in the surrounding tissue on US. The human epidermal growth factor receptor 2 (HER2) enriched subtypes mostly had microlobulated or indistinct margins with heterogeneous echoes accompanied by high calcification on mammography. The triple-negative (TN) subtypes generally appeared as microlobulated lesions with angular or indistinct margins, hypo echogenicity, posterior enhancement or shadowing, and vascularization.

Conclusion: Some radiological features of breast cancer in young women were found to be associated with molecular subtypes similar to other age groups in the literature. However, unlike other age groups, the incidences of the HER2-enriched subtype presenting with only calcification, TN subtypes presenting with circumscribed masses, and calcification were found to be low among the young women in our study.

Aims: The main objective of the investigation is to utilize 2-D colored fundus retina scans to determine if an individual possesses DR or not. In this regard, Engineering-based techniques such as deep learning and neural networks play a methodical role in fighting against this fatal disease.

Methods: In this research work, a Computational Model for detecting DR using Convolutional Neural Network (DRCNN) is proposed. This method contrasts the fundus retina scans of the DR-afflicted eye with the usual human eyes. Using CNN and layers like Conv2D, Pooling, Dense, Flatten, and Dropout, the model aids in comprehending the scan's curve and color-based features. For training and error reduction, the Visual Geometry Group (VGG-16) model and Adaptive Moment Estimation Optimizer are utilized.

Results: The variations in a dataset like 50%, 60%, 70%, 80%, and 90% images are reserved for the training phase, and the rest images are reserved for the testing phase. In the proposed model, the VGG-16 model comprises 138M parameters. The accuracy is achieved maximum rate of 90% when the training dataset is reserved at 80%. The model was validated using other datasets.

Conclusion: The suggested contribution to research determines conclusively whether the provided OCT scan utilizes an effective method for detecting DRaffected individuals within just a few moments.

Objective: The objective of this pilot study is to demonstrate the utility of linear modeling of standardized dynamic contrast-enhanced MRI (DCEMRI) signal for quantifying changes in BPE rates.

Methods: On a retrospective database search, 14 women with DCEMRI examinations pre- and post-treatment with tamoxifen were identified. DCEMRI signal was averaged over the parenchymal ROIs to obtain time-dependent signal curves S(t). The gradient echo signal equation was used to standardize scale S(t) to values of FA = 10° and TR= 5.5 ms, and obtain the standardized DCE-MRI signal S_P(t) . Relative signal enhancement RSE_P was calculated from S_P, and the reference tissue method for T1 calculation was used to standardize RSE_P to gadodiamide as the contrast agent, obtaining RSE. RSE in the first 6 minutes post-contrast administration was fit to a linear model with the slope α_RSE denoting the standardized rate relative BPE.

Results: Changes in α_RSE were not found to be significantly correlated with the average duration of tamoxifen treatment, age at the initiation of preventative treatment, or pre-treatment BIRADS breast density category. The average change in α_RSE showed a large effect size of -1.12, significantly higher than -0.86 observed without signal standardization (p < 0.01).

Conclusion: Linear modeling of BPE in standardized DCEMRI can provide quantitative measurements of BPE rates, improving sensitivity to changes due to tamoxifen treatment.

Objective: This review describes the essential neuroanatomy and neurophysiology of pain nociception and its relation with currently available neuroimaging methods focused on health professionals responsible for treating pain.

Methods: Conduct a PubMed search of pain pathways using pain-related search terms, selecting the most relevant and updated information.

Results: Current reviews of pain highlight the importance of their study in different areas from the cellular level, pain types, neuronal plasticity, ascending, descending, and integration pathways to their clinical evaluation and neuroimaging. Advanced neuroimaging techniques such as fMRI, PET, and MEG are used to better understand the neural mechanisms underlying pain processing and identify potential targets for pain therapy.

Conclusion: The study of pain pathways and neuroimaging methods allows physicians to evaluate and facilitate decision-making related to the pathologies that cause chronic pain. Some identifiable issues include a better understanding of the relationship between pain and mental health, developing more effective interventions for chronic pain's psychological and emotional aspects, and better integrating data from different neuroimaging modalities for the clinical efficacy of new pain therapies.

Background: Over recent years, diagnostic imaging has progressed from a state of commencement to an advanced level. Numerous modern imaging procedures have evolved. Although contemporary medical imaging comprises image exhibition together with image refining, computer-aided diagnosis (CAD), image inscribing and conserving, and image transference, the majority of which are embraced in picture documentation and communication processes.

Aim: This review targets to encapsulate toxicology information on skin cancer unpredictability essential to interpretation measures, report important factor that helps in defining skin cancer condition, and possible medical care alternatives or medical attention endorsed referring to diverse aspects involving the size and site of malignancy, the complications, patient’s priority and well being. We concisely review various therapy alternatives, methods of radiation autoimmunity, prime observational study designs of medical and distinct radiation resources and cancer risks, and current analysis methodologies and research precision.

Conclusion: The detail of this paper covers a brief review of research and evolution in medical imaging discipline and mechanism. This review considers the physiology of melanocytes and the pathogenesis of skin cancer using medical imaging. Also, a description of risk factors, prevention methods, screening, various diagnosis methods and different stages of skin cancer, sub-types and different types of treatment methods is provided in this paper for research and development.

Methods: We searched the literature for studies on Google Scholar and PubMed using the keywords “Segmentation,” “Classification,” “medical image,” and “generative adversarial network.” Specifically, the initial search revealed 5423 publications after the removal of duplicated and non-accessible fulltext publications. Then, after the title and abstract screening, 680 underwent full-text screening. Finally, 121 studies were included in our final analysis after full-text screening.

Results: The date range of the studies covered in this review is from January 1, 2017, to the present. After a thorough screening and qualification assessment, 121 studies involving GAN-based applications in seven areas of medical images were included in the final methodological review. These areas included synthesis, classification, segmentation, conversion, reconstruction, denoising, and lesion detection. We further classified and summarized these papers into clinical applications, classification methods, and imaging modalities.

Conclusion: We thoroughly examined the latest research progress of GAN-based medical image augmentation. These techniques effectively alleviate the challenge of limited training samples for medical image diagnosis and treatment models. Furthermore, several critical issues associated with GANs, such as pattern collapse, instability, and lack of interpretability, require attention in future research.

Objective: To address this problem, this paper proposes a joint model called mSegResRF-SPECT, which accomplishes for the first time the task of classifying whole-body bone scan images on a public SPECT dataset [BS-80K] for the diagnosis of bone metastases.

Methods: The mSegResRF-SPECT adopts a multi-bone region segmentation algorithm to segment the whole body image into 13 regions, ResNet34 as an extractor to extract the regional features, and a random forest algorithm as a classifier.

Results: The experimental results of the proposed model show that the average accuracy, sensitivity, and F1 score of the model on the BS-80K dataset reached SOTA.

Conclusion: The proposed method presents a promising solution for better bone scan classification methods.

Methods: The proposed methodology hinges on a patch antenna operating at 2.4 GHz and a bone phantom housing a simulated fracture, where the antenna is scanned. The collected signals are then processed with Delay-and-Sum (DAS), and Delay-Multiply-and-Sum (DMAS) reconstruction algorithms. The resulting images offer visual insights into the location of fractures.

Results: Through experimentation, the efficacy of the images varies considerably in terms of their capacity for noise and artifact suppression. While DAS exhibits reasonable effectiveness, it suppresses noise and artifacts comprehensively. In contrast, DMAS offers clearer and more precise images of bone fractures.

Conclusion: In summary, the research introduces a cost-effective and non-invasive strategy for detecting bone fractures. By involving a patch antenna at 2.4 GHz, along with image reconstruction algorithms like DMAS and DAS, one can effectively visualize the location of bone fractures. The experimental results highlight the superiority of DMAS over DAS in terms of contrast resolution, making it a highly promising avenue for fracture detection.

Objective: To determine the incidence of residual breast tumors in patients after VAEB and the efficacy of magnetic resonance imaging (MRI) in detecting these tumors.

Methods: This retrospective analysis examined patients who received VAEB before a diagnosis of breast cancer (BC) at our hospital from 2015 to 2019. The incidence of residual tumors after VAEB was determined by MRI and pathological examination. The diagnostic value of MRI in detecting residual tumors was determined for all patients and different subgroups. Logistic regression analysis was used to identify factors associated with residual tumors.

Results: We examined 147 patients and obtained pathological samples from 146 patients, including 103 (70.5%) with residual tumors and 43 (29.5%) without residual tumors. The MRI examinations demonstrated the complete tumor resection rate was 48.9%. Compared to the pathological results, MRI had a positive predictive value of 77.8%, negative predictive value of 48.8%, specificity of 65.6%, and sensitivity of 60.7%. Further analysis indicated that MRI had moderate accuracies for patients with stage pT-1 (71.9%), stage pTNM-IA (73.1%), and luminal B subtype (78.3%). Binary logistic regression analysis showed that the risk of tumor residue correlated with the pathological stage.

Conclusion: Tumor residue is common after VAEB, and MRI has limited accuracy in detecting these residual tumors. However, for small breast tumors and luminal B subtype BC, MRI had higher accuracy in the detection of residual tumors. The risk of tumor residue is closely associated with the pathological stage.

Methods: A total of 25 healthy participants with an average age of 35 years (20 men and 5 women) were selected in April 2022. Thermogram images were captured using a FLIR T series thermal camera. Conventional image processing techniques, such as filtering and edge detection, were used to preprocess thermograms. Next, the level set approach was used with the edge-detected pattern as an input to an automated segmented region of interest (ROI).

Results: Five metrics, namely Dice Coefficient, Tanimoto Index, Jaccard Index, Volume Similarity, and Structural Similarity, were used to assess the performance of the segmentation technique compared to ground truth, which showed 97.5%, 92.5%, 94.5%, 96.5%, and 96.5% correlation, respectively, between the segmented and the ground truth images with average values for both the eyes. Statistical analysis demonstrated that the contralateral portions of the ocular thermograms were significantly different in terms of vascular distribution between the left and right eyes (p < 0.005).

Conclusion: The level set method efficiently segmented the ROI in ocular thermograms with maximum correlation. According to the segmentation’s results, the model showed the dissimilarity between the contralateral parts of the left and right eyes in healthy cases.

Objective: In this study, we introduce a novel approach known as Unsupervised Imbalanced Registration, to address the challenge of data imbalance and prevent overconfidence while increasing the accuracy and stability of 4D image registration.

Methods: Our approach involves performing unsupervised image mixtures to smooth the input space, followed by unsupervised image registration to learn the continual target. We evaluated our method on 4D-Lung using two widely used unsupervised methods, namely VoxelMorph and ViT-V-Net.

Results: Our findings demonstrate that our proposed method significantly enhances the mean accuracy of registration by 3%-10% on a small dataset while also reducing the accuracy variance by 10%.

Conclusion: Unsupervised Imbalanced Registration is a promising approach that is compatible with current unsupervised image registration methods applied to 4D images.

Case Presentation: We report a case of a 63-year-old female who presented with abdominal pain. Abdominal CT Angio and dynamic contrast-enhanced abdominal MRI revealed a mass lesion showing markedly contrast enhancement, no vascular invasion sign, and diffusion restriction lesion in the truncus coelicus bifurcation region. The mass was surgically resected completely. Pathological evaluation showed a hyaline-vascular type of Castleman’s disease.

Conclusion: Castleman's disease should be kept in mind in the differential diagnosis of an isolated intra-abdominal mass.

Methods: In our method, we first verified the effectiveness of the shared matting method for the VHP slices and utilized it to segment a single image. Then, to meet the need for the automatic segmentation of serialized slice images, a method based on the parallel refinement method and flood-fill method was designed. The ROI (region of interest) image of the next slice can be extracted by using the skeleton image of the ROI in the current slice.

Results: Utilizing this strategy, the color slice images of the Visible Human body can be continuously and serially segmented. This method is not complex but is rapid and automatic with less manual participation.

Conclusion: The experimental results show that the primary organs of the Visible Human body can be accurately extracted.

Methods: The preprocessing techniques (smoothing, edge detection, filtering) and segmentation techniques (watershed) are applied to the online data set. The transfer learning technique is used as a classifier whose performance is measured in terms of classification accuracy. Resnet 50, Inception V3VGG16, and VGG19 models are used as classification algorithms. The proposed model is validated using different machine learning techniques considering hybrid features.

Results: 96% accuracy was obtained employing the Inception V3 model & 95% accuracy was attained using hybrid GLDS and GLCM features employing Support Vector Machine algorithm while 93% was attained using Probabilistic Neural Network and k Nearest Neighbor techniques.

Conclusion: Computer-aided systems gave much faster and more accurate results than image processing techniques.1.0% accuracy improvement was observed while using Inception V3 over GLDS + GLCM + SVM and 2.1% accuracy improvement using GLDS + GLCM + SVM over GLDS + GLCM + kNN.

Objective: The study aimed to introduce the application of Raman spectroscopy to tumor detection. We have introduced the current mainstream Raman spectroscopy technology and related application research.

Methods: This article has first introduced the grim situation of malignant tumors in the world. The advantages of tumor diagnosis based on Raman spectroscopy have also been analyzed. Secondly, various Raman spectroscopy techniques applied in the medical field are introduced. Several studies on the application of Raman spectroscopy to tumors in different parts of the human body are discussed. Then the advantages of combining deep learning with Raman spectroscopy in the diagnosis of tumors are discussed. Finally, the related problems of tumor diagnosis methods based on Raman spectroscopy are pointed out. This may provide useful clues for future work.

Conclusion: Raman spectroscopy can be an effective method for diagnosing tumors. Moreover, Raman spectroscopy diagnosis combined with deep learning can provide more convenient and accurate detection results.

Case Study: Herein, we present a case of fibrosarcoma in a 40-year-old male who was presented to the clinic with left-sided great toe pain for 20 years. Simple radiographs showed acrolysis at the distal phalanx of great toe. Magnetic resonance imaging (MRI) revealed a 1.5 cm sized heterogenous high signal intensity mass on T2-weighted images and iso signal intensity on T1- weighted images. Dorsal and distal portion of the mass showed markedly dark signal intensity on T1 and T2-weighted images.

Conclusion: In an enhanced image, the mass showed heterogenous enhancement. Surgical removal was performed and pathologic analysis revealed fibrosarcoma. Although extremely rare, fibrosarcoma of the bone should be kept in mind as a possibility when a lesion exhibits a black signal intensity component on an MRI with acrolysis.

Objective: This study examines the safety and efficacy of thoracoscopic-assisted surgery for the treatment of penetrating chest wall tuberculosis as a means of exploring novel concepts of minimally invasive surgery.

Methods: Our hospital conducted a retrospective study of 25 patients with penetrating chest wall TB who underwent thoracoscopic surgery between January 2020 and June 2021. General demographics, CT scan data linked to surgery, and postoperative patient outcomes were compared between the two groups. The data was also evaluated to determine the range of operation time and the volume of bleeding from different foci in the thoracic cavity.

Results: All procedures went well after patients took conventional antituberculosis medication for at least two weeks prior to surgery. CT scans showed that thoracoscopic surgery needed a smaller incision than traditional chest wall TB surgery, with no discernible increase in surgical time. Postoperative tube use, length of hospital stay, and blood loss were all significantly lower than they would have been with conventional surgery. In addition, thoracoscopy was associated with a significantly reduced rate of subsequent treatment. Fibrous plate development and calcification caused the longest operation times in the thoracoscopic surgery group, whereas multiple pleural tuberculomas generated the most hemorrhage. Thoracoscopic surgery usually reveals tuberculous foci hiding in the thoracic cavity.

Conclusion: Thethoracic surgery can eliminate the TB focus in the chest wall and intrathoracic while treating penetrating chest wall tuberculosis. The CT scan is a crucial part of the diagnostic process for these patients. Minor surgical trauma, low complication and recurrence rates, and good results. There is a greater distinction between the two surgical approaches for patients with penetrating chest wall TB as opposed to those with basic chest wall tuberculosis.

Methods: Multi-parametric MRI images of 136 breast cancer patients were retrospectively analyzed, 95 cases were stratified into the training cohort, and 41 cases were selected for the test group. According to the pathological molecular typing, the patients were divided into 23 cases of triple-negative breast cancer and 113 cases of non-triple-negative breast cancer. ITK software was used to manually delineate the lesion volume region of interest (VOI), and the Pyradiomics package was used to extract radiomic features for screening and model building. The platform was then used to analyze the clinical and imaging risk factors of breast cancer to build a characteristic model separately. Finally, a radiomic nomogram was constructed by integrating the radiomic and independent clinical image features. The diagnostic performance of the model was assessed using ROC curves.

Results: Univariate and multivariate analyses showed that the menstrual cycle, glandular density, and skin thickening were risk factors for clinical imaging characteristics of triple-negative breast cancer. The Area Under the Curve (AUC) was 0.839 and 0.826 for univariate and multivariate analysis, respectively. After screening, 11 radiomic features participated in the calculation of the radiomic score, and its AUC in the test set was 0.803. Combining it further with clinical models, the AUC improved to 0.899.

Conclusion: The radiomic nomogram developed in this study has great value in the diagnosis of triple-negative breast cancer.

Objective: This paper covers the general roadmap of the bioprinting process, different kinds of bioinks, and available bioprinters. The paper also includes designing the anatomical structure, which is the first phase of the bioprinting process, and how AI has facilitated this entire process of 3D printing in healthcare and associated applications like medical modelling and disease modelling.

Methods: The process of 3D bioprinting involves meticulous structure designing of the anatomical structure under study, which forms the base of the entire bioprinting process. One of the significant applications of 3D printing in healthcare is Medical Modelling and Disease Modelling, which requires the detection of disease in anatomy and its delineation from the rest of anatomy for meticulous creation of ROI using sophisticated segmentation software(s) for the construction of 3D models of diseased anatomy and healthy anatomical surroundings.

Conclusion: The study concluded that bioprinting is the future of the worldwide organ transplantation crisis. Anatomical accuracy is an important aspect that must be considered while producing 3D models. The reproduction of patient-specific 3D models requires human rights and ethics approval under four principles of ethics in healthcare: autonomy, non-maleficence, beneficence, and justice.

Case Presentation: This article reports a case of a patient with hormone receptor-positive, HER2-negative breast invasive lobular carcinoma with gastrointestinal tract and skin metastases. The patient was assessed by a second-look ultrasound and diagnosed by subsequent ultrasound-guided needle biopsy. Following endocrine therapy, a favorable effect was observed, with significant regression of the primary breast lesion, cutaneous metastases, and gastrointestinal metastases.

Conclusion: Patients with breast invasive lobular carcinoma should be alert to the possibility of breast cancer metastasis, even if there are no obvious symptoms or signs, when they encounter rapidly progressive cutaneous nodules or plaques, or if they possess gastrointestinal abnormalities. For patients with negative breast ultrasonography for the first time, after combining mammography, Contrast-enhanced Spectral Mammography (CESM) or Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) examinations, if breast cancer is highly suspected, second-look ultrasound is particularly crucial at this juncture, which is the key prerequisite for breast needle biopsy and obtaining the gold standard of pathology.]]> https://www.benthamscience.comarticle/135491Background: The definition of oligometastasis is still controversial. Cytoreductive nephrectomy and metastasectomy are important approaches in selected patients with oligometastasis for improving survival. We aimed to present our laparoscopic metastasectomy experience in a rare case of contralateral adrenal metastasis in an oligometastatic kidney tumor.

Case Report: A 52-year-old male patient was admitted to our clinic with the diagnosis of an incidental right renal mass. On contrast-enhanced abdominal CT revealed a mass reaching approximately 8 cm in diameter in the right kidney located in the middle pole. On contrast-enhanced thorax, CT showed a metastatic lesion in the left main bronchus bifurcation. The patient underwent an open radical nephrectomy with the diagnosis of an oligometastatic right renal mass. His pathology was reported as clear cell renal cell carcinoma (ccRCC). The patient was referred to the medical oncology clinic for immunotherapy. The metastatic lesion in the lung completely regressed in the follow-up of the patient who was started on Chek point inhibitors. However, he was referred to our clinic after an incidental metachronous mass was detected in the contralateral left adrenal in FDG PET/CT (SUVmax: 6.7) in 1st year. Dynamic contrast-enhanced MRI was performed to reevaluate and for mass characterization, and a 4 cm mass was observed in the left contralateral adrenal. Laparoscopic metastasectomy was performed for the left adrenal mass. No recurrence or adrenal insufficiency developed in the 6-month follow-up after discharge.

Conclusion: Transperitoneal adrenalectomy is a minimally invasive method that can be safely performed in metastatic adrenal masses. Although contralateral adrenal metastasis is rare in ccRCC, it should be kept in mind that adrenal metastasis may develop in the late period in patients with a history of renal cancer.

Introduction: The study included the seven most frequently performed investigations, which were carried out on over 1504 patients using digital radiography equipment.

Methods: The X-ray tube's output and exposure parameters were used to calculate the effective dose (ED) and patient entry surface air kerma (ESAK). Additionally, based on these results, conversion coefficients were determined. This study also examined the 75th percentile distributions of ESAK and KAP. The findings of this research were compared with the findings of other researchers throughout the country and the world. The study presents the uncertainty U values, as well as the mean ESAK, KAP, and ED values.

Results: The results of the ESAK, KAP, and ED values were 0.12-5.74 mGy, 0.9-1.84 Gy cm2, and 0.01-0.23 mSv, respectively. As a result, the dosages were much lower than those previously published for the European DRL, national standards, and other studies.

Conclusion: The study concludes that during dose surveys, the importance of detecting and comprehending radiation doses, as well as the proper technique for taking the finest photos possible, can be emphasized to patients in order to assist them in avoiding radioactive particles and radiation exposure.

Aim: This paper aims to define different types of skin cancers, diagnosis procedures and statistics. This paper presents skin cancer statistics over a period of time in India. The increment in the number of skin carcinoma and melanoma cases from 1990 to 2020 as well as the mortality rates, has been presented in this paper. Also, this paper provides a review of different technologies used by researchers in detecting melanoma.

Conclusion: The rise in the number of cases by 2040 and mortality rates are compared. The statistics that are used in this paper are as per hospital-based cancer registries (HBCR) 2021 prepared by the Indian Council of Medical Research - National Centre for Disease Informatics and Research, Bengaluru (ICMR-NCDIR) and from World Health Organization (WHO).

Materials and Methods: Sixty para-vascular VX2 liver tumor models in rabbits were randomly divided into CT-guided microwave ablation group (CT group, n=35) and MR-guided microwave ablation group (MR group, n=35). The complete ablation rate, mean operation time, postoperative complication rate and mean survival time were compared between the two groups.

Results: In the CT group, the rate of complete ablation was 68.6% (24/35), and the mean operation time was 42.1 ± 9.7 minutes. Three cases had ascites and one case had abdominal wall injury. In the MR group, the rate of complete ablation was 94.2% (33/35), and the mean operation time was 53.4 ± 10.9 minutes. One case was complicated with ascites. No serious complications such as pneumothorax, liver abscess, pleural effusion and diaphragm perforation were found in both groups. Between the two groups, the difference in complete ablation rate was statistically significant (P=0.006 < 0.05). A statistically significant difference can also be found in mean operation time (P < 0.01). The follow-up time was 21 days after the operation. As for the postoperative complication rate (11.4% in the CT group and 2.9% in the MR group, P=0.353) and mean survival time (16.9 ± 1.8 days in CT group, 18.3 ± 2.3 days in the MR group, P=0.925), the differences were not statistically significant.

Conclusion: Compared with CT guidance, although the microwave ablation time under MR guidance was longer, the complete ablation rate under MR guidance was high, which proved that MR guidance was a more effective way of microwave ablation guidance and was worth promoting in the clinic. In this experiment, the postoperative complication rate was lower in the MR group, although the difference was not statistically significant, which may be related to the small sample size, and the subsequent study on the postoperative complication rate can increase the sample content.

Case Presentation: In this study, we reported an 83-year-old female patient with ARMM. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) showed uneven thickening of the intestinal wall about 7.0 cm from the anal margin, and no typical T1 high signal was seen on MRI. Dual-energy spectral CT showed that the effective atomic number (Zeff) of the tumor and the iodine concentration in the arterial phase (AP) and venous phase (VP) were different from other rectal malignancies reported in the previous literature. Sigmoidoscopy showed a large polypoid mass approximately 7.0 cm from the anal verge. Immunohistochemical staining showed that about 60% of Melan A and HMB-45 were positive, S-100 protein and Ki-67 were positive, and the pathological diagnosis was ARMM.

Conclusion: This was the first dual-energy spectral CT imaging report of ARMM. The Zeff and iodine concentration in the arterial phase and venous phase could help distinguish between ARMM and other rectal malignancies.

Methods: 613 patients with GDP accrued from January 2013 to December 2021 were classified by column and fracture type based on imaging findings. First, the GDP was categorized into single-, double-, or three-column fractures. Second, the intermediate column fractures were divided into volar, dorsal, split, collapse, or mixed types; the radial column fractures were divided into metaphyseal, articular or mixed types; and the ulnar column fractures were divided into apical or basal types of the styloid process. The intra- and inter-observer consistency between the two assessors was analyzed with kappa statistics. 227 patients with less fracture displacement were treated conservatively, whereas 386 patients with increased fracture displacement were treated surgically, and the selection of surgical approaches and fracture reduction-fixation methods was guided by the classification. The differences in incidence, gender, age, treatment methods, and functional recovery were compared among the three categories, and the characteristics of different types were observed. The wrist joint function was evaluated according to the Sarmiento-modified Gartland- Werley method.

Results: The intra- and the inter-observer kappa coefficients were obtained as ≥ 0.810. There were significant differences in the incidence (12.7%, 68.5%, and 18.8%, respectively) and age (39.8, 46.6, and 47.1 years, respectively) for single-, double- and three-column fractures (P<0.05). However, there was no significant difference in terms of gender among the three (P>0.05). The mixed, collapse, split, dorsal, and volar types accounted for 28.7%, 27.7%, 21.9%, 15.5%, and 4.5%, respectively. The metaphyseal, articular surface, and mixed types accounted for 35.9%, 33.1%, and 31.0%, respectively. The apical and base types were 81.7% and 18.3%, respectively. Among the cases of volar and dorsal types, the missed diagnosis rate of X-ray alone was 28.5%, but it was confirmed by subsequent CT. In the last follow-up of 12.2 months (range, 6 to 24 months), the excellent plus good rate was 82.7% and 82.6%, respectively, in total and among patients undergoing surgical treatment; the excellent plus good rate of the single column fractures was 96.2%, significantly higher than that of double- and three-column fractures (80.0% and 83.5%, respectively) (P<0.05). All patients with fair or poor wrist function had collapse or mixed-type intermediate column fractures.

Conclusion: Different categories/types of GDP have significant differences in terms of incidence, age, efficacy, and prognosis. Imaging classification by column and type of GDP better reflects the features and injury mechanism of the fractures with good consistency. Therefore, it has important reference value for the surgical modality and prognosis evaluation.

Methods: A thorough study of different molecular structures and properties was done using extensive computational analyses and simulations in order to identify compounds with the potential to inhibit ER activity. Diverse chemical libraries were subjected to docking against the target ER-α, and molecules with docking scores less than -8.00 kcal/mol were retained.

Results: Further, these virtual hits were evaluated using 3D-QSAR models for predicting activity. ADME/Tox screening was performed to retain compounds with optimal pharmacokinetic profiles. Six compounds with excellent binding potential predicted biological activity and favorable ADME/Tox profiles were chosen. Prolonged molecular dynamics simulations were conducted to assess structural stability over time.

Conclusion: The computational study on breast cancer on the target ER has yielded significant progress with the identification of six promising compounds that can be further evaluated through experimental validations.

Objective: This study aimed to assess the efficacy of CEUS in LVA surgery and provide a novel approach for the clinical assessment and localization of superficial lymphatic vessels.

Methods: Retrospective analysis of imaging and surgical data was performed on 20 LVA patients. Among them, 10 cases underwent evaluation and localization using indocyanine green (ICG) lymphatic imaging (Group A), while 10 cases were evaluated and localized using CEUS (Group B). The differences in surgical data between the two groups were compared and analyzed.

Results: All 20 patients were female (mean age, 57.7 years ± 6.3 [SD]). CEUS demonstrated superior visualization and localization of superficial lymphatic vessels. The average diameter of lymphatic vessels identified in the CEUS group was significantly greater than that in the ICG group (0.78±0.06 vs. 0.52±0.05mm; P<0.001). The duration of operation in group B was significantly shorter than that in group A (4.47±0.37 vs. 6.70±0.45mm; P<0.001). The number of anastomosed lymphatic vessels in group B was less than that in group A [5.0(4.0, 6.0) vs. 9.5 (9.0, 11.3); P<0.001].

Conclusion: CEUS can serve as a viable alternative to ICG lymphatic imaging, facilitating improved lymphatic venous anastomosis surgery.

Objective: The primary aim of this review was to study and explore the Nano lipid carrier, its advantages, patent preferences, and advancement of NLCs use in nose-to-brain drug delivery.

Methods: The objective of this study was to conduct a literature review on the development of NLC for nose-to-brain drug delivery. The review focused on NLC, its significant role in nose-to-brain delivery, and relevant patents. To achieve this goal, different review articles searched, were studied, and summarized from various sources such as research articles, review articles, books, scientific reports, and patents.

Conclusion: This review article discusses the potential benefits of NLCs in brain-targeting drug delivery through the intranasal route and key aspects of NLCs, including their structure composition, formulation technique, and characterization, which are crucial for developing a reliable drug delivery.

Aim: This research aims to develop computer-aided diagnosis tools for malignant thyroid nodule detection using ultrasound images. This tool will be helpful for doctors and radiologists in the rapid detection of thyroid cancer at its early stages. The individual machine learning models are inferior to medical datasets because the size of medical image datasets is tiny, and there is a vast class imbalance problem. These problems lead to overfitting; hence, accuracy is very poor on the test dataset.

Objective: This research proposes ensemble learning models that achieve higher accuracy than individual models. The objective is to design different ensemble models and then utilize benchmarking techniques to select the best model among all trained models.

Methods: This research investigates four recently developed image transformer and mixer models for thyroid detection. The weighted average ensemble models are introduced, and model weights are optimized using the hunger games search (HGS) optimization algorithm. The recently developed distance correlation CRITIC (D-CRITIC) based TOPSIS method is utilized to rank the models.

Results: Based on the TOPSIS score, the best model for an 80:20 split is the gMLP + ViT model, which achieved an accuracy of 89.70%, whereas using a 70:30 data split, the gMLP + FNet + Mixer-MLP has achieved the highest accuracy of 82.18% on the publicly available thyroid dataset.

Conclusion: This study shows that the proposed ensemble models have better thyroid detection capabilities than individual base models for the imbalanced thyroid ultrasound dataset.

Materials and Methods: A simple ointment base, BP and 5% Ratanjot, and Sesame oil were prepared. All the components, i.e., Guggulu, 5% Ratanjot Sesame oil, and simple ointment base, were added and triturated uni-directionally until a smooth, homogenous mixture was obtained. 25% w/w (F1) and 27% w/w (F2) Guggulu ointment were prepared. Four groups, each with three wistar rats, were studied for fourteen days. On the fourteenth day, rats were sacrificed, and tissues were collected for histopathological studies.

Results: F1 was compared against the standard formulation (10% w/w betadine, Win-Medicare) for excisional wound healing and anti-inflammatory activity in rats. On the foutheenth day, the results for percentage wound contraction in groups 1 (Negative control, vaseline), 2 (Controlled, ointment base), 3 (F1), and 4 (positive control, standard) were found to be 12.01, 25.32, 96.14, and 81.23, respectively. Results of histopathological studies and H&E staining supported the action of F1, as skin sections showed the junction of normal skin and wound area. Sub-epithelial tissues showed low (-) to mild (+) inflammation. Mild oedema (+) was also noted.

Conclusion: The rat group treated with F1 showed maximum wound contraction, healing, and antiinflammatory activity as per percentage wound contraction and histopathological studies.

Objective: The aim of the present review is to discuss the various advantages and limitations of transfersomes and their mechanism to penetration across the skin, as well as their application for the delivery of various drugs like anticancer, antidiabetic, NSAIDs, herbal drugs, and transdermal immunization.

Methods: Data we searched from PubMed, Google Scholar, and ScienceDirect.

Results: In this review, we have explored the various methods of preparation of transfersomes and their application for the delivery of various drugs like anticancer, antidiabetic, NSAIDs, herbal drugs, and transdermal immunization.

Conclusion: In comparison to other vesicular systems, transfersomes are more flexible, have greater skin penetration capability, can transport systemic medicines, and are more stable. Transfersomes are capable of delivering both hydrophilic and hydrophobic drugs, making them suitable for transdermal drug delivery. The developed transfersomal gel could be used to improve medicine delivery through the skin.

Methods: We synthesized EF-AuNps using a direct reduction method and characterized the NPs by employing various techniques, including UV-visible spectroscopy, DLS, XRD, EDX, TEM, and FT-IR. The anti-proliferative activity against MDA-MB-231 cells was assessed using MTT and colony formation assays, alongside evaluating cell viability with PI-FACS and live/dead assays. Furthermore, a Western blot was performed to determine the mechanism of action of EFAuNps in TNBC cells.

Result: We successfully synthesized triangular EF-AuNps (<100nm) and observed a substantial inhibition of cell proliferation (IC₅₀ 18μg/ml). Compared to EF alone, EF-AuNps significantly enhanced cell death in TNBC cells, as confirmed by flow cytometry and viability assays. Besides, Western blot analysis verified that the expression of apoptotic-related signal proteins, such as survivin, caspase 3, and caspase 9, were modulated by EF-AuNps.

Conclusion: EF-AuNps showed higher anti-cancer efficacy than EF in the MDA-MB-231 cell line. These findings suggest the therapeutic potential of EF-AuNps for TNBC treatment, advocating for further preclinical and clinical investigations into this promising anti-cancer formulation.

Morphology : They contain a solid matrix at room temperature and are thought to be superior to many other conventional lipids-based nanocarriers, such as solid lipid nanoparticles (SLNs), nanoemulsions, and liposomes because of their improved stability, drug loading capacity, good biocompatibility, enhanced permeability, bioavailability, extended half-life, fewer side effects, tissue- specific delivery and wide range of potential applications.

Significance : NLCs have multiple applications in the manufacturing of pharmaceuticals and cosmetics due to their ease of preparation, the feasibility of scale-up, non-toxic, improved targeting efficiency and potential for site-specific delivery via various routes of administration.

Scope of Review: This review enlightens about the most recent developments of NLCs as a drug delivery system, types of NLCs, current techniques to prepare NLCs, and characterization techniques that are essential for the development of safe, effective and stable formulation. It also encompasses the potential of using NLCs for various administration routes and recent developments in pharmaceutical applications with successful outcomes.

Conclusion: This review certainly provide great insight into formulation considerations using design experts and modification strategies for improved targeting. On the whole, NLCs are broadly explored and preferred lipid nanocarrier systems with several advantages.

Case Presentation: Herein, we report the case of a 55-year-old woman with breast cancer. She previously underwent extensive excision of the breast lesion with adjuvant chemotherapy and endocrine therapy. After 9 years, she presented with neck discomfort and examination suggested right thyroid metastasis and lymph node metastasis in the neck. Imaging showed pulmonary and bone metastases. Furthermore, the patient received endocrine therapy. After 7 months of follow- up, the patient survived without any new distant metastases. Thyroid metastases originating from breast cancer often unfold with a subtle, intricate nature, making early detection challenging. They tend to emerge inconspicuously, intertwining with widespread systemic metastases, hinting at a less favorable prognosis.

Conclusion: Given the unusual clinical indicators, identifying heterochronic thyroid metastases in patients with tumors poses a distinct challenge, requiring clinicians to navigate the follow-up process with heightened sensitivity. The key lies in timely detection and early intervention, factors that can significantly enhance the overall quality of life for patients.

Objective: The main objective of this review-type paper is to provide a detailed overview of PCOS along with the current concept of a clinical stance in this complex multigenic disorder.

Method : The following databases were used for literature searches: PubMed, Frontiers, Science Direct, Springer, Wiley, and MDPI. For the purpose of finding pertinent articles and contents, the keywords “PCOS; hirsutism; psychological burden; obesity” and others of a similar nature were utilized.

Conclusion: PCOS is a complicated hormonal, metabolic, and psychological condition with many different clinical manifestations. It is among the most prevalent causes of infertility. Before considering any medication choices, lifestyle modifications should be considered the primary therapeutic prescription for PCOS-related infertility. According to recent studies, PCOS does not affect the risk of ovarian or breast cancer, but it does raise the risk of endometrial cancer in women of all ages. These results suggest that PCOS may increase the risk of gynaecological cancer morbidity. The following stage is ovulation stimulation, which is best accomplished with letrozole and is followed by clomiphene citrate. Women who had not responded to the first-line oral ovulatory medicine were given gonadotropins as a backup. Early detection of girls with a high propensity to develop PCOS will be made possible by a comprehensive knowledge of the condition's etiology. Adolescent PCOS will be better managed overall, related comorbidities will be prevented, and quality of life will increase with customized therapeutic approaches.

Method: An introduction to the epidemiology of UTIs and detailed herbal nanoformulation treatment approach through novel intravaginal route is intended through this narrative review. UTIs are associated with significant morbidity and mortality, and they affect the quality of life of the affected patients. Multidrug-resistant bacteria and recurrent UTIs are becoming more common. Development of resistance, adverse effects of antibiotics, and other associated problems lead to establishing the research framework to find out the alternative approaches in controlling UTIs. Antibiotic- free treatments for uncomplicated urinary tract infections UTIs should be used, saving drugs for severe infections. Herbal medication might be used instead of antibiotics for uncomplicated UTIs, in addition to analgesics for purely symptomatic treatment.

Conclusion: This review identifies the pathophysiology of UTI, distinguish the intravaginal route as an alternative to oral delivery route, summarizes the management of urinary tract infections and highlights the anti-uropathogenic and anti-bactericidal effects of herbal approaches to prevent or treat urinary tract infections.

Objective: This review provides a brief overview of the current research status of traditional materials used in glucose sensors. The sensing performance, chemical stability, and environmental properties of nanocellulose-based glucose sensors are compared and summarized based on the three sensing methods: electrochemical sensing, colorimetric sensing, and fluorescence sensing. The article focuses on recent strategies for glucose sensing using nanocellulose as a matrix. The development prospects of nanocellulose-based glucose sensors are also discussed.

Conclusion: Nanocellulose has outstanding structural characteristics that contribute significantly to the sensing performance of glucose sensors in different detection modes. However, the preparation process for high-quality nanocellulose is complicated and has a low yield. Furthermore, the sensitivity and selectivity of nanocellulose-based glucose sensors require further improvement.

Aim: The study aimed to contribute to the development of personalized treatment approaches for individuals with psoriasis.

Objectives: This article explores the types, development, and severity categories of psoriasis, delving into its pathophysiology. It also reviews both conventional and herbal topical therapies and their marketed formulations.

Methods: The article relies on a comprehensive review of existing literature and research studies on psoriasis. Information on types, severity categories, pathophysiology, and available treatments, both conventional and herbal, is gathered and analyzed.

Results: The results highlight the potential advantages of incorporating herbal therapies into treatment plans for individuals with psoriasis, especially for those with severe cases.

Conclusion: In conclusion, the article emphasizes the importance of individualized treatment plans for managing psoriasis. Both conventional and herbal topical formulations can be viable options, particularly for severe cases. By considering the safety profiles, side effects, and biological activities associated with these treatments, healthcare experts can collaborate with patients to create personalized and effective strategies for addressing the complexities of psoriasis management.

Methods: A retrospective observational study was conducted on all children with a haemato-oncology diagnosis or who underwent haematopoietic stem cell transplantation (HSCT) and who were admitted to the Hong Kong Children’s Hospital PICU over a one-year period. Infection characteristics and patient outcomes were evaluated and compared between different sub-groups. Univariable and multi-variable analyses were employed to identify risk factors associated with the development of active infection.

Results: Forty-five (36.3%) of 124 critically ill haemato-oncology admissions to PICU were associated with infections, of which 31 (25%) admissions involved bacterial infections, 26 (20.9%) involved viral infections and 6 (4.8%) involved fungal infections. Bloodstream infection was the most common type of infection. More than half (61.3%) of the bacterial infections were due to an antibiotic-resistant strain. After adjusting for confounding variables, post-HSCT status and neutropenia were significantly associated with active infections.

Conclusion: Infections in critically-ill haemato-oncological patients are associated with post haematopoietic stem cell transplant status and neutropenia. Further study is warranted to review effective strategies that may mitigate the likelihood of infection in this patient population.