STUDY DESIGN: A retrospective analysis was conducted on 371 cases at a Nigerian university hospital between 2000 and 2023. Age, gender, site, histological variants, tumor size and duration were analyzed. Statistical analyses included the Shapiro-Wilk test, Mann-Whitney U test, Chi-square test, and Spearman rank correlation analysis.
RESULTS: The median patient age was 30 years (mean age 32.2), with a male-to-female ratio of 1.12:1. 54.7% of cases occurred in young adults (age range 20-39 years). Among the lesions, 11.3% were in the maxilla and 88.7% in the mandible. Patients with mandibular lesions had a median age of 29 years, while those with maxillary lesions had a statistically significantly higher median age of 37.5 years p-value = 0.001. Median tumor size was 36 cm2 for the mandible and 24 cm2 for the maxilla (significant p-value of 0.002). There was no correlation between tumor size, age, or gender. However, there was a significant correlation between tumor size and the duration of the condition.
CONCLUSION: The study concludes that ameloblastoma is more frequent among younger individuals in Nigeria and often presents with larger tumor sizes, emphasizing the need for early detection and intervention.
MATERIALS AND METHODS: This was a single-centre cross-sectional study of 115 women with American College of Radiology (ACR) Breast Imaging-Reporting and Data System (BIRADS) breast density C and D on DBT with breast lesions who underwent AB-MR from June 2018 to December 2021. AB-MR was performed on a 3 T MRI system with an imaging protocol consisting of three sequences: axial T1 fat-saturated unenhanced; axial first contrast-enhanced; and subtracted first contrast-enhanced with maximum intensity projection (MIP). DBT and AB-MR images were evaluated by two radiologists blinded to the histopathology and patient outcomes. Diagnostic accuracy (sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV]) was assessed.
RESULT: Of the 115 women, the mean age was 50.6 years. There were 48 (41.7%) Malay, 54 (47%) Chinese, and 12 (10.4%) Indian women. The majority (n=87, 75.7%) were from the diagnostic population. Sixty-one (53.1%) were premenopausal and 54 (46.9%) postmenopausal. Seventy-eight (72.4%) had an increased risk of developing breast cancer. Ninety-one (79.1%) women had density C and 24 (20.9%) had density D. There were 164 histopathology-proven lesions; 69 (42.1%) were malignant and 95 (57.9%) were benign. There were 62.8% (n=103/164) lesions detected at DBT. All the malignant lesions 100% (n=69) and 35.7% (n=34) of benign lesions were detected. Of the 61 lesions that were not detected, 46 (75.4%) were in density C, and 15 (24.6%) were in density D. The sensitivity, specificity, PPV, and NPV for DBT were 98.5%, 34.6%, 66.3%, and 94.7%, respectively. There were 65.2% (n=107/164) lesions detected on AB-MR, with 98.6% (n=68) malignant and 41.1% (39) benign lesions detected. The sensitivity, specificity, PPV, and NPV for AB-MR were 98.5%, 43.9%, 67.2%, and 96.2%, respectively. One malignant lesion (0.6%), which was a low-grade ductal carcinoma in-situ (DCIS), was missed on AB-MR.
CONCLUSION: The present findings suggest that both DBT and AB-MR have comparable effectiveness as an imaging method for detecting breast cancer and have high NPV for low-risk lesions in women with dense breasts.
METHODOLOGY: This study was conducted in 2 tertiary centres: Hospital Putrajaya (HPJ) and Hospital Universiti Sains Malaysia (HUSM) from February to May 2020. Muslim T1DM patients between ages 8 to18 who intended to fast during Ramadan were given Ramadan-focused education. CGM iPro2® (Medtronic) was used before and during Ramadan, complemented by finger-prick glucose monitoring or self-monitoring of blood glucose (SMBG).
RESULTS: Of the 32 patients, only 24 (12 female) were analysed. Mean age was 13.6 ± 3.1 years old, mean HbAlc was 9.6 ± 1.9% and mean duration of illness was 5.4 ± 3.4 years. Majority (91.7%) were on multiple dose injections (MDI) while only 8.3% were on continuous subcutaneous insulin infusion (CSII). All fasted in Ramadan without acute complications. Retrospective CGM analysis revealed similar results in time in range (TIR), time in hyperglycaemia and time in hypoglycaemia before and during Ramadan, indicating no increased hypoglycaemic or hyperglycaemic events related to fasting. Glycaemic variability before Ramadan as measured by the LBGI, HBGI and MAG, were similar to values during Ramadan.
CONCLUSION: Ramadan fasting among T1DM children and adolescents, by itself, is not associated with short-term glycaemic deterioration. T1DM youths can fast safely in Ramadan with the provision of focused education and regular SMBG.
METHODS: Criteria were set for categorisation of patients as moderate or severe based on resource utilisation. The two methods used for cost computation were (1) cost estimation based on predefined clinical pathways for case management (2) computation of actual costs using patient-level data from retrospective review of all AHT admissions in 2021. Both methods utilised a combination of activity-based and top-down costing according to availability of reference data. Costs are presented in USD.
RESULTS: Costs for 9 severe and 3 moderate cases in 2021 amounted to $70,532.16, of which 93 % was for severe cases. Cost estimate for moderate cases was $2009.88 while actual costs ranged between $749.37-3115.47 (median $1422.76). Cost estimates of $15,125.76-$17,958.18 for severe cases exceeded actual costs of $2195.57-$13,186.03 (median $7379.40) for severe cases due to shorter-than-expected duration of stay, with only 2 who underwent neurosurgical procedures. Major cost contributors were duration of stay, intensive care, ventilation and neurosurgical procedures.
CONCLUSION: Cost comparison utilising predefined treatment standards versus actual patient data which reveals major cost determinants enables refinement of budget allocation. Median medical costs for severe cases which exceeded the monthly income ceilings of low- and middle-income households in Malaysia demonstrate the economic burden of AHT, reinforcing the need to invest in prevention.
PURPOSE: To examine the accuracy of AI-based radiomics in diagnosis, prognosis assessment and predicting the diagnostic value of radiomics for pelvic LN metastasis in cervical cancer patients.
MATERIAL AND METHODS: The study included 118 female patients with 660 LNs and 118 merged LNs. Four imaging histology models-decision tree, random forest, logistic regression, and support vector machine (SVM)-were created in this study. The imaging histology features were extracted from both the independent and merged LN groups. The AUC values for the test sets and the training sets of the four imaging histology models were compared for the independent LN group and the merged LN group. The DeLong test was used to compare the models.
RESULT: The imaging histology prediction model developed in the merged LN group outperformed the independent LN group in terms of test set AUC (0.668 vs. 0.535 for decision tree, 0.841 vs. 0.627 for logistic regression, 0.785 vs. 0.637 for random forest, 0.85 vs. 0.648 for SVM) and accuracy (0.754 vs. 0.676 for decision tree, 0.780 vs. 0.671 for random forest, 0.848 vs. 0.685 for logistic regression, 0.822 vs. 0.657 for SVM).
CONCLUSION: The constructed SVM imaging histology model for the merged LN group might be advantageous in predicting pelvic LN metastasis in cervical cancer.