Background: Breast cancer is the commonest cancer in women. Ultrasound has a high sensitivity but low specificity in the classification of benign and malignant breast masses. Strain elastography has the potential of increasing the specificity of breast ultrasound in classifying malignant and benign breast masses and reducing the number of benign breast biopsies performed. The diagnostic value of breast elastography in African women is not known.
Objective: The aim of this study was to evaluate the additive diagnostic value of strain elastography to conventional ultrasound in the classification of malignant and benign breast masses in an African population.
Materials and Methods: This prospective study was carried out between August and December 2016 in the Radiology Department, Aga Khan University Hospital, Nairobi. Conventional ultrasound and strain elastography were carried out in 74 breast masses. Histology was used as the refence standard. Mean elasticity scores were compared for malignant and benign masses using the two-sample t test. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for conventional ultrasound, elasticity score, length ratio and combined method were calculated. Receiver operating characteristic (ROC) curve analysis was also performed.
Results: The mean elasticity score of malignant and benign masses was 4.29 (±0.750) and 2.05 (±0.916) respectively. The difference in the mean values was statistically significant (P<0.0001). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 97.1%, 71.8%, 75.6% and 96.6% respectively, for conventional ultrasound and 97.1%, 92.3%, 91.9% and 97.3% respectively, for combined method. Combining elasticity score with conventional ultrasound resulted in a significant increase in the specificity (P value = 0.0012) and PPV (P value = 0.0074) compared to conventional ultrasound alone. The sensitivity and specificity of length ratio was 94.3% and 92.3% respectively compared to 94.3% and 89.7% respectively for elasticity score.
Conclusion: Adding strain elastography to conventional ultrasound significantly improves the specificity and positive predictive value in classifying malignant and benign breast masses in the African population. There was no significant difference between elasticity score and the length ratio.
The discipline of Hadith Studies is one of the richest and exclusive disciplines of knowledge as its branches extend to hundred. The religious scholars had written thousands monographs concerning Hadith interpretations and explana-tions. Many voluminous works appeared and exist and each of them is a commendable contribution to Hadith explanations. One of significant works on Hadith explanations is “Takmila Fath al-Mulhim” that is the result of scholastic efforts of many years by Mufti Muhammad Taqi Usmani. This explanation of Hadith Book Muslim was originated and finished till the “section of Marriage” by Allama Shabbir Ahmad Usmani but he could not extend to it to the last chapter due to his political engagements and later his demise closed the chapter. Molana Muhammad Taqi Usmani completed the remaining works in 18 years & 9 months. His method of interpretation is to decipher complicated, manifold and exotic words at first as the words plays key role in authentication and validity of any connotation. He provides detailed information regarding literal and lexical meaning of a word and then with proper justification and reasoning, he gives preference to someone. He also narrates variation and diversity of meaning attached to any word and proves his standpoint about meanings with allied arguments. This article analyses his method with examples and implications.
Due to inefficient power generation and power distribution, a huge amount of energy is lost. This increases the generating cost and thus makes the overall system unfeasible. In case of renewable energy, inefficient converters are the prime cause of this energy loss. The project specifically addresses a problem related to the inefficiency of the converters that are being used in renewable energy systems. The aim was to design an efficient Isolated DC-DC Boost Converter in order to minimize the power loss and, thus, to improve the efficiency of the overall system. In doing so, a vital role can be played in promoting renewable energy that is quite sustainable and self-sufficient, and thus, playing a small part in reducing the energy deficit in Pakistan. This can have a huge impact on utilizing the renewable energy sources, especially sunlight which is abundantly available in Pakistan