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Prevalence of Suspicious Ultrasound Findings in Patients With Mammographic Focal Asymmetry at Aga Khan University Hospital, Nairobi

Thesis Info

Author

Mavuti, Jacqueline Ndunge

Department

Imaging and Diagnostic Radiology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2015

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728063035

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Background: Breast cancer has become the leading cancer in women in both economically developed and developing countries, accounting for 25% of all cancers diagnosed worldwide in 2012. The cornerstone of breast cancer control remains early detection in order to improve outcomes and survival. Thus far the only breast cancer screening method that has proved to be effective is mammography. Although mammography is the mainstay of early detection, a fundamental limitation is its low inherent contrast difference between the soft tissue structures in the breast. Mammographic specificity relies on the ability to distinguish benign from malignant breast lesions based on their margins and morphological features. When breast malignancy presents with subtle mammographic features such as focal asymmetry, its specificity is reduced. Overall, the larger portion of false -negative mammograms comprises of cancers which are visible in retrospect as ‘minimal sign’ cancers. Additional imaging with ultrasound is useful to further characterize areas of mammographic focal asymmetry, and sonographic findings are used to determine the need for subsequent biopsy for histological confirmation. However, mammographic focal asymmetry has historically not been subjected to adequate follow up, and there is limited data in radiology literature regarding ultrasound findings in its evaluation. Objective: To determine the prevalence of suspicious ultrasound findings in patients with mammographic focal asymmetry. Methods: This was a cross-sectional study, whereby women presenting for mammograms at the Radiology Department with a mammographic descriptor of focal asymmetry (as per the American College of Radiology guidelines) and recommendation for additional imaging evaluation with breast ultrasound were consecutively recruited. The whole breast ultrasound images were evaluated for normal and abnormal findings, and allotted a final imaging assessment categorisation using the ACR Breast Imaging – Reporting and Data System (BI-RADS®) ultrasound lexicon. Ultrasound BI-RADS® 1-3 categories were assigned as benign findings, while ultrasound BI-RADS® 4 and 5 were assigned as suspicious findings. A total of 141 patients were enrolled. Analysis: Data collected were entered into a spreadsheet application (Excel for Microsoft Windows, Microsoft Corporation) and analysed using Stata® version 11.2. The proportion of suspicious ultrasound findings in mammographic focal asymmetries was calculated. Results: A total of 141 patients met the eligibility criteria during the study period and were enrolled into the study. The median age was 50 years, with a range of 31 to 79 years. The prevalence of suspicious ultrasound findings in patients with mammographic focal asymmetry was 7.1%. There was equal involvement of right and
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30. Al-Rum/The Byzantines

30. Al-Rum/The Byzantines

I/We begin by the Blessed Name of Allah

The Immensely Merciful to all, The Infinitely Compassionate to everyone.

30:01
a. Alif. Lam. Mim.

30:02
a. The Byzantines have been defeated,

30:03
a. in the nearby land,
b. yet after their defeat, they will be victorious once again over their Persian enemy…..

30:04
a. within a few years -
b. for their affair belongs to Allah - The One and Only God - from beginning to end,
c. and at that time of victory, the believers will celebrate -

30:05
a. It all happens with Allah’s help.
b. HE Helps whoever HE Wills to victory,
c. for HE is The Almighty, The Ever-Compassionate.

30:06
a. This is the firm Promise of Allah,
b. and Allah never breaks HIS Promise,
c. even though most people do not understand it.

30:07
a. They only understand what is apparent in this worldly life,
b. but they are oblivious of the realm of the Hereafter.

30:08
a. Would they never contemplate within themselves so as to emerge from their oblivion?
b. Allah did not create the celestial realm and the terrestrial world, and whatever is between
and beyond them, except in truth, and for a specified term.
c. Even so, many people are disbelievers in the Meeting with their Rabb - The Lord.

30:09
a. Have they never traveled around the world and visited the archaeological sites and seen the fate of those civilizations who were before them?
b. In fact, they were even more powerful than them - such as ‘Ad, Thamud, and Tubba’, and

A Post Structural Inquiry into Female Esl Learners’ Gender Identities at a Public University in Pakistan

The present study investigates how English language learning interacts with the gender identities and roles of female learners at the University of Sindh, Jamshoro, Pakistan. Who learns what and how, is influenced by the learners’ gendered and sexualized identities (Pavlenko, 2004). Language learners have to navigate power relations within the classroom and their specific communities and develop understanding of their limitations and opportunities within these communities. Institutional practices and gender ideologies inhibit their access to networks which in turn affect their linguistic output and interactional opportunities. Within Interpretive epistemological framework eight female learners of final year (fourth year) Linguistics studying at IELL were interviewed and observed twice during one year to gather data for the present study. From the data it appeared that Pakistani females’ access to linguistic resources is mediated by cultural norms and societal expectations. Throughout their academic journeys the learners’ agency remained active due to which they were able to invest in their ESL learning and challenge socially imposed identities on them.

Synthesis of Nanodiamonds for Nanocomposite Applications

The aim of the project is to design and develop a cost-effective and mass productive microplasma facility for the synthesis of Nanodiamonds (NDs) and their composites for the water purification. In order to produce microplasma, electrode assembly consisting of an array of hollow capillary cathode and a stainless steel mesh anode were fitted in a chamber which was attached with a gas flow system. NDs were formed by dissociation of gas mixture using this microplasma facility. Ethanol is chosen as a carbon precursor and argon as a carrier gas. A mixture of ethanol and argon has been dissociated in microplasma to form NDs. However, the addition of hydrogen is to enhance the quenching, etching, and stabilization of NDs. Initially, the focus was to find an effective root for the introduction of hydrogen in microplasma. hydrogen is introduced either directly or indirectly into the microplasma. Availability of high amount of atomic hydrogen and presence of argon makes the indirect dilution more efficient as compared to direct dilution. The next step was to explore the suitable flow rate of indirectly inserted hydrogen as flow rate is an important parameter to control the structure and properties of NDs. Therefore, the experiments were carried out at hydrogen flow rates of 3 and 5 L/min out of which 3 L/min was found to be better as flow rate for as the quality of the NDs are concerned. It was also attempted to produce NDs without the introduction of hydrogen. For this purpose, the experiments were carried out without hydrogen for different argon flow rates ranging from 3 to 9 L/min. Amongst all, 6 L/min appears to be the best flow rate for the growth of smallest size and near stress free NDs. It was established that NDs can be fabricated even without the hydrogen. The synthesized NDs (with and without hydrogen) were characterized by various diagnostic techniques. Raman spectroscopy and X-rays Diffractometer were utilized for structural analysis. Atomic force microscopy was used for surface morphology of NDs. The Optical characterization of NDs has been determined through UV-Visible absorption and Photoluminescence spectroscopy. The details of the functional groups present at the surface of the NDs has been investigated using Fourier Transform Infrared Spectrophotometer. The NDs produced at the optimized carrier gas (argon) flow rate of 6 L/min. are of best quality which were then utilized as a nanofillers to fabricate polymeric and metallic nanocomposites. Polyvinyl Alcohol (PVA) and silver (Ag) are used as polymer and metal matrix, respectively. The purpose of fabrication PVA-NDs and Ag-NDs composites was to utilize them for antibacterial applications PVA-NDs are prepared by solution casting method. XRD confirms that the intensity of PVA diffraction peak decreases with increasing content of NDs. The absence of NDs peak confirmed the homogeneous mixture PVA and NDs. Antibacterial activity has been evaluated against E-coli and S-aureus. PVA-NDs exhibits higher antibacterial activity than PVA. PVA-NDs composite could be a promising candidate for safe antibacterial packaging Silver nanoparticles (Ag-NPs) and Ag- NDs composites have been synthesized by microplasma techniques. Raman spectra confirm the formation of Ag-NPs and it also indicate the presence of both Ag and NDs in Ag-NDs composite. NDs act as seed and increases the Ag+ ion reduction. Thus, a core (NDs) shell (Ag) composite is obtained. Antibacterial activity of Ag-NDs composites have been tested against E-coli and S-aureus. An improvement in antimicrobial properties of Ag- NDs composite as compared to that of Ag has been observed. The enhanced antibacterial activity of the Ag-NDs composite makes it a potential candidate for water purification. Therefore, the water filtrates (fiberglass, cation resin, zeolite, anion resin and sand) were coated with Ag and Ag- NDs composites. XRD and EDX analyses confirm the coating of Ag and Ag-NDs on the filtrates. Tap water has been taken from Sabzazar, Lahore, Pakistan. Physicochemical properties of Tap water before and after incorporation of Ag and Ag-NDs coated filtrate were evaluated by standard methods. NDs reduced the pore size of filtrates. NDs improved the binding of silver to the various filtrates. The decreasing trend of total dissolved, total suspended solids, hardness and turbidity was more pronounced for Ag-NDs composite filtrates as compared to Ag coated filtrates. Antibacterial activity has been performed with black water taken from main sewerage line. Antimicrobial properties of Ag and Ag-NDs coated filtrated black water were investigated using total fecal coliform bacteria. Ag-NDs coating has positive effect antibacterial properties of water.