Abnormal Position Research Articles

Effect of inferior oblique anterior transposition on vertical deviation.

To evaluate the efficacy and complications of simplified graded inferior oblique anterior transposition (IOAT) in treating at least 10 PD vertical deviation in the primary position and inferior oblique muscle overaction (IOOA). This retrospective study reviewed the medical records of 65 patients treated with simplified graded IOAT procedures for both vertical deviation and IOOA. Patients were grouped according to vertical deviation in the primary position. Group 1: vertical deviation of not > 20 PD; the inferior oblique (IO) muscle was fixed 2mm posterior and 2mm temporal to the inferior rectus insertion. Group 2: vertical deviation > 20 PD; the muscle was fixed at the level of insertion of the inferior rectus muscle. Postoperative outcomes in vertical deviation (≤ 5 PD, excellent; 5-10 PD, fair; > 10 PD, poor), IOOA, anti-elevation syndrome (AES), abnormal head position (AHP), V-pattern, and foveal disc angle (FDA) were assessed. Patients were categorized as 43 (53.5% men) in group 1 and 22 (54.5% men) in group 2. IOAT improved vertical deviation, IO muscle function, AHP, V-pattern, and FDA. IOOA decreased from + 2.1 to 0.02 in group 1 and from + 2.4 to 0 in group 2. Mean vertical reduction after IOAT was 12.4 ± 3.8 and 23.8 ± 7.3 PD in groups 1 and 2, respectively. Excellent results were achieved in 83.7% and 77.3% of patients and fair results in 16.2% and 18.2%, respectively. Among the 48 asymmetric DVD patients, 83.8% and 82.3% in groups 1 and 2, respectively, achieved satisfactory results. No AES occurred in two groups. The simplified graded IOAT procedure, which is graded only on the basis of vertical deviation, can achieve satisfactory results for resolving IOOA with vertical deviation or DVD, AHP, V-pattern, and FDA. In addition, the modified procedure of fixing posterior fibers at a slight posterior tilt is clinically instructive in correcting vertical deviation > 20 PD while reducing AES complications.

The role of intrapartum ultrasound combined with free position delivery in the management of abnormal fetal positions during labor

ObjectiveTo investigate the effectiveness of combining intrapartum ultrasound with free maternal positions in managing abnormal labor, specifically focusing on its impact on delivery outcomes.MethodsA retrospective cohort study was conducted on 176 cases of abnormal labor progression in women who attempted vaginal delivery at our hospital from June 2021 to May 2022. Among these, 88 cases were diagnosed with abnormal fetal positions using a combination of intrapartum ultrasound and vaginal examination, and these patients were guided to adopt free maternal positions (experimental group). The control group comprised 88 cases diagnosed with abnormal fetal positions through vaginal examination alone, without any intervention to correct positioning. Maternal and neonatal outcomes, including the duration of the first and second stages of labor, total labor time, cesarean section rates due to failed progression, postpartum hemorrhage, and length of hospital stay, were compared between the two groups.ResultsThe experimental group demonstrated significantly reduced durations of the first and second stages of labor, as well as total labor time, compared to the control group. Furthermore, the rate of cesarean sections due to failed progression was significantly lower in the experimental group. Additionally, the experimental group experienced lower rates of postpartum hemorrhage and shorter hospital stays, with statistically significant differences observed.ConclusionCombining intrapartum ultrasound with free maternal positions shows promise in improving delivery outcomes for women with abnormal fetal positions during labor. These findings highlight the potential benefits of this approach in enhancing the quality of delivery.

AYURVEDIC MANAGEMENT OF SEVERE ADENOIDITIS: A CASE STUDY

Respiratory illness is more common in daily pediatric practice than other systemic diseases. Upper respiratory tract infection accounts for more respiratory problems. Adenoid hypertrophy is found at the age of 3 to 6 years. Viruses or Gram-positive bacteria cause most adenoiditis episodes. Children having adenoiditis present with chronic mouth breathing, nasal obstruction, hypo-nasal speech, repeated cold, loud snoring, abnormal sleep positions, etc. Ayurvedic management plays the most crucial role in Adenoiditis. According to Ayurvedic Chikitsa, Nidan parivarjana and treatment (Nasya) help equally in this case.

PANORAMIC RADIOGRAPHY IN ORTHODONTIC DECISION-MAKING: A FOCUS ON MANDIBULAR THIRD MOLAR IMPACTION

Background:Impaction is defined as the failure of complete eruption of a tooth into a normal functional position within normal time due to lack of space in the dental arch caused by obstruction by another tooth or development in an abnormal position. Radiographic imaging plays a pivotal role in the evaluation, diagnosis, and management planning of third molar impactions. It provides critical information regarding tooth position, angulation, proximity to vital structures, and surrounding bone quality. Objective: Hence present study was conducted to evaluate the pattern of mandibular third molar impaction and also assess the predictive validity of different linear measurements between the impacted and erupted mandibular third molars on digital panoramic radiographs. Method: A comparative cross-sectional study has included 350 subjects from the patients coming to the Department of Oral Medicine and Radiology of NIMS Dental College and Rajasthan Dental College.All participants were exposed to digital panoramic radiograph with SIRONA ORTHOPHOS XG using exposing parameters of 68kvp, 11m PmA, and 18 second/Carestream 8000C. Results:This age group has a relatively high frequency of impaction, with 69 subjects, accounting for 26.54% of the total cases of impaction.The AUC for LES-R is 0.858, indicating a high level of accuracy in predicting mandibular third molar impaction. The p-value (< 0.001) confirms that the result is statistically significant, indicating LES-R is a reliable predictor of impaction.The AUC for LES-Xi is 0.746, which represents a moderate level of accuracy in predicting impaction. The p-value (< 0.001) indicatesstatistical significance, meaning LES-Xi is a useful predictor, though slightly less accurate compared to LES-R.LES-R at the cut-off level of 19.45 mm has moderate sensitivity, indicating that it correctly identifies 61.20% of the impacted molars.The high specificitymeans LES-R accurately identifies 91.08% of erupted molars, minimizing false positives.Overall, LES-R has a high diagnostic accuracy, suggesting it is a reliable tool for predicting impaction, with a better performance in confirming non-impacted cases. Conclusion:Our study provides a comprehensive evaluation of the spatial and angular factors contributing to mandibular third molar impaction, utilizing a robust dataset of linear and angular measurementsby using digital panoramic radiographs.Ultimately, this research supports a more proactive approach to third molar management, aimed at preventing the complications associated with impaction.

Postnatal Outcome After Ultrasound Findings of an Abnormal Fetal Gallbladder: A Systematic Review and Meta-Analysis.

To describe postnatal outcome following the prenatal diagnosis of an abnormal fetal gallbladder. We conducted a systematic review of studies from January 1980 to January 2023 that described FGB abnormalities, which included agenesis or non-visualisation, abnormal content presence of sludge, abnormal shape or size and abnormal position, and postnatal outcome to determine the association with pathology. In 51 studies, 842 fetuses had abnormal FGB. Non-visualisation of the FGB was the most common diagnosis (521 fetuses, mean gestational age 21.6weeks, range 14-29). The FGB was subsequently visualised prenatally in 128 out of 521 cases (24.6%; 95% CI, 20.9%-28.3%). Of the 393 cases with persistent FGB non-visualisation (75.4%; 95% CI, 71.7-79.1), 48 cases (12.2%; 95% CI, 9.0-15.5) underwent termination of pregnancy (TOP) with FGB agenesis confirmed in 16 out of 26 fetuses that had a postmortem examination (61.5%; 95% CI, 42.8-80.2). After excluding cases with missing outcomes (n=121), postnatal ultrasound was performed in 82.4% of cases with persistent non-visualised FGB (224/272; 95% CI, 77.8%-86.9%). The gallbladder was not visualised in 63.4% (142/224; 95% CI, 57.1-69.7), confirming GB agenesis. This was an isolated finding in 41.1% of cases (92/224; 95% CI, 34.6-47.5). Of 272 known outcomes, biliary atresia, cystic fibrosis, and structural or chromosomal abnormalities were diagnosed in 8.5% (n=23), 12.5% (n=34), 18.0% (n=49) and 6.3% (n=17) cases, respectively. The sensitivity (true positive rate) of ultrasound for GB agenesis in fetuses with persistently non-visualised FGB was 58.1% (158/272; 95% CI, 52.2%-64.0%). Fetal gallbladder stones/sludge were described in 100 fetuses mainly in the third trimester of pregnancy (mean gestational age 33.8weeks). Resolution of postnatally followed up cases occurred in around one-third of the cases (37.3%) within 1month after birth. There was a low reported association with severe conditions (2%). This systematic review and meta-analysis found that when the fetal gallbladder was absent in mid-trimester, it was visualised in subsequent fetal ultrasound examinations in around 25% of cases. If persistently absent on prenatal ultrasound, the confirmed rate of GB agenesis was around 50%, with the neonates having biliary atresia, cystic fibrosis, or structural abnormalities. Because of the association with severe conditions, if persistent FGB agenesis is suspected, prenatal diagnosis should be offered. FGB abnormalities such as stones/sludge tended to resolve by 1year of age with around half of all cases resolving by 1month postnatal.

Analysis of Risk Factors and Establishment of a Risk Prediction Model for Severe Postpartum Haemorrhage.

Aims/Background Severe postpartum haemorrhage (PPH) is a dangerous condition, characterized by rapid progression and poor prognosis. It remains the leading preventable cause of maternal death worldwide. This study aimed to investigate the risk factors for severe PPH and establish a prediction model to identify severe PPH early, allowing for early intervention reduce maternal death. Methods Clinical data were collected from 784 patients diagnosed with PPH and delivered at the Second Affiliated Hospital of Anhui Medical University between December 2018 and December 2023. These cases were categorized into the training cohort. Severe PPH was diagnosed in 234 patients based on the criterion of the volume of vaginal bleeding volume exceeding 1000 mL within 24 hours after delivery; these patients were assigned to the experimental group. The remaining 550 patients with nonsevere PPH were assigned to the control group. Data from an additional 338 postpartum women from the same period were selected and classified into the validation cohort. Univariate and multivariate logistic regression analyses were performed to pinpoint the determinants associated with severe PPH. Additionally, these analyses were instrumental for developing and assessing a prediction model to forecast the risk of such complications. Results Most of the PPH cases in this study stemmed from uterine atony, the leading aetiology. The second most common factor was soft birth canal lacerations and haematoma formation, accounting for 7.26% of the subjects in experimental group and 6.55% of those in the control group. Uterine rupture, uterine inversion, and amniotic fluid embolism were exclusively observed in the experimental group. In the univariate analysis, notable disparities were identified across various parameters, including maternal age, gravidity, parity, abortion frequency, gestational week at delivery, prothrombin time (PT), activated partial thromboplastin time (APTT), in vitro fertilisation, foetal position, caesarean delivery, pregnancy with anaemia, and hypertensive disorders of pregnancy (p < 0.05). A multivariate logistic regression model revealed that a parity of two or more, two or more abortions, in vitro fertilisation, gestational weeks at delivery, foetal position, caesarean delivery, pregnancy with anaemia, and hypertensive disorders of pregnancy were independent predictors of severe PPH (p < 0.05). The predictive model demonstrated excellent calibration for the training and validation datasets, with the areas under the curve (AUC) for receiver operating characteristic (ROC) curves measuring 0.799 and 0.759, respectively. Clinical decision curve analysis (DCA) confirmed a significant threshold exceeding 0.9, signifying a substantial net benefit and model precision. Conclusion Parity ≥2 times, abortion ≥2 times, in vitro fertilisation, gestational week at delivery, abnormal foetal position, caesarean delivery, pregnancy with anaemia, and hypertensive disorders of pregnancy are independent risk factors for severe PPH. The predictive model established in this study accurately predicts the occurrence of severe PPH and has significant value for clinical application.

Angle between vein of Galen and straight sinus: a novel marker on microvascular flow imaging for prenatal assessment of tentorium cerebelli position.

Posterior fossa anomalies (PFAs) are associated with a wide spectrum of neurodevelopmental disabilities, with presentation ranging from no obvious clinical symptoms to severe neurodevelopmental delay. The differential diagnosis of fetal PFAs using imaging is crucial for prenatal counseling and prognostic evaluation. Imaging of the tentorium cerebelli (TC) is critical for the differential diagnosis of fetal PFAs; however, achieving this using prenatal grayscale ultrasound is challenging. This study aimed to establish a reference range for a new measurement, the angle between the vein of Galen and the straight sinus (AVGS), measured using microvascular flow imaging, and to evaluate prospectively the effectiveness of AVGS for assessment of the position of the fetal TC. This was a single-center prospective validation study including singleton pregnancies examined between 16 and 38 gestational weeks at Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, between January 2022 and July 2023. AVGS was measured in normal fetuses and used to establish a reference range. AVGS was then used to predict prospectively the position of the TC in 50 fetuses with one or more intracranial malformations, using cut-offs of ≤ 5th centile or ≥ 95th centile to define abnormal AVGS. All intracranial malformations and the position of the TC in these fetuses were confirmed using fetal brain magnetic resonance imaging. The sensitivity, specificity, positive and negative predictive values and likelihood ratios were calculated to assess the performance of AVGS in the prediction of abnormal position of the fetal TC. The study group comprised 602 singleton pregnancies, including 522 normal fetuses and 50 fetuses with an intracranial anomaly. A reference range for fetal AVGS was established. Fetal AVGS decreased with advancing gestational age. Ten of the 50 fetuses with an intracranial anomaly had an abnormally positioned TC. The sensitivity and specificity of AVGS for the prediction of abnormal position of the TC in fetuses with an intracranial malformation were 90.0% (95% CI, 71.4-100.0%) and 95.0% (95% CI, 88.2-100.0%), respectively. The positive and negative predictive values were 81.8% (95% CI, 47.8-96.8%) and 97.4% (95% CI, 84.9-99.9%), respectively, and the positive and negative likelihood ratios were 18.000 (95% CI, 4.590-70.592) and 0.105 (95% CI, 0.016-0.677), respectively. AVGS is a new and useful marker for the prenatal evaluation of fetal TC position. Increased AVGS (≥ 95th centile) suggests an abnormally elevated position of the TC, while decreased AVGS (≤ 5th centile) suggests an abnormally low TC. AVGS is helpful for differential diagnosis in fetuses with PFA and can inform appropriate prenatal counseling. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Ötzi: abnormal arm position possibly to staunch bleeding following arrow injury

Ötzi: abnormal arm position possibly to staunch bleeding following arrow injury

Exploring Testicular Descent: Recent Findings and Future Prospects in Canine Cryptorchidism.

Canine cryptorchidism, manifested by an abnormal testicular position, poses significant health risks and reproductive challenges in affected males. Despite a high prevalence, estimated at up to 10% in the canine population, a comprehensive understanding of its pathogenesis remains elusive. Studies in human cryptorchids and knockout mice have identified key factors involved in testicular descent, including INSL3, RXFP2, and AR. To date, only three DNA variants, found in the RXFP2, HMGA2, and KAT6A genes, have been associated with canine cryptorchidism. This review briefly summarizes current knowledge on testicular descent and the factors that regulate this process, based on cryptorchidism in humans and mice. It also highlights recent findings related to canine cryptorchidism, focusing on the INSL3, HMGA2, and KAT6A genes. The most significant results are discussed, with an emphasis on the role of the epididymis in testicular descent. This report presents insights that may facilitate further research aiming to broaden our understanding of canine cryptorchidism pathogenesis. DNA polymorphism in the KAT6A gene, associated with changes in global H3K9 acetylation, as well as the DNA methylation pattern in the INSL3 gene, suggest that further research should strongly focus on epigenetic modifications. In addition, the development of the epididymo-testicular junction and the link between cryptorchidism prevalence and dog size should be further investigated.

Fetus in the Abdominal Cavity After Uterine Rupture in a Primigravida Post-Adenomyosis Enucleation.

A 35-year-old primigravida with a history of adenomyosis enucleation was diagnosed with abnormal fetal position at 25 weeks of gestation. The patient presented with normal vital signs and no symptoms. A cardiotocogram and transabdominal ultrasound revealed a healthy fetus, normal amniotic fluid volume, and no intra-abdominal bleeding. Pelvic magnetic resonance imaging (MRI) indicated a ruptured muscular layer of the uterine fundus, with the fetus completely prolapsed into the abdominal cavity. An emergency cesarean section was performed, during which the fetus was found wrapped within the amniotic membrane in the abdominal cavity. The uterus exhibited extensive tearing along the line of the previous surgical scar; however, no hemorrhage was observed. In this case, despite uterine rupture, blood flow through the umbilical cord from the placenta in the uterus resulted in the survival of the fetus. In addition, MRI was essential in determining the appropriate timing to save the fetus.

Randomized Clinical Study of Nano-Cerium Oxide and its Efficacy in Sciatic Nerve Regeneration: A Histopathological Evaluation

Background: Peripheral nerve damage is a frequent clinical condition. peripheral nerve injuries are variable, and these injuries are mostly caused by trauma. Blunt trauma has many types, including contusion, laceration, stretching, traction, penetrating and perforating injuries, abnormal sleeping positions, external pressure, internal compression, ischemia. Cerium oxide nanoparticles are used widely in the materials field. Besides their material applications. Objective: this study was examining how cerium oxide nanoparticles impact axonal regeneration of the sciatic nerve in rats. Materials and Methods: 24 adult animals used, weighing average (M±SD: 230 ± 20 g). The animals were separated into two group. The first group (control) was left without treatment, The second group (Nano cerium Oxide) was treated orally with 50 mg of Nano cerium oxide daily for 7 days. Right Sciatic nerve was completely transected in all animals. The result evaluated at 4th, 8th and 12th weeks post-operative. Results: The histopathological results, indicated that the high effective result in the second group, then the control group. The control group has a significant nerve damage and some regenerative signs over time. While there are indications of severe damage particularly at 4 and 8 weeks, then presence of almost normal nerve fibers at 12 weeks suggests partial recovery. Conclusion: Nano Cerium Oxide accelerated the regeneration of the peripheral nerves These findings suggest that this nanoparticle could can be seen as a novel therapy for promoting the regeneration of the nervous system.

MENTOPLASTIA DE AVANÇO PARA CORREÇÃO DE RETRUSÃO MANDIBULAR – RELATO DE CASO.

The article addresses advancement mentoplasty as an effective solution for the correction of mandibular retrusion, a condition characterized by abnormal posterior positioning of the mandible, which has significant aesthetic and functional consequences. In this sense, the objective of this study was to construct a clinical case report, which describes the entire process of planning and performing the surgery in a 24-year-old patient who presented aesthetic complaints due to mandibular retrusion. The methodology used was case report and literature review, using articles published in the last 10 years to corroborate or refute the clinical findings. The surgical intervention involved an intraoral incision, chin osteotomy and fixation with a “Chin” plate with 6mm Advancement – System 2.0 (TRAUMEC).® The postoperative results indicated a significant improvement in facial harmony, in addition to an increase in the patient’s self-esteem. The study discusses the relevance of a detailed preoperative evaluation, emphasizing the importance of personalized surgical planning to ensure the effectiveness of the results. The reviewed literature corroborates the findings of the study, highlighting that advancement mentoplasty not only corrects mandibular retrusion but also improves patients’ quality of life by restoring facial aesthetics. The research contributes to the discussion on orthognathic surgery, reinforcing advancement mentoplasty as a safe and effective technique for the correction of mandibular anomalies, by combining functional and aesthetic aspects in its surgical approach. In addition, the use of three-dimensional technology in planning reinforces the precision and personalization of the treatment, ensuring long-lasting and aesthetically satisfactory results.

Early prediction of placenta accreta spectrum by evaluation of risk factors and ultrasound

IntroductionWe explored the predictive utility of clinical risk factors and first-trimester pregnancy ultrasound signs for severe placenta accreta spectrum.Material and methodsPatients with placenta accreta spectrum treated in our institution between March 1, 2017 and December 31, 2022 were analyzed. The patients were divided into those with mild and those with severe conditions. Univariate analysis was used to determine the clinical risk factors and first trimester ultrasound signs associated with severe placenta accreta spectrum. Receiver operating characteristic curves were drawn and the areas under the curves calculated.ResultsUnivariate analysis revealed significant between-group differences between the groups in the number of cesarean sections, scar pregnancy, low gestational sac position, abnormal placental position, focal exophytic mass and abnormal placental lacunae in placental parenchyma (p &lt; 0.05). The number of cesarean sections and first trimester ultrasound signs predicted severe placenta accreta spectrum, with areas under the curves of 0.66 and 0.75. When the number of cesarean sections was combined with low gestational sac position, the placenta position and related ultrasound signs, the areas under the curves for predicting severe placenta accreta spectrum were 0.78, 0.73, and 0.89, respectively.ConclusionsClinical risk factors and first-trimester ultrasound signs predicted severe placental accreta spectrum and their combinations had even greater clinical utility.

Use of a Microelectromechanical Systems Sensor for Objective Measurements of Abnormal Head Posture in Congenital Superior Oblique Palsy Patients.

The purpose of this study was to design an objective method for measurement of head positions as achieved with use of a microelectromechanical systems (MEMS) sensor. In addition, to use this system to observe the abnormal head position (AHP) in patients with congenital superior oblique palsy (SOP) before and after their surgery. An MEMS sensor was designed for recording of the pitch, roll, and yaw values of the head position in real time. The MEMS sensor was then fixed on the synoptophore from -30 degrees to +30 degrees positions horizontally and vertically to test the accuracy of these measurements. Then, we tested 13 participants with AHP using the MEMS method and the photographic method and compared their correlations. Finally, the pitch, roll, and yaw values of head positions were measured using this MEMS sensor in 31 patients with congenital SOP as performed before and after their surgery. The MEMS sensor (LPMS-B2; Alubi, Guangzhou, China; 400 hertz [Hz]), as based on the theory of a gyroscope, was designed and connected to a smartphone via Bluetooth. It was able to conveniently record the patient's pitch, roll, and yaw head positions in real time, recordings which were consistent with the scales of the synoptophore (P > 0.05) and good correlations with the photographic method (P < 0.001). The main preoperative AHP in patients with SOP was roll (22/31, 71%). Pre- and postoperative vertical deviations were 16.4 ± 7.3 prism diopters (PD) and 4.1 ± 4.2 PD, respectively (P = 0.001). The AHP in patients with SOP was positively correlated with the angle of extorsion in the dominant eye (P = 0.01), rather than that of the vertical deviation. The MEMS sensor described in this report is a simple, practical, and accurate objective device for use in head position measurements. In patients with SOP, the AHP is related to the angle of extorsion in the dominant eye. The MEMS sensor was designed as a micro-wireless dynamic high-precision device for AHP measurement, which has the potential for use in a clinic.

Orthodontic management of severe inversely impacted maxillary central incisors: a case series.

Abnormal positioning and dislocation of the central incisor can disturb tooth eruption. Generally, inversely impacted maxillary central incisors do not erupt naturally. Performing traction and applied extrusion of an inversely impacted maxillary central incisor with a high inclination angle of the crown is challenging. This study aimed to examine the possibility of orthodontic treatment for severely inversely impacted maxillary central incisors in a series of case studies. The inclination angle of the tooth crown, curvature of the tooth root, and length of the formed tooth root were measured using radiography. The teeth were then fenestrated and traction was applied using a lingual arch appliance with elastics. The average crown axis inclination was 113°, the degree of root curvature was 97.3°, and the root formation was 36.1%. Although the crown axis inclination and root curvature were severe, all the incisors were aligned in the correct position as vital teeth through surgical and orthodontic treatments. Traction should be performed in the early period of incisor development when root formation is not progressing, regardless of the tooth angle.

Detection and classification of breast cancer in mammographic images with fine-tuned convolutional neural networks

ABSTRACT Breast cancer is cancer that forms in the cells of the breasts and is a severe health issue that affects many people around the world, especially since it is the most deadly cancer in women. By finding it early and using new treatments, patients can overcome this challenge and get back to a healthier life. This study proposed a procedure to fine-tune the Convolutional Neural Networks (CNN) model with data preprocessing and augmentation in classifying mammogram images called the Hybrid Mammogram Classification and Detection Pipeline (HMCaD). After using CNN for classification because it brings higher confidence in classifying tasks, the YOLOv8 has been applied for localization subtask to detect abnormal positions with predicted bounding boxes. The database is provided by the Mammographic Image Analysis Society (MIAS) and is protected by the United Kingdom. It comprises 330 samples, including 79 benign, 54 malignant, and 207 normal images. As a result, the classification in our model based on the custom EfficientNetB3 model and seam carving technique received a great validation accuracy, test accuracy, and F1 score throughout three scenarios at 96.73%, 97.59%, and 97.58%, respectively. Furthermore, the area under the Receiver Operating Characteristic (ROC) curve also has a surprise result of 0.96 (i.e. AUC = 0.96 ). Moreover, YOLOv8 for detecting abnormal positions in our study achieved 83.22% in Intersection over Union (IoU). This led to the research reaching good results in classifying and detecting breast cancer by considering several performance metrics.

Association of SARS-CoV-2 infection during late pregnancy with maternal and neonatal outcomes

BackgroundLimited data on the impact of the coronavirus disease 2019 (COVID-19) during pregnancy on newborn outcomes are available. This study aimed to characterize and compare the clinical outcomes of newborns from women with and without the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during late pregnancy.MethodThis was a retrospective cohort study of women who were either infected or not infected with the SARS-CoV-2 virus during late pregnancy. The neonatal complications associated with COVID-19-positive pregnant women were investigated and analyzed.ResultsAmong 2063 pregnant women over 28 weeks of gestation, 1.2%, 3.3%, and 18.7% of patients with multiple pregnancies, abnormal fetal positions, and lack of maternal or neonatal follow-up data, respectively, were excluded. Patients who were COVID-19-negative (60.6%) and -positive (16.2%) remained for further analysis. SARS-CoV-2 infection was significantly associated with higher SARS-CoV-2 infection rates in newborns (0% vs. 1.49%, P < 0.01) and longer duration of hospital stay (6.39 ± 2.2 vs. 4.92 ± 1.6, P < 0.01). However, comparing neonatal complications, including Apgar score, preterm birth, low birth weight, cesarean section rate, newborn hearing, neonatal congenital heart defects, and height and weight compliance rate of 6-month-old children, between non-infected and infected participants did not reach statistical significance.ConclusionSARS-CoV-2 infection in late pregnancy has no significant impact on neonatal outcomes. After six months of follow-up of the neonates, we observed that SARS-CoV-2 infection in the third trimester of pregnancy did not affect their growth and development. Hopefully, these findings will guide management strategies and clinical practice.

Retrospective studies and quantitative proteomics reveal that abnormal expression of blood pressure, blood lipids, and coagulation related proteins is associated with hypospadias.

Hypospadias refers to the abnormal position of the male urethral orifice, which not only leads to urination disorder but also causes sexual dysfunction in adulthood. However, the complex and diverse pathogenic factors of hypospadias are still unclear. To study the pathogenesis and prognosis of hypospadias, we counted the serological indexes of children with hypospadias, and found that sSBP, TC and LDL increased in children with mild, moderate and severe hypospadias. Subsequently, we used quantitative proteomics to find differential proteins in mild, moderate and severe hypospadias. After bioinformatics analysis and biochemical experiments on the screened DEPs, we found that the expression of proteins related to immune inflammation, coagulation, blood pressure and inflammation, and blood lipid were differential expressed in the prepuce tissue of children with hypospadias. We further confirmed that the proteins FGB, FGG, SERPINA1, and AGT involved in the angiotensin system, cholesterol metabolism, and coagulation were significantly up-regulated by biochemical experiments. In particular, the AGT protein of the angiotensin system involved in blood pressure regulation, we have shown that it increases with the severity of hypospadias. This study suggests that children with hypospadias are more likely to suffer from hyperlipidemia and cardiovascular disease (CVD). Our findings provide a theoretical basis for early monitoring of blood lipids and blood pressure to prevent CVD in children with hypospadias.

A Unique Positioning of Saphenofemoral Junction: A Case Report and Literature Review

Introduction The saphenofemoral junction (SFJ) serves as a proximal link joining the superficial and deep veins in the lower limbs. Its anatomical position is typically 2.5 cm inferior and 4 cm lateral to the pubic tubercle. This study reports an exceptional case wherein the SFJ was found in the lower thigh. Case presentation A 24-year-old male presented with left leg pain and swelling for five years duration. Clinically, the left lower limb showed noticeable varicose veins. The duplex ultrasound showed several enlarged varicose veins, primarily around the knee. However, the SFJ was observed roughly 15 cm below the pubic tubercle, with a reflux lasting more than four seconds. The patient declined all therapy modalities, and regrettably, he was lost to further follow-up. Literature review No prior reports were found in the literature describing such an abnormal positioning of the SFJ approximately 15 cm below the pubic tubercle. Conclusion In conclusion, while the lower limb veins have various anatomical variations, locating the SFJ in the mid-third of the thigh is rare and has not been documented in the literature.

Scoring System for Evaluating Cosmetic Appearance in Operated Hypospadias Patients

Background: Hypospadias is a common congenital anomaly affecting male infants, characterized by abnormal positioning of the urethral meatus. Surgical correction aims to achieve both functional and cosmetic outcomes.Objective: To evaluate the cosmetic outcomes of hypospadias surgery using a standardized scoring system.Methods: A prospective observational study was conducted at Shaheed Mohtarma Benazir Bhutto Institute of Trauma from January to July 2023, including 154 male infants and young children who underwent primary hypospadias repair.The surgeries performed were Tubularized Incised Plate (TIP) urethroplasty, Onlay Island Flap, and Mathieu repair. Cosmetic outcomes were assessed using the Hypospadias Objective Scoring Evaluation (HOSE) system. Data were analyzed using SPSS version 25.Results: The mean age at surgery was 2.8 years. Distal hypospadias was most common (62%), followed by midshaft (28%) and proximal (10%). TIP urethroplasty had the highest mean HOSE score (15.4 ± 1.0), with 86% achieving satisfactory outcomes. Onlay Island Flap scored 14.9 ± 1.2, and Mathieu repair scored 14.2 ± 1.5. Residual penile curvature was noted in 15% and scarring in 12% of cases.Conclusion: TIP urethroplasty yielded the most favorable cosmetic outcomes in distal hypospadias. Standardized scoring systems are crucial for evaluating surgical success.