Aid In Diagnosis Research Articles

Retrospective analysis of prognostic determinants of neonatal hearing loss: an Indian experience in a tertiary care hospital

Background: Childhood hearing impairment is a result of combination of intrauterine environment, perinatal and postnatal factors. The Joint Committee on Infant Hearing (JCIH) has been providing guidelines for early detection of infants with or at risk of hearing loss. In India, UNHSP (Universal neonatal hearing screening program) as a part of NPPCD (National Program for Prevention and Control of Deafness) is a strategy that enables to identify congenital deafness and hearing loss. Methods: Retrospective cross-sectional study was carried out of a database of newborn hearing screening at a tertiary care hospital of New Delhi, India. The screening results, the risk indicators for hearing loss, diagnosis and the prognosis were descriptively analysed. Results: 3640 neonates were included in the study between January 2021 and November 2023. It was observed that, of the 25 babies diagnosed with hearing loss the common risk factors were low birth weight with preterm delivery, hyperbilirubinemia, low birth weight, preterm delivery, NICU stay>05 days and syndromes. Conclusions: UNHSP (Universal Neonatal Hearing Screening Program) aids in early diagnosis of hearing loss using DPOAE (distortion product otoacoustic emission) and BERA (brainstem evoked response audiometry) and significantly reduces the referral rate. Babies with hyperbilirubinemia, preterm delivery and low birth weight have a poor prognosis and are at a higher risk for neonatal hearing loss as per our study. Hearing augmentation in early years of life reduces morbidity and aids better quality of life.

Health-related quality of life in people with HIV from the multicentre CoRIS cohort in Spain: Associated factors and short-term changes over time.

We aimed to describe health-related quality of life (HRQoL), overall and across its dimensions, identify associated factors, and assess changes over time among people with HIV (PWH) from the Spanish multicentre CoRIS cohort. We developed a mobile app to collect HRQoL data every 3 months using the WHOQOL-HIV-BREF questionnaire (31 items across six domains), among PWH followed in CoRIS in 2021-2023. Factors associated with good/very good global HRQoL and with domain-specific mean scores were identified using multivariable logistic and linear regression, respectively. Of 414 PWH (94.2% on antiretroviral treatment, 91.1% virally suppressed), 51.2% reported good/very good HRQoL. Latin American migrants (adjusted OR: 0.60 [95% CI: 0.36; 1.00]), and participants with lower educational level (0.36 [0.21; 0.64]), a previous AIDS diagnosis (0.56 [0.29; 1.11]) and a history of non-AIDS-related cancers (0.40 [0.14; 1.14]) were less likely to report good/very good global HRQoL. The most affected items included sexual satisfaction, forgiveness and blame, sleep and rest, and concerns about the future, with spirituality, religion and personal beliefs as the most affected domain. Latin American origin, lower educational level and shorter (<2 years) or longer (>15 years) time since HIV diagnosis were associated with poorer HRQoL in specific domains. No significant changes in HRQoL were observed after 12 months except slightly higher scores in physical health. Only half of PWH reported good/very good global HRQoL. This highlights the need to develop targeted strategies to improve HRQoL among PWH, focusing on addressing the most affected dimensions and supporting the most vulnerable groups.

Familial Mediterranean fever in Romania: a case report and literature review

Familial Mediterranean Fever (FMF) is a hereditary autoinflammatory disease characterized by recurrent fever and systemic inflammation, most prevalent in Eastern Mediterranean populations. Rare in regions like Romania, FMF presents diagnostic challenges and risks severe complications if untreated. We report a 7-year-old Romanian girl, from a non-classical ethnic background, with recurrent febrile episodes and elevated inflammatory markers. Genetic testing confirmed a homozygous MEFV c.2082G&amp;gt;A (p.Met694Ile) variant. Colchicine therapy reduced flare frequency and normalized inflammatory markers. FMF should be considered in atypical populations with recurrent inflammation. Genetic testing aids diagnosis in non-endemic regions, enabling early colchicine treatment to prevent complications.

A Review on Imaging in Axial Spondyloarthritis: SPARTAN 2024 Annual Meeting Proceedings.

The purpose of this publication is to review the role of imaging in axial spondyloarthritis. These findings were presented at the SPARTAN annual meeting in May 2024. Imaging plays a major role in the diagnosis and monitoring of axial spondyloarthritis. Magnetic resonance imaging (MRI) findings of active inflammatory lesions (bone marrow edema, capsulitis, inflammation in an erosion cavity, enthesitis, fluid in the joint) and structural lesions (erosions, fat lesions, fat metaplasia in an erosion cavity, bone bud, ankylosis) aid in the early diagnosis of axial spondyloarthritis. Recent data strongly suggests that positive imaging of the sacroiliac joint, especially MRI signs of inflammation, can predict axial spondyloarthritis progression and prognosis. Emerging data supports that MRI findings at baseline might play a role in predicting treatment response. This review covered different imaging concepts, including the role of imaging in early diagnosis as well as prediction of progression, prognosis, and treatment response.

Glycosylation gene expression profiles enable prognosis prediction for colorectal cancer

This study developed a prognostic model for patients with colon adenocarcinoma (COAD) based on glycosylation-associated genes. By analyzing TCGA-COAD data, 110 key genes were identified, and a prognostic model incorporating five glycosylation-related genes was constructed. The model exhibits good predictive performance and is significantly associated with clinical features such as age, N stage, M stage, and lymph node count. The prognostic genes are involved in various biological processes and pathways, influence T cell differentiation, and may contribute to CRC development. High-risk patients show a higher degree of immune cell infiltration. This model aids in the early diagnosis, prognosis assessment, and treatment planning for CRC, and offers a direction for further research.

Reversible Manifestations of Hypothyroidism Section causing Diagnostic Dilemma: A Case Series

Hypothyroidism causes a wide spectrum of clinical manifestations, with various signs and symptoms. Some symptoms are common and aid in diagnosis, while the uncommon manifestations may be the sole feature causing diagnostic delays, leading to increased morbidity and mortality. Hereby the authors present a combination of three cases (50-year-old female, 22-year-old female, 56- year-old female): ascites, congenital hypothyroidism and myxoedema coma, respectively. Ascites in hypothyroidism responds to treatment and can help avoid unnecessary investigations; however, since this presentation is rare, clinicians should remain alert for low Serum Ascites Albumin Gradient (SAAG) with high protein ascites. myxoedema coma was diagnosed after excluding cerebrovascular accident, sepsis and dyselectrolytemia, with low body temperature serving as a diagnostic clue. Congenital hypothyroidism should be identified and treated promptly to prevent complications in newborns, as thyroid hormone is crucial for growth and development. Deficiency may lead to severe complications in newborns, so it is essential to rule out other causes. The importance of the present case series lies in the fact that hypothyroidism may present with variable manifestations. It is crucial to identify this hormone deficiency, as replacement with widely available thyroid hormone supplementation can promptly reverse some of the clinical manifestations, thereby aiding in accurate diagnosis and timely management with appropriate therapy.

Dermoscopy 101

ABSTRACT Dermoscopy is a noninvasive diagnostic technique that allows dermatology clinicians to evaluate suspicious skin lesions and determine the need for biopsy. Basal cell carcinomas (BCCs) exhibit distinct dermoscopic features that when accurately identified help aid in diagnosis. This article focuses on the most pathognomonic dermoscopic feature of BCC—arborizing vessels.

Positive signs from the history as an aid for early diagnosis in functional movement disorders: The prospective TASMAN study.

There has been a concerted move in recent times to shift from an exclusionary to a positive diagnosis of functional movement disorders (FMDs). To date, most of the focus has been on defining positive physical signs. Here the focus was on the diagnostic specificity of specific symptoms and patient characteristics. For this prospective cohort study, newly referred patients in the Netherlands and Australia were recruited before their first neurology appointment. Participants completed questionnaires within 2 months prior to their visit at one of the six different clinics. Directly following the first consultation, physicians received a questionnaire about their diagnostic process. Patients were excluded if the diagnosis was not a movement disorder. Univariate and multivariate regression analyses were conducted to identify predictors of FMDs. Subsequently, a predictive model was constructed and assessed using the area under the receiver operating curve. Between 1 March 2021 and 1 March 2023, 465 patients were eligible for inclusion, of whom 171 (37%) had an FMD and 294 (63%) a non-FMD. Distinguishing factors amongst these groups included age at onset, gender, history or family history of a functional and psychiatric disorder, sudden onset, specific triggers, fluctuation patterns throughout the day and over an extended period, pain, fatigue, depression, anxiety and dissociation. Using these, a predictive model was developed, yielding a discriminative accuracy of 88%. Specific symptoms and patient characteristics have high diagnostic discriminative value between FMDs and non-FMDs, providing an additional tool in positive diagnosis.

A Case of Leukemic Retinopathy

This case report describes a 4-year-old male with a known history of acute leukemia, presenting with blurred vision in both eyes following chemotherapy. On examination, the child exhibited central, steady, and maintained vision, with findings suggestive of leukemic retinopathy, including scattered retinal infiltration, vitreous cells, and exudative retinal detachment in both eyes. Leukemic retinopathy, a rare ocular manifestation of leukemia, often arises from the direct infiltration of leukemic cells and is more commonly seen in acute leukemia. Ocular involvement, which may include retinal hemorrhages, cotton wool spots, and tortuous veins, can serve as an indicator of disease progression and affect prognosis. The patient was managed with topical steroids for vitritis and referred to oncology for systemic reassessment. This case highlights the importance of recognizing ocular involvement in leukemia, as the eye can reveal direct signs of leukemic infiltration and aid in early diagnosis or monitoring of relapse. Close collaboration between ophthalmologists and hematologists is crucial for optimizing patient care and improving both visual and overall outcomes.

Adopting random forest for predicting the risk of cerebrovascular disease and diabetes using appropriate database

Random forest is used to predict the possibility of the existence of a cerebrovascular disease subjects curated from the BraVa and diabetes datasets. Towards analyzing and prediction of cerebrovascular diseases, SPSS for realizing the independence and correlation between the various metrics that could contribute to a subject been diagnosed with a cerebrovascular disease. An analysis of the various metrics of the overall vascular size revealed a significant correlation especially between Total Length and Total Number of Branches (R = 0.829, p = 0.000). Metrics like Age, Contraction, Tortuosity, mean bifurcation Angle, mean bifurcation tilt which has implication of a cerebrovascular disease diagnosis according to study was used as the input for the random forest algorithm. The BraVa dataset which is the main datasets for this work was used to train the algorithm and a prediction of either “risky” or “Not risky” with a high accuracy of 100% was recorded. To further test the algorithm, a second datasets from the from the diabetes database which has a high number of subjects was also used to test the algorithm and a high accuracy of 90.256% was recorded. It was determined from the results that machine learning based Random Forest algorithm can be adopted as a prediction method especially on bigger dataset of neuromorphological measurements of neurons and it will aid or facilitate accurate prediction of any form of cerebrovascular disease and also aid in accurate medical diagnosis.

Developing an early detection model for skin diseases using a hybrid deep neural network to enhance health independence in coastal communities

The object of study is a solution for early skin disease diagnosis by integrating hybrid deep neural networks – EfficientNetB7 for Classification and YOLOv8 for detection. The system is designed to classify five skin conditions: Melanoma, Basal Cell Carcinoma (BCC), melanoma is a type of skin cancer that originates from melanocytes, the cells that produce skin pigment, Melanocytic Nevi (NV) Melanocytic nevus is a mole or dark spot on the skin formed due to the accumulation of melanocytes, Benign Keratosis-like Lesions (BKL) is a term for a group of skin changes that resemble keratosis but are non-cancerous, and Seborrheic Keratoses and other benign tumors to enhance the health diagnostics. The problem to be solved in this study revolves around improving early and accurate skin disease diagnosis, particularly in resource-limited or underserved areas and the lack of Accessible Diagnostic Tools and Low Efficiency of Current Diagnostic Methods. The study highlights EfficientNetB7's classification accuracy at 94 % and YOLOv8's means average precision (mAP) of 0.812 for detection. This hybrid system processes skin images efficiently, providing classification and detection outcomes with consistent performance in multiple tests. The results demonstrate that the EfficientNetB7 model achieved an accuracy of 94 % on test data, while YOLOv8 delivered a detection performance with a mean average precision (mAP) of 0.812. The web-based system efficiently processed skin images and provided classification and detection outcomes. Furthermore, integrating EfficientNetB7 and YOLOv8 allowed the skin disease detection system to classify five different diseases and assess malignancy risk. The systems are portable and can be used with minimal setup, making them practical for real-world diagnostic use. The Scope and Practical applications are designed for accessibility in resource-limited settings. The website-based skin disease detection tool provides a user-friendly platform accessible to the public and healthcare providers, especially in underserved areas. Each application's high accuracy and ease of use make them viable aids in early diagnosis, potentially improving healthcare access

Type 1 diabetes genetic risk score variation across ancestries using whole genome sequencing and array-based approaches

A Type 1 Diabetes Genetic Risk Score (T1DGRS) aids diagnosis and prediction of Type 1 Diabetes (T1D). While traditionally derived from imputed array genotypes, Whole Genome Sequencing (WGS) provides a more direct approach and is now increasingly used in clinical and research studies. We investigated the concordance between WGS-based and array-based T1DGRS across genetic ancestries in 149,265 UK Biobank participants using WGS, TOPMed-imputed, and 1000 Genomes-imputed array genotypes. In the overall cohort, WGS-based T1DGRS demonstrated strong correlation with TOPMed-imputed array-based score (r = 0.996, average WGS-based score 0.0028 standard deviations (SD) lower, p < 10− 31), while showing lower correlation with 1000 Genomes-imputed array-based scores (r = 0.981, 0.043 SD lower in WGS, p < 10− 300). Ancestry-stratified analyses between WGS-based and TOPMed-imputed array-based score showed the highest correlation with European ancestry (r = 0.996, 0.044 SD lower in WGS, p < 10− 300) followed by African ancestry (r = 0.989, 0.0193 SD lower in WGS, p < 10− 14) and South Asian ancestry (r = 0.986, 0.0129 SD lower in WGS, p < 10 − 6). These differences were more pronounced when comparing WGS based score with 1000 Genomes-imputed array-based scores (r = 0.982, 0.975, 0.957 for European, South Asian, African respectively). Population-level analysis using WGS-based T1DGRS revealed significant ancestry-based stratification, with European ancestry individuals showing the highest scores, followed by South Asian (average 0.28 SD lower than Europeans, p < 10− 58) and African ancestry individuals (average 0.89 SD lower than Europeans, p < 10− 300). Notably, when applying the European ancestry-derived 90th centile risk threshold, only 0.71% (95% CI 0.41–1.13) of African ancestry individuals and 6.4% (95% CI 5.6–7.2) of South Asian individuals were identified as high-risk, substantially below the expected 10%. In conclusion, while WGS is viable for generating T1DGRS, with TOPMed-imputed genotypes offering a cost-effective alternative, the persistence of ancestry-based variations in T1DGRS distribution even using whole genome sequencing emphasises the need for ancestry-specific or pan-ancestry standards in clinical practice.

Detecting epithelial-mesenchymal transition signaling molecules in cervical epithelial cells aids in the early diagnosis of cervical lesions

BackgroundThis study aimed to investigate the potential utility of Epithelial-mesenchymal transition (EMT) signaling cell detection in the early diagnosis of cervical lesions.MethodsEnrichment of cervical epithelial cells was carried out using a calibrated membrane with 8-μm diameter pores. RNA-in situ hybridization (RNA-ISH) was employed to detect and characterize EMT cells utilizing specific EMT markers.ResultsEMT cells were successfully identified in cervical samples, while none were detected in the healthy control group. Meanwhile, the number of EMT cells is not correlated with either the presence or type of HPV infection. Comparison of diagnostic tests showed the area under the curve (AUC) for HPV DNA tests, Thinprep cytologic tests (TCT), colposcopy and EMT signaling tests to be 0.758, 0.800, 0.889 and 0.992, respectively. A higher detection rate of EMT cells was observed in patients with cervical lesions aged ≥ 45 compared to those aged < 45 years (P < 0.05). In cervical cancer patients, a significantly greater number of EMT cells were found in FIGO stage II than in FIGO stage I (P < 0.05). Notably, epithelial-type EMT cells were detected at significantly higher rates in patients with high-grade squamous intraepithelial lesion (HSIL) and cervical cancer compared to those with low-grade squamous intraepithelial lesion (LSIL).ConclusionsEMT markers demonstrate potential as effective tools for detecting cervical lesions.

UNDERSTANDING SATTVA PAREEKSHA– A COMPREHENSIVE CLINICAL GUIDE TO MENTAL STATUS EVALUATION

Ayurveda, an ancient system of medicine, considers human existence as dependent on the harmonious interac-tion of Shareera (body), Indriya (senses), Sattva (psychic strength) and Atma (spirit). Which Sattva component influences health and illness. Sattva, representing psychic strength (Sattva Bala), bridges the connection between body and soul, facilitating normal sensory function. The assessment of Sattva Bala, crucial in clinical practice, aids in diagnosis, treatment planning and prognostic evaluation by determining an individual's resilience and coping abilities. Therefore, integrating Sattva assessment, including Manasika Bhava evaluation, into clinical protocols is essential to optimise treatment efficacy. Individuals with higher Sattva Gunas demonstrate superior coping abilities, influencing their overall mental well-being and treatment response. According to the National Mental Health Survey of India (2015-16), the prevalence of mental disorders in India is estimated to be around 10-12% of the population. Sattva Bala is important for all individuals who are carrying out any activity, and it can also be assessed in pathological conditions. Whether the pathological condition is related to bodily or psy-chological factors, there will be a disturbance in the sattva that needs to be examined. A non-randomized, cross-sectional survey was conducted across 220 subjects to elicit the significance of Sattva Pareeksha among clini-cians. Discussion was done based on the importance of Sattva Pareeksha and uses of Sattva Pareeksha in clinical practice. This paper aims to critically analyse the concept of Sattva Pareeksha as depicted in Ayurvedic litera-ture, advocating for its systematic integration into clinical protocols to enhance patient care and treatment out-comes. So, in this study, analysis of the role of Sattva Pareeksha in clinical practice will be done.

Gastric Cytology: A Supplement to Early Diagnosis of Gastric Malignancies.

Gastric malignancies are one of the leading causes of morbidity and mortality globally. Rapid accurate interpretation of gastric cytology aids in early diagnosis and management. This study evaluates the utility of gastric cytology in diagnosing gastric malignancies. This retrospective, cross-sectional study was conducted in the Department of Pathology for a period of 3.5 years. The cases with clinical suspicion of gastric malignancy and those who have had both cytology and histopathology examinations were included. Cytology results were reported as positive for malignancy, suspicious for malignancy, atypical cells-favor reactive, and negative for malignancy. The cytology and histopathology results were correlated, and descriptive statistics were used to analyze data. Among 118 patients included in the study, 103 cases were malignant and 15 were nonmalignant. Out of 103 malignant cases, 89 cases were detected in cytology. False positive cases consisted of four gastritis cases with florid reactive atypia and one with moderate dysplasia. False negative cases were of diffuse and intestinal subtypes of adenocarcinoma, followed by non-Hodgkin lymphoma. Sensitivity and specificity were found to be 86.41% and 66.67%, respectively. The positive predictive value is 94.68% with 41.67% negative predictive value and a diagnostic accuracy of 83.90%. Gastric cytology is a reliable screening and diagnostic tool with a high positive predictive value and acceptable sensitivity. Negative cytology in suspected cases of gastric malignancy should always be correlated with biopsy reports. Diffuse type, intestinal type gastric adenocarcinoma and non-Hodgkin lymphoma were the major pitfall on cytology. The cells in the background must be meticulously observed for the malignant features. Gastric cytology is cost-effective and yields rapid diagnosis with a high positive predictive value, sensitivity, and diagnostic accuracy.

MRI Findings in Demyelinating Diseases of the Central Nervous System

Demyelinating diseases of the brain represent a complex group of neurological disorders characterised by the destruction of the myelin sheath surrounding nerve fibres, which disrupts neural transmission and leads to a wide range of neurological deficits1 . This article reviews the pathophysiology, radiologic features, and diagnostic criteria of key demyelinating disorders, including Multiple sclerosis (MS), Neuromyelitis optica, Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), Tumefactive demyelinating lesions, Acute necrotizing encephalopathy, and Krabbe disease. Advanced imaging techniques, particularly Magnetic resonance imaging (MRI), play a crucial role in the identification and differentiation of these diseases. Key MRI findings, such as T2-weighted hyperintense lesions in specific brain regions, contrast enhancement patterns, and lesion evolution, aid in diagnosis and disease monitoring. Radiologists play a vital role in early diagnosis, monitoring treatment response, and detecting complications, thereby guiding clinical management and improving patient outcomes in demyelinating brain diseases.

Anemia in Pregnancy: Mentzer Index as a Predictor for Iron Supplementation Needs

Anemia during pregnancy is a significant public health concern that affects a substantial proportion of women globally, with iron deficiency anemia being the most prevalent form. Effective early diagnosis and intervention are crucial to prevent adverse outcomes for both mothers and infants. The Mentzer Index, a simple calculation derived from the mean corpuscular volume (MCV) and red blood cell (RBC) count, serves as a useful tool to differentiate between iron deficiency anemia and thalassemia, thereby guiding appropriate treatment strategies. By categorizing the type of anemia, healthcare providers can more accurately assess the need for iron supplementation, which is essential for managing iron deficiency anemia but may not be beneficial in cases of thalassemia. The Mentzer Index has gained recognition for its ease of use, especially in resource-limited settings where access to advanced laboratory diagnostics may be restricted. With a straightforward calculation, it allows for rapid screening of pregnant women presenting with anemia symptoms. This index not only aids in timely diagnosis but also supports targeted interventions, ensuring that iron supplementation is administered only to those who truly need it. This targeted approach minimizes the risk of complications associated with unnecessary iron supplementation in individuals with thalassemia or other forms of anemia, highlighting the importance of accurate diagnostic tools in maternal health care. Keywords: Anemia, Pregnancy, Mentzer Index, Iron Supplementation, Iron Deficiency, Thalassemia, Hematological Indices, Maternal Health

How to distinguish spinocerebellar ataxia 27B from late onset cerebellar ataxia: insights from a case-control study.

Spinocerebellar ataxia 27B is the most common genetic late onset cerebellar ataxia (LOCA). However, it commonly overlaps with other genetic LOCA as with the cerebellar form of multiple system atrophy (MSA-C). To pinpoint which clinical signs and symptoms best discriminate between FGF14 + from FGF14 - patients at symptoms' onset. Twenty SCA27B (≥ 250 GAA repeat expansion) patients were retrospectively matched by gender and age at disease onset with 20 negative FGF14 (-) LOCA patients and with 20 MSA-C patients. Clinical features were ranked based on their contribution towards distinguishing between the groups (feature importance ranking). SCA27B patients had significantly higher rates of episodic symptoms, cerebellar oculomotor signs, dysdiadochokinesia, and alcohol intolerance than LOCA-FGF14 - ataxia patients. The lack of autonomic symptoms and MRI signs in SCA27B patients were the most discriminating features from MSA-C. An AUC of 0.87 was obtained if using the "top 3 clinical features model" (episodic symptoms, cerebellar oculomotor signs and dysdiadochokinesia) to distinguish SCAB27 from LCOA FGF14 - . Regarding MRI findings, no significant differences were found between SCA27B and FGF14 - patients, while a positive hot cross buns sign and the presence of brainstem atrophy were key distinguishing features between SCA27B from MSA-C patients (p < 0.005). Our pilot case-control study contributes to the identification of early clinical symptoms to differentiate SCA27B to LOCA patients including FGF14- and MSA-C ones. From a feature perspective, while clinical features are crucial, identifying surrogate biomarkers-such as ocular or gait parameters-could aid in the early diagnosis and follow-up of SCA27B patients.

A Novel Noninvasive Approach, “DrOroscope,” for Early Detection of Dysplasia in Oral Mucosal Lesions: A Cross-sectional Study

Background Oral cancer is a significant global burden in the present scenario, and early detection has critical importance in improving the survival rate. Devices which aid in the early diagnosis of dysplastic lesions noninvasively are necessary to reduce the oral cancer burden and improve the quality of life of the patients. Purpose To evaluate the efficacy of DrOroscope in diagnosing dysplasia in oral mucosal lesions. Methods A cross-sectional study was conducted among 40 individuals clinically diagnosed with oral mucosal lesions from various demographics in Hyderabad. Participants were screened using the DrOroscope device, which detects dysplastic changes via fluorescence imaging analyzed by artificial intelligence algorithms. Based on the image analysis, lesions were categorized as variable, borderline, or severe. Confirmatory biopsies were performed on all examined lesions, with histopathological results as the gold standard. Statistical analyses, including Chi-square tests, Fisher’s exact test, Cohen’s kappa, and receiver operating characteristic (ROC) curve analysis, were conducted using SPSS version 26.0 with a confidence interval at 95% and p &lt; .05 significance. Results DrOroscope exhibited a sensitivity of 100.00% and a specificity of 69.23%. Positive predictive value was 87.10%, negative predictive value was 100.00%, and overall diagnostic accuracy was 90.00%. Cohen’s kappa value for agreement between DrOroscope and biopsy results was 0.752, indicating substantial agreement, and 0.539 for detecting dysplasia levels, indicating moderate agreement. The ROC curve analysis supported these findings, demonstrating excellent diagnostic performance. Conclusion The DrOroscope device is highly sensitive and accurate in detecting dysplastic changes in oral lesions, making it a promising adjunctive noninvasive diagnostic tool, especially in screening larger populations. This aids in the early diagnosis of dysplasia and thus reducing patients’ morbidity. However, further refinement and larger studies are needed to improve agreement with biopsy for grading of dysplasia. Clinical Significance of the Study DrOroscope plays a promising role in the early diagnosis of dysplasia. This can have a huge impact on the treatment plan, thereby improving the quality of life of the patient. Such devices play a crucial role in oral cancer screening programs, thus promoting awareness on early detection of oral cancer and also enhancing the effectiveness of oral cancer prevention.

Is it time to acknowledge intramucosal colorectal carcinoma?

The term 'intramucosal carcinoma' in the colorectum is controversial when used as a synonym for high-grade dysplasia. However, setting clear definitions for this diagnosis (i.e. unequivocal infiltrative growth in the lamina propria, which might be most easily recognized in cases with overt poor differentiation or formation of signet ring cells or tumour budding) allow us to investigate its relevance. We reviewed cases from our archive (1990-2024) and selected 14 true intramucosal carcinomas using our strict histological criteria, excluding high-grade dysplasia and invasive carcinomas. These occur primarily in conventional adenomas and are frequently associated with microsatellite instability (50%). Our study shows a low estimated incidence of intramucosal carcinoma (0.01%) in population screening and highlights the low lymph node risk and the good outcome of patients with intramucosal carcinoma. The rare diagnosis of intramucosal colorectal carcinoma aids in identifying patients at increased colorectal cancer risk, notably those with hereditary syndromes. Standardizing this diagnosis is critical to prevent overdiagnosis and unnecessary treatment.