Diagnostic Features Research Articles

Menetrier‘s disease, an uncommon disease and a diagnostic challenge: Case Report

Acquired hypoproteinemic, hypertrophic gastropathy also known as Menetrier’s disease is one of the infrequently encountered disorders in clinical practice. Understanding of the pathogenesis, diagnostic features and course of this disease is important as the symptoms may closely resemble a variety of other conditions like malignancies. one of the case control studies, the disease is found to be associated with increased mortality and can predispose to adenocarcinoma

The morphology of the preimaginal stages of Choreutis muhabbet Koçak, 2008 (Choreutidae, Lepidoptera)

This work presents the first description of the last instar larval and pupal morphology of the metalmark moth species Choreutis muhabbet Koçak, 2008. All diagnostic morphological features are described in detail, and illustrated with photographs and line drawings. Diagnostic features for the genus Choreutis (Hübner) based on the described last instar larvae and pupae, are proposed and discussed. We compare the description of larval and pupal morphology of C. muhabbet to known morphological features of the preimaginal stages of other Choreutis species, especially with Choreutis pariana (Clerck).

Aquatic Angiosperms of Jaunpur

The present paper deals with an investigation of aquatic angiosperms of Jaunpur District. Geography, climate and ecological classification of the species along with diagnostic features and phenology are described. In all, 127 species representing 91 genera and 44 families have been recorded.

Description of a new whitefly genus and two new species (Hemiptera: Aleyrodidae) from the Western Ghats and Andaman Islands, India

Cerafilum gen. nov. is described for Cerafilum ochlandrae sp. nov. and Cerafilum saddlense sp. nov., from India and colonising bamboo species. Cerafilum gen. nov. is compared with the allied genus Aleuromarginatus Corbett and Setaleyrodes Takahashi and diagnoses and illustrations provided, including habitus, line drawings of holotype, diagnostic characteristics, types’ images and scanning electron microscope microphotographs.

Intraspecific karyotypic variability among 12 Indian accessions of Momordica charantia L. (bitter gourd): a medicinally important vegetable crop

Abstract Bitter gourd is a highly nutritious vegetable and important medicinal plant of economic importance. The present study is focused on cytogenetical characterization of 12 accessions of bitter gourd from different parts of India, aiming to differentiate their karyotypes and outline diagnostic features of the chromosomes within each accession's haploid complement. All the accessions possess 2n = 22 numbers of chromosomes. The chromosomes mainly were metacentric (16‒22 chromosomes), and the presence or absence of sub-metacentric (0‒6 chromosomes) chromosomes. The length of the chromosomes varied from 0.83 to 1.93 μm among the accessions studied. Significant differences were obtained for the seven intra-chromosomal indices and four inter-chromosomal indices among the accessions. Principal component analysis and unweighted pair group method with arithmetic mean study revealed relatively distant positioning of individuals that advocated intraspecific phylogenetic relationships and higher karyoevolutionary affinity in bitter gourd accessions. In the meiotic study, regular meiotic behaviour indicates genetic stability and a stable sexual cycle in different accessions. The percentage of pollen viability of all the studied accessions was very high (89.41–94.11%), and these accessions can be considered to be good pollinators. The results obtained will guide characterizing the elite genotypes, genotypes management and designing effective breeding programmes and crop improvement programmes.

DIFFERENTIAL DIAGNOSIS OF TUBERCULOSIS AND NON-SPECIFIC PULMONARY INFILTRATS (Lecture)

Following the reformation of healthcare system and the dissolution of the specialty "Phthisiology," the extensive anti-tuberculosis efforts in Ukraine now fall under the purview of family doctors and specialists across various fields. According to the Law of Ukraine “On Overcoming Tuberculosis in Ukraine”, enacted on 14.07.2023 under No. 3269-IX, Paragraph 4 (Article 4), individuals afflicted with tuberculosis or latent tuberculosis infection are entitled to specialized medical care. This includes the treatment of all forms of tuberculosis and associated conditions across a spectrum of healthcare institutions. Compliance with this legal mandate necessitates that doctors of various specialties possess not only proficiency in contemporary tuberculosis treatment methods, which will be facilitated by the regional tuberculosis control center, but also competence in diagnosing tuberculosis in its various presentations. When health issues arise, patients typically seek assistance first from primary care specialists. The “Pulmonary infiltrate syndrome” is an X-ray syndrome characterized by the presence of shadows in the lungs exceeding 1 cm in diameter. There are numerous causes for such changes in the lungs. Given that the lungs are the most common site for tuberculosis, particularly in the form of infiltrative shadows, which may signify not only tuberculosis but also pneumonia, tumors, lung infarction, eosinophilic infiltrate, and other conditions, the question of their differential diagnosis becomes quite relevant. The increasing frequency and subtle clinical presentation of the “Pulmonary infiltrate syndrome” necessitate proficiency in the clinical aspects and diagnosis of its most common manifestations. The key differential diagnostic features that distinguish infiltrative pulmonary tuberculosis from other nonspecific infiltrates include contact with a tuberculosis patient or a history of tuberculosis, often subacute onset, heterogeneous infiltrative shadow in 1, 2, or 6 segments with a connection to the lung root, moderate leukocytosis, lymphopenia, elevated ESR, presence of acid-fast bacilli in sputum or bronchial lavage, specific endobronchitis, positive response to antitubercular therapy, and lack of improvement with other nonspecific treatment methods.

Suicidal thoughts and attempts in a transdiagnostic eating disorder sample: Do diagnostic severity criteria predict risk?

Eating disorders (EDs) are associated with elevated suicide. Low body mass index (BMI) and frequency of purging and binge eating represent severity criteria for EDs and distinguish full-threshold EDs from other specified feeding and eating disorders (OSFED). However, no work has taken a transdiagnostic approach to studying whether severity of these or other features is associated with suicidal ideation (SI) and attempts. We examined diagnostic status, ED features, and SI and attempts in a large, transdiagnostic, community sample of 257 women with EDs and 45 controls without a current or past ED in the United States using the EDs Examination interview and the Structured Clinical Interview for the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). SI and suicide attempts (SA) were elevated in OSFED compared to controls but did not differ between OSFED and full-threshold EDs. Higher BMI predicted increased SI. Number of purging methods, but not frequency, was related to history of SA. Binge episode frequency and size were not significant predictors. OSFED presents with elevated SI and SA, and ED severity criteria that distinguish OSFED from full-threshold EDs do not predict SI or SA. Suicide risk assessments should be implemented universally across EDs in clinical practice.

Post-market surveillance of six COVID-19 point-of-care tests using pre-Omicron and Omicron SARS-CoV-2 variants.

Post-market surveillance of test performance is a critical function of public health agencies and clinical researchers that ensures tests maintaining diagnostic characteristics following their regulatory approval. Changes in product quality, manufacturing processes over time, or the evolution of new variants may impact product performance. During the COVID-19 pandemic, a plethora of point-of-care tests (POCTs) was released onto the Canadian market. This study evaluated the performance characteristics of several of the most widely distributed POCTs in Canada, including four rapid antigen tests (Abbott Panbio, BTNX Rapid Response, SD Biosensor, and Quidel QuickVue) and two molecular tests (Abbott ID NOW and Lucira Check IT). All tests were challenged with 149 SARS-CoV-2 clinical positives, including multiple variants up to and including Omicron XBB.1.5, as well as 29 clinical negatives. Results were stratified based on whether the isolate was Omicron or pre-Omicron as well as by reverse transcriptase quantitative PCR Ct value. The test performance of each POCT was consistent with the manufacturers' claims and showed no significant decline in clinical performance against any of the variants tested. These findings provide continued confidence in the results of these POCTs as they continue to be used to support decentralized COVID-19 testing. This work demonstrates the essential role of post-market surveillance in ensuring reliability in diagnostic tools.IMPORTANCEPost-market surveillance of diagnostic test performance is critical to ensure their reliability after regulatory approval. This is especially critical in the context of the COVID-19 pandemic as the use of point-of-care tests (POCTs) became widespread. Our study focused on four rapid antigen tests (Abbott Panbio, BTNX Rapid Response, SD Biosensor, and Quidel QuickVue) and two molecular tests (Abbott ID NOW and Lucira Check IT) that were widely distributed across Canada, assessing their performance using many SARS-CoV-2 variants, including up to Omicron subvariant XBB.1.5. Overall, we found no significant difference in performance against any variant, reinforcing confidence in their use. As concerns in test efficacy have been raised by news outlets, particularly regarding the BTNX Rapid Response, this work is even more timely and crucial. Our research offers insights into the performance of widely used COVID-19 POCTs but also highlights the necessity for post-market surveillance.

Miyake-jima Anorthite: A Lunar Crustal Material Analog

Abstract: High calcic (~95% anorthite) plagioclase is the key mineral comprising the primary lunar crustal suites that cover over 60% of the Moon’s surface. Pristine crystals of similar high calcic plagioclase are rare occurrences on Earth, which creates a roadblock to using terrestrial material as lunar crustal analogs. We discuss the potential of a particular megacrystic anorthite (An95.51 ± 0.31) occurring in the basaltic lava flows of island arc volcano in Miyake-jima, Japan as an material analog. A comprehensive analytical routine for the Miyake-jima anorthites has been performed to explore intra- and inter-crystalline heterogeneities in terms of major, minor, and trace elements. These anorthites show flat concentration gradients across core profiles for all major elements (Si, Al, Ca, Na), minor elements (Mg, Fe), and most trace elements (La, Ce, Pm, Nd, Eu). Comparing the chemical composition of the samples with that of different lunar crustal suites like ferroan anorthosites, high-magnesium suites, and high alkali suites show that the Miyake-jima anorthites are overlapping or depleted in most minor and trace elements except for a slight enrichment in Li, Ti, Fe, Sr, Eu, Ba, and Pb. Given the low abundance of most trace elements in the Miyake-jima anorthites we can treat this sample suite as a “blank slate”, which provides the opportunity to dope the crystalline matrix with the elements of interest at different levels and use them for geochemical, petrologic, and spectroscopic studies. The lack of typical magmatic zoning and overlapping elemental compositions across the different megacrysts make the Miyake-jima anorthites very well-suited as a lunar crustal material analog. Highly calcic, crystalline anorthite is shown to have unique spectral signatures from less calcic anorthite, and intermediate and sodic compositions of plagioclase feldspar as calcium and iron contents control the wavelength position and shape of the diagnostic spectral features in the thermal infrared region of the electromagnetic spectrum. Thus, near and thermal infrared spectral measurements of the Miyake-jima anorthites highlight the importance of developing chemically and mineralogically consistent terrestrial material analogs for remote sensing studies.

An illustrated list for the Tabanidae (Diptera: Brachycera) from thirteen localities of the São Paulo state and redescription of Catachlorops (Amphichlorops) flavus (Wiedemann)

ABSTRACT The family Tabanidae (Diptera: Brachycera) is composed of flies commonly known as horse flies and deer flies. The family is cosmopolitan and possesses both economic and conservation interests. The females are hematophagous attacking a variety of animals, including cattle, but both females and males from several genera are flower visitors. Despite the fauna of São Paulo being largely explored due to historical factors, several species of Tabanidae in the state are still poorly known. Several are known only from the type series, and information from the literature is limited to old, sometimes inadequate descriptions and drawings. Herein we provide an illustrated list, based on the literature and specimens collected in thirteen localities from São Paulo state. For all the identified specimens we provide high-definition images from different views. Important diagnostic features for each species are supplied to facilitate the identification of the species in the region. We report five new records for São Paulo state: Catachlorops (Amphichlorops) flavus (Wiedemann), Dichelacera rubricosa (Wulp), Leucotabanus sebastianus Fairchild, Phaeotabanus aphanopterus (Wiedemann), Tabanus schadei Fairchild and one for Brazil: D. rubricosa. Also, C. flavus is redescribed along with the description of the male.

Exploring Machine Learning Algorithms for Enhanced Diagnosis of Breast Cancer : A Comparative Study

Breast cancer remains a significant global health concern, necessitating accurate and efficient diagnostic methods for timely intervention and treatment. This study investigates the efficacy of various machine learning algorithms in diagnosing breast cancer based on clinical data. Leveraging a comprehensive dataset comprising demographic information, medical history, and diagnostic features, we employ supervised learning techniques to train and evaluate multiple classifiers. Through a comparative analysis, we assess the performance of popular machine learning algorithms including logistic regression, support vector machines, decision trees, random forests, and neural networks. Evaluation metrics such as accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC-ROC) are utilized to quantify the diagnostic capabilities of each model. Our results demonstrate promising performance across the evaluated algorithms, with some exhibiting superior accuracy and predictive power compared to others. Furthermore, we explore feature importance to gain insights into the characteristics influencing the classification process. This research contributes to the growing body of literature on utilizing machine learning for medical diagnosis, offering valuable insights for developing robust and accurate tools for detecting breast cancer.

Morton's Metatarsalgia: The Current State of the Issue

A typical complaint with Morton's neuroma is a burning paroxysmal pain in the area of the plantar surface of the metatarsal bones with irradiation into the III interdigital space, which forces the patient to take off his shoes and massage the foot in the most inappropriate situations. Given that women are mostly ill, clinical manifestations reduce the quality of life of patients, limit their daily professional and work activities. The paper presents the etiology, pathogenesis and clinical picture of this disease, diagnostic features. A radical method of treatment is surgery, which is relatively simple in technique and consists in dissecting the tissues that compress the nerve and creating optimal conditions for the nerve trunk, preventing its subsequent traumatization.

Smooth muscle hyperplasia in protein kinase C-fused blue naevi: Report of 12 cases.

PKC-fused blue naevi are a recently described group of melanocytic tumours that have distinctive morphological features, including a pigmented epithelioid melanocytoma-like junctional component or a dermal biphasic architecture associating with naevocytoid nests surrounded by dendritic and spindled pigmented melanocytes (so-called 'combined common and blue naevus'). There have been reports of smooth muscle hyperplasia in a hamartoma-like pattern in cases of combined blue naevi without genetic exploration. Herein, we describe 12 cases of protein kinase C (PKC)-fused blue tumours associated with a co-existing smooth muscle hyperplasia, identified from a total of 98 PKC-fused melanocytic tumours. Archived slides of PKC-fused blue naevi with haematoxylin, eosin and phloxin staining, immunohistochemistry and molecular confirmation of a PKC-fusion by fluorescence in-situ hybridisation (FISH) or RNAseq were re-evaluated for identification of notable smooth muscle hyperplasia. Fifty-one of these slides had already been studied in a previous publication from our group. The hyperplasia ranged from hypertrophic arrector pili muscles to extensive horizontal bundles of disorganised fibres constantly associated and limited within a biphasic dermal melanocytic component. At least one arrector pili muscle was always visible within the tumour, with occasionally direct extension of the hyperplastic fibres from the main muscle body. These muscle fibres were devoid of a PKC-fusion signal by FISH. PKC molecules are involved in the regulation of smooth muscle function, offering an explanatory framework. These data suggest incorporating smooth muscle hyperplasia as a diagnostic morphological feature of PKC-fused blue melanocytic tumours.

Systematic review of risk factors, prognosis, and management of colorectal signet-ring cell carcinoma.

Colorectal signet-ring cell carcinoma (CSRCC) is a rare clinical entity which accounts for approximately 1% of all colorectal cancers. Although multiple studies concerning this specific topic have been published in the past decades, the pathogenesis, associated risk factors, and potential implications on treatment are still poorly understood. Besides the low incidence, historically confusing histological criteria have resulted in confusing data. Nevertheless, the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis, highlight the actual interest to synthesize the known literature regarding CSRCC. To provide an updated overview of risk factors, prognosis, and management of CSRCC. A literature search in the MEDLINE/PubMed database was conducted with the following search terms used: 'Signet ring cell carcinoma' and 'colorectal'. Studies in English language, published after January 1980, were included. Studies included in the qualitative synthesis were evaluated for content concerning epidemiology, risk factors, and clinical, diagnostic, histological, and molecular features, as well as metastatic pattern and therapeutic management. If possible, presented data was extracted in order to present a more detailed overview of the literature. In total, 67 articles were included for qualitative analysis, of which 54 were eligible for detailed data extraction. CSRCC has a reported incidence between 0.1%-2.4% and frequently presents with advanced disease stage at the time of diagnosis. CSRCC is associated with an impaired overall survival (5-year OS: 0%-46%) and a worse stage-corrected outcome compared to mucinous and not otherwise specified adenocarcinoma. The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised. Surgery is the mainstay of treatment, although the rates of curative resection in CSRCC (21%-82%) are lower compared to those in other histological types. In case of peritoneal metastasis, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients. CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation. As such, diagnostic modalities and therapeutic approach should be tailored accordingly.

The sequence of acrania–exencephaly–anencephaly (AEAS)- An infrequent case report

Acrania–exencephaly–anencephaly sequence has an incidence of 3.6–5.4 for 10,000 live births and has been reported in literature. Exencephaly, described here is a defect of the neural tube which occurs due to the absence of closure of the neural fold. The main diagnostic ultrasound features include that are characterized by acrania, decreased size of cranial pole in comparison with the chest, irregular cranial surface, with increased amniotic fluid echogenicity due to the damaged brain tissue. Associated with amniotic band syndrome, Pentalogy of Cantrell, limb anomalies and ventral body wall defects. It is incompatible with life. Conducting programs training the budding neuro-sonographers about the knowledge in detection, diagnosis of NTD according to the Carnegie Classification is crucial to look forward in pathogenesis and application in the clinical scenario.

Interpretation of the pathological diagnostic criteria and characteristics of high-grade thyroid follicular-derived carcinoma in the 5th edition WHO classification

The 5th edition WHO classification of thyroid tumors proposed high-grade non-anaplastic thyroid carcinoma, which includes traditional poorly differentiated thyroid carcinoma (PDTC) and differentiated high-grade thyroid carcinoma (DHGTC), with a prognosis between highly differentiated thyroid carcinoma and anaplastic thyroid carcinoma (ATC), in which about 50% of patients do not take radioactive iodine. Therefore, this classification is of great clinical significance. This article interprets the diagnostic criteria and genetic features of high-grade non-anaplastic thyroid carcinoma in 5th edition WHO classification, comparing with ATC.

Molecular Data Confirm Interspecific Limits of Four Alloxysta and One Phaenoglyphis Species of Parasitic Wasps within the Subfamily Charipinae (Cynipoidea: Figitidae)

Molecular Data Confirm Interspecific Limits of Four Alloxysta and One Phaenoglyphis Species of Parasitic Wasps within the Subfamily Charipinae (Cynipoidea: Figitidae)

Chondrosarcoma evaluation using hematein-based x-ray staining and high-resolution 3D micro-CT: a feasibility study

BackgroundChondrosarcomas are rare malignant bone tumors diagnosed by analyzing radiological images and histology of tissue biopsies and evaluating features such as matrix calcification, cortical destruction, trabecular penetration, and tumor cell entrapment.MethodsWe retrospectively analyzed 16 cartilaginous tumor tissue samples from three patients (51-, 54-, and 70-year-old) diagnosed with a dedifferentiated chondrosarcoma at the femur, a moderately differentiated chondrosarcoma in the pelvis, and a predominantly moderately differentiated chondrosarcoma at the scapula, respectively. We combined a hematein-based x-ray staining with high-resolution three-dimensional (3D) microscopic x-ray computed tomography (micro-CT) for nondestructive 3D tumor assessment and tumor margin evaluation.ResultsWe detected trabecular entrapment on 3D micro-CT images and followed bone destruction throughout the volume. In addition to staining cell nuclei, hematein-based staining also improved the visualization of the tumor matrix, allowing for the distinction between the tumor and the bone marrow cavity. The hematein-based staining did not interfere with further conventional histology. There was a 5.97 ± 7.17% difference between the relative tumor area measured using micro-CT and histopathology (p = 0.806) (Pearson correlation coefficient r = 0.92, p = 0.009). Signal intensity in the tumor matrix (4.85 ± 2.94) was significantly higher in the stained samples compared to the unstained counterparts (1.92 ± 0.11, p = 0.002).ConclusionsUsing nondestructive 3D micro-CT, the simultaneous visualization of radiological and histopathological features is feasible.Relevance statement3D micro-CT data supports modern radiological and histopathological investigations of human bone tumor specimens. It has the potential for being an integrative part of clinical preoperative diagnostics.Key points• Matrix calcifications are a relevant diagnostic feature of bone tumors.• Micro-CT detects all clinically diagnostic relevant features of x-ray-stained chondrosarcoma.• Micro-CT has the potential to be an integrative part of clinical diagnostics.Graphical

A new sauropod species from north-western Brazil: biomechanics and the radiation of Titanosauria (Sauropoda: Somphospondyli)

Abstract Titanosaurs were the most diverse sauropod group during the Cretaceous period, with most of its diversity being found during the Late Cretaceous. In this work, Tiamat valdecii, gen. et sp. nov. is described, a new species of basal titanosaur prospected from the Açu Formation (Albian–Cenomanian), Potiguar Basin, Ceará state, north-east Brazil. The new taxon is composed by an associated sequence of anterior to middle caudal vertebrae, being diagnosed by four diagnostic features: a marked accessory tuberosity dorsoventrally developed, located on the prezygapophyses; deeply medioventral excavated articulation facets of prezygapophysis and post-zygapophyses articular facets; presence of developed hypantrum–hyposphene articulations; and short middle centra with a well-marked articular facet for the haemal arch. The phylogenetic analysis reveals that Tiamat valdecii was a basal member of Titanosauria. Tiamat is the first species of Early Cretaceous titanosaur known for the Açu Formation. Biomechanical analysis shows that the tuberosity and excavation of the zygapophyses of the middle caudal vertebrae of Tiamat provide greater stability against shear loads in the amphicoelous vertebrae presented; in addition, they allow greater range of lateral movements without affecting the integrity of the joints. These features may have been an evolutionary alternative for the stability of the middle of the caudal vertebral column. The discovery of T. valdecii in the Açu Formation not only increases the known dinosaur diversity for this unit, but also helps us elucidate part of the first titanosaur radiation.

Clinical Features and Treatment Outcome of Pediatric Acute Promyelocytic Leukemia in Combined Military Hospital, Dhaka

Background: Acute promyelocytic leukemia (APML) is a relatively rare blood disease in children that is highly curable with current treatment strategies. It is a distinct type of AML characterized by chromosomal translocations involving the retinoid acid receptor (RAR-A) gene on chromosome 17. It accounts for 20-25% of all AML cases. The aim of this study was to describe the diagnostic features of pediatric APL and the result with ATRA and ATO based protocol. Methods: It was a descriptive type of cross-sectional study with purposively selected 10 newly diagnosed APML patients treated in the Pediatric Oncology unit of the Department of Pediatrics in CMH Dhaka during the period of 2018 to 2022. Diagnosis of all patients were done by aspirating bone marrow morphology and cytogenetic t(15:17) or t(11:17) transcript. Informed written consent was taken from parents. Data were collected by semi-structured questionnaire and analyzed by Statistical Package for Social Sciences (SPSS version 25). Results: Among 10 respondents median age was 4.2 years with female predominant (60%). Most common clinical presentations at diagnosis were fever (100%), bleeding manifestations (100%), Hepatomegaly (90%) bony tenderness (90%), splenomegaly (70%), and lymphadenopathy (70%). Almost all the patients had low Hb & low platelet count & WBC were variable. Cytogenetic analysis revealed 90% had PML/RARA positive & 30% had FLT3/ITD positive. All of these patients were treated with trans-retinoic acid (ATRA) based treatment, which led to 80% cases ATRA syndrome. Other common toxicities noticed febrile neutropenia (50%), severe headache (30%), hyperpigmented skin (10%), pseudotumor cerebri (10%) and others. There were 10% relapse cases, which later proceeded to relapse protocol and were in remission. The remaining 90% of patients were alive and in remission until the last day of follow-up. Conclusion: With ATRA-based treatment overall survival is good achieved remission and only 10% of patients developed relapse. Bangladesh Armed Forces Med J Vol 56 No (2) December 2023, pp 1-9