Performance evaluation of deep learning techniques for lung cancer prediction

Due to the increase in pollution, the number of deaths caused by lung disease is rising rapidly. It is essential to predict the disease in earlier stages by means of high-level knowledge and acquaintance. Deep learning-based lung cancer prediction plays a vital role in assisting the medical practioners for diagnosing lung cancer in earlier stage. Computer-Aided diagnosis is considered to bring a boost to the field of medicine by tying it to automated systems. In this research paper, several models are experimented by using chest X-ray image or CT scan as an input to detect a particular disease. This research work is carried out to identify the best performing deep learning techniques for lung disease prediction. The performance of the method is evaluated using various performance metrics, such as precision, recall, accuracy and Jaccard index.

Histopathological spectrum of Psoriasiform dermatitis

Background: Psoriasiform dermatitis is a frequently encountered terminology in a wide variety of inflammatory dermatoses. It often poses challenges to both dermatologists and pathologists alike. Clinical features when considered alone may not be reliable, as they vary with both disease duration and treatment. On the contrary, histopathological material constitutes definite hard evidence, which can be preserved and will continue to be available for future review. The objective of the study is to study the histopathological findings in Psoriasiform dermatitis.Materials and Methods: This is a retrospective study in a tertiary care centre in Kerala, South India. All cases diagnosed as Psoriasis or mentioned as one of the differential diagnosis were included. The material included 66 skin biopsies. Patients with a previous diagnosis of the same were excluded from the study.Results: The lesions comprised 9% of the total number of skin biopsies. The age distribution pattern revealed that the highest percentage was in the 41-60 year age group (50%) with a male preponderance of 65%. Psoriasis was the most common lesion (60.60%) and Lichen simplex chronicus was the second most common lesion (10.60 %), encountered in the study.Conclusion: Some of the histopathological features are specific and characteristic for each entity like Psoriasis, Pityriasis rubra pilaris, Pityriasis rosea and Inflammatory linear verrucous epidermal nevus whereas some overlap in lesions like Prurigo nodularis, Lichen simplex chronicus and Allergic contact dermatitis. Hence, combination of proper clinical observation and histopathological study will give a conclusive diagnosis.

Penile pyoderma gangrenosum

A 70-year-old man presented with indurated penile ulcers of 1-month duration. Initial biopsy was reported as chronic ulcer. A repeat biopsy done due to inadequate response to doxycycline showed features of pyoderma gangrenosum. The ulcer healed with a course of steroids and has not recurred till date.

Penile pyoderma gangrenosum

A 70-year-old man presented with indurated penile ulcers of 1-month duration. Initial biopsy was reported as chronic ulcer. A repeat biopsy done due to inadequate response to doxycycline showed features of pyoderma gangrenosum. The ulcer healed with a course of steroids and has not recurred till date.

White lesions in the oral cavity: a clinicopathological study from a tertiary care dermatology centre in kerala, India

CONTEXT

White lesions in the oral cavity may be benign, pre-malignant or malignant. There are no signs and symptoms which can reliably predict whether a leukoplakia will undergo malignant change or not. Many systemic conditions appear initially in the oral cavity and prompt diagnosis and management can help in minimizing disease progression and organ destruction.

AIM

The aim of the paper was to study the clinical and histopathological patterns of white lesions in the oral cavity presented at the study setting and to study the factors associated with the histopathological patterns of the lesions.

SETTINGS AND DESIGN

A hospital based cross-sectional study of patients with white lesions in the oral cavity attending the Department of Dermatology and Venereology, Medical College, Thiruvananthapuram was done.

MATERIALS AND METHODS

After taking a detailed history, microscopic examination of Potassium hydroxide smear and an oral biopsy with histopathologial examination was done.

RESULTS

Out of the 50 patients in the study, clinically the diagnoses made were Lichen planus (32 patients; 64%), Frictional Keratosis (4;8%), Dysplasia (2;4%), Oral Hairy Leukoplakia (1;2%), Pemphigus Vulgaris (2;4%), Cutaneous Lupus Erythematosus (1;2%), Oral Submucous fibrosis (3;6%) and Oral Candidiasis alone (5;10%). Out of the 45 patients who had undergone biopsy, 25 (55.6%) had Lichen planus, 9 (20%) had Frictional Keratosis and mild Dysplasia was found in 4 (8.9%) patients.

CONCLUSION

The measure of agreement between the clinical and pathological diagnosis was only 32%. Older age, difficulty in opening the mouth, consumption of non-smoked tobacco, site of the lesion (gingival, floor of mouth or lingual vestibule) and presence of tenderness on the lesion were significantly associated with Dysplasia.

Determinants of quality of life in psoriasis patients: a cluster analysis of 50 patients

BACKGROUND

Although psoriasis generally does not affect survival, it certainly has a number of major negative effects on patients, demonstrable by a significant detriment to quality of life.

AIMS

We have done a study with the objective of assessing the clinical variables adversely affecting quality of life in patients diagnosed with psoriasis.

MATERIALS AND METHODS

This study is a cluster analysis of 50 consecutive consenting patients with psoriasis, of both sexes, aged over 18 years, attending the dermatology outpatient department of a tertiary care center. We measured the clinical severity using psoriasis area severity index and health-related quality of life using psoriasis disability index (PDI). Statistical analysis was performed using unpaired independent student's t-test, analysis of variance (and Scheffe's post hoc test as appropriate) and Pearson's correlation coefficients.

RESULTS

There was a significant correlation between the physician-rated severity of psoriasis and the extent of impact of psoriasis on physical disability as measured by the PDI. We have identified that a younger age at onset of disease and self-reported stress exacerbators suffer greater disability in most aspects of quality of life.

CONCLUSIONS

On the basis of this study, we would recommend that psoriasis patients especially with severe disease require a more holistic treatment approach that encompasses both medical and psychological measures.

Not just skin deep: a case report of multiple endocrine neoplasia type 1

Multiple endrocrine neoplasia (MEN) type 1 is characterized by mainly a triad of pancreatic, pituitary and parathyroid involvement. This is a case report of a 41-year-old male in whom recognition of collagenoma and gingival papule led to the identification of MEN type 1. Often the recognition of such dermatological manifestations help in the presymptomatic diagnosis of complex syndromes.

A study of oxidative stress in paucibacillary and multibacillary leprosy

BACKGROUND

The study and assessment of oxidative stress plays a significant role in the arena of leprosy treatment. Once the presence of oxidative stress is proved, antioxidant supplements can be provided to reduce tissue injury and deformity.

AIM

To study oxidative stress in paucibacillary (PB) and multibacillary (MB) leprosy and to compare it with that in a control group.

METHODS

Fifty-eight untreated leprosy patients (23 PB and 35 MB cases) were studied and compared with 58 healthy controls. Superoxide dismutase (SOD) level as a measure of antioxidant status; malondialdehyde (MDA)level, an indicator of lipid peroxidation; and MDA/SOD ratio, an index of oxidative stress were estimated in the serum.

RESULTS

The SOD level was decreased in leprosy patients, especially in MB leprosy. The MDA level was increased in PB and MB leprosy. The MDA/SOD ratio was significantly elevated in MB patients. There was a steady increase in this ratio along the spectrum from tuberculoid to lepromatous leprosy (LL).

CONCLUSION

There is increased oxidative stress in MB leprosy, especially in LL. This warrants antioxidant supplements to prevent tissue injury.

Moore Federman syndrome: A rare cause of pseudoscleroderma

The Moore Federman syndrome (MFS) is characterized by short stature, stiffness of the joints, characteristic facies and ocular abnormalities. Herein, we report the case of a 45 year-old lady with short stature, thickening of the skin, stiffness of the joints, typical facies, iridodonesis and cataract since the age of 12 years. She had short digits and no family history of similar illness. To the best of our knowledge, this could be the fourth report of MFS.

Primary cutaneous multifocal CD30+ anaplastic large cell lymphoma

A 45-year-old male presented with asymptomatic tumors all over the body. The tumors showed no signs of ulceration or regression. There were generalized, nontender, firm to hard enlarged lymph nodes without hepatosplenomegaly. Biopsy and immunophenotyping revealed CD 30+ anaplastic primary cutaneous large cell lymphoma. Primary cutaneous anaplastic large cell lymphoma is characterized by single or grouped reddish-brown tumor nodules, which frequently tend to ulcerate. Secondary involvement of lymph nodes is seen in only 25%. The lesions responded dramatically to chemotherapy, but recurred.

Cerebrotendinous xanthomatosis: need for early diagnosis

Cerebrotendinous xanthomatosis is a rare autosomal recessive lipid storage disease characterized by widespread tissue deposition of two neutral sterols, cholestanol and cholesterol, resulting in tendinous xanthomas, juvenile cataracts, progressive neurological defects and premature death from arteriosclerosis. The primary biochemical defect is deficiency of hepatic mitochondrial enzyme sterol-27-hydroxylase which catalyses the hydroxylation of cholestanol (5-alpha dehydro derivative of cholesterol) and this deficiency decreases bile acid synthesis. Substantial elevation of serum cholestanol and urinary bile alcohols with low to normal plasma cholesterol concentration establishes the diagnosis. Cerebrotendinous xanthomatosis is exceptionally rare in the Indian population. We are reporting a woman with this rare disorder, who was on antiepileptic and antipsychotic drugs for a prolonged period and whose original condition went undiagnosed. She presented with xanthomas on the Achilles tendons and the upper end of tibia. She was mentally subnormal and her serum cholestanol level was raised. Her younger sister too was severely affected by this disorder. Early treatment with chenodeoxycholic acid is known to prevent disease progression.

Cerebrotendinous xanthomatosis: Need for early diagnosis

Cerebrotendinous xanthomatosis is a rare autosomal recessive lipid storage disease characterized by widespread tissue deposition of two neutral sterols, cholestanol and cholesterol, resulting in tendinous xanthomas, juvenile cataracts, progressive neurological defects and premature death from arteriosclerosis. The primary biochemical defect is deficiency of hepatic mitochondrial enzyme sterol-27-hydroxylase which catalyses the hydroxylation of cholestanol (5-alpha dehydro derivative of cholesterol) and this deficiency decreases bile acid synthesis. Substantial elevation of serum cholestanol and urinary bile alcohols with low to normal plasma cholesterol concentration establishes the diagnosis. Cerebrotendinous xanthomatosis is exceptionally rare in the Indian population. We are reporting a woman with this rare disorder, who was on antiepileptic and antipsychotic drugs for a prolonged period and whose original condition went undiagnosed. She presented with xanthomas on the Achilles tendons and the upper end of tibia. She was mentally subnormal and her serum cholestanol level was raised. Her younger sister too was severely affected by this disorder. Early treatment with chenodeoxycholic acid is known to prevent disease progression.

Lymphangitic chromoblastomycosis

Chromoblastomycosis (CM), a chronic subcutaneous mycosis, is caused by several dematiaceous fungi, the most common being Fonsecaea pedrosoi. It usually occurs in the lower extremities following traumatic implantation of the organisms. We are reporting a case of chromoblastomycosis on the right lower limb in a sporotrichoid pattern caused by F. pedrosoi. The pattern was probably due to lymphatic spread that seems to be one of the rare presentations. The histopathology showed typical muriform or medlar bodies both intracellularly and extracellularly within the granuloma. Culture revealed sporulating organisms (Cladosporium and Rhinocladiella type) by a combination method, characteristic of F. pedrosoi. Our case responded well to itraconazole.