MyMedR

Displaying all 10 publications

Abstract:

Sort:

Fulltext An accurate rejection model for false positive reduction of mass localisation in Mammogram

Ashwaq Qasem, Siti Norul Huda Sheikh Abdullah, Shahnorbanun Sahran, Rizuana Iqbal Hussain, Fuad Ismail

Pertanika Journal of Science & Technology, 2017;25(106):49-62.
MyJurnal

The false positive (FP) is an over-segment result where the noncancerous pixel is segmented as a cancer pixel. The FP rate is considered a challenge in localising masses in mammogram images. Hence, in this article, a rejection model is proposed by using a supervised learning method in mass classification such as support vector machine (SVM). The goal of the rejection model which is based on SVM is the reduction of FP rate in segmenting mammogram through the Chan-Vese method, which is initialised by the marker controller watershed (MCWS) algorithm. The MCWS algorithm is utilised for segmentation of a mammogram image. The segmentation is subsequently refined through the Chan-Vese method, followed by the development of the proposed SVM rejection model with different window size as well as its application in eliminating incorrect segmented nodules. The dataset comprised of 57 nodules and 113 non-nodules and the study successfully proved the effectiveness of the SVM rejection model to decrease the FP rate.
A Rare Case of Post-Traumatic Cervical Ligamentous Tear Complicated by Vertebral Arteriovenous Fistula (vAVF), with Successful Endovascular Treatment

Fazdlin ARN, Rizuana IH, Ch'ng LS

Diagnostics (Basel), 2023 Aug 16;13(16).
PMID: 37627952 DOI: 10.3390/diagnostics13162693

Post-traumatic vertebral arteriovenous fistula (vAVF) caused by motor vehicle accidents (MVA) is a rare condition in which there is abnormal communication between the vertebral artery and its adjacent veins. In a post-MVA setting, it is commonly associated with vertebral body fracture. In this paper, we report a case of a 19-year-old girl with a complete C2/C3 anterior and posterior ligament tear post MVA without any cervical bony injury. Initial plain computed tomography (CT) cervical scan showed a prevertebral hematoma. A CT angiogram (CTA) raised the suspicion of a pseudo-aneurysm at the right posterior C3 vertebral body. Further imaging with magnetic resonance imaging (MRI) demonstrated traumatic AVF at the C2/C3 level involving the V2/V3 right vertebral artery to the vertebral venous plexus. Digital Subtraction Angiography (DSA) further revealed a transected right vertebral artery at the C2/C3 level with an arteriovenous fistula and an enlarged vertebral venous plexus. The fistulous communication was successfully occluded with coils from a cranial and caudal approach to the transected segment right vertebral artery, with a total of eight coils. Post-MVA vertebral arteriovenous fistula (vAVF) is a rare sequela of vertebral bony injury at the cervical region, and is an even rarer association with an isolated ligamentous injury, whereby endovascular treatment with ipsilateral vertebral artery closure is a feasible treatment of vAVF.
Case Report: Optimum excision with split skin graft closure in the management of penile sebaceous carcinoma

Fam XI, Liu CY, Md Pauzi SH, Rizuana IH

Front Oncol, 2023;13:1095147.
PMID: 37564939 DOI: 10.3389/fonc.2023.1095147

Sebaceous carcinoma (SC) is a rare malignant skin neoplasm derived from the meibomian gland of adnexal epithelium, which is frequently confused with basal cell carcinoma (BCC), exhibiting sebaceous differentiation and commonly found in the head and neck regions. We report a case of penile sebaceous carcinoma, an extremely rare anatomical site for SC. A 68-year-old man presented with a 4-month history of painless, non-healing ulcerated nodules over the left side of the penile shaft. Wedge biopsy showed adenocarcinoma with signet ring differentiation. We proceeded with wide local excision (WLE) of the lesion with the inclusion of the indurated skin and 5 mm of normal margin, followed by primary closure of the scrotal defect and split skin grafting of the penile shaft by using a thigh skin donor. The final histopathological examination revealed sebaceous carcinoma with pagetoid spread. The patient achieved recurrence-free survival without any form of adjuvant therapy after 4 years of follow-up.
Fulltext Comparative Study of Digital Breast Tomosynthesis (DBT) with and without Ultrasound versus Breast Magnetic Resonance Imaging (MRI) in Detecting Breast Lesion

Goh JHL, Tan TL, Aziz S, Rizuana IH

Int J Environ Res Public Health, 2022 Jan 11;19(2).
PMID: 35055581 DOI: 10.3390/ijerph19020759

Digital breast tomosynthesis (DBT) is a fairly recent breast imaging technique invented to overcome the challenges of overlapping breast tissue. Ultrasonography (USG) was used as a complementary tool to DBT for the purpose of this study. Nonetheless, breast magnetic resonance imaging (MRI) remains the most sensitive tool to detect breast lesion. The purpose of this study was to evaluate diagnostic performance of DBT, with and without USG, versus breast MRI in correlation to histopathological examination (HPE). This was a retrospective study in a university hospital over a duration of 24 months. Findings were acquired from a formal report and were correlated with HPE. The sensitivity of DBT with or without USG was lower than MRI. However, the accuracy, specificity and PPV were raised with the aid of USG to equivalent or better than MRI. These three modalities showed statistically significant in correlation with HPE (p < 0.005, chi-squared). Generally, DBT alone has lower sensitivity as compared to MRI. However, it is reassuring that DBT + USG could significantly improve diagnostic performance to that comparable to MRI. In conclusion, results of this study are vital to centers which do not have MRI, as complementary ultrasound can accentuate diagnostic performance of DBT.
Fulltext A rare case of prostate neuroendocrine tumor: A case report

Teh S, Inn FX, Rizuana IH, Wm WM

Front Oncol, 2022;12:1009146.
PMID: 36263212 DOI: 10.3389/fonc.2022.1009146

Small cell prostate neuroendocrine carcinoma (SCPC) is a rare and highly aggressive malignant tumor. We present a case of a 52-year-old Iranian man, presenting with complaints of occasional gross hematuria and perineal pain for 6 months. PSA was 0.8 ng/ml. A digital rectal examination found a huge and hard prostate mass. He underwent a transrectal ultrasound-guided (TRUS) biopsy of the prostate. Histopathology showed high-grade small cell neuroendocrine carcinoma. Immunohistochemical markers were positive for synaptophysin with a Ki67 index of almost 100%. However, CD56 and chromogranin A markers were negative. Magnetic resonance imaging (MRI) of the prostate showed a prostate mass with invasion to the rectum, while contrast-enhanced computed tomography of the thorax, abdomen, and pelvis (CT TAP) ruled out metastasis. A multidisciplinary team discussion was carried out, and a decision was made for concurrent chemotherapy and radiation (cisplatin and etoposide for 4 cycles and 70 Gy, 35 fractions). There is a lack of consensus on the management of SCPC. The main modality of management in advanced (stage IV) disease is chemotherapy. It is a highly aggressive tumor with a poor prognosis and is not responsive to hormonal therapy.
Fulltext Comparison of Mean Glandular Dose between Full-Field Digital Mammography and Digital Breast Tomosynthesis

Teoh KC, Manan HA, Mohd Norsuddin N, Rizuana IH

Healthcare (Basel), 2021 Dec 19;9(12).
PMID: 34946484 DOI: 10.3390/healthcare9121758

Early detection of breast cancer is diagnosed using mammography, the gold standard in breast screening. However, its increased use also provokes radiation-induced breast malignancy. Thus, monitoring and regulating the mean glandular dose (MGD) is essential. The purpose of this study was to determine MGD for full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in the radiology department of a single centre. We also analysed the exposure factors as a function of breast thickness. A total of 436 patients underwent both FFDM and DBT. MGD was auto calculated by the mammographic machine for each projection. Patients' data included compressed breast thickness (CBT), peak kilovoltage (kVp), milliampere-seconds (mAs) and MGD (mGy). Result analysis showed that there is a significant difference in MGD between the two systems, namely FFDM and DBT. However, the MGD values in our centre were comparable to other centres, as well as the European guideline (<2.5 mGy) for a standard breast. Although DBT improves the clinical outcome and quality of diagnosis, the risk of radiation-induced carcinogenesis should not be neglected. Regular quality control testing on mammography equipment must be performed for dose monitoring in women following a screening mammography in the future.
Fulltext Bilateral metachronous breast malignancies: Malignant phylloides and invasive breast carcinoma-a case report

Abdullah N, Rizuana IH, Goh JHL, Lee QZ, Md Isa N, Md Pauzi SH

Front Oncol, 2023;13:1034556.
PMID: 37035170 DOI: 10.3389/fonc.2023.1034556

A 57-year-old Malay nullipara initially presented with a right breast lump that was increasing in size but defaulted follow-up. Two years later, she developed a contralateral breast lump. She only returned to the hospital when the right breast lump had become painful, 4 years from its onset. The biopsy of the right breast lump was a phylloides tumor and that of the left breast lump was a carcinoma. She had bilateral palpable axillary lymph nodes. She underwent bilateral mastectomy and axillary dissection. The pathology report confirmed the right breast lesion to be a malignant phylloides and the left breast lesion to be a carcinoma (pT3N2). She declined adjuvant treatment. A year after the surgical operation of the metachronous lesions, she had a right chest wall recurrence with widespread pulmonary metastases. She was given palliative chemotherapy but succumbed several months later.
Exploring the beliefs of caregivers about the caregiving experiences of children with acute lymphoblastic leukemia in Malaysia

Chong ASS, Mahadir A, Hamidah A, Rizuana IH, Afifi L, Chan CMH

Belitung Nurs J, 2022;8(3):204-212.
PMID: 37547110 DOI: 10.33546/bnj.2083

BACKGROUND: Cancer is one of the major leading causes of childhood death, and the most common type is acute lymphoblastic leukemia. The survival rate has increased in recent years; however, the long patient trajectory may trigger psychological distress among caregivers as they play an active role in ensuring that the child's basic needs are met. Being in a patient-focused system, the needs of caregivers may be neglected.
OBJECTIVE: This study aimed to explore the caregivers' beliefs on children with acute lymphoblastic leukemia caregiving experiences in order to promote their well-being.
METHODS: Caregivers from thirteen families of children with acute lymphoblastic leukemia participated in this phenomenological study. NVivo 12 was used for the thematic analysis of the data. Consolidated criteria for reporting qualitative research (COREQ) were used in this study.
RESULTS: Overall, five main themes for caregivers' beliefs were identified from their responses: 1) dietary intake with emphasis on its importance in aiding recovery and its potential influence on cancer complications, 2) childcare which emphasized the need to be strong and self-sacrifice, 3) treatment which reflected the use of home or natural remedies and caregivers' negative perception towards chemotherapy, 4) causes of cancer believed to be linked to early childcare choices on food, beverage, and stress imposed on the child, and 5) source of beliefs that included doctors, online platforms, personal encounters and information on food labels.
CONCLUSION: Caregivers' beliefs are varied and nuanced, formed in a multicultural social background of Malaysia. These findings provide knowledge for future supportive cancer care for patients, their caregivers, and the treatment outcome in the Malaysian context. Nurses, who play an essential role between healthcare professionals and patients and/or their caregivers, can be empowered to provide psychological support, early detection of psychological distress, and exploration of caregiver beliefs, given that the number of clinical psychologists in Malaysia is lacking, and there is greater preference for care to be provided by doctors or nurses.
Fulltext Cat Scratch Disease-A Benign Disease with Thymic Hyperplasia Mimicking Lymphoma

Leong MH, Nabillah MJ, Rizuana IH, Asma A, Kew TY, Tan GC

Diagnostics (Basel), 2023 Jul 24;13(14).
PMID: 37510201 DOI: 10.3390/diagnostics13142457

Cat scratch disease (CSD) is a benign condition caused by the inoculation of Bartonella henselae. The imaging findings are non-specific, and it is difficult to diagnose the disease via imaging. However, imaging studies help exclude other differential diagnoses in diagnostic dilemmas. We encountered a case of a 17-year-old adolescent who presented with painful neck swelling. CT showed multiple bilateral cervical lymphadenopathies with triangular soft tissue mass at the anterior mediastinum likely to be thymic hyperplasia, which is unusual in CSD and was mistaken for a lymphoproliferative disorder. Tissue diagnosis with a thorough clinical history yielded the diagnosis of cat scratch disease, and follow-up imaging showed resolution of the cervical lymphadenopathy and thymic hyperplasia.
Giant paratesticular dedifferentiated liposarcoma with intraabdominal extension: a case report

Azizi MH, Rizuana IH, Wong YP, Sidek K, Fam XI

Front Oncol, 2023;13:1216776.
PMID: 37564941 DOI: 10.3389/fonc.2023.1216776

Giant paratesticular liposarcoma is a rare presentation of paratesticular tumor. We present a case of the largest paratesticular liposarcoma described to date with a weight of 4,100 g and measuring 460 × 210 × 130 mm. It was initially mistaken as an inguinoscrotal hernia until a contrast-enhanced computed tomography (CECT) scan of the abdomen and pelvis revealed a huge left paratesticular tumor extending from the scrotum to the mid-abdomen. The challenge was to achieve a tumor-free margin orchidectomy due to the poor fat plane of the tumor to the external iliac artery, psoas muscle, descending colon, and anterior abdominal wall. The surgery was started with laparoscopic dissection for the intraabdominal part of tumor from the vital structure, then followed by inguinal radical orchidectomy and inguinal mesh repair. Postoperative histopathological report revealed a paratesticular dedifferentiated liposarcoma with rhabdomyosarcomatous differentiation with clear margin. The patient had good recovery post operation.