Lateral Cephalometric Landmark Annotation Using Histogram Oriented Gradients Extracted from Region of Interest Patches

Introduction

Two-dimensional cephalometric image analysis plays a crucial role in orthodontic diagnosis and treatment planning. While deep learning-based algorithms have emerged to automate the laborious task of anatomical landmark annotation, their effectiveness is hampered by the challenges of acquiring and labelling clinical data. In this study, we propose a model that leverages conventional machine learning techniques to enhance the accuracy of landmark detection using limited dataset.

Materials and methods

Our methodology involves coarse localization through region of interest (ROI) extraction and fine localization utilizing histogram-oriented gradient (HOG) feature. The image patch containing landmark pixels is classified using the light gradient boosting machine (LGBM) algorithm. To evaluate our model's performance, we conducted rigorous tests on the ISBI Cephalometric dataset and Dental Cepha dataset, aiming to achieve accuracy within a 2 mm radial precision range. We also employed cross-validation to assess our approach, providing a robust evaluation.

Results

Our model's performance on the ISBI Cephalometric dataset showed an accuracy rate of 77.11% within the desired 2 mm radial precision range. The cross-validation results further confirmed the effectiveness of our approach, yielding a mean accuracy of 78.17%. Additionally, we applied our model to the Dental Cepha dataset, where we achieved a remarkable landmark detection accuracy of 84%.

Conclusion

The results demonstrate that traditional machine learning techniques can be effective for accurate landmark detection in cephalometric images, even with limited data. Our findings highlight the potential of these techniques for clinical applications, where large datasets of labelled images may not be available.

Oral and Topical Administration of a Standardized Saw Palmetto Oil Reduces Hair Fall and Improves the Hair Growth in Androgenetic Alopecia Subjects - A 16-Week Randomized, Placebo-Controlled Study

Purpose

Androgenetic alopecia (AGA) is the most common type of hair loss in humans, affecting self-esteem and emotional well-being. This study aimed to assess the safety and efficacy of VISPOTM, a standardized saw palmetto oil (2-3% β-sitosterol), in subjects with mild-to-moderate AGA.

Methods

In a double-blind, placebo-controlled, four-arm clinical study, 80 healthy male and female subjects aged 18-50 years were randomly allocated (1:1:1:1) to receive either 400 mg capsules of VISPO or 5 mL of a topical formulation containing 20% VISPO or the respective placebo once daily for 16 weeks. The primary endpoints included hair count (hair comb and hair pull tests) and the self-assessment of perceived efficacy. Objective evaluation was performed using the global photographic assessment score. Hair density, thickness, and anagen/telogen ratio were evaluated using phototrichogram analysis.

Results

At the end of the study, oral and topical formulations of VISPO reduced hair fall by up to 29% (p<0.001) and 22.19% (p<0.01) from the baseline, respectively. Hair density increased by 5.17% and 7.61% in the oral and topical VISPO groups, respectively (p<0.001). In addition, oral ingestion of VISPO resulted in a marked reduction in serum dihydrotestosterone (DHT) levels in the subjects compared to placebo (p<0.001). However, the effect of the VISPO formulations on the anagen/telogen ratio was insignificant. No serious adverse effects were observed during the study.

Conclusion

VISPO formulations reduced hair fall and promoted hair regrowth and scalp appearance in AGA patients.

Impact of radical dose escalation by endoluminal brachytherapy and induction chemotherapy in the definitive treatment of locally advanced esophageal cancer - A retrospective study

Background

The loco-regional recurrence rate remains the main concern in the treatment of esophageal cancer. However, there are controversial data regarding the benefit of dose escalation in the treatment of esophageal cancer. The study examines the implications of dose escalation with endoluminal brachytherapy after induction chemotherapy and definitive chemoradiation in cases of carcinoma esophagus.

Material and Methods

Total 31 biopsy-proven patients with inoperable, locally advanced esophageal cancer of stage IIA-IIIB were enrolled from January 2006 till December 2018. All patients underwent two cycles of three weekly induction chemotherapy followed by definitive external beam radiotherapy of 45-50.4 Gray (Gy) at 1.8 Gy per fraction along with chemotherapy, followed by intraluminal brachytherapy boost of two fractions with 5 Gy each. Overall survival (OS) was censored at death or the last follow-up.

Results

Of 31 patients, 26 (83.97%) received concurrent chemotherapy and 30 (96.77%) completed radiation therapy. At the end of 3 months, 10 (32.2%), 13 (41.9%), 5 (16.1%), and 3 (9.6%) had complete response, partial response, stable disease, and progression of the disease, respectively. Distal failure was seen in five (16.1%) cases. The median OS was 28 months. OS at 2 years and 5 years was 20 (64.5%) and 9 (28.3%), respectively. At the end of 3 months, 17 (54.8%) of patients had no dysphagia, four (12.9%) of patients had improvement of more than 2 points in dysphagia score, five (16.1%) of patients had no change in the score and five (16.1%) of the patients had worsening of the dysphagia score by 1 point. Median dysphagia-free survival was 10.7 months, eight (25.8%) developed dysphagia after the dysphagia-free interval and two (6.4%) had worsening of dysphagia after treatment. There were no reported grade III or grade IV acute toxicities.

Conclusion

The protocol has shown an acceptable survival and dysphagia-free interval. The study suggests intraluminal brachytherapy with induction chemotherapy and definitive chemoradiation is a feasible option in locally advanced esophageal cancer.

Assessment of the Association between Clinical Examination and Investigations with Outcome in Cases of Abdominal Malignancy

Introduction: Abdominal malignancy is a serious problem in the western world which is presently rising in India due to change in lifestyle. The etiopathogenesis are hereditary, environmental and lifestyle factors. The signs and symptoms vary depending upon the type and stage of cancer. Routine investigations, tumor markers, radiology, endoscopy and biopsy examine patients. There have been advances in chemotherapy, radiotherapy, and palliation but still surgery is curative. Methods: This is a prospective observational study including all cases of abdominal malignancy presenting to Surgery OPD. The sample size is 46 patients. Results: Mean age of presentation is 54.63 years. Preoperative abnormal parameters such as CEA, CA 19-9, preoperative biopsy, lymph nodal metastasis on CT and liver metastasis on CT were correlated with outcome which were found to be significant. Operative findings such as site, area, spread outside serosa, lymph nodal metastasis, and liver metastasis were correlated with same in the radio-pathological findings and were found to be significant. Outcome was assessed. Reasons for delay in presentation, diagnosis and treatment were assessed.  Conclusion: Maximum number of patients were in the age group of 41-60 years. There was a definite difference in outcome with reference to preoperative abnormal parameters. There was comparative variation of operative and radio-pathological findings. Study subjects death were due to malignancy as most of them presented to the hospital at advanced stages of malignancy and others dropped out of chemotherapy or radiotherapy and those who took proper treatment had good outcome.

Cross Sectional Study on Hyponatremia

Introduction: Sodium is the major extracellular cation, playing important role in maintaining homeostasis. Normal level of serum sodium is between 136-145 mmol/L. Hyponatremia (<136mmol/L) can present with nausea, vomiting, confusion, lethargy, disorientation.Severe hyponatremia (<125mmol/L) can present with seizures, coma or death. Methods: Our study was a cross sectional, retrospective study including 100 subjects of hyponatremia. Results: In our study, we analyzed the age-wise distribution, severity and various causes of hyponatremia in each grade of hyponatremia based on severity. Conclusion: Drug-induced hyponatremia is a more prevalent and a preventable cause and can be avoided by proper monitoring of patients.

Predicting the molecular subtype of breast cancer based on mammography and ultrasound findings

AIM

To determine the correlation between mammography and ultrasound features of breast cancer with molecular subtypes and to calculate the predictive value of these features.

MATERIALS AND METHOD

This is a prospective study of consecutive patients with breast cancer presenting between January 2016 and July 2017, who underwent mammography and/or ultrasound of breast and excision of the breast mass. Patients with contralateral breast mass, metastases, h/o prior cancer treatment, and other malignancies were excluded. On mammography, the presence or absence of microcalcification was noted. On ultrasound examination size, margins, microcalcification, posterior acoustic features, vascularity, and axillary nodes were assessed. Margins were categorized into circumscribed and non-circumscribed. Posterior acoustic features were classified into four categories: shadowing, enhancement, mixed, and no changes. Vascularity was assessed based on Adler's index into grades 0, 1, 2, and 3. Grades 0 and 1 were considered low and 2 and 3 were high.

RESULTS

Tumors with non-circumscribed margins and posterior acoustic shadowing were likely to be luminal A or B subtype of breast cancer [odds ratio (OR) 5.78; 95% confidence interval (CI) 3.68-9.80; P < 0.0001]. Tumors with non-circumscribed margins, posterior acoustic shadowing, and high vascularity were more likely to be luminal B subtype (OR 2.88; 95% CI 2-4.14; P- <0.0001). Tumors with microcalcification and posterior mixed acoustic pattern were strongly associated to be HER2-positive (OR 5.48; 95% CI 3.06-9.80; P < 0.0001). Tumors with circumscribed margins and posterior acoustic enhancement were highly suggestive of triple-negative breast cancer (OR 7.06; 95% CI 4.64-10.73; P < 0.0001).

CONCLUSION

Microcalcification detected on mammography and certain ultrasound features such as circumscribed or non-circumscribed margins, posterior acoustic features, and vascularity are strongly correlated in predicting the molecular subtypes of breast cancer, and thus may further expand the role of conventional breast imaging.

Clinical consequences of untreated dental caries evaluated using PUFA index in orphanage children from India

BACKGROUND

To determine the prevalence and severity of oral condition related to untreated dental caries with PUFA index and to relate period of institutional stay, oral hygiene practice and diet of orphan children to caries experience ratio.

MATERIALS & METHODS

A cross sectional survey conducted among 488 children of 12-14 years living in 5 different orphanages of Mysore district, India. Data regarding oral hygiene practices and oral health status (PUFA, DMFT, OH I-S and GI) were collected through structured questionnaire and by type III clinical oral examinations. The collected data were processed statistically.

RESULTS

The PUFA ratio indicates 21% of decayed component had progressed to pulp involvement and abscess formation. The overall prevalence of PUFA was 37.7%. 31.1% children showed one or more pulpally involved tooth in their oral cavity. Correlation between periods for being the child in the institute to DMFT showed negative value indicting decrease in DMFT as the duration of stay in orphanage increases.

CONCLUSION

The result show oral health condition in orphan children was neglected. Children from this disadvantaged background have shown a high prevalence of dental caries with low dental care utilization. PUFA index is an effective index in evaluating clinical consequences of un-treated caries. How to cite this article: Shanbhog R, Godhi BS, Nandlal B, Kumar SS, Raju V, Rashmi S. Clinical consequences of untreated dental caries evaluated using PUFA index in orphanage children from India. J Int Oral Health 2013; 5(5):1-9.

Effect of processing on nutritionally important starch fractions in rice varieties

In the present study the effect of processing on starch fractions (rapidly digestible starch (RDS), slowly digestible starch (SDS) and resistant starch) were measured, using controlled enzymic hydrolysis with pancreatin and amyloglucidase, in six rice varieties; namely, BT rice, Gauri rice, Sona masoori, parboiled rice, Salem parboiled rice, and steamed rice. The processes studied were pressure cooking, boiling, steaming and straining. Rapidly available glucose (RAG) was also measured to derive a Starch Digestion Index (SDI). Cooking of rice by different methods decreased the amylose content. The degree of gelatinization ranged from 56 to 95, with pressure cooking resulting in the maximum degree. The starch fractions varied depending on the cooking method. Significant inverse correlations were seen between RDS and SDS (r = 0.40, P < 0.05), and between amylose and SDI (r = 0.60, P < 0.01). RAG and RDS related positively (r = 0.90, P < 0.01). The SDI of rice varieties cooked by the boiling and straining method were significantly higher (P < 0.05). The results emphasize that cooking methods influence the nutritionally important starch fractions in rice varieties.