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Squamous Metaplasia in Pleomorphic Adenoma: A Diagnostic and Prognostic Enigma
Swati Sharma,Monica Mehendiratta,Nivedita Chaudhary,Vineet Gupta,Maulshree Kohli,Anjana Arora 대한병리학회 2018 Journal of Pathology and Translational Medicine Vol.52 No.6
Pleomorphic adenoma (PA) is the most common benign salivary gland tumor. Histologically, squamous metaplasia has been reported in PA, but has rarely been documented as being extensive enough to cause significant misdiagnosis. Here, we present an unusual case of PA in a 50-yearold female patient presenting with swelling on the postero-lateral aspect of the palate for a week. Histopathologically, the tumor exhibited the features of conventional PA with extensive squamous metaplasia and giant keratotic lamellae in cyst-like areas. Such exuberant squamous metaplasia and keratin can be a diagnostic and prognostic pitfall and lead to overtreatment of the patient.
Rule Extraction from Neural Networks : Enhancing the Explanation Capability
박상천,Lam, S. Monica,Gupta, Amit 한국지능정보시스템학회 1995 지능정보연구 Vol.1 No.2
This paper presents a rule extraction algorithm RE to acquire explicit rules from trained neural networks. The validity of extracted rules . has been confirmed using 6 different data sets. Based on experimental results, we conclude that extracted rules from RE predict more accurately and robustly than neural networks themselves and rules obtained from an inductive learning algorithm do. Rule extraction algorithms for neural networks are important for incorporating knowledge obtained from trained networks into knowledge based systems. In lieu of this, the proposed RE algorithm contributes to the trend toward developing hybrid and versatile knowledge-based systems including expert systems and knowledge-based decision support systems.
( Reeta Mahey ),( Shobha Kandpal ),( Monica Gupta ),( Perumal Vanamail ),( Biostatistics ),( Neerja Bhatla ),( Neena Malhotra ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.4
Objective The incidence of women in the reproductive age group diagnosed with cancer has recently increased. However, very few patients opt for or are offered fertility preservation (FP) strategies because of a significant lack in awareness. The present study was conducted to evaluate the knowledge of the effect of cancer treatment on fertility and available options for FP. Methods This was a cross-sectional study conducted at a tertiary care center from March 2019 through August 2019. One hundred female patients with gynecological or nongynecological cancer and 18-40 years of age were interviewed. The participants were categorized on the basis of the modified Kuppuswamy socioeconomic status (SES) scale and the responses of the patients in the different categories were compared. Results More than half the patients (63%) were in the 20-35-year age group. Most of the patients (71%) were married, and of them, 28 (39.4%) desired to have children. Only 32% of the patients were aware of the detrimental effect of cancer and its treatment on future fertility, and of them, only 28% could specify the gonadotoxic effect of chemotherapy. Knowledge was significantly higher in the upper and middle SES levels than it was in the lower SES level (P<0.001). More than half of the patients (68%) were not aware of the existing FP options, whereas one-third of the patients (32%) were given information about FP by their physicians. Conclusion The overall awareness of the gonadotoxic effect of cancer therapy and available FP options in the present study was poor. Awareness of FP among both patients and clinicians needs to be increased.
Parul Jaiswal,Reeta Mahey,Shalini Singh,Perumal Vanamail,Monica Gupta,Rohitha Cheluvaraju,J B Sharma,Neerja Bhatla 대한산부인과학회 2022 Obstetrics & Gynecology Science Vol.65 No.2
ObjectiveTo assess the psychological impact of suspension/postponement of various fertility treatments on infertile womenduring the coronavirus disease 2019 (COVID-19) pandemic. MethodsThis was a cross-sectional study conducted as an online survey among infertile women consulting either throughteleconsultation or physical consultation at a fertility clinic of a tertiary care referral unit. A validated questionnairewas given as a WhatsApp link to the women who were consulting for the resumption of services. Questions askedwere based on their socio-demographic parameters, fertility treatment at the time of suspension, anxiety (selfreported)and stress (perceived stress scale-4, PSS-4) due to delay in treatment, psychosocial effect of pandemic, andwishes regarding the resumption of fertility services. ResultsOf 430 patients who received the questionnaire, 250 completed the survey (response rate: 58%). The mean ageof participants was 29.26±4.18 years and the majority (70.4%) had lower socioeconomic status. The average PSS-4score was 7.8±0.71, and the prevalence of self-reported anxiety was 72%. Those who suffered migration during thepandemic had significantly higher PSS-4 scores, and increasing age was associated with increased self-reported anxietydue to the suspension of fertility services. The top three priorities reported were infertility and treatment delay (48.4%),job loss (19.2%), and the risk of contracting COVID-19 infection (16%). The degree of spousal support was significantlycorrelated with lower PSS-4 scores (r=-0.30, P<0.01). On multivariate logistic analysis, duration of infertility, delayin treatment due to suspension of services, and fear of COVID-19 infection were significant predictors of stress andanxiety. ConclusionThis study emphasizes the need to investigate psychosocial health and to provide psychological support to thisvulnerable population in addition to triaging fertility treatments in a phased manner.