Fibroadenoma of the breast; incidence of malignancy and indicators for surgical intervention: An analysis of 1392 patients.

BACKGROUND: Fibroadenomas are common among young females. The size of the lesion used to be an indication for further assessment or excision. With arising of the watch and see proponents, criteria for selecting patients are important to establish. METHODS: This is a retrospective study of a prospectively maintained database where all patients having the clinical/radiological provisional diagnosis of fibroadenoma and attending our center - from January 2008 to March 2020 - were enrolled. The primary outcome was the incidence of malignancy and the secondary outcomes were the correlation of malignancy-risk with epidemiologic and radiologic criteria. RESULTS: The study enrolled 1392 patients. The mean age of the patients was 35.7 + ∕- 13.1 years. The median of the longest diameter of the detected breast lesions was 25 mm. The incidence of malignancy was 188 (13.5%). The size of the lesion measured by largest diameter was insignificant (p = 0.99), while the patients' age, marital status, and imaging criteria as measured by BIRADS score were significant (<0.001). CONCLUSION: Approaching patients with the age above 35 or with BIRADS 4 provisionally diagnosed with fibroadenomas should be cautious with biopsy and short-term follow-ups The size of the tumor alone should not be used as an indication for surgical intervention.

Food Security and COVID-19 in Africa: Implications and Recommendations.

Before the COVID-19 pandemic ravaged Africa, a large percentage of Africans were already affected by poverty and food insecurity. The pandemic wreaked havoc on their already unfavorable situation. The direct and indirect impacts of COVID-19 included but not limited to illness and deaths of food systems' workers, interruption of food supply chains, unemployment, depreciation of currency value, and disruption of social protection programs. COVID-19 will lead to further economic fallout. Thus, the situation needs careful observation and timely intervention to safeguard the vulnerable African communities. Although Africa has sought ways to lessen the dire impact of the pandemic on food security, short-term solutions should include and enhance social and economic relief initiatives such as monetary intervention and social safety net. Considering a balance between health benefits of COVID-19 restrictions and their economic implications, the African countries, at the regional level, must preserve open and efficient social protection programs and cross-border supply and distribution networks for agricultural inputs. Africa's medium- and long-term strategies for improving food security should include improving and diversifying its agricultural productivity and production of key food commodities. This will reduce Africa's dependence on importation of these key commodities, and will help the continent address underlying economic vulnerabilities and better manage food, pandemic, and/or health-related crises affecting food security in the long term.

Treatment of atrophic acne scars using autologous platelet-rich plasma vs combined subcision and autologous platelet-rich plasma: A split-face comparative study.

BACKGROUND: Multiple therapeutic approaches are usually required when treating atrophic acne scars. Subcision was reported to be of value in improving rolling scars. Autologous platelet-rich plasma (PRP) has recently been proposed as an adjuvant treatment option for atrophic acne scars with few reports evaluating its efficacy. OBJECTIVE: Our objective was to compare the effect of intradermal injection of PRP vs combined PRP and subcision in the treatment of atrophic acne scars. METHODS: Thirty patients with bilateral atrophic acne scars were enrolled. Each patient received three monthly sessions. Each side of the face was randomly treated either with intradermal PRP alone or with combined treatment with subcision followed by PRP injection. Patients were assessed at 3 and 6 months following the last treatment session. Evaluation of serial photographs was performed by two blinded investigators. RESULTS: Platelet-rich plasma alone showed a better response, fewer side effects, and shorter downtime compared to combined subcision and PRP. CONCLUSION: Autologous PRP injection can be a therapeutic option in the treatment of atrophic acne scars, with fewer complications and better tolerability than combined subcision and autologous PRP.

Gigantic submandibular pleomorphic adenoma: A rare case report.

INTRODUCTION: Pleomorphic adenoma (PA) is the most common benign salivary gland tumor. When neglected on some occasions, its size and weight can enormously augment. CASE PRESENTATION: We report a case of a giant submandibular pleomorphic adenoma in a 75 years old female patient which measured 34 × 26 × 20 cm and weighed 8.1 kg. CONCLUSION: Neglecting such tumors without treatment, can cause severe facial disfigurement and can even hinder the airway.