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Fortifying Healthcare Data Security in the Cloud:A Comprehensive Examination of the EPM-KEA Encryption Protocol

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Computers, Materials & Continua 2024年第5期79卷 3397-3416页

作者： Umi Salma Basha Shashi kant Gupta Wedad Alawad SeongKi Kim Salil Bharany Computer Science and Information Technology Jazan UniversityJazanSaudi Arabia CSE Eudoxia Research UniversityNew CastleUSA Department of Information Technology College of Computer ScienceQassim UniversityBuraydahSaudi Arabia National Center of Excellence in Software Sangmyung UniversitySeoulKorea Department of Computer Science and Engineering Lovely Professional UniversityPhagwaraPunjabIndia

A new era of data access and management has begun with the use of cloud computing in the healthcare *** the efficiency and scalability that the cloud provides, the security of private patient data is still a majorconcern. Encryption, network security, and adherence to data protection laws are key to ensuring the confidentialityand integrity of healthcare data in the cloud. The computational overhead of encryption technologies could leadto delays in data access and processing rates. To address these challenges, we introduced the Enhanced ParallelMulti-Key Encryption Algorithm (EPM-KEA), aiming to bolster healthcare data security and facilitate the securestorage of critical patient records in the cloud. The data was gathered from two categories Authorization forHospital Admission (AIH) and Authorization for High Complexity *** use Z-score normalization forpreprocessing. The primary goal of implementing encryption techniques is to secure and store massive amountsof data on the cloud. It is feasible that cloud storage alternatives for protecting healthcare data will become morewidely available if security issues can be successfully fixed. As a result of our analysis using specific parametersincluding Execution time (42%), Encryption time (45%), Decryption time (40%), Security level (97%), and Energyconsumption (53%), the system demonstrated favorable performance when compared to the traditional *** suggests that by addressing these security concerns, there is the potential for broader accessibility to cloudstorage solutions for safeguarding healthcare data.

关键词： Cloud computing healthcare data security enhanced parallel multi-key encryption algorithm(EPM-KEA)

Male Breast Cancer: Diagnostic and Prognostic Features in Mali

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Journal of Cancer Therapy 2022年第2期13卷 71-79页

作者： Iriss A. Darar Zakari Saye Bourama Diarra Madiassa Konaté Amadou Traoré Seydou Pamateck Abdillahi I. Ismail Arouna Adama Doumbia Boubacar Karembé Bakary Tientigui Dembélé lassana kanté Drissa Traoré Zimogo Zié Sanogo Alhassane Traoré Adégné Togo Department General Surgery CHU Gabriel Toure Bamako Mali

Introduction: Male breast cancer is rare;representing 1% of breast cancers and less than 1% of all male neoplasia worldwide. We here analyzed the clinical, histological, therapeutic and prognostic characteristics of male breast cancer in Bamako, Mali. Patients and methods: A retrospective descriptive study was conducted on 14 male patients with breast cancer who visited two university hospitals in Bamako (Hospital Gabriel TOURE and Hospital du Point G) in Mali, from January 2005 to December 2018. Results: Male breast cancer represented 0.63% of all breast cancers and 0.23% of all male cancers. The following was observed: the mean age of 53 years (range: 23 - 82);a family history of cancer in 2;breast pain in 9;the average time to consultation of 8 years (6 - 24);gynecomastia found in 1;the tumor palpable in all 14 (size of 5 cm [3 - 10]);ulceration in 5. The most common histological type was non-specific infiltrating carcinoma with 92.8%. SBR II grade was found in 78.5% of cases. Of 8 patients with immunohistochemistry, hormone receptor positive was in 13 and Her2 positive was in 5. Metastases were found in 4, 2 pulmonary and 2 hepatic. Treatment: Neoadjuvant chemotherapy in 21.4%;radical surgery in 13 cases;surgery + radiotherapy in 2;surgery + hormonal therapy in 4. After an average follow-up of 36 months, 1 patient developed a lung metastasis and another patient had a lymph node recurrence. Conclusion: Male breast cancer was detected at relatively later stages. Physicians must be aware of this condition.

关键词： Breast Cancer Diagnostic Aspect Male Mali Therapeutic Aspect

Appendicular Abscess: Epidemio-Clinical and Therapeutic Aspects in the General Surgery Department of the Reference Health Center of Commune III (*** CIII) of the District of Bamako

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Surgical Science 2023年第2期14卷 77-83页

作者： Karembé Boubacar Tounkara Idrissa Diarra Issaka Soumaré Modibo Dianguina Traoré Boureima Sanogo Seydou Diallo Moctar Camara Aboubacar Touré Aboubacar Coulibaly Abdoulaye Fall Ibrahim Diakité Mané Diarra Mouminy Diarra Drissa Traoré Abdoulaye Coulibaly Yacaria kanté lassana Dembélé Bakary Tientigui Togo Adégné Départment of Surgery CHU Gabriel Touré Bamako Mali

Objectives: The main goal of this study is to determine the hospital frequency of appendicular abscess, to describe the diagnostic and therapeutic aspects and to analyze the postoperative follow-up. Methodology: This was a descriptive and analytical prospective study from January 1, 2020 to June 30, 2021 including patients admitted to our department for appendicular abscess diagnosed pre- and or intraoperatively and confirmed to histology. Results: We collected 30 appendicular abscesses that accounted for 18.75% of emergency interventions. The 16 - 25 age group was the most represented at 53%. The average age was 24 years with extremes of 10 and 58 years. The male sex was mostly represented (60%) with a sex ratio of 1.5. The majority of our patients were students (53.3%). The main clinical signs found were abdominal pain and vomiting (100%). The pain was localized in the Right Iliac Fossa (RIF) in 80% of cases. Fever was present in all our patients with a temperature between 38˚C and 38.5˚C. The physical examination found pain with defense of the right iliac fossa in 93.3% of cases. A painful mass was present in 27 patients (90%). Treatment consisted of appendectomy with abscess drainage in all patients. Postoperative follow-up was simple in 83.3% of cases;we recorded three cases (10%) of parietal suppuration, one case of fistula (3.3%) and one death. Conclusion: Appendicular abscess is a medical-surgical emergency frequent surgery in our context because of the delay in diagnosis. It is a condition with low morbidity and mortality subject to early diagnosis and prompt and appropriate treatment.

关键词： Abscess Appendix Surgery

Epidemiological-Clinical and Therapeutic Aspects of Acute Appendicitis at the Reference Health Center of Commune III (*** CIII) of the District of Bamako

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Surgical Science 2023年第1期14卷 30-37页

作者： Karembé Boubacar Tounkara Idrissa Soumaré Modibo Dianguina Diarra Issaka Diarra Mouminy Touré Aboubacar Traoré Boureima Camara Aboubacar Sanogo Seydou Fall Ibrahim Coulibaly Abdoulaye Traoré Abdoulaye Diarra Drissa Diakité Mané Coulibaly Yacaria kanté lassana Dembélé Bakary Tientigui Togo Adégné Départment of Surgery CHU Gabriel Touré Bamako Mali

Objectives: It was to determine the epidemiological-clinical and therapeutic aspects of acute appendicitis at the Reference Health Center of Commune III of the district of Bamako. Methodology: This was a prospective study from January 1 to December 31, 2020 including patients operated for acute appendicitis and confirmed at histology and cases of abscess and appendicular plastron. Results: We collected 60 cases of acute appendicitis. They accounted for 17.29% of surgical indications. The average age of our patients was 25.5 years. The male sex was the most represented at 63% with a sex ratio of 1.72. The Pain in the right iliac fossa was the most represented reason for consultation with 76.7%. It was at the type of bite 70% of the cases. On physical examination the defense of the right iliac fossa was present in 96.7%. Digestive signs were marked by nausea 28.4% (17 patients) and vomiting 25% (15 patients). The digital rectal exam was painful to the right of the Douglas fir in 76.7% of our patients. In biology a complete blood count (CBC) performed in all our patients has objectified hyper leukocytosis in 80% of cases. The reactive protein (CRP) performed in 36 patients was elevated with values between 18 and 46 mg/ml. The imaging performed was an abdominal ultrasound that found a roundel image of the appendix with increased size in 65%. Surgical treatment consisted of classical Mac Burney appendectomy in 54 patients (90%). The gesture performed was an appendectomy in all our patients. All our appendectomy parts were sent for pathological examination. This examination classified the parts as non-specific appendicitis in 60%, phlegmonous appendicitis in 22% and catarrhal appendicitis in 18% of cases. Surgical follow-up was simple in 98.4% (59 patients) and morbidity was marked by digestive fistula in one patient. We recorded one case of death (1.6%). Conclusion: Acute appendicitis remains the most common surgical emergency in commune III of the district of Bamako. It

关键词： Appendicitis Surgery Anatomical Pathology

Is primary transcatheter aortic valve implantation the new normal?

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Journal of Geriatric Cardiology 2024年第4期21卷 458-461页

作者： R.Anantharaman C.Sundar Kamal kant Jena K.Arun Department of Cardiology Kauvery HospitalChennaiIndia

Degenerative calcific aortic valve stenosis(AS)is the most common valvular heart disease in elderly.^[1] It is well documented that symptomatic severe AS follows a malignant course leading to cardiogenic shock(CS).

关键词： aortic stenosis implantation

Giant Lactant Adenoma: About a Case

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Surgical Science 2022年第12期13卷 561-565页

作者： Amadou Bah Amadou Maiga Boubacar Y. Sidibé Ibrahim Diakité Tani Koné Zakari Saye Arouna Doumbia Amadou Traoré Madiassa Konaté Pierre Coulibaly Amadou A. Traoré Bakary T. Dembélé lassana kanté Boubacar Karembé Assitan Koné Andre Kassogue Amidou Almeimoune Adegne Togo General Surgery Department CHU Gabriel Touré Bamako Mali Resuscitation Anesthesia Department CHU Gabriel Touré Bamako Mali

Affecting young women, lactating adenoma is a rare benign tumor of the breast. It is seen mainly in the third trimester of pregnancy and in the postpartum period. Clinically, it is a solid mass, mobile typically benign but its character of rapid evolution is reminiscent of phyllodes tumors, sarcomas and galactoceles. The definitive diagnosis is histological. We report a case of lactating adenoma in a 26-year-old lactating woman, third procedure, second pare, with a history of tumor resection of the outer quadrants of the left breast, 9 months ago, whose histology evoked a fibrotic disease, cystic breast associating non-specific subacute mastitis with suppuration. Received for recurrence of a tumor in the left breast which was the site of a polylobed mass of about 10/5 cm occupying 3/4 of the breast with mobile ipsilateral axillary adenopathies. A micro tru-cut biopsy was performed and the histology was in favor of a lactating breast adenoma with no signs of malignancy. She underwent surgical excision, the consequences of which were simple.

关键词： Lactating Adenoma Breast Histological Malignancy Surgical Excision

Traumatic Diaphragmatic Injury at Gabriel Toure University Hospital, Mali

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Surgical Science 2022年第3期13卷 110-118页

作者： Amadou Traoré Madiassa Konaté Abdoulaye Diarra Idrissa Tounkara Mohamed Traoré Arouna Doumbia Amadou Bah Boubacar Yoro Sidibé Amadou Maïga Tani Koné Boubacar Karembé Zakari Saye Koniba Kéita Yacouba Bouaré Assitan Koné Ibrahim Diakité lassana kanté Bakary Tientigui Dembélé Alhassane Traoré Adégné Togo General Surgery Department of Gabriel Touré University Hospital Bamako Mali Surgery Department of Kati University Hospital Kati Mali Reference Health Center of Commune II Bamako Mali Reference Health Center of Commune III Bamako Mali

Traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accident (TRA) or an assault. We initiated this study with the aims of determining the epidemiological, clinical and therapeutic aspects of TDI at Gabriel Toure University Hospital. This was a retrospective study from January 1999 to June 2021 that included all patients who presented a diaphragmatic injury consecutive to abdominal and/or thoracic trauma. In 22 years and 6 months, 46 cases of TDI were collected. They represented 0.17% of hospitalizations, 0.26% of surgical emergencies and 5.5% of thoraco-abdominal traumas. The average age was 31.69 years with a sex ratio of 3.2. Criminal stabbings accounted for 56.5% and TRA for 19.6%. Penetrating injuries accounted for 78.3% of cases. The parietal lesion was thoracic in 21 cases (45.7%), abdominal in 19 cases (41.3%) and thoraco-abdominal in 6 cases (13%). The chest X-ray, performed in 15 patients, showed an intrathoracic gas bubble (4 cases) and hemothorax (6 cases). Diagnosis of diaphragmatic lesion was preoperative in 21.7% (10 cases). The diaphragmatic breach was on the left side in 65.2% (30 cases) and the average size was 3.17 cm. Laparotomy was performed in 89.1%, thoracotomy in 4.4% and thoraco-laparotomy in 6.5% of cases. The surgical procedure consisted of reduction of the herniated viscera in 15.2% (7 cases) and closure of the diaphragmatic breach with non-absorbable sutures in 82.6% (36 cases). Chest tube drainage was performed in 73.9%. The average length of hospital stay was 9.8 days. Mortality was 13.04%. Conclusion: Traumatic diaphragmatic injury is rare but its frequency is increasing in our country. It most often affects the young man victim of assault or TRA. This type of trauma is rarely isolated;you have to think about it in case of any thoraco-abdominal trauma. The treatment is surgical. The prognosis depends on the severity of the associated lesions.

关键词： Diaphragmatic Injury Trauma Surgery Gabriel Toure

Explainable Artificial Intelligence(XAI)Model for Cancer Image Classification

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Computer Modeling in Engineering & Sciences 2024年第10期141卷 401-441页

作者： Amit Singhal Krishna kant Agrawal Angeles Quezada Adrian Rodriguez Aguiñaga Samantha Jiménez Satya Prakash Yadav Department of Computer Science&Engineering Raj Kumar Goel Institute of TechnologyGhaziabad201017India Department of School of Computing Science and Engineering Galgotias UniversityGreater Noida203201India Tecnológico Nacional de México Campus Tijuana Baja California22414México Universidad Autónoma de Baja California TijuanaBaja California22414México Department of Computer Science and Engineering G.LBajaj Institute of Technology and Management(GLBITM)Affiliated to Dr.A.P.J.Abdul Kalam Technical UniversityLucknow201306India School of Computer Science Engineering and Technology(SCSET) Bennett UniversityGreater Noida201310India

The use of Explainable Artificial Intelligence(XAI)models becomes increasingly important for making decisions in smart healthcare *** is to make sure that decisions are based on trustworthy algorithms and that healthcare workers understand the decisions made by these *** models can potentially enhance interpretability and explainability in decision-making processes that rely on artificial ***,the intricate nature of the healthcare field necessitates the utilization of sophisticated models to classify cancer *** research presents an advanced investigation of XAI models to classify cancer *** describes the different levels of explainability and interpretability associated with XAI models and the challenges faced in deploying them in healthcare *** addition,this study proposes a novel framework for cancer image classification that incorporates XAI models with deep learning and advanced medical imaging *** proposed model integrates several techniques,including end-to-end explainable evaluation,rule-based explanation,and useradaptive *** proposed XAI reaches 97.72%accuracy,90.72%precision,93.72%recall,96.72%F1-score,9.55%FDR,9.66%FOR,and 91.18%*** will discuss the potential applications of the proposed XAI models in the smart healthcare *** will help ensure trust and accountability in AI-based decisions,which is essential for achieving a safe and reliable smart healthcare environment.

关键词： Explainable artificial intelligence artificial intelligence XAI healthcare cancer image classification

Appendicular Peritonitis in the General Surgery Department of Gabriel TOURE CHU

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Surgical Science 2022年第1期13卷 9-14页

作者： Maïga Amadou Diakité Ibrahima Bah Amadou Diallo Aly Boubacar Traoré Bathio Moussa Diassana Sidibé Boubacar Yoro Koné Tani Doumbia Arouna Adama Traoré Amadou Saye Zakari Saadé Oumou Hélène kanté lassana Konaté Madiassa Dembélé Souleymane Samaké Moussa Dembélé Bakary Tientigui Traoré Alhassane Togo Adégné Service de chirurgie générale H&#244pital de Sikasso Sikasso Mali Service de chirurgie générale CHU Gabriel Tour&#233 Bamako Mali

The appendicular peritonitis is complications of acute appendicitis which are characterized by the diffusion of the infectious process to the peritoneal cavity thus carrying out a generalized or located purulent peritonitis. It can appear from the start or follow the stage of appendicular abscess. Our objectives were to determine the frequency, to describe the clinic and para clinic aspects, to identify the principal germs and their sensitivities to antibiotics and to describe the operative continuations. Our prospective and descriptive study focused on patients treated for appendicular peritonitis, from January 1st to December 31st 2016, in the General Surgery Department of the Hospital of Sikasso. During the period of our study, 31 cases of appendicular peritonitis were collected, which