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Objectives: The performance of shear wave elastography (SWE) for peripheral nerve pathology, predominantly compressive neuropathy, has been studied with the median nerve, sciatic nerve, and tibial nerve. However, studies for ulnar nerve are limited in literature. The aim of the study was to study the performance of SWE for ulnar nerve in arm by analyzing the correlation of elasticity value by two transducers of the same ultrasound system. Material and Methods: This was a prospective observational study. Elasticity of ulnar nerve was measured in the mid-arm and supracondylar region in longitudinal and transverse planes with two different transducers of the same ultrasound system. The reliability of measurement was assessed by interclass correlation of values obtained. Results: Ninety-two ulnar nerve measurement sets were analyzed. The ages of the patients ranged from 14 years to 76 years, with a median age of 50. The SWE values obtained by two probes showed a weak interclass correlation coefficient value Conclusion: Quantitative SWE measurements of the ulnar nerve in the arm by two transducers showed a weak interclass correlation. It should be used with caution as a diagnostic tool with a universally acceptable cut off values.

Anterior neck masses are common and such patients commonly present to ultrasonography units for further evaluation of underlying pathology. We encountered an atypical case of pulsatile anterior neck swelling in a 45-year-old lady. Evaluation of the swelling using neck ultrasonography and color doppler study revealed that the mass was of vascular origin and contrast-enhanced computed tomography of neck confirmed the presence of an aberrant high riding innominate artery. Knowledge of such variants is of great importance and should be reported by the concerned radiologist. Lack of knowledge of such variants may lead to inadvertent surgical complications during procedures and can be life-threatening to the patient.

Background: Emergency Department of National Trauma Center Nepal Center is the only specialized trauma care hospital in Nepal, in operation since 2012. Traumatic injury is one of the major causes for mortality worldwide. This study aims to see the epidemiology, pattern of injuries and outcome of the patients presenting to the emergency room.Methods: After getting ethical approval, we included all patients presenting to the Emergency Department with at least one injury, between Jan 2018 to Dec 2020. Informations on age, gender, mechanism of injury and outcome was abstracted for all patients presenting to the emergency department. Data were extracted from hospital database with the permission of hospital authority.Results: Total of 49991 patients presented to emergency department with different types of injuries. Among them 7792 (14.0%) needed hospital admission. Fall and road crashes comprised almost 80% of admitted cases. Mortality was 2.1% of admitted patients, mostly with head injuries followed by multiple injuries. Conclusions: Among the patient visiting the trauma center during the study period most common mechanism of the injury were fall and road crash with head and neck injury. Majority of the patients were only managed in the ward without surgery.Keywords: Emergency care; triage; trauma care system; unintentional injury

BACKGROUND: The first national severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serosurvey in India, done in May-June, 2020, among adults aged 18 years or older from 21 states, found a SARS-CoV-2 IgG antibody seroprevalence of 0·73% (95% CI 0·34-1·13). We aimed to assess the more recent nationwide seroprevalence in the general population in India. METHODS: We did a second household serosurvey among individuals aged 10 years or older in the same 700 villages or wards within 70 districts in India that were included in the first serosurvey. Individuals aged younger than 10 years and households that did not respond at the time of survey were excluded. Participants were interviewed to collect information on sociodemographics, symptoms suggestive of COVID-19, exposure history to laboratory-confirmed COVID-19 cases, and history of COVID-19 illness. 3-5 mL of venous blood was collected from each participant and blood samples were tested using the Abbott SARS-CoV-2 IgG assay. Seroprevalence was estimated after applying the sampling weights and adjusting for clustering and assay characteristics. We randomly selected one adult serum sample from each household to compare the seroprevalence among adults between the two serosurveys. FINDINGS: Between Aug 18 and Sept 20, 2020, we enrolled and collected serum samples from 29 082 individuals from 15 613 households. The weighted and adjusted seroprevalence of SARS-CoV-2 IgG antibodies in individuals aged 10 years or older was 6·6% (95% CI 5·8-7·4). Among 15 084 randomly selected adults (one per household), the weighted and adjusted seroprevalence was 7·1% (6·2-8·2). Seroprevalence was similar across age groups, sexes, and occupations. Seroprevalence was highest in urban slum areas followed by urban non-slum and rural areas. We estimated a cumulative 74·3 million infections in the country by Aug 18, 2020, with 26-32 infections for every reported COVID-19 case. INTERPRETATION: Approximately one in 15 individuals aged 10 years or older in India had SARS-CoV-2 infection by Aug 18, 2020. The adult seroprevalence increased approximately tenfold between May and August, 2020. Lower infection-to-case ratio in August than in May reflects a substantial increase in testing across the country. FUNDING: Indian Council of Medical Research.

Objective This work aimed to study the distribution of lymph nodal metastatic pattern in carcinoma gallbladder with multidetector computed tomography (CT). Materials and Methods A retrospective observational study was conducted including 80 patients with carcinoma gallbladder who underwent triple-phase CT angiography or single-phase contrast-enhanced CT scan of the abdomen between January 2019 and November 2019. Results In our study, 75 (93.7%) out of 80 cases showed metastasis to lymph nodes, with distribution as follows: periportal (69), peripancreatic (62), and aortocaval (47). The most common involved combination included all three lymph nodal groups (periportal, peripancreatic, and aortocaval), involving 40 (50%) cases. The combination of only periportal and peripancreatic lymph nodes was seen in 17 (21%) cases. Isolated periportal lymph nodes were seen in eight cases (10%) cases. The combination of only periportal and aortocaval lymph nodes was seen in four (5%) cases. Isolated peripancreatic lymph nodes were seen in three (3.7%) cases. The combination of periportal and aortocaval was seen in four (5%) cases followed by peripancreatic and aortocaval lymph nodes that was seen in two (2.5%) cases. Isolated aortocaval lymph nodes were seen in one (1.2%) case. Conclusion Periportal lymph nodes were the single most commonly involved station followed by peripancreatic and aortocaval lymph nodes. The combination of periportal, peripancreatic, and aortocaval lymph nodes was seen most commonly. The second most commonly involved combination was found to be periportal and peripancreatic lymph nodes followed by isolated periportal lymph nodes.

Coronary artery calcification is an acceptable tool for cardiovascular risk assessment in end-stage renal disease (ESRD) population. We aimed to identify the association and predictive value of components of blood cell parameters with coronary and thoracic aorta vascular calcification (VC) in ESRD population on dialysis. All ESRD patients receiving hemodialysis or peritoneal dialysis aged between 18 and 60 years were included in the study. Exclusion criteria comprised patients with active infection or inflammatory disease, autoimmune disease, congestive heart failure, angina pectoris and/or documented coronary artery disease, thyroid disease, and hepatic dysfunction. Agatston scoring was used for the evaluation of coronary aorta calcification (CAC) score (CACS) and thoracic aorta calcification (TAC) score (TACS). Compared to participants with no VC, those who had VC were statistically significantly older (P

In secure web application development, the role of web services will not continue if it is not trustworthy. Retaining customers with applications is one of the major challenges if the services are not reliable and trustworthy. This article proposes a trust evaluation and decision model where the authors have defined indirect attribute, trust, calculated based on available direct attributes in quality web service (QWS) data sets. After getting training of such evaluation and decision strategies, developers and customers, both will use the knowledge and improve the QoS. This research provides web-based learning about web service quality which will be utilized for prediction, recommendation and the selection of trusted web services in the pool of web services available globally. In this research, the authors include designs to make decisions about the trustworthy web services based on classification, correlation, and curve fitting to improve trust in web service prediction. In order to empower the web services life cycle, they have developed a quality assessment model to incorporate a security and performance policy.

Study Design: Epidemiological retrospective study. Objective: To describe the demographics, timing to surgery, delay, short-term neurological recovery, and complications in surgically treated subaxial cervical trauma in a resource-constrained country. Methods: Thirty consecutive subaxial cervical trauma patients presenting to a trauma hospital in Nepal between December 2015 and August 2017 were analyzed as a retrospective cohort. Patients were segregated into 4 groups based on the timing to surgery: within 2 days, 3 to 7 days, 8 to 30 days, and >31 days. Results: There were 27 male and 3 female patients with mean age 40 years. Twenty-four sustained fall injury, and 27 patients were from outside Kathmandu. No patients were treated within the first 48 hours; only 9 were treated between 3 and 7 days, 16 between 8 and 30 days, and 5 a month later. Major delay was finance and operating room availability. Thirteen patients had a C6C7 involvement followed by C5C6 in 6 patients. Seven patients had complete neurological deficit while 18 patients had incomplete deficit. A total of 46.7% improved their neurology in 6 months. No neurological recovery was observed in complete deficit patients. Conclusion: Seventy percent of our patients were treated longer than 1 week after injury, which would likely be considered unacceptable in most first world countries. As expected, the outcomes for many of these patients were far worse than reported in North American centers with early access to medical care and insurance. Despite this, nearly half of our patients improved neurologically following treatment; hence, surgery holds hope of some restoration of neurologic deficits.

Solar energy is the best among all renewable energy sources owing to its low effective cost and eco-friendly character. In this study, the header and riser pipe design is studied using an a...

Background: Repeated cross-sectional serosurveys in the same geographic area establish the trend of the evolving pandemic. We present the findings of the third round of a national serosurvey to estimate the seroprevalence of SARS-CoV-2 infection among the general population and health care workers of India. Methods: We conducted the third population-based serosurvey between Dec 18, 2020 and Jan 6, 2021 in the same 700 villages or wards from 70 districts in 21 states across India, which were selected for the first and second serosurveys. We enrolled from each district, at least 400 individuals aged ≥ 10 years from general population and 100 HCWs from sub-district level public health facilities. Serum samples from general population were tested for the presence of IgG antibodies against nucleocapsid (N) and spike protein (S1-RBD) of SARS-CoV-2 using the Abbott and Siemens assays respectively, whereas sera from HCWs were tested for anti-S1-RBD. For general population, sera positive for either of the antibodies were considered positive, while sera positive for anti-S1-RBD were considered as positive for HCW. Weighted seroprevalence estimates were adjusted for sensitivity and specificity of respective assays. Findings: Of the 28,598 sera from general population, 4585 (16%) had IgG antibodies against N, 6647 (23.2%) against S1-RBD and 7436 (26%) against either. The weighted and assay characteristic adjusted seroprevalence against either of the antibodies was 24.1 (95%CI: 23.0% to 25.3%). Seroprevalence was lower in rural areas (21.4%, 95% CI: 20.3% to 22.6%) compared to urban non-slum (29.4%, 95% CI: 26.9% - 32.1%) and slum areas (34.6%, 95% CI: 31.0% to 38.3%). Among 7385 HCWs, the seroprevalence of anti-S1-RBD IgG antibodies was 25.6% (95% CI: 23.5% to 27.8%). Interpretation: Nearly one in four individuals aged 10 years or older from general population as well as HCWs were exposed to SARS-CoV-2 by December 2020 amounting to 271 million infections in India. Funding Statement: Indian Council of Medical Research Declaration of Interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare no competing interests Ethics Approval Statement: The project was approved by Institutional Human Ethics Committee at ICMR-National Institute of Epidemiology.

Background: India witnessed a severe second wave of COVID-19 during March and June 2021. We did the fourth nationwide serosurvey to estimate prevalence of SARS-CoV-2 antibodies in the general population aged >=6 years and health care workers (HCWs). Methods: We did a cross-sectional study between 14 June and 6 July 2021 in 700 clusters in the same 70 districts across 21 states/Union Territory. From each district, a minimum of 400 individuals aged >=6 years from general population and 100 HCWs from the district public health facilities were included. The serum samples were tested for the presence of IgG antibodies against S1-RBD and nucleocapsid protein of SARS-CoV-2 using chemiluminescence immunoassay. We estimated the weighted and test adjusted seroprevalence of IgG antibodies against S1-RBD and/or nucleocapsid protein along with 95% CI. Findings: Of the 28,975 sera tested, the weighted and test adjusted prevalence of IgG antibodies against S1-RBD and/or nucleocapsid protein among the general population aged >=6 years was 67.6% (95% CI: 66.4 – 68.7). The seroprevalence increased with age and was not different in rural and urban areas. Compared to unvaccinated adults (62.3%, 95% CI: 60.9 – 63.7), seroprevalence was significantly higher among individuals who received one (81.0%, 95% CI: 79.6 - 82.3) and two doses (89.8%, 95% CI: 88.4 - 91.1). The seroprevalence of IgG antibodies among 7,252 health care workers was 85.2% (95% CI: 83.5 - 86.7). Interpretation: Nearly one third of the population is still seronegative. It is necessary to accelerate the coverage of COVID-19 vaccination among adults and continue adherence to non-pharmaceutical interventions. Funding: Indian Council of Medical Research. Declaration of Interest: None to declare. Ethical Approval: The Institutional Human Ethics Committee of the ICMR National Institute of Epidemiology, Chennai approved the study protocol.

Crossed beam energy transfer, CBET, in high-intensity laser–plasma interaction is investigated for the case of optically smoothed laser beams. In the two approaches to laser-driven inertial confinement fusion experiments, the direct-drive and the indirect-drive, CBET is of great importance because it governs the coupling of laser energy to the plasma. We use the two-dimensional wave-coupling code H armony to simulate the transfer between two laser beams with speckle structure that overlap in a plasma with an inhomogeneous flow profile. We compare the CBET dynamics for laser beams with spatial incoherence and with spatio-temporal incoherence; in particular we apply the smoothing techniques using random phase plates (RPPs) and smoothing by spectral dispersion (SSD), respectively. It is found that for laser beams (wavelength λ 0 ) with intensities ( I L ) above I L ∼ 2 × 10 15 W cm −2 ( λ 0 /0.35 µm) −2 ( T e /keV), both the so-called plasma-induced smoothing as well as self-focusing in intense laser speckles induce temporal incoherence; the latter affects the CBET and the angular distribution of the light transmitted behind the zone of beam overlap. For RPP-smoothed incident beams, the resulting band width of the transmitted light can already be of the same order as the effective band width of the SSD available at major laser facilities. We examine the conditions when spatio-temporal smoothing techniques become efficient for CBET. This article is part of a discussion meeting issue ‘Prospects for high gain inertial fusion energy (part 1)’.

Background & objectives: Population-based seroepidemiological studies measure the extent of SARS-CoV-2 infection in a country. We report the findings of the first round of a national serosurvey, conducted to estimate the seroprevalence of SARS-CoV-2 infection among adult population of India. Methods: From May 11 to June 4, 2020, a randomly sampled, community-based survey was conducted in 700 villages/wards, selected from the 70 districts of the 21 States of India, categorized into four strata based on the incidence of reported COVID-19 cases. Four hundred adults per district were enrolled from 10 clusters with one adult per household. Serum samples were tested for IgG antibodies using COVID Kavach ELISA kit. All positive serum samples were re-tested using Euroimmun SARS-CoV-2 ELISA. Adjusting for survey design and serial test performance, weighted seroprevalence, number of infections, infection to case ratio (ICR) and infection fatality ratio (IFR) were calculated. Logistic regression was used to determine the factors associated with IgG positivity. Results: Total of 30,283 households were visited and 28,000 individuals were enrolled. Population-weighted seroprevalence after adjusting for test performance was 0.73 per cent [95% confidence interval (CI): 0.34-1.13]. Males, living in urban slums and occupation with high risk of exposure to potentially infected persons were associated with seropositivity. A cumulative 6,468,388 adult infections (95% CI: 3,829,029-11,199,423) were estimated in India by the early May. The overall ICR was between 81.6 (95% CI: 48.3-141.4) and 130.1 (95% CI: 77.0-225.2) with May 11 and May 3, 2020 as plausible reference points for reported cases. The IFR in the surveyed districts from high stratum, where death reporting was more robust, was 11.72 (95% CI: 7.21-19.19) to 15.04 (9.26-24.62) per 10,000 adults, using May 24 and June 1, 2020 as plausible reference points for reported deaths. Interpretation & conclusions: Seroprevalence of SARS-CoV-2 was low among the adult population in India around the beginning of May 2020. Further national and local serosurveys are recommended to better inform the public health strategy for containment and mitigation of the epidemic in various parts of the country.

Monocrystalline silicon wafers find its use in semiconductor industries for a variety of applications. Therefore, its surface finish is of prime importance. The surface finish of Si (100) for semiconductor application should have nanofinishing characteristics that resemble mirror-like surface characteristics of polished Si (100). The present paper outlines the comparative study of nanofinishing of monocrystalline silicon wafers, i.e., Si (100) using double disk magnetic abrasive finishing and allied processes. Starting from the chemical etching of Si (100) wafer in KOH solution and polishing by DDMAF process, the implementation of chemical oxidizers in the polishing region with constant flow rate and application of ultrasonic vibrations, the work highlights the consistent improvement in finishing efficacy.

In today’s internet era, the increased rate of using cloud services has been one of the most burning issue. Even though the various server available with high encryptesd cloud services as it is almost used by popular platform such as Yahoo, Gmail, Microsoft Outlook Express. However, Due to distributed and centralised data repository of information in the cloud services are more lean for attackers. And they are more vulnerabke to attack if cloud based system is not perfectly configured. User perosonal data and shared information is not secured on centralised locations which results in lack of security mecanism.. If an attack targeting a server is successful, information for all users on that server may be compromised. The flow of this research paper is to be introduced with a cloud based communication paradigm which also referred to enhanced cloudsim architecture at different layers with the scope of providing end to end security architecture. We have performed simulation and include results in support of end to end security with various protocol analysis for communication in between cloud based web services. Here we analyse security in the client and cloud server as FTP, HTTP for Remote server uploading and downloading time response and size specifications.

Focus of health care data research has shifted towards configuring and handling e-health information from heterogeneous e-health administration entities in a Content Distribution Network (CDN) for gaining e-health benefits which may be a testing errand. In recent trends, CDNis typically is used to reserve e-health networking substance as ongoing images captured in real time sequences and ongoing videos. In mobile cloud computing, due to patient's movement, it is required for medicinal services professionals to bring information of patient health with quick access of e-health data to make effective choices and select medication. Caching and its invalidation mechanism will provide the solutions in effective e-health data availability. A lot of caching methodologies are proposed, such as the Scalable Asynchronous Cache Consistency Scheme (SACCS) which has demonstrated more versatility over others. In this article, the authors recommend another reserve reinstatement algorithm with SACCS in consideration that is dependent upon rule-based Least Profit Value.

Background The factors responsible for seizure recurrence in patients with Solitary calcified neurocysticercosis (NCC) are not well understood. Blood brain barrier (BBB) breach may be associated with seizure recurrence. Dynamic contrast enhanced (DCE) MRI derived indices kep, ktrans and ve are useful in quantifying BBB permeability. In this study, we assessed the possible role of DCE-MRI and matrix metalloproteinases (MMP)-9 levels in predicting seizure recurrence. Methods In this prospective-observational study, patients with new-onset seizures and a solitary calcified NCC were included. DCE-MRI was done to quantify BBB integrity. DCE-MRI parameters were measured as kep, ktrans and ve. MMP-9 levels were estimated. Patients were followed for 1 year, when DCE-MRI and MMP-9 levels were repeated. Patients were classified into two groups on the basis of seizure recurrence, which was defined as the recurrence of an episode of seizure at least 1 week after the initiation of the anti-epileptic drugs. Logistic regression analysis was done. Results At 1-year of follow up, 8 out of 32 patients had seizure recurrence. Baseline DCE-MRI derived kep (p = 0.015) and MMP-9 levels (p = 0.019) were significantly higher in the seizure “recurrence” group compared with the “no recurrence” group. On within-group analysis, a significant increase in kep (p = 0.012), ve (p = 0.012), and MMP-9 levels (p = 0.017) was observed in the seizure “recurrence” group while a decrease was seen in ve and MMP-9 levels in the “no recurrence” group. Conclusion Higher values of DCE-MRI indices and MMP-9 levels, with a corresponding trend in the follow-up, can be useful in predicting lesions with a higher propensity for seizure recurrence.

Gait analysis has a wide application in medical, rehabilitation, geriatric care, biometrics, sports, animation, and many other avenues. However, gait analysis systems require highly sophisticated devices and methods in a laboratory setup under controlled environment. Consequently, sometimes the subjects are not able to display their natural gait pattern. There is thus a need for a system that works in uncontrolled conditions under practical constraints. This paper proposes a new approach for identification of human joints for gait analysis in a markerless setup or environment. The proposed method has been used successfully to determine coordinates of joints (shoulder, hip, left knee, right knee, left ankle and right ankle). The extracted positions of the joints are then compared with those obtained from marker based identification and ground truth. This comparative analysis performed confirms the efficiency of the proposed techniques used in the determination of the joint trajectory. These trajectory can play crucial role in gait related pathology diagnosis.

Background: The first round of national serosurvey in India was conducted in May-June 2020 among adults from 21 States. The second serosurvey was conducted in August-September 2020 to estimate the nationwide seroprevalence for SARS-CoV-2 infection in the general population aged ten years and above. Methods: The household serosurvey was conducted among individuals aged ten years and above in the same 700 villages and wards from 70 districts selected during the first serosurvey. Blood samples were tested using the Abbott SARS-CoV-2 IgG assay. Seroprevalence was estimated after applying the sampling weights and adjusting for clustering and assay characteristics. In order to compare the adult seroprevalence between the two surveys, we randomly selected one adult serum sample from each household. Findings: The weighted and adjusted prevalence of infection among 29,082 individuals aged ten years and above was 6·6% (95% CI: 5·8% - 7·4%). The seroprevalence among adults was 7·1% (95% CI: 6·2% – 8·2%). Seroprevalence was similar across age groups, sex, and occupation. Seroprevalence was highest in urban slum areas followed by urban non-slum and rural areas. We estimated a cumulative 74·3 million infections in the country, with 26 – 32 infections for every reported COVID-19 case by August 2020. Interpretation: Nearly one in 15 individuals aged ten years and above had SARS-CoV-2 infection by August 2020. The adult seroprevalence increased ten times between May and August 2020. Lower infection to case ratio in August compared to May reflects a substantial increase in testing across the country. Funding: The study was funded by the Indian Council of Medical Research, New Delhi, India. The study sponsor was involved in reviewing the study design, writing of the manuscript and the decision to submit the paper for publication. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The authors obtained written informed consent from individuals aged 18 years and older. We obtained assent from children aged between 10–17 years, and written informed consent from their parents or guardians prior to the survey. The Central Ethics Committee of Health Research of Indian Council of Medical Research and the Institutional Human Ethics Committee of ICMR-National Institute of Epidemiology, Chennai approved the study protocol.

BACKGROUND Several classification systems exist for sacral fractures; however, these systems are primarily descriptive, are not uniformly used, have not been validated, and have not been associated with a treatment algorithm or prognosis. The goal of the present study was to demonstrate the reliability of the AOSpine Sacral Classification System among a group of international spine and trauma surgeons. METHODS A total of 38 sacral fractures were reviewed independently by 18 surgeons selected from an expert panel of AOSpine and AOTrauma members. Each case was graded by each surgeon on 2 separate occasions, 4 weeks apart. Intrarater reproducibility and interrater agreement were analyzed with use of the kappa statistic (κ) for fracture severity (i.e., A, B, and C) and fracture subtype (e.g., A1, A2, and A3). RESULTS Seventeen reviewers were included in the final analysis, and a total of 1,292 assessments were performed (646 assessments performed twice). Overall intrarater reproducibility was excellent (κ = 0.83) for fracture severity and substantial (κ = 0.71) for all fracture subtypes. When comparing fracture severity, overall interrater agreement was substantial (κ = 0.75), with the highest agreement for type-A fractures (κ = 0.95) and the lowest for type-C fractures (κ = 0.70). Overall interrater agreement was moderate (κ = 0.58) when comparing fracture subtype, with the highest agreement seen for A2 subtypes (κ = 0.81) and the lowest for A1 subtypes (κ = 0.20). CONCLUSIONS To our knowledge, the present study is the first to describe the reliability of the AOSpine Sacral Classification System among a worldwide group of expert spine and trauma surgeons, with substantial to excellent intrarater reproducibility and moderate to substantial interrater agreement for the majority of fracture subtypes. These results suggest that this classification system can be reliably applied to sacral injuries, providing an important step toward standardization of treatment.

Background: Selective Nerve Root Block using steroid is a proven technique for management of lumbar radiculopathy. The aim of the study was to determine the effectiveness of selective nerve root block in lumbar radiculopathy.Methods: A prospective observational study was conducted for duration of one year in patients diagnosed with lumbar radiculopathy. Patients with leg pain, positive straight leg raising test and single level disc prolapse were included in the study. The procedure was performed under fluoroscopic guidance and Visual Analogue Pain rating scale and Oswestry Disability Index score was used for assessment pre-injection, 1 week, 1 month, 6 months and 1-year post injection.Results: Total 35 patient with mean age of 37.7± 9.31 years were included in the study. The pre-injection Visual Analogue Pain Score(Mean ± S.D:7.8±0.7) was significantly reduced at one week (4.2±1.47, p

BACKGROUND: Plantar fascitis is one of the commonest causes of heel pain. Thickening of plantar fascia is the most consistent sonological finding in plantar fasciitis.Objective: To estimate normal plantar fascia thickness in healthy Nepalese volunteers and evaluate its relationship with age, sex, height, weight and body mass index (BMI).METHODS: The plantar fascia thickness was measured at 5mm distal to its insertion into the calcaneus using 10 MHz linear array transducer. Total 700 feet of 350 healthy volunteers were evaluated in our study. Physical examination was also performed to assess height, weight and BMI.RESULTS: The mean plantar fascia thickness among entire population, male subjects, female subjects, right side and left side were respectively 2.39±0.37 (Range 1.4-3.6; 95% confidence interval=2.36-2.42); 2.47±0.37 (Range 1.4-3.6; 95% confidence interval =2.43-2.51); 2.32±0.35 (Range 1.4-3.5; 95% confidence interval =2.28-2.36); 2.39±0.36 (Range 1.4-3.6; 95% confidence interval =2.35-2.43) and 2.40±0.37 (Range 1.4-3.5; 95% confidence interval of 2.36-2.44). The mean was significantly higher in men than in women (p 0.05). Amongst age, sex, weight, height and body mass index; only age significantly co-related with the plantar fascia thickness.CONCLUSION: The mean plantar fascia thickness was 2.39±0.37mm. The mean is significantly higher in men than in women but similar in both feet. Sex, weight, height and BMI are not significantly related to the thickness. Age is the single most determinant factor of plantar fascia thickness.Journal of Manmohan Memorial Institute of Health Sciences Vol. 2 2016 p.37-44

Recent progress in plasma based accelerator technology has demonstrated its ability to deliver high energy (GeV) beams in compact structures (centimeter to meter scale plasmas). Current developments of that technology are oriented toward producing beams with quality and energy spread comparable to those obtained using standard accelerating structures. In plasma based accelerators, the beam energy spread can be improved during the acceleration process through beam loading. To achieve optimum beam loading, the beam has to be shaped such that the superposition of its space charge fields and plasma fields result in a uniform accelerating field. In this work we show how beam-induced-ionization injection can be used to shape and inject a trailing beam suitable for beam loading. Our particle-in-cell numerical simulations done with OSIRIS show the ionization injection of a shaped 340 pC, 13 kA and $3\text{ }\text{ }\ensuremath{\mu}\mathrm{m}$ long electron beam accelerated to 900 MeV in less than 3 cm of plasma. The configurations considered numerically were based on the beams and plasmas that have been and will be available at the FACET facility.

Due to increase in the Service provider and related companies, Cloud plays vital role in service industries by providing cloud based web services, so there is an emerging need to wisely choose the cloud service providers. The classified variety of administration services a cloud offers makes it crucial for clients to assess the administration dimensions of various cloud suppliers in such a way with the goal that required quality, unwavering quality or security of an application can be guaranteed. This paper deal with the issues and show the comparison of AWS and IBM cloud. Both Platforms are tested in comparable situations using their respective instances. Performance is precised by the compilation based on standard program through Phoronix Test Suite 3.

The advent of internet has led to the formation of a totally digitized environment, where each and everything is constantly in connection & can be easily accessed from anywhere. Traditional IP networks are difficult to understand and manage. Configuring the networks as per the already defined policies & making changes to it to react to issues faced has become difficult. The vertical integration of current networks adds to the difficulties. Software-Defined Network (SDN) is a new paradigm that promises to change and solve the problem. SDN breaks network into traceable pieces, thus making it less demanding to make & present new changes in networking, making network management & network evolution simpler. In SDN, load balancing is a brilliant technology as it can save power & improve the utilization of resources. This research focuses on analyzing the load and data in SDN for various distributed network topologies. Various network emulator and packet tracker tools have been used in the paper for generating statics.

Progressive Web Applications emerged as a better alternative to traditional mobile application development. Possessing the best of both native applications and web applications, PWA also offers advantages like offline loading of the application as well as services like push notifications and background synchronization to enhance user engagement. The paper provides an overview of using Progressive Web Apps as modern application development cycle. We have discussed in detail in the paper how progressiveness in a web application offers advantage over native application. The paper also discusses about the architectural pattern followed to develop progressive web apps to improve loading time of the app. API provided by the service workers have also been discussed in detail including push notifications and background synchronization to provide native app like experience. A case study has been carried out to depict the working of various progressive features.

Artificial Intelligence in PC games is a known concept and refers to designing the game such that even while playing games alone, there is a degree of intelligence in actions performed by the non-playable characters (NPCs) simulating human like behavior. It is often argued that video game AI is not truly intelligent and simply follows a set of instructions scripted by the developer. Hence, the objective is to study and compare traditional AI against a machine learned AI and make inferences based on the result. A game is developed in unity engine which is complex enough such that there is a balance of complexity in terms of difficulty to learn the game while also being simple enough to generate results as fast as possible.

Security testing of a web service is the most integral part of its existence in Web service life cycle monitoring. Through testing, this system can monitor the possibility of attacks and redesign the services using the considerations provided by monitoring system. There is a never ending need to produce cyber safe web services which can be trusted. Penetration Testing is a professional testing where the test engineer is responsible for auditing the web service for its ability to withstand security attacks. The present work provides a monitoring system which includes penetration testing for vulnerability/malware detection. We introduced the survey done for vulnerabilities found in WSLC phases, include sample testing methodologies and propose the monitoring framework to identify vulnerabilities in requests for accessing phases of web services launched by worlds wide users. The system architecture is a cost-effective solution to provide security from malware. This system introduces a perimeter defence strategy.

Electronic communication is increased rapidly so the need of Cryptography is also increased. There are different algorithms are available but some of the algorithms take large amount of time in encryption and decryption. So there is a need of lightweight cryptographic algorithms. In this paper we proposed an algorithm based on Trigonometric concepts which lightweight and provide security by up a great extent by reducing the chances of cryptanalysis. As compared to other algorithms like Hill cipher, Blowfish, DES etc, the proposed algorithm provides better performance. Basic trigonometric concept is used to design the algorithm.

Today, number of research works are under process using computing resources delivered as a service over the network. This paper focuses in the field of cloud computing and proposes the model for service clustering of cab services using k-means clustering. This paper proposes a highly competent and efficient methodology. Our research includes the web service development using AWS, real time data collection and its analysis based on clustering. The web services are designed to provide approximate time and distance as per client inputs and then produces the output in terms of cost of different cab services provided by the cab service providers. Through our clustering approach, we are proposing the better approach for selecting the best service using data analysis of web service quality dataset over AWS based developed model.

Pollution is in India as well as in the whole world is depleting the ozone layer and is playing major role in air pollution. The objective of research is to implement a carbon monoxide detection system which will measure and track the CO levels and can also measure the values in any applications. The IOT (Internet of Things) is the bridge connector to the existing Internet infra; it plays the role of connecting the thing (things are the physical devices like lights, phones, cars) to the Internet. We developed prototype or system using a MQ-7 carbon monoxide sensor and GPS system, which detects the gas leakage in Car at location tracked using GPS. The functioning of the prototype is described where we include the sensors, Raspberry Pi3, AWS IOT and dynamoDB. A SNS service in AWS is used to send message if found gas leakage in car. The message will be sent to the user by using the user ID in the amazon web services IOT console. The MQ-7 sensor data is programmed in Python Which is one of the supporting SDK's for RaspberryPi in AWS.

Today as we can see the population of the country is increasing at a very fast rate, despite our various efforts. The hospitals and medical services available for the rising population is very low. There are still many areas in our country which do not have proper medical help available. But, during these past years, there has been a huge rise in the data service providers, which has provided a huge support for Internet of Things. Hence from the support of the IoT technology, remote and rural areas can also be provided with proper health services. In most of the researches which are done on the topic, there are many loopholes like, no machine learning is implemented, sensors are not secured over the network, etc. Some of these issues have been addressed in this paper with results output of the system. Further, the paper proposes a model based on the integration of machine learning with the current system to predict future diseases in the patient or that remote area.

Mobile software development is an emerging technology and so are the strategies to build them. This paper focuses on the budding technology i.e. Progressive Web Apps (PWAs), which bridges the gap between web and native mobile apps. Service Worker is the backbone of any PWA. It enables caching of memory, offline access, and other gem features. To prove that caching memory improves the performance, tests have been performed. Taking the advantage of Google's Lighthouse (beta) tool, metrics have been calculated and solutions to improve them are suggested. We has demonstrate the service worker and its impact on cross platform approaches and compare android, iOS and PWA performance growth.

Now a days, there are number of cab services providers which are confusing the client with number of similar kind of service options. That's why there is a need of selecting a quality service from a set of given services. It motivates us to design an approach which is efficient in providing the effective service after the data analysis of real time data developed and collected through Amazon Web Services. This paper aims at analyzing a mathematical model that is used to predict the most efficient output of a dataset of a model using Artificial Neural Network. The proposed mathematical model is made and applied on a database of real time cab services developed using Amazon Web Services to predict the effective web service. We have analyzed the real time dataset using Rapidminer. The Analysis is done on the bases of the threshold and root mean square error values obtained. We are proposing the methodology which is highly competent and accurate in obtaining the results.

Healthcare Automation is an area, which involves various services, such as the housekeeping & patient management system. There is a incredible quantity of consideration and focusing to improve health. Big healthcare survey organizations illustrate that sickness and death rate, to a great extent rely on accessing of suitable healthcare systems, which is not accessible to an enormous preponderance of the worldwide inhabitants. This research paper introduce automating healthcare functions such as monitoring, accessing of information of patients by doctors using effective grid search technology, interactive user interface assistance for the doctors and junior doctors for any queries & cache management technology based web application for efficient performance. We elucidate our thoughts on how technology can aid in this vital and crucial life sustaining goings-on. We provide insight hooked on our effort on automating medical sector by means of text mining techniques, Natural Language Processing, Elastic Search, PHP-MVC, Web Services and Cache and include some initial results.

is an explosion in the volume of data in the world. The amount of data is increasing by leaps and bounds. The sources are individuals, social media, organizations, etc. The data may be structured, semi-structured or unstructured. Gaining knowledge from this data and using it for competitive advantage is the primary focus of all the organizations. In the last few years Big Data has found its way in almost every field, from government to private sectors, industry to academia. The major challenges associated with Big Data are data organization, modeling, data analysis and retrieval. Hadoop is a widely used software framework used for the large scale management and analysis of data. The main components of Hadoop: HDFS and MapReduce, enable the distributed storage and processing of data over a large number of commodity servers. This paper provides an overview of MapReduce and its capabilities and discusses the related issues.

Speech recognition and artificial intelligence powers the automatic speech recognition systems, these system can be applied in the call center environments. This paper explains the use of emotion recognition techniques to identify if the customer are satisfied the ASR system’s performance. This paper presents approaches and techniques for how automatic speech recognition can improve the user experience and save capital in operations of call center.

Today's Classical cryptographic algorithms will fail against the quantum cryptosystems. In this paper, Security protocols are reviewed with analysis of intercept-resend, faked-state and light pulse attacks and eavesdropper strategies to gain the information transferred in between communication channel. The quantum cryptography is providing absolute security against the above stated attacking environment. That is the reason for using the concepts of quantum mechanics with cryptographic algorithms to achieve the utmost security. This paper is focusing on review to the key distribution techniques used for protecting the communication. We found that the communication is successfulif we use privacy amplification, authentication, and Bell's inequalities.

Stream ordering and analysis of tree networks are necessary for understanding graph data structures. The idea of stream ordering finds its base in hydrology and open networks. Large dataset representations of such networks are difficult to process for analysis. In this paper, the stream ordering concept has been extended to a general class of structures characterized by open network semantics. A new algorithm has been proposed for analyzing tree networks and hierarchal subdivision of network segments through traversal, with minimal and generic computation over Arc–Node topological data sets. The algorithm has been implemented as a case study for understanding the complexity and calculation of manhole invert levels of sewer network of wastewater utility in the capital city of Delhi.

The present work provides a system and method for malware detection wherein the system stores malicious files and replicates only safe files to the main server by the use of containerized scanners. This architecture is a cost-effective solution to provide security from malware. This system introduces a perimeter defense strategy. This works outside of main servers to maintain the confidentiality, integrity, and authenticity of already in place servers.

WS Recommendation is challenging job due to its dynamic behavior in QoS. This document explains the various web services that are provided on the internet, how they are implemented, the protocols used in order to invoke these ws, the architecture & lifecycle of ws. The document also elucidates the various Quality analysis parameters and states the quality metrics that are available in order to evaluate the QoS. The evaluation of QoS is very important for the recommendation of web services. In this document, grading or ranking of QoS is done in order to recommend web services. The formulas for computation of rank of QoS has been analyzed and deduced in this documentation. The order in which QoS is ranked, WS is recommended to the user or clients accordingly. The formulas computed in this document are more efficient and clear in terms of factors included.

To analyze the differences between standing and supine plain film lateral radiographs of the lumbosacral region in low grade (grade I/II) spondylolisthesis using the Picture Archiving and Communication System (PACS) software. Demonstrable difference might be a parameter of instability which might be useful in planning surgical treatment when it is too painful for patients to undergo flexion/extension Xrays.Radiographs of 23 patients with low grade spondylolisthesis were analyzed for percentage slip, lumbar lordosis, disc height, sacral inclination and slip angle. These standing and supine lateral radiographs were taken at the same distance with the same magnification. Measurements obtained were statistically analyzed with the SPSS software using the student t test for statistical significance (p

The concept of surveillance drones arises to aid the problem of tracking humans quickly without risking more human lives in desperate times like disasters or terrorist attacks. The design consists of a Quad-Copter with a Wi-Vi sensor, infrared camera and GPS to quickly track humans from distance on areas which are not quickly reachable from land and/or are not safe for a human to reach unknowingly. The key element here is the detection of humans below rubbles in case of disaster and terrorists hidden behind walls.

Internet of Things (IoT) refers to technological advancements in the networking with the help of which real world objects can be connected to communicate with each other over the internet. The objects that are connected are known as ‘things’. This interconnection of various things over the internet with the capability of sending and receiving information has a wide number of applications in almost every field like healthcare, business, transportation, agriculture, management and education. This paper will discuss about the Internet of Things (IoT) in general, some of its applications with particular emphasis on E-learning. Finally the paper gives a model of Smart Learning using the IoT and the gamification technique of E-Learning.

Flood attacks means a network becomes so weighed down with packets, caused by the attackers. It prevents packets being sent/received between the no des in the network. There are many methods adopted to prevent flood attacks in other networks, but non e has been installed successfully for DTN’s. Disrup tion tolerant network is a network, developed in such a manner that intermittent communication problems have very low effect on the outcome of the result. However, due to the limited network resources in th is network such as buffer space and bandwidth, it is l iable to flood attacks. In order to protect resourc es and defend against flood attacks, the rate limiting tec hnique should be adopted. In which each node must be set up with a restriction over the number of packet s it can send to the network and number of duplicat es that can be created for each packets, such as rate limit L and rate limit R respectively. However floo d attacks are caused even in application level result ing in losses of resources such as CPU and sockets. So, technique for detection of application level floods attacks is implemented by verifying DNS query with a specific tool and validating it with mysql database .

Due to the increasing complexity of web systems, security testing has become indispensable and critical activity of web application development life cycle. Security testing aims to maintain the confidentiality of the data, to check against any information leakage and to maintain the functionality as intended. It checks whether the security requirements are fulfilled by the web applications when they are subjected to malicious input data. Due to the rising explosion in the security vulnerabilities, there occurs a need to understand its unique challenges and issues which will eventually serve as a useful input for the security testing tool developers and test managers for their relative projects.

With the enhancement in mobile technology, QR (Quick Response) codes became popular. QR codes are widely used in our daily life from social media websites to cashless shopping wallets, ERP(Enterprise Resource Planning) software implementation to display advertising and digital marketing etc. In this paper we have focused upon one major issue with the QR codes. We have focused upon data various techniques used to increase data storage capacity of QR code. This paper is divided into five subparts. In first part we have introduced about basics of QR codes, their versions, creating and scanning process and its various applications. Then in second part we have written about various features of QR codes, due to them QR code became so popular and we have also discussed about its structure to understand its basic functionality. Thereafter we have compared three different kinds of co des-b ar code, quick response code and color quick response code, on the basis of its storage capacity, error resistance, 360° reading and other factors. Then in fourth part we have reviewed the literature and mentioned various techniques used by researcher to in crease data storage capacity of QR codes. In fifth part of this research paper we have proposed encoding and decoding algorithm, which will result into high storage color QR code. And a t the end, we have discussed about our future directions in order to increase storage capacity of QR codes and make stored information more secure and reliable for the end users.

Web Services Computing is a growing field with a vast potential for applications of business process management by the implementation of what is known as Service Oriented Architecture (SOA). Business activities can now be independently harvested and grown and later extracted from the “toolkit” of services for composition into large scale applications. This powerful architectural style has translated business logic into useful Web Services or Web APIs across the World Wide Web. This paper delves into the reason for continuously finding and implementing better Quality of Service parameters to define Quality Standards for Web Services. Apart from revisiting research in QoS parameters for Web Services, it is attempted to provide a better understanding of current techniques in Web Service selection, prediction and ranking. A research effort towards a model for Web Service Recommendation is proposed and critically analysed considering the possibility of its implementation in the future.

A more of work has been made to check the content of the social websites, especially the posts or the views of the users; their sentiment analysis has to be done. The main aim is to analyze the sentiments and then to compare those views with the main topics and other platforms. There are enormous amount of the posts given by the users on the social websites. But some of the people are interested in knowing the influence and the relations among those posts. Many of the researchers find the influence of the post on these social websites. But, we cannot find the influence of these posts without knowing the sentiments of the posts. Here we have discussed various methodologies for the sentiment analysis. Online reviews are important for the developers to improve their products and can compete in the market properly. There are several dimensions which help us to know the sentiment of the reviews on the websites. These analyses are also used to find some patterns and draw the conclusions. Hence we can find the favorable and as well as unfavorable parts of the posts. These reviews are important to analyze but there are a very few techniques to determine the sentiment of the reviews [2]. For example, one has given the approach to know the multidimensional rating from various reviews. From the vast amount of reviews on the internet based on different areas, it is very important to know about the different sentiments of the people.

The role of laser speckle structure (hot spots) and its ponderomotive self-focusing (PSF), in crossed beam energy transfer (CBET), of smoothed laser beams is investigated in an inhomogeneous expanding plasma. Numerical simulations using the code harmony in two spatial dimensions, demonstrate how self-focusing of laser hot spots in crossed beams can significantly affect the transfer of energy from one beam to the other in addition to the stimulated Brillouin scattering (SBS) process. It is shown that for sufficiently intense laser beams, when the laser hot spots exceed the criterion for self-focusing in a plasma with flow, the angular spread of transmitted light beams increases considerably with the intensity, which arises in particular, in expanding plasma where significant beam deflection is observed. It is shown for the first time that besides SBS, the contribution of speckle structure, PSF, and deflections of the intense hot spots in multiple speckle beams to CBET, therefore matters.