Search

Anterior urethral valves (AUVs) are rare congenital anomalies causing lower urinary tract obstruction in children. The present study highlights the clinical approach in identifying the condition and its treatment options.Single centre, retrospective study of children.Over a 16 year duration, 14 children were diagnosed with AUVs and diverticula with a mean age of 15 months. Clinical features included straining at micturation and a palpable penile swelling. Diagnosis was confirmed with voiding cystourethrogram and cystoscopy. An open surgical procedure was performed in 12 cases and endoscopic intervention done in one. On follow up 13 patients showed restoration of a normal voiding stream and normal renal function. One child died of chronic renal failure due to a delayed presentation, severe back-pressure changes, urinary ascites, and urosepsis. One patient developed a small urethrocutaneous fistula that healed spontaneously.AUV, though rare, should be recognizable due to the combination of a poor urinary stream and visible swelling in the ventral aspect of penis. Open surgical excision is the method of choice, and the outcome is excellent.Level IV.

During the COVID-19 pandemic, huge interstitial lung disease (ILD) lung images have been captured. It is high time to develop the efficient segmentation techniques utilized to separate the anatomical structures and ILD patterns for disease and infection level identification. The effectiveness of disease classification directly depends on the accuracy of initial stages like preprocessing and segmentation. This paper proposed a hybrid segmentation algorithm designed for ILD images by taking advantage of superpixel and K-means clustering approaches. Segmented superpixel images adapt the better irregular local and spatial neighborhoods that are helpful to improving the performance of K-means clustering-based ILD image segmentation. To overcome the limitations of multiclass belongings, semiadaptive wavelet-based fusion is applied over selected K-means clusters. The performance of the proposed SPFKMC was compared with that of 3-class Fuzzy C-Means clustering (FCM) and K-Means clustering in terms of accuracy, Jaccard similarity index, and Dice similarity coefficient. The SPFKMC algorithm gives an accuracy of 99.28%, DSC 98.72%, and JSI 97.87%. The proposed Fused Clustering gives better results as compared to traditional K-means clustering segmentation with wavelet-based fused cluster results.

Background:Cervical cancer is the most common malignancy and health problem in women of all sections of society. Cancer is a group of diseases characterized by the uncontrolled growth and spread of abnormal cells. Cervical cancer is the most common cause of death among women worldwide, with about 570, 000 cases and 311,000 deaths, despite the fact that cervical cancer is preventable. It ranks as the first most frequent cancer among women between 21 – 44 yr of age. Methods:A quantitative study was carried out in 35 adolescent girls and the non-probability purposive sampling technique was used for the selection of the subjects and the college. The data was collected through of using a structured knowledge questionnaire. A structured teaching program was developed and administered to the reproductive age girls (17-35 years). Results:The data were analyzed by using descriptive and inferential statistics. The result revealed that after the intervention the mean and standard deviation of the post-test knowledge was 17.65±2.11 being compared to mean and standard deviation of pre-test knowledge 7.2±2.35. The enhancement of knowledge score is the mean difference 10.54. It indicates that there was a significant improvement in the level of knowledge of participants. The calculated t- value (6.57) on analysis of the data was found to be significant at p value 0.05. Conclusions:The study concluded that a structured teaching programme was significant effective to improving the level of knowledge of cervical cancer.

A case of lupus erythematosus tumidus (LET), a subtype of chronic cutaneous lupus erythematosus, in an 85-year-old woman who presented with discrete indurated erythematous plaques over the face and upper chest is described. A skin biopsy showed features in keeping with a diagnosis of LET. Unusually however, the lymphocytic infiltrate contained frequent macrophages that demonstrated hemophagocytosis. Most of the phagocytosed cells were lymphocytes, but there was also evidence of erythrophagocytosis. The presence of conspicuous hemophagocytosis has only rarely been reported in skin biopsies of patients with autoimmune conditions. These include systemic lupus, neonatal lupus and dermatomyositis, and on 2 occasions in cases of nonspecified cutaneous lupus erythematosus. To the best of our knowledge, hemophagocytosis as a feature of LET has not been previously described in the literature.

Objective: The aim of the study was to analyze adverse drug reactions (ADRs) reported in patients prescribed antidepressants at tertiary care hospital. Methods: A prospective and observational study was conducted during January 2020–July 2021 at Department of Pharmacology in collaboration with the Department of Psychiatry, GSVM Medical College, and Kanpur. All patients diagnosed with depression and receiving pharmacotherapy were included in the study. ADRs were monitored using the standard form of the Central Drugs Standard Control Organization and causality was determined using the Naranjo algorithm. Data were evaluated for patient’s demography, risk factors for ADRs, and pattern of ADR. Results: A total of 293 ADRs were recorded from 110 patients. The most common ADRs observed were anxiety (47.42%) and insomnia (19.22%). Men (58.18%) were most commonly affected than women (41.82%). The most common causal drugs among antidepressants were Escitalopram (27.27%) and Venlafaxine (21.81%), respectively. The most common system involved was central nervous system (53.24%) followed by gastrointestinal system (41.63%). The majority of ADRs (97.95%) were possible according to the Naranjo’s scale. Conclusion: Anxiety, insomnia, and dizziness were the common ADRs which were associated with the use of antidepressants. This study offers a representative profile of the ADRs which can be expected in the psychiatry outpatients.

Introduction: Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. Objective: To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%). Materials and Methods: This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. Observation and Result: In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48). Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups. Keywords: Celiac plexus, Neurolysis, Alcohol, Abdominal malignancy.

Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%).This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48).Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups.

A ‘Smart Village’ will provide long-term social, economic, and environmental welfare activity for village community, which will enable and empower enhanced participation in local governance processes, promote entrepreneurship and build more resilient communities. At the same time, a ‘Smart Village’ will ensure proper sanitation facility, good education, better infrastructure, clean drinking water, health facilities, environment protection, resource use efficiency, waste management, renewable energy etc. There is an urgent need for designing and developing ‘Smart Village’, which are independent in providing the services and employment and yet well connected to the rest of the world. The Smart Village concept will be based on the local conditions, infrastructure, available resources in rural area and local demand as well as potential of export of good to urban areas. The present paper examine motivation behind the concept on ‘Smart Village’ is that the technology should acts as a catalyst for development, enabling education and local business opportunities, improving health and welfare, enhancing democratic engagement and overall enhancement of rural village dwellers. In the Indian context, villages are the heart of the nation. So we can achieve socio economic development of the Nation by enlarging the concept of smart villages on improving pattern.

Objectives: Postoperative pain after modified radical mastectomy ranges from moderate to severe. Pectoralis block in comparison to Erector Spinae block have been found better in reducing pain scores and reducing consumption of rescue analgesic in postoperative period. This study aimed to compare the effect of Erector Spinae block and Pectoralis block on quality of recovery after Modified Radical Mastectomy using QoR-40 score. Methods: After general anaesthesia, patients were given block according to computer generated randomization. Group-I-Pectoralis block including PEC I AND PEC II(PECS), Group-II-Erector spinae block(ESP) and Group III-Control Group (No intervention). Quality of recovery (QoR-40) score was observed on morning of surgery and at 24 hrs. Time to rescue analgesia and total consumption of rescue analgesia in first 24 hrs. were also observed. Results: In the postoperative period at 24 hrs. Global QoR-40 scores were 183.64±6.36 in PECS group, 179.68± 6.38 in ESP group and 171.37±6.88 in control group. (p

The hotel industry requires talented managers and this research examined the barriers and motivators that impact the intentions of employees to pursue higher management positions. Positions that of...

This paper simply presents a state of the art survey among the machine learning based approaches for the Glioma classification. As Glioma classification is a very challenging task in the field of medical science and this task is well addressed and taken by the fraternity of machine learning experts, who are working day and night to devise automated approaches that can automate this whole process of Glioma accurate classification from the various medical imaging modalities like Magnetic resonance imaging (MRI), Computed tomography (CT) etc. Although present machine learning techniques offers an opportunity to come up with a highly accurate and automated Glioma classification approach, by performing fusion among the various medical imaging modalities as well as utilizing the various features derived from the multi-modality medical imaging data. This paper also proposed an efficient and accurate automated approach of Glioma classification for the comparison analysis. This proposed approach is based on the use of hybrid ensemble learning model and hybrid feature extraction method, which relies on the Discrete wavelet Decomposition (DWD), Central pixel Neighbourhood Binary pattern (CNBP) and GLRLM (Gray level run length Matrix) methods in order to classify the Glioma (type of mostly diagnosed brain tumors) into Low grade Glioma and High grade Glioma from the fused MRI sequences. Improved eXtreme Gradient Boosting classifier is the hybrid ensemble learning model, which is used in this paper for the first time along with the proposed hybrid texture feature extraction method. Further this proposed approach is compared with the already existing state of the art approaches, which are based on the various machine learning classifiers like Support vector machine (SVM), K-Nearest neighbor (KNN), Naive Bayes (NB) etc. and conventional feature extraction methods in order to present a comprehensive and practical comparison study. The proposed approach is evaluated on the balanced large size local dataset consisting of MRI images of low and high grade Glioma collected from the various MRI centers located in Madhya Pradesh, India as well as on the popular global datasets like, BRATS 2013 and BRATS 2015 with various MRI fusion combinations (T1 + T1C + T2 + Flair, T1 + T1C + T2, T1 + T1C + Flair, T1C + T2 + Flair etc.). The proposed approach employing Improved eXtreme Gradient Boosting ensemble model offers highest accuracy of above 90% on the local dataset with the fusion of T1C + T2 + Flair MRI sequences.

In the era of globalization, student placement is very challenging issue for all educational institutions. For engineering institutions, placement is a key factor to maintain good ranking in the un...

A case of localized argyria in a 36-year-old female jeweler is described who presented with 2 discrete and asymptomatic bluish-black pigmented macules on the pulp of her left middle finger. A skin biopsy from both lesions demonstrated deposition of brown/black pigmented granules along the basement membrane zone of eccrine glands, blood vessels, nerves, and the dermo-epidermal junction fully in keeping with silver deposition. In addition, there was yellow-brown deposition seen within the interstitial dermis mimicking an early form of ochronosis, so called "pseudo-ochronosis." This latter feature is rarely described in cases of argyria. Transmission electron microscopy and energy dispersive x-ray spectroscopy confirmed the presence of electron dense particles up to 150 nm in diameter and the presence of silver, respectively. On further questioning, the patient had a history of localized and chronic exposure to silver, which specifically involved holding and manipulating silver wires and rings over the left middle finger. This case highlights an unusual and rare presentation of localized argyria in a jeweler. In addition, our case showed preferential silver deposition on dermal elastic fibers which has not been previously described in the literature.

Introduction: Adolescent girls often have lack of knowledge and practices regarding reproductive health including menstruation. Objectives: To evaluate effectiveness of structured teaching program (STP) to increase level of knowledge and practices on menstrual hygiene among adolescent school girls. Methodology: Pre-experimental one group pre-posttest study design was applied in four government schools using power analysis for sample size calculation. Data were re- checked for its consistency and analyzed. Descriptive statistical methods were used for describing sample characteristic and inferential statistics was used to evaluate effectiveness of STP. Chi-squared test was used to examine association between selected demographic variables and pretest knowledge level of adolescent girls on menstrual hygiene. Result: The mean age of participants was 13.79 ±1.3 years (range from 11-18 years). Distribution of pre-test knowledge among respondents regarding menstrual hygiene showed, 49.21% moderate and 50.79% adequate knowledge respectively. In the case of post-test, all of them demonstrated adequate knowledge and none of them showed inadequate knowledge. Pre-test practices among respondents regarding menstrual hygiene recorded as 3.75% inadequate, 61.25% moderate and 35.0% adequate practices. The pre-test mean score for the level of knowledge was 13.36±1.64, whereas the post-test mean score was 15.8±0.73. Practice related pre-test mean score was 10.66±1.81 in comparison to, post-test mean score 13.34±0.75. There was no significant association found between knowledge regarding menstrual hygiene among adolescents with socio-demographic variables at p

Introduction: Rupture in an unscarred uterus prior to onset of labor in third trimester is a rare event and very few cases have been reported in literature so far. Case Report 1: We describe a case of a primigravida who presented in emergency with pain abdomen with placenta praevia and severe oligominos. An ultrasound was conducted which reported bicornuate unicollis uterus with single live foetus 33+4 weeks having severe oligohydromnios (AFI=2) with placenta anterior and reaching upto internal os in one cornua, the other cornua was empty. A MRI was conducted, which was also inconclusive. She was taken up for laprotomy, peroperatively pregnancy was present in left horn of uterus which had ruptured with intact amniotic sac and was covered with omentum, the placenta was covering the lower half of the left horn and the right horn looked like normal uterus and was empty. The omentum was carefully separated and baby that was delivered weighed 700gms. The left horn was excised and then uterus was closed in layers. Patient was followed up for 6 months, mother was doing well, though baby was 5 kg which was less than the weight for that age and had slow developmental milestones. Case Report 2: Our second case was a 30 years old gravida 5, para 2, abortion 2 woman with 8 months amenorrhea. She was referred with chief complaint of pain abdomen. On examination, she looked almost stable. Even though she was pale; vital signs were within normal parameters. An ultrasound was conducted which showed single live intrauterine foetus 29+2 weeks with absent liquor with placenta praevia with placenta acreta. Emergency laprotomy was decided in view of placenta acreta. It was found to be an abdominal pregnancy. Amnion along with omentum and blood clot matting sac like structure sitting over the fundus with placenta perforating the fundus small incision was given at the fundus and baby weighing 1.15 kg delivered through it. Placenta did not separate and so decision of hysterectomy taken.

Stenosis, the abnormal narrowing of artery, significantly affects dynamics of blood flow due to increasing resistance to flow of blood. Velocity of blood flow, arterial pressure distribution, wall shear stress and resistance impedance factors are altered at different degree of stenosis. Prior knowledge of flow parameters such as velocity, flow rate, pressure drop in diseased artery is acknowledged to be crucial for preventive and curative medical intervention. The present paper develops the solution of Navier–Stokes equations for conservation of mass and momentum for axis-symmetric steady state case considering constitutive relation for Reiner–Rivlin fluid. Reiner–Rivlin constitutive relation renders the conservation equations non-linear partial differential equations. Few semi-analytical and numerical solutions are found to be reported in literature but no analytical solution. This has motivated the present research to obtain a closed-form solution considering Reiner–Rivlin constitutive relation. Solution yields an expression for axial velocity, which is utilized to obtain pressure gradient, resistance impedance and wall shear stress by considering volumetric flow rate as initial condition. The effect of viscosity, cross viscosity, flow rate, taper angle of artery and degree of stenosis on axial velocity, resistance impedance and wall shear stress are studied.

Background: The persistence of disease in periapical tissues is most commonly associated with difficulties or mishaps which occur during or after initial endodontic treatment. Aims and Objective: To isolate and identify the organisms in root canal failed cases & its current antibiotic susceptibility pattern. Materials and Methods: study was conducted on 51 patients attending the OPD of dental Department Nalanda Medical College and Hospital, Patna. The results were analyzed using VITEK-2 automated analyser (Bio Merieux UK). Results: A total of 18 types of bacteria were isolated and among them 17.3% cases reported E- faecalis and another 15.2% cases reported E-cloacae complex. Pseudomonas aeruginosa accounted for 8.7% while 6.5% constituted of E-faecium, Escherichia coli etc. Conclusion: Enterococcus species was found in majority of cases indicates that it is the predominant bacteria responsible for endodontic failure.

In this study, an insulated gate bipolar transistor (IGBT) with three-layer poly gate is proposed and investigated by TCAD simulation. Here, gate is spilt in two different workfunction materials of N+ poly ( $$\phi _{g}$$ = 4.17 eV) and P+ poly ( $$\phi _{g}$$ = 5.25 eV). Lower workfunction poly layer is sandwiched between higher workfunction poly, connected via a single metal. The gate oxide thickness is varied in x-direction. This leads to improvement in transconductance and reduction in miller capacitance. Thin oxide near the emitter serves good control over the charge carriers in the channel. This deployment of dual material gate in proposed device results in 36% reduction in area-specific on-resistance without any degradation in breakdown voltage. In addition to this, proposed device exhibits improved transient characteristics with 18.5% and 60% reduction in turn-off time and delay, respectively, as compared to conventional device. Further, the turn-off energy loss is reduced by 23.5% and 29.09% reduction in on-state voltage drop is achieved. Furthermore, proposed device offers 23%, 58%, and 30% improvement in FOM1, Baliga figure of merit (BFOM), and FOM2, respectively.

Electrocardiogram is the measure of heart electrical activity. Our heart generate electrical signals which we used to calculate heart activity .The electrical signals of heart are transformed into waveforms which are used to measure various heart conditions. We have various techniques which we used to analyze and classified the ECG signals in MATLAB. There are many types of heart Arrhythmia like Tachycardia in which heart rate is too fast, Bradycardia in which heart rate is too slow, Atrial Fibrillation, Atrial Flutter, Ventricular Fibrillation,Permature contractions these all conditions can easily classified in Matlab by using some proper approach. We have techniques like Wavelet transform, Graphical user interface using wavelet transform toolbox, Support vector machine, Convolutional neural network, Discrete cosine transform. To improve the order execution, molecule swarm improvement method is utilized for progressively tuning the learning parameters of the SVM classifier. This paper gives brief survey on different techniques for analysis and classification of ECG signals. Wavelet Transform gives more accuracy and precise result. And we analyze MATLAB software is a best approach for analysis and classification of ECG signals.

The loss of teeth leads to difficulty in chewing and smiling and an unesthetic appearance. The present study assessed the role of complete dentures in improving the chewing efficiency of edentulous patients.Eighty-two complete denture wearers of age group 40-75 years of both genders were enrolled in the study. The chewing efficiency of denture was determined by VMM machine. Patients were provided with the self- administered questionnaire and were advised to answer.Out of 82 patients, there were 42 (51.2%) males and 40 (48.8%) females. The mean ± SD particle size was found to be 0.12 ± 0.07 mm in males and 0.13 ± 0.06 mm in females. A non-significant difference was observed (There was improved chewing efficiency with the complete denture, and the patient satisfaction level was high among patients.