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Background: Primary lung cancers in India were reported to be rare in earlier studies. But the trend is changing and there is increased incidence of lung cancers. Aims and Objectives: This present descriptive observational study was conducted to report the risk factor profile of the lung cancer patients from the Himalayan state of the Indian population. Materials and Methods: This descriptive epidemiological study was conducted from a single centre, in a prospective observational design, among the patients who were diagnosed as carcinoma lung histologically or cytologically over a period of one year in a tertiary care referral centre in the Himalayan state of the Northern India. The patients data was collected in detailed manner pertaining to age, sex, residence and occupation, questionnaires regarding risk factors like smoking history, Environmental tobacco smoke exposure, Indoor pollution, Alcohol history, HIV infection, Structural lung disease, Religion and Geography. Results: One hundred and one consecutive patients of primary lung cancer were recruited in the study which was confirmed either cytologically or histopathologically. Out of 101 patients, 79 (78.2%) were males and 22 (21.8%) were females, mean age was 62.65 years, 97 (96%) patients had rural background and 4 (4%) patients had urban background, 96 (95.04%) patients were active smokers, 3 (2.9%) were passive smokers and non smokers were 2 (1.9%), 25 (24.8%) were vegetarians and 76 (75.2%) were non vegetarians. 36 patients (35.6%) were from altitude of 0-1000 meters, 41 patients (40.6%) were from altitude of 1001-2000 meters, 21.8% were from altitude of 2001-3000 meters and 2% were from altitude of 3001-4000 meters. Adenocarcinoma was the most common type at all altitudes. Conclusions: Awareness about carcinoma lung in the Himalayan state especially in rural population is still lacking and are presenting at an advanced stage, which largely impact on survival of the patients. This study provides the data pertaining to risk factor profile of the lung cancer patients from the Himalayan state and can be utilised for future comparison with other Indian studies, to educate the community and to spread the awareness of the prevailing lung cancer risk factors.

Due to increase in population and industrial growth, insufficient energy resources to generate or transmit the power in power system, increase in load causes power demand in the electrical power system. These power demand leads to voltage instability, increase the losses, reduces the power transfer capability and stability of the power system. To overcome this stability problem FACTS devices are optimally located in the power system to examine the stability of the system. To locate the FACTS devices different optimization algorithms are used in order to improve the stability of the electrical power system.

Content-based image classification has produced successful and automated applications in various service and product industries. In this paper, high-resolution satellite scene classification based on multiple feature combination is considered. We have proposed confidence co-occurrence matrix, which is a modification of the generalized co-occurrence matrix. The proposed framework combines RGB histogram, HSV histogram, local binary pattern, confidence co-occurrence matrix properties and Canny’s edge detection approach. The approach creates a fixed-size feature vector of size 1632. Once a feature vector has been constructed, classification is performed using linear support vector machine. The system is tested using widely popular benchmark Satellite Scene dataset and UC Merced land used dataset having 19 and 21 classes respectively. The proposed system also works well in agricultural science. The system is also tested on folio dataset having 32 species of leaf. The proposed system is implemented in MATLAB and achieves an average class classification accuracy of 99%.

In this paper, computer vision based Content-Based Image Classification systems have been described which are useful in various service and product industries. We have proposed Confidence Co-occurrence Matrix, which is a modification of Generalized Co-occurrence Matrix. The proposed framework merges properties of Confidence Co-occurrence Matrix along with other features such as RGB and HSV Histograms, Local Binary Pattern and Canny’s edge detection approach. Proposed approach creates a fixed- size descriptor of size 1632. Once a feature vector has been constructed, classification is performed using Linear Support Vector Machine. The System is tested on four different wellknown datasets namely, sport events Database, Flavia Leaf Dataset, Leeds Butterfly Dataset and Birds Dataset . The proposed system is implemented in MATLAB and achieves an average class accuracy of 96%, 99%,95% and 95% for the four datasets respectively

The pathologic hypertrophy of hypertensive heart disease is related to the quality, not the quantity, of myocardium; the presence of fibrosis is inevitably linked to structural and functional insufficiencies with increased cardiovascular risk. Elevations in plasma aldosterone that are inappropriate relative to dietary sodium, or relative aldosteronism, are accompanied by suppressed plasma renin activity, elevation in arterial pressure, and dyshomeostasis of divalent cations. The accompanying hypocalcemia, hypomagnesemia, and hypozincemia of aldosteronism contribute to the appearance of secondary hyperparathyroidism. Parathyroid hormone-mediated intracellular calcium overloading of cardiac myocytes and mitochondria leads to the induction of oxidative stress and molecular pathways associated with cardiomyocyte necrosis and scarring of myocardium, whereas the dyshomeostasis of zinc compromises antioxidant defenses. This dys-homeostasis of calcium and zinc, intrinsically coupling prooxidant calcium and antioxidant zinc, raises the prospect for therapeutic strategies designed to mitigate intracellular calcium overloading while enhancing zinc-mediated antioxidant defenses, thus preventing adverse myocardial remodeling with fibrosis, associated diastolic dysfunction, and cardiac arrhythmias.

The salt-avid state that accounts for the clinical syndrome congestive heart failure (CHF) leads to an initial expansion of intra- and subsequent rise in extravascular volumes that can include the appearance of pleural effusion. Herein, we present a 54-year-old man with a dilated cardiomyopathy who was hospitalized because of his CHF, which included bilateral pleural effusions, right hydrothorax greater than left. The pathophysiology of pleural fluid formation in CHF, previously debated, has now reached consensus, albeit not frequently reviewed. This index case offers such an opportunity.

Travel and tourism are the largest service industries in India. Every year people visit tourist places. and upload pictures of their visit on social networking sites or share via mobile device with friends and relatives. Millions of such photographs are uploaded and it is almost impossible to manually classify these pictures as per the monuments they have visited. Classification is helpful to hoteliers for development of new hotel with state of the art amenities, to travel service providers, to restaurant owners, to government agencies for security etc. The proposed system extracts Genetic programming evolved spatial descriptor and classifies the Indian monuments visited by tourists based on linear Support Vector Machine(SVM). The proposed system is divided into 3 main phases: preprocessing, genetic programming evolution and classification. The Preprocessing phase converts images into a form suitable for processing by genetic programming system using Generalized Co-Occurrence Matrix. The second phase generates best so far spatial descriptor in the form of program based on the fitness. The Fitness is calculated using SVM. Once program is obtained as output it can be utilized for classification. The proposed system is implemented in MATLAB and achieves high accuracy.

In this paper a novel approach for recognizing facial expressions from 3D sonography baby images is proposed. The posture of baby is uncertain in every image. It has been observed that sometimes face area is covered by some hand or leg portion. Identification of non-face part and removal of this portion is very essential. Preprocessing of image is essential to extract the face part from the image. A low intensity 3D sonography image is first preprocessed through various techniques such as histogram equalization, erosion and dilation. To extract the face part from the enhanced image, distance based clustering is applied. 3D sonography image may contain frontal or non-frontal face position because of the posture of baby during sonography. First level backpropagation neural network will classify the image in either frontal or non-frontal class with 97% of accuracy. Different feature extraction techniques have to be applied on classified frontal and non-frontal images. Local Binary Pattern (LBP) and template based matching techniques are used for feature extractions of frontal and non-frontal class of images respectively. The extracted features will be supplied to Minimum Redundancy and Maximum Relevance (MRMR) algorithm which will select the most promising N features. Extracted features are used to train the second level neural network and which classifies the image in any of the universal facial expression classes named: normal, happy and sad. Proposed approach is implemented in MATLAB and tested on about almost 500 images and significant amount of accuracy is obtained. Some anomalies like obesity, cleft lip or palate and birth-mark can also be found by the proposed approach.

Recently, Content-Based Image Retrieval is a widely popular and efficient searching and indexing approach used by knowledge seekers. Use of images by e-commerce sites, by product and by service industries is not new nowadays. Travel and tourism are the largest service industries in India. Every year people visit tourist places and upload pictures of their visit on social networking sites or share via the mobile device with friends and relatives. Classification of the monuments is helpful to hoteliers for the development of a new hotel with state of the art amenities, to travel service providers, to restaurant owners, to government agencies for security, etc.. The proposed system had extracted features and classified the Indian monuments visited by the tourists based on the linear Support Vector Machine (SVM). The proposed system was divided into 3 main phases: preprocessing, feature vector creation and classification. The extracted features are based on Local Binary Pattern, Histogram, Co-occurrence Matrix and Canny Edge Detection methods. Once the feature vector had been constructed, classification was performed using Linear SVM. The Database of 10 popular Indian monuments was generated with 50 images for each class. The proposed system is implemented in MATLAB and achieves very high accuracy. The proposed system was also tested on other popular benchmark databases.

Fibrosis is a fundamental component of the adverse structural remodeling of myocardium present in the failing heart. Replacement fibrosis appears at sites of previous cardiomyocyte necrosis to preserve the structural integrity of the myocardium, but not without adverse functional consequences. The extensive nature of this microscopic scarring suggests cardiomyocyte necrosis is widespread and the loss of these contractile elements, combined with fibrous tissue deposition in the form of a stiff in-series and in-parallel elastic elements, contributes to the progressive failure of this normally efficient muscular pump. Cellular and molecular studies into the signal-transducer-effector pathway involved in cardiomyocyte necrosis have identified the crucial pathogenic role of intracellular Ca2+ overloading and subsequent induction of oxidative stress, predominantly confined within its mitochondria, to be followed by the opening of the mitochondrial permeability transition pore that leads to the destruction of these organelles and cells. It is now further recognized that Ca2+ overloading of cardiac myocytes and mitochondria serves as a prooxidant and which is counterbalanced by an intrinsically coupled Zn2+ entry serving as antioxidant. The prospect of raising antioxidant defenses by increasing intracellular Zn2+ with adjuvant nutriceuticals can, therefore, be preferentially exploited to uncouple this intrinsically coupled Ca2+ - Zn2+ dyshomeostasis. Hence, novel yet simple cardioprotective strategies may be at hand that deserve to be further explored.

A dyshomeostasis of extra- and intracellular Ca(2+) and Zn(2+) occurs in rats receiving chronic aldosterone/salt treatment (ALDOST). Herein, we hypothesized that the dyshomeostasis of intracellular Ca(2+) and Zn(2+) is intrinsically coupled that alters the redox state of cardiac myocytes and mitochondria, with Ca(2+) serving as a pro-oxidant and Zn(2+) as an antioxidant. Toward this end, we harvested hearts from rats receiving 4 weeks of ALDOST alone or cotreatment with either spironolactone (Spiro), an aldosterone receptor antagonist, or amlodipine (Amlod), an L-type Ca(2+) channel blocker, and from age/sex-matched untreated controls. In each group, we monitored cardiomyocyte [Ca(2+)]i and [Zn(2+)]i and mitochondrial [Ca(2+)]m and [Zn(2+)]m; biomarkers of oxidative stress and antioxidant defenses; expression of Zn transporters, Zip1 and ZnT-1; metallothionein-1, a Zn(2+)-binding protein; and metal response element transcription factor-1, a [Zn(2+)]i sensor and regulator of antioxidant defenses. Compared with controls, at 4-week ALDOST, we found the following: (a) increased [Ca(2+)]i and [Zn(2+)]i, together with increased [Ca(2+)]m and [Zn(2+)]m, each of which could be prevented by Spiro and attenuated with Amlod; (b) increased levels of 3-nitrotyrosine and 4-hydroxy-2-nonenal in cardiomyocytes, together with increased H(2)O(2) production, malondialdehyde, and oxidized glutathione in mitochondria that were coincident with increased activities of Cu/Zn superoxide dismutase and glutathione peroxidase; and (c) increased expression of metallothionein-1, Zip1 and ZnT-1, and metal response element transcription factor-1, attenuated by Spiro. Thus, an intrinsically coupled dyshomeostasis of intracellular Ca(2+) and Zn(2+) occurs in cardiac myocytes and mitochondria in rats receiving ALDOST, where it serves to alter their redox state through a respective induction of oxidative stress and generation of antioxidant defenses. The importance of therapeutic strategies that can uncouple these two divalent cations and modulate their ratio in favor of sustained antioxidant defenses is therefore suggested.

The objective of this study was to determine the molecular bases of disordered hepatic function and disease susceptibility in obesity. We compared global gene expression in liver biopsies from morbidly obese (MO) women undergoing gastric bypass (GBP) surgery with that of women undergoing ventral hernia repair who had experienced massive weight loss (MWL) following prior GBP. Metabolic and hormonal profiles were examined in MO vs. MWL groups. Additionally, we analyzed individual profiles of hepatic gene expression in liver biopsy specimens obtained from MO and MWL subjects. All patients underwent preoperative metabolic profiling. RNAs were extracted from wedge biopsies of livers from MO and MWL subjects, and analysis of mRNA expression was carried out using Affymetrix HG-U133A microarray gene chips. Genes exhibiting greater than twofold differential expression between MO and MWL subjects were organized according to gene ontology and hierarchical clustering, and expression of key genes exhibiting differential regulation was quantified by real-time-polymerase chain reaction (RT-PCR). We discovered 154 genes to be differentially expressed in livers of MWL and MO subjects. A total of 28 candidate disease susceptibility genes were identified that encoded proteins regulating lipid and energy homeostasis (PLIN, ENO3, ELOVL2, APOF, LEPR, IGFBP1, DDIT4), signal transduction (MAP2K6, SOCS-2), postinflammatory tissue repair (HLA-DQB1, SPP1, P4HA1, LUM), bile acid transport (SULT2A, ABCB11), and metabolism of xenobiotics (GSTT2, CYP1A1). Using gene expression profiling, we have identified novel candidate disease susceptibility genes whose expression is altered in livers of MO subjects. The significance of altered expression of these genes to obesity-related disease is discussed.

Iterations in Ca2+ and Mg2+ balance accompany aldosteronism (inappropriate for dietary Na+ intake). Increased Zn excretion and Zn translocation to injured tissues, including the heart, also occurs. Several causes and consequences of Zn dyshomeostasis in rats receiving aldosterone/salt treatment (ALDOST) were examined. (1) To study the role of urinary acidification in promoting hyperzincuria, acetazolamide (75 mg/kg), a carbonic anhydrase inhibitor, was used as cotreatment to raise urinary HCO3 excretion. (2) To assess Zn levels in the heart, including cardiomyocyte cytosolic free [Zn2+]i and mitochondrial Zn, the expression of metallothionein (MT-I), a Zn binding protein, and biomarkers of oxidative stress were examined. (3) Oxidative stress and cardiac pathology in response to ZnSO4 supplement (40 mg/d) were also studied. Comparison of controls and rats receiving 4 weeks ALDOST revealed the following: (1) an acidification of urine and metabolic alkalosis associated with increased urinary Zn excretion and hypozincemia, each of which were prevented by acetazolamide; (2) a rise in cardiac Zn, including increased [Zn2+]i and mitochondrial Zn, associated with increased tissue MT-I, 8-isoprostane, malondialdehyde, and gp91(phox), coupled with oxidative stress in plasma and urine; (3) ZnSO4 prevented hypozincemia, but not ionized hypocalcemia, and attenuated oxidative stress and microscopic scarring without preventing the vasculitis and perivascular fibrosis of intramural coronary arteries. Thus, the hyperzincuria seen with ALDOST is due to urinary acidification. The oxidative stress that appears in the heart is accompanied by increased tissue Zn serving as an antioxidant. Cotreatment with ZnSO4 attenuated cardiomyocyte necrosis; however, polynutrient supplement may be required to counteract the dyshomeostasis of all 3 cations that accompanies aldosteronism and contributes to cardiac pathology.

Background Marine fish oil supplements are frequently administered with other lipid medications for treatment of hypertriglyceridemia. The efficacy of fish oil may be reduced in the presence of other lipid agents, particularly fibrates that also act as PPARα agonists. We therefore sought to determine the efficacy of fish-oil supplements when coadministered with other lipid-modifying agents. Methods Patients receiving fish oil supplements were identified from the computer database of a large governmental HMO. Change in plasma lipoprotein levels after administration of fish oil was compared between patients receiving fish oil as their only treatment and those for whom fish oil was added to other drugs. Results A total of 166 evaluable records were identified, 66 from patients treated with fish oil alone and 100 from patients for whom fish oil was added to another agent or other agents. Fish oil effectively reduced triglyceride levels to an equal extent in the fish oil only and fish oil added groups (−30% versus –27% respectively; P = 0.84). Conclusion Fish oil effectively reduces plasma triglyceride levels when administered with concomitant lipid medications. These findings suggest the presence of additional and even complementary mechanisms of action of fish oil to lower triglyceride when added to other lipid drugs. These findings validate the common clinical practice of combining fish oil supplements with other lipid-lowering medications in patients with hypertriglyceridemia.

Thyrotoxic hypokalemic periodic paralysis (THPP) has been reported earlier in the Asian population. However, it is now becoming increasingly common in the Western countries as well. Thus, its in-depth knowledge is a must for every physician so that this diagnosis is not overlooked in any case presenting with extremity weakness and paralysis, especially considering its reversible nature. We present an interesting case of THPP in a Vietnamese patient presenting with bilateral lower extremity weakness and extremely low serum potassium levels. We also present a comprehensive discussion and review of literature related to THPP, which would be helpful for the internists to diagnose and appropriately manage this disease.

Background Fish oil supplements are administered for treatment of hypertriglyceridemia, frequently in combination with other lipid-lowering agents. Given the presence of overlapping mechanisms of action of N-3 polyunsaturated fatty acids with that of other lipid-lowering agents, in particular fibrates, the efficacy of fish oil may be diminished with concomitant administration of other lipid-lowering agents. Objective To determine the efficacy (primarily triglyceride lowering) of fish oil supplements when co-administered with other lipid-lowering agents versus that of fish oil alone. Design/Setting Retrospective chart review. Outpatient clinics of large Gov. HMO (VA, Memphis). Patients Representative population of veterans attending outpatient clinics with active prescription for fish oil supplements at the time of survey, who had lipid profiles prior to and following initiation of fish oil. Results Over 500 individuals receiving fish oil supplements were identified. Of these, 94 individual patients had the required information available and were therefore evaluable for this study. Forty-eight were receiving fish oil alone and 46 had fish oil added to another hypolipidemic agent(s) (statin, fibrate, niacin). The average dose of fish oil administered in both groups was relatively low (3.2 and 3.3 grams per day in fish oil only and fish oil added groups), indicating use of relatively low doses of fish oil in many patients. Despite this, fish oil therapy effectively reduced triglyceride and to an equal extent in the fish oil only and fish oil added groups (228% versus 224% respectively, p = .24). Analysis of triglyceride response by type of lipid-lowering agent administered showed no significant attenuation of fish oil efficacy with concomitant administration of statin, niacin, or fibrate. Limitations A limited number of evaluable cases were identified. The study was not prospective or randomized. A limited effect of other hypolipidemic agents on triglyceride response to fish oil supplements may have gone undetected; however, the present study supports the hypothesis that fish oil supplements are effective when added to other hypolipidemic agents. Conclusions Fish oil supplements effectively reduce plasma triglyceride when administered alone or with concomitant lipid-lowering therapy. Submaximal doses of fish oil supplements are frequently used in this outpatient practice setting, thereby limiting the benefit gained.