A Complicated Case of Acute Promyelocytic Leukemia in the Second Trimester of Pregnancy Successfully Treated with All- trans

A 40-year-old female at 26-week gestation was diagnosed with acute promyelocytic leukemia (APL) after an abnormal prenatal lab workup showed pancytopenia. She was treated with all-trans-retinoic acid (ATRA), idarubicin, and dexamethasone. After day one of treatment, she developed differentiation syndrome, which was treated with dexamethasone. At 30-week gestation, she had preterm premature rupture of membranes and delivered by cesarean section because of the fetus’ breech presentation. Despite ATRA’s potential for teratogenicity, a viable infant was born without apparent anomalies. Postpartum, she underwent consolidation treatment with ATRA and arsenic trioxide (ATO). The patient continued ATRA therapy after delivery and is currently in remission

Chip Architecture for Data Sorting Using Recursive Algorithm

“This paper suggests a way to implement recursive algorithm on hardware with an example of sorting of numeric data. Every recursive call/return needs a mechanism to store/restore parameters, local variables and return addresses respectively. Also a control sequence is needed to control the flow of execution as in case of recursive call and recursive return. The number of states required for the execution of a recursion in hardware can be reduced compared with software. This paper describes all the details that are required to implement recursive algorithm in hardware. For implementation, all the entities are designed using VHDL and are synthesized, configured on Spartan-2 XC2S200-5PQ208.

A case report of Kounis syndrome: acute myocardial injury caused by multiple bee stings

Kounis syndrome, also known as “allergic angina syndrome” or “allergic myocardial infarction”, refers to acute coronary syndrome secondary to hypersensitivity reaction as a result of exposure to various allergens. Signs and symptoms may include chest pain, with or without raised troponins and cardiac enzymes, vomiting, syncope, hypotension or acute renal failure. A 60-year-old male, farmer by occupation, was bitten by multiple bees over head, neck region and bilateral upper limbs in the afternoon on 04/03/2022. On presentation, vitals were stable. After 2 hours, patient developed severe chest pain, palpitations, and dizziness. ECG showed inferior wall ST elevation MI. Subsequently CPK, CK-MB, troponin I were done, which were found to be elevated. Echocardiography was done, which showed regional wall motion abnormality in the inferior wall. Patient was treated with anticoagulants and antiplatelets. CT coronary angiography showed healthy coronaries. In literature, we had few cases of myocardial infarction following bee sting. In acute myocardial infarction after bee stings, it has been suggested that vasoconstriction secondary to mediators released after the sting, aggravated by exogenous adrenaline and platelet aggregation contributes to myocardial ischemia. Cardiac complications can accompany bee sting. Intensive supportive treatment in intensive or coronary care facilities with administration of drugs to treat complications early in the course of the illness will improve the outcome

Binary Wavelet Transform Based Histogram Feature for Content Based Image Retrieval

In this paper a new visual feature, binary wavelet transform based histogram (BWTH) is proposed for content based image retrieval. BWTH is facilitated with the color as well as texture properties. BWTH exhibits the advantages of binary wavelet transform and histogram. The performance of CBIR system with proposed feature is observed on Corel 1000 (DB1) and Corel 2450 (DB2) natural image database in color as well as gray space. The results analysis of DB1 database illustrates the better average precision and average recall of proposed method in RGB space (73.82%, 44.29%) compared to color histogram (70.85%, 42.16%), auto correlogram (66.15%, 39.52%) and discrete wavelet transform (60.83%, 38.25%). In case of gray space also performance of proposed method (66.69%, 40.77%) is better compared to auto correlogram (57.20%, 35.31%), discrete wavelet transform (52.70%, 32.98%) and wavelet correlogram (64.3%, 38.0%). It is verified that in case of DB2 database also average precision, average recall and average retrieval rate of proposed method are significantly better

Can heart failure phenotypes be predicted by cardiac remodelling peripartum or postpartum?

Hypertension during pregnancy affects up to 10% of pregnancies and is associated with significant cardiovascular morbidity and mortality. In the short-term it can result in pre-eclampsia, haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, or even hypertension associated acute heart failure, all of which may necessitate pre-term delivery to prevent maternal or neonatal death. In the long term, a history of gestational hypertension and pre-eclampsia significantly increases the risk of future cardiovascular disease including chronic hypertension, coronary artery disease, heart failure and stroke. This review explores our current level of knowledge of the phenotypes of heart failure, paying particular attention to those specific to women, and the role of pregnancy and non-pregnancy related risk factors in the development of this condition. We discuss why women with hypertensive pregnancy may be disproportionately affected by heart failure with preserved ejection fraction (HFpEF) and whether a unique phenotype of heart failure unique to hypertensive pregnancy exists. Finally, we explore how future cardiovascular risk may be predicted based on cardiac remodelling during or after pregnancy and suggest potential areas of further research in the field

Prediction and Judgmental Adjustments of Supply-Chain Planning in Festive Season

For a robust performance Shipping costs planning in festive seasons is given the input data as free from trends season-of-year effects etc Seasonal forecasting for supplychain planning with past few years of similar data impact shipping costs Additionally during a festive season of the year unbiased and accurate prediction of shipment load plays a major role in bringing up sales Time-series forecasting methods can be useful to remove traditional fluctuations due to gap in months-of-year of festivals We describe exponential smoothing techniques and trend fitting methods and compare the predictive accuracy The accuracy is compared using rootmean square error and median absolute deviation The exponential smoothing shows changing behavior with increased data size and data item values The data is compared with and without tuning the seasonal effects due to festive seaso

Acute pancreatitis in pregnancy: a case report

Acute pancreatitis is a rare event, can be associated with a high maternal mortality and fetal loss with an incidence of 3 in 10,000 pregnancies. A 24 years old primigravida with 28 weeks of gestation, presented with pain in upper abdomen since 4 days and nausea, vomiting and fever sine two days, abdomen distended and tenderness present in epigastric region. Serum amylase and lipase were raised. Sonography abdomen showed pancreas bulky with peripancreatic free fluid and inflammatory changes suggestive of pancreatitis. Patient was managed condervatively and was discharged to home after 7 days. Regular follow up was done till 36 weeks and emergency cesarean delivery was done in view of non-reassuring fetal heart rate at 36 weeks 3 days of gestation. Early diagnosis of acute pancreatitis in pregnancy and supportive treatment with maternal and fetal monitoring results in good perinatal outcome. The treatment of pancreatitis in pregnancy should be conservative as far as possible with delaying the definitive treatment until delivery of the baby

Analysing the Differential Performances of Indian States in the Tourism Sector : (1947-early 2020)

Tourism is an ever evolving and a dynamic industry which can play a crucial role in increasing income and in providing employment opportunities in an economy. India especially with its rich heritage, culture and geographical landscapes has always had immense potential to become a leading tourist destination. Presently the major types of tourism prevalent in India are Medical Tourism, Rural/ Natural Tourism, Religious Tourism and Historical& Educational Tourism. In 2018-19, the tourism sector contributed around 5% to India’s GDP. However with the health shock of Covid-19, the tourism sector has taken a major hit since early 2020, with several people losing their jobs in the tourism and hospitality sector when different states imposed lockdowns and took various measures to curb the pandemic. As restrictions in each state eased during the first wave of the pandemic, different states in India adopted various policies to revive the tourism industry. But to understand the effectiveness of these policies in each state/ UT, one needs to investigate the baseline at which the Tourism industry was before the pandemic hit the country. This paper attempts to look at the differential performances of states and UTs of India in tourism by categorizing them into various types of tourism between 1947 until March 2020.This paper aims to act as a base for further analysing the impact of this pandemic on Tourism across states in India

Stroke in sickle cell disease: case report

Sickle cell disease is an inherited blood disorder that affects red blood cells. It is characterized by polymerization of haemoglobin, erythrocyte stiffening, and subsequent vaso-occlusions. These can lead to microcirculation obstructions, tissue ischemia, infarction and acute stroke. Transient ischemic attack, Ischaemic stroke, haemorrhagic stroke, silent cerebral infarction, headache, Moyamoya disease, neuropathic pain, and neurocognitive impairment are neurological complications of sickle cell disease. Here we report a case of ischemic stroke in a patient of sickle cell disease. For early diagnosis and proper management of sickle cell disease neurological complications require specialised haematological and neurological expertise. The newly used medications under ongoing research will be the hope to overcome this devastating disease and its complications