Kala-azar without splenomegaly: A rare presentation

Visceral leishmaniasis is a major public health problem in Bangladesh, North East India, Nepal, Sudan and North East Brazil. In India, leishmaniasis is more prevalent in Bihar, Jharkhand, West Bengal and Uttar Pradesh. We present the case of a 55-year-old male farmer from Himachal Pradesh with complaints of fever for 2.5 months, appetite loss and weight loss for 1 month. On evaluation, he was found to have pancytopenia, transaminitis, and hyperbilirubinemia. Tropical fever serology and viral markers were negative. Blood and urine cultures were sterile, and ascitic fluid was acellular and high SAAG with normal ADA. Bone marrow was done due to non-responding pancytopenia which reveals intracellular amastigote form of Leishmania Donovani. A final diagnosis of Kala-azar without splenomegaly with moderate ascites was made as an absence of splenomegaly was the most striking aspect in our patient

TECHNIQUES TO AVOID UE REGISTRATION LOOPING DUE TO MULTIPLE AMF REDIRECTIONS

A service provider can deploy a 5G mobile core network by enabling network slices in order to offer different services to end users. In a network slicing deployment, a user equipment (UE) can initiate a registration procedure with a given Access and Mobility Management Function (AMF), however, an initial AMF with which a given UE initiates registration may not support the network slice with which UE seeks to register such that the UE is to be redirected to an appropriate AMF that serves the network slice. As there can be many different type of network slices provided for a 5G mobile core network, there can be many complexities and operational challenge with respect to configuring 5G core network nodes, such as AMFs, to serve all network slices that may be deployed for a network; thus, AMF redirects are likely to occur in many deployments. Proposed herein are techniques to facilitate efficient redirection to an AMF that serves a requested network slice. Further, techniques proposed herein may prevent deadlock conditions for UEs attempting to access network services/slices

Study of drug use in outdoor pediatric patients of upper respiratory tract infections in a tertiary care hospital

Background: Upper respiratory tract infections (URTI) are the most common and frequent occurring infections in the pediatric population. URTI is mostly viral in origin and requires mostly symptomatic treatment. The present study was undertaken to analyze the pattern of drug use in the management of URTI in the pediatric age group.Methods: It is a retrospective study to assess the pattern of drug use in URTI in pediatric outpatient department during the 5 months period from January 2015 to May 2015.Results: A total of 2256 prescriptions were analyzed. Most of the pediatric patients belonged to 1-5 years age group and 58.33% were males, and 41.66% were females. A total of 6332 drugs were prescribed out of which the antibiotics used was 1341. The average number of drugs per prescription used was 2.81. The percentage of prescriptions containing antibiotics was found to be 59.44%. Amoxicillin (70.91%) was the most frequent prescribed antibiotic followed by cotrimoxazole (10.21%). Antihistaminic and expectorant combinations were found to be the most common prescribed class of drugs (29.34%) followed by analgesic and antipyretics (26.45%) and antibiotics (21.17%).Conclusions: The study revealed that the majority of children were below 5 years of age. The most common class of drugs prescribed was antihistaminics and expectorant combinations followed by analgesics and antipyretics. Although the majority of the patients received antibiotics, 40.55% of patients received symptomatic treatment. This is a welcome step as inappropriate use of the antibiotics can potentiate to the increasing trend of antimicrobial resistance

A Review Approach on various form of Apriori with Association Rule Mining

Data mining is a computerized technology that uses complicated algorithms to find relationships in large databases Extensive growth of data gives the motivation to find meaningful patterns among the huge data. Sequential pattern provides us interesting relationships between different items in sequential database. Association Rules Mining (ARM) is a function of DM research domain and arise many researchers interest to design a high efficient algorithm to mine ass ociation rules from transaction database. Association Rule Mining plays a important role in the process of mining data for frequent pattern matching. It is a universal technique which uses to refine the mining techniques. In computer science and data min ing, Apriori is a classic algorithm for learning association rules Apriori algorithm has been vital algorithm in association rule mining. . Apriori alg orithm - a realization of frequent pattern matching based on support and confidence measures produced exc ellent results in various fields. Main idea of this algorithm is to find useful patterns between different set of data. It is a simple algorithm yet having man y drawbacks. Many researches have been done for the improvement of this algorithm. This paper sho ws a complete survey on few good improved approaches of Apriori algorithm. This will be really very helpful for the upcoming researchers to find some new ideas from these approaches. The paper below summarizes the basic methodology of association rules alo ng with the mining association algorithms. The algorithms include the most basic Apriori algorithm along with other algorithms such as AprioriTi d, AprioriHybrid

Occurrences of thrombocytopenia with valproic acid used for psychiatric indication

Background: The main aim of this study is to find out the effect of valproic acid on platelet count and to know the possible risk factors for thrombocytopenia in patients taking valproate (VPA).Methods: On 72 patients having psychiatric indication, a longitudinal observational study was designed and conducted from February 2012 to July 2013 at Department of Psychiatry (out-patient department) of Pt. Jawahar Lal Nehru Memorial Medical College and Dr. Bhim Rao Ambedkar Memorial Hospital, Jail Road, Raipur, Chhattisgarh. Platelet count was monitored and determined using an automatic coulter analyzer. The patients were followed up to 6 months. Statistical tool standard deviation ± was used for statistical analysis. p<0.05 is considered as statistically significant.Results: Total percentage of thrombocytopenia was found to be 12.5%; among that males constitute 9.8% and females 19.04%. The maximum number of cases falls in the age group between 51 and 60 years (55.5%). The major diagnostic group was reported to be consisted of mania (40.4%), followed by resistant cases of schizophrenia (25%) and then bipolar affective disorder (23.6%). The study indicated that maximum patients suffered from mild thrombocytopenia (11.1%) and (1.4%) patients have moderate thrombocytopenia. The mean time from exposure to VPA therapy to the first episode of thrombocytopenia was reported 92 days.Conclusions: Our findings underlined the importance of monitoring platelet counts in patients treated with VPA. This monitoring should be continued indefinitely on monthly basis. The studies indicate that the demands of more vigilant monitoring of patients should occur in age of 50-60 years, and result of entire studies indicates that females were found to be subjected to incidences of thrombocytopenia especially

Hashimoto’s Thyroiditis among Patients with Thyroid Disorders Visiting a Tertiary Care Centre

Introduction: Hashimoto’s thyroiditis is a chronic autoimmune lymphocytic thyroiditis characterised by thyroid autoantibodies. Early detection and treatment of this condition help in reducing the morbidity and mortality associated with it. The aim of the study was to find out the prevalence of Hashimoto’s thyroiditis among patients with thyroid disorders visiting a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients visiting the outpatient department of a tertiary care centre. Data from 14 April 2017 to 13 April 2019 was collected between 30 June 2022 to 15 September 2022 from medical records. Ethical approval was obtained from the Nepal Health Research Council. Hashimoto’s thyroiditis was diagnosed based on clinical presentation and positive antibodies to thyroid antigens. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 813 patients with thyroid disorders, 393 (48.33%) (44.89-51.77, 95% Confidence Interval) had Hashimoto’s thyroiditis. The manifestation of the spectrum of Hashimoto’s thyroiditis were euthyroid in 215 (54.70%), subclinical hypothyroidism in 102 (25.95%), subclinical hyperthyroidism in 23 (5.85%), overt hyperthyroidism in 9 (2.30%) and overt hypothyroidism in 4 (1.02%). Conclusions: The prevalence of Hashimoto’s thyroiditis among patients with thyroid disorders was higher than in other studies done in similar settings

Landscapes of Urbanization and De-Urbanization: A Large-Scale Approach to Investigating the Indus Civilization's Settlement Distributions in Northwest India.

Survey data play a fundamental role in studies of social complexity. Integrating the results from multiple projects into large-scale analyses encourages the reconsideration of existing interpretations. This approach is essential to understanding changes in the Indus Civilization's settlement distributions (ca. 2600-1600 b.c.), which shift from numerous small-scale settlements and a small number of larger urban centers to a de-nucleated pattern of settlement. This paper examines the interpretation that northwest India's settlement density increased as Indus cities declined by developing an integrated site location database and using this pilot database to conduct large-scale geographical information systems (GIS) analyses. It finds that settlement density in northwestern India may have increased in particular areas after ca. 1900 b.c., and that the resulting landscape of de-urbanization may have emerged at the expense of other processes. Investigating the Indus Civilization's landscapes has the potential to reveal broader dynamics of social complexity across extensive and varied environments.ER

Roadmap on spatiotemporal light fields

Spatiotemporal sculpturing of light pulse with ultimately sophisticated structures represents the holy grail of the human everlasting pursue of ultrafast information transmission and processing as well as ultra-intense energy concentration and extraction. It also holds the key to unlock new extraordinary fundamental physical effects. Traditionally, spatiotemporal light pulses are always treated as spatiotemporally separable wave packet as solution of the Maxwell's equations. In the past decade, however, more generalized forms of spatiotemporally nonseparable solution started to emerge with growing importance for their striking physical effects. This roadmap intends to highlight the recent advances in the creation and control of increasingly complex spatiotemporally sculptured pulses, from spatiotemporally separable to complex nonseparable states, with diverse geometric and topological structures, presenting a bird's eye viewpoint on the zoology of spatiotemporal light fields and the outlook of future trends and open challenges.Comment: This is the version of the article before peer review or editing, as submitted by an author to Journal of Optics. IOP Publishing Ltd is not responsible for any errors or omissions in this version of the manuscript or any version derived from i

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories.Background Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories