Prevalence of tracheobronchial anomalies among patients undergoing fibreoptic bronchoscopy: a retrospective analysis from a tertiary care hospital in Wayanad, Kerala, India

Background: Tracheobronchial anomalies are a rare clinical entity and often asymptomatic in nature. Some patients may experience symptoms such as cough, recurrent pneumonia or hemoptysis. Knowledge and understanding of tracheobronchial variations have important implications for diagnosis of symptomatic patients and performing certain procedures, including bronchoscopy and endotracheal intubation. Objective was to study the prevalence of tracheobronchial anomalies detected during routine bronchoscopy in a tertiary care setting.Methods: Retrospective analysis of hospital data of patients undergoing fibreoptic bronchoscopy for one year in a tertiary care setting.Results: There were 149 bronchoscopies evaluated. Total of 41 anomalies were detected in 34 (22.8%) subjects. The most common anomaly was bronchial diverticula.Conclusions: This retrospective study takes stock of various tracheobronchial anomalies among subjects who underwent bronchoscopy in a tertiary care hospital in Wayanad, North Malabar. This study revealed major tracheobronchial anomalies in 22.8% of subjects which is higher when compared to previous studies. This is particularly important due to the fact that Wayanad is a backward hilly district and tribal community constitutes 20% of its population

Aspergillus spp. infection as a cause of acute exacerbations of chronic obstructive pulmonary disease: a prospective observational study

Background: Majority of exacerbations of COPD (AECOPD) are due to infections. Usual agents causing AECOPD are gram negative bacteria, but rarely viruses and fungi are also implicated. However, the role of fungal infection, especially Aspergillus spp. in the clinical deterioration of COPD still remains unclear. This prospective observational study looks at the prevalence of aspergillus infection in AECOPD. The Objectives of this study were to analyse the prevalence and risk factors associated with Aspergillus infection in AECOPD, and to investigate the clinical outcomes.Methods: Patients admitted with AECOPD for a period of 3 months from 1st October 2017 to 31st December 2017 were prospectively included from ICU and general ward of Pulmonary Medicine department of a tertiary care hospital. Clinical, radiological and microbiological data were collected at admission and during the hospital stay. Clinical course and outcome are recorded.Results: There were 104 cases of AECOPD during the study period out of which 96 were males and 8 were females. 17 patients had evidence of aspergillus infection and diabetes was found to be an independent risk factor for aspergillus infection.Conclusions: Aspergillus infection is an important cause of COPD exacerbation and this is directly related to diabetes mellitus

Comparative geospatial approach for agricultural crops identification in interfluvial plain - A case study of Sahiwal district, Pakistan

Agricultural crop cover identification is a major issue and time-consuming effort to verify the crop type through surveys of the individual field or using prehistoric methods. To establish the scenario of crop identification, the stage of crop provides diverse spatial information about the variety of crops due to its spectral changes. The main aim of this study was to the identify the crop types and their behavior using remote sensing and geographical information system-based approach. Moreover, two main methods were applied to the Sentinel-2 satellite data in which one is random forest based supervised classification and another was Normalize Difference Vegetation Index (NDVI) density estimation method through the google earth engine to procure the data in time-efficient way. This study also established the comparison between classified and vegetation index based seasonal compositional datasets for wheat, cotton, maize, and fodder crops. Study discussed the best fit technique for crops identification in the light of observed methods. Furthermore, the vegetation index ranges by the zonal statistics of the field samples were established according to crop precision. Results showed that -22.94, -43.72, 20.61, and 32.49 % dissimilarities existed in wheat, fodder, cotton, and maize results respectively, after comparison of both techniques. Although, the accuracy assessment was performed on the classified dataset for validation of results by confusion matrix accuracy assessment process using field sample data. Moreover, the vegetation index was used to evaluate crop land surface temperature to estimate the crop growth stage valuation that revealed noticeably enthralling outcomes. The results determined that the classified accuracies of wheat, cotton, maize and fodder were 84, 80, 81 and 71 % respectively. This study also revealed that the random forest classifier has used more features and information potentially during the classifier trainings but vegetation index just implies the limited number of features such as crop growing status

Evolusi Ideologi Radikal dalam Sejarah Kebangkitan Gerakan Islam

Pasca serangan 11 September 2001 menggemparkan dunia apabila gerakan-gerakan Islam dikaitkan dengan ideologi radikal yang mengakibatkan keganasan dan kemusnahan. Serangan balas dan pelbagai tekanan dilakukan oleh Barat terhadap dunia Islam kononnya kerana mereka sebagai Polis Dunia perlu mempertahankan keamanan sejagat. Kenyataan bahawa Islam adalah agama radikal jelas bertentangan dengan matlamat ia diturunkan iaitu sebagai rahmatan lil alamin selain hakikat sebenar bahawa radikalisme agama turut wujud di dalam agama-agama samawi yang lain. Namun apa yang sememangnya jelas berlaku adalah tindakan ekstrem pejuang Islam yang merosakkan imej agama sekaligus seolah membenarkan tuduhan oleh Barat. Justeru kajian ini disediakan bagi menerangkan evolusi ideologi radikal yang muncul di dalam sejarah kebangkitan gerakan Islam bermula abad ke 18 sehingga kini. Artikel ini menggunakan pendekatan kajian kualitatif dan sumber dapatan dibuat secara kajian kepustakaan, analisis dokumen dan temubual. Hasil dapatan kajian menjelaskan bahawa terdapat empat fasa meliputi fasa ideologi Wahabi, fasa ideologi Sayyid Qutb, fasa ideologi Salafi Jihadi dan fasa ideologi Salafi Takfiri. Berdasarkan dapatan, dapat disimpulkan bahawa ideologi radikal mula terbentuk berikutan permasalahan semasa umat Islam pada ketika itu seperti perlakuan bidaah, syirik dan ancaman pemikiran dari tamadun Rom dan Parsi, namun berkembang menjadi lebih serius apabila wujudnya penindasan dan kezaliman berterusan oleh Barat sehingga ideologi radikal ini diterjemahkan dengan tindakan ekstrem di akhir fasa gerakan kebangkitan Islam. Ternyata evolusi radikal Islam melalui tempoh yang panjang dengan desakan permasalahan umat semasa dan menjadi lebih signifikan kerana situasi global hari ini yang kompleks

Psychiatry as a career: A survey of factors affecting students’ interest in Psychiatry as a career

The objectives of this study were to determine the characteristics of medical students and graduates interested in choosing psychiatry as a career and the obstacles in choosing this field of medicine. Two private and two public medical institutes were surveyed from June 2007 to August 2007. A self-administered questionnaire was distributed to third, fourth and final year students and to medical graduates doing their internship in these four medical institutes. A total of 909 medical students and graduates participated in the study. Seventeen percent of participants responded positively regarding their interest in psychiatry as a career. Significantly higher proportion belonged to private medical institutes (14% vs. 24%, P-value =0.001). There was no significant difference in reporting interest for psychiatry in regard to age, sex, year in medical school and whether or not the participant had done a psychiatry ward rotation. However significantly higher proportion of participants (22%, n=43) were reporting their interest in the field of psychiatry who had done more than a month long psychiatry ward rotation as compared to those participants (14%, n=54) with less than a month or no psychiatry rotation (P-value=0.01). More students were reporting their interest in psychiatry with a family history of psychiatric illness as compared to without family history (24% vs 16%, P-value=0.03). In conclusion, students and graduates with more than a month long rotation in psychiatry, studying in private medical colleges and with a family history of psychiatric illness were more interested in choosing psychiatry as a career

Anti-acne activity of Casuarina equisetifolia bark extract: A randomized clinical trial

The objective of this study was to evaluate the clinical efficacy of Casuarina equisetifolia bark extract (5% cream) in comparison with benzoyl peroxide as the standard drug for acne vulgaris. After exclusion, fifty patients were included in the study (n=50) with age group distribution between 17-34 years of age. Patients were distributed into Group 1 (5% cream) and Group 2 (benzoyl peroxide), and were advised to apply the herbal cream twice a day topically. The clinical efficacy of the herbal cream and severity of acne vulgaris was assessed by Cook's acne grading scale. Results revealed that there was no significant difference found in both test and standard control groups. Further, remarkable improvement was found in acne grading in the test group

Clinical practice guidelines on the management of variceal bleeding

Gastroesophageal variceal bleeding occurs in 30 - 50% of patients of liver cirrhosis with portal hypertension, with 20-70% mortality in one year. Therefore, it is essential to screen these patients for varices and prevent first episode of bleeding by treating them with β-blockers or endoscopic variceal band ligation. Ideally, the patients with variceal bleeding should be treated in a unit where the personnel are familiar with the management of such patients and where routine therapeutic interventions can be undertaken. Proper management of such patients include: initial assessment, resuscitation, blood volume replacement, vasoactive agents, prevention of associated complications such as bacterial infections, hepatic encephalopathy, coagulopathy and thrombocytopenia, and specific therapy. Rebleeding occurs in about 60% patients within 2 years of their recovery from first variceal bleeding episode, with 33% mortality. Therefore, it is mandatory that all such patients must be started on combination of β-blockers and band ligation to prevent recurrence of bleeding. Patients who required shunt surgery/TIPSS to control the acute episode do not require further preventive measures. These clinical practice guidelines (CPGs) have been jointly developed by Pakistan Society of Hepatology (PSH) and Pakistan Society of Study of Liver Diseases (PSSLD)