Bulk viscous matter and recent acceleration of the Universe

We consider a cosmological model dominated by bulk viscous matter with total bulk viscosity coefficient proportional to the velocity and acceleration of the expansion of the universe in such a way that $\zeta=\zeta_{0}+\zeta_{1}\frac{\dot{a}}{a}+\zeta_{2}\frac{\ddot{a}}{\dot{a}}.$ We show that there exist two limiting conditions in the bulk viscous coefficients, ($\zeta_{0}$, $\zeta_{1}$, $\zeta_{2}$) which corresponds to a universe having a Big-Bang at the origin, followed by an early decelerated epoch and then making a smooth transition into an accelerating epoch. We have constrained the model using the type Ia Supernovae data, evaluated the best estimated values of all the bulk viscous parameters and the Hubble parameter corresponding to the two limiting conditions. We found that even though the evolution of the cosmological parameters are in general different for the two limiting cases, they show identical behavior for the best estimated values of the parameters from both the limiting conditions. A recent acceleration would occur if $\tilde{\zeta}_{0}+\tilde{\zeta}_{1}>1$ for the first limiting conditions and if $\tilde{\zeta}_{0}+\tilde{\zeta}_{1}<1$ for the second limiting conditions. The age of the universe predicted by this model is found to be less than that predicted from the oldest galactic globular clusters. The total bulk viscosity seems to be negative in the past and becomes positive when $z\leq0.8$. So the model violates the local second law of thermodynamics. However, the model satisfies the generalized second law of thermodynamics at the apparent horizon throughout the evolution of the universe. We also made a statefinder analysis of the model and found that it is distinguishably different from the standard $\Lambda$CDM model at present, but shows a de Sitter type behavior in the far future of the evolution.Comment: 14 figure

Benign struma ovarii-a rare monodermal ovarian teratoma-a case report

Struma ovarii is a rare ovarian tumour, first described in 1889 by Boettlin. It is defined by the presence of thyroid tissue comprising of &gt;50% of overall mass. It comprises 1% of all ovarian tumours and 2-5% of all ovarian teratomas. Preoperative diagnosis of struma ovarii is difficult because symptoms, clinical presentation and ultrasound are often similar to that of ovarian carcinoma. Hence most of the patients are diagnosed post operatively. Most cases of strum aovarii are benign and can be treated by excision of the ovary or by unilateral salpingo-oophorectomy. In a small number of cases, there are complications, the most important being the development of malignancy or ascites associated with pleural effusion producing a pseudo-Meigs' syndrome. This is a case of struma ovary presented with features of pseudo-Meig’s syndrome. A 68 year old post-menopausal woman presented with acute abdomen and respiratory distress with an ultrasound diagnosis of ovarian torsion, ascites and pleural effusion and found to have atrial thrombus on evaluation. She had undergone staging laparotomy, TAH+ BSO, omental biopsy and peritoneal fluid cytology. Histopathology revealed predominantly benign and mature colloid filled thyroid follicles of varying sizes lined by cuboidal epithelium surrounded by lymphocytic infiltrate and congested blood vessels, which was suggestive of struma ovary.

Bayesian analysis of bulk viscous matter dominated universe

In our previous works, we have analyzed the evolution of bulk viscous matter dominated universe with a more general form for bulk viscous coefficient, $\zeta=\zeta_{0}+\zeta_{1}\frac{\dot{a}}{a}+\zeta_{2}\frac{\ddot{a}}{\dot{a}}$ and also carried out the dynamical system analysis. We found that the model reasonably describes the evolution of the universe if the viscous coefficient is a constant. In the present work we are contrasting this model with the standard $\Lambda$CDM model of the universe using the Bayesian method. We have shown that, even though the viscous model gives a reasonable back ground evolution of the universe, the Bayes factor of the model indicates that, it is not so superior over the $\Lambda$CDM model, but have a slight advantage over it.Comment: 15 pages, 9 figure

ASSIMILATING AND REPRODUCING CONCEPTS AFTER PHARMACOLOGY LECTURE - A QUESTIONNAIRE-BASED STUDY

Objective: Medical undergraduates learn pharmacology during the second phase of MBBS. Considering the expanding list of drugs and volatility associated with its learning, the objective of this study was to describe the factors that interfere with the assimilation and reproduction of the concepts in pharmacology. Methods: This was a descriptive study done in the Department of Pharmacology of a Government Medical College in Central Kerala for a period of 2 months. Five short answer questions were chosen to elicit responses from the participants in the form of a surprise test. A Google fill out form elicited the perception of the participants about learning during the pharmacology lecture. The data were sorted and entered into Statistical Package for the Social Sciences (SPSS) software version 16 (SPSS Inc, Chicago, USA). Descriptive data were expressed using frequencies and percentages. Results: Of the 148 students, 84 (56.75%) participated in the study. For the surprise test, the mean marks scored were 2.24±0.77 (maximum marks 5). Forty-seven (56%) participants claimed that they were attentive in pharmacology lectures only “sometimes.” The majority of the participants 82 (97.6%) “sometimes” found it difficult to imbibe the concepts in pharmacology. Seventy (83.3%) agreed that definitions are difficult to learn as such. Only 10 (11.9%) disagreed with the statement that a drug’s action cannot be interpreted as its use because sometimes actions can aggravate some diseases. Sixty-one (72.6%) participants had difficulty in understanding the word “rationale.” Five minutes break, continuity of topics, separate question-answer session at the end of class, summarization, a video demonstration of the mechanism of action, providing printed lecture notes, simple explanation, mnemonics to learn, clinical correlation, lectures during morning hours, and team-based quizzes were some suggestions to increase the assimilation of the subject. Conclusion: Participants had a mean score which was &lt;50% of the total score. While the scores for definitions varied the question on uses of drugs fetched similar marks; however, the students had poor performance on the question related to rationale. Ignorance about the meaning of the word “rationale” shows the importance of regular feedback and the use of simple language in understanding the problems faced by the participants in learning the concepts in pharmacology

Uterine lipo-leiomyoma in post-menopausal women: two interesting cases

Lipo-leiomyomas (LL), incidentally found lipomatous variants of uterine leiomyomas do not require surgical intervention unless symptomatic. Large LL of the uterine body is very rare. Majority being benign, these could co-exist with other gynaecological malignancies, metabolic diseases and abnormal oestrogen statuses and do rarely transform to liposarcoma. Here, we presented two interesting cases of postmenopausal women with LL. Ultrasonography and MRI performed in the workup of both, incidentally demonstrated a fatty lesion arising from the uterine corpus, consistent with a lipo-leiomyoma. This case report stresses the need for greater awareness of these variants regarding histogenesis, diagnosis and treatment

Experiences and challenges of people living with multiple long-term conditions in managing their care in primary care settings in Kerala, India:A qualitative study

Background: Multimorbidity or multiple long-term conditions (MLTCs), the coexistence of two or more chronic conditions within an individual, presents a growing concern for healthcare systems and individuals’ well-being. However, we know little about the experiences of those living with MLTCs in low- and middle-income countries (LMICs) such as India. We explore how people living with MLTCs describe their illness, their engagements with healthcare services, and challenges they face within primary care settings in Kerala, India. Methods: We designed a qualitative descriptive study and conducted in-depth, semi-structured interviews with 31 people (16 males and 15 females) from family health centres (FHCs) in Kerala. Interview data were recorded, transcribed, and thematic analysis using the Framework Method was undertaken. Findings: Two main themes and three sub-themes each were identified; (1) Illness impacts on life (a)physical issues (b) psychological difficulties (c) challenges of self-management and (2) Care-coordination maze (a)fragmentation and poor continuity of care (b) medication management; an uphill battle and (c) primary care falling short. All participants reported physical and psychological challenges associated with their MLTCs. Younger participants reported difficulties in their professional lives, while older participants found household activities challenging. Emotional struggles encompassed feelings of hopelessness and fear rooted in concerns about chronic illness and physical limitations. Older participants, adhering to Kerala’s familial support norms, often found themselves emotionally distressed by the notion of burdening their children. Challenges in self-management, such as dietary restrictions, medication adherence, and physical activity engagement, were common. The study highlighted difficulties in coordinating care, primarily related to traveling to multiple healthcare facilities, and patients’ perceptions of FHCs as fit for diabetes and hypertension management rather than their multiple conditions. Additionally, participants struggled to manage the task of remembering and consistently taking multiple medications, which was compounded by confusion and memory-related issues. Conclusion: This study offers an in-depth view of the experiences of individuals living with MLTCs from Kerala, India. It emphasizes the need for tailored and patient-centred approaches that enhance continuity and coordination of care to manage complex MLTCs in India and similar LMICs

Experiences and challenges of people living with multiple long-term conditions in managing their care in primary care settings in Kerala, India:A qualitative study

Background: Multimorbidity or multiple long-term conditions (MLTCs), the coexistence of two or more chronic conditions within an individual, presents a growing concern for healthcare systems and individuals’ well-being. However, we know little about the experiences of those living with MLTCs in low- and middle-income countries (LMICs) such as India. We explore how people living with MLTCs describe their illness, their engagements with healthcare services, and challenges they face within primary care settings in Kerala, India. Methods: We designed a qualitative descriptive study and conducted in-depth, semi-structured interviews with 31 people (16 males and 15 females) from family health centres (FHCs) in Kerala. Interview data were recorded, transcribed, and thematic analysis using the Framework Method was undertaken. Findings: Two main themes and three sub-themes each were identified; (1) Illness impacts on life (a)physical issues (b) psychological difficulties (c) challenges of self-management and (2) Care-coordination maze (a)fragmentation and poor continuity of care (b) medication management; an uphill battle and (c) primary care falling short. All participants reported physical and psychological challenges associated with their MLTCs. Younger participants reported difficulties in their professional lives, while older participants found household activities challenging. Emotional struggles encompassed feelings of hopelessness and fear rooted in concerns about chronic illness and physical limitations. Older participants, adhering to Kerala’s familial support norms, often found themselves emotionally distressed by the notion of burdening their children. Challenges in self-management, such as dietary restrictions, medication adherence, and physical activity engagement, were common. The study highlighted difficulties in coordinating care, primarily related to traveling to multiple healthcare facilities, and patients’ perceptions of FHCs as fit for diabetes and hypertension management rather than their multiple conditions. Additionally, participants struggled to manage the task of remembering and consistently taking multiple medications, which was compounded by confusion and memory-related issues. Conclusion: This study offers an in-depth view of the experiences of individuals living with MLTCs from Kerala, India. It emphasizes the need for tailored and patient-centred approaches that enhance continuity and coordination of care to manage complex MLTCs in India and similar LMICs