Feto maternal outcome in obstructed labor: a tertiary centre study

Background: The number of maternal deaths as a result of obstructed labor is 8% globally but this number varies in developing country, it ranges 4-70% of all maternal deaths and it is also associated to high perinatal mortality rate. Objective of the study was to find out the proportion of obstructed labour cases and their feto-maternal outcome during last 3 years at tertiary level institute.Methods: A cross sectional observation study was done at Department of Obstetrics and Gynecology, People’s College of Medical Sciences and Research Centre Bhopal. All pregnant women presenting with obstructed labor who delivered at our hospital during last 3 years duration (January 2015 to December 2017) were studied for their feto -maternal outcome.Results: 53% cases had duration of trail more than 16 hours. 84% were referred from primary health centers of nearby rural areas. All  cases  of obstructed labor  delivered by cesarean section (100%). 44% were primigravida. 72% of cases had Cephalopelvic disproportion as the cause. 28% of cases had longer stay more than 7 days at hospital. 32% had  fever  during post operative period 12.5% cases had wound sepsis and 6% of cases required re-suturing of wound during post operative period. 72% baby's birth weight was between 3 to 3.4 kg. 94% of the babies survived where as 6% of babies were still birth. 16% of babies born to obstructed labor mother had APGAR less than 7 at 5 minutes of birth. 6% fetus were IUFD.Conclusions: Cephalopelvic disproportion was the most common cause for obstructed labor. Timely identification of prolonged labor and timely referral and management at place where operation theatre, NICU and blood bank facilities are available can save the life of both baby and mother

Posterior reversible encephalopathy syndrome in dengue: a rare manifestation

Dengue is an important arthropod born disease with its cases spiking every 2-3 years and spectrum of disease ranging from mild febrile illness to severe illness with multiple systemic complications including rare neurological manifestation. We hereby presented a case report of rare presentation of posterior reversible encephalopathy syndrome (PRES) in an eight year old child suffering from dengue

Stability Analysis of Artificial Bee Colony Optimization Algorithm

Theoretical analysis of swarm intelligence and evolutionary algorithms is relatively less explored area of research. Stability and convergence analysis of swarm intelligence and evolutionary algorithms can help the researchers to fine tune the parameter values. This paper presents the stability analysis of a famous Artificial Bee Colony (ABC) optimization algorithm using von Neumann stability criterion for two-level finite difference scheme. Parameter selection for the ABC algorithm is recommended based on the obtained stability conditions. The findings are also validated through numerical experiments on test problems

Role of PFN in ipsilateral fracture neck and shaft femur: a single solution to double fracture

Background: Ipsilateral, concomitant femoral neck and shaft fracture is a rare fracture pattern that presents a diagnostic and treatment challenge. A variety of management modalities have been tried to treat this complex fracture pattern ranging from conservative approach to recently introduced proximal femoral nails (PFN).Methods: We analysed the retrospective data of 25 consecutive patients who had sustained a high energy trauma who had concomitant ipsilateral fractures of the femoral shaft associated with proximal femur fractures treated with PFN between January 2010 and January 2017.Results: Average follow up period was 1.2 years. All ipsilateral neck and shaft fractures were united with proximal femur nail (PFN). Neck fracture union averaged 4.3 months (range, 3–6 months). Shaft fracture union averaged 5.4 months (range, 4–7 months). Eighteen patients (70%) had a good functional result, five patients (21%) had fair result and in two patients the result (9%) was poor.Conclusions: We observed although technically demanding, the reconstruction nail is an acceptable, cost effective and minimal invasive alternative for the management of concomitant ipsilateral fractures of the femoral neck and shaft, with a good functional outcome and fewer complications

Giant-cell tumour of proximal radius in a 50-year-old female with wrist drop: a rare case report

Abstract Giant-cell tumour is a locally aggressive tumour of long bones of epiphyseal region commonly occurring in adults aged 20–40 years. Most common location is distal femur, proximal tibia, and distal radius. Different treatment options being used are curettage with bone graft or bone cement, resection with arthrodesis, reconstruction, radiation, and chemotherapy. We are reporting a case of giant-cell tumour of right proximal radius in a 50-year-old female with posterior interosseous nerve palsy. It is very rare, and only four cases have been reported in the literature. It was treated by wide margin resection with fibular grafting, titanium elastic nail system along with cancellous bone graft reconstruction

Music: an effective anxiolytic during caesarean section under spinal anaesthesia

Background: Parturient undergoing repeat caesarean section (CS) under spinal anaesthesia usually experience anxiety due to unpleasant operative environment. Music therapy has been found to have positive psychological impact to relieve anxiety, improve patient satisfaction and provide stable haemodyanamics.Methods: Sixty patients without any co morbidity having history of previous CS, scheduled for another caesarean under spinal anaesthesia were included in the study. Patients were divided into two groups of 30 each. Group(M) patients were subjected to hearing music of their choice with the help of headphones after administration of spinal anaesthesia till the end of surgery. Group(N) patients were not made to listen to any music but headphones were applied. Haemodyanamic parameters including mean arterial pressure (MAP) and heart rate (HR), visual analogue score for anxiety (VASA) after administering spinal block and at the end of surgery, patient satisfaction score (PSS) and comparison of anxiety with previous CS were observed and recorded.Results: Both MAP and HR in Group M started falling after 10 minutes of spinal anaesthesia as compared to Group N and difference was significant (P <0.005), VASA 2 (2.2±1.8) in Group M was significantly lower than VASA 1 (5.4±1.7). PSS was also in favour of music group (Group M) and difference was highly significant as compared to group N (p=0.018). Patient’s anxiety as compared to anxiety with previous CS was lesser in Group M as compared to Group N(p=0.009).Conclusions: Music is a non-invasive tool to relieve anxiety during intraoperative period along with higher patient satisfaction and stable haemodyanamics

Correlation of acromial morphology in association with rotator cuff tear : a retrospective study

Purpose: There have been many studies that have attempted to correlate radiographic acromial characteristics with rotator cuff tears, but the results have not been conclusive. Rotator cuff tears (RCT) are the common aetiology of shoulder pain. We assessed the association of rotator cuff tears with commonly used radiographic parameters of acromial morphology and their different radiographic characteristics. Material and methods: From a retrospective study of 98 patients, we characterised acromial type and measured acromial thickness (AT), critical shoulder angle (CSA), lateral acromial angle (LAA), acromiohumeral distance (AHD), and acromion index (AI) on a 1.5T MRI, from 68 patients with partial or full-thickness supraspinatus tendon tears and 30 controls without tears. Results: Out the 68 patients with rotator cuff tear, supraspinatus was the most commonly affected tendon, with 86% (59) cases showing abnormalities. The average age of the patients was 45.11 ± 21.45 years with male dominance (80%). Partial tears of rotator cuff were more common than complete tears. Forty-eight cases showed partial tears in supraspinatus as compared to 11 cases of complete tears. The acromial type did not show any correlation with any particular cuff lesion. The AT and AI of controls were significantly smaller than cuff-tear patients. The LAA of cuff-tear patients was significantly different from that of control patients. The impingement patients demonstrated a significantly greater acromial thickness, larger CSA, decreased AHD, and decreased LAA than their control counterparts. Conclusions: A higher prevalence of rotator cuff tears and impingement associated with low lateral acromial angle, larger CSA and decreased AHD was observed. AT and AI have a direct correlation with rotator cuff tear

Learning Visual Representations for Transfer Learning by Suppressing Texture

Recent literature has shown that features obtained from supervised training of CNNs may over-emphasize texture rather than encoding high-level information. In self-supervised learning in particular, texture as a low-level cue may provide shortcuts that prevent the network from learning higher level representations. To address these problems we propose to use classic methods based on anisotropic diffusion to augment training using images with suppressed texture. This simple method helps retain important edge information and suppress texture at the same time. We empirically show that our method achieves state-of-the-art results on object detection and image classification with eight diverse datasets in either supervised or self-supervised learning tasks such as MoCoV2 and Jigsaw. Our method is particularly effective for transfer learning tasks and we observed improved performance on five standard transfer learning datasets. The large improvements (up to 11.49\%) on the Sketch-ImageNet dataset, DTD dataset and additional visual analyses with saliency maps suggest that our approach helps in learning better representations that better transfer

Analysing convergence, consistency and trajectory of Artificial Bee Colony Algorithm

Recently, swarm intelligence based algorithms gained attention of the researchers due to their wide applicability and ease of implementation. However, much research has been made on the development of swarm intelligence algorithms but theoretical analysis of these algorithms is still a less explored area of the research. Theoretical analyses of trajectory and convergence of potential solutions towards the equilibrium point in the search space can help the researchers to understand the iteration-wise behaviour of the algorithms which can further help in making them efficient. Artificial Bee Colony (ABC) optimization algorithm is swarm intelligence based algorithm. This paper presents the convergence analysis of ABC algorithm by using results from the theory of dynamical system and convergent boundaries for the parameters $\phi$ and $\psi$ is proposed. Also the trajectory of potential solutions in the search space is analysed by obtaining a partial differential equation corresponding to the position update equation of ABC algorithm. The analysis reveals that the ABC algorithm performs better/efficiently when parameters $\phi$ and $\psi$ are in the convergent region and potential solutions movement follows 1-Dimensional advection equation