A Critical Overview of NoSQL Databases

ABSTRACT With the growth of Digital world, complexit

Effect of chronic exposure to biomass fuel smoke on pulmonary function test parameters

Background: Life in a typical Indian household revolves around the cooking area, and Indian women spend much of their time there. Cooking stoves in most households are nothing more than a pit, a chulha (a U-shaped construction made from mud), or three pieces of brick. Cooking under these conditions entails high levels of exposure to cooking smoke. Aim of this study was to evaluate the effect of Chronic Exposure to Biomass Fuel Smoke on Pulmonary Function Test Parameters.Methods: 60 non-smoking women without any history of any major chronic illness in the past were selected for this study. The study group comprised of 30 rural female subjects who were chronically exposed to biomass fuel smoke combustion and 30 age matched urban female subjects exposed chronically to clean fuel combustion (Liquified Petroleum Gas–LPG) in Haryana (India). All the subjects were evaluated for pulmonary function tests by RMS Medspiror.Results: Biomass exposure index came out to be 85.68±3.69 for women cooking on biomass and LPG index was 64.17±6.97 for women cooking on LPG. This implies significant chronic exposure of women to biomass fuel smoke. The lung function parameters were significantly lesser in biomass exposed rural women [FEV1 (p<0.01), FVC (p<0.01), FEF25-75 (p<0.01), FEV1/FVC ratio (p<0.01), PEFR (p<0.01), MVV (p<0.01)] than the LPG exposed urban women. The evaluation of PFT suggested obstructive type of pulmonary disease.Conclusion: The derangement in pulmonary function parameters in women exposed to biomass smoke pollutants could be due to chronic significant exposure as suggested by high Biomass exposure Index. Inadequate ventilation in cooking area without chimney/vent also contributed to pulmonary function derangement and COPD.

Open reduction of carpometacarpal fracture dislocations: a case report

Dislocations of the carpometacarpal (CMC) joints are uncommon injuries. Up to 70% of carpometacarpal dislocations are missed or misdiagnosed. Post traumatic dislocation of carpal and CMC joint results most commonly due to high energy trauma. A 24 year old male with right hand dominant presented 5 days after in emergency room with alleged history of fall from 4 feet height on right hand with wrist in extension. On clinical examination revealed marked swelling over dorsum of right hand with wound over volar aspect of hand. There was minimal movement of fingers due to pain. There was no finger paresthesia. CRT was normal. Radiography revealed a volar dislocation of 2nd to 5th CMC joint with intra-articular fracture of base of proximal phalanx of the thumb. He was treated by open reduction and percutaneous fixation using Kirschner wires. The functional results were excellent at 6 months of follow-up

Evaluation of relationship between bone mineral density and fragility fracture in perimenopausal women between 40-58 years of age: a hospital based prospective observational study

Background: At present the risk assessment for osteoporosis using low bone mineral density (BMD) is based on data obtained from elderly females, largely ≥ 65 years of age. The risk factors for low peak bone mass or accelerated bone loss that occurs during perimenopausal phase is ignored in this risk assessment. Osteoporosis is found to occur at a relatively younger age in the Indian population. Although lower BMD values have an established identity as a major risk factor for fractures in postmenopausal women, we endeavour to evaluate relationship between bone mineral density and fragility fracture in perimenopausal women.Methods: 65 Patients were recruited for the study. After X-ray of involved part, patients were divided into cases (with fracture, n=33) and control (no bony injury, n=32). All patients underwent dual energy X-ray absorptiometry (DEXA) scan. Results of DEXA scans were evaluated in both the groups. BMD was expressed in g/cm2.Results: 33 patients (50.77%) were diagnosed as fracture, 32(49.23%) had no bony injury. Threshold bone mineral density (BMD) for fragility fracture found out asfor L1, cut off ≤0.767. For L2, cut off ≤0.829. For L3, cut off ≤0.811. L4, cut off ≤0.798. For L1-L4, cut off ≤0.845. For left femur total hip, cut off ≤0.918. For left forearm-total, cut off ≤0.411. For right femur total hip-cut off ≤0.795. For right forearm-total, cut-off≤0.382.Conclusions: Perimenopausal women having BMD below threshold for involved site are at risk of fragility fracture and should be given prophylactic treatment to improve bone mineral density

Double intra venous cannula versus single needle technique of aspiration and methylprednisolone injection in the treatment of wrist ganglion: a comparative study

Background: Ganglion is the one of the common soft tissue swellings in the hand and wrist. Treatment options available include reassurance, nonsurgical means like aspiration with or without steroid or hyaluronidase injection and surgical or arthroscopic excision. All current treatment options produce suboptimal results. This study endeavours to compare the outcome and recurrence rate and other complications after treatment of wrist ganglion by aspiration and methylprednisolone injection by double Intravenous cannula versus single needle technique.Methods: A prospective comparative clinical study was done with a total of 72 patients. 36 patients in group 1 were treated with double intravenous cannula technique and 36 patients in group 2 were treated with single needle technique. All the patients were followed up for 6 months to look for recurrence and any complication. The patient’s age, sex and various characteristics of the ganglion cyst like side, site, size, etc. were recorded.Results: In group 1, recurrence was seen in 6 patients (15.7%) while in group 2, recurrence were seen in 14 (38.8%) patients. There was statistical significant difference between the two groups with p value of 0.04. No complication was seen in both groups due to methylprednisolone injection.Conclusions: Inspired by the results we advise to use aspiration and methylprednisolone injection by double intravenous cannula technique in the treatment of wrist ganglion before any surgical intervention. It is safe, simple, cost effective method and is less invasive and less time consuming with recurrence rate comparable to surgical and arthroscopic interventions

Current Status of Knowledge, Attitudes and Practices towards Healthcare Ethics among Doctors and Nurses from Northern India - A Multicentre Study

Background: Recent raise in litigation againsthealthcare practitioners is definitely an issueof immediate concern and may reflect an in-crease in unethical practices by them. Profes-sional relations between physicians and nursesmay have differences with respect to their atti-tudes towards patient-care. Aim and Objec-tives: To assess the knowledge of, and attitudesto healthcare ethics among north Indian physi-cians and nurses. Material and Methods: Thepresent cross sectional study was carried outamong 298 physicians and 107 nurses of threemedical colleges of northern India in the monthof July-August 2011 using pretested self ad-ministered questionnaire. Data analysis wasdone using SPSS version 20. Result and Con-clusion: There was a statistically significantdifference between the opinion of physiciansand nurses with respect to adherence to confi-dentiality, paternalistic attitude of doctors (doc-tors should do their best for the patient irre-spective of the patients opinion), informingclose relatives of a patients for consent proce-dures. The study highlighted gaps in the knowl-edge about practical aspects of health care eth-ics among physicians and nurses which theyencounter in day to day practice at workplace.Measures of workplace education like sensiti-zation workshops, CMEs, conferences onhealth care ethics would assist in bridging thisgap to a certain extent

Hypertrophic Cardiomyopathy and Pregnancy: A Retrospective Analysis From a Tertiary Care Hospital

Pregnancy in women with hypertrophic cardiomyopathy is not well described. In this retrospective study, we analyzed data on pregnant women with hypertrophic cardiomyopathy who were under follow-up care in the cardiology department of a tertiary care hospital. We reviewed data on all women registered in the hypertrophic cardiomyopathy cohort and those who attended the cardio-obstetric clinic and delivered between January 2010 and June 2019. From these 2 groups, we identified 7 pregnant women with hypertrophic cardiomyopathy who delivered during this period. These 7 women (mean [SD] age, 25 [3.3] years) had a total of 15 pregnancies (range per woman,1–4). This was a high-risk cohort, as 7 (46.7%) pregnancies were in the modified World Health Organization class III. The mean (SD) left ventricular wall thickness was 19.71 (2.56) mm in all pregnancies. Two of the 7 women with left ventricular outflow tract obstruction developed severe symptoms in the third trimester; these improved soon after delivery. Eight pregnancies without obstruction were well tolerated. Two pregnancies occurred after successful alcohol septal ablation. Both remained asymptomatic throughout pregnancy. All women tolerated labor well. Adverse maternal outcomes, including death, were not seen in any patient. All women who became symptomatic during pregnancy had relief of symptoms after delivery. Most women remained asymptomatic or had mild symptoms during pregnancy. Of the women with left ventricular outflow tract obstruction, 28.6% had severe symptoms that improved after delivery. Pregnancy was well tolerated after successful alcohol septal ablation

Single-Cell Phosphoproteomics Resolves Adaptive Signaling Dynamics and Informs Targeted Combination Therapy in Glioblastoma

Intratumoral heterogeneity of signaling networks may contribute to targeted cancer therapy resistance, including in the highly lethal brain cancer glioblastoma (GBM). We performed single-cell phosphoproteomics on a patient-derived in vivo GBM model of mTOR kinase inhibitor resistance and coupled it to an analytical approach for detecting changes in signaling coordination. Alterations in the protein signaling coordination were resolved as early as 2.5 days after treatment, anticipating drug resistance long before it was clinically manifest. Combination therapies were identified that resulted in complete and sustained tumor suppression in vivo. This approach may identify actionable alterations in signal coordination that underlie adaptive resistance, which can be suppressed through combination drug therapy, including non-obvious drug combinations

Effect of Magnetic-Field on the Microstructure and Macrosegregation in Directionally Solidified Pb-Sn Alloys

An investigation into the influence of a transverse magnetic field (0.45 T) on the mushy zone morphology and macrosegregation in directionally solidified hypoeutectic Pb-Sn alloy shows that the field has no influence on the morphology of dendritic arrays. The field does, however, cause severe distortion in the cellular array morphology. Cellular arrayed growth with the magnetic field results in an extensive channel formation in the mushy zone, as opposed to the well-aligned and uniformly distributed cells formed in the absence of the field. The channels are produced due to the anisotropy in the thermosolutal convection caused by the magnetic field. Macrosegregation, however, along the length of the directionally solidified samples is not influenced by this magnetic field for either the cellular or dendritic arrays

Outcomes after alemtuzumab-containing reduced-intensity allogeneic transplantation regimen for relapsed and refractory non-Hodgkin lymphoma

18-60 months) , the actuarial overall survival (OS) rates at 3 years were 34% for HG-NHL, 60% for MCL, and 73% for LG-NHL (P &lt; .001). The 100-day and 3-year transplant-related mortality (TRM) rates for patients with LG-NHL were 2% and 11%, respectively, and were better (P ‫؍‬ .01) than they were for patients with HG-NHL (27% and 38%, respectively). The actuarial current progression-free survival (PFS) rate at 3 years, including the rate for patients who achieved remission after donor lymphocyte infusion (DLI) for progression, was 65% for LG-NHL, 50% for MCL, and 34% for HG-NHL (P ‫؍‬ .002)