A Comparative Analysis of Scheuer Scoring System and Ishak Modified Histological Activity Index in Assessing Inflammation and Fibrosis from Liver Biopsies of Patients with Chronic Hepatitis

Introduction: Chronic hepatitis is characterized by any biochemical, serological or clinical evidence of persistent or recurring liver disease lasting over six months. Histological evaluation through liver biopsy remains essential for grading and staging of the disease. Among the established scoring systems, the Ishak modified histological activity index (HAI) and the Scheuer system are widely used; yet, comparative data on their concordance remain limited. Objectives: To determine the utility of the Ishak modified HAI system in comparison to the Scheuer system in determining the grade and stage in liver biopsies of patients with chronic hepatitis Methods: A total of 31 liver biopsies were included in the study. Each biopsy was independently scored using the Ishak Modified HAI and Scheuer system. Inter-system agreement was measured using Cohen’s kappa. Clinical and biochemical data, including transaminase levels, were also evaluated. Results: There were 19 females and 12 males. Their mean age was 44.5. Cohen’s kappa indicated a slight agreement for necro-inflammatory activity i.e grading (0.08) and moderate agreement for fibrosis i.e staging (0.2). The Ishak system offered more detailed stratification, particularly in intermediate stages. Conclusions: The study concluded that both the systems are nearly equally effective for grading and staging. The level of agreement was more in terms of staging compared to grading. Ishak graded lower than Scheuer in most of the cases, while staging was seen to be higher than the Scheuer system

Role of diagnostic laparoscopy in chronic pelvic pain

Background: Laparoscopy in chronic pelvic pain can reveal findings that cannot be detected clinically, so it can be treated and diagnosed at same sitting. This study was undertaken to evaluate role of diagnostic laparoscopy in chronic pelvic pain.Methods: It was a prospective study conducted at department of Obstetrics and Gynecology, ESI PGIMSR, Basaidarapur, New Delhi. The study was carried out from 2012- 2014. Total 110 cases were enrolled. 55 cases who had been suffering from chronic pelvic pain for ≥6 months were taken as study group (A). 55 cases without any symptoms that underwent laparoscopic sterilization were taken as control group (B). Results were statistically analyzed using Karl Pearson's correlation coefficient.Results: Chronic pelvic pain whereas on laparoscopy normal finding were seen only in 25.45% cases. This difference was found to be statistically significance (P value 0.04). Normal findings were seen in 60% cases of chronic pelvic pain on USG as compared to 25.14% cases on laparoscopy was statistically significant .( p value <0.05.)Conclusions: Laparoscopy is a gold standard tool in evaluation of women with chronic pelvic pain, because diagnosis and often treatment can be accomplished in one sitting, without subjecting them to exploratory laparotomy

Option Pricing: A Theoretical as well as Practical View

This particular study has been undertaken to form a basis of comparison in the 2 main pricing techniques for options, the Black Scholes model and the Binomial Lattice model. The Black Scholes has been the fundamental model for option pricing but has certain limitations. These limitations of the model have been provided for in the Binomial Tree model. Due to this, the Binomial Tree model is used for valuing American options taking real time market data for a stock option that trades on NASDAQ under the Chicago Board Options Exchange which is then compared to the actual price of the option for that given data. This is done with a view to develop a program that has the ability to calculate the price of an option using real time data as close to the actual market price of the option. Before comparing the pricing models for options and getting started with the computer programming part of it, it is important to understand options in theory. The research starts with defining options and talking about their various types and features and goes further ahead to examining the pricing models. Volatility is discussed in greater detail and its effect on option prices are observed by varying it in the binomial tree program. The program gives results that fortunately do not differ from the actual option prices too much. So the objective is achieved. Like any other model, this one too has limitations which are also looked into in this dissertation. The literature, methodology, testing and analysis are all done from the point of view of Computational Finance combined

Binomial Tree Model for Option Pricing: A Theoretical as well as Practical View

This particular study has been undertaken to implement the Binomial Option Pricing technique using computational software. This has been done with a view to price European as well as American options. Even though most of the option prices are given and available to the users, having a model to price them can prove as a useful tool for analysis and subsequent hedging. The Binomial Tree model has been chosen for valuing American options taking real time market data for stock options that trade on NASDAQ under the Chicago Board Options Exchange. Implied volatility has been used to compute option prices from the program to match their actual market value. This is done with a view to develop a program that has the ability to calculate the price of an option using real time data as close to the actual market price of the option.Volatility is discussed in greater detail and its effect on option prices are observed by varying it in the binomial tree program

A clinical study of postdated pregnancy

Background: Objective of the study was to find out the incidence of maternal complications, perinatal mortality and morbidity in postdated pregnancies. Design of the study was prospective observational study.Methods: Patients who have completed 40 weeks of gestational age, patients who were sure of the date of last menstrual period (LMP) along with 1st trimester obstetrics scan were included. Patients not sure of LMP were excluded.Results: There is high fetal and maternal risk associated with postdated pregnancy. Total 100 cases were selected from antenatal clinic and Labour Room and were divided into two groups. Study group and control group, 50 cases in each. Induction rate is more in postdated pregnancies. Incidence of operative deliveries is 54% in study group. Postpartum haemorrhage and septicaemia are the most common maternal complication in the study group. Perinatal mortality is higher and more NICU admissions were required.Conclusions: Considering this, policy of early intervention should be undertaken in postdated pregnancy to avoid maternal and perinatal complications

Conventional stimulation protocol failed to produce mature oocytes : rescue ivm resulted in six pregnancies after invitro fertilization and embryo transfer

When conventional stimulation protocol in IVF cycle fails to produce mature oocytes, many a times, the cycle is cancelled and the patient is disappointed.  Now that in-vitro maturation of oocyte is possible in view of commercial availability of media, perhaps it may be mandatory to retrieve immature oocytes and mature them in-vitro, freeze them if necessary and fertilize, develop embryos for transfer in order to help couples to achieve pregnancy.  Thus maturation in-vitro of GVs has become an important adjuvant for treating PCOS and in particular poor responders to gonadotrophin stimulation.  Our study is interesting because in spite of conventional stimulation protocol, we failed to recover any mature oocytes in eleven women when the average follicles size being 17mm at the time of hCG.  However, maturing these oocytes in-vitro, as a rescue measure, resulted in 50% of these women becoming pregnant after embryo transfer

Meaningful teaching of mathematics

It is always a good idea to use more than one method to draw/represent concepts so that the teacher can be reasonably sure that the learner has understood and is comfortable with the concept

Ultrasonographic evaluation of first trimester bleeding per vaginum

Background: First trimester is a very crucial period of pregnancy having high risks of pregnancy losses. The objective of this study was to assess the accuracy of ultrasound in diagnosis of cause of first trimester bleeding per vaginum.Methods: 200 women who attended the out-patient department with the complaint of bleeding per vagina in the first trimester pregnancy were taken for the study. Clinical assessment by pelvic examination was done and a provisional diagnosis was made. All necessary routine investigations were done followed by ultrasonographic scan of each patient. All the data was recorded in a proforma.Results: Among these 200 cases, threatened abortion in 72 cases. It was the commonest cause for bleeding. There were 20 cases of ectopic pregnancy out of which 16 were correctly diagnosed. There were 16 cases of missed abortion. There were 8 cases of hydatidi form mole. There were 40 cases of incomplete abortion, 16 cases of inevitable abortion, 8 cases of an embryonic gestation and 20 cases of complete abortion. By this study it is concluded that the accuracy of USG in diagnosing the cause of first trimester bleeding per vaginum is 96%.Conclusions: Use of USG in diagnosis of cause of bleeding in first trimester can lead to accurate and early diagnosis and save the patients from unneeded interventions based on history and clinical examination

A retrospective study on use of palliative care for patients with alcohol related end stage liver disease in United States

BACKGROUND: Palliative care (PC) has been shown to be beneficial in end stage liver disease (ESLD), yet the hospitalization data for PC utilization is unknown. AIM: To identify the trend of PC utilization for the special population of alcohol-associated ESLD patients, factors affecting its use and ascertain its impact on healthcare utilization. METHODS: We analyzed around 78 million discharges from the 2007-2014 national inpatient sample and 2010-2014 national readmission database including adult patients admitted for decompensated alcohol-associated cirrhosis. We identified patients with PC consultation as a secondary diagnosis. Odds ratios (OR) and means were adjusted for confounders using multivariate regression analysis models. RESULTS: Out of the total 1421849 hospitalizations for decompensated liver cirrhosis, 62782 (4.4%) hospitalizations had a PC consult, which increased from 0.8% (1258) of all alcohol-associated ESLD hospitalizations in 2007 to 6.6% in 2014 ( CONCLUSION: Inpatient PC is sparingly used for patients with decompensated alcohol related liver disease, however it has increased over the past decade. PC consultation is associated with lower 30-d readmission rates on multivariate analysis, and lower hospitalization cost and length of stay in patients with ACLF score ≥ 2

Help-Seeking for Illicit Drug Use in Adolescents: A Qualitative Study From India

Illicit drug use is a growing concern in India, with a treatment gap of 73%. Explanatory models can offer valuable insights into patients’ understanding of their condition and inform help-seeking and treatment strategies. This study aims to develop an explanatory model to identify barriers and facilitators for help-seeking, desired resources, and treatment strategies among adolescents struggling with illicit substance misuse. Semi-structured interviews were conducted with 23 adolescents seeking treatment for drug use and 25 healthcare providers across three Indian sites. Thematic analysis revealed barriers to help-seeking, such as stigma, lack of awareness, and financial constraints. Family awareness was crucial for recovery, and adolescents sought personalized, comprehensive treatment. Healthcare providers emphasized the need for more government funding and flexible treatment options. These findings provide valuable insights into help-seeking behaviors and treatment preferences, which could enhance treatment engagement and outcomes for adolescents with drug use disorders