Shiva: A Framework for Graph Based Ontology Matching

Since long, corporations are looking for knowledge sources which can provide structured description of data and can focus on meaning and shared understanding. Structures which can facilitate open world assumptions and can be flexible enough to incorporate and recognize more than one name for an entity. A source whose major purpose is to facilitate human communication and interoperability. Clearly, databases fail to provide these features and ontologies have emerged as an alternative choice, but corporations working on same domain tend to make different ontologies. The problem occurs when they want to share their data/knowledge. Thus we need tools to merge ontologies into one. This task is termed as ontology matching. This is an emerging area and still we have to go a long way in having an ideal matcher which can produce good results. In this paper we have shown a framework to matching ontologies using graphs

Role of cartridge-based nucleic acid amplification test to diagnose tuberculosis at tertiary care teaching hospital in Rajasthan, India

Background: Tuberculosis is one of the top 10 causes of death worldwide as per the Global TB report 2017, the estimated incidence of TB in India was approximately 28,00,000 cases accounting for about a quarter of the world’s TB cases (10 million). It is of utmost important to diagnose early and treat it to reduce disease transmission. GeneXpert MTB/RIF, an automated cartridge-based molecular technique detects Mycobacterium Tuberculosis and rifampicin resistance within two hours, has been recommended by WHO for rapid diagnosis of TB.Methods: Author conducted a retrospective study in the Department of TB and Chest, of tertiary care center at Jhalawar Medical College (JMC), Jhalawar to evaluate and analyze the role of CBNAAT to diagnose tuberculosis from 1st January 2018 to 31st December 2018. Author included all patients who came to department of TB and Chest of JMC, Jhalawar either new/ relapsed/ defaulters/ referred cases from ART/ ICTC center, Pediatric Department; Gynaecology and Obstetrics Department, peripheral Government Health Care Facilities and Private Hospitals of Jhalawar District catering about 15.5 lac population were subjected to both ZN staining/ Fluorescent microscopy and CBNAAT in the study period.Results: A total of 3078 samples (pulmonary 2739+EP 339) were tested for ZN staining / Fluorescent microscopy and CBNAAT during the study period. Mean age of the study population was 36.5±10.3 years. 1873 tested were negative and 1205 samples were positive for CBNAAT. Of these 1205 positive samples, 1174 were sputum/ BAL samples and 31 were extra pulmonary samples. Authors found rifampicin resistance rate of 6.98% (82/1174) in pulmonary tuberculosis cases, 3 rifampicin resistance cases were detected in extra pulmonary samples. CBNAAT could identify 255 cases (14.01%) that were smear negative. Author found TB-HIV coinfection rate of 18.75%.Conclusions: Author found CBNAAT to be an important diagnostic modality especially in smear negative patients for early diagnosis and treatment. Author could detect Mycobacterium Tuberculosis in 14.01% of patients with negative smear microscopy for AFB. In PLHIV, CBNAAT detected Mycobacterium Tuberculosis in 18.75% (12/64) of patients. Author found rifampicin resistance rate of 6.98% (82/1174) in pulmonary tuberculosis cases

Surgical Anatomy of Acetabulum and Biomechanics

Both column acetabular fractures are challenging articular injuries. Majority of them are treated operatively. The concept of “secondary congruence” was introduced by Letournel. Despite this, biomechanical data on secondary congruence indicate that nonoperative treatment leads to an increase in peak pressures in the supra-acetabular region with the potential risk of developing posttraumatic degenerative osteoarthritis. Operative management is therefore justified. A cohort of 10 patients having both column (anterior and posterior) acetabular fractures managed using bicolumnar plating between Jan 2016 and Dec 2017 were enrolled in the study and were analyzed during follow-up period. Eighty percent of the patients had excellent to good result. Average postoperative score was 85.7. Assessment was done using Modified Harris Hip score

Digital gangrene a rare early manifestation of Wegener’s granulomatosis: a case report

Wegener's granulomatosis (WG) or Granulomatosis with polyangiitis (GPA) rarely presents with digital gangrene being an early manifestation. We report a case of 60-year-old woman who presented with fever and cough with occasional hemoptysis along with painful bilateral feet digital gangrene. X ray chest and HRCT thorax of the patient was suggestive of multiple nodulo-cavitatory lesions. HPE of the lung lesion showed granulomatous pathology. CT Angiography was suggestive of multiple calcified and non-calcified lesions in infra renal aorta with stenosis of right dorsalis pedis artery. Biopsy of the skin lesion revealed a leucocytoclastic vasculitis. We eventually diagnosed GPA in light of clinical symptomatology with HPE of lung mass showing granulomatous lesion along with a positive cANCA. A few months after starting combined cyclophosphamide and steroids patient had significant symptomatic improvement. Hence Wegener’s granulomatosis should always be considered as a possibility while evaluating a patient of digital gangrene specially with pulmonary and renal involvement

Atrial myxoma causing cerebral embolic ischemic stroke as the first presentation in an apparently asymptomatic young male with birth asphyxial injury: a case report

A myxoma is the most common primary tumor of the heart. It has been reported as the source of a cardiogenic embolism. Therefore, it is important for clinicians to detect the myxoma early to prevent complications like cerebral embolic stroke. This report presents the case of a 40-year-old male with birth asphyxial injury whose first clinical manifestation of atrial myxoma was an ischemic stroke. Atrial myxoma was later confirmed as the cause of his symptoms by echocardiography and cardiac CT scan along with Doppler studies

Multi-organ Injuries Due to a Lightning Strike: A Rare Case

Injuries due to a lightning strike are uncommon presentations in the emergency department. Common injuries caused by lightning include burns, muscle pains, cardiac arrest, hearing loss, seizures, behavioral changes and ocular cataracts. We report a case of a 26-year-old primigravida with history of 3 months of amenorrhea who was struck by lightning as she was standing beside a tree. It left her unconscious, immediately after which she was taken to the emergency department of Maharana Bhupal Govt Hospital (MBGH Hospital), Udaipur, Rajasthan. Entry wound was from right ear and the exit wound was on abdomen. Examination confirmed linear first- and superficial second-degree burns. The electrocardiogram (ECG) showed deep and symmetrical T-wave inversion in precordial and lateral leads. There was an associated elevation of troponin T levels (peak: 432 ng/L), suggestive of myocarditis. On otoscopic examination, she was found to have rupture of tympanic membrane bilaterally. A transthoracic echocardiography revealed reduced ejection fraction of the left ventricle to 25% with global left ventricle hypokinesia, moderate mitral regurgitation and tricuspid regurgitation. This case aims to raise awareness among the healthcare providers regarding multiple organ involvement in lightning injury

Predictors of Mucormycosis in COVID-19

Background and Aims: Mucormycosis, a serious angioinvasive infection caused by common filamentous fungi, that is, mucormycetes, constitutes the third most common invasive fungal infection, following aspergillosis and candidiasis. Although a rare infection, in recent times we witnessed a sudden surge of mucormycosis cases post-COVID-19 (coronavirus disease 2019). The present study was carried out to understand its relation to COVID-19, inflammatory markers, steroid use during COVID-19 treatment, clinical course and outcome of the disease. Material and methods: The present study was conducted at RNT Medical College, Udaipur over a period of 1 month. Written and informed consent from patients were taken. In this study, 15 patients admitted in COVID wards, medical wards, muormycosis ward and ICU were included if fungal hyphae were found on potassium hydroxide (KOH) mount and there was a history of COVID-19 illness; negative KOH mount patients were excluded. Results: In the present study, on admission, out of 15 patients, 7 (46.7%) were admitted with mean neutrophil-to-lymphocyte ratio (NLR) >5.5, mean C-reactive protein (CRP) 126, mean interleukin (IL)-6 82.4, mean lactate dehydrogenase (LDH) 528, mean ferritin 662, mean D-dimer 1760; 5 (33.3%) patients were admitted with mean NLR 3.5-5.5, mean CRP 68, mean IL-6 39.6, mean LDH 336, mean ferritin 448, mean D-dimer 780; and 3 (20%) patients were admitted with mean NLR <3.5, mean CRP 16, mean IL-6 12.8, mean LDH 172, mean ferritin 226, mean D-dimer 430. Out of the 7 patients who were admitted with NLR >5.5, 3 (42.8%) were admitted with orbital cellulitis and 4 (57.2%) with invasive sinusitis. Out of 5 patients admitted with NLR 3.5-5.5, 3 (60%) were admitted with orbital cellulitis and 2 (40%) with invasive sinusitis. Out of 3 patients admitted with NLR <3.5, 1 (33.3%) patient had orbital cellulitis and 2 (66.7%) had invasive sinusitis. Out of total 7 patients who were admitted with orbital cellulitis, in 71.4% patients, steroid was used during COVID-19 treatment and out of 8 patients who were admitted with invasive sinusitis, in 62.5% patients, steroid was used during COVID-19 treatment. In the present study, 68% patients were male and 32% were female. Around 78% patients were from rural area and 22% patients were from urban area. Overall, 74% cases were treated with amphotericin B. Among these, 36% cases were diagnosed with orbital cellulitis and 38% cases were diagnosed with invasive sinusitis. Around 26% cases were treated with posaconazole, and among these 9% were orbital cellulitis cases and 17% were invasive sinusitis cases. About 85.72% cases of orbital cellulitis and 75% cases of invasive sinusitis improved. Nearly 42.86% cases who were admitted with NLR >5.5 did not improve with treatment. Conclusion: As per present study, inflammatory markers of COVID-19, NLR and history of steroid use during treatment can be considered as predictors of mucormycosis occurrence and their outcom

Evaluation of the effect of transcutaneous electrical nerve stimulation (TENS) on whole salivary flow rate

Background: Saliva plays a critical role in maintaining oral homeostasis; it modulates the ecosystem through lubrication of the alimentary bolus, protection against microorganisms, buffer and repair of the oral mucosa, and helps in dental re-mineralization. Various local and systemic factors such as medications, radiation therapy, systemic conditions, etc. can lead to reduction in salivary flow. A decrease in salivary function, known as Xerostomia, increases a patient's risk for caries and other oral infections. Palliative management of Xerostomia includes wetting agents such as ice chips, drugs and saliva substitutes. Systemic agents stimulate salivary flow but often have unfavorable side effects. Newer modalities like transcutaneous electrical nerve stimulation (TENS), which has fewer side effects, have been used to stimulate salivary flow. The aim of the present study was to assess and evaluate the effect of TENS on whole salivary flow rates in healthy adult subjects. Study Design: A total of 80 healthy adult subjects were enrolled in the study. Unstimulated and stimulated saliva (using TENS) was collected for 5 minutes and the mean salivary flow rates were calculated. Data obtained was analyzed using the SPSS (Statistical package for social sciences) version 15. Students "t" test was employed for comparative analysis. Results: Sixty-five of the 80 subjects demonstrated an increase in the salivary flow rate on application of TENS. Twelve subjects demonstrated a mild reduction in the salivary flow rates. Seven subjects experienced transient mild twitching of facial musculature as side effects. Conclusions: Significant increase in salivary flow rates was observed on application of TENS with minimal or no side effects