Quantum Optimization From a Computer Science Perspective

Optimization problems are ubiquitous in but not limited to the sciences, engineering, and applied mathematics. Examples range from the fastest way USPS can route packages through a delivery network to the best way an autonomous vehicle can navigate through a given traffic environment. Classical optimization algorithms dominate the way we solve these problems. However, with the rapid advance of quantum computers, we are looking at novel, quantum-inspired ways of solving old problems to achieve some speedup over classical algorithms. Specifically, we are looking at the Quantum Approximate Optimization Algorithm (QAOA). We show that QAOA provides a tunable, optimization algorithm whose quantum circuit grows linearly with the number of constraints for MAXSAT, an NP-complete problem

A study of incidence and outcome of acute kidney injury in common undifferentiated febrile illnesses

Background: Patients presenting with acute undifferentiated febrile illness may have delay in diagnosis due to nonspecific symptoms and signs. Kidney injury in these patients can cause detrimental effect on their prognosis and hence early diagnosis is warranted.Methods: This is an observational prospective study conducted in the Department of Medicine at Christian Medical College and Hospital, Ludhiana for a period of one year from 1st November 2014 till 31st October 2015.Results: Among the 532 patients acute febrile illness included in the study, 437(82.1%) were diagnosed with dengue fever. A total of 190(35.7%) patients were diagnosed to have AKI. The incidence of AKI in specific diseases was found to be the highest in Malaria 8(61.5%) out of 13 patients). In AKI, majority of them were in the risk category with 97(51.0%). A total of 26(13.6%) patients with AKI required Hemodialysis. Among the 190 patients who had AKI 43(22.6%) died.Conclusions: Dengue was the most common acute febrile illness. Among the patients with acute kidney injury majority were in the risk category with 97(18.2%). 326(61.2%) patients were males with a male to female ratio was found to be 1.5: 1. Dengue with acute kidney injury had the most proportion of patients in the risk and injury category and malaria with acute kidney injury having the highest proportion in failure category. The highest incidence of patients with AKI requiring hemodialysis was seen in scrub typhus. Leptospirosis with AKI had the highest proportion of mortality. The failure category had the highest proportion of mortality.

Low cost carriers versus traditional carriers and its impact on financial performance: a comparative study on the UAE airlines companies

The initial appearance of US low-cost carriers forced incumbents to create new forms of competitive advantage. However, these hindrances proved to be successful for nearly two decades. In any case, a new report by the NBK capital, an investment bank based in Kuwait, recorded that in the Middle East, especially in the Gulf region, the low cost carrier sector has established itself as a thriving industry with lots of potential in hardly four years. This paper endeavours to highlight some of the differences between the two markets and it gives an explanation as to how the advantages of the Middle East low cost airlines would be enough to bypass the financial performance of the traditional carriers

"Twiddler" In A Canine Model And A Modified Implant Technique To Prevent It

This report explains the Twiddler's syndrome, a well known human entity, in a canine model. We also describe a modified technique to implant internal cardioverter defibrillators (ICD) in dogs to prevent Twiddler's syndrome. Our original study was to identify the factors influencing the DFT measurement and a canine model was selected as it is the best proven electrophysiological model. During the course of the study, one of the dogs was evaluated for device failure at three weeks following implantation. While under general anesthesia, interrogation of the dog's ICD showed that the right ventricular (RV) pacing threshold was high and ventricular capture was intermittent. When examined under fluoroscopy, it was noted that the defibrillator lead was dislodged from the right ventricular apex. A surgical revision of the device pocket showed that the leads were twisted in an almost braided fashion - as if "twiddled" into position around the device [Figure1 (arrow)]. We suspect that this "twiddling" resulted in shortening and pulling of the lead from the ventricular myocardium causing intermittent capture and device failure

Unilateral asymptomatic optic disc edema: do not forget sinusitis

Background: Optic disc edema is a pathological condition with various causes. Cases of optic disc swelling should be dealt with a multidisciplinary approach to rule out those causes. Unilateral optic disc edema is seen in papillitis, non-arteritic anterior ischemic optic neuropathy, retinal vein occlusion, and infection or inflammation of the contiguous sinus or orbit. Here, we report a rare case of unilateral asymptomatic optic disc edema due to posterior ethmoid sinusitis.   Case Presentation: A 53-year-old man presented for a routine 3-monthly follow-up after an uneventful cataract surgery of the right eye. All examinations were unremarkable, except for the right eye optic disc edema on fundus examination, consistent with an enlarged blind spot in the visual field test. Contrast-enhanced magnetic resonance imaging revealed mucosal thickening with muco-inflammatory exudates of the posterior ethmoidal sinus overriding the optic disc on the right side, leading to optic disc edema of the right eye. The patient was diagnosed with unilateral asymptomatic optic disc edema in the right eye due to posterior ethmoid sinusitis and referred to an otorhinolaryngologist for the management. The otorhinolaryngologist performed functional endoscopic sinus surgery and prescribed antibiotics and anti-histamines for 6 weeks. At the final examination, his visual acuity was 6/6, and the fundus examination revealed no optic disc edema. Conclusions: We reported a rare case of unilateral optic nerve edema and visual field loss with a treatable cause. Contemporary imaging provided the accurate diagnosis. Therefore, in cases of disc edema, sinusitis of the adjacent paranasal sinuses should be ruled out as a possible cause of compressive optic neuropathy or inflammation overriding the optic nerve

Quality of life assessment in women with stress urinary incontinence following Trans Obturator Tape (TOT) insertion: a prospective study

Background: Stress urinary incontinence is a symptom or sign indicating that the woman has involuntary loss of urine associated with exertion in the absence of detrusor contraction. It has a significant impact on quality of life. TOT insertion is a popular procedure being done now. Studies related to quality of life assessment following Trans obturator tape (TOT) insertion is sparingly reported. Objectives of present study were to evaluate the quality of life following TOT insertion in patients with stress urinary incontinence and to assess the post operative complications.Methods: This is a prospective study done in the Department of Obstetrics and Gynecology, Government Medical College, Thrissur from January 2015 to December 2016. 48 women with Stress urinary incontinence who underwent TOT insertion were included in the study, out of which 30 patients were followed up. The King’s Health Questionnaire was used for assessment. Data was analyzed using Epi Info 7 and Microsoft Excel. The statistical analysis was done using student t-test.Results: At 6 months follow up 86.66% (26) of patients had significant improvement in quality of life. 2 patients (6.66%) had postoperative voiding dysfunction, required recatheterisation, discharged after relief of symptoms. 2 patients (6.66%) had urge incontinence, advised medical management and was sent home, showed no improvement even after 6 months. 2 patients (6.66%) had continuous incontinence, fistula ruled out. Now they were lost to our follow up. Most common late post operative complication was groin pain. None had mesh erosion, bladder and bowel injuries.Conclusions: TOT is a safe and effective procedure for the treatment of stress urinary incontinence (SUI) which significantly improves the quality of life

Role of magnesium in post thyroidectomy hypocalcemia.

Aim and objectives: The aim of the study was to evaluate the role of magnesium in postthyroidectomy hypocalcemia. The objectives were to: A) Estimate the prevalence of hypomagnesemia in patients undergoing thyroidectomy and in post thyroidectomy patients and its relationship with hypocalcemia B) Evaluate the relationship of the following factors to post thyroidectomy hypocalcemia: Age, gender, vitamin D level, thyrotoxicosis, inadvertent parathyroid injury/removal, hemodilution, extent of dissection and duration of operation Material and methods: This was a prospective observational study conducted from 1st October 2012 to 30th September 2013 at the department of Endocrine Surgery, Christian Medical College, Vellore, India. The sample size was 50. The statistical analysis was performed using STATA I/C 10.1. This study was approved by the institution review board. Results: Majority of the patients (26%) were in the fifth decade. A female predominance was noted. Seventy four percent of the patients had carcinoma thyroid, the most common malignancy being papillary carcinoma thyroid. Seventy two percent underwent total thyroidectomy. The prevalence of hypomagnesemia preoperatively was 24% and following thyroidectomy this increased to 70% percent. Hypovitaminosis D was prevalent (62%). Postoperative hypocalcemia was seen in fifteen patients (30%). We found a similar trend of the fall and gradual normalization of calcium and magnesium postoperatively though there was no significant association between the two. There was a significant direct correlation between amount of fluids used and development of hypocalcemia (p=0.04) and low PTH (<8pg/ml) with postoperative hypocalcemia (p=0.029). There seemed to be a protective effect of hypovitaminosis D for hypocalcemia. Age of the patient, gender, presence of thyrotoxicosis and duration of operation had no bearing on the postoperative hypocalcemia in our study. Conclusions: 1) The prevalence of hypomagnesemia is 24% preoperatively in this cohort of patients. They were all mild deficiency 1.6 to 1.8. Vitamin D deficiency (< 20) was 62%. 2) The postoperative hypocalcemia (calcium <8mg/dl) rate was 30%. Hypovitaminosis D appeared to protect against postoperative hypocalcemia; this finding is at variance with published literature. 3) There was a marked rise in postoperative hypomagnesemia (70%). A similar pattern of fall in calcium and magnesium following thyroid surgery which normalized by one to two weeks without intravenous correction was observed. 4) Hemodilution and low PTH were significantly associated with post thyroidectomy hypocalcemia. The ROC curve showed that a PTH of 4.1-6pg/ml was the best predictor of hypocalcemia. 5) The cause of hypocalcemia post thyroidectomy in this study is mainly a factor of parathyroid function and fluid status. Magnesium levels tend to mimic the calcium levels postoperatively and there is possibly an association rather than a causation. This study therefore does not prove or disprove the role of magnesium supplementation to help correct postoperative hypocalcemia

Headache associated with travoprost

Background: Putative adverse effects of prostaglandin analogs in patients treated for glaucoma include periocular skin darkening, herpes simplex keratitis, cystoid macular edema, iritis, and headaches. Here, we report a case of migraine headache after a travoprost administration and discuss the role of prostaglandin analogs in migraine-like headaches. Case Presentation: A 70-year-old man visited the hospital complaining of pain, redness, and sensitivity to light for 1 week associated with gradual loss of vision in the right eye after cataract surgery, which had been performed 2 years prior. After the examination, the patient was diagnosed with pseudophakic bullous keratopathy and advised to undergo optical penetrating keratoplasty of the right eye. On postoperative day 3, his intraocular pressure (IOP) was 30 mmHg at 10:00 AM in the right eye. A single dose of 0.004% travoprost was instilled in the right eye on the same day. His IOP decreased to 16 mmHg at 2:00 PM. The next day, he presented with migraine-like headache that had started within 1 h after the instillation the previous night. Unremarkable neurological examination and neuroimaging suggested that travoprost had caused the migraine. Although the headache gradually resolved, it reappeared after the administration of other prostaglandins. Trabeculectomy was performed on the right side. The IOP was controlled, and the headache was resolved. Conclusions: This case indicates a potential causal relationship between topical prostaglandin analogs and migraine-like headaches, as evidenced by symptom resolution upon discontinuation. However, large-scale studies including control groups are required to prove a causal relationship between topical prostaglandin analog administrations and headache development

Use of low dose misoprostol for induction of labour in a secondary hospital setting: a retrospective cohort study of a unique induction protocol

Background: Induction of labour is a procedure often used in pregnant women where there are clear medical indications. There are various modalities of induction of labour which differ in outcomes and complications. Our aim was to look at how effective our protocol using misoprostol was in achieving delivery within 24 hours of the start of induction, the induction delivery interval, Caesarean section rates and its indications using Robsons classification, uterine hyperstimulation with FHR changes and oxytocin augmentation and its duration. Methods: This was a retrospective study which looked at the mode of induction and outcomes of women during the period from 1st February, 2021 to 31st July,2021. Results: There were 2574 deliveries in the period February 1st, 2021 to July 31st, 2021. We found more nulliparous women and obese women in the induced group. The main indication for induction was past dates and the mean induction to delivery interval among the women being induced was 32 hours (SD: 22.58). There were significantly higher women who experienced PPH and Caesarean sections were 2.100 (1.577- 2.793) times higher among women who were induced. Conclusions: Induction protocols need to be developed taking into consideration the advantages as well as complications associated with it and then tailor it according to infrastructure and personnel available

Proposing Employee Level CSR as an Enabler for Economic Performance: The Role of Work Engagement and Quality of Work-Life

The aim of the current research is to foster the economic performance of a hotel enterprise through employee-level corporate social responsibility (CSR) activities with the mediating effect of work engagement (W.E) and quality of work-life (QWL). A hypothesized model was developed for this purpose. The data were collected from the hotel employees of a developing economy (n = 396). The hypothesized relations were tested by employing the structural equation modeling technique. The current work’s statistical outcomes validated CSR’s seminal role to influence W.E and QWL perceptions of hotel employees, which eventually contribute to the economic performance of a hotel enterprise. The findings of the current analysis have different theoretical and practical implications. To the extent of theory, the current work advances the fields of enterprise management and employee wellbeing from an individual-level perspective of CSR. Practically, the current study helps the hotel management to realize that a carefully planned CSR strategy not only improves the economic performance of a hotel enterprise through employees but also helps to fulfill its social responsibility, hence leading a hotel enterprise towards a win-win situation