End Organ Damage in Hypertensive Geriatric Age Group: A Cross Sectional Study

Objective: Hypertension is one of the common risk factors for cardiovascular and cerebrovascular diseases/disorders A developing country like India faces the double burden of communicable and non-communicable diseases; of the which, hypertension is the most important treatable cause of mortality and morbidity with loss of functional capacity and decline in the quality of life. Aim: To study the prevalence of end organ damage in the hypertensive geriatric age group. Method: The present study was a cross sectional study, conducted in 150 elderly patients admitted in MGM Hospital, Navi Mumbai, India with the diagnosis of stage I or II hypertension from 2011 to 2013. Results: Data analysis of the present study showed that 68% of elderly population aged between 60 to 69 years were suffering from hypertension. Compared to males, females had a higher rate of target organ damage. This study found that out of all patients with total end organ damage, 54.6 % had CVS complications, 15.7 % had hypertensive retinopathy, 25.9 % and 18.51 had raised creatinine and proteinuria respectively. 19.4 % had cerebrovascular accident (CVA) complications. Among Cardiovascular related complications Coronary artery disease (CAD) was found in 21 patients, out of them 7 had Congestive cardiac Failure (CCF). Left Ventricular Hypertrophy (LVH) was the most common complication and seen in 38 patients. 13.8 % patients had Regional Wall Motion Abnormality (RWMA) Conclusion: The present study concluded that Isolated Systolic Hypertension (ISH) is the commonest type of hypertension in geriatric age group. This study concluded that the most common risk factors of HTN in the elderly are sedentary life style, dyslipidemia and extra salt intake while the most common end organ damage was observed to be Left Ventricular Hypertrophy followed by renal dysfunction

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Randomized Clinical Trial of High-Dose Rifampicin With or Without Levofloxacin Versus Standard of Care for Pediatric Tuberculous Meningitis: The TBM-KIDS Trial

Background. Pediatric tuberculous meningitis (TBM) commonly causes death or disability. In adults, high-dose rifampicin may reduce mortality. The role of fluoroquinolones remains unclear. There have been no antimicrobial treatment trials for pediatric TBM. Methods. TBM-KIDS was a phase 2 open-label randomized trial among children with TBM in India and Malawi. Participants received isoniazid and pyrazinamide plus: (i) high-dose rifampicin (30 mg/kg) and ethambutol (R30HZE, arm 1); (ii) high-dose rifampicin and levofloxacin (R30HZL, arm 2); or (iii) standard-dose rifampicin and ethambutol (R15HZE, arm 3) for 8 weeks, followed by 10 months of standard treatment. Functional and neurocognitive outcomes were measured longitudinally using Modified Rankin Scale (MRS) and Mullen Scales of Early Learning (MSEL). Results. Of 2487 children prescreened, 79 were screened and 37 enrolled. Median age was 72 months; 49%, 43%, and 8% had stage I, II, and III disease, respectively. Grade 3 or higher adverse events occurred in 58%, 55%, and 36% of children in arms 1, 2, and 3, with 1 death (arm 1) and 6 early treatment discontinuations (4 in arm 1, 1 each in arms 2 and 3). By week 8, all children recovered to MRS score of 0 or 1. Average MSEL scores were significantly better in arm 1 than arm 3 in fine motor, receptive language, and expressive language domains (P < .01). Conclusions. In a pediatric TBM trial, functional outcomes were excellent overall. The trend toward higher frequency of adverse events but better neurocognitive outcomes in children receiving high-dose rifampicin requires confirmation in a larger trial. Clinical Trials Registration. NCT02958709

Experimental studies of natural convection of carbopol gels in a cavity with differentially heated sidewalls

Yield stress fluids resist flow unless an external force greater than their yield stress is applied to them. The current thesis investigates the behavior of yield stress fluids subjected to a temperature gradient. We use carbopol gels as a yield stress fluid to perform fluid flow characterization. The experimental setup includes a cubical acrylic cell with aluminum sidewalls, 2 Thermoelectric units, thermocouples, and thermistors. Rheological characterization of carbopol gels was performed, and yield stress was calculated by fitting the data using the Herschel Bulkley equation. PIV (Particle Image velocimetry) technique was used for flow characterization. Thermochromic liquid crystals (TLC) were used to visualize the temperature isotherms in the flow field. Our experimental observations suggested an immediate flow onset with extremely slow sub yield motions. The benchmark motionless experiments were compared with steady flow experiments to reveal the immediate flow onset dynamics. The flow development curves showed rapid flow acceleration until it reaches a maximum before decelerating to steady-state. The experiments with no steady flow developments were compared with benchmark motionless experiments, supporting the presence of subyield motions in yield stress fluids. The kinetic energy decayed exponentially to rest from the point when the supplied power turned off during experiments. ii

Smart Surveillance System for Anomaly Recognition

Situation awareness is the key to security. Surveillance systems are installed in all places where security is very important. Manually observing all the surveillance footage captured is a monotonous and time consuming task. Security can be defined in different terms in different conditions like violence detection, theft identification, detecting harmful activities etc. In crowded public places the term security covers almost all type of unusual events. To eliminate the tedious manual surveillance we have developed a smart surveillance which will detect an anomaly and alert the user and authority without any human interference. It is a very critical issue in a smart surveillance system to instantly detect an anomalous behaviour in video surveillance system. In this project, a unified framework based on deep neural network framework is proposed to detect anomalous activities. This neural network framework consists of (a) an object detection module, (b) an object discriminator and tracking module, (c) an anomalous activity detection module based on recurrent neural network. The system is a web application where user can apply for three different security services namely motion detection, fall detection and anomaly detection which is applicable for monitoring different environment like homes, roads, offices, schools, shops, etc. On detection of anomalous activity the system will notify the user and responsible authority regarding the anomaly through mail with an anomaly detected frame attachment

A STUDY ON M-BANKING OFFERED BY BANKS AGAINST MOBILE OPERATORS IN INDIA

<p>Mobile banking is a system that allows customers of a financial institution to conduct a number of financial transactions through a mobile device such as a mobile phone or personal digital assistant. Mobile Banking allows you to bank anytime anywhere through ones mobile phone. One can access the banking information and make transactions on Savings Account, Demat Accounts, Loan Accounts and Credit Cards at absolutely no cost. Mobile banking is on the cusp of transformation from a niche service for the technologically elite to a mass-market service demanded by all customer segments.</p

Retroperitoneal fibrosis-clinical presentation and outcome analysis from urological perspective

Purpose: To study clinical presentation, laboratory results, imaging findings and treatment options and outcomes of retroperito-neal fibrosis (RPF). To determine whether it follows the same natural course and response to treatment in the Asian population as in the Western world.Materials and Methods: Medical records of patients diagnosed with RPF on imaging and histopathology between February 2010 and April 2016 were reviewed.Results: Of the 21 patients analyzed, mean age at presentation was 50.81 years. The male to female ratio was 0.9:1. Pain was most common presenting complaint (95.23% cases), almost 85% cases were idiopathic and rests were postradiation induced. The me-dian creatinine level was 1.8 mg/dL. The mean erythrocyte sedimentation rate (ESR) was 53.2 mm/h. Hydronephrosis was present in all patients and 47.6% had atrophic kidneys. Diffuse retroperitoneal mass was present in 61.1%. Ureterolysis with lateralization, omental wrapping or gonadal pedicle wrap was done in 17 cases. Two patients underwent uretero-ureterostomy. One patient un-derwent ileal replacement of ureter, and one ileal conduit. Eighteen patients received concurrent medical treatment, 11 were given tamoxifen, 2 steroids (Prednisolone), and five were given both. Of the 20 patients with follow-up, 70% had complete symptomatic relief; ESR improvement was seen in 77.8%. Follow-up ultrasound showed resolved and decreased hydronephrosis in 20% and 55% respectively. One patient had treatment failure and 17.65% had disease recurrence.Conclusions: RPF is a rare disease with varied presentation and outcomes. The male to female ratio may be equal in Asians and smoking could be lesser contributing factor. More Asian cohort studies are required to support same

EffResUNet: Encoder Decoder Architecture for Cloud-Type Segmentation

Clouds play a vital role in Earth&rsquo;s water cycle and the energy balance of the climate system; understanding them and their composition is crucial in comprehending the Earth&ndash;atmosphere system. The dataset &ldquo;Understanding Clouds from Satellite Images&rdquo; contains cloud pattern images downloaded from NASA Worldview, captured by the satellites divided into four classes, labeled Fish, Flower, Gravel, and Sugar. Semantic segmentation, also known as semantic labeling, is a fundamental yet complex problem in remote sensing image interpretation of assigning pixel-by-pixel semantic class labels to a given picture. In this study, we propose a novel approach for the semantic segmentation of cloud patterns. We began our study with a simple convolutional neural network-based model. We worked our way up to a complex model consisting of a U-shaped encoder-decoder network, residual blocks, and an attention mechanism for efficient and accurate semantic segmentation. Being an architecture of the first of its kind, the model achieved an IoU score of 0.4239 and a Dice coefficient of 0.5557, both of which are improvements over the previous research conducted in this field

Duration of post-operative hypocortisolism predicts sustained remission after pituitary surgery for Cushing’s disease

Purpose: Transsphenoidal surgery (TSS) is the primary treatment modality for Cushing’s disease (CD). However, the predictors of post-operative remission and recurrence remain debatable. Thus, we studied the post-operative remission and long-term recurrence rates, as well as their respective predictive factors. Methods: A retrospective analysis of case records of 230 CD patients who underwent primary microscopic TSS at our tertiary care referral centre between 1987 and 2015 was undertaken. Demographic features, pre- and post-operative hormonal values, MRI findings, histopathological features and follow-up data were recorded. Remission and recurrence rates as well as their respective predictive factors were studied. Results: Overall, the post-operative remission rate was 65.6% (early remission 46%; delayed remission 19.6%), while the recurrence rate was 41% at mean follow-up of 74 ± 61.1 months (12–270 months). Significantly higher early remission rates were observed in patients with microadenoma vs macroadenoma (51.7% vs 30.6%, P = 0.005) and those with unequivocal vs equivocal MRI for microadenoma (55.8% vs 38.5%, P = 0.007). Patients with invasive macroadenoma had poorer (4.5% vs 45%, P = 0.001) remission rates. Recurrence rates were higher in patients with delayed remission than those with early remission (61.5% vs 30.8%, P = 0.001). Duration of post-operative hypocortisolemia ≥13 months predicted sustained remission with 100% specificity and 46.4% sensitivity. Recurrence could be detected significantly earlier (27.7 vs 69.2 months, P < 0.001) in patients with available serial follow-up biochemistry as compared to those with infrequent follow-up after remission. Conclusion: In our study, remission and recurrence rates were similar to that of reported literature, but proportion of delayed remission was relatively higher. Negative/equivocal MRI findings and presence of macroadenoma, especially those with cavernous sinus invasion were predictors of poor remission rates. In addition to early remission, longer duration of post-operative hypocortisolism is an important predictor of sustained remission. Regular biochemical surveillance may help in identifying recurrence early