Automated Heterogeneous Low-Bit Quantization of Multi-Model Deep Learning Inference Pipeline

Multiple Deep Neural Networks (DNNs) integrated into single Deep Learning (DL) inference pipelines e.g. Multi-Task Learning (MTL) or Ensemble Learning (EL), etc., albeit very accurate, pose challenges for edge deployment. In these systems, models vary in their quantization tolerance and resource demands, requiring meticulous tuning for accuracy-latency balance. This paper introduces an automated heterogeneous quantization approach for DL inference pipelines with multiple DNNs

Is Gene Therapy Really Fruitful for Osteoarthritis?

Letter to Editor by Jayeeta Chowdhury, Dattatreya Mukherjee, Debraj Mukhopadhya

Effect of International Federation of Gynecology and Obstetrics- the Federation of Obstetric and Gynecological Societies of India Postpartum Intra Uterine Contraceptive Device initiative, India on postpartum contraceptive choices- last year and post-project one-year review in a rural medical college

Background: The FIGO-FOGSI launched an initiative in 2015 to expand the use of PPIUCD in six centers in phase 1, including our institution. This study aimed at the evaluating the effect of this program on the postpartum contraceptive choices during the last year of the project and one year thereafter.Methods: This was a clinical study conducted in the Department of Obstetrics and Gynecology, College of Medicine and J. N. M. Hospital, Kalyani, West Bengal, India from 1 January 2018 to 31 December 2019. All antenatal women were counseled about the various methods available for postpartum contraception. Data was collected on a monthly basis and results were analyzed.Results: There was a marked reduction of the acceptance rate of PPIUCD after the withdrawal of the program, with mild variation of the user percentage of most other methods.Conclusions: Further initiation and continuation of this FIGO-FOGSI project may definitely improve the scenario of acceptance of postpartum family-planning methods in this institution. However, in the existing situation, the capacity of available human resources should be built towards achieving this, to sustain the same impact as while on the FOGSI-FIGO project

Comparison of Maternal and Foetal Outcome between Normal and Abnormal Amniotic Fluid Index in the Third Trimester of Pregnancy - A Longitudinal Analytical Study in A Tertiary Level Medical College of Suburban West Bengal, India

Background: Amniotic fluid (AF) is the protective liquid present in the amniotic sac of a gravid uterus. Amniotic fluid has nutritive, protective and diagnostic functions. Amniotic Fluid Index (AFI) is most popular and reliable method for quantifying amniotic fluid, till date. AFI is one of the major parameters of foetal biophysical profile (BPP) that can predict perinatal and maternal outcomes. Periodical scanning of foetus is utmost essential during antenatal visits, especially in high-risk pregnancies, but there is no definite standard protocol regarding its frequency.Methods: This study was conducted in the department of Obstetrics & Gynaecology, College of Medicine & JNM Hospital, Kalyani, Nadia, India. This longitudinal analytical study included 356 patients, among whom 151 (42.4%) were in oligohydramnios group, 174 (48.9%) in normal group and 31 (8.7%) in polyhydramnios group.Results: The data revealed oligohydramnios was strongly associated with caesarean section (p = 0.0010). In oligohydramnios group, IUGR was found in 37 (24.5%) patients (p = 0.0297). Meconium-stained liquor was almost similar in all three categories i.e. 15 (10.0%) in oligohydramnios group, 18 (10.3%) in normal group and 5 (16.1%) in polyhydramnios group, respectively. There was higher SNCU admission among babies delivered by mothers with oligohydramnios (p = 0.0369). There was no statistically significant difference in 1 and 5 minutes APGAR scores among normal and abnormal AFI groups. Conclusions: It was inferred that LSCS, IUGR baby and SNCU admission rates were more in oligohydramnios group compared to other categories. The perinatal death was 3.3% with oligohydramnios compared to 1.7% with normal liqour. The results from this study emphasize on the importance of AFI among the various means of antepartum surveillance and predictors of foetal outcome. Keywords: Oligohydramnios, Polyhydramnios, Foetal Outcome, IUGR, AF

A Cross-sectional Observational Study of the Etio-pathology, Socioeconomic Distribution and Clinical Pictures of Ectopic Pregnancy in a Tertiary Medical College and Hospital in Bankura, West Bengal, India

Background: Ectopic pregnancy or abnormal implantation of embryo is one of the foremost causes of mortality and morbidity in women of reproductive age worldwide. Its serious consequences can be effectively averted by early diagnosis and timely intervention. This study aimed at determining the incidence, predisposing socio-economic factors and etiolo-pathology, and assessment of various clinical manifestations and treatment modalities of ectopic pregnancy. Methods: This observational cross- sectional survey was conducted in the department of obstetrics and gynaecology BSMCH, Bankura from 1.4.2015 to 31.3.2016. It included 100 patients with admitted with clinically or sonologically confirmed ectopic pregnancy after informed consent, data was collected and analysed thereafter. Results: It was observed that 68% of the cases belonged to 21-30 years of age, 80% with low socio-economic status, 69 % comprised of multigravidas. The typical risk factors detected were history of PID, abortion and previous tubal surgery. The most consistent clinical feature was pain in lower abdomen (98%) followed by amenorrhoea (90%) and vaginal bleeding (82%). 97% of the patients presented with pallor and 23% with shock. In 73% patients cervical motion tenderness could be elicited clinically and adnexal mass in USG was found in 95 %. Urine pregnancy test was positive in all patients and right side was the commonest side of involvement (53%). All the patients underwent surgical intervention. Conclusion: Prompt detection from history, clinical features, USG and appropriate and well-timed management are of utmost importance to enhance better maternal survival and conservation of reproductive capacity. Keywords: Ectopic pregnancy, UPT, PID, Tubal surgery, Adnexal mass, POD fluid, Ampull

Isolation of bacteria from diabetic foot ulcers with special reference to anaerobe isolation by simple two-step combustion technique in candle jar

Background & objectives: Although polymicrobial infections involving both aerobic and anaerobic bacteria are very common in diabetic foot ulcers, in many centres of developing countries, anaerobes are rarely isolated due to technical difficulties. This can be overcome by using a new simple, innovative technique of a combination of candle combustion and use of acidified copper-coated steel wool, as reported here. Methods: In-house developed method was used in a prospective clinico-microbiological study for anaerobes from randomly selected 43 patients with diabetic foot ulcers along with conventional method of anaerobic culture in GasPak system and aerobic culture by standard laboratory procedures. For primary isolation of anaerobes, Brucella blood agar supplemented with hemin (5 μg/ml) and menadione (1 μg/ml) was used. Antibiotic sensitivity tests were performed by the standard disc diffusion method for aerobes and E-test method for anaerobes. Results: All the 43 samples were culture positive, of which aerobic Gram-negative bacteria (GNB) predominated, followed by Staphylococcus aureus, Enterococcus and diphtheroids. Anaerobes isolated from 21 samples were Peptostreptococcus, Bacteroides, Porphyromonas, Veillonella spp. and Clostridium perfringens by both GasPak and in-house developed and modified candle jar techniques. Imipenem and metronidazole were most sensitive while clindamycin, penicillin and cefoxitin were least sensitive drugs for anaerobes. Aerobic GNB were found to be multidrug resistant, especially to penicillin and cephalosporins. The most sensitive drug was piperacillin-tazobactam. Interpretation & conclusions: For isolation of anaerobes from clinical specimens such as diabetic foot ulcers, modified candle jar technique was found to be as reliable as GasPak system. This modified technique needs to be tested for many other clinical materials which are not yet evaluated

Biofilm colonization in chronic treatment refractory infections presenting with discharging sinuses: A study in a tertiary care hospital of Eastern India

INTRODUCTION: Treatment refractory chronic recurrent infections mean those chronic infections which recur by same causal agents with similar drug responsiveness after apparent relief following full course of recommended antimicrobial management. MATERIALS AND METHODS: Fifty different samples were collected from patients with chronic surgical site infections, laparoscopic port site infections, anal fistula, mesh hernioplasty, chronic dacryocystitis, chronic osteomyelitis, and chronic burn wounds. Samples were processed for culture, identification, antibiotic sensitivity testing using standard microbiological techniques. Biofilm (BF) forming capacity for aerobic organisms were tested by tissue culture plate method. Those for anaerobes and atypical mycobacteria were studied by a novel method using atomic force microscopy (AFM). In vivo BF colonization in lacrimal mucosae of chronic dacryocystitis, patients were studied from histopathological sections by Gram staining, H and E, and fluorescent in situ hybridization (FISH). RESULTS: Out of fifty different samples, sixty-three isolates were obtained in pure culture as follows: Staphylococcus aureus (25.39%), Escherichia coli (14.28%), Klebsiella pneumonia (14.28%), Mycobacterium abscessus (12.69%), Citrobacter spp. (9.52%), Bacteroides fragilis (6.3%), Pseudomonas aeruginosa (4.7%), Proteus spp. (4.7%), Staphylococcus epidermidis (3.1%), Enterobacter spp. (1.5%), Morganella morganii (1.5%), and Peptostreptococcus spp. (1.5%). Among the isolates, 74% were found to be BF producers in the following frequency: P. aeruginosa 100%, S. epidermidis 100%, B. fragilis 100%, Klebsiella spp. 88.88%, S. aureus 81.25%, M. abscessus 75%, Citrobacter spp. 83.33%, Proteus spp. 66.66%, E. coli spp. 33.33%, and Enterobacter spp. 0%. CONCLUSION: AFM has been proven to be a useful method for detection of in vitro grown BF including those for anaerobes and atypical Mycobacteria. In vivo BF detection becomes possible by FISH. S. aureus was the most common isolate. Among the aerobic isolates, P. aeruginosa and S. epidermidis were found to be the most common BF producers. Atypical mycobacteria were also found to be BF producers. Diagnosis of BF s in chronic infections significantly changes the management strategy as these infections can no longer be dealt simply with antibiotics alone but require mechanical removal of the foci along with antibiotic coverage for complete cure

Influence of Exteriorised versus Intra-abdominal Uterine Repair Caesarean Delivery under Spinal Anaesthesia on Intraoperative and Postoperative Complications

Introduction: Caesarean techniques have evolved over time to increase their safety. Intra-abdominal closure of uterine incision seems more physiological. Exteriorisation makes repair easier with a better exposure. But this causes tension to the supporting structures attached to uterus and stretching of vasculature with the risk of intraoperative haematoma or aneurysm later on. Aim: To compare the in-situ repair Group and exteriorised repair group caesarean delivery under spinal anaesthesia regarding occurrence of intraoperative and postoperative complications of interest. Materials and Methods: A prospective interventional study was conducted in the Department of Obstetrics and Gynaecology at College of Medicine and Jawaharlal Nehru Memorial Hospital, West Bengal, India, over a period of two years from April 2014 to March 2016. Four hundred women undergoing caesarean section who fulfilled the inclusion and exclusion criteria were recruited in the study. They were randomly allocated into two study groups as per a computer generated random allocation table. In Group A (n=200) uterine incision was closed after uterus was exteriorised and in Group B (n=200) uterine incision was closed keeping it inside the abdomen. Intraoperative and postoperative parameters of interest such as nausea-vomiting, drop in pulse rate, incision closure time, drop in haemoglobin, blood transfusion rate, return of bowel sounds, febrile morbidity, surgical site infection, hospital stay etc., were noted and compared between the two groups. Numerical variables were expressed as mean and standard deviation and analysed using independent sample t-test. For qualitative variables frequency and percentage were calculated and analysed using Chi-square. Collected data was transferred and analysed using Statistical Package for Social Sciences (SPSS) version25. The p-value ≤0.05 was considered significant. Results: The demographic profiles like age, parity, gestational age etc. of both the groups were similar. There was a significant difference in uterine closure time (9±2.5 minutes in in-situ repair group vs. 10±2 minutes in exteriorisation and repair groups, respectively (p0.05). Mean drop of haemoglobin was more in the intraabdominal closure group (1.5±1.3 gm/dL) as compared to the group of closure after exteriorisation (1.4±1.3 gm/dL) though the difference was not significant statistically (p=0.44). Postpartum blood transfusion rate was 6.5% in exteriorised repair group and 9% in in-situ repair group (p=0.35). Postoperative morbidity like fever, surgical site infection, length of hospital stay was similar in both the groups. Conclusion: Choice of uterine closure method is operator dependent and either method of uterine closure is acceptable when practiced and skill is gained. Exteriorisation is advantageous when excessive bleeding is encountered. Though time taken for closure in in-situ group is statistically more it is similar practically. Bowel sounds returned earlier postoperatively in in-situ group

Tocotrienols confer resistance to ischemia in hypercholesterolemic hearts: insight with genomics

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