Cytomorphological evaluation of squamous cell abnormalities observed on cervical smears in government medical college, Jabalpur, India: a five year study

Background: Cervical cancer is the fourth most common cancer affecting women worldwide, the most common cancer in women in several less developed countries, and now the second most common cancer in India. Cervical cytology by papanicolaou (PAP) smear test is an effective tool for detecting abnormal cytology in early stages, thus allowing early detection and treatment. The PAP smear is extremely important for detecting premalignant and malignant conditions of cervix. The study was conducted to determine; (1) Cytomorphologic incidence of various lesions of uterine cervix; (2) Categorization of detected lesions according to Bethesda system; (3) Determination of epithelial abnormalities by cervical cytology.Methods: The settings and design of this study is a hospital based prospective study from a tertiary care centre in Central India. A total of 5813 conventional pap smear tests collected from January 2010 and December 2014 were analyzed. All patients attending outpatient department of obstetrics and gynecology for complaints of abnormal cervical discharge, dyspareunia, inter-menstrual bleeding, post-coital bleeding and lower abdominal pain were included. Various cervical pap screening camps were also done during this period. Smears were fixed and stained with hematoxylin & eosin (H&E) and papanicolaou stain were done.Results: The overall frequency of normal, inadequate, inflammatory, and abnormal smears was 11.86%, 5.73%, 74.98% and 13.2% respectively. Atypical squamous cell carcinoma of undermined significance (ASCUS) was seen in 3.61%, squamous intraepithelial lesion (SIL) was seen in 5.36%, low grade squamous intraepithelial lesion (LSIL) was seen in 2.59% while high grade squamous intraepithelial lesion (HSIL) was seen in 2.77%. Invasive carcinoma was seen in 3.69%. The premalignant epithelial abnormalities like ASCUS, LSIL and HSIL were found to be highest in the age group of 31-50 years in our study, which correlated well with other similar studies.Conclusions: Hence we should advocate regular cervical cytology (PAP) smear study, which can help to treat cervix lesions early before the progress into cervical cancer. Early detection is the only key to saving a woman’s life as the later the abnormalities are discovered; mortality, morbidity and treatment cost all increase.

Clinical profile and short-term outcome of perinatally asphyxiated term neonates in a tertiary hospital in Southern Kerala

Introduction: In India, in spite of improvement in perinatal-neonatal care, perinatal asphyxia accounts for 23% of the neonatal deaths. Objective: The objective of the study was to study the clinical profile and short-term outcome of perinatally asphyxiated term neonates. Materials and Methods: This prospective study conducted at a tertiary care teaching hospital in Southern Kerala from June 2011 to June 2015. 120 term asphyxiated neonates fulfilling the inclusion criteria admitted in the NICU were followed up till death or survival. Results: 49.2% babies were inborn and 50.8% babies were outborn. Of the total, 53 (44.2%) were delivered vaginally, 54 (45%) by cesarean section, and 13 (10.8%) by instrumental delivery. Antenatal complications were seen in 58 (48.3%) and intrapartum complications in 93 (77.5%). Hypoxic ischemic encephalopathy (HIE) was diagnosed in 78.3%, with HIE 1 in 19.3%, HIE 2 in 27.5%, and HIE 3 in 31.6%. The mortality was 31 (25.8%) and it was more in out born babies compared to inborn. Factors associated with development of severe HIE (HIE 3) were male gender (p=0.0057), need for endotracheal intubation (p=0.0114), instrumental delivery and pH <7.2 (p=0.0013). Factors associated with mortality were instrumental delivery (p=0.0032), place of birth (p=0.0012), pH ≤ 7 (p=0.0006), HIE 3 (p<0.0001), and 5 min Apgar ≤3 (p=0.0372). Conclusion: HIE was seen in 78.3% perinatally asphyxiated babies with HIE 3 contributing to 31.6%. The mortality rate in HIE 3 was 81.6% which was significantly associated with place of birth, instrumental delivery, pH <7, and 5 min Apgar ≤3

Study of antimicrobial resistance profile and efflux mediated drug resistance in clinical isolates of Pseudomonas aeruginosa detected by ethidium bromide-agar Cartwheel method

Background: Development of antibiotic resistance or multidrug resistance (MDR) is one of the major causes of treatment failure of bacterial infections and has rapidly evolved into a threat to global health care. Bacterial efflux pumps play a significant role in the development of antibiotic resistance. This study evaluates the prevalence of efflux pump- mediated drug resistance in clinical isolates of P. aeruginosa.Methods: Clinical isolates (n=100) of P. aeruginosa were collected from various clinical laboratories in Kerala and their efflux mediated drug resistance detected by the ethidium bromide (EB) agar Cartwheel method.Results: The EB agar cartwheel method of screening revealed efflux activity in 17% (n=17) strains. The efflux activity was revealed at a minimum concentration of EB at 0 mg/l. P. aeruginosa strains showed the highest activity up to a concentration of 2.5 mg/l.Conclusions: This study discusses the emergence of efflux pump- mediated drug resistance in P. aeruginosa from various clinical samples. Our results showed that 17% drug resistance in P. aeruginosa is attributable to efflux related mechanisms.

Artificial Intelligence/Operations Research Workshop 2 Report Out

This workshop Report Out focuses on the foundational elements of trustworthy AI and OR technology, and how to ensure all AI and OR systems implement these elements in their system designs. Four sessions on various topics within Trustworthy AI were held, these being Fairness, Explainable AI/Causality, Robustness/Privacy, and Human Alignment and Human-Computer Interaction. Following discussions of each of these topics, workshop participants also brainstormed challenge problems which require the collaboration of AI and OR researchers and will result in the integration of basic techniques from both fields to eventually benefit societal needs

Widening Access to Applied Machine Learning with TinyML

Broadening access to both computational and educational resources is critical to diffusing machine-learning (ML) innovation. However, today, most ML resources and experts are siloed in a few countries and organizations. In this paper, we describe our pedagogical approach to increasing access to applied ML through a massive open online course (MOOC) on Tiny Machine Learning (TinyML). We suggest that TinyML, ML on resource-constrained embedded devices, is an attractive means to widen access because TinyML both leverages low-cost and globally accessible hardware, and encourages the development of complete, self-contained applications, from data collection to deployment. To this end, a collaboration between academia (Harvard University) and industry (Google) produced a four-part MOOC that provides application-oriented instruction on how to develop solutions using TinyML. The series is openly available on the edX MOOC platform, has no prerequisites beyond basic programming, and is designed for learners from a global variety of backgrounds. It introduces pupils to real-world applications, ML algorithms, data-set engineering, and the ethical considerations of these technologies via hands-on programming and deployment of TinyML applications in both the cloud and their own microcontrollers. To facilitate continued learning, community building, and collaboration beyond the courses, we launched a standalone website, a forum, a chat, and an optional course-project competition. We also released the course materials publicly, hoping they will inspire the next generation of ML practitioners and educators and further broaden access to cutting-edge ML technologies.Comment: Understanding the underpinnings of the TinyML edX course series: https://www.edx.org/professional-certificate/harvardx-tiny-machine-learnin

Widening Access to Applied Machine Learning With TinyML

Broadening access to both computational and educational resources is crit- ical to diffusing machine learning (ML) innovation. However, today, most ML resources and experts are siloed in a few countries and organizations. In this article, we describe our pedagogical approach to increasing access to applied ML through a massive open online course (MOOC) on Tiny Machine Learning (TinyML). We suggest that TinyML, applied ML on resource-constrained embedded devices, is an attractive means to widen access because TinyML leverages low-cost and globally accessible hardware and encourages the development of complete, self-contained applications, from data collection to deployment. To this end, a collaboration between academia and industry produced a four part MOOC that provides application-oriented instruction on how to develop solutions using TinyML. The series is openly available on the edX MOOC platform, has no prerequisites beyond basic programming, and is designed for global learners from a variety of backgrounds. It introduces real-world applications, ML algorithms, data-set engineering, and the ethi- cal considerations of these technologies through hands-on programming and deployment of TinyML applications in both the cloud and on their own microcontrollers. To facili- tate continued learning, community building, and collaboration beyond the courses, we launched a standalone website, a forum, a chat, and an optional course-project com- petition. We also open-sourced the course materials, hoping they will inspire the next generation of ML practitioners and educators and further broaden access to cutting-edge ML technologies

Viscocanalostomy for Refractory Glaucoma Secondary to Intravitreal Triamcinolone Acetonide Injection

Left side of facade facing Prins Hendrikstraat; A "Stadswinkel" literally translates into "city shop" in the sense it is the municipal service counter for fee-based services like passports and driver's licenses. Date and architect undetermined

Genetic And Environmental Factors In Disorders Of Sexual Differentiation- True Hermaphrodite

The purpose of the study is to find out the prevalence of disorders of sexual development in our population, the common anomaly prevalent and the genetic and environmental factors in the causation of disorders. Very few studies with the exception of a few case reports are present to document the incidence of True Hermaphroditism in the spectrum of genetic anomalies of the external Genitalia. This study tries to document this in our society. In our study of 300 cases of Ambiguous Genitalia over a period of 3 years there was only 1 case of True Hermaphroditism. A phenotypically male individual with unilateral testis (left side) and ultrasound showing gonad on the right groin which was an ova-testis with mullerian remnant through laparotomy. This shows a 0.333% of True Hermaphroditism out of the 300 cases of Ambiguous Genitalia. Such studies would provide better ability to plan prenatal diagnostic methods and to plan genetic counseling and preventive methods in affected families