New challenges and opportunities for governance in India: a session with Ajit Seth

On 13 July 2015, former Cabinet Secretary Ajit Seth spoke on the topic of ‘Governance in India- new challenges and opportunities’. The event was chaired by Rahul Roy-Chaudhury, Senior Fellow for South Asia at the IISS. Ankita Mukhopadhyay and Arushi Kumar report on the event

The Scalar Chemical Potential in Cosmological Collider Physics

Non-analyticity in co-moving momenta within the non-Gaussian bispectrum is a distinctive sign of on-shell particle production during inflation, presenting a unique opportunity for the "direct detection" of particles with masses as large as the inflationary Hubble scale ($H$). However, the strength of such non-analyticity ordinarily drops exponentially by a Boltzmann-like factor as masses exceed $H$. In this paper, we study an exception provided by a dimension-5 derivative coupling of the inflaton to heavy-particle currents, applying it specifically to the case of two real scalars. The operator has a "chemical potential" form, which harnesses the large kinetic energy scale of the inflaton, $\dot{\phi}_{0}^{1/2} \approx 60H$, to act as an efficient source of scalar particle production. Derivative couplings of inflaton ensure radiative stability of the slow-roll potential, which in turn maintains (approximate) scale-invariance of the inflationary correlations. We show that a signal not suffering Boltzmann suppression can be obtained in the bispectrum with strength $f_{\mathrm{NL}} \sim \mathcal{O}(0.01-10)$ for an extended range of scalar masses, $M \lesssim \dot{\phi}_{0}^{1/2}$, potentially as high as $10^{15}$ GeV, within the sensitivity of upcoming LSS and more futuristic 21-cm experiments. The mechanism does not invoke any particular fine-tuning of parameters or breakdown of perturbation-theoretic control. The leading contribution appears at tree-level, which makes the calculation analytically tractable and removes the loop-suppression as compared to earlier chemical potential studies of non-zero spins. The steady particle production allows us to infer the effective mass of the heavy particles and the chemical potential from the variation in bispectrum oscillations as a function of co-moving momenta. Our analysis sets the stage for generalization to heavy bosons with non-zero spin.Comment: 38 pages, 6 figures, v2: text added for clarification, figs. 2 and 3 changed to better represent the conclusions of our analysis, matches publication in JHE

EVALUATION OF DIAGNOSTIC PERFORMANCE OF USG GUIDED FNAC OF THYROID SWELLINGS: A PROSPECTIVE STUDY

  Background: USG-guided FNAC is a good preoperative screening technique when compared to FNAC and USG done separately for the diagnosis of a thyroid lesion. However, there is little evidence in the literature that emphasizes the importance of USG-guided FNAC as the first step in the investigation of thyroid lesions. Aim: Our study aims to see the sensitivity and specificity, adequacy, and diagnostic accuracy of USG-guided FNAC taking histopathology as a gold standard. Methods: This Hospital-based prospective observational study was carried out on patients who attended the OPD and/or IPD and underwent surgery in the Department of Otorhinolaryngology. Results: The sensitivity, specificity, and diagnostic accuracy of ultrasound-guided FNAC for thyroid lesions were 58.82%, 98.18%, and 88.89% respectively taking Bethesda categories 1 to 3 as benign and categories 4 to 6 as malignant. The positive likelihood ratio and negative likelihood ratio are 32.32 and 0.42 respectively. Positive predictive value and negative predictive value were 90.91% and 88.52%. The diagnostic accuracy of USG-guided FNAC for thyroid lesions in the present study is 88.89% and adequacy is 93.05%. Conclusion: Further study of a larger number of cases is desirable. US-FNAC is an expensive procedure as compared to palpable FNAC. Recommendation: We recommend the application of USG guide FNAC as the first step in the investigation of thyroid lesions along with a detailed interdepartmental correlation to make the diagnosis before surgery

Fungal Keratitis: Recent Advances in Diagnosis and Treatment

Fungal keratitis or fungal corneal ulcer is potentially blinding infection of cornea, is considered one of the major cause of ocular morbidity, particularly in developing countries. It is a common cause of infectious keratitis, especially in tropical and subtropical countries. Fungal keratitis is notoriously challenging to diagnosis and difficult to treat. Delay in diagnosis may result in irreversible sequelae of corneal fungal infections, which can be preventable. Fungal keratitis often have worse treatment outcomes than bacterial keratitis, Delayed diagnosis and scarcity of effective antifungal agents are the major factors for poor outcome. In the recent years considerable advancement in the diagnosis and treatment has been occurred. In this chapter, we will discuss the recent advances in diagnosis and management of fungal keratitis with a brief discussion on pathogenesis and future therapeutic models

Clinical Study of Granulomatous Mastitis- A Rare Entity

Introduction: Granulomatous Mastitis (GM), a rare and benign disorder, has two forms- Idiopathic Granulomatous Mastitis (IGM) and Specific Granulomatous Mastitis (SGM). IGM is caused without any particular discernable and attributable cause while SGM is caused secondary to tuberculosis, other infectious causes like syphilis, fungal, parasitic infections, corynebacterial; Wegener’s granulomatosis, sarcoidosis, reaction to a foreign body, vasculitis etc. Aim: To identify clinical presentations and to formulate a treatment protocol for patients with granulomatous mastitis. Materials and Methods: This study was a prospective descriptive observational study conducted at Government Wenlock Hospital and Kasturba Medical College Hospital, Attavar, Mangalore, Karnataka, India, from October 2015 to March 2018 on 32 patients admitted to the Department of General Surgery in the study centre, who had a histopathological diagnosis of granulomatous mastitis. All the relevant data of the patients: demographic data and clinical findings, any medical co-morbidities was collected by telephonic interview and case sheets, operative notes were studied thoroughly and the patients were followed up for regression of their signs and symptoms at one month, two months and six months of their hospital visits. Results of microbial cultures or stains, imaging (mammography, ultrasound if done) and biopsy results were collected. All the collected data was analysed by Chi-square test and Fisher’s exact test and the p-values <0.05 was considered significant. Results: Total of 32 female patients (13 patients were in the age group of 31-40 years) were analysed in the present study. A total of 27 (84.4%) had last child birth <5 years back. The patients who presented with a left laterality lesion were 25 (78%) with statistically significant difference. A total of 18 (56%) of the patients had a lesion in the upper outer while 11 (34%) in lower outer quadrant of breast. A total of 29 (90.6 %) of patients, the disease was extending upto the areola region. All the patients had a firm lump and out of these, 25 (78.1%) of the patient presented with a painful lump. Inflammatory skin changes were seen in 20 (62%) of the patients. Retraction of nipple was presented in 26 (81%) of the patients. A total of 19 (59.4%) patients underwent an excision biopsy of the lump and 22 (69%) patients were initiated with Antitubercular Therapy (ATT). Conclusion: Granulomatous mastitis is a highly unpredictable disease with frequent flares and periods of inactivity which may falsely be considered as successful treatment. Due to rare nature of this disease, randomisation of all treatment modalities are availabl

Incidental Intraoperative Diagnosis of Term Conjoined Twins: A Case Series

Conjoined twins (Siamese twins) represent the rarest form of twin pregnancy. Reported here are two rare cases of conjoined term twins presented to the department of Obstetrics and Gynaecology within 3 months. The first case, 32 years of gravida 6 parity 5 referred from periphery after full trial of labour following multi-organ dysfunction and term intrauterine dead twins. Intraoperatively it was dead conjoined thoraco-omphalopagus females. The patient died after 3 days following multiorgan dysfunction syndrome and disseminated intravascular coagulation. The second case, 22 years gravida 2 parity 1 also referred from periphery in second stage of labour with diagnosis of 39 weeks intrauterine dead twins with obstructed labour, delivered by caesarean with intraoperative conjoined dead females of thoracophagus type. Twins are high-risk pregnancy. This rare diagnosis with complications could have been prevented by regular antenatal checkups, ultrasonography performed by radiologists and early referral antenatally in labour along with multidisciplinary approach

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals &lt;1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

A rare cause of recurrent extubation failure in an infant

Despite multiple chest radiographs showing elevated hemidiaphragm, untrained eyes failed to notice it. “The eyes do not see what the mind does not know” is a saying well demonstrated by our patient who had multiple extubation failures secondary to recurrent lung collapse, that too on the same side. On reviewing all radiographs simultaneously, we suspected left side diaphragmatic palsy, which was later confirmed on ultrasonography. In spite of clear demonstration of elevated hemidiaphragm on multiple serial X-rays, diagnosis of diaphragmatic palsy was missed leading to delay in diagnosis, unnecessary antibiotics, and prolonged ventilation. There was a spontaneous recovery of the function of the affected side of the diaphragm, and he could be successfully extubated and subsequently discharged