To Study the Etiopathogenesis, Clinical Presentation and Management of Patients with Colorectal Emergencies Presenting as Acute Abdomen

BACKGROUND: Malignancies are most leading cause of mortality in this era, colorectal malignancies are third common cause of death due to cancers, about 60% of patient have malignant growth causing lower GI obstruction (followed by volvulus 35%) and their high mortality rate atributed to late presentation. OBJECTIVE: In this article the commenest etiology, presentation and commonest procedure performed in emergency in our institution are compared with existing articles and previous study. STUDY DESIGN: Observational study a prospective and retrospective study. STUDY POPLATION: about 50 patients admitted in emergency department Rajiv Gandhi Govt. General Hospital are studied . STUDY DURATION: Datas of 8 months studied in six months April 2016 to September2016. MATERIALS AND METHODIOLOGY: Patients are subjected to detailed history taking and clinical examination. Data are collected through medical records in case of retrospective analysis. Patients presented with acute abdomen in emergency ward in general surgery department satisfying the inclusion and exclusion criteria are taken into study. Detailed history and clinical examination is done. Baseline investigations and preoperative imaging (x-ray, ultrasonogram, contrast CT) are done and pathology is localized to colorectal region. Findings during the emergency laparotomy is recorded. The disease region and performance status of the patient is noted. The etiopathogensis of the colorectal emergency leading on to acute abdomen is noted. The patients are followed up post operatively. The various parameters affecting recovery of the patient and the nature of disease and its severity and its outcome are studied. The appropriate procedure favoring to prognosis of the patient in emergencies is studied. The post operative morbidity and mortality of the patients undergoing the emergency procedure is recorded. The age group of patients, their clinical presentation and etiopathogenesis in different age group causing obstruction, perforation and peritonitis necessitating the need for emergency laparotomy are also studied. The decision regarding performing primary procedure in emergency as a life saving procedure is also analyzed. RESULTS: About 50 patients are studied with maximum number of patients were older age group presented with obstruction and cause is due to colonic growth and most commonly involved region is recto sigmoid region, the mortality is more in this segment of bowel. Despite of advanced mode of diagnosis andsurgical techniques the death rate is high due to change in biology and emerging mutations making disease very aggressive ,nutritionally improved patient got rapid recovery. Secondly sigmoid volvulus is competeing with colonic malignancies leads to second most common cause of morbidity and mortality in that region. CONCLUSION: Adequate preparation preoperatively with hydration, electrolytes and nutrition early appropriate surgical procedure will have reduced mortality in emergencies. Early presentation to hospital after getting symptoms of disease will avoid deaths among people

Speculation of Orthogonal FDM with Index Modulation for High End Signals for Real Time Signal Transmission

IN RECENT YEARS, multicarrier transmission has turned into an alluring method in numerous remote measures to take care of the expanding demand for high information rate correspondence frameworks. A standout amongst the most mainstream multicarrier procedures, orthogonal recurrence division multiplexing (OF-DM), has formed into a generally utilized plan for wideband computerized correspondence. The real preferred standpoint OF-DM over single-transporter plans is its capacity to adapt to recurrence particular blurring channel with just a single tap equalizer. Many endeavors to additionally enhance the traditional OF-DM framework have been made. Spatial Modulation a strategy initially executed in numerous information different yield (MI-MO) transmissions, is a standout amongst the most encouraging methods. In the Spatial Modulation plot, other than the abundancy/stage adjustments, the data may likewise be brought through the radio wire lists. By treating the subcarrier lists of an OF-DM framework as the recieving wire records in a MI-MO framework, Spatial Modulation has been effectively connected to OF-DM. In any case, the plan is by all accounts illogical in light of the fact that an immaculate nourish forward from the transmitter to the recipient should be accepted. Just in that way will the recipient know the mapping technique for the subcarrier record choosing bits. This sustain forward necessity from the transmitter to the beneficiary has later been expelled in [18], where an improved subcarrier record adjustment OF-DM (ESIM-OF-DM) was proposed. Tragically, to accomplish an indistinguishable phantom proficiency from that of established OF-DM, this plan needs to receive higher request tweaks.

Location Security - Where to Enforce?

Enforcing security in location based services is very crucial in the current mobile world. Past literature has examined both location and identity obfuscation techniques in order to optimally tradeoff security/privacy with utility − this primarily addresses the ‘how to enforce location security problem’; however, it does not address the ‘where to enforce location security problem’. This paper examines the ‘where’ problem and in particular, examines tradeoffs between enforcing location security at a device vs. enforcing location security at an edge location server. This paper also sketches an implementation of location security solutions at both the device and the edge location server and presents detailed experiments using real mobility and user profile data sets collected from various data sources (taxicabs, Smartphones). Our results show that while device-based solutions do not require trust in the edge location server, they either suffer from high false positive rate (about 25% probability of not meeting the desired security requirement) or low utility (about 600 meters higher error in obfuscated location data)

Reasoning with Streamed Uncertain Information from Unreliable Sources

Humans or intelligent software agents are increasingly faced with the challenge of making decisions based on large volumes of streaming information from diverse sources. Decision makers must process the observed information by inferring additional information, estimating its reliability, and orienting it for decision making. Processing streaming trust framework, when fact is getting created and inferred is a process in online mode and our paper works effciently in online mode. In online mode, someone initiates a query and gets an output based on the query. In this paper we have mainly shown that unstructured reports from unreliable and heterogeneous sources are processed to generate structured information in Controlled English. Uncertainty in the information is modelled using Subjective Logic that allows statistical inference over uncertain information. Trustworthiness of information is modelled and conflicts are resolved before fusion. This process is totally undertaken on streaming information resulting in new facts being inferred from incoming information which immediately goes through trust assessment framework and trust is propagated to the inferred fact. In this paper, we propose a comprehensive framework where unstructured reports are streamed from heterogeneous and potentially untrustworthy information sources. These reports are processed to extract valuable uncertain information, which is represented using Controlled Natural Language and Subjective Logic. Additional information is inferred using deduction and abduction operations over subjective opinions derived from the reports. Before fusing extracted and inferred opinions, the framework estimates trustworthiness of these opinions, detects conflicts between them, and resolve these conflicts by analysing evidence about the reliability of their sources. Lastly, we describe an implementation of the framework using International Technology Alliance (ITA) assets (Information Fabric Services and Controlled English Fact Store) and present an experimental evaluation that quantifies the efficiency with respect to accuracy and overhead of the proposed framework

The role of the written script in shaping mirror-image discrimination: Evidence from illiterate, Tamil literate, and Tamil-Latin-alphabet bi-literate adults

Learning a script with mirrored graphs (e.g., d ≠ b) requires overcoming the evolutionary-old perceptual tendency to process mirror images as equivalent. Thus, breaking mirror invariance offers an important tool for understanding cultural re-shaping of evolutionarily ancient cognitive mechanisms. Here we investigated the role of script (i.e., presence vs. absence of mirrored graphs: Latin alphabet vs. Tamil) by revisiting mirror-image processing by illiterate, Tamil monoliterate, and Tamil-Latin-alphabet bi-literate adults. Participants performed two same-different tasks (one orientation-based, another shape-based) on Latin-alphabet letters. Tamil monoliterate were significantly better than illiterate and showed good explicit mirror-image discrimination. However, only bi-literate adults fully broke mirror invariance: slower shape-based judgments for mirrored than identical pairs and reduced disadvantage in orientation-based over shape-based judgments of mirrored pairs. These findings suggest learning a script with mirrored graphs is the strongest force for breaking mirror invariance

Prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) infections among patients admitted in critical care units in a tertiary care hospital

Background: The emergence of Methicillin-resistant Staphylococcus aureus (MRSA) infections in hospital leads to significant morbidity and mortality. Hence the present study was undertaken to estimate the prevalence of MRSA in critical care units (CCUs) at our centre. The objective of this study was to find the prevalence of MRSA infections in CCUs, to determine their antibiotic profile. And to screen for MRSA in the environment of CCUs in order to find whether they act as a source of infection.Methods: The present cross-sectional study included 100 patients admitted to various CCUs in our hospital. The clinical specimens (urine, Sputum, pus, blood and CSF) were collected from the admitted patients along with environmental samples from these CCUs. Two samples were collected from each patient and subjected to culture and antibiotic susceptibility testing.Results: 168 samples from 100 patients were processed. Out of which five pus samples from five different patients admitted in surgical intensive care unit (SICU) were positive for MRSA infection showing 5% prevalence in CCUs. All MRSA strains were sensitive to vancomycin and teicoplanin. Out of 30 environmental swabs, 1 swab taken from paediatric intensive care unit (PICU) showed positivity for MRSA (3%).Conclusions: CCUs in our hospital have shown 5% prevalence of MRSA among the admitted patients. There was no correlation between environmental MRSA presence and infection in the samples from patient

Study to assess the prevalence of human leukocyte antigen-A*3101 allele among Indian epileptic patients and its influence on safety and efficacy of antiepileptic therapy

Background: The objective was to study the prevalence of human leukocyte antigen (HLA)-A*3101 allele among epileptic patients and to assess the safety and efficacy of antiepileptic therapy.Methods: 295 subjects were selected and divided into two groups, Group I had 192 epileptic patients and Group II had 103 normal healthy controls. After written informed consent, 30 ml of mouthwash sample was collected from each subject and DNA was extracted by standard salting-out technique and used for HLA-A*3101 genotyping by two-step nested allele-specific polymerase chain reaction amplification and agarose gel electrophoresis.Results: In Group I, 12 (6.25%) of the 192 patients were tested positive for HLA-A*3101 allele and all were taking carbamazepine (CBZ). Among them, 56 (30%) subjects had developed less severe adverse effects such as headache and giddiness, skin rashes and memory disturbances, and HLA-A*3101 was present in 8 of them while 136 had no adverse effects in which 4 of them were tested positive for the allele. In Group II, 3 (2.9%) of the 103 healthy controls were tested positive for the allele. No difference was found in response to antiepileptic therapy between allele positive and negative patients.Conclusion: The present study had shown that HLA-A*3101 is prevalent in 6.25% of the Indian epileptic population under study. The presence of this allele has a significant association with the development of mild cutaneous reactions like skin rashes. However, no difference was observed in allele positive patients in response to antiepileptic therapy in comparison with allele negative patients

Location attestation and access control for mobile devices using GeoXACML

Access control has been applied in various scenarios in the past for negotiating the best policy. Solutions with XACML for access control has been very well explored by research and have resulted in significant contributions to various sectors including healthcare. In controlling access to the sensitive data such as medical records, it is important to guarantee that the data is accessed by the right person for the right reason. Location of access requestor can be a good indication for his/her eligibility and reasons for accessing the data. To reason with geospatial information for access control, Geospatial XACML (eXtensible Access Control Markup Language) is proposed as a standard. However, there is no available implementation and architecture for reasoning with Geospatial XACML policies. This paper proposes to extend XACML with geohashing to implement geospatial policies. It also proposes an architecture for checking reliability of the geospatial information provided by clients. With a case study, we demonstrate how our framework can be used to control the privacy and data access of health service data in handheld devices