Fine needle aspiration: a simple and handy tool to diagnose malignant lymphadenopathy

Background: Fine needle aspiration cytology (FNAC) of the lymph node is a simple useful screening test to diagnose suspected and unsuspected secondary and primary lymph node malignancy. The aim of the present study is to know the role of FNAC in the diagnosis of clinically suspected and unsuspected lymph node malignancies. Study design: prospective cohort study.Methods: Study material comprise of ‘76’ lymph nodes aspirates reported as malignant on cytology, out of total 445 cases of lymph node aspiration in two years period i.e. from October 2014 to September 2016.These 76 smears were studied and tabulated according to their cytomorphology and the lymph node group affected was noted. The clinical and radiological data were also noted.Results: Males were found more affected than females. cervical lymph node is the commonest group involved. Metastasis from squamous cell carcinoma was the most common diagnosis made on cytology.Conclusions: FNAC is found simple and very useful tool for diagnosing malignant lesions of lymph nodes especially in case of metastasis

Delay Comparison for 16x16 Vedic Multiplier Using RCA and CLA

In any integrated chip compulsory adders are required because first they are fast and second are the less power consumption and delay. And at the same time multiplication process is also used in various applications. So as the speed of multiplier increases then the speed of processor also increases. And hence we are proposing the Vedic multiplier using these adders. Vedic multiplier is an ancient mathematics which uses mainly 16 sutras for its operation. In this project we are using “urdhva triyagbhyam” sutra to do our process. This paper proposes the Vedic multiplier using the adders ripple carry adder(RCA) and carry look ahead adder(CLA) and puts forward that CLA is better than RCA.The major parameters we are simulating here are number of slices and delay. The code is written by using Verilog and is implemented using Xilinx ISE Design Suite

Linking and Recovering the Information of the User Sims for First Discontinued to the Latest using Big Data

Today�s scenario is that a individual can carry his(he /she) mobile everywhere. It becomes a body part to the young generation, particularly. Each mobile is simply multifunctional device which became inevitable in everyday life. Many mobile service vendors are available for few decades in the market. Generally these vendors sell their company Subscriber Identity Module (sim) cards with attractive features. These sims are sold to the users through the outlets of each company by satisfying a minimal documents submission and verification and activated within a small period. Any number of sims a candidate can buy and get activated. Most importantly any moment of time a user can stop using or discontinue the existing sim without furnishing any reason and get another one by following the same process. This paper is intend to see the accountability of sim(s) which were used by a user for some time and stopped using it and applying for a new one. It is also to see the number of sims from different vendors used by the same user and the cause to discontinue using any particular sim. Everyday huge number of sims getting activated by the service providers and how far the data is maintained

Cloud Computing: The Simplified Format of Pay�to-Use

Cloud computing is a paradigm of information technology enables the users to access all sharable resources over the internet by using an thin or thick client devices. Cloud computing is the effective technology in the field of computers in the present day. It evolved from the grid computing, virtualization, utility computing and autonomic computing. It was developed by using the features of these four technologies earlier. It helps the end users to complete their purpose irrespective of their background and location with cost effective. It is obvious that anything user friendly and cost effective is always adopted by the public

A Randomized Clinical Trial Comparing Midazolam and Pregabalin as Premedicants in Attenuating Neuroendocrine Stress Response during General Anaesthesia in Elective Surgeries

INTRODUCTION: The stress response to surgery is characterized by increased secretion of pituitary hormones and activation of the sympathetic nervous system. These changes due to the stress response have secondary effects on hormone secretion from other organs. For example, release of corticotropin from the pituitary stimulates cortisol secretion from the adrenal cortex. Arginine vasopressin which is secreted from the posterior pituitary has effects on the kidney. In the pancreas, glucagon is released and insulin secretion may be diminished. The overall metabolic effect of the hormonal changes is increased catabolism which mobilizes substrates to provide energy. The hormonal changes also lead to retention of salt and water to maintain fluid volume and cardiovascular homeostasis. The changes triggered by the stress response are short-lived and well tolerated by normal healthy patients belonging to class 1 and 2 of American Society of Anaesthesiologist classification of Physical Status. In patients with other co-morbidities like myocardial ischemia, renal insufficiency, uncontrolled diabetes, liver disease and cerebrovascular diseases these changes can be life threatening. AIM OF THE STUDY: A Randomised Clinical Trial comparing Midazolam and Pregabalin as premedicants in attenuating neuroendocrine stress response during General Anaesthesia in Elective Surgeries. OBJECTIVE OF THE STUDY: Primary Objective: To study the pattern of rise in serum cortisol levels during surgery in two groups of patients after premedicating one group with oral Midazolam and another with oral Pregabalin. Secondary Objective: To evaluate the changes in • serum prolactin, • Plasma glucose, • The hemodynamic parameters like heart rate and blood pressure. Primary outcome measure: Serum cortisol. Secondary outcome measure: Serum prolactin, plasma glucose, Heart rate and blood pressure. MATERIALS AND METHODS: INCLUSION CRITERIA: 1. Patients who were willing to participate, 2. Age: 18 to 55 years, 3. American Society of Anaesthesiologist Class 1 and II, 4. Elective surgical procedures under general anaethesia, 5. Duration of surgery: 30 minutes and 180 minutes. EXCLUSION CRITERIA: 1. Preexisting co-morbidities [cardiac disease, diabetes, asthma, hepatic and renal dysfunction], 2. anticipated difficult intubation, 3. obesity, 4. epileptics, 5. pregnant patients, 6. patients on antidepressants. After identifying the eligible patient, they were counselled on the day prior to sugery and separate consent got for the participation in the study. Those patients in whom more than one intubation attempt was required or laryngoscopy and intubation took more than 45 seconds were also considered as difficult airway. All menstruating women were tested for pregnancy using card test. Antidepressants can interfere with catecholamines, so those patients on antidepressants were also excluded. Those with baseline abnormalities in the lab values were also excluded. STATISTICAL ANALYSIS: After consulting the statistician the sample size was set at 80 patients. Intial pilot observation showed a 10% difference between the control and the premedicated group. This study was designed to find out the difference between the two premedicants namely T.Midazolam7.5mg and T.Pregabalin 150mg. After thorough review of previous studies approximately 40 patients including 5% for missing values were included in each group inorder to ensure a power of 80% which would permit a type 1 error of 0.05.The results were analysed using SPSS Version 17 software with the help of the statistician. Normality was checked using Kolmograv Smirnov test and it resulted in a p> 0.005 for almost all the variables which implies that the data are normally distributed. The students paired t-test was used to compare the mean change in the cortisol levels in the two groups. Categorical variables were analysed using Chi Square test. Values that were not normally distributed or when the mean value was less than two times the standard deviation, were analysed with nonparametric statistical methods. All results were presented as means ± standard deviation. A p value < .05 was considered as statistically significant. Eighty five patients belonging to ASA physical status 1 and 2 were enrolled after getting informed consent and randomly allocated to the two groups. Both groups were comparable in age, gender variability, the type of surgery and the mean duration of surgery. SUMMARY: This study was done to assess the pattern of rise of serum cortisol in patients premedicated with Midazolam and Pregabalin. A randomized prospective study was carried out in 85 patients aged between 18 and 55 undergoing general anaesthesia for elective surgeries .Serum cortisol, serum prolactin, blood glucose, heart rate and blood pressure were measured at five times namely baseline, after premedication, after intubation, after extubation, and twenty four hours after surgery. Our study demonstrated that both Midazolam and Pregabalin were able to reduce the serum cortisol levels before and after intubation (p < .01) thus proving to be good premedicants. We also found that both the drugs failed to decrease the neuroendocrine stress response following extubation at the end of the surgery. We found that with its advantageous therapeutic profile Pregabalin proves to be superior to Midazolam in maintaining stable hemodynamic parameters, anxiolysis with out undue sedation and efficient analgesia in the immediate postoperative period. Oral premedication given one hour before surgery is feasible only in preoperative wards which are far away from the well –equipped theatre suite and trained airway personnel. Also Pregabalin is found to be safe in hyperreactive airway disease. Pregabalin in the dose of 150 mg is safer than Midazolam in most of the populations and in places with little access to monitors. CONCLUSION: From this study it is concluded that Pregabalin in the dose of 150 mg given per orally one hour before elective surgeries can attenuate the neuroendocrine stress response due to induction and intubation. This dose (150mg) is optimal in that it doesn’t cause undue preoperative sedation at the same time provides efficient analgesia in the early postoperative period. Midazolam is also effective in attenuating the humoral stress response but stringent monitoring is warranted to avoid hypoxemia before induction more so in obese and in patients with respiratory diseases. Better surgical skills and techniques have got a major role in attenuating neuroendocrine stress response in addition to the conventional anesthetic interventions

High Gain Interleaved Boost Converter for Fuel Cell Applications

Fuel cell is one of the promising technologies for distributed generation. For designing high efficiency fuel cell power systems, a suitable DC-DC converter is required. Among the various topologies, interleaved converters using switched capacitor are considered as a better solution for fuel cell systems due to high conversion efficiency. The objective of the paper is to design and implement a high gain interleaved converter using switched capacitors for fuel cell systems. In the proposed interleaved converter, the front end inductors are magnetically cross-coupled to improve the electrical performance and reduce the weight and size. Also, switched capacitors are used to improve the voltage gain of the converter. The proposed converter has been performed. Simulation study of interleaved converter using switched capacitors interfaced with fuel cells has been studied using Matlab/Simulink. A prototype has been developed to verify the simulation results

Sparse Array Design for Dual-Function Radar-Communications System

The problem of sparse array design for dual-function radar-communications is investigated. Our goal is to design a sparse array which can simultaneously shape desired beam responses and serve multiple downlink users with the required signal-to-interference-plus-noise ratio levels. Besides, we also take into account the limitation of the radiated power by each antenna. The problem is formulated as a quadratically constrained quadratic program with a joint-sparsity-promoting regularization, which is NP-hard. The resulting problem is solved by the consensus alternating direction method of multipliers, which enjoys parallel implementation. Numerical simulations exhibit the effectiveness and superiority of the proposed method which leads to a more power-efficient solution.Comment: Accepted by IEEE Communications Letter