Open label study to assess the safety and efficacy of cinacalcet in refractory hyperparathyroidism with chronic renal failure

Background: Secondary hyperparathyroidism a common consequence of chronic kidney disease is associated with many complications like renal osteodystrophy, vascular and soft tissue calcification. This study is to assess the safety and efficacy of Cinacalcet a calcimimetic drug in patients with refractory hyperparathyroidism due to chronic renal failure.Methods: Patients with chronic kidney disease stage 5 on maintenance haemodialysis diagnosed to have refractory hyperparathyroidism who do not attain the target range for hyper-parathyroid indicators serum PTH ≤300, Serum Ca (8.4-9.5), serum phosphorous (3.5-5.5) with the use of calcitriol and phosphate binders were included in the study. Twenty patients satisfying the case definition of refractory hyperparathyroidism due to chronic renal failure received 30mg Cinacalcet therapy. Total duration of treatment was 6 weeks. Standard serum calcium, serum phosphorous, PTH was assessed before and after 6 weeks.Results: Cinacalcet significantly reduces serum PTH level when results were compared by paired t test. P=0.016 <0.05 (significant). No statistically significant reduction in serum calcium and phosphorous. Serum calcium P value=0.599>0.05, serum phosphorous P=0.132>0.05. In this study after overall assessment.Conclusions: Cinacalcet is more efficacious and safe in treating refractory hyperparathyroidism due to chronic renal failure

Ovarian collision tumour: a rare case of serous cystadenoma with granulosa cell tumor of ovary

A collision tumor is the coexistence of two distinct tumours without any histological intermixing in the same organ or tissue. Each component of collision tumors occurs coincidently and biologic behaviour depends on their own tumor characteristics. A 48 year aged P2L2 women with pain abdomen since 15 days, on abdominal examination-a cystic mass occupying left iliac fossa present, bimanual examination a cystic mass measuring 13x10x8 cm in size, felt separately from the uterus. Sonography of abdomen and pelvis revealed a large cyst in the right adnexa 11.5x10.5x9.5 cm extending upto umbilical region. The serum tumor markers were within the normal range. Patient complained of severe pain abdomen on next day. Emergency laparotomy was done. Left ovarian cyst measuring 13x12x7 cm in size with one loop of torsion seen. Left salphingo-ophorectomy done and specimen sent for frozen section. It reported as serous cystadenoma of left ovary. Then proceeded to total abdominal hysterectomy with right salphingo-oophorectomy. Histopathology reported Serous cystadenoma with focal Granulosa cell tumour- left ovary. Patient was followed up with serum inhibin and CECT abdomen. The demographic factors, presentations and diagnosis of collision tutors are as similar as with single ovarian tumours. It is important for gynaecologist, radiologist and pathologist to be aware of occurrence of collision tumours. Histopathogical diagnosis of such neoplasms becomes very important, to provide appropriate treatment based on the individual biological characteristics of each component of collision tumours

AmnioQuick® Duo+ for diagnosis of premature fetal membranes rupture

Background: Failure to identify women with premature fetal membranes rupture associated with infectious morbidities. Evaluation of the accuracy of AmnioQuick® Duo+ in diagnosing premature fetal membranes rupture compared to conventional diagnostic tests was the aim of this study.Methods: 220 pregnant women ≥37 and <39 weeks` gestation studied and classified into two groups; study group (premature fetal membranes rupture) and control group (no premature fetal membranes rupture). Participants examined by trans-abdominal ultrasound (TAS) and vaginal speculum to visualize amnion leaking and for collection of samples for fern, nitrazine and AmnioQuick® Duo+ tests on admission. A final diagnosis whether the studied women had PROM or not at the initial presentation made after delivery.Results: Sensitivity and specificity of the AmnioQuick® Duo+ to diagnose PROM was 93.6% and 86.4%; respectively compared with 72.7% and 80.9%; respectively for fern test and 76.4% and 83.6%; respectively for nitrazine test. Positive predictive value, negative predictive value and accuracy of AmnioQuick® Duo+ to detect PROM were 87.3%, 93.1% and 90%; respectively compared with 79.2%, 74.8% and 76.8%; respectively for fern test and 82.4%, 77.97% and 80%; respectively for nitrazine test. AmnioQuick® Duo+ test had higher accuracy to detect premature fetal membranes rupture compared to conventional diagnostic tests.Conclusions: AmnioQuick® Duo+ is accurate bedside immunoassay test, better than the individual conventional diagnostic tests and can used as complementary test to improve the management of women with women premature fetal membranes rupture

Managing The Tomato Leaf Disease Detection Accuracy Using Computer Vision Based Deep Neural Network

Development of leaf disease in the agricultural sector would decrease crop yield output. Thus, leaf disease identification can be achieved in an automatic way to increase the yield in the agriculture sector. However, most of the disease recognition system works with poor disease recognition due to varying patterns of leaf disease which impair detection accuracy. In this article, we are managing this issue by designing a computer vision model that assists in building a system that involves real-time image detection, feature extraction and image classification. The findings are given by the classifier, whether the leaf is diseased or not. In this paper we use Deep Neural Network (DNN) for real-time image classification. The experimental findings on tomato plant indicate that classification rates have increased with the proposed system relative to other current methods

A novel hybrid password authentication scheme based on text and image

Considering the popularity and wide deployment of text passwords, we predict that they will be used as a prevalent authentication mechanism for many years to come. Thus, we have carried out studies on mechanisms to enhance text passwords. These studies suggest that password space and memorability should be improved, with an additional mechanism based on images. The combination of text and images increases resistance to some password attacks, such as brute force and observing attacks. We propose a hybrid authentication scheme integrating text and recognition-based graphical passwords. This authentication scheme can reduce the phishing attacks because if users are deceived to share their key passwords, there is still a chance to save the complete password as attackers do not know the users' image preferences. In addition to the security aspect, the proposed authentication scheme increases memorability as it does not require users to remember long and complex passwords. Thus, with the proposed scheme users will be able to create strong passwords without sacrificing usability. The hybrid scheme also offers an enjoyable sign-in/log-in experience to users

A pre-post study of a multi-country scale up of resuscitation training of facility birth attendants: does Helping Babies Breathe training save lives?

Background: Whether facility-based implementation of Helping Babies Breathe (HBB) reduces neonatal mortality at a population level in low and middle income countries (LMIC) has not been studied. Therefore, we evaluated HBB implementation in this context where our study team has ongoing prospective outcome data on all pregnancies regardless of place of delivery. Methods: We compared outcomes of birth cohorts in three sites in India and Kenya pre-post implementation of a facility-based intervention, using a prospective, population-based registry in 52 geographic clusters. Our hypothesis was that HBB implementation would result in a 20 % decrease in the perinatal mortality rate (PMR) among births ≥1500 g. Results: We enrolled 70,704 births during two 12-month study periods. Births within each site did not differ prepost intervention, except for an increased proportion ofbirths; however, a post-hoc analysis stratified by birthweight documented improvement insurvival. Conclusions: Rapid scale up of HBB training of facility birth attendants in three diverse sites in India and Kenya was not associated with consistent improvements in mortality among all neonates ≥1500 g; however, differential improvements inpopulation, data collection, and ongoing quality monitoring activities. Trial registration: The study was registered at ClinicalTrials.gov: NCT0168101

MENCA experiment aboard India’s Mars Orbiter Mission

The Mars Exospheric Neutral Composition Analyser (MENCA) aboard the Indian Mars Orbiter Mission (MOM) is a quadrupole mass spectrometer-based experiment. Making use of the highly elliptical and low inclination (~150°) orbit of MOM, MENCA will conduct in situ measurements of the composition and radial distribution of the Martian neutral exosphere in the 1–300 amu mass range in the equatorial and low latitudes of Mars. The functionality of MENCA has been tested during the Earth-bound and heliocentric phases of MOM before its operation in the Martian orbit. This article describes the scientific objectives, instrument details, design and development, test and evaluation, and calibration of the MENCA instrument

The Antenatal Corticosteroids Trial (ACT)\u27s explanations for neonatal mortality - a secondary analysis.

BACKGROUND: The Antenatal Corticosteroid Trial assessed the feasibility, effectiveness, and safety of a multifaceted intervention to increase the use of antenatal corticosteroids (ACS) in mothers at risk of preterm birth at all levels of care in low and middle-income countries. The intervention effectively increased the use of ACS but was associated with an overall increase in neonatal deaths. We aimed to explore plausible pathways through which this intervention increased neonatal mortality. METHODS: We conducted a series of secondary analyses to assess whether ACS or other components of the multifaceted intervention that might have affected the quality of care contributed to the increased mortality observed: 1) we compared the proportion of neonatal deaths receiving ACS between the intervention and control groups; 2) we compared the antenatal and delivery care process in all births between groups; 3) we compared the rates of possible severe bacterial infection between groups; and 4) we compared the frequency of factors related to ACS administration or maternal high risk conditions at administration between the babies who died and those who survived 28 days among all births in the intervention group identified as high risk for preterm birth and received ACS. RESULTS: The ACS exposure among the infants who died up to 28 days was 29 % in the intervention group compared to 6 % in controls. No substantial differences were observed in antenatal and delivery care process between groups. The risk of pSBI plus neonatal death was significantly increased in intervention clusters compared to controls (2.4 % vs. 2.0 %, adjusted RR 1.17, 95 % CI 1.04-1.30, p = 0.008], primarily for infants with birth weight at or above the 25(th) percentile. Regarding factors related to ACS administration, term infants who died were more likely to have mothers who received ACS within 7 days of delivery compared to those who survived 28 days (26.5 % vs 17.9 %, p = 0.014), and their mothers were more likely to have been identified as high risk for hypertension and less likely for signs of preterm labor. CONCLUSIONS: These results suggest that ACS more than other components of the intervention may have contributed to the overall increased neonatal mortality. ACS may have also been involved in the observed increased risk of neonatal infection and death. Further trials are urgently needed to clarify the effectiveness and safety of ACS on neonatal health in low resource settings