Diagnostic Accuracy Of Barium Swallow For Dysphagia, Keeping Rigid Esophagoscopy As The Gold Standard

Objective: To determine the diagnostic accuracy of Barium Swallow in detection of patients presenting with dysphagia. Study Design: Cross-sectional validation study. Study Setting & Duration: Department of Otorhinolaryngology, Head & Neck Surgery, District Headquarter Hospital Rawalpindi from 01-09- 2022 to 01-03-2023. Materials and Methods: Approval of the study was obtained from the Hospital Ethical Committee. A total of 111 patients both male and female patients were selected. The patients suffering from dysphagia as per operational definitions and who have reported for work-up to the Department of ENT, District Headquarters Hospital, Rawalpindi, and fulfill the complete inclusion and exclusion criteria, were selected. Informed consent was obtained from all the patients. Patients were selected by consecutive non-probability sampling technique. The data was analyzed using SPSS 24. Results: A total of 111 patients were included in this study. The mean age of these patients was 50.79 ± 13.01 years, ranging from 28 to 70 years. The frequency distribution of females 70.27 % was found to be more than that of males 29.73 %. Majority of patients' barium swallow (74.77%) revealed pathologies, while only a small percentage of patients (25.23%) had normal barium swallow. Most of patients (87.39%) had pathologies found during rigid esophagoscopy, while just a small number (12.61%) had normal rigid esophagoscopy. Comparing both investigating tools, esophagoscopy discovered 87.39% of pathologies while Barium swallow detected 74.77%, indicating that esophagoscopy was a more accurate procedure. Patients had esophageal web 55 (25.2%) on barium swallow and 69 (62.2%) on the Rigid esophagoscopy. Barium Swallow had esophageal stricture 28 (52.2) and no Pathology was detected in 28 (25.2 %) patients. As well as Rigid esophagoscopy had esophageal growth13 (11.7), esophageal stricture 15 (13.5), and no Pathology was detected in 14 (12.6 %). Rigid esophagoscopy is more efficient in detecting esophageal pathology than Barium Swallow. In Barium swallows most patients had esophageal web 55 (25.2%) than the esophageal stricture 28 (52.2) and no pathology was detected 28 (25.2). In rigid esophagoscopy most patients had esophageal web 69 (62.2%) than the esophageal growth13 (11.7), esophageal stricture 15 (13.5) and no pathology detected 14 (12.6). Conclusion: A range of diseases are associated with dysphagia can be found in patients. Two often used diagnostic methods are barium swallow and rigid esophagoscopy. Both Barium swallow and Rigid esophagoscopy are successful in the diagnosis of esophageal cancer. The use of a Rigid esophagoscopy is still a gold standard diagnostic and therapeutic tool for upper aerodigestive tract pathologies

Fuzzy-Based Segmentation for Variable Font-Sized Text Extraction from Images/Videos

Textual information embedded in multimedia can provide a vital tool for indexing and retrieval. A lot of work is done in the field of text localization and detection because of its very fundamental importance. One of the biggest challenges of text detection is to deal with variation in font sizes and image resolution. This problem gets elevated due to the undersegmentation or oversegmentation of the regions in an image. The paper addresses this problem by proposing a solution using novel fuzzy-based method. This paper advocates postprocessing segmentation method that can solve the problem of variation in text sizes and image resolution. The methodology is tested on ICDAR 2011 Robust Reading Challenge dataset which amply proves the strength of the recommended method

Utility of participatory rural appraisal for health needs assessment and planning.

BACKGROUND: While poverty and lack of life opportunities are root causes of a high burden of disease and infant and maternal mortality, inadequate health care contributes heavily. Often those who are left without care are those who need it most. Existing health services are managed without taking into account acceptance and need perspectives. This further reduces the effectiveness of and equity in health care. In order to guide the planning of reproductive health services by a national NGO, health needs were assessed in a district in Sindh using a combination of participatory rural appraisal (PRA) and qualitative and quantitative research methods. PRA is considered as a better framework to assess, analyse and develop programs with communities. OBJECTIVE: The objective of PRA was to initiate community involvement and to understand the needs of health care from a community perspective. METHODOLOGY: PRA was conducted with groups of men and women from three rural areas in a district of Sindh, Pakistan using a life cycle framework. The community members identified various stages of their life with the associated health issues. RESULTS: This research was empowering to community members as it facilitated community involvement. The respondents took charge of the process of identification of health needs at PRA sessions. PRA helped identify health problems considered prevalent and important by the community. More importantly, it helped potential service providers and the community to initiate community involvement in planning. CONCLUSION: PRA is not only an effective tool for assessment and analysis of health issues but also a vehicle to promote community involvement. Additionally, participatory methods contribute to understand the context of quantitative data generated for planning purposes

Energy efficient parallel configuration based six degree of freedom machining bed

The process of material removal from a workpiece to obtain the desired shape is termed machining. Present-day material removal technologies have high spindle speeds and thus allow quick material removal. These high-speed spindles are highly exposed to vibrations and, as a result, the accuracy of the final workpiece’s dimensions is compromised. To overcome this problem, the motion of the tool is restricted, and multiple degrees of freedom are given through the motion of the workpiece in different axes. A machining bed configured as a parallel manipulator capable of giving six degrees of freedom (DOF) to the workpiece is proposed in this regard. However, the proposed six DOF machining bed should be energy efficient to avoid an increase in machining cost. The benefit of using the proposed configuration is a reduction in dimensional error and computational time which, as a result, reduces the energy utilization, vibrations, and machining time in practice. This paper presents kinematics, dynamics and energy efficiency models, and the development of the proposed configuration of the machining bed. The energy efficiency model is derived from the dynamics model. The models are verified in simulation and experimentally. To minimize error and computation time, a PID controller is also designed and tested in simulation as well as experimentally. The resulting energy efficiency is also analyzed. The results verify the efficacy of the proposed configuration of the machining bed, minimizing position error to 2% and reducing computation time by 27%, hence reducing the energy consumption and enhancing the energy efficiency by 60%

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Study of Effect of Physiochemical Parameters on the Reproducibility (validation) of Biodegradation of Textile Dyes

Background: Environmental pollution due to different industrial waste has become a major problem in modern world because of their high toxic in nature. Textile wastes are carcinogenic and mutagenic contain varieties of toxic dyes and fixers. Azo dyes widely used in textile, paper and printing industries are not easily degradable and having carcinogenic nature. Due to health hazards of textile wastes, several chemical and biological methods are being used to make the discharged wastewater less toxic by degrading colors and other harmful chemicals. Present research study was aimed to evaluate the sensitivity of biodegradation process in form of Chemical oxygen demand (COD) and, to check the reproducibility of biodegradation results for validation purpose.Method: Initially selective bacterial strains were isolated from different waste samples. COD of the three samples of dyes were performed by titration method to observe the pattern of reproducibility of the biodegradability (COD) results.Results: Textile industry sludge wastewater samples contained different characteristics of dye degrading consortium of bacterial strains as compared to soil extracts samples whereas did not get any bacterial growth in domestic wastewater samples.  It was interesting to observe that the reproducibility of COD results was very hard to get due to sensitivity of the test parameter to the prevailing environmental conditions.Conclusion: Present study is significant for understanding the sensitivity of reproducibility or validation of biodegradation study. On the basis of present findings of experiments, we can say that only the method of determining COD could be standardized which will ensure the credibility of the results and the changed environmental temperature could affect the controlled experimental results. Present finding would give benefit to the new scientists and students for understanding the normal behavior of biodegradation study.Keywords: Biodegradation, Bioremediation, Environmental Health, Sludge, Diseases

An Efficient Key Distribution Scheme for Heterogeneous Sensor Networks ABSTRACT

Key distribution refers to the problem of establishing shared secrets on sensor nodes such that secret symmetric keys for communication privacy, integrity and authenticity can be generated. In a wireless sensor network, pre-distribution of secret keys is possibly the most practical approach to protect network communications but it is difficult due to the ad hoc nature, intermittent connectivity, and resource limitations of the sensor networks. In this paper, we propose a key distribution scheme based on random key pre-distribution for heterogeneous sensor network (HSN) to achieve better performance and security as compared to homogeneous network which suffer from high communication overhead, computation overhead, and/or high storage requirements. In a key generation process, instead of generating a large pool of random keys, a key pool is represented by a small number of generation keys. For a given generation key and publicly known seed value, a one-way hash function generates a key chain, and these key chains collectively make a key pool. Each sensor node is assigned a small number of randomly selected generation keys. The proposed scheme reduces the storage requirements while maintaining the same security strength

Drug Money and Economy: A Case of Islamic Republic of Pakistan

The Islamic Republic of Pakistan is distinguished as it occupies the third place in terms of area and fifth in the proportion of population density that contains 64% of young people under 29 years of age where ages range between 15 to 29 years. Moreover, Pakistan ranks high for developing economies in South Asia, based on international economic reports (World Economic Outlook, 2019). Depending on this young labor, their economy is expected to thrive and grow. Pakistan, like other countries in the region, faces major challenges in the area of organized crime of promoting and using drugs. Which means there is an imminent danger to all economic plans that the state would like to preserve for the sake of economic prosperity, technological development and preservation of the most important segment of society, the youth category