A comparative study of clinical and radiological outcome between cages and morselized bone graft in transforaminal lumbar interbody fusion surgery: a hospital-based study

Background: Degenerative spinal diseases resulting in neuropathic backache are managed by nerve root decompression with instrumented interbody fusion is the treatment of choice for these groups of patients when not managed conservatively.Methods: Hospital based, comparative, retrospective study was carried out in such patients who underwent transforaminal lumbar interbody fusion (TLIF) with either cage with bone graft or stand-alone autologous morselized bone graft. The clinical and radiological outcomes were compared in these two methods of interbody fusion to assess any significant difference between them. A total of 20 patients with lumbar canal stenosis and degenerative grade 1/2 spondylolisthesis who failed conservative management were operated by TLIF approach and were evaluated for post-operative improvement in Oswestry disability index (ODI) and interbody fusion on imaging at 6 months and 1 year postoperatively. Vertebral level of surgical intervention, intra-operative blood loss and duration of surgery were recorded for each patient along with complications, if any.Results: In our study there was no significant difference in the clinical and radiological outcome between the two methods of interbody fusion. Although the group which was offered morselized bone graft with cage showed slightly better clinical outcome at 6 months of follow up, both showed no significant difference in ODI at 1 year of follow up.Conclusions: With this study, we can conclude that both the methods have similar clinical and radiological outcome with similar patient satisfaction and can be interchangeably employed for interbody fusion according to surgeon’s and patient’s preferences

Evaluation of functional outcome of tibial plateau fractures managed by different surgical modalities

Background: Tibial plateau makes up one of the most important weight bearing surface. Its fractures are commonly faced entity encompassing a wide spectrum of injuries of variable fracture morphology. Due to in-crease in incidence of high velocity trauma and higher functional demands of patients, surgery is warranted in most of the cases. Although, there is advancement in fracture fixation methods, apt treatment of tibial plateau fractures still remains controversial.Methods: In our series, we analyzed the functional outcomes of 58 of surgically treated tibial plateau fractures. Fractures were classified with Schatzker’s classification. Various fixation modalities of fixation were employed. Functional outcome was evaluated with modified Rasmussen’s criteria.Results: Most of the patient’s belonged to younger age groups (58.62%) and males (79.31%) were predominately involved. Road traffic accidents were the most common etiological factor (70.69%). Schatzker types I (29.31%) and II (27.59%) were the most common observed fracture type. The majority of the patients had a complication free recovery (81.03%). Infection was reported in only one case (1.72%). Similarly, malunion was noticed in only in one case (1.72%). None of the patients had complications like nonunion or neurovascular damage. The functional outcome assessment according to Modified Rasmussen’s criteria at the end of 12 months showed the excellent functional outcome in 41 (70.68%), good in eight (13.79%), fair in five (10.34%) and poor in four (6.9%) patients.Conclusions: Surgical treatment of tibial plateau fractures is challenging, yet it helps in achieving excellent anatomical restoration and rigid fracture fixation enabling in the restoration of articular congruity and facilitation of early knee motion thus achieving optimal knee function

IMPROVEMENT OF THE SOLUBILITY AND DISSOLUTION OF TOLFENAMIC ACID USING LYOPHILIZATION TECHNIQUE

Abstract: The aim of the present study was to prepare freeze dried crystals (FD) of Tolfenamic acid (TA) by freeze drying technique. Crystallization medium used for freeze drying of Tolfenamic acid consisted of N,N-dimethylformamide (DMF) and Water as solvent systems. The presence of solvents residuals in FD was determined by Gas chromatography and particles were characterized by DSC, FT-IR, XRD and SEM. The respective solubility study and dissolution behaviour studies were carried out. The samples were stored in stability chamber to investigate their physical stabilities. Residual Solvents in FDs were found to be within the limit and exhibited decreased crystallinity as well solubility and dissolution of the Freeze dried crystals was improved than commercial sample of Tolfenamic acid. In stability study, it was found that physical properties and release profile of the freeze dried crystals was unaffected for 3 months. Hence this technique can be used to obtain modified drug raw material for formulation of tablets of Tolfenamic acid by direct compression with directly compressible tablet excipients

Impact of health education on knowledge and attitude of self-breast examination among female nursing students

Background: Breast cancer is the most common cancer among women and a leading cause of death worldwide, including in India. Breast cancer usually shows a slow development rate, and when it is recognized in the early stages, successful treatment results can be achieved. Breast self-examination is a screening option for young women. Health awareness programs on screening and early detection are the cornerstones for reducing the morbidity and mortality resulting from breast cancer. Objective: To assess the impact of health education on knowledge and attitude of self-breast examination among nursing students. Study Design: The present interventional study was conducted between September and October 2019. Setting: This study was done among 79 nursing students of a tertiary care hospital situated in a central district of Uttar Pradesh. Main Outcome Measures: The self-reported pre-designed and structured questionnaire was used. It included three sections: 1. Sociodemographic profile 2. Knowledge regarding self-breast examination (SBE) 3. Attitude regarding self-breast examination (SBE). Knowledge and attitude scores were calculated and divided into the poor, average, and good categories. Results: There were 87.3% of girls had prior knowledge of the self-breast examination, while 12.7% of girls were not aware of the self-breast examination. Post-intervention, there was a significant increase (p<0.05) in their knowledge about self-breast examination. Conclusion and Relevance: Planned teaching intervention had a significant impact on the knowledge and attitude of self-breast examination. The knowledge and attitude were poor at the early stages, but it had increased significantly after the health education intervention

Machine Reading Comprehension using Case-based Reasoning

We present an accurate and interpretable method for answer extraction in machine reading comprehension that is reminiscent of case-based reasoning (CBR) from classical AI. Our method (CBR-MRC) builds on the hypothesis that contextualized answers to similar questions share semantic similarities with each other. Given a target question, CBR-MRC retrieves a set of similar questions from a memory of observed cases and predicts an answer by selecting the span in the target context that is most similar to the contextualized representations of answers in the retrieved cases. The semi-parametric nature of our approach allows CBR-MRC to attribute a prediction to the specific set of cases used during inference, making it a desirable choice for building reliable and debuggable QA systems. We show that CBR-MRC achieves high test accuracy comparable with large reader models, outperforming baselines by 11.5 and 8.4 EM on NaturalQuestions and NewsQA, respectively. Further, we also demonstrate the ability of CBR-MRC in identifying not just the correct answer tokens but also the span with the most relevant supporting evidence. Lastly, we observe that contexts for certain question types show higher lexical diversity than others and find CBR-MRC to be robust to these variations while performance using fully-parametric methods drops.Comment: 9 pages, 2 figure

Gastrointestinal stromal tumour in Meckel's diverticulum

<p>Abstract</p> <p>Background</p> <p>Meckel's Diverticulum is the most commonly encountered congenital anomaly of the small intestine, occurring in approximately 2% of the population. Occasionally Meckel's diverticulum harbors neoplasms.</p> <p>Case presentation</p> <p>A 65 year old gentleman, presented with a pelvic mass. On exploratory laparotomy, it turned out to be gastrointestinal stromal tumour (GIST) arising from Meckel's diverticulum. Short history and review of literature are discussed.</p> <p>Conclusion</p> <p>Neoplasms occurring from Meckel's diverticulum, even though rare, should be considered as differential diagnosis of pelvic masses arising from bowel, wherever imaging modalities fail to give a definitive diagnosis.</p

Analysing the Evolution of FinTech Research Topics in Academia

The FinTech or financial technology industry has burgeoned in the past decade and has emerged as one of the hottest industries in recent times thanks to a myriad of innovations and disruption. New technologies like artificial intelligence (AI), blockchain, regulatory technology (RegTech), robotic process automation (RPA), insurance technology (InsurTech), internet of things (IoT), cloud computing and many more have been implemented in various different industries in unprecedented ways thereby disrupting the status quo. KPMG indicates that investment in the FinTech industry has doubled from 2017 to 2018, hitting a record $111.8 billion. Owing to the enormous global investment in the FinTech sector and its rapid expansion, it becomes imperative to analyse the research topics directing the growth of the FinTech sector. This research analyses FinTech research done in the past decade to determine the hot topics and provide an overview of how these topics have changed over time. Abstracts of journals articles and conferences are taken and a Latent Dirichlet Allocation (LDA) model using Gibbs sampling is trained to extract topics from them using topic modelling. The trends of the extracted topics are also identified including the positive or negative linear trends as well as non-linear trends

Community Acquired Pneumonia Associated Fatal Secondary Hemophagocytic Lymphohistiocytosis Syndrome

The burden of community-acquired pneumonia (CAP) requiring hospitalization among adults is substantial and is a leading infectious cause of hospitalization and death. Severe CAP may rarely get complicated with secondary hemophagocytic lymphohistiocytosis (HLH). The term hemophagocytosis refers to the pathologic finding of activated macrophages engulfing erythrocytes, leukocytes, platelets, or their precursor cells in the bone marrow, liver, or lymph nodes; this being characteristic for hemophagocytic syndrome. HLH can be primary or secondary and has a high mortality if left untreated. We report a case of severe CAP with secondary HLH in a 26-year-old male, who presented with fever, pancytopenia, jaundice, and pneumonia due to polymicrobial infection. This case report is presented to enlighten clinicians about the clinical entity of HLH and to suspect and recognize this rare and fatal disease