Evaluation of fine needle aspiration cytology as the initial diagnostic test in cases of cervical lymphadenopathy

Background: Cervical lymph node enlargement is common amongst the various causes of neck swelling. Proper diagnosis and early treatment is necessary for cervical lymph node disease and it is also necessary to rule out potentially curable causes as against malignancy in which the treatment is generally palliative. Fine needle aspiration cytology (FNAC) is now a day the initial investigation in most of the cases of cervical lymph node enlargement. Aims and Objectives of the study were to evaluate the sensitivity and specificity of FNAC in the diagnosis of cervical lymph node disease with an emphasis on discordant cases between the cytology and the histopathology.Methods: Patients admitted with cervical lymph node enlargement in a tertiary hospital of western India (attached with a medical college) from October 2014 to September 2016 were prospectively studied. Detailed history, clinical examination and necessary investigations of all patients were done especially fine needle aspiration cytology and histopathology examination and inference was obtained after the diagnosis was confirmed.Results: The cytological diagnoses were found to be malignant in 48 cases (30.6%) and benign in 109 cases (69.4%). The overall diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of FNAC of cervical lymph nodes were 90.9%, 67.2%, 82.6%, and 81.3%, respectively. The overall diagnostic accuracy was 82.2%, while the overall discordance rate was 17.8%.Conclusions: FNAC is the initial investigation of choice in the diagnostic approach to most of the cases of cervical lymphadenopathy and it has good diagnostic sensitivity and specificity

Variations in palpal ornamentation of Anopheles fluviatilis species T and U (Diptera: Culicidae) and their taxonomic consequence

64-68Anopheles fluviatilis sensu lato James is a highly efficient malaria vector in Indian subcontinent and Iran which is comprised of at least four sibling species provisionally designated as species S, T, U and V. An important morphological characteristic for differentiation of this species complex from other closely related anopheline species complex, the Minimus Complex, is the ratio of length of subapical pale band to dark band intervening apical and subapical pale bands on the maxillary palps of female mosquito. Here, we report variation in the subapical pale band in An. fluviatilis, especially in species U, to the extent that palps of some specimens resemble members of Minimus Complex, inferring that palpal ornamentation may not be reliable characteristics for identification of An. fluviatilis. Taxonomic consequence of such variation is discussed

Evaluation of Power Quality Issues in grid Connected PV Systems

This paper deals with the evaluation of power quality issues in grid connected PV systems. This paper also presents  complete simulation, modeling and control of three phase grid connected solar PV module with Maximum Power Point Tracking. Perturb and Observe (P&O) method has been used for Maximum Power Point Tracking. In the proposed model DC bus voltage control , harmonic mitigation and power factor control are discussed as power quality issues. The simulation results are shown in the graphical waveforms and simulation is performed in MATLAB using SIMULINK environment and PSB toolboxes.

Combined use of CA 125 and Inhibin as tumor marker for detection of ovarian cancer in comparison to CA 125 or Inhibin alone

Background: Ovarian cancers are diagnosed at an advanced stage. Early diagnosis is the key to reduce death from ovarian cancer. The present study is an effort to assess the suitability of combined test using CA 125 and Inhibin for early diagnosis of ovarian cancer as compared to CA125 or Inhibin alone.Methods: Fifty women with clinical suspicion of ovarian malignancy attending Gynae OPD were enrolled. All of these women were subjected to estimation of CA 125 and Inhibin levels prior to surgical intervention. A value of 35 IU/ml was taken as positive for CA 125. For Inhibin, 10.5 pg/ml was taken as cut off for premenopausal patients, whereas, any detectable assays were taken as positive for postmenopausal patients. The results were analyzed after establishing final histopathology of the disease.Results: Out of 50 patients recruited, 30 (60%) were found to have carcinoma ovary and 20 (40%) were found to have benign diseases. Out of 30 cases of carcinoma ovary, CA125 was raised in 81% of cases and Inhibin was raised in 78% of cases. For detection of carcinoma ovary, CA 125 was found to have a sensitivity of 90% and specificity of 60% with a positive predictive value of 77% and negative predictive value of 80% which were statistically significant. Sensitivity and specificity of serum Inhibin for the same was 86.6% and 20% respectively. The positive and negative predictive value were 61.9% and 50%, which were not statistically significant. Sensitivity and specificity of combined CA125 and Inhibin were 100% and 30% respectively. The positive and negative predictive value were 68.1% and 100% respectively, which were statistically significant.Conclusions: Combined use of CA125 and Inhibin has got better sensitivity and specificity in detection of ovarian cancer in comparison to CA 125 or Inhibin used alone.

Immunopathogenesis of Craniotomy Infection and Niche-Specific Immune Responses to Biofilm

Bacterial infections in the central nervous system (CNS) can be life threatening and often impair neurological function. Biofilm infection is a complication following craniotomy, a neurosurgical procedure that involves the removal and replacement of a skull fragment (bone flap) to access the brain for surgical intervention. The incidence of infection following craniotomy ranges from 1% to 3% with approximately half caused by Staphylococcus aureus (S. aureus). These infections present a significant therapeutic challenge due to the antibiotic tolerance of biofilm and unique immune properties of the CNS. Previous studies have revealed a critical role for innate immune responses during S. aureus craniotomy infection. Experiments using knockout mouse models have highlighted the importance of the pattern recognition receptor Toll-like receptor 2 (TLR2) and its adaptor protein MyD88 for preventing S. aureus outgrowth during craniotomy biofilm infection. However, neither molecule affected bacterial burden in a mouse model of S. aureus brain abscess highlighting the distinctions between immune regulation of biofilm vs. planktonic infection in the CNS. Furthermore, the immune responses elicited during S. aureus craniotomy infection are distinct from biofilm infection in the periphery, emphasizing the critical role for niche-specific factors in dictating S. aureus biofilm-leukocyte crosstalk. In this review, we discuss the current knowledge concerning innate immunity to S. aureus craniotomy biofilm infection, compare this to S. aureus biofilm infection in the periphery, and discuss the importance of anatomical location in dictating how biofilm influences inflammatory responses and its impact on bacterial clearance

Functional outcome following external fixator (JESS) application for proximal humeral fractures

Background: Proximal humeral fractures account for 5% of all fractures. Observed frequently in older osteoporotic patients but found in young patients with high-energy trauma.About 80% of these fractures are undisplaced or minimally displaced. Non-operative method requiring immobilization of shoulder often leads to a stiff shoulder, whereas surgical procedures such as plating need excessive soft tissue dissection. It was overcome in this study by less soft tissue dissection by use of external fixator application and early mobilization.Methods: Total of 18 patients mean age 40.5 years, predominantly male (16/18) treated with external fixator - JESS (Joshi’s external immobilization system) for Neer’s two, three and four part proximal humeral fractures. Vehicular accidents were the most common mode of injury followed by fall. There were 8 cases each of Neer's two and three part fractures. Shoulder mobilization started within a week as postoperativelyas pain allowed. Patients followed up at 3, 6, 12 and 18 weeks for pain, function, range of motion and anatomy with check X-ray. After radiological union at 8-10 weeks JESS was removed. Cases were evaluated for functional result by constant scoring system.Results: Average score on constant scoring system was 72 after a mean follow-up of 6 months. All fractures united in mean duration of 9.33 weeks. The complications included shoulder stiffness in one case and pin tract infection in two cases.Conclusions: Early shoulder mobilization a prerequisite for good results can be achieved without compromising fracture union. Less soft tissue dissection required and significant cost effective

A Review on Extraction and Recommendation of Educational Resources from WWW

Keyphrases give a basic method for portraying a report, giving the peruser a few pieces of information about its substance. Wrapper adjustment goes for consequently adjusting a formerly took in wrapper from the source Web webpage to another concealed website for data extraction. It depends on a generative model for the age of content parts identified with characteristic things and designing information in a Web page. To take care of the wrapper adjustment issue, we consider two sorts of data from the source Web webpage. The principal sort of data is the extraction information contained in the already took in wrapper from the source Web webpage. The second sort of data is the beforehand separated or gathered things. Utilize a Bayesian learning way to deal with naturally select an arrangement of preparing cases for adjusting a wrapper for the new concealed site. To take care of the new property revelation issue, we build up a model which breaks down the encompassing content sections of the qualities in the new inconspicuous site. A Bayesian learning strategy is produced to find the new qualities and their headers. The direct broad investigations from various genuine Web locales to show the viability of our structure. Keyphrases can be helpful in a different applications, for example, recovery motors, perusing interfaces, thesaurus development, content mining and so on. There are likewise different errands for which keyphrases are helpful

Cytotoxic edema associated with hemorrhage predicts poor outcome after traumatic brain injury

Magnetic resonance imaging (MRI) is rarely used in the acute evaluation of traumatic brain injury (TBI), but may identify findings of clinical importance not detected by computed tomography (CT). We aimed to characterize the association of cytotoxic edema and hemorrhage, including traumatic microbleeds, on MRI obtained within hours of acute head trauma and investigated the relationship to clinical outcomes. Patients prospectively enrolled in the Traumatic Head Injury Neuroimaging Classification study (NCT01132937) with evidence of diffusion-related findings or hemorrhage on neuroimaging were included. Blinded interpretation of MRI for diffusion-weighted imaging and hemorrhage was conducted, with subsequent quantification of apparent diffusion coefficient (ADC) values. Of 161 who met criteria, 82 patients had conspicuous hyperintense lesions on diffusion-weighted imaging (DWI) with corresponding regions of hypointense ADC in proximity to hemorrhage. Median time from injury to MRI was 21 (10-30) hours. Median ADC values per patient grouped by time from injury to MRI were lowest within 24 hours after injury. ADC values associated with hemorrhagic lesions are lowest early after injury, with an increase in diffusion during the subacute period, suggesting transformation from cytotoxic to vasogenic edema during the subacute post-injury period. Of 118 patients with outcome data, 60 had Glasgow Outcome Scale Extended <6 at 30/90 days post-injury. Cytotoxic edema on MRI (OR 2.91 [1.32-6.37], P=0.008) and TBI severity (OR 2.51 [1.32-4.74], P=0.005) were independent predictors of outcome. These findings suggest that in TBI patients with findings of hemorrhage on CT, patients with DWI/ADC lesions on MRI are more likely to do worse