ENTERPRISE ANALYTICS: METHOD AND APPARATUS FOR SDA PACKET DEBUGGING, FLOW VISIBILITY AND MONITORING

The present techniques perform software defined access (SDA) packet visibility, monitoring, and analytics without impacting performance overhead. An Application Specific Integrated Circuit (ASIC) may be used to perform these processes at line rate without involvement from a central processing unit

Online Poker and Rummy -- Games of Skill or Chance?

The paper aims to investigate the degree of cognitive skills required for success in online versions of the popular card game rummy and poker. The study focuses on analyzing the impact of experience and learnable skills on success in the online card game. We also propose a framework to analyze online games to conclude on whether they are games of learnable skill or are they games of chance. The hypotheses proposed aim to test whether online and offline card games are comparable in terms of cognitive engagement and skill requirements. To assess these hypotheses, key elements of gameplay such as shuffling of cards, card deck randomness, and seating of players are analyzed. We also adopted statistical approaches to understand the characteristics of card games in terms of random chance or skill. From the analysis, we could see that the normality of the derived variables deviates significantly from the normal distribution showing a non-linear trend. It signifies that the mean of the involved skill variables is not zero as the user plays a greater number of games, thereby strengthening the assumption that the long-term success in online card games is attributed to skill and not chance. There is no difference in online and offline versions of card games (rummy and poker) from the perspective of requirement of skills. Moreover, our finding suggests that there is a preponderance of skills to succeed in online card gaming. Overall, the findings of this research contribute to a better understanding of cognitive skills in online gaming environments

SURVEY OF PRESCRIPTION PATTERN OF ANTIHYPERTENSIVE DRUGS IN HYPERTENSIVE AND DIABETIC HYPERTENSIVE PATIENTS

 Objective: This study was conducted in order to establish the drug prescribing trend of anti-hypertensive agents in hypertensives and diabetichypertensives in General Medicine Department of Veer Surendra Sai Medical College and Hospital, Sambalpur, Odisha.Methods: A prospective study of 2 months duration was conducted at the Veer Surendra Sai Medical College and Hospital, Sambalpur. Theprescriptions containing antihypertensives were collected from the patients attending the outpatient department of general medicine. Pregnantwomen were excluded from the study.Results: A total of 422 prescriptions were monitored, of which 285 were male and 137 were female. The age group of the patients varies from 35 to75 years. Among 422 prescriptions, 118 prescriptions were of hypertensives and 304 prescriptions were diabetic hypertensives. Among hypertensives,48% of patients were treated with anti-hypertensive drug combinations and 52% of patients were treated with single anti-hypertensive drug. 83%patients are suffering from primary hypertension (HTN) and only 17% patients suffering from secondary HTN. For the treatment of HTN, bothmonotherapy and combination therapy were followed. In monotherapy, amlodipine was most commonly prescribed followed by telmisartan. Incombination therapy, a two-drug combination consisting of calcium channel blockers (amlodipine) and beta blocker (atenolol) were given to themajority of patients, followed by amlodipine and AT1 antagonist (telmisartan or olmesartan) combination. Among diabetic hypertensives, 31% ofpatients were treated with single anti-hypertensive drug and 69% of patients were treated with anti-hypertensive drug combinations. In monotherapy,beta-blocker (metoprolol) was most commonly prescribed. In combination therapy, a two-drug combination consisting of calcium channel blockers(amlodipine) and beta blocker (atenolol or metoprolol) were given to the majority of patients, followed by a combination of calcium channel blockers(amlodipine) and AT1 antagonist (telmisartan or olmesartan).Conclusion: The present study represents the current prescribing trend for anti-hypertensive agents. According to JNC 7 guidelines, for Stage 1 HTN(systolic blood pressure [SBP] 140-159 or diastolic blood pressure [DBP] 90-99 mmHg), thiazides-type diuretics should be prescribed. For Stage 2HTN (SBP ≥160 or DBP ≥100 mmHg), two drug combinations (usually thiazide-type diuretics and angiotensin converting enzyme inhibitors) shouldbe prescribed. In our study, the prescription pattern does not follow the guideline.Keywords: Hypertension, Prescription, Diabetes, Cardiovascular disease.Â

Management of fistula-in-ano with special reference to ligation of intersphincteric fistula tract

Context: The surgical management of fistula-in-ano is still debatable and no clear recommendations have been made available until now. The present study analyses the results of ligation of intersphincteric fistula tract (LIFT) technique in treating fistula-in-ano in particular with recurrence, healing time, and continence status. Aims: LIFT in the management of patients of fistula-in-ano of cryptoglandular origin. Settings and Design: Prospective study. Materials and Methods: This is a prospective study of 52 patients admitted from September 2012 to August 2014. Patients were managed with LIFT technique and results of LIFT technique were compared with other studies in terms of recurrence rate, incontinence rate, and other postoperative complications. Results: A total of 52 patients were studied. Median follow-up was 24 weeks. Primary healing was achieved in 32 (71.11%) patients. Thirteen patients (28.88%) had a recurrence. No patient reported any subjective decrease incontinence after the procedure. Conclusions: LIFT technique is simple and easy to learn. With this method fistula-in-ano could be easily treated even at primary health care level. LIFT technique is a simple and novel modified approach for the treatment of fistula-in-ano with rapid healing rate and without any resultant incontinence

Management of Fistula‑In‑Ano with Special Reference to Ligation of Intersphincteric Fistula Tract

Context: The surgical management of fistula-in-ano is still debatable and no clear recommendations have been made available until now. The present study analyses the results of ligation of intersphincteric fistula tract (LIFT) technique in treating fistula-in-ano in particular with recurrence, healing time, and continence status. Aims: LIFT in the management of patients of fistula-in-ano of cryptoglandular origin. Settings and Design: Prospective study. Materials and Methods: This is a prospective study of 52 patients admitted from September 2012 to August 2014. Patients were managed with LIFT technique and results of LIFT technique were compared with other studies in terms of recurrence rate, incontinence rate, and other postoperative complications. Results: A total of 52 patients were studied. Median follow-up was 24 weeks. Primary healing was achieved in 32 (71.11%) patients. Thirteen patients (28.88%) had a recurrence. No patient reported any subjective decrease incontinence after the procedure. Conclusions: LIFT technique is simple and easy to learn. With this method fistula-in-ano could be easily treated even at primary health care level. LIFT technique is a simple and novel modified approach for the treatment of fistula-in-ano with rapid healing rate and without any resultant incontinence.Keywords: Crypto glandular infection, fistula-in-ano, ligation of intersphincteric fistula tract, sphincter saving operatio

To leave no one behind: Assessing utilization of maternal newborn and child health services by all the 13 particularly vulnerable tribal groups (PVTGs) of Odisha, India

Abstract Background Indigenous tribal people experience lower coverage of maternal, newborn and child healthcare (MNCH) services worldwide, including in India. Meanwhile, Indian tribal people comprise a special sub-population who are even more isolated, marginalized and underserved, designated as particularly vulnerable tribal groups (PVTGs). However, there is an extreme paucity of evidence on how this most vulnerable sub-population utilizes health services. Therefore, we aimed to estimate MNCH service utilization by all the 13 PVTGs of the eastern Indian state of Odisha and compare that with state and national rates. Methods A total of 1186 eligible mothers who gave birth to a live child in last 5 years, were interviewed using a validated questionnaire. The weighted MNCH service utilization rates were estimated for antenatal care (ANC), intranatal care (INC), postnatal care (PNC) and immunization (for 12–23-month-old children). The same rates were estimated for state (n = 7144) and nationally representative samples (n = 176 843) from National Family Health Survey-5. Results The ANC service utilization among PVTGs were considerably higher than national average except for early pregnancy registration (PVTGs 67% versus national 79.9%), and 5 ANC components (80.8% versus 82.3%). However, their institutional delivery rates (77.9%) were lower than averages for Odisha (93.1%) and India (90.1%). The PNC and immunization rates were substantially higher than the national averages. Furthermore, the main reasons behind greater home delivery in the PVTGs were accessibility issues (29.9%) and cultural barriers (23.1%). Conclusion Ours was the first study of MNCH service utilization by PVTGs of an Indian state. It is very pleasantly surprising to note that the most vulnerable subpopulation of India, the PVTGs, have achieved comparable or often greater utilization rates than the national average, which may be attributable to overall significantly better performance by the Odisha state. However, PVTGs have underperformed in terms of timely pregnancy registration and institutional delivery, which should be urgently addressed

Malignant duodeno-colic fistula

Colo-duodenal fistula is a rare complication of gastro-intestinal malignancy and inflammatory bowel disease. The fistula often results in diarrhea and vomiting with dramatic weight loss. Vomiting may be feculent or truly fecal associated with foul smelling eructation. We present an unusual case of colonic carcinoma, where a 61-year-old female patient presented with pain abdomen and vomiting secondary to a malignant colo-duodenal fistula near the hepatic flexure. Ultrasonography showed a mass in the hepatic flexure area, and invasive adenocarcinoma was confirmed on histology from biopsy obtained during colonoscopy. Coloduodenal fistulae from colonic primaries are rare, but early diagnosis may allow curative surgery