The Study and use of Dynamic Programming

When learning algorithms for the first time dynamic programming is one area that is not well understood but it is also a part that should be studied It has been used effectively in numerous fields such as controlling human movement distributing hydroelectric resources and gene sequencing The dynamic programming principle is explained in detail in this article Comparing it to other algorithms at the same time we are able to comprehend dynamic programming s nature as well as its benefits and drawbacks when compared to alternative techniques for problem-solving On the basis of pertinent application examples it then explores the dynamic programming problem-solving techniques and stage

Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p<0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p<0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p<0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

Severe Refractory Pulmonary Sarcoidosis: Case Report and a Review of Newer Therapeutic Options

Patients with sarcoidosis who fail to improve on corticosteroids pose a therapeutic challenge for clinicians, because there is a lack of consensus guidelines to manage these patients with other therapeutic options. Herein, we report one such patient with severe progressive sarcoidosis and review the alternative treatment options in patients with sarcoidosis who progress over corticosteroid therapy

Refractory bronchovascular pleuropulmonary mucormycosis: Case report and difficulties in management

Pulmonary mucormycosis is a life-threatening opportunistic fungal infection. It is considered as a disease of immunocompromised state and is rarely seen in immunocompetent patients. We here report a case of refractory bronchovascular pleuropulmonary mucormycosis, who despite early detection, optimal management with liposomal amphotericin B, and posaconazole therapy followed by surgery, progressed further and led to a fatal outcome. Dual antifungal therapy combined with surgery is the only definitive treatment option available in the literature. Many new therapeutic options for mucormycosis treatment have become available but none have shown promising results, and larger studies are required to assess their efficacy

Primary pleural primitive neuroendocrine tumor: A rare entity

The rare primitive neuro-ectodermal tumors (PNET) are classically described as tumors of the airways that can metastasize to the pleura. We describe here, a rare case of a PNET originating from the pleura in a 52-year-old, nonsmoker female. The patient presented with clinical features of a right sided pleural effusion. Thoracoscopic pleural biopsy revealed malignant small round cell proliferation consistent with PNET, and the final diagnosis was confirmed by immune-histochemical analysis. Fiberoptic bronchoscopy, contrast enhanced computed tomography chest, and positron emission tomography scan did not reveal any primary lung lesion. The patient underwent pleurodesis for symptom relief but refused any definitive therapy

Assessment of quality of life in patients with lung cancer and correlation with staging of disease at time of diagnosis in a tertiary care hospital

Background: Lung cancer is the leading cause of the cancer-related deaths in developed countries. In India, it is usually diagnosed in the advanced stages. Quality of life (QOL) is an important factor to be assessed to aid the therapeutic decisions and know the prognosis of the disease. This study is aimed at the assessment of QOL in patients at the time of diagnosis of lung cancer and correlating them with the stage of lung cancer. There is the paucity of similar data from the Indian subcontinent and the Western world on these issues. To the best of our knowledge, this is the first such paper correlating QOL with the stage of disease, in lung cancer patients. Materials and Methods: A retrospective observational study was conducted on 87 newly diagnosed patients with lung cancer at the Department of Respiratory, Sleep, Allergy, and Critical Care Medicine at the Metro Centre for Respiratory Diseases, Metro Hospital, Noida. Data were collected between January 2015 and June 2015. The QOL data was collected using questionnaires filled at the time of diagnosis of lung cancer and were correlated with the stage of lung cancer. Results: About 81.6% of lung cancer patients were male and 81.6% of patients were smokers. Most of our patients (93.1%) presented with advanced-stage lung cancer and 61.8% already had distant metastasis at the time of presentation. Data from QOL questionnaires revealed lower scores as compared to the Western population, indicating much poorer QOL at the time of diagnosis of lung cancer. Indian patients have more severe and distressing symptoms in comparison to the Western population. Patients had worse symptoms in Stage 3 B or 4, i.e., at the onset of the diagnosis. Conclusion: Lung cancer patients are diagnosed at advanced stages of the disease and have a significantly poor QOL as compared to their Western counterparts. A majority of these patients have a poor QOL that precludes definitive therapy

Primary Pulmonary Synovial Sarcoma: Is it Worth All the Hard Work?

Synovial sarcoma (SS) is highly malignant tumor that occurs mainly in adolescents and young adults and is usually seen in the extremities. However, primary SS arising from the lung is extremely rare, accounting for 0.3% to 1.3%. Primary pulmonary SS (PPSS) is an extremely aggressive malignant tumor that can invade adjacent organs or give distant metastases. Besides clinical evaluation and imaging methods for definitive diagnosis, immunohistochemical examination is must. We report a case of elderly male with left lung mass lesion invading into the pericardium and left-sided pleural effusion with a history of smoking. Positron emission tomography (PET)–computerised tomography (CT)-guided trucut biopsy from lung mass lesion led to the diagnosis, and thoracoscopic pleural biopsy showed the pleural involvement with final diagnosis of PPSS (monophasic type). There are no guidelines for optimal treatment due to the rarity of such tumors. Current treatment includes resectional surgery and adjuvant chemotherapy and/or radiotherapy. But because of advanced age and poor performance status, our patient was not candidate for any treatment but palliation

Geometric properties of Wright function

summary:In the present paper, we investigate certain geometric properties and inequalities for the Wright function and mention a few important consequences of our main results. A nonlinear differential equation involving the Wright function is also investigated

Hemoptysis: Beyond routine chest computed tomography and bronchoscopy

Hemoptysis is considered as a medical emergency which requires urgent stabilization with identification and correction of underlying etiology. Diagnosis of the cause of hemoptysis is not always readily identified after bronchoscopy and conventional computed tomography (CT) chest. Arteriovenous malformation (AVM) is a rare but important cause of massive hemoptysis which can be easily picked up by the use of double turn contrast CT chest. We here report a rare congenital AVM anomaly called Klippel-Trenaunay-Parks-Weber syndrome as a cause of massive hemoptysis and utility of double turn CT in diagnosing AVM as a cause of hemoptysis

Bounds on third Hankel determinant for close-to-convex functions

In this paper, we have obtained upper bound on third Hankel determinant for the functions belonging to the class of close-to-convex functions