Prospective study comparing the clinical abdominal scoring system (CASS) with blunt abdominal trauma severity scoring (BATSS) in predicting the necessity of laparotomy in cases admitted with blunt abdominal trauma in GRH, Madurai

BACKGROUND AND OBJECTIVE: Abdominal trauma is one of the most common causes among injuries caused mainly due to road traffic accidents. Motor vehicle accidents account for 75 to 80 % of blunt abdominal trauma Blunt abdominal trauma is usually not obvious. The knowledge in the management of blunt abdominal trauma has progressively increasing due to the in-patient data gathered from different parts of the world. In spite of the best techniques and advances in diagnostic and supportive care, the morbidity and mortality remains at large. METHODS: This study is a prospective study of blunt abdominal injuries during the period from May 2016 to August 2017 in Trauma Care Centre, Government Rajaji Hospital, Madurai Medical College. Number of cases studied is 100.After initial resuscitation and achieving, hemodynamic stability, all patients were subjected to careful examination, depending on the clinical findings, the clinical abdominal scoring system score (CASS) was calculated and all patients undergo the FAST ultra sound and plain radiograph of chest and abdomen scan and Blunt abdominal trauma severity score (BATTSS) is calculated then. Decision was taken for further investigations and CT scan if the patient is stable. If patient is hemodynamic unstable the patient is resuscitated and planned for emergency surgery if indicated Patients are followed up for a week to determine their possible need for laparotomy. The documented values of CASS and BATSS were recorded and was analysed with respect to the outcome whether or not the patient needed laparotomy or managed conservatively. Analysis was done using SPSS software. RESULTS: Our study revealed that strong correlation of higher CASS and BATS Scores with increased mortality. The Average CASS score of the operative group was 11.56 with a standard deviation of 2.02. The mean BATSScore of the operative group was 13.4 with a standard deviation of 2.17 The higher scores of both CASS and BATSS needed laparotomy (value of more than 12) with a specificity of 100% for both scoring systems

A Study of Correlation of Silent Myocardial Ischemia with Microalbuminuria in Patients of Type 2 Diabetes Mellitus

BACKGROUND: Diabetes is a common and serious disease leading to chronic, mostly irreversible macro and microvascular complications. Silent myocardial ischemia common in diabetic patients because of autonomic neuropathy. Microalbuminuria is one if the important risk factor for endothelial dysfunction that leads to coronary artery disease. So we decided to correlate microalbuminuria with asymptomatic myocardial ischemia. METHODS: 50 patients attending diabetic OPD at Government Vellore medical college and hospital were studied. Asymptomatic patients with no symptoms or history of ischemic heart disease and normal ECG with microalbuminuria were enrolled in this study. A complete clinical examination was done. RESULTS: Out of 50 diabetic patients with microlbuminuria in my study. Treadmill exercise test positive cases were 32 (64%) and negative cases were 18(36%) patients, which implies that microalbuminuria is an independent risk factor for SMI. 13 patients with diabetes duration more than 10 years, Treadmill test was positive in all 13 patients (100%). Duration of DM significantly associated with SMI. 30 patients with diabetes duration between 6-10 years. Treadmill test was positive in 19 patients (63.3%). 7 patients with diabetes duration of less than or equal to 5 years. Treadmill test positive in 5 (71.4%). CONCLUSIONS: Hence, in this study it was observed that longer the duration of diabetes with microalbuminuria, greater is the predisposition for silent myocardial ischemia. In the present study, 64% of asymptomatic patients with microalbuminuria had a positive treadmill exercise test. Hence, we concluded from this study that microalbuminuria is an independent risk factor for silent myocardial ischemia

Effect of osmotic stress on in vitro plant growth hormone production by osmotolerant bacteria isolated from chilli phyto microbiome

The present study was conducted to determine the effect of osmotic stress on the plant growth hormone production by six osmotolerant plant growth promoting bacterial strains. These strains originated from the phytomicrobiome of chilli cultivated in the drought prone areas of Andhra Pradesh. They possessed multiple plant growth promotion traits including the ability to produce a variety of plant growth hormones. The effect of osmotic stress on the plant growth hormone production was determined by High Performance Liquid Chromatography (HPLC) under normal and in vitro osmotic stress conditions using 25% Poly Ethylene Glycol (PEG) 8000. In general, it was observed that osmotic stress impacted the plant growth hormone production of the isolates, but nevertheless plant hormones were detected in all the bacterial strains. An exception to this was the cytokinin molecule zeatin riboside, which was produced at higher levels by five of the six bacterial isolates under osmotic stressed conditions

Effect of osmotic stress on in vitro plant growth hormone production by osmotolerant bacteria isolated from chilli phyto microbiome

The present study was conducted to determine the effect of osmotic stress on the plant growth hormone production by six osmotolerant plant growth promoting bacterial strains. These strains originated from the phytomicrobiome of chilli cultivated in the drought prone areas of Andhra Pradesh. They possessed multiple plant growth promotion traits including the ability to produce a variety of plant growth hormones. The effect of osmotic stress on the plant growth hormone production was determined by High Performance Liquid Chromatography (HPLC) under normal and in vitro osmotic stress conditions using 25% Poly Ethylene Glycol (PEG) 8000. In general, it was observed that osmotic stress impacted the plant growth hormone production of the isolates, but nevertheless plant hormones were detected in all the bacterial strains. An exception to this was the cytokinin molecule zeatin riboside, which was produced at higher levels by five of the six bacterial isolates under osmotic stressed conditions

Role of Lateral Anal Sphincterotomy Versus Maximal Anal Dilatation in Reducing Post Operative Pain after Open Hemorrhoidectomy: A Comparative study

INTRODUCTION: Haemorrhoids are one of the most frequent anorectal disorders to affect humans. They are the most common cause of bleeding per rectum and cause considerable pain and suffering. Numerous features have been appealed to be the aetiologies of haemorrhoidal progress and enlargement, which includes constipation and sustained straining while defecation. Lateral Anal Sphincterotomy (LAS) after a Milligan Morgan Haemorrhoidectomy significantly reduces pain in the first post-operative period. High anal pressures are common in patients with haemorrhoids suggesting that they may have a pathogenic role. Internal Sphincterotomy avoids pain, urinary retention and stenosis and is safe. Maximal Anal Dilatation (MAD) is based on careful but firm dilatation of the anal canal in order to reduce the anal canal pressure for management of Fissure in ano. This study was conducted to compare the post-operative pain in two groups of patients treated with Lateral Anal Sphincterotomy and Maximal Anal Dilatation following a Milligan Morgan Haemorrhoidectomy. AIMS AND OBJECTIVES: To assess and compare the outcomes of the postoperative pain in Lateral anal sphincterotomy against Maximal Anal Dilatation following a Milligan-Morgan Haemorrhoidectomy in terms of Postoperative pain. METHODS: 50 patients with a diagnosis of grade 2, 3 or 4 hemorrhoids were taken into the study. Each patient was randomly allotted into one of 2 groups: a) Group A: Patients subjected to Lateral anal sphincterotomy b) Group B: Patients subjected to Maximal anal dilatation All patients underwent Milligan Morgan hemorrhoidectomy followed by either Lateral Anal sphincterotomy or Maximal anal dilatation based on the group allotted. All patients received antibiotics in the form of Inj. Cipro 500mg TDS and Inj. Metrogyl 500mg TDS with first dose given at time of anesthesia. All patients were advised SITZ BATH following removal of anal pack post operatively. Post operative pain, pain during the first postoperative bowel motion, early postoperative complications, (urinary retention/reactionary bleeding/flatus or faeces incontinence) and duration of hospital stay were evaluated. Severity of post-operative pain was assessed according to the frequency of administration of analgesic, needed to control the pain for a patient and using visual analog scale as given below. Objective Pain level was categorised as ‘Mild’ (1 point) if required analgesics were 02/48hours to control the pain, ‘Moderate’(2 points) if numbers were 3-4/48hours and ‘Severe’ (3 points) when analgesics were >4 in numbers. Subjective pain score will be assessed on the 2ndpost operative day using Wong Baker’s Faces pain rating scale. A combined total score is calculated by adding up objective and subjective pain scores. On the 7th postoperative day a careful digital-rectal examination (DRE) was done in all the patients to assess the anal tone and anal stenosis if present. RESULTS: Out of 50 patients, 25 (50%) of them were manages using Lateral Anal Sphincterotomy and 25 of them (50%) were managed using Maximal Anal Dilatation. • Among 50 patients, 33 (66%) of them had normal sphincter tone on day 7 while 8 (16%) of them had low sphincter tone and 9 (n=18%) of them had high sphincter tone. • One-way ANOVA showed that pain management was better using Lateral Anal Sphincterotomy and varies from the group that had maximum anal dilatation. ANOVA was significant with F=60.293 and p-value very highly significant. CONCLUSION: With the above factors and the study results it is safe to conclude that Lateral Anal Sphincterotomy is far better than Maximal Anal Dilatation as an adjunct to Open hemorrhoidectomy to overcome the post operative pain severity

Implementing Efficient Search Results and Navigation in website J.Prasanth kumar

Designing structured website and organizing search results in website is Challenging task. For this we propose mathematical programming model to improve user navigation as well as novel search interface that enables the user to navigate large number of query results by organizing them using the concept hierarchy. The results are organized into a navigation tree. At each node expansion step we implement classification algorithms [TF-IDF, SVM] for efficient classification of nodes and an advanced k-means algorithm for assigning priorities to the web site navigation links based on the efficient content retrieved. It reveals only a small subset of the concept nodes finally the expected user navigation cost is minimized

Study of insulin resistance and antioxidant vitamin status in prostate cancer patients

The incidence of prostate cancer is 5 per 100000 in southern and eastern Asia. Both genetic and environmental factors have been implicated in its etiology. The mitogenic and growth stimulatory effects of Insulin growth factor may be involved in prostate carcinogenesis. To evaluate serum insulin and insulin resistance was passed by HOMA- IR. Prostatic specific antigen passed by immune-enzymatic assay. Vitamins were estimated by high performance liquid chromatography. In our study 30 prostate cancer patients aged 60-80years were taken as cases. 30 normal age matched disease free person were taken as controls in both groups, Insulin resistance and antioxidant vitamin status was studied.  In the present study, the value of HOMA-IR was (P <0.05) is significantly higher compare to controls. Serum vitamin E and vitamin C values for cases was reduced (P <0.05) significantly lower than controls. The development of prostate cancer is a multistep process. Hyperinsulinemia associated with insulin resistance may play a role in pathogenesis of prostate cancer. Prostate cancer cells generate high levels a ROS

A low-energy rate-adaptive bit-interleaved passive optical network

Energy consumption of customer premises equipment (CPE) has become a serious issue in the new generations of time-division multiplexing passive optical networks, which operate at 10 Gb/s or higher. It is becoming a major factor in global network energy consumption, and it poses problems during emergencies when CPE is battery-operated. In this paper, a low-energy passive optical network (PON) that uses a novel bit-interleaving downstream protocol is proposed. The details about the network architecture, protocol, and the key enabling implementation aspects, including dynamic traffic interleaving, rate-adaptive descrambling of decimated traffic, and the design and implementation of a downsampling clock and data recovery circuit, are described. The proposed concept is shown to reduce the energy consumption for protocol processing by a factor of 30. A detailed analysis of the energy consumption in the CPE shows that the interleaving protocol reduces the total energy consumption of the CPE significantly in comparison to the standard 10 Gb/s PON CPE. Experimental results obtained from measurements on the implemented CPE prototype confirm that the CPE consumes significantly less energy than the standard 10 Gb/s PON CPE