Case Record

EMOTIONALLY UNSTABLE PERSONALITY: Patient was apparently normal till 11 yrs of age with mild hard of hearing. Around that age he stopped going to school due to financial problem &started to go to work. He maintained well with family members and others without any significant behavioural problems. At that time, once his uncle commented about his hearing impairment in front of others, which made him very much irritated; he left that place immediately. Even after reaching home, he continued to have extreme irritability and restless following which around 12.00 am at night. He went to his uncle’s place by walk which was 5kms away and assaulted him. His uncle sustained severe injury. He ran back to home as the neighbours and others rushed to the place seeing the incident. After this as they were relatives , they didn’t make much issue about that incident. For the next 1 yr he started working as an unskilled labourer in his own village. He used to have a occasional anger outburst leading to quarrel in his work place and in his family circle either for trivial reason or if his hearing impairment being criticised by others. Later, at 13 yrs of age, he came to Chennai with his elder brother and started working as an unskilled labourer in constructional work. He stayed along with his brother and other co-worker. At that time he was introduced to brandy by his friends, he used to consume about <90ml, once in 10-15 days. By the end of April 2011, he was brought to IMH with c/o. Irritability, excessive anger outburst, binge drinking and increased sexual thought. From past 2months, he is not going for work telling he is sick and he is on regular treatment since then. He is on T.sertraline50mg110, T.Diazepam5mg001at present. No h/o. Hearing voices/ seeing images. No h/o. Pervasive low mood/ suicidal ideas/ suicidal attempt No h/o. Violation of rules. No h/o. Head injury/ Fever/ seizure/ loss of consciousness. No h/o. Haematemesis/ malaena No h/o. Withdrawal symptoms. PERSISTANT DELUSIONAL DISORDER, SOMATIC TYPE WITH MODERATE DEPRESSIVE EPISODE: Patient was apparently normal 2years back. He was working as a painter, regular to work. He was living alone as his parents expired and his sisters are married. He noticed that his body weight is increasing gradually and he also noticed that his breasts are increasing in size gradually, after he noticed these changes he felt that his body is developing feminine features and slowly he is becoming a female. He also felt that his body is becoming softer comparatively it was hard before. He felt his abdomen increasing in size and becoming softer as females, he feels even if abdomen size is increased in males it will be hard and not soft as females. He also noticed that he is losing hair from his moustache, he has reduced his frequency of shaving his beard as it takes around 20 days to re grow and previously it grew within a week. He also felt he is losing hair from other parts of his body like chest, legs and arms. All these features made him think that he is acquiring female characteristics and day by day he is changing into a female gradually. Following this he consulted sexologist in Chennai, he was told that till his 58 years of age his hormones might change and he has chances of converting in to female. He was advised blood investigations and asked to come back. 2 months back he again approached another astrologist and performed some rituals which didn’t improve his symptoms. He was advised by one of his friends to consult in IMH. So he came here. No h/o. Hearing voices. No h/o. Thought broadcasting/ withdrawal/ insertion/ echo. No h/o. Excessive happiness/ fear/ anxiety. H/o. Fall from ladder 6 months back, there was no loss of consciousness or any injuries. He consulted a doctor and was treated symptomatically for his pain. No ENT bleed. No h/o. Seizures. No h/o. Recurrent thoughts or acts. PERVASIVE DEVELEPMENTAL DISORDER WITH SEIZURE DISORDER: Master Y ,10 years old male child second born for a 3rd consanguineous parents with history of mother taking abortifacient in the form of two tablets for three days at the 40th (11/2 month) of LMP, as she thought that her husband will not be able to give proper (financial) care for that pregnancy. He already had not given proper financial care for her even before the pregnancy. During the same period she developed dental pain and she consulted private dentist. The dentist advised tooth extraction, but hesitated to do it because of her pregnancy and explained the possibility of abortion. She took the risk of abortion willingly and proceeded with extraction with the same dentist as she expected an abortion after tooth extraction and did not do so. Then she consulted gynaecologist for termination of pregnancy. She went to the operation theatre as per the advice of the gynaecologist for D&C. As she was being prepared in the theatre and when she saw the instruments, became afraid and ran out the theatre then out of the hospital. She went to her mother’s home, the pregnancy continued uneventfully. She delivered a male baby FTND in hospital without perinatal complications. After the baby was delivered with deformed Right pinna as like that his maternal Grand father. Cried soon after birth. Breast fed on the day of birth. Baby birth weight 3.2 kgs. Even in the ward used to be hyper activity restless, not listening to ward staff and doctors, not co-operating to interview frequent running out the room. He used to carry wire basket with water bottle in it throught day and during night even when he is sleeping. No h/o. Recurrant high fever. No h/o. Projectile vomiting. No h/o. Head injury with LOC. No h/o. Jaundice. No h/o. Unedible object eating. DEPRESSIVE EPISODE: Mrs. M was apparently normal 5 years back. She started to experience headache on both side occur in the temple region, and expanding to all over the scalp. It was mild in severity and was static throughout the day without obvious precipitating factor. She after experiences burning sensation over the palm and feet at times. As the headache was continuous, consulted general practitioner, advised spectacles which didn’t follow. She continued to live with headache and maintained self and family and starting from 7 months back, she heard some unknown male voices calling her by name at night during sleep. She would wake up and search for them in house. At times she would feel calling with gestures by their hand, while hearing voices and slapping her. She would continue to experience for most of the day in a month at night time. 4 months back, she started to hear the voices even when she awake. One night she wanted to search out of home as she continued to hear some 7 male voices calling her by name. Her husband needed to resist her. From then she continued to hear voices irrespective of day or night. 3 months back, her son was admitted in a hospital following severe abdominal pain and was said to be operated for some growth in intestine which was later said to be normal in another hospital. From that time she started to be dull and withdrawn. She had avoided interacting with other family members and would claim of feeling sad and would complain of burning sensation spreading from head down upper limb, back, genital region , lower limb and feet. She would complain of lack of energy, when her husband asked to do maintain home and household work and simply sitting and lying in the bed. She would not maintain her personal care and take food. Needed to feed, taking bath, brushing and even changing and adjusting clothes. She would simply sit and reply occasionally after continued questioning. She had expressed suicidal ideas on her own. She continued like that for about 20 days and then was taken to Meenakshi hospital for general consultation, where she was investigated routine blood investigation including Thyroid Function which have said to be normal. Then she was referred to Psychiatrist, where she was diagnosed as Acute Stress Reaction with Depression and treated with T.Dazide 50mg , T.Lorazep 0.5mg 102, T.Olanz 5mg 101, T.Nitrzepam10mg 001 For the last 2months, she had improvement in slowness of activities andspeech. She started to have the feeling of running out of home, getting suicidal ideas. She felt herself worthless to her, but hadn’t attempted to do so. Her sister used to console her whenever she expressed such ideas. She could not involve in previously pleasurable activities and continued to have headache, not able to do household works. She hadn’t heard voices for the last 1 month. As she was not affordable for medicine, she came here for consulation. No h/o. Head injury / LOC /Seizure /fever. No h/o tall claims /elated mood /excessive spending. No h/o. Repetitive act No h/o. Excessive fear /Tremor /sweating / palpitation. SCHIZOPHRENIA- PARANOID SUBTY: Mr. F was normal 6 years back. He was working as a car driver. He was regular at work, earned 500-600 rupees /day. ¼ th of money gives to the mother for household purpose, remaining money spent with his friends. After spending with his friends, went home late in the night regularly. Most of the time spend with his friends. During that time, he used smoking cigarettes and panparag, super pakku and occasionally use cannabis and alcohol- six months once. He slowly developed multiple somatic complaints like headache, ear ache, nasal block, mouth ulcers, body tiredness, weakness of limbs, abdominal pain, nausea and digastric problems. He took frequent consultation with frequent doctors treated symptomatically. He was not satisfied. Instead of that he also frequently took certain drugs (steroid, analgesics) over the counter for the same complaints. One day he consulted one new physician for the same complaints. After finishing his clinical examination, he said these are the complaints also occur in HIV/AIDS patient. He enquired about any contact with a commercial sex worker. He accepted his contact with a commercial sex worker 9 years ago. Doctor gave reassurance and advised regarding HIV awareness and precaution. He was apprehensive and preoccupied that he had HIV. He did a blood test to find out whether he had HIV, the blood result was negative. He was also worried as his parents were unconcerned about his marriage. Gradually he become dull and withdrawn, not going to work, sitting idly. His intake of food decreased. He neglected his self care. He had to be forced by his mother to take bath and change dress. He attempt suicide by using insect poison and oleander seeds. He never expressed these ideas to anybody, he not make a suicidal notes. The attempt was made when no one was present. The attempt was made at afternoon (2pm). He vomited soon (1hr). His mother return back from work, she took him to the hospital. Then treatment was given. She brought him to IMH on 30.6.04. He was diagnosed as a case of Anxiety with Depression. He was treated with T.Amitriptyline5mg. No h/o. Increased energy and activities. No h/o. Spending spree. No h/o. Colourful dressing. No h/o. Repeated checking and washing. No h/o. Excessive fear for particular place. No h/o. Crying spells

Female Body Language that is known through the Songs of Natrinai Avvaiyar

During the Sangam age, both male and female poets sang about the situations of women. The thoughts and understandings of women by the male poets are different. The female body songs of the male poets are shown as attractive and for the sake of lust. It is the same that can be seen in the songs of the female poets with a great deal of regret. This article attempts to explain these points. Titled ‘Pen Udal Mozhi (Female Body Language)’, which is known through the songs of Natrinai Avvaiyar, this article explains the information about the body language of a woman in Natrinai, one of the Ettutthokai books (The Eight Anthologies) of Sangam literature. Only four poems of a female poet, Avvaiyar, have been explained in the preface along with the songs of some male poets, feminist thought in Sangam literature, interpretation of body language, eight primary elements of body language, the body language of women, body language, organ welfare fiction, women and makeup, the destruction of organ welfare, conclusion, sub-book list, etc. In this article, it is explained that only the concepts spoken about the woman's body are body language

Choice of parents for developing two line hybrids in rice (Oryza sativa L.)

An investigation was carried out to evaluate two line hybrids in rice for yield traits. Four TGMS lines and eleven testers were crossed in line x Tester design. Greater proportion of sca variance was observed for all the characters which revealed that preponderance of non- additive gene action governing traits concerned and selection procedures based on the accumulation of additive effects would be successful in improving these traits. The line TS09 24 and testers viz., T 2006, KDML 105, Improved white ponni and BPT 5204 were found to be good combiners for the yield and yield components. The best hybrids based on sca value, TNAU 27S x Improved white ponni was derived from low x low combiners for thousand grain weight and TS 29 X ADT 38 for the number of filled grains per panicle spikelet fertility. The best performing hybrid TS 29 x KDML 105 produced 54.25g of grain yield per plant in 128 days which was 92.89 and 85.47 per cent increase over the standard checks CORH 3 and Improved white ponni respectively. This hybrid also recorded 27.32 and 64.30 per cent increase CORH 3 and Improved white ponni for thousand grain weight. Hence, the two line hybrid breeding system, utilizing thermo sensitive genic male sterility is economically feasible as well as viable alternative to cytoplasmic male sterile (CMS) based three line breeding due to much simplified hybrid seed production

Ontology based Comprehensive Architecture for Service Discovery in Emergency Cloud

Abstract — Disasters such as Tsunami, Landslides, and cyclones occur frequently and a strong emergency management system is required to manage such situations. These kinds of crisis circumstances are expected to increase in future. The role of Information and communication technology can largely aid in handling calamities and provide first aid support. The characteristics of Cloud computing such as sharing on demand, connecting communities and offering everything as a service clearly indicate that it can contribute to crisis without affecting business continuity. Hence efforts have taken to articulate web services and the cloud infrastructure as ontology, in the perspective of emergency management which can improve the understanding of this proposed agent based comprehensive architecture

Diabetic Retinopathy Diagnosis Categorization Using Deep Learning

Diabetic Retinopathy (DR) is an eye disease associated with chronic diabetes. DR is the leading cause of blindness among working aged adults around the world and estimated it may affect more than 93 million people. Progression to vision impairment can be slowed or controlled if DR is detected in time, however this can be difficult as the disease often shows few symptoms until it is too late to provide effective treatment. Currently, detecting DR is a time-consuming and manual process, which requires an ophthalmologist or trained clinician to examine and evaluate digital color fundus photographs of the retina, to identify DR by the presence of lesions associated with the vascular abnormalities caused by the disease. The automated method of DR screening will speed up the detection and decision-making process, which will help to control or manage DR progression. This paper presents an automated classification system, in which it analyzes fundus images with varying illumination and fields of view and generates a severity grade for diabetic retinopathy (DR) using machine learning models such as CNN, VGG-16 and VGG-19.This system achieves 80% sensitivity, 82% accuracy, 82% specificity, and 0.904 AUC for classifying images into 5 categories ranging from 0 to 4, where 0 is no DR and 4 is proliferative DR

Analysis of Priority Queueing System with Working Breakdown,Vacation and Vacation Interruption under Random Environment

study priority queueing system consisting of working breakdown, repair, single vacation and vacation interruption. At a breakdown instant during the busy period, without stop the servie, the server provides service at slower rate for the current customer. After completion of priority service, depending on the environment, the server can choose type I or type II vacation. Both types of vacation are considered as a single vacation. On completion of type I vacation if the server finds thepriority queue is empty, he has the option to take type II vacation. During the type II vacation, when priority customers arrive the server has the option to interrupt the vacation. We use the established norm which is the corresponding steady state results for time dependent probability generating functions are obtained. Along with that, the expected waiting time for theexpected number of customers for both high and low priority queues are computed. Numerical results along with the graphical representations are shown elaborately

AN M[X]/G/1M^{[X]}/G/1 QUEUE WITH OPTIONAL SERVICE AND WORKING BREAKDOWN

In this study, a batch arrival single service queue with two stages of service (second stage is optional) and working breakdown is investigated. When the system is in operation, it may breakdown at any time. During breakdown period, instead of terminating the service totally, it continues at a slower rate. We find the time-dependent probability generating functions in terms of their Laplace transforms and derive explicitly the corresponding steady state results. Furthermore, numerous measures indicating system performances, such as the average queue size and the average queue waiting time, has been obtained. Some of the numerical results and graphical representations were also presented

An Overview of Personalized Recommendation System to Improve Web Navigation

We present a new personalized recommendation system, which means the searches of each user is done according to their interest which is based on ranking or preference method. It also maintains the logs which records the sessions of each user and brings out the exact data required by the user. This is done by fetching the data that is already stored in the database. Web server logs maintains history of page results and consists of a log file which automatically creates and maintains the list of activities performed by the users. For extracting the data according to the user’s previous searches, we are using Stemming Algorithm. The Stemming Algorithm is a process where the exact, meaningful words are extracted from the URL. Because of this process the user’s search time will be reduced. It also improves the quality of web navigation and overcomes the limitation of existing system. In the proposed system we extract user’s behaviour from web server logs in the actual process whereas, in the anticipated system, the user’s behaviour is done with the help of cognitive user model and we perform the comparison between the two usage processes. The data produced from this comparison can help the users to discover usability issues and take actions to improve usability. In the anticipated usage the cognitive user model is done that can be used to simulate or predict human behaviour or by performance and task. Finally, the system is executed by using the top-k ranking algorithm. The advantage of this system are accuracy and better processing speed. The user’s convenience deals with the ease of navigation which helps the users to interact with their interface

Tribal farmers' perceived constraints in the adoption of good dairy farming practices in the northern hills zone of Chhattisgarh, India

This study was carried out during the year 2014-15 to explore the perceived constraints encountered by the tribal dairy farmers in the successful adoption of Good Dairy Farming Practices (GDFPs). Out of 27 districts in Chhattisgarh, three tribal populated districts were selected for this study from northern hills zone of the state and totally 300 respondents were selected for constraints analysis. The study revealed that 55.33 % of the tribal farmers realised that insufficient knowledge and awareness towards good dairy farming practices is the major constraints in the adoption process, majority (70.00 %) of the tribal farmers perceived that lack of progeny tested superior bulls for AI and natural service are the main constraint in the adoption of good breeding practices, about (75.70 %) of the tribal farmers expressed the higher cost of concentrates, mineral mixtures and vitamin supplements are the main constraints in the adoption of good feeding practices, majority (70.70 %) of the tribal farmers responded that less number of veterinary hospitals in their locality is the main constraints and its ranks first in the healthcare constraints list, little less than three-fourths (67.67 %) of the tribal farmers articulated that lack of advanced farm machineries (portable milking unit) for small dairy holders is the main constraints in the adoption of good management practices and about three-fourths (75.30 %) of the tribal farmers conveyed that the lack of insurance for longer period is the main constraints and tops in the socio-economic constraints. This constraints study will be highly useful to policy makers and the scientific community to assess the dairy production technologies for refinement and appropriate strategies can be formulated to promote tribal dairying from subsistence level to intensive in order to increase the income from dairy sector