Otorhinolaryngological myiasis: the problem and its presentations in the weak and forgotten

Introduction: Myiasis is common in tropical regions, but now increasing incidence is seen in the west due to international travel. Otorhinolaryngological myiasis is uncommon and is seen in diabetics, alcoholics or patients unable in self-care.Objectives: To study presentations of otorhinolaryngological myiasis, identify associated risk factors and species of flies causing myiasis.Methods: Clinical findings and co-morbidities of 67 myiasis cases were noted. Maggots were identified, manually removed, and patients were managed with topical treatment, systemic ivermectin and antibiotics.Findings: Thirty-three nasal myiasis, 13 aural myiasis and 5 patients with oral myiasis were noted. Seven patients with head neck wounds myiasis and nine patients of tracheostome myiasis were recorded.Discussion: Warm humid climate of tropical regions is a major concern along with co-existing conditions like poor sanitation, alcoholism, psychiatric diseases and neuropathies. Hesitancy is seen in attendants and health care professionals to deal with myiasis.Conclusion: Awareness about risk factors is important in avoiding myiasis along with prompt treatment which reduces morbidity. Tracheostome myiasis is an under-documented entity rather than a rare presentation.Keywords: Myiasis, Ivermectin, screwworm, Chrysomya bezziana, Musca domestica, Lucilia sericata.Funding: Non

Russel’s score and diabetes mellitus type 2 “finding the association”: a cross sectional study from one of the districts in Bihar, India

Background: Diabetes has been on the rise since last decade or so with prevalence rate changing as more research is being done. India is one of the most burdened country from diabetes specially type 2. With changing life style other diseases are also on the rise and evidence is being generated to find tangible association. One such disease is periodontitis. As evidence from the State of Bihar for association between periodontitis and diabetes mellitus is negligible this study was conducted to find the same.Methods: A cross sectional observational study in community settings was done for three months on 200 diabetic willing participants. Data was generated using a semi structured pretested questionnaire. Data analysis was done using SPSS version 22.0 and statistical measures of central tendency like mean, mode, median and standard deviation were used.  For establishing association chi square tests were used. P values<0.05 were considered to be statistically significant.Results: 61.5% of the participants were male while 65.5% were from rural area. The study population was on an average on the older side with a mean age of 52±12.15 and on the bulky size with a BMI of 28.85±4.08. Authors got the average Russel’s score to be 1.1±1.79. The mean blood sugar level for fasting was 146.40±59.99 and post prandial levels was 211.59±82.49. A Russel score category of established periodontal disease and terminal disease was present in 77.5% of participants having an altered fasting blood sugar level. Majority of the males had established periodontal disease and terminal disease. Patients with elevated postprandial blood sugar levels had more established periodontal disease and terminal disease.Conclusions: Oral health is definitely associated with diabetes mellitus type 2 and its other factors like duration, glycaemic control, blood sugar levels etc. Public awareness regarding this is minimal. More research and awareness regarding this will help in keeping the diabetic population healthy

Quantized Deep Transfer Learning - Gearbox Fault Diagnosis on Edge Devices

This study has designed and implemented a deep transfer learning (DTL) model-based framework that takes an input time series of gearbox vibration patterns, which are accelerometer readings. It classifies the gear’s damage type from a predefined catalog. Industrial gearboxes are often operated even after damage because damage detection is formidable. It causes a lot of wear and tear, which leads to more repair costs. With this proposed DTL model-based framework, at an early stage, gearbox damage can be detected so that gears can be replaced immediately with less repair cost. The proposed methodology involves training a convolutional neural network (CNN) model using a transfer learning technique on a predefined dataset of eight types of gearbox conditions. Then, using quantization, the size of the CNN model is reduced, leading to easy inference on edge and embedded devices. An accuracy of 99.49 % using transfer learning of the VGG16 model is achieved, pre-trained on the Imagenet dataset. Other models and architectures were also tested, but VGG16 emerged as the winner. The methodology also addresses the problem of deployment on edge/embedded devices, as in most cases, accurate models are too heavy to be used in the industry due to memory and computation power constraints in embedded devices. This is done with the help of quantization, enabling the proposed model to be deployed on devices like the Raspberry Pi, leading to inference on the go without the need for the internet and cloud computing. Consequently, the current methodology achieved a 4x reduction in model size with the help of INT8 Quantization

Evaluation of coronary arteries in congenital heart disease in children : diagnostic comparison of electrocardiogram-gated and non-electrocardiogram-gated computed tomography cardiac angiograpy

Purpose: To compare the visualization and anatomy of coronary arteries in children (≤ 2 years) with congenital heart disease (CHD) on non-electrocardiogram (ECG)-gated and ECG-gated computed tomography angiography (CTA). Material and methods: In this retrospective study, approved by the Ethics Committee of our institute, evaluation of coronary arteries in CHD was performed in 40 children on non-ECG-gated CTA and in 42 children on ECG-gated CTA. The origin and course of the right coronary artery (RCA), left main coronary artery (LMCA), left anterior descending (LAD) artery, and left circumflex (LCX) artery were evaluated by 2 paediatric radiologists independently. Results: ECG-gated CT scans yielded increased (additional) visualization of all the coronary arteries, when compared to non-ECG-gated CT scans. The RCA, LMCA, LAD artery, and LCX artery were visualized in 47.5%, 62.5%, 55%, and 32.5% of children, respectively, on non-ECG-gated studies, while they were visualized in 64.3%, 92.8%, 80.9%, and 62% children, respectively, on ECG-gated studies. The coronary artery anatomical variations were also supplementarily detected more in the ECG-gated group (23.8%) than in the non-ECG gated group (2.5%). Conclusions: ECG-gated CT cardiac angiography studies yield enhanced diagnostic outcomes for the evaluation of the coronary arteries in comparison to non-ECG-gated studies

Appropriateness of Proton Pump Inhibitor Use in Hospitalized Patients: A Cross Sectional Study in a Tertiary Care Hospital in North India

Background: Proton Pump Inhibitors (PPIs) are often prescribed inappropriately among hospitalized patients and same is often continued even after their discharge from the hospital. The inappropriate use of PPIs leads to an increased risk of adverse effects, drug interaction, and unnecessary hospital expenditure for such patients. Aim of this study was to determine the appropriateness of PPIs use among hospitalized patients. Methods: A cross sectional observational study was conducted on hospitalized patients in a tertiary care hospital in Northern India. The clinical records of adult patients hospitalized during April- May 2022 were assessed for the prescribing pattern and appropriateness of PPI use as per the National Institute of Health and Care Excellence (NICE) guidelines. Results: A total of 192 patient’s records were included in this study with the mean age 57 years and 61% of the study participants were males. Overall, 72% (138) of the study participants were prescribed PPIs by intravenous route and only in 28% (54) cases an oral route was preferred. Pantoprazole was the most commonly prescribed PPI in 112 (58%) patients and it was administered by intravenous route among 87 patients (78%) and by oral route in 25 (22%) patients. PPI use was appropriate in 54% of the cases and they were most commonly prescribed for ulcer prophylaxis. This study identified higher use of PPIs was seen in low risk patients for longer duration than indicated. Conclusion: PPIs are being prescribed inappropriately among hospitalized patient unrelated to their widely accepted clinical indications and are often continued unnecessarily once patient is discharged. These results suggest the need of regular audits on use of PPIs clubbed with educational initiatives to promote rational use of PPIs among hospitalized patients

In vitro assessment of Ag and TiO2 nanoparticles cytotoxicity

Background:Silver (Ag) and titanium dioxide (TiO2) nanoparticles are the most eminent nanoproducts. Due to their antimicrobial and antifungal activity, they have been the well commercialized nanosubstances. The hazards associated with human exposure to Ag and TiO2 nanoparticles should be investigated, and hence both the nanoparticles were synthesized to facilitate the risk assessment process.  Methods:Prior to the cytotoxic studies, Dynamic Light Scattering (DLS) and Transmission Electron Microscopy (TEM) were carried out to ensure the particle size. Glutathione (GSH), Nitric Oxide (NO) and superoxide dismutase (SOD) estimated by ELISA method.Results:In the present study, the cytotoxicity of Ag and TiO2 were investigated by using the glutathione (GSH), Nitric Oxide (NO) and superoxide dismutase (SOD) by incubating various concentration of silver (0.25 to 76 mg/mL) and titanium dioxide (0.25 to 2 mg/mL) nanoparticles in different incubation periods (24, 48 and 74 hours at 37°C) in plasma.  Results observed that significant decrease (P <0.0001) in the concentration of GSH associated with increased concentration of NO (P <0.0001) and SOD (P <0.0001) after incubation with silver and titanium dioxide nanoparticles at 24hrs at 37°C, however at 48 hours and 74 hours there is not much change.  Conclusion:The results indicate that silver and titanium dioxide nanoparticles exhibits, nanoparticles mediated cytotoxicity by induction of Reactive Oxygen Species (ROS).

Acid Peptic Disease among Patients with Acute Abdomen Visiting the Department of Emergency Medicine in a Tertiary Care Centre

Introduction: Acid peptic disease is caused by excessive acid secretion or weakened mucosal defense. Symptoms include epigastric pain, bloating, and nausea. Factors like gastric acid, Helicobacter pylori infection, alcohol consumption, smoking, and stress contribute to peptic ulcers. Imbalances between offensive and defensive factors can lead to ulcers. Acid-related disorders impact the quality of life and mortality. Accurate diagnosis and prompt treatment are vital. This study aimed to find out the prevalence of acid peptic disease among patients with acute abdomen in the Department of Emergency Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted from 2 April 2022 and 2 April 2023 among the patients presented in the Department of Emergency Medicine in a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee. All patients presenting with acute abdominal pain in the Emergency Department were included in the study. Patients not giving consent were excluded from the study. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of the 400 patients with acute abdomen, the prevalence of acid peptic disease was found to be 87 (21.75%) (17.71-25.79, 95% Confidence Interval). Conclusions: The prevalence of acid peptic disease among patients with acute abdomen was found to be lower than in other studies performed in similar settings