Clinico-pathological features and outcome of acute appendicitis: A prospective study in our institution

AIM OF THE STUDY: 1. To study the various clinical presentation of acute appendicitis. 2. To study the age and sex distribution. 3. Role of ultrasonogram in diagnosis. 4. Per operative appearance of appendix and peritoneal cavity. 5. Post operative complications and follow up. 6. HPE report of appendix after appendicectomy. STUDY DESIGN: Prospective study. MATERIALS AND METHODS: This study conducted in the department of General surgery, Government Stanley Medical College & Hospital from November-2016 to August 2017. This study includes the patients with features suggestive of acute appendicitis presented to us within 24-48 hrs. Features are RIF Pain, Rebound tenderness and leukocytosis + any one of the following features such as anorexia, nausea/ vomiting, diarrhea, fever and tachycardia. A detailed history and clinical examinations of the patient is carried out at the time of admission with special references to demographic characteristics, symptoms, signs and disease chronology etc. After admission patient’s Pulse, temperature and respiratory rate chart, routine blood investigations and USG are done and the findings are recorded. On the basis of history, clinical examinations and investigations, a diagnosis of acute appendicitis will be made and Emergency Appendectomy is performed if indicated. Per-operatively appearance of appendix and peritoneal cavity are recorded. After Appendectomy, all specimens are sent for Histopathological examination and findings are recorded. Post operatively patients are followed up for any complications for one month. RESULTS: A total of 601 patients were treated for appendicitis during this period with a male incidence 55.4%. The most common age group was the second decade, while most common symptom was abdominal pain and most common sign was right iliac fossa tenderness. Ultrasonography showed evidence of acute appendicitis in 84.9% and leucocytosis in 80.9%. The most common Histopathological report was acute appendicitis (51.4%). CONCLUSION: Diagnosis of acute appendicitis in our setting is still based on high index of suspicion following clinical evaluation. Combining this with laboratory findings and ultrasound scan has yielded an acceptable negative appendectomy rate. We advocate routine use of ultrasound along with clinical evaluation and laboratory tests for the timely diagnosis of acute appendicitis and an early surgical intervention to prevent complications

Wavelet and FFT Based Image Denoising Using Non-linear Filters

We propose a stationary and discrete wavelet based image denoising scheme and an FFTbased image denoising scheme to remove Gaussian noise. In the first approach, high subbands are added with each other and then soft thresholding is performed. The sum of low subbands is filtered with either piecewise linear (PWL) or Lagrange or spline interpolated PWL filter. In the second approach, FFT is employed on the noisy image and then low frequency and high frequency coefficients are separated with a specified cutoff frequency.Then the inverse of low frequency components is filtered with one of the PWL filters and the inverse of high frequency components is filtered with soft thresholding. The experimental results are compared with Liu and Liu's tensor-based diffusion model (TDM) approach

USER PERCEPTION TOWARDS SOCIAL NETWORKING SITES - AN ANALYTICAL APPROACH

A social networking site (SNS) or social media is an online platform that people use to build social networks or social relations with other people who share similar personal or career interests, activities, backgrounds or real-life connections. The advent of Social Networking sites and its resources have revolutionized the communication and social relation world. This paper aims to assess the user perception towards SNS like Facebook, Twitter and LinkedIn. In the study data was obtained through structured questionnaire collected from 250 users and the research data was tested using Percentage analysis, chi-square and spearman’s rank correlation. Factor of gender, age and purpose of social networking sites of Facebook users have significant association with level of perception. Age, occupation and annual income of Twitter users have significant association with level of perception and Gender, age and occupation of Linkedin users have significant association with level of perception. The study says there is a moderate association between ranks of Facebook and Twitter. Facebook was the most popular site compared to other Social Networking sites

A Study on Bacteriological Profile of Pyoderma in a Tertiary Care Hospital

BACKGROUND AND OBJECTIVES: Bacterial skin infection is one of the common skin problem in dermatology clinics among which pyoderma constitutes a major portion. Pyoderma is known for its chronicity, recurrence and other complications. The management of pyoderma has now become complicated due to the rapid emergence of multidrug resistance among the commonly isolated etiological agents. Thus, this study was carried out to establish the common causes of primary and secondary pyodermas, as well as to determine the antibiotic susceptibility pattern of the isolated pathogens. METHODOLOGY: The present study comprised of 200 randomly selected cases of clinically diagnosed Pyoderma, both primary and secondary, attended the Department of Dermatology, RGGGH, during the study period March 2017 - February 2018. Two sterile swabs from skin lesions was taken aseptically and one swab for Direct Gramstaining and other for Culture, done on Nutrient agar,Blood agar and MacConkey agar and incubated at 37o C. Organisms were identified using standard operative procedures. Antimicrobial susceptibility testing was done on Mueller Hinton Agar by Kirby-Bauer Disc Diffusion method as per CLSI guidelines. STATISTICAL ANALYSIS: Data were compiled, tabulated and analyzed using the statistical software SPSS version 16.0. P < 0.05 was considered statistically significant. RESULTS: The incidence of pyoderma in our study was 1.4% with male preponderance and common in 21-30 years of age group (39%). Secondary pyoderma (71%) was more common than Primary pyoderma (29%). Infected pemphigus was the commonest clinical type followed by folliculitis. Majority of the patients belongs to the lower income group. Among 200 samples processed 177 yielded growth whereas 23 samples showed no growth. Out of 177 cases that yielded growth 165 cases showed only one type of organism whereas 12 cases showed two types of organisms. Staphylococcus aureus (74.6%), was the most common organism isolated from both primary and secondary pyoderma followed by Pseudomonas aeruginosa (5. 8%). S. aureus was 100% sensitive to linezolid followed by Chloramphenicol (90.8%), tetracycline (79.4%), Gentamicin (78%) Cotrimoxazole (56.7%) and Erythromycin (43.3%). Most of the isolates were resistant to ciprofloxacin (75.9%) and penicillin (87. 9%). Out of total 141isolates of S. aureus, 113 (80.1%) were MSSA and 28 (19.9%) were MRSA. Among 28 MRSA isolates ,25(89.3%) were Mupirocin sensitive and 3 (10.7%) were highlevel mupirocin resistant. All the Gram-negative isolates showed 100% sensitivity to Imipenem and most of the strains were resistant to one or more antibiotics. CONCLUSION: This study gives an indication of the present pattern of bacteriological profile of pyodermas in a tertiary care hospital. With the knowledge of common causative organism and their resistance pattern, proper antibiotic therapy can be given, thus avoiding unnecessary medication and also keep newer antibiotics in reserve for use only when necessity arises. Therefore, timely recognition, and prompt bacterial diagnosis and antibiotic susceptibility testing is very important for the management of pyoderma and also to prevent further major complications

Multipath Ant Colony Optimization Algorithm (MBEEACO) to Improve the Life Time of MANET

MANET selects a path with least number of intermediate nodes to reach the destination node. As the distance between each node increases, the quantity of transmission control increases. The power level of nodes affects the simplicity with which a route is constituted between a couple of nodes. This research paper utilizes the swarm intelligence technique through the artificial bee colony (ABC) algorithm to optimize the energy consumption in a dynamic source routing (DSR) protocol in MANET. The ABC algorithm is used to identify the optimal path from the source to the destination to overcome energy problems. The performance of the proposed MBEEACO algorithm is compared with DSR and bee-inspired protocols. The comparison was conducted based on average energy consumption, average throughput, average end-to-end delay, routing overhead, and packet delivery ratio performance metrics, varying the node speed and packet size. The proposed MBEEACO algorithm is superior in performance than other protocols in terms of energy conservation and delay degradation relating to node speed and packet size

A study to assess the effectiveness of structured teaching programme (STP) regarding prevention of central line associated blood stream infection in terms of knowledge and skill among staff nurses in selected hospital at Dharmapuri

STATEMENT OF THE PROBLEM: “A Study to Assess the Effectiveness of Structured Teaching Programme (STP) regarding Prevention of Central Line Associated Blood Stream Infection in knowledge and Skill among Staff Nurses in selected Hospital at Dharmapuri” Hospital Acquired infection (MRSA-CLABSI) remains an important aspect in medical institute today. These infections may involve patients, health care worker and visitors. In spite of increase morbidity, they also account for a considerable financial and personal burden. Though its prevention is extremely simple and easy to practice, yet it is often over looked. This is leading to distressing consequences for both health care workers and their patients, so minimum standard safety precaution therefore needed to adopt to ensure compliance with the guidelines of the infection control programme and awareness need to be created among the staff nurses about infection control1. The present study aimed at assessing the effectiveness of Structural Teaching Programme (STP) on CLABSI in terms of knowledge and skill among staff nurses. OBJECTIVES: 1. To assess the level of knowledge of staff nurses regarding prevention of central line associated blood stream infection. 2. To identify the skill of staff nurses regarding prevention of central line associated blood stream infection. 3. To evaluate the effectiveness ofstructured teaching programme (STP) on prevention of central line associated blood stream infection. 4. To find out the relationship between the following. Pre-test knowledge score and pre-test skill scores. Post-test knowledge score and post-test skill scores. 5. To find out the association between the following: (a) Post test knowledge score and year of experience of the staff nurses. (b) Post test skill score and year of experience of the staff nurses. HYPOTHESES: All hypotheses will be tested at 0.05 level of significance. H1-Mean post test knowledge score of staff nurses who received structured teaching programme (STP) regarding CLABSI will be significantly higher than the mean pre-test knowledge score. H2- Mean post test skill score of staff nurses who received structured teaching programme (STP) regarding CLABSI will be significantly higher than the mean pre-test skill score. H3- (a) There will be significant relationship between pre-test knowledge score and pre-test skill score among staff nurses, who received structured teaching programme (STP) regarding CLABSI. (b) There will be significant relationship between post-test knowledge score and post-test skill score among staff nurses, who received structured teaching programme (STP) regarding CLABSI H4 (a) There will be significant association between post-test knowledge score and selected demographic variables among staff nurses, who received structured teaching programme (STP) regarding CLABSI . (b) There will be significant association between post-test skill score and selected demographic variables among staff nurses who received structured teaching programme (STP) regarding CLABSI. METHODS: The study was conducted in Kumutha & K.V Hospital. Criteria for selecting the approximately5 km from Srri Paspo College of Nursing. The total numbers of staff nurses in the hospital is 75. They are working in 3 shifts. The different departments available in the hospital are OT-2, Step down ICU-1, Recovery Room-2, Pre-operative wards-2, Postoperative wards-2, Casuality-2, OPD-3 and ECG Room-1, Labour room-1, Antenatal & Post natal ward -1. Population: The target population for the study was qualified staff nurses who are working in ICU & Emergency in Private hospital at Dharmapuri. Sample Size: A sample is a small portion of the population selected for the study. In the study sample consisted of 30 staff nurses who met the inclusion criteria. Sampling Technique: Sampling refers to the process of selecting a portion of population to represent the entire population. In this study purposive sampling technique has been used to select the sample. Purposive sampling is based on the belief that a researcher’s knowledge about the population can be used to handpick the cases to be included in the sample. Criteria for Sample Selection: Samples were selected based on the following inclusion and exclusion criteria. Inclusion Criteria: •Staff nurse who completed general nursing and B.Sc. Nursing. •Staff nurses of both genders. •Staff nurses who are willing to participate in the research study. •Staff nurses who are working in ICU and Emergency department. •Staff nurses between 20-45 years. Exclusion Criteria: •Staff nurses who were engaged in administrative work such as Nursing Supervisor and Superintendent. •Staff nurses of other categories like ANM and Trained worker. •Staff nurses who are not willing to participate. •Staff nurses who are working in other than ICU. MAJOR FINDINGS OF THE STUDY: H1. Mean post-test knowledge score of staff nurses who received structured teaching programme (STP) regarding CLABSI will be significantly higher than the mean pre-test knowledge score. H2. Mean post-test skill score of staff nurses who received structured teaching programme (STP) regarding CLABSI will be higher than the mean pre-test skill score. H3. (a) There will be a significant relationship between pre-test knowledge score and pre-test skill score among staff nurses, who received STP regarding CLABSI. (b) There will be a significant relationship between post-test knowledge score and post-test skill score among staff nurses who received STP regarding CLABSI. H4. (a) There will be a significant association between the post-test knowledge score and selected demographic variables among staff nurses who received STP regarding CLABSI. (b) There will be a significant association between the post-test skill scores and selected demographic variables, among staff nurses who received CLABSI. CONCLUSIONS: The present study assessed the knowledge of staff nurses on CLABSI and found that maximum number of staff nurses 15 (50%) had average knowledge and 6 (20%) had inadequate knowledge and only remaining 9 (30%) had adequate knowledge. After the structured teaching programme the post-test showed that the maximum number of samples 17 (56.7%) had adequate knowledge, 13 (43.3%) had average knowledge and none of the sample had inadequate knowledge

IDENTIFICATION OF SECONDARY METABOLIES FROM PENTATROPIS MICROPHYLLA BY GC-MS ANALYSIS

Background: The present study was aimed to determine the presence of biomolecules in the ethanolic leaves extract of Pentatropic microphylla. Materials and Methods: Pentatropic microphylla leaves extract was used. Gas Chromatography Mass Spectrum equipment used for identification and determination of the bio active compounds. Results: The GC-MS results have shown the different type of secondary metabolites present in the extract. A total of 28 bio active compounds were identified by GC-MS. Out of 28 compounds 2 compounds have shown highly potent 1,6-Anhydro-á-D-glucopyranose (28.7332%) and Propane, 1,1,3-triethoxy (25.9192%) respectively. Conclusion: From the results, it is evident that Pentatropic microphylla contains various secondary metabolites, which may heal many diseases. Hence, it is recommended for further evaluation of its pharmacological activity

Design, Synthesis and Screening of Pyrazole Linked Thiazolidinones, Oxazepines and Benzoxazepines As Pf-Enr And E.Coli Fabi Inhibitors

INTRODUCTION:Drug design, often referred to as rational drug design or simply rational design, is the inventive process of finding new medications based on the knowledge of a biological target. The drug is most commonly an organic small molecule that activates or inhibits the function of a biomolecule such as a protein, which in turn results in a therapeutic benefit to the patient. In the most basic sense, drug design involves design of molecules that are complementary in shape and charge to the biomolecular target with which they interact and therefore will bind to it. Drug design for the knowledge of the three-dimensional structure of the biomolecular target is equant but not necessarily relies on computer modelling techniques. This type of modelling is sometimes referred to as computer-aided drug design.PURPOSE AND PLAN OF WORK:The prime motivation of the present work is to design a drug in such a way that it can be used clinically to treat the disease. Drug discovery tools have been utilized now in designing new molecular entities which are safe and effective without consuming much of the research hours. Recent literatures shows that search of new drugs are now focussed on design of drugs as inhibitors of enzyme targets. Enoyl ACP reductase is such a potential drug target in the development of new antimicrobial agents. From the literature and virtual screening technique Triclosan analogues, pyrazole, thiazolidinone, oxazepine, etc., possess promising enoyl ACP reductase inhibiting action on both Plasmodium falciparum and Escherichia coli. Based on these reports an attempt was made here to design and develop new antiplasmodial and antibacterial agents by utilizing computational tools. The primary objective of the present work is to identify and synthesize pyrazole linked thiazolidinone, oxazepine and benzoxazepine as promising antiplasmodial and antibacterial agents by the inhibition of enoyl ACP reductase enzyme.SUMMARY:The present work was focused on the design, docking, synthesis and evaluation of antimalarial and antibacterial activity of Pyrazolyl linked thiazolidinone, oxazepine and benzoxazepine series as possible Enoyl ACP reductase inhibitors. Phase I - In-silico studies Selection of the target The enzyme involved in the fatty acid elongation of Plasmodium falciparum and Escherichia coli ie., Enoyl ACP reductase was selected as the drug target of the study. The corresponding enzyme were obtained from the protein data bank and their accession codes were 1VRW (PfENR) and 1C14 (E.coli Fab1). Selection of lead by virtual screening Virtual screening was performed by iGEMDOCK v.2. Forty nine hits were obtained from ZINC database, from which pyrazole, thiazolidinone and oxazepine were selected as the lead for inhibiting PfENR and E.coli FabI enzymes. Lead optimization The thirty modified ligands 2a-j, 3a-j and 4a-j were subjected to in-silico lead optimization. The ligands were optimized for evaluating oral bioavailability by utilizing the Molinspiration server. Lead optimization revealed that all the thirty selected derivatives possess good drug likeness score. Docking The optimized leads were subjected to docking studies using Autodock4.2 and the interactions of the derivatives with active sites of the enzymes were studied. The derivatives were subjected to interactions with PfENR and E.coli FabI. Triclosan was used as the standard ligand.CONCLUSION:The present study establishes that computational tools help in minimizing the tedious process of drug discovery and delivers new drug candidate more quickly. Virtual screening was utilized for filtering the compounds and selecting the lead compounds. The drug likeness score established the compounds to be pharmacokinetically active. The binding energy obtained from docking study further confirmed the possibility of the affinity of the selected leads towards the enzyme, enoyl ACP reductase from Plasmodium falciparum and Escherichia coli. Using the schemes various pyrazolyl linked thiazolidinone, oxazepine and benzoxazepine were synthesized with good yield. Structure of the synthesized compounds were confirmed by Melting point, TLC, UV, NMR and MASS spectra. The compounds were screened for antimalarial and antibacterial activity. Thus the present study depicts that the utilization of computer aided drug design is an efficient tool in predicting the effectiveness of a series of compounds under study and thus can result in the design of potent antimalarial and antibacterial agents

N-(3-chlorophenyl)-2-(1E)-(4-methylphenyl)-methyleneamino-4,5,6, 7-tetrahydro-1-benzo-thiophene-3-carboxamide

The crystal structure of the title compound, C23H 21ClN2OS, is stabilized by intramolecular N-H⋯N, C-H⋯S and C-H⋯O hydrogen bonds and a weak intermolecular C-H⋯O interaction. © 2005 International Union of Crystallography Printed in Great Britain - all rights reserved

6-Methyl-N-(4-methoxy-phen-yl)-2-(E)-(4-methyl-phen-yl)methyl-eneamino-4, 5,6,7-tetra-hydro-thieno2,3-cpyridine-3-carboxamide

The molecular structure of the title compound, C24H25N3O2S, is stabilized by intra-molecular N - Hâ¯N, C - Hâ¯O and C - Hâ¯S hydrogen bonds. There are no significant inter-molecular inter-actions. © 2008