My Child Has What? The Most Effective Means of Communication When Delivering a Difficult Diagnosis to the Parents of a Pediatric Patient

For the healthcare provider, disclosing a pediatric patient\u27s difficult diagnosis in the form of an acute or chronic condition to the parents is a challenging task. Healthcare providers often feel unprepared when relaying the news of such diagnosis, and the parents feel equally unprepared upon receiving it (Pririe, 2012). This systematic literature review examined the various communication techniques used in the past, and the techniques\u27 effectiveness in increasing parental satisfaction when first learning of the child\u27s diagnosis. A scarce number of studies related to the most effective techniques were found in the literature, and even fewer were found that evaluated the techniques presented. Overall, three of the most commonly occurring communication themes identified from the studies were: 1) Parents desired privacy during the disclosure and wanted a support system present (mostly a spouse); 2) The diagnosis must be given as soon as the healthcare provider suspected it, and; 3) The healthcare provider must emphasize the positive characteristics of the pediatric patient, as well as the patient\u27s future with the diagnosis. Both parents and providers agreed that further research is needed to identify effective communication techniques used during disclosure. The aim of the research should be to identify the most effective means of communication to increase parental satisfaction. Furthermore, all healthcare providers need collaborative and interdisciplinary training in delivering a difficult diagnosis to increase parental satisfaction

A New Cryptographic Strategy for Digital Images

In this paper, a new image block cipher encryption strategy for gray scale images using a different set of secret key and sizes is proposed. Initially, the swapping and dispersion is done without keys and in second stage the image is mixed with the chirikov map involving first secret key.  'N' rounds are taken to complete this process. The blended image is divided into blocks of block size 8X8.These blocks are also swapped to achieve good confusion. For making the encryption scheme more sturdy in each block the transmutation of pixels is done with the modified logistic map having three more secret keys.  The proposed scheme is simple, rapid and sensitive to the secret key. Due to the high order of substitution, common attacks such as linear and differential cryptanalysis are unattainable. The experimental results show that the proposed encryption technique is effective and has high security features.DOI:http://dx.doi.org/10.11591/ijece.v4i3.632

Image Compression Using Haar Wavelet Transform

Compressing an image is significantly different than compressing raw binary data. General purpose compression programs can be used to compress images, but the result is less than optimal. This is because images have certain statistical properties which can be exploited by encoders specifically designed for them. Also, some of the finer details in the image can be sacrificed for the sake of saving a little more bandwidth or storage space. This also means that lossy compression techniques can be used in this area. The discrete wavelet is essentially sub band's coding system and sub band coders have been quite successful in speech and image compression. In this paper we have implemented HAAR Wavelet Transform. The results in terms of PSNR(Peak Signal Noise Ratio) and MSE (Mean Square Error)show that the Haar transformation can be used for image compression. The quantization is done by dividing the image matrix into blocks and taking mean of the pixel in the given block. It is clear that DWT has potential application in the compression problem and the use of Haar transform is ideally suited

Image Compression Using Haar Wavelet Transform

Compressing an image is significantly different than compressing raw binary data. General purpose compression programs can be used to compress images, but the result is less than optimal. This is because images have certain statistical properties which can be exploited by encoders specifically designed for them. Also, some of the finer details in the image can be sacrificed for the sake of saving a little more bandwidth or storage space. This also means that lossy compression techniques can be used in this area. The discrete wavelet is essentially sub band's coding system and sub band coders have been quite successful in speech and image compression. In this paper we have implemented HAAR Wavelet Transform. The results in terms of PSNR(Peak Signal Noise Ratio) and MSE (Mean Square Error)show that the Haar transformation can be used for image compression. The quantization is done by dividing the image matrix into blocks and taking mean of the pixel in the given block. It is clear that DWT has potential application in the compression problem and the use of Haar transform is ideally suited

SKIN TEXTURE ANALYSIS FOR MEDICAL DIAGNOSIS -A REVIEW

ABSTRACT As the technicality in the day to day life is increasin

Do Socio-Economic Factors Play a Role in Delayed Presentation of Complicated Chronic Otitis Media (Squamous)?

Introduction The influence of Socioeconomic (SE) status on delayed reporting and consequent complications in cases of Chronic Otitis Media-squamous (COMS) has been investigated. Materials and Methods This prospective observational study included 34 patients with complicated COMS who presented to Otolaryngology Department at a tertiary care teaching hospital between December 2012 and December 2016. The patients were classified into 5 classes namely upper, upper middle, lower middle, upper lower, and lower based on a standardised real-time Kuppuswamy’s SE status scale (KS) taking an average of consumer price indices for Industrial workers over 4 years (Jan ‘12 to Dec ‘16) as 267 and calculating their incomes. Level of education and occupation of the head of the family were the other components of KS which was calculated for each presenting patient. Results Of the 34 patients, 15 were males (44%) and 19 females (56%) with their ages ranging from 18 months to 61 years (Mean-24.1 years, SD-17.3). 15 of the 34 patients (44.1%) were in the Upper-lower SE class as per KS Scale, 13 were in lower-middle class (38.23%), 5 were in Upper-middle class ( 14.70%) and 1 patient belonged to Upper class (2.9%).  Though the literacy levels are integral to KS Scale a differential analysis showed 23 of the 34 patients/guardians had education level poorer or equal to Intermediate high school (67.64%). The time gap between onset of symptoms of COMS and presentation with complications of COMS ranged from 9 months to 8 years with a mean time gap of 3.48 years (SD-2.01). There were 24 Extra-cranial complications and 21 Intra-cranial complications with 10 patients having more than one complications. There was a strong inverse correlation between Time gap and composite KS (-0.51). A differential analysis showed that Time gap most strongly correlated with Education level of the head of the family (-0.615), followed by total family income (-0.403) and occupation of the head of the family (-0.329).  Conclusion There is a strong association between the SE status of the family and the occurrence of complications in COMS that is otherwise highly amenable to successful management. Level of education, nature of employment and family income that constitute KS scale have significant inverse correlation with delayed reporting and consequent complications of COMS. Level of Education is the greatest influence on the time gap

Do Socio-Economic Factors Play a Role in Delayed Presentation of Complicated Chronic Otitis Media (Squamous)?

Introduction The influence of Socioeconomic (SE) status on delayed reporting and consequent complications in cases of Chronic Otitis Media-squamous (COMS) has been investigated. Materials and Methods This prospective observational study included 34 patients with complicated COMS who presented to Otolaryngology Department at a tertiary care teaching hospital between December 2012 and December 2016. The patients were classified into 5 classes namely upper, upper middle, lower middle, upper lower, and lower based on a standardised real-time Kuppuswamy’s SE status scale (KS) taking an average of consumer price indices for Industrial workers over 4 years (Jan ‘12 to Dec ‘16) as 267 and calculating their incomes. Level of education and occupation of the head of the family were the other components of KS which was calculated for each presenting patient. Results Of the 34 patients, 15 were males (44%) and 19 females (56%) with their ages ranging from 18 months to 61 years (Mean-24.1 years, SD-17.3). 15 of the 34 patients (44.1%) were in the Upper-lower SE class as per KS Scale, 13 were in lower-middle class (38.23%), 5 were in Upper-middle class ( 14.70%) and 1 patient belonged to Upper class (2.9%).  Though the literacy levels are integral to KS Scale a differential analysis showed 23 of the 34 patients/guardians had education level poorer or equal to Intermediate high school (67.64%). The time gap between onset of symptoms of COMS and presentation with complications of COMS ranged from 9 months to 8 years with a mean time gap of 3.48 years (SD-2.01). There were 24 Extra-cranial complications and 21 Intra-cranial complications with 10 patients having more than one complications. There was a strong inverse correlation between Time gap and composite KS (-0.51). A differential analysis showed that Time gap most strongly correlated with Education level of the head of the family (-0.615), followed by total family income (-0.403) and occupation of the head of the family (-0.329).  Conclusion There is a strong association between the SE status of the family and the occurrence of complications in COMS that is otherwise highly amenable to successful management. Level of education, nature of employment and family income that constitute KS scale have significant inverse correlation with delayed reporting and consequent complications of COMS. Level of Education is the greatest influence on the time gap

A meta-analysis on efficacy and safety: single-balloon vs. double-balloon enteroscopy

Background and aim: Double-balloon enteroscopy (DBE) and single-balloon enteroscopy (SBE) are new techniques capable of providing deep enteroscopy. Results of individual studies comparing these techniques have not been able to identify a superior strategy. Our aim was to systematically pool all available studies to compare the efficacy and safety of DBE with SBE for evaluation of the small bowel. Methods: Databases were searched, including PubMed, Embase, and the Cochrane Central Register of Controlled Trials. The main outcome measures were complete small-bowel visualization, diagnostic yield, therapeutic yield, and complication rate. Statistical analysis was performed using Review Manager (RevMan version 5.2). Meta-analysis was performed using fixed-effect or random-effect methods, depending on the absence or presence of significant heterogeneity. We used the χ2 and I2 test to assess heterogeneity between trials. Results were expressed as risk ratios (RR) or mean differences with 95% confidence intervals (CI). Results: Four prospective, randomized, controlled trials with a total of 375 patients were identified. DBE was superior to SBE for visualization of the entire small bowel [pooled RR = 0.37 (95% CI: 0.19–0.73; P = 0.004)]. DBE and SBE were similar in ability to provide diagnosis [pooled RR = 0.95 (95% CI: 0.77–1.17; P = 0.62)]. There was no significant difference between DBE and SBE in therapeutic yield [pooled RR = 0.78 (95% CI: 0.59–1.04; P = 0.09)] and complication rate [pooled RR = 1.08 (95% CI: 0.28–4.22); P = 0.91]. Conclusions: DBE was superior to SBE with regard to complete small bowel visualization. DBE was similar to SBE with regard to diagnostic yield, ability to provide treatment and complication rate, but these results should be interpreted with caution as they is based on very few studies and the overall quality of the evidence was rated as low to moderate, due to the small sample size

High resolution mapping of QTLs for fruit color and firmness in Amrapali/Sensation mango hybrids

IntroductionMango (Mangifera indica L.), acclaimed as the ‘king of fruits’ in the tropical world, has historical, religious, and economic values. It is grown commercially in more than 100 countries, and fresh mango world trade accounts for ~3,200 million US dollars for the year 2020. Mango is widely cultivated in sub-tropical and tropical regions of the world, with India, China, and Thailand being the top three producers. Mango fruit is adored for its taste, color, flavor, and aroma. Fruit color and firmness are important fruit quality traits for consumer acceptance, but their genetics is poorly understood.MethodsFor mapping of fruit color and firmness, mango varieties Amrapali and Sensation, having contrasting fruit quality traits, were crossed for the development of a mapping population. Ninety-two bi-parental progenies obtained from this cross were used for the construction of a high-density linkage map and identification of QTLs. Genotyping was carried out using an 80K SNP chip array.Results and discussionInitially, we constructed two high-density linkage maps based on the segregation of female and male parents. A female map with 3,213 SNPs and male map with 1,781 SNPs were distributed on 20 linkages groups covering map lengths of 2,844.39 and 2,684.22cM, respectively. Finally, the integrated map was constructed comprised of 4,361 SNP markers distributed on 20 linkage groups, which consisted of the chromosome haploid number in Mangifera indica (n =20). The integrated genetic map covered the entire genome of Mangifera indica cv. Dashehari, with a total genetic distance of 2,982.75 cM and an average distance between markers of 0.68 cM. The length of LGs varied from 85.78 to 218.28 cM, with a mean size of 149.14 cM. Phenotyping for fruit color and firmness traits was done for two consecutive seasons. We identified important consistent QTLs for 12 out of 20 traits, with integrated genetic linkages having significant LOD scores in at least one season. Important consistent QTLs for fruit peel color are located at Chr 3 and 18, and firmness on Chr 11 and 20. The QTLs mapped in this study would be useful in the marker-assisted breeding of mango for improved efficiency