A prospective study to compare levonogestrol intrauterine system and trans-cervical resection of endometrium for treatment of abnormal uterine bleeding

Background: This article is a study comparing the two most accepted forms of treatment for abnormal uterine bleeding - levonorgestrol intrauterine treatment and transcervical resection of endometrium, with regards to its acceptability, efficacy, adverse effects and user satisfaction. Aim of this study was to compare the acceptability, efficacy, adverse effects and user satisfaction of LNG-IUS and TCRE for treatment for AUB.Methods: A prospective observational study conducted in SKNMC and GH. Forty-nine women with abnormal uterine bleeding after hysteroscopic evaluation were included in this study; where 17 opted for LNG-IUS; 32 opted for TCRE with bipolar electrode. 15 patients in LNG-IUS group and 28 pts in TCRE group completed follow up. Menstrual pattern, pictorial blood loss assessment chart score, adverse effects, acceptability, satisfaction and reason for discontinuation were recorded at 6 weeks, 6 months and 12 months after the procedure. Prior to LNG-IUS insertion or endometrial ablation, endometrial and cervical pathology were excluded by D and C and cervical smear, respectively. TVUS was used to exclude possible causes of menorrhagia, including myomas and endometrial polyp as well as adnexal pathology. LNG-IUS insertion was performed as an office procedure one day after cessation of menstrual bleeding with a negative urine pregnancy test.Results: Menstrual blood loss reductions in TCRE and LNG-IUS groups were by 85.7% and 87.6% respectively after a year. Amenorrhoea was more common in TCRE group while spotting and systemic effects were more common in LNG-IUS group. Satisfaction and acceptance rates are higher in TCRE group.Conclusions: The TCRE and LNG-IUS are equally effective in reducing bleeding in AUB patients. Acceptance and satisfaction are better with TCRE, as a modality of treatment for AUB

Time dependence of Bragg forward scattering and self-seeding of hard x-ray free-electron lasers

Free-electron lasers (FELs) can now generate temporally short, high power x-ray pulses of unprecedented brightness, even though their longitudinal coherence is relatively poor. The longitudinal coherence can be potentially improved by employing narrow bandwidth x-ray crystal optics, in which case one must also understand how the crystal affects the field profile in time and space. We frame the dynamical theory of x-ray diffraction as a set of coupled waves in order to derive analytic expressions for the spatiotemporal response of Bragg scattering from temporally short incident pulses. We compute the profiles of both the reflected and forward scattered x-ray pulses, showing that the time delay of the wave $\tau$ is linked to its transverse spatial shift $\Delta x$ through the simple relationship $\Delta x = c\tau \cot\theta$, where $\theta$ is the grazing angle of incidence to the diffracting planes. Finally, we apply our findings to obtain an analytic description of Bragg forward scattering relevant to monochromatically seed hard x-ray FELs.Comment: 11 pages, 6 figure

Evaluating the Performance of Hybrid Capture 2 Test as a Primary Screening Test from Studies Conducted in Low and Middle-Income Country Settings-Special Focus India

Among the screening tests for cervical cancer, advantages of screening with second generation molecular Hybrid Capture 2 (HC2) test is the high sensitivity and negative predictive value that makes it easy to implement as a cervical cancer screening policy necessitating less screening rounds. High income countries are now implementing HC2 test in their national cervical cancer screening program. Since the acceptance of any screening test depends on the sensitivity of the test, the current study was carried out to evaluate the sensitivity of HC2 test reported from Low- and Middle-income countries (LMIC) which share major burden of cervical cancer globally and to establish if HC2 test could be used as a primary screening test in India. Materials and methods: The population based cross sectional studies from LMICs which evaluated HC2 test as a primary screening modality to diagnose Cervical intraepithelial neoplasm grade 2 and above (CIN2+) lesions were included. Results: A total of 18 studies from LMIC involving 1,13,086 women were reviewed for sensitivity of HC2 as a primary screening test. The overall average sensitivity and specificity to diagnose CIN2+ lesions were 79.84% (95% CI-71.01,86.73) and 85.63% (95% CI- 84.37,86.92) respectively. India demonstrated an average sensitivity and specificity of 65% (95% CI 57,77) and 93% (95% CI- 92,94) respectively. Conclusion: Results from LMIC demonstrate a comparably low sensitivity of HC2 test to diagnose CIN2+ lesions as compared to that reported from High income countries. Sensitivity of HC2 was substantially low for India. The current study discusses issues of HC2 assay and the role of untreated Reproductive tract infections as probable causes for low sensitivity of the test. This needs further research in an attempt to improve the sensitivity of the test in an era of self-sampling and low-cost HPV test on horizon to improve the coverage for cervical cancer

Evaluating the Performance of Hybrid Capture 2 Test as a Primary Screening Test from Studies Conducted in Low and Middle-Income Country Settings-Special Focus India

Among the screening tests for cervical cancer, advantages of screening with second generation molecular Hybrid Capture 2 (HC2) test is the high sensitivity and negative predictive value that makes it easy to implement as a cervical cancer screening policy necessitating less screening rounds. High income countries are now implementing HC2 test in their national cervical cancer screening program. Since the acceptance of any screening test depends on the sensitivity of the test, the current study was carried out to evaluate the sensitivity of HC2 test reported from Low- and Middle-income countries (LMIC) which share major burden of cervical cancer globally and to establish if HC2 test could be used as a primary screening test in India. Materials and methods: The population based cross sectional studies from LMICs which evaluated HC2 test as a primary screening modality to diagnose Cervical intraepithelial neoplasm grade 2 and above (CIN2+) lesions were included. Results: A total of 18 studies from LMIC involving 1,13,086 women were reviewed for sensitivity of HC2 as a primary screening test. The overall average sensitivity and specificity to diagnose CIN2+ lesions were 79.84% (95% CI-71.01,86.73) and 85.63% (95% CI- 84.37,86.92) respectively. India demonstrated an average sensitivity and specificity of 65% (95% CI 57,77) and 93% (95% CI- 92,94) respectively. Conclusion: Results from LMIC demonstrate a comparably low sensitivity of HC2 test to diagnose CIN2+ lesions as compared to that reported from High income countries. Sensitivity of HC2 was substantially low for India. The current study discusses issues of HC2 assay and the role of untreated Reproductive tract infections as probable causes for low sensitivity of the test. This needs further research in an attempt to improve the sensitivity of the test in an era of self-sampling and low-cost HPV test on horizon to improve the coverage for cervical cancer

Divergence of chikungunya virus in India: Tale of two cities

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Polyhedral units and network connectivity in calcium aluminosilicate glasses from high-energy x-ray diffraction

Structure factors for Cax/2AlxSi1-xO2 glasses (x=0,0.25,0.5,0.67) extended to a wave vector of magnitude Q= 40 1/A have been obtained by high-energy x-ray diffraction. For the first time, it is possible to resolve the contributions of Si-O, Al-O and Ca-O coordination polyhedra to the experimental atomic pair distribution functions (PDF). It has been found that both Si and Al are four-fold coordinated and so participate in a continuous tetrahedral network at low values of x. The number of network breaking defects in the form of non-bridging oxygens (NBO's) increases slowly with x until x=0.5 (NBO's ~ 10% at x=0.5). By x=0.67 the network breaking defects become significant as evidenced by the significant drop in the average coordination number of Si. By contrast, Al-O tetrahedra remain free of NBO's and fully integrated in the Al/Si-O network for all values of x. Calcium maintains a rather uniform coordination sphere of approximately 5 oxygen atoms for all values of x. The results suggest that not only Si/Al-O tetrahedra but Ca-O polyhedra, too, play a role in determining the glassy structure

Coplanar Stripline Loaded Reconfigurable Loop Antenna for WLAN and WiMAX Applications

In this paper, a loop antenna loaded with coplanar strip (CPS) line is proposed as a multiband antenna. The CPS line is added with two switches to vary the antenna perimeter to cover seven different bands. The CPS line introduced into the loop is not only useful in reconfiguring antenna dimensions but also provides stationary radiation patterns for the all the covered bands. The proposed antenna works in single and dual-band modes. When the proposed antenna works as a single band antenna, it produces a band from 4.2GHz to 5.7GHz. Under dual-band operation, it produces bands from 3.75GHz to 4.7GHz and from 6.4GHz to 7.8GHz. The other dual-band mode ranges from 3.5GHz to 3.8GHz and from 5.58GHz to 7.4 GHz. The simulated and measured results are in good agreement and the proposed antenna can be used satisfactorily for W-LAN and WiMax applications. The proposed technique can also be used for size reduction of loop antennas

Nonuniform C-Band Loop Antenna: A New Approach for Future UWB Applications

Antenna design becomes very difficult at very small wavelengths and a special lab is required to manufacture a small antenna which costs a lot. A new approach is proposed to enhance the bandwidth of the loop antenna which can be designed at very high frequency using conventional PCB design. The proposed antenna is a nonuniform loop and covers UWB frequency range. The nonuniform structure of the loop is designed using the concept of both thin and thick loop antenna together which leads to an improvement in the antenna bandwidth. The proposed nonuniform loop antenna covers a band of 91.4% which is higher than any existing printed loop antenna. The frequency ranges from 3.54GHz to 9.5GHz and the measured result is in agreement with the simulated result. This technique can be very helpful in designing UWB antennas in the range of Ku or higher than this

Fast by Nature - How Stress Patterns Define Human Experience and Performance in Dexterous Tasks

In the present study we quantify stress by measuring transient perspiratory responses on the perinasal area through thermal imaging. These responses prove to be sympathetically driven and hence, a likely indicator of stress processes in the brain. Armed with the unobtrusive measurement methodology we developed, we were able to monitor stress responses in the context of surgical training, the quintessence of human dexterity. We show that in dexterous tasking under critical conditions, novices attempt to perform a task's step equally fast with experienced individuals. We further show that while fast behavior in experienced individuals is afforded by skill, fast behavior in novices is likely instigated by high stress levels, at the expense of accuracy. Humans avoid adjusting speed to skill and rather grow their skill to a predetermined speed level, likely defined by neurophysiological latency