Image Segmentation Review A Survey of Image Segmentation Techniques

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Pregnancy following re-stenosis of complete transverse vaginal septum

We report a case of 23 year woman who came to us with 6 weeks pregnancy and complete transverse vaginal septum. Cesarean section along with resection of septum was done. Restenosis of vagina was observed during puerperium. No surgical intervention was done. Spontaneous pregnancy with well- formed vagina was noted after 3 years

Two years follow up study of post placental insertion of IUCD during caesarean sections: safety, efficacy and complications

Background: The present study evaluates safety, efficacy, expulsion rate and complications of PPIUCD insertion in women undergoing caesarean section in a medical college for 2 years period.Methods: This is a prospective cohort study done over a 2 year period. Total 185 patients undergoing caesarean section and fulfilling medical eligibility criteria for PPIUCD were enrolled in the study. The followup of these patients was done at 6 weeks, 6 months and 1-2 years.Results: Thirteen patients (7%) lost to follow up so final outcome analysis was done in 172 patients. The problems encountered were spontaneous expulsion in 4 patients, removal due to heavy menstrual flow in 13 patients, non-visibility of threads in 4 patients, discharge per-vaginum in 1 patient and pain lower abdomen in 1 patient. Voluntary removal was done in 3 patients by 2 years who wished to conceive. The successful continuation rate came out to be 84.9% by 2 years. There was no failure reported in terms of intra-uterine or extra-uterine pregnancy and no increased risk of infection or perforation over the 2 years follow up.Conclusions: Immediate post-placental IUCD insertion is safe and effective method of contraception with no need to wait for 6 weeks which thereby reduces unwanted pregnancy rates. Mild discomfort and the minor post procedure complaints are taken care of well in puerperium. Higher rate of expulsion can be taken care of by early follow-up with regular visits and offering other safe and effective method of contraception

Using different surgical techniques and ideas to reduce post-operative adhesion formation: a systematic review and meta-analysis

Adhesion development is the most common sequelae of intra-abdominal and pelvic surgery. Using a good surgical technique is advocated as a first step in preventing adhesions. However, the evidence for different surgical techniques to reduce adhesion formation needs confirmation. This review contributed to the growing knowledge pool by elucidating factors that potentially predispose to the development of adhesions. A literature search was performed using the PubMed database for all relevant English language articles and were reviewed with particular attention to predisposing factors to post-operative adhesion development. In addition, the reference lists of each article were reviewed to identify additional relevant articles. Various factors have been shown to directly increase the risk of post-operative adhesion development; namely, certain genetic polymorphisms in the interleukin-1 receptor antagonist, increased estrogen exposure, and endometriosis. There were 28 papers with 27 studies included for a systematic review. Of these, 17 studies were eligible for meta-analysis and 11 for qualitative assessment only. None of the techniques that were compared significantly reduced the incidence of adhesive small bowel obstruction. In a small low-quality trial, the pregnancy rate increased after subserous fixation of suture knots. However, the incidence of adhesions was lower after laparoscopic compared with open surgery (relative risk (RR): 0.14; 95% confidence interval (CI): 0.03-0.61) and when the peritoneum was not closed (RR: 0.36; 95% CI: 0.21-0.63). None of the specific techniques that were compared reduced the two main adhesion-related clinical outcomes, small bowel obstruction and infertility

A study for the efficacy of Amr's cervical traction maneuver along with AMTSL in prevention of postpartum hemorrhage

Background: Postpartum hemorrhage (PPH) contributes to 25% maternal mortality worldwide (WHO, 2007). In poor resource settings where facility of refrigeration is not available uterotonics may not prove to be useful in prevention of PPH. The aim of this study is to find out the efficacy and acceptability of Amr’s cervical traction maneuver in prevention of PPH in such set up. Methods: This interventional observational study was conducted among 220 patients coming in labour eligible for vaginal delivery in Department of Obstetrics and Gynaecology, S. N. Medical College, Agra between December 2020 to May 2022. Patients were divided into two groups: study group (110 patients) where Amr’s maneuver along with AMTSL is done and control group: where AMTSL is done alone. Results: The mean age of participants in study group was 23.76 years and control group was 23.75 years. In both groups, 59.5% were primigravidae. Mean BMI in both group was 25.02 kg/m2. Almost 61% had spontaneous labour. Nearly 92% delivered normally without instruments. In study group 66% patients had blood loss less than 400ml. Average blood loss was 255.23 ml in study group and 300.25 ml in control group. The difference is clinically significant. The mean blood loss in PPH patients in study group was 603.75 ml, and in control group it is 753.25 ml, which is clinically significant. Conclusions: Amr’s maneuver is a simple maneuver when done in combination with AMTSL results in reducing the incidence of PPH and amount of blood loss post-delivery to a great extent

AYURVEDIC MANAGEMENT OF ARDITA (BELLS PALSY): A CASE STUDY

Ardita is considered as one among the Vata Nanatmaja Vyadhis described in our Ayurvedic classics. It can be correlated with the disease Bells Palsy in modern aspects. The present study was conducted with an objective to find out the effective Ayurvedic management in Bells palsy. For present study, a 28 years old Hindu male having history of watering from right eye, difficulty in closing right eye, difficulty in moving up right eyebrow, difficulty in moving up right eyebrow with uneven frequency since last 5 years was registered in our OPD. History and examinations lead to the diagnosis of idiopathic facial nerve paralysis i.e. Bells palsy. Considering the signs and symptoms patient was treated on the lines of Ardita Chikitsa. Nasya Chikitsa with Bala Bilva Ghrita, Tarpana with Jeevantyadi Ghrita, Karnapoorana with Ksheer- Bala Taila were done along with oral drugs and exercise. 100% relief was found in watering from eyes, slurring of speech, dribbling of saliva from right corner of mouth (Lalasrava), earache (Karnshool). 75% relief was found in trapping of food between gums and cheek. 50% relief was found in widening of palpebral aperture (Netra Vikriti), absence of Nasolabial fold and in smiling sign. Before starting the treatment the House Brackmanns grading of facial nerve was Grade 4 and after commencement of 28 days treatment it was Grade 2. There was no side effect observed during and after the treatment

Oral nifedipine versus nitroglycerine patch for tocolysis in preterm labour

Background: Preterm delivery is a major cause of neonatal mortality and morbidity. Various modalities have been used to prediction of patient at risk of preterm labor. But due to multi-factorial etiology these predictors are not always useful. Tocolysis has a major role in arresting preterm labor. The purpose of this study was to compare the safety and efficacy of oral nifedipine with transdermal nitroglycerine in the inhibition of preterm labour.Methods: This single blinded randomized control trial was conducted in the labour room of department of Obstetrics and Gynecology from January 2011 to June 2012. One hundred women with singleton pregnancy between 28 weeks to 34 weeks preterm labour and no contraindication for tocolysis were enrolled in the study. After taking the informed consent subjects were randomized into two groups. Randomization was done by random number table. Fifty-one subjects in nifedipine group received oral nifedipine (Tab Depin 10mg). Forty-nine subjects receiving transdermal nitroglycerine patch (Nitroderm Patch 10) were included in NTG group. The variables analysed were delay in delivery for 48 hours, 7 days or more than 7 days, period of gestation at delivery and side effect profile of drugs.Results: The percentage of women delivering after 48hours of administration of nifedipine group (52.9%) and nitroglycerine group (53.1%). Failure of tocolysis, defined as delivery within 48 hours, with nitroglycerine group (32.7 %) was comparable to nifedipine (33.3 %). Headache was significantly higher in nitroglycerine group as compared to nifedipine group (p≤0.001). Maternal tachycardia was more common in nifedipine group compared to NTG group (p=0.001).Conclusions: Oral nifedipine and transdermal nitroglycerine have similar efficacy as tocolytic agent in patients with preterm labour.

Efficacy and safety of intravenous paracetamol versus intravenous tramadol for labour analgesia

Background: An effective labour analgesia improves maternal and perinatal outcome and improves the course of labour. Methods: This was a prospective, randomised study done to compare effectiveness and safety of intravenous infusion of paracetamol with tramadol when used for labour analgesia. Group A (25 parturients) received paracetamol 1000 mg and group B (25 parturients) received tramadol 1mg/Kg at 4 to 6 cm cervical dilatation. Visual analogue score for pain was assessed at the baseline, 1 hour and 3 hours of drug administration and was compared between the two groups along with various maternal and fetal outcomes. Results: The difference in mean Visual Analogue Score (VAS) just before the drug administration was not statistically significant. However, at 1 hour of drug administration, mean VAS was significantly lower in the Group A (4.60) in comparison to Group B (5.82). The mean VAS at 3 hours was slightly lower in group A (6.35) in comparison to group B (6.65), though statistically there was no significant difference. Nausea, vomiting and sedation were found to be more in the tramadol group as compared to paracetamol group. The mean 1 and 5 minute apgar scores were found to be comparable in both the groups. Conclusions: So, it can be concluded from our study that intravenous paracetamol may be preferred over intravenous tramadol as it is associated with better analgesic efficacy and less maternal side effects. Although both the drugs were found to have good neonatal outcome

Ytterbium triflate (and trimethylsilyl triflate) catalyzed isomerization of glycidic esters to α-hydroxy-β,γ-unsaturated esters and their conversion into cyclopentanoids using Johnson-Claisen rearrangement

A variety of glycidic esters undergo smooth isomerization to the corresponding α-hydroxy-β, γ-unsaturated esters upon reaction with Yb(OTf)3 or TMSOTf. These α-hydroxy-β, γ-unsaturated esters undergo Johnson-Claisen rearrangement to appropriately substituted diesters, some of which are converted into cyclopentanoids

Comparative Analysis between OFDMA and SC-FDMA: Model, Features and Applications

This paper represents Orthogonal Frequency Division Multiple Access (OFDMA) and Single Carrier Frequency Division Multiple Access (SCFDMA) techniques along with the Orthogonal Frequency Division Multiplexing (OFDM). The concept, model, features, scopes, applications and limitation for both types of multiple access have been discussed in this paper. In present 4G and 5G cellular communication system, both OFDMA and SC-FDMA have a notable applications. Dividing the available spectrum into overlapping orthogonal narrowband sub bands, OFDMA ensures high spectral efficiency. Besides by allocating multiple sub carriers to each user, OFDMA provides high data rate, reduces inter blockage interference, minimizes frequency selective fading and so on. But it suffers from high peak to average power ration (PAPR) which results in high power consumption at the transmitter end. SC-FDMA is one of the most promising techniques to solve the PAPR problems. Besides it also removes the capacity problem of wireless cellular systems and provides higher spectral efficiency, depending on multiplexing signals based on their spatial signature. On the other hand, in OFDM due to fixed subcarrier allocations for each user and its performance can suffer from narrowband fading and interference