Dissolution of Language Leads to Dissolution of Self: Pragmatic Analysis of Franz Kafka's Trial

The Trial (1999) is one of the most complex novels in world literature. The research starts with reviewing various attempts that have been made by critics to comprehend the meaning of the novel The Trial. After overviewing the various ways in which the novel has been analysed, the present research aims to unravel the meaning of the text from a linguistic angle. The research is intended to do a pragmatic study of the text by taking Grice‘s Cooperative Principle as the theoretical base. The main purpose of the study is to find out whether the Grice’s Maxims are followed in the text or not. In the case of the violation of four maxims of the Cooperative Principle, which type of maxims are violated and how and what impact it has on the overall understanding of the text

Inhaled Insulin: Intrapulmonary or Intranasal?

Initial attempts delivered the insulin hormone intramuscularly, intravenously, and eventually subcutaneously. Other routes of administration of the drug were explored. These included oral, rectal, sublingual, buccal, transdermal, vaginal, intramuscular, intrapulmonary, and intranasal delivery systems. The purpose of these latter studies was to determine a noninjectable method to deliver insulin to patients with type 1 and 2 diabetes that would effectively lower blood sugar, control hemoglobin A1c (in much later studies), and allow patients a simpler, less invasive, and more direct control oftheir underlying disease process.  In January 2006 the United States Food and Drug Administration approved Exubera (Pfizer Pharmaceuticals, New York, NY) as the first pulmonary inhaled insulin. In actuality attempts to explore various methods to deliver insulin using intrapulmonary delivery had occurred since1925. &#xb

Pregnancy outcomes in the in vitro fertilization conceived polycystic ovary syndrome patients: a prospective study

Background: In vitro fertilization (IVF) is the need of modern era which was first developed to overcome the infertility resulting from irreparable tubal disease but now is applied more broadly for treatment of all causes of infertility including polycystic ovary syndrome (PCOS) and is associated with obstetric complications as well. This study aimed to whether pregnancy-related outcomes and complications are differed between patients with polycystic ovary syndrome (PCOS) and those with other causes of infertility who had undergone IVF. Objective were to compare maternal and fetal outcome in IVF conceived women with PCOS v/s without PCOS. Prospective comparative study at a tertiary care hospital.Methods: After getting approval from institutional ethical and scientific research committee, 108 IVF conceived women are studied, where IVF is done using controlled ovarian stimulation with GnRH antagonist protocol followed by freeze all strategy and preparation of endometrial lining. Frozen embryo transfer done in subsequent cycle over a period of one year. Study group includes women with PCOS and control group includes women without PCOS. The entire data is statistically analysed using statistical package for social sciences (SPSS ver 22.0, IBM Corporation, USA) for MS Windows.Results: Out of 108 IVF conceived pregnant women studied, 50% were PCOS (study group) and 50% non PCOS (control group). We have compared maternal and neonatal outcome in both the groups which shows patient in PCOS group has higher incidence of GDM, severe pre-eclampsia, preterm labour, LBW babies, SGA babies and babies admitted to NICU.Conclusions: Women with PCOS should be given notice of additional adverse pregnancy outcomes as well receiving early diagnosis and treatment for these complications during pregnancy and postpartum period

The use of ATC/DDD WHO 2016 and Prescription audit study in the Dermatology OPD of a tertiary care hospital in Jharkhand

Background: To study the prescribing patterns, rationale of drug usage and use of anatomical, therapeutic, chemical (ATC) and defined daily dosage (DDD) classification for the monitoring of drug utilization in the dermatology department of a tertiary care hospital.Methods: A retrospective, observational study was conducted in out-patients department of dermatology at RIMS, Ranchi over a period of two months. Rationale of drug usage was assessed by analysing the prescriptions. Defined daily dosage/1000 patients/day of the commonly used medications was compared to the defined daily dosage by World Health Organization in 2016. Data was analysed by statistical tools. Most of the results were expressed in percentages.Results: The prescriptions were rational in most of the cases. Emphasis was more towards the branded drugs. Polypharmacy was evident in many of the prescriptions. The number of DDD/1000 patients/day in cases of antifungals was more than the WHO DDD and less than the WHO DDD in case of antihistaminics.Conclusions: The number of drugs per prescription must be rationalized so as to avoid polypharmacy. The drugs should be prescribed by their generic names also along with the brand names. Generic medicines should be available in the hospital pharmacy so that a more cost-effective treatment can be assured. CMEs and stewardship programs for health care professionals regarding rational drug usage should be organized.

Machine Learning in a data-limited regime: Augmenting experiments with synthetic data uncovers order in crumpled sheets

Machine learning has gained widespread attention as a powerful tool to identify structure in complex, high-dimensional data. However, these techniques are ostensibly inapplicable for experimental systems where data is scarce or expensive to obtain. Here we introduce a strategy to resolve this impasse by augmenting the experimental dataset with synthetically generated data of a much simpler sister system. Specifically, we study spontaneously emerging local order in crease networks of crumpled thin sheets, a paradigmatic example of spatial complexity, and show that machine learning techniques can be effective even in a data-limited regime. This is achieved by augmenting the scarce experimental dataset with inexhaustible amounts of simulated data of rigid flat-folded sheets, which are simple to simulate and share common statistical properties. This significantly improves the predictive power in a test problem of pattern completion and demonstrates the usefulness of machine learning in bench-top experiments where data is good but scarce.Comment: 8 pages, 5 figures (+ Supplemental Materials: 5 pages, 6 figures

CARDIOVASCULAR DISEASE PREVALENCE AND DRUG UTILIZATION PATTERNS AT A TERTIARY CARE HOSPITAL IN NORTHEASTERN INDIA

Objective: The objective of this study was to evaluate the disease prevalence and drug utilization pattern in the department of cardiology in a tertiary care hospital in northeastern India.Methods: Indoor case papers 112 of patients fulfilling inclusion criteria were included in this study. The study was performed in between December 2014 to February 2015. Case papers analyzed and documented for demographic variables, indication, disease prevalence, co-morbidities and prescribing pattern of the physician.Results: A total of 112 cases were evaluated. Patients of age group between 61-90 y were diagnosed 48.21% of cardiovascular diseases (CVDs). Male patients (67%) were diagnosed CVDs more than female patients (33%). Our findings indicated that hyperlipidemia (84.82%), hypertension (80.35%) and ischemic heart disease (66.96%) were most frequently diagnosed disease and most of the diseases were treated by the combination of two or three drugs. The use of statins, beta blockers, diuretics, calcium channel blockers and angiotensin-converting enzymes (ACE) inhibitors was very common. Diabetes, anemia and asthma were the comorbidities associated with CVDs.Conclusion: Hyperlipidemia, hypertension and ischemic heart disease were the prevalent diseases among CVDs. Statins and antihypertensive were most prescribed drugs. Combinations of drugs were prescribed to the patients for effective therapy. The present study will help the healthcare professionals to optimize the efficient and safe use of cardiovascular drugs.Keywords: Ischemic heart diseases, Hypertension, Rational, Health professional

Prevalence and clinical utility of sperm DNA fragmentation index in couples with unexplained infertility

Background: Worldwide increased burden of infertility has built up stress in reproductive age group couples. Female factor evaluation and semen analysis are carried out routinely in infertility work up. As per the recent observations, males with normal semen analysis may have abnormal sperm DNA fragmentation index (DFI). Thus, rendering semen analysis with poor diagnostic value in unexplained infertility cases. There is lack of adequate literature on prevalence of abnormal DFI in unexplained infertility. This study is directed to contribute to the literature by assessing prevalence of couples with ‘unexplained infertility’ having DFI>15% in male partners. Methods: After getting approval from institutional ethical and scientific research committee, 200 couples with unexplained infertility were recruited for the study and sperm DFI using sperm chromatin dispersion (SCD) test (Halo test) was done. Results: Out of 200 subjects, 54% were having low DFI, 32% were having moderate DFI and 14% were having high DFI.Conclusions: Many couples diagnosed as unexplained infertility according to traditional diagnostic methods has remarkably high degrees of fragmented sperm DNA. Identification of such couples provide vital information and better therapeutic options can be offered to them to achieve best reproductive outcomes

Aceclofenac induced morbilliform eruptions: a case report

Maculopapular or morbilliform eruptions may be the most common of all cutaneous drug reactions. Antimicrobials, NSAIDS, barbiturates, anticonvulsants, oral hypoglycemics etc. have been commonly implicated in these adverse reactions (ADR). Here, authors are presenting a case of a 38-year-old female with morbilliform eruptions due to aceclofenac for the treatment of joint pain. The patient was treated with antihistaminics, steroids, antimicrobials and local application of GV paint. She was discharged after eleven days with good recovery

A rare case of primary infertility with bilateral agenesis of medial part of fimbrial end with hypoplasia of fimbria and absence of fimbria ovarica with septate uterus with bilateral normal ovaries

Patients with infertility frequently present with associated congenital genital anomalies affecting around 5-6% of patients. Most of these patients have anomalies associated with uterus, cervix and vagina which have been extensively studied through time. The exact association of abnormalities of fallopian tube to infertility is still unknown due to the limited data available. The true incidence of congenital fallopian tube anomalies is unknown because abnormalities may be subtle and are often overlooked or thought to be due to acquired or iatrogenic causes. While reviewing the literature, we observed that partial or complete agenesis of the fallopian tube is rarely reported. They are usually incidental diagnosis on laparoscopy done for some other purposes. Due to rarity of such cases, their effect on fertility and its management is still a challenge. Here, we present a case report of septate uterus with bilateral fimbrial agenesis and normal ovaries in a patient of primary infertility.