Prevalence of non-alcoholic fatty liver disease in patients of metabolic syndrome in a rural population attending tertiary care centre

Background: Non-alcoholic fatty liver disease and steatohepatitis now constitute the major etiology of chronic liver disease. Prevalence of non-alcoholic fatty liver disease is rising due to the change in lifestyle habits, diet and obesity. Metabolic syndrome is closely related with the pathogenesis of non-alcoholic fatty liver disease. Studies showed that prevalence of metabolic syndrome is rising in Indian population. This study was conducted to look into the current status of the metabolic syndrome in rural population.Methods: The study was conducted among patients attending General Medicine OPD. Each participant was subjected to clinical examination, anthropometric measurements, laboratory investigations and abdominal ultrasound. NAFLD was diagnosed by ultrasound and metabolic syndrome was diagnosed based on modified NCEP:ATP III criteria.Results: The prevalence of NAFLD was found to be 18.78% and was higher among male population (20.05%) as compared to females (17.32%). The prevalence of metabolic syndrome among NAFLD and control groups were 42.74% and 17.91% respectively.Conclusions: Present study has shown moderate prevalence of NAFLD and metabolic syndrome among the rural population of western Uttar Pradesh with a more male predisposition.

Anorectal manometry profile among elderly patients with chronic constipation in a tertiary health center

Background: Constipation is a common condition in elderly in India. High resolution anorectal manometry (HRAM) is an essential tool in the evaluation. In this context, studies from south India are sparse regarding the motility data of elderly patients with functional constipation. We aimed at studying anorectal pressure patterns in this population of this part of the country. Methods: Manometric data of 50 elderly patients (≥60 year), who underwent the procedure for chronic constipation (Rome IV), was retrospectively collected. Manometric parameters were compiled and observations tabulated. Results: Among 50 patients, 35 were (70%) males and 15 (30%) females with mean age of 66.5±3.2 years. In HRAM study, the mean resting pressure was 90.2±27.5 mmHg (range 43-153 mmHg) and mean squeeze pressure was 136.9±39.76 mmHg (range 88-223 mmHg). In present study 23 patients had abnormal HRAM suggestive of dyssynergic defecation (46%). Conclusions: The present study showed that 46% of the elderly constipation patients had defecation disorder. Defecation disorders are common in our population and there is a need to diagnose it as treatment perspectives differ from other causes of constipation

Bacteriological profile of patients with biliary obstruction in tertiary care center

Background: Bile ducts are usually kept sterile by bacteriostatic and flushing effects of bile. Patients presenting with biliary obstruction especially due to benign etiology have either single or multiple bacterial organisms. Acute cholangitis carries significant morbidity with variable mortality rate. The serious presentation of such toxic patients signifies the requirement of appropriate antibiotic treatment.  Choledocholithiasis followed by neoplasm and benign biliary strictures are the common predisposing factors for obstruction. Widespread use of antibiotics over years lead to change in sensitivity pattern of organisms which necessitates change in empiric antibiotic usage. Methods: This retrospective study was conducted in department of medical gastroenterology. We studied 50 patients with biliary obstruction (clinical and demographic data were recorded). The diagnosis of cholangitis was made according to TG2018. While undergoing therapeutic ERCP, bile aspirate was collected by biliary cannulation and sent for microbiological analysis. The antibiotic susceptibility pattern and rest of the data were analyzed by appropriate statistical tests. Results: Mean age of the study group was 49 years. Majority were female in study (60%). Overall, 74% had benign etiology, 32% had cholangitis. Bile cultures were positive in 64% patients 75% of them had benign etiology (gallstone being most common; 56%) and 25% had malignant etiology. Bacterobilia in cholangitis patients was statistically significant in comparison to patients without cholangitis (p-0.01). Organisms grown are mainly aerobic gram negative, most common being E. coli, Klebsiella and Pseudomonas species. Patients having bacterobilia had mortality of 6.25% during hospital stay. Conclusions: In this study we found higher sensitivity to colistin (90.6%), tigecycline (81.25%), amikacin (75%) and least sensitivity was noted for ampicillin (6.25%) followed by cefixime (12.5%). Sensitivity to previously commonly used ciprofloxacin antibiotic was 31.25%. Study confirms the significance of obtaining routine bile sample during ERCP in obstructed biliary system to prevent dreaded complications of cholangitis

The prevalence of hypertension among young adults in a rural population of North India

Background: Most of the studies on hypertension provided the data on older age group. Most of the times, younger population remains unaddressed as they are assumed to be at a lower risk of developing the disease. So, the study on prevalence of hypertension among younger age group and their socio-demographic variables provides the guide for requirements of any intervention. Objective of present study is to estimate the prevalence of Hypertension among young adults in a rural population of central India.Methods: We collected data on socio-demographic characteristics and hypertension status from 1061 subjects aged 18–40 years. Relevant clinical parameters were collected (blood pressure recordings and anthropometric measurements).Results: Hypertension was detected in 188 of the 1061 subjects (17.7%). Prevalence among men was higher (18.8% compared to 15.2% among women). A total of 40.2% of the subjects was found to have pre-hypertension. Higher prevalence of hypertension was seen among those with a history of smoking.Conclusions: Most of the young adults with raised blood pressure were previously undiagnosed. A large number of subjects had prehypertension. Their early identification facilitates early, active management of blood pressure and formulation of preventive strategies thereby decreasing morbidity and mortality due to cardiovascular diseases and hypertension.

Physics Potential of the ICAL detector at the India-based Neutrino Observatory (INO)

The upcoming 50 kt magnetized iron calorimeter (ICAL) detector at the India-based Neutrino Observatory (INO) is designed to study the atmospheric neutrinos and antineutrinos separately over a wide range of energies and path lengths. The primary focus of this experiment is to explore the Earth matter effects by observing the energy and zenith angle dependence of the atmospheric neutrinos in the multi-GeV range. This study will be crucial to address some of the outstanding issues in neutrino oscillation physics, including the fundamental issue of neutrino mass hierarchy. In this document, we present the physics potential of the detector as obtained from realistic detector simulations. We describe the simulation framework, the neutrino interactions in the detector, and the expected response of the detector to particles traversing it. The ICAL detector can determine the energy and direction of the muons to a high precision, and in addition, its sensitivity to multi-GeV hadrons increases its physics reach substantially. Its charge identification capability, and hence its ability to distinguish neutrinos from antineutrinos, makes it an efficient detector for determining the neutrino mass hierarchy. In this report, we outline the analyses carried out for the determination of neutrino mass hierarchy and precision measurements of atmospheric neutrino mixing parameters at ICAL, and give the expected physics reach of the detector with 10 years of runtime. We also explore the potential of ICAL for probing new physics scenarios like CPT violation and the presence of magnetic monopoles.Comment: 139 pages, Physics White Paper of the ICAL (INO) Collaboration, Contents identical with the version published in Pramana - J. Physic

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV

Probing effective field theory operators in the associated production of top quarks with a Z boson in multilepton final states at root s=13 TeV

Peer reviewe

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe

Observation of tW production in the single-lepton channel in pp collisions at root s=13 TeV

A measurement of the cross section of the associated production of a single top quark and a W boson in final states with a muon or electron and jets in proton-proton collisions at root s = 13 TeV is presented. The data correspond to an integrated luminosity of 36 fb(-1) collected with the CMS detector at the CERN LHC in 2016. A boosted decision tree is used to separate the tW signal from the dominant t (t) over bar background, whilst the subleading W+jets and multijet backgrounds are constrained using data-based estimates. This result is the first observation of the tW process in final states containing a muon or electron and jets, with a significance exceeding 5 standard deviations. The cross section is determined to be 89 +/- 4 (stat) +/- 12 (syst) pb, consistent with the standard model.Peer reviewe