Pelvic abscess in a sexually inactive teenage girl: a case report and review of literature

Pelvic abscess, a potentially life-threatening collection of infected exudate in pelvic organs, commonly occurrs in sexually active women having pelvic inflammatory disease due to sexually transmitted infections. It is rare to find it in a girl never engaged in sexual activity. The index case was a of pelvic abscess in a 15year virgin girl. She presented with fever abdominal pain and lump. Ultrasonography suggested a complex pelvic mass but on CT imaging pelvic abscess was confirmed. She underwent surgical intervention after failed medical treatment to drain the collection and preservation of internal genital organs. Pelvic abscesses demand prompt diagnosis and management to prevent further complications and long-term poor fertility outcomes specially at young age and should be a differential diagnosis in girls with pain abdomen and fever

Borderline ovarian tumour of mixed seromucinous histology and bilateral presentation: a case report and review of literature

This article reports the case of a 40 year old woman who presented to the gynaecologic outpatient clinic with pain lower abdomen and an abdominopelvic lump. Clinical assessment, biochemical and radiological investigations revealed bilateral complex ovarian masses. Surgical exploration and histology of ovarian masses confirmed a rare bilateral borderline seromucinous cystadenoma. The purpose of this paper is to highlight the importance of thorough examination of women with symptoms of ovarian tumour which can be vague and to emphasize the necessity of a good collaboration between various medical specialties (primary physician/gynaecologist, oncosurgeon, radiologist and histopathologist) for correct diagnosis, optimum care and best outcome. This article also provides overview of the pathology and biology of borderline ovarian tumours, diagnosis, principles of surgical management and to appreciate the value of follow up

SCREENING OF LIPID PROFILE IN NON- OBESE HYPERTENSIVE SUBJECTS AT A TERTIARY CARE HOSPITAL IN BIHAR

Background: Obesity is a significant risk factor for metabolic syndrome in adults. Central fat distribution greatly alters the lipid profile and induces atherogenic dyslipidemia even in normoglycaemic, non-hypertensive subjects. Aim and Objectives: Hence, the aim of the present study to assess lipid profile changes in non-obese hypertensive subjects. Obesity, hypertension and dyslipidemia are the three highly significant risk factor for the deranged lipid profile. Obesity can be defined as excess accumulation of body fat arising from a sustained or a periodic positive energy balance that when energy intake exceeds energy expenditure [1]. Indicators of overweight are useful in the diagnosis and management of obesity in both children and adults. Materials and Methods: This study was conducted on newly diagnosed cases of essential hypertension attending medical outdoor of M.G.M. Medical College, Kisanganj. A complete clinical examination including laboratory investigation was done to exclude any systemic or other diseases which are likely to affect blood lipid levels directly or indirectly. Results: The association between dyslipidaemia, obesity and hypertension is well established and all have been found to be major risk factor for the development of CAD, a leading cause of visits to physician  and cause of death . Conclusion: Our study was carry out to know the effect of obesity on lipid profile profile only in hypertensive and not in general population, and the study found some definite but paradoxical effects. These are that in obesity on a background of hypertension, the total and LDL cholesterol as also the HDL cholesterol are decreased, but on use other hand, the value of VLDL cholesterol and triglycerides are grossly and significantly increased. These finding have two major Clinical implications in that obese hypertensives will be more prone to metabolic syndrome and type 2 diabetes mellitus, and steps should be taken to prevent them accordingly and also apart from statins one should treat the obese hypertensives with fibrates, fat restriction and physical exercise also

Serous cystadenoma of ovary with xanthogranulomatous oophoritis: combination of benign ovarian tumour with chronic inflammatory non-neoplastic pseudo-tumour-a rarity

Xanthogranulomatous inflammation is a rare type of chronic inflammation. It destroys the tissue of the affected organ, mostly affecting the kidney and gall bladder. Xanthogranulomatous inflammation of female genital tract being a rare entity, only few numbered cases involving the ovary have been reported in literature. This chronic inflammation of fallopian tubes and ovaries, usually present with pelvic masses, and on imaging and macroscopic appearance, are mostly misdiagnosed as ovarian neoplasm or tuberculosis. We are presenting a case of 14-year-old girl, who presented with an abdominal lump and on clinical and radiological investigations was suspected as ovarian malignancy but histo-pathology reported it as serous cystadenoma with xanthogranulomaotus oophoritis. The rarity of this case lies in the fact that rare destructive inflammatory features was present in a benign neoplasm of the ovary (serous cystadenoma) and that too in a youngest age reported till now

Modification of Hilbert's Space-Filling Curve to Avoid Obstacles: A Robotic Path-Planning Strategy

This paper addresses the problem of exploring a region using the Hilbert's space-filling curve in the presence of obstacles. No prior knowledge of the region being explored is assumed. An online algorithm is proposed which can implement evasive strategies to avoid obstacles comprising a single or two blocked unit squares placed side by side and successfully explore the entire region. The strategies are specified by the change in the waypoint array which robot going to follow. The fractal nature of the Hilbert's space-filling curve has been exploited in proving the validity of the solution

The development and application of a process model for R&D project management in a high tech firm: A field study

a b s t r a c t In R&D organizations of high tech firms, multiple R&D projects are executed concurrently and timeliness of project completion -i.e., developing the right products at the right times -is a matter of serious concern. Given that the priority of R&D projects and the interdependencies between the projects in a high tech firm change dynamically, high tech R&D project management is a complex and challenging endeavor. To improve the understanding and management of high tech R&D projects, this paper reports the findings of a field study where we, first, develop and empirically estimate a model that relates project priority over time with the generative mechanisms of market pull and technical challenge associated with R&D projects. Next, we develop and demonstrate the application of a process model within which the time-varying project priority model is embedded. The process model makes it possible to allocate fixed resources among competing projects with time-varying interdependencies, thereby improving the timeliness of project completion. This research was conducted in collaboration with a major U.S. high tech firm. The corporate R&D center of the firm served as the research setting for the field study. We present an application of the process model to delineate the evolution of the R&D organization with the merger of its (technology driven) parent firm with another (market driven) high tech manufacturing firm. The application of the process model generates theoretical insights that are used to develop testable propositions. Implications of the study findings and directions for future research are discussed

Cascaded Multi-View Canonical Correlation (CaMCCo) for Early Diagnosis of Alzheimer\u27s Disease via Fusion of Clinical, Imaging and Omic Features

The introduction of mild cognitive impairment (MCI) as a diagnostic category adds to the challenges of diagnosing Alzheimer\u27s Disease (AD). No single marker has been proven to accurately categorize patients into their respective diagnostic groups. Thus, previous studies have attempted to develop fused predictors of AD and MCI. These studies have two main limitations. Most do not simultaneously consider all diagnostic categories and provide suboptimal fused representations using the same set of modalities for prediction of all classes. In this work, we present a combined framework, cascaded multiview canonical correlation (CaMCCo), for fusion and cascaded classification that incorporates all diagnostic categories and optimizes classification by selectively combining a subset of modalities at each level of the cascade. CaMCCo is evaluated on a data cohort comprising 149 patients for whom neurophysiological, neuroimaging, proteomic and genomic data were available. Results suggest that fusion of select modalities for each classification task outperforms (mean AUC = 0.92) fusion of all modalities (mean AUC = 0.54) and individual modalities (mean AUC = 0.90, 0.53, 0.71, 0.73, 0.62, 0.68). In addition, CaMCCo outperforms all other multi-class classification methods for MCI prediction (PPV: 0.80 vs. 0.67, 0.63)

Hereditary gastrointestinal polyposis syndromes Rare Disease Collaborative Network consensus statement agreed at the RDCN meeting Birmingham 17th February 2022

NHS England set out in the Implementation Plan for the UK Strategy for Rare Diseases (https://www.england.nhs.uk/wp-content/uploads/2018/01/implementation-plan-uk-strategy-for-rare-diseases.pdf) that it would develop and implement Rare Disease Collaborative Networks (RDCNs), with the definition of a RDCN being a ‘recognised network of member providers, each of which has demonstrable research-active interest in a rare/very rare disease, the aim of the network being to improve patient outcomes’. The network is composed of Rare Disease Collaborative Centres. A Rare Disease Collaborative Centre (RDCC) is a ‘provider that has been recognised as having a demonstrable research-active interest in a rare/very rare disease and who works with other recognised providers in a network to improve patient outcomes’. This initiative is also in line with the NHS England Board paper ‘12 Actions to Support and Apply Research in the NHS’ discussed on 30 November 2017 (https://www.england.nhs.uk/wp-content/uploads/2018/05/12-actions-to-support-and-apply-research-in-the-nhs.pdf)

The Complex Spatio-Temporal Regulation of the Drosophila Myoblast Attractant Gene duf/kirre

A key early player in the regulation of myoblast fusion is the gene dumbfounded (duf, also known as kirre). Duf must be expressed, and function, in founder cells (FCs). A fixed number of FCs are chosen from a pool of equivalent myoblasts and serve to attract fusion-competent myoblasts (FCMs) to fuse with them to form a multinucleate muscle-fibre. The spatial and temporal regulation of duf expression and function are important and play a deciding role in choice of fibre number, location and perhaps size. We have used a combination of bioinformatics and functional enhancer deletion approaches to understand the regulation of duf. By transgenic enhancer-reporter deletion analysis of the duf regulatory region, we found that several distinct enhancer modules regulate duf expression in specific muscle founders of the embryo and the adult. In addition to existing bioinformatics tools, we used a new program for analysis of regulatory sequence, PhyloGibbs-MP, whose development was largely motivated by the requirements of this work. The results complement our deletion analysis by identifying transcription factors whose predicted binding regions match with our deletion constructs. Experimental evidence for the relevance of some of these TF binding sites comes from available ChIP-on-chip from the literature, and from our analysis of localization of myogenic transcription factors with duf enhancer reporter gene expression. Our results demonstrate the complex regulation in each founder cell of a gene that is expressed in all founder cells. They provide evidence for transcriptional control—both activation and repression—as an important player in the regulation of myoblast fusion. The set of enhancer constructs generated will be valuable in identifying novel trans-acting factor-binding sites and chromatin regulation during myoblast fusion in Drosophila. Our results and the bioinformatics tools developed provide a basis for the study of the transcriptional regulation of other complex genes

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research