Laparoscopic retrieval of misplaced copper T

Intrauterine contraceptive device is important part of family planning services in India. These can be inserted post menstrually, post abortal, post-delivery or in post puerperal period. Associated complications include bleeding, pain, infection, expulsion and most serious complication as perforation of uterine wall and migration to adjacent organs. We present a case of successful laparoscopic retrieval of a misplaced cuT. A 30-year-old female para 2 live 1 presented in SDMH outpatient department with right sided lower abdominal pain since one year. NCCT scan of pelvis showed IUCD in pelvic cavity anteriorly just above urinary bladder. Laparoscopic removal of cuT was done along with tubal recanalization

An unusual presentation of huge paraovarian cyst as papillary serous cyst adenofibroma: a rare case report

Paraovarian cysts constitute 10-20% of all adnexal masses and are usually less than two centimeter in diameter. Authors reported a 20-year-old unmarried female with vague abdominal discomfort since 1 year. On examination abdomen was uniformly distended with central position of umbilicus. Ultrasonography showed a large cystic mass extending from pelvis to pancreas likely of ovarian origin. Biochemical evaluation was not suggestive of malignant nature of this cystic mass. So, with due care of cosmesis, surgery was planned. After the midline vertical incision, peritoneal washings were collected for oicytological analysis to further exclude malignancy. Then 5mm cannula with trocar was inserted into the cyst to suck out the fluid then shrunken cystic wall was exteriorised. Right ovary was absolutely healthy. Enucleation of the cyst was done with preservation of ovary. Histopathology reported as a papillary serous cyst adenofibroma. Follow up period was uneventful.

One-Step versus Two-Step Diagnostic Test for Gestational Diabetes Mellitus

Aim: Comparison between one-step Diabetes in Pregnancy Study Group India (DIPSI) and American Diabetes Association (ADA) recommended two-step oral glucose tolerance test (OGTT). Material and methods: This study has a sample size of 200; 100 participants each were subjected to either of the two tests. Gestational diabetes mellitus (GDM) and non-GDM diagnosed by one-step test versus two-step test, respectively, were compared to one another and results were compared on the basis of various antenatal complications and fetomaternal outcomes. Results: No statistical difference was found between both the groups on the basis of various antenatal and fetomaternal outcomes. Conclusion: In Indian subcontinent with poor resources and lack of follow-up, single-step DIPSI can be preferred to ADA recommended two-step OGTT; however, large database studies are still required

One-Step versus Two-Step Diagnostic Test for Gestational Diabetes Mellitus

Aim: Comparison between one-step Diabetes in Pregnancy Study Group India (DIPSI) and American Diabetes Association (ADA) recommended two-step oral glucose tolerance test (OGTT). Material and methods: This study has a sample size of 200; 100 participants each were subjected to either of the two tests. Gestational diabetes mellitus (GDM) and non-GDM diagnosed by one-step test versus two-step test, respectively, were compared to one another and results were compared on the basis of various antenatal complications and fetomaternal outcomes. Results: No statistical difference was found between both the groups on the basis of various antenatal and fetomaternal outcomes. Conclusion: In Indian subcontinent with poor resources and lack of follow-up, single-step DIPSI can be preferred to ADA recommended two-step OGTT; however, large database studies are still required

SARC: Soft Actor Retrospective Critic

The two-time scale nature of SAC, which is an actor-critic algorithm, is characterised by the fact that the critic estimate has not converged for the actor at any given time, but since the critic learns faster than the actor, it ensures eventual consistency between the two. Various strategies have been introduced in literature to learn better gradient estimates to help achieve better convergence. Since gradient estimates depend upon the critic, we posit that improving the critic can provide a better gradient estimate for the actor at each time. Utilizing this, we propose Soft Actor Retrospective Critic (SARC), where we augment the SAC critic loss with another loss term - retrospective loss - leading to faster critic convergence and consequently, better policy gradient estimates for the actor. An existing implementation of SAC can be easily adapted to SARC with minimal modifications. Through extensive experimentation and analysis, we show that SARC provides consistent improvement over SAC on benchmark environments. We plan to open-source the code and all experiment data at: https://github.com/sukritiverma1996/SARC.Comment: Accepted at RLDM 202

Unraveling the Impact of High-Order Silk Structures on Molecular Drug Binding and Release Behaviors

Silk continues to amaze: over the past decade, new research threads have emerged that include the use of silk fibroin for advanced pharmaceutics, including its suitability for drug delivery. Despite this ongoing interest, the details of silk fibroin structures and their subsequent drug interactions at the molecular level remain elusive, primarily because of the difficulties encountered in modeling the silk fibroin molecule. Here, we generated an atomistic silk model containing amorphous and crystalline regions. We then exploited advanced well-tempered metadynamics simulations to generate molecular conformations that we subsequently exposed to classical molecular dynamics simulations to monitor both drug binding and release. Overall, this study demonstrated the importance of the silk fibroin primary sequence, electrostatic interactions, hydrogen bonding, and higher-order conformation in the processes of drug binding and release. © Copyright © 2019 American Chemical Society