Study of cutaneous manifestations of polycystic ovarian syndrome

Background: Polycystic ovarian syndrome (PCOS) is one of the most frequently encountered endocrine disorders that occurs in as many as 4 to 10% of women of reproductive age group. It presents with a series of skin changes including acne, hirsutism, seborrhea, androgenetic alopecia (AGA) and acanthosis nigricans. Aim of the study was to determine the prevalence and frequency of different cutaneous manifestations in PCOS patients and to correlate them with the degree of hormonal abnormalities.Methods: A total 100 patients with features of PCOS who presented to department of dermatology, gynecology (January 2018-December 2019) with cutaneous manifestations were recorded and diagnosis of PCOS was made using Rotterdam’s criteria. Pregnant women and diagnosed cases of any other endocrine disorder were excluded. Hirsutism was assessed using Ferriman-Gallwey score and AGA according to Ludwig’s classification. Serum hormonal profile including FSH, LH, prolactin, testosterone (free), DHEAS, TSH, FBS, fasting insulin were done. Insulin resistance was determined by calculating HOMA-IR score.Results: Among cutaneous manifestations of PCOS, hirsutism (85%) was the most common finding followed by acne (73%), seborrhea (50%), AGA (36%), acanthosis nigricans (29%) and acrochordons (9%). The most common hormonal abnormality was insulin resistance in 53% patients, followed by raised free testosterone in 19% and serum prolactin in 18% patients. A statistically significant association was present between AGA and insulin resistance, hirsutism and raised prolactin levels, seborrhea and raised body mass index (p < 0.05).Conclusions: Dermatological manifestations of PCOS play a significant role in making the diagnosis and constitute a substantial portion of the symptoms experienced by women with this syndrome

Scrub typhus: as it stands today

Scrub typhus is one of the three most common causes of prolonged fever in Southeast Asia and Pacific affecting almost 1 million people annually worldwide out of 1 billion exposed. Scrub typhus is a rickettsial infection caused by Orientia Tsutsugamushi transmitted through bite of Chiggers (larval stage of trombiculid mite). It is an acute febrile illness which generally causes non-specific symptoms and signs. The clinical manifestations of this disease range from sub-clinical disease to organ failure and death. Deaths are attributable to late presentation, delayed diagnosis, and drug resistance. Scrub typhus, though endemic in India; yet is under reported. It should be considered as an important differential diagnosis in a febrile patient with thrombocytopenia, deranged liver or renal functions, and B/L chest opacities. Relapse is not uncommon. Presumptive treatment with Doxycycline can be a suitable option in febrile patients from Typhus pockets. Alert physician should keep an eye on deviation from usual presentation to changing spectrum of the disease. Early diagnosis and appropriate treatment is rewarding and prevents morbidity and mortality

Tropical pulmonary eosinophilia: effect of addition of corticosteroids after failure of diethylcarbamazine therapy

Successful response in diethylcarbamazine (DEC) therapy in tropical pulmonary eosinophilia (TPE) is not universal with a 20–40% failure rates in chronic cases. Corticosteroids have been used in such patients. However, their role in management remains ill-defined. A patient of TPE with incomplete clinical, haematological and physiological response to a standard 3 weeks DEC therapy received additional corticosteroids for the next two cycles, after which complete remission occurred. However, there was a relapse two months later with evidence of a chronic state requiring further treatment with corticosteroids with good response.Successful response in diethylcarbamazine (DEC) therapy in tropical pulmonary eosinophilia (TPE) is not universal with a 20–40% failure rates in chronic cases. Corticosteroids have been used in such patients. However, their role in management remains ill-defined. A patient of TPE with incomplete clinical, haematological and physiological response to a standard 3 weeks DEC therapy received additional corticosteroids for the next two cycles, after which complete remission occurred. However, there was a relapse two months later with evidence of a chronic state requiring further treatment with corticosteroids with good response

Clinical profile and fetal outcome in women with preterm labor pains

Background: Preterm labor is a potential cause of preterm birth. Certain demographic and presenting features in pregnant women may correlate to the severity of the problem and progression to delivery. The aim of the study was to find out the clinical profile and fetal outcome in women with preterm labor pains in a tertiary care hospital of North India.Methods: 83 women with preterm labor were included in the study. Antenatal corticosteroids and tocolytic therapy were given. Women who delivered preterm comprised of Group A and who delivered at term were Group B. Clinical profile and fetal outcome was compared and statistically analyzed.Results: 39 (47.0%) women had preterm delivery (Group A) and 44 (53.0%) women delivered at term (Group B). 23.1% women in group A and 4.5% in group B had a previous preterm birth (p=0.021). 16 (41%) women in group A and 4 (9.1%) in group B had a positive microbial growth on high vaginal swab (p=0.001). The odds of having a preterm birth with cervical length of <2 cm was calculated to be 5.281 (p=0.000). A statistically significant difference was observed in the mean birth weight, Apgar score and nursery admissions in both the groups (p=0.000).Conclusions: A prior history of preterm birth, a positive growth on high vaginal swab and a cervical length of less than 2 cm were found to be significantly associated with preterm birth

Continual Learning with Dependency Preserving Hypernetworks

Humans learn continually throughout their lifespan by accumulating diverse knowledge and fine-tuning it for future tasks. When presented with a similar goal, neural networks suffer from catastrophic forgetting if data distributions across sequential tasks are not stationary over the course of learning. An effective approach to address such continual learning (CL) problems is to use hypernetworks which generate task dependent weights for a target network. However, the continual learning performance of existing hypernetwork based approaches are affected by the assumption of independence of the weights across the layers in order to maintain parameter efficiency. To address this limitation, we propose a novel approach that uses a dependency preserving hypernetwork to generate weights for the target network while also maintaining the parameter efficiency. We propose to use recurrent neural network (RNN) based hypernetwork that can generate layer weights efficiently while allowing for dependencies across them. In addition, we propose novel regularisation and network growth techniques for the RNN based hypernetwork to further improve the continual learning performance. To demonstrate the effectiveness of the proposed methods, we conducted experiments on several image classification continual learning tasks and settings. We found that the proposed methods based on the RNN hypernetworks outperformed the baselines in all these CL settings and tasks.Comment: Paper got accepted in IEEE/CVF Winter Conference on Applications of Computer Vision (WACV) 202

Formulation and standardization of homoeopathic mother tincture of Cinnamomum zeylanicum

Alcoholic preparation of drugs in Homoeopathy, are called as tincture. The mother tincture of Cinnamomum zeylanicum was prepared by 100 g of coarse powder (40 mess) of Cinnamomum zeylanicum was macerated with 95 v/v % of alcohol to make 1000 ml of mother tincture for eight days (drug strength 1/10). It was shaken occasionally, and filtered. The mother tincture was standardized by using various physical, chemical and chromatographic parameters.Keywords: Cinnamomum zeylanicum, mother tinctur