AN EFFICIENT ALGORITHM FOR LOAD BALANCING IN CLOUD COMPUTING

Cloud computing is a computing provided over the internet. The principle aspect of cloud computing is virtualization that deals with the construction and management of virtual machines efficiently. As the number of consumers and requests for the services are increasing day by day in cloud computing, therefore load balancing is an important research area for handling the users’ requests efficiently. For efficient & effective management and usage of cloud service provider’s resources, many load balancing algorithms have been already proposed. This paper proposed and implemented a hybrid approach for virtual machine level load balancing

Decidual cast

Decidual cast describes the spontaneous sloughing of endometrium as an entire piece while retaining the shape of endometrial cavity. 15 year old girl presented to the outpatient Department of Obstetrics and Gynaecology, Subharti medical college in September 2015 with complaints of heavy menstrual bleeding since the onset of menstruation. On examination her vitals were stable and there was mild pallor. Systemic examination was found to be normal. All her investigations were within normal limits. She was give iron supplementation and was started on low dose combined oral contraceptive pills. Every woman should obtain detailed information about the possible side effects of hormonal therapies including endometrial cast discharge

Comparative study of hysteroscopy, hysterosalpingography and transvaginal sonography in evaluation of the female infertility

Background: One of the most important and underappreciated reproductive health problems in developing countries is that of infertility. Objective of this study was to evaluate HSC (hysteroscopy), HSG (hysterosalpingography) and ultrasonography in infertility.Methods: This study was conducted among 100 infertile patients over a period of two years. The patients were questioned for the detailed history including socioeconomic status, medical history and previous history of taking any medications and supplements. The recruited patients had to undergo.Results: Transvaginal sonography and clinical examination were done. Transvaginal sonography detected abnormality in 40% of women. 65 women had normal hysterosalpingography findings whereas the rest 35 women had abnormal hysterosalpingography findings. Thirty nine percent (39%) had normal hysteroscopic findings while sixty one percent (61%) had abnormal findings. The study depicts that hysteroscopy has sensitivity (95%) and negative predictive value NPV (92%) whereas that of TVS is 48.9% and 44.9% respectively. Hysterosalpingography has sensitivity 68.3% and NPV 40.3%. Specificity (100%) and positive predictive value PPV (100%) of all the three modalities are the same.Conclusions: The results of the present study showed that each modality provided useful information but no single modality provided complete information for evaluating infertile women. Thus, a combination of all three modalities- TVS (transvaginal sonography), HSG (hysterosalpingography) and hysteroscopy is necessary to evaluate infertile women

Prevalence and complications of hypothyroidism during pregnancy in western Uttar Pradesh

Background: This study was designed to know the prevalence of hypothyroidism during pregnancy in western part of Uttar Pradesh and its potential complications. A prospective and comparative clinical study to know prevalence of thyroid disorder in pregnancy and pregnancy outcome was done.Methods: Eight Hundred eighty seven pregnant cases from Department of Obstetrics and Gynaecology, Chattrapati Shivaji Subharti Hospital, Meerut were enrolled in the study from the year 2018 to 2020. Detailed history and physical examination was done. Thyroid Function test (FT3, FT4, TSH and Anti-TPO) were performed after the confirmation of pregnancy. Patients were followed up during entire pregnancy. Thirty seven patients dropped out from the study.Results: In this study, prevalence of thyroid disorder was 27.28% which was high when compared to other regions in India and in other parts of Asia. Subclinical hypothyroidism and Overt hypothyroidism was 16.57% and 10.71% respectively. Subclinical hypothyroidism was more prevalent and hidden, leading to the poor obstetrical outcome and fetal complications. Rate of miscarriage was high in overt hypothyroid patients.Conclusions: Due to the immense impact that the maternal thyroid disorder has on maternal and fetal outcome, prompt identification of thyroid disorders and timely initiation of treatment is essential. Thus, universal screening of pregnant women for thyroid disorder should be considered especially in a country like India where there is a high prevalence of undiagnosed thyroid disorder

Comparison of ease of insertion, visibility of strings and continuation rate of post-partum intrauterine copper device insertion by long inserter versus with the help of Kelly’s forceps

Background: The objective of the study was to compare ease of insertion, visibility of strings and continuation rate of post-partum intrauterine copper devices (PPIUCD) insertion by long inserter versus with the help of Kelly’s forceps.Methods: 100 women were enrolled in our study which was conducted in department of obstetrics and gynecology, Subharti medical college and Chattrapati Shivaji Subharti hospital (CSSH), Meerut over a period of 2 years between November 2018 and August 2020. In study comparison was done on insertion technique of PPIUCD.Results: High fundal placement was achieved with long inserter. There was no perforation and decreased infection rate among the users with no increase in incidence of side effects and expulsion. Among 50 insertion, 1 woman (2%) had partial expulsion, 2 women (4%) had complete expulsion and 1 woman (2%) got PPIUCD removed on request. Providers reported 100% easier technique. 96% satisfaction among the users.Conclusions: The dedicated long inserter PPIUCD was found to be safe, with high acceptability among the participants and providers. Study revealed the reduced risk of infection and expulsion, providers also reported increased convenience in insertion compared to standard PPIUCD insertion techniques

Predictive value of admission and intrapartum cardiotocography in normal and high risk antenatal women

Background: Cardiotocography is the most common method for assessing fetal health and reveals brain oxygenation. This study is done for admission and intrapartum cardiotocography in high- and low-risk pregnancies and its correlation with neonatal outcome. Methods: All high-risk and normal antenatal women with more than 34 weeks of pregnancy and vertex presentation who came to the labor room were included in the study. 200 cases were taken, 100 were in the "high risk group," and the remaining 100 were in the "low risk group." On admission CTG and intrapartum CTG tracing were taken after written and informed consent, neonatal outcomes were observed, and adverse neonatal outcomes were noted. Results: Admission CTG results were unsatisfactory for 9% of women in the high-risk group and none in the low-risk group. Intrapartum NST was non reassuring in 51% of high-risk women and 6% of the low-risk group. Of the total number of neonates admitted to the NICU, 14 were from the low-risk group, while 50 were from the high-risk group. Conclusions: On admission NST in both low and high-risk women, the absence of category III NST predicted the absence of an adverse neonatal outcome most accurately. Even during labor in both high-risk and low-risk women, the absence of category III reassured the fetal well-being most precisely

Association of serum beta-hCG and urine albumin-creatinine ratio with hypertensive disorders during pregnancy

Background: Preeclampsia with or without severe symptoms, chronic hypertension with or without superimposed pre-eclampsia/eclampsia, gestational hypertension, HELLP syndrome, or eclampsia all pose a significant risk of morbidity for both the mother and the unborn child. The aim of this study was to investigate if the albumin-to-creatinine ratio in urine spots and the serum beta-hCG level correlate with the hypertensive illness of pregnancy.” Method: “The current inquiry was conducted during the months of October 2020 and August 2022 at the obstetrics and gynaecology department of Subharti medical college in Meerut, Uttar Pradesh. The study was not open to women who were more than 20 weeks pregnant, had gestational diabetes mellitus, had more than one pregnancy, had chronic hypertension, chronic renal disease, chronic liver disease, cardiac disease, systemic lupus erythematosus, or haematological illnesses. We measured the levels of serum beta hCG and the urine albumin-creatinine ratio, and we compared them between the groups.” Results:  After ensuring that each participant had given their informed permission, the trial comprised a total of 200 patients. In the hypertensive group of the participants in the study, 31% were between the ages of 21 and 35, and 29% were less than 20 years old. With increased beta hCG and UACR, there was a higher incidence of hypertensive retinopathy, acute renal failure, DIC, and PPH among the patients, as well as the poorest fetal outcomes. (p<0.05) Conclusions: The presence of a substantial relationship between hypertensive diseases and raised levels of beta-hCG during pregnancy, as well as a greater ratio of urine albumin to creatinine.  There is a considerable increase in the incidence of fetal growth retardation, preterm, and mortality occurring within the uterus among mothers who have higher levels of beta-hCG and urine ACR

Study of the frequency of female genital tract infection using cartridge based nucleic acid amplification test

Background: The aim of the study was to study the frequency of female genital tract infection using cartridge based nucleic acid amplification test (CBNAAT), to study the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CBNAAT.Methods: This prospective observational study was conducted among 100 patients as per inclusion criteria with genital tract infection in Swami Vivekanand Subharti University, Meerut over a period of two years. Investigations including ZN staining for acid fast bacillus (AFB), endometrial sampling for histopathology, CBNAAT and BACTEC culture were sent.Results: In a study of 100 patients’ histopathological examination detected tuberculosis in 2% patients while CBNAAT detected tuberculosis in 5% patients. Tubercle bacilli was found in 3% women on AFB stain while in only 1%-woman genital tuberculosis was diagnosed by BACTEC culture.Conclusions: Female genital tuberculosis is detected most frequently when a woman presents with unexplained infertility. Newer technologies allow genital tuberculosis to be identified at an earlier stage and enable us to provide treatment. CBNAAT being a sensitive test picked up more cases than histopathology, culture, AFB stain. Hence CBNAAT should be widely used for early detection of female genital tuberculosis

Comparative study of hysteroscopy with ultrasonography and its correlation with histopathology in cases of abnormal uterine bleeding in perimenipausal women

Background: The aim was to compare the diagnostic efficacy of ultrasonography (USG) and hysteroscopy in detecting uterine abnormalities in abnormal uterine bleeding (AUB) by correlating the results with histopathological examination.Methods: This prospective study was conducted among women attending gynecological OPD of Subharti medical college, Meerut over a period of two years from October 2019 to August 2021. A total of 100 perimenopasual women with AUB attending obstetrics and gynaecology OPD were included in this study. All patients underwent transvaginal scan to note down the endometrial thickness and to rule out uterine and adnexal pathology. All the patients underwent diagnostic hysteroscopy, followed by a biopsy of the endometrium using a curette. The endometrium was sent to the pathologist. Findings of these diagnostic modalities then correlated.Results: Out of 100 women, USG detected that 54 patients (54%) had no pathology and 46 patients (46%) had abnormal findings, out of which maximum patients, 29 patients (63.04%) had endometrial hyperplasia. According to hysteroscopy, 46 patients (46%) had normal hysteroscopic findings while 54 patients (54%) had abnormal findings of which maximum were 18 patients (33.33%) who had endometrial hyperplasia. Histopathology findings revealed that 47 patients (47%) had normal findings and 53 patients (53%) had abnormal findings out of which maximum patients 20 (37.7%) had endometrial hyperplasia. In our study of 100 women with AUB, on USG only 1 patient had endometrial malignancy and the same was reported by hysteroscopy and histopathology.Conclusions: In our study hysteroscopy proved to be highly sensitive and specific considering histopathology as gold standard. Ultrasonography has good sensitivity and specificity but less as compared to hysteroscopy

Colposcopic evaluation in cases of persistent inflammatory Pap smear

Background: The aim of the study was to assess the colposcopic evaluation in cases of persistant inflammatory Papanicolaou (Pap) smear.Methods: This was a prospective analytical study, conducted amongst 78 women attending the outpatient department of obstetrics and gynaecology at Subharti Medical College. Pap smear was performed by the conventional method and colposcopy was done for all 78 sexually active women who came with complaints of pain abdomen, irregular cycles, white discharge per vaginum and urinary tract infections. Final correlation of Pap smear and colposcopy were based on histopathology and human papillomavirus deoxyribonucleic acid (HPV DNA).Results: In this study of 78 women, 21% of women had normal colposcopic findings whereas 79% had abnormal colposcopic findings. Histopathological examination (HPE) findings revealed that 69% women had cervical intraepithelial neoplasia (CIN) 1, 23% had CIN II, 6% had CIN III and 3% had SCC. 25% women tested positive for HPV DNA and 75% women tested negative for HPV DNA.Conclusions: Patients with persistent inflammatory Pap smear despite undergoing treatment show changes on Colposcopic directed biopsies.