Clinical study of multiple myeloma and treatment responses in a tertiary care centre

Background: Multiple myeloma (MM) evolves from Monoclonal gammopathy of unknown significance (MGUS), a premalignant clinical condition. Second to non-Hodgkin’s lymphoma, MM is the most common haematological malignancy. The aim of the study was to review the clinical profile and response of individuals treated for MM from this part of country.Methods: We evaluated data of patients with MM managed between 2013 and 2019 at a tertiary care cancer hospital in Rajamahenderi, India. Data regarding demographic variables, clinical features, disease characteristics and treatment details were collected and analysed.Results: Total of 54 patients with MM were managed. Mean age was 59.4 years. Males accounted for 63%. Bone pain (90%) was the most common symptom. Elevated serum creatinine was noted in 16.7% and M band in 42 (77.8%). X-ray of skull showed lytic lesions in 41 (75.9%). Mean haemoglobin value was 8.8±1.9 g/dl and serum calcium was 9.12 mg/dl. Majority of subjects, 44 (81.48%) belong to stage IIIA, 9 (16.67%) to stage IIIB, and 1.85% to stage IIA of Durie Salmon staging system. No response was noted in 17 (31.5%), 4 (7.4%) subjects had a progressive disease even on treatment, and 8 (14.8%) subjects had a very good partial response. Median survival of subjects belonging to DSS stage II was 17 months, IIIA was 11.037 months and stage IIIB was 17.463 months.Conclusions: MM has an early onset in India. Though MM is an incurable disease, many promising treatment options are there which lead to increase in survival. Early treatment helps in improving mortality rates, better quality of life and decreases disease burden

Migration of forgotten stent into renal pelvis

Stent migration is a well recognized complication of forgotten stents, but migration into the renal pelvis is rarely documented. We present a case of migration and coiling of a forgotten stent in the renal pelvis, and discuss briefly, the etiological factors for the phenomenon and associated problems in management

Testicular leiomyosarcoma with metastasis

Primary leiomyosarcoma of testis is a rare entity with few cases reported in literature. Primary leiomyosarcoma of testis usually occurs following radiotherapy or long-term anabolic steroid use. Without these predisposing factors, its occurrence is rare. In the present study, we present a rare case of primary leiomyosarcoma of testis occurring in an elderly patient, with an unusual presentation mimicking epididymo-orchitis and metastasis eight months following high inguinal orchidectomy

Neural Comb Filtering Using Sliding Window Attention Network for Speech Enhancement

In this paper, we demonstrate the significance of restoring harmonics of the fundamental frequency (pitch) in the deep neural network (DNN)-based speech enhancement. The parameters of the DNN can be estimated by minimizing the mask loss, but it does not restore the pitch harmonics, especially at higher frequencies. In this paper, we propose to restore the pitch harmonics in the spectral domain by minimizing cepstral loss around the pitch peak. Restoring the cepstral pitch peak, in turn, helps in restoring the pitch harmonics in the enhanced spectrum. The proposed cepstral pitch-peak loss acts as an adaptive comb filter on voiced segments and emphasizes the pitch harmonics in the speech spectrum. The network parameters are estimated using a combination of mask loss and cepstral pitch-peak loss. We show that this combination offers the complementary advantages of enhancing both the voiced and unvoiced regions. The DNN-based methods primarily rely on the network architecture, and hence, the prediction accuracy improves with the increasing complexity of the architecture. The lower complex models are essential for real-time processing systems. In this work, we propose a compact model using a sliding-window attention network (SWAN). The SWAN is trained to regress the spectral magnitude mask (SMM) from the noisy speech signal. Our experimental results demonstrate that the proposed approach achieves comparable performance with the state-of-the-art noncausal and causal speech enhancement methods with much lesser computational complexity. Our three-layered noncausal SWAN achieves 2.99 PESQ on the Valentini database with only 10 9 floating-point operations (FLOPs). © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature

Midureteric knotted stent removed by percutaneous access!

Indwelling ureteric stents are commonly used in the management of upper urinary tract obstruction. A rare complication is the knotting of an indwelling ureteric stent at its proximal coiled end. We present a case of a mid ureteric knotted stent that put the kidney at risk. Stent was extracted successfully by Percutaneous method, after failed minimally invasive methods