Modification of Hill Cipher Technique using Self Repetitive Matrix (Modular Arithmatic) and Correlation of Eigen values of Matrix with the Exponent N

Cryptography has a long and fascinating history. Over the centuries, an elaborate set of protocols and mechanisms has been created to deal with information security issues when the information is conveyed by physical documents. Often the objectives of information security cannot solely be achieved through mathematical algorithms and protocols alone, but require procedural techniques and abidance of laws to achieve the desired result. For example, privacy of letters is provided by sealed envelopes delivered by an accepted mail service. The physical security of the envelope is, for practical necessity, limited and so laws are enacted which make it a criminal offense to open mail for which one is not authorized. It is sometimes the case that security is achieved not through the information itself but through the physical document recording it. For example, paper currency requires special inks and material to prevent counterfeiting

Profile of tuberculous pneumothorax and comparison with pulmonary tuberculosis without pneumothorax

Background: Tuberculosis is the most common cause of secondary spontaneous pneumothorax (SSP) in India. The prevalence of SSP in patients with pulmonary tuberculosis (PTB) is between 1- 3%. There were only few studies in the literature that specifically analyze tuberculous PNTX. In a study from this hospital, author found PTB was the most common cause of SSP. Now, author aimed at studying the clinical profile of tuberculosis associated PNTX cases and compared with pulmonary tuberculosis cases without PNTX.Methods: This was a single centre prospective observational case control study done at a tertiary care hospital. Fifty patients of tuberculous pneumothorax as cases, and 100 patients of pulmonary tuberculosis without pneumothorax were taken as control. The demographic data, clinical presentation, and radiologic presentation, outcomes after treatment were recorded in both the groups. The data was analyzed using statistical software (SPSS) using appropriate statistical tools.Results: The mean age of patients in the PNTX group was 38.18±14.132, where as in the control group it was 45.29±14.89 (p-value of 0.0052). Past history of tuberculosis was present in 27 (54%) cases of PNTX group and in 41 (41%) cases in the control group (p-value of 0.091). The mean duration of length of hospital stay in PNTX group was 16.5±11.865 days and in non-pneumothorax group was 6.2±2.54 days (p-value was 0.0001).Conclusions: Tuberculous pneumothorax was more common between 30-40 yrs age group. Gender and smoking have no association with PNTX. Tuberculous pneumothorax was more common in previously treated cases of TB. Patients with tuberculous PNTX have prolonged hospital stay and complications resulting in increased morbidity, financial burden and mortality

Septic Embolism in Endocarditis: Anatomic and Pathophysiologic Considerations

Septic embolism is a relatively common and potentially severe complication of infective endocarditis (IE). Septic emboli (SE), most often described as consisting of a combination of thrombus and infectious material—either bacterial or fungal—can be caused by hematogenous spread from virtually any anatomic site; however, it most commonly originates from cardiac valves. During the past two decades there has been a confluence of various risk factors that, both alone and in combination, led to greater incidence of both IE and SE, including increasing population age, greater use of prosthetic valves, implantation of various intracardiac devices, escalating intravenous drug use, and the high incidence of healthcare associated infections with antibiotic resistant microorganisms. From a clinical standpoint, SE can present at any time during the course of IE and may even be the initial presenting sign. SE may affect virtually any location in the human body, but some organs (e.g., liver, spleen, brain) and anatomic regions (e.g., lower extremity) tend to be more frequently involved. The most important aspect of management involves prompt recognition and proactive therapeutic approach. Given the broad spectrum of clinical presentations, symptoms and complications, SE can be challenging to diagnose and treat. Following the identification of SE, appropriate antibiotic coverage should be immediately instituted followed by supportive and/or interventional management, depending on the severity of presentation and the associated complications. In this chapter we explore the pathophysiology, anatomic origins, diagnostic tools, therapeutic measures, and new developments in SE, focusing predominantly on bacterial infections of cardiac origin

The Importance of Post-Doctoral Program to GME in an Academic Medical Center

Continuous advancements in the medical field and the need to promote scientific evidence has increased the concern for educators to ensure that physician trainees are provided with the appropriate tools and experiences to develop the skills necessary to enhance scientific discovery. To address this requirement, the Accreditation Council for Graduate Medical Education (ACGME) implemented core competencies, inclusive of scholarly activity requirements, for accreditation of Graduate Medical Education (GME) programs. These changes have challenged institutions to educate differently and incorporate scholarly activity and research into their curriculum through novel and creative approaches. One such mechanism is the development of post-doctoral research programs which utilize research fellows to provide the necessary support for research productivity across multiple specialties. In the following chapter, the authors will provide some background information on the goals and function of the ACGME, detail the development of the new research requirements, the utilization of post-doctoral research fellows to support the scholarly activity requirement laid out by the ACGME, and potential measures of performance and success

Outcomes of multi drug resistant tuberculosis under programmatic conditions: the experience

Background: Tuberculosis is the most common cause of death from an infectious disease worldwide after HIV/AIDS. Drug resistant tuberculosis continues to be a public health crisis. India stands, one among 27 “high burden” MDR countries and has over 2 million new TB cases every year and TB kill’s nearly 1000 people every day. The WHO 2018 Global Tuberculosis Report estimated that, worldwide, approximately 3.5 percent of all new TB cases and 18 percent of previously treated cases are caused by MDR or rifampicin-mono resistant strains.Methods: Presumptive drug resistance TB cases were subjected for CBNAAT or LPA to detect resistance patterns. About 231 cases of MDR/RR TB cases after pre-treatment evaluation started on CAT- IV regimen and both interim and final outcomes were analyzed.Results: Out of 231cases 172(74.4%) were males and 59(25.6%) were females with age between 13-75yrs. Total of 194 cases culture conversion occurred out of which 28 cases the cultures were reverted back to positives. Final Outcomes were, cured in 84 (36.3%) cases, treatment completed in 42 (18.18%) cases, defaulters in 31 (13.4%) cases, turned to be XDR in 10 (4.32%) cases, treatment failure in 10 (4.32%) cases, 50 (21.6%) cases died, 3(1.29%) cases were transferred out.Conclusions: Approximately 2/3rd of MDR/RR TB cases are retreatment sputum positive cases. Successful outcome observed in 54.54% of cases only. High rates of deaths and defaulters alarm the necessity of more effective implementation and surveillance of the programme

A rare case of plasma cell osteomyelitis with atypical presentation

Plasma cell osteomyelitis is an uncommon type of localized chronic osteomyelitis which is characterized by the absence of typical clinical features of infection. It usually affects the metaphysis of long bones and presents as dense thickening of bone without sequestrum formation. We present an atypical case of plasma cell osteomyelitis with a lesion in the diaphysis of long bone and sequestrum formation. A 23 year old male patient came to our OPD with complaint of pain in mid-thigh radiating to the left knee since 2 months. X-ray showed radiolucencies in the medulla of middle third of shaft of femur along with a linear sequestrum suggestive of chronic osteomyelitis. An open biopsy was performed and surgical curettage was done. Histopathological examination was consistent with plasma cell osteomyelitis. Chronic plasma cell osteomyelitis is a rare condition with nonspecific findings and an unclear cause. Histopathology is the definitive tool for obtaining a diagnosis. Knowledge of this condition and proper management can give a better outcome, at the same time avoiding unnecessary investigations and procedures