An unusual combination of extra-adrenal pheochromocytoma and arteriovenous malformation of the ureter in a young adult

We present a case of a 24-year-old gentleman who presented with painless pan haematuria for 2 weeks. During the workup, he was diagnosed to have a retrocaval mass after a CT scan while cystoscopy revealed a polypoidal pulsating lesion in the left ureter. After surgical manipulation of the retrocaval mass, the blood pressure of the patient raised to 260/130 mm Hg. It was completely resected and diagnosed as extra-adrenalpheochromocytoma (paraganglioma) after histopathology. The lesion in the ureter was completely excised and fulgurated and diagnosed as anarteriovenous malformation. To the best of our knowledge, this is the first patient to be presented in the literature with this unusual combination

Performance Evaluation of Content Based Image Retrieval Using Indexed Views

Digital information is expanding in exponential order in our life. Information that is residing online and offline are stored in huge repositories relating to every aspect of our lives. Getting the required information is a task of retrieval systems. Content based image retrieval (CBIR) is a retrieval system that retrieves the required information from repositories on the basis of the contents of the image. Time is a critical factor in retrieval system and using indexed views with CBIR system improves the time efficiency of retrieved results

Is laparoscopic pyeloplasty a comparable option to treat ureteropelvic junction obstruction (UPJO)? a comparative study

Abstract OBJECTIVE: To compare laparoscopic with open pyeloplasty. METHODS: The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised records of patients who underwent surgical correction of ureteropelvic junction obstruction between during January 2008 and December 2012. Patients with laparoscopic pyeloplasty were placed in group 1 and those with open pyeloplasty in group 2.The groups were compared for operative time, hospital stay, perioperative complications, blood loss, duration of surgery, outcome and follow-up. Data was analysed using SPSS 19. RESULTS: Of the 73 patients, 29(40%) were in group 1, and 44(60%) in group 2. A crossing vessel could be identified in 25(86.2%) in group 1 and in 33(75 %) in group 2. Laparoscopic procedures were associated with a longer mean operating time (p=0.04), median estimated blood loss (p\u3c0.001) and a shorter mean hospital stay (p\u3c0.001). Follow-up mercaptoacetyltriglycinescan was done in 21(74.5%) patients in group 1 and 23(52.2%) in group 2. Only 2(7%) patients in group 1 and 2(4.5%) in group 2 had poor response on mercaptoacetyltriglycine scan. Mean follow-up was 2.71±1.2 months. Postoperative complications were 5(13%) in group 1 and 9(20%) in group 2(p=0.141). CONCLUSIONS: Laparoscopic pyeloplasty was associated with shorter hospital stay, less pain and less blood loss. The efficacy in term of success rate and perioperative complications of laparoscopic pyeloplasty was comparable to that of open pyeloplasty

Determinants of method switching among social franchise clients who discontinued the use of intrauterine contraceptive device

Introduction: Women who do not switch to alternatemethods after contraceptive discontinuation, for reasons other than the desire to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating contraceptive usage altogether. Methods: The data used for this study comes from a larger cross-sectional survey conducted in nine (9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data on 333 women, who reported the removal of IUCDs due to reasons other than the desire to get pregnant. Results: We found that 39.9% of the women do not switch to another method of contraception within one month after IUCD discontinuation. Use of contraception before IUCD insertion increases the odds for method switching by 2.26 times after removal. Similarly, postremoval follow-up by community health worker doubles (OR = 2.0) the chances of method switching. Compared with women who received free IUCD service (via voucher scheme), the method switching is 2.01 times higher among women who had paid for IUCD insertion. Conclusion: To increase the likelihood of method switching among IUCD discontinuers this study emphasizes the need for postremoval client counseling, follow-up by healthcare provider, improved choices to a wider range of contraceptives for poor clients, and user satisfaction

Family planning knowledge, attitudes, and practices among married men and women in rural areas of Pakistan: Findings from a qualitative need assessment study

This paper presents the findings of a qualitative assessment aimed at exploring knowledge, attitudes, and practices regarding family planning and factors that influence the need for and use of modern contraceptives. A descriptive exploratory study was conducted with married women and men aged between 15 and 40. Overall, 24 focus group discussions were conducted with male and female participants in three provinces of Pakistan. The findings reveal that the majority knew about some modern contraceptive methods, but the overall contraceptive use was very low. Knowledge and use of any contraceptive method were particularly low. Reasons for not using family planning and modern contraception included incomplete family size, negative perceptions, in-laws\u27 disapproval, religious concerns, side-effects, and lack of access to quality services. The majority preferred private facilities over the government health facilities as the later were cited as derided. The study concluded the need for qualified female healthcare providers, especially for long term family planning services at health facilities instead of camps arranged occasionally. Addressing issues around access, affordability, availability, and sociocultural barriers about modern contraception as well as involving men will help to meet the needs and ensure that the women and couples fulfill their childbearing and reproductive health goals

Finite-Control-Set Model Predictive Control for Low-Voltage-Ride-Through Enhancement of PMSG Based Wind Energy Grid Connection Systems

Grid faults are found to be one of the major issues in renewable energy systems, particularly in wind energy conversion systems (WECS) connected to the grid via back-to-back (BTB) converters. Under such faulty grid conditions, the system requires an effective regulation of the active (P) and reactive (Q) power to accomplish low voltage ride through (LVRT) operation in accordance with the grid codes. In this paper, an improved finite-control-set model predictive control (FCS-MPC) scheme is proposed for a PMSG based WECS to achieve LVRT ability under symmetrical and asymmetrical grid faults, including mitigation of DC-link voltage fluctuation. With proposed predictive control, optimized switching states for cost function minimization with weighing factor (WF) selection guidelines are established for robust BTB converter control and reduced cross-coupling amid P and Q during transient conditions. Besides, grid voltage support is provided by grid side inverter control to inject reactive power during voltage dips. The effectiveness of the FCS-MPC method is compared with the conventional proportional-integral (PI) controller in case of symmetrical and asymmetrical grid faults. The simulation and experimental results endorse the superiority of the developed FCS-MPC scheme to diminish the fault effect quickly with lower overshoot and better damping performance than the traditional controller

Holistic User eXperience in Mobile Augmented Reality Using User eXperience Measurement Index

© 2019 IEEE. User eXperience (UX) evaluation in the field of Mobile Augmented Reality (MAR) is a challenging task, which requires the application of many heterogeneous methods, producing a variety of raw signals and subjective data. This multi-method approach is essential for capturing the holistic UX of any product, service or system. In order to convert this data into information and subsequently knowledge, a comprehensive and scalable system is required which can not only quantify the individual UX metrics but also produce a concise result, which is interpretable by anyone. We call this result, the User Experience Measurement Index, and in this paper we present the results of adopting the mixed method UX evaluation approach for evaluating a prototype MAR application using various methods and sensors, applied before, during, and after its usage. Additionally, we present the methodology and results for calculating the UXMI

Future Greener Seaports:A Review of New Infrastructure, Challenges, and Energy Efficiency Measures

Recently, the application of renewable energy sources (RESs) for power distribution systems is growing immensely. This advancement brings several advantages, such as energy sustainability and reliability, easier maintenance, cost-effective energy sources, and ecofriendly. The application of RESs in maritime systems such as port microgrids massively improves energy efficiency and reduces the utilization of fossil fuels, which is a serious threat to the environment. Accordingly, ports are receiving several initiatives to improve their energy efficiency by deploying different types of RESs based on the power electronic converters. This paper conducts a systematic review to provide cutting-edge state-of-the-art on the modern electrification and infrastructure of seaports taking into account some challenges such as the environmental aspects, energy efficiency enhancement, renewable energy integration, and legislative and regulatory requirements. Moreover, the technological methods, including electrifications, digitalization, onshore power supply applications, and energy storage systems of ports, are addressed. Furthermore, details of some operational strategies such as energy-aware operations and peak-shaving are delivered. Besides, the infrastructure scheme to enhance the energy efficiency of modern ports, including port microgrids and seaport smart microgrids are delivered. Finally, the applications of nascent technologies in seaports are presented

Offshore Wind Farm-Grid Integration: A Review on Infrastructure, Challenges, and Grid Solutions

Recently, the penetration of renewable energy sources (RESs) into electrical power systems is witnessing a large attention due to their inexhaustibility, environmental benefits, storage capabilities, lower maintenance and stronger economy, etc. Among these RESs, offshore wind power plants (OWPP) are ones of the most widespread power plants that have emerged with regard to being competitive with other energy technologies. However, the application of power electronic converters (PECs), offshore transmission lines and large substation transformers result in considerable power quality (PQ) issues in grid connected OWPP. Moreover, due to the installation of filters for each OWPP, some other challenges such as voltage and frequency stability arise. In this regard, various customs power devices along with integration control methodologies have been implemented to deal with stated issues. Furthermore, for a smooth and reliable operation of the system, each country established various grid codes. Although various mitigation schemes and related standards for OWPP are documented separately, a comprehensive review covering these aspects has not yet addressed in the literature. The objective of this study is to compare and relate prior as well as latest developments on PQ and stability challenges and their solutions. Low voltage ride through (LVRT) schemes and associated grid codes prevalent for the interconnection of OWPP based power grid have been deliberated. In addition, various PQ issues and mitigation options such as FACTS based filters, DFIG based adaptive and conventional control algorithms, ESS based methods and LVRT requirements have been summarized and compared. Finally, recommendations and future trends for PQ improvement are highlighted at the end