Convolutional Neural Network Based Image Classification

This paper presents the study of Convolutional Neural Network based Image Classification. In this study, different convolutional neural network model is implemented for image classification. There are two application which is performed in this namely, emotion detection from facial emotion recognition system and covid-19 detection from lung CT-scan. In this research work, AlexNet and ResNet-50 convolutional neural network models are used for comparison and evaluation is done based on its training accuracy and testing accuracy, confusion matrix and Area under the curve (AUC) of ROC graph. All the experiments are performed on MATLAB software. In the First application of CNN model is implemented to detect emotions from facial expressions and SVM classifier is used for classification of each emotion among eight facial expressions namely, surprise, contempt, happiness, sadness, fear, anger, disgust, and neutral. The following proposed work is carried out on CK+ datasets to determine the recognition. After performing on both CNN models accuracy of both the models are compared. The result shows that ResNet-50 model achieved the best accuracy of 97.32% which is better than 90.55% which got on AlexNet model. In Second application of CNN model is to detect covid-19 from lung CT-scans. The highest performing model, the ResNet-50 on a SARS-CoV-2 CT-scan dataset achieved an accuracy of 95.72% which is maximum than 85.50% which achieved on AlexNet Model. Gradient-Weighted Class Activation Mapping (Grad-CAM) is also used to display infected area in the lungs. After performing this experiment, the final results shows that the ResNet-50 model, performs much better as compared to AlexNet model

Reducing morbidity in second stage cesarean section by Patwardhan’s (shoulders first) method of delivery

Background: To evaluate Patwardhan’s method of delivering shoulders first during second stage cesarean section.Methods: 154 consecutive cases of cesarean section for second stage arrest or obstructed labor over a period of one year (July 2016 to June 2017) were included in the study. 77 cases delivered by Patwardhan’s method comprised of study group and 70 cases delivered by vertex, 7 cases delivered by breech served as control. Fetal and maternal outcomes were compared in these two groups.Results: Obstetric features like parity, maternal height, duration of pregnancy, hemoglobin levels, fetal weight were comparable in both groups. Perinatal outcomes were almost similar in both the groups. Extension of the uterine incision occurred in only 4 cases (5.19%) in the study group compared to 16 cases (20.77%) in control group. Excessive bleeding, uterine artery injury, need for blood transfusion and hysterectomy were also less in the study group.Conclusions: Morbidity due to extension of uterine incision occurs commonly during second stage cesarean section, when hand is forcibly introduced in the pelvis to deliver impacted head, since lower uterine segment is edematous and fragile. Patwardhan’s technique avoids this and hence should be practiced more widely. Its beauty lies in near absence of extension of uterine incision

An analysis of relaparotomy in operative obstetrics

Background: Relaparotomy in obstetrics following caesarean section or laparotomy is associated with high morbidity and mortality and hence, considered as maternal near miss. Selection of patient for the same is crucial. This study was done to know the incidence, indications, the risk factors, intraoperative procedures and mortality rates of relaparotomy.Methods: A retrospective analysis of relaparotomy after primary obstetric surgery over a period of two and half years (June 2016 to November 2018) was done in department of obstetrics and gynecology of Rajendra Institute of Medical Sciences, Ranchi, India.Results: During study period 28 cases of relaparotomy (18 inhouse and 10 referred cases) were identified. The incidence of relaparotomy was 0.24%. Intraperitoneal hemorrhage (39.2%) was commonest indication of reoperations followed by PPH (17.8%), rectus sheath hematoma (14.8%) and burst abdomen (10.7%). Obstructed labor (32.1%) was commonest indication of primary cesarean. Hysterectomy was required in 8 cases (25.7%), evacuation of blood for hemoperitoneum was required in another 8 cases. Most cases of hemorrhage were reopened within 24 hours, whereas most case of the rectus sheath hematoma, burst abdomen, and broad ligament hematoma were reopened between 5-9 days.Conclusions: Relaparotomy is often a lifesaving procedure. Decision to perform and manage relaparotomy should always be done by senior obstetricians. Meticulous surgical techniques to secure hemostasis at time of primary surgery should be adopted. Strict postoperative vigilance, is of utmost importance for early detection of intraperitoneal hemorrhage and other complications requiring relaparotomy as timely intervention

Association between maternal serum beta human chorionic gonadotropin levels and hypertensive disorders of pregnancy

Background: A major challenge in obstetrics is early identification of hypertensive disorders of pregnancy (HDP). This study was performed to determine the association between elevated maternal serum β-hCG levels and HDP, the correlation between serum β-hCG level and severity of preeclampsia and to determine the value of serum β-hCG level as a diagnostic marker for early diagnosis of HDP.Methods: This was a hospital based observational study conducted in the department of obstetrics and gynecology, Rajendra Institute of Medical Sciences, Ranchi on 375 pregnant women with period of gestation more than 20 weeks, including 250 pregnant women with HDP as study group and 125 normotensive pregnant women as controls. Serum β-hCG concentration was measured and its level was compared between two groups.Results: The maternal mean serum β-hCG levels (51161.08±30038.21 IU/L) of study group of HDP were higher than the normotensive control group (17603.23±16748.21 IU/L). In non-severe preeclampsia, the mean serum levels were 36417.32±23876.74 IU/L while in severe preeclampsia, 60030.34±28771.31 IU/L. There was statistically significant difference (p<0.001) with higher levels in early onset preeclamptic mothers than late onset preeclampsia. The cut-off point of β-hCG for predicting HDP was 32077 IU/L with sensitivity of 65% and specificity of 86%.Conclusions: Serum β-hCG level is higher in HDP when compared to normotensive women. Higher levels of β-hCG are associated with increasing severity of hypertensive disorders of pregnancy. The utility of serum β-hCG as a diagnostic test is limited because of low sensitivity and difficulty in deciding the cut-off value

Gestational trophoblastic diseases: an observational study at a tertiary care teaching hospital in Jharkhand, India

Background: Gestational Trophoblastic Diseases (GTD) encompass a wide spectrum of proliferative disorders of trophoblast tissue, which hold a good prognosis if diagnosed and treated on time. A close understanding of the disease spectrum is therefore needed to reduce morbidity and mortality.Methods: This is an observational study (both prospective and retrospective analysis) conducted in Rajendra Institute of Medical Sciences, a tertiary care teaching hospital in Ranchi, Jharkhand over a period of 2 years from 1st January 2017 to 31st December 2018.Results: A total of 162 cases of GTD were identified during the study period. Disease spectrum comprised of complete molar pregnancy in 146 (90.12%) and partial molar pregnancy in 7 (4.3%), GTN in 9 out of 162 cases (5.5%). Bleeding per vaginum preceded by amenorrhea was the most common symptom, observed in 95.4% of the cases. Uterine size was more than period of amenorrhea in almost 50% of the cases. Theca lutein cysts were found in 39.8% of the cases, hypertension in 21.5%, hyperthyroidism in 6.5% cases. Overall, there were nine (5.56%) cases of choriocarcinoma and six (3.7%) cases of Invasive mole. Remission rate in GTN was 86.7% with chemotherapy.Conclusions: Women complaining of vaginal bleeding in first half of pregnancy with uterine size more than period of amenorrhea must be evaluated for GTD by ultrasound and serum beta HCG. For cases of molar pregnancies, suction and evacuation remains the treatment of choice but need for regular follow-up and strict compliance to contraception during entire follow up has to be emphasized. Cases of GTN have excellent remission with chemotherapy

MANAGEMENT OF SHALYAJ NADIVRAN BY MODIFIED KSHARASUTRA W.S.R. TO PILONIDAL SINUS

Pilonidal sinus is a disease that most commonly arises in the hair follicles of the natal cleft of the sacrococcygeal. Incidence is more common in men as they are hairier than women. The factor which increases the risk of pilonidal sinus is continuous sitting, obesity, sedentary occupation, family history, local trauma. The surgical management commonly practiced are included incision and drainage, excision and primary closure, excision and healing by secondary intention, excision with reconstructive flap technique (Bascom’s method). However, the risk of recurrence or of developing an infection of the wound after the operation is high. In Ayurveda as clinical features, the pathology of Pilonidal sinus and Shalyaj nadivrana described in Sushruta Samhita are very much similar to each other we can correlate with Shalyaj type of Vrana with Pilonidal sinus. Sushruta has explained Shastrakarma with the intervention of ‘Ksharsutra’ procedure for the management of Nadi vran (PNS). This case study was presented on a male patient aged 39 years. He was suffering from pilonidal sinus for 9 months and treated successfully with partial sinus excision along with Ksharsutra therapy. Partial sinus excision followed by Ksharsutra ligation in the remaining intact tract was performed under local anaesthesia. The Ksharasutra was changed weekly for 3 sittings. Observation revealed that sinus track cut through and healed by 5 weeks. The patient was under observation for one year to check for recurrence. Ksharasutra treatment not only minimizes complications and recurrences, causing minimal scar but also facilitates the patient to resume early working with less discomfort as well as reduced time and cost

Anterior and Posterior Tongue Regions and Taste Papillae: Distinct Roles and Regulatory Mechanisms with an Emphasis on Hedgehog Signaling and Antagonism.

Sensory receptors across the entire tongue are engaged during eating. However, the tongue has distinctive regions with taste (fungiform and circumvallate) and non-taste (filiform) organs that are composed of specialized epithelia, connective tissues, and innervation. The tissue regions and papillae are adapted in form and function for taste and somatosensation associated with eating. It follows that homeostasis and regeneration of distinctive papillae and taste buds with particular functional roles require tailored molecular pathways. Nonetheless, in the chemosensory field, generalizations are often made between mechanisms that regulate anterior tongue fungiform and posterior circumvallate taste papillae, without a clear distinction that highlights the singular taste cell types and receptors in the papillae. We compare and contrast signaling regulation in the tongue and emphasize the Hedgehog pathway and antagonists as prime examples of signaling differences in anterior and posterior taste and non-taste papillae. Only with more attention to the roles and regulatory signals for different taste cells in distinct tongue regions can optimal treatments for taste dysfunctions be designed. In summary, if tissues are studied from one tongue region only, with associated specialized gustatory and non-gustatory organs, an incomplete and potentially misleading picture will emerge of how lingual sensory systems are involved in eating and altered in disease

Evaluating the Effect of a Taxane-Based Anti-Cancer Drug on the Adult Taste Organ Using a Mouse Model

Chemosensory alteration is one of the major side effects of chemotherapy that can negatively impact the quality of life of cancer patients. Decreased appetite and food aversions can consequently lead to substantial reductions in food intake and thereby malnutrition and poor patient outcomes. The chemotherapeutic agent, taxane (docetaxel), is an effective choice of treatment for breast cancer, gastric cancer, or prostate cancer. Despite its major effects as an anti-cancer medication, patients under taxane treatments have reported taste alterations. Essentially, the drug disrupts normal microtubule growth by inhibiting microtubule depolymerization. By binding to ß-tubulin, a major component of mitotic spindles, docetaxel (DTX) hyper-stabilizes the microtubule structure, rendering it incapable of properly shortening and elongating. This intrinsic property is especially crucial for chromosome segregation during cell division. DTX also causes apoptosis and peripheral neuropathy. Further, microtubules are essential components of cilia, where Hedgehog (HH) signaling takes place. HH signaling plays a critical regulatory role in taste organ formation and maintenance, while its deregulation can severely disrupt taste perception. Importantly, taxane-based therapies have demonstrated an upregulating effect on HH signaling, but in combination therapies such as with sodium butyrate, it exhibits a down regulating effect. It might be possible that the DTX is causing taste alterations via changes in HH signaling. Alternatively, disruption of cell division can also result in changes in taste cell turnover. The aim of this study is to elucidate whether DTX has an indirect or direct effect on the taste organ and whether it alters HH signaling

Evaluation of shelf-life of aonla (Emblica officinalis G.) cultivars during storage at room temperature

ive aonla cultivars viz. Chakaiya, Banarasi, Hathijhul, Krishna and Kanchan were evaluated for shelf-life during storage at room temperature. PLW increased with increase in the period of storage in all cultivars (0-15 days). There was no decay loss up to 6th day of storage, however it was observed on 9th day of storage in all the cultivars and it increased up to 15th day of storage. Maximum PLW and decay loss was recorded in fruits of cv. Banarasi (8.14 % and 38.97 %, respectively) on 15th day of storage whereas fruits of cv. Chakaiya had minimum PLW and decay loss (5.83 % and 15.17 %, respectively) on same day of storage. Specific gravity and firmness decreased during the storage from 0-15 days in all the cultivars. Fruits of cv. Banarasi had minimum specific gravity (0.99) as well as firmness (10.83kg/cm2) whereas fruits of cv. Chakaiya had maximum specific gravity (0.93) and firmness (11.10kg/cm2) at the end of the storage. The present experiment was conducted to evaluate the different cultivars of aonla fruit for their biochemical and physiological behavior under room temperature storage and to find out the best among five cultivars for their shelf life under the Haryana agro-climatic conditions