A study of wavelet-based noise reduction techniques in mammograms

Breast cancer is one of the most common cancers and claims over one thousand lives every day. Breast cancer turns fatal only when diagnosed in late stages, but can be cured when diagnosed in its early stages. Over the last two decades, Digital Mammography has served the diagnosis of breast cancer. It is a very powerful aid for early detection of breast cancer. However, the images produced by mammography typically contain a great amount noise from the inherent characteristics of the imaging system and the radiation involved. Shot noise or quantum noise is the most significant noise which emerges as a result of uneven distribution of incident photons on the receptor. The X-ray dose given to patients must be minimized because of the risk of exposure. This noise present in mammograms manifests itself more when the dose of X-ray radiation is less and therefore needs to be treated before enhancing the mammogram for contrast and clarity. Several approaches have been taken to reduce the amount of noise in mammograms. This thesis presents a study of the wavelet-based techniques employed for noise reduction in mammograms --Abstract, page iii

On Reinforcement Learning for Turn-based Zero-sum Markov Games

We consider the problem of finding Nash equilibrium for two-player turn-based zero-sum games. Inspired by the AlphaGo Zero (AGZ) algorithm, we develop a Reinforcement Learning based approach. Specifically, we propose Explore-Improve-Supervise (EIS) method that combines "exploration", "policy improvement"' and "supervised learning" to find the value function and policy associated with Nash equilibrium. We identify sufficient conditions for convergence and correctness for such an approach. For a concrete instance of EIS where random policy is used for "exploration", Monte-Carlo Tree Search is used for "policy improvement" and Nearest Neighbors is used for "supervised learning", we establish that this method finds an $\varepsilon$-approximate value function of Nash equilibrium in $\widetilde{O}(\varepsilon^{-(d+4)})$ steps when the underlying state-space of the game is continuous and $d$-dimensional. This is nearly optimal as we establish a lower bound of $\widetilde{\Omega}(\varepsilon^{-(d+2)})$ for any policy

Cecal Bascule after Colonoscopy - Case Report and Review of Literature

Cecal bascule is a rare disease variant of a cecal volvulus. It consists of upward and anterior folding of the ascending colon, forming a flap valve, and occluding the bowel lumen resulting in proximal cecal dilatation. Herein, we present a case of a patient who developed persistent abdominal pain few hours after a colonoscopy. CT scan of the abdomen revealed an upward and anterior folding of the cecum. Subsequently the patient was taken to the operating room for a right hemi-colectomy. This case emphasizes the importance to consider cecal bascule as a differential diagnosis in patients with persistent abdominal pain after colonoscopy, considering the ease of diagnosis with imaging studies and emergent surgical correction

A study of comparison of tension band wiring versus plating for olecranon fractures

Background: Olecranon fractures are one of the common fractures around the elbow, comprising around 37% of all fractures occurring around the elbow. Olecranon fractures are commonly treated with either plating or tension band wiring. The purpose of current study is to compare the clinical and radiological outcome of tension band wiring and plate fixation in patients operated for olecranon fractures.Methods: Current study was conducted in a tertiary care center from May 2017-2019. Study compromises of 30 patients operated for olecranon fractures. Clinical and radiological outcome of patients treated with tension band wiring or plating and assessed using the Mayo’s elbow score at 6 months follow up.Results: Out of the 30 patients, 15 were treated with tension band wiring and 15 were treated using open reduction and plating. Out of the 15 operated with tension-band wiring (TBW) K wire on follow up 11 showed excellent score on Mayo elbow score, 2 had good results and 2 had fair results. In patients operated with Plating 12 showed excellent result on follow up and 3 showed good result. No patient had fair or poor score.Conclusions: Both tension band wiring and plate fixation are effective methods for treatment of olecranon fractures however complications regarding symptomatic metal prominence and superficial infection were higher in patients treated with tension band wiring as compared to plate fixations

Prevalence of obesity in students with specific learning disorder in a metropolitan city of India

Background: Obesity is common in urban school children. Learning disability (LD) prevalence is also growing, primarily in cities. Objective: The objective of this study is to find the prevalence of obesity in students with specific LD (SLD). Materials and Methods: This observational cross-sectional study carried out at a tertiary care center attached to a medical college in Maharashtra, after obtaining permission from the institutional ethics committee. Consecutive 150 students with SLD between the ages of 8 and 18 years were studied over 18 months. Obesity was classified as per body mass index. Descriptive statistics and subgroup analysis were done by unpaired t-test. Results: Prevalence of obesity in students with SLD was 22.7% without genderpredisposition and family history correlation. Of total students with SLD, 44 (29.3%) had attention-deficit hyperactivity disorder (ADHD) without any association with the obesity. Conclusions: Family history, ADHD, gender, other medical conditions, and drug history have no correlation with regard to obesity in SLD. There is a further requirement of research with large population control size

A novel tissue-specific meta-analysis approach for gene expression predictions, initiated with a mammalian gene expression testis database

<p>Abstract</p> <p>Background</p> <p>In the recent years, there has been a rise in gene expression profiling reports. Unfortunately, it has not been possible to make maximum use of available gene expression data. Many databases and programs can be used to derive the possible expression patterns of mammalian genes, based on existing data. However, these available resources have limitations. For example, it is not possible to obtain a list of genes that are expressed in certain conditions. To overcome such limitations, we have taken up a new strategy to predict gene expression patterns using available information, for one tissue at a time.</p> <p>Results</p> <p>The first step of this approach involved manual collection of maximum data derived from large-scale (genome-wide) gene expression studies, pertaining to mammalian testis. These data have been compiled into a Mammalian Gene Expression Testis-database (MGEx-Tdb). This process resulted in a richer collection of gene expression data compared to other databases/resources, for multiple testicular conditions. The gene-lists collected this way in turn were exploited to derive a 'consensus' expression status for each gene, across studies. The expression information obtained from the newly developed database mostly agreed with results from multiple small-scale studies on selected genes. A comparative analysis showed that MGEx-Tdb can retrieve the gene expression information more efficiently than other commonly used databases. It has the ability to provide a clear expression status (transcribed or dormant) for most genes, in the testis tissue, under several specific physiological/experimental conditions and/or cell-types.</p> <p>Conclusions</p> <p>Manual compilation of gene expression data, which can be a painstaking process, followed by a consensus expression status determination for specific locations and conditions, can be a reliable way of making use of the existing data to predict gene expression patterns. MGEx-Tdb provides expression information for 14 different combinations of specific locations and conditions in humans (25,158 genes), 79 in mice (22,919 genes) and 23 in rats (14,108 genes). It is also the first system that can predict expression of genes with a 'reliability-score', which is calculated based on the extent of agreements and contradictions across gene-sets/studies. This new platform is publicly available at the following web address: <url>http://resource.ibab.ac.in/MGEx-Tdb/</url></p

The effect of report cards on the coverage of maternal and neonatal health care: a factorial, cluster-randomised controlled trial in Uttar Pradesh, India.

BACKGROUND: Report cards are a prominent strategy to increase the ability of citizens to express their view, improve public accountability, and foster community participation in the provision of health services in low-income and middle-income countries. In India, social accountability interventions that incorporate report cards and community meetings have been implemented at scale, attracting considerable policy attention, but there is little evidence on their effectiveness in improving health. We aimed to evaluate the effect of report cards, which contain information on village-level indicators of maternal and neonatal health care, and participatory meetings targeted at health providers and community members (including local leaders) on the coverage of maternal and neonatal health care in Uttar Pradesh, India. METHODS: We conducted a repeated cross-sectional, 2 × 2 factorial, cluster-randomised controlled trial, in which each cluster was a village (rural) or ward (urban). The clusters were randomly assigned to one of four groups: the provider group, in which we shared report cards and held participatory meetings with providers of maternal and neonatal health services; the community group, in which we shared report cards and held participatory meetings with community members (including local leaders); the providers and community group, in which report cards were targeted at both health providers and the community; and the control group, in which report cards were not shared with anyone. We generated these report cards by collating data from household surveys and shared the report cards with the recipients (as determined by their assigned groups) in participatory meetings. The primary outcome was the proportion of women who had at least four antenatal care visits (ie, attended a clinic or were visited at home by a health-care worker) during their last pregnancy. We measured outcomes with cross-sectional household surveys that were taken at baseline, at a first follow-up (after 8 months of the intervention), and at a second follow-up (21 months after the start of the intervention). Analyses were by intention to treat. This trial is registered with ISRCTN, number ISRCTN11070792. FINDINGS: We surveyed eligible women for the baseline survey between Jan 13, and Feb 5, 2015. We then randomly assigned 44 clusters to the provider group, 45 clusters to the community group, 45 clusters to the provider and community group, and 44 clusters to the control group. Report cards of collated survey data were provided to recipient groups, as per their random allocation, in October, 2015, and in September, 2016. We ran the first follow-up survey between May 16 and June 10, 2016. We ran the second follow-up survey between June 18 and July 18, 2017. We measured the primary outcome in 3133 women (795 in the provider group, 781 in the community group, 798 in the provider and community group, and 759 in the control group) who gave birth during implementation of the intervention, between Feb 1, 2016, and July 18, 2017 (the end of the second follow-up survey). The report card intervention did not significantly affect the proportion of women who had at least four antenatal care visits (provider vs non-provider: odds ratio 0·85, 95% CI 0·65-1·13; community vs non-community: 0·86, 0·65-1·13). INTERPRETATION: Maternal health report cards containing information on village performance, targeted at either the community or health providers, had no detectable effect on the coverage of maternal and neonatal health care. Future research should seek to understand how the content of information and the delivery of report cards affect the success of this type of social accountability intervention. FUNDING: Merck Sharp and Dohme

Snake bite: An unusual cause of ischaemic stroke

Snake bite continues to be one of the major and potential contributors for morbidity and mortality in India. Intracranial haemorrhage causing neurological deficits is a known entity due to snake bite but presentation with infarction is rare. The authors report a case of a healthy middle aged female who presented within hours of envenomation with altered sensorium and evaluation revealed left hemiplegia with deranged coagulation profile and multiple ischaemic infarcts instead of haemorrhage as a consequence of vasculotoxic envenomation due to viper bite