Gall bladder wall thickness in dengue and Its association with the disease severity

BACKGROUND AND OBJECTIVES: Dengue is a major public health problem, associated with epidemics and high morbidity. It is caused by a virus of same name, belonging to flavivirus family of class arbovirus. The principle vector of the disease is the Aedes family mosquitoes. The highest dengue epidemic of dengue fever in India occured in 2015 which claimed 800 lives and affected 4 million people. In 2016 it is still raging on, unstoppable causing great distress on the public health as well the individual. The most important phase of dengue fever is the critical phase. This is the phase where the plasma leakage occurs, the mechanism which is required for dengue shock syndrome. The other main complication of dengue is the hemorrhagic fever associated with it called dengue hemorrhagic fever. Close monitoring and early diagnosis of this stage is essentially crucial for treatment of dengue shock syndrome and dengue hemorrhagic fever. Most commonly haematocrit and platelet counts are used to monitor the patient in the critical phase. Many other tools are in the phase of developement. Serial ultrasound guided evaluation of gall bladder thickness has been proposed and has many positive reviews in the detection of plasma leakage. So this study comprises assessement of gall bladder wall thickness in diagnosed dengue patients and comparing it with disease severity. METHODS: Patients who are admitted with fever and who have been diagnosed with dengue confirmed by IgM ELISA were included in this study after their written informed consent. The patients were then subjected to history, clinical examination, vitals monitoring, lab investigations, and ultrasonogram of abdomen for gall bladder wall thickness and perinephric fluid collection. The data collected from 100 patients were compiled and using statistical tools were analysed. RESULTS: Of the 100 patients taken up for study 16 patients had mild thrombocytopenia, 21 had moderate thrombocytopenia, 38 had severe thrombocytopenia, 12 had severe thrombocytopenia. Only 6% had high haematocrit. 30 patients had bleeding manifestations. 31 patients had normal gall bladder wall thickness (GBWT). 62 patients had increased GBWT in the range of 4 to 6 mm. 7 patients had GBWT more than which is a sign of severe plasma leakage and they all had complications of bleeding, hypotension and features of multi-organ dysfunction. CONCLUSION: Gall bladder wall thickness is an excellent tool or monitoring and assessing the severity of dengue fever. It is relatively easy and non-invasive test that can be used even by physicians with training. Haematocrit value alone may not be useful. Ultrasonogram is a good synergetic tool in effective management of dengue as it can pick up evidence of plasma leakage at an early stage

Gastric Function in Children with Oesophageal Atresia and Tracheoesophageal Fistula.

Oesophageal atresia and tracheoesophageal fistula (OA-TOF) are a multifaceted condition which affects patients throughout their lives. Even though it is one of the most common gastrointestinal malformations, most of the current studies focus on gastro-oesophageal reflux disease, anastomotic strictures, and feeding difficulties. However, there is increasing evidence that a proportion of patients with OA-TOF also have abnormal gastric function. This review aims to provide a comprehensive understanding of studies of gastric function in patients with OA-TOF. The etiology of this abnormality has been hypothesized to be congenital and/or acquired. Several modalities are currently available for the investigation of gastric function, each of them trying to answer specific clinical questions. This review summarizes the studies that have looked at gastric function in the OA-TOF cohort with gastric emptying studies (gastric emptying scintigraphy and (13)C octanoic breath test), gastric manometry, electrogastrography, and oral glucose tolerance test. However, these modalities are limited due to poor age-specific normative values and heterogeneous methodologies used. The evaluation of symptoms in this cohort is crucial, modalities for abnormal gastric function are also described. With appropriate investigations and symptoms questionnaires, treatment strategies can be implemented to correct abnormal gastric function and thereby improve the outcomes and quality of life of patients with OA-TOF. This review highlights the need for large international multicentre collaborative studies and high-quality prospective randomized controlled trials to improve our understanding of gastric function in this cohort

Solvent Extraction Behaviour of Tris(oxalato)Co(III) with Long-chain Amines: Part II - Extraction from Hydrochloric & Sulphuric Acid Solutions

139-14

Nash equilibrium mapping vs Hamiltonian dynamics vs Darwinian evolution for some social dilemma games in the thermodynamic limit

How cooperation evolves and manifests itself in the thermodynamic or infinite player limit of social dilemma games is a matter of intense speculation. Various analytical methods have been proposed to analyse the thermodynamic limit of social dilemmas. In a previous work [Chaos Solitons and fractals 135, 109762(2020)] involving one among us, two of those methods, Hamiltonian Dynamics(HD) and Nash equilibrium(NE) mapping were compared. The inconsistency and incorrectness of HD approach vis-a-vis NE mapping was brought to light. In this work we compare a third analytical method, i.e, Darwinian evolution(DE) with NE mapping and a numerical agent based approach. For completeness, we give results for HD approach as well. In contrast to HD which involves maximisation of payoffs of all individuals, in DE, payoff of a single player is maximised with respect to its nearest neighbour. While, HD utterly fails as compared to NE mapping, DE method gives a false positive for game magnetisation -- the net difference between the fraction of cooperators and defectors -- when payoffs obey the condition a+d=b+c, wherein a, d represent the diagonal elements and b, c the off diagonal elements in symmetric social dilemma games. When either a+d =/= b+c or, when one looks at average payoff per player, DE method fails much like the HD approach. NE mapping and numerical agent based method on the other hand agree really well for both game magnetisation as well as average payoff per player for the social dilemmas in question, i.e., Hawk-Dove game and Public goods game. This paper thus bring to light the inconsistency of the DE method vis-a-vis both NE mapping as well as a numerical agent based approach.Comment: 15 pages, 4 figures, 2 table

Shape memory thermal conduction switch

A thermal conduction switch includes a thermally-conductive first member having a first thermal contacting structure for securing the first member as a stationary member to a thermally regulated body or a body requiring thermal regulation. A movable thermally-conductive second member has a second thermal contacting surface. A thermally conductive coupler is interposed between the first member and the second member for thermally coupling the first member to the second member. At least one control spring is coupled between the first member and the second member. The control spring includes a NiTiFe comprising shape memory (SM) material that provides a phase change temperature <273 K, a transformation range <40 K, and a hysteresis of <10 K. A bias spring is between the first member and the second member. At the phase change the switch provides a distance change (displacement) between first and second member by at least 1 mm, such as 2 to 4 mm

Efficient and Effective Query Auto-Completion

Query Auto-Completion (QAC) is an ubiquitous feature of modern textual search systems, suggesting possible ways of completing the query being typed by the user. Efficiency is crucial to make the system have a real-time responsiveness when operating in the million-scale search space. Prior work has extensively advocated the use of a trie data structure for fast prefix-search operations in compact space. However, searching by prefix has little discovery power in that only completions that are prefixed by the query are returned. This may impact negatively the effectiveness of the QAC system, with a consequent monetary loss for real applications like Web Search Engines and eCommerce. In this work we describe the implementation that empowers a new QAC system at eBay, and discuss its efficiency/effectiveness in relation to other approaches at the state-of-the-art. The solution is based on the combination of an inverted index with succinct data structures, a much less explored direction in the literature. This system is replacing the previous implementation based on Apache SOLR that was not always able to meet the required service-level-agreement.Comment: Published in SIGIR 202

PHYTOCHEMICAL STATUS, ANTIBACTERIAL ACTIVITY AND ANTIOXIDANT PROPERTY OF DATURA METEL L.

Objective: Medicinal plants are a source of great economic value all over the world and are on the front dusk of traditional medicine. Daturametel L, is one among the foresaid and this plant can be explored further as per its diversity of uses and on the basis of wide range of chemical compounds reported to be present in various parts of the plant. In the present investigation, Phyto-chemistry of D. metel has been analysed along with its antibacterial property.Methods: The selected plant leaves were collected and powdered. The bioactive compounds were extracted by using different solvents. Various phytochemical tests for alkaloids, flavonoids, saponins, steroids, terpenoids, tannins, glycosides and amino acids were done accordingly with standard protocol of testing. The study also extends to view the anti-bacterial potential by determining inhibition of growth using agar well diffusion method.Results: Phytochemical analysis reflected the presence of compounds like alkaloids, flavonoids, saponins, tannins, glycosides, and amino acids. It was noted that steroids and tannins are absent. Antimicrobial activity proves extract of ethanolis the most promising against the pathogens from the rest screened.Conclusion: Thearticle addresses, the undocumented knowledge regarding the phytochemical profile of D. metel which demand further exploration widely to serve Humanity. Antimicrobial potential of ethanol extract are very promising to deliver it as a pharmaceutical