Levonorgestrel intrauterine releasing system: long term health impact

Background: Menorrhagia, menstrual blood loss of more than 80 ml is a common health problem affecting 5-30% of women in India and accounts for 8% loss of economic wages annually. This study was conducted in PGIMER and Dr. RML Hospital New Delhi to evaluate the efficacy, acceptability and safety profile of LNG IUS (a non-invasive modality) in a variety of gynaecological disorders with associated menorrhagia.Methods: This was a noncomparative longitudinal observational study conducted in PGIMER and Dr RML Hospital New Delhi from June 2009 to September 2013.All patients with menorrhagia with or without dysmenorrhoea were screened and in suitable cases, LNG IUS was inserted in the postmenstrual phase after counselling and informed consent. Menstrual pattern, mean bleeding days, hemoglobin and satisfaction level was noted before insertion, 6 months, 1 year and 2 years post insertion.Results: 30 patients were recruited in the study over the first 2 years. 66.66% (20) had associated medical co morbidities. LNG IUS was spontaneously expelled in 2 (6.66%) and 3 subjects (10%) needed a hysterectomy due to persistent bleeding. The remaining 25 subjects continued with the device and these subjects had a significant decrease in mean bleeding days with associated significant rise in hemoglobin levels over 2 years.Conclusions: LNG-IUS is an underused useful device for several gynecological disorders and is a boon especially for those with medical comorbidities and should be offered to all suitable subjects.

Securing IoT Networks for Detection of Cyber Attacks using Automated Machine Learning

Cybercriminals are always developing innovative strategies to confound and frustrate their victims. Therefore, maintaining constant vigilance is essential if one wishes to protect the availability, confidentiality, and integrity of digital systems. Machine learning (ML) is becoming an increasingly powerful technique for doing intelligent cyber analysis, which enables proactive defenses. Machine learning (ML) has the potential to thwart future assaults by studying the recurring patterns that have already been successful. Nevertheless, there are two significant drawbacks associated with the utilization of ML in security analysis. To begin, the most advanced machine learning systems have significant problems with their computing overheads. Because of this constraint, firms are unable to completely embrace ML-based cyber strategies. Second, in order for security analysts to make advantage of ML for a wide variety of applications, they will need to develop specialized frameworks. In this study, we aim to put a numerical value on the degree to which a hub can improve the safety of an ecosystem. Typical cyberattacks were carried out on an Internet of Things (IoT) network located within a smart house in order to validate the hub. Further investigation of the intrusion detection system's (IDS) resistance to adversarial machine learning (AML) assaults was carried out. In this method, models can be attacked by supplying adversarial samples that attempt to take advantage of the defects in the detector that are present in the pre-trained model

Using different surgical techniques and ideas to reduce post-operative adhesion formation: a systematic review and meta-analysis

Adhesion development is the most common sequelae of intra-abdominal and pelvic surgery. Using a good surgical technique is advocated as a first step in preventing adhesions. However, the evidence for different surgical techniques to reduce adhesion formation needs confirmation. This review contributed to the growing knowledge pool by elucidating factors that potentially predispose to the development of adhesions. A literature search was performed using the PubMed database for all relevant English language articles and were reviewed with particular attention to predisposing factors to post-operative adhesion development. In addition, the reference lists of each article were reviewed to identify additional relevant articles. Various factors have been shown to directly increase the risk of post-operative adhesion development; namely, certain genetic polymorphisms in the interleukin-1 receptor antagonist, increased estrogen exposure, and endometriosis. There were 28 papers with 27 studies included for a systematic review. Of these, 17 studies were eligible for meta-analysis and 11 for qualitative assessment only. None of the techniques that were compared significantly reduced the incidence of adhesive small bowel obstruction. In a small low-quality trial, the pregnancy rate increased after subserous fixation of suture knots. However, the incidence of adhesions was lower after laparoscopic compared with open surgery (relative risk (RR): 0.14; 95% confidence interval (CI): 0.03-0.61) and when the peritoneum was not closed (RR: 0.36; 95% CI: 0.21-0.63). None of the specific techniques that were compared reduced the two main adhesion-related clinical outcomes, small bowel obstruction and infertility

Social Quality and Quality of Work Life Outline the Employees’ Quality of Life in Indian Public Sector: An Investigation

Many researchers have tried to identify the factors that determine quality of life and impact on these factors on social quality. The current research outlines the existing theory and provides an argument which suggests that the trust, loyalty and challenging works also can be part of the construct of social quality. Authors propose a model, supported by data, which suggests ways in which current social theories of trust, loyalty and challenging work may be incorporated within the quality of life framework.Design/Methodology/Approach- The study has two fold objectives. Firstly, to analyze the factors influencing employees social quality and quality of work life in Indian public sector and secondly, to understand the impact of identified variables on quality of life. The study is based on the primary data, collected from the employees of public sector of India. Data analysis was done using SPSS software. The statistical analysis method employed was descriptive analysis, factor analysis and multiple regressions

Twin reversed arterial perfusion syndrome: a rare but critical event of twin pregnancy

Twin-Reversed Arterial Perfusion (TRAP) sequence is also known as acardiac twin gestation or chorioangiopagus parasiticus, it is a rare and unique complication of monozygotic monochorionic twin pregnancies. 35 year old 8 gravida four alive issues and one spontaneous abortion. Patient came with complaint of pain in abdomen since 8 hours. She was having an ultrasonography report of twin pregnancy of 28 weeks gestation with one fetus alive and normal while other fetus was anomalous fetus FHS of first fetus was localised while FHS of other fetus was not localised. Twin-Reversed Arterial Perfusion (TRAP) sequence is a rare complication of monochorionic multiple gestation. Accurate antenatal diagnosis is essential to improve the prognosis of this rare entity

Role of low dose danazol therapy for endometriosis related infertility and its comparison with laparoscopic fulguration in low resources

Background: The objective was to study the role of laparoscopic fulguration and danazol therapy for endometriosis in case of infertility followed by comparison of both therapies.Methods: The present cross–sectional study was conducted in the department of obstetrics and gynecology SN Medical College Agra. Over the period from December 2010 to November 2013. Symptomatic women (n=50) of age group 20-39 yrs coming to gynecology OPD were selected for study group. The study group was subjected to detailed history, physical examination laboratory test, ultrasound examination, and laparoscopy. Then 50 patients were allotted for laparoscopic fulguration and 50 for danazol treatment.Results: Out of 100 on transvaginal sonography, 10%of patient have cyst 2cm size, rest 70% have normal scan. On laparoscopy 52% of patient have red lesion, 16% have bluish black lesion, 20% have yellow brown lesion rest 22% have normal findings. On danazol therapy pelvic pain and dysmenorrhoea was relieved in 64% and 52% conceived .on laparoscopic fulguration symptom were relieved in 69% and 60% conceived.Conclusions: Based on this study it can be concluded that choice of therapy depend on age of patient,  duration of infertility, physical findings, goal of surgery, experience of surgeon and most important the  availability of resources. In this study result was comparable

India's Firewood Crisis Re-examined

Households in rural India are highly dependent on firewood as their main source of energy, partly because non-biofuels tend to be expensive. The prevailing view is therefore that, when faced with shortages of firewood in the village commons, such households, and especially the women in them, have to spend more and more time searching for firewood and eventually settle for poorer-quality biomass such as twigs, branches and dry leaves. Using data from a random sample of rural households in the Indian state of Madhya Pradesh, we come to very different conclusions, however. We find that households in villages with degraded forests do not spend longer hours searching for firewood, but instead switch to either using firewood from private trees or to using agricultural waste for fuel. In the long run, moreover, households respond to the firewood shortage by altering the mix of private trees on their land in favor of firewood, as opposed to fruit, trees. We find also that, Joint Forest Management, a government program initiated in the 1990s, is having a positive impact on the firewood economy.firewood crisis, time allocation, fuel switching, JFM, India

Healthcare-Associated Meningitis Caused by <em>M. tuberculosis</em> and Non-Tuberculous Mycobacteria

Meningitis can be acquired in the community setting or secondary to invasive procedures or head trauma. The latter group has been classified as health-care-associated meningitis because the etiologic agents belong to a different spectrum of microorganisms, including Staphylococcus aureus, Coagulase negative staphylococcus Gram negative bacilli, Aspergillus, Candida albicans, Cryptococcus neoformans. IDSA Clinical Practice guidelines for Healthcare-associated ventriculitis and meningitis does not include M. tuberculosis and NTM, but in the last decade infections caused by these organisms are on a rise. These infections are mostly associated with cerebrospinal fluid shunts, cerebrospinal fluid drains, intra-thecal drug therapy, deep brain stimulation hardware, neurosurgery and head trauma. Most commonly these are introduced during surgical procedures. Another important pathogenic factor is biofilm formation that increases the persistence and resistance to antibiotic therapy, hence the survival. A high index of suspicion aids early diagnosis but preventive measures such as care of the devices introduced into sterile spaces is essential. Sterilization of the critical items is recommended by treating with different chemical sterilizing agents but most importantly meticulous cleaning must precede any high-level disinfection or sterilization process. A course of multidrug therapy is required for prolonged period of time depending on mycobacterial species

Synthesis and electrochemical studies of dimethyl glyoxime based heterotrimetallic macrocyclic complex

Synthesis dimethylglyoxime based heterotrimetallic macrocyclic complex was carried by taking the advantage of preferred coordination geometry of copper and chromium and selective use of sodium thiocyanate as axial ligand. The complex was characterized by elemental analysis, IR and MS. Magnetic behaviour of this complex, strong antiferromagnetic interactions were observed between metal ions which can be explained on the basis of spin orbit coupling. Electronic properties of the complex were studied using cyclic voltametry. Four well defined redox states were displayed in cyclic voltagram of which three were assigned to metal centers and one was ligand based redox state. On the other hand, the magnetic anisotropy due to different magnitude and nature of interactions in the complex makes it a possible single molecular magnet

Comprehensive Review on Herbal or Medicated Toothpaste--A Review on Herbal v/s Medicated Toothpaste

A dentifrices are the products which are used for oral hygiene such as freshness of mouth and to avoid tooth decay. The oral hygiene can be maintained throughout the day by using various dentifrices prepared by herbal and medicated ingredient. A tooth is small, calcified, whitish, structure found in the jaws of many vertebrates and used to breakdown food. Teeth are not made of bone but rather of multiple tissues of varying density and hardness. Dentifrices contain ingredients that help reduce caries, plaque, gingivitis, hypersensitivity, calculus, slain, halitosis. Herbal toothpaste where no chemicals, preservatives are added; instead glycerin and common salt are added as natural preservative. This toothpaste can cure various diseases as teeth like gingivitis, tooth decay, cavity, gum bleeding, bad breath and dental caries as well as it has antismoking and anti cancer properties. While medicated toothpaste is a type of toothpaste that applies a medicine to the teeth, gum and mouth. Some medicated toothpaste require pacific application technique or a set duration of contact with the teeth, gums and mouth in order to provide a medical benefit. As the name suggest, these toothpaste have some medicinal properties. They are created pacifically to help in solving an oral health issues