Management of an incidentally found large adrenal myelolipoma: a case report

Adrenal myelolipoma is a rare benign neoplasm composed of mature adipose and hematopoietic tissue. Most lesions are small, unilateral and asymptomatic, discovered incidentally at autopsy or on imaging studies performed for other reasons. We would like to present a case report of this rare tumour. Cross-sectional imaging is helpful in making a pre-operative diagnosis. The size of the lesion should be a criterion for surgical intervention

Impact of increase of caesarean section on postpartum hemorrhage in a tertiary care center of India over 6 years

Background: PPH (postpartum hemorrhage) is the leading cause of maternal mortality. Despite of all the medical advancement, maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Caesarean section is an obstetric intervention where, normal delivery can pose a risk for mother or foetus. The rate of caesarean section has increased worldwide. A survey conducted by WHO found that the worldwide rate of caesarean section increased from 26.4% between 2004 to 2008, to 31.2% between 2010 to 2011.Methods: We collected data of the caesarean sections and patients who developed PPH over 6 years. We studied the association of temporal increase of caesarean section with PPH.Results: Uterine atonicity continues to be the most common etiology of PPH each year, however, there is an increase in tissue abnormality (retained placenta, placenta praevia, accreta, increta, percreta) over years as there is a significant increase in the incidence of caesarean section. Atonic uterus was the most common cause for obstetric hysterectomies and mortality due to PPH every year.Conclusions: Family planning advise is essential in developing country like ours to counsel patients to prevent multiparity, thus reducing PPH. It is also important to train all the health workers in periphery and referral centers to manage the third stage of labor and atonic uterus to save the mothers. Sagacious attitude towards the decision of caesarean section is needed to prevent maternal morbidity and mortality

Development of a Civil Infrastructure Resilience Assessment Framework

Recent disruptive events, such as earthquakes or floods, have caused severe damage to civil infrastructural systems. Thus, there is a need to extend the focus of traditional design practices to consider resilience-based design approaches which can help in defining preventive actions and measures to mitigate the consequences caused by such disruptive events. This paper presents a Civil Infrastructure Resilience Assessment Framework (CIRAF) to assess the seismic fragility and resilience of a single or interconnected civil infrastructural systems following a disruptive event. Once the information regarding the infrastructural system, hazards, fragility databases, components damage state correlation, recovery models, and upgrade models are identified, then the framework can be used to quantify the loss of functionality, recovery time, repair cost, and overall resilience following an extreme event. Bayesian models are used to evaluate the probability of failure of a system, which consists of layers of sub-systems and components. A state-of-the-art engineering tool is also developed using the framework that would enable the stakeholders to compare different upgrade strategies through an easy to use web interface and thus easing the decision-making process. A simplified infrastructural system consisting of 3 components is illustrated in this paper using the CIRAF framework

PREDICTION OF SEVERITIES OF BUGS WITH LEVELS AND TYPES OF INHERITANCE

ABSTRACT Past researches have attributed level of inheritance as major contributor of effectiveness in prediction of severities of bugs. This research initially attempts to correlate effectiveness of prediction of severities of bugs with levels of inheritance. This research also attempts to take a step further by correlating the prediction of severities of bugs with types of inheritance as well. This present research has considered different levels of inheritance and has established a correlation framework for severities of bugs (non trivial bugs, major bugs, and critical bugs) with types and levels of inheritance. This research has successfully revealed that the severities of bugs can be associated with different levels and types of inheritance and has further concluded that with increasing levels as well as complexity of types of inheritance, the severity of bugs will also increase. In this research work, two back-propagation training functions such as Broyden-FletcherGoldfarb-Shanno (BFG) and LevenbergMarquardt (LM) have been selected for evaluation. The present research work has used these two training functions to validate the results on the basis of mean square error (MSE), prediction accuracy, R on testing, R on training and R on validation. The present research has generated sufficient interest with the help of correlation framework associating levels and types of inheritance with severities of bugs. The present research work has also resulted in development of a tool for demonstrating type of inheritance (single inheritance, multilevel inheritance, hierarchical inheritance, and multiple inheritances) associated with each file containing bugs. Furthermore, the findings are of growing importance suggesting that levels and types of inheritance need to be rationalized in order to contain severities of bugs for effective quality control in software project

An unusual cause of gastric outlet obstruction during percutaneous endogastric feeding: a case report

<p>Abstract</p> <p>Introduction</p> <p>The differential diagnoses of acute abdomen in children include common and rare pathologies. Within this list, different types of bezoars causing gastrointestinal obstruction have been reported in the literature and different methods of management have been described. The aim of this article is to highlight a rare presentation of lactobezoars following prolonged percutaneous endoscopic gastrostomy feeding and its successful surgical management.</p> <p>Case presentation</p> <p>A 16-year-old boy was admitted to a paediatric ward with abdominal distension and high output from his permanent gastrostomy feeding tube, with drainage of bilious fluids. The clinical, radiological and endoscopical examinations were suggestive of partial duodenal obstruction with multiple bezoars in the stomach and duodenum. Gastrojejunostomy was performed after the removal of 14 bezoars. The child had an uneventful postoperative course and was discharged on the sixth postoperative day in a stable condition.</p> <p>Conclusion</p> <p>Lactobezoars should be included in the differential diagnosis of acute abdominal pain in patients with percutaneous endogastric feeding. Endoscopy is important in making the diagnosis of this surgical condition of the upper gastrointestinal tract in a child.</p