English Teaching to Engineering Students difficulties and Solutions

Being science student and wondering about robots, electrons, engineering students hardly bother about nouns, verbs and tenses. English no doubt has taken place as first language in the corporate world but heart of an engineering student still resist the panorama of English language in their lives. Subconsciously aware of the importance of communication skills in getting a job, they fail to realize its importance consciously in the class rooms. They fail to realize that the gateway to express their core knowledge is communication skill only. Maximum engineering students neglect this most important skill because of many reasons. Though there might be many argumentations which favor causing lack of interest in English learning process but its importance cannot be neglected. This research basically focus on the reasons ;why engineering /business students lack interest in learning of communication skills and what tentative pedagogies can be adopted to develop their interest in learning of communication skills. This research paper aims to find out the difficulties in teaching, learning of English/communication skills to engineering students and tentative solutions to ease the process of learning. Keywords: communication skills, practical learning, listening skill, improve expression, communication skills in present scenario, Non verbal communicatio

Computed tomography texture-based radiomics analysis in gallbladder cancer: initial experience

Aim of the study: To investigate computed tomography (CT) texture parameters in suspected gallbladder cancer (GBC) and assess its utility in predicting histopathological grade and overall survival. Material and methods: This retrospective pilot study included consecutive patients with clinically suspected GBC. CT images, clinical, and histological or cytological data were retrieved from the database. CT images were reviewed by two radiologists. A single axial CT section in the portal venous phase was selected for texture analysis. Radiomic feature extraction was done using commercially available research software. Results: Thirty-eight patients (31 females, mean age 53.1 years) were included. Malignancy was confirmed in 29 patients in histopathology or cytology analysis, and the rest had no features of malignancy. Exophytic gallbladder mass with associated gallbladder wall thickening was present in 22 (58%) patients. Lymph nodal, liver, and omental metastases were present in 10, 1, and 3 patients, respectively. The mean overall survival was 9.7 months. There were significant differences in mean and kurtosis at medium texture scales to differentiate moderately differentiated and poorly differentiated adenocarcinoma (p < 0.05). The only texture parameter that was significantly associated with survival was kurtosis (p = 0.020) at medium texture scales. In multivariate analysis, factors found to be significantly associated with length of overall survival were mean number of positive pixels (p = 0.02), skewness (p = -0.046), kurtosis (0.018), and standard deviation (p = 0.045). Conclusions: Our preliminary results highlight the potential utility of CT texture-based radiomics analysis in patients with GBC. Medium texture scale parameters including both mean and kurtosis, or kurtosis alone, may help predict the histological grade and survival, respectively

Gallbladder reporting and data system (GB-RADS) for risk stratification of gallbladder wall thickening on ultrasonography:an international expert consensus

The Gallbladder Reporting and Data System (GB-RADS) ultrasound (US) risk stratification is proposed to improve consistency in US interpretations, reporting, and assessment of risk of malignancy in gallbladder wall thickening in non-acute setting. It was developed based on a systematic review of the literature and the consensus of an international multidisciplinary committee comprising expert radiologists, gastroenterologists, gastrointestinal surgeons, surgical oncologists, medical oncologists, and pathologists using modified Delphi method. For risk stratification, the GB-RADS system recommends six categories (GB-RADS 0–5) of gallbladder wall thickening with gradually increasing risk of malignancy. GB-RADS is based on gallbladder wall features on US including symmetry and extent (focal vs. circumferential) of involvement, layered appearance, intramural features (including intramural cysts and echogenic foci), and interface with the liver. GB-RADS represents the first collaborative effort at risk stratifying the gallbladder wall thickening. This concept is in line with the other US-based risk stratification systems which have been shown to increase the accuracy of detection of malignant lesions and improve management. Graphical abstract: [Figure not available: see fulltext.]

Immediate loading of bicortically engaged long implants in maxillary and mandibular esthetic region – A clinicoradiographic evaluation

Background: Bicortical engagement is the engagement of nasal cortical plate and basal cortical plate in maxillary and mandibular esthetic zone, respectively. These are longer implants which offer osseointegration along with high osseofixation. Increased length of implant provides increased bone–implant contact offering primary stability which permits immediate loading. Aim: The aim of the study was to clinicoradiographically evaluate immediate loading in bicortically engaged long implants in maxillary and mandibular esthetic region. Materials and Methods: Thirty patients with missing teeth in esthetic region were selected for the study. Implants were placed in both arches engaging nasal cortex and basal bone wherever required. One-time definitive abutment was placed and immediate loading was done. Results: No failure was observed in the study period of 9 months. The mean insertion and reverse torque was 66.67 ± 6.794 and 41.67 ± 3.101, respectively, indicating high primary stability. No pain, discomfort, infection, or implant mobility was observed. The mean crestal bone loss changes were statistically insignificant. Conclusion: Hundred percent implant survival was observed

Buprenorphine versus diclofenac for pain relief in acute pancreatitis: A double-blinded randomized-controlled trial

Background: While both non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are used for analgesia in acute pancreatitis (AP), the analgesic of choice is not known. We compared buprenorphine, an opioid, and diclofenac, an NSAID, for analgesia in AP. Methods: In a double-blind randomized controlled trial, AP patients were randomized to receive IV diclofenac or IV buprenorphine. Fentanyl was used as rescue analgesia, delivered through a patient- controlled analgesia pump. Primary outcome was the difference in the dose of rescue fentanyl required. Secondary outcomes were the number of effective and ineffective demands of rescue fentanyl, pain-free interval, reduction in visual analogue scale (VAS) score, adverse events, and organ failure development. Results: Twenty-four patients were randomized to diclofenac and 24 to buprenorphine. The two groups were matched at baseline. The total amount of rescue fentanyl required was significantly lower in the buprenorphine group:130 μg, interquartile range (IQR) 80-255 vs. 520 μg, IQR 380-1065 (p&lt;0.001). The number of total demands was 32[IQR 21-69] in the diclofenac vs 8[IQR 4-15] in the buprenorphine arm (p&lt;0.001). The buprenorphine group had more prolonged pain-free interval (20 hrs. vs. 4 hrs.; p &lt; 0.001) with greater reduction in the VAS score at 24, 48 and 72 hrs. compared to the diclofenac group. These findings were confirmed in the subgroup of moderately severe /severe pancreatitis. Adverse events profile was similar in the two groups. Conclusions: Compared to diclofenac, buprenorphine appears to be more effective and equally safe for pain management in AP patients, even in the sub-cohort of moderately severe or severe pancreatitis (Trial Registration number: CTRI/2020/07/026914)

Endoscopic drainage versus percutaneous drainage for the management of infected walled-off necrosis: a comparative analysis

Background: Comparative data on percutaneous catheter drainage (PCD) vs EUS-guided drainage (EUS-D) for management of symptomatic walled-off-necrosis (WON), specially infected WON with/without organ failure(OF) is limited. Methods: Patients with symptomatic WON were divided into two groups of PCD and EUS-D, depending on the modality of drainage. Resolution of OF, adverse events, and other outcome measures were recorded. The two modalities were compared among infected WON sub-cohort and also degree of solid component (SC). Results: 218 patients (175 males; 80.3%) were included who underwent either PCD (n&nbsp;=&nbsp;102) or EUS-D (n&nbsp;=&nbsp;116). Clinical success was significantly higher in the EUS-D group (92.1% vs 64.6%; p &lt;&nbsp;0.0001) and even for infected WON (n&nbsp;=&nbsp;128) (p&nbsp;=&nbsp;0.004), with higher (p&nbsp;=&nbsp;0.007) and faster (p&nbsp;&lt;&nbsp;0.0001) OF resolution. Other outcome measures including mortality were significantly higher in the PCD group. Among subgroups, PCD with &gt;40% SC had the worst clinical success/OF resolution rates, while EUS-D with &lt;40% SC had the best outcomes. Conclusion: EUS-D should be preferred over PCD in the management of WON, infected or otherwise, for higher clinical success, and higher/faster resolution of OF. PCD should be avoided in WON with&gt;40% SC