158 research outputs found
Spectrum of pleural effusion etiology revisited in 18–70 years of age group: A tertiary care center-based study of 1000 patients
No full textObjective: The main objective study was to evaluate the new-onset cases of pleural effusion with respect to etiology/causation. Materials and Methods: A total of 1000 patients were included in the study aged between 18 and 70 years. The patients with earlier diagnosis of pleural effusion or those who had undergone thoracocentesis were excluded from the study. All the patients were subjected to thorough clinical examination, chest radiography, chest and abdominal sonography, pleural fluid analysis, and pleural fluid cytology, and in select cases, pleural biopsy was done. The results were assimilated and tabulated, observations thereby drawn by. Results and Observations: Out of total 1000 patients, 69.5% had tuberculosis followed by malignancy (16%) with the systemic causes forming about 15% bulk of the patients with pleural effusion. It was found more in males, associated with smoking, and majority of patients had unilateral effusion. Eighty-nine percent of patients had exudative effusion. Conclusion: The results of the study revealed that tuberculosis is still the most common cause of pleural effusion and efforts need to be stepped up to control tuberculosis. The national programs for control of tuberculosis need to be revisited to assess the magnitude of the problem, and the patients need to be counseled for the compliance of the therapy. Furthermore, malignancy is trending upward in the etiology of pleural effusion
Clinico-radiological profile of pulmonary sarcoidosis: A study of 150 patients
No full textObjective: The main aim of this study was to study the radiological, including radiographic and computed tomographic, histopathologic and clinical profiles in patients of pulmonary sarcoidosis. Materials and Methods: A prospective study of 150 patients suspected of having sarcoidosis was carried out with their routine chest radiographs and computed tomography scans performed followed by histopatholgical analysis of the lymph nodes. Results: Most of the patients evaluated belonged to the Stage-I sarcoidosis least number of patients were from Stage-IV disease. Conclusion: All the modalities should be combined with clinico-radiologico-pathological diagnosis of the disease to avoid inconvenience to the patient and misdiagnosis
Next-Generation Technologies for Gravitational Wave Detectors
No full textSince the first detection of gravitational waves (GW) in 2015, gravitational wave detectors have continually been improved. Now, a compact binary coalescence (CBC) is detected once a week in a full sensitivity observation run of the Advanced Laser Interferometric Gravitational-wave Observatory (LIGO) detectors. This thesis describes research on a collection of projects aimed at developing next-generation of technologies for future gravitational wave detectors. In the first part, I describe my research on directly measuring the coatings Brownian noise of high-reflectivity coatings made out of crystalline AlGaAs. It is a part of the larger effort to reduce the classical noise limit in the 30 Hz to 300 Hz band in the current generation of detectors. The second part describes the Balanced Homodyne Readout (BHR) upgrade that was performed at the 40m prototype at Caltech. This new readout method would be instrumental in reducing excess noise at the lower frequencies in GW detectors. With several future detectors planned with an order of magnitude improvement in sensitivity, the parameter estimation about the merging bodies would be limited by the calibration uncertainty if the calibration method is not updated. In the third part of the thesis, I describe our work on developing a systematic-free absolute calibration of the detector. In this scheme, we refer the calibration to the ultra-stable optical common length mode of the arm cavities in the detectors. In the final part, I describe four new arm length stabilization schemes for the proposed cryogenic upgrade of Advanced LIGO detectors into Voyager
Magnetic Resonance Imaging in Non-traumatic Orbital Pathologies: An Observational Cross Sectional Study
No full textBackground: Orbital lesions form a wide range of pathologies, that create challenges in diagnosis, management and treatment. The high-resolution soft tissue detail provided by magnetic resonance imaging (MRI) has allowed for better lesion characterization. MRI is also important in the detection of extent and localization of orbital diseases.
Aim: The aim of the study was to evaluate the profile of orbital lesions on MRI in non-traumatic orbital pathologies. The objectives of this study were to examine the MRI characteristics of common diseases arising from or extending into the orbit to aid in the correct diagnosis of orbital lesions.
Material and Methods: The patient data was collected from GMC Jammu over a period of one year. The study comprises of 50 patients with symptoms of proptosis, orbital swelling, diminution of vision; referred from ophthalmology department of GMC Jammu. MRI examination was performed on Siemens Magnetom Symphony 1.5 Tesla machine and the cases were studied to determine the imaging features of various orbital pathologies on MRI. All patients were evaluated for the clinical symptoms and were also subjected to other routine investigations.
Results: The most common presenting symptom was diminution of vision (66%) followed by proptosis (50%). Most commonly encountered lesions were infective and inflammatory lesions, contributing 60% of total lesions. Various other lesions encountered were coloboma, orbital lymphoma, vascular hemangiomas and thyroid ophthalmopathy.
Conclusion: MRI is valuable for determining the extent of disease, describing its exact localisation and detecting involved orbital compartments. A compartmental approach to evaluating orbital disease can guide the differential diagnosis
Ending the child drowning epidemic in India and Bangladesh: Applying a framework for program development and implementation
No full textGlobally, drowning is the second largest cause of death by injury in children aged 1-14 years old. Risk factors for child drowning include poor supervision, lower socioeconomic status, poor swimming and rescue skills, and the proximity of open water near homes. These are more prevalent in low-and middle-income countries(LMICs). The WHO has developed recommended interventions for drowning prevention in rural LMIC contexts, such as the provision of supervised childcare to prevent access to nearby water bodies.
This thesis explores the process of developing and evaluating drowning prevention programs in two high-risk LMIC regions: the Sundarbans in India and the Barishal Division in Bangladesh. As no previous research on drowning burden and prevention has been conducted in India, the main aims were to: (1) Identify the burden of child drowning in the Sundarbans, and (2) identify implementation strategies for drowning prevention programs. Conversely, drowning prevention programs have been implemented in Bangladesh, but evaluation of their implementation remains. The Anchal program provides supervised childcare to younger children, while SwimSafe provides swim training to older children. The main aims in Bangladesh were to: (1) Understand implementation implications and best practices, and (2) understand the impact of gender norms on implementation.
The findings from the Sundarbans mortality survey showed a significant burden of drowning, with a rate of 243.8/100 000 for 1-4-year-old children, and 38.8/100 000 for 5-9-year-old children. Common circumstances were the lack of effective adult supervision, no physical barriers against water, and proximity of open water to homes. Findings from the analysis of relevant government policy and interviews with community-based stakeholders identified three existing government programs that could be leveraged for the implementation of drowning interventions.
In Bangladesh, the mixed-methods process evaluation of the Anchal program showed that while the program was acceptable in the community, geographical barriers to access, cultural beliefs and inadequate resources reduced attendance, limiting effectiveness. The gender analyses of both Anchal and SwimSafe programs revealed opportunities to ensure equitability. Fewer older girls enrolled in SwimSafe classes compared to boys due to cultural concerns. Female community-based staff found that employment in the programs improved social status, physical mobility and access to resources
Opportunities for gender transformative approaches in a community-based drowning reduction program in Bangladesh
No full textBackground: Community-based programs in rural low-and middle-income country settings are well-placed to conduct gender transformative activities that aid program sustainability and catalyse wider social change, such as reducing gender inequities that in turn improve health outcomes. The Anchal program is a drowning prevention intervention for children aged 1-5 years old in rural Bangladesh. It provides community crèche-based supervision delivered by local trained paid-female volunteers. We aimed to identify the influence of the Anchal program on gender norms and behaviours in the community context, and the effects these had on program delivery and men and women's outcomes. Methods: Qualitative in-depth interviews, focus group discussions and observations were conducted with program beneficiaries and providers. Gender outcomes were analysed using FHI 360's Gender Integration Framework. Results: The Anchal program was found to be a gender accommodating program as it catered for communities' gender-based roles and constraints but did not actively seek to change underlying beliefs, perceptions and norms that led to these. The program in some cases enhanced the independence and status of female community staff. This changed perceptions of communities towards acceptable levels of physical mobility and community involvement for women. Conversely, gender affected program delivery by reducing the ability of female supervisory staff to engage with male community leaders. The double burden of wage and household labour carried by local female staff also limited performance and progression. Gender-based constraints on staff performance, attrition and community engagement affected efficiency of program delivery and sustainability. Conclusions: The Anchal program both adapted to and shaped community gender norms and roles. The program has well-established relationships in the community and can be leveraged to implement gender transformative activities to improve gender-based equity. Health programs can broaden their impacts and target social determinants of health like gender equity to increase program sustainability and promote equitable health outcomes
Complexity in implementing community drowning reduction programs in southern bangladesh: A process evaluation protocol
No full textLiving and geographical conditions in Bangladesh expose children to a high risk of drowning. Two programs operating in the Barishal Division of Bangladesh aim to reduce drowning risk through the provision of crèches (Anchal) and swim and rescue classes (SwimSafe). Anchal provides a safe environment with early childhood education to children aged 1–5 years old, while SwimSafe teaches children aged 6–10 years old basic swimming and rescue skills. Despite evidence for their effectiveness, it is unclear under which conditions these programs best operate. This protocol describes a project that seeks to conduct a process evaluation and gender analysis to identify implementation inefficiencies and contextual considerations for improved sustainability of the programs. A mixed-method approach using both qualitative and quantitative data will be used. Quantitative program data will be analysed to measure program utilisation, delivery and reach, while qualitative data will be collected via key informant in-depth interviews (IDIs), focus group discussions (FGDs) and observations. The process evaluation of the Anchal and SwimSafe programs provides an opportunity for implementers to identify practical strategies to improve program delivery and improve contextual adaptability of these programs. Furthermore, the findings may provide guidance to other implementers aiming to deliver community-based programs in rural lower-middle income contexts
Influence of human resource practices on faculty's intention to stay in higher education management institutes
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