106 research outputs found
Wandering Spleen: A Rare Condition with Splenic Torsion and Infarction in an Elderly Patient
No full textEctopic spleen or wandering spleen is an uncommon presentation in which the spleen's anatomical location is different from its fixed position in the left upper quadrant of the abdomen, due to the absence of the typical peritoneal attachments; the spleen is more mobile inside the abdomen. Congenital or acquired conditions are the cause of this anomaly, which could ultimately result in torsion and splenic infarction. Less than 0.2% of wandering spleen cases are reported annually, making it a rare clinical manifestation. Splenic vascular pedicle torsion can result in complications that can cause symptoms of an acute abdomen as a result of ischemic necrosis of the spleen. Computed tomography and ultrasonography with Doppler or CEUS are essential for accurate diagnosis due to the vague clinical signs and potential complications. This case involves a 70-year-old elderly woman who complained of extreme abdominal pain and vomiting for three days. On physical examination, a tense right lower quadrant lump was palpated, when she visited the emergency room. An urgent CT scan was done for the acute abdomen which revealed torsion of the splenic pedicle in a wandering spleen
Study on rationality of different fixed dose drug combinations in tertiary care hospital: an evaluation study
No full textBackground: The fixed dose drug combinations (FDCs) of drugs is defined as product of two or more active ingredients in a defined composition. There is a need to study the pattern of prescription from time to time to evaluate their rationality. In this context we undertook this study to know the prescription pattern of FDC in our setting. To study the rationality of different prescribed FDCs.Methods: This is a prospective study which is carried out in NIMRA Institute of medical sciences which is a tertiary care teaching private hospital. For this study we have collected one thousand prescriptions of patients for 3 months that is from 10th March 2017 to 25th of June 2017 including both in-patients as well as outpatients. Selection criteria of patients mainly basing on their willingness to give prescriptions. Institutional ethical committee permission was taken for the study. The prescribed FDCs were compared with the essential drug list of FDCs approved by Drugs Controller General of India, July 2018. we have used descriptive statistics to analyze data. The percentage of FDCs used in each class and their contribution to overall FDCs were calculated.Results: In a total of 2952 drugs were prescribed, of this 747 were FDCs and 2205 were non FDCs. In the prescribed FDCs 89.2% drugs were rational and 10.8% drugs were irrational.Conclusions: From this study, we can conclude that 10.8% of irrational prescription of fixed dose drug combinations are prescribed in Nimra Institute of Medical Sciences which is a tertiary care teaching private hospital
A Study of Reduced Order 4D-VAR with a Finite Element Shallow Water Model
No full textForecast models often depend on unknown parameters, such as model initial and boundary conditions, or other tunable parameters not necessarily having any physical meaning. Calibration of these parameters to minimize errors between forecasted and observed states is called data assimilation. A common approach in this context are variational methods, of which four dimensional data variation (4D-VAR) is studied in this thesis. In 4D-VAR, a cost function is defined that penalizes misfits between observations and the corresponding numerical model results, obtained by running the model with the chosen configuration. Performing optimization with regard to this cost function yields an improved initial parameter set. Associated with this type of methods, however, are difficulties in connection with programming the adjoint model, which is needed to compute the exact gradient of the cost function. Additionally, having to integrate the adjoint model backwards in time adds significantly to the computational cost of the data assimilation process. To avoid manual implementation of adjoint code and to reduce computational complexity, approximation of the gradient calculation is considered through the use of proper orthogonal decomposition (POD), a flexible data-driven order reduction method. To facilitate this, a finite element model of the shallow water equations is tested with both the full adjoint 4D-VAR method and two different POD-reduced approaches. Twin experiments are performed and comparisons are made in terms of accuracy, computational complexity and sensitivity to perturbation and number of observation points.Applied mathematicsElectrical Engineering, Mathematics and Computer Scienc
Model reduced variational data assimilation for shallow water flow models
No full textIdentifying uncertain parameters in large-scale numerical flow models can be done using the variational method. However, for implementing the variational method the adjoint model have to be available, which requires highly complex computer code and maintenance and thus hampers its applications. To ease this problem, this thesis has explored several methods for efficiently identifying uncertain parameters in a large-scale tidal model of the entire European continental shelf which does not require the implementation of these complex adjoint code. In this study, as a first step an estimation method based on model reduction is developed and investigated for the estimation of diffusion coefficient in a simple 2D-advection diffusion model. Two projection based model reduction methods were considered, namely proper orthogonal decomposition (POD) and Balanced proper orthogonal decomposition (BPOD). In the POD based estimation method an ensemble of forward model simulations is used to determine an approximation of the covariance matrix of the model variability and a small number of the leading eigenvectors of this matrix is used to define a model subspace. By projecting the original model onto this subspace an approximate linear reduced model is obtained. Once the reduced model is available its adjoint can be implemented easily and the minimization problem is solved completely in reduced space with very low computational cost. BPOD is also a model reduction method which considers both inputs and outputs of the system while determining the reduce subspace. The estimation method has been extended by including BPOD procedure into the estimation procedure. Numerical results from a simple pollution model demonstrate that the POD based estimation approach successfully estimate the diffusion coefficient for both advection dominated problems as for diffusion dominated problems. Another important message in this study, although lots of effort had been made in constructing a reduced order model by the BPOD method, the minimization results demonstrated that both the POD and the BPOD methods performed similarly. Preliminary results showed the validity of the POD based model reduction methods for parameter estimation. As a next step, the POD based estimation method is used to calibrate numerical tidal models. Results from (twin) numerical experiments showed that the POD based calibration method performed very efficiently to estimate depth values in the selected regions of the model domain. The computational costs of the POD based calibration method are dominated by the generation of an ensemble of forward model simulations where the simulation period of the ensemble is equivalent to the timescale of the original model. It has also been found in the study that it is not needed to use a full simulations of the original model for the generation of the ensemble. The POD based calibration method has also been implemented for the estimation of the water depth and space varying bottom friction coefficient values in a very large-scale DCSM model. The recently designed large-scale spherical grid based water level model for the northwest European continental shelf (around 1000000 computational grid points) has been used for this purpose. This has been the first application of the POD based calibration method to a very large-scale model and with real data. Results from numerical experiments showed that the calibration method performs very efficiently. An overall improvement of more than 50\% was observed after the calibration in comparison with the initial model. The results also demonstrated that the POD based calibration method offered a very efficient minimization technique compared to the classical adjoint method without the burden of implementation of the adjoint. As a concluding step, to estimate depth values in the model DCSM, a Simultaneous perturbation stochastic approximation (SPSA) method has been used. The method uses stochastic simultaneous perturbation of all model parameters to generate a search at each iteration. SPSA is based on a highly efficient and easily implemented simultaneous perturbation approximation to the gradient. This gradient approximation for the central difference method uses only two objective function evaluations independent of the number of parameters being optimized. The results from experiments showed that SPSA has a lower convergence rate than POD based calibration method, however the computational cost in each iteration of the SPSA method is usually far less then the POD based calibration method. The results also demonstrated that the SPSA algorithm proved to be a promising optimization algorithm for model calibration for cases where adjoint code is not available for computing the gradient of the objective function.Applied mathematicsElectrical Engineering, Mathematics and Computer Scienc
Harpactus Shuckard 1837
No full textGenus Harpactus Shuckard, 1837 Arpactus Jurine, 1807: 192, junior homonym of Arpactus Panzer, 1805, and of Arpactus Panzer, 1806 (both junior synonyms of Gorytes Latreille, 1804). Type species: Arpactus formosus Jurine, 1807, designated by Shuckard 1837: 220. Harpactus Shuckard 1837: 221. Emendation of Arpactus Jurine, 107 on linguistic grounds, thus an available new name, with its own date and author (Articles 19 and 33.2). Since Harpactus is an emendation, it has the same type-species as Arpactus Jurine (Article 67.8). Harpactes Dahlbom 1843: 147, junior homonym of Harpactes Swainson, 1837 (Aves), and of Harpactes Templeton, 1834 (Arachnida). Emendation of Harpactus Shuckard. Dienoplus W.J. Fox 1894: 548. Type species: Dienoplus pictifrons Fox, 1894, by monotypy. Key to Harpactus species of India and adjacent territories 1. Head and mesosoma without distinct punctures............................................................. 2 - Head, mesosoma, [and T2] distinctly foveolate-punctate, with scattered foveae. [Kashmir].......... H. pulawskii sp. nov. 2. Propodeum with oblique and irregular striae................................................................ 3 - Propodeum with distinct coarse, longitudinal striae [Pakistan].................................. H. vividus (Turner) 3. Fore wing with fuscous patch in radial and cubital cells; propodeal enclosure red. [Northern India; Myanmar]................................................................................................. H. ornatus (Smith) - Fore wing usually without fuscous patch in radial and cubital cells; propodeal enclosure black. [Oriental India].............................................................................................. H. impudens (Nurse)Published as part of Binoy, C., Kumar, P. Girish, Monks, Joseph & Sheikh, Altaf Hussain, 2022, A review of digger wasp genus Harpactus Shuckard, 1837 (Hymenoptera Crabronidae) of the Indian subcontinent, with description of a new species and rediscovery of Harpactus impudens (Nurse, 1903), pp. 531-542 in Zootaxa 5190 (4) on page 532, DOI: 10.11646/zootaxa.5190.4.3, http://zenodo.org/record/713847
RECENT ADVANCES IN GAS, LIQUID AND SUPERCRITICAL FLUID CHROMATOGRAPHY IN THE CONTEXT OF SUSTAINABLE/ GREEN CHEMISTRY
No full textBackground: Chromatographic techniques such as gas chromatography (GC), liquid chromatography (LC) and supercritical fluid chromatography (SFC) have long been employed in analytical chemistry. However, using or producing certain organic solvents and non-renewable gases is hazardous to the environment. Green chemistry is essential for addressing the environmental hazards associated with traditional procedures. Objectives: This review focuses on recent updates and profound insights into new, greener techniques introduced in GC, LC and SFC. Methodology: To compile this review, several electronic databases were searched, preferably from January 2019-December 2023. Results: This review highlights advancements in miniaturization, rapid methods, and eco-friendly solvents in chromatographic techniques. Integrating micro-electro-mechanical systems (MEMS) and nano-electro-mechanical systems (NEMS) in GC enhances sensitivity and resolution while reducing solvent consumption. Innovations like monolithic micro-GC chips and the Quick, Easy, Cheap, Effective, Rugged, and Safe (QuEChERS) method further streamline analysis times. In LC, supercritical fluids are utilized as green mobile phases, optimizing techniques like electrochemical flow liquid chromatography (EFLC), high-performance liquid chromatography (HPLC), and ultra-high-performance liquid chromatography UHPLC. In contrast, SFC employs rapid methods, such as ultra-high-performance supercritical fluid chromatography-mass spectrometry (UHPSFC-MS). These developments collectively promote sustainability and efficiency in chromatographic practices. Conclusion: Green chromatography has become an essential tool in pharmaceutical analysis because it safeguards the operator’s health and the environment. It opens new horizons and generates new ideas for further experimentation while focusing on recent cutting-edge green technologies incorporated in GC, LC and SFC. These advancements significantly enhance safety and sustainability in analytical practices
Misconceptional views about epilepsy exist across social class system of society
No full textEpilepsy affects over 1% of population worldwide. Studies have shown that although our understanding about epilepsy has come a long way, misconceptions about its etiology and treatment exist in rural slums. However, no study has been conducted to see whether such misconceptions exist in middle and upper socio-economic class. This study aims to explore the existence of misconceptions and social stigma in the middle and upper socio-economic class. Materials and Methods: We conducted a survey-based study about epilepsy on 227 participants, belonging to middle and upper socio-economic class. Results: The symptoms of generalized tonic-clonic seizures were correctly described by participants. However, magic, superstition and ‘jin’ were considered as the etiology by some. Incorrect treatment options, like shoe sniffing and ‘taweez’ etc., were also mentioned. Social stigmas regarding sharing information about epilepsy and marrying epileptics also existed. Discussion: Our study shows that although the general understanding about epilepsy was correct in majority of participants belonging to the middle upper socio-economic class, it was restricted to generalized tonic clonic seizures. Key misconceptions regarding the etiology and treatment of epilepsy and social stigma associated with it did exist. These findings emphasize the need to educate all segments of the society about epileps
High-prevalence and high-estimated incidence of HIV infection among new injecting drug users in Estonia: need for large scale prevention programs.
No full textOBJECTIVE: To examine HIV risk behavior and HIV infection among new injectors in Tallinn, Estonia. Design and methods Data from two cross-sectional surveys of injecting drug users (IDUs) recruited from a syringe exchange program (N = 162, Study 1) or using respondent driven sampling (N = 350, Study 2). Behavioral surveys were administered; serum samples were collected for HIV testing. Subjects were categorized into new injectors (injecting 3 years). RESULTS: Twenty-eight of 161 (17%, Study 1) and 73/350 (21%, Study 2) of the study subjects were new injectors. HIV infection was substantial among the newer injectors: HIV prevalence was 50% (Study 1) and 34% (Study 2), and estimated HIV incidence 31/100 PY and 21/100 PY, respectively. In Study 2, new injectors were more likely to be female and ethnic Estonian and less likely to be injecting daily compared with long-term injectors. No significant difference was found among two groups on sharing injecting equipment or reported number of sexual partners. CONCLUSIONS: A continuing HIV epidemic among new injectors is of critical public health concern. Interventions to prevent initiation into injecting drug use and scaling up HIV prevention programs for IDUs in Estonia are of utmost importance
سرسیدکامقام:حالی وشبلی کی اردوشاعری کی روشنی میں
No full textSir Syed Ahmed Khan is known as a Muslim reformer of the 19th century. He played an important role in introducing modern Urdu verse and prose. He himself was a prominent author, editor and compiler. Altaf Husain Hali is a well known poet, prose writer and critic etc. Shibli Naumani is another great name of Urdu literature. Shibli was a distinguished scholar, writer and poet. Hali and Shibli were close companions of Sir Syed. They discussed the personality and achievements of Sir Syed in their verses. The article analyses the status of Sir Syed in the light of the verse of the said two great names of Urdu.
Socio-economic determinants of employment in Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) in Jammu and Kashmir
No full textPurposeThe purpose of this paper is to look at the socio-economic determinants of employment in Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) in Jammu and Kashmir (J&K) at both household and individual level. My results show that there is no discrimination in provision of employment to backward classes. Out of all the Indian States, J&K has lowest female participation in the scheme. My results show that women are discriminated against in provision of employment. Worksite facilities, like creche, can positively affect female participation in the scheme.Design/methodology/approachThe author uses multi-variate OLS regression model to analyse the data collected through primary survey of three heterogenous villages of district Ganderbal of J&K.FindingsThe author finds clear evidence of discrimination against females in provision of employment along with slight evidence of elite capture of the scheme. The author also finds negative relationship between the number of children in a household and the number of workdays which highlights the importance of worksite facilities to increase female and overall participation for the scheme to be successful.Research limitations/implicationsThe possible limitation could be small sample size but given that this is the first study of its kind in the J&K State, researchers can build up on it.Originality/valueThis is one of the first research papers which looks at the performance of MGNREGS in J&K in such detail. No comprehensive study of this magnitude and rigour has been undertaken in J&K till now.</jats:sec
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