13 research outputs found
A Correlative study of Clinical, Biochemical, Radiological, Diagnosis with Operative Diagnosis of Acute Abdomen
No full textINTRODUCTION:
The term acute abdomen refers toa clinical presentation that often requires emergency surgical therapy. This challenging clinical scenario requires a thorough and expeditious workup to determine the need for operative intervention and to initiate appropriate therapy.
AIM AND OBJECTIVES:
1. This study is aimed to correlate the clinical examination, biochemical investigations and radiological findings with operative diagnosis of acute abdomen.
2. To estimate the sensitivity, specificity and accuracy of biochemical diagnosis in acute abdomen.
3. To estimate the sensitivity, specificity and accuracy of radiological diagnosis in acute abdomen.
4. To know the importance of clinical examination in acute abdomen.
MATERIALS AND METHODS:
162 patients admitted inTirunelveli medical college with signs and symptoms of acute abdomen were included in the study. A clinical and radiological diagnosis was made for each patient and was compared with the operative diagnosis.
RESULTS:
Out of 162 patients, 83 patients who were clinically diagnosed as acute appendicitis, intra operatively acute appendicitis was found in 78 patients (93.9%), and 5 patients had appendicular perforation (6.02%).
Out of 15 patients clinically diagnosed to have appendicular perforation, all had appendicular perforation intraoperatively (100%).
Out of 35 patients with clinical diagnosis of perforative peritonitis, all had found to have perforation intraoperatively (100%) (duodenal perforation-22; gastric
perforation-10; ileal perforation-3).
CONCLUSION:
Clinical examination was found to be statistically correlating with the intraoperative findings.Radiological investigations like USG had high sensitivity for appendicitis but overall low specificity.Erect x-ray was diagnostic of perforation and intestinal obstruction.CT scan was superior when compared with x-ray and USG. Clinical judgement is key to the diagnosis of acute abdomen with biochemical and radiological investigations only aiding in its management and cannot replace the clinical decision.Despite the improvements in technology and time constraints, clinical examination of the patient remains noteworthy in making a diagnosis.Thus clinical examination remains gold standard in making a diagnosis of acute abdomen
Comparative Analysis of Techniques for Data Minimization for Recommender System algorithms
No full textRecommender systems (RS) often use a large amount of data for a marginal gain in performance. This thesis investigates the data minimization in Recommender Systems, which is not well studied in the literature. This thesis extends the data minimization principles advocated in GDPR and studies its effects on recommender systems. Minimizing data not only reduces storage and transmission requirements but also has the potential to improve privacy and increase training and prediction speeds. This thesis investigates the effects of reducing the amount of data used to model a recommender system. It evaluates the accuracy of the Biased Matrix Factorization (BMF) algorithm by varying the training data on the MovieLens 10 million ratings (ML-10M) dataset. In this thesis, four data minimization techniques were used. We reproduced one pervious work and proposed three new data minimization techniques. In the first technique, we confirmed previous work concerning training data analysis, where the data outside the selected temporal window were dropped. The second data minimization technique, user profile truncation, retained the recent N ratings for each of the users while truncating the historical ratings. The third technique improved the user profile truncation by selectively truncating a percentage of user's historical ratings. In the fourth technique, a long user profile was split into smaller pseudo-user profiles. Analysis of the results is conducted. The most interesting results come from the third data minimization technique. Here, we show that truncating a percentage of the least recently active long user-profiles does not damage the performance and may slightly help. 60% of the long users can truncate their profiles to 20 ratings with minimal impact on the performance. Based on the results, we conclude that a substantial amount of data can be dropped without a large impact on performance. The results hold for the ML-10M dataset. It should hold for other datasets. The privacy implications of data minimization warrant future work. The proposed techniques serve as a guide for future research in data minimization of recommender systems.Computer Science | Data Science and Technolog
Globalisation and women in India
No full textDescribing the way globalisation has affected India over the last decade, the author considers the impact of these changes on women, in the main areas of `development' due to globalisation: commercialisation, capitalisation, foreign trade orientation, and financialisation and industrial restructuring. She develops the point that the `skewed income and wealth' structure in India, and the gender discrimination suffered by women, has not altered in the face of the changes brought by globalisation: women continue to lose out, and are losing out more severely than before.This article is hosted by our co-publisher Taylor & Francis.</p
Comparative study of phytochemical antibacterial activity, antifungal and antioxidant activity Hibiscus cannabinus using various solvents *Corresponding Author
No full textKenaf, Hibiscus cannabinus, is a plant in the Malvaceae family. Hibiscus cannabinus belongs to the genus Hibiscus and is probably native to Southern Asia, In Ayurvedic medicine, the leaves are used in the treatment of dysentry and bilious, blood and throat disorders. The powdered leaves are applied to Guinea worms in Africa. The Hibiscus cannabinus leaves extract of four solvents such as hexane, chloroform, ethyl acetate, methanol were used in the present study. The soxhlet extractor was employed in this study. The plants were screened for the presence of phytochemicals and their effect on 2,2-Diphenyl-1-picryl-hydrazyl radical (DPPH) was used to determine their free radical scavenging activity. Phytochemical screening of the plant showed the presence of glycosides, steroids, falvonoids, terpenoids and tannins except alkaloids. Concentration of the plant extract required for 50% inhibition of DPPH radical scavenging effect was recorded as 0.343 mg/ml, 0.571 mg/ml, 0.325 mg/ml, 0.036 mg/ml for hexane, chloroform, ethyl acetate and methanol. The antimicrobial activity of Hibiscus cannabinus leaves shows a positive result in the sample by which it is extracted using chloroform as a solvent
Author Correction: An interpretable and transparent machine learning framework for appendicitis detection in pediatric patients
No full textThe association between the public reporting of individual operator outcomes with patient profiles, procedural management, and mortality after percutaneous coronary intervention: an observational study from the Pan-London PCI (BCIS) Registry using an interrupted time series analysis.
No full textThis is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal,, following peer review. The version of record: Daniel A Jones, Krishnaraj S Rathod, Sudheer Koganti, Pitt Lim, Sam Firoozi, Richard Bogle, Ajay K Jain, Philip A MacCarthy, Miles C Dalby, Iqbal S Malik, Anthony Mathur, Ranil DeSilva, Roby Rakhit, Sundeep Singh Kalra, Simon Redwood, Peter Ludman, Andrew Wragg, The association between the public reporting of individual operator outcomes with patient profiles, procedural management, and mortality after percutaneous coronary intervention: an observational study from the Pan-London PCI (BCIS) Registry using an interrupted time series analysis, European Heart Journal, Volume 40, Issue 31, 14 August 2019, Pages 2620–2629 is available online at: https://doi.org/10.1093/eurheartj/ehz152AIMS: The public reporting of healthcare outcomes has a number of potential benefits; however, unintended consequences may limit its effectiveness as a quality improvement process. We aimed to assess whether the introduction of individual operator specific outcome reporting after percutaneous coronary intervention (PCI) in the UK was associated with a change in patient risk factor profiles, procedural management, or 30-day mortality outcomes in a large cohort of consecutive patients. METHODS AND RESULTS: This was an observational cohort study of 123 780 consecutive PCI procedures from the Pan-London (UK) PCI registry, from January 2005 to December 2015. Outcomes were compared pre- (2005-11) and post- (2011-15) public reporting including the use of an interrupted time series analysis. Patients treated after public reporting was introduced were older and had more complex medical problems. Despite this, reported in-hospital major adverse cardiovascular and cerebrovascular events rates were significantly lower after the introduction of public reporting (2.3 vs. 2.7%, P < 0.0001). Interrupted time series analysis demonstrated evidence of a reduction in 30-day mortality rates after the introduction of public reporting, which was over and above the existing trend in mortality before the introduction of public outcome reporting (35% decrease relative risk 0.64, 95% confidence interval 0.55-0.77; P < 0.0001). CONCLUSION: The introduction of public reporting has been associated with an improvement in outcomes after PCI in this data set, without evidence of risk-averse behaviour. However, the lower reported complication rates might suggest a change in operator behaviour and decision-making confirming the need for continued surveillance of the impact of public reporting on outcomes and operator behaviour
The Use of Novel Oral Anti-Coagulant's (NOAC) compared to Vitamin K Antagonists (Warfarin) in patients with Left Ventricular thrombus after Acute Myocardial Infarction (AMI).
No full textThis is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal - Cardiovascular Pharmacotherapy following peer review. The version of record: Daniel A Jones, Paul Wright, Momin A Alizadeh, Sadeer Fhadil, Krishnaraj S Rathod, Oliver Guttmann, Charles Knight, Adam Timmis, Andreas Baumbach, Andrew Wragg, Anthony Mathur, Sotiris Antoniou, The Use of Novel Oral Anti-Coagulant’s (NOAC) compared to Vitamin K Antagonists (Warfarin) in patients with Left Ventricular thrombus after Acute Myocardial Infarction (AMI), European Heart Journal - Cardiovascular Pharmacotherapy, pvaa096, https://doi.org/10.1093/ehjcvp/pvaa096AIM: Current guidelines recommend the use of Vitamin K Antagonist (VKA) for up to 3 - 6 months for treatment of LV thrombus post-acute myocardial infarction (AMI). However, based on evidence supporting non-inferiority of Novel Oral Anti-Coagulant's (NOAC) compared to VKA for other indications such as DVT, PE and thrombo-embolic prevention in atrial fibrillation, NOACs are being increasingly used off licence for the treatment of LV thrombus post AMI. In this study we investigated the safety and effect of NOACs compared to VKA on LV thrombus resolution in patients presenting with AMI. METHODS AND RESULTS: This was an observational study of 2,328 consecutive patients undergoing Coronary Angiography +/- Percutaneous Coronary Intervention (PCI) for AMI between May 2015- December 2018, at a UK cardiac centre. Patients' details were collected from the hospital electronic database. The primary end-point was rate of LV thrombus resolution with bleeding rates a secondary outcome.Left ventricular (LV) thrombus was diagnosed in 101 (4.3%) patients. Sixty patients (59.4%) were started on VKA and 41 patients (40.6%) on NOAC therapy (rivaroxaban: 58.5%, apixaban, 36.5% and edoxaban: 5.0%). Both groups were well matched in terms of baseline characteristics including age, previous cardiac history (Previous MI, PCI, CABG), and cardiovascular risk factors (Hypertension, Diabetes, Hypercholesterolaemia).Over the follow up period (median 2.2 years), overall rates of LV thrombus resolution were 86.1%. There was greater and earlier LV thrombus resolution in the NOAC group compared to patients treated with warfarin (82% vs 64.4%, p = 0.0018, at 1 year), which persisted after adjusting for baseline variables (OR 1.8 95% CI 1.2-2.9). Major bleeding events during the f/u period were lower in the NOAC group, compared with VKA group (0% vs 6.7%, p = 0.030) with no difference in rates of systemic thromboembolism (5% vs 2.4%, p = 0.388). CONCLUSION: This data suggests improved thrombus resolution in post ACS LV thrombosis in patients treated with NOACs compared to vitamin K antagonists. This improvement in thrombus resolution was accompanied with a better safety profile for NOAC patients' vs VKA treated patients. Thus, provides data to support a randomised trial to answer this question
PRG-1 Regulates Synaptic Plasticity via Intracellular PP2A/β1-Integrin Signaling
No full textSummaryAlterations in dendritic spine numbers are linked to deficits in learning and memory. While we previously revealed that postsynaptic plasticity-related gene 1 (PRG-1) controls lysophosphatidic acid (LPA) signaling at glutamatergic synapses via presynaptic LPA receptors, we now show that PRG-1 also affects spine density and synaptic plasticity in a cell-autonomous fashion via protein phosphatase 2A (PP2A)/β1-integrin activation. PRG-1 deficiency reduces spine numbers and β1-integrin activation, alters long-term potentiation (LTP), and impairs spatial memory. The intracellular PRG-1 C terminus interacts in an LPA-dependent fashion with PP2A, thus modulating its phosphatase activity at the postsynaptic density. This results in recruitment of adhesome components src, paxillin, and talin to lipid rafts and ultimately in activation of β1-integrins. Consistent with these findings, activation of PP2A with FTY720 rescues defects in spine density and LTP of PRG-1-deficient animals. These results disclose a mechanism by which bioactive lipid signaling via PRG-1 could affect synaptic plasticity and memory formation
