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In India's current economic situation, women's entrepreneurship is gaining traction. It has been hailed as a significant step forward in the country's fight against poverty. In India, there is a list of successful businesses in both the social and monetary spheres. They are doing a fantastic job. The growing presence of women in the business world as entrepreneurs has resulted in a shift in the country's business and monetary development sector qualities. Women-led groups are doing an outstanding job in the public light encouraging others and expanding job opportunities across the country. Regardless, a manageable growth of women business visionaries is required to advance a reasonable development in the country. This study develops a model that addresses the various elements that are essential for the development of women business visionaries in India. What India requires is a well-organized, all-encompassing technique in which the general people and the government share equal responsibility for the growth of women business visionaries.

Introduction: A 37 years old female was diagnosed with Adenomyosis and heavy bleeding during menstrual cycle. She had a history of irregular menstrual cycle and lower abdominal pain. The prescribed medicines did not help her much. So she did not take medication. She decided to take help from Yoga Prana Vidya (YPV) Trained Healer. This paper presents the case of Adenomyosis treated successfully with Yoga Prana Vidya Healing protocol. Methods: This is the case study method with detailed analysis of medical records of patient’s health condition pre and post YPV healing treatment applied as alternative medicine. This is the case of a 37 years old female diagnosed with Adenomyosis in December 2020. Initial symptom was bleeding got started after one week of completion of menstrual cycle. A Gynaecologist advised to get the Ultrasound done which diagnosed Adenomyosis. The doctor prescribed Hysteroscopic D&C followed by Mirena insertion. She used to have painful menstrual cycle with heavy flow every month. Results: Analysis of the patient’s health condition and medical case documents pre and post treatment shows that she got cured with Yoga Prana Vidya (YPV) healing method for Adenomyosis. Conclusion: This case study documents the evidence on the effective use of YPV in treating Adenomyosis and heavy bleeding during menstrual cycle. There is ample scope to conduct further research on the application of YPV as alternatively effective and low cost medicine for various medical conditions.

Introduction: India possibly carries the highest burden of antimicrobial resistant typhoidal salmonellae in the world. We report on the health-care ecosystem that produces data on antimicrobial resistance (AMR) testing and the resistance patterns of typhoidal Salmonella isolates in the city of Ahmedabad. Materials and Methods: Through municipality records and internet searches, we identified 1696 private and 83 public laboratories in the city; 4 medical colleges, 4 health-care institution attached laboratories, and 4 corporate laboratories (CLs) were performing culture and antibiotic sensitivity testing (AST), but only 2 medical colleges and 1 CL shared their data with us. There was considerable variation in culturing and sensitivity testing methodology across laboratories. Results: Out of 51,260 blood cultures, Salmonella isolates were detected in only 146 (0.28%). AST was conducted on 124 isolates, of which 67 (54%) were found resistant. Multidrug resistance was absent. Concurrent resistance to more than one antibiotic was very high, 88%, among the 67 resistant isolates. Ciprofloxacin resistance varied widely between the private and public sector laboratories. Notably, isolates from the private sector laboratory showed complete resistance to azithromycin. Conclusions: High resistance to ciprofloxacin and azithromycin observed in Ahmedabad may be due to the increased use of these two antibiotics in the public and private sectors, respectively. The need of the hour is to identify a representative sample of laboratories from both the public and the private sectors and encourage them to participate in the national AMR surveillance network.

Introduction: Widal test has been used extensively for the sero-diagnosis of Enteric fever in India, however, its accuracy and reliability are debatable. We studied widal testing and widal positivity rates in the entire city of Ahmedabad for the diagnosis of Enteric Fever. Methods We screened all 1700 possible diagnostic laboratory facilities, in Ahmedabad, in the public and private sector. We performed telephonic surveys for the initial filtering of facilities that could be conducting widal testing. It was followed by physical visits to probable facilities to confirm testing methods and preservation of reports of widal testing. We followed a systematic process for screening and selection of 23 laboratories, which conducted widal tests and had reliable data. While 14 laboratories refused to share data, data provided by three of them were inappropriate and couldn’t be used. We finally analyzed data from four large public hospitals, one private trust hospital and one corporate laboratory for variable periods in a span of 15 years (2000 – 2015). Result: The Widal testing rate was found to be 8.7% and widal positivity as 12.5% in a sample of 1.2 million clinically suspected in-patients. In 15 years, the private hospital had admitted 1/10th as many cases as all the public hospitals together. However, the widal testing and positivity rates were similar in both. We observed a lower proportion of widal positivity among children below 12 years and a disproportionate, but insignificant, gender distribution of widal positivity. Conclusion: This study indicates that the widal test, which is meant to be an initial screening test, is widely used in the city. We propose linkage of testing and reporting of widal with other more reliable and accurate tests such as Typhidot and blood culture in order to strengthen our knowledge of enteric fever epidemiology in India.

Pilomatricoma is a relatively uncommon benign tumor derived from the matrix of hair follicles. Multiple pilomatricomas may arise sporadically or in association with other disease entities. These entities include myotonic dystrophy type-1, a multisystem disorder that confers increased susceptibility to developing neoplasms, as well as familial adenomatous polyposis-related syndromes (including Gardner syndrome) and others. Here we present two case reports of multiple pilomatricomas that were initially misidentified clinically. We discuss pilomatricoma as a differential diagnosis of multiple skin nodules, its association with myotonic dystrophy in one of two patients, and describe its distinguishing microscopic features. We emphasize the importance of screening patients with multiple pilomatricomas for various syndromes that predispose to malignancy.

Image fusion has been receiving increasing attention in the research community with the aim of investigating general formal solutions to a wide spectrum of applications such as multifocus, multiexposure, multispectral ( $$IR$$ -visible) and multimodal medical (CT and MRI) image and video fusion. While there exist many fusion techniques for each of these applications, it is difficult to formulate a common fusion technique that works equally well for all these applications. This is mainly because of the different characteristics of the images involved in various applications and the correspondingly different requirements on the fused image. In this work, we propose a common generalized fusion framework for all these classes, based on the statistical properties of local neighborhood of a pixel. As the eigenvalue of the unbiased estimate of the covariance matrix of an image block depends on the strength of edges in that block, we propose to employ it to compute a quantity we call as the significance of a pixel. This generalized pixel significance in turn can be used as a measure of the useful information content in that block, and hence can be used in the fusion process. Several data sets were fused to compare the results with various recently published methods. The analysis shows that for all the image types into consideration, the proposed methods improve the quality of the fused image, both visually and quantitatively, by preserving all the relevant information.

Image fusion has been receiving increasing attention in the research community with the aim of investigating general formal solutions to a wide spectrum of applications. The objective of this work is to formulate a method that can efficiently fuse multifocus as well as multispectral images for context enhancement and thus can be used by different applications. We propose a novel pixel fusion rule based on multiresolution decomposition of the source images using wavelet, wavelet-packet, and contourlet transform. To compute fused pixel value, we take weighted average of the source pixels, where the weight to be given to the pixel is adaptively decided based on the significance of the pixel, which in turn is decided by the corresponding children pixels in the finer resolution bands. The fusion performance has been extensively tested on different types of images viz. multifocus images, medical images (CT and MRI), as well as IR - visible surveillance images. Several pairs of images were fused to compare the results quantitatively as well as qualitatively with various recently published methods. The analysis shows that for all the image types into consideration, the proposed method increases the quality of the fused image significantly, both visually and quantitatively, by preserving all the relevant information. The major achievement is average 50% reduction in artifacts.

This paper presents two methods for fusion of infrared (IR) and visible surveillance images. The first method combines Curvelet Transform (CT) with Discrete Wavelet Transform (DWT). As wavelets do not represent long edges well while curvelets are challenged with small features, our objective is to combine both to achieve better performance. The second approach uses Discrete Wavelet Packet Transform (DWPT), which provides multiresolution in high frequency band as well and hence helps in handling edges better. The performance of the proposed methods have been extensively tested for a number of multimodal surveillance images and compared with various existing transform domain fusion methods. Experimental results show that evaluation based on entropy, gradient, contrast etc., the criteria normally used, are not enough, as in some cases, these criteria are not consistent with the visual quality. It also demonstrates that the Petrovic and Xydeas image fusion metric is a more appropriate criterion for fusion of IR and visible images, as in all the tested fused images, visual quality agrees with the Petrovic and Xydeas metric evaluation. The analysis shows that there is significant increase in the quality of fused image, both visually and quantitatively. The major achievement of the proposed fusion methods is its reduced artifacts, one of the most desired feature for fusion used in surveillance applications.

Mycetoma is a chronic, granulomatous disease of the skin, and subcutaneous tissue, which sometimes involves muscle, bones, and neighboring organs. It is characterized by tumefaction, abscess formation, and fistulae with discharge of grains from sinuses. Mycetoma can be caused by various species of fungi (eumycetoma) and aerobic actinomycetes (actinomycetoma), which occur as saprophytes in soil or plants. A tentative diagnosis sufficient to initiate treatment may be made on the basis of grain color. For instance, melanoid grains are always caused by fungi and ochroid or pale grains by actinomycetes. Although this is not the thumbrule, there are exceptional reports too. As trauma favors infection, most lesions are on the foot and lower leg but they may occur anywhere on the body mimicking actinomycosis. However, lab investigations and culture are important tool to differentiate apart from the clinical picture. We are reporting atypical case with unusual site of presentation (perineum and thigh) of mycetoma.

Camouflage is an attempt to conceal a target by making it look similar to the background to make the detection and recognition of the target difficult for the observer (a man or a machine or both). Detecting a camouflaged target in a video, captured in visible band is a big challenge. One can use the infrared (IR) video where the visibility of the same target is much better, but the problem with IR band is that most of the contrast, color, and edge information about the background are lost and thus localizing the target becomes difficult. The objective of this work is to fuse registered videos, captured in visible and IR band such that the target is no longer camouflaged and hence clearly visible to the human monitor. More importantly, this should be done without losing the background details. We have proposed four different video fusion methods. All the proposed methods are intensity invariant so that camouflaged targets are detected independent of the illumination conditions. The performance of these methods has been compared using Wang–Bovik and Petrovic–Xydeas fusion metric along with other information theoretic indices. Experimental video results show that the proposed methods improve the perception and thus facilitates detection and localization of a camouflaged target. Moreover, the fused video has minimum artefacts as indicated by the highest peak signal-to-noise ratio, which is one of the most desired quality of a good fusion method.

Synovial sarcoma is very rare and highly malignant tumour of the head and neck. Only 3 cases of synovial sarcoma have been treated 1980-1997 in Kasturba Medical College, Manipal. Treat-ment involved extensive surgical resection of the tumour (with neck dissection in two cases); and post- operative radiotherapy and chemotherapy in one case. Behaviour of the tumour was followed up till August 1997. It remains in our experience that synovial sarcoma, though a tumour or poor prognosis if treated by adequate tumour resection and adjunctive radiotherapy and chemotherapy, has good patient survival.

Invasive mycotic infections can be effectively treated if rapid identification of fungus is obtained. We reported a case of coinfection byAspergillusandRhizopussp. involving nose, paranasal sinuses, orbit, and brain in a 68-year-old known hypertensive male. He was presented to ENT OPD with history of fever and intermittent headache since fifteen days along with history of right-sided nasal obstruction and proptosis since seven days. CT scan of brain and paranasal sinuses showed findings of pansinusitis with cellulitic changes in right orbit. MRI confirmed the same along with features of intracranial extension with focal meningitis in right frontotemporal region. Laboratory parameters did not conclude much except for leucocytosis and hyponatremia. Patient was taken for endoscopic debridement from nose and paranasal sinuses, and tissue was sent for microbiological and histopathological examination. Minced tissue was processed, and after 48 hrs of incubation two types of growth were identified, one was yellowish, granular, and powdery consistent withAspergillussp., and another was cottony and woolly consistent withRhizopussp. LCB mount confirmed presence ofAspergillus flavusandRhizopus arrhizus. Patient responded to therapy with IV amphotericin B and surgical debridement. On discharge patient's condition was good.

Vault dehiscence and evisceration of peritoneal contents is a rare complication following total hysterectomy. A 43-yearold lady presented with history of something soft coming out per vaginum. She underwent total laparoscopic hysterectomy 2 months back for 16-week fibroid uterus. The surgery was uneventful, vaginal vault was sutured laparoscopically with no 1 polyglactin, interrupted figure of eight sutures. She was discharged after 48 h with uneventful recovery and subsequently presented with mass protruding per vaginum. Speculum examination showed loops of small bowel protruding in the vagina (Fig. 1). She was hospitalized and scheduled for reduction of the prolapsed bowel with vault repair. On examination under anaesthesia, there was complete dehiscence of the vaginal vault with loops of small bowel protruding through the defect. To maintain the pneumoperitoneum vagina was blocked using a simple vaginal tampon soaked in betadine solution (Fig. 2) [1]. On Laparoscopic evaluation the entire vault was deficient. There were no bowel, bladder or omental adhesions to the vault. The prolapsed ileal loops were seen just at the vault, with healthy pink colour and regular peristalsis. On giving Trendelenburg’s position the reposition was smooth. After confirming that the vault was free of any adhesions, the vault was closed vaginally using interrupted no 1 Polydioxone II sutures (Fig. 3). Patient was discharged on the third post-operative day and is asymptomatic at 6-month follow-up. Vaginal vault dehiscence with evisceration posthysterectomy can occur up to few weeks to even few years after hysterectomy. The commonest organ to eviscerate is small bowel, particularly terminal ileum. Several factors which may contribute to weakness of vaginal apex are poor surgical techniques, post-operative wound haematoma and cuff infection, post-menopausal status, any activity resulting in increased intra-abdominal pressure, early resumption of sexual activity, chronic steroid administration, history of previous radiotherapy in cases of radical hysterectomy [2] and systemic illness like diabetes mellitus and immunecompromised status [3].

Endoscopic endonasal dacryocystorhinostomy [EDCR] is considered to be a superior alternative technique to the conventional external dacryocystorhinostomy [DCR], both in primary and secondary cases. It is of particular value in children and young adults as it avoids an external scar. Sixteen cases of chronic dacryo-cystitis were treated by the endoscopic technique, including 8 revision cases of failed external approach. In all cases except one, a patent nasolacrimal fistula was noted, with a success rate of 93.7%. The authors share their experience in EDCR and review the relevant literature.

Effects of Intrauterine Exposure to Cocaine, Opium and Methadone on Gut Myoelectrical Activity of Neonates

Developmental Delay in Normal Gastric Wave Pattern Formation in Neonates Measured by Electrogastrography