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Introduction: Facial aesthetic surgery requires a thorough preoperative analysis of face and identification of problems to frame a comprehensive surgical plan. The conceptions of an attractive face must be analyzed beforehand. Powell and Humphrey had defined facial angles and had formulated range which would be perceived as attractive. Objective: To compare the change in pre- and post-operative nasolabial, nasofrontal and nasofacial angles in patients undergoing Rhinoplasty. Materials and Methods: A prospective observational study was conducted from October 2014 to October 2019 in ENT department of a tertiary care hospital. Twenty-one patients undergoing Rhinoplasty and fulfilling the inclusion criteria were considered as study population. Their pre- and post-operative profile photographs were taken for morphometric analysis. The nasolabial, nasofrontal and nasofacial angles were measured and compared, before and one month after the surgery in profile pictures. Results: A significant change in the nasolabial and nasofacial angles were seen following Rhinoplasty. The mean nasofrontal angle showed an increase following Rhinoplasty but was not found significant. Conclusions: Rhinoplasty results in significant change in nasofacial and nasolabial angles and in expert hands, is expected to restore the various facial angles to their acceptable range. Keywords: Rhinoplasty, Nasolabial, Nasofrontal, Nasofacial angles, Morphometric measurements.

This paper is concerned withthe problem of paraphrase detection. For a number of applications, the ability to detect similar sentences, such as text mining, summary text, plagiarism detection, authorship authentication, and question answering, is important. Given two phrases, the goal is to detect whether they are identical semantically. This work involves a novel model namely, ParaCap, which uses capsule networks for the investigation of sentences. Capsule networks understand the spatial information (context, language, length of sentences and others) by using the instantiation parameters for the better results as compared to CNNs. For the objective, the Quora Question Pair dataset containing 404291 pairs of Quora Questions is being used. The ParaCap model outperforms many state-of-art methods, and also proves to be comparable to other techniques by achieving the accuracy of 89.19%.

Background Telemedicine Practice Guidelines were promulgated in India in 2020. There is little information about the awareness, knowledge, attitude and skills (AKAS) of the healthcare professionals regarding telemedicine and its practice guidelines a year after. The aim of the study was to study the awareness, knowledge, attitudes and skills of the healthcare workers of the country about telemedicine especially in the context of telemedicine practice guidelines 2020. Methods An online survey was conducted over 12 weeks from active healthcare workers in India. A standard AKAS Questionnaire for telemedicine and other close and open ended questions were used. Results A total of 602 active healthcare workers participated in the study. It was seen that a majority of participants had high scores for awareness, knowledge, and attitude toward telemedicine but a mere 39.53% scored high for skills related to telemedicine. A majority of the respondents had no knowledge of the existence of telemedicine practice guidelines and very few had seen or read them. A majority of the respondents were keen to attend a course or training to enhance their understanding and practice of telemedicine. Conclusion The results of the study show that the basic awareness and background knowledge regarding telemedicine exists in the healthcare professionals in the country. The requirement is to train and educate them about the skills and provisions of the telemedicine practice guidelines 2020 to ensure optimal use of telemedicine and to avoid medico-legal issues.

Cloud Computing is one of the fastest emerging technology which is in a massive growth to transform the definition of computing with its service oriented paradigm. It has overcome the issue related accruing the own IT infrastructure by proving the service through pay and use model. As a resultant reduce the cost of ownership, headache of manageability and saving of time of or execution of the process. However, the cloud services could be deterring due to the security breaches. Data security might be the major issue in cloud as the entire service is provided through internet only. Current data encryption mechanism might not be so strong to provide true privacy and reliability. Here in this paper we proposed a novel solution to data security with data encryption along with salted password hashing technique. Efficacy of the proposed method is validated through comparison with the current traditional security approach on the basis of the security parameters.

The surge in the number of services being provided off cloud-based servers in recent times, has led to a concern in the security of these platforms. It is thus highly important to have in place systems which can efficiently recognize and alert the system administrators about malicious activities on the cloud platform. Further, it is desirable to know the kind of attack being made on the cloud server to better understand and mitigate the threats. The usage of Artificial Neural Networks(ANN) has been found in Intrusion Detection Systems(IDS). To bring these systems closer to the biological model of the neural system, in this paper, the authors have deployed Spiking Neural Networks (SNN) to create a highly efficient IDS. SNNs deploy spiking neurons which mimic the biological neuron more closely than the artificial neuron model which is an overly simplified mathematical model. In this paper, the authors propose a hybrid SNN-ANN model which achieves a high degree of accuracy in identifying and classifying malicious connections on the network into their type of attack using the NSL-KDD dataset.

Background There is a deluge of information and misinformation about COVID-19. The present survey was conducted to explore the sources of information /misinformation for healthcare professionals from India. Methods A cross-sectional online survey using snowballing technique was conducted from 24 Mar to 10 Apr 2020. The questionnaire was pretested and developed using standard techniques. It was circulated among medical students and physicians. Data were analysed using the STATA software. Results Data of 758 participants were analysed. A total of 255 (33.6%) medical students, 335 (44.2%) nonspecialists and 168 (22.1%) specialists participated. The most common source of formal and informal information was official government websites and online news, respectively. A total of 517 (68.2%) participants accepted receiving misinformation. Social media and family and friends were the most common sources of misinformation. Seventy-two percent of participants agreed that spread of information helped to contain COVID-19, but more than that 75% agreed to having received inaccurate information. Seventy-four percent of respondents felt the need for regulation of information during such times; 26% and 33% felt that information about COVID-19 made them feel uncomfortable and distracts routine decision-making, respectively, and 50% felt it was difficult to differentiate correct from incorrect information about COVID-19. Conclusion The study explored the sources of information and misinformation and found a high prevalence of misinformation, especially from social media. We suggest the need to better manage the flow of information so that it can be an effective weapon against SARS-CoV2. There is a need for doctors to adapt to the changing times of infodemics accompanying pandemics.

The current standard of care for surgical management of Otosclerosis is small fenestra stapedotomy, which can be done by CO2 Laser assisted as well as conventional techniques. Vertigo is the commonest complication after stapes surgery. The use of CO2 Laser has been rising recently owing to its no touch principle, high precision and possibly lower risk of vertigo post operatively. To compare the post-operative vestibular deficit in patients of Otosclerosis having undergone small fenestra stapedotomy by conventional versus CO2 Laser assisted technique. 80 clinically diagnosed Otosclerosis patients fulfilling the inclusion criteria were enrolled. They underwent small fenestra stapedotomy by either conventional or CO2 Laser assisted technique. Vestibular function was assessed objectively by measuring sway velocity using modified clinical test of sensory interaction on balance by static posturography. Subjective measurement of balance was done using Vestibular balance subscore of Vertigo Symptom Score (VSS-sf-V). The outcome measures were compared pre-operatively and at first and fourth week post-operatively. All patients had vestibular deficit 1 week post-operatively in the form of increased sway velocity and symptom scores, which reduced by 4 weeks after Stapedotomy. The vestibular deficit in the two groups was similar at 1 week after surgery. 4 weeks after surgery, the sway velocity in conventional group was significantly greater than Laser group though there was no significant difference in the symptom scores. The use of CO2 Laser for Stapedotomy results in lesser post-operative vestibular deficit as compared to conventional method.

Indian railways are one of the largest rail networks in the world, and millions of passengers travel daily through it, due to which there are also a vast number of complaints in front of Indian Railways coming every minute through various mediums like COMS (Complaint Management System) app, RailMadad, SMS etc. Given the top-down approach which is followed for the uncategorised complaints making official's work time-consuming. Therefore, faster complaint redressal becomes a critical factor for the passenger's satisfaction. Previous research has focused on traditional machine learning algorithms and Twitter dataset available publicly to tackle this problem. In this work, we have explored deep learning techniques on an official dataset of the COMS app from CRIS (Centre for Railways Information Systems) and proposed RailNeural: an Attention Based Bi-Directional Long Short-Term Memory (LSTM) model which analyses user's complaint input sequences, capturing the underlying character level feature and then classifies them into their respective departments of field units ensuring prompt and accurate redressal of complaints. Our model outperforms several baseline models achieving an accuracy of 93.25 per cent and an F1-Score of 0.93.

Otitis media with effusion (OME) has a detrimental effect on balance, which may not present as a clear symptom in children. This effect can be improved by the insertion of ventilation tubes. This study assesses balance in children suffering from OME pre and post operatively using computerized static posturography. 50 children of 3–6 years, suffering from OME were included in this observational descriptive study. These patients underwent myringotomy and grommet insertion. The balance was evaluated pre and post operatively after 3 months using computerized static posturography with Modified Clinical Test of Sensory Interaction on Balance under four conditions, namely eyes open/closed on firm surface/foam. Posturography mean sway velocity was deranged in these children preoperatively and it showed statistically significant improvement post operatively at 3 months. There is occult vestibular dysfunction in children with OME as assessed by static posturography which improves significantly 3 months after myringotomy and grommet insertion.

Human pose estimation has always been a challenging problem that holds great attention, it has the widespread and extensive variety of uses from the classification of images to activity acknowledgment, main challenge is the detection and localization of the key points in the variation of several body poses. To resolve this issue, substantial research work have been done in this area. This paper discusses the issues in human pose estimation and gives the overview of considerable research work in pose estimation, including deep learning approach and customary image-based techniques. After analyzing several results and detecting the restrictions, the author has reconstructed a simple model using convolutional neural network that estimates the poses and demonstrates the potential of CNN’s. The author concludes with a few promising bearings and directions that have to be explored for future research.

This paper deals with the quasi-static crushing behaviour of flanged circular thin walled tubes under axial compressive loading. Finite element model (FEM) was developed using the explicit LS DYNA to simulate the crushing of tubes with various combinations of length, diameter and thickness. Response Surface Methodology (RSM) was later incorporated to analyze the influence of the geometric parameters on the specific energy absorption (SEA) of the tubes. The adequacy of the model was verified by observing the trend of the residuals against fitted values. A relationship between the SEA and the geometrical parameters of the tubes were successfully established for crashworthiness applications.

Sudden sensorineural hearing loss (SNHL) is postulated to be caused due to a multitude of factors, but a definitive cause is seldom found despite extensive investigations. We present a rare case of sudden SNHL in which central venous thrombosis was found on magnetic resonance imaging. The case highlights the importance of neuroimaging in all cases of sudden SNHL before being labelled as “idiopathic” so that targeted therapy can be given.

Madura foot is a chronic infection of the skin and underlying tissues caused by both bacteria (actinomycotic mycetoma or actinomycetomas) and fungi (eumycetomas or mycotic mycetoma). Mycetoma occurs most often in people who work in rural areas, usually in farmers, hunter-gatherer populations, and field laborer. The disease was first described in the Indian town of Madura. Lower extremities involvement is more common. Our patient, 26-year-old agricultural worker, presented with 1-year history of recurrent swellings, itching, and chronic purulent discharge from his right foot. On examination, he had multiple small swellings of the right foot and indurations with sinus tracts discharging pus. The classic clinical triad of mycetoma is soft tissue swelling, sinus tracts, and characteristic macroscopic grains. Grains contain aggregates of the causative organisms that may be discharged onto the skin surface through multiple sinuses. Bone radiography may show cortical thinning, cortical hypertrophy, or multiple lytic lesions. Disuse osteoporosis may occur in late stages mycetoma. Medical therapy in a form of antibiotic or antifungal alone may be sufficient for actinomycetoma, but surgery is generally needed for eumycetoma. Madura foot is an uncommon entity in the west but still seen in the rural areas of India.

Craniofacial dermoids develop as a result of sequestration of epidermal and adnexal components within mesodermal and neuroectodermal structures during embryonic development. Frontotemporal dermoids are the most common of these and usually present as slow-growing masses without discharging sinus or deep bone or intracranial extension. We present a case of recurrent frontotemporal dermoid with discharging sinus and invasion into the sphenoid bone with bone erosion and intracranial extradural extension of dermoid. The patient was managed with surgical excision and clearance of dermoid. Complete surgical excision was ensured with the help of angled nasal endoscopes. Endoscopes provide a wide angle of view and are available in various angles, hence helping in complete visualization of bony cavity and clearance of its contents. The use of endoscopes in surgeries of craniofacial dermoids can help in reducing chances of residual lesion and requirement of subsequent revision surgery and ensure a better cosmesis.

Background: Deviated nasal septum is one of the most common disorders in human beings, which may lead to symptoms of nasal obstruction, headache, epistaxis, hyposmia, and post nasal drip. DNS correction may also be required to gain access during intranasal procedures like endoscopic sinus surgery, endoscopic dacryocystor-hinostomy and skull base surgery. The technique of septoplasty has evolved over the decades with a tendency towards more conservative and precise surgery. Over the last few decades endoscopic septoplasty has become increasingly popular.Methods: It was a cross-sectional comparative study done to compare the efficacy of endoscopic septoplasty with conventional septoplasty, conducted at a tertiary care centre over a period of 3 years. Records of 100 patients of nose and PNS disorders with DNS who were operated either by conventional or by endoscopic technique were studied. The patients were studied for the improvement in their symptoms, anatomical correction and intra-operative/post-operative complications. Results: Endoscopic septoplasty group patients showed better symptomatic relief, lesser incidence of residual anterior /posterior deviation and persistent spur and less complications as compared to the conventional septoplasty group.Conclusions: In our study we found more clientele satisfaction and lesser rate of complications in endoscopic septoplasty group. We recommend all ENT specialists to be trained in nasal endoscopic septoplasty technique as it offers many advantages such as more precision in post nasal spurs with less flap tears, it can be tailor made according to the disease and can be combined with various endoscopic surgeries.

Hypoglossal nerve schwannomas are rare benign tumors arising from the schwann cells covering the hypoglossal nerve. These tumors are slow growing and their symptoms are usually due to pressure effects over the adjacent structures. We present a rare case of a large intracranial and cervical schwannoma arising from the hypoglossal nerve. We discuss the atypical presentation and vague symptoms with which a patient of hypoglossal schwannoma may present. Surgery in such cases requires the joint efforts of the team of Neurosurgeons and Otorhinolaryngology and Head and Neck surgeons.

Osteomyelitis involving the maxillofacial skeleton is a rare entity today. In maxillofacial region mandible is more commonly involved as compared to maxilla. It continues to remain one of the most difficult to treat infections with considerable morbidity and costs to the healthcare system. Hallmark of osteomyelitis are progressive bony destruction and formation of sequestrum. When present, the possibility of underlying malignancy or granulomatous diseases should be kept in mind and ruled out. We present a rare case of osteomyelitis involving the maxilla in a 64 year old male diabetic. The patient was managed with sequestrectomy and debridement by infrastructure maxillectomy via a midfacial degloving approach, appropriate parentral antibiotic therapy and glycemic control. The patient had an uneventful recovery.

Sinonasal mucormycosis is uncommon entity and it rarely infects a healthy host. When it does occur; it becomes very difficult to treat because of the speed of progress of disease and can have fatal outcomes. The mainstays of therapy are treatment of immunocompromised status, systemic high dose Amphotericin B, and surgical debridement of necrosed or nonviable tissue. The following six cases, managed at our centre from July 2016 to October 2016, outline nuances in the diagnosis of invasive sinonasal mucormycosis and highlight the importance of timely surgical debridement and importance of endoscopic approach in complete clearance of disease in order to facilitate medical management to work. All cases included in this study were found to be immunocompromised and had unilateral severe diminution of vision due to periorbital extension of disease. Diagnostic nasal endoscopy revealed black-brown crust and tenacious pus filling up nasal cavity, erosion of turbinates and nasal septal perforation. One patient showed erosion of hard palate and eschar formation. CECT/MRI of PNS showed evidence of bony erosion and orbital involvement. Biopsy taken during nasal endoscopy confirmed the presence of mucormycosis. All patients were started on Liposomal Amphotericin B and broad spectrum antibiotics in renal corrected dosages and taken up for urgent endonasal endoscopic debridement. All paranasal sinuses were cleared and orbital decompression was done. Postoperatively all patients were continued on Liposomal Amphotericin B in renal corrected dosages for two-three weeks and being followed up monthly. One patient could not survive due to several co morbidities and severe immunocompromised status. Only one patient showed recurrence of disease on one month postoperative follow up. Five patients showed improvement in visual acuity. Sinonasal mucormycosis if inappropriately diagnosed and treated can be a fatal condition. Energetic diagnostic workup, combined with equally energetic management, surgical and management leads to favourable outcome.

Background: Tumors of the parapharyngeal space are a rare group of head & neck tumors. Due to their indolent nature they present late with either cranial nerve palsy or lateral neck swelling. The aim of the study was i) to determine the incidence of parapharyngeal space schwannoma among defence personnel’s and their dependents presenting to ENT OPD and ii) to study the clinical presentation, management and outcomes of such lesion.Methods: The study is a retrospective observational study. All new patients referred to ENT OPD at our center were included in the study. Data was collected from our OPD records over two years between Jan 2015 and Dec 2016. Results: It was found that the incidence rate of parapharyngeal space schwannoma was 0.034% out of all fresh cases reporting to ENT OPD and 0.47% out of all fresh diagnosed cases of head and neck tumours at our centre. Out of the total 5 cases of parapharyngeal space schwannomas, 2 patients had vagal schwannomas and one each had hypoglossal nerve schwannoma, spinal accessory nerve schwannoma and sympathetic chain schwannoma.Conclusions: Schwannomas of the parapharyngeal region can be very extensive and may require to be removed in a staged procedure involving the head & neck and neurosurgeons.It is important to distinguish these tumors from other head and neck malignancies by detail clinical and radiological examinations. Despite the benign nature of the disease, the surgery can be morbid with cranial nerve palsies in extensive tumors.

In mobile communication systems, the efficient use of available channels has been shown to improve the system capacity against limited resource. The role of a channel assignment scheme is to allocate channels to cells or mobiles in such a way that the communication facility is improved. In this context, a new approach on hybrid channel allocation scheme (HCA) for mobile networks is proposed in this paper. It includes the features of both fixed channel allocation (FCA) and dynamic channel allocation (DCA) schemes. The assigned channels through FCA are equally distributed among each of the side of a hexagonal cell under a base station (BS) for low traffic. The DCA is proposed for further improvement by introducing dynamic allocation policy. The intercellular channel allocation (ICA) phase describes call scheduling procedure. In addition, the proposed model is verified through Markov Chain representation. The characteristics of the proposed model are expressed with Markov Chain process. The proposed model achieves an improved performance in terms of reduced communication and computational overhead.

The biometrical observations on the heart of fowl (vencobb-400 strain) revealed that the average weight was 8.91 ± 0.25 g, the mean percentage ratio between the length of rostral and caudal borders was 54:46 and the circumference at the coronary groove was 6.92 ± 0.08 cm. The right and left longitudinal grooves anastomosed with each other 1.05 ± 0.09 cm above the apex of the heart on the right side. The distance between the termination of caudal venacava and the apex of the heart was less (3.38 ± 0.13 cm) than the distance between the latter and origin of pulmonary artery (3.83 ± 0.13 cm). The cardiac skeleton was characterized by the presence of hyaline cartilage. The rostrocaudal diameter of the base of heart was greater (3.12 ± 0.08 cm) than the transverse diameter (2.15 ± 0.09 cm). The cross-sectional area of common aorta (46.00 ± 3.03 mm2) was greater than the area of pulmonary artery (32.4 ± 2.16 mm2). The total area of two anterior aortae (8.47 mm2) was lesser than the area of caudal aorta (10.8 mm2). The moderator bands could not be seen in both the ventricles.