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In distributed systems multiple computers interact with each other over a network to perform data processing operations parallel over a network. Distributed systems can be setup depending on the application and its data with different combination of replications and then the partitioning of the data can be performed using sharding technique to enhance the scalability, consistency and fault-tolerance issues. The gaps identified in existing sharding techniques are, it is difficult to determine which particular shard or partition need to be searched to retrieve the relevant document matching to the user query. And also to rank the documents which has highest relevance to the user query. The main goal is to develop a mechanism to handle large scale data processing and searching operations using efficient sharding technique. The proposed paper aims to enhance the performance of distributed processing systems by applying effective shard partitioning and efficient shard selection techniques and perform the comparative study analysis of shard selection techniques considering precision, MAP and cost measures. The results interpret that sharding technique provides efficient mechanism to handle large scale data. Effectiveness and efficiency of shard selection techniques interpret that Rank-S algorithm performance better compared to CORI and Redde algorithms by reducing the overall cost by 28%. Sharding technique is an efficient mechanism to process big data, and provides better scalability and fault-tolerance.

Blockchain technology is evolving and revolutionizing the IT industry with better security, efficiency, and resilience. Blockchain technology is being used in many applications majorly in cryptocurrencies and bitcoin applications. Verified transactions which make a block and group of such transactions or blocks are immutable making the blockchain more secured and reliable. Blockchain achieves decentralization of power, trust, and secured of being hacked, which solves major problems or issues with the current systems. Ethereum, the most widely used blockchain platform because of its unlimited block size. Many complex problems with smart contracts can be implemented with Ethereum and the eradication of third party organizations interfering in transactions helps solving the issues of financial crisis and it is easy to implement compared to other blockchain technologies. There are certain limitations/issues in processing large number of transactions due to lack of speed in processing the transactions. Ethereum Blockchain code will be executed by different clients with varying speed and the performance level will be different. The goal of this paper is to understand Ethereum transactions and perform the comparative analysis of Geth and Parity ethereum clients on the private blockchain. In this paper, a private blockchain network is setup where the nodes will share the data among peer nodes or blocks within the network. Using this network setup a democracy voting application is developed which makes use of the blockchain to store and process the data, smart contracts are deployed to execute the transactions. Performance analysis of the two most popular ethereum clients Geth and Parity is carried out considering time, consistency and scalability parameters. Results interpret that the overall transactions are 91% on average faster in parity client as compared to Geth client.

Back Ground: Fractures of Distal Femur are common due to increased Road traffic accidents and fall from height because of increased construction activities. These fractures are quite disabling. So these fractures necessitate early stabilization. Internal fixation with VA-LCP has shown to give one of the best results in terms of fixation, recovery, fracture union and clinical outcome. Materials and Methods: 23 cases of Distal femur fractures treated with VA-LCP from August 2016 to August 2018 were selected for this study. They were admitted and examined according to protocol clinically and radiologically. All patients were followed up for a minimum of 6 months and outcome assessed with Neer’s score. Results: All fractures healed with an average duration of 23 weeks which is comparable with other studies. We had excellent outcome in 6 (26%) patient, satisfactory outcome in 13 (57%) patient and 4 had an unsatisfactory (17%) result. Average Neer’s Knee score was 81 which is comparable with other studies. Conclusion: The VA-LCP is the treatment of choice in the management of comminuted distal femoral fractures especially Type C fractures, where type C1 we have found higher Neer’s scores. VA-LCP also prevents compression of periosteal vessels. VA- LCP is the implant of choice especially in type C3 fractures as we can get purchase of multiple fracture fragments avoiding intra articular screw penetration because of screw insertion angle upto 150 compared to fixed orthogonal screw placement. Although in our series poor result were found in type C3 fractures we attribute this to long learning curve in treatment of type C3 fractures.

Electronic waste is one of the biggest problems that our world is facing today. The ever-growing demand and usage of electronic gadgets in this corona period contribute to this E-Waste to a greater extent. If not handled properly and recycled, electronic waste causes several health concerns in human beings and animals and causes severe pollution. All of this can be prevented by efficiently managing E-Waste. Many developed countries are disposing of their E-Waste in developing countries like India and China. These developing countries have a vast population affected by this E-waste as there is no organised system for managing it. To curtail these problems, in this work, the influence of IoT (Internet of Things) is leveraged to deposit and collect E-waste efficiently. The main objective is to bring the depositors (people who discard E-waste) and collectors (the people who collect and recycle E-waste) into a single platform and improve the proposed E-Waste management efficiency System.

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.)

Graphical abstract, The current coronavirus pandemic, COVID-19, is the third outbreak of disease caused by the coronavirus family, after Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome. It is an acute infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 Virus (SARS-CoV-2). The severe disease is characterised by acute respiratory distress syndrome, septic shock, metabolic acidosis, coagulation dysfunction, and multiple organ dysfunction syndromes. Currently, no drugs or vaccine exist against the disease and the only course of treatment is symptom management involving mechanical ventilation, immune suppressants, and repurposed drugs. As such the severe form of the disease has a relatively high mortality rate. Last 6 months have seen an explosion of information related to the host receptors, virus transmission, virus structure-function relationships, pathophysiology, co-morbidities, immune response, treatment and most promising vaccines. This review takes a critically comprehensive look at various aspects of host-pathogen interaction in COVID-19. We examine genomic aspects of SARS-CoV-2, modulation of innate and adaptive immunity, complement-triggered microangiopathy, and host transmission modalities. We also examine its pathophysiological impact during pregnancy, in addition to various gaps in our knowledge. The lessons learnt from various clinical trials involving repurposed drugs have been summarised. We also highlight the rationale and likely success of the most promising vaccine candidates.

Background: In January 2020, the US FDA published two final guidelines, one entitled “In vitro Drug Interaction Studies - Cytochrome P450 Enzyme- and Transporter-Mediated Drug Interactions Guidance for Industry” and the other entitled “Clinical Drug Interaction Studies - Cytochrome P450 Enzyme- and Transporter-Mediated Drug Interactions Guidance for Industry”. These were updated from the 2017 draft in vitro and clinical DDI guidance. Methods: This study is aimed to provide an analysis of the updates along with a comparison of the DDI guidelines published by the European Medicines Agency (EMA) and Japanese Pharmaceuticals and Medical Devices Agency (PMDA) along with the current literature. Results: The updates were provided in the final FDA DDI guidelines and explained the rationale of those changes based on the understanding from research and literature. Furthermore, a comparison among the FDA, EMA, and PMDA DDI guidelines are presented in Tables 1, 2 and 3. Conclusion: The new 2020 clinical DDI guidance from the FDA now has even higher harmonization with the guidance (or guidelines) from the EMA and PMDA. A comparison of DDI guidance from the FDA 2017, 2020, EMA, and PMDA on CYP and transporter based DDI, mathematical models, PBPK, and clinical evaluation of DDI is presented in this review.

Background: Supracondylar fractures of humerus is the commonest injury, constitutes about 65.4% of all fractures about the elbow in children. Displaced supracondylar fracture of humerus demand great respect and challenging one to treat, since it requires accurate anatomical reduction and internal fixation to prevent complications. So, in this study, we reported the results of closed and open reduction and internal fixation with K-wires in the displaced supracondylar fracture humerus in children. Material and Methods: Fourty cases of displaced (Gartland’s type 2 and 3) supracondylar fractures treated by internal fixation with K-wires were studied between September 2013 to August 2015 at our institution and followed for an average of 24 months. Results: We came across 26male patients and 14 female patients. Majority of the cases were due to high energy trauma of road traffic accidents involving relatively younger patients. At the end of 5 months, all except four patients could mobilize independently without any aid. We did not come across complications like fracture of femur and failure of fixation and no reoperations were required. Conclusions: Internal fixation with K-wires is the most commonly accepted treatment of displaced supracondylar fracture humerus in children when done at appropriate time. It gives more stable fixation, better anatomical reduction with negligible complication.

Background: Intertrochanteric fractures is the fracture of the proximal femur, in which the fracture line extends from the greater trochanter to lesser trochanter 1. Intertrochanteric fractures are common in patients above 60 years of age, however it may also occur in young adults. Nine out of ten intertrochanteric fractures occur in elderly, which is usually of a low velocity trauma occurring with the female to male ratio of 3:1.We studied the clinical outcome of unstable intertrochanteric fracture surgically managed by PFN-A. Materials & Methods: Design: A preliminary study. Duration: August 2015 - December 2016 Sample: 30 patients with unstable intertrochanteric fractures were treated surgically by PFN-A. Inclusion criteriaAge –All patients after skeletal maturity. Cases of intertrochanteric fractures based on AO system of classification Exclusion criteriaPatients with sub-trochanteric fractures. Non-ambulatory patients before injury. Patient unfit for anaesthesia. Patients with Osteoarthritis of hip before injury They were followed up for a minimum period of 1 year by the senior author and evaluated for clinical outcome using X-RAYS, SALVATTI and WILSON HIP SCORE.Results: Out of 30 cases 28 cases had excellent results without complications. 1 case had helical blade backed out, and did not come for follow up other case had superior migration of the helical blade, but the fracture is united.Conclusion: In our study of 30 cases of unstable intertrochanteric fractures, were effectively treated surgically with PFN-A gave excellent results & to be considered the best surgical modality for unstable Intertrochanteric fracture management.

Background: Total knee replacement surgery is considered as a treatment of choice in patients with advanced arthritis, especially in patients where conservative treatment have been failed. Total knee replacement is considered as second most successful surgery in Orthopaedics, which gives good pain relief, function and disabilities following advanced arthritis. Materials & methods: 60 primary total knee replacement surgeries in 50 patients done using posterior stabilized (PS) Depuy’s allpoly fixed bearing tibial cemented components, who were operated between March 2015 to August 2015, were prospectively enrolled into our study. This study was conducted at SS Institute of Medical Sciences & Research Centre, Davanagere, Karnataka. They were followed up for a minimum period of 1 year, and evaluated using knee society score. There were 24 right knees, 16 left knees, 10 bilateral knees. Results: There was a significant improvement in function of the patients and we have achieved excellent results in 42 patients and good results in 8 patients, no patient had a poor result. At one year follow up an average pre-op Knee Clinical Score of 28.28 improved to an average postop Knee Clinical Score of 94.23 and an average pre-op Knee Functional Score of 41.67 improved to an average post-op Knee Functional Score of 87.33.There was no case of infection or radiolucency’s at the end of one year. Conclusion: Among 50 patients who were diagnosed with primary osteoarthritis of knee, pain and deformity were the main presenting complaint. Inability to flex the affected knee and difficulty in doing activities like squatting and sitting cross legged was seen in most of the patients. In Indian scenario where patient comes late with gross varus deformity and fixed flexion deformity, it is difficult to balance the knee with retention of posterior cruciate ligament, where as Posterior Cruciate ligament Substituting Total Knee Replacement gives reproducible and good results, hence it is the preferred mode of management.

Scrub typhus is a rickettsial disease caused by O.tsutsugamushi which is maintained by trans-ovarian transmission in trobiculid mite¹. It causes a disseminated vasculitic and perivascular inflammatory lesions resulting in significant vascular leakage and end organ injury.The presentation can vary from self limiting illness to deadly systemic complications like ARDS, pneumonitis, myocarditis,AKI, Hepatic Dysfuntion and neurological manifestations².The classical clinical presentation includes an eschar,maculopapular rash and regional lymphadenopathy which are very rare. Incubation period is 6-21 days. It is important to differentiate it from other tropical fevers. We are reporting a case of scrub typhus from Vellore district of Tamilnadu with multi organ dysfunction in form of ARDS, Myocarditis,hepatic dysfunction and neurological manifestations and finally recovered after prolonged ventilator support.

Background Percutaneous catheter drainage (PCD) is an effective initial strategy of step-up approach for the management of acute pancreatitis (AP). The objective of this study was to identify factors associated with outcomes after PCD Methods This prospective observational study was conducted from July 2016 - Nov 2017. A total of 101 consecutive AP patients were recruited. Step up approach was followed for the management of patients. We evaluated the association between success of PCD ( survival without necrosectomy) and baseline parameters (aetiology, demography, severity scores(SIRS,APACHE II, organ failure),total leucocyte count, C-reactive protein(CRP), and intra-abdominal pressure (IAP), morphologic characteristics on computed tomography, percentage of necrosis , CT severity index (CTSI), characteristics of collection before PCD (timing, nature of collection, volume, site, solid component), PCD parameters (initial size, maximum size, number and duration of drainage) and factors after PCD insertion ( fall in IAP, reduction in volume of collection). Results Among 101 patients of AP, 51patients required PCD. The success of PCD 66.66% (34/51). Four patients required surgical necrosectomy after PCD. Mortality was 29.4% (15/51, including 2 deaths after necrosectomy). Multivariate analysis(6 factors included after univariate analysis) showed the percentage of volume reduction of fluid collection (p=0.016) and organ failure (OF) resolution(p=0.023) after one week of PCD predicted success of PCD. A predictive model based two factors resulted in AUROC- 0.915. Internal validation by bootstrapping of 5000 resamples showed AUROC 0.906 & is similar to the original model. Nomogram was developed with above factors to predict the probability of success of PCD((figure 1. Nomogram for predictor of PCD success in managing fluid collection in patients with necrotizing pancreatitis total points line indicates total points obtained from predictors and which is synchronized w) figure 1: Total points line indicates total points obtained from predictors and which is synchronized with probability of PCD success line which indicates probability of PCD success). (table 1). Conclusions Organ failure resolution and reduction in volume of collection after one week of PCD are significant predictors of successful PCD in patients with pancreatic fluid collection.

To find the strength of agreement between point-of-care and serum β-hydroxybutyrate. 236 paired samples (capillary β-hydroxybutyrate by a point of care device and serum β-hydroxybutyrate by colorimetric enzymatic estimation) samples were collected from 26 children aged

Breast cancer is typical viewed as the second dangerous infection wherever all through the world as a result of its passing rate. Impacted patient will liveonly when the sickness diagnosedprior to the most physical variations in the body. By and by, mammographic (X-ray emission region) picture was commonly used in revealing the breast cancer. The aim for the system is to design a Computer Aided Diagnosis systematictoolfor perceivingnon cancerous and perilous (cancer causing) mammogram. CAD tool helped radiologist in expanding his assurance accuracy. Thetextual features were estimatedby Grey Level Co occasion Matrix (GLCM) at 0°. Incorporate best featuresof the find outthat has significant responsibility in achieving the perfect turnoutwhich are then designated and associated with ANN to train and classify as ANN is extensively used in various field, for instance, pattern affirmation, therapeutic diagnose, machine learning, etc.,In thispapermini MIAS data setwas used and with the system the general sensitivity, expressness and precisionof 99.3%, 100% and 99.4% achieved separately.

In recent years, big data applications with scheduling algorithms have evolved lot due to the advancement of new technologies and techniques. We are living in digital data world where the data size is in terms of Exabyte or Pico Byte. This large volume of data is referred as big data. In today’s business environment, the performance of applications largely depends on the efficient retrieval of relevant data on time; the data analysis and retrieval of relevant data need to be done at faster rate. The traditional scheduling algorithms will not be efficient to handle such huge volume of data, considering the above facts managing big data applications and scheduling of big data on distributed architecture has become a challenging research area in the last three–four years. To process such huge volume of data, efficient scheduling algorithms need to be adopted to achieve better performance. The existing MapReduce implementation on Hadoop framework on single node cluster limits themselves to implement all the jobs on single node cluster. In this paper, we will discuss different scheduling techniques and their performance effects on a multimode clusters. The parameters considered for performance evaluation are CPU time, physical memory, and virtual memory. The main aim is to provide survey of different scheduling algorithms that can be used across distributed architecture to achieve better performance in analysis of big data considering YouTube dataset. The results interpret that capacity-based scheduling algorithm is more efficient as compared to FIFO and FAIR in terms of CPU cycles, physical and virtual memory utilization.

In today’s multimedia age, Content Based Video Retrieval (CBVR) is a trending area and lot of research is being carried out in Video Surveillance, Big Data analysis and multimedia applications. Usage of multimedia data is becoming very common in day today life, content based video retrieval provides an effective mechanism for maintaining, managing and retrieving large number of videos efficiently as per user’s interest. The advancement in the technology is evolving and multimedia applications are gaining more importance so the performance of the CBVR system need to be high and accurate to fulfill user demands. The proposed paper focuses on surveying the different techniques for feature extraction and similarity computation for retrieving relevant videos. Feature extraction can be done using different techniques such as shot boundary detection, based on histogram, PCA Shift, Gist and SURF (Speeded up Robust Features) and Quadratic Equation are used for feature extraction and similarity computation. In CBVR technique the videos are retrieved from the large databases based on the given Input Query as an image, on processing this query the features from videos and the query image are extracted mainly the color, texture and shape. Once these features are extracted then a similarity between query and the videos is computed, ranking will be done based on the similarity score. The results interpret that SURF technique provides better results as compared to other techniques and the system has a retrieval performance of more than 70%.

The role of adjunctive steroids in abdominal tuberculosis is unclear. To evaluate effect of adjunctive use of steroids for abdominal tuberculosis in reducing/preventing complications. We searched electronic databases (Medline, Embase, CENTRAL, Scopus, Web of Science, CINAHL) from inception to 25th June 2018 using the terms “abdominal tuberculosis” OR “intestinal tuberculosis” OR “peritoneal tuberculosis” OR “tuberculous peritonitis” AND steroids OR methylprednisolone OR prednisolone. Bibliography of potential articles was also searched. We included studies comparing adjunctive steroids to antitubercular therapy (ATT) alone. We excluded non-English articles, case reports, reviews and unrelated papers. The primary outcome was a comprehensive clinical outcome including need for surgery or the presence of symptomatic stricture (abdominal pain or intestinal obstruction). Quality assessment of included studies was done using ROBINS-I tool. Random-effects model was used to calculate the summary effect for all the outcomes. Of total 633 records, three studies on peritoneal tuberculosis were included in meta-analysis. These papers were of poor quality (one quasi-randomised study and two retrospective cohort studies). Meta-analyses showed adjunctive steroids, with ATT is more effective than ATT alone in tuberculous peritonitis patients for the prevention of composite end point (RR 0.15 [0.04, 0.62], p = 0.008), symptomatic stricture(RR 0.15 [0.04–0.62] p = 0.008) and intestinal obstruction (RR 0.18 [0.03–0.99] p = 0.05). The data on use of steroids for abdominal tuberculosis are limited to peritoneal tuberculosis. Although steroids seem to have some benefit in patients of tubercular peritonitis, the poor quality of studies limits the generalisability of the findings. CRD42016047347.

Human action detection and recognition is the most trending research topic in applications like surveillance of videos, analysis of sports videos and many applications which involve human computer interaction. Many researchers are working on different algorithms to improve the accuracy of human detection. Identifying the actions of human from the given video is a challenging task. In the proposed paper combination of two different techniques is applied i.e. SVM and SIFT techniques are used to identify and recognize the human actions in a given video or image. To extract local features of the given video SIFT based technique is used. In this techniques initially we extract features based on the interest points at a particular point or frames, Mainly SIFT techniques involves 4 basic steps Scale-space extreme detection, Key-point localization, Orientation assignment and Key-point descriptor. Once the key features are extracted they are further classified using SVM classifier. In the results and discussion we perform the comparative analysis of these two techniques on a standard KTH dataset with running and hand clapping actions. The experimental results determine the overall accuracy of 82% for the actions: running and hand clapping actions.

Currently in India and most of the other countries, if there is any leakage of water pipes in remote areas then it’s difficult to trace and repair the leakage within a short span of time, it takes some amount of time usually two to three days to locate the leakage and to repair it. During this time a lot of water is wasted. In this paper we discuss the techniques to detect the leakage and locate the leak point on the pipeline. In the proposed approach we discuss efficient techniques for monitoring, detecting leakage in pipes and checking the durability of the pipes using flow rate and vibration sensors. The objective is to build a prototype model for detecting leakage in water pipeline using flow rate sensors and also to predict the durability of the pipe using vibration and pressure sensors. Data from remote sensors are collected through wireless medium and are monitored in a server. If there is any leakage in the pipelines then the server sends the sms message to the water board authorities and notifies the leak point in the pipeline system. Further the durability of pipe can be predicted using pressure sensor so that the authorities can be intimated in prior about chances of breakage in pipelines. Thus the proposed system can save huge amount of water by intimating the authorities in time. Thus the experimental result validates the effectives and reliability of the proposed system.

Aim: To study endoscopic collagen spray as a hemostatic agent in peptic ulcer bleeding not controlled by conventional therapy. Methods: In this prospective study, endoscopic collagen spray, VGM’s Haemoseal spray has been used in the treatment of peptic ulcer bleeding, as a single agent or in combination with other agents. Haemoseal Spray Kit consists of air pump, Haemoseal probe, a 7.5 Fr spray catheter, 230 cm in length and a pre-loaded collagen cartridge that contains 5 grams of powder. A maximum of 2 grams is applied depending on the area to be covered. Results: Eighteen consecutive patients, who presented with peptic ulcer bleeding were included. There were sixteen patients with duodenal ulcer and two patients with gastric ulcer. The hemorrhagic ulcers were Forrest classification category Ib in sixteen patients and Ia in two patients. After spraying collagen, the bleeding stopped within seconds in all the patients. Repeat endoscopy after 48 hours showed no rebleeding. One patient had an arterial spurt from duodenal ulcer. Collagen spray was used initially as there was poor visibility. After 24 hours, repeat endoscopy revealed visible vessel with no bleeding. Hemoclipping could be achieved. There were no side effects experienced by the patients. Conclusion: Collagen spray is a safe and effective endoscopic hemostatic agent in treatment of peptic ulcer bleeding not controlled by conventional therapy.

Today in India and most other countries, accident is considered as an unexpected and unintended event. According to the survey road accidents lead to hospitalization, injuries and disabilities, considering these facts the safety of the riders has become a most crucial and important issue and concern in majority of the countries. The usage of two wheeler’s vehicles is increasing day by day for transport convenience we need to have proper safety and efficient measures to handle accidents. In the proposed paper we discuss smart helmet system using cloud and GPS technology for accident detection and location tracking, GSM is used to send a notification message of accident location to the concerned people to avoid major casualty/life of the person can be saved. MQ3 sensor is also embedded in the helmet to check whether the motorcyclist has consumed alcohol or not. The sensor data captured is stored in the cloud so that the accident information can be fetched anywhere and anytime at a faster rate. Considering the above facts, the prototype of smart helmet is designed and implemented to enhance the safety of the motorcyclist. This new idea will reduce the risk of motorcyclist life. The experimental results confined that the developed prototype model gives 84% accurate result of the accident detection and concerned persons will receive notification message.

Aim: The aim was to determine the utility of capsule endoscopy (CE) in patients with obscure gastrointestinal bleeding (OGIB). Materials and Methods: A prospective study of patients who underwent CE at our institution from 2002 to 2010. Results: A total of 259 patients were included in this study (mean age 52.3 years; 200 male and 59 female), including 175 with overt OGIB, and 20 with occult OGIB, underwent CE. One hundred eighty-nine of 195 patients (96%) with OGIB had positive findings. Gastric erosions (23%), duodenal erosions (13%) and ileal erosions (11%) were the most frequent findings. Conclusion: Capsule endoscopy is a useful diagnostic technique in patients with OGIB.

A numerical and experimental study has been carried out with a pair of water drops coalescing over a superhydrophobic surface. Initially, a stationary isolated drop (of given radius R1) in the sessile configuration is just touched by another drop (of radius R2), vertically in line with it, at zero speed. The solid substrate is a chemically treated, polished superhydrophobic surface made up of copper, for which the equilibrium contact angle for water was measured to be 150 ◦ . The Bond number, considering the total volume of the combined drop, falls in the range of 0.3–0.5. For these conditions, experiments clearly reveal that for a given range of R1=R2, the merged drop bounces off once before it starts to eventually spread and attain an equilibrium configuration. The above experiment has been numerically simulated using COMSOL c ⃝ , in an axisymmetric coordinate system. The simulations have been carried out for different combinations of droplet volumes, while keeping their combined volume to be fixed. The predictions of the simulation are compared with the experiment in terms of the interface shapes attained, distinctive timescales, and recoil height. The comparison between the two sets of data is seen to be favorable. Factors leading to recoil are delineated according to the available energy budget.

Proximal humerus fractures encompass a broad spectrum of injuries. They are often the result of a fall in an osteoporotic patient, but also occur in high-energy trauma. These account for 4 -5 % of all fractures and incidence increase rapidly with age and occurs twice as often in women as in men. Functional results associated with non-operative treatment of displaced fracture of proximal humerus are poor. Over the last decades, several techniques have been applied for treatment of proximal humerus fractures. Widely accepted is the initiation of a conservative treatment regimen for undisplaced fractures, however, the ideal treatment of displaced fractures, especially 3 and 4 part fractures is still the center of scientific debate . In our hospital 36 patients with 36 proximal humerus fractures were treated with locking compression plate from December 2010 to December 2012. Among these 21 patients were male & 15 patients were female. Youngest patient was 29 years & oldest was 76 years. Fractures were classified according to Neer’s classification & type 2, 3, & 4 were included in the study. Post operatively rehabilitation started depending upon stability of fixation & tolerability of patient. According to Neer’s scoring system approximately 60% of patients had satisfactory to excellent results, 30% had fair results and 10% had unsatisfactory to poor results.

BACKGROUND: Unstable distal end radius fracture with intra articular extension is difficult to reduce and maintain the reduction despite continued refinements in treatments if treated non- operatively. Most have recommended some type of skeletal fixation to maintain the reduction. It is a challenging problem to many surgeons with large variety of treatment options and cost involved. The purpose of this study was to stabilize & asses the efficiency of external fixators in the management of intra-articular fractures of lower end of radius. METHODS: A total of forty patients with forty distal radius intra articular fractures were included in our study between Jan 2009-Jan 2011. The average age of the patient was forty years and all of them were below 70 years or less. All the patients were treated with static external fixators by ligamentotaxis. At 3, 6 and 12 months post operatively patients were assessed using Gartland and Werely point system. Arthritis was graded on radiograph according to modification to Knirk and Jupiter criteria. RESULTS: At the end of 1 year 70% had good or excellent results according to the scoring system of Gartland and Werely point system, 25% had fair and 5% had poor results of which one patient had radiocarpal arthritis. CONCLUSION: In our series with intra articular fracture of distal end radius with proper case selection, meticulous technique, low cost affective static external fixators we were able to achieve 70% good and excellent results.

Aim: Anemia of chronic disease is defined as anemia occurring in chronic infections and inflammatory conditions that is not caused by marrow deficiencies or other diseases and in the presence of adequate iron stores and vitamins. The present case control study was aimed to assess the red blood cell parameters for signs of anemia in patients with mild, moderate, and severe chronic periodontitis. Materials and Methods: A simple random sampling method was used to select 80 healthy male patients, who were divided into four groups based on full mouth periodontal examination as follows: group I patients comprised the control group (n = 20), which included patients with a clinically healthy periodontium, group II patients (n = 20) were diagnosed with mild chronic periodontitis, group III (n = 20) included moderate chronic periodontitis patients, and patients with severe chronic periodontitis formed group IV (n = 20). Laboratory blood investigations included total number of erythrocytes, hemoglobin concentration, packed cell volume, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. Results: Data analysis showed a statistically significant decrease in red blood cell parameters with increase in different grades of periodontitis. Conclusion: Results of the present study show a substantial decrease in red blood cell parameters with increase in the severity of periodontal destruction.

In this modern age, electrical motors impact innumerable aspects of modern living. Though different kinds of motors are available, it is estimated that Induction motors comprise 85% of all the electric motors in the industrial and domestic applications. With the advancement of Power Electronics, Induction motors have been gaining traction even for variable-speed applications, which was traditionally considered to be the forte of DC motors. The advantages that Induction motors offer due to their high robustness, reliability, low cost and high efficiency (80%) have made them the preferred choice for motor applications Speed control of an Induction motor is possible when it is fed by a PWM-controlled inverter. Among the strategies used to exercise control over the inverter output, SVPWM control delivers more output voltage from the inverter, makes better utilization of DC link voltage, produces lower THD and lower torque ripple than the other popular methods like SPWM method and Hysteresis PWM control method. However, the conventional SVPWM method could still be improved by using a simple Bus-Clamping control logic and maintaining voltage/frequency ratio constant to drive the Induction motor as presented in this work. The impact of this method on the harmonic content of the inverter output voltage is also studied.

We applied in silico methods to automatically classify drugs according to the Biopharmaceutics Drug Disposition Classification System (BDDCS).Models were developed using machine learning methods including recursive partitioning (RP), random forest (RF) and support vector machine (SVM) algorithms with ChemDraw, clogP, polar surface area, VolSurf and MolConnZ descriptors. The dataset consisted of 165 training and 56 test set molecules.RF model 3, RP model 1, and SVM model 1 can correctly predict 73.1, 63.6 and 78.6% test compounds in classes 1, 2 and 3, respectively. Both RP and SVM models can be used for class 4 prediction. The inclusion of consensus analysis resulted in improved test set predictions for class 2 and 4 drugs.The models can be used to predict BDDCS class for new compounds from molecular structure using readily available molecular descriptors and software, representing an area where in silico approaches could aid the pharmaceutical industry in speeding drugs to the patient and reducing costs. This could have significant applications in drug discovery to identify molecules that may have future developability issues.

Over the past century, the use of stents has evolved to a point where they are now used extensively throughout the gastrointestinal tract. Endoscopic stenting has become widely used for treatment of gastrointestinal and hepatobiliary strictures. Metallic stents are deployed in malignant strictures as a palliative procedure. Adverse events of stenting include perforation, migration, bleeding, occlusion, and pain. Finally, the use of multidisciplinary teams which include endoscopists, interventional radiologists, and surgeons allows for the exchange of ideas and procedural planning necessary for successful innovation. We present a case of successful cessation of bleeding by using cyanoacrylate glue therapy in post-enteral self-expandable metallic stent bleeding. In conclusion, glue therapy may also be considered as a mode of treatment other than conservative approach and angiographic coil embolization.

Background: Commonest approach in emergency open abdominal surgeries remains to be midline laparotomy because it is simple, saves time and causes minimal blood loss. Optimal technique for laparotomy wound closure has been a topic of debate since long. Risk factors for development of incisional hernia and burst abdomen are wound infection, systemic illnesses of patient and closure technique. Factors related to patients like age, gender, body mass index (BMI), systemic illnesses are not modifiable when an emergency laparotomy is the only option. Hence closure technique is one factor where surgeon has total control, which can bring down the incidence of burst abdomen and incisional hernias.Methods: Prospective study conducted in 150 patients who underwent emergency midline laparotomy from December 2014 to February 2016 in Krishna Rajendra Hospital attached to Mysore Medical College and Research Institute, Mysore, Karnataka, India with 6 months’ follow-up after surgery.Results: Most of patients in the study belonged to 30-40-year group and were males (78%). Gastrointestinal perforation peritonitis (52%) was the single most common indication for emergency midline laparotomy. In the continuous and interrupted groups, post-operative wound infection was found in 54.6% and 34.6%, wound dehiscence was found in 16% and 6.6% and incisional hernia in 14.4% and 4% respectively.Conclusions: Interrupted suturing is superior to continuous technique in emergency midline laparotomy wound closure in terms of complications and post-operative morbidity.

Background: There have been many attempts to find less painful surgical methods for treating haemorrhoids. Harmonic scalpel is a device that simultaneously cuts and coagulates soft tissues through ultrasonic vibrations. The aim of this study was to compare the results of Harmonic scalpel hemorrhoidectomy with conventional Milligan Morgan hemorrhoidectomy for the treatment of grade III and IV hemorrhoids.Methods: Patients with grade III or IV hemorrhoids, operated between January 2016 and December 2016, using the harmonic scalpel (n=30) or the conventional open technique (n=30) were studied. Both the groups were compared with respect to Operative time, Blood loss during surgery, early postoperative complications, postoperative pain measured on a visual analog scale (VAS), hospital stay, and return to normal work.Results: Harmonic scalpel and conventional open haemorrhoidectomy patients differ significantly in terms of VAS score of postoperative pain, blood loss during surgery, early post-operative complications, return to normal work. However, there is no significant difference in terms of duration of surgery and hospital stay in both the groups.Conclusions: Harmonic scalpel haemorrhoidectomy has been found advantageous method when assessing the amount of bleeding intraoperatively, post-operative pain, early postoperative complications, and Return to normal work. Hence Harmonic scalpel haemorrhoidectomy can be adapted as a safe and effective alternate method for treating symptomatic haemorrhoids.

Background: Diabetic foot ulcer is a very common condition encountered in surgical practise. Wound management pose a good challenge for a treating surgeon due to its physical, mental and social implications. The devitalised necrotic tissue present in ulcer does not favour the wound healing as it increases the chance of infection and delays appearance of granulation tissue. Hence debriding of devitalised tissue plays a key role in wound care. In present study ,we used papain urea based preparation in dressings which is a autolytic agent. This study was conducted to evaluate the effectiveness of use of papain urea based preparations compared with regular conventional dressing in diabetic foot ulcer management.Methods: This was a prospective study conducted in K. R. Hospital, Mysore, Karnataka, India. 60 eligible subjects with diabetic foot ulcers were selected and subjects were randomly allocated into two groups Group A and Group B with 30 subjects in each group. Subjects in Group A underwent dressing with papain urea based preparation and in Group B underwent regular conventional dressing. Results were assessed with respect to percentage decrease in necrotic tissue, incidence of infection, appearance of granulation and hospital stay.Results: Among Group A subjects percentage reduction of necrotic tissue was more, granulation appeared early and the hospital stay was less compared to Group B subjects which were statistically significant. However, there was no significant difference with respect to incidence of infection in both groups.Conclusions: Papain urea based preparation is effective in diabetic foot ulcer care.

Objective To measure image clarity, ease of use, and handling performance of a flexible fiberoptic bronchoscope (B-F 100; Vision Sciences; Natick, MA) and sterile single-use disposable-sheath endoscope system (BS-F21 EndoSheath; Vision Sciences). Design Prospective, multicenter diagnostic technology evaluation of a medical device newly approved by the US Food and Drug Administration. Setting Three tertiary care referral centers with busy bronchoscopy practices. Patients Twenty-four patients undergoing bronchoscopy with a flexible fiberoptic bronchoscope and disposable sheath endoscope system. Methods Flexible bronchoscopy was performed through a transnasal or transoral route after topical upper airway anesthesia using standard techniques. After each procedure, the bronchoscopist rated the performance of the medical device under study using a linear scale of 1 (poor) to 5 (excellent and equal to that of a conventional flexible fiberoptic bronchoscope). Results Mean performance ratings were > 4.0 (range, 4.17 to 4.63) for image clarity, illumination, lack of fogging, distal tip angulation, and ease of transnasal passage. All other ratings were > 3.0 (range, 3.54 to 3.87), the lowest of which was handling comfort. Conclusion The flexible fiberoptic bronchoscope with sterile single-use disposable-sheath endoscope system has the potential to reduce scope downtime by eliminating the need for high-level disinfection between procedures. Illumination, image clarity, and ease of insertion are very good, justifying future prospective studies comparing this device to conventional flexible fiberoptic bronchoscopes.

This chapter outlines the development of interventional pulmonology over the last three decades beginning with the introduction of the Nd:YAG laser for use in therapeutic bronchoscopy. Mention will be made of early pioneers who set the stage for modern interventional pulmonology. The chapter reviews the current scope of practice of interventional pulmonology with emphasis on newer bronchoscopy techniques for diagnosis and staging of thoracic malignancy. The current status of training in interventional pulmonology will be discussed along with issues regarding credentialing and the need for a formal 1-year interventional pulmonology fellowship.

The Cockayne Syndrome is a rare syndrome of congenital originwhich is charcterized by growth retardation, facial dysmorphism, facial naevi,retinopathy and mental retardation, which are associated with the changes in the brain parenchyma. The findings of MRI of the brain support the clinical diagnosis of the Cockayne Syndrome. We would like to highlight the MRI findings of this rare syndrome.

The key to survival in today's competitive market is manufacturing high quality products at low cost. In the context of metal forming, this translates into fewer and more efficient processes, elimination of secondary operations, while maintaining the surface finish, tolerance and dimensional specifications. Making the right choice of a process that is cost-effective for the required production volume and yet meets the design requirements, is extremely important. One approach to achieving this objective is through process modeling for net shape manufacturing. This paper presents ongoing industry relevant research at the Engineering Research Center in the area of cold and warm forging towards better quality and lower cost. It reports current research on sequence design for fuel injector nozzle, modeling of fracture during induction heating, modeling of warm/hot forging of microalloyed steels and development of an integrated process planning system. These efforts could result in reduced process defects and lower process costs.

A case report of cerebro cerebellar lissencephaly shows complete agenesis of cerebellum and brainstem which is rare imaging finding of group lissencephaly (type I lissencephaly). Though agenesis of cerebellum and brainstem were included in literature, in most of the cases we saw a hypoplasia or atrophy of cerebellum in lissencephaly syndrome. The CT scan findings of this patient shows features of lissencephaly with complete agenesis of brain stem and cerebellum associated with multiple congenital abnormalities.

One of the most common computer vision tasks is that of recognizing the category of objects present in a given image. Previous work has mostly focused on building accurate classifiers based on carefully selected features. Classification is often carried on individual test images, while most of the practical situations, such as webscale image indexing, demand the simultaneous classification of a large collection of images. This is especially true for real-world datasets, that already contain numerous un-indexed images and videos. In this paper, we work towards developing a computationally efficient approach towards object recognition, that is inspired by retrieval schemes. We perform an offline indexing of the features from the collection, so that the classifier only needs to work on a small subset of the entire feature set. Over a set of 2 Million features extracted from 7000 images, classification against 5 object categories using a standard SVM would require more than 260 hours. Over the same test case, the classification time using our indexing based approach is reduced to less than 13 hours. The compromise on the accuracy is less than 7% for the 20X speedup achieved.

The authors used an 11-region, 22-commodity world net trade model to study the economic implications of agricultural policy reform in industrial market economies. Their analysis shows that elimination of protectionist agricultural policies would drive up world prices for most commodities and that the increases would be related to the levels of government assistance. The results also indicate that consumers and taxpayers have had to bear the burden of agricultural support and that the costs to them outweigh benefits to producers by 30%. The EC, USA and Japan account for 80% of the income gains from multilateral liberalization.

This case study of categorized laboratory is basically to explore the effectiveness of structured enquiry in database application laboratory to encourage inquiry for the undergraduate students of Information Science & engg department. Enquiry based learning approaches enhance student's learning as compared to the conventional method. In enquiry based approach all the experiments are classified into four categories such as demonstration, exercise, structured enquiry and open ended experiment. During the year 2012-13 and 2013-14 batches, students are compared with respect to their exam score, understanding of concepts, analyzing and implementing the studied concepts, database design and the nature of problem statement given in the laboratory. All the batches are given with different set of unique problem statements to avoid plagiarism and that really encouraged the students to study DBMS subject in depth, and also stimulated them to choose data mining and information retrieval subject, data engineering theme to build the capstone projects in their higher semesters. This enquiry-based laboratory conduction has enhanced the students learning skills, stimulated to acquire content knowledge, problem solving skills, asking questions, and coming up with alternate design approaches for given problem. The results of this two years study give us a clear differentiation that inquiry based approach is better for students to acquire in depth knowledge and problem solving skills as compared to traditional approach where there was no categorization of lab experiments.

Postpartum ovarian vein thrombosis (POVT) is an uncommon but serious complication. Clinically it is a difficultly diagnosed entity, must be thought of as differential diagnosis in cases of postpartum acute abdomen. POVT may cause serious complications like sepsis, pulmonary embolism, thrombosis of the inferior vena cava and renal veins, and may cause death. It is often clinically indistinguishable from other causes of post partum acute pain. Most of the cases present as right loin and right iliac fossa pain, within initial 10 days of the puerperal period. This report presents a case of left ovarian vein thrombosis complicated by renal vein thrombosis presenting as left ureteric colic. The imaging findings illustrate the difficulty in clinical and radiological diagnosis of post-partum ovarian vein thrombosis, and thus highlight the need to include it as one of the differential diagnosis in such cases of post partum acute abdomen. Anti-coagulants and intravenous antibiotics remain the mainstay of treatment. Non-invasive investigations help in accurate diagnosis of POVT and a surgery can be avoided.

The urinary proteome in health and disease attracts increasing attention because of the potential diagnostic and pathophysiologic biomarker information carried by specific excreted proteins or their constellations. This cross-sectional study aimed to analyze the urinary proteome in patients with biopsy-proven acute rejection (n = 23) compared with transplant recipients with stable graft function (n = 22) and healthy volunteers (n = 20) and to correlate this with clinical, morphologic, and laboratory data. Urine samples were preadsorbed on four different protein chip surfaces, and the protein composition was analyzed using a surface-enhanced laser desorption/ionization time-of-flight mass spectrometer platform. The data were analyzed using two independent approaches to sample classification. Patients who experienced acute rejection could be distinguished from stable patients with a sensitivity of 90.5 to 91.3% and a specificity of 77.2 to 83.3%, depending on the classifier used. Protein masses that were important in constructing the classification algorithms included those of mass 2003.0, 2802.6, 4756.3, 5872.4, 6990.6, 19,018.8, and 25,665.7 Da. Normal urine was distinguished from transplant urine using a protein marker of mass 78,531.2 Da with both a sensitivity and a specificity of 100%. In conclusion, (1) urine proteome in transplant recipients with stable graft function was significantly different from healthy control subjects, and (2) acute rejections were characterized by a constellation of excreted proteins. Analysis of the urinary proteome may expedite the noninvasive prediction of acute graft rejection, thus importantly assisting in establishing the diagnosis.

The causes of upper gastrointestinal bleed are manifold with the most common being peptic ulcers and oesophageal varices. We present a rare cause of upper gastrointestinal bleeding due to Hereditary Hemorrhagic Telangiectasia presenting with hematemesis and malaena due to bleeding from telangectatic lesions in the stomach and duodenum. The patient also had typical mucosal and nail manifestations of the disease which aided in the diagnosis of the condition.