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Context Although percutaneous nephrolithotomy (PCNL) has been performed for decades and has gone through many refinements, there are still concerns regarding its more widespread utilization because of the long learning curve and the potential risk of severe complications. Many technical details are not included in the guidelines because of their nature and research protocol. Objective To achieve an expert consensus viewpoint on PCNL indications, preoperative patient preparation, surgical strategy, management and prevention of severe complications, postoperative management, and follow-up. Evidence acquisition An international panel of experts from the Urolithiasis Section of the European Association of Urology, International Alliance of Urolithiasis, and other urology associations was enrolled, and a prospectively conducted study, incorporating literature review, discussion on research gaps (RGs), and questionnaires and following data analysis, was performed to reach a consensus on PCNL. Evidence synthesis The expert panel consisted of 36 specialists in PCNL from 20 countries all around the world. A consensus on PCNL was developed. The expert panel was not as large as expected, and the discussion on RGs did not bring in more supportive evidence in the present consensus. Conclusions Adequate preoperative preparation, especially elimination of urinary tract infection prior to PCNL, accurate puncture with guidance of fluoroscopy and/or ultrasonography or a combination, keeping a low intrarenal pressure, and shortening of operation time during PCNL are important technical requirements to ensure safety and efficiency in PCNL. Patient summary Percutaneous nephrolithotomy (PCNL) has been a well-established procedure for the management of upper urinary tract stones. However, according to an expert panel consensus, core technical aspects, as well as the urologist’s experience, are critical to the safety and effectiveness of PCNL.

Paraovarian cysts constitute about 10% of all adnexal masses in females and occur most commonly in the third and fourth decades of life. These cysts are benign and usually uncommon in adolescence. Such cysts pose a diagnostic challenge while distinguishing them from ovarian cysts clinically and during radiological investigations. We report a rare case of a 13-year-old female patient with bilateral paraovarian cysts, including a giant cyst in right mesosalpinx presenting to Sohar hospital, Oman in 2018. The definitive origin of the huge mass on the right side of abdominal cavity could not be established in the current case despite contrast enhanced computerized tomography. It was only on laparoscopic exploration that this mass was identified as a giant paraovarian cyst. Both the giant cyst and a smaller paraovarian cyst on the left side were enucleated with minimally invasive surgery while preserving the fertility of the patient. Only one other similar case of bilateral paraovarian cysts in an adolescent, including a giant cyst managed with laparoscopy, has been documented previously. Keywords: Adolescent; Parovarian Cyst; Laparoscopy; Ultrasonography; Minimally Invasive Surgical Procedures; Case Report; Oman.

Background: COVID-19 caused the world to shut down and made us to critically look out at our advanced healthcare systems that are well prepared for heart diseases, cancers, organ transplantation but not for attack of a tiny virus. WHO and other authorized bodies are continuously issuing advisory on preventive measurements, tracking the outbreak and distributing vital medical kits. Scientific community and vaccine experts have developed and started to distribute safe and effective immunization worldwide. Objective: The paper outlines several developed and developing immunization vehicles for the management of COVID -19 that will hit global market in year 2021. Method: Non clinical and clinical data are collected from authentic sources of World Health Organization portal and press release provided by COVID-19 vaccine developers. Result: Different platforms including mRNA, DNA, Viral vectors, Synthetic peptides etc. have been conversed that are globally involved for elimination of SARS-CoV-2, a causative virus of COVID-19. Conclusion: Numerous academic institutions and companies of worldwide have developed and evaluated their inoculums after extremely compressed clinical trial agendas. Worldwide eminent developers such as Pfizer and BioNTech, Moderna, AstraZenaca and Bharat Biotech are ready with their esteemed products for the management of pandemic COVID-19. They explored pharmaceutical technologies reliant on genetics, nanoengineering and biotechnology for successful development of these anti SARS-CoV-2 inoculums. Taking account on conditions of more vulnerable community including immunocompromised, geriatrics and comorbidities patients the safety and efficacy of vaccine are yet to be monitored..

BACKGROUND Almost a quarter of India's population comprises of girls below 20 years. One of the major physiological changes that take place in adolescent girls is the onset of menarche, which is often associated with problems of irregular menstruation, unwarranted bleeding, and dysmenorrhea. We wanted to evaluate the prevalence, severity, knowledge aspect of treatment and impact of dysmenorrhea in females of reproductive age group in a tertiary care teaching hospital in Koshi Region (Northern Bihar) India. METHODS This was a survey based, cross sectional study conducted over a period of six months from June 2019 to January 2020. After obtaining consent, the study included 100 women in the age group of 18-28 years, studying or functioning (general college, college students and nursing students and personnel) in the Department of Obstetrics and Gynaecology, Lord Buddha Koshi Medical College and Hospital, Saharsa, Bihar, and Associated Hospital of Bihar. Patients suffering from DM, HTN. Renal disorders and hepatic disorders were excluded from the study. RESULTS In this study it was found that they often use over the counter pain medication. Those who self-medicated with over the counter preparations use sub beneficial dose and of substandard drugs. By experience they knew that which medicine could relieve dysmenorrhea. Dysmenorrhea is a common gynaecological problem among adolescents in Saharsa, Bihar. CONCLUSIONS Dysmenorrhea is common gynaecological problem among adolescents in Saharsa, Bihar. Mild and moderate dysmenorrhea do not cause absenteeism from school, college and work place. In this study only 6% were absent from school, college or work place during menstruation .But several studies had reported 34 to 50% absenteeism from school, college or work place During menstruation.13,14 Adolescent girls, almost always, silently suffer the pain due to dysmenorrhea and the embarrassment associated with it due to lack of knowledge about reproductive health.

Background: The aim of this study was to reach a consensus in the classification and standardized reporting for the different types of PCNLs. Methods: The RAND/UCLA appropriateness methodology was used to reach a consensus. Thirty-two statements were formulated reviewing the literature on guidelines and consensus on PCNLs, and included procedure specific details, outcome measurements and a classification for PCNLs. Experts were invited to two rounds of input, the first enabled independent modifications of the proposed statements and provided the option to add statements. The second round facilitated scoring of all statements. Each statement was discussed in the third round to decide which statements to include. Any suggestion or disagreement was debated and discussed to reach a consensual agreement. Results: Twenty-five recommendations were identified to provide standardized reporting of procedure and outcomes. Consensual scoring above 80% were strongly agreed upon by the panel. The top treatment related outcomes were size of sheath used (99.1%) and position for PCNL (93.5%). The highest ranked Outcome Measures included definition of postoperative hospital length of stay (94.4%) and estimated blood loss (93.5%). Conclusions: The consensus statements will be useful to clarify operative technique, in the design of clinical trials and standardized reporting, and presentation of results to compare outcomes of different types of PCNLs.

The Six Sigma (6σ) method is used to improve and optimize an organization’s products, services, and processes by constantly decreasing defects. In this paper we try implementing the 6σ methodology in Academia. The challenges and actuality of implementation of 6σ methodologies successfully in Academia are immense. However, the benefits of applying 6σ are equally great. The objective of this paper is to understand the evolution, benefits, and challenges of 6σ practices in academia through a case study of Presidency University situated in Bangalore, Karnataka, India. The problem statement in the paper is the poor performance of students in academics and by using the DMAIC approach of 6σ we try to identify and understand the causes and set out to improve them so the students can have better placement and academic opportunities. This paper is also an attempt to show the readers about the wide application of 6σ in fields other than manufacturing and how it can be beneficial.

Background: Ovarian cysts are more common in adolescents than has been assumed. Large ovarian cysts, however, are rare. Conventionally, large ovarian cysts have been managed by laparotomy. Laparosc...

Objective The aim of the study was to evaluate the long-term functional outcome (exocrine and endocrine) and morphological changes in remnant pancreas after pancreatoduodenectomy and its clinical impact. Methods Periampullary carcinoma patients with minimum follow-up of 2 years and without recurrence were included (N = 102). Exocrine insufficiency includes clinical steatorrhea and fecal elastase-1 (FE-1) levels; endocrine insufficiency, glucose levels and glycated hemoglobin; and morphological changes, main pancreatic duct (MPD) diameter and thickness of remnant pancreas. Results The mean (standard deviation) follow-up period was 59 (26) months. Of the 102 patients, 81 (80%) had severely deficient FE-1 (0-100 μg/g). The preoperative MPD was significantly more and thickness of remnant pancreas was significantly less in patients with severely deficient FE-1. Overall, 15.6% (16/102) developed steatorrhea and improved on enzyme replacement therapy. The presence of MPD stricture (P = 0.008) and weight loss (P = 0.001) were significantly associated with steatorrhea. New-onset diabetes was seen in 17% (15/90) patients, of whom 3 of 5 developed it after 4 years (range, 4-7 years). The blood glucose was controlled on oral hypoglycemics in 2 (10/15) of 3 patients. Conclusions The assessment by FE-1 indicates loss of exocrine function in more than 90%, whereas only 1 of 6 developed steatorrhea and new-onset diabetes. Morphological changes especially MPD stricture affect the functional status of remnant pancreas.

Background: Pain management is an everyday challenge in dentistry. Analgesics are the group of drugs prescribed for effective pain management, of which nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly prescribed drugs. Selection of NSAIDs must be judiciously made considering their pharmacological properties and adverse effects. Aim: This study aimed to analyze the attitude toward analgesic prescription among practicing dentists and the awareness to update their knowledge about them. Materials and Methods: The study was carried out among 100 dental practitioners, where a questionnaire consisting of 16 questions was formulated based on the awareness of indication and contraindication, actual practice, and required future trends for updating the knowledge. The questionnaire was distributed among the practitioners; the answered questionnaire was collected and tabulated. Statistical analysis included χ2 test to evaluate the significance. Results: Of 100 dental practitioners, 63% prescribed drugs based on the diagnosis. Aceclofenac was found to be the effective drug in postoperative pain management, whereas paracetamol was considered to be the safest among NSAIDs in clinical conditions such as bleeding disorders, gastric irritation, chronic kidney disease, and during pregnancy. All practicing dentists showed their willingness to participate in awareness programs in updating their knowledge. Conclusion: This study showed that dental clinical practitioners are well aware of the drugs to be prescribed in different clinical conditions but pitfalls have been observed in areas of systemic complication, where continuous educational programs are needed to overcome the same.

Background: “Oblique subcostal” transversus abdominis plane (TAP) block is a combination of rectus abdominis and TAP block which is currently used in a wide variety of abdominal procedures. Dexamethasone and tramadol are both used as adjuvants in several blocks for improving efficacy and prolonging analgesia. The present study was intended to compare both these drugs along with ropivacaine in ultrasound-guided subcostal TAP block following open cholecystectomy. Materials and Methods: The present prospective, randomized, and double-blind study was conducted in 60 adult patients of either sex undergoing open cholecystectomy. The patients were randomized into two groups; Group D (n = 30) and Group T (n = 30). Former received 18 ml of 0.75% ropivacaine with 2 ml (8 mg) of dexamethasone whereas latter received 18 ml of 0.75% ropivacaine with 2 ml (25 mg/ml) of tramadol through right-sided ultrasound-guided oblique subcostal TAP block after the induction of general anesthesia following standard protocol. Postoperative pain at rest and knee flexion as per visual analog scale (VAS) score, time for first and second rescue analgesia, total tramadol consumption in 24 h, sedation and nausea score, and quality of healing at discharge were noted. Results: Requirement for first and second rescue analgesia was similar in two groups but overall 24 h tramadol consumption was less in Group D. VAS score was similar in two groups except at 4 and 24 h. None of the patients were sedated, but nausea score was less in Group D. The quality of wound healing was good in both groups. Conclusion: The addition of 8 mg dexamethasone or 50 mg tramadol as adjuvants to ropivacaine is effective and safe drugs to administer in TAP block for postoperative analgesia following open cholecystectomy.

Modern integrated circuits (ICs) contain thousands of instruments to enable testing, tuning, monitoring, and so on. These on-chip instruments must be accessed through the ICs’ life- time. However, when ICs are mounted on Printed Circuit Boards (PCBs), access from system-level is challenged due to complex system hierarchies with a multitude of interfaces. In this paper we enable access from system-level to chip-level instruments by proposing hardware, protocol, and communication schemes. We have validated our scheme by implementing a system with two ICs on a Field-Programmable Gate Array (FPGA) where each IC includes an IEEE Std. 1687 network, communication between ICs is with Serial Peripheral Interface (SPI) and communication with the outside is with Universal Asynchronous Receiver Transmitter (UART). In experiments we evaluate communication based on software (polling) and hardware (interrupt) as well as overhead in terms of transported data and needed area.

Previously, IMEC proposed the i(2)-module concept which allows to process silicon heterojunction interdigitated back-contact (SHJ-IBC) cells on thin ( < 50 mu m) Si wafers at module level. This concept includes the bonding of the thin wafer early on to the module cover glass, which delivers mechanical support to the wafer and thus significantly improves the production yield. In this work, we test silicone and ethylene vinyl acetate bonding agents and prove them to be resistant to all rear side processes, including wet and plasma processes. Moreover, a lift-off process using a sacrificial SiOx layer has been developed for emitter patterning to replace conventional lithography. The optimized process steps are demonstrated by the fabrication of SHJ-IBC cells on 6-inch 190 mu m-thick wafers. Efficiencies up to 22.6% have been achieved on reference freestanding wafers. Excellent V-oc of 734 my and J(sc) of 40.8 mA/cm(2) lead to an efficiency of 21.7% on silicone-bonded cells, where the high V-oc indicates the process compatibility of the bonding agent. The developments that enabled such achievements and the key factors that limit the device performance are discussed in this paper. The authors would like to thank the financial support of imec's industrial affiliation program for Si-PV. This work was also partially funded by Kuwait Foundation for the Advancement of Sciences under project code: P115-15EE-01. The research has received funding from the European Union's Seventh Programme for research, technological development and demonstration under grant agreements no. 609788 (Cheetah), and also funding from the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 657270. The authors gratefully acknowledge Joachim John for the spectral response measurements and Yiming Yang for the SEM measurements.

This paper provides an idea of modeling a Photovoltaic (PV) system, which is to be used as a primary energy source for an electric vehicle. A basic PV array fails to provide the power ratings needed to run a vehicle. Such high power applications require a step-up DC converter to not only boost its output voltage but also deal with the high current and voltage ratings, which the interleaved boost converter satisfies. The proposed model increases the efficiency of PV arrays. The model is simulated using MATLAB-Simulink.

Backgrounds/Aims Lymph node (LN) metastasis though, is a poor prognostic factor for ampullary carcinoma (APC), the impact of Lymph node ratio (LNR) and Logarithm odds of positive lymph node (LODDS) in the long-term survival remains controversial. We evaluated the factors affecting the long-term outcome in APC patients with emphasis on LNR and LODDS. Methods The prospectively collected data of 198 patients who underwent pancreatoduodenectomy for APC was analyzed after excluding 12 patients for various reasons. Factors affecting Disease specific survival (DSS) and Recurrence free survival (RFS) were analyzed with special reference to LN positivity, LNR and LODDS. Results Out of 186, 117 (62.9%) patients were alive at a median follow-up of 39.5 months and 72 (38.7%) developed recurrence. The overall 5-year DSS was 59.3% & RFS 54.9%. Univariate analysis showed T-stage, tumor differentiation, perineural invasion, LN positivity, LNR and LODDS was significantly affected DSS and RFS. On multivariate analysis, perineural invasion, LN positivity, LNR and LODDS lost its significance for DSS and RFS. AUC for prediction of DSS and RFS for LNR was 0.654 (p

Background: Bruxism is the commonest of the many parafunctional activities of the masticatory system. Opinions on the causes of bruxism were numerous and widely varying. It can occur during sleep as well as wakefulness. Bruxism was for long considered a major cause of tooth wear. Other effects of bruxism may include tooth movement and tooth mobility, as well as changes in oral soft tissues and jaw bone. Since the exact etiology and manifestations are unclear, it was difficult to diagnose Bruxism. In this study, we evaluated the area change as measured from digital panoramic radiographs that can occur in the lower jaw bone in those with Bruxism and compared the results with non-bruxers. Aims and Objective: To determine the surface area changes of the mandible, condylar and coronoid processes in Bruxers from Panoramic radiographs and to compare and contrast the changes with age and gender matched controls. Materials and Methods: The study was conducted in the department of Oral Medicine and Radiology. The total sample size was 40. The sample was divided into two groups, Bruxers and non-bruxers with 20 subjects in each group. Healthy volunteers aged between 20- 30 years diagnosed with Bruxism and Healthy volunteers aged between 20- 30 years diagnosed without Bruxism were included in group II (Non-Bruxers). Bruxchecker was made use of in confirming the Bruxism in Group I. The Panoramic radiograph was used as the imaging modality for the study. The measurements were made with the help of software, Image J. All the measurements were tabulated and statistical analysis was made using ANOVA (Post hoc) followed by Dunnett’s test and unpaired t test. Results: A comparison of the mandibular surface area as a whole and also condylar and coronoid processes individually were carried out. Significant results were obtained in case of condylar and coronoid processes between the two groups. The surface area of condylar process of Group I was found to be lower than that of Group II. The surface area of the right coronoid process of group I was found to be less when compared to that of group II but the values of the left coronoid process of group I was found to be more when compared with group II. The surface area of the mandible showed no significant difference between the groups. There was significant difference between the genders in case of mandible, condyle and coronoid. The surface area of mandible and condylar process was found to be lower in female when compared to male. The surface area of coronoid process was found to be more in case of females when compared to that of males in Group I. The results of our study show that while the overall surface area of bruxers remain unaffected when compared to controls, the condylar and coronoid process show significant change. The hitherto belief that the primary brunt of bruxism is borne by the masseter would require a revisit since alteration in tonicity of the masseter would reflect in surface area change of the mandible as a whole. An increase in the surface area of the coronoid process in bruxers was observed in our study which could be attributed to altered activity of the temporalis, a muscle largely responsible for the posture of the mandible. This could imply that bruxers show alteration in temporalis activity which would explain several clinical manifestations such as headache, neck pain, shoulder pain and altered posture and so on which we have observed in the clinical practice of neuromuscular dentistry. Further studies examining the activity of the temporalis and masseter would further corroborate our findings and form the basis for future research in this arena. Conclusion: This original research was carried out to assess the surface area changes in mandible and condylar and coronoid processes of Bruxers and non-bruxers. The results showed significant changes in the surface area of condylar and coronoid process in Bruxers when compared to the controls. This is an area of study with paucity of available literature. This study would be a stepping stone for future studies in this arena.

Pulses are an important commodity group of crops that provide high quality protein complementing cereal proteins for pre-dominantly substantial vegetarian population of the country. In India, pulses can be produced with a minimum use of resources and hence, it becomes less costly even than animal protein. Although this crop group is more important from the nutritional point of view, there has not been any significant development both in area and production during the last 50 years. In recent years, commercial and major millets are replacing the area under pulses and has led to several issues requiring attention of all the concerned. The study is based on time-series data for 60 years (1950-51 to 2009-10) on area, production and productivity of pulses in India. Exponential growth rate, instability index and Hazel’s decomposition analysis was used and it was found that, the growth rate of area under pulses during the study period was non-significant, while production growth rate was just 0.59. The variation around the trend (instability index 10.56) and the variation around mean (CV 14.45 %) was more in case of production. Increase in mean yield accounted for 99 per cent of the increase in production. Variance in production of pulses was mainly due to residual factors.

In this paper, single- image super-resolution framework is presented by means of sparse representation. Patch-based super resolution is a technique where spatial features from a low-resolution (LR) patches are used as references for the reconstruction of high-resolution (HR) image patches. Sparse representation for each patch is extracted and these coefficients are used to recover super-resolution patch. Two dictionaries are jointly trained for the LR and HR image patches. By this, similarity between sparse representation between the LR and HR patch pair is established. Hence, the sparse representation of a LR image patch can be applied with the HR image patch dictionary to obtain a HR image patch. The dictionary thus learnt is a compact one. The experimental results demonstrate the effectiveness of the proposed algorithm.

Background Alpha-methylacetoacetic aciduria, an autosomal recessive disorder of isoleucine and ketone body metabolism, is caused by a mutation in the acetyl coenzyme A acetyltransferase-1 gene (ACAT1; 607809) on chromosome 11q22. Ketoacidotic episodes in such patients are triggered by stress situations with increased energy demands. Pregnancy, surgical procedures, and prolonged fasting are potential triggers for metabolic crisis in such cases. Case A young Rh-negative Omani woman with alpha-methylacetoacetic aciduria is described here during her second pregnancy. Her metabolic condition was detected at the age of 18 months. She was successfully delivered of a clinically healthy baby through emergency CS for breech presentation. Conclusion Prompt management by a multidisciplinary team is vital to avoid metabolic crisis and to promote a favourable outcome in these cases.

Background While clinical factors such as age, grade, stage, and histological subtype provide physicians with information about patient prognosis, genomic data can further improve these predictions. Previous studies have shown that germline variants in known cancer driver genes are predictive of patient outcome, but no study has systematically analyzed multiple cancers in an unbiased way to identify genetic loci that can improve patient outcome predictions made using clinical factors. Methods We analyzed sequencing data from the over 10,000 cancer patients available through The Cancer Genome Atlas to identify germline variants associated with patient outcome using multivariate Cox regression models. Results We identified 79 prognostic germline variants in individual cancers and 112 prognostic germline variants in groups of cancers. The germline variants identified in individual cancers provide additional predictive power about patient outcomes beyond clinical information currently in use and may therefore augment clinical decisions based on expected tumor aggressiveness. Molecularly, at least 12 of the germline variants are likely associated with patient outcome through perturbation of protein structure and at least five through association with gene expression differences. Almost half of these germline variants are in previously reported tumor suppressors, oncogenes or cancer driver genes with the other half pointing to genomic loci that should be further investigated for their roles in cancers. Conclusions Germline variants are predictive of outcome in cancer patients and specific germline variants can improve patient outcome predictions beyond predictions made using clinical factors alone. The germline variants also implicate new means by which known oncogenes, tumor suppressor genes, and driver genes are perturbed in cancer and suggest roles in cancer for other genes that have not been extensively studied in oncology. Further studies in other cancer cohorts are necessary to confirm that germline variation is associated with outcome in cancer patients as this is a proof-of-principle study.

Objective: This study was designed to evaluate the correlation between vertical dimension at occlusion (VDO) and various grades of temporomandibular disorders (TMDs) versus controls.Methods...

Magnetic Resonance Imaging (MRI) is a medical imaging technique for diagnosing patients suffering from torn ligaments to cancerous tumors. MRI is also very useful for examining the brain and spinal cord related issues. The size of the image decides how many times the Radio Frequency pulse needs to be applied, hence making the MRI scan a time consuming process. There is a growing requirement for reducing the diagnosing time in MRI necessitating investigation to accelerate this non linear optimization problem. Compressed Sensing (CS) aims to reconstruct images from considerably smaller measurements than were thought before. Applying CS to MRI offers potentially significant scan time reductions. A method to MRI reconstruction from under sampled measurements is proposed in this paper. Discrete Wavelet Transform is used to sparsely characterize MRI. CS reconstruction is performed using l 1 norm by applying Basis pursuit primal-dual interior point method. Experimental results reveal that the proposed method reconstructs images with good quality.

Background: We continue to experience an inexorable transition from communicable to chronic non-communicable diseases (NCD), worldwide. This is especially true in India, where it appears that metabolic syndrome (MetS) is increasing in prevalence due to rapid economic growth, change in food intake and physical inactivity have lead to increase in MetS. However access to health service is poor in India and proper assessment for metabolic disease is often lacking. Accredited Social Health Activists(ASHA) are available throughout India for doing house to house assessment and providing health care, a potential solution for identifying people with abnormal metabolic factors. The aim of this study was to conduct capacity building of ASHA workers for screening of metabolic syndrome in rural India and identify people in rural India with features of MetS. Methods: After obtaining approval from institutional ethics committee 300 ASHAs were trained under World Diabetes Foundation fundedproject (WDF15-941) about aspects ofMetS, diabetes mellitus and diabetic foot. Hand holding training activities were held for each ASHA intheir respective area of practice. This was conducted by project staffs. Participants over the ageof 30 years were screened for the presence of MetS. Random blood glucose (RBS), blood pressure, body mass index (BMI) and waist circumference were measured. Results: A total of 38,346 people were screened for the presence of metabolic syndrome,of which13,911(36.3%) were found to have MetS of which 4200(35.9%) were male and 9,711(37.2%) were female. Those with type 2 diabetes mellitus(T2DM) 1,555(36.7%) also had MetS. Among 3 diagnostic criteria, waist circumference was the highest with 34.1%. Individual with impaired random glucose levels have 1.5 times more risk of developing metabolic syndrome adjusted for age and gender. Conclusion: In conclusion, MetS was present in 36.3% participants residing in rural part of Indiai.e one third of the population. Amongst people with T2DM 36.7% had MetS. The result suggest better screening and early identification of these people will help in proper treatment which might reduce the risk of cardiovascular diseases. Funding: The field screening was conducted as a part of ongoing project funded by World Diabetes Foundation WDF 15-941 “Diabetic Foot care: Stepping Ahead”. Declaration of Interest: The author(s) declare no potential conflict of interest with respect to the research, authorship, and/or publication of this article. Ethical Approval: The study was initiated after obtaining the approval from institutional research committee and institutional ethics committee (IEC 700/2015).

Handling huge amount of data from different sources more so in the images is the latest challenge. One of the solutions to this is sparse representation. The idea of sparsity has been receiving much attention recently from many researchers in the areas such as satellite image processing, signal processing, medical image processing, microscopy image processing, pattern recognition, neuroscience, seismic imaging, etc. Many algorithms have been developed for various areas of sparse representation. The main objective of this paper is to provide a comprehensive study and highlight the challenges in the area of sparse representation which will be helpful for researchers. Also, the current challenges and opportunities of applying sparsity to image reconstruction, namely, image super-resolution, image denoising and image restoration are discussed. This survey on sparse representation categorizes the existing methods into three groups: dictionary learning approach, greedy strategy approximation approach and deep learning approach.

In order to reduce the material cost for silicon solar cells, several research groups are investigating methods to minimize the silicon consumption for making monocrystalline silicon wafers. One promising approach is deposition of an epitaxial layer on porous silicon, followed by detachment of the layer. This contribution discusses improvements in the epitaxial wafer fabrication by optimization of the porosification process. The introduction of a layered porous silicon structure allows to independently improve both epitaxial layer quality and detachment yield. In this way, we have managed to obtain 100µm thick silicon wafers with effective lifetimes up to 1.3ms, and 40µm thick wafers with effective lifetimes up to 700µs. We will also review the current status of the process development for solar cells made on thin wafers. Two approaches are presented. In the first approach, heterojunction solar cells are fabricated on freestanding epitaxial wafers of 40µm thickness. In the second approach, high efficiency (21%) heterojunction back-contacted cells are fabricated on wafers that are bonded to a glass superstrate. Challenges for device processing and limitations in cell performance are discussed.

Aim and Objective: The aim and objective is to evaluate the level of awareness and attitude about radiation hazards and safety practices among general dental practitioners in Trivandrum District, Kerala, India. Materials and Methods: A questionnaire-based cross-sectional study was conducted among 300 general dental practitioners in Trivandrum District, Kerala, India. Postanswering the questions, a handout regarding radiation safety and related preventive measures was distributed to encourage radiation understanding and protection. Statistical Analysis: Statistical analysis were done by assessing the results using Chi-square statistical test, t -test, and other software (Microsoft excel + SPSS 20.0 trail version). Results: Among 300 general practitioners (247 females and 53 males), 80.3% of the practitioners were found to have a separate section for radiographic examination in their clinics. Intraoral radiographic machines were found to be the most commonly (63.3%) used radiographic equipment while osteoprotegerin was the least (2%). Regarding the practitioner's safety measures, only 11.7% of them were following all the necessary steps while 6.7% clinicians were not using any safety measure in their clinic, and with respect to patient safety, only 9.7% of practitioners were following the protocol. Conclusion: The level of awareness of practitioners regarding radiation hazards and safety was found to be acceptable. However, implementation of their knowledge with respect to patient and personnel safety was found wanting. Insisting that they follow the protocols and take necessary safety measures by means of continuing medical education programs, pamphlets, articles, and workshops is strongly recommended.

Background: oral cancer is a result of disordered cellular behavior initiated by various stimuli which is characterized by the alteration of serum glycoproteins consisting of different monosaccharides. One of these is levo-fucose (L-fucose), a methyl pentose. Elevated levels of protein-bound fucose have been reported in various malignancies. Aim: The present study attempted to correlate levels of serum L-fucose as a biomarker with the various tumor node metastasis (TNM) stages of oral cancer. Methodology: The study was carried out on 90 subjects consisting of 30 healthy controls and 60 histopathologically proven oral squamous cell carcinoma (OSCC) cases. The serum fucose level estimation was done based on the method adopted by Winzler. Statistical analysis included independent sample's t -test, one-way ANOVA test, Karl–Pearson correlation test, and Tukey's HSD post hoc test to evaluate the significance and variability of values between groups. Results: Significant elevation in serum fucose levels was noticed among OSCC patients when compared with the controls and a progressive ascent of L-fucose levels were noted as the stage of severity increased. Serum fucose levels were independent of histopathological grading, age, and sex. Conclusion: Serum L-fucose levels were increased in OSCC patients, and a positive correlation was observed between serum L-fucose levels and TNM staging of OSCC. Thus, serum L-fucose can be used as an effective diagnostic and prognostic biomarker in OSCC patients.

Articular eminence fractures are a rarity in practice and documented cases of articular eminence fractures are far and few and range around 3 to 4, and are due to trauma. To the best of our knowledge, this is the first case of self-inflicted articular eminence fracture documented to date. A high degree of clinical acuity, suspicion, and cutting edge imaging techniques are required to identify and diagnose fractures of the articular eminence. In this case report, we report a case presenting with unexplained facial pain and diagnosed using cone-beam volumetric imaging as fracture of the articular eminence. We attempt to highlight cone-beam volumetric imaging as a diagnostic tool with considerable benefits in the identification and diagnosis of sublime pathologies of the maxillofacial region.

Background: Potential transmission of disease to personnel during dental procedures has become a source of increasing concern to the dental profession. Certain dental procedures may potentially contribute to the transmission of infections in the dental operatory. Hence, it would be worthwhile to analyze the microbiology of the mouth mask used by dental personnel to minimize cross infection and to improve patient and clinician safety. Aims and Objectives: The aim of the study was to identify, evaluate, and categorize the microorganisms colonizing the mouth mask used by general dental practitioners. Materials and Methods: The swabs for the study were taken from the triple layered mouth masks used by general dental practitioners after 30 min of routine dental procedure. The microbial contamination was studied by observing and recording the colony morphology on the culture plates, Gram’s-staining with light microscopic screening of the slides, and the biochemical characterization of the isolates using standard microbiology protocols. Results: Microbiological analysis of swabs taken from the mouth mask of general dental practitioners showed that all the mouth masks had bacterial contamination of which Gram-positive Streptococci species and Gram-negative Pseudomonas species are predominant. Conclusion: Our study revealed that there is increased concentration of both Grampositive (especially Streptococci, Staphylococci species) and Gram-negative organisms (Pseudomonas, Klebsiella species) on the surgical masks used by dentists which are potentially pathogenic. To reduce a load of bacterial contamination in the clinical environment, measures to improve air quality in the dental operatory should be undertaken.

From the time of its introduction in the 1040s, glucocorticoids have provided a panacea for many diseases. The therapeutic benefit of corticosteroids lies in their anti-inflammatory and immunosuppressive properties which makes them highly effective in the management of oral mucosal lesions. This article aims to present to the clinician, the plethora of options available as steroid therapy and enables one to choose based on the underlying disease and the properties of the drug.

Agricultural productions particularly raw material helped in the growth of industry during the medieval period. The industrial organization was of two types. One was the artisan system and the other one was the karkhana system. In the artisan system an independent artisan supplied his own capital on a small scale level and prevailed in the towns only. In the State karkhanas, the materials were supplied by the state and mostly established in the big cities e.g. Delhi, Agra etc. Infect karkhanas worked on the lines of large scale industries in which the workshop, the raw materials, the tools, and the implements were provided by the state and they produced commodities according to the taste of the owner. The needs of the state were very large. The state maintained karkhanas were set up not only in the capital but also in the provincial headquarters. On the contrary, their existence depended on the choice and taste of the emperor and the state requirements. However, they produced some fine commercial commodities by employed labour even in the declining phase. The use of agricultural labour was widespread and it was practically forced labour. Different types of industry were situated here e.g. luxury goods, war auxiliaries, metal industry, textile (cotton, wool and silk), sugar, ghee, etc. There were small scale industries also in every corner of the region to cater the local demands. Textile industry was the most important industry. The cotton industry helped the Mughals to acquire an eminent and advanced position in the market of the contemporary world. Samana and Sunam were famous for the cotton textile industry. The native process of weaving was slow and the weavers were very poor. But the peculiar feature of various industries was that the industrial skill and profession passed on from father to son. All the clothes were manufactured on handloom. The cotton textiles were produced probably everywhere both for local consumption and distant markets. The most important subsidiary industry, however, was that of dye and printing due to rich production of indigo. Sugar industry was exclusively owned by the local people and produced the best quality of refined sugar. Ghee, produced in Hisar-Firoza was sent to Delhi for the royal kitchen. The small, indigenous and popular industries were the handicrafts. The weaver, the spinner, the shoe maker, the carpenter, the smith and the blacksmith, the potter and the worker in brass and copper were seen in every village and town. Metal resources were sufficient for the metal industry. The village pottery was as old as the country itself. Earthen wares were often used than that of brass ware. Ironmongery was limited by the high cost of the metal. Leather was not a prominent industry because shoes were less commonly worn than at present times. It was rather surprising that the cotton and the silk weaving as well as the other industries became wide-spread in every household and was persuaded during the vacations from the agricultural pursuit. Growth of industry led to the growth of trade and trading centers.

Social history of a region generally endeavors to present the varied aspects of daily life of the inhabitants of villages, towns and cities in the medieval period. The dwelling houses were congregated together usually at a central site, with the land of the cultivators spreading around. The roofs of the houses were flat. The house of the poorer classes had a small courtyard and one room or two. The most common plan of the house of the well to do classes was that the courtyard was surrounded by a wall. The entrance served as a temporary cattle-shed and the men of the family frequented it to smoke and gossip. Usually, there was a detached sitting room, variously called diwan-khana or baithak. Female apartments were separate. The rooms were dark, damp and badly ventilated. The houses were of bricks and in lanes near to each other for the sake of shade. The sanitary condition was not proper but the inside of the houses were kept very clean. In the houses of the common people very little furniture was kept in the rooms. For lighting in the houses of the nobles and the rich men, other appliances and devices were in vogue. Ordinarily, the earthen pots (diya) filled with mustard oil with cotton wicks were used for light. The people of Haryana in general were vegetarian but in common high class people and the Muslims were non-vegetarian and used to drinking. Rrice, millet and pulses, milk and milk products were chiefly consumed in general in the rural areas. Khicheri was relished both by the gentry and commonalty. In the matter of diet, the Muslims were notoriously extravagant and fastidious. However, the diet of the peasants was much cheaper and they used pulses and vegetables. The imported fruits dry and fresh were costly and were used only by the rich. Common people used to eat seasonal fruits which grew wild in the jungles and were easily available and gathered for sustenance by the poor. Ice fetched a high price and used by the rich people. Indian dress varied from place to place and clan to clan and according to their social status and financial conditions. Indian dresses were chiefly determined by the geographical factors, climatic conditions and the changing needs and customs of the different areas. Clothes were generally woven by the village weavers with yarn spun by the peasant women folk. These garments except turban were made of ‘khaddar’, the rough cotton. The upper classes spent lavishly on their dresses and used silk, brocade and fine muslin according to their social status and financial conditions. Children used to remain naked till four to five years age. The peasants and the poorer classes tried their best to cut their dress requirements to the minimum. The love of ornaments was inherent in the human races. The love of jewellery was not confined to the people of any religion, sect or class. Various kinds of ornaments of gold and silver were worn according to their financial and social position. The Hindu women, except widows, were generally loaded with as much jewellery as their husbands could afford. Beside ornaments, the women decorated themselves by various kinds of ‘tawizees’ (amulets).

LTE operation in unlicensed spectrum is considered as a promising solution to meet the increase in user data demand. Licensed Assisted Access (LAA), and duty cycled LTE-U are two options for LTE to operate in the unlicensed band for fair sharing of unlicensed spectrum with IEEE 802.11 (Wi-Fi). Due to restriction on the transmission power in the unlicensed band, LAA/LTE-U Base Stations (BSs) will get deployed mostly inside residential and office buildings to provide high data rates for indoor User Equipments (UEs). In an indoor scenario, walls and other obstacles in the communication path along with co-tier and cross-tier interferences decrease the Signal-to-Interference plus Noise Ratio (SINR) significantly which results in throughput decrease. Hence, an optimal placement of LAA BSs is essential. As the available bandwidth in the unlicensed spectrum is more compared to the licensed spectrum, an efficient resource allocation is also necessary for ensuring minimum throughput for the indoor UEs. In this paper, our goal is to find the optimal number of LAA/LTE-U BSs with minimum throughput guarantee inside the building using licensed and unlicensed bands. To do this, we formulate an optimization model (MinLAA) for LAA BSs placement which is Mixed Integer Non-Linear Programming (MINLP) problem. So, we propose a heuristic algorithm to find the minimum number of LAA/LTE-U BSs such that all the users inside the building get minimum guaranteed throughput.

Diagnosis is the first step before giving a medicine to the patient. In the recent past such diagnosis is performed using medical images where segmentation is the prime part in the medical image retrieval which improves the feature set that is collected from the segmented image. In this paper, it is proposed to segment the medical image a semi decision algorithm that can segment only the tumor part from the CT image. Further texture based techniques are used to extract the feature vector from the segmented region of interest. Medical images under test are classified using decision tree classifier. Results show better performance in terms of accuracy when compared to the conventional methods.

Objective To present a novel miniature endoscopic system designed to improve the safety and efficacy of percutaneous nephrolithotomy, named the ‘super-mini percutaneous nephrolithotomy’ (SMP). Patients and Methods The endoscopic system consists of a 7-F nephroscope with enhanced irrigation and a modified 10–14 F access sheath with a suction-evacuation function. This system was tested in patients with renal stones of

Simple bone cyst is an oft-described entity, which goes by many sobriquets and has been presented in the literature as early as 1926. It is a lesion of unclear etiology with many proposed hypothesis for its pathogenesis and nonspecific histopathological presentation. We present a case of a solitary bone cyst, which clinically presented as a solitary lesion, but radiological examination revealed multiple lesions peppering the maxilla and the mandible, thereby highlighting the importance of atypical presentation and "surprise" lesions that may show up on radiological examination.

The conch shell as a music tool with its innumerable uses has occupied a singular place in almost all ancient traditions and cultures across the globe. It could be considered as the sole musical instrument designed by Nature herself into a fascinating piece of art. However, studies aimed at understanding the acoustical attributes of a conch shell received very less attention in modern times. None of the previous studies on conch shell aimed at looking into a few aspects for which it is usually adored and considered sacred. In general, the sound radiated from a conch shell is believed to hold a healing aspect, and that is the underlying reason why different cultures used it during ritual practices, special ceremonies and at acoustically designed sacred sites. The present concept seminates from the observation that we have an additional ultrasonic component in the sound spectrum of a conch shell along with other harmonic frequencies. Since the low-range ultrasonic frequencies are known for their beneficial and healing effects, it’s obvious to relate them to such component existing in the conch shell spectrum. In this respect, the present note serves as a starting step in analyzing the fundamental grounds for its healing aspect.

BACKGROUND: Voluntary donors normally tolerate blood donation very well as the history and preliminary examination is clear without any hidden history or facts related to the health status of the donor, occasionally, adverse reactions of variable severity may occur during or at the end of the collection. AIM: Aim of this study is to estimate and possibly avoid the cause of unwanted reactions. MATERIALS AND METHODS: This study is conducted over a period of three years, from January 2011 to December 2013. The donor population consisted of 43492 donors (37724 male and 5768 female). The minimum age is 18 years and the maximum age for donation considered in this study was 58 years. RESULTS: Overall a total of 408 adverse reaction events were reported in relation to the total of 43492 donations for an overall adverse reaction rate of 0.93 % and an incidence of 1 every 107 donations. Of the 408 adverse reactions to blood donations 328 were observed in males while 80 were observed in females. Based on the type of blood donor reaction 231 males and 65 females reported giddiness. 52 males and 16 females reported nausea, 19 males and 7 females had an episode of vomiting, 24 males and 8 females reported cramps, one male reported of chills and one male reported anxiety. CONCLUSIONS: Although the number of donors who developed disturbances during or at the end of blood donation was very low and was mostly mild type which resolved rapidly, it is nevertheless desirable to reduce risks to a minimum by following a set of