Search

Abstract In river research, forecasting flow velocity accurately in vegetated channels is a significant challenge. The forecasting performance of various independent and hybrid machine learning (ML) models are thus quantified for the first time in this work. Utilizing flow velocity measurements in both natural and laboratory flume experiments, we assess the efficacy of four distinct standalone machine learning techniques—Kstar, M5P, reduced error pruning tree (REPT) and random forest (RF) models. In addition, we also test for eight types of hybrid ML algorithms trained with an Additive Regression (AR) and Bagging (BA) (AR-Kstar, AR-M5P, AR-REPT, AR-RF, BA-Kstar, BA-M5P, BA-REPT and BA-RF). Findings from a comparison of their predictive capabilities, along with a sensitivity analysis of the influencing factors, indicated: (1) Vegetation height emerged as the most sensitive parameter for determining the flow velocity; (2) all ML models displayed outperforming empirical equations; (3) nearly all ML algorithms worked optimal when the model was built using all of the input parameters. Overall, the findings showed that hybrid ML algorithms outperform regular ML algorithms and empirical equations at forecasting flow velocity. AR-M5P (R2 = 0.954, R = 0.977, NSE = 0.954, MAE = 0.042, MSE = 0.003, and PBias = 1.466) turned out to be the optimal model for forecasting of flow velocity in vegetated-rivers.

Abstract The purpose of this work is to analyze the impact of reinforced Al2O3–LM6 aluminum composite made with dual mixed slurry for semi-solid casting with stirring, which is documented according to microstructure and wear properties. Under dry sliding pin-on-disk conditions, the composition and surface morphology of worn surfaces were carefully examined for the 10 N applied force, 1.2 m/s sliding speed, and sliding distances up to 750 m. Experimental findings indicate that Al2O3 reinforcement with semi-solid dual slurry effects give outstanding resistance against the adhesive wear. Microstructure, EDS, and XRD results from worn surface evaluation all show evidence of protective layers, which helps explain the reason for the rate of wear decreased due to processing. In this experiment, LM6 serves as the matrix material and Al2O3 as reinforcement. Al2O3–LM6 semi-solid cast composite was created via a dual mixed slurry technique with temperature control close to the solidus line for varying compositions. This work reports a substantial relationship between metallurgical and mechanical parameters. Mechanical properties and wear characteristics have been investigated.

Network intrusion detection systems (NIDS) are essential to mitigate the increasing cyber security risks since they protect computer networks from a wide range of attacks. Class imbalances in the datasets frequently impede the effectiveness of these systems, leading to incorrect classification of minority classes. In addition, improper feature selection may lead to a degradation of results and higher computing time. This research combines the Jaya optimization technique with the Synthetic Minority Oversampling Technique—Edited Nearest Neighbors (SMOTE-ENN) method to address the problems of feature dimensionality and class imbalance, offering an efficient approach to identifying network intrusions. The Jaya optimization algorithm selects the most suitable features after the preprocessing stage. We test the proposed method on two widely used IDS datasets, namely UNSW-NB15 and NSL-KDD. We perform the classification task using five machine-learning approaches: decision trees (DT), random forests (RF), bagging, J48, and extra-tree classifiers for a comprehensive analysis. The Extra Tree Classifier emerged as the best performer, achieving exceptional accuracy values of 99.94% and 99.13% for NSL-KDD and UNSW-NB15, respectively. In both datasets, our proposed model outperforms the existing solutions proposed in the literature. The proposed methodology effectively addresses the problems of feature dimensionality and class imbalance, offering an efficient approach to identifying network intrusions.

Introduction: Gastrointestinal neuropathies are frequently found in diabetic patients. The pathogenesis of diabetic gastroparesis (DG) is multifactorial. The usual treatment for DG includes dietary modifications, prokinetic and antiemetic agents. There is increasing demand for more effective medicines to treat DG. The current study was conducted on the Pistacia lentiscus stem extract to add to the armamentarium of DG treatment and to find the efficacy of P. lentiscus plant extract (mastic gum) in comparison to levosulpiride in DG for improvement in gastroparesis symptoms and gastric emptying scintigraphy (GES) in a single centric double-blind non-inferiority randomised control trial. Methods: Thirty-eight individuals were recruited and equally randomised into two study groups based on Gastroparesis Cardinal Symptom Index (GCSI) score and TC99 Radionuclide GES, mastic gum group and levosulpiride group. Both pre and post-intervention (8 weeks) GCSI scores were calculated, GES was performed to quantify the improvement in gastric emptying. Power analysis was performed using G*POWER software version 3.1.9.7 and data analysis using SPSS 23.0, variables measured in mean ± standard deviation (SD). Various statistical tests were used such as independent t-test, Chi-square test or Fisher's exact test, Wilcox Mann–Whitney test, analysis of variance (ANOVA) test, and posthoc pairwise tests. Results: The mastic gum is found effective in the improvement of 4 h gastric emptying percentage from the mean (SD) 76.60 (± 9.96) to mean (SD) 97.20 (2.17)% (P < 0.001). Mastic gum has the property of HbA1c reduction, which is more significant than that of levosulpiride (P = 0.044). Mastic gum also had significant Low density lipoprotein (LDL) (mg/dL) levels reduction, (P < 0.001), compared to levosupiride. An absolute increase was observed in haemoglobin (HB) level in mastic gum at a 2-month mean (SD) of 1.03 (0.77) (g/dL) (P-value

Sediment deposition has a substantial effect on the hydraulic capacity of channels in urban drainage and sewer systems. In this sense, the self-cleaning concept has been extensively used in the construction of urban drainage and sewer systems. In this regard, the design of the sewer system heavily depends on the accurate forecasting of the particle Froude number (Fr). This study is conducted on experimental data sets collected from existing studies, including a wide range of dimensionless grain size of particles (Dgr), sediment median size (d), hydraulic radius (R), volumetric sediment concentration (Cv), and pipe friction factor (λ) for the condition of clear bed. We forecasted the particle Froude number using four different input combinations. We employed the Random Tree (RT) and Reduced Error Pruning Tree (REPT) methods as standalone methods, as well as Random Committee (RC) and Bagging (BA) methods as hybrid machine learning (ML) methods in particle Froude number forecasting. Hybrid machine learning methods demonstrate enhanced performance compared to both standalone machine learning methods and empirical equations. In the context of sewer system design under non-deposited bed conditions, there is a need to accurately forecast the particle Froude number, RC-RT (IA = 0.96, R = 0.928, MSE = 0.718, RRMSE = 0.197, NSE = 0.86, and PBias = −0.284) performed the best, followed by BA-RT, RC-REPT, BA-REPT, RT, and REPT. In our research, it was found that, in forecasting the particle Froude number under non-deposited bed conditions, Cv emerges as the most responsive input parameter among others.

In order to comprehend potential changes in the hydrodynamics of flow under downward seepage condition when water is extracted from a threshold alluvial channel, investigations in a laboratory flume were carried out. Experiments in the present study, were organized in two categories: in absence of downward seepage and in presence of downward seepage. Increased in transport of bed-material in the channel was observed on introduction of downward seepage. Instantaneous velocity samples were collected employing an acoustic Doppler velocimeter (ADV) to calculate various length scales of turbulent motions such as: integral length scale, Taylor microscale, and Kolmogorov's microscale. An increase in the values of these length scales has been observed under the influence of downward seepage. Three sub-ranges in the velocity power spectra both for seepage and no-seepage situations are confirmed by the results of the spectral analysis in the channel near-bed area. Toward the channel bed, spectral densities were found increasing for both types of experiments. At every measurement location, velocity power spectra of the seepage experiment shifted toward higher spectral densities and higher frequencies than the power spectra of the no-seepage experiment. Moreover, the power spectra of seepage experiment were found flatter than that of the no-seepage experiment. This flatness in the velocity power spectra indicates an increased bed roughness when a threshold alluvial channel is subjected to downward seepage.

Background: In general, the risks associated with transcatheter atrial septal defect (ASD) device closure are reported to be relatively low, but the evidence stems from trials involving adults and older children. Current guidelines do not recommend ASD device closure in children with defect sizes >20 mm due to limited data available in this group of patients. This retrospective study sought to determine the clinical and procedural characteristics of successful transcatheter ASD device closure in small children with large defects and assess the complication rates and reasons for unsuccessful device closure. Methods: We retrospectively reviewed the data of all patients who underwent elective transcatheter closure of ostium secundum ASD in our department between September 2013 and February 2022. All children weighing

Fossil fuel power plants play a significant role in fulfilling global energy demands but are also responsible for high CO2 emissions. Amine-based post-combustion CO2 capture (PCC) is one of the technologies used in such power plants to reduce CO2 emissions. However, high energy consumption in amine-based PCC technology causes a reduction in the overall energy efficiency of power plants. The energy consumption significantly depends on the solvents used in the PCC process. Therefore, in this work, we performed CO2 absorption in the piperazine (PZ), triethylenetetramine (TETA), and N-methyldiethanolamine (MDEA) blend and tri-blend solvents. For the absorption performance and energy consumption calculation, a simulation is performed for the 430 MW power plant data in the DWSIM software. Initially, solvent screening was done, and four solvents are selected based on the optimum energy consumption of various solvents. Further, the solvents’ performance in terms of energy consumption is done based on the effect of different temperatures, CO2 composition in feed, and %CO2 recovery. Overall, the TETA+PZ MDEA tri-blend solvent showed optimum energy consumption for most of the conditions. Additionally, a techno-economy assessment was done considering annual capital cost and annual operating cost, and results revealed that the cost per ton of CO2 capture in 5 %TETA+ 5 %PZ+ 20 %MDEA solvent is 27.33 % lesser than industrial MEA solvent, and 1.56 % lower than 10 %PZ+ 20 %MDEA.

Key Clinical Message Crigler–Najjar syndrome type 2 should be suspected in any young patient presenting with isolated indirect hyperbilirubinemia where all other common etiologies have been excluded. It is a relatively benign condition that responds to phenobarbitone. Abstract Crigler–Najjar syndrome (CNS) type 2 is an inborn cause of isolated indirect hyperbilirubinemia characterized by a partial deficiency of the enzyme uridine 5′‐diphosphate‐glucuronosyltransferase (UGT) responsible for bilirubin conjugation. Typically, this condition is diagnosed based on clinical manifestations, supplemented by enzyme analysis if feasible, and exhibits a significant response to phenobarbitone, known for its enzyme‐inducing properties. In this case, we present a young male patient who had experienced recurrent isolated indirect hyperbilirubinemia since early childhood, with negative results in the hemolytic workup. The patient exhibited a UGT1A1 gene defect and demonstrated a highly favorable response to phenobarbitone treatment. The purpose of this report is to raise awareness among physicians about this benign condition and underscore the importance of avoiding unnecessary investigations.

Pheochromocytoma is a rare neuroendocrine tumor presenting with a classical triad of symptoms. In 10% of the cases, the presentation can be atypical, and the diagnosis is often missed for several years. Most common neurological manifestations are haemorrhage, seizures, etc., but pheochromocytoma crisis presenting as delirium has been infrequently reported. We present a case of a middle-aged female who presented with hypertensive emergency and an acute confusional state. Other causes of delirium were ruled out in the patient and a timely diagnosis of pheochromocytoma was made with CT abdomen showed a large right suprarenal mass which was confirmed on 123I-MIBG scan and supported by elevated plasma metanephrines. She responded to alpha and beta blockers following which her blood pressure spikes were controlled, and subsequently, her sensorium improved significantly. Patient underwent surgical resection of the tumor and was followed up after 2 weeks with her blood pressure controlled without any medications. Conclusion: A high degree of clinical suspicion is essential in such rare presentations of pheochromocytoma. Early diagnosis, adequate preoperative preoperative stabilization followed by a definitive surgical excision offers a complete cure to such patients.

Background: Natural history and disease progression in patients with Idiopathic Parkinson's Disease (PD) is quite heterogeneous. Autonomic dysfunction occurs commonly among Idiopathic PD patients. Heart rate variability and ambulatory blood pressure monitoring are used to assess cardiac autonomic dysfunction. The prevalence and magnitude of supine hypertension in Indian PD patients has not been studied to date. The present study aimed to record cardiovascular autonomic functions and supine hypertension in PD patients and to correlate them with the age of onset, duration and severity of the disease, and non-motor symptom burden. Material and Methods: The cross-sectional study involved 60 PD patients. Webster rating scale was used to determine the disease severity. Non-motor symptom burden was assessed using the Non-Motor Symptom Scale (NMSS). Ambulatory blood pressure monitoring and heart rate variability parameters determined cardiac autonomic function. Supine hypertension was defined as Systolic Blood Pressure (SBP) ≥150 mmHg and/or DBP ≥90 mmHg. Less than 10% decrease or even increase in blood pressure during the night were classified as non-dippers. Pearson coefficient was used appropriately to establish correlation. P ≤ 0.05 was considered significant. Results: Age of onset was 61.2 ± 8.7 years and duration of disease was 1.7 ± 1.1 years. Mean Webster and non-motor symptom scores were 12.7 ± 4.4 and 15.5 ± 8.0, respectively. About 50 patients (83%) were non-dipper, while 32 (53%) had supine hypertension. Low Frequency oscillations (LF) (r = 0.28), High Frequency oscillations (HF) (r = 0.29), Standard Deviation NN intervals (SDNN) (0.26), and Root Mean Squared Successive Differences of NN intervals (RMSSD) (r = 0.28) correlated significantly with non-motor symptoms scale. LF (r = −0.39), HF (r = −0.43), SDNN (−0.40), RMSSD (r = −0.41), NN50 (r = −0.38), PNN50 (r = −0.42), mean SBP (r = 0.26), and mean DBP (r = 0.33) correlated significantly with disease duration. PNN50 (r = −0.255), mean SBP (r = −0.29), and mean DBP (r = −0.27) correlated significantly with age at onset. Conclusion: Awareness regarding neurogenic supine hypertension is needed as it occurs commonly among Indian PD patients. Heart rate variability (HRV) parameters and ambulatory blood pressure are of significant help in the detection of early cardiovascular autonomic dysfunction and correlate significantly with disease duration and non-motor symptom burden among PD patients.

Diabetes mellitus (DM) is a clinical syndrome that is manifested by hyperglycemia. Out of the numerous causes of diabetes, an uncommon cause is chronic pancreatic disease due to destruction of islet cells. Diabetic ketoacidosis is a rare entity in such cases as alpha cells are destroyed along with beta cells, which causes lack of glucagon that is responsible for ketogenesis. We hereby report a case of a 55-year-old woman with history of gall stone disease and who presented to the emergency department with multiple episodes of non-bilious, non-blood mixed vomiting along with increased frequency of micturition on background of malaise and anorexia along with significant weight loss. Her capillary blood glucose was 501 mg/dl, arterial blood gas showed high anion gap metabolic acidosis, and urine ketone were largely positive. Thus, she was diagnosed with diabetic ketoacidosis. She was admitted to the high dependency unit and her condition was treated along the lines of diabetic ketoacidosis. Further evaluation showed high HbA1c values without previous history of diabetes and computed tomography of the abdomen revealed presence of chronic pancreatitis. Though being a rare entity, this case outlines that DM3c can present with diabetic ketoacidosis (DKA); thus, early diagnosis and management are crucial to prevent mortality.

Introduction: Leptin is secreted in concentrations proportional to body fat mass. The anthropometric parameter among Sagittal Abdominal Diameter (SAD), Body Mass Index (BMI), Hip Circumference (HC), Waist Circumference (WC), Waist-Hip Ratio (WHR), and Waist-Height Ratio (WHtR) that correlates maximally with serum leptin levels could be used preferably to assess adiposity. Aim: The present study aims to correlate serum leptin levels with SAD, BMI, HC, WC, WHR and WHtR in young and healthy North Indian adults. Materials and Methods: The present cross-sectional study was conducted jointly in the Department of Physiology and Biochemistry at the King George’s Medical University, Lucknow, Uttar Pradesh, India from September 2015 to August 2016 and it included apparently healthy individuals, aged 18-25 years, native to North India, after obtaining an informed consent. A convenient sample size of 100 was taken. One investigator took all anthropometric measurements. (SAD, BMI, HC, WC, WHR and WHtR) RayBio human leptin ELISA kit was used for the estimation of leptin level. For statistical analysis, Pearson’s correlation coefficient was used. P

Background: Few studies have reported that circadian rhythm affects fat oxidation (FOx) during exercise. Time-of-day causing greater FOx and energy expenditure (EE) during exercise would be beneficial in the prevention of physical inactivity-related health disorders such as metabolic syndrome. The study aims to compare EE and FOx rate after an endurance exercise session done in the morning and late-afternoon hours by apparently healthy young male participants. Material and Methods: The present crossover quasi-experimental study involved 10 moderately active but physically untrained male participants of age 18–25 years with normal body mass index. Participants did a steady-state exercise on a motorized treadmill for 30 minutes at a moderate-intensity (50 ± 2% of their heart rate reserve) on two separate occasions at 9:00–10:00 and 15:00–16:00. A similar meal followed by 2 hours of fasting was done before each trial session. During the last 2 minutes of the exercise session, the respiratory gas analysis estimated volume of oxygen (VO2) and volume of carbon dioxide (VCO2) consumed in L/min. Indirect calorimetry equations assessed FOx (mg/min), EE (Kcal/min) and respiratory exchange ratio (RER). Data of one participant were removed to adjust for extreme chronotype. Paired t-test was applied, and P ≤ 0.05 was considered significant. Results: Morning versus late-afternoon variations in FOx (269 ± 110 vs 290 ± 110, P = 0.016), RER (0.86 ± 0.05 vs 0.85 ± 0.05, P = 0.040), EE (5.454 ± 0.987 vs 5.494 ± 0.959, P = 0.079) and VO2 (1.104 ± 0.201 vs 1.113 ± 0.196, P = 0.035) were present after adjustment for chronotype. Conclusion: In an acute bout of endurance, exercise done by young and healthy male individuals, FOx was significantly higher, while EE tends to be higher in late-afternoon than in the morning.

Neurofibromatosis type 1 (NF1) is a rare Autosomal Dominant (AD) disease manifesting in paediatric age group with an incidence of 1/3500 births. It has a varied clinical presentation most commonly involving skin followed by the skeletal and central nervous systems. Genitourinary involvement is very rare. Peripheral neuroblastic tumours are classified into Neuroblastomas (NB), Ganglioneuroblastomas (GNB) and Ganglioneuromas (GN). They are classified according to their stage of maturation in a spectrum, which starts from NB, the most primitive form, and extends to GN, the most mature form. The authors hereby present a rare case report of a paediatric patient presenting with NF1 features and a bladder ganglioneuroma. The 11-year-old male child presented with a history of haematuria since two weeks accompanied with increased micturation frequency and nocturia. Neurocutaneous markers suggestive of a diagnosis of Neurofibromatosis type 1 were observed during clinical examination. Computed Tomography Intravenous Urogram (CT-IVU) revealed a large irregular pelvic mass involving the wall of the urinary bladder. Enlarged mesenteric lymph nodes were observed during exploratory laparotomy, frozen section bipopsy of which was reported as ganglioneuroma. Partial cystectomy was performed along with complete excision of the mass. Histopathological examination confirmed the diagnosis of bladder ganglioneuroma.

Abstract We present Python Statistical Analysis of Turbulence (P-SAT), a lightweight, Python framework that can automate the process of parsing, filtering, computation of various turbulent statistics, spectra computation for steady flows. P-SAT framework is capable to work with single as well as on batch inputs. The framework quickly filters the raw velocity data using various methods like velocity correlation, signal-to-noise ratio (SNR), and acceleration thresholding method in order to de-spike the velocity signal of steady flows. It is flexible enough to provide default threshold values in methods like correlation, SNR, acceleration thresholding and also provide the end user with an option to provide a user defined value. The framework generates a .csv file at the end of the execution, which contains various turbulent parameters mentioned earlier. The P-SAT framework can handle velocity time series of steady flows as well as unsteady flows. The P-SAT framework is capable to obtain mean velocities from instantaneous velocities of unsteady flows by using Fourier-component based averaging method. Since P-SAT framework is developed using Python, it can be deployed and executed across the widely used operating systems. The GitHub link for the P-SAT framework is: https://github.com/mayank265/flume.git .

Background: Parental history of cardiovascular disease (CVD) and obesity is associated with delayed parasympathetic nervous system reactivation after exercise. Heart rate recovery (HRRe) after a minute of exercise is inversely related to cardiovascular events. Aim: To determine the effect of body mass index (BMI) and parental CVD history on HRRe in apparently healthy young Indian males. Method: The present cross-sectional experimental study involved 100 males, aged18–25 years. Subjects were divided into two equal groups based on the parental CVD history—(i) Parental CVD history present, and (ii) Parental CVD history absent. Each of these groups were further divided into two equal sub groups based on BMI—(a) BMI

Background and Aims: Various methods have been used to check vocal cord movements as a routine before awakening the patient at the end of thyroidectomy to rule out recurrent laryngeal nerve (RLN) palsy; out of which, fibreoptic-assisted visualisation via laryngeal mask airway (LMA) being the most desirable. Methods: Thirty patients of either sex, aged 18-65 years, American Society of Anaesthesiologists (ASA) grade I/II, scheduled for thyroidectomy under general anaesthesia (GA) were included and were randomised to receive either fibreoptic assisted (FB) or LMA CTrach-assisted (CT) visualisation of laryngeal structures at the end of thyroidectomy. The primary outcome was grade of view of laryngeal structures and secondary outcomes were time taken to achieve optimal view of laryngeal structures, ease of visualisation, hemodynamic parameters, and complications. Results: In the fibreoptic group, we obtained comparable optimal laryngeal view i.e., grade 1 and 2 in all (100%) patients in comparison to 14 (93.33%) in LMA CTrach group. The “time taken to achieve the optimal view” was significantly lower in the CTrach group when compared to Fibreoptic group (220.67 ± 95.98 vis-a-vis 136.67 ± 68.98). The ease of visualisation of laryngeal structures was comparable (P = 0.713) and the baseline haemodynamic parameters were comparable between the 2 groups and at various designated intervals. In total, 6.66% and 26.66% patients in group FB and CT group, respectively, required manoeuvres. However, difference was statistically significant (P < 0.05). Conclusion: Both Fibreoptic-assisted and LMA CTrach-assisted visualization of laryngeal structures in thyroidectomy are equally efficacious in terms of the optimal laryngeal view obtained and ease of visualisation. However, the time taken to achieve optimal laryngeal view was lesser with LMA CTrach.

Scrub typhus is a zoonotic infection which is endemic to the tropical regions of South-East Asia including the sub-Himalayan belt of North India. Clinical manifestations of scrub typhus range from self-limiting acute febrile illness to sometimes fatal multiorgan involvement. However, it does not usually involve the central nervous system, if affected meningoencephalitis is the most common presentation. Hereby the authors report a 60-year-old patient of scrub encephalitis who developed acute onset ascending, symmetric flaccid quadriparesis with sensory involvement. Electrophysiological studies and demonstration of antiganglioside antibodies confirmed the diagnosis of AMSAN variant of Guillain-Barré syndrome. The patient was treated successfully with five days of intravenous immunoglobulins. She became ambulatory with complete recovery four weeks after discharge. Guillain-Barré syndrome is a treatable entity and should be evaluated in all cases of scrub typhus having a similar presentation. It can lead to a diagnostic challenge that can often be missed as it is a rare presentation of scrub infection. Therefore, prompt diagnosis and treatment is necessary for better outcomes.

A polarization insensitive, wide angle low profile metamaterial absorber with dual-band absorption characteristics in C- and X-frequency bands is presented in this paper. The parametric variation is discussed in details to understand the dependence of absorption frequency and absorption level on the design parameters. The proposed structure supports the realization of near unity absorption at the two absorption frequencies independently by suitably varying the design parameters. The absorption mechanism is explained with the E-field and surface current distribution plots at the peak absorption frequencies. The absorption is due to the simultaneous excitation of electric and magnetic resonance in the structure. Constitutive electromagnetic parameters of the proposed structure are also retrieved and plotted against frequency. A sample of the proposed absorber is fabricated and measured response validates the numerical results.

Introduction: Various cross-sectional studies indicate that dyslipidemia and increased activity of enzyme Aldose Reductase (ALDR-2) are associated with the establishment of Diabetic Retinopathy (DR). However, it remains unclear that among dyslipidemia and ALDR-2 activity, which is more important for the progression of DR from nonproliferative to the proliferative stage. Aim: The present study was designed to explore the role of dyslipidemia and ALDR-2 activity in the progression of DR. Materials and Methods: Two hundred subjects were involved in this cross-sectional study, 150 subjects had Type 2 diabetes while 50 had No Diabetes and No Retinopathy (NDNR) and acted as controls. On the basis of fundus examination, diabetic subjects were further divided equally into those having: No Retinopathy (DNR), Non-Proliferative DR (NPDR), and Proliferative DR (PDR). Fasting lipid profile, ALDR-2 level, fasting and postprandial blood sugar were measured using a standard protocol. Data were analysed using both descriptive and inferential statistics using unpaired t-test. Results: ALDR-2 level was significantly (p-value=0.0001) higher in NPDR than DNR. Low-Density Lipoprotein Cholesterol (LDL-C) was significantly (p-value=0.0235) higher in PDR than NPDR. Fasting Blood Sugar (FBS), Postprandial Blood Sugar (PPS), and LDL-C were significantly higher in DNR than NDNR while high-density lipoprotein cholesterol was significantly lower in DNR than NDNR group. Conclusion: Persistent hyperglycaemia causes an increased ALDR-2 activity that has a significant role in the establishment of DR. However, dyslipidemia is more important as a risk factor for progression of NPDR to PDR. Hypolipidemic drug as an adjunctive therapy could prevent the progression of DR from NPDR to PDR.

Introduction: Cardiovascular Disease (CVD) is a leading cause of morbidity and mortality in India. Resistance exercise is strongly recommended for implementation in CVD prevention programs. Dynamic resistance exercise comprises of concentric (muscle shortening) and eccentric (muscle lengthening) phase. The contraction of skeletal muscle promotes the synthesis and secretion of cytokines and peptides from myocytes, known as ‘myokines’. Interleukin-6 (IL-6) is the first myokine to be released in the blood in response to exercise. Aim: To compare the cardiovascular response and serum IL-6 level in concentric and eccentric exercise done at same absolute workload. Materials and Methods: In this non-randomised crossover study 24, apparently healthy and young male adults performed an acute bout of concentric and eccentric exercise. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Heart Rate (HR), Mean Arterial Pressure (MAP), Pulse Pressure (PP) and serum IL-6 were measured just before and immediately after exercise. Paired t-test or Wilcoxon signed-rank test were applied to compare the data within-group and in-between group. Results: SBP, HR, MAP, PP, DBP and IL-6 level increased significantly after both, concentric and eccentric exercise. The mean change in SBP, HR, MAP, PP, and IL-6 after concentric exercise (18.54±3.06, 57.21±10.73, 8.35±1.40, 15.25±5.29, 5.40±3.13 respectively) was significantly higher than after eccentric exercise (13.38±1.72, 43.25±8.34, 6.50±1.0, 10.21±3.16, 4.36±2.54 respectively). A non-significant rise in DBP was obtained after concentric exercise (3.25±2.79) as compared to eccentric exercise (3.08±1.89). Conclusion: Eccentric exercise not only caused a lesser cardiovascular demand as compared to concentric exercise but also a significant increment in IL-6 level. Exercise-induced IL-6 may prevent the initiation and development of CVD. Hence, eccentric exercise training might be recommended for reducing morbidity and mortality in individuals with- or at a risk of developing CVD.

The role of percutaneous nephrostomy tube for drainage after percutaneous nephrolithotomy (PCNL) procedure has come under scrutiny in recent years. The procedure has been modified to use of small diameter tubes, ′tubeless′ PCNL, and even ′totally tubeless′ PCNL. A review of the available literature confirms that the chosen method of drainage after PCNL has a bearing upon the post-operative course. It is generally recognized now that small tubes offer benefit in terms of reduced post-operative pain and morbidity. Similarly, nephrostomy-free or ′tubeless′ PCNL, using a double-J stent or ureteric catheter as alternative form of drainage, can be used with a favorable outcome in selected patients with the advantage of decreased postoperative pain, analgesia requirement, and hospital stay. Although the tubeless technique has been applied for extended indications as well, the available evidence is insufficient, and needs to be substantiated by prospective randomized trials. In addition, ′totally tubeless′ approach has also been shown to be feasible in selected patients.

Introduction: Acute myocardial infarction (AMI) is one of the leading causes of mortality and morbidity. Various prognostic markers have been used in AMI some of which are expensive and/or not easily available. Aim: To determine the role of serum uric acid levels in predicting short-term outcome in AMI. Materials and Methods: A hospital-based prospective, analytical observational study, in 102 consecutive AMI patients (WHO criteria), ≥ 18 years of age, admitted to the Departments of Medicine and Cardiology. Patients with recurrent myocardial infarction (MI), with additional confounding factors likely to alter serum uric acid levels were excluded. Serum uric acid was measured by using VITROS Uric acid slide method. Statistical Analysis: Unpaired ‘t’ test was used to study association of serum uric acid levels with individual parameters. Unadjusted multivariate logistic regression analysis was used for comparison of variables against in-hospital mortality. A ‘p-value’ 7.0 mg/dL); mean serum uric acid levels were maximum in patients ≥80 years (7.38mg/dL). Mean serum uric acid level was higher in NSTEMI compared to STEMI (5.78mg/ dl vs. 5.59mg/dL; p=0.60). Mean serum uric acid was higher in higher Killip classes (6.58 and 7.38 mg/dL in classes III, IV respectively) compared to lower classes (3.80 & 4.58mg/dL in classes I, II respectively). Higher serum uric acid levels were associated with longer hospital stay (6 days for serum uric acid 7 mg/dL). Overall in-hospital mortality was 9.8%; of which the highest number (70%) had serum uric acid level >7mg/dL (p=0.03). Conclusion: In AMI, patients with a higher Killip class, signifying severe disease, were found to have a higher serum uric acid level. Further, patients with higher serum uric acid had longer hospital stay and significantly higher in-hospital mortality. Serum uric acid may be used as a cheap and effective prognostic indicator in AMI.

Introduction: Inflammatory Bowel Disease (IBD) is an immune mediated chronic intestinal condition. Crohn’s Disease (CD) and Ulcerative Colitis(UC) are the two major types of IBD. Aims and Objectives: i) To study the prevalence of IBD in Gauhati Medical College and Hospital.ii) To study the clinical profile of patients with IBD. Materials and Methods: A total of 38 patients of IBD were enrolled in this prospective observational hospital based study. The study was conducted from July 2014 to June 2015. All patients presenting to the department of Medicine, Gauhati Medical College and Hospital with history suggestive of IBD were evaluated through history taking, clinical evaluation and laboratory investigation as per requirement of the patients. Results: The hospital prevalence of UC was found to be 22.99 and of CD was9.37 per 100,000 persons. Males were more affected than females in both UC and CD. The most common clinical features of UC were rectal urgency, increased frequency of stools, blood in stools, tenesmus, mucus in stools, loose stools and abdominal pain whereas in CD abdominal pain, loose stools, weight loss and mucus in stools were the common clinical presentations. Extraintestinal manifestations were seen in 11.11% of UC patients and 27.27% of CD patients with arthralgia being the most common. Conclusion: Since this was a hospital based study with a small sample size, a larger study recruiting more patients with a longer duration of follow up is necessary for a better understanding of the disease and to arrive at definite conclusion.

Hemodynamic compromise immediately after chest closure can be potentially fatal event. Such condition warrants urgent reopening of sternum. In the present case, we discover An uncommon cause of unstable hemodynamics.

Global SOA requires a dynamic and ubiquitous security which cannot be provided by the SOA due to its static and pre-configured nature. Security is the major barrier for migrating SOA from intra-enterprise to the web. In this paper we are defining the security risk associated with the Global SOA and proposing the handler mechanism to prevent Denial of Service attack in a Global SOA environment. Our method emphasizes on the DoS attack on Web Services and suggests counter measures through the use of dynamic handlers.

Short message service (SMS) is extremely popular today. Currently, it is being mainly used for peer-to-peer communication. However, SMS could be used as public media platform to enhance social and public interactions in an intuitive way. We have developed BlogWall to extend the SMS to a new level of self-expression and public communication by combining art and poetry. Furthermore, it will provide a means of expression in the language that children can understand, and the forms of social communication. BlogWall can also be used to educate the children while they interact and play with the system. The most notable feature of the system is its ability to mix up and generate poetry in multiple languages such as English, Korean, Chinese poems, or Japanese “Haiku” all based on the SMS. This system facilitates a cultural experience to children unknowingly, thus it is a step into new forms of cultural computing.