Neuroendocrine Carcinoma of the Hypopharynx - An Elusive Clinical Rarity

Neuroendocrine carcinoma originating from neuroendocrine cells is typically linked to unfavourable survival rates. We are introducing an exceptional case of neuroendocrine carcinoma occurring in the hypopharynx. To date, only a handful of instances involving primary neuroendocrine carcinoma of the hypopharynx have been documented. Advanced age, being male, a history of chronic alcoholism, smoking, and previous radiation are all risk factors associated with this condition. The majority of patients present with distant metastases and are not amenable to a complete cure. As there are no guidelines for the treatment of this rare tumour, various treatment modalities have been tried. Here, we are reporting one such case which was diagnosed as small-cell neuroendocrine carcinoma of the hypopharynx on the basis of histopathological cues and received concurrent chemoradiotherapy.

A case series on Treatment of Secondary Amenorrhea cases with Soothaga thadai kudineer - a Siddha Herbal Decoction

Background: Secondary amenorrhea is an absence of menstrual bleeding in a woman in her reproductive period for consecutive three or more months except the periods of pregnancy, lactation (production of breast milk), under contraceptives (birth control) or menopause. It could be noted in 1 of 15 women during their reproductive period. The objective of the present study is to find the efficacy of Soothaga thadai kudineer a Siddha herbal preparation in the management of secondary amenorrhea. Methods: Study was conducted among the college students of Sri Sairam Siddha medical college and research centre (10 students) with the administration of above mentioned kudineer, for three days 165ml once a day. Results were observed and noted. Results: Administration of Soothaga thadai kudineer was found to be more effective in the treatment of secondary amenorrhea. In this study, we have noticed that 5 of the subjects attained pre-menstrual symptoms and other 5 showed positive results of menstruation with the free flow. Friedman test analysis, it reveals the Mean rank is high for Lower abdominal pain (5.95) followed by Back pain (4.55). Conclusion: This study reveals the positive effect of Soothaga thadai kudineer in the secondary amenorrhea and it can be prescribed as a medicine in the treatment of various gynaecological disorders which have secondary amenorrhea as a symptom. Further evaluation is needed.

Dynamic access control and security performance prediction for IoT networking using a novel deep learning technique.. [DOI: 10.21203/rs.3.rs-947700/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Internet of things (IoT) has increased an importance for an area of interest in many devices. Then, the applications such as sensitive home sensors, medical devices, wireless sensors,and other devices are related to IoT network. The transmission of big data is subject to a possible attack that could cause network interruptions and problems with security. The security performance prediction is important for IoT networks to address complicated security issues in real-time which one of the attacks can freely threaten its global performance. Initially,investigate the safety performance of security intelligent prediction techniques is linking with deep learning algorithms into the IoT security risks. This contribution provides a CNN model that improves IoT security risk assessment (SRA) performance. Then, the access control techniques are changed with IoT-like dynamic systems with the number of items spread all over the place. Therefore, dynamic access control models are necessary. Thesedesign not individual use strategies of access but incorporate environmental and real-time data to predict the decision on access. The risk-based access control approach is one of those dynamic models. To decide the access decision, this model assesses the security risk value associated with the access request. This assessment of the model proposed results from the performance and accuracy of IoT networks.

Metastatic adenocarcinoma presenting as monoarticular arthritis of the knee: A case report with review of literature

Patients who develop metastatic arthritis secondary to solid tumors are rare. It is even more uncommon to be a presenting symptom. We present a case where a known case of osteoarthritic patient presented with complaints of knee swelling secondary to primary colonic carcinoma with lung metastasis. It was initially diagnosed on histopathology examination as metastatic adenocarcinoma from excised synovial mass and further investigated for primary carcinoma. Later, computed tomography was done and found out the primary colonic carcinoma arising from transverse colon along with lung metastasis.

Beneficial Primary Outcomes of Metabolic Surgery with Changes in Telomere Length and Mitochondrial DNA in Obese Asian Indians with Dysglycemia

INTRODUCTION

Although metabolic surgery has been shown to offer beneficial primary outcome results in obese individuals / obese Type 2 diabetes mellitus (T2DM) patients, there is paucity of information on the underlying mechanisms. In the recent years, estimations of non-invasive molecular parameters viz., telomere length and mtDNA copy number (mtDNAcn) assume significance as robust biomarkers. However, there is lack of evidence about this especially, in the Indian context. To assess the changes in the telomere length and mtDNAcn levels after metabolic surgery in obese Asian Indians with dysglycemia along with routine measurements of anthropometry, glycemic/lipidimic parameters and inflammatory markers.

METHODS

This study is a prospective one-year follow-up study of 16 obese individuals with dysglycemia who underwent metabolic surgery at a tertiary diabetes centre in South India. Telomere length, mtDNAcn, serum adiponectin, glycated haemoglobin and high- sensitivity C-reactive protein (hs-CRP) levels were analysed before surgery and at 6 and 12 months after surgery.

RESULTS

There was a significant reduction in weight (p<0.001), BMI (p<0.001), waist circumference (p<0.001), fasting and postprandial glucose (p<0.05), HbA1c (p<0.001), triglycerides (p<0.05), hs CRP (p<0.05) and increase in serum adiponectin (p<0.05) at 6 and 12 months post-surgery compared to the preoperative status. There was a significant reduction in mtDNAcn (p<0.001) and a significant increase in telomere length (p<0.001) at 6 and 12 months post metabolic surgery.

CONCLUSION

We report an increase in telomere length and decrease in circulatory mtDNA copy number levels at 6 and 12 months post metabolic surgery in obese individuals with T2DM in India.

Accuracy of the smartphone-based nonmydriatic retinal camera in the detection of sight-threatening diabetic retinopathy

Purpose:

To evaluate the sensitivity and specificity of smartphone-based nonmydriatic (NM) retinal camera in the detection of diabetic retinopathy (DR) and sight-threatening DR (STDR) in a tertiary eye care facility.

Methods:

Patients with diabetes underwent retinal photography with a smartphone-based NM fundus camera before mydriasis and standard 7-field fundus photography with a desktop mydriatic fundus camera after mydriasis. DR was graded using the international clinical classification of diabetic retinopathy system by two retinal expert ophthalmologists masked to each other and to the patient's identity. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to detect DR and STDR by NM retinal imaging were assessed.

Results:

245 people had gradable images in one or both eyes. DR and STDR were detected in 45.3% and 24.5%, respectively using NM camera, and in 57.6% and 28.6%, respectively using mydriatic camera. The sensitivity and specificity to detect any DR by NM camera was 75.2% (95% confidence interval (CI) 68.1–82.3) and 95.2% (95%CI 91.1–99.3). For STDR the values were 82.9% (95% CI 74.0–91.7) and 98.9% (95% CI 97.3–100), respectively. The PPV to detect any DR was 95.5% (95% CI 89.8–98.5) and NPV was 73.9% (95% CI 66.4–81.3); PPV for STDR detection was 96.7% (95% CI 92.1–100)) and NPV was 93.5% (95% CI 90.0–97.1).

Conclusion:

Smartphone-based NM retinal camera had fairly high sensitivity and specificity for detection of DR and STDR in this clinic-based study. Further studies are warranted in other settings.

National health policy, the need of the hour: an analysis in Indian perspective

Purpose

The national health policy should strive towards achieving the concept of “healthcare for all” conceptualized by the World Health Organization (WHO) through health insurance scheme. The purpose of this paper is to identify and discuss the various gaps affecting the health care systems and to evolve strategic issues in health care in India through an exploratory survey.

Design/methodology/approach

The main thrust is to analyze the problems of India's health care system and review of related literature, to identify the areas in the field of healthcare and health insurance which are unexplored or need to be tapped. This evaluation would give ample data to reinforce these areas and would lead us ultimately to the pre‐set target of WHO.

Findings

India's march to prosperity faces a serious risk of slowing down due to the main reason – lack of proper access to health care due to the absence of a well laid out public policy. Therefore, the key stakeholders of the health insurance industry jointly need to build a robust health insurance system and help to bridge the gap that exists in reaching quality healthcare in India. A review of the health policy for modifications and to implement it successfully through health insurance without road blocks is called for.

Practical implications

The results of this study, it is hoped, will outline equity in health care, which matters to every Indian citizen and how it can be achieved in India.

Originality/value

This paper suggests the adoption of an approach of management science called the gaps model of service quality in dealing with India's healthcare system problems, a new indicator aimed at assessment of the deficit in access to health services through a structured integrated way. The strategy takes account of the significant gaps identified to suggest new pragmatic methods to close the gaps.

A Roadmap to Integrate Document Clustering in Information Retrieval

The World Wide Web is a large distributed digital information space. The ability to search and retrieve information from the Web efficiently and effectively is an enabling technology for realizing its full potential. Information Retrieval (IR) plays an important role in search engines. Today’s most advanced engines use the keyword-based (“bag of words”) paradigm, which has inherent disadvantages. Organizing web search results into clusters facilitates the user’s quick browsing of search results. Traditional clustering techniques are inadequate because they do not generate clusters with highly readable names. This paper proposes an approach for web search results in clustering based on a phrase based clustering algorithm. It is an alternative to a single ordered result of search engines. This approach presents a list of clusters to the user. Experimental results verify the method s feasibility and effectiveness.

Adriamycin induced myocardial failure in rats: Protective role of Centella asiatica

Generation of reactive oxygen species and mitochondrial dysfunction has been implicated in adriamycin induced cardiotoxicity. Mitochondrial dysfunction is characterized by the accumulation of oxidized lipids, proteins and DNA, leading to disorganization of mitochondrial structure and systolic failure. The present study was aimed to evaluate the efficacy of Centella asiatica on the mitochondrial enzymes; mitochondrial antioxidant status in adriamycin induced myocardial injury. Adriamycin (2.5 mg/kg body wt., i.p.) induced mitochondrial damage in rats was assessed in terms of decreased activities (p<0.05) of cardiac marker enzymes (lactate dehydrogenase, creatine phosphokinase, amino transferases), TCA cycle enzymes (isocitrate dehydrogenase, alpha-ketoglutarate dehydrogenase, malate dehydrogenase, respiratory marker enzymes (NADH-dehydrogenase, cytochrome-C-oxidase), mitochondrial antioxidant enzymes (GPx, GSH, SOD,CAT) and increased (p<0.05) level of lipid peroxidation. Mitochondrial damage was confirmed by transmission electron microscopic examination. Pre-co-treatment with aqueous extract of Centella asiatica (200 mg/kg body wt, oral) effectively counteracted the alterations in mitochondrial enzymes and mitochondrial defense system. In addition, transmission electron microscopy study confirms the restoration of cellular normalcy and accredits the cytoprotective role of Centella asiatica against adriamycin induced myocardial injury. Our results demonstrated elevated oxidative stress and mitochondrial dysfunction in adriamycin treated rats. Moreover, on the basis of our findings it may be concluded that the aqueous extract of C. asiatica not only possesses antioxidant properties but it may also reduce the extent of mitochondrial damage.

Biodiversity of Anabaena azollae isolates from different Azolla cultures

The random amplified polymorphic DNA (RAPD) profile of A. azollae strains isolated from four different Azolla cultures was studied by using different primers. The objective of this study was to determine whether polymerase chain reaction (PCR) with different primers could differentiate the isolated A. azollae strains from one another. The primers amplified specific sequences of the isolates and generated fingerprinting pattern characteristic of each isolate. Clear polymorphism was noticed among all the strains which depends on the primer sequence.