bluuebunny/crossref_metadata_2025 huggingface dataset:
Inhaled budesonide versus oral prednisolone in the treatment of acute exacerbation of moderate bronchial asthma: an open label randomized clinical trial
Authors: Roshan Reashma , Shah Mubashir H. , Bhat Aejaz A.
Published: March 2021

Background: Recently published studies have suggested that inhaled corticosteroids may offer benefit over systemic steroids in bronchial asthma. This research was carried out to study the efficacy of inhaled budesonide and to compare the efficacy of inhaled budesonide with oral prednisolone in the treatment of acute moderate asthma in children.Methods: This was an open label randomized clinical trial. Children in the age group of 1-12 years with acute exacerbation of asthma presenting to pediatric emergency from November 1, 2015 to October 31, 2016 who fail to show prompt improvement after initial treatment with oxygenand three doses of inhaled salbutamol, were enrolled. Children in group B (n=35) and group P (n=35) received inhaled budesonide and oral prednisolone, respectively, in addition to oxygen inhalation and salbutamol as per the study protocol. Outcome was measured in terms of pulmonary score at the beginning, at 6 hours, and at 24 hours of starting the treatment. The analysis was undertaken according to intent to treat principle.Results: Baseline characteristics (sex, age, weight, height, body mass index) were comparable in the 2 groups. Mean heart rate, respiratory rate, pulmonary score at 6 and 24 hours, mean SpO2 at 24 hours were significantly showing normalizing trend (p<0.05) and mean hospital stay was significantly reduced [2.60 (±0.60) vs 3.11 (±0.80); p<0.05] in group B as compared to group P.Conclusions: Outcome measures of clinical improvement were better in inhaled budesonide group than oral prednisolone group in acute moderate exacerbation of bronchial asthma.
Study of serum magnesium levels in pre-diabetics and its correlation to body mass index
Authors: Koshy Ajeesh , M. Roshan
Published: March 2021

Background: Diabetes is a growing public health burden across the world, particularly in the developing countries. Homeostasis of the trace elements such as magnesium has been found to play an important role in the pathogenesis of diabetes and diabetic complications. Studies had found out an association between serum magnesium and incident diabetes; where diabetes may induce urinary magnesium loss. But in pre-diabetes, serum glucose levels are below the threshold for urinary magnesium wasting and hence unlikely to influence serum magnesium levels. This study was done to assess their serum magnesium levels and find its correlation.Methods: This cross sectional study was done among 120 pre-diabetic subjects. Pre-diabetes was diagnosed as per ADA guidelines and body mass index was calculated according to Asian guidelines of BMI. Serum magnesium levels were done for all of them and statistically analysed to correlate the serum magnesium with body mass.Results: The present study observed that 69 out of 120 pre-diabetics, 57.5% have low magnesium levels. This study showed that 57.5% of pre-diabetics is having normal body mass index, out of which more than half of them are having normal serum magnesium. But out of 12 obese pre-diabetics, 11 were having low serum magnesium 91.6%. (P value 0.026 which is statistically significant).Conclusions: This study observed that serum magnesium levels are low in Pre-diabetics. Significant hyomagnesemia has been seen in pre-diabetics with high BMI compared to those with normal BMI.
Comparative evaluation of strain ratio on sonographic elastography and T2* values on 3 Tesla magnetic resonance imaging in differentiating malignant from benign axillary lymph nodes in breast cancer
Authors: Sharma Shweta , Bansal Richa , Jain Shubham
Published: March 2021

Background: The study aimed to assess whether strain ratio and T2* values can improve the sensitivity and specificity of differentiating metastatic from benign axillary lymph nodes in breast cancer patients taking histopathology as reference standard.Methods: The study was done on 43 patients. A multi-echo transverse T2*W MR sequence was obtained with TE = 0.9- 1.5 ms, TR=37.2 ms and flip angle = 25°. Sonographic elastography was done using high frequency linear probe (L3-16 MHz). Manual selection of the region of interest was done on suspicious lymph nodes for calculation of T2* values and strain ratio. ROC curves were obtained for various T2* and strain ratio values in comparison to histopathological findings as gold standard.Results: Correlation with histopathology was better with T2* values than strain ratio. The sensitivity and specificity were calculated using cut off values obtained from ROC curve (31.225 ms for T2* value and 1.85 for SR) and were 70.37%, 68.75% for strain ratio and 96.29%, 93.75% for T2* value respectively. The positive predictive value and negative predictive value were also assessed, values being higher for T2* than strain ratio. Comparison of areas under ROC curve was statistically significant with p=0.018.Conclusions: T2* can be used as a potential biomarker for differentiating metastatic from benign axillary lymph nodes owing to its high sensitivity, specificity and relative ease of performance. Quantitative assessment of changes in T2* values may allow more objective analysis of signal changes with significant differences between benign and malignant lymph nodes, even in case of partial infiltration.
Clinical application of the anterolateral thigh free flap in high energy injuries of the lower extremity
Authors: Ignacio Del Carmen-Ortega , Ignacio Cahuana-Quispe Alberto , Michel Jaimes-Duran Edwing , Enrique Soulé-Martínez Christian
Published: March 2021

One of the recurring problems in plastic and reconstructive surgery is the loss of tissues of the lower extremities as a result of high-energy injuries. The difficulty of this reconstruction lies in the need for a sufficiently suitable and resistant tissue to allow this restoration. The thigh-free anterolateral flap, since its description in 1984, has great versatility for complex or extensive lower extremity reconstructions. We presented the case of a 37-year-old male patient who had a high-energy road accident on a bicycle, impacting a moving vehicle causing a multi fragmented fracture of the right proximal tibia AO 41 C2.2/Schatzker V. He was treated surgically with material from osteosynthesis and iliac crest graft. It is complicated by infection of the surgical wound, exposure of osteosynthesis material and absence of skin covering. Reconstruction of the upper third of the right leg was performed with a thigh-free anterolateral free flap with 2 end-to-end venous anastomoses from the flap to anterior tibial veins, and 1 end-to-end anastomosis from perforating artery to anterior tibial artery, with no associated complications. The thigh-free anterolateral free flap is a versatile and reliable mechanism for the reconstructive surgeon, as it provides excellent coverage for complex lower extremity wounds as well as low donor site morbidity. Outpatient follow-up with adequate clinical evolution was done.
Importance of magnetic resonance imaging brain in metronidazole-induced cerebellar ataxia- a case report
Authors: Kumar Munish , Priyadarshini Chitra
Published: March 2021

Metronidazole is an antibiotic and an antiprotozoal drug, is cost effective treatment of choice in amoebic liver abscess. Cerebellar toxicity is quite rare and serious side effect of metronidazole, which is reversible. The importance of MRI brain in this condition is the typical finding of abnormal T2 as well as FLAIR hyperintensities in dentate nuclei and splenium of corpus callosum. We present a case of liver abscess on prolong metronidazole treatment presented with acute onset cerebellar ataxia.
Bilobed right lung: a case of absent horizontal fissure
Authors: Chauhan Ankita , Yadav Suman , Patiyal Nitin
Published: March 2021

The human lungs are organs of respiration present in the greater part of thoracic cavity on each side of heart in the mediastinum resting on diaphragm. The right lung is classically divided into three lobes namely superior, middle and inferior by the oblique and horizontal fissures. The left lung is divided into superior and inferior lobes by a single deep oblique fissure. The fissures help in expansion of lungs during respiration. During the routine dissection of thoracic region of human cadaver, bilobed right lung with absent horizontal fissure was observed. The right lung was divided into superior and inferior lobe by a single oblique fissure. The left lung had normal anatomy in this case. The variations in the fissures and lobar pattern of lungs are common and are due to altered developmental process during intrauterine life. The anatomical knowledge of these disparities in fissures is important for clinicians prior to performing any pulmonary surgical procedures and to prevent postoperative complications.
India seems to outperform in handling COVID-19 pandemic
Authors: Mangla Anita Garg , Kandpal Shreya , Mahendru Parthvi , Dhamija Neeru
Published: March 2021

The coronavirus pandemic is an ongoing pandemic of coronavirus disease 2019 caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). The outbreak was first identified in Wuhan, China and soon within months it engulfed more than 188 countries. As of 25 January 2020, more than 100 million cases have been reported globally. Worst affected countries globally include USA, India, Brazil, Russian, UK, France, Turkey, Italy, Spain and Germany. By far India has taken robust immediate measures to contain the spread of virus by implementing stringent nationwide lockdowns at an early stage. This review focuses on how India, in several ways, is placed better in handling COVID-19 than the developed countries.
An effective medical replacement therapy: ketogenic diet for intractable childhood epilepsy
Authors: Chaudhary Ansh , Chaudhary Bhupendra
Published: March 2021

Ketogenic diet (KD) a high fat, adequate protein and low carbohydrate restrictive diet has a long history of its use in intractable epilepsy of childhood. The diet produces biochemical changes mimicking that of starvation. The high levels of ketone bodies produced by KD act as a major source of energy for brain replacing the usual glucose.1 Comprising the ratio of 4:1 (fat:carbohydrate and protein) by weight, the diet produces state of ketonemia or ketosis that leads to reduction in frequency of epileptic seizures by is unique mode of action. To increase the palatability medium chain triglycerides (as coconut oil) in ratio of 3:1 is used which is more efficiently absorbed and have lesser gastro intestinal side effects as compared to traditional 4:1 ratio diet with long chain triglycerides like PUFA
Comparative study between two days versus seven days urethral stenting of distal hypospadias after tubularized incised plate urethroplasty
Authors: Fakhry Tamer , Amer Ahmed Mohammad , Fawzy Ahmed Nabil
Published: March 2021

Background: The duration of urethral stenting after tubularized incised plate (TIP) urethroplasty for hypospadias varies among surgeons.Methods: Forty male cases with distal hypospadias aging from one year till the age of six years randomly allocated into two groups for undergoing tubularized incised plate urethroplasty with removal of the urethral stent after two days in one group and after seven days in the other one. The rate of postoperative complications such as urethrocutaneous fistula, urinary retention, meatal stenosis and complete wound dehiscence requiring redo and cosmetic results were compared.Results: The prevalence of post-operative complications and cosmetic results in two studied groups were not significantly different.Conclusions: There is no significant difference between removal of the stent after two days or seven days regarding the incidence of postoperative complications and the cosmetic results.
Comparative study between clinical diagnosis using modified Alvarado score and ultrasound imaging in decreasing negative appendectomy rate
Authors: Samudre Sayali S. , Munde Anil S.
Published: March 2021

Background: Acute appendicitis is the acute inflammation of appendix which is the most common cause of acute surgical emergencies. Appendicitis can mimic other pathologies. Removing normal appendix is an economical burden both on patients and health resources. Misdiagnosis and delay in surgery can lead to complications like perforation and finally peritonitis.Methods: This was prospective comparative study carried out in 200 patients over the period of 2 years. Patients with clinical features of acute appendicitis and fitting in inclusion and exclusion criteria were selected. Detailed history was noted and clinical examination was done. Necessary investigations were done, modified Alvarado score was calculated and all were subjected to ultrasonography of abdomen and pelvis. Intra operative findings were noted about nature of appendix and histopathology findings were noted.Results: The sensitivity of ultrasound is 78.19% and specificity is 50%. The sensitivity of modified Alvarado scoring system is 78.7% and specificity is 25%. Negative appendicectomy rate in the study was 6%.Conclusions: Modified Alvarado score has slightly higher sensitivity and ultrasound imaging has higher specificity of in the diagnosis of acute appendicitis and in decreasing negative appendicectomy rates. Ultrasound imaging provides good supportive diagnosis in cases of low or equivocal modified Alvarado scores.
Tuberculosis of breast: scrofulous swelling in the bosom of young women
Authors: Patil Linganagouda S. , N. Hanumanthappa B. , P. Sahana M.
Published: March 2021

Background: Tuberculous breast is a rare extra pulmonary presentation of tuberculosis with nonspecific clinical, radiological and histological findings. The significance of breast tuberculosis lies in its rare occurrence and mistaken identity with breast carcinoma and pyogenic abscess.Methods: A prospective observational study was done to know the incidence, presentation and management modality of tuberculosis of breast.Results: 8 female patients, ranging between 21- 50 years were included, painless lump in breast in 4 patients (50%) was the most common presentation followed by 2 (25%) multiple discharging sinus,1 (12.5%) patient presented as abscess and one had painful lump. Axillary lymphadenopathy seen in 3 (37.5%) patients. All patients had an FNAC but Core needle biopsy or excisional biopsy was definitive for diagnosis. Anti-tubercular chemotherapy was the mainstay of treatment.Conclusions: Breast tuberculosis is an obscure disease and clinical signs can be insidious and non-specific Diagnostic expertise can identify a potentially curable disease of breast tuberculosis.
Role of sclerotherapy in management of low flow vascular malformations
Authors: Kaur Manpreet , Sachdeva Parul , Syal Rajan , Singh Savijot
Published: March 2021

Background: Low flow vascular malformations are most common in the head and neck region. Only symptomatic malformations require treatment. Sclerotherapy followed by surgery was considered the gold standard treatment but in the head and neck region, it may produce cosmetic and physiological defects. In the present study, multiple injections of sclerotherapy with 3% sodium tetradecyl sulphate was used for the treatment of low flow vascular malformations.Methods: Twenty cases of low flow vascular malformations of the oral cavity who presented in the outpatient department of ESIC Model Hospital, Ludhiana from 2014-2016 were selected for the study. Only significantly sized (>4 cm) and easily accessible lesions were included. Staged sequential sclerotherapy with 3% STS under strict fluoroscopy control was used as the sole treatment.Results: A total of 20 patients were taken of which, 25% required three sessions, 65% five to six sessions each and 10% required eight sessions each. All patients showed good results with complete regression and no mucosal ulceration.Conclusions: Staged sequential sclerotherapy with 3% STS should be the treatment of choice in low flow vascular lesions involving mucosal and cutaneous structures of head and neck region especially anterior two-thirds of tongue, palate, gingiva, buccal mucosa and lips. Surgical removal may affect critical neurovascular structures and cause cosmetic deformity. So the removal is advisable in life-threatening conditions, lesions requiring general anaesthesia and single sitting removal.
Surgical site infections in human immunodeficiency virus positive patients and their correlation with CD4 count
Authors: Mahajan Vinayak , Dikshit Bharat , Phalgune Deepak , Mohite Saurabh
Published: March 2021

Background: The CD4 count is like a snapshot of how well the immune system is functioning. The progressive failure of the immune system caused by the human immunodeficiency virus (HIV) can increase the possibility of developing surgical site infections (SSI) after surgery. Study about the incidence of SSI and their correlation with CD4 count in HIV positive patients has not been done in India. The present study was aimed to find the incidence and microbiological profile of SSI among HIV positive patients, and the correlation between SSI and CD4 count.Methods: One hundred forty-six HIV positive patients >18 years of age scheduled for surgery were included. CD4 count of each patient was noted. The primary outcome measure was the incidence of SSI, whereas secondary outcome measures were the correlation of SSI with CD4 count and microbiological profile of infective material. Intergroup comparison of categorical, and continuous variables was done using the chi-square test/Fisher’s exact test and unpaired ‘t’ test respectively.Results: The incidence of SSI in HIV positive patients was 14/146 (9.6%). The incidence of SSI was significantly higher among patients with CD4 count <200 (60.0%) as compared to patients with CD4 count >500 (0.9 %). Mean±SD of CD4 count in patients without SSI and with SSI was 712.5±238.9 and 330.1±118.1 (cells/mm3) respectively (p<0.001). Klebsiella pneumoniae was the most common organism isolated in this study.Conclusions: SSI is frequent in HIV positive patients whose CD4 count is <200 cells/mm3.
Correlation between CT and operative findings in pancreatic cancers and role of pre-operative CA19-9 values in predicting metastatic disease
Authors: Prabhakar Rajat , Jaiswal Shyam S. , Prakash Ravi
Published: March 2021

Background: Pancreatic cancers carry a poor prognosis with 20-30% of cases found resectable on MDCT (Multi-detector CT). 60-91% of these lesions are actually found resectable during surgery. CA 19-9 is an extensively studied tumour marker in pancreatic cancers and its abnormally high value may point towards metastatic disease.Methods: A study was conducted in a tertiary care centre in which all patients of pancreatic cancers found resectable on imaging were subjected to surgery after staging laparoscopy to find metastatic disease missed on MDCT, the findings were noted and correlated with the radiological findings. Also, pre-operative CA 19-9 levels were analysed to predict metastatic disease in patients with high CA 19-9 values.Results: The study included 34 patients of pancreatic cancers deemed resectable on imaging. Out of these, four (11.7%) patients were found to be unresectable on staging laparoscopy in the form of subcentimetric liver/peritoneal metastasis. It was also found that preoperative CA 19-9 levels were higher in patients found to be metastatic. By using ROC curve, it was found that pre-operative values of CA 19-9 had 100% sensitivity and 80% specificity at the cut off level >106.75 U/ml.Conclusions: MDCT fails to identify some unresectable diseases because of presence of distant metastasis in the form of liver and peritoneal metastatic nodules and malignant ascites. Staging laparoscopy prior to laparotomy is a useful procedure which prevents unwanted laparotomy in some cases of metastatic pancreatic cancer not identified on imaging. Abnormally high values of CA 19-9 may point towards metastatic disease.
High-intensity focused ultrasound for the treatment of hepatic echinococcosis
Authors: Chen Zhenzhen , Salameen Haitham , Gong Jianping , Wen Xuegang
Published: March 2021

Objective of the study was to investigate the safety and effectiveness of high-intensity focused ultrasound (HIFU) to treat hepatic echinococcosis (HE). Eight HE patients treated between 2008 and 2010 were evaluated for the effectiveness of HIFU treatment; the occurrence of complications such as post treatment pain, fever, and skin burns; prognosis; and recurrence. Clinical and imaging evaluation of disease improved after treatment in all eight patients. Postoperatively, all patients experienced changes in liver function that returned to normal within 5 days. Three patients experienced low-grade fever that resolved in 6 days. Six patients complained of right upper quadrant pain that resolved in 7 days. Three patients experienced minor swelling of the skin. No unexpected complications were noted. HIFU was safe and effective for treating HE. It is non-invasive and caused no severe postoperative complications.
Adrenalectomies for adrenal gland tumours-a retrospective study of 15 cases at a single center
Authors: Kalabhavi Srinivas , Kanagali Revanasiddappa , Makannavar Pramod , Benthur Sangamanth , Aradhya Bhuvanesh
Published: March 2021

We present our experience of 15 cases of adrenal tumours who underwent adrenalectomy procedure in last 5 years at our institute and analysed retrospectively clinical outcome. Pre-operative, intra-operative and post-operative data from 15 patients who underwent adrenalectomy between August2015 and July 2020 at our institution were retrospectively collected and reviewed. Diagnosis was obtained on the basis of clinical examination, laboratory values and imaging techniques. Prazosin was preoperatively administered in case of pheochromocytoma. All adrenalectomies were performed by team of urologists. A multidisciplinary management involving endocrinologists, urologists, oncologists, onco-surgeons and anaesthesiologists was carried at our institute. Fifteen patients were evaluated retrospectively in our study. Functioning tumours were diagnosed in 08(53.3%) patients, 06 patients were affected by pheochromocytomas, 2 cases by adrenal cortical carcinoma (ACC). 3 (20%) patients had incidentalomas. 11 (73.3%) patients underwent open adrenalectomy and in 04 (26.6%) patients, laparoscopic adrenalectomy (LA) was performed. An accurate preoperative examination (radiological and biochemical evaluation) is mandatory to select eligible patients to LA or open adrenalectomy (OA). LA is safe and feasible for benign lesions up to 6 cm. A skilled operative team, composed by surgeons experienced in LA after adequate learning curve, is required. Preoperative alfa blockade does not prevent PCC hypertensive crises but, facilitating their pharmacological control, must be recommended.
Meckel’s diverticulum: a rare cause of small bowel obstruction in an adult
Authors: Jabeen Nusrat , Abdulla Hussain Adnan , Alqaseer Asma , Abushwemeh Mohamed Ayed , Alrayes Amal
Published: March 2021

Meckel’s diverticulum is the most common congenital abnormality of the gastrointestinal tract. Complications involving Meckel’s diverticulum include bleeding, bowel obstruction and inflammation. We present a rare case of small bowel obstruction caused by Meckel’s diverticulum. A 50-year-old male presented to the emergency department with abdominal pain and vomiting. Computed tomography (CT) abdomen showed dilated small bowel loops with transition zone at the mid ileum, consistent with small bowel obstruction. The patient was taken to the operating theatre for exploratory laparotomy and was found to have a Meckel’s diverticulum causing mechanical small bowel obstruction, which was resected with primary anastomosis. The patient recovered with no postoperative complications and was discharged home. Meckel’s diverticulum is difficult to diagnose preoperatively since most patients are asymptomatic and requires a high index of suspicion. In patients presenting with an acute abdomen, it may be overlooked because of nonspecific symptoms. In the case of small bowel obstruction, Meckel’s diverticulum should be kept in mind as part of the differential diagnosis.
Re-visiting laparoscopic radical nephrectomy- the past, present and future: case report and review of literature
Authors: Shetty Saiprasad , Shetty Prakash , Joshi Abhijit
Published: March 2021

Laparoscopic radical nephrectomy (LRN) has since long proven its therapeautic credentials in the field of renal cancer. Since the first reported case of LRN thirty years ago, it has stood the test of time. With the development of newer energy sources, better optics and ergonomically superior instruments, it has further established itself as the milestone or the landmark with which all future variations in the field of renal cancer surgery would be compared. Newer procedures such as retroperitoneoscopic radical nephrectomy, laparoscopic partial nephrectomy, robotic radical nephrectomy and partial nephrectomy and few other more conservative procedures such as radio-frequency ablation, cryo-ablation etc. are examples of these variations. In this paper, we present a case report on laparoscopic radical nephrectomy, review literature on the subject and delve into comparisons with newer procedures vis-à-vis their individual pros and cons. Through this study we are portraying the past, present and future of laparoscopic radical nephrectomy.
Third head of biceps femoris muscle-a case report
Authors: Ghatak Surajit , Adole Sonali , Deka Debajani , Faizal Muhamed
Published: March 2021

Sometimes variations in biceps femoris may be noticed like an accessory head of biceps femoris. Here during routine cadaveric dissection in the department of anatomy. All India institute of medical sciences, Jodhpur we found a case with an accessory head of biceps femoris in both the lower limbs. The muscle belly is originating from the fibers of long head of biceps femoris and going downward medially to get inserted to the medial condyle of tibia on its medial superior aspect. On the right-side insertion site is like a sheath and on half a way it is merging with medial intermuscular septum of thigh. On the left side insertion is first like a thin sheath and then a thin muscle belly. The muscle belly is thin as compared to the long and short head of the main muscle bellies. On the left side thickness is around 3.7 mm in the upper end and thinner in the lower end while on right side also it is around 3.75 mm. On right side length of muscle belly is around 5 cm and on left side it is around 5.5 cm muscle belly, then becomes a sheath with length around 0.5 mm and then again becomes a muscle belly of around 3.5 cm length. Short head is arising high up on the left side while on right side it is as normal.
XY female with complete androgen insensitivity syndrome with bilateral inguinal hernia
Authors: Baldiwala Aafrin Shabbir , Lad Vipul C.
Published: March 2021

The complete androgen insensitivity syndrome (AIS), previously called testicular feminization syndrome, is an X-linked recessive rare disorder. AIS is the most common male pseudohermaphrodite. Patient has 46, XY chromosome and testis. The individual is phenotypically female and genotypically male. Antimullerian hormone is produced by the testis. So, uterus and fallopian tubes do not develop in fetus. The fault lies with androgen receptors which are mutated. Male differentiation of external genitals does not occur. The individuals are reared as girls and the condition is suspected when the individual is evaluated for primary amenorrhea, infertility or when unilateral/bilateral inguinal hernia is diagnosed in girls. This disorder includes a spectrum of changes ranging from male infertility to completely normal female external genitalia in a chromosomally male individual. These cases need proper diagnosis and appropriate management. We report this case for its interesting presentation. The patient is a 23 year old female, presented with bilateral labial swellings and primary amenorrhoea. Subsequent investigations were done which revealed that the patient is a genetically male with absence of female internal genitalia but presence of testes. Proper psychological support was also given to her, which is more important.
Intraperitoneal liposarcoma: a rare presentation
Authors: Rajendran Gokul , Kapuluru Saichaithanya , Thimmappa Durganna
Published: March 2021

Liposarcoma are frequently seen in the retroperitoneum. It is of four types pathologically: Well-differentiated, dedifferentiated, myxoid and pleomorphic. Well-differentiated is the most common type. Dedifferentiated has the worst prognosis. Reports of Liposarcoma arising from the intraperitoneal sites such as stomach, omentum, mesentery and sigmoid mesocolon are rare. A 47 year old gentleman presented with pain in abdomen and abdominal distention, had a provisional diagnosis of GIST, intra-peritoneal liposarcoma. Imaging revealed a well-defined encapsulated abdominal mass indicative of liposarcoma with fibrous differentiation/fibro-lipoma. On surgery a well encapsulated mass was excised completely arising from the greater curvature of stomach. The mass on histopathological examination indicated features suggestive of liposarcoma (well-differentiated) with IHC markers positive for S100, CDK4 and MDM2. A diagnosis of intraperitoneal liposarcoma form greater curvature of stomach was made. This was an exceedingly rare presentation of liposarcoma arising from the greater curvature of stomach with differential diagnosis of GIST which was ruled out with histopathological features and negative CD117 and CD34. Thus to conclude liposarcoma being quite common retroperitoneal tumor, has an exceedingly rare occurrence from intraperitoneal sites and should be taken as an exceedingly rare differential diagnosis for mass per abdomen.
A rare case of COVID-19 related stomach gangrene after an abortion: a case report
Authors: Gupta Komal , Puri Gopal , Jayaram Jnaneshwari , Huzaifa Muhammed , Kataria Kamal
Published: March 2021

A 25 year old female had presented with complaints of severe epigastric pain with abdominal distension and vomiting for 4 days. She had undergone medical termination of pregnancy for a missed abortion of 5 weeks of gestation 5 days prior. The patient's COVID-19 RT PCR was found to be positive. Her CECT showed covid related changes in bilateral lungs and pneumoperitoneum. Stomach was distended. Other small bowels appeared normal. Patient underwent emergency laparotomy. Two third of stomach appeared gangrenous with a perforation in the posterior wall of stomach so she underwent a subtotal gastrectomy. She had features of covid associated coagulopathy (CAC) with high D-dimer (520 ng/ml), thrombocytosis (up to 705,000/mcl), high activated partial thromboplastin time (aPTT) (up to 55.6 sec) and high prothrombin time (PT) (up to 27.9 sec and INR 2.11) for which low molecular heparin was given. Stomach is a highly vascular organ. Gangrene of the stomach has been very rarely reported. CAC is known to lead to both arterial thrombus and venous thromboembolism. COVID-19 related abortions have also been reported though the exact mechanism not certain but CAC could be one of them.
A rare case of blunt trauma abdomen leading to isolated grade 4 pancreatic injury
Authors: Swami Ganesh A. , Punpale Ajay , Halnikar Chandrashekhar S. , Samudre Sayali S.
Published: March 2021

Isolated pancreatic injury due to blunt trauma abdomen is a rare case in children and is associated with higher morbidity and mortality rates. We present a case of isolated grade 4 pancreatic injury in a 12 years old male child, presented with history of trauma to abdomen by bicycle handle, pain in abdomen, abdominal distention and vomiting. Ultrasonography of revealed hemoperitoneum with peri-pancreatic fluid collection, Contrast enhanced Computed tomography of abdomen and pelvis showed grade 4 pancreatic injury with mild hemoperitoneum. Emergency exploratory laparotomy was done and saponified part of pancreas along with omentum was debrided and Roux-en-Y pancreaticojejunostomy was performed. Procedure was uneventful and patient recovered well in post-operative period. In conclusion, isolated grade 4 pancreatic injury is a rare presentation following blunt trauma to abdomen and conservative approach as well as many operative procedures have been described for treatment of such injury. Roux-en-Y pancreaticojejunostomy procedure can be considered as a definitive treatment in such cases and to avoid long term complications.
Las imprentas nómadas. Artefactos, conspiraciones y propaganda
Authors: Mora Rodríguez Jorge Omar
Published: March 2021

Alessandro Corubolo y Maria Gioia Tavoni, Las Imprentas nómadas. Artefactos, conspiraciones y propaganda, Buenos Aires, Ampersand, 2019, 316 pp. ISBN 978-987-416130-7
Catálogo de hongos (Ascomycota y Basidiomycota) de la Colección Micológica del Herbario Nacional del Ecuador (QCNE) del Instituto Nacional de Biodiversidad (INABIO)
Authors: Batallas Molina Rosa Carmen
Published: March 2021

El Herbario Nacional del Ecuador (QCNE) del Instituto Nacional de Biodiversidad conserva la primera colección micológica del sector público y la más representativa del país con 6200 especímenes entre hongos y hongos liquenizados, siendo los hongos (4400) el eje de este trabajo. La colección micológica nació en 1999 y forma parte del Herbario QCNE, esta investigación toma como base los vouchers de las muestras y los registros digitados en el fichero de excel a partir del 2013 de la colección micológica (hongos), el objetivo del presente trabajo es divulgar a la comunidad científica el contenido y características de la colección de especímenes y reportar el listado de especies de la colección micológica del QCNE. El repositorio se encuentra organizado siguiendo criterios de la literatura especializada más reciente, se reportan los datos correspondientes a muestras de las divisiones Ascomycota y Basidiomycota, dentro de Ascomycota constan 12 órdenes, 30 familias, 72 géneros, 119 especies, la familia con mayor representatividad fue Xylariaceae 45%, y el género con más especímenes Xylaria (Xylariaceae) con 31%. Basidiomycota con 12 órdenes, 53 familias, 168 géneros, 199 especies siendo la familia Polyporaceae con el 24% la mejor representada, el género Polyporus (Polyporaceae) con el 14% presenta gran cantidad de especímenes. Como aporte de la investigación se presenta la lista de 318 especies de los cuales 119 son del grupo Ascomycota y 199 Basidiomycota, depositadas en la colección micológica del herbario QCNE del INABIO.
Classification of Remote Sensing Images Through Reweighted Sparse Subspace Representation Using Compressed Data
Authors: Zhu Jianchen , Zhao Shengjie , Wu Di
Published: March 2021

In many real-world scenarios, subspace clustering essentially aims to cluster unlabeled high-dimensional data into a union of finite-dimensional linear subspaces. The problem is that the data are always high-dimensional, with the increase of the computation, storge, and communication of various intelligent data-driven systems. This paper attempts to develop a method to cluster spectral images directly using the measurements of compressive coded aperture snapshot spectral imager (CASSI), eliminating the need to reconstruct the entire data cube. Assuming that compressed measurements are drawn from multiple subspaces, a novel algorithm was developed by solving a 1-norm minimization problem, which is known as reweighted sparse subspace clustering (RSSC). The proposed algorithm clusters the compressed measurements into different subspaces, which greatly improves the clustering accuracy over the SSC algorithm by adding a reweighted step. The compressed CASSI measurements obtained using the coherence-based coded aperture can improve the performance of the proposed spectral image clustering method. The accuracy of our spectral image clustering approach was verified through simulations on two real datasets.
Contrast Enhancement of Digital Images Using an Improved Type-II Fuzzy Set-Based Algorithm
Authors: Al-Ameen Zohair
Published: March 2021

Contrast is a distinctive image feature that tells if it has adequate visual quality or not. On many occasions, images are captured with low-contrast due to inevitable obstacles. Therefore, an improved type-II fuzzy set-based algorithm is developed to enhance the contrast of various color and grayscale images properly while preserving the brightness and providing natural colors. The proposed algorithm utilizes new upper and lower ranges, amended Hamacher t-conorm, and a transform-based gamma correction method to provide the enhanced images. The proposed algorithm is assessed with artificial and real contrast distorted images, compared with twelve specialized methods, and the outcomes are evaluated using four advanced metrics. From the obtained results of experiments and comparisons, the developed algorithm demonstrated the ability to process various color and grayscale images, performed the best among the comparative methods, and scored the best in all four quality evaluation metrics. The findings of this study are significant because the proposed algorithm has low-complexity and can adjust the contrast of different images expeditiously, which enables it to be used with different imaging modalities especially those with limited hardware resources or produce high-resolution images.
Detection of Dense Small Rigid Targets Based on Convolutional Neural Network and Synthetic Images
Authors: Zhang Xianrong , Chen Gang
Published: March 2021

Facing the image detection of dense small rigid targets, the main bottleneck of convolutional neural network (CNN)-based algorithms is the lack of massive correctly labeled training images. To make up for the lack, this paper proposes an automatic end-to-end synthesis algorithm to generate a huge amount of labeled training samples. The synthetic image set was adopted to train the network progressively and iteratively, realizing the detection of dense small rigid targets based on the CNN and synthetic images. Specifically, the standard images of the target classes and the typical background mages were imported, and the color, brightness, position, orientation, and perspective of real images were simulated by image processing algorithm, creating a sufficiently large initial training set with correctly labeled images. Then, the network was preliminarily trained on this set. After that, a few real images were compiled into the test set. Taking the missed and incorrectly detected target images as inputs, the initial training set was progressively expanded, and then used to iteratively train the network. The results show that our method can automatically generate a training set that fully substitutes manually labeled dataset for network training, eliminating the dependence on massive manually labeled images. The research opens a new way to implement the tasks similar to the detection of dense small rigid targets, and provides a good reference for solving similar problems through deep learning (DL).
Abnormal Behavior Recognition in Classroom Pose Estimation of College Students Based on Spatiotemporal Representation Learning
Authors: Xie Yunfang , Zhang Su , Liu Yingdi
Published: March 2021

Artificial intelligence and fifth generation (5G) technology are widely adopted to evaluate the classroom poses of college students, with the help of campus video surveillance equipment. To ensure the effective learning in class, it is important to detect and intervene in abnormal behaviors like sleeping and using cellphones in time. Based on spatiotemporal representation learning, this paper presents a deep learning algorithm to evaluate classroom poses of college students. Firstly, feature engineering was adopted to mine the moving trajectories of college students, which were used to determine student distribution and establish a classroom prewarning system. Then, k-means clustering (KMC) was employed for cluster analysis on different student groups, and identify the features of each group. For a specific student group, the classroom surveillance video was decomposed into several frames; the edge of each frame was extracted by edge detection algorithm, and imported to the proposed convolutional neural network (CNN). Experimental results show that our algorithm is 5% more accurate than the benchmark three-dimensional CNN (C3D), making it an effective tool to recognize abnormal behaviors of college students in class.
Design and Optimization of a Finite Element Model for Electrical Resistance Tomography of Human Lungs
Authors: Xiao Liqing
Published: March 2021

To improve the reconstruction quality of electrical resistance tomography (ERT) images, this paper designs and optimizes the finite element model for human lungs. According to the computer tomography (CT) scan image on human chest, the entire simulation domain was divided into a region of lungs, heart, and spine, and a region of adipose tissue, and the boundary curve equations of each region were derived by the improved particle swarm optimization (PSO). Based on the prior knowledge, a structural model was established for human lungs; the ERT forward problem was solved by the finite element model based on grid reconstruction, and the calculated boundary voltage of sensitivity field was taken as the theoretical value. Next, two optimization goals were set up: improving the calculation accuracy of forward problem, and easing the ill-conditionedness of the sensitivity matrix; two variables were configured: the number of layers of the finite element model in each region, and the polar diameter ratio of the finite element nodes on each layer to the finite element nodes on the boundary of each region corresponding to the same polar angle. On this basis, the finite element model was optimized by the improved PSO to adapt to human lung ERT. Simulation results show that, under the same experimental conditions, the proposed finite element model could solve the forward problem more accurately, improve the ill-conditionedness of the sensitivity matrix and the Hessian matrix, and make the sensitivity distribution more uniformly, thereby enhancing the accuracy of image reconstruction.
Classification of Pneumonia Cell Images Using Improved ResNet50 Model
Authors: Çınar Ahmet , Yıldırım Muhammed , Eroğlu Yeşim
Published: March 2021

Pneumonia is a disease caused by inflammation of the lung tissue that is transmitted by various means, primarily bacteria. Early and accurate diagnosis is important in reducing the morbidity and mortality of the disease. The primary imaging method used for the diagnosis of pneumonia is lung x-ray. While typical imaging findings of pneumonia may be present on lung imaging, nonspecific images may be present. In addition, many health units may not have qualified personnel to perform this procedure or there may be errors in diagnoses made by traditional methods. For this reason, computer systems can be used to prevent error rates that may occur in traditional methods. Many methods have been developed to train data sets. In this article, a new model has been developed based on the layers of the ResNet50. The developed model was compared with the architectures InceptionV3, AlexNet, GoogleNet, ResNet50 and DenseNet201. In the developed model, the maximum accuracy rate was achieved as 97.22%. The model developed was followed by DenseNet201, ResNet50, InceptionV3, GoogleNet and AlexNet, respectively, according to their accuracy. With these developed models, the diagnosis of pneumonia can be made early and accurately, and the treatment management of the patient will be determined quickly.
Feature Extraction and Retrieval of Ecommerce Product Images Based on Image Processing
Authors: Wei Zhenfeng , Zhang Xiaohua
Published: March 2021

The new retail is an industry featured by online ecommerce. One of the key techniques of the industry is the product identification based on image processing. This technique has an important business application value, because it is capable of improving the retrieval efficiency of products and the level of information supervision. To acquire high-level semantics of images and enhance the retrieval effect of products, this paper explores the feature extraction and retrieval of ecommerce product images based on image processing. The improved Fourier descriptor was innovatively into a metric learning-based product image feature extraction network, and the attention mechanism was introduced to realize accurate retrieval of product images. Firstly, the authors detailed how to acquire the product contour and the axis with minimum moment of inertia, and then extracted the shape feature of products. Next, a feature extraction network was established based on the metric learning supervision, which is capable of obtaining distinctive feature, and thus realized the extraction of distinctive and classification features of products. Finally, the authors expounded on the product image retrieval method based on cluster attention neural network. The effectiveness of our method was confirmed through experiments. The research results provide a reference for feature extraction and retrieval in other fields of image processing.
An Efficient Multi-stage Object-Based Classification to Extract Urban Building Footprints from HR Satellite Images
Authors: Pendyala Gopala Krishna VSSN , Kalluri Hemantha Kumar , Rao Venkateswara C.
Published: March 2021

Urban building information can be effectively extracted by applying object-based image segmentation and multi-stage thresholding on High Resolution (HR) remote sensing satellite imageries. This study provides the results obtained using this method on the images of Indian remote sensing satellite, CARTOSAT-2S launched by the Indian Space Research Organization (ISRO). In this study, a method is developed to extract urban building footprints from the HR remote sensing satellite images. The first step of the process consists of generating highly dense per pixel Digital Surface Model (DSM) by using semi global matching algorithm on HR satellite stereo images and applying robust ground filtering to generate Digital Terrain Model (DTM). In the second step, multi-stage object-based approach is adopted to extract building bases using the PAN sharpened image, normalized Digital Surface Model (nDSM) derived from DSM and DTM, and Normalised Difference Vegetation Index (NDVI). The results are compared with the manual method of drawing building footprints by cartographers. An average precision of 0.930, recall of 0.917, and f-score of 0.922 are obtained. The results are found to be in a match with the method using the high resolution Airborne LiDAR DSM by providing a solution for large areas, low cost and low time.
Location Identification and Personalized Recommendation of Tourist Attractions Based on Image Processing
Authors: Zhang Qian , Liu Yi , Liu Lei , Lu Shuang , Feng Yuxue , Yu Xiao
Published: March 2021

Currently, tourists tend to plan travel routes and itineraries by searching for relevant information on tourist attractions via the Internet and intelligent terminals. However, it is difficult to achieve good retrieval effect on tourist attraction images with text labels. Based on deep learning, the visual location identification faces such defects as frequent mismatching, high probability of weak matching, and long execution time. To solve these defects, this paper puts forward a novel method for location identification and personalized recommendation of tourist attractions based on image processing. Specifically, the authors detailed the ideas and steps of the location identification algorithm for tourist attractions. The algorithm, grounded on hash retrieval, encompasses two stages: an offline stage, and an online stage. Besides, a personalized recommendation model for tourist attractions based on geographical location and time period. Finally, the proposed algorithm and model were proved accurate and effective through experiments.