Cervical Auscultation: A Systematic Review

Cervical auscultation refers to the technique of listening to the sounds of swallowing using a stethoscope or other measurement device such as placing microphone on the surface of the neck. This is based on the assumption that the normal biological sounds will be different from the abnormal biological sounds. The clinical applications of cervical auscultation were reviewed and discussed Keywords: Cervical auscultation, swallow sounds, swallowing assessment, biological sound

A comparative study of adverse reactions of taxol and non taxol based chemotherapy regimens in breast cancer

Background: The incidence of breast cancer is increasing in India. A combination of medicines is typically used to treat breast cancer. All the medications used in treatment are associated with various side effects. So this study is done to estimate and compare the adverse reactions of taxol and non-taxol based chemotherapy regimens in breast cancer patients attending Tirunelveli Medical College Hospital.Methods: The study was conducted in the oncology ward at TVMCH for a period of 60 days from August 2nd October 2nd 2014. Patients with unilateral or bilateral carcinoma breast with or without metastasis, receiving chemotherapy were included. Medication details such as the type of regimen, dose, and duration of regimen and relevant data of lab investigations were collected. 30 patients who fulfilled study criteria were included, out of which 16 were assigned FAC (5flurouracil, adriamycin, cyclophosphamide) regimen and 14 were assigned PAC (paclitaxel, adriamycin, cyclophosphamide) regimen.Results: The incidence of adverse reactions like myelodepression resulting in Neutropenia (64.28%), Anaemia (57%) and Thrombocytopaenia (21%) was comparatively higher with PAC regimens than FAC regimen. Nausea (75%) and vomiting (43%) was found to be higher with FAC regimen despite anti-emetic use. No serious adverse reactions occurred in either regimens.Conclusions: The adverse reaction profile of FAC regimen was found to be favourable than PAC therapy though not statistically significant, with no references to efficacy and potency of these regimens in the treatment of breast cancer patients with or without metastasis

On the Supergravity Gauge theory Correspondence and the Matrix Model

We review the assumptions and the logic underlying the derivation of DLCQ Matrix models. In particular we try to clarify what remains valid at finite $N$, the role of the non-renormalization theorems and higher order terms in the supergravity expansion. The relation to Maldacena's conjecture is also discussed. In particular the compactification of the Matrix model on $T_3$ is compared to the $AdS_5\times S_5$ ${\cal N}=4$ super Yang-Mills duality, and the different role of the branes in the two cases is pointed out.Comment: 19 pages, Late

Screening of liver protective effect of ethanolic leaf extract of Callicarpa lanata (EECL) in ethanol induced hepatotoxicity in wister rats

Background: The ethanolic extract of Callicarpa lanata (EECL), belonging to the family Verbenaceae, were studied for hepatoprotective activity in Wister rats with liver damage induced by ethanol.Methods: Ethanol treated rats showed significant increase in the levels of serum enzyme activities, total bilirubin and reduction in total proteins reflecting the liver injury caused by ethanol. EECL, at a dose of 400 and 200mg/kg body weight exhibited hepatoprotective effect by lowering the Serum Glutamate Pyruvate Transaminase (SGPT), Serum Glutamate Oxaloacetate Transaminase (SGOT), Serum Alkaline Phosphate (SALP), Gama Glutamyl Transpeptidase (GGTP), total Bilirubin to a significant extent and also significantly increased the levels of total protein in a dose dependent manner.Results: The results were highly significant at dose level of 400mg/kg body weight (p <0.01) and significant at dose level of 200mg/kg body weight (p <0.05). The effects of EECL at both levels were comparable with standard drug silymarin. The hepatoprotective activity was also supported by histopathological studies of liver tissue.Conclusions: In-vivo hepatoprotective activity of ethanolic leaf extract of Callicarpa lanata (EECL) against Ethanol induced acute liver injury in rats showed significant results in a dose dependent manner

Cepstral peak prominence: a comprehensive analysis

An analytical study of cepstral peak prominence (CPP) is presented, intended to provide an insight into its meaning and relation with voice perturbation parameters. To carry out this analysis, a parametric approach is adopted in which voice production is modelled using the traditional source-filter model and the first cepstral peak is assumed to have Gaussian shape. It is concluded that the meaning of CPP is very similar to that of the first rahmonic and some insights are provided on its dependence with fundamental frequency and vocal tract resonances. It is further shown that CPP integrates measures of voice waveform and periodicity perturbations, be them either amplitude, frequency or noise

Public-Private-Partnerships for Primary Care in India, Pakistan and Bangladesh: Lessons on Pathways and Drivers

Formalised public-private-partnerships (PPPs) for primary care have proliferated in the mixed health systems of India, Pakistan and Bangladesh, managed and funded by the state. This perspective provides a process-based understanding of pathways adopted by home-grown PPPs and underlying drivers to identify lessons for advancement under Universal Health Coverage (UHC). PPPs have been deployed to respond to local primary care needs ranging from diagnostic screening, maternity services, management of government health centres, mobile clinics to urban primary care systems. Partnerships have evolved to include a diverse range of private partners and more purposeful arrangements, with increase in service volumes, innovations albeit less standardised quality of care. The pathway of PPP instigation, rollout and sustaining in South Asia is based on local starting points by sub-national governments, diffusion of practice across states, common interests and shared bureaucratic coalitions. Success drivers include administrative support beyond the health sector, simplified contractual and payment systems providing operational ease and decision space, and the use of relational management and digital monitoring for resolving issues. However, PPPs are constrained by either too little accountability or excessive accountability in contract design, trust deficits between private and government, and fire-walled PPP implementation creates disconnects from national primary care planning and regulation. Donor supported projectized PPP funding and accompanying rules of business makes PPPs implementation more cumbersome. We conclude that future attention must centrally focus on pathways and drivers to impactfully introduce, scale-up and sustain PPPs in South Asia. Emphasis must be on pathways that build on local simplified ideation, progressive adaptation and allowing contextual diversity under a larger UHC planning architecture, as opposed to centralised one-fit and heavily technocratic initiatives. Success drivers must feature in design of PPP initiatives. Furthermore, we contend that international donor assistance should shift from projectized support for PPPs to building public sector competencies for stewardship, private sector engagement skills as well as the more traditional performance management capacity

Laparoscopic management of early stage primary fallopian tube carcinoma

Primary fallopian tube cancer (PFTC) is a rare malignancy with an incidence of 0.14-1.8% of all genital malignancies. Presentationsof fallopian tube cancer are mostly nonspecific and include abdominal pain, profuse watery or serosanguinous discharge. Here, wepresent the case of a 51-year-old patient with FIGO stage 1A PFTC. It was diagnosed as hematosalpinx intraoperatively, during totallaparoscopic hysterectomy and diagnosed as PFTC on histopathology. Further management was by laparoscopic staging. A high indexof suspicion is needed in peri and postmenopausal women who present with unexplained uterine bleeding, profuse discharge, pelvicpain, adnexal mass or abnormal pap smear