Background: Intra-myocardial re-entry is the predominant mechanism in scar-related ventricular tachycardia (VT). We investigated the presence of focal VTs found either remote or adjacent to scar borderzones in a cohort of patients with structural heart disease (SHD). Methods and Results: Nineteen patients referred for catheter ablation were included (mean age, 67 ± 13 years; ejection fraction, 46% ± 14%; ICD, 17 patients (89%); cardiomyopathy, 15 patients (79%). A median of 3 VTs were inducible per patient (29 focal VTs and 34 reentrant VTs), 21% of patients with >1 focal VT (median 3.5) induced and 53% had both focal and re-entrant VT induced. The RVOT was the most common site (37%), followed by the RV moderator band (21%) lateral LV (16%) and papillary muscles (15%). Overall, in 12 patients the focal VT matched the clinical VT. Acute procedural success was observed in 11 patients (58%). After a median follow-up of 258 days, 11 patients (61%) remained arrhythmia-free. In those with recurrence, ICD therapies were significantly reduced from a median of 53 ATP episodes pre-ablation (with 69% of patients experiencing failed ATP reversions) to a median of 7 ATP episodes post catheter ablation. During follow-up, there was no focal VT recurrence. Conclusion: Focal VTs commonly originate remote or adjacent to the scar border in regions of normal voltage. Revealing and treating focal VTs may result in improved outcomes as it commonly correlates to the clinical VT morphology and offers a potential explanation for high rates of failed ICD therapies with ATP in this group.

Background: Melioidosis is an emerging infectious disease caused by soil inhabitant gram negative bacterium Burkholderia pseudomallei. The disease which is endemic in Thailand and Northern Australia has shown an increasing trend in India in past few years. Epidemiological study of clinical isolates and their genetic relatedness to strains from neighboring south Asian countries remains undefined. The aim of the study was to analyze the molecular diversity of clinical B.pseudomallei isolates from southern India. Methods & Materials: A total of 28 clinical strains of B.pseudomallei isolated from patients diagnosed with melioidosis at a tertiary care teaching hospital in southern India were included in the study. All isolated were subjected to Multilocus sequence typing (MLST) by amplification and sequencing of seven housekeeping genes. Sequences obtained from each locus were compared with the mlst database available on http://mlst.net. Further, sequence types (ST) were assigned for each isolate were tested for their genetic relatedness using e-burst analysis to the STs of isolates reported from neighboring countries of south Asia. Results: Of the 28 isolates tested, 26 isolates had novel allelic profiles and 2 isolates matched with previously reported allelic profiles. Among the 26 isolates with novel allelic profiles, 15(53.6%) isolates were assigned as a new ST 1368 and the other 10 (38.4%) isolates were assigned STs 1369, 1370 (2), 1371(2), 1372, 1375(2), 1379 and 1380. One isolate had a novel allele in the gltB region. Two isolates which matched in their STs with previously reported isolates on the MLST database belonged to a single patient who presented initially with a systemic illness followed by a localized form of re-infection. Upon eburst analysis, we observed distinct molecular epidemiology of our isolates in comparison with STs reported from the neighboring countries of south Asia. Conclusion: Predominance of a novel ST 1368 among our patients, which does not demonstrate genetic relatedness with other STs from neighboring countries of South Asia as well as from Australia was observed in the study. Further, our study findings underscore the high level of genetic diversity among clinical isolates of B. pseudomallei from coastal parts of south western India.

A radiographic diagnosisA 29-year-old man presented with a penetrating injury in the posterior aspect of his neck.His vital signs were stable.On plain CT head and neck, pneumorrhachis along with air in subcutaneous plane was seen (figures 1 and 2).Pneumorrhachis is a rare and usually missed radiographic finding in a patient with coincident underlying injuries and disease.Two types are seen: intradural and extradural.The etiologies are iatrogenic, traumatic, and atraumatic. 1 A few rare causes follow violent coughing, forceful emesis,

A 29-year-old man presented with a penetrating injury in the posterior aspect of his neck. His vital signs were stable. On plain CT head and neck, pneumorrhachis along with air in subcutaneous plane was seen (figures 1 and 2).

Maternal to child transmission (MTCT) is responsible for over 90 % of all childhood HIV infections. Lack of awareness regarding HIV and preventive practices against MTCT maybe one of the reasons behind high HIV transmission rates. In our study, we assessed the knowledge of HIV/AIDS in antenatal women, attending a tertiary care hospital in India as well as their attitude toward voluntary counseling and testing (VCT) for HIV.

Summary This prospective study was designed to evaluate whether early changes in actin‐free G c‐globulin levels were associated with complications and outcomes and to identify factors associated with persistent low actin‐free G c‐globulin levels in acute liver failure ( ALF ). Thirty‐two consecutive ALF patients admitted from O ctober 2011 to D ecember 2012 were followed up until death or complete recovery. All had serum actin‐free G c‐globulin estimation at admission and at day three or expiry. Logistic regression analysis was performed to identify independent predictors of mortality. A receiver operating characteristic curve analysis was also performed. Nonsurvivors had significantly lower median actin‐free G c‐globulin levels than survivors (87.32 vs 180 mg/L; P < 0.001). A receiver operating characteristic curve analysis revealed an area under curve ( AUC ) of 0.771 and showed that serum actin‐free G c‐globulin level of ≤124 mg/L would predict mortality with 92% sensitivity and 71.4% specificity. Patients with lower serum actin‐free G c‐globulin levels and decreasing trend in serum actin‐free G c‐globulin levels were found to have more mortality and developed more complications. Logistic regression analysis showed that serum actin‐free G c‐globulin, total leucocyte count and serum creatinine at admission were independent predictors of mortality. Incorporating these variables, a score predicting mortality risk at admission was derived. The scoring system was compared to MELD score and K ing's C ollege C riteria as individual predictor of mortality. Serum actin‐free G c‐globulin level at presentation is predictive of outcome and can be used for risk stratification. Its persistent low‐level predicts mortality and is correlated with various complications.

Although tubercular meningitis is common in children, tubercular ventriculitis is uncommon. The authors report a 3-mo-old infant who had tubercular ventriculitis secondary to disseminated tuberculosis.

Summary The Ravva field in K-G Basin, India was discovered in 1987 and brought into production in 1993. To-date the field has produced more than 259 MMbbls of oil and sold 327 BCF of gas, more than double of its initial estimates. Staged and appropriate use of geophysical technologies and multi-disciplinary integration has helped in extending the life of this field. The Ravva Field JV's reservoir management team's commitment to excellence in reservoir management is evident from the production performance of the field. Production plateau was significantly extended before it declined in 2008, through sound reservoir management practices and regular infill drilling of the wells. The multi-disciplinary integration of various reservoir characterization and simulation studies, dynamic reservoir surveillance programs and 4D monitoring techniques further extending the field life. In this paper, we provide a brief history on the role geophysical technologies in extending the life of the field. From the beginning of the field development to the current phase of sustaining the production, the geophysical technologies played a vital role by accurately mapping the structure, extending the field limits, understanding fault compartmentalization, providing insights into the reservoir quality, optimizing infill well locations, identifying bypassed pay areas and finally discovering and developing the near field hydrocarbon pools.

Craniosynostosis means premature closure of calvarial sutures. It may be primary or secondary. The patient presents with unexplained neuropsychological impairment and radiological imaging clinches the diagnosis. We present a case of 31-year-old female having primary isolated craniosynostosis who survived into adulthood without any surgical intervention. The imaging findings of such a case are rarely described in the literature.

Electrolyte abnormalities are very common problems in clinical practice, and if chronic, their management can be difficult. Hypokalemia, defined as a serum potassium level 20% of hospitalized patients have been reported to have some degree of hypokalemia [1]. Hypomagnesemia is also common and has been observed in as many as 50% of critically ill and Intensive Care Unit patients [2]. Patients with severe electrolyte deficiencies may be treated with intravenous (IV) or oral replacement regimens. We discuss a case in which a patient was treated for 16 years with an IV electrolyte replacement regimen. Using a stepwise approach, we were able to stop the IV replacement therapy and transition the patient to an oral electrolyte replacement.

The present study deals with the phytosociological analysis, anthropogenic impacts and regeneration status of tree species in five dominant forest types along an altitudinal gradient in Paddar valley of Northwest Himalaya. The tree density varied between 179 to 245 trees/ha whereas the total basal area varied between 24.7 and 37.7 m²/ha in five forest types. The value of Shannon-Weiner index (H') was found maximum for western mixed coniferous forest (1.75) whereas Concentration of dominance (Cd) and Evenness (J') were found maximum for dry temperate deciduous forest (0.41) and dry deodar forest (0.32) respectively. The maximum disturbance was found in the dry temperate deciduous forests due to heavy dependence of the locals on oak, Quercus baloot for fuelwood and fodder. The results pertaining to regeneration status of 18 tree species shows 4 species with good regeneration,6 species with fair regeneration and 5 species with poor regeneration status whereas 3 tree species were found to have no regeneration at all. The regeneration was good for mixed coniferous forest and birch fir forests, poor for broadleaved and coniferous forest and fair for dry temperate deciduous forest and dry deodar forests.

2 I. INTRODUCTION Power system economics procedure includes of two aspects: active power regulation and reactive power dispatch. This forms a global optimization problem of a large-scale industrial system.The reactive power problem is less manageable to solve than the active power problem due to its more complicated relationship between variables. The reactive power problem is largelyassociated to voltage stability.Reactive power and voltage control is incredibly essential for the right operation and control of power system. Reactive power dispatch is one of the necessary tasks in the operation and control of power system.Voltage stability is a drawback in power systems that are heavily loaded, faulted or have a deficiency of reactive power. The character of voltage stability may be analysed by examining the generation, transmission and consumption of reactive power. Transfer of reactive Power is toughbecause of extremely high reactive power losses; that " s why the reactive power needed for voltage control is generated and consumed at the control area.Optimization is a mathematical procedurewhich discusses the finding of maxima or minima of functions in some realistic region. There " s no industry or businessthat is not involved in solving optimization problems.By Optimizing reactive power Dispatch in Power systems, the maximum active power transfer capability to the distribution systems can be improved. Stand-by reactive power sources (capacitor banks generally) are needed for loss minimization, in order to maintain the voltage stability in the Power systems [11-12].

Microarray is new techniques to investigate the expression levels of thousands of genes simultaneously. Gene expressions provide information about the cell activity in an organism. cDNA (complementary DNA) microarray is one of the most recent and important technology for exploring the genome. By comparing gene expression in normal and abnormal cells, microarrays may be used to identify genes, which are involved in particular diseases. These genes may then be targeted by therapeutic drug. The segmentation step is important, because it considerably affects the precision of microarray data. This paper makes a fine distinction against the gene expressions in the microarray image processing. For this reason, the k-means and fuzzy c–means methods and observed the results. And the method of thresholding the intensity of each spot is calculated and the gene expression is observed.

Basic aim of our study is to analyze the medical image. In computer vision, segmentationRefers to the process of partitioning a digital image into multiple regions. The goal ofSegmentation is to simplify and/or change the representation of an image into something thatIs more meaningful and easier to analyze. Image segmentation is typically used to locateObjects and boundaries (lines, curves, etc.) in images. There is a lot of scope of the analysis that we have done in our project; our analysis couldBe used for the purpose of monitoring the medical image. Medical imaging refers to theTechniques and processes used to create images of the human body (or parts thereof) forClinical purposes (medical procedures seeking to reveal, diagnose or examine disease) orMedical science (including the study of normal anatomy and function). As a discipline and in its widest sense, it is part of biological imaging and incorporatesRadiology (in the wider sense), radiological sciences, endoscopy, (medical) thermography, Medical photography and microscopy (e. g. for human pathological investigations). Measurement and recording techniques which are not primarily designed to produce images,

Abstract Ras, a critical oncogene, is one of small GTPase family members. It is active when bound to GTP and inactive when bound to GDP. The activation process needs membrane translocation of Ras because its activators are recruited by membrane receptors, such as EGF receptors. In addition, appropriate localization of activated Ras also is critical for interacting with the downstream effectors. Therefore, regulation of Ras membrane translocation is very important for Ras function. Nogo-B receptor (NgBR) is a type I receptor with a single transmembrane domain. Our previous work has shown that axon guidance gene family Nogo-B and its receptor (NgBR) are essential for chemotaxis and morphogenesis of endothelial cells in vitro and blood vessel formation in Zebrafish. Here, we demonstrate that NgBR can bind and recruit farnesylated Ras to plasma membrane, which results in the activation of PI3K-Akt and Raf-MEK-ERK signaling pathways in human breast cancer cells. Direct interaction between NgBR and farnesylated Ras has been demonstrated by co-immunoprecipitation of MBP-NgBR from incubation of purified recombinant farnesylated Ras and MBP-NgBR protein. Knockdown of NgBR in MDA-MB-231 human breast cancer cells remarkably reduces the amount of membrane-associated Ras. These results suggest that NgBR is a potential modulator for Ras translocation. Knockdown of NgBR expression in MDA-MB-231 breast cancer cells decreases cancer cell colony formation, and abolishes EGF-stimulated Ras activation and phosphorylation of Akt in MDA-MB-231 cells. In addition, overexpression of NgBR caused the transformation of NIH-3T3 cells via increasing Ras plasma membrane translocation and enhancing EGF-stimulated Ras signaling. Knockdown of NgBR decreases the survival and colony formation of MDA-MB-231 cells after irradiation and increases the cisplatin-induced apoptosis and Caspase-3 activity of MDA-MB-231 Cells. These results suggest that NgBR can increase MDA-MB-231 breast cancer cell sensitivity to chemotherapeutic drug and irradiation. Consequently, our preliminary results further demonstrated that inducible knockdown of NgBR in tumor xenograft of MDA-MB-231 cells in nude mice significantly retards tumor growth. Thus, these data demonstrate that NgBR is a unique receptor that recruits farnesylated Ras to the plasma membrane via its hydrophobic cytoplasmic domain and then activates both PI3K-Akt and Raf-MEK-ERK pathways in human breast cancer cells. Collectively, it is the first study to demonstrate that NgBR is a potential therapeutic target for inhibiting Ras-dependent growth of breast cancer and decreasing the sensitivity of breast cancer cells to chemotherapeutic drug and irradiation.

Secondary tuberculosis of mandible is an uncommon complication of primary tuberculosis elsewhere in the body, most frequently, in the lungs. Primary tuberculosis of the mandible is a very rare entity, of which only eight cases have been reported in literature till date. A case of primary tuberculosis of mandible in a 9-year-old girl is presented here.

Tharparkar is a backward district of Sindh, Pakistan. Most of the rural population of this district suffers from poverty and is deprived of very basic necessities of life such as drinking water and electricity. Demographic pattern was the main hurdle for rural electrification as the villages are scattered far apart in a random manner and a grid supplied electrical distribution was not technically feasible. Solar energy is one of the alternatives for rural electrification and other applications at desert of Tharparkar.This chapter presents the practical applications of solar energy at desert of Tharparkar, Pakistan. Alternative Energy Development Board (AEDB) has successfully electrified 50 villages of Tharparkar district through about 168 kW of DC power. A solar refrigerator has also been installed at BHU of village Khensir taluka Chacharo to store vaccines for snake bites and other lifesaving drugs. Remarkable socioeconomic and sociocultural change has been visualized in the dark areas which has been brightened through solar energy.