Our study reported higher incidence of acute PTE in the middle age group population. Prevalence of dyslipidemia was high in this cohort of patients studied although the exact association of it in APE could not be determined. Thrombolytic therapy can be considered for patients with both massive and submassive pulmonary thromboembolism. Repeat thrombolysis can be considered in case one thrombolytic agent failed to give the desirable results.
This paper presents various applications of evolutionary computing approach for architectural space planning problem. As such the problem of architectural space planning is NP-complete. Finding an optimal solution within a reasonable amount of time for these problems is impossible. However for architectural space planning problem we may not be even looking for an optimal but some feasible solution based on varied parameters. Many different computing approaches for space planning like procedural algorithms, heuristic search based methods, genetic algorithms, fuzzy logic, and artificial neural networks etc. have been developed and are being employed. In recent years evolutionary computation approaches have been applied to a wide variety of applications as it has the advantage of giving reasonably acceptable solution in a reasonable amount of time. There are also hybrid systems such as neural network and fuzzy logic which incorporates the features of evolutionary computing paradigm. The present paper aims to compare the various aspects and merits/demerits of each of these methods developed so far. Sixteen papers have been reviewed and compared on various parameters such as input features, output produced, set of constraints, scope of space coverage-single floor, multi-floor and urban spaces. Recent publications emphasized on energy aspect as well. The paper will help the better understanding of the Evolutionary computing perspective of solving architectural space planning problem. The findings of this paper provide useful insight into current developments and are beneficial for those who look for automating architectural space planning task within given design constraints.
BACKGROUND: This study aimed to compare the postoperative outcomes and success rate of the endorectal advancement flap and ligation of intersphincteric fistulous tract (LIFT) in high-type fistula in ano. STUDY DESIGN: This randomized control trial included patients with high-type fistula in ano of cryptoglandular origin. The primary endpoint was complete fistula healing at the end of 6 months. However, the patients were followed up for 2 years. Other parameters studied were perioperative complications, duration of surgery, postoperative pain, hospital stay in hours, continence, and quality of life at 6 months. RESULTS: A total of 84 patients were recruited (42 in each group). The healing rate in the LIFT arm was better than that in the endorectal advancement flap arm (76.2.% vs 54.7%, p = 0.039). Four patients in the endorectal advancement flap group and two in the LIFT group had flatus incontinence at the end of 6 months, but all were continent at 2 years. At the end of the first week, the Visual Analog Scale score and quality of life at 6 months were better in the LIFT arm (3.7 ± 1.16 vs 4.7 ± 0.81 and 0.7 vs 0.6, p < 0.05). The mean duration of surgery was significantly less in the LIFT group (46.43 ± 9.32 vs 89.29 ± 10.90 minutes). None had any postoperative complications, and >80% were discharged within 24 hours. CONCLUSIONS: The shorter operative duration, better quality of life at 6 months, and higher healing rate make LIFT a superior treatment option for high fistula in ano. However, studies with a large sample size will be needed to verify these results.
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