Chronic anal fissure (CAF) is usually associated with internal anal sphincter spasm, the relief of which is central to provide fissure healing. The treatment for CAF has undergone a transformation in recent years from surgical to medical. Both the approaches share the common goal of reducing the spasm. Though surgical treatment has a high success rate, it can permanently impair fecal continence in a large number of patients. Smooth muscle relaxation seems to be a novel way by which more than 60% of the patients can be cured with the topical use of the agents. This treatment is in addition to the normalization of stools mostly. Smooth muscle relaxation is well tolerated, can be administered on an outpatient basis, does not cause any lesion of the continence organ, and subsequently, does not lead to any permanent latent or apparent fecal incontinence. This review encompasses various agents that are used for smooth muscle relaxation. In addition, it describes various clinical studies reported in the literature with their success rates and side effects.
Back ground The discrimination between benign and malignant ovarian tumors is important considering to optimally plan for an appropriate surgical treatment. Aims To determine the applicability of risk of malignancy index (RMI 2) for triaging patients with adnexal masses seen at tertiary care hospital in India. Subjects and Methods A retrospective case note review of patients with adnexal masses admitted in Gynecology department was done. RMI 2 was calculated for each patient using ultrasound score, menopausal status, and CA-125 levels (U/ml), and the value of RMI was compared to the histological diagnosis. Statistical analyses were performed using SPSS version 17.0 by descriptive and inferential statistics. The p value B0.05 was considered significant. Results The Mean age and SD of hundred patients was 52.8 (10) years. Most of the patients were postmenopausal (68/100). A significant relationship of ovarian malignancy was found with increasing age, high ultrasound score, and high serum CA-125. The average value of CA-125 in benign and malignant ovarian tumor was 7.4 and 625, respectively. The RMI 2 at a cut-off value of 200 had a sensitivity of 96.7 %, specificity of 84 %, positive predictive value of 85.5 %, and negative predictive value of 67.7 %. Conclusion Our study confirms the applicability of RMI 2 [200 in diagnosing adnexal masses with high risk of malignancy. It can be easily introduced into clinical 123practice to facilitate the selection of the patients for surgery and also helpful in triaging patients to different treatment groups.
Most of the literature around text classification treats it as a supervised learning problem: given a corpus of labeled documents, train a classifier such that it can accurately predict the classes of unseen documents. In industry, however, it is not uncommon for a business to have entire corpora of documents where few or none have been classified, or where existing classifications have become meaningless. With web content, for example, poor taxonomy management can result in labels being applied indiscriminately, making filtering by these labels unhelpful. Our work aims to make it possible to classify an entire corpus of unlabeled documents using a human-in-the-loop approach, where the content owner manually classifies just one or two documents per category and the rest can be automatically classified. This "few-shot" learning approach requires rich representations of the documents such that those that have been manually labeled can be treated as prototypes, and automatic classification of the rest is a simple case of measuring the distance to prototypes. This approach uses pre-trained word embeddings, where documents are represented using a simple weighted average of constituent word embeddings. We have tested the accuracy of the approach on existing labeled datasets and provide the results here. We have also made code available for reproducing the results we got on the 20 Newsgroups dataset 1 .
Background: Iron is an essential trace element. It has a pivotal role in maintaining various cellular functions and enzyme reactions; whereas, iron overload has been known as a risk factor in progression of atherosclerosis. Objectives: The aim of this study was to investigate the role of the serum iron, serum ferritin and total iron binding capacity (TIBC) in the causation of coronary artery disease (CAD) and their relationship with other risk factors of CAD. Material and Methods: The study group consisted of 40 angiographically confirmed cases of CAD and 40 healthy controls. Serum lipids, serum lipoproteins, serum iron and TIBC were estimated by autoanalyzer (Dxc 900 Beckman coulter). Serum ferritin was measured on Mini VIDAS and malondialdehyde (MDA) was being done by Thiobarbituric acid method. Results: Significant difference was found among the controls and CAD patients regarding the occurrence of weight, height, BMI, Hip circumference and Waist circumference and FBS. The ratio of Total cholesterol and HDL was significantly raised in CAD patients (4.80) than controls (3.48). Serum iron and Serum ferritin levels were significantly elevated in patients with CAD when compared with control groups (118.2 ± 22.7mg/dl versus 105 ± 19.6mg/dl, p<0.001) and (218.3 ± 58.6mg/dl versus 139.8 ± 66 mg/ dl, p<0.0001) respectively. TIBC levels were lower in patients than controls (211.5 + 61.2 versus 309.8 + 79.2, p<0.0001). When body iron was compared with other risk factors (like smoking, hypertension, diabetes mellitus, tobacco etc) of the disease it was found to be significantly raised. Conclusion: Study concluded that increased levels of serum iron, ferritin might consider as risk factor for CAD in conjunction with other risk factors.
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