Mobility based key management technique for multicast security in mobile ad hoc networks.

In MANET multicasting, forward and backward secrecy result in increased packet drop rate owing to mobility. Frequent rekeying causes large message overhead which increases energy consumption and end-to-end delay. Particularly, the prevailing group key management techniques cause frequent mobility and disconnections. So there is a need to design a multicast key management technique to overcome these problems. In this paper, we propose the mobility based key management technique for multicast security in MANET. Initially, the nodes are categorized according to their stability index which is estimated based on the link availability and mobility. A multicast tree is constructed such that for every weak node, there is a strong parent node. A session key-based encryption technique is utilized to transmit a multicast data. The rekeying process is performed periodically by the initiator node. The rekeying interval is fixed depending on the node category so that this technique greatly minimizes the rekeying overhead. By simulation results, we show that our proposed approach reduces the packet drop rate and improves the data confidentiality.

Treatment of lepromatous ulcers using citric acid as a sole antimicrobial agent.

A prospective study was carried out to assess the role of citric acid as a sole antimicrobial agent in the management of lepromatous ulcers. Thirty-four known cases of lepromatous ulcers not responding to conventional antibiotic therapies for long duration were investigated for culture and susceptibility studies. Staphylococcus aureus (25·00%) and Klebsiella spp. (23·43%) were found to be the most common isolates. Amikacin (68·75%) and ciprofloxacin (67·18%) were found to be the most effective antimicrobial agents. Topical application of citric acid ointment resulted in complete healing in 25 (73·52%) cases. In eight cases (26·48%), there was elimination of infective agent from ulcer site and formation of healthy granulation, but no complete healing of ulcer was seen. Results indicate that citric acid is the best alternative for the effective management of lepromatous ulcers when other therapies are exhausted.

A comparison of clinical outcomes between vaccinated and vaccine-naive patients of COVID-19, in four tertiary care hospitals of Kerala, South India.

THE PROBLEM CONSIDERED: This multi-centric study analyzed data of COVID-19 patients and compared differences in symptomatology, management, and outcomes between vaccinated and vaccine-naive patients. METHODS: All COVID-19 positive individuals treated as an in-or out-patient from the 1stMarch to 15th May 2021 in four selected study sites were considered for the study. Treatment details, symptoms, and clinical course were obtained from hospital records. Chi-square was used to test the association of socio-demographic and treatment variables with the vaccination status and binary logistic regression were used to obtain the odds ratio with a 95% confidence interval. RESULTS: The analysis was of 1446 patients after exclusion of 156 with missing data of which males were 57.3% and females 42.7%. 346 were vaccinated; 189 received one dose and 157 both doses. Hospitalization was more in vaccinated (38.2% vs 27.4%); ICU admissions were less in vaccinated (3.5% vs 7.1%). More vaccinated were symptomatic (OR = 1.5); half less likely to be on non-invasive ventilation (OR = 0.5) while vaccine naive patients had 4.21 times the risk of death. CONCLUSION: Severe infection, duration of hospital stays, need for ventilation and death were significantly less among vaccinated when compared with vaccine naive patients.

Citric acid treatment of postoperative wound in an operated case of synovial sarcoma of the knee.

A 40-year-old female presented with history of swelling at the upper and middle of the left leg since 6 months was confirmed as post cancer surgery non healing wound not responding to conventional antibiotic therapy and local wound care in an operated case of synovial sarcoma of the knee, monophasic fibrous type with no lung metastasis. Post surgical non healing wound not responding to conventional therapy was treated successfully with local application of 3% citric acid ointment for 25 days.

Security and Privacy of Cloud- and IoT-Based Medical Image Diagnosis Using Fuzzy Convolutional Neural Network.

In recent times, security in cloud computing has become a significant part in healthcare services specifically in medical data storage and disease prediction. A large volume of data are produced in the healthcare environment day by day due to the development in the medical devices. Thus, cloud computing technology is utilised for storing, processing, and handling these large volumes of data in a highly secured manner from various attacks. This paper focuses on disease classification by utilising image processing with secured cloud computing environment using an extended zigzag image encryption scheme possessing a greater tolerance to different data attacks. Secondly, a fuzzy convolutional neural network (FCNN) algorithm is proposed for effective classification of images. The decrypted images are used for classification of cancer levels with different layers of training. After classification, the results are transferred to the concern doctors and patients for further treatment process. Here, the experimental process is carried out by utilising the standard dataset. The results from the experiment concluded that the proposed algorithm shows better performance than the other existing algorithms and can be effectively utilised for the medical image diagnosis.

Citric acid treatment of necrotizing fasciitis: a report of two cases.

Necrotizing fasciitis is a destructive invasive infection of skin, subcutaneous tissue and deep fascia, with relative sparing of muscle. It is a life-threatening condition. Here we report two cases of necrotizing fasciitis, which were not responding to conventional antibiotic therapy and local wound care after aggressive debridement. These two cases were treated simply by local application of 3% citric acid. Thus, citric acid was used to compliment wound management following surgical treatment with antibiotics.

A simple and effective approach for the treatment of diabetic foot ulcers with different Wagner grades.

Diabetic foot infections are the major cause of morbidity. Infection is the common sequel of diabetic foot ulceration that leads to delayed wound healing. These infections are difficult to control. If not addressed well in time, they may lead to amputation of foot. An attempt has been made to develop simple and effective treatment modality by using citric acid as a sole antimicrobial agent to control diabetic foot infections not responding to conventional treatment. Hundred and fifteen cases of diabetic foot ulcers of different Wagner grades infected with a variety of bacteria were investigated for culture and susceptibility, and susceptibility to citric acid. Citric acid gel was applied to ulcer to determine its efficacy in the management of diabetic foot ulcers with different Wagner grades. Citric acid gel was found effective in the control of foot infections; especially in Wagner grades I and II, the success rate was found to be more than 94%. In Wagner grade III also, it was found effective in complete healing of ulcers without deep osteomyelitis. Citric acid treatment is effective in the control of diabetic foot infections and in successful management of diabetic foot ulcers with Wagner grades I and II, and even with Wagner grade III, without deep osteomyelitis.

Marker Assisted Gene Pyramiding (MAGP) for bacterial blight and blast resistance into mega rice variety "Tellahamsa".

Bacterial blight (BB) and fungal blast diseases are the major biotic constraints that limit rice productivity. To sustain yield improvement in rice, it is necessary to developed yield potential of the rice varieties by incorporation of biotic stress resistance genes. Tellahamsa is a well-adapted popular high yielding rice variety in Telangana state, India. However, the variety is highly susceptible to BB and blast. In this study, simultaneous stepwise transfer of genes through marker-assisted backcross breeding (MABB) strategy was used to introgress two major BB (Xa21 and xa13) and two major blast resistance genes (Pi54 and Pi1) into Tellahamsa. In each generation (from F1 to ICF3) foreground selection was done using gene-specific markers viz., pTA248 (Xa21), xa13prom (xa13), Pi54MAS (Pi54) and RM224 (Pi1). Two independent BC2F1 lines of Tellahamsa/ISM (Cross-I) and Tellahamsa/NLR145 (Cross-II) possessing 92% and 94% recurrent parent genome (RPG) respectively were intercrossed to develop ICF1-ICF3 generations. These gene pyramided lines were evaluated for key agro-morphological traits, quality, and resistance against blast at three different hotspot locations as well as BB at two locations. Two ICF3 gene pyramided lines viz., TH-625-159 and TH-625-491 possessing four genes exhibited a high level of resistance to BB and blast. In the future, these improved Tellahamsa lines could be developed as mega varieties for different agro-climatic zones and also as potential donors for different pre-breeding rice research.

Arthrobacter sp. lipase immobilization for preparation of enantiopure masked beta-amino alcohols.

Recent reports on immobilization of lipase from Arthrobacter sp. (ABL, MTCC 5125; IIIM isolate) on insoluble polymers have shown altered properties including stability and enantioselectivity. Present work demonstrates a facile method for the preparation of enantiopure beta-amino alcohols by modulation of ABL enzyme properties via immobilization on insoluble as well as soluble supports using entrapment/covalent binding techniques. Efficacies of immobilized ABL on insoluble supports prepared from tetraethylorthosilicate/aminopropyltriethoxy silane and soluble supports derived from copolymerization of N-vinyl pyrrolidone-allylglycidyl ether (ANP type)/N-vinyl pyrrolidone-glycidyl methacrylate (GNP type) for kinetic resolution of masked beta-amino alcohols have been studied vis-à-vis free ABL enzyme/wet cell biomass. The immobilized lipase on different insoluble/soluble supports has shown 21-110 mg/g protein binding and 30-700 U/g activity for hydrolyzing tributyrin substrate. The findings have shown a significant enhancement in enantioselectivity (ee 99%) vis-à-vis wet cell biomass providing ee 70-90% for resolution of beta-amino alcohols.

C S in Surgery, a Personal Perspective.

This is a reflection of a 30-year career of a general surgeon, who has maintained a logbook of all his surgical work. Reading between the lines in this logbook, a number of essential qualities and traits needed for a successful career have been brought out. All these have been grouped into a novel way, using the letters "C" and "S" to describe each of them. Success in surgery relate to the tripod of Common Sense, dealing with the Changing Scenario, and having Civic Sensibility. Each component of this tripod is further broken down into several entities, all with the letter "C" and "S," to finally give the benefits of such qualities to the surgeon, each of which also begins with the letters "C" and "S."

Macroporous copolymer matrix. IV. Expanded bed adsorption application.

Macroporous crosslinked hydroxyethyl methacrylate-ethylene dimethacrylate copolymeric beads (HEG beads) were synthesized by suspension polymerization in the presence of a pore generating agent. These beads were coupled to alpha-cyclodextrin through a urethane spacer. These modified copolymer beads (affinity-HEG beads) so prepared were evaluated for their suitability in expanded bed chromatography. The optimum thickness of the distributor plate for stable expanded bed for use in expanded bed adsorption (EBA) was established. The affinity-HEG beads are comparable in density to Streamline diethyl amino ethane (DEAE) and exhibit better mechanical stability at higher superficial velocity under fluidization. The affinity-BEG beads were used as affinity chromatography matrices for the purification of cyclodextrin glycosyltransferase. Feeding of 5-fold diluted fermented broth to the column containing affinity-HEG beads of settled bed height 7.5 cm (I.D. 26 mm and length 42 cm) at double bed expansion resulted in a sharp breakthrough curve of alpha-cyclodextrin glycosyltransferase (CGTase). The adsorbed enzyme was eluted from the bed in 50 mM Tris-HCl buffer containing 10 mM CaCl2 at 25 degrees C in packed bed configuration.

Adsorption and expression of penicillin G acylase immobilized onto methacrylate polymers generated with varying pore generating solvent volume.

Adsorption and expression of penicillin G acylase was studied on macroporous methacrylate polymer beads of differing pore volume, generated with kerosene. The absorption and expression of the penicillin G acylase was dependent on pore volume. Maximum expression of 57% of adsorbed enzyme was obtained on beads synthesized with 40 mL of kerosene, indicating minimum pore-diffusion limitations.

Bilateral proptosis due to metastatic Ewing's sarcoma of the orbit: fine needle aspiration cytology (FNAC) and histopathology of a case.

Bilateral proptosis due to metastatic Ewing's sarcoma is an extremely rare presentation and thus merits reporting. The role of fine needle aspiration cytology in the diagnosis is highlighted.

Training and assessment of psychomotor skills for performing laparoscopic surgery using BEST-IRIS virtual reality training simulator.

In this article, we present the results of a pilot study that examined the performance of people training on a Virtual Reality based BEST-IRIS Laparoscopic Surgery Training Simulator. The performance of experienced surgeons was examined and compared to the performance of residents. The purpose of this study is to validate the BEST-IRIS training simulator. It appeared to be a useful training and assessment tool.

Limberg flap for sacrococcygeal pilonidal sinus a safe and sound procedure.

Sacrococcygeal pilonidal sinus (SC-PSD) is an acquired condition usually seen in young adults especially males. This prospective study has been performed to determine effects of the Limberg flap rotation surgery for sacrococcygeal pilonidal sinus, its feasibility to the patients, their compliance, and outcomes such as wound infection, postoperative pain relief, recurrence rates, and return to work. A total of 30 patients were operated by the same two surgeons from January 2009 to June 2011, including both primary and recurrent diseases, and patients with previous incision and drainage done for the pilonidal abscess. All patients successfully underwent surgery, with very minimal postoperative pain, stayed in hospital for average 5 days, returned to work after 3 weeks, with 3 patients having flap edema, 2 having flap necrosis, and no recurrences so far. Patients with flap edema and flap necrosis took 2-3 weeks to heal with regular dressing and antibiotic usage. Limberg flap for sacrococcygeal pilonidal sinus was found very useful and sound in terms of postoperative pain, infection rates, and early return to work with almost nil recurrences.

Simple, effective and affordable approach for the treatment of burns infections.

OBJECTIVE: The aim of the present study was to develop a simple and effective treatment modality using citric acid as a sole antimicrobial agent to control infections in burns patients not responding to conventional treatment. METHODS: Forty-six cases with 5-60% superficial to deep burns in a study group and 20 cases with 10-70% superficial to deep burns in a control group were investigated for culture and susceptibility. The isolates in study group were further tested for susceptibility to citric acid. Three percent citric acid gel was applied to burns wounds in study group; however, the control group received conventional antibiotic therapy and local wound care. RESULTS: In the control group, Pseudomonas aeruginosa (44.44%) and Staphylococcus aureus (33.33%) were found to be the commonest bacterial isolates and, amikacin and ciprofloxacin (40.74%) were found to be most effective antibacterial agents. In study group, P. aeruginosa (30.48%) and S. aureus (23.17%) were found to be the commonest bacterial isolates. Ceftazidime (52.43%), ciprofloxacin (47.56%) and amikacin (46.34%) were found to be most effective antibacterial agents. Application of citric acid to burn wounds resulted in complete healing in 40 (86.95%) cases in 7-25 applications (P value 0.145); however, in a control group conventional antibiotic therapy and local wound care resulted in complete healing in nine (45%) patients only. CONCLUSIONS: Citric acid treatment was found effective in the control of burns infections as compared to conventional therapy. Complete healing in 86.95% cases as compared to 45% in a control group indicates that citric acid is nontoxic, economical and quite effective in the management of burns infections.

Preserved vision in a case of morning glory syndrome: some pertinent questions.

Morning glory syndrome, an unusual developmental anomaly of the optic nerve head, presenting with funnelled enlargement of the disc with a white dot in the centre and a peripheral vascular pattern along the disc margin, with features of typical entry and exit of retinal vessels on the optic nerve head and exceptionally good vision in the involved eye with old traumatic retinal detachment in the other, in a young Indian girl is described here for its rarity and indifferent clinical presentation. Various factors in its pathogenesis are postulated.

Status of cyclopentolate as a cycloplegic in children: a comparison with atropine and homatropine.

We compared the cycloplegic effects of cyclopentolate, homatropine and atropine by the retinoscopy findings and residual accommodation left following their use in the same individual. The mean residual accommodation measured after the use of cyclopentolate, homatropine and atropine was 1.48 +/- 0.33 D, 2.32 +/- 0.37 D and 1.10 D +/- 0.28 D, respectively, and the mean difference in retinoscopy readings between cyclopentolate and homatropine, homatropine and atropine, and atropine and cyclopentolate was 0.46 +/- 0.21, 0.71 +/- 0.23 and 0.26 +/- 0.14, respectively. We further observed that a tonus allowance of about +0.75 D would suffice for cyclopentolate. The merits for recommending cyclopentolate as a routine cycloplegic in children are discussed.