Non-invasive glucose prediction and classification using NIR technology with machine learning.

In this paper, a dual wavelength short near-infrared system is described for the detection of glucose levels. The system aims to improve the accuracy of blood glucose detection in a cost-effective and non-invasive way. The accuracy of the method is evaluated using real-time samples collected with the reference finger prick glucose device. A feed forward neural network (FFNN) regression method is employed to predict glucose levels based on the input data obtained from NIR technology. The system calculates glucose evaluation metrics and performs Surveillance error grid (SEG) analysis. The coefficient of determination R2 and mean absolute error are observed 0.99 and 2.49 mg/dl, respectively. Additionally, the system determines the root mean square error (RMSE) as 3.02 mg/dl. It also shows that the mean absolute percentage error (MAPE) is 1.94% and mean squared error (MSE) is 9.16 (mg/dl)2 for FFNN. The SEG analysis shows that the glucose values measured by the system fall within the clinically acceptable range when compared to the reference method. Finally, the system uses the multi-class classification method of the multilayer perceptron (MLP) and K-nearest neighbors (KNN) classifier to classify glucose levels with an accuracy of 99%.

Low-profile 700 MHz conformal omni-directional antenna for commercial wireless and safety communication wearable applications.

The 700 MHz public safety spectrum is released for commercial wireless and safety communication wearable applications (CWSC-WA). However, the 700 MHz band need a larger aperture for an efficient radiation due to a larger wavelength. In this paper, we have systematically developed a novel miniature omnidirectional 700 MHz antenna for the CWSC-WA. Over 40% miniaturization is realized by truncating the ground plane and a meander line inspired radiator compared to a conventional rectangular patch antenna. The truncation of the ground plane also yields a perfect omnidirectional radiation pattern desired for the CWSCA. Considering current and future demands of wearable electronics and virtual reality, the antenna is made on a flexible substrate and conformity analysis is also performed. The prototype of the antenna is developed and simulated results are verified in planar as well as conformal configurations.

Recent Development in the Search for Epidermal Growth Factor Receptor (EGFR) Inhibitors based on the Indole Pharmacophore.

The signal transduction and cell proliferation are regulated by the epidermal growth factor receptor. The proliferation of tumor cells, apoptosis, invasion, and angiogenesis is inhibited by the epidermal growth factor receptor. Thus, breast cancer, non-small cell lung cancer, cervical cancer, glioma, and bladder cancer can be treated by targeting the epidermal growth factor receptor. Although third-generation epidermal growth factor receptor inhibitors are potent drugs, patients exhibit drug resistance after treatment. Thus, the search for new drugs is being continued. Among the different potent epidermal growth factor receptor inhibitors, we have reviewed the indole-based inhibitors. We have discussed the structure-activity relationship of the compounds with the active sites of the epidermal growth factor receptor receptors, their synthesis, and molecular docking studies.

Miniaturized Parasitic Loaded High-Isolation MIMO Antenna for 5G Applications.

In this paper, a multiple-input-multiple-output (MIMO) antenna is reported for 5G frequency range-2 (FR-2), 28 GHz bands. The MIMO antenna is developed in multiple iterations, including single-element design, cross-polarization reduction, and mutual coupling reduction. Initially, a single-element coplanar edge feed rectangular patch antenna is designed and the E-plane cross-polarization is reduced by -13 dB by trimming the forward corners of the patch. The ground plane is truncated to improve the -3 dB half-power-beamwidth (HPBW). A multi-wavelength spiral inspired parasitic surrounding the single element antenna is loaded, and performance analysis is performed. This parasitic element is used for self-field cancelation for the MIMO configuration. Two MIMO configurations, one with linear and the second with inverted elements, are developed and investigated. The first configuration is found to have better isolation of less than -25 dB compared to the -20 dB of the second configuration. Similarly, the gain of 4.8 dBi, the bandwidth of 3 GHz, envelope correlation coefficient (ECC) of 0.01, and diversity gain (DG) of 9.99 dB are superior to the second configuration. To validate the work, one of two MIMO configurations is fabricated and good agreement is found between simulation and measurement results.

Elevated Skull Fractures - Too Rare to Care for, Yet too Common to Ignore.

Elevated skull fractures form a rare subset of compound skull fractures owing to the paucity of cases studied and reported. In this article, we present 17 cases of elevated skull fracture in a mixed population of adult and pediatric age groups which were operated over a period of 5 years (2012-2017) at our institute. We have discussed the mode of injury, clinical presentation, clinicoradiological findings, and treatment options highlighting the appropriate management strategies opted. Although elevated fractures are rare; issuing definite treatment protocol can reduce the morbidity and mortality of the patients.

Depressed Fractures of Skull: An Institutional Series of 453 Patients and Brief Review of Literature.

BACKGROUND: There has been a substantial increase in the number of cases with head injuries in the past two decades which has simultaneously led to increase in the annual incidence of depressed fractures of skull. Most of these skull fractures are associated with considerable morbidity and mortality of patients and an unavoidable financial burden on the family members. However, many changes have been undertaken directed toward improved management of patients with head injuries and skull fractures in the past 20 years. OBJECTIVE: To study and compare the patterns of occurrence of the depressed fractures of skull and examine the factors which may influence the surgical outcome of patients with reference to similar case series from the past literature. PATIENTS AND METHODS: We reviewed patient records of 453 patients admitted with depressed skull fractures in Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, India, during the period of March 2004 through July 2009. RESULTS: The incidence of depressed skull fracture was highest (56%) in the age group of 16-45 years. There was a predominance of male cases over females with a ratio of 7:1. The most common mode of injury was noted to be alleged assault (36%) and the parietal region (34%) being the most common site. Most cases had mild injury (62%) with Glasgow Coma Scale score of 13-15. The percentage of pure depressed fractures was 57% and the rest 42% were associated with intracranial lesion, of which the most common was contusion (25%). Superficial wound infection was observed in 38% of the patients. Of all the 453 patients, 91% were operated and most of them were operated within 24 h with overall mortality rate of 17%. CONCLUSIONS: Our study revealed the increased incidence of mortality in the age group of 16-45 years, which can guide our focus of management on them with strategic planning at individual as well as community level. Primary surgical repair of depressed skull fractures is safe, feasible, and associated with good outcomes. There was no significant association between tear in dura and an increase in the complications and, also, no substantial data to support the use of prophylactic antibiotics in patients to reduce chances of infection with it.

Vertex Extradural Hematoma: A Diagnostic Dilemma.

Extradural hematomas (EDHs) of vertex are rarely seen and form a small percentage of all EDH. Usual cause of an EDH located at the vertex is tearing of the superior sagittal sinus. A 35-year-old male patient was admitted to our department, with history of fall and lucid interval. Imaging studies showed contusion in the right frontal region with midline shift and bilateral EDH located at vertex which was misinterpreted as artifact or subdural hematoma. We present this rare case and briefly review the literature regarding its etiopathology and associated clinico-radiological findings. The principles of management of this rare entity are also discussed.

Intracranial en-plaque tuberculoma impersonating en-plaque meningioma: Case report and brief review of literature.

BACKGROUND: Tuberculosis of the central nervous system continues to be a major health hazard in developing countries like India. There are various manifestations of central nervous system tuberculosis including meningitis and space occupying lesions. We present a case of tuberculoma en-plaque which is often initially confused with a meningioma on presentation. We also review the literature relevant to this unusual entity. METHODS: A search of PubMed, PubMed Central, the Cochrane Library, and MEDLINE were performed to identify all English language reports of intracranial en-plaque tuberculomas. The combinations of text strings "tuberculoma," "en*," and "plaque" were used to perform the query on PubMed. Only the studies reporting intracranial en-plaque tuberculomas were included. RESULTS: Literature review revealed six reports on en-plaque tuberculomas including seven patients. The mean age at presentation was 40.5 years, and no sex predilection was seen. Five of the six reported studies used anti-tuberculous therapy with or without surgical excision of the mass. Most of the patients in reported cases recovered fully. CONCLUSION: It is imperative to consider tuberculoma as an important differential when encountering intracranial en-plaque masses as en-plaque tuberculomas can be effectively treated with a combination of anti-tuberculosis therapy and surgical resection, yet consequences of a missed or late diagnosis can prove fatal.

Elevated fracture of skull in pediatric age group: A series of five patients with review of literature.

Elevated fractures of skull in pediatric age group are rarely reported in the literature. In view of rarity, we present a series of five cases of elevated skull fracture in pediatric age group. Over a period of 1-year, we operated on five such cases. In this article, we have discussed the mode, mechanism and extent of injury, its clinico-radiological findings, course of the disease, and the management outcome. Four out of five cases improved after surgery and did not suffer any complications. Early recognition and appropriate management of compound elevated fracture in pediatric age group comes with good outcome and prevents unwanted morbidity and mortality.

A curious case of spontaneously resolving closed "jigsaw" depressed skull fracture in an adolescent.

Spontaneously resolving depressed skull fractures have been previously reported in the pediatric age group, however they are very rare in adolescents. We report a case of spontaneously elevating depressed fracture in a 13 year old boy. Depressed skull fractures in this age group might resolve on its own but may also complicate during its course of non-operative self elevation. In the reported case, the child developed gliosis and suffered seizures two years after the trauma. Repeat scans showed almost normal skull topography with underlying gliotic changes. Although all depressed skull fractures won't complicate as such, patients without neurological deficits should also be operated to prevent any delayed complications.

Posttraumatic Bilateral Epidural Hygroma of the Posterior Cranial Fossa: Case Report and Brief Review of Literature.

BACKGROUND: Posttraumatic posterior fossa epidural hygroma is a rare entity, and a clear management has not been established in the medical literature. We present 1 case and review the literature relevant to this unusual entity. The mechanism of formation and management of posterior cranial fossa epidural hygroma are also outlined. CASE DESCRIPTION: A 2-year-old child presented after a rooftop fall injury with symptoms of headache, drowsiness, vomiting, and brief loss of consciousness. Computed tomography scan demonstrated swelling in the left occipital region and epidural hygroma. After conservative management failed, surgical repair of the dura mater was performed. The child was discharged postoperative day 11 in stable condition with marked improvement in occipital swelling. CONCLUSIONS: It is imperative to consider epidural hygroma in very small children presenting with occipital injury. As a result of loose adhesion of dura mater and internal cranial lamina layers in younger pediatric patients, potential epidural space may be easily created secondary to injury, and small breaches in meningeal integrity near the cisterna magna may favor cerebrospinal fluid leak. During surgery, if watertight repair of a visible dural tear is performed, duro-periosteal hitching or vacuum drain placement may not be required.

Recurrent primary retro-bulbar hydatid cysts.

Retro-bulbar hydatid cysts are extremely uncommon, while nonorbital forms are frequently encountered disease in underdeveloped countries. Most of these are situated in the superolateral and superomedial angle of the orbit. We report a case of recurrent primary hydatid cysts of the orbit, situated in different locations in the orbit. A 35-year-old female patient was admitted to Department of Neurosurgery with proptosis, ptosis and watering from left eye. She also complained for headache with excruciating pain in left eye and loss of vision in left eye. Neurological examination revealed limited ocular mobility in all directions. Visual acuity was reduced to finger counting at 2-feet distance. Papilledema was found in ophthalmic examination. This case was considered as recurrence of primary infection because there was no previous history of hydatid disease and no finding of liver and lung cysts on radiological examinations. Treatment of orbital hydatid cyst, early diagnosis, surgical excision and systemic use of albendazole are suggested.