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Aim: The key motive of this research is to evaluate the frequency of kidney diseases in subjects with type 2 diabetes vs. nondiabetic patients. For the estimation of the similarity between the relation of normoalbuminuria and microalbuminuria with type 2 diabetes and on which point renal diseases different percentage of the patient of type 2 diabetes lies. Materials and Methods: This was a cross-sectional study of 200 cases organized at a tertiary care center in Bihar, India. The study was performed for 24 months, and all the patients were 20-80 years of age. Age, body mass, height, BMI, fasting blood sugar, random blood sugar, and duration of diabetes of patients were recorded. Results: It was evaluated that the incidence of kidney diseases in subjects with diabetes was higher in contrast to non-diabetic subjects. No gender-wise variation was found. The majority of the patients had a period of diabetes between 5 and 10 years. Hypertension was common in both the groups that are type 2 diabetic and nondiabetic. Conclusion: Chronic kidney diseases are highly frequent in diabetic patients. There is a need to deal with hypertension, increased BMI, and weight.

Environmental awareness among masses has created tremendous pressure on government and corporates to preserve our natural resources. Globally, many companies have successfully initiated product recovery operations in their business plans. Remanufacturing is one of the highly profitable and sustainable product recovery options. Many Western countries successfully adopted remanufacturing as an alternate source of revenue generation model. But in India, it is still in nascent stage. In this research, we tried to identify the critical factors in the area of “Strategy & Environment” for the viability of remanufacturing business in India. For this, a questionnaire survey was conducted among Indian manufacturing companies and their responses were analyzed. The sample size of the study consists of 72 responses. Afterwards, the identified factors were ranked based on their criticality in initiating remanufacturing activity. The findings may help Indian government and manufacturing firms to frame proper strategy related to environmental aspect of remanufacturing operations in India.

Coronary artery disease is a leading global cause of mortality. It can be diagnosed by fractional flow reserve (FFR) estimation using computed tomography (CT) angiography. This systematic review aims to review the literature about the diagnostic efficacy of FFR estimation using CT scan (FFR-CT) for the diagnosis of coronary artery disease. The dual databases of Medline and Cochrane Central Register of Controlled Trials were searched for relevant literature from their inception till August 15, 2017. The methodological quality was assessed using the Cochrane risk of bias tool. Pooled estimates of specificity and sensitivity were assessed with the corresponding 95% confidence intervals (CI). After careful screening, five studies involving a total of 296 patients were included in the study. For FFR-CT, on meta-analysis of the pooled risk ratio per patient, random-effects model value was 3.79 (95% CI, 2.93–4.90) and odds ratio per patient was 11.78 (95% CI, 8.08–17.17). The odds ratio by year to see if heterogeneity is due to sample size was 2.50 (95% CI, 1.06–5.91). FFR-CT appears to be a reliable and efficacious noninvasive imaging modality, as it demonstrates high accuracy in the determination of anatomy and lesion-specific ischemia, which justifies the performance of additional randomized controlled trials to evaluate the clinical benefits of FFR-CT-guided coronary revascularization.

Purpose: In this study, we intend to analyze ropivacaine and bupivacaine in various parameters during phacoemulsification under deep topical fornix nerve block (DTFNB), a known form of nerve block for phacoemulsification. Methods: This prospective randomized study was conducted on 100 patients undergoing elective cataract surgery by phacoemulsification under DTFNB. Patients were divided into two equal groups of fifty patients each, Groups B (bupivacaine) and Group R (ropivacaine). Two sponges, approximately 2 mm × 3 mm dimensions, saturated with either 0.5% bupivacaine or 0.75% ropivacaine were placed deep in the conjunctival fornices to perform the deep topical block. Both groups were evaluated for magnitude of pain and discomfort at various stages of phacoemulsification using a simple pain scoring system. The level of surgeon satisfaction, requirement for supplementary anesthesia, and surgical complications were also evaluated. Quantitative variables between the two groups were compared using unpaired t-test. Qualitative variables were correlated using Chi-square test. Results: Overall demographic parameters of patients were similar in both groups. Similar mean pain scores were found in the ropivacaine and bupivacaine groups, with no statistical significance. Surgical satisfaction and the need for supplemental anesthesia were also statistically insignificant. Conclusion: Ropivacaine is a good alternative for deep topical anesthesia as it has a better safety margin and lesser toxic effect than other comparable local anesthetic agents.

Management of airway in trauma victim with penetrating cervical/thoracic spine injury has always been a challenge to the anaesthesiologist. Stabilisation of spine during airway manipulation, to prevent any further neural damage, is of obvious concern to the anaesthesiologist. Most anaesthesiologists are not exposed to direct laryngoscopy and intubation in lateral position during their training period. Tracheal intubation in the lateral position may be unavoidable in some circumstances. Difficult airway in an uncooperative patient compounds the problem to secure airway in lateral position. We present a 46-year-old alcoholic, hypertensive, morbidly obese person who suffered a sharp instrument (screwdriver) spinal injury with anticipated difficult intubation; the case was managed successfully.