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Background: Hypertensive disorders are among the most common medical disorder during pregnancy and continue to be a serious challenge in obstetric practice. It affects about 7-15% of all gestations. In India it accounts for the third most important cause of maternal mortality. Aim if this study was to study the prevalence of pre-eclampsia and feto-maternal outcome in cases of pre-eclampsia. Methods: This was a descriptive observational study conducted over a period from February 2019 to July 2021. This study enrolled 106 cases of pre-eclampsia, cases were selected by inclusion and exclusion criteria, data were entered and analysed by using SPSS version 20. Results: A total of 106 patients were analysed. It was observed that it was more common in age group of 26 to 30 years 51%, 56% were unbooked patients. Maximum number of patients were primigravida 60%, 96% patients were from lower socioeconomic class, 37% patients had normal vaginal delivery, 63% had caesarean delivery. The most common maternal complication was eclampsia (12%), HELLP Syndrome 12%, abruptio occurred in 8% of patients. Maternal mortality occurred in 4 cases. Out of 106 babies 37 (34.93%) babies had normal outcome while 29% (27.35%) had low birth weight, 16 (15.09%) babies were IUGR, 15 (14.5%) babies were IUFD, 7 (6.6%) babies had RDS and 2 (1.8%) babies were stillbirth 40 (44.94%) babies were admitted in NICU. Conclusions: This study concludes that foetal and maternal outcome were markedly affected by pre-eclampsia and also the grave complications were more common in pre-eclampsia. So proper antenatal care, early diagnosis of pre-eclampsia and timely intervention will decrease maternal perinatal morbidity and mortality.

Instantaneous and rapid developments in nanotechnology stimulated innovative ideas across many fields of day-to-day life. Carbon-based nanomaterials have developed many platforms for an extensive range of applications due to their unique mechanical, electrical and biological properties. Nanoparticles of noble metals and their compounds are also playing an enormous role in many aspects of our life i.e. medical devices, pharmaceuticals, polymer industry, biomedical field, coating of kitchen appliances, food packing, clothes and gifts. Silver and carbon-based nanoparticles are being used diversely in food, fitness and health care, therapeutic, manufacturing and optical devices industries due to their distinctive chemical and physical characteristics. This study provides a short review of antibacterial and conducting activities of graphene and silver nanoparticles (AgNPs) both. These are well known conducting nanomaterials applied in many areas and a wide literature is available on these characteristics. Thermal conducting behaviour of both materials also has a noteworthy standing. Thus, it becomes interesting to utilize these features to create new composite materials with improved electrical, thermal and antimicrobial properties; comparative study is also an interesting field to do innovations.

Distoangular impacted teeth are considered challenging to remove due to their anatomic position. Proper tooth sectioning ensures the removal with minimal bone removal. This study is aimed to compare the outcome of 2 different tooth sectioning methods.Patients with distoangular-impacted mandibular third molar were included in this single-blinded randomized controlled trial. Patients with Class III-impacted, grossly decayed teeth and who were ASA III and above were excluded. The subjects were randomly allocated into Group-A conventional method, where tooth sectioning at the cementoenamel junction, and Group B, the modified method, where tooth sectioning removes only the distal portion of the crown. The primary predictor variable was the tooth sectioning method. The primary outcome variable was the operative time and the secondary outcomes included postoperative pain, trismus, and edema assessed on postoperative days 3 and 7. The effect of treatment on operative time was assessed using a t-test and Chi-squared test was used to compare the categorical data.Thirty eight patients were included in this study. With a 1:1 allocation ratio, 18 (50%) patients were included in each group. No statistically significant differences were observed in the 2 groups for gender allocation (P = .32), age (P = .34), tooth classification (P = .97), and side of extraction (P = .32). The mean operative time was 31.61 ± 14.13 minutes for group A and 22.72 ± 10.79 minutes for group B, at the 95% confidence interval had a P value of .04 (P .05), favoring group B. Secondary outcomes of pain measured by visual analogue scale 3.83 ± 3.06 for group A and 3.88 ± 3.06 for group B (P = .95), facial edema 22.79 ± 2.08 and 22.88 ± 1.32, respectively (P = .88), and the maximal interincisal opening of 33 ± 8.59 and 31.33 ± 7.42 on day 3 (P = .54) and 36.16 ± 11.62 and 39.05 ± 6.08 on day 7 (P = .36). However, the difference in need for rescue analgesia 2.05 ± 2.15 and 0.44 ± 0.85 (P .01) was statistically significant, suggesting the superiority of the conventional sectioning method.The results show that both methods of tooth sectioning yield comparably acceptable results. However, the tooth removal was faster by the modified sectioning and the need for rescue analgesia was minimal in this group, suggesting it to be a preferred technique over the conventional method.

Water-related hazards like floods and droughts are increasing due to climate change. The study aims towards balancing a double edge situation of the inevitable flood and drought. The Soil Conservation Service-Curve Number (SCS-CN) method is used to calculate the rainfall–runoff and the Topographic Wetness Index (TWI) is used for identifying potential water accumulation zones, whereas the Normalized Differential Water Index (NDWI) is used to calculate surface waterbody variations and the Soil Water Index (SWI) is used to identify zones varying in the range of dry-to-wet soil moisture. The study focuses on the use of nature-based solutions (NbS) for achieving mutual flood–drought mitigation for the pilot case of the Banaskantha district, Gujarat, and is validated for the study case of the Muzaffarpur district, Bihar. The application of the developed contingency plan in the form of an applicability rubric agrees to solve the issue by 44.44% for the pilot case and 22.22% for the study case. It suggests the application of NbS for the regions having similar situations of flood–drought as of the pilot case.

Varicose veins are one associated aspect of evolution that humans could have happily lived without. It's almost certainly the price we pay for the two-legged erect posture. Though we have achieved cure for various diseases, till now no reliable cure has been found for venous insufciency.The gold standard for treating chronic venous insufciency has been surgery. The surgeon dealing with varicose veins has always had to strike a balance between an aesthetically pleasing outcome and a low rate of recurrence and complications. Sclerotherapy, which was rst used over 150 years ago, is still the most efcient method for permanently removing pathologically swollen as well as cosmetically unpleasant but otherwise normal veins.Foam sclerotherapy, in which the sclerosant is mixed with air or physiological gases, is more effective than direct injection of sclerosants, because the agent's contact with the endothelium is prolonged by the air in the foam. The use of foam sclerotherapy for big veins has reduced recurrence rates. Large-scale researches have demonstrated the safety of foam sclerotherapy. Foam sclerotherapy has a recurrence rate that is comparable to surgery. The efcacy of foam sclerotherapy has been variable as per different studies across different institutions.

Background: Virtual bronchoscopy is a noninvasive tool for assessing the airway. It can be used along with multiplanar CT scan for better assessment of endobronchial tree. A lot of researches has been conducted in various parts of the world weather CT bronchoscopy can replace actual exible beroptic bronchoscopy. We aimed to explore the utility of virtual bronchoscopy (VB) for evaluation of tracheobronchial lesions and weather this can be helpful for pulmonologist for better assessment of airway while using real time exible bronchoscopy. Our age group comprised of patients from 21 years to a maximum a Results : ge of 80 years with a mean age of 52.6 years. VB was better in detecting external compression with a Kappa value of 0.68. VB had a moderate agreement with FOB to detect endoluminal lesions with kappa value of 0.70. None of the mucosal changes detected by FOB was detected by VB. In detecting obstructive lesions VB substantially agreed with FOB with a kappa value of 0.8. Moderate agreement was seen by VB in detecting both malignant and non-malignant lesions vompared to FOB. Virtual bronchoscopy when used in conjunction with axial CT Conclusion: images can enhance diagnostic accuracy of bronchial pathologies. VB cannot replace conventional bronchoscopy due to associated disadvantages such as the inability to perform a biopsy, the inability to detect mucosal inltration, the relatively low specicity rate when compared to high sensitivity rates, and the inability to offer real-time evaluation.

Cardiac arrest in the peri-operative period is rare but associated with significant morbidity and mortality. Current reporting systems do not capture many such events, so there is an incomplete understanding of incidence and outcomes. As peri-operative cardiac arrest is rare, many hospitals may only see a small number of cases over long periods, and anaesthetists may not be involved in such cases for years. Therefore, a large-scale prospective cohort is needed to gain a deep understanding of events leading up to cardiac arrest, management of the arrest itself and patient outcomes. Consequently, the Royal College of Anaesthetists chose peri-operative cardiac arrest as the 7th National Audit Project topic. The study was open to all UK hospitals offering anaesthetic services and had a three-part design. First, baseline surveys of all anaesthetic departments and anaesthetists in the UK, examining respondents' prior peri-operative cardiac arrest experience, resuscitation training and local departmental preparedness. Second, an activity survey to record anonymised details of all anaesthetic activity in each site over 4 days, enabling national estimates of annual anaesthetic activity, complexity and complication rates. Third, a case registry of all instances of peri-operative cardiac arrest in the UK, reported confidentially and anonymously, over 1 year starting 16 June 2021, followed by expert review using a structured process to minimise bias. The definition of peri-operative cardiac arrest was the delivery of five or more chest compressions and/or defibrillation in a patient having a procedure under the care of an anaesthetist. The peri-operative period began with the World Health Organization 'sign-in' checklist or first hands-on contact with the patient and ended either 24 h after the patient handover (e.g. to the recovery room or intensive care unit) or at discharge if this occured earlier than 24 h. These components described the epidemiology of peri-operative cardiac arrest in the UK and provide a basis for developing guidelines and interventional studies.

Major haemorrhage is a leading cause of morbidity and mortality worldwide. Successful treatment requires early recognition, planned responses, readily available resources (such as blood products) and rapid access to surgery or interventional radiology. Major haemorrhage is often accompanied by volume loss, haemodilution, acidaemia, hypothermia and coagulopathy (factor consumption and fibrinolysis). Management of major haemorrhage over the past decade has evolved to now deliver a 'package' of haemostatic resuscitation including: surgical or radiological control of bleeding; regular monitoring of haemostasis; advanced critical care support; and avoidance of the lethal triad of hypothermia, acidaemia and coagulopathy. Recent trial data advocate for a more personalised approach depending on the clinical scenario. Fresh frozen plasma should be given as early as possible in major trauma in a 1:1 ratio with red blood cells until the results of coagulation tests are available. Tranexamic acid is a cheap, life-saving drug and is advocated in major trauma, postpartum haemorrhage and surgery, but not in patients with gastrointestinal bleeding. Fibrinogen levels should be maintained 2 g.l

Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): British Heart Foundation. Background HOPE-HF was a randomised, placebo-controlled, cross-over trial of AV-optimised His bundle pacing in patients with heart failure (LVEF ≤40%), a PR interval (≥200ms) and without left bundle branch block.1,2. In this analysis we studied the impact of baseline PR interval and acute blood pressure change at the optimal AV-delay on the placebo-controlled effect of His bundle pacing on the trial endpoints of peak VO2 (primary) and patient symptoms (using the Minnesota Living with Heart Failure Questionnaire). Methods and Results 167 patients were successfully implanted and randomised to 6 month blocks of pacing and placebo. We performed a non-invasive, high-precision protocol to calculate the optimal AV delay and associated acute blood-pressure response at randomisation. To test the impact of the baseline PR interval and acute BP response on the placebo-controlled effect of AV-optimised His bundle pacing on endpoints we compared Bayesian ordinal regression models and the relative explained variance (REV) of variables in the model. There was weak evidence that His-bundle pacing improved peak VO2 across all patients (OR 1.31, 95% CrI 0.86 to 2.01, Pr(OR > 1)=89%). The baseline PR interval had little impact on this benefit (REV 0%), and the blood pressure response was more likely (88% vs 12%) to be predictive. However, there was strong evidence that overall AV-optimised His-bundle pacing improved patient symptoms as compared to placebo (OR 1.58, 95% CrI 1.04 to 2.40, Pr(OR>1)=98%). Again, the baseline PR interval had little impact on this benefit (REV 0%) and the blood pressure response was much more likely (97% vs 3%) to be predictive. Higher acute BP increments led to greater placebo-controlled improvements in MLWHF at 6-months. Conclusion An individual’s acute BP response with AV-optimised His-pacing is a powerful predictor of their placebo-controlled improvement in symptoms (MLWHF) at 6-months. This can form the basis of patient selection for future studies and clinical practice.

ObjectiveTo study unusual presentations of coronavirus-associated mucormycosis that are rarely seen in sinonasal mucormycosis cases.MethodThe data of 400 rhino-orbito-cerebral mucormycosis patients admitted to Sawai Man Singh Hospital, Jaipur, from May 2021 to June 2021, were retrospectively collected. The diagnosis of mucormycosis was made by histological examination of biopsy samples.ResultsOut of 400 patients, 62 had symptoms other than common symptoms of rhino-orbito-cerebral mucormycosis. Thirty-four patients had facial palsy, 19 complained of gum ulcers, 6 developed a cheek abscess, 2 complained of maggots in the nose along with common rhino-orbito-cerebral mucormycosis symptoms, and 1 had a cerebellar infarct.ConclusionMucormycosis is a disease with various presentations, and coronavirus-associated mucormycosis has added unusual presentations to the existing list of manifestations of rhino-orbito-cerebral mucormycosis. In this coronavirus disease era, mucormycosis should always be considered as a diagnosis in patients with these unusual presentations.

Malnutrition is a major public health problem in India and it effects the growth and development of young children. It is one of the leading causes of morbidity and mortality in under five children in developing countries. Globally, more than three million children under five years of age die each year from environment related causes and conditions. To study the environmental factors affecting severe acute malnutrition under five children admitted at nutritional rehabilitation centre. This was a case control study design. 350 cases were selected from N.R.C. of N.S.C.B. Medical College Jabalpur and 350 neighbourhood controls were selected from same community. The chi square test is applied for categorical variables and student t test is used to compare the continuous variables and odds ratio was calculated in statistical analysis. There was significant association between severe acute malnutrition in under five children with absence of separate kitchen (OR -3.2), kaccha house (OR-14.2), overcrowding present (OR-3.3), cross ventilation absent (OR-5.7), natural light absent in the house (OR-7.2) and open field defecation present (OR-6.5) in study subjects.

Open classical and quantum systems have attracted great interest in the past two decades. These include systems described by non-Hermitian Hamiltonians with parity-time $(\mathcal{PT})$ symmetry that are best understood as systems with balanced, separated gain and loss. Here, we present an alternative way to characterize and derive conserved quantities, or intertwining operators, in such open systems. As a consequence, we also obtain non-Hermitian or Hermitian operators whose expectations values show single exponential time dependence. By using a simple example of a $\mathcal{PT}$-symmetric dimer that arises in two distinct physical realizations, we demonstrate our procedure for static Hamiltonians and generalize it to time-periodic (Floquet) cases where intertwining operators are stroboscopically conserved. Inspired by the Lindblad density matrix equation, our approach provides a useful addition to the well-established methods for characterizing time-invariants in non-Hermitian systems., 7 pages, 2 figure: Proceedings of AAMP XVIII (Prague 2021)

The aim of present research is to study the concept of digital payment along with impact of COVID-19 on digital payment with special reference on consumer payments, as we all know that people in the economy on first hand use more of cash for any kind of their purchase made and even few digital transaction also by linking the bank account details, but due to the COVID 19 virus which had spreaded across the country made the consumer to use more of the mobile based applications to avoid direct contact with merchants in a view that it transfer the virus, this made a way to analyse growth of digital payment the economy. The research paper is making focus on the problems of digital payment system in India and effects of the system in people and economic system of India. The research paper is also trying to explain the future scope of the Digital payment system as announced in Budget 2023. The secondary research covers some view-points or insights of other researches who contributed their knowledge in related concern. The conclusion of present research paper shows that there is an high increase in use of digital payments services through various applications in India which was not much high before the happening of world-wide pandemic Covid-19.

The evolution of the spectral energy distribution during flares constrains models of particle acceleration in blazar jets. The archetypical blazar BL Lac provided a unique opportunity to study spectral variations during an extended strong flaring episode from 2020-2021. During its brightest $\gamma$-ray state, the observed flux (0.1-300 GeV) reached up to $2.15\,\times\,10^{-5}\,\rm{ph\,cm^{-2}\,s^{-1}}$, with sub-hour scale variability. The synchrotron hump extended into the X-ray regime showing a minute-scale flare with an associated peak shift of inverse-Compton hump in gamma-rays. In shock acceleration models, a high Doppler factor value $>$100 is required to explain the observed rapid variability, change of state, and $\gamma$-ray peak shift. Assuming particle acceleration in mini-jets produced by magnetic reconnection during flares, on the other hand, alleviates the constraint on required bulk Doppler factor. In such jet-in-jet models, observed spectral shift to higher energies (towards TeV regime) and simultaneous rapid variability arises from the accidental alignment of a magnetic plasmoid with the direction of the line of sight. We infer a magnetic field of $\sim0.6\,\rm{G}$ in a reconnection region located at the edge of BLR ($\sim0.02\,\rm{pc}$). The scenario is further supported by log-normal flux distribution arising from merging of plasmoids in reconnection region., Comment: 6 pages, 3 figures, 1 table, Accepted for publication in MNRAS-L

We demonstrate how the Hong-Ou-Mandel (HOM) interference with polarization-entangled photons can be used to probe ultrafast dephasing. We can infer the optical properties like the real and imaginary parts of the complex susceptibility of the medium from changes in the position and the shape of the HOM dip. From the shift of the HOM dip, we are able to measure 22 fs dephasing time using a continuous-wave (CW) laser even with optical loss > 97%, while the HOM dip visibility is maintained at 92.3~\% (which can be as high as 96.7%). The experimental observations, which are explained in terms of a rigorous theoretical model, demonstrate the utility of HOM interference in probing ultrafast dephasing., 12 pages, 7 figures

Cavity-mediated magnon-magnon coupling can lead to a transfer of spin-wave excitations between two spatially separated magnetic samples. We enunciate how the application of a two-photon parametric drive to the cavity can lead to stark amplification in this transfer efficiency. The recurrent multiphoton absorption by the cavity opens up an infinite ladder of accessible energy levels, which can induce higher-order transitions within the magnon Fock space. This is reflected in a heightened spin-current response from one of the magnetic samples when the neighboring sample is coherently pumped. The enhancement induced by the parametric drive can be considerably high within the stable dynamical region. Specifically, near the periphery of the stability boundary, the spin current is amplified by several orders of magnitude. Such striking enhancement factors are attributed to the emergence of parametrically induced strong coherences precipitated by a long-lived mode. While contextualized in magnonics, the generality of the principle would allow applications to energy transfer between systems contained in parametric cavities.

AIM: To compare the histopathological grading of breast tumors detected with digital breast tomosynthesis(DBT) to those found with digital mammography(DM). The study was conducted in the MATERIALS ANS METHODS: department of Radiodiagnosis, Gauhati Medical College and Hospital, Guwahati, from January 2021 to January 2022. A sample of 100 women with signs and symptoms of breast disease were evaluated based on inclusion and exclusion criteria. DM and RESULTS AND DISCUSSION: DBT were performed and the ndings were recorded. During statistical analysis BIRADS category allotted in DM and DBT was compared in benign and malignant tumors and nal results were formulated in tables and graphs. The ndings we obtained in our study were compared with the results of previous research works. DBT is a promising imaging technique tha CONCLUSION: t has higher sensitivity and specicity than DM for the diagnosis and characterization of various breast disorders

In recent times the possibility of non-reciprocity in heat transfer between two bodies has been extensively studied. In particular the role of strong magnetic fields has been investigated. A much simpler approach with considerable flexibility would be to consider heat transfer in synthetic electric and magnetic fields which are easily applied. We demonstrate the breakdown of detailed balance for the heat transfer function $\mathcal{T} ({\omega})$, i.e. the spectrum of heat transfer between two objects due to the presence of synthetic electric and magnetic fields. The spectral measurements carry lot more physical information and were the reason for the quantum theory of radiation. We demonstrate explicitly the synthetic field induced non-reciprocity in the heat transfer transmission function between two graphene flakes and for the Casimir coupling between two objects. Unlike many other cases of heat transfer, the latter case has interesting features of the strong coupling. Further the presence of synthetic fields affects the mean occupation numbers of two membranes and propose this system for the experimental verification of the breakdown of detailed balance.