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BACKGROUND Clonidine and dexmedetomidine are two α-2 adrenergic receptor agonists which have been used as an adjuvant to intrathecal local anaesthetics. Both drugs act by different mechanisms and potentiate the effect of each other. The purpose of the study was to assess the efficacy and safety of adding clonidine and dexmedetomidine to intrathecal hyperbaric bupivacaine on spinal block characteristics in gynaecological procedures. METHODS This study was conducted as a prospective comparative, randomized, double blind, placebo-controlled trial. Based on exclusion and inclusion criteria, 90 patients were included in this study by using a computer generated randomization. Patients were randomly divided into three groups each as follows: Gr BD: 0.5 % hyperbaric bupivacaine (3.5 ml) + 3 μg preservative free dexmedetomidine (total volume of 4 ml), group BC: 0.5 % hyperbaric bupivacaine (3.5 ml) + 0.5 ml clonidine (30 μg) (total volume of 4 ml), group BN (control): 3.5 ml of 0.5 % hyperbaric bupivacaine + same volume normal saline. The spinal block characteristics, hemodynamic stability, and side effects were compared. RESULTS Time to reach sensory block to T10 was 2.52 ± 0.33 minutes in group BN, 1.95 ± 0.38 ms in gr BC and 1.53 ± 0.24 minutes in group BD. The span of sensory block was longer in group BD in comparison to group BC (453.76 ± 52.78 v 389.36 ± 37.4) and group BN (453.76 ± 52.78 vs. 173.33 ± 14.56). Time for rescue analgesia was 169.12 ± 21.14 minutes in group BN, 245.21 ± 32.42 minutes in group BC and 289 ± 24 minutes in group BD. CONCLUSIONS When α-2 adrenergic receptor agonist is used intrathecally with bupivacaine, early motor and sensory block can be achieved along with long span of analgesia. KEYWORDS Bupivacaine, Dexmedetomidine, Clonidine, Spinal Anaesthesia

The role of extracorporeal therapies for poisoning is expanding in the present days with technological advances and increased awareness among physicians attending critically ill patients both intensivists and nephrologists. In this regard we present our experience on hemoperfusion in poisonings over a period of 5 years. A total of 6 patients were treated with hemoperfusion during this period with majority of them were due to antiepileptic drugs (phenytoin, phenobarbitone, carbamazepine) followed by paraquat (a weedicide).The age range is from 19-59 years with a mean age of 31.3 years and male: female ratio of 1:1. Coming to the clinical presentation, 3 of them presented with unconsciousness, one with altered sensorium and two of them with vomiting associated with oliguria and breathlessness. Five of the six (83.3%) required ventilatory support during the hospital stay. The total number of hemoperfusion sessions required was 10, with an average of 1.6 sessions per patient. The average number of hemodialysis sessions required was 2.3 sessions per patient. Only one patient developed procedure related complication of thrombocytopenia related oral bleeding which subsided with supportive therapy and no further hemoperfusion. Four out of six patients (66.6 %) recovered while 33.4 % expired and both the patients who expired consumed paraquat poisoning. In conclusion hemoperfusion has a significant role in the management of certain poisonings which would reduce the morbidity and mortality associated with these poisonings.

In this paper, a nine level multilevel inverter is proposed. The proposed nine-level inverter generates a nine levels Ac output voltage with the appropriate gate signals design. The topology is a self-voltage balanced across the series connected capacitors. The switching losses and the voltage stresses of power devices can be reduced in the proposed nine-level inverter. The operating principles of proposed inverter are discussed. The proposed multilevel inverter needs a single Dc voltage source with a series connection of four capacitors, three diodes, five acting switches for synthesizing output voltage levels and an H-bridge cell. Thus the proposed nine-level inverter helps in reducing the number of independent dc voltage sources and switches. Also the harmonic content in the output voltage is very less when compared conventional topologies. The proposed topology is verified by using MATLAB/Simulink.

Cloud computing is a new style of computing in which dynamically scalable and often virtualized resources are provided as service over internet. Resource procurement of cloud resources is an interesting and yet unexplored area in cloud computing, to automates the selection of resources for cloud vendor becomes a challenging issue in recent years. This problem is solve by using three novel mechanism for cloud vendor with resource procurement: cloud-dominant strategy incentive compatible (C-DSIC), cloud-Bayesian incentive compatible (C-BIC), and cloud optimal (C-OPT). In C-OPT modules, where the resource allocation is performed based host winner value, the major issue of the work is that authentication is performed for each cloud user. To solve security issue problem in the cloud resource procurement approach, in this work introduce a novel expectation maximization (EM) algorithm for cloud optimal modules resources. The proposed EM methods are used for finding maximum likelihood depends on unobserved latent cloud resource variables for virtual cost and quality of service constraints. To authenticate the cloud user data, cryptography method is introduced in this proposed work. The proposed cryptographic method follows the procedure of Elliptic curve cryptography for authenticating users and cloud vendors. Key values between the cloud user and cloud vendors are exchanged. Each and every key is verified by both cloud user and cloud vendor. If the key value anyone becomes wrong the resource Procurement is not allocated to cloud user, since these users becomes unauthenticated user, there are not allowed to performed resource Procurement process. A cloud broker with such a procurement module enables users to automate the choice of a cloud vendor. Our experiments indicate that the resource procurement cost decrease by calculation of the expectation maximization algorithm and more security than the existing COPT methods by using the elliptic curve cryptography with increase in number of cloud vendors irrespective of the mechanisms.

A GPS signal simulator is a versatile instrument used for testing and performance evaluation of a GPS receiver during its design and manufacture. A real-time GPS signal simulator (RTGPSSS) outputs the L1 signal of GPS satellites as received by the GPS receiver at its antenna. The generation of the GPS L1 signal for our design specification requires the transmission of a coarse acquisition (CA)-code, which is a pseudorandom noise (PRN) code at a rate of 1.023 Mchip/s, and the calculation of Doppler frequency at a rate of 19.55 μs under high receiver dynamics. These critical timing requirements necessitate parallel processing techniques. In this paper, the design of a 12-channel RTGPSSS using a digital signal processor (DSP)–based parallel processing system is presented. The effects of receiver dynamics, receiver clock drift, multipath, and atmosphere anomalies (ionospheric and tropospheric delay) are also incorporated in the simulated GPS signal.