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Byline: Dipti. Kapoor, Sidharth, Divyani. Garg, Rajiv. Malhotra, Virendra. Kumar, Suvasini. Sharma Introduction: Scoring systems to predict outcomes in pediatric status epilepticus (SE) are limited. We sought to assess usefulness [...]

In this manuscript, we comprehensively evaluate a newly devised biosensor that utilizes the Kretschman configuration and incorporates Tantalum Disulfide (TaS2) for Long Range Surface Plasmon Resonance (LRSPR). We optimized the performance of the sensor by simulating with different metals [specifically, gold (Au), silver (Ag), and aluminium (Al)] and four distinct dielectric buffer layers (namely, LiF, Teflon, Cytop, and MgF2) using MATLAB software. The most favourable configuration emerges when we employ a 28 nm thick Al layer and 800 nm thick MgF2 layer. It yields exceptional performance parameters, particularly in response to variations in the refractive index (RI) of the sensing medium (SM, nSM = 1.33–1.38). These parameters include a reduced full width at half maximum (FWHM) of 0.1 Deg., enhanced detection accuracy (DA) at 10 (1/Deg.), imaging figure of merit (IFOM) measuring 26,903 [(Deg. RIU)]−1, an angular figure of merit (FOMang.) of 189.9 (RIU−1), and an imaging sensitivity (Simg.) of 2690.3 RIU−1 at a wavelength of 633 nm. Comparing the LRSPR sensor to the conventional SPR (CSPR) sensor, it significantly outperforms them with 7.053 times higher Simg., 57.84 times higher IFOM, 8.20 times higher DA, and 4.61 times higher FOMang. The analysis performed using COMSOL Multiphysics software demonstrates that the proposed LRSPR biosensor achieves a notably deeper penetration depth (PD) of 348.25 nm, surpassing the PD of CSPR sensors (PD = 197.65 nm). This remarkable PD underlines the potential of the proposed sensor for highly precise and sensitive RI sensing, placing it as a promising contender for diverse biomedical applications. [ABSTRACT FROM AUTHOR]

Supravalvular aortic stenosis (SVAS), characterized by elastin arteriopathy, presents either as a localized narrowing at the sinotubular junction or as a diffuse form with additional involvement of the ascending aorta, aortic arch, and its branches. Associated lesions of the aortic valve, coronary artery narrowing, and pulmonary artery stenosis can further complicate the disease process. These patients are inherently at risk for developing myocardial ischemia, particularly in the setting of anesthesia or sedation. The left ventricular hypertrophy, secondary to the obstruction, results in increased left ventricular wall tension and myocardial oxygen consumption. Associated anatomic factors in the coronary arteries can further impair coronary blood flow. Any anesthetic drug that further increases oxygen consumption or decreases the coronary blood flow will result in an imbalance and increase the risk of cardiac arrest. We present a series of three patients with SVAS who were operated at our institute and subsequently discharged with good outcomes. The hemodynamic goal during the perioperative should aim to balance the myocardial oxygen supply-demand ratio. Extreme vigilance and aggressive resuscitative measures are needed to prevent any adverse myocardial event that can happen immediately after anesthetic induction or during periods of intense sympathetic stimulation such as laryngoscopy, sternotomy, aortic cannulation, or during emergence from anesthesia. [ABSTRACT FROM AUTHOR]

Background: The anaesthetic agents can affect the quality of motor-evoked potential intraoperatively as they inhibit synaptic transmission. Intravenous anaesthetics suppress motor-evoked potential lesser than inhalational agents, so total intravenous anaesthesia or a combination of intravenous with minimal inhalational anaesthetic supplementation is used when motor-evoked potential is monitored. Motor-evoked potential can get depressed at high doses of propofol required to maintain surgical depth, hence, adjuvant agents like dexmedetomidine that maintain anaesthetic depth without affecting the motor-evoked potential are often required. This study was a prospective non-randomized and comparative study (quasi-experimental) assigned into two groups of 64 each, labelled as the propofol group (group P) and Propofol + dexmedetomidine group (group PD). The primary objective of our study was to compare the total dose reduction of propofol with the addition of dexmedetomidine and their interference with motor-evoked potential readings. The secondary objective was to assess the hemodynamic changes, changes in amplitude and latency of motor-evoked potential, and complications if any. Results: The mean total dose of propofol consumed in our study was 502.81 ± 71.01 mg in group propofol(P) and 392.18 ± 59.00 mg in group propofol + dexmedetomidine (PD). Moreover, the mean total dose of propofol (mg) was significantly less used in group PD. Intraoperative hemodynamic stability, no difference in amplitude and latency for motor-evoked potential, and only significant bradycardia in group propofol + dexmedetomidine (PD). Conclusions: Dexmedetomidine can be successfully used in propofol-based total intravenous anaesthesia for motor-evoked potential monitoring in spine surgeries, but it is better to maintain stable hemodynamics with a significant reduction of the mean dose of propofol. [ABSTRACT FROM AUTHOR]

This paper investigates Darcy–Brinkman thermal convection in the stratified porous saturated suspension of active particles subjected to vertical oscillation. For a heated layer, in the context of no-slip boundaries, the derived critical numbers are found to be real-valued, which signifies that the mechanism of convection is through the stationary mode, although for a certain range of heat parameters, oscillatory convection is inevitable. The dispersion expressions are developed to characterize the stationary and overstability thresholds of the system using the Galerkin method. An attempt has been made to analyze and substantiate the significance of important parameters such as modified Darcy number (D a) , wave number (α ȷ) , and Rayleigh numbers [bioconvection (R b) , thermal (R a) , and their vibrational analogs (R v , R t) ] for the representative ranges of Péclet (1 ≤ Pe ≤ 2) and gyrotactic (1 ≤ G ≤ 5) numbers. While incremental gyrotactic propulsion encourages the decrease in bioconvection strength, higher Péclet values induce the suspension to stabilize. Porosity has a destabilizing effect that considerably lessens the ability of vertical vibration to stabilize. The layer becomes unstable due to the thermal-oscillational connection of the thermal vibration parameter, which slows the development of bioconvection blooms. [ABSTRACT FROM AUTHOR]

Pulmonary Alveolar Proteinosis (PAP) is a rare disease of the lungs characterized by deposition of lipo-proteinaceous material in the alveoli. This leads to reduced lung compliance and V/Q mismatch, causing respiratory failure. Patients with PAP may be posted for Whole Lung Lavage (WLL) under anesthesia, which is a challenging case for anesthetists. Preexisting respiratory failure is complicated by requirement of single lung ventilation with the help of double lumen tube during the procedure. Intraoperative ventilation is difficult and is managed with blood gas and airway pressure monitoring. Some degree of hypoxemia and hypercapnia may have to be tolerated. Large volumes of fluid are instilled into the lung which may cause hypothermia, hypervolemia, and electrolyte disturbances. These patients frequently require elective ventilation and intensive care admission in the postoperative period. We report the case of a young woman with PAP, posted for unilateral WLL under anesthesia. We wish to highlight the possible challenges posed by this case and how to conduct a safe anesthesia for this patient. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to determine the level of nitric oxide (NO) in both serum and saliva of smokers and nonsmokers with chronic periodontitis before and after scaling and root planing, as well as to compare the same (NO levels) with the severity of periodontitis. Materials and Methods: Sixty people took part in the study and were divided into three groups. The control group (Group I) involved 20 patients who were nonsmokers with healthy periodontium. The other two groups included 20 patients each, where Group II was nonsmokers with chronic periodontitis and Group III was smokers with chronic periodontitis. In addition, NO generation was quantified indirectly in this study using the Griess reaction to determine the nitrite level in serum and saliva. Results: The mean value of salivary and serum NO was higher in Group III than in Group II, and NO decreased considerably (P < 0.01) in both Groups II and III after treatment compared to before treatment. Conclusion: Serum and salivary NO levels can be used as a good predictor of the inflammatory condition of the periodontium in smokers. [ABSTRACT FROM AUTHOR]