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Objective: To evaluate the efficacy of burr whole craniostomy and irrigation without any post-operative drainage in the treatment of patients of Chronic subdural hematoma (CSDH). Methods: This was a prospective study. A total of 50 patients of CSDH were included in the study. The clinical history of patients was noted. At the time of admission, level of consciousness as well as Galsgow Coma Score (GCS), conditions of the pupil as well as long tract signs in any of the limbs were recorded. All patients undergone for computed tomography (CT) at pre and 48 hours after operation. The findings of CT were recorded. Results: The mean age of patients was 61.00±12.33 ranging from 20-90 years. Majority were males (78%). Headache (92%) and hemi paresis (76%) were the most common clinical presentation. Previous history of trauma was present among half of patients (50%). Incontinence was present in 26% of patients. Right side subdural haematoma was involved in 48% of patients. Bilateral was in 32% patients. After 48 hours post-operative, CT showed that 52% patients of unilateral CSDH did not had Residual collection not causing midline shift. Of the bilateral CSDH, 60% patients had no collection. Clinically, there was improvement among 92% patients. Conclusion: Burr whole craniostomy with intraoperative irrigation and without post-operative drainage is an effective treatment option for CSDH. The results of surgical intervention with one burr hole are as good as using 2 burr holes for drainage of hemispheric chronic subdural haematoma.

Structured grids have drawbacks such as cell distortion and artefacts leading to numerical accuracy reduction during simulations. Spatial support size had proven its importance in various estimation, and this is where unstructured grid comes into action. Performing geostatistical simulation on unstructured grid requires accounting of support size effect. In this article, two methods have been used for accounting the support size effect, one is the classical fine-scale simulation approach and the other approach is using Discrete Gaussian Model (DGM). Each method is applied to generate simulated Digital Elevation Model (DEM) (as used in this study) and the resultant DEMs are studied to understand the effect of spatial support size on surface flow estimation of water. It was observed that due to regularisation in the data of unstructured grid the flow velocity and water surface elevation of the unstructured DEM gave a similar behaviour than the structured DEM. The minimum RMSE for water surface elevation is 0.83 m for unstructured DEM while the minimum RMSE for flow discharge is 0.38 m3/s. The maximum coefficient of determination of flow channel velocity and water surface elevation is 0.709 and 0.86 respectively. The results suggested that the unstructured DEM generated using DGM approach shows a high correlation to reference DEM used in this study than the simulated structured DEM. The surface flow output it was inferred the flow variation in both structured and unstructured DEM is affected not only by the vertical resolution of DEM but also by the horizontal resolution.

This study has investigated the association between the amount of atmospheric aerosols and the occurrences of Asthma, Chronic Obstructive Pulmonary Disease (COPD) and Lung Cancer in Delhi, Mumbai, Chennai, Kolkata and Bengaluru. Aerosol Optical Thickness (AOT) data of Visible Infrared Imaging Radiometer Suite (VIIRS) and Google Trends (GT) have been used to acquire information regarding the abundance of atmospheric aerosols and the occurrences of the respiratory diseases respectively. The result of Granger causality test between AOT and GT has shown that Delhi, Mumbai and Chennai were quite vulnerable to the three respiratory diseases whereas Bengaluru did not display so much vulnerability to these ailments. Kolkata was not so much vulnerable to Asthma but did exhibit susceptibility to the other two diseases. GT is validated by correlating with Annual Morbidity data of Delhi. The result of Granger causality test between Particulate Matter (diameter ≤ 10 μm) (PM10) data and GT validates the result of Granger causality between AOT and GT, and shows the trustworthiness of GT and AOT. Thus, this study also proves the usefulness of VIIRS AOT and GT as dependable sources of information on atmospheric aerosols and prevalence of the respiratory diseases respectively, and the effectiveness of Granger causality test as a tool of analysis in health and geographic information systems (GIS).

There is an increased prevalence of cognitive impairment (CI) in patients with type 2 diabetes; thus, there is a need for a sensitive and a convenient screening tool for its detection. While Mini-Mental State Examination (MMSE) is a widely used tool for the assessment of cognition, it is not available for free for research. Hindi version of Addenbrooke’s Cognitive Examination III is a freely available cognition assessment tool that has been widely used on diverse group of diseases including diabetes. To assess cognitive function in patients with type 2 diabetes using Hindi version of ACE-III and compare its performance with MMSE. Cognition was assessed using validated Hindi version of ACE-III and MMSE among 54 participants with type 2 diabetes and similar number of age, sex, and educational status matched healthy controls. The cut-off for CI was taken at 82/100 for ACE-III, and for MMSE, education level–based cut-offs were used: 21 for the illiterate group, 22 for the low education group, 23 for the middle education group, and 24 for the high education group. Mean age of the study population was 64.5 ± 5.3 years. The average duration of diabetes was 8.5 ± 6.0 years with mean HbA1C of 8.8 ± 2.5%. Both the tools showed high prevalence of CI among cases, but ACE-III was more sensitive in detection of CI when compared to MMSE (64.8% vs. 55.6%). There was a good agreement between ACE-III and MMSE outcomes (Cohen’s kappa = 0.732). Type 2 diabetes mellitus is an independent risk factor for cognitive decline in elderly patients. ACE-III is an easy to use, sensitive, and freely available screening tool for cognition assessment in diabetes population.

Bangalore, one of the Indian metropolitan cities, has witnessed rapid urbanization during the last decade with an overwhelming spatial growth of 696 sq. km to 2185 sq.km within a span of ten years (2006 to 2016). With this exponential rate of urban growth, the city is experiencing a shift in its micro- climatic condition. This paper aims to identify the surface urban heat island (SUHI) effect by comparing normalized difference vegetation index (NDVI), normalized difference built-up index (NDBI) and the fraction of impervious surface area (ISA) as indicators of SUHI. Landsat 8 datasets were used to estimate the land surface temperature (LST) for two different seasons representing winter (January) and summer (April) using radiative transfer algorithm. A spatial map of ISA was generated using normalized spectral mixture analysis (NSMA) showing a standard error of 9.25%. Correlations between NDVI, NDBI and fraction of ISA with LST indicate a strong linear negative relationship between LST and ISA with a coefficient of correlation 0.85 and 0.94 s for January and April respectively and is contrary to the conventionally accepted positive SUHI phenomenon. The relationship between LST and NDVI was in particular negative at areas bearing high NDVI values. Results indicate that ISA is quantitatively a better metric indicating that the city experiences cool island effect indicative of high vegetative cover presence in the Bangalore Urban (BU) area. Also, NDVI is greatly affected by seasonal variation and NDBI shows mixing of soil characters and hence failed in providing conclusive results.

Masonry infill walls are widely known to increase the lateral stiffness of the structure and for this reason, it is accepted all over the world. This paper presents a review work on the performance of infill framed structures that were damaged during several earthquakes. A study of the behavior of damaged buildings during different earthquakes in the world has been carried out. The mentioned earthquakes substantially caused damage to the RC buildings. The RC buildings were damaged primarily because of improper design and reinforcement detailing at the design phase and improper workmanship and quality control at the construction phase. The main objective of this paper is to describe and analyze the failure patterns observed in reinforced concrete frame buildings with masonry infill walls and without masonry infill walls all over the world.

This is a commentary on recently published article in Allergy entitled as “Mishra A, Majid D, Kandikattu HK, Yadavalli CS, Upparahalli Venkateshaiah S. Role of IL-18-transformed CD274-expressing eosinophils in promoting airway obstruction in experimental asthma. Allergy. 2021 Nov 20. doi: 10.1111/all.15180

In India, a national program for stroke (national programme for the control of cardiovascular diseases, diabetes, cancer, and stroke) and stroke management guidelines exist. Its successful implementation would need an organized system of stroke care in practice. However, many challenges exist including lack of awareness, prehospital notification systems, stroke ready hospitals, infrastructural weaknesses, and rehabilitation. We present here a protocol to investigate the feasibility and fidelity of implementing a uniform stroke care pathway in medical colleges of India.This is a multicentric, prospective, multiphase, mixed-method, quasi-experimental implementation study intended to examine the changes in a select set of stroke care-related indicators over time within the sites exposed to the same implementation strategy. We shall conduct process evaluation of the implementation process as well as evaluate the effect of the implementation strategy using the interrupted time series design. During implementation phase, education and training about standard stroke care pathway will be provided to all stakeholders of implementing sites. Patient-level outcomes in the form of modified Rankin Scale score will be collected for all consecutive patients throughout the study. Process evaluation outcomes will be collected and reported in the form of various stroke care indicators. We will report level and trend changes in various indicators during the three study phases.Acute stroke requires timely detection, management, and secondary prevention. Implementation of the uniform stroke care pathway is a unique opportunity to promote the requirements of homogenous stroke care in medical colleges of India.

Introduction: This study is done to evaluate the role of different clinical factors in hematoma enlargement, especially severe hypertension during the early phase of spontaneous ICH. Materials and Methods: All patients with spontaneous intracranial hematoma who were of > 18 years in age, presented within 24 hour of onset, were enrolled for this study. Repeat CT scan was done within 24 - 48 hours after 1st scan. Results: 88 patients were enrolled and among them, 11 (12.5%) had >20% enlargement in the size of the hematoma on the second CT. The Mean increase in the size of hematoma was 19.8 11.4 ml (47.3 27.2 %). Progression of symptom after onset and after admission, lower GCS ( from onset to CT the enlargement of the hematoma. Mean systolic BP at admission > 200 mm Hg was present in a higher proportion of patients with hematoma enlargement. Conclusion: The present study showed that patients of spontaneous ICH presenting within 6 hours with higher NIHSS, low GCS (GCS hematoma enlargement. SBP >200 mm of Hg at admission may be a potential risk factor. ( Hematoma enlargement, NIHSS =National Institute Health Stroke Scale score, GCS =Glasgow Coma Scale, MAP=mean arterial pressure) Keywords: ute Health SHematoma enlargement, National Instittroke Scale score, Glasgow Coma Scale

With the objective of identifying an ecologically sustainable substrate for commercial gerbera production, we conducted an experiment to assess the effects of super absorbent polymer and organic vermi-products on the physico-chemical properties of the growing media, and plant growth and flower yield in gerbera cv. Yosemite. CPV (Cocopeat: Perlite: Vermiculite) and soil amended with vermicompost (VC, 20%), Pusa hydrogel (PHG, 0.25%) and horn bio-manure (HBM, 1%) had significant positive effects on growth and flowering of gerbera. The lowest (0.29 ± 0.02 g cm−3) bulk density was recorded in CPV + PHG + HBM while the maximum (59.75 ± 0.63%) water holding capacity was observed in CPV + PHG + VC substrate. The maximum electric conductivity (0.99 ± 0.06 dS m−1) and pH (7.90 ± 0.04) were recorded in Soil + PHG + VC. Plants grown on CPV + PHG + VC media and sprayed with 20% of vermiwash produced the highest number of leaves during the entire period (31 ± 0.58), maximum leaf length (30.18 ± 0.18 cm) and width (8.30 ± 0.16 cm), maximum number of primary roots (42 ± 1.53), highest flowers per plant (19.67 ± 0.33), stalk length (41.08 ± 0.10 cm) and flower head diameter (10.11 ± 0.03 cm). Flowers produced on this medium also had an extended attractive appearance (20.33 ± 0.33 days) and longer vase life (14.33 ± 0.33 days). Water requirement of gerbera (litre/crop season) on CPV + PHG + VC medium, with or without Vermiwash spray was also considerably lower than other treatments. Overall results suggest that CPV amended with PHG and VC coupled with Vermiwash spray provide congenial conditions for gerbera plant growth and flower production while also simultaneously reducing irrigation water use considerably.

Background: The Corona virus disease, COVID-19 is characterised by varied clinical course. Most patients experience only mild symptoms and get cured while others develop severe disease with increasing hypoxia ending in acute respiratory failure In current scenario, disease progression mainly relies on clinical manifestations and some investigations. It has been suggested that one of the possible mechanism underlying rapid progression is a Cytokine storm . Objective: The study was aimed to early detection of IL-6 that could help in identifying Cytokine storm and direct patients to specific treatment so as to reduce severity of disease. Material and Methods: This is the study done on patients presented with symptoms of corona virus disease. These patients were examined clinically and investigated according. Result: 321 patients were found positive for Corona virus out of which 206 males & 115 females. Fever (84%) and cough (71.4%)are the most common symptoms. 167 patients had increased IL-6 who presented with severe symptoms These patients were followed up strictly and proper treatment given Out of which maximum patients responded well within 15 days and 27 patients required hospitalisation and were managed Conclusion: Early detection of IL-6 along with clinical assessment of the patient condition could help clinician identifying and treating those most at risk of deterioration Therefore early identification of Cytokine storm and managing hyper inflammation could be a key route to reduce severity and mortality in COVID-19 patients. Keywords: COVID-19, IL-6 , Cytokine storm .

Carbon dioxide (CO2) is the key atmospheric gas that controls the earth's greenhouse effect, and forests play a major role in abating the atmospheric CO2 by storing carbon as biomass. Therefore, it is vital to understand the role of different forests in regulating the spatiotemporal dynamics of atmospheric CO2 concentration. In this study, we have used eddy covariance (EC) tower-based atmospheric CO2 concentration measurements and satellite-retrieved column average CO2 concentration of 2018 to understand the diurnal and seasonal dynamics of atmospheric CO2 concentration over the sub-tropical forest in the foothills of northwest Himalaya, Uttarakhand, India. EC study revealed that the CO2 concentration over the forest canopy peaks during mid-night to early morning and drop to a minimum during the afternoon. On a monthly scale, peak atmospheric CO2 concentration was observed during July in both the sites, which was a result of more release of CO2 by the forest ecosystem through ecosystem respiration and microbial decomposition. Enhanced photosynthetic activities during the late monsoon and post-monsoon resulted in the decrease of atmospheric CO2 concentration over the forest ecosystem. Among the meteorological variables, rainfall was found to have the highest control over the seasonal variability of the atmospheric CO2 concentration. Orbiting Carbon Observatory-2 (OCO-2) satellite-retrieved column average CO2 (XCO2) was also examined to comprehend its reliability on an ecosystem scale. The OCO-2 retrieved XCO2 value was higher than the EC carbon flux tower-measured atmospheric CO2 concentration, which might be due to differences in the vertical resolution of the CO2 column and scale difference. However, the monthly atmospheric XCO2 retrieved from OCO-2 strongly adheres with the ground-measured monthly pattern. Our study highlights that forests with varying functional traits within the same climatic conditions show variability in the regulation of atmospheric CO2 concentration.

BackgroundRecent evidences suggested that deficiency of Vit-D is associated with risk of ischemic stroke and its severity. The mechanism behind its relationship have been linked to total oxidant level and some other modifiable risk factor like hypertension, diabetes, smoking and alcohol consumption and tobacco chewing. However, there are disappearances in evidences. The aim of this study is to find out the role of Vit-D and Total oxidants in ischemic stroke and in disease progression.MethodsIn this case control study total 205 individuals of case and control enrolled in this study the demographic data like age, gender, ethnicity, dietary habit, addiction (smoking, alcohol, tobacco chewing) previous history of disease (hypertension, diabetes, any cardiovascular disease) were collected from family members and other medical record. ResultsThe mean age of case and control group of 63.91 ± 12.66 and 62.52 ± 7.04 respectively. There was significant difference between insufficient Vit-D level in case and control group (p