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In its simplest form, coarctation of the aorta (CoA) refers to congenital narrowing of the thoracic aorta. Usually, a significant pressure gradient between the arms and legs is suggestive of the diagnosis. With the advancement of aortic imaging in our country many CoA patients are diagnosed at an adult age, but the management still carries a challenge. We reported a case of 30-year-old lady with CoA with an aortic aneurysm involving proximal left subclavian artery with proximal DTA and LV dysfunction. J Bangladesh Coll Phys Surg 2023; 41: 93-97

POEMS syndrome is a rare multisystem disorder that clinically manifests as a paraneoplastic syndrome and monoclonal plasma cell dyscrasia. Its acronym is derived from its principal characteristics: polyneuropathy, organomegaly, endocrinopathy, M proteins, and skin changes. Here, a case of POEMS syndrome was reported also having features of Castleman disease. A 43-year-old man was admitted with weakness of all four limbs, tingling, heaviness, muscle cramps along with headache for the last 6 months; examination revealed flaccid quadriparesis, generalized areflexia with flexor plantar response, papilloedema, cervical lymphadenopathy, hepatomegaly, tender mass at the left parieto-occipital region, pitting edema and testicular atrophy. Laboratory tests revealed thrombocytosis, high blood sugar, hepatomegaly, lytic lesions at the left parietal bone, pelvis, and intraosseous mass in the Pareto-occipital region; nerve conduction study showed the demyelinating motor neuropathy without conduction block. Intraosseous mass biopsy showed solitary plasmacytoma and immunohistochemical markers positive for CD138 and Ki- 67 MUM-1 and lambda/kappa >10:1, suggesting plasma cell dyscrasia with lambda chain restriction. Biopsy from the cervical lymph node revealed features of Castleman disease. With these clinical and laboratory parameters, this case was finally diagnosed as POEMS syndrome in association with Castleman disease which is a common accompaniment with the syndrome. J Bangladesh Coll Phys Surg 2022; 40: 204-208

A large ascending Aortic pseudoaneurysm is a rare life threatening complication after off pump coronary artery bypass surgery. We herein describe such a case of massive ascending Aortic pseudoaneurysm, with impending rupture which was adherent to undersurface of sternum, was successfully treated by us at Square Hospitals Limited. Bangladesh Heart Journal 2022; 37(1): 72-76

Double valve replacement is now-a-days a common procedure to treat diseased cardiac valves and the primary aim of prophylactic aortic replacement during concomitant valve replacement is to prevent dreadful complication like dissection, aortic rupture and even death. Although aortic surgeries are complex and have high morbidity and mortality rates, additional double valve procedure with coronary surgery can make it even worse. But for these patients, surgery remains the one and only treatment option for symptom relieve and prolongation of life. We herein present a case of severe aortic stenosis (AS) with severe aortic regurgitation (AR) with severe mitral regurgitation (MR) with coronary artery disease (CAD) and aortic aneurysm treated successfully by us at Square Hospitals; and to our best knowledge and according to the published articles, this is probably the first time, this type of combined cardiac procedure has been accomplished along with aortic surgery, in our country. We recommend that surgeons should perform bypass grafting along with aortic replacement and valve replacement surgery when indicated, without worrying that adding such a procedure will escalate post-operative adverse effect. Cardiovasc j 2021; 14(1): 82-87

The field experiment was carried out at KrishiVigyan Kendra, Aurangabad and at farmers’ field during rabi seasons of 2013-14 and 2014-15, to response of time of sowing affect the yield attributes, Yield and Economics of wheat (Triticum aestivum L.). Experiment was laid out in a completely randomized block design with 4date of sowing i.e5th November, 15th November 25th November, 5thDecemberin a total of five replications duringrabi 2013-14 and 2014-15. Significantly maximum grain yield (44.64 q/ha) recorded with wheat sown at 5th November being at par with 15th November both were significantly more over 25th November and 5th December. 6.13%, 3.70% more grain yield recorded with at 5th November and 15th November produces over sowing of wheat at 25th November and 33.65% and30.59% more grain yield over 5th December, respectively. Sowing of wheat at 5th November produced more straw yield (52.90q/ha) being at par with 15th November and they were significantly more over 25th November and 5th December. Straw yield recorded 8.49%, 7.51% more with at 5th November and 15th November produces more straw yield over 25th November and 15.96% and14.91% more straw yield over 5th December Sowing of wheat. Significantly highest B-C ratio was also recorded with 5thNovember and statically at par with 15th November over 25th November and 5th December. Highest return 6.13 and 3.71% & by 33.65% & 30.60%, respectively higher returns by were recorded when wheat sown at 5th November and 15th November over 25th November and 5th December respectively.

An approach for design simplification and improvement in power-flow efficiency of an automotive planetary gearbox is presented in this article. Integrated CAD-CAE model, formed on stick diagram representation of geartrain operation, is developed for gleaning efficient gearbox configuration. A stick diagram for a three-stage planetary gearbox is a case exemplified here. CAE/simulation for dynamic analysis is conducted to determine deformation in geartrain. Powertrain model of the vehicle, Saturn-SL1, is selected from NREL ADVISOR. The power flow efficiency for each gear ratio is computed using DelCastillo's principle, and deformation is analysed to identify suitable gear ratios. It is observed that designing gearbox with five ratios yields higher efficiency than with seven. The developed model is tested on MATLAB, with New European Driving Cycle, to specify best operating range.Higher efficiency range is underscored, that is, driving in second through fourth gear. The proposed approach specifies driving conditions and efficiency while designing a gearbox.

Background: Multisystem inflammatory syndrome in children (MIS-C) is a newly recognised syndrome temporally associated with SARS CoV-2 infections.Methods: This was an observational both retrospective and prospective study in a rural medical college in eastern India. MIS‑C was diagnosed as per the criteria given by the WHO.Results: First case of MIS-C of the institute was found in November 2020, maximum cases were seen during the second wave. There were 66 cases. Mortality was 6%. All presented with fever. There was swelling of joints in 56.6% cases, gastrointestinal symptoms in 65%, respiratory distress in (43.9%) and shock was present in 12.1% of cases in this study. Co-morbidities were present only in four cases (6%).Conclusions: All cases of MIS-C had evidence of past infection with SARS CoV-2. There were relatively more cases of joint involvement and relatively less cases of shock in this study. The treatment using IVIG and methyl prednisolone was satisfactory. The 50% of the mortality was due to co-morbidities.

A 30-year-old woman, patient of severe MR with pulmonary hypertension presented with symptoms. On evaluation, giant left atrium was found on echocardiography (65 mm). Most strikingly, the patient was still in sinus rhythm. She was managed medically and after stabilization of symptoms, discharged with advice for mitral valve surgery and regular follow-up.University Heart Journal Vol. 12, No. 1, January 2016; 51-54

Atomic layer deposition (ALD) of chromium oxide (Cr2O3) thin films is investigated in a custom built hot wall viscous flow reactor configuration at 300 °C. Chromium(III) 2,4-pentanedionate [Cr(acac)3] and ozone (O3) are employed as the metal and the oxygen sources, respectively. In situ quartz crystal microbalance (QCM) and ex situ x-ray reflectivity studies are utilized as the two complementary techniques to monitor the growth mechanism and self-limiting deposition chemistry during Cr2O3 ALD. In situ QCM studies reveal a negligible nucleation period on the previously grown Al-OH* terminated surface before revealing the perfectly linear growth mechanism at 300 °C. The saturated growth rate is found to be ca. 0.28 A/cycle. In addition, excessive O3 exposure also reveals an alternative, controlled, and spontaneous etching pathway of the growing film as a result of the partial surface oxidation of Cr2O3. The as-deposited thin films are found to exhibit a polycrystalline rhombohedral structure without any preferential orientation. X-ray photoelectron spectroscopy studies reveal uniform distribution of Cr and O throughout the stack of ca. 40 nm film with minimum C impurities. High resolution scans of Cr 2p core level also confirm the presence of Cr in the +3 oxidation state with the corresponding multiplet spectrum.

In this paper, a novel single phase multilevel inverter with reduced number of switches is presented which is named as Half-height neutral point clamped (NPC) inverter. The proposed inverter consists of a single DC voltage source, a full bridge cell, switching devices, and power diodes which are half in number as compared to conventional topology. Unipolar modulation technique is used to generate switching signals for the proposed inverter, that provides optimum total harmonic distortion (THD) performance in both output voltage and current. The offered inverter topology is described with the help of a single-phase eleven-level inverter. The simulation of the topology is carried out through MATLAB/ Simulink. A comparison of the proposed topology with conventional one is also presented.