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The evolution of artificial intelligence (AI) systems in the field of anaesthesiology owes to notable advancements in data processing, databases, algorithmic programs, and computation power. Over the past decades, its accelerated progression has enhanced safety in anaesthesia by improving the efficiency of equipment, perioperative risk assessments, monitoring, and drug administration systems. AI in the field of anaesthesia aims to improve patient safety, optimise resources, and improve the quality of anaesthesia management in all phases of perioperative care. The use of AI is likely to impact difficult airway management and patient safety considerably. AI has been explored to predict difficult intubation to outperform conventional airway examinations by integrating subjective factors, such as facial appearance, speech features, habitus, and other poorly known features. This narrative review delves into the status of AI in airway management, the most recent developments in this field, and its future clinical applications.

Objective: This pilot study aimed to assess the safety and feasibility of robotic gait training and its' effects on gait parameters in individuals with incomplete motor spinal cord injury-SCI (AIS C and AIS D). Methods: The study was conducted in a tertiary research center with indigenously developed Robotic Exoskeleton Assisted Rehabilitation Systems (REARS). Primary outcome measures used were the ten-meter walk test (10MWT), two-minute walk test (2MWT), six-minute walk test (6MWT), the timed up and go test (TUG), the walking index for spinal cord injury II (WISCI II), and the spinal cord independence measure version III (SCIM III) at baseline, 12 sessions, and after 24 sessions (endpoint) of training. At baseline, individuals who could not perform 10MWT, TUG, and 6MWT were grouped in G1 for analysis. Participants in G2 were able to perform all the tests at baseline. Results: The median (interquartile range [IQR]) age and duration of illness was 41 (24) years and 167 (147) days, respectively. Five out of seven participants had non-traumatic etiology and five were males. After completing training, participants in G1 were able to complete the 10MWT, 6MWT, and TUG, and the mean (SD) scores were 0.2 m/s (0.2), 66.3 m (61.2) and 113.3 s (117.4), respectively. Participants in G2 could perform the TUG test 13.5 s faster at the end of the study (11.9 s vs 25.4 s). The minimum clinically important difference (MCID) for TUG was 10.8 s. In G2, the pre-post training change in mean score of 10MWT and 6MWT was 0.11 m/s and 42 m, respectively; these values approached the MCID for these measures. None of the participants had any injury during training. Conclusions: Robotic gait training with REARS is safe and feasible. Such training may lead to an improvement in balance and walking capacity.

Study Design Prospective observational study. Purpose To evaluate bone turnover markers (BTMs) in individuals with acute spinal cord injury (SCI) and to compare the results with those of healthy controls and postmenopausal females. Overview of Literature SCI significantly impacts bone health. Change in bone mineral density appears 6 months after SCI and rapid bone loss during the acute phase is often underestimated, resulting in osteoporosis and a high risk of sublesional fractures. However, few studies have evaluated BTMs in the Indian SCI population. Despite a high risk of fracture, there are no guidelines for the diagnosis, monitoring, and management of SCI-induced osteoporosis. Methods Twenty patients within 1 month of traumatic SCI who had been admitted to a tertiary care rehabilitation center were included in this study. Serum BTMs, C telopeptide (CTX) as a bone resorption marker, and osteocalcin as a bone formation marker, were serially measured at baseline, and 3 and 6 months after SCI. BTMs of SCI patients were compared with those of a control group of age-matched healthy males, premenopausal females, and a vulnerable group of postmenopausal females. Results BTMs were significantly elevated in patients with SCI, with maximum levels observed at the 3rd month of injury. At baseline, the bone resorption marker CTX was approximately 3 times higher in SCI patients than in the control male population and premenopausal females, and about double that of postmenopausal females. The rise in the bone formation marker was marginal in comparison to that of the bone resorption marker. BTMs were persistently elevated and did not reach the normative range until the 6th month of SCI. Conclusions Raised bone resorption markers in comparison to bone formation markers indicate hyper-resorption-related bone loss following acute SCI. Markedly elevated bone resorption markers in the SCI population, compared with those in control and vulnerable groups, emphasize the need for early bone health monitoring and management.

This study examines the activities of the informal recycling sector in Abuja, Nigeria. This is no formal recycling programme in Abuja. Scavengers carry out waste segregation and identification for recyclable materials. The questionnaires were administered to one thousand, five hundred (1500) scavengers and scrap dealers (stakeholders) to obtain socioeconomic and demographic characteristics. The questionnaires contain age distribution, gender, marital status, education level, working hours, number of stakeholders, citizenship, experience on the job, materials recovered, quantities of recyclables, and income. The majority of the scavengers are between the ages of 21 and 40 years, and they work between 10–12 h. The scavengers are predominantly male. The scavengers sort out recyclables 19.76 kg/c/d. The estimated quantity of recyclables generated in Abuja is 133,688 kg per day (133.688 tons per day). A waste picker earns between N1000 ($2.8) and N1500 ($4.2) per day; itinerant dealers earn between N1500 ($2.8) and N2000 ($5.6) per day, and scrap dealers earn between N10, 000 ($27.77) and N15, 000 ($41.67) per day in Abuja. The activities of stakeholders contribute to the recovery and sorting of secondary waste recyclables. The study highlighted the challenges of scavengers.

Dementia is an eurodegenerative disorder, which causes significant disability, especially among the elderly population worldwide. The affected person shows a progressive cognitive decline, which interferes with the independence in performing the activities of daily living. Other than the cognitive domain, the patient tends to have neuropsychiatric, behavioral, sensorimotor, speech, and language-related issues. It is expected that the global burden of the disease will rise with more people entering the geriatric age group. By 2050 close, to 140 million people will be living with one or the other type of dementia. Alzheimer’s disease contributes to more than 60% of cases worldwide, followed by vascular dementia. Pharmacotherapy has a limited role to play in the treatment, and at present, no drug is available, which can halt or reverse the progress of the disease. World Health Organization has mandated rehabilitation as a core recommendation in the global action plan on the public health response to dementia. Rehabilitation services are widely recognized as a practical framework to maximize independence and community participation in dementia care. The rehabilitation program is customized to achieve the desired goals, as each person has different experiences, preferences, motivations, strengths, and requirements based on type, course, and severity of the illness. It is an interdisciplinary-team approach with the involvement of several health care professionals. This article reviews the existing literature and outlines the effective rehabilitation strategies concisely in dementia care.

Background: Autonomic dysfunction has been documented in cirrhosis liver. Its influence on variceal bleed is not known. Aim: To determine the autonomic function amongst variceal bleeders in cirrhosis of the liver.Materials and methods: Fifty cirrhotics (variceal bleeders: 34) belonging to either sex, Childs B, age more than 15 years and non diabetic constituted the study group. Parasympathetic function tests included valsalva ratio (E:I ratio) and deep breathing test. (Max.-Min. heart rate); sympathetic function included postural fall of B.P and a rise in diastolic B.P. with sustained hand grip. A cirrhotic was considered to have ‘True’ autonomic dysfunction when both parasympathetic and one of the two sympathetic tests were abnormal.Results: The mean age for men was 39.64 + 10.6 yrs and for women 39.54 + 15.8 yrs. The male female ratio was 3.5:1. Only 10 of the 50 patients (all bleeders) had ‘true’ autonomic dysfunction i.e. 20%. Parasympathetic dysfunction alone was positive in 19 (38%) and sympathetic in 10 patients (20%). The E:I ratio (p < 0.001) and an increase in diastolic B.P. during sustained hand grip (p < 0.04) were significantly positive amongst variceal bleeders.Conclusion: ‘True’ autonomic dysfunction can predispose a cirrhotic to variceal bleed.

Context: India faces an acute shortage of health personnel. Together with inequalities in distribution of health workers, dental health workers also become a part contributing to it impeding the progress towards achievement of the Millennium Development Goals. Aim: To assess dental health-workforce distribution, identify inequalities in dental health-workers provision and report the impact of this mal distribution in India. Materials and Methods: Situational analysis done by using the primary data from the records of Dental Council of India. Results: In India, 0.088% of dental health worker per 1000 population exists. Inequalities in the distribution of dentists exist in India. Certain states are experiencing an acute shortage of dental health personnel whereas certain cities are over fledged with dentists like Karnataka, Maharastra, Tamilnadu being states with high concentration & Jharkhand, Rajasthan, Uttaranchal being the least. Conclusion: Although the production of health workers has expanded greatly in recent years by increase in number of dental colleges the problems of imbalances in their distribution persist. In the race of increasing dentist population ratio in total, inequitable distribution of appropriately trained, motivated and supported dentists gives a mere feel of saturation in jobs making youngsters to not to choose dentistry as a career giving an alarm.

Isolated dilation of common bile duct (CBD) with normal sized pancreatic duct and without identifiable stones or mass lesion (unexplained) is frequently encountered by computed tomography/magnetic resonance imaging. We studied the final diagnoses in these patients and tried to elucidate factors that can predict a malignant etiology. This is a retrospective analysis of prospective database from a University based clinical practice (2002- 2008). We included 107 consecutive patients who underwent endoscopic ultrasound (EUS) for evaluation of isolated and unexplained CBD dilation noted on contrast computed tomography scans. EUS examination was performed using a radial echoendoscope followed by a linear echoechoendoscope, if a focal mass lesion was identified. Fine-needle aspirates were assessed immediately by an attending cytopathologist. Main outcome measurements included i) prevalence of neoplasms, CBD stones and chronic pancreatitis and ii) performance characteristics of EUS/EUS-fine needle aspiration (EUS-FNA). A malignant neoplasm was found in 16 patients (14.9%) of the study subjects, all with obstructive jaundice (ObJ). Six patients had CBD stones; three with ObJ and three with abnormal liver function tests. EUS findings suggestive of chronic pancreatitis were identified in 27 patients. EUSFNA had 97.3% accuracy (94.1% in subset with ObJ) with a sensitivity of 81.2% and specificity of 100% for diagnosing malignancy. Presence of ObJ and older patient age were only significant predictors of malignancy in our cohort. Amongst patients with isolated and unexplained dilation of CBD, the risk of malignancy is significantly higher in older patients presenting with ObJ. EUS-FNA can diagnose malignancy in these patients with high accuracy besides identifying other potential etiologies including missed CBD stones and chronic pancreatitis.

Paediatric joint pain and swelling is a frequent presentation. The clinical profile and relevant laboratory investigations often lead to the correct diagnosis; however some patients present a diagnostic conundrum. Pigmented villonodular synovitis (PVNS) is a rare entity that may afflict children and be easily missed. [ABSTRACT FROM AUTHOR]

Landfill design needs to consider dynamic properties for safety not only under static conditions, but also under dynamic loading conditions. In recent years, geophysical surveys are becoming popular mainly to understand the profiles within the landfills and estimate its dynamic properties like shear wave velocity, shear modulus and Poisson's ratio. Shear wave and P-wave velocity (Vs, Vp) are very well related to the dynamic properties of soil at lower strains. Geophysical tests provide a direct measurement of Vs and hence widely accepted for the seismic site characterization purpose. In this study, seismic survey was performed using Multi channel Analyzer of Surface Waves (MASW) technique at Mavallipura landfill site, Bangalore. MASW test involves three steps: data acquisition, construction of a dispersion curve (showing the variation of phase velocity among various frequencies), and inversion of the dispersion curve to get shear wave (Vs) profile from the calculated dispersion curve. The typical MASW test setup used for the present study consists of 24-channel geode seismograph and 24 geophones of 4.5 Hz capacity. Seismic data were recorded using geode seismograph with sledge hammer source on one side of the landfill and geophones on the other side with 1m spacing of geophones. The landfill was surveyed up to a length of about 25m from the top level. The deposit consisted of uncompacted waste up to a depth 6m with Shear wave velocity of 74 to 130m/s. Series of 1-D MASW tests have been carried out to map the entire solid waste site and the results will be presented in the paper. Overall, the results from the study showed that seismic surveys have the potential to capture the changes in dynamic properties like shear wave velocity and Poisson's ratio with respect to depth of MSW landfill to infer the extent of degradation and provide dynamic properties needed for seismic stability evaluations. [ABSTRACT FROM AUTHOR]