Search

Aims and objectives: To monitor perfusion index in each patient in immediate pre-operative period; To assess co-relation of perfusion index with other hemodynamic parameters observed simultaneously; and To observe variation in perfusion index with different anesthesia techniques- general anesthesia, neuraxial blockade and peripheral nerve blocks. Methodology: 50 cases each under ASA class I, II or III posted for elective surgeries under brachial plexus nerve blocks, neuraxial and general anesthesia were included. The perfusion index, heart rate, systolic and diastolic blood pressure was monitored in the immediate pre-operative period and after induction of anesthesia at 5, 10 and 15 mins. Results: In our study, it was noted perfusion index increased significantly from the baseline (p

The major goal of this project is to design and construct a Multi-Lingual Braille System Output Device for visually impaired people that will allow them to access and read computer texts. The device collects English texts and displays them with the help of a controller. It can also make a sound that corresponds to the displayed characters. The cells are controlled by a microcontroller called a Programmable Interface Controller (PIC). The Universal Serial Bus is used to communicate between the device and the computer (USB). The program that controls this interaction is written in the VB.net programming language. For the visually impaired to keep up with technology breakthroughs, such devices must be developed on a continuous basis. The inexpensive cost, the added multilingual, and the audio features are the key advantages of this system. Many other features, such as new languages and the Grade 2 Braille System, can be added to meet the demands of the users.

Philately is one of the most popular hobbies since its inception and there are millions of known philatelists across the globe. Other than just a hobby, it can also be seen as a tool for reflecting social, political, natural specialities of the country for internal and external demonstration. It is an effective medium to display the richness of natural diversity, customs, and traditions and also the man-made wonders for its users. Stamps and other philatelic items can be viewed as conservation tool. They not only sensitize the public to the fate of the threatened environment or biota but also help in raising funds. Mangroves represent one of the most diverse coastal ecotonal wetlands of tropics and subtropics. They are the ecosystems inhabited by diverse group of floral, faunal, and microbial elements. Though neglected initially, these forests have attracted the global attention after understanding their role in coastal ecology and economy. The current study is a modest attempt to use themed philately to investigate the unique representation of the world’s most diversified mangrove ecosystem. With this goal in mind, a systematic spatio-temporal review of philatelic publications was conducted, and the results are presented along with the available data and alternative interpretations.

Background Due to waning immunity following primary immunization with Covid-19 vaccines, booster doses may be required. The present study assessed a heterologous booster of SII-NVX-CoV2373 (spike protein vaccine) in adults primed with viral vector and inactivated vaccines. Methods In this Phase 3, observer-blind, randomized, active controlled study, a total of 372 adults primed with ChAdOx1 nCoV-19 (n = 186) or BBV152 (n = 186) at least six months ago, were randomized to receive a booster of SII-NVX-CoV2373 or control vaccine. The control group received homologous booster of ChAdOx1 nCoV-19 or BBV152 depending upon the prime cohort. Anti-S IgG and neutralizing antibodies were assessed at baseline (day 1), day 29, day 91 and day 181 for immunogenicity assessments. Solicited reactions were collected for one week after vaccination. Unsolicited adverse events (AEs) were collected for 28 days while serious adverse events (SAE) and adverse events of special interest (AESI) were reported throughout the six-month study duration. (Identifier: CTRI/2022/04/042017) Results In both the ChAdOx1 nCoV-19 primed group and BBV152 primed group, 186 participants each received the study vaccines. In the ChAdOx1 nCoV-19 Prime cohort, at 28 days after the booster dose, there was a 3.9- to 5.1-fold-rise and 1.9- to 2.8-fold-rise in anti-S IgG and neutralizing antibody titres from the baseline in the SII-NVX-CoV2373 group and the ChAdOx1 nCoV-19 group, respectively. The same responses for the BBV152 prime cohort was 7.4- to 10.4-fold-rise and 1.5- to 2.5-fold-rise in the SII-NVX-CoV2373 group and the BBV152 group, respectively. There was 86.96% (95% CI 78.32, 93.07) to 94.57% (95% CI 87.77, 98.21) and 37.63% (95% CI 27.79, 48.28) to 79.57% (95% CI 69.95, 87.23) anti-S IgG and neutralizing antibody seroresponse (2-fold-rise from baseline) in the SII-NVX-CoV2373 group and ChAdOx1 nCoV-19 group, respectively. The same was 94.51% (95% CI 87.64, 98.19) to 98.90% (95% CI 94.03, 99.97) and 20.43% (95% CI 12.77, 30.05) to 74.19% (95% CI 64.08, 82.71) in the SII-NVX-CoV2373 group and BBV152 group, respectively. No SAE or AESI was caused by the study vaccines. Conclusion SII-NVX-CoV2373 showed a numerically higher boosting effect than homologous boosters in adults primed with ChAdOx1 nCoV-19 and BBV152. The vaccine was also safe and well tolerated.

Background Yellow fever, a mosquito borne flavivirus infection, is an important public health problem in Africa and Latin America. A Yellow Fever vaccine (YFV) was developed and tested in a study in India. Methods This was a Phase I, open-label, randomized, controlled study where healthy adults received SII YFV intramuscularly (SII YFV IM), SII YFV subcutaneously (SII YFV SC) or STAMARIL® (Sanofi-Pasteur) in 1:1:1 ratio. They were followed for solicited reactions for 10 days and unsolicited events for 28 days and serious adverse events for 3 months. YF neutralizing antibodies were measured at baseline and on Days 10, 14, 28. Results A total of 60 adults were enrolled in the study. The proportion of participants with solicited reactions was 10%, 40% and 25% in SII YFV SC, SII YFV IM and STAMARIL® arms, respectively. No causally related unsolicited AEs or any SAE was reported. After vaccination, the seroconversion was 94.44%, 100% and 100%, in the three arms respectively. The post-vaccination GMTs were similar in the study arms. Conclusion The new YFV was found safe and immunogenic by IM as well as SC routes. The vaccine can be tested in further phases of clinical studies.

Thyrist or controlled series compensator (TCSC) configuration in power system comprises of controlled reactors in parallel with sections of a capacitor bank. This combination offers smooth control of basic frequency capacitive reactance over a wide range. Its benefits include eradication of resonance risks, stability improvements and so on, offering dynamic power flow control. However, the TCSC controllers face issues, while determining their optimal locations and parameter settings (sizing). Hence, this study intends to solve these problems by considering three objectives, namely, congestion minimisation, investment cost minimisation and increased transient stability. The objectives are achieved by optimising various locations of the bus system, where the TCSC has to be placed, and its sizing. From the optimised results, the best solution is chosen to attain the abovementioned objectives. The presented scheme obtains the best solution by a hybridised model, exploiting the dragonfly algorithm (DA) and the particle swarm optimisation (PSO), called PSO-dependent step vector for DA. Finally, the proposed approach is compared with the conventional schemes by analysing the outcomes for two benchmark systems, namely, IEEE 24 and IEEE 9 test bus systems.

Almost 800 million people currently lack access to reliable electricity, for many of whom solar microgrid systems are expected to be the most cost-effective solution. Quantifying current and future electricity demand is crucial for cost-effective design of reliable microgrids. However, electricity usage is connected to a wide range of social and economic factors alongside climatic conditions, making estimation of demand challenging. This paper presents a framework facilitating each stage of solar microgrid design from demand estimation through to cost-optimal sizing of the microgrid and its economic and environmental characterisation. Household demand is simulated based upon (1) climatic conditions, (2) appliance ratings and usage patterns, and (3) rates of growth in appliance ownership based upon the Multi-Tier Framework for measuring household electricity access. Microgrid demands are simulated based on the combination of these with (4) nondomestic demand based upon locally available data. The framework is demonstrated across four rates of domestic demand growth and two climatic conditions (‘tropical savanna’ and ‘humid subtropical’), alongside nondomestic demand based upon two operational microgrids (one rural and one peri-urban). When growth rates are high, newly introduced appliances tend to dominate, with differing impacts on the demand profile depending on power and usage times. Cooling represents a modest contribution to demand in the tropical savanna climate. However, in the hotter and more seasonally varying humid subtropical climate, cooling becomes the dominant driver of demand, increasing seasonality and proportion of demand at night. Nondomestic demand in the rural microgrid is primarily agricultural, and exhibits more seasonality and better alignment with daylight hours than demand in the peri-urban setting, which is more service-based. Across cases, increased seasonality and proportion of demand at night lead to poorer alignment with PV generation, increasing cost and GHG emissions per unit of electricity used in a cost-optimised microgrid system.

Everyone depends upon various online resources for news in this modern age, where the internet is pervasive. As the use of social media platforms such as Facebook, Twitter, and others has increased, news spreads quickly among millions of users in a short time. The consequences of Fake news are far-reaching, from swaying election outcomes in favor of certain candidates to creating biased opinions. WhatsApp, Instagram, and many other social media platforms are the main source for spreading fake news. This work provides a solution by introducing a fake news detection model using machine learning. This model requires prerequisite data extracted from various news websites. Web scraping technique is used for data extraction which is further used to create datasets. The data is classified into two major categories which are true dataset and false dataset. Classifiers used for the classification of data are Random Forest, Logistic Regression, Decision Tree, KNN and Gradient Booster. Based on the output received the data is classified either as true or false data. Based on that, the user can find out whether the given news is fake or not on the webserver.

The retailing sector in India has undergone significant transformation in the past 10 years. The organized retail industry in India is expected to grow at 25-30% annually and would triple in size from Rs. 35,000 crore in 2004-05 to Rs.109,000 crore ($24 billion) by 2010. Retailing is gradually inching its way towards becoming the next boom industry. The consumer decision-making process is a complex phenomenon. The purchase of goods or services includes a number of factors that could affect each decision. Decision making is more complex and even more important for consumers today than in thepast. The objectives of this study were to investigate the decision-making styles of Indian shoppers in shopping malls and to study the variations in these styles across different demographic variables. https://journalnx.com/journal-article/20150694

Background: A lower segment caesarean section (LSCS) commonly induces moderate to severe postoperative pain for 48 hours. Aim of the study was to compare 0.25% bupivacaine with dexamethasone and 0.25% bupivacaine with clonidine for transversus abdominis plane (TAP) block as post-operative analgesia in patients undergoing lower segment caesarean section (LSCS). Methods: A randomized prospective controlled clinical study was conducted in 104 patients undergoing LSCS. Participants were divided into two groups in which group TAP-D (n=54) received 0.25% Bupivacaine with Dexamethasone 4mg and those in group TAP-C (n=50) received 0.25% Bupivacaine with Clonidine 75mcg as TAP block at the end of surgery. The postoperative pain was evaluated by visual analog scale (VAS) for pain scoring at every 2 hours for 12 hours postoperatively. Subjective assessment of duration of analgesia was done. Results: The average duration of analgesia with TAP bock for the overall study population was 316.15 minutes. The average VAS score in patients who received TAP with dexamethasone was 1.50 which is significantly lower than those who received clonidine (1.95) (P value-0.0001). Further the duration of analgesia was 151 minutes longer in the first group who received dexamethasone TAP. In majority of the patients (84%) who received clonidine TAP, the analgesia persisted for 2-4 hours. While in patients who received dexamethasone addition, the analgesia persisted for 6-8 hours in 37%. Conclusions: TAP block is a safe and effective way of relieving postoperative pain in LSCS patients. Addition of dexamethasone to bupivacaine significantly enhances its effect in terms of block quality and analgesia duration as compared to clonidine addition.

Background: Organophosphate (OP) pesticides are the main agents for pest control in agricultural crops making them the agent of choice for self-poisoning. In India, self-poisoning with OP pesticides is the second most frequently reported method of suicide owing to its ready and easy availability with mortality varying from 12% to 50%. Methods: A retrospective study was conducted over a period of one year to compare the socio-demographic variables with the outcomes in patients with OP poisoning. A total 94 patients were consecutively included in the study and a statistical analysis was carried out. Results: Majority of the patients belonged to the 21-30 years age group (54.3%), emphasizing the involvement of the young and productive age group into suicidal attempts. The study population consisted of 58 males (61.7 %) and 36 females (38.3%) depicting a higher incidence of OP poisoning amongst males. There was an overall mortality of 3.2 % amongst the treated patients. Females had a higher mortality (5.6%) as compared to males (1.7%). It was observed that the mortality was the maximum among the 41-50 years age group patients (p = 0.007). Conclusions: Self-poisoning with OP pesticides is highly prevalent in the rural areas due to the ease of availability of these compounds and lack of regulatory control over the same. The young population is the most commonly affected by this. Regulation in sales and distribution of pesticides should be taken as a priority and early treatment yields a favourable outcome in majority of the patients.

OBJECTIVE The aim of this study was to examine the prevalence of nutritional risk and its association with multiple adverse clinical outcomes in a large cohort of acutely ill medical inpatients from a Swiss tertiary care hospital. METHODS We prospectively followed consecutive adult medical inpatients for 30 d. Multivariate regression models were used to investigate the association of the initial Nutritional Risk Score (NRS 2002) with mortality, impairment in activities of daily living (Barthel Index

Use of inflammatory biomarkers to guide antibiotic decisions has shown promising results in the risk-adapted management of respiratory tract infections, mainly in the inpatient setting. Several observational and interventional trials have investigated the benefits of procalcitonin (PCT) and C-reactive protein (CRP) testing in primary care. Both markers have shown promising results, although CRP is an inflammatory biomarker while PCT is more specific for bacterial infections. For CRP, point-of-care testing is widely established. Recently, sensitive point-of-care testing for PCT has also become available. A high-quality trial comparing these two markers for the management of patients in primary care is currently lacking. The aim of this paper is to review the existing literature investigating the use of PCT and CRP in primary care. The authors compare their performance for guiding antibiotic stewardship and analyze the cut-off values and endpoints to put these parameters into context in a low-acuity environment.

Unanticipated difficult airway still forms about 93% of the total number of difficult airway scenarios encountered. Difficult airway can be due to difficulty in mask ventilation, difficult laryngoscopy or difficulty in intubation. Difficult intubation can be due to a number of causes. Pathologies like enlarged lingual tonsil, valecular or epiglottic cysts, laryngeal papillomas, hyperplastic mucosal folds, oropharyngeal stenosis lead to difficulty visualizing the larynx. Tracheal stenosis, laryngeal webs, tumors of the larynx, airway trauma and undetected mediastinal masses lead to difficulty in advancing the endotracheal tube. Management of these cases is always challenging. Although a thorough history that includes previous endotracheal intubation, weight changes, episodes of dyspnea or wheeze may help identify at risk patients, very often these patients may be asymptomatic and the pathology may not be until the time of laryngoscopy and intubation. At the time of unanticipated crisis, following the stepwise protocol of difficult airway and being prepared for surgical airway access can prevent complications and save the life of the patient. Here we present two such cases of unanticipated difficult airway how we managed them. Post-operatively these patients were found to have laryngeal webs.

In hemodynamically unstable patients, injection ketamine and injection etomidate are thought to be more suitable drugs for induction of anaesthesia, hence this study was conducted with the aim to evaluate the onset of action, hemodynamic effects during intubation and to assess untoward effects of injection ketamine and etomidate for intravenous induction.

Diaphragmatic Eventration (DE) is a congenital or acquired abnormal elevation of diaphragm, may be complete or partial. Partial eventration is called as Dromedary hump. DE is caused by paralysis, aplasia or atrophy of the muscular fibres of the diaphragm. Anaesthetic management of patients with DE in adults is not adequately described in literature, as it is rare and usually asymptomatic. In some cases, it may cause severe dyspnoea, orthopnea and hypoxia.