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We report a novel two-step percutaneous endovascular technique for retrieval of peripherally inserted central catheter, free ends of which were inaccessible, that had embolized to the segmental branch of left pulmonary artery using SIM 1 catheter and a loop snare, in a 17 year old female patient diagnosed with osteosarcoma right femur. Step one involved, inserting SIM 1 catheter through the heart to hook the embolized peripherally inserted central catheter and bring it down to the lower segment of inferior vena cava. In the second step, a loop snare was used to grasp the free end of peripherally inserted central catheter, and the whole assembly was withdrawn via right common femoral vein access. Patient was monitored for 24 hours and discharged as there were no complications. SIM 1 catheter followed by the use of loop snare as a retrieval system is safe and efficacious and can be considered by an intervention radiologist for retrieval of embolized vascular access device, in which none of the free ends are available to catch hold with a loop snare.

To evaluate the accuracy of lung ultrasound in diagnosing and differentiating transient tachypnea of the newborn and respiratory distress syndrome in preterm neonates.

Background: Microsurgical technique is a recent advancement in periodontal plastic surgery, which improves the predictability of periodontal procedures, providing better esthetic results with minimal postoperative discomfort. Alloderm is an alternate to connective tissue grafts, which has been successfully used for root coverage. The present study aims at Comparative assessment of Micro and Conventional surgical techniques for root coverage using coronally positioned flap (CPF) with Alloderm. Materials and Methods: Twenty sites with Miller's Class I or II gingival recession defects were selected; sites were randomly divided into control and test groups. Test sites were treated with CPF and acellular dermal matrix (ADM) using Microsurgery and control sites were treated with CPF and ADM using conventional method. Results: Conventional and Microsurgical procedures for root coverage showed a statistically significant difference in all clinical parameters from baseline to 3 and 6 months (P < 0.01). The microsurgical technique demonstrated a significant difference in ultrasonographic thickness of gingiva (P < 0.003) and patient satisfaction score (P < 0.005). Conclusion: Microsurgical procedure for root coverage was found to be superior to the conventional macrosurgical approach under magnification. Microsurgical sites healed faster with neovascularization demonstrated on ultrasonographic evaluation with improved gingival thickness and patient satisfaction scores.

Aim: This study aims to assess the various ocular and systemic complications of peribulbar block in supine posture among patients undergoing cataract surgery in a tertiary care center in Chennai. Materials and Methods: A retrospective analysis of complications that occurred in 880 patients who had been given peribulbar block in supine posture, during 36 months between January 2016 and January 2019 among patients who underwent cataract surgery at a tertiary care hospital. Patients with uncontrolled diabetes mellitus, hypertension, bronchial asthma, and cardiac illness were excluded from the study. The other exclusion criteria were pediatric age group and trauma. The data thus collected from the records were entered and analyzed using descriptive analysis. Results: Out of 880 patients operated in a 36-month period at Government Medical College Hospital who received peribulbar block in the supine posture, 42 (4.77%) patients had block-related systemic complications; bradycardia and vasovagal attack-40 (4.54%) patients; brainstem anesthesia and syncope-2 (0.22%). The incidence of orbital complications was 82 (9.31%). Out of the orbital complications, the most common complication was periorbital hematoma occurred in 50 (5.68%), followed by retrobulbar hemorrhage occurred in 32 (3.63%). Conclusion: The observation-based conclusion is various ocular and systemic complications can occur in peribulbar block. Hence, the operation theatre should be equipped with appropriate instruments and trained personnel to deal with all kinds of emergencies.

The primary cause of road accident results in fatalities, serious injuries and monetary losses is known to be due to drowsy or sleepy drivers, according to analysis reports on recent traffic accidents. Lack of sleep, medication, drugs, or prolonged driving contributes to drowsiness. A system that can identify a driver’s drowsy state and warn him before an accident occurs is required to avoid roadside accidents caused by distracted driving. Many researchers have recently expressed their interest in drowsiness detection. The methods essentially involve monitoring the driver’s physiological or behavioral 1summarizes some of the most recent methods put forth in this field is given. We propose an algorithm to monitor eye blinks that uses eye feature points to determine whether the eye is open or closed and sets off an alarm if the driver is drowsy. In-depth experimental results are also provided to highlight the benefits and drawbacks of the proposed method.

The frenum is a mucous membrane fold that attaches the lip and the cheek to the alveolar mucosa, the gingiva, and the underlying periosteum. The frena may jeopardize the gingival health when they are attached too closely to the gingival margin, either due to an interference in the plaque control or due to a muscle pull. In addition to this, the maxillary frenum may present esthetic problems or compromise the orthodontic result in the midline diastema cases, thus causing a recurrence after the treatment. Archer's “classical frenectomy” is an extensive procedure including the excision of fibers, interdental papilla, and exposure of the alveolar bone up to the palatine papilla. The resultant delayed healing, loss of the interdental papilla, and abnormal scar led toward the conservative approaches such as Edward's frenectomy, frenum relocation by Z-plasty, and free gingival graft, with their technical and esthetic limitations. A better approach in frenectomy to make a primary closure in the midline and to avoid an unesthetic scar by creating a zone of the attached gingiva is assisted with a lateral pedicle graft. A case series of this technique with its distinct advantages is presented.

Background and Aims: Epidural analgesia (EA) and transversus abdominal plane (TAP) block have been part of multimodal analgesia techniques for postoperative pain relief in abdominal surgeries though EA has been established as gold standard. This study assesses and compares the analgesic efficacy of continuous bilateral TAP catheter infusion and lumbar epidural infusion. Methods: In this randomised, single-blind, prospective, non-inferiority trial, 75 patients were randomised to receive a bolus dose of 15 ml, 0.25% bupivacaine followed by an infusion of 5–12 ml/h of 0.125% bupivacaine via lumbar epidural in EA group and a bolus dose of 0.4 ml/kg of 0.25% bupivacaine bilaterally via TAP catheter followed by continuous infusion at 5ml/h of 0.125% bupivacaine in TAP group postoperatively. VAS scores (primary objective) and sensory dermatome blockade were recorded at 1, 4, 8, 12 and 24 h. Total morphine consumption, PONV, incidence of hypotension and patient satisfaction scales were recorded at the end of 24 hours. Results: The median VAS scores were comparable between the groups at 1, 4, 8, 12 and 24 hours both at rest (P = 0.11, 0.649, 0.615, 0.280 and 0.191, respectively) and on coughing (p = 0.171, 0.224, 0.207, 0.142 and 0.158, respectively). Total morphine consumption in 24 h between TAP and EA group was comparable (p = 0.366). There was no statistical difference in the incidence of hypotension, PONV and patient satisfaction scale. Conclusion: Continuous bilateral TAP block is as efficacious as the continuous lumbar epidural infusion in relieving postoperative pain in patients undergoing lower abdominal surgeries.

Abstract The agonist–antagonist myoneural interface (AMI) is an amputation surgery that preserves sensorimotor signaling mechanisms of the central-peripheral nervous systems. Our first neuroimaging study investigating AMI subjects conducted by Srinivasan et al. (2020) focused on task-based neural signatures, and showed evidence of proprioceptive feedback to the central nervous system. The study of resting state neural activity helps non-invasively characterize the neural patterns that prime task response. In this study on resting state functional magnetic resonance imaging in AMI subjects, we compared functional connectivity in patients with transtibial AMI (n = 12) and traditional (n = 7) amputations (TA). To test our hypothesis that we would find significant neurophysiological differences between AMI and TA subjects, we performed a whole-brain exploratory analysis to identify a seed region; namely, we conducted ANOVA, followed by t-test statistics to locate a seed in the salience network. Then, we implemented a seed-based connectivity analysis to gather cluster-level inferences contrasting our subject groups. We show evidence supporting our hypothesis that the AMI surgery induces functional network reorganization resulting in a neural configuration that significantly differs from the neural configuration after TA surgery. AMI subjects show significantly less coupling with regions functionally dedicated to selecting where to focus attention when it comes to salient stimuli. Our findings provide researchers and clinicians with a critical mechanistic understanding of the effect of AMI amputation on brain networks at rest, which has promising implications for improved neurorehabilitation and prosthetic control.

Aim: To study the epidemiological data of paediatric burn patients to determine the role of demographic distribution and epidemiological parameters for assessment of mortality rate and development of burn prevention strategy.Materials and methods : epidemiological data of 500 patients admitted to the burns and plastic surgery unit of b.j. wadia hospital, mumbai over a period of six years (2000-2005) was reviewed from medical records. age, sex, demographic distribution, seasonal variation, total body surface area (tbsa) involved, type and place of burn injury, parental occupation, family size, first aid and mortality rate were studied.Result: Median age group for patient was 3.44 years (range one month to 14 years). the majority (24%) of burns occurred in children between the one to two years age group. male to female sex ratio was 1.38:1. most of the patients were from the defined demographic region served by the hospital. a significant number of patients however were from outside this region. burn injury occurred predominantly during winter. most common type of burn was scalds which occurred mainly in domestic circumstances. in the majority of patients, less than 10% tbsa was involved. all patients were managed as per the unit protocol. mortality rate was 10.4%. mortality rate was high in patients having more than 40% tbsa involvement. seventy-three per cent of the total deaths occurred in the patients coming from regions outside the demographic region served by the hospital. parental occupation, family size and the first aid did not affect the mortality rate.Conclusion: Availability of a burn care unit in the vicinity can decrease the mortality rates in the paediatric burn patients. an intense and focused burn prevention campaign to educate the general population about dangerous aetiological factors will decrease the incidence of paediatric burns.

In this paper a fuzzy logic based fault diagnosis system for a deaerator in a power plant unit is presented. The system parameters are obtained using the linearised state space deaerator model. The fuzzy inference system is created and rule base are evaluated relating the parameters to the type and severity of the faults. These rules are fired for specific changes in system parameters and the faults are diagnosed.

The Coronavirus disease (COVID-19) has emerged as a global epidemic, posing a significant threat to countries worldwide. COVID-19 is closely associated with pneumonia, leading to the unfortunate loss of many lives due to pulmonary conditions. Differentiating between pneumonia and COVID-19 based on chest X-ray images has become a challenging task. This paper proposes a Local Search Enhanced AHO-based Inception-ResNet-v2 Model to develop a robust and accurate classification model for identifying and categorizing chronic lung diseases in patients who have recovered from COVID-19. The proposed model utilizes the Inception-ResNet-v2 architecture to extract features from CT scan images, which are then used to classify the lung diseases present in the patients. A curated dataset of CT scan images from post-COVID-19 patients with known lung disease classes is used to train the model. Experimental results demonstrate that the proposed method achieves an accuracy of 98.97%, precision of 98.95%, sensitivity of 98.91%, F-score of 98.86%, and specificity of 98.89%. These performance metrics are comparable to those achieved by methods based on manually delineated contaminated areas.

One hundred normal individuals of different age groups from Mumbai (India) were included in this study. Various dimensions of lip-nose complex were measured. The results were compared with the available data for blacks, Caucasians and Chinese. In the population under study lip-nose complex measurements differ in all dimensions with blacks and Caucasians and show resemblance to the Chinese. The analysis of the data does not simply indicate the differences in the measurements but also points out change in growth patterns which will have a clinical significance.

The newest developments in the IoMT, wearable devices, and communications systems to offer smart healthcare services have made human life in the age of pervasive computing wiser. The healthcare sector may transform thanks to IoMT. Through software and Information Communication Technology (ICT), IoMT links wearable devices, patients, healthcare professionals, and careers. Ambient Assisted Lifestyle (AAL) allows it to incorporate new technology into day-to-day activities. Edge computation and cloud technologies are essential to achieving this goal to meet the needs of smart medical infrastructures. In this research wok, the IoMT-AAL architecture in the edge computing-assisted IoMT system based Deep Neural Networks (DNN) is presented in this study. The proposed IoMT-AAL aims to speed up timely data collecting and processing so that judgments are made utilizing the data. The IoMT-AAL model is used to identify the patient via the IoMT sensors, sending the data they have collected to edge computation. Then, many empirical analyses are conducted, and the outcomes are examined from many angles. It can be said that the IoMT-AAL effectively predicts the healthcare framework using DNN based on various parameters like specificity, precision, improvement, physical activity, tracking, and security. The simulation results demonstrated the IoMT-AALmodel's advantages over the other techniques.

Background: Glaucoma is the second most common cause of blindness globally and is characterised by raised intraocular pressure, optic disc cupping, and visual field defects. However, advanced imaging modalities such as optical coherence tomography (OCT) can pick up early changes. Our study aims to examine the role of OCT for the early diagnosis of primary open-angle glaucoma (POAG), its correlation with standard automated perimetry, and the diagnostic efficiency of both in POAG patients at a rural tertiary care centre in the Chengelpet District. Materials and Methods: This was a prospective observational study comparing the quantitative measurement of RNFL using OCT with functional loss analysed using the Automated Perimetry Humphrey Visual Field Analyzer in patients with POAG visiting the tertiary health centre in the Chengelpet district in Tamil Nadu. The study was conducted in 92 eyes of 50 patients diagnosed with POAG for 15 months from March 2022 to May 2023. Results: Of the 92 eyes of 50 patients, 26 were male patients and 24 were female patients. In total, 21 eyes had no demonstrable visual field defect, 49 eyes had single hemifield defect and 22 eyes had both hemifield defect. The area under the receiver operator characteristic curve for OCT RNFL layer measurement in patients diagnosed with visually confirmed ONH changes was 1.00, which was highly significant (P value = 0.01) and correlated well with the type of visual field defect with Humphrey's automated perimetry, suggesting significant correlation between the two. OCT–RNFL measurements are better diagnostic tests than standard automated perimetry for the early detection of glaucoma. Conclusion: Both OCT RNFL and Humphrey's automated visual field analysis play a most crucial role as an investigative modality for early diagnosis of POAG; however, OCT has an added advantage of detecting early glaucoma changes even without visible field changes and hence useful for very early detection of POAG in a tertiary care centre.

The aim of the present study was to make a polyherbal formulation of three herbs that would offset the negative effects of the high-fat cafeteria diet on rats and the beneficial effects of exercise. The ingredients for this herbal remedy included a water extract of Garcinia cambogia fruit, Trigonella foenum-graecum seed, and Glycyrrhiza glabra root in a 1:1:1 ratio. Nine groups of six male Wistar albino rats were chosen. Animals in Group I were normal and fed a standard diet; animals in Group II were given HFCD to prevent disease; animals in Group III were given HFCD plus exercise; while animals in Groups IV and V were given PHF at doses of 400 and 200 mg/kg p. o. Daily, respectively, in addition to HFCD; while animals in Groups VI and VII were exercised obese rats prevented from gaining more weight had their serum glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and very low-density lipoprotein cholesterol levels lowered. HDL cholesterol was raised. Further, the liver biopsy showed increased mononuclear cells; fat globules numbered less; and the enzymes and cells that are regenerating were at lower levels. The polyherbal formulation plus exercise exhibited significant anti-obesity efficacy at 400 mg/kg p. o.; the effect was equivalent to orlistat plus exercise. The research employed HFCD-induced obese rats as a model to investigate the joint effects of PHF and exercise against obesity.

We study polar molecule scattering in quasi-one-dimensional geometries. Elastic and reactive collision rates are computed as a function of collision energy and electric dipole moment for different confinement strengths. The numerical results are interpreted in terms of first order scattering and of adiabatic models. Universal dipolar scattering is also discussed. Our results are relevant to experiments where control of the collision dynamics through one-dimensional confinement and an applied electric field is envisioned.

Along the line of available efficient nonlinear optical (NLO) organic single crystals in the literature, it is worthwhile to bring in a novel organic single crystal of Brucinium-3,5-dihydroxybenzoate dihydrate (B35D) which was successfully grown utilizing the technique of slow evaporation of solution at ambient conditions. As the solubility of B35D was found to be the highest in water-ethanol 1:1 mixed solvent among the conventional solvents, crystallization of B35D was accomplished by making use of the solvent. The required confirmation of the crystal structure of the crystal and its lattice parameter could be achieved by the single-crystal X-ray diffraction analysis such that B35D was found to be crystallized in the monoclinic system with the non-centrosymmetric space group C2. The recording of UV-Vis-NIR transmittance spectrum of the crystal was undertaken between the range of 300 and 900 nm whereby the lower optical cutoff wavelength was identified to be 321 nm. The spectral study of photoluminescence was carried out in the range of 300-600 nm by which the band gap energy was calculated to be about 3.8 eV (at 373 nm) indicating that B35D has a violet fluorescence spectrum. The thermal stability and melting point of the title crystal have been investigated through Thermo gravimetric and differential thermal analysis (TG-DTA) such that the thermal stability of the crystal was found to be 95.6 °C. The Nd: YAG Q-switched laser was employed so as to obtain the laser-induced surface damage threshold of the specimen which was estimated to be 3.1 GW/cm2. The Vickers microhardness test was implemented in order to arrive at the mechanical strength of the crystal. The performed non-linear optical study could reveal that the second-order harmonic generation (SHG) efficiency of B35D crystal is 2.16 times higher than KDP. So that B35D crystals are among the class of NLO materials. [ABSTRACT FROM AUTHOR]