Search

Introduction: It is well established that diabetes mellitus impairs the hearing threshold levels. However, there is insufcient literature describing the effect of gestational diabetes mellitus on hearing threshold levels and its reversibility. A prospective cross sectional study was conducted betw Method: een 2019 to 2021 in which 33 primigravida patients with gestational diabetes mellitus in the case group and 33 primigravida patients without gestational diabetes mellitus in third trimester were included in the control group, matched for gestational age and body mass index. A medical history was taken for each participant, and otological inspections and high-frequency audiometry tests were performed. There was statistically signicant difference between the hearing thresholds of the cas Results: e and control group especially above 8kHz with cases showing poor thresholds as compared to controls. However, the hearing improves in the postnatal period. Gestational diabetes mellitus causes signicant reversible hearing loss mai Conclusion: nly at high frequencies and more research should be done on large sample size with long follow up in post natal period to conrm the ndings.

“Epilepsy” is the common neurological brain disorder that is affects the human being at any stage of life. About 1-2% of the world’s population affected by this major chronic disorder. Electroencephalogram (EEG) signal is the most important tool for the early detection of the epileptic seizure in several applications of epilepsy diagnosis. Electroencephalogram (EEG) signals can be categorized in Epileptic and Non epileptic as per epilepsy seizures. Recent research has carried out various ppossibilities of predicting & analyzing epileptic seizures by mainly using two approaches: Conventional methods using signal processing and Deep learning based methods.

Objectives The aim of this study was to evaluate clinical characteristics, mechanisms of failure, and outcomes of transcatheter aortic valve replacement (TAVR) explantation. Background Surgical explantation following TAVR may be required for structural valve degeneration, paravalvular leak, infection, or other reasons. However, in-depth data on indications and outcomes are lacking. Methods Data from a multicenter, international registry (EXPLANT-TAVR) of patients who underwent TAVR explantation were reviewed retrospectively. Explantations performed during the same admission as initial TAVR were excluded. Clinical and echocardiographic outcomes were evaluated. Median follow-up duration was 6.7 months (interquartile range [IQR]: 1.0-18.8 months) after TAVR explantation and was 97.7% complete at 30 days and 86.1% complete at 1 year. Results From November 2009 to September 2020, 269 patients across 42 centers with a mean age of 72.7 ± 10.4 years underwent TAVR explantation. About one quarter (25.9%) were deemed low surgical risk at index TAVR, and median Society of Thoracic Surgeons risk at TAVR explantation was 5.6% (IQR: 3.2%-9.6%). The median time to explantation was 11.5 months (IQR: 4.0-32.4 months). Balloon-expandable and self-expanding or mechanically expandable valves accounted for 50.9% and 49.1%, respectively. Indications for explantation included endocarditis (43.1%), structural valve degeneration (20.1%), paravalvular leak (18.2%), and prosthesis-patient mismatch (10.8%). Redo TAVR was not feasible because of unfavorable anatomy in 26.8% of patients. Urgent or emergency cases were performed in 53.1% of patients, aortic root replacement in 13.4%, and 54.6% had concomitant cardiac procedures. Overall survival at last follow-up was 76.1%. In-hospital, 30-day, and 1-year mortality rates were 11.9%, 13.1%, and 28.5%, respectively, and stroke rates were 5.9%, 8.6%, and 18.7%, respectively. Conclusions The EXPLANT-TAVR registry reveals that surgical risks associated with TAVR explantation are not negligible and should be taken into consideration in the lifetime management of aortic stenosis.

Introduction:: The rapid emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in an increased mortality rate across the globe. However, the underlying mechanism of SARS-CoV-2 altering human immune response is still elusive. The existing literature on miRNA mediated pathogenesis of RNA virus viz. Dengue virus, West Nile virus, etc. raises a suspicion that miRNA encoded by SARS-CoV-2 might facilitate virus replication and regulate the host’s gene expression at the post-transcriptional level. Methods:: We investigated this possibility via computational prediction of putative miRNAs encoded by the SARS-CoV-2 genome using a novel systematic pipeline that predicts putative mature-miRNA and their targeted genes transcripts. To trace down if viral-miRNAs targeted the genes critical to the immune pathway, we assessed whether mature miRNA transcripts exhibit effective hybridization with the 3’UTR region of human gene transcripts. Conversely, we also tried to study human miRNA-mediated viral gene regulation to get insight into the miRNA mediated offense and defense mechanism of viruses and their host organisms in toto. Results:: Our analysis led us to shortlist six putative miRNAs that target, majorly, genes related to cell proliferation/differentiation/signaling, and senescence. Nonetheless, they also target immune-related genes that directly/indirectly orchestrate immune pathways like TNF (Tumor Necrosis Factor) signaling and Chemokine signaling pathways putatively serving as the nucleus to cytokine storms. Conclusion:: Besides, these six miRNAs were found to conserved so far across 80 complete genomes of SARS-CoV-2 (NCBI Virus, last assessed 12 April 2020) including Indian strains that are also targeted by 7 human miRNAs and can, therefore, be exploited to develop MicroRNA-Attenuated Vaccines.

The interfacial tension (IFT) is a critical parameter to inform our understanding of the phenomena of drop breakup and droplet-droplet coalescence in sheared water-in-diluted bitumen (dilbit) emulsions. A microfluidic extensional flow device (MEFD) was used to determine the IFT of the dilbit-water emulsion system for bitumen concentrations of 33%, 50%, and 67% by weight (solvent to bitumen ratio (S/B) = 2, 1, and 0.5, respectively) and two different pH values of water: 8.3 and 9.9. The IFT was observed to increase with the bitumen concentration and decrease significantly upon lowering the water pH. The time scale for achieving the steady state IFT increased with bitumen concentration and was less sensitive to the water pH. But the most important feature of our measurements is that the IFTs recorded were significantly smaller than the values reported in the literature. We recognized two important differences between our studies and prior investigations: measurement of the IFT of water drops in dilbit as opposed to dilbit drops in water in earlier studies, and time scales of measurement of IFT that ranged from hundreds of milliseconds to a few seconds, as compared to a minute or longer in past investigations. These differences were examined carefully, but neither was found to explain the low IFTs measured in our studies. Our work leads to the following hypothesis: the mechanical properties of the interface of a sheared water drop in bitumen are significantly different from a stagnant one.

In the cutting edge world we see cell phone managing job which prior needed help from PCs. The development of portable applications in the business made it workable for individuals to get things done in simple way. The paper examines about portable applications and the advancement of versatile applications. These applications are utilized by all and each individual has an alternate perspective to have a basic judgment of value, yet what is normal in all situations is dependability of versatile applications. The main thing to an individual is dependability of uses as they give a safe climate to share data, along these lines secure applications are significant. We will likewise examine about the quality and dependability of portable applications and will likewise examine why have a reliable application.

Complex software is taking over the current existence of the technology. With the furtherance of software, the deepest levels of constituents have originated. Aspects like time, expenses, and, error solving has been expounded to at most levels of convolution. The purpose of Software is to plunge deep into the concepts and then perceive the enduring and deep-rooted solutions. The paper focuses on three major characteristics of software: middleware, frameworks, and APIs. The reinforcement of these strands has escalated the development of new magnitudes in this field. We will assimilate about Middleware which is software whose function is to bridge together the operating system or database with the applications over a network. Another predominant module is Framework that incorporates various libraries, compiler, and supplementary programs that can be used to fabricate unique applications. Beyond Middleware and Framework, APIs i.e. Application Programming Interface facilitates interactivity between two applications. It has been thoroughly explained about the conjunction of these emerging technologies into new applications and how they can change the working of the software.

The coalescence of water drops in diluted bitumen solutions has been previously studied via micropipette experiments in which water drops are brought to contact, and the onset of drop coalescence is evaluated as a function of bitumen dilution, type of solvent, etc. Due to the opacity of concentrated bitumen solutions, most of these studies have been conducted in highly diluted systems. Under those conditions (typically solvent/bitumen or S/B mass ratios greater than 4), asphaltenes tend to form skins at the oil/water interface that prevent coalescence altogether. In ‘naphthenic’ froth treatment (NFT) process, however, S/B ratios of 0.5–2 are often used. To study S/B ratios relevant to NFT operations, we developed a Hele-Shaw version of the micropipette aspiration experiment, in which drops held on micropipettes are sandwiched to disks by two hydrophobically-treated plates spaced less than a few hundred microns apart. The resulting thin layer of bitumen is optically transparent in brightfield microscopy, allowing us to execute micropipette contacting experiments at industrially relevant bitumen dilutions. Another departure from almost all the literature in the past is that we have measured the time, t c , required to observe coalescence from the moment two disk-shaped drops are contacted under an imposed contact pressure, P. t c was observed to decrease when P, pH or bitumen dilution was increased. Deasphalting bitumen also led to a significant decrease in t c , while increasing the aging time of the interface from 15 to 60 min dramatically increased t c . The coalescence time was found to obey an exponential relationship with P, and was explained to be a result of an activated process related to the formation of a bridge of water across the thin film of bitumen in the contact zone between the drops. The t c - P correlations measured in this work provide the foundation for designing coalescers that coarsen the drop size distribution in water-in-bitumen emulsions under given conditions of bitumen concentration and water pH.

The objective of this study is to analyze oncological outcomes for treatment of Tis and T1 glottic squamous cell carcinoma after transoral laser microsurgery. This study is retrospective analysis of previously untreated, suspected lesion of glottis, staged cT1a and cT1b squamous cell carcinoma in a tertiary care hospital and 53 patients were included in the study. End points for analysis were local control, overall and disease specific survival rates. The local control, ultimate local control with laser alone, 3-year overall survival, 3-year disease specific survival and organ preservation rates were 86.7, 90.5, 92.4, 98.1 and 98.1% respectively. The involvement of anterior commissure did not show any significant impact on local control or survival. TLM is safe and effective treatment of early glottis cancer, associated with less morbidity and a high percentage of local control, survival and organ preservation rates.

Sternocleidomastoid tumor of infancy (STOI) is a common cause of neck mass in the neonatal period. However, STOIs presenting bilaterally is a rare finding in medical literature. We herein report an unusual case of a bilateral STOI in a five-week infant. The child was given physical therapy which consisted of active and passive physical exercises, warm compresses and massage. Within 10 weeks the swellings reduced considerably in size. Bilateral, firm masses are often confused with lymphadenopathy and are inadvertently treated with antibiotics. Hence, STOI should be kept as an important differential diagnosis for neck mass in the neonatal period.

Cervical chondrocutaneous branchial remnants (CCBR) are rare congenital benign neck masses. They are usually present in males and can be both unilateral and bilateral. In this article, we present a case of bilateral CCBR in a child which is one of the very few bilateral cases that have been reported till date in the literature. The masses were excised completely and diagnosis was confirmed on histopathology. It is important to be aware of this disease entity as it is associated with a number of congenital anomalies and syndromes.

Sustainable development is the trade-offs among social, economic and ecological objectives and is required to maintain sustainability of overall system. The sustainability of the built environment is partially based on individual behaviour. It has been argued that to improve sustainability, the changes should be brought in the individual behaviour patterns, replacing the unsustainable living patterns with the sustainable ones. The unsustainable behaviour patterns are 'embedded' and 'deep-rooted' in the normal living behaviour of individuals that it is not so easy to change them only by creating sustainable policies. There are several reasons why the unsustainable lifestyle patterns are easily adapted, and restrict change. This paper will use insights and case study examples from social practice theory in understanding those reasons. The aim of this paper is to elaborate how sustainable living practices can be brought about at community level for the individuals to easily adapt as part of their daily lives. Refereed/Peer-reviewed

Schwannomas are rare, solitary, slow growing, smooth surfaced and well encapsulated tumors. Schwannomas of head and neck region account for 25-40% of all the cases. Approximately 1%–12% of schwannomas occur intraorally, the tongue being the most common site. Complete surgical excision is the treatment of choice. In this article, we describe a case of tongue schwannoma in a child, along with diagnostic and treatment options of tongue lesions. The tongue mass was completely excised via trans-oral approach using coblation method. The patient followed up for 1 year; he had an uneventful recovery and no recurrence.

Kimura’s disease (KD) is a chronic inflammatory disorder with angiolymphatic proliferation of unknown etiology, usually affecting young men of Asian race but is rare in other races. Affected Indians are very rare. Herein, we present an atypical manifestation of Kimura’s disease occurring in an Indian male who presented with bilateral postaural lymphadenopathy. The diagnosis of Kimura’s disease can be very difficult and misleading; it is important not to ignore histopathological features.

A 65-year-old gentleman was referred to our hospital with encephalopathy and renal failure. His medications included lithium for the treatment of bipolar disorder. The clinical examination and the laboratory investigations that followed revealed findings classical of lithium overdose. The patient was successfully managed and discharged from the hospital on Day 9 of admission. Clinicians should be aware of this rather unusual and relatively rare differential cause of acute on chronic renal failure with encephalopathy.

Endoscopic gastroplication is a new technique in the management of gastroesophageal reflux disease. No comparisons of this technique with laparoscopic fundoplication have been done. Twenty-seven patients with symptoms of reflux disease were evaluated with upper endoscopy, esophageal manometry, and 24-hour esophageal pH monitoring, as well as a symptom severity questionnaire. Patients then underwent endoscopic gastroplication with use of the Bard Interventional Endoscopic Suturing System. Patients completed the symptom severity questionnaire 6 weeks after the procedure. These 27 patients were matched for age, gender, and pre-procedure symptom score with patients in a prospectively gathered database of laparoscopic antireflux operations. Twenty-one patients (78%) in the endoscopic gastroplication group were satisfied with their symptomatic outcome, 2 (7%) were neutral, and 4 (15%) were dissatisfied. In comparison, there were 26 satisfied patients (96%) in the laparoscopic group ( < 0.01). Median symptom scores improved similarly in both groups, with no statistically significant difference. The patients who were dissatisfied had a mean improvement in symptom score of 10, compared with 27 for the satisfied patients ( < 0.01). Endoscopic gastroplication is a viable alternative to laparoscopic fundoplication in selected patients. Nevertheless, approximately one quarter of patients will have no improvement, which is much more than those undergoing laparoscopic fundoplication.

The clinical benefit of percutaneous interventional therapies for atherosclerotic renal artery stenosis (ARAS) is still obscure. Randomized trials conducted on general patient populations provided unsatisfactory results in justifying the interventional treatment. In this study, the predictive value of renal resistive index (RRI) was retrospectively analyzed in identifying the patients who may benefit from renal angioplasty and stenting.The records of patients who underwent percutaneous intervention for ARAS were analyzed between 2006 and 2010; we compared the clinical outcomes with preprocedural RRI values. Seventy-three patients were included in the analysis. RRI is calculated as follows: RRI = 1 - (Vmin/Vmax). Patients with RRI ≤ 0.75 were grouped as low RRI (group I) and compared with high RRI patients (RRI0.75, group II).The comparison was in follow-up systolic and diastolic blood pressures, blood creatinine levels, estimated glomerular filtration rate (eGFR) and need for anti-hypertensive therapy. Data were collected by a customized online database created using Research Electronic Data Capture (REDCap) application.The mean follow-up was 12.4 (9-14) months and 11.1 (5-14) months for groups I and II, respectively (P=NS). After follow-up, group I patients significantly improved compared to baseline in their blood creatinine levels (2.0 ± 1.2 mg/dL vs 1.5 ± 0.60 mg/dL; P.05), eGFR (45.2 ± 26.2 mL/min vs 51.6 ± 23.8 mL/min; P.05), systolic blood pressure (143.6 ± 31.0 mm Hg vs 129.6 ± 18.4 mm Hg; P.05), diastolic blood pressure (73.6 ± 13.4 mm Hg vs 69.5 ± 9.5 mm Hg; P.05), and need for anti-hypertensive drugs (2.2 ± 0.9 vs 2.0 ± 0.9; P.05). However, in group II, follow-up blood creatinine levels (1.8 ± 0.7 mg/dL vs 2.1 ± 1.0 mg/dL; P.05) increased and eGFR (39.99 ± 22.53 mL/min vs 36.3 ± 23.2 mL/min; P.05) decreased, indicating continuing clinical deterioration despite the intervention.RRI ≤ 0.75 may predict better clinical outcomes after renal angioplasty and stenting. Preprocedural RRI can be considered a useful parameter in defining patients who may benefit from interventional procedures.

This study presents a semi-analytical solution for the problem of two touching drops with slipping interfaces pushed against each other in a uniaxial compressional flow at low capillary and Reynolds numbers. The jump in the tangential velocity at the liquid-liquid interface is modeled using the Navier slip condition. Analytical solutions of the contact force, the drop-scale stresses, and the drop-scale pressure are provided as functions of the slip coefficient α, the viscosity ratio κ, and the drop size ratio k. Since unequal drop sizes are considered, two problems are solved in the tangent sphere co-ordinate system to determine the steady state position: a pair of touching drops with its contact point at the origin of an axisymmetric straining flow, and two touching drops placed in a uniform flow parallel to the axis of symmetry of the drops. A general observation is that the effect of slip is manifested most strongly for drops whose viscosity is much greater than the suspending fluid κ≫1. For highly viscous drops, the flow and stress fields transition from those corresponding to solid particles for ακ ≪ 1, to those for inviscid drops in the limit ακ ≫ 1. The analytical expressions provided here for the contact force and the stress distributions will serve to provide the restrictions that complete the definition of the lubrication flow problem in the thin film between the two colliding drops. While the contact force that drains fluid out of the thin film is relatively unaffected by slip, the tangential stress and pressure in the near-contact region are mitigated significantly for ακ ≫ 1. The latter is expected to assist coalescence at high capillary numbers.