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Background: The assessment of hidradenitis suppurativa (HS) severity requires detailed, and error‐prone lesion counts. This proof‐of‐concept study aimed to automatically classify HS disease severity using machine learning of clinical smartphone images. Methods: 777 ambient‐light and size‐controlled images were used to build a class‐balanced synthetic dataset (n = 7675). Convolutional neural networks (CNN) were used for automated severity classification (scale 0–3), and to assess disease‐dynamics. International Hidradenitis Suppurativa Severity Score System (IHS4) served as reference. A U‐NET algorithm was implemented for automated localization of diseased skin. Results: CNNs were able to distinguish no/mild from moderate/severe disease with an overall prediction accuracy of 78% [receiver operating curve (AUC) 0.85]. Correct IHS4 classification was achieved with an overall accuracy of 72% (AUC 0.84–0.89). In addition, disease dynamics using IHS4 numerical values aligned with CNN outputs (NRMSE 0.262). The UNET algorithm localized lesions with a pixel accuracy of 88.1% and test loss of 0.42. Limitations: Limitations in assessing tattooed and hairy skin. Limited number of patients with dark skin colour and Hurley I. Conclusion: CNNs were able to distinguish no/mild from moderate/severe disease, classify disease severity over time, and automatically identify diseased skin areas and the skin phototype. This study breaks new grounds for fast, reliable, reproducible and easy‐to‐use HS severity assessments using clinical images. [ABSTRACT FROM AUTHOR]

The present study addresses an exponentially fitted finite difference method to obtain the solution of singularly perturbed two-point boundary value problems (BVPs) having a boundary layer at one end (left or right) point on uniform mesh. A fitting factor is introduced in the derived scheme using the theory of singular perturbations. Thomas algorithm is employed to solve the resulting tri-diagonal system of equations. The convergence of the presented method is investigated. Several model example problems are solved using the proposed method. The results are presented with terms of maximum absolute errors, which demonstrate the accuracy and efficiency of the method. It is observed that the proposed method is capable of producing highly accurate results with minimal computational effort for a fixed value of step size h, when the perturbation parameter tends to zero. From the graphs, we also observed that a numerical solution approximates the exact solution very well in the boundary layers for smaller value of ε. [ABSTRACT FROM AUTHOR]

Single parent adoption (SPA) is a relatively new construct worldwide and in India. The Ministry of Women and Child Development, Government of India, has laid down criteria for adoption in general and SPA in particular, in conjunction with the Juvenile Justice Act (Care and Protection of Children), 2015. There is scant literature on this topic of SPA, more so in India, that looks into the various psychological nuances of SPA from a mental health professional's (MHP) perspective. This review paper aims to assess SPA from the perspective of a MHP that will focus on its various legal nuances as well as the psychological connotations attached to it. For this, a search strategy was employed that included a thorough literature search from two databases (PubMed and Google Scholar) with relevant keywords related to the topic. The various legal issues pertaining to SPA in the current scenario, the psychological issues and challenges faced by single parents, the behavioral outcomes of adoptees who are adopted by single parents, and ways to deal with the various obstacles of SPA are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Anterior Cruciate Ligament (ACL) is the most commonly injured ligament in the knee. Arthroscopic ACL reconstruction is the gold standard procedure for treating ACL tears. Good postoperative analgesia is the secret for immediate postoperative rehabilitation. Various techniques, such as Femoral Nerve Blocks (FNB), epidural blocks, adductor canal blocks, and Intra-Articular injections (IA), are used to manage postoperative pain. Aim: To compare the quality of postoperative analgesia using a combination of levobupivacaine with clonidine via IA and FNB in patients undergoing ACL reconstruction under spinal anaesthesia. Materials and Methods: This randomised, double-blinded trial was conducted at Pondicherry Institute of Medical Sciences, Puducherry, India, from August 2016 to May 2018. Forty patients with American Society of Anaesthesiologists (ASA) physical status I and II, aged between 18-60 years, undergoing arthroscopic ACL repair under spinal anaesthesia were randomly assigned to two groups, with 20 patients in each group. After the surgery, patients in group 1 received FNB with 15 mL of 0.25% levobupivacaine and 30 mcg clonidine, while patients in group 2 received IA with 15 mL of 0.25% levobupivacaine and 30 mcg clonidine. Parameters such as the total duration of sensory block, the need for rescue analgesia, and total analgesic consumption within 24 hours were recorded postoperatively. The data were analysed using Student’s unpaired t-test, Analysis of Variance (ANOVA), Chi-square test, and Fisher’s-exact test. Statistical analysis was performed using Statistical package for the Social Science (SPSS) software (version 20.0 and info version 3.5.1) for Windows, with a p-value <0.05 considered significant. Results: The quality of postoperative analgesia, including the total duration of block, the need for rescue analgesia, and total analgesic consumption within 24 hours, was similar in both groups. The total duration of block was 216±36.041 minutes for the FNB group and 224±47.395 minutes for the intra-articular group, with a p-value of 0.552. The time for rescue analgesia was 307±87.666 minutes for the FNB group and 305±82.00 minutes for the intra-articular group, with a p-value of 0.963. There were no significant differences between the groups in terms of sex, age, weight, or ASA physical status classification. Conclusion: The present study showed that the postoperative analgesia following arthroscopic ACL reconstruction was equally effective in both groups. Both combinations reduced postoperative pain, expedited the return of postoperative function, maintained vital parameters, and had no apparent side-effects. However, IA may be considered as the preferred option since it is easier to perform than a femoral block. [ABSTRACT FROM AUTHOR]

The article focuses on a rare case of black grain mycetoma caused by the hyaline fungus Fusarium spp. The topics covered include the clinical presentation and diagnostic challenges of mycetoma, the identification and implications of the hyaline fungus Fusarium spp. in causing eumycetoma, and the rarity of effective medical therapy for this condition, emphasizing the unique response observed in this particular case.

Insulin like growth factor-1 (IGF-I) has an antioxidant effect to maintain sperm motility. The present study designed to evaluate the effect of different levels IGF-1 on semen characteristic after cryopreservation of buck semen. Fifty ejaculates were collected and were extended with tris-citric acid-fructose diluent with 10% egg yolk and 6% glycerol with sperm concentrations of 4 × 108 mL-1. The effect of IGF-1 concentration showed significant differences (P<0.05) on most of studied traits (sperm motility, live sperm count, acrosomes integrity, hypo osmotic swelling positive spermatozoa, malondialdehyde (MDA)) and were significantly (P<0.05) highest in 250 ng/mL of IGF-1in post thaw semen. The post thaw progressive motility, live, hypo osmotic swelled and acrosome intact sperm increased by 25.26%, 26.77%, 30.35% and 25.52%, respectively in 250 ng/mL IGF1supplemented group in compare with control group. The 250 ng/mL IGF-1 supplemented group showed the lowest MDA content (P<0.05) in compare with other studied groups. The fortification 250 ng/mL IGF-1 reduced the MDA content by 31.16% more than the control group. The results suggested that IGF-1 protects sperm membrane lipid peroxidation by lowering MDA production by reducing the harmful effect of reactive oxygen species. Eight out of ten goats were conceived and kidded by using supplemented of 250 ng/mL IGF-1 and three goats were kidded by non-supplemented (control) frozen semen straw through artificial insemination (AI). The success of kidding was 40.00% in supplemented group (250 ng/mL IGF-1) than 30.00% in non-supplemented group (control) on actual kidding basis. [ABSTRACT FROM AUTHOR]

A new current-mode fractional-power CMOS circuit such as cube-root and squared-cube-root configurations that give output signal in four quadrants has been presented for the first time. MOSFETs utilized in the design exploit translinear principle in weak-inversion region. The second-order effects on the circuit proposition have been analysed. The implementation justification has been validated by post-layout simulation on Virtuoso-SPECTRE tool with 180 nm GPDK CMOS process parameters. It has been found that using ± 0.5 V supply voltage, the realized cube-root and squared-cube-root circuits work for an input range of ± 30 µA while consuming few hundred nano-watts of static power and exhibit a maximum of ± 1 dB error over a wide input range of ± 1.5 µA to ± 30 µA in all four quadrants. Utility of the proposed circuits, as companding and gamma corrector, has also been elaborated. [ABSTRACT FROM AUTHOR]

Adverse drug reactions are defined as the effects created by drugs producing unintended or noxious response in doses normally used for prophylaxis, diagnosis or therapy of diseases. Adverse drug reactions under anaesthesia occur by a number of mechanisms and several risk factors are often involved. The overall incidence of adverse drug reactions to anaesthetic drugs ranges between 1 in 10,000 and 1 in 20,000. Electronic databases were searched to obtain the relevant literature with keywords related to adverse drug reactions and anaesthesia. Total 110 articles were reviewed, bibliography cross-checked and relevant literature was included. This article discusses about the adverse drug reactions to various anaesthetic as well as non anaesthetic drugs used intraoperatively. Anaphylaxis under anaesthesia, its pathophysiology, clinical and laboratory diagnosis, management and prevention has also been discussed in detail. Allergic drug reactions and anaphylaxis in the operating room often presents unique diagnostic concerns as the early signs of anaphylaxis are often masked under general anaesthesia. The use of surgical drapes and use of multiple potential allergen drugs under anaesthesia also make the diagnostic process difficult. Thus, an adequate knowledge, understanding, vigilance and proper documentation with reporting in case of an event is warranted by the attending anaesthesiologist for a good perioperative outcome with decreased morbidity and mortality. [ABSTRACT FROM AUTHOR]

A novel constraint to prevent local overheating is presented for use in topology optimization (TO). The very basis for the constraint is the Additive Manufacturing (AM) process physics. AM enables fabrication of highly complex topologically optimized designs. However, local overheating is a major concern especially in metal AM processes leading to part failure, poor surface finish, lack of dimensional precision, and inferior mechanical properties. It should therefore be taken into account at the design optimization stage. However, including a detailed process simulation in the optimization would make the optimization intractable. Hence, a computationally inexpensive thermal process model, recently presented in the literature, is used to detect zones prone to local overheating in a given part geometry. The process model is integrated into density-based TO in combination with a robust formulation, and applied in various numerical test examples. It is found that existing AM-oriented TO methods which rely purely on overhang control do not ensure overheating avoidance. Instead, the proposed physics-based constraint is able to suppress geometric features causing local overheating and delivers optimized results in a computationally efficient manner. [ABSTRACT FROM AUTHOR]

Introduction: A wide array of drugs are available for blunting the laryngoscopy response. Amongst them both dexmedetomidine, and esmolol belong to the non-opioid group having least interference with the recovery process without causing significant respiratory depression, thus are suitable intervention for this purpose. Dexmedetomidine a sedative highly selective α2 adrenoceptor agonist and has an anaesthetic-sparing effect at induction. It suppresses the release of catecholamine in response to a noxious stimulant because of its central sympatholytic action. Esmolol with a different pharmacokinetic profile is a water soluble, cardio-selective, an ultrashort acting beta blocker has a short t1/2 thus suited for suppressing the transient pressor reflexes following acute noxious surgical or anesthesia stimuli. Aim: To compare the degree of attenuation of the laryngoscopy response following the use of single preinduction dose (Intravenous infusion at a dose of 1 µg/kg) of dexmedetomidine with that of esmolol (intravenous bolus at a dose of 0.5 mg/kg) in adult normotensives undergoing elective intubations. Materials and Methods: The randomised clinical trial was conducted in Pondicherry Institute of Medical Sciences from September 2016 to March 2018, on 60 patients of either sex, aged between 20-60 years with American Society of Anesthesiologists (ASA) physical status I or II requiring elective intubations for general surgical procedures. The patients were randomly divided into two groups (n=30 each). Prior to induction group A received 1 µg/kg dexmedetomidine IV infusion over 10 min, and group B received 100 mL IV infusion of normal saline over 10 min. Also 2 minute before laryngoscopy group A received 10 mL of normal saline (IV) bolus, whereas, group B received esmolol 0.5 mg/kg IV diluted in 10 mL of normal saline as a bolus. Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Mean Arterial Pressure (MAP) were recorded at baseline i.e, pre-procedure before the study drug infusion, preinduction, at laryngoscopy (0min) and 1,3,5 min after intubation. A rise of MAP and/or HR more than 20% from the baseline was considered as positive laryngoscopy response. Student's unpaired t-test was used for analysis of inter group variables. Intra group variables were analysed using repeated measures Analysis Of Variance (ANOVA). results: Mean age of patients in group A was 38.77±13.082 years and group B was 37.20±13.069 years (p-value=0.644). Results revealed that both the groups had an increase in HR and MAP at 1 minute after laryngoscopy and intubation. Mean readings of MAP showed a maximum rise of group A (2.15%) vs group B (7.25%) from the baseline readings at 1min following laryngoscopy which showed no statistical significance. The maximum HR increase following laryngoscopy was at 1 minute in group A (8.28%) vs group B (13.59%), which were below the positive laryngoscopy response. The mean HR, SBP, DBP and MAP recorded at preinduction, at laryngoscopy, 1, 3 and 5 mins following intubation showed no statistical difference (p-value >0.05) between the two groups. conclusion: Usage of single dose preinduction dexmedetomidine iv infusion 1 µg/kg over 10 min was found to be equally effective in blunting the pressor response to laryngoscopy and intubation when compared to bolus dose of iv esmolol 0.5 mg/kg given 2 min prior to laryngoscopy. [ABSTRACT FROM AUTHOR]

The pattern of dependence between liquidity, durations (orders and trades) and bid-ask spreads in a limit order market are examined in high resolution invoking copulas and graph theory. Using intraday data from a sample of NASDAQ 100 stocks and an experimental design, we study the information pathways in markets in the presence of algorithmic traders. Our results confirm that multivariate analysis is more appropriate to investigate these information pathways. We observe that the strength and nature of the dependence between variables vary through the trading day. We confirm the existence of stylised aspects of algorithmic trading, such as tail dependence in trade durations, a balance between buy and sell side in order durations, liquidity and bid-ask spreads, and the bid-ask spread and liquidity trade-off in the dependence structure. [ABSTRACT FROM AUTHOR]

Sternal dehiscence is a grave complication after cardiac surgery. Deep sternal dehiscence usually requires debridement and flap coverage as the mainstay of management. The perioperative period is considered very challenging and the anesthetic technique has a direct impact on the risk of perioperative complications. Perioperative pain management is usually carried out with the help of regional anesthetic techniques as they offer various benefits for this patient population, including the provision of high-quality analgesia, reduced requirements for opioids and nonsteroidal anti-inflammatory drugs, and reduced autonomic system activation. Conventionally, regional anesthesia techniques such as epidural and paravertebral blocks have been shown to provide effective analgesia and enhance postoperative recovery. However, these techniques were associated with minimal but unacceptable complications. Ultrasound-guided erector spinae plane (ESP) block is a recently described technique providing thoracic analgesia. This is the first case report to our knowledge, which describes the use of ESP block as perioperative analgesic technique for pectoralis flap in a high-risk cardiovascular patient. [ABSTRACT FROM AUTHOR]

Artificial Insemination (AI) in goats is less developed compared to the large animals due to the lack of suitable protocol of goat semen freezing and AI in India. The AI plays a pivotal role in the long-term ex-situ in vitro conservation of threatened breeds, increased productivity, and performance of a large number of nondescript and low potential goats. The objective of the present study was to enhance the life and fertility potential of cryopreserved semen and consequently the conception rate through frozen semen AI by the addition of catalase in an extender. Ejaculates (30) were collected and were extended with tris-citric acid-fructose diluent. Catalases were added in diluent (0 IU/mL, 200 IU/mL, 400 IU/mL, 600 IU/mL, 800 IU/mL and 1000 IU/mL). Analysis of data using SPSS 16 revealed that motility, live sperm count, acrosomal integrity, and hypo-osmotic swelling positive spermatozoa were counted differed significantly (P<0.05) at different concentrations of catalase. The post-thaw motility, live sperm count, acrosomal integrity, and hypo-osmotic swelling positive spermatozoa were significantly (P<0.05) highest in 800 U/mL of catalase used in the present study. Mitochondrial membrane potential was also significantly highest (P<0.05) in frozen semen in 800 IU/mL catalase. Goats (20) were inseminated with frozen semen straw of 800 IU/mL catalase and 8 goats (40%) were pregnant. The conception rate in the control group was 35%. Our study suggested that the addition of catalase reduced the detrimental effects of freezing on motility, viability, plasma membrane and acrosome integrity and can be used for routine semen freezing and AI. [ABSTRACT FROM AUTHOR]

Background and Aims: Emergence agitation (EA) in children is one of the most common postoperative problems encountered in the recovery room. Sevoflurane has been strongly associated with EA owing to its lower solubility and rapid recovery. Dexmedetomidine has been found to reduce the incidence of EA. This study was designed to evaluate the effectiveness of dexmedetomidine in two doses in reducing EA in children. Methods: This was a prospective double-blinded randomised study done on eighty children aged 5–14 years undergoing adenotonsillectomy/tonsillectomy under sevoflurane anaesthesia. Patients in Group A (n = 40) received 0.3 μg/kg/h and patients in group B (n = 40) received 0.5 μg/kg/h infusion after a bolus dose of 0.5 μg/kg of dexmedetomidine. The primary objective was to compare two different doses of dexmedetomidine on EA in the postoperative period. The secondary objectives were to assess the pain and perioperative haemodynamics in the recovery room. The anaesthesiologist blinded to the study charted the paediatric anaesthesia emergence delirium score (PAED), perioperative haemodynamic parameters, objective pain score and rescue medications if given. The data were analysed using Student's unpaired t-test, Chi-square test, repeated measures Analysis of Variance (ANOVA) and Mann-Whitney U test wherever appropriate. Results: The incidence of EA was comparable between both groups (P = 0.960). The haemodynamic parameters (P > 0.05) and the objective pain score (P = 0.810) also did not show a statistically significant difference. Conclusion: A lower dose of dexmedetomidine (0.3 μg/kg/h) is equally effective as a higher dose (0.5 μg/kg/h) after a bolus dose of 0.5 μg/kg in decreasing EA. [ABSTRACT FROM AUTHOR]

Introduction: Ultrasonography (USG) guided supraclavicular block is an excellent choice for upper limb surgeries. It not only allows smaller volumes of local anaesthetic usage but also provides optimal tourniquet coverage. Ropivacaine is structurally related to bupivacaine with reduced potential for toxicity and improved sensory and motor blocking profiles. Nalbuphine acquired a significant place in pain control but its efficacy as a local anaesthetic adjuvant is yet to be proved in peripheral nerve blockades. Aim: To evaluate the efficacy of adding nalbuphine to ropivacaine in supraclavicular brachial plexus blockade and to assess the quality of block for patients undergoing ambulatory forearm and hand surgeries. Materials and Methods: Seventy American Society of Anesthesiologists (ASA) grade 1 and 2 patients were randomised into two groups of 35 each. Group A (n=35): received 24 mL of 0.5% of ropivacaine + 1 mL of nalbuphine (10 mg) and Group B (n=35): received 24 mL of 0.5% of ropivacaine + 1 mL of normal saline. The parameters observed were duration of analgesia, onset of sensory and motor blockade, duration of motor blockade and haemodynamic changes during the procedure. Categorical variables were analysed using the Pearson's Chi-square test. Continuous variables were analysed using the independent sample t-test and p<0.05 was considered as statistically significant. Results: The onset of sensory and motor blockades were faster in the nalbuphine group compared to the control group (p<0.001). The duration of sensory and motor blockades was similarly longer in nalbuphine group (p<0.001). Also, the mean duration of analgesia was significantly longer with nalbuphine group (p<0.001). Conclusion: Nalbuphine significantly prolonged the duration of analgesia and duration of block while accelerating the onset of blockade thereby improving the overall quality of blockade. [ABSTRACT FROM AUTHOR]

Pregnancy makes a patient undergo diverse physiological changes and predisposes them to many pathological disorders such as pre-eclampsia, eclampsia, cortical vein thrombosis, and pituitary apoplexy. Any intervention during pregnancy presents a unique challenge as it affects two individuals. Once diagnosed with a clinical condition, they are prone to further medical, obstetric and anaesthetic complications. Herein, we report the anaesthetic management of a 32-year-old female previously diagnosed with pituitary adenoma and now presenting with twin pregnancy for emergency caesarean section along with emphasis on the anaesthetic concerns pertinent to brain tumours in pregnancy. [ABSTRACT FROM AUTHOR]

Aerosol climatology during typical haze dominating period over South and Southeast Asia was explored using several Earth‐Observing A‐Train satellite products retrieved in between 2010 and 2020. Comparatively high aerosol optical depth (AOD) with dominance of fine and UV‐absorbing aerosols are noted across the Indo‐Gangetic plain, South Asia (IGP; AOD: 0.58; UVAI: 0.74) against weak UV‐absorbing fine aerosols over Southeast Asia (SEA; AOD: 0.26; UVAI: 0.07). Among inland IGP sites, decadal mean AOD resembles in Lahore (0.72 ± 0.45), Delhi (0.81 ± 0.46), Kanpur (0.84 ± 0.42), and Varanasi (0.78 ± 0.45); all exhibiting bimodal AOD distribution with a first peak in early November followed by a second in early January. In contrast, except mainland site Chiang Mai, all SEA maritime cities resemble in having typical September‐October AOD peak, with the presence of fine and UV‐neutral aerosols. Urban hotspots across IGP and SEA (except Dhaka, Chiang Mai) denote a spatially consistent minor increasing trend in AOD (0.2–1.8 × 10−2 year−1) while increase in UVAI is more prominent over upper IGP. Dust aerosols dominate only in Karachi (46%) against strong UV‐absorbing smoke aerosols over rest of the IGP (71–91%), and UV‐neutral smoke aerosols across SEA (84–92%). Vertical stratification of aerosol types is noted across IGP as in lower atmosphere (<4 km) polluted dust/urban aerosols remain abundant, with gradual decrease in dust aerosols from upper to lower IGP and consequent increase in smoke aerosols. At upper atmosphere (>4 km), however, dust aerosols clearly dominate. Over SEA, smoke are the most abundant aerosols across the atmospheric column followed by polluted dust. No evidence of intracontinental transport of aerosols from IGP to Southeast Asia or vice versa is, however, noted. Plain Language Summary: Aerosol climatology during typical haze dominating period over two global aerosol hotspots: South and Southeast Asia was explored using several satellite‐based aerosol optical properties retrieved using Earth Observing A‐Train satellites (Aqua, Aura, CALIPSO). Comparatively high aerosol optical depth with dominance of fine and absorbing aerosol are noted across the Indo‐Gangetic plain, South Asia against weak absorbing fine particles over Southeast Asia. Presence of strong absorbing aerosol over Indo‐Gangetic plain may have greater implications on regional climate. We note absorbing dust aerosols only over Karachi against strong absorbing smoke aerosols over Lahore, Delhi, Kanpur, Varanasi, and Dhaka, and UV‐neutral smoke aerosols over Singapore, Penang, and Kuala Lumpur. Vertical stratification of aerosol types is also noted across IGP as in lower atmosphere (<4km) polluted dust/ polluted urban aerosol remains abundant, with gradual decrease in dust aerosols from upper to lower IGP and consequent increase in smoke aerosols. No evidence in intracontinental transport of smoke aerosols is found, as biomass burning emissions over upper IGP, Kalimantan, and Sumatra primarily modulating climatology of regional aerosols. Key Points: Smoke aerosols are more UV‐absorbing across South Asia compared to Southeast AsiaVertical stratification of aerosols is prominent over IGP as urban aerosols and smoke dominate at low altitude while mineral dust at high altitudeSmoke and urban aerosols are abundant across the atmospheric column over SEA [ABSTRACT FROM AUTHOR]

In this study, the two-level simulation (TLS) modeling strategy developed earlier for momentum mixing is assessed in turbulent flows with passive scalar mixing and transport. Compared to the conventional algebraic and transport equation based subgrid-scale closures for large-eddy simulation (LES), where the effects of the unresolved small scales (SS) of motion on the large scales (LS) are modeled, in the TLS model, both large and small scales are explicitly evolved in a coupled two-scale decomposition method called TLS. Earlier studies demonstrated the ability of the SS model in the TLS to simulate high Reynolds number wall-bounded flows with a reasonable LS grid resolution. In the present study, this two-scale strategy is extended to model passive scalar mixing in turbulent channel flows. A comprehensive a priori assessment of the scalar SS model is performed using direct numerical simulation datasets for passive scalar transport in a fully developed turbulent channel flow at frictional Reynolds number R e τ = 395 and at Schmidt numbers S c = 1 and 4. This assessment is carried out to study the evolution of the large and the small scales of the scalar field in physical and spectral space and also to assess the SS prediction of quantities relevant for modeling of scalars such as scalar dissipation rate, counter-gradient transport, and backscatter. A TLS model is, then, used in a posteriori near-wall study using a hybrid TLS–LES approach to assess the two-scale scalar model. [ABSTRACT FROM AUTHOR]

Introduction: The use of Ultrasound (USG) for needle precision aids in reduction of local anaesthetic volume needed for peripheral nerve blockade. Conventional dosages of 30 to 40 mL of local anaesthetic mixture have been used in peripheral nerve blockades but using a lesser volume will reduce the incidence of local anaesthesia associated systemic toxicity. Aim: To assess the efficacy of two different doses 20 mL and 25 mL of Bupivacaine in USG guided axillary plexus block. Materials and Methods: Sixty patients requiring forearm and hand surgeries were randomised into two groups. Group A received low volume (20 mL of 0.375% bupivacaine) and group B received intermediate volume (25 mL of 0.375% bupivacaine). The quality of anaesthesia in regards to sensory and motor blockade, duration of analgesia, haemodynamic variability and complications were evaluated. Successful block was defined by Vester Anderson’s criteria. Duration of analgesia was measured using Visual Analogue Scale (VAS). Statistical comparison of all continuous variables were assessed utilising Student’s t-test and Mann-Whitney U-test as applicable. Results: No significant difference in onset times were observed as far as sensory and motor blockade was concerned between the two groups A and B with p-values of 0.69 and 0.40, respectively. Group B had significantly longer duration of block in comparison with Group A (p<0.001). Two patients in group A and one patient in Group B required supplemental analgesia with fentanyl boluses. Haemodynamics were stable and no complications were seen in both the groups. Conclusion: Lower volume of Bupivacaine is convincingly prudent for regional blockade under USG guidance than suggested in literature. [ABSTRACT FROM AUTHOR]

Medical gas production, supply and distribution is a closely regulated process with its intrinsic safety designs and procedure along with this anaesthesia work station designed with utmost safety for delivering anaesthetic gases to patients during the peri-operative period. The ingress of condensed water into anaesthesia machine from central medical gas pipeline can lead to catastrophic incidents. [ABSTRACT FROM AUTHOR]

Background: Oxytocin administration regimens are arbitrary and highly subjective. Hence, it is essential to reinvestigate the appropriate dose for effective uterine contraction with minimal bleeding and adverse effects. Aim: To determine the optimal dose of bolus oxytocin for uterine contractions for elective caesarean section under spinal anaesthesia. Methods: Ninety term mothers (37 to 41 weeks) undergoing caesarean section electively under spinal anaesthesia were considered for the trial and divided into three groups to receive oxytocin bolus of one, two or three units. The uterine tone was assessed at 2 min after oxytocin administration. Intraoperative blood loss, mean arterial pressure, heart rate and possible side effects were also compared. Paired t‑test, Kruskal‑Wallis test, Chi‑square test and analysis of variance (ANOVA) test with Scheffe multiple comparisons were used as inferential statistics. Results: Adequate uterine contraction was seen in 66% of participants who received one unit of oxytocin, and in 83.3% of participants who received two units of oxytocin. All those who received three units of oxytocin had an adequate uterine contraction. Blood loss was inversely related to the bolus dose of oxytocin. Conclusions: Lower bolus oxytocin doses of one and two units were inadequate for uterine contraction at elective caeserean section, while three units appeared to be effective in terms of adequate uterine contraction, reduced blood loss and stable haemodynamic system and absent side effects. [ABSTRACT FROM AUTHOR]

Sheehan’s syndrome is postpartum hypopituitarism caused by necrosis of the pituitary gland due to severe hypotension or shock caused by massive hemorrhage during or after delivery. Patients with Sheehan’s syndrome have varying degrees of pituitary hormone deficiency. There is increased sensitivity to barbiturates and opiates in patients with Sheehan’s syndrome. They are more prone to hypotension, hypoxia, and hypothermia which must be addressed intraoperatively. Herein, we report successful anesthetic management of a patient with Sheehan’s syndrome with distal third femoral shaft fracture for fixation who had numerous hormonal and electrolyte abnormalities. This case report emphasizes the importance of meticulous preanesthetic assessment, optimization, and perioperative management of patients with Sheehan’s syndrome for successful management of the case. [ABSTRACT FROM AUTHOR]

Hydatid cyst caused by Echinococcus granulosus is a common health problem in developing countries. The rupture of hydatid cyst can cause anaphylactic shock or even death during the surgical treatment. We present a report regarding anaphylactic reaction due to surgery to the liver for a hydatid cyst. Clinical examination and contrast-enhanced computed tomography preoperatively revealed a large hydatid cyst measuring 18 cm × 13 cm × 11 cm with few thin septations in the right lobe causing mass effect and splaying of intrahepatic vessels. Intraoperatively, the patient was successfully managed with antihistamines, steroids, crystalloids, and a small dose of vasopressor. After the surgery, she was transferred from the Intensive care unit to the surgical ward on the first postoperative day. The possibility of anaphylactic reactions should be kept in mind, and close monitoring for early diagnosis and appropriate management of anaphylaxis is essential for a favorable perioperative outcome in the case of hydatid cyst surgery. [ABSTRACT FROM AUTHOR]

Extreme rainfall events pose an ever increasing threat to cities due to the potential for surface water flooding resulting in damage to properties and major disruption of transport systems. Modern sensor networks offer enormous potential for the real-time monitoring of urban systems and potentially allow improved situational awareness of impeding hazards and their impacts such as flooding. However, monitoring in itself is not enough if we are to be able to adapt in in real-time to hazards. Systems are required that allow analytics and models, that feed of real-time observations, to make predictions of impacts and suggest adaption options ahead of the hazard event. The Flood-PREPARED project is developing a system for real-time adaption to surface water flooding. The system comprises of advanced spatiotemporal models of rainfall, surface water flooding and road traffic impacts. These models are linked and orchestrated within into a Big Data workflow that allows events to be simulated using emerging rainfall data recorded by a short range weather radar. This approach allows nowcasting to be undertaken where predictions of surface water inundation and impacts on the road network can be predicted ahead of the rainfall event reaching the city; thus providing the ability for an improved adaptive response to the actual event. [ABSTRACT FROM AUTHOR]

Remote sensing and hydrological models are one of the foremost tools for rapid and comprehensive study of flood hazards and disasters in any parts of the world. Current study is focused on severe 2018 Kerala flood, and is done using various remote sensing data, geospatial tools and combination of hydrological/hydrodynamic/topographical models. Flood mapping is done with pre and post floods remote sensing datasets. For pre-Flood analysis, Normalized Difference Water Index (NDWI) map was prepared on Google Earth Engine (GEE), using Sentinel-2 images for the period of Feb. 2017 to identify permanent water bodies. For post-Flood analysis, GEE was used to download the pre-processed and thermal noise removed Sentinel-1 SAR image for Aug. 9, 2018, Aug. 14 and Aug. 21, 2018 and flood maps were generated using this data. In addition to SAR data, probable flood inundation areas using topography-based flood inundation tool HAND (Height Above Nearest Drainage tool) was also utilized. Hydrological simulation was carried out for all 12 major river sub-basins of Kerala, where floods are reported. Indian Meteorological Department-Global Precipitation Measurement (IMD-GPM) gridded daily data is used as input meteorological data for hydrological simulations. The hydrological simulations results were verified using published Central Water Commission (CWC) reports and reservoirs data for India-WRIS. The hydrodynamic simulation was also performed for simulating the Idukki dam release data and flood condition in downstream areas. Overall, an integrated study and developed approach can be utilized by state and central water and disaster management agencies to develop flood early warning systems. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of clonidine and magnesium sulfate (MgSO4) when administered as an adjuvant to supraclavicular brachial plexus block in upper limb surgery. Materials and Methods: Sixty patients belonging to the American Society of Anesthesiologists classification (ASA) 1 and 2 undergoing upper limb surgical procedures were randomized to receive either 30 μg injection clonidine or 200 mg injection MgSO4 added to 18 ml of 0.5% levobupivacaine + 7 ml of 2% lignocaine with adrenaline. The primary objective of the study was to compare the duration of sensory (postoperative analgesia) and motor block between the two groups. The secondary objectives were to compare the onset time of motor and sensory block along with heart rate and mean arterial pressure between the two groups, which was recorded at regular intervals by the blinded anesthesiologist intraoperatively. Unpaired Student's t-test and repeated-measures analysis of variance were used for the analysis of parameters between the two groups. Results: There was no statistically significant difference between clonidine and MgSO4 groups in terms of primary outcome, i.e., the duration of postoperative analgesia (12.10 ± 3.86 h vs. 10.93 ± 3.68 h, P = 0.236) or duration of motor block (10.67 ± 3.70 h vs. 9.50 ± 2.89 h, P = 0.180). The mean onset time for motor block was relatively faster in clonidine group compared to MgSO4 with a borderline significance (P = 0.049). No clinically significant difference was observed in the mean onset of sensory block or hemodynamics between the two groups. Conclusion: Both, clonidine and MgSO4, as an adjuvant to supraclavicular brachial plexus block were found to have a similar onset time and duration of analgesia and motor block. [ABSTRACT FROM AUTHOR]

Introduction: Patients with suspected cervical spine fracture or cervical pathology, utmost care has to be taken while intubating these patients to prevent further cervical cord injury. Protective measures include application of rigid collar, a forehead tape and manual inline stabilisation. Application of these manoeuvres reduces the cervical spine movement, making it more difficult to intubate. Aim: To compare the performance of McCoy blade with C-MAC D blade for endotracheal intubation in patients with simulated cervical spine injury. Materials and Methods: One hundred and twenty adult patients were randomly allocated into two groups to achieve tracheal intubation with McCoy (group M=sixty patients), or C-MAC D video laryngoscopes (group C=sixty patients). The ASA patients of grade I-II undergoing elective surgery for having immobilised cervical spine using manual inline axial cervical spine stabilisation technique were enrolled in the study. Patient's Comparative data on the total time to intubate (Z-test), Cormack- Lehane (CL) laryngoscopic view (Chi-Square test), number of optimising manoeuvres (Yate's corrected Chi-Square test) and haemodynamic variables (Z-test) were recorded in both groups. Results: The time taken for tracheal tube insertion was significantly longer with C-MAC D blade group of thirty eight seconds compared with McCoy blade group which was thirty one seconds. There was an increase in heart rate at first and second minute in both the groups which returned back to normal after five minutes. Good grade glottic visualisation was obtained with both the laryngoscopic blades. Conclusion: C-MAC D blade as well as McCoy blade forms an effective tool for the airway management of suspected cervical spine injured patients with cervical immobilisation. [ABSTRACT FROM AUTHOR]

Aim: Study aims to investigate the effect of cigarette smoking on cancer-related transformation in oral epithelial cells of smokers through evaluating the alteration in Wnt/β-catenin and MAPK pathways. Materials & methods: Exfoliated oral epithelial cells were collected from 138 subjects and categorized into nonsmokers, smokers and clinically diagnosed precancer and cancer patients. Real-time quantitative PCR was performed to detect the fold changes of related genes. Expressions of biomarkers were assessed using immunofluorescence and western blot. Results: Study shows significant (p < 0.001) alteration in mRNA level of TNF-α, NF-κβ, FZD1, β-catenin, PARD3, MAPK1 and vimentin genes under cigarette smoking. Conclusion: Results suggested the progression of oral cancer under cigarette smoking occurs through multiple events and activation of canonical Wnt/MAPK pathways. [ABSTRACT FROM AUTHOR]

A multi-agent control framework is proposed that is capable of designing a rising and gating system for a three-dimensional computer-aided design model of a casting. The proposed framework uses autonomous and self-communicating agents to interact with the environment and to extract knowledge from it. Agents are capable of taking the optimal decision related to the various facets of casting design. Information on the computer-aided design model of casting is fed into the system through which a casting agent is generated. Other agents like a riser agent, an ingate agent, a runner agent and a sprue agent are the offshoots emanated from the casting agent. They interact with each other to share detailed information related to the riser and gating system design. The proposed multi-agent framework focuses on autonomous real-time analysis required to generate geometric shapes without much involvement of the user. [ABSTRACT FROM AUTHOR]

The study was conducted to assess the macro mineral profile of the dairy animals of the Bathinda district of Punjab and in relationship to soil and plants. Based on plasma analysis, sub-clinical deficiencies of all the macro minerals were observed in both crossbred cattle and buffaloes with maximal deficiency of Na. Prevalence of Ca, Mg, Pi, Na and K deficiencies in crossbred cattle were 26.36, 5.85, 35.11, 76.15 and 24.27 per cent, respectively and in buffaloes the prevalence of Ca, Mg, Pi, Na and K deficiencies were 19.35, 3.81, 23.86, 76.83 and 28.45 per cent, respectively. Deficiencies of Ca and Mg in fodder samples were also observed. On the other hand the concentrations of all the macro minerals in the soil samples were above the critical limit. Based on the findings it was concluded that mineral mixture supplementation is required in these areas to prevent sub-clinical deficiencies of various macro minerals and to maintain the proper production status of dairy animals. [ABSTRACT FROM AUTHOR]

Turbulent premixed flames observed in combustion devices exhibit the presence of multiscale and nonlinear turbulence–chemistry interactions, which make predictions using large-eddy simulation (LES) extremely challenging. In this study, two well-established chemistry modeling paradigms, namely, finite-rate chemistry (FRC) and flamelet generated manifold (FGM) are compared using the same computational framework to assess their predictive capabilities. The classical FGM-based framework for LES is extended further by using it in the linear eddy mixing (LEM) model for the closure of the filtered source term for the scalar field. The assessment is performed using two computational setups, a canonical configuration of a freely propagating methane-air turbulent premixed flame, and a practically relevant swirl premixed combustor, both in the thin reaction zone regime, where the focus is to examine the effects of chemistry modeling paradigm and SGS turbulence–chemistry interactions. While for the first setup, direct numerical simulation (DNS) is considered as a reference for comparison of different models, for the second configuration, the results are compared with the available experimental data. Overall, while mean flow features are predicted reasonably well by the FGM-based approaches, quantitative differences are observed for intermediate species and conditional statistics when compared with the FRC-based approaches, and possible reasons for these differences are discussed. [ABSTRACT FROM AUTHOR]

As per the recent statistical data, the consumption of fuel has increased from 1965 to 2012 at a very high rate. Earlier, we used to relay mostly on coal for running steam engines, and with the advancement of technology, this switched over to gasoline, diesel, natural gas and alternative fuels. Most of the emission coming from automotive engines was the main contributor to air pollution. An Aqua silencer composed of E glass-based composite was introduced to avoid the release of such gases directly into the atmosphere from diesel engines. It was manufactured using core moulding and vacuum bagging technology and was fitted to the exhaust pipe of the diesel engine to treat the toxic gasses before releasing to the atmosphere. Other than reducing the regulated emission, it also reduced particulate matter significantly. The particulate matter was reduced using an activated charcoal layer. The noise and particulate level were found to be less by 40 and 93% respectively when compared with the conventional silencer. Besides this, it has ease of installation. The current paper discussed the utilisation of this innovative mechanism in automobiles and its contribution to various fields such as refineries and chemical processing units. [ABSTRACT FROM AUTHOR]

The paper proposes the hybrid technique to observe the contingency and improve the reliability of radial distribution system (RDS). The hybrid algorithm used is interface of Bat algorithm and particle swarm optimization that is used to examine the contingency and reliability indices in the RDS. The feeder power loss, system node voltage deviation, system average interruption frequency index, system average interruption unavailability index and the energy not supplied at every load position in a sharing scheme are used to resolve the contingencies to minimize the power quality and reliability indices. The proposed techniques are implemented on MATLAB/Simulink platform and experienced on the IEEE 33 bus RDS. To establish the effectiveness of the proposed algorithm, results are compared with the reported Bat and Firefly Algorithm. [ABSTRACT FROM AUTHOR]

Introduction: Postoperative Nausea and Vomiting (PONV) is defined as any nausea or vomiting that occurs during the first 48 hours after surgery. It is considered as a distressing event following anaesthesia. The incidences of PONV is 25-30% in all post-surgical patients and the incidence of PONV with middle ear surgeries are 50%-80%. Various pharmacological techniques were used to prevent PONV. Five-HT3 receptor antagonists are most commonly used prophylactic agents. Aim: To compare the efficacy and safety of intravenous Palonosetron 75 mcg, and intravenous Dexamethasone 8 mg in preventing PONV. Materials and Methods: Hundred patients of 18-60 years undergoing ear and nose surgeries under general anaesthesia requiring intubation for more than one hour were randomised into two groups of 50 patients each. Group P received 75mcg of palanosetron and Group D received 8 mg of dexamethasone before induction. The incidence of PONV in the two groups was noted using a four point score until 24 hours postoperatively. Results: The overall incidence of PONV in 0-24 hours were maximum in the dexamethasone group with 50% and 20% in palanosetron group. The four point score was higher in dexamethasone group compared to palanosetron group & with statistically significant difference. The requirement of rescue antiemetic medication was 30% in dexamethasone group and 10% in palanosetron group. Conclusion: Our study has shown that palanosetron is more effective in the prevention of PONV without apparent side effects. [ABSTRACT FROM AUTHOR]

Examines the magnetic properties of NiCu and NiCo alloys with compositions in the range 70%-100% nickel. Function of magnetic induction B; Result that occurred after the addition of cobalt; Effect of the tensile stress on the magnetization.

Longitudinal recording media made with chromium and with nickel-aluminum underlayers are compared. NiAl films have smaller grains and random crystallographic orientation, while Cr films have larger grains and either a {110} or a {200} preferred orientation depending on the deposition conditions. Cobalt alloy films grown on NiAl have nearly random crystallographic orientation and significant c-axis out-of-plane component, and lower hysteresis loop squareness and coercivity than films made on a heated Cr underlayer. NiAl-underlayer media do not exhibit in-plane magnetic anisotropy induced by the substrate texture lines. CoCrTaPt/Cr/NiAl media had higher overwrite than CoCrTaPt/Cr media due to higher coercive squareness and a sharper hysteresis loop closure. [ABSTRACT FROM AUTHOR]

Examines the crystallographic orientation of chromium underlayer and a Co[sub84]Cr[sub14]Ta[sub2] alloy magnetic thin film. Processing parameters upon which the results of the effect of deposition conditions on the magnetic properties of the media depend on; Coercive anisotropy of the films; Differences between the crystallography of the untextured sample and that of the textured sample parallel to and perpendicular to texture grooves.