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Background: The Dyspnea, Eosinopenia, Consolidation, Acidemia, and Atrial Fibrillation (DECAF) score at presentation is designed to predict the risk of death in patients with chronic obstructive pulmonary disease (COPD). Aims and Objectives: To study the DECAF score at admission to predict the clinical outcome of the patients during hospitalization for acute exacerbation of COPD (AE-COPD). Materials and Methods: The study was conducted using a prospective cross-sectional observational study design in a tertiary care center in South India from April 2022 to March 2023. Patients were recruited based on specific inclusion and exclusion criteria. The data corresponding to the five variables of the DECAF score was obtained, and the relation to outcome measures such as survival, ventilation, and duration of stay was measured. Results: Two hundred consecutive patients were assessed. Based on the DECAF score, 102 patients (51%) were classified as low-risk, and this group had no mortalities. In the intermediate-risk group, the mortality rate was 7.4%; in the high-risk group, the observed mortality rate was 38.6%. The differences noted were significant statistically. Higher dyspnea grade as measured by extended Modified Research Council criteria was related to DECAF score was significant and with the outcome. Conclusion: Our study shows that the DECAF score at the initial presentation can be used as a reliable tool to predict the outcome of AE-COPD. Dyspnea grading can be used to predict mortality indirectly.

Martensitic stainless steel exhibits a lower corrosion resistance, higher hardness, wear resistance, and strength, but no ductility. As a result, tempering techniques have been used to stabilise the ductility. AISI 420 stainless were chosen and prepared in cylindrical shape for a dimension of 35 mm length, 10 mm diameter. The specimens were tempered to 245°C, 345°C, 445°C temperatures respectively and termed as T1, T2 and T3. The material which is not treated is kept on the other side for results comparison. Testing of hardness was taken up by Rockwell method. Wear tests were carried out for all the specimens using pin-on disc wear analyser. The changes in microstructure were distinguished with all the samples and were captured by electron microscopic techniques. The goal of the test is to determine, the best treated specimen suited for a particular application. It was noted that, phase change from martensite stage to residual austenite is determined.

BACKGROUND Enduring the disease and curing internal sphincter spasm while maintaining continence is the aim of treating the anal fissure. Although they can lead to issues like decreased anal continence, surgical techniques such as lateral internal sphincterotomy or manual anal dilatation have a positive healing impact. We wanted to study the effects of lateral internal sphincterotomy and the application of 2% diltiazem gel. METHODS At Government Vellore Medical College, 100 patients of both sexes, ages 20 to 60, who had recurrent symptoms of fissure in ano for longer than six weeks, participated in this two-year observational study. Patients were chosen at random for either surgery or diltiazem therapy. Patients who were chosen to get diltiazem therapy were told to implant the gel twice daily, up to a 1.5-2 cm length. Spinal anaesthesia was used for the internal sphincterotomy procedure. Post-surgery complications like haemorrhage and hematoma were noted. For a descriptive analysis, the results were tabulated. RESULTS 39% of the sample belonged to the 20-30 age group, and 31% to the 31-40 age group. 17% and 13% of those were between the ages of 41 and 50 and 51 and 60, respectively. 36% of people were female, and 64% of people were male. After four weeks, every patient in the internal sphincterotomy group had totally healed and was pain-free. After three months of follow-up, 10 (20%) patients in the diltiazem group reported having minor pain, while 39 (78%) reported being almost pain-free. Due to inadequate pain alleviation from diltiazem, four patients (8%) had internal sphincterotomies. Eight patients were lost to follow-up after receiving treatment with diltiazem gel, leaving 40 (80%) of the patients with fully healed fissures after 4-8 weeks. Out of the 50 patients who had an internal sphincterotomy, 45 (90%) fully recovered after 4 weeks, with six patients lost to follow-up. Both the internal sphincterotomy group and the diltiazem gel group reported no problems. CONCLUSION In treating chronic anal fissures, internal sphincterotomy works better than topical diltiazem. However, topical diltiazem is safe, simple to use, and has few side effects. It might be taken into consideration for people who are not surgical candidates or who refuse surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND In order to distinguish individuals with a difficult perforated appendicitis from those with an acute appendicitis that is not too complicated, there is a growing need for quick and safe markers. That is why the current study was conducted to see if a higher-than-normal bilirubin level may be used as a predictor of an appendicular perforation diagnosis. METHODS Between October 2021 and October 2022, 100 patients who had been hospitalised at Government Vellore Medical College and Hospital for acute appendicitis and were undergoing emergency appendectomy participated in a prospective, non-randomized observational study. A Microsoft Excel spreadsheet was used to total and analyse the data that was gathered. The odds ratio, sensitivity, specificity, positive predictive value, and negative predictive value were computed using a 2 x 2 table. RESULTS Of the 100 patients, 36% had an appendicular perforation and 64% had a clinical diagnosis of acute appendicitis. Out of the 36 patients who received an appendix perforation diagnosis, 24 had high bilirubin levels and 12 had normal bilirubin levels. The age range of 21 to 30 years old was the one where appendicular perforations were most common. Compared to just 16.7% of individuals with values <=1, appendicular perforation was seen in 85.7% of patients with total bilirubin >1 mg/dl. There was a statistically significant difference (p<0.001). Total bilirubin had 83.3% and 85.7%, respectively, of sensitivity and specificity in predicting the diagnosis of acute appendicitis and appendicular perforation. Total bilirubin had a 93.7% positive predictive value for both the diagnosis of appendicitis and appendicular perforation. 66.7% was the negative predictive value. 86.2% of patients with direct bilirubin >0.3 mg/dl developed appendicular perforation, whereas only 15.5% of patients with levels between 0.1 and 0.3 mg/dl experienced this condition. CONCLUSION In addition to or instead of other biochemical and radiographic markers, serum bilirubin has the specificity and sensitivity to predict appendicular perforation. [ABSTRACT FROM AUTHOR]

The requirement for petroleum fuel has amplified due to the growth of automobile industries and population growth. To meet fossil fuel demand in the future, alternative fuel for diesel fuel is necessary. The technique for engine modification is also considered as the latest advance in engine research aimed to complete combustion. The engine has been coated with a mixture of a ceramic thermal barrier material of 88% Yttria Stabilized Zirconia (YSZ), 4% Magnesium oxide (MgO), and 8% Titanium oxide (TiO2) of 150 µm thickness by the plasma spray process. After engine modification, the coated engine has been analyzed with the mixing of Copper oxide (CuO) nanoadditive to the B20 Punnai Methyl Ester. The structural and chemical constituents of the biofuel are determined using Fourier transform infrared spectroscopy and gas chromatography. The test result noted that brake thermal efficiency is increased by 17.14% for the coated engine as compared to the uncoated engine. The brake specific fuel consumption for the tested fuel used in the coated engine is decreased by 11.16%. Engine emission parameters are reduced especially oxides of nitrogen (NOx) emission of 10.84% for the tested fuel in the coated engine. [ABSTRACT FROM AUTHOR]