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Introduction- Dengue is associated with high morbidity & at times develops potentially fatal complication. Predicting the outcome on the basis of clinical presentation alone is less reliable and complicated owing to variable symptomatology. there is a need for developing and testing a scoring system, for the detection of complicated and severe dengue fever early in the course of infection, to identify those children who may progress to DSS/DHF and succumb to disease subsequently & to triage sick patients for early referral from primary and community health centers to higher center for intensive care management. This Material & methodsProspective observational study was conducted in Department of Pediatrics, SMS Medical College, Jaipur during January 2020 to September 2021. Sample size is calculated at 95 % condence interval expecting sensitivity of 86% using dengue severity score of more than equal to 12 in the assessment of outcome of dengue severity among the dengue fever patients. An absolute allowable error of 15% and at prevalence of 17.4% of severe dengue patients, the required sample size was 125 cases with dengue fever. Statistical analyses were done using computer software (SPSS Trial version 23 and primer). if we use the critical cut off of DDS Results- S >10.5 on day 1 of hospital admission; it was a strong predictor of mortality with p

Solution-processable organic semiconductor-based ambient-stable and flexible-compatible ionic liquid-gated inverter with a gain >10 and noise margin ≈60% paves the way for the integration of ionic liquid-gated logic components into circuits.

Background: Anthropometry is widely used for Identification of an individual. Height is one of the most important parameters of anthropometry. It is strongly correlated with the individual’s hand dimensions and if either of the measurements are known, the other can be calculated. Aim and Objective: To know correlation between the hand dimensions and Height of an individual and to apply the regression line of height on hand dimension of the person. Methods and Material: A cross-sectional study was conducted among the medical students. Anthropometric indices were recorded after obtaining written consent and institutional approval using standard equipments. Linear regression and Pearson coefficient were calculated to study the correlation and arrive at the equation to calculate Height from Hand length. Results: Age of the study participants who consented for study (150) ranged between 18-24 years. Mean height was 165.91 cm. Mean right hand length was 17.71 cm and 17.69 cm on left hand. Mean hand width was 7.79 cm on right side and 7.56 cm on left side. A statistically significant positive correlation was observed between height and the hand dimensions. Conclusions: There was a statistically significant positive correlation between hand dimensions and height. Forensic investigation, body identification and triage can be facilitated through calculating Height from hand dimensions when only mutilated body remains are received during disasters.

Determination of sex from the skeletal remains is of medico legal importance for establishing the identity of an individual. The determination of deceased sex is first step in skeletal analysis since estimation of age at death, race,and stature depends on sex of the deceased. Total 100 adult dry skull were of unknown sex available in the Department of Anatomy Santosh medical college and hospital,Gaziabad and Government Institute of Medical Sciences,Greater Noida, were studied. Distance between bregma and lambda were obtained and presence of any sutural bone was observed in bregma. The results were compared with the present literature. Still there is a demand for further research to validate the distance from bregma to lambda for anthropometric use for particular race and various other surgical procedures.

This study is to analyze the morphometry of anterior clinoid process (ACP) and the surrounding parasellar structures which is important for the surgeries related to cavernous sinus, ICA, and basilar artery. A cross-sectional study has been done on 77 adult human dry skulls among North Indian population. The length, width, thickness of ACP and distance between ACP to OS, distance between two ACPs, distance between PCPs, distance between ACP to PCP were measured using digital vernier caliper. The mean and standard deviation was calculated and paired t-test was applied for the comparison. The mean length and width and thickness of ACP was 8.72±0.94 mm, 8.13±1.16 mm and 1.10±0.44 mm on right and 8.57±0.91mm, 8.05±1.24 mm and 1.40±0.41mm on left side. The average distance between the ACP tip to OS and ACP and PCP tip was 6.01±1.11mm and 8.79±1.49mm on the right and 5.90±0.99mm and 8.47±1.49mm left side. The mean distance between the ACP tip and PCP tip was 20.10±2.36 mm and 12.63±2.03 mm respectively. We did not find any significant difference of morphometric parameters between the right and the left side. The anatomical knowledge of these structures and its variation will help surgeons to plan surgery around the parasellar region.

Aim: The goal of the current study was to determine the average placenta thickness and foetus weight for each group of gestational age, as well as the relationship between placenta thickness and foetus weight for pregnant Indian women of various gestational ages. Methods: 202 pregnant women were included as study subjects in the current study utilising a convenient sample technique. The antenatal women underwent an ultrasound examination to measure placental thickness, gestational age, and fetus weight. The correlation between the gestational age in weeks, placental thickness in cm, and foetal weight in gram was determined using the Pearson's Correlation (r value). Statistical significance was defined as a P value of 0.05 or lower. Results: The mean placental thickness increased significantly from first follow up (1.61±0.26 cms) to second follow up (2.62±0.07 cms) and third follow up visit (3.35±0.26 cms). The mean placental thickness increased significantly from first follow up (1.61±0.26 cms) to second follow up (2.62±0.07 cms) and third follow up visit (3.350±0.26 cms). The estimated gestational age (11–20 weeks) had a 79.9% variability (R2) based on placental thickness (mm).

Aim: To evaluate the mean vascular area (MVA) and to correlate it with immunomorphological pattern of lymph nodes. Materials and Methods: A total of 50 positive OSCC cases (clinically and histopathologically diagnosed) from Santosh Medical College and I.T.S Dental college, ghaziabad were taken for the study. The lymph nodes collected were stained with routine hematoxylin & eosin and accessed for immunomorphological pattern. The sections were evaluated immunohistochemically by anti-von Willebrand factor (vWF) VIII to analyze the micro vessels in OSCC. Results: Three hundred and forty two lymph nodes were evaluated and the most predominant lymph node patterns were found to be Germinal Center Predominance (37.43%). Our results showed a significant association between tumor node metastasis (TNM) staging, histopathological grading, and mean vascular area with lymph node reactivity pattern. Conclusion: There was an increase in angiogenesis with in different grades of OSCC and mean vascular area with morphological pattern of lymph nodes can be used as an additional parameter which would help in assessing prognosis and survival of the patient.

Introduction: Cervical spinal stenosis is a frequent condition that causes a lot of pain and disability. To avoid long-term disability as a result of irreversible spinal cord injury, quick diagnosis and treatment are required. Cervical vertebrae have smaller bodies than other vertebrae, and their purpose is to support the head, protect the spinal cord, and permit head movement. Material and Methods: A case control study has been undertaken at a tertiary care setting of Uttar Pradesh for a period of 1 year from June 2020 to May 2021. Patients with either cervical spine stenosis or facet joint arthrosis or both aged between 20 to 80 years of either gender who attended Out-patient departments of the hospitals were involved. Results: A sum of 83 individuals were made part of the Case group and 50 patients were included as the Controls. Around 50% of the case population were females (n=42) and 56% of the controls were males (n=28). The Mean±SD Torg ratio of C3 cervical vertebra among the case group was 0.78±0.05, where as it was 0.84±0.06 in the control group. Mean±SD Torg ratio of C4 cervical vertebra among the case group was 0.76±0.05, whereas it was 0.83±0.08 in the control group.

The caudate lobe is a vertically elongated central projection from posterior surface of liver. It is bordered on the right by the groove for the inferior vena cava (IVC), on the left by the fissure for the ligamentum venosum, and on the bottom by the porta hepatis. It is continuous on the superior aspect with the upper part of the right limb of the fissure for the ligamentum venosum. The morphology of the caudate lobe was studied in 100 cadaveric human livers (15-70 years old) stored in 10% formaldehyde, regardless of gender, obtained from the department of anatomy at Santosh Medical College in Ghaziabad. The caudate lobe was observed in a variety of shapes. Vertical fissures extending upward from the lower border of the caudate lobe were seen in 52% of the liver specimens, while accessory caudate fissures extending downward from the upper border were seen in 9% and accessory transverse fissures were seen in 3% cases. Caudate notch was horizontal in 11% of liver specimens. The papillary process was visible in 27% of the liver specimens; a hook shape of the papillary process was seen in one liver specimen. Caudate process was present in 18% of the cases. Linguiform process was observed in 46% of cadaveric liver specimens. As observed, the incidences of morphological variations of the caudate lobe are very high, so it is critical for both radiologists and surgeons to keep these variations in mind when making diagnoses and planning surgeries for a favourable clinical outcome.

The structural models, do not necessarily predict the measured data sufficiently accurately. Because of this, there is a need for these models to be updated to better reflect the measured data. This paper introduces computational intelligence techniques to update finite element models. The model updating is formulated as a constrained optimization problem and solved using a recently developed meta-heuristic algorithm called Artificial Bee Colony (ABC) algorithm. A MATLAB code is developed using the model-updating formulations presented in this paper. Numerical simulation studies are carried out by solving for the proposed model updating technique by using pseudo-experimental data of an 8storey framed structure and also the experimental data of ASCE three storey benchmark structure. Studies presented in this paper clearly indicate the effectiveness of the proposed computational intelligence-based model updating technique.

Introduction: Cervical spinal stenosis is a common disease that results in considerable morbidity and disability. It requires prompt diagnosis and treatment to prevent long-term disabilities secondary to irreversible spinal cord injury. The bodies of the cervical vertebrae are smaller in size compared with those of other vertebrae and function to protect the spinal cord, support the head, and allow movement of the head (in flexion, extension, and rotation). Material and Methods: This is a Case control prospective study conducted at Santosh Medical College, Ghaziabad and Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh. The present study was conducted in the Department of Anatomy and Radio diagnosis. Diagnosed cases of (Neck pain) with suspected cervical canal stenosis and facet joint arthrosis from OPD of Department of Orthopedics and Neurology of Santosh Medical referred to Radio diagnosis department for CT scan was chosen as subject. Result: In our study, results suggest gradual increase of spinal canal Sagittal vertebral body diameter (AP-V), from C3 (14.06±0.76) to C7 (14.44±0.75). Furthermore, in our study at the level of C7 (9.23±0.40) the Sagittal spinal cord diameter (AP-SC) increases and the smallest sagittal diameter of the canal were detected at the level of C3 (9.05±0.47).

Parag Shah,1 Sanjay Kalra,2 Yogesh Yadav,3 Nilakshi Deka,4 Tejal Lathia,5 Jubbin Jagan Jacob,6 Sunil Kumar Kota,7 Saptrishi Bhattacharya,8 Sharvil S Gadve,9 KAV Subramanium,10 Joe George,11 Vageesh Iyer,12 Sujit Chandratreya,13 Pankaj Kumar Aggrawal,14 Shailendra Kumar Singh,15 Ameya Joshi,16 Chitra Selvan,17 Gagan Priya,18 Atul Dhingra,19 Sambit Das20 1Department of Endocrinology, Gujarat Endocrine Centre, Ahmedabad, Gujarat, India; 2Department of Endocrinology, Bharti Hospital & B.R.I.D.E, Karnal, Haryana, India; 3Department of Endocrinology, MAX Super Specialty Hospital, Dehradun, Uttarakhand, India; 4Department of Endocrinology, Apollo Hospital & Dispur Polyclinic and Nursing Home, Guwahati, West Bengal, India; 5Department of Endocrinology, Apollo Hospital, Mumbai, Maharashtra, India; 6Department of Endocrinology, CMC Hospital, Ludhiana, Punjab, India; 7Department of Endocrinology, Diabetes and Endocrine Clinic, Berhampur, Orissa, India; 8Department of Endocrinology, OeHealth Diabates & Endocrinology Centre, Delhi, Delhi, India; 9Department of Endocrinology, Excel Endocrine Centre, Kolhapur, Maharashtra, India; 10Department of Endocrinology, Visakha Diabates & Endocrine Centre, Vishakhapatnam, Andhra Pradesh, India; 11Department of Endocrinology, Endodiab Clinic, Calicut, Kerala, India; 12Department of Endocrinology, St.John’s Medical College & Hospital, Bangalore, Karnataka, India; 13Department of Endocrinology, Endocare Clinic, Nashik, Maharashtra, India; 14Department of Endocrinology, Hormone Care & Research Centre, Ghaziabad, Uttar Pradesh, India; 15Department of Endocrinology, Endocrine Clinic, Varanasi, Uttar Pradesh, India; 16Department of Endocrinology, Endocrine and Diabetes Clinic, Mumbai, Maharashtra, India; 17Department of Endocrinology, Ramaiah Memorial Hospital, Bangalore, Karnataka, India; 18Department of Endocrinology, IVY Hospital, Chandigarh, Punjab, India; 19Department of Endocrinology, Bansal Hospital, Sri Ganganagar, Rajasthan, India; 20Department of Endocrinology, Endeavour Clinic, Bhubaneshwar, Orissa, IndiaCorrespondence: Sanjay Kalra, Kunjpura Road, Model Town, Near State Bank of India, Sector 12, Karnal, Haryana, 132001, India, Tel +9215848555, Email brideknl@gmail.comAbstract: Glucocorticoids are potent immunosuppressive and anti-inflammatory drugs used for various systemic and localized conditions. The use of glucocorticoids needs to be weighed against their adverse effect of aggravating hyperglycemia in persons with diabetes mellitus, unmask undiagnosed diabetes mellitus, or precipitate glucocorticoid-induced diabetes mellitus appearance. Hyperglycemia is associated with poor clinical outcomes, including infection, disability after hospital discharge, prolonged hospital stay, and death. Furthermore, clear guidelines for managing glucocorticoid-induced hyperglycemia are lacking. Therefore, this consensus document aims to develop guidance on the management of glucocorticoid-induced hyperglycemia. Twenty expert endocrinologists, in a virtual meeting, discussed the evidence and practical experience of real-life management of glucocorticoid-induced hyperglycemia. The expert group concluded that we should be proactive in terms of diagnosis, management, and post-steroid care. Since every patient has different severity of underlying disease, clinical stratification would help understand patient profiles and determine the treatment course. Patients at home with pre-existing diabetes who are already on oral or injectable therapy can continue the same as long as they are clinically stable and eating adequately. However, depending on the degree of hyperglycemia, modification of doses may be required. Initiating basal bolus with correction regimen is recommended for patients in non-intensive care unit settings. For patients in intensive care unit, variable rate intravenous insulin infusion could be temporarily used, but under supervision of diabetes inpatient team, and patients can be transitioned to subcutaneous insulin once stable baseline assessment and continual evaluation are crucial for day-to-day decisions concerning insulin doses. Glycemic variability should be carefully monitored, and interventions to treat patients should also aim at achieving and maintaining euglycemia. Rational use of glucose-lowering drugs is recommended and treatment regimen should ensure maximum safety for both patient and provider. Glucovigilance is required as the steroids taper during transition, and insulin dosage should be reduced subsequently. Increased clinical and economic burden resulting from corticosteroid-related adverse events highlights the need for effective management. Therefore, these recommendations would help successfully manage GC-induced hyperglycemia and judiciously allocate resources.Keywords: corticosteroids, insulin, steroid-induced hyperglycemia, steroid-induced diabetes, stress hyperglycemia, diabetes

To evaluate whether short-term treatment with a selective 11β-Hydroxysteroid dehydrogenase-1 (11β-HSD1) inhibitor, AZD4017, would block hepatic cortisol production and thereby decrease hepatic fat in patients with nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH), with or without type 2 diabetes (T2D).This was a randomized, double-blind, placebo-controlled, phase 2 study conducted at two sites. Key inclusion criteria were the presence of NAFLD or NASH on magnetic resonance imaging (MRI) or recent biopsy positive for NASH. Enrolled patients were randomly assigned (1:1) to AZD4017 or placebo for 12 weeks. Primary outcomes were between-group differences in mean change from baseline to week 12 in liver fat fraction (LFF) and conversion ofA total of 93 patients were randomized; 85 patients completed treatment. The mean (standard deviation [SD]) change in LFF was -0.667 (5.246) and 0.139 (4.323) in the AZD4017 and placebo groups (P = 0.441). For patients with NASH and T2D, the mean (SD) change in LFF was significantly improved in the AZD4017 versus the placebo group (-1.087 [5.374] vs. 1.675 [3.318]; P = 0.033). Conversion ofAlthough the study did not meet one of the primary outcomes, AZD4017 blocked the conversion of

To assess the diurnal patterns of postprandial glucose tolerance and insulin sensitivity, 19 subjects with type 2 diabetes (8 women; 60 ± 11 years; BMI 32 ± 5 kg/m2) and 19 anthropometrically matched subjects with no diabetes (ND; 11 women; 53 ± 12 years; BMI 29 ± 5 kg/m2) were studied during breakfast (B), lunch (L), and dinner (D) with identical mixed meals (75 g carbohydrates) on 3 consecutive days in a randomized Latin square design. Three stable isotopes of glucose were ustilized to estimate meal fluxes, and mathematical models were used in estimating indices of insulin action and β-cell function. Postmeal glucose excursions were higher at D versus B and at D versus L in type 2 diabetes (P < 0.05), while in ND they were higher at D versus B (P = 0.025) and at L versus B (P = 0.04). The insulin area under the curve was highest at B compared with L and D in type 2 diabetes, while no differences were observed in ND. Disposition index (DI) was higher at B than at L (P < 0.01) and at D (P < 0.001) in ND subjects, whereas DI was low with unchanging pattern across B-L-D in individuals with type 2 diabetes. Furthermore, between-meal differences in β-cell responsivity to glucose (F) and insulin sensitivity (SI) were concurrent with changes in the DI within groups. Fasting and postmeal glucose, insulin, and C-peptide concentrations, along with estimates of endogenous glucose production (EGP), Rd, SI, F, hepatic extraction of insulin, insulin secretion rate, extracted insulin, and DI, were altered in type 2 diabetes compared with ND (P < 0.011 for all). The data show a diurnal pattern of postprandial glucose tolerance in overweight otherwise glucose-tolerant ND individuals that differs from overweight individuals with type 2 diabetes. The results not only provide valuable insight into management strategies for better glycemic control in people with type 2 diabetes, but also improved understanding of daytime glucose metabolism in overweight individuals without impaired glucose tolerance or overt diabetes.

Background: Temporomandibular disorders (TMDs) are broad group of clinical problems involving the masticatory musculature, the temporomandibular joint (TMJ), and the surrounding hard and soft-tissue components or combination of these problems. It can also be secondary to muscle hyperfunction or parafunction, traumatic injuries, hormonal influences, and articular changes within the joint. Magnetic resonance imaging (MRI) is currently considered as the preferred method for imaging the soft-tissue structures of the TMJ and has been pointed out as the best imaging modality in diagnosing disc displacements. Aim: The aim of this study is to comparatively evaluate the clinical findings of temporomandibular pathology with the MRI. Methodology: This is a cross-sectional observational study with comprised multiethnic group. A total of 50 patients reporting to the dental OPD with TMJ pathology were selected. These subjects underwent thorough clinical examination of TMJ and MRI of the TMJ was taken for all the individuals and parameters such as change in disk position, condylar surface, and effusion were recorded with the help of the radiologist. Statistical Data Analysis: Statistical presentation and analysis of the present study were done using the P value and Chi-square test by SPSSV20. Results: The results obtained in this study showed that out of 50 individuals, pain was present only in 28, that is, 56% of population other complaints of jaw deviation, clicking sound, and restricted mouth opening. Disc displacement was found only in 57.14% of symptomatic individual and 72.72% of asymptomatic individuals. MRI revealed pain and effusion was present only in 28% of symptomatic patients. About 76% of the subjects had jaw deviation while mouth opening out of which 68.42% showed disc displacement in MRI. About 56% of the subjects had positive history of trauma out of which 50% showed disc displacement in MRI. About 56% of the subjects reported with the clicking sound out of which 64.28% showed disc displacement in MRI. Conclusion: TMJ is one of the complex joints in the entire body. Because of this complexity of the TMJ, the pathologies as well as normal anatomical patterns must be known before any diagnosis. The selection of the proper radiological technique for TMJ, as well as of the patient, must be carefully made by the practitioner, in correlation with the clinical signs and symptoms. MRI is the diagnostic study of choice for evaluation of disk position and internal derangement of the joint. Although already many studies had been done on MRI, such type of studies should be conducted on large scale in future based on specific parameters for early diagnosis and treatment planning for patients suffering with TMD to provide quality treatment to the patients at initial stage.

Background: Because of the anatomic complexity of the temporomandibular joint (TMJ) clinician cannot arrive at the accurate diagnosis only by clinical evaluation of TMJ hence would require some special imaging methods and techniques which would facilitate the accurate clinical diagnosis. One such imaging method is orthopantomography (OPG) of TMJ. Even though OPG has various limitations, it provides valuable information of TMJ and seems to be the primary choice of imaging modality for the diagnosis of TMJ pathologies. Magnetic Resonance Imaging (MRI) is considered to be the one of the best imaging technology to assess the soft tissue structures surrounding the TMJ and evolved as the best imaging modality for the diagnosis of disc displacement of TMJ. Aim: The aim of the study is to evaluate the clinical findings of the TMJ pathologies and to compare the findings of the OPG and MRI of the TMJ pathologies. Methodology: This is a cross-sectional observational study with comprised of multi-ethnic groups, selected from amongst those attending our dental c. Fifty subjects reporting to the Department of Oral Medicine and Radiology with TMJ pathologies were selected. Radiological bone changes were evaluated for flattening (flat bony contour deviating from normal convex form) and erosion (area of decreased density of cortical bone and adjacent subcortical bone) by OPG. After that, MRI of TMJ been taken and changes in the disk position was recorded with the help of radiologist. Statistical Analysis: Statistical presentation and analysis of the present study were done using the p value and Chi-square test by SPSSV20. Results: Result obtained from our study showed that pain was present in 28 (56%) patients and only 44% patients having chief complain other than pain such as noise in front of ear while mastication or restricted mouth opening [Table 1] Out of 28 patients with a chief complain of pain, 22 patients (78.57%) were having abnormal/flattened condylar head surface but out of 22 patients with a chief complain other than pain 18 patients (81.82%) were having abnormal/flattened condylar head surface [Table 2]. Out of 28 patients with a chief complain of pain, 18 patients (64.28%) were with an shortened condylar neck and also out of 22 patients with a chief complain other than pain 16 patients (72.72%) were having shortened condylar neck. The result showed statistically non-significant (P > O.05) [Table 3]. Results also showed that 40% patients with Anterior Disc Displacement With Reduction (ADDR) and 50% with Anterior disc displacement without reduction (ADDWR) had abnormal condylar head surface [Table 4]. About 47.05% patients with ADDR and 41.17% with ADDWR had abnormal condylar neck [Table 5]. Even though there was a positive correlation between the OPG and MRI findings of the TMJ pathologies with the clinical findings of TMJ pathologies, result was not statistically significant which might be due to the reduced sample size. Conclusion: Based on the observation, it can be concluded that OPG and MRI provide valuable information regarding the temporomandibular disorders (TMD) and can play a key role in arriving at accurate clinical diagnosis of complex TMJ pathologies. It also makes the clinical diagnosis easy by correlating the clinical findings of the TMD with this imaging modality and helps clinician to arrive at the proper diagnosis and treatment plan at the earliest. This type of studies should be done on large scale in future based on specific parameters for early diagnosis and treatment planning for patients suffering with TMD to provide quality treatment to the patients at initial stage.

Background: Coronary artery disease (CAD) morbidity and mortality increasing day by day in India as well as worldwide. Coronary arteries visualization by using invasive catheterization angiography is still using as a front-line diagnostic tool to evaluate the patients with CAD. 128 slice dual source CT improves the cardiac imaging such as high scanning speed, good temporal resolution and low radiation dose. Objective: To assess the diagnostic accuracy of 128-slice dual source CT cardiac angiography with conventional catheter angiography to find common arteries involved in CAD. Methods: This is a prospective, comparative, cross sectional study conducted at cardiology OPD. Patients with complaint of chest pain and suspected CAD were evaluated by CT and conventional coronary angiography and results were compared. Serum creatinine and ECG status were analyzed before the angiography. SIEMENS 128-slice Dual Source Flash Definition CT Scanner was used as a CT coronary angiography. Severity distribution of coronary artery disease, artery wise distribution of non-significant, significant lesions and coronary artery dominance pattern were analyzed and compared. Results: A total of 70 suspected CAD patients were selected and analyzed. American Heart Association (AHA) model of 17-segment was used to assess the coronary arteries. Normal angiograms reported in 15.71% patients and 58.57% had significant disease. A total of 356 lesions were identified from 690 out of 720 segments. Right coronary artery (RCA) is the most common location of significant lesions which contributes 33.5% (n=55/164). Coronary circulation of right-sided dominance was most commonly reported (70.0%). CT angiography showed 96.13% of an overall sensitivity, 96.28% specificity, 89.72% positive predictive value and 98.49% negative predictive value. Conclusion: 128-slice dual source CT scanner has showed high accuracy and act as non-invasive assessment of coronary arteries in patients with CAD Keywords: Cardiac angiography, Catheter coronary angiography, CT coronary angiography, 128-slice MDCT, Conventional angiography

Learning outcomes To enable the students to appreciate the importance of the retail business environment and identification of opportunities set in the context of an emerging market. To make students understand how a value proposition (product) is crafted in a retail organisation. To introduce the technique of developing a service blueprint for designing the retail consumption experience. To induce students to analyse on what criteria should retail business models be evaluated. To introduce the students to the concept of omnichannel retail strategy. Case overview/synopsis The case is about a value-retail chain We Mart India facing the sudden lockdown situation in April 2020 because of the Covid-19 pandemic hitting India. Shailesh Mehta, the Chief Operating Officer of We Mart is wondering what he should do post the lockdown to bring back the retail chain to its pre-Covid fast-paced growth of 25% YOY in June 2019. We Mart focussed on physical stores as a part of its strategy with an emphasis on the in-store experience. The company catered to the aspirations in fashion for the youth through a series of fashion apparel and accessories in Tiers 2 and 3 cities. The company had grown successfully in two decades and had expansion plans for 2020, which now seemed hazy because of this unpredicted biological disruption impacting businesses. Mehta’s worries were intensified by the change in the consumer trend that was witnessing a shift from offline to online. He wondered about how to incorporate this change and also realign the corporate growth plans in amidst of a challenging situation. To add to his woes were thoughts about established competitors online already apart from the existing offline ones. Research methods: This case is based on primary and secondary data gathered through interviews and publicly available secondary sources. The name of the company and protagonist have been disguised. Complexity academic level The case is suitable for post-graduate (masters in buisness administration) level courses on retail management. The length of the case enables the participants to even read in the class. Supplementary materials Teaching Notes are available for educators only. Subject code CSS 8: Marketing

Inducement of high charge carrier density in organic field-effect transistors (OFETs) is a subject of immense interest due to its fundamental and applied impact on device operation. Here, the high ...

BACKGROUND Sepsis remains an important cause of hospitalisation and mortality worldwide among patients admitted in intensive care units (ICU). Due to increasing mortality and morbidity of sepsis early diagnosis and treatment are essential. This can be achieved with the help of biomarkers–haematological and inflammatory i.e., C-reactive protein (CRP) and pro calcitonin (PCT). They are found to be highly sensitive and useful markers for early detection and management of sepsis. METHODS This is a cross-sectional study conducted from May 2019 to March 2020 in the Department of Biochemistry, ESI Hospital, Okhla. A total of 104 subjects were recruited for the study. Of them, 52 subjects were healthy controls, and 52 cases were ICU patients. Samples were taken to evaluate differential leucocyte count (DLC), red cell distribution width standard deviation (RDW SD), platelet count (PLT), absolute neutrophil count (ANC) and platelet crit as haematological markers whereas Creactive protein, fibrinogen and pro calcitonin indices were chosen as inflammatory. markers. RESULTS There was significant increase in the TLC (21583.51 ± 2240.36), total neutrophil count (7889.48 ± 1482.83), immature neutrophil (2.97 ± 1.67), fibrinogen levels (518.07 ± 66.74), CRP (0.048 ± 0.01) and pro calcitonin levels (0.062 ± 0.22) of the cases as compared to the healthy controls. The platelet count was observed to be higher in healthy subjects as compared to the patients in ICU. CONCLUSIONS The study results showed that clinical examination along with laboratory testing which include hematologic and inflammatory biomarkers is the most effective combination of parameters for rapidly and accurately predicting or diagnosing sepsis in a critically ill patient. KEY WORDS Sepsis, Haematological, Inflammatory, CRP, PCT, Fibrinogen

Introduction Cervical spinal stenosis is a common disease that results in considerable morbidity and disability. To avoid long-term disability caused by irreversible spinal cord damage, quick diagnosis and treatment are required. To our knowledge, until recently, there has been no report or study evaluating the cervical canal stenosis and associated facet joint arthrosis as the major cause of neck pain, so the current study used computed tomography (CT) scans to determine the prevalence of cervical canal stenosis and facet joint osteoarthrosis in patients who presented with neck pain, including its relationship with age, sex, and cervical spinal levels (C3-C7). Methods The current clinical descriptive cross-sectional study was conducted in the Department of Anatomy and Radiodiagnosis at Santosh Medical College, Ghaziabad, for a period of 24 months among newly diagnosed outpatient department (OPD) cases of neck pain (18 years or older) with suspected cervical canal stenosis and facet joint arthrosis. Clinical history, patient-specific clinical examination, and relevant information were obtained in a structured data collection schedule through interviews during OPD hours. All of the participants underwent a CT scan of the cervical region. The independent factors (age, gender, height, and weight) were used in a multiple linear regression analysis of neck pain grading, Torg ratio (TR), and right and left facet joint degeneration, which were expressed as R-squared (R

The placenta is an organ which is an indicator of maternal and fetal disorders. Gestational Diabetes mellitus complicates 2-5% of all pregnancy. Therefore our work was an analysis of changes in placental morphometric anatomy in mothers of gestational diabetes mellitus and the influence of gestational diabetes mellitus on the fetal weight. Sixty-two placentas of full-term pregnancy collected from labour room/operation theatre of Gynaecology and obstetrics, department of government medical college and super facility hospital Azamgarh, Uttar Pradesh. Out of sixty-two placentas, 31 are from mothers with no known history of preexisting gestational diabetes mellitus cases as controls and 31 collected from mothers with gestational diabetes mellitus. We found mean placental weight, mean placental area, mean placental volume, mean no of cotyledons significantly more in placentas of gestational diabetic mothers. Mean fetal weight of gestational diabetic mothers were more in comparison with controls. Mean transverse diameter of placentas of the diabetic mothers were more than mean transverse diameter of placentas of the non-diabetic mothers, statistically significant. Mean longitudinal diameter also more in placentas of diabetic mothers, not statistically significant. Mean thickness at the centre more in placentas of diabetic mothers, statistically significant. Mean thickness mid-way between centre and margin and mean thickness at margin more in diabetic placentas, not statistically significant. Gestational diabetic mothers had more round-shaped placentas. Marginal insertion of umbilical cord presents more in placentas of gestational diabetic mothers.

Introduction: Asphyxia could occur in various situations like: Traumatic asphyxia, Hanging, Choking, Smothering, Strangulation, poisoning, etc. There are both external and internal general features to diagnose fatal asphyxia macroscopically such as: a) External (i) ligature mark (ii) congestion, cyanosis & petechial hemorrhages. b) Internal – fluidity of blood, dilatation of right chamber of heart and visceral congestion. Materials and Methods: An observational Cross sectional study was carried out in Department of Forensic Medicine & Toxicology, Santosh Medical College, Ghaziabad. A total 58 cases of fatal neck compression were included in this study during. All the cases with alleged history of fatal neck compression were included in the study, except where the dead body was severely decomposed, that would effect the observation of findings. In study the aim was to find out the different associated lesions, injuries / fracture of the organo-complex of the larynx, bleeds in the tongue, hemorrhage in the tonsils and tonsilar beds. Results: Majority cases of hanging were seen in young adult age group of 20 ± 30 years. The overall male : female ratio in cases of hanging was 11:1. Majority cases of hanging were suicidal. Neck compression and hanging were seen between time interval of 6 + AM to 12 noon. Congestion of the face was observed in 60.86%. Hemorrhage in Sub-conjunctiva, strap muscle, tongue, epiglottis and tonsil were seen in 13%, 23.91%, 13.04%, 20% and 15.21% cases respectively. Hyoid bone fracture was present in 13.04% while thyroid cartilage fracture was present in 4.34%. Conclusion: According to the present study hanging is more common in young adults mostly suicidal in nature. congestion of face is most significant external feature in hanging while tonsillar heamorrage is significant internal feature. Keywords: Hanging, Asphaxia, External neck injury, Internal neck injury, Ligature mark.

Introduction: An accurate gestational age is must for Obstetricians and Gynecologists to make appropriate decisions, for identify and counseling women who are at risk of a preterm delivery and to evaluation of fetal growth and the detection of intrauterine growth restriction (IUGR). In our present study, we worked on fetal tibial length & foot length and found that in normal growing fetus, fetal tibial length increase with advancing gestational age and regression analysis showed a strongly significant relationship between gestational age and fetal tibial length. Materials and Methods: 100 pregnant women underwent ultrasonographic measurements of Tibia and Foot Length from 15 to 36 weeks of gestation, in the Radio diagnosis Department. Results: In our study, we found the earliest age at which Tibia and foot length could be seen by ultrasound was 15 weeks of gestation and mean tibia length 10.25± 0.50, mean foot length is 17.5±1.29 while at 36 weeks of gestation are 70.80±0.84 and 64.4±3.28 respectively. A strongly significant relationship has been observed between fetal foot length and gestational age by regression analysis. Conclusion: Fetal tibia length and foot length can be considered as one of the good parameter for the determination of gestational age. Keywords: Fetal tibial length, Fetal foot length, Gestational age by USG.

The aim of the article is to the determination of transverse diameter and longitudinal axis in patients with cholecystitis and with the help of CT scan in the north Indian population for the estimation of epidemiology. Patients with cholecystitis and of ages between 17-80 years irrespective of gender were included in the study (cases). All patient's cases (100) and controls (100) were advised the night before that did not eat or drink. Control groups (Normal Gallbladder) were collected when patients are comprised of other abdominal disease diagnosed by computed tomography. The mean age of controls and cases was 47.24±11.57 and 45.20±16.22 years, respectively studied by computed tomography. More than half of cases (62%) and 50% of controls were females. The transverse diameter was significantly (p=0.0001) higher among cases (36.42±15.52 mm) than controls (24.12±9.11 mm) studied by computed tomography. Longitudinal axis was significantly (p=0.0001) higher among cases (33.23±14.73 mm) than controls (21.75±8.69) studied by computed tomography. Transverse diameter>25 correctly predicted cholecystitis and by CT in 38.5% cases with sensitivity and specificity of 77% (95%CI=68.8-85.2) and 74% (95%CI=55.7-74.3%) respectively. Longitudinal axis >25 correctly predicted cholecystitis and by CT in 34.5% cases with specificity and sensitivity of 69% (95%CI=59.9-78.1) and 71% (95%CI=62.1-79.9%) respectively. We concluded in this study, increased transverse diameter and longitudinal axis were observed. Good sensitivity and specificity of these two parameters were also found in predicting cholecystitis and by computed tomography. All such cases should be subjected to biopsy for examination to rule out the gallbladder carcinoma for better prognosis.

Introduction: Communication is usually a two-way process. It is not just giving information or signaling someone; it also involves the comprehension of the information or the signal by the receiver. When the act of giving information or sending message reaches the recipient and gets comprehended by him/her and the receiver sends a feedback as desired by the sender, the process of communication is said to be complete. Communication, therefore, involves more than one person. According to a research by Press Ganey Associates Inc. The nurse patient relationship sets the tone of the care experience and has a powerful impact on patient satisfaction. Nurses spend the most time with patients. Patients are seen nurses’ interactions with others on the care team and draw conclusions about the hospital based on their observations. Without a positive nurse patient relationship, there cannot be patient and family satisfaction. Quality of communication in nursing has the highest impact on the life of the patients. Material and Method: The present study will be conducted in the St. Florence College of Nursing and Institute of medical technology and Nursing Education, Sitapura, Jaipur. In the study 300 samples were selected from the population by using simple random sampling technique. Evaluative approach and quasi experimental one group pre-test and post test design was adopted. Structured knowledge questionnaire were used to collect the data. Results: Findings revealed that the highest 50% of the B.Sc. nursing students were in the age group of 21-23 years, 80% of them were males, 80% were belongs to Hindu religion, 60% were belongs to nuclear family, 29% of the respondents father educated upto Graduate & 28% of the respondents mother educated up to senior secondary, 86% were not having previous knowledge about assertive communication and finally 42% were receiving information from their teachers. During Post-test 10.0% of the respondents have moderate knowledge level and 90.0% of the respondents have gain adequate knowledge level on Assertive Communication and Its Benefits in Nurse Patient Relationship after structured teaching program. The overall mean score was 32.20 plus or minus 4.90 in post-test of B.Sc. Nursing Students which was higher than the overall mean score 11.22 plus or minus 3.97 in pre-test. overall improvement in mean score was 20.98 (0.93) with paired t-value 91.44. The mean post-test knowledge score was significantly higher than the mean pre-test knowledge scores of B.Sc. Nursing students, t-value is 59 = 2.39, p< .0.05 level. Thus, the research hypothesis was accepted. Conclusion: Students have less moderate Knowledge level and none of them have adequate knowledge about assertive communication. So, after highly recommendation of structured teaching programme adequate knowledge level of the B.Sc. Nursing Students are high.

Highly stable symmetric and asymmetric squaraine fluorophores have been synthesized featuring an internal salt bridge between a quaternary ammonium cation and the central oxycyclobutenolate ring of the chromophore. Some of our newly synthesized symmetric and asymmetric compounds display increased molar absorptivity, quantum yield in serum, and thermal/photochemical stability over previously reported squaraine-based dyes. Consequently, both classes show great promise in resurfacing the normal environment-labile squaraine dyes as novel imaging agents and scaffolds for fluorescence sensing. Furthermore, incorporating a covalent attachment point away from the conjugated system allows for biological tagging applications without disturbing the optimum optical characteristics of the newly designed fluorophore.

Introduction: Shoulder arthroplasty offers pain relief and improvement in patients of shoulder arthritis. It need proper fixation of glenoid cavity to prevent loosening, a common cause for surgery. As glenoid cavity is small, it permits only a tight spot for limited fixation devices. So, knowledge of the morphological data of various parameters of glenoid cavity is of utter importance. Materials and Methods: An observational cross-Sectional study was done on 66 unpaired human scapulae. They belong to adult population of North India and of unknown sex. Superior-inferior diameter and Anterior-posterior diameter of maximum distance at the glenoid cavity were measured and based on these measurements index of glenoid cavity calculated. Result and Discussion: The shape of the glenoid cavity was classified on basis of the presence or absence of a notch on the glenoid rim as pear shaped, inverted comma shaped and oval shaped. All the parameters exhibit a greater value for the right side. The ethnic and racial variations could be the explanation for difference seen between the values of present study and that of other workers. The above mentioned parameters may be taken into consideration while doing shoulder arthroplasty and designing glenoid prostheses for North Indian population. Conclusion: Extensive and detail knowledge of various data of the glenoid cavity measurements is important for the anatomists, orthopaedicians, prosthetists, and anthropologists. Keywords: Glenoid cavity, Glenoid notch, Shape of Glenoid cavity, Glenoid prostheses, Shoulder arthroplasty.

Background: The antiretroviral protease inhibitor drug lopinavir (LPV) is used to treat HIV-1 infection. LPV is known to have limited oral bioavailability, which may be attributed to its poor aqueous solubility, low efficacy and high first-pass metabolism. Self-nanoemulsifying drug delivery systems (SNEDDS) for LPV have been developed and optimised to counter the current issues. Methods: The titration method was used to prepare LPV-loaded SNEDDS (LPV-SNEDDS). Six different pseudo-ternary phase diagrams were constructed to identify the nanoemulsifying region. The developed formulations were chosen in terms of globule size < 100 nm, dispersity ≤ 0.5, dispersibility (Grade A) and % transmittance > 85. Heating-cooling cycle, freeze-thaw cycle, and centrifugation studies were performed to confirm the stability of the developed SNEDDS. Results: The final LPV-SNEDDS (L-14) droplet size was 58.18 ± 0.62 nm, with polydispersity index, zeta potential, and entrapment efficiency (EE%) values of 0.326 ± 0.005, -22.08 ± 1.2 mV, and 98.93 ± 1.18%, respectively. According to high-resolution transmission electron microscopy (HRTEM) analysis, the droplets in the optimised formulation were < 60 nm in size. The selected SNEDDS released nearly 99% of the LPV within 30 min, which was significantly (p < 0.05) higher than the LPV-suspension in methylcellulose (0.5% w/v). It indicates the potential use of SNEDDS to enhance the solubility of LPV, which eventually could help improve the oral bioavailability of LPV. The Caco-2 cellular uptake study showed a significantly (p < 0.05) higher LPV uptake from the SNEEDS (LPV-SNEDDS-L-14) than the free LPV (LPV-suspension). Conclusion: The LPV-SNEDDS could be a potential carrier for LPV oral delivery.

Introduction The consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) /Coronavirus disease 2019 (COVID-19) on mothers and neonates are uncertain due to the lack of robust evidence from various available studies. Furthermore, conflicting data exist regarding the vertical transmission of coronavirus. Therefore, a hospital-based study was conducted to evaluate the effect of COVID-19 on maternal and perinatal outcomes of COVID-19 infected pregnant women. Methodology A hospital-based retrospective observational study was conducted between July-December 2020 in Rajarshi Dashrath Autonomous State Medical College, Ayodhya, Uttar Pradesh, a designated level-2 COVID-19 Hospital. A total of 37 confirmed COVID-19 positive pregnant women (mean age 27.5 ± 05 years) of more than 28 weeks of gestation were included in this study to evaluate the effect of COVID-19 on maternal and perinatal outcomes. Maternal symptoms related to COVID-19, comorbidities, intensive care unit (ICU) admissions, intrauterine growth retardation (IUGR), leaking per vagina, mode of delivery, preterm deliveries, and maternal deaths were recorded. Birth weight of newborns, neonatal intensive care unit (NICU) admissions, neonatal illness, neonatal deaths, and COVID-19 testing reports were recorded. Result Out of 37 COVID-19 positive pregnant women, 27 (72.9%) women were asymptomatic, nine (24.4%) women were having mild disease, and one (2.7%) developed severe disease requiring ICU admission. No maternal deaths were observed. Twenty-six (70.3%) women were delivered by caesarean section, 11 (29.7%) women by normal vaginal delivery, four (10.8%) were of leaking per vagina. Among newborns, five (13.5%) were preterm, one (2.7%) newborn require NICU admission, two (5.4%) were tested COVID-19 positive on the 5th day of life but were asymptomatic, and four (10.8%) newborns developed a fever but were COVID-19 negative. One case (2.7%) was of stillbirth. No neonatal deaths were observed. Conclusion The present study did not reveal any direct evidence for vertical transmission of SARS-CoV-2 virus through the placenta and during vaginal delivery, but the possibility of mother-to-child infection cannot be completely ignored. SARS-CoV-2 infection during late pregnancy may have a maternal and neonatal impact. COVID-19 infections in late pregnancy might lead to an increased incidence of caesarean deliveries as observed in the present study. This study reveals that most of the COVID-19 positive pregnant women remained asymptomatic or had mild infections. Hence, efforts to limit exposure to COVID-19 of pregnant women should be strengthened for saving mother and child.