Environmental Stress Cracking of Interior Polymers used in the car

The thesis project was about testing of polymers used in the interiors of the cars - ABS and PC/ABS for resistance to cracking due to environmental stress conditions. This includes testing cracking/crazing of the materials when the stress is applied on the material (below yield point) and the materials are exposed to different chemicals and at different temperature levels. The thesis was performed at Volvo Car Corporation, Sweden

Skeletal muscle modulation and functional recovery after colonic resection

Introduction: Colorectal cancer surgery involves a period of recovery in hospital followed by convalescence at home. Enhanced recovery programs, in particular the use of laparoscopic surgery have reduced length of inpatient stay. Knowledge regarding the impact of surgery upon functional recovery is lacking. Loss of lean muscle mass and strength may compromise function. We conducted two studies (1) To assess skeletal muscle modulation and functional recovery after potentially curative colon cancer surgery, comparing traditional open surgery (OS) with laparoscopic (LS) techniques and (2) To review return to work (RTW) 1 year post colorectal cancer surgery. Methods: (1) A prospective longitudinal observational study was conducted at a single UK institution (April 2013 and December 2014). Participants undergoing OS and LS for colon cancer were recruited preoperatively and assessed over 6 months. The study was powered to changes in hand grip strength (minimum sample size of 24 patients in each group), and included analysis of serological inflammatory markers (granulocyte lymphocyte ratio (GLR)); muscle architecture (pennation angle (PA), muscle thickness (MT) and fascicle length (FL)), muscle protein synthesis rate and assessment of function (numerical pain score, dukes activity status index (DASI)) and health status (EQ5d5L). (2) A retrospective cohort questionnaire study was conducted. A specific questionnaire was created and dispatched to 204 patients who had undergone surgery with curative intent for colorectal cancer within a single teaching hospital in 2011-2012. Results: (1) Fifty-three patients (OS n=27; LS n=26) were recruited with no statistical differences between groups (age, sex, body mass index, tumour stage, blood loss). LS associated with longer mean operating time (182.5mins v 142.1mins, p<0.05), fewer complications (p<0.05) and shorter length of stay (3 days v 5 days, p<0.05). Hand grip decreased post surgery (maximum decrease day 3 (OS 24% v LS 15%, p<0.05), with OS data significantly lower at 2, 4 and 6 weeks (p<0.05)). GLR peaked on day 1 post surgery with no difference between groups at any time point. Muscle architecture assessment noted OS associated with decreased MT (8% v 1%, p<0.05) and PA (6% v 1%, p<0.05) at 4 and 6 weeks post surgery. Muscle protein synthesis rate for OS was 1.02±0.02%/day. OS pain scores were significantly higher at 2, 4 and 6 weeks (p<0.05). EQ5d5L and DASI scores were significantly lower for OS at 2, 4, 6 weeks and 6 months (p<0.05). (2) Response rate was 75% (OS=82%, LS=51%). LS reported earlier 'return to full fitness' (1-3 months) than OS (>6 months; p<0.05). Recovery from LS was 'better than expected' compared to OS 'worse than expected' (p<0.05). Forty-nine patients were employed preoperatively and 61% (n=30) returned to work. RTW was more frequent after LS (p<0.05). Length of time to RTW was significantly less after LS [44 (6-84) days] than OS [71 (14-252) days] (p<0.05). Conclusions: OS was associated with increased loss of strength, muscle mass and reduced MPS in the first six weeks after surgery, together with poorer functional recovery including RTW. One-third of patients failed to RTW 1 year post colorectal cancer surgery. We must invest more in managing expectations and provide better post discharge support to improve long term functionality

Effect of slant angle variation on the drag force for Ahmed body car model

In this paper, numerical investigation is carried out on two-dimensional Ahmed body model using Computational Fluid Dynamics in ANSYS Fluent 19.1. The 2-D model is designed in Catia v5 for 25°, 35° and 45° slant angles. The turbulent model used to analyze the flow dynamics is Realizable k-ε model. The drag coefficient variation with respect to slant angle is computed. The skin friction coefficient, wall shear stress and frictional velocity are also calculated

Disseminated cysticercosis: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Cysticercosis is a common tropical disease. One of the uncommon manifestations of cysticercosis is its disseminated form.</p> <p>Case presentation</p> <p>We report an immunocompetent patient with disseminated cysticercosis, who had involvement of the brain, subcutaneous tissues, skeletal muscles, right orbit and thyroid gland. In addition, this patient developed a serum sickness which responded to therapy.</p> <p>Conclusion</p> <p>Wide spread dissemination is a rare complication of cysticercosis. A planned approach to therapy is required.</p

Prognostic Significance of Blood Glucose Levels and Alterations Among Patients with Aluminium Phosphide Poisoning

Objectives: This study aimed to assess the prognostic significance of blood glucose levels and blood glucose alterations (i.e. hyper- or hypoglycaemia) among patients with aluminium phosphide (AlP) poisoning. Methods: This prospective observational study was conducted at the Postgraduate Institute of Medical Education &amp; Research, Chandigarh, India, between January 2010 and June 2011. All patients presenting to the emergency department with a definitive history of AlP ingestion or symptoms compatible with AlP poisoning were included in the study. Blood glucose levels were recorded at presentation and every six hours thereafter. Alterations in blood glucose levels and other clinical and laboratory variables were subsequently compared between survivors and non-survivors. Results: A total of 116 patients with AlP poisoning were identified. Of these, 57 patients (49%) survived and 59 patients (51%) died. At presentation, the mean blood glucose levels of survivors and non-survivors were 119.9 ± 35.7 mg/dL and 159.7 ± 92.5 mg/dL, respectively (P &lt;0.001). In comparison to the survivors, non-survivors had significantly higher heart rates, total leukocyte counts, blood glucose level alterations and serum creatinine levels (P &lt;0.050). In addition, systolic blood pressure, Glasgow coma scale scores, arterial blood gas pH and bicarbonate values and duration of hospital stay was significantly lower compared to survivors (P &lt;0.001). However, neither blood glucose levels at admission nor blood glucose alterations correlated independently with mortality in a multivariate analysis. Conclusion: The role of blood glucose level alterations in predicting patient outcomes in AlP poisoning cases remains inconclusive. Further studies with larger sample sizes are required.Keywords: Aluminum Phosphide; Poisoning; Blood Glucose; Hyperglycemia; Hypoglycemia; Mortality; Prognostic Factors; India

Head nodding: An unusual presentation of congenital brain tumor

Congenital brain tumors (CBTs) in neonates are defined as tumors presenting within 60 days after birth. Teratoma is the most common type of CBT. A 37-day-old baby was presented to pediatric emergency with complaints of difficulty in breathing, refusal of feed, and lethargy. The baby had continuous head nodding, drooling of saliva, and slight hypotonia of lower limbs which mother, then confirmed, was present since birth. There was a history of admission to another hospital with similar complaints at day 15 of life, where the child was discharged after 5 days of hospitalization with a diagnosis of nasal block. Magnetic resonance imaging brain showed a large mass located centrally suggestive of either pilocytic astrocytoma or medulloblastoma. The patient expired after 6 months in a private hospital. The present case report aims to focuse the importance of an early diagnosis based on the clinical presentation and imaging studies followed by timely intervention which is critical as the prognosis is very poor

Importance of pesticides for lethal poisoning in India during 1999 to 2018: a systematic review

BACKGROUND: Poisoning is a major problem in India. However, there is little systematic information on the key poisons responsible for most deaths by geographical area and over time. We aimed to review the literature to identify the poison classes causing the greatest number of deaths in India over the last 20 years. METHODS: We performed a systematic literature review in Medline, Embase and Google Scholar (1999–2018), and Indian online medical journals, to find papers that reported deaths from all forms of poisoning in India, with last search 20 April 2020. We included epidemiological studies, observational studies, randomised trials, interventional studies, and case series published from 1999 to 2018 that showed the number of deaths and autopsy studies indicating the specific poisons or poison classes. Studies providing the case fatality for specific poisons or classes, which enabled calculation of the number of deaths, were also included. We excluded deaths due to animal bites and stings, ethanol or methanol poisoning, and gas inhalation as well as papers reporting a single death (case study of single patient). We grouped the papers into 5-year intervals and identified the two most common poison classes in each paper. We used descriptive statistics to summarise the findings over time based on the causative poison and the location of the study. RESULTS: We identified 186 papers reporting 16,659 poisoning deaths between 1999 and 2018. The number of publications per 5-year interval showed no clear trend over the period (48, 38, 67, and 36 for consecutive periods). Half of the deaths (n = 8338, 50.0%) were reported during the first 5 years of the study (1999–2003), the number of deaths declining thereafter (to n = 1714 in 2014–2018). Deaths due to pesticide poisoning (94.5%) were dominant across the study period compared to other classes of poison [hair dye paraphenylenediamine poisoning (2.6%), medicine overdose (1.4%) or plant poisoning (1.0%)]. Among the pesticides, aluminium phosphide was the most important lethal poison during the first 10 years before declining markedly; organophosphorus insecticides were important throughout the period, becoming dominant in the last decade as aluminium phosphide cases declined. Unfortunately, few papers identified the specific organophosphorus insecticide responsible for deaths. CONCLUSION: Use of the published literature to better understand the epidemiology of lethal poisoning in India has clear limitations, including secular variation in publishing practices and interest in poisoning. Unfortunately, there are no long-term detailed, combination hospital and community studies from India to provide this information. In their absence, our review indicates that pesticides are the most important poison in India, with organophosphorus insecticides replacing aluminium phosphide as the key lethal poison after government regulatory changes in 2001 reduced the latter’s lethality. Plant and hair dye poisoning and medicines overdose caused few deaths. Aluminium phosphide deaths mostly occurred in northern Indian states, whereas deaths from organophosphorus insecticide poisoning occurred throughout India. Paraquat poisoning has become a clinical problem in the last 10 years. Lethal pesticide poisoning remains alarmingly common, emphasising the need for additional regulatory interventions to curtail the burden of pesticide poisoning deaths in India. More detailed reporting about the specific pesticide involved in lethal poisoning will be helpful to guide regulatory decisions

Role of neostigmine and polyvalent antivenom in Indian common krait (Bungarus caeruleus) bite

SummaryBungarus caeruleus (Indian common krait) bite during monsoons is common in Northwest India. This study was undertaken to find the effectiveness of neostigmine and polyvalent antivenom in improving neuromuscular paralysis following bite. All the consecutive patients admitted between June 2007 and December 2008 with common krait bite, identified either from brought snake or circumstantial evidence were studied. Ten vials of polyvalent antivenom and three doses of 2.5mg neostigmine at 30min intervals after administration of 0.6mg of atropine were administered I.V. and patients were assessed for any improvement in neuroparalysis. Seventy-two patients were admitted during the study period. All the patients except two came from rural areas and were brought between June and September. Sixty-two patients were bitten during the day while clearing bricks, cutting grass or walking. The mean time interval between bite and arrival to hospital was 4.5h. None of the patients showed any improvement following treatment and all patients developed respiratory paralysis, requiring assisted ventilation. Seventy survived and two died. Neostigmine is ineffective in reversing or improving neuroparalytic features in patients with B. caeruleus bite even at higher dose than normally recommended

Chronic brucellosis with hepatic brucelloma and AA amyloidosis in a patient with autosomal dominant polycystic kidney disease

We describe an autopsy case of a 45-year-old male diagnosed with autosomal dominant polycystic kidney disease who presented with complaints of altered sensorium. The autopsy revealed multiple tumor-like masses in the liver, which on histological examination depicted multiple large suppurative granulomas with the presence of variable acid-fast coccobacilli (consistent with Brucella spp.). Interestingly, extensive amyloid deposition in multiple organs was noted. To the best of our knowledge, this is the first case of chronic brucellosis causing tumor-like abscesses in the liver accompanied by secondary systemic amyloidosis in a patient with underlying autosomal dominant polycystic kidney disease

Pulmonary lymphoma mimicking metastases: a case report

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