Prolongation of the QT Interval and Post-Extrasystolic Augmentation of the TU-Wave During Emotional Stress

We present a case of a 25-year-old woman with multiple blackouts and no structural heart disease, with abnormal T-U waves and borderline QT interval on her resting electrocardiogram. During emotional stress she developed frequent monomorphic ventricular premature beats, with characteristic changes of the sinus complexes immediately following the premature beats, namely augmentation and greater degree of merging of the T and U waves and QTc interval prolongation. The changes alert about the possibility of congenital long QT syndrome, specifically genotype 2 or 1

Exclusively cephalic venous access for cardiac resynchronisation: A prospective multi-centre evaluation.

BACKGROUND: Small series has shown that cardiac resynchronisation therapy (CRT) can be achieved in a majority of patients using exclusively cephalic venous access. We sought to determine whether this method is suitable for widespread use. METHODS: A group of 19 operators including 11 trainees in three pacing centres attempted to use cephalic access alone for all CRT device implants over a period of 8 years. The access route for each lead, the procedure outcome, duration, and complications were collected prospectively. Data were also collected for 105 consecutive CRT device implants performed by experienced operators not using the exclusively cephalic method. RESULTS: A new implantation of a CRT device using exclusively cephalic venous access was attempted in 1091 patients (73.6% male, aged 73 ± 12 years). Implantation was achieved using cephalic venous access alone in 801 cases (73.4%) and using a combination of cephalic and other access in a further 180 (16.5%). Cephalic access was used for 2468 of 3132 leads implanted (78.8%). Compared to a non-cephalic reference group, complications occurred less frequently (69/1091 vs 12/105; P = .0468), and there were no pneumothoraces with cephalic implants. Procedure and fluoroscopy duration were shorter (procedure duration 118 ± 45 vs 144 ± 39 minutes, P < .0001; fluoroscopy duration 15.7 ± 12.9 vs 22.8 ± 12.2 minutes, P < .0001). CONCLUSIONS: CRT devices can be implanted using cephalic access alone in a substantial majority of cases. This approach is safe and efficient

Randomized comparison of oesophageal protection with a temperature control device: results of the IMPACT study.

AIMS : Thermal injury to the oesophagus is an important cause of life-threatening complication after ablation for atrial fibrillation (AF). Thermal protection of the oesophageal lumen by infusing cold liquid reduces thermal injury to a limited extent. We tested the ability of a more powerful method of oesophageal temperature control to reduce the incidence of thermal injury. METHODS AND RESULTS : A single-centre, prospective, double-blinded randomized trial was used to investigate the ability of the ensoETM device to protect the oesophagus from thermal injury. This device was compared in a 1:1 randomization with a control group of standard practice utilizing a single-point temperature probe. In the protected group, the device maintained the luminal temperature at 4°C during radiofrequency (RF) ablation for AF under general anaesthesia. Endoscopic examination was performed at 7 days post-ablation and oesophageal injury was scored. The patient and the endoscopist were blinded to the randomization. We recruited 188 patients, of whom 120 underwent endoscopy. Thermal injury to the mucosa was significantly more common in the control group than in those receiving oesophageal protection (12/60 vs. 2/60; P = 0.008), with a trend toward reduction in gastroparesis (6/60 vs. 2/60, P = 0.27). There was no difference between groups in the duration of RF or in the force applied (P value range= 0.2-0.9). Procedure duration and fluoroscopy duration were similar (P = 0.97, P = 0.91, respectively). CONCLUSION : Thermal protection of the oesophagus significantly reduces ablation-related thermal injury compared with standard care. This method of oesophageal protection is safe and does not compromise the efficacy or efficiency of the ablation procedure

Zone-based Manufacturing

The biggest improvement possible with productivity and profit in a manufacturing environment is to decrease the production time or cycle time and increase the takt time without any significant or no loss to product quality. But this could come at a cost of unequal work distribution if it is a people-based manufacturing process. This paper provides the best possible schedule by using a heuristic model that gives an optimal schedule. Based on jobs precedence the schedule is made to have the least possible makespan for the process at any given station in an assembly line. Furthermore, the objective is to minimize the difference of the entire duration of work allotted to each employee by an optimization model that performs an unbiased employee assignment Integer programming problem. The computational results are proven by a case study provided later in the paper

Evaluation of hepatoprotective potential of rubia cordifolia in experimentally (carbon tetrachloride) induced hepatotoxicity in albino rats

Liver is one of the largest glands of the body and the main site for intense metabolism and excretion. Liver disease is a term for a collection of conditions that adversely affect the cells, tissues, structures, or functions of the liver. &nbsp;Treatment of liver diseses with various drugs develops risk of toxicity. Rubiacordifolia is an herbal plant has, been claimed to have hepatoprotective potentials. The present study was conducted to explore the hepatoprotective activity of aqueous extract of Rubiacordifolia against carbon tetrachloride induced hepatotoxicity in albino rats. This experimental study was conducted after getting approval from institutional animal ethics committee using, routes of Rubiacordifolia in wistar albino rats (150-200g) of either sex. The hepatoprotective activity was evaluated by using histo-pathological examination. Animals were divided in to five groups with six animals in each group. Group-1 was given Normal saline (1ml/kg/day), Group-2 was injected with carbon tetrachloride (1ml/kg) i.p. only once to produce hepatotoxicity. Group-3 and Group-4 were given&nbsp;&nbsp;&nbsp; Rubiacordifolia (100mg/kg and 200mg/kg) orally every morning for 21 days followed by carbon tetrachloride (1ml/kg) i.p on 21st day (respectively)

Evaluation of hepatoprotective effect of Withania somnifera and Rubia cordifolia against carbon tetrachloride induced hepatotoxicity in albino rats

Liver is one of the largest gland of the body and the main site for intense metabolism and&nbsp; excretion. Liver is concerned with metabolism of endogenous as well as exogenous substances. “Withania somnifera” and “Rubia cordifolia” claim to have hepatoprotective action. Till now, no scientific study has been performed to evaluate such claims. This was an experiment study conducted on wistar rats, in Department of Pharmacology, Index Medical College.&nbsp; Healthy Albino wistar rats&nbsp; of either gender, weighing 150- 200g were obtained from CPCSEA approved Central Animal House. The selected rats were housed in polpropylene cages under controlled conditions of temperature (25 0C) and alternating periods of light and darkness of 12 hours each. The rats had free access to standard rat pellet diet and tap water ad libitum. After one week of acclimatization, the animals were rendered suitable for study. Pregnant female rats were not included in the study. ALT level in normal saline treated group was 29.5±3.35 IU/L. It was found to be significantly increased (p&lt;0.001) with administration of CCl4 to 433.5±48.67 IU/L

An Energy Analysis of Condenser

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An Energy Analysis of Condenser

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Evaluation of Hepatoprotective Effect of Withania Somnifera and Rubia Cordifolia Against Carbon Tetrachloride Induced Hepatotoxicity in Albino Rats

Liver is one of the largest gland of the body and the main site for intense metabolism and&nbsp; excretion. Liver is concerned with metabolism of endogenous as well as exogenous substances. “Withania somnifera” and “Rubia cordifolia” claim to have hepatoprotective action. Till now, no scientific study has been performed to evaluate such claims. This was an experiment study conducted on wistar rats, in Department of Pharmacology, Index Medical College.&nbsp; Healthy Albino wistar rats&nbsp; of either gender, weighing 150- 200g were obtained from CPCSEA approved Central Animal House. The selected rats were housed in polpropylene cages under controlled conditions of temperature (25 0C) and alternating periods of light and darkness of 12 hours each. The rats had free access to standard rat pellet diet and tap water ad libitum. After one week of acclimatization, the animals were rendered suitable for study. Pregnant female rats were not included in the study. ALT level in normal saline treated group was 29.5±3.35 IU/L. It was found to be significantly increased (p&lt;0.001) with administration of CCl4 to 433.5±48.67 IU/L