Impact of magnetic resonance imaging on arthroscopic surgeries of knee joint

Background: Though magnetic resonance imaging (MRI) is popular as a diagnostic tool, questions arise regarding imaging when clinical diagnosis of most internal derangements of knee can be done. Treatment of meniscal and anterior cruciate ligament (ACL) injuries usually involves arthroscopic surgery after MRI. But accurately performed examination with positive signs alone will be justified for arthroscopy directly without MRI. The aims and objectives of this study are to assess the impact of MRI in selecting or excluding cases which genuinely require an arthroscopic surgery. To know whether routine MRI is required pre-operatively in all cases with positive clinical findings.Methods: 60 cases underwent clinical examination of affected knee and a preliminary diagnosis was made. Further they were subjected to MRI. Results of arthroscopy were considered as definitive diagnosis and results of clinical examination and MRI were judged accordingly.Results: Of 60 patients, examination revealed 85% accuracy, 82% sensitivity, 89% specificity for ACL injuries. For medial meniscus 58% accuracy, 66% sensitivity, 48% specificity. For lateral meniscus 55% accuracy, 58% sensitivity, 50% specificity. MRI revealed 73% accuracy, 82% sensitivity, 63% specificity for ACL injuries. For medial meniscus 63% accuracy, 90% sensitivity, 39% specificity. For lateral meniscus 62% accuracy, 79% sensitivity, 50% specificity.Conclusions: Clinical examination is more sensitive, specific and accurate in diagnosis of ACL. MRI is more sensitive but less specific for meniscal injuries. Clinical examination for cruciate injuries can surpass the MRI findings. Arthroscopy can be performed without MRI in single lesion injuries. However, MRI will play a role in meniscal injuries or doubtful cases

A study to assess the utility of poison severity score, pseudocholinesterase levels and Glasgow coma scale in predicting severity and clinical outcome of organophosphorus poisoning

Background: Suicides due to organophosphate self-poisoning is a major cause of concern world over. Organophosphate compounds (OP) possess a major cause of suicide in India.  There is a greater need for tools to predict severity of OP poisoning. We in this study try to assess the utility of the Glasgow coma scale (GCS), pseudocholinesterase levels and the poisoning severity score (PSS) in estimating severity and clinical prognosis of OP poisoning in patients of south India.Methods: A prospective study was conducted over 2 years in department of medicine, KIMS hospital and research centre, patients who were >18 years of age were included. OP poisoning was determined by either history of consumption or clinical features. Pseudocholinesterase levels at admission, PPS and GCS scores were assessed at admission and at 24 hours. Clinical, demographical, and certain laboratory investigation were recorded. Patients were followed till the patient stayed in intensive care unit.Results: In present study 100 patients were enrolled. Significant association was observed between GCS (p<0.001), PSS (p<0.001) and outcome of OP poisoning. Unexpectedly no significant association was observed with pseudocholinesterase level (p=0.118). A total of 83% patients were improved after treatment and mortality rate observed was 17%. Out of these 83% severe complications were observed in 14% of the patients.Conclusions: The findings of this study highlight the usefulness of GCS and PSS systems for predicting severity of OP poisoning. Identification of severity at an early stage followed by prompt treatment can prevent deaths. Our study did not find any association between pseudocholinesterase levels at admission and severity of OP poisoning

Incidence, determinants and outcomes of ventilator associated pneumonia in medical intensive care unit: a prospective cohort study from South Western India

Background: Ventilators are being increasingly used in developing countries as a result of which complications like ventilator associated pneumonia is also increasing. Present study is being undertaken to evaluate the impact of risk factors and their changing trends for Ventilator associated pneumonia.Methods: A prospective observational study was conducted in mechanically ventilated patients of medical intensive care unit from October 2013 to April 2015.Results: In present study 166 patients receiving mechanical ventilation in a medical ICU were observed. Incidence of VAP in present study is 43.5 for 1000 days of mechanical ventilation. The risk factors that were significant in the study are organ failure (p=0.001), emergency intubation (p=0.001), reintubation (p=0.023) and COPD (p=0.026). The common organisms responsible for VAP were Acinetobacter (30%), Klebsiella pneumoniae (27.1%) and Pseudomonas aeruginosa (20%). The mortality was higher in VAP group (31.3%) compared to the non VAP group (15.7%).Conclusions: There is high incidence of VAP in the developing countries. The risk factors that were found to be associated with VAP in the present study were the presence of COPD, reintubation, organ failure and emergency intubation. VAP is associated with significantly increased duration of hospital stay, morbidity and mortality

IN VITRO ANTIOXIDANT, ANTIMICROBIAL AND ADMET STUDY OF NOVEL FURAN/BENZOFURAN C-2 COUPLED QUINOLINE HYBRIDS

Objectives: Synthesis of novel 2-(benzofuran-2-yl) and 2-(furan-2-yl) quinoline-4- carboxylates and their [2-(1-benzofuran-2-yl) quinolin-4-yl] methanol, [2-(1-furan-2-yl) quinolin-4-yl] methanol and its derivatives for antioxidant, antimicrobial and ADMET study.Methods: Synthesis was carried with conventional method and the structures were confirmed by IR, 1H NMR, 13C NMR and mass spectral analysis. The antioxidant activity was performed by DPPH and H2O2 radical scavenging method. Antimicrobial investigation was established by cup plate and food poison technique. The in silico absorption, distribution, metabolism, excretion and toxicity (ADMET) study of the drug was carried out in ACD/lab-2.Results: The antioxidant activity results revealed that, compounds 4b-c, 5a-b, 10c and 10f exhibited good DPPH radical and hydrogen peroxide scavenging activity. The antibacterial results revealed that, compounds 4c, 5a-b, 10b, 10d and 10f exhibited good activity against Escherichia coli, Klebsiella pneumonia and Salmonella typhimurium. Further, the antifungal activity results showed that, compounds 4c, 5c and 10c-e were showing good activity against Aspergillus flavus and Candida neoformans.  The mean value of P<0.05 were considered to be statistically significant. The ADMET results revealed that compounds emerged as a potential candidate for antioxidant and antimicrobial agents.Conclusion: The study reveals that compounds containing furan/benzofuran coupled heterocycles are play the important role for activity as they possess potent antioxidant and antimicrobial agents. The in silico ADME analysis also suggesting the compounds were in acceptable range to obey the pharmacokinetic parameters.Â

Comparative Review on Energy Management for Hybrid Electric Vehicles in Smart Cities

This paper reviews different ways to manage energy in Hybrid Electric Vehicles (HEVs) for smart cities by looking at three separate studies. Initially, it explores a structured approach to solving energy management issues in HEVs, comparing three known methods and highlighting one that can be used in real-time. Next, it discusses a creative use of Petri Nets (PNs) for managing energy, either on its own or with the Global Positioning System (GPS). This part points out the benefits of using GPS to manage energy better during different driving conditions. Lastly, the paper talks about the need to improve energy management in a specific type of HEV to address current environmental and energy challenges. It mentions the use of a Genetic Algorithm (GA) to improve energy management strategies, aiming to extend the life of the vehicle’s fuel cell and improve energy efficiency. Through these discussions, this review aims to provide a clear understanding of how energy management in HEVs can be improved in smart city settings

A systematic quantitative literature review of aquaculture genetic resource access and benefit sharing

The Convention on Biological Diversity provides a framework for countries to implement laws regulating the access, use and exchange of genetic resources, including how users and providers share the benefits from their use. While the international community has been preoccupied with resolving the unintended effects of access and benefit sharing (ABS) on domestication in agriculture for the past 25 years, its far-reaching consequences for global aquaculture has only recently dawned on policymakers, aquaculture producers and researchers. Using a systematic quantitative literature review methodology, we analysed the trends, biases and gaps in the ABS literature. Only 5% of the ABS literature related to the use and exchange of aquaculture genetic resources. Most of this literature related to use in developing countries or global use, but its authors were predominantly from developed countries. The literature covered a narrow range of countries (7) and regions (3), a narrow range of taxonomic groups (9) and a narrow range of uses. Given that aquaculture is the fastest growing global food production sector with products primarily from developing countries using over 580 species, there are significant gaps in aquaculture-related ABS literature. We conclude that the sector needs urgent analyses on the consequences of ABS restrictions, obligations and opportunities for its early stages of domestication and product development. We recommend priority areas for attention to ensure that rapidly evolving national ABS laws take into account the special characteristics and needs of the aquaculture sector

Morphometric Analysis of Chilenahalli Micro-watershed in the North-eastern Dry Zone of Karnataka using GIS and Remote Sensing Techniques

The structure and landform of watershed and their associated stream networks are described mainly by their morphometric parameters and Watershed analysis based on morphometric parameters is very important for watershed planning, since it gives an idea about the basin characteristics regarding slope, topography, soil condition, runoff characteristics, surface water potential and quantify the linear, areal and relief aspects of watershed. Geographic information system and remote sensing techniques were employed for the identification of morphological features, drainage pattern and its planning in basin area. The Shuttle Radar Topography Mission (SRTM) digital elevation model (DEM) 30m resolution was used to digitize study watershed and generate drainage pattern and analysis done using GIS software and excel spreadsheet. The study reveals that Chilenahalli micro-watershed designated as 4thstream order and drainage indicate dendritic pattern with mature geomorphic stage and stream order verifies the Horton’s law of stream number. The Mean Bifurcation Ratio was found to be 4.46, which indicates low rainfall, shallow weathering and low dissection of the valley and it shows low to medium relief aspect during investigation of the basin. This can be visualised using DEM, relief ratio, ruggedness number, and slope maps of the study area. The drainage density was found to be 2.13 km/km2which indicate a low class Dd value, thereby indicating a poorly drained watershed with low response to hydrological parameters. The texture ratio of the micro-watershed is 3.52, which indicated coarse texture of drainage basin and the values of Form Factor, Circulatory ratio and Elongation ratio may imply an oval shape of the basin with a slightly elongated main stream and the length of overland flow values in this study is 0.23 km which shows moderate infiltration and percolation characteristics of soil. The study which also helps in planning erosion control strategy, prioritization of watershed and management practices for soil and rainwater conservation. The research study helps to formulate the selection and adoption of crop management practices by preparing soil map of the watershed in future

VIBRATION LEVEL OPTIMIZATION OF LATHE MACHINE BY CONSIDERING NONLINEARITIES IN VIBRATION PAD: AN OVERVIEW

Shock and vibration often result in instantaneous transcendental damage and fatigue failure of structure, performance failure of instrument, overall performance drop of structure and poor dynamic characteristics of equipment. Therefore vibration isolation is most important thing in any machine. Vibrations Pads are used to reduce noise and vibration and to eliminate the need for bolting down.Visco elastic materials are used for the purpose of vibration isolation. This is one of the lowest and easy methods to reduce vibration of machine. It also helps to reduce noise. This paper tries to give an idea about the previous researches and their findings about the study of noise and vibration isolation methods

Performance of Ternary Binder Blend Containing Cement, Waste Gypsum Wall Boards and Blast Furnace Slag in CLSM

AbstractControlled low strength materials (CLSM), is a self-flowing cementitious backfill material, most suitable for sustainability objectives since it makes use of wastes in large quantities. Wasted gypsum wall boards (drywalls), a construction & demolition waste, are known to pollute atmosphere by releasing harmful H2S gas when dumped at landfills. Use of waste drywalls with flyash, as cement replacement in concrete and CLSM, have resulted in low strength mixes at initial & later ages, respectively. In this paper powdered drywalls with ground granulated blast furnace slag (GGBS), was used as secondary cementitious material along with stone dust as fine aggregates, to produce sustainable CLSM mixtures with varying binder ratios and water contents. Reduction in compressive strength at later ages was not observed for mixes with low water contents, hence use of GGBS instead of flyash with lesser water contents, is effective in resisting detrimental effects of sulfates present in drywalls