Effect of drains on dynamic proprioception after arthroscopically assisted anterior cruciate ligament reconstruction

Background: Decrease in proprioception and kinesthesia occurs after ACL injury. Changes occurring within the joint following injury affect normal recruitment and firing patterns of the surrounding musculature. There are little data in the literature with reference to drain use after arthroscopic procedures on the knee or ACL reconstruction. The objective of the study was to determine the effect of postoperative drain use on proprioception after arthroscopically assisted anterior cruciate ligament (ACL) reconstruction with quadrupled hamstring graft.Methods: In this study, 54 arthroscopic ACL reconstruction patients were randomized for either intra-articular suction drain group or non-drain group. Outcome Assessment was done at 1 month, 3, 6 and 12 months after the surgery in which patients were assessed using Star excursion balance test by measuring excursion distances in each of the 8 directions.Results: Excursion distances in eight directions showed more increment in drainage tube (DT) group compared to no DT group. However it was found to be statistically significant only for posteromedial (p =0.018) and medial directions (p <0.001).Conclusions: Postoperative drain should be used after arthroscopically assisted anterior cruciate ligament (ACL) reconstruction with quadrupled hamstring graft for improving the deficits in dynamic posture control

Simulative analysis of enhanced data rate using light wave system

For next generation network required that high data rate along the good quality of service ,when data rate is increased losses are also increased. At the high data rate, dispersion is occurred so that we need dispersion compensating techniques. in this paper we will vary the data rate at adequate level. our link designing is without using dispersion compensating techniques. Transmission distance is several hundred of kilometre has been used. The performance characteristics like that that maximum bit error rate yields for different data variation. DOI: 10.17762/ijritcc2321-8169.15085

Comparison of arthroscopic partial meniscectomy with physical therapy alone co existing meniscal tear and knee osteoarthritis

Background: In patients with a meniscal tear and mild-to moderate osteoarthritis, we analyzed whether arthroscopic partial meniscectomy improve physical and functional outcomes more than physical therapy does.Methods: 52 patients had a meniscal tear as well as osteoarthritis confirmed by magnetic resonance imaging or radiography. Symptoms had persisted for more than 3 months despite conservative measures. Patients were allocated to Group A subjected to partial meniscectomy and postoperative physical therapy (n=26) or to Group B with physical therapy alone (n=26). The primary outcome measure was change on the physical-function scale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) during the 6 months after randomization. A 12-month assessment was added to determine the stability of the result. Secondary outcomes were the pain score on the Knee Injury and Osteoarthritis Outcome Score (KOOS).Results: At 6 months, the 2 groups did not differ in mean improvement in the WOMAC physical-function score, in decreases on the KOOS pain score. The results were similar at 12 months. Conclusions: In patients with a meniscal tear and mild-tomoderate osteoarthritis, both groups showed similar outcomes between arthroscopic meniscectomy and physical therapy

Tie-line modelling in interconnected synchrophasor network for monitoring grid observability, cyber intrusion and reliability

The incorporation of a tie-line between two areas may be beneficial in two ways. First, the reserve capacity of the assisting area support to the assisted area, and second, the number of Phasor Measurement Unit (PMU) requirements will become smaller for complete observability of the interconnected grid. The objective function is formulated to integrate the observability and reliability analysis for the two interconnected synchrophasor networks. The effect of Zero Injection Bus (ZIB) is included in the observability constraints to reduce the number of PMUs deployed in the system. The number of optimal PMU deployments will be greater for two interconnected systems in comparison with a single area. Therefore, interconnected systems become more vulnerable to cyber risk. The paper discusses the cumulative analysis of system observability and reliability during an anomaly situation that occurs with a PMU device due to a cyber-attack. The reliability indices Interconnected System Load Interruption Probability (ISLIP) and Interconnected System Demand Not Supplied (ISDNS) are evaluated when an anomaly occurs with optimally deployed PMU in the network by including and excluding the effect of ZIB. By doing so, the most reliable location for PMU deployment can be obtained for both the area. Reliability Test System (RTS)-24 bus is used for each area to modify the test system by incorporating tie-lines between them

Self-Addressable Memory-Based FSM: A Scalable Intrusion Detection Engine

One way to detect and thwart a network attack is to compare each incoming packet with predefined patterns, also called an attack pattern database, and raise an alert upon detecting a match. This article presents a novel pattern-matching engine that exploits a memory-based, programmable state machine to achieve deterministic processing rates that are independent of packet and pattern characteristics. Our engine is a self-addressable memory-based finite state machine (SAMFSM), whose current state coding exhibits all its possible next states. Moreover, it is fully reconfigurable in that new attack patterns can be updated easily. A methodology was developed to program the memory and logic. Specifically, we merge non-equivalent states by introducing super characters on their inputs to further enhance memory efficiency without adding labels. SAM-FSM is one of the most storage-efficient machines and reduces the memory requirement by 60 times. Experimental results are presented to demonstrate the validity of SAM-FSM

Occupational Health in the Digital Age: Implications for Remote Work Environments

In this digital age, where working from home is becoming more common, the patterns of workplace health are changing in ways that require a thorough analysis of the effects on employee health. This study looks into the many parts of job health in places where people work from home, looking at how technology, human behavior, and company rules interact.The digital age has made work plans more flexible than ever before, letting workers do their jobs from anywhere. This paradigm shift has some benefits, like making things more flexible and easy to access, but it also brings a lot of problems that need to be carefully thought through. Long-term use of digital devices can be bad for your body, and being alone at work can be bad for your mental health. Remote work situations have their own health issues that need a unique approach.This study brings together different pieces of research on workplace health to highlight the new health risks that come with the digitalization of work. There is a close look at how technology can help or hurt employee health and a study of how companies can lower health risks in remote work settings.Additionally, the study looks into the possible long-term effects of long-term remote work on mental and physical health, as well as how well present workplace health systems can adapt to the changing nature of work. By critically evaluating the intersection of technology and health, this study provides valuable insights for policymakers, organizations, and individuals seeking to optimize the well-being of remote workers in the digital age

Variations in coronary artery diameter: a retrospective observational study in Indian population

Objective: The diameter of coronary arteries varies greatly among general population. The knowledge of variations in coronary arteries helps the clinicians to define abnormalities and plan the treatment. Hence, the present study was aimed to study common primary variations of coronary arteries by angiography in Indian population. Methods: The data for this unicenter, retrospective, observational study was collected from general hospital, Maharashtra, as patient data sheets and coronary angiograms (CAG) reports for a period of 1 year and 8 months. The CAG were studied for variations in main trunk diameter of coronary arteries and range of diameters of coronary arteries. Results: A total of 400 conventional CAGs were observed, of which 17 angiograms showed anatomical variations. The diameter of left coronary artery was more than right coronary artery (RCA) in 90.5% and less in 9.5% of CAGs. Statistically significant difference was observed on comparing the mean diameter of RCA (3.40(0.81 mm) and left coronary artery (4.52(0.95 mm; p<0.001). The range of diameter of RCA (1.8 to 6.2 mm) and left coronary artery differed significantly (2 to 7.3 mm; p <0.001). Conclusion: From the results, it was evident that the diameter of left coronary artery was larger than right coronary artery in majority of CAGs

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary.

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Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

Aims The objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM). Methods and results ASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction). Conclusion This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without D