A Novel approach for optimization in Mathematical calculations using Vedic Mathematics Techniques

Vedic Mathematics is the name given to the ancient system of mathematics, or to be precise, a unique technique of calculations based on simple rules and principles with which any mathematical problem can be solved – be it arithmetic, algebra, geometry or trigonometry. The system is based on 16 Vedic sutras or aphorisms, which are actually word formulae describing natural ways of solving a whole range of mathematical problems. In this paper, we will be taking a few Vedic sutras. Akadhiken Purven (By one more than the one before), Nikhilam Navtashcharam Dashat (All from 9 and the last from 10) are two of them. NASA has adopted it fully in the realms of advanced robotics. Calculations that can be solved as quick as lightning are a great tool to adopt, but you wouldn’t want to teach it worldwide in the fear that you may churn out a generation of child geniuses that may threaten the intellectual status quo. The gift that the Hindus gave to the world, thousands of years ago, and that which is currently responsible for global silicon chip technology, was none other than the invention of zero and the use of the decimal point. We call our common numbers “Arabic Numerals” but really they extend back to the Hindu concept of creation and were known as “Bindu” or Unity. All Vedic Maths is based on the understanding of Unity Consciousness which means they utilize processes or Number Bases that correspond to 0, 10, 100, 1000, 10000, etc all of which add to 1. In light of the fact that the Vedas, literally “the illimitable storehouse of All Knowledge” came under 4 headings or categories like the Rig Veda, the Yajur Veda, the Sama Veda, and the Atharva Veda. Thus a Vedic Mathematician was also an astronomer, healer, and poet. It was a total system if you are out in the field and you need to tile a square floor that is, say 108 units square. How do you do it with mental ease? I think only of the excess “8”, saying how much is 108 more than my Base of 100. It is “8”. So we will merely add this “8” to the number in question “108” and tag on the squaring of this excess: 108 Squared = 108 + 8 / 8×8 = 116 / 64 = 11,664.Vedic mathematical methods are derived from ancient systems of computations, Compared to conventional mathematical methods, these are computationally faster and easier to perform. An application of Vedic mathematics can be effectively increased if it can make available to the beginners in various fields of study

Outcomes of Transcatheter Aortic Valve Replacement in Patients With Cardiogenic Shock

AIMS: The safety and efficacy of transcatheter aortic valve replacement (TAVR) with contemporary balloon expandable transcatheter valves in patients with cardiogenic shock (CS) remain largely unknown. In this study, the TAVRs performed for CS between June 2015 and September 2022 using SAPIEN 3 and SAPIEN 3 Ultra bioprosthesis from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry were analysed. METHODS AND RESULTS: CS was defined as: (i) coding of CS within 24 h on Transcatheter Valve Therapy Registry form; and/or (ii) pre-procedural use of inotropes or mechanical circulatory support devices and/or (iii) cardiac arrest within 24 h prior to TAVR. The control group was comprised of all the other patients undergoing TAVR. Baseline characteristics, all-cause mortality, and major complications at 30-day and 1-year outcomes were reported. Landmark analysis was performed at 30 days post-TAVR. Cox-proportional multivariable analysis was performed to determine the predictors of all-cause mortality at 1 year. A total of 309 505 patients underwent TAVR with balloon-expandable valves during the study period. Of these, 5006 patients presented with CS prior to TAVR (1.6%). The mean Society of Thoracic Surgeons score was 10.76 ± 10.4. The valve was successfully implanted in 97.9% of patients. Technical success according to Valve Academic Research Consortium-3 criteria was 94.5%. In a propensity-matched analysis, CS was associated with higher in-hospital (9.9% vs. 2.7%), 30-day (12.9% vs. 4.9%), and 1-year (29.7% vs. 22.6%) mortality compared to the patients undergoing TAVR without CS. In the landmark analysis after 30 days, the risk of 1-year mortality was similar between the two groups [hazard ratio (HR) 1.07, 95% confidence interval (CI) 0.95-1.21]. Patients who were alive at 1 year noted significant improvements in functional class (Class I/II 89%) and quality of life (ΔKCCQ score +50). In the multivariable analysis, older age (HR 1.02, 95% CI 1.02-1.03), peripheral artery disease (HR 1.25, 95% CI 1.06-1.47), prior implantation of an implantable cardioverter-defibrillator (HR 1.37, 95% CI 1.07-1.77), patients on dialysis (HR 2.07, 95% CI 1.69-2.53), immunocompromised status (HR 1.33, 95% CI 1.05-1.69), New York Heart Association class III/IV symptoms (HR 1.50, 95% CI 1.06-2.12), lower aortic valve mean gradient, lower albumin levels, lower haemoglobin levels, and lower Kansas City Cardiomyopathy Questionnaire scores were independently associated with 1-year mortality. CONCLUSION: This large observational real-world study demonstrates that the TAVR is a safe and effective treatment for aortic stenosis patients presenting with CS. Patients who survived the first 30 days after TAVR had similar mortality rates to those who were not in CS

Management of Patients with Refractory Cardiogenic Shock and Cardiointestinal Syndrome with Impella 5.5 as Bridge to Decision: Case Series

Patients with advanced heart failure require multi-system management as a majority succumb to end-organ dysfunction, including gastrointestinal sequelae. Temporizing measures, such as early mechanical circulatory support, can assist in the recovery of patients with acute cardiogenic shock. The temporary support can improve patient characteristics to enable future definitive heart failure therapies such as durable left ventricular assist devices and orthotopic heart transplantation. We present two cases of cardiogenic shock that were successfully bridged with an Impella 5.5 (Abiomed). The management enabled the patients to recover from reversible cardiointestinal syndrome and undergo successful definitive therapies

Special Considerations in the Care of Women With Advanced Heart Failure

Advanced heart failure (AHF) is associated with increased morbidity and mortality, and greater healthcare utilization. Recognition requires a thorough clinical assessment and appropriate risk stratification. There are persisting inequities in the allocation of AHF therapies. Women are less likely to be referred for evaluation of candidacy for heart transplantation or left ventricular assist device despite facing a higher risk of AHF-related mortality. Sex-specific risk factors influence progression to advanced disease and should be considered when evaluating women for advanced therapies. The purpose of this review is to discuss the role of sex hormones on the pathophysiology of AHF, describe the clinical presentation, diagnostic evaluation and definitive therapies of AHF in women with special attention to pregnancy, lactation, contraception and menopause. Future studies are needed to address areas of equipoise in the care of women with AHF

Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the Global Burden of Disease Study

18% of the world's population lives in India, and many states of India have populations similar to those of large countries. Action to effectively improve population health in India requires availability of reliable and comprehensive state-level estimates of disease burden and risk factors over time. Such comprehensive estimates have not been available so far for all major diseases and risk factors. Thus, we aimed to estimate the disease burden and risk factors in every state of India as part of the Global Burden of Disease (GBD) Study 2016

Transcatheter Interatrial Shunts for the Treatment of Heart Failure with Preserved Ejection Fraction

Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome, which accounts for about 50% of patients with heart failure (HF). The morbidity and mortality associated with HFpEF is similar to HFrEF. Clinical trials to date have failed to show a benefit of medical therapy for HFpEF, which may due to lack of uniform phenotypes and heterogeneous population. In addition, medical therapy proven for HFrEF may not address the pathophysiologic basis for HFpEF. Left atrial remodeling and dysfunction is central to HFpEF and accounts for secondary pulmonary hypertension and pulmonary vascular congestion that frequently occurs with exertion. Interatrial shunts represent a novel treatment modality for HFpEF. These shunts allow for left atrial decongestion and a reduction in pulmonary venous hypertension during exercise leading to improvements in hemodynamics, functional status and quality of life. Trials to date have demonstrated safety and short-term efficacy of these devices for HFpEF. The long-term benefits are currently being evaluated in ongoing trials. If effective, the use of interatrial shunts may be a new therapeutic paradigm for the treatment of HFpEF

A Hospital Based Prospective Study to Assess the Early Lactate Clearance For Predicting Hospital Mortality of Children with Sepsis

Background: Sepsis is one of the most common and deadly diseases worldwide. It is characterized by a life-threatening “disproportionate” immune response to infection, with high mortality. Lactate is known to play a major role in energy production and cellular metabolism. Hence, the present study was undertaken for assessing the role of early lactate clearance for predicting n hospital mortality children with sepsis. Martials &Methods: Assessment of all the patients of the pediatric ICU was done. A total of 50 sepsis patients were enrolled. Complete demographic and clinical details were obtained. Lactate levels were measured in arterial blood using a blood gas analyser at different time intervals. Outcome was recorded. All the results were summered and were subjected to statistical analysis. Results: A total of 50 subjects with mean age of 52.1 months were enrolled. Among them, 60 percent were males while the remaining were females. Pneumonia, Encephalitis, Meningitis, Dengue, Burn and Abscess were the underlying pathology in 36 %, 30 %, 20 %, 6 %, 4 %, and 4 % of the patients respectively. Mortality rate was 30 percent. Lactate clearance was found to be significant predictor of mortality. Conclusion: From the above results, the authors conclude that persistently high lactate levels are a predictor of mortality in pediatric patients with sepsis