A comparative evaluation of I-gel and laryngeal mask airway supreme in laparoscopic surgeries: a randomized comparative study

Background: Supraglottic airway device results in less hemodynamic responses during laparoscopic surgery but supraglottic airway device to be used should have higher oropharyngeal seal pressure than peak pressure for effective ventilation as laparoscopic surgery also leads to higher airway pressure. In this study the efficiency of the I-gel with SLMA is compared in patients undergoing laparoscopic cholecystectomy surgeries.Methods: Sixty patients were randomized in to two groups, group A where I-gel was considered for airway management and group B where LMA Supreme was the device chosen for airway management.Results: Oropharyngeal seal pressure was significantly lower in group A than group B, 5 minutes after insertion of airway device it was 24.90±3.03 cm H2O and 27.30±3.41 cm H2O in group A and group B, respectively and 5 minutes after creation of pneumoperitoneum it was 25.53±3.17 cm H2O and 27.57±3.36 cm H2O in group A and group B, respectively. There was significant difference in the difference between inspiratory and expiratory tidal volume between the groups at all the time periods being higher in group A than group B. Hemodynamics were comparable between the two groups. Time taken to insert the airway device and Ryle’s tube insertion was significantly lesser in group B in comparison to group A. The percentage of complications was higher in group A than group B with no significant (p>0.05) association.Conclusions: Both the I-gel and SLMA devices can be used safely in laparoscopic cholecystectomy in non-obese patients. But in SLMA group oropharyngeal seal pressure was higher with lesser leak volume in comparison to I-gel group

Structural, Dielectric, Semiconducting and optical properties of High-Energy Ball Milled YFeO3 Nano-particles

In this work, we report the effects of calcination temperature on structural, dielectric, semiconducting and optical properties of YFeO3 nanoparticles prepared by a high energy ball milling process. The structural analysis of the X-ray diffraction data shows that YFeO3 exists in orthorhombic as well as in hexagonal mixed-phase states. The Rietveld analysis confirms that orthorhombic YFeO3 crystallizes into Pnma space group. The optical band gap of YFeO3 reduces from 1.96 eV to 1.68 eV with increasing the calcination temperature of the YFeO3 sample. The bandgap reducing effect might be attributed to the increased crystallite size and decreased lattice strain which is confirmed by the Williamson-Hall plot method. The obtained low bandgap YFeO3 ceramic may provide a new possibility to develop eco-friendly Ferroelectric photovoltaic devices

A Review on Secure Access to Cloud Storage by using ABE

Cloud computing is going to be very famous technology in IT enterprises. For an enterprise, the data stored is huge and it is very precious. All tasks are performed through networks. Hence, it becomes very important to have the secured use of data. In cloud computing, the most important concerns of security are data security and privacy. For access control, being one of the classic research topics, many schemes have been proposed and implemented. In this paper, various schemes for encryption that consist of Attribute based encryption (ABE) and its types KP-ABE, CP-ABE is explored. Public Key Encryption acts as the basic technique for ABE where it provides one to many encryptions, here, the private key of users & the cipher-text both rely on attributes such that, when the set of the attributes of users key matches set of attributes of cipher-text with its corresponding access policy, only then decryption is possible

Cervical sonomorphometric evaluation of normal and preterm labour by transvaginal and transabdominal sonography

Background: Preterm delivery is major cause of perinatal morbidity and mortality. Measuring cervical length (CL) with ultrasonography has become increasingly acceptable as an early diagnostic procedure in patients at risk for PTL, with transvaginal ultrasonography (TV Us) being considered as the gold standard for the CL assessment.Methods: A cohort of women with singleton pregnancies, and confirmed gestational age by first or early second trimester ultrasonography, last menstrual period & clinical assessment were selected to undergo transvaginal and transabdominal sonographic measurement of cervical length between 16 and 34 week gestation. Cervical length was first measured by transabdominal route (TAS) using a 3.5 MHz curved electronic array transducer with the patient in the supine position and with a full bladder, transvaginal sonography (TVS) was done by a 7.5 MHz probe attached to an ultrasound machine. The probe was covered with a latex condom and gel placed between the transducer and the cover and also on the surface. It was then gently inserted in the vagina to obtain a sagittal view of the cervix. Doppler measurement were taken by both transabdominal and transvaginal route.Results: Gradual decrease in cervical length is seen with advancement of gestation weeks. TA Us cervical length values are noted higher than TV Us however significance is seen only at 24 weeks and cervical width are showing gradual increase with advancement of gestation weeks without significant difference between them. The study compared the mean spectral Doppler parameters RI, PI and S/D Ratio at different weeks & observed that TV Us values are more at each gestation weeks than TA Us showing significant difference 24 weeks onwards.Conclusions: Although discrepancy in statistical significance, short cervical length, funneling and gland area are important to recognize for prediction of premature onset of labour, owing to the potential for perinatal morbidity and mortality and socioeconomic burden. Transvaginal sonography remains the dominant imaging modality for evaluation of the cervix. It is operator dependent modality so care should be taken to evaluate each morphologic character

Management of acute diarrhea in children: is the treatment guidelines is really implemented?

Background: Acute diarrhea is a common problem in children especially in poor and developing nations. It is one of the leading cause of under-five years’ mortality globally. The children used to die each year of dehydration and electrolyte imbalance caused by acute diarrhea. Despite of WHO recommendations on the use of ORS and zinc in the management of acute diarrhea as a simple and effective treatment, the prescribing trend of ORS and zinc in acute diarrhoea is not up to the mark, which further increases the burden of the problems. Objectives: we aimed to assess; (1) prescribing trend of ORS and zinc in acute diarrhoea in children aged 6months to 5years by health care providers, (2) to asses’ proportion of patient education in acute diarrhea by health care providers.Methods: This was a qualitative, cross-sectional, hospital based study carried among children aged 6months to 5yrs.Results: This study was conducted among 313 children of acute diarrhoea who had been treated outside. Mean age (months) was 27.53±15.87. Out of all children who were treated from outside, 180 (57.50%) took treatment from general physician, 113 (36.10%) children took the treatment from pediatrician, and 20 (6.85%) took the treatment from the physician and 25 (7.9%) took treatment as over the counter antidiarrheal by the pharmacists. Out of them dehydration was documented only in 97 (30.99%), while ORS was given in 229 (73.16%) and zinc was given in 121 (38.65%) children. Patients education was done in 39 (12.46%).Conclusions: There was gross under implementation of treatment guidelines in the management of acute diarrhea by health care providers especially by general physicians

Clinical Metabolomics Investigation of Rheumatoid Arthritis Patients Receiving Ayurvedic Whole System Intervention

BACKGROUND: Arthritis is a common clinical condition seen in Ayurveda clinics. Clinical trials have reported Ayurvedic interventions to be of benefits in many arthritic conditions including Rheumatoid Arthritis (RA). No mechanistic details however are available about how such interventions on their own or as a combination of whole system Ayurveda might be working. OBJECTIVE: The study aims to evaluate simultaneously the clinical outcome of Ayurveda whole system (AWS) intervention in RA patients and identifying the serum metabolic signatures which could be useful for diagnosing the disease and monitoring treatment response. MATERIAL AND METHODS: RA patients (n = 37) simultaneously diagnosed as Amavata fulfilling the specific inclusion and exclusion criteria were recruited in the study and were given Ayurveda whole system (AWS) intervention comprised of oral medicines, local therapy and dietary recommendation for 3 months. The clinical and serum metabolic changes were investigated for pre-treatment RA patients (baseline RA group, n = 37) and post-treatment RA patients (following treatment of 6-weeks (RA_F, n = 26) and three months (RA_T, n = 36). For comparative serum metabolomics analysis, 57 normal healthy control (HC) subjects were also involved and the serum metabolic profiles were measured at high-field 800 MHz NMR spectrometer. The serum metabolic profiles were compared using multivariate statistical analysis and discriminatory metabolic features were evaluated for diagnostic potential using receiver operating characteristic (ROC) curve analysis. RESULTS: A significant reduction in DAS-28 ESR, AAM Score, total swollen joints, total tender joints were observed following AWS intervention. The clinical outcomes were concordant with changes in metabolic profiles of RA patients as these were also shifting towards the normal levels following the intervention. Compared to healthy control (HC) subjects, the sera of baseline RA patients were characterised by increased circulatory level of succinate, lysine, mannose, creatine, and 3-Hydroxybutyrate (3-HB) and decreased levels of alanine. The present study also evaluated the serum metabolic ratios for their discriminatory and diagnostic potential and notably, six metabolic ratios (KHR, KThR, KVR, GHR, PTR and SHR) were found significantly altered (elevated) in baseline RA patients. However, in RA patients receiving AWS treatment, these metabolic changes showed marked convergence towards the metabolic signatures of healthy controls. CONCLUSION: This first of its kind study clearly shows the clinical efficacy of Ayurvedic Whole System (AWS) intervention in the management of Rheumatoid Arthritis (RA), as demonstrated by significant improvements in key clinical parameters. The intervention not only alleviated symptoms but also induced a profound metabolic shifting towards normalization; thus, underscoring the potential of AWS intervention to modulate cellular metabolism in a manner that facilitates a return to homeostasis in RA patients. However, future studies are imperative to confirm these preliminary observations and delineate the underlying mechanisms of action of intervention in cases of RA

Impact of Irpex lenis and Schizophyllum commune endophytic fungi on Perilla frutescens: enhancing nutritional uptake, phytochemicals, and antioxidant potential

Background: Endophytic fungi (EF) reside within plants without causing harm and provide benefits such as enhancing nutrients and producing bioactive compounds, which improve the medicinal properties of host plants. Selecting plants with established medicinal properties for studying EF is important, as it allows a deeper understanding of their influence. Therefore, the study aimed to investigate the impact of EF after inoculating the medicinal plant Perilla frutescens, specifically focusing on their role in enhancing medicinal properties. Results: In the current study, the impact of two EF i.e., Irpex lenis and Schizophyllum commune isolated from A. bracteosa was observed on plant Perilla frutescens leaves after inoculation. Plants were divided into four groups i.e., group A: the control group, group B: inoculated with I. lenis; group C: inoculated with S. commune and group D: inoculated with both the EF. Inoculation impact of I. lenis showed an increase in the concentration of chlorophyll a (5.32 mg/g), chlorophyll b (4.46 mg/g), total chlorophyll content (9.78 mg/g), protein (68.517 ± 0.77 mg/g), carbohydrates (137.886 ± 13.71 mg/g), and crude fiber (3.333 ± 0.37%). Furthermore, the plants inoculated with I. lenis showed the highest concentrations of P (14605 mg/kg), Mg (4964.320 mg/kg), Ca (27389.400 mg/kg), and Mn (86.883 mg/kg). The results of the phytochemical analysis also indicated an increased content of total flavonoids (2.347 mg/g), phenols (3.086 mg/g), tannins (3.902 mg/g), and alkaloids (1.037 mg/g) in the leaf extract of P. frutescens inoculated with I. lenis. Thus, overall the best results of inoculation were observed in Group B i.e. inoculated with I. lenis. GC-MS analysis of methanol leaf extract showed ten bioactive constituents, including 9-Octadecenoic acid (Z)-, methyl ester, and hexadecanoic acid, methyl ester as major constituents found in all the groups of P. frutescens leaves. The phenol (gallic acid) and flavonoids (rutin, kaempferol, and quercetin) were also observed to increase after inoculation by HPTLC analysis. The enhancement in the phytochemical content was co-related with improved anti-oxidant potential which was analyzed by DPPH (% Inhibition: 83.45 µg/ml) and FRAP (2.980 µM Fe (II) equivalent) assay as compared with the control group. Conclusion: Inoculation with I. lenis significantly enhances the uptake of nutritional constituents, phytochemicals, and antioxidant properties in P. frutescens, suggesting its potential to boost the therapeutic properties of host plants. Graphical Abstract: (Figure presented.)Microbial Cell Factorie

Description of clinical factors for suicide attempts in a tertiary care hospital of northern part of India

Background: Suicide is the result of an act deliberately initiated and performed by a person in the full knowledge or expectation of its fatal outcome. Suicide attempts are a significant public health problem. The present study aimed to explore the variousclinical characteristics of suicideattempters in a tertiary care hospital of Shimla, Himachal Pradesh, a northern state of India.Methods: We conducted a descriptive study among patients with attempted suicide to the department of Psychiatry, Indira Gandhi Medical College (IGMC) Shimla. A structured, self-designed interview schedule and short-form revised Eyseneck personality questionnaire-Hindi (EPQRS-H) was used for data collection. Data was analyzed using Epi info software v 7.2.0.Results: There were total 77 participants in the study out of which 44 (57.1%) were females. Mean age (Standard deviation) of participants was 30.8 years (9.9 years). Relationship problems were the most common (48.1%) recent life event followed by health events (28.6%). Depression was found to be the most common diagnosis (62.3%). Pesticide consumption was the method of attempting suicide in 72.7% of females compared to 66.7% of males.Conclusions: Recent major life events especially relationship problems may lead to majority of suicide attempts. There is urgent need to focus on patients suffering from depression by health personnel as well as family members. The sale of the pesticides should be regulated to keep in check the misuse of the same

Elastic Moduli of Carbon Nanohorns

Carbon nanotube is a special case of carbon nanohorns or carbon nanocones with zero apex angle. Research into carbon nanohorns started almost at the same time as the discovery of nanotubes in 1991. Most researchers focused on the investigation of nanotubes, and the exploration of nanohorns attracted little attention. To model the carbon nanohorns, we make use of a more reliable second-generation reactive empirical bond-order potential by Brenner and coworkers. We investigate the elastic moduli and conclude that these nanohorns are equally strong and require in-depth investigation. The values of Young's and Shear moduli decrease with apex angle

Diversity and status of migratory and resident wetland birds in Haridwar, Uttarakhand, India

Migration is the seasonal habitual movement, exhibited by many avian species along a flyway from breeding to wintering grounds and vice versa all over the world. Migratory birds are very sensitive to even small changes in water level which may be affected by flood or drought on their breeding and wintering grounds. High rains during monsoon season can cause flood conditions in the lower hills and Gangetic plains including Haridwar district. In our study, conducted during last ten years (2009-2018), we covered Bheemgoda Barrage and Missarpur Ganga Ghat of Haridwar, Uttarakhand, where 46 species of Migratory (M) and Resident Migratory (RM) wetland birds were observed. Bird survey indicated that there was a significant increase (p = 0.064, t-test) in the population of certain species such as Bhraminy Shelduck (67%), Black Headed Gull (31%), Gadwall (7%), Northern Pintail (59%), Red Crested Pochard (10%) and Tufted Pochard (47%) in Missarpur Ganga Ghat as compared to Bheemgoda Barrage (based on the average abundance of the species observed during study period). It may be pointed out that after flood and loss of vegetated island, there was significant decrease (p= 0.023, t-test) in the population of species such as Black necked stork (76%), Great crested grebe (56), Pallas gull (47%) at Bheemgoda barrage, while some species such as Bar headed goose, Common pochard did not arrive in Bheemgoda barrage after the flood. The study would help to understand the effect of climatic change on water birds species distribution in natural and man-made wetlands