Doctor of Philosophy

dissertationCarpal tunnel syndrome (CTS) is the number one cause of disability at work in the United States. Loss of time at work and worker's compensation expenditure caused by CTS is more than that caused by any other condition. However, workplace surveillance is likely to help in detecting CTS at a stage that is treatable at a significantly lower cost. Vibrotactile threshold (VT) testing can be used for this purpose. The VT is the smallest displacement applied (as a sinusoid) to a finger innervated by the median nerve that can be detected by the patient. Vibrotactile threshold evaluation can be a versatile tool for applications involving haptics interfaces, for evaluating peripheral neuropathies, and for studying the effects of chemotherapy induced neuropathies. This dissertation presents the prototype design of a vibrotactile threshold evaluator for the workplace (VTEW), which is portable, and configurable in terms of the probe diameter (1-6 mm), surround diameter (8-10 mm), applied frequency (1-250 Hz), angle of probe (0-1200), and displacement of probe (1-1500 ?m) and is operated with a customizable LabView interface. The VTEW also incorporates a special mount for the probe stimulus to test the subjects in at least two distinctive postures of the hand. Subjects were tested using an existing validated device, Vibrotactile Threshold Tester (VTT) and VTEW. Subjects were tested at 50 Hz with VTT and VTEW for validation. The effect of flexion on VT was observed by testing the subjects on VTEW at 50 Hz with their dominant hand in neutral posture and again with their dominant hand in provocative flexion. Use of low frequency for testing in VT studies is uncommon due to hardware constraints. However, low frequency studies could be potentially useful for investigating the effects of chemotherapy on the perception of pain. Thus, subjects were also tested at 4 Hz using VTEW to obtain preliminary data. Finally, an age regression model was developed to correct for the changes occurring in VT with age

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Synthesis of chiral organocatalysts derived from aziridines: application in asymmetric aldol reaction

This article does not have an abstract

N-Heterocyclic carbene/palladium synergistic catalysis in organic synthesis†

<jats:p>This review summarizes the progress made in the area of synergistic catalysis with N-heterocyclic carbenes and palladium.</jats:p&gt

Comparison of Nalbuphine and Dexmedetomidine versus Nalbuphine and Propofol for Monitored Anaesthesia Care in Tympanoplasty: A Randomised Double-blind Study

Introduction: Tymanoplasty, a middle ear surgery, is done either under Local Anaesthesia (LA), General Anaesthesia (GA) or sedation with local anaesthesia. It is usually performed under Monitored Anesthesia Care (MAC) providing advantages of rapid onset, allowing hearing test intraoperatively and early mobilisation of the patient. Aim: To study the effect of nalbuphine/dexmedetomidine with nalbuphine/propofol on sedation and analgesia in tympanoplasties performed under MAC. Materials and Methods: This randomised, double-blind, clinical study was conducted from June 2020 to June 2021 in the Department of Anaesthesiology at Mahatma Gandhi Memorial Medical College and MY Hospital, Indore, Madhya Pradesh, India. Total 60 adult patients, of American Society of Anesthesiologists (ASA) grade I and II undergoing tympanoplasty under MAC, were randomly allocated into two groups. All patients received injection nalbuphine 50 μg/kg intravenously (i.v.). Group D received a bolus dose of injection dexmedetomidine 1 μg/kg i.v. over 10 min followed by an infusion at 0.3 μg/kg/h i.v. Group P received a bolus dose of injection propofol 0.75 mg/kg followed by an infusion at 0.025 mg/kg/min i.v. Sedation and analgesia were titrated to Ramsay Sedation Score (RSS) and Visual Analog Scale (VAS) of 3 each. The vital parameters and need for intraoperative rescue sedation/analgesia were recorded and compared. Results: Mean RSS was significantly more in group D (3.11±0.055) than group P (2.80±0.350). Overall, VAS score was significantly less in group D (1.60±0.670) than group P (2.70±0.691). In group D, 2 (6%) patients and in group P, 4 (12%) patients required inj. midazolam. Similarly, the requirement of inj. paracetamol in group D was in 3 (10%) patients, and in group P, it was 10 (33%) patients. Bradycardia (23.3% in group D and 13.3% in group P) and hypotension (20% in group D and 13.3% in group P) were the major side effects seen in the study. Conclusion: The present study concludes that, Nalbuphine/dexmedetomidine is superior to nalbuphine/propofol in producing sedation and decreasing VAS in patients undergoing tympanoplasty under MAC

Women Ecopreneurship-A Case Study from Emerging Country Women Ecopreneurship-A Case Study from Emerging Country

ABSTRACT Purpose: The purpose of this paper is to extend research into social and ecological entrepreneurship. It aims to examine how ecopreneurs can create an economically viable business whilst retaining their core environmental and social values. Market systems have adversely affected the environment by: (a) failing to deal with negative environmental externalities and (b) undervaluing natural resources, leading to their over-exploitation and depletion. Governments have sought to deal with the problem through a mix of command-and-control and market-based instruments, with limited success. One of the most potent alternatives for dealing with such market failures is ecopreneurship, which refers to a process by which entrepreneurs introduce eco-friendly (or relatively more eco-friendly) products and process into the marketplace. In this paper a theoretical framework to assess the emergence of ecopreneurship in a given society or industry is presented. Likewise nowadays women entrepreneurs are getting adopted to F Commerce which is actually based on Facebook

PPh<SUB>3</SUB>/halogenating agent-mediated highly efficient ring opening of activated and non-activated aziridines

We report here the use of PPh3/halogenating agents as highly efficient reagents for the ring opening of aziridines with halides. The method works effectively for both activated and non-activated aziridines, and furnishes the products in excellent yields within a short period of time

Efficient ring opening of aziridines with carboxylic acids

An efficient ring cleavage of aziridines with acids has been studied in the absence of any catalyst. The hydrolysis of the products, amino esters, leads to the corresponding amino alcohols. The reaction has been extended to chiral cycloalkyl aziridines, leading to the formation of diastereomers. After separation, these diastereomers have been converted to optically pure amino alcohols in two steps