Validating the Usefulness of Doppler study of Hepatic Veins in Predicting Esophageal Varices in Cirrhotic Patients

Loss of normal hepatic venous triphasic wave form is a very sensitive non invasive marker for predicting the presence of large esophagial varices with reasonably high positive and negative predictive value. latelet count/splenic diameter ratio, if taken with a cut off of ≤909, can predict the presence of large esophagial varices with reasonably good accuracy. Comparing hepatic venous flow pattern to platelet count splenic diameter ratio,the formor is more strongly associated with the presence of large varices and scores over the latter in terms of negative predictive value. Both are comparable in terms of sensitivity, specificity and positive predictive value. Hepatic venous flow pattern did not have a statistically significant correlation with the incidence of UGI bleed

Echocardiographic Evaluation of Papillary Muscle function in Ischemic Mitral Regurgitation.

Ischemic mitral regurgitation is defined as mitral regurgitation due to coronary artery disease with structurally normal mitral valve leaflet and chordae. Some authors prefer to use the term as functional mirtal regurgitation. But functional mitral regurgitation can occur in idiopathic dilated cardiomyopathy without coronary artery disease. So Ischemic mitral regurgitation and functional mitral regurgitation are not synonymous. The incidence of coronary artery diseases in rural and urban population in India is reported to be between 14.8 per thousand to 65.4 per thousand(2). Patients with coronary artery diseases during their course may develop complications such as arrhythmias, mechanical complications (ventricular septal rupture, Ischemic mitral regurgitation) and pump failure. Ischemic mitral regurgitation occurs in approximately 20% of patients after myocardial infarction and 56% of patients with heart failure due to ischemic or non ischemic cardiomyopathy. Ischemic mitral regurgitation can occur in coronary artery disease both during acute phase and chronic phase. Ischemic mitral regurgitation is more common in inferior wall myocardial infarction than anterior wall myocardial infarction. There is a graded independent association between the severity of ischemic MR and the development of Heart failure after myocardial infarction. Even mild ischemic MR is associated with an increase in the risk of heart failure. Ischemic mitral regurgitation is an independent prognostic factor in patients with chest pain even without myocardial infarction. Advancing age, female gender, multiple vessel coronary artery disease, congestive heart failure, recurrent ischemia, large infarct size, and prior acute myocardial infarction are all risk factors for developing IMR. THE AIM OF THE STUDY: 1) To assess the mechanisms of ischemic mitral regurgitation in patients with old myocardial infarction. 2) To assess the role of Tissue Doppler imaging in evaluation of papillary muscle function. 3) To assess the contribution of papillary muscle dysfunction in the pathogenesis of ischemic mitral regurgitation. CONCLUSIONS: 1. Mitral leaflet tethering distance is consistently directly proportional to severity of Ischemic mitral regurgitation. 2. Papillary muscle function is better assessed by tissue Doppler echo than M Mode and 2D echocardiography. 3. Papillary muscle dysfunction is not an independent determinant of ischemic MR in all cases. 4. Papillary muscle dysfunction attenuates ischemic MR in patients with old inferior wall MI with increased left ventricular sphericity due to focal remodeling. 5. Role of papillary muscle dysfunction in ischemic MR is still elusive and varies depending on factors such as location of myocardial infarction and extent of left ventricular remodeling

Scheuthauer-Marie-Sainton syndrome: a case report

The term Scheuthauer-Marie-Sainton syndrome is also known as cleidocranial dysplasia or cleidocranial dystosis and is derived from ancient greek words cleido (collar bone), knanion (head) and dysplasia (abnormal formation). It is an uncommon but well known genetic skeletal condition and an autosomal dominant malformation affecting bones and teeth. The most common skeletal and dental abnormalities in affected individuals are hypoplastic/ aplastic clavicles, open frontanelles, short stature, retention of primary teeth, delayed eruption of permanent teeth, supernumerary teeth and multiple impacted teeth. Affected person have a characteristic facial appearance with a bulky forehead, hypertelorism and midfacial hypoplasia. General health is usually good and the intellect is unimpaired. This article describes clinical and radiographic features of Scheuthauer-Marie-Sainton syndrome in a 29 years old male patien

Immobilization of Ruthenium Benzylidene on Thermoresponsive Polymer : Methodology and Application

Attachment of metal complex on polymer has direct implication for the development of novel catalyst with recyclability, reusability and water solubility in the context environmental concern. In this paper, we illustrate a simple strategy to immobilize ruthenium benzylidene organometallic complex on thermoresponsive polymer. For this, pyridine-substituted poly (N-isopropylacrylamide) has been synthesized by atom transfer radical polymerization from a suitable initiator. Then, ruthenium benzylidene has been conjugated by binding with pyridine part of the polymer. Polymer conjugated ruthenium benzylidene is shown to have thermoresponsive characteristic in water (soluble below lower critical solution temperature (LCST) but precipitates out above LCST in water). Hence it can act as smart catalyst for metathesis reaction in water. For instance, it can be used as homogeneous metathesis catalyst for allyl alcohol in aqueous medium below lower critical solution temperature (LCST), that can be recovered as heterogeneous catalyst above LCST and recycled again as homogeneous catalyst. This is the first example of water-soluble recyclable metathesis catalyst. It is further demonstrated that steric crowding in the ligand play an important role in the superior performance of the catalyst

BlockCRN-IoCV: Secure Spectrum Access and Beamforming for Defense Against Attacks in mmWave Massive MIMO CRN in 6G Internet of Connected Vehicles

Cognitive Radio (CR) is a wireless communication system that is used for intelligent vehicles to solve spectrum scarcity and improve the utilization of the spectrum. However, spectrum sensing and data sharing are difficult due to the presence of malicious nodes which degrades the performance. To overcome these issues, we proposed the BlockCRN-IoCV method which includes authentication, density aware clustering, dual agent based spectrum access and secure beamforming. Here, authentication is performed for both Primary Users (PUs) and Secondary Users (SUs) using the Hybrid Advanced Encryption Standard and Hyper-elliptic Curve Cryptography (AES-HCC) algorithm by considering ID, PUF and location which ensures the legitimacy of the users. To address the mobility of the vehicle we perform density aware clustering using Density aware Dynamic Radius Clustering (DADRC) by considering location, distance and direction for increasing throughput. After completing clustering, we perform efficient spectrum access by using the Dual Agent based Twin Delayed (DA-TD3) algorithm which includes two agents, the first agent performs spectrum sensing by considering SNR, noise level and trust, and the second agent performs spectrum allocation by considering Channel State Information (CSI), in which the CSI is predicted by Quasi-Newton Iterative Unscented Kalman Filter (QNIUKF) algorithm for effective data transmission. Finally, secure beamforming is performed using Bi-Gated Recurrent Neural Network (BiGRU-CapsNet) by considering CSI, beam score, array factor, and direction of angle. The simulation is carried out by OMNET++ and SUMO simulation tools and the performance of this work is evaluated by throughput, packet delivery ratio, SNR, detection accuracy, BER, and delay. The simulation result shows that the proposed work achieves superior performance compared to existing work for secure spectrum sensing and beamforming

Solvent free <i>N</i>-alkylation of phenyl sulfanilides under microwave irradiation

1048-1050A facile N-alkylation of phenylsulfanilides by reaction with primary alkyl halides (benzyl bromide, ethyl bromoacetate and n-butyl bromide)in the presence of anhydrous potassium carbonate under microwave condition to give N-alkylated products in good yields is reporte

Synthesis, Spectroscopy and Antimicrobial Activity of Iron Complexes of some Smoke Flavour Compounds

Iron (III) complexes of some smoke flavour compounds (2-allyloxyphenol, guaiacol, eugenol and 2-ethoxyphenol) were synthesised and characterised by UV-Vis spectroscopy and ESI mass spectrometry. The ligand metal binding ratio was found to be 1 : 1 by the Job plot method. Antimicrobial activity of the ligand iron complex was determined against Bacillus subtilis, Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa. This activity was compared with that of the free ligand (four smoke flavour compounds). While enhanced antimicrobial activities of guaiacol and 2-ethoxyphenol iron complexes were observed, this effect was, however, limited for eugenol and 2-allyloxyphenol iron complexes. In this study, it was established for the first time that not only do smoke flavour compounds complex with iron which could potentially retard food spoilage, but also after complexation, some complexes attain antimicrobial activities compared to the inactive free ligands