Gastric dilatation and volvulus (bloat) - A case report and mini review of literature

Gastric dilatation and volvulus (GDV) is a progressing bloat condition in dogs characterized as dilatation followed by rotation of stomach. A sevenyear old 18 kg black colour female non-descriptive dog presented, with history of difficulty in respiration within half an hour after feeding of curd meals. With the history and general clinical examination the case tentatively diagnosed as gastric dilatation. After unsuccessful advancement of oro-gastric tube, needle gastric paracentesis was performed on left side of the abdomen caudal to the last rib for decompression. Mid-ventral celiotomy and gastrotomy were performed after stabilization of heart rate and respiratory rate. After evacuating the whitish frothy content from the stomach, derotation and incisional gastropexy was performed. On 14thpostoperative day telecommunication confirmed the milk based meal induced GDV canine patient recovered uneventfully. Electrocardiogram monitoring done for first 24 hours period and ventricular arrhythmia was managed by using lidocaine (loading@2mg/ kg bw followed by 25mcg/kg/min for 30 min). It is concluded that on 14th postoperative day telecommunication confirmed the milk based meal induced GDV canine patient recovered uneventfully

A Pilot Study of Short-Duration Sputum Pretreatment Procedures for Optimizing Smear Microscopy for Tuberculosis

Direct sputum smear microscopy for tuberculosis (TB) lacks sensitivity for the detection of acid fast bacilli. Sputum pretreatment procedures may enhance sensitivity. We did a pilot study to compare the diagnostic accuracy and incremental yield of two short-duration (<1 hour) sputum pretreatment procedures to optimize direct smears among patients with suspected TB at a referral hospital in India.Blinded laboratory comparison of bleach and universal sediment processing (USP) pretreated centrifuged auramine smears to direct Ziehl-Neelsen (ZN) and direct auramine smears and to solid (Loweinstein-Jensen (LJ)) and liquid (BACTEC 460) culture. 178 pulmonary and extrapulmonary TB suspects were prospectively recruited during a one year period. Thirty six (20.2%) were positive by either solid or liquid culture. Direct ZN smear detected 22 of 36 cases and direct auramine smears detected 26 of 36 cases. Bleach and USP centrifugation detected 24 cases each, providing no incremental yield beyond direct smears. When compared to combined culture, pretreated smears were not more sensitive than direct smears (66.6% vs 61.1 (ZN) or 72.2 (auramine)), and were not more specific (92.3% vs 93.0 (ZN) or 97.2 (auramine).Short duration sputum pretreatment with bleach and USP centrifugation did not increase yield as compared to direct sputum smears. Further work is needed to confirm this in a larger study and also determine if longer duration pre-treatment might be effective in optimizing smear microscopy for TB

Heat Energy Recovery Using Thermo Electric Generator

Internal combustion Engines converts only a small portion of heat energy into useful work resulting in a very low thermal efficiency. Most of the heat energy is lost in forms of cooling, exhaust gas, friction and unaccounted losses. Though energy lost in exhaust gas can be recovered by using thermoelectric generators (TEGs, also known as peltier element), which converts heat into electrical energy. A model has been prepared which helps TEG to extract heat from exhaust gas efficiently. This electrical energy obtained is used for powering hybrid drive

DEVELOPMENT OF COMPOSITE BUBALINE CANCELLOUS BONE XENOGRAFTS BY SEEDING GUINEA PIG FETAL OSTEOBLASTS

Xenografts are considered as an alternative strategy to restore a critical-sized bone defect. The present study was conducted to standardize the technique for seeding and cryopreservation of decellularized bubaline cancellous bone with Guinea pig fetal osteoblast for the development of a composite bone xenograft. The composite bone grafts were prepared by seeding the expanded osteoblasts on the acellular bubaline cancellous bone matrix. The foetal osteoblast seeded scaffold, acellular bone scaffold, and native bovine bone were analyzed using scanning electron microscopy (SEM) and histological examination. Composite bone xenograft was cryopreserved in 10% glycerol at - 80°C for three months and evaluated for post-thaw viability. Findings from the in vitro study suggested that the seeding of acellular scaffold was adequate, and osteoblasts had good adhesion and proliferation inside pores of acellular bone matrix. Histologically the integrity of collagen matrix was best preserved in the acellular group as compared to the freshly seeded and cryopreserved scaffold. The osteoblast seeded decellularized bubaline cancellous bone xenografts can be preserved for three months with adequate cell viability in the post-thaw evaluation at – 80°C in sterile tubes containing 10% glycerol as the cryoprotectant

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Optimizations of Friction Stir Welding Process Parameters for the Welding of Al-B4C Composite Plates using Generalized Reduced Gradient Method

AbstractNow a days Friction stir Welding (FSW) has become very popular for joining of aluminium alloys and aluminium based composites. FSW produced the effective joints on the Metal matrix composites (MMCs) without defects like porosity, interfacial chemical reactions, reinforcement segregation etc., The desired mechanical properties of the weld can be achieved, depends on the FSW parameters such as rotational speed (N), welding speed (S), axial force (F) and the reinforcement content (%R) in the MMCs. In this study, a mathematical model was developed to predict the tensile strength friction stir welded Al/B4C joints using SYSTAT software. The central composite design of four factors and five levels has been used to conduct the experiments. The optimal process parameters were estimated from the developed regression equation using Generalized Reduced Gradient (GRG) method

Development of Empirical Relationships for Prediction of Mechanical and Wear Behavior of Copper Matrix Surface Composite by Friction Stir Processing Technique

In this investigation, Copper Matrix Surface Composites (CMSCs) were reinforced with various ceramic particles like Aluminum Nitrate (AlN), Titanium diboride (TiB2), and Rice Husk Ash (RHA) are used to increase the metallurgical and mechanical properties by Friction Stir Processing (FSP). The Design of the Experiment (DOE) Taguchi L9 orthogonal array method was used. The process parameters considered were groove width and various types of reinforcement particles. The fabrication of CMSCs was achieved by using optimized process parameters, such as the tool transverse speed of 40 mm/min, rotational tool speed of 1000 rpm, and an axial load of 10 kN with one pass. The influence of FSP process parameters on CMSCs in the stir zone is observed through optical microscope (OM), Field Emission Scanning Electron Microscope (FESEM), and Transmission Electron Microscope (TEM). Mechanical properties such as microhardness and wear rate are studied and compared. It reveals that good interfacial bonding was produced between ceramic particles in CMSCs. TiB2 reinforced with copper matrix surface composites enhance microhardness and had a lesser wear rate