Fetal Anomalies in Ultrasonographically Detected Polyhydramnios

Background: To determine the frequency and types of fetal anomalies in cases of polyhydramnios detected on ultrasonography and to compare maternal age and parity of these subjects with fetal anomalies and those without fetal anomalies. Methods: In this cross sectional study, using colour and power Doppler ultrasound machine, one hundred diagnosed patients with ultrasonographically detected polyhydramnios were included . Sonographic examination was conducted between 12 to 40 weeks of gestation and fetal anomalies were examined. Results: Out of 100 patients, 35 fetal anomalies were found in 30(30%) patients. The age of the patients included in the study ranged from 18 to 40 years. Majority of the anomalies (73%) were found between age group 30 – 40 years and in multigravida (83%). Central Nervous System was the commonest site with fetal anomalies (46%) followed by gastrointestinal tract (20%) Conclusion: Prenatal detection of fetal anomalies has a decisive effect on the outcome of pregnancy and helps the obstetrician in planning the intrapartum management and for post delivery resuscitative measures, if require

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Advanced Modulation Scheme of a Dual-Active-Bridge Series Resonant Converter (DABSRC) for Enhanced Performance

This paper proposes a two-degree-of-freedom (2-DoF) modulation technique for the efficient optimization of an open-loop three-phase dual-active-bridge series resonant converter (3P-DABSRC). The efficiency and performance of an conventional dual-active-bridge (DAB) converter decrease when it is operated over a wide range of voltage gain. The efficiency and performance of a DAB converter depend upon the switching and conduction losses. Circulating current is the main cause of conduction loss, and hard switching of active switches adds a switching loss. To increase the performance of DAB converters, the first objective is to minimize the conduction loss, and the second objective is to reduce the switching loss. Still, unfortunately, it is not easy to achieve these two objectives simultaneously. Circulating current helps us to reduce the switching loss, but the unbridled amount of circulating current will increase the root-mean-square inductor tank current, and as a result, the conduction loss will be increased. This paper presents an advanced modulation scheme for a 3P-DABSRC that can be used not only in low-power applications, but also in high-power applications. The DABSRC consists of a series LC resonant tank, isolated high-frequency transformer, and dual active bridge connected with the primary and secondary sides of the transformer. The proposed 2-DoF modulation technique not only minimizes the circulating current, but also eliminates the switching loss. Keeping the minimum phase shift between the primary and secondary bridges reduces the circulating current, and thus, all switches can be operated with zero-voltage switching (ZVS) for the entire power range. The power is controlled by changing the switching frequency from 45 to 63 kHz. To confirm the proposed topology and modulation scheme, a 1500 W DABSRC, which interfaces a 300 V DC bus with a 75 V DC bus, is simulated. A loss model of the proposed topology is also made to verify the results. The simulation results are used to confirm the proper operation of the 3P-DABSRC

Advanced Modulation Scheme of a Dual-Active-Bridge Series Resonant Converter (DABSRC) for Enhanced Performance

This paper proposes a two-degree-of-freedom (2-DoF) modulation technique for the efficient optimization of an open-loop three-phase dual-active-bridge series resonant converter (3P-DABSRC). The efficiency and performance of an conventional dual-active-bridge (DAB) converter decrease when it is operated over a wide range of voltage gain. The efficiency and performance of a DAB converter depend upon the switching and conduction losses. Circulating current is the main cause of conduction loss, and hard switching of active switches adds a switching loss. To increase the performance of DAB converters, the first objective is to minimize the conduction loss, and the second objective is to reduce the switching loss. Still, unfortunately, it is not easy to achieve these two objectives simultaneously. Circulating current helps us to reduce the switching loss, but the unbridled amount of circulating current will increase the root-mean-square inductor tank current, and as a result, the conduction loss will be increased. This paper presents an advanced modulation scheme for a 3P-DABSRC that can be used not only in low-power applications, but also in high-power applications. The DABSRC consists of a series LC resonant tank, isolated high-frequency transformer, and dual active bridge connected with the primary and secondary sides of the transformer. The proposed 2-DoF modulation technique not only minimizes the circulating current, but also eliminates the switching loss. Keeping the minimum phase shift between the primary and secondary bridges reduces the circulating current, and thus, all switches can be operated with zero-voltage switching (ZVS) for the entire power range. The power is controlled by changing the switching frequency from 45 to 63 kHz. To confirm the proposed topology and modulation scheme, a 1500 W DABSRC, which interfaces a 300 V DC bus with a 75 V DC bus, is simulated. A loss model of the proposed topology is also made to verify the results. The simulation results are used to confirm the proper operation of the 3P-DABSRC

Encephalitis as a clinical manifestation of COVID-19: A Case Series

COVID-19 is a novel virus which causes a variety of clinical manifestations in the body some of which are still yet to be discovered. The main aim of our study is to highlight the neurological manifestations of COVID-19 as it is still new to the medical world and to emphasize the fact that the physicians have to be vary of the possibility that patients affected with COVID-19 can present with encephalitis. Only a few studies are available so far regarding the neurological manifestations of this novel virus which highlights the need of this study. We present a case series of four patients who were found to have COVID-19 encephalitis. There is still no disease defining test for diagnosis so the mainstay of diagnosis is exclusion of all the common causes of encephalitis. Brain MRI and CSF analysis performs an ancillary in the diagnostic tools. Our study also supports the use of IV Tocilizumab (4-8 mg/kg) and IV methylprednisolone (0.5-2 mg/kg) as possible treatment options with good results as the patients described in our case series responded well to these medications

Remediation of environmental contaminants through phytotechnology

Environmental pollution caused by organic pollutants, radionuclides, and potentially toxic elements (PTEs) affects the quality of the biosphere (water, air, and soil). Rapid industrial growth, mining, agricultural inputs, sewage water, and industrial effluents application in soil all contribute to contamination. Remediation of these valuable resources, as well as prevention of new pollutants, have long been required to avoid negative health effects. Several remediation strategies have been applied for environmental pollutants. Phytoremediation is potentially a viable and promising approach which uses green plants to remove, detoxify, or degrade toxic PTEs from the environment. In this review, the application of phytotechnology for pollutants removal and their underlying mechanisms (phytoextraction/phytoaccumulation, phytotransformation, phytostimulation, phytovolatilization, phytorhizodegration, and phytostabilization) were studied. The current study pointed out that the efficiency of phytoremediation can be affected by various factors such as treatment time, temperature, pH, EC, OM, plant density, electric field, and chelating agents. In the end, this review systematically summarized existing knowledge, merits/demerits, prospects, and future aspects of the phytoremediation for remediating polluted soil and water bodies