Endoscopic removal of intrauterine contraceptive device embedded into detrusor muscle of urinary bladder: our experience of two cases

Migration of intrauterine contraceptive device (IUD) into urinary bladder is a rare event, presenting as irritative lower urinary tract symptoms; we present two cases of migrated IUD into urinary bladder and embedded inside the detrusor muscle of bladder. Both patients were assessed by ultrasonography and computed tomography. Both patients were successfully treated by endoscopic approach via per urethral route. One patient was having embedded vertical arm of IUD which was pulled using forceps and second patient was having embedded horizontal arm of IUD in detrusor muscle which was treated by taking mucosal incision with help of Collin’s knife followed by pulling IUD with help of forceps. There was no evidence of fistula or any other complication. We would like to conclude that endoscopic removal of IUD embedded into detrusor muscle is safe, feasible alternative to open surgery without any further risk of fistula formation

Process and die profile design for tube extrusion of γ iron

This study is related to material modeling and die and process design of tube extrusion of γ iron. Strain dependent rate power law is used for material modeling whose coefficients are arrived at through genetic algorithm (GA). Die profile of the tube extrusion process is optimized to produce microstructurally sound product at maximum production speed and minimum left out material in the die. The design problem is formulated as a nonlinear programming problem which is solved using GA. Selection of the processing parameters is carried out using dynamic material modeling (DMM). Using this approach tube extrusion process of γ iron is successfully designed

Tube extrusion design for some selected inner profiles.

In this study, tube extrusion process of non-circular inner sections is optimized to satisfy micro structural criteria at maximum production speed and minimum left out material in the die cavity. The die profile design is for-mulated as a constrained non-linear programming problem, which is solved using genetic algorithms (GA). Three extrusion processes are successfully optimized based on this approach. Computer simulations, account-ing the optimized parameters are also carried out to obtain stress, strain distributions and load requirements

Process and die design for square tube extrusion.

In this study, die profile of the square tube extrusion process is optimized to produce microstructuarlly sound product at maximum production speed and minimum left out material in the die. The design problem is formulated as a nonlinear programming model, which is solved using genetic algorithms (GA). Selection of the processing parameters is carried out using dynamic material modeling (DMM). Using this approach a square tube extrusion process is successfully designed

Die Profile Design for Tube Extrusion and its Experimental Verification.

In this study, experimental verification of a proposed extrusion die profile design approach, which aims to satisfy microstructural criteria at maximum production speed and minimum left out material in the die cavity, is presented. The design problem is formulated as a nonlinear programming problem, which is solved using genetic algorithm (GA). Selection of the processing parameters is carried out using dynamic material modeling (DMM). Microstructural study reveals considerable grain refinement in the extruded tube. Keywords: dynamic recrystallization, die profile, microstructure, processing parameters, extrusion, genetic algorithm

Changing Demographics of Stroke Mimics in Present Day Stroke Code Era: Need of a Streamlined Clinical Assessment for Emergency Physicians

Background There is an apparently high incidence of stroke mimics in the present-day stroke code era. The reason being is the intense pressure to run with time to achieve the “time is brain”-based goals. Methods The present study was a retrospective analysis of the data collected over a duration of 6 months from April 2019 to September 2019. We observed the incidence of stroke mimics among the patients for whom rapid response stroke code was activated during the study period. We also performed a logistic regression analysis to identify the clinical features which can act as strong predictors of stroke and mimics. Results A total of 314 stroke codes were activated of which 256 (81.5%) were stroke and 58 (18.5%) were the mimics. Functional disorders and epilepsy were the most common mimics (24.1% each). Female gender (p = 0.04; odds ratio [OR] 2.9[1.0–8.8]), isolated impairment of consciousness (p < 0.01; OR 4.3[1.5–12.6]), and isolated dysarthria (p < 0.001) were the strong independent predictors for a stroke mimic. Hemiparesis was the strong independent predictor for a stroke (p < 0.001; OR 0.0[0.0–0.1]). Conclusion In the present epoch of rapid response stroke management, a streamlined assessment by the emergency physicians based on the above clinical predictors may help in avoiding the misdiagnosis of a mimic as stroke

Comparative evaluation of the stability of two different dental implant designs and surgical protocols—a pilot study

Abstract Background The purpose of this study was to compare a parallel wall design implant to a tapered apex design implant when placed in the posterior maxilla using two different surgical protocols. Methods Twenty-seven patients (30 implants) were divided into three groups. All implants were 4 mm wide in diameter and 8 mm long. Group A received 10 tapered implants (OSPTX) (Astra Tech OsseoSpeed TX™) using the soft bone surgical protocol (TXSoft). Group B received 10 tapered implants (OSPTX) (AstraTech OsseoSpeedTX™) using the standard surgical protocol (TXStd). Group C received 10 parallel wall implants (OSP) (AstraTech OsseoSpeed™) using the standard surgical protocol (OStd). All implants were placed in the posterior maxilla in areas with a minimum of 8-mm crestal bone height. Resonance frequency measurements (implant stability quotient (ISQ)) and torque values were recorded to determine initial implant stability. All implants were uncovered 6 weeks after placement and restored with a functionally loaded resin provisional screw-retained crown. Resonance frequency measurements were recorded at the time of implant placement, at 6 weeks and 6 and 12 months. Twelve months after implant placement, the stability of the implants was recorded and the final restorations were placed using custom CAD/CAM fabricated abutments and cement-retained PFM DSIGN porcelain crowns. After implant restoration, bone levels were measured at 6 and 12 months with standardized radiographs. Results Radiographic mean bone loss was less than 0.5 mm in all groups, with no statistically significant differences between the groups. Implant survival rate at 1 year was 93.3%, with 2/30 implants failing to integrate prior to functional loading at 6 weeks. No statistically significant difference was found between ISQ measurements between the three groups at all time intervals measured. Strong positive correlations were found between overall bone loss at 6 months and insertion torque at time of placement. A very weak correlation was found between insertion torque and ISQ values at time of implant placement. Conclusions Survival and stability of OSPTX and OSP implants is comparable. Osteotomy preparation by either standard or soft bone surgical protocol presented no significant effect on implant survival and stability for the specific implant designs