Utility of bilateral superficial cervical plexus block in thyroidectomy patients for post-operative analgesia

Background: Thyroidectomy is painful procedure hence multimodal analgesia is required. Superficial cervical plexus block can be used for analgesia in thyroid surgeries. USG guided cervical plexus block administration is safe and latest technique as a part of multimodal analgesia for thyroid surgery.Methods: After obtaining consent 60 ASA grade I-II adult patients undergoing elective thyroid surgery were included and randomly divided into two groups (group B)-0.25% bupivacaine and (group S)-normal saline. Induction and maintenance under general anesthesia carried out as per standard protocol. After Induction USG guided block was administered with the drug solution as per allocated group. After surgery, patients were extubated and shifted to recovery room. Vital parameters were monitored. Patients were asked about their pain based on the 11-point numerical rating scales (NRS) score. The NRS score and other variables were documented at 3rd hour, 6th hour, 12th hour, and 24th hour at wards after the end of surgery. Time since the end of surgery to the first analgesia request was documented together with total analgesia consumed in the first 24 hours. If NRS score was ≥4 inj. Tramadol iv in incremental doses of 25 mg was given until pain relieved.Results: Time to first dose of analgesia was higher in group B compared to group S. Total analgesic dose of tramadol during first 24 hours was lower in group B compared to group SConclusions: bilateral superficial cervical plexus block can be used as a part of multi-modal analgesia in patients of thyroidectoy

Prediction of forest aboveground biomass using multitemporal multispectral remote sensing data

Forest aboveground biomass (AGB) is a prime forest parameter that requires global level estimates to study the global carbon cycle. Light detection and ranging (LiDAR) is the state-of-the-art technology for AGB prediction but it is expensive, and its coverage is restricted to small areas. On the contrary, spaceborne Earth observation data are effective and economical information sources to estimate and monitor AGB at a large scale. In this paper, we present a study on the use of different spaceborne multispectral remote sensing data for the prediction of forest AGB. The objective is to evaluate the effects of temporal, spectral, and spatial capacities of multispectral satellite data for AGB prediction. The study was performed on multispectral data acquired by Sentinel-2, RapidEye, and Dove satellites which are characterized by different spatial resolutions, temporal availability, and number of spectral bands. A systematic process of least absolute shrinkage and selection operator (lasso) variable selection generalized linear modeling, leave-one-out cross-validation, and analysis was accomplished on each satellite dataset for AGB prediction. Results point out that the multitemporal data based AGB models were more effective in prediction than the single-time models. In addition, red-edge and short wave infrared (SWIR) channel dependent variables showed significant improvement in the modeling results and contributed to more than 50% of the selected variables. Results also suggest that high spatial resolution plays a smaller role than spectral and temporal information in the prediction of AGB. The overall analysis emphasizes a good potential of spaceborne multispectral data for developing sophisticated methods for AGB prediction especially with specific spectral channels and temporal informatio

Automatic Gait Balance Detection System

Falls are one of the major causes of injury in elderly people over 65 years. Each year, 2.5 million people are treated for a serious fall injury. In addition to the fall there is the delay in receiving assistance. Researchers have developed three methodologies to detect falls: image/video processing by implementing cameras and trackers, acoustic recognition using floor and wall sensors and by analysis of wearable sensors. Fall detection using smartphones has also been proposed in the past. A smartphone may have many constraints due to which a wearable device is a much more viable option for such a critical issue. This poster aims to suggest an effective way to detect falls by using a wearable device of which the major components are: 3-axial accelerometer, Arduino Uno, and GPS-GSM device. Apart from that, a buzzer is also integrated to notify people nearby for assistance. The location of the wearable device also affects the acceleration and the result of fall and motion detection. Although the wrist is the most common body part for any wearable device, the acceleration signal may vary widely. It is efficient to place the device in areas of least movement like a knee or waist

Long-term TNF-alpha therapy for preserving beta cell function in new onset type 1 diabetes:a case report

Background: Type 1 diabetes mellitus (T1D) is an autoimmune disease caused by destruction of pancreatic islet beta-cells. There is significant residual beta-cell function, measured through circulating C-peptide, present at the time of T1D diagnosis but this subsequently decreases with time. Higher residual beta-cell function at diagnosis associates with better glycaemic control and less glucose variability, and later in the disease course with less hypoglycaemia, lower glucose variability and fewer microvascular complications. There is therefore value in preserving residual beta cell function in new onset T1D Immunotherapeutic agents can protect residual beta-cell function in type 1 diabetes. However, clinical trials of such agents, whilst demonstrating C-peptide preservation in short term studies, have yet to be taken forward into routine clinical care due to concerns around safety and long-term efficacy. Here we report the case of a gentleman with newly diagnosed T1D whose glycaemic control and insulin requirement improved whilst on a five year infusion programme of infliximab, a monoclonal antibody against TNF-alpha, for colitis. Case presentation: A 52-year-old White Caucasian man was diagnosed with T1D in August 2018. Glucose was 25.6 mmol/L, HbA1c was 98mmol/mol and GAD antibodies were strongly positive. HbA1c marginally improved to 91mmol/mol following initiation of insulin detemir 5 units at night and 1:10 g of insulin aspart (November 2018). In June 2019, he developed rectal bleeding and abdominal pain. Following colonoscopy, he was diagnosed with “indeterminate colitis” and commenced on 6-weekly infusions of 400-450 mg infliximab. Thus far, he has received 32 doses and achieved colitis remission. Following infliximab initiation there was increased frequency of mild-moderate hypoglycaemia and he was gradually weaned off and discontinued detemir in June 2020. Since then, HbA1c improved from 57mmol/mol in August 2019 to 52mmol/mol in April 2022, remaining stable at 51mmol/mol. His most recent HbA1c is 54mmol/mol in February 2024. His c-peptide was 550pmol/L in October 2022 and 442pmol/L in February 2024, suggesting well-preserved beta-cell function almost 6 years post-diagnosis. Conclusions: Our patient’s improvement in glycaemic control can be explained by immunomodulation and C peptide preservation from infliximab. With the growing focus on type 1 diabetes disease modulation and working towards an ‘insulin free T1D’, our findings strengthen the evidence base for the repurposing of and long-term treatment with anti-TNF-α agents to preserve beta-cell function in new onset T1D

Concrete Pavement Joint Deterioration

Concrete pavements are an important part of our national infrastructure. In recent years the relatively small number of reported joints deteriorating prematurely in concrete pavements around Indiana has increased. Changes over the past 45 years in INDOT specification, pavement materials, designs and construction practices, and current de-icing materials were examined and related to the durability of concrete at the joints of existing pavements. A survey of concrete pavements across the state revealed that no pavements from the two southern districts less than 40 years old showed this distress except in more recently placed patches. Cores were retrieved from the joints and mid-panel of 11 pavement sections that represented different materials, ages, construction, deicer exposure, and different levels of deterioration, from non-deteriorated concrete to concrete with severe deterioration at the joints. The pavement base drained well at the mid-panel of most pavements but was reduced at the joints for over half the pavements with the most severe joint deterioration associated with the slowest drainage. None of the concrete had an air void system that met all the criteria recommended for FT durable concrete but was better at the mid-panel than at the joints. Infilling and lining of the entrained air voids with ettringite and some Friedel’s salt was more common near the joints and could account for the reduced air void system. The FT testing did not correlate directly with the air void parameters but generally mid-panel samples did test as more durable than joints. Evidence from the presence of unhydrated cement grains suggested that the concrete at the joint face was not fully cured. One pavement section that did not have fly ash had worse deterioration than the panels nearby that had fly ash and calcium hydrate was more noticeable in the concrete from joints with severe deterioration. Several variables were identified that influence the durability of the concrete at the joints and there may be other variables that were beyond the scope or capacity of this study. In summary this study identified the following variables likely influenced the durability of the concrete at the joints: the drainability of the base at the joints, original air void system, reduced air void parameters due to lining and infilling of the air voids with secondary minerals, poor hydration of the concrete at the joint face and increased moisture at the joint

Vibration analysis of moving machine tool axes based on phase information in video data

Vibrations of machine tools limit quality and productivity and therefore need to be analyzed. Video based vibration analysis using spatial phase information could in principle reduce measuring effort significantly. However, feasibility of these approaches for moving machine tool axes and relative movement between camera and object is yet to be shown. This paper investigates an approach for stabilizing linear axis movement to analyze vibration. It is shown that shaker induced vibration on a linearly moving clamping tower can be derived for low frequencies. However, influences of actual cutting processes as well as compensation of unwanted camera vibration needs further investigation

Drug price control order: the impact on pharmacoeconomics

Background: The objective of the present study was to analyze the prices of metformin, losartan, atorvastatin, paracetamol and aspirin for the doses which are included in the list of Drug Price Control Order (DPCO) 2013.Methods: Current index medical specialties India, 37th year, April-July 2015 issue was used for analysis. The retail prices of the drugs in INR were tabulated in Microsoft Office Excel 2013. The prices of the above listed drugs were compared with prices of DPCO 2013 for the same doses of drugs. The analysis of drugs costing more than the prices listed in the DPCO with the margin of the difference in percentage was carried out.Results: Out of 25 brands of metformin 500 mg tablet, 11 (44%) brands had price higher than listed in DPCO 2013. Similarly, prices for losartan 25 mg and 50 mg tablets, 8 (25%) out of 32 and 11 (31.42%) out of 35 were higher respectively. For atorvastatin 5 mg and 10 mg tablets, 2 (9.52%) out of 21 and 8 (13.55%) out of 59 brands had higher prices. For paracetamol 500 mg tablet, 12 (63.15%) out of 19 brands were priced higher than DPCO list. For aspirin 100 mg tablet and 325 mg tablet, 3 (100%) out of 3 brands and 1 (100%) out of 1 brand had higher prices.Conclusions: Many of the brand formulations have higher prices than the DPCO 2013 issued by government of India. The clinicians prescribing these drugs should be aware of these brand formulations to reduce the cost of the drug therapy