Chondroid tenosynovial giant cell tumour : a rarity in the temporomandibular joint

Tenosynovial giant cell tumours of the temporomandibular joint (TMJ) are extremely rare, particularly the subset of chondroid tumours. They can be broadly divided into localised and diffuse types, of which we know of only 116 reported cases in the TMJ. Rarer still are the subset of chondroid tenosynovial giant cell tumours, of which we know of only 30 cases that have affected the TMJ. We present a case that involved the TMJ, and include a discussion of its management

Performance of Integrated IoT Network with Hybrid mmWave/FSO/THz Backhaul Link

Establishing end-to-end connectivity of Internet of Things (IoT) network with the core for collecting sensing data from remote and hard-to-reach terrains is a challenging task. In this article, we analyze the performance of an IoT network integrated with wireless backhaul link for data collection. We propose a solution that involves a self-configuring protocol for aggregate node (AN) selection in an IoT network, which sends the data packet to an unmanned aerial vehicle (UAV) over radio frequency (RF) channels. We adopt a novel hybrid transmission technique for wireless backhaul employing opportunistic selections combining (OSC) and maximal ratio combining (MRC) that simultaneously transmits the data packet on mmWave (mW), free space optical (FSO), and terahertz (THz) technologies to take advantage of their complementary characteristics. We employ the decode-and-forward (DF) protocol to integrate the IoT and backhaul links and provide physical layer performance assessment using outage probability and average bit-error-rate (BER) under diverse channel conditions. We also develop simplified expressions to gain a better understanding of the system's performance at high signal-to-noise ratio (SNR). We provide computer simulations to compare different wireless backhaul technologies under various channel and SNR scenarios and demonstrate the performance of the data collection using the integrated link.Comment: This work has been submitted to IEEE for possible publicatio

An update work of pulse oximetry screening for detecting critical congenital heart disease in the newborn

Background: Congenital Heart Disease (CHD) is the commonest group of congenital malformations and affects 7-8 per 1000 live born newborns. Nevertheless, it is estimated that more than 50% of babies with undiagnosed CHD are not detected by routine neonatal cardiac examination. Aim: To find the incidence of CHD in newborns and to determine the accuracy of pulse oximetry for detecting clinically unrecognized critical congenital heart disease (CCHD) in the newborns. Methods: Pulse oximetry was performed on clinically normal newborns within 4 hours of first day of life. Inclusion criteria: All newborns who were admitted in postnatal ward & Neonatal Intensive care unit (NICU). Exclusion criteria: babies and neonates with a prenatal diagnosis of duct dependent circulation. If oxygen saturation (SpO2) was below 90%, then echocardiography was performed. Results: During the study period, 4926 live born neonates were examined. Nine out of 12 neonates with SpO2<90% had CCHD. Four neonates had tetralogy of Fallot (TOF), two had tricuspid atresia, two had transposition of great arteries (TGA) and one had truncus arteriosus. The incidence of CHD was 33.49 per 1000 live births and CCHD was 1.82 per 1000. A pulse oximetry cut-off value of below 90% for detecting CCHD showed 90% sensitivity, 99.94% specificity, 75% positive predictive value (PPV) and 99.98% negative predictive value (NPV). Conclusion: Pulse oximetry is safe, feasible and noninvasive and also used to screen for CCHD. It is the nice method to detect the CHD along with the physical examination of neonates by medical personal.peer-reviewe

Ultrasonographic visualisation of anatomical variation of the medial cutaneous nerve of forearm and its depiction by the novel use of a custom computer program to generate 2D diagrams

Cutaneous nerves display significant anatomical variation, and are therefore vulnerable to iatrogenic injury during various surgical procedures. High-resolution ultrasonography (USG) was used in this study to investigate this variation, and map the course of the medial cutaneous nerve of the forearm (MCNF). We also aimed to develop a method to virtually represent this variation, which could be used to plan procedures involving the MCNF

Formulation and Physical Characterization of Bio-Degradable Chitosan-Poloxamer Gel Base for Local Drug Delivery

Objective: Thermo-modulated in-situ hydrogel (TSHG) are formulated routinely utilizing poloxamer for extended drug release. However physical properties of such formulations may have some flaws, which can be rectified using a combination of polymers with better physical properties such as chitosan. The purpose of the present study was to fabricate biodegradable chitosan-poloxamer-based in-situ drug delivery systems and assessment of their physical properties. Methods: The present chitosan-poloxamer gel base was formulated using a two-stage method. Initially, chitosan gel was prepared by dissolving 1% w/w chitosan in glacial acetic acid. The poloxamer gel was prepared using “cold method”. The final chitosan-poloxamer gel base was prepared by mixing equal amounts of both solutions and evaluated for physical and mechanical properties. Result and Discussion: The DSC thermogram demonstrated no obvious interactions among ingredients or micellization temperature. The gelation temperature of the gel was between 27 and 330C. The pH was 7 with slight clarity. The viscosity of the gel ranged from 15.14 to 41.19 pa.s. The gel was syringable between 4-300C and biodegradable under physiological conditions. The mean particle size of the gel under SEM was found in the range of 300-554 nm. Conclusion: After the evaluation of the formulation, it can be concluded that all the ingredients in the gel showed good compatibility with each other, which could form a stable and homogeneous gel with favorable mechanical and physical properties. Keywords: chitosan, drug delivery system, hydrogels, poloxame

Autonomous Tissue Retraction in Robotic Assisted Minimally Invasive Surgery – A Feasibility Study

In this letter, we describe a novel framework for planning and executing semi-autonomous tissue retraction in minimally invasive robotic surgery. The approach is aimed at removing tissue flaps or connective tissue from the surgical area autonomously, thus exposing the underlying anatomical structures. First, a deep neural network is used to analyse the endoscopic image and detect candidate tissue flaps obstructing the surgical field. A procedural algorithm for planning and executing the retraction gesture is then developed from extended discussions with clinicians. Experimental validation, carried out on a DaVinci Research Kit, shows an average 25% increase of the visible background after retraction. Another significant contribution of this letter is a dataset containing 1,080 labelled surgical stereo images and the associated depth maps, representing tissue flaps in different scenarios. The work described in this letter is a fundamental step towards the autonomous execution of tissue retraction, and the first example of simultaneous use of deep learning and procedural algorithms. The same framework could be applied to a wide range of autonomous tasks, such as debridement and placement of laparoscopic clips

Assessment of modifiable risk factors for acute lower Respiratory tract infections in under-five children

Background: Acute lower respiratory tract infection (ALRTI) continues to be the biggest killer worldwide of children under 5 years&nbsp;of age. Objective: The objective of this study is to identify and assess the modifiable risk factors for ALRTI in children under&nbsp;5 years of age. Materials and Methods: This prospective case–control study was conducted in the pediatrics department of a tertiary&nbsp;care pediatric hospital. A sample size of 106 cases and 106 controls were selected. A detailed general and systemic examination&nbsp;(including respiratory and heart rate measurements, anthropometry, and nutritional assessment) along with the routine hematologicalinvestigations and chest X rays was done in both cases and controls. Other specific investigations were done as per requirement in&nbsp;individual cases, and all the cases were treated as per the standard protocol depending on the type of ALRTI. Chi-square-test was&nbsp;used and p&lt;0.05 was taken as statistically significant. Results: Statistically significant risk factors identified with increased incidence&nbsp;of ALRTI included incomplete immunization for age, low socioeconomic status, families having more than two under-five children&nbsp;at home, family history of moking, respiratory infections, overcrowding, use of biomass as fuel for cooking, lack of ventilation,&nbsp;not having separate kitchen, low birth weight, pre-lacteal feeding, lack of exclusive breastfeeding for 4–6 months, malnutrition, and&nbsp;anemia. Conclusion: The present study identifies various significant risk factors for severe pneumonia in under-five children

Do design variations in the artificial disc influence cervical spine biomechanics? A finite element investigation

Various ball and socket-type designs of cervical artificial discs are in use or under investigation. Many artificial disc designs claim to restore the normal kinematics of the cervical spine. What differentiates one type of design from another design is currently not well understood. In this study, authors examined various clinically relevant parameters using a finite element model of C3–C7 cervical spine to study the effects of variations of ball and socket disc designs. Four variations of ball and socket-type artificial disc were placed at the C5–C6 level in an experimentally validated finite element model. Biomechanical effects of the shape (oval vs. spherical ball) and location (inferior vs. superior ball) were studied in detail. Range of motion, facet loading, implant stresses and capsule ligament strains were computed to investigate the influence of disc designs on resulting biomechanics. Motions at the implant level tended to increase following disc replacement. No major kinematic differences were observed among the disc designs tested. However, implant stresses were substantially higher in the spherical designs when compared to the oval designs. For both spherical and oval designs, the facet loads were lower for the designs with an inferior ball component. The capsule ligament strains were lower for the oval design with an inferior ball component. Overall, the oval design with an inferior ball component, produced motion, facet loads, implant stresses and capsule ligament strains closest to the intact spine, which may be key to long-term implant survival