Perioperative glycemic control and its outcome in patients following open heart surgery

Background: Diabetes is not uncommon in patients requiring cardiac surgery. These patients have a higher incidence of morbidity and mortality. Subsequently, diabetes represents a major medico-economic problem in both developed and developing countries. This study was designed to observe the association between glycemic control and outcome of patients after open heart surgery in adult population.Materials and methods: Data was collected retrospectively in all patients who underwent open cardiac surgery (coronary artery bypass grafting, valve, or bypass grafting with valve surgery) and survived 72 hours postoperatively and had diabetes. The study was conducted from January 2015 to December 2016.Results: Of the 129 patients included in the study, male dominated 101 (78.3%). Most frequent surgery was coronary artery bypass grafting (CABG) 123 (95.3%), CABG plus aortic valve replacement 4 (3.1%), and CABG plus mitral valve replacement 2 (1.6%). Considering diabetes, only 3 (2.3%) were on diet control, 112 (86.8%) on oral hypoglycemic agents (OHA), whereas 9 (7%) had control on both insulin and OHA. Only 5 (3.9%) had type I diabetes. The mean fasting blood sugar (FBS) was 154.58 g/dl, and the mean duration of diabetic mellitus was observed 12.32 years. Microvascular and macrovascular complications were 26/129 (20.16%) and 17/129 (13.17%), respectively. Total 75 (58.1%) patients did not require insulin and 54 (41.9%) were treated with insulin intraoperatively to keep the blood glucose level less than 200 g/dl. Cardiac arrhythmias were frequent in the insulin group (P \u3c 0.05), which was also associated with increased stay in the cardiac intensive care unit.Conclusion: Inadequate glycemic control during open cardiac surgery can possibly lead to increased perioperative morbidity and mortality and with decreased long-term survival and recurrent ischemic events. Therefore, aiming for blood glucose levels around 140 mg/dl appears reasonable. Further studies are required to define specific glucose ranges for a clearer definition of recommended blood glucose goals in postoperative cardiac patients for the best outcomes in patients with diabetes mellitus

Seasonal variance in the incidence rate of epistaxis

Background: Epistaxis, commonly known as a nosebleed, is a medical term that refers to the occurrence of bleeding from the nose. This study aimed to assess the seasonal variance in the incidence rate of epistaxis. Methods: This was a cross-sectional observational study that was conducted in the department of otolaryngology and head-neck surgery (ENT) at Combined Military hospital (CMH), Chattogram from January 2013 to December 2016 and in CMH, Dhaka from January 2017 to July 2019. In total 165 patients who reported complaints of nose bleeding to the ENT Outpatient Department or Emergency unit of the aforementioned hospitals were enrolled in this study as the study subjects. All the patients were diagnosed based on, clinical examination, history, and radiological and laboratory investigations. All data were processed, analyzed and disseminated by using MS office. Results: The mean age of the participants was 34.44 years; the majority (21.8%) were from the age group of 11-20 years. Bilateral nasal bleeding was in 108 (65.5%) cases, 125 (75.8%) patients had the first episode of bleeding and 117 (70.9%) patients had anterior epistaxis. In analyzing the monthly wise incidences rate of epistaxis among participants we observed that, in February (11%), March (10%), June (10%), July (13%) and December (15%) the incidence rates were higher than in other months. In evaluating the seasonal variation of epistaxis among our participants we observed that the highest incidences occurred in the winter season which was 32% followed by 30% in the summer season. Conclusions: Younger male individuals are mainly prone to epistaxis. The frequency of the incidence of epistaxis during the winter and summer seasons is higher than in other seasons

Reversing Chromatin Accessibility Differences that Distinguish Homologous Mitotic Metaphase Chromosomes

BACKGROUND: Chromatin-modifying reagents that alter histone associating proteins, DNA conformation or its sequence are well established strategies for studying chromatin structure in interphase (G1, S, G2). Little is known about how these compounds act during metaphase. We assessed the effects of these reagents at genomic loci that show reproducible, non-random differences in accessibility to chromatin that distinguish homologous targets by single copy DNA probe fluorescence in situ hybridization (scFISH). By super-resolution 3-D structured illumination microscopy (3D-SIM) and other criteria, the differences correspond to \u27differential accessibility\u27 (DA) to these chromosomal regions. At these chromosomal loci, DA of the same homologous chromosome is stable and epigenetic hallmarks of less accessible interphase chromatin are present. RESULTS: To understand the basis for DA, we investigate the impact of epigenetic modifiers on these allelic differences in chromatin accessibility between metaphase homologs in lymphoblastoid cell lines. Allelic differences in metaphase chromosome accessibility represent a stable chromatin mark on mitotic metaphase chromosomes. Inhibition of the topoisomerase IIα-DNA cleavage complex reversed DA. Inter-homolog probe fluorescence intensity ratios between chromosomes treated with ICRF-193 were significantly lower than untreated controls. 3D-SIM demonstrated that differences in hybridized probe volume and depth between allelic targets were equalized by this treatment. By contrast, DA was impervious to chromosome decondensation treatments targeting histone modifying enzymes, cytosine methylation, as well as in cells with regulatory defects in chromatid cohesion. These data altogether suggest that DA is a reflection of allelic differences in metaphase chromosome compaction, dictated by the localized catenation state of the chromosome, rather than by other epigenetic marks. CONCLUSIONS: Inhibition of the topoisomerase IIα-DNA cleavage complex mitigated DA by decreasing DNA superhelicity and axial metaphase chromosome condensation. This has potential implications for the mechanism of preservation of cellular phenotypes that enables the same chromatin structure to be correctly reestablished in progeny cells of the same tissue or individual

Design of multi-valued quaternary based analog-to-digital converter

Problem statement: The design of multi-valued quaternary based Analog-to-Digital Converter (ADC) circuit was presented. The ADC generates multi-valued logic outputs rather than the conventional binary output system to overall reduction in circuit complexity and size. Approach: Design was implemented using pipeline ADC architecture and was simulated using model parameters based on standard 0.13 µm CMOS process. Results: Performance analysis of the design showed desirable performance parameters in terms of response, low power consumption, and a sampling rate of 10 MHz at a supply voltage of 1.3V was achieved. Conclusion/Recommendations: The ADC design was suitable for the needs of mixed-signal integrated circuit design and can be implemented as a conversion circuit for systems based on multiple-valued logic design

Piece-wise linear analog to digital (PLADC) converter process

Transducers are devices that transform energy from one form to another. Such transformation process may be applicable in the measurement of physical quantities, transfer of information and also in performing a certain control action. Transducers used as measuring devices are generally termed as sensors. Such transducers detect the changes in characteristics of a physical quantity and convert the change into a corresponding electrical signal. This is a common phenomenon when transducers are used to detect temperature, speed, force, liquid level or viscosity. On the other hand transducers, used to carry out control actions, are termed as actuators. These transducers usually convert an electrical signal into some form of physical control action such as heating or movement and are carried by the control devices. Various types of transducers exist meant for sensing and controlling different physical quantities. For example, a light dependent resistor (LOR) or a photodiode can be used to sense light intensity of an environment while lamps and LED displays can be used to control it. Likewise, a thermistor can be used to measure the temperature of an environment while a heater/fan can be used to control it and a tachometer can be used to measure the speed of a device while a stepper motor can be used to control it [1-3]. The focus of this chapter is on the problems and issues related to the interfacing of transducers when used as measuring devices or sensors in smart applications. Smart applications are also termed as tuned control for detecting changes in the parameter of interest which used to be ignorable in the traditional measurement and control system

Dual-Band Bandpass Filter with Dumbbell Shaped Defective Ground Structure

A dumbbell shaped defective ground structure (DGS) is implemented to improve the performance of an existing dual-band bandpass filter topology. The filter design is based on parallel-coupled lines connected to matched transmission lines. Various positions and dimensions of dumbbell DGSs are implemented and their effects on the filter performance are investigated. It is found that the utilisation of dumbbell shaped DGSs in this topology improve the steepness of the responses for the first and second passbands with centre frequencies of 1.365 and 2.932 GHz respectively. The optimised dimensions of the DGS are 5 x 5 mm2 for both its rectangular slots connected by a 0.5 mm narrow slot width. The optimised positions of the DGSs are located at the centre and the edges of the parallel-coupled lines. The simulated and measured results of the filter are analysed and discussed in this paper

Catalyst-free fabrication of novel ZnO/CuO core-Shell nanowires heterojunction: Controlled growth, structural and optoelectronic properties

Development of controlled growth and vertically aligned ZnO/CuO core-shell heterojunction nanowires (NWs) with large area by a catalyst free vapor deposition and oxidation approach has been investigated. Structural characterization reveals successful fabrication of a core ZnO nanowire having single crystalline hexagonal wurtzite structure along [002] direction and CuO nanostructure shell with thickness (8–10 nm) having polycrystalline monoclinic structure. The optical property analysis suggests that the reflectance spectrum of ZnO/CuO heterostructure nanowires is decreased by 18% in the visible range, which correspondingly shows high absorption in this region as compared to pristine ZnO nanowires. The current-voltage (I–V) characteristics of core-shell heterojunction nanowires measured by conductive atomic force microscopy (C-AFM) shows excellent rectifying behavior, which indicates the characteristics of a good p-n junction. The high-resolution transmission electron microscopy (HRTEM) has confirmed the sharp junction interface between the core-shell heterojunction nanowire arrays. The valence band offset and conduction band offset at ZnO/CuO heterointerfaces are measured to be 2.4 ± 0.05 and 0.23 ± 0.005 eV respectively, using X-ray photoelectron spectroscopy (XPS) and a type-II band alignment structure is found. The results of this study contribute to the development of new advanced device heterostructures for solar energy conversion and optoelectronics applications

Phytoconstituents from Vernonia glaberrima Welw. Ex O. Hoffm. leaves and their cytotoxic activities on a panel of human cancer cell lines

Vernonia glaberrima is a medicinal plant that is used in African traditional medicine for the treatment of skin cancer. The aim of this study was to investigate the anticancer activity of V. glaberrima leaves and isolate its bioactive constituents. Crude methanolic leaves extract of V. glaberrima showing significant cytotoxic activity against cancer cell lines was subjected to chromatographic separation, purification and hydrolysis to yield four compounds namely, nonacosanoic acid, lupeol, 5-methylcoumarin-4-β-glucoside and 4-hydroxy-5-methylcoumarin. Three of the isolated compounds showed significant cytotoxic activity against human malignant melanoma (A375) cell line (IC50: 59.18 ± 2.70 to 139.53 ± 10.79 μg/mL) and human caucasian colon adenocarcinoma (HT-29) cell line (IC50: 4.22 ± 0.13 to 20.0 ± 1.91 μg/mL) while only lupeol displayed significant activity against human breast adenocarcinoma (MCF7) (IC50: 34.15 ± 2.32 μg/mL) cell line. CDK2 receptor and CAIX were identified through molecular docking as potential targets for the bioactive compounds. The findings of this study have revealed the therapeutic potential of V. glaberrima against breast cancer, skin cancer and colorectal carcinoma, respectively and further support its traditional uses in the treatment of skin cancer. Keywords: Vernonia glaberrima; Anticancer activity; 5-Methylcoumarin-4-β-glucoside; Molecular docking; Carbonic anhydrase I

Design and implementation of an optimal fuzzy logic controller using egentic algorithm

Most control systems suITer from problems related to undesirable overshoot, longer settling times aoo vibrations while going from one state 10 an(){her state. Works so far reponed techniques which are on how to oveTCQme or reduce the effects of these issues for ensuring smoother and finely tuned eolltrolling proceM. The devised solution is softwllrebased which employs an algorithmic approach for programming II PICI6F877A microcontroller, thus eliminating allogether the parametric dependence issues while adding the benefits of easier modification to suit a given control system for varying operational conditions_ The approach is first simulated using MATLAB/and the simulated results are verified by programming {he PICI6I'g77A mierocontrolter with {he algorithm and using it on a temperature control system where a fan is regulated in response to variations in the ambient system temperature. The results justify the effectiveness of the approach implemented in this study and they lUnher prove toot the optimized Fuzzy Logic Controller is functioning better than the conventional PID Controlle

Xuetonglactones A–F: Highly Oxidized Lanostane and Cycloartane Triterpenoids From Kadsura heteroclita Roxb. Craib

© Copyright © 2020 Shehla, Li, Cao, Zhao, Jian, Daniyal, Wahab, Khan, Liao, Rahman, Choudhary and Wang. Xuetonglactones A–F (1–6), six unreported highly oxidized lanostane- and cycloartane-type triterpenoids along with 22 known scaffolds (7–28) were isolated from the stems of Kadsura heteroclita (Roxb.) Craib. Compared with previous congeners, xuetonglactone A (1), possesses an unprecedented 20,21-α-epoxide, and xuetonglactone D (4) features an unusual 19-α-hydroperoxyl moiety. The structures and the absolute configurations of the compounds were established by extensive one- and two-dimensional NMR, and electronic circular dichroism (ECD) spectroscopic analysis, with those of 1 and 5 confirmed by single-crystal X-ray diffraction technique. Compounds 1 and 2 exhibited inhibition of iNOS activity in LPS-induced macrophages with IC50 values of 22.0, and 17.0 μg/mL, respectively. While compounds 6, 7, 8, and 24 showed potent cytotoxic activities against human cervical cancer cell lines (HeLa) with the IC50 values of 4.0, 5.8, 5.0, and 6.4 μM, and against human gastric cancer cells (BGC 823) with the IC50 values of 2.0, 5.0, 2.5, and 2.0 μM, respectively. Moreover, plausible biogenetic pathways of (1–6) were also proposed