Comparative study of various supraglottic devices with clinical and fiber optic assessment in elective laparoscopic procedures

Background: Aim of present study was to compare the efficacy and safety of supraglottic devices (LMA supreme, LMA proseal and I-Gel) by clinical and fiberoptic evaluation in elective laparoscopic surgeries under general anaesthesia with controlled ventilation.Methods: The design was a prospective, randomized study enrolling total 105 patients of either sex, (age 18-65 years), ASA grade I/II and mallampati score I and II, were randomly allocated to LS (LMAS), LP (PLMA), and IG (I-Gel) groups according to the supraglottic device applied. The three devices were compared as regards insertion parameters, adequacy of ventilation (oxygen saturation, endtidal carbon dioxide and air leak), fibreoptic vision and intra or postoperative complications.Results: The overall ease of insertion of LMAS was found to be better than the other two devices. Adequacy of ventilation was comparable in all the study groups. Safety of these devices was found to be comparable but if OLP was considered as a marker of safety of the device, LMA proseal was a better option than the other two devices. There was no significant difference in the fiberoptic view of the laryngeal inlet between the three study groups but the number of patients with grade 4 view of laryngeal inlet fiberoptic was more in I gel than LMA proseal and LMA supreme.Conclusions: It was concluded that the LMAS, PLMA and I-Gel are effective ventilatory devices during controlled ventilation, without major complications. But in clinical practice it is advisable to monitor peak airway pressure, OLP and laparoscopic view of gastric distension whenever these devices are used in laparoscopic surgeries

TYPICAL DERMATOSIS IN KWASHIORKOR

Protein-energy malnutrition is the most widespread nutritional deficiency disorder in India, commonly occurring in children aged 6 months-2 years,as per the National Family Health Survey, 2007. The dermatologic manifestations are more florid and characteristic in kwashiorkor than in marasmus.Here, we present a case of a 1½ years old male, with extensive skin lesions, owing to severe malnutrition. Malnourishment is one of the foremostconditions seen in the developing countries. It is essential to provide adequate nutritional support to the growing children and to impart proper education to the mothers with regard to weaning and care during the illness of children aged under 5 years

LIPIDS AND ISCHEMIA MODIFIED ALBUMIN IN MILD SUBCLINICAL HYPOTHYROIDISM: RESPONSE TO LEVOTHYROXINE REPLACEMENT

Objective: Subclinical hypothyroidism (SCH) with thyroid-stimulating hormone (TSH) less than 10 µIU/ml is a common finding discovered duringroutine thyroid function testing. Thyroxine substitution and its benefits to alleviate dyslipidemia and oxidative stress (OXs) markers at this stage area matter of debate.Methods: This study aimed to investigate the influence of thyroxine substitution on lipid profile and OXs markers in newly diagnosed SCH subjects.The study included a total number of 50 newly diagnosed (20 treated and 30 untreated), SCH subjects aged 20-50 years with (TSH<10 µIU/ml), andfree thyroxine (FT4) levels in the normal range. Patients on medications that could cause thyroid hormone dysfunction, diabetes mellitus, and currentor pregnancy during the last 2 years were excluded from the study. Serum TSH, T3, T4, FT4, anti-thyroid peroxidase antibodies, total cholesterol (TC),high-density lipoprotein cholesterol (HDL), triglycerides (TG), low-density lipoprotein cholesterol (LDL), and ischemia modified albumin (IMA) weredetermined in all subjects at baseline and after 9 months.Results: After thyroxine replacement, a significant decrease in TSH, LDL, IMA and an increase in FT4 were observed. The decrease in TC was notstatistically evident. There was no significant change in T3, T4, TG, HDL, after treatment. The untreated group showed an insignificant increase onlyin TSH.Conclusion: Thyroid substitution therapy has a favorable influence on lipid profile and OXs, where it particularly reduced LDL and IMA

PREDOMINANCE AND INFLUENCE OF VITAMIN D DEFICIENCY ON GLYCEMIC AND LIPID INDICES IN TYPE 2 DIABETES SUBJECTS: A CASE CONTROL STUDY

Objective To investigate the existence of vitamin D deficiency (VDD) among type 2 diabetes, non-diabetes subjects and its effect on both glycemic and lipid profiles.MethodsA case control study was conducted on 200 subjects of both gender (100 type 2 diabetes and 100 non-diabetes individuals) aged 40 to 60 years. Fasting serum 25(OH) D levels, Fasting Blood Sugar (FBS), HbA1C, lipid profile including total cholesterol, triglycerides, high density lipoprotein, low density lipoprotein TC/HDL and very low density lipoprotein were estimated. Atherogenic Index of Plasma (AIP) was calculated. Group comparisons were done by one way ANOVA followed by post hoc Tukey's test and Student's independent T test. Chi-square test was performed for categorical variables. Correlation was done by Pearson's analysis. P < 0.05 was considered significant.Results The average serum 25(OH) D levels were significantly (p<0.001) low in diabetes group. The prevalence of VDD and the percentage of insufficient and sufficient categories was significantly (p<0.001) high and low respectively in diabetes group. In the deficient category diabetes group had severe VDD with significantly low HDL and elevated triglycerides and there was an insignificant but negative association between serum vitamin D levels, FBS, HbA1c, TC, TG, LDL, TC / HDL and AIP among diabetes subjects.ConclusionThe occurrence of severe vitamin D deficiency coupled with the independent association of the same with the glycemic and lipid profiles in type 2 diabetes may further add to the aggravation of complications Keywords: Vitamin D deficiency, Type 2 diabetes, Glycemic and lipid indice

Design Optimization of a Very High Power Density Motor with a Reluctance Rotor and a Modular Stator Having PMs and Toroidal Windings

This paper proposes a new high power density permanent magnet (PM) motor design for traction applications to achieve the 50kW/L target set by the US Department of Energy by increasing the torque capability and operating speed compared to conventional PM machine topologies. A large-scale multi-objective design optimization based on 2D finite element analysis (FEA) and differential evolution algorithm was conducted to achieve the best trade-off among high efficiency, high power density and high power factor. The torque-speed envelopes are also checked for the Pareto front designs to make sure they have a constant power speed ratio of at least 3:1. An open frame lab prototype (OFLP) motor has been fabricated and tested to validate the principle of operation and design optimization approach, and to identify the potential challenges in manufacturing and testing. Ongoing work on further pushing the electromagnetic performance to the limit and improving the manufacturing and cooling techniques are also discussed

Assessment of Arsenic, Vanadium, Mercury, and Cadmium in Food and Drug Packaging [version 3; peer review: 2 approved, 1 not approved]

Background Food and drug packaging materials are an integral part of our everyday life.  Noxious elements can inadvertently be included in packaging materials in various stages of their production. Adulterants, adhesives, colorants and heavy metal interference are the common sources of contamination in food packaging materials. Heavy metal toxicity has far-reaching ill effects on living organisms. The present study aimed at qualitatively and quantitatively analysing heavy metal content of various materials that are used for food and drug packaging in India. Methods The qualitative detection was done by rapid assay and heavy metals were quantified with the help of inductively coupled plasma-optical emission spectrometry (ICP-OES). A total of thirteen types of food and drug packaging materials were procured from local market and analysed for four heavy metals viz. arsenic (As), vanadium (V), mercury (Hg) and cadmium (Cd). The concentration of each heavy metal in the samples was compared with the permissible values published by the European Council. Results Heavy metals were qualitatively detected in ten out of thirteen samples. Among the ten samples mercury and arsenic were detected the most followed by cadmium and vanadium. Quantitative estimation by ICP-OES showed presence of vanadium and cadmium in ten samples and arsenic and mercury in all the thirteen samples above the permissible range. Conclusions The notable elevation in mercury concentration, followed by cadmium, arsenic and vanadium registering the least, presents a potential health hazard to consumers and compromises the food quality

Undifferentiated Nasopharyngeal Carcinoma with Oral Manifestation: A Case Report

Nazofaringealni karcinom (NPC) rijetka je maligna bolest u većem dijelu svijeta, pa se zato često pogrešno dijagnosticira. Ta se vrsta raka teško pronađe među karcinomima glave i vrata zbog predilekcijskog mjesta, malignih karakteristika rasta, posebnih teškoća u otkrivanju i određivanju stupnja proširenosti te visoke stope neuspjeha u liječenju, iako je osjetljiv na radioterapiju. O toj bolesti malo se zna i obično na godinu oboli jedna osoba u populaciji od 100 tisuća. Uobičajen je u južnoj Kini i sjevernoj Africi, gdje se njegova etiologija povezuje s prehrambenim navikama. Kako bismo bolje razumjeli etiološku patogenezu i mogli prepoznati klinička obilježja te postaviti ranu dijagnozu i prognozu NPC-a, izvještavamo o rijetkom slučaju nazofaringealnog karcinoma u srednjoj Indiji. Pacijentica je bila u dobi od 19 godina i došla je na liječenje zbog tkivne mase u sklopu vrata intraoralno uključene u meko nepce.Nasopharyngeal carcinoma (NPC) is a rare malignancy in most parts of the world and is one of the most confusing, commonly misdiagnosed, and poorly understood diseases. It is unusual among all the head and neck cancers due to its marked geographical predilection, highly malignant tumor growth characteristics, special difficulties in detection and staging and a high rate of treatment failure despite of its radiosensitivity. This carcinoma is rare in most parts of the world with reported incidence of around 1 case per 100,000 population per year. Nasopharyngeal carcinoma is common in Southern China and North Africa, where the etiology is related to dietary habits but it is rare in other parts of the world. Therefore, for better understanding of etiopathogenesis, clinical pathological features, early diagnosis and prognosis of NPC, we report a rare case of a nasopharyngeal carcinoma in Central India, of a 19 year old female patient who presented with a mass in her neck and intraoral involvement of the soft palate

Fungal Histidine Phosphotransferase Plays a Crucial Role in Photomorphogenesis and Pathogenesis in Magnaporthe oryzae

Two-component signal transduction (TCST) pathways play crucial roles in many cellular functions such as stress responses, biofilm formation, and sporulation. The histidine phosphotransferase (HPt), which is an intermediate phosphotransfer protein in a two-component system, transfers a phosphate group to a phosphorylatable aspartate residue in the target protein(s), and up-regulates stress-activated MAP kinase cascades. Most fungal genomes carry a single copy of the gene coding for HPt, which are potential antifungal targets. However, unlike the histidine kinases (HK) or the downstream response regulators (RR) in two-component system, the HPts have not been well-studied in phytopathogenic fungi. In this study, we investigated the role of HPt in the model rice-blast fungal pathogen Magnaporthe oryzae. We found that in M. oryzae an additional isoform of the HPT gene YPD1 was expressed specifically in response to light. Further, the expression of light-regulated genes such as those encoding envoy and blue-light-harvesting protein, and PAS domain containing HKs was significantly reduced upon down-regulation of YPD1 in M. oryzae. Importantly, down-regulation of YPD1 led to a significant decrease in the ability to penetrate the host cuticle and in light-dependent conidiation in M. oryzae. Thus, our results indicate that Ypd1 plays an important role in asexual development and host invasion, and suggest that YPD1 isoforms likely have distinct roles to play in the rice-blast pathogen M. oryzae

Provable Multi-copy Dynamic Data Possession with Multi-owner in Cloud Computing System

Most of organization store almost unlimited amount of their data in cloud with facility of retrieving. Users pay fees for storing data. Many of the users are in collaborative relationship; at that time data sharing and dynamic operation are useful to improve productive benefits. So, propose system introduced the multi owner with data sharing concept. Most of the time customers store their important data on multiple servers for accessing on different geographical location. When data store on multiple server then data owner need evidence of all outsourced file copies are intact. But some time few copies may be corrupt. So, proposed system identifies corrupted copies and corrects it before dynamic operation performs. In addition, proposed system allows multi-owner facility for sharing data