Passivity and Pitting Corrosion of Carbon Steel in Chloride Containing Borate Buffer Solution

Passivity breakdown of high manganese steel in deaerated borate buffer solution has been studied in the following thesis. The steel used here is a special high strength C-Mn steel used extensively in pressure vessels. This article describes an attempt to predict and interpret the pitting corrosion of the steel in terms of the point defect model (PDM) in deaerated borate buffer solution at different pH (6, 8, 9, 10) at different chloride ion concentration ([Cl¯] = 0.01, 0.1, 0.6, 1M). The objectives of the work is to study the state of passivity and the related characteristics, determine the breakdown potential (Vc) as functions of pH, chloride concentration and potential sweep rate (?), analyze the relationship between Vc and [Cl¯], pH and scan rate (v) in terms of PDM to extract parameter values for passivity breakdown and assess the ability of PDM to account for passivity breakdown. The passive film was found to contain n-type defect with film thickness depending directly on the passivation potential. The near normal distribution in breakdown potential is in satisfactory agreement with the analytical prediction of the breakdown potential distribution obtained from PDM. The linear dependence of breakdown potential on the square root of potential scan rate and polarizability dependence of the barrier layer/solution interface upon potential and pH are 0.83 and ­ 0.01 respectively, as predicted by the PDM, yields an estimate of the critical areal concentration of condensed vacancies at the metal/film interface (? = 4.9×1014 cm-2) that leads to passivity breakdown. The value of the critical areal concentration of condensed vacancies falls in well agreement with the value obtained from structural argument. These provide convincing evidence for the validity of PDM for modelling passivity breakdown on high manganese carbon steel

Utilisation of Scholarly Communication through DRDO E-journal Consortium during 2012-2017

Timely, speedy dissemination of latest information is the benchmark of any information and documentation center, but utilisation of e-journals is an important factor for its significance and cost effectiveness. However, in R&D community especially for defence R&D, where scientists are involved in core technology areas, value of information is more important instead of its utilisation. The aim of the study is to find out the utilisation of e-journals with cost effectiveness under Consortium, which was established in the year 2009 for resource sharing among DRDO labs with least expenses. The data was analysed for the period 2011-2017 to know the current trends of utilisation under Consortium. Feedbacks and suggestions were collected from all DRDO users to evaluate the importance of information and its effectiveness. The study shows that productivity of DRDO scientists in publications were increased in high impact factor journal and majority of scientists preferred e-journals instead of print subscriptions

Comparison of Baska Mask Versus I-Gel in Short Gynaecological Laparoscopic Surgeries Under General Anaesthesia in Adult Female: A Randomized Interventional Study

Background: Various newer generations of Supraglottic Airway Devices (SAD) with improved designs and performance are available for use by anaesthesiologist. We conducted the present study to compare 3rd generation SAD Baska Mask with 2nd generation SAD I-gel with the aim of comparing their clinical performance in terms of insertion parameters and oropharyngeal leak pressure in short laparoscopic gynaecological surgeries in adult females. Methods: 80 adult female patients were randomly allocated to either Baska Mask (n=40) or I-gel (n=40) groups. Insertion characteristics that included number of attempts, mean insertion time and manipulation frequency were recorded and compared. Oropharyngeal leak pressure was measured just after insertion of device and after 5 min of creating pneumoperitoneum in both devices and were compared. Results: Baska Mask insertion was successfully achieved in first attempt in 38/40 patients in Baska group vs 35/40 patients in I-gel group. Mean oropharyngeal leak pressure (OLP) in Baska Mask versus I-gel just after insertion was (29.24±4.20cm H20 vs 26.33±2.51cm H2O, P=0.003) whereas it was (29.42±2.70 vs 26.18±2.54 cm H2O) after 5 min of creating pneumoperitoneum. Both groups were comparable in terms of removal characteristics and postoperative laryngopharyngeal airway morbidities. Conclusion: Baska Mask provided more effective ventilation in terms of greater oropharyngeal leak pressure as compared to I-gel. However Baska Mask was more difficult to insert and the incidence of postoperative laryngopharyngeal morbidity was higher in case of Baska Mask

Real-world evidence on the effectiveness and safety of gliclazide extended release treatment in Indian patients with type 2 diabetes undergoing Ramadan fast: an analysis from the global DIA-RAMADAN study

Context and Aim: Glycemic imbalance, especially hypoglycemia, is one of the greatest risks for patients with type 2 diabetes mellitus (T2DM) during Ramadan fasting. This paper outlines the efficacy and safety of gliclazide extended release (XR) in Indian patients with T2DM enrolled in the global DIA-RAMADAN study. Methods and Material: Adults (aged ≥18 years) with T2DM who chose to fast during Ramadan and received a gliclazide-based regimen once daily for 90 days before Ramadan were included in the study. Baseline and end-of-study visits were conducted 6–8 weeks before and 4–6 weeks after Ramadan, respectively. Primary outcome was the incidence of ≥1 symptomatic hypoglycemic event (HE). Changes in glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body weight were secondary outcomes. Results: Among 246 Indian patients enrolled in the study, most (78.9%, n=194) were at moderate/low risk as per the International Diabetes Federation and Diabetes and Ramadan guidelines. Most patients (69.1%) received gliclazide XR as monotherapy, and the rest received gliclazide XR with metformin or other antidiabetic therapy. Significant reductions in HbA1c (−0.5±0.8%, P<0.001) and FPG (−21.8±59.4 mg/dL, P<0.001) levels were observed but the slight reduction in body weight was not statistically significant (−0.3±3.7 kg, P=0.614) in patients post-Ramadan. Overall, no HE was reported in Indian patients with T2DM during Ramadan fasting. Conclusion: Overall, the effectiveness and safety of gliclazide XR in Indian patients was consistent with that observed in the global cohort. Gliclazide XR significantly reduced HbA1c with no incidence of hypoglycemic events in Indian patients with type 2 diabetes undergoing Ramadan fast, suggesting that gliclazide XR may be used without dose modification at Iftar to maintain optimal glycemic control during Ramadan

Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial

BackgroundAnterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability.MethodsWe did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367.FindingsBetween Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications.InterpretationSurgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management

A COMPREHENSIVE AND PROSPECTIVE ANALYSIS TO IMPROVE PATIENT OUTCOMES IN POSTOPERATIVE PERIOD BY OPTIMIZING NEOSTIGMINE DOSE AND TIMING WITH THE HELP OF TOF MONITORING

Objective: The objective is to find out the optimum neuromuscular reversal strategy using Train-of-Four (TOF) monitoring in the postoperative period for complete and risk-free recovery without residual paralysis. In this study, the neuromuscular blockade brought on by cisatracurium will be reversed using a neuromuscular monitor (TOF) and neostigmine administered at the best possible time and dose. In addition, we'll look at the prevalence of neuromuscular paralysis that persists after general anesthesia, as some research have revealed that paralysis may worsen and return once patients leave the recovery area. Methods: A comprehensive prospective, randomized, double-blind and prospective analysis was conducted involving various study groups. Demographic data, residual neuromuscular weakness, negative head lift tests, and Visual Analog Scale (VAS) scores were assessed. TOF monitoring was used regularly to tailor neuromuscular reversal strategies. Results: Incidence of regression of TOF ratio<0.9 and incidence of negative head lift test after extubation among different groups were statistically non-significant by Chi square test at 15 min (p value 0.4), 30 min (0.8) and 60 min (p value 0.9). It also concludes that neuromuscular stimulation given for TOF monitoring is well tolerated by different group of the population in terms of VAS score (mean 3.9, ranging from 3.3 to 3.8). Conclusion: This research suggests that tailoring strategies of neostigmine dose and time of its administration according to TOF ratio leads to complete recovery of neuromuscular function with all the doses (20/30/40 micrograms/kg). This study emphasizes the use of neuromuscular monitoring guided reversal methods to attain complete recovery without residual paralysis

ASSESSMENT OF DIFFERENT DOSES OF NEOSTIGMINE IN REVERSING CISATRACURIUM INDUCED NEUROMUSCULAR BLOCK BY USING NEUROMUSCULAR MONITOR: A PROSPECTIVE, DOUBLE-BLIND RANDOMIZED TRIAL

Objective: This study aimed to evaluate the effectiveness of different reversal strategies with neostigmine in cisatracurium-induced neuromuscular blockade by, focusing on recovery times, incidence of residual blockade, and patient safety profile. Methods: A prospective, randomized, double-blind trial was conducted involving six groups of patients (n=30 each) receiving different dosages of neostigmine at different TOF ratios. Neuromuscular function recovery, residual blockade incidence, and safety were assessed using various measurements. Statistical analysis included ANOVA, Chi-square tests, and post-hoc analyses. Results: The study found that recovery times varied based on neostigmine dosages and train-of-four (TOF) ratios at the time of administration. The study groups exhibited varying mean times to achieve TOF ratios of 0.9 and 1.0 after neostigmine administration. The incidence of post-extubation TOF ratios below 0.9 showed no substantial variation among the groups. The overall incidence of adverse effects was low, with no significant differences observed among the study groups. Conclusion: The study concludes that 30 mcg/kg administered at TOF ratio 0.6 may be the most effective dosage of neostigmine for rapid and sufficient recovery from shallow neuromuscular blockade at TOF ratio 0.4 or 0.6, with the fewest adverse effects. 20 mcg/kg is the lowest dose that can be used to successfully restore shallow neuromuscular block, albeit it does take longer time