A CASE REPORT ON PHENYTOIN INDUCED ATAXIA

ABSTRACTPhenytoin is commonly used anticonvulsant drug which has several adverse effects such as motor ataxia, dizziness, and visual disturbance. Here,we report a case of phenytoin toxicity presenting with behavioral disorder ensuring from underlying primary adverse effects of phenytoin that wereclinically unnoted. A termination of phenytoin resulted in remission of side effects.Keywords: Phenytoin toxicity, Anticonvulsant drug, Behavioral disorder

Interdisciplinary Management of an Adult Bilateral Cleft Lip and Palate Patient with Excessive Incisor Display - A Case Report

This case report shows a successful orthodontic treatment of an operated adult bilateral cleft lip and palate subject with short upper lip and excessive incisor display. The patient underwent cleft lip repair at an early age of 2.5 years, followed by palatoplasty at the age of 21 years. She presented with malaligned teeth, inability to close the lips, excessive upper incisor display, and difficulty in speech. She was treated with upper and lower arch alignment and intrusion of the upper incisors, followed by prosthetic replacement of the missing right lateral incisor and left lateral incisor and canine. Normal dental occlusion was achieved using orthodontic procedures, followed by prosthodontic rehabilitation that resulted in significant improvement in facial aesthetics and psychosocial benefit to the individual

A comparative study on patient specific absolute dosimetry using slab phantom, acrylic body phantom and goat head phantom

Purpose: To compare the results of patient specific absolute dosimetry using slab phantom, acrylic body phantom and goat head phantom. Methods: Fifteen intensity modulated radiotherapy (IMRT) plans already planned on treatment planning system (TPS) for head-and-neck cancer patients were exported on all three kinds of phantoms viz. slab phantom, acrylic body phantom and goat head phantom, and dose was calculated using anisotropic analytic algorithm (AAA). All the gantry angles were set to zero in case of slab phantom while set to as it is in actual plan in case of other two phantoms. All the plans were delivered by linear accelerator (LA) and dose for each plan was measured by 0.13 cc ion chamber. The percentage (%) variations between planned and measured doses were calculated and analyzed. Results: The mean % variations between planned and measured doses of all IMRT quality assurance (QA) plans were as 0.65 (Standard deviation (SD): 0.38) with confidence limit (CL) 1.39, 1.16 (SD: 0.61) with CL 2.36 and 2.40 (SD: 0.86) with CL 4.09 for slab phantom, acrylic head phantom and goat head phantom respectively. Conclusion: Higher dose variations found in case of real tissue phantom compare to results in case of slab and acrylic body phantoms. The algorithm AAA does not calculate doses in heterogeneous medium as accurate as it calculates in homogeneous medium. Therefore the patient specific absolute dosimetry should be done using heterogeneous phantom mimicking density wise as well as design wise to the actual human body.  </p

A comparative study on patient specific absolute dosimetry using slab phantom, acrylic body phantom and goat head phantom

Purpose: To compare the results of patient specific absolute dosimetry using slab phantom, acrylic body phantom and goat head phantom. Methods: Fifteen intensity modulated radiotherapy (IMRT) plans already planned on treatment planning system (TPS) for head-and-neck cancer patients were exported on all three kinds of phantoms viz. slab phantom, acrylic body phantom and goat head phantom, and dose was calculated using anisotropic analytic algorithm (AAA). All the gantry angles were set to zero in case of slab phantom while set to as it is in actual plan in case of other two phantoms. All the plans were delivered by linear accelerator (LA) and dose for each plan was measured by 0.13 cc ion chamber. The percentage (%) variations between planned and measured doses were calculated and analyzed. Results: The mean % variations between planned and measured doses of all IMRT quality assurance (QA) plans were as 0.65 (Standard deviation (SD): 0.38) with confidence limit (CL) 1.39, 1.16 (SD: 0.61) with CL 2.36 and 2.40 (SD: 0.86) with CL 4.09 for slab phantom, acrylic head phantom and goat head phantom respectively. Conclusion: Higher dose variations found in case of real tissue phantom compare to results in case of slab and acrylic body phantoms. The algorithm AAA does not calculate doses in heterogeneous medium as accurate as it calculates in homogeneous medium. Therefore the patient specific absolute dosimetry should be done using heterogeneous phantom mimicking density wise as well as design wise to the actual human body.

NUMERICAL SIMULATION OF SHIP NAVIGATION IN ROUGH SEAS BASED ON ECMWF DATA

Recently, several changes have been observed in the Earth’s environment. This is also applicable to the ocean environment. The concept of weather routing has been applied for ship navigation for a long time. Many service providers offer weather routing service with the availability of high-quality satellite data. Unfortunately, not much information is available in the public domain as to how much the recent change in the weather pattern has affected ship navigation. The purpose of this paper is to fill this information gap. We investigate the influence of recent changes in the ocean environment on ship navigation. Weather data from ECMWF, namely ERA-Interim, is used for this purpose. The ECMWF data for the last 27 years is analysed. We compute the statistical characteristics of this data for the first 10 years, last 10 years, and 27 years. The statistical characteristics of the data are determined based on “summer” and “winter” zones as defined by international maritime regulations. Six different worldwide commercial ship routes are selected covering all the ocean regions. Navigation on great ellipse with waypoint is considered. MMG type ship manoeuvring model for 3 different ship types (DTMB 5415, PCC, VLCC) is used. The added resistance due to wave, wind and the effort of keeping the ship on the desired course using autopilot in the rough ocean environment is included in the MMG model. The fuel consumption and the duration of each one of the voyage are computed. Based on the analysis and simulation results it is shown that: (i) The mean wave height, wave period, and wind speed has increased in some ocean zones and decreased in other ocean zones. If any change has occurred, it is uniform for both seasons (summer and winter). (ii) In which ocean regions there is a perceptible change in fuel consumption, average ship speed and voyage time due to the changes in the weather pattern. (iii) The changing weather pattern in different ocean zones affects each ship type differently

Manoeuvring simulations of Autonomous Underwater Vehicle using quaternion

The dynamics of an autonomous underwater vehicle (AUV), which can perform manoeuvres with pitch angles in the range of 90° is investigated in this paper. The purpose of the AUV is to perform station keeping manoeuvre at about 90° pitch angle by varying propeller revolution. The AUV is launched / retrieved in horizontal orientation.&nbsp; Quaternion mathematics, 4 quadrant propeller open water characteristics and PID controller for propeller revolution are incorporated in manoeuvring mathematical model for this purpose.&nbsp; A procedure for optimizing the gain coefficients for the PID controller is developed using the manoeuvring mathematical model. Two design configuration of the AUV are investigated, positively buoyant and negatively buoyant. It is shown that both the optimal gain coefficients for the PID controller for propeller revolution and dynamic response of the AUV are different for each design configuration.&nbsp

Perception of caregivers regarding danger signs of childhood diarrhea and attitude towards its management in rural Lucknow, UP, India

Background: Diarrhoea is a major cause of morbidity and mortality in children. Most deaths are caused by dehydration and are easily preventable by using oral rehydration therapy. Early management and recognition of danger signs are key strategies in treating diarrhoeal diseases at home.&nbsp;Aims &amp; Objectives: 1. To assess the knowledge of caregivers regarding childhood diarrhoea and signs of dehydration and danger signs, 2. To assesses the mothers’ approach towards its home based management and health seeking behaviour. Material &amp; Methods: A community based cross sectional study was conducted in different rural blocks of Lucknow selected by multistage sampling. Total of 240 households were interviewed to achieve targeted sample size of 410 children of less than five years age group. Perception of diarrhoea, signs of dehydration and danger signs were asked to caregivers and associations were established maternal knowledge and presence or absence of diarrhoea in children of less than five age group.&nbsp;Results:&nbsp;The study showed that 74.2 per cent of caregivers recognized diarrhoea correctly i.e. increased frequency of watery stool or blood and mucus in stool or both. Decreased urination or dis-coloured urine (89.6%), thirsty or eagerly drinking (55.7%), dry mouth and tongue (37.7%) etc. were recognized by caregivers as major signs of dehydration*. Caregivers recognized child getting seeker/ unconscious (94.9%), not able to drink or breast feed (66.7%), blood in stool (59%) etc. as danger signs* developing during diarrhoea episodes of child.&nbsp;&nbsp;Conclusions:&nbsp;Caregiver’s knowledge regarding recognition of childhood diarrhoea in proper and early detection of signs of dehydration and development of danger signs at community level are keys to prevention of diarrhoea related death in less than five years age group

Functional Characterization of a Magnesium Transporter of Root Endophytic Fungus Piriformospora indica

Magnesium (Mg) is a crucial macronutrient required for the regular growth of plants. Here we report the identification, isolation and functional characterization of Mg-transporter PiMgT1 in root endophytic fungus Piriformospora indica. We also report the role of P. indica in the improvement of the Mg nutrition of the plant particularly under Mg deficiency condition. Protein BLAST (BLASTp) for conserved domains analysis showed that PiMgT1 belong to CorA like protein family of bacteria. We have also observed the presence of conserved ‘GMN’ signature sequence which suggests that PiMgT1 belongs to Mg transporter family. Phylogenetic analysis revealed that PiMgT1 clustered among fungal CorA family members nearer to basidiomycetes. Functionality of PiMgT1 was confirmed by complementation of a yeast magnesium transporter mutant CM66. We have observed that PiMgT1 restored the growth of mutant and showed comparable growth with that of WT. We found statistically significant (p &lt; 0.05) two fold increase in the total intracellular Mg content of mutant complemented with PiMgT1 as compared to the mutant. These observations suggest that PiMgT1 is actively involved in Mg uptake by the fungus and may be helping in the nutritional status of the host plant

Cone beam computed tomography: An accurate imaging technique in comparison with orthogonal portal imaging in intensity-modulated radiotherapy for prostate cancer

Purpose: Various factors cause geometric uncertainties during prostate radiotherapy, including interfractional and intrafractional patient motions, organ motion, and daily setup errors. This may lead to increased normal tissue complications when a high dose to the prostate is administered. More-accurate treatment delivery is possible with daily imaging and localization of the prostate. This study aims to measure the shift of the prostate by using kilovoltage (kV) cone beam computed tomography (CBCT) after position verification by kV orthogonal portal imaging (OPI).Methods: Position verification in 10 patients with prostate cancer was performed by using OPI followed by CBCT before treatment delivery in 25 sessions per patient. In each session, OPI was performed by using an on-board imaging (OBI) system and pelvic bone-to-pelvic bone matching was performed. After applying the noted shift by using OPI, CBCT was performed by using the OBI system and prostate-to-prostate matching was performed. The isocenter shifts along all three translational directions in both techniques were combined into a three-dimensional (3-D) iso-displacement vector (IDV).Results: The mean (SD) IDV (in centimeters) calculated during the 250 imaging sessions was 0.931 (0.598, median 0.825) for OPI and 0.515 (336, median 0.43) for CBCT, p-value was less than 0.0001 which shows extremely statistical significant difference.Conclusion: Even after bone-to-bone matching by using OPI, a significant shift in prostate was observed on CBCT. This study concludes that imaging with CBCT provides a more accurate prostate localization than the OPI technique. Hence, CBCT should be chosen as the preferred imaging technique

Cone beam computed tomography: An accurate imaging technique in comparison with orthogonal portal imaging in intensity-modulated radiotherapy for prostate cancer

Purpose: Various factors cause geometric uncertainties during prostate radiotherapy, including interfractional and intrafractional patient motions, organ motion, and daily setup errors. This may lead to increased normal tissue complications when a high dose to the prostate is administered. More-accurate treatment delivery is possible with daily imaging and localization of the prostate. This study aims to measure the shift of the prostate by using kilovoltage (kV) cone beam computed tomography (CBCT) after position verification by kV orthogonal portal imaging (OPI).Methods: Position verification in 10 patients with prostate cancer was performed by using OPI followed by CBCT before treatment delivery in 25 sessions per patient. In each session, OPI was performed by using an on-board imaging (OBI) system and pelvic bone-to-pelvic bone matching was performed. After applying the noted shift by using OPI, CBCT was performed by using the OBI system and prostate-to-prostate matching was performed. The isocenter shifts along all three translational directions in both techniques were combined into a three-dimensional (3-D) iso-displacement vector (IDV).Results: The mean (SD) IDV (in centimeters) calculated during the 250 imaging sessions was 0.931 (0.598, median 0.825) for OPI and 0.515 (336, median 0.43) for CBCT, p-value was less than 0.0001 which shows extremely statistical significant difference.Conclusion: Even after bone-to-bone matching by using OPI, a significant shift in prostate was observed on CBCT. This study concludes that imaging with CBCT provides a more accurate prostate localization than the OPI technique. Hence, CBCT should be chosen as the preferred imaging technique.</p