Effect of surgical trauma on serum magnesium levels in the early postoperative period

Background: For proper functioning of energy system in the body, magnesium is essential. Deficiency of magnesium leads to hyperactivity of central nervous system and neuromuscular system. During surgery or before surgery or after surgery there can be alterations in the volume of fluid and composition of electrolytes. Objective was to study the effect of surgical trauma on serum magnesium levels in the early postoperative period.Methods: The present hospital based cross sectional study was carried out for a period of one year among 35 cases of surgical stress and 10 normal as control. Institutional ethics committee permission was taken prior to the start of the study. Individual informed consent was noted from each individual patient from both cases and controls. Data was recorded in the pre-designed pre-tested semi structured questionnaire for the present study. Serum magnesium level was assessed in both the groups and compared.Results: It was found that the preoperative magnesium levels were more as compared to postoperative levels among both the types of stress groups but the difference was not found to be statistically significant (p > 0.05). Among the mild to moderate stress groups, it was found that the preoperative magnesium levels were more as compared to postoperative levels among all the age groups but the difference was not found to be statistically significant (p > 0.05). Among the severe stress groups, it was found that the preoperative magnesium levels were more as compared to postoperative levels among all the age groups but the difference was not found to be statistically significant (p > 0.05).Conclusions: Occurrence of postoperative hypomagnesaemia plays a minor role in normal surgical convalescence

A Multicenter, Randomized, Placebo‐Controlled Trial of Atorvastatin for the Primary Prevention of Cardiovascular Events in Patients With Rheumatoid Arthritis

Objective: Rheumatoid arthritis (RA) is associated with increased cardiovascular event (CVE) risk. The impact of statins in RA is not established. We assessed whether atorvastatin is superior to placebo for the primary prevention of CVEs in RA patients. Methods: A randomized, double‐blind, placebo‐controlled trial was designed to detect a 32% CVE risk reduction based on an estimated 1.6% per annum event rate with 80% power at P 50 years or with a disease duration of >10 years who did not have clinical atherosclerosis, diabetes, or myopathy received atorvastatin 40 mg daily or matching placebo. The primary end point was a composite of cardiovascular death, myocardial infarction, stroke, transient ischemic attack, or any arterial revascularization. Secondary and tertiary end points included plasma lipids and safety. Results: A total of 3,002 patients (mean age 61 years; 74% female) were followed up for a median of 2.51 years (interquartile range [IQR] 1.90, 3.49 years) (7,827 patient‐years). The study was terminated early due to a lower than expected event rate (0.70% per annum). Of the 1,504 patients receiving atorvastatin, 24 (1.6%) experienced a primary end point, compared with 36 (2.4%) of the 1,498 receiving placebo (hazard ratio [HR] 0.66 [95% confidence interval (95% CI) 0.39, 1.11]; P = 0.115 and adjusted HR 0.60 [95% CI 0.32, 1.15]; P = 0.127). At trial end, patients receiving atorvastatin had a mean ± SD low‐density lipoprotein (LDL) cholesterol level 0.77 ± 0.04 mmoles/liter lower than those receiving placebo (P < 0.0001). C‐reactive protein level was also significantly lower in the atorvastatin group than the placebo group (median 2.59 mg/liter [IQR 0.94, 6.08] versus 3.60 mg/liter [IQR 1.47, 7.49]; P < 0.0001). CVE risk reduction per mmole/liter reduction in LDL cholesterol was 42% (95% CI −14%, 70%). The rates of adverse events in the atorvastatin group (n = 298 [19.8%]) and placebo group (n = 292 [19.5%]) were similar. Conclusion: Atorvastatin 40 mg daily is safe and results in a significantly greater reduction of LDL cholesterol level than placebo in patients with RA. The 34% CVE risk reduction is consistent with the Cholesterol Treatment Trialists’ Collaboration meta‐analysis of statin effects in other populations

Short-duration judgment in young Indian subjects under 30 h constant wakefulness

559-568The present study aimed to investigate probability of a possible endogenous circadian rhythm in human cognitive attribute to estimate short intervals. Apparently healthy young males and females were selected for our study. Eight subjects prospectively produced the short-time intervals 10 s and 60 s at 2 hourly intervals in 30 h constant routine (CR) study conducted in spring (CR-1). The study was repeated again in autumn (CR-2) in the remaining eight subjects. The established circadian markers, namely serum cortisol, salivary melatonin levels and tympanic temperature were also measured either in CR-1 or CR-2. Oral temperature was measured simultaneously. Circadian rhythms were validated in serum cortisol, salivary melatonin, oral, and tympanic temperatures. Circadian rhythm in 60 s estimates was observed in a few subjects and in all males at group level in CR-1. The cognitive attribute to perceive short intervals vary as function of season. The results provide evidence in support of interaction among the interval, circadian and circannual timing systems in human

Electromagnetic shielding behavior of polyaniline using Red Mud (industrial waste) as filler in the X - band (8.2-12.4 GHz) frequency range

In today's times where pollution of all kinds is at its peak, numerous efforts are being made to find proper waste disposal methods. Moving on the same lines, this paper presents an economical and environmentally safe method of disposal of red mud to control electromagnetic pollution by using it as an electromagnetic shielding material. Composites of PANI/RM have been prepared by in-situ chemical oxidative polymerization and have been tested for structural analysis, thermal stability and magnetization by XRD, TGA and VSM techniques respectively. Further, the composites have shown shielding effectiveness of 33-41 dB (>99.99% attenuation) in 8.2-12.4 GHz frequency range (X-band) at a thickness of 3 mm which is absorption dominated. Thus, the results conclude that the incorporation of red mud into polymer matrix can serve two purposes firstly, it can provide a good alternative as a shielding material and secondly, it can prove to be a feasible way of waste disposal

Management outcome of the transcallosal, transforaminal approach to colloid cysts of the anterior third ventricle: An analysis of 78 cases

Background: Colloid cysts are not common brain lesions and account for 0.2-2.0% of all brain lesions. Transcallosal, transforaminal approach is a safe route and the most direct path to excise third ventricular colloid cyst, without dependence on hydrocephalus. Aim: To assess the surgical outcome of patients with colloid cysts of the anterior third ventricle treated by the transcallosal, transforaminal approach. Patients and Methods: Seventy-eight patients operated by the above approach over a period of 20 years were analyzed. A pre- and postoperative neurological assessment was done in all the patients. Neuro-cognitive evaluation of corpus callosum function was done in the last 20 patients. Computer tomography scan of the brain was done in all patients pre- and postoperatively. Results: Clinical features of raised intracranial pressure without localizing signs were the commonest presenting feature in 52 (66.7%) patients. Hydrocephalus was present in 65 (83.3%) patients. All patients underwent the transcallosal, transforaminal approach, and total excision of the lesion was achieved in 77 patients and subtotal in 1. Four patients required a postoperative shunt for acute hydrocephalus. There was no incidence of postoperative disconnection syndrome. In two patients, there was recurrence of the lesion after 2 and 6 years, respectively. Two patients died in the postoperative period. Conclusion: Colloid cyst is surgically curable. Early detection and total excision of the lesion can be a permanent cure with low mortality and minimum morbidity, when compared to the natural history of the disease. The limited anterior callosotomy does not result in disconnection syndromes or behavioral disturbance

Groundwater quality characterization using an integrated water quality index and multivariate statistical techniques.

This study attempts to characterize and interpret the groundwater quality (GWQ) using a GIS environment and multivariate statistical approach (MSA) for the Jakham River Basin (JRB) in Southern Rajasthan. In this paper, analysis of various statistical indicators such as the Water Quality Index (WQI) and multivariate statistical methods, i.e., principal component analysis and correspondence analysis (PCA and CA), were implemented on the pre and post-monsoon water quality datasets. All these methods help identify the most critical factor in controlling GWQ for potable water. In pre-monsoon (PRM) and post-monsoon (POM) seasons, the computed value of WQI has ranged between 28.28 to 116.74 and from 29.49 to 111.98, respectively. As per the GIS-based WQI findings, 63.42 percent of the groundwater samples during the PRM season and 42.02 percent during the POM were classed as 'good' and could be consumed for drinking. The Principal component analysis (PCA) is a suitable tool for simplification of the evaluation process in water quality analysis. The PCA correlation matrix defines the relation among the water quality parameters, which helps to detect the natural or anthropogenic influence on sub-surface water. The finding of PCA's factor analysis shows the impact of geological and human intervention, as increased levels of EC, TDS, Na+, Cl-, HCO3-, F-, and SO42- on potable water. In this study, hierarchical cluster analysis (HCA) was used to categories the WQ parameters for PRM and POR seasons using the Ward technique. The research outcomes of this study can be used as baseline data for GWQ development activities and protect human health from water-borne diseases in the southern region of Rajasthan

K-M-O and Barlett’s test result.

This study attempts to characterize and interpret the groundwater quality (GWQ) using a GIS environment and multivariate statistical approach (MSA) for the Jakham River Basin (JRB) in Southern Rajasthan. In this paper, analysis of various statistical indicators such as the Water Quality Index (WQI) and multivariate statistical methods, i.e., principal component analysis and correspondence analysis (PCA and CA), were implemented on the pre and post-monsoon water quality datasets. All these methods help identify the most critical factor in controlling GWQ for potable water. In pre-monsoon (PRM) and post-monsoon (POM) seasons, the computed value of WQI has ranged between 28.28 to 116.74 and from 29.49 to 111.98, respectively. As per the GIS-based WQI findings, 63.42 percent of the groundwater samples during the PRM season and 42.02 percent during the POM were classed as ‘good’ and could be consumed for drinking. The Principal component analysis (PCA) is a suitable tool for simplification of the evaluation process in water quality analysis. The PCA correlation matrix defines the relation among the water quality parameters, which helps to detect the natural or anthropogenic influence on sub-surface water. The finding of PCA’s factor analysis shows the impact of geological and human intervention, as increased levels of EC, TDS, Na+, Cl-, HCO3-, F-, and SO42- on potable water. In this study, hierarchical cluster analysis (HCA) was used to categories the WQ parameters for PRM and POR seasons using the Ward technique. The research outcomes of this study can be used as baseline data for GWQ development activities and protect human health from water-borne diseases in the southern region of Rajasthan.</div

Do practice gaps exist in evidence-based medication prescription at hospital discharge in patients undergoing coronary artery bypass surgery & coronary angioplasty?

Background & objectives: Prescription patterns of guideline-directed medical therapy (GDMT) after coronary artery bypass surgery [coronary artery bypass graft (CABG)] and percutaneous coronary intervention (PCI) at hospital discharge are often not optimal. In view of scarce data from the developing world, a retrospective analysis of medication advice to patients following CABG and PCI was conducted. Methods: Records of 5948 patients (post-PCI: 5152, post-CABG: 796) who underwent revascularization from 2010 to 2014 at a single tertiary care centre in north India were analyzed. >Results: While age and gender distributions were similar, diabetes and stable angina were more frequent in CABG group. Prescription rates for aspirin 100 per cent versus 98.2 per cent were similar, while beta-blockers (BBs, 95.2 vs 90%), statins (98.2 vs 91.6%), angiotensin-converting enzyme inhibitors (89.4 vs 41.4%), nitrates (51.2 vs 1.1%) and calcium channel blockers (6.6 vs 1.6%) were more frequently prescribed following PCI. Despite similar baseline left ventricular ejection fraction (48.1 vs 51.1%), diuretics were prescribed almost universally post-CABG (98.2 vs 10.9%, P<0.001). Nearly all (94.4%) post-CABG patients received a prescription for clopidogrel. Patients undergoing PCI were much more likely to receive higher statin dose; 40-80 mg atorvastatin (72 vs <1%, P<0.001) and a higher dose of BB. >Interpretation & conclusions: Significant differences in prescription of GDMT between PCI and CABG patients existed at hospital discharge. A substantial proportion of post-CABG patients did not receive BB and/or statins. These patients were also less likely to receive high-dose statin or optimal BB dose and more likely to routinely receive clopidogrel and diuretics. Such deviations from GDMT need to be rectified to improve quality of cardiac care after coronary revascularization

Sample points of GW wells.

This study attempts to characterize and interpret the groundwater quality (GWQ) using a GIS environment and multivariate statistical approach (MSA) for the Jakham River Basin (JRB) in Southern Rajasthan. In this paper, analysis of various statistical indicators such as the Water Quality Index (WQI) and multivariate statistical methods, i.e., principal component analysis and correspondence analysis (PCA and CA), were implemented on the pre and post-monsoon water quality datasets. All these methods help identify the most critical factor in controlling GWQ for potable water. In pre-monsoon (PRM) and post-monsoon (POM) seasons, the computed value of WQI has ranged between 28.28 to 116.74 and from 29.49 to 111.98, respectively. As per the GIS-based WQI findings, 63.42 percent of the groundwater samples during the PRM season and 42.02 percent during the POM were classed as ‘good’ and could be consumed for drinking. The Principal component analysis (PCA) is a suitable tool for simplification of the evaluation process in water quality analysis. The PCA correlation matrix defines the relation among the water quality parameters, which helps to detect the natural or anthropogenic influence on sub-surface water. The finding of PCA’s factor analysis shows the impact of geological and human intervention, as increased levels of EC, TDS, Na+, Cl-, HCO3-, F-, and SO42- on potable water. In this study, hierarchical cluster analysis (HCA) was used to categories the WQ parameters for PRM and POR seasons using the Ward technique. The research outcomes of this study can be used as baseline data for GWQ development activities and protect human health from water-borne diseases in the southern region of Rajasthan.</div

Inter-correlations matrix of different water quality parameters for PRM season.

Inter-correlations matrix of different water quality parameters for PRM season.</p