Effect of a Government Scheme on Reperfusion Trends in a tertiary care centre in South India

Aims: Coronary artery disease is the leading cause of mortality and morbidity in our country, of which ST elevation myocardial infarction (STEMI) accounts for the major part of health spending. We sought to study the effect of induction of government health insurance scheme on the trends of reperfusion in patients of acute STEMI. Methods and results: 1133 patients presenting with acute STEMI enrolled. 1079 (95.1%) received some form of reperfusion therapy. Primary PCI was used in 60.6% of patients as the primary reperfusion modality, a six fold increase as compared to previous years. Government health insurance accounted for the one third of all. 34.5% patients underwent pharmacological reperfusion, most commonly with streptokinase. 4.9% patients of STEMI did not receive any form of reperfusion therapy in contrast to 14% during previous years. Conclusion: Introduction of government health insurance along with increased awareness has resulted in dramatic changes in the management of STEMI patients

Multi-Response Optimization during the High-Speed Drilling of Composite Laminate Using the Grey Entropy Fuzzy Method (GEF)

The machining of glass-fiber-reinforced composites is complex due to their heterogeneous structures. Research has indicated that high-speed machining, at high spindle speeds and feed rates, not only increases productivity but also reduces drilling defects, such as delamination. However, there are several challenges with high-speed machining, such as the heat generated during drilling between the drill tool and chip contact surfaces that can result in hole size errors. Therefore, it is essential to determine the optimum drilling parameters. This paper presents an innovative hybrid optimization approach called Grey Entropy Fuzzy. This approach is a combination of entropy-based weight integrated Grey Relation analysis and fuzzy logic. With the consideration of all responses simultaneously, an optimum machining combination was obtained at a spindle speed of 12,000 rpm and a feed rate of 0.02 mm/rev using a drill bit with a point angle of 118° and a drill diameter of 6 mm

Prosthetic Rehabilitation by Palatal Hollow Bulb Obturator with Cast Metal Denture Base: A Case Report

Background: Prosthetic reconstruction of partial maxillectomy defects is a challenging procedure that requires multidisciplinary expertise to achieve an acceptable function, speech and esthetics. This procedure improves the quality of life for the patient as a normal individual. Obturation of the defect depends on its volume and position of remaining hard and soft tissues which determine the retention, stability and support for the prosthesis. The prosthesis should be simple to handle, easy to maintain, biocompatible, light in weight and convenient for future adjustments. This case report describes a clinical case of partial maxillectomy which was successfully rehabilitated with a definitive closed hollow bulb obturator and cast metal denture base

Drilling Technology: Fundamentals and Recent Advances De Gruyter series in advanced mechanical engineering ;, v. 3./ J. Paulo Davim.

In English.Includes bibliographical references and index.This book aims to provide recent information on advances in drilling technology. The use of advanced machines, appropriate strategies and special drilling tools can signifi cantly reduce the machining time required for drilling operations, and consequently the production costs, and improve the quality of the holes produced. For these reasons an improvement of the drilling technology is very important for the modern manufacturing industries. This book can be used as a research book for fi nal undergraduate engineering course or at postgraduate level. It can also serve as a useful reference for academics, researchers, mechanical, industrial, production, manufacturing and materials engineers, professionals in drilling technology and related matters.Astakhov, Viktor P. / Patel, Swapnil -- Woon, Keng Soon / Tnay, Guan Leong / Yeo, Swee Hock -- Vijayan, Krishnaraj / Nasseri, Simin / Castellano, Vitale Kyle / Sobtaguim, Herve / Hilderbrand, Joshua / Chealvan, Hari -- Babu, J. / Paul, Lijo / Davim, J. Paulo -- Hejjaji, Akshay / Zitoune, Redouane / Fayçal, Ameur Mohamed / Habiba, Bougherara -- Gaitonde, V. N. / Shashikant / Lakkundi, Anand / Karnik, S. R. / Deshpande, A. S. / Davim, J. Paulo -- Frontmatter -- Preface -- About the Editor -- Contents -- List of contributing authors -- 1. Efficient drilling of high-silicon aluminum alloys / 2 Deep hole gun drilling of nickel-based superalloys / 3. A new model pertaining to highspeed drilling of titanium alloy (Ti-6Al-4V) / 4. Drilling of composite materials: methods and tools / 5. Challenges of machining natural fiber-reinforced composites: A review / 6. Analysis and optimization of hole quality parameters in cenosphere-multiwall carbon nanotube hybrid composites drilling using artificial neural network and gravitational search technique / Index1 online resource (205 p.)