Safety of Needle Electromyography in Critically Ill Patients

Introduction: To evaluate the safety of needle electromyography (EMG) in critically ill intensive care unit (ICU) patients who are on anticoagulants and have comorbidities that increase the risk of bleeding and infections. Methods: We conducted a retrospective chart review of critically ill patients who underwent needle EMG studies. The most common complications followed by needle EMG were reviewed and classified based upon common terminology criteria for adverse events (CTAC) criteria. Descriptive statistics were reported using the frequencies and percentages for categorical variables. The mean and interquartile range is used for continuous variables. All analyses were conducted using the Statistical Package for the Social Sciences (IBM SPSS Statistic Version 21, IMB Inc., Chicago, IL. Results: Twenty-nine patients were included. 17 (58.6%) were males with a mean age of 60.8 +/- 16.7 years.  The mean PT, PTT, and INR were 15.2 sec, 36.5 seconds, and 1.13, respectively. Fourteen (48.2%) patients in this cohort were treated with low molecular weight heparin (LMWH), and an additional 8 (27.5%) patients were administered subcutaneous (SC) heparin for deep vein thrombosis prophylaxis. Therapeutic heparin was being used in 3 (10.3%) patients and sequential compression devices (SCDs) in 4 (13.7%) patients. A total of 228 muscles were tested. Among them, 38 (16.6%) were deep muscles. There were no major bleeding complications at the time of the procedure and for the next seven days in any of the patients, including those with multiple medical comorbidities. All our patients met the grade 1 scale in the severity of adverse events criteria proposed by CTCAE. Conclusion: Needle EMG is safe in critically ill ICU patients on anticoagulants and multiple comorbidities including those that increase the risk of bleeding and infection

Evaluation of Biomedical Waste Management Practices in Multispeciality Tertiary Hospital

Background: Biomedical waste collection and proper disposal has become significant concern for medical and general community. The scientific hospital waste management is a vital importance as its improper management poses risk to healthcare workers, waste handlers, patients, community in general and largely the environment.Aims and Objectives: (i.)To assess current practices of biomedical waste management including generation, collection, transportation, storage, treatment and disposal technologies in tertiary health care center. (ii.)To assess health and safety practices for health care personal involved in biomedical waste management.Material and Method: Waste management practices in tertiary care center was study during in May 2016 to June 2016 the information/data regarding biomedical waste management practices and safety was collected by way of semi-structured interview, proforma being the one used for waste AUDITING QUESTIONNAIRE. The information collected was verified by personal observations of waste management practices in each ward of hospital.The information collected was verified by personal observation of waste management practices in each wards of hospital.Results: MMCH (Muzaffarnagar medical college and hospital) generates 1.25 kg wastes per bed per day and maximum waste is generated in wards. The hospital has got separate colour coded bins in each ward for collection of waste but segregation practices need to be more refined.The safety measure taken by health care workers was not satisfactory, it was not due to unavailability of personal protective measures but because un-awareness of health hazards which may occur due to improper waste management practices.Thus it concluded that there should be strict implementation of waste management policy set up in the hospital, training and motivation must be given paramount impotence to meet the current needs and standards of biomedical waste-management

Association of ABO blood group and Rh factor in cleft lip and palate patients

Background: One of the most common congenital malformations, with widespread racial and regional variation is an orofacial cleft. The occurrence is attributed to an array of environmental and genetic factors. Blood grouping and Rh factor are genetically determined. Any possible association of clefts with them helps in planning interventional services. Methods: A case control observational study was conducted on 111 samples who were cases presenting with oral clefts in Super speciality hospitals and other 111 samples who came to hospital for their treatment other than for cleft lip or cleft palate, were controls in the study. Cases were evaluated for various phenotypes of clefts. Blood samples of each case and control was collected to elaborate on blood group genotype and Rh typing. SPSS 22.0 version was employed for statistical analysis. Results: The most common blood group noted in cases as well in controls respectively was type ‘B’ in 31.5% and 43.2%, while blood group ‘AB’ was noted the lowest in both cases (14.5%) and controls (7.3%).Rh positive was noted 94.6% in both cases and control population. Clefts were observed more in male population than female counterparts.Cases of cleft lip and palate (CLP) was noted the highest, in 61 (55%) of cases, followed by defects in lip, palate and lastly in soft palate. Conclusions: Though not associated to the biological characteristics of cleft lip and palate in the current study, the functional importance of ABO blood group distribution may be the subject of future research. Identification of any associative traits for clefts assesses individuals with risk so as to help eliminate the chance of occurrence and early identification for better prognosis

Uncovering Genomic Regions Associated With 36 Agro-Morphological Traits in Indian Spring Wheat Using GWAS

Wheat genetic improvement by integration of advanced genomic technologies is one way of improving productivity. To facilitate the breeding of economically important traits in wheat, SNP loci and underlying candidate genes associated with the 36 agro-morphological traits were studied in a diverse panel of 404 genotypes. By using Breeders’ 35K Axiom array in a comprehensive genome-wide association study covering 4364.79 cM of the wheat genome and applying a compressed mixed linear model, a total of 146 SNPs (-log10P ≥ 4) were found associated with 23 traits out of 36 traits studied explaining 3.7–47.0% of phenotypic variance. To reveal this a subset of 260 genotypes was characterized phenotypically for six quantitative traits [days to heading (DTH), days to maturity (DTM), plant height (PH), spike length (SL), awn length (Awn_L), and leaf length (Leaf_L)] under five environments. Gene annotations mined ∼38 putative candidate genes which were confirmed using tissue and stage specific gene expression data from RNA Seq. We observed strong co-localized loci for four traits (glume pubescence, SL, PH, and awn color) on chromosome 1B (24.64 cM) annotated five putative candidate genes. This study led to the discovery of hitherto unreported loci for some less explored traits (such as leaf sheath wax, awn attitude, and glume pubescence) besides the refined chromosomal regions of known loci associated with the traits. This study provides valuable information of the genetic loci and their potential genes underlying the traits such as awn characters which are being considered as important contributors toward yield enhancement

Why WITS? Why not a way beyond?

Introduction: WITS appraisal is a common parameter in cephalometrics to assess maxillo-mandibular skeletal relationship as an adjunct to angle ANB. The high variability of the WITS appraisal is attributable to difficulties or inaccuracies in identifying the occlusal plane or variations due to tooth eruption, dental development or treatment changes by vertical movement of incisors, molars, or both. Aim: An extracranial reference line common to both denture bases, instead of the occlusal plane is proposed to assess antero-posterior jaw relationships. Materials and Methods: A true vertical obtained by plumb line was recorded, while taking the cephalogram for 40 subjects. A line drawn perpendicular to this true vertical gave a stable and reproducible extracranial true horizontal (HOR) reference line. The linear distance between perpendiculars from points A and B was measured as an adjunct to angle ANB. Result: The Pearson′s product moment correlation coefficient calculated for the entire sample indicated higher correlation coefficient (r = 0.8712) for the linear measurements on HOR (AH-BH) with respect to the angle ANB when compared with the WITS readings (AO-BO) (r = 0.549). Conclusion: The horizontal appraisal method proposed eliminates the demerits of the occlusal plane and has the merits of simplicity and accuracy in comparison to WITS appraisal

Role of orthodontist in cleft lip and palate

Cleft lip and palate is one of the most common congenital anomalies occurring round the world varying with the race, ethnicity and geography. Cleft lip and/or palate problems tends to worsen as the individual grows older. Although it occurs as a different entity in itself but its presence can hamper aesthetics as well as functions by effecting growth, dentition, speech, hearing and overall appearance resulting in social and psychological problems for the child as well as the parents. Cleft lip and palate is of a multifactorial origin such as inheritance, teratogenic drugs, and nutritional deficiencies and can also occur as syndromic or non-syndromic cleft. Treatment of Cleft Lip and Palate comprises of different specialists having an individual insight in a particular case ultimately reaching to a consensus for a successful culmination of the treatment. Although appropriate timing and method of each intervention is still arguable. An orthodontist plays a role in pre surgical maxillary orthopaedics, in aligning the maxillary segments and dentition, in preparation for secondary alveolar bone grafting and finally in obtaining ideal dental relation and preparing the dentition for prosthetic rehabilitation or orthognathic surgery if required. Therefore, for efficient treatment outcome and refinement of individual techniques or variations of the treatment protocol a highly able team of specialists from different specialities is a must, preferably on a multicentre basis

Subretinal tissue plasminogen-assisted vitrectomy for posttraumatic full-thickness macular hole with submacular hemorrhage

A young male presented with diminution of vision left eye, attributable to full-thickness macular hole, and submacular hemorrhage, following closed globe injury 2 weeks ago. The patient was managed successfully with 25-gauge vitrectomy, subretinal injection of tissue plasminogen activator and aspiration of liquefied blood through the macular hole, internal limiting membrane peeling, short-acting gas tamponade, and prone positioning. This resulted in good visual improvement, type 1 macular hole closure, and restoration of foveal architecture. The outcome and rationale of treatment in this unique scenario is discussed

CHAOTIC IMAGE ENCRYPTION TECHNIQUE

In this paper, we will provide an overview of the mechanisms used in image protection, especially Chaos-based encryption techniques available today. We will see how previously proposed methods such as Data Encryption Standard (DES), Triple Data Encryption Standard (Triple-DES), and International Data Encryption Algorithm (IDEA) have been applied in image protection domain and how new concepts of Chaos-based encryption techniques are superior to traditional methods.The chaotic system is rich in significance and in implication because of sensitivity to change initial conditions, control parameters, ergodicity, random-like behaviour, repeated processing and very high diffusion and confusion properties that are desirable for cryptography