Effectiveness of ligation of uterine vessels prior to uterine incision for major placenta previa on reducing maternal morbidity without increasing neonatal morbidity

Background: Placenta previa causes massive obstetric haemorrhage and severe maternal morbidity. The objective is to analyse the effectiveness of uterine vessels (artery and vein) ligation before uterine incision in reducing blood loss and hysterectomy during caesarean section for major placenta previa without increasing morbidity in the newborn.Methods: A retrospective analysis of caesarean section for major placenta previa from 2002 to 2017 was done.  Uterine vessels ligation before uterine incision was done in 52 patients. In 19 patients unilateral and in 33 patients bilateral uterine vessels ligation was done before uterine incision. In control group, 12 patients with major placenta previa uterine vessels were ligated after the removal of the placenta. The blood loss, blood transfusion, maternal morbidity and NICU admission of the newborns were compared.Results: The mean blood loss was 1002 ml in unilateral, 793 ml in bilateral uterine vessels ligation group, compared to 2191 ml in the control group. The mean blood transfusion volume 0.89 units in unilateral 0.60 units in bilateral ligation group while 2.33 units in the control group. The difference in blood loss and blood transfusion were statistically significant. Out of 52 babies, only 6 babies were admitted in NICU for mild depression with stay less than 3 days.Conclusions: Uterine vessels ligation before uterine incision reduces blood loss and hysterectomy during caesarean section for placenta previa without increasing the morbidity in the newborns

Twin talons cusp: A case report with review of literature

Talon cusp is one developmental anomaly of tooth that shows varied presentation as mentioned in the literature. The occurrence of talon cusp in the palatal aspect of the maxillary teeth has been the most common of all. These cases tend to occur due to hyperactivity of the enamel organ. The occurrence of this developmental defect in turn can lead to alteration in normal structure and function of the tooth. Hereby, we are reporting a rare occurrence of twin talon's cusp involving the palatal aspect of maxillary central incisor

Solar assisted liquid desiccant cooling using clay based membranes

The environmental concerns have led to the urge of the usage of non-conventional energy resources like solar, wind, thermal, geothermal etc. which provide enormous source of energy without causing any further diminution of the environment. Instead of the conventional HVAC systems that cause colossal environmental perils, usage of liquid desiccants in coming in vogue whereby reducing ecological threats. Moreover, solar assisted systems provide further impulse to such systems. This paper discusses about the various comparisons between liquid desiccants: Lithium chloride, Potassium formate and Calcium chloride and concludes that potassium formate is the best desiccant to be used among the three. Potassium formate (HCOOK) is used which is cheaper and less corrosive as compared to the other aqueous salts, and has a negative crystallization temperature. Potassium formate is a new liquid desiccant and thus, not much research is available currently. The weather conditions of Manipal provide an appropriate condition for the experimentations of solar aided liquid desiccant evaporative cooling systems due to its humid climate and intense solar radiation obtained. The small scale experimentation also encounters the problem of liquid desiccant carryover by the air flow, with the help of clay based membranes which are again cheap, environmentally benign and obtained in a facile way. The projected system takes complete advantage of pure solar energy aimed at the regeneration of liquid desiccant

Solar assisted liquid desiccant cooling using clay based membranes

The environmental concerns have led to the urge of the usage of non-conventional energy resources like solar, wind, thermal, geothermal etc. which provide enormous source of energy without causing any further diminution of the environment. Instead of the conventional HVAC systems that cause colossal environmental perils, usage of liquid desiccants in coming in vogue whereby reducing ecological threats. Moreover, solar assisted systems provide further impulse to such systems. This paper discusses about the various comparisons between liquid desiccants: Lithium chloride, Potassium formate and Calcium chloride and concludes that potassium formate is the best desiccant to be used among the three. Potassium formate (HCOOK) is used which is cheaper and less corrosive as compared to the other aqueous salts, and has a negative crystallization temperature. Potassium formate is a new liquid desiccant and thus, not much research is available currently. The weather conditions of Manipal provide an appropriate condition for the experimentations of solar aided liquid desiccant evaporative cooling systems due to its humid climate and intense solar radiation obtained. The small scale experimentation also encounters the problem of liquid desiccant carryover by the air flow, with the help of clay based membranes which are again cheap, environmentally benign and obtained in a facile way. The projected system takes complete advantage of pure solar energy aimed at the regeneration of liquid desiccant

Hypothyroidism in acute coronary syndrome – A prospective Indian study

Background: Evidence suggests that hypothyroidism may be associated with an increased risk of acute coronary syndrome (ACS).The data regarding the influence of hypothyroidism on cardiovascular disease in the Asian population is conflicting. Therefore, we undertook this study to assess the overall prevalence of hypothyroidism in Acute Coronary Syndrome (ACS) patients and determine if there is a relationship between hypothyroidism, both sub-clinical and overt and other significant risk factors of ACS in an Indian population. Methods: We studied 487 hospitalized patients between March 2018 and February 2021 with a diagnosis of ACS to determine the prevalence of hypothyroidism, both clinical and sub-clinical and their relationship with other known coronary risk factors. Thyroid function Tests - free T3, free T4 and TSH were collected from all the patients within 24 h of their admission to the coronary care unit (CCU) of 2 major hospitals in New Delhi and Imphal (Manipur). Results: Subclinical hypothyroidism was prevalent in 44 (9 %), followed by overt hypothyroidism in 25 (5.2 %).Subclinical hypothyroidism was more common in females, whereas overt hypothyroidism was more common in males. ST Elevation Myocardial Infarction (STEMI) (52 %), followed by Non-ST-Elevation Myocardial Infarction (NSTEMI) (25 %), was the commonest diagnosis at presentation. Patients with overt hypothyroidism showed a higher proportion of increased triglyceride levels.Patients with hypothyroidism had no differences in the prevalence of concomitant diabetes hypertension and other coronary risk factors. Conclusions: Patients with ACS without known thyroid disorders should be screened for hypothyroidism since it is found frequently. There might be a case to treat their thyroid dysfunction appropriately

Understanding partial fuel stratification for low temperature gasoline combustion using large eddy simulations

The development of gasoline compression ignition engines operating in a low temperature combustion mode depends heavily on robust control of the heat release profile. Partial fuel stratification is an effective method for controlling the heat release by creating a stratified mixture prior to autoignition, which can be beneficial for operation across a wide load range. In this study, three-dimensional large eddy simulations were used to model a double direct injection strategy for which 80% of the fuel was injected during the intake stroke, and 20% of the fuel was injected at varying timing during the compression stroke. The simulations replicated a set of experiments performed at Sandia National Laboratories on a 1-L single-cylinder research engine using E10 gasoline (gasoline fuel containing 10% vol. ethanol). The objective of this study is to analyze the effects of the double direct injection strategy on the compositional and thermal stratification of the mixture, and understand the best use of this operating strategy. The modeling results indicated that by retarding the start of the second injection, the mixture stratification increases, which can be used to control the autoignition timing and the combustion phasing. Ignition and CA50 (crank angle of 50% mass fraction burned) are dictated by the mass concentration of the richest zones in the combustion chamber, as well as their location. The richer zones have the lowest temperatures before ignition primarily due to evaporative cooling from direct fuel injection. Overall, this study enhances the understanding of partial fuel stratification that can be used for controlling the heat release in gasoline compression ignition engines

Understanding partial fuel stratification for low temperature gasoline combustion using large eddy simulations

The development of gasoline compression ignition engines operating in a low temperature combustion mode depends heavily on robust control of the heat release profile. Partial fuel stratification is an effective method for controlling the heat release by creating a stratified mixture prior to autoignition, which can be beneficial for operation across a wide load range. In this study, three-dimensional large eddy simulations were used to model a double direct injection strategy for which 80% of the fuel was injected during the intake stroke, and 20% of the fuel was injected at varying timing during the compression stroke. The simulations replicated a set of experiments performed at Sandia National Laboratories on a 1-L single-cylinder research engine using E10 gasoline (gasoline fuel containing 10% vol. ethanol). The objective of this study is to analyze the effects of the double direct injection strategy on the compositional and thermal stratification of the mixture, and understand the best use of this operating strategy. The modeling results indicated that by retarding the start of the second injection, the mixture stratification increases, which can be used to control the autoignition timing and the combustion phasing. Ignition and CA50 (crank angle of 50% mass fraction burned) are dictated by the mass concentration of the richest zones in the combustion chamber, as well as their location. The richer zones have the lowest temperatures before ignition primarily due to evaporative cooling from direct fuel injection. Overall, this study enhances the understanding of partial fuel stratification that can be used for controlling the heat release in gasoline compression ignition engines

Earth Mover’s Distance-Based Tool for Rapid Screening of Cervical Cancer Using Cervigrams

Cervical cancer is a major public health challenge that can be cured with early diagnosis and timely treatment. This challenge formed the rationale behind our design and development of an intelligent and robust image analysis and diagnostic tool/scale, namely “OM—The OncoMeter”, for which we used R (version-3.6.3) and Linux (Ubuntu-20.04) to tag and triage patients in order of their disease severity. The socio-demographic profiles and cervigrams of 398 patients evaluated at OPDs of Batra Hospital & Medical Research Centre, New Delhi, India, and Delhi State Cancer Institute (East), New Delhi, India, were acquired during the course of this study. Tested on 398 India-specific women’s cervigrams, the scale yielded significant achievements, with 80.15% accuracy, a sensitivity of 84.79%, and a specificity of 66.66%. The statistical analysis of sociodemographic profiles showed significant associations of age, education, annual income, occupation, and menstrual health with the health of the cervix, where a p-value less than (<) 0.05 was considered statistically significant. The deployment of cervical cancer screening tools such as “OM—The OncoMeter” in live clinical settings of resource-limited healthcare infrastructure will facilitate early diagnosis in a non-invasive manner, leading to a timely clinical intervention for infected patients upon detection even during primary healthcare (PHC)