Venous thromboembolism after major gynecological cancer surgery: an analysis of cause and effect from the experience of a tertiary referral oncologic centre

Background: Patients undergoing extensive gynecological oncologic surgeries are at greater risk for developing deep vein thrombosis and pulmonary embolism than other oncological procedures. The anatomical confinement of vessels, lymphatics, and other structures in the restrictive pelvic space is contributory. We aimed to establish the etiopathogenesis of venous thromboembolism (VTE) with our practical experience. Methods: We present our experience from a tertiary referral oncologic centre in north India in patients with ovarian cancer undergoing cytoreductive surgery (CRS) with or without HIPEC, with a focus on the incidence and etiopathogenesis of deep venous thromboembolism (DVT), including anatomical barriers, restricted movement during surgical dissection, risk stratification and preventive measures. Results: Of 250 patients who underwent cytoreductive surgery (CRS) for ovarian cancer, 124 additionally underwent hyperthermic intraperitoneal chemotherapy (HIPEC). 20 (8%) patients were diagnosed with DVT within 30 days of surgery, and 3 (1.2%) were detected after 30 days. It is the most common significant postoperative morbidity. Conclusions: DVT is the most common postoperative complication in patients undergoing CRS+HIPEC for carcinoma ovary. Anatomical confinement, closed dependant spaces and more significant surgical trauma to pelvic vessels and lymphatics may be the leading cause. Detailed knowledge of anatomy and careful surgical dissection may prevent the development of DVT

A Critical Review on Tamaka Shwasa (Bronchial Asthma) - An Ayurvedic View

Difficulty in breathing or shortness of breath may be simply termed as Shwasa (Asthma), As per Ayurveda, Shwasa is mainly caused by the Vata and Kapha Doshas. Shwasa is broadly classified into five types in Maha Shwasa (Dyspnoea major), Urdhawa Shwasa (Expiratory Dyspnoea), Chinna Shwasa (Chyne-stroke respiration), Kshudra Shwasa (Dyspnoea minor), Tamaka Shwasa (Bronchial Asthma). In modern science Tamaka Shwasa can be correlated with Asthma, Asthma which is a chronic inflammatory disease of airway. In modern medicine there is no cure for Asthma, symptoms can typically be improved. In Ayurveda, Asthma can be effectively and safely manage the condition without inducing any drug dependency where Pachakarma procedures and use of internal medication detoxifies the body, provides nutrition and increases the elasticity of lung tissue it also develops natural immunity of the body thus decreasing episodic recurrence of the disease

Operative choice for subtrochanteric femoral fracture in school-aged children: Triple elastic stable intramedullary nail versus locking plate

BackgroundThe management strategy of subtrochanteric fractures remains controversial, and triple elastic stable intramedullary nail (ESIN) has not been reported for pediatric subtrochanteric fractures. This study aimed to compare the clinical effects of treating school-aged children with subtrochanteric fractures with triple ESINs versus locking plates.MethodsWe conducted a retrospective review of pediatric patients with subtrochanteric femoral fracture receiving either triple ESINs (TE) or locking plates (LPs) between January 2010 and January 2018. Sixteen patients in each group with matched age, sex, and fracture characteristics were included in the study. The preoperative data, including baseline information of the patients, fracture pattern, and types of surgical procedure, were collected from the hospital database. Patients were followed-up at the outpatient clinic in the 3rd month, 6th month, 12th month, and annually afterward. Hardware removal was performed at 9 – 18 months after the primary surgery.ResultsIn all, 16 patients (8.4 ± 1.5-year-old, 7 boys, 9 girls) in the TE group and 16 patients (8.4 ± 1.4-year-old, 7 boys, 9 girls) in the LP group were included. There was significantly less operative time, reduced estimated blood loss, and shortened hospital stay for the TE as compared with the LP (P < 0.001). However, higher fluoroscopy frequency was observed in the TE group than in the LP group (P < 0.001). The time to union was faster in the TE group than in the LP group (P = 0.031). However, the angulation was higher in the TE group (3.2 ± 0.6) than the LP group (1.8 ± 0.5), and the incidence of implant prominence was higher in the TE group (7/16, 43.8%) than the LP group (1/16, 6.3%).ConclusionCompared with the locking plates, triple ESINs demonstrated significantly less operative time, reduced estimated blood loss, and shortened hospital stay. Besides, both TE and LP groups produced satisfactory outcomes in school-aged children with subtrochanteric fractures. Therefore, TE remains a feasible choice for subtrochanteric fractures in school-aged children

Efficacy of different doses of NPK on growth and yield of rice bean (Vigna umbellata) in Khadbari, Sankhuwasabha, Nepal

An essential cultural technique for ensuring correct development and maximizing output is administering fertilizer sources for the crops. The experiment was carried out from February 2022 to May 2022 at Khadbari-3, Maruwa, Sankhuwasabha, to determine the efficacy of various dosages of NPK on the growth performance of the rice bean variety (Sunehri). The trial used a Randomized Complete Block Design (RCBD) with seven treatments replicated three times. The treatments were listed and named as T1 (0:0:0 kg NPK/ha); T2 (20:30:10 kg NPK/ha) (Recommended dose); T3 (10:20:15 kg NPK/ha); T4 (40:80:40 kg NPK/ha); T5 (20:20:20 kg NPK/ha); T6 (80:100:60 kg NPK/ha); and T7 (20:0:30 kg NPK/ha), respectively. The experimental results revealed that the highest yield/plant (39g) was obtained from the plot treated with T4 (40:80:40 kg NPK/ha), followed by 24.93 g and 24.13 g from the plot receiving T2 (20:30:10 kg NPK/ha) and T6 (80:100:60 kg NPK/ha), respectively. The lowest yield of 14.07 g was obtained from the control plot, followed by 15.27 g and 21.20 g from the plot receiving T7 (20:0:30 kg NPK/ha) and T3 (10:20:15 kg NPK/ha), respectively. Vegetative parameters such as plant height, branch numbers, and leaves numbers were recorded as a maximum of 19.72 cm, 6.88, and 18.97 in plots treated with T5 (20:20:20 kg NPK/ha), T7 (20:0:30 kg NPK/ha), and T1 (0:0:0 kg NPK/ha), consecutively, and corresponding minimum values were found 18.12 cm, 5.36 and 15.63 in T3 (10:20:15 kg NPK/ha), T1 (0:0:0 kg NPK/ha), and T7 (20:0:30 kg NPK/ha), respectively. Conclusively, the study's findings suggest that the rice bean crop responds to fertilizers and applying T4 (40:80:40 kg NPK/ha) enhances crop production considerably

Image quality measures in proton computed tomography

Advisors: Bela Erdelyi.Committee members: George Coutrakon; Bogdan Dabrowski.Proton therapy is an external beam radiotherapy that uses proton beam as ionizing radiation to treat localized tumor cells within the human body. The calculated proton beam range is used to locate and damage the DNA of cancerous tissue, thus, leading to cell death. Due to the Bragg peak characteristic of protons, the range of proton beam in matter can be calculated accordingly which offers greater degree of conformal dose delivery than conventional X-ray beam therapy. Currently, the treatment planning of proton therapy is based on the X-ray computed tomography (CT) scans of the patient anatomy. The images reconstructed from the xCT scans relies on the calculation of photon relative linear attenuation coefficients called Hounsfield units (HU). Proton treatment planning involves converting attenuation coefficients from xCT scans to relative stopping power (RSP). This conversion procedure results in range uncertainties in pre-treatment room. Therefore, a new imaging procedure is needed that can directly calculate the reconstructed RSP values of each patient and this is the aim of proton computed tomography.;Proton computed tomography (pCT) is a medical imaging procedure that has the potential to improve and better the currently existing proton therapy treatments. The proper implementation of pCT would resolve the discrepancies in converting attenuation coefficients to RSP values by directly calculating the reconstructed proton RSP distribution. This leads to the reduction of uncertainties in the RSP values of tissues, decreased irradiation to healthy tissues, greater degree of conformality and improved patient position in the pre-treatment room. However, the main objective of this thesis is to better understand the image reconstruction method in pCT by studying the image quality measures in pCT scans, and investigating methods and strategies to improve reconstructed image quality with an eye on proton treatment planning.M.S. (Master of Science

New results on optical and electrical properties of precipitation patterns of metal oxinates in gel media

311-319New results on conditions to obtain nonnal spaced periodic, complex and continuous precipitation patterns of different metal oxinates in agar agar gel have been reported. A spatial sequence of events from the start of a Liesegang experiment to the completion of the ring pattern has been determined at different experimental conditions viz. electrolyte concentration, pH of the medium, light, external electric field and orientation of tubes. Zig-Zag pattern of zinc oxinate has been obtained when the tube was exposed with the light of intensity in the region 300-350 Lux for zinc oxinate. A critical field intensity exists for cobalt, zinc and iron oxinates beyond which a transition from banded to continuous patterns is obtained. In most of the cases nonlinear plots between location of bands xn and band number n are obtained obeying the equation xn = cemn where m and c are constants

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Not AvailableIn order to survive, plants must adapt to abiotic stress like drought, temperature, high- salinity etc. The study of plant responses to abiotic stress is one of the most active research thrust in plant biology, not only due to its indisputable academic interest, but also because of its practical implications in agriculture, since abiotic stress (mainly drought, high & low temperature and soil salinity) is the major cause for the reduction in crop yields worldwide. Studies on abiotic stress response in model systems, like in Arabidopsis, have only allowed to describe basic molecular mechanisms of stress responses viz. osmotic balance regulation, ion homeostasis, activation of antioxidant systems and protective metabolites synthesis, etc. However, in majority of cases, these responses, could not lead to abiotic stress tolerance. Indeed, like Arabidopsis, almost all the important crop plants are somewhat susceptible to abiotic stresses, while some specialized plants groups like halophytes, gypsophytes, xerophytes etc. are tolerant to drastic abiotic stress conditions in their natural habitats. Although, both tolerant and susceptible may share the same molecular response, Therefore, the mechanisms of response operating in stress tolerant taxa can be expected to be more effective than those of non-tolerant species. Consequently, comparative studies of genetically related, stress tolerant and stress sensitive naturally occurring species under natural habitat are gaining increasing attention because of their potential for understanding stress tolerance mechanisms. These quantitative differences might be dependent on, and modulated by the edafo-climatic properties and their spatial and temporal changes of the habitat, where plants develop. Therefore, the abiotic stress response studies on non-tolerant model under in-vitro conditions allows a stricter experimental control but do not reflect the natural atmosphere of the plants. Therefore, the studies on abiotic stress response of tolerant plants under their natural habitat may contribute to our understanding on abiotic stress tolerance mechanisms, providing complementary information to that obtained from more common studies with non-tolerant model species and laboratory or greenhouse artificial conditions.Not Availabl

Primary total knee arthroplasty using constrained condylar knee design for severe deformity and stiffness of knee secondary to post-traumatic arthritis

Abstract Background Key to a successful outcome of total knee arthroplasty (TKA) is to attain optimum alignment, adequate balance, and deformity correction. In primary TKA, this can be achieved efficiently by posterior stabilized (PS) design with or without the sub-periosteal release. However, certain circumstances such as post-traumatic arthritis are often associated with severe deformities with a significant bone defect, stiffness, and instability. Such deformities are extremely difficult to balance with soft tissue release only and require additionally constrained prostheses even in primary TKA. In such situation, constrained condylar knee (CCK) design is the ultimate choice. This study primarily aimed to report on clinical outcome, regain of function, and complication of patients who underwent primary CCK-TKA for severe deformity of the knee secondary to post-traumatic arthritis. The secondary aim was to find out the mid-term prostheses survival. Methods Between February 2007 and November 2013, 38 consecutive patients with post-traumatic arthritis of the knee received cemented primary CCK-TKA. Thirty-four patients (21 men and 13 women) who had a minimum of 3 years follow-up were included in this retrospective study. We used Knee Society Score (KSS), Hospital for Special Surgery (HSS) score, and roentgenographic evaluation form to assess the patients. Prostheses survival was assessed using Kaplan-Meier’s survival analysis. Results Patients were followed up for an average duration of 6.47 years. KSS knee score improved from 44 points (23–68) pre-operatively to 91 points (76–100) post-operatively [P < 0.001]. The average KSS functional score improved from 49 points (20–75) pre-operatively to 91 points (65–100) post-operatively [P < 0.001]. The average HSS score improved from 51 points (27–83) pre-operatively to 91 points (75–100) post-operatively [P < 0.001]. Similarly, the average ROM improved from 68.09° ± 35.99° (0°–120°) to 113.68° ± 8.90° (100°–130°) post-operatively [P < 0.001]. The average hip-knee-ankle (HKA) angle was 176.88° ± 14.48° (135°–199°) pre-operatively and 180.24° ± 1.77° (175°–184°) post-operatively. Radiolucencies were evident in 13 knees, mostly on the tibial side. Prostheses survival was 94.7% at a mean follow-up of 6.47 years. Conclusion Despite severe deformity, instability, and stiffness at a relatively young age, mid-term follow-up of primary CCK-TKA in post-traumatic arthritis provides satisfactory clinical and functional outcomes with 94.7% prostheses survival. However, it is not without complication