Study of performance of Adiabatic Carry Look Ahead Adder Using Dynamic CMOS Logic

Performance of adiabatic carry look ahead adder using dynamic CMOS are studied and compared with Adiabatic carry look ahead adder using Pass Transistor. adiabatic carry look ahead adder using pass transistor has higher delay and lower power consumption while adiabatic carry look ahead adder using dynamic cmos logic has lower power dissipation and higher speed. adiabatic carry look ahead adder using dynamic cmos are design using 180 nm cmos technology and compared power dissipation and delay with respect to supply voltage and frequency. simulation result show that power dissipation of carry look ahead adder using dynamic cmos has higher performance comparison adiabatic CLA using pass transistor. simulation result show that adiabatic CLA using dynamic cmos reduce the power consumption 45% and delay reduce to 70% comparison to adiabatic CLA using pass transistor

Giant fibrosarcoma of anterior abdominal wall: a rare case report and review literature

Adult type fibrosarcoma is very rare malignant soft tissue tumor. It usually arises in soft tissues of extremities, trunk, head and neck. Fibrosarcoma is essentially a diagnosis of exclusion from other spindle cell mesenchymal malignant neoplasm; by definition negative for epithelial, myogenous and neural markers on immunohistochemistry. To the best of our knowledge, very few cases have been reported in the literature. We here report a case of giant fibrosarcoma arising from anterior abdominal wall in a recurrent dermatofibrosarcoma proturbens and managed with surgical excision and reconstruction with meshplasty.

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Uniportal video-assisted thoracoscopic Ivor Lewis oesophagectomy

Standard minimally invasive Ivor Lewis oesophagectomy is performed through a multiport technique using carbon dioxide. However, access to video-assisted thoracoscopic surgery (VATS) is increasingly shifting to a single-port approach due to its proven safety and efficacy in lung surgeries. Therefore, the preamble of this submission is to describe, 'How I do differently' uniportal VATS MIO in three major steps: (a) VATS dissection through a single 4-cm incision in a semi-prone position without artificial capnothorax; (b) fluorescence dye to check conduit perfusion and (c) intrathoracic overlay anastomosis with a linear stapler