On the balance energy and nuclear dynamics in peripheral heavy-ion collisions

We present here the system size dependence of balance energy for semi-central and peripheral collisions using quantum molecular dynamics model. For this study, the reactions of $Ne^{20}+Ne^{20}$, $Ca^{40}+Ca^{40}$, $Ni^{58}+Ni^{58}$, $Nb^{93}+Nb^{93}$, $Xe^{131}+Xe^{131}$ and $Au^{197}+Au^{197}$ are simulated at different incident energies and impact parameters. A hard equation of state along with nucleon-nucleon cross-sections between 40 - 55 mb explains the data nicely. Interestingly, balance energy follows a power law $\propto{A^{\tau}}$ for the mass dependence at all colliding geometries. The power factor $\tau$ is close to -1/3 in central collisions whereas it is -2/3 for peripheral collisions suggesting stronger system size dependence at peripheral geometries. This also suggests that in the absence of momentum dependent interactions, Coulomb's interaction plays an exceedingly significant role. These results are further analyzed for nuclear dynamics at the balance point.Comment: 13 pages, 9 figures Accepted in IJMPE (in press

Introduction of case-based learning to teach Pharmacology to second year MBBS students

Background: Our medical education system has various limitations. In the initial few years of medical education, the focus is more on teaching the theoretical aspect of various subjects and not to apply the knowledge gained to practice. It is important to stimulate a student’s analytic thinking and provide them with an opportunity to see theory in practice. In case-based learning (CBL) a case acts as a stimulant of learning. The aim of the study was to introduce CBL in Pharmacology to teach second year MBBS students and see its effect on their performance. The study also aimed to get student and faculty (Department of Pharmacology) feedback on this teaching model.Methods: A total 180 students of second prof. MBBS and faculty of Department of Pharmacology were included in the study. A total of two topics were taken for CBL sessions. The theory lecture of the first topic was conducted. The students were divided into smaller groups of 15 each and a pretest was taken. This was followed by CBL session and after that post-test was administered. The second topic was covered on similar format. At the end of the two sessions the student and faculty feedback were taken on a five-point Likert scale.Results: A total 127 students participated in the study. 90% of the students agreed or strongly agreed that CBL had been useful in understanding the topics and it will be useful for foundation of their clinical years. All faculty members agreed that CBL does improve student teacher interaction but they found CBL to be time consuming. Conclusions: CBL was well accepted by the students and they want that other topics should be taken up by this method. The faculty also believes that it is worth giving a try but at the same time CBL is time consuming and it may be possible to conduct it for only a few topics in a session

Giant intra-abdominal hydatid cysts with multivisceral locations

The disseminated intra-peritoneal hydatid disease is a very rare finding. A case of disseminated intra abdominal hydatid disease is presented along with a review of literature and various therapeutic modalitie

Traumatic Cyclodialysis Cleft Surgical Management Using Encirclage and Cryotherapy : A Novel Approach

This is a retrospective case series of 4 patients with traumatic cyclodialysis cleft (CC) with features of hypotony and posterior segment manifestations of blunt trauma who were treated using encirclage and trans scleral cryoptherapy along with vitrectomy. Encirclage was placed anteriorly in order to support the cleft. There was closure of cleft and improvement in Intra ocular pressure (IOP) in all cases. Thus the identification and treatment of CC with encirclage in cases with varied posterior manifestation of trauma can lead to good anatomical and visual restoration

Quantitative assessment of airway and parenchymal components of chronic obstructive pulmonary disease using thin-section helical computed tomography

Purpose: The purpose of this study was to diagnose and characterise chronic obstructive pulmonary disease (COPD) into its forms, patterns, and severity using MDCT. Material and methods: In this prospective study, spirometric and MDCT evaluation was done in 52 consecutive patients diagnosed with COPD. In each patient six segmental bronchi were evaluated for CT morphometric indices of bronchial wall thickness (BWT) and wall area percentage (WAP). Quantitative evaluation of emphysema was done using inbuilt software, and volume of emphysematous lung was determined using percentage low attenuation area (LAA). COPD was categorised into the following: emphysema predominant; airway predominant; or mixed phenotypes, and severity grading was assigned as mild, moderate, or severe. Results: Centrilobular was the predominant emphysema pattern occurring alone (36.5%) or in combination with paraseptal changes (34.6%). Among COPD phenotypes, emphysema predominant was the commonest (44.3%), followed by mixed (30.8%), and bronchitis predominant (25.0%). The mean BWT in the airway-predominant group was significantly higher (1.94 ± 0.28 mm) than in the emphysema-predominant subgroup (1.79 ± 0.23 mm) with a p value of 0.005. Conclusion: MDCT is an indispensable tool in quantitative and qualitative evaluation of COPD patients. Measurement of CT indices like BWT, WAP, and %LAA can reliably categorise COPD into phenoty

Immediate Bilateral Breast Reconstruction with Unilateral Deep Superior Epigastric Artery and Superficial Circumflex Iliac Artery Flaps

Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments

Plastic and Reconstructive Surgery Advance Online Article

Background: The aim of this study was to evaluate the efficacy, safety profile, and complications associated with mandibular distraction osteogenesis performed in infants weighing less than 4 kg with Robin sequence. Methods: An 11-year retrospective review of all infants (younger than 6 months) with mandibular distraction osteogenesis–treated Robin sequence was performed. Patients weighing less than 4 kg (experimental) and 4 kg or more (control) who underwent mandibular distraction osteogenesis were compared. Demographics, medical comorbidities, improvement in apnea/hypopnea index, need for tracheostomy, repeated distraction, and complications were evaluated. Results: One hundred twenty-one patients underwent mandibular distraction osteogenesis. Eighty-one patients weighed less than 4 kg and 40 weighed 4 kg or more. The mean follow-up was 2.8 years in patients weighing less than 4 kg and 3.0 years in the control group. Mean age and weight at the time of distraction were 23 days and 3.1 kg, respectively, in the study group; and 2.7 years and 11 kg, respectively, in the control group. There was no significant difference in success of mandibular distraction osteogenesis to treat airway obstruction in the group weighing less than 4 kg compared with the control group (92.6 percent versus 88.9 percent; p = 0.49). The most common complication in each group was surgical-site infection (9.9 percent and 20.0 percent; p = 0.15). Overall complication rates were similar between the two groups (17.3 percent versus 25.0 percent; p = 0.34). The rates of repeated distraction were similar between the two groups (6.3 percent and 13.5 percent; p = 0.28). Conclusions: Mandibular distraction osteogenesis is a safe and effective treatment modality for infants weighing less than 4 kg with severe airway obstruction. The efficacy, safety, and complication profiles are not significantly different from those of larger patients. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III

Skin Regeneration Using Dermal Substrates that Contain Autologous Cells and Silver Nanoparticles to Promote Antibacterial Activity: In Vitro Studies

We hypothesized that the addition of silver nanoparticles (AgNP) to a dermal substrate would impart antibacterial properties without inhibiting the proliferation of contained cells. Our in vitro model was based on the commercial substrate, Integra. The substrate was prepared by simple immersion into 0 to 1% suspension of AgNP (75 or 200 nm diameter) followed by rinsing for 20 minutes and sterilization under an ultraviolet C lamp. A total of 107 human adipose stem cells per cubic centimeter were injected and after 1 hour, 6 × 105 keratinocytes/cm2 were seeded and cultured for up to 14 days. Constructs were evaluated using a metabolic assay (WST-1), and hematoxylin and eosin and immunoperoxidase staining. Bactericidal activity was measured using a log reduction assay against bacteria that are prevalent in burns. The presence of AgNP did not significantly change the metabolic activity of constructs after 14 days of culture, and the distribution of cells within the substrate was unchanged from the controls that did not have AgNP. Antibacterial activity of Integra containing AgNP (75 nm diameter) was concentration dependent. In conclusion, the addition of AgNP to the dermal substrate suppressed bacterial growth but did not significantly affect cell proliferation, and may represent an important property to incorporate into a future clinical skin regeneration system

Smoking Related Home Oxygen Burn Injuries: Continued Cause for Alarm

Background: Home oxygen therapy is a mainstay of treatment for patients with various cardiopulmonary diseases. In spite of warnings against smoking while using home oxygen, many patients sustain burn injuries. Objectives: We aimed to quantify the morbidity and mortality of such patients admitted to our regional burn unit over a 6-year period. Methods: A retrospective chart review of all patients admitted to a regional burn center from 2008 through 2013 was completed. Admitted patients sustaining burns secondary to smoking while using home oxygen therapy were selected as the study population to determine morbidity. Results: Fifty-five subjects were admitted to the burn unit for smoking-related home oxygen injuries. The age range was 40-84 years. Almost all subjects were on home oxygen for chronic obstructive pulmonary disease (96%). Seventy-two percent of burns involved <5% of the total body surface area, 51% of patients were intubated, and of those 33% had evidence of inhalation injury. The hospital mortality rate was 14.5%. The mean length of hospital stay was 8.6 days, and 54.5% were discharged to a nursing home or another advanced facility. Finally, concomitant substance abuse was found in 27%, and a previous history of injury from smoking while on home oxygen was discovered in 14.5%. Conclusions: This single-center analysis is one of the largest describing burn injuries stemming from smoking while using home oxygen therapy. We identified the morbidity and mortality associated with these injuries. Ongoing education and careful consideration of prescribing home oxygen therapy for known smokers is highly encouraged