Twin reversed arterial perfusion sequence: the heartless twin

To report a case of twin reversal arterial perfusion sequence and its management by means of laser coagulation of the vascular malformation in the placenta. Twin reversed arterial perfusion sequence is a rare form of twin to twin transfusion syndrome occurring primarily in Monochorionic monoamniotic twins. The prevalence is about 1 in 35,000 pregnancies. The significance of this condition is that there is a normal foetus and an acardiac foetus. The blood is shunted from the normal twin to the acardiac twin through vascular malformations in the placenta. The normal twin faces a high risk of both morbidity and mortality due to cardiac failure. A case of twin reversal arterial perfusion sequence diagnosed at 22 weeks following a target scan underwent laser photocoagulation and gave birth vaginally at 30 weeks without any complications. Early detection of this condition can lead to timely intervention and thereby improve the outcome. In Twin reversal arterial perfusion sequence, the normal or the pump twin has a high chance of mortality due to cardiac failure. As the size of the acardiac twin increases, there is a higher chance of mortality of the pump twin. There is a need for regular follow up with ultrasonography and foetal echocardiography along with early therapeutic interventions to ensure the survival of the normal twin. In our case, despite the large size of the acardiac twin, we had a successful pregnancy outcome for the normal twin due to timely intervention

Current Practices in Structural Analysis and Testing of Aero-Engine Main Shafts

AbstractGas turbine engines are widely used in both Military and Civil Aircrafts. The power generated at the turbine is transmitted to compressor through Engine main shafts. These shafts are classified as Class-I critical components of the engine. During the flight operating conditions engine main shafts are subjected to complex loading conditions, such as Torsional, Centrifugal, Thermal, Gyroscopic etc… The combination of these loads lead to multimode failure mechanisms, such as Low cycle Fatigue (LCF), High cycle Fatigue (HCF) and Ductile overload failures in shafts. Designing of shafts for structural integrity is very critical in single engine aircrafts, as the failure of any one shaft may result in the failure of engine, which in turn may lead to the catastrophic failure of the entire aircraft. The complex geometry of the shafts calls for combination of design tools for stress and life estimation of these parts (both analytical and finite element method (FEM)) backed up by extensive material and component test programs. In the present paper structural analysis and life estimation is carried out on Low Pressure Spool and Spline Coupling under various engine operating conditions. The design analysis cycle consists of several phases, such as Heat Transfer Analysis, Structural Analysis, Optimization and Fatigue Lifing. Detailed modeling and stress analysis carried out to evaluate the strength of the splines is also presented. This paper highlights the methodology of design subjected to clearance of stipulated MIL 5007 D/E specifications to ensure the structural integrity. Based on the stress analysis, a Stress Test Schedule is prepared to carry-out the testing at shaft fatigue rig facility. In the testing facility, mechanical testing of the shaft assembly is carried out to establish strength and fatigue life of the shafts. Brief results on the material tests carried out and fatigue life testing of full scale component are also presented

Diastematomyelia differences in management of diastemetomyelia with associated abnormalities versus isolated diastemetomyelia: a case series

Diastematomyelia (DM), also known as split cord malformation (SCM) is a type of spinal dysraphism. It is a very rare congenital spinal anomaly characterized by clefting of the spinal cord due to a partial or complete bony or fibrous septum within the spinal canal with splaying of the posterior spinal elements resulting in localized division of the spinal cord into two parts on either side of the septum which typically reunite below the cleft. The pathology was first described by Cruvelhier in 1853. About 1-3 per 1000 live birth, is the estimated incidence of spinal dysraphism and neural tube defects (NTD) occurs more commonly in females (55-70%). Prenatal diagnosis of DM is possible by ultrasonography (USG). The clinical significance of DM is that it may manifest as an isolated abnormality or in association with other spinal abnormalities such as spina bifida, Arnold-Chiari malformation, hemivertebra, butterfly vertebra, kyphoscoliosis or part of Jarcho-Levin syndrome. The management of pregnancy with a foetus diagnosed with DM antenatally, differs based on whether the foetus has an isolated DM with intact skin or DM with more serious associated anomalies. We present two cases of Foetal DM both diagnosed by antenatal USG, Case 1 was diagnosed at 16 weeks gestation age (GA) with DM associated with Type II Arnold-Chiari malformation, hydrocephalus and case 2 was diagnosed with isolated DM at 19 weeks 2 days GA

BIOSORPTION OF CRYSTAL VIOLET DYE FROM AQUEOUS SOLUTIONS USING NATURAL BIOSORBENTS

Textile and dyeing industries are continuously increasing the pollution levels of water bodies regularly due to improper treatment and disposal of their effluents. The synthetic dyes are recalcitrant in nature and their intense color leads to the reduction in photosynthesis and raise temperature in the deeper layers of water bodies causing serious damage to the aquatic life. It is necessary to adopt eco-friendly treatment methods like bio sorption and microbial decolorization to decolorize the effluents before they are disposed into the environment. Batch mode bio sorption experiments were carried out using the Annona reticulata leaves powder and Cucurbita maxima seed powder. Optimization studies were carried out for the decolorization of crystal violet dye. Under optimized conditions, the percentage decolorization by bio sorbent, Annona reticulata leaves powder (at pH = 8, temperature 400C) was 90.3% for 60 minutes. The amount of biosorbent dosage added for maximum color removal is 0.2g/ 100ml. In case of Cucurbita maxima seed powder, the percentage removal was 98.5% under same conditions. Effective removal was observed by Cucurbita maxima seed powder compared to Annona reticulata leaves powder. Toxicity assay showed that in the presence of biosorbent Annona reticulata leaves the growth of microbes was more favorable when compared to Cucurbita maxima seed powder. The present study reveals that the use of natural biosorbents in the decolorization of industrial effluents is an effective and commercially viable technique

ASSESSMENT OF PRESCRIBING PATTERN AMONG ORTHOPEDIC IN-PATIENTS USING WHO PRESCRIBING INDICATORS

Objective: Evaluating the prescribing indicators regularly help to monitor the prescriptions to reduce indiscriminate use of drugs. The present study was conducted to explore the prescribing pattern in orthopedic in-patients using the WHO prescribing indicators in a tertiary care teaching hospital, Mangalore.Methods: Data was collected from case records of orthopedic in-patients regarding patient demographics, diagnosis, and details of drugs in a structured pro forma and analyzed for the WHO prescribing indicators using descriptive statistics. Values are expressed as mean ± standard deviation, percentages as applicable.Results: A total of 379 patient prescriptions were included in the study which consisted of 2195 drugs. Of the 379 patients, 221 (58.3%) were male and 158 (41.7%) were female. The mean age group of the patients was 44 years. Acute trauma such as fractures, tendon damage, and disc prolapse (57.8%) were the most common indications for admission. Analgesics were the most commonly prescribed group of drugs comprising 27.28% of the prescriptions followed by multivitamins (20.68%) and proton-pump inhibitors (17.12%). The most commonly prescribed analgesic was nonsteroidal anti-inflammatory drugs (86.81%). Most of the drugs (65.80%) were administered through the oral route and 40.31% of drugs were fixed-dose combinations. The mean number of drugs per prescription was 5.79± 2.59. Antibiotics were prescribed in 60.4% of the prescriptions. 76.3% of prescriptions were with injectables. Use of drugs by generic name was 7.7% and only 44% of drugs were from the national list of essential medicines 2015.Conclusion: The study provides an insight into the prescribing pattern in orthopedic in-patients. It highlights the importance of emphasizing rational drug prescribing and toward improving awareness of the physicians and medical students to the WHO recommended standards on prescribing indicators

Ekspresija i pročišćavanje glavnoga proteina (OmpH) bakterije Pasteurella multocida P52 proizvedenoga u bakteriji Escherichia coli.

Porin H (OmpH) is the major outer membrane protein in the envelope of Pasteurella multocida. The gene ompH, encoding major outer membrane protein was amplified by PCR excluding the region coding for signal peptide and cloned in the pQE32 prokaryotic expression vector. The recombinant OmpH was expressed as a fusion protein with 6-His tag at N-terminal in E. coli M15 cells transformed with recombinant plasmid pQE32-ompH. The expressed protein was purified from E. coli and characterized by SDS-PAGE and western blot analysis. The fusion recombinant protein eluted had a molecular mass of about 37 kDa. The expressed recombinant protein was confirmed with western blot analysis using RGS-His antibody and anti-P. multocida serum raised against whole cell lysate.Porin H (OmpH) je glavni protein stanične stijenke bakterije Pasteurella multocida. Gen ompH, koji kodira njegovu tvorbu, isključujući područje za tvorbu signalnog peptida, bio je umnožen lančanom reakcijom polimerazom i kloniran u prokariotskom vektoru pQE32. Rekombinantni OmpH bio je izražen kao fuzijski protein sa 6-His tag na N-kraju u stanicama E. coli M15 transformiranima rekombinantnim plazmidom pQE32- ompH. Proizveden protein bio je pročišćen iz E. coli i identificiran SDS-PAGE-om i western blotom. Izdvojeni fuzijski rekombinantni protein imao je molekularnu masu oko 37 kDa. Identitet proizvedenog rekombinantnog proteina bio je povrđen western blot analizom uporabom protutijela za RGS-His i antiseruma za lizat cjelovite stanice P. multocida

Comparative Evaluation of Surface Roughness of Resin- Modified Glass Ionomer and Glass Hybrid Restorative Materials Simulated by Tooth Brushing: An in-Vitro Study

Objective: To compare the effect of tooth brushing on surface roughness of Resin-Modified Glass Ionomer Cement (RMGIC; GC Gold label 2LC Light Cured Universal Restorative) and Glass Hybrid (GH; GC EQUIA SYSTEM- EQUIA Forte™ Fil and EQUIA Forte™ Coat) restorative material at 1- and 3-months interval simulated by tooth brushing. Material and Methods: RMGIC and GH material specimens (20 each) were prepared according to manufacturer instructions in 10 mm × 2 mm dimensions using a mylar strip. A specially designed toothbrush simulator was used along with Oral B Pro 2 2000N powered toothbrush and Colgate Total dentifrice (Colgate-Palmolive India limited; Relative dentin abrasivity - RDA: 70 - Low abrasive) to perform brushing strokes. Specimens were subjected to surface roughness analysis before and after simulated tooth brushing at baseline, 1, and 3 months. Results: The intragroup comparison was done using repeated-measures ANOVA. Intergroup comparisons were done using an independent sample t-test and General Linear Model (ANCOVA). Surface roughness increased from baseline through 3 months in both RMGIC and GH groups. The mean surface roughness in RMGIC group was significantly higher than GH group at baseline 1 and 3-months, respectively (p<0.001, <0.001, and <0.001). Interaction between group and baseline surface roughness was not significant (p=0.466).  The estimated marginal means were significantly higher in RMGIC than GH group (p=0.008). Conclusion: The surface roughness of both RMGIC and GH restorative increased from baseline to 1 month and 3 months after the simulated toothbrushing protocol. GH exhibited significantly lower surface roughness than RMGIC at all the tested intervals

Evaluation of laryngoscopic view, intubation difficulty and sympathetic response during direct laryngoscopy in sniffing position and simple head extension: a prospective and randomized comparative study

Background: Airway management is critical to the care of patients and direct laryngoscopy is the mainstay of airway management. Despite the proliferation of difficult airway devices, sniffing position for laryngoscopy remains the gold standard and ideal position. This prospective, randomized and single-blind study was done to evaluate and compare the laryngoscopic view, complexity of intubation and sympathetic response during laryngoscopy in sniffing position and simple head extension.Methods: One hundred and twenty patients, aged 20-50 years with American Society of Anesthesiologists (ASA) status 1 and 2 undergoing general anesthesia requiring orotracheal intubation were randomized into two groups. Group A used sniffing position and group B was put in simple head extension. Glottis visualization was assessed using Cormack and Lehane grade and ease of intubation was assessed on intubation difficulty scale. Laryngoscopic sympathetic response in two positions was also assessed.Results: Both the groups were comparable in demographic profiles. Glottic visualization and intubation difficulty score were better and statistically significant in sniffing position as compared to simple head extension. Although, sympathetic response was lower in sniffing position as compared to simple head extension, it was statistically insignificant.Conclusion: Sniffing position provided better glottis visualization and intubation difficulty score and increased the success rate of intubation as compared to simple head extension.

His230 of serine hydroxymethyltransferase facilitates the proton abstraction step in catalysis

The three-dimensional structures of rabbit and human liver cytosolic serine hydroxymethyltransferase revealed that H231 interacts with the O3′ of pyridoxal-5′-phosphate and other residues at the active site such as S203, K257, H357 and R402 (numbering as per the human enzyme). This and the conserved nature of H231 in all serine hydroxymethyltransferases highlights its importance in catalysis and/or maintenance of oligomeric structure of the enzyme. In an attempt to decipher the role of H230 (H231 of the human enzyme) in the catalytic mechanism and/or maintenance of oligomeric structure of sheep liver serine hydroxymethyltransferase, the residue was mutated to arginine, phenylalanine, alanine, asparagine or tyrosine. Our results suggest that the nature of the amino acid substitution has a marked effect on the catalytic activity of the enzyme. H230R and H230F mutant proteins were completely inactive, dimeric and did not bind pyridoxal-5′-phosphate. On the other hand, mutation to alanine and asparagine retained the oligomeric structure and ability to bind pyridoxal-5′-phosphate. These mutants had only 2-3% catalytic activity. The side reactions like transamination and 5,6,7,8-tetrahydrofolate independent aldol cleavage were much more severely affected. They were able to form the external aldimine with glycine and serine but the quinonoid intermediate was not observed upon the addition of 5,6,7,8-tetrahydrofolate. Mutation to tyrosine did not affect the oligomeric structure and pyridoxal-50-phosphate binding. The H230Y enzyme was 10% active and showed a correspondingly lower amount of quinonoid intermediate. The kcat/Km values for L-serine and L-allothreonine were 10-fold and 174-fold less for this mutant enzyme compared to the wild-type protein. These results suggest that H230 is involved in the step prior to the formation of the quinonoid intermediate, possibly in orienting the pyridine ring of the cofactor, in order to facilitate effective proton abstraction