Analytical study of Acute Intestinal Obstruction – Large Intestine Vs Small Intestine

INTRODUCTION: Acute intestinal obstruction continued to be a emergency presentation till date. It is one of the gravest emergencies presenting to the surgeon in all aspects. It was said by Berkeley Moynihans in 1926 “when called upon to deal with a case of acute intestinal obstruction the surgeon is confronted with of the gravest and most disastrous emergencies. The patient may be, and often is, a man or woman in the prime of life, in full enjoyment of vigorous health, who, without, warning, is suddenly seized with the most intolerable pain in the abdomen…..” Physical signs and their interpretation reach very much of importance in the diagnosis. It is one of the emergencies where as quickly as possible we act, the result will be remarkable. This fact was indicated by Sir Heneage Ogilvie that “in the acute abdominal emergencies the difference between the best and worst surgery is infinitely less than that between early and late surgery, and greatest sacrifice of all is the sacrifice of time” more apt in the present context. AIM OF THE STUDY: 1. To evaluate the common causes of acute intestinal obstruction in this region. 2. To identify the aetiopathogenesis. 3. To evaluate the various modes of presentation. 4. To study the various modalities of treatment in this centre. 5. To evaluate the morbidity and mortality of acute intestinal obstruction. 6. Causes may vary in acute intestional obstruction in different cases. MATERIALS AND METHODS: A total of 90 cases of acute intestinal obstruction admitted in all surgical wards, Thanjavur Medical College Hospital, Thanjavur, over a span of 1 year form October 2014 – October 2015. Both men and women more than 15 years of age totaling 60 cases with features of acute intestinal obstruction were chosen. The paediatric patients were not included in this study. The Age, Sex detailed History relevant to the etiology were noted. The characteristic clinical features of acute intestinal obstruction were abdominal pain, vomiting, constipation/obstipation, Abdominal distension and clinical signs including Fever (>37.2C). Tachycardia (>100/mt), Palpable abdominal mass if any were noted. All the patients were subjected to investigation while resuscitative measures were on progress: 1. Urine – albumin, sugar, 2. Hb%, 3. Blood Grouping with typing, 4. WBC count 5. Blood – urea, sugar, 6. Serum Creatinine, Electrolytes – in cases with severe dehydration. 7. X – ray chest PA view, 8. ECG, 9. Plain X-ray abdomen erect and supine position and results were recorded. After adequate preoperative preparation, all patients were subjected to surgical procedures appropriate to the condition and preoperative pathology were noted. The etiological incidence, Sex incidence, Age incidence, incidence of strangulation, value of plain X-ray Abdomen in diagnosis of acute intestinal obstruction, importance of early treatment were studied. CONCLUSION: 1. Among the causes of Acute Intestinal obstruction, 78.16% is contributed by Small bowel obstruction and 21.84% by Large bowel obstruction. 2. The major cause of acute intestinal obstruction is still External hernia (48.03%) here. Among this, inguinal hernia alone accounts for 81.82% in total. 3. Even though the inguinal hernia causing obstruction is highly prevalent, the Strangulation rate comes down dramatically to 13.33% (12) cases. 4. Adhesive obstruction accounts for 18.78% in total, of which the Postsurgical adhesion is the major cause. 5. Sigmoid volvulus ranks fourth in etiology of acute intestinal obstruction contributing 9.61%, next only to large bowel neoplasms contributing 10.48%. 6. Sigmoid volvulus contributes to large bowel obstruction accounting for 44 % and Neoplasm contributes to 48 % only. 7. Clinical parameters fail to differentiate between simple and strangulated obstruction exactly. 8. Plain X-ray abdomen is a valuable in the diagnosis of the acute obstruction (73%) and hence it is considered as minimal investigation before surgery. 9. Early surgical intervention and antibiotics has reduced the mortality of the simple bowel obstruction. 10. In Strangulated obstruction, the mortality rate is still significantly more, due to age, associated diseases and late arrival to hospital. 11. Mortality associated with large bowel obstruction is 14% compared to 7.26% with small bowel obstruction. 12. Early diagnosis and early surgical intervention is the key to reduce the mortality

MACHINE LEARNING OF TWITTER FEEDS AND WOMEN SAFETY IN INDIAN CITIES

Aim: The paper focuses on the role of Twitter feeds in finding safety aspects of women and girls in Indian cities using machine learning algorithms. Results: The data set obtained through Twitter about women and girls' safety status in Indian cities is analyzed using machine learning tools. Conclusion: Machine learning algorithms help organize and analyze Twitter data, including millions of daily tweets and messages. The same can be extended to other social media platforms. HIGHLIGHTS: A simple machine learning algorithm will help analyze tweet feeds concerning girls' safety

DETECTION AND REMOVAL OF DUST PARTICLES IN PIPELINES USING 3-D MEMS

Currently, the detection of dust particles is realized through manual sampling. Thus it is desirable to develop an automated online technique. Generally, industries run with the help of pipelines through which liquid can flow. The main aim of the work is to detect the dust particles which are present inside the pipeline when liquid is flowing through it. Distributed Acoustic Sensing (DAS) is a recent addition to the pipeline security world. Opta sense system is designed to prevent the damage in pipeline by providing the advance warning to the concern department and make them alert. The dust particles are detected by using MEMS, which can sense in three axis (Heat, Vibration, Movement). It is identified by the IR sensor. The approach can also be simulated by using MATLAB

Swallow Strength Training Exercise For Elderly: A Health Maintenance Need

Background: Recent studies have shown high prevalence of oropharyngeal dysphagia associated with frailty‐ and age‐related muscle weakness. Strength training exercises have been advocated for locomotive health maintenance in the elderly and have shown positive outcomes. As muscles involved in oropharyngeal phase of swallowing are also comprised of striated muscles, the aim of this study was to determine biomechanical effect of a novel resistance exercise program, Swallowing Against Laryngeal Restriction (SALR), on pharyngeal phase swallowing in the healthy elderly. Methods: A total of 28 volunteers (75 + 7 years; 17 females) with no complaint of dysphagia were studied using video fluoroscopy before and after 6 weeks of the swallow strength training exercise. Eighteen of these volunteers also underwent high‐resolution pharyngeal manometry non‐concurrent with fluoroscopy. Ten additional volunteers (81 + 6 years; 9 females) were studied by videofluoroscopy before and after 6 weeks of a sham exercise. Key Results: Swallow resistance exercise but not the sham exercise resulted in a significant increase in maximum upper esophageal sphincter opening (P \u3c .01), superior and anterior laryngeal excursion (P \u3c .01) as well as posterior pharyngeal wall thickness (P \u3c .01). Resistance exercise but not sham exercise also resulted in a significant increase in deglutitive pharyngeal contractile integral (P \u3c .01). Conclusions & Inferences: Strength training of muscles involved in the pharyngeal phase of swallowing using the swallowing against laryngeal restriction technique is feasible and significantly improves key physiologic features of the pharyngeal phase of swallowing. These findings provide the basis for consideration of developing an exercise‐based swallow health maintenance program for the elderly swallow health maintenance program for the elderly

REDUCED KINETIC MECHANISM FOR REACTIVE FLOW SIMULATION OF SYNGAS/METHANE COMBUSTION AT GAS TURBINE CONDITIONS

ABSTRACT The reduced kinetic mechanism for syngas/methane developed in the present work consists of a global reaction step for fuel decomposition in which the fuel molecule breaks down into CH 2 O and H 2 . A detailed CH 2 O/H 2 /O 2 elementary reaction sub-set is included as the formation of intermediate combustion radicals such as OH, H, O, HO 2 , and H 2 O 2 is essential for accurate predictions of non-equilibrium phenomena such as ignition and extinction. Since the chemical kinetics of H 2 and CH 2 O are the fundamental building blocks of any hydrocarbon oxidation, the inclusion of detailed kinetic mechanisms for CH 2 O and H 2 oxidation enables the reduced mechanism to predict over a wide range of operating conditions provided the reaction rate parameters of fuel-decomposition reaction is optimized over those conditions. Therefore, the rate coefficients for the fuel-decomposition step are estimated and optimized for the ignition delay time measurements of CH 4 , H 2 , CH 4 /H 2, CH 4 /CO and CO/H 2 mixtures available in the literature over a wide range of pressures, temperatures and equivalence ratios that are relevant to gas turbine operating conditions. The optimized reduced mechanism, consisting of 15 species and around 40 reactions, is able to predict the ignition delay time and laminar flame speed measurements of CH 4 , H 2 , CH 4 /H 2 , CH 4 /CO and CO/H 2 mixtures fairly well over a wide range conditions. The model predictions are also compared with that of GRI3.0 mechanism. The reduced kinetic mechanism predicts the ignition delay time of CH 4 and CH 4 /H 2 mixtures far better than GRI mechanism at higher pressures. To demonstrate the predictive capability of the model in reactive flow systems, the reduced mechanism was implemented in Star-CD/KINetics commercial code using a RANS turbulence model to simulate CH 4 /air premixed combustion in a backward facing step. The CFD model predictions of the stable species in the exhaust gas agree well with the GRI mechanism predictions in a chemical reactor network modeling by approximating the backward facing step with a series of perfectly-stirred reactor and plug-flow reactor. INTRODUCTION The production of syngas and H 2 -enriched fuels from Integrated Gasification Combined Cycles (IGCC) technology has become economically and environmentally feasible due to increased energy cost in recent times. Although the term 'syngas' refers to a fuel mixture of CO and H 2 , many of the H 2 -enriched fuels from IGCC consists of mainly CO, H 2 , CH 4 and N 2 and trace amount of COS, H 2 S and NH 3 . Moreover, the composition of H 2 -enriched fuel mixtures varies widely; for example, the methane composition in the fuel mixtures can vary from 6.5 to 65 mole

Gaseous emissions during concurrent combustion of biomass and non-recyclable municipal solid waste

Background: Biomass and municipal solid waste offer sustainable sources of energy; for example to meet heat and electricity demand in the form of combined cooling, heat and power. Combustion of biomass has a lesser impact than solid fossil fuels (e. g. coal) upon gas pollutant emissions, whilst energy recovery from municipal solid waste is a beneficial component of an integrated, sustainable waste management programme. Concurrent combustion of these fuels using a fluidised bed combustor may be a successful method of overcoming some of the disadvantages of biomass (high fuel supply and distribution costs, combustion characteristics) and characteristics of municipal solid waste (heterogeneous content, conflict with materials recycling). It should be considered that combustion of municipal solid waste may be a financially attractive disposal route if a 'gate fee' value exists for accepting waste for combustion, which will reduce the net cost of utilising relatively more expensive biomass fuels. Results: Emissions of nitrogen monoxide and sulphur dioxide for combustion of biomass are suppressed after substitution of biomass for municipal solid waste materials as the input fuel mixture. Interactions between these and other pollutants such as hydrogen chloride, nitrous oxide and carbon monoxide indicate complex, competing reactions occur between intermediates of these compounds to determine final resultant emissions. Conclusions: Fluidised bed concurrent combustion is an appropriate technique to exploit biomass and municipal solid waste resources, without the use of fossil fuels. The addition of municipal solid waste to biomass combustion has the effect of reducing emissions of some gaseous pollutants

Glucolipotoxicity initiates pancreatic beta-cell death through TNFR5/CD40-mediated STAT1 and NF-kappa B activation

Funded by Diabetes UK, NovoNordisk UK Research Foundation, and St. Bartholomew’s & The Royal London Charitable Foundation grant awards