Rare presentation of an ulnar artery aneurysm in a six-month-old baby: Case discussion

Ulnar artery aneurysm cases have been rarely reported in the literature previously. A number of these cases occur in the adult population and are mostly occupational associated. In children, however, this condition is much less. Only 10 cases in children have been reported in the literature to the best of our knowledge, and the minimum age was 1 year. The etiology is mainly post-traumatic. We present a case for discussion of an ulnar artery aneurysm in a 6-month-old baby with the habit of hitting his hand against a table and the floor

Reducing the donor site morbidity in radial forearm free flaps by utilizing a narrow radial forearm free flap

Background: The radial forearm free flap (RFFF) has remained a leading choice of many plastic surgeons as a fasciocutaneous flap due to its versatility, pedicle length, and simple elevation technique. However, donor site morbidity has led many reconstructive surgeons to limit their use of the RFFF and to use other flaps instead. We propose that using a narrow RFFF (nRFFF) decreases the aesthetic and functional morbidity of the donor site.Methods: We report our experiences with the nRFFF from April 2012 through May 2015 at the Department of Plastic, Reconstructive, and Hand Surgery at Liaquat National Hospital, Karachi. The donor defects were closed primarily. The Stony Brook Scar Evaluation Scale and comparison with the contralateral hand were used to assess aesthetic and functional outcomes, respectively.Results: A total of 24 patients underwent nRFFF procedures during the study period. The donor arm showed excellent motor function in 22 cases (91.7%), and very good function in the remaining two cases (8.3%). The aesthetic outcomes were excellent in four patients (16.6%), very good in eight patients (33.3%), good in 10 patients (41.6%), and fair in two patients (8.3%) who developed a hypertrophic scar. All flaps were successful and there were no cases of partial or complete loss.Conclusions: For small to medium-sized soft tissue defects, the nRFFF had acceptable outcomes due to its thinness, pliability, and major reduction in donor site aesthetic and functional morbidity

Design of a high speed 18/12 switched reluctance motor drive with an asymmetrical bridge converter for electric vehicles

The application of permanent magnet free motors have gained a huge attention for pure electric and hybrid electric vehicles. This paper proposed the design of 20-kW switched reluctance motor having 18 stator poles and 12 rotor poles by using finite element analysis machine design software Infolytica magnet and the main focus is to achieve the high speed, torque with adequate performance for electric vehicles. The asymmetric bridge converter has been used and the series of varying the excitation voltage, slot fill factor with respect to the number of turns and stranded area of the conductor has been analysed. Additionally, in order to the electromagnetic force vector, the switching sequence is examined. The simulation results show the great potential of the suggested motor and can provide a good starting torque with high speed and can be suitable to achieve the freedom Car 2020 electric vehicle target

Use of cephalic vein for venous anastomosis in head and neck reconstruction: A case series

Purpose: To describe the use of the cephalic vein as a recipient vessel for venous outflow in head and neck reconstruction. The cephalic vein is used as a vessel in cases where there is a paucity of veins in the neck. This may be due to previous surgery, previous radiation therapy, or advanced cancer. The cephalic vein may also be used to salvage a failing free flap. Methods: It is a retrospective review of 230 free flaps that had been used in head and neck reconstruction performed from July 2014 to July 2018 by a single surgeon. Results: There were 6 patients in whom the cephalic vein was used as a recipient vessel. The cephalic vein was used in 2 cases where a tumor was involved with the internal jugular vein, in 1 case where a previous neck dissection had been done, in 1 case where internal jugular vein had iatrogenic damage, and in 2 cases a salvage procedure was done. In all cases, the cephalic vein was rotated above the clavicle. The cephalic vein easily reached the free flap vein and had a good caliber. There were no failures in any of the patients. Conclusion: The cephalic vein is a good option for venous anastomoses in patients in whom there is a paucity of recipient vessels in the neck

Effective role of olive oil use on lipid profile, blood pressure and blood glucose in subjects of metabolic syndrome

Study was taken with an object to investigate the role of oil extracted from olives on lipid profile, blood pressure and glucose level in subjects having metabolic syndrome. A total of 115 subjects of metabolic syndrome according to International Diabetes Federation criteria, aged between 20-40 years were included. Lipid profile, blood pressure and fasting glucose levels were performed at base line. 30ml of olive oil per day in divided doses 15 ml in the morning and 15 ml in the evening was given to these subjects for six weeks. Then lipid profile, blood pressure and fasting glucose level were performed and compared with base line values. Significant decrease was observed in total cholesterol, low density lipoprotein cholesterol, triglycerides and increase in high density lipoprotein cholesterol, all P values < 0.01. Nonsignificant low level of fasting blood sugar was observed. Significant decrease in systolic and diastolic blood pressure at P value < 0.01 was observed. It is concluded that use of olive oil caused improvement in lipid profile and blood pressure measurement in metabolic syndrome subjects significantly while nonsignificant decrease was observed in fasting blood glucose

Should 1 or 2 venous anastomoses be done in microsurgical flap transfer?

Background: Venous compromise is still the most common cause of free flap failure. The need of a second venous anastomosis to prevent free flap failure is controversial. It is proposed that the use of dual venous anastomoses reduces venous compromise. However, some surgeons suggest that dual venous drainage reduces venous blood flow causing a potential risk of thrombosis.Objective: This study aimed to compare the frequency of reexploration secondary to venous thrombosis in free flap surgeries in reconstruction of soft tissue defects with 1-vein versus 2-vein anastomosis.Materials and methods: We performed a retrospective cohort study including 298 flaps. In 180 of these patients, 2-vein anastomosis was done, and in 118, 1-vein anastomosis was done. The study was conducted at Aga Khan University Hospital from January 2017 to December 2018.Results: The number of venous anastomosis was not associated with flap survival. The group with dual anastomosis required more frequent reexploration as compared with 1 venous anastomosis group (8% vs 1.7%).Outcome and salvage rate were better in the 2-vein group as compared with the 1-vein group (64% vs 50%).Conclusion: There is no difference in flap survival in single or dual venous anastomosis, but we have noticed higher reexploration rates in the 2-vein group. However, outcome is better in the 2-vein group

Dermatofibrosarcoma protuberans of the breast

Dermatofibrosarcoma protuberans (DFSP) of the breast is an infrequent soft tissue sarcoma that usually affects young to middle-aged women. Our case report describes a unique occurrence of DFSP of the breast in an adolescent girl, which was initially being managed as a keloid for 2 years under dermatology despite being refractory to treatment. Once the diagnosis of DFSP was confirmed through punch biopsy, our patient underwent surgical excision of the lesion under general anaesthesia. Our patient was at an increased risk of damage to the ductal system due to proximity of the lesion to the nipple-areolar complex, warranting the need for early recognition and treatment. As demonstrated by our case, DFSP of the breast can be difficult to diagnose since it resembles a range of benign and malignant pathologies of the breast

The Design and Evaluation of Novel Ananimated CAPTCHA Schemes Based on Humans’ Natural Vision Capabilities

CAPTCHAs are ubiquitously found on the web these days. It is most commonly used security mechanism against bots. Numerous design variants of static text-based CAPTCHAs were proposed and implemented on the internet over the years. However due to advancements in machine learning and image processing techniques they were proved vulnerable against automated attacks. In this research a new and robust animated CAPTCHA scheme is presented which is based on human’s natural vision capabilities. The newly designed CAPTCHAs are user friendly for humans but extremely hard for bots. The security and usability is kept in mind while designing these CAPTCHAs. Various types of characters, patterns and filters are used to protect them against automated attacks. Overall, 20 types of animated CAPTCHAs are designed in this work. Further in this research, a group of participants have evaluated the usability of newly designed CAPTCHAs and solved with an average success rate of 76.85%. The analysis has proved that the proposed scheme is very much usable for humans and extremely difficult for bots

Prevalence of GCKR rs1260326 Variant in Subjects with Obesity Associated NAFLD and T2DM: A Case-Control Study in South Punjab, Pakistan

The glucokinase regulatory protein (GCKR) regulates glycogen metabolism and insulin secretion, and the GCKR rs1260326 is a putative single nucleotide polymorphism (SNP) associated with metabolic disorders including nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). This study was conducted to investigate the genetic association of the GCKR rs1260326 in NAFLD and T2DM in our population. NAFLD (n = 103), T2DM (n = 100), and control (n = 100) samples were collected and genotyped for GCKR rs1260326 by tetra-arm PCR. The genetic variant GCKR rs1260326 was significantly linked with NAFLD and T2DM, while the GCKR rs1260326 was significantly associated with the progression of obesity only in NAFLD subjects. The frequency of the C allele (mutant) was higher in both NAFLD (f = 0.69) and T2DM (f = 0.66) subjects as compared to healthy controls of NAFLD (0.52) and T2DM (f = 0.32). The frequency of the C allele was also positively linked with the progression of obesity in both diseases. The frequency of the C allele was 0.66, 0.67, and 0.74 in NAFLD normal weight, overweight, and obese subjects, respectively, while the frequency of the C allele was 0.60, 0.60, and 0.74 in T2DM in normal weight, overweight, and obese subjects, respectively. Homozygous mutant (CC) was 53% in both NAFLD and T2DM subjects, while heterozygous mutant (CT) was 15.53% in NAFLD and 22% in T2DM subjects. Wild-type allele (TT) was 31.06% in NAFLD and 25% in T2DM subjects. In conclusion, the GCKR rs1260326 is a highly prevalent SNP in NAFLD and T2DM subjects, which possibly contributed to obesity, insulin resistance, and metabolic disorders in our population