A PROSPECTIVE STUDY ON EXPLORING MICRONUTRIENT DEFICIENCY IN NON-ISCHEMIC CARDIOMYOPATHY AMONG THE YOUNG: POTENTIAL FOR CORRECTION

Background Micronutrient deficiencies are increasingly recognized as significant yet often overlooked factors in the pathogenesis and progression of non-ischemic cardiomyopathy (NICM), especially among young populations. This study aims to explore the prevalence and effects of micronutrient deficiencies in young patients with NICM, assessing the relationship between micronutrient levels and disease severity, and evaluating the efficacy of nutritional interventions.  Methods A prospective cohort study was conducted, enrolling 64 participants aged 18-35  diagnosed with NICM. Exclusion criteria included ischemic heart disease, primary valvular heart disease, and chronic diseases affecting micronutrient levels. Baseline assessments included medical history, physical examination, dietary assessment, blood tests for key micronutrients, and cardiac imaging. Participants with identified deficiencies received tailored supplementation plans. Follow-ups were conducted monthly, with repeat assessments at 6 and 12 months.  Results At baseline, 56% of participants had at least one micronutrient deficiency, with vitamin D being the most common. After 6 months of supplementation, significant improvements in micronutrient levels and mean left ventricular ejection fraction (LVEF) were observed (from 45% to 52%, p < 0.001). Quality of life improved significantly, and a reduction in cardiovascular event rates was noted, although not statistically significant.  Conclusion This study highlights the high prevalence of micronutrient deficiencies among young individuals with NICM and demonstrates that tailored nutritional interventions can significantly improve cardiac function and quality of life. These findings underscore the importance of screening for and addressing micronutrient deficiencies in this population, suggesting a potential avenue for improving cardiovascular outcomes in NICM.  Recommendations Healthcare providers should screen young NICM patients for micronutrient deficiencies and incorporate tailored nutritional interventions into their management. This can potentially improve cardiac function and quality of life, though further research is needed to establish comprehensive guidelines

A Retrospective Study on Peripartum cardiomyopathy, Recent Trends and disease profile, study at tertiary centre of Bihar

Background: Peripartum Cardiomyopathy (PPCM) is a rare but serious cardiovascular condition that affects women in the peripartum period. The aim of this study is to comprehensively investigate the recent trends and disease profile of PPCM among patients at a tertiary center in Bihar. Methods: A retrospective study was conducted which included 50 female participants who met specific inclusion criteria, such as being aged 18 years or older, having a confirmed PPCM diagnosis, and having complete medical records available for analysis. Data collection encompassed demographic information, clinical presentation, diagnostic criteria, echocardiographic findings, laboratory results, and treatment modalities employed. Statistical analysis involved descriptive statistics, categorical and continuous variable presentations, and the use of SPSS ver. 18 for data analysis. Results: The mean age at PPCM diagnosis was 32.5 years, with 60% being parous and 40% nulliparous. Clinical symptoms included dyspnea (84%), fatigue (76%), and edema (70%). Echocardiographic findings revealed compromised cardiac function, with a mean LVEF of 35%. Laboratory results demonstrated elevated BNP and troponin levels. Treatment approaches were diverse, including medications, interventions, and lifestyle modifications. Complications included arrhythmias (20%), thromboembolic events (10%), and cardiogenic shock (14%). The overall survival rate was 84%, with a mortality rate of 16%. Conclusion: The study provides valuable insights into the clinical profile, diagnosis, treatment, and outcomes of PPCM in a retrospective cohort. The findings highlight the complex nature of PPCM and the importance of early recognition and comprehensive management strategies in improving patient outcomes. Further research and awareness efforts are needed to enhance the understanding and management of this challenging condition. Recommendations: Medical practitioners should be educated about PPCM to aid early diagnosis. Obstetricians, cardiologists, and other professionals collaborate for multidisciplinary treatment. Frequent cardiac monitoring for high-risk pregnant and postpartum women. More research on risk factors and innovative PPCM treatments

COMPARISON OF VARIOUS NUMERICAL DIFFERENCING SCHEMES IN PREDICTING NON-NEWTONIAN TRANSITION FLOW THROUGH AN ECCENTRIC ANNULUS WITH INNER CYLINDER IN ROTATION

Flow through annulus is a widely solved problem in fluid mechanics because of its practical applicability in many areas. In oil well drilling, cuttings generated are of non-Newtonian nature which flows through an eccentric annulus with inner cylinder in rotation, considering the real drilling situations. In the present work, a comparison have been done amongst three differencing schemes, the second order upwind, the Power law scheme and QUICK scheme used in computational fluid dynamics solution algorithms, so as to find the best amongst them to solve transition flow for this case as well as in general. A three dimensional orthogonal hexahedral mesh with suitable boundary conditions & input parameters was taken as computational domain for eccentric annulus. This was solved with standard k-ω turbulence model and SIMPLE algorithm. Results were validated against the published experimental work of J. M. Nouri, et. al [1]. Radial velocity, axial velocity and tangential velocity of fluid were plotted along chosen planes and contours of molecular viscosity as well as turbulence kinetic energy were observed for comparison amongst the solutions obtained by three differencing schemes. Although in most of the cases close agreement have been observed between computational data, but as far as prediction of radial velocity is concerned there was surprising difference amongst the three schemes

Seismic wave characteristics in anisotropic attenuating media .

Seismic anisotropy in shales is a complex phenomenon. A number of theoretical shale models are investigated to study the effects of clay orientation, aspect ratio of cracks, porosity and fluid types on the synthetic seismograms.A synthetic seismogram is a tool to investigate seismic wave characteristics in anisotropic attenuating media. A numerical technique for the computation of synthetic seismograms in a homogeneous, as well as in a multilayered anisotropic medium was developed. Full waveform theory is used to compute the synthetic seismograms. The medium can be elastic or viscoelastic. In the latter case, attenuation is introduced by giving materials complex elastic constants. To ensure that there are no false arrivals in the synthetic seismogram, it is important to carefully control the integration kernel singularity points, especially those due to repeated roots of the associated Green-Christoffel equation. A novel approach is developed to safely track the continuity of the integration kernel and, hence, the polarization vectors in critical and supercritical zones.The reflectivity approach is followed to consider wave propagation in a multilayered medium. A simple and concise implementation of this method is developed. This approach also enables one to investigate frequency dependent reflection coefficients varying with incidence angle and azimuth. The modeling of reflection coefficients in fractured media suggests that amplitude versus offset and azimuth (AVOAz) can be helpful in detecting fractured reservoirs.In a new development, the effect of attenuation on P- and S-wave radiation patterns in viscoelastic anisotropic media is investigated. The understanding of radiation patterns in homogeneous media is applied to interpret various wave types in attenuating multilayered media. Both the amplitude and the frequency content of the synthetic seismograms are affected by attenuation properties of the media. The spectral decomposition technique is found to be useful in our understanding of the attenuation effects

Seborrahic keratitis: a benign pigmented skin lesion management

Seborrhoeic keratosis are formed from the basal layer of epidermal cells and contain melanocytes. Many terms such as senile wart, melanoacanthoma, basal cell papilloma, senile keratosis and seborrhoeic wart have been applied, but seborrhoeic keratosis is the most widely accepted term. In our case a 50-year-old female presented to the surgery OPD with a painless pigmented skin lesion 2.5cm lateral to the left lateral canthus and 1cm below the hairline of size of 4 *4cm. Pigmented lesion was from last 8 years and slowly progressive in nature and was not associated with any co morbid conditions. On clinical evaluation the clinical diagnosis of epidermal nevus was given and an excisional biopsy with rhomboid flap placement was performed and the tissue was sent for histopathological examination. Post operative period was uneventful and the histopathology report states the seborrhoeic keratosis. Hence, lesions for which the diagnosis is uncertain, based on the history and gross examination, should be biopsied for histopathologic examination to rule out malignancy

EMERGENCE OF METABOLIC SYNDROME IN POLICE PROFESSIONALS: A LONGITUDINAL OBSERVATIONAL STUDY

Objective: This is a longitudinal observation looking for the emergence of metabolic syndrome (MetS) in a rapid response police unit. Methods: After taking informed consent, measurements were taken of blood pressure, body mass index (BMI), waist circumference, triglycerides, HDL-cholesterol, and fasting blood glucose periodically in 2019, 2021, and 2023 in January. 146 police officers enrolled out of 148 screened and 117 completed the study. Results: In four years, the proportion of individuals with MetS values exceeding the norm increased by 20-30% for each component with 56 new cases of impaired metabolic parameters and 13 new cases of MetS observed among 110 previously unaffected police officers. Conclusion: A significant increase in the number of Metabolic Syndrome was found, particularly via its effects on blood lipid levels in police personnel which a highly stressful for professionals. Future longitudinal studies with continuous stress monitoring and comparing with a control will more in-depth knowledge into it

A safe method for the retrieval of a dislocated trial head in total hip arthroplasty

Total hip arthroplasty is a life changing procedure providing a significant improvement in the quality of life for those receiving treatment. An 81-year-old male with severe right sided hip osteoarthritis underwent uncemented total hiparthroplasty. Intraoperatively the 32mm trial head dislodged from the trial stem over the anterior rim of the acetabulum relocating to within the pelvic cavity. Time efficient retrieval was performed during primary surgery through a mini-incision at the iliac crest