Evaluation of Pre-Operative and Post Operative Polysomnography for Obstructive Sleep Apnea

BACKGROUND: Obstructive sleep a pnea which is an entity of sleep disordered breathing is a chronic disorder with various cardiovascular and neurocognitive sequlae. Among various available treatment modalities, surgery is indicated for patients who fail or refuse conservative management. OBJECTIVE: The purpose of the study is to assess the efficacy of soft tissue surgeries for the treatment of obstructive sleep apnea by comparing preoperative and postoperative polysomnography data (done at 3rd and 5th month) and by assessing the reduction in symptoms after surgery. MATERIALS AND METHODS: A Retrospective and prospective study was conducted in 34 patients after getting ethical committee approval. The study population consisted of both sexes with age group of 20-40 years with complaints of excessive day time sleepiness. All patients underwent PSG and those patients with AHI >5 are further investigated with DISE and dynamic MRI to confirm the level of obstruction. Patients were channelized to different surgeries depending upon the level of obstruction. PSG done at 3rd and 5th month after surgery. RESULTS: Thirty four patients, 29 male (85.3%) with mean±SD age 37.53±5.2. mean±SD BMI 29.02±2.85, mean±SD ESS 16.41±3.09 underwent PSG at 3rd and 5th month after surgery. Surgery cure is defined as decrease in AHI greater than or equal to 50% or a total of less than 10 events/hour. 28(82.4%) patients had 50% improvement in AHI, of which 2(5.8%) patients had more than 80% improvement. ESS was reduced to <10 in 27 patients (79.42%). Temporary VPI occurred in 6 (17.6%) patients and bleeding in 4 (11.8%) patients. None of the study population required ventilator support. Mean±SD duration of pain was 15.53±6.08 with maximum duration in patients undergoing multilevel surgery especially those who underwent tongue base surgery. CONCLUSION: Substantial proportion of general population suffer from sleep disordered breathing. With continued lifestyle modification and proper surgical technique directed at appropriate site of obstruction patients can be alleviated from sequlae of OSA

Sequential Synthesis of Distributed Controllers for Cascade Interconnected Systems

We consider the problem of designing distributed controllers to ensure passivity of a large-scale interconnection of linear subsystems connected in a cascade topology. The control design process needs to be carried out at the subsystem-level with no direct knowledge of the dynamics of other subsystems in the interconnection. We present a distributed approach to solve this problem, where subsystem-level controllers are locally designed in a sequence starting at one end of the cascade using only the dynamics of the particular subsystem, coupling with the immediately preceding subsystem and limited information from the preceding subsystem in the cascade to ensure passivity of the interconnected system up to that point. We demonstrate that this design framework also allows for new subsystems to be compositionally added to the interconnection without requiring redesign of the pre-existing controllers.Comment: Accepted to appear in the proceedings of the American Control Conference (ACC) 201

Provably safe cruise control of vehicular platoons

We synthesize performance-aware safe cruise control policies for longitudinal motion of platoons of autonomous vehicles. Using set-invariance theories, we guarantee infinite-time collision avoidance in the presence of bounded additive disturbances, while ensuring that the length and the cruise speed of the platoon are bounded within specified ranges. We propose: 1) a centralized control policy and 2) a distributed control policy, where each vehicle's control decision depends solely on its relative kinematics with respect to the platoon leader. Numerical examples are included.NSF; CPS-1446151; CMMI-1400167; FA 9550-15-1-0186 - AFOSR; Schlumberger Foundation Faculty for the Future Fellowship; FA 9550-15-1-0186 - AFOSR; NSF; ECCS-1550016; CNS 123922

Spectra and the exact number of Automorphisms of Paley-type graphs of order a product of n distinct primes

Paley graphs are Cayley graphs which are circulant and strongly regular. Paley-type graph of order a product of two distinct Pythagorean primes was introduced by Dr Angsuman Das. In this paper, we extend the study of Paley-type graphs to the order a product of n distinct Pythagorean primes. We have determined its adjacency spectra and the exact number of the automorphisms

Value of Understanding and Accepting for the Students of Professional Studies

The art of effective teaching is the information should reach the students in proper way. And it interest to the students. The need of these two to assess the value of understanding and accepting between teachers and students, know the importance of teachers–students interactions within the learning environment. And to know the importance of a teacher for the student’s success in their career. The way of selections are based on interactiveness, ice breakers, communications and link experience. Here, the modes of catagories of students divided like excellent, good, fair and poor and the analysis are interpreted and discussed. Key words: Value; Understanding; Accepting; Evaluation technique; Teaching Practic

A COMPARATIVE ANALYSIS OF TWO DIFFERENT SAMPLES OF SIDDHA CLASSICAL FORMULATION-PADIGALINGA CHENDURAM

Siddha is the traditional system of medicine in India which is practiced in southern part. This traditional system has many polyherbal and herbo-mineral formulation which is more effective but they lack standardization procedures. Standardization of a herbo- mineral formulation is essential to assess the quality, efficacy, purity and safety of the drug. The present paper deals with standardization of Padigalinga Chenduram, the Siddha formulation which is used for treating menorrhagia, diarrhoea, dysentry etc. In-house preparation and one marketed sample were subjected to standardization techniques like organoleptic study, physicochemical screening and heavy metal analysis. It was observed that both the samples differ in their organoleptic character, physicochemical analysis and heavy metal analysis like colour variance, percent weight loss on drying or moisture content was found to be less in market sample and total ash value was high as well. And the market sample was found to be better than the in-house sample in water-soluble and alcohol-soluble extractive values. The toxic heavy metals as per AAS is found in both formulations and the values are not matching with each other, and it may be due to the raw material collection time and geographical variation, etc. which can be further investigated for its pharmacological activity. More number of samples from different pharmas has to be studied to arrive at definite standard for manufacturing Padigalinga Chenduram. When a definite standard is arrived from future studies, Padigalinga Chenduram will be a cost effective Siddha formulation for the treatment of various ailments

Elicitors induced changes in essential oil constituents of turmeric (Curcuma longa L.) rhizome

An experiment was conducted at IISR, Kozhikode to study the effect of foliar application of chemical elicitors, namely, chitosan (100, 200 and 500 ppm), phenylalanine (0.1, 1 and 10 mM) and salicylic acid (0.01, 0.1 and 1 mM) on volatile constituents of turmeric rhizome essential oil (EO). Three genotypes (Pragati, Rajapuri and Acc.849) which vary in growth duration and volatile profile were taken for the study in randomized block design with three replications. The highest EO content in Pragati (6%) and Acc. 849 (5.3%) was found in Phenylalanine (1 mM) treatment. No significant changes in EO content were observed in the genotype Rajapuri. Phenylalanine and salicylic acid were found to have positive influence on ar-turmerone, the major sesquiterpenoid in Pragati. Acc.849 and Rajapuri did not produce any significant changes to ar-turmerone content in elicitor treated samples. Moreover, the treatment related variation in the total monoterpenes and total sesquiterpene content was found significant among the genotypes. Multivariate analysis using partial least square discriminant analysis supported the variation observed among the treatments and variable importance in projection scoreidentified the metabolites responsible for variation among treatments

Socioeconomic Status, Self-Rated Health, and Mortality in a Multiethnic Sample of US Adults

Objective: To examine the association between socioeconomic status (SES), self-rated health (SRH), and mortality separately by race-ethnicity in a nationally representative sample of US adults. Methods: We analyzed data from 16 716 adult women and men who were followed up for mortality for up to 12 years as part of the third National Health and Nutrition Examination survey (NHANES III). Poverty-income ratio (PIR) and education were assessed as measures of SES. All-cause mortality (n = 2850) was recorded from the NHANES III linked mortality file. Results: Lower PIR was associated with mortality after adjustment for lifestyle, clinical risk factors, and SRH in all racial-ethnic groups (P-trend \u3c0.005). In contrast, after adjusting for lifestyle and clinical risk factors, lower education was not associated with all-cause mortality in non-Hispanic whites (P-trend = 0.16), whereas the association remained significant after adjustment for SRH and lifestyle and clinical risk factors in other race- ethnicities (P-trend = 0.005; P-interaction between education categories and race-ethnicity was 0.02). Conclusions: Our results suggest that lower PIR was associated with mortality in all racial-ethnic groups. In contrast, lower education was significantly associated with mortality only in racial-ethnic groups other than non- Hispanic whites. Our results indicate that, beyond lifestyle and clinical risk factors, adjusting for SRH resulted in only a modest change in the association of SES and mortality