A study on comparison of cerviprime and IV oxytocin in labour induction and evaluation of changes in the bishop’s score with these two agents

Background: There are several strategies for the induction of labor (IOL), and pharmacologic agents, including oxytocin and prostaglandins, are most commonly used in clinical practice. Compared with oxytocin, the prostaglandin E2 agent, dinoprostone, has been regarded as moreeffective for the induction of labor of LTPs with a non-dilated cervix. Objective was to compare the PGE2 gel placed intracervically with that of oxytocin given intravenously for induction of labor in both primipara as well as multipara with the comparison of Bishop’s score at the starting of induction and its improvement with both of these inducing agents in those with indications for induction with gestational age greater than 36 weeks. Methods: Hospital based prospective observational study over a period of one year on patients attending the antenatal and high-riskpregnancy clinic and scheduled for induction of labor with Bishop score <4. Results: The number of successful induction was low in primiparae group with low Bishop’s score (1-2). There were greater number of successful inductions in both primi as well as multiparae with higher Bishop’s score. Conclusions: When a primigravida had a low cervical score or an unfavourable cervix, intracervical PGE2 gel was found to be more effective at ripening the cervix and inducing labour. Both medicines were equally effective at inducing labour in cases of multigavidae with any Bishop's score and primi with a higher Bishop's score

Diabetes a risk for antimicrobial resistance?

Background: Diabetic foot infections can cause substantial morbidity. The role of Diabetes mellitus in the antimicrobial resistance of pathogens in patients with foot infections is not well clarified. So, we compared the profile of antibiotic resistance in diabetic and non-diabetic foot ulcer infections. Objectives were to compare the antimicrobial resistance pattern in diabetic and non-diabetic lower limb infections.Methods: T Pus was isolated in 50 Diabetic and 50 non-diabetic foot ulcer infections. The organisms were isolated on specific media and antibiotic susceptibility was done by using Kirby-Bauer disc diffusion method.Results: The most frequent causative organism in diabetic and non-diabetics is Pseudomonas 27.5% vs 27.1%, Staphylococcus 24.1% vs 27.1%, Klebsiella 24.1% vs 22.03%, E. coli 10.3% vs 10.16%, Proteus 5.17% vs 5.08%. No significant differences in resistance rates to Amikacin, Penicillin, Ofloxacin, Vancomycin, Piperacillin + Tazobactum were observed between diabetic and non-diabetic patients. There is significant difference in resistance to Ampicillin (p=0.017).Conclusions: Diabetes per se does not seem to influence the susceptibility pattern to antimicrobials in our group of patients with foot ulcer infections

Combined PSOAS Compartment Block and Sciatic Nerve Block for Elective Lower Limb Surgeries

AIM AND OBJECTIVE OF THE STUDY : This study was aimed at evaluation of the motor and sensory blockade and post operative analgesia using both psoas compartment block and sciatic nerve block in elective lower extremity surgeries. PRIMARY OBJECTIVE : To assess the effectiveness of the lower limb block based on 1. Sensory block. 2. Motor block. 3. Post operative analgesia. SECONDARY OBJECTIVE : To assess the onset of block, total duration of block, and the time taken for the first dose of rescue analgesia and to look for complications if any MATERIAL AND METHOD : DESIGN OF THE STUDY: Randomized Prospective study. Selection of Subjects : • Study involves adult patients between 18 to 60 years ofASAps I- II posted for elective lower limb surgeries. • Sample size 60. • Randomization – computer generated random numbers. PSOAS COMPARTMENT BLOCK AND SCIATIC NERVE BLOCK : Sixty patients subjected to psoas compartment block followed by sciatic nerve block using nerve stimulator 0.25% bupivacaine over 30 ml for psoas compartment block and 0.25% of 20ml bupivacaine for sciatic nerve block was administered. Under strict aseptic precautions, psoas compartment block performed by winnes technique and and sciatic nerve block by labat’s technique using peripheral nerve stimulator after obtaining twitch of quadriceps and calf muscle contraction and dorsiflexion of foot. Results are based on following parameters. • Time of onset of sensory blockade. • Time taken for onset of motor blockade. • From the time of block, visual analogue scale noted for every 30 minutes 1hour, 2 hour by 4, 6, and 8 hours • From the time of block Bromage score noted for 2, 6,and 8 hours. • Time elapsed till first rescue analgesia dose. • The incidence of first dose of rescue analgesia at 9 to 10 hours is 48.3 % (29 out of 60 patients) and at 10 to 11 hours is 51.7 % (31 out of 60 patients). • Sensory blockade by visual analogue scale reveals no pain upto 8 hours and almost complete block upto 6 hours in 73.3% of patients and good analgesic effect upto 9 to 10 hours in 48.3 % (29 out of 60 patients) and at 10 to 11 hours is 51.7 % (31 out of 60 patients). • So overall combined psoas comapartment block and sciatic nerve block provides effective sensoryblockade, motor blockade and good postoperative analgesic effect. CONCLUSION : This study concluded that skillful application of psoas compartment block by posterior approach [WINNIES APPROACH] and proximal sciatic nerve blockv [LABATS APPROACH] provides adequate intraoperative analgesia for major lower extremity procedures and maintains prolonged postoperative analgesia with significantly lower consumption of opioid analgesics. It also provides, early ambulation, short hospital stay and far less side effects when compared with neuroaxial blocks such as hemodynamic instability, meningeal irritation, introduction of infections, neurological complications and others. Finally, both patient and surgeon satisfaction were achieved successfully with psoas compartment block and sciatic nerve block. Combined psoas compartment block and sciatic nerve block is a safe and effective alternative for analgesia for lower limb surgeries

Synchronous double malignancy: Acute lymphoblastic leukemia and carcinoma rectum

Synchronous double malignancy involving hematopoietic system and solid organs is rare. We report an interesting case of acute lymphoblastic leukemia (ALL) and carcinoma rectum. High index of suspicion is required in leukemic patients with bleeding per rectum to diagnose synchronous malignancy at an early stage

Power Savings with all SiC Inverter in Electric Traction applications

The advantage of Silicon Carbide (SiC) based devices are less thermal management requirements and smaller passive components which result in higher power density. SiC devices have higher blocking voltages, lower on-state resistance and switching losses and higher thermal conductivity and operating temperatures. SiC devices can operate at higher voltages, higher frequencies and higher junction temperatures than comparable Si devices, which results in significant reduction in weight and size of the power converter and increase in system efficiency

Comparison of multilevel inverters with T-type MLI: A brief review

This paper gives a comparative analysis of different types of Multilevel Inverters with T-Type inverters. The principal aim of the work is to analyse the T-type multilevel inverter operation with different multilevel inverters such as Diode-Clamped Multilevel Inverter, Flying Capacitor Multilevel Inverter and Cascaded H-bridge Multilevel Inverter. All the inverters are compared and their advantages, disadvantages and usages are specified. The inverter used in our work runs on the multilayer bidirectional DC-DC converter. This can be used in Renewable Energy Sources and Electric Vehicle applications. The proposed design includes two power switches with an additional capacitor to balance the currents of the multilayer T-type (MLI) capacitor during an entire drive pattern or fault circumstances. In this design, the big capacitors being electrolytic in T-type Multilevel Inverter has been exchanged with longer-lasting film capacitors due to the high-frequency cycle-by-cycle current security between CN and CP. The converter’s dimensions and weight would be lowered by 20% because of this topology, as the number of switches and the capacitors used for balancing is reduced in this proposed design. The simulation analysis for five-level conventional T-type inverter and proposed T-type inverter with capacitor voltage balancing is done. The line-to-line voltages, line currents, phase voltages, three-phase voltages, and voltage total harmonic distortions are compared for conventional T-type inverter and proposed T-type inverter with capacitor voltage balancing. The simulation results shows that the proposed T-type inverter gives better performance compared to conventional T-type multilevel inverter

Forecasting meteorological analysis using machine learning algorithms.

Weather prediction is gaining up ubiquity quickly in the current period of Machine learning and Technologies. It is fundamental to foresee the temperature of the climate for quite a while. Decision trees, K-NN, Random Forest algorithms are an integral asset which has been utilized in several prediction works for instance, flood prediction, storm detection etc. In this paper, a simple approach for weather prediction of future years by utilizing the past data analysis is proposed by the decision tree, K-NN and random forest algorithm calculations and showing the best accuracy result of these three algorithms. Weather prediction plays a significant job in everyday applications and in this paper the prediction is done based on the temperature changes of the certain area. All these algorithms calculate the mean values, median, confidence values, probability and show the difference between plots of all the three algorithms etc. Finally, using these algorithms in this work we can predict whether the temperature increases or decreases, is it a rainy day or not. The dataset is completely based on the weather of certain area including few objects like year, month, and temperature, predicted values and so on.

An Inter digital- Poison Ivy Leaf Shaped Filtenna with Multiple Defects in Ground for S-Band bandwidth Applications

The proposed work, a filtenna for s band application is implemented. It is designed by embedding an Interdigital band pass filter (IDBPF) and leaf shaped antenna which are operated in S band. The IDFBPF is having seven resonators with one end shorted through dual vias. It offers a bandwidth of 1.3GHz from 1.65GHz to 2.95GHz.  A Dumbbell shaped DGS (Defected Ground Structure) provided in ground to improve the filter characteristics.  Measured pass (BRL) band return loss (S11) & insertion loss (S12) are -18dB & -4.6dB correspondingly. Further, leaf shaped antenna is designed based on modified polar transformation equation; it has 2.7 GHz bandwidth from 1.3 GH to 3 GHz and has a gain of -5.45dBi, and return loss (S11) of -19.5 dB. The filtenna is obtained by integrating the IDBBPF in the fodder line of the leaf designed antenna. The final model has 1.2 GHz operating bandwidth from 02.30 GHz to 03.50 GHz with peak arrival damages at 2.4GHz and 3.1GHz with -20dB and-24dB respectively. The designed filtenna has a pass band gain of -5.3dBi. The shift in operating band is due to combining the filter with antenna. The proposed model is invented on FR4 substrate having a wideness of 01.60 mm and having a dimension of 0.25 0.58 ?02. In this final model two complementary slip ring resonators (CSRR) are used in addition with four dumbbell structures as defects in the ground plane to avoid ripples in return loss (S11) graph. A high degree of concordance exists between empirically measured and simulated outcomes. The radiation band is showing its application in S band wireless mobile communications, Wi-Fi and ISM 2.4GHz band

EVALUATING RISK FACTORS, CLINICAL AND THERAPEUTIC PROFILE OF STROKE PATIENTS PRESENTING TO A TERTIARY CARE HOSPITAL

Objective: According to the World Health Organization, stroke is the second leading cause of death for people above the age of 60 years, and the fifth leading cause in people aged 15–59 years old. This study mainly aims to evaluate the prevalence of risk factors, clinical features, pattern of drugs prescribed, and severity of stroke among patients. Methods: A cross-sectional study was carried out in a tertiary care teaching hospital on 210 patients for a period of 6 months. Patients aged 18 years and above were included in the study. The severity of stroke was assessed using National Institute of Health Stroke Scale (NIHSS). Results: The majority of the patients were under the age group of 61–70 years (31%). The incidence of ischemic stroke (81%) was more common compared to hemorrhagic stroke (19%). Males (66%) are prone to stroke compared to females (34%). The most common risk factor was hyperlipidemia (29%) followed by hypertension (17%). Antihypertensives (28%) were most commonly used drugs followed by antihyperlipidemics (23%). Most of the prescriptions were prescribed with 4–6 drugs per prescription (62%). Moderate stroke (69%) was most commonly observed in patients. A total of 147 drug-drug interactions were observed. Among 147 drug-drug interaction, the most commonly observed drug-drug interaction was aspirin with metformin (15%). Conclusion: The present study emphasizes on the need to identify risk factors and providing awareness among the patients by a pharmacist in minimizing the disease burden. Early identification of risk factors and pattern of therapy based on therapeutic guidelines plays a crucial role in qualitative patient care

OCCLUSION IN IMPLANT-AT A GLANCE

Objectives: Occlusion is a critical and very important component for the clinical success and longevity of dental implants. This review article focuses on the various aspects of implant protective occlusion. Our scientific literature regarding implant occlusion, particularly in implant-supported fixed dental prostheses remains controversial.Materials and methods: A search strategy was performed in MEDLINE/PubMed, Scopus and Google Scholar with keywords – ‘implants’ and ‘occlusion’, ‘implants’ and ‘fixed prosthesis, ‘implants’ and ‘fixed dental prostheses’, ‘implants’ and ‘partial edentulism’, ‘implants’ and ‘complications’, ‘implants’ and ‘failures’, ‘implants’ and ‘cantilever’, ‘implants’ and ‘occlusal load’.Results: 135 articles were retrieved. After hand search a total of 290 articles were identified. Ultimately, 30 articles were selected and summarized and discussed as they met the selection criteria.Conclusion: Most of the available clinical data are controversial. Implant-protected occlusion can be accomplished by decreasing the width of the occlusal table and improving the direction of force. By doing these things, we can minimize overload on bone-implant interfaces and implant prostheses, to maintain an implant load within the physiological limits of individualized occlusion, and ultimately provide long-term stability of implants and implant prostheses. Current clinical practices rely heavily on principles extracted from the natural dentition or removable dental prostheses on complete edentulous patients and on expert opinions