Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Salivary Glucose and Oral Mucosal Alterations in Type II Diabetic Mellitus Patients

Aim: The study was undertaken: 1) To assess salivary glucose (SaG) levels in diabetic and nondiabetic subjects and to determine if saliva could be used as a noninvasive tool to diagnose and monitor Type II diabetes mellitus. 2) Correlation of SaG levels with serum glucose (SeG) levels in nondiabetic and diabetic patients. 3) To correlate the oral manifestations of diabetes mellitus with serum and SaG levels. Material and Methods: Both fasting and postprandial serum and SaG levels were analyzed from 70 Type II diabetic and 70 nondiabetic subjects. The detailed examination of oral cavity in relation to periodontal and dental status and subjective oral complaints were recorded. The obtained values were subjected to statistical analysis. Results: The mean fasting salivary glucose (FSaG) was 5.469 + 2.347 mg/dL and 7.634 + 4.468 mg/dL in nondiabetic and diabetics, respectively (P = 0.000) and postprandial salivary glucose (PSaG) was 6.434 + 2.111 mg/dL and 8.736 + 4.962 mg/dL in nondiabetic and diabetics, respectively (P = 0.000). The positive correlation was found between SeG levels and SaG in diabetics (P = 0.000). Strong positive correlation was observed between SeG and SaG with oral manifestations in Type II diabetic patients (P < 0.05). Conclusion: Saliva can be a useful tool in regular monitoring of “already diagnosed Type II diabetics” (by their SeG levels) rather than diagnosing subjects with “unknown status of diabetes mellitus.” Strong positive correlation exists between SeG level and SaG level with oral manifestations in Type II diabetic patients

Implementation of GSM Module based Smart Aquarium Monitoring and Controlling System

The aquarist feeds the fish in the aquarium tanks which demands a proper setup for maintenance. The challenges faced are alterations in water quality, fish care, temperature regulation, light control, and difficulty in manually monitoring the aquarium’s conditions. Consequently, close monitoring of the physical parameters and improvement of water conditions become essential. As a result, this system utilizes a Global System for Mobile (GSM) module for aquarium observation and control, described real-time sensor capabilities. It conducts temperature checks, detects water pH levels, manages the aeration system, and handles water renewal operations. Based fish aquarium is a fully automated and remotely monitored aquarium, fully capable of operating without human intervention or interaction. The mechanical feed design, web-based fish feeding, and remote monitoring of all parameters are the crucial components of the project. Feed level, water temperature, pH, and water level are some of the parameters. These can be accessible through a phone app or through a website on a computer. This method’s objective is to reduce errors and effort required by humans to manage an aquarium containing aquatic animals. As a result, this system achieves optimal results in terms of accuracy and efficiency

Microstructure, mechanical response and fractography of AZ91E/Al2O3 (p) nano composite fabricated by semi solid stir casting method

The present study confers to the fabrication and its characterization of magnesium alloy (AZ91E) based nano composites with nano Al2O3 particulate reinforcements. A novel Semi Solid stir casting technique was adopted for the fabrication of the composite. An average particle size of 50 nm was used as reinforcement to disperse in matrix. The effects of change in weight fraction of reinforcements on the distribution of particles, particle–matrix interfacial reactions, physical as well as mechanical properties were reported. The SEM and EDS analysis has shown the uniform distribution of particles in the composite along with the presence of elements. The mechanical properties of reinforced and unreinforced composite were evaluated and presented. Fractography of tensile specimens was also discusse