Higher Spin Cosmology

We construct cosmological solutions of higher spin gravity in 2+1 dimensional de Sitter space. We show that a consistent thermodynamics can be obtained for their horizons by demanding appropriate holonomy conditions. This is equivalent to demanding the integrability of the Euclidean boundary CFT partition function, and reduces to Gibbons-Hawking thermodynamics in the spin-2 case. By using a prescription of Maldacena, we relate the thermodynamics of these solutions to those of higher spin black holes in AdS_3.Comment: 21 pages, v2: many typos fixed, refs added, v3: minor corrections/improvements, Phys. Rev. D version, v4: one more re

Mini percutaneous nephrolithotomy: its role in the management of renal stone and our tertiary care centre experience

Background: Miniaturized percutaneous nephrolithotomy (PCNL) procedures for urolithiasis have gained increased popularity in recent years. To decrease the complications of conventional PCNL by  reduced tract size led to the development of Mini PCNL, which makes the use of 15-18F sheaths in place of 24-30F of conventional PCNL. It has developed rapidly and become a popular technique of renal stone management with reduced morbidity and excellent outcome. Authors report our experience with Mini PCNL for the treatment of renal stone.Methods: In between his August 2015 and January 2018, sixty patients with the diagnosis of unilateral single medium size (8-20mm) renal stone were identified. Patient’s demographical, clinical, diagnostic and procedural data were recorded.  All patients were evaluated by history taking, physical examination and laboratory investigations. Radiological evaluation was done with X ray kidney, ureter and bladder region (KUB) and also with renal ultrasonography followed by computed tomography (CT). All patients underwent Mini PCNL using 12F nephroscope and 16.5/17.5F sheath. Holmium: YAG laser was used for stone fragmentation. No nephrostomy tube was used routinely. Treatment outcome was assessed in terms of operative time, haemoglobin drop, hospital stay and stone free rate.Results: Complete stone fragmentation was achieved in 41 out of 60 patients using Mini PCNL, so initial stone free rate was 68.3%. After 4 weeks of surgery total 53 patients were stone free (88.3%), 5 patients required some auxiliary procedure for complete clearance of stone and other 2 were managed conservatively. The mean operative time was 48.28 min, mean haemoglobin drop was 0.74gm/l and mean postoperative hospital stay was 54.22 hours. After 12 weeks postoperatively all patients were stone free. There were no significant postoperative complications, and all had good quality of life.Conclusion: Mini PCNL technique appears to be safe and effective alternative to conventional PCNL for moderate size renal calculi. It is usually related to less blood loss and shorter hospital stay than the standard method. It can achieve good stone-free rates with minimal complications and low morbidity. Mini PCNL can also be considered as a good alternative to retrograde intrarenal surgery and shockwave lithotripsy in selected cases. However, further high quality studies with larger sample size are required in future

Prevalence and determinants of tobacco consumption among pregnant women of three Central Indian Districts

Background: About 6.8% of Indian women consume tobacco and only 21.0%  receive ‘full’ antenatal care. Thus, there are chances that women who consume tobacco during the non‑pregnant state will continue to use tobacco during  pregnancy.Materials and Methods: A cross‑sectional study was conducted across nine health centres in three districts of Madhya Pradesh, India. A total of 3,839 women  admitted in the post‑partum ward of selected hospitals were interviewed about  tobacco consumption during pregnancy. Adjusted odds ratios were calculated to determine the predictors of tobacco consumption during pregnancy.Results: The prevalence of tobacco consumption during pregnancy was 13.1%. Only 4.4% of women who consumed tobacco and 1.6% of women who did not use tobacco were advised against tobacco consumption by frontline health workers. The strongest predictors of tobacco consumption were tobacco consumption by husband [AOR = 36.16 (CI = 22.89–68.86)], neighbor/female friend consuming tobacco [AOR = 22.29 (CI = 13.11–31.82)], and female family members consuming tobacco [AOR = 5.63 (CI = 4.39–7.53)].Conclusion: Awareness among women about adverse effects of tobacco consumption during pregnancy was low. Health system intervention in the form of health education and advice against tobacco consumption was virtually non‑existent.Key words: India; pregnancy; tobacco; women

Retroperitoneal laparoscopic adrenalectomy: its role in the management of adrenal tumour and tertiary care centre experience

Background: Laparoscopic adrenalectomy for adrenal tumour has gained increased popularity worldwide. To decrease the complications of commonly used transperitoneal approach, by not entering into peritoneal cavity the retroperitoneal laparoscopic adrenalectomy (RLA) has developed. It has several advantages over the transperitoneal approach and associated with reduced morbidity and excellent outcome. The objective of this study was to report our experience with RLA for treatment of adrenal tumour.Methods: The study was done from August 2014 and December 2017, data of 44 patients who underwent RLA for adrenal tumour in the institute were retrospectively reviewed. Patient’s demographical, clinical, diagnostic and procedural data were recorded. All patients were assessed by history, physical examinations, laboratory values with biochemical marker test and imaging by computed tomography/magnetic resonance imaging. Treatment outcome was assessed in terms of operative time, haemoglobin drop, conversion rate, hospital stay and complications.Results: In 44 adrenalectomy, 24 men and 20 women, with a mean age of 47.0±8.9 years were enrolled. Mean body mass index was 23.5±2.2 kg/m2. Right adrenal tumour was seen in 26 cases and left in 18 cases. Mean adrenal mass size was 2.6±0.85 cm. Mean operative time was 109.1±21.16 minutes, mean haemoglobin drop was 0.47±0.26 gram/L. Conversion to open surgery was necessary in 2 patients. Mean postoperative hospital stay was 4.0±0.91 days. Recovery time mean value was 12.18±1.7 days postoperatively. In final histopathology result adenoma was most prevalent (25 cases) and myelolipoma was least (1 case).  Conclusions: RLA appears to be safe and effective alternative to transperitoneal adrenalectomy for moderate size adrenal tumour in particular less than 6 cm. It is associated with less blood loss, shorter hospitalization, low conversion rate, fewer complications and early recovery. RLA offers an alternative method for treating adrenal tumour with improved surgical outcomes

Parametric Optimization of Lactic Acid Production by Immobilized Lactobacillus casei Using Box-Behnken Design

Technological optimization of process parameters posses one of the open challenge for fermentative lactic acid (LA) production. Hence optimization of process parameters viz. sugar concentration, pH, biomass, incubation temperature and incubation time for maximizing fermentative lactic acid production from molasses sugar and corn steep liquor as a low cost carbon and nitrogen source, respectively by immobilized Lactobacillus casei MTCC 1423 cells has been carried out using Box Behnken Design (BBD). By applying multiple regressions on experimental data, quadratic models have been realized, explaining role of each variable and their quadratic interaction on LA production, LA productivity and yield coefficient. Analysis of variance has demonstrated that models are significant. The maximum LA production (132 g/(L fermentor volume) ), LA productivity of 2.36 g/(L×h) and yield coefficient of 0.936 g/(g substrate) have been estimated by the quadratic regression model for optimum process parameters values of sugar concentration (194 g/L), pH (6.85), biomass (310 mg, CDW), incubation temperature (37°C) and incubation time (57 h). The optimization validated experiments had resulted in LA production of 130±2.1 g/(L fermentor volume) ; LA productivity of 2.28±0.037 g/(L×h) and yield coefficient of 0.921±0.003 g/(g substrate) and which are substantially higher than those obtained with free cells of Lb. casei MTCC 1423 (2%, v/v inoculums size) at obtained optimized process parameters values. Thus resulted quadratic models provided an opportunity for scaling up the lactic acid production process and demonstrated the economic potential of using agro industrial waste molasses sugar for lactic acid production by Lb. casei MTCC 1423

Usunięcie przemieszczonych stentów z pnia lewej tętnicy wieńcowej w trakcie przezskórnej interwencji wieńcowej techniką trappingu

Dislodgement and embolisation of the new generation of drug eluting stents is a very rare but recognized and potentially serious complication of percutaneous coronary intervention (PCI). Various methods from including tangling wire, bioptome, and goose neck snare to surgical removal have been described. Here we report a case of successful retrieval of a deformed coronary stent from left main coronary artery by trapping technique.Przemieszczenie stentu nowej generacji wydzielającego lek i związany z tym zator to bardzo rzadkie, lecz znane powikłanie przezskórnej interwencji wieńcowej, które może się wiązać z poważnymi następstwami. Opisywano różne metody chirurgicznego usunięcia stentu z życiem rozmaitych narzędzi endoskopowych, w tym narzędzi z końcówką w postaci splątanego drutu, szczypczyków biopsyjnych i pętli. W niniejszej pracy przedstawiono przypadek skutecznej ewakuacji zdeformowanego stentu wieńcowego z pnia lewej tętnicy wieńcowej techniką trappingu

Point Prevalence of Indwelling Catheterized Patients Admitted in a Tertiary Care Hospital and Related Nursing Care Practices

Urinary catheterization facilitates the drainage of urinary bladder. The current study was carried out to assess the point prevalence of indwelling catheterized patients admitted in a tertiary care hospital and to assess the related practices of nurses. A descriptive cross-sectional design was employed. Sampling technique was purposive. Survey of all the admitted patients was carried out in a single day to assess the point prevalence of catheterized patients. Tools for data collection comprised of sociodemographic profile and clinical profile of the catheterized patients. A checklist was used to assess the self-expressed practices of nurses regarding insertion, care and removal of catheter. The total number of admitted patients on the day of survey was 1718. 317 (18.5%) patients were found to be catheterized. Majority of the patients were in Intensive Care Unit followed by Emergency areas and were suffering from neurological disorders. Most of the self-expressed practices of nurses regarding catheterization were adequate other than documentation of the procedure; providing perineal care at the time of catheterization, catheter care and removing the catheter; and clamping the catheter before its removal.

“Evaluation Of Efficacy Of Homeopathic Medicine Silicea Terra In Subcutaneous Abscess In Experimental Animals”

Abscess is a common skin problem in all human beings however the standard treatment involves drainage of pus and use of antibiotics which may be painful. There is a need to develop an alternative therapy like Homoeopathy. Homoeopathic medicines are broadly used for various skin diseases involved with pus formation with gentle and permanent results; however, their preclinical assessment remains a key challenge. Objectives: This study aimed to see the efficacy of homeopathic medicine Silicea terra in subcutaneous abscess in experimental animals. Hypothesis: We hypothesize that all potencies of homoeopathic medicine Silicea terra shows efficacy in treating subcutaneous abscess in mice. Methods: Homoeopathic medicine Silicea terra was used in different liquid potencies (12CH, 30CH, 200CH ) against subcutaneous abscess in mice and the results were observed against standard antibiotic amoxicillin. Results: Homoeopathic medicine Silicea terra in different liquid potencies (12CH, 30CH, 200CH ) were used and it was observed that it has an antibacterial effect and also positive effect on subcutaneous abscess size, therefore it can be used in treatment of subcutaneous abscess Conclusions: The present study reveals that Homoeopathic Medicine Silicea terra could be an effective drug in treating subcutaneous abscess

Reinforcement Learning and Advanced Reinforcement Learning to Improve Autonomous Vehicle Planning

Planning for autonomous vehicles is a challenging process that involves navigating through dynamic and unpredictable surroundings while making judgments in real-time. Traditional planning methods sometimes rely on predetermined rules or customized heuristics, which could not generalize well to various driving conditions. In this article, we provide a unique framework to enhance autonomous vehicle planning by fusing conventional RL methods with cutting-edge reinforcement learning techniques. To handle many elements of planning issues, our system integrates cutting-edge algorithms including deep reinforcement learning, hierarchical reinforcement learning, and meta-learning. Our framework helps autonomous vehicles make decisions that are more reliable and effective by utilizing the advantages of these cutting-edge strategies.With the use of the RLTT technique, an autonomous vehicle can learn about the intentions and preferences of human drivers by inferring the underlying reward function from expert behaviour that has been seen. The autonomous car can make safer and more human-like decisions by learning from expert demonstrations about the fundamental goals and limitations of driving. Large-scale simulations and practical experiments can be carried out to gauge the effectiveness of the suggested approach. On the basis of parameters like safety, effectiveness, and human likeness, the autonomous vehicle planning system's performance can be assessed. The outcomes of these assessments can help to inform future developments and offer insightful information about the strengths and weaknesses of the strategy

Percutaneous retrieval of a fractured multipurpose catheter by an indigenous snare in a 25-year-old patient: a safe and feasible approach

Since the first report of percutaneous retrieval of intravascular foreign body in 1964, it has become a favourite approach for intravascular foreign body removal. Snares, biopsy forceps, dormia basket or tip deflecting wires are available options for this approach. Herein, we report percutaneous retrieval a fractured multipurpose catheter by an indigenous snare in a 25-year-old patient. The patient was a 25-year-old male being admitted with ostium secundum atrial septal defect and catheterization study was planned for shunt quantification. During manipulation to right ventricular outflow tract, multipurpose catheter got broken approx. 4 cm. proximal to tip. The broken part was captured through right femoral vein by a self-constructed snare. While removal, it broke at tip of venous sheath. Smaller one was retrieved and bigger was recaptured and finally retrieved by exaggerating the curve of same snare without any complications. Use of snares for intravascular foreign body removal is frequently reported and has been successful with low complication rates.Since the first report of percutaneous retrieval of intravascular foreign body in 1964, it has become a favourite approach for intravascular foreign body removal. Snares, biopsy forceps, dormia basket or tip deflecting wires are available options for this approach. Herein, we report percutaneous retrieval a fractured multipurpose catheter by an indigenous snare in a 25-year-old patient. The patient was a 25-year-old male being admitted with ostium secundum atrial septal defect and catheterization study was planned for shunt quantification. During manipulation to right ventricular outflow tract, multipurpose catheter got broken approx. 4 cm. proximal to tip. The broken part was captured through right femoral vein by a self-constructed snare. While removal, it broke at tip of venous sheath. Smaller one was retrieved and bigger was recaptured and finally retrieved by exaggerating the curve of same snare without any complications. Use of snares for intravascular foreign body removal is frequently reported and has been successful with low complication rates