Mediastinitis after oesophagoscopy: A case report

A 50-year-old male presented with signs and symptoms of oesophageal perforation after a biopsy. Suggestive symptoms and signs were pain in the neck radiating to the back, a rise in temperature and pulse, emphysema in the neck and widening of the mediastinum or a pneumothorax revealed by a chest X-ray. He survived with medical managemen

Variability-aware low-power techniques for nanoscale mixed-signal circuits.

New circuit design techniques that accommodate lower supply voltages necessary for portable systems need to be integrated into the semiconductor intellectual property (IP) core. Systems that once worked at 3.3 V or 2.5 V now need to work at 1.8 V or lower, without causing any performance degradation. Also, the fluctuation of device characteristics caused by process variation in nanometer technologies is seen as design yield loss. The numerous parasitic effects induced by layouts, especially for high-performance and high-speed circuits, pose a problem for IC design. Lack of exact layout information during circuit sizing leads to long design iterations involving time-consuming runs of complex tools. There is a strong need for low-power, high-performance, parasitic-aware and process-variation-tolerant circuit design. This dissertation proposes methodologies and techniques to achieve variability, power, performance, and parasitic-aware circuit designs. Three approaches are proposed: the single iteration automatic approach, the hybrid Monte Carlo and design of experiments (DOE) approach, and the corner-based approach. Widely used mixed-signal circuits such as analog-to-digital converter (ADC), voltage controlled oscillator (VCO), voltage level converter and active pixel sensor (APS) have been designed at nanoscale complementary metal oxide semiconductor (CMOS) and subjected to the proposed methodologies. The effectiveness of the proposed methodologies has been demonstrated through exhaustive simulations. Apart from these methodologies, the application of dual-oxide and dual-threshold techniques at circuit level in order to minimize power and leakage is also explored

Metronidazole vaginal gel 0.75% (MetroGel-Vaginal): a brief review.

OBJECTIVE: A retrospective review of appendectomies performed at the University of Kansas Medical Center between January 1, 1989, and January 1, 1994, was conducted. In addition, the literature evaluating effectiveness of incidental appendectomy in preventing future operation and morbidity from appendicitis was reviewed. The results of the two reviews were analyzed to formulate guidelines for the appropriateness of performing incidental appendectomy in association with other operative procedures. METHOD: A retrospective review of results of appendectomies performed in 460 patients at the University of Kansas Medical Center with analysis of operative findings, pathology of the removed appendix and operative complications was performed. These results were compared with those of a systematic review of the literature utilizing a Medline search relating to the subject of incidental appendix removal. RESULTS: Two hundred sixty-one incidental appendectomies were performed in this study of 460 patients (60%). The procedure was most commonly performed with total abdominal hysterectomy (56%), followed by oophorectomy (15%) and exploratory laparotomy (11%). Morbidity was minimal at all ages. Microscopic pathology was found in 25% of the cases. CONCLUSION: The data from the current survey and literature review support incidental removal of the appendix in the young patient (< 35 years old). In patients 35-50 years old the literature is controversial, and the patient's clinical condition and judgment of the operating surgeon should determine whether incidental appendectomy should be performed. However, routine incidental appendectomy cannot be justified in patients greater than age 50

STUDY AND DESIGN OF PORTABLE ANTIMICROBIAL WATER FILTER

  Objective: This study was conducted to design a portable antimicrobial water filter which is both economic and easy to use.Methods: A prototype following the designing of the water filter was constructed. Layers of sand, cloth, activated charcoal, and cotton containing compartments were built for carrying out water analysis.Results: Most probable number index of Vellore Institute of Technology lake water was compared with that of filtered water. Complete water analysis was done, and the sand filter layer was observed to be responsible for a maximum of the antimicrobial action of the filter.Conclusion: The study demonstrated that the proposed design of water filter is efficient in removal of turbidity, odor, and microbial content of lake water along with decreasing the acidity of water

Mesh-Free Laparoscopic High Uterosacral Ligament Suspension during Total Laparoscopic Hysterectomy for Uterine Prolapse.

STUDY OBJECTIVE: To demonstrate a mesh-free approach for uterine prolapse during a hysterectomy. DESIGN: Technical video (Canadian Task Force classification III). SETTING: Benign gynecology department at a university hospital. PATIENT: A 50-year-old woman. INTERVENTION: Laparoscopic high uterosacral ligament suspension technique. MEASUREMENTS AND MAIN RESULTS: A 50-year-old woman presented with irregular vaginal bleeding and grade 3 uterine prolapse. The patient was concerned regarding the use of mesh and erosion. After counseling the patient agreed to a mesh-free single procedure. The use of mesh for the treatment of pelvic organ prolapse has become the subject of controversy and litigation. Complications of mesh erosion have resulted in the US Food and Drug Administration reclassifying transvaginal meshes as high-risk devices in 2016 [1]. Mesh erosion risk is up to 23% with hysterectomy and concomitant laparoscopic sacrocolpopexy [2] and 3% with sacrohysteropexy [3]. We present an alternative laparoscopic approach of treating uterine prolapse with high uterosacral suspension during laparoscopic hysterectomy. Our method avoids the use of mesh, sacrocervicopexy and morcellation, or an interval sacrocolpopexy. Although high uterosacral ligament suspension can be performed vaginally, it carries up to an 11% risk of ureteric injury [4]. CONCLUSION: In this video a bilateral ureterolysis is performed, before hysterectomy, isolating the uterosacral ligaments. These are then suspended to the vaginal vault in a purse-string fashion using Vicryl 0 (polyglactin 910) and intracorporeal knot-tying. Postprocedure the vault is well supported with a vaginal length of 12 cm

Printable Flexible Robots for Remote Learning

The COVID-19 pandemic has revealed the importance of digital fabrication to enable online learning, which remains a challenge for robotics courses. We introduce a teaching methodology that allows students to participate remotely in a hands-on robotics course involving the design and fabrication of robots. Our methodology employs 3D printing techniques with flexible filaments to create innovative soft robots; robots are made from flexible, as opposed to rigid, materials. Students design flexible robotic components such as actuators, sensors, and controllers using CAD software, upload their designs to a remote 3D printing station, monitor the print with a web camera, and inspect the components with lab staff before being mailed for testing and assembly. At the end of the course, students will have iterated through several designs and created fluidically-driven soft robots. Our remote teaching methodology enables educators to utilize 3D printing resources to teach soft robotics and cultivate creativity among students to design novel and innovative robots. Our methodology seeks to democratize robotics engineering by decoupling hands-on learning experiences from expensive equipment in the learning environment.Comment: 9 pages, 4 figures, peer reviewed and presented paper at American Society of Engineering Education, April 22-23rd, 2022 - Wentworth Institute of Technolog

A systematic review highlighting poor quality of evidence for content validity of quality of life instruments in female chronic pelvic pain.

OBJECTIVES: To evaluate the content validity of 19 patient-reported outcome measures (PROMs) used to measure quality of life (QoL) in women with chronic pelvic pain (CPP). STUDY DESIGN AND SETTING: We searched Embase, MEDLINE, PsycINFO databases and Google Scholar from inception to August 2020. We included records describing the development or studies assessing content validity of PROMs. Two reviewers independently assessed the methodological quality of PROMs using the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. Evidence was synthesized for relevance, comprehensiveness, and comprehensibility. Quality of evidence was rated using a modified Grading of Recommendations, Assessment, Development, and Evaluations approach. RESULTS: PROM development was inadequate for all instruments included in this review. No high-quality evidence ratings were found for relevance, comprehensiveness, and comprehensibility. QoL was measured using generic instruments (68.42%, 13/19) rather than those specific to chronic pain (21.04%, 4/19) or pelvic pain (10.53%, 2/19). Quality of concept elicitation was inadequate for 90% of PROMs. Half of PROMs did not include patients in their development and only 40% were devised using a sample representative of the target population for which the PROM was developed. Cognitive interviews were conducted in one-fifth of PROMs and were mostly of inadequate/doubtful quality. CONCLUSION: There is poor quality of evidence for content validity of PROMs used to measure QoL in women with CPP