Inflammation modulatory effect of perioperative high-dose statin in prevention of post-operative atrial fibrillation in patients undergoing coronary artery bypass grafting

Background: Atrial fibrillation (AF) is one of the most common complications after coronary artery bypass grafting (CABG), occurring in 20% to 40% of patients. Statins exert pleiotropic effects which are largely independent from their lipid-lowering properties.  The objective of this study was based on to affirm the evidence that perioperative statins have a significant role in preventing early postoperative AF in patients undergoing CABG.Methods: A prospective, randomized, cohort study of all consecutive patients who underwent primary isolated on pump CABG surgery was performed. Patients were divided into two groups -statin and non-statin groups - to examine the influence of statins on early postoperative prevention of AF.Results: In total, 127 patients who underwent isolated CABG were included in the study and were analysed. There were no significant differences in age, gender, history of cardiac infarction, concomitant diseases (hypertension, smoking, PPCI, hyperlipidaemia), cardiac functional grading (NYHA III-IV), electro- cardiograms, and preoperative medication. There were no significant differences in the average number of grafts where the left internal mammary artery was used as a bypass conduit, the surgical procedure or total cardiopulmonary bypass time, or aortic cross-clamping (ACC) time. In addition, there were no significant differences in the postoperative mechanical ventilation duration time, length of ICU stays or length of hospitalization between the two groups. The incidence of AF following CABG in the statin group was significantly lower than that in the non-statin group.Conclusions: Oral atorvastatin 40 mg/d, initiated at least 1 week before the scheduled CABG and continued in the early postoperative period, significantly decreases the risk of post-operative AF

E-puck motion control using multi-objective particle swarm optimization

This article describes the velocity-based motion and orientation control method for a differential-driven two-wheeled E-puck Robot (DDER) using the Multi-Objective Particle Swarm Optimization (MPSO) algorithm in the Virtual Robot Experimentation Platform (V-REP) software environment. The wheel velocities data and Infra-Red (IR) sensors reading make the multi-objective fitness functions for MPSO. We use front, left, and right IR sensors reading and right wheel velocity data to design the first fitness function for MPSO. Similarly, the front, left, and right IR sensors reading, and left wheel velocity data have been taken for making the second fitness function for MPSO. The multi-objective fitness functions of MPSO minimize the motion and orientation of the DDER during navigation. Due to the minimization of motion and orientation, the DDER covers less distance to reach the goal and takes less time. The Two-Dimensional (2D) and Three-Dimensional (3D) navigation results of the DDER among the scattered obstacles have been presented in the V-REP software environment. The comparative analysis with previously developed Invasive Weed Optimization (IWO) algorithm has also been performed to show the effectiveness and efficiency of the proposed MPSO algorithm

Design of Optimal Hybrid Position/Force Controller for a Robot Manipulator Using Neural Networks

The application of quadratic optimization and sliding-mode approach is considered for hybrid position and force control of a robot manipulator. The dynamic model of the manipulator is transformed into a state-space model to contain two sets of state variables, where one describes the constrained motion and the other describes the unconstrained motion. The optimal feedback control law is derived solving matrix differential Riccati equation, which is obtained using Hamilton Jacobi Bellman optimization. The optimal feedback control law is shown to be globally exponentially stable using Lyapunov function approach. The dynamic model uncertainties are compensated with a feedforward neural network. The neural network requires no preliminary offline training and is trained with online weight tuning algorithms that guarantee small errors and bounded control signals. The application of the derived control law is demonstrated through simulation with a 4-DOF robot manipulator to track an elliptical planar constrained surface while applying the desired force on the surface

Advancements in Intravesical Chemotherapy in Non-Muscle Invasive Bladder Cancer

The treatment for non-muscle-invasive bladder cancer is transurethral resection of bladder cancer followed by intravesical chemotherapy or BCG. There have been various advancements in low risk, intermediate risk, high risk, and BCG failure cases of non-muscle invasive bladder cancer. There has been increased research on hyperthermia and intravesical chemotherapy, new agents like apaziquone, use of gemcitabine in low-risk cases, and combination chemotherapy in cases of BCG failure. Combining docetaxel and gemcitabine has taken a significant stage because of BCG shortage in some parts of the world. This chapter will discuss the latest advancements in intravesical chemotherapy in low, intermediate, and high-risk patients

Surgical Management of Genitourinary Tuberculosis: our Experience and review of literature

Background: Genitourinary tuberculosis is one of the most common forms of extra-pulmonary tuberculosis. Owing to a myriad of clinical presentations and discrepancies in the diagnostic modalities, patients usually present late, which results in a high number of them requiring surgical intervention. The present study aims to retrospectively analyze the role of surgery in genitourinary tuberculosis. Patients and method: All patients diagnosed with genitourinary tuberculosis at our centre between October 2017 and September 2019 were included in the study. The mode of presentation, duration of symptoms, investigations performed, treatment received, and follow-up were studied. Results: Out of 25 patients diagnosed with genitourinary tuberculosis (GUTB), there were 15 (60%) males and 10 (40%) females. The mean age of presentation was 40.84 years. Nineteen (76%) patients underwent surgical intervention, and many patients required more than one surgical procedure. A reconstructive procedure was carried out in seven patients. At a median follow-up of 12 months, all patients did well, showing no relapse. Conclusion: Surgery, along with antitubercular treatment, is the key to the management of GUTB presenting with structural damage. However, surgery can be ablative or reconstructive, depending on various factors discussed in the present study. This preserves or restores the optimal function of the genitourinary system affected by the mycobacterium bacilli

Chirurgiczne leczenie gruźlicy układu moczowo-płciowego: doświadczenie własne i przegląd literatury

Wprowadzenie: Gruźlica układu moczowo-płciowego jest jedną z najczęstszych postaci gruźlicy pozapłucnej. Z uwagi na zróżnicowanie obrazu klinicznego i rozbieżności w badaniach diagnostycznych, pacjenci zazwyczaj zgłaszają się do leczenia na późnym etapie choroby i – w konsekwencji – duża liczba z nich wymaga interwencji chirurgicznej. Cel: Celem niniejszego badania jest dokonanie retrospektywnej analizy roli operacji chirurgicznych w leczeniu gruźlicy układu moczowo-płciowego. Materiały i metoda: W badaniu udział wzięli wszyscy pacjenci zdiagnozowani w naszym ośrodku w kierunku gruźlicy moczowo-płciowej w okresie od października 2017 r. do września 2019 r. W analizach uwzględniono: sposób prezentacji, czas trwania objawów, przeprowadzone badania, zastosowane leczenie i dalsze działania. Wyniki: W grupie 25 chorych, u których stwierdzono gruźlicę układu moczowo-płciowego (GUTB), znalazło się 15 (60%) mężczyzn i 10 (40%) kobiet. Średni wiek w momencie prezentacji wynosił 40,84 lat. Dziewiętnaścioro (76%) pacjentów poddano interwencji chirurgicznej, przy czym u wielu wymagany był więcej niż jeden zabieg chirurgiczny. Procedurę rekonstrukcyjną wykonano u siedmiu osób. Przy medianie obserwacji kontrolnej wynoszącej 12 miesięcy wszyscy pacjenci są w dobrym stanie zdrowia, bez nawrotów choroby. Wniosek: Leczenie chirurgiczne w połączeniu z terapią przeciwgruźliczą stanowi klucz do postępowania w przypadkach GUTB przebiegających z uszkodzeniami strukturalnymi. Sam zabieg chirurgiczny może jednak mieć charakter ablacyjny lub rekonstrukcyjny, zależnie od różnorodnych czynników omówionych w niniejszym badaniu. Zabieg pozwala na zachowanie lub przywrócenie optymalnej czynności układu moczowo-płciowego dotkniętego zakażeniem prątkami gruźlicy

Generalised regression neural network (GRNN) architecture-based motion planning and control of an e-puck robot in V-REP software platform

This article focuses on the motion planning and control of an automated differential-driven two-wheeled E-puck robot using Generalized Regression Neural Network (GRNN) architecture in the Virtual Robot Experimentation Platform (V-REP) software platform among scattered obstacles. The main advantage of this GRNN over the feedforward neural network is that it provides accurate results in a short period with minimal error. First, the designed GRNN architecture receives real-time obstacle information from the Infra-Red (IR) sensors of an E-puck robot. According to IR sensor data interpretation, this architecture sends the left and right wheel velocities command to the E-puck robot in the V-REP software platform. In the present study, the GRNN architecture includes the MIMO system, i.e., multiple inputs (IR sensors data) and multiple outputs (left and right wheel velocities). The three-dimensional (3D) motion and orientation results of the GRNN architecture-controlled E-puck robot are carried out in the V-REP software platform among scattered and wall-type obstacles. Further on, compared with the feedforward neural network, the proposed GRNN architecture obtains better navigation path length with minimum error results

Experimental Investigation of Jute Fabric / Nano-SiO2 Reinforced Epoxy Composite

The effect of Nano-SiO2 powder on the mechanical behavior of a jute fabric/epoxy composite has been investigated experimentally. Due to qualities like biodegradability, strength, light weight, and affordability, composites are preferred for static and dynamic applications. Nano – SiO2 powder size of 15 nm was used as a filler material. Hand lay-up techniques were used to develop the composites, which had filler contents of 2%, 3%, and 5% Nano – SiO2 by weight of the epoxy resin. Tensile, Impact, Wear, Moisture Absorption, and Thermo – Gravimetric Analysis were used to characterize the mechanical properties of the composites. The results reveal that the jute/epoxy composite is significantly improved by the hybridization process using fillers. The maximum improvement in the composite’s tensile (44.09 MPa), impact (4 joules), wear, moisture absorption (0.5–4%), and thermos-gravimetric (2.96%) properties is achieved when 2 wt.% of nano-SiO2 is added