A STUDY ON SAMANYAM VRUDDHI KARANAM WITH REFERENCE TO MUKTASHUKTI PISHTI IN ASTHI KSHAYA

Asthikshaya is a state where the functional capacity of Asthi (bone) is compromised due to the decrease in its Guna (properties) Karma (function) and structure of Asthi. Asthikshaya is correlated to osteopenia/ osteoporosis in contemporary science. Osteopenia/osteoporosis is a major global health problem affecting females at an average age of 50 making their bones susceptible to fracture. 1 out of 3 females in India suffer from osteopenia/osteoporosis making it a burning problem in present era. This has led to tremendous interest in Ayurvedic alternatives. Ayurveda states decrease of any entity in the body should be increased by administering similar entity by the means of food or activity. This treatment is based on Samanya (similarity) where Samanya is the cause for Vruddhi (increase in its properties and functional capacity). 30 female subjects between the age of 45 to 65, were included in a single group study by purposive consecutive sampling method, were administered with Muktashuktipishti 250mg 2 capsules per day with lukewarm water before food for a period of 2 months. Subjects were assessed pre intervention, during and post intervention. Obtained results were subjected to appropriate statistical analysis to see the significance. By the result it is noted that Muktashukti is Gunasamanya (Sthira, Sthula, Katina, and Sandragunas) to Asthi thus increases Asthi in Asthikshaya with improvement in Kesha (hair fall), Nakha (breakage of nails) Dantashadana (loosening of teeth), Shrama (tiredness) and Asthitoda (pain in bony area) and statistically significant

No-Load and Load Tests on 3 Phase Induction Motors used in Irrigation Pumping with Balanced and Unbalanced Supply

Agriculture is the major ocupation in villages and is backbone of India, where irrigated agriculture sector plays an important role in economic development and poverty alleviation of the nation. About 75% of present population of India obtains its livelyhood from the same. Iirrigation is harnessing of water resources for the crops by using motor pumps. Usually wells, tanks, perennial canal and multipurpose river valley projects are worked out. As electrical motors are very affordable and cheaper they are the usual choice to drive pumps. Due to the variation in supply to the pump motor the expected performance is not achieved and lead to variation in machine parameters. The operation of 3 phase motor on single phase supply leads to negative effects like overheating, insulation failure, torque pulsation, de rating and reduction in efficiency. In spite of these adverse effects on motor and irrigation power supply feeder, it is observed that farmers run their 3 phase motor on reduced voltage condition using capacitor splitter and other such. A study of operation of 3 phase motor on no-load and load is performed with balanced and unbalanced voltage condition. Simulation is performed in MATLAB/SIMULINK package for the comparison and justification

Preoperative Atrial Fibrillation/Flutter Impact on Risk-Adjusted Repeat Aortic Intervention Patients[PROTOCOL]

Aim: Impacts of pre-operative atrial fibrillation or flutter (AF/AFL) upon repeat aortic valve replacement (r-AVR) patients’ risk-adjusted short-term outcomes is unknown.Methods: From 2005-2018, New York State AF/AFL versus non-AF/AFL adults’ risk-adjusted r-AVR outcomes were compared. Primary endpoints included the Society of Thoracic Surgeons’ 30-day operative mortality or major morbidity (MM) composite and 30-day readmission (READMIT); the MM sub-components were secondary endpoints. Multivariable logistic regression models evaluated AF/AFL impact upon these endpoints while holding other factors constant.Results: Of 36,783 adults initially undergoing aortic valve replacement, 334 subsequently underwent r-AVR. Within this r-AVR group, 42.4% of repeat surgical (r-SAVR) patients had AF/AFL; 50.4% of repeat transcatheter (viv-TAVR) patients had AF/AFL. R-SAVR AF/AFL patients were older and had more comorbidities than those without AF/AFL. Viv-TAVR AF/AFL patients were similar to those without AF/AFL except for lower rates of chronic obstructive pulmonary disease. Comparing risk-adjusted r-AVR outcomes, AF/AFL did not impact MM [odds ratio (OR), 95% confidence interval (CI): 1.23, 0.66-2.28, P = 0.512] or READMIT (OR, 95%CI: 1.15, 0.60-2.19, P = 0.681). Black race (OR, 95%CI: 2.89, 1.01-8.32, P = 0.049) and Elixhauser mortality score (OR, 95%CI: 1.07, 1.04-1.10, P < 0.0001) predicted MM risk. Cerebrovascular disease (OR, 95%CI: 2.54, 1.23-5.25, P = 0.012) predicted READMIT risk, while viv-TAVR was protective compared to r-SAVR (OR, 95%CI: 0.44, 0.21-0.91, P = 0.027).Conclusion: AF/AFL was not associated with risk-adjusted short-term r-AVR outcomes. Black race, Elixhauser mortality score, and cerebrovascular disease predicted adverse outcomes

Thoracic Aortic Aneurysm Patients’ Diagnosis, Treatments, and Outcomes: The New York Experience

IMPORTANCE: Traditionally, thoracic aortic aneurysms (TAA) were diagnosed upon complications arising or post-mortem examination. Following 2014, asymptomatic new TAA diagnoses noticeably rose at increasing rates. In parallel, reductions in the rates of urgent/emergent TAA-related treatments and adverse risk-adjusted short-term outcomes were observed. OBJECTIVES: For New York State adult residents, the trends from 2005 to 2018 in new thoracic aortic aneurysm (TAA) diagnoses, surgical treatments, percutaneous treatments, and risk-adjusted outcomes were examined. DESIGN: This retrospective cohort study documented the quality of TAA care provided to New York adult residents. SETTING: Using the 2005 to 2018 New York Statewide Planning and Research Cooperative System (SPARCS) database, billing codes detected 74,118 newly diagnosed TAA patients; of these, 84.06% (n = 62,307) were non-ruptured diagnoses. PARTICIPANTS: Overall, TAA patients’ mean age was 71.00 years + 19.00 years; 62.47% were male. EXPOSURES: TAA patients’ baseline characteristics, TAA-related interventions, and adverse outcomes were reported. MAIN OUTCOMES: Trends over time were evaluated for TAA diagnosis rates, TAA surgical and percutaneous treatment rates, and adverse clinical outcomes (e.g., 30-day mortality, and 30-day readmission). RESULTS: Overall, new TAA diagnoses increased from 19.8/100,000 residents (2005) to 75.73/100,000 residents (2018); starting in 2014, a dramatic rise in detection of new non-ruptured TAA diagnoses was observed. In contrast, treatment rates decreased for surgical (19.33% in 2005 to 6.54% in 2018) and percutaneous (4.17% in 2006 to 1.53% in 2018) procedures. Comparing pre-2014 versus post-2014, TAA patients had greater chances of having an open surgery (odds ratio [OR] = 1.77; p \u3c 0.0001) or percutaneous procedure (OR = 1.79; p \u3c 0.0001). Over time, 30-day operative mortality decreased (OR = 0.94; p-value \u3c 0.0001). As an “at risk” patient sub-group, however, elderly women had very high 30-day mortality risk (OR: 1.87; p \u3c 0.0001). CONCLUSIONS: Post-2014, the New York State rates of new non-rupture TAA diagnoses radically increased; serendipitously, the TAA-related treatment and short-term adverse outcome rates decreased. Given expanded chest imaging due (in part) to new lung cancer guidelines and transcatheter aortic valve procedures, the enhanced TAA diagnosis rates post-2014 appear to have resulted in overall TAA patients’ quality of care improvements

Trends Over Time in Incidence of Bicuspid Aortic Valve Patients with Thoracic Aortic Aneurysms in New York

Aim: Bicuspid aortic valve (BAV) is one of the most common congenital cardiac malformations, with increased risk for early onset thoracic aortic aneurysms (TAA). This study aims to examine the trends over time in incidence of BAV patients with TAA, given imaging advancements and increased frequency of imaging. Methods: Using administrative billing codes, this retrospective cohort study analyzed New York Statewide Planning and Research Cooperative System records from January 2007- December 2018, evaluating BAV+TAA incidence trends. Subgroups based on index admission were evaluated with a pre-identified 2014 inflection time point using an interrupted time series (ITS) analysis. Results: Using a New York State-wide billing database, 3,294 BAV and TAA first-time encounters were classified into three diagnosis-related patient sub-groups, as patients with: historical BAV + new TAA diagnoses (24.74%); new BAV + historical TAA diagnoses (27.57%); and new BAV + new TAA diagnoses (47.69%). Total BAV and TAA diagnostic incidence increased from 7.93/1,000,000 residents in 2007, to 24.75/1,000,000 residents in 2018 (overall annual rate of 17.91/1,000,000, p\u3c .001). With a pre-established 2014 inflection point, the incidence rate dramatically changed for new BAV+ new TAA patients (slope = 0.7592, 95% CI 0.2332-1.2851)

End-Stage Acute Thoracic Aortic Care Patients’ Interventions and Two-Year Survival: the New York State Experience

BACKGROUND: Scarce US-based regional or State-specific reports exist recording the incidence, prevalence, or post-diagnosis clinical outcomes for end-stage thoracic aortic aneurysmal (TAA) disease. This retrospective cohort study of New York State (NYS) patients with newly diagnosed ruptured or dissected thoracic aortic aneurysms (TAA-RD) documents two-year follow-up after elective and emergent procedures. METHODS: Using hospital billing codes, NYS first-time TAA-RD encounters were extracted. As the primary study endpoint, the two-year composite included all-cause death, subsequent rupture or dissection, or non-elective intervention; individual composite sub-components were secondary study endpoints. Multivariable logistic regression models estimated two-year intervention and composite outcome risks. Using multivariable regression models created for the composite endpoints, post-discharge elective TAA procedural impact was evaluated. RESULTS: Of the 5,789 NYS residents identified, 49.92% reached the two-year composite endpoint with 23.98% two-year deaths. Only 1902 (32.86%) of TAA-RD patients had an index intervention. Post-discharge elective TAA interventions dramatically reduced adverse outcome risk (odds ratio [O.R.] = 0.36; 95% confidence interval [C.I.] = 0.26 - 0.51). Multivariable regression models identified patient characteristics associated with the two-year adverse composite outcome including urgent/emergent status, increased Elixhauser comorbidity score, non-rheumatic aortic regurgitation, and carotid disease. CONCLUSIONS: Nearly 50% of NYS TAA-RD patients reached the two-year adverse endpoint. Post-2014, the TAA-RD diagnosis rates increased but emergent thoracic aortic surgery rates decreased. Surprisingly, under 50% of NYS TAA-RD patients received an index admission procedure; this rate is lower than anticipated. Beyond traditional morphologic metrics, “at risk” TAA patient-characteristics were identified. Post-discharge survivors had excellent post-procedural two-year durability rates

A simplified method for assessment of volume change behavior of rockfill material

In this paper an attempt was made to generalize the results of laboratory tests on modeled rockfill materials so as to evolve a simplified method for assessment of their hulk mechanical properties from minimum test data with an acceptable degree of confidence. Examination of the experimental data of the modeled rockfill materials from different sites revealed that the plots of logarithm of strain at failure against logarithm of confining pressure are linear. A trend of increase in failure strain with increase in confining pressure and maximum size of particle is also observed. The simplified approach highlights prediction of volume change properties of rockfill materials during isotropic consolidation and triaxial state of stress over a range of confining pressures and particle sizes. This approach is based on the results of only two tests carried out at two different confining pressures for a selected maximum particle size on modeled rockfill material with the use of the parallel gradation technique. The two-test approach and its application in engineering design of rockfill materials is illustrated by means of selected experimental data available in the literature

Generalized method for assessment of compressibility of rockfill material

Examination of experimental data of the modelled rockfill materials using parallel gradation technique has revealed that the plots of logarithm of strain at failure against logarithm of confining pressure are linear. Also, a trend of increase in failure strain with increase in confining pressure and maximum size of the particle have been observed. The approach presented in this paper highlights the prediction of volume change properties of rockfill materials over a range of confining pressures and particle sizes based on the results of only two tests carried out at two different confining pressures for a maximum particle size of modelled material with the use of parallel gradation technique. Two test approach and its application in modelling of rockfill materials to estimate its volume change behaviour is illustrated by means of a selected experimental data available in the literature