Source-synchronous I/O Links using Adaptive Interface Training for High Bandwidth Applications

Mobility is the key to the global business which requires people to be always connected to a central server. With the exponential increase in smart phones, tablets, laptops, mobile traffic will soon reach in the range of Exabytes per month by 2018. Applications like video streaming, on-demand-video, online gaming, social media applications will further increase the traffic load. Future application scenarios, such as Smart Cities, Industry 4.0, Machine-to-Machine (M2M) communications bring the concepts of Internet of Things (IoT) which requires high-speed low power communication infrastructures. Scientific applications, such as space exploration, oil exploration also require computing speed in the range of Exaflops/s by 2018 which means TB/s bandwidth at each memory node. To achieve such bandwidth, Input/Output (I/O) link speed between two devices needs to be increased to GB/s. The data at high speed between devices can be transferred serially using complex Clock-Data-Recovery (CDR) I/O links or parallely using simple source-synchronous I/O links. Even though CDR is more efficient than the source-synchronous method for single I/O link, but to achieve TB/s bandwidth from a single device, additional I/O links will be required and the source-synchronous method will be more advantageous in terms of area and power requirements as additional I/O links do not require extra hardware resources. At high speed, there are several non-idealities (Supply noise, crosstalk, Inter- Symbol-Interference (ISI), etc.) which create unwanted skew problem among parallel source-synchronous I/O links. To solve these problems, adaptive trainings are used in time domain to synchronize parallel source-synchronous I/O links irrespective of these non-idealities. In this thesis, two novel adaptive training architectures for source-synchronous I/O links are discussed which require significantly less silicon area and power in comparison to state-of-the-art architectures. First novel adaptive architecture is based on the unit delay concept to synchronize two parallel clocks by adjusting the phase of one clock in only one direction. Second novel adaptive architecture concept consists of Phase Interpolator (PI)-based Phase Locked Loop (PLL) which can adjust the phase in both direction and achieve faster synchronization at the expense of added complexity. With an increase in parallel I/O links, clock skew which is generated by the improper clock tree, also affects the timing margin. Incorrect duty cycle further reduces the timing margin mainly in Double Data Rate (DDR) systems which are generally used to increase the bandwidth of a high-speed communication system. To solve clock skew and duty cycle problems, a novel clock tree buffering algorithm and a novel duty cycle corrector are described which further reduce the power consumption of a source-synchronous system

Posttraumatic hydrocephalus: Lessons learned from management and evaluation at a tertiary institute with review of literature

Background: Post traumatic hydrocephalus (PTH) is a commonest treatable complication of severe traumatic brain injury that’s leads to failure of improvement and worsening of the outcome. Incidence of posttraumatic hydrocephalus is 0.7%-29% reported in different literature. We have observed the development of PTH frequently seen in patients with severe head injury and after decompressive craniectomy (DC). Pathophysiology includes inflammatory changes and adhesion of arachnoid granulation, cerebral ischemia and alteration in cerebrospinal fluid (CSF) dynamics. We studied 35 cases of PTH diagnosed and treated at our institute from May 2008 to May 2017.Material and methods: This is hospital based retrospective and prospective study conducted in tertiary center on the basis of neuro-radiological examination of the patient. Clinical biodata and radiological profile of the patients was studied at initial presentation with trauma, and when the patient worsened with symptoms of raised intracranial pressure (ICP) in state of established PTH. These cases were treated by medium pressure ventriculoperitoneal shunt (V.P shunt) and outcome was evaluated.Results: Incidence of PTH in our study is (2.3%). Out of 35 cases 24 (68.57%) were male and 11(31.4%) were female. Road traffic accident (RTA) was the most common mode of injury (82.85%), acute subdural hematoma (SDH) was the most common finding on C.T scan in 15 cases (42.8 %). Decompressive craniectomy was performed in 77% at time of initial trauma. PTH had favourable outcome with V.P. shunting in 91.42%.Conclusion: Patients with traumatic brain injury present with many complications but PTH is most frequent sequeale that can present in form of various neurological symptoms after trauma and decompressive craniectomy. C.T. scan brain is the investigation of choice for diagnosis of PTH. Outcome was favourable after V.P. shunt in PTH

Bone flap preservation in abdominal wall after decompressive craniectomy in head injury: A single institute experience

Objective: The objective of this study is to study factors associated with infection of calvarial bone flap preserved in subcutaneous tissue of abdominal wall after decompressive craniectomy (DC) in head injury. Associated factors include age, sex, nutrition of patient, GCS of patient at time of surgery, vacuum drain placement, type of paramedian abdominal incision, site of decompressive craniectomy and associated comorbid conditions. Method: This is a prospective study carried out in department of neurosurgery, tertiary care centre of southern Rajasthan (India) from July 2016 to December 2018. Total of 66 patient with head injury were enrolled, who underwent DC and bone flap preservation in abdominal wall. Result: Out of 112 patients who underwent DC in this study period 66 were included in this study. Out of 66 patient 7(10.6%) patient develop bone flap infection. Bone flap infection was more in poor nutrition patient, poor GCS (5-8), patient in which vacuum drain was not placed, patient with bifrontal decompressive craniectomy and associated comorbid condition. Conclusion: Bone flap preservation in subcutaneous abdominal wall after DC is safe and efficient. Cranioplasty with autologous bone graft has lower cost, good cosmetic results and is well accepted by patient

When hanging caused an intracranial haemorrhage: A rare case report

Depressive illness is a growing health hazard into modern era days. Depression may sometimes result in suicidal tendency in a major number of patients. Suicidal attempt not only leads to loss of life, but also a significant number of survivors retain various morbidity. We here report a rare case of intracranial haemorrhage (ICH) following a suicidal attempt by hanging

Kinked and retained nasogastric tube in polytrauma patient: A rare case report

Enteral feeding is an important and preferred technique of feeding in head injury patient to provide nutrition. As inadequate nutrition causes decrease in physical ability, neurological impairment and takes a long time for improvement or delayed deterioratation. With our best knowledge kinked and retained nasogastric tube in stomach is a very rare complication of feeding in head injuries patients. Predisposing factors that can cause kinking is excess tube length, tube in situ for long time and small bore tube. We are reporting one such case of kinked and retained nasogastric tube in the stomach of a polytrauma patient which was retrieved by upper GI endoscope

A single institute five-year surgical experience with Chronic Subdural Hematoma: Analysis of 270 consecutive patients at a Tertiary Care Centre

Chronic subdural hematoma (CSDH) is one of the very common surgically treatable neurosurgical entities. Still there is lack of uniformity in the management of CSDH amongst surgeons in terms of various treatment strategies and protocols. Burr-hole drainage is the treatment modality of choice for an uncomplicated CSDH. Some recent trials support the use of drain to lessen the rate of recurrence. Twist drill craniostomy and craniotomy do also play a role in the management of CSDH. The current study is a retrospective analysis of 270 surgically treated patients with chronic subdural hematoma at a tertiary care center over a span of five years. The present study highlighted on rate of recurrence, re-surgery, mortality and morbidity

Ertugliflozin: a novel anti-diabetic drug

Diabetes Mellitus is a disorder of global proportion. Despite various treatment modalities presently being available, yet the desired glycaemic control and patient outcomes have not been achieved completely. Sodium glucose co-transporter type 2 inhibitors (SGLT2 inhibitors) are one such promising group of emerging drugs in diabetes treatment. Ertugliflozin prevents the reabsorption of glucose by inhibiting sodium-glucose cotransporter-2 (SGLT2) at proximal convoluted tubules. Ertugliflozin is available as 5mg and 15mg tablets. Ertugliflozin has been related to genital mycotic infections and urinary tract infections. Benefits of Ertugliflozin include better control on blood glucose, body weight and blood pressure

Expression of estrogen and progesterone receptors in vestibular schwannomas and their clinical significance

<p>Abstract</p> <p>Objective</p> <p>The objective was to determine the expression of estrogen and progesterone receptors in vestibular schwannomas as well as to determine predictive factors for estrogen and progesterone receptor positivity.</p> <p>Materials and methods</p> <p>The study included 100 cases of vestibular schwannomas operated from January 2006 to June 2009. The clinical details were noted from the medical case files. Formaldehyde-fixed parafiin-embedded archival vestibular schwannomas specimens were used for the immunohistochemical assessment of estrogen and progesterone receptors.</p> <p>Results</p> <p>Neither estrogen nor progesterone receptors could be detected in any of our cases by means of well known immunohistochemical method using well documented monoclonal antibodies. In the control specimens, a strongly positive reaction could be seen.</p> <p>Conclusion</p> <p>No estrogen and progesterone receptor could be found in any of our 100 cases of vestibular schwannomas. Hence our study does not support a causative role of estrogen and progesterone in the growth of vestibular schwannoma as well as hormonal manipulation in the treatment of this tumor.</p