50 research outputs found

    Hysteroscopic evaluation of uterine cavity in cases of infertility and its correlation with transvaginal ultrasound and hysterosalpingography

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    Background: Infertility is defined as one year of unprotected intercourse without pregnancy. This study was taken up to evaluate the diagnostic accuracy of hysteroscopy in comparison with hysterosalpingography and vaginal ultrasound in the evaluation of the uterine cavity as first line study in the infertile patient.Methods: A Prospective and comparative study was carried out in the department of Obstetrics and Gynaecology, S.S. Medical College and associated Gandhi Memorial Hospital, Rewa, MP, India in a period of 13 months from August 2014 to September 2015 conducted on 60 subjects.Results: 60 patients were evaluated with diagnosis of primary and secondary infertility. Hysteroscopy showed alterations in 65%, predominantly uterine synechiae, chronic endometritis and endometrial polyp. Hysterosalpingography reported a sensitivity of 90% and a specificity of 100%, with a positive predictive value of 100% and a negative predictive value of 66.6%. The agreement between the two methods was moderate. The transvaginal ultrasound reported a sensitivity of 51.21% and a specificity of 100%, the agreement between these two procedures was moderate. There were no complications during hysteroscopy.Conclusions: We believe that transvaginal ultrasound, hysterosalpingography and hysteroscopy are complementary in the evaluation of the infertile patient but Hysteroscopy can diagnose small intrauterine lesions much more precisely, (compared with HSG and even TVS) and treat them simultaneously. Thus we consider routine hysteroscopy should be included in the evaluation of the infertile couple.

    Child Drawing: A Projective Tool for Dental Anxiety Assessment

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    INTRODUCTION: Assessment of child’s anxiety is important in order to determine the success of dental treatment. Drawing, a nonverbal, self-report, projective and non-invasive technique may prove be helpful and needs to be explored in order to access anxiety in children requiring dental treatment.AIM: To investigate the applicability of children’s drawings as an indicator to measure their level of anxiety.MATERIALS & METHOD: A cross-sectional study was conducted in a total of hundred children between age group of 4-6 years. Children were asked to draw dental operatory on A4 sheet and colour it with basic set of 12 colours. The drawing was scored using Child Drawing: Hospital (projective scale) scale and the results were compared with pulse oximeter readings (physiological parameter) and Venham Picture Test scorings.RESULTS: Child Drawing: Hospital scale scoring had a positive correlation with pulse oximeter reading (involuntary) (p-value = 0.125) and a negative correlation with Venham picture test (p-value = 0.140).CONCLUSION: Drawing may be statistically significant projective tool significant to assess child anxiety in dental setting

    Topographic Distribution of Carious Lesion on Young Permanent Mandibular Molars and Its Relation to Periapical Index Score of Apical Periodontitis: A Radiographic Analysis

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    INTRODUCTION: Caries in young permanent teeth progress rapidly resulting in early pulp involvement which further progresses into loss of mineralized tissue and severe periapical pathologies. The Periapical Index scoring system (PAI) proposed by Ørstavik et al. in 1986 is an invaluable diagnostic tool used to evaluate periapical lesion extent and severity by 2D digital intraoral periapical radiographic analysis with minimal radiation exposure and hence treatment planning.AIM: To evaluate the relationship of the surface distribution of caries in young permanent molars, pulpal involvement and periapical index (PAI) score with respect to individual root forming young permanent mandibular molars. MATERIALS AND METHOD: In this retrospective single-centre study, 100 pulpally involved carious young permanent mandibular molars were included, selected from the departmental records between August 2018-2019. Topographic distribution of caries and radiographic analysis (using PAI) was evaluated to see the effect of anatomical site of caries, individual anatomical form of root, and extent & severity of apical periodontitis developed.RESULT: No significant correlation between the site of caries involvement and PAI score was observed. PAI score for distal roots was higher(PAI> 2) as compared to mesial root for pulpally involved carious young permanent first molars (p-value mesial root-0.576 , distal root-0.591)CONCLUSION: PAI score is independent of the topographic distribution of caries and no correlation was observed. Periapical radiolucency does not depend on caries distribution, either it is mesial, distal or occlusal

    Pain Management in the Emergency Department- Newer Modalities and Current Perspective

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    Pain is one of the most common complaints and yet one of the most neglected aspects of management in the emergency department. Optimal pain management is a nuanced skill which focusses on reduction of pain to an acceptable level to allow for safe discharge and return to normal activities, in addition to improving patient satisfaction and comfort during their stay in hospital. Adequate analgesia also improves physiological parameters such as heart rate and blood pressure. The aim is improving rather than eradication of pain altogether while maintaining an acceptable level of adverse effects. This chapter will discuss assessment of pain in the emergency department along with various modalities of pain management with specific focus on newer modalities including ultrasound guided regional nerve blocks. Ultrasound guided nerve blocks are associated with better analgesia and have fewer chances of drug related adverse events, especially in older patients and those with comorbidities where large doses of systemic medications are associated with a significant risk of adverse effects

    Practice Changing Innovations for Emergency Care during the COVID-19 Pandemic in Resource Limited Settings

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    COVID-19 has affected millions worldwide. To combat the infectious pandemic in resource limited settings, healthcare workers and techies have come up with multiple innovations. Nations with scarcity of resources have resorted to innovative strategies involving optimal utilization and repurposing of available commodities to overcome the demand–supply mismatch. Emergency rooms overburdened with diseased population are resorting to local innovative ideas to overcome obstacles in COVID-19 patient care. Point of care testing strategies in emergency rooms, sampling booths to reduce Personal Protective Equipment (PPE) use, disinfection strategies such as tunnel disinfection and local production of sanitizers, face masks/shields, aerosol containment chambers, novel triage protocols, telehealth care strategies reaching out to remote population and utilizing point for care ultrasound for resuscitation are few of the novel innovations which have benefitted medical fraternity and patient care in testing times. Medical innovations have emerged as the positive outcome of otherwise devastating COVID-19 pandemic. These practice changing innovations could also prove beneficial in future infectious pandemics

    Particle size distribution from municipal solid waste burning over National Capital Territory, India

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    Proceeding paper, presented at the 5th International Electronic Conference on Atmospheric Sciences, 16–31 July 2022. Emission of particulate matter (PM) of different sizes from Municipal Solid Waste (MSW) burning may have an impact on air quality and human health of the National Capital Territory (NCT) of India, particularly during winter months. MSW samples were collected from three sanitary landfill sites in the NCT Delhi. Experiments were performed to mimic real world burning during different stages of sample combustion (ignition, flaming smoldering, smoldering and pyrolysis). We determined the emission factor for the number and mass concentration of particles of different sizes, ranging from 0.34 to 9.05 µm, for MSW burning. Present results confirm the assumption that MSW burning emits the maximum number concentration (No/cm3) of particles (90%) in the range < 1.0 µm, or fine-mode aerosol

    Non-methane volatile organic compounds emitted from domestic fuels in Delhi: Emission factors and total city-wide emissions

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    In controlled laboratory conditions, 62 samples of domestic fuels collected from 56 grids of Delhi were burnt to quantify the emissions of 23 non-methane volatile organic compounds (NMVOCs), i.e., alkanes (11), alkenes (6), alkynes (1) and aromatic compounds (5). The domestic fuels used for residential activities were comprised of 20 unique types of fuel woods, 3 species of crop residue, dung cakes and coal. These fuels are primarily used for cooking and water/space heating during winters. The current study reports the total emission budget of NMVOCs from domestic burning over Delhi. Furthermore, this study also compares the differences in EFs of NMVOCs which are calculated for different burning cycles and sample collection methods. The EFs of NMVOCs calculated from the samples collected during the flaming stage using canisters were analysed for 23 NMVOCs and then compared with same species emitted from complete burning cycle. In addition to this, 10 consumption and emission hotspot grids were also identified in Delhi; based on the ground survey and laboratory simulated results. The total annual usage of domestic fuels for the year 2019 was found to be 0.415 Mt/yr (million tonnes) in Delhi. 12.01 Gg/yr of annual NMVOC emissions was calculated from domestic fuel burning in which the emissions from dung cake and fuel wood dominated with 6.6 Gg/yr and 5.4 Gg/yr, respectively. The EFs of NMVOCs calculated using canister and online collection method differ significantly from each other. The flaming stage presented enhanced emissions compared to the complete burning cycle by ~7 times which suggests that the method of data analysis and the period of sample collection play a pivotal role in the preparation of an emission inventory and estimating the budget

    Emissions of non-methane volatile organic compounds from combustion of domestic fuels in Delhi, India

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    Twenty-nine different fuel types used in residential dwellings in northern India were collected from across Delhi (76 samples in total). Emission factors of a wide range of non-methane volatile organic compounds (NMVOCs) (192 compounds in total) were measured during controlled burning experiments using dualchannel gas chromatography with flame ionisation detection (DC-GC-FID), two-dimensional gas chromatography (GC×GC-FID), proton-transfer-reaction time-of-flight mass spectrometry (PTR-ToF-MS) and solid-phase extraction two-dimensional gas chromatography with time-offlight mass spectrometry (SPE-GC×GC-ToF-MS). On average, 94% speciation of total measured NMVOC emissions was achieved across all fuel types. The largest contributors to emissions from most fuel types were small non-aromatic oxygenated species, phenolics and furanics. The emission factors (in g kg-1) for total gas-phase NMVOCs were fuelwood (18.7, 4.3-96.7), cow dung cake (62.0, 35.3-83.0), crop residue (37.9, 8.9-73.8), charcoal (5.4, 2.4-7.9), sawdust (72.4, 28.6-115.5), municipal solid waste (87.3, 56.6- 119.1) and liquefied petroleum gas (5.7, 1.9-9.8). The emission factors measured in this study allow for better characterisation, evaluation and understanding of the air quality impacts of residential solid-fuel combustion in India

    Emissions of intermediate-volatility and semi-volatile organic compounds from domestic fuels used in Delhi, India

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    Biomass burning emits significant quantities of intermediate-volatility and semi-volatile organic compounds (I/SVOCs) in a complex mixture, probably containing many thousands of chemical species. These components are significantly more toxic and have poorly understood chemistry compared to volatile organic compounds routinely quantified in ambient air; however, analysis of I/SVOCs presents a difficult analytical challenge. The gases and particles emitted during the test combustion of a range of domestic solid fuels collected from across Delhi were sampled and analysed. Organic aerosol was collected onto Teflon (PTFE) filters, and residual low-volatility gases were adsorbed to the surface of solid-phase extraction (SPE) discs. A new method relying on accelerated solvent extraction (ASE) coupled to comprehensive two-dimensional gas chromatography with time-of-flight mass spectrometry (GC×GC-ToF-MS) was developed. This highly sensitive and powerful analytical technique enabled over 3000 peaks from I/SVOC species with unique mass spectra to be detected. A total of 15 %-100% of gas-phase emissions and 7 %-100% of particle-phase emissions were characterised. The method was analysed for suitability to make quantitative measurements of I/SVOCs using SPE discs. Analysis of SPE discs indicated phenolic and furanic compounds were important for gas-phase I/SVOC emissions and levoglucosan to the aerosol phase. Gas- and particle-phase emission factors for 21 polycyclic aromatic hydrocarbons (PAHs) were derived, including 16 compounds listed by the US EPA as priority pollutants. Gas-phase emissions were dominated by smaller PAHs. The new emission factors were measured (mg kg-1) for PAHs from combustion of cow dung cake (615), municipal solid waste (1022), crop residue (747), sawdust (1236), fuelwood (247), charcoal (151) and liquefied petroleum gas (56). The results of this study indicate that cow dung cake and municipal solid waste burning are likely to be significant PAH sources, and further study is required to quantify their impact alongside emissions from fuelwood burning
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