Comparison between standard and dual mobility implants in total hip arthroplasty for femoral neck fractures in elderly

Background: Dislocation is a major concern after total hip replacement (THR) in displaced fracture neck of femur. Recent studies have shown reduced dislocation rates with dual mobility THR (DMTHR) for femur neck fractures; however, there is a lack of comparative research to show its superiority over conventional THR. Further, its role in the Asian subcontinent, where the patient requires sitting cross-legged or squatting, has not been studied. Methods: A prospective cohort study of 30 elderly patients with displaced NOF with a minimum follow-up of 2-year. Sixteen patients were operated on with DMTHR and fourteen patients with conventional THR. Both the groups were matched; radiological and functional outcomes in terms of Harris hip score (HHS), visual analog scale (VAS), range of motion, and dislocation rate were compared between the two groups. Results: Mean HHS of the DMTHR group was 79.99 at three months and 92.73 at the end of the 2 year postoperatively, which was significantly better than the conventional THR group 59.5 at three months and 88.14 at 2-year. The range of motion was significantly better in the DMTHR group than the conventional THR group. There was no significant difference in radiological outcomes and postoperative dislocation rate between the two groups. Conclusions: Dual mobility implants give better results than conventional implants for primary THA in elderly patients of displaced FNOF regarding better function and greater range of motion. More long-term multicentric studies are still needed

Colorectal polyps and heterotrophic esophageal polyp of colon in a paediatric cohort in South India

Background: Clinical profile of polyps in paediatric cases are less in South India. Juvenile Polyps were the most common polyps in paediatric cases described in literature, presenting as LGI bleed. The aim of the study is to describe the clinical profile of colorectal polyps in paediatric population in a single tertiary care centre in South India.Methods: Paediatric cases between 0 and 16 years of age who underwent colonoscopy in our department from January 2002 to July 2018 were included from database. These cases were retrospectively analysed for presence of polyps, clinical presentation, indication for colonoscopy, histopathology of the resected polyps and other demographic details.  Incomplete procedures were excluded.Results: About 166 paediatric cases underwent colonoscopy in the study period. 21 cases (12.65%) had colorectal Polyps. 85.7% of the polyps were in recto sigmoid region. Most common histological type was Juvenile Polyp (51.6%). One infant had sessile polyp in descending colon which was reported as heterotrophic esophageal mucosa in histopathology. LGI bleed was the most common presentation in children with polyps (66.6%).Conclusions: The prevalence of polyps in our cohort was 12.65%. Solitary Juvenile Polyp was the most common polyp in children, with lower GI bleed as the most common presenting feature. Rare case of heterotrophic esophageal polyp was seen in descending colon

Unveiling mediastinal pathology: role of EUS guided fine needle aspiration in diagnosing mediastinal lesions

Background: Mediastinal lesion is the focus of investigation in diagnosis of infective, granulomatous or neoplastic pathology of respiratory system. Metastatic mediastinal node assessment is an integral part of oncological management. EUS provides access to sampling of mediastinal mass, sub-carinal and aorto-pulmonary nodes. This study aims to assess the clinical impact, diagnostic yield and safety of EUS guided FNA for mediastinal lesions.Methods: Retrospective analysis of prospectively collected data of 72 cases of mediastinal lesions between January 2014 and December 2017 was done. EUS-FNA was performed with a linear echoendoscope using a 22- or 25-gauge needle. Adequacy of cellularity was assessed by on site pathologist. Patient data (demographics, intervention and follow-up) were prospectively collected and introduced in a predefined computer database for later review.Results: EUS-FNA was performed from 57 lymph nodes and 15 mediastinal masses. Adequate samples were obtained in 67 of 72 patients (93.05%). All mediastinal masses were malignant and were identified in the 3rd, 5th and 6th decade of life. Of the 57 lymph nodes, 15 were malignant, 28 had granulomatous lymphadenitis of which 16 individuals became asymptomatic after anti tubercular therapy. Sample was inadequate in 5 circumstances. No major complications were encountered with the procedure in any of the individuals.Conclusions: EUS guided tissue diagnosis is a safe technique and our data supports the use of EUS-FNA in work-up of mediastinal lesions. It is minimally invasive, accurate and has easy access to mediastinum. It has significant impact on patient diagnosis, management and should be considered over other invasive techniques

Statin therapy and Vitamin D

Background: Statins are well-known drugs used in dyslipidemia and cardiac disorders since several years. Recently, it has been reported that long-term use of statins reduce serum vitamin D level. When statins are administered to patients with low vitamin D more muscular side effects have been reported. On the contrary, a few studies report that statins might increase vitamin D level competing with its metabolism. Hence, this study was conducted to evaluate the association between statins and vitamin D.Methods: 125 participants who fulfilled the selection criteria were enrolled in the study. 65 subjects belonged to control group and 60, statin group. The blood sample was collected for Vitamin D estimation. The results were correlated with a demographic profile, nature of statin and the muscular side effects and compared with control group.Results: The mean vitamin D level in statin group was 15.82 ng/ml±11.51 and 20.57 ng/ml±7.007 in the control group. The difference was found to be statistically significant.  13.85% in the control group and 10% in statin group had sufficient vitamin D level. 18.33% and 36.92 % had insufficient levels and 71.67% and 49.23% had a deficiency in the statin and control groups respectively.  Myalgia was reported by 30 among 60 subjects (50%) in statin group and 5 among 65 subjects (7.69%) in the control group.Conclusion: The present study has shown that statin therapy is associated with low vitamin D level and that this could contribute to the increased incidence of myalgia in the statin group

Geographical Mapping and Socio-Demographic Analysis of Out-Patient at A Tertiary Hospital in Chennai

There is a lack of comprehensive geographical mapping and socio-demographic analysis of outpatients at a Tertiary Hospital in Chennai. This knowledge gap hinders the understanding of distribution patterns and socio-demographic characteristics of patients visiting the hospital from different geographic locations. The study seeks to enhance healthcare delivery by identifying specific health needs, catchment zones, and areas for improvement in healthcare services. Therefore, the study aims to assess the geographical distribution of outpatients attending the institution, to identify catchment zones and investigate changes in the pattern of geographic distribution of outpatients and to assess the socio-demographic characteristics of outpatients. Geographical data, including addresses, and patient demographic data such as age and gender are collected from the Hospital's Electronic Health Records (EHR) department. The sampling technique employed is an entire population approach, where data is collected and analyzed from every patient attending the outpatient department. MS Excel, Power BI, and ArcGIS are used for data analysis. A total of 40,90,460 patients visited the Outpatient department from 2018 to 2022. Female patients accounted for approximately 57.96% of the total patient visits. Patients between the ages of 31-64 years are the most frequent visitors. General medicine is the most visited department, followed by general surgery and obstetrics & gynecology. The geographical distribution analysis identified Chennai, Kancheepuram, Tiruvallur, and Vellore as major catchment zones. There is a need for targeted outreach programs and resource allocation to improve healthcare services. The results emphasize the importance of tailoring healthcare to the specific needs of female patients and middle-aged adults. Strengthening the general medicine department and optimizing resource allocation based on patient demand can enhance service delivery. Continuous monitoring and analysis of patient data are essential for adapting healthcare strategies to evolving patient demographics and needs

Generation of realistic nonwoven and foam filter geometry and mesh for filtration simulation using open-source tools

Recovery of liquid aerosols (mists) from industrial processes is typically accomplished through coalescence filtration, employing highly porous nonwoven (fibrous), knitted or foam media which are regarded to potentially provide high collection efficiencies. Highly resolved pore-scale computational fluid dynamics (CFD) analysis of mist filtration processes is increasingly becoming an important tool for design and optimization of such filter media. A key to efficient application-specific optimization of filter media is the ability to generate CFD-suitable virtual filter geometries with controllable geometric parameters including solidity, fibre diameters, morphology, etc. - yet, a review of the literature suggests that the current designs are heavily reliant on computed tomography (CT) scans of available filter media for accurate representation of the pore-scale structures in a computational simulation. In the present study, a novel methodology is presented for generating realistic virtual nonwoven (fibrous) and foam filter geometries with parametric customizability, using open-source tools including Python, OpenFOAM libraries, Gmsh and Blender. Further, a methodology for the generation of a computational mesh suitable for multiphase CFD at the pore-scale is delineated for the two types of filter media generated using the present technique, viz: nonwoven and foam, using open-source tools available within the OpenFOAM framework. The proposed methodology for the generation of virtual filter media and computational mesh is validated by qualitative comparison against with images from electron-microscopy (SEM) scans of real filters as well as comparison of the single-phase pressure drops predicted from CFD simulations using the generated fibrous and foam media with different solidities, fibre (or strand of foam) diameters, filter thicknesses, against the literature. The excellent agreement between the predicted pressure drops and the literature and its consistency over the several different geometric conditions considered for comparison reaffirms the validity of the proposed methodology for efficient virtual filter media development, which can eventually lead to enhanced parametric optimization capabilities and reduced design costs and lead times

Post-harvest soil nutrient prediction in hybrid castor (Ricinus communis l.) Cropping sequence using a multivariate analysis technique

In the era of precision agriculture, the fertilizer prescription based on the soil fertility status is much required.  Analyzing the soil after each crop is necessary for fertilizer recommendation and developing an alternative technique to forecast the soil available nutrient value rather than analyzing the soil. Multiple linear regression (MLR) equation was developed using filed experiment data to predict the soil available nutrient in castor cropping sequence. The post-harvest soil available nutrient was considered as the dependent variable and the initially available soil nutrient values, fertilizer added, yield and nutrient uptake of castor as an independent variable. In general, the post-harvest soil nutrient model's prediction accuracy was notable and had a coefficient of determination of less than 0.90. By calculating the RMSE (root means square error), R2 value, the ratio performance to deviation (RPD) and, RE (relative error) the performance of the MLR model was confirmed.Using the validated model, post-harvest soil available nutrients were predicted and compared with laboratory tested soil available nutreints. It turned out that the established model is more precisely effective and equally precise. Fertilizer recommendation could be made to subsequent crop after hybrid castor using the predicted soil available nutrients

Carica Papaya’s Anti-Diabetic and Anti-Cancer Properties – A Review

The Carica papaya originates from the Caricaceae family, and various members of this family have been used as treatments for a range of ailments. The perennial plant C. papaya, which is currently found over the whole tropical region, is thought to have originated in the southern region of Mexico. To assess the biological activity of distinct C. papaya sections, several scientific studies have been carried out. Since ancient times, the papaya plant's many components have been employed for medicinal purposes. In this article, the process of extracting Carica papaya leaves as well as the anti-cancer and anti-diabetic properties of papaya leaf activity were all things we wanted to assess. The information for this review paper, which focuses mostly on the therapeutic potential of papaya leaf extract was obtained via researching a collection of wider internet databases, including Google Scholar, PubMed, Science Direct, and Elsevier. The papaya plant, which has different parts such as fruit, leaves, seeds, bark, latex, and other substances, is very important in controlling the spread of illness. Alkaloids, glycosides, tannins, saponins, and flavonoids are just a few of the bioactive constituents in this, we focused on the papaya plant leaf's anti-cancer and anti-diabetic properties. The papaya has a wide range of therapeutic qualities. Papaya is a potent remedy, according to traditional beliefs. Biological activities have been the subject of much research. In the current review, all the pharmacological applications and activities of certain chemical components are discussed

Detection of Obstructive Sleep Apnea from ECG Signal using SVM based Grid Search

Obstructive Sleep Apnea is one common form of sleep apnea and is now tested by means of a process called Polysomnography which is time-consuming, expensive and also requires a human observer throughout the study of the subject which makes it inconvenient and new detection techniques are now being developed to overcome these difficulties. Heart rate variability has proven to be related to sleep apnea episodes and thus the features from the ECG signal can be used in the detection of sleep apnea. The proposed detection technique uses Support Vector Machines using Grid search algorithm and the classifier is trained using features based on heart rate variability derived from the ECG signal. The developed system is tested using the dataset and the results show that this classification system can recognize the disorder with an accuracy rate of 89%. Further, the use of the grid search algorithm has made this system a reliable and an accurate means for the classification of sleep apnea and can serve as a basis for the future development of its screening

Influence of filter domain size on the simulation of gas-liquid filtration in nonwoven and foam media

The process of coalescence mist filtration in liquid- or gas-liquid systems is strongly controlled by the dynamics of the multi-component fluid transport at the pore- or fibrescales and its interactions with the filter media. However, current designs of mist filters are largely based on empirical data or on single-fibre filtration theory, primarily because of the complexity and difficulty in making accurate measurements at such (small) length scales. Current advancements in high performance computing provide a unique possibility to understand the dynamics of such flows using highly resolved droplet and interface capturing computational fluid dynamics (CFD) simulations - which can provide vital data for application-specific optimization of filter media. However it is important that the spatio-temporal resolutions required to accurately numerical model the fluid dynamics of micro or nano-fibre filtration processes at full size of the filters may typically demand simulations to be run with several hundred million (to over a billion) computational cells and long run-times. Hence, for reduced design lead times as well as computational cost, it is desirable to keep the size of the filter domain to a minimum, while ensuring that the largest fluid structures and scales are captured in the simulations. A review of the (limited) literature on CFD simulations of the mist-filtration process reveals that the size of the filtration domain have been predominantly chosen rather arbitrarily based on the a set multiple of the Brinkman screening length or by the computing power available - and no reported studies are yet available that address conditions of high levels of fluid saturation that involve large fluid structures. In the present study, a series of systematic computational simulations using successively larger domain sizes are carried out to identify the relationship between the characteristics of the two phase flow (such as saturation, thickness of liquid layer, pressure drop, etc.) and the size of the filter domains considered. Two vastly different types of filter media, nonwoven and foam, with similar properties such as packing density, fibre (or element of foam) diameters are chosen to additionally infer the influence of filter structures at the pore-scales to the domain size. The transient simulations are carried out using the interface capturing volume-of-fluid (VOF) solver available within the open-source CFD framework OpenFOAM