Maternal and foetal outcome of acute kidney injury in pregnancy single centre experience from North India

Background: The diagnosis and treatment of acute kidney injury in pregnancy is a challenge to the physician as various pathophysiological changes take place during pregnancy, variability of symptoms and occasionally overlapping laboratory and clinical features. The occurrences of feto-maternal mortality associated with it decreased in developing nations due to increased prenatal and postnatal care and improved medical facilities. This study was undertaken to provide insight into feto-maternal outcome in patients presenting with acute kidney injury (AKI) during pregnancy. Methods: This was an open label prospective hospital-based cohort study comprising patients admitted in obstetrics and nephrology wards, presenting with AKI and no known chronic illnesses prior to pregnancy. Following criteria were used to diagnose AKI during pregnancy: (a) Elevation of S. creatinine ≥ 1 mg/dl; (b) Oligo-anuria for ≥ 12 hours and (c) Need for RRT. 50 such cases were enrolled in the study. Results: Out of all patients enrolled, majority (60%) had improved renal function, 16% expired, and 24% had no recovery in renal function. Out of all patients taken for haemodialysis, 20% of patients had improved renal function, 20% expired and 60% had no recovery in renal function. Mean S. creatinine on 3 months follow-up in conservative group found-1.67±1.31 mg/dl. 60% pregnancies resulted in the birth of a live baby and rest resulted in foetal loss. Conclusions: In our study, it was found that acute kidney injury in pregnancy results in significant feto-maternal mortality and morbidity. Those patients, who had significant renal derangement and concomitant complications, had poorer outcome

Numerical simulation of suddenly expanded flow at Mach 2.2

A numerical simulation has been performed to investigate the control of base pressure with microjets in a suddenly expanded duct. Microjets placed at the pitch circle diameter (PCD) of 13 mm, two micro jets of 1 mm orifice diameter located at 900 for active control. The flow Mach number of the investigation was M = 2.2, the L/D ratio of the enlarged duct considered is 6, and the area ratio is 3.24. The convergent-divergent (CD) nozzle geometry has been modeled and simulated employing K-ε turbulence model for standard wall function. From the code independently was checked with the commercial computational fluid dynamics software. The numerical simulations carried for nozzle pressure ratio’s (NPR) 3, 5, 7, 9 and 11. From the present numerical investigation, it is observed that the NPR, Mach number, and area ratio plays a vital role in fixing the base pressure values. NPR's of the present study is such that the flow mostly remained over expanded. Despite jets being over-expanded the control is effective in decreasing the base suction and hence the base drag

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial

Background Tranexamic acid reduces surgical bleeding and decreases mortality in patients with traumatic extracranial bleeding. Intracranial bleeding is common after traumatic brain injury (TBI) and can cause brain herniation and death. We aimed to assess the effects of tranexamic acid in patients with TBI. Methods This randomised, placebo-controlled trial was done in 175 hospitals in 29 countries. Adults with TBI who were within 3 h of injury, had a Glasgow Coma Scale (GCS) score of 12 or lower or any intracranial bleeding on CT scan, and no major extracranial bleeding were eligible. The time window for eligibility was originally 8 h but in 2016 the protocol was changed to limit recruitment to patients within 3 h of injury. This change was made blind to the trial data, in response to external evidence suggesting that delayed treatment is unlikely to be effective. We randomly assigned (1:1) patients to receive tranexamic acid (loading dose 1 g over 10 min then infusion of 1 g over 8 h) or matching placebo. Patients were assigned by selecting a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was head injury-related death in hospital within 28 days of injury in patients treated within 3 h of injury. We prespecified a sensitivity analysis that excluded patients with a GCS score of 3 and those with bilateral unreactive pupils at baseline. All analyses were done by intention to treat. This trial was registered with ISRCTN (ISRCTN15088122), ClinicalTrials.gov (NCT01402882), EudraCT (2011-003669-14), and the Pan African Clinical Trial Registry (PACTR20121000441277). Results Between July 20, 2012, and Jan 31, 2019, we randomly allocated 12 737 patients with TBI to receive tranexamic acid (6406 [50·3%] or placebo [6331 [49·7%], of whom 9202 (72·2%) patients were treated within 3 h of injury. Among patients treated within 3 h of injury, the risk of head injury-related death was 18·5% in the tranexamic acid group versus 19·8% in the placebo group (855 vs 892 events; risk ratio [RR] 0·94 [95% CI 0·86-1·02]). In the prespecified sensitivity analysis that excluded patients with a GCS score of 3 or bilateral unreactive pupils at baseline, the risk of head injury-related death was 12·5% in the tranexamic acid group versus 14·0% in the placebo group (485 vs 525 events; RR 0·89 [95% CI 0·80-1·00]). The risk of head injury-related death reduced with tranexamic acid in patients with mild-to-moderate head injury (RR 0·78 [95% CI 0·64-0·95]) but not in patients with severe head injury (0·99 [95% CI 0·91-1·07]; p value for heterogeneity 0·030). Early treatment was more effective than was later treatment in patients with mild and moderate head injury (p=0·005) but time to treatment had no obvious effect in patients with severe head injury (p=0·73). The risk of vascular occlusive events was similar in the tranexamic acid and placebo groups (RR 0·98 (0·74-1·28). The risk of seizures was also similar between groups (1·09 [95% CI 0·90-1·33]). Interpretation Our results show that tranexamic acid is safe in patients with TBI and that treatment within 3 h of injury reduces head injury-related death. Patients should be treated as soon as possible after injury. Funding National Institute for Health Research Health Technology Assessment, JP Moulton Charitable Trust, Department of Health and Social Care, Department for International Development, Global Challenges Research Fund, Medical Research Council, and Wellcome Trust (Joint Global Health Trials scheme)

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Numerical investigation of mathematical non-dimensional constant representing smoothness in the Nusselt profile

Cooling of devices using air-jet and other fluid impingement has acquired pace in the manufacturing and electronic device industries. The cooling of the surface using liquid jets is studied using the Nusselt distribution profile. The pattern of the Nusselt profile becomes non-uniform when some parameters are wrongly selected. This may lead to heating of some locations instead of cooling of the surface. Thus research for keeping the Nusselt profile uniform is a primary task. The Nusselt profile depends mainly on the Reynolds number (Re) and nozzle-target spacing (Z/d). Therefore, the current study numerically evaluates the value of constant, which is a ratio of Reynolds number and nozzle-target spacing (C = Re/ (Z/d)) up to which the Nusselt profile remains uniform. The value of constant C is found to be 7400. Also, the present work uses a computational model for study, which is validated using grid independence test and turbulence modeling

Development of Heavy Metal Potentiostat for Batik Industry

The consumption of reactive dyes in the batik industry has led to a severe concern in monitoring the heavy metal level in wastewater. Due to the necessity of implementing a wastewater monitoring system in the batik factory, a Heavy Metal potentiostat (HMstat) was designed. The main goal of this study is to understand the optimal design concept of the potentiostat function in order to investigate the losses of accuracy in measurement using off-the-shelf devices. Through lab-scale design, the HMstat comprises of an analog potentiostat read-out circuit component (PRCC) and a digital control signal component (CSC). The PRCC is based on easy to use components integrated with a NI-myRIO controller in a CSC. Here, the myRIO was equipped with built-in analog to digital converter (ADC) and digital to analog converter (DAC) components. In this paper, the accuracy test and detection of cadmium(II) (Cd2+) and lead(II) (Pb2+) were conducted using the HMstat. The results were compared with the Rodeostat (an open source potentiostat available on the online market). The accuracy of the HMStat was higher than 95% and within the precision rate of the components used. The HMstat was able to detect Cd2+ and Pb2+ at −0.25 and −0.3 V, respectively. Similar potential peaks were obtained using Rodeostat (Cd2+ at −0.25 V and Pb2+ at −0.3 V)

Experimental investigation and gray relational optimization of engine parameters to improve the output characteristics of an ammonia biodiesel-powered dual-fuel combustion engine

An innovative approach to this research is to evaluate the effects of different concentrations of biodiesel with premixed ammonia energy in a dual-fuel combustion engine and determine the best operating conditions for optimal engine responses. Experimental results of a 40% ammonia energy premixing fraction with direct injection of a biodiesel blend of 30% (40%AEPF + B30) at 80% load improved brake thermal efficiency (BTE) by 8.42% while reducing brake specific energy consumption (BSEC) by 13.28%. It also reduces the hydrocarbon (HC) emission by 16.8%, the carbon monoxide (CO) emission by 15.06%, and the smoke opacity by 26.8%. As opposed to this, carbon dioxide (CO2) and nitrogen oxide (NOx) emissions are elevated by 21.5% and 16.54%, respectively, relative to the 40% ammonia energy premixing fraction with direct injection of diesel (40%AEPF + Diesel). Thereafter, the ANOVA technique is also utilized to analyze the impact of operational parameters, and the findings show that the responses are statistically significant. Additionally, the results are utilized in a grey relational analysis (GRA) based optimization process to determine the appropriate operational variables. According to optimization results, 40%AEPF + B30 at 80% load provides the most efficiency and fuel economy. It is capable of being used as an alternate fuel instead of conventional diesel

Experimental investigation and gray relational optimization of engine parameters to improve the output characteristics of an ammonia biodiesel powered dual fuel combustion engine

An innovative approach to this research is to evaluate the effects of different concentrations of biodiesel with premixed ammonia energy in a dual-fuel combustion engine and determine the best operating conditions for optimal engine responses. Experimental results of a 40% ammonia energy premixing fraction with direct injection of a biodiesel blend of 30% (40%AEPF + B30) at 80% load improved brake thermal efficiency (BTE) by 8.42% while reducing brake specific energy consumption (BSEC) by 13.28%. It also reduces the hydrocarbon (HC) emission by 16.8%, the carbon monoxide (CO) emission by 15.06%, and the smoke opacity by 26.8%. As opposed to this, carbon dioxide (CO2) and nitrogen oxide (NOx) emissions are elevated by 21.5% and 16.54%, respectively, relative to the 40% ammonia energy premixing fraction with direct injection of diesel (40%AEPF + Diesel). Thereafter, the ANOVA technique is also utilized to analyze the impact of operational parameters, and the findings show that the responses are statistically significant. Additionally, the results are utilized in a grey relational analysis (GRA) based optimization process to determine the appropriate operational variables. According to optimization results, 40%AEPF + B30 at 80% load provides the most efficiency and fuel economy. It is capable of being used as an alternate fuel instead of conventional diesel

Optimization of Process Parameters in CNC Turning of Aluminum 7075 Alloy Using L27 Array-Based Taguchi Method

With the advent of the industrial revolution 4.0, the goal of the manufacturing industry is to produce a large number of products in relatively less time. This study applies the Taguchi L27 orthogonal array methodological paradigm along with response surface design. This work optimizes the process parameters in the turning of Aluminum Alloy 7075 using a Computer Numerical Control (CNC) machine. The optimal parameters influenced the rate of metal removal, the roughness of the machined surface, and the force of cutting. This experimental investigation deals with the optimization of speed (800 rpm, 1200 rpm, and 1600 rpm) and feed (0.15, 0.20, and 0.25 mm/rev) in addition to cutting depth (1.0, 1.5, and 2.0 mm) on the turning of Aluminum 7075 alloy in a CNC machine. The outcome in terms of results such as the removal rate of material (maximum), roughness on the machined surface (minimum), along with cutting force (least amount) were improved by the L27 array Taguchi method. There were 27 specimens of Al7075 alloy produced as per the array, and the corresponding responses were measured with the help of various direct contact and indirect contact sensors. Results were concluded all the way through diagrams of main effects in favor of signal-to-noise ratios and diagrams of surfaces with contour diagrams for various combinations of responses