Incidence and patterns of valvular heart disease in a tertiary care high-volume cardiac center: A single center experience

AbstractBackgroundDiseases of the heart valves constitute a major cause of cardiovascular morbidity and mortality worldwide with rheumatic heart disease (RHD) being the dominant form of valvular heart disease (VHD) in developing nations. The current study was undertaken at a tertiary care cardiac center with the objective of establishing the incidence and patterns of VHD by Echocardiography (Echo).MethodsAmong the 136,098 first-time Echocardiograms performed between January 2010 and December 2012, an exclusion criterion of trivial and functional regurgitant lesions yielded a total of 13,289 cases of organic valvular heart disease as the study cohort.ResultsIn RHD, the order of involvement of valves was mitral (60.2%), followed by aortic, tricuspid and pulmonary valves. Mitral stenosis, predominantly seen in females, was almost exclusively of rheumatic etiology (97.4%). The predominant form of isolated MR was rheumatic (41.1%) followed closely by myxomatous or mitral valve prolapse (40.8%). Isolated AS, more common in males, was the third most common valve lesion seen in 7.3% of cases. Degenerative calcification was the commonest cause of isolated AS (65.0%) followed by bicuspid aortic valve (BAV) (33.9%) and RHD (1.1%). Multiple valves were involved in more than a third of all cases (36.8%). The order of involvement was MS + MR > MS + AR > MR + AR > AS + AR > MR + AS > MS + AS. Overall, 9.7% of cases had organic tricuspid valve disease.ConclusionRHD contributed most to the burden of VHD in the present study with calcific degeneration, myxomatous disease and BAV being the other major forms of VHD. Multiple valves were affected in more than a third of all cases

Sensor networks security based on sensitive robots agents. A conceptual model

Multi-agent systems are currently applied to solve complex problems. The security of networks is an eloquent example of a complex and difficult problem. A new model-concept Hybrid Sensitive Robot Metaheuristic for Intrusion Detection is introduced in the current paper. The proposed technique could be used with machine learning based intrusion detection techniques. The new model uses the reaction of virtual sensitive robots to different stigmergic variables in order to keep the tracks of the intruders when securing a sensor network.Comment: 5 page

Double blind randomized comparative study of transdermal fentanyl patch for post operative pain relief in major abdominal surgery as a component of multimodal analgesic therapy

Background: There are various methods of alleviating post-operative pain, multimodal analgesia is the recommended practice. Fentanyl patch can also be used in the management of acute postoperative pain. We have done a study to compare the efficacy of fentanyl patch to a placebo patch as a part of multimodal analgesic strategy.Methods: Forty four patients were randomized into two groups. Groups were named as FP (Fentanyl patch) and P (Placebo). The Patch was placed 10-12 hours before surgery and patient was monitored for 72 hours postoperatively for pain by NRS (Numeric Rating Scale). All the patients received regular Paracetamol and Diclofenac Sodium. Tramadol was given as rescue analgesia if the NRS scale was more than 5. Data was analysed using Windows stat version 9.2 from Indostat services.Results: There was statistically significant difference in the consumption of Tramadol in patients with FP group (19.44 mg) as compared to P group (72.22mg) over 72 hours. The Numerical Rating scale was also much lower in the FP group at 8, 16, 24, 32, 40, 48, 56, 64 and 72 hours. Maximum difference in the pain score being at 24 hours for the FP group. No difference in the Sedation, Pruritus, Respiratory depression, Nausea and vomiting scores in the two groups.Conclusions: Transdermal Fentanyl Patch of 25 µg/hr when applied 10-12 hours before surgery provides effective postoperative pain relief after major abdominal surgery as a part of multimodal analgesia

सिंचाई व्य्वस्थाओं के साथ मछ्ली पालन का एकीकरण - एक नया व्य्वस्थित दृष्टिकोण

कृपया पूरा लेख पढे

Combination of Woody and Grass type Biomass: Waste Management, Influence of Process Parameters, Yield of Bio-oil by Pyrolysis and its Chromatographic Characterization

172-180Due to looming demand for fossil fuels and environmental concerns over global warming, extensive attention has been given on the development of renewable energy. Biomass materials are used since millennia for meeting myriad human needs including energy and chemicals. In this study, co-pyrolysis characteristics of woody and grass type agricultural wastes, namely Borassus flabellifer and Cymbopogon flexuosus were studied in a fixed bed reactor to evaluate their potential use as source of bio-oil. The effects of operating parameters such as temperature, particle size and heating rate were investigated. In this co-pyrolysis process, the maximum yield of pyrolysis bio-oil 47.10 wt% can been obtained under the pyrolysis temperature of 500ºC, 1.0 mm particle size and at the heating rate of 30 ºC/min. The bio-oil product was analyzed for physical, elemental and chemical composition using Fourier transform infra-red (FTIR) spectroscopy and gas chromatography (GC)

Performance Evaluation of Energy Efficient Optimized Routing Protocol for WBANs Using PSO Protocol

A Wireless Body Area Network (WBAN) is a network that may be worn on the human body or implanted in the human body to transmit data, audio, and video in real-time to assess how vital organs are performing. A WBAN may be either an inter-WBAN or an intra-WBAN network. Intra-WBAN communication occurs when the various body sensors can share information. This is known as inter-WBAN communication, which occurs when two or more WBANs can exchange data with one another. One difficulty involves getting data traffic from wireless sensor nodes to the gateway with as little wasted energy, dropped packets, and downtime as possible. In this paper, the WBAN protocols have been compared with WBAN under Particle Swarm Optimization (PSO), and the performance of various parameters has been analysed for different simulation areas. The WBAN under the PSO protocol reduces the energy consumption by 43.2% against the SIMPLE protocoldue to the effective selection of forwarding nodes based on PSO optimization. In addition to that the experimental WBAN testbed is conducted in indoor environment to study the performance of the routing metrics towards energy and packet reception.

Combination of woody and grass type biomass: waste management, influence of process parameters, yield of bio-oil by pyrolysis and its chromatographic characterization

Extensive concentration has been given to the conservation of environment in order to minimize the emission. Global warming is a long-term rise in the average temperature of the Earth's climate system due to the emission by burning fossil fuels. Biomass materials are used since millennia for meeting myriad human needs including energy and chemicals. In this study co-pyrolysis of woody and grass type agricultural wastes, namely Borassus flabellifer and Cymbopogon flexuosus have been conducted in a fixed-bed reactor. The yield and chemical characterization of bio-oil and char products obtained from the pyrolysis of the mixture of Borassus flabellifer and Cymbopogon flexuosus under an inert atmosphere have been studied. The effects of operating parameters such as temperature, particle size and heating rate were investigated. In this co-pyrolysis process, the maximum yield of pyrolysis bio-oil of 47.10 wt% have been obtained under the pyrolysis temperature of 500 ºC, 1.0 mm particle size and at the heating rate of 30 ºC/min. The bio-oil product was analyzed for physical, elemental and chemical composition using Fourier transform infra-red (FTIR) spectroscopy and gas chromatography (GC)

Evaluation of the efficacy, safety and tolerability of Tacrolimus ointment in Indian patients of moderate to severe atopic dermatitis: A multicentric, open label, phase III study

AIM OF STUDY: Tacrolimus, a topical immunomodulator, has been introduced as a new treatment for moderate to severe atopic dermatitis. The present study was conducted to evaluate the efficacy, safety and tolerability of Tacrolimus ointment in patients of atopic dermatitis in an Indian setting. METHODS: The present study was a prospective, open, multicentric, Phase III trial.The duration of study was 5 weeks, including a 3-week active treatment period, preceded by a 1-week washout phase and followed by a 1-week follow-up phase. Patients diagnosed to be suffering from moderate to severe atopic dermatitis as per the Rajka and Langeland criteria were treated with Tacrolimus ointment 0.03% twice daily. Efficacy was assessed by modified Eczema Area Sensitivity Index (mEASI) score, patient's and physician's global assessment. Tolerability and safety was assessed by physical examination, laboratory parameters and evaluation of adverse events. RESULTS: There was a statistically significant decrease in the modified Eczema Area Sensitivity Index (mEASI) score (P<0.05). Patient's and Physician's global evaluation of treatment was complete resolution to very good improvement in most of the patients. The laboratory values were within normal limits. The drug was well tolerated. CONCLUSIONS: This study confirms the efficacy and safety of Tacrolimus ointment 0.03% in Indian patients of moderate to severe atopic dermatitis

Effectiveness of pegylated erythropoietin in renal anaemia patients on dialysis-a multicentre, cross-sectional, observational outcome study

Background: Low dose of pegylated erythropoietin (PegEPO) is better than conventional erythropoietin stimulating agents (ESAs) in improving hyporesponsiveness and maintaining stable haemoglobin (Hb) levels in renal anaemic patients undergoing hemodialysis. This real-world study aimed to assess effectiveness and safety of low-dose PegEPO (30 µg/0.3 mL), administered at different time-points in renal anaemia patients on dialysis. Methods: HEMEPEG (HEMoglobin outcomE with PegEPO) was a multicentre, retrospective, cross-sectional, observational study of renal anaemia patients receiving PegEPO up to 3 months. The study assessed an increase in Hb, patients achieving Hb 10-12 g/dl, and Hb increase by ≥1 and ≥2 g/dl. Results: Data from 223 out of 273 patients from 19 Indian centers were analyzed. PegEPO was administered weekly to 132 patients (59.19%), with 38.64% being diabetic and 77.27% previously treated with ESAs. Ten day dosing was given to 91 patients (40.81%), including 46.15% diabetic patients and 72.53% previously treated with ESAs. A Significant (p<0.0001) increase in mean Hb levels from baseline to day 30, 60 and 90 were observed for both studied groups, with a target Hb of 10-12 g/dl achieved in 51.08% and 52.85% of patients in the respective groups after 3 months. An increase in Hb by ≥1 and ≥2 g/dl were observed in weekly (68.67% and 45.78%) and 10-day group (77.14% and 50.00%) patients, respectively. Conclusions: PegEPO (30 µg/0.3 mL) was effective treatment of renal anaemia and diabetic chronic kidney disease (CKD) patients on dialysis when administered weekly or every 10 days over a 3-month treatment period