AIM: To assess role of combined modality of mechanical fragmentation and intralesional thrombolysis in patients with massive pulmonary embolism presenting subacutely. METHODS: Eight of 70 patients presenting in terti... AIM: To assess role of combined modality of mechanical fragmentation and intralesional thrombolysis in patients with massive pulmonary embolism presenting subacutely. METHODS: Eight of 70 patients presenting in tertiary care centre of North India with massive pulmonary embolism within 4 years had subacute presentation (symptom onset more than 2 wk). These patients were subjected to pulmonary angiography with intention to treat basis via mechanical breakdown and intra lesional thrombolysis. Mechanical breakdown of embolus was accomplished with 5-F multipurpose catheter to reestablish flow, followed by intralesional infusion of urokinase (4400 IU/kg over 10 min followed by 4400 IU/kg per hour over 24 h). RESULTS: Eight patients, mean age 47.77±12.20 years presented with subacute pulmonary embolism (mean duration of symptoms 2.4 wk). At presentation, mean heart rate, shock index, miller score and mean pulmonary pressures were 101.5±15.2/min, 0.995±0.156, 23.87±3.76 and 37.62±6.67 mmHg which reduced to 91.5±12.2/min (P=0.0325), 0.789±0.139 (P=0.0019), 5.87±1.73 (P=0.0000004) and 27.75±8.66 mmHg (P=0.0003) post procedurally. Mean BP improved from 80.00±3.09 mmHg to 90.58±9.13 mmHg (P=0.0100) post procedurally. Minor complications in the form of local hematoma-minor hematoma in 1 (12.5%), and pseudoaneurysm (due to femoral artery puncture) in 1 (12.5 %) patient were seen. At 30 d and 6 mo follow up survival rate was 100% and all the patients were asymptomatic and in New York Heart Association class 1. CONCLUSION: Combined modality of mechanical fragmentation and intralesional thrombolysis appears to be a promising alternative to high risk surgical procedures in patients with subacute massive pulmonary embolism.展开更多
Encroachment, disposal of untreated domestic and industrial wastewater and dumping of solid wastes have degraded the overall quality of the river Turag, which is located in Dhaka—the Capital City of Bangladesh. The p...Encroachment, disposal of untreated domestic and industrial wastewater and dumping of solid wastes have degraded the overall quality of the river Turag, which is located in Dhaka—the Capital City of Bangladesh. The present study investigated the extent of pollution of sediments of this river and analyzed the regional variability for the concentrations of Cr, Pb, Zn, Cu and Cd—all of concern because of their potential toxicity, using atomic absorption spectrophotometer. As per US EPA sediment quality guideline, metal concentrations ranged between Cd: 0.00 - 0.80, Cr: 32.00 - 75.50, Cu: 46.30 - 60.00, Pb: 28.30 - 36.40, and Zn: 94.60 - 190.10 mg/kg in the Turag river sediments. Cr, Cu, Zn belongs to moderately to highly polluted, Pb and Cd belongs to not polluted for Turag river. The heavy metals contamination in the sediments were also evaluated by applying Index of geo-accumulation (Igeo), contamination factor (Cf), pollution load index (PLI) etc. Toxicity characteristics leaching procedure (TCLP) test (US EPA 1311) for sediment samples have been performed also for metals (Pb, Cd, Cr, Cu and Zn) to determine the readily toxicity level of heavy metals. Sieve analysis of sediment performed in this study to determine the physical characteristic of sediment samples. The metal concentrations are well below the regulated level as per US EPA. This index can be complemented with the contamination index, which allows more site-specific and accurate information on contaminant levels. If the aim of work on contamination evaluation is to assess the overall contamination of a study area, the indices are highly appropriate.展开更多
Background:An affordable approach accepted worldwide to successfully treat mild maternal hyperglycemia in gestational diabetes(GDM),is diet-controlled therapy.As no elaborate research was available,this study was craf...Background:An affordable approach accepted worldwide to successfully treat mild maternal hyperglycemia in gestational diabetes(GDM),is diet-controlled therapy.As no elaborate research was available,this study was crafted to investigate morphometric stereological details and to determine the mean placental oxygen diffusion capacity for patients who were kept on diet therapy for mild gestational hyperglycemia.Methods:A clinical trial(NCT04907708)was conducted from January 2018 to February 2019.A total of 70 women completed the study,out of which 35 served as healthy controls as Group A and 35 were diagnosed as mild gestational diabetics according to WHO criteria(Group B).These patients were kept on a restricted calorie diet with light exercise during gestation and were followed regularly during gestation.Soon after delivery,conserved placentas underwent complete gross,microscopic,and stereological investigations with the point and intersection-counting methods.Results:Significant differences were observed for placental width and syncytial knots(p<0.010 and 0.025 respectively)between the groups on gross and light microscopy.Most of the parameters were non-significant,though numerically more in the GDM group.On stereological details,mean placental volume,mean placental components volumes(villi,inter-villous space,fetal capillary,and fetal connective tissue),mean villi and mean fetal capillary diameter,mean villi and capillary surface density and mean morphometric diffusing capacity of placenta showed non-significant results between the groups.Conclusion:Minimal changes were observed in gross,microscopy,and morphometric stereological details in the placentae of GDM patients managed with nutritional therapy during gestation compared with the healthy controls.展开更多
Objective: To evaluate the epidemiology, clinical profile and treatment for patients with snake bite in the intensive care unit of our hospital. Methods: A retrospective analysis of patients with snake bite admitted t...Objective: To evaluate the epidemiology, clinical profile and treatment for patients with snake bite in the intensive care unit of our hospital. Methods: A retrospective analysis of patients with snake bite admitted to the intensive care unit of a tertiary care hospital, North Delhi, was conducted between January 2013 and October 2018. Their demographic profile, time and site of bite, clinical manifestations and time interval between the bite and anti-snake venom administration were recorded. Results: A total number of 102 patients with snake bite were studied, of which 54.9% were males and 45.1% were females. Most patients were presented in the monsoon season and snake bites occurred mainly in the night and early morning. A total of 56.3% of the patients with clinical manifestations received anti-snake venom within 3 h after the snake bite. Most patients presented with painless bites and neuroparalytic features with ptosis that was the most common clinical manifestation (50.9%). Anti-snake venom was administered to 55 patients (53.9%) with an average dose of 42 vials per patient and the mortality was 11.7%. Conclusions: Neuroparalytic krait envenomation accounted for the highest incidence of venomous bites in our study. Early medical treatment with judicious anti snake venom administration and related education is crucial.展开更多
<strong>Purpose:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">We harvested bilateral Internal Mammary Arteries and made LIMA-R...<strong>Purpose:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">We harvested bilateral Internal Mammary Arteries and made LIMA-RIMA Y in all the patients undergoing OPCAB at our center irrespective of the presence or absence of various risk factors for sternal dehiscence. The purpose of this study was to find an effective way of sternal closure in patients undergoing OPCAB with both the Internal Mammary Arteries harvested for grafting. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">The patients who did not have any risk factors were placed in group I and all of them had a standard six wire closure of sternotomy. The patients having any risk factors were placed in group II. The patients in group II were randomized by including every alternate patient from group II to subgroup II A and every other alternate patient from group II to subgroup II B. Patients in subgroup II A again had a standard closure of sternotomy while in patients of subgroup II B bilateral Robiscek repair and four-five interlocking figure of eight wires were used for closure of sternotomy. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The patients who had risk factors for sternal dehiscence had higher risk for sternal dehiscence as compared to patients without any risk factors if bilateral Internal Mammary Arteries were harvested for OPCAB. But if we used bilateral Robiscek repair with four to five interlocking figure of eight wires for sternal closure then the rate of sternal complications in the patients with risk factors for sternal dehiscence was not more than the patients without risk factors. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> We can harvest bilateral Internal Mammary Arteries for OPCAB without fear of sternal complications even in patients with high risk for sternal dehiscence if we use bilateral Robiscek repair with four to five interlock展开更多
Let m and n be fixed, positive integers and P a space composed of real polynomials in m variables. The authors study functions f ： R →R which map Gram matrices, based upon n points of R^m, into matrices, which are n...Let m and n be fixed, positive integers and P a space composed of real polynomials in m variables. The authors study functions f ： R →R which map Gram matrices, based upon n points of R^m, into matrices, which are nonnegative definite with respect to P Among other things, the authors discuss continuity, differentiability, convexity, and convexity in the sense of Jensen, of such functions展开更多
This contribution gives results on the action of the Laplace-Beltrami derivative on suffi- ciently smooth kernels on the sphere, those defined by absolutely and uniformly expansions generated by a family of at least c...This contribution gives results on the action of the Laplace-Beltrami derivative on suffi- ciently smooth kernels on the sphere, those defined by absolutely and uniformly expansions generated by a family of at least continuous functions. Among other things, the results show that convenient Laplace-Beltrami derivatives of positive definite kernels on the sphere are positive definite too. We also include similar results on the action of the Laplace-Beltrami derivative on condensed spherical harmonic expansions.展开更多
Electronic components are normally assembled to printed circuit boards (PCBs). Such components generate heat in operation which must be conducted away efficiently from the small mounting areas to frames where the PCB ...Electronic components are normally assembled to printed circuit boards (PCBs). Such components generate heat in operation which must be conducted away efficiently from the small mounting areas to frames where the PCB is fixed. The temperature of the component depends on heat dissipation rate, technology and parameters of mounting, component placement and finally effective thermal conductivity (keff) of the board. The temperature of some components may reach significant magnitudes over 100°C while the PCB frame is kept at near-ambient temperature. The reliability of electronic components is directly related to operating temperature;?so the thermal project should be able to provide a correct temperature prediction of all PCB components under the hottest operational condition. In space applications, the main way to spread and reject heat of electronic equipment is by thermal conduction once there is no air available to apply convection-based cooling techniques. The PCB keff is an important parameter for the electronics thermal analysis when the PCB is modeled as a simplified homogeneous board with a unique thermal conductivity. In this paper, an intrinsic uncertainty of such approach is firstly reveled and its magnitude is evaluated for a real space use PCB. The simulation uses SINDA/FLUINT Thermal Desktop and aims to determine the keff of the PCB by comparison between a detailed multi-layered anisotropic model and an equivalent homogeneous single-layer model. The model was validated using available data for two-layered FR4-copper PCB. Multiple simulations are performed with different dissipating component position and mounting area.展开更多
文摘 AIM: To assess role of combined modality of mechanical fragmentation and intralesional thrombolysis in patients with massive pulmonary embolism presenting subacutely. METHODS: Eight of 70 patients presenting in tertiary care centre of North India with massive pulmonary embolism within 4 years had subacute presentation (symptom onset more than 2 wk). These patients were subjected to pulmonary angiography with intention to treat basis via mechanical breakdown and intra lesional thrombolysis. Mechanical breakdown of embolus was accomplished with 5-F multipurpose catheter to reestablish flow, followed by intralesional infusion of urokinase (4400 IU/kg over 10 min followed by 4400 IU/kg per hour over 24 h). RESULTS: Eight patients, mean age 47.77±12.20 years presented with subacute pulmonary embolism (mean duration of symptoms 2.4 wk). At presentation, mean heart rate, shock index, miller score and mean pulmonary pressures were 101.5±15.2/min, 0.995±0.156, 23.87±3.76 and 37.62±6.67 mmHg which reduced to 91.5±12.2/min (P=0.0325), 0.789±0.139 (P=0.0019), 5.87±1.73 (P=0.0000004) and 27.75±8.66 mmHg (P=0.0003) post procedurally. Mean BP improved from 80.00±3.09 mmHg to 90.58±9.13 mmHg (P=0.0100) post procedurally. Minor complications in the form of local hematoma-minor hematoma in 1 (12.5%), and pseudoaneurysm (due to femoral artery puncture) in 1 (12.5 %) patient were seen. At 30 d and 6 mo follow up survival rate was 100% and all the patients were asymptomatic and in New York Heart Association class 1. CONCLUSION: Combined modality of mechanical fragmentation and intralesional thrombolysis appears to be a promising alternative to high risk surgical procedures in patients with subacute massive pulmonary embolism.
文摘Encroachment, disposal of untreated domestic and industrial wastewater and dumping of solid wastes have degraded the overall quality of the river Turag, which is located in Dhaka—the Capital City of Bangladesh. The present study investigated the extent of pollution of sediments of this river and analyzed the regional variability for the concentrations of Cr, Pb, Zn, Cu and Cd—all of concern because of their potential toxicity, using atomic absorption spectrophotometer. As per US EPA sediment quality guideline, metal concentrations ranged between Cd: 0.00 - 0.80, Cr: 32.00 - 75.50, Cu: 46.30 - 60.00, Pb: 28.30 - 36.40, and Zn: 94.60 - 190.10 mg/kg in the Turag river sediments. Cr, Cu, Zn belongs to moderately to highly polluted, Pb and Cd belongs to not polluted for Turag river. The heavy metals contamination in the sediments were also evaluated by applying Index of geo-accumulation (Igeo), contamination factor (Cf), pollution load index (PLI) etc. Toxicity characteristics leaching procedure (TCLP) test (US EPA 1311) for sediment samples have been performed also for metals (Pb, Cd, Cr, Cu and Zn) to determine the readily toxicity level of heavy metals. Sieve analysis of sediment performed in this study to determine the physical characteristic of sediment samples. The metal concentrations are well below the regulated level as per US EPA. This index can be complemented with the contamination index, which allows more site-specific and accurate information on contaminant levels. If the aim of work on contamination evaluation is to assess the overall contamination of a study area, the indices are highly appropriate.
文摘Background:An affordable approach accepted worldwide to successfully treat mild maternal hyperglycemia in gestational diabetes(GDM),is diet-controlled therapy.As no elaborate research was available,this study was crafted to investigate morphometric stereological details and to determine the mean placental oxygen diffusion capacity for patients who were kept on diet therapy for mild gestational hyperglycemia.Methods:A clinical trial(NCT04907708)was conducted from January 2018 to February 2019.A total of 70 women completed the study,out of which 35 served as healthy controls as Group A and 35 were diagnosed as mild gestational diabetics according to WHO criteria(Group B).These patients were kept on a restricted calorie diet with light exercise during gestation and were followed regularly during gestation.Soon after delivery,conserved placentas underwent complete gross,microscopic,and stereological investigations with the point and intersection-counting methods.Results:Significant differences were observed for placental width and syncytial knots(p<0.010 and 0.025 respectively)between the groups on gross and light microscopy.Most of the parameters were non-significant,though numerically more in the GDM group.On stereological details,mean placental volume,mean placental components volumes(villi,inter-villous space,fetal capillary,and fetal connective tissue),mean villi and mean fetal capillary diameter,mean villi and capillary surface density and mean morphometric diffusing capacity of placenta showed non-significant results between the groups.Conclusion:Minimal changes were observed in gross,microscopy,and morphometric stereological details in the placentae of GDM patients managed with nutritional therapy during gestation compared with the healthy controls.
文摘Objective: To evaluate the epidemiology, clinical profile and treatment for patients with snake bite in the intensive care unit of our hospital. Methods: A retrospective analysis of patients with snake bite admitted to the intensive care unit of a tertiary care hospital, North Delhi, was conducted between January 2013 and October 2018. Their demographic profile, time and site of bite, clinical manifestations and time interval between the bite and anti-snake venom administration were recorded. Results: A total number of 102 patients with snake bite were studied, of which 54.9% were males and 45.1% were females. Most patients were presented in the monsoon season and snake bites occurred mainly in the night and early morning. A total of 56.3% of the patients with clinical manifestations received anti-snake venom within 3 h after the snake bite. Most patients presented with painless bites and neuroparalytic features with ptosis that was the most common clinical manifestation (50.9%). Anti-snake venom was administered to 55 patients (53.9%) with an average dose of 42 vials per patient and the mortality was 11.7%. Conclusions: Neuroparalytic krait envenomation accounted for the highest incidence of venomous bites in our study. Early medical treatment with judicious anti snake venom administration and related education is crucial.
文摘<strong>Purpose:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">We harvested bilateral Internal Mammary Arteries and made LIMA-RIMA Y in all the patients undergoing OPCAB at our center irrespective of the presence or absence of various risk factors for sternal dehiscence. The purpose of this study was to find an effective way of sternal closure in patients undergoing OPCAB with both the Internal Mammary Arteries harvested for grafting. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">The patients who did not have any risk factors were placed in group I and all of them had a standard six wire closure of sternotomy. The patients having any risk factors were placed in group II. The patients in group II were randomized by including every alternate patient from group II to subgroup II A and every other alternate patient from group II to subgroup II B. Patients in subgroup II A again had a standard closure of sternotomy while in patients of subgroup II B bilateral Robiscek repair and four-five interlocking figure of eight wires were used for closure of sternotomy. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The patients who had risk factors for sternal dehiscence had higher risk for sternal dehiscence as compared to patients without any risk factors if bilateral Internal Mammary Arteries were harvested for OPCAB. But if we used bilateral Robiscek repair with four to five interlocking figure of eight wires for sternal closure then the rate of sternal complications in the patients with risk factors for sternal dehiscence was not more than the patients without risk factors. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> We can harvest bilateral Internal Mammary Arteries for OPCAB without fear of sternal complications even in patients with high risk for sternal dehiscence if we use bilateral Robiscek repair with four to five interlock
文摘Let m and n be fixed, positive integers and P a space composed of real polynomials in m variables. The authors study functions f ： R →R which map Gram matrices, based upon n points of R^m, into matrices, which are nonnegative definite with respect to P Among other things, the authors discuss continuity, differentiability, convexity, and convexity in the sense of Jensen, of such functions
基金supported by CAPES-Brasilsupported by FAPESP-Brasil(Grant No.2010/19734-6)
文摘This contribution gives results on the action of the Laplace-Beltrami derivative on suffi- ciently smooth kernels on the sphere, those defined by absolutely and uniformly expansions generated by a family of at least continuous functions. Among other things, the results show that convenient Laplace-Beltrami derivatives of positive definite kernels on the sphere are positive definite too. We also include similar results on the action of the Laplace-Beltrami derivative on condensed spherical harmonic expansions.
基金support of the Space Mechanics and Control Division-DMC of ETE(General Coordination of Engineering and Space Technology)of the National Institute for Space Research-INPE.
文摘Electronic components are normally assembled to printed circuit boards (PCBs). Such components generate heat in operation which must be conducted away efficiently from the small mounting areas to frames where the PCB is fixed. The temperature of the component depends on heat dissipation rate, technology and parameters of mounting, component placement and finally effective thermal conductivity (keff) of the board. The temperature of some components may reach significant magnitudes over 100°C while the PCB frame is kept at near-ambient temperature. The reliability of electronic components is directly related to operating temperature;?so the thermal project should be able to provide a correct temperature prediction of all PCB components under the hottest operational condition. In space applications, the main way to spread and reject heat of electronic equipment is by thermal conduction once there is no air available to apply convection-based cooling techniques. The PCB keff is an important parameter for the electronics thermal analysis when the PCB is modeled as a simplified homogeneous board with a unique thermal conductivity. In this paper, an intrinsic uncertainty of such approach is firstly reveled and its magnitude is evaluated for a real space use PCB. The simulation uses SINDA/FLUINT Thermal Desktop and aims to determine the keff of the PCB by comparison between a detailed multi-layered anisotropic model and an equivalent homogeneous single-layer model. The model was validated using available data for two-layered FR4-copper PCB. Multiple simulations are performed with different dissipating component position and mounting area.
