The Coimbatore Medical College is a state government-run medical college recognized by the Medical Council of India. It is located in the city of Coimbatore, in Tamil Nadu, India. The hospital attached to the college is located near the railway station and harbours departments like Gastroenterology, Microbiology, Anatomy, Biochemistry, Pharmacology, Pathology, Physiology, Ophthalmology, ENT, SPM, Obstretics and gynecology, Orthopeadics, Pediatrics, Respiratory medicine, Radiology, Diabetology, Surgery, Medicine, Dermatology, Psychiatry, FM etc.
Oral cavity malignancies causing full thickness cheek defects constitute a special group which require meticulous reconstruction post resection in resource limited settings where free flaps are not routinely feasible. We aimed to study the post operative outcome of patients in whom the bipaddled pectoralis major myocutaneous flap was used to reconstruct through and through defects.of the oral cavity. This is a retrospective study in which we analysed data of patients undergoing bipaddled pectoralis major myocutaneous flap reconstruction for full thickness cheek defects in our institute during the period from April 2022 to April 2024. A total of 44 patients with T4a disease underwent bipaddled PMMC flap reconstruction during the two year period. Women constituted 72.7
Large language model (LLM) agents deployed in clinical settings often exhibit abrupt, threshold-driven behavior, offering little visibility into accumulating risk prior to escalation. In real-world care, however, clinicians act on gradually rising concern rather than instantaneous triggers. We study whether explicit state dynamics can expose such pre-escalation signals without delegating clinical authority to the agent. We introduce a lightweight agent architecture in which a memoryless clinical risk encoder is integrated over time using first- and second-order dynamics to produce a continuous escalation pressure signal. Across synthetic ward scenarios, stateless agents exhibit sharp escalation cliffs, while second-order dynamics produce smooth, anticipatory concern trajectories despite similar escalation timing. These trajectories surface sustained unease prior to escalation, enabling human-in-the-loop monitoring and more informed intervention. Our results suggest that explicit state dynamics can make LLM agents more clinically legible by revealing how long concern has been rising, not just when thresholds are crossed.
A polyvinyl alcohol (PVA) film loaded with Centella Asiatica (CA) extracts was made for wound healing applications. The film was produced using solvent casting and analysed for its phytochemical, chemical compositions, morphology, mechanical properties, drug release, and biocompatibility. The HPLC showed that quercetin and other active ingredients were present, and FTIR confirmed strong hydrogen bonding between CA and PVA. The degrees film displayed a contact angle of 86.60 , indicating hydrophilicity crucial for cellular attachment and moisture retention. Mechanical testing revealed a tensile strength of 3.54 MPa and an elongation of 17.09 %, confirming the film's durability and flexibility. The film demonstrated 91 % wound healing at a concentration of 100 mu g/mL, and cell toxicity tests revealed that more than 88 % of the cells remained alive, indicating high compatibility with living tissue. In vivo confirmation showed rapid wound contraction, whereas histological investigation revealed substantial collagen deposition and fibroblast proliferation in the treated groups. The drug release profile demonstrated a biphasic pattern characterised by anomalous (non-Fickian) diffusion behaviour. These results highlight the CA-PVA film as a promising wound dressing with suitable biological activity, biocompatibility, and mechanical strength.
Fahr’s syndrome is a rare neurological disorder characterized by bilateral intracranial calcifications, most commonly affecting the basal ganglia, dentate nucleus, and thalamus. Unlike primary familial brain calcification, which is genetic, Fahr’s syndrome occurs secondary to identifiable metabolic or endocrine abnormalities, most commonly hypoparathyroidism. We report a case of a 36-year-old female who presented with signs of hypocalcemia and who had a history of thyroidectomy, with imaging showing extensive bilateral basal ganglia and white matter calcifications. Fahr’s syndrome should be considered a potential complication of thyroidectomy. Early diagnosis using computed tomography imaging to identify calcifications, along with calcium and Vitamin D supplementation, is associated with improved outcomes. A multidisciplinary approach is important to monitor clinical features and manage the condition effectively.
