Laryngopharynx is funnel-shaped, wider above & has rich lymphatic supply. These two points are very significant in the management of cancers in this region. These patients present very late, usually in a very poor general condition, often with lymph node metastasis. Many such patients are not fit for major surgery. Advanced cancers can be treated by radical surgery like total laryngopharyngoesophagectomy which solves the swallowing problem. By creating a fistula between the stomach and trachea using a modified Blom-Singer technique, the patient will develop good gastric speech. Radical neck dissection & surgery for thyroid involvement can be combined with the main operation. Gastric pull-up was thought to be not possible earlier. The oesophagus is mobilized by blunt finger dissection from above and from below. Two teams of surgeons operate at the same time, one for the neck for doing total laryngopharyngotomy and, if necessary, radical neck dissection. The second team operates in the abdomen to mobilize the stomach, keeping the right gastroepiploic artery pedicle. Duodenum is mobilized & cocherisation is done. Pyloroplasty is done for drainage purpose. The neck surgeon, by blunt finger dissection, mobilizes the upper part of the thoracic oesophagus and trachea. The abdominal surgeon, by blunt finger dissection, mobilizes the lower oesophagus. Now the two teams work together and the stomach is pulled into the neck through the posterior mediastinum. By bringing the stomach to the neck through the posterior mediastinum, this technique works well, and the stomach, acts as a tamponade to prevent any bleeding in the mediastinum. By using Gluck-Sorensen's incision in the neck, the resulting scar is cosmetically acceptable. In course of time, this method has been used in many centers including ours.
The increasing administrative workload across industries significantly impacts efficiency, productivity, and resource allocation. This study explores the transformative potential of artificial intelligence (AI) in automating administrative processes, with a particular focus on healthcare, education, and finance. By leveraging technologies such as natural language processing (NLP), machine learning (ML), and robotic process automation (RPA), AI can streamline workflows, enhance data accuracy, and reduce human error. Key applications discussed include intelligent document processing, automated form filling, and task scheduling, which collectively minimize repetitive tasks and enable professionals to prioritize strategic decision-making and client interactions. By synthesizing cross-industry AI applications, identifying key governance challenges, and proposing a comprehensive policy roadmap, this study advances AI and policy discourses with actionable strategies for ethically scaling AI-driven automation in administrative workflows.
Background Metabolic syndrome (MetS) constitutes a multifaceted clinical condition characterised by a constellation of metabolic risk factors including central obesity, atherogenic dyslipidemia, elevated blood pressure, and impaired glucose metabolism, which synergistically elevate the risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Rapid shifts in lifestyle have notably elevated the incidence of MetS in India, particularly in urban regions. Yet, sparse comparative data is available regarding the urban-rural differences in MetS prevalence within Tamil Nadu. Thus, this research sought to assess the prevalence of MetS and to identify associated risk factors among adults residing in urban and rural locales of Tamil Nadu. Methods Employing a multistage random sampling approach, this community-centric cross-sectional study encompassed 1,000 adults, evenly divided between urban (n=500) and rural (n=500) settings. Data were gathered through structured face-to-face interviews, anthropometric assessments, and biochemical analyses. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines were utilised to define MetS. Analytical methods included descriptive statistics, chi-square tests, independent samples t-tests, and multivariate logistic regression modelling to pinpoint the critical determinants of MetS. Results The cumulative prevalence of MetS was 31.6% (95% confidence interval (CI): 28.7%-34.6%; 316 participants), with a higher prevalence in urban areas at 34.8% (95% CI: 31.9%-37.8%; 174 participants) compared to 28.4% in rural areas (95% CI: 25.6%-31.3%; 142 participants). The study identified significant predictors of MetS, such as age 40 years or above (adjusted odds ratio (AOR): 2.2, p<0.01), female sex (AOR: 2.8, p<0.01), tobacco smoking (AOR: 2.7, p<0.01), sedentary lifestyle (AOR: 2.7, p=0.02), minimal fruit intake (AOR: 4.4, p=0.01), habitual consumption of fried foods (AOR: 5.3, p=0.01), existing diabetes mellitus (AOR: 3.2, p=0.02), and obesity (AOR: 2.3, p=0.03). Conclusion Urban populations exhibited a higher MetS prevalence, likely attributed to modifiable dietary patterns and lifestyle choices. Regular screening initiatives, lifestyle adjustments, and targeted nutritional interventions emerge as vital preventive and therapeutic measures. Public health strategies should emphasise early detection and encourage behavioural modifications, specifically targeting at-risk populations.
The synthesis of high-performance nanomaterials from agricultural waste is a challenge in green nanotechnology. This study presents the first synthesis of graphene quantum dots (GQDs) from groundnut oil cake (GOC) and Medicago sativa (MS), establishing an eco-friendly platform for biomedical applications. Using a hydrothermal method, we synthesized ultra-small (4.17 nm), monodispersed, hydrophilic GQDs, verified by high-resolution transmission electron microscopy (HR-TEM). The UV–Vis absorption spectra of the synthesized GQDs show distinctive peaks at 257 nm for GQD-GOC and 260 nm for GQD-MS, which correspond to π → π* electronic transitions. At 484 and 460 nm, respectively, these GQDs show emission maxima for excitation-independent photoluminescence (PL). Their well-defined crystalline structure and successful surface functionalization are confirmed by thorough structural and chemical characterizations employing Fourier-transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), atomic force microscopy (AFM), and Raman spectroscopy. Biological evaluations show excellent biocompatibility, with a 100
Background: There have been 20.5 million deaths due to cardiovascular diseases (CVDs), including atherosclerotic coronary artery disease (CAD) and stroke, so far in 2025. Atherosclerosis, which begins in newborns, may be influenced by preconception factors and continues to develop in adults, requiring a proper assessment of the burden of atherosclerotic plaque, as it is the direct cause of CAD. This review aims to emphasize the role of a staging system proposed by the Lancet Commission for the quantification of atherosclerotic coronary artery disease (ACAD) with an emphasis on preconception risk factors and protective factors, based on coronary computed tomography angiography (CCTA). Methods: It is suggested that the use of CCTA scanning makes it possible to quantify the atherosclerotic plaque burden into four stages. Results: CCTA enables us to see how much plaque has built up, as well as the type of plaque, but not the biochemistry of the plaque, to determine its vulnerability. However, if the plaque is a non-calcified fatty plaque, it is considered to be a strong predictor of the risk of myocardial infarction (MI), whereas a more stable calcified plaque is known to be protective against MI. There are several risk factors and protective factors which may influence the process of the rupture or vulnerability of the plaque. A randomized trial revealed that, after a median follow-up of 10·0 years, deaths due to CAD or non-fatal MI were less frequent in the CCTA group compared with a control group. Conclusions: Despite a few gaps in knowledge about the value of a staging system of ACAD, the available evidence indicates that it is helpful in decreasing morbidity and mortality with available therapies.
