Background: Pain could lead to an increased consumption of opioids intraoperatively as well as postoperatively with subsequent side effects and prolonged post-operative recovery. Transverse abdominus plain (TAP) block is commonly used for post-operative analgesia. We wanted to study the effect of TAP block, when given as pre-emtive analgesia. Aims and Objectives: The study was conducted to ascertain the benefit TAP block when given before surgical incision. The primary objective was to study the intraoperative fentanyl requirement in patients undergoing Laparoscopic gynecological surgeries. The secondary objectives was to analyze the Intra-operative hemodynamic parameters, time needed to extubate the patient, sedation score, visual analog scale (VAS) scores, and the time of first rescue analgesia. Materials and Methods: Sixty-two eligible female patients posted for total laproscopic hysterectomy or Laproscopic-assisted Vaginal Hysterectomy coming were divided into two groups. Group A – Standard General Anaesthesia with pre-operative TAP block. Group B- Standard General Anaesthesia. Whenever there was 15% rise in heart rate (HR) or mean blood pressure (MBP) above the baseline, 20 mcg bolus of fentanyl was given. Total intra-operative Fentanyl consumption, intraoperative HR and MBP, time needed to extubate, post-operative sedation, VAS score, and time of first rescue analgesia was noted. Results: There was no difference in the demographic profile between two groups. The mean intraoperative fentanyl required was significantly higher in Group B (140.33±12.17 mcg) than in Group A (101.33±5.07 mcg). HR and MBP were lower in Group A throughout the procedure. The mean time of extubation was 5.4 min and 15.77 min in Group A and B. The mean sedation score observed was significantly higher up to 30 min in Group B. Mean Time of first rescue analgesia in Group A was 452.90±110.46 min and Group B was 240±89.13 min. Conclusion: Pre-operative TAP block given in laparoscopic gynecological surgeries decreases intraoperative fentanyl consumption leading to early extubation and causes less sedation in early post-operative period.

Background: Brachial plexus block is a key technique in anesthesiologist’s practice. Ropivacaine is a long acting local anaesthetic, Dexmedetomidine has been included as an adjuvant to enhance block duration. Aim: To elucidate the effect of addition of Dexmedetomidine to Ropivacaine in ultrasound guided parasagittal supraclavicular brachial plexus approach with respect to duration of analgesia, onset and duration of sensorimotor blockade. Methods: A randomized single blinded prospective clinical study was conducted among Forty patients of 20-50yrs, ASA Grade I and II, weighing >60kgs scheduled for elective upper limb orthopedic surgeries. Group RN received 25ml of 0.75% ropivacaine with 1ml normal saline, Group RD received 25ml of 0.75% ropivacaine with 1mcg/kg dexmedetomidine diluted to 1ml. Analgesic efficacy, sensorimotor blockade was determined. Statistical Analysis: Demographic and hemodynamic data was analyzed using student t-test. Unpaired t-test was used to analyze onset, duration of sensorimotor blockade and analgesic duration. Results were statistically significant if p-value <0.05. P-value <0.001 was considered highly significant. Results: Analgesic duration was prolonged in Group RD rather than Group RN (646.82 +/- 21.56min vs 484.78 +/- 15.52min). Group RD had rapid onset of sensory (7.4 +/- 1.02min vs 9.9 +/- 1.16min) and motor blockade (10.25 +/- 1.13min vs 13.28+/- 1.22min). Duration of sensory (536.62 +/- 9.61min vs 413.79 +/- 15.61min) and motor blockade (430.13 +/- 11.68min vs 298.12 +/- 15.36min) was enhanced in Group RD. Conclusion: Adding Dexmedetomidine to Ropivacaine provided superior analgesia along with rapid onset and longer duration of sensorimotor blockade.

Innovation is something original, more effective, and, as a consequence, new, that “breaks into” the market or society, by development and implementation of a new product, process, or service, with the aim of improving efficiency, effectiveness, or competitive advantage. Entrepreneurship, by contrast, is applying the innovation to bring the ideas to life. It is a social invention, which lets people do what they could not previously do. Health-care delivery is a complex subject, which determines whether a government succeeds in improving the health of the nation or not. In this article, we will be talking on the innovations – specifically financial innovations as applicable to neonatal care, pregnancy care, and pediatrics – as this can make a huge impact on our everyday life.

Super-resolution (SR) image reconstruction is the process ofcombining several low resolution images into a single higherresolution image or Generating high resolution image from a single low resolution image. There is a driving need for digital images ofhigher resolutions and quality.In order to improvethe resolution and perceptual quality of such web image/video, webring forward a sensible solution which mixes adaptive regularization and learning-based super-resolution. The contributionof this work is twofold. First, we tend to propose to research the imageenergy modification characteristics during the iterative regularizationprocess, i.e., the energy change magnitude relation between primitive (e.g., edges, ridges and corners) and non-primitive fields supported therevealed convergence property of the energy modification magnitude relation, acceptable regularization strength will then be determined to wellbalance compression artifacts removal and primitive elementspreservation. Second, we tend to verify that this adaptive regularizationcan steady and greatly improve the try matching accuracy inlearning-based super-resolution.

Occupational exposure is unregulated in developing countries like India, and becoming the most common cause of disease of environmental origin. The present study was aimed to investigate the effects of occupational exposure on plasma lipid profiles, and risk of cardiovascular diseases. A total of 79 human volunteers were included in the study. Control subjects were healthy housewives of Karimnagar, India. Occupationally exposed individuals included different occupational workers like petrol station attendants, battery chargers, drivers, welders, pesticide-exposed workers, painters, and auto mechanics. These subjects were shown to be chronic occupationally-exposed for at least three years, and neither associated with any other chronic pathological conditions like hypertension or diabetes, nor under any medication other than analgesics during the month preceding the study. Subjects with excessive high or low caloric intake were excluded from the study. Total cholesterol (TC), LDL cholesterol, triglycerides (TG), VLDL cholesterol, LDL/HDL cholesterol, and TC/HDL ratio in these subjects were significantly higher than those in control subjects, whereas HDL cholesterol was not markedly affected. Blood pressure (systolic and diastolic), and other anthropometric parameters (body mass index (BMI), body fat index (BFI), body surface area (BSA)) were not significantly different between groups. Data suggest that chronic occupational exposure increases plasma lipid levels and is thereby associated with cardiovascular complications.

Research on ultrasonography and elastography instrumentation is crucially dependent on the quality of tissue-mimicking phantoms on which the instrumental parameters are tested. The phantoms should ideally possess values of various acoustic parameters corresponding to normal and abnormal tissues of different types and these properties should not change significantly with time. Designing such phantoms requires a molecular level understanding of the material to be used. In this context, polyacrylamide gels made from corresponding monomer, initiator and cross-linker were developed. An understanding of the network structure of these hydrogels at the molecular level was made possible using fluorescence spectroscopy with anilinonaphthylsulfonate as an extrinsic fluorescent probe. TiO2 was used to adjust the acoustic transparency so as to bring the ultrasound reflection parameters close to those of human tissues. It was found that the network structure of poly-acrylamide (PAM) hydrogels as well as their acoustic and viscoelastic properties could be conveniently varied by altering the composition of the components. This understanding at the molecular as well as the bulk level was then used to develop tissue phantoms appropriate for imaging in ultrasound-B and elastography modes.

The design and development of computer aided diagnosis (CAD) systems is done based on the features extracted from medical images. It will be appropriate to combine the information obtained from different images for better diagnosis. Diagnosis capability of ultrasound elastography and echography are analysed using the images obtained from tissue mimicking phantoms and patient images. The results of this analysis can be used to select the feature set for the design of CAD system for the diagnosis of solid lesions. Ultrasound B mode and elastography images were obtained from the commercial available scanner. Parameters are extracted from the analysis of these images.

Objective— To examine variants at the 9p21 locus in a case-control study of acute myocardial infarction (MI) in Pakistanis and to perform an updated meta-analysis of published studies in people of European ancestry. Methods and Results— A total of 1851 patients with first-ever confirmed MI and 1903 controls were genotyped for 89 tagging single-nucleotide polymorphisms at locus 9p21, including the lead variant ( rs1333049 ) identified by the Wellcome Trust Case Control Consortium. Minor allele frequencies and extent of linkage disequilibrium observed in Pakistanis were broadly similar to those seen in Europeans. In the Pakistani study, 6 variants were associated with MI ( P <10 −2 ) in the initial sample set, and in an additional 741 cases and 674 controls in whom further genotyping was performed for these variants. For Pakistanis, the odds ratio for MI was 1.13 (95% CI, 1.05 to 1.22; P =2×10 −3 ) for each copy of the C allele at rs1333049 . In comparison, a meta-analysis of studies in Europeans yielded an odds ratio of 1.31 (95% CI, 1.26 to 1.37) for the same variant ( P =1×10 −3 for heterogeneity). Meta-analyses of 23 variants, in up to 38 250 cases and 84 820 controls generally yielded higher values in Europeans than in Pakistanis. Conclusion— To our knowledge, this study provides the first demonstration that variants at the 9p21 locus are significantly associated with MI risk in Pakistanis. However, association signals at this locus were weaker in Pakistanis than those in European studies.

Background— Evidence is sparse about the genetic determinants of major lipids in Pakistanis. Methods and Results— Variants (n=45 000) across 2000 genes were assessed in 3200 Pakistanis and compared with 2450 Germans using the same gene array and similar lipid assays. We also did a meta-analysis of selected lipid-related variants in Europeans. Pakistani genetic architecture was distinct from that of several ethnic groups represented in international reference samples. Forty-one variants at 14 loci were significantly associated with levels of HDL-C, triglyceride, or LDL-C. The most significant lipid-related variants identified among Pakistanis corresponded to genes previously shown to be relevant to Europeans, such as CETP associated with HDL-C levels (rs711752; P <10 −13 ), APOA5/ZNF259 (rs651821; P <10 −13 ) and GCKR (rs1260326; P <10 −13 ) with triglyceride levels; and CELSR2 variants with LDL-C levels (rs646776; P <10 −9 ). For Pakistanis, these 41 variants explained 6.2%, 7.1%, and 0.9% of the variation in HDL-C, triglyceride, and LDL-C, respectively. Compared with Europeans, the allele frequency of rs662799 in APOA5 among Pakistanis was higher and its impact on triglyceride concentration was greater ( P -value for difference <10 −4 ). Conclusions— Several lipid-related genetic variants are common to Pakistanis and Europeans, though they explain only a modest proportion of population variation in lipid concentration. Allelic frequencies and effect sizes of lipid-related variants can differ between Pakistanis and Europeans.

Many ailments and/or malfunctions of the body have been observed to change the viscous behavior and elastic properties of biological soft tissues. The technique of elastography has evolved to image such properties. The clinical evidence gathered during studies involving elastography to identify cancerous lesions is very promising. However, the quantification of the resolution and specificity of elastography is best achieved under a controlled study using tissue-mimicking phantoms. One challenge is to reproduce viscoelastic behavior in phantoms as observed in biological tissues. In this paper, polyacrylamide gel based tissue-mimicking phantoms have been developed to experimentally study the role of viscoelastic properties in a controlled manner. To measure the Young's modulus, the phantoms were subjected to linear loading, and the stress-strain relationship is deduced therefrom. It is seen that the phantoms show hysteresis behavior. The viscoelastic properties of these phantoms were measured by subjecting the samples to cyclic loading. Normal forces during this process of loading were also measured as a measure of sample elasticity. To emulate the normal and pathological lesions, samples were prepared with varying concentration of monomer and studied. Three models, namely, Maxwell, Kelvin-Voigt (KV), and Kelvin-Voigt fractional derivative (KVFD), were chosen to fit the experimental data. Of these, the KVFD model was found to be best fitting for the experimental data obtained. Results indicate that stiffer samples exhibit large variations in the storage modulus when the precompression levels are altered.

Due to the isoechoic nature of lesions and their poor contrast with neighbouring tissue, a lesion may remain undetected in ultrasound B mode imaging for cancerous tissue. Imaging of the elastic properties of tissue provides new information which is collateral to tissue pathology. This study provides quantitative analysis of improvements in tumour diagnosis when the ultrasound B mode imaging is combined with elastography. Quantification was based on the textural parameters measured from the ultrasound B mode image and strain measured from the elastogram. The ability of a parameter to discriminate between diseased cases and normal cases was evaluated using receiver operating characteristic (ROC) analysis. Polyacrylamide gel based tissue mimicking phantoms with embedded inclusions of varying stiffness were used for the analysis.

Most biological soft tissues exhibit viscous behavior in addition to their well known elastic properties. Polyacrylamide gel based tissue mimicking phantoms have been developed. The viscoelastic properties of these phantoms were measured by subjecting the samples to cyclic loading. Samples prepared with varying concentration of monomer were considered so as to cover the normal and pathological lesions. Results obtained in the measurement are fit to three models - Maxwell, Kelvin-Voigt (KV) and Kelvin-Voigt fractional derivative (KVFD) models, in order to determine the best fitting model. KVFD model is found to be best fitting model for the experimental data obtained.

Many lesions remain undetected in normal ultrasound B mode imaging of cancerous tissues because of their isoechoic nature and poor contrast. Imaging of the elastic properties of tissue provides new information which is correlated with tissue pathology. A quantitative analysis of the improvement in the diagnosis of the tumor by combining the ultrasound B mode imaging and elastography is carried out. Quantification is based on the textural parameters measured from the ultrasound B mode image and strain measured from the elastogram. Polyacrylamide gel based tissue mimicking phantoms were used for the analysis.

Polyacrylamide based tissue mimicking phantom with embedded cysts is designed and analyzed for better understanding of cyst elastograms. Cysts filled with different fluids of varying density and bulk moduli are embedded in the phantom. Characterization is done based on parameters measured from the ultrasound B mode and elastogram of the cystic lesions. Such a phantom can serve as tool for better understanding of the elastographic appearance of cysts. Thus simple and complex cysts can be easily distinguished. It can also be used to teach a complex procedure like ultrasound guided fine needle aspiration.

A method to estimate the risk of heart disease in a person, based on diagnostic ultrasound is proposed here. The "vascular age" obtained from carotid ultrasound is very commonly used as a measure of cardiac health. Existing methods of vascular age estimation make use of the Carotid Intima Media Thickness (CIMT) measurements to arrive at an estimate of the vascular age. Recent work has demonstrated that the carotid inter adventitial distance (CAD) has a direct relation with the risk of coronary heart disease in persons. It has also been demonstrated that CAD correlates better to a number of risk factors accounting for heart disease than the CIMT. Hence, we propose a method to estimate vascular age based on CAD. B mode images of the carotid artery are analyzed to find out the carotid inter adventitial distance. The vascular age is estimated from carotid diameter using a statistical model developed based on the Atherosclerosis Risk In Communities Limited access database. This vascular age is then used to modify standard risk assessment procedures like the Framingham risk equation to give a better estimate of coronary heart disease risk. A comparison of the method with the CIMT based method is also performed.

The short circuit test in a power transformer is a special test that establishes confidence in the designer and user in the integrity of the winding. Conventional tests rely on the measurement of reactance before and after the test in order to assess failure. We propose alternative method on a cycle to cycle basis based on continuous evaluation of certain phasors as well as real and reactive power measurement. Further we propose model tests based on FEM analysis of windings in conjunction with video recordings. The objective is to establish a design margin for the withstand capability at the laboratory stage which will be more instructive than mere Go/No-Go tests. The method will also directly useful in situations where a complete transformer cannot be tested due test facility limitations. All the proposed methods are demonstrated through tests on windings.