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An Iron Rod Impaling the Axilla with Major Vascular Injury: a Case Report
Get PDFBackground and Objective
Impalement injury is an uncommon cause of vascular trauma; however such spectacular injuries are associated with a high mortality rate and need to be managed by a multidisciplinary medical team at tertiary trauma center. The reported literature is scarce and no available well-written guidelines so that the management plan should be individualized and tailored to the situation at hand. The objective of this case study is to update our experience and protocols to maximize the clinical outcome and minimize the fatality rate of such challenging life-threatening events.
Methods
It is a case report of a 31-year construction worker that sustained an impalement injury when he fell down on an iron rod traversing his left axilla; he was transferred to our hospital with a 90- cm rod in situ. The patient was rapidly resuscitated and investigated preparing him for prompt surgical intervention; the metallic rod was extracted at the theater gently under direct vision with gushing out of blood due to the major vascular injury that was immediately controlled, followed by proper washout and thorough debridement of all devitalized tissues. Then, exploration of the neurovascular bundle at the axilla showed an injury of the axillary vein for which primary repair was successfully performed, but fortunately the axillary artery and brachial plexus were intact. Results: The patient had uneventful postoperative course with no complications and his limb was saved; he is being followed for 14 months up till now.
Conclusion
Major vascular injuries caused by impalement accidents are rare events; however they are challenging and may be fatal. Our current conclusions and recommendations are deficient and we need more updated research work to improve the outcome and decrease the number of deaths. We can acknowledge the end points which include careful and rapid transportation of the patient to a tertiary trauma centre with the impaled objects in situ that should be extracted only at the theater, proper diagnosis and prompt surgical intervention by a multidisciplinary team
Review on Carbon-Graphene Nanocomposite based conductive-ink in printed electronics
Get PDFEnergy is the divesting need of human being to make the life easy going and comfortable. But according to the recent scenario, there will be insufficient source of generating energy. Printed electronics is a new concept of printing technology. PE is safest printing ink technology for securing documentation, for making circuits on different subtracts, less time consuming for making and easily detect if counterfeit. Nanoprint technology with semiconductor materials is in improvising and it has been future trend in energy sector with enhancing various properties of nanomaterials. It has been developed in the area of the digital printing technology by using and combining different nanomaterials. With ever-increasing demand for light-weight, small, and transportable devices, the speed of production of electronic and optoelectronic devices is consistently increasing, and alternatives to the current vital, voluminous, fragile, semi semiconducting and clear materials will inevitably be needed at intervals the long run. This review article explains about the carbon-Graphene nanocomposite based conductive ink, which can be a source in digital printing technology to draw various types of circuits and to make different surface to conductive surfaces. It also describes brief information about carbon and Graphene material individually. It also concludes carbon-graphene nanocomposite based conductive ink in printed electronics technology with several literature surveys.  
A Rare Case of Atypical Formation of Musculocutaneous Nerve not Perforating Coracobrachialis Muscle: Embryological and Clinical Implications
Get PDFAn rare anomaly of the musculocutaneous nerve was detected during routine dissection of the left upper limb of a 42-year-old Turkish male cadaver. Musculocutaneous nerve extend in a common cover together with the lateral cord and lateral root of median nerve without separating from the lateral cord. The lateral and medial roots deriving from their corresponding cords combined ventral to the axillary artery forming a true common trunk of the musculocutaneous nerve and median nerve. The musculocutaneous nerve branched off from the median nerve 0.5 cm distal to the junction of the lateral and medial roots of median nerve. The musculocutaneous nerve traveled between the biceps brachii and coracobrachialis muscles without piercing the coracobrachialis muscle and crossed over the axillary artery. After passing between the biceps brachii and brachialis muscles, the musculocutaneous nerve continued as the lateral cutaneous nerve of the forearm. There was no prominent musculocutaneous nerve branch observed to innervate the coracobrachialis muscle. Very thin nerve branches were observed extending from the lateral cord and musculocutaneous nerve to the oracobrachialis muscle. A connection extending from the proximal part of the lateral cord to the point where the ulnar nerve originated in the distal part of the medial cord was also detected. Knowledge of upper extremity anatomical variations helps surgeons during surgical interventions and treatments to avoid potential iatrogenic injuries during surgery
A Recommender System for Adaptive Examination Preparation using Pearson Correlation Collaborative Filtering
Get PDFDistance learning is any type of far-off instruction where the understudy isn't actually present for the exercise. It is blasting gratitude to the force of the Internet. Distance learning plays a vital role for examination preparation where multiple choice questions can be utilized to evaluate the performance of students. Multiple Choice Question (MCQ) is a type of question used in the examination to evaluate the performance of students accordingly where usually four options are given along with the question, and one has to choose the correct answer. This research includes a simulation model that has been built to keep the learners continue to learn the subjects they might be weak in. We have developed a methodology that may guide a student to update his/her area of weakness by using a recommender system based on Pearson Correlation Collaborative Filtering approach. The paper describes a recommender system that will keep track of a learner's profile and create an adaptive training mechanism using the performance matrix
Effect of Corpora on Classification of Fake News using Naive Bayes Classifier
Get PDFAt the present world, one of the main sources of the news is an online platform like different websites and social media i.e. Facebook, Twitter, Linkedin, Youtube, Instagram and so on. However, due to the lack of proper knowledge or deliberate activity of some cunning people, fake news is spreading more than ever. People in general, struggling to filter which news to trust and which one to discard. Even the sly people take advantage of the situation by spreading false news and misleading the people. Natural Language Processing, one of the major branch of Machine Learning, the wealth of research is remarkable. However, new challenges underpinning this development. Here in this work, Naive Bayes Classifier, a Bayesian approach of Machine Learning algorithm has applied to identify the fake news. We showed, besides the algorithms, how the wealth of corpora can assist to improve the performance. The dataset collected from an open-source, has been used to classify whether the news is authenticated or not. Initially, we achieved classification accuracy about 87% which is higher than previously reported accuracy and then 92% by the same Naive Bayes Algorithm with enriched corpora
Pulmonary Fissures – How do they form?
Get PDFVariations of pulmonary fissures are a factor during pulmonary surgery. Data regarding their development is limited. Early fixation of the visceral pleura seems to be mediated by myofibroblasts and extracellular components like fibronectin. So far, no concepts explain sufficiently the origin of the shape and orientation of these
Development and Investigation of Cost-Sensitive Pruned Decision Tree Model for Improved Schizophrenia Diagnosis
Get PDFSchizophrenia is often characterized by delusions, hallucinations, and other cognitive difficulties, affects approximately seventy million adults globally. This study presents a cost-sensitive pruned Decision Tree J48 model for fast and accurate diagnosis of Schizophrenia. The model implements supervised learning procedures with 10-fold cross-validation resampling method and utilizes unstructured filter to replace missing values in the data with the modal values of corresponding features. Features are selected using Pearson’s correlation on hot-coded data to detect redundancy in data. Cost matrix is designed to minimize the tendencies of the J48 algorithm to predict false negative outcomes. This consequently reduces the error of the model in diagnosing a Schizophrenia candidate as free from the disease. The model is found to significantly diagnose Schizophrenia with 78% accuracy, 89.7% sensitivity, 57.4% specificity and Area under the Receiver Operator Characteristic (ROC) curve of 0.895. The ROC curve is also seen to distinguish Schizophrenia from other conditions with similar symptoms. These results show the potential of machine-learning models for quick, effective diagnosis of schizophrenia
Isolated Metatarsal Artery Balloon Angioplasty for Toe Salvage in Critical Limb Ischemia: A Case Report
No full textPurpose: To report a case of percutaneous balloon angioplasty (PTA) performed in the second metatarsal artery for treatment of a non-healing forefoot wound without proximal intervention.
Methods and Results: An 80-year-old diabetic woman with a 1.5-year history of a non-healing right second digit ulcer refractory to conservative management underwent a lower extremity arteriogram. Angiography demonstrated unobstructed flow from the aortic bifurcation through to the pedal arch, with an isolated occluded segment in the second metatarsal artery wound supply. This was treated with 1.5 mm balloon angioplasty, with completion angiography demonstrating restored flow to the wound base. There were no procedural events and the wound completely healed after 9 months.
Conclusion: Isolated angioplasty of the arteries distal to the pedal arch may be technically feasible and clinically valuable in selected cases
Immunohistochemical Study of C-cells morphology, distribution and localization in the thyroid gland: A pilot study in cadaveric tissue
Get PDFObjective: Exact identification of C-cells in thyroid with defined morphological features, number of cells present in whole population, ratio of parafollicular to follicular cells and localization is a challenge with conventional analysis. A specific and sensitive calcitonin immunohistochemistry is necessary for the demonstration.
Method: Tissue obtained from 30 cadaveric specimens at AIIMS Jodhpur were processed, sectioned and stained for immunohistochemical analysis using calcitonin. The results obtained were also compared with H&E staining for same section.
Results: C-cells were found distributed in both lateral lobes, concentrated around a vertical axis in cranio-caudal direction. It was a randomized distribution with hardly any symmetry. A complete homogeneous distribution of C-cells all over the thyroid was never demonstrated. C-cells were usually concentrated in the middle thirds of the thyroid, and more in the right lobe. Upper third predominantly had more C-cells as compared to lower third of the gland. Incidentally, no C-cells were found in the isthmus in any thyroid at all. When observed for the localization, most of the C-cells were in the interfollicular position.
Conclusion: The present study findings corroborate the use of IHC for C-cell analysis in thyroid gland. Calcitonin proved to be an important diagnostic marker in C-cell identification. Quantification was done reliably, proving calcitonin used in the procedure justified due to its high specificity and affinity
Increased number of major amputations during pandemic could be caused by patients’ fear of COVID-19
Get PDFObjective. To prove or discard the thesis that lessening of number of patients who went to the surgeon’s check-ups even if it led to major amputations of their leg was caused by fear of COVID-19 pandemic.
Methods. A retrospective data analysis in a single institution, a tertiary health care centre.
Results. The data revealed a significant decrease in number of patients who went to the surgeon’s check-up and increase of major amputations in Corona virus period in four months of most actual COVID-19 pandemic time in Croatia.
Conclusion. The patients’ fear of pandemic thesis might best explain this kind of patients’ behaviour