The literature regarding the different patterns of atlas and axis injuries and their appropriate ... more The literature regarding the different patterns of atlas and axis injuries and their appropriate management and the progressive development in the management of these injuries is scarce from our world, so we presenting here our experience of management of these injuries by applying Halovest. Thirty patients (22 males, 8 females) with atlas and axis injuries were treated and then followed-up for an average of 24 months. The data was analysed with respect to type of injury and use of Halovest in the treatment of these injuries. The patients with neuro defecit were scored as per ASIA grading scale (from Grade A to Grade E). The halo-vest immobilization was used for a mean period of 12 ± 3weeks (range 9 to 15 weeks) for atlas and axis injuries. Four patients had neurodeficit. Two patients recovered from ASIA Grade C to ASIA Grade D. One patient improved from ASIA grade D to ASIA grade E while as one patient with neurodeficit was lost to follow up. No death or worsening of the neurodefic...
Optimization of a passive vehicle suspension system for ride comfort enhancement with different s... more Optimization of a passive vehicle suspension system for ride comfort enhancement with different speeds based on DOE method
Aneurysmal bone cyst (ABC) of the talus is an extremely rare lesion; less than 20 cases have been... more Aneurysmal bone cyst (ABC) of the talus is an extremely rare lesion; less than 20 cases have been reported in PubMed till 2012. Although benign, it has a locally aggressive behaviour making it difficult from diagnostic and therapeutic point of view. It becomes even more challenging when presented at unusual sites. Here is reported a rare case of primary ABC of talus in a 19 year male treated by curettage and autologous iliac crest bone grafting. The patient has excellent functional outcome within 6 months of follow up.
World Academy of Science, Engineering and Technology, International Journal of Mechanical, Aerospace, Industrial, Mechatronic and Manufacturing Engineering, 2017
In this study, a validated 3D finite volume model of human eye is developed to study the fluid fl... more In this study, a validated 3D finite volume model of human eye is developed to study the fluid flow and heat transfer in the human eye at steady state conditions. For this purpose, discretized bio-heat transfer equation coupled with Boussinesq equation is analyzed with different anatomical, environmental, and physiological conditions. It is demonstrated that the fluid circulation is formed as a result of thermal gradients in various regions of eye. It is also shown that posterior region of the human eye is less affected by the ambient conditions compared to the anterior segment which is sensitive to the ambient conditions and also to the way the gravitational field is defined compared to the geometry of the eye making the circulations and the thermal field complicated in transient states. The effect of variation in material and boundary conditions guides us to the conclusion that thermal field of a healthy and non-healthy eye can be distinguished via computer simulations. Keywords—B...
INTRODUCTION The clean bedding and clean clothes installs psychological confidence in the patient... more INTRODUCTION The clean bedding and clean clothes installs psychological confidence in the patients and the public and enhances their faith in the services rendered by the hospital. Being an important Component in the management of the patients, a study was carried out to find out the current quality status and its conformity with the known standards and identify the areas of intervention in order to further increase the patient and staff satisfaction regarding the services provided by linen and laundry department METHODS Quality control practised in the Linen and Laundry Service was studied by conducting a prospective study on the concept of Donabedian model of structure, process and outcome. Study was done by pre-designed Proforma along with observation / Interviews / Questionnaire and study of records. The input studied included physical facilities, manpower, materials, equipments and environmental factors. The various elements of manpower studied consisted of number of staff work...
Self-harming behaviors include cutting, burning, needle sticking, and severe scratching. Self-mut... more Self-harming behaviors include cutting, burning, needle sticking, and severe scratching. Self-mutilation usually serves a different purpose than attempting at killing one’s self. Self-mutilators report that they do this behavior to escape from emotional pain, release anger, slow racing thoughts, end episodes of dissociation, or have a sense of control. Only 122 cases of genital self-mutilation have been reported till 2006. Herein, we report a case of selfamputation of right testis in an adolescent.
Thirteen cases of infected non union of tibia were treated by tibialisation of fibula. The durati... more Thirteen cases of infected non union of tibia were treated by tibialisation of fibula. The duration of non union ranged from 3 to 24 months. There was a preexisting gap ranging from 2 to 7 cm. The operation consisted of first stage of Huntington’s two stage procedure of fibular transfer. All the cases except 2 (15.38 percent) showed fracture union. The time taken for fracture union ranged from 5 to 10 months. Anterior bowing of tibia without adding to the morbidity was observed in few cases.
Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 2012
Aneurysmal bone cyst (ABC) of the talus is an extremely rare lesion; less than 20 cases have been... more Aneurysmal bone cyst (ABC) of the talus is an extremely rare lesion; less than 20 cases have been reported in PubMed till 2012. We report a primary ABC of the talus in a 20-year-old male that was managed by extended intralesional curettage with phenol as an adjuvant and autologous cancellous iliac crest bone grafting. The patient had excellent functional outcome and there was no recurrence at 2 years of follow-up.
This prospective study was conducted in the Post Graduate Department of Orthopaedics, Government ... more This prospective study was conducted in the Post Graduate Department of Orthopaedics, Government Medical College Jammu, India from November 2007 to October 2008 and included twenty cases, 19 males and 1 female in the age group of 20 60 years with various disorders of cervical spine who underwent anterior decompression and fusion using TCI graft and CSLP. Results were evaluated as neurological improvement according to Frankel’s grading, bony fusion achieved at final follow-up and rate of complications. Eighteen out of 20 (90%) patients showed neurological improvement, with 10 (50%) patients showing complete neurological recovery. A stable bony fusion was achieved in all the cases. Two patients suffered from dysphagia, urinary tract infection and bed sores were seen in 2 patients and one developed joint contractures. There were no instances of surgical or hardware related complication.
Nine cases of avascular necrosis of femoral head probably caused by long term steroid therapy, ar... more Nine cases of avascular necrosis of femoral head probably caused by long term steroid therapy, are reported here. All but two cases received steroid therapy over periods ranging from 11/2 to 17 years for diseases like systemic lupus erythematosus, thrombocytopic pupura, cancer chemotherapy, etc. Most of the cases exhibited bilateral involvement, one hip following the other over a period of 9 months to 4 years.
International Journal of Health Sciences and Research, 2014
Objective: The decision of internal fixation in Gustilo's Type IIIA becomes a formidable chal... more Objective: The decision of internal fixation in Gustilo's Type IIIA becomes a formidable challenge in patients reaching late. The purpose of the present study was to find out results of intramedullary interlocking nailing in these patients. Materials and Methods: Twenty five compound IIIA fractures, which were internally fixed within 24h after injury, were included in the present analysis. Follow-up ranged from 12 to24 months. Mean follow-up was 18 months. Result: Superficial infection was found in 12 patients and deep infection was found in 6 patients. Non-union was found in 2 cases. Functional evaluation using Katenjian's criteria showed 60% (15) fractures have good to excellent results. Conclusion: Up gradation of the infrastructure is needed in the developing country to obtain satisfactory results of interlocking nailing in Gustilo's Type IIIA fracture tibia in emergency department, strict protocol such as aggressive debridement, prophylactic antibiotic coverage, and...
OF DISSERTATION A COMPUTATIONAL STUDY OF PATCH IMPLANTATION AND MITRAL VALVE MECHANICS Myocardial... more OF DISSERTATION A COMPUTATIONAL STUDY OF PATCH IMPLANTATION AND MITRAL VALVE MECHANICS Myocardial infarction (i.e., a heart attack) is the most common heart disease in the United States. Mitral valve regurgitation, or the backflow of blood into the atrium from the left ventricle, is one of the complications associated with myocardial infarction. In this dissertation, a validated model of a sheep heart that has suffered myocardial infarction has been employed to study mitral valve regurgitation. The model was rebuilt with the knowledge of geometrical changes captured with MRI technique and is assigned with anisotropic, inhomogeneous, nearly incompressible and highly non-linear material properties. Patch augmentation was performed on its anterior leaflet, using a simplified approach, and its posterior leaflet, using a more realistic approach. In this finite element simulation, we virtually installed an elliptical patch within the central portion of the posterior leaflet. To the best o...
In a prospective study conducted in the Postgraduate Department of Orthopaedics Govt. Medical Col... more In a prospective study conducted in the Postgraduate Department of Orthopaedics Govt. Medical College, Jammu, over a period of 2 years. Forty cases, both male and female in the age group of 20 to 50 years with thoracolumbar spinal injury between D11 and L2 vertebra with neurological deficit were included . Out of these forty cases, 20 cases were managed by posterior decompression and stabilization with Steffee plating and 20 cases of similar injuries were managed conservatively and comparison of the two groups was made. The results were analyzed according to neurological improvement as per Frankel's grading, the complications and the duration of hospital stay in both the groups. In operative group; 50% of the patients showed some degree of recovery with 30% of the patients showed full recovery. The mean postoperative correction of kyphosis was 12.5% and the average hospital stay was 23.7days. 15% of the patients in operated group developed complications. In the conservative grou...
Injuries to Lisfranc complex are infrequent, usually a result of high energy trauma. Upto 20% of ... more Injuries to Lisfranc complex are infrequent, usually a result of high energy trauma. Upto 20% of these go unrecognized initially and can have significant long term consequences. Complete isolated dislocation of cuboid is extremely rare. When present, it is usually in conjunction with the complex injuries of hindfoot and midfoot.We report a case of 30yr old male, presenting to the emergency room after having sustained a motor vehicle accident with injury to right foot and ankle region.The injury was diagnosed to be Lisfranc injury with associated cuboid dislocation, the latter part was missed initially. Lisfranc injury is most commonly associated with second metatarsal fracture but rarely it can also be associated with cuboid dislocation which can be easily missed on initial evaluation. High suspicion of this type of injury should be present following high energy trauma as it can result in prolonged recovery and significant long term morbidity.
Maintaining a patent airway is the first principle of resuscitation and life support. Successful ... more Maintaining a patent airway is the first principle of resuscitation and life support. Successful intubation with the appropriate size endotracheal tube (ETT) is more difficult in children than adults. Use of inappropriate size of ETT can cause significant morbidity and mortality. Visualization of the pediatric airway diameter with the help of ultrasound can enable anesthesiologist to better predict ETT size and it will prevent unnecessary tube changes and airway trauma. Hence, we undertook this study to assess accuracy of USG guided tracheal diameter measurement in predicting ETT size in pediatric patients and its comparison with that determined by age-based formula and diameter of little finger. A total of 50 patients aged between 2 and 6 years were included in this study from July 2017 to June 2018. Agreement between actual ETT inserted and ETT estimation by diameter of little finger, age-based formula and ultrasonography was calculated by using kappa statistics. ETT measurement b...
Introduction: This study was undertaken in Indira Gandhi Medical College, Shimla to evaluate anti... more Introduction: This study was undertaken in Indira Gandhi Medical College, Shimla to evaluate antibiotic sensitivity patterns of various microbes isolated from patients in general Intensive Care Unit. Thus it would serve as a guide to institute empirical antibiotic therapy. Materials and methods: All patients admitted to general ICU with Endotracheal tube (ETT) in situ were included in this observational study. Those with ETT in place for more than 24 h were excluded from the study. ETT culture samples were collected at 36-48 h and on seventh day of intubation. Culture report and antibiotic susceptibility profile were observed and data hence collected were evaluated. Results: Out of the total 946 ET culture samples studied 533 (56.3%) showed growth of microorganisms. The number of ET culture isolates increased as the days of intubation increased, i.e., from 45.33% on second day to 70.07% on seventh day. NFG, Klebsiella spp. and Pseudomonas spp. contributed to more than 70% of the ET ...
Mobile Ad-hoc Network has broad impact on research area from past two eras. Its structure less es... more Mobile Ad-hoc Network has broad impact on research area from past two eras. Its structure less establishment and flexibility increases its growth of attention in the field of Ad hoc network. MANET is defined as instant alteration in network topology and constrained energy. Clustering is useful to make network more efficient and scalable in MANET. In MANET nodes are continuously change their location due to mobility nature. Hence it became challenging task to manage them while preserving the energy. Many clustering algorithms and protocols are proposed to overcome these lacks and to make the network more stable and trusted. In this paper we describe the most prominent aspect related to the MANET . The motive of this paper compared and analyzed different clustering algorithms under different parameters such as Reputation, Misbehavior detection, Energy efficient and mobility of node. Keywords— MANET, Security, Clustering, Mobility, Efficiency, Stability, Misbehavior, Overhead.
The literature regarding the different patterns of atlas and axis injuries and their appropriate ... more The literature regarding the different patterns of atlas and axis injuries and their appropriate management and the progressive development in the management of these injuries is scarce from our world, so we presenting here our experience of management of these injuries by applying Halovest. Thirty patients (22 males, 8 females) with atlas and axis injuries were treated and then followed-up for an average of 24 months. The data was analysed with respect to type of injury and use of Halovest in the treatment of these injuries. The patients with neuro defecit were scored as per ASIA grading scale (from Grade A to Grade E). The halo-vest immobilization was used for a mean period of 12 ± 3weeks (range 9 to 15 weeks) for atlas and axis injuries. Four patients had neurodeficit. Two patients recovered from ASIA Grade C to ASIA Grade D. One patient improved from ASIA grade D to ASIA grade E while as one patient with neurodeficit was lost to follow up. No death or worsening of the neurodefic...
Optimization of a passive vehicle suspension system for ride comfort enhancement with different s... more Optimization of a passive vehicle suspension system for ride comfort enhancement with different speeds based on DOE method
Aneurysmal bone cyst (ABC) of the talus is an extremely rare lesion; less than 20 cases have been... more Aneurysmal bone cyst (ABC) of the talus is an extremely rare lesion; less than 20 cases have been reported in PubMed till 2012. Although benign, it has a locally aggressive behaviour making it difficult from diagnostic and therapeutic point of view. It becomes even more challenging when presented at unusual sites. Here is reported a rare case of primary ABC of talus in a 19 year male treated by curettage and autologous iliac crest bone grafting. The patient has excellent functional outcome within 6 months of follow up.
World Academy of Science, Engineering and Technology, International Journal of Mechanical, Aerospace, Industrial, Mechatronic and Manufacturing Engineering, 2017
In this study, a validated 3D finite volume model of human eye is developed to study the fluid fl... more In this study, a validated 3D finite volume model of human eye is developed to study the fluid flow and heat transfer in the human eye at steady state conditions. For this purpose, discretized bio-heat transfer equation coupled with Boussinesq equation is analyzed with different anatomical, environmental, and physiological conditions. It is demonstrated that the fluid circulation is formed as a result of thermal gradients in various regions of eye. It is also shown that posterior region of the human eye is less affected by the ambient conditions compared to the anterior segment which is sensitive to the ambient conditions and also to the way the gravitational field is defined compared to the geometry of the eye making the circulations and the thermal field complicated in transient states. The effect of variation in material and boundary conditions guides us to the conclusion that thermal field of a healthy and non-healthy eye can be distinguished via computer simulations. Keywords—B...
INTRODUCTION The clean bedding and clean clothes installs psychological confidence in the patient... more INTRODUCTION The clean bedding and clean clothes installs psychological confidence in the patients and the public and enhances their faith in the services rendered by the hospital. Being an important Component in the management of the patients, a study was carried out to find out the current quality status and its conformity with the known standards and identify the areas of intervention in order to further increase the patient and staff satisfaction regarding the services provided by linen and laundry department METHODS Quality control practised in the Linen and Laundry Service was studied by conducting a prospective study on the concept of Donabedian model of structure, process and outcome. Study was done by pre-designed Proforma along with observation / Interviews / Questionnaire and study of records. The input studied included physical facilities, manpower, materials, equipments and environmental factors. The various elements of manpower studied consisted of number of staff work...
Self-harming behaviors include cutting, burning, needle sticking, and severe scratching. Self-mut... more Self-harming behaviors include cutting, burning, needle sticking, and severe scratching. Self-mutilation usually serves a different purpose than attempting at killing one’s self. Self-mutilators report that they do this behavior to escape from emotional pain, release anger, slow racing thoughts, end episodes of dissociation, or have a sense of control. Only 122 cases of genital self-mutilation have been reported till 2006. Herein, we report a case of selfamputation of right testis in an adolescent.
Thirteen cases of infected non union of tibia were treated by tibialisation of fibula. The durati... more Thirteen cases of infected non union of tibia were treated by tibialisation of fibula. The duration of non union ranged from 3 to 24 months. There was a preexisting gap ranging from 2 to 7 cm. The operation consisted of first stage of Huntington’s two stage procedure of fibular transfer. All the cases except 2 (15.38 percent) showed fracture union. The time taken for fracture union ranged from 5 to 10 months. Anterior bowing of tibia without adding to the morbidity was observed in few cases.
Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 2012
Aneurysmal bone cyst (ABC) of the talus is an extremely rare lesion; less than 20 cases have been... more Aneurysmal bone cyst (ABC) of the talus is an extremely rare lesion; less than 20 cases have been reported in PubMed till 2012. We report a primary ABC of the talus in a 20-year-old male that was managed by extended intralesional curettage with phenol as an adjuvant and autologous cancellous iliac crest bone grafting. The patient had excellent functional outcome and there was no recurrence at 2 years of follow-up.
This prospective study was conducted in the Post Graduate Department of Orthopaedics, Government ... more This prospective study was conducted in the Post Graduate Department of Orthopaedics, Government Medical College Jammu, India from November 2007 to October 2008 and included twenty cases, 19 males and 1 female in the age group of 20 60 years with various disorders of cervical spine who underwent anterior decompression and fusion using TCI graft and CSLP. Results were evaluated as neurological improvement according to Frankel’s grading, bony fusion achieved at final follow-up and rate of complications. Eighteen out of 20 (90%) patients showed neurological improvement, with 10 (50%) patients showing complete neurological recovery. A stable bony fusion was achieved in all the cases. Two patients suffered from dysphagia, urinary tract infection and bed sores were seen in 2 patients and one developed joint contractures. There were no instances of surgical or hardware related complication.
Nine cases of avascular necrosis of femoral head probably caused by long term steroid therapy, ar... more Nine cases of avascular necrosis of femoral head probably caused by long term steroid therapy, are reported here. All but two cases received steroid therapy over periods ranging from 11/2 to 17 years for diseases like systemic lupus erythematosus, thrombocytopic pupura, cancer chemotherapy, etc. Most of the cases exhibited bilateral involvement, one hip following the other over a period of 9 months to 4 years.
International Journal of Health Sciences and Research, 2014
Objective: The decision of internal fixation in Gustilo's Type IIIA becomes a formidable chal... more Objective: The decision of internal fixation in Gustilo's Type IIIA becomes a formidable challenge in patients reaching late. The purpose of the present study was to find out results of intramedullary interlocking nailing in these patients. Materials and Methods: Twenty five compound IIIA fractures, which were internally fixed within 24h after injury, were included in the present analysis. Follow-up ranged from 12 to24 months. Mean follow-up was 18 months. Result: Superficial infection was found in 12 patients and deep infection was found in 6 patients. Non-union was found in 2 cases. Functional evaluation using Katenjian's criteria showed 60% (15) fractures have good to excellent results. Conclusion: Up gradation of the infrastructure is needed in the developing country to obtain satisfactory results of interlocking nailing in Gustilo's Type IIIA fracture tibia in emergency department, strict protocol such as aggressive debridement, prophylactic antibiotic coverage, and...
OF DISSERTATION A COMPUTATIONAL STUDY OF PATCH IMPLANTATION AND MITRAL VALVE MECHANICS Myocardial... more OF DISSERTATION A COMPUTATIONAL STUDY OF PATCH IMPLANTATION AND MITRAL VALVE MECHANICS Myocardial infarction (i.e., a heart attack) is the most common heart disease in the United States. Mitral valve regurgitation, or the backflow of blood into the atrium from the left ventricle, is one of the complications associated with myocardial infarction. In this dissertation, a validated model of a sheep heart that has suffered myocardial infarction has been employed to study mitral valve regurgitation. The model was rebuilt with the knowledge of geometrical changes captured with MRI technique and is assigned with anisotropic, inhomogeneous, nearly incompressible and highly non-linear material properties. Patch augmentation was performed on its anterior leaflet, using a simplified approach, and its posterior leaflet, using a more realistic approach. In this finite element simulation, we virtually installed an elliptical patch within the central portion of the posterior leaflet. To the best o...
In a prospective study conducted in the Postgraduate Department of Orthopaedics Govt. Medical Col... more In a prospective study conducted in the Postgraduate Department of Orthopaedics Govt. Medical College, Jammu, over a period of 2 years. Forty cases, both male and female in the age group of 20 to 50 years with thoracolumbar spinal injury between D11 and L2 vertebra with neurological deficit were included . Out of these forty cases, 20 cases were managed by posterior decompression and stabilization with Steffee plating and 20 cases of similar injuries were managed conservatively and comparison of the two groups was made. The results were analyzed according to neurological improvement as per Frankel's grading, the complications and the duration of hospital stay in both the groups. In operative group; 50% of the patients showed some degree of recovery with 30% of the patients showed full recovery. The mean postoperative correction of kyphosis was 12.5% and the average hospital stay was 23.7days. 15% of the patients in operated group developed complications. In the conservative grou...
Injuries to Lisfranc complex are infrequent, usually a result of high energy trauma. Upto 20% of ... more Injuries to Lisfranc complex are infrequent, usually a result of high energy trauma. Upto 20% of these go unrecognized initially and can have significant long term consequences. Complete isolated dislocation of cuboid is extremely rare. When present, it is usually in conjunction with the complex injuries of hindfoot and midfoot.We report a case of 30yr old male, presenting to the emergency room after having sustained a motor vehicle accident with injury to right foot and ankle region.The injury was diagnosed to be Lisfranc injury with associated cuboid dislocation, the latter part was missed initially. Lisfranc injury is most commonly associated with second metatarsal fracture but rarely it can also be associated with cuboid dislocation which can be easily missed on initial evaluation. High suspicion of this type of injury should be present following high energy trauma as it can result in prolonged recovery and significant long term morbidity.
Maintaining a patent airway is the first principle of resuscitation and life support. Successful ... more Maintaining a patent airway is the first principle of resuscitation and life support. Successful intubation with the appropriate size endotracheal tube (ETT) is more difficult in children than adults. Use of inappropriate size of ETT can cause significant morbidity and mortality. Visualization of the pediatric airway diameter with the help of ultrasound can enable anesthesiologist to better predict ETT size and it will prevent unnecessary tube changes and airway trauma. Hence, we undertook this study to assess accuracy of USG guided tracheal diameter measurement in predicting ETT size in pediatric patients and its comparison with that determined by age-based formula and diameter of little finger. A total of 50 patients aged between 2 and 6 years were included in this study from July 2017 to June 2018. Agreement between actual ETT inserted and ETT estimation by diameter of little finger, age-based formula and ultrasonography was calculated by using kappa statistics. ETT measurement b...
Introduction: This study was undertaken in Indira Gandhi Medical College, Shimla to evaluate anti... more Introduction: This study was undertaken in Indira Gandhi Medical College, Shimla to evaluate antibiotic sensitivity patterns of various microbes isolated from patients in general Intensive Care Unit. Thus it would serve as a guide to institute empirical antibiotic therapy. Materials and methods: All patients admitted to general ICU with Endotracheal tube (ETT) in situ were included in this observational study. Those with ETT in place for more than 24 h were excluded from the study. ETT culture samples were collected at 36-48 h and on seventh day of intubation. Culture report and antibiotic susceptibility profile were observed and data hence collected were evaluated. Results: Out of the total 946 ET culture samples studied 533 (56.3%) showed growth of microorganisms. The number of ET culture isolates increased as the days of intubation increased, i.e., from 45.33% on second day to 70.07% on seventh day. NFG, Klebsiella spp. and Pseudomonas spp. contributed to more than 70% of the ET ...
Mobile Ad-hoc Network has broad impact on research area from past two eras. Its structure less es... more Mobile Ad-hoc Network has broad impact on research area from past two eras. Its structure less establishment and flexibility increases its growth of attention in the field of Ad hoc network. MANET is defined as instant alteration in network topology and constrained energy. Clustering is useful to make network more efficient and scalable in MANET. In MANET nodes are continuously change their location due to mobility nature. Hence it became challenging task to manage them while preserving the energy. Many clustering algorithms and protocols are proposed to overcome these lacks and to make the network more stable and trusted. In this paper we describe the most prominent aspect related to the MANET . The motive of this paper compared and analyzed different clustering algorithms under different parameters such as Reputation, Misbehavior detection, Energy efficient and mobility of node. Keywords— MANET, Security, Clustering, Mobility, Efficiency, Stability, Misbehavior, Overhead.
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