Obliquity of the Stapes in Otosclerosis: A New Radiological Sign

Abstract Introduction Observing the obliquity of stapes by closely scrutinizing the HRCT temporal bone in otosclerosis revealed a reliable and consistent finding. This finding can add to the existing radiological criteria in diagnosis of otosclerosis. Objective The objective of this study is to establish the obliquity of stapes in otosclerosis by radiological measurements using HRCT temporal bone by comparing: (a) the distance between the horizontal (tympanic) segment of facial nerve and stapes head in otosclerotic ears (study group) with non-otosclerotic ears (control group); and (b) the angle subtended by stapes with promontory in the study and control groups. Methods This is a prospective study performed after the institutional Ethics Committee clearance (IEC 3/2013). Results An increased mean distance between the horizontal segment of facial nerve and stapes head in otosclerotic patients (i.e., 2.49mm +/− 0.24mm SD), when compared with the non-otosclerotic patients (i.e., 1.46mm +/− 0.16mm SD) is noted. There is a change in angle (i.e., 64.550 +/− 7.190 SD) subtended by the stapes toward the promontory in otosclerotic ears when compared with that of controls (i.e., 99.700 +/− 40 SD). We applied the Mann-Whitney U non-parametric test and considered p value of < 0.0001 highly significant. Conclusions Obliquity of stapes in otosclerosis referred to as a “Pisa” sign by the senior author has diagnostic value as a new radiological sign in imaging of otosclerosis. This obliquity explains the torsional effect of otosclerosis on the ossicular chain. The findings correlate with late complications and failures in stapes surgery

Rare case of complete gonadal dysgenesis 46 XY, Swyer syndrome

Swyer syndrome also known as 46XY complete gonadal dysgenesis is a rare cause of primary amenorrhea. These patients are phenotypically females with female type of internal and external genitalia with absence of testicular tissues. They have streak gonads which have increased potential to turn into malignancy.  Bilateral gonadectomy should be done as soon as diagnosis is made. In present case, 20 years unmarried female came with complaints of menstrual bleeding only on taking medication. She never attained menarche, following which she was started on treatment outside, on withdrawal bleeding for the past 3 years. She was now evaluated and diagnosed as Swyer syndrome and bilateral gonadectomy was done laproscopically. Swyer syndrome patients can get married, have normal sexual life and can get pregnant through invitro fertilisation with donor oocyte if desired

Recent Progress in Nanostructured Zinc Oxide Grown on Fabric for Wearable Thermoelectric Power Generator with UV Shielding

Traditional materials for thermoelectric such as bismuth telluride have been studied and utilized commercially for the last half century, but recent advancements in materials selection are one of the principal function of the active thermoelectric device as it determines the reliability of the fabrication regarding technical and economic aspects. Recently, many researcher’s efforts have been made to utilize oxide nanomaterials for wearable thermoelectric power generator (WTPG) applications which may provide environmental stable, mechanical flexibility, and light weight with low cost of manufacturing. In precise, fabric containing oxide metals have shown great promise as P−/N-type materials with improved transport and UV shielding properties. On the other hand, we have focused on ZnO nanostructures as a high-efficiency WTPG material because they are non-toxic to skin, inexpensive and easy to obtain and possess attractive electronic properties, which means that they are available for clothing with low-cost fabrication. To our observation, we are chaptering about the thermoelectric properties of ZnO and their composite nanostructures coated cotton fabric via the solvothermal method for the first time

Can isolated tibia intramedullary interlocking nailing in fracture distal 1/3rd both bone leg prevent fracture malalignment: will concurrent fibula fixation help?

Background: Different stand point prevails till date concerning fibular osteosynthesis in distal third both bone fracture fixation. This study was done to assess the post op alignment of distal third both bones fracture without fixing Fibula.Methods: A total of 30 patients who had distal 1/3rd extra articular tibia and fibula fractures were included in the study from July 2016 to April 2019. Tibial nailing was done in all cases with care is taken particularly to prevent malalingment of distal fragment. Radiological malalignment were assessed post operatively.Results: Of 30 patients, 5 patients had excellent results and 21 patients had good results, only 4 patients had fair results with valgus and varus malalignment, however these patients did not have any clinical problems associated with these malalignment at one year follow up. No patients had poor results. Valgus tibial malalignment is observed more frequently when fibular fracture is at proximal level.Conclusions: The level of Fibular fracture is important to determine when the fixation of this bone is indicated. Fixing ipsilateral tibial fracture with intramedullary interlocking (IMIL) nailing without fibular synthesis produce no gross change in alignment provided adequate care is taken for intra operative centering of the nail in both AP and lateral views

Towards sustainable precipitation management in Madurai Town Planning Area (India)

Abstract This study aimed to look for efficient development strategies towards achieving sustainable precipitation management in the Madurai Town Planning Area (MTPA) in India. In the MTPA, precipitation is the predominant source of freshwater for agricultural and domestic uses in addition to water received through conventional systems. The average annual precipitation in the region is ~ 816 mm with standard deviation of 233 mm. The regression analysis showed that annual precipitation is following a decreasing trend and will be about 716 mm by 2030. The Precipitation Concentration Index (PCI) values ranging from 18 to 20 represented strong irregularities and seasonality in annual precipitation over the study area. March, July, September, and November months contributed 2.5, 6.19, 14, and 16% to annual precipitation, respectively, and all showed decreasing trends over time. Only 20% of Northeast monsoon was active over the past 44 years (1976–2019), resulting in a 15% probability of flood and drought occurrences throughout the MTPA. The long-term (1976–2019) average value of annual precipitation days was about 42. The Concentration Index (CI) showed that 60–70% of precipitation was received within 25% of precipitable days. Daily precipitation class of moderate (7.5–34 mm) and rather heavy (34–64 mm) ranges were the dominant types of precipitation, contributing 46% and 26% to total annual precipitation, respectively. Except for October, the monthly precipitation received was deficit to meet the irrigation water demand in the MTPA. However, development of precipitation harvesting systems can annually preserve about 27 Mm3 freshwater in the urban space of the MTPA.Abstract This study aimed to look for efficient development strategies towards achieving sustainable precipitation management in the Madurai Town Planning Area (MTPA) in India. In the MTPA, precipitation is the predominant source of freshwater for agricultural and domestic uses in addition to water received through conventional systems. The average annual precipitation in the region is ~ 816 mm with standard deviation of 233 mm. The regression analysis showed that annual precipitation is following a decreasing trend and will be about 716 mm by 2030. The Precipitation Concentration Index (PCI) values ranging from 18 to 20 represented strong irregularities and seasonality in annual precipitation over the study area. March, July, September, and November months contributed 2.5, 6.19, 14, and 16% to annual precipitation, respectively, and all showed decreasing trends over time. Only 20% of Northeast monsoon was active over the past 44 years (1976–2019), resulting in a 15% probability of flood and drought occurrences throughout the MTPA. The long-term (1976–2019) average value of annual precipitation days was about 42. The Concentration Index (CI) showed that 60–70% of precipitation was received within 25% of precipitable days. Daily precipitation class of moderate (7.5–34 mm) and rather heavy (34–64 mm) ranges were the dominant types of precipitation, contributing 46% and 26% to total annual precipitation, respectively. Except for October, the monthly precipitation received was deficit to meet the irrigation water demand in the MTPA. However, development of precipitation harvesting systems can annually preserve about 27 Mm3 freshwater in the urban space of the MTPA

Advocacy and Action: Systemic Approaches to Climate Education at University of the​ Arts London​

Presentation at Advance HE's Sustainability Symposium 202

Exercise-based interventions for cancer survivors in India: a systematic review

Existing literature suggests that cancer survivors present with high rates of morbidity due to various treatment and disease induced factors. Research globally has shown exercise to be beneficial in improving treatment outcomes and quality of life. India has a high prevalence of cancer and not much is known about exercise interventions for cancer survivors in India. This review was planned to review the state of exercise based interventions for cancer survivors in India. A comprehensive literature search was performed in PubMed, CINAHL, EMBASE, Scopus, Cochrane Library, PEDro, IndMed, and Shoda Ganga. The search results were screened and data extracted by two independent reviewers. All eligible studies were assessed for methodological quality rating using Downs and Black checklist. Data was extracted using a pilot tested pro forma to summarize information on site and stage of cancer, type of exercise intervention and outcome measures. The review identified 13 studies, published from 1991 to 2013, after screening 4060 articles. Exercise interventions fell into one of three categories: (1) yoga-based, (2) physiotherapy-based and (3) speech therapy based interventions; and exclusively involved either breast or head and neck cancers. Studies were generally of low to moderate quality. A broad range of outcomes were found including symptoms, speech and swallowing, and quality of life and largely supported the benefits of exercise-based interventions. At present, research involving exercise-based rehabilitation interventions in India is limited in volume, quality and scope. With the growing burden of cancer in the country, there is an immediate need for research on exercise based interventions for cancer survivors within the sociocultural context of India

Development of strategies to support home-based exercise adherence after stroke: a Delphi consensus

Objective To develop a set of strategies to enhance adherence to home-based exercises after stroke, and an overarching framework to classify these strategies. Method We conducted a four-round Delphi consensus (two online surveys, followed by a focus group then a consensus round). The Delphi panel consisted of 13 experts from physiotherapy, occupational therapy, clinical psychology, behaviour science and community medicine. The experts were from India, Australia and UK. Results In round 1, a 10-item survey using open-ended questions was emailed to panel members and 75 strategies were generated. Of these, 25 strategies were included in round 2 for further consideration. A total of 64 strategies were finally included in the subsequent rounds. In round 3, the strategies were categorised into nine domains - (1) patient education on stroke and recovery, (2) method of exercise prescription, (3) feedback and supervision, (4) cognitive remediation, (5) involvement of family members, (6) involvement of society, (7) promoting self-efficacy, (8) motivational strategies and (9) reminder strategies. The consensus from 12 experts (93%) led to the development of the framework in round 4. Conclusion We developed a framework of comprehensive strategies to assist clinicians in supporting exercise adherence among stroke survivors. It provides practical methods that can be deployed in both research and clinical practices. Future studies should explore stakeholders' experiences and the cost-effectiveness of implementing these strategies

Theoretical Power Output of Thermoelectric Power Generator based on Metal Oxide Semiconductor

Optimizing the structure and material combination of thermoelectric power generators (TEGs) is essential to their efficiency. In order to develop an efficient TEG based on an oxide semiconductor, we theoretically simulated the power output of a TEG based on potential oxide semiconductors (ZnO, TiO2, and CuO) combined with electrode materials (Au, Ag, Cu, graphene, graphite, ITO, IZO, and AZO), and determined the influence of this material combination on the TEG’s power output. In this study, the power output was evaluated from simulated heat distribution and output voltage of a single leg and thermopiles using a simulator. The combination of ZnO and graphene showed the highest power output. This is likely due to the high thermal conductivity of graphene which allowed a high temperature difference in the ZnO. Moreover, the power output increased with decreasing electrode thickness, which allowed high output voltage to be generated by the thermoelectric material. The power density of the TEG consisting of several thermopiles based on ZnO and graphene materials was 29 mW/cm2, which was comparable with that of the\ud reported TEG consisting of Te-based materials. Thus, a TEG based on oxide semiconductor materials could be developed to reduce the use of harmful thermoelectric materials