Evaluating seismic risk by MCDM and machine learning for the eastern coast of India.

Natural disasters such as earthquakes endanger human lives and infrastructure, particularly in urban areas. With the advancements in science and technology in understanding natural hazards, recent studies have attempted to mitigate them by mapping the risks using geospatial technology. In this paper, we attempt to integrate the multi-criteria decision-making (MCDM) models, namely the Analytical Hierarchy Process (AHP) and the Criteria Importance Through Inter-criteria Correlation (CRITIC), besides using the artificial neural network (ANN) to assess the seismic risk in the eastern coast of India. The AHP-CRITIC technique is used to evaluate the earthquake coping capacity and vulnerability and has been further used to generate a training base for earthquake probability mapping by ANN. The earthquake probability and spatial intensity information are used to develop the hazard map. Following that, integrating vulnerability, hazard and coping capacity spatial information assessed earthquake risk. Our results indicate that approximately 5% of the study area is at high risk, whilst more than 11% of the population is at high risk due to seismic induced hazards. The area under the curve of the receiver operating characteristic curve is 0.85, which indicates reliable results. The results of this study may help various agencies involved in planning, development and disaster mitigation to develop seismic hazard mitigation methods by better understanding their impacts on the eastern coastal region of India.

Perioperative Management Conundrum for a Case With Multiple Commonly Used Drug Hypersensitivity.

Perioperative hypersensitivity reactions vary from mild to potentially fatal anaphylaxis, resulting in significant morbidity and mortality. Most of the perioperative hypersensitivity and allergic reactions are attributed to antibiotics, antiseptic solutions, latex, and opioids. In the current thrust for opioid-free anesthesia, owing to its multiple advantages, paracetamol and nonsteroidal antiinflammatory agents play a significant role in multi-modal pain and inflammatory response management. Nearly nine out of ten individuals experience postoperative pain, one-third experience postoperative nausea and vomiting, and one-fourth experience fever, irrespective of surgery and type of anesthesia, often as an inflammatory response. While perioperative hypersensitivity reactions are common, a patient allergic to multiple commonly used drugs for the treatment of pain, fever, acid-peptic disorder, and nausea and vomiting is scarce. Such cases pose a great challenge in perioperative management. A 14-year-old male child with a traumatic foot drop planned for tibialis posterior tendon transfer developed an allergic reaction with mild fever following an injection of Ranitidine and Ondansetron in the preoperative area. Surgery was deferred and was investigated for allergy profile testing for commonly used drugs, which showed high IgE levels and moderate to severe hypersensitivity for diclofenac and paracetamol. The patient was operated on after one month under spinal anesthesia, avoiding ranitidine, ondansetron, diclofenac, and paracetamol. The following morning, he developed a high-grade fever (102.3° F), which did not resolve with conservative measures. Hypersensitivity and allergic reactions to NSAIDs are reported in the literature. While there are multiple drugs available as NSAIDs, cross-sensitivity or allergy to other drugs within the same group, and even chemically related groups, is also another possibility that needs to be considered while managing such patients. Mefenamic acid controlled the fever, and the child was discharged home after 48 hours of observation. However, the case posed a great perioperative management dilemma; the present report intends to highlight and discuss it.

Estimating suitability of groundwater for drinking and irrigation, in Odisha (India) by statistical and WQI methods.

Twelve major hydro-geochemical parameters derived from about 1134 water samples were studied to understand spatial variation of groundwater quality in the coastal state of Odisha. Multivariate statistical analysis techniques, i.e., cluster analysis and principal component analysis (PCA), and varimax rotation were used to classify various types of groundwater, and plausible sources that control the quality of water in the region. The concentration of major ions varies in the order of Na+ > Ca2+ > Mg2+ > K+ and HCO3- > Cl- > SO42- > F-. Out of the three clusters identified, the 2nd cluster is having more mineralization and relatively poor quality of groundwater as compared to the first and the third cluster. Furthermore, estimates of the Water Quality Index (WQI) indicate that the groundwater in the area can be classified from excellent to medium quality. Furthermore, the sodium absorption ratio (SAR) and Kelly's ratio (KR) suggest that about 70% of groundwater samples are of low to medium salinity, whereas about 30% show higher salinity. The Wilcox diagram reveals that almost 90% of the groundwater is suitable for irrigation. The mining activity appears less likely to be affecting the quality of subsurface water. Water-rock interactions and evaporation-crystallization may be the two dominant factors that appear to control the groundwater away from the coastal areas. Results of this study may be useful to identify the suitable sites for groundwater extraction for drinking and irrigation purposes, besides being useful to the policy-makers in formulating effective plans for preventing further contamination of groundwater aquifers.

A case of cervical OPLL and DISH mimicking stroke.

Background: Ossification of the posterior longitudinal ligament (OPLL) is a progressive disorder that mostly involves the cervical spine. It is more prevalent in East Asian countries. Patients typically present with the gradual onset of myelopathy, while about 5% show rapid progression. Case Description: A 51-year-old diabetic and hypertensive male presented with a left-sided hemiparesis following trivial trauma. The first diagnosis was a stroke, but the subsequent workup proved negative. Subsequently, the MRI and CT studies demonstrated significant cord compression due to OPLL extending from C2 to C7. There was also a heterogeneous hyperintense intramedullary cord signal indicative of edema/myelomalacia in the retro- odontoid region. The CT also diagnosed C2-C7 diffuse idiopathic skeletal hyperostosis. Conclusion: Patients with cervical myelopathy due to OPLL rarely present about 5% of the time with the acute onset of neurological deficit following minor trauma. Certainly, one must consider high cervical OPLL as responsible for hemiparesis in a patient whose brain MR has ruled out a stroke.

Short-Term Analysis of the Changes in the Bone Mineral Density of the Proximal Femur After Uncemented Total Hip Arthroplasty: A Prospective Study of 110 Patients.

Introduction Mechanical loading continuously exposes the bone to remodeling processes. Increased load leads to a gain in bone mass, and reduced load results in a loss. After inserting a prosthesis, the proximal femur is bypassed in loading as the bodyweight shifts distally. This lack of load induces bone resorption according to Wolff's law. To avoid this bone resorption, the implant's bending stiffness should be less than the femoral bone. Dual-energy X-ray absorptiometry (DEXA) is a well-accepted method to measure periprosthetic bone mineral density (BMD) after total hip arthroplasty (THA). Since the strength and durability of the fixation of a femoral prosthesis in cementless hip arthroplasty depend largely on the quantity and quality of the surrounding bone, preoperative and postoperative evaluation of the quantity and quality of the femoral bone is very important in the long-term prognosis of hip arthroplasty. Materials and methods A prospective study of 110 patients in the age group of 25-60 years who underwent uncemented total hip arthroplasty in our tertiary healthcare institution was performed. An uncemented, fully hydroxyapatite-coated implant from a single manufacturer was used in all the patients. All the patients were mobilized on the first post-operative day. The BMD was measured at the proximal femur and the distal tip using a DEXA scan. Gruen zones were used for calculating BMD at different anatomical locations in the femur, with particular importance to zones 1, 4, and 7. Results The pre-operative BMD in all zones measured, viz. zones 1, 4, and zone 7 of the affected side, was found to be significantly lower as compared to the BMD values on the control side (P< 0.05). The mean change in the mean BMD was calculated for all the zones and compared with each other using an unpaired t-test. The mean BMD changes were found to be significantly higher in zone 7 in comparison to both zones 1 and 4 (p<0.05). Conclusion Significant periprosthetic bone loss after uncemented THA in the femur was noted in Gruen zones 1, 4, and 7 during the first six months after THA, with the greatest bone loss in the femoral calcar area (zone 7). The lower the preoperative BMD of the patient, the greater the postoperative bone loss.

Comparative Analysis of Clavicular Hook Plate Versus Distal Radius Volar Plate With Coracoclavicular Augmentation for Neer's Type 2b Lateral Clavicle Fractures: A Prospective Study.

Background Clavicle fractures are common injuries in the adult population. The commonest site of fracture in the clavicle is the mid-shaft followed by the lateral end fracture. The anatomy and biomechanics of the lateral end clavicle make it prone to be unstable. Conservative management usually fails due to the deforming forces. Aim Our study evaluates pain relief, functional outcome, and the union rate in unstable lateral end clavicle fracture fixed by two different modalities of operative management, namely clavicular hook plate fixation and distal radius volar plate fixation. Materials and method A total of 60 patients with the unstable lateral end of clavicle fracture were evaluated in this study at a single tertiary care center between August 2015 and September 2021. Half of the patients (30 patients) were managed by open reduction and internal fixation with clavicular hook plate. The remaining half (30 patients) underwent open reduction and internal fixation by distal radius volar plate supplemented with coracoclavicular fixation. All patients were followed up for a mean duration of 20 months. The functional outcome was assessed at regular intervals by Constant score and Disability of the Arm, Shoulder and the Hand (DASH) score for a period of one year. Result There was significant pain relief and improvement in the functional status of patients. The pain relief was significant in the group managed by distal radius volar plate. The decrease in DASH score and increase in Constant score suggests better functional outcomes in these patients. Conclusion Our study highlights the fact that the distal radius volar plate is an excellent alternative to the hook plate in the treatment of unstable lateral third clavicle fractures. The decrease in pain and improved functional outcome stresses the fact that the volar locking plate is the recent most advancement in the fracture fixation of Neer's type ll fractures. The distal radius volar plate is the recent internal fixation technique to manage unstable lateral end clavicle fractures.

Chronic Unreduced Anterior Shoulder Dislocation Managed by Latarjet Procedure: A Prospective Study.

The shoulder joint is the most common joint to undergo dislocation, with the anterior subtype being the most common. The most accepted definition of chronic dislocation is a shoulder joint that has remained dislocated for a minimum of three weeks. Due to rare presentation, there is a lack of consensus among surgeons regarding the optimal management option of chronic shoulder dislocation. The goal of this prospective study was to assess the efficacy of open reduction with Latarjet procedure in the management of chronic unreduced shoulder dislocation. A total of seven patients were included in this study. Five patients were males and two were females. The study was conducted in a single tertiary care centre between July 2015 and May 2018. All patients were managed by open reduction with the Latarjet procedure. The capsulolabral structures were repaired in all the cases. The post-operative functional outcome was assessed by shoulder range, Rowe score, and the University of California, Los Angeles (UCLA) score at regular intervals for a period of one year. There was a significant improvement in terms of pain relief and functional status of the patients. The patients were satisfied as they could do their daily routine activities without pain at a one-year follow-up. Early post-operative rehabilitation and physiotherapy are key to improving the functional range.

The Plasma Spectroscopic Study of Dergaon Meteorite, India.

Meteorites are the recoverable portions of asteroids that reach the surface of the Earth. Meteorites are rare extraterrestrial objects studied extensively to improve our understanding of planetary evolution. In this work, we used calibration-free laser-induced breakdown spectroscopy (CF-LIBS) to evaluate the quantitative elemental and molecular analyses of the Dergaon meteorite, a H 4-5 chondrite fall sample from Assam, India. Spectral signatures of H, N, O, Na, Mg, Al, Si, P, K, Ca, Ti, Cr, Mn, Fe, Co, Ni, andIrweredetected. Along with the atomic emission, this work reports the molecular emission from FeO molecules. The concentration of the measured elements obtained using CF-LIBS is in close agreement with earlier reports. The elements H, N, and O and their concentrations are estimated by using CF-LIBS for the first time. This study applies laser spectroscopy to establish the presence of Ni, Cr, Co, and Ir in meteorites. The elemental analysis forms the basis for the establishment of the potential molecular composition of the Dergaon meteorite. Moreover, the elemental analysis approach bodes well for in-situ analyses of extraterrestrial objects including applications in planetary rover missions.