When Rare Meets Reality: A Case of Kikuchi-Fujimoto Disease in Tertiary Care Center.

Kikuchi-Fujimoto disease is a very rare disease, basically involving young adults and ubiquitously distributed. It is characterized by fever and benign lymph node swelling. The distinguishing features of this disease are cervical lymphadenopathy, constitutional symptoms resembling tuberculosis, and its penchant to affect young people of Oriental or Asian descent, especially women. We describe an instance of a 42-year-old female who arrived with multiple neck swellings. On physical examination, there was palpable right-sided cervical lymphadenopathy, while laboratory investigations were essentially within normal limits except for raised erythrocyte sedimentation rate and anemia. After cefepime and nonsteroidal anti-inflammatory medications were administered, symptoms subsided, and lymphadenopathy receded in the patient. This case supports the importance of histological evaluation to reach an exact diagnosis and guide treatment and the need to consider Kikuchi-Fujimoto disease in the differential diagnosis of lymphadenopathy.

Graphene oxide nanoribbons conjugated with 1, 2-distearoyl-sn-glycero-3 phosphoethanolamine-poly (ethylene glycol)-transferrin enhanced targeted delivery and cytotoxicity of raloxifene against breast cancer.

The clinical utility of raloxifene (RLX), a selective estrogen receptor modulator (SERM), has been compromised by severe side effects and unfavorable drug properties. To address these, a transferrin (Tf) conjugated graphene oxide nanoribbon (GONR) platform was tried for RLX. The stability of GONRs in biological media was improved by surface modification with 1, 2-Distearoyl-sn-glycero-3 phosphoethanolamine-Poly (ethylene glycol) (DSPE-PEG). The Tf molecule was covalently attached to DSPE-PEG (DPT) using EDC-NHS chemistry. The surface of GONR was then modified with DSPE-PEG (DP) or DPT and loaded with RLX (GDP-RLX and GDPT-RLX). The final formulations were characterized for drug loading and stability. The anticancer activities of pure RLX, GDP-RLX, and GDPT-RLX were evaluated and compared in all the in vitro and in vivo studies. In vitro cell line studies showed that GDPT-RLX have significantly high cytotoxicity, cellular uptake, apoptosis induction, G2/M phase arrest, anti-migration properties, and apoptotic protein expression, followed by GDP-RLX and RLX. Pharmacokinetics and tumor biodistribution were also found to be excellent with GDPT-RLX. The in vivo tumor therapy and tumor evaluation outcomes were also consistent with the in vitro data. The Tf conjugated GDPT-RLX represents a promising approach for targeted and sustained delivery of RLX with enhanced therapeutic efficacy.

Rare disease clinical trials in the European Union: navigating regulatory and clinical challenges.

BACKGROUND: Clinical development for orphan drugs presents significant difficulties and challenges. There is no unique or standard design, conduct, and outcome assessment methodology and it is sometimes impractical to fit design models of rare disease trials in any practiced and well-known framework. In the European Union (EU) these challenges encompass a broad array of subjects, including trial design, study outcomes, patient recruitment, trial conduct ethics, trial cost, and chances of success. This literature-based review study aims to provide a thorough overview of the critical aspects of rare disease trials in the EU by analyzing the current landscape of rare disease trials, highlighting key challenges, delving into regulatory and research initiatives and innovation in trial designs, and proposing multi-faceted solutions to implement effective rare disease clinical trials in the region. DISCUSSION: Traditional clinical trial designs, validation, and evaluation methodologies used for nonorphan drugs often prove unsuitable for orphan drugs, given the small patient populations, sometimes fewer than 1000 cases. There is an increasing need for accessible therapies and both regulators as well as industry are trying to develop affordable and effective drugs to address this need. Despite several steps that have been taken, the timely development of drugs remains a challenge. One of the reasons behind the long development timeline is the recruitment, retention, and conduct of rare disease trials. To optimize the development timelines of orphan drugs in the EU, it is important to ensure that the safety and efficacy of the product is not compromised. Industry and regulatory agencies must implement innovative trial designs, devise flexible policies, and incorporate real-world data for assessing clinical outcomes. CONCLUSION: Collaboration among academic institutions, pharmaceutical companies (both small and major), patient groups, and health authorities is crucial in overcoming obstacles related to clinical trials and providing assistance and creative ideas. The ultimate objective of granting rare disease patients timely and affordable access to medications with a positive balance between benefits and risks is to be met.

Two Rings, Two Recoveries: Exploring the Thiersch Method in Complicated Cases.

Rectal prolapse, characterized by the protrusion of rectal mucosa or full-thickness tissue through the anal canal, significantly impacts quality of life, necessitating prompt intervention upon diagnosis. This case report presents the management of rectal prolapse in two cases admitted to our institution presenting with complaints of a prolapsing anal mass and many associated comorbidities and their subsequent surgical management using the Thiersch procedure. Following the procedure, both patients were monitored postoperatively, discharged once vitally stable, and kept on regular follow-up. Surgery is the primary therapy for rectal prolapse, and while various surgical techniques address rectal prolapse, anal encirclement procedures like the Thiersch procedure have been largely replaced by newer abdominal or perineal approaches. However, it is a valuable option for select patient populations. The Thiersch procedure is an ideal modality for treating high-risk patients with rectal prolapse or those patients with poor compliance for more extensive procedures. It can also be used temporarily until a further definitive treatment is planned later in the future.

Navigating the mammography quality standard act in USA: Role of US FDA and future scopes of regulation.

BACKGROUND: The Mammography Quality Standards Act (MQSA) has significant impact on providing high-quality mammography services for the early detection of breast cancer. MQSA emphasizes quality assurance, regulatory compliance, and patient safety. It guides technological integration, ensuring uniform quality across the United States of America (USA). This review synthesizes key MQSA information, analysing compliance, and facilitating policy discussions for improvements, aiming to inspire further policy research in cancer screening by adopting MQSA's success factors. METHODS: The review spanned 1997 to 2023, adhering to Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Databases like PubMed, ScienceDirect, and Google Scholar were searched for relevant literature. Selection criteria covered English-language journals, US Food and Drug Administration (FDA) guidelines, and professional organizational standards, revealing key aspects of MQSA and breast cancer diagnostics in the USA. RESULTS AND DISCUSSION: MQSA's legislative aspects guarantee the effectiveness of regulations for high-quality mammography. It addresses technology, emphasizes inspections, and balances compliance with healthcare burdens. Procedural guidelines prioritize patient outcomes, minimize errors, and address access disparities. Regular updates are crucial to align screening services with technological changes, maintaining safety and accuracy nationwide. CONCLUSION: The FDA's collaboration with stakeholders, including medical specialists and patient advocacy groups, has contributed to crucial legislative aspects of MQSA. The accuracy of mammography screenings has significantly improved by MQSA's installation of stringent quality and regulatory standards. Compliance with MQSA guidelines led to higher accuracy, safety, and better detection rates. Ongoing efforts must aim to refine guidelines, address emerging challenges, and optimize breast cancer detection.

Al2O3/ZrO2 dual-dielectric Gr/CNT nanoribbon vertical tunnel FET based biosensor for genomic classification and S-protein detection in SARS-CoV-2.

The ongoing genetic mutation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) possesses the capacity to inadvertently lead to an increase in both the rates of transmission and mortality. In this study, we showcase the use of an Al2O3/ZrO2 Dual-Dielectric Gr/CNT Nanoribbon vertical tunnel field-effect transistor biosensor for the purpose of detecting spike proteins of SARS-CoV-2 in clinical samples. The proteins mentioned above are situated within the protein capsids of the virus. The effectiveness of the suggested detector has been assessed through measurements of the alteration in current drain. The present study utilizes the dielectric coefficient analogue of viral proteins as a substitute for biomolecules that exhibit internal hybridization nanogaps. The high sensitivity of the suggested detector, as evaluated on a scale ranging from 0 to 115, suggests its potential as a high-quality sensing instrument. The purpose of this study is to examine the sensitivity of DNA charge density with the aim of identifying any alterations in the virus that may impact its ability to spread and infect humans. The chromosomal composition of SARS-CoV-2 has been determined. The CMC Research Centre, situated in Vellore, Tamil Nadu, India, conducted an examination of SARS-CoV-2 samples. The scientists possess the capability to do genome sequencing on these specimens, so facilitating the examination of mutation patterns and the dispersion of different clades. A total of 250 different mutations were found out of the 600 sequences that were evaluated. The sequencing data consists of a complete collection of 250 distinct variants, including 150 missense mutations, 80 synonymous mutations, 15 mutations in noncoding regions, and 5 deletions. The comprehension of genetic variety is significantly dependent on these mutations. The proposed detector is connected to a variety of previously documented biosensors based on field-effect transistors (FETs), which are employed for the examination of genetic modifications.

Fecal microbiota transplantation: History, procedure and regulatory considerations.

Fecal microbiota transplantation (FMT) is a medical treatment which involves the transfer of feces from a healthy donor to a recipient to restore the balance of gut microbiota and improve clinical outcomes. FMT has gained recognition in recent years due to its effectiveness in treating recurrent Clostridioides difficile infections (rCDI) and other gastrointestinal disorders. Additionally, it has been studied as an intervention for some other conditions, like inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). This review covers regulatory considerations related to FMT, including the current state of FMT regulation and the need for further research to fully understand the safety and efficacy of this treatment. For transplantation of fecal microbiota, the Food and Drug Administration (FDA) classifies the treatment as an investigational new drug (IND), which typically requires physicians and scientists to submit an IND application. Ethical issues surrounding FMT, including the necessity of informed consent from donors and recipients and the potential transmission of infectious agents, are also discussed. Overall, FMT has the potential to offer significant therapeutic benefits, but it also raises regulatory and ethical considerations that require careful consideration. Further research is necessary to fully comprehend risks and benefits of FMT and to develop guidelines for its use in clinical practice.

Effect of the timing of insertion of postpartum intrauterine contraceptive device (PPIUCD) copper T380A on expulsion rates.

Background & objectives: Postpartum intrauterine contraceptive device (PPIUCD) is well accepted and recommended for contraception. However, anxiety at the time of delivery may restrict the acceptance of a PPIUCD for its immediate insertion. So far there is limited evidence to conclude anything concrete on the association between the expulsion rates and the timing of insertion following a vaginal delivery. Thus, this study was undertaken to compare the expulsion rates in immediate and early insertions and their safety and complications. Methods: This prospective comparative study was carried out over 17 months on women delivering vaginally in a tertiary care teaching hospital in South India. A copper device (CuT380A) was inserted using Kelly's placental forceps either within 10 min of placental delivery (immediate group, n=160) or between 10 min upto 48 h postpartum (early group, n=160). Ultrasound was done before discharge from the hospital. The expulsion rates and any other complications at six-week and three-month follow up were studied. Chi-square test was used to compare the difference in expulsion rates. Results: The expulsion rate was five per cent in the immediate compared to 3.7 per cent in the early group (no significant difference). In ten cases, the device was found to be in the lower uterus upon ultrasound before discharge. These were repositioned. There was no case with perforation, irregular bleeding or infection up to the three-month follow up. Higher age, higher parity, lack of satisfaction and motivation to continue were predictors of expulsion. Interpretation & conclusions: In the present study PPIUCD was found to be safe with overall expulsion in 4.3 per cent. It was marginally, though not significantly, higher in the immediate group.

A comparative study of clinical outcome in ALT free flap reconstruction using superficial or deep and single or dual recipient vein anastomosis in different sites.

BACKGROUND: During the free flap surgery obtaining a suitable recipient vein is an important factor for successful outcome. As in all other flaps even in ALT flap, single or double venous anastomosis, superficial or deep venous anastomosis is still a matter of debate among the micro vascular surgeons. Though dual vein anastomosis is a time-tested method, single vein anastomosis has the advantage of reducing the operative time and hospitalization cost. Similarly, in situation where the deep veins are dubious superficial veins are savior. This study explores the outcome of ALT flap using different system of recipient veins. PATIENTS AND METHODS: Retrospective analysis of the 54 free ALT flaps performed over a period of 5 years from June 2017 till June 2022, was carried out. Out of 54, 38 (63%) were male patients and 16 (37%) were females. The outcome of the flaps was evaluated in single or dual anastomosis group. Similarly, the outcome of the flaps with deep or superficial vein anastomosis was also evaluated. The flaps outcomes are evaluated as favorable (successful as well as partial loss are considered as favorable) and unfavorable (complete loss of the flap). RESULTS: Among the 54 flaps, 31 patients had lower limb reconstruction, majority were post-traumatic defects. Twenty patients had head and neck reconstruction following post malignancy excision. Three patients had upper-limb reconstruction for post traumatic and burn injury defects. The outcome was analyzed. Twenty patients had dual vein anastomosis, 90% (18 out of 20) of patients had favorable outcome and 10% (2 out of 20) had unfavorable outcome. Thirty-four patients underwent single vein anastomosis, 94% had favorable outcome and 6% had unfavorable outcome. The result was not statistically significant as p < .05. Seven patients underwent superficial vein recipient anastomosis, and all flaps were (100%) successful and no failure, whereas out of 27 patients who had undergone deep vein anastomosis 25 (92%) had favorable outcome and 2 (8%) had unfavorable outcome. The results were not statistically significant as p > .05. CONCLUSION: As in other free flaps venous anastomosis compromise is the cause for flap failure in majority of the times. Whenever possible, dual vein anastomosis should be considered. But when impervious, single vein anastomosis can be resorted to without any hesitation. Similarly, unavailability of deep veins should not deter the surgeons. Superficial veins were a savior in such situation and can be advantageous too.

Treatment algorithm for post sternotomy wound infection - our experience.

INTRODUCTION: Median sternotomy is the most commonly used approach in open cardiac surgery. As in any other surgery, surgical site infections are a known phenomenon, but morbidity depends on the depth of infection. Superficial wound infections can be managed conservatively; however, deep sternal wound infections need an aggressive approach to prevent disastrous consequence like mediastinitis. Hence, this study was conducted with the aim to classify sternotomy wound infection and to develop a treatment algorithm for superficial and deep sternotomy wound infections. MATERIAL AND METHODS: Between January 2016 to August 2021, 25 patients who had sternotomy wound infections were studied. These wound infections were classified as superficial or deep sternal wound infections. RESULTS: Superficial wound infections underwent treatment with diluted vinegar dressings and deep infections underwent treatment with bilateral pectoralis major muscle advancement flaps. Patients were followed up till the wounds healed completely without complications. Patient characteristics, comorbidities, duration of treatment and outcomes of treatment were analyzed. Superficial sternal wound infection patients responded favorably to diluted vinegar dressings and deep sternal wound infection patients to pectoralis major muscle advancement flaps. Average time duration of healing for superficial and deep wound infections was 66.2 days and 18 days respectively. None of the patients had an increased severity of infection or re-dehiscence following treatment and during follow-up. CONCLUSION: Relatively conservative approach using diluted vinegar (1% acetic acid) dressing for superficial sternal wound infections was efficacious, whereas aggressive debridement and bilateral pectoralis major advancement muscle flaps for deep sternal wound infections are necessary for favorable outcomes. However, more studies are needed to ascertain this treatment algorithm.

Hybrid Silicon Substrate FinFET-Metal Insulator Metal (MIM) Memristor Based Sense Amplifier Design for the Non-Volatile SRAM Cell.

Maintaining power consumption has become a critical hurdle in the manufacturing process as CMOS technologies continue to be downscaled. The longevity of portable gadgets is reduced as power usage increases. As a result, less-cost, high-density, less-power, and better-performance memory devices are in great demand in the electronics industry for a wide range of applications, including Internet of Things (IoT) and electronic devices like laptops and smartphones. All of the specifications for designing a non-volatile memory will benefit from the use of memristors. In addition to being non-volatile, memristive devices are also characterized by the high switching frequency, low wattage requirement, and compact size. Traditional transistors can be replaced by silicon substrate-based FinFETs, which are substantially more efficient in terms of area and power, to improve the design. As a result, the design of non-volatile SRAM cell in conjunction with silicon substrate-based FinFET and Metal Insulator Metal (MIM) based Memristor is proposed and compared to traditional SRAMs. The power consumption of the proposed hybrid design has outperformed the standard Silicon substrate FinFET design by 91.8% better. It has also been reported that the delay for the suggested design is actually quite a bit shorter, coming in at approximately 1.989 ps. The proposed architecture has been made significantly more practical for use as a low-power and high-speed memory system because of the incorporation of high-K insulation at the interface of metal regions. In addition, Monte Carlo (MC) simulations have been run for the reported 6T-SRAM designs in order to have a better understanding of the device stability.

Environmental role of aromatic carboxylesterases.

The carboxylesterases (EC 3.1.1.x) are widely distributed and form an important yet diverse group of hydrolases catalysing the ester bond cleavage in a variety of substrates. Besides acting on plant cell wall components like cutin, tannin and feruloyl esters, they are often the first line of defence to metabolize drugs, xenobiotics, pesticides, insecticides and plastic. But for the promiscuity of some carboxylesterases and cutinases, very few enzymes act exclusively on aromatic carboxylic acid esters. Infrequent occurrence of aromatic carboxylesterases suggests that aromatic carboxylesters are inherently more difficult to hydrolyse than the regular carboxylesters because of both steric and polar effects. Naturally occurring aromatic carboxylesters were rare before the anthropogenic activity augmented their environmental presence and diversity. An appraisal of the literature shows that the hydrolysis of aromatic carboxylic esters is a uniquely difficult endeavour and hence deserves special attention. Enzymes to hydrolyse such esters are evolving rapidly in nature. Very few such enzymes are known and they often display much lower catalytic efficiencies. Obviously, the esters of aromatic carboxylic acids, including polyethylene terephthalate waste, pose an environmental challenge. In this review, we highlight the uniqueness of aromatic carboxylesters and then underscore the importance of relevant carboxylesterases.

Comparison between caudal epidural and ultrasound-guided ilioinguinal-iliohypogastric block with bupivacaine and dexmedetomidine for postoperative analgesia following pediatric inguinal hernia surgeries: A prospective randomized, double-blind study.

BACKGROUND AND AIMS: Caudal epidural and ultrasound-guided ilioinguinal, iliohypogastric nerve (IL/IH) blocks are commonly used regional anesthesia techniques for postoperative analgesia in pediatric inguinal surgeries. Dexmedetomidine as an adjuvant has been proven to prolong the duration of both neuraxial and peripheral nerve blocks. We compared the duration of analgesia provided by local anesthetic (LA) and dexmedetomidine for caudal and IL/IH block for pediatric inguinal surgeries. MATERIAL AND METHODS: Forty-six children undergoing inguinal hernia repair were selected for this randomized double-blind study. After general anesthesia, children received either 0.75 mL.kg-1 of 0.25% bupivacaine with 1 mcg.kg-1 of dexmedetomidine in caudal epidural or 0.25 mL.kg-1 of 0.25% bupivacaine with 1 mcg.kg-1 of dexmedetomidine in IL/IH block. The pain was assessed up to 24 h postoperatively using face, legs, activity, cry, consolability (FLACC) score. For FLACC ≥4, rescue analgesia was provided using 1 µg/kg of intravenous fentanyl, up to 2 h postoperatively and 10 mg/kg of oral ibuprofen between 2 and 24 postoperative hours. The time for first rescue analgesia was taken as the duration of analgesia. RESULTS: There were no significant differences in the pain scores or analgesic utilization between the groups. The duration of analgesia of caudal and IL/IH blocks was similar (720.3 ± 430.1 min and 808.4 ± 453.1 min, respectively). The time taken for the performance of block was significantly higher for caudal compared to IL/IH (547 ± 93 vs. 317 ± 179 s; P < 0.001). CONCLUSION: Both caudal epidural and USG-IL/IH block with dexmedetomidine as additive provide the comparable duration of postoperative analgesia with no significant side effects.

Are carcinogens electron acceptors? A novel hypothesis.

Carcinogens play a key role in cancer initiation. Conventional theories support the concept of genetic changes inducing tumorigenesis through proteomics and metabolomics which lead to cancer development. Current research provides evidence that metabolic genes may be altered long before mutation of tumour suppressor genes, strongly suggesting that metabolic changes may be preceding the changes seen at a genetic level. Since cancer has long been known to occur through gene regulation, an impaired cellular respiration without utilizing mitochondrial function has been an area of active interest. We hypothesize the activity of carcinogens as electron acceptors to disrupt the normal glycolysis cycle happening in a cell by acting as positive ligands. The continuous restoration of NAD+ to cytosol by oxidation of NADH with carcinogen as electron acceptor creates a metabolic pathway to assist in the carcinogenic process. This metabolic pathway continues through an adaptive process, supplemented by pyruvate converting to lactate providing a constant pool of NAD+ to continue the glycolytic pathway. We also hypothesize that carcinogenesis occurs as a precursor to metabolic stress which may promote altered genetic and protein expression causing aberrant epigenetic and cell signaling pathways.

Linear and nonlinear temperature-dependent transmission/absorption characteristics of cadmium telluride crystal for terahertz generation.

This paper reports on the temperature-dependent investigation of linear and nonlinear transmission/absorption characteristics of CdTe crystal in the 300-408 K range using 780-970 nm tunable wavelengths of 140 fs pulses obtained from a Ti:Sapphire laser at 80 MHz repetition rate. The same pulses were also used for terahertz generation. The linear transmission/absorption properties were measured using a specially improvised temperature-tuned spectrophotometer in the 500-1500 nm wavelength range. The linear absorption of 750 nm wavelength gradually increases with respect to a rise in the temperature, and transmission becomes zero at 408 K. Nonlinear absorption induced by femtosecond pulses shows a sudden drop of 18% in transmission above the 800 nm range, due to electron-phonon interaction, which affects the strength of the terahertz signal. It is also responsible for change in the temperature along with the linear shift in the refractive index of the crystal.

Comparison of Antimicrobial Efficacy of Cinnamon Bark Oil Incorporated and Probiotic Blend Incorporated Mucoadhesive Patch against Salivary Streptococcus mutans in Caries Active 7-10-year-old Children: An In Vivo Study.

INTRODUCTION: Among the various plants studied, cinnamon has emerged as a potential herbal antimicrobial agent. Besides the medicinal plants, recently probiotics have also been recognized to affect cinnamon bark oil Streptococcus mutans (S. mutans) and other harmful oral and gut microflora. AIM AND OBJECTIVE: This placebo-controlled study aims to compare the antimicrobial potential of cinnamon bark oil incorporated and probiotic blend [Lactobacillus plantarum (TSP-Lp1), and Lactobacillus rhamnosus (TSP-Lrh1)] incorporated mucoadhesive patch against salivary S. mutans in caries active 7-10-year-old children. DESIGN: It was a double-blinded placebo-controlled study with n = 60. They were randomly allotted into three groups-Group I: Cinnamon patch, group II: probiotic patch, and group III: control patch (placebo) with n = 20 in each group. MATERIALS AND METHODS: The study was carried out in three phases. In the first phase, the minimal inhibitory concentration (MIC) of cinnamon bark oil was determined against S. mutans followed by the formulation of cinnamon and probiotic patches. After a washout period of 2 weeks and a collection of baseline saliva samples, these patches were tested on the subjects from respective groups for 14 days with twice a day placement protocol. On the 15th day, saliva samples were collected and cultured, CFU/mL of the saliva of S. mutans for each subject was recorded and compared with baseline samples. Feedback in the form of a questionnaire was obtained from the patients. STATISTICAL ANALYSIS: Descriptive statistics, paired t-test for intragroup comparison, unpaired t-test for intergroup comparison, analysis of variance (ANOVA) for intergroup comparison, and post hoc Scheffe's. RESULTS: The results showed that both cinnamon patch and probiotic patch were comparable to each other in terms of their anti-S. mutans activity. The intragroup comparison of the CFU/mL count showed a highly significant reduction from baseline to post-intervention for both the groups (p = 0.001). CONCLUSION: Both cinnamon and probiotic blend have a strong antimicrobial property owing to their ability to cause significant reduction in salivary S. mutans and both the patches showed good patient acceptance. HOW TO CITE THIS ARTICLE: Gandhi HA, Srilatha KT, Deshmukh S, et al. Comparison of Antimicrobial Efficacy of Cinnamon Bark Oil Incorporated and Probiotic Blend Incorporated Mucoadhesive Patch against Salivary Streptococcus mutans in Caries Active 7-10-year-old Children: An In Vivo Study. Int J Clin Pediatr Dent 2020;13(5):543-550.

Temperature-dependent terahertz spectroscopy and refractive index measurements of aqua-soluble and plastic explosives.

The paper reports the temperature-dependent time domain terahertz spectroscopy of premium aqua-soluble and plastic explosives such as NH4NO3, TNT, and RDX between 0.1 and 2.2 THz. Tunable terahertz radiation was generated using ZnTe crystal as a source, and a photoconductive antenna was used as a detector. The temperature-dependent study was carried out between 30°C and 200°C in a specially designed oven. The signature peaks of RDX and TNT present at 0.82 and 1.60 THz, respectively, show a strong redshift, whereas the NH4NO3 molecule shows a comparatively small shift. The high-temperature-based redshift phenomenon is just the opposite of the blueshift recorded at low temperatures. In addition, the temperature-dependent absorption coefficient data of these molecules support the change in the concentration of the NO2 molecule. We have also ascertained the temperature-dependent refractive indices of these molecules between 0.1 and 2.0 THz, which confirms the effect of temperature on the refractive indices. Finally, the signature peak of RDX with respect to the reduction in the weight concentration of RDX in the Teflon matrix was studied at 0.82 THz.

Distal major pedicle of sartorius muscle flap: Anatomical study and its clinical implications.

BACKGROUND: Reconstruction of the popliteal region has limited option in terms of muscle flaps or myocutaneous flaps. Gastrocnemius muscle or the myocutaneous flaps are the option for majority of cases. However, reach of Gastrocnemius is limited if the wound is on the distal one-third thigh or the lateral aspect of knee region. Similarly, if the wound injures the muscle, then coverage becomes all the more difficult. Although inferiorly based fasciocutaneous flaps can cover the wound in case of bony injuries, muscle flaps are beneficial as they help in fracture healing. However, in cases with direct gastrocnemius muscle injury or if the wound on the distal one-third thigh or the lateral aspect then the options of muscle flaps is limited. An inferiorly based sartorius muscle can be one suitable alternative to cover this region. AIMS AND OBJECTIVE: The aim is to devise an inferiorly based sartorius muscle flap for coverage of lower thigh, popliteal and upper one-third leg region. OBJECTIVES: (1) To identify the location of distal major (largest diameter) pedicle in cadavers and its clinical application. (2) To determine the arc of rotation with distal major pedicle as pivot point. METHODS: Ten Cadavers and 20 sartorius muscle dissected out. Prior silicone injection onto the femoral vessels was done to identify the location of the perforators for the sartorius muscle. The distance of perforators from anterior superior iliac spine (ASIS) measured and the diameter of each perforator by transverse cut measured using callipers. In clinical cases, the arc of rotation was measured by keeping the distal perforator intact as pedicle (detaching the muscle from the ASIS without detaching from the insertion and then rotating it). RESULTS: Out of the 10 cadavers analysed, 6 were male and 4 were female. The mean location of the distal major pedicle was at 35.25 cm from ASIS and range was between 30.4 cm to 38.3 cm. There was no significant variation between right and left limbs in individual cadaver (range 0.2 cm-1.6 cm). The mean diameter of the arterial component of distal major pedicle was 1.54 mm. In three clinical cases where this flap was harvested the arc of rotation were 95°, 110°, 125°. In one of the cases where flap was used to cover the tibial plateau (arc of rotation 155°), distal end of the muscle necrosed. CONCLUSION: This cadaver study supported by various other studies show that it has sizeable distal pedicle based on which whole muscle can be harvested as flap. In our study, the usual location of this pedicle is at 35 cm from ASIS. The mean diameter of the widest pedicle in distal one-third was 1.54 mm which along with other small diameter pedicle can support the entire muscle. This flap reached up to the infrapatellar region without any vascular compromise.

Trace metal distribution, assessment and enrichment in the surface sediments of Sundarban mangrove ecosystem in India and Bangladesh.

Comparative study of trace metals distribution in the surface sediment of Sundarban mangrove ecosystem in India and Bangladesh is one of the primary baseline study done so far. Trace metal distribution assessment covering lower salinity zone to higher salinity zone was done along Matla River (tidal river) in Indian side and freshwater zone to higher salinity zone along Passur River in Bangladesh side of Sundarban; representing anthropogenic influenced area, agricultural area, tourist site and pristine area. Trace metals distribution in the surface sediments of Sundarban mangrove ecosystem shows relatively higher value of trace metals, Co, Cr, Cu, Fe, Ni, Pb and Zn in Indian part when compared to Bangladesh. Enrichment factor shows the highest enrichment of Pb in both parts of Sundarban mangroves. Co, Cr, Cu, Pb and Zn show EF>1 indicates sediment contamination from anthropogenic activities. Cr, Ni and Pb were found to have moderate accumulation in geoaccumulation index with Fe showing high accumulation. Normalized data of trace metals shows 87.5% from Indian site and 80% of Bangladesh site as outlier, indicating anthropogenic influence. Out of total sampling site 50% of Indian and 40% of Bangladesh site show trace metal values enriched more than predicted value of trace metals indicating Indian part have more polluted sites than Bangladesh side of Sundarban, which is also confirmed by enrichment factor, I-geo and normalization values in both the sides.