Comparative Evaluation of Cutting Efficiency of Three File Systems-Kedo-SH Manual, Pedoflex Rotary, and Manual K File: An In Vitro Study.

Aims: The purpose of this study was to comparatively evaluate the cutting efficiency of Pedoflex rotary, Kedo SH manual file, and manual K file systems used in root canal instrumentation while performing pulp therapy of deciduous teeth with a stereomicroscope. Materials and Methods: Forty-five extracted primary human root canals were chosen, and following the removal of pulp tissue, the canals were dyed with Indian ink and left to dry for 2 h. The samples were randomly divided into three groups, Group A: Kedo SH manual file system (n = 15), Group B: Pedoflex rotary file system (n = 15), and Group C: Manual K files (n = 15). After root canal instrumentation, all the root canals were cleared to make them transparent. The teeth after clearing were observed under stereomicroscope and scored according to the amount of dye present in the root canals. The data were tabulated and statistically analyzed with SPSS version 16 using Chi-square, Kruskal-Wallis, and Dunn's test (post-hoc). Results: With regards to cutting efficiency, there was a statistically noteworthy difference among groups A and C [P = 0.000] and groups B and C [P = 0.000]. Furthermore, groups A and B did not differ statistically significantly [P = 0.950]. Conclusions: Cutting efficacy of the Pedoflex rotary files was seen to be superior to that of Kedo SH and manual K files. Clinical Significance: Rotary files in deciduous teeth have various benefits over manual files, resulting in a noticeable reduction in working time, which has aided in maintaining patient participation by reducing the risk for fatigue. We conclude that NiTi rotary devices result in a superior cutting efficiency and, as a result, greater clinical success.

A multi-layer perceptron-Markov chain based LULC change analysis and prediction using remote sensing data in Prayagraj district, India.

Land use land cover (LULC) mapping and temporal observations are indispensable drivers for sustainable development. This research showed the growth trends and land use transition for the Prayagraj district in the last three decades. Supervised classification of Landsat images was performed on 5-year temporal intervals using a maximum likelihood classifier. All satellite images were organized into six major LULC feature classes viz agriculture/open land, barren land, built-up, forest, sand, and water. The overall accuracy of LULC classification was achieved by more than 89% in all seven temporal points. Furthermore, the accuracy of the classified maps was estimated through area-based error matrix. The Land Change Modeler tool of TerrSet 2020 software was used to analyze the transition of classes and to incorporate the multi-layer perceptron-Markov chain (MLP-MC) technique. The transition potentials were included in MLP-MC with the help of sensitive explanatory variables and significant transitions of classes. Furthermore, these transition potentials and the Markov chain transition matrix were used to predict the future LULC dynamics and vulnerability. The change analysis revealed that a significant portion of the agriculture/open land gradually decreased and got converted to built-up land. The results depicted that agriculture/open land was reduced by 8.03% in the last three decades while the built-up region was grown by 199.61%. Forest area was continuously decreasing while the sand area increased due to river meandering. Overall, more than 75% of accuracy was achieved in MLP. The prediction model was first validated with observed data, and then the LULC scenario of 2035 and 2050 was simulated. LULC of 2050 showed that the built-up area would likely reach 13.90% of district area whereas the forest area would remain only 0.79%. The prediction model has given the output in the form of future LULC map along with projected potential transition maps. This would be useful for sustainable urban planning to deal with the alarming rate of built-up growth and agriculture/open land shrinkage.

Overlooked contributions of Ayurveda literature to the history of physiology of digestion and metabolism.

Ayurveda is a traditional system of healthcare that is native to India and has a rich documented literature of its own. Most of the historians agree that the documentation of core Ayurveda literature took place approximately in between 400 BCE and 200 CE, while acknowledging that the roots of its theoretical framework can be traced back to a much earlier period. For multiple reasons many significant contributions of Ayurveda literature to various streams of biological and medical sciences have remained under-recognized while recounting the historical milestones of development. This is true in the context of the physiology of digestion and metabolism too. In this communication we try to reconstruct a picture of the processes of digestion and metabolism as had been understood by ancient Ayurveda scholars. Though this understanding was primitive and insufficient in many ways, we argue that this deserves to be documented and acknowledged. To help with grasping the importance of these contributions, we juxtapose them with the corresponding insights pertaining to this subject reported by prominent western scientists. The major contributions of Ayurveda that have been recounted in this paper are those related to the description of three distinct phases of digestion (Avasthapaka), multiple sets of transformative entities acting at different levels of metabolism (Agni), and the roles ascribed to various internal and external factors in executing these physiological functions.

An evaluation of primary schools and its accessibility using GIS techniques: a case study of Prayagraj district, India.

The spatial analysis of primary schools is needed to ensure that they meet standards set by the Government of India. Therefore, mapping of Prayagraj district primary schools is carried out in this research work. The spatial analysis of schools is performed using various parameters that include: literacy rate, student gender ratio, teacher taught ratio, and students' toilets ratio. Several problems were revealed in the GIS based analysis of schools by highlighting their locations on the map. The results identify the location of all those schools where there is a need to take corrective measures. Further, the route analysis between home and school is handled in this research work. Sometimes, commutation is the sole criteria in the selection of a school. Therefore, optimal path analysis has been performed based on three parameters, i.e. population density, traveling distance and traveling time. A combined weight function is also given to find the optimal path. This work will help people to select the best possible path based upon their requirements. There is often a requirement to reach all the schools to distribute the goods or other physical monitoring activities. This work gave the optimal route to visit all the schools by using the Travelling Salesman Problem (TSP). School accessibility results obtained in this research through TSP will assist in choosing the best possible route. This will help the government identify locations where new roads need to be constructed to have road connectivity.

Comparison of GIS-based AHP and fuzzy AHP methods for hospital site selection: a case study for Prayagraj City, India.

Identification of hospital sites and their ranking is important for the planning and development of any country's health infrastructure. The site selection problem is a typical multi-criteria decision making problem involving multiple stakeholders and their interests. Multi-Criteria Decision Analysis (MCDA) is a promising approach to solve a location-based problem due to the constitution of various criteria involved in decision making. In this research, eleven criterion are chosen which are classified under three main criteria; socio-economic, geographical and environmental. This research aims to identify the appropriate MCDA method for the selection of a new hospital sites. Here, two MCDA methods named Analytical Hierarchy Process (AHP) and Fuzzy AHP (FAHP) are used. Further, Geographical Information System (GIS) based MCDA methodology is proposed in this paper. The results obtained with both AHP and FAHP methods are compared. This comparison is based on criterion rankings, proposed hospital locations and sensitivity analysis. The main difference in results is shown in the result of sensitivity analysis in which constant variation in site ranking is obtained when weight change analysis is performed using AHP. The FAHP result shows only one variation in site ranking after a change in weight from +10 to +20%. The result suggests that FAHP may be a better approach to the hospital site selection problem.

Rare but not Abdicated: Status of Haemophilia in foothills of Himalaya, Uttarakhand: A cross-sectional study.

BACKGROUND: Haemophilia is one of the bleeding disorders, which is inherited, in an xlinked recessive pattern. The diagnosis is by estimation of factor levels of 8 and 9. Timebound treatment for people living with Haemophilia (PWH) is factor replacement during bleeding manifestation. The prevalence of Haemophilia was mostly underestimated, and it is more so in hilly terrains like the state of Uttarakhand. MATERIALS AND METHOD: This is a crosssectional study by compiling the data of PWH visiting the tertiary care centre for Haemophilia in Uttarakhand. We collected data from the patients with bleeding disorder reporting to the Haemophilia centre from July 2017 to December 2018. In this manuscript, we try to describe the pattern of Haemophilia and the degree of severity and incidence of inhibitors among the sample population of PWH who represent the population of Uttarakhand. The magnitude of problems faced by PWH from this hilly terrain to assess basic treatment in case of emergency is also being depicted. RESULT: We reported Haemophilia A contributing about 80% of the PWH in our centre. Average distance a PWH has to travel to obtain treatment was about 131.5 km (SD ± 83.7 km). Incidence of inhibitors was about 5%. CONCLUSION: We infer from our study that Hemophilia A is more common than Hemophilia B. Through this manuscript we hope to spread awareness of the Haemophilia care that is ongoing, the role of prophylaxis therapy and the future role of primary care physicians that may change the care of PWH in future.

Synergetic interaction between spatial land cover dynamics and expanding urban heat islands.

Inherent statistics of the surface temperature pattern were used to categorize urban heat islands (UHIs) for a tropical mega city and its satellite towns. Application of flexible threshold values for UHI zoning made this procedure independent of seasonal or locational influences. UHI zones for the years 1999, 2009, and 2019 were mapped from Landsat thermal bands by applying the mono-window algorithm. The parameters affecting the UHI intensity were rigorously investigated. Dynamics of land use land cover patterns provided in-depth insight into the spatiotemporal variability of UHI. The abrupt rises in localized surface temperature for every decade were recognized and thoroughly explained with the fall in fractional vegetation cover index and increase in normalized difference impervious surface index. The temporal nature of urban agglomeration and fragmentation of vegetation cover was quantified through landscape metric algorithms. The vegetation pattern and associated surface temperature fall were further used to evaluate the weakening of UHI intensity around major recreational zones. Substantial cooling by 0.938 °C was noted on daytime, from urban built-up at a 50-m distance to the green parks. Differential rates of urbanization and associated magnification of UHIs were looked into separately for central urban and satellite town areas. The characteristics of built-up density and proximity to green areas were employed to strategize mitigatory measures for the constantly growing UHI problem. Urgent needs for sustainable policies and green landscaping were highlighted through multi-criterion analysis.

Explication on tissue nutrition in prenatal and postnatal life: An Ayurveda perspective.

Tissue nutrition is the continuous process which is established just after the conception and persists throughout the life. Ayurveda scholars have mentioned that the manner of tissue nutrition is not same in all phases of life. In prenatal life embryo gets nutrition by Upasneha (filtration) and Upasweda (percolation/secretion) and fetus by Garbhanabhinadi (umbilical cord) which is attached with the heart of mother via Rasavahanadi (blood vessels). Thus in intrauterine life the nutrition of embryo is histotrophic, whereas just after the formation of placenta nutrition becomes haemotrophic. In post-natal life nutrition is enteral means nutrients are taken in the form of food via mouth called Aahar. Ayurveda scholars have postulated theories to understand the mechanism of tissue nutrition are Ksheera Dadhi Nyaya (transformation of nutrients), Khale Kapota Nyaya (selective uptake of nutrients), KedariKulya Nyaya (transportation of nutrients via channels), Ek Kala Dhatu Poshan Nyaya (simultaneous supply of nutrients to whole body). The theories of tissue nutrition discussed in Ayurveda suggest that although tissues are nourished and replenished continuously at different rate as per the functional state of Agni by circulating nutrients obtained from Ahara, but tissues are also dependent on each other for their proper nourishment and metabolism. This concept has great implication in management of malnourishment and various other disorders. This manuscript is an attempt to explore the Ayurveda's view on tissue nutrition along with physiological and clinical significance of theories of tissue nutrition in a scientific manner.

Magnetic Resonance Spectroscopy in Children With Developmental Delay: Time to Look Beyond Conventional Magnetic Resonance Imaging (MRI).

Developmental delay (DD) is an important long-term neuromorbidity owing to various insults to the developing brain and neuroimaging plays a key role in evaluating these children. Magnetic resonance spectroscopy (MRS) is the only noninvasive method to determine the levels of various metabolites in the brain which aids in delineating the underlying abnormalities. A total of 48 children aged between 6 months to 6 years with developmental delay were included and evaluated with neuroimaging in our study. Sensitivity of MRS in children with DD and DD plus (DD along with seizures, abnormal motor findings, behavior, brainstem evoked response audiometry, visual assessment, and microcephaly) was 81.2% and 89.6% respectively. 86.6% of children with microcephaly had abnormal MRS. MRS detected abnormalities in two-thirds of children with normal magnetic resonance imaging (MRI). Children with behavioral abnormalities had significantly lower N-acetyl aspartate (NAA)-creatine and NAA-choline ratios on MRS. Thus, MRS is additive to MRI in delineating the underlying pathophysiology in children with DD.

Pulmonary Embolism in Children: A Case Series.

BACKGROUND: Pulmonary embolism (PE) is a life-threatening event with a mortality of ~10%. It is relatively uncommon in children and literature regarding the condition is sparse. In adults, the classical clinical presentation is with pleuritic chest pain, hemoptysis, and dyspnea, whereas in children, the presentation is often nonspecific. MATERIALS AND METHODS: Clinical features, risk factors, and outcome of children with PE presenting to our unit between December, 19 and March, 2020 were recorded. RESULTS: Four children [mean age: 10 (6-16) years, 3 females], all presenting with tachycardia and dyspnea were diagnosed with PE. Different risk factors such as deep vein thrombosis, nephrotic syndrome, softtissue infection, and infective endocarditis (IE) were identified in all patients. One child died while others responded to anticoagulation. CONCLUSION: We aim to highlight the importance of timely recognition of PE in children with known risk factors for the same. Early recognition and timely treatment of PE are critical to save lives. HOW TO CITE THIS ARTICLE: Agrawal S, Shrivastava Y, Bolia R, Panda PK, Sharawat IK, Bhat NK. Pulmonary Embolism in Children: A Case Series. Indian J Crit Care Med 2020;24(12):1272-1275.