Computational analysis of Darcy-Forchheimer relation, reduced gravity, and external applied magnetic field influence on radiative fluid flow and heat transfer past a sphere: Finite difference method.

The study of radiation, Darcy-Forchheimer relation, and reduced gravity, effects on magnetohydrodynamic flow across a solid sphere immersed in porous material, is the focus of the current work. Coupled and nonlinear partial differential governing equations, are established to model the studied configuration. By using appropriate scaling variables, the resultant set of governing equations is converted to its dimensionless form. Based on these established equations, a numerical algorithm is written based on the finite element approach to solve the considered problem. A verification of the validity of the proposed model is done by comparing with already published results. Furthermore, to check the precision of solutions, a grid independence test has been accomplished. The unknown variables, such as fluid velocity and temperature, and their gradients are evaluated. This investigation's main objective is to demonstrate how the Darcy-Forchheimer law and reduced gravity due to density difference affect the natural convective heat transfer across a solid sphere immersed in a porous medium. Results show that the flow intensity decreases with the magnetic field parameter, local inertial coefficient, Prandtl number, and porosity parameter and becomes more important by increasing the reduced gravity and radiation parameters. In addition, the temperature increases with the inertial coefficient, porosity parameter, Prandtl number, radiation parameter, and magnetic field parameter and get declined with the reduced gravity parameter.

Seasonal abundance of Henosepilachna vigintioctopunctata (Fab.) on Solanum melongena L. and natural occurrence of its two hymenopteran parasitoids

ABSTRACT The 28-spotted hadda beetle Henosepilachna vigintioctopunctata Fab. (Coleoptera: Coccinellidae) is a poly-phagous pest, commonly infesting solanacious crops including brinjal, Solanum melongena L. Upon its severe infestation on brinjal, it causes considerable damage to the foliage and also to the calyx of fruits. The studies were made to record the seasonal abundance of hadda beetle and identification of its natural enemies present in the region for two consecutive years. The pooled data for two years showed that the maximum number of H. vigintioctopunctata egg clusters on brinjal were recorded in the 27th (0.40 egg cluster/ plant), followed by grub population in 35th (3.78 grubs/ plant), pupae in 33rd and 39th (0.83 pupae/ plant) and adult beetles in 36th (5.48 adults/ plant) standard meteorological weeks, respectively. It was observed that the key meteorological factors had 35.9%, 87.3%, 66.8% and 81.9% effect on the abundance of egg clusters, grubs, pupae and adults respectively in summer planted brinjal crop. Two natural enemies of hadda beetle viz. Tetrastichus sp. (egg parasitoid) and Pediobius foveolatus (pupal parasitoid) were recorded. The maximum parasitisation by Tetrastichus sp. and P. foveolatus on the egg clusters and pupae was recorded 22.64% and 6.62% respectively, during the month of August (34th and 35th standard meteorological week respectively). Further, the morphometric parameters of these two adult parasitoids were recorded and greater morphometric variability was observed in P. foveolatus in comparison to Tetrastichus sp.

Topical (intra-articular) tranexamic acid reduces blood loss and transfusion rates following total hip replacement: a randomized controlled trial (TRANX-H).

BACKGROUND: Approximately one-third of patients undergoing total hip replacement surgery require one to three units of blood postoperatively. Tranexamic acid is a synthetic antifibrinolytic agent that has been successfully used intravenously to control bleeding after total hip replacement. A topical application is easy to administer, provides a maximum concentration of tranexamic acid at the bleeding site, and is associated with little or no systemic absorption of the tranexamic acid. METHODS: A double-blind, randomized controlled trial of 161 patients undergoing unilateral primary total hip replacement investigated the effect of topical (intra-articular) application of tranexamic acid on blood loss. The primary outcome was the blood transfusion rate. Secondary outcomes included the drain blood loss, hemoglobin concentration drop, generic quality of life (EuroQol), Oxford Hip Score, length of stay, a cost analysis, and complications. RESULTS: Tranexamic acid reduced the absolute risk of blood transfusion by 19.6% (95% confidence interval [CI], 6.9% to 32.1%; p = 0.004), from 32.1% to 12.5%, and reduced blood loss by 129 mL (95% CI, 47 to 211 mL; p = 0.002), the hemoglobin concentration drop by 0.84 g/dL (95% CI, 0.41 to 1.27; p < 0.0001), the length of stay by 1.0 days (95% CI, -0.2 to 2.3 days; p = 0.109), and the cost per episode by £305 (95% CI, £0 to £610; p = 0.05). (In 2010, £1 = 1.5 U.S. dollars.) Oxford Hip Scores and EuroQol scores were similar at three months. CONCLUSIONS: Topically applied tranexamic acid was effective in reducing blood loss and the need for blood transfusion following total hip replacement, avoiding the potential complications of intravenous tranexamic acid administration. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Nevirapine versus efavirenz-based antiretroviral therapy regimens in antiretroviral-naive patients with HIV and tuberculosis infections in India: a pilot study.

BACKGROUND: Administration of rifampicin along with nevirapine reduces the plasma concentration of nevirapine in human immunodeficiency virus positive individuals with concomitant tuberculosis (HIV-TB patients). Nevirapine is a much cheaper drug than its alternative efavirenz, and might be beneficial in resource constrained settings. METHODS: A randomised open label trial was conducted at All India Institute of Medical Sciences, New Delhi, India. During the regimen of an antiretroviral therapy (ART), naive HIV-TB patients were randomly assigned to receive either nevirapine or efavirenz based ART with concomitant rifampicin based anti-tubercular therapy (ATT). Participants were followed for 24 months after starting ART. The end points were virological, immunological and clinical responses, and progression of HIV disease marked by failure of ART. RESULTS: Of the 135 HIV-TB patients, who were receiving rifampicin based ATT, 68 were selected randomly to receive efavirenz based ART and 67 to receive nevirapine based ART. The virological failure rates in the overall population, and the nevirapine and efavirenz groups were 14.1% (19/135); 14.9% (10/67) and 13.2% (9/68), respectively (p =0.94). No significant difference was found between the groups in the rate of clinical, immunological or virological failures. The overall mortality was 17% with no significant difference between the two groups. Except for the lead in period on day 14, the mean nevirapine concentration remained above 3 mg/L. No association was found between plasma levels of nevirapine and incidence of unfavourable outcomes in this group. CONCLUSIONS: Outcome of ART in HIV-TB patients on rifampicin based ATT showed no significant difference, irrespective of whether efavirenz or nevirapine was used. Therefore, nevirapine based ART could be an alternative in the resource limited settings in patients with HIV and tuberculosis co-infection. TRIAL REGISTRATION: NCT No. 01805258.

The antiretroviral efficacy of highly active antiretroviral therapy and plasma nevirapine concentrations in HIV-TB co-infected Indian patients receiving rifampicin based antituberculosis treatment.

BACKGROUND: Rifampicin reduces the plasma concentrations of nevirapine in human immunodeficiency virus (HIV) and tuberculosis (TB) co-infected patients, who are administered these drugs concomitantly. We conducted a prospective interventional study to assess the efficacy of nevirapine-containing highly active antiretroviral treatment (HAART) when co-administered with rifampicin-containing antituberculosis treatment (ATT) and also measured plasma nevirapine concentrations in patients receiving such a nevirapine-containing HAART regimen. METHODS: 63 cases included antiretroviral treatment naïve HIV-TB co-infected patients with CD4 counts less than 200 cells/mm3 started on rifampicin-containing ATT followed by nevirapine-containing HAART. In control group we included 51 HIV patients without tuberculosis and on nevirapine-containing HAART. They were assessed for clinical and immunological response at the end of 24 and 48 weeks. Plasma nevirapine concentrations were measured at days 14, 28, 42 and 180 of starting HAART. RESULTS: 97 out of 114 (85.1%) patients were alive at the end of 48 weeks. The CD4 cell count showed a mean increase of 108 vs.113 cells/mm3 (p=0.83) at 24 weeks of HAART in cases and controls respectively. Overall, 58.73% patients in cases had viral loads of less than 400 copies/ml at the end of 48 weeks. The mean (± SD) Nevirapine concentrations of cases and control at 14, 28, 42 and 180 days were 2.19 ± 1.49 vs. 3.27 ± 4.95 (p = 0.10), 2.78 ± 1.60 vs. 3.67 ± 3.59 (p = 0.08), 3.06 ± 3.32 vs. 4.04 ± 2.55 (p = 0.10) respectively and 3.04 µg/ml (in cases). CONCLUSIONS: Good immunological and clinical response can be obtained in HIV-TB co-infected patients receiving rifampicin and nevirapine concomitantly despite somewhat lower nevirapine trough concentrations. This suggests that rifampicin-containing ATT may be co administered in resource limited setting with nevirapine-containing HAART regimen without substantial reduction in antiretroviral effectiveness. Larger sample sized studies and longer follow-up are required to identify populations of individuals where the reduction in nevirapine concentration may result in lower ART response or shorter response duration.