Numerical Study of Stratified Flames Using Reynolds Averaged Navier Stokes Modeling.

Reynolds averaged Navier Stokes technique was used to develop a validated numerical model for stratified flames. The validation was carried out with the experimental data of the non-swirl flames of the Cambridge dual annulus swirl burner. The RNG k-ε turbulence model along with the SG-35 skeletal chemical mechanism was found to give a good prediction of scalar and vector quantities while resulting in the reduction of computational time by 99.75% in comparison with that required for large eddy simulation techniques used in the literature. The effect of stratification at a constant input power, global equivalence ratio, and Reynolds number was examined. At stratification ratios (SRs = ϕin/ϕout) 1 and 2, intense burning, marked by the higher OH concentration, was observed close to the bluff body. Beyond SR = 2, the region of intense burning shifts downstream away from the bluff body. This is a result of the high equivalence ratio in the inner annulus, which is beyond the rich flammability limit of methane-air flames, and as a result, the primary flame region is shifted downstream after the mixtures from inner and outer annulus have mixed properly to produce a mixture with the equivalence ratio in the flammability limit. The maximum temperature was found to increase by 24.1% when the SR is increased from 1 to 2 and the combustion efficiency was found to significantly improve by 267%. The highest maximum temperature of 2249 K is observed for the mildly stratified flame at SR = 2. Beyond SR = 2, the maximum temperature decreases, while the combustion efficiency increases slightly.

The success of tibiotalocalcaneal arthrodesis with intramedullary nailing--a systematic review of the literature.

Tibiotalocalcaneal arthrodesis with an intramedullary nail may find indications for a variety of conditions of the hindfoot. We performed a systematic review of the literature primarily to find out the union rates and complications of tibiotalocalcaneal arthrodesis with an intramedullary nail. We included 33 studies for this review. These studies included 631 patients who had 659 procedures. Eighteen cases were excluded and 641 joints (613 patients) were available for the final analysis. We analysed the indications, union rates, complications and re-operation rates. The union rate was 86.7% with an average union time of 4.5 months. The complication rate was 55.7%. Metalwork related complications made a significant proportion of all the complications. The re-operation rate was 22%. Revision arthrodesis was done in 3% and amputation in 1.5% the cases. The review indicates that tibiotalocalcaneal arthrodesis with an intramedullary nail has a relatively good union rate but a high rate of complications. Majority of the complications are related to the metalwork. The suggested strategies to minimise these complications are discussed.

Role of Proton Pump Inhibitors in Laryngopharyngeal Reflux: Clinical Evaluation in a North Indian Population.

There has been an escalation of patients presenting with symptoms of Laryngopharyngeal reflux disease (LPRD) in the otorhinolaryngology clinics due to life style and dietary changes. This study was undertaken to evaluate the effect of various proton pump inhibitors in the treatment of LPRD using Reflux symptom index (RSI) and Reflux finding score (RFS). This was a prospective study conducted from June 2016 to February 2017 with a total of 240 patients with symptoms and signs of LPR. The patients were divided into 5 groups. Each group was subjected to particular proton pump inhibitor. There were 124 males 116 females with a mean age 34.3 and rural to urban ratio being 11. After 3 months, RFS and RSI score within each group, improved significantly with Proton pump inhibitor therapy. In our study patients who were treated with omeprazole 20 mg twice daily had the highest improvement in laryngeal symptoms and laryngeal findings. We conclude emphasizing the effectiveness of proton pump inhibitors with incorporation of lifestyle modification in the successful management of LPRD.

Emerging Trends of Intentional Firearm Injuries in Northern India: A Study.

INTRODUCTION: Many developing countries are facing rise in firearm injury cases owing to communal and ethnic clashes, political violence, armed robberies and suicide causing huge economic loss to society. On the basis of intention, injuries can be categorized as intentional and unintentional or accidental injuries. Intentional injuries will include suicidal, homicidal and assault related injuries. AIM: This study was undertaken to document the trends and patterns associated with intentional firearm injuries in order to suggest ways to curb the emerging trends. MATERIALS AND METHODS: This was a cross-sectional and descriptive study conducted at Jawaharlal Nehru Medical College and Hospital (JNMCH), AMU, Aligarh, UP, India from May 2007 to April 2008. The parameters studied were month wise distribution of cases, age and sex distribution of victims of intentional gunshot injuries, body part injured, alleged assailant and medical management provided to the victim. The observed data was entered onto a worksheet and descriptive statistics were used. RESULTS: A total of 140 cases of intentional firearm injuries were studied, 133 were assault cases and 7 were suicide by means of firearm. Maximum number of intentional gunshot injury cases were reported during the month of September (17.14%) and October (14.29%) and least during month of December (2.14%). For intentional injuries, 21-40 years was the high risk age group (91 or 65% cases) with male preponderance (95.71%) and male to female ratio of 22:1. Preferred site for assault was the trunk, with 50.38% cases with chest abdomen and back injuries. Family feud (20.71%) was the leading cause of assault and assailant was not known (47.86%) to the victim in majority of cases of assault injuries. CONCLUSION: Increasing cases of firearms as a means of assault and suicide, calls for limiting the number of handgun purchase, regulations to check illegal trade of firearms, accountability of ammunition used and to develop standardised hospital based data collection system so that trend and patterns associated with intentional firearm injuries can be determined.

Unusual pseudomyiasis with Musca domestica (housefly) larvae in a tracheostomy wound: a case report and literature review.

We report a case of pseudomyiasis (accidental myiasis) in a 52-year-old man who had previously undergone surgery and placement of a tracheostomy tube for laryngeal cancer. The patient presented to our outpatient department with a foul-smelling, blood-stained discharge and frequent and severe episodic pain at the site of the tracheostomy. He also reported the discharge of many whitish larvae from the site. On clinical examination, 3 of these larvae were removed from the tracheostomy wound and later identified as Musca domestica (housefly) larvae. The patient underwent further mechanical removal twice daily for 3 days, during which time 23 more larvae, or maggots, were removed. His condition improved, and he returned for regular follow-up with no recurrence or complications. Myiasis is an infestation of humans and vertebrate animals by insect larvae that feed on both dead and living tissue. Myiasis is most common in hot and humid climates in tropical and subtropical regions, such as the underdeveloped areas of India, Africa, and Southeast Asia, which provide favorable breeding grounds for flies. Myiasis is classified as specific, semispecific, or accidental, depending on whether the fly larvae require a host in order to develop. We review the literature on myiasis and its entomologic aspects in general. We also discuss the need for the proper care of tracheostomy wound myiasis because the site of such an infestation is close to vital organs in the neck. To the best of our knowledge, only 3 cases of tracheostomy wound myiasis have been previously reported in the English-language literature; 2 of them involved infestation with Chrysomyia bezziana larvae and 1 with Lucilia caesar larvae. We believe our case is the first case of tracheostomy wound pseudomyiasis attributable to M domestica larvae.