Comparative Analysis of Various Materials Used for Mastoid Cavity Obliteration in Canal Wall Down Mastoid Surgery.

To study the surgical result and efficacy of different methods of mastoid obliteration with cavity care. This prospective study included 60 patients who had cholesteatoma, conducted in the Department of Ear Nose and Throat (ENT), Institute of Medical Sciences, Banaras Hindu University, Varanasi from July 2015 to July 2017. The mastoid cavity was obliterated with either muscle flap/bone dust/hydroxyapatite. detailed history otoscopic examination was done pre-operatively and follow up were recorded at 1 month and 3 months in postoperative period. 60 patients were included, who underwent canal wall down mastoid surgery. each group muscle flap (group 1), bone dust (group 2) and hydroxyapatite (group 3) included 20 patients, age group 31-40 year with its maximum incidence of 43.3%, Preop PTA value were almost equal in all group but on comparison at 1 month in postoperative period significant improvement was present in group 1 versus 2(0.021) and group 2 versus 3(0.003) but not in group 1 versus 3. Although at 3 month there were significant improvement was present in all groups. The incidence of pain, discharge, giddiness and wax formation were markedly reduced and healing of cavities was early and better in obliterated cavities done by muscle flap and bone dust material as compared to hydroxyapatite cavities, at the end of 3 months. outcome and quality of life was better and almost equal in muscle flap and bone dust material group as compared to hydroxyapatite group.

Transient analysis and reliability modeling of fault-tolerant system operating under admission control policy with double retrial features and working vacation.

Maintaining a high-level reliability and efficiency without interruption are the key concerns for many real-time machining systems. Using the redundancy and repair facility features, we develop a double retrial orbit queueing model for the fault-tolerant machining system (FTMS) operating under the restriction of admission of repair jobs based on threshold policy and working vacation. The provision of primary and secondary orbits is made so that the failed units can wait there based on the facility available in case the repairman is occupied. From the orbits, the failed units retry to get the repairman free so that the repair job can be accomplished. Chapman-Kolmogorov equations for the system states of FTMS have been constructed to evaluate the transient reliability and queueing indices using the spectral technique. The sensitivity along with the relative sensitivity analysis of crucial system parameters, have facilitated. The impacts of parameter variability on the system metrics and total expected cost are examined for illustrative examples.

Optimal control of fault tolerant machining system with reboot and recovery in fuzzy environment using harmony search algorithm.

In this study, fuzzy modeling and service control based on optimal N-policy for fault tolerance system have been investigated. The impacts of failures and recovery along with the reboot process are taken into account for the assessment of performance indices of the system operating under redundancy and provision of maintainability. The non-Markovian M/G/1 model of the fault-tolerant system with vacationing server is developed by using the supplementary variable to represent the remaining time to repair and further employing recursive approach. The parametric non-linear programming is used to derive fuzzy performance metrics. The sensitiveness of parameters concerning system indices is done. The cost function is framed to obtain the optimal descriptors and minimal cost using harmony search.

A Study of Anxiety and Depression in Benign Breast Disease.

BACKGROUND: To compare the prevalence of anxiety and depression levels in patients with benign breast disease (BBD) and healthy individuals using Hospital Anxiety and Depression Scale (HADS) and Brief Patient Health Questionnaire (BPHQ). METHODS: This study includes 100 patients who were clinically suspected of having BBDs and were matched against 100 healthy age-matched controls from June 2016 and July 2018. The diagnosis of BBD was established on the basis of ultrasonography, fine needle aspiration cytology, and/or histopathology. For the diagnosis of anxiety and depression, BPHQ was used and the level of anxiety and depression was measured using the HADS. The questionnaire at both prediagnosis and at follow-up assessment after 3 months was done. RESULTS: On comparing anxiety and depression using BPHQ score among cases and controls, both were significantly associated with cases than controls (P < 0.001 and P = 0.0016, respectively). On comparing anxiety and depression using HADS score, there was a significant difference (median) in both anxiety and depression level between cases and controls (P < 0.001 and P < 0.001, respectively). After 3 months of follow-up, there was a significant improvement in anxiety and depression scores by both BPHQ (P = 0.007 and P = 0.0016) and HADS (P < 0.001 and P < 0.001). The 3-month follow-up data showed a significant improvement in BPHQ (depression) score in patients with breast lump and mastalgia (P = 0.001 and P = 0.008). The HADS (anxiety score) showed significant improvement in patients presenting with diseases/aberrations other than fibroadenoma while the HADS (depression) score showed a significant improvement in all except fibroadenosis present either alone or along with fibroadenoma. The HADS (depression) score showed a significant improvement in fibroadenoma, others group, breast lump, and mastalgia (P = 0.040, P = 0.005, P < 0.001, and P = 0.025, respectively). CONCLUSION: Indian female patients who present with BBDs are also affected by anxiety and depression.

Comparative clinical study of Guggulu-based Ksharasutra in Bhagandara (fistula-in-ano) with or without partial fistulectomy.

BACKGROUND: In Ayurveda, Bhagandara is considered as one of the grave disease by Sushruta due to more recurrence rate. Ksharasutra is para-surgical procedure which is found more effective in the management of fistula-in-ano. Ksharasutra is routinely prepared with Snuhi Ksheera (latex), Haridra powder and Apamarga Kshara. In conventional method collection of Snuhi latex is time consuming and laborious. Guggulu was selected as an alternative for preparation of Ksharasutra having similar binding property as Snuhi latex, and has antiseptic, anti-inflammatory and wound-healing properties. That is why, here, in this trial, the Snuhi latex was replaced by Guggulu. AIM: To evaluate the efficacy of Guggulu based Ksharasutra with and without partial fistulectomy in the management of Bhagandara. MATERIALS AND METHODS: In this research study, 42 patients of Bhagandara (fistula-in-ano) were selected and randomly divided into two groups. In group-A (n = 22), patients were treated only with application of Guggulu-based Ksharasutra and in group-B (n = 20), partial fistulectomy was done and then Guggulu-based Ksharasutra was applied in remaining fistulous tract. After Ksharasutra application, patients were assessed for relief in symptoms such as pain, discharge, itching and swelling as subjective parameters and unit cutting time (UCT) as an objective parameter, on weekly follow-up basis and Ksharasutra was changed by railroad technique up to complete cut through of the tract. RESULTS: In patients of group-A (plain Guggulu-based Ksharasutra), highly significant relief was seen in pain and discharge. The significant result was seen in itching while insignificant relief in swelling. In patients of group-B (partial fistulectomy with Guggulu-based Ksharasutra), relief in symptoms such as pain, discharge, and itching was statistically highly significant. The relief in swelling in this group was found statistically significant. The mean UCT was 8.85 days/cm in group-A, whereas the mean UCT was 8.19 days/cm in group-B. CONCLUSION: Partial fistulectomy with Guggulu-based Ksharasutra is better as compared to plain Guggulu-based Ksharasutra application in cases of Bhagandara (fistula-in-ano).

Arsenic-induced genotoxic responses and their amelioration by diphenylene iodonium, 24-epibrassinolide and proline in Glycine max L.

Presence of the toxic metalloid, "arsenic (As)" is ubiquitous in the environment especially in the soil and water. Its excess availability in the soil retards growth and metabolism of plants via (a) slowing down the cell division/elongation, (b) overproduction of reactive oxygen species (ROS), (c) modulation of antioxidant enzymes, and (d) alteration of DNA profile/genomic template stability (GTS). In the current study, diphenylene iodonium (DPI), 24-epibrassinolide (EBL) and proline (Pro) were used to analyze their roles in eliminating the adverse effects of As. Glycine max L. (variety JS 335) seeds were subjected to As (75 µM, Sodium arsenite was used as source of As), and in combination with DPI (10 µM), EBL (0.5 µM) or Pro (10 mM), for five consecutive days, and effects of these treatment combinations were analyzed on germination percentage, biomass, membrane stability, GTS and expressions of defensive genes. In addition, the levels of As, ROS, malondialdehyde, DNA content, oxidation, fragmentation, polymorphism, DNase activity, endogenous Pro and pyrroline-5-carboxylate synthetase activity were evaluated. The results indicated that the treatments of DPI, EBL or Pro are capable to alleviate detrimental effects of As, gauged from above variables, but with different magnitudes. Apropos As-stress mitigation, Pro was found to be the most effective under the confines of the study protocol. This study certainly provides new ideas for intensifying studies to unravel elusive central mechanism of amelioration involving use of DPI, EBL or Pro in plants with confirmed As-toxicity.

Prediction of Phenotypic Effects of Variants Observed in LOC_Os04g36720 of FRO1 Gene in Rice (Oryza sativa L.).

In rice, ferric-chelate reductase-1 (FRO1) (LOC_Os04g36720) gene was present on chromosome number 4 and its beginning and ending coordinates where coding sequence lies are 22182599 and 22186943, respectively. It plays a vital role in metal homeostasis and iron transportation in plants. Based on the alignment results, location of single-nucleotide variants is located in open reading frame and their effects of variants were predicted using SIFT sequence tool. The non-synonymous variants at position 342 and 436 lies in helical and coil parts of the protein, respectively, as predicted by Psi-pred server. PSI-Blast which resulted in significant hits and the most similar protein sequence (Accession ID: NP_001052896) with available sequence features displayed 100 % identity with query cover of 99 %. Results suggest the non-synonymous variant at position 436 (Accession ID: TBGI204002) lies in FAD-binding domain and nsSNV at position 342 (Accession ID: TBGI203998) lies in periphery of NADP. The SNPs were also analyzed for the deleterious effect by PANTHER subPSEC scores and I-mutant score, and it was postulated that SNPs would be hampering on biological as well as molecular function of FRO 1 gene of rice. A cutoff of -3 corresponds to a 50 % probability that a score is deleterious. From this, the probability that a given variant will cause a deleterious effect on protein function is estimated by P deleterious, such that a subPSEC score of -4 corresponds to a P deleterious of 0.79. Hence, to study the phenotypic consequences of variant TBGI204002, we performed comparative molecular docking studies of native modeled protein and protein with induced mutation as receptors and FAD as ligand to be utilized for binding. The docking process was performed by AutoDock 4.2 software with Lamarckian Genetic algorithm as computational algorithm. Results suggest binding energies are higher in case of mutation-induced protein which suggests presence of variant TBGI204002 enhances binding of FAD ligand at FAD-binding domain site. In case of TBGI203998, similar comparative docking procedure was performed with FAD as binding ligand, which suggests presence of variant does not impact FAD binding at the domain site. We revealed impact of SNPs on the protein structure and its function using sequence-based tools.

Wound healing potential of Pañcavalkala formulations in a postfistulectomy wound.

Sushruta mentioned sixty measures for management of wounds. Panchavalkal is the combination of five herbs having properties like Shodhana (cleaning) and Ropana (healing) of wounds. Individual drugs and in combination have Kashaya rasa (astringent) dominant and useful in the management of Vrana (wounds) as well as Shotha (inflammations). A 35 years old male patient consulted in Shalya OPD with complaints like discharge per anum, induration and intermittent pain at perianal region since last five years. On inspection external opening was observed at anterior portion 1 O' clock position which was four centimeter away from anal verge. That case was diagnosed as Bhagandara (fistula-in-ano) and was treated with partial fistulectomy and application of Guggulu based Ksharasutra in the remaining tract. The big fistulectomy wound was treated with local application of Panchavalkal ointment daily and simultaneous change of Ksharasutra. The wound was assessed daily for pain, swelling, discharge, size, and shape. The wound healed completely within two and half month with normal scar having good tissue strength. This case demonstrated that post fistulectomy wound can be treated with Panchavalkal ointment.