Comparative Study of Outcome of Tympanoplasty by Postauricular and Permeatal Approach

Background: As from time of residency, tympanoplasty is the most common operation performed by an otolaryngologist. Because of the continuing efforts of otologists all around the world to produce the maximum surgical outcome, significant improvements in this surgical method have developed during the middle ages. Objective: The aim of the study was to compare the outcome of Tympanoplasty in Postauricular and Permeatal Approach.Methods:A total of 74 patients between the age group 15 to 44 years who were attending the ENT OPD, suffering from Chronic Suppurative Otitis Media (CSOM) were selected on the basis of type of perforation and their workup was done to assess the candidature for tympanoplasty. Comparative analysis between the two groups were done based on analysis using SPSS 24 software version. The level of significance was set to 5% (p < 0.05).Results:A total of 74 patients were included in the study and the overall graft take was 76.92% in cases of Permeatal technique as compared to 91.66% in the case of postaural underlay technique. The complication of postaural approach higher than Permeatal approach. There was a difference in hearing improvement with majority of the cases improving to the range of 10-22 dB in Permeatal technique compared to 08-18 dB in Postaural Underlay technique.Conclusion:In terms of complications and hearing improvement, the Permeatal method outperforms the Postauricular Approach, however the graft takes a higher percentage in the Postauricular Approach than the Permeatal Approach.

Influence of natural production conditions on efficient operation of wheel tractors

For the zones of “risky farming” characteristic of the Far East of the Russian Federation, the natural production conditions of the region are an important problem in preparing the soil for further basic agricultural work. So, when carrying out early spring agricultural work, due to presence of a solid underlying layer in the form of permafrost, they shall be completed in operational terms no more than 10 days, until the permafrost base thaws and the soil has not lost its bearing capacity. In addition, due to the peculiarities of the relief, the soil does not thaw equally in depth everywhere, which reduces the quality of field work and harrowing, as the most common operation, namely. This article provides theoretical and experimental studies on the adaptation of a wheeled tractor as part of a machine-tractor unit (MTU) used in harrowing to natural production conditions by installing a device that automatically regulates the load on the working body of the disc harrow or on the propellers of the energy device, depending on the conditions of use or the state of the motion surface.

Clinical Outcome and Operative Findings with Ectopic Pregnancy at Tertiary Medical College & Hospital

Introduction: An ectopic pregnancy is an emergency condition worldwide now a days which defined as a pregnancy that progresses after implantation of the blastocyst anywhere other than the endometrium lining the uterine cavity. Objective: In this study our main goal is to identify clinical outcome and operative situation in patients. Materials and Methods: This descriptive study was performed from January 2015 to December, 2018 at tertiary medical College & Hospital. During the study 200 patients were evaluated and data was extracted from socio-demographic, menstrual, obstetric and clinical history of the patients. Results: most of the patients belong to 30 years (19.7%) age group and history of pelvic infection (26.26%), induced abortion (17.4%), previous MR (16.26%) and sub fertility (11.25%) were common risk factor in ectopic pregnancy found in the study. Also majority of the patients faced laparotomy followed by right sided salphinogectomy (40.40%) which was the most common operation. Conclusion: quick diagnosis, classifying of risk factors and timely intervention in the form of surgical treatment is necessary for reduction mortality rate in ectopic pregnancy. Medicine Today 2021 Vol.33(2): 160-164

Ten-Year (2010–2019) Activity Report of the Replantation Service for Hand and Finger Amputations in Poland

Replantation of amputated hands is now considered a routine procedure in countries representing high standards of medical care. However, organization of care for patients with hand amputations is not uniform and varies from country to country, even in the European Union. This article presents organization of the Replantation Service for hand amputations in Poland, and ten-year activity report of the Service. Data to this report were obtained by mailing questionnaires to seven participating departments.A total of 974 patients, 871 men (89 %) and 103 women (11 %) at a mean age of 40 years with total or subtotal amputations or other severe upper limb-threatening injuries were admitted to the seven units participating in the Service. The most common injury was multidigital amputation – 353 (36 %), followed by the thumb – 282 (29 %), the metacarpal and wrist – 231 (24 %) and the forearm and arm – 108 (11 %) amputations. The most common operation was replantation of totally amputated hands/fingers – 368 cases (38 %), followed by revascularization of subtotal amputated hands/fingers – 344 (35 %). Primary reconstruction of a complex injury to the hand was performed in 135 patients (14 %). The rate of survival of the replanted/revascularized hands/fingers was a mean of 80 %. The report is supported by literature review about replantation services in other countries.

Curative intent treatment in recurrent carcinoma cervix, numbers need to increase

Cervical cancer is most common cancer among females in Nepal. Majority of them presents in advanced stage and treated with definitive chemo-radiation. Fifteen to thirty percent recurs and among them 50% are localised in pelvis. The only curative treatment available at this point is surgery in selected patients and total pelvic exenteration is most common operation performed among few other surgical options. First described almost 72 years back, now the morbidity and mortality of this so-called brutal procedure has decreased and this becomes the only hope of survival in these patients. We present a case of a person from remote village of Nepal who had recurrence following primary treatment and underwent total pelvic exenteration. She recovered well and is disease free at 1-year follow up and is treatment free. The aim of this case report is to create awareness among clinicians, patient and other person involved in cancer care that treatment with curative intent is still possible after cancer recurrence.

Image Splicing Location Based on Illumination Maps and Cluster Region Proposal Network

Splicing is the most common operation in image forgery, where the tampered background regions are imported from different images. Illumination maps are inherent attribute of images and provide significant clues when searching for splicing locations. This paper proposes an end-to-end dual-stream network for splicing location, where the illumination stream, which includes Grey-Edge (GE) and Inverse-Intensity Chromaticity (IIC), extract the inconsistent features, and the image stream extracts the global unnatural tampered features. The dual-stream feature in our network is fused through Multiple Feature Pyramid Network (MFPN), which contains richer context information. Finally, a Cluster Region Proposal Network (C-RPN) with spatial attention and an adaptive cluster anchor are proposed to generate potential tampered regions with greater retention of location information. Extensive experiments, which were evaluated on the NIST16 and CASIA standard datasets, show that our proposed algorithm is superior to some state-of-the-art algorithms, because it achieves accurate tampered locations at the pixel level, and has great robustness in post-processing operations, such as noise, blur and JPEG recompression.

Volvulus of the Transverse Colon

Background In the United States, the third leading cause of a large bowel obstruction (LBO) is colonic volvulus with torsion occurring most commonly in the sigmoid and the cecum. Transverse colonic volvulus (TCV) is exceedingly rare and specific involvement of the splenic flexure (SFV) is even less common. The present analysis was undertaken to interrogate current trends in presentation, management, and outcomes of TCV. Methods In the present report, the world literature was reviewed for the past 90 years (1932 to 2021). We conducted a systematic review to identify all cases of TCV following the PRISMA guidelines. Results We identified 317 cases of TCV. This included SFV (n = 75), TCV in pediatric patients (n = 63), TCV in pregnant patients (n = 8), and TCV associated with other pathology such as Chilaiditi’s syndrome (n = 11). Compared to sigmoid and cecal volvulus, TCV was rare (.94%). It affected slightly more women (54%) than men, commonly in their third decade of life (37.7 ± 23.8). The clinical presentation and diagnostic imaging were consistent with LBO. Compared to sigmoid volvulus, there was a limited role for conservative management and colonoscopic decompression was less effective. The most common operation was segmental resection (25%). Mortality was (20%) commonly because of cardiopulmonary complications and affected more women (63%). The average age of this cohort was 55.7±24.6 years old. Discussion Our review showed that TCV is an uncommon surgical entity. The diagnosis is likely to be made at laparotomy. Prompt recognition is paramount in preventing ischemia necrosis and perforation. Compared to sigmoid and cecal volvulus, the mortality for TCV remains high.

Epidemiology and Management of Pediatric Tracheomalacia

Tracheomalacia is excessive trachea collapse, usually upon expiration. Severe symptoms accompany congenital types. Often milder versions occur following the neonatal period. Adult malacia is mostly linked to pulmonary chronic obstruction. There's still no standardized functional bronchoscopy. Dynamic CT airway is an excellent diagnostic tool. Bronchoscopy and stent insertion led to a major improvement, although with a high incidence of complication. Surgical lateropexia, excision of trachea and external surgical stabilization are possibilities. Aortopexy is the most common operation in children.

ON THE POSSIBILITY OF LASER STRIPPING OF COMMUNICATION CABLES WITH LOW-POWER CO2 LASER

Laser engraving is one of the most commonly used laser procedures for interacting with laser material. The speed, ease of use and high precision make it an attractive process for use by manufacturers and for removing insulation from various cables. Cable stripping is a particularly common operation in aeronautics. The aircraft is equipped with several hundred kilometers of cables to control and operate the various systems of the aircraft and most of these cables must be stripped at both opposite ends to allow the cable to be connected to different terminals.This report examines the possibility of removing polyvinyl chloride (PVC) insulation from telecommunication cables of different colours and thicknesses up to 600 [μm]. The experimental measurements of the study were performed with a low-power continuous CO2 laser system. The main functional dependence of the width and depth of the ablation zone on the main technological parameters, such as the average power and the processing speed, have been experimentally studied. The zones of laser impact are observed with a laser microscope. The graphic dependencies are analyzed in order to determine the optimal working intervals.The analysis aims to help solve problems related to the application of small diameter communication cables in the production of various communication devices and components for the needs of industry.

Design and Implementation of a 32-bit Floating Point Unit

A Floating Point Unit is a math co-processor that is in the most demand of Digital Signal Processing (DSP), Processors and more. It is used to perform functions or operations on floating point numbers like addition, subtraction, multiplication, division, square root and more. It is specifically designed to carry out mathematical operations and it can be emulated in CPU. Floating point unit is a common operation used in advanced Digital Signal Processing and various processor applications. The aim was to develop an optimized floating point unit so that the delay was reduced and efficiency was increased. The floating point unit has been written according to IEEE 754 standard and the entire design has been coded in Verilog HDL. The results are improved by 12% with the usage of Vedic multiplier that is a delay of 4.450ns as compared to 5.123ns with an array multiplier. Designs can be further optimized using low power designing techniques at architectural level. Different behaviour can be observed for different size and technologies.