Objectives:The uses of devices of electromagnetic waves(EMWs)are increasing day by day.Similarly,the gen-eration of the waves is increasing.The frequency spectrum of the generation of waves is also increased.In this manuscript,an analysis of the high frequency EMWs has been made by the electric fields generated due to the exposure of 5th generation(5 G)of mobile phones. Methods:Due to the emission of waves from the towers,the electric field is generated around the transmission tower of mobile phones.The electric fields are computed by the power of the transmission tower.The electric fields across the biological tissues/cells are also computed when the EMWs penetrate inside the body.The electric fields are made across the organs of different depths inside the body. Results:The induced electric fields inside the organs of the human beings are responsible for the absorption of energy from high frequency EMWs.The absorbed amount of energy from high frequency waves may become the cause of harmful effects on the life of organs of human beings. Conclusion:In this manuscript,after analysis of the computed electric fields inside the organs of human beings,it is concluded that the EMWs of 5 G spectrum of mobile phone towers may more harmful for the life of organs as 4th generation(4 G)spectrum of mobile phone waves.The energy absorption by the 4 G spectrum is lower than 5 G spectrum due to the range of frequency of waves.The effects on the pancreas,retina,skin,intestine,spleen,stomach and uterus are more than low water content organs like nails,bone,teeth etc.

Purpose: Uncertainty exists about whether early laparoscopic cholecystectomy (LC) is an appropriate surgical treatment for acute calculous cholecystitis. This study aimed to compare early vs. late LC for acute calculous cholecystitis regarding intraoperative difficulty and postoperative outcomes. Methods: This was a prospective randomized study carried out between December 2015 and June 2017; 60 patients with acute calculous cholecystitis were divided into two groups (early and delayed groups), each comprising 30 patients. Thirty patients treated with LC within 3 to 5 days of arrival at the hospital were assigned to the early group. The other 30 patients were placed in the delayed group, first treated conservatively, and followed by LC 3 to 6 weeks later. Results: The conversion rates in both groups were 6.7% and 0%, respectively (p = 0.143). The operating time was 56.67 ± 11.70 minutes in the early group and 75.67 ± 20.52 minutes in the delayed group (p = 0.001), and both groups observed equal levels of postoperative complications. Early LC patients, on the other hand, required much fewer postoperative hospital stay (3.40 ± 1.99 vs. 6.27 ± 2.90 days, p = 0.006). Conclusion Considering shorter operative time and hospital stay without significant increase of open conversion rates, early LC might have benefits over late LC.

STUDY DESIGN: Retrospective study. PURPOSE: To outline the etiology, complications and management difficulties encountered in the management of neglected thoracolumbar spine injuries. OVERVIEW OF LITERATURE: The English literature describes overlooked diagnosis as the most common cause of neglected spine injuries. However, the reasons differ in developing or under-developed nations. Moreover, there is scarcity of literature about the neglected spinal injuries. METHODS: Patients presenting with thoracolumbar traumatic injuries who had not received any form of treatment for more than three weeks were included in the study. The demographic details, operative procedure performed and complications encountered, along with American Spinal Injury Association grade and spinal cord independence measure score recorded on the history sheets were noted. The data were analyzed. RESULTS: Forty patients were included in the study. Inadequate treatment at the first contact hospital (45%) followed by late presentation (38%) and missed injury (17%) were the major etiological factors for the neglected traumatic injuries in the thoracolumbar spine. The most common complications seen in the management of these cases were pressure sores (58%), back pain (57%), urinary tract infection (42%) and residual kyphotic deformity (42%). CONCLUSIONS: Management of neglected thoracolumbar injuries is challenging. The delay in presentation should not prevent spine surgeon in proceeding with operative intervention as good results can be expected.
Back Pain ; Congenital Abnormalities ; Developing Countries ; Diagnosis ; Humans ; Neglected Diseases ; Pressure Ulcer ; Retrospective Studies ; Spinal Cord ; Spinal Cord Injuries ; Spinal Fractures ; Spinal Injuries ; Spine* ; Surgical Procedures, Operative ; Urinary Tract Infections

Objectives: Obstructive Sleep apnea (OSA) is characterized by complete or partial obstruction of upper airflow despite the effort to breathe, leading to hypoxemia and hypercapnia. The resultant apnea causes sleep fragmentation, which in turn increases sympathetic activity, decreases insulin sensitivity and glucose uptake, and stimulates hepatic gluconeogenesis that ultimately leads to type 2 diabetes. Most studies exploring the effect of continuous positive airway pressure on insulin sensitivity have showed a positive effect. However, there is no evidence on the effect of mandibular advancement device on insulin resistance (IR). This study was aimed to evaluate the effect of mandibular advancement splint (MAS) on IR in patients with OSA. Methods: The present study was conducted at Department of Prosthodontics, Dental College Azamgarh, from June 2015 to July 2017. Sixty eight dentulous patients with type 2 diabetes and mild to moderate OSA and with stable diabetic regimen were included in the study. A MAS was fabricated and fixed at 70% of the maximum mandibular protrusion recorded. Patients that were comfortable with MAS after one month were assessed for apnea-hypopnea index, mean oxygen saturation, and IR at baseline, 6 months, and 1 year after wearing MAS. Results: An improvement in insulin sensitivity was observed at 6 months for mild OSA patients (p=0.001). For moderate OSA patients, no significant improvement was observed following MAS use (p>0.05). Conclusions The finding suggested that MAS is effective in improving IR in mild OSA patients.

The management of multiple complicated injured patients remains a great challenge despite advance- ments in modern medical care. We present a rare case of bilateral unstable pelvic fractures associated with bilateral segmental femoral shaft fractures.We have proposed a mechanism of such complex injury pattern and discussed the plan of management. We believe that a timely and aggressive surgical intervention to fix all the major fractures soon after medically stabilizing the patient helped our patient to overcome these serious and lethal injuries. It is necessary to establish an optimal protocol for management of such complex fractures by conducting prospective and multicentric studies in the future.
Adult ; Female ; Femoral Fractures ; diagnostic imaging ; surgery ; Humans ; Pelvic Bones ; diagnostic imaging ; injuries

Thoracic impalement injuries are very rare and the majority of patients do not survive to reach a medical care facility. In this case report, we describe the successful outcome of a case of double thoracic impalement by two steel tors, of which one steel tor had impaled two patients simultaneously. The case report highlights all aspects of managing such rare and complex cases right from prehospital care; extrication process which happened under controlled environment at the trauma centre itself, till the definitive management of the impaled thoracic objects. Thoracic impalement injuries are dramatic and appear very challenging. However presence of mind of the managing team, coordinated team effort and availability of adequate facilities can lead to a successful outcome.
Humans ; Thoracic Injuries ; Wounds, Penetrating

BACKGROUND: Street vendors spend relatively more time near roadways and are vulnerable to air pollution related health disorders. However, there is limited information on the quality of the air they breathe. The objectives of this present study were to calculate the mass concentration of atmospheric particulate matter (PM) in eight size fractions (PM0.4–0.7, PM0.7–1.1, PM1.1–2.1, PM2.1–3.3, PM3.3–4.7, PM4.7–5.8, PM5.8–9.0, and PM9.0-–0µm) at commercial (CML) and residential site (RSL) in Dehradun city from November 2015 to May 2016. To estimate the corresponding respiratory deposition dose (RDDs) in alveolar (AL), tracheobronchial (TB), and head airway (HD) region on street vendors working at CML and RSL. To find the association of atmospheric PM with RDDs and the incidence of respiratory related disorders among street vendors. METHODS: Andersen cascade impactor was employed for calculating the PM mass concentration. Questionnaire based health survey among street vendors were carried out through personal interview. RESULTS: A significant difference (p < 0.05; t-test) between the mean PM0.4–10µm mass concentration at CML and RSL was observed with (mean±SD) 84.05±14.5 and 77.23±11.7 µgm−3, respectively. RDDs in AL, TB and HD region at CML was observed to be 9.9, 7.8, and 7.3% higher than at RSL, respectively. Health survey revealed 1.62, 0.96, 0.04, and 0.57 times higher incidence of cold, cough, breathlessness, and chest pain, respectively with street vendors at CML compared to RSL. CONCLUSION: The site characteristics plays a major role in the respiratory health status of street vendors at Dehradun.
Air Pollution ; Chest Pain ; Commerce ; Cough ; Dyspnea ; Head ; Health Surveys ; Humans ; Incidence ; Particulate Matter

Monogenic disorders are traditionally attributed to the presence of mutations in a single gene. However, recent advancements in genomics have revealed instances where the phenotypic expression of apparently monogenic disorders cannot be fully explained by mutations in a single gene alone. This review article aims to explore the emerging concept of digenic or oligogenic inheritance in seemingly monogenic disorders. We discuss the underlying mechanisms, clinical implications, and the challenges associated with deciphering the contribution of multiple genes in the development and manifestation of such disorders. We present relevant studies and highlight the importance of adopting a broader genetic approach in understanding the complex genetic architecture of these conditions.

PURPOSE: Perineal transposition of the antropyloric valve following an anorectal excision as a substitute for a permanent colostomy has recently been reported in humans. However, the problem of neural control still remains in these patients. Our aim herein was to study the anatomical feasibility of an anastomosis between the pudendal nerve branches (inferior rectal nerve) innervating the external anal sphincter and the anterior vagal branches of the perineally-transposed antropyloric segment in cadavers. METHODS: The antropyloric segment, along with its carefully dissected branch of the anterior vagus, was mobilized based on the left gastroepiploic pedicle in six fresh human cadavers. The antropyloric valve was then transposed in the perineum after the pudendal nerve branches had been dissected out, and an approximation of these two nerves was performed to ascertain the technical feasibility of their neural anastomosis. RESULTS: The anterior vagus innervating the antropylorus could be harvested in all cadavers below the hepatic division of the main vagus trunk. The inferior rectal nerve or its branches were found consistently around the 3 or the 9 o'clock position in the ischioanal fossa. An anatomical tension-free approximation of the anterior vagus branch (of the transposed antropyloric segment) to the inferior rectal nerve in the perineum was feasible in all the cadavers studied. CONCLUSION: An inferior rectal nerve anastomosis with the anterior vagal branch of the perineally-transposed antropyloric segment can be achieved anatomically. This preliminary step can be the basis for future animal studies and subsequent clinical application of the procedure for possible neural control of the transposed antropyloric segment in the perineum.
Anal Canal ; Animals ; Cadaver ; Colostomy ; Humans ; Perineum ; Pudendal Nerve ; Pylorus ; Vagus Nerve

STUDY DESIGN: Prospective case series. PURPOSE: To study the safety and feasibility of cotransplantation of bone marrow stem cells and autologous olfactory mucosa in chronic spinal cord injury. OVERVIEW OF LITERATURE: Stem cell therapies are a novel method in the attempt to restitute heavily damaged tissues. We discuss our experience with this modality in postspinal cord injury paraplegics. METHODS: The study includes 9 dorsal spine injury patients with American Spinal Injury Association (ASIA) Impairment Scale (AIS) A neurological impairment who underwent de-tethering of the spinal cord followed by cotransplantation with bone marrow stem cells and an olfactory mucosal graft. Participants were evaluated at the baseline and at 6 monthly intervals. Safety and tolerability were evaluated through the monitoring for adverse events and magnetic resonance imaging evaluation. Efficacy assessment was done through neurological and functional outcome measures. RESULTS: Surgery was tolerated well by all participants. No significant difference in the ASIA score was observed, although differences in the Functional Independence Measure and Modified Ashworth Scale were statistically significant. No significant complication was observed in any of our patients, except for neurogenic pain in one participant. The follow-up magnetic resonance imaging evaluation revealed an increase in the length of myelomalacia in seven participants. CONCLUSIONS: The cotransplantation of bone marrow stem cells and olfactory mucosa is a safe, feasible and viable procedure in AIS A participants with thoracic level injuries, as assessed at the 24-month follow-up. No efficacy could be demonstrated. For application, further large-scale multicenter studies are needed.
Asia ; Bone Marrow* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Olfactory Mucosa* ; Outcome Assessment (Health Care) ; Prospective Studies ; Spinal Cord ; Spinal Cord Injuries* ; Spinal Cord Regeneration ; Spinal Injuries ; Spine ; Stem Cells* ; Thorax ; Transplants