Fragmented QRS – Its significance Supreeth, R.N.; Francis, Johnson
Indian pacing and electrophysiology journal,
01/2020, Letnik:
20, Številka:
1
Journal Article
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Fragment QRS (fQRS) complex is a myocardial conduction abnormality that indicates myocardial scar. It is defined as additional notches in the QRS complex. Though initially fQRS was defined in the ...setting of normal QRS duration (<120 m s), later it has been expanded to include conditions with wide QRS complexes as in bundle branch block, ventricular ectopy and paced rhythm, when more than 2 notches are present. It is an important, yet often overlooked marker of mortality and arrhythmic events in many cardiac diseases. The significance of fQRS lies in the fact that it just requires a surface ECG for its recording and the value of information about the condition of the heart it dispenses based on the clinical setting. We review the role of fQRS in predicting adverse cardiac events in various conditions.
•Chopart fracture-dislocations are missed or misdiagnosed in up to 41% of cases.•The restoration of integrity of the talonavicular, calcaneocuboid joint results in good long-term outcome.•These ...dislocations are often accompanied with long-term morbidity due to its role in balance and stability of the foot.
A rare case of Dorsal Chopart’s fracture dislocation after a fall from height is presented. It combines the features of pure dorsal Chopart’s dislocation and the longitudinal swivel variant described by Main and Jowett presenting as dorsomedial fracture dislocation of the medial three fourths of the navicular, crushing the lateral one fourth. The possible mechanism of injury has been described. It has been successfully treated with closed reduction and percutaneous k-wire fixation. At two-year follow-up the patient was asymptomatic, back to his moderately active work.
Investigating the role of leading edge tubercles on the aerodynamic behavior of S823 airfoil tailored for wind turbine applications has been the forefront of the study. The aerodynamic ...characteristics of S823 airfoil effectuated by leading edge tubercles are ascertained at Reynolds number Re=200000 which is the usual operating range of most of the small-scale wind turbines. Firstly, the study elucidates the numerical investigation of baseline airfoil and later modified airfoils exhibiting different amplitude A and wavelength λ of the sinusoidal leading edge tubercles represented as A07W50, A12W50, and A07W25. The aerodynamic characteristics of the airfoils at Re=200000 and angles-of-attack ranging from 00 to 200 are evaluated numerically through k-ω SST turbulence model using ANSYS FLUENT® software package. A preliminary comparison of the computational data shows that the coefficient of lift Cl of all the modified airfoils was visibly superior to the baseline model across the angles tested. A07W50, A12W50 and A07W25 registered 20.6%, 26.2%, and 8.7% increase in the Cl values as compared to the baseline model. Contrasting to the Cl values, the aerodynamic efficiency Cl/Cd of the baseline model was slightly better but only across the pre-stall regime and later culminated with a sudden hard stall. Promisingly, this type of hard stall was not true for the tubercled models that demonstrated a more gradual and restrained stalling characteristic, thus showcasing superior performance in the post stall envelope that was never observed for the baseline model. Based on the outcomes, A07W50 model that displayed better aerodynamic characteristics was eventually fabricated and experimentally tested for its performance in a low speed wind tunnel. The numerical results of A07W50 were in good agreement with the experimental results. The overall results of the study prove beyond any point of doubt that tubercles indeed aid in improving the aerodynamic characteristics by enhancing the lift Coefficient Cl, rendering soft stalling nature and extending the scope of operation for the airfoil under study. Finally, the study positively confirms that leading edge tubercles very much play a significant role in passively augmenting the fluid dynamic characteristics of S823 airfoil and also qualify them to be a competitive passive flow control device.
With this case report we underline the risk of misdiagnosis by fine-needle aspiration cytology (FNAC), need for improvement in tissue diagnostic facilities in rural India, and importance of repeat ...neuroimaging at proper intervals to clinch the diagnosis of unusual cases. ...MRI brain was repeated on Day 10, which showed bilateral medial temporal lobe and hippocampal hyperintensities on T2-weighted fluid-attenuated inversion recovery (FLAIR) sequence Figure 3 and Figure 4. ...diagnosis of TB lymphadenitis should not entirely be based on FNAC.
Background: An outbreak of Nipah virus infection was confirmed in Kerala, India in May 2018. Five out of 23 cases including the first laboratory-confirmed case were treated at Baby Memorial Hospital ...(BMH), Kozhikode. The study describes the clinical characteristics and epidemiology of the Nipah virus outbreak at Kozhikode during May 2018. Objective: To study the clinical and epidemiological profile of Nipah virus epidemic that occurred in Kerala in May 2018. Methods: A collaborative team of physicians and epidemiologists from BMH, Medical College Hospital (MCH) Kozhikode and from the Indian Medical Association (IMA) conducted this study. The clinical and exposure history and the data on outbreak response were gathered from hospital medical records and through interviewing patient relatives and health workers using questionnaires. Results: It was identified that out of the 23 patients with Nipah virus infection, 21 (91.3%) expired. Out of the 21 patients, 18 tested positive for Nipah virus by Real Time polymerase chain reaction (RT-PCR). It has been found that only the index case was infected in the community from fruit bats. Rest of the cases were due to transmission of the virus at three public hospitals. Median age was 45 years. 65% of them were males. Median incubation period was 9.5 days. Fever (100%), altered sensorium (84.2%), tachycardia (63.1%), hypertension (36.8%), segmental myoclonus (15.7%), segmental sweating (15.7%) and shortness of breath (73.6%) were common features. Mean duration of illness was 6.4 days. Conclusion: The rapid spread of infection uncovered the miserable state of health care system in implementing infection control measures. The case fatality and the socio-economic burden warrant developing appropriate treatments, vaccines and diagnostics.
In the present study, Blade Element Momentum theory (BEMT) has been implemented to heuristically design a rotor blade for a 2kW Fixed Pitch Fixed Speed (FPFS) Small Scale Horizontal Axis Wind Turbine ...(SSHAWT). Critical geometrical properties viz. Sectional Chord ci and Twist distribution θTi for the idealized, optimized and linearized blades are analytically determined for various operating conditions. Results obtained from BEM theory demonstrate that the average sectional chord ci and twist distribution θTi of the idealized blade are 20.42% and 14.08% more in comparison with optimized blade. Additionally, the employment of linearization technique further reduced the sectional chord ci and twist distribution θTi of the idealized blade by 17.9% and 14% respectively, thus achieving a viable blade bounded by the limits of economic and manufacturing constraints. Finally, the study also reveals that the iteratively reducing blade geometry has an influential effect on the solidity of the blade that in turn affects the performance of the wind turbine.
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