Role of carotid corrected flow time and peak velocity variation in predicting fluid responsiveness: a systematic review and meta-analysis

Singla Deepak,Gupta Bhavna,Varshney Pragya,Mangla Mishu,Walikar Beeraling Ningappa,Jamir Tiajem 대한마취통증의학회 2023 Korean Journal of Anesthesiology Vol.76 No.3

Background: Dynamic parameters used for predicting fluid responsiveness require special equipment and are minimally invasive. Therefore, recent interest in the use of carotid artery ultrasound parameters, such as carotid corrected flow time (FTc) and peak velocity variation (ΔVpeak) has grown. Therefore, we performed this systematic review and meta-analysis to assess the ability of carotid FTc and/or ΔVpeak to accurately predict fluid responsiveness.Methods: We searched the PubMed and Embase databases for articles evaluating the diagnostic accuracy of carotid FTc or ΔVpeak for predicting fluid responsiveness. Two independent authors performed the search and selected studies published until May 2022. The studies were assessed for the inclusion and exclusion criteria using Rayyan (Rayyan Systems Inc., 2022).Results: Ten studies (n=438) that fulfilled the inclusion criteria were selected. Studies were divided into those assessing carotid FTc and those assessing carotid ΔVpeak. Five studies (six datasets) assessed FTc. The pooled sensitivity and specificity of carotid FTc were 0.76 and 0.88, respectively. The summary receiver operating characteristic (SROC) curve for carotid FTc had an area under the curve (AUC) of 0.9092, with a Q value of 0.8412. Seven studies calculated carotid ΔVpeak. The pooled sensitivity and specificity for ΔVpeak were 0.83 and 0.81, respectively. The SROC curve had an AUC of 0.8941 and a Q value of 0.8250.Conclusions: Our meta-analysis showed that both carotid FTc and ΔVpeak are useful for predicting fluid responsiveness in anesthesia and critical care settings with good specificity and sensitivity.

Implementation of Cuckoo Search Optimized Firing Scheme in 5-Level Cascaded H-Bridge Multilevel Inverter for Power Quality Improvement

Singla, Deepshikha,Sharma, P.R. The Korean Institute of Power Electronics 2019 JOURNAL OF POWER ELECTRONICS Vol.19 No.6

Multilevel inverters have appeared as a successful and utilitarian solution in many power applications. The prime objective of an inverter is to keep the fundamental component of the output voltage of a multilevel inverter at a preferred value. Equally important is the need to keep the harmonic components in the output voltage within stated harmonic limits. Therefore, the basis of this research is to develop a harmonic minimization function that optimizes the switching angles of cascaded H-bridge multilevel inverter. Due to benefits of the Cuckoo Search (CS) algorithm, it is applied to determine the switching angles, which are further used to generate the switching pattern for firing the H-bridges of multilevel inverter. Simulation results are compared with SPWM based firing scheme. The switching frequency for SPWM firing scheme is taken as 200 Hz since the switching losses are increased when switching frequency is high. To validate the ability of Cuckoo Search optimized firing scheme in minimization of harmonics, experimental results obtained from hardware prototype of Five Level Cascaded H-Bridge Multilevel Inverter equipped with a FPGA controller are presented to verify the simulation results.

Stabilizing Periodontally Compromized Teeth with Polyethylene Fibre Splint: A Case Report

Ruchi Singla,Rahul Grover 대한예방치과학회 2015 International Journal of Clinical Preventive Denti Vol.11 No.2

The aim of this article is to present a case of splinting periodontally compromised mandibular right anterior teeth with polyethylene fibre reinforced composite splint-ribbond. A 34-year-old male with Grade II mobile mandibular right anterior teeth splinted with ribbond. Different materials have been successfully used for splinting which include–composite, wire and composite and fibre reinforced splints. In order to fulfill both the periodontal and restorative needs, ribbons and fibers were developed that could be reinforced with composite resin to form thin-but-strong splints. These splints are more stable and durable than the approaches of splinting used in the past.

Bohr’s Phenomenon for Some Univalent Harmonic Functions

Chinu Singla,Sushma Gupta,Sukhjit Singh 경북대학교 자연과학대학 수학과 2022 Kyungpook mathematical journal Vol.62 No.2

The largest value of such r0 is called the Bohr radius. In this article, we find Bohr radius for some univalent harmonic mappings having different dilatations. We also compute the Bohr radius for functions that are convex in one direction.

C-Shaped Canals: A Review

Meenu Singla,Divyam Girdhar,Haryana, India 대한예방치과학회 2019 International Journal of Clinical Preventive Denti Vol.15 No.1

C-shaped canal configuration is a variation that has a racial predilection and is commonly seen in mandibular second molars. The intricacies present in this variation of canal morphology can pose a challenge to the clinician during negotiation, debridement and obturation knowledge of the C-shaped canal configuration is essential to achieve success in endodontic therapy. Radiographic and clinical diagnosis can aid in identification and negotiation of the fan-shaped areas and intricacies of the C-shaped anatomy. Effective management of this anomalous canal configuration can be achieved with rotary and hand instrumentation assisted with sonics and ultrasonics. Modifications in the obturation techniques will ensure a 3-dimensional fill of the canal system and chamber retained restorations like amalgam or composites, serve as satisfactory post endodontic restorations.

External Cervical Resorption - A Diagnostic Challenge

Meenu Singla 대한예방치과학회 2012 International Journal of Clinical Preventive Denti Vol.8 No.4

External cervical resorption (ECR) is a relatively uncommon form of external resorption. Diagnosis & treatment of ECR is highly challenging to the clinician. This article discusses the etiology, histology, clinical features, differential diagnosis and management of ECR. It also discusses a case report of ECR which was earlier misdiagnosed as cervical caries with pulp and periapical pathology.

An energy-efficient technique for mobile-wireless-sensor-network-based IoT

Jatin Singla,Rita Mahajan,Deepak Bagai 한국전자통신연구원 2022 ETRI Journal Vol.44 No.3

Wireless sensor networks (WSNs) are one of the basic building blocks of Internet of Things (IoT) systems. However, the wireless sensing nodes in WSNs suffer from energy constraint issues because the replacement/recharging of the batteries of the nodes tends to be difficult. Furthermore, a number of realistic IoT scenarios, such as habitat and battlefield monitoring, contain mobile sensing elements, which makes the energy issues more critical. This research paper focuses on realistic WSN scenarios that involve mobile sensing elements with the aim of mitigating the attendant energy constraint issues using the concept of radio-frequency (RF) energy extraction. The proposed technique incorporates a cluster head election workflow for WSNs that includes mobile sensing elements capable of RF energy harvesting. The extensive simulation analysis demonstrated the higher efficacy of the proposed technique compared with the existing techniques in terms of residual energy, number of functional nodes, and network lifetime, with approximately 50% of the nodes found to be functional at the 4000th, 5000th, and 6000th rounds for the proposed technique with initial energies of 0.25, 0.5 and 1 J, respectively.

A Randomized Controlled Study to Compare the Total and Hidden Blood Loss in Computer-Assisted Surgery and Conventional Surgical Technique of Total Knee Replacement

Amit Singla,Rajesh Malhotra,Vijay Kumar,Chandra Lekha,G. Karthikeyan,Vishwas Malik 대한정형외과학회 2015 Clinics in Orthopedic Surgery Vol.7 No.2

Background: Total knee arthroplasty (TKA) is associated with considerable blood loss. Computer-assisted surgery (CAS) is different from conventional TKA as it avoids opening the intramedullary canal. Hence, CAS should be associated with less blood loss. Methods: Fifty-seven patients were randomized into two groups of CAS and conventional TKA. In conventional group intramedullary femoral and extramedullary tibial jigs were used whereas in CAS group imageless navigation system was used. All surgeries were done under tourniquet. Total and hidden blood loss was calculated in both groups and compared. Results: The mean total blood loss was 980 mL in conventional group and 970 mL in CAS group with median of 1,067 mL (range, 59 to 1,791 mL) in conventional group and 863 mL (range, 111 to 2,032 mL) in CAS group. There was no significant difference in total blood loss between the two groups (p = 0.811). We have found significant hidden blood loss in both techniques, which is 54.8% of the total loss in the conventional technique and 59.5% in the computer-assisted navigation technique. Conclusions: There is no significant difference in total and hidden blood loss in the TKA in CAS and conventional TKA. However, there is significant hidden blood loss in both techniques. There was no relation of tourniquet time with blood loss.

Does the presence and amount of epinephrine in 2% lidocaine affect its anesthetic efficacy in the management of symptomatic maxillary molars with irreversible pulpitis?

Mamta Singla,Megha Gugnani,Mandeep S Grewal,Umesh Kumar,Vivek Aggarwal 대한치과마취과학회 2022 Journal of Dental Anesthesia and Pain Medicine Vol.22 No.1

Background: This was a randomized controlled clinical trial that aimed to evaluate the anesthetic efficacy of 2% lidocaine combined with different concentrations of epinephrine (plain, 1:200,000 and 1:80,000) during endodontic treatment of maxillary molars with symptomatic irreversible pulpitis. Methods: The trial included 144 adult patients who were randomly allocated to three treatment groups. All patients received buccal-plus-palatal infiltration. After 10 min, pulp sensibility testing was performed using an electric pulp test (EPT). If a tooth responded positively, anesthesia was considered to have failed. In the case of a negative EPT response, endodontic access was initiated under rubber dam isolation. The success of anesthesia was defined as having a pain score less than 55 on the Heft Parker visual analog scale (HP VAS), which was categorized as ‘no pain’ or ‘faint/weak/mild’ pain on the HP VAS. Baseline pre-injection and post-injection maximum heart rates were recorded. The Pearson chi-square test was used to analyze the anesthetic success rates at 5% significance. Results: Plain 2% lidocaine and 2% lidocaine with 1:200,000 epinephrine and 1:80,000 epinephrine had anesthetic success rates of 18.75%, 72.9%, and 82.3%, respectively. Statistical analysis indicated significant differences between the groups (P < 0.001, χ2 = 47.5, df = 2). The maximum heart rate increase was seen with 2% lidocaine solution with epinephrine. Conclusion: Adding epinephrine to 2% lidocaine significantly improves its anesthetic success rates during the root canal treatment of maxillary molars with symptomatic irreversible pulpitis.

Lag Screw Trajectory in Supination-External Rotation Fractures: Does the Direction of the Fibula Lag Screw Have an Effect?

Amit Singla,Adam D Sahlstrom,Steven M Tommasini,Brad J Yoo 대한정형외과학회 2021 Clinics in Orthopedic Surgery Vol.13 No.4

Background: The fracture obliquity of supination-external rotation injury of the fibula is often amenable to lag screw insertion. The purpose of the study was to determine whether biomechanical differences exist between lag screws inserted from an anterior to posterior direction and from a posterior to anterior direction and the thickness of the anterior and posterior fibular cortices were correlated with biomechanical testing. Methods: Ten cadaver fibulae were harvested and submitted to material testing following 3.5-mm cortical screw insertion from either an anterior to posterior direction or a posterior to anterior direction. Screw torsional insertion strength and axial pullout strength were measured. Computed tomography images of 40 consecutive patients undergoing preoperative planning for fractures excluding the fibula were examined to define fibular cortical thickness and correlate anatomic findings with the biomechanical testing. Results: The axial pullout strength of lag screws inserted from posterior to anterior was significantly greater than that of lag screws inserted from anterior to posterior (p < 0.05). Screw insertion torque measurements demonstrated a similar trend although the data did not reach statistical significance (p = 0.056). The anterior cortex of the distal fibula exhibited a radiographically greater thickness than that of the posterior cortex at the same level (p < 0.001). Conclusions: For oblique fractures of the distal fibula, posterior to anterior lag screw insertion exhibited improved biomechanical properties when compared with a similar screw inserted from anterior to posterior. These results correlated with the thicker cortical bone present along the anterior fibula.