Dr. D. Y. Patil Medical College, Hospital and Research Centre

About: Dr. D. Y. Patil Medical College, Hospital and Research Centre is a healthcare organization based out in . It is known for research contribution in the topics: Medicine & Internal medicine. The organization has 17 authors who have published 28 publications receiving 14 citations.

Effective cooling methods for Ti6Al4V CNC milling: a review

Abstract: The Ti6Al4V is an eminent material by its high strength, dimensional stability, lower weight and corrosion resistance. Its lower thermal conductivity leads to poor machinability by exhibiting metallurgical alterations. This article discusses the details of dry, wet, cryogenic, minimum quantity lubrication and hybrid cooling methods in the milling of Ti6Al4V. Dry cooling has a worse acute effect on tool life and surface quality by thermal degradation. The widespread high-pressure cooling controls heat dissipation, but cutting tools are affected by chipping and adhesion under long-run milling. In the first instance, cryogenic cooling like liquid nitrogen and liquid carbon dioxide assisted cooling shows excellent tool life and surface integrity; however, excessive uncontrolled chilling and abnormal lubrication affect milling performance. Minimum quantity lubrication with nanoparticles and their combination with multi-wall carbon nanotubes improves the machinability by balanced cooling and lubrication under the concept of green manufacturing engineering. Indirect hybrid cryogenic cooling is a new era in superalloy’s cooling methods for long-run applications. The prime drive of this review is to formulate a bridge between cooling and performance under sustainability concerns and propounds the hybrid nanofluids and indirect hybrid cryogenic cooling being the future of Ti6Al4V milling under the mapping of sustainable scale.

Vision centre helps reduce blindness and vision impairment. Proof of concept in a four-year longitudinal study in an urban area in India

Abstract: Purpose: To estimate the prevalence of blindness and severe visual impairment (SVI) by using a door-to-door screening and vision center (VC) examination strategy in an urban area in western Maharashtra (Pune), India and repeat the exercise after 4 years to study its impact. Methods: Four trained community health workers measured the visual acuity and performed an external ocular examination in patients’ homes. People with vision <6/18 were requested to visit the VC for a comprehensive eye examination by an optometrist. An ophthalmologist examined people whose vision did not improve to 6/12. A home examination was done for people who did not visit the VC despite two requests. The same population was examined twice in an interval of 4 years. Results: In the study, 44,535 people in 2015–16 and 98.14% (n = 43,708) of them in 2018–19 were examined. Blindness (vision < 3/60 in better eye), and moderate-to-severe visual impairment (MSVI, vision 6/18–6/60 in better eye) were 0.26% and 1.3%, respectively, in the first cohort, and 0.16% and 1.1%, respectively, in the second cohort (P < 0.001). When the worse eye was considered, the prevalence of blindness reduced from 0.72% to 0.44%, SVI reduced from 0.1% to 0.07%, and MVI decreased from 1.7% to 1.49% between 2015 and 2019 (P < 0.001). Females (P < 0.001) and older individuals (P < 0.001) were more likely to have blindness or SVI. In the VC, 8211 people were examined in 4 years. Conclusion: The reduction of blindness and MSVI in the urban area of Pune can be partly ascribed to the presence of a VC and attendant screening in this locality.

Comparison Between Dexamethasone and Fentanyl as an Adjuvant to Bupivacaine and Lignocaine in Supraclavicular Brachial Plexus Block for Upper Limb Surgery

Abstract: Objective: To compare the effects of dexamethasone and fentanyl when added to a mixture of bupivacaine and lignocaine in supraclavicular blocks in patients undergoing forearm surgeries. Methods: Sixty-six patients aged between 20 to 60 years old belonging to ASA one or two were recruited prospectively, double-blinded, and randomized way. Supraclavicular block under sonographic guidance was performed in the three groups by using injection bupivacaine (0.5%) 20 cc + injection lignocaine (2%) 10 cc + injection 0.9% normal saline; 2ml (Group S), injection bupivacaine (0.5%) 20 cc + injection lignocaine (2%) 10 cc + injection dexamethasone 8 mg (Group D), and injection bupivacaine (0.5%) 20 cc + injection lignocaine (2%) 10 cc + injection fentanyl 50 µgm (Group F). The onset time of sensory and motor block, duration of sensory and motor block, and hemodynamic variables were recorded. Results: Group D showed a significantly greater sensory and motor block duration than other groups ( P = 0.001). Comparison of hemodynamic variables failed to reveal any statistically significant differences between all the groups. Conclusion: Both dexamethasone and fentanyl are good adjuvants in the supraclavicular block, but dexamethasone is better, given faster onset and duration of analgesia.