King George Hospital

Accurate prediction of the heat conduction coefficient (HCC) of renewable fuels is essential for improving thermal management and advancing clean combustion technologies. Existing empirical correlations lack robustness across wide thermodynamic and molecular domains, creating a significant research gap. This study applies six machine‑learning techniques, Support Vector Machine (SVM), Artificial Neural Networks (ANN), Decision Tree (DT), Bagged Tree (BT), Least Squares Boosting Trees (LSBT), and Genetic Programming (GP), to develop generalized HCC models using 2051 high‑quality experimental data points described by reduced pressure, reduced temperature, and molecular weight. Among these models, SVM demonstrated the strongest predictive capability, achieving an overall Mean Absolute Percentage Error (MAPE) of 0.96 % and a coefficient of determination (R²) of 98.78 % on unseen data. Complementarily, GP provided a transparent analytical correlation with MAPE of 1.97 % and R² of 95.18 %, offering a novel interpretable alternative to black‑box models. Additional evaluations, cross‑plot analysis, violin–box deviation profiling, five-fold cross‑validation, and training‑size generalization tests, confirmed SVM’s robustness, stability, and minimal sensitivity to dataset partitioning. Trend analysis further revealed physically consistent dependencies of HCC on pressure, temperature, and molecular chain length, while the SHapley Additive exPlanations (SHAP) interpretability demonstrated that reduced temperature is the dominant factor, followed by molecular weight and reduced pressure. Overall, this research delivers both high‑accuracy predictive models and a practically deployable mathematical correlation, bridging engineering usability with modern machine learning performance. The findings offer a comprehensive and reliable framework for estimating HCC in renewable fuels across broad operating conditions. • Machine learning models developed for accurate prediction of biofuel HCC. • SVM achieved superior accuracy with MAPE below 1 % across wide conditions. • GP delivered an explicit, interpretable HCC correlation for engineering use. • SHAP analysis revealed temperature as the dominant factor governing HCC. • Robust validation confirms reliability across diverse esters and regimes.

Introduction: Inhaled alkyl nitrite analogues, commonly known as “poppers,” are short-acting vasodilators that can cause euphoria, dizziness, and related effects. Nitrites rarely result in acute life-threatening complications such as ventricular dysrhythmias. We report a case of electrical storm following accidental inhalation of isobutyl nitrite. Case Presentation: A 40-year-old male had accidental occupational exposure to isobutyl nitrite, after which he became unconscious and was brought to our hospital. On arrival, he was found to be in ventricular fibrillation, and cardiopulmonary resuscitation was initiated as per Advanced Cardiac Life Support protocol. He required three defibrillations, with return of spontaneous circulation achieved after 30 minutes. Post-resuscitation, an SaO2–SpO2 gap of 15% was noted, suggesting a high probability of methemoglobinemia. The patient was immediately treated with methylene blue (2 mg/kg) and transferred to the intensive care unit. Due to hypotension, vasopressors and inotropes were initiated. Two-dimensional echocardiography revealed severe left ventricular systolic dysfunction with an ejection fraction of approximately 30%. Management and Outcome: In the ICU, the patient developed multiple episodes of ventricular tachycardia requiring cardioversion, without sustained return of spontaneous circulation. Extracorporeal cardiopulmonary resuscitation was initiated using a 25 Fr multistage venous cannula in the left femoral vein and a 19 Fr return cannula in the right common femoral artery. Spontaneous circulation was achieved within eight minutes. Over the next 24 hours, the patient experienced eight additional episodes of ventricular tachycardia, all managed with cardioversion, and was started on a lignocaine infusion for 48 hours. The patient gradually regained sensorium, and co-oximetry showed no evidence of methemoglobinemia. Left ventricular function improved to 40%. ECMO was weaned and discontinued on day three. The patient was extubated on day four and discharged on day nine with no recurrence of arrhythmias on telemetry. Conclusion: This case highlights a rare but life-threatening complication of isobutyl nitrite exposure presenting as refractory ventricular arrhythmias. Prompt recognition and timely initiation of extracorporeal support were crucial for survival.

In the intensive care unit (ICU), changes in urine color can result from various causes, such as medications, metabolic disorders, and infections, and are always a cause of concern to the treating physician. We managed a polytrauma patient in the ICU and noticed passing green color urine, which was associated with intravenous Propofol administered for sedation. There are various factors that cause changes in urine color. Green color urine induced by Propofol is a rare and remarkable side effect. Propofol metabolites, such as the 4-sulfate and the 1- or 4-glucuronide conjugates of 2, 6-diisopropyl-1, 4-quinol, are excreted in the urine after undergoing glycoconjugation in the liver. The green color of urine is attributed to the presence of these phenolic metabolites in the urine. Phenolic metabolites of Propofol are produced in the liver and excreted in the urine, resulting in a green discoloration. Prompt recognition of this effect can help avoid unnecessary laboratory investigations.

Dyslipidemia is a major, yet under-recognized, driver of atherosclerotic cardiovascular disease (ASCVD) in Indian women. This expert consensus provides India-specific guidance on early detection, risk stratification, and management of lipid disorders across the female life course. Seventy-five specialists from cardiology, endocrinology, lipidology, obstetrics–gynecology, and primary care participated in a modified Delphi process with three structured rounds. An agreement threshold of ≥80% was maintained to develop statements based on 20 key clinical questions and a comprehensive review of international and Indian evidence. The consensus emphasizes early and repeated lipid screening. All women should have at least one lipid profile between ages 20 and 39 years, with earlier and more frequent testing in those with a family history of premature ASCVD, suspected familial hypercholesterolemia, polycystic ovary syndrome, gestational diabetes, pre-eclampsia, premature menopause, or autoimmune disorders. Life-stage checkpoints such as pre-conception, 6–12 weeks postpartum, and at menopause are highlighted as critical opportunities for evaluation and intervention. The panel developed India-specific, life-stage-oriented risk assessment and management statements for women, emphasizing early lipid screening, recognition of female-specific risk enhancers, and practical treatment pathways. Management begins with lifestyle optimization and, when indicated, stepwise pharmacotherapy: Statins as first line (avoiding routine use in pregnancy and lactation), ezetimibe or fibrates as add-on therapy, and PCSK9 inhibitors or Inclisiran for very-high-risk cases not at target. Bile-acid sequestrants are identified as the safest drug option during pregnancy or breastfeeding. This statement integrates global best practice with India-specific risk profiles and care pathways. By embedding life-stage-oriented screening, female-specific risk enhancers, and risk stratification into routine care, it provides a practical roadmap for clinicians and public health programs to reduce the burden of ASCVD in Indian women.

This paper presents a compact, reconfigurable rhombic-shaped microstrip filtering antenna for $\mathbf{5 G}$ sub-6 GHz band applications. The proposed design integrates a combined $\mathbf{U}$ and T-shaped bandpass filters directly into a rhombic patch with defected ground structure (DGS), achieving both filtering and radiation functions in a single structure. The main contributions of this work include a 13.4% metallization-reduced rhombic geometry that enables wideband operation, embedded bandpass filters that deliver sharp roll-off characteristics ($-\mathbf{2 5 ~ d B} /$ decade), and PIN diode-based reconfiguration supporting quad-band operation ($\mathbf{4. 9 6 - 6. 6 3 ~ G H z}$). Simulation results demonstrate a $\mathbf{1. 7}$ GHz operational bandwidth $(3.5-5.2 \mathrm{GHz})$, peak gain of 4.8 dBi, and radiation efficiency exceeding 80%. The antenna’s integrated filtering response ($S_{11}\lt-10 \mathrm{~dB}$) eliminates the need for external filters while maintaining compact dimensions of $40 \times 29 \times 1.6 \mathrm{~mm}^{3}$. The filtering antenna is implemented on FR-4 substrate and simulated using CST MWS, the design addresses critical $\mathbf{5 G}$ requirements of size reduction, frequency selectivity, and tunability.

When it comes to mental health, gender matters. Men and women experience psychological stress in different ways. Gender disparities are especially noticeable in mental illnesses that are more common in women. In addition to beingmore likely than other women to experience sexual or physical abuse, women who misuse alcohol or drugs tend to blame their drinking on stressful situations or traumatic experiences. Young married women and girls from nuclear homes are more likely to commit suicide or self-harm. Social and gender-specific variables influence the occurrence and progression of mental illnesses in female patients. The low number of hospital visits among women can be partially attributed to their lack of resources. In India, over two-thirds of married women are victims of domestic abuse. The prevalence of domestic violence from 2019 to 2021 was 31.2%. Approximately 28.5%, 13.1% and 5.7% of women reported experiences of physical, emotional and sexual violence (Mishra et al., 2024).Social, political, economic and legal reforms have the potential to transform Indian women’s lives and improve their mental wellbeing. To deal with the difficulties that women’s mental health presents today, it is critical to approach mental health initiatives from a gender perspective. In addition, investigating alternative approaches to service delivery, including the use of mobile phone technology, which has the potential to be efficient and increase accessibility to services, can enhance the provision of mental healthcare for women.

The online version contains supplementary material available at 10.1007/s12055-025-02028-0.

IntroductionAnkle trauma is a frequent presentation to the emergency department (ED) and poses a significant demand on radiology services. Efficient triage is essential to identify patients requiring urgent imaging, optimising resources, reducing waiting times, and minimising unnecessary radiation exposure. Injuries range from soft tissue damage to fractures of the distal tibia, fibula, or malleoli. Not all ankle injuries require immediate imaging, and clinical decision-making tools can guide the use of radiographs. The Ottawa Ankle Rules (OAR) are a validated tool, endorsed by the Royal College of Radiologists (RCR), designed to identify ankle injuries requiring radiographs. Imaging is indicated if the patient is unable to bear weight both immediately after injury and during examination, or if there is bone tenderness along the distal six centimetres of the posterior edge of the tibia or fibula, or over the lateral or medial malleoli. Adherence to the OAR has been shown to reduce unnecessary imaging while maintaining high sensitivity for fractures.MethodsA two-cycle retrospective review was conducted of patients presenting with traumatic ankle injuries who underwent radiography. Records were reviewed via the Picture Archiving and Communication System (PACS) until 100 patients per cycle were included. Data collected included whether the OAR were referenced in radiograph requests and whether a fracture was diagnosed. After the first cycle, educational interventions were implemented to increase guideline awareness. The second cycle evaluated the impact of these interventions. Statistical analysis assessed the significance of observed changes. Exclusions included patients aged ≤16 years or ≥55 years, those with non-traumatic or chronic ankle presentations, and those with polytrauma or high-energy mechanisms of injury. Results were compared against RCR standards, which state that 100% of all ankle plain-film requests for trauma should reference the OAR. Results were presented at departmental governance meetings, and recommendations were subsequently implemented.ResultsIn the first cycle, 37 (37%) of radiograph requests referenced the OAR. Fractures were identified in 21 (21%) patients, with 13 (61.9%) of these requests documenting the OAR and 8 (38.1%) omitting them. Following educational interventions, the second cycle demonstrated significant improvement, with 51 (51%) of requests referencing the OAR (P = 0.046). The proportion of patients with fractures increased to 31 (31%), of whom 26 (83.9%) had OAR documented, compared with 5 (16.1%) without documentation (P < 0.001). These findings reinforce that adherence to the OAR improves fracture detection, reduces unnecessary imaging, and remains a sensitive tool for ankle trauma assessment.ConclusionThis quality improvement project demonstrates that focused interventions, particularly clinician education and guideline awareness, can enhance adherence to the OAR. Increased documentation and use of the OAR were associated with a higher diagnostic yield for fractures, improved triage, and a potential reduction in unnecessary imaging. Although full compliance was not achieved, incremental improvements contribute to patient safety and alignment with national recommendations. Future strategies may include regular departmental teaching sessions and system-based interventions such as electronic prompts to sustain compliance.