The ganglion Impar is an unpaired sympathetic structure located at the level of the Sacrococcygeal joint. The modified technique replaced the previously using technique of the Impar block via the horizontal approach through the anococcygeal ligament. Modified technique of Ganglion Impar block through transsacroccygeal approach is easy to perform and give maximum pain relief with margin of safety. Aims and objectives To study, 1) Ease and complications of Impar block through trans- sacrococcygeal approach 2) The analgesic efficacy of Impar block, 3) Duration of analgesic effect of Impar block Method In this retrospective study,15 patients who had chronic perineal pain had given ganglion Impar block.., The ganglion Impar block was given through trans-sacrococcygeal approach, After written and informed consent, patient was asked to lie down on his abdomen, facing down with a pillow under the pelvis to help flatten out the lower lumber spine’s natural curvature. Skin was infiltrate with local anaesthetic, after proper aseptic precautions. The needle is advanced under fluoroscopy guidance until correct needle placement is obtained. Once position is confirmed, therapeutic block is performed with administration of 2ml of 100% absolute alcohol after confirming 50% reduction in VAS from baseline with diagnostic block (0.125% Bupivacaine 5 ml). Attempts of procedure were recorded in all patients. VAS was assessed after 12 and 24 hours. Patients were discharged after 24 hours, asked to report every week and whenever VAS is more than 4 for 3 months Result Fifteen patients with advanced cancer with perineal pain who were not responding to pharmacotherapy treatment received a neurolytic ganglion Impar block through trans-sacrococcygeal approach. Thirteen Patients were not needed any medication. Two patients were needed Tab Morphine after 2 weeks of block. All the blocks were effective without any adverse events. All the patients had significant pain relief during 3 months follow…
In today’s rising competition, the benefit generated by the development of high organizational quality is becoming more important. The role of human resource tasks and the culture of organizations can impact the achievement of substantial organizational effectiveness, which in return draw much more attention from both theoreticians and practitioners. Outsourcing is deemed one of the tools which companies use to reinforce their core competencies to assign their resources effectively. The rise of globalization has transformed outsourcing into one of the broadly adopted business plans towards supplying exceptional services to consumers. As can be seen by the ever-increasing trends in outsourcing, the literature on how outsourcing activities affect manufacturing companies’ results is insufficient. The main aim of this research was to investigate the impact on the performance of the outsourcing of human resources functions. Therefore, the results revealed that outsourcing HR functions play an important role in the improvement of organizational performance which can be characterized in three major dimensions; productivity, profitability, and cost efficiency. This study is limited to literature analysis and in future the three dimensions found by research can be investigated empirically. Policy makers and human resource managers can incorporate the strategies suggested by study to increase the performance of their organization.
Introduction The active methodology is an educational conception that stimulates critical-reflexive teaching-learning processes. Objective to apply the Arco de Maguerez in the Jardim Oasis community, in the municipality of Iguatu-CE. Methodology The first method was applied to the Hanlon method, in which priorities were established, based on the criteria of magnitude, severity, effectiveness and feasibility. Each criterion was analyzed using numerical score scores: magnitude (1-10); severity (1-10), effectiveness (0.5-1.5) and feasibility (0 or 1). It was through the observational analysis that the problematization “difficulty in adhering to the treatment of alcoholism” was highlighted. As a methodological framework, he used the Maguerez Arch based on “five steps”: observation of reality; key points of the problem; theorization; hypotheses of solution; application of action in reality. Results First Step – Observation of Concrete Reality. Second Step – Determination of Key Posts Third Step – Theorizing: There is a consensus in the literature on the low adherence rate of dependents, the dropout rates are generally above 50%. The literature found that more than 50% of patients evade in the first month. Fourth Step – Solution Hypotheses: Establish Links; inform; use harm reduction policy. Step Five – Application to Reality; Action plans to improve the problem in the reference territory. Conclusion It was understood that despite being a pedagogical instrument focused on the teaching – learning process, it can be fully applied in the daily routine of health services, starting from a social reality up to the moment of effective
ANALYSIS OF THE KNOWLEDGE FROM DIABETICS ABOUT SAFETY OF ADMINISTRATION, PACKAGING AND DISPOSAL OF INSULIN IN THE OUTPATIENT PHARMACY AT A PHILANTHROPIC HOSPITAL IN RECIFE, STATE OF PERNAMBUCO
Objective: In order to analysis some aspects about the knowledge from diabetics patients related to therapy with insulin it was performed an observational, descriptive and cross-sectional study in the outpatient pharmacy at a hospital in Recife. Methods: This study was between February and May 2016, and involved 60 diabetics patients that were interviewed by a semi-structured questionnaire. Results: Some positive results included: self-monitoring of blood glucose, handling and application method, however there was little knowledge about sharpener disposal. Conclusion: This study provided subsidies to identify some of the main user needs in order to guide orientations regarding the accomplishment of educational activities in the service.
Socio-demographic correlates of heavy drinking after hospital discharge among Thai alcohol-dependent patients: 6-month follow-up
Background: After receiving in-patient treatment for alcohol abuse, alcohol-dependent patients (ADP) are at risk to return to heavy drinking. Little has been known regarding the correlates of socio-demographic and heavy drinking within 6-month after inpatient treatment. Objectives: This study aims to examine the socio-demographic correlates of heavy drinking among Thai ADP after hospital discharge within six-months. Methods: A prospective cohort study of 618 ADP who received inpatient treatment at two tertiary care hospitals in Northern Thailand between July and December 2014. Heavy drinking is defined by the World Health Organization as ≥5 standard drinks for men and ≥4 standard drinks for women per occasion. Heavy drinking data was collected using a Timeline Follow Back Calendar (TLFB) every month after discharge. Other measures included the Alcohol Use Disorder Identification Test (AUDIT), Rosenberg Self-esteem Scale, Alcohol Craving Control (ACC), Severity of Alcohol Dependence Questionnaire (SADQ), and demographic questionnaires. Results: 618 participants present with a mean age of 43.28 (SD=10.01) years, 94.2% male, 216 (35%) reported that family members are drinkers, and 400 (70.7%) continue to exhibit heavy drinking behaviour. The logistic regression model revealed that age at onset of alcohol use was correlated with heavy drinking after hospital discharge within 6 months (p
Development of a Health Information Exchange (HIE) system using the Unstructured Supplementary Service Data (USSD) Technology
Most advanced nations have existing software systems that enforce a significant level of Health Information Exchange interoperability. A straightforward implementation or integration of the technique of such an application into the healthcare system in regions that have infrastructure challenges may not achieve the maximum result. Existing EHR interoperability solutions are primarily Web-based and are explicitly compatible to particular health standards. Resulting from this, such current technologies also need, at the very least, secure access to internet connectivity.On the other hand, several regions around the world (especially in developing countries) are characterized with bad internet accessibility, imbalanced spread of computer technology and literacy, and acute information breach.Therefore, this work aims to develop a system that allows patient records to be exchanged between health facilities given the challenge of lack of ubiquitous internet connectivity, unreliable internet access and also bridging the digital divide gap.This research will have positive impacts on different stakeholders in the health sector. Health institutions can access patients’ information evading the issue of poor or no internet connectivity. As a result of this, healthcare professionals will be able to give better and prompt treatments in cases of emergencies and avoid medical errors. Medical practitioners will also not have to deal with the communication gap or barrier when seeing a patient with low literacy level.This research would not only be of relevance to the health sector, it can also be adapted by other sectors using the USSD technology as a means of storage and retrieval of information.
In the era of information explosion today, videos are easily captured and made viral in a short time and tampering videos have become easier due to editing software. So, the authenticity of videos become very essential. Video inter-frame forgeries are the most common type of video forgery methods. Until now some algorithms have been suggested for detecting inter-frame forgeries based on handicraft features but the accuracy and speed in processing of suggested algorithms are still challenging. In this paper, we are going to put forward a video forgeries detection method for detecting video inter-frame forgeries based on convolutional neural network (CNN) models by retraining the available CNN models trained on ImageNet dataset. The proposed methods based on CNN models which have been retrained to exploit spatial-temporal relationships in a video to robustly detect inter-frame forgeries. And in order to eliminate the errors due by the network, we have proposed a confidence score instead of the raw output score from networks. Through the results of experiments, we have proven that the proposed method has significantly higher efficiency and accuracy than recent methods.
Hierarchical Model and Characterize Identified E-Commerce Trust to Generate Customer Satisfaction Data
The main reason consumers are reluctant to purchase from the internet vendors is the lack of trust. The lack of clues and face-to-face interaction in the online environment has made it more difficult to establish trust with consumers in e-commerce. The e-commerce trust issue is identified as a Multi-Criteria Decision Making (MCDM) problem thereby resulting to MCDM as an approach used to solve the problem because it emphasizes on the integration between fuzzy logic and Analytical Hierarchical Process (AHP) and is commonly used in the research community. This approach is being used to form the bases for the conceptual framework of this study. The literature review used a narrative method to give a direction and scope of the research, while the exploratory research approach is adopted to narrow it down to specific direction in order to be able to determine the research design, sample size, technique, design and data collection method. Such techniques are both implemented in order to give clear answers to lingering questions about the researcher’s mind, to synthesize all the information obtained and to arrive at a stand on which methodology and methods to be used to solve the problem under investigation. A hierarchical model has been developed which can be used to assess trust parameters in application using MCDM techniques. The methodology used can accurately determine both the subjective and objective trust factors and parameters of e-commerce trust applications simultaneously in complex situations where there is an abundance of ambiguity that is highly inherent in the process of human decision making. To evaluate the overall success of any information system, the usability evaluation was described as an essential construct based on the findings from this study.
This article on dysplastic nevi was compiled and written in August 2004 but never published in a print journal. It is our opinion that now, 15 years later, the same conclusions documented in the initial article still exist. In fact, the further studies and reports strongly support the lack of malignancy (nor evidence of pre-cursors of malignancy) in correctly histologically diagnosed junctional or compound dysplastic nevi and the lack of need of re-excision of these nevi in almost all cases. 1,2,3,4
Introduction. Measles is an acute infectious disease, whose etiological agent is a RNA virus of the paramyxovirus family. It is transmitted by aerosols through nasopharyngeal secretion within four to six days before the appearance of rash up to four days after. The clinical manifestations of the disease are quite characteristic and may evolve with serious complications, being one of the main causes of morbidity in malnourished or immunosuppressed children and under one year old. Currently the triple viral vaccine is the only way to prevent the disease, providing protection against measles, and also for mumps and rubella. However, some outbreaks are becoming more frequent, including in Brazil and may be related to several factors such as individuals who were not vaccinated by individual decision, thus exposing unvaccinated populations to the pathogen. Objective. To verify the prevalence of measles cases in Brazil from 2018 to 2019. Method. A descriptive cross-sectional study was conducted by surveying the numbers of cases reported by measles in the regions of Brazil from 2018 to 2019, available from the World Health Organization (WHO) database. Result and discussion. To prepare the study, we analyzed the information that was available in the World Health Organization (WHO) database. From November 26, 2018 to October 19, 2019, there were a total of 16,991 confirmed measles cases in eleven states of Brazil. In 2018, the state of Amazonas had the highest notification with 11,156 cases, with 9,695 (89.9%) confirmed, 1,442 (12.9%) discarded and 19 (0.2%) remaining under investigation. It was observed that 6,217 (55.7%) are male and the highest concentration is in the age group of 15 to 29 years, with 5,078 (45.5%), when calculating the incidence of confirmed cases by age group, notes a higher incidence in children under 1 (2,191.8 / 100,000 inhabitant). In 2019, 6,828 cases were reported,…