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  • SUPERIOR MESENTERIC ARTERY: CLINICAL CASE

    Acute mesenteric ischemia refers to a sudden onset of intestinal hypoperfusion, which can be due to a reduction or cessation of arterial inflow leading to cellular damage, intestinal necrosis and eventually death if untreated.[1] The incidence is low, estimated at 0.09-0.2% of all acute surgical admissions [2] , this incidence increases with age having a median age of presentation of 70 years old and has a predispose for women at a 3:1 ratio.[3] Prompt diagnostic and innervation are necessary due to increase mortality rates from 50-80%. Mayor risk factors include atrial fibrillation, recent myocardial infarction, cardiac valvulopathies, hypertension, atherosclerosis, obesity, and tabaco. [4]

  • Fluodot Nanoparticle – A Promising Novel Delivery System For Veterinary Vaccine

    Most of the killed, inactivated, or live-attenuated pathogen vaccines are now replaced by modern vaccines containing isolated, highly purified antigenic protein subunits which are safer than live viruses or deactivated viruses. Another strategy is the development of nanoparticles which can mimic the repetitiveness, geometry, size and shape of the host-pathogen surface and provide improved stability and long lasting immunogenicity, as well as serve as vehicles to deliver multiple copies of the antigens to the target cells. Several interesting advances have been made recently in the area of protein nanotechnology and here, we provide a concise review of one such novel nanoparticle called FluoDot which may be effectively used as a delivery system in some veterinary medicine applications.

  • HOW SURGERY SAVES MONEY: A PARADOX EXPLAINED

    “A new analysis from U.S. federal government actuaries say that Americans spent $3.65 trillion on healthcare in 2018, according to a report from Axios. “1 This impacts on companies, where health insurance benefits are the second largest cost in a service business, and 3rd largest in manufacturing business2. Back pain alone accounted for $86 billion a year in 2008 3. The top 5 expenses for a commercial line of insurance were for back pain, osteoarthritis, childbirth, injuries, and non-hip/non- spine fractures4. Work related injuries cost an estimated $1.2 trillion annually, which includes lost wage payment, medical care, and short and long term disability5. Of all health care expenses paid by a company, workers’ compensation becomes the most expensive, since the company pays not only for medical care, but also the lost wage of the employee. This is usually 66% of the employee’s salary, which come to the employee tax free. This provides the employee with essentially the same income received when at work. These generous benefits lead insurance adjusters to suspect potential for abuse. Estimates of fraudulent claims range from 1% to 80% depending on unsubstantiated reports in the insurance literature6,7,8,9. However, methods to identify fraudulent cases are not always productive. The State Auditor of the State of California reported that the $30,000,000 a year spent by the State of California to detect workers’ compensation fraud was not cost effective10. Detection methods used include Functional Capacity Evaluations (FCEs). However, Feeler and Schapmire in a review of 180,000 patients found that FCEs were subjective and had no predictive nor diagnostic value11. Attempts to blame prolonged recovery on psychological issues, using the Minnesota Multiphasic Personality Inventory MMPI are consistently thrown out of court often 12. The most reliable method of fraud detection is the Pain Validity Test, which can predict with 95%…

  • Disaster management strategy for avoiding the future losses by a slope failure at Nanhuan road, Fuxin area, Northeast China

    Many surrounding areas in the vicinity of failed slope at Nanhuan road, Fuxin area, Northeast China are witnessed as the signs of disaster. The observed settlement as wastage of an active mass in the area has been observed after the excessive precipitation in 2012 (May to October) which caused infrastructural damages (Roads at the top and bottom of the failure zone), agricultural fields and residential areas. Therefore, the paper proposes examining this subject. An extensive field investigation was conducted in the area of Fuxin, west of Liaoning province China. It is recommended and suggested that a series of disaster prevention and both structural and non-structural mitigation measures with the involvement of government and local community are required, to be prepared in advance for avoiding the future economic loss as well as the impending disaster in the area. This paper also highlights the need of investigation in response mechanism and forward planning for awareness initiatives: to avoid the future hazard in the remotest failure zones of Fuxin area, Northeast China.

  • Principal optimization of semi-submersible support platform based on multi-island genetic algorithm

    Aiming at the conceptual design stage of semi-submersible support platform, the optimal primary scale scheme is designed. Latin hypercube design is adopted to sample the sample space. At the same time, SESAM software is used for parametric modeling based on sample point parameters to obtain the model of all schemes. According to the existing data of semi-submersible platforms, the main scale constraints of platforms are determined, and the mathematical model with the minimum heave, trim and roll response as the objective function is established. The multi-island genetic algorithm was used to optimize the main scale of the supporting platform model, and the scheme with the highest stability and suitable displacement was selected. The results show that the model and algorithm are feasible, and the smallest scale scheme of each response can be obtained under the constraint conditions. The multi-island genetic algorithm is proposed to optimize the primary scale of the platform, which has a strong reference value for the determination of the primary scale scheme in the conceptual design stage of the platform.

  • Meningoencephalitis in a Child with Mycoplasma Pneumonia

    The patient is a 15-year-old girl who presented with a 4-day history of fever, a persistent cough, and x-ray evidence of a right middle lobe pneumonia. On day 10 of her illness, at a time when she was afebrile and her pneumonia had cleared, she developed a severe headache and within hours lapsed into coma. Cerebral spinal fluid analysis and serological tests were diagnostic of a post-infectious meningoencephalitis due to Mycoplasma pneumoniae.

  • Evaluation of laboratory risk indicator for necrotizing fasciitis (Lrinec) scoring system for diagnosis of necrotizing fasciitis in patients presenting with soft tissue infection

    Necrotizing soft tissue infection represents a diverse process; the term itself encompasses a continuum ranging from pyoderma to life threatening infections (clostridial gas gangrene with myonecrosis, anaerobic cellulitis, and severe, necrotizing vibrio infections). These can occur in any anatomical area but the commonest site is the extremities. Necrotizing fasciitis is often underestimated because of the lack of specific clinical findings in the initial stages of the disease. The paucity of specific cutaneous signs to distinguish necrotizing fasciitis from other soft tissue infections such as cellulitis makes the diagnosis extremely difficult. The first and most important consideration for an accurate, prompt diagnosis is to have a high index of suspicion. It has been shown by numerous studies in the past that early recognition and surgical intervention at the earliest is the sole factor in preventing the morbidity and mortality in patients with necrotizing fasciitis [1-3]. So a scoring system which is easy to follow and cost effective with high positive and negative predictive value is required. One such scoring system is the LRINEC scoring system devised by Wong et al [4] in 2005 which claims to have a positive predictive value of 92.0% and negative predictive value of 96.0%. The mortality in necrotizing fasciitis is as high as 34%. [5] We evaluated LRINEC scoring system in patients presenting with symptoms and signs suggestive of soft tissue infection that progresses to necrotizing fasciitis in Sri Ramachandra Medical College and Hospital, Porur, Chennai over a period of two years.

  • Application of comprehensive evaluation method based on combination weight in valve workshop layout

    The evaluation index system and evaluation method for the reliability of current workshop facility layout have not yet formed the standard. Taking the facility layout plan of valve production workshop as the research object, 9 evaluation indexes were put forward from four aspects of working environment, layout cost, production flexibility and management convenience, and a comprehensive evaluation system of valve production workshop layout was established. The AHP- entropy weight method was used to calculate the index weight. Based on the survey data and experts’ opinions, the evaluation model is used for analysis and evaluation. The evaluation results of the facility layout plan of valve production workshop are consistent with the reality. The results show that the weight method of this model not only considers the objective opinions of workshop personnel, but also uses the knowledge and experience of experts, which makes the workshop facility layout evaluation more objective and accurate, and provides reference for the standards of workshop facility layout evaluation.

  • Intra Cholecystic Papillary Tubular Neoplasm – A Case Report Of A Rare Differential Diagnosis Of Carcinoma Gall Bladder

    We present a case report of a 57 year old lady who presented with complaints of right sided upper abdominal pain. The patient was initially diagnosed with carcinoma gall bladder(CAGB) by CECT Abdomen and PET CT imaging studies. Intra cholecystic papillary tubular neoplasm of the gall bladder(ICPN) was diagnosed after histopathological examination of the radical cholecystectomy specimen. ICPN can be managed with a cholecystectomy if the diagnosis is known pre operatively as the prognosis for ICPN is much better as compared with that for gallbladder adenocarcinoma.

  • Integration through friendships in school classes – A study of pupils with a migrant background in school friendship networks at primary and secondary schools in Germany

    This paper deals with the integration of migrant children in informal communication networks in primary and secondary schools in Germany. The basic assumption is that these networks can serve as an indicator for the networking and embedding that take place within the class community and therefore can be used to investigate the integration of pupils with a migrant background. The initial results of our network analytical study reveal that pupils with a migrant background are well integrated into class networks. The study discloses that the migrant background does not serve as a conclusive characteristic of the pattern of class networks. The pupils are more or less networked with each other regardless of their migrant background, though it did emerge that children and adolescents born abroad, in particular, are far more likely to have outgoing relationships that remain unreciprocated. Remarkable is, that results from primary school correspond with data from secondary school.