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An Automated Petri-Net Based Approach for Change Management in Distributed Telemedicine Environment
No full textThe worldwide healthcare industry is facing a number of daunting challenges which are forcing healthcare systems worldwide to adapt and transform, and will ultimately completely redefine the way they do business and deliver care for patients. In this paper, we present a distributed telemedicine environement reaping from both the benefits of Service Oriented Approach (SOA) and the strong telecoms capabilities. We propose an automated approach to handle changes in a distributed telemedicine environement. A combined Petri nets model to handle changes and Reconfigurable Petri nets model to react to these changes are used to fulfill telemedicine functional and non functional requirements
GIST- A Rare Tumor in Paediatric Age Group
No full textA 13 years old male child presented to us with complaints of pain abdomen, radiating towards back. Child underwent CT-abdomen with contrast which showed volvulus and child was operated immediately and resected part of gut was sent for histopathology examination. Histopathology report showed features suggestive of gastrointestinal stromal tumour and tumour marker CD-117 was sent for confirmation and report was found to be positive
Rare Coinfection of Scrub Typhus and Malaria in Immunocompetent Person
No full textScrub Typhus, or tsutsugamushi disease is a febrile illness caused by bacteria of the family Rickettsiaceae and named Orientia tsutsugamushi. Recently it has been found to endemic in Subhimalayan region of India.Malaria is highly endemic in rest of India but its prevalence is low in Subhimalayan region because of the altitude. We report a rare case of a patient having coinfection with scrub typhus and malaria
Cost - utility analysis of parenteral antibiotics prescribed in medical wards in a tertiary care health facility in southern province of Sri Lanka.
No full textIntroduction: Parenteral antibiotic (PA) prescription pattern in a hospital will directly influence the annual budget allocation, development of bacterial resistance and occurrence of unnecessary adverse drug reactions if it is done with poor adherence to the standard guidelines of prescription. As specialist in the field we understand the need of conducting economic studies in relation to the cost and utility of PA prescription pattern. It will be helpful to predict the drug procurement plan for the next year and also to prevent unnecessary complications mentioned above. Objective: Our main objective was to analyze the cost/utility relationship of PA drugs which were used in medical wards in this hospital according to the top ten of the cost (TTTC) and the top ten of the consumption (TTCS). Materials and method : Aggregate data from the pharmacy record books were collected for year 2010 from indoor pharmacy. Unit prize was obtained from medical supplies division. Total quantity consumed by each medical ward was considered for analysis of the cost /utility relationship. Two top ten lists were prepared according to the cost and the consumption respectively for medical wards and the correlation was analyzed using non parametric testing with spearman test. Results: Regarding PA drugs used in this hospital, 7/10 PA drugs in TTTC are not included in the TTCS. Out of the total cost for TTTC, 82.6% of the cost had been spent for the PA drugs which are not in the TTCS and 17.5% of the cost of TTTC was used to purchase only three drugs from the TTCS. But these three drugs had contributed only 28% of top ten consumption. 72% of the PA drugs in TTCS were not costly drugs and highly consumed in medical wards. Correlation was significantly positive between cost and utility of PA drugs. ( r=-0.91,p<0.001) Conclusion: Majority of the consumed PA drugs are non-costly and it indicates the prescriptions had been done according to the rational guidelines including cost, availability and affordability. Correlation further confirms that majority of the PA consumption was low costly drugs. As most of the money had been spent to purchase highly expensive PA drugs for medical wards we suggest to review the clinical indications for these drugs with the microbiological evidence to be compatible with the allocated health budget for the hospital. This further suggests conducting the cost effective economic studies to evaluate the suitable drug alternatives for such indications
Complex problem solving — More than reasoning?
No full textThis study investigates the internal structure and construct validity of Complex Problem Solving (CPS), which is measured by a Multiple-Item-Approach.It is tested, if(a) three facets of CPS – rule identification (adequateness of strategies), rule knowledge (generated knowledge) and rule application (ability to control a system) – can be empirically distinguished, how (b) reasoning is related to these CPS-facets and if (c) CPS shows incremental validity in predicting school grade point average (GPA) beyond reasoning. N=222 university students completed MicroDYN, a computer-based CPS test and Ravens Advanced Progressive Matrices. Analysis including structural equation models showed that a 2-dimensionsal model of CPS including rule knowledge and rule application fitted the data best. Furthermore, reasoning predicted performance in rule application only indirectly through its influence on rule knowledge indicating that learning during system exploration is a prerequisite for controlling a system successfully. Finally, CPS explained variance in GPA even beyond reasoning, showing incremental validity of CPS. Thus, CPS measures important aspects of academic performance not assessed by reasoning and should be considered when predicting real life criteria such as GPA
Reactivation of Short Term Memory
No full textThe reactivation mechanism of short term memory is studied. In recognition and cued recall, reactivation is externally driven and accounts for the linear relationship between recognition probability and response time. In free recall the reactivation is internal. The free recall initial item distribution indicates that the mechanism is imprecise and reactivates several memory items at the same time. A competition ensues and the winners are the items which can be reactivated the quickest. Those items that take longer to reactivate are heavily suppressed. The internal reactivation mechanism also activates erroneous items, proportional to the internal reactivation time, in effect erasing memory while searching it. We find no discontinuities in the error rate which challenges the notion of a limited capacity, “quantized,” working memory. Internal reactivation of long term memory does not seem to have the same erasure effect
Primary Transitional Cell Carcinoma of the Fallopian Tube
No full textPrimary carcinoma of the fallopian tube is a rare entity that accounts for 0.2-0.5% of all gynecologic malignancies, and most are discovered during or after surgery. Primary transitional cell carcinoma of the fallopian tube is an extremely rare tumor that is reported only occasionally in the worldwide literature. As primary transitional cell carcinoma (TCC) of the fallopian tube is so rare, the clinicopathologic characteristics are as yet unknown. The authors recently experienced a case of primary transitional cell carcinoma arising in the left fallopian tube and thus report the clinical features, management, and also a review of the past pertinent literature. A 52 years old woman presenting with lower abdominal pain was found to have a left adnexal mass. Exploratory laparotomy revealed a mass arising from the left fallopian tube with the histologic features of transitional cell carcinoma
Causes of Acquired Vocal Cord Palsy in Indian Scenario
No full textVocal cord paresis or paralysis occurs due to lesion in the vagus nerve. Vocal cord paralysis can lead to dysphonia as well as dysphagia which lead the patient to frustration and emotional problems. The literature available on the etiology and the problems faced by them in Indian population is very scanty. Hence a prospective study was done on 41 Patients with vocal cord palsy who were referred to the Department of ENT for voice assessment and management from March 1st 2012 till 1st August 2012. The medical and surgical reports were examined. They were evaluated by an otorhinolaryngologist, and a Speech Language Pathologist. Diagnosis was made based on video stroboscopic findings. We also examined voice-related quality of life (V-RQOL) outcomes in these patients. In this study, endo-tracheal intubation (15/41; 36.5%) was the major cause of vocal cord palsy. The second major cause for vocal cord palsy in our study was surgical trauma (iatrogenic) which constituted 26.8% (11/41), out of which thyroidectomy contributed to 81.81% (9/11) and cardiac surgery (Coronary Artery Bypass Grafting (CABG) contributed to 18.18% (2/11). Neurological problems caused 14.63% (6/41) of the total cases. Non-surgical trauma constituted 9.75% (4/41) of the total patients. Left recurrent laryngeal nerve paralysis was found as a complication of heart disease in 7.3%(3/41). Tuberculosis of lungs and cancer of lungs accounted to be the rarest causes. Hoarseness of voice was the most common symptom with associated dysphagia in a few. The voice related quality of life of these patients was found to be poor. They were found to have problems in the social-emotional domain and physical functioning domain
Excitable Media Seminar
No full textThe simulation data presented here, and the conceptual framework developed for their interpretation are, both, in need of substantial refinement and extension. However, granting that they are initial pointers of some merit, and elementary indicators of general principles, several implications follow: the activity patterns of neurons and their assemblies are\ud
interdependent with the extracellular milieu in which they are embedded, and to whose time varying composition they contribute. The complexity of this interdependence in the temporal dimension forecloses any time and context invariant relation between what the experimenter may consider stimulus input and its representation in neural activity. Hence, ideas of coding by (quasi)-digital neurons are called in question by the mutual interdependence of neurons and their\ud
humoral milieu. Instead, concepts of 'mass action' in the Nervous system gain a new perspective: this time augmented by including the chemical medium surrounding neurons as part of the dynamics of the system as a whole. Accordingly, a meaningful way to describe activity in a neuron assembly would be in terms of a state space in which it can move along an infinite number of trajectories.\u
On Social and Economic Spheres: An Observation of the “gantangan” Indonesian tradition\ud
No full textIndonesian traditional villagers have a tradition for the sake of their own social and economic security named “nyumbang”. There are wide variations of the traditions across the archipelago, and we revisit an observation to one in Subang, West Java, Indonesia. The paper discusses and employs the evolutionary game theoretic insights to see the process of “gantangan”, of the intertwining social cohesion and economic expectation of the participation within the traditional activities. The current development of the “gantangan” tradition is approached and generalized to propose a view between the economic and social sphere surrounding modern people. The interaction between social and economic sphere might be seen as a kind of Lokta-Volterra’s predator-prey-like interaction, where both are conflicting yet in a great necessity one another for the sustainability of the social life. While some explanations due to the current development of “gantangan” is drawn, some aspects related to traditional views complying the modern life with social and economic expectations is outlined