151 research outputs found
Essentials of Marketing Research : A Hands-On Orientation
No full textFor courses in Marketing Research at two- and four-year colleges and universities An engaging, do-it-yourself approach to marketing research Essentials of Marketing Research: A Hands-On Orientation presents a concise overview of marketing research via a do-it-yourself approach that engages students. Building on the foundation of his successful previous titles-Basic Marketing Research: Integration of Social Media and Marketing Research: An Applied Orientation-author Naresh Malhotra covers concepts at an elementary level, deemphasizing statistics and formulas. Sensitive to the needs of today\u27s undergraduates, Malhotra integrates online and social media content, and provides current, contemporary examples that ground course material in the real world
Pits and pearls in the management of giant goiters
No full textObjective: Giant goiters invariably have been neglected by the patients allowing them to grow to huge sizes. Usually, these are slow growing and are not troublesome, and hence, the patients ignore them. The treatment of such goiters is surgery. However, when these become >10 cm, they pose challenges to the patient, the anesthetist, and foremost the surgeon. Materials and Methods: We present here a single-institutional experience of managing 13 monster goiters. Harmonic scalpel and bipolar cautery were used intraoperatively. The surgical loupes were used in all cases for identification of the nerves. Their clinical presentation, salient symptoms and our experience, and key factors affecting successful outcomes were analyzed. Results: Ten patients had benign lesion and three harbored malignancy. All patients were made euthyroid before surgery except one in whom the indication for surgery was thyrotoxicosis. All patients underwent awake fiber-optic intubation. Four patients underwent total thyroidectomy, two underwent hemithyroidectomy, and remaining underwent subtotal thyroidectomy. One patient required sternotomy for retrosternal extension of the goiter. Harmonic scalpel and bipolar cautery were used intraoperatively. Surgical loupes were used in all cases for identification of the nerve. In all cases, recurrent laryngeal nerve was identified. Tracheomalacia was noted in two patients, and only one of them had to be tracheostomized postoperatively. Conclusion: Anatomy was found to be distorted in all our cases. Identifying the nerve was difficult due to distorted anatomy. Transient hypocalcemia was a consistent feature in spite of identifying the parathyroids and preserving its blood supply. Cases with tracheomalacia and bilateral vocal cord palsy can pose challenge for extubation, and tracheostomy needs to be considered in them
Communication outcomes following cochlear implantation in a child with cystic cochleovestibular anomaly
No full textAbstractCochlear implantation is one of the best amongst the various management options available for children and adults with severe to profound sensorineural hearing loss. Inner ear and internal auditory canal (IAC) malformations accounts to approximately 25% of congenital sensorineural hearing loss in children. The primary goal of this report was to evaluate the communication outcomes after cochlear implantation in a child with cystic cochleovestibular anomaly (CCVA). The child was evaluated through various standardized outcome measures at regular intervals to track the progress in terms of auditory and spoken language skills. The scores on Categories of Auditory Perception (CAP), Meaningful Auditory Integration Scale (MAIS), Speech Intelligibility Rating (SIR), Meaningful Use of Speech Scale (MUSS), and listening and spoken language skills showed a significant leap in 12 months duration post implantation. The report thus highlights and correlates the significant progress in auditory and spoken language skills of the child with congenital malformations to appropriate auditory rehabilitation and intensive parental training
Changing trends in antibiotic prophylaxis in head and neck surgery: Is short-term prophylaxis feasible?
No full textBackground: The duration and dosage of prophylactic antibiotics vary substantially among surgeons. This study explored the outcome and efficiency of short-term antibiotic prophylaxis in head and neck procedures. Methods: One hundred and forty-three patients undergoing various head and neck surgical procedures were included. They were categorized into two groups, clean (Group C) and clean-contaminated (Group CC). They received short-term prophylaxis with intravenous (IV) antibiotics. Group C patients received single dose IV antibiotic at induction and Group CC received antibiotic for 3 days. The scoring methods such as American Society of Anesthesiologist (ASA) score, National Nosocomial Infections Surveillance (NNIS) score, and additional treatment, discharge, erythema, purulent discharge, separation of deep tissue, isolation of bacteria and stay (ASEPSIS) were used. Scoring methods were used to analyze the risk factors and complications up to a period of 4 weeks postoperatively. Results: There were 83 patients in Group C and 60 patients in Group CC. Parameters such as body weight, body mass index (BMI), biochemical and hematological parameters along with surgical details, and postoperative wound assessment were analyzed. A significant association of surgical site infection (SSI) with BMI, anemia, hypoalbuminemia, and tobacco usage was noted along with a high incidence of SSI in surgical procedures involving the larynx. There was no significant relationship with ASA score and NNIS score. Conclusion: Short-term antibiotic prophylaxis in clean and clean-contaminated cases is feasible and effective as long-term prophylaxis. Correction of anemia, hypoalbuminemia, weight reduction, and avoidance of tobacco can prevent SSIs
Assessment of calcium homeostasis after total thyroidectomy in differentiated thyroid carcinoma
No full textBackground: After total thyroidectomy, hypocalcaemia can be transient or permanent. Most of the patients are being prescribed long term calcium supplementation despite preserving parathyroid glands. We have tried to study the various calcium homeostatic factors to predict the long term calcium levels in differentiated thyroid carcinoma following total thyroidectomy. Method: Study was conducted in a tertiary care centre and a total number of 28 patients of differentiated thyroid carcinoma were retrospectively analysed who underwent surgery from 2013 - 2015. Post surgery patients were given thyroxine and calcium supplementation with regular monitoring of thyroid function test and serum calcium. Serum Parathormone(PTH) levels were recorded after minimum of one year of completion of surgery. Results: Out of 28 patients, 26 patients have serum parathormone within normal range (15-65 pg/ml). Only two patients have low serum PTH values (<15pg/ml). Total number of 23 patients are taking calcium supplementation out of which 21 patients have normal parathormone value. None of the patients without calcium supplementation have low parathormone levels. Conclusion: Our study reveals optimum calcium homeostasis in patients undergoing total thyroidectomy. A long term follow up of these patients is required so that many patients with normal PTH levels may not require calcium supplementation
Postauricular Transcanal Posterior Tympanectomy (PT<sup>2</sup>) Approach – A Modified Surgical Technique for Jugulotympanic Paragangliomas
No full textIntroduction The surgical management of jugulotympanic paragangliomas has remained challenging. They are the second most common type of tumor of the temporal bone after acoustic neuroma. It has been noticed by the authors that the jugulotympanic paragangliomas may have extensions to the epitympanum and aditus in addition to the mesotympanum and hypotympanum. The modified technique could be an alternative to the conventional facial recess technique for complete removal of the tumors
Identification of Linear Multivariable Continuous-Time Systems
No full textThe problem of identification of linear multivariable continuous-time systems from input-output data is considered. A survey has been made to present the direct and the indirect approaches in identifying continuous-time systems from the samples of the observations. The direct approach with approximate integration seems to be more promising and hence it is adopted in this work. Three direct methods based on the use of block pulse functions, trapezoidal pulse functions and cubic splines have been compared and applied for multivariable systems. A comprehensive study has been conducted to analyze the effect of noise on the identification. The analysis was carried out first for the single-input single-output case and then extended to the multivariable case. A new approach is presented to overcome the combined effect of the errors in the approximation/and additive white noise on the identification of continuous-time systems. The method consists of modelling the combined error term. Extensive simulations are conducted in order to illustrate the merits of the new procedure. The problem of order determination has been considered and three order determination tests have been studied and applied for continuous-time systems, two of them for the first time as far as the author is aware. The problem of the selection of the structure that will give good conditioned parameterization is also considered. A new procedure to identify the structure in the input-output form is presented. This procedure is suitable for both stationary and non-stationary systems when a change in the structure occurs while the order remains constant. It uses the concept of overlapping parameterization to choose a better conditioned parameterization for the multivariable system whenever ill conditioning is detected. A switching criterion is presented based on the complexity principle which provides a good monitor of the conditioning of the parameterization as well as the suitability of the tested structure.Doctor of Philosophy (PhD
Development of life marker chip technology for in-situ life detection on Mars
Get PDFThe European Space Agency (ESA) is currently developing its flagship Life Detection Mission, ExoMars, which is scheduled to fly to Mars in 2013. The primary goal of this mission is to compliment the Phoenix NASA mission in confirming the presence of organic material on Mars, and, for the first time, analyse this organic material to determine the presence of organic species indicative of presence of past or present Life. One of the proposed Life detection technologies is the Life Marker Chip (LMC), which uses immunoassays with fluorescent readout to detect small organics and proteins in a microarray format within microfluidic channel structures. This PhD thesis encompasses the work done by the author on the development of the SMILE LMC during the period prior to, and during part of the first phase of, the Life Marker Chip Technology Readiness Level Upgrade Study funded by ESA from 2005 and 2007. Cont/d
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