21 research outputs found
OUTCOME OF PATIENTS WITH HEMORRHOIDAL DISEASE TREATED BY HYBRID DIGITAL HEMORRHOIDAL ARTERY LIGATION WITH LASER HEMORRHOIDOPLASTY
No full textObjectives: The objectives of the study are as follows: (1) To analyze the efficacy of hybrid digital hemorrhoidal artery ligation (HAL) with laser hemorrhoidectoplasty in terms of post-operative pain as well as time taken to return to daily routine activities. (2) To analyze complications as recurrence rates in studied patients.
Methods: This was a prospective study conducted in the Department of General Surgery, GMERS Medical College Navsari, Gujarat, India. Sixty adult patients with haemorrhoids were included in the study on the basis of a predefined inclusion and exclusion criteria. All patients underwent HAL with laser hemorrhoidectoplasty. Patients were followed up for pain (as assessed by Visual Analog score), per rectal bleeding and whether they have completely returned to their pre-intervention activities. Complications and recurrence rates were also analyzed.
Results: There were 38 (63.33%) males and 22 (36.67%) females with male preponderance having an M: F ratio of 1:0.57. The mean age of the studied cases was found to be 43.24±13.98 years. The most common presenting complaint was rectal bleeding which was seen in 54 (90%) patients followed by pain (80%) and pruritis (30%). Prolapse was seen in 12 (20%) patients. The mean duration of post-operative bleeding was 28.36±9.86 h. Mean duration when pain-free bowel movement occurred was found to be 21.86±12.76 h. At 1-month follow-up, pain has been reduced as compared to at the time of presentation and the difference was found to be statistically highly significant (p<0.0001). Mean duration of hospital stay was found to be 2.12±1.14 days. In 3 patients (5%), there was recurrence during follow-up period of 6 months.
Conclusion: Hybrid digital HAL with laser hemorrhoidoplasty is a minimally invasive procedure found to have excellent outcome, with respect to reduced post-operative pain and low complication rates
Overuse of Teeth Whitening and Fluoride Products Can Be Harmful to Your Oral Health
No full textSummer 2014Accompanied by video fil
A Clinician's Survival Guide to Leadership and Management on the Ward
No full textWhen you become a ward or unit manager or allied health professionals team leader, your responsibilities change and you need a very different set of skills compared with your previous roles. You are now required to manage a team of staff with a set budget and are responsible for maintaining an environment in which people can work together efficiently and effectively. This new fourth edition of the Survival Guide to Leadership and Management on the Ward welcomes AHP Krishna Gohil to the author team of nurses Brian Dolan and Amy Lochtie, and thereby extends its guidance on these crucial skills to both nurses and allied health professionals
Evaluating Geospatial Methods for Marketing Concert Tickets in Rock Music
No full textThink back to the last concert you attended. How did you find out about it? Did you go by yourself or did you go with friends? Past research shows that concert attendance is a group experience. Many attendees will go with friends or in small groups. Email marketing plays a critical role in informing potential customers about a show, and subsequently driving ticket sales for the show. Traditional email concert marketing targets past purchasers of the headliner artist as well as past purchasers of similar artists. The author, a veteran of the concert industry, has observed that fans of artists are not randomly distributed spatially; they tend to cluster. Tobler's first law of geography states "everything is related to everything else, but near things are more related than distant things" (Tobler 1970). Does this apply to concert attendees? Is location an effective method of determining likely customer behavior, and if we marketed to customers in these clusters would they buy concert tickets? Will fans of similar artists also attend the concert, and can these similar artists be found through an artist classification algorithm? The author conducted an experiment on an amphitheater tour for a well-known national artist to test this question. The experiment selected customer targets for an email campaign to compare traditional methods against an algorithm built from both location and artist classification methodologies. The author hypothesized that if location or artist classification influenced customer behavior, then customers selected via the location-based or artist classification method would show greater ticket sales compared to the traditional method. Conversely, if location or artist classification did not play a role, then the traditional method would show greater ticket sales compared to the location-based or artist classification method. The results of the experiment showed a 137% increase in sales from location-based and artist classification methods compared to the traditional method. The conclusion that we can draw from these results is that location and artist classification is an effective determinant of customer behavior with regards to concerts, and the use of location-based and artist classification methods greatly increases the ticket sales and revenue for concerts.California State University, Northridge. Department of Geography and Environmental Studies
100 African Writers of SFF Part One Nairobi
No full textTor is the world’s biggest science fiction and fantasy publisher. Their website, www.tor.com, publishes fiction online but also a lot of reviews, blogs, articles. A page can get up to 70,000 likes. I was pleased when they agreed to begin publishing my project 100 African Writers of SFF. The project is the output from a Leverhulme International Academic Fellowship, which allowed the author to travel to five African countries and research the rise of science fiction in Africa. Part One: Nairobi (12,700 words) focussed on writers in that city and found a tendency there for fantastic fiction to lean towards more literary or even modernist models such as the Beats . One possible correlation was a forced loss of local languages once Kenyans attend school. Writers interviewed in Kenya included Kiprop Kimutai, Clifton Cachagua, Richard Oduor Oduku, Moses Kilolo and Mehul Gohil. Specialist side articles discussed other writers such as Binyavanga Wainaina and Ngugi wa Thiong’o. The author also provided photographs. The publication of this article will soon be taken over by another online SF publisher, Strange Horizons
100 African Writers of SFF Part One Nairobi
No full textTor is the world’s biggest science fiction and fantasy publisher. Their website, www.tor.com, publishes fiction online but also a lot of reviews, blogs, articles. A page can get up to 70,000 likes. I was pleased when they agreed to begin publishing my project 100 African Writers of SFF. The project is the output from a Leverhulme International Academic Fellowship, which allowed the author to travel to five African countries and research the rise of science fiction in Africa. Part One: Nairobi (12,700 words) focussed on writers in that city and found a tendency there for fantastic fiction to lean towards more literary or even modernist models such as the Beats . One possible correlation was a forced loss of local languages once Kenyans attend school. Writers interviewed in Kenya included Kiprop Kimutai, Clifton Cachagua, Richard Oduor Oduku, Moses Kilolo and Mehul Gohil. Specialist side articles discussed other writers such as Binyavanga Wainaina and Ngugi wa Thiong’o. The author also provided photographs. The publication of this article will soon be taken over by another online SF publisher, Strange Horizons
100 African Writers of SFF Part One Nairobi
No full textTor is the world’s biggest science fiction and fantasy publisher. Their website, www.tor.com, publishes fiction online but also a lot of reviews, blogs, articles. A page can get up to 70,000 likes. I was pleased when they agreed to begin publishing my project 100 African Writers of SFF. The project is the output from a Leverhulme International Academic Fellowship, which allowed the author to travel to five African countries and research the rise of science fiction in Africa. Part One: Nairobi (12,700 words) focussed on writers in that city and found a tendency there for fantastic fiction to lean towards more literary or even modernist models such as the Beats . One possible correlation was a forced loss of local languages once Kenyans attend school. Writers interviewed in Kenya included Kiprop Kimutai, Clifton Cachagua, Richard Oduor Oduku, Moses Kilolo and Mehul Gohil. Specialist side articles discussed other writers such as Binyavanga Wainaina and Ngugi wa Thiong’o. The author also provided photographs. The publication of this article will soon be taken over by another online SF publisher, Strange Horizons
Development of control strategy for bioreactor and refill strategy of feeding system
No full textThe progressive acceleration of continuous bioprocessing method has become the focal point of advanced research and study for the biotech companies in recent years. Implementation of this method is a tedious and lengthy process but has been proven beneficial down the line. Advancement of this methodology is initiated by the U. S. Food and Drug Administration (FDA) through introduction of Quality by Design (QbD) approach. In parallel, sophisticated bioreactors are now available in the market with various applications to support the continuous upstream process. In motion, monoclonal antibodies (mAb’s) are produced by studying the behavior of CHO cell culture, affected by different media and controlled variables. Focus of this thesis is to demonstrate a systematic approach towards developing a control strategy for the critical process parameters (CPPs) of the bioreactor. Based on the study of bioreactor, control relevant process models have been developed using experimental data. Feedback control architecture has been developed in silico using proportional integral derivative (PID) controller. Further, on using advanced model predictive control (MPC) algorithm, the performance of these feedback-control loops has been investigated and compared with the performance of the PID controller. Framework for the integration of bioreactor with the control platform has been explained. As the industry is shifting towards the development of continuous process, it becomes important to make sure that these continuous processes never run short on the material. For the success of such processes, timely refilling of the required material to the feeding system becomes necessary. To illustrate this idea, refill strategy for the feed tank has been developed by mathematical modelling approach. Case studies have been conducted to investigate the impact of ambient temperature on fluid inside the feed tank during refill period.M.S.Includes bibliographical reference
Reducing the prevalence of compassion fatigue among emergency department advanced practice providers by increasing awareness
No full textPurpose of Project: The purpose of this Doctoral project was to reduce the level of compassion fatigue suffered by the Emergency Department Advances Practice Providers. Healthcare workers especially the ones that practice in high-stress level areas such as an emergency department are at great risk for developing compassion fatigue (Bellolio et al., 2014). A concern is providers managing care for variety of critical and non-acute patients while bottling up their emotional are at great risk for suffering a negative consequences of compassion fatigue (Weilenmann et al. 2018). By increasing awareness of the concept, self-care activities and the available resources clinicians are likely to improve compassion satisfaction scores and reduce the effects of compassion fatigue (Dasan, Gohil, Cornelius & Taylor, 2015).
Methodology: The project was carried out at two urban emergency departments located in the Northeast United States. A total of 11 out of 15 prospect participants took part in the study. This quasi-experimental study’s intervention included one-on-one interviews with the participants to increase awareness of the phenomena and informational pamphlets. The Compassion Fatigue/ Satisfaction Self-test was administrated as pre and post-test to evaluate the study findings.
Results: This study found an improvement in participants compassion fatigue and satisfaction scores one- month after the intervention. Their answers collected during the interview will serve as tool to change practices and improve future studies.
Implications for Practice: As supported by the literature review and this study finding, it can be concluded that all clinician can benefit from compassion fatigue awareness project.DNPIncludes bibliographical reference
Peeping into genomic architecture by re-sequencing of Ochrobactrum intermedium M86 strain during laboratory adapted conditions
No full textAbstractAdvances in de novo sequencing technologies allow us to track deeper insights into microbial genomes for restructuring events during the course of their evolution inside and outside the host. Bacterial species belonging to Ochrobactrum genus are being reported as emerging, and opportunistic pathogens in this technology driven era probably due to insertion and deletion of genes. The Ochrobactrum intermedium M86 was isolated in 2005 from a case of non-ulcer dyspeptic human stomach followed by its first draft genome sequence in 2009. Here we report re-sequencing of O. intermedium M86 laboratory adapted strain in terms of gain and loss of genes. We also attempted for finer scale genome sequence with 10 times more genome coverage than earlier one followed by comparative evaluation on Ion PGM and Illumina MiSeq. Despite their similarities at genomic level, lab-adapted strain mainly lacked genes encoding for transposase protein, insertion elements family, phage tail-proteins that were not detected in original strain on both chromosomes. Interestingly, a 5kb indel was detected in chromosome 2 that was absent in original strain mapped with phage integrase gene of Rhizobium spp. and may be acquired and integrated through horizontal gene transfer indicating the gene loss and gene gain phenomenon in this genus. Majority of indel fragments did not match with known genes indicating more bioinformatic dissection of this fragment. Additionally we report genes related to antibiotic resistance, heavy metal tolerance in earlier and re-sequenced strain. Though SNPs detected, there did not span urease and flagellar genes. We also conclude that third generation sequencing technologies might be useful for understanding genomic architecture and re-arrangement of genes in the genome due to their ability of larger coverage that can be used to trace evolutionary aspects in microbial system
