Transparent Collaboration Amongst Stakeholders - The Key To Project Performance

Aligning stakeholders is the key to awakening \u27Project Consciousness\u27. Whenever we undertake projects it is in regard to building the future which in turn gives rise to the challenge of facing numerous uncertainties. The conflicting interests of various stakeholders, a common aspect in most projects adds to the level of uncertainties that have to be managed in the project. Stakeholders view the project from different perspectives with different expectations and the possible inward looking quest of \u27What is in it for me\u27 makes it extremely difficult to create a common denominator

Breast lump, a rare presentation of costochondral junction tuberculosis: a case report

The diagnosis of musculoskeletal tuberculosis remains a challenge for clinicians and requires a high index of suspicion. The combination of indolent onset of symptom and signs with histological or cytological features and compatible radiography findings, strongly suggest the diagnosis. Prompt diagnosis and treatment are important to prevent serious bone and joint destruction. Tuberculosis involving ribs and presenting with breast mass is a very rare entity and only a few cases have been reported in the literature previously. We present a case of 30-year-old female having tuberculous involvement of the costochondral junction and presenting as a lump in the lower inner & outer quadrant of right breast. Surgical exploration and histopathological evaluation revealed costochondral junction tuberculosis and secondary abscess formation in the right breast. The lump was located in the breast rather than the usual retromammary location, when arising from chest wall or internal mammary nodes. This unusual manifestation of tuberculosis should be included in differential diagnosis of patients presenting with a breast mass and high risk of tuberculosis

Effect of frequent hand washing for COVID-19 prevention

Background: Coronavirus disease 2019 (COVID-19) has become a global public health concern. While dealing with COVID-19 pandemic, hand washing and the use of hand-hygiene products has been advocated, as a preventive measure. However, frequent hand washing leads to an increased risk of skin changes ranging from dryness and peeling of skin to itching, redness and blister formation. This study aims to understand the hand-hygiene practices and compare side effects between group using hand sanitizers with the group using soap with water.Methods: A 12-item self-administered close ended questionnaire assessing the hand washing habits and effect of the same on skin was used. A total of 60 cases were enrolled. The correlation between use of hand hygiene measures and the clinical changes was studied.Results: In our study, 32 out of the 60 reported a frequency of hand washing between 5-10 times a day. The awareness about using hand moisturizer was noted in 75% individuals. Side effects were more commonly observed in group B using alcohol-based sanitizers as compared to group A using soap with water. Dryness was the most common symptom, observed in 23.3% individuals using alcohol-based sanitizers and 10% individuals using soap with water.Conclusions: Hand-hygiene measures remain the cornerstone of prevention of COVID-19 transmission. However, the use of hand-hygiene products is associated with side effects especially dryness. Regular use of hand moisturizer is essential in preventing the unnecessary effects of frequent hand washing

Massive Liver Abscess Caused by Multidrug Resistant Citrobacter freundii

Pyogenic liver abscess is a disease entity that may follow infections of the biliary tract, blood stream and intra abdominal conditions like appendicitis, diverticulitis etc. Co- morbid conditions like diabetes mellitus, renal disease, malignancy, immune suppression etc. may contribute to the development of an abscess and affect the overall outcome of liver abscess as well. Escherichia coli and Klebsiellapneumoniae have been reported to be the most common isolations from these cases. Citrobacter infections usually occur in patients with some underlying co- morbidities and mostly in hospitalized patients. Recently, an increased emergence of multi- drug resistant strains is presenting a challenge to clinicians and microbiologists.Here, we report a case of massive liver abscess in an immunocompetent patient caused due to Citrobacterfreundii resistant to gentamicin, ciprofloxacin, cotrimoxazole, amikacin, ceftriaxone and piperacillin-tazobactam. It showed in vitro sensitivity to meropenem and aztreonam only

Networked control system with MANET communication and AODV routing

The industries are presently exploring the use of wired and wireless systems for control, automation, and monitoring. The primary benefit of wireless technology is that it reduces the installation cost, in both money and labor terms, as companies already have a significant investment in wiring. The research article presents the work on the analysis of Mobile Ad Hoc Network (MANET) in a wireless real-time communication medium for a Networked Control System (NCS), and determining whether the simulated behavior is significant for a plant or not. The behavior of the MANET is analyzed for Ad-hoc on-demand distance vector routing (AODV) that maintenances communication among 150 nodes for NCS. The simulation is carried out in Network Simulator (NS2) software with different nodes cluster to estimate the network throughput, end-to-end delay, packet delivery ratio (PDR), and control overhead. The benefit of MANET is that it has a fixed topology, which permits flexibility since mobile devices may be used to construct ad-hoc networks anywhere, scalability because more nodes can be added to the network, and minimal operating expenses in that no original infrastructure needs to be developed. AODV routing is a flat routing system that does not require central routing nodes. As the network grows in size, the network can be scaled to meet the network design and configuration requirements. AODV is flexible to support different configurations and topological nodes in dynamic networks because of its versatility. The advantage of such network simulation and routing behavior provides the future direction for the researchers who are working towards the embedded hardware solutions for NCS, as the hardware complexity depends on the delay, throughput, and PDR