Asymptotic Behavior Of Third Order Nonlinear Difference Equations With Mixed Arguments

In this paper, we established criteria for asymptotic properties of nonlinear dierence equation with mixed arguments of the form ? 2(an(? xn)a) + qnf(xn-l) + pnh(xn+m) = 0,    n ? N 0where {an},  {pn} and {qn} are nonnegative real sequences,  a is a ratio of odd positive integer, and l and m are positive integers. We duduce the properties of studied equation by establishing new comparison theorem, so that some asymptotic properties of nonoscillatory solutions are resulted from the oscillation of a set of first order difference equations. Some examples are provided to illustrate the main results

A study of viral infections in renal transplant recipients: Risk factors, clinical profile and outcome analysis

INTRODUCTION: Renal transplantation has become the most effective means of rehabilitating patients with end stage renal disease. In well established centres, 90% 1 year graft survival and 95% patient survival is achieved. Inspite of this, infection occurs more than 60% of renal transplant recipients and being the one of the main cause of death in renal transplant recipients. AIMS AND OBJECTIVES: 1. To study the clinical profile of viral infections in renal transplant recipients. 2. To study the risk factors for viral infections and the effect of viral infections on graft outcome. MATERIALS AND METHODS: Study Place: Department of Nephrology. Study Design: Cross-sectional descriptive prospective and retrospective study. Period of study: Two years. Study population: Patients attending the Transplant clinic, Nephrology Department in Rajiv Gandhi Government General Hospital. Ethical approval: Obtained from ethical committee headed by Dean, Madras Medical College. Consent: Obtained from all patients. Inclusion Criteria: Renal transplant recipients diagnosed with viral infections diagnosed by either clinical or laboratory evidence or serological methods or radiological or by renal biopsy. Exclusion Criteria: Renal transplant recipients with empirical antiviral therapy given. This study was done in prospective and retrospective manner. Retrospective cases selected by examining the case records and examining the patients while coming for follow up and in prospective cases are followed during the time period of study. CONCLUSION: 1. Bacterial, viral, fungal and parasitic infection contributes to 45%, 30.5%, 9.5%, 5.3% respectively to the total infective episodes. 2. Most of the viral episodes occurred after 6 months post transplant. 3. Commonest viral infection is the CMV and its prevalence 17.4% and mean time of onset is between 1-6 months after transplantation. 4. On Univariate analysis, antirejection therapy and NODAT had statistical significant risk factor for developing viral infection (P < 0.05). 5. In patients affected with viral infection on univariate analysis, there is a statistical significance for graft dysfunction, graft loss and death (p < 0.05). 6. CMV infection has a statistical significant risk factor for bacterial, fungal and other viral infections. (p < 0.05). 7. Hepatitis C infection is the second most commonest virus found in our study, mean onset of infection is seen 6 months after transplant. Nearly 50% HCV infected patients developed NODAT. 8. Lamivudine resistance is more common in post transplant situation because prolonged treatment is necessary. 9. All the three patients with BK virus infection had persistent graft dysfunction. 10. Multi dermatomal involvement is commonly seen in our patients with herpes zoster (56%)

A Case Report and Overview of Familial Cerebral Cavernous Malformation Pathogenesis in an Adult Patient

OBJECTIVE We present a case of a 39 year-old woman who presented with a solitary cavernous malformation hemorrhage without any other lesions, and subsequently presented several months later with a new hemorrhage from a de novo lesion. We discuss mechanisms of paradominant inheritance and haploinsufficiency to describe phenotype expression of familial cavernous malformations. CASE DESCRIPTION The patient presented with unremitting headaches, who had a known history of a solitary cerebral cavernous malformation (CCM) for which she underwent resection several months prior with no evidence of any other CCM lesions seen on post-operative MRI. She has no history of whole brain radiation, family history of cavernous malformations, or prior head trauma. During this hospital visit, she was found to have develop two new lesions in the left fronto-parietal lobe and cerebellum. She was treated with surgical resection of the left frontoparietal lesion, and recovered fully. It is of interest that a patient approaching her fourth decade of life would start to develop formation of multiple de novo cavernous malformations, especially with an absent family history. Paradominant Inheritance and haploinsufficiency are two proposed models of inheritance that can be related to this patient’s disease progression. CONCLUSION The case illustrates an atypical clinical course of a patient with familia

A Study on Hepatic Trauma: Single Centre Experience in Rajiv Gandhi Government General Hospital, Chennai

INTRODUCTION: Liver injuries are common in any high volume trauma center. Our knowledge in its management has improved in the past three decades. Recent advances and minimally invasive techniques play a vital role in the conservative approach. It is very difficult for a trauma surgeon to control massive bleeding occurring in the liver following trauma. The bleeding structure is very tough to find out, and the crucial period of time to save the trauma victim before the onset of hypothermia, acidosis, and coagulopathy—the markers of an irreversible physiologic insult. Usual techniques of elective hepato-biliary surgery like segmental resection do not apply in hostile environment where the timing of intervention is a major factor in saving the life of the patient. It is very clear that the management of hepatic trauma has been a formidable challenge to all surgeons. The evolvement of the management of hepatic trauma over the recent years is a reflection of the rapid understanding of the key parameters deciding the line of management in hepatic trauma. There were poor outcomes in patients where resection was done but future learning of the injured patient’s patho-physiology paved way for the concept of damage control that has been the key in modern trauma management. Meanwhile better learning of the outcome of various liver injuries in clinically stable patients has increased the conservative line of approach by using the modern imaging and minimally invasive procedures. AIMS AND OBJECTIVES: 1. To identify clinical and imaging parameters to decide upon the line of management in hepatic trauma. 2. To study the clinical course of patients managed conservatively. 3. To study the profile of various other associated injuries in liver trauma. MATERIALS AND METHODS: Sample Size: 35 cases. Study Design: Observational study (Prospective & Retrospective). Study Population: 35 cases. Study period: Oct 2015 to Sep 2016. Study Centre: Madras Medical College and Rajiv Gandhi Government General Hospital , Chennai. Subject Selection: Inclusion Criteria: All trauma victims sustaining blunt and penetrating trauma to the liver with or without associated injuries. Exclusion criteria: Abdominal trauma with isolated injury to the extra hepatic biliary tree or other visceral structures without liver trauma . ASSESSMENT OF PARAMETERS: All Patients who fit the inclusion criteria were observed and following data collected 1. Routine blood investigations, Hemoglobin, Hematocrit, Liver Function Test. All these were done serially. 2. USG Abdomen. 3. CECT Abdomen (i.v. contrast)/plain CT for all cases. 4. AAST grading system was the standard methodology to assess severity of liver injury. 5. Patients managed conservatively were followed up prospectively and till discharge. 6. Conclusions were drawn based on the above parameters. CONCLUSION: From this study it is clear that all hemodynamically stable patients can be subjected to conservative line of management irrespective of the grade of the injury. • Those managed conservatively must be subjected to serial monitoring. If there are findings of sepsis like biloma, infected necrosis, liver abscess at any point of time the first option of intervention will be minimally invasive procedures like image guided drainage. • If there are features of peritonitis then laparotomy must be considered without any delay. • Non operative management is employed for hemodynamically unstable patients. • The first step will always be a Pringles maneuver to identify the possible source of bleeding which can be from either the portal vein or hepatic artery and hemostasis can be achieved by topical hemostatic agents like gel foam etc. • If the patients hemodynamic status is in jeopardy then Perihepatic packing serves as the best operative intervention in reversing the patients hemodynamic status to normalcy

Oscillation Theorems for Third Order Nonlinear Delay Differential Equation with “Maxima”

In this paper we obtain oscillation criteria for the third order delay differential equation with “maxima” of the formvia comparison with the oscillatory behavior of first order differential equations. Some examples are given to illustrate the main result

Demand Side Management Studies on Distributed Energy Resources: A Survey

The number of distributed environmentally friendly energy sources and generators necessitates new operating methods and a power network board to preserve or even increase the efficiency and quality of the power supply. Similarly, the growth of matriculates promotes the formation of new institutional systems, in which power and power exchanges become increasingly essential. Because of how an inactive entity traditionally organizes distribution systems, the DG’s connection inevitably changes the system’s qualifications to which it is connected. As a consequence of the Distributed Generation, this presumption is currently legal and non-existent. This article glides on demand side management and analysis on distributed energy resources. Investigation of DSM along with zonal wise classification has been carried out in this survey. Its merits and applications are also presented

Demand side management studies on distributed energy resources: A survey

The number of distributed environmentally friendly energy sources and generators necessitates new operating methods and a power network board to preserve or even increase the efficiency and quality of the power supply. Similarly, the growth of matriculates promotes the formation of new institutional systems, in which power and power exchanges become increasingly essential. Because of how an inactive entity traditionally organizes distribution systems, the DG’s connection inevitably changes the system’s qualifications to which it is connected. As a consequence of the Distributed Generation, this presumption is currently legal and non-existent. This article glides on demand side management and analysis on distributed energy resources. Investigation of DSM along with zonal wise classification has been carried out in this survey. Its merits and applications are also presented.Universidad Tecnológica de Bolíva