Managing a surgical unit using google drive - a feasibility study

Background: Managing a surgical unit can be a daunting task. Being a consultant in a teaching hospital only adds to the challenge. One of the main challenges in running a unit is to have an effective channel of communication between the various members of the surgical team. Many medical errors have their origin in the lapse of communication. We are living in the era of telecommunication explosion where we have access to innumerable instruments of communications, all converged into a single device - “The Smart phone”. In this article we present the various challenges that are faced by a surgical unit and how a simple free to use software can be used to overcome some of those challenges.Methods: Electronic patient management software was created with the google drive software which is free to use. It was used to prepare various documents involved in the management of a surgical unit such as operation theatre list, Operation notes, Discharge summary and the team members were given a questionnaire regarding the ease of use of the software. The average time taken and the data usage for each of the activities were calculated.Results: A total of 30 residents and interns who worked in the unit during the study period answered the questionnaire. All the members of the team adapted favourably to this system. The cost involved and the data usage are minimal.Conclusions: It is feasible to use google drive as a patient management system by a surgical unit to organise work. This system is efficient, secure and cost effective

A case control study of possible additional risk factors for chronic alcoholic pancreatitis

Background: Chronic pancreatitis (CP) is characterised by irreversible damage to pancreas leading to endocrine and exocrine insufficiency with considerable morbidity. Etiopathogenesis is multifactorial with interplay between genetics & environmental toxins. Alcoholism is more commonly associated with chronic pancreatitis. But it is not very clear why only certain proportion of the alcoholics develop pancreatitis. So this study was conducted to find the possible additional risk factors involved in alcoholic pancreatitis.Methods: A total of 30 patients with alcoholic pancreatitis from a tertiary care hospital in Pondicherry, India were enrolled and compared with age matched alcoholics without pancreatitis. The diagnostic criteria for alcoholism were based on diagnostic and statistical manual of mental disorders (DSM) criteria IV of alcohol consumption >80gms/day for a period of 5 years or more and chronic pancreatitis was based on significant clinical findings and positive ultrasound findings of pancreatitis. Questions regarding additional risk factors of pancreatitis like smoking, blood group and Diabetes mellitus were asked and recorded using the standard questionnaire.Results: Smoking history was noted in 73% of cases and 63.4% of controls. Non O blood group was noted in 56.6% of cases and 46.6% of controls. 10% of cases and 6.6% of controls gave history of diabetes before the development of pancreatitis. The additional risk factors were almost similar in both the groups and there was no statistical difference.Conclusions: It was concluded that there is no statistically significant additional risk factors for chronic alcoholic pancreatitis noted in present study and a study with a large sample size for an extended period is recommended

Improvements to the RV Waste-transfer Station Design to Reduce Contaminated Storm Runoff

Mammoth Cave in Central Kentucky is the world’s longest cave system and has been designated an international biosphere. It has unique organisms that live in the cave system and they are dependant upon high quality water supplied through rain recharge. We have documented quaternary ammonia compounds (QAC) levels ranging from 0.2 to 22 mg/L in storm fl ow, as well as, other chemicals coming from the RV waste-transfer station. The objective of this project was to re-design the drain system around the dump station to prevent spillage from washing down into the cave. The first design feature is a v-trench to catch storm runoff and redirect it into the sanitary sewer. The second feature is a gently elevated barrier that will impede the fl ow of runoff from the impacted area. The designs presented in this paper incorporate both features

Evaluation of Stormwater Filters at Mammoth Cave National Park, Kentucky, 2011-12

Studies in the 1970s found potentially toxic levels of metals entering Mammoth Cave’s underground streams through storm recharge. Additional studies confirmed that stormwater from parking lots and buildings fl owed rapidly into critical cave habitats. The Park’s management responded to these findings by installing storm runoff filter systems on the most heavily used parking lots in 2001. The Park entered an agreement (2010-12) with Tennessee State University, the USGS, and WKU-Mammoth Cave International Center for Science and Learning to evaluate the filter systems to determine if they were removing hazardous compounds from stormwater runoff . The objective of this study was to evaluate stormwater filters before and after replacing 2-year-old ZPG cartridge filters. The study focused on the first-flush runoff waters during the storms. The filters were not effective at removing quaternary ammonia compounds (QACs), and moderately eff ective at removing zinc and copper. The filters were very effective at removing diesel-range aromatic ring compounds (fuels). Regression analyses were used to evaluate trends between parking lot size and filter efficiency. The efficiency of the filters to remove fuels improved with basin size. The efficiency to remove QACs decreased with basin size. Basin size did not appear to have any correlation to zinc or copper removal efficiency. Human activity, such as construction, probably played a role in the storm-water chemistry and the efficacy of the filters to remove certain contaminants

Targeted loss of the ATR-X syndrome protein in the limb mesenchyme of mice causes brachydactyly

ATR-X syndrome is a rare genetic disorder caused by mutations in the ATRX gene. Affected individuals are cognitively impaired and display a variety of developmental abnormalities, including skeletal deformities. To investigate the function of ATRX during skeletal development, we selectively deleted the gene in the developing forelimb mesenchyme of mice. The absence of ATRX in the limb mesenchyme resulted in shorter digits, or brachydactyly, a defect also observed in a subset of ATR-X patients. This phenotype persisted until adulthood, causing reduced grip strength and altered gait in mutant mice. Examination of the embryonic ATRX-null forelimbs revealed a significant increase in apoptotic cell death, which could explain the reduced digit length. In addition, staining for the DNA damage markers γ-histone 2A family member X (γ-H2AX) and 53BP1 demonstrated a significant increase in the number of cells with DNA damage in the embryonic ATRX-null forepaw. Strikingly, only one large bright DNA damage event was observed per nucleus in proliferating cells. These large γ-H2AX foci were located in close proximity to the nuclear lamina and remained largely unresolved after cell differentiation. In addition, ATRX-depleted forelimb mesenchymal cells did not exhibit hypersensitivity to DNA fork-stalling compounds, suggesting that the nature as well as the response to DNA damage incurred by loss of ATRX in the developing limb fundamentally differs from other tissues. Our data suggest that DNA damage-induced apoptosis is a novel cellular mechanism underlying brachydactyly that might be relevant to additional skeletal syndromes. © The Author 2013. Published by Oxford University Press. All rights reserved

Artificial amplification of warming trends across the mountains of the western United States

Observations from the main mountain climate station network in the western United States (U.S.) suggest that higher elevations are warming faster than lower elevations. This has led to the assumption that elevation-dependent warming is prevalent throughout the region with impacts to water resources and ecosystem services. Here we critically evaluate this network\u27s temperature observations and show that extreme warming observed at higher elevations is the result of systematic artifacts and not climatic conditions. With artifacts removed, the network\u27s 1991–2012 minimum temperature trend decreases from +1.16°C decade−1 to +0.106°C decade−1 and is statistically indistinguishable from lower elevation trends. Moreover, longer-term widely used gridded climate products propagate the spurious temperature trend, thereby amplifying 1981–2012 western U.S. elevation-dependent warming by +217 to +562%. In the context of a warming climate, this artificial amplification of mountain climate trends has likely compromised our ability to accurately attribute climate change impacts across the mountainous western U.S

Three Examples of Chemical Transport in Storm Runoff at Mammoth Cave National Park, Kentucky

The karst landscape at Mammoth Cave National Park, Kentucky, was formed by water through the dissolution of soluble rocks forming sinkholes, disappearing streams, emerging springs, closed depressions, and a combination of wet and dry caves. The Park’s cave streams and pools provide a home to unique organisms. Surface waters in the Park tend to rapidly drain into subsurface geologic features and caves. This rapid infiltration makes the subsurface vulnerable to contamination. The objective of this investigation was to characterize chemical transport from the surface into the cave. The preliminary results were achieved by tracer studies and monitoring water chemistry along known flowpaths. The results presented in this paper are the outcome of several studies occurring between 2009-2012 in a partnership between Mammoth Cave National Park, Tennessee State University, Mammoth Cave International Center for Science and Learning, and U.S. Geological Survey. Processes that influenced chemical transport included storm intensity, time between storms, epikarst saturation, dispersion, dilution, and complex fl ow paths in the geology

The Lantern Vol. 73, No. 1, Fall 2005

• Newspaper Clippings Found on the Wall of Giuseppe Luchenzo\u27s Home When it was Raided by Police • All the Time in the World • The Man Who Would Win • Souffle Suit • A Day in the Mind • Context • Felicity / Awareness • Frivolous • Thank You Note to J.S.B. • September 17, 2005 • Eight Ways of Looking at a Highway • Dusty Glass Spreads Air Like Light • Clockwork • Rubber Band • Outside Eye or I Am? • A Mundane Mysticism • Half Carat • Things I Learned on My Trip to the Mutter Museum of Medical Oddities • Peer Editing • The Attic Bones • Yeshttps://digitalcommons.ursinus.edu/lantern/1167/thumbnail.jp