COST OPTIMIZATION OF INVENTORY SYSTEM IN TWO-ECHELON WITH TWO SUPPLIERS

This paper presents a continuous review two echelon inventory system. The operating policy at the lower echelon is (s, S) that is whenever the inventory level traps to s on order for Q = (S-s) items is placed, the ordered items are received after a random time which is distributed as exponential. We assume that the demands accruing during the stock-out period are lost. The retailer replenishes their stock from the regular supplier which adopts (0, M) policy, M = nQ. When the regular supplier stock is empty the replacement of retailer stock made by the outside supplier who adopts (0, N) policy N = nQ. The joint probability disruption of the inventory levels of retailer, regular supplier and the outside supplier are obtained in the steady state case. Various system performance measures are derived and the long run total expected inventory cost rate is calculated. Several instances of numerical examples, which provide insight into the behavior of the system are presented

The antimicrobial efficacy of three chlorhexidine mouth rinses: an in-vitro analysis

>Magister Scientiae - MScDifferent chlorhexidine (CHX) preparations and formulations are available in local markets. Some preparations contain anti-discoloration systems (ADS), additional antimicrobials like cetylpyridinium chloride (CPC), or alcohol. The aim of this study was to compare the antimicrobial efficacies of 3 different CHX preparations (Corsodyl®, Curasept® and GUM® Paroex®

Chronic thoracolumbar subdural empyema: Case report and surgical management.

BACKGROUND: Spinal cord abscesses and spinal subdural empyemas are rare and difficult to treat. CASE DESCRIPTION: A 35-year-old male presented to an outside institution with 2 months of progressive low back pain, weakness, and bowel incontinence; he was diagnosed with an L4 epidural abscess that was poorly managed. When the patient presented to our institution, magnetic resonance imaging (MRI) revealed a well-organized chronic subdural abscess at the thoracolumbar junction. Following resection, his back pain resolved but he was left with a residual paraparesis. CONCLUSION: Subdural abscesses are rare and should be considered among the differential diagnoses for intraspinal mass lesions. Treatment should include prompt surgical exploration and decompression combined with appropriate prolonged antibiotic treatment

Comparison of Naïve bayes classifier with back propagation neural network classifier based on f - folds feature extraction algorithm for ball bearing fault diagnostic system

This paper is intended to compare the Naïve bayes classifier for ball bearing fault diagnostic system with the back propagation neural network based on the f-folds feature extraction algorithm. The f-folds feature extraction algorithm has been used with different number of folders and clusters. The two classifiers have shown similar classification accuracies. The Naive bayes classifier has not shown any case of false negative or false positive classification. However, the back propagation neural network classifier has shown many cases of false positive and false negative classifications

The Role of EZH2 in the Induction and Maintenance of Acute Myeloid Leukaemia

Epigenetic regulators are commonly mutated in cancer. Activating mutations and overexpression of EZH2 occur in lymphoma and other malignancies, while loss-of-function mutations are found in myeloid malignancies. This thesis is a study of this apparent contradiction, examining the importance of cellular context for Ezh2 loss during the evolution of a single malignancy, Acute Myeloid Leukaemia (AML). This work demonstrates diametrically opposite functions for Ezh2 at early and late stages during the evolution of leukemias generated by disparate AML-associated fusion-oncogenes. Ezh2 functions as an oncogene that may be therapeutically targeted during disease maintenance. In contrast, Ezh2 behaves as a tumour suppressor gene during AML induction. Integrated genomic analysis demonstrates that largely different expression programmes are de-repressed during disease induction and maintenance following Ezh2 loss. Studying disease induction, Ezh2 represses a subset of bivalent promoters that resolve towards gene activation upon Ezh2 loss, inducing a feto-oncogene programme including genes like Plag1, whose overexpression phenocopies Ezh2 loss to accelerate AML induction in mouse models. This data highlights the importance of cellular context and phase of disease evolution for Ezh2 function. Moreover, the work herein identifies EZH2 as a potential target in AML, whilst providing reassurance of the safety of this therapeutic strategy

A Study of 100 Cases of Pancytopenia : A Clinicohematological Correlation

INTRODUCTION: Pancytopenia is the simultaneous occurrence of anaemia, leucopenia, thrombocytopenia and it is a not a disease but rather a clinico-hematological entity encountered in clinical practice. Pancytopenia is a feature of many serious and life threating diseases. It is generally due to decrease in hematopoietic production in bone marrow resulting from nutritional deficiencies, infections, inflammation, cancers, chemotherapeutic drugs and other toxins. Different studies conducted at different centres showed varying frequencies of diseases producing pancytopenia. The pattern of disease leading to pancytopenia may vary in different population groups with their differences in age pattern, nutritional status and the prevalence of infection. It is generally due to decrease in hematopoietic production in bone marrow resulting from nutritional deficiencies, infections, inflammation, cancers, chemotherapeutic drugs and other toxins. Different studies conducted at different centres showed varying frequencies of diseases producing pancytopenia. The pattern of disease leading to pancytopenia may vary in different population groups with their differences in age pattern, nutritional status and the prevalence of infection. OBJECTIVES: 1. To study the various patterns of clinical presentation and co-relate hematological parameters & bone marrow findings with clinical findings, in differentiating various causes of pancytopenia. 2. To estimate frequency of different diseases producing pancytopenia. MATERIALS AND METHODS: Data consists of primary data collected by the principal investigator directly from 100 cases of PANCYTOPENIA patients admitted in the medical ward in Coimbatore Medical College Hospital. This is a crosssectional/observational study done for a period of one year from July 2017 to June 2018. Inclusion Criteria: 1.All patients above age 18 yrs & below 65 yrs. 2. Patients with Hb < 10 g%, Total leucocyte count < 4000 cells/mm3, platelet count < 1,50000 cells/mm3. Exclusion Criteria: 1.Patients below 18yrs of age. 2. Diagnosed case of malignancy including leukaemia receiving chemotherapy or radiotherapy. RESULTS: The age of the patients ranged from 18 years to 65 years with a mean age of 45 years. Males accounted for 61 cases (61%) and female 39 cases (39%) with a M:F ratio of 1.5:1. Commonest presenting complaint was fatigue, bleeding manifestations and dyspnoea. Commonest physical finding was pallor followed by cardiac failure and then hepatomegaly & splenomegaly. Lowest haemoglobin percentage was 1.6 gm/dl and it was noted in a case of aplastic anaemia. Lowest total leucocyte count was 500 cells/mm3 and noted in a case of acute promyelocytic leukemia. Lowest platelet count of 2000 cells/mm3 was noted in a case of aplastic anaemia. Serum vitamin B12 level is low in 59% of patients of which 36% of patients were found to have megaloblastic anemia. Abnormal RFT/Renal failure is noted in only 7% of patients which were mainly seen in multiple myeloma & malaria patients. Abnormal LFT is observed only in 25% of patients of which chronic liver disease, hematological malignancy & infection were the major cause of pancytopenia. Dimorphic anaemia (microcytic & macrocytic) was predominant blood picture in pancytopenic patients. Hypercellular marrow was noted in 72 patients and the common cause was megaloblastic anaemia, followed by leukemia, infections, MDS and chronic liver disease. Hypocellular marrow was noted in 18 patients and commonest cause was aplastic anaemia. Finally, by this study, Megaloblastic anemia (36%) was found to be the commonest cause of pancytopenia followed by hypoplastic / aplastic anemia (18%), infections (12%), myelodysplastic syndrome (10%), chronic liver disease (10%), autoimmune disorders (8%) and haematological Malignancy (6%). Infections encountered in this study were HIV, TB and MALARIA. Of hematological malignancies, acute lymphoblastic leukemia was the commonest followed by multiple myeloma and one case of acute promyelotic leukemia & hairy cell leukemia

Detection of Trypanozoon trypanosomes infections on Glossina fuscipes fuscipes (Diptera: Glossinidae) using polymerase chain reaction (PCR) technique in the Blue Nile State, Sudan

Tsetse flies transmit many species of trypanosomes in Africa, some of which are human and livestock pathogens of major medical and socio-economic impact. Identification of trypanosomes is essential to assess the disease risk imposed by particular tsetse populations. The present study was carried out to determine the trypanosomal infection rate of tsetse flies (Glossina fuscipes fuscipes) in the Blue Nile State of Sudan. A polymerase chain reaction (PCR) assay was used because of the inherent difficulty of speciating trypanosomal parasites in the fly. Our results show that 4.44% (8/180) of the flies were positive for a Trypanosoma brucei group. Three of eight positive flies reacted with primers for Trypanosoma b. rhodesiense. We did not detect flies infected with T. b. gambiense. Thus, the burden of flies harboring T. b. rhodesiense and T. b. brucei trypanosomes were 1.67 and 2.78%, respectively. This is the first evidence of T. b. rhodesiense in the Yabus District. Thus, HAT case-detection active surveillance and tsetse fly control campaigns should be conducted before the establishment of human settlement, investment of natural resources into agricultural and animal husbandry.Key words: Glossina fuscipes fuscipes, Trypanosoma brucei, T. b. gambiense, T. b. rhodesiense, infection rate, PCR technique, Blue Nile State