The Pattern of Hydatid Disease—A Retrospective Study from Himachal Pradesh, India

Hydatid disease is a common but little studied disease in Himachal Pradesh, India. This is a retrospective study from the Lady Willingdon Hospital, Manali. 115 patients presenting from April 1996 to March 2007 were included. Outcome measures were mortality and morbidity. 70 patients were female and 46 were male. (One female patient was operated on twice). 78% (n = 90) of the occurrences were hepatic. There were other varied sites. There were fourteen pulmonary hydatids. All patients underwent surgical cystectomy. An “AIR Technique” (Aspiration, Injection, Reaspiration) is described for scolicidal deactivation after March 2003 utilized in thirty two patients. There was no mortality. There were five documented recurrences in our series all of which occurred in cystectomy done without the AIR (Aspiration, Injection, Reaspiration) technique. Hydatid disease is a common disease in Himachal Pradesh warranting a high index of suspicion leading to an early diagnosis. A simple technique called the “AIR TECHNIQUE” (Aspiration, Injection, Reaspiration) is described

Fuzzy criteria programming approach for optimising the TBL performance of closed loop supply chain network design problem

Immense concern for sustainability and increasing stakeholders’ involvement has sparked tremendous interest towards designing optimal supply chain networks with significant economic, environmental, and social influence. Central to the idea, this study aims to design a closed loop supply chain (CLSC) network for an Indian laptop manufacturer. The network configuration, which involves a manufacturer, suppliers, third party logistics providers (forward and reverse), retailers, customers and a non-government organisation (NGO), is modelled as a mixed integer linear programming problem with fuzzy goals of minimising environmental impact and maximising net profit and social impact, subject to fuzzy demand and capacity constraints. Profit is generated from the sale of primary and secondary laptops, earned tax credits, and revenue sharing with reverse logistics providers. The environmental implications are investigated by measuring the carbon emitted due to activities of manufacturing, assembling, dismantling, fabrication, and transportation. The social dimension is quantified in terms of the number of jobs created, training hours, community service hours, and donations to NGO. The novelty of the model rests on its quantification of the three triple bottom line (TBL) indicators and on its use of AHP–TOPSIS for modelling the multi-criteria perspectives of the stakeholders. Numerical weights for the triple lines of sustainability are utilized. Further, a fuzzy multi-objective programming approach that integrates fuzzy set theory with goal programming techniques is utilised to yield properly efficient solutions to the multi-objective problem and to provide a trade-off set for conflicting objectives. The significance of the CLSC model is empirically established as a decision support tool for improving the TBL performance of a particular Indian laptop manufacturer. Practical and theoretical implications are derived from the result analysis, and a generalised quantitative closed-loop model can be effectively adapted by other electronic manufacturers to increase their competitiveness, profitability, and to improve their TBL.</p