An Inventory Model under Space Constraint in Neutrosophic Environment: A Neutrosophic Geometric Programming Approach

In this paper, an inventory model is developed without shortages where the production cost is inversely related to the set up cost and production quantity. In addition, the holding cost is considered time dependent. Here impreciseness is introduced in the storage area. The objective and constraint functions are defined by the truth (membership) degree, indeterminacy (hesitation) degree and falsity (non-membership) degree. Likewise, a non-linear programming problem with a constraint is also considered. Then these are solved by Neutrosophic Geometric Programming Technique for linear membership, hesitation and non-membership functions. Also the solution procedure for Neutrosophic Non-linear Programming Problem is proposed by using additive operator and Geometric Programming method. Numerical examples are presented to illustrate the models using the proposed procedure and the results are compared with the results obtained by other optimization techniques

Optimization of EOQ Model with Limited Storage Capacity by Neutrosophic Geometric Programming

In this article, we present deterministic single objective economic order quantity model with limited storage capacity in neutrosophic environment. We consider variable limit production cost and time dependent holding cost into account. Here we minimize total average cost of proposed model by applying neutrosophic geometric programming, which is obtained by extending existing fuzzy and intuitionistic fuzzy geometric programming for solving resultant non-linear optimization model. Next we consider numerical application to show that optimal solution obtained by neutrosophic geometric programming is more desirable than that of crisp, fuzzy and intuitionistic fuzzy geometric programming. Also we perform sensitivity analysis of parameters and present key managerial insights

Effect of prophylactic amiodarone in patients with rheumatic valve disease undergoing valve replacement surgery

The study was carried out to evaluate the effect of prophylactic single-dose intravenous amiodarone in patients undergoing valve replacement surgery. Maintenance of sinus rhythm is better than maintenance of fixed ventricular rate in atrial fibrillation (AF) especially in the presence of irritable left or right atrium because of enlargement. Fifty-six patients with valvular heart disease with or without AF were randomly divided into two groups. Group I or the amiodarone group (n=28) received amiodarone (3 mg/kg in 100 ml normal saline) and group II or the control group received same volume of normal saline. The standardized protocol for cardiopulmonary bypass was maintained for all the patients. AF occurred in 7.14% patients in group I, and in group II, 28.57% (P=0.035); ventricular tachycardia/fibrillation was observed in 21.43% patients in group I and 46.43% patients in group II (P=0.089) after release of aortic clamp. Most of the patients in group I (92.86%) maintained sinus rhythm without cardioversion or defibrillation after release of aortic cross clamp (P=0.002). Defibrillation or cardio version was needed in 7.14% patients in group I and 28.57% patients in group II (P=0.078). A single prophylactic intraoperative dose of intravenous amiodarone decreased post bypass arrhythmia in this study in comparison to the control group. Single dose of intraoperative amiodarone may be used to decrease postoperative arrhythmia in open heart surgery

A Discussion about Modalities of Smoking Cessation in Perioperative Phase for Addicts: A Review Article

Cigarette smoking is a worldwide healthcare problem of modern age. It is a leading cause of death, mainly in male population. Excess deaths among smokers, as compared to non smokers, are chiefly due to tuberculosis and respiratory, cardiovascular or malignant diseases. Smoking significantly increases intraoperative and postoperative complications in a person undergoing surgical procedure. Smoking is menace to people and physicians and cessation of smoking is very much desirable, especially in persons undergoing operative intervention. Smoking cessation prior to the operation has been traditionally advised to be for 6 weeks but such an endeavour may have unwanted consequences because of withdrawal symptoms. Hence it is necessary that smoking cessation is achieved with minimal consequences so that the operative procedure can be conducted with minimal problems. Smoking cessation for a current user needs an active approach and provision of support for a cessation attempt. A combination of pharmacotherapy with behavioral interventions provides the best results. Available treatment modalities are nicotine replacement therapy and non-nicotine therapies such as bupropion, nortriptyline and varenicline. The most commonly used drugs are varenicline and bupropion. The focus of this article is on partial selective nicotine receptor agonist drug varenicline. By comparing different studies and researches worldwide, we showed in this article that varenicline provides the most sustaining and cost effective result. It also has less cardiovascular and respiratory side effects than nicotine replacement therapy and bupropion. The only limiting side effect may be psychiatric side effects including depression, self harm and suicidal tendencies, though they warrant further investigation and research.</p

Effect of intravenous levosimendan or milrinone on left atrial pressure in patients undergoing off-pump coronary artery bypass grafting—A prospective double-blind, randomized controlled trial

Background: Maintaining a low left atrial pressure (LAP) in off-pump coronary artery bypass grafting (OPCAB) is desirable. This study was done to compare the effects of intravenous levosimendan or milrinone on LAP at different stages of OPCAB. Materials and Methods: After institutional ethics committee clearance, this two-arm double-blind randomized control trial was done in 44 adult patients with triple vessel coronary artery disease undergoing OPCAB at cardiac OT of IPGME&R, Kolkata. The patients were randomly allocated into two groups receiving intraoperative either levosimendan or milrinone. Pulmonary capillary wedge pressure (PCWP) was compared as the primary outcome parameter, whereas other echocardiographic and hemodynamic parameters were also assessed during six stages of OPCAB, that is, after sternotomy, proximal(s), left anterior descending artery (LAD), obtuse marginal (OM), posterior descending artery (PDA) grafting, and before sternal closure. Numerical parameters were compared using Student's unpaired two-tailed t-test. Results: PCWP was found to be significantly lower (P < 0.05) in the levosimendan group during proximal (P = 0.047), LAD (P = 0.018), OM (P < 0.0001), PDA grafting (P = 0.028), and before sternal closure (P = 0.015). Other parameters indicate LAP, that is, from mitral early diastolic inflow velocity to mitral annular early diastolic velocity ratio (E/e'), which indicated significantly lower LAP in levosimendan group during LAD, OM, and PDA grafting and before sternal closure. Conclusion: Levosimendan may be used as a primary inotrope in terms of better reduction in left atrial pressure during different stages of OPCAB, translating to a decrease in left ventricular end-diastolic pressure, therefore maintaining optimum coronary perfusion pressure, which is the primary goal of the surgery