Antibiotic misuse in children by the primary care physicians - an indian experience

To determine the misuse of antibiotics in the Pediatric outpatients department (OPD) of a busy teaching hospital and to ascertain the probable reasons behind it. Over a 6 months period, new cases primarily treated with antibiotics by Medical Officers (first contact physicians in Peadiatric Medicine and Surgery OPD) were recruited in the study after obtaining written consent from the parents. Various errors of antibiotic usage were noted. All Medical Officers were asked to fill up a preformed questionnaire and the parents/guardians were interviewed on their ideas about antibiotics. Data were analyzed by the statistical software SPSS 10. Antibiotics were prescribed in 2427 (84.9%) new patients. Misuse of antibiotics was documented in 36.8% patients (no indication in 35.3%, improper selection in 17.9% and incorrect dosage in 7.7%). All medical officers were aware that they overuse antibiotics. The various reasons sited were demand of the parents, reluctance to counsel due to patient overload, free supply of medicines from OPD and sympathetic grounds as follow up visits were uncertain. Majority of the parents/attendants belonged to poor socioeconomic status and did not have any idea regarding antibiotics. All parents wanted quick relief without hospitalization and only 2.3% were willing to revisit the OPD for the same illness. Both medical officers and parents felt that base line investigations were unnecessary. Antibiotic misuse is quite common in this part of the world. Irrational use was mostly seen in over-prescribing and improper selection of antibiotic. Poor socio-economic status and overcrowding of patients in OPD were the main responsible factors.Antibiotics, child, physicians. Nigerian Journal of Clinical Practice Vol. 11 (1) 2008: pp.53-5

Protein Stabilized and Sustained Deliverable Nanofiber Smart Scaffold for Multiphase Tissue Regeneration

Tissue engineering (TE) represent a paradigm shift in healthcare therapies and treatments by repairing, replacing, or regenerating damaged cells and tissues in human body. Chemical cues such as growth factors (GFs) and cytokines, and there successful delivery is the key components in TE with the ability to target specific tissue regeneration

A Novel Three Phase Multilevel Inverter with Single Dc Link For Induction Motor Drive Applications

All industrial drives need a controlled output and it can be achieved by controlling the input supply. In this regard, the inverter circuit plays an important role in the applications of industrial drives. The industrial drives are operated at high rated power and the conventional inverters cannot be applicable for high power demands because of the large dV/dt (rate of change of voltage) and more switching losses. Therefore, multilevel inverters are introduced for high power-medium voltage applications. For all AC drives the MLIs are reliable in operation. This MLI topology also reduces the harmonics and bearings stress of a motor with low dV/dt. In most applications multilevel inverters are used because we can get more number of voltage levels. To increase the number of voltage levels, circuit needs to have more switches. But, we have to optimize the switch count and switching operations. The power level of the inverter is limited due to high currents and stress. In this paper, we proposed a new circuit topology which enables the switches to be active at different voltage levels, causes reduction of the switching losses and also increases the efficiency of the inverter. In this we have presented two configurations for an eleven level MLI for three phase induction motor drive application. In this an individual DC source is connected for each bridge circuit of each phase in one configuration and only one common DC link is used for three phases in another configuration. With this the size, cost and complexity could be decreased. In both the configurations the controlled output of the inverter is connected to the induction motor drive. The circuits are modeled using Matlab/simulink software and corresponding output waveforms are analyzed for both configurations

Event by Event Analysis of High Multiplicity Events Produced in 158 A GeV/c 208 Pb- 208 Pb Collisions

An extensive analysis of individual high multiplicity events produced in 158 A GeV /c 208Pb- 208Pb collisions is carried by adopting different methods to examine the anomalous behavior of these rare events. A method of selecting the events with densely populated narrow regions or spikes out of a given sample of collision events is discussed.Employing this approach two events with large spikes in their eta- and phi- distributions are selected for further analysis. For the sake of comparison, another two events which do not exhibit such spikes are simultaneously analyzed. The findings suggest that the systematic studies of particle density fluctuations in one- and two-dimensional phase-spaces and comparison with those obtained from the studies of correlation free Monte Carlo events, would be useful for identifying the events with large dynamical fluctuations. Formation of clusters or jet like phenomena in multihadronic final states in individual events is also discussed and the experimental findings are compared with the independent particle emission hypothesis by carrying out Monte Carlo simulations

Protein Stabilized and Sustained Deliverable Nanofiber Smart Scaffold for Multiphase Tissue Regeneration

Tissue engineering (TE) represent a paradigm shift in healthcare therapies and treatments by repairing, replacing, or regenerating damaged cells and tissues in human body. Chemical cues such as growth factors (GFs) and cytokines, and there successful delivery is the key components in TE with the ability to target specific tissue regeneration

Assessment of Reliability of Composite Power System Including Smart Grids

The large service interruptions of power supply in the transmission system have significant impact on modern society. The aim of the power system engineers is to prevent and mitigate such events with optimal decisions in design, planning, operation and maintenance. Due to the rapid growth in the power demand and competitive power market scenario, the transmission and distribution systems are frequently being operated under heavily loaded conditions. This tends to make failure of components more frequent in the power system necessitating large downtime to repair or replace the equipment. A majority of the service interruptions are happening due to lack of proper planning and operation of power system. Therefore, complete reliability assessment in generation, transmission and distribution systems is needed at the planning stage. The reliability assessment in smart grids is very much beneficial to the power operator and reduces the risk of grid failure due to failure of major components in power systems. This chapter is confined to composite power system reliability assessment. The composite power system combines both the generation and transmission systems’ adequacy. The generation system in the composite power system includes both conventional and renewable sources. The composite power system reliability assessment is quite difficult due to the large number of equipment, interconnected network topology and uncertainties in generation capacity. The reliability assessment concentrates mainly on the use of probabilistic states of components in generation and transmission systems to evaluate the overall reliability. This analysis will result in a cost-effective system configuration to provide continuous power supply to the consumers at reasonable cost. The reliability level of the system is measured by the defined indices. One of these indices is the probability of average power availability at load bus. This reliability assessment mainly focuses on development of methods to evaluate the probability of average power availability at load buses for a specified system configuration. This chapter discusses the two main techniques called node elimination method and modified minimal cut set method

Effectiveness of Surgical Management of Ankle Fractures in Attaining the Stability of Ankle

Introduction: Ankle injuries comprise a major group of lower limb trauma. Many of these injuries can be treated by manipulative reduction and conservative treatment and some of these yield satisfactory results, so present study was undertaken to know the effectiveness of surgical management of ankle fractures. Method: 42 surgically treated displaced fractures are included and studied in detail of age, sex, occupation, type of fracture, mode of injury, type of treatment, Clinical evidence of fracture union, Radiological evidence of fracture union, Relation of talus in the ankle mortise, Range of mobility of the ankle, Residual disability and pain, Ability to walk and time of return to duty and complications were noted. Result:  42 cases were surgically treated, most of the patients were operated on an emergency basis within 24 hours of injury. Based on the mechanism of injury Pronation- External Rotation (30.9%) and Based on Ao Classification Type B - B2 (53.3%) were the major type of fractures. In the majority of cases, Malleolar screws type of implants used.  In overall the final status of patients is good (ability to walk).  Conclusion: Displaced ankle fractures need accurate open reduction and internal fixation and postoperative immobilization for 6 weeks. This will suffice to get good results. Post-operative rigid immobilization and protected weight bearing for 12 weeks is minimal to achieve good union followed by physiotherapy to restore the maximum range of movements Keywords: Ankle Fractures; Surgical management, Stability; Effectiveness

Surgical management of pertrochanteric fractures with proximal lateral femur locking compression plate

Background: Pertrochanteric femoral fractures are of intense interest globally. Pertrochanteric fracture is a one of the most serious cause of mortality and morbidity in elderly people. The number of such admissions is on a raise because of increasing life span, sedentary habits and increased road traffic accidents. Pertrochanteric region is a high stress area. Hence delayed union, implant failures, varus collapse and non-union are common complications. Choice of implant was also a tough decision for surgeons in this area. Hence this study was intended to evaluate the functional outcome of proximal femur fractures treated with proximal femur locking compression plate (PFLCP) in terms of union of fracture, patient compliance and complications.Methods: This prospective study was conducted at the department of orthopaedics, Narayana Medical College and Hospital, Nellore from December 2014 to June 2016. The complete data was collected from all the patients by taking history of illness and by doing detailed clinical examination and relevant investigations. Finally after the diagnosis, the patients were selected for the study depending on the inclusion and exclusion criteria. Postoperatively all the cases were followed for the minimum period of 6 months to maximum period of 1 year.Results: In this study 22 patients were involved. There were 14 males and 8 females, with a mean age of 46 years. 19 cases were admitted due to slip and fall and with slight predominance of right side. Mean duration of hospital stay was 20 days and mean time of full weight bearing is 10 weeks. Out of 22 cases 2 cases lost follow up before first follow up time of 6 weeks. Out of 20, remaining cases 8 were type 3 and 12 were type 4. Functional results were graded by Harris hip scoring system. Good to excellent results were seen in 87% cases of type 3 fractures and 83% cases in type 4 fractures.Conclusions: Treatment with a PFLCP can provide good-to-excellent healing for proximal femur fractures, with a limited occurrence of complications especially for severe comminuted fracture and osteoporosis