Early recovery after surgery in elective obstetrics-gynaecology surgeries: prospective single-center pilot study

Background: Enhanced recovery after surgery (ERAS) programmes employed in elective colorectal, vascular, urologic and orthopaedic surgery has provided strong evidence for decreased hospital stay without increase in postoperative complications. The aim of the study was to explore role and benefits, if any, of ERAS/ERP (early recovery protocols) implemented in patients undergoing elective obstetrics-gynaecological surgeries.Methods: Prospective cohort of 48 consecutive patients undergoing elective obstetrics-gynaecological surgeries were included. ERP included early feeding, urinary catheter removal, mobilisation/physiotherapy, intravenous line removal and optimal oral analgesia. This was compared to control group of 50 patients undergoing similar operations prior to introduction of ERP, SPC group-standard perioperative care. Demographics and indications of surgeries were similar for both groups. The primary end-points were length of stay (LOS) and incidence of complications (Clavien-Dindo classification). Difference in means was tested using the t test assuming unequal variances. Statistical significance was defined as p<0.05.Results: Two groups, A (non-ERAS/SPC) and B (ERAS) were comparable with regards to demographics and indication of surgery. The mean time to solid diet, urinary catheter removal, mobilization, iv fluid removal and shift to oral analgesia was 2.57, 1.13 (p<0.00001), 1.99 ,1.03 (p<0.00268), 1.63, 1.2 (p<0.00001), 1.72, 1.14 (p<0.00001), 1.8, 1.37 (p<0.00001) days respectively. There were 31 and 21 complications in both groups, respectively (p<0.0097). Hospital stay was significantly shorter in the ERAS group, 2.87, 2.61 (p<0.0378).Conclusions: This pilot study shows that ERPs can be successfully implemented with significant shorter hospital stays without increase in postoperative complications in elective obstetrics-gynecology patients

Entrepreneurship Business Plan (N14T17): Jainco Group

This is an entrepreneurship business plan on my family business - Jainco Group

OPTIMIZATION OF CYCLE TIME IN HYUNDAI MOTORS INDIA LTD

This paper sheds light on the application of quality control tools to reduce Cycle time (including Weld time and Squeeze time). Successive use of these tools identifies and addresses the weakness and leads to improved processes. These tools address the problems in logical and sequential manners which are easy to observe and interpret the result. The main gist of this paper is to achieve the target cycle time of body build line. Cycle time includes process time, during which a unit is acted upon to bring it closer to an output. Every production line always has a target cycle time. With the collected data it was found that cycle time was higher than the target cycle time, so it needed to be optimized. There are lots of factors which are to be eliminated in order to achieve the target cycle time. The root cause of the factors affecting the target cycle time was observed using quality improvement tools known as the Ishikawa diagram or the ‘Fish Bone Diagram’

Prevalence of psychosocial problems among adolescents in rural areas of District Muzaffarnagar, Uttar Pradesh

Introduction:&nbsp;Adolescence is a period of transition between childhood and adulthood. It is a phase of life marked by special attributes including rapid physical growth and development; physical, social and psychological maturity.&nbsp;Aims &amp; Objectives:&nbsp;The present cross sectional study was conducted to assess the prevalence of psychosocial problems among adolescents in a rural area of District Muzaffarnagar.&nbsp;Materials &amp; Methods: The study subjects were 210 adolescent girls and boys (10-19 years old) selected using multistage random sampling technique. The subjects were interviewed &amp; detailed information was collected on a structured and pre-tested questionnaire after taking consent from the subject/ parents. The clinical diagnosis was generated as per the criteria laid down in ICD-10. The data was entered in Epi Info statistical software package Version 3.4.3 and suitable statistical methods were applied.&nbsp;Results:&nbsp;The overall prevalence of psychosocial problems amongst adolescent was found to be 41.43%. Most of them had conduct disorder (40.51% males &amp; 35.88% females) followed by depression (30.38% males &amp; 26.72% females).&nbsp;Conclusions:&nbsp;There are significant psychosocial problems amongst the adolescents. So, enough emphasis should be given to this component of adolescent health and thus it is recommended that a holistic approach to the underlying causes of psychosocial problems of adolescents should be undertaken