Elevated C-reative protein (CRP) as a surgical indication for appendicitis

Objective: Role of C-reactive protein value in the diagnosis of appendicitis by correlating with severity of appendicitis on histopathological findings. Methodology: This descriptive study was conducted at the department of general surgery Unit-IV, Liaquat University Hospital Hyderabad from March 2016 to February 2017. All cases above 12 years of age with severe appendicitis based on presenting signs and symptoms were included. The patient underwent routine laboratory investigations including abdominal plain x-ray in an erect position and ultrasound abdomen. The blood sample was taken from each patient for C-reactive protein and was send to Hospital diagnostic laboratory. During surgery, a specimen of each patient was sent to a diagnostic laboratory for histopathology. All the data were record on Performa. Results: A total of 305 patients were studied; their mean age was 35.7+9.7 years. Males were found in the majority (73%). 75.41% of patients had leukocytosis. C-reactive protein was raised among 26.22% of patients. On histopathological findings, 04.91% of patients had a normal appendix, while 69.83% had gross inflammation of the appendix, 19.67% patients had gangrenous appendix, and 05.57% patients had perforation and peritonitis. Elevated C reactive protein (CRP) and leukocytosis were significantly associated with the severity of appendicitis, p value 0.001. Conclusion: C-reactive protein is a non-invasive and reliable indicator for surgical treatment of appendicitis. C-reactive protein and white blood cells (WBCs) were significantly associated with the severity of appendicitis

Automatic Generation Control Problem in Interconnected Power Systems

The present article is aimed to discuss the various operational and control aspects of interconnected power systems. The structure of present day power systems is discussed and it is followed by the identification of automatic generation control (AGC) problem among the overall control of interconnected power systems. The article describes the duties and functional areas of AGC in a power system. The relevant aspects of frequency deviations and associated operating controls, structure of frequency control loops and functions of typical AGC system are described. Keywords: Interconnected power systems, EHVAC/DVDC transmission links, Control function hierarchy, Subsystems, Primary, secondary and emergency control

Outcome of Percutaneous Ultrasound Guided Aspiration versus Open Surgical Drainage of Psoas Muscle Abscess

Objective: To compare the outcome of percutaneous ultrasound guided aspiration V/S open surgical drainage for psoas muscle abscess. Methodology: This comparative study was conducted in department of general surgery at Liaquat medical university hospital Hyderabad/Jamshoro, from June 2017 to November 2017. Diagnosed Patients of psoas muscle abscess size more than 5cm, between 18 to 60 years of age and either of gender were included. Patients were randomly divided into two groups, A and B by odd and even method, patients in group A abscess was aspirated by percutaneous ultrasound guided aspiration and patients in group B was underwent open surgical drainage, all the data were entered in the pre designed performa and analyzed into SPSS V:16.0 Results: A total of 58 patients of Psoas muscle abscess were selected, the mean age of study subjects of group A was 38.5+10.5 and group B was 36.5+12.7 (p-673). Early post-operative pain relief was assessed among patients of group A as compared to group B. As per outcome resolution of abscess cavity was significantly high among patients of group B (p-0.004), while post-operative Hospital stay was significantly lower in group A (p-0.002). Conclusion: Both techniques has their own benefits like percutaneous aspiration has shorter duration of hospital stay while in complete resolution of abscess cavity was found in open surgical drainage group of patients

Interscalene Block in the Modern Era: When Stuck, Go Back to the Roots!

The traditional interscalene block has evolved over time to lower, lateral and posterior approaches, coinciding with the advent of Peripheral Nerve Stimulator and Ultrasonography. In limited infrastructure settings, such technology remains elusive and the classical paresthesia technique comes to the rescue. This approach is however very difficult to elicit in pediatric patients. It is here that the grassroot approach of a fascial “click” or “pop” emerges as the savior to administer a satisfactory block. We describe a case of a young boy with successful conduct of anaesthesia for K wire fixation of supracondylar fracture of humerus under lower interscalene block with loss of resistance technique. In light of recent research showing about 40-50% variation in the brachial plexus anatomy around the subclavian artery, use of technology in anaesthesia is the future. However, till such technology is made universally affordable, it is pertinent to remember the roots of interscalene block

Comparison of Outcome of one Versus two Drains Insertion for Seroma Formation Following Modified Radical Mastectomy in Breast Carcinoma

Objective: Comparative outcome of one versus two drains insertion for in the term of seroma formation following modified radical mastectomy in breast carcinoma. Methodology: This Prospective Interventional trial was conducted at Department of General Surgery, Liaquat University Hospital Hyderabad from February 2018 to January 2019.  Females with breast carcinoma admitted for modified radical mastectomy were included. Patients were divided into two groups.  Groups I underwent one drain placement and group II underwent two drains placement. All patients were observed to measure and record the volume of the fluid. Patients were discharged from Hospital in stable condition and after removal of drains, and followed up weekly for one month. Data was recorded on self-made proforma and analyzed by using SPSS-20. Results: Total of 80 patients were selected, 38 in group A and 42 in group B. Mean age of patients of group A was 49.08 ± 9.89 years and group B was 51.40 ± 13.59 years. , Excised Mass weight was lesser in group A as compared to group B. Mean volume of drain discharge was significantly higher in Group B 323.43 ± 158.88 ml, while it was in group A 230.29± 200.98, findings were statistically significant 0.013. Seroma formation was statistically insignificant among both groups as 8(21.1%) in group A and   10(23.8%) in group B, p-value 0.768. Conclusion: One-drain and two-drain insertion are equally effective to reduce the seroma formation after modified radical mastectomy; however, one drain insertion leads to more patient compliance and comfort with probably less morbidity and cost

Optimal output vector feedback control strategy for wind power systems

This article presents the design of optimal output feedback controllers to enhance the dynamic performance of wind turbine generator supplying an infinite bus through transmission line. Efforts have been made to propose optimal regulators based on feedback of output state variables, which are easily accessible and available for the measurement. The designed optimal output feedback controllers are implemented in the wake of step disturbance in the system. The system dynamic responses and pattern of closed loop system eigenvalues for various system states are obtained with the designed optimal regulators to investigate the system dynamic performance. The investigations of the results obtained reveal that the reduction in system states used for feedback has resulted in degradation of system dynamic performance. However, for a particular set of output variables used as feedback; five states are used for feedback for an eighth order original system. The system dynamic performance is the same as offered by optimal controllers based on full state vector feedback control strategy.http://www.tandfonline.com/loi/uemp202016-06-30hb2016Electrical, Electronic and Computer Engineerin

Speed control of wheeled mobile robot by nature-inspired social spider algorithm-based PID controller

: Mobile robot is an automatic vehicle with wheels that can be moved automatically from one place to another. A motor is built on its wheels for mobility purposes, which is controlled using a controller. DC motor speed is controlled by the proportional integral derivative (PID) controller. Kinematic modeling is used in our work to understand the mechanical behavior of robots for designing the appropriate mobile robots. Right and left wheel velocity and direction are calculated by using the kinematic modeling, and the kinematic modeling is given to the PID controller to gain the output. Motor speed is controlled by the PID low-level controller for the robot mobility; the speed controlling is done using the constant values Kd, Kp, and Ki which depend on the past, future, and present errors. For better control performance, the integral gain, differential gain, and proportional gain are adjusted by the PID controller. Robot speed may vary by changing the direction of the vehicle, so to avoid this the Social Spider Optimization (SSO) algorithm is used in PID controllers. PID controller parameter tuning is hard by using separate algorithms, so the parameters are tuned by the SSO algorithm which is a novel nature-inspired algorithm. The main goal of this paper is to demonstrate the effectiveness of the proposed approach in achieving precise speed control of the robot, particularly in the presence of disturbances and uncertainties

TO SEE THE PATTERN OF INTERNAL ORGAN INJURIES ASSOCIATED TO ABDOMINAL TRAUMA

OBJECTIVE: To evaluate the frequency of intra-abdominal injuries associated to abdominal trauma. MATERIAL AND METHODS: This cross sectional study was conducted at general surgery departments of Isra University Hospital and LUH Hyderabad with the duration of one year from 2014 to 2015. All the patients with abdominal trauma (blunt trauma and penetrating trauma) were incorporated in the study. All cases less than 12 years of age and having brain injuries and unconscious patients were excluded from the study. Details of history, clinical examination, ultrasound abdomen and all required laboratory investigations were carried out. All the causes of abdominal trauma were noted. Frequency of all intra-abdominal injuries including spleen, kidneys, liver, and pancreas), stomach, ureters, small intestine, and urinary bladder were noted. All the findings according to study objective were noted in the Performa. RESULTS: Total 60 cases were selected, male gender was found commonest 86.6%, while female were only 13.4%. 23-33 years age group was found commonest 25.0%. Majority of the cases 66.66% had blunt trauma, while 33.34% of the cases had penetrating trauma. Clinically mostly patients were found with abdominal pain and vomiting, 92.30% and 55.20% respectively. Liver was the commonest intra-abdominal injury in both blunt and penetrating trauma, 37.5% and 20.0% respectively. Conclusion: We concluded that intra-abdominal injuries are significantly more prevalent in Blunt abdominal trauma as compare to penetrating trauma. Liver and spleen were commonest intra-abdominal organ injuries. Key words: Abdominal trauma, intra-abdominal organ injurie