Comparison of outcome of Modified Millard’s Incision and Delaire’s Functional Method in Primary Repair of Unilateral Cleft Lip.

Objective: To contrast results of two surgical methods for correction of Unilateral Cleft lip. Methodology: Prospective study was conducted from October 2018 to October 2019 after ethical approval from institute ethical board. Data was collected than arranged over Microsoft Excel 2007.Variables then formed or for further statistical results data was entered in SPSS version 15.0. Variables were assessed by using. . Standard Deviation and Mean was calculated and presented for quantitative data like age and weight. Frequency (percentages) were calculated and presented for qualitative data such as gender and outome variables. Post stratification statistical chi square test was used to see effect modification. P value ≤ 0.05 was considerable. Results: Out of 100% (n=66) unilateral cleft lip patients, 50% (n=33) patients each were operated with Modified Millard’s incision and Delaire’s functional method respectively. Various parameters were analyzed—white roll match, cupid bow, lip length and alar dome demonstrated favorable measurements in Millard’s group and the vermilion match, scar appearance, nostril symmetry and alar base was better in Delaire’s methods. All the differences in these parameters were not statistically significant, except lip length (p=0.023). Conclusion: Overall clinical outcomes like vermilion match, white roll, and cupid bow appearance was similarly effective in both techniques. Outcome related to lip length was considerable in incision by Millard’s technique. Similarly nasal symmetry was better in Delaire’s functional method. This leads to significance of one method over other. Keywords: Primary Repair, Modified Millard’s, Delaire’s Functional Method Unilateral Cleft Lip. DOI: 10.7176/JMPB/54-04 Publication date: April 30th 201

Comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy

Objective: The basic aim of this study is to find out comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy. Methodology: This randomized control trial was conducted in Surgery Department, Bahawal Victoria Hospital Bahawalpur. This study was completed in 5 months (August 2018 to January 2019) and all the patients under trial were asked for informed consent. A total number of 100% (n=62) were taken in this trial and online source Openepi.com was used for calculating sample size. Patients were selected by lottery method. Computer software SPSS version 23.2 was used for complete data entry and analysis. All the descriptive variables like onset of action and age were presented as SD and mean. Statistical test ANOVA was applied to find the significance among all groups. Chi square test was applied for analysis of continuous stats among groups. P value 0.05 was to be considered as significant. Result: A total number of 100% (n=62) patients were included, divided into two equal groups, 31 in each i.e. harmonic scalpel and conventional knot groups. The mean age of the patients, in harmonic scalpel group, was 45.29±4.56 years. There were 64.5% (n=20) males and 35.5% (n=11) females. The mean age of the patients, in conventional knot, was 44.96±2.97 years. There were 74.2% (n=23) males and 25.8% (n=8) females. No significant difference was found for age (t=0.329, p=0.743) and gender (χ2=0.683, p=0.409) in groups. The main outcome variables of this study were the time of procedure (minutes) and blood loss volume (ml). The mean time of procedure was 98.80±16.52minutes and 119.81±9.95 minutes for the harmonic scalpel and conventional knot groups respectively. Significant difference was found for the time of procedure in groups (t=-6.060, p-value = 0.000). Conclusion: The whole study can be ended with this conclusion that the harmonic scalpel is more effective than the conventional method of ligation or knotting in thyroidectomy. Its use offer many clinical benefits including reduction in time of surgery and blood volume as well. Keywords: Thyroidectomy, Harmonic, Conventional and Bleeding control. DOI: 10.7176/JMPB/54-09 Publication date: April 30th 201

The Economic Impact of Lower Extremity Amputations in Diabetics. a Retrospective Study From a Tertiary Care Hospital of Faisalabad, Pakistan

Background: Among the various complications of diabetes, lower-extremity amputation due to diabetic foot is a common problem. In Pakistan, 6-7% of patients with diabetes suffer from diabetic foot ulceration. Objectives: Our primary objective was to explore the frequency of diabetic foot amputations, and the secondary objective was to calculate the economic burden of these preventable surgeries on the health budget of the provincial government. Materials & Methods: It was a retrospective cross-sectional observational study conducted after obtaining approval from the Ethical Review Committee of Allied hospital, Faisalabad Medical University. The data of diabetic foot patients who underwent amputations between July 2017 and December 2017 were retrieved from three Surgical Units (I, II & III), using a purposive sampling technique. All amputations carried out for reasons other than diabetic foot were excluded. The direct medical cost of one diabetic foot amputation was calculated via a local survey of the various private hospitals of Faisalabad. The indirect costs in terms of loss of productivity and disability costs, transport costs, rehabilitation costs were not included in this study. The data were evaluated by using SPSS Version 23. Results: A total of 85 patients were included in our study. The male to female ratio was 2.7 to 1. The mean direct treatment cost for minor amputation was PKR 46926.00 ± 11730.90 ($382.35 ± 95.58), and the mean direct treatment cost for major amputation was PKR 53720.00 ± 12401.24 ($437.71 ± 101.40). Out of 85 amputations, 63 (74%) were major amputations, and the remaining 22 (26%) were minor amputations. The total cost for 63 major amputations was PKR 3,384,360 ($27568.91) and for 22 minor amputation was PKR 1,032,372 ($8409.67). The net cost came out to be PKR 4,416,732 ($35978.59) for all the 85 cases being reported in a tertiary care hospital of Faisalabad for six months. Conclusion: Diabetic foot, a preventable complication of long-term diabetes mellitus, has an economic burden on the hospital budget, which, if adequately addressed via primary prevention programme, can yield not just economical but medical benefits as well

ANALISIS KESESUAIAN KAWASAN TAMBAK UDANG VAMANE (LITOPENAEUS VANNAMEI) DI DESA PASAR BEMBAH KABUPATEN BENGKULU UTARA

Provinsi Bengkulu secara geografis terletak di Pantai Barat Pulau Sumatera, dengan panjang garis pantai 525 km. Selain potensi perikanan tangkap, juga memiliki potensi perikanan budidaya. Kegiatan perikanan budidaya di wilayah pesisir adalah tambak udang. Kabupaten Bengkulu Utara memiliki potensi yang paling luas untuk pengembangan tambak udang. Dalam rangka mengoptimalkan pemanfaatan potensi tambak Udang Vaname (Litopenaeus vannamei) maka perlu diteliti analisis kesesuaian kawasan di Desa Pasar Bembah Kabupaten Bengkulu Utara. Metode yang digunakan dalam penelitia ini adalah Metode Survei. Data yang dikumpulkan terdiri dari data primer dan sekunder. Data primer diperoleh melalui observasi lapangan dan data sekunder meliputi literatur-literatur penunjang serta data pendukung lainnya. Kesesuaian kawasan untuk pengembangan tambak Udang Vaname (Litopenaeus vannamei) di Desa Pasar Bembah Kecamatan Air Napal Kabupaten Bengkulu Utara diperoleh luas kawasan yang masuk dalam kategori sangat sesuai adalah 362.20 ha. Adapun nilai Indek Kesesuaian Tambak (IKT) berkisar 66,67-100% dan luas kawasan yang masuk dalam kategori sesuai adalah 42.63 ha, adapun nilai Indek Kesesuaian Tambak (IKT) berkisar 33,34 – 66,66 %. Strategi yang perlu dilakukan dalam pengembangan kawasan tambak udang: 1) Mengoptimalkan pemanfaatan tata ruang untuk pengembangan tambak udang sehingga potensi lahan dapat dioptimalkan sesuai dengan daya dukung lingkungan, 2) Menerapkan manajemen pengelolaan tambak udang dengan konsep biosecurity dan Best Manajemen Pratices (BMP), 3) Bergabung dengan asosiasi tambak udang, 4) Meningkatkan produksi tambak udang dengan menerapkan teknologi super intensif ramah lingkungan, dan 5) Meningkatkan pengawasan terhadap keamanan produk/ menerapkan standar cara berbudidaya udang yang baik

Internet of Things: Architectural Components, Protocols and Its Implementation for Ubiquitous Environment

Ubiquitous data processing of the sensing nodes has revolutionized the development of electronic industries manufacturing. The concept of the Internet of Things (IoT) is the connectivity of distributed sensing and processing nodes from anywhere rather than fixed computing. For the Implementation of Ubiquitous smart environment, anything and everything can be converted to smart IO Things, and where things have sensing and processing abilities for automation and analysis of environmental processes. Sensors, actuators, embedded processing systems, networking gateways, and IoT Cloud Services are the building blocks of IoT implementation. This paper presents a brief discussion on the connectivity of building blocks with various enabling technologies for the implementation of the Internet of Things. Moreover, many of data link standards and the internet of things data communication protocols will be in the discussion

Research on the improvement of mixed titania and Co(Mn) oxide nano-composite coatings

The structure and the properties of the oxide films formed on titanium in the diphosphate based electrolytes by means of plasma electrolytic oxidizing at direct current density of 2-2.5 A·dm⁻² have been studied. Oxide layers of different composition and content of alloying elements were obtained by modification of electrolytes and variation in current density. The interelectrode voltage during PEO, chemical and phase composition, topography and microstructure of the formed layers depend on the electrolyte composition and applied current density. The spark-discharge regime was shown to be reached at inter-electrode voltage 100 to 130 V depending on the composition of electrolyte. The effect of chemical composition and surface morphology formed mixed oxide films on the corrosion resistance and catalytic activity has been discussed

Prospective Comparison of Ultrasound-Guided Versus Palpation Techniques for Arterial Line Placement by Residents in a Teaching Institution

Background: Arterial line insertion is traditionally done by blind palpation. Residents may need multiple attempts for successful insertion, leading to longer procedure times and many failed attempts. Objective: We hypothesized that ultrasound guidance (USG) would be faster and more successful than traditional blind palpation (TBP) for radial artery line placement by residents. Methods: Patients undergoing elective surgery requiring a radial arterial line were randomized to either the USG or TBP groups. Exclusion criteria included a need for arterial line placement in an awake patient, emergent surgery, or American Society of Anesthesiologists (ASA) physical status class VI. After the induction of anesthesia, a postgraduate year 3 (PGY-3) or PGY-4 anesthesia resident placed an arterial line by either USG or TBP. Results: A total of 412 patients and 85 of 106 residents (80%) in the training program were included. The 2 groups were similar with respect to sex, weight, height, ASA class, baseline systolic blood pressure, and baseline heart rate. USG was faster than TBP (mean times 171.1 ± 16.7 seconds versus 243.6 ± 23.5 seconds, P = .012), required fewer attempts (mean 1.78 ± 0.11 versus 2.48 ± 0.15, P = .035), and had an improved success rate (96% versus 90%, P = .012). Conclusions: We found that residents using USG in an academic institution resulted in significantly faster placement of the arterial lines, fewer attempts, and fewer catheters used

The distance to the SNR CTB109 deduced from its environment

We conducted a study of the environment around the supernova remnant CTB109. We found that the SNR is part of a large complex of HII regions extending over an area of 400 pc along the Galactic plane at a distance of about 3 kpc at the closer edge of the Perseus spiral arm. At this distance CTB109 has a diameter of about 24 pc. We demonstrated that including spiral shocks in the distance estimation is an ultimate requirement to determine reliable distances to objects located in the Perseus arm. The most likely explanation for the high concentration of HII regions and SNRs is that the star formation in this part of the Perseus arm is triggered by the spiral shock.Comment: 6 pages, 6 figures. accepted for publication in the Astrophysical Journa