A comparative study of stool antigen Immunocard STAT HpSA test with biopsy in diagnosis of H Pylori Infection

The present study was conducted on 78 cases in the Department of Medicine at G.S.V.M Medical College, Kanpur who reported with various gastrointestinal symptoms such as dyspepsia, heartburns, nausea, vomiting and loss of appetite. They all were advised for biopsy by the physician. Patients treated with antibiotics, bismuth or proton pump inhibitors within 4 weeks preceding the study were excluded. Invasive tests using mucosal biopsies including histology and rapid urease test (RUT) were used to establish the gold standard in order to evaluate the accuracy of Immunocard STAT HpSA. Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value of Immunocard STAT HpSA as compared to gold standard were 95.5%, 81.8%, 96.9% and 75.0% respectively. It is thus concluded that the Immunocard STAT HpSA test has a diagnostic value comparable to the gold standard in detecting H Pylori. The sensitivity and specificity of the test is fair enough to be used as a test for screening purpose and also for diagnosis and treatment of H.Pylori infection in clinical practic

Application of Handheld Tele-ECG for Health Care Delivery in Rural India

Telemonitoring is a medical practice that involves remotely monitoring patients who are not at the same location as the health care provider. The purpose of our study was to use handheld tele-electrocardiogram (ECG) developed by Bhabha Atomic Research Center (BARC) to identify heart conditions in the rural underserved population where the doctor-patient ratio is low and access to health care is difficult. The objective of our study was clinical validation of handheld tele-ECG as a screening tool for evaluation of cardiac diseases in the rural population. ECG was obtained in 450 individuals (mean age 31.49 ± 20.058) residing in the periphery of Chandigarh, India, from April 2011 to March 2013, using the handheld tele-ECG machine. The data were then transmitted to physicians in Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, for their expert opinion. ECG was interpreted as normal in 70% individuals. Left ventricular hypertrophy (9.3%) was the commonest abnormality followed closely by old myocardial infarction (5.3%). Patient satisfaction was reported to be ~95%. Thus, it can be safely concluded that tele-ECG is a portable, cost-effective, and convenient tool for diagnosis and monitoring of heart diseases and thus improves quality and accessibility, especially in rural areas

The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients.

The quick sequential organ failure assessment (qSOFA) score has been proposed as a means to rapidly identify adult patients with suspected infection, in pre-hospital, Emergency Department (ED), or general hospital ward locations, who are in a high-risk category with increased likelihood of poor outcomes: a greater than 10% chance of dying or an increased likelihood of spending 3 or more days in the ICU. This score is intended to replace the use of systemic inflammatory response syndrome (SIRS) criteria as a screening tool; however, its role in ED screening and identification has yet to be fully elucidated. In this retrospective observational study, we explored the performance of triage qSOFA (tqSOFA), maximum qSOFA, and first initial serum lactate (\u3e 3 mmol/L) at predicting in-hospital mortality and compared these results to those for the initial SIRS criteria obtained in triage. A total of 2859 sepsis cases were included and the in-hospital mortality rate was 14.4%. The sensitivity of tqSOFA ≥ 2 and maximum qSOFA ≥ 2 to predict in-hospital mortality were 33% and 69%, respectively. For comparison, the triage SIRS criteria and the initial lactate \u3e 3 mmol/L had sensitivities of 82% and 65%, respectively. These results demonstrate that in a large ED sepsis database the earliest measurement of end organ impairment, tqSOFA, performed poorly at identifying patients at increased risk of mortality and maximum qSOFA did not significantly outperform initial serum lactate levels

An automated coding and classification system with supporting database for effective design of manufacturing systems

The philosophy of group technology (GT) is an important concept in the design of flexible manufacturing systems and manufacturing cells. Group technology is a manufacturing philosophy that identifies similar parts and groups them into families. Beside assigning unique codes to these parts, group technology developers intend to take advantage of part similarities during design and manufacturing processes. GT is not the answer to all manufacturing problems, but it is a good management technique with which to standardize efforts and eliminate duplication. Group technology classifies parts by assigning them to different families based on their similarities in: (1) design attributes (physical shape and size), and/or (2) manufacturing attributes (processing sequence). The manufacturing industry today is process focused; departments and sub units are no longer independent but are interdependent. If the product development process is to be optimized, engineering and manufacturing cannot remain independent any more: they must be coordinated. Each sub-system is a critical component within an integrated manufacturing framework. The coding and classification system is the basis of CAPP and the functioning and reliability of CAPP depends on the robustness of the coding system. The proposed coding system is considered superior to the previously proposed coding systems, in that it has the capability to migrate into multiple manufacturing environments. This article presents the design of a coding and classification system and the supporting database for manufacturing processes based on both design and manufacturing attributes of parts. An interface with the spreadsheet will calculate the machine operation costs for various processes. This menu-driven interactive package is implemented using dBASE-IV. Part Family formation is achieved using a KAMCELL package developed in TURBO Pascal.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46606/1/10845_2004_Article_BF00123696.pd

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

An Automated Coding And Classification System With Supporting Database For Effective Design Of Integrated Manufacturing Systems

Group technology is a philosophy in manufacturing that identifies similar parts and group them into families. One method which is considered to be the most powerful and reliable is classification and coding. In this method each part is inspected individually by means of its design and processing feature. This article presents the design of a coding and classification system and the supporting database for manufacturing processes based on both design and manufacturing attributes of parts. An interface with the spreadsheet will calculate the machine operation costs for various processes. This menu driven interactive package is implemented using DBASE-IV. Part family formation and the final cell assignment is done using KAMCELL package developed in TURBO Pascal. © 1993

A clinical study On Changes in oxygen saturation, haemodynamics and ECG in patients during postoperative period undergoing abdominal surgery using different analgesic

Patient generally faces some degree of cardio-pulmonary complication, in post operative period, measuring O2 saturation, ECG changes and haemodynamics changes despites pulmonary and circulatory complication in post operative patient receiving Morphine, Tramadol and Pathedine. Patients were divided into 3 groups. Group A: Morphine Group -: Subgroup I: morphine IM, Subgroup II: morphine IV, Subgroup III: Morphine epidurally, Group B: Tramadol Group -: Subgroup I: tramadol IM, Subgroup II: tramadol IV, Subgroup III: Tramadol epidurally., Group C: Control Group-: Patients receiving Pethidine IM on demand, which is the standard practice. In each .sub group we 10 patient included (n=10).In our study we found Variables like pulse rate, systolic or diastolic or mean blood pressure, respiratory rate, changes in ECG and arterial oxygen saturation showed no statistically significant difference between study and control groups. Keeping in view all the factors considered in the present study, epidural morphine was found to be the best analgesic with very good analgesia, less sedation and hemodynamic stability with fewer side effects. Epidural Tramadol was found to be the next best. IM Tramadol was last in rating as it was a poor analgesic for intense postoperative pain, although hemodynamic and respiratory stability was good without any side effects. So we recommend epidural morphine 3mg in 10ml saline for control of postoperative pain relief