SPECTRUM OF PLEURAL EFFUSION DUE TO RENAL PATHOLOGIES AT TERTIARY CARE HOSPITAL

Objective: To determine the spectrum of pleural effusion due to renal pathologies at tertiary care hospital. Patients And Methods: The one year cross sectional study was conducted at tertiary care hospital. All the patients either gender who were diagnosed as chronic kidney disease (on haemodialysis) were included in the study. These patients were allowed to undergo necessary investigations and treatment. All the specific patients had thorough clinical history, relevant clinical examination and important investigations to explore the pulmonary pathology (pleural effusion) while the frequency / percentages (%) and means ±SD computed for study variables. Results: During one year study period total fifty patients with pleural effusion were explored and studied. The frequency for male and female population was 32 (64%) and 18 (36%) with mean ± sd for age of male and female individuals was 59.82±7.83 and 53.85±6.94 respectively. Gender male 30 (60%), female 20 (40%), pleural effusion 32 (64%). The cause includes idiopathic (unknown) 05 (10%), over hydration 15 (30%), heart failure 06 (12%), parapneumonic effusion 08 (16%), uremic pleuritis 05 (10%), tuberculous pleurisy 06 (12%), malignancy (prostate cancer) 05 (10%). Conclusion: Pleural effusion is regular in hospitalized patients getting long haul hemodialysis due to chronic kidney disorders. Keywords: Pleural effusion, Kidney, Lung and Renal disease

Isolation and biochemical characterizations of the bacteria (Acidovorax avenae subsp. avenae) associated with red stripe disease of sugarcane

Studies on Acidovorax avenae subsp. avenae, associated with red stripe disease of sugarcane was conducted in the Department of Plant Pathology, Pir Mehr Ali Shah Arid Agriculture University Rawalpindi during 2009 to 2010, in collaboration with Shakarganj Sugar Research Institute (SSRI), Jhang, Pakistan. Red stripe of sugarcane were recently observed on promising clones of sugarcane planted in autumn 2009 at Ashaba Research Farm of SSRI. Bacteria were isolated from diseased plants. These isolates yielded off white convex colonies on potato dextrose agar (PDA) media at 29°C with 1.7 to 1.9 mm diameter and were yellow on yeast extract dextrose chalk agar (YDC) media at 27°C with 1.8 to 2.0 mm diameter. The bacteria were rod shape measuring 0.5 to 0.6 × 1.4 to 1.6 μm on PDA and 0.6 to 0.7 × 1.5 to 1.7 μm on YDC. Bacterial culture was stored at different temperature levels for 150 days. Reisolation of bacterial culture which was stored at 4°C showed best result on YDC at 27°C after 150 days, whereas it showed positive result after 120 days on PDA at 29°C. Bacteria were gram negative, citrate utilization was positive, oxidase was negative, catalase was positive and urease was negative. Morphological appearance and biochemical characterizations identified the bacteria as A. avenae subsp. Avenae. In vitro screening for the efficacy of various antibiotics to inhibit the growth of A. avenae subsp. avenae on YDC media showed that ampicillin and vancomycin were most effective. Artificial inoculation on sugarcane against red stripe disease was observed. Observations were made upto six weeks for disease development. Out of 27 varieties, 16 were found resistant, four moderately resistant, five moderately susceptible and two susceptible.Key words: Sugarcane, yeast extract dextrose chalk agar (YDC), potato dextrose agar (PDA), Acidovorax avenae subsp. avenae, biochemical characterization, antibiotics

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Performance Analysis of Table Driven and Event Driven Protocols for Voice and Video Services in MANET

This research paper encompasses the performance analysis of table driven and event driven routing protocols by using voice and video traffic in mobile Adhoc network (MANET). Particularly, OLSR (table driven) and DSR (Event driven) protocol are considered. The nodes of MANET establish the connections with each other energetically and can move freely in any direction. In mobile Adhoc network, environment event driven and table driven protocols have significant subject matter of study. There is a mobility issue which matters the service performance due to breakage and renewal of links of mobile nodes. Protocols performance has significance on overall performance of MANET. The aim of this study is to present the performance analysis of selected routing protocols by varying the node densities and WLAN physical characteristics. The voice and video traffic applications are configured discretely by using OLSR and DSR in scenarios. Moreover, for the performance observation the parameters are jitter, traffic received, traffic sent, end-to-end delay, traffic load, and throughput. The simulations have been carried out through OPNET 14.5 modeller tool and results has been analysed

Performance Analysis of Table Driven and Event Driven Protocols for Voice and Video Services in MANET

This research paper encompasses the performance analysis of table driven and event driven routing protocols by using voice and video traffic in mobile Adhoc network (MANET). Particularly, OLSR (table driven) and DSR (Event driven) protocol are considered. The nodes of MANET establish the connections with each other energetically and can move freely in any direction. In mobile Adhoc network, environment event driven and table driven protocols have significant subject matter of study. There is a mobility issue which matters the service performance due to breakage and renewal of links of mobile nodes. Protocols performance has significance on overall performance of MANET. The aim of this study is to present the performance analysis of selected routing protocols by varying the node densities and WLAN physical characteristics. The voice and video traffic applications are configured discretely by using OLSR and DSR in scenarios. Moreover, for the performance observation the parameters are jitter, traffic received, traffic sent, end-to-end delay, traffic load, and throughput. The simulations have been carried out through OPNET 14.5 modeller tool and results has been analysed

Analysis Of Routing Protocol Metrics In MANET

This research paper work is about the analysis of routing protocol metrics in MANET. The routing protocols metrics are important subject matter in the mobile Adhoc network environment. The MANET environment connecting devices or nodes with each other energetically and develop mobile Adhoc wireless network . It offers the mobility to network devices to freely move in any direction and develop connection to any device. The aim of this research paper is to analyze the routing protocol metrics as, radio range, delay, load, media access delay and throughput by evaluating the simulation of AODV, DSR and TORA routing protocols using video conferencing application. The simulation results have been carried out through OPNET 14.5 modeler tool, however scenarios created, having different node densities and different WLAN physical characteristics and routing protocol metrics and analyzed results

A Study of Mobility Models for UAV Communication Networks

The Unmanned aerial vehicle communication network (UAVCN) is a group or swarm of unmanned aerial vehicles which can be used for specific military and civilian applications without human intercession. This network faces the design problem which is based on network mobility. The frequent topology changes affect communication and collaboration among the UAVs (Unmanned aerial vehicles). To govern the movement pattern of UAVCN different mobility models needed to be studied in order to solve this communication issue. In this paper, mobility models are explored which provides the particular mobility pattern to resolve the problem of collaboration, communication and cooperation of UAVs. These models have been categorized into five groups and classified each group in detail. These mobility models provide the platform to understand and implement the unmanned aerial communication network for specific environment scenarios. The mobisim simulator tool is used to generate the mobility model s trajectories for different mobility models

Supplier Selection Process Improvement through Six-Sigma DMAIC : A case of Lafarge Pakistan Cement Limited

  Degree Project Advanced Level - Business Administration, Linnaeus Business School at Linnaeus University, Business Process and Supply Chain Management, 4FE02E, Spring 2010.   Authors: Muhammad Rizwan ul Haque, Ahmed Nawaz Shaikh, Kamonmarn Jaenglom, Zaheer Tariq Tutor: Petra Andersson   Title: Supplier Selection Process Improvement through Six-Sigma DMAIC (A case of Lafarge Pakistan Cement Limited)   Background: Cement industry is considered to be an intensive supplier base industry. Cement manufacturing involves several types of suppliers ranging from general utilities to large plant equipments. Also, supply chain performance is significant topic in many cement organisations. The supply chain department at Lafarge Pakistan Cement Limited (LPCL) wants to inspect and improve their supplier selection process. The intended objective of this inspection is two folded. First, LPCL wants to develop a competitive supplier base out of bulk suppliers available in the market that would result in competitive advantage over its competitors. Second, they want to improve their supplier selection process so that there would be low variance and exclusion of unnecessary activities that would ultimately help in achieving the cost, quality and service enhancement objectives.   Research question: How can the existing supplier selection process at Lafarge Pakistan Cement Limited (LPCL) be improved by applying Six-Sigma DMAIC?   Methodology: This thesis is a descriptive case study and was conducted with a deductive approach. Data was collected through interviews, discussions and questionnaire. The scientific credibility of this thesis was secured by using many sources, avoidance of assumptions, studying a common process and following standardized steps of supplier selection. Conclusion: The existing process of supplier selection at LPCL was defined and mapped to understand the process characteristics and capabilities. The existing process was then analysed to identify problem areas, variations and unnecessary activities. Corrective actions were recommended to deal with problem areas and an improved supplier selection process for LPCL was suggested with process coordination and control measures. Suggestions for future research: Based on the findings of this thesis, we suggest that the further research for LPCL could be done in the area of sourcing and suppliers relationship management. Sourcing; a study could examine the sourcing policy at LPCL on purchasing practises of products. It would also be interesting to focus more on this area which leads to excellent cost reduction. Using scenario method could compare and analyse regional, national and worldwide sourcing. Supplier Relationship Management; a study could investigate supplier relationship management that leads to creating a competitive advantage for LPCL through the development of supplier performance monitoring and supplier development programme. More details could continuously move towards cost reduction, increased reliability and risk mitigation, transparency of supplier costs and quality, and enhanced efficiency of sourcing process