Bihar 2015: grand victory for the Mahagathbandhan, debacle for the BJP

The Bihar election results announced earlier this month revealed a decisive victory for Nitish Kumar and Lalu Prasad Yadav’s ‘Mahagathbandhan’ (Grand Alliance), while the BJP and its allies were soundly defeated. Pranav Gupta offers an overview of the results and analyses the likely contributing factors as well as the longer-term implications of the victory

The battle for Bihar

As the first of five phases in the Bihar Assembly election gets underway Pranav Gupta takes a look at the political alliances that have formed to contest what is shaping up to be a very tight race. He argues that although voting patterns in the 2014 Lok Sabha elections would suggest an easy win for Nitish Kumar and Lalu Prasad Yadav’s partnership, there are multiple factors which mean the contest remains open in Bihar

The 2016 Assam Assembly elections: political manoeuvres behind the spotlight

Ahead of Assam’s Legislative Assembly Elections, Pranav Gupta assesses how recent political developments in the North Eastern state could affect the electoral fortunes of the key players. He writes the while the current trends indicate that the BJP will emerge as the single largest party in the state, things could easily change as the election draws closer

The role of laparoscopy in patients with abdominal trauma

Background: Use of laparoscopy in penetrating trauma has been well established; however, its application in blunt trauma is gaining popularity as a useful diagnostic tool to avoid unnecessary laparotomies where there is diagnostic dilemma. Even though recent case reports seem to suggest that these patients can be managed using laparoscopy, the practice is not yet wildly adopted.Methods: All adult patients who presented with abdominal trauma laparoscopic surgery was considered in patients who were deemed fit for the same in the Department of General Surgery, MMIMSR, Mullana, Ambala during a period of 18 months starting from January 1st 2015 to June 30th 2016. Data was analysed using descriptive statistics.Results: A total of 53 patients with either blunt or penetrating abdominal trauma that required surgery were included in the study. Exploratory laparotomy was performed in 45 patients (84.91%) and laparoscopy was performed in 8 patients (15.09%). Overall mesenteric injury (45.28%) was the most common intra-abdominal injury noted. The most common organ involved in blunt trauma was the spleen (68.97%). The mean operating time of laparoscopy was lesser by 57 minutes as compared to exploratory laparotomy. The use of laparoscopy avoided negative and non-therapeutic laparotomy in 2 patients (25%). Therapeutic laparoscopy was performed in 3 patients with repair of bowel and mesenteric injuries. There was no documented procedure‑related morbidity and mortality.Conclusions: The positive outcomes from the study suggest that laparoscopy can be safe and feasible in both diagnostic and therapeutic interventions in carefully selected blunt abdominal trauma patients

Pre and per operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters

Background: Cholecystectomy is the procedure of choice for symptomatic gall stones. Laparoscopic Cholecystectomy (LC) may be rendered difficult by various problems encountered during surgery. Several factors have been implicated with a difficult case, but no reliable criteria are available yet to identify patients preoperatively with a difficult LC. Preoperative prediction of a difficult LC can help the patient as well as the surgeon prepare better for the intraoperative risk and the risk of conversion to open cholecystectomy. The present study was undertaken to evaluate role of various factors responsible for conversion from laparoscopic to open cholecystectomy and also to study the intraoperative problems faced by the surgeon responsible for conversion in order to make the procedure safer for the patient as well as the surgeon.Methods: In 50 consecutive patients who underwent LC during 2013 to 2014 patient’s characteristics, clinical history, laboratory data, ultrasonography results and intraoperative details were prospectively analyzed to determine predictors of difficult LC.Results: Of 50 patients 3 (06%) required conversion to open cholecystectomy. Significant predictors of conversion were obscured anatomy of Calot’s due to adhesions, sessile gall bladder, male gender and gall bladder wall thickness >3 mm.Conclusions: With preoperative clinical and ultrasonographic parameters, proper patient selection can be made to help predict difficult LC and a likelihood of conversion to open cholecystectomy.

Supporting Excess Real-Time Traffic With Active Drop Queue

Real-time applications often stand to benefit from service guarantees, and in particular delay guarantees. However, most mechanisms that provide delay guarantees also hard-limit the amount of traffic the application can generate, i.e., to enforce to a traffic contract. This can be a significant constraint and interfere with the operation of many real-time applications. Our purpose in this paper is to propose and investigate solutions that overcome this limitation. We have four major goals: 1) guarantee a delay bound to a contracted amount of real-time traffic; 2)transmit with the same delay bound as many excess real-time packets as possible; 3) enforce a given link sharing ratio between excess real-time traffic and other service classes, e.g., best-effort; and 4) preserve the ordering of real-time packets, if required. Our approach is based on a combination of buffer management and scheduling mechanisms for both guaranteeing delay bounds, while allowing the transmission of excess traffic. We evaluate the cost of our scheme by measuring the processing overhead of an actual implementation, and we investigate its performance by means of simulations using video traffic traces