Green Hotels ::an overview

In this article, we adopt a real estate perspective and explore the sustainability implications of hotels. First, we provide a background on sustainability, describe how it relates to the hotel sector and synthesize literature on the economic implications of sustainability. Further, we provide and explain trends on sustainability certifications, LEED in particular, in the US context

Study of factors affecting low birth weight of newborn in Uttar Pradesh, India

Background: Low birth weight is defined as weight at birth is less than 2.5 kg. Low birth weight infants are at a greater risk of having a disability and survival and respiratory problems. To reduce the incidence of low birth weight babies we studied the maternal factors which affect the baby in utero and cause preterm or low birth weight babies.Methods: Eighty-two pregnant ladies aged between 16-30 years were studied who regularly visiting to obstetrics and gynecology department of G. S. medical college hospital, Peeplabandpur, Pilkahuwa, Uttar Pradesh, India were selected for study.Results: In this study, it was seen that mothers who were illiterate, belonging to lower socioeconomic status, multiparous and pregnancy associated with PIH, Anaemia and Oligohydramnios had high incidence of low birth weight babies.Conclusions: This pragmatic approach study of LBW will be quite helpful to obstetrics and gynecologist, pediatrician, physician to treat such patients actively to prevent morbidity and mortality of low birth newborn which is a great threat and challenge to the medical fraternity globally

CONTROLLING IP SPOOFING THROUGH INTER DOMAIN PACKET FILTERS

IP Spoofing is a serious threat to the legitimate use of the Internet. By employing IP spoofing, attackers can overload the destination network thus preventing it from providing service to legitimate user. In this paper, we propose an inter domain packet filter (IDPF) architecture that can minimize the level of IP spoofing on the Internet. A key feature of our scheme is that it does not require global routing information.  IDPFs are constructed from the information implicit in Border Gateway Protocol (BGP) route updates and are deployed in network border routers.  We establish the conditions under which the IDPF framework correctly works in that it does not discard packets with valid source addresses. We show that, even with partial deployment on the Internet, IDPFs can proactively limit the spoofing capability of attackers. In addition, they can help localize the origin of an attack packet to a small number of candidate networks

A rare case of abdominal lymphangioma masquerading an adenaxal mass

Lymphangioma is an uncommon benign tumour of the lymphatic system. It can be localized (spleen, liver or thorax) or generalized. An abdominal location is exceptional (5%) and majority of cases occur in early childhood and it rarely presents in adulthood. Retroperitoneal lymphangioma account for less than 1% of all lymphangiomas here we present a rare case of retroperitoneal lymphangioma and patient presented as adenaxal mass

Clinical efficacy of clonidine versus nalbuphine as intrathecal adjuvants to 0.5% hyperbaric bupivacaine for subarachnoid block during gynaecological procedures: a double blind study

Background: Regional anesthesia techniques for gynaecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for gynaecological procedures.Methods: Regional anesthesia techniques for gynaecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for gynaecological procedures.Results: The onset of sensory block was earlier in patients of Group BN (3.91±2.25 min vs 4.30±0.87 min, p=0.039). The onset of motor block was also earlier in patients of Group BN (p=0.042). The time to first rescue analgesia in patients receiving intrathecal clonidine was significantly delayed (283±14.18 min vs 231.50±26.18 min, p=0.001). Intraoperative hemodynamic changes were comparable and none of the patient suffered from respiratory depression, shivering, nausea or vomiting.Conclusions: Intrathecal clonidine as adjuvant to bupivacaine provided was clinically more effective than nalbuphine for prolonging the duration of analgesia for gynaecological procedures

The socio-demographic profile and clinical correlation of Chlamydia trachomatis among infertile women at a tertiary care center in North India

Background: The frequency of Chlamydia trachomatis infection in infertile Indian women and potential risk factors associated with the infection is not well understood. To improve the primordial prevention C. trachomatis infection in developing countries, there is an urgent need to understand the prevalence of the infection among women with infertility and establish the common risk factors associated with this. This study was conducted to determine prevalence of Chlamydia trachomatis infection in infertile women attending an infertility clinic in north India and the associated socio-demographic and clinical features associated with it. Methods: Endocervical swabs, collected from 105 infertile women were tested for C. trachomatis by real time-PCR and direct gram’s stain. A detailed clinical history and examination was done on each subject during sample collection. The study group was then divided into two comparison groups and p factor was determined and factors with significant correlation were established. Results: Total 9 out of 105 infertile women visiting infertility clinic were RT-PCR positive for Chlamydia trachomatis. The socio-demographic factors that significantly correlated with Chlamydia trachomatis infection were lower age group, rural locality and illiteracy. The clinical history and examination findings that significantly correlated with the infection were past history of RTI/STI in the subject, history of RTI/STI in husband, cervical/ vaginal discharge, lower abdominal pain, burning micturition, erythema of genitalia, backache, dyspareunia and dysmenorrhea. The gram’s stain finding confirmed the active infection by presence of pus cells. Conclusions: The study concluded that the socio-demographic risk factor for Chlamydia trachomatis infection among infertile women is lower age group, rural locality and illiteracy while several clinical features that are red flags for the presence of such infection are past history of reproductive tract infection along with partner, cervical/vagina discharge, lower abdominal pain, burning micturition, erythema of genitalia, backache, dyspareunia and dysmenorrhea that should never be overseen

Bilobed gallbladder: a rare congenital anomaly of the biliary system

Duplication of the gallbladder is a rare congenital anomaly, which Boyden first illustrated in 1926. No additional risk of cholelithiasis or malignancy with this congenital anomaly was documented. However, this congenital anomaly is associated with more risk for complications during and after laparoscopic cholecystectomy. So, preoperative diagnosis is essential in identifying anatomical abnormalities to avoid biliary injuries at the time of surgery or the performance of an incomplete operation. The removal of an asymptomatic double gallbladder remains controversial. Here, we are reporting a case of the incidentally detected duplex gallbladder in a teenager and review the literature that will enrich the reader’s knowledge regarding this rare congenital anomaly

Comparative study to assess the functional outcome in management of inter-trochanteric fractures by proximal femoral nail versus proximal femoral nail anti-rotation

Background: Proximal femoral fractures are one of the most common fractures occurring in elderly due to osteoporosis and increase in life expectancy. The management of these fractures poses a serious challenge in terms of obtaining a stable fixation and a good post-operative outcome. In this study, we compare two intramedullary devices: Proximal femoral nail (PFN) and proximal femoral nail anti-rotation (PFN-A), used commonly for the fixation of proximal femoral fractures.Methods: Patients presenting with inter-trochanteric fractures were included and randomly allocated to two groups for treatment with either PFN or PFN-A. Pre-operative radiographs of normal side were used to grade osteoporosis by Singh’s index. Post-operative radiographs were used to assess the tip-apex distance and quality of reduction. Functional outcome was compared on the basis of Harris hip score at final follow-up. Patients were followed up at an interval of 1, 3 and 6 months respectively.Results: The study included 30 patients with 15 patients in each group. The duration of surgery and blood loss was significantly less in PFN-A group as compared to PFN. Functional outcome as assessed by Harris hip score was similar in both the groups. Implant related complications, though less in PFN-A group, had statistically insignificant difference.Conclusions: It can be safely concluded that, in spite of no differences in functional outcome between the two groups, a shorter duration of surgery and less blood loss would still make PFN-A a better choice in such patients, especially the elderly and co-morbid/compromised patients

Comparative study between delto-pectoral and deltoid splitting approach in surgical treatment of proximal humerus fractures using philos plating

Background: The present study was done to compare the two approaches of proximal humerus PHILOS plating on the basis of functional outcome of patients and other perioperative parameters.Methods: 40 patients with type 2 and type 3 proximal humerus were assigned to group A and B pre-operatively using random alternate allocation. Patients in group-A were operated with deltoid splitting approach while patients in group-B were operated with delto-pectoral approach. Functional outcome was assessed at 6 weeks, 3-months and 6-months. Perioperative parameters like duration of surgery, associated complications, and hospital stay were also noted and compared.Results: In each group, there were 12 two-part fractures and 8 three-part fractures. For 2-part fractures the mean duration of surgery was 51.33 min for group A and 63.37 min for group B. While for 3-part fractures it was 67.5 min and 80 min respectively. Irrespective of fracture type, there was statistically significant difference between the constant scores in both groups at 3 months (2-part: group A: 67.67; group B: 44.7; p value=0.001. 3-part: group A: 66; group B: 48; p value=0.001). However, the difference between two groups at 6 months was not statistically significant.Conclusions: Both approaches show satisfactory outcomes over a long period. However, the significantly less operative time and minimal soft tissue dissection in deltoid splitting approach can be used as an advantage in particular cases. Moreover, there was an early return to day-to-day activities for the deltoid splitting group which should be considered when treating an active individual