Negative Pressure Wound Therapy in Infected Wounds – Indian Public Hospital

Introduction: Negative pressure wound therapy (NPWT) is a procedure in which vacuum is used to enhance wound healing. Vacuum-assisted closure (VAC) refers to wound dressing that uses pressure below normal continuously or intermittently to the surface of a wound. The negative pressure is maintained by an apparatus; this promotes healing in various kinds of wounds and also helps in wound debridement. Aims: This study was carried out with an aim to find outthe rate of wound contraction, compare infection clearance, granulation tissue formation and to study postoperative pain after using NPWT. Material and methods: All types of infected wounds with slough were selected. Patients irrespective of sex between 18 and 70 years of age were included. The wounds included were traumatic, diabetic foot, varicose ulcer, infected wounds, carbuncle, etc. The procedure included surgical debridement as a preliminary procedure, followed by application of NPWT. The wound criteria: 1) size, 2) shape, 3) wound margin and floor, 4) edge and contraction were studied. Results and  Discussion: Infected wounds can be treated by specific modalities like daily wound dressing, surgical debridement, hyperbaric oxygen therapy and NPWT.  PWT seems more efficient than standard wound care for infected wounds. In our study, the mean size of ulcer in diabetic patients before NPWT was found to be 6.33 × 4.52 cm; after application of NPWT, it was 4.7 × 2.95 cm. The mean size of ulcer in traumatic patients before NPWT was found to be 7.1 × 5.1 cm, while after application of NPWT, it was 5 × 3.63 cm. The mean size of ulcer in vascular patients was found to be 5.71 × 3.85 cm before NPWT, and after application  of NPWT, it was 4 × 2.42 cm. NPWT dressings have been proven to be beneficial as a variant method of dressing, mainly by negative pressure which sucks out serous fluid and helps in the formation of granulation tissue. Used in various wounds, continuous suction over period of time and later intermittent suction depending on wound status enhance wound healing process and lead to faster recovery compared to conventional methods of dressing. Conclusion: The wound healing period for large traumatic wounds and chronic diabetic wounds is 123 days as per published data. In our study, where NPWT was used, the average wound healing period was 35 days, ranging between 10 and 62, which is statistically significant (p < 0.005). NPWT is cost-effective, reduces hospital stay ofpatient with minimal chances of limb amputation with better results than standard wound care

A Review of Diabetic Foot Osteomyelitis: Focus on Diagnosis, Clinical Presentation, Management and Outcomes

Diabetic foot osteomyelitis (DFO) affects around 38.5 lakh patients in India. It is diagnosed using clinical and radiologicalapproaches. Polymicrobial etiology, peripheral artery disease (PAD) and peripheral neuropathy are commonly observed. Ahigh degree of clinical vigil is required to avoid underestimation of the extent of damage due to speed and spread of infectionand prevent chances of lower extremity amputation. ‘Time is Tissue’ (time taken to access multidisciplinary care) aptlyrepresents one of the critical factors affecting outcomes, along with anatomical location and presence of gangrenous tissues.Traditionally, DFO treatment is the most complex and controversial aspect of managing diabetic foot infections (DFIs). Thetherapeutic paradigm has evolved from high-level surgical resection of all necrotic and infected bone to the more refined andindividualized surgical interventions along with appropriate antibiotics and topical antimicrobials. It is necessary to have asurgeon available with diabetic foot expertise. The surgical outcome is facilitated with strict off-loading, wound management,agitation (freshening and scrapping of wound edges), biofilm disruption and negative pressure wound therapy (NPWT) toaccelerate healing. Formal protocol-driven treatment can be provided by a multidisciplinary team involving surgical, medicaland podiatric specialties to reduce hospital stay and the need for repeat debridement.This review aims to present a completeoverview of the diagnosis, clinical presentation, management and outcomes of DFO according to scientific recommendationsand our experience, along with few illustrative case reports

Crime Analysis Using Self Learning

An unsupervised algorithm for event extraction is proposed . Some small number of seed examples and corpus of text documents are used as inputs. Here, we are interested in finding out relationships which may be spanned over the entire length of the document. The goal is to extract relations among mention that lie across sentences. These mention relations can be binary, ternary or even quaternary relations. For this paper our algorithm concentrates on picking out a specific binary relation in a tagged data set. We are using co reference resolution to solve the problem of relation extraction. Earlier approaches co - refer identity relations while our approach co - refers independent mention pairs based on feature rules. This paper proposes an approach for coreference resolution which uses the EM (Expectation Maximization) algorithm as a reference to train data and co relate entities inter sentential

Deploying Digital Media as Innovations in Marketing Government Policies and Enhancing Civic Engagement among Vulnerable Youths in Calabar

Governments have often sought improved ways to market their policies, which are variedly viewed as adequate or inadequate, in a bid to get the citizens actively engaged in the process of development. Digital media usage has inundated the social media space with both individual and governments presences. However, despite strong digital media presence driven by massive deployment of human and material resources, the question still arises as to how well such efforts have been used to deepen civic engagement among the citizens generally, and the vulnerable youth population that is digital media savvy. Data gathered from a sample of 900 respondents, revealed a positive correlation between digital media deployment in marketing government policies and enhancement of civic engagement among the vulnerable community provided such policies are people-oriented, and adequate marketing strategies are used. It recommends creation and deployment of digital media content as marketing tools to harness accrued gains

The magnetic dynamics of NiPS3_3

Neutron spectroscopy measurements have been performed on single crystals of the antiferromagnetic van der Waals compound NiPS$_3$. Linear spin wave theory using a Heisenberg Hamiltonian with single-ion anisotropies has been applied to determine the magnetic exchange parameters and the nature of the anisotropy. The analysis reveals that NiPS$_3$ is less two-dimensional than its sister compounds, with a relatively large ferromagnetic exchange of $J^{\prime} = -0.3$ meV between the layered \emph{ab} planes. In-plane magnetic exchange interactions up to the third nearest-neighbour were required to fit the data. The nearest-neighbour exchange was ferromagnetic with $J_1 = -2.6$ meV, the second neighbour was antiferromagnetic and small with $J_2 = 0.2$ meV, and the dominant antiferromagnetic third neighbour exchange was $J_3 = 13.5$ meV. The anisotropy was shown to be largely XY-like with a small uniaxial component, leading to the appearance of two low-energy spin wave modes in the spin wave spectrum at the Brillouin zone centre. The analysis could reproduce the spin wave energies, however there are discrepancies with the calculated neutron intensities hinting at more exotic phenomena.Comment: 12 pages, 8 figures, 33 reference

Ns. lastenhoitajain kielestä

Über die Ammensprache (saksa)Kielenaineksettibi (kieli: viro, sivulla: 85

Art. 1154 B. W. /

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Implementing Software-Hardware Cooperative Memory Disambiguation

In high-end processors, increasing the number of in-flight instructions can improve performance by overlapping useful processing with long-latency accesses to the main memory. Buffering these instructions requires a tremendous amount of microarchitectural resources. Unfortunately, large structures negatively impact processor clock speed and energy efficiency. Thus, innovations in effective and efficient utilization of these resources are needed. In this paper, we target the load-store queue, a dynamic memory disambiguation logic that is among the least scalable structures in a modern microprocessor. We propose to use software assistance to identify load instructions that are guaranteed not to overlap with earlier pending stores and prevent them from competing for the resources in the load-store queue. We show that the design is practical, requiring off-line analyses and minimum architectural support. It is also very effective, allowing more than 40 % of loads to bypass the load-store queue for floating-point applications. This reduces resource pressure and can lead to significant performance improvements.