Comparison of knowledge and practice regarding colostrum feeding among mothers in rural and urban area

Background: Basic food of infant is mother’s milk. Breast feeding should be initiated within the first half an hour of birth. The first milk is the most suitable feed for the newborn. Colostrum is very important for growth, development and protection from infections in infants. The importance of colostrum is still not known to many mothers and caregivers. This study aimed to compare the knowledge and practice regarding colostrum feeding among mothers in urban and rural area.Methods: A descriptive approach and comparative survey design was adopted for the study. Data was collected from 150 mothers (75 each from urban and rural area) having infants of birth to 6 months age. Data was collected using a performa with items on socio-demographic varibles, a structured questionnaire to assess knowledge and a practice questionnaire regarding colostrum feeding.Results: 46.7% urban and 48% rural had moderate level of knowledge and 22.7% mothers from rural had poor knowledge. The urban mothers were more aware about colostrum feeding and its importance than rural mothers. Majority of the mothers (92% urban, 89.3% rural) practiced colostrum feeding. Comparison of knowledge and practice showed statistically significant difference between mothers of urban and rural area.Conclusions: Knowledge regarding colostrum feeding was inadequate and improper breast feeding practices were found in both urban and rural area. Urban area mothers had more knowledge and better feeding practices compared to mothers of rural area. There is an ongoing need for individual and community awareness programmes regarding importance of colostrum feeding

Explanatory Study on Impact of PPM on Plant Performance

Abstract In the last few decades, evaluating the advanced technology investments in industries especially its contribution on enterprise performance has been a central concern of research and practice. Project portfolio management helps industries in executing the strategic activities and optimizing the investments with the effective project evaluation. The present paper aims at evaluating and establishing the impact of project portfolio management on productivity of industries in portfolio perspective. This exploratory research study endeavors its evaluation based on the statistical data analysis of primary data using cumulative weighed average. The primary data is collected with the help of a survey questionnaire from the selected of respondents of the companies that are practicing the project portfolio management. The analysis reveals that the impact of project portfolio management on performance in the selected firms is highly moderate. Further the research suggests, companies must focus on weak areas that impacting the performance in order to gain the competitive advantage and to maximize the benefits. Keywords Plant Performance, Strategic Management, Managing Industrial Projects, Project Portfolio Management I. Introduction Evaluating the impact of advanced technology investments has been a central concern in information systems research and practice for decades. Many organizations are now taking an enterprise portfolio approach to manage their project investments. Projects created in different departments and the priorities of these departments often do not relate to each other and to the corporate level strategy. Thus the project evaluation, selection and funding should be at the enterprise level and the key criteria in project selectio

Sternal plating for primary and secondary sternal closure; can it improve sternal stability?

<p>Abstract</p> <p>Background</p> <p>Sternal instability with mediastinitis is a very serious complication after median sternotomy. Biomechanical studies have suggested superiority of rigid plate fixation over wire cerclage for sternal fixation. This study tests the hypothesis that sternal closure stability can be improved by adding plate fixation in a human cadaver model.</p> <p>Methods</p> <p>Midline sternotomy was performed in 18 human cadavers. Four sternal closure techniques were tested: (1) approximation with six interrupted steel wires; (2) approximation with six interrupted cables; (3) closure 1 (wires) or 2 (cables) reinforced with a transverse sternal plate at the sixth rib; (4) Closure using 4 sternal plates alone. Intrathoracic pressure was increased in all techniques while sternal separation was measured by three pairs of sonomicrometry crystals fixed at the upper, middle and lower parts of the sternum until 2.0 mm separation was detected. Differences in displacement pressures were analyzed using repeated measures ANOVA and Regression Coefficients.</p> <p>Results</p> <p>Intrathoracic pressure required to cause 2.0 mm separation increased significantly from 183.3 ± 123.9 to 301.4 ± 204.5 in wires/cables alone vs. wires/cables plus one plate respectively, and to 355.0 ± 210.4 in the 4 plates group (p < 0.05). Regression Coefficients (95% CI) were 120 (47–194) and 142 (66–219) respectively for the plate groups.</p> <p>Conclusion</p> <p>Transverse sternal plating with 1 or 4 plates significantly improves sternal stability closure in human cadaver model. Adding a single sternal plate to primary closure improves the strength of sternal closure with traditional wiring potentially reducing the risk of sternal dehiscence and could be considered in high risk patients.</p

Prevention of acute kidney injury and protection of renal function in the intensive care unit

Acute renal failure on the intensive care unit is associated with significant mortality and morbidity. To determine recommendations for the prevention of acute kidney injury (AKI), focusing on the role of potential preventative maneuvers including volume expansion, diuretics, use of inotropes, vasopressors/vasodilators, hormonal interventions, nutrition, and extracorporeal techniques. A systematic search of the literature was performed for studies using these potential protective agents in adult patients at risk for acute renal failure/kidney injury between 1966 and 2009. The following clinical conditions were considered: major surgery, critical illness, sepsis, shock, and use of potentially nephrotoxic drugs and radiocontrast media. Where possible the following endpoints were extracted: creatinine clearance, glomerular filtration rate, increase in serum creatinine, urine output, and markers of tubular injury. Clinical endpoints included the need for renal replacement therapy, length of stay, and mortality. Studies are graded according to the international Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) group system Several measures are recommended, though none carries grade 1A. We recommend prompt resuscitation of the circulation with special attention to providing adequate hydration whilst avoiding high-molecular-weight hydroxy-ethyl starch (HES) preparations, maintaining adequate blood pressure using vasopressors in vasodilatory shock. We suggest using vasopressors in vasodilatory hypotension, specific vasodilators under strict hemodynamic control, sodium bicarbonate for emergency procedures administering contrast media, and periprocedural hemofiltration in severe chronic renal insufficiency undergoing coronary intervention