A Pilot Study To Investigate Concerns In Patients Undergoing Neck Dissection Surgery

Abstract: This study investigates concerns in patients undergoing neck dissection surgery. Forty patients were recruited at Pre-surgery, Discharge and 1-month Post-surgery. The Patient Concerns Inventory - Level of Importance questionnaire (PCI-LOI), Shoulder Pain and Disability Index (SPADI), Neck Dissection Impairment Index (NDII) and the University of Washington - Quality of Life questionnaire (UWQOL) were used. The study identified Anxiety at Pre-surgery and Appearance at Discharge and 1-month Post-surgery as the important patient concerns. Patients’ concerns were found to change over time. Support for cross-sectional convergent validity of the PCI-LOI was evidenced by significant correlations between the PCI-LOI and the UWQOL (r = -0.48 and -0.43), and the PCI-LOI and the SPADI (r = 0.45 and 0.57), at Discharge and 1-month Post-surgery, respectively. Identification of patient concerns and the importance of these concerns should assist health care professionals to respond to the needs of patients undergoing head and neck cancer surgery. Keywords head and neck cancer, neck dissection surgery, patient concerns, quality of lif

Awareness on Entrepreneurial Orientation Among Management Students in Vellore

Purpose: Thus, the objective of this study was to analyze, by means of multivariate techniques, an instrument whose function is to measure the learning of teaching Entrepreneurship, verifying the change in the entrepreneurial profile between participants and non-participants of the entrepreneurial formation process. The research was carried out among university students of the Business Administration course, Vellore.   Theoretical Framework: Entrepreneurship is a socio-economic phenomenon that has been valued for its influence on the growth and development of regional and national economies. The main agent promoting this phenomenon is the entrepreneur; a subject endowed with multiple characteristics who act in a dynamic way and is focused on reaping results, the fruits of their personal efforts. The insertion and search for enterprising subjects in different societies have been noticeable in public, economic and educational programs and policies. Entrepreneurial education is highlighted as one of the most efficient ways to disseminate culture and train new entrepreneurs. From this perspective, the teaching of Entrepreneurship stands out as a resource used for the formation of new entrepreneurs.   Design/Methodology/Approach: The present study aims to analyze the entrepreneurial intention of students from four Institutions in Vellore, relating it to entrepreneurial self-efficacy and academic self-efficacy, and to try to understand which factors influence it. The sample of this study consists of 290 students from four Institutions in Vellore, of which 114 (39.3%) are male and 176 (60.7%) are female.   Findings: Regarding the degree of importance that students attribute to the Institution support structures for the creation of a company, there is a statistically significant difference, in which the GTEC students stand out, who are the ones who attach the most importance to ”Spaces and equipment for starting the business". With regard to the remaining questions, there are no statistically significant differences between the mean values of the answers given depending on the Institution.   Research, Practical/ & Social Implications: In the analysis of the differences between Institutions, it was verified the existence of statistically significant differences in the questions related to the desire to create their own company and to have a concrete business idea to create, in which SPIM showed a higher average in relation to the other three Institutions. Regarding the other two research questions, “I consider myself capable of creating a company”, and “I am able to work on my own”, there were no statistically significant differences between the four Institutions.   Originality/Value: The present study adds value among the management students with regard to the awareness on entrepreneurship which leads to the country’ economic development

The Study on Programmes, Facilities and Achievements in USHA Schools of Athletics

The study on this paper focus on the various programmes, facilities and achievements that are available at USHA School of Athletics, Quilandy, Calicut District, Kerala, India. The personal interview technique was adopted for the collection of data. After obtaining permission to visit the school, through proper channel, the author visited the campus personally for the detailed study with a check list to collect data. The detail of the collected data pattern to the study was classified as General Information, Programmes, Facilities, Achievements and Special Information. Going through the analysis and interpretation of the data, it shows about the detailed information of the school and its vision, mission, various future plans and table wise detailed information about achievements and its diagrammatic representation on both state and national level. In short we can state USHA School of Athletics is best in their organization and administration looking forward its goal for achieving the Olympic medals

The Detour Monophonic Convexity Number of a Graph

A set  is detour monophonic convexif  The detour monophonic convexity number is denoted by  is the cardinality of a maximum proper detour monophonic convex subset of  Some general properties satisfied by this concept are studied. The detour monophonic convexity number of certain classes of graphs are determined. It is shown that for every pair of integers   and  with  there exists a connected graph  such that   and , where  is the monophonic convexity number of

Methodologies for performance enhancement in decentralized supply chains

Ph.DDOCTOR OF PHILOSOPH

Predictors, Outcome, Profile of Anti-Tubercular Drug Induced Hepatitis: A Prospective Nested Case- Control Study in a South Indian Tertiary Hospital

OBJECTIVES: This study was conducted to determine the incidence of anti-tubercular drug (ATT) induced hepatitis and to study the clinical risk factors, clinical, laboratory profile and outcome of patients with ATT induced hepatitis. METHODOLOGY: This case-control study was nested in a cohort of patients from Christian Medical College, Vellore. It was carried out from April 2014 to May 2015. All patients newly diagnosed to have tuberculosis, started on ATT were eligible for this study. All patients who present with suspected ATT related hepatotoxicity were also enrolled in the study. All patients were clinically assessed for symptoms of hepatitis at every visit until completion of treatment. Once the patient developed ATT induced hepatitis, all hepatotoxic drugs were stopped and a non-hepatotoxic regimen was continued. Once the liver function tests normalized, patients were re- introduced with first line regimen as per decision of the treating physician and followed up till the completion of treatment. The incidence of ATT induced hepatitis was obtained from the cohort. The identification of risk factors of ATT induced hepatitis was based on a case control design nested in the cohort study. A descriptive study of clinical profile and outcome of patients with ATT induced hepatitis was also conducted. The risk factors for ATT induced hepatitis were identified by bivariate analysis and logistic regression analysis with odds ratio and 95 % confidence interval. RESULTS: A total of 393 patients were eligible for our study which included 5 patients presenting with ATT induced hepatitis. In the cohort, 61% were male and 81% were in the age group 20-59. HIV infection was found in 72 patients (18.3%). One hundred and fourteen patients (29%) were started on DOTS regimen and the remaining 279 patients (71%) were treated with weight based daily regimen. Patients on DOTS regimen had lower rates of HIV infection and disseminated disease but had greater undernutrition when compared with patients on daily regimen. Majority of the patients (38.9 %) patients had sputum positive pulmonary tuberculosis. A total of 281 patients (72%) had localized disease and 112 patients (28%) had disseminated disease. Forty three patients out of 393 patients developed DILI. The incidence of anti-tubercular drug induced liver injury was 9.7 % (95% C.I 7-13.2%) with lower incidence among patients on DOTS regimen (DOTS 3.5% (95% C.I 2.4%-4.8%) Vs Daily 14% (95% C.I 7.9 – 22.4%)). HIV infection (OR 2.84, p value 0.002, 95% C.I 1.42 – 5.67), daily regimen (OR 4.46, p value 0.003, 95% C.I 1.55 – 12.81), disseminated disease (OR 1.769, p value 0.006, 95% C.I 1.23-2.55), hypoalbuminemia ( OR 1.92, p value 0.045, 95% C.I 1.01 – 3.68) and chronic liver disease (OR 4.72, p value 0.004, 95% C.I 1.5-14.82) were independent risk factors for development of drug induced liver injury. On multivariate logistic regression analysis, HIV infection, hypoalbuminemia, chronic liver disease and daily regimen were found to be significant risk factors for DILI. A prediction score based on the above risk factors is suggested to identify patients who will develop DILI. A score of > 5 will predict DILI with a sensitivity and specificity of 74% and 67%. Vomiting was the most common symptom seen in 58.1% of patients with drug induced hepatitis followed by jaundice in 30.2 % of patients. Four patients developed acute liver failure. The majority of patients (77%) developed drug induced liver injury within first 2 months. The mean time duration for normalization of liver function was 22 days ranging from 3 to 81 days. Fifteen patients (35%) had severe hepatitis. All cause mortality in DILI was 4.7 % (2 patients). 36 patients (84%) had complete resolution of hepatitis. At least 1 drug was successfully rechallenged in 28 out of 29 patients. Rechallenge by both ATS and BTS guidelines had similar successful rechallenge. The rates of rechallenge hepatitis were similar in patients who were rechallenged according to both ATS and BTS guidelines (13.3% Vs 13% respectively). CONCLUSION: Incidence of ATT induced hepatitis from our study was 9.7% (95% C.I 7-13.2%) with lower incidence among patients on DOTS regimen. HIV infection, daily regimen, disseminated disease, hypoalbuminemia and chronic liver disease were independent risk factors for development of DILI. Mortality rate was low (4.3%) among patients who developed DILI. Rechallenge by both ATS and BTS guidelines had similar successful rate. The predictive scoring system proposed from our study needs to be validated by a well designed prospective study. The study suggests that the combination of risk factors of extensive TB disease, HIV and undernutrition increase the vulnerability to drug induced liver disease particularly with daily TB treatment regimen, emphasizing the role of acquired risk factors in the development of DILI

Detection of Latent HIV-1 Infection and Drug Resistant Mutation Testing in Nepal: HIV-1 env V3 DNA Sequence and RT Gene (M184V) Mutation

HIV-1 resistance to antiretroviral therapy (ART) is a crucial issue, despite various effective drugs are available for the treatment. Although the viral RNA is suppressed below the detection limit (<50 copies/ml) with the use of potent antiviral drugs, the mutation can be archived in the cellular reservoir as proviral DNA. The detection of proviral DNA and mutation screening in HIV 1 RNA for genotypic resistance is the sole basis for monitoring the effectiveness of ART. Our study aim to access the extent of latent HIV infections by detecting env V3 DNA and also testing of M184V (meth184val; ATG - GTG substitution at 184th codon) specific mutations in HIV-1 RT gene to monitor the effectiveness of ART. The HIV-1 env V3 DNA sequence was amplified using multiple upstream and downstream primes to show the latent HIV infections, whereas polymerase chain reaction- restriction fragment digestion assay (PCR-RFDA) was used for testing M184V mutation in HIV-1 RT gene. In the study, out of 15 HIV infected patient blood samples, 12 shows amplification of env V3 DNA, confirming the latent HIV infections while 3 were negative for env V3 DNA. HIV-1 RT gene tested for M184V mutation in all 15 samples showed wild type after analysis using PCR-RFDA. After digestion with CviAII, three bands were observed in wild type whereas in mutant only two bands. Although the study shows negative for the M184V resistance mutation, screening of various panels of drug resistance mutations should be performed in recently infected HIV-1 patients for planning the effective ART strategy. The data is not enough to compare the overall scenario of the Nepal thus warrant urgency for large scale study with standard genotypic tools

Mobile Secure Examination System

The increasing features of Internet Technologies in all application domains have changed life styles and interactions. With the rapid development of Mobile Learning, collaborative technologies is an important for teaching, learning methods and schemes.Interaction between the students also student with the teacher is important for student to gain knowledge.In this paper, we introduce an effective queries and answers Q&A system for collaborative technologies, which can act not just like a virtual teacher, but also virtual discussion for student. With the proposed system, brings a new Questions and Answering system, student can attach their question when they want collaborate using collaborative technologies capitalize on one another?s resources and skills. Students can ask their questions to the related collaborative Group when they want to collaborate with others, asking one another for information, evaluating one another?s ideas, then each of the answer will compare with data base. These systems are based on cognitive learning theory which is a learning theory interested in how information organizes in human?s memory. ITSs are intelligent programs which know whom they will teach so computers play an important part in education and instruction aims are performed and suggested in this work. In this project described and reviewed some of ITSs in educational application and demonstrate used modules in ITSs

Fuzzy Prime Ideals of ADL's

In this paper the concept of prime L-fuzzy ideals and L-fuzzy prime ideals of an ADL A with truth values in a complete lattice L satisfying the infinite meet distributive law are introduced. All prime L-fuzzy ideals of a given ADL A are determined by establishing a one-to- one correspondence between prime L-fuzzy ideals of an ADL A and the pairs (P;a), where P is a prime ideal of A and a is a prime element in L. Also, here minimal prime L-fuzzy ideals and L-fuzzy minimal prime ideals of an ADL A are introduced and characterized

Heat transfer intensification of Zirconia/water nanofluid

This paper investigated convective heat transfer and friction factor of ZrO2/H2O nanofluid through a circular pipe under laminar flow condition with constant heat flux. Nanofluid is prepared for 0.5, 0.75 and 1% volume concentrations with yttrium oxide surfactant. Nanofluid’s thermal conductivity and viscosity is measured by KD2 Pro thermal analyser and Brookfield viscometer respectively. Results showed that the thermal conductivity and viscosity increased with increase in particle volume concentration. These nanofluids are experimented in a forced convection system, first heat transfer characteristics of DI (Deionised) water  under laminar flow in a copper tube measured, then three nanofluids are carried out the tests, results revealed that the enhanced Nusselt numbers of 21.09,28.05 and 35.73%  at the 0.5, 0.75 and 1% volume concentrations, There is no excess penalty in pumping power  and results showed  less variations in friction factor for nanofluids comparatively with the base fluid DIWater