Prevalence of HIV Infection In Children (0-12 Years) with Tuberculosis and Correlation of CD4 Cell Count Level with Types of Tuberculosis

OBJECTIVE OF THE STUDY: To determine the frequency of HIV in children with disseminated tuberculosis and tuberculous meningitis in a low HIV prevalence area, and to study clinical profile of those found HIV positive. STUDY DESIGN: Cross-sectional, descriptive study. PLACE AND DURATION OF STUDY: Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India from February 2005 to January 2008. METHODOLOGY: The study was conducted on 215 children under 14 years of age with either disseminated tuberculosis or tuberculous meningitis. HIV infection was diagnosed in accordance with WHO strategy II. In children younger than 18 months, the strategy (to cut down costs) was to screen first by HIV antibody testing and subject only positive cases to virological tests. Parents of HIV positive children were also tested for HIV and counselled. The clinical profile of HIV positive patient was noted. RESULTS: The frequency of HIV in all cases of TB was 5.12%, while that in cases of disseminated tuberculosis was much higher (22%). No case with isolated tuberculous meningitis was HIV positive. The majority (45.45%) of patients with HIV were between 1-5 years of age. The mode of infection in 7 (63.63%) cases was parent to child transmission. Loss of weight, prolonged fever, pallor, hepato-splenomegaly and oral candidiasis were the commonest clinical manifestations among HIV positive patients. CONCLUSION: Clinically directed selective HIV screening in cases of disseminated tuberculosis can pickup undiagnosed cases of the same in areas with low prevalence of HIV infection

Budget participation and budget emphasis in low uncertainty conditions - Considering alternative reasons to budget

This case study investigates how lower budget participation may be better suited to firms with a high budget emphasis, in lower uncertainty conditions. The organisation studied generates greater benefits when budget participation is low, though it has a high budget emphasis. This result is opposite to that found in Lau, et.al. (1995). The reason for this difference is shown to arise because budget emphasis in the case firm is not primarily related to performance evaluation as defined in prior budget research (Hopwood, 1972). Instead, the main reason for budgeting is operational planning (Hansen and Van der Stede, 2003), and this difference is shown to lead to the opposing findings. When budgets are used primarily for operational planning, their relationships to organisational antecedents appear to be different than when used for performance evaluation

Emphasis on accounting controls: asset specificity and the use of accounting and non-accounting information within IT outsourcing engagements

This study observes the nature of asset specificity in different Information Technology (IT) outsourcing typologies, and investigates the relevance of accounting and non-accounting numbers in relation to these outsourcing typologies, with consideration to the findings of literatures concerning Transaction Cost Economics Theory and Social Capital Theory. It represents a response to the lack of research on relationships of IT outsourcing engagements. A case study research method is used to analyse the effect of asset specificity on the nature of relationship, and the use of accounting and non-accounting information in supporting the decision making processes of the Outsourcing Service Provider. Contrary to the findings of many researchers, the outsourcing-service provider adopted an integrative approach to its relationships as opposed to a distributive approach even in engagements that were highly asset specific, and short-term in duration. Additionally, the nature of asset specificity for IT outsourcing engagements is not static, but dynamic and in continual flux. Overall, this study suggests that large IT outsourcing-service providers value non-accounting factors in decision-making processes, in addition to accounting information, thus reflecting the Integrative Outsourcing Typology. This further validated the fact that factors advocated by Social Capital Theory such as corporate reputation, trust and collaborative interactions are crucial in IT outsourcing relationships

Organisational characteristics, alternative reasons to budget and two budget forms

This study examines contingency relationships between organisational characteristics and four alternative operational reasons to budget, across two budget forms (fixed budget and rolling forecasts). Furthering the work of Hansen and Van der Stede (2004), results show that contingency relationships between organisational characteristics and the importance of operational reasons to budget were different for performance evaluation reasons, in comparison to operational planning reasons

Balanced scorecard design and performance impacts: some Australian evidence

consideration to the use of performance measurement systems, notably the Balanced Scorecard (BSC). However, there has been limited empirical investigation into the particular benefits that result from the use of the BSC (Ittner and Larcker, 1998). This study empirically examines how the BSC has been applied in practice and whether different BSC designs result in varying performance outcomes. Data is from a cross sectional survey, which provided a sample of 92 Australian firms using BSC. It is hypothesised that the BSC provides greater benefits when 1) cause and effect logic is used between measures 2) nonfinancial measures are tied to compensation and 3) implemented at multiple levels within the organisation. Results support the first proposition, although cause and effect logic appears to be more important if the BSC is tied to compensation. These results are discussed, and implications for practice and future research are presented

Functional analysis of cemented bipolar hemiarthroplasty with medial calcar augmentation for unstable intertrochanteric fractures in elderly

Background: Intertrochanteric fracture is one of the most common fractures among the elderly osteoporotic population, constituting about 50% of hip fractures. These fractures are managed either by fixation using dynamic hip screw (DHS), proximal femur nail (PFN) or by replacement, based on the stability of fracture pattern, age of the patient, quality of bone and associated co-morbid conditions. Prosthetic replacement which is routinely done for femoral neck fractures requires modification when done for trochanteric fractures to improve stability. This study aims to analyse the short term functional outcome of cemented bipolar hemiarthroplasty with medial calcar augmentation for unstable intertrochanteric fractures in elderly.Methods: Our study includes 60 patients of age more than 70 years admitted in our institution during June 2012 to September 2016 with unstable intertrochanteric fractures. All patients operated through posterior approach to hip and cemented hemiarthroplasty with medial calcar augmentation with bone graft was done. Patients were followed up for an average of period of 2 years. Functional outcome was evaluated with Harris Hip score.Results: 28% of cases had excellent outcome. 43% of cases had good and 23% of cases had fair outcome. 2% of cases ended with poor outcome. The in-hospital mortality rate was 3.3%. The survival rate of the patients in this study at the end of one year is 85%. Conclusions: Cemented bipolar hemiarthroplasty with medial calcar augumentation can be considered as a good primary option for elderly unstable intertrochanteric fracture patients with osteoporotic bones and associated co-morbidities. 

Effectiveness of Nursing Interventions on Physical and Psychological Outcome among Cancer Patients Undergoing Chemotherapy

Background: Cancer patient's undergoing chemotherapy experiences a variety of side effects which has influence on prognosis of illness, activity of daily living and the quality of life. There is a need of nursing care interventions for management and prevention of problem among cancer patients. Aim & Objectives: The present study aimed to assess the effectiveness of nursing interventions on physical and psychological outcome among cancer patients undergoing chemotherapy. Material and Methods: A true experimental study, post test only design with control group approach was conducted among 130 cancer patients undergoing chemotherapy at oncology ward of Pravara Rural Hospital, Loni (Bk), Ahmednagar, Maharashtra. Cancer patients who are 18 years old or older were selected with systematic random sampling method. Pre tested semi structured interview schedule was used to gather data. The assessment of health status before start of chemotherapy was carried out, followed by the nursing interventions was implemented based on patient needs and problems, and the post test was conducted after the period of interventions. The collected data was tabulated and analyzed using appropriate statistical methods wherever required. Results: The results revealed that the cancer patients experienced a wide range of physical and psychological problems prior to chemotherapy treatment. Cancer patients who received nursing interventions had improved post test mean scores on chemotherapy symptoms, pain and fatigue; emotional well being, anxiety and depression than the patients who received routine care, notably it was statistically significant at p<0.05 level. A significant association was observed between physical, psychological outcome variables and the socio demographic characteristics like sex, site of cancer, stage of cancer, duration of cancer, metastasis of cancer and the regimen of chemotherapy at p<0.05 level. Conclusion: This study demonstrated that the nursing interventions were well accepted by cancer patients and has significant effect towards the improvement of physical and psychological outcomes of cancer patients undergoing chemotherapy