Implementation of RFID Technology in Libraries: A Case Study in UPES Library

Implementation of Radio Frequency Identification (RFID) in libraries has carried exceptional improvement like automated issue return, security of library materials, inventory control etc. RFID is the latest technology used in libraries for managing the automated library and also for theft detection. The paper highlights that the importance of Implementing RFID system in UPES library and emphasizing its advantages, disadvantages, different component of the system and their standards. The relevant cost of the different component and approximate total cost of implementing an RFID system for a library is given

Sinus arrest following right coronary artery stent implantation

Sinus arrest rarely occurs during acute myocardial infarction involving the right coronary artery (RCA) and sinus node (SN) artery. We report a rare case of sinus arrest caused by SN artery occlusion following RCA stenting. A 56-year-old woman with a significant history of RCA stenosis with prior bare metal stenting, presented to the emergency department with anginal chest pain. Initial work up showed significant elevation of cardiac troponin T with T-wave inversion in the inferior leads on electrocardiogram (ECG). Coronary angiography revealed a 90% stenosis of midportion of the RCA, mild occlusion in the left anterior descending coronary and left circumflex coronary arteries. Stenting was performed on the RCA lesion. Immediately after undergoing those interventions, thrombosis developed and occluded SN artery. Electrocardiogram showed junctional escape rhythm without P waves at a heart rate of 30 beats per minute, suggesting sinus arrest. The clot in the SN artery was identified and thrombectomy was performed. Neither symptoms nor hypotension were identified during this arrhythmia. Six days later, normal sinus rhythm began to appear on EKG with improving heart rate, and patient still remained completely hemodynamically stable. Pre-discharge exercise stress test had shown 50% predicted heart rate without ST segment change. Sinus node dysfunction is commonly related to degenerative processes, and rarely caused by thrombosis in the SN artery. In our case, we emphasize the potential complication of sinus arrest after RCA stent implantation

Study of compliance and impact of infant and young child feeding counseling in Patna district, Bihar

Background: The infant and young child feeding (IYCF) practices have crucial role for physical and mental development of the child. Objective: To study the compliance to IYCF practices and impact of IYCF counseling in and around Patna district. Methods: Cross-sectional study was done in a hospital-based survey to find out compliance, and impact of IYCF practice counseling among infants and children attending a tertiary level hospital, Patna. Children in the age group, 6-24 months in and around Patna, were studied. Results: About 24% of the mothers initiated breastfeeding within an hour after birth. Exclusive breastfeeding for 6 months was practiced only by 36% of the mothers. Nearly, 43% of the mothers started complementary feeding at 6 months, and 45% of the infants were breastfed for 2 years. In the present study, 26% of mothers were using as age-appropriate complementary feeding and 35% of the mothers were feeding actively their child both during and after illness. Conclusion: Despite 3 years of counseling, compliance to IYCF practice in our area is low, and thus, the impact of IYCF counseling is poor in our area. Low knowledge score of mothers, lesser number of antenatal care visit is found to be an important factor responsible for low compliance

Role of oral antibiotic preparation in bowel preparation for colorectal surgery in reducing surgical site infection

Background: Mechanical bowel preparation for colorectal surgeries is thought to clear the bowel lumen of stool, thus decreasing intraluminal pressure of hard, potentially impacting stool and reduce ischemia at the new anastomosis. This reduces the dreaded complication of organ space surgical site infection (SSI) that leads to anastomotic leak which is most commonly seen in colorectal surgeries. Oral antibiotic preparation is thought to reduce the bacterial concentration of colonic mucosa which is thought to further bring down the incidence of organ space SSI in colorectal surgery. Aim of this study was to evaluate the role of oral antibiotics given preoperatively as an adjunct to mechanical bowel preparation and intravenous antibiotics, in reducing SSI in colorectal surgeries. Methods: Comparative study of 60 cases of colorectal surgery divided into two equal groups (group A-patients who received oral antibiotic preparations (OABP) with mechanical bowel preparations (MBPs) and ivAb preoperatively (oral antibiotic preparation and mechanical bowel preparation +intravenous antibiotic) versus group B-patients who only received MBP and ivAb preoperatively. Outcomes of SSI results were compared. Results: Incidence of SSI in group A was 16% whereas it was 40% in group B. Incidence of anastomotic leak in group A was 3.3% and in group B was 13.3%. E. coli was found in the pus culture of 60% cases of SSI in study groups whereas S. aureus was found to be the causative organism in rest of the cases that developed SSI. Conclusions: The study supports the use of OABP as an adjunct to MBP and ivAb preoperatively in colorectal surgery for the prevention of SSI and its related complications

Analysis of presentation, etiology, management and outcome of perforation peritonitis in a tertiary care centre

Background: The most common surgical emergency in general surgery is perforation peritonitis. It is a serious condition with a mortality rate of up to 20%, and it is the third most common cause of surgical abdomen after appendicitis and intestinal obstruction. The aim of this study to discuss presentation, etiology, management and outcome of perforation peritonitis in our hospital. Methods: The 60 patients with features of perforation peritonitis admitted from September 2021 to August 2022 in the department of general surgery, PMCH, Patna were chosen. Descriptive statistics was used for analysis. Detailed history was taken, physical examination and X-ray was done. Signs and symptoms, duration of illness, age of presentation, intra-op findings regarding size and location, its management, post-op complications were documented. Results: Total 60 cases of perforation peritonitis were included in this study, among that 80% (48) were males and 20% (12) were females, with male to female ratio of 4:1. Pain abdomen was a universal symptom. Generalized pain abdomen was seen in 54 (90%) cases, followed by lower quadrant in 3 cases (5%) and epigastrium pain seen in 3 cases (5%). Radiation of pain to right iliac fossa was seen in 6 cases (10%). Blunt injury was seen in 9 (15%) case. 14 patients were treated with anti-ulcer medications. Three patients with duodenal ulcer perforation were treated with nonsteroidal anti-inflammatory drugs. Liver dullness was obliterated in 28 patients (47%). Bowel sounds were either sluggish or absent in most cases. Conclusions: Perforation peritonitis is a frequently encountered surgical emergency. Various factors like age, sex, duration, site of perforation, extent of peritonitis and delay in surgical intervention are associated with morbidity and mortality. A successful management depends upon early surgical intervention, source control and exclusive intraoperative peritoneal lavage

Experience of laparoscopic cholecystectomy in patients presenting with acute cholecystitis at different duration

Background: Acute inflammation of a gall bladder that contains stones is acute calculous cholecystitis, laparoscopic cholecystectomy is now the gold standard treatment for patients with gall stone disease. laparoscopic cholecystectomy for acute cholecystitis was initially considered technically challenging and potentially risky for the patient. Aim was to evaluate results of laparoscopic cholecystectomy in patients presenting with acute cholecystitis at different duration in a tertiary centre in eastern India.Methods: Comparative study of 71 cases of acute cholecystitis who presented at different days and were treated by laparoscopic cholecystectomy. Outcome was compared.Results: The incidence of conversion to open was 12.6%. Day of presentation 5 to 7 had the maximum 21% risk of conversion. Major intraoperative complications included 4 cases of common bile duct injury, 4 cases of vascular injury and 3 cases of bowel injury out of which vascular injury and one case of bowel injury was managed laparoscopically. 9 cases converted to open surgery. patient with DOP 1, 2 and 3 had an average hospital stays of 3 days. It was 5 for those with DOP 4 and 7 days for patients with DOP 5 to 7.Conclusions: The study supports laparoscopic cholecystectomy in acute cholecystitis specially in patients presenting within 72 hours of onset of pain. Laparoscopic cholecystectomy can be attempted in patients who present at DOP 4 and DOP 5 to7 after explaining them the risk and benefit of the procedure to the patient. Conversion to open surgery should not be stigmatized

Gall bladder specimen histopathological findings after cholecystectomy

Background: Cholecystitis is a generally widespread problem in adult population. Multiple finding has been found in gross and microscopic examination of gallbladder. Existence of stones is one of the known causative factors that lead to histopathological changes in gallbladder. It is also responsible for the development of gallbladder carcinoma. The purpose of this study was to find out the histopathology of gall bladder specimens following surgical intervention. Methods: This observational study included 116 patients admitted in the department of general surgery, PMCH, Patna with acute or chronic cholecystitis from August 2018 to July 2019. Written and informed consent was taken from all the participants. Data was analyzed using SPSS version 20. Results: A total of 116 gallbladder specimens that presented for histopathological examination during the study period were included into the study, with male to female ratio of 1:3. The highest prevalence was found in the age group of 31-50 years. The results of histopathological examination of these gallbladder specimens showed that chronic cholecystitis was found in 93 (80.1%), acute cholecystitis in 17 (14.6%), and dysplasia was found in 5 (4.3%) patients, and gall bladder carcinoma was detected in 1 (0.8%) patients. On morphological analysis, the commonest gall stones were made up of cholesterol and the most common lesion was chronic cholecystitis by histopathology. Conclusions: This study concludes that the chronic calculus cholecystitis was dominant in our population. It is assumed that routine histopathological examination following cholecystectomies essential for all gallbladder specimens even in the non-existence of macroscopic signs of carcinoma, which was the case in our patients

Role of closed subcutaneous drain in prevention of surgical site infection in perforation peritonitis

Background: Surgery for perforation peritonitis is associated with the highest rates of infective complications, especially surgical site infection. SSI occurs due to failure of obliteration of dead space during abdominal wound closure resulting in formation of hematoma and seroma collection in the surgical wound viz. abdominal wound in cases of perforation peritonitis. This acts as a good culture medium for bacterial organisms to grow and cause wound infection. The bacterial pathogens can be either from intra-abdominal sepsis or nosocomial in origin. Closed suction drains can be used effectively to eliminate dead space in the wound and evacuates the seroma or hematoma collection, thereby reducing chances of SSI and also helps in early detection of SSI by inspecting the nature of drain output. Aim was to evaluate the role of closed suction drains in prevention of SSI in cases of perforation peritonitis. Methods: Comparative study of 60 cases of perforation peritonitis divided into two equal groups (Group A patient with closed suction drain in subcutaneous space vs. Group B patient without closed suction drain). Outcomes of SSI were compared. Results: The incidence of SSI in Group A was 33% whereas in Group B was 70%. 40% cases in SSI in Group A whereas 76% cases of SSI in Group B developed wound dehiscence. Most cases of SSI was diagnosed on POD 2 for Group A and on POD 4 for Group B. Conclusions: The study supports use of closed suction drain in perforation peritonitis for prevention, early detection and appropriate management of SSI

Coupling HEC-RAS and HEC-HMS in Precipitation Runoff Modelling and Evaluating Flood Plain Inundation Map

The climate change and land use change have raised the challenges associated with increased runoff and flood management. The risks associated with flooding have been increasing with development in flood plain and changing climate resulting in increase in inundation of flood plain. The current study will help to evaluate the extent of flood plain in the study area – copper slough watershed (CSW) in Champaign, Illinois; utilizing the known precipitation and land use. The study of CSW is taken into account, as this is the largest watershed of Champaign City and had undergone major land use change increasing the flooding issues in the region. The conducted research utilizes the hydrologic engineering center - hydrologic modelling system (HEC-HMS) and Hydrologic Engineering Center – River Analysis System (HEC-RAS) as the modelling tool to develop runoff and floodplain inundation evaluation model for known precipitation. The model also incorporates Aeronautical Reconnaissance Coverage Geographic Information System (ARCGIS) extensions- HEC-GeoRAS and HEC-GeoHMS for the spatial analysis of the watershed. The hydrologic analysis is performed using HEC-HMS while the hydraulic modeling is done using HEC-RAS. Forcing the model with forecasted precipitation can also help with flood warning system by generating pre-flood inundation maps

Acute chest pain: Acute coronary syndrome versus lead perforation: A case report

<p>Abstract</p> <p>Background</p> <p>Diagnosing pacemaker lead perforation in the setting of chest pain and EKG changes is difficult and usually not considered unless we have awareness and high index of suspicion. This kind of clinical scenario represents one of the diagnostic challenges.</p> <p>Case presentation</p> <p>A 77 year-old Caucasian female came to emergency room with left sided non-exertional chest pain radiating to her back for the past two days. A week prior to this presentation, she had a stent supported angioplasty for in-stent re-stenosis and subsequently dual chamber pacemaker implantation for sick sinus syndrome. On physical exam she is very obese, had normal vital signs, peripheral pulses and cardio-respiratory exam. Electrocardiogram revealed new T- wave inversions in inferior and anterior leads. Initial chest X-ray, 2D-Echocardiogram and cardiac enzymes were normal. Acute coronary syndrome was considered as an initial probable diagnosis. She was anticoagulated with heparin and eptifibatide. Patient continued to have chest pain with negative cardiac biomarkers. She developed hypotension, oliguria, elevated white count, pyuria and renal failure. Because of a normal 2D-echocardiogram, cardiac etiology for shock was not suspected. After initial fluid challenge, empiric treatment for septic shock was initiated with antibiotics and vasopressors. Work up for pulmonary embolism and intra-abdominal hemorrhage was negative. Because of persistent chest pain, shock with cold & clammy extremities and elevated central venous pressure cardiogenic shock was considered and a repeat 2D-echocardiogram was done on third day of hospitalization which revealed pericardial effusion. Non-contrast CT-scan chest done to look for lead position confirmed that she had hemorrhagic pericardial effusion along with lead perforation. Patient underwent pericardial window placement along with over-sewing of atrial wall to seal the leakage point. The patient improved and was then discharged from the hospital.</p> <p>Conclusion</p> <p>Lead perforation presenting with chest pain and EKG changes is often not appreciated resulting in significant delay in diagnosis and inappropriate treatment.</p