Comparative Analysis of Nonpenetrating and Penetrating Abdominal Injuries

Trauma is an accidental or intentional injury caused by of energy which is usually mechanical in nature to a victim 1% of hospital admissions for trauma involve the Abdomen. Several abdominal injuries are common in patients with multiple injuries. Trauma to the abdomen are classified as PENETRATING and NONPENETRATING. While penetrating injuries are common in urban Places, nonpenetrating is common in civilian trauma victims. Damage to organs can occur in both penetrating and non-penetrating trauma. The sudden application of pressure in non penetrating trauma is more likely to rupture solid Organ. While penetrating trauma causes more injury to hallow viscus. Two major life threatening situations occur following organ injury in both penetrating and non-penetrating trauma are HAEMORRHAGE and HOLLOW VISCUS PERFORATION with associated chemical and bacterial peritonitis. AIM AND OBJECTIVES: To do a comparative observational study of organ injuries and sequalae in penetrating and non penetrating abdominal trauma patients admitting in trauma ward, Rajiv Gandhi Government General Hospital and emergency laparotomy done, in the following aspects. a. Single & Multiple Organ injuries-incidence, effects and sequalae. b. To know the various epidemiological factors related to trauma. c. To know the cause and mode of injury in organ injuries. d. Complications of various organ injuries. To determine the cause, presentation, anatomical distribution of abdominal trauma. MATERIALS AND METHODS: This comparative study was done in RGGGH CHENNAI during the period September 2015 to September 2016. 45 consecutive cases of abdominal trauma was chosen from this department, these 45 cases were classified into penetrating and non penetrating types according to the standard classification. All abdominal trauma patients were received by the Casualty Medical Officer (both MLC and non MLC) and these patients were admitted in Napier Ward, where the Duty Assistant Surgeon attended the patients. Resuscitative measures and the baseline investigations were done simultaneously. Careful history was elicited from the patients, if consciousness was altered, history was elicited from the attender of the patient. Thorough clinical examination was done. Age, Sex, IP No, mode of injury were noted. General examination of the patient was carried out. Pallor and hydration looked for in particular. On gross examination head injury, fracture ribs, fracture longbones or Pelvic fracture were looked for. A thorough abdominal examination was done. External bruise or abrasion were noted in particular for non penetrating trauma. In case of penetrating trauma, external wounds, evidence of peritoneal penetration, evisceration of omentum or viscera were noted. Signs of peritonitis or internal haemorrhage was looked for and noted in both types of abdominal trauma. Serial abdominal girth measurements, half hourly pulse, temperature, respiration and hourly BP chart were maintained in relevant cases. Base line blood investigations and radiological examination done in all cases. Tetanus Toxoid was given to all patients. All cases were given antibiotics parenterally. Diagnostic peritoneal tap was done in relavant cases. CONCLUSION: The following conclusions were drawn from this study; • Non penetrating trauma is more common than penetrating trauma. • Solid organ injury is common in Non Penetrating Trauma. • Hollow viscus injury is common in Penetrating Trauma. • Spleen is the commonest organ affected in Non Penetrating Trauma. • Liver injuries in this study are not very serious and they are treatable. Extensive liver injuries are potentially dangerous. • Hollow viscus like jejunum.ileum, colon, stomach are the common organs affected in penetrating trauma • Mortality and morbidity depends on delay in treatment, number of organs affected, number of injuries in each organ and which organ is affected. • Omentum is commonest structure to be prolapsed in wound site in penetrating trauma. • Bladder is the common organ associated with pelvic bone fractures. • wound infection is the common complication in the penetrating trauma

Association of Small Dense LDL with Coronary Artery Disease and Diabetes in Urban Asian Indians - The Chennai Urban Rural Epidemiology Study (CURES-8)

Objective: Earlier studies in Europeans have identified small dense LDL to be associated with coronary artery disease and diabetes. In this study we assessed the association of small dense LDL with diabetes and CAD in Asian Indians. Methods: Study subjects were selected from the Chennai Urban Rural Epidemiology Study (CURES), a population based study on representative sample of Chennai city in southern India. Group 1:non-diabetic subjects (n=30); Group 2: diabetic subjects without CAD (n=30); Group 3:diabetic subjects with CAD (n=30). LDL subfractions were estimated using LipoPrint LDL system. LDL subfractions 3 and above, defined as small dense LDL was summed up to determine the overall small LDL. 75th percentile of the overall small dense LDL in non-diabetic subjects was used as a cut-off for defining elevated levels of small dense LDL. Results: The mean age of the study subjects was not significantly different among groups. Overall small dense LDL was significantly higher in diabetic subjects with CAD (16.7 ± 11.1 mg/dl, p<0.05) and without CAD (11.1 ± 8.0 mg/dl, p<0.05) compared to non-diabetic subjects without CAD (7.2 ± 6.8 mg/dl). Small dense LDL showed a positive correlation with fasting plasma glucose (r=0.252, p=0.023), HbA1c (r=0.281, p=0.012), total cholesterol (r=0.443, p<0.001), triglycerides(r=0.685, p<0.001), LDL(r=0.342, p=0.002), total cholesterol/HDL ratio (r=0.660, p=<0.001) and triglycerides/HDL ratio(r=0.728, p<0.001) and a negative correlation with HDL cholesterol (r= -0.341, p=0.002) and QUICKI values (r= -0.260, p=0.019). ROC curves constructed to predict elevated small dense LDL ((9.0 mg/dl) revealed that triglycerides/HDL ratio and total cholesterol/HDL ratio had higher AUC values compared to other parameters. A triglycerides/HDL ratio of 3.0 had the optimum sensitivity (80.0%) and specificity (78.0%) for detecting elevated small dense LDL. Conclusion: This data suggests that in Asian Indians, small dense LDL is associated with both diabetes and CAD and that a triglycerides/HDL ratio (3.0 could serve a surrogate marker of small dense LDL

Tris(2,4-di-tert-butyl­phen­yl) phosphate

The title compound, C42H63O4P, was isolated from the leaves of Vitex negundo. Two of the tert-butyl groups are disordered over two orientations with occupancy ratios of 0.57 (1):0.43 (1) and 0.67 (1):0.33 (1). Several intra­molecular C—H⋯O inter­actions are observed in the mol­ecular structure

Immunopathogenesis of tuberculosis and novel mechanisms of vaccine activity

SummaryThe 4th Global Forum on TB Vaccines, convened in Shanghai, China, from 21 – 24 April 2015, brought together a wide and diverse community involved in tuberculosis vaccine research and development to discuss the current status of, and future directions for this critical effort. This paper summarizes the sessions on Immunopathogenesis of Tuberculosis, and Immunopathogenesis and Novel Mechanisms of Vaccine Activity. Summaries of all sessions from the 4th Global Forum are compiled in a special supplement of Tuberculosis

Suppression of pdc2 regulating pyruvate decarboxylase synthesis in yeast

Mutants lacking pyruvate decarboxylase cannot grow on glucose. We have isolated three different complementation groups of extragenic suppressors that suppress mutations in pdc2, a regulatory locus required for the synthesis of the glycolytic enzyme pyruvate decarboxylase. The most frequent of these is a recessive mutation in the structural gene PFK1 of the soluble phosphofructokinase. The other class XSP18 (extragenic suppressor of pdc2) is a dominant temperature-sensitive suppressor that allows the cells to grow on glucose only at 30{deg} but not at 36{deg}. It also affects the normal induction of the glucose-inducible enolase 2, which can be rescued by providing a copy of wild-type xsp18 in trans-heterozygotes. The pyruvate decarboxylase activity in the triple mutant pdc2 pfk1 XSP18 is nearly equal to the sum of the activities in the two double mutants pdc2 pfk1 and pdc2 XSP18, respectively. This implies that the two suppressors act through independent pathways or that there is no cooperativity between them. In the pdc2 pfk1 XSP18 strain, pfk1 suppresses the loss of induction of glucose-inducible enolase 2 brought about by XSP18, but fails to rescue temperature sensitivity. The third class (xsp37) supports the growth of the pdc2 mutant on glucose but fails to support growth on gluconeogenic carbon sources. All the three suppressors suppress pdc2{Delta} as well and act on PDC1 at the level of transcription

Regional nitrogen cycle: an Indian perspective

During the past century through food and energy production, human activities have altered the world's nitrogen cycle by accelerating the rate of reactive nitrogen creation. India has made impressive strides in the agricultural front, in which N fertilizer plays a major role. There has been a marked change in the supply and use of land, water, fertilizers, seeds and livestock, but the N use efficiency remained at a low level. Exploring the nature of these changes and quantification of the impacts on the N cycle has become essential. Hence we have presented data on various N pools and fluxes based on a conceptual N model. In India, efforts should focus on understanding the fate and consequences of the applied N and to increase the efficiency of N use

Modeling Volume Loss of Heat Treated Al 6061 Composites Using an Artificial Neural Network

AbstractIn the present study, artificial neural network (ANN) approach was used to predict the volume loss of heat treated Al 6061 metal matrix composites reinforced with 10% SiC particles and 2% graphite particles. Composite was produced using stir casting process. Volume loss of composite was measured during wear testing in a pin on disc apparatus. Microstructure examination at wear surface was investigated by Scanning Electron Microscope (SEM). In Artificial Neural Network (ANN), Multi Layer Perceptron (MLP) architecture with back-propagation neural network that uses gradient descent learning algorithm is utilized. The results clearly revealed that the developed ANN model is reliable and accurate

MAGNETIC NANOPARTICLE-BASED APPROACHES IN CANCER THERAPY–A CRITICAL REVIEW

Cancer is definitely one of the leading causes of mortality worldwide. Failure in the efficacy of the standard treatments (chemo-, radiotherapy and surgery), and the severe side effects, resistance of tumor cells to chemotherapeutics have necessitated alternative therapeutic strategies. Magnetic nanoparticles (MNPs) have been assessed as potential cancer therapy materials. Their intrinsic magnetic properties provide a cancer detection, monitoring, and therapy platform based on multimodal theranostics. MNPs can be functionalized by binding them to a wide variety of substances, including chemotherapeutic drugs, radionuclides, nucleic acids, and antibodies. They can be used for drug delivery, magnetic or photothermal induced local hyperthermia and photodynamic therapy aimed at killing cancer cells at the tumor site. MNPs may also be useful to challenge drug resistance. The combination of different options of these treatment modalities offers a synergistic effect and significantly reduces the side effects. The functionalized MNPs may be used to remove the unwanted cells from blood, including leukemia cells and circulating tumor cells that key factors in the metastatic process. Despite numerous successful studies, there are still some unpredictable obstacles relevant to the use of MNPs in cancer therapy. This review mainly focuses on the application of MNPs in cancer treatment, covering future perspectives and challenges aspects

A Role of Knowledge Level of Employees in Customer Relationship Management With Special Reference to Lic

Purpose: Role ofknowledge level of employees in customer relationship management with special reference to LIC. In order to investigate a range of factors of CRM in LIC of India. In this specially concentrate to understand the knowledge level of the employees as perceived by the customer.   Theoretical framework: The theoretical frame work of the study, CRM is assessed the Knowledge level of employees isthe independent variables and the customer satisfaction is the dependent variable in the study. CRM is shown influencing the customer satisfaction. The significant influences of the factors on CRM vary according to different demographic profiles and views on policy holdings.   Design/Methodology/Approach:Descriptive research design was use in this studyThe prime data were collected from the sample of the respondents was identified from the total population of lic policy holders. The statistical analysis was carried out with the application of SPSS package. Both Descriptive and Inferential Analysis were carried out. The tools for the Inferential Analysis included Independent Sample t-test, One Way ANOVA, Chi Square Test, Friedman Test, Correlation and Regression.   Findings: The findings of the study based on output of the study. Henceforth reasoned that there is a huge distinction between mean positions towards Factors of Customer Relationship Management. In light of mean position, Customer Engagement is the main variable of CRM, trailed by Deployment of Modern Technology Knowledge level of the Employees etc. There is no importance contrast between capability of representatives concerning the Factors of Knowledge level of the Employees, There is significance contrast among male and female of laborers with respect to the Factors of Knowledge level of the Employees. The connection coefficient between Perception on Explanation of various items and Ready for Clarification is positive connections between Perception on Explanation of various item and Perception on Ready for Clarification .The connection coefficient between Explanation of various item and Recommending Right Schemes is positive connections between Explanation of various item and Recommending Right Schemes. The connection coefficient between Perception on Explanation of various items and Knowledge about Procedure is positive connections between Perception on Explanation of various items and Easy Acquisition of Policy and also different variables are decidedly corresponded with one another.   Research, practical &amp; social implications:This article express a different perspective on CRM in LIC.The results of this study indicate knowledge level of employees has a strong impact on customer satisfaction. Therefore top management should implement latest technology based increase the knowledge level of employees. To increase the knowledge level of employees to help the increasing satisfaction level of policy holders. It is intended to help guide and reassure current and potential Ph. D students.   Originality/value:To date, no systematic review has been conducted on the knowledge level of employees in LIC .This paper makes an important contribution to knowledge level of employees in CRM