Patellar tendon mid-substance tear after total knee arthroplasty: a case report

Extensor mechanism of knee plays important role in successful long term functional outcome after total knee arthroplasty (TKA). Any injury to extensor mechanism during or after surgery can cause functional disability which can be devastating for patients. Patellar tendon injuries are not very common after TKA. The author reported a rare case of patellar tendon mid-substance tear after TKA, which was successfully managed by reconstruction using grafts without any implant

Impact of ATM Service on Customer Perception and Satisfaction of Indian Banks

Abstract. Indian banking sector has completely changed. It has undergone much technological advancement that makes banking easy. Technological advancements are important but at the end what build customer satisfaction is proper management, employee behavior and customer relationship handling. Customer satisfaction is a sum of many variables that is many factors together leads to customer satisfaction. This modern electronic banking has completely changed the concept and functioning of banking system in India. Indian banking has moved from cash economy to cheque to and finally to the use of plastic cards. The customer satisfaction is dependent on customer awareness to a lot of extent. An unaware customer has less knowledge and therefore they cannot use the facilities completely even if they have it at their disposal. Customers prefer public sector banks when they are looking for trust and security and reliability. When it comes to speed, advancements and up gradation people shits from public sector banks to private sector banks. Customer gets satisfied only when they get quality service from the brand they are dealing with. This is very important for the marketers or the service providers as this leads to consumer satisfaction which benefits them and this brings loyalty to the brand enhancing the brand positioning. This research is important because new modern era has made people technology savvy they start their day with technology and end with technology therefore it is important to see the perception of users towards various factors of ATM. This research is conducted to see the highlighting factors that have direct impact on ATM services. Keywords: ATM, Customer satisfaction, Service quality, Private Banks, Public bank

Impact of ATM Service on Customer Perception and Satisfaction of Indian Banks

. Indian banking sector has completely changed. It has undergone much technological advancement that makes banking easy. Technological advancements are important but at the end what build customer satisfaction is proper management, employee behavior and customer relationship handling. Customer satisfaction is a sum of many variables that is many factors together leads to customer satisfaction. This modern electronic banking has completely changed the concept and functioning of banking system in India. Indian banking has moved from cash economy to cheque to and finally to the use of plastic cards. The customer satisfaction is dependent on customer awareness to a lot of extent. An unaware customer has less knowledge and therefore they cannot use the facilities completely even if they have it at their disposal. Customers prefer public sector banks when they are looking for trust and security and reliability. When it comes to speed, advancements and up gradation people shits from public sector banks to private sector banks. Customer gets satisfied only when they get quality service from the brand they are dealing with. This is very important for the marketers or the service providers as this leads to consumer satisfaction which benefits them and this brings loyalty to the brand enhancing the brand positioning. This research is important because new modern era has made people technology savvy they start their day with technology and end with technology therefore it is important to see the perception of users towards various factors of ATM. This research is conducted to see the highlighting factors that have direct impact on ATM services

The diagnostic role of saliva: a review

As a diagnostic fluid, saliva offers distinctive advantages over serum because it can be collected non-invasively by individuals, even by patient. Does not require special equipment for collection and storage as unlike blood saliva does not clot. Advantageous for person in whom blood drawing is difficult as in obese and haemophilic patient. Whole saliva used for diagnosis of systemic diseases, because it contains serum constituents. These constituents are derived from the local vasculature of the salivary glands and gingival cervicular fluid.This review examines the diagnostic application of saliva for hereditary disorders, autoimmune diseases, malignant and infectious diseases, and endocrine disorders, as well as in the assessment of therapeutic levels of drugs and the monitoring of illicit drug use, and also for forensic evidence and others. . In future we are likely to see the increased utilization of saliva as a diagnostic fluid. As we enter the era of genomic medicine, sialochemistry will play an increasingly important role in the early detection, the monitoring and progression of the systemic and oral diseases

Prevalence of traumatic dental injuries and role of incisal overjet and inadequate lip coverage as risk factors among 4-15 years old government school children in Baddi-Barotiwala area, Himachal Pradesh, India

Objective: To assess the prevalence of traumatic dental injuries (TDI) in school children in Baddi- Barotiwala, Himachal Pradesh, India. Methods: A cross-sectional survey was carried out in Government schools among 1059 government school children aged 4- 15 years. The study was conducted from October 2009 to March 2010 during the school hours. The demographic detail was carried on a structured questionnaire. The data regarding the traumatic injuries was recorded using modified Ellis' classification. Results: Prevalence of TDI was found to be 4.15%. 95.45% of the injuries were to the maxillary anterior teeth. Maxillary central incisor was the most common tooth to be affected due to trauma (54.5%). Enamel with dentin fracture with pulp exposure was the main type of TDI (43.1%). The majority of TDIs were untreated (97.7%). Falls (54.5%) were found to be the main cause. Over jet over 3 mm and inadequate lip coverage were found to be important contributing factors for TDIs. Conclusion: The present study revealed a relatively low prevalence of dental trauma, but still this figure represents a large number of children. Therefore, educational programs are to be initiated for the community regarding causes, prevention and treatment of traumatic dental injuries. It is crucial to generate considerable efforts to implement health promotion strategies to reverse the observed trends and to provide treatment to TDIs to prevent their biologic and psychological consequences. © Medicina Oral S. L

Prevalence of elderly patients who refuse to get discharge from coronary intensive care unit in a tertiary care hospital of North India: a pilot study

Background: The elderly population ≥60 years is increasing as the life span is increasing. So is the number of elderly patients who are refusing to get discharge from the hospital is also increasing. Authors are conducting this study in the elderly population who want to stay against medical advice.The aim to find the prevalence of elderly patients who refuse to get discharge from Coronary Care Unit (CCU) in a Tertiary care hospital of North IndiaMethods: A retrospective, observational study conducted in patients of age ≥60 years admitted to the coronary intensive care unit of a tertiary health care centre who refused discharge from the unit, were included in the study. Results: Of the 575 patients 44(7.65%) were willing to stay against medical advice. Of these 24(54.5%) were males and 20(45.5%) females. 6(13.6%) patients were terminally ill suffering from malignancies. Among all the patients who were willing to stay against medical advice, 8(18.2%) were covered by some health insurance scheme of either State or Central Government. 3(6.8%) patients were discharged after 24 hours, 22(50%) patients after 48 hours, 14(31.9%) patients after 72 hours and 5(11.3%) patients after 96 hours of advising discharge from hospital.Conclusions: As the intensive care beds at tertiary healthcare level are limited, the treatment of other salvageable sick patients who need the intensive care is affected by the unnecessary stay in hospital. Apart from the worsened nurse to patient ratio this increases the cost of treatment. This is need of hour to provide safe environment for the elderly outside the hospital settings and increase resources to provide better homecare

COVID-19: considerations for optimum surgical team protection before, during and after operation

SARS CoV-2, the virus responsible for coronavirus disease 2019 (COVID-19), has caused a global pandemic. Surgeons’ obligation, as always, will be to provide timely, high-quality surgical care that achieves the best outcomes for patients. It is imperative to ensure the safety of health-care workers not only to safeguard continuous patient care but also to ensure they do not transmit the virus further. Viral particles have been found in nasal swabs, pharyngeal swabs, sputum, bronchial swabs, gastrointestinal tissue, blood, and stool.Surfaces in isolation rooms and even clinician shoe covers have tested positive as well. Some key considerations for protecting surgical teams; structure frequent communication before key events; assume the entire operation theater will be contaminated; choose personal protective equipment (PPE) effective against aerosolized particles; adapt surgical technique to reduce exposure risks; use a “buddy system” for donning and doffing; after operation/recovery; going home – what should be done to keep your family safe. Though careful planning and appropriate PPE are essential, the most effective way to prevent viral exposure is to avoid performing non-essential surgical procedures. Non-operative approaches may be a safe alternative to surgery for some patients. Many patients, however, will require emergency operative intervention

An Analytical Approach to Understand Customer Relationship Management in Indian Banking Sector from the Perspective of Customers

In recent years, significant developments have been experienced in the banking sector. With the improved technology, banks have become institutions that offer services for 24 hours through telephone, internet and ATMs. Besides the classic banking services, they have taken over a number of activities such as automatic billing, which facilitate the lives of the customers. To maximize lifetime profitability from valued customers, banks have changed traditional silo mindset and have adopted Customer Relationship Management (CRM) techniques.This paper examines the relationship between thecustomer loyalty and CRM in National Capital Region of India. Methodology of the paper has been designed such that, it abstracts the scales into 5 dimensions related to CRM of banks. This paper uses regression analysis to arrive at a model which explains customer loyalty. This paper also provides insights for the banks which adopt CRM at a strategic standpoint as well as operational standpoint and implement a customer–centric vision. &nbsp

Human knee abnormality detection from imbalanced sEMG data

The classification of imbalanced datasets, especially in medicine, is a major problem in data mining. Such a problem is evident in analyzing normal and abnormal subjects about knee from data collected during walking. In this work, surface electromyography (sEMG) data were collected during walking from the lower limb of 22 individuals (11 with and 11 without knee abnormality). Subjects with a knee abnormality take longer to complete the walking task than healthy subjects. Therefore, the SEMG signal length of unhealthy subjects is longer than that of healthy subjects, resulting in a problem of imbalance in the collected sEMG signal data. Thus, the development of a classification model for such datasets is challenging due to the bias towards the majority class in the data. The collected sEMG signals are challenging due to the contribution of multiple motor units at a time and their dependency on neuromuscular activity, physiological and anatomical properties of the involved muscles. Hence, automated analysis of such sEMG signals is an arduous task. A multi-step classification scheme is proposed in this research to overcome this limitation. The wavelet denoising (WD) scheme is used to denoise the collected sEMG signals, followed by the extraction of eleven time-domain features. The oversampling techniques are then used to balance the data under analysis by increasing the training minority class. The competency of the proposed scheme was assessed using various computational classifiers with 10 fold cross-validation. It was found that the oversampling techniques improve the performance of all studied classifiers when applied to the studied imbalanced sEMG data. (c) 2021 Elsevier Lt