Strategic planning for a SME

The purpose of this research is to find competitive advantages for an organisation and prepare a long-term strategic planning for the SME. In a New Zealand context, small business enterprises play vital roles in business and the economic sector. However, most small business do not have specific competitive advantage and long-term strategies to compete in the market. Both qualitative and quantitative approaches have been used as mixed method research. Interviews and surveys have been done. Using those methods, researchers are intended to use the most effective implementation methodology to find out the best solution to the problem and cause of a SME. Location and customer satisfaction have been identified as the prime factors for the firm to run the business successfully. The business has been operating smoothly without using any further strategies to compete in the market. Recommendations involve pricing, advertising and stock management

Strategic planning for a SME

The purpose of this research is to find competitive advantages for an organisation and prepare a long-term strategic planning for the SME. In a New Zealand context, small business enterprises play vital roles in business and the economic sector. However, most small business do not have specific competitive advantage and long-term strategies to compete in the market. Both qualitative and quantitative approaches have been used as mixed method research. Interviews and surveys have been done. Using those methods, researchers are intended to use the most effective implementation methodology to find out the best solution to the problem and cause of a SME. Location and customer satisfaction have been identified as the prime factors for the firm to run the business successfully. The business has been operating smoothly without using any further strategies to compete in the market. Recommendations involve pricing, advertising and stock management

Effect of disinfectants on viability of Ascaris suum and Ascaridia galli eggs

Ascaris suum and Ascaridia galli, the large round worm of pigs and poultry, respectively, persist even in intensive management systems, where a high level of hygiene is practiced. It is necessary to control these helminths to minimize production losses and improve animal welfare. Commercial disinfectants are commonly used to clean pens in conventional pig and poultry farms but their efficacy against the thick-shelled nematode eggs has not been sufficiently documented. However, it might be difficult to control these parasites because of their complex thick-shelled eggs, which can resist harsh environmental conditions. Commonly used disinfectants such as Virkon S®, FL-des GA® typically claim efficacy against viruses, bacteria and some fungi, but very few disinfectants (FL-des Allround®) claim to also eliminate parasite eggs

Perception of patients towards the role of pharmacist: a cross-sectional study from selected three hospitals in Central Nepal

Objectives: To determine the perception of patients towards pharmacist and factors affecting their choice of pharmacy in hospitals of central Nepal. Methods: A prospective cross-sectional study was conducted among outpatients (n = 400) of three different purposively selected hospitals of Bharatpur, Nepal, using a systematic random sampling technique. Information on socio-demographic features, patient's description about pharmacist, frequency of interaction with pharmacist, reason for interaction, factors affecting the choice of pharmacy and patient's perception towards the role of pharmacist were collected. Descriptive statistics were calculated and chi-squared test was used to determine the association of patient's perception and factors influencing choice of pharmacy with socio-demographic variables. Key findings: Of 400 participants, majority (45.5%) believed that pharmacists have knowledge and information about medicines and their use. Most patients (213, 53.3%) interacted rarely with pharmacist, and most common reasons for interaction were queries about drug dosage (242, 60.5%) and drug availability (110, 27.5%). The overall perception of patients towards the role and responsibilities of pharmacist was positive, and most of the perception was associated with socio-demographic variables. Efficient communication (399, 99.7%) and appropriate counselling on side effects (397, 99.2%) were two major factors that determined the selection of pharmacy by the patients. Conclusion: The overall perception of patients towards pharmacist was positive in central Nepal. However, misconceptions still persist. Selection of pharmacy in our setting was mainly based on effective communication and proper counselling on side effects

Biofilm Formation and Phenotypic Detection of ESBL, MBL, KPC and AmpC Enzymes and Their Coexistence in Klebsiella spp. Isolated at the National Reference Laboratory, Kathmandu, Nepal

Klebsiella spp. are associated with several nosocomial and opportunistic infections. Increasing antimicrobial resistance of Klebsiella species is aggravated by a number of intrinsic and extrinsic factors. The main aim of this study is to determine antimicrobial resistance due to production of β-lactamase enzymes, extended spectrum beta-lactamase (ESBL), metallo-beta-lactamase (MBL) and AmpC and Klebsiella pneumoniae carbapenemase (KPC) and biofilm formation in Klebsiella isolates. A total of 2197 non-duplicate specimens of urine, sputum and pus were obtained from the National Public Health Laboratory (NPHL), Kathmandu, Nepal, between February and August 2019. Klebsiella species were isolated, identified and screened for antimicrobial susceptibility testing with the disk diffusion method. Phenotypic detection of ESBL, MBL, KPC and AmpC production was observed and biofilm production was detected by the microtiter plate method. Out of a total of 2197 clinical specimens, bacterial growth was detected in 8% (175/2197) of the specimens. Of the total isolates, 86.3% (151/175) were Gram-negative bacteria and 37.7% (57/151) were Klebsiella spp. Of the total Klebsiella spp., 56% (32/57) were multi drug resistant (MDR), 16% (9/57) were ESBL, 26% (15/57) were MBL, 4% (2/57) were KPC (class A carbapenemase), 16% (9/57) were AmpC producers and 95% (54/57) were biofilm producers. Gentamicin was the most effective antibiotic, followed by cotrimoxazole, as 68% (39/57) and 47% (27/57) of the Klebsiella isolates were susceptible towards these drugs, respectively. The study results show evidence of β-lactamase production, high prevalence of MDR and biofilm producing Klebsiella species. Integrating the test parameters for phenotypic confirmation of ESBL, MBL, AmpC β lactamase and KPC in routine diagnostic procedures can help in the early detection and management of these resistant strains

International consensus statement on obstructive sleep apnea

BACKGROUND: Evaluation and interpretation of the literature on obstructive sleep apnea is needed to consolidate and summarize key factors important for clinical management of the OSA adult patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). METHODS: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. RESULTS: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA and treatment on the multiple comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. CONCLUSION: This review of the literature in OSA consolidates the available knowledge and identifies the limitations of the current evidence. This effort aims to highlight the basis of OSA evidence-based practice and identify future research needs. Knowledge gaps and opportunities for improvement include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy