Loss Of Man-hours Research Articles

Trauma-Related Deaths in the Accident and Emergency Department of a Nigerian Teaching Hospital

Background: Trauma is a significant contributor to morbidity, disabilities, loss of man hours and mortality in both the developed and developing world with 90% of global trauma deaths occurring in low and middle income countries. The extent of motor vehicular use, degree of adherence to use of safety gadgets, strength of enforcement of industrial safety regulations, level of civil unrest as well as other socio-demographic indices predict the contribution of various etiologic factors. Deaths from the trauma may perhaps have far more psychologic and physical impact on families that from acute/chronic medical cases Method: A retrospective study of the admission records and in-patient records of all trauma related deaths in the accident and emergency unit of the University of Port Harcourt Teaching Hospital from 1st January 2018 to 31st December 2022 was done. Relevant information was extracted and analyzed. Data obtained was analyzed descriptively. Results were presented in tables and charts where necessary. Means and standard deviations were used to represent certain variables. Results: Total emergencies (medical and surgical) seen within the study period were 42,443, total injuries seen were 10,787 giving a crude injury prevalence rate of 25.4%. There were a total of 766 deaths among injured patients giving a crude mortality rate of 7.1%. Road traffic accidents (RTAs) (46.3%) and Firearm injuries (23.5%) were the most common injury mechanisms seen. Traumatic brain injuries are by far the leading cause of trauma-related deaths in the ER (82.5%) with most deaths (96.1%) occurring within the first 72hours of Admission. Conclusion: Trauma-related deaths occur in 7.1% of all injuries presenting at the study sight. The most common mechanism is RTA while the most affected victim is the young adult male. Traumatic brain injury accounts for more deaths than all others combined with most of the deaths occurring within the first 72hours of presentation. All efforts at reducing these injuries should be encouraged.

Academic Staff Union of Universities (ASUU) – Federal Government of Nigeria (FGN) Trade disputes and the advancement of University Education in South-South, Nigeria

The study examines ASUU-Federal Government trade disputes and the advancement of university education in Nigeria, a study of Universities in South South Nigeria; University of Port Harcourt, Delta state university and Niger Delta University, 2010-2022. Universities Nigeria has at various times experienced disruption in their academic calendar due to industrial disputes between FGN-ASUU, state government-ASUU or university management. But the goals of tertiary education are fundamental to the building of a productive society, through the ground work for excellence expertise, research and release technological breakthrough, but universities education have suffered setbacks from strikes, leading to loss of man hours in teaching and learning. Scholars have contended that trade disputes have tremendously affected the fabrics of the university system and the productivity of the Nigerian economy. Others have argued that trade unions have become veritable tools and important agents of quality education and socio-economic transformation. It is based on this that the study investigates ASUU/FGN disputes in Universities. The study is be guided by three main objectives. First to identify the causes of the protracted trade disputes between FGN-ASUU, secondly, to evaluate the positive effects of disputes on the advancement on infrastructural development and the third to examine the effect on quality education. To achieve the objectives, the study employs the Hegelian Dialectics theory as its explaining framework for analysis. Data from primary sources generated from questionnaires and was complemented with focus group discussion for this study. The responses from the field work through questionnaire are presented in simple frequency distribution, tables and the quantitative data are analyzed using SPSS statistical tool. The findings show and ascertain that industrial disputes between FGN-ASUU is a blessing in Nigeria Universities’ as result of establishment of Tetfund and the massive infrastructural advancement and others for qualitative education. The recommend among others government must budgetary allocation to 26% bench mark and abide by the agreements signed with ASUU

Assessment of the Current Bus Route Network in the Federal Capital City Abuja, Nigeria

The inadequacy of buses for the public transportation system in the Federal Capital City (FCC) of Abuja has resulted to the dominant use of private automobiles, which has created a lot of problems, such as, long waiting times, lateness to work, kidnapping and loss of man-hours. The effort of Government in providing high capacity public buses through Abuja Urban Mass Transit Company (AUMTCO), has not been satisfactory. Therefore, in this study, an evaluation of the existing bus route networks and the availability of public transport bus services in the FCC, including an assessment of the factors that determine the present choice of travel mode in the City is presented. The methodology adopted includes: manual traffic volume count, measurement of traffic data and scope of the current bus route network using GPSmap76Cx (GARMIN) receiver, and questionnaire administration. The results show that public bus is 0.12% of vehicular traffic volume in the metropolitan city, while private car has 86.81%, which carries significant consequences that impact different facets of its citizens' lives. The existing bus routes network does not cover Wuse II and Maitama districts. Mode choice influences by social demographic characteristics, such as; occupation, marital status, time spent going to work, bus inconvenience, time to leave home for work, and decision to patronize public mode if available are among the trip factors assessed. The mean peak travel speed on the bus routes ranges from 15km/hr to 23 km/hr, while average time spent from house to and at bus stop are 10 minutes and 20 minutes respectively for public bus. The results suggest that the existing bus route networks should be optimized to cover all the districts of the Federal Capital City for effective accessibility and services to commuters. This will improve the security indices of commuters in the Federal capital city.

Single Anesthesia ERCP and Laparoscopic Cholecystectomy for Management of Common Bile Duct Stones

Abstract Management of choledocho-cholelithiasis requires a multi-disciplinary approach. It involves clearance of common bile duct stones (CBDS) on the one hand and addressing gallstone disease (GSD) on the other hand. With technological advancements and growing expertise in the fields of endoscopy and laparoscopy, endoscopic retrograde (or radiological) cholangiopancreatography (ERCP) and laparoscopy cholecystectomy (LC) have become modalities of choice for CBDS and GSD, respectively. Conventionally, in patients with choledocho-cholelithiasis, ERCP is performed first followed by LC after an interval of 4–6 weeks. This approach requires two separate admissions involving anesthesia twice, thus increasing the risk related to multiple general anesthesia, higher cost of care, and greater loss of man hours. These issues can be mitigated by the novel approach of single anesthesia ERCP and laparoscopic cholecystectomy (SERLAC). At our center, we follow both approaches, depending on the availability of resources and patient characteristics. Aim: This study aims to evaluate the safety of SERLAC. Materials and Methods: In this retrospective, descriptive study, we analyzed data of patients undergoing SERLAC for outcome, complications, benefits, and constraints. Results: Of the 36 patients who underwent ERCP before LC for choledocho-cholelithiasis, 10 opted for SERLAC. Despite relatively prolonged anesthesia time (mean 85.3 min), owing to both ERCP and LC being performed in the same sitting, no anesthesia-related adverse event was noted. SERLAC was preferred in two cases to avoid exposure to second general anesthesia due to comorbidities such as old age with polytrauma and use of oral anticoagulant related to a prosthetic cardiac valve. Hospital stay was significantly lower (mean 4.3 days) in patients opting for SERLAC and it provided a definite cure for 8 out of 10 patients. The major constraint noted was logistical, in terms of ensuring the availability of the operating room (OR) and teams for both procedures besides setting up the ERCP and laparoscopy workstations in the same OR in quick succession. Our study shows that SERLAC is a safe approach and further studies are required to build consensus. Conclusion: This study has proven that SERLAC is safe and comparable to interval ERCP and LC. It offers a definite cure with a single admission, single anaesthesia, and significantly shorter hospital stay and thus results in much greater patient satisfaction in expert hands.

Comparative Study of Intravenous Methylprednisolone Pulse Therapy versus Oral Prednisolone Minipulse Therapy in Progressive Vitiligo

Abstract Background: Vitiligo is an idiopathic acquired illness characterized by limited depigmented macules and patches. We aim to compare intravenous (IV) methylprednisolone pulse therapy with oral prednisolone minipulse therapy in the treatment of progressive vitiligo. Objective: The assessment of the efficacy of both treatment methods in the arrest of the progression of vitiligo and repigmentation of the existing lesions. Materials and Methods: A total of 60 patients, 30 in each group, were enrolled for the study. Each patient underwent a detailed clinical, general physical, systemic, and thorough dermatological examination. A set of routine investigations, consisting of hemoglobin%, total leukocyte count, differential leukocyte count, urine routine examination, blood sugar (fasting and postprandial), liver function tests, renal function test, serum electrolytes, Montoux test, chest X-ray posteroanterior view, and thyroid profile were carried out before the analysis. Clinical photographs were taken before the start of therapy and after each month thereafter were used for the analysis after taking written consent. Results: The age of vitiligo patients considered for the study ranged from 13 to 70 years. The ratio of male-to-female patients considered for the study was 22:38 (36.6%: 63.3%). The duration of instability in vitiligo cases studied varied from 6 months to 2 years. In both Group A and Group B, the maximum number of patients (66.7% and 86.7%, respectively) had unstable vitiligo for 6 months to 1 year. Percentage repigmentation was better in Group A (IV) than Group B (OMP). In Group A, 17 out of 20 (85%) patients had shown different degrees of repigmentation, while 20 out of 30 (66.7%) patients of Group B had shown the same. This was statistically insignificant. Types of repigmentation observed in patients were of the following types: perifollicular, marginal, and combined. In both groups, all patients showed perifollicular regimentation. Conclusions: In progressive vitiligo, it was observed that oral mini pulse with prednisolone is superior to IV methylprednisolone pulse therapy for the arrest of progression. Considering the cost, mode of administration, hospital admission, loss of man-hours, and patients’ compliance, OMP was considered simpler and cost-effective.

Harnessing BIM with risk assessment for generating automated safety schedule and developing application for safety training

The construction industry accounts for 24.20% of all accidents in India, resulting in almost 75 accidents daily. Every construction job involves certain risk levels, often resulting in losses such as fatalities, compensation costs, man-hour loss, work delays, and ergonomic disorders in workers. Poor site safety management and hesitation towards adopting new methods and technologies often result in inefficient workflow, accidents, and inferior productivity. All these factors pile up, causing a surge in indirect costs, almost four times direct costs. The Indian construction industry employs 51 million workers but has only 4% formally trained workforce. Safety planning is currently considered a 'secondary' task due to insufficient safety budget, lack of well-defined training modules and modern tools, unawareness about underlying hazards, etc. The current study is an attempt to identify and assess underlying activity-based hazards using the Failure Mode and Effect Analysis (FMEA) approach by harnessing the potential of digital tools such as Building Information Modelling (BIM) and Visual Scripting in Dynamo v.2.10 to facilitate automation in generating 'Safety Schedule' in coordination with the project schedule. This study presents a novel idea of proactive safety planning, enabling workers and managers to foresee possible hazards associated with ongoing activity. Further, a worker training tracker prototype is developed in Microsoft Visual Studio using C# to store and track workers' safety training information. Managers can use this tracker to review workers' competence and ensure that they would have received appropriate role-based safety training. The applicability and effectiveness of the proposed method are demonstrated through a case study project.

Online Learning And The It Sector A Systematic Literature Review Using Prisma

IT sector in India is world-renowned for its competencies and fast-flawless project handling. This sector undergoes frequent upgrades and upskilling. Online upskilling programs aid IT organizations and their employees in being future-ready, without loss of man-hours. Through exhaustive research article resources available, a confined and sector-oriented review of the literature is not immediately available. This paper is a systematic review of research literature - listed in the Scopus database - on Online Learning and its Outcomes limited to the IT sector. The method employed is PRISMA to identify the research gaps, vide the subject. This paper attempts to highlight the research gaps and newer avenues for empirical research that would readily serve future scholarly research.

Workplace Bullying against Certified Registered Anaesthetists in the Tamale Metropolis in the Northern Region of Ghana

Background: Workplace bullying is a major occupational hazard globally with negative consequences on employee health and organizational performance. Workplace bullying has significant implications for quality care delivery and care outcomes.
 Aim: We sought to investigate the nature and occurrence of workplace bullying and its effects on the health and job performance of Certified Registered Anaesthetists (CRAs) in the Tamale Metropolitan area of the Northern Region of Ghana. The characteristics of workplace bullying against CRAs included assigning unpleasant and menial tasks, spontaneous anger, hostilities, intimidation, unmanageable workload and threats of physical violence or actual abuse.
 Methodology: The study was conducted at Tamale Teaching Hospital (TTH), the largest referral hospital in northern Ghana. Data was collected from Certified Registered Anaesthetists, doctors, nurses, and hospital administrators, using interviews, questionnaires, and observations.
 Results: Prevalence of workplace bullying was 56.5% by quantitative inventory and 74.2% by subjective inventory. Also 40.3% of participants had witnessed bullying against a CRA often and 75.3% had suffered physical and psychological effects from bullying, 16.1% were off-duty between 1-20 days within the last 6 months as a result of bullying.
 Conclusion: The study concluded there is a high prevalence of workplace bullying against CRAs in the Tamale Metropolis with psychological and physical consequences on the victims that could affect quality patient care, care outcomes and loss of man-hours at work. It is recommended that workplace policy and worker education be undertaken by the metropolitan health directorate to urgently address the issue of workplace bullying.

Markov Chain theoretic approach to modelling industrial safety: some results from Nigeria oil and gas industry

the oil and gas industry. This study seeks to unravel the hidden details enwrapped in the safety data which enable the development of a model that would be effective in predicting future occurrence of industrial accidents. The purpose of this study is to spotlight the epidemiological impact of industrial accidents which claim lives, maim personnel and lower productivity through loss of man-hours. The major strategy adopted consists of the examination of a 10-year unified industrial accident recorded from 2007 to 2016 in the oil and gas sector of the Niger Delta of Nigeria. The Markov Chain model was applied to determine how workers habituate among different positions in the company before getting entrapped in any of the absorbing states. The industrial accident records are examined for embedded Markov properties, namely: stochastic regularity, absorbing behavior and the long-run distribution amongst the various states. The statistical computations were carried out with the aid of Matlab (R2017a) software. The historical Health Safety and Environment (HSE) statistical data were found to have an absorbing chain property. Thirteen (13) transition states were defined and named as; fatality, medical treatment, first aid cases, Lost time injury frequency, restricted work cases, first aid case, near miss, lost time injury, environmental incident, fire incident, unsafe acts, unsafe condition and number of attendance of clinic. The result from the study also revealed that staff makes between 17-18 habituations before being trapped in an absorbing state. Remarkably, 99% of workers in the organization had severe medical treatment cases (MTCs) as a result of work-related occupational illness and injury. The implication of the study is that the safety policy outlook of this company should be reorganized to reduce its lost workdays due to minor injury and illness.

Possible Interference in Protein – Protein Interaction as a New Approach in Micro- Inhibition of Respiratory Pathogens on Nasal– Oral Epithelium: An Early On-Screen Study with Reference Tosars-Cov-2–ACE2 Binding Interference

Upper and lower respiratory pathogens – both microbes and viruses –are responsible for very high morbidity, man-hour loss, residual long term clinical conditions and even mortality. In India only, high incidence of annual respiratory infections – both UT and LT – demands prophylactic intervention in addition to all therapeutic interventions available. The issue of respiratory infections is more pronounced now in the backdrop of nearly uncontrolled high incidences of SARS-Cov-2 affection resulting in death and damage of human lives to the extent of hundreds of millions spreading over entire world, with incidence variations from country to country. After the initial unanswered phase of spread of SARS-Cov-2 virus with attendant unseen mortalities, quickest invention of a series of unusual vaccines have stemmed the lethal progress to a very significant extent, although vaccinating each and every human subject – nearly 8 to 9 bn in supremely divided world –economically-- is an unthinkable proposition where economic disparity dictates vaccine availability and implementation. Moreover, being of highly unstable nucleic acid composition, the original virus, by now has a thick set of variants around the globe with variable clinical outcome. Given this complex background of scanty availability and inefficient implementation , there always is a need of a preventive approach which can possibly micro-fix the pathogens , including SARS-2 on nasal epithelium so as to interfere with viral [or any pathogen] entry through specified receptor gate[s] or any other ways. The present formulation is under study -- as a candidate of interference on nasal/oral mucosa for all respiratory pathogens. This brief report describes dry on-screen studies of protein–protein interaction as well as its possible interference by an amino acid Lysine. Phospholipid bilayer responses in presence of added loads of the same essential amino acid –Lysine – showed unusual and unexplained behavior both in structural integrity as well in spatial orientation.

Nexus between flooding impacts and coping strategies in Nairobi’s settlements

Nairobi's settlements are vulnerable to urban flooding exacerbated by anthropogenic factors. Households living in flood-prone areas suffer perennially. However, little scientific evidence exists on the relationship between impacts of flooding and coping strategies in Nairobi's settlements. In this study, primary data was obtained through ground-truth surveys and administration of questionnaires to 310 households in Nairobi's crowded informal settlements of Mathare Kosovo and Kibera Mashimoni. Information captured included their bio-data, knowledge and perception of flooding, socio-economic, susceptibility and recovery indicators. Secondary data was mainly from literature review. The findings of the canonical correlation revealed that an insignificant relationship of 0.2964 and 0.2503 existed between flooding impacts and coping strategies adopted by households and communities respectively. Floods caused inaccessibility of houses, workplaces and schools, damages to settlements infrastructure, drowning, diseases and displacement of residents. The indirect impacts were loss of livelihoods, environmental degradation, loss of manhours in traffic jams and economic loss. This study is novel in that it provides empirical scientific evidence on the nexus between impacts of flooding and coping strategies in an urban settlement. It augments existing literature on flood risks in urban settlements. It also provides an entry point for policy and decision makers such as scientists, private sector leaders, urban planners and government technocrats to make informed policy guidelines and intervention strategies.

Covid-19 and delivery of dental health care services at Army Dental centre Research & Referral: A holistic assessment

Background: The practice of dentistry has been worst affected in Covid-19 pandemic due to its non-emergency nature and fear of rapid spread of disease through aerosol generating procedures. But, multiple dental problems can severely compromise function. This assumes even greater significance when it concerns the health of Armed Forces. ADC (R&R) was always at the forefront providing essential, urgent and scheduled dental care at various stages of pandemic with stringent management protocols.Aims and Objectives: To evaluate challenges, measures and the outcome in delivery of dental services based on observational assessment from 20 Mar-30 Nov 2020. The objectives were to assess patient attendance trends, reason for availing dental services, loss of manhours, antibiotic usage, Covid protection measures and resources, aerosol generating procedures, Knowledge/Attitude/Perception (KAP) studies, Covid-19 casualties, management of quarantine periods.Materials and Methods: Patients and staff data based on attendance, treatment instituted, patient screening procedures, additional expenses on Covid related resources, infrastructural changes etc.Results and Conclusion: The total of 13,046 patients were treated. There has been a considerable loss of manhours and more than 65% of the allocated budget was used in managing patients which otherwise were less than 25-30% of the pre-covid attendance. The manpower requirements tripled and the housekeeping services were heavily taxed. The staff Covid-19 casualties were considerably low and no patient reported acquiring Covid-19 infection post dental treatment at this centre. If the condition persisted, the ability to provide dental health care services will be an uphill administrative and financial challenge.

Estimates of Economic Cost of Congestion Travel Time Delay Between Onne-Seaport and Eleme-Junction Traffic Corridor

Abstract Travelers along the Onne-seaport to Eleme-junction road corridor in the hub of the oil and gas industry in Port-Harcourt, Nigeria, have continued to experience very serious traffic congestion travel time delays, culminating into loss of man-hours and declining productivity. This study estimated the economic cost of traffic congestion travel time delay along the corridor, with a view to providing economic justification for developing traffic management policies and road infrastructure, to remedy it. A mixed research approach was adopted in which data was sourced through field survey and from secondary sources. The gross output model was used to estimate the output losses occasioned by productive time losses related to traffic congestion. The study established that the average daily traffic congestion travel time delay along the traffic corridor by travelers in trucks, car, bus and taxi modes are 104.17 minutes, 46.60 minutes, 58.5 minutes and 56.4 minutes respectively. The estimated daily aggregate economic cost of output losses associated with traffic congestion time delay on the corridor is 46049809.8 naira (210923.5USD) for all modes. This justifies any investment in traffic congestion remedial strategies along the route.

Estimating the Financial Costs of Funeral Celebrations in Ghana: (A Case Study of Greater Accra, Central and Ashanti Regions)

Funerals and burial practices are a universal human social experience, and every society has a unique pattern of dealing with the death of its members. In Ghana, it is noticed that Ghanaians revere the dead so much that funerals are at the heart of Ghanaians' social life. This study sought to estimate the cost of funeral celebrations on personal finances and on productivity through man-hour loss. Interviews and questionnaires were the basis for data collection. The results from the sample, using a purposive sampling technique indicated funeral attendees in Ghana often incur costs in the form of expenditure elements including, but not limited to transportation, the buying of funeral cloths and the expenditure at funeral ground. It also showed that families hosting a funeral incur high costs when organizing it. Data interpretation was done using Microsoft excel. It is recommended that funeral celebration days should be reduced to one day, especially Saturdays so that attendees can leave on Friday after work and return on Sunday. And that, families should reduce how much they spend on food and drink by organizing simple but befitting burials.

Strategies to Control Human Lymphatic Filarial Infection: Tweaking Host's Immune System.

Human lymphatic filariasis (LF), a parasitic infection caused by the nematodes Wuchereria bancrofti, Brugia malayi and B. timori, and transmitted by mosquito, results in a debilitating disease commonly identified as 'elephantiasis'. LF affects millions of people in India and several other tropical and sub-tropical countries imposing a huge economic burden on governments due to disability associated loss of man-hours and for disease management. Efforts to control the infection by WHO's mass drug administration (MDA) strategy using three antifilarials diethylcarbamazine, albendazole and ivermectin are only partly successful and therefore, there is an immediate need for alternative strategies. Some of the alternative strategies being explored in laboratories are: enhancing the immune competence of host by immunomodulation, combining immunomodulation with antifilarials, identifying immunoprophylactic parasite molecules (vaccine candidates) and identifying parasite molecules that can be potential drug targets. This review focuses on the advances made in this direction.

Clinical radiology: Going an extra mile for patient care

Context:Clinical details help radiologists report accurately. However, the clinical aspect has taken a backseat among radiologists, who are overdependent on referral notes. This leads to inaccurate assessment, financial burden, and loss of man hours.Aims:To re-emphasize the benefits of detailed clinical evaluation and real-time monitoring of imaging in interpreting images.Settings and Design:Prospective study.Materials and Methods:A study was done in the Department of Radiodiagnosis for 10 days, including all referred patients above 18 years of age. Detailed history taking and examination was done by radiologists prior to imaging. Any additional significant clinical detail was endorsed on the referral slips. Appropriate imaging modality under given circumstances was carried out. Imaging was studied by the radiologists, near simultaneously with the acquisition. Any additional imaging needed was performed on the same day. Comprehensive reports with specific outputs were provided. Wherever apt, imaging-guided management options were offered to the patients.Results:During the study, 1024 patients with mean age of 46.3 years underwent various types of imaging, including radiography, computed tomography, magnetic resonance imaging, ultrasound scans, and fluoroscopic procedures. Additional clinical details were endorsed in referral slips in 32.4% patients, 53% of which helped in interpreting images appropriately. Primary imaging modality was changed in 3% patients. Additional imaging was done in 10.9% patients. 3.6% of patients underwent imaging-guided procedures.Conclusion:Detailed history taking and examination help radiologists in deciding appropriate imaging and better interpretation of images. This will also reduce the number of visits to the hospital and expenditure on part of patients.

Machine-learning based approaches for self-tuning trajectory tracking controllers under terrain changes in repetitive tasks

The use of resources in autonomous vehicles when manoeuvring along changing terrain is an issue yet to be faced in the industrial field, such as mining and agriculture, where automated machinery performs repetitive tasks. If the machinery is not capable to overcome such terrain disturbances during its motion, the vehicle spends more energy than the necessary as the motion controller is adapted to the new terramechanical scenario. The latter usually includes a re-tuning of the controller and the corresponding loss of man-hours until obtaining the desired responses. In this context, we propose a self-tuning methodology based on probabilistic approaches and machine learning techniques to improve the performance of the controllers through reducing trajectory tracking errors and control input efforts, as the vehicle repeats its trajectory and learns from the wheel-terrain interaction. Three degree-of-freedom motion controllers are used to test our techniques, although our proposal is not restricted to the nature of such controllers. For the validation of our hypothesis, we considered three tests: one is performed via simulation using a modified kinematic model of the vehicle and slippage constraints, whereas other two extensive trials were carried out in field using an electric vehicle – Twizy, made by Renault – under different types of shaped trajectories and irregular terrain. In particular, two terrains: grass and muddy, and their transitions. The metrics used herein and previously published in the literature have shown that the self-tuning methodologies proposed in this work decreases the trajectory tracking errors up to 18%, saves energy in the effort input of the actuators up 15%, and in general, increases the performance of the controllers up to 22% when compared to efficient manual tuning. The experimental results as well as the statistical analysis of our proposal are presented in detail herein.

Comparative evaluation of 5% lignocaine ointment and a combination of 0.2% glyceryl trinitrate and 5% lignocaine in management of acute fissure in ano.

Background: Anal fissure is one of the most common anorectal problem and presents as a tear in the anoderm distal to the dentate line. It is a common proctologic problem and accounts for 10-15% of proctological consultations and seen frequently in young and middle-aged patients. Presently wide range of medical and surgical treatment options were available. Present study was aimed to evaluate the therapeutic efficacy of 5% lignocaine ointment and a combination of 0.2% glyceryl trinitrate and 5% lignocaine in management of acute fissure in ano.Methods: In the present study, a total of 100 patients diagnosed with acute fissure in ano were randomly allocated into two groups (I, II) of 50 patients each and were managed by local application of 5% Lignocaine (LIG) ointment and a combination of both 0.2% Glyceryl trinitrate (NTG) and 5% Lignocaine (LIG) ointment respectively.Results: In the present study, the incidence of anal fissure was higher in males than in females with mean age of occurrence of 35.12 years. Pain was the most common symptom to present with. After six weeks, complete pain relief was seen in most of the patients and was comparable in both the groups but healing was superior in group II when compared to group I. Headache and dizziness were the side effects only noticed in group II.Conclusions: To conclude the study, we can say that the treatment of anal fissure is becoming increasingly medical as it can be carried out on outpatient basis and is cost effective and there is no loss of man hours. Lignocaine may be preferred as the first line treatment as there are no side effects and if there is failure to heal then we can prescribe the combination of both drugs owing to their risk benefit ratio.

A Stochastic Model for Estimation of Mean and Variance of Time to Recruitment in a Two Graded Manpower System under Order Statistics Wastage with NonIdentically Inter-Decision Times

In this paper, an organization subjected to a random exit of personnel due to policy decisions taken by the organization is considered; there is an associated loss of manpower if a person quits the organization. As the exit of personnel is unpredictable, a recruitment policy involving two thresholds, optional and mandatory is suggested to enable the organization to plan its decision on appropriate univariate policy of recruitment. Based on shock model approach, a mathematical model is constructed using an appropriate univariate policy of recruitment. The analytical expressions for mean and variance of time to recruitment is obtained when ( i) the loss of man hours forms an order statistics (ii) the inter-decision times are sequence of independent and non-identically distributed exponential random variables (iii) the optional and mandatory thresholds having exponential distribution.

Extensor tendon injury to the fingers, lack of insight and poor assessment leading to late presentations: A report of 10 case series

The subcutaneous position of the extensor tendons makes it possible for the tendon/s to be lacerated in many cases of sharp object cuts on the dorsum of hand. The lack of insight and the poor patients' assessment cause the primary clinician to secure hemostasis and repair the obvious skin wound only. This unrecognized tendon injury would later become obvious because of persistent deformity and loss of function. This is a case series of patients with delayed diagnosis of extensor tendon injuries to the fingers as seen in a level II surgical specialty from January 2006 to December 2016.These extensor tendon injuries presented late after healing of skin wounds. Tenolysis, tenorrhaphy and physiotherapy were successful but the delay caused loss of man hours and added cost to treatment.