Post Emergency Research Articles

UAV and Structure from Motion Approach to Monitor the Maierato Landslide Evolution

In February 2010 a large landslide affected the Maierato municipality (Calabria, Italy). The landslide, mainly caused by a period of prolonged and intense rainfalls, produced a mass displacement of about 5 million m³ and several damages to farmlands, houses and infrastructures. In the aftermath several conventional monitoring actions were carried out. In the current post emergency phase, the monitoring was resumed by carrying out unmanned aerial vehicles (UAV) flights in order to describe the recent behavior of the landslide and to assess residual risk. Thanks to the potentialities of the structure from motion algorithms and the availability of post emergency reconnaissance photos and a previous 3D dataset, the three-dimensional evolution of the area was computed. Moreover, an experimental multispectral flight was carried out and its results supported the interpretation of local phenomena. The dataset allowed to quantify the elevation losses and raises in several peculiar sectors of the landslide. The obtained results confirm that the UAV monitoring and the structure from motion approach can effectively contribute to manage residual risk in the medium and long term within an integrated geotechnical monitoring network.

Supply planning for shelters and emergency management crews

This paper addresses the problem of supplying provisions to civilians affected by an emergency and to the intervention groups that provide post emergency relief. We define the Emergency Supply using Heterogeneous Fleet Problem (ESHFP) using a Mixed Integer Linear Programming mathematical model that describes the complexities involved in these operations. Furthermore, we propose a novel heuristic algorithm which constructs a plan comprising a set of efficient vehicle routes in order to minimize the total supply time, respecting constraints concerning timing, demand, capacity and supply. The characteristics of the problem have been studied by solving an extensive set of test cases. The efficiency and practicality of the algorithm has been tested by applying it to a large scale ESHFP instance and to a case study involving a forest fire in the Province of Teruel, Spain.

The Resilience and Agricultural Household Livelihood Strategies of the 2018 Lombok Earthquake Victims at the Emergency Period in North Lombok Regency

A great earthquake was hitting Lombok in August 2018 that caused damage to home and livelihood sources of almost 100% of North Lombok Regency (KLU) population. This research is aimed to investigate the resilience capacity and livelihood strategies of displaced people (the earthquake victims) of KLU, especially the agricultural families during the post disaster emergency period. This research is using mix method between qualitative and quantitative approaches that explained descriptively. The qualitative data in this research was obtained using purposive area snowball sampling technique while the quantitative data was obtained through a comprehensive survey using Displacement Tracking Matrix (DTM) technique. Result of the research revealed that the earthquake caused the lost of jobs and livelihood sources of KLU’s people in all economic sectors, including agricultural sector. Social capital of the society was influencial as a main strategy of the victims to fulfil their daily needs and strengthen their social resilience in facing the damaging impact of the disaster. By exploiting their social capital, the society was able to fulfil their daily needs by managing all external aids, natural resources, and their remaining personal assets based on their common understanding, local wisdom, and social norms that exist in the society.

The effect of caregiver's and nurse's perception of a patient's discharge readiness on postdischarge medical resource consumption.

The purpose of this study was to validate patient's primary caregiver and their nurse's perception of patient discharge readiness assessment and their association with postdischarge medical consumption. The study employed a descriptive research, prospective longitudinal study design. The study was performed in a ward of a medical centre in Taipei, Taiwan, from June 2017-May 2018. Obtained data were analysed using an independent t test, one-way ANOVA and logistic regression approach. The number of comorbidities and the number of days of hospital stay were positively associated with post discharge emergency room visits. Caregiver readiness for hospital discharge had significant negative correlation with patient's 30-day readmission. Both caregiver and nurse readiness for the hospital discharge scale score were not factors associated with the patients' 30-day emergency room visit. Based on the research findings, to assess the discharge readiness as perceived by caregivers at patients' discharge is recommended. Caregiver and nurse scores on readiness for hospital discharge showed a significant positive correlation. The higher the score of a caregiver's readiness for a patient's hospital discharge, the lower the 30-day readmission rate. Family-centred care enables patients to safely pass though the transition phase from hospital to community and reduces the postrelease consumption of medical resources. The discharge readiness perceived by caregivers should be included in any decision-making.

Радіоповідомлення щодо планування сім’ї, спрямовані на чоловіків та жінок у суспільстві, що розвивається: кейс-дослідження

The study examined radio family planning messages with particular reference to the nature of the audience influence on communication content by using a chat program on radio in a developing society. The study adopted content analysis research method with a purposive sampling technique and used a radio script having six items for analyses. Results showed that there were more family planning segments for women than for men and, there were more family planning for drugs/pills and materials/implantation than for injection. In addition, there were side effects in the use of family planning just as there were quite a number of frequently asked questions except for condoms-fiesta/kiss. This paper concludes that radio scripts/messages for family planning programs should accommodate more topics/segments of family planning for men and women, specifically, natural methods should be included. Furthermore, radio family planning messages should focus more on the benefits of family planning and specifically the benefits of contraceptive pill and post pill emergency should be examined. Other formats of programs should be employed in the campaign for family planning messages on radio, and development communicators and content developers of radio family planning scripts should explore more areas to make radio messages more robust.

STRENGTHENING PERSONAL AND COMMUNITY DISASTER SUPPORT NETWORKS OF OLDER ADULTS

The Ecological Model posits a multilevel approach to understanding of and strengthening social networks of community based older adults. We present findings from our intervention, network analysis, and efforts at influencing policy making at the state level to better prepare them for pre and post disaster and emergency situations. At the individual-level, we implemented the Disaster PrepWise program to help community-based older adults develop personal disaster plans. We found increases in personal emergency network size by an average of three non-familial individuals. At the community-level, we evaluated two disaster management networks in Eastern Iowa counties. We found strong collaborations in disaster planning and response among 44 governmental and community-based organizations, but weaker collaborations in supporting older residents, suggesting a need in this area. At the policy-level, we are developing a state-level network of organizations to address policy barriers to effectively support older Iowans.

Anemia measurements to distinguish between viral and bacterial infections in the emergency department.

The clinical diagnosis of acute infections in the emergency department is a challenging task due to the similarity in symptom presentation between virally and bacterially infected individuals, while the use of routine laboratory tests for pathogen identification is often time-consuming and may contain contaminants. We investigated the ability of various anemia-related parameters, including hemoglobin, red cell distribution width (RDW), and iron, to differentiate between viral and bacterial infection in a retrospective study of 3883 patients admitted to the emergency department with a confirmed viral (n = 1238) or bacterial (n = 2645) infection based on either laboratory tests or microbiological cultures. The ratio between hemoglobin to RDW was found to be significant in distinguishing between virally and bacterially infected patients and outperformed other anemia measurements. Moreover, the predictive value of the ratio was high even in patients presenting with low C-reactive protein values (< 21mg/L). We followed the dynamics of hemoglobin, RDW, and the ratio between them up to 72h post emergency department admission, and observed a consistent discrepancy between virally and bacterially infected patients over time. Additional analysis demonstrated higher levels of ferritin and lower levels of iron in bacterially infected compared with virally infected patients. The anemia measurements were associated with length of hospital stay, where all higher levels, except for RDW, corresponded to a shorter hospitalization period. We highlighted the importance of various anemia measurements as an additional host-biomarker to discern virally from bacterially infected patients.

Occurrence and Biological Control of Cucumber Damping Off Disease under Protected Cultivation in Sulaimani, Iraq

Occurrence and cucumber damping-off disease incidence was determined in Sulaimani plastic houses in 2014 revealed from overall disease incidence of 6.82%. The highest incidence and severity reached to 23.7% and 5.0 respectively in Kharajian. While the lowest incidence and severity was detected in Arabit (0.2% and 0.6 respectively). Disease symptoms include pre and post-emergency damping-off of cucumber seedlings. Twelve fungal pathogens were isolated from roots and crown of infected seedlings and plants that explore typical damping-off and root rot symptoms. Rhizoctonia solani was the most frequently isolated fungi followed by Pythium aphanidermatum, Fusarium solani and Pythium sp. Morphology and characteristics of R. solani and P. aphanidermatum match with the original described characters of the fungi. The optimum growth temperature for P. aphanidermatum was 30°C and for R. solani was between 25-30°C. Pathogenicity test revealed that R. solani significantly surpassed all other treatment except P. aphanidermatum by inciting 53.3% pre and 66.4% post-emergency damping-off followed by P. aphanidermatum that incited 43.6% and 56.3% pre and post emergency damping-off respectively. T. harzianum showed high antagonistic ability against both pathogens. Antagonistic ability degree of T. harzianum reached to 37.02 against P. aphanidermatum and 32.00 against R. solani. The bio-control bacterial Bacillus subtilis, Rhizobacteria, Streptomyces coelicolor showed high efficiency in controlling the disease. Rhizobacteria and S. coelicolor completely inhibit R. solani growth at 10-1 bacteria dilution and significantly surpassed all other treatments. dilution 10-1 from all the used bacteria were significantly more efficient against P. aphanidermatum. This dilution was contain 21.4 × 107 cell forming unit in each milliliter (CFU/ml) in B. subtilis, 28 × 107(CFU/ml) in Rhizobacteria, 29.5 × 107 (CFU/ml) in S. coelicolor, 32.2× 107(CFU/ml) in Pseudomonas flouresence and 22.6 × 107 (CFU/ml) in Azotobacter chroococcus.

Side effects from opioids used for acute pain after emergency department discharge

ObjectiveOpioid side effects are common when treating chronic pain. However, the frequency of opioid side effects has rarely been examined in acute pain conditions, particularly in a post emergency department (ED) setting. The objective of this study was to evaluate the short-term incidence of opioid-induced side effects (constipation, nausea/vomiting, dizziness, drowsiness, sweating, and weakness) in patients discharged from the ED with an opioid prescription. MethodsThis is a prospective cohort study of patients aged ≥18 years who visited the ED for an acute pain condition (≤2 weeks) and were discharged with an opioid prescription. Patients completed a 14-day diary assessing daily pain medication use and side effects. ResultsWe recruited 386 patients with a median age of 54 years (IQR:43–66); 50% were women. During the 2-week follow-up, 80% of patients consumed opioids. Among the patients who used opioids, 79% (95%CI:75–83) reported side effects compared to 38% (95%CI:27–49) for non-users. Adjusting for age, sex, and pain condition, patients who used opioids were more likely to report constipation (OR:7.5; 95%CI:3.1–17.9), nausea/vomiting (OR:4.1; 95%CI:1.8–9.5), dizziness (OR:5.4; 95%CI: 2.2–13.2), drowsiness (OR:4.6; 95%CI:2.5–8.7), and weakness (OR:4.2; 95%CI:1.6–11.0) compared to non-users. A dose-response trend was observed for constipation but not for the other side effects. Nausea/vomiting (OR:2.0; 95%CI:1.1–3.6) and dizziness (OR:1.9; 95%CI:1.1–3.4) were more often associated with oxycodone than with morphine. ConclusionAs observed for chronic pain treatment, side effects are highly prevalent during short-term opioid treatment for acute pain. Physicians should inform patients about those side effects and should consider prescribing laxatives.

MP36: Short-term side effects associated with opioids for acute pain

Introduction: Opioid side effects are common when treating chronic pain. However, the rate of opioid side effects for acute pain has rarely been examined, particularly in the post emergency department (ED) setting. The objective of this study was to evaluate the short-term incidence of opioid induced side effects (constipation, nausea/vomiting, dizziness, and drowsiness) in patients discharged from the ED with an opioid prescription. Methods: This was a prospective cohort study of patients aged ≥18 years that visited the ED for an acute pain condition (≤ 2 weeks) and were discharged with an opioid prescription. Patients completed a 14-day diary assessing daily pain medication use and side effects. Results: Mean age of the 386 patients included was 55 ± 16 years; 50% were women. During the 2-week follow-up, 80% of patients consumed at least one dose of opioids. Among the patients who used opioids, 38% (95%CI: 33-48) reported constipation, 27% (95%CI:22-32) nausea/vomiting, 30% (95%CI:25-35) dizziness, 51% (95%CI:45-57) drowsiness, and 77% (95%CI:72-82) reported any side effects. Adjusting for age, sex, and pain condition, patients who used opioids were more likely to report any side effect (OR 7.5, 95%CI:4.3-13.3) and constipation (OR 7.5, 95%CI:3.1-17.9). A significant dose response effect was observed for constipation but not for the other side effects. Nausea/vomiting (OR 2.0, 95%CI:1.1-3.6) and dizziness (OR 1.9, 95%CI:1.1-3.4) were associated with oxycodone compared to morphine. Conclusion: Similar to chronic pain, opioid side effects are highly prevalent during short-term treatment for acute pain. Physicians should be aware and inform patients about those side effects.

FINAL YEAR MEDICAL STUDENTS’ KNOWLEDGE, ATTITUDE AND PRACTICE OF MEDICO-LEGAL PROBLEMS: A CROSS SECTIONAL STUDY AT IBN SINA NATIONAL COLLEGE IN JEDDAH

Forensic medicine encompasses various subspecialties that involve resolving legal issues using diverse techniques. Medical students should be prepared for their near future career, in particular, the challenge of facing medico-legal cases with their consequent legal responsibilities. The aim of the study was to assess final year medical students’ knowledge, attitude and practice of medico-legal problems. This crosssectional study included randomly selected 138 6th year medical students at Ibn Sina National College in Jeddah. 56 (40.6%) were male and 82 (59.4%) were female, aged 24.46±1.45 years, and 114 (82.6%) were Saudis. A pre-designed, self-answered 23-item questionnaire in English was devised by a specialist in the field and circulated though Survey-Monkey forms from November 2018 to January 2019. Most students had good knowledge (66.27%) and positive attitude (71.47%). Some had poor (14.49%) or no knowledge (19.24%), negative (15.67%), or borderline attitude (14.31%). Poor responses were the legal value of incomplete reports (28.99%), notifications of relatives before police notification (15.94%) and informed consent before photographing (21.74%). Many students (44%) had negative attitude towards their current medico-legal overall education and knowledge. Only 14.5% had been previously involved in photographic documentation. Students thought that the main sources of stress/pressure during managing medico-legal problems were the victim’s relatives (69.79%), followed by fear of legal consequences (54.17%). They also thought that the best educational stage for medico-legal training programs should be during undergraduate years (57.25%), or less frequently during residency (55.8%) or post-graduate years (46.38%). In conclusion, final year medical students were prepared for their future practice by good knowledge and positive attitude towards medico-legal problems. However, many gaps were detected between theory and practice. Therefore, we recommend medical colleges to initiate an undergraduate clinical forensic medicine training program. Moreover, residents and post graduate emergency physicians need to know their medico-legal responsibilities and to acquire technical skills to perform forensic evaluations of victims.

Vesicocervical Fistula Post Emergency Repeat Caesarean Delivery

Urogenital fistula is an abnormal communication between the urinary tract and genital tract at different levels, vesicocervical fistula being rare. It has been the consequence of poor obstetric care in developing world and iatrogenic following gynecologic surgeries in developed world. Diagnosis is mainly done by clinical examination, conventional dye test with methylene blue and imaging studies and cystoscopy, if required. Though prevention is better than cure, early detection followed by transurethral bladder drainage and surgical correction via vaginal or abdominal approach is the mainstay of treatment. A 30 years postnatal mother was referred to our centre with complaints of continuous involuntary leakage of urine per vaginum following emergency repeat caesarean delivery done six weeks back. There was pooling of urine over Sim’s speculum and dye test was positive. Under spinal anesthesia, vesicocervical fistula was repaired vaginally and patient was kept on Foley’s catheter for three weeks. Dye test performed at the end was negative. She went home dry and continent. We present here a rare case of successful repair of vesicocervial fistula post emergency repeat caesarean delivery.

Bacteriological analysis of infected wound and their antibiotic sensitivity following emergency caesarean section-a study of 100 cases

Background: Emergency caesarean section is one of the commonly performed operation in the department of gynae and obstetrics.Objectives: The aim and objective of the study was to evaluate the organisms responsible for post emergency caesarean wound infection and their antibiotics sensitivity.Materials &amp; Methods: The study is a prospective type of cross sectional study where 100 patient of post emergency caesarean wound infection was evaluated during July 2012 to December 2012 (6 Month Duration) at Rajshahi Medical College Hospital (RMCH) Rajshahi. The wound swab was sent for culture and sensitivity test.Results: The peak incidence of wound infection to between 6th - 8th post operative day. In wound discharge shows various organism but 16% showed no growth. The most of the infected wound showed (48%) thick creamy pus and the organisms isolated is Staphylococcus. antibiotics mostly used were Ciprofloxacin, Cephradine and Metronidazole. This study revealed that maximum wound infection is due to S. aureus. Regarding antibiotic sensitivity of the cultured organisms, all of them are sensitive to Imepenem (100%). Staphylococcus aureus mostly sensitive to Flucloxacillin (79.16%). Ciprofloxacin sensitivity is found in 58.33% cases. E coli mostly sensitive to Imepenem (100%) followed by Ceftriaxone (53.84%). Klebsiella pneumonia found mostly sensitive to Imepenem (100%) followed by Ceftriaxone (75%) and Cephradine (50%).Conclusion: Selection of appropriate antibiotic is important to reduce post caesarean wound infection.KYAMC Journal Vol. 9, No.-2, July 2018, Page 61-64

Awareness &amp; Knowledge Regarding Research Skills among Post Graduate Emergency Medicine Doctors in Teaching Hospitals of Kolkata

In today’s world, all doctors are required to keep their medical knowledge and training up-to-date. Doctors should provide effective treatments based on the ‘best available evidence’. It is widely accepted that evidence-based medicine has contributed significantly to the practice of medicine and advancement of medical science. Every doctor should strive to contribute to the generation of evidence by conducting research. Objectives of the Study: To assess the awareness and knowledge of research skills among post graduate emergency medicine doctors in teaching hospitals of Kolkata and identify any further scope inculcating research skills of emergency medicine residents leading to contribution in health research. Methodology: It is a multicentre, prospective questionnaire survey among post graduate emergency medicine residents of teaching hospitals in Kolkata. The sample size was 100 done during period of 1 year. Discussion: 60.6% were more than 29 years of age and 32% among 26-28. 60% had prior experience of writing research paper and even then 96% wanted to participate in research methodology workshop. 99% knew that research improves outcomes in patient management and that they require continue guidance and supervision during their thesis projects. Only few were able to complete their research work on time. The major reasons cited for poor research activity in our study were inadequate facilities for research and lack of time. In institutional reasons, we found 54% had found inadequate support from mentors or assistants and 20% cited lack of research curriculum. 51% believe that active participation can be done by MCI/DNB and universities by allocating time for research and making it mandatory. Conclusion: The study population was male predominant and young with majority having the background of research knowledge. Most of the participants however agreed that research methodology workshop was needed to improve their knowledge and in fact should be made compulsory in post graduation courses. 97% felt that specific time should be allotted separately during curriculum planning for research. In conclusion research is the realized need among our study population. Steps should be taken for promotion of research among emergency medicine post graduate residents.

Predictors of morbidity and mortality post emergency abdominal surgery: A national study.

Background/Aim:Emergency surgeries have increased in Saudi Arabia. This study examines these surgeries and associated complications.Patients and Methods:This was a prospective multicenter cohort study of patients undergoing emergency intraperitoneal surgery from the eight health sectors of Saudi Arabia. Patients' data were collected over 14 days.Results:In total, 283 patients were included (163 men [54.06%]). The majority of cases were open surgery (204 vs. 79). The 24 h and 30-day mortality rates for the cohort were 0.7 and 2.47%, respectively. Twenty-nine patients (10.24%) required re-intervention, while 19 (8.12%) needed critical care admission. The median length of hospital stay was 3 days. Multivariate analysis showed American Society of Anesthesiologist (ASA) classification score (P = 0.0003), diagnosis (P < 0.0001), stoma formation (P = 0.0123), and anastomotic leak (P = 0.0015) to correlate significantly with 30-day mortality.Conclusion:American Society of Anesthesiologist score, diagnosis, stoma formation and anastomotic leak are associated with 30-day mortality after emergency surgery in Saudi Arabia.

Reasons of repeat dental treatment under general anaesthesia: A retrospective study.

The purpose of this chart review study was to investigate the common factors that exist in paediatric patients requiring a repeat dental treatment under general anaesthesia (GA2) within four years after the initial dental treatment under general anaesthesia (GA1). The Electronic Health Records of one to 12 year-old children who received dental treatment under general anaesthesia (GA) between April 2004 and October 2009 were identified and analysed by a single examiner. Children who had GA2, within a four year period following GA1 were categorised as cases. Children who had only one dental treatment under GA were considered the control pool. Each case was matched to three controls based on sex and age range at GA1 of &#177; 6 months. Other recorded variables included: date of birth, date of GAs (GA1 and GA2 for cases; GA1 for controls), type of payment, dmfs before GA1, dental treatments provided under GA, return of 1-week post-GA1 follow-up, frequency of recare/recall visits following one-year post-GA1 visit and the type and frequency of post GA1 emergency visits. Out of 581 subjects, 29 (4.99%) cases were matched to 87 controls. Medically compromised patients had four times the risk of GA2. At GA1, cases received statistically significant less sealants (p=0.026), less extractions (p<0.0001), and more composite restorations (p=0.0002) compared to controls. Medically compromised children and children treated with more composites and fewer sealants and extractions at their initial dental treatment under general anaesthesia were more likely to have a repeat dental treatment under general anaesthesia within 4 years.

Evaluation of a smart toilet in an emergency camp

An experimental prototype of the eSOS (emergency Sanitation Operation System) Smart Toilet® was evaluated in an emergency settlement in the Philippines. The toilet was equipped with sensors and information communication technologies (ICT) for an efficient operation in an emergency setting. The field testing aimed at evaluating the toilet's service capacity related to the user frequency/intensity obtaining insight on the usage patterns in an actual post emergency situation. In addition, the novel features and functionality of the toilet were assessed. Operational performance of the toilet was assessed based on data collected from nearly 700 users within a 7-weeks period. The eSOS Smart Toilet has been properly operating during the evaluation period. A methodology to distinguish defecation and urination activities was developed based on determining discharges to faeces and urine tank. The toilet achieved up to 97% savings on water consumption compared to conventional toilets. The application of sensors and ICT features, combined with manually obtained data informed comprehensive usages data e.g. 62% of identified users were female users, 40% children, and 60% of the visits were for urination and 40% and for defecation. The accumulation of urine, faeces and grey water was measured to allow for a responsive maintenance resulting in optimized operation and increased interest to use the toilet. The field evaluation generated ideas for further improvements in terms of cost savings, services, and an overall vision for sustainability.

Mathematical modeling for a p-mobile hub location problem in a dynamic environment by a genetic algorithm

• Developing a mathematical model for the p -mobile hub location problem. • Proposing a genetic algorithm augmented by a local search to solve the proposed model in large instances. • Analysis of proposed genetic algorithm operators performance in the proposed problem. • Comparison of the proposed model with classic networks to show mobile hub effectiveness in the networks. • Sensitivity analysis to show the model validation as well as the model applicability. In this study, a new mobile p -hub location problem in a dynamic environment is proposed, where there are mobile facilities inside hub nodes that can be transferred to other nodes in the next period. Mobile facilities have a mobility feature and can be transferred to other nodes in order to meet demand. Using such facilities will save extra hub establishment and closing costs in networks. This approach can be used in some real-world applications with rapidly changing demand, such as mobile post offices or emergency medical service centers, because designing immobile hub networks may be less efficient. In addition, designing dynamic hub networks entails establishing and closing costs in different periods. The model also considers a mobility infrastructure of hub facilities. The numerical examples confirm that a mobile hub network is more efficient than an immobile hub network in a dynamic environment. The effect of different parameters on the model is analyzed to consider its applicability conditions. A genetic algorithm, along with tuned parameters and a simulated annealing algorithm, are proposed to solve the model in large instances. Proposing of a model considering mobility feature in the hub location networks, proving its efficiency and finally proposing a proper solution algorithm are main contributions of this study. The model and solutions algorithms were analyzed by more numerical instances using Australia post (AP) dataset.

A computer emergency trainer for dispatchers of the united power system of Ukraine

The purpose of this work is forming structure of emergency trainer for dispatchers of the IPS of Ukraine. The research method is computer simulation of electric power systems. The trainer structure is developed using dynamics calculations after big disturbances using software AVR-74 and virtual structures to display post emergency EPS modes using full-scale mode simulator PORT. Operation of the developed trainer has been demonstrated for an example of dispatcher training on the theme «Balancing mode of the IPS of Ukraine after wearing-out of emergency automatics in case of line disconnecting in the IPS cross section West-Vinnitsa». As an information model, is used the test-based model of the West-Vinnitsa section (54 bases, 72 branches, 18 generators), in which the electric network of 750 kV and 330 kV of the South-Western EPS and its connections with adjacent regional power systems are presented. Electric mode of the IPS of Ukraine is isolated from the UPS of Russia. The calculations of the stability at the cross section of West-Vinnitsa for planning the regime of winter maximum load showed the need for automatic unloading of the Rivne nuclear power plant (RNPP), which, in the case of switching off power transmission line 330 kV Shepetovka-Zhytomyr, turns off the units 1,2 RNPP. The current frequency in the post emergency mode after wearing-out of emergency automatics is the 49.88 H. It requires action to restore the normal frequency level. Consistent steps to increase the frequency are: loading Dnipro-1 hydro power plant (HPP) up to a maximum capacity of 600 MW, loading Kremenchug HPP at 150 MW, loading two units of Trypilsky power plant up to 630 MW. As a result, the frequency is set to 49.92 Hz.Computer emergency trainer for dispatchers provides:formation of the calculation model of the UPS with the use of information about retrospective regimes from the archive of the software KOSMOS;calculations of normal, repair, weighted and self-aligned on frequency and voltage of post-emergency stationary electric modes of the IPS;verification of static and dynamic stability of the UPS taking into account the automatic regulators of excitation of synchronous generators, automatic regulators of turbine speed and hydro units of power stations, system anti-emergency automatics;calculations of long transient processes after a sudden disturbance of the balance of active power of the IPS, taking into account the effect of frequency unloading automation and automation of limiting the increase of the frequency of current;execution of calculations of cascading accidents in a given scenario;issuance of operative information about the mode of IPS to remote monitors of the simulator, which is carried out by means of a full-function mode simulator PORT.Ref. 3, fig. 7.

Role of subcutaneous suction drain in reducing surgical site infections after emergency laparotomy

Background: One of important morbidity postoperatively is surgical site infection and the important cause is collection of blood and serous fluids which can get infected and this factor is even more important in emergency laparotomies. our prospective randomised study compares the incidence of surgical site infection in post emergency abdominal surgical wounds with subcutaneous suction drains versus those in whom drain was not placed.Methods: A prospective interventional study of 100 subjects done in department of surgery at rural tertiary centre. on the basis of exclusion and inclusion criteria patient were randomly selected for cases (with post-operative suction drain) and controls. subcutaneous drain in emergency setting play significant role in reducing the incidence of surgical site infection which is significant statistically.Results: 24% of patients in drain group develop surgical site infections. 50% of patients in non-drain group develop infection. Incidence of infection in drain group was lower than the no drain group (p value 0.05) and was statistically significant.Conclusions: Subcutaneous drain in emergency laparotomy play significant role in reducing the incidence of surgical site infection