A massive free-floating right atrial thrombus in a patient with permanent atrial fibrillation complicated by a pulmonary embolism: A case report.
The association between atrial fibrillation and left atrial thrombus had been widely described; on the contrary, the relation between atrial fibrillation and right atrial thrombus hasn’t been demonstrated. We always thought that right atrial thrombus originated from deep venous thrombosis and named as “emboli in transit”. We report the case of a 91 year-old male patient, presenting with a permanent atrial fibrillation, his echocardiography showed a huge floating right atrial thrombus complicated with a bilateral pulmonary embolism. Our aim is to demonstrate through this case the association between atrial fibrillation and right atrial thrombus, using our findings in the literature, and comparing between the prevalence of right and left atrial thrombi in association with atrial fibrillation, explaining the difference between the both, and discussing therapeutic options.
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A novel method for the estimation of carrier frequency offset in OFDM systems
In the latest development of Orthogonal Frequency Division Multiplexing (OFDM) communication system, the system performance can be distracted by the frequency offsets (FOs) which can demolish the orthogonality of the subcarriers, and hence leads to a number of impairments in the received signal, thereby making its detection incorrect. In this paper, a new threshold-based frequency offset estimation algorithm for orthogonal frequency division multiplexing (OFDM) systems is proposed. Through a detailed analysis and simulation over AWGN channel, it has been shown that the proposed method shows good performance i.e. it offers low error variance as the SNR (signal to noise ratio) increases.
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A Review of Soil Enzyme, Humic Acid and Microbial Activities Methods of Assessment: The Pros and Cons
In view of the place of biological parameters in defining soil health, many scientists of repute have developed methods of assessing environmental parameters one of which is soil health. Soil health is assessed from several angles: biological, chemical, physical, bearing in mind that the top and sub soils are the zones of plant growth and active flora and fauna activities. Biological parameters of the soil cannot do without reference to enzyme, humic acid and microbial activities. A lot of methods have been developed for their assessment and a lot of scientists have adopted and modified the methods with varying results. Each of them have additional benefits. There may be limitations but that is the basis of science. A big thank you to all the scientists living and dead who have shaped the scientific community and the world from their research and findings. All of them have been recognized globally directly as nobel laureates and indirectly through other honours by peer groups. This paper presents enzyme and microbial activities methods of assessment and their pros and cons.
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A strategic experimentation towards multi objective optimization during turning of hardened tool steel using Taguchi integrated with Deng’s similarity approach
Environmental and Ecological issues call for the reduction in usage of cutting fluids in metal cutting industry. New techniques are being inquired to achieve this objective. Hard turning with minimum quantity lubrication is one such technique which can alleviate the pollution problems associated with cutting fluids. In the present work, vegetable oil based cutting fluids like castor oil, palm oil and ground nut oil is made to drop at tool-work interface using over-head system. The present paper deals with experimental investigation carried out for machinability study of hardened AISI D3 steel in combination with CVD coated cemented carbide inserts of different styles and to obtain optimum process parameters using Deng’s similarity approach. An orthogonal array, overall performance index and analysis of variance ( ANOVA) are applied to study the performance of process parameters such as insert style, cutting fluid cutting speed, feed and depth of cut with consideration of quality characteristics i.e., surface roughness, material removal rate and specific energy. Finally a clear presentation is made for Deng’s approach
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A study of different external beam radiotherapy techniques for cervix cancer and measurement of dose to the rectum
The aim of the present study is to investigate the rectal dose during three different radiotherapy techniques of cervical cancer. The study was carried out using a Anderson Rando female phantom. The thermo-luminescent dosimeter (TLD) capsules and detectors of rainbow dosimeter were employed for rectal and target volume dose determination. Several techniques of external beam radiation therapy such as two-field (AP-PA), three-field and four-field with equal applied dose were planned. During application of different radiotherapy techniques, the maximum dose received by rectum is due to the two-field technique. The results of two dosimetry types were compared with each other, In three-field, four-field equal applied dose, rectal dose was lower than tumor dose. This study showed that using TLD and rainbow dosimetry during radiotherapy could have a useful role as a predictor of choosing appropriate technique for preventing future rectal complications. Dose limitation to the rectum could possibly be achieved by using three-field and four-field techniques with equal tumor dose while maintaining a high dose to the tumor.
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A Study on Customer Relationship Management with Special Reference to Private Hospital in Tiruchirappalli
The aim of this study is to investigate, identify and compare Human Resource Management (HRM) practices in private hospital in Tiruchirappalli, Tamil Nadu India. Self developed survey; based on literature reviews are an instrument used for data collection. The findings of this study such as social characteristics sex, ages religion, community, nativity etc., are important for understanding the needs of human resource management practices in hospitals. This study also deals with the contributions of different factors towards quality care of patients and work culture among the staff.
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Acceptability and feasibity for scale-up of the new birth companion role of traditional birth attendants in Kakamega county, Kenya
Reduction of maternal and newborn mortality is still a global public health challenge. The other challenge is redefining the roles of traditional birth attendants with a view of integrating them into the formal health system. To this end, the Linda Afya ya Mama na Mtoto Project implemented in Kakamega county re-oriented 345 former traditional birth attendants into the new role of birth companions. It was therefore fitting to establish perceptions of stakeholders on this new roleTo establish perceptions of stakeholders on the birth companion role of former traditional birth companions. A cross-sectional qualitative design was applied in this study. Eighteen (18) in-depth interviews were conducted with health service providers, health managers, programme officers, and policy makers based on similar interview schedules. Ten focus group discussions were conducted with pregnant and lactating women, male spouses and community health workers. Raw data was transcribed and analyzed using Atlas Ti software. The following six themes emerged: the policy environment; perceived benefits, acceptability, challenges, the issue of integration into the formal health system and sustainability. The policy environment was not conducive for integration into the formal health system. However, across the board, the new role was highly acceptable linked to numerous perceived benefits; remuneration and travel difficulties were considered major bottlenecks to sustainability. The new birth companion role of former TBAs is widely acceptable and can be feasibly sustained and scale-up. Birth companionship is both a health system and client-centred high impact intervention. Governments should institutionalize new birth companion role of former TBAs as a way of incorporating them into the formal health system given the evidence on benefits to the client and health system. Conduct studies on cost-effectiveness of various sustainability and incentivizing mechanisms
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Acoustic neuroma: appearance of ice-cream cone on MRI
Acoustic neuromas represent 6-7% of all intracranial tumors and develop slowly in the internal auditory canal, in the cerebellopontine angle. It is usually unilateral. The bilateral forms are exceptional and suggest neurofibromatosis type 2 "NF2". It can cause neurological disorders because of its development but also because of its volume and the compression caused on adjacent neurological structures. Magnetic resonance imaging (MRI) is the standard imaging modality for the diagnosis of the disease. which shows a mass of the cerebellopontine angle of intermediate signal in the T2-weighted sequence, heterogeneous, strongly enhanced after injection, with the famous sign of the ice cream cone aspect testifying to damage of the VIII nerve in the internal auditory canal, these tumors are classified according to their extent and size, which conditions the therapeutic management, the treatment is based on microsurgery, radiosurgery or therapeutic abstinence, depending on the tumor stage.
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Action Oriented Learning (AOL) and tribal empowerment: the panacea for sustainable rural development-experiences from integrated tribal development agencies of Andhra Pradesh, India
Rural development hinges on soci-economic and institutional development of the region and the inhabitants. Inclusion of excluded confirms to sumptuous development and amidst women is considered as one of the strong deterministic pillars to it. The “
Action-Oriented Learning (AoL)” is a process led approach of inclusion of marginalized to the mainstream development, and thereby ensures sustainable development. The study is assessing the inclusive impact of “Sustainable Tribal Empowerment Project-(STEP)” executed in four northern districts of the state of Andhra Pradesh to restore the life and livelihood of tribal adhering
in-situ approaches to rural development as well as fostering due cognizance of social-ecological-institutional factors.
The paper is attempting to assess the induced impact as well as suitability of the strategies and the possibility of replication. The study establishes that AoL approach to tribal women empowerment is happily accepted by the poor and marginalized section of the society without any inhibition. The strategy adopted is enabling them to retain their social status, self-esteem and value in the society as well as inside the household. The vibrancy and multi-faceted abilities of women headed institutions in the ITDAs are tested to address socio-ecological-institutional and economical needs for acclaiming economic prosperity in the rural and tribal areas and proven successful. Proliferation and diversifications injected to the system of livelihood activities to meet the emerging economic need is proven to be essential and worthy. In view of the complexity of activities and institutions in tribal areas, the study therefore suggests that (i) priority lending to be extended to institutions working with integrated activities for integrated development, (ii) extensive financial support to purely women organizations/institutions ensures better and quick multiplier effect, (iii) reliving off the stringent policy of collateral securities to financial disbursement for institutions in tribal and rural areas , and (iv) following up of NABARD guidelines for institutional assessment for loan disbursement to women headed institutions.
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Activated Carbon Prepared from Rice Husk: Nitric Acid Modification and BTX Adsorption
Activated carbons (AC) prepared from rice husk by KOH activation in inert atmosphere at 750 and 850 0C were modified with nitric acid. Activation at 850 0C resulted in better pore development and was confirmed by SEM, Boehm titration and BET. The modification by nitric acid could reduce the particle size while enhance the amount of hydroxyl and carbonyl groups on the surface of AC samples. Bath adsorption of benzene, toluene and m-xylene (BTX) as well as dynamic adsorption of m-xylene were measured in order to evaluate the performance of AC for removing volatile organic compounds (VOCs). The results showed that AC sample prepared at 850 oC (RH-850) exhibited the best benzene adsorption capacity of 11.62 mmol g-1 in bath adsorption and m-xylene adsorption capacity of 9.140 mmol g-1 in dynamic adsorption at 50 0C.
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