A randomized clinical trial compared the effect of intra-alveolar 0.2 % Chlorohexidine bio-adhesive gel versus 0.12% Chlorohexidine rinse in reducing alveolar osteitis following molar teeth extractions

Objectives: To evaluate socket healing, incidence of acute alveolar ostieitis (AO) and associated pain following single molar tooth extraction in patients who receive intra-alveolar 0.2% chlorhexidine (CHX) gel, and those who rinsed with 0.12 % CHX rinse. Study Design: A prospective randomized clinical trial was conducted on two parallel groups of patients. Group1 (141 patients): Rinsed with 0.12 % CHX rinse from the second postoperative day, two times daily for a week. Group2 (160 patients): Who had direct intra-alveolar application of 0.2% CHX gel and day 3 post-operatively. The socket was evaluated 3 and 7 day postoperatively for the presence of AO by checking probing tenderness in the socket, empty socket, food debris, halitosis and pain assessment by VAS. Results: Forty-eight AO cases were diagnosed out of 301 extractions (15.9%). In Group1, 25 cases were found (17.7%) while 23 cases were found in Group2 (14.4%). The difference was not statistically significant ( p =0.428). Presence of empty socket and food debris in Group1 were higher than in Group2 but the difference was not sta - tistically significant ( p = 0.390 & p = 0.415). Occurrence of halitosis in Group2 was more than Group1, but the difference was not significant ( p = 0.440). Statistical significance was found between AO in extraction done by root separation (29%) and those routinely extracted (12.3 %) ( p =0.001). Conclusions: Postoperative evaluation of molar extraction sockets that received direct intra-alveolar application of 0.2% CHX gel showed insignificant less occurrence of AO when compared with 0.12 % CHX rins

Warranty and Maintainability Analysis for Sensor Embedded Remanufactured Products in Reverse Supply Chain Environment

Remanufactured products are very popular with consumers due to their appeal to offer the latest technology with lower prices compared to brand new products. The quality of a remanufactured product induces hesitation for many consumers, in regards to its efficacy and reliability. One stratagem that remanufacturers could employ to encourage customer security are product warranties. This paper studies and scrutinizes the impact that would be had by offering renewing warranties on remanufactured products. This study was able to determine the optimal costs of warranty for two-dimensional non-renewable warranty offered on remanufactured products using the simulation model and design of experiments

Kinematic Design Analysis and Optimization of Mobility System Using MATLAB

209-212In this research work, several sophisticated types of equipment and automation have been studied, points taken and considered to realise the locomotion of modern territory of all uneven environments. One of the most main mission and structure of this study is the preferred simplicity of the bipedal walking locomotion system. The study included from simple to complicated legs as like single-legged, like humanoid and up to sixteen legs like a caterpillar. Most of the bipedal walking robots are with research study and we concentrated to emphasizes the significance of robotic legged motion stability in the compact. These bipedal walking robots can walk on rough surfaces, turn efficiently and climb staircase if needed. In particular, a suitable bipedal walking model having an upper link and a lower link will make the system to the desired motions, which has been experimentally exposed to provide a stable walking system. The MATLAB software tool is used to optimize the mechanical constraints and to compare, analyse and investigate the influence of motion stability. The simulation results show a possible performance of projected leg bipedal walking mechanism

AN MCDM-BASED APPROACH TO COMPARE THE PERFORMANCE OF HEURISTIC TECHNIQUES FOR PERMUTATION FLOW-SHOP SCHEDULING PROBLEMS

In the industrial and manufacturing sectors, scheduling is an essential component in the process of determining crucial production cost aspects of corporate strategy. Solving flow-shop problems minimizes the makespan it takes for all jobs to be completed, reducing production costs and boosting output. Therefore, many heuristics techniques have been developed to assist in reaching a good and quick solution. However, newly developed techniques necessitate testing their performance against the classical ones. Therefore, this paper aims to conduct a comparative analytical, computational study of heuristic techniques for solving Permutation Flow-Shop Sequencing Problems and evaluating their performance. Eight techniques were compared by generating a set of problems of varying sizes and then solving them via a developed computer simulation program. Furthermore, a multi-criteria decision-making approach is followed for their performance evaluation. Results of the study revealed that based on six performance evaluation criteria, Dannenbring’s technique is the first best, followed by the Slope Index technique as the second best, then the technique by Campbell, Dudek, and Smith, Hundal, the Time Deviation technique, Palmer, Gupta, and the technique by Jayasankari, Jayakumar, and Vijayaragavan, respectively. This paper puts forward a ranking of the developed techniques for flow-shop problems and a framework for the performance evaluation of new permutation flow-shop scheduling problem methods

Kinematic Design Analysis and Optimization of Mobility System Using MATLAB

In this research work, several sophisticated types of equipment and automation have been studied, points taken and considered to realise the locomotion of modern territory of all uneven environments. One of the most main mission and structure of this study is the preferred simplicity of the bipedal walking locomotion system. The study included from simple to complicated legs as like single-legged, like humanoid and up to sixteen legs like a caterpillar. Most of the bipedal walking robots are with research study and we concentrated to emphasizes the significance of robotic legged motion stability in the compact. These bipedal walking robots can walk on rough surfaces, turn efficiently and climb staircase if needed. In particular, a suitable bipedal walking model having an upper link and a lower link will make the system to the desired motions, which has been experimentally exposed to provide a stable walking system. The MATLAB software tool is used to optimize the mechanical constraints and to compare, analyse and investigate the influence of motion stability. The simulation results show a possible performance of projected leg bipedal walking mechanism

An In vitro Analysis of the Efficacy of Saudi Clover and Talh Honey on Bacterial Resistance to Antibiotics and Biofilm Formation

The emergence of multidrug-resistant bacteria presents a significant global health risk, necessitating the exploration of alternative treatment options. This in vitro study aimed to evaluate the efficacy of Saudi honey Clover and Talh against Gram-negative and positive bacteria, including Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus epidermidis and Methicillin-resistant Staphylococcus aureus. All tested bacteria were collected and two types of Saudi honey were diluted and stored. This is followed by microbiological identification, prolonged exposure to honey (10 times), antibiotic susceptibility testing, and biofilm formation assay. The findings offer valuable insights into potential antimicrobial properties of Saudi honey against bacteria. The results demonstrated that Talh and Clover Honey caused alterations in the antimicrobial sensitivity of the bacteria tested. In Gram-negative bacteria, E. coli treated with honey showed increased sensitivity to imipenem, while P. aeruginosa and K. pneumoniae became increasingly susceptible to cell wall inhibitors. In Gram-positive bacteria, adapted MRSA and S. epidermidis strains exhibited increased sensitivity to ampicillin, amoxicillin/clavulanic acid, and ceftriaxone. The results suggest that honey’s antimicrobial effects vary based on its components and bacterial species. Consequently, further analysis is required to uncover the underlying mechanisms of the observed changes. The complex interactions between honey and pathogens, as shown by varying bacterial responses and limited impact on biofilm formation, highlighting the necessity for alternative therapeutic approaches. This study contributes to the existing evidence on the antimicrobial properties of honey

Eradication Of Endodontic Infection By Instrumentation Role Of Nursing In The Management

There are a number of various working processes that are involved in endodontic therapy. These procedures include the isolation of the operating field, access to the pulp chamber, cleaning and shaping stages, and finally, the necessity for a three-dimensional filling of the canals. During each stage, a set of instruments that are either single-use or sterilizable is required. Nursing has a very essential part in the management of endodontic infection eradication because they will be the first line of defense in recognizing the symptoms being experienced by the patient. When it comes to reusable tools, it is essential to pay attention to the removal of material that has been deposited on the blades, which is not easy to remove manually. This review demonstrated that the use of single-use or first-use instruments necessitates the implementation of procedures associated with presterilization or sterilization

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112