Pattern of trauma in a rural hospital and factors affecting mortality in trauma patients

Background: Trauma is associated with human civilization since ancient times. With the modern urbanization and increase in motor vehicles incidence and pattern of trauma changed. Hence the present study was conducted to study the pattern of trauma in a rural population admitted to a Kasturba Hospital Sewagram (Rural Hospital) and to detect factors affecting the mortality of trauma patients.Methods: A prospective randomized controlled trial was conducted in Department of general surgery, Kasturba Hospital, Mahatma Gandhi Institute of Medical Sciences, Sewagram. A total number of 1525 trauma patients were studied over a period of 2 yrs. The detail examination was done and findings were recorded. All the factors affectingmortality of trauma patients were studied.Results: Trauma affects younger population more with a male predominance. Incidences of vehicular accidents are more than the non-vehicular accidents and other modes of trauma. Head injury was most common type of injury as observed in the present study. Advancing age and polytrauma were the main factors for high mortality. The mortality increased as the Revised Trauma Score decreased. While mortality increased with increasing Injury Severity Score and vice versa.Conclusions: Age, sex, mechanism and type of injury affect the mortality in Trauma Patients. The mortality increased as the Revised Trauma Score decreased while mortality increased with increasing Injury Severity Score

TWINLATIN: Twinning European and Latin-American river basins for research enabling sustainable water resources management. Combined Report D3.1 Hydrological modelling report and D3.2 Evaluation report

Water use has almost tripled over the past 50 years and in some regions the water demand already exceeds supply (Vorosmarty et al., 2000). The world is facing a “global water crisis”; in many countries, current levels of water use are unsustainable, with systems vulnerable to collapse from even small changes in water availability. The need for a scientifically-based assessment of the potential impacts on water resources of future changes, as a basis for society to adapt to such changes, is strong for most parts of the world. Although the focus of such assessments has tended to be climate change, socio-economic changes can have as significant an impact on water availability across the four main use sectors i.e. domestic, agricultural, industrial (including energy) and environmental. Withdrawal and consumption of water is expected to continue to grow substantially over the next 20-50 years (Cosgrove & Rijsberman, 2002), and consequent changes in availability may drastically affect society and economies. One of the most needed improvements in Latin American river basin management is a higher level of detail in hydrological modelling and erosion risk assessment, as a basis for identification and analysis of mitigation actions, as well as for analysis of global change scenarios. Flow measurements are too costly to be realised at more than a few locations, which means that modelled data are required for the rest of the basin. Hence, TWINLATIN Work Package 3 “Hydrological modelling and extremes” was formulated to provide methods and tools to be used by other WPs, in particular WP6 on “Pollution pressure and impact analysis” and WP8 on “Change effects and vulnerability assessment”. With an emphasis on high and low flows and their impacts, WP3 was originally called “Hydrological modelling, flooding, erosion, water scarcity and water abstraction”. However, at the TWINLATIN kick-off meeting it was agreed that some of these issues resided more appropriately in WP6 and WP8, and so WP3 was renamed to focus on hydrological modelling and hydrological extremes. The specific objectives of WP3 as set out in the Description of Work are

PENGARUH BEBAN KERJA TERHADAP STRES KERJA SERTA IMPLIKASINYA PADA TURNOVER INTENTION (Studi pada karyawan PT. Victory International Futures Kota Malang)

Tujuan penelitian ini adalah untuk mengetahui pengaruh beban kerja terhadap stres kerja serta implikasinya pada turnover intention pada karyawan PT. Victory International Futures Kota Malang. Penelitian ini merupakan penelitian kuantitatif dengan menggunakan metode sampling jenuh, dimana seluruh populasi digunakan sebagai sampel 50 karyawan PT. Victory International Futures Kota Malang. Penelitian ini menggunakan data primer. Pengunpulan data dalam penelitian ini adalah dengan menyebarkan dan mengumpulkan kuesioner menggunakan skala likert 5 poin. Data dalam penelitian ini dianalisis menggunakan PLS (Partial Least Square) Ver. 3.0 dengan bantuan sofware pada komputer. Hasil penelitian menunjukkan bahwa terdapat pengaruh positif dan signifikan antara beban kerja dengan stres kerja, beban kerja dengan turnover intention, stres kerja dengan turnover intention dan stres kerja mampu memediasi pengaruh beban kerja terhadap turnover intention

Solar Operated Coin Based Universal Mobile Battery Charger

The growth of mobile phone market is increase day by day and the need for charging the mobile battery is required anytime and anywhere. This paper describes mobile battery charger using solar panel system based on coin and RFID module.Many times on Public Places such as Railway Station & Bus Stop, Unfortunately battery gets discharge during conversation. To overcome this problem the universal mobile battery charger is design. This system is very useful specially in semi urban and rural area where grid power is not available for partial/full time on daily basis. The coin-based mobile battery chargers are designed to solve this problem. This design is based on AVR ATMEGA16, a 40 pin microcontroller with LCD displays showing the actual time left. During the time period, a relay output is latched. This can be used at Hotels, colleges, bus station, Conference centers, Exhibition halls, service offices, Shopping malls, Airports, Train terminals. So that the mobile phone users can reactivate a low battery or dead battery by simply plug in & charging for one rupee

Calidad del servicio del Hospedaje Entre Dos de la ciudad de Iquitos, abril 2022

The thesis Quality of the Lodging Service between two in the city of Iquitos, April 2022, has as its general objective to analyze the dimensions of the quality of service in the lodging between two in the city of Iquitos, period April 2022, the research is of level descriptive, basic type of non-experimental and cross-sectional design. The population consisted of 35 external clients, which is the monthly average number of room users. The results show that 85.7% of the external clients have a good perception of the quality of the service; Regarding the dimensions, security and empathy stand out with perceptions of 85.7% as good, with the intangible aspects dimension being the one that has a good rating with only 14.30%, its highest rating being regular with 80.0%.La tesis Calidad del Servicio del Hospedaje entre dos de la ciudad de Iquitos, abril 2022, tiene como objetivo general Analizar las dimensiones de la calidad de servicio en el hospedaje entre dos de la ciudad de Iquitos, periodo abril 2022, la investigación es de nivel descriptivo, tipo básica de diseño no experimental y de corte transversal. La población estuvo conformada por 35 clientes externos que es el promedio mensual de usuarios de las habitaciones. Los resultados demuestran que el 85.7% de los clientes externos tienen una percepción de bueno de la calidad del servicio; en cuanto a las dimensiones, destacan la seguridad y la empatía con percepciones también de 85.7% como bueno, siendo la dimensión aspectos intangibles la que tiene una calificación buena con solo 14.30%, siendo su calificación más alta en regular con 80.0%

Recurrent madura foot without draining sinuses: a case report

Madura foot or mycetoma is a chronic granulomatous disease characterized by localized infection of subcutaneous tissues by actinomycetes or fungi. The recurrence rate for the disease if treated inadequately is very high. Recurrence presents with swelling and multiple discharging sinuses. This is an unusual presentation of the disease without discharging sinuses which is probable the first report of this kind in the literature. A 34 year old, male, presented with the painless, progressive swellings over right foot since 4 years. No sinuses or discharge could be found on skin surface. The postoperative recurrence rate is very high, and this can be local or distant at the regional lymph nodes. This could be due to the disease biology and behavior or inadequate surgical excision. Usually it presents with multiple sinus tracts, and granule. We reported a case with classical absence of sinus tracts in recurrent actinomycosis

O PAPEL DO ENFERMEIRO NA AVALIAÇÃO E PREVENÇÃO DE COMPLICAÇÕES DO PÉ DIABÉTICO

O “pé diabético” é doença uma crônica do Diabetes Mellitus e ocorre quando uma área machucada ou infeccionada nos pés desenvolve uma úlcera (ferida). Seu aparecimento pode ocorrer quando a circulação sanguínea é deficiente e os níveis de glicemia são mal controlados. Estima-se que uma em cada quatro pessoas com diabetes pode apresentar problemas nos pés ao longo da vida. A Polineuropatia diabética (PND), uma complicação que afeta 50% dos pacientes diabéticos, que precedem 85% das amputações. A poli neuropatia diabética leva a insensibilidade e nos estágios mais avançados a deformidade. A tríade PND, mais deformidades e trauma são fatores determinantes para o chamado “pé diabético”, caracterizado por ulceração acompanhada de infecção que pode evoluir para amputação, principalmente se há má circulação, doença arterial obstrutiva crônica. O dano em tecidos moles, formação de fissura entre os dedos ou área ressecada e calosidades são eventos que, em geral, desencadeiam a ocorrência de úlceras diabética. Os danos não percebidos pelo paciente podem ser decorrentes de traumas (por exemplo, dano ao cortar as unhas, objetos não percebidos dentro dos calçados, falta de ajuste do sapato ou a meia) alterações químicas como, por exemplo, (agentes cáusticas para tratar calosidades ou joanetes) ou também as alterações térmica ( bolsa de água quente, testar a água do banho com os pés, caminhar descalço em superfície quentes). Sendo assim, o estudo justifica-se pela necessidade de desenvolver um trabalho entre a equipe multidisciplinar, visando prevenir ou retardar as complicações crônicas do Diabete Mellitus, incentivar o controle da doença, melhorar a qualidade da assistência e condições para o bem-estar global do indivíduo e reduzir os impactos socioeconômicos. No curso de Enfermagem do Centro Universitário Autônomo do Brasil o acadêmico tem oportunidade de trabalhar com projetos assistenciais em unidades hospitalares. A apresentação do projeto é um método utilizado no processo de ensino aprendizagem do Estágio Curricular Supervisionado II do 8º período do curso. Consequentemente este projeto tem como objetivo orientar os usuários sobre as medidas preventivas e como realizar o exame periódico dos pés; Realizar avaliação física, neurológica e vascular nos pés diabéticos. Como método de planejamento e desenvolvimento do projeto foi utilizado o 6W3H que tem como objetivo estabelecer metas, prazos e planejamentos adequados. O início das atividades ocorreu em agosto de 2018 com encerramento previsto para novembro de 2018 em uma Unidade Básica de Saúde de referência em saúde da família na região metropolitana de Curitiba. A primeira etapa dia 13/08 foi realizado levantamento do diagnóstico situacional da UBS juntamente com Autoridade Sanitária, passando pela validação da enfermeira supervisora no dia 15/08 e equipe multidisciplinar que compõe a estratégia da família nos dias 18 e 19/08. Após aprovação, segue com a elaboração do projeto. No dia 26/08 no espaço saúde foi apresentado a primeira etapa do projeto aos pacientes diabéticos, durante o programa para diabéticos com orientações educativas sobre o cuidado com os pés. Os recursos utilizados para a apresentação do projeto foram o espaço saúde, projetor para apresentação de slides e para a próxima etapa do projeto será utilizado uma ficha de avalição neurológica sobre como examinar os pés. No mesmo dia foi agendado consulta com a enfermagem para avalição física, neurológica e vascular dos pés, para o mês de setembro. Participarão do projeto os pacientes inscritos no programa para diabetes e a equipe da estratégia da saúde da família responsável pela micro área 2, totalizando 55 participantes. Não há considerações no momento, pois, o projeto está em desenvolvimento de acordo o cronograma de estágio. Os demais resultados serão apresentados posteriormente. Espera-se com este projeto melhorar a assistência prestada aos pacientes portadores de Diabetes Mellitus e proporcionar qualidade de vida