scholarly journals Comparison of Two-Port Verses Three-Port Laparoscopic Appendicectomy in CCM Medical and Hospital

2018 ◽  
Vol 3 (06) ◽  
Author(s):  
Dr. Manish Khare ◽  
Dr. Ajay Khanolkar
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Acute Abdomen ◽  
Operative Time ◽  
Low Cost ◽  
Cost Effective ◽  
Laparoscopic Appendicectomy ◽  
Single Incision Laparoscopic Surgery ◽  
Aesthetic Appearance ◽  
The Cost

One of the most common cause of acute abdomen is acute appendicitis. A concept of ‘‘scarless’’ abdomen first described in 1998 by Esposito by Single Incision Laparoscopic Surgery was and has gained popularity. Still appendectomy is performed by laparotomy in most of the countries, causes may be the cost of the instruments or availability and affordability by the patients. Laparoscopic appendectomies are gaining popularity because of decreased pain, fewer postoperative complications, earlier mobilization, shorter hospitalization, earlier return to work, and better cosmesis. The aim of the study is to compare operative time, intra and post -operative complications, hospital stay after surgery in patients with two-port laparoscopic appendicectomy with the conventional three-port laparoscopic appendicectomy and to describe this technique for performing laparoscopic appendectomy with three portals at very low cost and with good aesthetic appearance and to compare the results with the conventional three-port laparoscopic appendicectomy. Material and Methods - Patients over the age of 18 with a diagnosis of acute abdomen, later on confirmed to acute appendicitis were included in the study. Out of 50 patients with laparoscopic appendicectomy, 23 for two port appendicectomy and 27 three port were included in the study. Hasson's technique was adopted for laproscopic access in to the abdomen. 10-mm umbilical port and 5-mm port was inserted with a grasper. Through the umbilical working trocar mesoappendix transected base of the appendix was ligated and the appendix was resected. Results - 23 cases performed using the two-port technique and 27 cases were performed using conventional 3 port technique. Operative time in two port appendicectomy (n=23) was 58±3.6 while in Conventional 3 port appendicectomy (n = 27) it was 52±2.4. Hospital stay for patients with two port appendicectomy was shorter and statistically significant. Conclusion - Two port appendicectomy is a safe and cost effective procedure and no major complications were found in this procedure.

scholarly journals Comparative study of single incision versus conventional three port laparoscopic appendectomy

2018 ◽  
Vol 5 (12) ◽  
pp. 3852 ◽  
Author(s):  
Sahil Rometra ◽  
Rahil Rometra ◽  
Neeraj Koul ◽  
R. K. Chrungoo
Keyword(s):  
Laparoscopic Surgery ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Single Incision ◽  
Open Appendectomy ◽  
Single Incision Laparoscopic Surgery ◽  
Abdominal Incision ◽  
Significant Difference

Background: Appendicitis is primarily a disease of adolescents and young adults with a peak incidence in the second and third decades of life. Appendectomy for appendicitis is the most commonly performed emergency operation in the world.For more than a century, open appendectomy remained the gold standard for the treatment of acute appendicitis.  Laparoscopic surgery has become popular universally during the last couple of decades.   Efforts are still being made to decrease abdominal incision and visible scars after laparoscopy.  Single incision laparoscopic surgery (SILS) is a new innovation allowing minimal access surgery to be performed through a single umbilical incision.Methods: It was a prospective study carried out on 50 patients diagnosed as acute appendicitis. They were divided into two groups of 25 each. One group underwent Conventional Laparoscopic Appendectomy (CLA) and other group underwent Single Incision Laparoscopic Surgery (SILS).  Results were compared with regard to mean operative time,   complications, post-operative pain and discomfort (vas score at 12 hours), post-operative morbidity, duration of hospital stay and condition at discharge and cosmesis.Results: There was no statistically significant difference between the two groups with respect to the parameters like postoperative pain, hospital stay and complication profile. However, operative time for SILS appendectomy were found to be significantly higher compared to conventional group.Conclusions: Single incision laparoscopic appendectomy using standard laparoscopic instruments is safe and effective, feasible surgery with better cosmetic results.

scholarly journals Is the laparoscopic approach superior to open approach for treatment of acute appendicitis? A hospital based experience

2017 ◽  
Vol 4 (5) ◽  
pp. 1726
Author(s):  
Anil Reddy Pinate ◽  
Mohammad Fazelul Rahman Shoeb ◽  
Shiva Kumar C. R.
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Operative Time ◽  
Laparoscopic Group ◽  
Laparoscopic Appendicectomy ◽  
Open Group ◽  
Open Appendicectomy ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Laparoscopic appendicetomy remains controversial in Indian perspective. The objective was to compare the clinical outcome of open with laparoscopic appendicectomy.Methods: Prospectively collected data from 150 consecutive patients with acute appendicitis was studied. Patients undergoing surgery for acute appendicitis were alternately assigned into one of the two groups (Group-A patients underwent open appendicectomy and in Group B laparoscopic appendicectomy). The two groups were compared with respect to operative time, length of hospital stay, postoperative pain & wound complications.Results: The mean operative time in the open group was 84.40 minutes; for laparoscopic group, 95.20 minutes (p-0.001). Duration of paralytic ileus, tolerance to oral feeds, resumption of daily routine activity and ambulation of patients were started earlier in laparoscopic group than open group. Group A (OA) patients had pain at the mean of 2.66 days as compared group B (LA), in which patients had pain at the mean of 1.66 days.  Study also showed that the hospital stay for laparoscopic group was almost half of that for open group. Laparoscopic appendicectomy was safe as compared to open surgery in context to post-operative complications.Conclusions: Provided surgical experience and equipment are available, Laparoscopic appendicectomy is as safe and efficient than open appendicectomy.

scholarly journals Laparoscopic Appendectomy Using Hem-o-lok Polymer Clips: A Single-Center Experience

2017 ◽  
Vol 102 (7-8) ◽  
pp. 334-339
Author(s):  
Bahadır Öz ◽  
Ertan Emek ◽  
Muhammet Akyüz ◽  
Erdoğan Sözüer ◽  
Türkmen Arıkan ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Cost Effective ◽  
Total Hospital Cost ◽  
Intraoperative Complication ◽  
The Mean ◽  
Appendicular Stump

Although the surgical technique of laparoscopic appendectomy (LA) stump has been well understood, there are many alternative techniques in relation to torocar positioning and closure of appendicular stump. In recent times, Hem-o-lok polymer clips (HOLP) was implemented in several studies in the closure of appendicular stump because of its lower cost and easy implementation. The purpose of this study to investigate the safety, usefulness, and cost effectiveness of HOLP for the closure appendecular stumps in LA. The study was carried out between December 2011 and December 2013. Patients with acute appendicitis were included in the study. Two groups were defined as patients with the HOLP and patients with endoloop. The prospectively collected data, including age, sex, body mass index, operative time, hospital stay, cost effectiveness, intraoperative, and postoperative complications were retrospectively analyzed. A total of 66 (35 male, 31 female) LA were performed. The endoloop group consisted of 30 patients (16 male, 14 female, and mean age, 30.4 ± 1.8), while the HOLP group consisted of 36 patients (19 male, 17 female, and mean age, 28.6 ± 1.6). The mean operative time was 42.5 ± 1.3 in the HOLP group and 53.8 ± 1.5 in the endoloop group (P < 0.0001). The mean hospital stay was 2.1 ± 0.2 days in HOLP group and 2 ± 0.2 in the endoloop group (P = 0.73). Both patient groups had no intraoperative complication, and no cases were converted to open procedure. Total hospital cost was 1170.8 ± 6.3 dollars in the HOLP group and 1094 ± 6.9 dollars in the endoloop group (P < 0.0001). The use of HOLP for the appendicular stumps in LA is a feasible, safe, and cost-effective procedure in patients with uncomplicated acute appendicitis.

scholarly journals Laparoscopic Versus Open Appendicectomy for Treatment of Acute Appendicitis

2019 ◽  
Vol 20 (1) ◽  
pp. 24-25
Author(s):  
Mohammad Ali ◽  
Kazi Lsrat Jahan
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Gold Standard ◽  
Operative Time ◽  
The Other ◽  
Laparoscopic Appendicectomy ◽  
Abdominal Abscess ◽  
Open Appendicectomy ◽  
Laparoscopic Skills ◽  
Operative Complications

Laparoscopic appendicectomy is not yet considered the "gold standard" in the treatment of acuteappendicitis because of its higher operative time, intra-abdominal abscess risk, and costscompared to open appendicectomy. On the other hand laparoscopic appendicectomy is associatedwith fewer post operative complications, shorter hospital stay, and nearly similar operative time,intra-abdominal abscess rate, and total costs, compared with open appendicectomy. With increasein the experience of the surgeon in laparoscopic skills pit falls will be much lower. Therefore, laparoscopicappendectomy can be recommended as preferred approach in acute appendicitis Journal of Surgical Sciences (2016) Vol. 20 (1) : 24-25

Janus – A New Approach to Air Combat Pilot Training

2019 ◽  
Vol 2019 (4) ◽  
pp. 7-22
Author(s):  
Georges Bridel ◽  
Zdobyslaw Goraj ◽  
Lukasz Kiszkowiak ◽  
Jean-Georges Brévot ◽  
Jean-Pierre Devaux ◽  
...  
Keyword(s):  
Low Cost ◽  
Cost Effective ◽  
High Energy ◽  
Training System ◽  
Embedded Sensors ◽  
Pilot Training ◽  
New Approach ◽  
Combat Aircraft ◽  
Air Combat ◽  
The Cost

Abstract Advanced jet training still relies on old concepts and solutions that are no longer efficient when considering the current and forthcoming changes in air combat. The cost of those old solutions to develop and maintain combat pilot skills are important, adding even more constraints to the training limitations. The requirement of having a trainer aircraft able to perform also light combat aircraft operational mission is adding unnecessary complexity and cost without any real operational advantages to air combat mission training. Thanks to emerging technologies, the JANUS project will study the feasibility of a brand-new concept of agile manoeuvrable training aircraft and an integrated training system, able to provide a live, virtual and constructive environment. The JANUS concept is based on a lightweight, low-cost, high energy aircraft associated to a ground based Integrated Training System providing simulated and emulated signals, simulated and real opponents, combined with real-time feedback on pilot’s physiological characteristics: traditionally embedded sensors are replaced with emulated signals, simulated opponents are proposed to the pilot, enabling out of sight engagement. JANUS is also providing new cost effective and more realistic solutions for “Red air aircraft” missions, organised in so-called “Aggressor Squadrons”.

scholarly journals Growth and biochemical composition of Chlorella vulgaris in different growth media

2013 ◽  
Vol 85 (4) ◽  
pp. 1427-1438 ◽  
Author(s):  
MATHIAS A. CHIA ◽  
ANA T. LOMBARDI ◽  
MARIA DA GRACA G. MELAO
Keyword(s):  
Biomass Production ◽  
Chlorella Vulgaris ◽  
Biochemical Composition ◽  
Physiological Response ◽  
Low Cost ◽  
Cost Effective ◽  
Growth Conditions ◽  
Growth Media ◽  
Continuous Cultures ◽  
The Cost

The need for clean and low-cost algae production demands for investigations on algal physiological response under different growth conditions. In this research, we investigated the growth, biomass production and biochemical composition of Chlorella vulgaris using semi-continuous cultures employing three growth media (LC Oligo, Chu 10 and WC media). The highest cell density was obtained in LC Oligo, while the lowest in Chu medium. Chlorophyll a, carbohydrate and protein concentrations and yield were highest in Chu and LC Oligo media. Lipid class analysis showed that hydrocarbons (HC), sterol esthers (SE), free fatty acids (FFA), aliphatic alcohols (ALC), acetone mobile polar lipids (AMPL) and phospholipids (PL) concentrations and yields were highest in the Chu medium. Triglyceride (TAG) and sterol (ST) concentrations were highest in the LC Oligo medium. The results suggested that for cost effective cultivation, LC Oligo medium is the best choice among those studied, as it saved the cost of buying vitamins and EDTA associated with the other growth media, while at the same time resulted in the best growth performance and biomass production.

scholarly journals Protection of computers from side electromagnetic radiation during monitor images formation

2021 ◽  
Vol 4 (4) ◽  
pp. 377-385
Author(s):  
Volodymyr M. Lucenko ◽  
Dmytro O. Progonov
Keyword(s):  
Electromagnetic Radiation ◽  
Ad Hoc ◽  
Low Cost ◽  
Cost Effective ◽  
Switching Speed ◽  
Cost Effective Approach ◽  
Alternative Approach ◽  
Confidential Data ◽  
The Cost ◽  
Communication Lines

Reliable protection of confidential data processed in critical information infrastructure elements of public institutions and private organizations is topical task today. Of particular interest are methods to prevent the leakage of confidential data by localizing informative (dangerous) signals that both carry an informative component, and have a signal level higher than predefined threshold. The increase in signal energy from personal computers is caused by increasing of its transistors switching speed. Modern passive shielding methods for secured computers, similar to the well-known program TEMPEST, require either costly and large shielding units or technological simplification by using of low-cost fragmentary shielding of computer’s individual elements. Therefore, localization of side electromagnetic radiation produced by personal computer is needed. The paper presents a cost-effective approach to reducing the level of computer’s electromagnetic radiation by passive method. The radiation are localized and measured by its estimation on personal computer’s elements, namely unshielded communication lines between video processor and a monitor, fragments of electric tracks on motherboards, etc. During experiments authors used ad-hoc miniature electric (ball antenna) and magnetic (Hall sensor) antennas connected to selective voltmeters. This approach significantly reduces the cost of equipment and measurements as well as requirements to analytics’ qualification for improving computer’s protection. Also, the alternative approach for computer protection is proposed. The approach is based on image content protection by distorting the image on the monitor instead of reducing electromagnetic radiation caused by signals from the monitor. The protection includes image scrambling using Arnold transform that randomly “shuffle” the lines in each frame.

An Active Low Cost Mesh Networking Indoor Tracking System

2014 ◽  
Vol 6 (1) ◽  
pp. 45-79 ◽  
Author(s):  
Sean Carlin ◽  
Kevin Curran
Keyword(s):  
Tracking System ◽  
Low Cost ◽  
Cost Effective ◽  
Limiting Factors ◽  
Unique Contribution ◽  
Scalable Vector Graphics ◽  
Web Technologies ◽  
Working Environments ◽  
System A ◽  
The Cost

Indoor radio frequency tracking systems are generally quite expensive and can vary in accuracy due to interference, equipment quality or other environmental factors. Due to these limiting factors of the technology, many businesses today find it hard to justify investing in RFID tracking technologies to improve the safety, efficiency and security of their working environments. The aim of this project was to provide a budget RFID tracking system that was capable of tracking a person or object through an indoor environment. To minimize the cost of the RFID tracking system, the components of the system were built from existing electronic equipment and hardware. The software was also written to minimize licensing and support fees allowing a cost effective budget RFID tracking system to be developed. The tracking system consists of a tag, reader nodes and a PC reader which utilize synapse RF 100 engines with python scripts embedded on to the chips. The tracking system software operates through a web portal utilizing web technologies such as HTML, JavaScript and PHP to allow the tags location to be represented on a two dimensional map using scalable vector graphics. During development of the system a new trilateration algorithm was developed and used convert the signals received from the tag to a virtual position on the map correlating to the actual physical position of the tag. A unique contribution of this system is the low cost of building which we estimate as less than £200 UK sterling for a five node system.

scholarly journals MINILAPAROSCOPIC APPENDECTOMY

2016 ◽  
Vol 29 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Lúcio Américo Della COLETTA ◽  
Bruno Ziade GIL ◽  
Renato Morato ZANATTO
Keyword(s):  
Acute Appendicitis ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Operative Time ◽  
Treatment Method ◽  
Public Health Services ◽  
Surgical Time ◽  
Aesthetic Result ◽  
The Mean ◽  
The Aesthetic

Background: Minilaparoscopy is considered one of the minimally invasive options available for acute appendicitis treatment, although not always employed in less complexity public health services. Aim: Report surgical outcomes of minilaparoscopy use in acute appendicitis treatment. Method : The study included 21 patients undergoing minilaparoscopic appendectomy with instrumental of 3 mm. The following variables were analyzed: sex, age, body mass index, stage of appendicitis, surgical time, hospital stay, surgical complications, conversion rate to conventional laparoscopy or laparotomy, pain after surgery and aesthetic result. Results: Twelve men and nine women underwent minilaparoscopic appendectomy. The average age was 27,8 years, the mean BMI was 24,8 kg/m2. The operative time ranged from 33 to 160 min and the average of hospital stay was three days. Among the 21 patients, 20 reported mild pain or no pain in the first postoperative day. The aesthetic result was considered "satisfactory" and "very satisfactory" by 95% of the patients. Conclusions: The minilaparoscopy is viable technique for treating acute appendicitis with a satisfactory recovery. It combines the benefits of minimally invasive procedures with results similar to conventional techniques.

scholarly journals Self-managed, computerised word finding therapy as an add-on to usual care for chronic aphasia post-stroke: An economic evaluation

2020 ◽  
pp. 026921552097534
Author(s):  
Nicholas R Latimer ◽  
Arjun Bhadhuri ◽  
Abu O Alshreef ◽  
Rebecca Palmer ◽  
Elizabeth Cross ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Usual Care ◽  
Low Cost ◽  
Controlled Trial ◽  
Life Time ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Post Stroke ◽  
Word Finding ◽  
The Cost

Objective: To examine the cost-effectiveness of self-managed computerised word finding therapy as an add-on to usual care for people with aphasia post-stroke. Design: Cost-effectiveness modelling over a life-time period, taking a UK National Health Service (NHS) and personal social service perspective. Setting: Based on the Big CACTUS randomised controlled trial, conducted in 21 UK NHS speech and language therapy departments. Participants: Big CACTUS included 278 people with long-standing aphasia post-stroke. Interventions: Computerised word finding therapy plus usual care; usual care alone; usual care plus attention control. Main measures: Incremental cost-effectiveness ratios (ICER) were calculated, comparing the cost per quality adjusted life year (QALY) gained for each intervention. Credible intervals (CrI) for costs and QALYs, and probabilities of cost-effectiveness, were obtained using probabilistic sensitivity analysis. Subgroup and scenario analyses investigated cost-effectiveness in different subsets of the population, and the sensitivity of results to key model inputs. Results: Adding computerised word finding therapy to usual care had an ICER of £42,686 per QALY gained compared with usual care alone (incremental QALY gain: 0.02 per patient (95% CrI: −0.05 to 0.10); incremental costs: £732.73 per patient (95% CrI: £674.23 to £798.05)). ICERs for subgroups with mild or moderate word finding difficulties were £22,371 and £21,262 per QALY gained respectively. Conclusion: Computerised word finding therapy represents a low cost add-on to usual care, but QALY gains and estimates of cost-effectiveness are uncertain. Computerised therapy is more likely to be cost-effective for people with mild or moderate, as opposed to severe, word finding difficulties.

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