MANAGEMENT AND OUTCOME OF ABDOMINAL WALL CLOSURE IN EMERGENCY LAPAROTOMY AT A TERTIARY CARE CENTRE

Objective: Abdominal wall closure of an emergency laparotomy involves a great deal of consideration. An ideal laparotomy wound closure should be efficient. provide strength and serve as a barrier to infection. The aim of this study is to compare and evaluate the advantages of layered closure in comparison with the mass layered closure, the types of suture materials used in the closure, absorbable/nonabsorbable and its correlation with post operative complications such as wound sepsis, burst abdomen and incisional hernia. Methods: This prospective study was carried out over a period of 18 months enrolling a total of 90 patients split into two groups with group 1 undergoing mass closure using both interrupted and continuous methods and group 2 undergoing layered closure using both interrupted and continuous methods of suturing. Results: A higher rate of wound complications was noted in the layered closure group (37.7%) than the mass closure group (17%). Wound complications were also noted to be higher in closures done with prolene suture (37.7%) than PDS (20%). As far as techniques were concerned, interrupted and continuous suturing had a similar rate of complications. Of all the comorbidities, considered in the study, the highest rate of wound related complications were seen in patients with pulmonary complications (13.3%). Conclusion: Although the ideal way to close an abdomen post laparotomy has not yet been discovered, our study shows that mass closure with PDS suture to close the abdominal wall should be advocated as there is decreased early and late post operative wound complications Keywords: PDS.

Selection of the Best Swimming Athletes using MCDM-AHP and VIKOR Methods

The process of selecting the best swimming athletes is carried out in several test stages, the first is the ability in the four basic swimming styles which often contested in international competitions and the second test is the basic physical abilities possessed by a number of swimming athletes. The tests related to the swimming style consist of breaststroke swimming, butterfly swimming, backstroke swimming and crawlstroke swimming, while the plyometrics test consists of banded knee jump, squat jump, jump to side, and dept jump, Due to the large number of selections, a test is required for every athlete. The purpose of this selection is to find the best swimming athletes who will be competed in the international swimming class event. The nine athletes of millenium aquatic swimming club that were selected previously, they are the forerunners of the selected swimming athletes and will be evaluated on a representative basis, which is the best among the nine athletes. The method used in the evaluation and selection process uses two continuous methods, namely the AHP and VIKOR methods. From the results selection assessment, it was found that the best three of the nine nominations selected, the first position selected was AT2 with an index 0.00, the second position was AT8 with an index 0.25 and the third position was AT7 with an index 0.61. Thus it can be concluded that the AHP and VIKOR methods can be used as decision support to determine optimally in the optimal selection process for swimming athletes.

Inorganic nanoparticle synthesis in flow reactors – applications and future directions

The use of flow technologies for obtaining nanoparticles can play an important role in the development of ecological and sustainable processes for obtaining inorganic nanomaterials, and the continuous methods are part of the Flow Chemistry trend.

Prediction of Restraint Moments in Precast, Prestressed Structures Made Continuous

This paper studies restraint moments developing in simple-span precast, prestressed beams made continuous. Methods of evaluating restraint moments produced by creep and differential shrinkage are presented. Shrinkage and creep properties of composite structures, beam and deck parts were tested and compared to values defined according to Eurocode models. Finally, the restraint moments were calculated with both material models for the two-span parking deck structure. The study confirmed the findings of previous studies: that the methods that are used overestimate the negative restraint moment produced by differential shrinkage.