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Optimizing the supply chain activities has been the focus of supply chain managers in their quest for creating value. However, optimizing these activities can only lead to operational efficiency and not organizational effectiveness, which is seen by most as a more effective means of gaining competitive advantage, meaning growth. On the other hand, considering value chain for growth has the potential to achieve organizational effectiveness--without compromising on operational efficiency--as value chain not only strives to withdraw activities that do not add value to its primary activities, but also introduces additional (support) activities such as infrastructure, human resource, finance and technology. These primary and support activities lay the foundation for competitive advantage and subsequently growth. Notably, primary activities in a value chain address the functions of the supply chain. In addition, the value chain focuses on the critical elements that seed competitive advantage, through their support activities. The numerous primary and secondary elements of the value chain, with their interrelationships, linkages and synergy make the value chain act as a source of opportunity for growth. This paper aims to provide a grounded understanding of the value chain, marked by theoretical review and analytical constructs. It exemplifies the usage of value chain for competitive advantage and growth by taking the case of an industry group, the Indian wine industry, which asserts the unexpected emergence of the industry group in the first place. Specific levels of differentiation and cost benefits can be seen as a source for competitive advantage and growth. The paper builds heavily on the concepts of Porter, where he proposes the value chain through which an industry group can create value in its offering by rationalizing costs--through process improvement or management--to the elements of differentiation that create value for the consumers. [ABSTRACT FROM AUTHOR]

Presents a study that investigated start transients of liquids flowing through sharp-edged cylindrical nozzles in a feedline nozzle assembly. Correlation of transition time with characteristic response time; Mechanism for delayed transition.

Background and objective: Administration of some additives with local anesthetics can prolong pain free period post-operatively, thereby reducing need for post-operative analgesics and improving patient comfort. Potassium chloride was found to increase duration and quality of anesthesia in various studies on brachial plexus blockade. This study was designed to evaluate and compare the effect of 2% lignocaine with 1.5% potassium chloride, 2% lignocaine with adrenaline and 2% lignocaine (plain) in pterygomandibular nerve blocks. Materials and methods: A triple blind randomized controlled study was conducted on 120 adults, aged 18–45 years in ASA-I category, requiring surgical extraction of impacted mandibular third molars. The subjects were divided equally into 3 groups randomly by computer generated sequence; Group 1: 2% lignocaine plus 1.5% solution of potassium chloride, group 2: 2% lignocaine with 1:80,000 adrenaline and group 3: 2% plain lignocaine. Onset, duration, depth (pain) of anesthesia, patient satisfaction, systolic and diastolic blood pressures, heart rate and oxygen saturation, were evaluated and compared. Results: Onset was shortest for group1 and longest for grp3, statistically highly significant difference between the 3 groups (p < 0.01). Statistically significant difference (p < 0.05) was found in duration of surgery, duration of analgesia and VAS scores between groups 1 & 3. Duration and depth of anesthesia were comparable for groups 1 & 2. There was no statistically significant difference seen for total amount of dose used, SBP, DBP, HR and SpO2 between the 3 groups (p > 0.05). Conclusion: Potassium chloride, a physiological salt is inert and causes no local/systemic adverse effects when injected with lignocaine in physiologically permissible amounts. The combination achieves satisfactory onset, duration, depth of anesthesia without altering hemodynamic variables. Hence, it may be considered as a safe and effective additive.

A rapid and sensitive reverse phase high performance liquid chromatographic method is depicted for the qualitative and quantitative assay of letrozole in pharmaceutical dosage forms. Letrozole was chromatographed on a reverse phase C18 column with a mobile phase consisting of acetonitrile and phosphate buffer (pH 7.8) in the ratio of 70:30 v/v. The mobilephase was pumped at a flow rate of 1 ml/min. Acenaphthene was used as an internal standard and the eluents were monitored at 232 nm. The retention time of the drug was 3.385 min. With this method, linearity was observed in the range of 10-100 µg/ml. The LOD and LOQ were found to be 0.51 µg/ml and 1.52 µg/ml, respectively. The method was found to be applicable for analysis of drug in tablets. The results of the analysis were validated statistically. [ABSTRACT FROM AUTHOR]

Background: Small bowel obstruction is the commonest surgical emergency encountered in childhood. We observed that intestinal obstruction caused by ascariasis is one of the leading causes of death in our children and consumes a major portion of our hospital resources. Other causes include intussusception, adhesions, volvulus, hernias, and worm obstruction. The aim of this study was to analyze the presentation, diagnosis, management of mechanical bowel and complication of obstruction in children. Patients and Methods : The study was conducted from Jan 2005 to Dec 2007 in the Department of Pediatric Surgery at Sheri- Kashmir Institute of Medical Sciences, Srinagar, Kashmir. All patients who presented in the emergency department with the diagnosis of intestinal obstruction were recruited. Patients with a dynamic obstruction were excluded from the study. Diagnosis was based on history and radiological findings. Data regarding the type of management, operative findings, operative procedure and post-operative complications were collected. Results: There were 207 patients admitted for intestinal obstruction. Males and females were equally affected. Most of the children (55%) were aged 3-5 years. The causes of obstruction included ascariasis 131 (63.2%), adhesion 23 (11.1%), intussusception 21 (10.1%), obstructed hernia 17 (8.2%), and volvulus 11 (5.3%). One hundred twenty-six patients needed an operative intervention and 81 were treated conservatively. The operative procedures performed included enterotomy in 37 (29.3%), milking of worms in 18 (14.2%), resection anastomosis in 31 (24.6%) and adhesiolysis in 13 (10.3%). Appendicular perforation was seen in 4 (1.9%) and worm in gall bladder in 1 (0.5%) patients. Surgical complications were wound infection in 18 (14.2%), burst abdomen in 5 (3.9%) and fecal fistula in 3 (2.3%) patients. Conclusion: Intestinal obstruction is associated with considerable morbidity and mortality in children. Obstruction by ascariasis constituted the majority of intestinal obstruction in this study. Efforts should be made to eradicate ascariasis in endemic areas through proper sanitation, hygiene and use of antihelminthics.

Purpose: To report on to the possibility of development of severe postoperative sterile endophthalmitis due to heat-resistant bacterial endotoxins in commercially available infusion fluids Methods: A case study of 4 eyes that had previously undergone vitreoretinal surgery, which developed clinical endophthalmitis within 18 hours of surgery and two eyes that had vitreous surgery with intraocular gas and did not develop clinical endophthalmitis following intraocular surgery on three consecutive operative days Results: The vitreous samples were sterile, both for bacteria and fungi. The only common supply in all cases was a new batch of Ringer′s lactate infusion fluid. Though the Ringer′s lactate solutions in the same batch were also sterile, the infusion fluids contained abnormally high levels of bacterial endotoxins detected by gel clot method. Conclusion: Commercially available infusion fluid may be sterile, yet contain endotoxins from killed bacteria. This could cause postoperative sterile endophthalmitis.

Prune belly syndrome (PBS) is a rare congenital constellation of defects in pediatric surgical practice. Although anorectal anomalies have been reported in association with PBS, only few case of pouch colon with PBS has been reported. [1] In addition, our patient had deficient abdominal wall with absent dermatome in left upper quadrant, which has never been reported in the English literature. This association with abdominal wall deficiency and absent dermatome not only strengthens the theory of mesodermal arrest in the etiology of PBS but also points towards a defect in the ectodermal development.

When d-α-tocopherol is administered i.v. to vitamin E dificient rats, significant amounts of this vitamin are bound to a nucleoprotein complex in hepatic nuclei, and this complex can be solubilized by high concentrations of sodium chloride (0.6 M). The bound vitamin in this complex, extractable by ethanol, was found to be identical with authentic α-tocopherol by thin layer chromatography. [ABSTRACT FROM AUTHOR]

Aim Of Study: Breast conserving surgery (BCS) is the standard treatment for stage I and II breast cancer. Multiple studies have shown that recurrences after lumpectomy occur mainly in or near the tumor bed. Use of accelerated partial breast irradiation (APBI) allows for significant reduction in the overall treatment time that results in increasing patient compliance and decreasing healthcare costs. We conducted a treatment planning study to evaluate the role of intensity modulated radiation therapy (IMRT) with regards to three-dimensional conformal radiation therapy (3DCRT) in APBI.Materials and Methods: Computed tomography planning data sets of 33 patients (20 right sided and 13 left sided) with tumor size less than 3 cm and negative axillary lymph nodes were used for our study. Tumor location was upper outer, upper inner, central, lower inner, and lower outer quadrants in 10, 10, 5, 4 and 4 patients, respectively. Multiple 3DCRT and IMRT plans were created for each patient. Total dose of 38.5 Gy in 10 fractions were planned. Dosimetric analysis was done for the best 3DCRT and IMRT plans.Results: The target coverage has been achieved by both the methods but IMRT provided better coverage (P = 0.04) with improved conformity index (P = 0.01). Maximum doses were well controlled in IMRT to below 108% (P < 0.01). Heart V2 Gy (P < 0.01), lung V5 Gy (P = 0.01), lung V10 Gy (P = 0.02), contralateral breast V1 Gy (P < 0.01), contralateral lung V2 Gy (P < 0.01), and ipsilateral uninvolved breast (P < 0.01) doses were higher with 3DCRT compared to IMRT.Conclusion: Dosimetrically, IMRT-APBI provided best target coverage with less dose to normal tissues compared with 3DCRT-APBI. [ABSTRACT FROM AUTHOR]

Presents case study of the findings of an acarus scabiei in the urine. Context of the study; Treatment to the symptoms; Result of the treatment.

The dynamics of business have been altered as a result of modern marketing. Consumers are acquiring more information, but at the same time the market is getting more saturated with competitors. Every day, markets must confront new problems and experiment with different tactics in order to expand their sphere of influence. Because urban markets are reaching their capacity, businesses are being compelled to investigate rural areas, which offer the possibility of significant growth. More so than urban markets, the growth of rural markets has been consistent throughout the course of the previous several years. The vast majority of Indians, as a rule, like fresh food items, and as a result, they tend to buy relatively little amounts of food more often. This stands in stark contrast to the situation in the majority of western countries, where it is becoming more standard practice to buy food in bulk and store it for a comparatively longer amount of time. In point of fact, the fast-moving consumer goods (FMCG) sector is primarily the responsibility of the market's end users. [ABSTRACT FROM AUTHOR]

Ultimate load capacity assessment of nuclear containments has been a thrust research area for Indian Pressurized Heavy Water Reactor (PHWR) power programme. For containment safety assessment of Indian PHWRs a finite element code ULCA was earlier developed at BARC, Trombay. This code has been extensively benchmarked with experimental results. The present paper highlights the analysis results obtained from code ULCA for Prestressed Concrete Containment Vessel (PCCV) that was tested at Sandia National Labs, USA in a Round Robin analysis. This test programme was co-sponsored by Nuclear Power Engineering Corporation (NUPEC), Japan and the US Nuclear Regulatory Commission (NRC). Three values of failure pressure predictions namely the upper bound, the most probable and the lower bound (all with 90% confidence) were made as per the requirements of the round robin analysis activity. The most likely failure pressure is predicted to be in the range of 2.95–3.15 Pd (Pd=design pressure of 0.39 MPa for the PCCV model) depending on the type of liners used in the construction of the PCCV model. The lower bound value of the ultimate pressure of 2.80 Pd and the upper bound of the ultimate pressure of 3.45 Pd are also predicted from the analysis. These limiting values depend on the assumptions of the analysis for simulating the concrete-tendon interaction and the strain hardening characteristics of the steel members. The experimental test has been recently concluded at Sandia Laboratory and the peak pressure reached during the test is 3.3 Pd that is enveloped by our upper bound prediction of 3.45 Pd and is close to the predicted most likely pressure of 3.15 Pd. This paper highlights the features of BARC code ULCA and addresses a few issues related to constitutive modeling of pre-stressed concrete structure that is relevant for ultimate load capacity prediction of nuclear containments. These would be useful for evaluation of the present numerical results with the test data obtained by Sandia National Laboratory. [Copyright &y& Elsevier]

The present investigation has been carried out in the copper mineralized region of Jharkhand, India. Apart from the natural deposit of copper minerals, which is found along with uranium in this region, different industrial sites of copper were accounted for, in the study. The integrated radon measurement technique has been used with dosimeter deployment interval of 90 days. The indoor 222Rn activity concentration varied at different locations from 58.4 to 100.7 Bq m - 3 with an average of 79.8 ± 14.5 Bq m - 3 . In the outdoor environment, annual average 222Rn activity concentration varies from 36.5 to 75.8 Bq m - 3 with an average of 57.9 ± 14.0 Bq m - 3 . The corresponding annual inhalation dose due to indoor and outdoor 222Rn activity concentration to the inhabitants of the region has been worked out as 1.95 mSv year - 1 to 3.28 mSv year - 1 respectively with a mean of 2.60 ± 0.38 mSv year - 1 . [ABSTRACT FROM AUTHOR]

The natural activity of U, Th and K present in soil, fertilizer and palaeosols besides animal fossils was determined using low background gamma ray spectrometry. The highest uranium activity level were found in animal fossils of geogenic origin compared to palaeosols, soils and fertilizers, a result of post-mortem uranium assimilation in these fossils via diagenetic processes. Hence, geogenic mobilization is likely a major cause of elevated uranium levels in Malwa region of Punjab, also known for higher than normal cancer incidence. [ABSTRACT FROM AUTHOR]

This paper presents the assessment of inhalation exposure potential of broken uranium ore piles in different stopes of Jaduguda uranium mines of India. Rn emanation coefficient of broken uranium ore was measured in laboratory by collecting air sample from airtight glass jar containing ore sample. An attempt was also made to correlate the emanation coefficient with Ra content of the ore. The Rn progeny doses estimated based on radon activity concentration of broken ore, occupancy period and equilibrium ratio in different stopes were well below the prescribed limit of International Commission on Radiological Protection. The maximum Rn progeny dose contribution from broken ore piles was worked out to be 0.22 mSv year. This suggests that the broken ore piles are not the significant contributor of inhalation exposure under the existing ventilation condition of Jaduguda uranium mine. [ABSTRACT FROM AUTHOR]

Abstract: Coarser mill tailings used as backfill to stabilize the stoped out areas in underground uranium mines is a potential source of radon contamination. This paper presents the quantitative assessment of radon emanation from the backfilled tailings in Jaduguda mine, India using a cylindrical accumulator. Some of the important parameters such as 226Ra activity concentration, bulk density, bulk porosity, moisture content and radon emanation factor of the tailings affecting radon emanation were determined in the laboratory. The study revealed that the radon emanation rate of the tailings varied in the range of 0.12–7.03 Bq m−2 s−1 with geometric mean of 1.01 Bq m−2 s−1 and geometric standard deviation of 3.39. An increase in radon emanation rate was noticed up to a moisture saturation of 0.09 in the tailings, after which the emanation rate gradually started declining with saturation due to low diffusion coefficient of radon in the saturated tailings. Radon emanation factor of the tailings varied in the range of 0.08–0.23 with the mean value of 0.21. The emanation factor of the tailings with moisture saturation level over 0.09 was found to be about three times higher than that of the absolutely dry tailings. The empirical relationship obtained between 222Rn emanation rate and 226Ra activity concentration of the tailings indicated a significant positive linear correlation (r = 0.95, p < 0.001). This relationship may be useful for quick prediction of radon emanation rate from the backfill material of similar nature. [Copyright &y& Elsevier]

Estimation of radon emanation in uranium mines is given top priority to minimize the risk of inhalation exposure due to short-lived radon progeny. This paper describes the radon emanation studies conducted in the laboratory as well as inside an operating underground uranium mine at Jaduguda, India. Some of the important parameters, such as grade/226Ra activity, moisture content, bulk density, porosity and emanation fraction of ore, governing the migration of radon through the ore were determined. Emanation from the ore samples in terms of emanation rate and emanation fraction was measured in the laboratory under airtight condition in glass jar. The in situ radon emanation rate inside the mine was measured from drill holes made in the ore body. The in situ 222Rn emanation rate from the mine walls varied in the range of 0.22–51.84 × 10−3 Bq m−2 s−1 with the geometric mean of 8.68 × 10−3 Bq m−2 s−1. A significant positive linear correlation (r = 0.99, p < 0.001) between in situ 222Rn emanation rate and the ore grade was observed. The emanation fraction of the ore samples, which varied in the range of 0.004–0.089 with mean value of 0.025 ± 0.02, showed poor correlation with ore grade and porosity. Empirical relationships between radon emanation rate and the ore grade/226Ra were also established for quick prediction of radon emanation rate from the ore body. [ABSTRACT FROM AUTHOR]

The possibility that drugs attached to innocuous nanowires enhance their delivery within the central nervous system (CNS) and thereby increase their therapeutic efficacy was examined in a rat model of spinal cord injury (SCI). Three compounds—AP173 (SCI-1), AP713 (SCI-2), and AP364 (SCI-5) (Acure Pharma, Uppsala, Sweden)—were tagged with TiO2-based nanowires using standard procedure. Normal compounds were used for comparison. SCI was produced by making a longitudinal incision into the right dorsal horn of the T10–T11 segments under Equithesin anesthesia. The compounds, either alone or tagged with nanowires, were applied topically within 5 to 10 min after SCI. In these rats, behavioral outcome, blood–spinal cord barrier (BSCB) permeability, edema formation, and cell injury were examined at 5 h after injury. Topical application of normal compounds in high quantity (10 μg in 20 μL) attenuated behavioral dysfunction (3 h after trauma), edema formation, and cell injury, as well as reducing BSCB permeability to Evans blue albumin and 131I. These beneficial effects are most pronounced with AP713 (SCI-2) treatment. Interestingly, when these compounds were administered in identical conditions after tagging with nanowires, their beneficial effects on functional recovery and spinal cord pathology were further enhanced. However, topical administration of nanowires alone did not influence trauma-induced spinal cord pathology or motor functions. Taken together, our results, probably for the first time, indicate that drug delivery and therapeutic efficacy are enhanced when the compounds are administered with nanowires. [ABSTRACT FROM AUTHOR]