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Introduction: Lumbar Canal Stenosis is the narrowing of the Spinal Canal and/or the intervertebral foramina, which causes compression of the thecal sac and/or caudal roots at a single vertebral level. Stenosis may be local, segmental, or generalised; bone or soft tissue can cause it. Stenosis can involve the bony canal, dural sac or both.[9] Aim: Assessment of outcomes of multilevel fenestration with soft tissue decompression in lumbar canal stenosis. Material and method: A prospective study comprised patients with two or more lumbar canal stenosis levels. The Study eliminated patients with infective pathology or recurrent surgery on identical levels. The surgical technique of canal decompression via multilevel fenestrations was used in this study, which enables the decompression of the neural structures while preserving as much of the bony and ligamentous structures as possible. Post-op clinical measures such as motor, sensory, post-op complications, and VAS score improvement assessed study outcomes. Result: Studies showed improvement in symptoms of pain, motor power and sensory deficit, post-operative improvement in VAS score for pain, and improved quality of life in almost all the patients from day 7 to day 60 after surgery. Conclusion: The study shows that “Multilevel interlaminar fenestration with Soft Tissue Decompression in Lumbar Canal Stenosis” is a feasible, safe, and effective approach to lumbar canal stenosis and is associated with minimal complications and minimal perioperative morbidity. [ABSTRACT FROM AUTHOR]

Byline: Saumya. Vishnoi, Ayush. Agarwal, Sandeep. Chowdhary, Anup. Thacker, Mohd. Ahmed, Tauseef. Ahamad, Atul. Agarwal Sir, Seizure and headache are both paroxysmal hyperexcitability disorders and probably have shared underlying pathogenic [...]

Bending operation is a very popular operation in the field of sheet metal forming. In bending operations several problems are encountered, springback is a very critical defect among them. In this research paper, effect of punch radius and sheet setting on the springback of AA1050/SS430 laminated sheet has been investigated. It has been found that punch radii and setting conditions have great influence on the prediction of springback. The study shows that the springback values can be decreased by decreasing the punch profile radius. Selecting appropriate sheet placing arrangement of 2-ply laminated sheets springback can fairly be controlled. A good agreement has been established between simulation and experimental results. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to assess the reliability and validity of the Hindi translation of the Migraine Disability Assessment (MIDAS) and Headache Impact Test-6 (HIT-6) questionnaires. Materials and Methods: The study was conducted on the migraine patients. For test-retest reliability, the respondents filled the MIDAS and HIT-6 questionnaires twice, at an interval of three weeks. For validity, the same population of patients filled the headache diary for three months. After three months they filled the MIDAS and HIT-6 questionnaires again. The patients were subgrouped according to their occupation and level of education. The test-retest reliability and validity were calculated by the Pearson correlation coefficient. Internal consistency was calculated using the Cronbach alpha. Results: A total of 236 migraine patients were screened. Seventy-nine patients fulfilled the inclusion criteria. A total of 69 patients completed the study. The HIT-6 questionnaire was applicable to all the subgroups of patients and had better comprehensibility than the MIDAS. Housewives missed out on the first two questions of the MIDAS and had lower mean MIDAS scores than HIT-6. The test-retest correlation coefficients for the total MIDAS and HIT-6 scores were 0.94 and 0.81, respectively. The correlation coefficients between the total score in the headache diary equivalent and the MIDAS and HIT-6 total score were 0.91 and 0.77, respectively. Cronbach alpha, a measure of internal consistency for the MIDAS questionnaire was > 0.90 at all the compilations. For the HIT-6 questionnaire, it ranged from 0.67 to 0.79. Conclusion: The Hindi versions of MIDAS and HIT-6 questionnaires were reliable and valid, but could not be interchanged. HIT-6 had better comprehensibility.

This study was planned to evaluate the role of steroid alone and with albendazole in patients of single-small enhancing computerized tomography (CT) lesions in Indian patients presenting with new-onset seizures. In this study, 95 patients with new onset seizures and a single enhancing CT lesion were randomly divided in two groups to receive either antiepileptic drug and steroid alone (n=42) or antiepileptic drug with a steroid and albendazole (n=48). These patients were prospectively followed-up for six months. Repeat CT scans were performed after 30 days and six months of registration. The majority of patients were below 30 years of age. Simple partial seizure, with or without secondary generalization, was the commonest type of seizure encountered in these patients. Follow-up CT scans, after one month of registration showed complete disappearance of lesion in 16.7% of patients in Group I and in 25% of patients in Group II (χ2 =0.93, P =0.334). Follow-up CT scans, after six months of registration showed complete disappearance of lesion in 59.5% of patients in Group I and in 68.8% of patients in Group II (χ2=0.83, P =0.362). During the six months follow-up five patients (11.8%) in Group I and nine patients (18.7%) in Group II experienced seizures recurrence. Two patients in Group II experienced seizure recurrence despite complete disappearance of CT lesions. Seizure control and disappearance of lesion was same in both Groups. Albendazole does not seem to affect resolution.

Project scheduling in organizations has become increasingly difficult in today's multi-project and multi-tasking environment. Traditional project management approaches like PERT/CPM often do not work well in such environments. In the late 1990s, Eliyahu Goldratt brought about a paradigm shift in project management by proposing Critical Chain methodology which embodies direct application of his Theory of Constraints (TOC) to project management. Several vendors have since incorporated his ideas into software packages to address project management needs in multi-project environments. In spite of using such sophisticated project management scheduling systems companies continue to face the critical challenge of completing projects on-time and within budget. This paper highlights the behavioral and accountability issues associated with Critical Chain's 1-dimensional focus on buffer management for managing projects in a multi-project environment. It proposes a 2-dimensional model and a resulting new metric as a modification to Goldratt's model to address the behavioral issues associated with Critical Chain implementation. It also presents an objective metric based approach for comparative assessment of departmental performance by organizational leadership in a multi-project environment. A simplified case study from a local company is employed to evaluate the practical dimensions of the model and study results. Key Words: Critical Chain, Multiple project management, Buffer burn index, 1.0 INTRODUCTION In today's competitive environment, delivery time has assumed a level of significance in the tool dies industry that can no longer be negotiated. There is a growing trend [...]