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Enterocutaneous fistula is a common complication encountered in the post-operative period. It is the most catastrophic problem resulting in significant morbidity and mortality. Various factors have been detected which play a role in the development of enterocutaneous fistulae like age of the patient, time of presentation, Organ of Origin, pathology of the disease, general condition of the patient, metabolic abnormalities, etc. Identification of these risk factors, early diagnosis and early intervention and decision making will give good outcomes. AIM To study the aetiology, risk factors, morbidity and ideal management of enterocutaneous fistulae. MATERIALS AND METHODS Study includes thirty two (32) patients treated for enterocutaneous fistulae in our hospital between January 2012 and December 2014.At the time of diagnosis of the fistula, the patients were classified according to the site of the fistula and the volume of output. They were subsequently investigated and managed according to the standard protocol. RESULTS Mortality is 50% in 5th decade of life. In the present series, 0% mortality was noted in patients who had duodenum and jejunum as the organ of origin. Ileum and stomach comprised of 25% each in the contribution to mortality while 50% of all the patients with colocutaneous fistulae died subsequently. High output fistula has mortality of 27.77%. Mortality of 20% and 27.41% was noted in patients were managed conservatively and by surgery respectively. CONCLUSION: Index surgery early admission, an adequate antibiotic cover, vigorous resuscitation replacing fluids and electrolytes, blood transfusions, monitoring of all basic parameters and rightful decompression of the proximal bowel are all important measures to prevent the development of an enterocutaneous fistula. Prevention plays a definitely important role in patients with enterocutaneous fistulae.

Abdominal tuberculosis is the 6th most common form of extrapulmonary tuberculosis, among which ileocaecal tuberculosis is most common. Tuberculosis has been declared a global emergency by the World Health Organization (WHO) and is the most important communicable disease worldwide. Approximately one third of the world population is infected and about three millions die each year from this disease. It presents with a wide variety of symptoms and signs. Gastrointestinal tuberculosis presents to emergency department as subacute intestinal obstruction, acute intestinal obstruction and peritonitis. Although Antitubercular chemotherapy is the mainstay in treatment of abdominal tuberculosis, surgical intervention becomes necessary for two reasons- diagnostic and therapeutic. Diagnostic laparotomy becomes necessary for histopathological/microbiological diagnosis, more often in patients with peritoneal or lymph node TB. Therapeutic surgery is the treatment of choice in emergency for treating intestinal obstruction & peritonitis. Morbidity and mortality will be high in patients with late presentation and associated comorbidities. AIMS AND OBJECTIVES: (1) To study various modes of presentation and management of Gastrointestinal Tuberculosis at emergency surgical care, in our hospital, its management and outcomes. (2) To evaluate the morbidity and mortality in acute presentations of Gastrointestinal tuberculosis. MATERIALS AND METHODS An Observational study of 40 patients admitted in the acute surgical care unit of Our Hospital, Hyderabad, presenting with acute abdomen who have been confirmed to have Gastrointestinal tuberculosis at laparotomy and on histopathology from Aug 2013 to Aug 2015. The patient was managed by laparotomy and procedure according to the mode of presentation. All the patients were given ATT post operatively. RESULTS Gastrointestinal tuberculosis is more common in 2nd and 3rd decade of life. Acute presentations were found to be more common in male. Intestinal obstruction is one of the commonest presentation of gastrointestinal tuberculosis presenting as surgical emergency and contributes significantly to high morbidity and mortality. Morbidity and mortality is less in the study due to early intervention and effective chemotherapy. CONCLUSION A high index of suspicion, proper evaluation and therapeutic trial in suspected patients is essential for an early diagnosis and timely definitive treatment, in order to decrease the morbidity and mortality associated with this disease.

Carcinoma of the breast is one of the commonest cancers occurring in female and accounts for 1/3rd of all the malignant diseases occurring in them. It is mainly a disease of the developed countries and accounts for 1,00,000 deaths annually. Breast carcinoma is classified as Early breast cancer, Locally advanced breast cancer and Metastatic breast cancer. By definition early stage breast cancer constitutes breast tumors of clinical stages I, IIa and T2N1M0. Early breast cancer is the one diagnosed by mammography. Women when approaches at this stage, they can go for breast conservation surgery. Not all women are candidates for this approach, and some require mastectomy as part of their treatment. AIM To observe the incidence of early breast carcinoma with particular reference to the time taken by the patients to seek medical advice after the symptoms have developed i.e. the average time taken by the patients to seek medical advice, their appropriate management and prognosis. MATERIALS AND METHODS This prospective study was conducted over a period of 2 years from Oct-2012 to Oct-2014 in 30 female patients aged between 25-65 years who were presented with lump in breast of size ≤5cms with or without pain, with or without lymph nodes to the outpatient department. All the patients were thoroughly asked about history, examined clinically, investigated, staged and managed by surgery either Breast Conservation Surgery or Modified Radical Mastectomy. Postoperative complications were recorded and followed up regularly. RESULTS The incidence of early breast cancer in this study was 0.98% with peak age incidence between 40-60 years and duration of symptoms

The present world energy scenario signifies the importance of renewable energy utilization and paves the pathway towards green and net zero energy building concepts for a sustainable future. In the recent years, substantial energy is spent in building space heating/cooling applications to meet the human comfort requirements. In order to reduce the unnecessary losses associated with the buildings, several advancements toward energy efficient concepts are also being proposed and implemented in many buildings. Free cooling is one such novel concept through which building cooling demands can be met without compromising the indoor air quality. Free cooling concept stores the abundant atmospheric night cool energy in phase change materials (PCM) and uses the stored energy during the day hours to achieve the desired room comfort conditions. This review article aims to update and consolidate the substantial work carried out in the recent years by various researchers on free cooling technology using PCMs in latent heat thermal energy storage (LHTES) systems. In addition, future potential of free cooling technologies, scope for further improvement, policies that needs be promoted by the government toward its sustainability to ensure market penetration of free cooling technologies are also discussed in detail.

PURPOSE OF STUDY: Diabetic foot is the most common complication of diabetes. Amputation which is the end result of diabetic foot disease is associated with significant morbidity and mortality. Since it is crucial to identify those at an increased risk of diabetic foot complications, a detailed study of the natural history of diabetic foot, various clinical characteristics, according to Wagner grading of lesions, their outcome and management protocol followed in our hospital was undertaken in our hospital. AIM AND OBJECTIVE: Evaluation of diabetic foot lesions based on Wagner grading system, outcome and management protocol followed in our hospital. MATERIALS AND METHODS: A prospective study done on hundred diabetic foot patients in our own hospital over a period of one and half year. Data was obtained from a questionnaire developed to record the medical history, examination details, investigations reports, treatment details and final outcome at the end of stay. Infection was classified based on Meggitt-Wagner, classification/grading. RESULTS: Diabetic foot was very common in elderly age group (>55yrs) 54% and male dominant (87%). Majority of them had diabetes for more than five years (47%) and complications of diabetes were present on admission in 15% of them. Grade I(29%), Grade III (27%) & Grade IV (24%) lesions based on Wagner’s grading accounted for majority of diabetic foot lesions. Multiple toe disarticulation/ above knee / below knee amputation accounted for a quarter (23%) of surgical interventions in our hospital. The glycemic control in most of patients was very poor with RBS>200 mg/dl (70%) and glycosylated hemoglobin>7g% (74%) of them. A quarter of the patients stayed for at least a month in the hospital (25%). CONCLUSION: It can be concluded that diabetic foot in various forms accounts for significant morbidity in the surgical wards. Wagner’s grade I (29%) Grade III (27%), Grade IV (24%) constituted majority of lesions. Factors contributing mainly are poor glycemic control at the time of admission, presence of gangrene, complications of diabetes nephropathy, neuropathy and associated co morbidities ( peripheral vascular disease, hypertension, ischemic disease). A lot of scope for improvement is their in the approach to treatment of diabetic foot as most of the cases belong to Grade I (29%) where proper patient education can avoid dreadful complications and Grade III (27%), Grade IV (24%) if properly managed morbidity can be reduced considerably.

Pancreatic pseudocysts constitute in 5-15% of patients who have peripancreatic fluid collections after acute pancreatitis. By definition, the capsule of a pseudocyst is composed of collagen and granulation tissue and it is not lined by epithelium.The fibrotic reaction typically requires atleast 4-8 weeks to develop. Most common causes are gall stones, alcohol, metabolic disorders,etc.50 % cases will be symptomatic. Spontaneous regression is seen in up to 70% of cases. Complications of pseudocyst include infection,rupture of cyst causing pancreatic ascites and pancreaticopleural fistula and haemorrhage into the cyst. AIM: To evaluate any correlation between different types of etiology and complications arising in pseudocyst of pancreas. MATERIALS AND METHODS: It is prospective study conducted over a period of 2 years from 1st January 2012 to 31st December 2014.The study included 40 patients treated in a tertiary care hospital.Detailed histories were taken, thorough clinical examinations done and patients were subjected to available diagnostic modalities. They were treated with conservative management, external drainage and internal drainage depending on the presentation. Follow up for a period of 6 months to 1 year was done after the treatment to check for recurrence and development of complications. Relation between the etiology and complications of pseudocyst were studied. RESULTS: In 67.5% cases alcohol was the etiological factor,27.5% cases were due to gall stones. Complications were seen in 30% cases of which infection is the most common. Complications were seen irrespective of etiology. CONCLUSION: Complications in pseudocyst of pancreas occur irrespective of its etiology.

Hydatid disease continues to be a common surgical condition in many rural parts of India, carrying a significant morbidity and mortality. Hydatid liver disease affects all age groups, both sexes equally, and no predisposing pathologic conditions are associated with infection . Echinococcosis, is a zoonosis that occurs primarily in sheep - grazing areas of the world Humans contract the disease from dogs, and there is no human - to - hum an transmission it is limited geographically to areas where close and continuous contact exists between domesticated carnivores such as the dog and ungulates such as cattle and sheep. AIM: This study aims to evaluate the incidence of important risk factors of contact history in the patients presented with abdominal hydatid disease and also treatment modalities followed. MATERIAL AND METHODS: It is a prospective & analytic study was conducted by selection of patients admitted in the wards of the department o f general surgery of a tertiary care hospital. Over a period of 1 year from January 2013 to January 2014 and followed for a period of 1 year . The data in the study was collected by the use of a pretested proforma to collect relevant information from indivi dual patient, by a meticulous clinical examination and specific investigations of 12 cases for hydatid disease were studied. Majority of liver hydatid were treated by partial pericystectomy & enucleation with external tube drainage which is an optimum trea tment in our institute, and a follow up for a minimum of 1 year was conducted after the treatment during the study period . RESULTS: In our study we had patients in all age groups, history of contact with dog or sheep was present in 33.33% of patients which is comparable with a majority of our patients(66.66%) as well as patients in the above compared study had the disease without contact with animals. Liver was the most common . The commonest symptom of hydatid cyst of liver was mass per abdomen, 7 Patients (62.36%) followed by pain abdomen 3 patients. CONCLUSIONS: Absence of history of contact with pets doesn't rule out the possibility of disease. Majority of liver hydatid were treated by partial pericystectomy & enucleation with external tube drainage which is an optimum treatment in our institute

The micro-electro-mechanical systems (MEMS) technology requires a robust non-contact quantitative measurement system for the characterisation of their performance, reliability and integrity. A TV holographic system with long working distance microscope is developed for the static, dynamic and 3-D surface profile characterisation of microsystems. The system can be operated either in continuous or stroboscopic illumination mode of operation. The usefulness of the system for measurement of deflection, discontinuities, resonance mode shapes and vibration amplitudes on both smooth and rough micro samples is discussed and demonstrated. � 2011, DESIDOC.

TV holo-shearography is a powerful non contact optical measurement technique for non destructive evaluation (NDE). The technique combines both TV holography and TV shearography into one unit to detect defects in structures by correlating the anomalies of out-of-plane deformation and its derivatives in lateral direction (slope), respectively. We present here such a system which detects the anomalies in honeycomb structures. A Lab VIEW based software has been developed to control the precision movement of the piezoelectric transducer unit for phase shifting, storing, and for real-time visualization of deviations of the correlation speckle and speckle shear patterns near the defect area. A (5,1) phase shifting algorithm is used for quantitative analysis. Such an algorithm is suitable for NDE of structures under quasi-dynamic loads. An advanced filtering technique has been incorporated to reduce the speckle noise and improve the wrapped or modulo-2? phase map obtained from the phase shifted speckle and speckle shear fringe patterns. Phase unwrapping software has been developed using a discrete cosine transform (DCT) to generate the 3-D profiles. � 2006 Old City Publishing, Inc.

A novel TV holography method is proposed for parallel evaluation of in-plane and out-of-plane deformation fields. The method permits a trade-off between in-plane and out-of-plane measuring sensitivity. A four-exposure, four-frame phase shifting technique is used in the experiments; the experimental results for an aluminum specimen subjected to both rotation in its own plane and a bending couple load at the center are presented. ? 2000 Optical Society of America.

Photorefractive two-beam coupling and energy transfer in BaTiO3 are studied at multiple wavelengths using He-Cd, He-Ne, and diode lasers. The photorefractive signal beam gain is measured as a function of the pump beam intensity, beam ratio intensity, spatial frequency of the grating, and angle between the grating vector and c axis of the crystal. The exponential gain coefficient is calculated from signal beam gain, and its dependence on the same parameters is studied. The dependence of the signal beam gain and exponential gain coefficient on spatial frequency are also evaluated theoretically and found to be in good agreement with the experimental data. Also, the signal beam gain is studied as a function of wavelength, and a very high value is obtained at 441.6 nm. Figure-of-merit parameters such as the maximum change in the refractive index, the space charge field at saturation, the trap density of the charge carriers, and the photorefractive sensitivity of the crystal are calculated from the experimental data. Since the absorption in BaTiO3 varies strongly with wavelength, its influence has been included in the calculations of the figure-of-merit parameters. The results are discussed in the light of the present understanding of photorefractive phenomena in crystals.

A modified in-line optical configuration in speckle interferometry is presented here for contouring in three-dimensional objects. This configuration uses single beam illumination and two directions of observation as in Duffy's configuration but the sensitivity obtainable is equal to that of Leendertz's configuration. This configuration is simple to implement and provides the possibility to vary the sensitivity over a wide range. The detailed theory and experimental results are presented.

A real-time visual approach for the calibration of phase step in image plane holography using BaTiO3 crystal as a recording medium is reported. In this method, the diffuse object is illuminated symmetrically with two collimated beams and a pump beam is added at the crystal plane. Each illuminating beam generates an individual interferogram at the observation plane when the object is subjected to load. A � phase shift to one of the illuminating beams results in the complete disappearance of the fringes due to phase reversal between the individual interferograms, and at 2� phase change, the fringe pattern is restored. After calibration, a single-beam illumination configuration is used for phase measurement. We present the theory of the method and experimental results for a centrally loaded diaphragm rigidly clamped along the periphery. ?1998 Society of Photo-Optical Instrumentation Engineers.

Multi-aperture speckle shear interferometry also exhibits sensitivity to the in-plane displacement component. The interferogram obtained even at normal illumination contains fringes due to the combined contributions of slope, strain and in-plane components. The fringe pattern, therefore, changes when the shear element is placed at different aperture positions for the same experimental conditions. We have examined a three-aperture symmetric configuration where the shear element is either placed at the peripheral aperture or at the central aperture. The experimental results are presented. Copyright ? 1996 Elsevier Science Ltd.

A modified two-aperture speckle shear interferometer that eliminates the contribution of the in-plane component and its derivative to the phase change, and yields a fringe pattern corresponding to the first-order partial derivatives of the out-of-plane displacement component, is reported in this note. In this method, two laterally sheared object points are viewed axially. The wave fields from these points are independently combined at the image plane of the imaging system. ? 1998 Elsevier Science Ltd. All rights reserved.