Introduction: Microtubular decompression (MTD) being a short-duration surgery, with many advantages, has gained popularity and can be done either in general anaesthesia (GA) or awake techniques like spinal anaesthesia (SA). The authors ventured to assess perioperative parameters, quantify peri-operative complications as the primary aim and determine patient satisfaction as the secondary aim of the study. Materials and Methods: It was a retrospective study performed over a period of ten years (2009–2019) and included 625 patients. The patients included were aged greater than 18 years, American Society of Anaesthesiologists (ASA) score 1, 2, or 3. Patients with ASA 4 or 5, spinal instability, infection, or revision surgeries were excluded. Results: There is no significant difference in the complication rates. The clinical outcome in the form of VAS and ODI scores showed significant differences both in SA and GA groups at the final follow-up. The total anaesthetic, surgical times, mean arterial pressure (MAP), and heart rate (HR) perioperatively were longer in the GA group (P < 0.05). The perioperative blood pressures are lower in the SA group. The dissatisfaction rate is about 3.5%, of which the patients and a total of 88.5% of patients would like to opt for SA for future surgeries. Conclusion: This study represents the ten-year experience with MTD operated either with SA or GA. Awake spinal surgery is promising and has the glaring benefits of better peri-operative hemodynamic stability, and faster recovery with reduced surgical and anaesthetic duration. Dissatisfaction rates can be decreased by better explanation and the patient’s decision. Keywords: Awake spine surgery, Microtubular decompression, Hemodynamic parameters, Complications, Patient satisfaction.
<p><strong>Background</strong>: Spinal anaesthesia carries the advantage of having rapid onset, lesser blood loss, early recovery and hospital stay as compared to general anaesthesia. The present study evaluated outcomes of awake spinal fusion i.e., minimal invasive single level transforaminal lumbar interbody fusion (MIS-TLIF) under spinal anaesthesia. Current study is a retrospective analysis of prospectively collected data carried to assess patient related outcome benefits for a single level transforaminal lumbar interbody fusion done under spinal anaesthesia.</p><p><strong>Methods</strong>: Patients who fit deemed criteria not responding to 6 weeks of conservative treatment to lumbar degenerative pathologies underwent MIS-TLIF. The demographic data, visual analogue pain scale (VAS), Oswestry disability index (ODI), blood loss, time from entering operation theatre to time of incision, time of bandaging to exit from operation theatre, time of stay in post anaesthesia care unit (PACU), duration of surgery, nausea/vomiting, urinary retention, requirement of analgesics, duration of stay in hospital, peri-operative complications, fusion rate and satisfaction score were compiled and assessed.</p><p><strong>Results:</strong> 150 patients were operated with MISTLIF under spinal anaesthesia. VAS and ODI score improved significantly at final follow up (p<0.05). The mean duration of surgery was 148±18.24 minutes and blood loss were 109.64±110.45 ml. The average time from entering OT to incision and bandaging to exit was respectively 27.32±8.44 and 6.43±3.28 minutes. Mean PACU time was 36.74±6.32 minutes while duration of stay averaged 1.58±0.67 days. Post operative analgesia requirement was in 10.6% patients and radiographic fusion was observed in 96.6% patients. 90.6% patients were fully satisfied with spinal anaesthesia.</p><p><strong>Conclusions: </strong>Awake spinal fusion should be considered as a novel surgical approach with newer minimal invasive surgical techniques and regional anaesthesia to improve patient satisfaction and overall surgical outcome.</p>
The objective of this paper is to introduce a new CPU Scheduling Algorithm called time quantum based CPU Scheduling Algorithm which acts as preemptive based on the arrival time. The algorithm helps to improve the average waiting time of Round Robin algorithm in real time uniprocessor-multi programming operating system. CPU Scheduling is the basis of multi-programmed operating system. The scheduler is responsible for multiplexing processes on the CPU. There are many scheduling algorithms available for a multi-programmed operating system like FCFS, SJF, Priority, Round Robin etc. The proposed algorithm is based on Round robin scheduling . In this paper, the results of the existing Round Robin algorithm is compared with the proposed algorithm General TermsCPU Scheduling Algorithms, Context Switching.
Wireless Sensor Network (WSN) is a combination of various small size processing units called sensors. Sensors are deployed over a region to monitor the environment and other happenings. Sensors sense the environmental situations and communicate the sensor data to nearby nodes or base stations. Sensor’s energy keeps on depleting due to their multiple functionalities like sensing, aggregating of received data and communication with neighbor nodes. Energy constraint is one of the vital challenges for sensor nodes as they are majorly operational in unreachable locations with non-replaceable power resources. Various techniques have been implemented to overcome the challenge of limited power resources. Clustering is one of the techniques that facilitate to prolong the network lifetime through effective utilization of energy resources. Numerous clustering protocols have been implemented based on various parameters. Mutual Exclusive Distributive Clustering (MEDC) is one of the distributed clustering protocols that elect the cluster head based on residual energy. Selected cluster head performs the dual functionality i.e. combining the collected data and sending the same to the base station. This paper present the proposed algorithm which employed relay nodes in MEDC to distribute the load of cluster head and the distribution would lead to further enhance the network lifetime of WSN.
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