CRF is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. The commonest are xerosis and pruritus and the early recognition of cutaneous signs can relieve suffering and decrease morbidity.
Purpose -The paper aims to provide business process designers a formal yet user friendly technique to evaluate the implications of a process design on process performance even before its implementation. Design/methodology/approach -Based on practical experience, the paper has built on past research to hypothesize structural metrics for business processes that help assess the influence of process design on organizational goals. Findings -This paper suggests a list of structural metrics that can be used to approximate common performance goals (i.e. soft goals) at the stage of process design. Distinct views for process depiction are discussed to explain how each metric can be calculated and what kind of performance goals it can approximate.Research limitations/implications -The paper has assumed an intuitive relationship between process structure and process performance which has to be validated empirically. There is scope for developing formal methods to translate changes in structural metrics to monetary value for business and also to refine the structural metrics further if required. Practical implications -The suggested list of structural metrics and the corresponding process views can be used to compare process design alternatives to select a process design better aligned to organization goals. Originality/value -A list of structural metrics based on practical experience can be easily applied by business process designers to create a formal yet user friendly approach for process design evaluation.
A 29 day old male infant presented with a history of fever, cough, increasing respiratory distress and abdominal distension from the 10th day of life. Examination revealed failure to thrive, marked tachypnea, pallor, hepatosplenomegaly and harsh vesicular breath sounds. Chest skiagram showed extensive broncho-pneumonic changes. As the infant did not respond to antibiotics, he was investigated for tuberculosis. The gastric aspirate smear showed plenty of acid fast bacilli (AFB) and culture showed M. tuberculosis growth. Endometrial biopsy of the mother showed tuberculous granuloma and acid fast bacilli and culture of the aspirate from endometrium grew M. tuberculosis. The need for endometrial biopsy of mothers of infants with congenital tuberculosis is highlighted.
Fluid and salt retention have been described as a side effect of tacrolimus therapy. We report a case of unexplained massive fluid retention with pleural effusion and ascites in the immediate post-transplant period. The patient recovered immediately on conversion from tacrolimus to sirolimus.
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