“Using Cross-Sector Capability to Build the Energy Companies of
You are the CEO of a small-medium enterprise of your choice within the oil and gas supply chain, based in the UK. The period 2014-2017 has seen an unprecedented decline in the number of companies operating within the UK oil and gas sector.
1. Using an applicable framework of your choice, critically evaluate your company’s market-entry opportunities with a clear focus on
the current business situation, to use their cross-sector capabilities to enter into the renewables and offshore wind sector, to optimise your company’s profitability in the next five years, to ensure their long-term success.
Lasting one-sided and respective assymetrical sensorineural hearing misfortune: Clinical, vestibular, audiological and radiological assessment. Dynamic The point of this examination was to assess the clinical, vestibular, audiological and radiological highlights of patients with perpetual one-sided and assymetrical sensoneural hearing misfortune (SNHL). Material and techniques: Twenty eight patients with either lasting one-sided and topsy-turvy two-sided SNHL,diagonosed by methods for unadulterated tone audiometry(PTA) have been submitted to clinical,vestibular, audiological and radiological assessment. Results: Total twenty eight patients with male :female proportion of 2.11 were investigated. 22 (78.57%)patients had one-sided and 6(21.43%)patients had reciprocal topsy-turvy SNHL.Right :left proportion in instances of one-sided SNHLwas 0.83:1. Both tinnitus and vertigo was available in 12(42.95%)patients and missing in 10 (35.8%)patients.On otoscopy tympanic layer was in place in all cases.PTA demonstrated significant misfortune in dominant part of cases.Tone rot was done in11 patients and was typical in all cases.Cold calorie was done in 27 patients and was truant in 7(25.9%)patients ,hypoactive in 8(29.6%)patients.MRI examination was done in 9 patients.Out of 9,7 were ordinary and rest two indicated positive discoveries. Conclusion: Proper clinical, vestibular and audiological work up is essential before radiological examination is tried to increment diagonostic yield and cost adequacy in one-sided, reciprocal (asymmetrical)SNHL. Presentation Despite the fact that a regularly experienced conclusion by otolaryngolist, one-sided SNHL speaks to a troublesome clinical element for the expert. Though the analysis is effortlessly gotten by PTA, diagonosis of cause and treatment speaks to the multifaceted nature of this clinical circumstance. Additionally entangling work up is the evergrowing taken a toll for research facility and radiological studies(1).Reiss M (1994) did think about for differential determination of one-sided hearing loss(2).Hendrix RA(1990) did contemplate on awry sensoneural hearing loss.(3).Asymetrical hearing misfortune is the distinction of in excess of 10 db found the middle value of over the frequencies 0.5,1,2 and 4Khz or 20 db or more at any single frequency(4).A late investigation has proposed a run 3000 where in asymmetry of 15 db or more at 3000Hz require a MRI. On the off chance that under 15 db, a semiannual audiometric take after – up is sufficient(13).In introduce examine, we show clinical, vestibular ,audiological and radiological highlights of patients with either perpetual one-sided SNHL or unbalanced hearing misfortune. MATERIAL AND METHODS This forthcoming examination was led in the branch of Otorhinolaryngology,government medicinal college,Srinagar,Kashmir on 28 patients, comprising both pediatric and grown-up patients from December 2013 to May 2014. In the wake of assuming history about hearing misfortune and related manifestations, otoscopy and PTA, patients were subjected to audiological and vestibular assessment. Radiological investigation(MRI) was done in chosen gathering of patients as a result of money related and different reasons. Sex conveyance, laterality, audiological, vestibular and radiological discoveries are exhibited in tables1-6. RESULTS An aggregate of 28 patients were incorporated into exhibit think about. Out of 28 patients,19 were guys and 9 were females with male to female proportion of 2.11.(table 1).Involvement of left ear was more typical than right and 6 patients (21.42%) had respective deviated loss(table2).Vertigo and tinnitus was related indications in 12 patients(42.95) and 10patients(35.8%) gave hearing without related symptoms(table3).Tone rot test was ordinary in all tried patients.(table4).Cold calorie test was hypo-dynamic in 8 patients(29.6%) and missing in 7 patients(25.9%)(table5).Radiological discoveries were ordinary in 7 out of 9 patients(table6). DISSCUSSION We depict 28 patients of one-sided and awry SNHL which were clinically ,audiologically and radiologically assessed. Male dominance was seen in the present investigation which is reliable to other study.(5). In thinks about by Cadoni G etal(2005) and Stefano Berrettini(2013), both have female dominance which is as opposed to display study(6,7). In show study,left ear was more influenced when contrasted with right which is in consistant to ponder done by Stefano Berrettini(2013).(7). In our investigation tinnitus is available in 14 patients(50.09%) and vertigo is available in 16 patients(59.3%). Concentrate done by Stefano Berrettini indicated tinnitus was available in 87% and vertigo in 44% cases(7). In show think about, Tone rot test(TDT) was done in 11 patients.TDT was not done inpatients having significant SNHL. In all patients in which TDT was done ,comes about were typical. P.L.Bhatia (1969) etal in his examination utilized TDT for diagonosis of retro cochlear pathology(8). It helps in diagonosing neural sores very accurately(9). In our investigation vestibular capacity test (frosty calorie test) was done in all patients aside from one.CCT was absent(no reaction) in 7 patients(25.9%) and hypoactive in 8 patients(29.6%).Stafano Berrettini etal utilized calorie incitement test in his study(7). Despite the fact that the discoveries of diminished vestibular capacity on calorie testing in ipsilateral side to a SNHL truly has been usefull in proposing the diagonosis of vestibular schwannoma. In any case, at introduce ,it isn't sufficiently delicate tobe accommodating diagonostically for vestibular schwannoma in light of the fact that a little substandard vestibular nerve schwannoma won't not cause an anomalous calorie response(10).Hypoactivity of the influenced side is seen in meineres disease(11). In exhibit study,patients having hypoactive calorie test or truant calorie test or in whom tone rot test wasn't possible because of significant hearing misfortune were subjected to radiological investigation(MRI).One quiet on MRI indicated small scale hemorrhages in left peritrigonal territory and other patient on MRI demonstrated vestibular schwannoma.MRI is currently the prescribed examination for diagonosis of retrocochlear pathology.(2,12).MRI filtering with Gagolinium will recognize for all intents and purposes all tumors and was thought to be gold standard(14).Recently T2-weighted quick turn reverberate MRI has been observed to be touchy and more affordable than gadolinium improved >GET ANSWER