Managerial accounting Production cannot be increased by giving incentives to direct workers only. It is necessary to have the cooperation of indirect workers to attain maximum efficiency. Indirect workers are equally important and should be given incentives. It is difficult to introduce an incentive scheme for indirect workers because standards cannot be set easily, efficiency is difficult to measure and actual output cannot be determined in relation to set standards.

41 What drugs cause Budd-Chiari syndrome?

42 I recently saw a patient with pyrexia of unknown origin (PUO). He was not particularly unwell and not jaundiced. But 1 week later he was found to have a liver abscess on ultrasound. How can one make the diagnosis earlier?

43 What is the most recent management of HCC (hepatocellular carcinoma)? What is radiofrequency ablation? What is its role in the management of HCC and its prognosis?

44 How do you differentiate haemorrhagic ascitic fluid due to malignancy and accidental rupture of blood vessel while withdrawing the fluid?

45 Is there any place for the medical treatment of gallstones with ursodeoxycholic acid?

46 In a case of common bile duct stones, where it is acknowledged that spontaneous passage within 24 hours is observed in approximately 50% of patients provided the stone is small, and that in these cases there is no need for a sphincterotomy, is the use of antispasmodics, e.g. Buscopan (active ingredient hyoscine-N-butylbromide), recommended? Surely these will reduce the pain and improve the chance of a spontaneous release of obstruction without surgical procedure?

47 What is sphincter of Oddi dysfunction?

48 I would like to know: what is the role of lysosomal hydrolases (cathepsin B) in the pathogenesis of acute pancreatitis?

49 What is the role of octreotide in management of acute pancreatitis?

50 Why does paralytic ileus occur in pancreatitis?