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Πέμπτη, 1 Δεκεμβρίου 2016

Appraise the Health-Related Quality of Life among Trauma Patients

2016-12-01T16-50-10Z
Source: International Journal of Health and Rehabilitation Sciences (IJHRS)
Ravi Kant Jain, Neelesh Dhadse, Chirag Sethi, Ravindra Kumar, Susmit Kosta.
Background: Limb injures is revolve a life-changing event that can cause significant disruptions in many important areas of life. Objectives: The objective of our study was to appraise the Health Related Quality of Life (HRQOL) and psychosocial factors associated with pain and disability in patients following Upper limb (UL) and lower limb (LL) trauma patients Materials and methods: A sample of convenience 300 adult male and female patients who met the inclusion criteria was included. A short form (36) health status questionnaire was filled by a single author from each patient after one year of follow up. This part was utilized to assess the QOL among limbs traumas patients. Results: Intraclass correlation coefficients were greater than 0.7 in five of the eight domains of SF 36 except mental health, social function and general health. Chronbachs α was higher than 0.8 all the domains except in social function domain. There was no difference in Health Related Quality of Life in patients with upper and lower limb trauma. However there was significant difference in 4 domains related to physical components of SF 36 survey form between male and females. Conclusion: Both upper and lower limb trauma similarly affects the Health Related Quality of Life in all age group of patients. Keywords: Sf-36, Trauma, HRQOL


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Levels of toxic metals and trace elements in autopsy liver tissue samples

2016-12-01T07-22-30Z
Source: Medicine Science | International Medical Journal
Servet Birgin Iritas, Ahmet Hakan Dinc, Aybike Dip, Bahri Melih Unal, Mevlut Ertan, Tulin Soylemezoglu.
The aim of the study is to determine the levels of toxic metals (cadmium and lead) and trace elements (zinc and copper) in the liver tissues of autopsy cases in Ankara and to evaluate the statistical relationship of these metals with subjects physical properties, smoking status, occupational exposure and environmental factors. Results are expected to establish the average burden of involved metals in liver tissue of Turkish population. Hepatic trace elements and toxic metal levels were assessed in 119 autopsy cases. Digestion procedure for liver tissues was carried out using a Mars Xpress microwave system (CEM, Matthews, USA) with PTFE microwave digestion vessels. Lead and cadmium were analyzed by Graphite Furnace Atomic Spectrometry; copper and zinc were analyzed by Flame Atomic Absorption Spectrometry. Average liver levels of metals and trace elements were found 29.5 µg/g, 216 µg/g, 0.39 µg/g and 4.38 µg/g dry weight for copper, zinc, lead and cadmium, respectively. Copper and lead levels were found higher in men. There was a significant decrease in copper levels with age. Lead levels in city dwellers were significantly higher and there was no correlation between metal levels and occupations of the individuals. Significant increase in copper, lead and cadmium were observed in smokers liver tissues. All metal levels were compared with each other and positive correlation was found between zinc-copper, lead-zinc and copper-zinc levels (p˂0.01). In Turkey, it is the first study which gives liver tissue levels of trace elements and heavy metals of autopsy samples in a city which has a median-scale industrial development.


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Severe major depression: a case of neurobrucellosis

2016-12-01T07-22-30Z
Source: Medicine Science | International Medical Journal
Lara Utku Ince, Nursel Akti Kavuran, Abdulcemal Ozcan, Suheyla Unal.



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Langerhans Cell Histiocytosis In Postauricular Region

2016-12-01T06-58-27Z
Source: The Southeast Asian Journal of Case Report and Review
Karthikeyan Ramasamy, John Kiran Rayer, Sivaraman Ganesan, Arun Alexander, Sunil Kumar Saxena.
We present a rare case report of eosinophilic granuloma in 10 year old female which was managed surgically. We also review the case literature, the clinical presentations briefly with surgical management.


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Unique Pearls In Synergy-Atrial Myxoma And Hypertrophic Cardiomyopathy

2016-12-01T06-58-27Z
Source: The Southeast Asian Journal of Case Report and Review
Avinash Mani, Manoj Kumar, Vineeta Ojha.
Primary cardiac tumors are a rare occurrence amongst general population, myxoma being the most common benign primary cardiac tumor. Hypertrophic cardiomyopathy(HCM) is a genetic cardiovascular disorder which usually presents with syncope or palpitations. The case we present here is a unique amalgamation of both these pathologies which are uncommon as well as completely unrelated to each other as far as literature describes. The patient presented with symptoms of congestive cardiac failure without any history of syncope and palpitation ,however echocardiography revealed the presence of HCM as well as atrial myxoma. This case reveals that remote possibility of such coexisting conditions should be kept in mind in clinical practice and also the fact that HCM can notoriously remain undetected presenting only as heart failure instead of its usual clinical features.


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Maternal And Perinatal Outcome In Antepartum Hemorrhage :At Sir T Hospital

2016-12-01T06-58-27Z
Source: The Southeast Asian Journal of Case Report and Review
Mehul Patel, Kanaklatta Nakum, Mayank Lunagariya, Juhi Patel.
Introduction: Antepartum haemorrhage is one of the major causes of maternal mortality. It contributes to 15-20% of maternal mortality in India. Incidence of antepartum haemorrhage is varies from 2-5 % of all deliveries. APH arising from placental abruption and placenta praevia is associated with an increased risk of postpartum haemorrhage 1 .Maternal and perinatal complication of antepartum haemorrhage are anaemia, postpartum haemorrhage, shock, low birth weight, intrauterine death, and birth asphyxia. Aim & Objectives: 1) To study Maternal and Perinatal outcome in Antepartum haemorrhage. 2) to study factors associated with Antepartum haemorrhage. Method & Materials: It is retrospective study carried out on 56 women admitted with the diagnosis of antepartum haemorrhage at Sir T. Hospital Bhavnagar during August 2015 to July 2016. The diagnosis was made on the basis of history, Clinical examination and few cases aided by ultrasonography. Result: In present study the incidence of APH was 1.4%. out of 56 cases 66% were multigravida and 71% of them were of low socio economic status.56% had feature of pre-eclampsia. Maternal and perinatal mortality was very high with increase rates of anaemia (100%), caesarean section rate (61%), need of blood transfusion (86%), coagulation failure (13%), low birth weight (75%). Perinatal mortality was 43%.


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Retinopathy of prematurity: incidence and risk factors: a hospital based study from Shimla, Himachal Pradesh, India

2016-12-01T03-48-47Z
Source: International Journal of Research in Medical Sciences
Nitin Kumar, Shayam L. Kaushik, Neelam Grover, Ram L. Sharma.
Background: The blindness due to retinopathy of prematurity (ROP) is avoidable, if it is detected in time by screening. With increasing survival of preterm and low birth weight newborns in neonatal units, who are on prolonged oxygen therapy and mechanical ventilation; ROP is bound to affect these babies. This study was planned to investigate the incidence and the risk factors of ROP in a tertiary care institute in Himalayan region of north India. Methods: This was a hospital based prospective study, conducted at neonatal intensive care units at IGMC, Shimla, from June 2011 to July 2012. 64 premature and low birth weight neonates born or admitted for neonatal intensive care unit (NICU) were screened for ROP using indirect ophthalmoscope. Cases found positive for ROP were closely followed up and managed as per international guidelines. Results: Out of 64 neonates, 14 were lost to follow up and 50 babies were enrolled in the study. Out of them 21 were males and 29 were females. Among them 3 male and 5 female newborns developed ROP. Mean gestational age of babies with ROP was 30.63 weeks. ROP was significantly associated with oxygen administration (p=0.027), RDS (p=0.003), septicaemia (p=0.028) and exchange transfusion (p=0.003). Apneic spells, surfactant administration, hyperbilirubinemia, phototherapy, blood transfusion and maternal factors were not associated with increased risk of ROP. Conclusions: For premature infants with birth weight less than 1200 grams, who has received prolonged oxygen therapy, associated respiratory distress and had received exchange transfusion the screening of ROP should be done at most appropriate time that is 32 - 40 weeks of gestational age. Timely referral of detected ROP cases for early treatment prevents blindness. There is a need for the obstetricians, neonatologist and ophthalmologist to work in close co-operation to prevent blindness due to ROP.


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The First Mediterranean Seminar on Science Writing, Editing and Publishing, Sarajevo, December 2-3, 2016

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Izet Masic, Doncho Donev, Osman Sinanovic, Miro Jakovljevic, Enver Zerem, Dejan B. Milosevic, Srecko Gajovic, Armen Yuri Gasparyan, Sekib Sokolovic, Nermin Salkic, Selma Uzunovic, Silva Dobric, Floreta Kurti, Edin Begic, Admir Kurtcehajic.
The First Mediterranean Seminar on Science Writing, Editing & Publishing (SWEP 2016) was held in Sarajevo, Bosnia & Herzegovina from 2nd to 3rd December 2016. It was organized by Academy of Medical Sciences of Bosnia and Herzegovina, running concurrent sessions as part of its Annual Meeting titled Days of AMNuBiH - Theory and Practice in Science Communication and Scientometrics. Hotel Bosnia in the city centre was the chosen venue. On the first day, nineteen presentations on various issues of science writing and publication ethics were delivered by speakers from Croatia, Serbia, Macedonia, Albania, Bosnia & Herzegovina and the UK (Asim Kurjak, Milivoj Boranić, Doncho Donev, Osman Sinanović, Miro Jakovljević, Enver Zerem, Dejan Miloević, Silva Dobrić, Srećko Gajović, Izet Maić, Armen Yuri Gasparyan, ekib Sokolović, Nermin Salkić, Selma Uzunović, Admir Kurtčehajić, Edin Begić and Floreta Kurti). Each presentation had a take-home message for novice and seasoned authors, encountering numerous problems in non-Anglophone research environment. Lecturers, who were internationally recognized editors of regional journals, generously shared their experience of adhering to the best ethical guidance. Elegant presentations by Srećko Gajović (Editor-in-Chief of the Croatian Medical Journal) and Armen Yuri Gasparyan (past Chief Editor of the European Science Editing) showcased their accomplishments that strengthened ties between authors from all over the world. Gasparyan reflected on educational resources of editorial associations, such as the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE), and called not just to declare the adherence to, but also to enforce their ethical guidance in daily practice. Editors of Medical Archives, Croatian Medica Journal, Vojnosanitetski Pregled, Psychiatria Danubina, Acta Informatica Medica, Materia Socio-Medica, The Donald School Journal of Ultrasound in Obstretics and Gynecology, Acta Medica Saliniana and Medicinski Glasnik presented their editorial strategies aimed at attracting best authors and resolving problems with authorship, conflicts of interest, and plagiarism. Topical education on science writing and editing was considered as an inseparable part of continuing professional development in biomedicine. Armen Yuri Gasparyan (UK) was offered an opportunity to interact with more than 70 participants, attending the SWEP 2016 on the second day. The lecturer talked about author contributions, disclosures of conflicts of interests, plagiarism of ideas and words, research performance and impact indicators, and targeting ethical journals. Topics were presented in a way to help non-Anglophone authors, reviewers and editors avoid common ethical problems. Dr Gasparyan stressed the importance of regularly arranging such meetings across Balkan and Mediterranean countries to eradicate plagiarism and other forms research misconduct. The organizers of the SWEP 2016 awarded selected keynote speakers with certificates of lifetime achievement in journal editing, and decided to run the Seminar annually with support of Balkan and Mediterranean editors and publishers. The SWEP 2016 marked a turning point in the process of regional developments since all attending editors opted for nurturing enthusiasm of the organizers and launching the Mediterranean Association of Science Editors and Publishers (MASEP). The Seminar was a great success with its impressive scientific and social activities. It attracted more than 100 students, researchers, editors, and publishers from Bosnia & Herzegovina and neighbouring countries. Proceedings, in the form of short reports, were published in Acta Informatica Medica and archived in PubMed Central. New friendships were forged between regional experts in editing and young specialists during those unforgettable two days of intensive discussions a


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The Most Influential Scientists in the Development of Medical Informatics (15)

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Izet Masic.



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Magnetic Resonance Imaging of a Case of Central Neurocytoma

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Kreshnike Dedushi, Serbeze Kabashi, Mehmet Sahin Ugurel, Naser Ramadani, Sefedin Mucaj, Kamber Zeqiraj.
Background: The purpose of this study is to investigate the MRI features of central neurocytoma. Case report: A 45 year old man with 3 months of worsening daily headaches. These headaches were diffuse, lasted for several hours, and mostly occurred in the morning. She was initially diagnosed and treated for migraines but later he had epileptic attack and diplopia and neurolog recomaded MRI. Methods: precontrast MRI; TSE/T2Wsequence in axial/coronal planes; 3DHi-resolution T1W sagittal; FLAIR/T2W axial; FLAIR/T2W and Flash/T2W oblique coronal plane (perpendicular to temporal lobes) GRE/T2W axial plane for detection of heme products. Post-contrast TSE/T1W sequence in axial, coronal and sagittal planes. Diffusion weighted and ADC mapping MRI images for EPI sequence in axial plane. Results: A 23x12mm heterogeneous mass within aqueductus cerebri, with calcified and hemorrhagic foci and extending downwards till fourth ventricle. Its originating from the right paramedian posterior aqueductal wall (tectum), and also extending to and involving the tegmentum of mesencephalon at its right paramedian aspect. CSF flow obstruction secondary to described aqueductal mass, with resultant triventricular hydrocephalus). Marked transependymal CSF leak can be noted at periventricular white matter, secondary to severe hydrocephalus. After IV injection of contrast media, this mass shows mild-to-moderate heterogenous speckled enhancement. Conclusion: MRI is helpful in defining tumor extension, which is important in preoperative planning. Although IN is a relatively rare lesion, it should be considered in the differential diagnosis of intraventricular lesions in the presence of such typical MR findings. However, a definitive diagnosis requires immunochemical study and electron microscopy.


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How to Compose, Write and Publish a Scientific or Professional Communication

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Milivoj Boranic.
There is an ample number of recommendations, guides and monographs addressing the art of composing and publishing written, oral or visual communications in science and various professions. In order to write an article, autors have to follow certain rules. Presentation of the article (oral or poster presentation) also requires skill, meaning that you have to fulfill certain guidelines and regulations.


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How to Improve Visibility of Scientific Biomedical Sources

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Asim Kurjak.
With the rapid development of information and communications technologies, industrial nations are transforming into societies in which knowledge is the most contested and valuable good. The increased speed at which we have to acquire new knowledge, insights, and abilities is forcing us to divide up learning into novel, shorter phases. The traditional choreography of learning with its long, rigid defined school, job, and university educational periods is already obsolete today. Self-organized, lifelong learning is becoming a must. Everyone knows that without the uncertainty of the new nothing new is possible. To try to prevent this in one way or another would be fatal for science, as well as for our society as a whole. Research means thinking ahead. Research means recognizing challenges and taking responsibility for the new. The freedom needed for this is now the international standard, to which we have to adapt. The question of the development of such standards for research can therefore not be posed frequently and persistently enough. We all know that creativity is biological privilege of young age and the best test for their scientific creativity is publication in respectable journals with a solid impact factor. Conferences like this one in Sarajevo in 2016 should be very stimulated for younger as well as more senior research workers.


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Biomedical Scientific and Professional Social Networks in the Service of the Development of Modern Scientific Publishing

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Izet Masic, Edin Begic.
Information technologies have found their application in virtually every branch of health care. In recent years they have demonstrated their potential in the development of online library, where scientists and researchers can share their latest findings. Academia.edu, ResearchGate, Mendeley, Kudos, with the support of platform GoogleScholar, have indeed increased the visibility of scientific work of one author, and enable a much greater availability of the scientific work to the broader audience. Online libraries have allowed free access to the scientific content to the countries that could not follow the economic costs of getting access to certain scientific bases. Especially great benefit occurred in countries in transition and developing countries. Online libraries have great potential in terms of expanding knowledge, but they also present a major problem for many publishers, because their rights can be violated, which are signed by the author when publishing the paper. In the future it will lead to a major conflict of the author, the editorial board and online database, about the right to scientific content This question certainly represents one of the most pressing issues of publishing, whose future in printed form is already in the past, and the future of the online editions will be a problem of large-scale.


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Regadenoson in Myocardial Perfusion Study - First Institutional Experiences in Bosnia and Herzegovina

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Nermina Beslic, Renata Milardovic, Amera Sadija, Sejla Ceric, Zeljka Raic.
Introduction: Myocardial perfusion imaging (MPI) is widely used in the evaluation of known and suspected coronary artery disease (CAD). Imaging of heart in stress and rest enables the comparison of myocardial uptake of radiotracer in proportion to the needs and coronary flow, which is used for detection of perfusion defects. Exercise stress and pharmacologic agents are used for the stressing purpose. Novel pharmacologic stressor regadenoson is A2A selective adenosine agonist, which selectively binds to the adenosine receptors in coronary arteries causing coronary dilatation. Materials and methods: We analyzed 50 myocardial perfusion studies performed with regadenoson as a pharmacologic agent that was injected before Tc99m-sestamibi in stress imaging. Stress and rest sets of images were evaluated for relative uptake of Tc99m-sestamibi in order to detect and characterize perfusion defects. After the injection of regadenoson, hemodynamic parameters and potential side-effects were closely monitored. Side-effects were stratified per severity as mild, moderate and severe. Studies were read by nuclear medicine physicians using quantitative perfusion SPECT software. Additional diagnostic information such as wall motion and wall thickening were provided by gating. Results: Thirty-three patients (66%) experienced one or more side-effects upon the administration of regadenoson, most commonly warmth and chest discomfort. In all patients but one (98%), the symptoms were mild, of short duration and self-limiting. Out of all side-effects registered, 44 (96%) were mild, and 2 (4%) were moderate. Two moderate side-effects developed in one patient with a prior history of asthma, and included shortness of breath and cough. Heart rate changed by 16 +- 31 bpm. Highest increase in blood pressure was 30 mm Hg for systolic, and 10 mm Hg for diastolic. One case of significant decrease in blood pressure was noted from the hypertensive basal values, 50 mm for systolic, and 30 mm Hg for diastolic. ST segment depression of up to 1 mm occurred in 4 cases (8%), and T-wave changes in 3 cases (6%). No conduction abnormalities, significant hypotension, symptomatic bradycardia or cardiac arrest ocurred. Conclusion: Our first institutional experiences proved regadenoson as A2A selective adenosine agonist as a pharmacologic stressor to be safe, tolerable and easily used. Its safety profile enabled the study to be performed in patients with respiratory disease also.


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Self-citation of Medical and Non-medical Universities in Northern Iran

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Mohammad Ali Jahani, Mousa Yaminfirooz.
Background: Self-citation is one of the main challenges in the evaluation of researchers scientific output. This study aimed at comparing the institutional self-citation among the universities located in Northern Iran. Methods: This study was conducted as a scientometric study. Research population included all scientific productions of 16 Northern Iran Universities with at least 100 indexed documents indexed in the Web of Science (WoS) by 2 June 2015. The citation analysis section of WoS was used for data collection. SPSS was applied for data analysis. Study hypotheses were tested with two independent sample t-test and paired sample t-test. Results: Producing 16,399 papers, northern Iran universities had 5.33% of contribution in Irans scientific production. They received 84,058 citations with 17% and 12% of self-citations belonged to the non-medical and medical universities, respectively. Testing hypotheses revealed that increase in received citations significantly increases the rate of self-citation and increase in scientific production does not necessarily increase the rate of self-citation. Conclusion: The rate of self-citation in the studied universities was not relatively high. However, investigating into the factors affecting the rate of and motives for self-citation needs further research.


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The Length of the Greater Palatine Canal in a Lebanese Population: a Radio-anatomical Study

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Georges Aoun, Ibrahim Nasseh.
Objective: The aim of this study was to evaluate the length of the greater palatine canal in a Lebanese population using cone-beam computed tomography (CBCT) technology. Material and methods: In this study, we measured the length of 148 greater palatine canals in 74 CBCT images of Lebanese adult patients (38 females and 36 males). The data obtained was analyzed statistically to determine 1) if age is related to the length of the canal, 2) if the length of the left side tends to be systematically larger or smaller than the length of the right side, and 3) if the mean length of the canals in females is different than the one in males. Results: In a sagittal plane, the average length of the greater palatine canal was 30.62 (30.64 mm on the right and 30.60 mm on the left). Conclusion: Within the limits of this study, we concluded that in our sample in a Lebanese population, the length of the greater palatine canal does not significantly vary according to age, gender, and side.


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Feasibility and Value of Radiographic Union Score Hip Fracture after Treatment with Intramedullary Nail of Stable Hip Fractures

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Daniele Maiettini, Michele Bisaccia, Auro Caraffa, Giuseppe Rinonapoli, Luigi Piscitelli, Olga Bisaccia, Giuseppe Rollo, Luigi Meccariello, Paolo Ceccarini, Alberto Rebonato.
Introduction: Given the importance of fracture healing on patient outcome in clinical practice, it is critical to assess fracture healing. Aim: The aim of this study was to evaluate the feasibility of the Radiographic Union Score Hip fracture after treatment with intramedullary nail of stable hip fractures. Patients and Methods: We retrospectively collected the data from the clinical records of our institution of the 47 patientswho had undergone intertrochanteric hip fracture treatment using an intramedullary nail. Pain visual analogic score (VAS) was collected the same day that X-rays were taken. Plain hip X-rays were performed, in two radiographic views, at 40 and 90 days after the surgical procedure. The correlation between the RUSH and VAS score was evaluated. Results: Mean RUSH and VAS scores showed a strong statistical improvement between the 40 and 90 day follow-ups. RUSH value at 40 days fitted an inverse linear regression with VAS, p-value of 0.0063 and r2 of 0.15. At 90 days the regression between RUSH and VAS scores was not significant. Conclusion: RUSH could be proposed as an objective system to evaluate union in hip fractures treated with intramedullary nail.


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Prevalence of Oral Lichen Planus in Diabetes Mellitus: a Meta-Analysis Study

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Hamid Reza Mozaffari, Roohollah Sharifi, Masoud Sadeghi.
Background: Oral lichen planus (OLP) is associated with various other systemic conditions such as hypertension, diabetes mellitus (DM). This study evaluated the prevalence of OLP in DM patients compared with non-diabetic control subjectsin a meta-analysis study. Methods: In this study from January 1973 to August 2016, we searched the studies in Web of Science, Medline/PubMed, Scopus, Science direct, SID (Scientific Information Database), Cochrane and Embase databases. Strategy search was the Medical Subject Heading (MeSH) term oral lichen planus or oral mucosa combined with diabetes in PubMed and this search in other databases. Heterogeneity between estimates was evaluated by the Q and I2 statistic. Also, publication bias was assessed through funnel plot analysis with the Kendalls and Eggers tests. Results: From 831 studies were identified with different search strategies, 11 studies met the criteria to be included in meta-analysis (11 case-control studies). The overall prevalence of OLP in 11 studies with 4937 DM patients and 3698 control subjectswas 1.5% and 0.75%, respectively. In this meta-analysis, the OR in prevalence of OLP in DM patients compared with control subjects was 1.584 (95%CI1.013-2.477; P=0.044) with a low level of heterogeneity (I2 = 0%) that the result showed the prevalence of OLP in DM patients is significantly more than control subjects. Conclusions: This meta-analysis study showed an association between OLP with DM, whereas this association was no significant in previous studies, it was probably because different selecting of age, sex, type of DM, medications and criteria. Totally, the meta-analysis showed the risk of OLP in DM washigher compared with control subjects.


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A Double-Blind Randomized Clinical Trial Comparing the Effect of Neostigmine and Metoclopramide on Gastric Residual Volume of Mechanically Ventilated ICU Patients

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Afshin Gholipour Baradari, Abbas Alipour, Abolfazl Firouzian, Laleh Moarab, Amir Emami Zeydi.
Background: In critically ill patients, enteral feeding through the nasogastric tube is the method of choice for nutritional support. Gastrointestinal feeding intolerance and disturbed gastric emptying are common challenges in these patients. The aim of this study was to compare the effect of Neostigmine and Metoclopramide on gastric residual volume (GRV) in mechanically ventilated ICU patients. Methods: In a double blind, randomized clinical trial, a total of 60 mechanically ventilated ICU patients with GRV >120 mL (3 hours after the last gavage), were randomly assigned into two groups A and B. At baseline and 6 hours later, patients in group A and B received intravenous infusion of neostigmine in a dose of 2.5 mg and metoclopramide in a dose of 10 mg in 100 ml of normal saline, within 30 minutes. Patients gastric residual volumes were evaluated before the beginning of the intervention, and 3, 6, 9 and 12 hours after the intervention. Results: After adjusting of other variables (Sex, BMI and ICU stay period) generalized estimating equation (GEE) model revealed that neostigmine treatment increased odds of GRV improvement compare to metoclopramide group (Estimate: 1.291, OR= 0.3.64, 95% CI: 1.07-12.34). However there is a statistically significant time trend (within-subject differences or time effect) regardless of treatment groups (P


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Quality Improvement of Liver Ultrasound Images Using Fuzzy Techniques

2016-12-01T01-44-00Z
Source: Acta Informatica Medica
Azadeh Bayani, Mostafa Langarizadeh, Leila Shahmoradi, Amir Reza Radmard, Ahmadreza Farzaneh Nejad.
Background: Liver ultrasound images are so common and are applied so often to diagnose diffuse liver diseases like fatty liver. However, the low quality of such images makes it difficult to analyze them and diagnose diseases. The purpose of this study, therefore, is to improve the contrast and quality of liver ultrasound images. Methods: In this study, a number of image contrast enhancement algorithms which are based on fuzzy logic were applied to liver ultrasound images - in which the view of kidney is observable - using Matlab2013b to improve the image contrast and quality which has a fuzzy definition; just like image contrast improvement algorithms using a fuzzy intensification operator, contrast improvement algorithms applying fuzzy image histogram hyperbolization, and contrast improvement algorithms by fuzzy IF-THEN rules. Results: With the measurement of Mean Squared Error and Peak Signal to Noise Ratio obtained from different images, fuzzy methods provided better results, and their implementation - compared with histogram equalization method - led both to the improvement of contrast and visual quality of images and to the improvement of liver segmentation algorithms results in images. Conclusion: Comparison of the four algorithms revealed the power of fuzzy logic in improving image contrast compared with traditional image processing algorithms. Moreover, contrast improvement algorithm based on a fuzzy intensification operator was selected as the strongest algorithm considering the measured indicators. This method can also be used in future studies on other ultrasound images for quality improvement and other image processing and analysis applications.


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Non-prescription sale of antibiotics in pharmacies across Puducherry, India

2016-12-01T00-40-16Z
Source: International Journal of Basic & Clinical Pharmacology
Mohan Jaganathan, Vallish BN, Brahadeesh Mayathevar, Raj Kishore Mahato.
Background: Despite being illegal, non-prescription sales of antibiotics in India continue to be a major contributor to antibiotic abuse, which fosters antibiotic resistance. Methods: Two trained actors simulated symptoms of acute gastroenteritis (AGE) and upper respiratory tract infections (URTI) in 60 pharmacies each randomly selected in the Union Territory of Pondicherry, India. The ease of obtaining antibiotics, any additional enquiries made by the pharmacies, and any additional advise given were noted. Results: Only 33/120 pharmacies (27.5%) declined to dispense antibiotics without prescription; all 33 were attached to a hospital or nursing home. The most frequently dispensed antibiotics for AGE and URTI were ciprofloxacin (41.4%) and coamoxiclav (41.3%) respectively. Out of the 87 pharmacies which dispensed antibiotics without prescription, the presence of additional symptoms and previous drug allergy were enquired by 20 (22.9%) and 9 (10.3%) pharmacies respectively. While over half of the pharmacies gave instructions regarding dose, duration and frequency of antibiotic consumption, none of the pharmacies provided information regarding adverse reaction profile of antibiotics. Non-pharmacological measures for symptomatic improvement were advised by 24/120 pharmacies (20%). Conclusions: Non-prescription sales of antibiotics are unacceptably high in Pondicherry. Stricter implementation of the law and public awareness of the perils of inappropriate antibiotic usage are the need of the hour.


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