Test-retest reliability of transcarpal sensory NCV method for diagnosis of carpal tunnel syndrome

Background: Carpal Tunnel Syndrome (CTS) is the most frequent entrapment neuropathy affecting the upper extremity. There are a variety of electrodiagnostic methods available for documenting median neuropathy in CTS. In some studies, determining the sensory NCV across the palm-wrist segment has been introduced as the most sensitive diagnostic procedure for CTS. The aim of this study was to investigate the test-retest reliability of transcarpal median sensory NCV method for the diagnosis of CTS. Materials and Methods: Twenty-three patients with clinical symptoms of CTS were tested two times by two different practitioners in one session and again by the first practitioner after one week. Stimulation of the median nerve was performed in the wrist and palm, with a conduction distance maximum of 7 cm, reliabilities of median nerves sensory nerve action potential latencies with stimulation at wrist and palm (W-SNAP, P-SNAP) and its transcarpal NCV were assessed with intraclass correlation coefficient (ICC). Results: Comparison of the obtained values, which were done by two practitioners in one session showed ICC of W-SNAP latency, P-SNAP latency and transcarpal NCV of 0.93, 0.88 and 0.87, respectively and values that were done by one practitioner in two sessions with one-week interval showed ICC of 0.60, 0.50 and 0.47, respectively. Conclusion: Our findings suggest excellent interpractitioner test-retest reliability of transcarpal median sensory NCV method for diagnosing CTS

Molecular detection of antimicrobial resistance in local isolates of Staphylococcus epidermidis from urinary tract infections in Faisalabad region of Pakistan

Staphylococci are one of the foremost causes of urinary tract infections (UTIs) in humans. The emergence of multiple drug resistance (MDR) among Staphylococci poses serious challenges in antimicrobial therapy for UTIs. Most work has been done on S. aureus while coagulase negative Staphylococci (mainly S. epidermidis) are often neglected. This study was conducted to establish a baseline profile of drug resistance in local S. epidermidis isolates from UTIs. Eighty urine samples were collected from suspected UTIs cases and screened for S. epidermidis. Twenty isolates were suspected as S. epidermidis based on colony morphology and Gram staining. Molecular detection by polymerase chain reaction (PCR) confirmed 13 isolates as S. epidermidis. Using disc diffusion method, phenotypic drug resistance of the isolates was observed towards erythromycin (100 %), gentamycin, azithromycin and tetracycline (92.3 %), ampicillin and oxytetracyclin (84.6 %), amikacin and srteptomycin (76.9 %), methicillin (69.2 %), cephradine, cefaclor and cefazolin (53.8 %) and vancomycin (15.3 %). Eighteen most commonly reported genes responsible for conferring resistance towards these drugs were targeted by PCR: among these tetM gene was found most prevalent (46.1 %) followed by tetK (30.7 %), aac(6’)/aph(2”) (30.7 %), aacA-aphD (23 %), ermA (23 %), blaZ (23 %), mecA (23 %) blaTEM-1 (23 %), MeccA (23 %) and mecA (15.3 %). No gene fragment for vancomycin resistance was detected. The salient finding was that all S. epidermidis isolates were multiple drugs resistant as they showed resistance against at least three structurally different antimicrobial agents. It is concluded that in addition to the mostly used antimicrobial agent vancomycin, the cephalosporins including cephradine, cefaclor and cefazolin are also the drugs of choice against UTIs caused by S. epidermidis

Psychosocial interventions for depression among young people in Sub-Saharan Africa:a systematic review and meta-analysis

Background: Depression among young people is a global health problem due to its rising prevalence and negative physical and social outcomes. The prevalence of depression and the treatment gap among young people in Sub-Saharan Africa (SSA) is higher than global estimates. Most psychosocial interventions for adolescent and youth depression were developed in high-income countries and less is known about their effectiveness in SSA. Due to contextual differences, findings from High-Income Countries (HICs) are less applicable to SSA. Yet, no systematic review of psychosocial interventions for depression among young people in SSA has been conducted. Methods: A systematic literature search of four databases (Medline, Web of Science, PsycInfo, and Cochrane library) was conducted. Experimental studies published before May 2024 that evaluated the effect of psychosocial interventions on depressive symptoms among young people (aged 10–24 years) in SSA were included in the systematic review. Effect sizes (Hedge’s g (g)) indicating differences between intervention and control groups were calculated using a random effects model.Results: Twenty-two eligible studies were identified for the systematic review, of which eighteen randomized control trials (RCTs) involving 2338 participants were included in the meta-analysis. The findings revealed that psychosocial interventions significantly reduced depressive symptoms (g = −1.55, 95% CI −2.48, −0.63), although heterogeneity was high (I2 = 98.8%). Subgroup analysis revealed that efficacy differed significantly by intervention type, with Cognitive Behavioural Therapy (9 studies) showing the strongest effect (g = −2.84, 95% CI −4.29; −1.38). While Wise Interventions (a form of positive psychology interventions; 2 studies) had a moderate effect (g = −0.46, 95% C.I −0.53, −0.39), Interpersonal Psychotherapy (2 studies; g = −0.08, 95% CI −1.05, 0.88) and Creative Psychological Interventions (3 studies; g = −0.29, 95% CI −1.38, 0.79) showed smaller, non-significant effects. Sensitivity analysis excluding studies at high risk of bias strengthened the effect size. Few studies assessed factors affecting intervention efficacy and showed mixed effects of age, gender, and adherence levels.Conclusion: Psychosocial interventions, particularly CBT, significantly reduced depressive symptoms among young people in SSA. However, it is crucial to acknowledge the high heterogeneity which likely stems from variations in study populations and intervention delivery modalities. This highlights the need for further research to identify the specific intervention components and delivery methods that work best for distinct subpopulations. Future research should also explore how long intervention effects are maintained and factors affecting efficacy

Comparison of sampling adequacy between OPD based pipelle biopsy and in- patient conventional D&C, presented with abnormal uterine bleeding

Objective: To determine agreement on adequacy of sample by pipelle biopsy and conventional dilatation and curettage in patients with abnormal uterine bleeding. Study design: Cross sectional studySetting and Duration of Study: Department of Obstetrics and Gyneacology, Islamic International Medical College Trust, Railway Hospital Rawalpindi. Study was carried out over a period of six months (11-07-2012 to 14-01-2013). Patients and Methods: 84 patients presented with abnormal uterine bleeding age 45 years and older, attended Gynecology department of Railway Hospital Rawalpindi. Who qualified the inclusion criteria were enrolled in this study by non-probability consecutive sampling technique. The diagnostic intervention for endometrial sampling was by pipelle device and by conventional D&C. Both procedures were performed in the OT at the same time.First the pipelle sample was taken and was labeled as “A” then conventional D&C was performed and was labeled as “B”. Both samples were sent to the pathologist, who was blinded as to the method of sample collection for histopathology assessment. Adequacy of the sample was assessed as per operational definition. A data base was made in SPSS version 17. Kappa statistics was applied to assess the agreement. Results: Out of 84 patients, 80 (98.8%) of the patients had adequate sample with Pipelle Biopsy as compared to conventional curettage and dilatation (D & C). We therefore recommend the use of pipelle biopsy as a first line tool for endometrial assessment for our setups instead of D&C. Conclusion: Our study concluded that the Pipelle biopsy is a useful and convenient method to the patients and physicians as ompared to D&C performed in the operating theatre. It is useful in obese and high-risk patients with minimum chances of perforation of uterus due to its soft flexible tip

Predicting Heart Disease and Reducing Survey Time Using Machine Learning Algorithms

Currently, many researchers and analysts are working toward medical diagnosis enhancement for various diseases. Heart disease is one of the common diseases that can be considered a significant cause of mortality worldwide. Early detection of heart disease significantly helps in reducing the risk of heart failure. Consequently, the Centers for Disease Control and Prevention (CDC) conducts a health-related telephone survey yearly from over 400,000 participants. However, several concerns arise regarding the reliability of the data in predicting heart disease and whether all of the survey questions are strongly related. This study aims to utilize several machine learning techniques, such as support vector machines and logistic regression, to investigate the accuracy of the CDC's heart disease survey in the United States. Furthermore, we use various feature selection methods to identify the most relevant subset of questions that can be utilized to forecast heart conditions. To reach a robust conclusion, we perform stability analysis by randomly sampling the data 300 times. The experimental results show that the survey data can be useful up to 80% in terms of predicting heart disease, which significantly improves the diagnostic process before bloodwork and tests. In addition, the amount of time spent conducting the survey can be reduced by 77% while maintaining the same level of performance

Molecular Mechanisms of Peritoneal Dialysis–Induced Microvascular Vasodilation

Peritoneal dialysis (PD) solutions dilate microvessels by undefined mechanisms. This vasodilation directly affects ultrafiltration and solute exchange during a PD dwell and is thought to account for the variable mass transfer area coefficient for small solutes during a glucose-based hypertonic dwell. We hypothesized that PD-mediated vasodilation occurs by endothelium-dependent mechanisms that involve endothelium energy-dependent K+ channels (KATP), adenosine A1 receptor activation, and NO release. We used intravital videomicroscopy to study 3 levels of microvessels (A1 inflow arterioles about 100 μm diameter to pre-capillary A3 arterioles 10 – 15 μm diameter) in the terminal ileum of anesthetized rats under control conditions in vivo in a tissue bath. Ileum was bathed with hypertonic mannitol or 2.5% glucose-based PD solution (Delflex: Fresenius Medical Care North America, Waltham, MA, U.S.A.) with or without topical application of individual or combined specific inhibitors of the endotheliumdependent dilation pathways: NO (L-NMMA), prostaglandin I2 (mefenamic acid), endothelium hyperpolarizing factor (glibenclamide), and adenosine A1 receptor antagonist (DPCPX). The mannitol and PD solutions induced rapid and sustained peritoneal vasodilation whose magnitude depended on microvascular level and osmotic solute. Combined inhibition of endothelium-dependent dilation pathways completely abolished the mannitolinduced hyperosmolality-mediated dilation at all microvascular levels, but selectively eliminated the PD solution–mediated A3 dilation. The KATP and adenosine receptor antagonists, individually or combined, remarkably attenuated dilation in the smaller pre-capillary arterioles; NO inhibition, alone or combined with KATP and adenosine receptor antagonists, eliminated the PD solution–induced dilation. The cyclooxygenase pathway is not involved in PD-induced dilation. Solutions for PD dilate the visceral peritoneal microvasculature by endothelium-dependent mechanisms, primarily the NO pathway. Adenosine receptor–activated NO release and KATP channelmediated endothelium hyperpolarization significantly contribute to vasodilation in the smaller peritoneal pre-capillary arterioles.Qatar National Research Fund NPRP 09-268-3-06

Prevalence and Evaluation of Multidrug Resistance Pattern of Pseudomonas Aeruginosa among Critical and Non-Critical Areas at a Tertiary Care hospital of Multan

Pseudomonas aeruginosa is an extremely wide spread microorganism linked to nosocomial illnesses. Effective inspection of variations in antimicrobial resistance patterns of P. aeruginosa is vital for selecting suitable antimicrobial drugs for pragmatic treatment. The current research has been performed for assessing antimicrobial sensitivity profile of P. aeruginosa isolated as of a variety of medical specimens collected from critical and non-critical admitted patients of Nishtar Hospital, Multan. The isolates were detected utilizing standard lab practices, as well as the sensitivity was examined employing Kirby-Bauer disk diffusion method corresponding to Clinical and Laboratory Standard Institute (CLSI) recommendations 2019. Out of 373 samples, 110 (29.49 %) P. aeruginosa isolates were from admitted patients in different wards. 82 (74.5 %) came from non-critical units along with 28 (25.4 %) belonged to critical units. Prevalence of P. aeruginosafrom the non-critical units was detected from surgical ward 35 (42.6 %) followed by medical ward 25 (30.48 %), gynecology 15 (18.29 %) and orthopedics 7 (8.5 %). The highest prevalence of P. aeruginosa among critical areas were from Medicine Intensive Care Unit 14 (50 %) followed by Surgery Intensive Care Unit 9 (32.14 %) and Respiratory Intensive Care Unit 5 (17.85 %). All were observed as multidrug-resistant against different antibiotics. The current research facilitates estimating the occurrence of MDR strains in intensive care units. Therefore, routine investigation of antibiotic sensitivity patterns is crucial for lowering the healthcare-linked infection levels as well as antimicrobial resistance

Morphometric analysis of soldier cast of Odontotermes obesus (Rambur) and Microtermes obesi (Holmgren) (Blattodea: Termitidae; Macrotermitinae) from three localities of Potohar region, Pakistan

A great diversity of termite species is found all over the world, among these 53 species are identified from Pakistan. The knowledge about morphological features in soldier cast of termites is proved to be a technical tool for taxonomy and identification. In the present studies, the morphometric variations of external morphology in soldier caste of Odontotermes obesus (Rambur) and Microtermes obesi (Holmgren) from three different areas i.e. Gujar Khan (A), Rawalpindi (B) and Islamabad (C) were studied. About 36 characters like body, thorax, abdomen, from head to mandible tip, head, pronotum, postmentum, mandible, antenna (scape, pedicle, flagellum), and legs parts were used for morphometric measurements. The data were statistically analyzed for significant differences in their mean, standard deviation, standard error, 95% confidence interval, coefficient of variability and analysis of variance. “Student t-test” was used for the comparison of mean values using Minitab version 16. The results of the present study revealed no significant differences among the population samples collected from various localities. However little variations were observed in a few characters like antennal segments (pedicle, scape) and legs (trochanter, tibia) among the soldier cast which are adaptive in nature to survive in the environment

Maximum allowable delay bound estimation using Lambert W function

The widespread of communication networks make them very promising to play a great role in future control systems. The communication networks will be present in the feedback control system which makes it a kind of time delay system. Closing the feedback system through a communication network introduces many challenges for the controller designers. Communication networks induce inherent time delay and some of the data may be lost which can destabilize the control system or result in poor system performance. It is important to identify the maximum time delay that the control system can withstand. In this paper, we report the application of the Lambert W function for calculating the maximum allowable delay bound in linear time delay control systems. The results of the calculation are compared with the most widely used Linear Matrix Inequalities based method. © 2017 IEEE