36 research outputs found

    UWB Reflectarray Antenna for Chipless RFID Reader Gain Enhancement

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    The main limitation of chipless Radio Frequency Identification (RFID) systems is its short reading range which is generally less than  as the amplitude of the back scattered tag signal is inversely proportional to the fourth root of the reading distance. In this paper, a design of reflectarray (RA) antenna consisting of unified unit cell. Five different unit cells structures centered at 6GHz for chipless RFID reader applications is introduced. The proposed RA has a narrow half power beam width (HPBW) and high gain which significantly enhance the reader sensitivity, maximize the reader reading range, reduce the multipath effects, and improve the tag localization. The proposed RA is realized on a rectangular single layer Rogers RT5880 lossy substrate of thickness and relative permittivity. radiating cells or elements with uniform element spacing are arranged on the rectangular substrate of dimensions and fed by a pyramidal horn antenna with gain of   and HPBW equals 46.7°and 42.8° at E-plane and H-plane respectively. The simulation results showed that the proposed RA gives high gain up to which is greater than the feeder gain by and three times narrower HPBW of about .It operates over frequency range from to with fractional bandwidth (FBW) and has side lobe level,, which can't be achieved by the conventional antenna arrays

    Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

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    Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

    Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

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    Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

    A near miss case of ruptured non-communicating rudimentary horn pregnancy in primigravida

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    Rudimentary horn pregnancy is a rare site of ectopic pregnancy. Diagnosis of rudimentary horn pregnancy requires a high index of suspicion as it can be easily missed during routine ultrasound scan. Rupture of rudimentary horn pregnancy can lead to catastrophic intraperitoneal hemorrhage with consequent maternal morbidity and mortality. Here, we report a case of ruptured non-communicating rudimentary horn pregnancy at 21 weeks of gestation in a 19 years old nulliparous woman which was initially missed during ultrasound scan and misdiagnosed as a case of anemia with pregnancy. The patient was managed immediately with excision of the horn through urgent exploratory laparotomy. High index of suspicion and early referral from the discrete hospitals is needed before exact time is lost; thus reducing the morbidity and mortality of the pregnant women

    Successful term delivery after Khairy’s modified B-lynch suture technique: First case rep

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    Postpartum hemorrhage (PPH) is a life-threatening obstetric complication. Uterine atony is the most common cause presenting in approximately 80% of cases. As regards management options, B-lynch brace suture, and its modifications have been used for more than a decade with a great success as a substitution for hysterectomy. Their efficiency in preserving future fertility is not well-established. This case reports the first successful pregnancy and delivery after one of the recent B-lynch suture modifications “Khairy’s modification” for control of atonic PPH during cesarean delivery. The patient got pregnant two months after the surgery. The course of pregnancy was smooth and she was delivered by Repeat cesarean section with no deformities of uterine cavity or contour. Khairy’s modified B-lynch suture is an effective technique that has no reported complications of the classic B-lynch suture or affection of subsequent fertility

    Assessment of patient's satisfaction with pharmaceutical care services in community pharmacies in the United Arab Emirates

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    Objective: To determine some aspects of patient's satisfaction of pharmaceutical services provided by the community pharmacist. To assess consumer's attitude towards the services provided in the community pharmacy. Methods: An anonymous pre-piloted questionnaire-based study was conducted in the various Emirates of the United Arab Emirates. Data were analyzed using SPSS and results were expressed as frequency and percentage of respondents. Results: The response rate was 93.8% with more female than male respondents. The majority of participants were Arabs (80.5%) of young age and with no medical background. Slightly more than half of the respondents (198, 52.8%) visited the pharmacy to collect prescriptions, and 50.5% of them were able to collect the prescriptions straight away. Only 31.7% of respondents visited the pharmacy to purchase items and of these group 289 (77.1%) were satisfied with the pharmacist's help. When asked to describe their usual pharmacist, “experienced,” “trustworthy,” and “confident” were the descriptions given by 27.7%, 22.9%, and 67.9% respondents, respectively. The majority (74.1%) of respondents agreed that the pharmacist delivers their medicines in a polite way, and 43.7% agreed that the instructions were clearly labeled by the pharmacist on each medication and 24.5% agreed that the pharmacists provided them with information on drug storage. About 38.4% agreed that the place of pharmaceutical counseling respects their privacy. Conclusion: Results of the present study showed a general patient's satisfaction of the help provided by the community pharmacist. However, the pharmacist needs to fully practice his/her role to the advantage of the patients and the latter needs to be aware of what to expect and demand from the community pharmacist

    Assessment of sleep quality, anxiety, depression, and quality of life in Behçet’s disease

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    Abstract Background Behçet’s disease (BD) is a multi-organ disease with different systemic manifestations. While rare in the United States and Europe, it is more common in the Middle East and Asia. BD is one of the commonest encountered vasculitis in Egypt. This study aims to evaluate BD patients' sleep patterns, quality of life, and psychological aspects. Methods Patients suffering from Behçet’s disease (thirty patients) and 30 matched age and sex-healthy control participants were recruited in our study. The assessment included the entire clinical history and laboratory investigations, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Oxygen saturation level. Evaluation of sleep quality and presence of sleep-disordered breathing was done using the Pittsburgh Sleep Quality Index (PSQI), Insomnia severity index (ISI), and Epworth sleepiness scale (ESS). Hamilton’s anxiety (HAM-A) and depression rating scales (HAM-D) were used for psychological assessment. The Short Form 36 Quality Of Life Scale (SF-36 QOL) assessed participants' quality of life. Results Behçet’s disease patients suffered significantly higher levels of anxiety and depression compared to the control group. The prevalence of insomnia and daytime sleepiness was significantly higher among BD patients. All components of PSQI, including the global score, were significantly higher among the BD group. Physical functioning, role limitation due to physical health, and emotional problems; also, general health indices were significantly lower for the BD group. Patients with active BD showed significantly higher levels of anxiety, depression, insomnia, day time dysfunction and significantly lower all domains of the SF-36 QOL Scale. Conclusions BD is associated with low sleep quality and high levels of anxiety and depression. Disease activity directly impacts anxiety, depression levels, lower sleep quality, and lower quality of life among BD patients. Trial registration ClinicalTrials.gov. NCT05142995. Registered November 20, 2021

    Sleep quality, anxiety, depression, and quality of life in rheumatoid arthritis patients and impact of disease activity 

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    Abstract Background Rheumatoid arthritis (RA) is an autoimmune lifelong disease. Systemic manifestations represent a significant aspect of the disease burden. This study aimed to assess sleep quality and psychosocial aspects among RA patients and the impact of disease duration and activity. Results The mean age for included RA patients was 50.00 ± 9.37 years. The median disease duration was 9.50 (Interquartile range (IQR)=5–15) years and 90% of patients were females. Disease activity score 28 was 4.65 ± 1.66. Anxiety and depression were significantly higher among RA participants. Regarding sleep quality assessment, RA group had significantly higher levels of insomnia than the control group (Insomnia Severity Index median (IQR) was 4.5 (0–15) versus 1 (0–3); p value = 0.013) and daytime sleepiness (Epworth Sleepiness Scale median (IQR) was 4 (1–11.25) versus 1 (0–3); p value = 0.002). RA patients showed significantly higher values of Pittsburgh Sleep Quality Index components as well as the global score indicating poor sleep quality. The 36-item short-form health survey domains, representing physical and mental health, were significantly lower among RA cases versus control subjects. Higher disease activity was positively correlated with anxiety, depression, insomnia, sleep quality, sleep efficiency, and daytime dysfunction, while negatively correlated with all domains of the 36-item short-form health survey. Conclusions RA patients have increased anxiety and depression levels in addition to poor sleep quality. High disease activity is linked to increased anxiety and depression levels, impaired quality of life, and poor sleep quality
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