425 research outputs found

    Comparison of keorolac with morphine for intraoperative analgesia in patients undergoing total abdominal hysterectomy

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    Direct laryngoscopy and endotracheal intubation during anaesthesia and cutting, stretching and tissue manipulation during surgery is the most painful time for a patient undergoing surgery. The elicited pain during a surgical procedure is associated with significant hemodynamic changes including rise in blood pressure, heart rate, sweating, pupillary dilatation etc. These hemodynamic changes are not desirable and may produce deleterious effects in patients with hypertension, ischemic heart disease and cerebro-vascular disease and impose a great challenge for anaesthesiologist to maintain physiologic homeostasis during these periods of stress. Opioids are considered to be the corner stone in the management of intraoperative and postoperative pain, morphine being the gold standard . Use of Opioids to provide intraoperative analgesia is associated with some untoward effects i.e., somnolence, respiratory depression and nausea and vomiting, which are well known causes of delay in discharge from the post anaesthesia care unit (PACU) and unplanned hospital admission or delay in discharge to home-1

    Anxiolytic effect of midazolam premedication assessed by clinical and platelet aggregation profiles

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    BACKGROUND: It is well documented that surgery is associated with increased anxiety, which has an adverse impact on patient\u27s outcome. This study was designed to assess the anxiolytic effect of midazolam in pre-anaesthetic medication by using clinical and platelet aggregation profiles.METHODS: Sixty ASA I and II female patients aged between 35 and 60 years undergoing elective abdominal hysterectomy were randomly divided into two equal groups. Group I received placebo as pre-medication while group II received 0.15 mg/kg midazolam as pre-medication 1 hour preoperatively. They were monitored for visual analogue scale (VAS) for anxiety, observer\u27s anxiety criteria, sedation score, blood pressure, heart rate and platelet aggregation profile immediately before and 1 hour after pre-medication.RESULTS: There was statistically significant difference with respect to VAS of anxiety, observer\u27s anxiety criteria, sedation scores, systolic and diastolic blood pressure (

    Complications of endotracheal intubation in mechanically ventilated patients in a general intensive care unit

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    During a period of one year, 126 patients were prospectively audited to analyse complications of endotra­cheal intubation in a general intensive care unit setting. A total of 62 complications were observed in 48 patients. The most frequent complications during intubation were hypotension and bradycardia. The blockage of endotracheal tubes significantly increased with the duration of intubation. Sore throat was the commonest (22%) complication following extubation. Other complications like stridor and ulceration of mouth and lips which followed extubation were not related to the duration of intubatio

    RTSim: A cycle-accurate simulator for racetrack memories

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    Racetrack memories (RTMs) have drawn considerable attention from computer architects of late. Owing to the ultra-high capacity and comparable access latency to SRAM, RTMs are promising candidates to revolutionize the memory subsystem. In order to evaluate their performance and suitability at various levels in the memory hierarchy, it is crucial to have RTM-specific simulation tools that accurately model their behavior and enable exhaustive design space exploration. To this end, we propose RTSim, an open source cycle-accurate memory simulator that enables performance evaluation of the domain-wall-based racetrack memories. The skyrmions-based RTMs can also be modeled with RTSim because they are architecturally similar to domain-wall-based RTMs. RTSim is developed in collaboration with physicists and computer scientists. It accurately models RTM-specific shift operations, access ports management and the sequence of memory commands beside handling the routine read/write operations. RTSim is built on top of NVMain2.0, offering larger design space for exploration

    Shiftsreduce: Minimizing shifts in racetrack memory 4.0

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    Racetrack memories (RMs) have significantly evolved since their conception in 2008, making them a serious contender in the field of emerging memory technologies. Despite key technological advancements, the access latency and energy consumption of an RM-based system are still highly influenced by the number of shift operations. These operations are required to move bits to the right positions in the racetracks. This article presents data-placement techniques for RMs that maximize the likelihood that consecutive references access nearby memory locations at runtime, thereby minimizing the number of shifts. We present an integer linear programming (ILP) formulation for optimal data placement in RMs, and we revisit existing offset assignment heuristics, originally proposed for random-access memories. We introduce a novel heuristic tailored to a realistic RM and combine it with a genetic search to further improve the solution. We show a reduction in the number of shifts of up to 52.5%, outperforming the state of the art by up to 16.1%

    Outcome of home mechanical ventilation

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    OBJECTIVE: To determine the outcome of patients discharged home on portable ventilator. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi from January 2000 to December 2004. PATIENTS AND METHODS: All ventilator-dependent patients discharged home were contacted. Survivors were administered the EQ-5D Quality-of-Life instrument. SPSS version 13 was used to analyze data. RESULTS: Eleven patients were discharged home on invasive ventilation. Mean age was 49 years (range 10-98 years). Cause of ventilatory failure were cervical spine trauma in 36%, primary neurological disease in 27%, critical illness neuropathy and respiratory failure in 18% each. Survival rate was 73%, with three deaths. Mean duration of ventilation was 9.45 months (95% CI 3.24, 15.67). Rate of successful weaning after discharge was 36%, with 4 patients off all forms of ventilatory support and 2 on only nocturnal support. A 2.8 (95% CI 0.5, 16.6) relative risk towards successful weaning was associated with the presence of a family member as the primary care giver. Mean scores on the EQ-5D descriptive tool were; mobility 2 (-/+0.82), self-care 2 (-/+0.82), usual activities 1.86 (-/+0.69), pain/discomfort 1.43(-/+0.79), anxiety/depression 1.29 (-/+0.76). Mean score on the EQ-VAS was 48.2(-/+ 27.3). CONCLUSION: In carefully selected patients, home ventilation is a viable option with the expectation of successful weaning and survival. Patients discharged home on ventilation reported a reasonably good quality of life with proportionately more problems related to independence compared to overall well-being

    Magnetic racetrack memory: from physics to the cusp of applications within a decade

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    Racetrack memory (RTM) is a novel spintronic memory-storage technology that has the potential to overcome fundamental constraints of existing memory and storage devices. It is unique in that its core differentiating feature is the movement of data, which is composed of magnetic domain walls (DWs), by short current pulses. This enables more data to be stored per unit area compared to any other current technologies. On the one hand, RTM has the potential for mass data storage with unlimited endurance using considerably less energy than today's technologies. On the other hand, RTM promises an ultrafast nonvolatile memory competitive with static random access memory (SRAM) but with a much smaller footprint. During the last decade, the discovery of novel physical mechanisms to operate RTM has led to a major enhancement in the efficiency with which nanoscopic, chiral DWs can be manipulated. New materials and artificially atomically engineered thin-film structures have been found to increase the speed and lower the threshold current with which the data bits can be manipulated. With these recent developments, RTM has attracted the attention of the computer architecture community that has evaluated the use of RTM at various levels in the memory stack. Recent studies advocate RTM as a promising compromise between, on the one hand, power-hungry, volatile memories and, on the other hand, slow, nonvolatile storage. By optimizing the memory subsystem, significant performance improvements can be achieved, enabling a new era of cache, graphical processing units, and high capacity memory devices. In this article, we provide an overview of the major developments of RTM technology from both the physics and computer architecture perspectives over the past decade. We identify the remaining challenges and give an outlook on its future

    Stevens Johnson syndrome in Pakistan: a ten-year survey

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    Objective: A pre-tested questionnaire-based, retrospective study to highlight the causative factors, mode of presentation, complications and outcome of patients with Stevens Johnson syndrome.SETTING: Aga Khan University Hospital over a 10 year period.Methods: All case records with a diagnosis of Steven Johnson Syndrome in the period 1990 to 2000 were retrospectively reviewed. Data was retrieved on a comprehensive questionnaire. The demographic variatbles and drugs taken within the previous 21 days were noted. Date analysis was done by Epi-Info Version 6.0.Results: Of the 101 studied patient files, the most common offender was found to be the Penicillins as a group and Sulfadoxine-Pyrimethamine (Fansidar) when considering all drugs individually. Most common complications included electrolyte disturbances (13.9%) and congestive heart failure (6.9%). Mortality rate was high at 10.1%.CONCLUSION: SJS was found to be a rare condition but having a mortality rate of 10.1%. As it can be induced by a large number of drugs, caution should be practiced while prescribing

    Morbidity Pattern and Health-related Quality of Life among Elderly in Rural Coastal Karnataka

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    Introduction : In elderly individuals, morbidity has a substantial impact on the physical and psychological well-being. Quality of life in elderly may be affected by the morbidities that they suffer. Material and Methods: A community-based cross-sectional study was conducted from September to November 2021 in the rural areas attached to the Rural Health Training Centre of a teaching hospital. Elderly individuals were selected by multistage sampling. The sample size was estimated as 118. Participants’ data was collected using a pretested semi-structured questionnaire regarding their socio-demographic profile and morbidity status. Quality of life (QOL) was assessed by using the WHOQOL-BREF scale. The difference between mean scores in the domains was tested by using an independent sample t-test. Statistical significance was set at 5% level of significance (p < 0.05). Results: Majority (57.6%) of the study population were males, 57.6% were illiterate and only 9.3% lived in joint families. Major morbidities reported were hypertension (55.9%), impaired vision (52.5%) and joint pain or stiffness (50.8%). The mean perceived overall quality of life scores in the study population were 61.9±17.5. Male participants had higher mean social and environmental domain scores. Literate individuals had higher social domain mean scores which was statistically significant. Conclusion: Appropriate rehabilitation measures along with health education with the assistance of a geriatric psychologist in order to identify gaps in QOL domains and approaches to solve them would help to improve the quality of life of the elderly. Keywords: Morbidity, Elderly, Quality of life, Rura

    Far-Field DOA Estimation of Uncorrelated RADAR Signals through Coprime Arrays in Low SNR Regime by Implementing Cuckoo Search Algorithm

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    For the purpose of attaining a high degree of freedom (DOF) for the direction of arrival (DOA) estimations in radar technology, coprime sensor arrays (CSAs) are evaluated in this paper. In addition, the global and local minima of extremely non-linear functions are investigated, aiming to improve DOF. The optimization features of the cuckoo search (CS) algorithm are utilized for DOA estimation of far-field sources in a low signal-to-noise ratio (SNR) environment. The analytical approach of the proposed CSAs, CS and global and local minima in terms of cumulative distribution function (CDF), fitness function and SNR for DOA accuracy are presented. The parameters like root mean square error (RMSE) for frequency distribution, RMSE variability analysis, estimation accuracy, RMSE for CDF, robustness against snapshots and noise and RMSE for Monte Carlo simulation runs are explored for proposed model performance estimation. In conclusion, the proposed DOA estimation in radar technology through CS and CSA achievements are contrasted with existing tools such as particle swarm optimization (PSO).This project has received funding from Universidad Carlos III de Madrid and the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie Grant 801538
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