The Compliance Chronic Renal Failure Patient on Restrictions Liquids in Hemodialysis Therapy

Introduction: Nonadherence is a rampant problem among patients undergoing dialysis and can impact multiple aspects of patient care, including medications, and treatment regimens as well as dietary and fluid restriction. The purpose of this descriptive correlative research, on hemodyalysa patient with chronic renal failure was to know the influencing factors of compliance patient to fluid restriction. Method: This study used descriptive correlative design, Data was analysed by using distibution frequency and chi square for analysys relation between variable. Result: The result revealed there were nor significant statistic difference at p > 0.05 between age, gender, education level, frequency of hemodyalysa and health education from nurse to compliance patient to fluid restriction (p = 0.647; p = 0.717; p = 0.345; p = 0.774; p = 0.273). Discussion: Level of patient adherence to therapy not influenced by demographi factor but by the quality of interaction health workers and other factors. This study recommended for further analysis of the factors that influence the level of compliance of the patient as psychological factors (belieft , motivation), socio-economic, and social support

Effect of case management on neonatal mortality due to sepsis and pneumonia.

BACKGROUND: Each year almost one million newborns die from infections, mostly in low-income countries. Timely case management would save many lives but the relative mortality effect of varying strategies is unknown. We have estimated the effect of providing oral, or injectable antibiotics at home or in first-level facilities, and of in-patient hospital care on neonatal mortality from pneumonia and sepsis for use in the Lives Saved Tool (LiST). METHODS: We conducted systematic searches of multiple databases to identify relevant studies with mortality data. Standardized abstraction tables were used and study quality assessed by adapted GRADE criteria. Meta-analyses were undertaken where appropriate. For interventions with biological plausibility but low quality evidence, a Delphi process was undertaken to estimate effectiveness. RESULTS: Searches of 2876 titles identified 7 studies. Among these, 4 evaluated oral antibiotics for neonatal pneumonia in non-randomised, concurrently controlled designs. Meta-analysis suggested reductions in all-cause neonatal mortality (RR 0.75 95% CI 0.64- 0.89; 4 studies) and neonatal pneumonia-specific mortality (RR 0.58 95% CI 0.41- 0.82; 3 studies). Two studies (1 RCT, 1 observational study), evaluated community-based neonatal care packages including injectable antibiotics and reported mortality reductions of 44% (RR = 0.56, 95% CI 0.41-0.77) and 34% (RR = 0.66, 95% CI 0.47-0.93), but the interpretation of these results is complicated by co-interventions. A third, clinic-based, study reported a case-fatality ratio of 3.3% among neonates treated with injectable antibiotics as outpatients. No studies were identified evaluating injectable antibiotics alone for neonatal pneumonia. Delphi consensus (median from 20 respondents) effects on sepsis-specific mortality were 30% reduction for oral antibiotics, 65% for injectable antibiotics and 75% for injectable antibiotics on pneumonia-specific mortality. No trials were identified assessing effect of hospital management for neonatal infections and Delphi consensus suggested 80%, and 90% reductions for sepsis and pneumonia-specific mortality respectively. CONCLUSION: Oral antibiotics administered in the community are effective for neonatal pneumonia mortality reduction based on a meta-analysis, but expert opinion suggests much higher impact from injectable antibiotics in the community or primary care level and even higher for facility-based care. Despite feasibility and low cost, these interventions are not widely available in many low income countries. FUNDING: This work was supported by the Bill & Melinda Gates Foundation through a grant to the US Fund for UNICEF, and to Saving Newborn Lives Save the Children, through Save the Children US

COVID-19 Case Complicated with Organizing Pneumonia and Pneumothorax: A Case Report

Organizing pneumonia can be idiopathic or caused by multiple etiologies, including viral or bacterial pneumonia, drugs, and autoimmune disorders. It can rarely lead to cyst formation and pneumothorax with the exact mechanism remaining unclear. This case presents a previously healthy 50-year-old male who contracted COVID-19 with subsequent development of organizing pneumonia and pneumothorax. Patients presenting with hypoxic respiratory failure due to COVID-19 should be screened for organizing pneumonia upon discharge. This case also illustrates the importance of following such patients radiologically to monitor interstitial lung disease and consider pneumothorax for patients re-presenting with acute symptoms

The Tourism Demarketing Mix: Working to Reduce Revisits to Egyptian Nature Reserves

This study tests the impact of the tourism demarketing mix (product, price, place, promotion) on tourists’ intention to reduce revisits to nature reserves in Egypt. In particular, this work focuses on the moderating role of switching cost. Data were collected from 401 tourists of the Wadi Degla and Petrified Forest nature reserves in Egypt. Path analysis is employed to test the research hypotheses using WarpPLS 6. Findings confirm that the tourism demarketing mix significantly affects tourists’ perception and intention to reduce revisits to the nature reserves. Lower switching cost partially enhanced the relationship between the tourism demarketing mix and tourists’ intention to reduce revisits. Regarding implications, managers can use findings from this study to design marketing plans that contribute to sustainable stewardship of destinations and protect nature reserves. Limitations and conclusions were also provided

Oleoquímica I: Estudios sobre la preparación y la estructura de los jabones de litio.

Lithium stéarate, palmitate, myristate, laurate, caprate and caprylate were prepared by means of fusion method. Elementary analysis and the infrared absorptions spectra of the prepared lithium soaps as well as their X-ray diffractions and the thermogravimetric analyses were carried out. The anhydrous lithium salts of fatty acids with 12 carbon atoms or less showed thermal stability up to ca. 300 ± 78 °C depending on the chain length. On other hand the salts with 14 carbon atoms or more were decomposed at 126 ± 4 °C leading to formation of lithium carbonate. The homologous lithium soaps had very similar crystal structure among them and their metal -to- oxygen bonds were similar for the acyl chains between 8 and 18 carbons. However the angle of inclination of the molecular axes to the basal plane increased with the decreasing of the number of carbon atoms of the fatty acid chain, as determined by X-ray diffraction. In addition, the ionic character of the metal -to- oxygen bond was enhanced with the decrease of the number of carbon atoms as shown by infrared spectroscopy.Se han preparado estearato, palmitato, miristato, laurato, caprato y caprilato de litio por fusión. Se ha realizado el análisis elemental, los espectros de absorción en el infrarrojo y las difracciones de rayos X de los Jabones de litio preparados, además del análisis termogravimétrico de los mismos. Las sales de litio anhidra de los ácidos con 12 átomos de carbono o menos mostraron una estabilidad térmica hasta los 300 ± 78 °C dependiendo de la longitud de la cadena. Por otro lado las sales con 14 átomos de carbono o más se descompusieron a 126 ± 4 °C formándose carbonato de litio. Los jabones homólogos de litio mostraron una estructura cristalina similar, siendo los enlaces metal-oxígeno del mismo tipo para los ácidos grasos de número de átomos de carbono entre 8 y 18. Sin embargo el ángulo de inclinación que forma la molécula con el plano basal aumentó con la disminución del número de átomos de carbono, lo que se observó por difracción de rayos X. Se comprobó por espectroscopia infrarroja la intensificación del carácter iónico del enlace metal-oxígeno al disminuir el número de átomos de carbono

Impact of Delay and Queue on the Length of Left-Turn Storage at Palestine Intersections in Baghdad city, Iraq

At intersections, Left-turning vehicles seek to occupy the same physical space as close to the stop line as possible. These result in high conflicts, delays, and blockage of vehicles by turning vehicles and vice versa. The impact of the lengths of Left-turn lanes on intersection delays is considered to optimize the lengths of the Left-turn lanes. Data for traffic counts, queue lengths, and signal timing are collected from three intersections in Baghdad city in Iraq. The methodology involves the development of estimation models using traffic Simulation SIDRA INTERSECTION 8.0 and simulating various scenarios by varying traffic signal conditions to evaluate delays and queues caused by varying lengths of the Left-turn Lane. Optimal lengths are computed and compared to existing lengths in intersections. No differences in delay, queue, and lengths of the Left turn lane are found using t-test analysis for significance. Outputs from the three models were compared to the maximum observed in the field from the selected intersections. Data analysis involved determining the R2 and the standard error mean between the model output and the observed data. In general, SIDRA INTERSECTION 8.0 overestimated queue vehicles and length of storage for approaches with a high degree of saturation ratios and underestimated it for those with a high degree of saturation ratios

A Grammian matrix and controllability study of fractional delay integro-differential Langevin systems

This study focused on introducing a fresh model of fractional operators incorporating multiple delays, termed fractional integro-differential Langevin equations with multiple delays. Additionally, the research evaluated the relative controllability of this model within finite-dimensional spaces. Employing fixed-point theory yields the desired outcomes, with the controllability assessment facilitated by Schauder's fixed point and the Grammian matrix defined through the Mittag-Leffler matrix function. Validation of the results was conducted through an application