Electrocardiogram changes due to sodium stibogluconate treatment of kala-azar

Background: Kala-azar [visceral leishmaniasis (VL)] is caused by the protozoon Leishmania donovani complex. Without adequate treatment, most patients with clinical VL die due to secondary infections. Pentavalent antimonial compounds are commercially available as sodium stibogluconate and meglumine antimoniate. Sodium stibogluconate remains the mainstay of treatment in most parts of the world. The aim of the study was to evaluate the serious adverse effects of sodium stibogluconate in the treatment of kala-azar (VL).   Methods: The study was carried out in the medicine department of North Bengal Medical College Hospital, Sirajganj during the period of June 2021 to December 2021. It was a descriptive cross-sectional study with a sample size of 30. Complete history taking and physical examination were done and recorded in a case record form. At least 7 electrocardiograms (ECGs) were done (1 before treatment, 5 during treatment weekly intervals, and 1 after completion of treatment). Results: In ECG, the following changes were noted (the rhythm, T wave amplitude, ST segment, and QTc interval). Out of 30 patients, 19 patients (63.33%) developed abnormalities in ECG. Among them, 14 patients (46.67%) developed prolongation of QTc interval, 6 patients developed T wave inversion, and 1 patient developed transient 1st-degree heart block. No patients developed symptomatic arrhythmia. Conclusions: Kala-azar is prevalent among the poor in Bangladesh and can be fatal without treatment. Sodium stibogluconate has been associated with cardiological adverse effects, but it can be used safely with proper monitoring

Cost Benefit Analysis of Procurement Systems and the Performance of Construction Projects in East Malaysia

This research investigated the impacts of procurement systems on the performance of construction projects in East Malaysia. Construction project outcome may be measured in terms of time, cost and quality achieved. Project clients demand and want best value for their money and they want their projects to be completed on time, within budgeted cost and at appropriate quality or specification. The sample in this research consists of 58 participants that work in a construction companies/industry. 90 questionnaires were distributed, 69 were successfully returned and 58 were fully completed. The sample comprises project clients/owners, project managers, consultants and construction workers. However, due to the fact that the time allocated for this research is limited and it is of qualitative in nature for which the sample size is less important (Kumar, 2005). The aim of using project clients, project managers, consultants and construction workers from different companies is because they work under different circumstances, which will ensure all questions are answered from different perspective. Therefore, the researcher distributed questionnaires randomly among the participants in different construction companies. This also minimises any bias towards any particular company. The key findings and conclusions from literature review and the analysis of results of questionnaires issued to project clients, projects managers, consultants and construction workers showed that traditional procurement system benefits cost and quality but at the expense of time. In other words, traditional procurement system has positive impacts on project objectives of cost and quality and negative impact on project time. Design and build procurement system benefits cost and time but at the expense of quality and this implies that the impacts of design and build procurement system on project objectives of cost and time are positive with negative impact on project quality

Determinants of Anxiety in Amputees Owed to Traumatic & Non-Traumatic Causes in Quetta

Objective: To find out the causes and factors of anxiety among amputees suffering from traumatic and non-traumatic causes. Methodology: This descriptive cross-sectional study was conducted in Quetta from the month of May 2018 to July 2018. This study included those clients with amputations as a result of Traumatic & non-traumatic causes and the data was collected from them. This study involved a total of 54 participants. All amputees who visited the three Physical Rehabilitation Centre were included during data collection process. A structured adopted questionnaire using the Hospital Anxiety and Depression Scale (HADS) according to the inclusion & exclusion criteria & then tabularized and analyzed by applying Chi square test. Results: This study involved a total of 54 participants of whom 7(13%) were females and 47(87%) males. Among amputees 36(66.7 %), amputations were due to Traumatic injuries and 18(33.3%) were due to non-traumatic amputations. In traumatic, the majority was due to RTA with 25(46.3 %) and in non-traumatic causes diabetes stood first with 13(24.1%) amputation. Traumatic are more anxious than non-traumatic. There is a significant relationship between marital status and anxiety level (p-value 0.047). Statistically significant relationships between amputation and anxiety level were noticed, p value=0.049. Conclusion: Amputation has a significant association with anxiety level. Traumatic experiences make people feel more anxious than non-traumatic ones. Socio-demographics has association with levels of anxiety. It is recommended to do regular or annual screening of these patients following amputation

Jejunal Intussusception: A Rare Manifestation of a Primary Thyroid Non-Hodgkin Lymphoma

Primary thyroid lymphoma (PTL) is an uncommon malignancy of the thyroid gland, with most lymphomas of the thyroid being almost exclusively of the non-Hodgkin\u27s B cell variety. PTL requires a prompt diagnosis because of its ability to cause progressive compression symptoms, and its unusual presentation can make the diagnosis very challenging. Herein, we present a case of PTL in a young woman with an uncommon initial presentation and discuss the complications she faced during the surgery, as well as postoperatively, due to the compression of the trachea by the thyroid mass

UWB antenna based time-domain approach for through the walls gap estimation

This paper has introduced a novel experimental system adopted a time domain approach for estimating through wall distance and recognizes buried objects behind the wall. The designed and fabricated balanced antipodal Vivaldi antenna (BAVA) has been used for the development of UWB system. The working mechanism of an intended detection system based on time domain reflectometry (TDR) and ground-penetrating radar (GPR). A miniature pulse in the UWB range is generated by the vector network analyzer (VNA) to irradiate a barrier made of two walls separated by airgap between them. The signal radiations reflect partially from the front wall while remaining goes through for getting reflected from the rear wall. The VNA is used for measuring the time interval passed between the instant when an incident signal irradiates the first wall and the instant when the incident signal gets reflected from the rear wall. The investigational process of a system is carried out by UWB antenna probe. The detected information is attained using the values of reflection coefficient (S 11 ) represented in time domain measurements. Experimental results have been proved the ability to detect wall gap as well as the width estimation between two walls with high accuracy. The maximum percentage error has been found to not exceeding 4.5% in the worst condition

Synthesis, characterization and electrochemical evaluation of anticorrosion property of a tetrapolymer for carbon steel in strong acid media

A novel tetrapolymer (TP) consisting of carboxylate, sulphonate, phosphonate and sulfur dioxide based comonomers was synthesized using Butler cyclopoymerization technique. The synthesized tetrapolymer was characterized using FTIR, 1H-NMR, 13CNMR and elemental analysis. The performance of the tetrapolymer as a corrosion inhibitor for St37 carbon steel in 15% HCl and 15% H2SO4 acid media was assessed using electrochemical impedance spectroscopy (EIS), linear polarization resistance (LPR), potentiodynamic polarization (PDP) and electrochemical frequencymodulation (EFM) techniques. The influence of addition of a small amount of KI on the corrosion inhibition efficiency of TP was also assessed. Results obtained showed that the tetrapolymer moderately inhibited the corrosion of St37 steel in the acid media with protection efficiency of 79.5% and 61.1% at the optimum concentration of 1000 mg·L−1 studied in HCl and H2SO4 media respectively. On addition of 5 mmol·L−1 KI to the optimum tetrapolymer concentration, the protection efficiency was upgraded to 90.6% and 93.5% in HCl and H2SO4 environment, respectively. The enhanced performance of the polymer in the presence of KI is due to synergistic action deduced from synergism parameter (S1) which was found to be greater than unity. The tetrapolymer afforded the corrosion inhibition of St37 steel in the acid media by virtue of adsorption of the polymermolecules on the steel surfacewhichwas confirmed by ATR-FTIR analysis of the adsorbed film extracted from the steel surface. TP+KI formed complex with St37 steel surface in H2SO4 solution but not in HCl solution

Urosepsis: Flow is Life

Urosepsis is one of the important etiological factors for community as well as hospital-acquired infections. Accordingly, urosepsis is divided into community-acquired and hospital-acquired urosepsis. Obstruction to the flow of urine is a common risk factor for community-acquired urosepsis, whereas the indwelling urinary catheter is the risk for the hospital-acquired urosepsis. E. coli remained the most common bacteria-causing urosepsis. If not treated early and appropriately, urosepsis can complicate into septic shock and multiple organ dysfunction. The cornerstone for the improved outcome of these patients is initial resuscitation and proper antibiotic therapy and restoring the flow of urine or removing the infected urinary catheter. Community-acquired urosepsis can be prevented by removing the obstruction to flow of urine permanently. The hospital-acquired urosepsis can be prevented by strictly following catheter-associated urinary tract infection prevention bundle and removing the catheter as early as possible

Structure Preserving Splitting Techniques for Ebola Reaction–Diffusion Epidemic System

In this paper, we deal with the numerical solution of the reaction–diffusion Ebola epidemic model. The diffusion which is an important phenomenon for the epidemic model is included in the model. This inclusion has made the model more comprehensive for studying the disease dynamics in the human population. The quantities linked with the model indicate the population sizes which are taken as absolute, therefore, the numerical schemes utilized to solve the underlying Ebola epidemic system should sustain the positivity. The numerical approaches used to solve the underlying epidemic models are explicit nonstandard finite difference operator splitting (ENSFD-OS) and implicit nonstandard finite difference operator splitting (INSFD-OS) techniques. These schemes preserve all the physical features of the state variables, i.e. projected schemes hold the positive solution acquired by the Ebola diffusive epidemic model. The underlying epidemic model illustrates two stable steady states, a virus-free state, and a virus existence state. The suggested approaches retain the stability of each of the steady states possessed by the assumed epidemic model. A numerical example and simulations for validation of all the characteristics of suggested techniques are also investigated

Ultra-wideband antipodal vivaldi antenna for radar and microwave imaging application

In this an ultra-wideband antipodal Vivaldi antenna among end fire radiation patterns function at UWB (3.1 GHz to 10.6 GHz) frequency range for radar and microwave imaging application is proposed. This article presents the designing of two different types of antipodal Vivaldi antennas. First is conventional and second is modified antipodal Vivaldi antenna. This paper presents a parametric analysis of each antenna. While designing the proposed antennas, originally a conventional antipodal Vivaldi antenna is presented for wide impedance bandwidth performance assessment. Further, the Vivaldi antenna is modified by incorporating corrugations on the edges which results in gain significantly along with increased directivity in the low frequency band. In addition, the antenna offers high gain and flat gain in the operating UWB band. The design and optimization process is carried out using the CST simulation software for performance assessment of parameters of return loss, radiation pattern, directivity and input impedance. Prototypes of two different proposed antennas are fabricated and tested for its return loss and directional pattern