Film Retakes in Digital and Conventional Radiography

Objective: To determine the film-retake rates and causes in digital radiography comparison to conventional X-rays method. Study Design: Comparative study. Place and Duration of Study: Radiology Department, Aga Khan University Hospital, Karachi, from January 2004 to December 2006. Patients and Methods: X-rays of different body parts, conducted during the year 2004, with conventional radiography (n=170300), and in 2006 with digital radiography (n=174550), were included in this study. Measurements were done for number of X-rays re-take due to different quality control reasons for both the conventional and digital radiography. Quality control reasons included underexposure, overexposure, positioning errors, patient movements, portable X-rays, grid cutoff, and others (i.e. equipment related) due to which X-ray quality was questionable. Results were expressed in percentages. Results: A total of 9423 X-rays (5.5%) were repeated in conventional radiography (n=170300) due to underexposure (38%), overexposure (28.5%), positioning errors (25%), portable procedures (4%), patient movement (2%), grid cut-off (0.5%), and others (2%). Underexposure was the most frequently responsible factor for the X-ray repetition as compared to other factors (p\u3c0.001). In digital radiography (n=174550), 1464 X-rays (1%) needed to be repeated, which was significantly less in comparison to X-ray repetition in conventional method of radiography (5.5%) [p\u3c0.001]. In digital radiography, the most frequent factor for X-ray re-take was positioning error (435, 30%). Conclusion: Digital radiography is associated with significantly lesser number of re-take X-rays as compared to conventional radiography, hence minimizes the exposure of the patients to unnecessary radiations due to re-take X-rays. Positioning error remains a problem even in digital radiography, emphasizing training need for technologists

Carotid intima media thickness evaluation by ultrasound comparison amongst healthy, diabetic and hypertensive Pakistani patients

Objective: To compare carotid Intima media thickness and atherosclerosis burden amongst healthy, diabetic and hypertensive Pakistani patients.Methods: A cross-sectional study was carried out at the Department of radiology and family medicine, Aga Khan University Hospital Karachi from April 2014 to July 2015. Bilateral carotid ultrasound was done in 133 healthy adults, 65 hypertensive, 31 type-2 diabetic and 37 hypertensive with type-2 diabetes patients. Normal adults were matched for age and gender. Mean intimal media thickness was measured for common and internal carotid arteries. Presence or absence of atherosclerotic plaque was also identified. Height, weight, ethnicity, socioeconomic status and other risk factors were also assessed. Ultrasound findings were compared between healthy and diseased patients through statistical tests.Results: A total of 266 patients participated (Controls=133, Hypertensive=65, Diabetic=31, and Diabetes with Hypertension=37). There was no significant difference in the baseline characteristics between the four patients\u27 groups for age (p\u3e0.05) and gender (p\u3e0.05). The mean carotid intima media thickenss of right common carotid artery was significantly higher in patients with diabetes along with hypertension as compared to the control group (p=0.03). For (RICA) Right Internal Carotid Artery, (LCCA) Left Common Carotid Artery and (LICA) Left Internal Carotid Artery, there was a significantly higher thickness among patients with hypertension as compared to the control group with p=0.011, p=0.002, and p=0.039 respectively.Conclusion: Increased CIMT is most likely associated with underlying chronic diseases. Ultrasound is a non-invasive, easily available and useful modality for early detection and prevention of vascular atherosclerosis

Isolated tuberculous thyroiditis as solitary thyroid nodule

Isolated involvement of the thyroid by tuberculosis is very rare as reported in literature. We are presenting a case of isolated tuberculous thyroiditis presented as a solitary thyroid nodule. The patient was treated with anti-tuberculous regimen and he responded well with disappearance of the nodule and normalization of the thyroid scan

Cleaning Methods for Ultrasound Probes

Objective: To determine the effectiveness of three different methods of ultrasound probe cleaning for the prevention of nosocomial infections. Study Design: Experimental study. Place and Duration of Study: Radiology Department, the Aga Khan University Hospital, Karachi and Microbiology Department, JPMC, Karachi, from December 2006 to April 2007. Patients and Methods: A total of 75 culture swabs from ultrasound probes used for sonographic examinations of different body parts of patients were included in the study. Probes were prospectively randomized into three equal groups with 25 probes in each group. Culture was sent before and after using three different techniques of cleaning ultrasound probe, which included sterilized paper towel, 0.9% saline and swipe over with standard bath soap applied on group A (n=25), group B (n=25) and group C (n=25) respectively. Number of Colony Forming Unit (CFU) of bacteria were calculated on standard agar plate to find out the effectiveness of cleaning methods in reducing bacterial count from the ultrasound probe after the procedures. All samples were tested in single microbiology lab by using same bacterial growth media provided by same manufacturer. Kruskall Wallis, Jonchkheere-Terpstra and Wilcoxon sign rank tests were applied to find out statistical significance. Results: There was a significant reduction in bacterial count after applying either of all three cleaning methods for ultrasound probe compared to count on the probes before cleaning (p Conclusion: Cleaning ultrasound probe after performing each procedure is a cost-effective practice with potential of reducing nosocomial infections. Soap cleaning technique is the most effective method for reducing bacterial count acquired due to patients’ body contact with the ultrasound probes

Applications of Carbon Based Materials in Developing Advanced Energy Storage Devices

With the increasing pressure of population, the energy demand is growing explosively. By 2050, it is expected that the world population may reach to about 9 billion which may result in the increase of energy requirement to about 12.5 trillion watts. Due to increasing pressures of population, industries and technology, concerns to find possibilities to cope with increasing demand of energy resources, arise. Although the renewable energy resources including fossil fuels, wind, water and solar energy have been used for a long time to fulfill the energy requirements, but they need efficient conversions and storage techniques and are responsible for causing environmental pollution due to greenhouse gases as well. It is thus noteworthy to develop methods for the generation and storage of renewable energy devices that can replace the conventional energy resources to meet the requirement of energy consumption. Due to high energy demands, the sustainable energy storage devices have remained the subject of interest for scientists in the history, however, the traditional methods are not efficient enough to fulfill the energy requirements. In the present era, among other variety of advanced treatments, nano-sciences have attracted the attention of the scientists. While talking about nano-science, one cannot move on without admiring the extraordinary features of carbon nanotubes (CNTs) and other carbon based materials. CNTs are on the cutting edge of nano science research and finding enormous applications in energy storage devices. Excellent adsorption capabilities, high surface area, better electrical conductivity, high mechanical strength, corrosion resistance, high aspect ratio and good chemical and physical properties of CNTs have grabbed tremendous attention worldwide. Their charge transfer properties make them favorable for energy conversion applications. The limitation to the laboratory research on CNTs for energy storage techniques due to low specific capacitance and limited electrochemical performance can be overcome by surface functionalization using surface functional groups that can enhance their electrical and dispersion properties. In this chapter, ways CNTs employed to boost the abilities of the existing material used to store and transfer of energy have been discussed critically. Moreover, how anisotropic properties of CNTs play important role in increasing the energy storage capabilities of functional materials. It will also be discussed how various kinds of materials can be combined along CNTs to get better results

Revealing the microstructure and mechanical attributes of pre-heated conditions for Gas Tungsten Arc Welded AISI 1045 steel joints

Gas tungsten arc welding (GTAW) is considered a well-established process in the manufacturing industry. Despite, certain challenges associated with high hardness of heat affected zone and cold cracking susceptibility of joints, are the main barriers for this process to be implemented successfully within high integrity structure. By using a combined procedure of experiments and modelling (response surface methodology (RSM) and multi-objective optimization: multi-objective genetic algorithm (MOGA)) allows obtaining good enhancement over uniform heating, cooling and the heat-affected zone which enable major progress in obtaining high quality welded parts. Therefore, this research study combines the experiments and modelling in a systematic manner considering for the first type the pre-heated treatment and without- pre-heating conditions of GTAW manufacturing. It leads to optimizing the process parameters of GTAW when manufacturing AISI 1045 medium carbon steel. The effects of critical parameters i.e. welding current: WC, welding speed: WS, and gas flow rate: GFR on the mechanical properties (ultimate tensile strength (UTS) and hardness) were investigated and evaluated against the microstructure of weld fracture. The multi-objective genetic algorithm corroborated with experimental observation enables to obtain a maximum UTS of approx. 625 MPa and hardness of 80.19 HRB for preheat condition. The results highlight an improvement in UTS of 0.2% to 6.7% and a decrease in hardness of 0.1% to 21.5% by implementing the preheating conditio

Unmanned Aerial Vehicles: A Revolution in the Making

Since the flight of a kite by some Chinese, thousands of years ago, the UAVs have developed to the level of unleashing immeasurable destruction even without endangering the life of the „man in the loop‟. This paper traces the history of the drones in the modern times while focusing on the American utilization of the UAVs in the wars of the twenty-first century. Drones basically address the „friction‟ element of the war. While analyzing the technical aspects of the UAVs, the article assesses the revolution these have brought in the conduct of the warfare. There are issues of collateral damage being labeled against the use of UAVs, but there is no denying the fact that these are the best weapons available in the arsenal to minimize the number of civilian casualties – as compared with the manned aircrafts and the casualties caused by the missiles fired from the aircraft carriers at times stationed hundreds of miles away. Pilotless target aircraft (PTA), Reconnaissance UAVs, and Strike UAVs or UCAVs are the three main types of Drones according to their function. The advantages of the UAVs over the manned aircrafts are the performance of dull, dirty, and dangerous work, their development and use being economical, their tactical advantage of not endangering the life of the controller, and most recently their use in the civilian arena like the flood relief activities, monitoring of the borders, reconnaissance of the areas after accidents or natural disasters, etc. Biggest challenges in the development of the drones are enhancing the endurance and autonomy of the UAVs, in-flight refueling, increasing the payload capacity, having less numbers of satellites, and most importantly the issues related with the international law and the attached ethical issues. With the successful tests of Burraq, Pakistan has also joined the club of the states developing the UAVs and the race is still „on‟

Heavy metals in selected vegetables from markets of Faisalabad, Pakistan

Two hundred ten samples of selected vegetables (okra, pumpkin, tomato, potato, eggplant, spinach, and cabbage) from Faisalabad, Pakistan, were analyzed for the analysis of heavy metals: cadmium (Cd), lead (Pb), arsenic (As), and mercury (Hg). Inductively coupled plasma optical emission spectrometry was used for the analysis of heavy metals. The mean levels of Cd, Pb, As, and Hg were 0.24, 2.23, 0.58, and 7.98 mg/kg, respectively. The samples with Cd (27%), Pb (50%), and Hg (63%) exceeded the maximum residual levels set by the European Commission. The mean levels of heavy metals found in the current study are high and may pose significant health concerns for consumers. Furthermore, considerable attention should be paid to implement comprehensive monitoring and regulations

Chitin based polyurethanes using hydroxyl terminated polybutadiene, part III: surface characteristics.

Hydroxy terminated polybutadiene (HTPB)-chitin based polyurethanes (PUs) with controlled hydrophobicity were synthesized using HTPB and toluene diisocyanate (TDI). The prepolymer was extended with different mass ratios of chitin and 1,4-butane diol (BDO). The effect of chitin contents in chain extender (CE) proportions on surface properties was studied and investigated. Incorporation of chitin contents into the final PU showed decrease in contact angle value of water drop, water absorption (%) and swelling behavior. The antibacterial activity of the prepared samples was affected by varying the chitin contents in the chemical composition of the final PU. The results demonstrated that the use of prepared material can be suggested as non-absorbable suture

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London