CT evaluation of malignant PNS mass and histopathological correlation

Background: Computed tomography (CT) is the gold standard for exact delineation of paranasal sinus(PNS) disease. There are many radiologically important diseases of paranasal sinuses. Objective: to evaluate the malignant PNS mass by computed tomographic image and the findings of this modality were compared with histopathological result.Methods: It was a cross sectional type of study and carried out with suspected PNS mass having patients during January 2009 to Octo­ber 2010.Results: The mean age of the patients was 35.95 ± 18.24 and common complaints of the patients were nasal obstruction (73.7%) and maximum 53.9% patients had PNS mass in maxillary sinuses. Out of 76 cases 21.1 % found malignant mass on CT and after histopathology 19. 7% had malignant mass. Out of all cases 14 were diagnosed as malig­nant PNS mass by CT scan and confirmed by histopathological evaluation and they were true positive. Two cases were diagnosed as malignant PNS mass by CT scan but not confirmed by histopathological findings and they were false positive. Of 60 cases, which were diagnosed by CT scan, one was confirmed as malignant and 59 were benign by histopa­thology. They were false negative and true negative respectively. Sensitivity of CT scan to diagnose malignant PNS mass was 93.3%, specificity 96.7%, positive predictive value 87.5%, negative predictive value 98.3% and accuracy 96.1 %. Conclusion: CT scan of the malignant para nasal sinus mass provides more information and better image quality and CT diagnosis correlate well with the findings of histopathology

The linkage between international trade and economic growth in Kazakhstan

Increased international trade flows and reduced trade restrictions have sparked ongoing debate and discussion about the influence of international trade on economic progress. Based on the empirical evaluation, the paper investigates the impact of trade openness on Kazakhstan's economic growth in a multivariate framework. It includes investment, international trade, labour force, human capital, and natural resource as explanatory constructs when gross domestic product per capita is the regressand variable. This research aims to assess the long-term relationship between trade and income development in Kazakhstan from 1992 to 2020. The Phillips and Perron (1988) and augmented Dickey and Fuller (1981) tests are used to check data stationarity. The bound test shows that the concerned variables have a long-term relationship. The results conclude that trade negatively impacts growth in the short and long run. While capital formation, labour quantity, quality, and natural resources positively affect the development of Kazakhstan's economy. This negative impact of trade on growth could be attributed to the country's shortage of good institutions and inefficient management, economic structure, and development policies. Also, it could be due to the substantial negative impact of imports countering the positive effect of exports

Factors affecting motivation of close-to-community sexual and reproductive health workers in low-income urban settlements in Bangladesh: A qualitative study

Close-to-community (CTC) health workers play a vital role in providing sexual and reproductive health services in low-income urban settlements in Bangladesh. Retention of CTC health workers is a challenge, and work motivation plays a vital role in this regard. Here, we explored the factors which affect their work motivation. We conducted 22 in-depth interviews in two phases with purposively selected CTC health workers operating in low-income urban settlements in Dhaka, Bangladesh. We analyzed our data using the framework technique which involved identifying, abstracting, charting, and matching themes across the interviews following the two-factor theory on work motivation suggested by Herzberg and colleagues. Our results suggest that factors affecting CTC sexual and reproductive health workers’ work motivation include both extrinsic and intrinsic factors. Extrinsic or hygiene factors include financial incentives, job security, community attitude, relationship with the stakeholders, supportive and regular supervision, monitoring, and physical safety and security. While, the intrinsic factors or motivators are the perceived quality of the services provided, witnessing the positive impact of the work in the community, the opportunity to serve vulnerable clients, professional development opportunities, recognition, and clients’ compliance. In the context of a high unemployment rate, people might take a CTC health worker’s job temporarily to earn a living or to use it as a pathway move to more secure employment. To maintain and improve the work motivation of the CTC sexual and reproductive health workers serving in low-income urban settlements, organizations should provide adequate financial incentives, job security, and professional development opportunities in addition to supportive and regular supervision

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

CT evaluation of malignant PNS mass and histopathological correlation

Background: Computed tomography (CT) is the gold standard for exact delineation of paranasal sinus(PNS) disease. There are many radiologically important diseases of paranasal sinuses. Objective: to evaluate the malignant PNS mass by computed tomographic image and the findings of this modality were compared with histopathological result. Methods: It was a cross sectional type of study and carried out with suspected PNS mass having patients during January 2009 to Octo­ber 2010. Results: The mean age of the patients was 35.95 ± 18.24 and common complaints of the patients were nasal obstruction (73.7%) and maximum 53.9% patients had PNS mass in maxillary sinuses. Out of 76 cases 21.1 % found malignant mass on CT and after histopathology 19. 7% had malignant mass. Out of all cases 14 were diagnosed as malig­nant PNS mass by CT scan and confirmed by histopathological evaluation and they were true positive. Two cases were diagnosed as malignant PNS mass by CT scan but not confirmed by histopathological findings and they were false positive. Of 60 cases, which were diagnosed by CT scan, one was confirmed as malignant and 59 were benign by histopa­thology. They were false negative and true negative respectively. Sensitivity of CT scan to diagnose malignant PNS mass was 93.3%, specificity 96.7%, positive predictive value 87.5%, negative predictive value 98.3% and accuracy 96.1 %. Conclusion: CT scan of the malignant para nasal sinus mass provides more information and better image quality and CT diagnosis correlate well with the findings of histopathology

Factors affecting motivation of close-to-community sexual and reproductive health workers in low-income urban settlements in Bangladesh: A qualitative study.

Close-to-community (CTC) health workers play a vital role in providing sexual and reproductive health services in low-income urban settlements in Bangladesh. Retention of CTC health workers is a challenge, and work motivation plays a vital role in this regard. Here, we explored the factors which affect their work motivation. We conducted 22 in-depth interviews in two phases with purposively selected CTC health workers operating in low-income urban settlements in Dhaka, Bangladesh. We analyzed our data using the framework technique which involved identifying, abstracting, charting, and matching themes across the interviews following the two-factor theory on work motivation suggested by Herzberg and colleagues. Our results suggest that factors affecting CTC sexual and reproductive health workers' work motivation include both extrinsic and intrinsic factors. Extrinsic or hygiene factors include financial incentives, job security, community attitude, relationship with the stakeholders, supportive and regular supervision, monitoring, and physical safety and security. While, the intrinsic factors or motivators are the perceived quality of the services provided, witnessing the positive impact of the work in the community, the opportunity to serve vulnerable clients, professional development opportunities, recognition, and clients' compliance. In the context of a high unemployment rate, people might take a CTC health worker's job temporarily to earn a living or to use it as a pathway move to more secure employment. To maintain and improve the work motivation of the CTC sexual and reproductive health workers serving in low-income urban settlements, organizations should provide adequate financial incentives, job security, and professional development opportunities in addition to supportive and regular supervision

Preparation and characterization of biochar: A case study on textile and food industry sludge management

This study aimed to prepare and characterize biochars from Textile and Food industry sludges set at 300 °C, 400 °C, and 500 °C. The residence time was 2 hours for each treatment with nitrogen flow. Biochar yields were decreased by increasing pyrolysis temperature. The parameters such as pH, Electric Conductivity (EC), Carbon/Nitrogen ratio, Total Phosphorus (TP), and Total Potassium (TK) increased with increased pyrolysis temperature. The pH values of textile sludge increased from 6.96 to 7.08, 7.13, respectively, with the increase in pyrolysis temperature. The total phosphorus content 71.75 ppm was found for biochar produced from food industry sludge at 300 °C pyrolysis temperature, and the highest TP value of 170.75 ppm was found for biochar produced from food industry sludge at 500 °C pyrolysis temperature. The TK value of biochar produced from the Food industry sludge was also increased by increasing pyrolysis temperature and ranged from 3277.77 ppm to 3494.72 ppm. The ATR- FTIR identified functional groups O–H, C–H, C–O, and CC from the fingerprint region. This work demonstrates that the thermal conversion of industrial sludge to biochar is a sustainable, cost-effective, and environmentally friendly management approaches

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures