Clinical spectrum and outcomes of neonatal candidiasis in a tertiary care hospital in Karachi, Pakistan

Introduction: Candidal infections are a serious problem in neonatal intensive care units, increasing morbidity and mortality in low birth weight infants in addition to escalating health-care costs. Studies exploring the epidemiology of candidiasis in developing country hospitals are rare. This retrospective case-control study aimed to evaluate epidemiology and risk factors associated with candidiasis in a neonatal intensive care unit in Karachi, Pakistan. Methodology: Cases (neonates (age \u3c 28days, (n = 45) with NICU discharge diagnosis of candidal sepsis or candidemia between January 1996 and December 2006 were matched with controls (newborns with discharge diagnoses other than the above during the same study period) for gender, gestational age, and admission within 72 hours of admission of an index case. Risk factors were identified and clinical course and outcomes (discharge disposition) described. P-value and match-adjusted odds ratios were calculated. Results: A frequency of 0.9% candidemia was documented in the NICU. The incidence was highest (46%) in VLBW (\u3c 1500gm). C. albicans was the leading causative organism (55%), and neonatal risk factors identified were mechanical ventilation (\u3e 7 days), positive bacterial culture, and duration of hospitalization of \u3e 7 days. Conclusions: Prolonged ventilation, positive bacterial blood culture, and prolonged duration of NICU stay were the major risk factors associated with newborn fungal sepsis in our center. Presence of antenatal care was a significant protective factor in our subset of neonatal population

In Vitro Effects of Some Insecticides on Rumen Fluid Fermentation

A study to investigate the effects of different levels (0,5,10 and 15ppm) of three insecticides (Endosulfan, Phosalone and Chlorpyrifos) on rumen fluid fermentation characteristics (rumen pH, rumen ammonia, rumen V FA and in vitro dry matter disappearance) was carried out in the laboratory of biology in the University of Gezira, Wad Medani, Sudan in 1998. The study indicated that all the levels of each insecticide significantly (P<0.05) inhibited the in vitro dry matter disappearance )IVDMD), the rumen fluid volatile fatty acids and the rumen fluid total protozoa, and elevated the rumen fluid ammonia compared to the control. However, the rumen fluid pH was not affected. Also, the study revealed that endosulfan significantly (P<0.05) inhibited the rumen protozoa and the IVDMD percent than both phosalpne and chlorpyrifos

High Pressure Study of IrN in Zinc-Blende Structure

The structural phase transition, volume collapse and second order elastic constants of 5d-transition metal mononitride (IrN) have been investigated by using interaction potential model (IPM) which consists of Coulomb interaction, three-body interaction and short range overlap repulsive interactions. The present theoretical approach has predicted pressure-volume relationship curves which shows that IrN exhibits a zinc-blend (ZB) type structure at an ambient pressure and undergoes a structural phase transition from B3 to B1 phase at pressure 72 GPa. The equation of state shows volume collapse of 9.09 %. The phase transition pressure and associated volume collapses obtained from this model show a reasonable agreement with other theoretical results. The second order elastic constants are also investigated for ZB phase. Keywords: High Pressure, Phase Transition, Transition Metal Compound

Some Application of Switched Current Circuits.

A complete digital signal processing system requires analog circuits acting as an interface between the digital system and the outside analog world. Various techniques have been proposed to implement these circuits, but the one compatible with digital technology is switched capacitor (SC) technique. However, there are still some problems with SC circuits which are as follows: (i) The process technology used for these circuits is not compatible with the standard digital process technology due to extra poly-silicon layer, (ii) the performance of these circuits worsens for low voltage operations, because lower supply voltage will tend to increase power consumption for the same dynamic range, and in order to maintain the same dynamic range on a low supply voltage requires a quadratic increase in sampling capacitance to reduce thermal noise. The required increase in bias current to maintain circuit bandwidth results in a net increase in the overall power consumption. To overcome these problems, a new technique called the switched current (SI) technique has been proposed. The technique utilizes the ability of an MOS transistor to maintain its drain current, when its gate is open circuited, through the charge stored on its gate oxide capacitance. In this technique signals are represented by currents instead of voltages and, therefore, the signal swing is only indirectly limited by a reduction of the available voltage range. In a traditional voltage mode circuit, the supply voltage imposes a direct limitation on signal swing. Switched current circuits could therefore be a better for low voltage operation. 5 The application of switched current systems is much same as for switched capacitor systems viz. filters, A/D and D/A converters, general signal processing etc. but the prime aim is that switched current circuits should be implemented using a standard VLSI. In this work, the SI technique has been studied and several reported SI circuits have been simulated for their performance. Specifically, the work was aimed at the study of developing SI technique for the design of high performance circuits such as Integrators, Differentiators, Programmable filters, A/D and D/A converters, Sigma Delta Modulators, Multipliers, Delays etc. All the investigations are based on the PSPICE simulations using model parameters of the BISIM335 MOS transistors. The investigations match the theoretical interpretations and predictions. The entire gamut of this dissertation has been to study the already reported SI circuits and to investigate them for improved accuracy, dynamic range, bandwidth, linearity and low voltage operation

Haemato-biochemical Response to Lignocaine alone or in Combination with Xylazine for Epidural Analgesia in Cow Calves

The present study was undertaken to evaluate the effect of local analgesic (lignocaine) alone or in combination withalpha-2 adrenergic agonist (xylazine) on haemato-biochemical parameters. The study was conducted on 12 healthy male cowcalves, which were divided into two equal groups (group A and group B), and induced into two equal quantity of lignocainealone (group A) or in combination with xylazine (group B). Haematological and biochemical parameters were measued beforeand at 15, 30, 60, 90, 120, 240 minutes and 24 hours intervals after administration of drugs. No significant changes were observedin animals of the group A, except the significant increase (P <0.01) in serum glucose concentration from 30 to 120minutes intervals. In group B, a significant decrease in haemoglobin concentration and packed cell volume was observed after 30 minutes, which persisted up to 120 minutes interval as compared to base value. There was a significant decrease in total leucocytes count at 60 minutes interval and a significant increase in neutrophils percent and simultaneous decrease in lymphocytes percent between 60 to 120 minutes intervals. In addition, a significant (P <0.01) increase in serum glucose concentration from 30 to 240 minutes intervals was observed. The decrease in serum total proteins (P <0.05), and the increase in blood urea nitrogen and creatinine (P <0.05) levels, and in ALT and AST (P <0.01) activities were significant between 60 to 120 minutes intervals. The values were returned to normalcy by 24 hours in both groups. Thus, epidural xylazine along with local anaesthetic can be safely used in cow calves as it caused transient haemato-biochemical alterations

Role of Modified Biophysical Profile in Prediction of Fetal Asphyxia

Objective    To determine the diagnostic accuracy of Modified Biophysical Profile (MBPP) in determining fetal asphyxia in high risk pregnancies keeping actual birth asphyxia on Apgar Score as gold standard.       Patients and Methods After written informed consent from patients, 235 patients with high risk pregnancies admitted to obstetric ward unit 2 Holy Family Hospital were enrolled in study. BPP was done by modified method in high risk patient at > 36 week gestation. Amniotic fluid index was calculated by measuring 4 quadrant vertical pockets and if sum of 4 pockets was< 5 it was considered as abnormal. Total score in MBPP is 4.Out of which 2 score for CTG and 2 score of AFI. These patients were followed till delivery and newborn will be assessed at the time of delivery for fetal asphyxia. Fetal asphyxia was assessed on the basis of Apgar score at 5 min after birth. All patients delivering beyond 7 days of MBPP was excluded from the study. Results Mean age (years) in our study was 27.11+1.47 whereas mean parity was 2+1.06 with ranges from nulliparous to para four. The sensitivity, specificity, positive predicative value and negative predicative value of Modified Biophysical Profile (MBPP) in determining fetal asphyxia in high risk pregnancies keeping actual birth asphyxia on Apgar score as gold standard was 95.02%, 71.43%, 98.13% and 47.62% respectively. Conclusion MBPP was found to have high sensitivity and positive predictive value in predicting fetal asphyxia as assessed by Apgar score at birth. Key words:             Modified Biophysical profile, Perinatal outcome, High risk pregnancies, Non stress tes

Cognitive function and its association with level of education and work status in adults in Saudi Arabia: a cross-sectional study

Background: Cognitive decline is not inevitable with age; studies have shown that it can be affected by a number of education and work related factors. We explored this association by carrying out a cross-sectional study in King Khalid University Hospital and King Abdulaziz University Hospital in Riyadh, Saudi Arabia.Methods: We enrolled 202 adults, whose ages ranged between 40 and 85 years. Data was collected using a validated Arabic translation of a standardized test assessing cognitive function, known as the Mini Mental State Examination (MMSE). Subjects were also inquired about their level of education and work status.Results: The results showed that in our subjects of adults above the age of 40, the mean MMSE score was 23.45 (SD=4.203). Females (n=94) had lower scores than their male counterparts (n=108) (mean difference: 3.11, 95% CI 2 to 4.22; p<0.001). There was a strong negative correlation between Age and MMSE scores (r=-0.308; p<0.001). Higher levels of education were associated with higher MMSE scores (p<0.001). Having no education was associated with a major decline in scores compared to a college education (mean difference: 8.16, 95% CI 6.76 to 9.56; p<0.001). Being employed was associated with higher scores (p<0.001). This was irrespective of gender, although females were more likely to have had no education or work (p<0.001).Conclusions: Higher levels of education and employment both seem to be associated with higher cognitive function scores in the studied demographic. Further research is required for population generalization and to establish a causal relationship.

Sink-to-Sink Coordination Framework Using RPL: Routing Protocol for Low Power and Lossy Networks

RPL (Routing Protocol for low power and Lossy networks) is recommended by Internet Engineering Task Force (IETF) for IPv6-based LLNs (Low Power and Lossy Networks). RPL uses a proactive routing approach and each node always maintains an active path to the sink node. Sink-to-sink coordination defines syntax and semantics for the exchange of any network defined parameters among sink nodes like network size, traffic load, mobility of a sink, and so forth. The coordination allows sink to learn about the network condition of neighboring sinks. As a result, sinks can make coordinated decision to increase/decrease their network size for optimizing over all network performance in terms of load sharing, increasing network lifetime, and lowering end-to-end latency of communication. Currently, RPL does not provide any coordination framework that can define message exchange between different sink nodes for enhancing the network performance. In this paper, a sink-to-sink coordination framework is proposed which utilizes the periodic route maintenance messages issued by RPL to exchange network status observed at a sink with its neighboring sinks. The proposed framework distributes network load among sink nodes for achieving higher throughputs and longer network&apos;s life time