Adult Onset Morgagni Hernia: Medical vs. Surgical Management.

Morgagni hernia is a type of diaphragmatic hernia where bowel content herniates through an irregular opening into the thoracic cavity. Herein, we present the case of an 84-year-old female patient with multiple hospital admissions for abdominal symptoms. Radiological studies confirmed Morgagni hernia. She underwent a laparoscopic intervention with mesh placement. She was discharged in stable condition and was doing well on follow-up

Damping Reduction Factors for Crustal, Inslab, and Interface Earthquakes Characterizing Seismic Hazard in Southwestern British Columbia, Canada

High-damping displacement spectra and corresponding damping reduction factors ( η) are important ingredients in seismic design and analysis of structures equipped with seismic protection systems, as well as in displacement-based design methodologies. In this study, we investigated η factors for three types of earthquake characterizing seismic hazard in southwestern British Columbia, Canada: shallow crustal, deep inslab, and interface subduction. We used a large and comprehensive database including records from recent relevant earthquakes, such as the 2011 Tohoku event. Our key observations were as follows: (1) there is negligible dependence of η on soil class; (2) there is significant dependence of η on the frequency content and duration of ground motions that characterize the different record types, and (3) η is dependent on period, particularly for inslab events. Period-dependent equations were proposed to predict η for damping ratios between 5% and 30% corresponding to the three event types.</jats:p

Genetic variability and differentiation of common Kilka fish (Clupeonella cultriventris Nordmann, 1840) in the southern coasts of Caspian Sea

A total of 120 samples of adult common Kilka fish (Clupeonella cultriventris) were collected during spring and summer from the southern coasts of Caspian Sea (Bandar Anzali and Babolsar). Fifteen sets of microsatellite primers were developed from Clupeidae being tested on genomic DNA of common Kilka. Allele frequency, observed and expected heterozygosity, FST, RST, FIS index were determined. Five primer sets as polymorphic loci were used to analyze the genetic variation in adults of the common Kilka population. Results revealed that average alleles per locus was 13.1 (range 5 to 22 alleles per locus in regions, Ne=9.5). All sampled regions contained private alleles. Average observed and expected heterozygosity was 0.348 and 0.877, respectively. Deviations from Hardy Weinberg equilibrium were observed in most cases. FST, RST and gene flow estimates in AMOVA and the genetic distance between populations indicated that the genetic difference among the studied populations was pronounced. The data generated in this study provide primary information on the genetic variation and differentiation in populations of Caspian common Kilka

Clinical and parasitological response to oral chloroquine and primaquine in uncomplicated human Plasmodium knowlesi infections

Background: Plasmodium knowlesi is a cause of symptomatic and potentially fatal infections in humans. There are no studies assessing the detailed parasitological response to treatment of knowlesi malaria infections in man and whether antimalarial resistance occurs. Methods: A prospective observational study of oral chloroquine and primaquine therapy was conducted in consecutive patients admitted to Kapit Hospital, Sarawak, Malaysian Borneo with PCR-confirmed single P. knowlesi infections. These patients were given oral chloroquine for three days, and at 24 hours oral primaquine was administered for two consecutive days, primarily as a gametocidal agent. Clinical and parasitological responses were recorded at 6-hourly intervals during the first 24 hours, daily until discharge and then weekly to day 28. Vivax malaria patients were studied as a comparator group. Results: Of 96 knowlesi malaria patients who met the study criteria, 73 were recruited to an assessment of the acute response to treatment and 60 completed follow-up over 28 days. On admission, the mean parasite stage distributions were 49.5%, 41.5%, 4.0% and 5.6% for early trophozoites, late trophozoites, schizonts and gametocytes respectively. The median fever clearance time was 26.5 [inter-quartile range 16-34] hours. The mean times to 50% (PCT50) and 90% (PCT90) parasite clearance were 3.1 (95% confidence intervals [CI] 2.8-3.4) hours and 10.3 (9.4-11.4) hours. These were more rapid than in a group of 23 patients with vivax malaria 6.3 (5.3-7.8) hours and 20.9 (17.6-25.9) hours; P = 0.02). It was difficult to assess the effect of primaquine on P. knowlesi parasites, due to the rapid anti-malarial properties of chloroquine and since primaquine was administered 24 hours after chloroquine. No P. knowlesi recrudescences or re-infections were detected by PCR. Conclusions: Chloroquine plus primaqine is an inexpensive and highly effective treatment for uncomplicated knowlesi malaria infections in humans and there is no evidence of drug resistance. Further studies using alternative anti-malarial drugs, including artemisinin derivatives, would be desirable to define optimal management strategies for P. knowlesi.Publisher PDFPeer reviewe

An Experimental Investigation on the Amount of Drag Force of Sand on a Cone Moving at Low Uniform Speed

The amount of resistance of a particular medium like soil to the moving objects is the interest of many areas in science. These include soil mechanics, geotechnical engineering, powder mechanics etc. Knowledge of drag force is also used for estimating the amount of momentum of fired objects like bullets. This paper focuses on measurement of drag force of sand on a cone when it moves at a low constant speed. A 30-degree apex angle cone has been used for this purpose. The study consisted of both loose and dense conditions of the soil. The applied speed has been in the range of 0.1 to 10 mm/min. The results indicate that the required force is basically independent of the cone speed; but, it is very dependent on the material densification and confining stress

Prevalence of beta lactamase producing species of pseudomonas and acinetobacter in pediatric burn patients Prevalence de pseudomonas et acinetobacter secreteurs de blse et metallo-beta lactamases chez les brules pediatriques

Burn wound infection is a major cause of morbidity and mortality in burn victims. Pseudomonas and Acinetobacter species are among the most common organisms complicating burn wounds. Presence of extended spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL) genes plays an important role in spreading β-lactam resistant strains of these organisms and is a serious condition in the treatment of the affected patients. As a result, we aimed to determine the prevalence of SHV, TEM, PER and VIM β-lactamases in Pseudomonas and Acinetobacter species isolates from burn wound swabs of children with burn injury. In this descriptive observational study, 107 Pseudomonas and Acinetobacter isolates collected from burn patients were subjected to PCR assay. Using PCR method and DNA sequencing, the existence of SHV-, TEM-, PER- and VIM-type β-lactamase encoding genes were determined. Out of the 107 Pseudomonas and Acinetobacter isolates, 66 (77.6) were ESBL positive, 26.2 were positive for SHV gene, 37.4 were positive for TEM gene, 14 were positive for PER gene and 15.9 of them harbored VIM gene. More than half of the Pseudomonas and Acinetobacter strains in our pediatric burn unit harbor β-lactamase encoding genes that make them resistant to a wide range of β-lactam antibiotics. Consequently, it is suggested to choose an appropriate antibiotic regimen based on the antibiogram pattern of the strains. © 2015, Mediterranean Club for Burns and Fire Disasters. All rights reserved

Adapted MMSE and TYM cognitive tests: how much powerful in screening for Alzheimer�s disease in Iranian people

Alzheimer�s disease (AD) is a major global health priority and providing an efficient way for early diagnosis of people developing dementia is important. The Mini-Mental State Examination (MMSE, total score = 30) and Test Your Memory (TYM, total score = 50) are widely used as screening tests for cognitive function. In the present study 174 subjects including healthy people (CON group) and those having Alzheimer�s disease (AD group) were introduced to MMSE and TYM cognitive tests adjusted to Iranian population. Sensitivities and specificities with optimal cut-off scores, area under curve (AUC), positive predictive value (PPV) and negative predictive value (NPV) were measured for both tests. The MMSE scores of the CON and AD groups were 23.77 ± 0.327 and 10.88 ± 0.762, respectively. The TYM scores were 44.32 ± 0.389 and 14.37 ± 1.368 in the CON and AD participants, respectively. Findings in the MMSE test were: AUC = 0.962, optimal cut-off score = 18.5, sensitivity = 0.90 and specificity = 0.96. Values in the TYM test were: AUC = 0.991, optimal cut-off score = 31, sensitivity = 0.90 and specificity = 1. We found no correlation between the cognitive performance and age in the CON group but a positive correlation in the AD patients. On the other hand, t-test analysis indicated that achievement of the test scores are significantly sex dependent, with more scores attained by the females. Taken together, in regard to correct classification rate (CCR); the TYM test seems to be more appropriate for cognitive screening in our study. However, considering an analogous AUC, both tests are comparable and have high sensitivity and specificity for discriminating between people with and without AD. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group

Porous SnO2-Cu x O nanocomposite thin film on carbon nanotubes as electrodes for high performance supercapacitors.

Metal oxides are promising materials for supercapacitors due to their high theoretical capacitance. However, their poor electrical conductivity is a major challenge. Hybridization with conductive nanostructured carbon-based materials such as carbon nanotubes (CNTs) has been proposed to improve the conductivity and increase the surface area. In this work, CNTs are used as a template for synthesizing porous thin films of SnO2-CuO-Cu2O (SnO2-Cu x O) via an electroless deposition technique. Tin, with its high wettability and electrical conductivity, acts as an intermediate layer between copper and the CNTs and provides a strong interaction between them. We also observed that by controlling the interfacial characteristics of CNTs and varying the composition of the electroless bath, the SnO2-Cu x O thin film morphology can be easily manipulated. Electrochemical characterizations show that CNT/SnO2-Cu x O nanocomposite possesses pseudocapacitive behavior that reaches a specific capacitance of 662 F g-1 and the retention is 94% after 5000 cycles, which outperforms any known copper and tin-based supercapacitors in the literature. This excellent performance is mainly attributed to high specific surface area, small particle size, the synergistic effect of Sn, and conductivity improvement by using CNTs. The combination of CNTs and metal oxides holds promise for supercapacitors with improved performance.Lloyds Register Foundation Londo