Effect of adding magnesium sulphate to bupivacaine on the clinical profile of ultrasound-guided thoracic paravertebral block in patients undergoing modified radical mastectomy

AbstractBackgroundParavertebral block is an effective perioperative analgesic modality in patients undergoing breast or thoracic surgery. Several adjuvants have been reported to improve the clinical profile of local anaesthetic-induced paravertebral block. In the present study, we hypothesized that the addition of magnesium sulphate could potentiate the analgesic effects of paravertebral bupivacaine in female patients undergoing modified radical mastectomy.MethodsNinety female patients ASA physical status 1 and 2 patients scheduled for modified radical mastectomy were allocated into 2 groups (45 patients each). Group (B) received bupivacaine 0.25% 0.3ml/kg in the paravertebral space while group (BM) received 100mg magnesium sulphate+bupivacaine 0.25% 0.3ml/kg in the paravertebral space. Both blocks were done guided by ultrasound before induction of standard general anaesthetic technique which was the same in both groups. The two groups were assessed in the first post-operative 24h for post-operative visual analogue scale (VAS) scores, time to first analgesic request, total 24h morphine consumption, number of attacks of PONV and any complications from paravertebral block or from the drugs used in the study.ResultsPatients in group (BM) were found to have reduced VAS scores at 30min, 2, 4, 6, 12, 24h intervals post-operative. The time to first analgesic request was longer in patients of group (BM) with less amount of post-operative opioid consumption and consequently less number of attacks of PONV in first post-operative 24h. These results were significant with a P value<0.001.ConclusionAdding magnesium sulphate to bupivacaine in ultrasound-guided paravertebral block resulted in more efficient analgesia and opioid-sparing in female patients undergoing modified radical mastectomy

Bounding of double-differenced correlated errors of multi-GNSS observations using RTK for AV positioning

Integrity monitoring of autonomous vehicle (AV) localization is essential to guarantee their safety. In this process, satellite observation errors should be bounded using proper statistical methods to calculate a protection level that is neither optimistic nor overly conservative. Therefore, a realistic weighting function that is based on real data was developed in this research to achieve that balance. When using RTK as a positioning method, a real challenge is dealing with the cross-correlation between differenced observations. In this work, the overbounding parameters, i.e. the standard deviation (STD) and mean (bias) of the observation errors, were empirically computed for numerous combinations of different signals and frequencies from multiple GNSS constellations. the Two-Step Gaussian Bounding (TSGB) method is used as it could maintain overbounding after convolution from the observation domain to the position domain. Two empirical methods were designed to obtain the overbounding parameters and build the covariance (weighting) observation matrix using one full year of satellite observations. In the first method, a mapping function was utilised to re-compute the observation residuals from the slant direction to the zenith. Accordingly, a user can simply map them back along the observed satellites directions at different elevation angles (EAs). The correlation coefficients between correlated observations are derived based on the EAs of the studied satellites, so that they can be used in the stochastic model. In a second approach, the differenced residuals were categorized based on the EAs of both the pivot and other satellites in intervals of five degrees and building look-up tables. The correlation coefficients in this case were empirically calculated using Pearson’s Correlation Coefficient equation. The overbounding mean and STD of both code and phase observation errors for both approaches were in the range of 0.0003–1.369 m and 0.007–2.497 m, respectively. While the first approach provides a tight overbounding results, the second is more conservative

The Effect of Family Centered Care Model on Caregivers of Children with Hemophilia

Hemophilia is one of the most common serious congenital coagulation factor deficiency diseases characterized by decreased function or absence of factor VIII or factor IX that is associated with significant morbidity and mortality. Aim: the current study aimed to evaluate the effect of family centered care model on caregivers of children with hemophilia. Design: A quasi-experimental research design (one group pre-posttest) was used. Setting: the study was conducted at inpatient department and outpatient clinic in Badr University Hospitals affiliated to Helwan University Hospitals and Mustafa Hassan pediatric Hospital affiliated to Fayoum University Hospitals. Sample: the study involved 60 children and their accompanying caregivers suffering from hemophilia disease. Tool: consists of four tools to assess: I: A structured interviewing questionnaire sheet to assess caregivers’ knowledge regarding hemophilia disease (one group pre/posttest). II: Observational checklist to assess caregivers' reported practice regarding care of their children with hemophilia. III:&nbsp; caregiver's coping patterns, IV: The Family-Centered Care (FCC) scale for caregivers. Results: the current results referred that there was statistically significant difference between family centered care scale and their total knowledge and their total practices regarding hemophilia pre and post intervention. Also, there were statistically significant a positive correlation between their total knowledge, their total practices, their total coping and family centered care scale. Conclusion: the present study concluded that there was a positive effect of implementation of model on improving knowledge, practices and coping pattern of the studied caregivers. Recommendations: encourage family centered care programs periodically for caregivers having children with hemophilia to help them improve care for their children and reduce complications of the disease

Realisierungsformen der Sprechereinstellung in der deutschen Wissenschaftskommunikation - Versuch einer Klassifikation

Die Klasse der Sprechereinstellung gilt als eine heterogene Klasse, die sprachlich durch diverse Ausdrucksformen realisiert wird. Trotz der Heterogenität der Realisierungsformen werden dieser Klasse keine Arbeiten zur Differenzierung zwischen den einzelnen Formen gewidmet. Die Sprechereinstellung ist der Modalität zuzuordnen. In der Literatur gibt es jedoch verschiedene semantisch-logische Typologien für die Modalität, nämlich subjektive und objektive Modalität (Helbig/Buscha 1996, S. 131 f.), epistemische und nicht-epistemische Modalität (Duden 2005, S. 562 ff.), logische, psychologische und soziale Modalität (Gabelentz 1891, S. 495 ff.) und kognitive, volitive und emotive Modalität (Bublitz 1978, S. 6 f.) Redder (2009, S. 88 ff.) macht einen Vorschlag zur Unterscheidung zwischen drei handlungstheoretischen Arten der Modalität, die die kommunikative Qualität der Modalität in den Vordergrund rücken. Diese Arten sind Handlungsmodalität, Wirklichkeitsmodalität und Wissensmodalität. In diesem Klassifizierungsversuch sind die Realisierungsformen der Sprechereinstellung unter der Wissensmodalität zu finden. Auf dieser Basis wird in der vorliegenden Arbeit versucht, eine wissensbezogene Klassifikation der variablen Realisierungsformen der Sprechereinstellung aus funktional-pragmatischer Sicht in einer konkreten Textart zu erstellen, nämlich im wissenschaftlichen Text. Parallel zur Klassifizierung lässt sich ebenso die Handlungsqualität der Sprechereinstellung darin ermitteln

Comparasion between Oil Immersed and SF6 Gas Power Transformers Ratings

           Power transformers present the largest portion of the capital investment in addition the power transformer remains oil immersed which presents a fire hazard that is particularly objectionable in urban and metropolitan environment. After careful studies of various alternatives to conventional transformer technology to produce a gas insulated power transformer with increased mega volt-ampere ratings, gas insulated power transformer has been developed with a use with non flammable SF6 gas. For changing the insulating material from oil to SF6 gas a comparative study between these types of transformers should be made. In this paper two mathematical models are suggested and simulated by computer programs to calculate the temperature of the cooling mediums and transformer windings. The obtained results are in agreement wit the measured values in the field

Occupational Stress, Job Satisfaction and Cervical Screening Intention of Maternity Oncology Nurses

Background: Cervical Cancer could be a preventable disease, and a key aspect of its interference is that the detection of the premalignant form by cervical screening. Nursing could be a skilled job characterized by high stress. Stress could be associated with less practice of health promoting behaviors; however, no study has investigated the relationship between job stress and health screeningbehaviors among nurses in Egypt. Aim: describe the rate of Pap smears in hospital nurses and assess the effects of job stress on receiving cervical cancer screening. Subject and Methods: Purposive sampling included 30 nurses who worked in gynecological inpatient and outpatient department in all general hospitals in Beni-Suef city. Data collection was carried out by self-administered structured questionnaire, Job stressors & Job Satisfaction Scales for Nurses. Results: 86.7% of staff nurses working in maternity oncology units never Performed cervical screening pap smear Previously. 90% & 93.4% of the nurses, respectively, were unsatisfied with their salary and job. 70% of them had anoccupational stress and 100% Perceived occupational health risks. Conclusion: The great majority of nurses has unsatisfied and job stress. Most of them never Performed pap smear Previously and absolutely refuse to do in future. The main cause for refusing cervical screening as mentioned by nurses was a high flow rate of positive cases

Le rôle des acteurs de la société civile : le cas des organisations non gouvernementales et des groupes communautaires dans la gestion des déchets solides urbains au Caire

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal

Phylogenetic and characterization of salt-tolerant rhizobial strain nodulating faba bean plants

Improvement of faba bean production in the new reclamation land in Egypt requires isolation and selection of effective abiotic stress tolerant rhizobial strains. Three rhizobial strains were isolated from healthy faba bean plants growing in different geographic areas in Egypt. These isolates were adapted against different concentrations of NaCl (100, 150 and 200 mM) by using the enrichment method. They were evaluated by measuring the symbiotic N2-fixation parameters under greenhouse and field conditions during two seasons (2010/2011 and 2011/2012). One rhizobial strain exhibited the highest values of symbiotic N2-parameters, nitrogenase activity and proline content. Based on 16S rDNA and nifH gene sequence, this strain was shown to belong to the Rhizobium leguminosarum bv. viciae. A strong similarity was found between the 16S rDNA and nifH gene sequence of the strain E15 and R. leguminosarum bv. viciae 3841 (100% similarity for 16S rDNA and 95% similarity for nifH gene). The results show that the maximum growth of this strain was obtained at pH 7 and 30°C. This strain was tolerant to drought stress till 20% polyethylene glycol and it yielded the highest concentrations of indole-3-acetic acid (IAA) at the end of the logarithmic phase. This strain solubilized inorganic phosphorus. R. leguminosarum bv. viciae was able to survive, persist, grow and effectively nodulated faba bean plants at high salt concentrations under greenhouse and field conditions and it could be used for biofertilization to reduce the severe effects of salinity and drought stress in the new reclamation land in Egypt.Keywords: Vicia faba, Rhizobium leguminosarum bv. viciae, abiotic stress, nifH geneAfrican Journal of Biotechnology Vol. 12(27), pp. 4324-433

Staphylococcus aureus Nasal Carriage among Surgical personnel in National Ribat University Teaching Hospital-Khartoum-Sudan

Introduction: Staphylococcus aureus (S. aureus) is one of the most common causes of both community and hospital acquired bacterial infection. There is strong correlation between S aureus nasal carriage and disease progress. Nasal carriage is high among health care workers. Inappropriate usage of antibiotic may lead to emergence of resistant strains which has serious consequences. Objective: The objective of this study is to reveal the frequency of S aureus nasal carriage and its drug resistance among surgical personnel in National Ribat Teaching Hospital Khartoum Sudan. Methods: This is a hospital-based case study. Nasal smears were taken from medical workers in the surgical department and operational theater at National Ribat Teaching Hospital in Khartoum State, Sudan. Samples were processed, cultured, then susceptibility tests were performed using Bauer-Kirby disc diffusion methods following recommendations of National Committee for Laboratory Standards (NCCLS). Results were analyzed and discussed. Results: Sixty three samples were taken. Thirty were males. Growth was achieved in only eight (12.6%). Majority showed resistance to penicillin. However, alls strain were sensitive to amoxicillin/calvunalic acid, vancomycin and oxacillin. Conclusion: this study gives an early alarm on the problems related to S. aureus colonization rate and its drug resistance. Nevertheless, the small number of our study group is a bit fall. Keywords: drug resistance, hospital acquired bacterial infection Sudan Journal of Medical Science Vol. 3 (4) 2008: pp. 281-28