Ibn Qutaybah al-Dinuri\u27s Critical Measures and Statements of Judgement

This research presents Ibn Qutaybah al-Dinuri\u27s efforts in establishing literary standards and critical terms and the issues of ancient and modern in literature, as well as lexical items and meaning, and the indication of the critical judgement terms for the critic\u27s stance on poetry from objective points of view such as linguistic and phonological aspects, and following the way of the ancients as to the division of the poem, the effect of the quantity and quality on the poets ranking, and general taste. The research shows that Ibn Qutaybah was creative and influenced the critics who came after him. The research concludes that Ibn Qutaybah was creative in terms of establishing, organizing, and systematicaly criticizing poetry, especially in controlling the terms and sections of the poem. Nevertheles, Ibn Qutaybah did not directly address the issue of influence, artistic image and imagination, and this may be due to the temporal stage, the nature of Arab poetry in most cases that abounds in realistic descriptions, and his imagination is close to the nature of Arab life

Comparison of temperature measurements in bladder, rectum and pulmonary artery in patients after cardiac surgery

In many patients in the intensive care unit (ICU) continuous temperature monitoring is performed with rectal probes. Currently there are more options to measure temperature in critically ill patients. Since bladder catheters are routinely used in the majority of ICU patients, using bladder temperature (Tb) could do away with rectal probes. In this prospective study, we compared Tb, rectal temperature (Tr) and pulmonary artery catheter temperature (Tpa) in pa-tients who underwent cardiac surgery. We also evaluated if urinary production affected Tb. Patients admitted after cardiac surgery with sensors in place for measurement of Tr, Tb and Tpa upon arrival at the ICU were included. Diuresis was recorded every hour. Data were collected until 24 h after admission or until ICU discharge. Nineteen consecutive patients (9 males; mean age 61 years) were evaluated. Over a median observation period of 17 hours 382 Tb, 333 Tr and 371 Tpa measurements were recorded. Linear correlations (R) between Tb and Tr, between Tb and Tpa and between Tr and Tpa were 0.95, 0.95 and 0.91 respectively (P < 0.001). Bland-Altman analysis demonstrated no relation between temperature and the (Tb-Tr) offset. No relation of diuresis with (Tb- Tr) or (Tb-Tpa) was observed. After cardiac surgery, bladder temperature performed as well as conven-tional rectal probes with no interference of diuresis on bladder temperature measurement. Thus, the use of bladder temperature probes may be preferable to rectal probes in patients after cardiac surgery

Ultrasonographic prevalence of polycystic ovarian morphology among women of reproductive age group

Background and objective: Polycystic ovarian cyst is the most common and complex reproductive endocrinopathy affecting females of childbearing age. This study aimed to investigate the sonographic prevalence of polycystic ovary morphology among women of reproductive age group, and correlate it with age, menstrual disturbances, fertility problems, obesity, and hormonal profile. Methods: This study was carried out in the Rizgary Teaching Hospital and private clinic in Erbil city, Kurdistan region of Iraqfrom 1st August 2016 to 1st June 2017. A total of 782 women were included in this study. Inclusion criteria were any woman attending to pelvic ultrasound for whatever the cause other than pregnancy. The prevalence of polycystic ovary morphology was determined depending on Rotterdam's criteria; correlation with clinical history and biochemical indices was done. Results: Of the total study sample of 782 women, 147 (18.8%)had polycystic ovarian cyst. The highest prevalence (32.7% and 43%) was among the age group 18-27 years and participants with high body mass index (31-≥40).There was a statistically significant correlation between menstrual cycle irregularities and serum prolactin andserum testosterone. The highest polycystic ovary prevalence was found among participants with a history of amenorrhea and oligomenorrhoea, 92.3% and 75.2%, respectively. Conclusion: We observed that polycystic ovary is an age-related disease and the prevalence of the disease decreases with age. The highest prevalence was seen among the age group of 18-27 years and least in the age group of 38-47 years. No patients with polycystic ovary were found above 48 years

Bedside lung ultrasound in the critically ill patient with pulmonary pathology:different diagnoses with comparable chest X-ray opacification

The differential diagnosis and treatment of opacifications on the chest X-ray in critically ill patients may be challenging. This holds in particular the patient that suffers from respiratory failure with hemodynamic instability. Opacification in the chest X-ray could be the result of hematothorax, pleural effusion, atelectasis, or consolidation. Physical examination of such patients may not always indicate what the cause of the opacification is and thus may not always help indicate the correct therapeutic approach. In such cases, bedside ultrasound may be very helpful. We present two cases with similar chest X-ray opacifications but different diagnoses established with the help of a bedside lung ultrasound. There is documented accuracy of ultrasound in differentiating pleural effusions from consolidation. Ultrasound is safe and may be an alternative for computed tomography scan in a hemodynamically or respiratory unstable intensive care patient

The caval index:an adequate non-invasive ultrasound parameter to predict fluid responsiveness in the emergency department?

Background: Fluid therapy is the first important step in patients with signs of shock but assessment of the volume status is difficult and invasive measurements are not readily available in the emergency department. We have investigated whether the respiratory variation in diameter of the inferior vena cava is a reliable parameter to predict fluid responsiveness in spontaneous breathing emergency department patients with signs of shock. Methods: All patients admitted to the emergency department during a 15 week period were screened for signs of shock. If the attending physician planned to give a fluid challenge, the caval index was determined by transabdominal ultrasonography in supine position. Immediately afterwards 500 ml NaCl 0.9% was administered in 15 minutes and the clinical response was observed. An adequate response was defined as an increase in systolic blood pressure of at least 10 mm Hg. Based on this definition patients were divided into responders and non-responders. Results: After selection a total number of 45 patients was included. A low caval index (<36.5%) in patients with signs of shock reliably predicted the absence of an adequate response to fluid therapy (negative predictive value 92%). The positive predictive value of a high caval index was much lower (48%) despite the fact that responders had a significantly higher pre-infusion caval index than non-responders (48.7% vs 31.8%, p 0.014). Conclusions: In spontaneously breathing patients with signs of shock in the emergency department, a high caval index (>36.5%) does not reliably predict fluid responsiveness in our study, while a low caval index (<36.5%) makes fluid responsiveness unlikely. An explanation for the absence of a blood pressure response in the group of patients with a low high caval index might be that these patients represent a group requiring more volume therapy than 500 ml

Trial design: Computer guided normal-low versus normal-high potassium control in critically ill patients: Rationale of the GRIP-COMPASS study

Background: Potassium depletion is common in hospitalized patients and can cause serious complications such as cardiac arrhythmias. In the intensive care unit (ICU) the majority of patients require potassium suppletion. However, there are no data regarding the optimal control target in critically ill patients. After open-heart surgery, patients have a strongly increased risk of atrial fibrillation or atrial flutter (AFF). In a novel trial design, we examined if in these patients different potassium control-targets within the normal range may have different effects on the incidence of AFF. Methods/Design: The "computer-driven Glucose and potassium Regulation program in Intensive care Patients with COMparison of PotASSium targets within normokalemic range (GRIP-COMPASS) trial" is a single-center prospective trial in which a total of 1200 patients are assigned to either a potassium control-target of 4.0 mmol/L or 4.5 mmol/L in consecutive alternating blocks of 50 patients each. Potassium levels are regulated by the computer-assisted potassium suppletion algorithm called GRIP-II (Glucose and potassium regulation for Intensive care Patients). Primary endpoint is the in-hospital incidence of AFF after cardiac surgery. Secondary endpoints are: in-hospital AFF in medical patients or patients after non-cardiac surgery, actually achieved potassium levels and their variation, electrolyte and glucose levels, potassium and insulin requirements, cumulative fluid balance, (ICU) length of stay, ICU mortality, hospital mortality and 90-day mortality. Discussion: The GRIP-COMPASS trial is the first controlled clinical trial to date that compares potassium targets. Other novel methodological elements of the study are that it is performed in ICU patients where both targets are within the normal range and that a computer-assisted potassium suppletion algorithm is used