Epidemiology, Causes and Outcome of Obstetric Acute Kidney Injury

Namrata Khanal, Ejaz Ahmed, and Fazal Akhta

A Weighted Linear Combining Scheme for Cooperative Spectrum Sensing

AbstractCooperative spectrum sensing exploits spatial diversity of secondary-users (SUs), to reliably detect the availability of a spectrum. Soft energy combining schemes have optimal detection performance at the cost of high cooperation overhead, since actual sensed data is required at the fusion center. To reduce cooperation overhead, in hard combining only local decisions are shared; however the detection performance is suboptimal due to the loss of information. In this paper, a weighted linear combining scheme is proposed in which a SU performs a local sensing test based on two threshold levels. If local test result lies between the two thresholds then the SU report neither its local decision nor sequentially estimated unknown SNR parameter values, to the fusion center. Thereby, uncertain decisions about the presence/absence of the primary-user signal are suppressed. Simulation results suggest that the detection performance of the proposed scheme is close to optimal soft combining schemes yet its overhead is similar to hard combining techniques

Fast track extubation in adult patients on pump open heart surgery at a tertiary care hospital

Background: Fast-track cardiac surgery programs have been established as the standard of cardiac surgical care. Studies have shown that early extubation in elective cardiac surgery patients, including coronary and non-coronary open-heart surgery patients does not increase perioperative morbidity and mortality. The objective of this observational study was to determine the success and failure profile of fast track extubation (FTE) practice in adult open-heart surgical patients. Methods: The study was conducted at cardiac operating room and Cardiac Intensive Care Unit (CICU) of a tertiary care hospital for a period of nine months, i.e., from Oct 2014 to June-2015. All on pump elective adult cardiac surgery patients including isolated CABG, isolated Valve replacements, combined procedures and aortic root replacements were enrolled in the study. Standardized anesthetic technique was adopted. Surgical and bypass techniques were tailored according to the procedure. Success of Fast track extubation was defined as extubation within 6 hours of arrival in CICU. Results: A total of 290 patients were recruited. The average age of the patients was 56.3±10.5 years. There were 77.6% male and 22.4% female patients. Overall success rate was 51.9% and failure rate was 48.1%. The peri-operative renal insufficiency, cross clamp time and CICU stay (hours) were significantly lower in success group. Re-intubation rate was 0.74%. Conclusion: The perioperative parameters were significantly better in success group and the safety was also demonstrated in the patients who were fast tracked successfully. To implement the practice in its full capacity and benefit, a fast track protocol needs to be devised to standardize the current practices and to disseminate the strategy among junior anaesthesiologists, perfusionists and nursing staff

Pulmonary artery catheter knotting in a coronary artery bypass surgery patient

A fifty seven years old female patient came to operating room for coronary artery bypass grafting (CABG) surgery. After induction, invasive monitoring lines were placed. Pulmonary artery catheter (PAC) floated after three attempts and it was wedged at 60cm. Intra operative course was smooth and patient transferred to cardiac intensive care unit (CICU). First chest X-ray revealed PAC knotting in the right ventricle. Vascular surgeon was involved and he removed it through right internal jugular vein under fluoroscopic guidance. Pulmonary arterial catheterization is an invasive procedure. Knotting usually occurs due to excessive advancement of the pulmonary artery catheter beyond the normally expected distance. The removal of a catheter should never be forced when resistance is encountered. PA catheter knotting is a rare complication but it should be suspected whenever there is excessive length of catheter required to reach pulmonary artery

Grown up congenital heart disease patient presenting for non cardiac surgery: anaesthetic implications

Congenital heart disease patients surviving to adulthood have increased over the years due to various reasons. These patients are admitted in the hospital for non cardiac surgeries and other procedures more often than normal adult population. Management of grown up congenital heart disease patient presents a challenge during perioperative period for cardiologists, surgeons, intensivists and particularly for the anaesthetist. Management issues include psychological and physiological impact on the patient, complexity of defects, presence of previous palliative procedure, impact of anaesthetic agents on shunting and myocardium, endocarditis prophylaxis and associated extra cardiac anamolies

Monozygotic and Dizygotic Twins Differences in Fingerprint Patterns of Swat District

Background: The identification of individual is important for both legal and humanitarian reasons. It is of great importance because every individual exists as an entity in a society and is dealt with as such by the legal system. The most commonly used method for identification is fingerprinting which relies on the uniqueness of ridges present on thumbs and fingers. These are unique in arrangements and remain constant throughout an individual’s life. Fingerprints of no two individuals are same even if they are twins. The power of discrimination of the basis of fingerprinting is about one in 64 billion. The study was designed to carry out analysis of fingerprints from mono and dizygotic twins and to differentiate them on the basis of fingerprinting.Methods: This was a prospective cross-sectional study carried out among 30 pairs of twins including 17 pair of monozygotic twins and 13 pair of dizygotic twins. After taking an informed expressed consent, the participants were asked to press their individual fingers on the stamp pad. They were asked to then put and roll the stamped finger onto an A4 size paper on which blocks for each finger were already made. Both left and right hands were fingerprinted and with the help of magnifying glass, different types were identified including Arches, Composite type, Loops and Whorls. SPSS software was used for data analysis.Results: There was 7.6% of Arch type, 6.1% of tented arches, 1.5% of plain arches, 62.32% of loops, 6.66% of double loop, and 3.83% of central pocket loop, 44.83% of ulnar loop, 7% of radial loop, 0.83% of accidental loop, 29.93% of whorls, 9% of plain whorl and 20.1% of central the pocket whorl.Conclusion: When the left and right thumbs are compared with each other using eight (8) points, there are matches on the first six (6) points, matching percentage for each of these pairs of fingers is 75%. But when the both fingers were rotated on 180° and compared, the matching percentage was 87.5%. These 8 points fingerprinting can be used to distinguish twins.Keywords: Fingerprint; Identification; Twin; Monozygotic; Dizygotic

Effects of probiotic on the intestinal morphology with special reference to the growth of broilers.

The probiotic (Protexin)® increases the growth rate in broilers. It must interfere with the intestinal cell morphology and absorption. The intestinal epithelium is one of the most rapidly renewed tissues in the body and is renewed by a process of continuous cell division. This study was carried out with an aim to establish a link between the use of probiotic doses, growth rate, and intestinal cell proliferation by measuring the length and weight of the intestine and intestinal crypt cell proliferation (CCP) of broiler chicks. The results revealed significant increase in intestinal CCP but no effect was observed on the intestinal weight and length. The increase in CCP has also no significant influence towards growth factor. The increased weight gain in this study is associated with more feed consumption which is observed with Protexin® dose 1.0 g / 10 kg of feed. Furthermore, feed consumption reduced beyond this dose may lead to reduced weight gain

Range for Normal Body Temperature in Hemodialysis Patients and Its Comparison with That of Healthy Individuals

Background/Aims: Patients with chronic kidney disease undergoing hemodialysis have an altered homeostasis leading to altered body temperatures. We aimed to determine the range for normal body temperature in hemodialysis Patients and compared it to healthy individuals. Also, we determined how much axillary temperatures differed from oral temperatures in both groups and whether axillary temperature is affected by the presence of an arteriovenous fistula (AVF) in hemodialysis Patients. Methods: Oral and axillary (left & right) temperatures were recorded using an ordinary mercury-in-glass thermometer in 400 subjects (200 hemodialysis Patients, 200 healthy individuals) at the Sindh Institute of Urology and Transplantation from mid-May to mid-June 2006. Comparisons were made between the temperatures of both groups. Results: Mean oral temperature in hemodialysis Patients was higher than in healthy individuals [98.7 degrees F (37 degrees C) vs. 98.4 degrees F (36.8 degrees C), p \u3c 0.001], as was the mean average axillary temperature [97.7 degrees F (36.5 degrees C) vs. 97.5 degrees F (36.3 degrees C), p = 0.02] and mean left axillary temperature [97.9 degrees F (36.6 degrees C) vs. 97.6 degrees F (36.4 degrees C), p \u3c 0.001]. The fistula arm had higher axillary temperature in 77 (44%) hemodialysis Patients. The difference between oral and axillary temperatures varied widely, making it impossible to obtain an accurate correction factor in both groups. Conclusion: Hemodialysis Patients have higher normal body temperatures than healthy individuals. Axillary temperatures require cautious interpretation. In hemodialysis Patients, the non-fistula arm should be preferred for recording axillary temperatures, as the presence of AVF may cause discrepancies in temperature measurements

Synthesis of Novel MOF-5 Based BiCoO3 Photocatalyst for the Treatment of Textile Wastewater

Water pollution, having organic dyes, has lethal impacts on aquatic life and public health. To eliminate or degrade dyes, a metal-organic framework (MOF) based BiCoO3 semiconductor is considered a potential photocatalyst for the degradation of dyes. In this study, the MOF-5-based BiCoO3 (MOF-5/BiCoO3) composite was successfully synthesized using a one-pot hydrothermal process. Different analytical techniques were used to characterize MOF-5/BiCoO3 composite and pure MOF-5 samples. When compared to pure MOF-5, the experimental and characterization analysis showed that the MOF-5/BiCoO3 composite has better photocatalytic activity (99.6%) for the degradation of Congo-red (CR) dye due to the formation of heterostructure between MOF-5 and BiCoO3, which improve the separation of charge carriers. Meanwhile, the introduction of BiCoO3 with MOF-5 changes the surface morphology of MOF-5/BiCoO3 composite, increasing the surface area for CR adsorption and thus improving photocatalytic efficiency. Based on radical trapping experiments, the superoxide and hydroxyl radicals are dominant species in the CR degradation process. The reusability results demonstrate that MOF-5/BiCoO3 composite can be used effectively for up to five cycles, which makes the process more economical. Hence, MOF-5/BiCoO3 composite offers a promising approach to developing a highly effective, stable, efficient, economical, and sustainable photocatalyst for the dissociation of organic pollutants from wastewater streams