Effectiveness of daily fluid balance charting versus body weight measurement as a guide for fluid administration therapy after cardiac surgery

Background: Several studies have established a link between fluid overload and an increased risk of death. After cardiac surgery, patients' fluid status should be assessed at close intervals. A daily fluid balance (FB) has several limitations. This study aims to determine the agreement and correlation between fluid status changes calculated by the daily fluid balance through the conventional charting approach and body weight (BW) change using beds equipped with weighing scales. Methods: This is a prospective observational study that included 50 patients who underwent cardiac surgeries. It evaluates the precision and usefulness of determining body fluid status and requirements using daily fluid balance and body weight measurements. Results: The mean age of the study group was 52.9 ±10.44 years. The mean weight, height, and BMI were 87.1 ± 16.68 Kg, 170.4 ± 4.59 cm, and 30.12 ± 6.21 kg/m2. The mean duration of mechanical ventilation was 9.5 ±3.73 h. Mean ICU and hospitalization times were 2.4 ± 0.67 and 6.3 ± 1.36 days, respectively. The mean cumulative fluid balance was 0.52 ± 3.21 L, and the overall change in body weight (discharge weight − admission weight) was 0.55 ± 2.89 kg. There was a highly significant positive correlation between overall bodyweight and cumulative fluid balance (r- coefficeient= 0.947, p-value <0.001). Conclusion: Bodyweight measured by weight-enabled beds could seem sufficiently robust or accurate to replace daily FB in ICU post open heart. Such measurement might be used to monitor overall changes in BW in patients with a prolonged ICU stay

Usefulness of atropine in patients with chronotropic incompetence and poor exercise capacity during treadmill stress testing

AbstractBackgroundAtropine, an anticholinergic agent, has been shown to increase heart rate and enhance the sensitivity of dobutamine stress echocardiography in the detection of CAD in patients with chronotropic incompetence; however, the addition of atropine to exercise stress testing EST, in these types of patients has not been well studied previously.ObjectiveInvestigating the usefulness and accuracy of atropine in decreasing the number of inconclusive results of EST in patients with chronotropic incompetence and poor exercise capacity.MethodsThirty patients (16 males and 14 females with the age range of 40:73years with mean of 55±8) out of 180 patients who preformed EST were chosen as having chronotropic incompetence or poor exercise capacity by Borg scale. Atropine was administered during the exercise phase in doses of 0.5mg per minute until test conclusion or the maximum dose of 2mg was reached. All patients were subjected to stress myocardial perfusion imaging SMPI to confirm accuracy.ResultsConclusive test results were achieved in 29 patients (97%). Heart rate and blood pressure were markedly increased with statically highly significant difference (P value <0.001), patients on b-blocker treatment had lower maximum heart rate compared to other patients with significant difference. Twenty-three (79%) patients had negative test results and six (21%) patients had positive test results, and if compared to SMPT results, EST was considered better positive than negative test, with higher specificity than sensitivity and accuracy.ConclusionsAtropine injection during EST significantly reduced the inconclusive test results in patients with chronotropic incompetence and poor exercise capacity

Usefulness of atropine in patients with chronotropic incompetence and poor exercise capacity during treadmill stress testing

AbstractBackgroundAtropine, an anticholinergic agent, has been shown to increase heart rate and enhance the sensitivity of dobutamine stress echocardiography in the detection of CAD in patients with chronotropic incompetence; however, the addition of atropine to exercise stress testing EST, in these types of patients has not been well studied previously.ObjectiveInvestigating the usefulness and accuracy of atropine in decreasing the number of inconclusive results of EST in patients with chronotropic incompetence and poor exercise capacity.MethodsThirty patients (16 males and 14 females with the age range of 40:73years with mean of 55±8) out of 180 patients who preformed EST were chosen as having chronotropic incompetence or poor exercise capacity by Borg scale. Atropine was administered during the exercise phase in doses of 0.5mg per minute until test conclusion or the maximum dose of 2mg was reached. All patients were subjected to stress myocardial perfusion imaging SMPI to confirm accuracy.ResultsConclusive test results were achieved in 29 patients (97%). Heart rate and blood pressure were markedly increased with statically highly significant difference (P value <0.001), patients on b-blocker treatment had lower maximum heart rate compared to other patients with significant difference. Twenty-three (79%) patients had negative test results and six (21%) patients had positive test results, and if compared to SMPT results, EST was considered better positive than negative test, with higher specificity than sensitivity and accuracy.ConclusionsAtropine injection during EST significantly reduced the inconclusive test results in patients with chronotropic incompetence and poor exercise capacity

Synthesis and efficiency of new pyridine, chromene and thiazole containing compounds as antimicrobial and antioxidant agents

ABSTRACT. The versatile scaffold, N'-(2-cyanoacetyl)-2-hydroxybenzohydrazide (3) was utilized in the production of new pyridine, chromene and thiazole derivatives as antimicrobial and antioxidant agents. The synthetic strategy involves the treatment of precursor 3 with various arylidene-malononitrile and 3-aryl-2-cyanoacrylate compounds to furnish substituted pyridines 5 and 7. The interaction of 3 with salicylaldehyde and/or phenyl isothiocyanate followed by cyclization with chloroacetone produced the corresponding 2-imino-2H-chromene-3-carbohydrazide and (thiazol-2-ylidene-acetyl)-salicylic acid hydrazide compounds 8 and 9, respectively. The structural features of the synthesized compounds were confirmed by using spectroscopic methods such as (IR, 1H NMR, 13C NMR and MS). The new pyridine, chromene and thiazole products showed potent antioxidants and antimicrobial activities. The thiazole derivative 9 exhibited the highest anti-bacterial and antifungal activities against S. aureus (75.0%) and B. subtilis (73.9%) and C. albicans (66.6%). The combination between salicylic acid hydrazide and thiazole moieties in the hybrid 9 indicated the best antioxidant activity (87.9%). &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; KEY WORDS: Salicylic hydrazide, Arylidene-malononitrile, Pyridine, Thiazole, Antioxidant &nbsp; Bull. Chem. Soc. Ethiop. 2022, 36(1), 137-148.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; DOI: https://dx.doi.org/10.4314/bcse.v36i1.12&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp

Surgical treatment of displaced intra-articular calcaneal fracture using a single small lateral approach

The objective of this study was to evaluate the outcome of semi-open reduction and minimal internal fixation through a single small lateral approach as a minimally invasive technique for treatment of displaced intra-articular calcaneal fractures. This prospective study was conducted on eighteen patients (16 men and 2 women). The average age was 37.7 (22–55). The most common cause of injury was a fall from height in fourteen patients. Patients were operated on within a mean time of 4.8 days of admission (1–11 days) and were followed up for an average period of 24.1 months (6–39 months). Patients were evaluated clinically using the Creighton-Nebraska Heath Foundation Assessment score of Crosby and Fitzgibbons (J Bone Joint Surg (Am) 72-A:852–859, 1990). The scoring system proposed by Knirk and Jupiter was used for radiological assessment of the posterior subtalar joint (Knirk and Jupiter in J Bone Joint Surg (Am) 68-A: 647–659, 1986). The skin incision healed in all cases without necrosis, infection, or sural nerve injury. All fractures healed after an average of 8 weeks (7–10 weeks), and patients returned to the routine daily activities after an average time of 4.3 months (3–7 months). In conclusion, semi-open reduction and minimal internal fixation through a small lateral approach is an effective treatment for carefully selected cases of displaced intra-articular calcaneal fractures

Sagitol C, a new cytotoxic pyridoacridine alkaloid from the sponge Oceanapia sp.

AbstractA new pyridoacridine alkaloid named sagitol C (2) together with two known compounds; kuanoniamine C (1) and sagitol (3) were isolated from the EtOAc fraction of the Indonesian sponge Oceanapia sp. Their chemical structures were established on the basis of physical and spectroscopic methods 1D and 2D NMR, in addition to mass spectrometry and comparison with literature data. Sagitol C was found to exhibit cytotoxic activity when tested against different cancer cell lines

Improve Quality of Smart Universities through Information Technology Infrastructure Library Methodology

This paper focuses on educational institutions are increasingly seeking innovative ways to enhance the quality of their services. Smart universities, a product of this technological evolution, aim to provide students with cutting-edge educational experiences. One of the pivotal factors in achieving this goal is the effective management of Information Technology (IT) services. The Information Technology Infrastructure Library (ITIL) methodology is recognized worldwide as a robust framework for IT service management. Its principles and best practices have been successfully applied in various sectors to optimize processes, enhance service quality, and ensure efficient resource utilization. Given the ever-growing reliance on IT within educational institutions, implementing ITIL in smart universities has the potential to significantly elevate the quality of education. This paper explores the vital role that the ITIL methodology plays in improving the quality of smart universities. It delves into how the principles and practices of ITIL can be strategically integrated into the operational fabric of higher education institutions. By leveraging ITIL, universities can not only bolster their IT service management but also enrich the overall educational experience for students, ultimately contributing to the realization of truly smart and technologically advanced learning environments

Effect of Different Storage Temperatures on the Efficacy of the Bivalent Foot and Mouth Disease Oil Vaccine

The storage stability of locally produced double oil emulsion adjuvant bivalent Foot and mouth disease (FMD) vaccine prepared from type O1/Aga/ EGY/93 strain and A/EGY/1/2006 had been determined depending on its shelf life in different storage temperatures during the registration of this vaccine by the Central Laboratory for Evaluation of Veterinary Biologics, Abbasia, Cairo. Samples of this vaccine were kept at 4°C for period of 27 months; at 25°C for 5 weeks and at 37°C for 3 weeks. The potency of these vaccine samples was evaluated in guinea pigs as laboratory animal's model. The obtained results confirmed that the vaccine keep its potency beyond the normal conservation period at 4°C for two years with 100% protection against challenge with FMDV O1/Aga/EGY/93 and at 25°C for 3 weeks and at 37°C for 1 week, showing 80% protection when storage of the vaccine at 25°C for 4 weeks; at 37°C for 2 weeks. On challenge with A/EGY/1/2006 the vaccine gave 100% protection when storage at 4°C for 21 months; at 25°C for 2 weeks and at 37°C for 1 week. Otherwise it gave 80% protection when storage at 4°C for 24 months; at 25°C for 3 weeks and at 37°C for 2 weeks then became invalid after 27 months at 4°C; after 4 weeks at 25°C and for 3 weeks at 37°C. So it could be concluded that 4°C is the best temperature of choice for storage of the oil inactivated bivalent FMD vaccine

Seminavis aegyptiaca sp. nov., a new amphoroid diatom species from estuary epilithon of the River-Nile Damietta Branch, Egypt

[EN] During a recent floristic–taxonomic study on the algal flora, including diatoms, from the estuary of the Damietta Branch of the Nile in Egypt, an interesting epilithic diatom species belonging to the genus Seminavis (Naviculaceae) was collected and investigated using both light and scanning electron microscopy. This new diatom species shares morphologically some taxonomic diagnostic features with other related taxa such as S. insignis, S. robusta, and S. ventricosa. However, it still differs by having ventral central striae that are shorter and more or less straight in the middle of the smaller frustules to be clearly radiate in the larger ones and then become geniculate and only radiate near the poles, the central raphe endings are externally more distantly spaced than in the similar species, the elongate central nodule is internally less prominent, and the areola density is much denser. Therefore, we here describe it as Seminavis aegyptiaca sp. nov. Hydrochemical analyses revealed that S. aegyptiaca commonly inhabits typical marine, with a weak tendency towards brackish water, habitats. It was found to be tolerant to meso–eutrophic, nutrient–enriched conditions, based on the data available on seasonal concentrations of N and P compounds. These findings not only contribute to the inventory of Egyptian diatoms, but also increase our understanding of the autecology and distribution of this relatively poorly–known diatom genusSIThis work was a part of the PhyBiO project funded by the Italian Ministry of Foreign Affairs and International Cooperation (MAECI) to the MUSE Post–Doc Abdullah A. Saber for the academic year 2018/201

The Cleveland Clinic Experience with Supraclavicular and Popliteal Ambulatory Nerve Catheters

Continuous peripheral nerve blocks (CPNB) are commonly used for intraoperative and postoperative analgesia. Our study aimed at describing our experience with ambulatory peripheral nerve catheters. After Institutional Review Board approval, records for all patients discharged with supraclavicular or popliteal catheters between January 1, 2009 and December 31, 2011 were reviewed. A licensed practitioner provided verbal and written instructions to the patients prior to discharge. Daily follow-up phone calls were conducted. Patients either removed their catheters at home with real-time simultaneous telephone guidance by a member of the Acute Pain Service or had them removed by the surgeon during a regular office visit. The primary outcome of this analysis was the incidence of complications, categorized as pharmacologic, infectious, or other. The secondary outcome measure was the average daily pain score. Our study included a total of 1059 patients with ambulatory catheters (769 supraclavicular, 290 popliteal). The median infusion duration was 5 days for both groups. Forty-two possible complications were identified: 13 infectious, 23 pharmacologic, and 6 labeled as other. Two patients had retained catheters, 2 had catheter leakage, and 2 had shortness of breath. Our study showed that prolonged use of ambulatory catheters for a median period of 5 days did not lead to an increased incidence of complications