Intrastromal antifungal injection as a successful modality of treatment for fungal keratitis: a case series

Fungal keratitis is a dreaded occurrence in the cornea and anterior segment given the difficulty in treating the disease. Hereby reporting 5 cases of fungal keratitis causes by virulent organisms such as Aspergillus versicolor, Aspergillus fumigatus, Phialophora sp, and Fusarium sp. A retrospective interventional case series of 5 fungal keratitis which were successfully treated by intrastromal antifungal injection performed by a single surgeon from March 2017 till April 2018. The fungal keratitis stromal abscess sizes range from largest of 3mm x 2mm to smallest of 1mmx 1mm, mostly located paracentral and one case was noted to have hypopyon measuring about 1mm. On the first week of treatment, patients noted to exhibit poor response to topical antifungal. Hence, intrastromal amphotericin B injection 5mcg/0.1ml about 0.1ml administered into the affected eye ranging from once to 3 times in all patients except for one patient; who is post-operative 1 year penetrating keratoplasty infected with Phialophora keratitis is given intrastromal amphotericin B injection 5mcg/0.1ml about 0.1ml for 3 times and intrastromal voriconazole injection 50mcg/0.1ml about 0.1ml for 3 times. Within next four weeks, all the 5 cases of fungal keratitis became completely quiet with healed epithelial defect and corneal scarring. In summary, the intrastromal antifungal injection can constitute a good modality for the treatment of recalcitrant cases of fungal keratitis, revealing highly potent antifungal effects as the medication is administrated directly to the site of keratitis, promises shorter recovery period, and early intrastromal antifungal injection also leads to quicker healing with good vision prognosis

Examining the Product Quality Attributes that influences customer satisfaction most when the price was discounted: A case study in Kuching Sarawak

The study is about customer satisfaction towards the product quality. The effect of low pricing product with the product quality plays the same result of low price products produces low quality product and vice-versa. Data instrument that is used in obtaining data is by distributing survey questionnaire. The main purpose of this research is to classify whether the eight dimension of product quality after price discounting is satisfying towards customer. The respondent of the research was chosen through sampling method by using the non-probability sampling. The results infer that that the customer’s satisfaction towards the discounted product quality is based on the three attributes most namely perceived quality, performance and reliability. The Perceived quality- on image, brand name, and advertising is positively related to the level of satisfaction towards the quality of discounted product; were all supported as the relationships between the variables were statistically significant. This study does also provide useful guidelines for future researcher to be more rigorous and also in-depth to empirical and theoretical processes. In future study, customer satisfaction towards discounted product quality of the product to be specified to a product only determine by one gender (female) and also a perception towards a certain discounted price level of a product and its quality with extension of product design and customer requirements

Antisense PNA accumulates in Escherichia coli and mediates a long post-antibiotic effect

Antisense agents that target growth-essential genes display surprisingly potent bactericidal properties. In particular, peptide nucleic acid (PNA) and phosphorodiamidate morpholino oligomers linked to cationic carrier peptides are effective in time kill assays and as inhibitors of bacterial peritonitis in mice. It is unclear how these relatively large antimicrobials overcome stringent bacterial barriers and mediate killing. Here we determined the transit kinetics of peptide-PNAs and observed an accumulation of cell-associated PNA in Escherichia coli and slow efflux. An inhibitor of drug efflux pumps did not alter peptide-PNA potency, indicating a lack of active efflux from cells. Consistent with cell retention, the post-antibiotic effect (PAE) of the anti-acyl carrier protein (acpP) peptide-PNA was greater than 11 hours. Bacterial cell accumulation and a long PAE are properties of significant interest for antimicrobial development.Peer reviewe

Examining t.he product quality attributes that influences customer satisfaction most when the price was discounted: A case study

Abstract The study is about customer satisfaction towards the product quality.The effect of low pricing product with the product quality plays the same result of low price products produces low quality product and vice-versa. Data instrument that is used in obtaining data is by distributing survey questionnaire. The main purpose of this research is to classify whether the eight dimension of product quality after price discounting is satisfying towards customer. The respondent of the research was chosen through sampling method by using the non-probability sampling. The results infer that that the customer's satisfaction towards the discounted product quality is based on the three attributes most namely perceived quality, performance and reliability. The Perceived quality-on image, brand name, and advertising is positively related to the level of satisfaction towards the quality of discounted product; were all supported as the relationships between the variables were statistically significant. This study does also provide useful guidelines for future researcher to be more rigorous and also in-depth to empirical and theoretical processes. In future study, customer satisfaction towards discounted product quality of the product to be specified to a product only determine by one gender (female) and also a perception towards a certain discounted price level of a product and its quality with extension of product design and customer requirements

Huntington's disease: Neuropsychiatric manifestations of Huntington's disease

Objectives: Huntington’s disease (HD) is a profoundly incapacitating, and ultimately fatal, neurodegenerative disease. HD is presently incurable, so the current goal is to allow affected individuals to live as well as possible with the illness, to maximise functional independence and quality of life for the person with HD, their carers and family members. This clinical update review focuses on the common neuropsychiatric manifestations in HD, and outlines and evaluates the various neuropsychiatric facets of HD, including the aetiology, symptoms and diagnosis. Conclusions: Neuropsychiatric symptoms can precede the classic motor clinical symptoms of HD (prodromal HD) by decades, and cause significant functional impairment. HD provides key insights and understanding into the organic psychiatric disorders, including contemporary clinical insights into the process of neurodegeneration and manifestation of neuropsychiatric symptoms

Study and design of an ultrasonic flow tomographic front-end multi level measurement system

With the rapid evolution of electro-acoustical technology, ultrasonic tomography has made considerable progress in industry. An ultrasonic tomography system provides non-invasive and non-intrusive flow visualisation that enhances the understanding of fluid flow processes. The function of ultrasonic tomography is to continuously monitor the dynamics of liquid flow without interrupting the flow. The ultrasonic tomography technique is fully supported by a front-end hardware system. The front end is defined as all the hardware circuitries, including the ultrasonic transducer up to the Analogue-to-Digital Convertors (ADCs), even though the primary focus is the analogue signal processing components. We present here the challenges and trade-offs in the implementation of a front-end system by first explaining the basic operation of such a system, and then indicating what particular performance parameters are needed to ensure optimal system operation. Based on the results from our research studies, we propose an improved front-end multi-level solution that is more accurate than previous solutions and provides real-time measurement capability

Visually identified Tau 18F-MK6240 PET patterns in symptomatic Alzheimer\u27s disease

Background: In Alzheimer\u27s disease, heterogeneity has been observed in the postmortem distribution of tau neurofibrillary tangles. Visualizing the topography of tau in vivo may facilitate clinical trials and clinical practice. Objective: This study aimed to investigate whether tau distribution patterns that are limited to mesial temporal lobe (MTL)/limbic regions, and those that spare MTL regions, can be visually identified using 18F-MK6240, and whether these patterns are associated with different demographic and cognitive profiles. Methods : Tau 18F-MK6240 PET images of 151 amyloid-β positive participants with mild cognitive impairment (MCI) and dementia were visually rated as: tau negative, limbic predominant (LP), MTL-sparing, and Typical by two readers. Groups were evaluated for differences in age, APOE ɛ4 carriage, hippocampal volumes, and cognition (MMSE, composite memory and non-memory scores). Voxel-wise contrasts were also performed. Results: Visual rating resulted in 59.6 % classified as Typical, 17.9 % as MTL-sparing, 9.9 % LP, and 12.6% as tau negative. Intra-rater and inter-rater reliability was strong (Cohen\u27s kappa values of 0.89 and 0.86 respectively). Tracer retention in a hook -like distribution on sagittal sequences was observed in the LP and Typical groups. The visually classified MTL-sparing group had lower APOE ɛ4 carriage and relatively preserved hippocampal volumes. Higher MTL tau was associated with greater amnestic cognitive impairment. High crtical tau was associated with greater impairments on non-memory domains of cognition, and individuals with high cortical tau were more likely to have dementia than MCI. Conclusion: Tau distribution patterns can be visually identified using 18F-MK6240 PET and are associated with differences in APOE ɛ4 carriage, hippocampal volumes, and cognition

Simulation studies of waves transmission in a steel-vessel ultrasonic tomography system

This paper addresses a specific form of inspection, that of ultrasonic wave propagation in the ultrasonic tomographic imaging system. From the sensing configuration standpoint, ultrasound wave simulation is an important imaging process. From the simulation results, ultrasonic sensors with suitable centre frequency can be mounted spherically on a sealed vessel, facilitating the local pitch-catch measurements of the fan-beam sensor configuration to reconstruct the ultrasound image as a fluid flow diagnostic tool. Two basic quantities are measured in ultrasonic flow systems: time-of-flight or the amount of time for the sound to travel through the sample, and the amplitude of the received signal. We used the acoustics pressure model in COMSOL version 4.2a to predict the propagation of acoustic waves through three-phase structures and bubbly flow. Our overall goal is to enable structurally specific inspection tasks to be optimized, taking into account both the physical aspects of the ultrasound propagation and the dynamic capabilities and restrictions of the vessel platform

Promoting Independence Through quality dementia Care at Home (PITCH): a research protocol for a stepped-wedge cluster-randomised controlled trial

BACKGROUND: Home care service providers are increasingly supporting clients living with dementia. Targeted and comprehensive dementia-specific training for home care staff is necessary to meet this need. This study evaluates a training programme delivered to care staff (paid personal carers) of clients living with dementia at home. METHODS: This study is a pragmatic stepped-wedge cluster-randomised controlled trial (SW-CRT). Home care workers (HCWs) from seven home care service providers are grouped into 18 geographical clusters. Clusters are randomly assigned to intervention or control groups. The intervention group receives 7 h of a dementia education and upskilling programme (Promoting Independence Through quality dementia Care at Home [PITCH]) after baseline measures. The control group receives PITCH training 6 months after baseline measures. This approach will ensure that all participants are offered the program. Home care clients living with dementia are also invited to participate, as well as their family carers. The primary outcome measure is HCWs’ sense of competence in dementia care provision. DISCUSSION: Upskilling home care staff is needed to support the increasing numbers of people living with dementia who choose to remain at home. This study uses a stepped-wedge cluster-randomised trial to evaluate a training programme (PITCH) for dementia care that is delivered to front-line HCWs. TRIAL REGISTRATION: anzctr.org.au; ACTRN12619000251123. Registered on 20 February 2019