Comparative analysis of case screening with varying cough duration and sputum samples for diagnosis of tuberculosis in patients attending the OPD at a tertiary care hospital at Srinagar, India

Research Question: Can we minimize cough duration and number of sputum samples in chest symptomatic patients for screening of TB?Objective: To evaluate cough of 3 weeks versus 2 weeks duration using two sputum samples versus three samples in chest symptomatic patients attending the OPD.Study Design: Hospital-based cross-sectional study.Materials and Methods: Outpatients (2810) with H/O cough of 3 weeks and 2 weeks duration were screened by subjecting them to sputum microscopy for tuberculosis using two sputum samples as well as three samples following standard procedure for sputum collection, staining and acid-fast bacillus (AFB) identification. Those on drugs were not included.Results: Using .2 weeks cough, sputum positivity rate was 12%, nearly as high as the sputum positivity among patients with .3 weeks cough, i.e. 14%. First sputum smear alone on an average could detect 91.8% cases, while the first two sputum smears could detect on an average 96% cases. The study showed that maximum number of cases was diagnosed by only two sputum smears and added diagnostic value of third specimen was small, i.e. 4%.High sputum positivity rate using .2 weeks cough with two sputum samples was seen.Conclusion: The sensitivity analysis of the study showed that using .2 weeks cough with two sputum samples gives almost similar values as .3 weeks cough with three sputum samples, but this needs further confirmatory results of culture sensitivity. Hence, using .2 weeks cough with two sputum samples as the diagnostic criteria for screening of cough patients for TB should be recommended as one way of improving efficient use of scarce resources

The antiproliferative effect of mulberry (Morus alba L.) plant on hepatocarcinoma cell line HepG2

This study aimed to investigate the antiproliferative effect of aqueous and organic extracts of mulberry leaves (Morus Alba L.) on human hepatocellular carcinoma HepG2 cell line. Mulberry leaf extracts were prepared using the solvents: water, 50% aqueous MeOH, and 100% MeOH for different time intervals, while the cells treated with dimethyl sulfoxide (DMSO) served as control. The effects of aqueous and organic extracts of M. alba L. leaves on HepG2 cell viability, nuclear factor kappa B (NF-κB) gene expression, alfa-fetoprotein (AFP), albumin (ALB), gammaglutamyl transpeptidase (γ-GT) and alkaline phosphatase (ALP) were measured. The results of the cell viability assays showed that water, 50% aqueous MeOH, and 100% MeOH extracts exhibited a highly significant inhibitory effect on HepG2 cell proliferation which was evidenced by a reduction in viable cell count. The results were confirmed by microscopical examination of cell morphology. Furthermore, the mulberry leaf extracts suppressed the activity of NF-κB gene expression of HepG2 cells compared to the control. Also a highly significant depression occurred at the levels of AFP, γ-GT and ALP in HepG2 cells compared with that of controls in a time dependent manner. By contrast, the mulberry leaf extracts increased the secretion of ALB. Therefore, the conclusion was that the organic and aqueous extracts of mulberry leaves inhibit the growth of HepG2 cells through suppressing the activity of NF-κB gene expression and modulate the biochemical markers.Keywords: HepG2 cell line; Morus alba L.; NF-κB; Antiproliferative effect; Alfa-fetoprotei

A State-Dependent Damping Method to Reduce Collision Force and Its Variability

This paper investigates the effect of biologically inspired angle-dependent damping profile in a robotic joint primarily on the magnitude and the variability of the peak collision force. Joints such as the knee that experience collision forces are known to have an angle-dependent damping profile. In this paper, we have quantified and compared three damping profiles. Our numerical and experimental results show that the proposed hyperbolic angle-dependent damping profile can minimize both the magnitude and the variability of the peak collision force(average magnitude and variability reduction of 26% and 47% compared to the peak constant damping profile). Very often, the variability of the force across the collision between the robot and the environment cause uncertainty about the state variables of the robotic joint. We show that by increasing the slope of the proposed hyperbolic angle-dependent damping profile, we can also reduce the variability and the magnitude of post-collision peak displacement and peak velocity compared to those of constant damping profile. This was achieved while reducing the mean root square of power consumed by the robotic joint

Impact of truncation error and numerical scheme on the simulation of the early time growth of viscous fingering

The truncation error associated with different numerical schemes (first order finite volume, second order finite difference, control volume finite element) and meshes (fixed Cartesian, fixed structured triangular, fixed unstructured triangular and dynamically adapting unstructured triangular) is quantified in terms of apparent longitudinal and transverse diffusivity in tracer displacements and in terms of the early time growth rate of immiscible viscous fingers. The change in apparent numerical longitudinal diffusivity with element size agrees well with the predictions of Taylor series analysis of truncation error but the apparent, numerical transverse diffusivity is much lower than the longitudinal diffusivity in all cases. Truncation error reduces the growth rate of immiscible viscous fingers for wavenumbers greater than 1 in all cases but does not affect the growth rate of higher wavenumber fingers as much as would be seen if capillary pressure were present. The dynamically adapting mesh in the control volume finite element model gave similar levels of truncation error to much more computationally intensive fine resolution fixed meshes, confirming that these approaches have the potential to significantly reduce the computational effort required to model viscous fingering

Knowledge and Attitudes of Population Towards HIV/Aids in Four States, Sudan

Back ground: HIV/AIDS is a public health problem in the Sudan. The country is the most severely affected in North Africa and the Middle East with an estimated 500,000 people living with HIV/AIDS. The objectives of the study were to determine knowledge and attitude of the localpopulation in selected states about HIV/ AIDS and to determine the relation between knowledge and attitude towards HIV/AIDS and associated social factors.Methodology: Design was descriptive, cross-sectional, community- based study conducted in Gezira, Sinnar, River Nile and Northern states. The population was those found in their settings during the visits in April 2009. Both sexes were enrolled and children below the age of 15 years ofboth sexes were excluded from the study. Data were collected by a pre- coded and pre -tested questionnaire and were analyzed by the computer using SPSS, version 13, soft ware.Results: Knowledge of the population in the selected four states about HIV/AIDS was favorable (73%). Tolerant attitude towards HIV-infected people was low (40%). Results showed that males acquired better knowledge than females (76.2% versus 71.8%) but females were more tolerant towards HIV/AIDS than males (42% versus 37.4%). Results showed that HIV/AIDS Knowledge increased as the educational level increased. Level of knowledge was higher among university graduates (92.6%) followed by basic and secondary (76.7%). Illiterates acquired the least level of knowledge (42.4%). The study showed that tolerance of population towards PLWHA increased according to the level of education. The university graduated was more tolerant (55.1%) than thebasic/secondary (40.5%) and the illiterates (21.9%). It was shown that the single population was more tolerant towards PLWHA, followed by the married, the divorced and the widowed constituting 41.6%, 40.4%, 31.4% and 25% respectively.Conclusion: The study concluded that, level of knowledge about HIV/AIDS of the population in the selected states was good. Level of knowledge among males, the working force and the single population was higher than the females, those without jobs and the married. Level of HIV/AIDSknowledge increased according to the level of education, was higher among university graduates followed by basic / secondary and Illiterates. Attitude of the population in the selected states towards people living with HIV/AIDS “PLWHA” was low, only 40% had more tolerant attitude.Females, the highly educated and the working population were more tolerant towards HIV/AIDS than males, the less educated, and the nonworking population

Pattern and severity of childhood unintentional injuries in Ismailia city, Egypt

In 2009, more than 746 000 injury cases were registered in the Ministry of Health hospitals in Egypt, with an injury rate of 1 004/100 000 population. Around 38% of all injuries occur among children and young adults less than 20 years of age. Furthermore, more than 20 000 people lose their lives to injuries every year (27/100 000). However, these data lack information on injury pattern, severity, provided care and outcome of injuries, which are essential data for planning injury control programmes.The aim of this study was to determine the frequency, nature and risk factors of childhood injuries in the Suez Canal University Hospital Emergency Department.The study included a total of 551 children of 12 years of age. The most common causes of injuries among those children were falls (60%), road traffic injuries (15%) and burns (7%). The most commonly sustained injuries were fractures (23%), cuts or open wounds (21%), sprains (20%) and burns (13%). Overall injury severity scores (ISSs) were low across all injury types, except road traffic injuries (RTIs). The majority of patients were treated and discharged without disability (50.5%), while 7.4% had long-term temporary disability that lasted for more than 6 weeks, and 1.9% sustained permanent disability. There were two deaths (0.4% proportionate mortality); both of them were due to falls from a height.In conclusion, the study confirms the feasibility of documenting the burden of childhood injuries on health systems in Egypt. It also confirmed the need for tailored injury-prevention research in Egypt. The resulting data should encourage interventional trials to be conducted, appropriate injury-prevention strategies to be implemented and timely interventions to be planned.Keywords: Childhood unintentional injuries, Egypt, risk factors

A Moral Code of Conduct in Sciences: It's Essence, Argument and Method of Preparation

Despite great progresses in Iran, there are very few works on the making and formulation of moral codes of conduct. As a result, moral conflicts in social and scientific activities have turned into a serious pathology in society. Since many specialists have been concerned about providing moral codes based on Islamic-Iranian culture in recent years, it is necessary to compile the regulations and method of formulation of these codes of conduct. The present paper was written with the aim of compiling a method of formulation for these codes of conduct. Findings show that the formation of codes of conduct has six stages which are as follows: 1. Finding  cases which need moral decisions; 2. Specifying those in charge who need moral codes; 3. Recognizing moral challenges in that science; 4. Determining moral principles; 5. Specifying a fundamental approach in Ethics; and (6) Formulating a moral code of conduct in that science. Of course, it should be noted that some considerations have been proposed regarding the pre-preparation of the code of conduct and also for its utilization.[1] [1]. The paper has been extracted from a project entitled "methodology of formulating moral code of conduct in sciences" codified as 941060 " for the Foundation for Supporting Researchers and Technologists of the country", Presidency of the Islamic Republic of Iran, Vice Presidency for Science and Technology

Effect of single dose magnesium on arrhythmias in patients undergoing coronary artery bypass surgery

OBJECTIVE: To evaluate the safety and role of prophylactic administration of magnesium in preventing arrhythmias. METHOD: This double blind randomized placebo controlled clinical trial was conducted at Aga Khan University Hospital on coronary artery bypass surgery patients. All patients were connected to holter monitor before induction of anaesthesia and this monitoring continued for 24 hours. Study drug containing either 2-grams of magnesium or normal saline was given after intubation. Levels of serum magnesium was checked preoperatively and then in ICU at 0, 6, 12, and 24 hours. Independent t-test and chi square test were used for analysis. Statistical significance was defined as p-value \u3c 0.05. RESULTS: A total of 104 patients consented to participate in the study, 53 patients were randomly allocated in magnesium (Mg) group and 51 in placebo group. Two (3.77%) patients in magnesium group and five patients (9.8%) in placebo group developed atrial fibrillation. Incidence of ventricular and supraventricular tachycardia was also slightly higher in placebo. Mg level after arrival in CICU (Cardiac Intensive Care Unit) showed mean of 2.1 in magnesium group and 1.6 in placebo group (p = 0.6). CONCLUSION: Low magnesium levels were noticed in the placebo group after cardiopulmonary bypass and although prophylactic administration of magnesium sulphate was relatively safe but significant benefit on prevention of arrhythmias could not be attained

Copy-number variation in BMPR2 is not associated with the pathogenesis of pulmonary arterial hypertension

<p>Abstract</p> <p>Background</p> <p>Copy-number variations (CNVs) are structural variations in the genome involving 1 kb to 3 mb of DNA. CNV has been reported within intron 1 of the <it>BMPR2 </it>gene. We propose that CNV could affect phenotype in familial and/or sporadic pulmonary arterial hypertension (PAH) by altering gene expression.</p> <p>Methods</p> <p>97 human DNA samples were obtained which included 24 patients with familial PAH, 18 obligate carriers (<it>BMPR2 </it>mutation positive), 20 sporadic PAH patients, and 35 controls. Two sets of primers were designed within the CNV, and two sets of control primers were designed outside the CNV. Quantitative PCR was performed to quantify genomic copies of CNV and control sequences.</p> <p>Results</p> <p>A CNV in <it>BMPR2 </it>was present in one African American negative control subject.</p> <p>Conclusion</p> <p>We conclude that the CNV in intron 1 in <it>BMPR2 </it>is unlikely to play a role in the pathogenesis of either familial or sporadic PAH.</p> <p>Trial Registration</p> <p>NIH NCT00091546.</p

Reliability analysis of moment redistribution in reinforced concrete beams

Design codes allow a limited amount of moment redistribution in continuous reinforced concrete beams and often make use of lower bound values in the procedure for estimating the moment redistribution factors. Here, based on the concept of demand and capacity rotation, and by means of Monte Carlo simulation, a probabilistic model is derived for the evaluation of moment redistribution factors. Results show that in all considered cases, the evaluated mean and nominal values of moment redistribution factor are greater than the values provided by the ACI code. On the other hand, the 5th percentile value of moment redistribution factor could be lower than those specified by the code. Although the reduction of strength limit state reliability index attributable to uncertainty in moment redistribution factors is not large, it is comparable to the reduction in reliability index resulting from increasing the ratio of live to dead load