Successful removal of a telephone cable, a foreign body through the urethra into the bladder: a case report

The variety of foreign bodies inserted into or externally attached to the genitourinary tract defies imagination and includes all types of objects. The frequency of such cases renders these an important addition to the diseases of the genitourinary organs. The most common motive associated with the insertion of foreign bodies into the genitourinary tract is sexual or erotic in nature. In adults this is commonly caused by the insertion of objects used for masturbation and is frequently associated with mental health disorders. We report a case of insertion of telephone cable wire into the urethra. Our case highlights the importance of good history, clinical examination, relevant radiological investigation and simple measures to solve the problem

The Mediating Impact of Self-Confidence on Relationship of Perceived Formal Support and Entrepreneurial Intention in the Education Sector of Pakistan: Dr. Kashif Rathore, Saba Shaukat, Kashif Ali, Arshad Haroon

The purpose of this study is to find out the mediating influence of selfconfidence level (SC) on the relationship of perceived formal support (PFS) and students‟ entrepreneurial intention (EI). There are few studies that investigated the influence of mediator (self confidence level). As a result, this study contributes to the area of entrepreneurship. The study used a crosssectional research design. The population of this study consists of final year undergraduates of University of the Punjab, Lahore. Sample consists of 250 students from three departments. Zero-order correlation, multiple regression analysis and t-test are used for data analysis. The multiple regression analysis shows that self-confidence level (SC) significantly mediates the relationship of perceived formal support (PFS) and entrepreneurial intentions (EI) of students. Furthermore, t-test shows that male and female students significantly different in terms of perceived formal support (PFS) but there is no difference between male and female students in terms of their entrepreneurial intentions (EI).&nbsp

Role of Papaya Dressings in the Management of Diabetic Foot Ulcers

Background: To assess the role of papaya dressings in the management of diabetic foot in terms of healing of ulcers.Methods: In this experimental study patients with diabetic foot (n=43) were included. Initial management included empirical antibiotics, surgical debridement or amputation, control of glycemia and then wound care with the help of papaya dressings. . Dressings were changed after every 48 hours. The wounds were declared healthy when they were filled with healthy granulation tissue and had epithelial growth on their edgesResults: Majority (72.1%) were males. Twenty four (55.8%) were operated for debridement and 19 patients (44.2%) for amputations. After the initial surgical treatment and dressings 88.4% needed no further surgery. Three patients (7%) were operated for further debridement and 2 (4.7%) patients were operated for amputations. Healing time ranged from 18 to 29 days. Mean healing duration was 19.23 days with Standard Deviation (SD) of ± 3.624. Conclusion: Topical papaya dressing provides cost effective and favourable outcome in patients with diabetic foot ulcer by decreasing the healing duration, reducing surgical interventions

Developing and Integrating Asynchronous Web-Based Cases for Discussing and Learning Clinical Reasoning: Repeated Cross-sectional Study

BackgroundTrainees rely on clinical experience to learn clinical reasoning in pediatric emergency medicine (PEM). Outside of clinical experience, graduate medical education provides a handful of explicit activities focused on developing skills in clinical reasoning. ObjectiveIn this paper, we describe the development, use, and changing perceptions of a web-based asynchronous tool to facilitate clinical reasoning discussion for PEM providers. MethodsWe created a case-based web-based discussion tool for PEM clinicians and fellows to post and discuss cases. We examined website analytics for site use and collected user survey data over a 3-year period to assess the use and acceptability of the tool. ResultsThe learning tool had more than 30,000 site visits and 172 case comments for the 55 published cases over 3 years. Self-reported engagement with the learning tool varied inversely with clinical experience in PEM. The tool was relevant to clinical practice and useful for learning PEM for most respondents. The most experienced clinicians were more likely than fellows to report posting commentary, although absolute rate of commentary was low. ConclusionsAn asynchronous method of case presentation and web-based commentary may present an acceptable way to supplement clinical experience and traditional education methods for sharing clinical reasoning

Energy efficiency mechanism using mobile-based fermat's spiral in wireless sensor networks

There are 2 well-known ways to optimize energy efficiency in wireless sensor networks (WSN). The first one is to deploy multiple sinks in wireless sensor networks to balance the energy consumption among the wireless sensor nodes. The second technique is to move the sink navigating through wireless sensor network to redirect traffic flow while gathering sensed data timely and efficiently. Both ways will try to reduce the famous bottleneck problem that cause wireless sensor nodes energy nearest to base station depleted very quickly. We evaluated the performance of wireless sensor network using minimum spanning tree algorithm specifically Prim’s Algorithm in order to know the bottleneck effect on wireless sensor network and propose a better solution performance based on Fermat Spiral model. We show that such a solution reduces the bottleneck problem, increases the energy efficiency of the network and produces greater data transmission throughput

Practice patterns and perceptions of influenza testing amongst pediatric urgent care providers

INTRODUCTION: Despite a sensitivity of 50% to 70% the rapid influenza diagnostic test (RIDT) continues to play an important role in clinical decision-making due to its quick turn-around time, high specificity, relative simplicity of use, and low cost. METHODS: A quantitative study using a web-based survey was distributed to 110 members of the Society of Pediatric Urgent Care aimed to assess RIDT use for diagnosis and management of influenza in outpatient pediatric patients. RESULTS: Responses from 61 providers were received. Forty-two percent (95% CI 29.5-54.5%) of respondents report higher confidence in their diagnosis of influenza with the aid of a positive RIDT. 28% of respondents (95% CI 16.6-39.4%) report a higher likelihood of prescribing antiviral medications to low-risk patients if an RIDT is positive than without laboratory confirmation. CONCLUSION: Most pediatric urgent care respondents reported higher confidence in their diagnosis and higher likelihood of prescribing antivirals with a positive RIDT rather than by clinical symptoms alone

Bond Stress Behavior of a Steel Reinforcing Bar Embedded in Geopolymer Concrete Incorporating Natural and Recycled Aggregates

The rise in greenhouse gases, particularly carbon dioxide (CO2) emissions, in the atmosphere is one of the major causes of global warming and climate change. The production of ordinary Portland cement (OPC) emits harmful CO2 gases, which contribute to sporadic heatwaves, rapid melting of glaciers, flash flooding, and food shortages. To address global warming and climate change challenges, this research study explores the use of a cement-less recycled aggregate concrete, a sustainable approach for future constructions. This study uses fly ash, an industrial waste of coal power plants, as a 100% substitute for OPC. Moreover, this research study also uses recycled coarse aggregates (RCAs) as a partial to complete replacement for natural coarse aggregates (NCAs) to preserve natural resources for future generations. In this research investigation, a total of 60 pull-out specimens were prepared to investigate the influence of steel bar diameter (9.5 mm, 12.7 mm, and 19.1 mm), bar embedment length, db (4db and 6db), and percentage replacements of NCA with RCA (25%, 50%, 75%, and 100%) on the bond stress behavior of cement-less RA concrete. The test results exhibited that the bond stress of cement-less RCA concrete decreased by 6% with increasing steel bar diameter. Moreover, the bond stress decreased by 5.5% with increasing bar embedment length. Furthermore, the bond stress decreased by 7.6%, 7%, 8.8%, and 20.4%, respectively, with increasing percentage replacements (25%, 50%, 75%, and 100%) of NCA with RCA. An empirical model was developed correlating the bond strength to the mean compressive strength of cement-less RCA concrete, which matched well with the experimental test results and predictions of the CEB-FIP model for OPC. The CRAC mixes exhibited higher costs but significantly lower embodied CO2 emissions than OPC concrete