Isolation and Molecular Detection of Pathogenic Vibrio Species among Economic Fish from Red Sea in Egypt

Peer reviewedPublisher PD

Brain Drain: Post Graduation Migration Intentions and the influencing factors among Medical Graduates from Lahore, Pakistan

<p>Abstract</p> <p>Background</p> <p>The increasing migration of health professionals to affluent countries is not a recent phenomenon and has been addressed in literature. However the various facets of physician migration from Pakistan, the third leading source of International medical graduates has not been rigorously evaluated. The objective of the current study was to survey final year students and recent medical graduates in Lahore, Pakistan about their intentions to train abroad, their post training plans as well as to identify the factors responsible for their motivation for international migration.</p> <p>Method</p> <p>A self administered structured questionnaire was developed to collect respondents' demographic and educational characteristics, intention to train abroad, their preferred destination & post training intentions of returning to Pakistan. Various influencing factors which impact on medical graduate's motivation to train abroad or stay in Pakistan were explored using a 10 point scale. SPSS software was used for data entry and analysis.</p> <p>Results</p> <p>Of the 400 eligible respondents, 275 responded (response rate 68.7%). One hundred and sixty six respondents (60.4%) intended to train abroad either for a specialty (54.9%) or a subspecialty (5.5%) The United States and United Kingdom were the most preferred destination. While 14.2% intended to return to Pakistan immediately after training, a significant percentage (10%) never intended to return to Pakistan or wished to stay abroad temporarily (37%). Professional excellence and establishing quickly in the competitive market were the most important goal to be achieved by the respondents for intention for postgraduate training abroad. The most common reasons cited for training abroad were the impact of residency training on future career (mean score 8.20 ± 2.3), financial conditions of doctors (mean score 7.97 ± 2.37) and job opportunities (mean score7.90 ± 2.34).</p> <p>Conclusion</p> <p>An alarming percentage of medical graduates from Lahore, Pakistan intend to migrate for post graduate training, mainly to United States. A significant proportion wished to stay in the host country either temporarily or indefinitely. Impact of residency abroad on future career, financial conditions of doctors, job opportunities and better working conditions were some of the motivating factors behind the migration.</p

Comparative Analysis of Eight Numerical Methods Using Weibull Distribution to Estimate Wind Power Density for Coastal Areas in Pakistan

Currently, Pakistan is facing severe energy crises and global warming effects. Hence, there is an urgent need to utilize renewable energy generation. In this context, Pakistan possesses massive wind energy potential across the coastal areas. This paper investigates and numerically analyzes coastal areas' wind power density potential. Eight different state-of-the-art numerical methods, namely an (a) empirical method, (b) graphical method, (c) wasp algorithm, (d) energy pattern method, (e) moment method, (f) maximum likelihood method, (g) energy trend method, and (h) least-squares regression method, were analyzed to calculate Weibull parameters. We computed Weibull shape parameters (WSP) and Weibull scale parameters (WCP) for four regions: Jiwani, Gwadar, Pasni, and Ormara in Pakistan. These Weibull parameters from the above-mentioned numerical methods were analyzed and compared to find an optimal numerical method for the coastal areas of Pakistan. Further, the following statistical indicators were used to compare the efficiency of the above numerical methods: (i) analysis of variance (R-2), (ii) chi-square (X-2), and (iii) root mean square error (RMSE). The performance validation showed that the energy trend and graphical method provided weak performance for the observed period for four coastal regions of Pakistan. Further, we observed that Ormara is the best and Jiwani is the worst area for wind power generation using comparative analyses for actual and estimated data of wind power density from four regions of Pakistan

Cystic artery pseudo-aneurysm: a complication of xanthogranulomatous cholecystitis

A 54-year-old man presented for radiology with pain and a feeling of fullness in the upper abdomen and an epigastric mass. Ultrasound revealed a large cystic mass with internal echoes, lying posterior and inferior to left lobe of the liver. The gallbladder was thick-walled and contracted, and contained a calculus and echogenic sludge. A cystic structure that produced swirling flow signals on colour Doppler was demonstrated within the gallbladder. The CT scan showed a thickened gallbladder with adjacent inflammation and a 2-cm pseudo-aneurysm in its wall. High-density material was present in the gallbladder lumen, in the extra-hepatic bile ducts and around the gastrohepatic ligament. A thick haemorrhagic pus, from which Escherichia coli was cultured, was drained from the gastrohepatic collection. An elective coeliac angiogram demonstrated a solitary pseudo-aneurysm of the medial branch of the cystic artery. Selective catheterisation of this artery with a micro-catheter enabled complete exclusion of the pseudo-aneurysm by a single micro-coil. Histological examination of the gallbladder, which was ultimately removed at open cholecystectomy, demonstrated xanthogranulomatous cholecystitis

Neutrophil CD64 in early-onset neonatal sepsis

Background: Neonatal sepsis is a life threatening disease with an incidence of 3.5 to 8 cases per 1,000 live births; and mortality rate 16 to 30%. Cytokines, produced by monocytes, macrophages, and endothelial cells in response to infectious stimuli are important proinflammatory mediators in the early phases of the sepsis syndrome. Elevated serum levels of interleukin-6 (IL-6) had been found in both neonatal and adult sepsis. However, for neonatal sepsis, little is known about a group of molecules playing a central role in the innate immune system. Among them is the neutrophil CD64 which is expressed on neutrophil surface in many inflammatory conditions. Objective: To study the neutrophil CD64 expression in neonates with early onset sepsis and its relation to other laboratory markers as IL6, CRP, total leucocytic count and platelet count. Methods: This study comprised 30 neonates with a gestational age of 28 to 40 weeks with a picture of early onset neonatal sepsis within 48 hours of life admitted to neonatal care unit, Suzan Mubarak Hospital, El-Minia University, Egypt during the period from February, 2008 to January, 2009 and 20 healthy neonates age and sex matched as a control group. Neutrophil surface expression of CD64 was quantified with flow cytometry. We measured plasma IL6, C-reactive protein, complete blood count and blood culture. Results: Neutrophil CD64 expression was increased significantly in neonates with neonatal sepsis than controls (p=0.001). Cases with history of premature rupture of membranes (PROM) ≥48 hours, with positive blood culture or poor outcome had the highest levels of neutrophil CD64 expression (528±50.7, 558±58.4 and 560.9±43.9 relative fluorescence units (RFU) respectively). A significant positive correlation was found between CD64 levels and the levels of IL6 (r=0.71, p=0.001),C-reactive protein (r=0.74, p=0.001) and total leucocytic count (r=0.76 ,p=0.01) and negative correlation with gestational age (r=-0.92, p=0.001) and body weight (r=-0.92, p=0.006), but there was no correlation between it and platelet count (r=-0.32, p=0.08). Conclusion: Neutrophil CD64 expression is increased in neonates with early-onset neonatal sepsis and correlated well with other laboratory markers of sepsis.Keywords: Neonatal sepsis, Cytokines, Neutrophil CD64, IL6, PROMEgypt J Pediatr Allergy Immunol 2010;8(1):19-2

Space‐time analysis of TIMED Doppler Interferometer (TIDI) measurements

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/95273/1/grl12774.pd

Patients’ satisfaction with sedoanalgesia versus subarachnoid analgesia in endourology

AbstractObjectiveIn this study the effectiveness and safety of sedoanalgesia technique compared to spinal anesthesia in endourology procedure as well as patients’ satisfaction was assessed.Patients and methodsA prospective randomized study was performed in 80 adult patients, ASA I, II, and III who underwent various endoscopic procedures randomly allocated into two groups 40 patients each: Sedoanalgesia group, received local anesthesia (2% lignocaine gel), i.v. midazolam incremental doses 0.015mg/kg on demand, and i.v. fentanyl 2μg/kg, and 0.5μg/kg on demand interaoperative, and Spinal anesthesia group received 2.5ml heavy bupivacaine 0.5% to achieve around T10 level. We recorded vital parameters, and the number of cases with hemodynamic, respiratory complications, nausea and vomiting, and conversion to general anesthesia (failure). Postoperatively the intensity of pain (VAS 0-100mm), time to first analgesic request (VAS ⩾30), patient satisfaction (complete, partial or not satisfied) and time to readiness for discharge were assessed.ResultsThere was no significant difference in intra, postoperative hemodynamic changes and complications between groups but hypotension was more frequent in Spinal group. Immediate postoperative, there was no significant difference in pain score between groups, but 1 and 2h postoperatively there were higher pain scores in Sedoanalgesia group. Time to first analgesic request and readiness for discharge were significantly less in Sedoanalgesia group, but the difference was not significant as regard satisfaction scores.ConclusionSedoanalgesia is an effective, safe and simple alternative to Spinal anesthesia for endourology, with good patients’ satisfaction and less time to discharge

Stevens Johnson syndrome in Pakistan: a ten-year survey

Objective: A pre-tested questionnaire-based, retrospective study to highlight the causative factors, mode of presentation, complications and outcome of patients with Stevens Johnson syndrome.SETTING: Aga Khan University Hospital over a 10 year period.Methods: All case records with a diagnosis of Steven Johnson Syndrome in the period 1990 to 2000 were retrospectively reviewed. Data was retrieved on a comprehensive questionnaire. The demographic variatbles and drugs taken within the previous 21 days were noted. Date analysis was done by Epi-Info Version 6.0.Results: Of the 101 studied patient files, the most common offender was found to be the Penicillins as a group and Sulfadoxine-Pyrimethamine (Fansidar) when considering all drugs individually. Most common complications included electrolyte disturbances (13.9%) and congestive heart failure (6.9%). Mortality rate was high at 10.1%.CONCLUSION: SJS was found to be a rare condition but having a mortality rate of 10.1%. As it can be induced by a large number of drugs, caution should be practiced while prescribing