Comparison of causes and manifestations of pain in Parkinson’s disease patients to healthy controls

Objective To assess the manifestations of pain in PD (Parkinson’s disease ) patients versus healthy controls.Methods Data on pain was collected from 127 patients and an equivalent number of controls using two self-report questionnaires: the Brief Pain Inventory (BPI) and a custom-made questionnaire focusing on specific details not covered by the former. Additional analysis was conducted within the patient group only to analyze the potential effects of factors relating to PD on the various measure of interest relating to pain.Results Parkinson disease patients had lower odds of experiencing pain in both arms (ExpB=0.061, p<0.001), greater probability of demonstrating pain in both legs (ExpB=2.409, p=0.024), and an increase difficulty in localizing pain (ExpB=2.958, p=0.030). There was no relationship between duration of pain (F=12.414, p=0.001) or arthritis (ExpB=0.724, p=0.309) and pain in PD. The likelihood of experiencing nagging pain (ExpB=3.533, p=0.028), but not other forms, was much more strongly associated with PD patients than normal controls. When all other types of pain were controlled for, pain in PD is more likely associated with akathesic pain (ExpB=9.046, p<0.001).Conclusion There are major differences between pain in PD patients and pain in normal controls, which could have implications on the pathophysiology and adequate management of pain in different populations.Key words: Healthy controls, movement disorders, pain, Parkinson’s diseas

Bacterial isolates from neutropenic febrile pediatric patients and their sensitivity patterns to antibiotics

Patients on cytotoxic therapy often develop neutropenia and fever. Our interest was to identify the common pathogens isolated from such patients and to study the sensitivity patterns of these organisms to the antibiotics used in their treatment. Thus, guidelines can be established by hospitals to identify which antibiotics can be used in the treatment of these patients when the results of cultures and sensitivities are not available. We conducted a retrospective study of neutropenic pediatrics presenting to AKUH from July, 1990 to June, 1996. A total of 153 isolates in 35 different patients were studied. Samples for culture were taken from the sites at risk. The majority of samples consisted of blood, stool, pus and urine. Twenty stool samples were also sent for microscopy. Malignancies were both hematological and non-hematological. Gram negatives were isolated in 52.9%, gram positives in 33.9% and parasites in 13.2%. Salmonella paratyphi B was the most commonly isolated organism, followed by Pseudomonas aeroginosa, Giardia lamblia was the most common parasite. Sensitivity patterns of these organisms to antibiotics studied showed that Escheria coli had the lowest sensitivity rate being only 40% sensitive to Aztreonam and 64% sensitive to Ofloxacillin. A comparison was made between our findings and those reported in literature, as well as the risk factors for developing neutropenia. A guide to management is also discussed

COVID-19: Causes of anxiety and wellbeing support needs of healthcare professionals in the UK: A cross-sectional survey.

BACKGROUND: COVID-19 has caused acute changes in healthcare delivery; this may impact mental health and wellbeing needs of healthcare professionals (HCPs). AIMS: We aimed to identify the causes of anxiety in HCPs during the COVID-19 pandemic, to assess whether HCPs felt they had adequate mental health and wellbeing support and to identify their unmet support needs. METHOD: We used a web-based survey utilising an online tool circulated to UK HCPs over 5 weeks. Self-perceived anxiety levels prior to and during the COVID-19 pandemic were measured on a 10-point Likert-type rating scale. RESULTS: The survey was completed by 558 HCPs. During the pandemic, self-perceived anxiety scores significantly increased from a median of 2 to 7 (paired Wilcoxon signed-rank test; p<0.001). The main reasons were concerns about exposure to SARS-CoV-2 and lack of personal protective equipment. Other wide-ranging reasons were identified. Only 41% of respondents felt there was adequate support. Thematic analysis of what support HCPs wanted identified 13 wide-ranging themes; including effective leadership and peer support. CONCLUSION: Anxiety levels in HCPs significantly increased during the COVID-19 pandemic and the main causes were identified. Many HCPs felt there was inadequate support and identified what support they needed. Implementing effective strategies to support HCPs' unmet wellbeing needs are required as a matter of urgency

Appendicitis with appendicular atresia: A rare presentation

Acute appendicitis is the most common acute surgical condition; making appendectomy the most commonly performed emergency surgical procedure in the world. Anomalies of the appendix are relatively  uncommon. However, their presence may alter the course of pre-operativediagnosis and the surgical treatment provided, leading to medico-legal issues in certain cases as well. We hereby present the case of a 17  year-old female who had the suggestive signs, symptoms and  investigations of appendicular lump. She was managed according to the Ochsner-Sherren regimen and then underwent interval open appendectomy 6 weeks later. During the procedure, the findings of a 5 cm long appendix were noted. The base of the appendix was attached to the caecum, however there was complete mucosal discontinuity between the base and the remaining portion of the appendix. A fibrous strand connected the two blind ending parts together. After thorough literature search, the authors concluded that this is only the fourth reported case of appendicular atresia ever to have been reported. Considering the rarity of this finding we feel this could be of valuable interest to surgeons and readers alik

Enhanced Secure Multi Keyword Top-K Retrieval in Cloud

This research is capable to do cryptography with multi keywords search. This research is target to provide search files from cloud network using multi keywords. This paper is target to provide a security at the maximum level by includes encryption and decryption. The administrator has control of authorization and allowing files to move more secured. Encryption and decryption of files and file names which is used symmetric and asymmetric algorithm respectively. The unique key is generated for every users to protect other user cannot access the files. While implementing this project the user can understand very simple environment. The user can reduce incapable systems in server side process to hold most of the processes. The client side system has used less work for the corresponding task to perform the necessary role like arranging and ranking the files from requested order. This project can apply in various applications for this user friendly

A systematic review of physiological signals based driver drowsiness detection systems.

Driving a vehicle is a complex, multidimensional, and potentially risky activity demanding full mobilization and utilization of physiological and cognitive abilities. Drowsiness, often caused by stress, fatigue, and illness declines cognitive capabilities that affect drivers' capability and cause many accidents. Drowsiness-related road accidents are associated with trauma, physical injuries, and fatalities, and often accompany economic loss. Drowsy-related crashes are most common in young people and night shift workers. Real-time and accurate driver drowsiness detection is necessary to bring down the drowsy driving accident rate. Many researchers endeavored for systems to detect drowsiness using different features related to vehicles, and drivers' behavior, as well as, physiological measures. Keeping in view the rising trend in the use of physiological measures, this study presents a comprehensive and systematic review of the recent techniques to detect driver drowsiness using physiological signals. Different sensors augmented with machine learning are utilized which subsequently yield better results. These techniques are analyzed with respect to several aspects such as data collection sensor, environment consideration like controlled or dynamic, experimental set up like real traffic or driving simulators, etc. Similarly, by investigating the type of sensors involved in experiments, this study discusses the advantages and disadvantages of existing studies and points out the research gaps. Perceptions and conceptions are made to provide future research directions for drowsiness detection techniques based on physiological signals. [Abstract copyright: © The Author(s), under exclusive licence to Springer Nature B.V. 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Extended Huckel theory for bandstructure, chemistry, and transport. II. Silicon

In this second paper, we develop transferable semi-empirical parameters for the technologically important material, silicon, using Extended Huckel Theory (EHT) to calculate its electronic structure. The EHT-parameters areoptimized to experimental target values of the band dispersion of bulk-silicon. We obtain a very good quantitative match to the bandstructure characteristics such as bandedges and effective masses, which are competitive with the values obtained within an $sp^3 d^5 s^*$ orthogonal-tight binding model for silicon. The transferability of the parameters is investigated applying them to different physical and chemical environments by calculating the bandstructure of two reconstructed surfaces with different orientations: Si(100) (2x1) and Si(111) (2x1). The reproduced $\pi$- and $\pi^*$-surface bands agree in part quantitatively with DFT-GW calculations and PES/IPES experiments demonstrating their robustness to environmental changes. We further apply the silicon parameters to describe the 1D band dispersion of a unrelaxed rectangular silicon nanowire (SiNW) and demonstrate the EHT-approach of surface passivation using hydrogen. Our EHT-parameters thus provide a quantitative model of bulk-silicon and silicon-based materials such as contacts and surfaces, which are essential ingredients towards a quantitative quantum transport simulation through silicon-based heterostructures.Comment: 9 pages, 9 figure

Increased levels of multiple forms of dihydrofolate reductase in peripheral blood leucocytes of cancer patients receiving haematopoietic colony-stimulating factors: Interim analysis

The precise mechanism whereby granulocytes proliferate when haematopoietic colony stimulating factors (CSFs) are used in neutropenic cancer patients is poorly understood. The purpose of this study was to investigate whether these cytokines bring about leucocyte proliferation by increasing the levels of multiple forms of dihydrofolate reductase (DHFR). Blood samples were collected from 36 cancer patients (25 males and 11 females) with chemotherapy-induced neutropenia. One sample of blood from each patient was obtained before therapy either with CSF, such as granulocyte colony stimulating factor (G-CSF) and granulocyte-macrophage colony stimulating factor (GM-CSF) or with placebo, and another one at the time of resolution of neutropenia. Peripheral blood leucocytes in these blood samples were counted, separated and lysed. From lysates, cytoplasmic samples were prepared and analyzed for active DHFR by a methotrexate-binding assay and for total immunoreactive DHFR by an enzyme linked immunosorbent assay. The increase in total leucocyte count (TLC) was most prominent (P \u3c 0.005) in the CSF group and less so (P \u3c 0.05) in the placebo group. The mean +/- SD concentration values of active DHFR before and after stimulation with GM-CSF found were to be 0.34 +/- 0.4 ng/mg protein and 0.99 +/- 0.82 ng/mg protein, respectively, and in the group treated with G-CSF, 0.24 +/- 0.32 ng/mg protein and 1.18 +/- 2.4 ng/mg protein, respectively. This increase in active DHFR after stimulation with CSF was statistically significant (P \u3c 0.05). Similarly, concentration values of immunoreactive but nonfunctional form of DHFR (IRE) were 110 +/- 97 ng/mg protein and 605 +/- 475 ng/mg protein before and after stimulation with GM-CSF, and 115 +/- 165 ng/mg protein and 1,054 +/- 1,095 ng/ mg protein before and after stimulation with G-CSF. This increase in concentration of IRE after stimulation with GM-CSF or G-CSF was statistically significant (P \u3c 0.005). In the control group, there was an increase in the concentration of both active DHFR and IRE after treatment with placebo. However, this was not statistically significant. Resolution of neutropenia was quicker in the groups treated with CSF compared to the control group. Results of this study indicate that colony stimulating factors (G-CSF and GM-CSF) induce white cell proliferation by increasing the levels of multiple forms of DHFR

Lack of benefit of granulocyte macrophage or granulocyte colony stimulating factor in patients with febrile neutropenia

Objectives: To compare the clinical benefits of granulocyte-colony stimulating factor (G-CSF) or granulocyte macrophage-colony stimulating factor (GM-CSF) plus standard supportive care to supportive care alone among cancer patients with febrile neutropenia. Methods: Clinical data were collected retrospectively from 148 consecutive cancer patients with neutropenia and fever. Patients had hematologic (i.e., acute leukemias or lymphoproliferative disorders) or non-hematologic malignancies (i.e., solid tumors including carcinoma of breast, lung, or colon). Clinical variables analyzed included: age and sex; underlying malignancies; chemotherapy regimens; symptoms at time of presentation; duration of fever prior to study enrollment; days from chemotherapy until administration of GM-CSF or G-CSF; number of previous neutropenic episodes; duration of fever and day of defervescence; absolute neutrophil count on day of defervescence; duration of neutropenia; number and types of antibiotics used; day amphotericin B begun; number of culture-documented infective episodes involving bloodstream, lung, pleura, urinary tract, gastrointestinal tract, intravenous cannulae, or skin; types of antimicrobial isolates; cost of cytokine therapy; length of hospital stay and clinical outcome. Results:The use of myeloid growth factors increased the number of circulating peripheral white blood cells, but no significant effect was noted in terms of duration of neutropenia or fever, number of culture-proven infections (except pneumonia; p \u3c 0.04), length of hospital stay, or survival. Conclusion: In areas with limited health care resources, expensive treatment with GM-CSF or G-CSF should be reserved for patients with complicated febrile neutropenia where the expected risk of infection is high and the documented infections that are refractory to antibiotic duration of neutropenia is prolonged, or those with treatment (JPMA 52: 206, 2002)