56 research outputs found
Massive Fluid Requirements and an Unusual BUN/Creatinine Ratio for Pre-Renal Failure in Patients with Cholera
Background: Cholera is an important infectious cause of secretory diarrhea. The primary symptom of infection is the sudden onset of watery diarrhea with subsequent volume depletion causing renal insufficiency. The objective of this research is to study the level of dehydration at presentation and subsequent fluid management in Patients with cholera. Methods: This study was conducted on 191 Patients of Cholera admitted at a tertiary care hospital in Karachi, Pakistan during the period of 5 years. Medical charts were evaluated retrospectively for initial hydration status, baseline lab investigations on admission and discharge and fluid therapy given to all the Patients while their stay in the hospital and the data was analyzed on SPSS 15.0. Results: Out of the 191 Patients, 83(43%) were males and 108 (57%) were females with mean age of 42.3 years (SD+/-18.34). The average duration of symptoms was 3.75 days (SD+/-2.04). Of 191 Patients, 175 (92.1%) presented with dehydration, 80 (42.3%) were given Ringer\u27s Lactate (R/L) + Normal Saline (N/S), 45 (24%) Patients were given R/L + N/S + Oral Rehydration Therapy (ORS), 27 (14.3%) of the Patients were kept on R/L only and remaining were given various combinations of R/L, N/S, ORS and Dextrose Saline (D/S). On admission mean Blood Urea Nitrogen (BUN) was 24.54 (SD+/-16.6), mean creatinine was 2.47 (SD+/-2.35) and mean BUN/Creatinine ratio was 11.63 (SD+/-5.7). Conclusion: Aggressive fluid rehydration remains the cornerstone of management of cholera. Instead of presenting with a classical BUN/Creatinine ratio of \u3e20:1, Patients with pre-renal failure in cholera may present with a BUN/Creatinine ratio of \u3c15:1
Seasonal activity of tick infestation in goats and buffalo of punjab province (district sargodha), pakistan
Lepton polarization asymmetry and forward backward asymmetry in exclusive B->K_1 tau^(+)tau^(-) decay in universal extra dimension scenario
Decay rate, forward-backward asymmetry and polarization asymmetries of final
state leptons in B-> K_{1}tau ^{+}tau ^{-}, where K_{1} is the axial vector
meson, are calculated in Standard Model and in the universal extra dimension
(UED) model. The sensitivity of the observables on the compactification radius
, the only unknown paramter in UED model, is studied. Finally, the helicity
fractions of the final state K_{1} are calculated and their dependence on the
compactification radius is discussed. This analysis of helicity fraction is
briefly extended to B->K^{*}l ^{+}l ^{-}(l =e,mu) and compared with the other
approaches exist in the literatureComment: 19 pages, 6 figure
LEARN: A multi-centre, cross-sectional evaluation of Urology teaching in UK medical schools
OBJECTIVE: To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. MATERIALS AND METHODS: LEARN was a national multicentre cross-sectional study. Year 2 to Year 5 medical students and FY1 doctors were invited to complete a survey between 3rd October and 20th December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). RESULTS: 7,063/8,346 (84.6%) responses from all 39 UK medical schools were included; 1,127/7,063 (16.0%) were from Foundation Year (FY) 1 doctors, who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and clinical placements in the later years of medical school. 20.1% of FY1 doctors reported no undergraduate clinical attachment in urology. CONCLUSION: LEARN is the largest ever evaluation of undergraduate urology teaching. In the UK, teaching seemed satisfactory as evaluated by the BAUS undergraduate syllabus. However, many students report having no clinical attachments in Urology and some newly qualified doctors report never having inserted a catheter, which is a GMC mandated requirement. We recommend a greater emphasis on undergraduate clinical exposure to urology and stricter adherence to GMC mandated procedures
A checklist for assessing the methodological quality of concurrent tES-fMRI studies (ContES checklist): a consensus study and statement
Background: Low intensity transcranial electrical stimulation (tES), including alternating or direct current stimulation (tACS or tDCS), applies weak electrical stimulation to modulate the activity of brain circuits. Integration of tES with concurrent functional magnetic resonance imaging (fMRI) allows for the mapping of neural activity during neuromodulation, supporting causal studies of both brain function and tES effects. Methodological aspects of tES-fMRI studies underpin the results, and reporting them in appropriate detail is required for reproducibility and interpretability. Despite the growing number of published reports, there are no consensus-based checklists for disclosing methodological details of concurrent tES-fMRI studies. Objective: To develop a consensus-based checklist of reporting standards for concurrent tES-fMRI studies to support methodological rigor, transparency, and reproducibility (ContES Checklist). Methods: A two-phase Delphi consensus process was conducted by a steering committee (SC) of 13 members and 49 expert panelists (EP) through the International Network of the tES-fMRI (INTF) Consortium. The process began with a circulation of a preliminary checklist of essential items and additional recommendations, developed by the SC based on a systematic review of 57 concurrent tES-fMRI studies. Contributors were then invited to suggest revisions or additions to the initial checklist. After the revision phase, contributors rated the importance of the 17 essential items and 42 additional recommendations in the final checklist. The state of methodological transparency within the 57 reviewed concurrent tES-fMRI studies was then assessed using the checklist. Results: Experts refined the checklist through the revision and rating phases, leading to a checklist with three categories of essential items and additional recommendations: (1) technological factors, (2) safety and noise tests, and (3) methodological factors. The level of reporting of checklist items varied among the 57 concurrent tES-fMRI papers, ranging from 24% to 76%. On average, 53% of checklist items were reported in a given article. Conclusions: Use of the ContES checklist is expected to enhance the methodological reporting quality of future concurrent tES-fMRI studies, and increase methodological transparency and reproducibility
Transcranial electrical and magnetic stimulation (tES and TMS) for addiction medicine: A consensus paper on the present state of the science and the road ahead
There is growing interest in non-invasive brain stimulation (NIBS) as a novel treatment option for substance-use disorders (SUDs). Recent momentum stems from a foundation of preclinical neuroscience demonstrating links between neural circuits and drug consuming behavior, as well as recent FDA-approval of NIBS treatments for mental health disorders that share overlapping pathology with SUDs. As with any emerging field, enthusiasm must be tempered by reason; lessons learned from the past should be prudently applied to future therapies. Here, an international ensemble of experts provides an overview of the state of transcranial-electrical (tES) and transcranial-magnetic (TMS) stimulation applied in SUDs. This consensus paper provides a systematic literature review on published data â emphasizing the heterogeneity of methods and outcome measures while suggesting strategies to help bridge knowledge gaps. The goal of this effort is to provide the community with guidelines for best practices in tES/TMS SUD research. We hope this will accelerate the speed at which the community translates basic neuroscience into advanced neuromodulation tools for clinical practice in addiction medicine
Tunnel support design by comparison of empirical and finite element analysis of the Nahakki Tunnel in Mohmand Agency, Pakistan
The paper analyses the geological conditions of study area, rock mass strength parameters with suitable support structure propositions for the under construction Nahakki tunnel in Mohmand Agency. Geology of study area varies from mica schist to graphitic marble/phyllite to schist. The tunnel ground is classified and divided by the empisical classification systems like Rock mass rating (RMR), Q system (Q), and Geological strength index (GSI). Tunnel support measures are selected based on RMR and Q classification systems. Computer based finite element analysis (FEM) has given yet another dimension to design approach. FEM software Phase2 version 7.017 is used to calculate and compare deformations and stress concentrations around the tunnel, analyze interaction of support systems with excavated rock masses and verify and check the validity of empirically determined excavation and support systems
S181. Optimizing the neuroplastic effects of cathodal transcranial direct current stimulation (tDCS) over the primary motor cortex
Systematic evaluation of the impact of stimulation intensity on neuroplastic after-effects induced by transcranial direct current stimulation
KEY POINTS: Applications of transcranial direct current stimulation to modulate human neuroplasticity have increased in research and clinical settings. However, the need for longerâlasting effects, combined with marked interâindividual variability, necessitates a deeper understanding of the relationship between stimulation parameters and physiological effects. We systematically investigated the full DC intensity range (0.5â2.0Â mA) for both anodal and cathodal tDCS in a shamâcontrolled repeated measures design, monitoring changes in motorâcortical excitability via transcranial magnetic stimulation up to 2Â h after stimulation. For both tDCS polarities, the excitability afterâeffects did not linearly correlate with increasing DC intensity; effects of lower intensities (0.5, 1.0Â mA) showed equal, if not greater effects in motorâcortical excitability. Further, while intraâindividual responses showed good reliability, interâindividual sensitivity to TMS accounted for a modest percentage of the variance in the early afterâeffects of 1.0Â mA anodal tDCS, which may be of practical relevance for future optimizations. ABSTRACT: Contemporary nonâinvasive neuromodulatory techniques, such as transcranial direct current stimulation (tDCS), have shown promising potential in both restituting impairments in cortical physiology in clinical settings, as well as modulating cognitive abilities in the healthy population. However, neuroplastic afterâeffects of tDCS are highly dependent on stimulation parameters, relatively short lasting, and not expectedly uniform between individuals. The present study systematically investigates the full range of current intensity between 0.5 and 2.0Â mA on left primary motor cortex (M1) plasticity, as well as the impact of individualâlevel covariates on explaining interâindividual variability. Thirtyâeight healthy subjects were divided into groups of anodal and cathodal tDCS. Five DC intensities (sham, 0.5, 1.0, 1.5 and 2.0Â mA) were investigated in separate sessions. Using transcranial magnetic stimulation (TMS), 25 motorâevoked potentials (MEPs) were recorded before, and 10 time points up to 2Â h following 15Â min of tDCS. Repeatedâmeasures ANOVAs indicated a main effect of intensity for both anodal and cathodal tDCS. With anodal tDCS, all active intensities resulted in equivalent facilitatory effects relative to sham while for cathodal tDCS, only 1.0Â mA resulted in sustained excitability diminution. An additional experiment conducted to assess intraâindividual variability revealed generally good reliability of 1.0Â mA anodal tDCS (ICC(2,1)Â =Â 0.74 over the first 30Â min). A post hoc analysis to discern sources of interâindividual variability confirmed a previous finding in which individual TMS SI(1mV) (stimulus intensity for 1Â mV MEP amplitude) sensitivity correlated negatively with 1.0Â mA anodal tDCS effects on excitability. Our study thus provides further insights on the extent of nonâlinear intensityâdependent neuroplastic afterâeffects of anodal and cathodal tDCS
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