Use of proton pump inhibitors in dialysis unit in tertiary care hospital: a pharmaco-epidemiological study

Background: Proton pump inhibitors (PPI) are generally thought to be safer drug with fewer adverse effects. Though this class of the drug is thought to be well tolerated, a detail study about actual use of these agents in nephrology department is still awaited in many parts of India. There had been case reports and case series which were reporting PPIs producing acute interstitial nephritis progressing to acute renal failure. The risk of PPI treatment in haemodialysis patients remains unexplored. The aim of the study was to evaluate a drug utilization of PPI in patient undergoing haemodialysis procedure.Methods: In this study every day visit to the dialysis units of the hospitals was carried out. After taking consent from the patients, the information from the case-report form was noted like; age, sex, diagnosis, laboratory reports and drug prescried. No personally identifiable information about patient or physician was collected. After this an interview of patients was taken.Results: In this study, out of 126 patients 76.6% were male and 23.4% were female. Out of these 126 patients 88.89% patients were on PPI. Nearly 54% were using PPI for more than six months. Nearly 29% patients were using PPI for more than 12 months.Conclusions: As many case-reports and studies are suggesting, there is co-relation of PPI and acute interstitial nephritis from this study we suggest that especially in nephrology unit patients’, more caution must be exercised while using PPI

Parabolic resonances and instabilities in near-integrable two degrees of freedom Hamiltonian flows

When an integrable two-degrees-of-freedom Hamiltonian system possessing a circle of parabolic fixed points is perturbed, a parabolic resonance occurs. It is proved that its occurrence is generic for one parameter families (co-dimension one phenomenon) of near-integrable, t.d.o. systems. Numerical experiments indicate that the motion near a parabolic resonance exhibits new type of chaotic behavior which includes instabilities in some directions and long trapping times in others. Moreover, in a degenerate case, near a {\it flat parabolic resonance}, large scale instabilities appear. A model arising from an atmospherical study is shown to exhibit flat parabolic resonance. This supplies a simple mechanism for the transport of particles with {\it small} (i.e. atmospherically relevant) initial velocities from the vicinity of the equator to high latitudes. A modification of the model which allows the development of atmospherical jets unfolds the degeneracy, yet traces of the flat instabilities are clearly observed

Universal behaviour of entrainment due to coherent structures in turbulent shear flow

I suggest a solution to a persistent mystery in the physics of turbulent shear flows: cumulus clouds rise to towering heights, practically without entraining the ambient medium, while apparently similar turbulent jets in general lose their identity within a small distance through entrainment and mixing. From dynamical systems computations on a model chaotic vortical flow, I show that entrainment and mixing due to coherent structures depend sensitively on the relative speeds of different portions of the flow. A small change in these speeds, effected for example by heating, drastically alters the sizes of the KAM tori and the chaotic mixing region. The entrainment rate and, hence, the lifetime of a turbulent shear flow, shows a universal, non-monotone dependence on the heating.Comment: Preprint replaced in order to add the following comment: accepted for publication in Phys. Rev. Let

Synthesis and structure characterization of [Co(H2O)2(DMSO)2(4-nba)]4-nba (DMSO = dimethylsulfoxide; 4-nba = 4-nitrobenzoate)

51-56Dissolution of a fine powder obtained by mechanochemical grinding of cobaltous carbonate with 4-nitrobenzoic acid (4-nbaH) in hot dimethylsulfoxide (DMSO) followed by slow evaporation of the solvent resulted in the formation of cis-diaquabis(dimethylsul-foxide)4-nitrobenzoatocobalt(II) 4-nitrobenzoate 1 in good yield. The title compound [Co(H2O)2(DMSO)2(4-nba)]4-nba 1 crystallizes in the centrosymmetric monoclinic P21/c space group. The structure of 1 consists of two crystallographically independent Co(II) ions. Each unique cobalt exhibits octahedral geometry and is bonded to a pair of terminal aqua ligands situated cis to each other and a bidentate 4-nba ligand which form the square base of the octahedron. A pair of DMSO ligands disposed trans to each other complete the hexa coordination around the central metal. The [Co(H2O)2(DMSO)2 (4-nba)]+ cations and the 4-nba anions are interlinked with the aid of several weak H-bonding interactions. A comparative study of several 4-nitrobenzoate compounds of cobalt is described

Symmetry breaking perturbations and strange attractors

The asymmetrically forced, damped Duffing oscillator is introduced as a prototype model for analyzing the homoclinic tangle of symmetric dissipative systems with \textit{symmetry breaking} disturbances. Even a slight fixed asymmetry in the perturbation may cause a substantial change in the asymptotic behavior of the system, e.g. transitions from two sided to one sided strange attractors as the other parameters are varied. Moreover, slight asymmetries may cause substantial asymmetries in the relative size of the basins of attraction of the unforced nearly symmetric attracting regions. These changes seems to be associated with homoclinic bifurcations. Numerical evidence indicates that \textit{strange attractors} appear near curves corresponding to specific secondary homoclinic bifurcations. These curves are found using analytical perturbational tools

Multicritical crossovers near the dilute Bose gas quantum critical point

Many zero temperature transitions, involving the deviation in the value of a $U(1)$ conserved charge from a quantized value, are described by the dilute Bose gas quantum critical point. On such transitions, we study the consequences of perturbations which break the symmetry down to $Z_N$ in $d$ spatial dimensions. For the case $d=1$, $N=2$, we obtain exact, finite temperature, multicritical crossover functions by a mapping to an integrable lattice model.Comment: 10 pages, REVTEX 3.0, 2 EPS figure

Global Superdiffusion of Weak Chaos

A class of kicked rotors is introduced, exhibiting accelerator-mode islands (AIs) and {\em global} superdiffusion for {\em arbitrarily weak} chaos. The corresponding standard maps are shown to be exactly related to generalized web maps taken modulo an ``oblique cylinder''. Then, in a case that the web-map orbit structure is periodic in the phase plane, the AIs are essentially {\em normal} web islands folded back into the cylinder. As a consequence, chaotic orbits sticking around the AI boundary are accelerated {\em only} when they traverse tiny {\em ``acceleration spots''}. This leads to chaotic flights having a quasiregular {\em steplike} structure. The global weak-chaos superdiffusion is thus basically different in nature from the strong-chaos one in the usual standard and web maps.Comment: REVTEX, 4 Figures: fig1.jpg, fig2.ps, fig3.ps, fig4.p

Ultra Thin White Topping

Paper consists of subsistence of highway road and improvement in low cost and increasing the strength and vitality of the pavement. Ultra-Thin White Topping may be defined as a concrete cover with closely spaced joints and bonded to an existing bituminous pavement. It consists of a fine layer of high durability, fibre-reinforced concrete laid over a clean, milled surface of distressed bituminous concrete pavement, to achieve full or partial bonding. From the degradation summary it is identified that even after 10 years, the riding quality of Ultra-Thin White Topping is the most admirable and the most desirable one without any mediation. Structural collapse emerges from the action that contrarily affects the traffic volume carrying capacity of the pavement. This structural collapse can be overcome by using Ultra-Thin White Topping pavement over bituminous pavement. Ultra-Thin White Topping achieves very low End User Cost values thus resulting in the maximization of Gross Economic Benefits than that of ordinary bitumen overlay