Prolonged intermediate syndrome pue to prganophosphate poisoning

Organophosphate poisoning can present as acute cholinergic syndrome, Intermediate syndrome and delayed neuropathy. Intermediate syndrome secondary to organophosphate poisoning is a serious health problem leading to increased morbidity and mortality. The incidence of problem varies and range from 8%-84% of organophosphate poisoning cases. The factors account for this difference is nature of organophosphate compound, severity of poisoning and inadequate Oxime therapy. The recognition of this syndrome is important as organophosphate poisoning is common in our country. We presented this case of organophosphate poisoning leading to prolonged intermediate syndrome. The muscle weakness associated with this syndrome generally resolves in 5-18 days but in our case this lasted for 23 days. After a prolonged Intensive Care Unit (ICU) stay patient was discharged home with no residual symptoms. The case highlights anticipation and recognition of this problem after cholinergic crisis is over

Wideband and High Gain Array Antenna for 5G Smart Phone Applications Using Frequency Selective Surface

This work presents an eight element array antenna with single layer frequency selective surface (FSS) to obtain high gain. The eight elements are fed by single port. The FSS consists of 14 × 6 unit cells with one unit cell size is 5 × 5 mm2 having wideband behavior. The antenna uses Rogers RT Duroid 5880 substrate and giving very wide bandwidth from 20 GHz to 65 GHz, covering millimeter wave 5G bands (including 28 GHz, 38 GHz and 60 GHz). The designed FSS is showing stop band transmission characteristics below −10 dB threshold from 25 GHz to 42 GHz and 59 GHz to 61 GHz. The eight element antenna integrated with the FSS reflector, which results an improvement in the gain level from 12 dB to 15 dB at 28 GHz, from 10 dB to 12 dB at 38 GHz, and from 9.5 to 11 dB at 60 GHz. The dimensions of the antenna are 65 × 27 × 0.857 mm3. The proposed antenna shows stable gain and directional radiation patterns. The simulation findings are experimentally confirmed, by testing the fabricated prototypes of the proposed antenna system

Measurement of indoor radon concentration in district Mardan, Khyber Pakhtunkhwa, Pakistan

The study of the indoor radon concentration in district Mardan Khyber Pakhtunkhwa (KPK), Pakistan is presented. To know the impact of the dose for Mardan city, 40 CR-39 detectors were installed in different houses for a period of three months. The radon concentration for this phase of the year (early summer) is from 18.45 ± 0.53 to 41.51 ± 3.4 Bq/m3. The level of indoor radon concentration is the highest in the basements i.e. 41.51 ± 3.4 Bq/m3 which is within acceptable limit (148 Bq/m3), recommended by the Environmental Protection Agency. The annual effective dose calculated from this study is ERn = 0.704 mSv. It was concluded that indoor radon concentration may not suppose any severe threat to the health of residents

Left atrial volumes and associated stroke subtypes.

Background: Cardio embolism and cerebrovascular atherosclerosis are two major mechanisms of stroke. Studies investigating associations between advanced echocardiographic parameters and stroke mechanisms are limited. Methods: This study is a standardized review of 633 patients admitted to the stroke service of a tertiary care hospital following a standardized stroke investigation and management pathway. Stroke subtypes were characterized using the Causative Classification System, using the hospitals online radiologic archival system with CCS certified stroke investigators. Patients with two mechanisms were excluded. Results: Patients with cardioembolic stroke had a higher proportion of atrial fibrillation (p \u3c 0.001), acute myocardial infarction (p \u3c 0.001) and ischemic heart disease (p \u3c 0.001). On electrocardiogram (ECG) and transthoracic Echo (TTE), patients with cardioembolic stroke had a greater atrial fibrillation (p \u3c .00), left ventricular thrombus (p \u3c .00), left ventricular ejection fraction \u3c30% (p \u3e\u3c .00) and global hypokinesia (p \u3c .00) Patients with cardioembolic stroke had higher mean left atrial volume indices (LAVi) (p \u3c 0.001), mean left ventricular mass indices (LVMi) (p \u3c 0.05) and mean left atrial diameters (LAD) (p \u3c 0.05). At LAVi of 29–33 ml/m2 , the risk of atherothrombotic stroke increased. The risk of cardioembolic stroke increased with LAVi of 34 ml/m2 and above. Conclusion: Left atrial volume indices may be linked to specific stroke phenotype. At mild increases in left atrial dimensions, the risks of atherosclerotic stroke are high, and probably reflect hypertension as the unifying mechanism. Further increases in left atrial dimensions shifts the risk towards cardioembolic stroke

Alarming prevalence of Candida auris among critically ill patients in intensive care units in Dhaka City, Bangladesh

Background: Candida auris is a multidrug-resistant yeast capable of invasive infection with high mortality and healthcare-associated outbreaks globally. Due to limited labratory capacity, the burden of C. auris is unknown in Bangladesh. We estimated the extent of C. auris colonization and infection among patients in Dhaka city intensive care units. Methods: During August 2021–September 2022 at adult intensive care units (ICUs) and neonatal intensive care units (NICUs) of 1 government and 1 private tertiary-care hospital, we collected skin swabs from all patients and blood samples from sepsis patients on admission, mid-way through, and at the end of ICU or NICU stays. Skin swab and blood with growth in blood-culture bottle were inoculated in CHROMagar, and identification of isolates was confirmed by VITEK-2. Patient characteristics and healthcare history were collected. We performed descriptive analyses, stratifying by specimen and ICU type. Results: Of 740 patients enrolled, 59 (8%) were colonized with C. auris, of whom 2 (0.3%) later developed a bloodstream infection (BSI). Among patients colonized with C. auris, 27 (46%) were identified in the ICU and 32 (54%) were identified from the NICU. The median age was 55 years for C. auris–positive ICU patients and 4 days for those in the NICU. Also, 60% of all C. auris patients were male. Among 366 ICU patients, 15 (4%) were positive on admission and 12 (3%) became colonized during their ICU stay. Among 374 NICU patients, 19 (5%) were colonized on admission and 13 (4%) became colonized during their NICU stay. All units identified C. auris patients on admission and those who acquired it during their ICU or NICU stay, but some differences were observed among hospitals and ICUs (Figure). Among patients colonized on admission to the ICU, 11 (73%) were admitted from another ward, 3 (20%) were admitted from another hospital, and 1 (7%) were admitted from home. Of patients colonized on admission to the NICU, 4 (21%) were admitted from the obstetric ward, 9 (47%) were admitted from another hospital, and 6 (32%) were admitted from home. In addition, 18 patients with C. auris died (12 in the ICU and 6 in the NICU); both patients with C. auris BSIs died. Conclusions: In these Bangladesh hospitals, 8% of ICU or NICU patients were positive for C. auris, including on admission and acquired during their ICU or NICU stay. This high C. auris prevalence emphasizes the need to enhance case detection and strengthen infection prevention and control. Factors contributing to C. auris colonization should be investigated to inform and strengthen prevention and control strategies