Abdominal pain with rigidity secondary to the anti-emetic drug metoclopramide

We report a case of abdominal pain with rigidity, mimicking an acute abdomen, caused by metoclopramide, a common anti-emetic drug. Extrapyramidal symptoms are commonly reported side-effects of this medication. They generally include involuntary movements of limbs, torticollis, oculogyric crisis, rhythmic protrusion of tongue, trismus, or dystonic reactions resembling tetanus, etc. Abdominal rigidity due to this medication, resembling an acute abdomen, has not been reported previously. This case report illustrates the importance of considering medication side-effects when evaluating a patient with abdominal pain and rigidity

Ectopic placement of central venous catheter, importance of x-ray chest

A case of malpositioning of central venous catheter which was judged to be correctly placed on clinical criteria isbeing presented. Abberant positioning was picked up on X-ra

M-GEAR: Gateway-Based Energy-Aware Multi-Hop Routing Protocol for WSNs

In this research work, we advise gateway based energy-efficient routing protocol (M-GEAR) for Wireless Sensor Networks (WSNs). We divide the sensor nodes into four logical regions on the basis of their location in the sensing field. We install Base Station (BS) out of the sensing area and a gateway node at the centre of the sensing area. If the distance of a sensor node from BS or gateway is less than predefined distance threshold, the node uses direct communication. We divide the rest of nodes into two equal regions whose distance is beyond the threshold distance. We select cluster heads (CHs)in each region which are independent of the other region. These CHs are selected on the basis of a probability. We compare performance of our protocol with LEACH (Low Energy Adaptive Clustering Hierarchy). Performance analysis and compared statistic results show that our proposed protocol perform well in terms of energy consumption and network lifetime.Comment: IEEE 8th International Conference on Broadband and Wireless Computing, Communication and Applications (BWCCA'13), Compiegne, Franc

Management of intercondylar femur fracture with distal femur locking compression plate: outcome analysis of 72 cases

Background: Supra-condylar and inter-condylar fractures of the distal femur account for 7% of all femoral fractures and have always been difficult to treat and regaining full knee function is often difficult. The purpose of this study is to evaluate the functional outcome, fracture healing, complications of distal femoral intercondylar fractures managed by locking compression plate.Methods: Total 72 patients of intercondylar femur fracture were operated by ORIF with distal femur-locking compression plate via the standard swashbuckler approach. The functional outcomes were analyzed using modified hospital for special surgery scoring system.Results: Muller type C2 fracture was the most common fracture type with 50 out of 72 patients. The average range of motion achieved was about 99.03°±24.73° (Closed fractures =105.83°±19.41°and open fractures = 89.50°±28.36°). There was also a significant difference in the duration of operative time, 84.28±18.32 minutes for closed fractures and 98.46±22.47 minutes for open fractures. The average duration for radiological union was 14.52±2.21 weeks for closed and 17.20±2.44 weeks for open fractures. The average knee score was 80.13±13.38 using modified Hospital for Special Surgery score.Conclusions: Closed fractures have a higher range of motion and a better knee score compared to open fractures, supporting the fact that soft tissue compromise also affects range of motion and post-op rehabilitation of the limb. The outcome seems to correlate with the nature of injury i.e. high vs low velocity, type of fracture, anatomic reduction, associated injuries, time elapsed since injury to fixation and the stability of fixation

Non-Traumatic Aortic Emergencies - Experience from a Tertiary Care Centre in

Objective: To review the incidence, clinical presentation and outcome of Non traumatic Aortic emergencies in a tertiary care hospital and its evaluation in the Emergency department (ED).Methods: We conducted a retrospective review of cases presented to the ED at Aga Khan University Hospital during 15 year period (1988 - 2002) who had final diagnosis of Aortic Dissection or Ruptured Aortic Aneurysm. Patients without confirmatory investigations were excluded. We aimed at looking for the incidence, clinical presentation, evaluation in the ED and final outcome.Results: Of the 12 cases, 7 had aortic dissection while the remaining 5 had ruptured aortic aneurysm. For Aortic dissection, mean age of presentation was 53 years with male predominance. Most of these patients had chest pain. Most common comorbid condition was hypertension. Pulse deficit was found in 2 cases, murmur in 4 cases, and focal neurologic deficit in 2 cases. Electrocardiogram revealed ischemic changes in 3 cases. Widened mediastinum on chest x-ray was present in all cases. The only initial misdiagnosis was cardiac ischemia. One patient survived to discharge. For patients presenting with ruptured aortic aneurysm, mean age of presentation was 52 yrs with a male predominance. The associated comorbid condition was hypertension. Almost all patients presented classically with abdominal pain, hypotension and palpable mass. No patient survived to discharge.Conclusion: Aortic emergencies although rare, are associated with significant mortality. High index of suspicion and prompt recognition by the emergency physician is of key importanc

Pathways and LegislationTowards Hospital Wastewater Discharged Around Globe

In every section of the environment pharmaceuticals are now can be observed and detected. Hospitals are one of the major sources of pollution via either through environment or wastewater treatment plants (WWTPs). The treatment plants are not prepared for effective treatment of emerging contaminants (ECs). This paper further illustrates the lack of understanding of the ecotoxicity of certain large concentrations of pharmaceutical compounds in HWW (mg L-1). In order to expand this analysis, the ecotoxic risks associated with numerous pollution scenarios, particularly water-dilution and metabolite processing, particularly during transit inside WWPs, have now to be investigated. Furthermore, in hospitals, the average water demand is reported to be between 200-1200 L bed– 1 day–1. Water is consumed in the hospital system with equivalent wastewater discharge. There is also domestic waste disposal in hospital fluids from kitchens, washrooms, and toilets. This paper reviews about characteristics of hospital wastewater, legislation around the globe and its paths ways in biotics system. This review also provides an overview of the pathways of ECs and focused few of its characteristics in biological treatment

Comparing the Reaction Rates of Plasmonic (Gold) and Non-Plasmonic (Palladium) Metal Particles in Photocatalytic Hydrogen Production

Both Pd and Au metal particles are used in photocatalytic hydrogen generation. Yet while both act as electron sink only gold is poised to respond to visible light due to its plasmonic response. In order to quantitatively gauge their relative contribution into the reaction, the photocatalytic H2 production, from Au/TiO2 and Pd/TiO2 catalysts was studied under UV and UV–Vis light. While under UV light excitation, a weak dependence on the work function of the metal is observed, under UV–Vis light, Au is found to be twice more active than Pd. Under identical UV–Vis light irradiation, the turn over frequency calculated from XPS at.% is found to be 2.8 and 1.8 s−1 for Au and Pd, respectively. The effect is far more pronounced when the rates are normalized to the number of particles of each metal. Both the semiconductor TiO2 (UV light) and the plasmonic metal (visible light) need to be excited for the enhancement to occur; visible light alone causes a negligible reaction rate. Photocurrent measurements further confirmed the difference in the photocatalytic activity under UV and UV–Vis light excitation. Moreover, because of the presence of Au particles responding to visible light the reaction rate is enhanced due to “light penetration depth” effect

Mathematical analysis of neurological disorder under fractional order derivative

Multiple sclerosis (MS) is a common neurological disorder that affects the central nervous system (CNS) and can cause lesions that spread over space and time. Our study proposes a mathematical model that illustrates the progression of the disease and its likelihood of recurrence. We use Caputo fractional-order (FO) derivative operators to represent non-negative solutions and to establish a steady-state point and basic reproductive number. We also employ functional analysis to prove the existence of unique solutions and use the Ulam-Hyres (UH) notion to demonstrate the stability of the solution for the proposed model. Furthermore, we conduct numerical simulations using an Euler-type numerical technique to validate our theoretical results. Our findings are presented through graphs that depict various behaviors of the model for different parameter values