Diagnostic issues in abdominal tuberculosis

Objective: To analyze the modes of presentation and diagnostic issues in the management of abdominal tuberculosis at a tertiary care hospital in a developing country, where most of the established diagnostic modalities are available.SETTING: The Aga Khan University Hospital, Karachi.Methods: This study is a retrospective review of medical records of all inpatients, diagnosed to have abdominal tuberculosis, from January 1991 to December 1997. The data was collected and particularly analyzed for spectrum of presentation and role of various diagnostic modalities. Of special interest was the sub-group of patients, who after all investigations did not have a firm diagnosis. Following a literature review recommendations have been developed for empiric antituberculous therapy in such patients.Results: A total of 135 patients were diagnosed to have abdominal tuberculosis with a mean age of 34 years and a male to female ratio of 1:2. Ninety-six (71%) patients presented with chronic abdominal symptoms, while 39 (29%) presented as an acute surgical emergency mandating exploratory laparotomy. A tissue-based diagnosis was established in 95 (70.30%) patients, while radiological diagnosis was made in 30 (22.2%) patients. In 10 (7.4%) patients all investigations undertaken could not reveal a final diagnosis; these were treated empirically on the basis of a strong clinical suspicion.CONCLUSION: The diagnosis of abdominal tuberculosis can be made confidently in most of the cases. There may be a small group of patients where diagnosis cannot be made despite appropriate investigations and a therapeutic trial of ATT may be considered with close monitoring according to a pre-fixed protocol

Search for a Signal on QCD Critical Point in Central Nucleus-Nucleus Collisions

We discuss that the QCD critical point could appear in central collisions in percolation cluster. We suggest using the nuclear transparency effect and the one of the light nuclear production to identify the critical point.Comment: To appear in the proceedings of the 20th International Conference on Ultra-Relativistic Nucleus-Nucleus Collisions (QM2008), Jaipur, India, February 4-10, 200

Wakefield damping for the CLIC crab cavity

A crab cavity is required in the CLIC to allow effective head-on collision of bunches at the IP. A high operating frequency is preferred as the deflection voltage required for a given rotation angle and the RF phase tolerance for a crab cavity are inversely proportional to the operating frequency. The short bunch spacing of the CLIC scheme and the high sensitivity of the crab cavity to dipole kicks demand very high damping of the inter-bunch wakes, the major contributor to the luminosity loss of colliding bunches. This paper investigates the nature of the wakefields in the CLIC crab cavity and the possibility of using various damping schemes to suppress them effectively

Hysterectomy, endometrial destruction, and levonorgestrel releasing intrauterine system (Mirena) for heavy menstrual bleeding : systematic review and meta-analysis of data from individual patients

Peer reviewedPublisher PD

A Strategy for Emergency Vehicle Preemption and Route Selection

Emergency vehicle preemption (EVP) aims to give right of way to emergency vehicles (EV) heading toward the incident location through a network of signalized intersections by creating a green wave en-route. The design goals of EVP systems are two folds: first, to avoid any hindrance to the passage of EV along the road and at the intersections and second, to reduce the negative impact of preemption on general traffic. The negative impact of EVP on normal traffic can be minimized by selecting appropriate preemption strategy. The EVP schemes proposed earlier aim to minimize the travel time of the EV with no or little consideration to the negative impact of EVP on the normal traffic. In this study, a joint strategy for optimal path selection and EV preemption is developed. The proposed scheme selects the optimal path for the EV before it departs from its origin and then activates the preemption on each intersection en-route at the right time to clear the intersection before the EV reaches. The proposed EVP scheme also aims to minimize the impact of EVP over normal traffic at both stages (i.e., path selection phase and preemption phase). A major advantage of the proposed method is that once the optimal path is selected, the emergency information can be disseminated to other vehicles using vehicle-to-vehicle and vehicle-to-infrastructure communication in the EV path to clear the entire route or the approaching lane. The strategy was tested using a microscopic simulation environment for a real traffic network. The findings indicated a major reduction in the travel time of the EV while minimizing the impact of preemption on the normal traffic. The proposed strategy and evaluation procedure can be helpful for corresponding agencies and practitioners to assess the impact of implementing preemption on existing or proposed arterials. - 2019, The Author(s).Open access funding provided by the Qatar National Library.Scopu