Negative pressure pulmonary oedema: A rare case report of two brothers

Negative Pressure Pulmonary O/Edema (NPPE) is potentially life-threatening and it is a general anaesthesia side effect. We are mentioning a rare case report of two brothers who were referred to our hospital for elective surgeries (varicocele and septoplasty) in a 3 years period. Both of them were athletes and their coagulation factors were disturbed after surgeries. Pulmonary oedema was healed after treating it by reintubation, mechanical ventilation by Positive End-Expiratory Pressure (PEEP), diuretics, morphine, Fresh Frozen Plasma (FFP) and liquid bounding

Change in bone mineral density in post menopausal women with rheumatoid arthritis

Introduction: Low bone mass is a serious complication of post menopausal women with rheumatoid arthritis. We determined the Change in Bone Mineral Density in postmenopausal women with rheumatoid arthritis. Methods: This retrospective cohort study was carried out on consecutive postmenopausal women with rheumatoid arthritis who were referred to the Azar 5th teaching hospital affiliated to Golestan University of Medical Sciences, North of Iran in 2009. The required data were gathered from the patients' medical records. The data were analyzed using SPSS software and statistical tests. Results: We studied 98 postmenopausal women with rheumatoid arthritis. Mean number of years since menopause and mean duration of disease were 9.39 and 5.13 respectively. T Score mean in femoral neck and lumbar spines was -1.45±1.26 and -2.45±1.44 respectively. The overall prevalence of osteoporosis at both the lumbar spine and femoral neck was 13.3. We have found a significant correlation between age, duration of disease, duration of menopause and bone mineral density (P-Value<0.01). Conlusion: Our results indicate a negative effect of age, number of years since menopause and duration of disease on bone mineral density. So, BMD should be measured in high risk women prior to the implementation of any treatment or prevention program

Hospital trainees' worries, perceived sufficiency of information and reported psychological health during the COVID-19 pandemic

INTRODUCTION: The COVID-19 pandemic has been unsurpassed in clinical severity or infectivity since the 1918 Spanish influenza pandemic and continues to impact the world. During the A/H1N1 pandemic, healthcare workers presented concerns regarding their own and their families' health, as well as high levels of psychological distress. We aim to assess hospital trainees' concerns, perceived sufficiency of information, behaviour and reported psychological health during the COVID-19 pandemic. DESIGN: Single 39-point questionnaire. SETTING: A large NHS foundation trust in London. PARTICIPANTS: 204 hospital trainee doctors. RESULTS: 204 trainees participated, of whom 91.7% (n=187) looked after COVID-19 patients. 91.6% (n=164) were worried about COVID-19; the most frequent concern was that of family and friends dying from COVID-19 (74.6%, n=126). 22.2% (n=36) reported being infected with COVID-19. 6.8% (n=11) of trainees considered avoiding going to work. Perceived sufficiency of information about COVID-19 was moderately high. 25.9% (n=42) reported social distancing at work compared with 94.4% (n=152) outside work. 98.2% (n=159) reported using PPE and 24.7% (n=40) were confident the provided PPE protected them. 41.9% (n=67) reported their psychological health had been adversely affected. 95.6% (n=153) supported provision of psychological support services and 62.5% (n=100) stated they would consider using them. CONCLUSIONS: A significant proportion of hospital trainees expressed worries about COVID-19, above all with regards to the wellbeing of their loved ones over their own. Confidence in sufficiency of provided information was high and in utilised infection control measures low. A larger proportion of trainees reported psychological as compared with physical health concerns, with a smaller proportion confirming having been infected with COVID-19 although most perceived their risk of infection as high. Seeking solutions to support hospital trainees in their duties and their wellbeing with their input would help to empower them and improve their health and morale while working during pandemics

The effect of dietary nucleotide on the haematological and serum biochemical parameters of Persian sturgeon (Acipenser persicus) juveniles

This study was aimed to examine the impact of different levels of dietary nucleotides (Vannagen) on serum biochemical and blood parameters of Persian sturgeon (Acipenser persicus). Fish (42.37± 2.12 g and 23.67± 0.61 cm) were divided into four treatments with different levels of dietary nucleotides (0, 0.25, 0.35 and 0.5 percent of diet). There were three replicates with a density of 12 fish per tank. After 10 weeks of feeding, serum biochemical and blood parameters were measured. Among the measured factors, blood glucose, triglycerides, cholesterol, erythrocyte and heterophil showed significant differences between the groups fed with nucleotides and the control group (P ≤ 0.05). By increasing the nucleotide levels, the mean heterophil and serum glucose showed significant increase and decrease, respectively. The highest and lowest values of cholesterol and triglyceride were found in groups fed with 0.25% and 0.35% nucleotides, respectively. The other measured factors had no significant difference (P≤0.05). Therefore, it could be said that with regard to the limited capacity of cells to synthesize nucleotides, external preparing of nucleotides could result in the production of needed nucleotides and an increase of its production speed, especially during stress. Such preparation can also improve fish physiology and health status

The patient safety practices of emergency medical teams in disaster zones: a systematic analysis

Introduction: Disaster zone medical relief has been criticised for poor quality care, lack of standardisation and accountability. Traditional patient safety practices of Emergency Medical Teams (EMT) in disaster zones were not well understood. Improving the quality of healthcare in disaster zones has gained importance within global health policy. Ascertaining patient safety practices of EMTs in disaster zones may identify areas of practice that can be improved. Methods: A systematic search of OvidSP, Embase and Medline databases, key journals of interest, key grey-literature texts, the databases of the World Health Organisation (WHO), Médecins Sans Frontieres (MSF) and the International Committee of the Red Cross (ICRC), and Google Scholar were performed. Descriptive studies, case reports, case series, prospective trials and opinion pieces were included with no limitation on date or language of publication. Results: There were 9,685 records, evenly distributed between the peer-reviewed and grey literature. Of these, 30 studies and 9 grey literature texts met the inclusion criteria and underwent qualitative synthesis. From these articles, 302 patient safety statements were extracted. Thematic analysis categorised these statements into 84 themes (total frequency 632). The most frequent themes were limb injury (9%), medical records (5.4%), surgery decision making (4.6%), medicines safety (4.4%) and protocol (4.4%) Conclusion: Patient safety practices of EMTs in disaster zones are weighted towards acute clinical care, particularly surgery. The management of Non-Communicable Disease (NCD) is underrepresented. There is widespread recognition of the need to improve medical record keeping. High-quality data and institutional level patient safety practices are lacking. There is no consensus on disaster zone specific performance indicators. These deficiencies represent opportunities to improve patient safety in disaster zones

Risk assessment of drug management process in women surgery department of qaem educational hospital (QEH) using HFMEA method (2013)

Evaluation and improvement of drug management process are essential for patient safety. The present study was performed whit the aim of assessing risk of drug management process in Women Surgery Department of QEH using HFMEA method in 2013. A mixed method was used to analyze failure modes and their effects with HFMEA. To classify failure modes; nursing errors in clinical management model, for classifying factors affecting error; approved model by the UK National Health System, and for determining solutions for improvement; Theory of Inventive Problem Solving, were used. 48 failure modes were identified for 14 sub-process of five steps drug management process. The frequency of failure modes were as follow:35.3 in supplying step, 20.75 in prescription step, 10.4 in preparing step, 22.9 in distribution step and 10.35 in follow up and monitoring step. Seventeen failure modes (35.14) were considered as non-acceptable risk (hazard score� 8) and were transferred to decision tree. Among 51 Influencing factors, the most common reasons for error were related to environmental factors (21.5), and the less common reasons for error were related to patient factors (4.3). HFMEA is a useful tool to evaluating, prioritization and analyzing failure modes in drug management process. Revision drug management process based focus-PDCA, assessing adverse drug reactions (ADR), USE patient identification bracelet, holding periodical pharmaceutical conferences to improve personnel knowledge, patient contribution in drug therapy; are performance solutions which were placed in work order. © 2015 by School of Pharmac

Design and evaluation of oral nanoemulsion drug delivery system of mebudipine

A nanoemulsion drug delivery system was developed to increase the oral bioavailability of mebudipine as a calcium channel blocker with very low bioavailability profile. The impact of nano-formulation on the pharmacokinetic parameters of mebudipine in rats was investigated. Nanoemulsion formulations containing ethyl oleate, Tween 80, Span 80, polyethylene glycol 400, ethanol and deionized water were prepared using probe sonicator. The optimum formulation was evaluated for physicochemical properties, such as particle size, morphology and stability. The particle size of optimum formulation was 22.8 ± 4.0 nm. Based on the results of this study, the relative bioavailability of mebudipine nanoemulsion was enhanced by about 2.6-, 2.0- and 1.9-fold, respectively, compared with suspension, ethyl oleate solution and micellar solution. In conclusion, nanoemulsion is an interesting option for the delivery of poorly water soluble molecules, such as mebudipine. © 2015 Informa UK Limited, trading as Taylor & Francis Group

Optimal generation of Fock states in a weakly nonlinear oscillator

We apply optimal control theory to determine the shortest time in which an energy eigenstate of a weakly anharmonic oscillator can be created under the practical constraint of linear driving. We show that the optimal pulses are beatings of mostly the transition frequencies for the transitions up to the desired state and the next leakage level. The time of a shortest possible pulse for a given nonlinearity scale with the nonlinearity parameter delta as a power law of alpha with alpha=-0.73 +/-0.029. This is a qualitative improvement relative to the value alpha=1 suggested by a simple Landau-Zener argument.Comment: 10 pages, 6 figure

Comparison effect of oral propranolol and oxytocin versus oxytocin only on induction of labour in nulliparous women (a double blind randomized trial)

BACKGROUND AND AIM: Today, research on new methods for preventing caesarean sections owing to labour induction, have been requested in obstetric practice, because of the increased morbidity related to caesarean section. Therefore, the aim of this study was to compare the effect of Oral Propranolol and Oxytocin versus Oxytocin only on induction of labour in nulliparous women. MATERIAL AND METHODS: A double blind randomized controlled trial was performed at the Ilam Mostafa Hospital, Ilam, Iran, from March 2010 to March 2011 on 146 nulliparous pregnant women who had gestational age of 40-42 weeks of pregnancy and a Bishop score of .05) DISCUSSION AND CONCLUSION: Our study showed that oral Propranolol was effective for labour induction and that it could decrease the frequency of caesarean deliveries without producing any adverse effects on mothers or neonates

Genetic and epigenetic contribution to astrocytic gliomas pathogenesis

Astrocytic gliomas are the most common and lethal form of intracranial tumors. These tumors are characterized by a significant heterogeneity in terms of cytopathological, transcriptional, and (epi)genomic features. This heterogeneity has made these cancers one of the most challenging types of cancers to study and treat. To uncover these complexities and to have better understanding of the disease initiation and progression, identification, and characterization of underlying cellular and molecular pathways related to (epi)genetics of astrocytic gliomas is crucial. Here, we discuss and summarize molecular and (epi)genetic mechanisms that provide clues as to the pathogenesis of astrocytic gliomas. (Figure presented.). © 2018 International Society for Neurochemistr