Early recurrent ischemic stroke complicating intravenous thrombolysis for stroke: incidence and association with atrial fibrillation

<p><b>Background and Purpose:</b> Mechanisms of early neurologic deterioration after treatment with intravenous, recombinant, tissue-type plasminogen activator (IV rt-PA) include symptomatic intracerebral hemorrhage (SICH) and early recurrent ischemic stroke. We observed a number of cases of acute deterioration due to recurrent ischemic events.</p> <p><b>Methods:</b> We undertook a single-center, retrospective analysis of consecutive acute stroke patients treated with IV rt-PA between January 2006 and December 2008 to define the incidence of early neurologic deterioration (>= 4-point drop on the National Institutes of Health Stroke Scale within 72 hours) and its mechanism. Deterioration was attributed to SICH when associated with a PH1 or PH2 hemorrhage on postdeterioration computed tomography scans, to recurrent ischemic stroke when there was clinical and radiologic evidence of a new territorial infarction or new vessel occlusion, and otherwise to evolution of the incident stroke.</p> <p><b>Results:</b> Of 228 consecutive IV rt-PA-treated patients, 34 (15%) developed early neurologic deterioration, 18 (8%) secondary to incident strokes 10 (4.4%) due to SICH, and 6 (2.6%) due to early recurrent ischemic events, which were significantly associated with atrial fibrillation (present in 5 of 6 patients; 4 paroxysmal, 1 permanent). In 4 patients, sudden clinical deterioration developed during or shortly after IV rt-PA infusion, and in 2, deterioration developed 3 days later. All died 2 days to 2 weeks later. The single case without atrial fibrillation had a recurrent, contralateral, middle cerebral artery stroke during IV rt-PA infusion and multiple high-signal emboli detected by transcranial Doppler. Early recurrent ischemic stroke accounted for 5 of 12 (42%) cases of early neurologic deterioration in patients with atrial fibrillation.</p> <p><b>Conclusion:</b> In this single-center series, the incidence of early recurrent ischemic stroke after IV rt-PA was 2.6% and was associated with previous atrial fibrillation.</p&gt

Mobile station movement direction prediction (MMDP) based handover scanning for mobile WiMAX system

Mobile WiMAX is a broadband technology that is capable of delivering triple play services (voice, data, and video). However, mobility in mobile WiMAX system is still an issue when the mobile station (MS) moves and its connection is handed over between base stations (BSs). In the handover process, scanning is one of the required phases to find the target BS. During the handover scanning process, the MS must synchronize with all the advertised neighbour BSs (nBSs) to select the best BS candidate for the incoming handover action. Without terminating the connection between the SBS and MS, the SBS will schedule the scanning intervals and sleep-intervals (also called interleaving interval) to MS for the handover scanning. However, during the scanning interval period, all the coming transmissions will be paused. Therefore, the redundant or unnecessary scanning of neighbouring BS cause delay and MAC overhead which may affect real-time applications. In this paper, the MS movement direction prediction (MMDP) based handover scanning scheme is introduced to overcome the mobile WiMAX handover scanning issue. It based on dividing the BS coverage area is into zones and sectors. According to the signal quality; there are three zones, no handover (No-HO), low handover (Low-HO) and high handover (High-HO) zones respectively and six sectors. In this scheme, only two BSs can become candidates; the two that the MS moves toward them will be chosen as the candidate for the handover scanning purpose. Hence, the handover scanning process repetition will be reduced with these two shortlisted BS candidates instead of scanning all nBSs. Thus, MMDP will reduce scanning delay and the number of exchange messages during the handover scanning comparing to the conventional scanning scheme. Although, the MMDP may need an extra computational time, the prediction and scanning process will be finished before the MS reach the High-HO zone, which mean the end-user’s running application will be affected. Simulation results show that the proposed MMDP scheme reduces the total handover scanning delay and scanning interval duration by 25 and 50 % respectively. Also, the size of scanning message is reduced, which leads to reduced signalling overhead

Expression of Pro Inflammatory Cytokines and Anti-Chlamydia Antibody in Bacterial Ocular Infection.

Current study was done to investigate the bacterial causes of eye infection for 130 patients with different ages in Babylon city , the study includes swab for eye and sample of blood. Bacteriological diagnostic  for eye swab which taken from different site include Conjunctivitis, Dacryocystitis, Lidinfection showed variation in types and number of isolates . Gram positive bacterial isolates include Staphylococcus aureus 67 (38.06%), Which represent the predominating bacteria, Staphylococcus epidermidis 18 (10.22%), While gram negative bacteria represent Escherichia coli 40 (22.7%), Neisseriae gonorrhoeae 5 (2.84%). Detection of Chlamydia trachomatis reveals only one positive case  out of 42 eye infected case for anti Chlamydia IgG –IgM ( 3.7 %), Immunological test of Cytokine IL-6 in patient show increased in their concentration compared with healthy at P< 0.05 reached 8.52 pg/ml especially at age group 41-50. IFN-? also show increased in their concentration in patient than controls although, there is no significant differences between patient and control groups. . Key words ; IFN gamma , IL-6 , eye infection , bacterial isolates ,Chlamydia trachomati

Effects of Waiting List on Treatments of ( RCT - Ortho - Surgery) in Qassim Area, Saudi Arabia

This study aimed at exploring the effects Waiting List on Treatments of (RCT - Ortho - Surgery) in Qassim Area, Saudi Arabia, as the researchers adopted the methodology of descriptive analytical statistics by conducting a questionnaire of three levels (Patients, Administrative employees and Doctors). The study sample consisted of (20) doctors, (30) administrative employees and (50) patients in four hospitals (King Fahad Specialist Hospital, Central Hospital, King Saud Hospital in Unayzah and Qassim Regional Dental Center ) in Qassim Area, Saudi Arabia. The results of the study showed that the paragraph stated (Itis overcrowding in the number of patients who visit the clinics) had the highest approval grades in the three levels of questionnaire (Patients, Administrative employees and Doctors). The study results also concluded that there is an effect of the Waiting List on Treatments of (RCT - Ortho - Surgery) in Qassim Area, Saudi Arabia upon the (doctors, patients and administrative employees) point of view. Keywords: Waiting List, Waiting Time, Treatments, Qassim Area

WAR THORACIC WOUNDS AMONG CIVILIANS CASUALTIES IN ADEN DURING THE 2015

ارتبطت إصابة الصدر أثناء الحرب بنسب حدوث عالية للمرضية و الوفيات. وفي زمن الحرب، حيث أصبحوا المدنيون هدفاً مباشر لها وتتسبّب في نصف إلى ثلثي الإصابات بينهم. ولذلك هدفنا إلى إبراز الأهمية الخاصة لإصابة الصدر من حيث مدى الحدوث والنمط ونتائج إدارة علاجها بين المدنيين أثناء الحرب في عدن. وهذه دراسة ذات منهج اسْتعادِيّ، استندت على استعادة بيانات لأحداث ماضية كَانتْ قَدْ سُجّلتْ وقت النظر في سير تطور حدوثها في السجل الطبّي. كَانتْ هناك 84 إصابة مُيّزتْ بين المدنيين أثناء فترة الدراسة. ومن تلك الإصابات، 97.6٪ كَانتْ ذكور و 2.4٪ كَانتْ إناث. متوسّط أعمارهم كَانَ9.8 ± 30.8 سنة ( بمدى يتراوح : 10 – 65 سنة) .و من تلك الإصابات، 73.8٪ كَانتْ ناتجة عن رصاص بندقية، بينما 26.2٪ إصابة كَانتْ ناشئة عن أسلحة متشظّية. دم الاسترواح الصّدري كَانَ أكثر أنماط الإصابة شيوعاً. إصابة البطن كَانتْ أكثر الإصابات المُصاحبة شيوعاً. تفْمِيم الصّدر بإدخال أنبوب كَانَ الإجراء العلاجي الوحيد ل 91.7٪ من الإصابات. شَقْ الصّدر الاستقصائي أُجْري ل 7.1٪ من الإصابات. نسبة المضاعفات كَانتْ54.8 ٪. عدوى الجرح كَانتْ أكثر المضاعفات شيوعاً. نسبة الوفيات كَانتْ 3.6٪. متوسّط البقاء في المستشفى كَانَ 5.9 ± 8.3 أيام. و اِستنتجنا بأنّ استفراغ الصّدر بإدخال أنبوب كَانَ الخيار الأفضل للمعالجة أغلبية جروح الصّدر المخترِقة (النافذة).Thoracic injury during warfare was associated with a high incidence of morbidity and mortality. In wartime, civilians have became a direct target and accounted for one-half to two-thirds of the casualties. We aimed to highlight the incidence and pattern of thoracic injury and its outcomes management among civilians during the war in Aden.  This retrospective study was based on the data were prospectively recorded in Medical Registry. There were 84 civilian casualties identified during the study period. Of those, 97.6% of casualties were males and 2.4% were females. The overall mean age was 30.8 ± 9.8 years (range: 10 – 65 years). Of those, 73.8% of casualties were produced by rifle bullets, while 26.2% of casualties were due to fragmentation weapons. Hemopneumothorax was the most common injury patterns. Abdomen injury was the most common associated injuries. Of those, 91.7% of casualties were treated with chest tube insertion alone. Thoracotomy was performed for 7.1% of casualties. The overall complications were 54.8%. Wound infection was the most frequent complications. The overall mortality rate was 3.6%. The overall mean hospital stay was 8.3 ± 5.9 days. We concluded that chest drain is best option for treatment the majority penetrating chest wounds

The effect of graphite and carbon black ratios on conductive ink performance

Conductive inks based on graphite and carbon black are used in a host of applications including energy storage, energy harvesting, electrochemical sensors and printed heaters. This requires accurate control of electrical properties tailored to the application; ink formulation is a fundamental element of this. Data on how formulation relates to properties have tended to apply to only single types of conductor at any time, with data on mixed types of carbon only empirical thus far. Therefore, screen printable carbon inks with differing graphite, carbon black and vinyl polymer content were formulated and printed to establish the effect on rheology, deposition and conductivity. The study found that at a higher total carbon loading ink of 29.4% by mass, optimal conductivity (0.029 Ω cm) was achieved at a graphite to carbon black ratio of 2.6 to 1. For a lower total carbon loading (21.7 mass %), this ratio was reduced to 1.8 to 1. Formulation affected viscosity and hence ink transfer and also surface roughness due to retention of features from the screen printing mesh and the inherent roughness of the carbon components, as well as the ability of features to be reproduced consistently

The reality of using smartphone applications for learning in higher education of Saudi Arabia

The smartphone has emerged as one of the most important educational tools in today's digital era due to its ability to facilitate access to learning materials without the traditional time and locational limitations. Smartphones and their associated applications also have the potential advantages of enhancing communication between learners and educators as well as simplifying the research process. However, there have been concerns over the extent to which college and university students use smartphone apps for educational rather than non-educational purposes. Moreover, there are concerns over the real usefulness of smartphone devices in the learning process. Therefore, this study focused on the perceptions of students and their faculty staff concerning the reality of smartphone apps usage and their value regarding the learning process and collegiality in the context of higher education in Saudi Arabia. The study also sought to determine the major challenges that students and faculty members face in the use of smartphone apps for educational purposes within a particular e-learning environment that using the Blackboard system and associated resources. In order to study the usage of smartphone apps in Saudi Arabia’s higher education sector, this study adopted a mixed methods research approach within a case study university; the Saudi Electronic University. Quantitative research was conducted involving a survey of 324 students from the Saudi Electronic University (SEU) using self-administered questionnaires that assessed the patterns of smartphone apps usage. In addition, a qualitative study was conducted using semi-structured interviews with 13 faculty members. Survey data was subjected to statistical analysis while interview data was analyzed using thematic content analysis. The findings of this study reveal that smartphone apps are extensively used for learning purposes as part of a wider e-learning environment in the Saudi Electronic University in Saudi Arabia. It emerged that 70% of all learning is delivered through digital platforms while 30% of learning takes place through face-to-face interactions. Most faculty members in the case study agreed on the usefulness of integrating smartphones in the learning process. In this context, faculty members believed that the use of smartphone apps in education is a necessity today. Furthermore, smartphone apps were viewed as being useful in enhancing skills of learners and faculty members as well as promoting communication between educational stakeholders. From the students’ perspectives, the findings of this study revealed a positive engagement with smartphone apps for educational purposes. Most students used smartphone apps to check their emails (73.5%), the students were browsing the internet for learning purposes (59.3%), communicate with other learners and instructors (53.1%, access learning materials (37.3%), and engage in general learning activities (35.5%). The study showed a wide acceptance of mobile learning and positive perceptions on the usefulness of smartphone apps in learning. However, there was variation in students’ views and understanding among students about the role of smartphone apps for certain learning purposes. Factors that were seen to influence the students’ attitudes towards smartphone apps usage for learning included class standing, age, and brand of smartphones, mobile operator (P<0.05). The qualitative findings highlighted that the use of smartphone apps as part of a broader mobile learning environment contributed to online communities of practice involving staff and students. Finally, the findings of this study revealed that students and faculty members experience several major challenges in the use of smartphone apps in learning. These include slow internet connections, incompatibility with certain devices, small screen sizes of the smartphones, low battery life, high costs, technical failures on the university learning app, and distractions on students’ attention, among others. Therefore, the findings of this study suggest a need for Saudi higher education institutions to reflect on the practical and technical challenges affecting mobile learning platforms that can inhibit the use of smartphone apps in the mobile learning environment and students’ awareness of the benefits of mobile learning. In addition to revealing the areas of potential improvement for optimization of mobile learning in Saudi Arabia, the present study also makes important contributions to the theoretical and conceptual understanding of aspects of e-learning using the Saudi context as a focus for the study. The study findings revealed that the Technology Acceptance Model (TAM) as well as the situative and cognitive learning theories are useful models to help explain the behavioural intentions and processes of technology use among students and faculty members in the Saudi higher education sector. Based on the study findings, and in line with the TAM theory, it may be concluded that perceived usefulness and perceived ease of use of the technology have a strong influence on the learners’ evaluation of the appropriateness of e-learning systems in Saudi Arabia. While the Technology Acceptance Model highlights the importance of physical aspects of e-learning technology, the Cognitive and Associative theories are also helpful in understanding the social processes involved in this context and the role of online communities, respectively for higher education learners in Saudi Arabia

Genetic Study of TORCH Infections in Women with Bad Obstetric History: Multiplex Polymerase Chain Reaction for Detection of Common Pathogens and Agents of Congenital Infections

To revealed the incidence of TORCH infections among pregnancy wastage in women which had bad obstetric history (BOH). METHODS: The study included 132 women with bad obstetric history. Genetic evaluation for TORCH infections was carried out by specific primers designed for that purpose using PCR method. RESULT: Toxoplasma was 36.36%, rubella 20.45%, cytomegalovirus 29.55% and herpes simplex virus 13.64%. Maximum number of cases of abortion 52 (39.39%), preterm labor 29 (21.96%) was associated with toxoplasma infection, early neonatal deaths 19 (14.39%) were maximally associated with toxoplasma and CMV infections. while congenital malformations 14 (10.6%) were evident maximally with toxoplasma infection and intrauterine death 8 (6.06%). CONCLUSIONS: Women with BOH are significantly higher in infection compared with that in control. A previous history of pregnancy wastage, genetic infestation using specific primers for TORCH agent’s detection and the serological reaction for TORCH infections during current pregnancy must be considered while managing BOH cases so as to reduce the adverse fetal outcome