Evaluation of medical consultation letters at King Fahd Hospital, Al Hufuf, Saudi Arabia

Background: In surgical wards, it is of paramount importance to communicate with other health care providers, mostly physicians, referring patients to them for their consultation on any health conditions that affect pre-operative, operative and post-operative patient care. The purposes of this investigation were to assess the appropriateness of physician responses in medical consultation reports and compare physician responses when using these reports from different levels of health care providers. Methods: This study was conducted in Al-Hufuf, Saudi Arabia. The researchers evaluated all the surgical consultation letters in the files during the period be¬tween March 2010 and March 2011. From the explored 234 files, only 200 consultation letters were chosen as there was a referral data plus consultation data in the same file. We evaluated the quality of consultation report included the ethical concerns towards colleagues and patient, consideration of patient safety in all opinions, comprehensive pertinent scientific information, addressing the patient’s medical condition with putting possible differential diagnosis, conclusion and precise management plans suggested. Results: The results showed that the specialists' consultation letters had the highest percentage of fulfillment of all the six items in the consultation report. There is no uniform existing consultation report form. Conclusion:  Specialist form showed the highest number of mentioning the diagnosis. Consultant form showed the highest number of mentioning the concise aim of referral. The highest percentage of all categories mentioned all items in consultation report with a good level were the specialists. Pan African Medical Journal 2012; 12:5

Treatment of Multiple Common Warts by Intralesional Immunotherapy: Review Article

Background: Human papillomavirus (HPV) is the most prevalent cause of warts on the skin and mucous membranes of the human body. With the aid of a variety of destructive and immunotherapeutic methods, wart therapy remains a major difficulty. Antigen immunotherapy by intralesional technique uses the immune system's ability to recognize viral, bacterial, and fungal antigens that elicit a delayed-type hypersensitivity reaction, not only to the antigen but also to the wart virus, which in turn boosts the immune system's ability to recognize and remove HPV. All lesions on the body, not just the injected one, could be destroyed by this boosted immune response. Different antigens, including Candida and pure protein derivative (PPD), have been shown to be useful in the treatment of various wart forms. Objective: Intralesional immunotherapy for numerous common warts is to be evaluated for its effectiveness. Conclusion: There has been substantial research into the use of intralesional vaccinations and organic antigens to treat warts, with good results of effectiveness

Antisynthetase Syndrome Complicating the Course of Established Case with Rheumatoid Arthritis:A Rare and Under-recognized Overlapping Disease

A 52-year-old male patient developed RA in March 2009 at the age of 43, with symmetric polyarthritis and active synovitis affecting hands, knees, ankles and both feet without symptoms or signs suggestive of extra-articular features. Laboratory investigations showed negative RF and positive anti-CCP antibodies, negative ANA, negative anti-dsDNA antibodies; the X-rays of both hands showed typical erosive changes in RA and fulfilled the new ACR/EULAR (2010) criteria of RA. The patient achieved remission on a combination of DMARDs. He did well until January 2017 when he developed acute onset of progressive chest pain, dyspnea, and acute respiratory failure. High-resolution CT of the lung showed extensive areas of ground glass veiling, and interstitial subpleural infiltrates were found consistent with aggressive interstitial lung disease (ILD). Autoantibodies against extractable nuclear antigens were screened and showed positive results for anti-RO and anti-Jo1 autoantibodies. The positive anti-Jo1was an expression of anti-synthetase syndrome complicating the RA course and explained the rapidly aggressive course of ILD

VLSI IMPLEMENTATON OF RESIDUE NUMBER SYSTEM ARCHITECTURES.

This work is an investigation into the use of Residue Number System (RNS) architectures in the Very Large Scale Integration (VLSI) medium. The work proposes RNS models, design methods, and system architectures for Digital Signal Processing (DSP) applications. A new look-up table layout model is developed, which is valid for any modulus. It is used to estimate both area and time required for implementing modulo look-up tables. Using the model, a look-up table layout procedure is developed to select the most efficient layout according to the design requirements. A new abstract model, devoted to RNS systems, is shown to provide asymptotic bounds for large moduli systems. A new set of building block modules are proposed, they are based on storing several independent look-up tables in the same chip with appropriate interconnections. Several procedures have been developed to optimize the layout of these modules. A binary adder design method is given to support RNS modules based on a binary adder. Two new structures for implementing FIR digital filters have been described; both structures employ systolic arrays. The first structure is based on the look-up table approach, while the second combines both look-up tables and combinatorial elements. The second structure is efficient for large moduli and large set of data. Both highly modular structures employ pipelining in order to maximize the throughput rate. Source: Dissertation Abstracts International, Volume: 46-08, Section: B, page: 2751. Thesis (Ph.D.)--University of Windsor (Canada), 1985

La narrativa a través de los ojos infantiles en El niño que enloqueció de amor (1915) de Eduardo Barrios.

El niño que enloqueció de amor es una novela psicológica y compleja, en la que nos relata la historia de un niño que se enamora de la amiga de su madre. Es una historia que se refleja por la tristeza, por el amor, por la ansiedad. El niño está encerrado en un espacio íntimo que se recoge en un diario. Es la escritura en donde se plasman los sentimientos que de otra forma habrían quedado difuminados por el olvido. La narración pone en relieve la voz de infancia en el discurso, por eso se vuelve complicado. De allí, el tema de la representación de la voz de infancia me lleva a cuestionar por las estrategias que el autor utiliza en la novela y cómo se refleja el mundo por la perspectiva del niño

Microalbuminuria as a Predictor of Outcome in Non-Diabetic Patients Undergo Percutaneous Coronary Intervention for Acute Coronary Syndrome

Background: Acute coronary syndrome (ACS) is a medical emergency requiring prompt diagnosis and care. Percutaneous coronary intervention (PCI) has become integral part of management of coronary artery disease (CAD) and become lifesaving in acute STEMI patients. Microalbuminuria (MA) is a common phenomenon in patients with cardiovascular disease. Objective: To assess importance of microalbuminuria as a predictor of outcome in non-diabetic patients undergoing PCI for ACS. Subjects and methods: This study was conducted on 123 patients admitted with ACS and were divided equally into three groups [unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI) andSTEMI). The patients were then divided into patients with negative and positive microalbuminuria (MA). Echocardiography, coronary angiography and estimation of microalbuminuria level were done to all patients. Results: Mean age of patients 54.94 ± 9.86 years. There were 28 females (22.8%) and 95 males (77.2%). MA was more common in smokers than non-smokers were. There was statistically significant decrease in EF% and increase in WMSI in patients with positive MA than those with negative MA. There was statistically significant increase in the complications and mortality rate in patients with positive MA than those with negative MA. The univariate logistic regression analysis showed statistically significant association between presence of MA and wall motion score index (WMSI) >1.25, amount of dye > 160 ml, no reflow, occurrence of complications, EF pre ≤ 55%, and EF post ≤ 59%. Conclusion: Albuminuria was a strong predictor of outcome in non-diabetic patients underwent PCI for ACS

Bioconversion of plant wastes to β-carotene by Rhodotorula glutinis KU550702

Microbial synthesis of β-carotene has gained more interest as an alternative to synthetic β-carotene due to easy extraction and high yield. The vitamin microbial production is mainly dependent on culture conditions and the medium compositions. In this study, the β-carotene production by the Rhodo-torula glutinis ASU6 (KU550702) was evaluated under different growth conditions and nutrient composition. Different agro-renewable wastes were tested as carbon source for R. glutinis to obtain maximum amount of β-carotene. Meanwhile, it is clear that R. glutinis could grow well on acid extract of onion peels and produced large amount of β-carotene. Initial statistical screening using a Plackett-Burman design showed temperature, incubation time, fermentation type, non-treated onion waste, KH2PO4 and L-asparagine as significantly, influencing β-carotene production. Response surface methodology was applied to determine the mutual interactions between these parameters and optimal levels for β-carotene production. The maximum value of β-carotene production was 204.29 mg/l (7.5-fold) of value observed as central point of the central composite design. All the experimental data are in good agreement with predicted ones, confirming the responsibility of the proposed empirical model in describing β-carotene production by R. glutinis. In the whole, the outcomes of this study support the exploitation of onion peels through microbial fermentation for β-carotene production