RELAPSE OF GUILLAIN-BARRE SYNDROME AFTER SPINAL ANESTHESIA: A CASE REPORT

Guillain-Barre Syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy characterized by progressive symmetric ascending muscle weakness, paralysis and hyporeflexia with or without sensory or autonomic symptoms. It is most commonly caused by an autoimmune response of the body to an infectious agent like Campylobacter jejuni. It is less common during pregnancy but it may relapse during postpartum period. Cases of GBS have been reported after Spinal, epidural and general anesthesia. Here we report a case of 28year old female patient who had relapse of GBS after undergoing emergency laparotomy for ruptured ectopic pregnancy. In this case report, we are presenting an unusual case of GBS relapsing 4 years after initial episode following spinal anesthesia.KEYWORDS: Guillain-Barre Syndrome; Campylobacter jejuni; Postpartum period

RELAPSE OF GUILLAIN-BARRE SYNDROME AFTER SPINAL ANESTHESIA: A CASE REPORT

Guillain-Barre Syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy characterized by progressive symmetric ascending muscle weakness, paralysis and hyporeflexia with or without sensory or autonomic symptoms. It is most commonly caused by an autoimmune response of the body to an infectious agent like Campylobacter jejuni. It is less common during pregnancy but it may relapse during postpartum period. Cases of GBS have been reported after Spinal, epidural and general anesthesia. Here we report a case of 28year old female patient who had relapse of GBS after undergoing emergency laparotomy for ruptured ectopic pregnancy. In this case report, we are presenting an unusual case of GBS relapsing 4 years after initial episode following spinal anesthesia.KEYWORDS: Guillain-Barre Syndrome; Campylobacter jejuni; Postpartum period

Semen Quality Characteristics of Dairy Goats

Semen was collected, processed, and frozen from five dairy bucks for 2 successive yr for use in quality classification and evaluation for inclusion in artificial insemination programs. Semen was evaluated for volume, initial, postthaw and 37°C incubated percent progressive motility, percent postthaw 3-h 37°C incubated intact acrosomes, autoagglurination, whey-induced agglutination, and percent primary, secondary, and tertiary abnormalities. Significant high correlations were found between: percent progressive motility and percent intact acrosomes, percent intact acrosomes and percent autoagglutination, and percent autoagglutination and percent whey agglutination. Means of the postthaw quality parameters, percent progressive motility, precent intact acrosomes, and percent primary and secondary abnormalities were used to categorize ejaculates within each incubation time (0 and 2 h). At 0 h, 25 ejaculates were classified as high quality and 11 were low quality. Using 2-h data, 19 ejaculates were classified as high quality and 17 as low. Inclusion of both agglutination parameters in the 2-h data analysis resulted in 13 ejaculates categorized as high and 23 as low quality. Based on assessment with techniques used in bovine artificial insemination programs, semen quality of goat semen could be used to discriminate between acceptable or unacceptable ejaculates. Based on recommended sperm numbers per inseminate and average ejaculate characteristics the low number of marketable units per ejaculate would make incorporation of goats into existing artificial insemination programs prohibitive. © 1988, American Dairy Science Association. All rights reserved

Five-year publication rate of clinical presentations at the open and closed American shoulder and elbow surgeons annual meeting from 2005–2010

© 2016, The Author(s). Background: The purpose of this study was to evaluate the five-year publication rate of papers presented at both the open and closed American Shoulder and Elbow Surgeons’ (ASES) annual meetings from 2005 to 2010. Methods: Online abstracts of the presentations at the open and closed ASES annual meetings were independently screened for clinical studies and graded for quality using level of evidence. The databases PubMed (MEDLINE), Ovid (MEDLINE), and EMBASE were comprehensively searched for full-text publications corresponding to these presentations and any paper published within five years of the presentation date was counted. Results: Overall, 131/266 papers corresponding to the meeting presentations were identified for a five-year publication rate of 49.2 %. Sixty two (48 %) of the papers were published in The Journal of Shoulder and Elbow Surgeons, 23 (18 %) were published in The American Journal of Sports Medicine, and 20 (16 %) were published in The Journal of Bone and Joint Surgery. The mean patient sample size included in presentations with a subsequent full-text publication was higher (154; standard error =27) than the presentations not published (93; standard error = 13) (p = 0.039). There was no correlation (p = 0.248) between the publication rate and the level of evidence of the presentations. Conclusions: The publication rate of presentations at ASES meetings from 2005 to 2010 is similar to that reported from other orthopaedic meetings. Studies with large sample sizes should continue to be encouraged, and high quality presentations must consistently be followed up with full-text manuscript preparation in order to maximize the future clinical impact

An Optimized Concurrent Proof of Authority Consensus Protocol

Security and reliability in Blockchain software systems is a major challenge in Blockchain Oriented Software Engineering. One of the most critical components to address at the architectural level is the consensus protocol, as it serves as the mechanism for accepting valid transactions and incorporating them into the ledger history. Given that this process is executed by specific blockchain nodes, it is crucial to consider them as a key point of focus for ensuring the integrity of the entire blockchain history. This paper addresses the major challenge of security and reliability in Blockchain software systems by proposing a new protocol for Permissioned Concurrent Proof of Authority (CPoA). This protocol involves selecting a group of nodes as authority nodes, responsible for validating new identities, blocks, and transactions. The protocol is integrated with a framework that subjects validators to a unique eligibility criterion and a combination of reputation, security score, online aging, and general performance indicators related to node reliability, significantly reducing the risk of validator misbehavior and enhancing security, reliability and confidentiality of the entire blockchain compared to other existing approaches

Koliko su studenti više medicinske škole u Bitoli upoznati s problemom infekcije HCV-om

Healthcare workers are at risk of occupationally-acquired viral infections such as human immunodefi ciency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV). HCV is parenterally transmitted and has been found in every part of the world. This cross-sectional study was conducted to establish the awareness and attitude about HCV infections among 210 full-time and part-time nursing students of the Medical College in Bitola, Macedonia ‘from May to June 2009. For this purpose we used a self-administered questionnaire which consisted of three parts. The fi rst included demographic data, the second included questions about causes of infection, mode of transmission, symptoms, acute and chronic hepatitis, and prevention, and the third questions about students’ attitude toward patients with suspect or confi rmed HCV infection. Full-time students showed higher HCV awareness (84 %) than part-time students (69 %). 58 % of the full-time and 79 % of the part-time students said they would not avoid professional contact with suspect or HCV infected patients. Our study has shown that even though both groups of students have a suffi cient knowledge about HCV to face future challenges, they need further education on the subject. Practical recommendations would help to reduce stigmatising behaviour still further.Zdravstveni su radnici izloženi profesionalnomu riziku od infekcije virusom humane imunodefi cijencije (HIV-om), hepatitis B virusom (HBV-om) te hepatitis C virusom (HCV-om). HCV se prenosi parenteralno i ima ga posvuda u svijetu. Ovo smo presječno ispitivanje proveli da utvrdimo koliko su studenti za medicinske tehničare i sestre upoznati s infekcijom HCV-om i saznamo njihove stavove o tome. Ispitivanje je obuhvatilo 210 redovitih i izvanrednih studenata Visoke medicinske škole u Bitoli i trajalo je od svibnja do lipnja 2009. Za ispitivanje je rabljen opširan upitnik. Odgovori su pokazali da redoviti studenti imaju bolji uvid u predmet (s 84 % točnih odgovora) od izvanrednih studenata (69 %). U pogledu stava prema pacijentima 58 % redovitih i 79 % izvanrednih studenata ne izbjegava dodir s pacijentima koji su infi cirani HCV-om. Ispitivanje je pokazalo da su studenti iz obje skupine dovoljno upoznati s infekcijom HCV-om, rizičnim čimbenicima i načinom prijenosa, ali je potrebno to znanje nadograditi

A lesson on interrogations from detainees: Predicting self-reported confessions and cooperation

The ability to predict confessions and cooperation from the elements of an interrogation was examined. Incarcerated men (N = 100) completed a 50-item questionnaire about their most recent police interrogation, and regression analyses were performed on self-reported decisions to confess and cooperate. Results showed that the likelihood of an interrogation resulting in a confession was greatest when evidence strength and score on a humanitarian interviewing scale were high, and when the detainee had few previous convictions or did not seek legal advice. We also found that the level of cooperation was greatest when the humanitarian interviewing score was high, and when previous convictions were low. The implications of the findings for interrogation practices are discussed

Hierarchy measure for complex networks

Nature, technology and society are full of complexity arising from the intricate web of the interactions among the units of the related systems (e.g., proteins, computers, people). Consequently, one of the most successful recent approaches to capturing the fundamental features of the structure and dynamics of complex systems has been the investigation of the networks associated with the above units (nodes) together with their relations (edges). Most complex systems have an inherently hierarchical organization and, correspondingly, the networks behind them also exhibit hierarchical features. Indeed, several papers have been devoted to describing this essential aspect of networks, however, without resulting in a widely accepted, converging concept concerning the quantitative characterization of the level of their hierarchy. Here we develop an approach and propose a quantity (measure) which is simple enough to be widely applicable, reveals a number of universal features of the organization of real-world networks and, as we demonstrate, is capable of capturing the essential features of the structure and the degree of hierarchy in a complex network. The measure we introduce is based on a generalization of the m-reach centrality, which we first extend to directed/partially directed graphs. Then, we define the global reaching centrality (GRC), which is the difference between the maximum and the average value of the generalized reach centralities over the network. We investigate the behavior of the GRC considering both a synthetic model with an adjustable level of hierarchy and real networks. Results for real networks show that our hierarchy measure is related to the controllability of the given system. We also propose a visualization procedure for large complex networks that can be used to obtain an overall qualitative picture about the nature of their hierarchical structure.Comment: 29 pages, 9 figures, 4 table