Systemic Arterial-to-Pulmonary Artery Shunt Utilization

Background: Congenital heart disease (CHD) is a significant cause of childhood morbidity and mortality worldwide. Treatment often involves systemic arterial-to-pulmonary artery shunts (SAPAS); local data is sparse. Methods: A retrospective study was carried out at the Kenyatta National Hospital in Nairobi (Kenya) between January 1st 2006 and December the 31st 2012. All patients who received a SAPAS at the institution during the study period were included. Results: Twenty-four SAPAS were performed on 22 patients. Ten of 24 SAPAS’s (41.7%) were central shunts and 14 of 24 SAPAS’s (58.3%) were modified Blalock-Taussig shunts. The median age and median weight were 20 months (range 3-120) and 11.6 kilograms (range 4.7-23) respectively. The median pre-operative and post-operative arterial oxygen saturations were 68% (range:29-92) and 89% (range 52-100) respectively. Postoperative heparin was used in 4 of 23 shunt procedures (17.4%). The in-hospital operative mortality was 25%. Median length of post-operative follow-up was 1 year; 95% were lost to follow-up. Four out of 22 patients (18.2%) had a subsequent definitive palliative procedure. Conclusion: The utilization of SAPAS’s is not optimal; this may be related to the poor post-operative follow up of our patients. Further study is required to determine the reasons for poor follow-up.Key words: Blalock Taussig, Shun

Utility of the Bidirectional Glenn Shunt

Background: Congenital heart disease (CHD) is a significant cause of childhood morbidity and mortality worldwide. Bidirectional Glenn Shunts (BDGS) form part of the surgical strategy used to treat CHD; no data exists on BDGS usage in the study locality.Methods: A 7-year retrospective, descriptive study was carried out at the Kenyatta National Hospital in Nairobi, Kenya, between 1 January 2006 and 31 December 2012.Results: Eleven BDGS were performed on 11 patients; 63.6% had tricuspid atresia, 27.3% had double outlet right ventricle and 9.1% had pulmonary atresia with intact ventricular septum.Conclusion: Further studies are warranted to identify factors contributing to the late performance of BDGS, poor post-operative follow-up and failure to perform FC.Keywords: Cavopulmonary, Glenn, Shunt, Bidirectiona

DISTRIBUTION AND RISK FACTORS FOR GIARDIA LAMBLIA AMONG CHILDREN AT AMRAN GOVERNORATE, YEMEN

Objective: The widespread prevalence of Giardiasis is a public health problem worldwide, and it is also common among Yemeni children. Hence, this work aims to identify the prevalent Giardia lamblia infection and risk factors among children admitted to health care centers in Amran governorate in Yemen. Methods: Three hundred and thirty-four stool samples were collected from infected children between March and July 2019 and the parasite is identified by light-microscope according to standard parasitology methods. Also, relevant data was obtained using a designed questionnaire. Results: The results showed that 181 cases (54.2%) were infected with G. lamblia infection. 57.5% of the infected children were from urban areas, while 42.5% of the cases were from rural areas. The highest incidence of G. lamblia was 60.3% among males compared to 47.5% among females. The results for age, residents and male children aged 8-14 years in both urban and rural areas recorded the highest prevalence of G. lamblia infection while the lowest was among females between 1 and 7 years and 8-14 years old, respectively, in the rural and urban area. Conclusion: In conclusion, as described in this work, multisectoral efforts are needed that include hygiene practices, personal hygiene habits, the provision of safe drinking water and the provision of sanitation systems to efficiently reduce this infection from all governorates of Yemen.                                           Peer Review History: Received 22 May 2020; Revised 14 June; Accepted 3 July, Available online 15 July 2020 Academic Editor: Dr. Nuray Arı, Ankara University, Turkiye, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewer(s) detail: Prof. Dr. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, [email protected] Dr. Mahmoud S. Abdallah, University of Sadat city, Egypt, [email protected] Similar Articles: PREVALENCE OF MALOCCLUSION AMONG YEMENI CHILDREN OF PRIMARY SCHOOLS COCCIDIAN INTESTINAL PARASITES AMONG CHILDREN IN AL-TORBAH CITY IN YEMEN: IN COUNTRY WITH HIGH INCIDENCE OF MALNUTRITION OCCLUSAL CHARACTERISTICS OF THE PRIMARY DENTITION AMONG A SAMPLE OF YEMENI PRE-SCHOOL CHILDREN EVALUATION OF THE IMMUNE RESPONSE TO POLIO VACCINE IN MALNOURISHED CHILDREN IN SANA'A CIT

An optimal energy management system for real-time operation of multiagent-based microgrids using a T-cell algorithm

The real-time operation of the energy management system (RT-EMS) is one of the vital functions of Microgrids (MG). In this context, the reliability and smooth operation should be maintained in real time regardless of load and generation variations and without losing the optimum operation cost. This paper presents a design and implementation of a RT-EMS based on Multiagent system (MAS) and the fast converging T-Cell algorithm to minimize the MG operational cost and maximize the real-time response in grid-connected MG. The RT-EMS has the main function to ensure the energy dispatch between the distributed generation (DG) units that consist in this work on a wind generator, solar energy, energy storage units, controllable loads and the main grid. A modular multi-agent platform is proposed to implement the RT-EMS. The MAS has features such as peer-to-peer communication capability, a fault-tolerance structure, and high flexibility, which make it convenient for MG context. Each component of the MG has its own managing agent. While, the MG optimizer (MGO) is the agent responsible for running the optimization and ensuring the seamless operation of the MG in real time, the MG supervisor (MGS) is the agent that intercepts sudden high load variations and computes the new optimum operating point. In addition, the proposed RT-EMS develops an integration of the MAS platform with the Data Distribution Service (DDS) as a middleware to communicate with the physical units. In this work, the proposed algorithm minimizes the cost function of the MG as well as maximizes the use of renewable energy generation; Then, it assigns the power reference to each DG of the MG. The total time delay of the optimization and the communication between the EMS components were reduced. To verify the performance of our proposed system, an experimental validation in a MG testbed were conducted. Results show the reliability and the effectiveness of the proposed multiagent based RT-EMS. Various scenarios were tested such as normal operation as well as sudden load variation. The optimum values were obtained faster in terms of computation time as compared to existing techniques. The latency from the proposed system was 43% faster than other heuristic or deterministic methods in the literature. This significant improvement makes this proposed system more competitive for RT applications

Study of the Injured Persons and the Injury Pattern in Road Traffic Accident in Sana'a City, Yemen

Background. Fatal road traffic accidents constitute a significant public health problem. Aim. The aim of the study was to analyze road traffic accidents in Sana'a city, Yemen, during 2013-2015. Methods. The required information and data of accidents were collected, respectively, from police reported road accident statistics, Sana'a city. 11684 cases of road traffic accidents during period 2013-2015 were studied. Results. 840 people were killed and 9760 people were injured in RTAs during 2013-2015 in Sana'a city. The accident rates per 100000 of the population were 234.8 in 2013, 180.3 in 2014, and 92.2 in 2015. Mortality rates per 100000 of the population were 15.17 in 2013, 12.2 in 2014, and 8.9 in 2015. High speed was the single most important factor responsible for accidents, deaths, and injuries accounting for 38.1% of RTAs followed by drivers' fault accounting for 18.9% of the total RTAs. The most common age group involved was ≥18 years. Males accounted for 83.1% of killed and injured persons. Most frequent victims of road traffic accidents were vehicles motor (48.9%) followed by pedestrians (38.1%). More than half of RTAs occurred on the straight road. Conclusion. RTAs are a major source of public health concern in Sana'a city, Yemen. Preventive measures to reduce the burden of mortality and morbidity due to road accidents should be introduced

The Tooth and Skin Colour Interrelationship across the Different Ethnic Groups

Objectives. The purpose of the study was to investigate the relation between skin and tooth colour parameters in various ethnic groups. Materials and Methods. Saudi Arabian, Indian, African, and East Asian ethnic groups of 75 each were included in the study. The tooth colour was determined by spectrophotometer in CIELAB parameters. The skin colour was measured at earlobe, forehead, and malar locations by clinical skin photography. The data was statistically analysed by one-way ANOVA and correlation tests. Results. The “L” vale for the Saudi Arabian group had a strong correlation at earlobe location (r=0.275), while correlation was found at forehead (r=0.271) and malar region (r=0.261) with Indian ethnic group. A strong negative correlation was observed in African ethnic group at all three locations for “L” parameter. The redness value “a” is found to have strong negative linear correlation between the earlobe and tooth for Saudi Arabian (r=-0.240) and Indian ethnic groups (r=-0.268). The “b” showed no correlation with skin location in all groups except positive correlation in African ethnic groups. Conclusions. The strong correlation was found between the skin and tooth colour parameters; hence the skin colour can be used as a guide for artificial tooth selection in edentulous patients

Can Interferon-Gamma or Interferon-Gamma-Induced-Protein-10 Differentiate Tuberculosis Infection and Disease in Children of High Endemic Areas?

Diagnosis of childhood tuberculosis (TB) is difficult in high TB burden settings. Interferon-gamma-induced protein 10 (IP10) has been suggested as a marker of TB infection and disease, but its ability to differentiate the two conditions remains uncertain.To describe Interferon-gamma (INFγ) and IP10 expression in children with TB infection and disease and controls to assess their potential to differentiate latent and active TB. TB), 335 children in contact with adults with pulmonary TB and 156 community controls in Southern Ethiopia. The Tuberculin Skin Test (TST) and Quantiferon-In-Tube (QFT-IT) were performed. INFγ and IP10 were measured in plasma supernatants.INFγ and IP10 can identify children with TB infection and disease, but cannot differentiate between the two conditions. HIV status did not affect the expression of IP10

Acute limb ischemia due to left brachial artery occlusion in a 40-year-old female patient: a case report

Acute upper limb ischemia (ALI) due to brachial artery occlusion is a rare but catastrophic condition that poses a significant threat to limb viability and can result in limb amputation or death. Accurate diagnosis and timely intervention are crucial to avoid catastrophic consequences. Literature on ALI due to brachial artery occlusion is scant and usually related to atrial fibrillation. We report a 40-year-old female presented with sudden onset left upper limb pain, change in color, and neurological deficits in the last three days. A color Doppler ultrasound revealed a complete occlusion of the left brachial artery with echogenic thrombosis suggestive of ALI. The patient urgently underwent a thrombectomy with an uneventful outcome. In conclusion, even though ALI due to brachial artery occlusion is rare, a heightened level of suspicion, precise diagnosis, and timely management are essential to prevent any fatal consequences