Uplift of Himalaya and it’s implications on the evolution of Indian monsoon

Abstract HKT-ISTP 2013 A

Post-partum right ovarian vein thrombosis mimicking acute appendicitis: a rare entity

Postpartum ovarian vein thrombosis (OVT) is a rare condition that must be distinguished from other causes of acute abdominal pain because it presents with non-specific, predominantly lower abdominal pain. If the right ovarian vein is involved, pain would be predominantly right-sided and may be missed for acute appendicitis. OVT has been reported to occur in 0.05% to 0.18% in the postpartum period following normal vaginal deliveries, and in up to 2% following caesarean sections. Untreated, postpartum OVT can lead to serious consequences such as sepsis, pulmonary embolism, and even death. We share a case that was admitted to our hospital with symptoms of acute appendicitis that proved later to be due to postpartum ovarian thrombosis. A 28-year-old woman was admitted to our hospital on her 4th postpartum day, following a spontaneous vaginal delivery of a live born full term female baby, complaining of anorexia, nausea, and abdominal pain in her right lower quadrant accompanied by low grade fever. On examination, she appeared ill and had a significant tenderness in her right lower quadrant. An ultrasonography did not reveal any abnormality and did not visualize her appendix. Patient was referred to a consultant gynecologist and was discharged as having no obstetric nor gynaecological cause of her complaint. Patient was admitted to general surgery department where a venography CT of her abdomen confirmed a thrombus in the right ovarian vein with a normal appendix. Blood tests were positive for anticardiolipin. Patient was treated conservatively and responded well to treatment with low molecular weight heparin and antibiotics. OVT is a rare disease, occurring mostly in the postpartum period. Rapid diagnosis is needed to prevent serious consequences and unnecessary surgical procedures, especially when mimicking an acute abdomen

Diabetes education program for people with type 2 diabetes: An international perspective

© 2016 Elsevier Ltd. Background: In the Palestinian community, lifestyle changes, rapid urbanization and socioeconomic development, stress, smoking, and changes in food habits has increased the risk of non-communicable diseases especially diabetes mellitus. Diabetes complications can be prevented if the glycemic status of patients with diabetes is maintained within a nearly normal range. Therefore, patient education is critical in controlling blood glucose levels within the normal range. Objective: This study aimed at measuring the effect of diabetes educational intervention program for patients suffering from type 2 diabetes attending the Diabetes Clinic in Tulkarim Directorate of Health. Methods: A short duration observational study involving pre- and post-test educational intervention program was carried out on a relatively small number of type 2 diabetes patients at the Diabetes Clinic in Tulkarim Directorate of Health. In total, 215 patients attended a group-based 4 h educational intervention session about diabetes. The program included explaining diabetes mellitus-symptoms, risk factors, types, treatment and complications and main aspects of self-care of the disease (foot care, eye care, and blood glucose monitoring), main aspects of dietary management, weight reduction, blood pressure, smoking cessation, periodic investigations, home monitoring and importance of physical activity. Knowledge evaluation questionnaire were evaluated pre- and post-study. Anthropometric measurements such as body weight (WT), body mass index (BMI) and laboratory tests such as fasting blood glucose (FBG), hemoglobin A1C (HbA1c), cholesterol (Chol), and triglycerides (TG) were measured both at the beginning and at the end of the study. Significance of the results was assessed by paired t-test at 95% confidence interval. Results: The participant\u27s mean age was 51.07 that ranged between 31 and 70 years. For a total of 215 participants, 41.4% were males and 58.6% were females. The mean weight before educational intervention was 80.81 ± 14.95 kg (82.6 kg for males and 79.5 kg for females) that decreased to 78.9 ± 14.33 kg (81.1 kg for males and 77.3 kg for females) after educational intervention program. The BMI also decreased significantly after educational intervention. The mean fasting blood sugar was 188.65 ± 71.45 mg/dL before educational intervention that decreased to 177.7 ± 66.11 mg/dL after the educational intervention (p = 0.049). The mean glycosylated hemoglobin was 8.57 ± 1.21 before educational intervention that decreased to 7.95 ± 1.42 after educational intervention. The mean value of cholesterol before educational intervention was 183.27 ± 37.74 mg/dL that decreased to 169.57 ± 34.23 mg/dL after educational intervention. The mean triglycerides value decreased after educational intervention from 209.85 ± 171.04 mg/dL to 183.28 ± 152.4 mg/dL (p = 0.025). The mean score of knowledge questionnaire before educational intervention was 60.6 ± 20.65 that increased to 78.1 ± 13.4 after conducting educational intervention. Conclusions: Diabetes education was found to be effective on BMI, FBG, HbA1c, Chol, TG, and knowledge. Recommendations: Diabetes education is a cornerstone in the management and care of diabetes and should be an integral part of health planning involving patient\u27s family, diabetes care team, community, and decision makers in the education process

Determination of free desmosine and isodesmosine as urinary biomarkers of lung disorder by ultra performance liquid chromatography-ion mobility-mass spectrometry

The elastin degradation products, desmosine (DES) and isodesmosine (IDES) are highly stable, cross-linking amino-acids that are unique to mature elastin. The excretion of DES/IDES in urine, in the free form and with associated peptide fragments, provides an indicator of lung damage in chronic obstructive pulmonary disease (COPD). A quantitative ion mobility-mass spectrometry (IM-MS) method has been developed for the analysis of free DES/IDES in urine with deuterated IDES as an internal standard. Resolution of DES/IDES isomers was achieved in less than five minutes using ultra performance liquid chromatography (UPLC) combined with ion pairing. The optimized UPLC-IM-MS method provided a linear dynamic range of 10-300 ng/mL and a limit of quantitation of 0.028 ng/mL for IDES and 0.03 ng/mL for DES (0.55 ng and 0.61 ng on column respectively). The method reproducibility (%RSD) was < 4% for DES and IDES. The UPLC-IM-MS method was applied to the analysis of urine samples obtained from healthy volunteers and COPD patients. The DES/IDES concentrations in healthy and COPD urine showed an increase in DES (79%) and IDES (74%) in the COPD samples, relative to healthy controls. The incorporation of an IM separation prior to m/z measurement by MS was shown to reduce non-target ion responses from the bio-fluid matrix

Energy Commitment for a Power System Supplied by Multiple Energy Carriers System using Following Optimization Algorithm

In today’s world, the development and continuation of life require energy. Supplying this energy demand requires careful and scientific planning of the energy provided by a variety of products, such as oil, gas, coal, electricity, etc. A new study on the operation of energy carriers called Energy Commitment (EC) is proposed. The purpose of the EC is to set a pattern for the use of energy carriers to supply energy demand, considering technical and economic constraints. EC is a constrained optimization problem that can be solved by using optimization methods. This study suggests the Following Optimization Algorithm (FOA) to solve the EC problem to achieve technical and economic benefits. Minimizing energy supply costs for the total study period is considered as an objective function. The FOA simulates social relationships among the community members who try to improve their community by following each other. Simulation is carried out on a 10-unit energy system supplied by various types of energy carriers that includes transportation, agriculture, industrial, residential, commercial, and public sectors. The results show that the optimal energy supply for a grid with 0.15447 Millions of Barrels of Oil Equivalent (MBOE) of energy demand costs 9.0922 millions dollar for a 24-h study period. However, if the energy supply is not optimal, the costs of operating energy carriers will increase and move away from the optimal economic situation. The economic distribution of electrical demand between 10 power plants and the amount of production units per hour of the study period is determined. The EC outputs are presented, which include an appropriate pattern of energy carrier utilization, energy demand supply costs, appropriate combination of units, and power plant production. The behavior and process of achieving the answer in the convergence curve for the implementation of FOA on EC indicates the exploration and exploitation capacity of FOA. Based on the simulated results, EC provides more information than Unit Commitment (UC) and analyzes the network more efficiently and deeply.Peer ReviewedPostprint (published version

Patterns of thromboembolic pulmonary vascular disease in COVID-19

SARS-CoV-2 (COVID-19) is associated with increased thrombosis. Here, we demonstrate patterns of pulmonary vascular disease in COVID-19 including classical acute pulmonary embolism and subsegmental perfusion defects in the absence of acute pulmonary embolism suggestive of microvascular thrombosis

Recurrent Modification of a Conserved Cis-Regulatory Element Underlies Fruit Fly Pigmentation Diversity

The development of morphological traits occurs through the collective action of networks of genes connected at the level of gene expression. As any node in a network may be a target of evolutionary change, the recurrent targeting of the same node would indicate that the path of evolution is biased for the relevant trait and network. Although examples of parallel evolution have implicated recurrent modification of the same gene and cis-regulatory element (CRE), little is known about the mutational and molecular paths of parallel CRE evolution. In Drosophila melanogaster fruit flies, the Bric-à-brac (Bab) transcription factors control the development of a suite of sexually dimorphic traits on the posterior abdomen. Female-specific Bab expression is regulated by the dimorphic element, a CRE that possesses direct inputs from body plan (ABD-B) and sex-determination (DSX) transcription factors. Here, we find that the recurrent evolutionary modification of this CRE underlies both intraspecific and interspecific variation in female pigmentation in the melanogaster species group. By reconstructing the sequence and regulatory activity of the ancestral Drosophila melanogaster dimorphic element, we demonstrate that a handful of mutations were sufficient to create independent CRE alleles with differing activities. Moreover, intraspecific and interspecific dimorphic element evolution proceeded with little to no alterations to the known body plan and sex-determination regulatory linkages. Collectively, our findings represent an example where the paths of evolution appear biased to a specific CRE, and drastic changes in function were accompanied by deep conservation of key regulatory linkages. © 2013 Rogers et al