The application of impact dampers to continuous systems

A study has been made of the application of impact dampers to two types of continuous systems, a simply supported and a clamped beam. Previous efforts have included the effect of impact dampers on single degree of freedom and other systems with finite numbers of degrees of freedom. Experimental models were tested in the laboratory and finite element computer programs were developed to calculate response. Results from calculations agree favorably with experimental tests. Further, results from the first few natural modes also compare reasonably with data published on systems with finite number of degrees of freedom. Curves are presented which enable the user to apply impact dampers to these types of continuous systems. Curves show the amount of the isolation to be expected for values of significant system parameters --Abstract, page ii

Application of approximate transmission matrices to describe transverse beam vibrations

This paper is a report of an investigation of an approximate method for finding the principal mode frequency roots for beams in transverse vibration. The method utilizes approximate transmission matrices obtained by a power series expansion of the basic differential equation which governs the transmission matrix. Investigation has been carried out to examine the efficiency of the method in producing the first several normal mode frequency roots. This has been achieved by applying the method to several uniform and non-uniform beams and comparing the results with the exact solutions. The technique has further been applied to non-uniform beams of tapered rectangular cross section and the results are given in non-dimensional form for use in practical application. Frequency root errors obtained by this method when applied to uniform beams of Fixed-Fixed and Fixed-Free ends are seen to be proportional to l/N² (N, the number of segments), when two terms in the series are considered and N is large . With three and four series terms errors are proportional to 1/N³ . The method utilizes only two variables of the beam to be analyzed, the cross sectional area and the area moment of inertia. Progressively better results are obtained by increasing the number of terms in the series--Abstract, Page ii

Public Health Policy and Advocacy: A Management Perspective

The division of authority and accountability between the federal government and the states is one of the public health governance system\u27s most significant advantages and concurrent problems. The policy management suggests that the best course of action is to develop institutional frameworks for consultative decision-making, allocate resources in an equitable manner, and implement policies in a coordinated manner. The proposed methods include improved fiduciary risk management, capacity building, technical support for state-specific strategic plans, active local self-government engagement, and community-based health output monitoring. The idea put forth in this paper is that HR rules, which are centred around the requirement that individuals with a background in public health management hold high positions in the field, should be tightened

The Application Of Impact Dampers To Continuous Systems

A study has been made of the application of impact dampers to two types of continuous systems, a simply supported and a clamped beam. Experimental models were tested in the laboratory and computer programs were developed to calculate response by two separate approaches. Results from calculations agreed favorably with experimental tests. Curves presented show the response to be expected for values of significant system parameters and enable the user to apply impact dampers to these types of continuous systems. © 1975 by ASME

Hypertensive Cardiogenic Shock in a Child with Acute Poststreptococcal Glomerulonephritis: An Unusual Presentation - A Case Report

AAcute poststreptococcal glomerulonephritis (APSGN) is one of the most common renal diseases resulting from a prior infection with group A β-hemolytic streptococcus. Manifestations of acute poststreptococcal glomerulonephritis ranges from subclinical infections to life threatening conditions. Typical clinical features of the disease include an acute onset with gross hematuria, edema, hypertension and moderate proteinuria (acute nephritic syndrome) 1 to 2 weeks after an antecedent streptococcal pharyngitis or 3 to 6 weeks after a streptococcal pyoderma. Patients with APSGN sometimes exhibit unusual clinical manifestations, which may lead to diagnostic delay or misdiagnosis of the disorder. Cardiogenic shock is uncommon but potentially fatal initial manifestations of ASPGN. There are very few reports of cardiogenic shock as the initial manifestation of APSGN. In patients presenting with cardiogenic shock, without a clear etiology, APSGN should be considered. We report a 07 year old boy presenting with cardiogenic shock as initial manifestations of APSGN.Keywords: Glomerulonephritis; Shock, Cardiogenic; Hypertension; Infections; Streptococcal

Tethered Cord Syndrome Causing Chronic Kidney Disease in a Child: A rare event

The fixing of the spinal cord, regardless of the underlying cause of the fixation, is called a tethered cord. Tethered cord syndrome is a group of diseases that develops as a result of the regression of the spinal cord due to congenital or acquired causes and is characterized by evaluative neurologic losses. In stretched tethered cord syndrome which is observed during childhood usually manifested by skin symptoms, motor losses, urologic symptoms, and evaluative spinal cord deformations such as scoliosis are more frequently observed while perinea and primal pain, urologic symptoms, and motor losses are more frequent in adults. Tethered cord complicating a neurogenic bladder in childhood is a rare disease. So, this case report is presented.                                   Keywords: Tethered cord; Child; Chronic Kidney Disease; Neurogenic Bladder

Fetomaternal outcome in eclampsia

Background: Eclampsia is the third most common cause of maternal mortality, after haemorrhage and infection in the developing countries. Majority of cases of eclampsia are young primigravidas. The reduction in both maternal and perinatal morbidity and mortality remains the yard stick of success in the management of eclampsia.Methods: A hospital based analytical cross-sectional study was conducted among the pregnant women with eclampsia admitted in the department of Obstetrics and Gynecology in Regional Institute of Medical Sciences, Imphal. The study was conducted for a period of one and half years from September 2018 to March 2020.Results: Fifty-five (55) patients in the age group between 21 and 25 years constitute the maximum percentage of eclampsia (67.3%). Forty-five (81.8%) cases were antepartum eclampsia, 2 (3.6%) were intrapartum eclampsia and 8 (14.5%) cases were postpartum eclampsia. Majority (78.2%) of the cases were primigravidae, which is comparable to other studies. As much as 23 (41.8%) of the cases presented at 32-37 weeks period of gestation. There were two maternal deaths (3.6%) due to eclampsia related complications. There were 13 (21.7%) perinatal deaths in this study, out of which 10 (16.7%) were still births and 3(5%) were early neonatal deaths.Conclusions: Eclampsia is still an important obstetric emergency in the community contributing to significant maternal and perinatal morbidity and mortality. Eclampsia may not develop de novo and as such, it is not always a preventable condition. Early detection and prompt intervention of complications is vital to ensure a healthy outcome for both mother and baby

Mycophenolate Mofetil versus Cyclosporine in Children with Frequent Relapse Nephrotic Syndrome

Introduction: Children with frequently relapsing nephrotic syndrome (FRNS) frequently develop adverse effects of prednisolone and attempts to induce long term remission in such patients have varying degree of success. Materials & Methods: We conducted a randomized clinical trial in a tertiary care level hospital to compare the efficacy and safety of a 1 year treatment with mycophenolate mofetil (MMF) and Cyclosporine (CsA) in 60 pediatric patients with FR-SSNS during one year period. We assessed the frequency of relapse as the primary end point and evaluated clinical and laboratory profile after 3 and 6 months of treatment. Results: Mean number of relapse was 1.50 ± 1.44 in MMF group and 0.72 ± 1.30 in CsA group at 6 months (p=0.045). Diarrhoea was statistically significant in MMF group. Hypertrichosis & hypertension were statistically significant in CsA group. There was no significant difference between groups with Hb levels, lipid profile, eGFR. Conclusion: The result of the study showed MMF is inferior to CsA in preventing relapse in patient with FRNS but less nephrotoxic

Echocardiographic Assessment of Systolic Myocardial Dysfunction in Children with Chronic Kidney Disease

Background and Aim: Chronic Kidney Disease (CKD) is associated with significantly increased morbidity and mortality.  Cardiovascular causes contribute to the large proportion of morbidity and mortality in this group. The aim of the current study was to assess systolic myocardial dysfunction of the heart in children with chronic kidney disease (stage V). Methods: This cross-sectional study was carried out in a tertiary center from January 2018 to December 2018. Children aged 1 to 18 years having chronic kidney disease (stage V) were included in the study. All the patients underwent color Doppler echocardiography for the evaluation of cardiac abnormalities. Age and sex-matched healthy children with no clinical evidence of renal and cardiovascular disease were taken as a comparison group. Results: Out of Thirty children with Chronic kidney disease (stage V), 21(70%) were male and 9 (30%) female. Echocardiographic findings revealed a statistically significant difference in case of CKD patients group and a comparison group in relation with left atrium (LA), left ventricular internal diameter in diastole (LVIDd), left ventricular internal diameter in systole (LVIDs), interventricular septum in diastole (IVSd), interventricular septum in systole (IVSs), left ventricular posterior wall thickness in diastole (LVPWd) and left ventricular posterior wall thickness in systole (LVPWs) (p<0.001) but no difference in relation to FS and EF (p-0.934 & p-0.754 respectively). Conclusion: It can be concluded from the present study that children with chronic kidney disease are prone to develop left ventricular structural abnormality but systolic functional changes are less frequent

Predictors of Relapse in Idiopathic Nephrotic Syndrome in Children Presenting to a Tertiary Center

Background and Aim: Idiopathic nephrotic syndrome (INS) is a disease of relapse and remission in children in which about 20-30% of the patients may experience a single episode in their lives while the rest suffer from relapse. Some factors contribute to relapse. The objective of this study was to explore the predictors of relapse in INS.Methods: A prospective longitudinal study was conducted in the Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from September 2015 to August 2016. One hundred and ten patients with the first episode of INS were uninterruptedly enrolled in this study. After screening and subsequent confirmatory diagnosis, the patients were treated with a single morning dose of oral prednisolone 60 mg/m2/day for 6 weeks followed by oral prednisolone 40 mg/m2 every alternate day for the subsequent 6 weeks. The total number of relapses within six months after the initial episode was collected in a data collection sheet. Every relapse was correlated with age of onset, sex, initial serum albumin level, fasting serum cholesterol level, and time to response in the initial attack. The association between relapse and its potential risk factors was investigated using logistic regression analysis. Results: The study found that INS was significantly associated with sex and age (p< 0.05). Male children were 3.04 times (95% CI= 1.09- 8.45, P=0.03) more likely to experience relapse. Furthermore, children with respiratory tract infection  had a higher chance of relapse (OR= 4.43, 95% CI= 1.26-15.53, P=0.02). Lower cholesterol levels (≤500 mg/dl) were found to be a protective factor (OR= 0.13, 95% CI= 0.04-0.54, P=0.005) in this study. The chance of relapse was higher in children who responded after 2-4 weeks of starting treatment compared to those who responded in less than one week (p<0.005).Conclusion: The study found that the first episode INS had a higher risk of relapse in boys with respiratory tract infection and in patients who needed more than two weeks of prednisolone treatment to achieve remission.Keywords: Children; Frequently Relapsing; Predictors; Idiopathic Nephrotic Syndrome