Pattern of morphine prescription by doctors in a Nigeria tertiary hospital

Background: Morphine was reintroduced into Nigeria after a long period of absence due to technical problems relating to stock accounting. With this reintroduction, prescriber education was commenced in many centers including the University of Ibadan. Aims and Objective: The aim of this study is to review the morphine prescription habits of the medical doctors practicing at the University College Hospital, Ibadan, and to assess the level of conformity with international guidelines. Materials and Methods: All the prescriptions on oral morphine in the hospital’s pharmacy records within a 6 months period were reviewed. Results: The results showed that more than half (51.7%) of all morphine prescriptions were from the Radiation Oncology Department, while the newly created Day Care Hospice Unit accounted for 31.8% of the prescriptions. No prescriptions were seen from the Labor ward. Only 1.1% of all the prescriptions conformed to international guideline as contained in the “Blue Book.” Conclusion: The results showed that there is a need for more education and advocacy programmes to increase awareness among doctors about morphine prescriptions.Keywords: Audit, doctors, morphine, Nigeria, prescriptionsNigerian Journal of Clinical Practice • Jan-Mar 2012 • Vol 15 • Issue

Patient satisfaction with quality of primary health care in Benghazi, Libya

Introduction: The Libyan National Health System (LNHS) is debated for the paradox of its performance versus impact. It has poor performance, but the national health statistics are good and competitive. There are concerted efforts to manage health care services and to regain the lost trust. A primary health care (PHC) system that focuses on preventive and promotive care is the core focus of LNHS efforts. Objectives: To assess patient satisfaction with quality of PHC assessed in terms of (a) customer profile, (b) patient satisfaction, and (c) health care-seeking behavior. Methodology: A sample of nine health centers and seven polyclinics from various locations in Benghazi, Libya were selected for gathering information by structured face-to-face interviews. A total of 310 beneficiaries were interviewed by using an Arabic translation of the Charleston Psychiatric Outpatient Satisfaction Scale. Results: The beneficiaries appear to be quite satisfied with the quality of services. Geographical zone, marital status of beneficiary, and type of facility are satisfaction-related factors. There are preferences for facilities located within the City Centre over those located elsewhere. There is also an interaction effect of the geographical zone and the type of facility in creating differences in satisfaction. Conclusions: A customer-friendly facility concept that emphasizes reception, physician interaction, and cordiality shall add value. Polyclinics require more attention as does the Al Slawy area. A few utility services might also be considered.Keywords: exit interviews; Health For All by All; geographic zone; administrative and environmental factors; health-seeking behavior; interaction effect; type and location of facility; place of residenc

Serum interferon-alpha level in first degree relatives of systemic lupus erythematosus patients: Correlation with autoantibodies titers

Background and objectives: Interferon-a (IFN-a), a cytokine with both antiviral and immune-regulatory functions, was suggested as a useful tool which can evaluate current systemic lupus erythematosus (SLE) disease activity and identify patients whoare at risk of future disease flares. In the current study, serum IFN-a levels and associated demographic, and serological features in Egyptian SLE patients and their first degree relatives (FDRs) in comparison to unrelated healthy controls (UHCs) were examined, in order to identify individuals at the greatest risk for clinical illness.Methods: In a cross-sectional study, blood samples were drawn from 54 SLE patients, 93 of their FDRs who consented to enroll into the study and 76 UHCs. Measurement of serum IFN-a by a modified ELISA was carried out. Data were analyzed for associations of serum IFN-a levels with autoantibodies titer.Results: Meanserum IFN-a inFDRswas statistically higher than theUHCsand lower than inSLE patients (P < 0.0001) and it was correlated with ANA titer (r = 0.6, P < 0.0001) and anti ds DNA titer (r = 0.62, P < 0.0001).Conclusion: IFN-a is a crucial player in the complicated autoimmune changes that occur in SLE and serum IFN-a can be a useful marker identifying persons who are at risk of future disease development.Keywords: Interferon-a; Systemic lupus erythematosus; First degree relatives; Autoantibodie

Current Advances in Internet of Underground Things

The latest developments in Internet of Underground Things are covered in this chapter. First, the IOUT Architecture is discussed followed by the explanation of the challenges being faced in this paradigm. Moreover, a comprehensive coverage of the different IOUT components is presented that includes communications, sensing, and system integration with the cloud. An in-depth coverage of the applications of the IOUT in various disciplines is also surveyed. These applications include areas such as decision agriculture, pipeline monitoring, border control, and oil wells

Phenomenology and Cosmology of an Electroweak Pseudo-Dilaton and Electroweak Baryons

In many strongly-interacting models of electroweak symmetry breaking the lowest-lying observable particle is a pseudo-Goldstone boson of approximate scale symmetry, the pseudo-dilaton. Its interactions with Standard Model particles can be described using a low-energy effective nonlinear chiral Lagrangian supplemented by terms that restore approximate scale symmetry, yielding couplings of the pseudo-dilaton that differ from those of a Standard Model Higgs boson by fixed factors. We review the experimental constraints on such a pseudo-dilaton in light of new data from the LHC and elsewhere. The effective nonlinear chiral Lagrangian has Skyrmion solutions that may be identified with the `electroweak baryons' of the underlying strongly-interacting theory, whose nature may be revealed by the properties of the Skyrmions. We discuss the finite-temperature electroweak phase transition in the low-energy effective theory, finding that the possibility of a first-order electroweak phase transition is resurrected. We discuss the evolution of the Universe during this transition and derive an order-of-magnitude lower limit on the abundance of electroweak baryons in the absence of a cosmological asymmetry, which suggests that such an asymmetry would be necessary if the electroweak baryons are to provide the cosmological density of dark matter. We revisit estimates of the corresponding spin-independent dark matter scattering cross section, with a view to direct detection experiments.Comment: 34 pages, 4 figures, additional references adde

Modulation of Sn concentration in ZnO nanorod array: intensification on the conductivity and humidity sensing properties

Tin (Sn)-doped zinc oxide (ZnO) nanorod arrays (TZO) were synthesized onto aluminum-doped ZnO-coated glass substrate via a facile sonicated sol–gel immersion method for humidity sensor applications. These nanorod arrays were grown at different Sn concentrations ranging from 0.6 to 3 at.%. X-ray diffraction patterns showed that the deposited TZO arrays exhibited a wurtzite structure. The stress/strain condition of the ZnO film metamorphosed from tensile strain/compressive stress to compressive strain/tensile stress when the Sn concentrations increased. Results indicated that 1 at.% Sn doping of TZO, which has the lowest tensile stress of 0.14 GPa, generated the highest conductivity of 1.31 S cm− 1. In addition, 1 at.% Sn doping of TZO possessed superior sensitivity to a humidity of 3.36. These results revealed that the optimum performance of a humidity-sensing device can be obtained mainly by controlling the amount of extrinsic element in a ZnO film

Non invasive ventilation after extubation in paediatric patients: a preliminary study

<p>Abstract</p> <p>Background</p> <p>Non-invasive ventilation (NIV) may be useful after extubation in children. Our objective was to determine postextubation NIV characteristics and to identify risk factors of postextubation NIV failure.</p> <p>Methods</p> <p>A prospective observational study was conducted in an 8-bed pediatric intensive care unit (PICU). Following PICU protocol, NIV was applied to patients who had been mechanically ventilated for over 12 hours considered at high-risk of extubation failure -elective NIV (eNIV), immediately after extubation- or those who developed respiratory failure within 48 hours after extubation -rescue NIV (rNIV)-. Patients were categorized in subgroups according to their main underlying conditions. NIV was deemed successful when reintubation was avoided. Logistic regression analysis was performed in order to identify predictors of NIV failure.</p> <p>Results</p> <p>There were 41 episodes (rNIV in 20 episodes). Success rate was 50% in rNIV and 81% in eNIV (p = 0.037). We found significant differences in univariate analysis between success and failure groups in respiratory rate (RR) decrease at 6 hours, FiO₂at 1 hour and PO₂/FiO₂ratio at 6 hours. Neurologic condition was found to be associated with NIV failure. Multiple logistic regression analysis identified no variable as independent NIV outcome predictor.</p> <p>Conclusions</p> <p>Our data suggest that postextubation NIV seems to be useful in avoiding reintubation in high-risk children when applied immediately after extubation. NIV was more likely to fail when ARF has already developed (rNIV), when RR at 6 hours did not decrease and if oxygen requirements increased. Neurologic patients seem to be at higher risk of reintubation despite NIV use.</p

Strong interface-induced spin-orbit coupling in graphene on WS2

Interfacial interactions allow the electronic properties of graphene to be modified, as recently demonstrated by the appearance of satellite Dirac cones in the band structure of graphene on hexagonal boron nitride (hBN) substrates. Ongoing research strives to explore interfacial interactions in a broader class of materials in order to engineer targeted electronic properties. Here we show that at an interface with a tungsten disulfide (WS2) substrate, the strength of the spin-orbit interaction (SOI) in graphene is very strongly enhanced. The induced SOI leads to a pronounced low-temperature weak anti-localization (WAL) effect, from which we determine the spin-relaxation time. We find that spin-relaxation time in graphene is two-to-three orders of magnitude smaller on WS2 than on SiO2 or hBN, and that it is comparable to the intervalley scattering time. To interpret our findings we have performed first-principle electronic structure calculations, which both confirm that carriers in graphene-on-WS2 experience a strong SOI and allow us to extract a spin-dependent low-energy effective Hamiltonian. Our analysis further shows that the use of WS2 substrates opens a possible new route to access topological states of matter in graphene-based systems.Comment: Originally submitted version in compliance with editorial guidelines. Final version with expanded discussion of the relation between theory and experiments to be published in Nature Communication

Climate Services for Resilient Development in South Asia Mid-Term Report, January - June 2018

Aligned with the Global Framework for Climate Services, Climate Services for Resilient Development (CSRD) is a global partnership that works to link climate science, data streams, decision support tools, and training with decision-makers in developing countries. CSRD is led by the United States Government and is supported by the UK Government Department for International Development (DFID), UK Meteorological Office, ESRI, Google, the Inter-American Development Bank, the Asian Development Bank, and the American Red Cross. Led by the International Maize and Wheat Improvement Center (CIMMYT), the CSRD initiative in South Asia implements applied research and facilitates an expanding network of partners assure that actionable climate information and crop management advisories can be generated, refined, and delivered to smallholder farmers. This report details activities of the CSRD project in South Asia during the first six months of 2018