A suggested approach to the diagnosis of urinary tract infection and empiric use of antibiotics among hospitalized older adults with acute confusion and or underlying cognitive and communication deficits

BackgroundThe true incidence of urinary tract infection (UTI) among hospitalized older adults remains unknown.AimsWe aim to present an approach to improve correct identification of UTI diagnosis and empiric use of antibiotics among those who are unable to provide history.Methods A comprehensive review of the literature was undertaken.Results Our suggested approach appears safe and likely to enhance diagnostic accuracy and judicious use of antibiotics among hospitalized older adults.ConclusionOur suggested approach is based on best available literature evidence but requires validation in clinical studies

Effect of fiber orientation and fiber loading on the mechanical and thermal properties of sugar palm yarn fiber reinforced unsaturated polyester resin composites

Sugar palm [Arenga pinnata (Wurmb.) Merr] fiber reinforced unsaturated polyester resin composites with 0°, 45°, and 90° fiber different orientations were prepared and tested. The composites were characterized for tensile, flexural, impact and compression properties using ASTM D3039, ASTM D790, ASTM D250, and ASTM D3410 standards, respectively. For the thermal characterization, dynamic mechanical analysis (DMA) was conducted to characterize the on storage modulus (E’), loss modulus (E’’) and damping behavior (tan δ) of the composites. The highest mechanical performance of composites was achieved at 0° of fiber orientation composites followed by 45° and 90° fiber orientations. The fiber loading was insignificant for the 90° fiber orientation as the properties were inconsistent. The theoretical value of modulus from the tensile test was calculated using rules of mixture (ROM) and compared with the experimental values for all composites specimens. This research showed that the optimum properties occurred at 30 wt % fiber loading as reflected by the superior tensile and flexural strengths. The optimum properties of compression, impact, storage modulus and better damping properties were achieved at 40 wt % fiber loading

Thermogravimetric analysis properties of cellulosic natural fiber polymer composites: a review on influence of chemical treatments

Natural fiber such as bamboo fiber, oil palm empty fruit bunch (OPEFB) fiber, kenaf fiber, and sugar palm fiber-reinforced polymer composites are being increasingly developed for lightweight structures with high specific strength in the automotive, marine, aerospace, and construction industries with significant economic benefits, sustainability, and environmental benefits. The plant-based natural fibers are hydrophilic, which is incompatible with hydrophobic polymer matrices. This leads to a reduction of their interfacial bonding and to the poor thermal stability performance of the resulting fiber-reinforced polymer composite. Based on the literature, the effect of chemical treatment of natural fiber-reinforced polymer composites had significantly influenced the thermogravimetric analysis (TGA) together with the thermal stability performance of the composite structure. In this review, the effect of chemical treatments used on cellulose natural fiber-reinforced thermoplastic and thermosetting polymer composites has been reviewed. From the present review, the TGA data are useful as guidance in determining the purity and composition of the composites’ structures, drying, and the ignition temperatures of materials. Knowing the stability temperatures of compounds based on their weight, changes in the temperature dependence is another factor to consider regarding the effectiveness of chemical treatments for the purpose of synergizing the chemical bonding between the natural fiber with polymer matrix or with the synthetic fibers

Pneumoperitoneum during treatment of abdominal tuberculosis in a Non-HIV patient: Natural progression or paradoxical worsening?

Paradoxical reactions during tuberculosis (TB) treatment are well-described in the HIV seropositive population but less so in the HIV seronegative group. Abdominal TB rarely presents as spontaneous perforation; cases occurring during anti-TB therapy are even rarer. We describe the clinical progress of a case of an HIV-negative patient who developed acute peritonitis while on anti-TB treatment for peritoneal TB through a series of clinical, radiological and histological images. Visceral perforation can occur as a complication of TB treatment. A high index of suspicion with early surgical intervention is crucial in the management of such cases

Assessment of Agility in Elderly Population of Islamabad

Background: Agility is considered as one of the important components of physical fitness. In older adults, it is of utmost importance in response to any stimulus. The objective of this study was to determine normative values of agility in elderly population of Islamabad. Methods: A Cross-Sectional Survey was conducted in community settings of Islamabad from February–July 2019 after approval by the Ethical Review Committee of Foundation University Islamabad.  The calculated sample size was found to be 267, but due to missing data, analysis was done on 250(100 females and 150 males).   Participants were selected by convenient sampling. Physically independent participants were included and diseased population (severe musculoskeletal, neurological, and cardiopulmonary disorders), decreased functional status affecting hearing, vision, memory recall was excluded from the study. PAR-Q was utilized in uncovering any possible health risks linked to exercise. For evaluation of agility, the American Alliance for Health, Physical Education, Recreation, and Dance (AAHPERD) Agility Test was performed. Agility scoring is based on time in seconds, with higher score representing less agility, and agility score of less than 62 represents good agility. Data were analyzed through SPSS version 21. Results: The mean age, BMI and agility score of participants were 60.7±5.81 years, 26±4.30 kg/m² and 22.42±5.2 respectively. There was significant difference (P<0.001) in agility between males and females, with the mean agility score higher in females as compared to males. Similarly, Agility score was significantly high in females as compared to males in BMI range of 18.5 to >30 and all age categories. Conclusion: Elderly population of Pakistan has good agility scor

Assessment of frequency, risk category and intervention needs in psychoactive drug users by using WHOASSIST Questionnaire among medical students in Karachi

Objectives: To determine the frequency of use of various psychoactive drugs among medical students in an urban setting, and to assess the risk category and intervention needs. Methods: The descriptive cross-sectional study was conducted from January to June 2018 at four medical education institutions of Karachi; 2 each randomly selected from registered public and private sectors. From the clinical classes of each institution, fourth year was randomly chosen by lottery method. Data was collected using the Alcohol, Smoking and Substance Involvement Screening Test version 3.0. Data was analysed using SPSS 20. ---Continu

The challenges and future perspective of Kenaf Wo-ven reinforcement in thermoset polymer composites in Malaysia: a review

In this review, the challenges faced by woven kenaf thermoset polymer composites in Malaysia were addressed with respect to three major aspects: woven kenaf reinforcement quality, Malaysian citizen awareness of woven kenaf thermoset composite products, and government supports. Kenaf plantations were introduced in Malaysia in the last two decades, but have generally not produced much kenaf composite product that has been widely accepted by the public. However, woven kenaf fiber enhances the thermoset composites to a similar degree or better than other natural fibers, especially with respect to impact resistance. Woven kenaf composites have been applied in automotive structural studies in Malaysia, yet they are still far from commercialization. Hence, this review discusses the kenaf fiber woven in Malaysia, thermoset and bio-based thermoset polymers, thermoset composite processing methods and, most importantly, the challenges faced in Malaysia. This review sets guidelines, provides an overview, and shares knowledge as to the potential challenges currently faced by woven kenaf reinforcements in thermoset polymer composites, allowing researchers to shift their interests and plans for conducting future studies on woven kenaf thermoset polymer composites