Distribution of epifauna in offshore benthic environments along the west and south coast of South Africa

Marine unconsolidated sediments, such as sand, gravel and muds, constitute the most extensive benthic ecosystems globally. Biological data for these ecosystems are frequently sparse which can hinder the success and implementation of marine management strategies for benthic ecosystems. There are limited studies in South Africa on benthic epifauna. This study investigates the composition and distribution of epibenthic invertebrate assemblages along the west and south coast of South Africa (sampled using depth-stratified demersal trawls) to inform marine environmental management. Sample depth varied from 36m to 899m. Multivariate tools (PRIMER and PERMANOVA+) were used to analyse spatial (west vs south coast) and temporal (2011 vs 2017) patterns in epifauna. This study also investigated an overlap region between the west and south coast. A group average linkage cluster analysis defined biotopes using significant branching (p< 0.05). Biotopes were compared against the 2012 National Biodiversity Assessment (NBA) benthic habitat map to investigate whether epifaunal biotopes identified, align with the existing classification. A significant difference among epifauna between region and depth was found, where the west coast had a higher average number of individuals and species per station. Sympagarus dimorphus and Pelagia noctiluca were characteristic species for west and south coast respectively. Epifauna was found to be significantly different between 2011 and 2017, with a notable increase in the abundance of Crossaster penicillatus in 2017. The majority of the biotopes aligned with the current NBA classification, in particular the Agulhas Sandy Shelf Edge ecosystem type on the south coast and South Atlantic Upper Bathyal and Namaqua Muddy Inner Shelf ecosystem types on the west coast. This thesis contributes to the mapping and description of offshore ecosystem types to inform marine environmental impact assessments, marine spatial planning and marine protected area expansion

Perioperative hemodynamic effects of dexmedetomidine as an adjuvant to 0.2% ropivacaine in ultrasonography guided interscalene brachial plexus block for elective shoulder arthroscopic surgeries under general anaesthesia: a prospective observational study

Background: Although an increasing number of anesthesiologists are using peripheral nerve catheters for postoperative analgesia, single shot blocks are still more common. Ropivacaine has become the most commonly used long-acting local anesthetic, and the duration of analgesia has been estimated to be 8 to 14 hours.Methods: The study was conducted from February 2020 to October 2021 after obtaining approval from the institutional ethics committee. The study was a prospective observational study.Results: Hemodynamic changes in patients who received dexmedetomidine in combination with Ropivacaine had a favorable reduction in both heart rate and blood pressure without causing any major side effect. Comparison of postoperative MAP (mmHg) in two groups at various intervals of time was observed and found to be statistically significant (p value of &lt;0.05). Comparison of postoperative heart rate (beats/min) among two groups at various intervals of time was statistically significant (p value of &lt;0.05).Conclusions: We can conclude that preoperative inter-scalene block given reduces the analgesic requirement intraoperatively as well postoperatively. And the hemodynamic changes in patients who received dexmedetomidine in combination with ropivacaine had a favorable reduction in both heart rate and blood pressure without causing any major side effect.

Premedication in Surgical Day Care Patients

The purpose of this audit was to find out the efficiencyof our system in providing premedication to surgical daycare patients. This audit was conducted in the Surgical DayCare (SDC) Unit of a University Hospital. All patientsanaesthetised in the SDC unit on day care basis were includedin this audit. Nursing notes and preoperative orders of allpatients to be anaesthetised were checked to see whetherpremedication was given or not and was the timing accordingto the orders written. The result showed that out of 205patients scheduled, twenty (9.7%) patients did not receivepremedication. Only 37.2% of our patients were receivingpremedication according to the orders. The majority of theerrors noted in our audit were system errors related to cancellation,rescheduling and admitting the outpatient in theinpatient ward

Efficacy of combined phenotypic methods for methicillin-resistant Staphylococcus aureus detection and antibiotic susceptibility

Background: The main aim of our study is to demonstrate comparative evaluation of oxacillin disc diffusion (ODD), oxacillin screen agar (OSA), CHROM agar (CA) with cefoxitin disc diffusion (CDD) method for the detection of methicillin-resistant Staphylococcus aureus obtained from various clinical samples.Methods: This prospective study was conducted to detect Methicillin resistance among staphylococcus aureus by four phenotypic methods isolated from various clinical samples received in the Department of microbiology MMIMSR, Mullana.Results: The data was statistically analyzed, compiled in form of tables, graphs, percentage and test of significance will also be done wherever necessary (using Microsoft Excel, 2008 version) CDD+ODD+OSA+CA proved to be 100% followed by ODD+OSA+CA and CDD+OSA+CA 82.07% and CDD+ODD+OSA 80.1%.Conclusions: Combined phenotypic methods are better in evaluating and studying MRSA infections in hospitals as compared to tests done in isolation for proper diagnosis and timely treatment of infections

Clinical features, pathological outcomes and management of internal rectal prolapse-combined retro-prospective observational study

Background: Internal rectal prolapse probably represents the first stage of a progressive anomaly that eventually leads to full thickness external prolapse. Non-surgical treatment modalities like dietary advice and feedback therapy should be used before doing any surgical intervention in such cases. This study focuses on clinical features, pathological outcomes and treatment modalities of internal rectal prolapse.Methods: The study is a combined prospective (from Aug. 2018 to Aug. 2020) and retrospective (from Aug. 2015 to Aug. 2018) conducted at Sher-I-Kashmir institute of medical sciences, Soura, SrinagarResults: A total of 79 patients were studied out of which 39 were retrospective and 40 were prospective. Internal rectal prolapse is usually missed by surgeons as a cause of obstructed defecation syndrome. So, it was worthwhile to study this entity in our patients.Conclusions: Before choosing any treatment strategy for internal rectal prolapse, conservative trial with dietary modification and feedback therapy should be attempted

Post spinal anaesthesia shivering- incidence and associated risk factors in patients undergoing lower limb and abdominal surgeries

Background: This study was conducted to evaluate the incidence of shivering and likely associated risk factors following spinal anaesthesia in patients undergoing lower abdominal and lower limb surgeries.Methods: The present study was conducted in MMIMSR, Department of anaesthesia from December 2016 to September 2018. It was an observational study which was conducted over a period of 2 years. Patients who were scheduled to undergo elective lower abdominal and lower limb surgeries under spinal anaesthesia were included in study.Results: The present study depicts a high incidence of post spinal shivering, which was 42.8%. Majority of the patients belonged to the young age group between 20-30 years. The mean time of onset of shivering, was around 25 mins. Duration of shivering was observed between 15-75 minutess with a mean of 43.75 and SD±19.39.Conclusions: Shivering is one of the distressing complications of spinal block, which may be deleterious to the patients with poor cardio-respiratory reserve

Students Experiment of Online Classes during the Pandemic of COVID-19 and their Socio-economic affection toward Psychological impact on their Learning Behaviors’ (With Special Reference to University of Karachi)

Millenary we are seeing the world changing for the second time. There was diversity before 9/11 and it changed the complete picture of demographical status, socio-economic condition, and social movement. There might be a global change again after COVID-19. In this pandemic where the people already suffering from socio-economic inequality, if we exaggerate the students‟ perspectives and they found that online learning couldn‟t produce desired results in underdeveloped countries like Pakistan, where most of the students are unable to access the internet due to technical as well as financial issues. Accordingly, the quick speed of COVID- 19 became a big challenge for the massive number of the students to get the lecture of courses offline in the classrooms. Moreover, due to the ripped spread of Covid-19 created an E-learning environment where the instruction of online network system to enhance the quality of teaching and learning to manage their provided contents accurately and managed their online classes and courses.The research objectives of the present papers contain with, to investigate the awareness of Covid-19 in university students, socioeconomic status of students, the problems faced by students in the pandemic, the curriculum satisfaction of students, the experience of online classes on students, and the lack of internet resources in students. While the hypotheses likewise (a) Students learning behavior affected by taking online classes. (b) By attending the online classes, student‟s study became disturbed in the Covid-19 pandemic. The present study was “Explanatory” in nature. The Universe was the University of Karachi. The researchers selected the mix-method likewise qualitative and quantitative strategy for data collection. The respondent has comprised the students of (First and Second Minor). The convenience sampling techniques adopted through which 65 respondents have been selected for the data collection, included three case studies. A tailor-made such as questionnaire and observations are used for data collection

Oxford 2100: Adapting to Climatic Changes

Project for LARC642: Graduate Studio III (Fall 2021). University of Maryland, College Park.This project, supported by the National Center for Smarth Growth’s Partnership for Action Learning in Sustainability (PALS), provides the Oxford community with a visual glimpse of their newly-imagined port town in the year 2100. Students responded to projected sea level rise of 3.5 feet as identified by the Town of Oxford and the Department of Natural Resources (DNR) Coastal Planners. In addition to a change in mean sea level, students considered mean higher high water (MHHW) above sea level to explore planning and design-scale interventions to inform Oxford’s strategies on climate-sensitive development. The design of this hypothetical intervention focused on sea level rise, as well related factors such as pluvial hydrology, saltwater intrusion, and storm surge.Maryland Department of Natural Resource

Streptococcus pneumoniae Serotype-2 Childhood Meningitis in Bangladesh: A Newly Recognized Pneumococcal Infection Threat

BACKGROUND: Streptococcus pneumoniae is a leading cause of meningitis in countries where pneumococcal conjugate vaccines (PCV) targeting commonly occurring serotypes are not routinely used. However, effectiveness of PCV would be jeopardized by emergence of invasive pneumococcal diseases (IPD) caused by serotypes which are not included in PCV. Systematic hospital based surveillance in Bangladesh was established and progressively improved to determine the pathogens causing childhood sepsis and meningitis. This also provided the foundation for determining the spectrum of serotypes causing IPD. This article reports an unprecedented upsurge of serotype 2, an uncommon pneumococcal serotype, without any known intervention. METHODS AND FINDINGS: Cases with suspected IPD had blood or cerebrospinal fluid (CSF) collected from the beginning of 2001 till 2009. Pneumococcal serotypes were determined by capsular swelling of isolates or PCR of culture-negative CSF specimens. Multicenter national surveillance, expanded from 2004, identified 45,437 patients with suspected bacteremia who were blood cultured and 10,618 suspected meningitis cases who had a lumber puncture. Pneumococcus accounted for 230 culture positive cases of meningitis in children <5 years. Serotype-2 was the leading cause of pneumococcal meningitis, accounting for 20.4% (45/221; 95% CI 15%-26%) of cases. Ninety eight percent (45/46) of these serotype-2 strains were isolated from meningitis cases, yielding the highest serotype-specific odds ratio for meningitis (29.6; 95% CI 3.4-256.3). The serotype-2 strains had three closely related pulsed field gel electrophoresis types. CONCLUSIONS: S. pneumoniae serotype-2 was found to possess an unusually high potential for causing meningitis and was the leading serotype-specific cause of childhood meningitis in Bangladesh over the past decade. Persisting disease occurrence or progressive spread would represent a major potential infection threat since serotype-2 is not included in PCVs currently licensed or under development

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely