Is there an association between vitamin D and risk of stroke?: a North Indian study

Background: Vitamin D deficiency is present in India in epidemic proportions despite plenty of sunshine. Reduced plasma 25(OH) D concentrations as a diagnostic marker of vitamin D deficiency have been in past decade associated with several well-established risk factors for ischaemic stroke, such as arterial hypertension, thrombosis, atherosclerosis. The aims and objectives of this study was to compare the serum 25(OH) D levels between the first ever acute stroke patients and healthy controls.Methods: A cross-sectional, case control study was conducted in a tertiary care hospital in New Delhi situated in north India. Serum 25‑hydroxyvitamin D (25(OH) D) levels in 85 patients of ischemic stroke, presenting within 7 days of onset of stroke was measured and was compared with 70 age and gender matched controls.Results: The mean age was 61.02±11.58 years and 58.63±11.28 years in cases and controls respectively. Females constituted 37.6% of the total number of cases and 43.4% of the controls. The age and gender-distribution were comparable between the cases and controls. The median value (IQR) of serum 25(OH) vitamin D level was 7.94 ng/mL (4.59-14.00) in the cases and it was 8.82 ng/mL (5.59-14.70) in the controls. The difference between the serum 25(OH) vitamin D levels of the two groups was not found to be statistically significant.Conclusions: There is a high prevalence of biochemical hypo-vitaminosis D in apparently healthy Indians of all age and sex groups despite adequate sunshine. There is no association between low vitamin D levels and stroke

Arterial blood gas levels in high altitude Kashmiri population, India

Background: The valley of Kashmir lies at an average height of 1730 m above the sea level with a barometric pressure of 624 mmHg. The fall in atmospheric pressure at higher altitude decreases the partial pressure of inspired oxygen and hence the driving pressure for gas exchange in the lungs. At sea level the normal range of PaCO2 is 35 mmHg to 45 mmHg and at 1500m above sea level (barometric pressure 634 mmHg), the predicted normal PaO2 in a healthy young adult is approximately 80 mmHg; this contrasts with a value close to 95 mmHg at sea level. On these grounds this study was undertaken to formulate normal ABG values for this place as it lies at a higher altitude.Methods: The study was undertaken to measure "arterial blood gases" (ABG) in ethnic Kashmiri population and consisted of a sample of one hundred healthy Kashmiri subjects of either sex after proper inclusion and exclusion by spirometrically measuring Vital Capacity and Forced expiratory volume in one second/Forced vital capacity (Fev1/FVC). A modified Allen's test was performed to check for adequate collateral circulation ruling out Ischemia.Results: The average mean PaO2 of 78.51 ± 4.40 mmHg and the average mean PaCO2 of 33.37 ± 2.38 mmHg was obtained of the volunteers of both the sexes. The average mean pH of males (7.43 ± 0.02) was significantly lower than the mean pH of females (7.45 ± 0.021).Conclusions: The present study might provide useful base line normal values of Arterial Blood Gases for the local population and will be beneficial to the clinicians.

Closure of anterior palatal fistula using tongue flap: our experience

Background: Palatal fistula is one of the most common complications following cleft palate repair. It occurs mostly due to tip necrosis of palatal flaps. Small palatal fistulas are usually closed by transposition of adjacent tissues, however these local tissues are not sufficient for the closure of bigger fistulas. The tongue flap serves as a reliable and most easily obtainable local flap for closure of large sized palatal fistulas.Methods: This is a prospective study conducted from Aug 2006 to July 2015 in the department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India. A total of 25 patients with large anterior palatal fistula were treated using anteriorly based tongue flap. Patients were selected on the basis of size of fistula (> 1x1 cm), scarred local palatal tissue or history of fistula recurrence after previous attempts of closure using local palatal tissues.Results: In present study 25 patients of palatal fistula were treated using tongue flap. Eighty percent patients were in the age group of 3 to 5 years. Male-to-female ratio was 2:3. The largest dimension of treated fistula was 4x3 cm. There was partial dehiscence of flap suture line in two patients while remnant fistula was observed in three patients. None of our patients had flap necrosis.Conclusions: Tongue flap is an excellent and versatile option for closure of large palatal fistulas with high success rate and least morbidity

Psychological impact of COVID-19 on healthcare workers: cross-sectional analyses from 14 countries

Abstract Background Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs. Methods A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively. Results A total of 2447 HCWs participated; 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs; the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20%; the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63%; the lowest rate was reported in Libya (28%) and the highest in Syria (76%). Conclusion COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered

New technique for strengthening squarereinforced concrete columns by the circularisation with reactive powder concrete and wrapping with fibre-reinforced polymer

This paper presents a new strengthening technique for square-reinforced concrete (RC) columns by circularisation with reactive powder concrete (RPC) and wrapping with fibre-reinforced polymer (FRP). RC column specimens were tested, divided into four groups of four specimens based on the strengthening technique: four reference square specimens (150mm side length) without any strengthening, four were wrapped with two layers of carbon fibre-reinforced polymer (CFRP) and the remaining eight were strengthened by changing the square cross-section to a 240mm diameter circle with RPC jacket. Four of the RPC jacketed specimens were left unwrapped, while the last four were wrapped with two layers of CFRP. From each group, one specimen was tested under concentric axial load, two were tested under eccentric axial load and one was tested under four-point bending. It was found that using the RPC for circularisation and strengthening of existing square RC columns is an effective technique to significantly increase their axial carrying capacity, ultimate flexural load and energy absorption. Wrapping the circularised RC columns with CFRP prevented the failure of the RPC jacket at the corners of the existing square RC columns under the axial load, and improved the ultimate load as well as the energy absorption of the circularised RC columns

Analytical investigation on the behavior of circular and square RC columns strengthened with RPC and wrapped with FRP under uniaxial compression

This paper presents an analytical approach to predict the uniaxial compression behavior of circular and square reinforced concrete (RC) columns strengthened with reactive powder concrete (RPC) jackets and wrapped with fiber reinforced polymer (FRP). The analytical axial load-axial strain responses of the strengthened RC columns were compared with experimental axial load-axial strain responses. The analytical approach presented in this study conservatively predicted the ultimate axial load of the strengthened RC columns. Also, a parametric study was carried out to investigate key factors that influence the axial load-axial strain response of the strengthened RC columns. It was found that the ratio of the RPC jacket thickness to the diameter or side length of the base RC column significantly influenced the service axial load, ultimate axial load and ductility of a strengthened RC column

Mechanical properties of steel, glass, and hybrid fiber reinforced reactive powder concrete

This study examines the properties of fiber-reinforced reactive powder concrete (FR-RPC). Steel fibers, glass fibers, and steel-glass hybrid fibers were used to prepare the FR-RPC. The non-fibrous reactive powder concrete (NF-RPC) was prepared as a reference mix. The proportion of fibers by volume for all FR-RPC mixes was 1.5%. Steel fibers of 13 mm length and 0.2 mm diameter were used to prepare the steel fiber-reinforced RPC (SFR-RPC). Glass fibers of 13 mm length and 1.3 mm diameter were used to prepare the glass fiber-reinforced RPC (GFR-RPC). The hybrid fiber-reinforced RPC (HFR-RPC) was prepared by mixing 0.9% steel fibers and 0.6% glass fibers. Compressive strength, axial load-axial deformation behavior, modulus of elasticity, indirect tensile strength, and shear strength of the RPC mixes were investigated. The results showed that SFR-RPC achieved higher compressive strength, indirect tensile strength and shear strength than NF-RPC, GFR-RPC, and HFR-RPC. Although the compressive strengths of GFR-RPC and HFR-RPC were slightly lower than the compressive strength of NF-RPC, the shear strengths of GFR-RPC and HFR-RPC were higher than that of NF-RPC

Analysis of Lithuania public debt during for the 2005-2009 period

The governmental borrowing does not cause damage to the economy if only the opportunities provided by debt are used in an optimal way. Increase in the public debt would not cause any special problems theoretically because the economical development and rise of revenue would promote in maintaining or indemnifying the public debt. The aim of this article to clarify what is the composition of public debt, what factors are stimulating the government borrowing. In the article is analysing the arrears variation tendencies of Lithuania's public debt in 2005-2009 period and what had the greatest impact for public debt increasing. The results show us that the Lithuanian public debt is relatively low compared with European Union countries and satisfy requirements of the Maastricht Treaty. However, during the analysis period, the public debt increased by two times. It gives us pause for thought and find decision how to solve this problem, because the rising public debt destine the increasing taxes for future taxpayers

Design and Pedagogy Features in Online Courses: A survey

Purpose: The study investigates the preferences of instructors and students for design and pedagogy features of online instruction at the post-graduate level. Design/Methodology/Approach: The study was carried out using questionnaire as a data gathering tool. Characteristics and features were identified through a comprehensive literature review combined with focus groups. Various design and pedagogy features were identified and the items were structured in a Likert Scale format. Respondents were asked to rate their preferences on a five-point scale, ranging from strongly agree to strongly disagree, for each individual feature. Participants include 7 instructors and 50 students at Indira Gandhi National Open University (IGNOU).An independent sample T-test was conducted to determine if there was a significant difference between the preferences of instructors and students on the rating of individual features.Scope: To better understand the design and pedagogy features of online instruction, India’s largest e-learning academic institution IGNOU was selected.Findings: Major findings include the high level of agreement on design and pedagogy features by instructors and students and the similarities in rank order by both students earning regular university credit and those pursuing professional development goals. When compared with the ranking of instructors and students, low preferences were being placed on social interactive features.Practical Implications: While there are many parallels between face-to-face teaching and online instruction, there are some differences also. Asynchronous online instruction must be designed in advance of being delivered.Keywords: Pedagogy; e-learning; Continuing education; Online instruction; Development expertisePaper Type: Researc

Axial and flexural behaviour of circular reinforced concrete columns strengthened with reactive powder concrete jacket and fibre reinforced polymer wrapping

This paper investigates axial and flexural behaviour of circular reinforced concrete (RC) columns strengthened with reactive powder concrete (RPC) jacket and fibre reinforced polymer wrapping. The experimental results of 16 circular RC column specimens have been presented. The specimens were divided into four groups of four specimens. Column specimens of the first group were the reference RC specimens without any strengthening, specimens of the second group were strengthened by wrapping with two layers of carbon fibre reinforced polymer (CFRP), specimens of the third group were jacketed with a 25 mm thick layer of RPC and specimens of the fourth group were jacketed with a 25 mm thick layer of RPC then wrapped with a single layer of CFRP. Test results demonstrated that jacketing with a thin layer of the RPC enhanced significantly the ultimate axial and flexural loads as well as energy absorption of circular RC column specimens. Wrapping the RPC jacketed specimens with CFRP improved the ultimate axial load, ductility and energy absorption of the specimens