Digitizing radiology films using flat-bed scanner and produce a multimedia digital teaching file in musculoskeletal radiology

Digital images have been long established in radiology department. Despite this, most radiology teaching films has been film-based. The drawback of this conventional system is that it consumed space, only one user can use at any one time and expensive. Analogue radiology films were digitized using flatbed scanner with transparency adaptor and digital camera. Digital-based teaching files using personal computer (PC) should be encouraged as this will reduce space for storing, can be distributed without much cost, inexpensive, many users can use at the same time and others can use even though at different place using the internet. The teaching file was prepared using HyperText Mark-up Language (HTML) as this can be used using any web browser. It is now available in University Sains Malaysia, Kelantan Campus Branch (USMKCK) intranet

Tc-99m NIDP and Tc-99m HMPAO labelled leukocyte scans in tuberculous spondylitis

A study was undertaken to assess the pattern of uptake on bone and labelled leukocyte scans in tuberculous spondylitis. Nine consecutive newly diagnosed cases were studied with Tc-99m MDP bone scans and Tc-99m HMPAO labelled leukocyte scans.The patients had basic laboratory investigations, plain chest and spine radiographs and computed tomography of the spine. Static images of bone scans were acquired at 3 hours and labelled leukocyte scans were acquired at 1,3 and 24 hours post-injection. A total of 11 spinal lesions were detected. Six bone scans were done demonstrating eight lesions and all showed abnormally increased activity.Labelled leukocyte scans were done in eight patients involving ten lesions and all except one showed photopaenic defects at the regions of interest.Both bone scan and leukocyte scan provided important information about the extent of the lesions and the combination of their pattern of uptake helped in the diagnosis of tuberculous spondylitis

NXY-059 for the treatment of acute stroke: pooled analysis of the SAINT I and II trials

<p><b>Background and Purpose:</b> In animal models of acute ischemic stroke (AIS), the free radical-trapping agent NXY-059 showed promise as a neuroprotectant. SAINT I and II were randomized, placebo-controlled, double-blind trials to investigate the efficacy of NXY-059 in patients with AIS.</p> <p><b>Methods:</b> Patients with AIS received an infusion of intravenous NXY-059 or placebo within 6 hours from the onset of stroke symptoms. A pooled individual patient analysis was prespecified to assess the overall efficacy and to examine subgroups. The primary end point was the distribution of disability scores measured on the modified Rankin scale (mRS) at 90 days. Neurologic and activities of daily living scores were investigated as secondary end points. We also evaluated whether treatment with NXY-059 would reduce alteplase-related intracranial hemorrhages. Finally, we evaluated possible predictors of good or poor outcome.</p> <p><b>Results:</b> An intent-to-treat efficacy analysis was based on 5028 patients. Baseline parameters and prognostic factors were well balanced between treatment groups. The distribution of scores on the mRS was not different in the group treated with NXY-059 (n = 2438) compared with the placebo group (n = 2456): odds ratio for limiting disability = 1.02; 95% CI, 0.92 to 1.13 (P = 0.682, Cochran-Mantel-Haenszel test). Comparisons at each level of the mRS confirmed an absence of benefit. There was no evidence of efficacy in prespecified subgroups or from the secondary outcome analyses. Mortality was equal in the 2 groups (16.7% vs 16.5%), and adverse event rates were similar. Among patients treated with alteplase, there was no decrease in rates of symptomatic or asymptomatic hemorrhage associated with NXY-059 treatment versus placebo. Subgroup analyses identified National Institutes of Health Stroke Scale score, age, markers of inflammation, blood glucose, and right-sided infarct as predictors of poor outcome.</p> <p><b>Conclusions:</b> NXY-059 is ineffective for treatment of AIS within 6 hours of symptom onset. This is also true for subgroups and the prevention of alteplase-associated hemorrhage.</p&gt

Safety and tolerability of NXY-059 for acute intracerebral hemorrhage: the CHANT trial

<p><b>Background and Purpose:</b> NXY-059 is a free radical-trapping neuroprotectant developed for use in acute ischemic stroke. To facilitate prompt administration of treatment, potentially before neuroimaging, we investigated the safety of NXY-059 in patients with intracerebral hemorrhage (ICH).</p> <p><b>Methods:</b> We randomized 607 patients within 6 hours of acute ICH to receive 2270 mg intravenous NXY-059 over 1 hour and then up to 960 mg/h over 71 hours, or matching placebo, in addition to standard care. The primary outcome was safety: the mortality and the frequency of adverse events, and the change from baseline for a variety of serum, imaging, and electrophysiological measurements. We also studied the overall distribution of disability scores on the modified Rankin Scale (mRS) and the Barthel index.</p> <p><b>Results:</b> We treated 300 patients with NXY-059 and 303 with placebo. Treatment groups were well matched for prognostic variables including Glasgow Coma Scale, risk factors, and age. The mean National Institute of Health Stroke Scale score on admission was 14 in both groups. The baseline hemorrhage volume was 22.4±20.1 mL in the NXY-059 group and 23.3±22.8 mL in the placebo group (mean±SD). Most hemorrhages were related to hypertension or anticoagulant use. Mortality was similar in both groups: 20.3% for NXY-059 and 19.8% for placebo-treated patients. The proportion of patients who experienced an adverse event was the same for both groups, whereas for serious adverse events the proportion was slightly higher in the NXY-059 group. However, no pattern emerged to indicate a safety concern. Serum potassium fell transiently in both groups, lower in the NXY-059 group. There were no differences in 3-month function, disability, or neurological deficit scores. The odds ratio for an improved outcome in 3-month mRS scores in the NXY-059 group was 1.01 (95% CI 0.75, 1.35).</p> <p><b>Conclusions:</b> NXY-059 given within 6 hours of acute ICH has a good safety and tolerability profile, with no adverse effect on important clinical outcomes.</p&gt

Evaluation of Chemical and Physico-Mechanical Properties of some Nigeria Natural Clays Samples for Foundry Applications

Studies have shown that Nigerian clays have not been fully utilized for foundry applications, either as refractories or even bonding clays, and are still being imported into the country. There is need to effectively exploit and adequately utilize the available natural resources to improve Nigeria economic activities, most especially during the present economic recession. Samples of clays were obtained from Auchi, Dada-Okelele (Ilorin), Kaba, Maraba-Rido, Mokwa and New-Bussa in Nigeria. The samples’ physico-mechanical properties were examined for its suitability for foundry/refractory applications. The results of the chemical analysis revealed that the samples belong to Alumino-Silicate refractories. The samples exhibited 35.3-96.2%, 17.1-28.7%, 1.72-2.34 g/cm3, 2.2-10.1%, 73-86 and >1300oC as values for percentage clay contents, apparent porosity, bulk density, permeability, linear shrinkage and refractoriness respectively. These values were within the standard range values of >35%, 22-30%, 17-2.4%, 2.0-10.1% and 25-90 required as percentage clay contents, apparent porosity, bulk density, permeability and linear shrinkage values respectively, for refractory clays/brick lining or alumina-silicates, kaolin and fireclays. Hence, the clays could suitably replace imported clays / ceramics in refractory applications, such as in production of earthen wares, chalk; as insulating refractories for casting and melting of low and medium temperature iron and steel. Appropriate utilization of these clays for local foundry applications will assist in addressing the problem of inadequate job, and over dependence on foreign goods.Keywords— Alumino-Silicate, Clay, Foundry, Moisture and Refractorines

Screening for developmental disabilities in HIV positive and HIV negative children in South Africa: Results from the Asenze Study

Background While neurodevelopmental abnormalities are common in children with HIV infection, their detection can be challenging in settings with limited availability of health professionals. The aim of this study was to assess the ability to identify developmental disability among HIV positive and HIV negative children living in South Africa with an internationally used screen. Methods and findings This analysis uses a sample of 1,330 4–6 year old children and 1,231 of their caregivers in KwaZulu-Natal, South Africa, including administration of the Ten Questions (TQ) screen, a standardized medical history and physical examination conducted by a medical doctor, with hearing and vision screening, psychological assessment for cognition and language delay, and voluntary HIV testing. There was a high prevalence of disability among the sample. Compared to HIV negative children, HIV positive children were more likely to screen positive on at least one TQ item (59.3 vs 42.8%, p = 0.01), be delayed in sitting, standing or walking (OR 3.89, 95% CI = 2.1–7.2) and have difficulty walking or weakness in the arms or legs (OR = 2.7, 95%CI = 0.8–9.37). By medical doctor assessment, HIV positive children were more likely to be diagnosed with gross motor disability (OR = 3.5, 95%CI = 1.3–9.2) and hearing disability (OR = 2.5, 95%CI = 1.2–5.3). By independent psychological assessment, HIV positive children were more likely to have cognitive delay (OR = 2.2, 95%CI = 1.2–3.9) and language delay (OR = 4.3, 95%CI = 2.2–8.4). Among HIV positive children, the sensitivity and specificity of the TQ for serious disability (vs. no disability) was 100% and 51.2%, respectively. Among HIV-negative children, the sensitivity and specificity of the TQ for serious disability (vs. no disability) was 90.2% and 63.9%, respectively. Conclusions In this first report of the use of the TQ screen in the isiZulu language, it was found to have high sensitivity for detecting serious developmental disabilities in children, especially HIV positive children. The performance of the TQ in this sample indicates utility for making best use of limited neurodevelopmental resources by screening HIV positive children

Is the effect of precipitation on acute gastrointestinal illness in southwestern Uganda different between Indigenous and non-Indigenous communities?

Acute gastrointestinal illness (AGI) is a global public health priority that often disproportionately effects Indigenous populations. While previous research examines the association between meteorological conditions and AGI, little is known about how socio-cultural factors may modify this relationship. This present study seeks to address this research gap by comparing AGI prevalence and determinants between an Indigenous and non-Indigenous population in Uganda. We estimate the 14-day self-reported prevalence of AGI among adults in an Indigenous Batwa population and their non-Indigenous neighbours using cross-sectional panel data collected over four periods spanning typically rainy and dry seasons (January 2013 to April 2014). The independent associations between Indigenous status, precipitation, and AGI are examined with multivariable multi-level logistic regression models, controlling for relative wealth status and clustering at the community level. Estimated prevalence of AGI among the Indigenous Batwa was greater than among the non-Indigenous Bakiga. Our models indicate that both Indigenous identity and decreased levels of precipitation in the weeks preceding the survey period were significantly associated with increased AGI, after adjusting for confounders. Multivariable models stratified by Indigenous identity suggest that Indigenous identity may not modify the association between precipitation and AGI in this context. Our results suggest that short-term changes in precipitation affect both Indigenous and non-Indigenous populations similarly, though from different baseline AGI prevalences, maintaining rather than exacerbating this socially patterned health disparity. In the context of climate change, these results may challenge the assumption that changing weather patterns will necessarily exacerbate existing socially patterned health disparities

Numerical Evaluation of Fatigue Crack Growth of Structural Steels Using Energy Release Rate with VCCT

This research presents the numerical evaluation of fatigue crack growth of structural steels S355 and S960 based on Paris’ law parameters (C and m) that are experimentally determined with a single edge notched tension (SENT) specimen using optical and crack gauge measurements on an electromotive resonance machine at constant amplitude load. The sustainable technique is replacing destructive, time-consuming and expensive approaches in structural integrity. The crack propagation is modelled using the 3D finite element method (FEM) with adaptive remeshing of tetrahedral elements along with the crack initiator elements provided in simulation software for crack propagation based on linear elastic fracture mechanics (LEFM). The stress intensity is computed based on the evaluation of energy release rates according to Irwin’s crack closure integral with applied cyclic load of 62.5 MPa, 100 MPa and 150 MPa and stress ratios of R = 0 and 0.1. In order to achieve optimized mesh size towards load cycle and computational time, mesh and re-mesh sensitivity analysis is conducted. The results indicate that the virtual crack closure technique VCCT-based 3D FEM shows acceptable agreement compared to the experimental investigation with the percentage error up to 7.9% for S355 and 12.8% for S960 structural steel