Topical antihistamines and mast cell stabilisers for treating seasonal and perennial allergic conjunctivitis

Peer reviewedPublisher PD

Cost-effectiveness of malaria diagnosis using rapid diagnostic tests compared to microscopy or clinical symptoms alone in Afghanistan

Background Improving access to parasitological diagnosis of malaria is a central strategy for control and elimination of the disease. Malaria rapid diagnostic tests (RDTs) are relatively easy to perform and could be used in primary level clinics to increase coverage of diagnostics and improve treatment of malaria.<p></p> Methods A cost-effectiveness analysis was undertaken of RDT-based diagnosis in public health sector facilities in Afghanistan comparing the societal and health sector costs of RDTs versus microscopy and RDTs versus clinical diagnosis in low and moderate transmission areas. The effect measure was ‘appropriate treatment for malaria’ defined using a reference diagnosis. Effects were obtained from a recent trial of RDTs in 22 public health centres with cost data collected directly from health centres and from patients enrolled in the trial. Decision models were used to compare the cost of RDT diagnosis versus the current diagnostic method in use at the clinic per appropriately treated case (incremental cost-effectiveness ratio, ICER).<p></p> Results RDT diagnosis of Plasmodium vivax and Plasmodium falciparum malaria in patients with uncomplicated febrile illness had higher effectiveness and lower cost compared to microscopy and was cost-effective across the moderate and low transmission settings. RDTs remained cost-effective when microscopy was used for other clinical purposes. In the low transmission setting, RDTs were much more effective than clinical diagnosis (65.2% (212/325) vs 12.5% (40/321)) but at an additional cost (ICER) of US$4.5 per appropriately treated patient including a health sector cost (ICER) of US$2.5 and household cost of US$2.0. Sensitivity analysis, which varied drug costs, indicated that RDTs would remain cost-effective if artemisinin combination therapy was used for treating both P. vivax and P. falciparum. Cost-effectiveness of microscopy relative to RDT is further reduced if the former is used exclusively for malaria diagnosis. In the health service setting of Afghanistan, RDTs are a cost-effective intervention compared to microscopy.<p></p> Conclusions RDTs remain cost-effective across a range of drug costs and if microscopy is used for a range of diagnostic services. RDTs have significant advantages over clinical diagnosis with minor increases in the cost of service provision.<p></p&gt

The Limnological Effects of River Lesser-Zab on Tigris River, Iraq

The present study included the physico-chemical parameters of Lesser-Zab river and its effects on Tigris river. Monthly water samples were taken from the two rivers during January to October 1999.There were no signifcant difference in water temperatures. Both rivers were fresh to oligohalin, alkaline and very hard. Close values were determined in total suspended solids in both rivers with little increasing during rainfall period and high discharge. Water was well areated and over saturation was recorded in several occasions. Dissolved oxygen values of Tigris river were influenced by Lesser-Zab. Cations were more dominant than anions in both rivers. In Lesser-Zab, the anions were increased during spring season and declined in summer which their values influenced in Tigris river. The concentration of plant nutrients (NO2,NO3,PO4 and SiO2) were fluctuated during the study period in Lesser-Zab and their effects were cleared on Tigris river.N:P ratio values were indicated the deficiency of nitrogen in both rivers

Demonstration of Polarization-Independent Surface Plasmon Resonance Polymer Waveguide for Refractive Index Sensing

The effect of the variation of the refractive index in a gold-coated ormocomp waveguide for sensing application is studied in this paper. The ormocomp waveguide is fabricated by using the nanoimprint method. A waveguide with width and height both equal to 10 μm is coated with 100 nm thick gold using the sputtering technique in order to introduce surface plasmon resonance at the vertical sides and also at the top of the structure. Here, polarization-independent waveguide is achieved by supporting both the plasmonic TE and TM modes and the light confinement in these modes are studied. Supermodes forming from coupling between the fundamental dielectric mode and the plasmonic supermode at the resonance peak are also investigated. This paper presents the numerical simulated results and also their experimental validations. For this structure, there are two dielectric-plasmon supermodes with two resonance peaks separated by 50 nm. A red shift is observed when the refractive index of the cladding material increases. The cladding material includes water (n = 1.333) and iso-propanol solutions with refractive indices of 1.344, 1.351, and 1.365. The gold-coated ormocomp waveguide has sensitivity of about 544.55 nm/RIU with a resolution of 5.3 × 10⁻³ RIU

Continuous flow vortex fluidic-mediated exfoliation and fragmentation of two-dimensional MXene

MXene (Ti2CTx) is exfoliated in a vortex fluidic device (VFD), as a thin film microfluidic platform, under continuous flow conditions, down to ca 3 nm thin multi-layered twodimensional (2D) material, as determined using AFM. The optimized process, under an inert atmosphere of nitrogen to avoid oxidation of the material, was established by systematically exploring the operating parameters of the VFD, along with the concentration of the dispersed starting material and the choice of solvent, which was a 1 : 1 mixture of isopropyl alcohol and water. There is also some fragmentation of the 2D material into nanoparticles ca 68 nm in diameter

Heat Transfer Enhancement in Vertical Channel for Two Phase Flow by using Compound Turbulater

الخليط من تدفق الماء والهواء (غاز – ماء) له العديد من التطبيقات في الصناعات الميكانيكية والكيمياوية و انظمة التسخين (المبادلات الحراريه والفتحات ),مجال الطاقة ,النفط,التبريد والتكيف.خصائص هذا الخليط (ماء – هواء) تم التحقق منه عمليا داخل قناة مستطيلة وضعت عموديا بواسطة استخدام لوحة مسخنة (معرقل مركب من الاضلاع وتجويف ) مع معدلات تدفق حجمية مختلفة من الماء والهواء وبثبوت الحرارة على  وحدة المساحة .ابعاد القناة المستطيلة (5×3×70 سم) .الهدف من هذه التجارب هو لبيان ظاهرة الجريان ثنائي الطور بوجود لوحة المسخنة (المعرقل المركب بثلاث اشكال ) ولمختلف معدلات التدفق من الماء والهواء .اربع قيم مختلفة لتدفق الماء (3,6,9,و12)لتر/دقيقة,ثلاث قيم مختلفة لتدفق  الهواء (8.33,16.67,و 25)لتر / دقيقة,و ثلاث قيم مختلفة من الطاقة الحرارية (109.65,150,و 235 واط) تم استخدامها.درجة حرارة الخليط تم قياسها في مواقع متعددة على طول القناة,و وتم تصور سلوك الخليط داخل القناة باستخدام كاميرا الفيديو.اظهرت النتائج بانه عند زيادة تدفق الماء والهواء الجريان يصبح مضطربا,وتتكون الدوامات حول اللوحة المسخنه ,درجة حرارة الخروج تقل ومعامل انتقال الحرارة سوف يزداد. المعرقل المركب مع موقع نسبي للتجويف = 0.55 له معدل اكبر في انتقال الحرارة , حيث ان النسبة المئوية للفرق عن  الانواع الاخرى   ( g/p = 0.73 و 0.37) كانت 4%  و  6% بالتعاقب ويرجع ذلك إلى حقيقة أن الخلط والسطح الكاسح في هذه الأنواع من مثيرات الاضطراب المركبة هي أكثر من الانواع الاخرى.The mixture of air-water (gas-water) flow has many applications in chemical and mechanical industries and heating systems (heat exchangers and manifolds), fields of energy, petroleum, refrigeration, and air conditioning. The characteristics of the mixture (water, air) have been investigated experimentally in a rectangular channel placed vertically by using internal heated plate (compound turbulater ribs and groove) with different volume flow rates of water and air, and constant heat flux. The dimensions of the rectangular channel are (5 × 3 × 70 cm). The aim of these experiments is to display the two-phase flow phenomenon with heated plate (three compound turbulater) for different water and air discharges. Four different values of water flow rate (3, 6, 9, and 12 l/min), three different values of air flow rate (8.33, 16.67, and 25 l/m), and three different values of heat power (109.65, 150, and 235 watts) have been used. The temperature of the mixture has been measured at several locations along the channel, and the behavior for the mixture inside the channel has been visualized by using video camera. The results showed that when water and air flow rate increases, flow becomes turbulent, vortices develops around the heated plate, the exit temperature decreases and local heat transfer coefficient increases. The compound turbulater with relative groove position (g/p)=0.55 had a higher rate of heat transfer ,where the percentage difference from other model (g/p = 0.73 and 0.37) were 4% and 6% , respectively due to the fact that the flow mixing and sweeping surface in these types of compound turbulater are more than others type

Design and Characterization of Porous Core Polarization Maintaining Photonic Crystal Fiber for THz Guidance

An improved design of Teflon photonic crystal fiber with a porous air-core is presented for low-loss terahertz guidance. Optimization of total power confinement in the air-holes, together both in the cladding and core regions, is carried out for both quasi-TE and quasi-TM polarizations by using a full-vectorial finite element method. To achieve the polarization maintenance, modal birefringence is enhanced by destroying the circular symmetry with the introduction of unequal size air-holes in the first ring

Factors associated with emergency department green zone utilization in hospital

Introduction: In hospital, emergency departments are highly utilized by patients. Overcrowding, congestion and long waiting time were among the issues highlighted resulting from it. In Selangor, there has been a steady increase in utilization of emergency department of government hospitals over the past five (5) years. Utilization of green zone was the highest in these hospitals. Being a department that provides a comprehensive emergency service and provides easy access for the community, issues of appropriateness utilization arise. This study aims to determine the level of appropriateness of green zone utilization by patients attending Emergency Department in Serdang Hospital and factors influencing its utilization. Methodology: A cross-sectional study was conducted in Emergency Department of Serdang Hospital. Sample sizes of green zone adult patients were obtained by systematic random sampling. Emergency Medicine and Trauma Services Policy Malaysia 2012 were used to classify patients to appropriate and inappropriate utilization of green zone. Pre-tested self-administered questionnaire were used to interview patients. Descriptive statistics, chi-square test and logistic regression used to analyse the data collected. Data analysis conducted using IBM SPSS Statistics version 22 and p value significant at <0.05. Result: There were 793 (90.7%) patients in this study. It was found that level of appropriateness utilization in green zone emergency department was 83.6% appropriate and 16.4% was inappropriate. Median age of patients were 29 years old (IQR ± 25th, 75th; 23, 40). Majority were Malays (74%). The results of chi-square test indicated that there were significant association between marital status (p=0.032), patients attending emergency department because treatment cost is cheap (p=0.025), emergency department operates 24 hours (p=0.045) and time of patient presentation to emergency department (p=0.001). From the study, the multivariate results revealed that the odds of married patients (AOR=1.481, 95% CI: 1.008, 2.174) to utilize the emergency department were higher than not married patients, the odds of patients utilize emergency department not because of the cheap treatment (AOR=1.614, 95% CI: 1.073, 2.469) was almost two times more and lastly the odds of utilization after office hours were two times more than during office hours (AOR=2.117, 95% CI: 1.388, 3.227). Conclusion: The study revealed majority of patients utilized green zone appropriately. Married patient, patient attend emergency department not because treatment cost is cheap and patient attending after office hour were significantly associated with appropriateness utilization of emergency department. Further study needed to determine the cause and effect relationship

Early functional outcome of two surgical protocols used in the repair of complete unilateral cleft lip palate: a comparative study

Background and objective The outcome of different treatment protocols for primary management of patients with complete unilateral cleft lip palate (UCLP) may vary considerably. This study aimed to compare the results of quality of speech and velopharyngeal sphincter mechanism between two surgical protocols used in the repair of complete UCLP.Patients and methods This study was conducted in Zagazig University Hospitals from February 2009 to April 2012 on 30 patients. The patients were categorized into two groups: group A, which consisted of 15 patients who underwent cleft lip repair and cleft hard palate repair with a vomer flap in same sitting; and group B, which consisted of 15 patients who underwent only cleft lip repair at first sitting. At the age of 12 months in both groups, repair of the remaining cleft palate was performed.Results A significant difference between groups A and B at all postoperative comparisons was found in terms of grade of nasality, grade of closure of the velopharyngeal valve, and nasal emission of air.Conclusion Early repair of the hard palate with simultaneous cleft lip repair can be considered as a reliable alternative procedure to one-stage palatoplasty and appeared to have better early functional results in the treatment of complete UCLP