Different methods of providing automatic external defibrillators to out-of-hospital cardiac arrests to prevent sudden cardiac death

OBJECTIVES: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To establish the effectiveness of different methods of early AED application (non-dispatched layperson, dispatched layperson, dispatched professional, drone delivery - all interventions) versus standard care (comparator) in adults who suffer a witnessed out-of-hospital cardiac arrest in a public setting (population) upon outcomes of survival and neurological function

Incidence and etiology of omphalitis in Pakistan: a community-based cohort study

Introduction: Although omphalitis (umbilical infections) among newborns is common and a major cause of neonatal deaths in developing countries, information on its burden and etiology from community settings is lacking. This study aimed to determine the incidence and etiology of omphalitis in newborns in high neonatal mortality settings in Karachi, Pakistan. Methodology: Trained community health workers surveyed all new births in three low-income areas from September 2004 to August 2007. Pus samples from the umbilical stumps were obtained from babies with pre-defined signs of illness and subjected to culture and antimicrobial susceptibility testing. Results: Among 6904 births, 1501 (21.7%) newborns were diagnosed with omphalitis. Of these, 325 (21.6%) were classified as mild, 1042 (69.4%) as moderate, and 134 (8.9%) as severe, 141 (9.3%) were associated with clinical signs of sepsis. The incidence of omphalitis was 217.4/1000 live births, moderate-severe omphalitis 170.3 per 1000 live births, and associated with sepsis 20.4 per 1000 live births. Of 853 infants with purulent umbilical discharge, 64% yielded 583 isolates. The most common pathogens were Staphylococcus aureus, of which 291 (95.7%) were methicillin-susceptible Staphylococcus aureus (MSSA) and 13 (4.2%) methicillin-resistant S. aureus (MRSA), Streptococcus pyogenes 105 (18%), Group B beta-hemolytic streptococci 59 (10 %), Pseudomonas spp., 52 (8.9 %), Aeromonas spp. 19 (3.2%), and Klebsiella spp. 12 (2%). Conclusions: A high burden of omphalitis can be associated with sepsis among newborns in low-income communities in Pakistan. S. aureus is the most common pathogen isolated from umbilical pus. Appropriate low-cost prevention strategies need to be implemented

Oral Class I and III antiarrhythmic drugs for maintaining sinus rhythm after catheter ablation of atrial fibrillation

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of oral Class I and III antiarrhythmic drugs for maintaining sinus rhythm in patients undergoing catheter ablation, compared to catheter ablation alone, for atrial fibrillation (AF)

Comparison the efficient reclamation of different inorganic materials with organic amendments to rice-wheat crop sustainable production in salt-affected soils

Amelioration of salt-affected soils requires an integrated management approach, which not only improves their effectiveness for improving soil properties, but also increases the crop production and quality of the produce. Hence, a study was planned to evaluate combined use of organic and inorganic amendments for better rehabilitation of salt affected soil in ricewheat cropping sequence from 2013 to 2016. Treatments included T1 - control, T2 - gypsum @ 100 SGR, T3 - CaCl2 @ 50% SGR, T4 - CaCl2 @ 50% SGR + biogas slurry @ 10 tˑha-1, T5 - H2SO4 @ 25% GR, T6 - H2SO4 @ 25% SGR + biogas slurry @10 tˑha-1. A saline sodic field was selected, prepared and leveled. Composite soil samples were collected and analyzed for pHs = 9.15, ECe (dS m-1) = 4.86, SAR (mmol L-1)1/2 = 42.52 and GR (tˑha-1) = 8.64. Experiment was laid out in RCBD with three replications. The inorganic amendments (gypsum and CaCl2) were applied 30 days before rice transplanting in the respective treatment plots, followed by leaching while biogas slurry was applied 15 days before transplanting and H2SO4 was applied with first irrigation. Recommended dose of fertilizer 120-110-70 NPK kg ha-1 for wheat (Inqlab-91) and 110-90-60 NPK kg ha-1 for rice (Shaheen Basmati) was applied. Soil samples were collected before application of amendment and after harvesting of each crop. Straw and grain/paddy yield data were recorded at maturity. Pooled data showed that grain/paddy and straw yield of wheat and rice crop was higher in T2 (gypsum @ 100% SGR), but statistically (P≤ 0.05) non significant with T4 (CaCl2 @ 50% SGR + biogas slurry @ 10 tˑha-1). T3 (CaCl2 @ 50 % SGR) was at par with T6 (H2SO4 @ 25% SGR + biogas slurry @ 10 tˑha-1), followed by T5 (H2SO4 @ 25% SGR). The minimum yield was recorded in T1 (control). Soil analysis showed that pHs, ECe and SAR were significantly decreased in T2, (Gypsum @ 100% SGR), followed by T4 (CaCl2 @ 50% SGR + biogas slurry @ 10 tˑha-1). Hence, CaCl2 @ 50% SGR + biogas slurry @ 10 tˑha-1 may be an effective alternative reclamation strategy for areas that are restricted use because of salinity

Population structure and association studies for reproductive stage salinity tolerance in rice (Oryza sativa L.)

Salinity is a major abiotic stress responsible for yield loss in rice as it severely affects various yield contributing traits. Rice is categorised as salt sensitive crop and it is important to identify genomic regions associated to salinity tolerance. In the present study, association mapping was performed to investigate the functional relationship between microsatellite markers and salinity related traits in a set of 180 diverse rice accessions. Association analysis was carried out by employing mixed linear model (MLM) approach. Population structure analysis revealed four subgroups in entire study panel while the admixture level ranged from 0.7-57.2%. A total of 22 marker-trait associations were discovered and four marker-trait associations explained phenotypic variation (R2) greater than 10%. Furthermore, 7 markers were found close to the candidate genes loci. Several markers were significantly associated with more than one trait, suggesting pleiotropic effects. The phenotypic variation explained by associated markers ranged from 2.92 to 18.50%. Comparative genomic search revealed that associated markers were close to candidate genes which play significant role in signal transduction, metabolic pathways and transcription factor activity. The significant associations identified in the present study could be used to improve salt tolerance in rice with introgression of favourable alleles through marker assisted breeding

FUS mutations in amyotrophic lateral sclerosis: clinical, pathological, neurophysiological and genetic analysis

Objective: FUS gene mutations were recently identified in familial amyotrophic lateral sclerosis (ALS). The present studies sought to define the clinical, post-mortem and neurophysiological phenotypes in ALS families with FUS mutations and to determine the frequency of FUS mutations in familial and sporadic ALS. Methods: FUS was screened for mutations in familial and sporadic ALS cases. Clinical, post-mortem and neurophysiological features of large families with FUS mutations are described. Results and conclusions: FUS mutations were evident in 3.2% (4/124) of familial ALS, representing the second most common gene abnormality to be described in familial ALS after SOD1. No mutations were present in 247 sporadic ALS cases. The clinical presentation in 49 affected patients was consistent with a predominantly lower motor neuron disorder, supported by post-mortem findings. Upper motor neuron involvement varied, with Wallerian degeneration of corticospinal tracts present in one post-mortem case but absent in a second case from the same family. Features of cortical hyperexcitability demonstrated upper motor neuron involvement consistent with other forms of familial and sporadic ALS. One case presented with frontotemporal dementia (FTD) indicating that this may be a rare presenting feature in families with FUS mutation. Ubiquitin-positive cytoplasmic skein-like inclusions were present in lower motor neurons, but in contrast to sporadic ALS, no TDP-43 pathology was evident. Mutation-specific clinical features were identified. Patients with a R521C mutation were significantly more likely to develop disease at a younger age, and dropped-head syndrome was a frequent feature. Reduced disease penetrance was evident among most affected families.Ian P Blair, Kelly L Williams, Sadaf T Warraich, Jennifer C Durnall, Annora D Thoeng, Jim Manavis, Peter C Blumbergs, Steve Vucic, Matthew C Kiernan, Garth A Nicholso

Surgical treatment of zygomatic bone fracture using two points fixation versus three point fixation-a randomised prospective clinical trial

<p>Abstract</p> <p>Background</p> <p>The zygoma plays an important role in the facial contour for both cosmetic and functional reasons; therefore zygomatic bone injuries should be properly diagnosed and adequately treated. Comparison of various surgical approaches and their complications can only be done objectively using outcome measurements which in turn require protocol management and long-term follow up. The preference for open reduction and internal fixation of zygomatic fractures at three points has continued to grow in response to observations of inadequate results from two point and one point fixation techniques.</p> <p>The objectives of this study were to compare the efficacy of zygomatic bone after treatment with ORIF using 2 point fixation and ORIF using 3 point fixation and compare the outcome of two procedures.</p> <p>Methods</p> <p>100 patients were randomly divided equally into two groups. In group A, 50 patients were treated by ORIF using two point fixation by miniplates and in group B, 50 patients were treated by ORIF using three point fixation by miniplates. They were evaluated for their complications during and after surgery with their advantages and disadvantages and the difference between the two groups was observed.</p> <p>Results</p> <p>A total of 100 fractures were sustained. We found that postoperative complication like decreased malar height and vertical dystopia was more common in those patients who were treated by two point fixation than those who were treated with three point fixation.</p> <p>Conclusions</p> <p>Based on this study open reduction and internal fixation using three point fixation by miniplates is the best available method for the treatment zygomatic bone fractures.</p