Percutaneous Non-Stenting Approach for Distal Simultaneous Multivessel Acute Coronary Occlusions

The occurrence of distal coronary lesions causing simultaneous occlusion of two coronary arteries in the setting of ST elevation myocardial infarction is a rare occurrence. This can occur due to simultaneous plaque rupture at more than one site or embolisation in coronary arteries. We describe a case of a middle-aged man who presented with acute inferoposterior lateral wall ST elevation myocardial infarction with simultaneous occlusion of distal left anterior descending artery and distal left circumflex artery on angiogram. The patient was treated with intracoronary streptokinase, followed by glycoprotein (GP) IIb/IIIa inhibitor and Factor X inhibitor (Rivaroxaban) with full resolution of flow in the distal vessels. Thus, coronary lesions, not amenable to stenting, can be dealt percutaneously, using a combination of old and newer pharmacological agents without stenting

Do Transformational Leadership and Employee Learning Orientation Lead to Organizational Innovation? The Moderating Role of Psychological Empowerment

Drawing upon theories of transformational leadership and psychological empowerment, this research tested several hypotheses associating transformational leadership and employee learning orientation with organizational innovation via intervening variable, i.e., employee creativity. Using survey data from administrative and professional employees from public sector in People’s Republic of China (PRC), we found that, as anticipated, transformational leadership and employee learning orientation positively influenced employee creativity, while employee creativity in return positively affected organizational innovation. Whereas, the relationship of transformational leadership and employee learning orientation with employee creativity was moderated by psychological empowerment

Condition-based monitoring system for diagnostics and prognostics of centrifugal pumps

Centrifugal pumps are the most commonly used pumps in industry. Therefore, maintenance is a very important part of the pump's life cycle. This work presents a systematic robust conditionbased monitoring process for diagnostics and prognostics of centrifugal pumps. The process includes industrial design of experiments; data acquisition software and hardware; transient modeling using transfer functions, artificial intelligent control methods; and spectral analysis using Fast Fourier Transform. Industrial design of experiments used in this work includes orthogonal arrays or Taguchi method, full factorial design, and response surface methodology. As for the data acquisition system, NI DAQ (National Instruments) hardware were used interactively with LabVIEW software to collect the data from the different sensors. Transient modeling using time domain data was established using MATLAB's modeling toolbox, identification toolbox. Artificial intelligent control methods used were NARMA-L2 and Predictive Neural Networks, Fuzzy Logic control method, and Neuro-Fuzzy control method. Lastly, spectral analysis using Fast Fourier Transform was performed on the vibrations of the system

Study of Biochemical Changes and Elevated Levels of Enzymes in Salmonella typhi Infected Patients in Pakistani Population

Typhoid fever causes significant biochemical changes and hepatic complications. As many studies have indicated several biochemical parameters that are involved in developing the risk of typhoid fever. The current study was designed to evaluate these risk factors in general Pakistani population. Serum biochemistry and liver enzymes were studied to investigate the relationship of these risk factors to Typhoid fever. Total 100 subjects were studied, 50 healthy individuals and 50 typhoid patients. Blood samples were collected from Allied and National Hospital, Faisalabad, Pakistan. In this study, Nested PCR was used to test the samples. Elevated level of ALT (P<0.0001) and AST (P<0.0001) were observed in typhoid patients. Typhoid patients had significantly higher concentrations of Triglyceride (P=0.0044), Globulin (P=0.0004) and Total protein (P=0.0978) while LDL (P=0.0197), Albumin (P<0.0001), Glucose (P=0.0006), HDL-cholesterol (P<0.0001) and Cholesterol (P=0.04) were significantly lower than those of healthy individuals. This study appears to be ample evidence based on the physiological and biochemical parameters in typhoid patients to explain influence of typhoid morbidity. Extensive research in this field would enable us to make modern drugs to treat typhoid fever patients

Bacteriological Spectrum and Sensitivity Pattern in Culture Proven Urinary Tract Infection in Children

To determine the different types of organisms causing urinary tract infections in children and their sensitivity to antibiotics.Methods: This cross sectional study was conducted at Children Hospital, PIMS Islamabad and consisted of 117 patients of either gender between age of 03 months to 12 years.Results: Mean age of children enrolled in our study was 4.4 (± 2.6) years. Out of 117 patients, 63 (54 %) were girls. The most common isolate was E. coli (57.3%) percent, followed by Klebsiella (18.8 %), Staphylococcus aureus (13.7 %), Pseudomonas (5.1 %) and Proteus (3.4 %) children. All isolates were sensitive to ciprofloxacin, of loxacin, amikacin, cefixime and imepenem. Only 38.5% E coli and 37.5% Klebsiella were sensitive to Ampicillin, and 14.3% E coli and 9.1% Klebsiella were sensitive to Trimethoprim-sulphamethoxazole.Conclusion: The most common isolate was E. coli, followed by Klebsiella, Staphylococcus aureus, Pseudomonas and Proteus. Most antibiotics tested for the E. coli, Klebsiella, Staphylococcus, Pseudomonas and Proteus are effective except Cotrimoxazole, Ampicillin, and Gentamicin which show high resistanc

Cardiac magnetic resonance imaging in a young patient with left ventricular spongiform cardiomyopathy: A case report and review of literature

Left ventricular spongiform or non compaction cardiomyopathy is one of the rarer forms of cardiomyopathy with a reported prevalence of 0.014-0.05% in adults. It is characterized by severe left ventricular systolic dysfunction occurring secondary to the failure of the myocardium to fuse resulting in non-compacted myocardium with a trabeculated appearance of the myocardium. Initially described on the basis of 2-D echocardiography, the identification of left ventricular non compaction has now improved with the introduction of sophisticated imaging modalities such as cardiac magnetic resonance imaging that allows better visualization of the non-compacted myocardium assisting in accurate diagnosis. We report a case of isolated left ventricular spongiform or non-compaction cardiomyopathy that was diagnosed on cardiac magnetic resonance imaging with classical features. The patient was started on standard heart failure medications along with anticoagulation and continues to do well on follow up

Outcomes of Left Main Percutaneous Coronary Intervention

Objective: To study the outcomes of left main percutaneous coronary artery (LMCA) revascularisation. Study Design: A descriptive study. Place and Duration of Study: The Aga Khan University Hospital (AKUH), Karachi, from February till July 2016. Methodology: The study included all adult patients aged 18 years or more, who underwent percutaneous LMCA revascularisation at study centre from April 2006 till April 2015. In-hospital outcomes were ascertained of patients via charts along with telephonic follow-up for outcome ascertainment at 1-year and 5-year. Results were expressed in terms of means and standard deviation for quantitative variables and percentages for qualitative variables. Results: Of the 86 patients, the mean age was 66.05 ±12.6 years and 69% (59 cases, n=86) of them were males. Sixteen (18.6%) patients presented with cardiogenic shock and 17.4% (15 cases, n=86) required mechanical ventilation upon arrival. Among the 86 patients, 23.3% (20 patients, n=86) underwent PCI because of unstable condition for CABG and refusal by the surgeons. Mean follow up time for participants was 40.5 ±25.7 months with mean length of hospital stay of 4.36 ±2.4 days. In-hospital mortality was 12.8%, while mortality at 1-year and at mean follow-up was 7.3% and 6.9%, respectively. Conclusion: LM percutaneous coronary intervention is a viable option for patients who are hemodynamicaly unstable and require urgent revascularisation or for patients denying bypass surgery due to other reasons in Pakistan. Prospective studies in future may be required to evaluate the role of PCI for LM lesions in elective setting in contrast to existing treatment options

Development of a Python model for electricity retail prices in Germany under present regulatory framework and future expectations of high re penetrations

This thesis presents the perspective and basis for modeling of retail electricity price components in Germany. Detailed Python models are developed to provide predictions for yearly development of average network charges, EEG, StromNEV-19 and KWK surcharges for the period 2015-2035. For network charges and EEG surcharge, scenario-B (2035) from NEP2015 has been chosen as the model scenario. For KWK surcharge, the 2025 KWK share target, set by KWKG-2016, has been chosen as the model scenario. Individual component model results are validated against available academic literature and institutional reports. Model results for EEG surcharge, indicate an increasing yearly EEG costs till 2024, after which the expiring EEG plants of past will unburden the related high costs and EEG surcharge will drop but still be around 99% of 2015 level in 2035. Model results for network charges indicate a consistently increasing yearly trend owing to high grid investments needed for reaching the target RE share of 57%. KWK model results also indicate a growing KWK surcharge until 2020 which then would remain stagnant at that level onwards. All model results are collected under three consumption categories, namely, households, privileged and nonprivileged industries. The final results indicate that the average German household will face an overall increase of around 3.37 Cents/kWh in retail electricity prices (excluding VAT) till 2028, after which the retail prices will drop a little due to dropping EEG surcharge. The similar but slightly reduced trend can be seen for nonprivileged industrial consumption. The increment effect, however, is only minute for privileged industrial consumption due to high exemptions in EEG & KWK surcharges and reduced individual network charges

Muslims Never Bomb on Stage: Audience Perceptions of Muslim Standup Comedy

This research investigates the audience perceptions of Muslim standup comedy by Muslim-American college and university students. The research question is ‘Do Muslim-Americans feel as if Muslim standup comedy is painting a new image of Islam and Muslims?’ There has yet to be any published research that asks Muslim-Americans for their perspectives regarding Muslim standup comedy. Since Muslim-Americans are some of the consumers of Muslim standup comedy, this demographic is necessary to study when it comes to exploring the consumption of Muslim standup comedy. The methodology for this research is a qualitative method that involves semi-structured in-depth interviews with Muslim-Americans. I will sample Muslim-American college and university students from various colleges and universities throughout the Chicago-land and Illinois area. Respondents are between the ages of 18 – 30 years. The respondents were recruited through snowball sampling for this research, since the respondents were interconnected to the same social group. Muslim-Americans provided their own perspectives regarding the role that Muslim standup comedy has with their lives