A Qualitative Study: Why Prolonged Stay in the Recovery Room?

There are a number of factors that prolong patients’ stay in the recovery room (RR), which are related to system or clinical issues. However, less has been discovered from the RR nurses about reasons for prolonged patient stay and recommendations to solve this issue. Prolonged patient stay of more than 2 hours in the RR interferes with the primary role of the RR nurse, which is to provide care to immediate postanaesthesia patients. Consequently, this could affect the operating room schedule, normal flow of patients to the RR and discharge to the nursing units

A Study of Wear Rate Epoxy Resin filled with SiO2 particle and Glass fibers

This research is devoted to study the effect of different in weight percentage of Sio2 particles and glass fibers (5, 10, 15, 20) wt. % on the wear rate epoxy resin. The results show that the value of hardness increase with the increase for the weight percentage of reinforcing particles and fibers, while the wear rate decrease with the increase the load level of the reinforcing particles and fibers . The largest value of the hardness, and the lowest value of the wear rate for epoxy reinforced with 20% of SiO2, the wear rate increase in general with increasing the applied load

Nanosecond Laser Fabrication of Hydrophobic Stainless Steel Surfaces: The Impact on Microstructure and Corrosion Resistance

Creation of hydrophobic and superhydrophobic surfaces has attracted broad attention as a promising solution for protection of metal surfaces from corrosive environments. This work investigates the capability of nanosecond fiber laser surface texturing followed by a low energy coating in the fabrication of hydrophobic 17-4 PH stainless steel surfaces as an alternative to the ultrashort lasers previously utilized for hydrophobic surfaces production. Laser texturing of the surface followed by applying the hydrophobic coating resulted in steady-state contact angles of up to 145°, while the non-textured coated base metal exhibited the contact angle of 121°. The microstructure and compositional analysis results confirmed that the laser texturing process neither affects the microstructure of the base metal nor causes elemental loss from the melted regions during the ultrafast melting process. However, the electrochemical measurements demonstrated that the water-repelling property of the surface did not contribute to the anticorrosion capability of the substrate. The resultant higher corrosion current density, lower corrosion potential, and higher corrosion rate of the laser textured surfaces were ascribed to the size of fabricated surface micro-grooves, which cannot retain the entrapped air inside the hierarchical structure when fully immersed in a corrosive medium, thus degrading the material's corrosion performance

STUDY ON PREVALENCE OF ADVERSE DRUG REACTIONS IN PATIENTS SUFFERING FROM TUBERCULOSIS IN A TERTIARY CARE HOSPITAL

Objective: To study the prevalence of ADRs associated with the use of anti-tubercular drugs in patients with tuberculosis in a tertiary care hospital.Methods: A prospective observational and active surveillance study was conducted in the department of pulmonology and DOTS Centre in Owaisi Hospital and Research Centre over a period of 6 mo after the study was approved by IRB. The patients who gave informed consent were included in the study and their information was analysed after being recorded in a data collection form.Results: Descriptive statistical analysis was carried out to generate results, the continuous measurement being presented as mean standard deviation (min-max) and categorical measurement presented in number (%). The results showed the prevalence of ADRs to be 69%. The prevalence of ADRs was more in females (55%) than in males (45%) and 75.9% of them reporting more than 1 ADR. ADR's affecting the skin and appendages were high (23.56%) while ADR's affecting gastrointestinal system (19.28%), the hepatic system (4.28%), the musculoskeletal system (15.7%), Central and peripheral nervous system (7.85%), Vision (0.7%) were comparatively less.Conclusion: The study highlighted the importance of developing strategies to ameliorate ADRs both to improve the quality of patient care and to control TB safely.Â

Removal of Ni (Ii) and Cd (Ii) Ions From Aqueous Solutions by Adsorption on to Synthetic Zeolite

In this study, the removal of Ni (II) and Cd (II) ions from aqueous solutions using the adsorption process onto synthetic Zeolite has been investigated as a function of initial metal concentration, contact time, pH and temperature. In order to find out the effect of temperature on adsorption, the experiments were conducted at 20, 30, 40, 50 °C and 15, 30, 50 °C for Ni (II) and Cd (II) respectively. Kinetics data show that at higher temperatures, the rate of adsorption on the synthetic Zeolite is much higher compared to that on the lower temperatures. The optimum pH for Ni (II) and Cd (II) removal is found out to be 5.5 and 6 respectively. The batch method has been employed using initial metal concentrations in solution ranging from 25 to 100 mg/l for Ni (II) and from 10 to 25 for Cd (II) at optimum pH. An Atomic Absorption Spectrophotometer was used for measuring the heavy metal concentrations before and after adsorption. Langmuir, Freundlich, models were applied to adsorption equilibrium data to find the best amongst these models. This study has demonstrated that Zeolite was capable to remove 90% of nickel and cadmium from solution of different concentrations. This implies that Zeolite is an important in the removal process. These capabilities of Zeolite could lead to development of a viable and cost effective technology for removal of these pollutants from wastewater for countries like Iraq

Dual modality intravascular optical coherence tomography (OCT) and near-infrared fluorescence (NIRF) imaging: a fully automated algorithm for the distance-calibration of NIRF signal intensity for quantitative molecular imaging

Intravascular optical coherence tomography (IVOCT) is a well-established method for the high-resolution investigation of atherosclerosis in vivo. Intravascular near-infrared fluorescence (NIRF) imaging is a novel technique for the assessment of molecular processes associated with coronary artery disease. Integration of NIRF and IVOCT technology in a single catheter provides the capability to simultaneously obtain co-localized anatomical and molecular information from the artery wall. Since NIRF signal intensity attenuates as a function of imaging catheter distance to the vessel wall, the generation of quantitative NIRF data requires an accurate measurement of the vessel wall in IVOCT images. Given that dual modality, intravascular OCT–NIRF systems acquire data at a very high frame-rate (>100 frames/s), a high number of images per pullback need to be analyzed, making manual processing of OCT–NIRF data extremely time consuming. To overcome this limitation, we developed an algorithm for the automatic distance-correction of dual-modality OCT–NIRF images. We validated this method by comparing automatic to manual segmentation results in 180 in vivo images from six New Zealand White rabbit atherosclerotic after indocyanine-green injection. A high Dice similarity coefficient was found (0.97 ± 0.03) together with an average individual A-line error of 22 µm (i.e., approximately twice the axial resolution of IVOCT) and a processing time of 44 ms per image. In a similar manner, the algorithm was validated using 120 IVOCT clinical images from eight different in vivo pullbacks in human coronary arteries. The results suggest that the proposed algorithm enables fully automatic visualization of dual modality OCT–NIRF pullbacks, and provides an accurate and efficient calibration of NIRF data for quantification of the molecular agent in the atherosclerotic vessel wall.National Institutes of Health (U.S.) (NIH R01HL093717)Merck & Co., Inc

CAUSES AND MANAGEMENT OF VIRAL EYE INFECTION

Introduction: The eye is a fascinating organ for several reasons. It is not only have a composite structure, however it is considered an immune-privileged organ. The anatomy of the eye is composed of the anterior and posterior parts, the line of division is posterior to the lens. The anterior chamber lies within the anterior segment and is an immuneprivileged anatomical location, this is due to the fact that the T-cell response in this area is suppressed This protects the eye from potentially destructive immune attacks however it also makes defence against infectious agents challenging, particularly where T-cell responses are critical for immunological defence. Viruses could get into the eye by direct inoculation, or through haematogenous or neuronal spread. The diagnoses of viral eye infections are usually clinical one, helped by taking a thorough history and performing ophthalmic examination. But in challenging cases the lab tests are essential. In this review, we will discuss the most recent evidence regarding Causes and management of viral eye infection Aim of work: In this review, we will discuss the most recent evidence regarding Causes and management of viral eye infection Methodology: We did a systematic search for Causes and management of viral eye infection using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles. Conclusions: A wide range of of viruses can affect the eye and cause viral eye infections, either as a primary infection or reactivation. Some affect the eye directly while the others indirectly but may still manifest with eye disease. One virus may affect several parts of the eye, while different viruses may cause the same eye disease. This could complicate the clinical diagnosis of viral eye disease, but the lab tests like PCR and antibody tests could assist in challenging cases where there may be diagnostic dilemma. The HIV epidemic has had an huge impact on ophthalmology clinics, this is because the virus can cause different eye diseases, and the associated decrease in cell-mediated immunity makes the person highly susceptible to opportunistic viral eye infections, sometimes with severe morbidity. There could be other viruses that may affect the eye that we did not discuss. Key words: Causes, management, viral eye infection

Achieving accurate estimates of fetal gestational age and personalised predictions of fetal growth based on data from an international prospective cohort study: a population-based machine learning study.

Background: Preterm birth is a major global health challenge, the leading cause of death in children under 5 years of age, and a key measure of a population's general health and nutritional status. Current clinical methods of estimating fetal gestational age are often inaccurate. For example, between 20 and 30 weeks of gestation, the width of the 95% prediction interval around the actual gestational age is estimated to be 18-36 days, even when the best ultrasound estimates are used. The aims of this study are to improve estimates of fetal gestational age and provide personalised predictions of future growth. Methods: Using ultrasound-derived, fetal biometric data, we developed a machine learning approach to accurately estimate gestational age. The accuracy of the method is determined by reference to exactly known facts pertaining to each fetus-specifically, intervals between ultrasound visits-rather than the date of the mother's last menstrual period. The data stem from a sample of healthy, well-nourished participants in a large, multicentre, population-based study, the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st). The generalisability of the algorithm is shown with data from a different and more heterogeneous population (INTERBIO-21st Fetal Study). Findings: In the context of two large datasets, we estimated gestational age between 20 and 30 weeks of gestation with 95% confidence to within 3 days, using measurements made in a 10-week window spanning the second and third trimesters. Fetal gestational age can thus be estimated in the 20-30 weeks gestational age window with a prediction interval 3-5 times better than with any previous algorithm. This will enable improved management of individual pregnancies. 6-week forecasts of the growth trajectory for a given fetus are accurate to within 7 days. This will help identify at-risk fetuses more accurately than currently possible. At population level, the higher accuracy is expected to improve fetal growth charts and population health assessments. Interpretation: Machine learning can circumvent long-standing limitations in determining fetal gestational age and future growth trajectory, without recourse to often inaccurately known information, such as the date of the mother's last menstrual period. Using this algorithm in clinical practice could facilitate the management of individual pregnancies and improve population-level health. Upon publication of this study, the algorithm for gestational age estimates will be provided for research purposes free of charge via a web portal. Funding: Bill & Melinda Gates Foundation, Office of Science (US Department of Energy), US National Science Foundation, and National Institute for Health Research Oxford Biomedical Research Centre

Awareness and preparedness of healthcare workers against the first wave of the COVID-19 pandemic: A cross-sectional survey across 57 countries.

BACKGROUND: Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave. METHODS: This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training. RESULTS: We surveyed 24,653 HCWs from 371 hospitals across 57 countries and received 17,302 responses from 70.2% HCWs overall. The median COVID-19 preparedness score was 11.0 (interquartile range [IQR] = 6.0-14.0) and the median awareness score was 29.6 (IQR = 26.6-32.6). HCWs at COVID-19 designated facilities with previous outbreak experience, or HCWs who were trained for dealing with the SARS-CoV-2 outbreak, had significantly higher levels of preparedness and awareness (p<0.001). Association rule mining suggests that nurses and doctors who had a 'great-extent-of-confidence' in handling suspected COVID-19 patients had participated in COVID-19 training courses. Male participants (mean difference = 0.34; 95% CI = 0.22, 0.46; p<0.001) and nurses (mean difference = 0.67; 95% CI = 0.53, 0.81; p<0.001) had higher preparedness scores compared to women participants and doctors. INTERPRETATION: There was an unsurprising high level of awareness and preparedness among HCWs who participated in COVID-19 training courses. However, disparity existed along the lines of gender and type of HCW. It is unknown whether the difference in COVID-19 preparedness that we detected early in the pandemic may have translated into disproportionate SARS-CoV-2 burden of disease by gender or HCW type