The use of CAPD in the management of renal failure in diabetics

Continuous Ambulatory Peritoneal Dialysis (CAPD) was originally introduced by Popovich et al. in 1976, and since its introduction, it has offered better management of diabetic patients with End-Stage Renal Failure. In this context CAPD offers several medical advantages which include, steady-state control of uraemia, easier control of hypertension, stable cardiovascular status without rapid fluid shifts, and good tight control of blood sugar achieved by the intraperitoneal administration of insulin. Social advantages include, freedom from machine and electrical outlets, thereby enabling patients to travel extensively, no need to learn complex machinery and training time can be reduced to 10 - 15 days. In this project, four studies were conducted. The aims of the studies were to: Study - Epidemiology (A) Investigate the trend in the incidence of chronic renal failure, and to establish, the frequency of the various causes of chronic renal failure, the stage of renal failure, and the method of treatment (B) Investigate the trend in the incidence of diabetic nephropathy as a cause of chronic renal failure and obtain an idea of the demographic characteristics of patients suffering from diabetic nephropathy. (C) Investigate and perform a retrospective record analysis of a group of diabetic patients and determine the rate and extent of diabetic nephropathy, and obtain an idea of the demographic characteristics of these patients.peer-reviewe

Spatio-temporal variation in the structure of a deep water Posidonia oceanica meadow assessed using non-destructive techniques

The Malta-Comino Channel (Maltese islands, central Mediterranean), supports extensive meadows of the seagrass Posidonia oceanica that in some places extend to a depth of around 43 m, which is rare for this seagrass. To assess spatial and temporal variation in the state of the deeper parts of the P. oceanica meadow with time, data on the structural characteristics of the seagrass meadow at its lower bathymetric limit were collected during the summers of 2001, 2003 and 2004 from four stations (two stations within each of two sites) located at a similar depth, over a spatial extent of 500 m. Shoot density was estimated in situ, while data on plant architecture (number of leaves, mean leaf length, and epiphyte load) were successfully obtained using an underwater photographic technique that was specifically designed to avoid destructive sampling of the seagrass. Results indicated that P. oceanica shoot density was lower than that recorded from the same meadow during a study undertaken in 1995; the observed decrease was attributed to the activities of an offshore aquaculture farm that operated during the period 1995–2000 in the vicinity of the meadow. ANOVA indicated significant spatial and temporal variations in meadow structural attributes at both sites during the 3-year study; for example, shoot density values increased overall with time at site A; a indication of potential recovery of the meadow following cessation of the aquaculture operations. Lower shoot density values recorded from site B (compared with site A) were attributed to higher epiphyte loads on the seagrass, relative to those at site A. The findings, which include new data on the structural characteristics of P. oceanica occurring at depths >40 m, are discussed with reference to the use of the nondestructive photographic technique to monitor the state of health of deep water seagrass meadows.peer-reviewe

3 year old with chronic wet cough : Intralobar Bronchopulmonary sequestration

Bronchopulmonary sequestration (BPS) is a rare congenital foregut anomaly of the lung, consisting of nonfunctioning primitive tissue that does not communicate with the healthy tracheobronchial tree. The abnormal segment has its own anomalous systemic blood supply, and typically drains into the pulmonary venous system. It is frequently asymptomatic and may be discovered incidentally. Symptoms may vary, with patients presenting with vague symptoms related to chronic respiratory infection. Early diagnosis and intervention decreases morbidity and mortality. We present a case of intralobar pulmonary sequestration involving the right lower lobe in a male child.peer-reviewe

Screening for heart disease in athletes

Physical activity, be it regular exercise or sports at whatever level, should be beneficial and not deleterious. Hence, it is important that the medical profession is aware that cardiovascular related deaths are the leading cause of mortality in athletes during sports. In 2009 the International Olympic Committee issued a consensus statement on the periodic health evaluation of elite athletes. This includes ‘a comprehensive assessment of the athlete’s current health status and risk of future injury or disease and, typically, is the entry point for medical care of the athlete’. Although this consensus statement targeted elite athletes, the periodic health evaluation design is simple enough that it could easily be extrapolated for use for all physically active individuals. The periodic health evaluation’s role is to screen for musculoskeletal or medical conditions that may place an athlete at risk for safe participation. Since this statement was issued, numerous international sport organisations have recommended a screening programme for individuals who partake in regular physical activity. Stress is made on the importance of a thorough health and family history with an emphasis on cardiovascular issues. There is no international consensus on the use of an electrocardiogram (ECG) as part of a screening programme; however most international sports federations and the European Cardiac and Sports Medicine societies strongly recommend it. What there is agreement on is that the doctor that reads an ECG should be knowledgeable of the physiological adaptations of the athletic heart that could lead to errant, yet perfectly safe, ECG traces.peer-reviewe

Baseline marine benthic surveys in the Maltese Islands (Central Mediterranean)

Extract from: MEDCOAST 97 : Proceedings of the Third International Conference on the Mediterranean Coastal Environment, Qawra, Malta / E. Ozhan (editor), (1997)During the period 1991 to 1997, extensive baseline studies of the submarine geomorphology, infralittoral habitats, macrobenthic assemblages, and demersal fish fauna, were carried out in 14 different sites around the Maltese Islands, using conventional SCUBA diving techniques. These were made as part of assessments of the environmental impact of existing or proposed projects, or in order to produce an inventory of coastal resources. In total, these surveys covered a sea-bed area of ca. 7.55Km² and a coastline length of ca 24 km, and represent the most extensive biological surveys of the marine environment carried out to date in the Maltese Islands. The results of these surveys have been presented as maps showing the type, location, and spatial extent of these physical and biological features. The Peres & Picard (1964) scheme, as adapted by Pen~s (1967; 1982) was used to classify and characterize the benthic assemblages recorded during the surveys. Our results show that, in tenus of spatial extent, the most important macrobenthic assemblages are the communities of photophilic 'algae on hard substrata, meadows of the sea-grass Posidonia oceanica and communities of bare well-sorted sand. For all these, many subtypes and facies exist, depending on the light intensity, hydrodynamic conditions, microtopography, sediment granulometry and other edaphic factors, and anthropic influences, including pollution. Other assemblages with a limited spatial distribution include meadows of the sea-grass (vmodocea nodosa and of the Lessepsian immigrant Halophila stipu/acea on sandy bottoms, the assemblages of boulder fields which are complexes of photophilic and sciaphilic communities, and those of marine caves. Our maps are supplemented by descriptions of the different habitats and macrobenthjc assemblages, species lists, and semi-quantitative data on percentage cover for the dominant macroalgae, shoot density counts for sea-grass meadows, and population density counts for the main macrofaunal species. These maps and data-sets are intended to be used (i) for assessing the status of habitats, species assemblages, and individual species, around the Maltese Islands in order to recommend appropriate measures for their conservation, including inclusion in red data lists; (ii) for designation of marine protected areas; and (iii) as baselines against which future monitoring studies and surveys can be compared.peer-reviewe

Warpage issues in large area mould embedding technologies

The need for higher communications speed, heterogeneous integration and further miniaturisation have increased demand in developing new 3D integrated packaging technologies which include wafer-level moulding and chip-to-wafer interconnections . Wafer-level moulding refers to the embedding of multiple chips or heterogeneous systems on the wafer scale. This can be achieved through a relatively new technology consisting of thermal compression moulding of granular or liquid epoxy moulding compounds. Experimental measurements from compression moulding on 8” blank wafers have shown an unexpected tendency to warp into a cylindrical-shape following cooling from the moulding temperature to room temperature. Wafer warpage occurs primarily as a result of a mismatch between the coefficient of thermal expansion of the resin compound and the Si wafer. This paper will delve into possible causes of such asymmetric warpage related to mould, dimensional and material characteristics using finite element (FE) software (ANSYS Mechanical). The FE model of the resin on wafer deposition will be validated against the measurement results and will be used to deduce appropriate guidelines for low warpage wafer encapsulation.peer-reviewe

Utilisation of microsystems technology in radio frequency and microwave applications

The market trends of the rapidly growing communication systems require new product architectures and services that are only realisable by utilising technologies beyond that of planar integrated circuits. Microsystems technology (MST) is one such technology which can revolutionise radio frequency (RF) and microwave applications. This article discusses the enabling potential of the MST to meet the stringent requirements of modern communication systems. RF MST fabrication technologies and actuation mechanisms empower conventional processes by alleviating the substrate effects on passive devices and provide product designers with high quality versatile microscale components which can facilitate system integration and lead to novel architectures with enhanced robustness and reduced power consumption. An insight on the variety of components that can be fabricated using the MST is given, emphasizing their excellent electrical performance and versatility. Research issues that need to be addressed are also discussed. Finally, this article discusses the main approaches for integrating MST devices in RF and microwave applications together with the difficulties that need to be overcome in order to make such devices readily available for volume-production.peer-reviewe

A low voltage wide-input-range bulk-input CMOS OTA

The Gm-C technique is extensively used for continuous-time filtering applications because it results in tunable, wideband and compact designs. In this paper, an OTA architecture using a novel bulk-input differential pair without the use of a tail current source is proposed. Good CMRR is still achieved by using the gate terminal to control the total current in the differential pair, via the use of a dummy pair. The OTA also exhibits a wide differential input range and good Gm-tunability. For this design, two standard double-poly double-metal CMOS processes were investigated: a 0.8 μm process having a nominal threshold voltage of around 0.7 V and a 0.35 μm process having a nominal threshold voltage of 0.5 V. Simulation results are presented for both designs while test results are presented, for the OTA, implemented using the 0.8 μm process, used in a second order cochlea low-pass filter.peer-reviewe

Two cases of aspiration of calcium tablets

Two clinical cases of aspiration are reported in elderly ladies with differing presentations following inhalation of the same brand of calcium tablet. One of the patients distinctly recalled the choking episode, whereas the other failed to do so making the diagnosis of aspiration difficult. One of the aspirated tablets was successfully retrieved during rigid bronchoscopy after the patient reported several months of cough requiring multiple courses of antibiotics. The other aspirated tablet was coughed up by the patient after the successful treatment of a pneumonia complicated by a parapneumonic effusion.peer-reviewe