Variations in information flow patterns following intracranial hypertensive events in traumatic brain injured patients

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Simulation-based training in the paediatric surgery population: A review of current trends and future direction

In recent years, simulation-based training in surgery has emerged as a viable accompaniment to traditional teaching methods. Multiple studies have highlighted the benefits of simulation-based training in both learning and teaching aspects of surgical training, with a particular emphasis on the honing of technical skills. However, multiple issues still exist in widespread implementation of simulation-based training, especially in the developing countries. Furthermore, the existing literature needs to be expanded upon in both quantity and quality domains to ensure a more evidence-based transition to simulation-based training in surgery. The current review article was planned to take a look at the existing literature on the current state of simulation-based training in paediatric surgery, its potential to revolutionise paediatric surgical training, and to propose solutions to the issues that are delaying wider implementation

Amoebic liver abscess: Outcomes of percutaneous needle aspiration vs drain placement in paediatric population

Objective: To compare the effectiveness of percutaneous catheter drain placement with percutaneous needle aspiration in terms of hospital stay, time to resolution of symptoms and cost of intervention performed.Methods: The retrospective cohort study was conducted at Aga Khan University Hospital, Karachi, and comprised data of patients with amoebic liver abscess from, January 2006 to December 2016 which was collected using non-probability purposeful sampling. Primary outcome included length of hospital stay, time to resolution of symptoms and cost of intervention. Secondary outcomes included development of complications, need for re-intervention and abscess resolution. SPSS 22 was used for data analysis. .Results: Of the 62 patients, 36(58%) underwent percutaneous needle aspiration Group A, and 26(42%) were treated with percutaneous catheter drain placement Group B. Both groups were malnourished and anaemic at presentation. Overall, 56(90.3%) patients had single abscess and 44(71%) had it in the right lobe. Mean duration of symptoms was less in Group B compared to Group A (11.2±4.5 versus 16.4±3.2 days). Mean abscess size was 6.13cm ± 9.75cm in Group A and 7.40cm ± 8.40cm in Group B. The mean length of hospital stay Group A was shorter than in Group B (p=0.047) with earlier resolution of symptoms (p=0.027).Conclusion: Both methods were found to be effective in treating amoebic liver abscess in children, but percutaneous needle aspiration was more effective

Design and analysis of a high-gain and robust multi-DOF electro-thermally actuated MEMS gyroscope

© 2018 by the authors. This paper presents the design and analysis of a multi degree of freedom (DOF) electro-thermally actuated non-resonant MEMS gyroscope with a 3-DOF drive mode and 1-DOF sense mode system. The 3-DOF drive mode system consists of three masses coupled together using suspension beams. The 1-DOF system consists of a single mass whose motion is decoupled from the drive mode using a decoupling frame. The gyroscope is designed to be operated in the flat region between the first two resonant peaks in drive mode, thus minimizing the effect of environmental and fabrication process variations on device performance. The high gain in the flat operational region is achieved by tuning the suspension beams stiffness. A detailed analytical model, considering the dynamics of both the electro-thermal actuator and multi-mass system, is developed. A parametric optimization is carried out, considering the microfabrication process constraints of the Metal Multi-User MEMS Processes (MetalMUMPs), to achieve high gain. The stiffness of suspension beams is optimized such that the sense mode resonant frequency lies in the flat region between the first two resonant peaks in the drive mode. The results acquired through the developed analytical model are verified with the help of 3D finite element method (FEM)-based simulations. The first three resonant frequencies in the drive mode are designed to be 2.51 kHz, 3.68 kHz, and 5.77 kHz, respectively. The sense mode resonant frequency is designed to be 3.13 kHz. At an actuation voltage of 0.2 V, the dynamically amplified drive mode gain in the sense mass is obtained to be 18.6 μm. With this gain, a capacitive change of 28.11 f F and 862.13 f F is achieved corresponding to the sense mode amplitude of 0.15 μm and 4.5 μm at atmospheric air pressure and in a vacuum, respectively

DNA Barcoding: Amplification and sequence analysis of rbcl and matK genome regions in three divergent plant species

Background: DNA barcoding is a novel method of species identification based on nucleotide diversity of conserved sequences. The establishment and refining of plant DNA barcoding systems is more challenging due to high genetic diversity among different species. Therefore, targeting the conserved nuclear transcribed regions would be more reliable for plant scientists to reveal genetic diversity, species discrimination and phylogeny.Methods: In this study, we amplified and sequenced the chloroplast DNA regions (matk+rbcl) of Solanum nigrum, Euphorbia helioscopia and Dalbergia sissoo to study the functional annotation, homology modeling and sequence analysis to allow a more efficient utilization of these sequences among different plant species. These three species represent three families; Solanaceae, Euphorbiaceae and Fabaceae respectively. Biological sequence homology and divergence of amplified sequences was studied using Basic Local Alignment Tool (BLAST).Results: Both primers (matk+rbcl) showed good amplification in three species. The sequenced regions reveled conserved genome information for future identification of different medicinal plants belonging to these species. The amplified conserved barcodes revealed different levels of biological homology after sequence analysis. The results clearly showed that the use of these conserved DNA sequences as barcode primers would be an accurate way for species identification and discrimination.Conclusion: The amplification and sequencing of conserved genome regions identified a novel sequence of matK in native species of Solanum nigrum. The findings of the study would be applicable in medicinal industry to establish DNA based identification of different medicinal plant species to monitor adulteration

Current standards of postgraduate surgical education and training in Pakistan: Time to bridge the gaps in lieu of national necessity

The provision of good-quality surgical care is a salient feature of every public health system. Pakistan is ranked among low and middle-income countries where the burden of surgical disease is rapidly increasing, but the capacity of the health system has not expanded at the same pace to cater current needs. One of the key components is the dearth of trained surgical specialists and lack of easy access to surgical care. College of Physicians and Surgeons, Pakistan is the main certifying institution for surgeons, while public and private teaching hospitals bear the burden of responsibility for surgical education and training. The current review article was planned to describe current standards of postgraduate surgical education and training in Pakistan and to highlight the challenges that need to be faced and the existent deficiencies that need to be met to match the nation\u27s demand against the immense burden of surgical diseases

Intramedullary spinal cord lesions in children

Paediatric intramedullary spinal cord lesions are uncommon pathologies, prone to result in dismal prognosis if not managed promptly and aggressively. While children usually present in good functional grades compared to adults, early recognition and treatment is important to improve outcomes. In this review, we present tumour demographics, patient factors, and treatment modalities of intramedullary spinal cord lesions in paediatric patients