901 research outputs found
Combining Ketamine and Propofol (“Ketofol”) for Emergency Department Procedural Sedation and Analgesia: A Review
Pesticides effect on soil microbial ecology and enzyme activity- An overview
In modern agriculture, chemical pesticides are frequently used in agricultural fields to increase crop production. Besides combating insect pests, these insecticides also affect the activity and population of beneficial soil microbial communities. Chemical pesticides upset the activities of soil microbes and thus may affect the nutritional quality of soils. This results in serious ecological consequences. Soil microbes had different response to different pesticides. Soil microbial biomass that plays an important role in the soil ecosystem where they have crucial role in nutrient cycling. It has been reported that field application of glyphosate increased microbial biomass carbon by 17% and microbial biomass nitrogen by 76% in nine soils at 14 days after treatment. The soil microbial biomass C increased significantly upto 30 days in chlorpyrifos as well as cartap hydrochloride treated soil, but thereafter decreased progressively with time. Soil nematodes, earthworms and protozoa are affected by field application rates of the fungicide fenpropimorph and other herbicides. Thus, there is need to assess the effect of indiscriminate use of pesticides on soil microorganisms, affecting microbial activity and soil fertility
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Penalties for Emergency Medical Treatment and Labor Act Violations Involving Obstetrical Emergencies
Introduction: The Emergency Medical Treatment and Labor Act (EMTALA) was intended to prevent inadequate, delayed, or denied treatment of emergent conditions by emergency departments (ED). While controversies exist regarding the scope of the law, there is no question that EMTALA applies to active labor, a key tenet of the statute and the only medical condition – labor – specifically included in the title of the law. In light of rising maternal mortality rates in the United States, further exploration into the state of emergency obstetrical (OB) care is warranted. Understanding civil monetary penalty settlements levied by the Office of the Inspector General (OIG) related to EMTALA violations involving labor and other OB emergencies will help to inform the current state of access to and quality of OB emergency care.Methods: We reviewed descriptions of all EMTALA-related OIG civil monetary penalty settlements from 2002-2018. OB-related cases were identified using keywords in settlement descriptions. We described characteristics of settlements including the nature of the allegation and compared them with non-OB settlements.Results: Of 232 EMTALA-related OIG settlements during the study period, 39 (17%) involved active labor and other OB emergencies. Between 2002 and 2018 the proportion of settlements involving OB emergencies increased from 17% to 40%. Seven (18%) of these settlements involved a pregnant minor. Most OB cases involved failure to provide screening exam (82%) and/or stabilizing treatment (51%). Failure to arrange appropriate transfer was more common for OB (36%) compared with non-OB settlements (21%) (p = 0.041). Fifteen (38%) involved a provider specifically directing a pregnant woman to proceed to another hospital, typically by private vehicle.Conclusion: Despite inclusion of the term “labor” in the law’s title, one in six settlements related to EMTALA violations involved OB emergencies. One in five settlements involved a pregnant minor, indicating that providers may benefit from education regarding obligations to evaluate and stabilize minors absent parental consent. Failure to arrange appropriate transfer was more common among OB settlements. Findings suggesting need for providers to understand EMTALA-specific requirements for appropriate transfer and for EDs at hospitals without dedicated OB services to implement policies for evaluation of active labor and protocols for transfer when indicated
Ayurveda and Endocrinology: Common Ground, Common Goals
In this editorial, we explore Ayurvedic concepts of health, and analyze how they relate to modern endocrinology. We expand our discussions to inclusion of other South Asian schools of medicine, as well as philosophical and metaphysical models of South Asian thought. A detailed assessment suggests that Ayurveda is based upon sound endocrine and metabolic foundation, which can serve as a framework for person-centered, integrative management of modern pandemics such as diabetes, obesity and other endocrine disorders. We call for awareness and understanding of the common ground, as well as common goals of Ayurveda and modern endocrinology
Test Characteristics of Urine Dipstick for Identifying Renal Insufficiency in Patients with Diabetes
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A New Type of Coincidence and Common Fixed-Point Theorems for Modified ð-Admissible ð©-Contraction Via Simulation Function
In this manuscript, we introduce the concept of modified α-admissible contraction with the help of a simulation function and use this concept to establish some coincidence and common fixed-point theorems in metric space. An illustrative example that yields the main result is given. Also, several existing results within the frame of metric space are established. The main theorem was applied to derive the coincidence and common fixed-point results for α-admissible ð’µ-contraction
Different Strategies of Asymmetric Synthesis
Asymmetric synthesis is one of the significant subjects of research in recent times. It incorporates regulating stereochemistry of compounds to produce enantiomerically pure chemical substances. Chiral auxiliaries/substrates and enantioselective reagents and organocatalysis are used for the synthesis of enantiomerically pure molecules in organic synthesis. Significance of chiral compounds results in the generation of new bonds in a stereo and enantio-controlled method. Separation of enantiomers from enantiomerically impure sources is a difficult process. Asymmetric synthesis finds its challenging applications in medicinal chemistry, pharmacology, life sciences, chromatography, and extraterrestrial chemistry. This article features the eco- friendly approach and cost-effectiveness of different strategies of asymmetric synthesi
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