Objective We evaluated whether ivermectin combined with doxycycline reduced the clinical recovery time in adults with COVID-19 infection. Methods This was a randomized, blinded, placebo-controlled trial in patients with mild-to-moderate COVID-19 symptoms randomly assigned to treatment (n = 200) and placebo (n = 200) groups. The primary outcome was duration from treatment to clinical recovery. Secondary outcomes were disease progression and persistent COVID-19 positivity by RT-PCR. Results Among 556 screened patients, 400 were enrolled and 363 completed follow-up. The mean patient age was 40 years, and 59% were men. The median recovery time was 7 (4–10, treatment group) and 9 (5–12, placebo group) days (hazard ratio, 0.73; 95% confidence interval, 0.60–0.90). The number of patients with a ≤7-day recovery was 61% (treatment group) and 44% (placebo groups) (hazard ratio, 0.06; 95% confidence interval, 0.04–0.09). The proportion of patients who remained RT-PCR positive on day 14 and whose disease did not progress was significantly lower in the treatment group than in the placebo group. Conclusions Patients with mild-to-moderate COVID-19 infection treated with ivermectin plus doxycycline recovered earlier, were less likely to progress to more serious disease, and were more likely to be COVID-19 negative by RT-PCR on day 14. Trial Registration ClinicalTrials.gov Identifier: NCT04523831. Data Repository ID Dryad. doi:10.5061/dryad.qjq2bvqf6

This study investigates the mechanics of block failure in frozen bluffs underlain by permafrost along Arctic coasts. Different block failure modes with and without thermoerosional niches and ice wedges are identified. A comprehensive analytical model is developed by coupling slope stability analysis with the progressive formation of a thermoerosional niche and the existence of ice wedges in the perennially frozen backshore area. Model computations involve three steps. First, the stability of frozen cliffs is examined by calculating the factor of safety based on slope analysis using the strength of permafrost soil. Second, in the presence of thermoerosional niches at the base of frozen cliffs, the failure modes and critical niche depths are determined by applying the moving boundary of a developing thermoerosional niche to the stability analysis. Finally, the effects of ice wedges are examined by imposing a change in strength conditions related to the existence of ice wedges at different locations in the potential failure region. Different potential failure modes and the critical combination of features contributing to block failure occurrences in Arctic coastal bluffs are identified through model calculations. Nondimensional parameters, regression equations, and graphs are derived to be used for determining the block failure potential for Arctic coasts.

No abstract

Cross-cutting relationships of glacial striations on carbonate bedrock, in the Steep Rock – Gypsumville district, Manitoba, suggest movement of glacier ice generally to the southeast followed by movement generally to the west or southwest.These two major sets of striations have orientations similar to those of linear topographic depressions and ridges of low relief, which are conspicuous on airphotos. Although in glacial drift, the surface grooves overlie grooves in bedrock which apparently are the result of glacial erosion. The topographic grooves and intervening ridges resemble features described from other parts of the Lake Agassiz Plain, and have been assigned a variety of origins. The surface grooves cannot be correlated in trend to joints in bedrock.Two major sets of superposed folds are exposed in gypsum at Gypsumville and in carbonates at Spearhill. The similarities between the folds, in the gypsum and the carbonates, suggest that they have a common origin. The trends of the axial planes of the two sets of folds are approximately perpendicular to the two major trends of glacial striations and surface grooves. Glacial drag is the most probable cause of folding in both gypsum and limestone.

No abstract

Abstract

No abstract

The aim of our study was to determine the types of epilepsies and epileptic syndromes along with their treatment strategies among patients attending the outdoor epilepsy clinic in a tertiary care hospital. Methods: We did a retrospective chart review of all 2236 epilepsy patients attending the epilepsy clinic of Dept. of Neurology, Dhaka Medical College Hospital from October 1996 to September 2010. Data were collected through a predesigned questionnaire containing information on age, sex, habitat, clinical features, management, EEG and imaging findings. Result: Most of the patients in our study were in 15-40 year-old group (46%), with a male predominance (59%). Though a large proportion (83%) of patients got prior medical treatment, mainly with phenobarbitone (30%), many took indigenous treatment and had superstitious belief regarding epilepsy (35%). About 36% of the patients were found to have abnormal EEG finding while only 12% had abnormal brain imaging. Among them, 46% of the patients who were classified as IGE mostly presented with GTCS (76%). Within the LRE group 63% had secondary generalized seizure. Carbamazepine (56%), phenobarbitone (35%), sodium valproate (20%) were the commonly prescribed drugs at the epilepsy clinic. Conclusion: Epilepsy is not uncommon in our day to day practice. Most of the patients remained seizure-free with commonly used anti-epileptic drugs. Patients should be adequately advised about the disease and the effect of drug noncompliance.