We describe efforts towards introducing infection control (IC) practices and establishment of antimicrobial resistance (AMR) surveillance in a public sector hospital in Pakistan. The study was conducted in an eight-bed intensive care unit. IC principles, introduced through interactive sessions, were used as an intervention and their impact was observed by conducting surveillance for ventilator-associated pneumonia (VAP) before and after the intervention. Respiratory isolates of VAP patients in the period after intervention were screened for AMR, and empiric antibiotic at the time of admission was compared with the antimicrobial sensitivity pattern reported. VAP rates were high in general and declined in the period after intervention, although the difference was not significant. Of 37 VAP patients in the period after intervention, 68% had more than one clinically significant organism isolated from the respiratory specimen. Acinetobacter spp. were isolated from 76% of patients and Pseudomonas aeruginosa from 43%. All Acinetobacter spp. and 72% P. aeruginosa were multidrug resistant. The mean stay of the nosocomially infected patients was significantly higher than for the uninfected group (6.5 vs. 2.1 days, P<0.001). Our study suggests IC education needs to be supplemented by a hospital system that facilitates IC practices and development of surveillance programmes.
BackgroundChronic liver disease (CLD) encompasses a series of single or multifactorial insults to the liver, most common of which are hepatitis, alcohol abuse, and non-alcoholic liver disease. CLD represents a major public health problem worldwide as well as in Pakistan. Unfortunately, studies evaluating the awareness of its risk factors among people are quite scarce. The purpose of this study was to assess the knowledge about risk factors of CLD in patients admitted to Dr. Ruth K M Pfau, Civil Hospital Karachi (CHK).MethodsThis quantitative cross-sectional study was conducted at CHK, among 368 patients admitted to CHK, during the period from February 2018 to September 2018. Frequencies and percentages were evaluated for categorical variables using Statistical Package for Social Sciences (SPSS), version 22 (IBM Corp., Armonk, NY). Chi-square test was applied to determine if there was any significant association between the variables. A p-value of <0.05 was considered significant.ResultsA scoring scale was developed to assess the level of knowledge. We found that only 32% of our study population had good knowledge about the risk factors of CLD while majority of them (68%) had poor knowledge. Regarding individual risk factors, >60% patients were aware that obesity, high fat intake, prolonged use of drugs, use of alcohol and hepatitis B and C are risk factors of CLD, while most of them did not know diabetes to be a risk factor as well. 51.4% patients thought that hepatitis B and C could not be transmitted via sexual contact and from mother to her baby. There was a positive association between education level and awareness about the risk factors of CLD (p = 0.006).ConclusionFuture interventions to increase public awareness about CLD should promptly be taken. The lack of knowledge about this disease is the main cause of its rapid increment and the reason why it is so prevalent in our part of the world especially Pakistan. More studies and nationwide awareness programs are needed to control its spread.
On the other hand, imaging devices like magnetic resonance imaging (MRI) are employed to evaluate the iron chelation therapeutic effects based on signal intensity on T1 and T2 weighted sequences, as lower 8 signal intensity suggests iron overload. Such intervention expedites the assessment of iron levels in the body before the onset of dysfunction of organs and 10,11 hemosiderosis could set in. Many studies showed that beta thalassemia affects the neurological conditions of those individuals who suffer 12,15 from this disease.However, these neurological anomalies have not been fully compiled or discussed yet. In this article, we will discuss these neurological impairments caused by beta-thalassemia and their possible curative therapy to alleviate some of these conditions. EXTRAMEDULLARY HEMATOPOIESISExtramedullary hematopoiesis (EMH) is a homeostatic phenomenon that arises among chronic anemic patients in which hematopoietic foci are formed other than bone marrow to compensate the circulatory 16-18 needs. In 1954, Gatto and their colleagues reported
Cardiovascular diseases, which include all heart and circulatory diseases, are among the major death-causing diseases in women. Cardiovascular diseases are not subject to screening programs, and early detection can reduce their mortal effect. Recent studies have shown a strong association between severe Breast Arterial Calcifications and cardiovascular diseases. The aim of this study is to use the screening programs for breast cancer to detect the high severity of BACs and therefore to obtain indirect information about coronary diseases. Previous attempts in the literature on the detection of BACs from digital mammograms still need improvements to be used as a standalone technique. In this study, a dataset of mammograms with BACs is divided into 4 grades of severity, and this study aims to improve their classification through a transfer learning approach to overcome the need for a large dataset of training. The performances achieved in this study by using pre-trained models to detect four Breast Arterial Calcifications severity grades reached an accuracy of 94% during testing. Therefore, it is possible to benefit from the advantage of Deep Learning models to define a rapid marker of BACs along Brest Cancer screening programs.
Abstract. This paper investigates the literature available for derivation of the elastic modulus (E) as employed specifically in non-homogenous materials. There is a big pool of E-values in the literature which user can pick and use. However their reliability is still a question. This study will therefore focus on the values of elastic modulus acquired from the secondary databases and their reliability in numerical methods like Finite Elements (FE). This study uses E-values obtained from bones, muscles and tissues. Bone is a composite material with a very intricate internal geometry. Acquiring the elastic modulus values for irregular geometries like bones is not a straight forward process. This study therefore compares the different studies provided in literature for derivation of elastic properties of bones from different vertebrates and investigates the reason of variations. The study infers that populating all the values of elastic modulus without a standard procedure, creates a level of ambiguity that bars the understanding of the use of modulus of elasticity where insightful procedures are in question for example finite element analysis of sensitive materials . Therefore there is a need to take great care in deriving the values of E.
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