bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Affecting Quality of Home Based Long-term Care Provision for the Bedridden Patients in Chandigarh, North India
Authors: Singh Tarundeep , Minhas Amarjeet Singh
Published: July 2019

Objective

To determine the factors affecting the quality of home based long-term care (LTC) provision for the adult bedridden patients in Chandigarh, India.

Materials and methods

This cross-sectional study was conducted on 100 bedridden patients in Chandigarh. Disability was assessed using the Katz index and an interview schedule based on Craig handicap assessment and reporting technique (CHART) was used to assess the care provision to the bedridden patients. Available medical records and brief medical examination were also conducted on the spot. Quality of care was assessed based on the Donabedian model. Factors associated with the quality of care provision, based on literature, were examined for association in the study cases.

Results

Mean age of the bedridden patients was 69 years. Sixtyeight patients lived in joint families. All had total dependence in the domains of bathing, dressing, toileting and transfer. The commonest cause of disability was neurological diseases. Mean duration of being bedridden was 16.4 months. Though the rates of complications like urinary infections (89%), bedsores (54%) were quite high, 57% patients reported satisfaction with the quality of care they were receiving. However, only 18 males and 6 females subjects were receiving good quality care according to our evaluation. Ownership of property/money by the subject was the only factor found to be associated with good quality of care. Gender of the subject, degree of disability, type of family in which the subject was living in and whether the patient is currently married or not did not seem to significantly affect the quality of care received by the subjects.

Conclusion

Though more than half of the study subjects reported subjective satisfaction with the quality of care being received, objective evaluation based on the study criteria showed that only a quarter were actually receiving good quality care. Furthermore, the economic worth seemed to positively influence the quality of care being received by the subjects.

How to cite this article

Singh T, Minhas AS. Factors Affecting Quality of Home Based Long-term Care Provision for the Bedridden Patients in Chandigarh, North India. J Postgrad Med Edu Res 2015;49(3):126-131.
Polymyositis
Authors: Cheema Yuvraj Singh , Gupta Parveen , Attri Sahil , Jamdagni Vipin , Mittal Deven
Published: July 2019

Polymyositis is an uncommon inflammatory disease that causes muscle weakness affecting both sides of the body, typically the proximal muscles. Most commonly, it affects adults in their 30s, 40s, or 50s. Signs and symptoms usually develop gradually, over weeks or months. Raised creatinine phosphokinase (CPK) levels are commonly seen during the acute phase. The electromyogram characteristically shows a myopathic pattern. The affected muscles histopathologically demonstrate endomysial inflammation, lymphocytic infiltration, zonalmyofibrillar loss, and perifascicular atrophy. We report a male patient with a classical presentation of polymyositis.

How to cite this article

Cheema YS, Gupta P, Attri S, Jamdagni V, Mittal D. Polymyositis. J Postgrad Med Edu Res 2016;50(4):199-200.
Posttraumatic Late-onset Extradural Hematoma in Dorsal Spine: A Rare Presentation
Authors: Peswani Rahul , Trivedi Adarsh
Published: July 2019

Spinal epidural hematoma is a rare condition, which may be due to trauma, coagulopathy, surgery, or epidural catheterization. Its incidence is estimated at 0.1/100,000/year. We report a case of late-onset extradural hematoma due to trauma causing compression, and was surgically evacuated followed by immediate neurological recovery of patient.

How to cite this article

Peswani R, Trivedi A. Posttraumatic Late-onset Extradural Hematoma in Dorsal Spine: A Rare Presentation. J Postgrad Med Edu Res 2017;51(1):30-32.
Adolescent Idiopathic Scoliosis
Authors: Trivedi Jayesh
Published: July 2019

How to cite this article

Trivedi J. Adolescent Idiopathic Scoliosis. J Postgrad Med Edu Res 2017;51(2):58-67.
Resurgence of Serial Casting in Early-onset Scoliosis: Is It “Old Wine served in a New Bottle”?
Authors: Gopinathan Nirmal R , Viswanathan Vibhu K
Published: July 2019

Casting as a treatment of scoliosis has been practiced since 1800s. However, the practice fell into disfavor following the serious chest deformities and thoracic constrictions secondary to casting, as well as tremendous improvements in the surgical modalities. Recently, there has been a resurgence of this technique in early-onset scoliosis (EOS) and it has been considered to be a definitive treatment modality and a delaying tactic prior to the inevitable surgery. It carries the triple advantages including correction of the spinal deformity, allowing spinal growth uninterruptedly as well as low complication rates. The current article elaborately discusses the role of serial casting in EOS.

How to cite this article

Viswanathan VK, Gopinathan NR. Resurgence of Serial Casting in Early-onset Scoliosis: Is It “Old Wine served in a New Bottle”? J Postgrad Med Edu Res 2017;51(2):79-83.
Idiopathic Generalized Root Agenesis
Authors: Gauba Krishan , Goyal Ashima , Kapur Aditi , Jaiswal Manoj A
Published: July 2019

The shape and size of tooth roots are genetically predetermined. Clinical defects in root formation can manifest in the form of shortened roots, caused reported either by root agenesis or root resorption. The present case report is of a 17-year-old patient who reported with fully erupted permanent dentition, with roots only half of the normal length as seen in orthopantomograph. In the absence of any other significant finding, it is speculated that the arrested root development was most likely due to a genetic predisposition. Adequate and accurate records are critical from medical and legal point of view in the treatment of patients with potential problems in root agenesis.

How to cite this article

Jaiswal MA, Kapur A, Goyal A, Gauba K, Idiopathic Generalized Root Agenesis. J Postgrad Med Edu Res 2017;51(3):134-136.
Oral Presentation III
Authors: Rasihashemi Seyed Ziaeddin , Ramouz Ali , Rostambeigi Nassir
Published: July 2019

BACKGROUND AND AIMS

Thyroid nodules occur in more than 50% of populations over 50 years, and only 5% of thyroid nodules are malignant. This study was aimed to evaluate Doppler ultrasonography (US) combined with elastography in the diagnosis of the malignant thyroid nodules with suspicious fine needle aspiration cytological (FNAC) results.

METHODS

From August 2012 to March 2013, 107 consecutive patients eligible for thyroid surgery enrolled in the study. All patients underwent FNAC study followed by conventional US, color Doppler US, and US elastography with a real-time instrument. Thyroid nodules ultrasonographic parameters were evaluated during conventional and color Doppler US study and elastography performed in order to calculate the strain index (SI) by dividing the strain value of the nodule by that of the peripheral normal parenchyma, prior to thyroidectomy.

RESULTS

Of 161 nodules in 107 patients, 76 (47.2%) were benign lesions and 85 (52.8%) were malignant. The overall Doppler US score depicted a sensitivity of 64% and specificity of 59%. Using a cut of 2.905, the sensitivity and specificity for elastography US were about 54 and 76% respectively, with positive predictive value of 71.8% and negative predictive value of 59.8%. Evaluating quantitative elastography combined with Doppler US, out of 68 nodules with positive peripheral halo ring, 44 had elasticity ≥ 2.905, which was statistically significant (p < 0.001).

CONCLUSION

Quantitative elastography combined with Doppler US is more accurate in thyroid nodules diagnosis comparing to other methods and can limit the use of FNAC and the subsequent thyroidectomy in patients with nondiagnostic or unsatisfactory cytological findings.
Drug-Induced Bullous Pemphigoid: Expect the Unexpected
Authors: Chandra Jagdish , Chatra Laxmikanth , Prashanth Shenai K , Agrawal Jayshree , Veena KM
Published: July 2019

Several systemic factors are known to contribute oral diseases. At same time, the drugs used for the treatment of such systemic diseases itself might cause spectrum of clinical conditions. The identification of a positive agent becomes difficult when the patient is on multiple drug regimens.

Reporting a case of an elderly female patient, who was on regular medication for hypertension over 5 years, developed generalized bullous eruptions in couple of weeks after being treated with Ciprofloxacin and Paracetamol for urinary tract infection. The dermal lesion worsened with administration of Dapsone.
Mechanisms for a remote response to Asian anthropogenic aerosol in boreal winter
Authors: Wilcox Laura J. , Dunstone Nick , Lewinschal Anna , Bollasina Massimo , Ekman Annica M. L. , Highwood Eleanor J.
Published: July 2019

Abstract. Asian emissions of anthropogenic aerosols and their precursors have increased rapidly since 1980, with half of the increase since the pre-industrial era occurring in this period. Transient experiments with the HadGEM3-GC2 coupled model were designed to isolate the impact of Asian anthropogenic aerosols on global climate in boreal winter. It is found that this increase has resulted in local circulation changes, which in turn have driven decreases in precipitation over China, alongside an intensification of the offshore monsoon flow. No large temperature changes are seen over China. Over India, the opposite response is found, with decreasing temperatures and increasing precipitation. The dominant feature of the local circulation changes is an increase in low-level convergence, ascent, and precipitation over the Maritime Continent, which forms part of a tropical Pacific-wide La Niña-like response. HadGEM3-GC2 also simulates pronounced far-field responses. A decreased meridional temperature gradient in the North Pacific leads to a positive Pacific–North American circulation pattern, with associated temperature anomalies over the North Pacific and North America. Anomalous northeasterly flow over northeast Europe drives advection of cold air into central and western Europe, causing cooling in this region. An anomalous anticyclonic circulation over the North Atlantic causes drying over western Europe. Using a steady-state primitive equation model, LUMA, we demonstrate that these far-field midlatitude responses arise primarily as a result of Rossby waves generated over China, rather than in the equatorial Pacific.
Contribution of personal weather stations to the observation of
deep-convection features near the ground
Authors: Mandement Marc , Caumont Olivier
Published: July 2019

Abstract. The lack of observations near the surface is often cited as a limiting factor in the observation and prediction of deep convection. Recently, networks of personal weather stations (PWSs) measuring pressure, temperature and humidity in near-real time have been rapidly developing. Even if they suffer from quality issues, their high temporal resolution and their higher spatial density than standard weather station (SWS) networks have aroused interest in using them to observe deep convection. In this study, the PWSs contribution to the observation of deep-convection features near the ground is evaluated. Four cases of deep convection in 2018 over France were considered using data from Netatmo, a PWS manufacturer. A fully automatic PWS processing algorithm, including PWS quality control, was developed. After processing, the mean number of observations available increased by a factor of 134 in mean sea level pressure (MSLP), of 11 in temperature and of 14 in relative humidity over the areas of study. Near-surface SWS analyses, and analyses comprising standard and personal weather stations (SPWS) were built. The usefulness of crowdsourced data was proven both objectively and subjectively for deep convection observation. Objective validations of SWS and SPWS analyses by leave-one-out cross-validation (LOOCV) were performed using SWSs as the validation dataset. Over the four cases, LOOCV root mean square errors (RMSEs) decreased for all parameters in SPWS analyses compared to SWS analyses. RMSEs decreased by 73 to 77 % in MSLP, 12 to 23 % in temperature and 17 to 21 % in relative humidity. Subjectively, fine-scale structures showed up in SPWS analyses, while partly or not at all visible in SWS observations only. MSLP jumps accompanying squall lines or individual cells were observed, as well as wake lows at the rear of these lines. Temperature drops and humidity rises accompanying most of the storms were observed sooner and at a finer resolution in SPWS analyses than in SWS analyses. The virtual potential temperature was spatialized at an unprecedented spatial resolution. It gave the opportunity to observe cold pool propagation and secondary convective initiation over areas with high virtual potential temperatures, i.e. favorable locations for near surface parcel lifting.
Spatiotemporal variability and decadal trends of snowmelt processes on Antarctic sea ice observed by satellite scatterometers
Authors: Arndt Stefanie , Haas Christian
Published: July 2019

Abstract. The timing and intensity of snowmelt processes on sea ice
are key drivers determining the seasonal sea-ice energy and mass budgets. In
the Arctic, satellite passive microwave and radar observations have revealed
a trend towards an earlier snowmelt onset during the last decades, which is
an important aspect of Arctic amplification and sea-ice decline. Around
Antarctica, snowmelt on perennial ice is weak and very different than in the
Arctic, with most snow surviving the summer. Here we compile time series of snowmelt onset dates on seasonal and
perennial Antarctic sea ice from 1992 to 2014/15 using active microwave
observations from the European Space Agency's (ESA) European
Remote Sensing (ERS) 1 and 2 missions (ERS-1 and ERS-2), Quick
Scatterometer (QSCAT), and Advanced Scatterometer (ASCAT) radar
scatterometers. We define two snowmelt transition stages: a weak backscatter
rise, indicating the initial warming and destructive metamorphism of the
snowpack (pre-melt), followed by a rapid backscatter rise, indicating the
onset of thaw–freeze cycles (snowmelt). Results show large interannual variability, with an average pre-melt onset
date of 29 November and melt onset of 10 December, respectively, on
perennial ice, without any significant trends over the study period,
consistent with the small trends of Antarctic sea-ice extent. There was a
latitudinal gradient from early snowmelt onsets in mid-November in the
northern Weddell Sea to late (end of December) or even absent snowmelt
conditions in the southern Weddell Sea. We show that QSCAT Ku-band-derived (13.4 GHz signal frequency) pre-melt and
snowmelt onset dates are earlier by 20 and 18 d, respectively, than ERS
and ASCAT C-band-derived (5.6 GHz) dates. This offset has been considered
when constructing the time series. Snowmelt onset dates from passive
microwave observations (37 GHz) are later by 14 and 6 d than those from
the scatterometers, respectively. Based on these characteristic differences between melt onset dates observed
by different microwave wavelengths, we developed a conceptual model which
illustrates how the seasonal evolution of snow temperature profiles may
affect different microwave bands with different penetration depths. These
suggest that future multi-frequency active and passive microwave satellite
missions could be used to resolve melt processes throughout the vertical
snow column of thick snow on perennial Antarctic sea ice.
Implementation of Transmigration Settlement Unit Transformation to Village Policy for Increasing Society Welfare in Indonesia
Authors: Syahruddin Jufri , Effendy Khasan , Hamdi Muchlis , Soemartono Triyuni
Published: July 2019

This research relies on the concept of process theory and policy implementation determinants from Hamdi (2014), where the theoretical concepts of policy implementation processes include dimensions of productivity, linearity, and efficiency, while the theoretical determinants of policy implementation include substance policy factors, behavior of implementing tasks, network interactions employment, target group participation, and resource factors. The research method used in this study is a qualitative research method with the characteristics of construction built on natural conditions, more descriptive, more emphasis on processes, inductive analysis, and more emphasis on the value or meaning contained in a data or event. In an effort to obtain accurate analysis results related to the process and the determinants of the implementation of the transmigration settlement unit transformation into Madapuhi Trans Village, the informants selected were all stakeholders at the local level, both local government and the community. This study found that the process of implementing the UPT transformation policy into Madapuhi Trans Village has not gone well, as indicated by low productivity, lack of linearity and lack of efficiency in policy implementation, as well as several factors that hinder successful implementation of policies such as Policy Substance, Implementing Task Behavior, Target Group Participation, and Resources. The supporting factors in implementing this policy are factors of network interaction. The results also showed that from the 5 determinants of policy implementation, the Target Group Participation factor was the most influential factor in the context of the implementation of the transformation of the transmigration settlement unit to the Madapuhi Trans Village. This study found that understanding harmony is also a determinant of policy implementation. The model produced by this research is the model of the Effectiveness of the Process of Implementing the Policy of Transforming the UPT into a village. Based on the results and findings of the study, it is suggested that a theory of the implementation of the transformation of the transmigration settlement unit into a village be developed, which includes the theory of the process of policy implementation and the determinant theory of policy implementation by Hamdi.
Seaport Sustainable: Use of Artificial Intelligence to Evaluate Liquid Natural Gas Utilization in Short Sea Shipping
Authors: González-Cancelas Nicoleta , Serrano Beatriz Molina , Soler-Flores Francisco
Published: July 2019

In the present research, a methodology is developed to determine the relationship between the variables that define the use of liquefied natural gas in short sea shipping in Europe, through the use of data-mining techniques. The project takes place in the European space, which includes data from 30 countries, the 28 members of the European Union plus Norway and Iceland. A Bayesian network is constructed with the 35 indicators selected, which are classified into five different categories: international trade and transport, economy and finance, population and social condition, environment and energy, and institutional and political. It is found that capacity of liquefied natural gas regasification terminals under construction and modal distribution of cargo transport by inland waters are the two root nodes of the network. In addition, the variables of transport and international trade and economy and finance become the most important in the decision to implement liquefied natural gas as marine fuel, while those of environment and energy and population and condition are the most dependent on the network.
طرق المكتبيون العمانيون واستراتيجياتهم في معالجة ارتفاع أسعار مصادر المعلومات الإلكترونية
Authors: العريمي، علي بن حمد بن خميس آل فنة , الحراصي نبهان بن حارث , العوفي علي بن سيف
Published: July 2019

المستخلص
المكتبات الاكاديمية العمانية وبعد دخولها البيئة الرقمية والاشتراك في مجموعة من قواعد البيانات الإلكترونية
وفقاً لإمكاناتها المادية والتقنية، تأثرت، كحال المكتبات الأخرى، بارتفاع أسعار مصادر المعلومات. هذا التحدي كان
مفصلياً وله أبعاد كثيرة على الاستمرار في التميز في تقديم الخدمات والثبات، إذا لم يكن التنامي، في الاشتراك
في مصادر المعلومات الإلكترونية.

وعليه، فالهدف الرئيسي للدراسة الحالية هو التعرف على الخطط والاستراتيجيات التي أتبعها القائمين
على المكتبات الاكاديمية العمانية في تقليل آثار ارتفاع مصادر المعلومات الإلكترونية. وكنتيجة يمكن النظر في
تجارب عالمية أخرى أدرجتها الدراسات السابقة للنظر في مدى تشابه واختلاف نمط التفكير وأسلوب المعالجة
لهذه القضية. وهنا تكمن أهمية الدراسة كونها تحلل بعمق مدى قدرة مدراء المكتبات الاكاديمية العمانية
في إيجاد بدائل تتوافق من جهة مع رغبتهم ورغبة المستفيدين من مكتباتهم في توفير مصادر معلومات
إلكترونية عالية المستوى، ومن جهة أخرى، التوافق مع الميزانية المحدودة والاستمرار المتزايد في أسعار مصادر
المعلومات الإلكترونية.

ولتحقيق أهداف الدراسة استخدمت الدراسة المنهج الوصفي النوعي القائم على المقابلات الشخصية
المركزة والحوار المتبادل الذي ساعد على التعرف على اختلاف الخطط والاستراتيجيات التي أتبعتها كل مكتبة
ومدى فعاليتها ونتائجها. واشارت نتائج الدراسة بأن معظم المكتبات الاكاديمية العمانية استخدمت اسلوب
التفاوض مع الناشرين لتخفيض السعر مقابل التنازل في بعض الأحيان عن بعض المميزات التي توفرها قواعد
البيانات الإلكترونية كالدخول اللامحدود لأعداد المستفيدين في المرة الواحدة. كما أشارت النتائج الى استخدام
بعض المكتبات للمصادر المفتوحة كبديل لقواعد البيانات التجارية، كما توصلت الدراسة الى أن الاشتراك
التعاوني لمصادر المعلومات الالكترونية لغرض تقليل التكلفة غير ممارس حتى وقتنا الحاضر، عدا تجربة كليات
العلوم التطبيقية التابعة لوزارة التعليم العالي التي وحدت اشتراكها في قواعد البيانات والنظام الإلكتروني.
أوصت الدراسة بالاستفادة الأكبر من المصادر المفتوحة المتاحة عبر شبكة الإنترنت وبذل الجهد في تكشيفها
وتجميعها وعرضها عن طريق الموقع الالكتروني للمكتبات. كما أوصت بتطوير سياسات وتشريعات المكتبات
بحيث تتبنى استراتيجيات تتعلق بالتشارك في مصادر المعلومات الالكترونية، كونها وبحسب دراسة مجموعة
من التجارب الإقليمية والدولية تساهم في تقاسم تكاليف هذه المصادر وتقلل من تأثير ارتفاع الاسعار.
تقنية مراكز المعلومات :استثمار
خفي لقطاع الشركات
Authors: مكاوي محمد
Published: July 2019

المستخلص لاشك ان المعلومات اليوم تعبتر هي أساس صناعة القرار ، سواء القرار السياسي أو التجاري أو خلافه ،
وبالقطع فان الاستثمار الامثل في أي مجال قائم في الاساس ليس فقط على الحصول على المعلومة ولكن
قائم على توظيف وتطويع المعلومات الصحيحة والدقيقة ، وبناءا علي ذلك فقد فطن مؤخرا جزء كبير
من قطاع الشركات في مصر الي أهمية تقنية المعلومات من حفظ واستدعاء بل وتوظيف المعلومات
محل الاهتمام كل في مجاله ، وأفرد لها جزءا من الميزانية لتطوير قطاعات نظم المعلومات باعتبارها عقل
ومرجعية وتاريخ الشركات وتوجهت الي مايعرف باقتصاد المعلومات.

والدراسة تقدم نموذجًا لقيمة وهوية المعلومات في إطار مجتمع المعلومات ، ثم تسقط هذه الاطلالة
النظرية على النواحي التطبيقية في قطاع الشركات في مصر ومدي الاموال التي يمكن توفيرها من جراء
استخدام تقنية المعلومات المستخدمة في إدارة الوثائق والمستندات والملفات.

وفي النهاية : تستخلص الدراسة عدة توصيات عملية ارشادية للشركات في إطار الاستثمار الامثل لكافة
مواردها.
Features of mobile provider education applications for prehospital trauma life support
Authors: Nieto-Gutierrez Wendy , Aguirre-Tipismana Luis , Torres-Mallma Cristina , Salazar-Rojas Ronald , Taype-Rondan Alvaro
Published: July 2019

Many educational tools are used for prehospital trauma life support (PHTLS) training, including mobile apps. This study describes the currently available mobile apps for PHTLS training. Systematic searches in the Apple Store, Google Play Store, and BlackBerry World were conducted in December 2015. Two researchers performed all searches independently and collected their findings in different databases, which were later compared. Finally, a descriptive analysis was carried out. A total of 41 mobile apps that fulfilled the inclusion criteria were found. Among these, 97.5% (n = 40) were in English, 58.5% (n = 24) were updated in 2015, and 51.2% (n = 21) were not free. Of the 20 free apps, 85% (n = 17) did not require an internet connection for any function, 70% (n = 14) had no videos or animation, 10% (n = 2) had any game, and 70% (n = 14) had no institutional certification. In conclusion, it was found that PHTLS apps usually lack interactive content and institutional certification, which should be taken into consideration by users and researchers.
Financial analysis of the United States Military's Health Professions Scholarship Program for emergency physicians
Authors: Aycock Ryan D.
Published: July 2019

Background: As the cost of attendance for US medical schools continues to increase faster than inflation, students can turn to alternative sources of funding beyond traditional educational loans. The Armed Forces Health Professions Scholarship Program (HPSP) pays for medical students' tuition and fees as well as provides a stipend in exchange for an active-duty service commitment. The aim of this study was to compare the financial impact of an emergency physician joining the military versus taking student loans and going the civilian route. Methods: Cash outflows (in the way of annual attendance costs) and cash inflows (in the form of salaries) were discounted using current student loan interest rates and then added together to calculate the net present values (NPVs) of HPSP versus the civilian route. The numbers for all assumptions were taken from the Association of American Medical Colleges, military pay tables, and physician salary surveys. Results: The NPV of the HPSP for a physician with dependents after four years of practice was found to be $576,432, which is slightly higher than the NPV of civilian physicians, calculated to be $573,351 using a nationwide median annual salary of $300,000. Conclusion: HPSP confers an NPV that is $3080 more than when students take the civilian route. However, any alterations in assumptions regarding pay grade, martial status, or years of service will cause great differences in final calculations. Furthermore, the financial impact of taking the scholarship is only one part of the larger decision-making process when considering to join the military.
Correlation of inferior vena cava ultrasound with packed cell volume and clinical condition in children with dengue fever
Authors: Raman Radhika , Lakshmi Muthukrishnan
Published: July 2019

Objective: To correlate collapsibility of the inferior vena cava (IVC) with packed cell volume (PCV) and clinical condition and to ascertain IVC collapsibility as a guide to estimate intravascular volume using bedside ultrasonography (USG) in children with dengue fever. Methods: A prospective observational study was conducted in the Pediatric Emergency Department of an academic hospital in India. Clinical data and PCV of children with dengue fever aged between 1 month to 18 years were documented. The collapsibility of IVC was determined using bedside ultrasonogram. Results: IVC collapsibility correlates with high PCV and dengue shock in children (p = 0.000). IVC was not collapsible in children with normal PCV (p = 0.000). The collapsibility of IVC correlated with the need for normal saline bolus (p = 0.000), colloids (p = 0.002), PICU admission (p = 0.015) and mortality (p = < 0.05). Conclusions: The assessment of intravascular volume status by determining IVC collapsibility using bedside USG is a helpful non-invasive tool in children with dengue fever.
Physician's perspective on point-of-care ultrasound: Experience at a tertiary care emergency department in Qatar
Authors: Bashir Khalid , Chaudhry Sohaib , Bashir Israr , Cameron Peter
Published: July 2019

Background: Point-of-care ultrasound (POCUS) is an invaluable tool in the diagnosis and management of conditions presenting to emergency departments across the world. It has also improved the success rate of invasive bedside procedures. Objectives: This study aimed to investigate the current utilization of POCUS in a large tertiary care emergency department in the Middle East and to identify barriers to its utilization. Methods: A cross-sectional survey of emergency physicians' experience with ultrasound was conducted, which included examining the training, exposure, and barriers to use. This paper-based survey was completed by the participants in the presence of the authors of this study to improve compliance. Data were collected over a period of two months, from October to November 2014. Results: A total of 105 physicians participated in the survey. Of these participants, 56 had undergone prior training in ultrasonography by successfully completing courses approved by the Royal College of Emergency Medicine in the United Kingdom, and the Royal College of Physicians and Surgeons of Canada. Twenty-two physicians had completed other non-accredited ultrasound courses. An improvement in ultrasound procedural skills was reported by all those who completed training. A perceived lack of time in the emergency department was the main barrier to scanning patients. Other shortcomings included a deficiency of trained personnel for guidance, shortage of equipment, and a lack of experience and interest among physicians. Hands-on training was considered the preferred method among physicians for enhancing ultrasonography skills. Conclusions: The study identified an underutilization of POCUS by emergency physicians. Availability of dedicated time, equipment, supervision, and training may help to increase its usage.
Medical genetics:present and future
Authors: Teebi A.S.
Published: July 2019

Medical genetics is an exponentially progressing field. In less than a decade, the increase in our understanding of genetics, particularly Molecular genetics has exceeded that achieved over the previous 4 decades marked by Watson and Crick's specification of the double helix structure of DNA in 1953. Since then the genetic code has been deciphered, the nature of the gene was clarified and many of the intricacies of its function became overt. Genetics has a long tradition of merging clinical observation with basic laboratory investigation. This has culminated in the emergence of molecular biology in which biological processes are understood from the level of the gene through proteins that direct the development and function of the creature. Genetics is therefore playing an increasingly central role in the medical field, and no physician can remain ignorant of its fundamental principles and practice.
Orf in the ear and cheek
Authors: El Bakry O.T. , Shams M.
Published: July 2019

A case of orf affecting the ear and cheek is presented. Although this is a common viral infection in the farming community, the otolaryngologist's encounter with orf is rare. However, being a worldwide self-limiting infection, awareness of orf is important to avoid unnecessary or extensive Surgical intervention.
Hypertrichosis associated with malignancy: case report and review of the literature
Authors: Pilsczek F.H. , Nield V.S. , Wheeler P.G.
Published: July 2019

A case report of an 80 year old woman with squamous cell carcinoma of the bronchus presenting with the rare Paraneoplastic cutaneous sign of acquired hypertrichosis lanuginosa, and a review of the literature on acquired hypertrichosis associated with malignancy by searching the database Medline (since 1966) and hand searching the Index Medicus (1903-1965). Fifty three case reports of hypertrichosis associated with malignancy were found. Sixteen of these described an association with carcinoma of lhe bronchus. Since1970 one case report per year has been Published. It was concluded that hypertrichosis is a rare but important cutaneous sign of malignancy. Despite a large number of case reports the suspected cause, a hormone, remains to be found.
Gestational diabetes mellitus screening and obstetrical complications: a review
Authors: Hasseb F.
Published: July 2019

Gestational diabetes mellitus (GDM) is a common medical complication that can have a profound impact on the mother and infant. It is defined as Carbohydrate intolerance of variable severity with onset or first recognition during the present pregnancy. The definition applies irrespective of whether or not insulin is used for treatment or the condition persists after pregnancy. It does not exclude the possibility that unrecognized glucose intolerance may have antedated the pregnancy.

The fasting plasma glucose levels are lower in normal pregnancy than in the nonpregnant state, and this decline occurs before any rise in fasting plasma insulin levels can be detected. The fasting levels of glucose fall despite a rise in hepatic glucose production, which serves to provide the needs of the developing fetus. The rise in plasma glucose following an oral glucose load or a normal meal is exaggerated. This occurs despite an increase in insulin secretion in response to both oral and intravenous glucose and to normal meals. This indicates that insulin sensitivity declines as pregnancy progresses. The postprandial glucose and insulin levels are increased further in the pregnant woman who is obese. Although glucose tolerance deteriorates in human pregnancy, about 97 to 98% of all pregnant women retain a normal glucose tolerance and only 2 to 3% develop gestational diabetes. However, the prevalence of GDM depends upon the genetic characteristics and environment of the population under study.
Percutaneous transluminal coronary angioplasty experience in qatar: an analysis of more than 600 consecutive procedures
Authors: Gehani A.A. , Horak J. , Banna A. , Hockings B. , Gehani A.A. , Pomposiello J. , Chauhan L. , Hajar H.A.
Published: July 2019

The present study describes the indications and results of 636 Percutaneous Transluminal Coronary Angioplasty (PTCA) procedures that were carried out in 596 patients. Of these, 366 (61.4 %) patients had Single Vessel Disease (SVD), 183 (30.7%) had Two Vessel Disease (2VD) and 47 (7.8%) had all Three Vessels Diseased (3VD). Dilatation of a single lesion was carried out in 564 (93.5%) patients. In another 41 (6.5%) patients, more than one vessel was dilated. The patients were predominantly male (562/596,93%) with a mean age of 46 (7.9 years. The indication for angiography was angina in 65.8% and for recent Acute Myocardial Infarction (AMI) in 34.2%. The number of procedures increased from 106 in 86-89 to 320 in 92-96 (an increase of 280%).

PTCA was carried out in the same session as the angiography in 113/596 (19%). In the remaining 81%, PTCA was planned as an elective procedure with a similar success rate (85% and 87% respectively, p=N.S). Females and Qatari patients had the highest success rates (97.6% and 90.5%) respectively.

The Left Anterior Descending (LAD) was the most frequently tackled vessel (53% of cases), Left Circumflex (LCX) in 20% and Right Coronary Artery (RCA) in 27%. For coronary stenoses, the overall success rate was 89%, being highest in the LAD (89.5%), lowest for LCX (82%) and moderate for RCA (88%). When faced with a total occlusion the overall success rate was 71% and was highest in RCA (84% success) and lowest in LCX (43%) and moderate in LAD (74%). Major complications were rare with only one mortality (1/596, 0.16%) and four emergency CABG is (4/596, 0.7%). Intracoronary stents were used as a bailout device in five patients and to obtain an optimal result in one patient.
Stents were technically successful in all but one case.
Epidemiology of infantile spasm in Qatar
Authors: Bessisso M. , Fawzi M.
Published: July 2019

In a 3-year retrospective study in Qatar (1992-1994) eleven patients, eight boys and three girls were diagnosed as having infantile spasm. The incidence was 0.36/1000 live births. Two patients had idiopathic infantile spasm and nine patients (82%) were symptomatic. A positive family history of epilepsy was found in 27% of the patients and Parental consanguinity was found in 45% of the patients. Two patients had cerebral malformation and all the patients had one or more risk factors during pregnancy and delivery-The outcome for the idiopathic group -1 out of the two was normal, and all the patients from the symptomatic group were found to be abnormal at the end of the follow-up. Seizures were controlled in six of the patients, partially controlled in four, and only one continued to have seizures in
spite of treatment.
Bacterial contamination of platelet concentrate units: a study on 200 units
Authors: Ahmed F. , Elhag K.
Published: July 2019

200 Platelet Concentrate (PC) bags were tested for bacterial growth on day 1 (3-5 hrs after blood collection) using segments from tubings. The same bags were retested on their expiry date (5th day) by culturing a specimen drawn from the bag by syringe.

The frequency ofpositive cultures on day 1 was not statistically significantly higher than on day 5 (p = 0.07).

This interesting finding is explained and its relation to febrile transfusion reaction (FTR) is discussed. The organisms isolated were most likely contaminants from the skin or air at the time of blood collection.
Retrospective case-control study of the outcome of pregnancy after paternal leukocytes transfusion in cases of recurrent pregnancy loss
Authors: Saad F.A. , Rizvi Z. , Sharara H.A.
Published: July 2019

Immunization therapy, for treatment of recurrent pregnancy loss (RPL), has been developed since the mid-1980's. The effect of this kind of therapy is still controversial The purpose of this retrospective, case-control study, was to evaluate the beneficial effect of immunotherapy for the treatment of patients with RPL and negative antipaternal cytotoxic antibodies. During a 3-year period (1992 to 1994), we were able to collect 25 such patients who conceived after having been immunized abroad. We compared the outcome of the pregnancies of those 25 patients with that of 41 unimmunized patients used as controls. There was no statistically significant difference between the two groups regarding maternal age, parity, number of previous abortions, gestational age, infant weight, and Apgar score at 5 minutes. The pregnancy success rate was higher in patients who were not immunized (80.5%) than in those who were immunized (56%). The difference bordered on, but did not reach, statistical significance (P=0.064). There was no significant difference whether immunization was performed before or during pregnancy or whether pregnancy occurred within 26 weeks of immunization or between 27 and 52 weeks. The only significant difference between the two groups was related to the drugs (Aspirin and progesterone) used in the antenatal period and this may explain the higher; although not significant, success rate in the control group. It is not yet clear whether immunotherapy has any substantial effect in preventing recurrent abortions. More controlled prospective studies are required to reach a final conclusion regarding this form of treatment.
Assessments of pugh's modification of childturcotte classification as prognostic indicator in liver cirrhotics: a cohort study
Authors: Altaee M. Y.
Published: July 2019

The purpose of this study was to validate Pugh's modification of the Child-Turcotte Classification (CTC) in the prediction of mortality in patients with liver cirrhosis.

A cohort of 45 cirrhotics collected in Mosul Teaching Hospitals, Iraq, was followed for five years and deaths were recorded at twelve month intervals from the individual dates of diagnosis. Cohort analysis and estimation of Relative Risk measured the strength of the association between Pugh's classes and five year mortality. Life table analysis was used to compute the probability of survival or death in each year during the 5 year period.

Results . During the five-year period of study twenty patients died. Eighteen of the total deaths (90%) occurred in class C (severe class) from which 78% of the patients died while only two (15% of the group) died in class B (Relative Risk = 5.2). None died in class A (mild class).

In the first year 20% of the cohort died (all from Class C) and the Life Table Analysis showed a high probability of death for the whole cohort. A further 24% died during the next four years..

Conclusion - Pugh's grading can confidently be used in clinical practice to categorize the chances of patient survival. Patients with cirrhosis in the severe grade have a poor chance of survival.
Survey of biomedical research in a developing country
Authors: Pilseczek F. H.
Published: July 2019

By using the Silver Platten International CD-ROM version with MedSPIRS of the database Medline from 1966 to 1995 the intention of this survey was to investigate biomedical research in a developing country, Afghanistan, through collating the number and types of publications and to review the number of publications concerned with diseases of particular relevance to the country.

Six hundred and two publications were identified and their types and distribution are discussed in relation to Afghanistan and to developing countries in general and to research published from more developed regions of the World.
The association of acute hepatitis B infection with malaria
Authors: Al Ali H.Y.M.
Published: July 2019

Seventy eight acute hepatitis B cases, identified by the presence of HbsAg and IgM anti-HBC markers, were compared with 102 normal individuals from malaria endemic areas in Ninevah (Northern Iraq). Both groups were asked for any history of malaria. More hepatitis B cases reported malaria (70.5%) than normal individuals (odd's ratio 11) which suggests that the vector of malaria plays a role in the transmission of hepatitis B.
Is shorter preoperative fasting equieffective?
Authors: Dahyat G. , Gharaibeh H.
Published: July 2019

This study is a comparison between the allowing of free clear fluids until about two hours preoperatively and the usual preoperative fasting.

In a prospective trial the residual volume and pH of gastric content were measured in 60 patients who were put into either a study group where the intake of free fluids was allowed up to two hours preoperatively or a control group who were fasted for six hours.

There were no significant differences between the study group's residual gastric volume (RGV) (22±16) and the control group's RGV (21±14) nor the study group's pH (2.5±0.8) and the control group's pH(2.3±0.9). There were no complications of aspiration or regurgitation in either group but the patients in the study group reported less preoperative thirst.

We believe that to allow the drinking of clear fluids until two hours before an operation is safe and enhances the comfort of the patient.
Intrauterine fetal death: termination of pregnancy withintravaginal prostagladin E2 pessaries
Authors: Barqawi R.
Published: July 2019

Objective: To evaluate the effectiveness of intravaginal prostaglandin E2 pessaries, for the induction of labor in intrauterine fetal death.

Design: Sixty five women at 20-40 weeks gestation, with intrauterine fetal death proved by ultrasound examination and with no history of previous delivery by caesarean section, were treated with 20mgprostaglandin E2 pessaries intravaginaly. The dose was repeated 8-hourly for up to 48 hours until effective uterine contractions were obtained.

Setting: Patients with intrauterine fetal death who presented to King Hussein Medical Center in the period from 1994 to 1996.

Results: The mean time from induction to delivery was 14 hours, and only 4 patients (6%) required between 30 - 48 hours. Two patients (3%) required only 4 hours to deliver completely.

Conclusions: The use of prostaglandin E2 vaginal pessaries at a dose of 20mg every 8 hours appears to be a safe, effective, practical method for the termination of pregnancy in intrauterine fetal death.
Omenn syndrome: the first case in qatar
Authors: El Araby I. , Abulaban M. , Abdul Wahab A. , Salem M.M. , Al Saad T. , Morsi N.
Published: July 2019

Omenn syndrome is a rare form of severe combined immune deficiency (SCID) with distinctive clinical and immunologic features(1). It was first described by Omenn in 1965 under the title of: Familial Reticuloen-Dotheliosis

with Eosinophilia(2),. Since then, over 45 cases has been described(1). In this paper; we are reporting the first case of Omenn's syndrome in Qatar community.
Familial sarcoidosis in a jordanian family
Authors: Sharara A. , Hijazi M.
Published: July 2019

Sarcoidosis is an idiopathic granulomatous disease involving one or more multiple organ systems, characterised by the histologic finding of noncaseating epitheloid cell granulomas. This is the first report of familial sarcoidosis in Jordan. We report a mother and her son who Presented with bilateral hilar lymphadenopathy and lung infiltrates.

Sarcoidosis is a rare disease in Jordan. We reported thirty-three cases of sarcoidosis(1). Although the familial tendency is reported in many studies(2), this was not the case in our study. Though the etiology is unknown; both Prevalence of sarcoidosis in different ethnic groups and familial occurrence of the disease strongly suggest the hypothesis of a possible genetic predisposition(3).
Rhino-cerebral mucormycosis: first case report in qatar
Authors: Al Kaabi S. , Ahmad A/R , Addassi A.
Published: July 2019

A case of rhino-cerebral mucormycosis is described which is the first such case report from Qatar; The patient was a young female with systemic lupus erythematosis and was on regular dialysis for renal failure. She was admitted primarily because of diarrhea but her condition was complicated by progressive swelling of the face and eyes, total ophthalmoplegia, cavernous sinus thrombosis, a lower motor neurone facial nerve lesion and contralateral hemiplegia. Despite aggressive supportive efforts and Amphotericin-B therapy, she died. Although the disease is a potentially fatal fungal infection, cure can be achieved if the case is properly managed, hence the value of reporting the case.
Hyperlipidemic pancreatitis: the qatar experience
Authors: Tariq Butt M. , Al Emadi M. , Al Hassan M.SJ. , Al Kaabi S. , El Dweik N. , Al Muslemani M.Y.
Published: July 2019

Hyperlipidemic pancreatitis represents one of the most acute and dramatic consequences of the chylomicronemia syndrome which, if misdiagnosed, can lead to pancreatic destruction and death.

A retrospective analysis of 16 cases admitted to Hamad General Hospital since 1990 investigated the relationship between hyperlipidemia and pancreatitis.

All the patients had discrete, recurrent episodes of acute pancreatitis with typical pain, hyperamylasemia and hypertriglyceridemia. Acute pancreatitis usually occurred when the serum triglyceride levels were above 10 mmol/L. Chylomicronemia, with the serum being visibly creamy, was a constant feature of the lipoprotein pattern of the patients during these acute episodes.

It seems that chylomicronemia is the most consistent feature of hyperlipidemic pancreatitis. Most patients respond well to a low fat diet but lipid lowering agents are generally required to prevent recurrence.
Colon cancer on top of colonic schistosomiasis
Authors: Hussain A. A. , Aboulwafa A. F.
Published: July 2019

The association of Schistosoma japonicum and colonic carcinoma has been well established. Such an association has not been confirmed in cases of Schistosoma mansoni infestation. We report the first case detected in Qatar of a young woman with long-standing schistosomal colitis on top of which developed carcinoma of the colon.
Massive upper GI bleeding in a child
Authors: Rahman A. , Khalil N. , Al Thani G. , Ismail A.
Published: July 2019

Two year and seven month female child, known case of cerebral palsy, presented with sudden onset of hematemesis, which progressed to uncontrollable massive upper GI bleeding requiering devascularization and more than 36 blood transfusions.
HB A2 Quantitation by Microcolumn-Precise Normal Range and Invalidity on the Quantitation in Presence of HBS
Authors: Al Hilali A. , Abu Saud K. , Al Bishri T.
Published: July 2019

The reference range for Haemoglobin A2 (HbA2) by the microcolumn technique is not well defined. Various textbooks and inserts give different reference ranges. This leads to confusion in interpretation. Normal Saudi individuals were checked by the method, excluding all disease in them that can affect HbA2 level. The reference range obtained was 2.0-2.7 (mean+SD). This new range will decrease remarkably the overlap between normal, alpha thalassemia trait and beta thalassemia trait individuals.

Also>, and in spite of the claim by the manufacturer to the contrary, it was shown that presence of sickle haemoglobin, places the assay of Hb A2 significantly outside the normal range> using a column that is supposed to be just for the purpose of accurate assay of Hb A2 in presence of HbS. The range in sickle trait patients was shown to be 2.5-3.4 (mean+SD).