Evaluation of the role of bedside lung ultrasound versus chest x-ray in critically ill patients

Background: Although chest X-ray is the main imaging approach in many settings, many limitations for it exist. Ultrasound has quite similar performances to CT with many advantages. Methods: From January 2017 till May 2018, a prospective cohort study conducted in emergency ICU at Zagazig university hospitals including 124 critically ill patients older than 18 years with respiratory distress, cough, fever, or hypoxemia. We excluded from the study pregnant females, patients with massive chest wall emphysema or hematoma, morbidly obese and finally patients with risk of transportation. All patients underwent thorough physical examination, history, laboratory investigations & Chest radiology (X-rays, chest ultrasound & CT). We measured the sensitivity and specificity of chest ultrasound and chest X-rays in comparison with CT with measurement of the learning curve of chest US. Results: 124 patients were assessed for eligibility. 24 patients were excluded for different causes and 100 patients (69 males & 31 females) completed the study with mean age of 49.22±11.52 years. Regarding all study population, whatever diagnosis, sensitivity and specificity of chest ultrasound and chest X-rays were 91.4%, 98.3% and 61.7%, 96.2% respectively. Concordance of the results of ultrasound with results of X-rays and clinical diagnosis increased sensitivity, specificity and overall accuracy to highly comparable results with chest computed tomography. Sensitivity, specificity and accuracy of chest ultrasound increased with time and with number of patients. Conclusions: Chest ultrasound is reliable, quick, bedside, low-cost, non-invasive, non-ionizing, more accurate, and easily educated for early detection of chest diseases and their follow up

Efficacy and safety of Duloxetine compared with placebo for diabetic neuropathy pain: meta-analysis.

Background: Duloxetine is relatively considered as a treatment for diabetic neuropathy pain due it is balanced and potent reuptake inhibitor of both serotonin and nor epinephrine where these neurotransmitters play a great in pain inhibition. Materials and Methods: We searched DLX related articles in Pubmed, Cochrane and Embase from 2005 to 2010. 158 articles were found after through search out of which 68 articles were case reports, reviews and meta-analysis, 40 studies were clinical trials but not efficient data was available, 45 studies were RCTs but not related to our topic. Only 5 RCTs included after exclusion. We then performed the meta-analysis of the studies which met our eligibility criteria we performed fixed effect model network meta-analysis to analyze the efficacy of DLX compare to placebo. We chose diabetic neuropathy duration, diabetes mellitus duration, types of diabetes and DLX with regard to MNSI scale. Results: 5 published RCTs were included in this meta-analysis no significant difference observed for DLX and DND [(SD mean difference 0.22 (95%CI -0.16 to 0.60); P=0.25)] , on diabetes mellitus duration for HbA1c and fasting blood glucose (FBG) [(SD mean difference -0.00 (95%CI-0.087 to 0.87); P=1.00)] and on types of diabetes[(COR 1.00 (95% CI 0.73 to 1.38; P=0.98)] and [(OR 1.00 (95% CI 0.72 to 1.37); P=0.98)] .DLX shown to have significant efficacious compared to placebo for MNSI (95% CI -0.37 to – 0.03); P=0.02)]. Conclusion: In the fixed effect model analyses of DLX, showed similar efficacy to placebo for efficacy parameters, except on MNSI scale but not clinically relevant.

Macrobenthic Diversity During Pre and Post Drought Period of a Floodplain Wetland in Vaishali District of Bihar.

Qualitative and quantitative estimation of macrobenthic fauna was done during pre and post drought period. A total of 18 species of macrobenthos were recorded during pre drought and 17 in post drought period. Maximum number of species was reported in Mollusca followed by Diptera and Oligochaeta. The average contribution of Mollusca was 94.72%, Dipetra 2.98% and Oligochaeta 2.30% to total benthic species of the Chaur. Bellamya bengalensis, Gabbia orcula, Gyraulus convexiusculus, Lymnaea acuminata and Lymnaea auricularia were the molluccs which were found in all the monthly samples. Number wise Gyraulus convexiusculus was most abundant followed by Gabbia orcula while Lamellidens marginalis and Pila glabosa were the least abundant. In pre drought period average number of macrobenthos was 3176/m2 while in post drought period, it was 2676/m2. Analysis of the various index showed that diversity of benthic fauna was higher in WIN season followed by RMON, PRM and MON season. Winter seems to be a favourable season for benthic organisms. Availability of different species of mollusks indicated the good cultural and unpolluted condition of Chaur.

Age at Menarche among School Girls in Sokoto; Northern Nigeria

Background/Objectives: Menarche; the first menstrual period; is influenced by many factors including socio-economic status and rural or urban dwelling. The aims of the study were to compare the age at menarche between rural and urban girls and evaluate the anthropometric indices at menarche. Materials and Methods: A cross-sectional study of rural secondary school girls and urban school girls. A structured questionnaire was used to obtain information on their age at menarche and other relevant data. Their weights and heights were measured using computerized scales and calibrated walls. Results: Two hundred and twenty eight (228) rural girls and four hundred and eighty (480) urban girls that had attained menarche within a year were studied. Mean age at menarche for all the girls was 15.26 years. Mean menarcheal age for the rural and urban girls were 15.32 years and 15.20 years; respectively. Mean weight and height were 47.6 kg and 156.76 cm; respectively for the rural girls and 48.12 kg and 156.8 cm; respectively for the urban girls. There was no significance difference in age of menarche among the groups (P 0.05). Conclusion: The mean age at menarche for the school girls is 15.26 years. There was no difference in menarcheal age between the rural and urban school girls. Further longitudinal studies to compare rural school girls and urban school girls in private schools are required

Assessment of Existing Practices in the Operating Theatre in the Khartoum North Teaching Hospital; Sudan

This study; assessing existing practices in the operating theatre regarding hand washing; disinfection and sterilisation; was conducted at Khartoum North Teaching Hospital. As far as we know; this is the first study of its kind since the inauguration of the hospital in 1950. A total of 55 health personnel working in the operating theatre participated in the study. These included nurses and environmental service personnel (housekeepers and sterilisation and disinfection personnel). Knowledge and practice were evaluated using multiple choice and direct interview questions. Operation theatre sterilisation and disinfection practices were monitored using checklists modified from World Health Organization recommendations. A marked lack of knowledge and defective attitudes and practices were observed among a large number of personnel. It was observed that 51of the nurses were 46 years of age or older and that two-thirds had only a primary and intermediate school level education. The study recommends the upgrading of the operating theatres and additional training and education of staff. Theatres should be provided with facilities for proper disinfection and waste disposal. Qualified nurses should be employed. We also recommend the establishment of an infection control committee. The role of the committee would include the planning and execution of hygiene policies. In addition; planning and organising training courses in infection control should be seen as a priority

Health profile of lock factory workers in Aligarh.

In order to assess the health problems and its relationship to the nature of work of lock factory workers, a field based cross sectional study was carried out in sixty randomly selected lock factories in urban industrial areas of Aligarh city. Nine hundred fifty seven lock factory workers were included in the study out of them 45.7 percent were found to be suffering from one or more than one diseases. Detailed study of the workers showed that 73.05 percent were suffering from respiratory tract diseases, a majority of them having upper respiratory tract infection. Diseases showed a definite trend either increasing (Chronic bronchitis, Emphysema etc) or decreasing (upper respiratory tract infection, Bronchial asthma, Injuries & accidents), according to the age and duration of work. Polishing & filing appeared to be the most hazardous type of the work as shown in the proportion of chest diseases, (56.6%) & (38.3%) in polishing & filling workers respectively.

Comparative study of the clinical effects of general anesthesia versus combined general and epidural anesthesia in upper abdominal surgery

Fifty two adult patients of both sexes were anaesthetized for uper abdominal surgery and they were allocated into two equal groups. General anaesthesia was performed for the first group and was used as a control. The 2nd group received combined general and epidural analgesia between Th 8-9. Blood pressure, heart rote and blood gases were measured and proved no significant changes between the two groups except post-operative alterations of pa 0[2], which showed a significant change, which suggests improved ventilations. Good operative circumstances were observed in the combined group, in addition to reduction of analgesics, halothane percentage and meuromuscular blockers. Also it improve postoperative analgesia which facilitate early ambulation. Rapid recovery with pain relief help for good cantact with the surroundings. So combined general and epidural anaesthesia in, upper abdominal surgery is preferred