Multi proxy approach to evaluate and delineate the potential of hot springs in the Kotli District (Kashmir, Pakistan)

Tattapani hot springs are located near the Kotli District of Azad Kashmir, Pakistan. This study evaluates these hot springs based on surface geological information, radon emission measurements, hydro-geochemical and isotopic signatures and potential source mechanisms. Field observations reveal that the hot springs are located at the crest of the Tattapani anticline along the faulted contact of Cambrian carbonates with Paleocene siliciclastics. In addition, remnants of igneous intrusions in the Cambrian carbonates are commonly observed. Spatial distribution of radon emissions (ranging between 2.1 and 29.5KBq m-3) indicates an anomalous zone located over the Cambrian-Paleocene faulted contact. Hydro-geochemical data show sodium-bicarbonate affinity of hot springs. The highest surface temperature of these springs is recorded at 60.8ºC. Average reservoir temperatures based on silica and cation geo-thermometers are 101ºC and 115ºC, respectively. Giggenbach ternary diagram (Na-K-Mg) suggests a non-equilibrium state between fluid and rock, whereas isotopic and chemical data indicate heat loss by conductive cooling and mixing with groundwater during the flow of thermal water up to the surface. Oxygen and deuterium isotopes indicate that thermal water is of meteoric origin, rain and/or snow in the north at higher altitudes providing the potential recharge. Furthermore, absence of tritium in the thermal water suggests a residence time of more than 50 years

Iron Deposition following Chronic Myocardial Infarction as a Substrate for Cardiac Electrical Anomalies: Initial Findings in a Canine Model

Purpose: Iron deposition has been shown to occur following myocardial infarction (MI). We investigated whether such focal iron deposition within chronic MI lead to electrical anomalies. Methods: Two groups of dogs (ex-vivo (n = 12) and in-vivo (n = 10)) were studied at 16 weeks post MI. Hearts of animals from ex-vivo group were explanted and sectioned into infarcted and non-infarcted segments. Impedance spectroscopy was used to derive electrical permittivity () and conductivity (). Mass spectrometry was used to classify and characterize tissue sections with (IRON+) and without (IRON-) iron. Animals from in-vivo group underwent cardiac magnetic resonance imaging (CMR) for estimation of scar volume (late-gadolinium enhancement, LGE) and iron deposition (T2*) relative to left-ventricular volume. 24-hour electrocardiogram recordings were obtained and used to examine Heart Rate (HR), QT interval (QT), QT corrected for HR (QTc) and QTc dispersion (QTcd). In a fraction of these animals (n = 5), ultra-high resolution electroanatomical mapping (EAM) was performed, co-registered with LGE and T2* CMR and were used to characterize the spatial locations of isolated late potentials (ILPs). Results: Compared to IRON- sections, IRON+ sections had higher, but no difference in. A linear relationship was found between iron content and (p1.5%)) with similar scar volumes (7.28%±1.02% (Iron (1.5%)), p = 0.51) but markedly different iron volumes (1.12%±0.64% (Iron (1.5%)), p = 0.02), QT and QTc were elevated and QTcd was decreased in the group with the higher iron volume during the day, night and 24-hour period (p<0.05). EAMs co-registered with CMR images showed a greater tendency for ILPs to emerge from scar regions with iron versus without iron. Conclusion: The electrical behavior of infarcted hearts with iron appears to be different from those without iron. Iron within infarcted zones may evolve as an arrhythmogenic substrate in the post MI period

In a Persian Mosque: Revolutionary Shi'a Islam and Independence in Iran

No abstract provided

The combined diabetes and renal control trial (C-DIRECT) - a feasibility randomised controlled trial to evaluate outcomes in multi-morbid patients with diabetes and on dialysis using a mixed methods approach

Background: This cluster randomised controlled trial set out to investigate the feasibility and acceptability of the “Combined Diabetes and Renal Control Trial” (C-DIRECT) intervention, a nurse-led intervention based on motivational interviewing and self-management in patients with coexisting end stage renal diseases and diabetes mellitus (DM ESRD). Its efficacy to improve glycaemic control, as well as psychosocial and self-care outcomes were also evaluated as secondary outcomes. Methods: An assessor-blinded, clustered randomised-controlled trial was conducted with 44 haemodialysis patients with DM ESRD and ≥ 8% glycated haemoglobin (HbA1c), in dialysis centres across Singapore. Patients were randomised according to dialysis shifts. 20 patients were assigned to intervention and 24 were in usual care. The C-DIRECT intervention consisted of three weekly chair-side sessions delivered by diabetes specialist nurses. Data on recruitment, randomisation, and retention, and secondary outcomes such as clinical endpoints, emotional distress, adherence, and self-management skills measures were obtained at baseline and at 12 weeks follow-up. A qualitative evaluation using interviews was conducted at the end of the trial. Results: Of the 44 recruited at baseline, 42 patients were evaluated at follow-up. One patient died, and one discontinued the study due to deteriorating health. Recruitment, retention, and acceptability rates of C-DIRECT were generally satisfactory HbA1c levels decreased in both groups, but C-DIRECT had more participants with HbA1c < 8% at follow up compared to usual care. Significant improvements in role limitations due to physical health were noted for C-DIRECT whereas levels remained stable in usual care. No statistically significant differences between groups were observed for other clinical markers and other patient-reported outcomes. There were no adverse effects. Conclusions: The trial demonstrated satisfactory feasibility. A brief intervention delivered on bedside as part of routine dialysis care showed some benefits in glycaemic control and on QOL domain compared with usual care, although no effect was observed in other secondary outcomes. Further research is needed to design and assess interventions to promote diabetes self-management in socially vulnerable patients

Acute phase reactants and lipid profile in acute chest pain presentations: a multimarker approach

Background: Cardiovascular diseases cause more deaths and disability and incur greater economic cost than any other illness in the world. Our objective is to study the biological activity and evaluate the diagnostic and prognostic values of acute phase reactants, high sensitivity C-reactive protein (hsCRP) and ferritin in association with traditional lipid profile, in screening subjects who developed chest pain due to cardiac event as indicated by a positive cardiac troponin I (cTnI) test.Methods: In this hospital-based prospective study, a total of 150 cases (n=150), presented consecutively to the emergency department with symptoms of cardiac ischemia and tested positive for troponin I (enzyme-linked flourescent assay), were compared with an equal number of age and gender matched healthy controls (n=150) for hsCRP (immunoturbidimetric assay), ferritin (immunoturbidimetric assay) and lipid profile (enzymatic colorimetric assay).Results: Median serum hsCRP levels were 2.12 mg/L)±1.79 mg/L) than controls (2.82±significantly elevated in cases (3.57 (p0.05) different between the two groups.Conclusions: hsCRP and ferritin are independent novel predictors for cardiovascular risks and events. Lipid profile demonstrates low specificity in such cases.

Awareness of geriatric welfare services among rural elderly population

Background: Elderly population suffers from income loss, decreased social role and increased dependence along with physical and mental problems associated with ageing. Geriatric welfare services are aimed to address this problem related to old age. The main focus of the existing geriatric welfare services are below the poverty line elderly population. However, the benefit from these services can be obtained if elderly population have awareness about these welfare services. Main objective of the study was to study the awareness regarding geriatric welfare services among rural elderly population and its association with gender.Methods: Community based cross- sectional study was carried out at field practice area of Rural Health Training Centre, JN Medical College, AMU, Aligarh, Uttar Pradesh, India by using systematic random sampling with probability proportionate to size among 225 rural elderly individuals using pretested and predesigned questionnaire. Data analysis was done using SPSS 20. Chi square test was used. P value <0.05 was considered significant.Results: Among the geriatric welfare services 28.9% were aware of the social security schemes, 84% were aware of the special govt. facilities, 35.6% were aware of the health insurance schemes. Males had significant higher awareness of geriatric welfare services than the females.Conclusions: The study revealed that awareness of geriatric welfare services among rural elderly population was very low that needs to be addressed to improve utilization of these services.

Segmentation of fetal 2D images with deep learning: a review

Image segmentation plays a vital role in providing sustainable medical care in this evolving biomedical image processing technology. Nowadays, it is considered one of the most important research directions in the computer vision field. Since the last decade, deep learning-based medical image processing has become a research hotspot due to its exceptional performance. In this paper, we present a review of different deep learning techniques used to segment fetal 2D images. First, we explain the basic ideas of each approach and then thoroughly investigate the methods used for the segmentation of fetal images. Secondly, the results and accuracy of different approaches are also discussed. The dataset details used for assessing the performance of the respective method are also documented. Based on the review studies, the challenges and future work are also pointed out at the end. As a result, it is shown that deep learning techniques are very effective in the segmentation of fetal 2D images.info:eu-repo/semantics/publishedVersio