Timing and documentation of key events in neonatal resuscitation

Only a minority of babies require extended resuscitation at birth. Resuscitations concerning babies who die or who survive with adverse outcomes are increasingly subject to medicolegal scrutiny. Our aim was to describe real-life timings of key resuscitation events observed in a historical series of newborns who required full resuscitation at birth. Twenty-seven babies born in our centre over a 10-year period had an Apgar score of 0 at 1 min and required full resuscitation. The median (95% confidence interval) postnatal age at achieving key events were commencing cardiac compressions, 2.0 (1.5–4.0) min; endotracheal intubation, 3.8 (2.0–6.0) min; umbilical venous catheterisation 9.0 (7.5–12.0) min; and administration of first adrenaline dose 10.0 (8.0–14.0) min. Conclusion: The wide range of timings presented from real-life cases may prove useful to clinicians involved in medical negligence claims and provide a baseline for quality improvements in resuscitation training

Great Expectations: Plans and Predictions for New Horizons Encounter with Kuiper Belt Object 2014 MU69 ('Ultima Thule')

The New Horizons encounter with the cold classical Kuiper Belt object (KBO) 2014 MU69 (informally named 'Ultima Thule,' hereafter Ultima) on 1 January 2019 will be the first time a spacecraft has ever closely observed one of the free-orbiting small denizens of the Kuiper Belt. Related to but not thought to have formed in the same region of the Solar System as the comets that been explored so far, it will also be the largest, most distant, and most primitive body yet visited by spacecraft. In this letter we begin with a brief overview of cold classical KBOs, of which Ultima is a prime example. We give a short preview of our encounter plans. We note what is currently known about Ultima from earth-based observations. We then review our expectations and capabilities to evaluate Ultima's composition, surface geology, structure, near space environment, small moons, rings, and the search for activity

PHYTOCHEMICAL STUDY OF GOKSHUR (TRIBULUS TERRESTRIS LINN.) AND EVALUATION OF ITS ANTIBACTERIAL ACTIVITY WITH SPECIAL REFERENCE TO MUTRAKRUCHCHA

Infection of the urinary tract is the second commonest site after respiratory tract infection. It is more frequent in women than men. Almost 50% women suffer UTI. In our classical texts, urinary tract infection is described as Mutrakruchcha. A great Acharya Charak has mentioned it in Chikitsa sthana, Trimarmiya adhyay, its 8 types and Basti as a Marma. For the treatment of all types of Mutrakruchcha, Gokshur is mentioned. Gokshur is diuretic, aphrodisiac, tonic and rejuvenating herb with the ability to build lean muscle and strength. Gokshur possess Madhur rasa, Madhur vipaka and sheet Virya which causes diuresis by increasing Kleda in the body. So in this study 30 patients complaining of urinary tract infection were taken. 50 ml of Gokshur decoction, twice a day was given orally for 30 days. Weekly assessment was done on the basis of sign and symptoms like Mutra daha (burning micturition), Sashula mutrapravruti (painful micturition), Bastishul (suprapubic pain), Mutrapravruti (frequency of micturition), Jwaraprachiti (fever with chills), Sarakta mutrapravruti (haematuria), Sapuya mutrapravruti (pyuria). Objective improvement was done on the basis of reduction in pus cells in urine and serum creatinine at initial and after 30 days. Subjective improvement was shown in percentage it was 67.71%. The observations were found to be significant. Paired t test was found to be highly significant at 1 % level of significance i. e. p < 0. 01

From Fine- to Coarse-Grained Dynamic Information Flow Control and Back, a Tutorial on Dynamic Information Flow

This tutorial provides a complete and homogeneous account of the latestadvances in fine- and coarse-grained dynamic information-flow control (IFC)security. Since the 70s, the programming language and the operating systemcommunities have proposed different IFC approaches. IFC operating systems trackinformation flows in a coarse-grained fashion, at the granularity of a process.In contrast, traditional language-based approaches to IFC are fine-grained:they track information flows at the granularity of program variables. Fordecades, researchers believed coarse-grained IFC to be strictly less permissivethan fine-grained IFC -- coarse-grained IFC systems seem inherently lessprecise because they track less information -- and so granularity appeared tobe a fundamental feature of IFC systems. We show that the granularity of thetracking system does not fundamentally restrict how precise or permissivedynamic IFC systems can be. To this end, we mechanize two mostly standardlanguages, one with a fine-grained dynamic IFC system and the other with acoarse-grained dynamic IFC system, and prove a semantics-preserving translationfrom each language to the other. In addition, we derive the standard securityproperty of non-interference of each language from that of the other via ourverified translation. These translations stand to have important implicationson the usability of IFC approaches. The coarse- to fine-grained direction canbe used to remove the label annotation burden that fine-grained systems imposeon developers, while the fine- to coarse-grained translation shows thatcoarse-grained systems -- which are easier to design and implement -- can trackinformation as precisely as fine-grained systems and provides an algorithm forautomatically retrofitting legacy applications to run on existingcoarse-grained systems.<br

Adherence of popular smoking cessation mobile applications to evidence-based guidelines

Background Smoking remains one of the major preventable causes of chronic diseases. Considering the promising evidence on the effectiveness of mobile technology for health behaviour change, along with the increasing adoption of smartphones, this review aims to systematically assess the adherence of popular mobile apps for smoking cessation to evidence-based guidelines. Methods The United Kingdom Android and iOS markets were searched in February 2018 to identify smoking cessation apps. After screening, 125 Android and 15 iOS apps were tested independently by two reviewers for adherence to the National Institute of Care and Excellence (NICE) Smoking Cessation Guidelines for Self-Help Materials and the Five A Guidelines for Smoking Cessation. Pearson chi square tests were run to examine differences between the two operating systems. Results A majority of apps across both operating systems had low adherence (fulfils 1–2 out of 5 guidelines) to the Five A Guidelines (65.7%) and low adherence (fulfils 1–3 out of 9 guidelines) to the NICE Smoking Cessation Guidelines for Self-Help Materials (63.6%). Only 15% of mobile apps provided information about the benefits of nicotine replacement therapy (NRT), and even fewer provided information regarding types of NRT products (7.1%) or how to use them (2.1%). In addition, only a minority of apps arrange follow-up appointments or provide additional support to help smokers quit. Conclusion Similar to previous mobile app reviews dating back to 2014, our findings show that most mobile apps do not follow existing smoking cessation treatment guidelines, indicating little change regarding the availability of evidence-based mobile apps for smoking cessation in the UK market. Smokers seeking to quit, tobacco control policy makers and software developers need to work together to develop apps that are in line with the latest clinical guidelines and strategies to maximise effectiveness

Prevalence of diabetes mellitus in tuberculosis patients: a hospital based study

Background: Screening of high risk individuals with weak immunity as in diabetics for active tuberculosis is of great public health importance. The prevalence of diabetes in tuberculosis is high and the data regarding the same is necessary for strengthening TB control activities.Methods: This study was conducted to know the prevalence of diabetes mellitus in tuberculosis patients diagnosed from the hospital. This was a hospital based descriptive study conducted in Department of Respiratory medicine, Academy of Medical Sciences, Northern Kerala in association with DOTS center during a one year period from August 2014 to July 2015. All patients diagnosed as a case of tuberculosis from our institution were included for the study. All patients were screened for diabetes mellitus using Fasting Plasma Glucose value. Additional information regarding age, body mass index (BMI), sputum smear positivity and treatment category of tuberculosis were collected.Results: There was a higher prevalence of diabetes in tuberculosis patients than in general population and the rate was found to be 19.6%. There was a statistically significant association of diabetes with older age, higher BMI and sputum positivity.Conclusions: Routine screening for diabetes needs to be intensified in the community and more importantly in Tuberculosis patients.

A NEW SOLAR PV-DRIVEN SRM FOR EVS WITH ENERGY MANAGEMENT FUNCTIONS

This research implements a novel energy management function for an SRM for EVs powered by solar PV. This system's primary goal is to lower greenhouse gas emissions. This is mostly employed in electrical car applications, drive applications, and industrial applications. Photovoltaic systems are primarily utilised to lessen the reliance of automobiles on their batteries. Basically, PI controller is employed in the older system, while P &amp; O algorithm is used for MPPT tracking. Therefore, during tracking, there would be a high power and voltage consumption. In order to prevent this, fuzzy logic controllers are used in place of PI controllers. The incremental conductance (IC) technique is used for MPPT tracking. Using the MATLAB/Simulink programme, the entire design is simulated. Comparing simulation results to older systems demonstrates that SRM drive for electric car applications using fuzzy logic controller produces effective results

Clinico-pathological profile of abdominal tuberculosis and their treatment response in a tertiary care centre

Background: Abdominal tuberculosis is an important clinical entity having varied mode of clinical presentation. So the diagnosis of abdominal TB is difficult and careful approach to the patients and supportive investigation data are necessary to make the final diagnosis. Objectives of the study were to evaluate the clinic-pathological profile of patients with abdominal TB in a tertiary care centre in northern Kerala and to assess their response to anti-tubercular therapy under DOTS.Methods: This was a retrospective follow up study conducted in the department of Pulmonary Medicine in association with the department of Gastro-medicine and Surgery, and medical college DOTS centre Pariyaram Medical College, Pariyaram Kannur district–Kerala, India. Total 55 patients with abdominal TB diagnosed on the basis of clinical profile and supported investigation data like gross morphological findings at endoscopy, colonoscopy, diagnostic laparoscopy, laparotomy or histologically proven caseating granulomas were selected for this study.Results: Out of the 55 patients, 31 were males and 24 females with age ranging 16-80 (Mean 30.01±11.7) years. Abdominal pain was the most common presenting symptom in 45 (81.81%). The diagnosis of abdominal TB was confirmed histopathologically in 42 (76.36%). Remaining 13 (23.64%) cases were diagnosed microscopically and with supportive clinical and imaging background. All the patients were treated under DOTS.Conclusions: Neither clinical features, laboratory, radiological and Endoscopic methods nor bacteriological and histopathological findings by themselves provide a gold standard in the diagnosis of abdominal TB. If diagnosed early, it can be treated successfully with anti-TB drugs