Assessing Variability in End-of-Life Intensity of Care After Out-of-Hospital Cardiac Arrest

Out of hospital cardiac arrest (OHCA) affects over 300,000 Americans per year.1 Many factors affect the outcomes and overall OHCA survival in a community; some of these include an individual’s characteristics such as age, co-morbid conditions, availability of an AED on scene, time to CPR, and the characteristics of the hospital they are treated at.1,2 Directly following resuscitation from cardiac arrest, the individual is at risk of developing numerous problems caused by sequelae of ischemic injury sustained during the arrest. The national average rate of survival to discharge is only 10%.2,3 Many of these factors are modifiable and provide an opportunity to improve outcomes. In our project, we focus on lifesustaining procedures administered by hospitals upon receiving and admitting individuals experiencing OHCA. We used previously validated measures as defined by Barnato et al as “life sustaining end of life (EOL) measures”:4 • Intubation and mechanical ventilation • Tracheostomy • Gastrostomy tube insertion • Hemodialysis • Enteral/parenteral nutrition • CPRhttps://jdc.jefferson.edu/cwicposters/1035/thumbnail.jp

RADIOLOGY REQUEST FORMS (RRF) INADEQUATELY COMPLETED; THE CASE OF A TERTIARY HEALTH CENTER IN NORTHWEST NIGERIA

Background: The need and importance of adequately completing radiology request forms cannot be over emphasized. Thus, this study investigated the pattern in which radiology request forms are completed by clinicians in a tertiary health center. Methods: A total of two hundred and fourteen (214) samples of request forms were randomly selected from records of the Radiology Department of the Federal Medical Center, BirninKebbi, Nigeria. The request forms comprises of requests from various departments within the hospital. All the data collected from the request forms where entered into Microsoft excel and items/fields on the form were examined. Results: From this study, it was observed that out of the total 214 forms collected, 209 (97.7%) of the forms were not adequately completed with only 5 (2.3%) fully completed. Other items on the request form that were also least completed were the referring physicians name (2.3%), patient\u27s full address (2.3%) and patients age (62.6%).Conclusion: We conclude that radiology request forms are inadequately completed as seen from the present study, thus the need to enlighten the referring physicians on the need to adequately and properly complete radiology request forms as this is vital in improving the accuracy of radiologists report / interpretation. KEYWORDS: Radiology; Physician; Request forms; Patients; Health center

RADIOLOGY REQUEST FORMS (RRF) INADEQUATELY COMPLETED; THE CASE OF A TERTIARY HEALTH CENTER IN NORTHWEST NIGERIA

Background: The need and importance of adequately completing radiology request forms cannot be over emphasized. Thus, this study investigated the pattern in which radiology request forms are completed by clinicians in a tertiary health center. Methods: A total of two hundred and fourteen (214) samples of request forms were randomly selected from records of the Radiology Department of the Federal Medical Center, BirninKebbi, Nigeria. The request forms comprises of requests from various departments within the hospital. All the data collected from the request forms where entered into Microsoft excel and items/fields on the form were examined. Results: From this study, it was observed that out of the total 214 forms collected, 209 (97.7%) of the forms were not adequately completed with only 5 (2.3%) fully completed. Other items on the request form that were also least completed were the referring physicians name (2.3%), patient's full address (2.3%) and patients age (62.6%).Conclusion: We conclude that radiology request forms are inadequately completed as seen from the present study, thus the need to enlighten the referring physicians on the need to adequately and properly complete radiology request forms as this is vital in improving the accuracy of radiologists report / interpretation. KEYWORDS: Radiology; Physician; Request forms; Patients; Health center

Audit of laparoscopic cholecystectomy Omdurman teaching hospital

Objectives: To review and audit our experience in laparoscopic cholecystectomy [LC] at Omdurman Teaching Hospital, Sudan. Methods: A prospective study for patients who underwent laparoscopic cholecystectomy in the period, from January 2006 to October 2007. Demographic data, indications for surgery, rate of conversion to open cholecystectomy, morbidity, and mortality rates were noted. Results: A total of 114 patients underwent LC in 21 months, They were female 100 patients and 14 males, age range from 25 to70 years, mean age 44 years. Indications for surgery were biliary colic 65.8%, fatty dyspepsia 37.7%, and acute cholecystitis 3.5%. The range of operative time was 25-90 minutes. Conversion rate was (7.9%). The reasons for conversions were bleeding, extensive dense adhesions, severe inflammation. Conclusion: Our findings were consistent with the literature, demonstrating that LC is a safe minimal invasive technique Keywords: Laparoscopic, cholecystectomy, minimal invasive surgery, surgical audit, Sudan.Sudan Journal of Medical Sciences Vol. 3 (1) 2008: pp. 21-2

Characterisation and expression of SPLUNC2, the human orthologue of rodent parotid secretory protein

We recently described the Palate Lung Nasal Clone (PLUNC) family of proteins as an extended group of proteins expressed in the upper airways, nose and mouth. Little is known about these proteins, but they are secreted into the airway and nasal lining fluids and saliva where, due to their structural similarity with lipopolysaccharide-binding protein and bactericidal/permeability-increasing protein, they may play a role in the innate immune defence. We now describe the generation and characterisation of novel affinity-purified antibodies to SPLUNC2, and use them to determine the expression of this, the major salivary gland PLUNC. Western blotting showed that the antibodies identified a number of distinct protein bands in saliva, whilst immunohistochemical analysis demonstrated protein expression in serous cells of the major salivary glands and in the ductal lumens as well as in cells of minor mucosal glands. Antibodies directed against distinct epitopes of the protein yielded different staining patterns in both minor and major salivary glands. Using RT-PCR of tissues from the oral cavity, coupled with EST analysis, we showed that the gene undergoes alternative splicing using two 5' non-coding exons, suggesting that the gene is regulated by alternative promoters. Comprehensive RACE analysis using salivary gland RNA as template failed to identify any additional exons. Analysis of saliva showed that SPLUNC2 is subject to N-glycosylation. Thus, our study shows that multiple SPLUNC2 isoforms are found in the oral cavity and suggest that these proteins may be differentially regulated in distinct tissues where they may function in the innate immune response

BPIFB1 (LPLUNC1) is upregulated in cystic fibrosis lung disease

Although the biology the PLUNC (recently renamed BPI fold, BPIF) family of secreted proteins is poorly understood, multiple array based studies have suggested that some are differentially expressed in lung diseases. We have examined the expression of BPIFB1 (LPLUNC1), the prototypic two-domain containing family member, in lungs from CF patients and in mouse models of CF lung disease. BPIFB1 was localized in CF lung samples along with BPIFA1, MUC5AC, CD68 and NE and directly compared to histologically normal lung tissues and that of bacterial pneumonia. We generated novel antibodies to mouse BPIF proteins to conduct similar studies on ENaC transgenic (ENaC-Tg) mice, a model for CF-like lung disease. Small airways in CF demonstrated marked epithelial staining of BPIFB1 in goblet cells but staining was absent from alveolar regions. BPIFA1 and BPIFB1 were not co-localised in the diseased lungs. In ENaC-Tg mice there was strong staining of both proteins in the airways and luminal contents. This was most marked for BPIFB1 and was noted within 2 weeks of birth. The two proteins were present in distinct cells within epithelium. BPIFB1 was readily detected in BAL from ENaC-Tg mice but was absent from wild-type mice. Alterations in the expression of BPIF proteins is associated with CF lung disease in humans and mice. It is unclear if this elevation of protein production, which results from phenotypic alteration of the cells within the diseased epithelium, plays a role in the pathogenesis of the disease

Designing and Validating a New Asian Family Scale

Introduction: All available family scales are designed for western countries and there is no validated family scale which is specifically devised for Asian population. The difference in culture and family values warrants the formulation of a specific Asian family scale to cater the regional needs. The objectives are to devise and validate a new family scale and eventually to validate it for Malaysian population. Method: The development of the questionnaire can be divided into 5 stages; identifying the domains of Asian family values, items identification for each domain and language review, pretest the pre-final version, pilot study and validation. Respondents were recruited from different ethnic groups and cultural backgrounds to represent the Malaysian population. They were selected by using stratified quota sampling from various health centres in the district of Kuantan, Malaysia. Results: A total of 588 participants enrolled in the validation stage with various ethnic backgrounds. Bartlet’s KMO value is 0.93. From 43 items, 67% had good factor loading (>0.4) and 13 items were finally dropped. Total Cronbach’s alpha values of 0.9 with 5 domains were identified by using exploratory factor analysis. There are 6 items in each domain. Conclusion: This new scale has good psychometric properties and it is a valid family scale for Malaysians. Further psychometric evaluation will further enhance the evidence for other populations in Asia

Faecal Contamination of Feeding Bottles Contents, Among Artificially Fed Children

This study was carried out to investigate the bacterial contamination of feeding bottles contents in artificially fed children presenting with diarrhoea at the Paediatric outpatient clinic in Khartoum Hospital.Methods: Hundred bottle fed infants presenting with diarrhoea were included in the study. Specimens were collected from the contents of the feeding bottles and the faeces of children.Results: Hundred and ten bacterial species were isolated from the contents. E. coli was the commonest isolate [33 (30%)]. Different other bacterial species were also isolated with very high count (1X106 - > 15X105/ml). Twenty one enteric pathogens were isolated from the stool specimens [Enteropathogenic E. coli (7) and Shigella species (14)]. The antibiotic sensitivity of the E. coli and Shigella species showed high resistance to co-trimoxazole (57.5%, 53.3% respectively) and to coamoxiclav (85% - 53.3% respectively).Conclusion: Awareness to the hazards of the feeding bottles among the community should be raised and breast feeding should be encouraged.Key words: diarrhea, enteric pathogens, E. coli

Effective Rheology of Bubbles Moving in a Capillary Tube

We calculate the average volumetric flux versus pressure drop of bubbles moving in a single capillary tube with varying diameter, finding a square-root relation from mapping the flow equations onto that of a driven overdamped pendulum. The calculation is based on a derivation of the equation of motion of a bubble train from considering the capillary forces and the entropy production associated with the viscous flow. We also calculate the configurational probability of the positions of the bubbles.Comment: 4 pages, 1 figur

Design and analysis 5G mobile network model to enhancement high-density subscribers

To obtain a high data rate that is commensurate with the growing demand for internet services, the fifth generation (5G) cellular networks will use the bandwidth beyond 6 GHz, called millimeters waves (mm-waves), to obtain a higher. The first phase (phase I) of the 5G network design for high user density, where the optimized microcells are deployed at carrier frequency 700 MHz with 20 MHz bandwidth. The second phase (phase II) of the design consists of the deployment of microcells which are operating at 3.6 GHz with 100 MHz bandwidth; this phase is planned to cover 200000 users within the province. The third phase (phase III) of the design is represented by the deployment of picocells, which are planned to operate at 26 GHz frequency and bandwidth 500 MHz; this phase is planned to cover 3,500,000 users within the province. Two types of modulation are adopted for the network (orthogonal frequency division multiplexing (OFDM) and 256 quadrature amplitude modulation (QAM)); the overall performance of the network is studied with regards to the percentage of coverage, power overlapping ratio, frequency interference, and quality of service (QoS)