Stem and Leaf Anatomical Studies of Selected Species of Barlerieae and Ruellieae (Acanthaceae) from Yemen

The anatomy of stems and leaves of selected species of tribes Barlerieae and Ruellieae (Acanthaceae) was studied to assess the taxonomic significance of anatomical characteristics in the two tribes. The anatomical characters such as the outline of stems, midribs, petioles, margins, shape of epidermal cells, vascular bundles, stomata, anticlinal cells, cystoliths, aerenchyma cells, layer of wax, layer of hypodermis were observed and analysed. Type of trichomes observed on the leaf surface using Scanning Electron Microscopy and light microscope provides information of taxonomic significance to both tribes and the taxa within them. The trichomes vary from non-glandular (unicellular, bicellular, multicellular, and multiradiate) to capitate glandular. Abundance of long-stalked trichomes was recorded only in Neuracanthus aculeatus. Cystoliths of different size and position are present in epidermis, parenchyma and collenchyma in addition to oil cells in some genera. The placement of Neuracanthus among the recognized tribes of Acanthaceae is assessed using anatomical characters.

Characteristics and Early Predictors of Intensive Care Unit Admission among COVID-19 Patients in Qatar

Purpose

This study aimed to explore the early predictors of intensive care unit (ICU) admission and in-hospital mortality among patients diagnosed with Coronavirus disease (COVID-19).

Methods & Materials

This was a case-control study of adult patients with confirmed COVID-19. Cases were defined as patients admitted to ICU during the period February 29 - May 29, 2020. For each case enrolled, one control was matched by age and gender. Univariate and multivariate logistic regression models were used to identify the predictors for ICU admission and in-hospital mortality among the COVID‐19 patients.

Results

A total of 1560 patients with confirmed COVID-19 were included. Each group included 780 patients with a predominant male gender (89.7%) and a median age of 49 years (interquartile range, IQR=18). Predictors independently associated with ICU admission included having cardiovascular disease (CVD) (adjusted odds ratio (aOR)=1.64, 95% confidence interval (CI): 1.16 - 2.32, p= 0.005), diabetes (aOR=1.52, 95% CI: 1.08 - 2.13, p= 0.016), body mass index ≥30 kg/m2 (aOR=1.46, 95% CI: 1.03-2.08, p= 0.034), lymphocytes ≤0.8 × 103/μL (aOR=2.69, 95% CI: 1.80-4.02, p<0.001), aspartate aminotransferase (AST) >120 U/L (aOR= 2.59, 95% CI: 1.53-4.36, p<0.001), ferritin >600 μg/L (aOR=1.96, 95% CI: 1.40-2.74, p<0.001), C-reactive protein (CRP) >100 mg/L (aOR=4.09, 95% CI: 2.81-5.96, p<0.001), and dyspnea (aOR=2.50, 95% CI: 1.77-3.54, p <0.001). Similarly, significant predictors of mortality included CVD (aOR=2.16, 95% CI: 1.32- 3.53, p=0.002), diabetes (aOR=1.77, 95% CI: 1.07-2.90, p=0.025), cancer (aOR=4.65, 95% CI: 1.50-14.42, p= 0.008), lymphocytes ≤0.8 x,103/μL (aOR=2.34, 95% CI: 1.45-3.78, p= 0.001), and AST >120 U/L (aOR= 1.89, 95% CI: 1.04-3.43, p=0.036).

Conclusion

Having CVD, diabetes, lymphopenia, and increased AST were independent predictors for both ICU admission and in-hospital mortality in patients with COVID-19. In addition, obesity, high ferritin, and CRP levels were also associated with increased risk of ICU admission, while cancer was strongly associated with in-hospital mortality. Early identification and monitoring of patients at risk is essential in planning the level of care needed to prevent delay in medical intervention.

Perceptions and practices regarding the process of obtaining informed consent from surgical patients at a tertiary care hospital

Background

Proper informed consent is essential for patients to have sound knowledge about the indication, risks, and benefits of a proposed surgical procedure. The study aim was to assess the perceptions of postoperative patients about the informed consent process and identify various influential factors in a tertiary care hospital.

Methods

A cross-sectional study was conducted from February to August 2018 at a tertiary care hospital in Lahore, Pakistan. A validated questionnaire was used to conduct interviews of 101 patients planning to undergo elective surgery after fulfilling all ethical considerations. A purposive sampling technique was employed to enroll and the data analysis was performed by using SPSS version 23.

Results

Out of total 101 patients, 50 (49.5%) of them were males and the mean age of total sample was 36.98 ± 14.23 years. The majority 92 (91.1%) considered informed consent to be important and that it did not influence their surgical decision 85 (84.2%). Consent was obtained by the consulting surgeon from 41 (40.6%) patients and by the residents/house officer from 60 (59.4%) patients. Fifteen (14.8%) patients signed the consent form themselves, and 86 (85.1%) relatives of patients signed. Ninety-eight (97.0) patients were told about indications of the surgery, and 54 (53.5%) were told about possible complications. Seventy-five (74.3%) patients were informed about alternatives to surgery. Significant reasons for not signing were language (p = 0.03), educational status (p = 0.002), and not being informed by relatives before signing (p = 0.02).

Conclusion

The patients had adequate knowledge about the process of informed consent and considered it important. Factors identified as barriers to signing the consent form by the patients themselves included language, better educational status, and not being asked by relatives. It is imperative to involve the patients in the process of consent, especially in signing by them or in their presence by their surrogate.

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Informed consent is the basic right of the patient to express acceptance or rejection based on the information provided by the physician about the proposed medical treatment.

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Patients had adequate knowledge about the process of informed consent and considered it important in developing countries.

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Factors identified as barriers in signing of consent form by patients themselves included language, better educational status and not being asked by relatives.

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A higher proportion of patients are satisfied with the process of informed consent.

Intellectual disability among special children and its associated factors: A case control study, Lahore Pakistan

OBJECTIVE

To study the association of maternal, paternal and social factors with intellectual disability in special children..

METHODS

The case-control study was conducted in four schools of Lahore, Pakistan, from September 2014 to September 2015, and comprised intellectually disabled children aged 6-15 years, and an equal number of matching healthy subjects. group. Interviews were conducted with the help of a pre-tested structured questionnaire. SPSS -17 was utilised to analyse the data.

RESULTS

Of the 298 participants, 149(50%) each were cases and controls. Overall, there were 83(56%) boys and 66(44%) girls. Significant association of intellectual disability was found with consanguinity (p=0.001), father's educational status (p=0.03), paternal history of mental retardation (p=0.01) and history of delayed cry (p=0.001). Breastfeeding (depicted a protective relationship (p=0.03).

CONCLUSIONS

Parental, social, environmental and familial causes contributed to intellectual disability among the subjects.

High Prevalence of Factor V Leiden in Healthy Jordanian Arabs

The prevalence of APC resistance in healthy Jordanian Arabs was studied. Between October 1996 through September 1997 a total of 400 healthy subjects were studied. There were 212 males and 188 females. APC resistance was studied by functional and DNA methods. There were a total of 52 subjects (13%) who were APC resistant by the functional test. There were 49 subjects (12.25%) who had FV Q506 by DNA test. Of these there were 42 heterozygous and 7 homozygous (allele frequency 0.07). None of the subjects had clinical thrombosis. It is concluded that the prevalence of APC resistance due to FV Q506 is high in Jordanian Arabs.

The thermoluminescence glow curve and the deconvoluted glow peak characteristics of erbium doped silica fiber exposed to 70-130 kVp x-rays

In regard to thermoluminescence (TL) applied to dosimetry, in recent times a number of researchers have explored the role of optical fibers for radiation detection and measurement. Many of the studies have focused on the specific dopant concentration, the type of dopant and the fiber core diameter, all key dependencies in producing significant increase in the sensitivity of such fibers. At doses of less than 1 Gy none of these investigations have addressed the relationship between dose response and TL glow peak behavior of erbium (Er)-doped silica cylindrical fibers (CF). For x-rays obtained at accelerating potentials from 70 to 130 kVp, delivering doses of between 0.1 and 0.7 Gy, present study explores the issue of dose response, special attention being paid to determination of the kinetic parameters and dosimetric peak properties of Er-doped CF. The effect of dose response on the kinetic parameters of the glow peak has been compared against other fiber types, revealing previously misunderstood connections between kinetic parameters and radiation dose. Within the investigated dose range there was an absence of supralinearity of response of the Er-doped silica CF, instead sub-linear response being observed. Detailed examination of glow peak response and kinetic parameters has thus been shown to shed new light of the rarely acknowledged issue of the limitation of TL kinetic model and sub-linear dose response of Er-doped silica CF.

The axillary arch - morphological and histological study with clinical importance

The latissimus dorsi is a muscle of the back which forms the posterior fold of the axilla and its tendon twists to insert into the floor of the intertubercular sulcus of the humerus. Occasionally, the muscle has a muscular slip which crosses the axilla to insert into the pectoralis major. This muscular slip is often termed as "axillary arch." In the present study, we report bilateral axillary arch detected in a 45-year-old male cadaver. The average vertical length of the axillary arch measured 7 cm. The average maximum width of the uppermost, middle and lower part of the arch measured 2, 3.5 and 3.2 cm, respectively. The presence of the axillary arch is an uncommon finding in humans, considering the fact that it is solely found in the animals who prefer to hang on the trees. A histological study of the axillary arch was also performed and it showed skeletal muscle fibres which was uniformly arranged. The presence of the axillary arch may assist in the adduction of the shoulder. It may also compress the axillary vessels and nerves thereby causing resultant symptoms. Prior anatomical knowledge of the presence of axillary arch may be helpful for surgeons performing radical dissection of the axillary lymph nodes and ligation of axillary vessels, clinicians diagnosing abduction syndromes and interventional radiologists interpreting axillary mass in day to day clinical practice.

An unusual presentation of whiplash injury: long thoracic and spinal accessory nerve injury

Whiplash injuries from motor vehicle accidents are very common. The usual presentation and course of this condition normally results in resolution of symptoms within a few weeks. Brachial plexus traction injuries without any bone or joint lesion of the cervical spine have been reported before. We report a case where a gentleman was involved in a rear end vehicle collision, sustained a whiplash injury and was later found to have a long thoracic nerve palsy and spinal accessory nerve palsy. Although isolated injuries of both nerves following a whiplash injury have been reported, combined injury of the two nerves following a whiplash injury is very uncommon and is being reported for the first time.

Definition and application of a five-parameter characterization of one-dimensional cellular automata rule space

Cellular automata (CA) are important as prototypical, spatially extended, discrete dynamical systems. Because the problem of forecasting dynamic behavior of CA is undecidable, various parameter-based approximations have been developed to address the problem. Out of the analysis of the most important parameters available to this end we proposed some guidelines that should be followed when defining a parameter of that kind. Based upon the guidelines, new parameters were proposed and a set of five parameters was selected; two of them were drawn from the literature and three are new ones, defined here. This article presents all of them and makes their qualities evident. Then, two results are described, related to the use of the parameter set in the Elementary Rule Space: a phase transition diagram, and some general heuristics for forecasting the dynamics of one-dimensional CA. Finally, as an example of the application of the selected parameters in high cardinality spaces, results are presented from experiments involving the evolution of radius-3 CA in the Density Classification Task, and radius-2 CA in the Synchronization Task.

High prevalence of factor V Leiden in healthy Jordanian Arabs

The prevalence of APC resistance in healthy Jordanian Arabs was studied. Between October 1996 through September 1997 a total of 400 healthy subjects were studied. There were 212 males and 188 females. APC resistance was studied by functional and DNA methods. There were a total of 52 subjects (13%) who were APC resistant by the functional test. There were 49 subjects (12.25%) who had FV Q506 by DNA test. Of these there were 42 heterozygous and 7 homozygous (allele frequency 0.07). None of the subjects had clinical thrombosis. It is concluded that the prevalence of APC resistance due to FV Q506 is high in Jordanian Arabs.

Pattern waxes and inaccuracies in fixed and removable partial denture castings

It is the desire of every dentist and dental technician to produce a restoration that will fit the patient with a minimum of adjustments and certainly one that does not require remaking. Yet many abuse the materials with which they work, either through improper manipulation, lack of familiarity with their properties, or by attempting to reduce laboratory time by taking short cuts. Wax is one of the materials that requires more knowledge and skill to manipulate accurately because it has a considerably higher coefficient of thermal expansion (and contraction) than any other dental material. It often contributes considerably to the inaccuracies of cast dental restorations. This article provides a review of dental waxes used to make prosthodontic castings and points out some of the properties of waxes that must be controlled to make accurate restorations.

The effect of storage time of removable partial denture wax pattern on the accuracy of fit of the cast framework

STATEMENT OF PROBLEM

Situations may arise in dental laboratories that could result in a time lapse between preparing the wax pattern of the removable partial denture framework and its casting into the cobalt-chromium alloy.

PURPOSE

This study investigated the effect of storage time of the wax pattern before casting and the influence of the palatal major connector design on the accuracy of its fit on the master casts.

MATERIAL AND METHODS

Forty-two frameworks were prepared with two designs of major connectors, which were divided into three subgroups according to the storage time of the wax patterns: 24 hours, 1 week, and 1 month. Discrepancies in the fit of the connectors to their respective casts were measured at specific locations for both connector designs.

RESULTS

In both framework design groups, there was a significant deterioration in fit (p < 0.0005) of the major connectors with the increase in storage time of their wax patterns on their respective refractory casts. Gap discrepancies were more pronounced towards the center of the palate.

CONCLUSIONS

The greatest discrepancies appeared at the middle sections of the connectors more than at the lateral section (p < 0.0005). Furthermore, frameworks with modified palatal plate major connectors exhibited greater inaccuracies in their fit than those with the anterior posterior palatal strap design, as evidenced by the increase in mean gap discrepancies under the palatal plate design (p < 0.0005).

Imidazo[2,1-b]benzothiazoles. II. Synthesis and antiinflammatory activity of some imidazo[2,1-b]benzothiazoles

3-[2-[p-(Un)substituted phenyl]imidazo [2,1-b]benzothiazol-3- yl]propionic acid derivatives (2a--e) were prepared via the interaction of the corresponding 2-[p-(un)substituted phenyl]imidazo[2,1-b]benzothiazoles (1a--e) with acrylic acid in the presence of acetic anhydride and acetic acid. Esterification of 2a--e produced methyl esters (3a--e). Upon the interaction of 3a with m-chloroperbenzoic acid, the S-dioxide (4a) was obtained. Compound 5a was prepared from 4a by alkaline hydrolysis. Vilsmeier formylation for 1a--e produced novel [2-[p-(un)substituted phenyl]imidazo[2,1-b]benzothiazol-3- yl]formaldehyde derivatives (6a--e). Derivatives 6a--e reacted with ethyl bromoacetate to give ethyl 3-hydroxy-3-[2-[p-(un)substituted phenyl]imidazo[2,1-b]benzothiazol- 3-yl]propionate esters (7a--e). Compound dl-7a was resolved with l-(+)-tartaric acid. Compounds 2a--e showed weak or no activity in the carrageein-induced paw edema assay. Compound 4a significantly inhibited the leakage of pontamine-sky blue dye into the peritoneal cavity of mice, in the capillary permeability inhibition assay. Compound 5a inhibited the writhing by 62% in the acetic acid-induced writhing assay.

Microcalorimetric and chromatographic investigations of the binding of some pyridine derivatives to cyclodextrins

The binding of some pyridine derivatives to alpha-, beta- and gamma-cyclodextrins has been investigated by microcalorimetry. The strongest binding is to beta-cyclodextrin, but the binding constants are of the order 10(2) M(-1). The binding to beta-cyclodextrin was also investigated by high performance liquid chromatography. The addition of beta-cyclodextrin to the mobile phase allowed separation of molecules with similar binding constants and of racemates in the case of tropicamide.

Analysis of some dosage forms containing pyridine derivatives using a cyclodextrin bonded stationary phase in HPLC

The high performance liquid chromatography of some pyridine derivatives using a silica column to which beta-cyclodextrin has been bonded, has been investigated. In spite of the low affinity constants of the drugs for cyclodextrin (of the order of 10(2) M(-1)) good separations can be achieved using a mobile phase of methanol and pH 7.0 phosphate. Good analysis of some dosage forms are achieved, including one on a tablet containing pheniramine maleate, pyrilamine maleate and phenylpropanolamine hydrochloride. Extractions and chromatography are quick and simple.