Effect of drilling process parameters on bearing strength of glass fiber/aluminum mesh reinforced epoxy composites

The current study attempted to evaluate the impact of drilling parameters and delamination on the bearing strength of both neat GFRP (NG) and hybrid GFRP/aluminum (Al)-wire mesh with two various configurations, first with Al-mesh in the outer surface of specimen (AG) and the other with Al-mesh in the core of specimen (GA). Drilling procedure is carried out using [Formula: see text] 6 mm carbide twist drill with three different tip angles (90°, 120° and 135°), as well as Three different speeds and feeds (1000, 2000, and 3000 rpm) and (20, 40, and 60 mm/min), respectively. Taguchi and ANOVA analyses are used to analyze the influence of processing parameters. The findings showed that AG specimen experienced the least delamination damage. The maximum bearing strength refers to NG specimen, which is 9.6% and 8.7% more than AG and GA specimens, respectively. Drill point angle has the major effect on bearing strength for both AG and GA specimens, while for NG feed rate is of the major effect. The developed regression model displayed a high level of fitness with an average prediction error of less than 3%.

Endoscopic management of acute oesophageal variceal bleeding within 12 hours of admission is superior to 12-24 hours

Background: Acute oesophageal variceal haemorrhage (AOVH) is a medical emergency. The American Association for the Study of Liver Diseases recommends endoscopy management as soon as possible and not more than 12 hours after presentation. The United Kingdom guidelines recommended endoscopy for unstable patients with severe acute upper gastrointestinal bleeding immediately after resuscitation and within 24 hours of admission. We aimed to evaluate the outcome of endoscopic management of AOVH in less than 12 hours compared to 12-24 hours post admission.Methods: 297 patients with AOVH were divided into groups depending on the timing of the endoscopic management: 180 within 12 h of admission and 117 patients at 12-24 hours of admission. Routine clinical and laboratory data were collected.Results: Compared to patients with endoscopic management at 12-24 hours (mean 16 hours), patients with endoscopic management within 12 hours (mean 8.3 hours) of admission had fewer hospital stay days (P = 0.001), significant reduction of ammonia levels (P < 0.0001) and significant improvement in associated hepatic encephalopathy grade 25 (p = 0.048). There were no major clinical events in the 12-hour group, but 8 events in the 12-24 hour group (p < 0.01).Conclusion: Endoscopic management of acute variceal bleeding within 12 hours of admission is superior to endoscopic management at 12-24 hours of admission regarding reduction of hospital stay, ammonia levels, correction of hepatic encephalopathy, re-bleeding and mortality rate, hence, reducing the cost of treatment benefiting patient satisfaction and improving hospital bed availability.

Non-invasive IGFBP1, IGFBP2 biomarkers as predictors and outcomes of usual interstitial pneumonia (UIP) therapeutic response

Background

Usual interstitial pneumonia (UIP) is a fatal disease that is associated with poor prognosis and survival. Several growth factors such as IGFs (insulin-like growth factors) and IGFBPs (insulin-like growth factor binding proteins) seem to take part to this pathogenesis.

Pirfenidone is an immunosuppressant drug that is thought to have anti-inflammatory and anti-fibrotic effects both in vitro and in vivo.

Objective

To assess IGFBP1 and IGFBP2 as non-invasive biomarkers for prediction and outcomes of UIP clinical activity and therapeutic response to the anti-fibrotic pirfenidone.

Results

Serum levels of IGFBP1 and IGFBP2 were significantly higher in the UIP group than in the healthy subjects (p ≤ 0.005). After 6 months therapy, UIP patients were divided into 2 groups according to improvement in MRC dyspnea grading into clinically improved and non-improved groups. 6MWT and SPaO2 were significantly improved in the clinically improved group compared to the non-improved one with no differences as regards other parameters (p < 0.0001). Both IGFBP1 and IGFBP2 were significantly decreased in serum while only IGFBP2 was decreased in BAL of all UIP after completing 12 months therapy.

Conclusion

IGFBP1 and IGFBP2 were increased in active UIP patients and reduced after 12 months anti-fibrosing therapy. IGFBPs may be promising biomarkers and predictors of response to therapy in UIP.

The burden of anti-HCV genotye-4 positivity in renal transplant recipients: 8 years follow-up

Whether renal transplant recipients with anti-HCV antibodies positivity and normal liver function tests within the first year after transplantation have different morbidity and mortality and graft failure compared to anti-HCV-negative recipients remains controversial. In this retrospective study, on 411 renal transplant recipients, we analyzed grafts morbidity, survival, and liver function tests over a period of 8 years. Patients were stratified according to their anti-HCV antibody status 1 year after transplantation into anti-HCV-positive and HCV-negative patients. The presence of normal liver function tests was mandatory at inclusion. All patients received the same immunosuppressive protocol consisting of cyclosporine A, mycophenolate mofetil and steroids. One year after transplantation, 137 patients were anti-HCV negative (33 %) while the rest 274 (67 %) were positive. At 5 years of follow-up, the study population consisted of 205 patients (71 patients, 35 % with anti-HCV negativity, and 134, 65 % with positivity). At the end of the study, only 144 patients were followed up (43 patients, 30 % with negative anti-HCV and 101 patients, 70 %, with positivity). We found that graft survival was not different between both groups. Moreover, serum creatinine showed a trend to be lower in HCV-positive patients compared to negative group although difference was not statistically significant. The number of graft loss was not different between both groups. Moreover, there was no difference between both groups as regards prevalence of acute rejection, diabetes mellitus, hypertension, CMV disease and proteinuria. We can conclude that anti-HCV positivity for 8 years in patients with normal liver function tests at 1 year does not impact graft morbidity and patient survival.

Distance from treatment facility and risk of death from cardiovascular and infectious causes in renal transplant patients

We investigated whether patients receiving RTx who live farther from their attending nephrologist are more likely to die than those who live closer. A random sample of 167 patients who undergone RTx between 1996 and 2004 was examined. We calculated the distance between each patient's residence and the practice location of their attending nephrologist. We used Cox proportional hazards models to examine the adjusted relation between distance and clinical outcomes (death from all causes, rejection episodes, infectious causes, and cardiovascular complications) over a follow-up period of upto 6 years. During the follow-up period (median: 3.3, range: 1.0-6.5 years), 22% of patients died. Compared with patients who lived within 50 km of their nephrologist, the adjusted hazard ratio of death was 1.04 among those who lived 50.1-150 km away, 1.16 for those who lived 150.1-300 km away, and 1.19 for those who lived more than 300 km (P for trend <0.001). The risk of death from infectious causes increased with greater distance from the attending nephrologist (P for trend <0.001). The risk of developing acute rejection episodes did not increase with distance from the attending nephrologist (P for trend = 0.2). The risk of death from cardiovascular causes increased with distance from the attending nephrologist (P for trend <0.05). Compared with patients who lived within 50 km of their nephrologist, the adjusted hazard ratio of death among those who lived >300 km away was 1.75 for infectious causes and 1.39 for cardiovascular causes. We conclude that mortality and morbidity associated with RTx was greater among patients who lived farther from their attending nephrologist, as compared with those who lived closer.

Semen quality and reproductive endocrinal function related to blood lead levels in infertile painters

Lead causes male reproductive impairment among painters, but information is still limited. Therefore, the effect of lead on semen quality and reproductive endocrinal function in those patients was investigated. A case series of 27 infertile painters were subjected to semen analysis, measuring of blood lead level (PbB) and serum levels of endocrinal parameters including follicle-stimulating hormone (FSH), luteinising hormone (LH), testosterone (T) and prolactin (PRL). Significantly lower sperm count and motility were found in those with duration of exposure (≥ 15 years), but no significant difference was found for PbB and serum levels of FSH, LH, PRL and T. A significant negative correlation between PbB and spermatic count and motility was observed, while there was no significant correlation between PbB and all endocrinal parameters. Patients with PbB ≥ 20 μg dl(-1) showed a significant decrease in sperm motility and increase in testosterone alone among all measured hormones. But the observed decrease in sperm count did not reach a significant level. It is concluded that infertile painters are at risk of lead-related influence on semen quality, especially sperm motility and increased testosterone level without significant affection of other reproductive endocrinal parameters.

Comparison of inguinal approach, scrotal sclerotherapy and subinguinal antegrade sclerotherapy in varicocele treatment: a randomized prospective study

We compared outcome and complications of three simple varicocelectomy techniques. Groups were divided according to whether they would receive the Ivanissevich technique (n = 55), Tauber's technique (n = 51) or subinguinal sclerotherapy (n = 49). Selection criteria were: infertility >1 year, subnormal semen, sonographic diameter of veins >3 mm and time of regurge >2 s. Patients were randomly assigned to the groups of treatment, with follow-up every 3 months for 1 year. Improvement was only in sperm count and total motility for all groups. Pregnancy rates were 20, 13.73 and 12.24%, respectively, with no significant difference between groups. Hydrocele occurred only in the group which received the Ivanissevich technique (5.5%). Tauber's technique is simple; however, it has the disadvantage of multiple branching of small veins.

First aid for obstetric haemorrhage: the pilot study of the non-pneumatic anti-shock garment in Egypt

OBJECTIVE

To compare the effect of non-pneumatic anti-shock garment (NASG) on blood loss from obstetric haemorrhage with standard management of obstetric haemorrhage.

DESIGN

Observational study of consecutive obstetric haemorrhage cases before and after introduction of the NASG.

SETTING

Four tertiary care maternity facilities in Egypt.

SAMPLE

The sample consisted of women with obstetric haemorrhage and signs of shock and the entry criteria were: >750 mL of blood loss and either pulse of >100 beats per minute or systolic blood pressure of <100 mmHg. A total of 158 women were in the preintervention group and 206 in the postintervention group.

METHODS

All the women with haemorrhage meeting the eligibility criteria were treated according to the standard protocol for 4 months (May-August 2004); blood loss was measured and recorded. The NASG was then introduced, and all the women meeting the eligibility criteria were treated according to the standard haemorrhage protocol plus the NASG for 4 months (September-December 2004).

MAIN OUTCOME MEASURES

Measured blood loss collected in a closed-end, graduated, plastic, under buttocks collection drape.

RESULTS

Median measured blood loss in the drape following study entry was 50% lower in those treated with the NASG (250 versus 500 mL, P < 0.001). There was also a non-statistically significant decrease in morbidity and mortality.

CONCLUSIONS

This is the first comparative study of the NASG with a standard obstetric haemorrhage treatment protocol. The NASG shows promise for management of obstetric haemorrhage, particularly in lower resource settings. Larger studies will be needed to determine if the NASG contributes to statistically significant decreases in morbidity and mortality.

Heterochromia iridis in water buffaloes (Bubalus bubalis)

This study included 45 unaffected animals and 593 animals affected with heterochromia irides, and 85 enucleated eyeballs with heterochromia irides. The classification of heterochromia irides, morphology of normal and heterochromic irides, and the histology, ultrastructure, and scanning electron microscopy are presented. The incidence of heterochromia irides in water buffaloes was 7.62% affecting either one or both eyes. Both complete and partial heterochromia irides occurred. Complete heterochromia iridis is more frequent than the partial form in either bilateral or unilateral cases. The pupil has a dumb-bell-shape appearance. Granula iridica occurred at the upper (100%) and lower (30%) pupillary margins and originated from the posterior pigmented epithelium. In heterochromia irides, the melanocytes is absent in the anterior border and stromal layers, and iridal thickness appeared thinner than that of normal eyes.

Effect of i.v. tenoxicam during caesarean delivery on platelet activity

BACKGROUND

Non-steroidal anti-inflammatory drugs inhibit platelet aggregation and prolong bleeding time in healthy subjects. We have studied the effect of i.v. tenoxicam during caesarean delivery on skin bleeding time, operative, and postoperative blood loss, and beta-thromboglobulin and platelet factor 4 as specific molecular markers for platelet activity.

METHODS

Fifty women were studied. Twenty-five were given tenoxicam 20 mg i.v. 10 min before induction of general anaesthesia, and 25 formed a control group. Skin bleeding time and platelet markers were determined the day before and 1 h after induction of anaesthesia.

RESULTS

In the tenoxicam group, there was an slight increase in skin bleeding time with no statistically significant changes in platelet marker levels. In the control group, platelet markers increased 1 h after surgery. The surgeon's assessment of uterine relaxation, using a visual analogue score, operating theatre blood loss, and the frequency of bleeding over 24 h after operation, showed no significant difference between the two groups.

CONCLUSION

During caesarean delivery i.v. tenoxicam causes a slight increase in bleeding time with no significant changes in platelet marker levels.

Intra-articular tenoxicam relieves post-arthroscopy pain

BACKGROUND

Nonsteroidal anti-inflammatory drugs have been documented to be effective in the treatment of postoperative pain. The aim of this study was to evaluate the analgesic effect of local intra-articular injection of tenoxicam compared with intravenous injection on postoperative pain after arthroscopy.

METHODS

After day-case arthroscopy, 60 patients were randomized to receive either tenoxicam 20 mg in 20 ml of normal saline intra-articularly and 2 ml of normal saline i.v., or 20 ml of normal saline intra-articularly and 2 ml tenoxicam 20 mg i.v. Postoperative pain was assessed using a visual analogue scale and measuring analgesic requirements.

RESULTS

Pain scores were significantly lower in the intra-articular group at rest and during active flexion of the knee at 1, 2 and 4 hours postoperatively and during walking at 6 hours postoperatively (P < 0.05). Significantly more patients in the intravenous group required supplemental opioid analgesia within the first 4 hours postoperatively (P < 0.05).

CONCLUSION

Intra-articular tenoxicam 20 mg provided better analgesia and decreased the requirements for postoperative analgesic compared with i.v. tenoxicam 20 mg.