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Background The COVID-19 pandemic resulted in reduced numbers of patients presenting with and undergoing procedures for cardiac conditions worldwide. This impact, specifically looking at the changes in patient visits, admissions and procedure volumes, has not been recorded thus far, in terms of a South Asian LMIC setting. Purpose We aimed to assess the impact of the pandemic on emergency room (ER) visits, cardiology admissions, out-patient and in-patient procedures at a LMIC tertiary cardiac centre. Methods Data on ER visits, specific in-patient and out-patient procedures (echocardiography, exercise stress tests, electrocardiography [ECG]) were collected via hospital electronic records from January to December 2020, and compared with corresponding data for the same months in 2019. The difference or deficits were expressed as a percentage (%Δ). Data for each quarter were compared using paired t-test. A p value Results There were significantly reduced numbers of out-patient visits (Δ −31.2%; p=0.007), ER visits (%Δ −59.5%; p=0.0), in-patient admissions (Δ −33.1%; p=0.005), total out-patient procedures (%Δ −31.9%; p=0.008) and catheterization volumes (%Δ-29.7%; p=0.001) in 2020, as compared with 2019 (Table 1 & Figure 1). Among out-patient procedures, adult trans-thoracic echo, ECG and stress tests showed greatest deficits in April 2020. No trans-oesophageal echocardiograms were performed in April to July 2020. The greatest deficits were observed in April 2020, as compared with 2019 (out-patient visits: Δ-92.7%; out-patient procedures: %Δ-94.5%; in-patient admissions: %Δ-85.9%; catheterization procedures: %Δ-85.2%), except for ER visits, where the greatest deficit was seen in June 2020: %Δ-90.7%). Numbers continued to remain extremely low in May 2020, coinciding with the nation-wide lockdown measures. Out-patient visits, procedures and in-patient admissions have gradually increased since July 2020. However, the greatest impact seems to have been on ER visits, continued to remain low, with significantly reduced volumes in both 2nd and 3rd quarters of 2020. The lowest deficits in outpatient visits (Δ-4.9%), ER visits (Δ-31.9%) and out-patient procedures (Δ-0.9%) were seen in December 2020, while for in-patient admissions (Δ-7.9%) and catheterization procedures (Δ-6.5%) this was in October 2020. Conclusion There was a significant reduction of out-patient and in-patient cardiology services volumes in 2020, with the greatest reduction in April and May, coinciding with a general “lockdown”. ER visits were the most greatly affected. Trends show a steady increase in out-patient and catheterization procedures, beginning from July, but have not yet reached pre-COVID volumes, even by the end of 2020. These findings indicate that, the pandemic has resulted in significantly fewer ER visits; however, patients still present as outpatients, both for procedures and catheterization. Funding Acknowledgement Type of funding sources: None. Table 1Figure 1

In response to concerns raised about the quality of parenteral vancomycin products, the U.S. Food and Drug Administration (FDA) is investigating the product quality of all FDA-approved parenteral vancomycin products available in the United States. Product quality was evaluated independently at two FDA Office of Testing and Research (FDA-OTR) sites. In the next phase of the investigation, being done in collaboration with the National Institute of Allergy and Infectious Diseases, the in vivo activity of these products will be evaluated in an appropriate animal model. This paper summarizes results of the FDA investigation completed thus far. One site used a validated ultrahigh-pressure liquid chromatography method (OTR-UPLC), and the second site used the high-performance liquid chromatography (HPLC) method for related substances provided in the British Pharmacopeia (BP) monograph for vancomycin intravenous infusion. Similar results were obtained by the two FDA-OTR laboratories using two different analytical methods. The products tested had 90 to 95% vancomycin B (active component of vancomycin) by the BP-HPLC method and 89 to 94% vancomycin by OTR-UPLC methods. Total impurities were 5 to 10% by BP-HPLC and 6 to 11% by OTR-UPLC methods. No single impurity was >2.0%, and the CDP-1 level was ≤2.0% across all products. Some variability in impurity profiles of the various products was observed. No adverse product quality issues were identified with the six U.S. vancomycin parenteral products. The quality parameters of all parenteral vancomycin products tested surpassed the United States Pharmacopeia acceptance criteria. Additional testing will characterize in vivo performance characteristics of these products.

The liquefaction of natural gas is an energy intensive process and accounts for a considerable portion of the costs in the liquefied natural gas (LNG) value chain. Within this, the selection of the driver for running the gas compressor is one of the most important decisions and indeed the plant may well be designed around the driver, so one can appreciate the importance of driver selection. This paper forms part of a series of papers focusing on the research collaboration between Shell Global Solutions and Cranfield University, looking at the equipment selection of gas turbines in LNG service. The paper is a broad summary of the LNG Technoeconomic and Environmental Risk Analysis (TERA) tool created for equipment selection and looks at all the important factors affecting selection, including thermodynamic performance simulation of the gas turbines, lifing of hot gas path components, risk analysis, emissions, maintenance scheduling, and economic aspects. Moreover, the paper looks at comparisons between heavy duty industrial frame engines and two artificial design variants representing potential engine uprates. The focus is to provide a quantitative and multidisciplinary approach to equipment selection. The paper is not aimed to produce absolute accurate results (e.g., in terms of engine life prediction or emissions), but useful and realistic trends for the comparison of different driver solutions. The process technology is simulated based on the Shell DMR technology and single isolated trains are simulated with two engines in each train. The final analysis is normalized per tonne of LNG produced to better compare the technologies.

The ultraviolet, visible and infrared properties of as-deposited and annealed Cu-SiO cermet thin films prepared by co-evaporation in vacuo at approximately 1 mPa in the thickness range 100-400 nm were investigated. The composition of copper was varied between 2-20vol%Cu. The evaluated optical band gap E opt varied between 2.71 and l.98eV over the composition range studied. A systematic reduction of E opt and an increase in the width of the band tailing E e were observed with increasing copper content. At 20°C, E opt for a fixed composition was found to increase with film thickness while the value of E e decreased. For annealed films, the absorption edges shifted towards shorter wavelength, with E opt, increasing and E e decreasing. The values of refractive index varied between 2.16 and 2.63, depending on film thickness and composition. The main infrared absorption band of the films was found at 1000cm−1. Electron diffraction and transmission electron microscopy revealed that the cermet structure consisted...

Procurement of process plant equipment involves decisions based not only on an economic agenda but also on long term plant capability, which in turn depends on equipment reliability. As the greater global community raises environmental concerns and pushes for economic reform, a tool is evermore required for specific and critical selection of plant equipment. Risk assessments based on NASA’s Technology Readiness Level (TRL) scale have been employed in many previous risk models to map technology in terms of risk and reliability. The authors envisage a scale for quantifying technical risk. The focus of this paper is the technical risk assessment of gas turbines as mechanical drivers for producing Liquefied Natural Gas (LNG). This risk assessment is a cornerstone of the TERA philosophy, a Technoeconomic and Environmental Risk Analysis developed by Cranfield University’s Department of Power and Propulsion in the UK. Monte Carlo simulations are used in order to compare the risks of introducing new plant equipment against existing and established plant equipment. Three scenarios are investigated using an 87MW single spool, typical industrial machine; a baseline engine followed by an engine with increased firing temperature and finally an engine with a zero staged compressor. The results suggest that if the baseline engine was to be upgraded then the zero staging option would be a better solution than increasing firing temperature since zero staging gives the lower rise in Total Time to Repair (TTTR), or downtime. The authors suggest a scaling system based on NASA’s TRL but with modified definition criteria for the separate technology readiness levels in order to better relate the scale to gas turbine technology. The intention is to link the modified TRL to downtime, since downtime has been identified as a quantitative measure of technical risk. Latest developments of the modelling are looking at integrating risk analysis and a maintenance cost and scheduling model to provide a platform for total risk assessment. This, coupled with emissions modelling, is set to provide the overall TERA tool for LNG technology selection.Copyright © 2010 by ASME

In Pakistan there are a number of acute problems related to maternal and infant health in the perinatal period. There is also lack of reliable data needed for the formulation of action strategies. To provide a database 1490 women have been followed from the 5th month of pregnancy in four different areas at various levels of urbanization and socio-economic development. After adjusting for gestational age, the proportion of newborns with weight for length < -2SDS in relation to the Swedish National Standard was 12-31% for boys and 12-25% for girls, the figure being highest in the most deprived area. Preterm birth was infrequent compared with IUGR. The overall prevalence rate of birth defects was 21% out of which 8% were severe defects. The overall perinatal mortality rate was 56/1000 births, with rates of 60, 75, 36 and 33/1000 births for the village, periurban slum, urban slum and the upper middle class. Two thirds of the deaths were related to either a continuation of intrauterine disturbances or severe congenital defects incompatible with life. One third of the deaths were due to infection; mostly diarrhoea, clinical sepsis and ARI. Neonatal mortality was significantly related to birth length (< -2SDS, odds ratio 5.5) and length of gestation (< 37 weeks, odds ratio 5.6) and was to a lesser extent related to weight (< -2SDS, odds ratio 2.0) and weight for length (< -2SDS, odds ratio 1.3). Forty percent of the mothers had weight for height below -2SDS, 23-35% had height < -2SDS. Forty percent of mothers from a subset within the cohort had a hemoglobin < 10 gm/dl and 20% showed signs of pre-eclampsia. This presentation raises the issue of expanding the current Child Survival Programs into the perinatal period as well.

Thin vanadium oxide films were made by vacuum evaporation followed by the annealing posttreatment in the presence of air. The thickness increased by a factor as large as approximately 2.3 on oxidation. Electron diffractograms indicated a bcc ? monoclinic transformation during the annealing, and electron micrographs showed pronounced grain growth. Temperature-dependent electrical conductivity as well as spectral transmittance was measured vs annealing time. At an initial thickness of 0.12 microm, it took a few hours to establish VO(2) films with a well defined semiconductor-metal transition and concomitant thermochromic switching at approximately 57 degrees C.

The study was performed with a view to isolate and identify a virulent strain of S. gallinarum and determine the purity, safety and efficacy of BIO-TYPHOID ® vaccine. A total of 40 backyard layer chicken were used for this study where Group A was used for experimental vaccination, Group B kept as control and Group C was used for calculating virulent S. gallinarum challenge dose. Primary and secondary vaccination was carried out at 40 days and 110 days of age, respectively. Blood samples were collected to obtain the sera after vaccination from both vaccinated and unvaccinated control group and antibody titres were determined by Microplate agglutination test. The antibody titre increased in primary vaccination up to days 56 days post vaccination (DPV) and then decreased gradually. The highest antibody titre (Mean ± SE) 384.00 ± 42.67 was obtained at 91 DPV (21 days later of secondary vaccination) and maintained up to 98 DPV. Safety test was done by inoculating mice and purity test of the vaccine was done by inoculating on to Blood Agar media. The efficacy of BIO-TYPHOID ® vaccine was recorded as 90% which was determined by challenge infection with 0.1 ml of 5x10 5 CFU virulent S. gallinarum . Results of this study revealed successful protections by BIO-TYPHOID ® vaccine. Keywords: BIO-TYPHOID ® vaccine; Chicken; Efficacy; Fowl Typhoid DOI: 10.3329/jbau.v7i2.4737 J. Bangladesh Agril. Univ. 7(2): 295-299, 2009

This paper concentrates on the emissions module of what is part of a wider project dealing with various aspects of gas turbine usage as drivers for Liquefied Natural Gas (LNG) production. The framework is known as TERA, a Techno-Economic and Environmental Risk Analysis, developed at Cranfield University with the core of the study being the performance module whilst the risk, economics and environmental modules are built around the performance. Whilst TERA exists for aviation and power production no such system is available for assessment of LNG production. With environmental issues high on the public agenda new legislation on emissions can be expected, especially in Europe. This will mean Oil & Gas companies will have to look for ways to reduce their emissions. One way to reduce turbo machinery losses is to replace out dated and/or obsolete machinery having less overall energy efficiency. The selection of turbomachinery involves assessments of risk, both economic and technical, as well as environmental impacts of the new technology. The core to all of this is the performance assessment, the primary basis on which selection is made. An aviation emissions model, developed at Cranfield University, is adapted for industrial applications. Technical performance calculations are made using the inhouse software called Turbomatch. Performance results for three typical days of the year (summer, winter and spring/autumn) are fed into the emissions model to get the levels of NOx, CO2, H2O, CO and unburnt hydrocarbon emissions. Later, NOx, CO2 and H2O emissions levels are fed into the environmental module to estimate the damage the engine causes to the environment over 100 years with respect to global warming. Two hypothetical engine configurations are investigated based on engine data available in the public domain. The first one, an 85MW single spool industrial machine (SSI-85), is used as the baseline to compare against a 100MW triple spool, intercooled aeroderivative (ITSA-100). The results suggest that the ITSA-100 produces more NOx but has less carbon emissions and consequently less global warming effects. This has varied economic impacts depending on which emission is a priority for reduction. CO2 and H2O emissions are more important than NOx for LNG gas turbine applications. The paper shows how this simple but effective system can be utilised to give a viable comparison between one or more proposed solutions for turbomachinery selection and replacement. The scope of the system is expanded as other modules come together to give a total assessment in terms of technical, economic, environmental and risk perspectives for LNG production.

Rectal cultures from Swedish and Pakistani hospital-delivered newborn infants were analysed regarding the early acquisition of enterobacteria. Swedish infants were delivered vaginally, Pakistani infants were delivered either vaginally or by caesarean section. The Swedish infants were all breast-fed, whereas breastfeeding was incomplete and often started late among the Pakistani infants. Both groups of Pakistani infants were more rapidly colonized with enterobacteria than were the Swedish infants. Cultures from Swedish infants seldom yielded more than one kind of enterobacteria; E. coli and Klebsiella were most frequently isolated. E. coli dominated in both Pakistani groups, but especially caesarean section delivered infants were in addition often colonized with Proteus, Klebsiella, Enterobacter or Citrobacter species. Breastfeeding from the first day of life reduced colonization with Klebsiella/Enterobacter/Citrobacter. The results suggest that environmental exposure, delivery mode and early feeding habits all influence the early intestinal colonization with enterobacteria.

Bacteremia in hemodialysis patients with cuffed tunneled catheters is a significant cause of morbidity and mortality. Native arteriovenous fistulas or vascular prostheses are preferred forms of vascular access, but their creation may not always be possible. Catheter-related bacteremia is due primarily to Gram-positive organisms, but Gram-negative infections are of increasing importance. Bacteremia in patients with catheters results from luminal or extraluminal contamination and may be perpetuated by infected fibrin sheaths associated with the catheter. Bacteremic patients require antibiotic therapy and catheter removal. Guide wire catheter exchange is appropriate in stable patients, but catheter removal and later reinsertion of a new catheter is indicated for tunnel infection or frank sepsis. Late diagnosis or ineffective therapy predisposes to vascular and extravascular infectious complications. Catheter-related bacteremia may be minimized with appropriate sterile technique at insertion, meticulous exit site care, and antibiotic lock solutions. Early recognition and treatment minimize morbidity and mortality, but the optimal solution remains the placement of permanent access.

The morphometry of the intercommissural distances and their relation with other structures of the aortic valve of bovine heart was carried out. A total of 32 apparently healthy bovine hearts of indigenous cattle of both sexes (50% male and 50% female), 2-4 years of age, weighing 500 to 800 gms were used in this study. The external intercommissural distances were higher in all cusps of the valve compared to the internal intercommissural distances. The internal intercommissural distance was larger in the RC sinus in case of male animals followed by that of the LC and NC sinus. The mean external intercommissural distances were 34.67+/-3.40, 34.40+/-3.64 and 34.97+/-4.37 mm and the internal intercommissural distances were 21.60+/-4.21, 21.20+/-4.70 and 20.67+/-4.06 mm for LC, RC and NC respectively. Analyzing the internal intercommissural distance, value in the LC sinus was higher followed by the RC and the NC but this variation was non-significant. In regard to the position of the coronary ostia, there were two coronary ostia, the right coronary ostium present in the RC sinus and the left coronary ostium in the LC sinus respectively and the right coronary ostium was supracommissural in position in bovine heart. Data about the morphometrical analysis of intercommissural distances and the position of the coronary ostia of the aortic valve facilitate the knowledge of manufacturing bovine tissue valve as well as those might be involved in valve replacement in human.

Objectives: To test the hypothesis that reinforcement of the advice given at the time of discharge from the emergency department by telephone consultation would improve asthma outcomes. Methods: A randomized controlled trial of the parents of 310 children who had been discharged from the emergency department with asthma was undertaken. The parents were randomized to receive either standard care (155 children) or standard care plus education by telephone (155 children) from a trained asthma educator. Symptoms, parental asthma knowledge, parental quality of life and use of asthma action plans and preventer therapy were collected at baseline and 6 months later. The primary measure was days of wheeze in last 3 months; intermediate measures were regular use of preventer medications, possession and use of written asthma action plan, parental asthma knowledge scores and parental quality of life scores. Results: A total of 266 parents (136 intervention) completed the follow-up questionnaires after 6 months. Both groups showed similar symptoms and process measures at baseline, apart from more regular use of preventer medication in the control children. At follow up, the intervention group children were significantly more likely than controls to possess (87.5% vs 72.3%; P = 0.002) a written asthma action plan. Possession of action plans increased from baseline in the intervention group but tended to decrease in the control group. Use of action plans was greater in the intervention group but decreased from baseline in both groups. Both intervention and control groups showed significant decreases in asthma symptoms. Conclusions: Reinforcement by telephone consultation did not improve the primary outcome of wheeze in the last 3 months. However, it increased the possession and regular use of written asthma action plans in the intervention group.

Objective: Attendance at an Emergency Department (ED) with an acute attack of asthma may be indicative of undertreatment of persistent disease. However, many presentations are in children with infrequent episodic asthma. The aim of this study was to characterize the pattern of asthma of children discharged from ED to determine whether there was potential to improve underlying disease control. Methodology: This was a cohort study. Three hundred and ten parental caretakers of 1 to 15-year-old children, attended and discharged from an ED with asthma, completed an asthma control questionnaire, an asthma knowledge questionnaire and a caregiver's quality of life questionnaire. Background severity of asthma was classified and medication history was assessed. Also included were those with their first attack of asthma. Results: One hundred and thirty-two (43%) children had infrequent episodic asthma, 105 (34%) frequent episodic, 40 (13%) persistent asthma and 33 (11%) first attack asthma. Thirty-nine per cent of children were not receiving preventer therapy and this seemed appropriate; 14% of children with frequent episodic and persistent asthma were not receiving appropriate preventer therapy; and a further 34% had frequent symptoms despite receiving preventer therapy. Conclusions: We observed deficiencies in use of preventer medications, use of written asthma management plans and lack of parental knowledge in some children with established asthma who presented to an ED. There was also a large number of children who did not have frequent background symptoms or who presented with their first episode.

Chronic ocular pain may have many causes and can be a frustrating problem for both patient and doctor alike. We describe two patients who had similar symptoms and eye findings who had been unable to relieve their pain with conventional analgesia. We postulate a cause for their pain and describe our experience of a treatment strategy using a standard dose of botulinum toxin injection into an extraocular muscles. A 56 year old white woman presented with what was initially thought to be a right orbital cellulitis but investigations and clinical course subsequently suggested a non-infectious idiopathic inflammatory aetiology. Her history suggested orbital myositis and she described right sided facial weakness, nausea, and right sided ptosis. She had a 9 month course of oral steroids and despite this needed tramadol, paracetamol, and flurbiprofen to control her pain. Her symptoms and examination findings slowly stabilised until she was left with marked limitation of upgaze in her right eye. Her symptoms did not change over the next 3 years, at which point she was referred to our care. When she attempted to look up she described a juddering sensation and severe pain just above the eye. She rarely had pain …

The feeding practices of children (n = 1476) from birth to 24 months, as determined in a longitudinal study, in Lahore, Pakistan, are presented. Four socioeconomic groups at various levels of urbanization were included; a village, periurban slum, urban slum and an upper middle class. Initiation of breastfeeding was delayed in all the neonates. Sixty-five percent of the periurban slum mothers and 45% of the village mothers had not started breastfeeding at 48 hours after the birth of the infant. Prelacteal feedings, especially of herb water and honey, were the norm. Breastfeeding was highly prevalent. Eighty-seven to 98% of the infants in all the areas were breastfed at one month of age. Exclusive breastfeeding was rare, with 9% at one month, declining rapidly with age and being highly influenced by season. Partial breastfeeding was the most common mode of feeding. Water in addition to human milk was given by 45-73% of the mothers living in the urban slum, village and periurban slum at one month of age. Fresh animal milk and/or commercial formula was already being given at 1 month by 22-64% of the mothers in all areas. Commercial formula was the preferred food in the upper middle class, while in the other three areas it was rare and fresh animal milk was mainly used. More than 50% of the mothers in the village and in the periurban slum gave diluted animal milk even beyond the age of 10-15 months. In the upper middle class 50% of the infants were fed semisolids at the age of four months, while in the village, the periurban and the urban slum at 6 months of age only 10%, 12% and 47% of the infants received semisolids. The results of this study indicate that breastfeeding was highly prevalent in the three poorest areas. However, in all the areas initiation of breastfeeding was delayed and prelacteal feeding was the norm. Exclusive breastfeeding was rare, feeding bottles were used by 82-100% of the mothers to feed supplements and human milk substitutes, in the four areas.

The causative agents of acute diarrhoea were investigated in children under the age of five years from 1985-1991 in three socio-economically different areas in Lahore, Pakistan. The aim was to determine the frequencies of the most common enteropathogens in faeces. The total isolation rate was 73.4%; two thirds (53.5%) were of bacterial and one third (19.9%) of viral origin. ETEC-LT (23.4%), Rota virus (19.9%), EPEC (15%) and Campylobacter (12%) were the single most frequent pathogens in all age groups and areas of living. The positivity of Campylobacter increased from 1.6% to 12% after the change of isolation technique. Shigella was isolated significantly (p > 0.001) more in children over than under one year of age. The incidence of bacterial infections was high during all seasons, while in certain years Rota virus was relatively low in the summer compared to the cooler months. The prevalence of ETEC-LT diarrhoea was higher in the periurban slum as compared to the village and the urban slum. The study is the first of its kind in Pakistan, and the results are similar to other comparable studies. It is thus possible to establish a well functioning and reliable microbiological laboratory in developing countries in a setting with restricted trained personnel and material resources.

Protection against neonatal sepsis by breast feeding was investigated in a developing community. A case-control study was carried out with 42 cases from a hospital and 270 controls, matched for age and socioeconomic conditions from the community. Exclusive breast feeding was extremely rare, most babies being partially breast fed and a few being given formula feed or animal milk. A highly significant odds ratio of 18 was obtained, showing that even partial breast feeding protects against neonatal sepsis in such a population.

Tetanic convulsions are not uncommon among severely dehydrated children in the developing countries. This raises the question whether these children have disturbances in the homeostasis of divalent ions. Serum values are reported of calcium, magnesium, phosphorus, sodium and potassium, as well as blood pH in children below 3 years of age with acute watery diarrhoea and with an estimated weight loss of about 10%. The study was performed on dehydrated children with (DC) or without (D) convulsions. Values were obtained on admission and following rehydration therapy (RT). On admission serum calcium was low in both D and DC children. Serum phosphorus was likewise elevated in both D and DC children. Serum magnesium was slightly elevated in the DC but not in the D group. No patient had Hypernatremia. During RT, serum calcium increased significantly and serum phosphorus decreased significantly in D and DC children. Serum calcium showed a significant inverse correlation with serum phosphorus and a significant direct correlation with blood pH. Treatment of DC children with i.v. calcium and i.m. magnesium had no immediate effect on the convulsions. Our conclusion is that severely dehydrated children will develop hypocalcemia. The cause may be a redistribution of calcium into the cells, parallelled by a redistribution of phosphorus from the intra- to the extracellular space.

The effect of poliovirus vaccination on mucosal immunity was studied in lactating women because secretory IgA antibodies to poliovirus in milk may reflect intestinal immunity. Swedish mothers lacked significant titers of secretory IgA antibodies in their milk before vaccination. Subcutaneous vaccination with killed poliovirus vaccine resulted in low but transient increases in titers of secretory IgA antibodies in the milk of most of these women. Pakistani mothers had significant titers of secretory IgA antibodies in their milk before immunization; these titers increased after subcutaneous poliovirus vaccination in 45% of the women. Peroral vaccination of Pakistani women with liver poliovirus vaccine diminished already existing titers of secretory IgA antibodies in their milk. The decrease in titer was especially pronounced when the liver poliovirus vaccine was given together with a subcutaneous vaccine consisting of killed Vibrio cholerae organisms; the mean titer of secretory IgA antibodies in milk 14 days after vaccination was about 40-fold lower than it was before vaccination.

Intestinal hypomotility is a common late complication in infants with acute diarrhoeal disease in pakistan. Among the infants admitted to our gastrointestinal unit with a history of acute diarrhoea, 35% developed abdominal distension and 12% developed the full clinical picture of paralytic ileus. The infants with ileus were treated with decompression and total parenteral nutrition; in this group the mortality rate was 25%. We compared 30 infants who developed ileus (group A) with an age-matched control group of infants (group B) who were admitted because of acute diarrhoea but did not develope ileus. The use of antimotility drugs was significantly more frequent in group A. Serum-K was not different in in group A (3.92 +/- 0.22 mmol/l) and group B (4.32 +/- 0.18 mmol/1). However, there were more patients who had serum-K below 3 mmol/l in group A (8/30) than in group B (5/30). We conclude that the use of antimotility drugs predisposes to the development of ileus in infants with acute diarrhoea. Hypokalemia may contribute to ileus in a few cases but is generally not a prerequisite.

Intestinal permeability was assessed with different-sized polyethylene glycols (PEG 400 and PEG 1,000) in small children with acute diarrhea. All children with acute diarrhea absorbed and excreted less PEG of all molecular sizes into the urine when compared with healthy control children (p less than 0.001). Children with acute rotavirus infection excreted significantly less PEG of all sizes than children with Shigella, Salmonella, and enteropathogenic Escherichia coli (EPEC) infection (p less than 0.001-0.01), suggesting a more severe mucosal lesion caused by rotavirus. In patients with severe malnutrition there was also a significant decrease in absorption of PEGs observed. In addition, malnourished patients with rotavirus diarrhea showed a pronounced decrease of PEGs in comparison with well-nourished patients. The ratio between the recovery of a large PEG molecule, 1,074 Da, and a small molecule, 370 Da, was utilized to assess the absorption of large molecules in relation to that of smaller ones. On applying this ratio, it was noted that the intestine in children with Shigella and EPEC infection was relatively more permeable to larger molecules than in healthy controls, while in rotavirus and Salmonella infection it was less permeable to larger molecules. In this study significant differences in the permeability characteristics were observed, suggesting etiology-specific effects on the mucosal barrier.

Retroperitoneal hematoma may occur as a result of trauma, rupture of arterial aneurysms (aortic or iliac), surgical complications, tumors and anticoagulation therapy. A life threatening retroperitoneal hemorrhage or hematoma is an infrequent complication of anticoagulation treatment. Enoxaparin is a low-molecular-weight heparin (LMWH) with several advantages over unfractionated heparin. Nevertheless, enoxaparin use is not without risk and severe retroperitoneal bleeding may occur following its use with a potentially fatal outcome. We report a case of sixty six years old female patient who develops a fatal retroperitoneal hematoma two days after enoxaparin treatment for acute coronary syndrome. Keywords: Retroperitoneal hematoma; Enoxaparin; Acute coronary syndrome. DOI: 10.3329/cardio.v3i1.6434Cardiovasc. j. 2010; 3(1): 94-97

Normal 0 MicrosoftInternetExplorer4 st1\:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} The investigation was conducted to detect infectious bronchitis (IB) virus-specific antibody in chicken from some selected areas of Bangladesh. The indirect enzyme linked immunosorbent assay (iELISA) was performed to estimate the infectious bronchitis virus specific antibody. In case of sera-samples collected from BRAC diagnostic laboratory, Gazipur, 100% sera samples were found to be positive to IBV; the highest antibody titres were recorded as 9867.29. The average antibody titre of samples from Anis Poultry Farm, Pabna and farms driven by beneficiary of SDC, Faridpur and layer chickens reared with the help of BEES, Hobigonj were recorded as 1234.38, 1076.94 and 4572.85 and percent of sero-positive cases were 56.67%, 43.33% and 92.50% respectively. In this study all breeds of chicken (non descriptive indigenous and commercial) and age groups were found equally susceptible to IB.

This report gives an account of steady flow tests carried out on poppet valves. The object of the investigation was to determine the boundary conditions for exhaust and inlet valves for subsequent use in the general programme of unsteady flow research. The exhaust valve was tested with and without pipes over a much wider range of pressure ratio and valve lift than has been carried out before and the boundary conditions have been found to be independent of the pipe and also almost independent of the position of the pressure tapping in the exhaust pipe. This result is very important and it will simplify subsequent boundary curve tests. Comprehensive tests have also been performed on the inlet valve and for reverse flow through each valve. The two usual mathematical flow models, namely, the constant pressure and the sudden enlargement, are discussed in detail and the concept of an effective area for a poppet valve is clearly explained. The effective areas for the exhaust and inlet valves for normal and reverse flow have been computed on the basis of the constant pressure flow model. The pressure ratio has been found to have little effect on the effective areas at low valve lifts but has considerable effects at high valve lifts. The results are presented graphically on a complete set of charts. It is illustrated in Appendix 3.II that the effective area of an exhaust poppet valve may be predicted for low valve lifts.

The immunogenicity of available fowl typhoid vaccine was studied in layer chickens following usual and suggested schedule of vaccination. A total of 30 chickens were divided into three groups; group A (vaccinated following usual schedule of vaccination), B (vaccinated following suggested schedule of vaccination) and C (as control), each containing 10 layer chickens of Fayoumi breed. Chickens of group A and B were vaccinated with available fowl typhoid vaccine produced by the Governments laboratory at a dose rate of 0.5ml at each occasion through SC route, where 1st dose was administered at 42 days and 35 days of age, respectively, and 2nd dose at 72 days and 65 days of age, respectively. Blood samples were collected to obtain sera from each chicken at every 7 days interval up to 105 days post vaccination for determination of antibody titre following primary and secondary vaccination using microplate agglutination test. The highest mean antibody titre obtained from Group A was 460.8 than that of B was 435.2, respectively. Among the two groups, the highest mean antibody titre of 460.8 was obtained at 56 days post vaccination in group A following usual schedule of vaccination. It revealed that government supplied fowl typhoid vaccine induced higher level of antibody production in both usual and suggested schedule of vaccination. Keywords: Immunogenicity; Fowl Typhoid; Vaccine; Layer chicken; Suggested; Usual DOI: 10.3329/jbau.v7i1.4970 J. Bangladesh Agril. Univ. 7(1): 99-102, 2009

The study was carried out to determine the appropriate age and route of vaccination with duck plague vaccine (LRI, Mohakhali) in experimentally reared local ducks during the period from September 2006 to May 2007. A total of 90 local ducklings were divided into eight groups namely A, C, D and E for vaccinated parent origin and B, F, G and H for non-vaccinated parent origin. Again Group C, D, E, F, G and H were divided into subgroups C1 & C2; D­1& D­2; E1& E2; F1 & F2; G1 & G2; H1 & H2 respectively and contained 5 ducklings each. Group A and B contained 15 ducklings in each group and were used as unvaccinated control and also for studying persistence of maternally derived antibody level. Highest mean MDA titre in ducklings of Group A was found 53.33 ± 4.03 at the age of day 1 that declined to a negligible level (≤4) at the age of day 21 and highest mean MDA titre in ducklings of Group B was found 29.86 ± 1.45 at the age of day 1 that declined to a negligible level (≤4) at the age of day 16. Ducklings of different sub-groups were vaccinated with duck plague vaccine at day 14, day 21 and day 28 through intramuscular (breast) and subcutaneous route at the dose rate of 1ml per duckling. Sera were collected from vaccinated ducklings on day 7, day 14 and day 21 after vaccination and antibody titre was measured by passive hemagglutination test. Among the vaccinated subgroups, the highest mean PHA titre was found 89.60 ± 15.67 and 83.20 ± 19.20 in subgroups E1 (vaccinated at day 28) and F1 (vaccinated at day 14) respectively. At challenge, ducklings of vaccinated subgroups showed 100% protection except C1 and C2 (showed 80% protection) and control subgroups showed 0% protection. From the results of protection test it may be concluded that both intramuscular (breast) and subcutaneous routes are equally suitable for duck plague virus vaccination in ducklings and the optimum age for vaccination to ducklings originated from vaccinated parent to duck plague vaccine might be at day 21 or 28 and ducklings originated from non-vaccinated parent at day 14 or 21 instead of usual schedule of day 28. Key words: Vaccination, duck plague vaccine, age, route, ducklings DOI = 10.3329/bjvm.v6i1.1335 Bangl. J. Vet. Med. 2008. 6 (1): 27-30

A 20 year old housewife presented with multiple needles in her abdominal wall as revealed byradiological examination. She had unrelated symptoms but the needles were more or less silentfor months except one group caused foreign body granuloma formation. Exploration andremoval of four of these needles were done under general anaesthesia. Deliberately insertedneedles in the abdominal wall are very unusual, which is not yet reported to our knowledge.doi: 10.3329/taj.v15i2.3916TAJ December 2002; Vol.15(2): 87-89

Rupture sinus of Valsalva is a relatively rare condition. We report a rare case of ruptured left sinus of valsalva with aneurysm, presenting with acute left ventricular failure. Transthoracic echocardiography showed an aneurysmal dilatation of the base of interventricular septum and part of the aortic root and a marked turbulent flow from the aortic root to the left ventricle with a continuous systolodiastolic shunting. The patient underwent successful repair of ruptured sinus of valsulva with closure of fistula. During Ventriculotomy the defect was repaired using pledgeted 5/ 0 prolene interrupted sutures and pericardial patch. Key Words: Rupture sinus of valsalva; Aneurysm; Left ventricle DOI: http://dx.doi.org/10.3329/cardio.v4i1.9398 Cardiovasc. J. 2011; 4(1): 96-98

The decline in breast feeding during the last few decades seen first in the developed and then in the developing countries is not as unique in history as often believed. We tend to think that previously mothers always breast-fed, but we are rather repeating history. The authorities in Sweden became aware of the slow population growth during the eighteenth and nineteenth centuries through the Central Bureau of Statistics founded in 1749. It was obvious that this slow growth was due to a very high infant mortality, which was around 200 promill from 1750–1800. In local areas it remained even around 400 promille up to about 1830. According to the registries of the priests in each parish and the continuous reporting to the authorities by the provincial doctors the infant mortality was due mainly to gastroenteritis and was inversely related to the frequency of breast feeding (1,2). In some quite distinct areas in Sweden and Finland artificial feeding was predominant. Here infant mortality was high. The babies were mostly fed undiluted cow’s milk through a cow horn which could not be cleaned and was stinking so that the doctor knew already when he entered a home that there was an artificially fed baby.

Diarrhoeal diseases constitute a very important threat to child life and health in Pakistan. Some health statistics of the country relevant to the problem are given in Table 1.