Development of Multi-Vessel Coronary No-Reflow Following Elective Percutaneous Intervention in One Vessel.

Percutaneous coronary intervention (PCI) is a frequently performed procedure that can have minor or major complications. One of the more serious complications of PCI is the development of coronary no-reflow. No-reflow signifies reduced or absent coronary flow in the distal coronary circulation in the absence of flow-limiting lesions.

A Rare Case of Dilated Cardiomyopathy, Focal Segmental Glomerulosclerosis, and Bell's Palsy in a 29-Year-Old Male After Coxsackievirus Infection.

Dilated cardiomyopathy (DCM) is a severe myocardial disease with diversified etiologies. Coxsackievirus serotype B (CV-B) is a known cause of infectious myocarditis that leads to DCM. The pathogenesis of CV-B myocarditis is complex and involves a combination of tissue destruction from viral proliferation and host immune response.

Microstructural evolution and mechanical characterization of a WC-reinforced CoCrFeNi HEA matrix composite.

High entropy alloys (HEAs) are a relatively new class of material that have shown the potential to exhibit excellent combinations of mechanical properties. Various microstructural modifications have been explored to further enhance their mechanical properties for use in demanding structural applications. The main focus of the present work is an investigation of the effect of adding varying amounts of hard ceramic material (WC) to a tough HEA matrix (CoCrFeNi) by arc melting under an argon atmosphere, including microstructural changes, and evaluation of the WC additions on mechanical properties.

Introgression of Into Allotetraploid White Clover () Using the Ancestral Parent as a Bridging Species.

White clover () is an allotetraploid pasture legume widely used in moist temperate climates, but its vulnerability to drought, grazing pressure and pests has restricted its wider use. A related species, Caucasian clover (), is a potential source of resistances to drought, cold, grazing pressure and pests that could potentially be transferred to white clover by interspecific hybridization. Although direct hybridization has been achieved with difficulty, the hybrids have not been easy to backcross for introgression breeding and no interspecific chromosome recombination has been demonstrated.

Worsening of the COVID-19 Pandemic in New York City: Analysis of Response Gaps and Challenges at the Public Policy and Community Levels.

This review was aimed to probe into factors that resulted in worsening of novel coronavirus disease 2019 (COVID-19) pandemic in New York City, USA. Extensive review of available information sources, such as scientific literature, COVID-19 data generating websites, expert opinions as well as government briefings and simultaneous measures, were carried out to fulfil the objectives of this paper. Data was arranged in tabular form.

Diagnostic Utility of N-terminal pro-Brain Natriuretic Peptide and C-reactive Protein in Diagnosing Heart Failure in Patients with Acute Hypoxemic Respiratory Failure.

Introduction Shortness of breath is a leading cause of intensive care unit (ICU) admissions and is multifactorial. Acute hypoxemic respiratory failure due to heart failure is one of the leading causes of ICU admissions. N-terminal pro-brain natriuretic peptide (NT-proBNP) is secreted by ventricles and carries a negative predictive value for heart failure (2).

Hyperchloremia in Intensive Care Unit Mortality: An Underestimated Fact.

Objective The goal of the study was to determine the percentage of hyperchloremia in patients who died in medical intensive care unit (ICU) and thus emphasizing the need of avoiding chloride-rich solutions due to their deleterious effects. Study design We conducted a retrospective study of data from 206 patients who expired in medical ICU in one year from January 2017 to December 2017 in the department of critical care medicine at Shifa International Hospital, Islamabad. Material and methods The study included 206 patients: 93 (43.

Role of Anti-ganglioside Antibodies in the Diagnosis of Guillain-Barré Syndrome as an Alternate Investigation.

Objective The goal of the study was to see if anti-ganglioside antibodies have a role in the diagnosis of Guillain-Barré syndrome (GBS). Study design Between May 2016 to October 2017, we conducted a prospective pilot study of 15 patients with a clinical diagnosis of GBS with equivocal cerebrospinal fluid (CSF) analysis and/or nerve conduction studies (NCS) . Materials and methods All adult patients (age >18 years) whose clinical diagnosis was GBS but diagnostic tests (either NCS or CSF analysis or both) were not suggestive of GBS were included in the study and were tested for anti-gangliosides antibodies.

Optic Nerve Sheath Diameter Correlation with Elevated Intracranial Pressure Determined via Ultrasound.

Background The early detection of elevated intracranial pressure (ICP) can not only prevent mortality but also aid in more aggressive management. Brain computed tomography (CT) is a mainstay modality in detecting elevated ICP, but the feasibility of using brain CTs to detect elevated ICP in critically ill patients is limited, especially for patients who require high levels of inotropic support. The optic nerve sheath is a direct extension of the brain meninges.

Determining the Incidence of Acute Kidney Injury Using the RIFLE Criteria in the Medical Intensive Care Unit in a Tertiary Care Hospital Setting in Pakistan.

Background Acute kidney injury (AKI) is a frequently encountered clinical condition in hospitalized patients, particularly those admitted to intensive care units (ICU). AKI has its systemic sequelae and contributes to the morbidity of underlying diseases. Methods This descriptive case series aimed to determine the frequency of acute kidney injury in critically ill patients admitted to the ICU at Shifa International Hospital, Islamabad, according to the RIFLE (risk, injury, failure, loss, and end-stage) criteria.

Measurement of Internal Jugular Vein and Common Carotid Artery Diameter Ratio by Ultrasound to Estimate Central Venous Pressure.

Objective The objective of this study is to find a correlation between internal jugular vein (IJV) and common carotid artery (CCA) diameter ratio and central venous pressure (CVP) measurement and find a cut-off value for the IJV/CCA ratio to predict low CVP i.e. < 10 cm H0, for estimating the volume status in critically ill patients.

Comparing Ultrasound-based Diaphragmatic Excursion with Rapid Shallow Breathing Index as a Weaning Predictor.

Background A challenging task in the intensive care unit is weaning intubated patients from mechanical ventilation. The most commonly used weaning parameter, the rapid shallow breathing index (RSBI), gives thorough guidance on extubation timing with spontaneous breathing trials. Diaphragm plays vital role in tidal volume generation.

Early Versus Late Tracheostomy After Decompressive Craniectomy.

Objective The goal of this study was to determine the efficacy of early tracheostomy (i.e., ≤ 10 days of intubation) compared with a late tracheostomy (> 10 days of intubation) with regards to timing, frequency of ventilator-associated pneumonia (VAP), mortality rate, and hospital stay in patients who received decompressive craniectomy.

Comparison of Hospital-Wide Code Rates and Mortality Before and After the Implementation of a Rapid Response Team.

Objective To compare hospital-wide code rates and mortality before and after the implementation of a rapid response team (RRT). Study design A prospective cohort design with historical controls. Place of study This study was conducted at Shifa International Hospital, Islamabad, from January 21, 2016, to January 20, 2017.

Analysis of pattern of mortality in Medicine and Allied Departments at a tertiary care hospital in Islamabad: A losing battle against sepsis.

Objective: To identify the pattern of mortality in medical wards of a tertiary care hospital.

Methods: This retrospective study was conducted at the Khan Research Laboratories Hospital, Islamabad, Pakistan, and comprised medical records of people who died during hospital stay between December 2013 and November 2014.SPSS 11 was used for data analysis.

Fe(3)O(4)/polyethylene glycol nanocomposite as a solid-phase microextraction fiber coating for the determination of some volatile organic compounds in water.

A high-performance metal oxide polymer magnetite/polyethylene glycol nanocomposite was prepared and coated in situ on the surface of the optical fiber by sol-gel technology. The magnetite nanoparticles as nanofillers were synthesized by a coprecipitation method and bonded with polyethylene glycol as a polymer. The chemically bonded coating was evaluated for the headspace solid-phase microextraction of some environmentally important volatile organic compounds from aqueous samples in combination with gas chromatography and mass spectrometry.

Fluorescence chromosome banding and FISH mapping in perennial ryegrass, Lolium perenne L.

Background: The unambiguous identification of individual chromosomes is a key part of the genomic characterization of any species. In this respect, the development and application of chromosome banding techniques has revolutionised mammalian and especially, human genomics. However, partly because of the traditional use of chromosome squash preparations, consistent fluorescence banding has rarely been achieved in plants.

Polyvinylimidazole/sol-gel composite as a novel solid-phase microextraction coating for the determination of halogenated benzenes from aqueous solutions.

A polyvinylimidazole/sol-gel composite is proposed as a novel solid-phase microextraction fiber to extract five halobenzenes from the headspace of aqueous solutions in combination with gas chromatography with mass spectrometry. The prepared fiber was characterized by scanning electron microscopy and Fourier transform infrared spectroscopy. The obtained results showed that porous polyvinylimidazole/sol-gel composite was chemically deposited on fused silica fiber.

Formulation development and in vitro evaluation of theophylline microcapsules.

The study was aimed to investigate microencapsulation of theophylline using different ratios of eudragit S 100 as wall material by the emulsion solvent evaporation technique. The release profiles, effect of stirring speed and different pH of dissolution medium on release profiles and stability were also studied. Various formulations of microcapsules were compressed in to tablets.

Inflammatory bowel disease in the elderly.

Although inflammatory bowel disease (IBD) is generally considered a disease of young adults, it can occur in elderly individuals. The clinical features and treatment considerations in older patients are similar to those in younger patients, with some notable exceptions, which are reviewed in this article. Consideration of appropriate differential diagnoses is critical in older IBD patients to achieve the correct diagnosis and appropriate therapy.

Hand hygiene in long-term care facilities: a multicenter study of knowledge, attitudes, practices, and barriers.

An anonymous survey of 1143 employees in 17 nursing facilities assessed knowledge of, attitudes about, self-perceived compliance with, and barriers to implementing the 2002 Centers for Disease Control and Prevention hand hygiene guidelines. Overall, employees reported positive attitudes toward the guidelines but differed with regard to knowledge, compliance, and perceived barriers. These findings provide guidance for practice improvement programs in long-term care settings.

Are live kidney donors at risk?

Objective: To share experience of live donor nephrectomy (including intraoperative variables, morbidity and ethical aspects) and to give an overview of surgical technique being practiced.

Design: A department-based prospective study.

Place And Duration Of Study: Department of Urology and Kidney Transplantation, Lahore General Hospital, Lahore, (September 1998 to March 2002).