15 research outputs found
Outcomes of implementation of enhanced goal directed therapy in high-risk patients undergoing abdominal surgery
No full textBackground and Aims: Advanced monitoring targeting haemodynamic and oxygenation variables can improve outcomes of surgery in high-risk patients. We aimed to assess the impact of goal directed therapy (GDT) targeting cardiac index (CI) and oxygen extraction ratio (O 2 ER) on outcomes of high-risk patients undergoing abdominal surgery. Methods: In a prospective randomised trial, forty patients (American Society of Anaesthesiologists II and III) undergoing major abdominal surgeries were randomised into two groups. In-Group A mean arterial pressure ≥ 65 mmHg, central venous pressure ≥ 8-10 mmHg, urine output ≥ 0.5 mL/kg/h and central venous oxygen saturation ≥ 70% were targeted intra-operatively and 12 h postoperatively. In-Group-B (enhanced GDT), in addition to the monitoring in-Group-A, CI ≥ 2.5 L/min/m 2 and O 2 ER ≤ 27% were targeted. The end-points were lactate levels and base deficit during and after surgery. The secondary end points were length of Intensive Care Unit (ICU) and hospital stay and postoperative complications. Wilcoxon Mann Whitney and Chi-square tests were used for statistical assessment. Results: Lactate levels postoperatively at 4 and 8 h were lower in-Group-B (P < 0.05). The mean base deficit at 3, 4, 5 and 6 h intra-operatively and postoperatively after 4, 8 and 12 h were lower in-Group-B (P < 0.05). There were no significant differences in ICU stay (2.10 ± 1.52 vs. 2.90 ± 2.51 days) or hospital stay (10.85 + 4.39 vs. 13.35 + 6.77 days) between Group A and B. Conclusions: Implementation of enhanced GDT targeting CI and OER was associated with improved tissue oxygenation
A novel approach for power-gating technique with Improved Efficient Charge Recovery Logic
No full textA Systematic Review of Dietary Supplements in Alzheimer’s Disease
No full textAlzheimer’s is the most common neurodegenerative disease among the aging population, which has been a major global challenge. The pathogenesis of the disease is still undetermined but postulated to be involved in various mechanisms including oxidative stress, excitotoxicity, inflammation, cell death, genetic factors, protein accumulation, and degradation. There are few Food and Drug Administration (FDA)-approved drugs available for the treatment of Alzheimer’s disease (AD) that have limited benefits along with associated adverse effects. A retrospective review of randomized double-blind controlled trials of various supplements used in AD patients was performed on a PubMed search from January 1983 to March 2022. We found 10 articles that have shown positive outcomes in various cognitive domains. We conclude that there should be a global standard to endorse the quality and safety of these supplements
PSYCHOSOCIAL FACTORS ASSOCIATED WITH ABSTINENCE AND RELAPSE IN ALCOHOL DEPENDENCE: A CROSS-SECTIONAL COMPARATIVE STUDY
No full textObjectives: This study evaluated psychosocial predictors of relapse and abstinence in alcohol-dependent individuals using standardized psychosocial assessment tools.
Methods: A cross-sectional study was conducted among 100 Diagnostic and Statistical Manual of Mental Disorders, 5th Edition–diagnosed alcohol-dependent patients (50 relapse; 50 abstinent). Four validated scales – Coping Behavior Inventory (CBI), Alcohol Abstinence Self-Efficacy Scale (AASES), Multidimensional Scale of Perceived Social Support (MSPSS), and Social Readjustment Rating Scale (SRRS) – were administered. Continuous predictors were standardized (z-scores). A single logistic regression model predicted relapse.
Results: Maladaptive coping was the strongest predictor of relapse (odds ratio [OR] = 30.98; 95% confidence interval [CI]: 7.99–120.16; p<0.001). Higher self-efficacy was protective (OR=0.34; 95% CI: 0.16–0.70; p=0.003). Higher perceived social support predicted relapse (OR=3.61; 95% CI: 1.52–8.58; p=0.004). Stress showed borderline significance (OR=2.06; p=0.055). Model fit was strong (Nagelkerke R2=0.54).
Conclusion: Coping, self-efficacy, social support, and stress significantly influence relapse risk. Psychosocial interventions enhancing coping and self-efficacy and modifying maladaptive family support may reduce relapse
A case study of an adverse drug reaction caused by long term use of proton pump inhibitors
Get PDFProton pump inhibitors (PPI) are the class of drugs used to treat a wide variety of disorders related to the stomach's acid production. Although it is considered safe for short term use, reports revealed that many serious life-threatening adverse reactions occurred from long term use. Here we report a case of hypomagnesemia and hypocalcemia induced by long-term use of PPIs in a patient with crest syndrome. From his past history, it was revealed that he was on pantoprazole 40 mg for more than 3 months. While he was admitted here for other complaints, we were able to discover that he had hypomagnesemia defined by low magnesium level of 1.3 mg/dL. As a consequence, he also showed signs of hypocalcemia with a low calcium level of 7 mg/dL. A peculiar complaint seen in this patient was three episodes of supraventricular tachycardia which is the most common cardiac manifestations of hypomagnesemia. As a conclusion, hypomagnesemia can sometimes be asymptomatic and cause unspecific and serious manifestations such as asthenia, paresthesia’s, seizures, arrhythmias, and cardiac arrest. Hence routine monitoring of serum magnesium and calcium levels should be made mandatory in practice for patients on long term use of PPI. Besides, it should be kept in mind that interchanging PPI class with histamine 2 receptor antagonist or fitful use of PPI may not cause hypomagnesemia
Securing Crowdfunding Platforms: Implementing Blockchain for Fraud Detection
Get PDFCrowdfunding is an online fundraising procedure that was originally designed to allow members of the public tocontribute small sums of money to support creative people's projects. Crowdfunding uses blockchain technologyto provide consumers with smart contracts. This allows us to deliver crowdfunding in a safe, open, and transparentmanner. This project aims to create interactive forms for campaign development and financial contributions. Thissystem allows campaign creators and contributors to view or submit requests for approval, as well as constructand support their initiatives. Furthermore, the donor may be able to monitor the utilization of the funds theydonate. Every transaction will be recorded as blocks on the blockchain and monitored accordingly. The use ofsmart contracts in the blockchain is tempting. A blockchain-based agreement must be created, carried out, andenforced by untrustworthy members without the intervention of a trustworthy third party. Developing blockchaincompatible executable code is critical. Blockchain was initially used primarily as the foundation forcryptocurrencies, but it has since spread to a variety of other enterprises. Blockchain technology is expected tobecome the most widely used green method of conducting internet transactions. Blockchain technology isemployed in a variety of applications, including crowdfunding sites. The biggest difficulty confronting the globalcrowdfunding industry today is a lack of strong control over campaigns, as some attempts at crowd investing haveproven fraudulent. This work aims to address these issues by ensuring that initiatives may be added within thegiven time frame, eliminating fraud, and allowing contracts to be fully mechanically executed using Ethereumsmart contracts on the crowdfunding site. 
