Blood transfusion practices in military medicine

Background: This observational study was conducted in a small, 45 bed border static hospital, located in a field area, where no blood bank facilities were available. The present study was conducted to elucidate the blood transfusion practices of this hospital.     

Health services utilization by school going Omani adolescents and youths with DSM IV mental disorders and barriers to service use

Background  

Recent corpus of research suggests that psychiatric disorders amongst adolescents and youths are an emerging global challenge, but there is paucity of studies exploring health services utilization by this age group in Arab region.     

Numerical analysis of the flow characteristics of rotary blood pump

Thrombus formation and hemolysis have been linked to the dynamics of blood flow in rotary blood pumps and ventricular assist devices. Hemolysis occurs as the blood passes through the pump housing, and thrombi develop in stagnation and low-velocity regions. The predicted velocities, pressure, and turbulence quantities from the numerical simulation are used to identify regions of high shear stress and internal recirculation. A nimerical technique is described that simulates the hydrodynamic characteristics of a rotary blood pump with a flow rate of 6 l/min at a rotational speed of 3000 RPM. A computational fluid dynamics (CFD) code, CFX 4, is used to solve the time-dependent incompressible Navier-Stokes equations using a transient finite volume method and three-dimensional structured grids. The simulation utilized the sliding mesh capabilities of this numerical code to model the rotating impeller and examine the effect of blade shape on the hydrodynamic performance of the blood pump in terms of pressure rise, flow rates, and energy losses. The first impeller model has six straight channels; the second impeller has six backward-curved channels. The results for two impeller configurations are presented and discussed. The curvedpump design resulted in higher pressure rise and maximum shear stresses than the straight-channel one. In general the paper demonstrates that CFD is an essential numerical tool for optimizing pump performance with the aim of reducing trauma to the blood cells.     

RETRACTED ARTICLE: Microwave sterilization of bovine pericardium for heart valve applications

It is widely recognised that the bioprosthetic valves widely used for heart valve replacements have some drawbacks, for example tearing and occurrence of infections, which can be attributed to the fixation and sterilization techniques currently available. These techniques adversely affect the physical properties, functionality, and lifespan of the leaflets. In the work discussed in this paper we examined a novel procedure of using high-frequency microwaves to fix and disinfect the pericardium, without causing any harmful affects. The test bacteria used were Escherichia coli and Staphylococcus aureus. The pericardium was exposed to microwaves at a frequency of 18 GHz for three consecutive replicates. The findings indicated that there was almost complete inactivation of the bacteria on the biomaterial without compromising the biocompatibility, which was studied using ovine fibroblasts. An effective fixation and sterilization procedure, that is quick and has no adverse effects is presented and discussed.     

Social and Self-Reflective Use of a Web-Based Personally Controlled Health Management System

Background

Personally controlled health management systems (PCHMSs) contain a bundle of features to help patients and consumers manage their health. However, it is unclear how consumers actually use a PCHMS in their everyday settings.

Objective

To conduct an empirical analysis of how consumers used the social (forum and poll) and self-reflective (diary and personal health record [PHR]) features of a Web-based PCHMS designed to support their physical and emotional well-being.

Methods

A single-group pre/post-test online prospective study was conducted to measure use of a Web-based PCHMS for physical and emotional well-being needs during a university academic semester. The PCHMS integrated an untethered PHR with social forums, polls, a diary, and online messaging links with a health service provider. Well-being journeys additionally provided information to encourage engagement with clinicians and health services. A total of 1985 students and staff aged 18 and above with access to the Internet were recruited online, of which 709 were eligible for analysis. Participants’ self-reported well-being, health status, health service utilization, and help-seeking behaviors were compared using chi-square, McNemar’s test, and Student’s t test. Social networks were constructed to examine the online forum communication patterns among consumers and clinicians.

Results

The two PCHMS features that were used most frequently and considered most useful and engaging were the social features (ie, the poll and forum). More than 30% (213/709) of participants who sought well-being assistance during the study indicated that other people had influenced their decision to seek help (54.4%, 386/709 sought assistance for physical well-being; 31.7%, 225/709 for emotional well-being). Although the prevalence of using a self-reflective feature (diary or PHR) was not as high (diary: 8.6%, 61/709; PHR: 15.0%, 106/709), the proportion of participants who visited a health care professional during the study was more than 20% greater in the group that did use a self-reflective feature (diary: P=.03; PHR: P<.001).

Conclusions

There was variation in the degree to which consumers used social and self-reflective PCHMS features but both were significantly associated with increased help-seeking behaviors and health service utilization. A PCHMS should combine both self-reflective as well as socially driven components to most effectively influence consumers’ help-seeking behaviors.     

Relationship between gastric cancer and precancerous lesions

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Phrenic Nerve Conduction Abnormalities Correlate with Diaphragmatic Descent in Chronic Obstructive Pulmonary Disease

Diaphragmatic weakness in chronic obstructive pulmonary disease (COPD) is ascribed to hyperinflation-induced diaphragm shortening as well as impairment in cellular and subcellular structures. Although phrenic neuropathy is known to cause diaphragmatic weakness, phrenic neuropathy is rarely considered in COPD. This work aimed at assessing phrenic nerve conduction in COPD and its relation to radiographic hyperinflation and pulmonary function. Patients and methods: Forty COPD patients were evaluated. Radiographic parameters of lung hyperinflation were measured on postero-anterior and lateral chest x-ray films. Flow volume loop parameters were obtained from all patients. Motor conduction study of the phrenic nerves was performed and potentials were recorded over the xiphoid process and the ipsilateral 7th intercostal space. Twenty-seven healthy subjects were enrolled as controls. Results: Parameters of phrenic nerve conduction differed significantly in patients compared to controls. Phrenic nerve abnormalities were detected in 17 patients (42.5%). Electrophysiological measures correlated with diaphragmatic angle of depression on lateral view films and with lung height on postero-anterior films. They did not correlate with the flow volume loop data or disease severity score. Conclusion: Phrenic nerve conduction abnormality is an appreciated finding in COPD. Nerve stretching associated with diaphragmatic descent can be a suggested mechanism for nerve lesion. The presence of phrenic neuropathy may be an additional contributing factor to diaphragmatic dysfunction in COPD patients.