Remifentanil as single agent to facilitate awake fibreoptic intubation in the absence of premedication

Remifentanil is increasingly being used as the primary agent to provide sedation during awake fibreoptic nasal intubation. In this observational study, we aimed to determine the optimal effect site concentration of remifentanil, using a target controlled infusion based on the Minto pharmacological model, to provide optimal safe intubation conditions without the use of other sedatives/premedication and/or spray-as-you-go local anaesthesia. Twenty patients with anticipated difficult airway participated in the study. Good intubating conditions were achieved in all patients with mean (SD) effect site concentration of 6.3 (3.87) ng.ml(-1) of remifentanil recorded at nasal endoscopy and 8.06 (3.52) ng.ml(-1) during tracheal intubation. No serious adverse event occurred during any of these procedures. These preliminary findings suggest that this is a feasible and safe technique for awake fibreoptic nasal intubation.     

Influenza surveillance in Middle East,North, East and South Africa: Report of the 8th MENA Influenza Stakeholders Network

The Middle‐East and Africa Influenza Surveillance Network (MENA‐ISN), established in 2014, includes 15 countries at present. Country representatives presented their influenza surveillance programmes, vaccine coverage and influenza control actions achieved, and provided a list of country surveillance/control objectives for the upcoming 3 years. This report details the current situation of influenza surveillance and action plans to move forward in MENA‐ISN countries. Data were presented at the 8th MENA‐ISN meeting, organized by the Mérieux Foundation that was held on 10‐11 April 2018 in Cairo, Egypt. The meeting included MENA‐ISN representatives from 12 countries (Algeria, Egypt, Jordan, Kenya, Lebanon, Libya, Morocco, Pakistan, Saudi Arabia, South Africa, Tunisia and United Arab Emirates) and experts from the Canadian Centre for Vaccinology, and the World Health Organization. Meeting participants concluded that influenza remains a significant threat especially in high‐risk groups (children under‐5, elderly, pregnant women and immunosuppressed individuals) in the MENA‐ISN region. Additional funding and planning are required by member countries to contain this threat. Future meetings will need to focus on creative and innovative ways to inform policy and initiatives for vaccination, surveillance and management of influenza‐related morbidity and mortality especially among the most vulnerable groups of the population.     

Weight cycling in adolescent Taekwondo athletes

Background

Weight reduction cycles are used by weight classed athletes in Taekwondo to make a weight category. Tension, dizziness, headaches, and confusion have been associated with rapid weight loss (RWL). There is a lack of research in weight cycling and its benefits among Taekwondo athletes.

Purpose

To investigate the rate of weight cycling in Junior Taekwondo athletes and its effect on performance.

Methods

Athletes were weighed prior to competition, then again before their first match. Body mass difference in relation to winning was compared.

Results

A significant increase from weigh-in to pre-match measurements was consistently found in both genders with no significant difference between them. Winners had a mean body mass gain (1.02 kg) which was non-significantly less than the non-winners (1.09 kg).

Conclusions

RWL practices do not define which athlete will perform better. Negative effects of weight cycling coupled with RWL has unclear performance benefits which indicates a need for further research.     

Multiple indicator cluster survey 2003 in Afghanistan: outdated sampling frame and the effect of sampling weights on estimates of maternal and child health coverage

Due to an urgent need for information on the coverage of health service for women and children after the fall of Taliban regime in Afghanistan, a multiple indicator cluster survey (MICS) was conducted in 2003 using the outdated 1979 census as the sampling frame. When 2004 pre-census data became available, population-sampling weights were generated based on the survey-sampling scheme. Using these weights, the population estimates for seven maternal and child healthcare-coverage indicators were generated and compared with the unweighted MICS 2003 estimates. The use of sample weights provided unbiased estimates of population parameters. Results of the comparison of weighted and unweighted estimates showed some wide differences for individual provincial estimates and confidence intervals. However, the mean, median and absolute mean of the differences between weighted and unweighted estimates and their confidence intervals were close to zero for all indicators at the national level. Ranking of the five highest and the five lowest provinces on weighted and unweighted estimates also yielded similar results. The general consistency of results suggests that outdated sampling frames can be appropriate for use in similar situations to obtain initial estimates from household surveys to guide policy and programming directions. However, the power to detect change from these estimates is lower than originally planned, requiring a greater tolerance for error when the data are used as a baseline for evaluation. The generalizability of using outdated sampling frames in similar settings is qualified by the specific characteristics of the MICS 2003-low replacement rate of clusters and zero probability of inclusion of clusters created after the 1979 census.     

A 9-year study of shigellosis in Northeast Malaysia: Antimicrobial susceptibility and shifting species dominance

Aims  

In Malaysia, Shigella spp. is the third most common bacterial agent responsible for childhood diarrhoea. This study was conducted to determine the prevalence and antimicrobial susceptibility patterns of Shigella spp. isolated from patients admitted to the Hospital Universiti Sains Malaysia from January 2001 to December 2009.     

Effect of Structural Differences on the Mechanical Properties of 3D Integrated Woven Spacer Sandwich Composites

Three-dimensional integrated woven spacer sandwich composites have been widely used as industrial textiles for many applications due to their superior physical and mechanical properties. In this research, 3D integrated woven spacer sandwich composites of five different specifications were produced, and the mechanical properties and performance were investigated under different load conditions. XR-CT (X-ray computed tomography) images were employed to visualize the microstructural details and analyze the fracture morphologies of fractured specimens under different load conditions. In addition, the effects of warp and weft direction, face sheet thickness, and core pile height on the mechanical properties and performance of the composite materials were analyzed. This investigation can provide significant guidance to help determine the structure of composite materials and design new products according to the required mechanical properties.     

A feeding aid prosthesis for a preterm baby with cleft lip and palate

Cleft lip and palate is a common congenital defect of human being. If a child is born with congenital cleft palate defect, it is very painful to their parents. They are very much worried about the feeding of their baby. In this situation feeding aid prosthesis is the only treatment of choice. The feeding aid prosthesis helps not only feeding the baby but also help to develop proper articulation of speech. The article describes an advanced clinical and laboratory technique for the fabrication of a feeding aid prosthesis for new born baby. 9 infants who were suffering from congenital cleft lip and palate defect and a 9 month old baby with acquired palatal defect (acid-victim) were included in this study. All of them had treated with feeding aid prosthesis for feeding till palatoplasty was done. The feeding aid prosthesis was fabricated with acrylic resin and finally relined with soft lining materials. The impression of the palate was taken with heavy body silicon putty with the help of modeling wax custom tray. Data were collected before and after prosthesis on the basis of feeding time, amount of consumption of milk and growth pattern of the infants with their height and weight. Out of ten babies, 30% rejected the prostheses and 70% had accepted and used the prostheses until they were fit for palatoplasty. Growth of the babies was significantly improved who accepted the prosthesis than who rejected the prosthesis.