Thermal and hydraulic performance of ZnO/EG based nanofluids in mini tubes of different diameters: An experimental investigation

The present experimental study investigates the thermal and hydraulic performance of Ethylene Glycol (EG)-based ZnO nanofluids (NFs) in circular minichannel test sections, each of 330 mm in length and 1.0-2.0 mm inner diameters. The experiments were conducted under steady-state constant heat flux and laminar flow conditions. The stable ZnO/EG-based NFs were synthesized using a standard two-step method in varying nanoparticles (NPs) loadings (0.012-0.048 wt%). The morphological characteristics, crystal structure, and specific surface area (SSA) showed that the NPs were sized in nm, possessing excellent crystal structure and enhanced surface area. Thermal conductivity (TC) and viscosity (VC) of the NFs were examined in the 20-60 °C temperature range. Both TC and VC possessed an increasing trend with the rise in concentration of the NPs. However, with the temperature rise, TC increased while the VC decreased and vice versa. The highest enhancements in TC and VC were 14.38 % and 15.22 %, respectively, at 40 °C and 0.048 wt% of NPs loading. The highest enrichment recorded in the local and average heat transfer coefficient (HTC) were 14.80 % and 13.48% in a minichannel with 1.0 mm inner diameter, respectively. It was directly proportional to the NPs loading and volume flow rate of the NFs. The friction factor was also directly proportional to the test section's inner cross-sectional area, while the pressure gradient showed an inverse behavior. An inverse relationship was recorded for the volume flow rate of the NFs and vice versa. Maximum friction factor and the pressure drop for all three minichannel test sections were recorded as 34.58 % and 32.16 %, respectively. The well-known Shah correlation predicted the local and average HTC within ±15.0 %, while the friction factor and the pressure gradient were well predicted by the Darcy correlation within the ±10.0 % range.

Inguinal hernia leading to omental torsion: Role of CT in differentiating from other clinical mimics - a case report and literature review

Omental torsion is a very rare cause of acute abdomen. Clinically, it mimics other common pathologies such as acute appendicitis, acute diverticulitis and acute cholecystitis. It is therefore no surprise, that it was rarely diagnosed pre operatively before the advent and easy availability of modern imaging techniques. CT scan, in particular, can diagnose omental torsion with confidence pre operatively. This can make conservative treatment possible in cases of primary omental torsion and guide regarding the appropriate treatment in cases of secondary torsion. We present a case of a young male patient who presented to Emergency department with symptoms of acute abdomen. Clinical and laboratory findings were non-specific for any specific cause of acute abdomen. CT scan, however, showed omental fat stranding with whirlpool sign representing omental torsion which was seen to be secondary to left inguinal hernia. Patient was operated in emergency and necrotic omentum was resected and hernia repaired. Post-operative recovery was uneventful.

Antimicrobial activity of AgNO3 nanoparticles synthesized using Valeriana wallichii against ESKAPE pathogens

The emergence of multidrug-resistant ESKAPE infections has emerged as a serious public health threat. Nosocomial infections are most often caused by ESKAPE bacteria. To combat multidrug-resistant ESKAPE, the research team used Valeriana Wallichii extracts and nanoparticles. The well diffusion technique was used to test antimicrobial activity on Muller Hinton agar medium. The FTIR, SEM and XRD techniques were used to characterize the nanoparticles synthesized in an environmentally benign manner. Both NPs performed better than extracts made with methanol and water in this investigation. The smallest zones of inhibition were shown against A. baumannii and Enterobacter cloacae, whereas the largest zones of inhibition were seen against E. faecium. However, NPs synthesized from shoot extracts exhibited remarkable effects against all MDR ESKAPE infections, with zones of inhibition of 23, 20, 12, 18, 22 and 14mm, respectively. Although E. faecium. had the largest inhibitory zone in both methanolic root and shoot extracts (19mm and 22mm, respectively), K. pneumonia and E. cloacae had the smallest zones when tested with these solvents. Water-based extracts inactivated multidrug-resistant bacteria. Our research show that extracts and nanoparticles have stronger antibacterial efficiency because biologically active substances including Terpenoids, Alkaloids, Phenol and Pholobutannins affect people and microbe.

Determination of chemical composition and investigation of potential of triphala powder in hypercholesterolemia in men in controlled randomized trial

Hypercholesterolemia is a condition with elevated cholesterol and lipid profile. It is the leading reason behind myocardial infarction and coronary heart disease. It is observed in young people as well due to a sedentary lifestyle. Triphala powder has a hypolipidemic and anti-hypercholesterolemia effect. This study was designed to investigate the effect of triphala powder against hypercholesterolemia. This study also examined Triphala powder's chemical composition. Total phenolic and flavonoid content were examined. Encapsulated 400 mg and 600 mg Triphala powder were given to treatment groups I and II. Lipid profile parameters were measured and compared at 0 weeks and 10th weeks in all groups. All results were analyzed using ANOVA in IBM SPSS Statistics 20. Results of proximate analyses have shown that Okra pod powder contains moisture 12.27%, ash 11.25%, nitrogen-free extract 45.93%, crude protein 13.37%, crude fat 2.95% and crude fiber 14.23%. Mineral analysis showed that iron and manganese are major minerals in triphala powder. Triphala powder showed a significant reduction in lipid profile parameters in hypercholesterolemia. All results are taken significantly at p<0.05.

Adherence to Positive Airway Pressure Therapy in Patients With Obstructive Sleep Apnea

Adherence to either continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) therapy in patients with obstructive sleep apnea syndrome (OSAS) represents a real challenge to sleep medicine physicians. Many risk factors/predictors for nonadherence exist, and usually, it is multifactorial. Long-term nonadherence with CPAP therapy has been associated with the use of CPAP for <4 hours/night during early treatment, moderate to severe obstructive sleep apnea (OSA), poor self-efficacy, and unsupportive bed partner. The American Academy of Sleep Medicine (AASM) recommends follow-up of patients with OSA within the first two weeks of CPAP use to optimize adherence. Measures to improve adherence to positive airway pressure (PAP) therapy go through an integrated approach that involves behavioral therapy and prompt management of side effects. Pharmacologic therapy in the form of a sedative-hypnotic sleep aid has a minor role in managing nonadherence to CPAP based on the greater risk of side effects. This article will briefly discuss the risk factors and management of nonadherence to PAP therapy in patients with OSAS.

Is the Modified Distress Thermometer Useful for Screening Pregnant Women With COVID-19 for Psychological Distress?

Background: Pregnant women may be more vulnerable than others to the psychological and social effects of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we try to answer the question - is the modified distress thermometer (m-DT) useful for screening pregnant women with COVID-19 for psychological distress?

Methods: We have used the m-DT to screen pregnant women with COVID-19 for psychological distress. A total of 112 pregnant women with COVID-19 were prospectively enrolled. The study participants were asked to rate their distress in the past three days on an 11-point visual analog scale ranging from 0 (no distress) to 10 (extreme distress). They were then asked to fill in the problem list (PL) which accompanied the visual image of the m-DT. To explore the association between these scores and the clinical variables, binary logistic regression tests were carried out.

Results: Sixty-eight percent (76/112) of the study subjects experienced significant (m-DT score ≥ 4) COVID-19-related distress. Regression analysis showed that m-DT score of ≥4 had statistically significant associations with gravida status length of quarantine time, the presence of chronic medical or respiratory disease, fears, worry, shortness of breath, and sleep. Multivariable analysis confirmed that the presence of chronic respiratory disease, shortness of breath, and sleep were independent factors associated with significant distress in pregnant women with COVID-19.

Conclusion: With the use of m-DT, two-thirds of pregnant women with COVID-19 experienced significant distress. This distress was significantly related to older age, multigravida, exposure to longer quarantine time, presence of underlying medical disorder, and the presence of chronic respiratory disorders. The presence of chronic respiratory disease, shortness of breath, and sleep disturbance were independent factors associated with significant distress in pregnant women with COVID-19.

Diagnostic Accuracy of Doppler Ultrasonography in Predicting Presence of Esophageal Varices in Patients with Hepatitis-C Induced Cirrhosis

OBJECTIVE

To determine the diagnostic accuracy of Doppler ultrasonography in predicting presence of esophageal varices in patients with hepatitis-C induced cirrhosis.

STUDY DESIGN

Descriptive analytical study.

PLACE AND DURATION OF STUDY

Department of Radiology, Jinnah Hospital, Lahore, from May 2016 to October 2016.

METHODOLOGY

Patients aged 15-70 years, who presented with cirrhosis and proved to be cirrhosis caused by Hepatitis-C of any gender and duration of disease more than 6 months, were included. Patients with hepatocelullar carcinoma or portal vein thrombosis, having received treatment for esophageal varices, and unwilling to undergo endoscopy were excluded. All the patients then underwent Doppler ultrasonography to calculate splenoportal index and findings were correlated with endoscopy findings.

RESULTS

Out of 200 patients, 137 (68.50%) were males and 63 (31.50%) were females. In Doppler ultrasonography positive patients, 113 were true positive and 8 were false positive. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Doppler ultrasonography in predicting presence of esophageal varices was 88.98%, 89.04%, 93.00%, 82.28% and 89.00%, respectively.

CONCLUSION

Doppler ultrasonography is the non-invasive modality of choice with high diagnostic accuracy in predicting presence of esophageal varices in hepatitis-C induced cirrhosis.

Migratory Gossypiboma: An Unusual Presentation Of A Rare Surgical Complication

Gossypiboma is a rare surgical complication associated with significant patient morbidity and even mortality. Migratory gossypiboma is a rarer subset of these cases, representing the erosion of surgical sponge into the intestine with consequent complications. A 40 years old female presented with a surgical sponge that had eroded into the caecum and subsequently moved with peristalsis up to the anal canal from which it was protruding out at the time of presentation. Proper checking before surgical closure can prevent this serious potentially lifethreatening complication.