Relative costs of anesthesiologist prepared, hospital pharmacy prepared and outsourced anesthesia drugs

Anesthesia drugs can be prepared by anesthesia providers, hospital pharmacies or outsourcing facilities. The decision whether to outsource all or some anesthesia drugs is challenging since the costs associated with different anesthesia drug preparation methods remain poorly described.

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Md. county approves $195K loan to purchase ambulance

This new equipment will replace one of the fire company's current ambulances from 2005 that has about 130,000 miles on it

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Effectiveness Of Blood Transfusion Therapy And Awareness Among Kinfolks Of Thalassemia Patients Visiting A Tertiary Care Hospital In North India

2016-12-04T10-35-00Z
Source: National Journal of Integrated Research in Medicine
Daljit Kaur*, Veena Doda**, Alok Hemal**.
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An Open, Retrospective Study Of Comparison Of Fine Needle Aspiration Cytology (FNAC) And Histopathology Findings In 75 Cases Of Solitary Thyroid Nodule.

2016-12-04T10-35-00Z
Source: National Journal of Integrated Research in Medicine
Hiren Doshi, Meeta Bathla, Atul Kansara.
Background and objectives: Solitary thyroid nodule(STN} is a common clinical entity encountered in routine clinical practice.STN is defined as a single swelling involving either lobe of thyroid or isthmus of thyroid gland. Present study was undertaken to know distribution of lesion according to age and sex, and also to evaluate efficacy of FNAC in diagnosis of clinically obvious and palpable solitary thyroid nodule. Method: This study was done on 75cases operated in our hospital from May 2012 to May 2016. All patients included in the study were submitted to FNAC and ultrasonography. All patients were subjected to surgery and histopathology examination was obtained. Results: Out of 75 cases of thyroid lesions, 63 cases were benign (84%), 6 cases were malignant (8%) and 6 cases were suspicious(8%) on FNAC. On Histopathological examination, 60 cases were benign(80%) and 15 cases were malignant(20%). Conclusion: FNAC is a single best investigation for preoperative evaluation for STN to differentiate between benign and malignant nodules with 88% accuracy rate.[Doshi H NJIRM2016; 7(5):53-55]


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New insights into plant nutrient signaling and adaptation to fluctuating environments

Publication date: 20 November 2016
Source:Journal of Genetics and Genomics, Volume 43, Issue 11
Author(s): Xiangdong Fu




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The relation between radon in schools and in dwellings: A case study in a rural region of Southern Serbia

Publication date: Available online 3 December 2016
Source:Journal of Environmental Radioactivity
Author(s): Z.S. Žunić, P. Bossew, F. Bochicchio, N. Veselinovic, C. Carpentieri, G. Venoso, S. Antignani, R. Simovic, Z. Ćurguz, V. Udovicic, Z. Stojanovska, T. Tollefsen
Recognized as a significant health hazard, radon (Rn) has been given increasing attention for years. Surveys of different kinds have been performed in many countries to assess the intensity and the geographical extent of possible Rn problems. Common surveys cover mainly dwellings, the indoor place with highest occupancy, and schools, where people spend a large fraction of their lifetime and which can also be considered exemplary for Rn exposure at workplaces; it has however been observed that relating them is difficult. It was unclear whether residential Rn at a location, or in a region, can be predicted by Rn at a school of that location, or vice versa. To current knowledge, no general rule seems applicable, as few models to describe the relationship between Rn in dwellings and in schools have been developed.In Southern Serbia, a Rn survey in a predominantly rural region was based on measurements in primary schools. The question arose whether or to which degree the results can be considered as indicative or even representative for residential Rn concentrations. To answer the question an additional survey of indoor Rn concentrations in dwellings was initiated, designed and performed in Sokobanja district in 2010–2012 in a manner to be able to detect a relationship if it exists. In the study region, 108 dwellings in 12 villages and towns were selected, with one primary school each.In this paper, we investigate how a relation between Rn in schools and dwellings could be identified and quantified, by developing a model and using experimental data from both the above main and additional surveys. The key criterion is the hypothesis that the relation dwellings – schools, if it exists, is stronger for dwellings closer to a school than for those dwellings further away. We propose methods to test the hypothesis.As result, the hypothesis is corroborated at 95% significance level. More specifically, on town level (typical size about 1 km), the Rn concentration ratio dwelling/school is about 0.8 (geometrical mean), with geometrical standard deviation (GSD) about 1.9. For dwelling and school hypothetically in the same location, the ratio is estimated about 0.7 with GSD about 1.5.We think that the methodology can be applied to structurally similar problems. The results could be used to create "conditional maps" of Rn concentration in dwellings, i.e., for example a map of probabilities that indoor Rn concentrations in dwellings exceed 100 Bq/m³, as function of Rn concentration in the local school.



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Assessing neuromuscular junction stability from stimulated EMG in children

Publication date: Available online 3 December 2016
Source:Clinical Neurophysiology
Author(s): Matthew C Pitt, John C Mchugh, Jacquie Deeb, Ralph A Smith
ObjectiveWe present our 9-year experience of stimulated EMG potential analysis using concentric electrodes (SPACE) to evaluate neuromuscular junction (NMJ) disorders in awake children. The technique uses high frequency filtration of stimulated motor unit potentials and applies peak detection software to estimate mean consecutive difference (MCD).MethodsSPACE was carried out in orbicularis oculi of 878 children (377 girls; median age 47 months) between 2007-2015, stimulating the facial nerve with a monopolar cathode. Mean MCD-index (MCD-I) was expressed as a ratio of the measured MCD to the upper normal limit. Diagnostic accuracy was calculated for primary NMJ disorders based on the 660 cases with clinical follow-up data.ResultsPrimary NMJ disorders were present in 106 children, including 46 with genetically confirmed congenital myasthenic syndrome (CMS). Mean MCD-I was two times higher in children with primary NMJ disorders compared to others (205 +/- 108 μs vs 94 +/- 38 μs, p < 0.005). After excluding children with neuronopathies, an MCD-I >100% had 84% sensitivity and 74% specificity for the primary NMJ disorders. Receiver operating characteristics (ROC) curve identified an MCD-I >115% as providing best diagnostic accuracy with sensitivity of 77% and specificity of 84%.ConclusionSPACE is practicable and safe in unsedated children.SignificanceIn combination with routine EMG, it has high diagnostic accuracy and can facilitate recognition of paediatric NMJ transmission disorders.



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