Diabetes mellitus (DM) is a common disorder affecting individuals in the United States and in the world. The prevalence of DM has increased noticeably over the last three decades with an estimated ...380 million people currently diagnosed with this disease. DM is associated with numerous systemic complications that affect the retina, heart, brain, kidneys, and nerves. The most common complication of DM is diabetic peripheral neuropathy. Diabetic peripheral neuropathy causes reduced sensation, reflexes, proprioception, and strength in lower limbs that leads to balance problems. Various manual therapy techniques have not approached a pilot study for the efficacy of a manual therapy technique to evaluate symptom alleviation in patients with diabetic peripheral neuropathy in order to improve balance. The purpose of this study is to look at the impact of a novel intervention called Intraneual facilitation (INF) on objective static, objective dynamic, subjective balance measures, and a peripheral neuropathy scale in patients with Diabetic Peripheral Neuropathy (DPN). Balance will be assessed using VSR Computerized Dynamic Posturography Sensory Organization Test (SOT, objective static balance measure), VSR Computerized Dynamic Posturography Limits of Stability (LOS, objective dynamic balance measure), and Activities-Specific Confidence in Balance Scale (ABC, subjective balance measure) and neuropathy will be assessed using modified total neuropathy scale (mTNS). Evaluation will be conducted at baseline (pre intervention) and (post intervention). The results of this study showed hat subjects showed significant improvement in the SOT, one component in the LOS (movement velocity, MVL), and mTNS (P < .05). In conclusion, intraneural facilitation improved objective balance measures and neuropathy symptoms in patients with diabetic peripheral neuropathy. Further study is needed to determine long-term benefits of this intervention.
A salinity gradient solar pond (SGSP) is capable of storing a significant quantity of heat for an extended period of time. It is a great option for providing hot water at a reduced energy cost. ...Additionally, SGSP is used in low-temperature industrial applications such as saltwater desalination, space heating, and power generation. Solar pond thermal performance is dependent on a variety of operational variables, including the soil conditions, the climate of the particular site, the thickness of the solar pond layers, the depth of the water table, and the salt content of the pond. As such, this study examines the thermal performance of a solar pond under a variety of operational conditions. The solar pond model is used to test the thermal performance by simulating two-dimensional heat and mass transport equations. The equations are solved using the finite difference technique utilizing MATLAB® scripts. Salt distributions and temperature profiles are computed for a variety of factors influencing SGSP's thermal performance. The main distinguishing variables influencing the thermal performance of SGSP are soil conditions, such as soil texture, types, the moisture level in soil, and water table depth. The final findings indicated that the fine sand dry soil performed better than the other soil types owing to its poor heat conductivity. The economic results indicated that the period of return (POR) of the intended system is around 2 years. The solar pond construction costs such as excavation, transportation, salt and lining, were considered based on the local prices. This modeled study extracted the greatest possible energy is 110W/m2, with the fine sand dry at 62.48°C lowest temperature. This study suggested that the climatic conditions of Lahore is better than climatic conditions of Islamabad. Additionally, deeper water tables are suggested for improved thermal performance of the pond.
Introduction: Community pharmacists play a key role as vaccinators for COVID-19. They can reduce the burden of the disease worldwide. Objective: This study used a cross-sectional questionnaire to ...determine whether the Saudi Arabian public was willing to obtain the COVID-19 vaccine via community pharmacists. Results: The questionnaire focused on the satisfaction, concerns, and opinions towards providing vaccination by community pharmacists. The study featured 415 individuals aged 18 and older (eligible for the COVID-19 vaccine). Of the participants in this study, 58.1% were aged 18-25, with 55.4% female. Most participants (72.8%) have not been exposed to COVID-19 and are not aware of the approval of COVID-19 vaccination by community pharmacists. Of the 415 complete questionnaires, 45% believed that community pharmacists are not experienced in administering vaccines. However, 63% of participants are satisfied with getting the COVID-19 vaccination by a community pharmacist if no other option is available. More than 68% of the respondents agree that community pharmacies should expand their health care services to include vaccinations, prescriptions, checkups, and other forms of preventative medicine. Discussion: The availability of community pharmacist-administered vaccination in Saudi Arabia could be a significant factor in the success of the country's vaccination program. This study may serve as a model to expand the role of pharmacists in other countries' vaccination programs. Keywords: SARS-CoV-2, community pharmacy, immunization, perspective, adherence, patient satisfaction
Background
Middle East respiratory syndrome (MERS) is caused by a coronavirus (MERS‐CoV) and is characterized by hypoxemic respiratory failure. The objective of this study is to compare the outcomes ...of MERS-CoV patients before and after the availability of extracorporeal membrane oxygenation (ECMO) as a rescue therapy in severely hypoxemic patients who failed conventional strategies.
Methods
We collected data retrospectively on MERS-CoV patients with refractory respiratory failure from April 2014 to December 2015 in 5 intensive care units (ICUs) in Saudi Arabia. Patients were classified into two groups: ECMO versus conventional therapy. Our primary outcome was in-hospital mortality; secondary outcomes included ICU and hospital length of stay.
Results
Thirty-five patients were included; 17 received ECMO and 18 received conventional therapy. Both groups had similar baseline characteristics. The ECMO group had lower in-hospital mortality (65 vs. 100%,
P
= 0.02), longer ICU stay (median 25 vs. 8 days, respectively,
P
< 0.01), and similar hospital stay (median 41 vs. 31 days,
P
= 0.421). In addition, patients in the ECMO group had better PaO2/FiO2 at days 7 and 14 of admission to the ICU (124 vs. 63, and 138 vs. 36,
P
< 0.05), and less use of norepinephrine at days 1 and 14 (29 vs. 80%; and 36 vs. 93%,
P
< 0.05).
Conclusions
ECMO use, as a rescue therapy, was associated with lower mortality in MERS patients with refractory hypoxemia. The results of this, largest to date, support the use of ECMO as a rescue therapy in patients with severe MERS-CoV.
PDF
