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jcsmicasereports · 21 days ago

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Emerging infectious agents: an unusual case of Metapneumovirus pneumonia in an adult patient by Graziana Francesca Greco in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

Human Metapneumovirus (hMPV), a relatively new virus, is a common cause of acute respiratory infection, especially common in the pediatric population. Despite hMPV infection in adults is possible, this rarely results in serious clinical manifestation. Here, we describe a hypoxemic respiratory failure related to pneumonia in an adult patient in whom hMPV was detected in respiratory samples.

Keywords

Human Metapneumovirus; SARS-CoV-2; Covid-19.

CASE HISTORY

A 61-yr-old caucasian man presented to the Emergency Department (ASST Mantua Hospital, Mantua, Italy) with fever up to 39°C, poorly responsive to antipyretics, nocturnal dyspnea and productive cough with mucus-purulent sputum for three days. On physical examination he appeared in good general condition, collaborating and oriented. The following parameters were recorded: blood pressure 140/90mmHg, heart rate of 100 beats min-1; respiratory rate of 23 breaths min-1; and body temperature of 38.4°C. His arterial oxygen saturation on room air was 87%. Chest examination revealed abnormal breath sounds with rhonchi and fine crackles in the middle lobe and inferior lobes bilaterally, no wheezes were heard. Laboratory findings revealed lymphocytosis (81000 x 103/µl), low platelet count (113000 x 106/µl) and an increase in alanine transaminase value (59 U/L), total bilirubin value (1.13 mg/dL) and CPR value (112 mg/L). Room air arterial blood gas analysis showed a normocapnic hypoxemia: pH 7.43, carbon dioxide tension 40.5 mmHg, oxygen tension 60.4 mmHg, and HCO3 24 mmol L-1. The SARS-CoV-2 antigen detection test on nasopharyngeal swab was negative. A chest radiograph showed multiple, small, patchy opacities in the right upper and middle lobe and no pleural effusion was observed. Based on these findings he was admitted to the Respiratory Department.

His medical history included chronic lymphocytic leukemia in follow-up which did not require any specific treatment. He denied taking any medications or to be a smoker, he drinks a glass of wine once a day and has no known allergies. The patient was a farmer who cultivates wheat and maize but he had no animal exposure and no travel history in the last few years. There is no family history or childhood history of respiratory complaints. He was vaccinated with three dosesagainst the SARS-CoV-2 infection (Pfizer) but not against the influenza virus.

Based on the patient’s presentation and testing results, on suspicion of bacterial pneumonia he was empirically treated with IV Piperacillin/Tazobactam, the patient required oxygen support at 3L min-1 and an inhalation therapy with Beclomethasone/Formoterol was set up ex adiuvantibus. In the following days, several microbiological investigations were carried out to determine the etiology of pneumonia: blood culture, urinoculture, sputum culture, Legionella, Haemofilus and Pneumococcus serologic tests, Legionella pneumophila and Pneumococcal urinary antigen test, all of which were negative.

A nasopharyngeal swab FilmArray Respiratory Panel Assay (NP FARP) was then requested: it was positive for human Metapneumovirus and the result was confirmed by repeating the test. For non responder fever and further increase of CPR (230 mg/l) and PCT (0.27 ng/ml), Levofloxacin and later Meropenem were added in the perspective of a resistant bacterial etiology. On the 6th hospitalization day a chest computed tomography (CT) scan was obtained (Figures 1 and 2) which demonstrated large opacities with gradient borders, distributed in the peribronchial area at the right upper lobe, middle lobe and both the lower lobes; they tended to the confluence configuring parenchymal consolidations with aerial bronchogram at the level of the cost-phrenic angle. Imaging also showed bilateral hilar and mediastinal lymphadenopathy (max diameter 3.4 x 2 cm), splenomegaly and absence of pleural effusion. Blood chemistry tests for HIV, Aspergillus antigen and galactomannan were also investigated but turned out negative. To rule out other infectious agents the patient underwent bronchoscopy with bronchoalveolar lavage (BAL) into the middle lobe. BAL provides material for various microbiological and cytological tests: Gram stain, culture, Koch’s bacillus DNA, Galactomannan, Cytomegalovirus and P. Jirovecii and immunological analysis were negative. From respiratory virus panel on BAL only human Metapneumovirus was isolated, this unique microbiological data was according to the NP FARP’s result, thus supporting and confirming the new hypothesis of a viral pneumonia in an adult patient with probable secondary mild immunosuppression due to his hematological disease. About ten days after entering the ward, there was a gradual decrease of CPR and a progressive improvement in clinical conditions and respiratory function to allow the suspension of oxygen therapy. At the end of hospitalization, pulmonary function tests were performed and showed a restrictive syndrome (FEV1/FVC 76.2, TLC 68% and VC 79% of predicted) and mild reduction of diffusion capacity (DLCO 62% and KCO 99%), probably representing the residual functional impairment due to viral pneumonia. The patient finally suspended all therapies and at discharge was referred for a one-month follow-up visit.

DISCUSSION

Human Metapneumovirus (hMPV), a relatively new virus first discovered in 2001, has been detected in 4-16% of patients with acute respiratory infections [1] [2] [3]. In particular, a recent review of 48 previous articles, including 100,151 patients under the age of five hospitalized for CAP, identified this virus as a cause of pneumonia in 3.9% of patients [4]. A recent study of 1386 hospitalized adult patients identified hMPV pneumonia in only 1.64%, indicating that it was much less common than in the infant population [5]. Metapneumovirus causes disease primarily in infants, but rarely can infect immunosuppressed individuals and elderly as well. Seroprevalence studies have shown that 90-100% of 5-10 years old children have previous infection [6]. Reinfection can occur during adulthood because of defected immunity acquired during the first contact with hMPV and/or because of different viral genotypes. The incubation period varies widely but is typically 3-5 days. The disease severity depends on the patient's condition and it ranges from mild upper airway infection to life-threatening pneumonia or bronchiolitis [7]. Clinically, Metapneumovirus infection is often indistinguishable from RSV infection, particularly in the pediatric population, and common symptoms include hypoxemia, cough, fever, upper and lower airway infections and wheezing [8]. hMPV infant patients are often hospitalized for bronchiolitis and pneumonia [9]. In young adults, a flu-like syndrome with fever may occur in a small number of instances, but infection in geriatric subjects may cause severe clinical manifestations such as pneumonia and, in rare cases, death [10].

As described in this case, it was not surprising that antibiotics and corticosteroids were administered in most patients infected with Metapneumovirus mainly for two reasons: in most cases the specific diagnostic tests for hMPV are not carried out at admission and/or physicians prefer to continue steroid and antibiotic treatment to control potential unidentified bacterial infections in patients in which no etiological agent had been identified associated with hMPV infection. The overuse of these drugs could therefore be reduced through the adoption at admission of specific diagnostic tests for such etiological agent, especially if specific risk factors are present (age, immunodepression, etc.). In addition, the adoption of such tests could reduce the nosocomial spread of this virus, allowing an early isolation of the infected patient [11].

Conflicts of interest: The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript. Funding: The authors report no involvement in the research by the sponsor that could have influenced the outcome of this work.

Authors’ contributions : All authors contributed equally to the manuscript and read and approved the final version of the manuscript.

#Human Metapneumovirus #sars cov 2 #covid 19 #jcrmhs #Journal of Clinical Case Reports Medical Images and Health Sciences quartile

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topparamedicalcourse · 4 days ago

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Paramedical Studies: A Comprehensive Guide to Courses, Careers, and Opportunities in India

Paramedical studies play a crucial role in the healthcare sector, providing essential support to doctors and nurses in diagnosis, treatment, and patient care. As the demand for quality healthcare services rises, so does the need for skilled paramedics. In India, paramedical courses offer a gateway to various rewarding career opportunities in healthcare. This blog post explores the scope, types of courses, career prospects, and other essential information about paramedical studies in India.

What Are Paramedical Studies?

Paramedical studies encompass the training and education of healthcare professionals who assist doctors and nurses in clinical settings. Unlike traditional medicine, which requires extensive years of study, paramedical courses offer specialized training in specific fields such as radiology, medical lab technology, physiotherapy, and emergency medical services. These professionals are trained to diagnose diseases, provide patient care, and operate medical equipment, making them an integral part of the healthcare system.

Why Choose a Career in Paramedical Studies?

A career in paramedical studies offers numerous benefits:

High Demand for Paramedics: With growing healthcare needs, there is a steady demand for skilled paramedics in both urban and rural areas.

Shorter Duration of Study: Paramedical courses typically have shorter durations compared to traditional medical degrees, allowing students to enter the workforce quickly.

Diverse Career Opportunities: Paramedics can work in various sectors, including hospitals, diagnostic labs, rehabilitation centers, and emergency response teams.

Satisfying and Rewarding Career: Working in healthcare is fulfilling as it involves helping others and making a positive impact on their lives.

Popular Paramedical Courses in India

India offers a variety of paramedical courses catering to different interests and specializations. These courses can be classified into diploma, undergraduate, and postgraduate levels.

1. Diploma Courses in Paramedical Studies

Diploma courses are typically shorter in duration, ranging from 1 to 2 years, and are ideal for those looking to enter the workforce quickly.

Some popular diploma courses include:

Diploma in Medical Laboratory Technology (DMLT): Training in lab technology, sample collection, and testing.

Diploma in Radiology and Imaging Technology: Focuses on operating imaging equipment like X-rays, MRI, and CT scanners.

Diploma in Physiotherapy (DPT): Teaches skills to help patients recover from physical injuries.

Diploma in Emergency Medical Technology: Training to respond to medical emergencies and provide first aid.

2. Undergraduate Paramedical Courses

Undergraduate programs, such as Bachelor’s degrees, offer more in-depth training and are usually 3-4 years in duration. These courses offer better career opportunities and higher salary prospects.

Popular undergraduate paramedical courses in India include:

Bachelor of Science in Medical Laboratory Technology (BSc MLT): Comprehensive training in lab procedures, testing, and sample analysis.

Bachelor of Physiotherapy (BPT): In-depth study of physical therapy techniques, rehabilitation, and patient care.

Bachelor of Science in Radiology and Imaging Technology: Focuses on radiographic imaging and diagnostic techniques.

Bachelor of Science in Operation Theatre Technology (BSc OTT): Training for assisting during surgeries and operating theater management.

3. Postgraduate Paramedical Courses

For those interested in further specialization, postgraduate courses offer advanced training in specific areas of paramedical studies. A Master’s degree or a specialized diploma can help professionals move into research, education, or higher-level clinical roles.

Examples of postgraduate paramedical courses include:

Master of Science in Medical Laboratory Technology (MSc MLT)

Master of Science in Radiology and Imaging Technology

Master of Physiotherapy (MPT)

Postgraduate Diploma in Emergency Medicine

Eligibility Criteria for Paramedical Courses in India

The eligibility criteria vary depending on the level of the course:

Diploma Courses: Students need to have completed 10th or 12th grade with Science as a primary subject.

Undergraduate Courses: A 12th-grade pass with Physics, Chemistry, and Biology is usually required.

Postgraduate Courses: A Bachelor’s degree in a related field is necessary for admission.

Additionally, some institutions may require students to clear entrance exams for certain courses.

Top Institutes Offering Paramedical Courses in India

Numerous reputed institutions across India offer quality paramedical education. Some of the top institutes include:

All India Institute of Medical Sciences (AIIMS), New Delhi

Christian Medical College (CMC), Vellore

Tata Memorial Centre, Mumbai

Manipal Academy of Higher Education (MAHE), Manipal

Armed Forces Medical College (AFMC), Pune

Career Opportunities After Paramedical Studies

After completing a paramedical course, graduates can explore various job roles based on their specialization. Here are some prominent career paths for paramedics:

Medical Laboratory Technician: Work in laboratories, conducting tests and analyzing samples to aid in diagnosis.

Radiology Technician: Operate imaging equipment to capture images for diagnosis.

Physiotherapist: Assist patients in regaining mobility and managing pain through physical exercises and therapies.

Operation Theatre Technician: Help in preparing the operation theater, assist during surgeries, and ensure equipment sterilization.

Emergency Medical Technician: Provide pre-hospital care, respond to emergencies, and stabilize patients in critical conditions.

Expected Salary for Paramedics in India

The salary for paramedics varies based on the level of education, specialization, and experience. Here’s an overview of average salaries:

Entry-level Paramedic: ₹2.5 - ₹4 Lakh per annum

Mid-level Professional: ₹4 - ₹6 Lakh per annum

Experienced Paramedic: ₹6 - ₹10 Lakh per annum

Skills Required for a Successful Career in Paramedical Studies

A successful paramedic needs both technical knowledge and a set of personal qualities, such as:

Attention to Detail: Essential for diagnosing and providing accurate results in medical tests.

Compassion and Empathy: Working with patients requires a caring attitude and sensitivity.

Communication Skills: Clear communication with doctors, nurses, and patients is crucial.

Physical Stamina: Certain roles, such as emergency technicians and physiotherapists, require physical endurance.

Problem-solving Skills: Quick decision-making is often needed in emergency situations.

Future Scope of Paramedical Courses in India

The future of paramedical studies in India is promising. As healthcare infrastructure expands and the demand for healthcare professionals rises, the need for trained paramedics is expected to grow. The emergence of telemedicine and health-tech is also expanding the roles of paramedics, allowing them to work remotely or in innovative healthcare settings.

Conclusion

Paramedical studies offer a fulfilling and diverse career path for those interested in healthcare. With various options in terms of courses and specializations, students can choose a field that aligns with their interests and career goals. Whether you aim to work in a laboratory, assist in surgeries, or respond to emergencies, paramedical courses in India equip you with the skills and knowledge needed to excel.

Investing in paramedical education opens the doors to numerous job opportunities, career growth, and the satisfaction of contributing to society’s well-being. For aspiring healthcare professionals, paramedical studies provide an accessible, efficient, and impactful way to make a difference in people’s lives.

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fresherjobwala · 1 month ago

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ITBP ASI, HC, Constable Various Medical Post Recruitment 2024 – 20 Vacancies

Recruitment Authority: Indo-Tibetan Border Police Force (ITBP)Post Name: ASI, HC, ConstableTotal Vacancies: 20Application Start Date: 28/10/2024Application End Date: 26/11/2024 ITBP has announced a recruitment drive for various medical posts in 2024, including positions like ASI Laboratory Technician, Radiographer, OT Technician, Physiotherapist, Head Constable, and Constable. Candidates can…

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johnrame · 1 month ago

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High demand jobs in New Zealand for international workers

High-demand jobs in New Zealand refers to a profession or occupation where there is a significant need for workers due to various factors such as industry growth, technological advancements, societal changes, or shortages of skilled professionals. These jobs typically have more available positions than there are qualified candidates to fill them, leading to increased opportunities for employment. High-demand jobs often offer competitive salaries, job stability, and growth potential as employers seek to attract and retain talent in these critical areas.

High demand jobs in New Zealand for international workers

New Zealand has several high-demand jobs for international workers, especially in sectors where there is a shortage of skilled professionals. The government regularly updates a list known as the Skill Shortage List, which highlights these areas. Here is an overview of some of the high-demand jobs for international workers, from NZ part time jobs to seasonal farm jobs in NZ:

Healthcare and Medical Professionals

Doctors (General Practitioners and Specialists): New Zealand has a significant demand for healthcare professionals, especially in rural areas.

Nurses: Registered nurses are in high demand across the country.

Medical Technicians: Roles like radiographers, sonographers, and laboratory technicians are needed.

Construction and Engineering

Civil Engineers: Due to infrastructure development and earthquake recovery projects, there is a strong need for civil engineers.

Construction Managers: Overseeing building projects is critical, especially with ongoing urban development.

Surveyors and Quantity Surveyors: These roles are essential for construction and land development projects.

Information Technology (IT)

Software Developers and Programmers: The tech industry in New Zealand is growing, leading to a high demand for software developers.

Cybersecurity Specialists: As digital security becomes more important, professionals in this field are increasingly sought after.

Network and Systems Administrators: Maintaining and managing IT infrastructure is crucial for businesses.

Education

Early Childhood Teachers: There is a shortage of qualified early childhood educators in New Zealand.

Secondary School Teachers: Particularly in subjects like science, mathematics, and technology.

Trades and Technical Jobs

Electricians: With ongoing construction projects, skilled electricians are needed.

Plumbers and Gasfitters: These trades are essential for both residential and commercial construction.

Mechanics: Automotive and heavy machinery mechanics are in demand, especially in rural areas.

Agriculture and Forestry

Farm Managers: New Zealand's strong agricultural sector requires skilled farm managers.

Agricultural Scientists and Technicians: These roles support the agricultural industry with research and innovation.

Forestry Workers: The forestry sector, important to New Zealand's economy, needs skilled workers.

Hospitality and Tourism

Chefs: As tourism is a major industry, there is a consistent demand for skilled chefs.

Hotel Managers: Managing accommodations and hospitality services is critical for tourism.

Tour Guides: With New Zealand's natural beauty attracting tourists, knowledgeable guides are needed.

Finance and Business

Accountants: As businesses grow, there is a need for qualified accountants.

Financial Analysts: Helping businesses make informed financial decisions is a key role.

Human Resource Professionals: Managing talent and organisational culture is crucial for companies.

Pathways for International Workers

Skilled Migrant Category: This visa pathway allows skilled workers to live and work in New Zealand permanently.

Essential Skills Work Visa: Issued to those who have a job offer in New Zealand and whose skills are in demand.

Accredited Employer Work Visa: If you are hired by an accredited employer, you may qualify for this visa.

Regional Demand

Auckland: The largest city with strong demand in IT, healthcare, and construction.

Wellington: Known for government jobs, IT, and creative industries.

Christchurch: Strong demand in construction and engineering, especially post-earthquake rebuilding efforts.

Rural Areas: Higher demand for healthcare, education, and agriculture-related jobs.

New Zealand's labour market is dynamic, and the demand for certain jobs can change. Therefore, it is advisable to check the most recent Skill Shortage List and consult with New Zealand immigration authorities or professional advisors when considering moving for work.

How to find high demand jobs in New Zealand

Finding high-demand jobs in New Zealand involves researching and utilising various resources that provide up-to-date information about the labour market. Here are some steps to help you find high-demand jobs in New Zealand:

Check the Skill Shortage Lists

Essential Skills in Demand (ESID) Lists: New Zealand's government publishes these lists, which identify occupations with shortages of skilled workers. The lists include:

Long Term Skill Shortage List (LTSSL): Occupations that are in demand long-term across New Zealand.

Regional Skill Shortage List (RSSL): Occupations that are in demand in specific regions.

Construction and Infrastructure Skill Shortage List (CISSL): Jobs needed for ongoing infrastructure projects.

You can view these lists on the New Zealand Immigration website.

Use Online Job Portals

Seek New Zealand: A popular job portal where you can search for jobs by industry, location, and skill level. Check the "in-demand" or "featured" jobs sections.

Trade Me Jobs: Another major job portal that lists various job vacancies, including those in high demand.

Indeed, New Zealand: A global job search engine that aggregates job postings from various sources.

LinkedIn: Use LinkedIn to search for jobs and connect with recruiters and companies in New Zealand.

Consult Recruitment Agencies

Specialised Agencies: Many recruitment agencies in NZ specialise in industries like healthcare, IT, construction, and finance. They can provide insights into high-demand roles and help you find job opportunities.

Online Search: Look for recruitment agencies that cater to your field of expertise, such as Hays, Michael Page, or Robert Walters.

Follow Industry News and Reports

MBIE Reports: The Ministry of Business, Innovation, and Employment (MBIE) in New Zealand publishes regular reports and labour market updates. These can help you identify trends and high-demand sectors.

Industry Associations: Join professional associations in your industry. They often have job boards, networking events, and reports on industry trends.

Network with Professionals

Attend Job Fairs and Expos: These events are a great way to meet employers, learn about job openings, and understand industry demand.

Join Professional Networks: Online platforms like LinkedIn can help you connect with professionals in your field who can provide advice or referrals.

Explore Regional Opportunities

Consider Regional Needs: Some high-demand jobs are more prevalent in certain regions of New Zealand. For instance, healthcare and agriculture jobs might be more available in rural areas, while IT and finance roles are more concentrated in cities like Auckland and Wellington.

Research Visa and Immigration Options

Skilled Migrant Category (SMC) Visa: If your skills are in demand, you may be eligible for this visa, which allows you to live and work in New Zealand permanently.

Work to Residence Visa: If you have a job offer in a high-demand occupation, you might qualify for a visa that leads to permanent residence.

Check Company Career Pages

Direct Applications: Many companies in New Zealand post job openings on their own websites. If you are interested in working for a particular company, check their careers page regularly.

Large Employers: Consider large companies or those known for hiring international talent, like Fonterra, Air New Zealand, or Fisher & Paykel Healthcare.

By utilising these resources, you can stay informed about which jobs are in high demand in New Zealand and position yourself to find employment in your desired field.

#jobs #Careers #employment #recruitment

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noidainternationaluniversity · 6 months ago

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Allied health sciences by Noida International University

In the vast realm of healthcare, there exists a domain that plays a pivotal role in supporting the backbone of medical services Allied Health Sciences. Amidst the bustling educational landscape, Noida International University stands as a beacon for aspiring healthcare professionals, offering a comprehensive platform to delve into this dynamic field. Let's embark on a journey to unravel the significance and allure of Allied Health Sciences at Noida International University.

Understanding Allied Health Sciences

Before delving into the specifics, it's crucial to grasp the essence of Allied Health Sciences. Often referred to as the "hidden healthcare workforce," professionals in this domain work collaboratively with physicians, nurses, and other specialists to deliver holistic patient care. Allied Health Sciences encompass a spectrum of disciplines ranging from medical laboratory technology and radiology to physiotherapy and nutrition.

Noida International University: A Nexus of Excellence

Noida International University (NIU) stands tall as an epitome of academic excellence and innovation. Situated in the vibrant city of Noida, India, NIU has carved a niche for itself in the realm of healthcare education. With state-of-the-art infrastructure, experienced faculty, and a commitment to fostering holistic development, NIU provides an ideal breeding ground for aspiring healthcare professionals.

Diving into the Curriculum

At NIU, the Allied Health Sciences program is meticulously crafted to equip students with the requisite knowledge, skills, and competencies demanded by the industry. The curriculum strikes a fine balance between theoretical learning and practical exposure, ensuring that students are well-prepared to navigate the complexities of the healthcare landscape upon graduation.

From anatomy and physiology to diagnostic techniques and therapeutic interventions, students undergo comprehensive training across various disciplines. Moreover, hands-on training in well-equipped laboratories and clinical settings further enhances their proficiency and confidence, enabling them to seamlessly transition into the professional realm.

Beyond the Classroom: Opportunities and Beyond

While academic rigor forms the cornerstone of education at NIU, the university goes the extra mile to provide students with ample opportunities for experiential learning and professional development. Collaborations with leading healthcare institutions, internships, and industry interactions enable students to gain real-world insights and establish valuable connections within the healthcare fraternity.

Furthermore, NIU fosters a culture of research and innovation, encouraging students to explore new frontiers in Allied Health Sciences through projects and scholarly pursuits. This not only broadens their horizons but also equips them with critical thinking and problem-solving abilities essential for addressing the evolving challenges in healthcare.

Embracing the Future

As we stand at the precipice of a new era in healthcare, the role of Allied Health Sciences becomes increasingly indispensable. With advancements in technology, changing demographics, and emerging healthcare trends, the demand for skilled professionals in this domain is poised to soar.

Noida International University, with its unwavering commitment to excellence and innovation, continues to nurture the next generation of Allied Health professionals who will drive positive change and innovation in healthcare.

In conclusion, Allied Health Sciences at Noida International University isn't just an academic pursuit; it's a transformative journey that empowers individuals to make a meaningful impact in the world of healthcare. Whether you aspire to become a radiographer, physiotherapist, or clinical laboratory scientist, NIU provides the perfect platform to realize your dreams and shape a brighter, healthier future for generations to come.

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peoplesuniversitybhopal · 7 months ago

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Empowering Healthcare Heroes: Unveiling Bhopal's Premier Paramedical Colleges

In the realm of healthcare, paramedical professionals play a crucial role in supporting doctors and nurses, ensuring efficient patient care and recovery. Bhopal, renowned for its rich heritage and cultural diversity, also stands as a beacon of excellence in paramedical education. Aspiring healthcare heroes seeking to make a difference in people's lives are drawn to the top paramedical college in Bhopal, where knowledge meets compassion and excellence thrives. Let's embark on a journey to discover these esteemed institutions and their contributions to the healthcare landscape.

Paramedical College in Bhopal:

Nestled amidst the serene surroundings of Bhopal is a institution dedicated to shaping the future of paramedical professionals –People's College of Paramedical Science & Research Centre, People's University. This paramedical college in Bhopal offer a diverse range of programs, catering to various disciplines within the paramedical field, including medical laboratory technology, radiography, physiotherapy, and more. With modern infrastructure, experienced faculty, and hands-on training, students are equipped with the skills and expertise needed to excel in their chosen profession.

Best Paramedical College in Bhopal:

When it comes to excellence in paramedical education, one institution stands out as a shining example –People's College of Paramedical Science & Research Centre, People's University. Renowned for its comprehensive curriculum, ultra-modern facilities, and industry partnerships, this best paramedical college in Bhopal sets the benchmark for paramedical education in the region. With a focus on practical learning and clinical exposure, students graduate with the confidence and competence to meet the evolving needs of the healthcare industry.

Empowering Healthcare Heroes:

Paramedical colleges in Bhopal play a pivotal role in nurturing the next generation of healthcare professionals, empowering them to become frontline warriors in the battle against disease and disability. From diagnosing medical conditions to administering treatments and therapies, paramedical professionals work tirelessly to ensure the well-being of patients and communities. Through rigorous training, experiential learning, and mentorship, these colleges prepare students to tackle real-world challenges with compassion, integrity, and professionalism.

Fostering Excellence and Innovation:

The best paramedical college in Bhopal goes beyond traditional pedagogy to foster innovation and leadership among its students. Here, emphasis is not just placed on academic excellence but also on critical thinking, problem-solving, and research skills. With opportunities for internships, workshops, and industry collaborations, students are exposed to cutting-edge technologies and best practices, enabling them to stay ahead of the curve in a rapidly evolving healthcare landscape.

Driving Positive Change:

Paramedical professionals trained at colleges in Bhopal are not just caregivers but also agents of change within their communities. Through community outreach programs, health camps, and awareness campaigns, they strive to improve health outcomes and promote preventive healthcare practices. With a deep-rooted commitment to serving humanity, these professionals are making a tangible difference in the lives of individuals and families across Bhopal and beyond.

In conclusion, Bhopal stands as a beacon of excellence in paramedical education, offering a conducive environment for aspiring healthcare heroes to pursue their passion and make a positive impact on society. Whether seeking to become medical laboratory technologists, radiographers, physiotherapists, or any other paramedical professional, students can find their ideal educational pathway amidst the vibrant academic landscape of this historic city. With the best paramedical colleges in Bhopal leading the way, the journey towards a rewarding career in healthcare becomes not just attainable but also immensely fulfilling.

#best paramedical college in bhopal #paramedical college in bhopal

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jcmicr · 1 year ago

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Spontaneous Rupture of Wandering Spleen: Case Report by Mina Alvandipour in Journal of Clinical and Medical Images, Case Reports

Abstract

Keywords: Spleen; wandering spleen; ectopic spleen; splenic rupture.

Introduction

A wandering spleen is a rare clinical occurrence with fewer than 500 cases reported and an incidence of less than 0.2% [1]. wandering spleen is caused by either extreme laxity or absence of the normal ligaments that anchor the spleen to the left upper quadrant. Gravity also plays a role by allowing the spleen to descend into the lower abdomen attached by its vascular pedicle [2]. Symptoms depend on the degree of torsion and range from chronic abdominal pain in mild torsion to acute pain in severe torsion and infarction. Accurate clinical diagnosis is difficult because of the rarity of the condition and non-specific symptoms. Radiological evaluation includes usage of ultrasound, Doppler, abdominal CT or MRI depending upon availability or preference [3]. A wandering spleen can be either congenital or acquired. In the congenital condition the ligaments fail to develop properly, whereas in the acquired form the hormonal effects of pregnancy and abdominal wall laxity are proposed as determining factors .However, the precise etiology of the wandering spleen is not known [1]. We present a spontaneous rupture of a wandering spleen with severe torsion and infarction and abdominal pain without any history of trauma.

Case Report

A 25 years old female present to emergency unit with 2 week history of progressive abdominal pain, recurrent constipation ,vomiting and loss of appetite. There was no history of melena, fever, and hematochezia and weight loss. On examination there was periumbilical and epigastria tenderness and a firm and tender mass in the right side of the abdomen without muscle guarding and rebound tenderness. The vital sign and laboratory results were all within the normal ranges, except decreased hematocrit (hemoglobin-8.4). The plain abdominal radiograph was un-remarkable while abdominal ultrasonography with color Doppler showed absence of spleen in its normal location in the left upper abdomen. Also it detects a heterogeneous hypoechoic capsulated mass with diameter of 175mm in right lower abdomen. Other organs of the abdomen were normal. Abdominal pelvic CT scan with and without contrast was recommended and findings was Absence of the spleen in its normal position in the left hypochondrium, and presence of large diameter mass (splenomegaly)in the right sub hepatic area(Wandering spleen) . Other organs of the abdomen were normal. Contrast-enhanced computed tomography (CECT) of the abdomen revealed whirlpool sign near the umbilicus. The splenic parenchyma showed abnormal enhanced areas, suggestive of splenic torsion and infarction.

A final diagnosis was wandering spleen with torsion of the vascular pedicle and infarction. The patient underwent a total splenectomy. During the laparotomy, an enlarged and infarcted mass was seen in right side of abdomen. The characteristic “whirlsign” can be seen in the area of the splenic vascular pedicle, indicative of torsion. Histological examination confirmed total infraction of the wandering spleen. The postoperative course was uneventful, and the patient was discharged on the 4th day after the operation.

Discussion

A wandering spleen is a rare but well-known entity. The incidence is < 0.2%. It is more common in females than males between the second to fourth decade of life and children [4]. Splenic weight >500 g in more than 8 out of 10 cases [5]. Interestingly, it has been reported that one out of three cases of wandering spleen appears in children bellow the age of 10 years old [7].

Wandering is characterized by splenic hyper mobility that results from elongation or mal-development of its suspensory ligaments. It is also known as aberrant, floating, displaced, prolapsed, ptotic, dislocated or dystopic spleen. Ectopic spleen, splenosis and accessory spleens are separate clinical entities and must be distinguished from it [5]. If the pedicle is twisted in the course of movement of the spleen, blood supply may be interrupted or blocked, resulting in severe damage to the blood vessels .Acute splenic torsion compromises venous outflow, which causes congestion and impairment of arterial inflow. Pain is originated from the splenic capsular stretching with rapid splenic enlargement and localized peritonitis [6]. Etiology is congenital or acquired. In case of congenital anomaly, a failure occur in fusion of the dorsal mesogastrium with the posterior abdominal wall during the second month of embryogenesis. Acquired risk factors that predispose to wandering spleen include pregnancy, trauma and splenomegaly [7]. Splenic torsion is usually clockwise. Complications of splenic torsion include: gangrene, abscess formation, local peritonitis, intestinal obstruction and necrosis of the pancreatic tail, which can lead to recurrent acute pancreatitis [8].

Wondering spleen had nonspecific symptoms such as abdominal pain that make diagnosis extremely challenging. As a result, radiologists play a major role in the diagnosis of this condition and its complications. Torsion may occur acutely and present with infarction or peritonitis. Chronic intermittent torsion can lead to pain, splenomegaly, and functional splenectomy. Contrast-enhanced computed tomography (CT) is the best imaging tool to make this diagnosis, although ultrasound may be used as well. Imaging findings on CT include identification of a spleen in an abnormal location, or with an abnormal orientation in the left upper quadrant. Often the wandering spleen is identified as a “comma” shaped mass in abdomen, with no normal left upper quadrant spleen [9].

Laboratory investigations are non-specific. Thrombocytopenia, through a mechanism of spleen enlargement secondary to compression of the splenic pedicle is rarely found [7]. The clinical presentation of wandering spleen is variable; it is either asymptomatic or noted incidentally during physical and radiographic examination or presents as acute abdomen due to torsion with subsequent infarction. The most common presentation is a mass with non-specific abdominal symptoms or intermittent abdominal discomfort due to congestion resulting from torsion and spontaneous detorsion [10]. Today, the only recommended treatment for wandering spleen is operation [7]. Splenectomy is indicated for infracted spleen and sometimes for huge splenomegaly precluding splenopexy. Splenopexy is the choice of treatment if the spleen is not infarcted [6]. Splenic preservation is highly recommended for young patients—those under one year of age up to those in their thirties—who are at particular risk for overwhelming post-splenectomy sepsis [10]. This should be appropriately followed up by the prophylactic vaccines against post-splenectomy sepsis syndrome. Ideally they should be administered before surgery; however, in emergencies this is not always possible [1].

Conclusion

In this case, splenectomy was done due to spleen infarction. Laparotomy was done in this case because of low experience at laparoscopy splenectomy. This report highlights the investigations and management necessary for a patient who presents with an ischaemic torted wandering spleen.

Acknowledgement: None.

Conflict of Interest: None.

Funds: None.

For more details : https://jcmimagescasereports.org/author-guidelines/

#Spleen #wandering spleen #ectopic spleen #splenic rupture #Radiological #ultrasonography #Contrast-enhanced computed tomography #laparotomy #laparoscopy #Mina Alvandipour #JCMICR

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aihsw · 2 years ago

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BSc Radiology in Bangalore

AIHS BSc Radiology in Bangalore

If you're looking to pursue a BSc Radiology in Bangalore, there are a lot of options available. The first is to attend a training course that will lead to accreditation and placement. After that, you can go on to look for an institute that offers a degree in radiology. In this article, we'll tell you more about the courses available and the opportunities for career growth in India and abroad.

Accreditation

Radiography is a field of medicine that combines imaging and radiation therapy to produce images of body organs. It is also an essential part of the healthcare team, with radiography technicians performing a wide range of tasks in a variety of hospital settings.

ACR accreditation accredits medical imaging facilities in the United States, and is a great way to make sure you are getting the best care possible. The ACR has accredited more than 38,000 facilities in ten different imaging modalities since 1987.

There are a number of ways to become a radiographer. Several universities offer graduate and undergraduate programs. In addition to earning a master's or PhD, radiographers can pursue a career in medical research, telemedicine, or clinical trials.

The medical imaging industry is booming. Many radiographers have positions in super specialty hospitals or nursing homes. But, the most important role a radiographer can play is patient care. They are able to evaluate radiographic images, and modify standard procedures to meet the needs of patients.

Courses offered

The Acharya Institute of Health Sciences is a prominent medical education institute located in Bangalore, India. This institution offers various undergraduate and graduate programs in health sciences. Its campus features advanced infrastructural facilities.

AIHS is affiliated to Rajiv Gandhi University of Health Sciences and recognized by IAP. Students studying at AIHS get value-based and industry-oriented training. As a result, the students are well equipped to take up nursing and other health science careers.

Acharya Institute of Health Sciences and Nursing offers paramedical and nursing courses, in addition to medical imaging technology. The campus also has a career guidance cell that facilitates placements.

X-rays have revolutionized treatment of patients. Radiographers use non-ionizing radiations and ultrasound to scan images of the patient. These pictures are used to diagnose diseases. Moreover, radiographers are required to have good problem-solving skills.

The bsc mit course at AIHS prepares aspirants to work in hospitals, forensic laboratories, and other healthcare organizations. Students study subjects like gamma rays, nuclear medicine, and other basic concepts of radiations.

Placements

There are many reasons why students choose to pursue the BSc Radiology course. One of the main reasons is the high demand for these professionals in the medical field. The salary packages offered by top institutions are also very good.

Students of the course receive firsthand training on various techniques and equipment. They are also provided with career counseling by the class coordinators and faculty members. This proactive learning style has helped alumni stars to perform well in a demanding environment.

During the placement season, AIHS holds interviews for the students. These interviews are conducted on all campuses. All the candidates are selected based on their performance and aptitude. A selection committee may also conduct aptitude tests.

AIHS has an excellent placement cell that works on the student's behalf to help them secure the best job opportunities. Most of the students are able to land the job of their choice. Moreover, the institute maintains a near 100% placement record.

Career opportunities for radiographers in India and overseas

Radiographers are part of a healthcare team that uses imaging techniques to diagnose and treat patients. They may use X-rays, ultrasounds, and positron emission tomography (PET) to detect diseases. These professionals help patients heal and live healthy lives.

With technological advances in the medical field, the need for radiologists is on the rise. Radiologists can work in hospitals, health care facilities, or clinics. This means they have the flexibility to work on a full-time or part-time basis. A radiology career can be rewarding and exciting.

During their education, radiographers are taught the technical aspects of imaging techniques. They also learn to interpret the images and explain the procedures. In addition, they can specialize in a variety of areas. Some radiologists choose to work in research. Other radiographers work with interventionists to provide treatment for certain diseases.

#bsc mit course #BSc MIT Colleges in Bangalore #BSc Radiology Colleges in Bangalore #bsc mit

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jcrmhscasereports · 2 years ago

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Emerging infectious agents: an unusual case of Metapneumovirus pneumonia in an adult patient by Greco GF in Journal of Clinical Case Reports Medical Images and Health Sciences

ABSTRACT

KEYWORDS

Human Metapneumovirus; SARS-CoV-2; Covid-19.

CASE HISTORY

DISCUSSION

Authors’ contributions : All authors contributed equally to the manuscript and read and approved the final version of the manuscript.

For more information: https://jmedcasereportsimages.org/about-us/

For more submission of articles: https://jmedcasereportsimages.org/

#Human Metapneumovirus #SARS-CoV-2 #Covid-19 #Metapneumovirus pneumonia #Emerging infectious agents #Greco GF #jcrmhs #casereports

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mcatmemoranda · 2 years ago

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In general, the diagnosis of osteomyelitis is established via culture obtained from biopsy of the involved bone. A diagnosis of osteomyelitis may be inferred in the following circumstances (see 'Overview' above):

•Clinical and radiographic findings typical of osteomyelitis and positive blood cultures with a likely pathogen (such as Staphylococcus aureus); in such cases, bone biopsy is not required but may be useful, particularly if subsequent therapeutic debridement is needed.

•Bone histopathology consistent with osteomyelitis in the absence of positive culture data (particularly in the setting of recent antibiotic administration).

•Suggestive clinical and typical radiographic findings and persistently elevated inflammatory markers, in circumstances with no positive culture data and a biopsy is not feasible.

●Patients with suspected osteomyelitis should undergo laboratory evaluation (including erythrocyte sedimentation rate, C-reactive protein, white blood cell count), blood cultures, and radiographic imaging. In patients with ≥2 weeks of symptoms, conventional radiography is a reasonable initial imaging modality. In patients with <2 weeks of symptoms, an advanced imaging modality (magnetic resonance imaging, computed tomography, or nuclear imaging) should be pursued. Advanced imaging is also warranted for patients with diabetes, localized symptoms, and/or abnormal laboratory results whose plain radiographs are normal or suggestive of osteomyelitis without characteristic features. Osteomyelitis is unlikely in the absence of radiographic evidence on advanced imaging. (See 'Clinical approach' above.)

●Findings of osteomyelitis on radiographic imaging should prompt bone biopsy for culture and histology to confirm the diagnosis and to guide antimicrobial therapy, unless blood cultures are positive for a likely pathogen (such as S. aureus, a gram-negative enteric rod, or Pseudomonas aeruginosa). (See 'Clinical approach' above.)

#osteomyelitis

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refcco · 3 years ago

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BATTERIES GONE WRONG – ASSESSMENT, MITIGATION, AND EXPECTATIONS

In the world of product safety, it could be said that there are two basic approaches to risk mitigation, proactive and reactive, with proactive being the preferred choice. Most would agree with the adage that “an ounce of prevention is worth a pound of cure,” but in truth, this oversimplifies the reality in which product manufacturers operate. As with most things in life, things are rarely black and white but rather a continuous spectrum of shades of gray. To this, there are many competing aspects in all commercial product ventures. Could you make a product that was fully reliable under all conditions? Perhaps, but the odds are that it would be a commercial failure as it would take an inordinate amount of time to produce and be prohibitively expensive. In today’s market, the traditional characteristics of safety, time to market, quality, cost, reliability, manufacturability, testability, and usability (to name a few) still apply. But these have been further augmented by more modern concerns of environmental impact, sustainability, social responsibility, and others. We mention these not to offer any judgment but only to note that the expectation that a product will perform flawlessly over its lifecycle is a difficult proposition given the myriad of competing needs. The battery industry is no different when it comes to satisfying market requirements. With batteries having become ubiquitous in our daily lives as the world has migrated to all things becoming portable, the challenge for providers of these products has increased. With the advent of high-energy, rechargeable lithium-ion chemistries, battery performance has dramatically increased, but so have the risks. No longer are battery packs simple devices. In most modern electronic products, they are better characterized as complex components of an integrated system with one key difference – most other components of such systems rarely have the ability to spontaneously overheat and burn (i.e., go to “thermal runaway”) with little to no warning, potentially resulting in personal injury, product damage, and the associated legal and market liabilities.

HOW DO WE ASSESS BATTERY SAFETY RISKS? In focusing on the safety risks, what are the options for risk mitigation in the battery space? Ideally, these begin early in the design phase. Clearly, there is no substitute for a good design using high-quality components. In the world of batteries, safety-critical components such as the cell, safety circuit, and passive protective devices such as fuses, positive temperature coefficient (PTC) devices, and other thermal devices are the initial focus. Mechanical considerations also come into play to help ensure that the cell is accommodated within its specified limits including levels of protection against reasonably foreseeable external use conditions. To ensure that such efforts are yielding the desired result, testing of both the components and the battery pack assembly is key, covering the aspects of safety as well as long-term reliability and performance. This testing should be initiated early in the product development process so that, if issues are uncovered, there is the time and flexibility to adjust the design, followed by retesting to verify the efficacy of the changes and to ensure that other problems were not inadvertently introduced. As the development process progresses, production samples should be built and evaluated to understand if manufacturing variations can create unanticipated safety risks. In many cases, this design-build-test-adjust process is performed by the component and battery pack manufacturers and is sometimes augmented by external testing laboratory resources. For more complex systems, the end-device manufacturer may also be involved early in the process to ensure system aspects do not negatively impact battery safety.

TESTING BATTERIES FOR REGULATORY APPROVAL As the design stabilizes, regulatory approval at the battery pack level is usually the next layer of risk mitigation. A key input to this process is the approval of the component cell as it represents the greatest single safety risk. Regulatory testing typically involves small sample sizes and is not meant to serve as a statistically significant sample size to find outliers in a large population but rather is meant to find gross issues such as design or process defects that have escaped detection in the early stages of product development. Common testing protocols involve a combination of electrical, mechanical, and thermal overstress. Some involve the application of faults to better assess the inherent safety robustness of the battery pack. Other tests attempt to evaluate the product for stresses that might be common to a specific industry or use case. At a minimum, battery packs will be tested to the transportation requirements found in UN 38.3. Testing to one of the 62133-2 series of standards (IEC, EN, UL) is also commonly performed and is required for regulatory approval in many global markets. Testing to such standards is usually conducted by accredited third-party testing laboratories with the end result being the authorized application of the testing lab’s mark to the product. This approval facilitates regulatory acceptance by government authorities and may also be a prerequisite for commercial entities such as retailers and distributors to offer the product for sale. Some approvals also require periodic post-market inspection of production facilities to ensure the design is still being manufactured as originally qualified. Infrequently, a testing laboratory or regulatory agency may mandate retesting when significant changes to the relevant test standards are implemented.

THE CHALLENGES OF BATTERIES AS END-PRODUCT COMPONENTS The discussion up to this point is intended as background for what is typically done in a normal battery pack product development cycle. The level to which these actions are implemented directly correlates to a base level of risk mitigation for safety events once the product is released into the market. This does not mean that there are any guarantees that there won’t be field problems, but the level of exposure is certainly reduced as more product safety information is proactively discerned and addressed. What if the battery pack is simply a purchased component and the purchaser was not involved in the design process and may not even have any visibility into the production of the battery pack? Similarly, what if the purchaser is procuring an end device that has an embedded battery pack? These are both very common situations for retailers and distributors who typically have very limited internal engineering resources. Certainly, buying such products from reputable sources and checking for the presence of the requisite safety marks is a good start, but is it sufficient? Modern supply chains are global. Therefore, discerning where a product was manufactured and by whom can be a challenge in itself. This means that regardless of the actual manufacturer’s liability, a retailer’s or distributor’s brand can be put in jeopardy by a single video posted on social media that quickly goes viral. How can product risk be mitigated in this situation? The general answer is to work backward beginning with production samples. A product teardown of new product samples by a knowledgeable third party can aid in assessing what risks exist with purchased products where the detailed design knowledge is not available. Although every product is different, an evaluation of a product from a portable energy safety perspective might include such items as: • Verification of any regulatory marks on the product. Was the testing actually done and is the regulatory status current? • Evaluation of insulating methods including their integrity and consistency • Evaluation of conductor sizing • Review of manufacturing quality indicators that might equate to latent defects • Review of the safety circuit or other protective devices for proper operation under abnormal conditions such as over-voltage, over-current, short-circuit, and under-voltage • Review of the charging circuit design. Does it subject the battery or cell to improper conditions? • Determination of the cell manufacturer and type. This also includes an assessment of whether the cell might be counterfeit • Cell examination (radiographs and/or CT scans), teardown, and construction analysis • Review of the mechanical design of the product in terms of its ability to protect the safety critical components • End-user instructions and safety warnings

WHAT ABOUT BATTERY PERFORMANCE ISSUES? In addition to a review of safety concerns, performance relative to competing market options should be evaluated through benchmarking. This is typically done in parallel with the safety review and is focused on how a user is expected to employ the product in expected use cases. Competing samples are drawn from the market ensuring that they are of the same price tier to ensure that the comparisons are valid. A custom evaluation plan is drafted and might involve visual inspections, functional checks, and even comparisons of long-term electrical or mechanical reliability. Many times, the criteria are drawn from marketing assertions as shown on the products’ packaging. Examples might include the number of hours that the device will operate in a given mode before needing to be recharged and how long that recharge might take. The evaluation can also go much further, perhaps considering the relative drop performance from a given height or the number of charge-discharge cycles before a loss of function is detected. As a general rule, safety concerns tend towards the absolute given the nature of such risks to people and property. Conversely, performance concerns lend themselves towards a more relative evaluation against other competing market options.

ANTICIPATING THERMAL RUNAWAY RISKS Given the above processes for minimizing risks through proper design or post-production design evaluations, are there other proactive risk mitigation actions that warrant consideration from a product safety perspective? Consider this – even if all of the above steps are followed with the best of intentions, what happens if things still go wrong? More specifically, what is the effect to the end product and nearby users if a cell goes into thermal runaway when the device is in use? Second, what happens if a cell goes into thermal runaway during the transportation and shipping process? Most designers can only guess as definitively knowing what happens is rarely directly investigated. To answer these questions, there are two general methodologies. Simulation is an option but requires very advanced electrochemical and thermal modeling. Our experience is that this tends to be cost-prohibitive for most organizations and thus is only seen in relatively large companies where such expertise is available in-house. What about direct testing? Like simulation, it has barriers for implementation as well, the most obvious being concerns related to personnel safety and expertise, as well as having the appropriate facilities to provide the proper test containment of high-energy events while being able to document their effects. With the right facilities and expertise available, a determination must be made about how to force the cell or battery into thermal runaway. Overcharging and surface heating are two common methods, although the design of the product and the chemistry of the cells will guide what method is most appropriate. Other considerations for such testing involve what data is to be collected and how. Video evidence is considered by most clients to be the most useful. It should be further supported by appropriate logging of relevant temperatures and possibly other product parameters, as well as forensic documentation of the actual effects to the end-product. Once again, the goal is to use the information obtained to determine if design improvement should be made to minimize the chances of personal injury or property damage during a thermal runaway event. Although the above is presented in a relatively clinical fashion, the danger of injury and property damage is very real. Depending on the energy level of the particular sample, an exploding cell can produce temperatures above 1200 °C (2192 °F) and deadly shrapnel particularly in the case of large-format cells with metal cans. Readers are strongly cautioned to not attempt such testing without the proper expertise and containment equipment.

THE IMPORTANCE OF FAILURE ANALYSIS Designing and testing cells and batteries properly from a safety perspective, including understanding the impacts should a thermal runaway event occur, are the best risk mitigation tools that we have at our disposal. Even with those best proactive efforts, things will still go wrong. The real question is how often. True failure rates for cells and batteries are not publicly available as companies keep such information confidential. But anecdotally, high-quality lithium-ion cells have a rough order of magnitude (ROM) failure rate somewhere around 1 in 10 million, while lesser quality cells are likely to have poorer field performance. With over eight billion cells being produced globally every year, the math is inescapable that bad things will happen. These factors make clear the importance of using retrospective methods to gain insights into what happened, how it happened, and why it happened. These methods collectively fall under the heading of lithium battery failure analysis. Failures in the field can happen at any point in the battery’s life cycle and can vary significantly in severity and frequency. Responses to such issues also vary accordingly, ranging from simply replacing a product under warranty to retrieval of the product for a full forensic evaluation. For minor issues, it may be determined that a product change is not warranted. Conversely, safety issues may mandate a full product recall and rework of the design. In the end, failure analysis actions provide after-the-fact knowledge for organizations from which to make decisions that will impact future risk.

THE VALUE OF THIRD-PARTY EXPERTISE Like thermal runaway testing, cell and battery failure analysis involves expertise, processes, and tools that may not be readily available to most organizations. Because of the uniqueness and the infrequency of need, expertise tends to be primarily resident in third-party test labs that specialize in portable energy. Conducting cell and battery failure analysis through an expert third party offers a number of benefits, including: • Reduction of personal bias: A third-party test lab has no vested interest in the outcome of the analysis, nor do they have intimate knowledge of the product or company’s history. • Independent verification: A third-party lab can help to independently verify the findings of an internal team or a supplier. • Resource utilization: As noted previously, field safety events are generally an infrequent occurrence. Having an internal team staffed with the proper expertise and equipment to respond to such a rare event is generally not possible or even desirable. • Diligence: In the most severe of cases such as potential product recalls, it may be valuable for the company to have an independent party involved to minimize negative perceptions regarding objectivity. • Focus: Having failure analysis conducted by an external party may permit the company’s internal teams to remain focused on the day-to-day operations of their mainline business. • Process rigor: An external testing lab will have already developed the processes and methods for orderly evaluation and documentation of field failures, with specific expertise in evidence preservation. • Breadth of experience: Because of their focus on failure analysis spread across multiple clients over time, a third-party testing lab will generally have a wider range of technical experience when it comes to what constitutes typical versus atypical findings.

WORKING WITH A THIRD-PARTY EXPERT When working with a third-party failure analysis provider, you will be asked to provide more than the failed unit to facilitate the investigation. It is important to be as open and honest as possible. Your provider should be accustomed to handling confidential materials and should be willing to work under a non-disclosure agreement (NDA) to protect all proprietary information. In terms of the supplemental information, basic product information is the starting point. This might include specifications and similar documents to support the work along with any relevant details regarding product history. These will not be used to prematurely assume conclusions, but rather to supplement the physical evidence and help prioritize the investigatory efforts. Information on the specific unit along with incident details are also very important to piecing together what happened. How was the unit configured? Was it operating in a particular mode? Did the unit demonstrate anything unusual prior to the event? It is best to provide all of the information that is available and let the failure analysis team draw their own conclusions regarding relevance. It is important to realize that as the investigation moves forward, the relevance of such information may change as more information is learned. The actual failed units will need to be delivered to the laboratory. In this situation, more is better. It is possible that there may be multiple failure modes at play and having additional samples may help to isolate these. It is also important to preserve the evidence as much as possible by limiting unnecessary handling, examining, or actual tampering which might further damage the unit and lead to erroneous findings. Proper packaging is a must. It is best if all components of the reported system can be provided, i.e., the failed cell or battery, the end-device if applicable, charging devices and cables, etc., as it is possible that the root cause of the failure may have been external to the cell or battery that failed. Samples should be marked or segregated so that it is clear which components go together. In addition to the failed systems, it is also good if a fully functional new system can be provided for purposes of comparison. What should you expect from your third party expert? Every investigation is unique, and your provider should work with you to generate a project scope that meets your needs, and they should limit their efforts to that scope. Considerations include specific concerns, communication frequency, deliverables, and budget. Be aware that the actual work of failure analysis involves a mix of analytical tools such as fault tree analysis (FTA) combined with empirical methods such as x-ray imaging, CT scanning, optical microscopy, product dissection (battery pack and cell teardowns), quantitative measurement, circuit testing, and replication testing. Not every tool is appropriate for every situation. Your provider will provide guidance on these technical aspects. In the end, your provider should provide your team a clear, unbiased analysis report that details the investigation and its associated findings. What should you not expect from your provider? First, don’t expect speculation. This is a “just the facts” activity. If the evidence doesn’t support it, your provider shouldn’t be offering it up. Second, keep in mind that not every investigation yields the root cause or even the true failure mode. Depending upon the condition of the evidence and nature of the incident, it simply may not be feasible to reach this level of understanding. Conversely, the efforts may seek to eliminate likely root causes thus narrowing the possibilities. Third, don’t expect your provider to tell you if this issue will repeat in the future. A risk analysis to predict the likelihood of future failures requires a different set of information, although data from the failure analysis investigation may serve as key inputs into that analysis. Finally, don’t expect your provider to tell you what actions to take, although the root cause data from your provider may serve as a basis for your team to make those decisions.

FINAL THOUGHTS In conclusion, there is a wide array of proactive and reactive steps that can be taken to minimize and mitigate product risks associated with modern lithium-ion cells and battery packs. On the front end, these include the proper design for safety, use of high quality cells and components, thorough testing from the component to the system level to include thermal runaway evaluations, and third-party certifications where appropriate. When problems do occur in the field, consider the engagement of a reputable third-party failure analysis organization that specializes in cells and batteries. Their team of experts can help to assess what happened, how it happened, and possibly even why the incident occurred. In turn, your organization can use this information to objectively determine appropriate responses, both immediate and longer-term, to mitigate risk to your customers, your product, and your brand.

#product safety consulting UL consulting compliance certification. SEMI S2 CE Marking

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iheartvmt · 5 years ago

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Feline Infectious Peritonitis

• Other names: FIP

• Cause: Feline coronavirus.

- Most cats are infected with feline coronavirus (up to 50% of cats in single cat households will test positive for coronavirus antibodies; that percentage jumps to 80-90% in multi-cat environments)

- Most feline coronavirus infections cause no or minor symptoms (some people call the virus at this point "feline enteric coronavirus"), and the cat is able to clear the infection. However, cats can be re-infected if exposed again.

- In <5-10% of infected cats, the infection progresses to clinical FIP. This occurs due to a mutation of the virus (at this point some people refer to the virus as "feline infectious peritonitis virus," or FIPV) combined with an aberrant immune response that results in the white blood cells transporting the virus throughout the cat's body, and a subsequent intense inflammatory reaction around vessels in the tissues where these infected cells locate, often in the abdomen, kidney, or brain.

• Species: Domestic cats, and most members of the Felidae family (cheetahs in captivity are especially susceptible)

• Transmission: FIP is not contagious from cat to cat, but when one cat in a household develops FIP, it's likely that all in-contact cats will have already been exposed to the same initial feline coronavirus. However, as a precaution it's not recommended to allow a naïve cat to have contact with a cat that has FIP.

- Transmission of feline coronavirus is via direct contact, fecal-nasal/oral route, and fomites (coronavirus can remain viable in an average household or shelter/cattery environment for days to weeks, or even months if the conditions are cool and dry). Rarely spread can also occur by aerosized droplets from sneezing, or transplacentally.

- Most cats cease shedding the virus after a few months, but about 13% of cats will continue to shed the coronavirus for life.

- In large multi-cat environments, about 40-60% of cats will be shedding the virus in their feces at any given time, and cats will continue to pass the infection back and forth.

- Most cats contract coronavirus either from their infected mothers when they are kittens or through sharing litter boxes with infected cats.

• Signs:

- Any cat that carries coronavirus is potentially at risk for developing FIP. Most cats show no symptoms during the initial infection, but some develop mild signs such as sneezing, watery eyes, nasal discharge, vomiting, or diarrhea.

- Weeks, months, or even years after the initial exposure, a small percentage of cats will develop FIP

- Cats with weak immune systems are most likely to develop FIP (kittens, especially if weaned eay, cats infected with feline leukemia virus or feline immunodeficieny virus, stressed cats, geriatric cats).

- Most cats that develop FIP are under two years of age or over 12 years, but any age cat can be affected.

- FIP is more common in intact cats, especially males

- FIP is relatively uncommon in the general cat population. However, the disease rate is much higher in multiple-cat populations, such as shelters, pet stores, and catteries due to increased viral exposure, likelihood of concurrent diseases, and stress

- Persians, Australian mist, Abyssinian, Bengal, Birman, British shorthair, Himalayan, Ragdoll, Scottish folds, and Rex breeds are more likely to develop FIP

- Littermates of cats with FIP have a higher likelihood of developing FIP than other cats in the same environment

- Once FIP symptoms develop, severity generally increases over the course of several weeks, ending in death.

- First signs are usually vague and nonspecific: hyporexia/anorexia (however some cats may have normal or increased appetite), weight loss, depression, lethargy, rough hair coat, and fever.

- May be icteric

- Two major forms: effusive ("wet") and noneffusive ("dry")

- Noneffusive form: usually progresses slower than effusive; chronic weight loss, depression, anemia, and a persistent fever that does not respond to antibiotic therapy. Often involves severe inflammation and granulomatous changes in one or more organs, such as the eyes, brain, liver, intestine; signs will vary based on which organ(s) affected. If the lungs are involved, thoracic radiographs may show patchy densities in the lungs. Enlarged mesenteric lymph nodes, irregular kidneys, or nodular irregularities in other viscera can sometimes be palpated. CNS signs may be present (ataxia, nystagmus, seizures, intention tremors, hyperesthesia, behavioral changes, visual deficits, loss of menace reflex, lameness, progressive ataxia). Finding hydrocephalus on a CT scan is suggestive of neurologic FIP (75% of cats with neurological FIP have hydrocephalus on necropsy). Ocular lesions include retinal lesions, (granulomatous changes on the retina, retinal hemorrhage or detachment), uveitis, change in color of the iris, hemorrhage into the anterior chamber of the eye, buildup of inflammatory cells in the anterior chamber of the eye, leading to keratic precipitates. Intestinal lesions or pyogranulomas may occur, leading to omental/visceral adhesions, lymphadenopathy, diarrhea, vomiting, and/or obstruction.

- Effusive form: Most common, and usually progresses rapidly. Symptoms similar to dry form early on, then patient also develops ascites, resulting in a pot-bellied appearance. A fluid wave may be present in severe cases. Fluid may also accumulate in the chest (less common; causes muffled heart sounds, EKG changes, and increased respiratory signs). Eventually the fluid accumulation makes it difficult for the cat to breathe normally, and if pericardial effusion is present, cardiac tamponade can occur.

• Diagnosis: Difficult due to wide variance in clinical signs, which often overlap with many other diseases

- Generally presumptive based on history, clinical signs, cytology of effusion fluid (if present), and ruling out other diseases

- CBC and blood chemistry changes: WBC may be decreased or increased (Lymphopenia + neutrophilia common), nonregenerative anemia, increase in total serum protein, increased globulins, low albumin, low albumin:globulin ratio, hyperbilirubinemia (in absence of hemolysis), icterus, increased liver enzymes, increased serum AGP, increased serum amyloid A (SAA), other laboratory parameters can be variably increased depending on the degree and localization of organ damage

- Ultrasound may be normal or may show lymphadenopathy, peritoneal or retroperitoneal effusion, renomegaly, irregular renal contour, hypoechoic subcapsular echogenicity, and diffuse changes within the intestines.

- Abdomenocentesis -- fluid typically clear, straw yellow with a sticky consistency; protein content is very high, cellular content is low (cytology often consists predominantly of macrophages and nondegenerate neutrophils in much lower numbers than with bacterial infection). If the albumin to globulin ratio of the fluid is >0.81, FIP can be ruled out.

- Rivalta's test: "To perform the test, a transparent reagent tube (10 mL) is filled with ~8 mL distilled water, to which 1 drop of acetic acid (highly concentrated vinegar, 98%) is added and mixed thoroughly. On the surface of this solution, 1 drop of the effusion fluid is carefully layered. If the drop disappears and the solution remains clear, the Rivalta’s test is defined as negative.If the drop retains its shape, stays attached to the surface, or slowly floats down to the bottom of the tube (drop- or jelly-fish-like), the test is defined as positive. Rivalta’s test has a high PPV (86%) and a very high NPV (96%) for FIP. Positive results can sometimes be seen in cats with bacterial peritonitis or lymphoma." (Merck Veterinary Manual) If the test is negative, it's likely safe to rule-out FIP

- Cerebrospinal fluid (CSF) from cats with neurologic signs may be normal or may have increased protein and pleocytosis (neutrophils, lymphocytes, and macrophages)

- ELISA, IFA, and virus-neutralization tests detect the presence of coronavirus antibodies, but cannot differentiate between the various strains of feline coronavirus. A positive result means only that the cat has had a prior exposure to coronavirus, not that the coronavirus has mutated into FIPV.

- In advanced disease, there is also the risk of false negative results due to antibodies being bound into complexes that aren't detectable by laboratory tests.

- PCR to detect viral genetic material in tissue or body fluid (presently only capable of detecting coronaviruses in general, not necessarily those that cause FIP)

- Only way to definitively diagnose FIP is by biopsy or examination of tissues at necropsy: "H&E-stained samples typically contain localized perivascular mixed inflammation with macrophages, neutrophils, lymphocytes, and plasma cells. FCoV can be identified by immunohistochemistry in the macrophages within the lesions. Pyogranulomas may be large and consolidated, sometimes with focal tissue necrosis, or numerous and small. Lymphoid tissues in cats with FIP often show lymphoid depletion caused by apoptosis." (Merck Veterinary Manual)

• Treatment: Once a cat develops clinical FIP, the disease is progressive and always fatal. Some treatments may induce short-term remissions in a small percentage of cats, but eventually the disease will result in death.

- Euthanasia [most humane option in my professional opinion]

- Palliative options if owner is unwilling to euthanize: supportive care (nursing care, nutritional support, fluid therapy, blood transfusions, draining accumulated fluids), corticosteroids, cytotoxic drugs, antibiotics

- Currently further research is being done to explore new, effective treatment options, but unlikely that anything will be available to clinical practitioners any time soon.

• Prevention:

- Keeping cats as healthy as possible and minimizing exposure to infectious diseases can help decrease the risk of FIP in multiple-cat environments: locate litter boxes away from food and water dishes, remove feces from litter boxes daily, thoroughly clean and disinfect litter boxes regularly; quarantine new cats and any cats suspected of infectious disease; prevent overcrowding; ensure cats are well-vaccinated, and provide proper nutrition, environmental enrichment, and treatment for any illnesses that occur.

- Some sources recommend avoiding bringing kittens (who have greatest risk of developing FIP) into an environment with a recent history of FIP if possible

- Some sources recommend waiting at least 2-3 months after the death of an FIP cat before bringing new, naive cats into the environment if possible

- In shelters and in multicat environments with >10 cats, feline coronavirus is endemic and FIP is almost inevitable. "Households of <5 cats may spontaneously and naturally become FCoV-free, but in households of >10 cats per group, this is almost impossible because the virus passes from one cat to another, maintaining the infection. In these FCoV-endemic environments, such as breeding catteries, shelters, foster homes, and other multicat homes, there is virtually nothing to prevent FIP." (Merck Veterinary Manual)

- To decrease the risk of FIP, some breeding catteries practice an early (<5-6 weeks old) weaning protocol. To be successful, this depends on strict isolation procedures including separate caretakers and air space, low numbers of cats, and intense socialization of kittens to prevent subsequent behavioral problems from being removed from their mother at such a young age [Also deliberately taking kittens away from their mothers that young may be legally considered animal cruelty depending on local animal welfare laws!]

- Some breeding catteries focus on increasing genetic resistance to FIP in their lines by removing cats from their breeding program if 2 or more litters they sired or birthed contain kittens that developed FIP.

- Some breeding catteries test for feline coronavirus and remove all positive cats; others remove only cats that prove through sequential testing to be chronic viral shedders. Once the cattery is free of feline coronavirus, care must be taken to test and quarantine all incoming cats to ensure the virus is not reintroduced to the cattery.

- FIP vaccine available but ineffective. Efficacy is questionable to start with, plus most cats have already been infected by the time the vaccine can be administered (16 weeks). Additionally, the vaccine causes a positive antibody titer, further complicating diagnosis or testing to maintain a coronavirus-free environment.

Sources:

• Feline Infectious Peritonitis

https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/feline-infectious-peritonitis

• Feline Infectious Peritonitis

https://vcahospitals.com/know-your-pet/feline-infectious-peritonitis

• Overview of Feline Infectious Peritonitis

https://www.merckvetmanual.com/generalized-conditions/feline-infectious-peritonitis/overview-of-feline-infectious-peritonitis

• FIP kitten https://commons.m.wikimedia.org/wiki/File:FIP_kitten.jpg#mw-jump-to-license (image source)

• Feline Infectious Peritonitis https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951549

• Feline infectious peritonitis: Strategies for diagnosing and treating this deadly disease in young cats http://veterinarymedicine.dvm360.com/feline-infectious-peritonitis-strategies-diagnosing-and-treating-deadly-disease-young-cats

•Feline Infectious Peritonitis/Feline Coronavirus (FIP/FCoV) https://www.sheltermedicine.com/library/resources/?utf8=%E2%9C%93&site=sheltermedicine&search%5Bslug%5D=feline-infectious-peritonitis-feline-coronavirus-fip-fcov

• Feline Infectious Peritonitis (FIP)

http://muncity.blogspot.com/2013/08/feline-infectious-peritonitis-fip.html?m=1 (image source only)

[This disease is especially heartwrenching for me every time we see a case in my clinic... When I was about 7 or 8 years old, my family lost our kitten, Cuddles, to effusive FIP. While she wasn't the first pet I had who passed away, she was the first one we had to euthanize, and I still remember that appointment every time we put an FIP kitty to sleep. I definitely hugged my guys a bit tighter while doing this write-up 😢 Doc and I hope that by the time we retire, the new research into FIP will have yielded a clinical treatment affordable for our clients!]

#veterinary #vet tech #cat #infectious disease #diseases #feline infectious peritonitis #FIP

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theinformationpedia-blog · 5 years ago

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Board of trustees framed to turn out 5G Innovation

ISLAMABAD: The Federal Ministry of Federal Ministry of Information Technology and Telecommunication Wednesday framed a board of trustees to give a guide to turning out 5G innovation in Pakistan.

As per a freebee gave by the service, the '5G Pakistan Plan Committee' would build up an essential arrangement and guide to present the most recent innovation in Pakistan by figuring working gatherings for improvement of 5G range administration telecom foundation and audit of telecom guidelines including wellbeing security and 5G applications and use cases.

The advisory group will include individuals from its Ministry, Pakistan Telecommunication Authority (PTA), Frequency Allocation Board (FAB) Prime Minister's SRIU (Strategic Reforms Implementation Unit), PM's Task power on IT, and delegates from telecom the scholarly world, versatile cell administrators, and telecom merchants.

Zong said 5G would bring significant and long haul changes to Pakistan's economic transformation, social advancement, and individuals' job improvement in the future. "It is normal that 5G will affect medicinal services, horticulture, and instruction."

Prior, Zong, China Mobile Pakistan (CMPak), effectively directed preliminaries of its 5G remote system — the principal 5G preliminary in Pakistan.

NASA finds Earth-sized planet in 'Goldilocks zone'

NASA said Monday that its planet tracker satellite TESS had found an Earth-sized world inside the tenable scope of its star, which could permit the nearness of flowing water.

Named "TOI 700 d", the planet is generally near-Earth — just 100 light-years away, NASA's Jet Propulsion Laboratory declared during the yearly American Astronomical Society meeting in Honolulu, Hawaii.

"The TES was planned to detect Earth-sized planets close to stars clearly, and this was carried forward," said Paul Hertz, head of NASA's astronomy division.

At first, TES rated the stars incorrectly, which meant that the planets were more prominent and more moving than them. Be that as it may, some early astronomers, including secondary school educator Alton Spencer - who work with the TESS group - recognized the error.

Emily Gilbert, a former University of Chicago student, said, "When we corrected star parameters, the planets' steps dropped, and we realized that the distances were about the size of the Earth and the actionable zone. Was. "

Spitzer Space Telescope later confirmed this disclosure.

Surprisingly, other comparable planets have been found by the earlier Kepler space telescope. However, this is the core found by TES, which was rolled out in 2018.

The TES maintains a balance in an area of the sky to distinguish whether objects - planets - move before the stars, causing a small drop in the brightness of the stars. It allows TES to establish its proximity to the world, its size, and its scope.

Star TOI 700 is very low, which is 40% of our sun size and half of the sweaters.

TESS found three planets in the circle called TOI 700 b, c, and d. Only the "D" is reportedly in the usable zone, not too far from the star nor too far, where the temperature allows it to get closer to the flowing water.

It is about 20 to 20 percent larger than the Earth and surrounds its star in 37 days. "D" receives 86% of the vitality that the Earth receives from the sun.

It is not yet clear what D is made of. Experts have developed models based on the size and configuration of the star, to anticipate the air management and surface temperature of the D.

In one production, NASA explained, the planet was "canvassed into the sea with a thick, carbon dioxide command climate as researchers speculate that Mars surrounded it in its youth."

Like the case of the moon and the Earth, the planet is tilted with stars, which means that one side is always facing the edge. This synchronous turn implied that, in another model, one side of the planet was always canvassed in mists.

A third reenactment anticipated an all-land world, where winds stream from the planet's clouded side to its light one.

Many stargazers will watch the planet with different instruments, to get new information that may coordinate one of NASA's models.

Man-made consciousness tantamount to specialists at bosom malignant growth analysis

A PC program can recognize bosom malignant growth from routine sweeps with more prominent exactness than human specialists, analysts said in what they trusted could demonstrate a leap forward in the battle against the worldwide executioner.

Bosom disease is one of the most widely recognized malignant growths in ladies, with in excess of 2,000,000 new judgments a year ago alone.

Normal screening is imperative in recognizing the most punctual indications of the ailment in patients who show no undeniable manifestations.

In Britain, ladies more than 50 are encouraged to get a mammogram like clockwork, the consequences of which are investigated by two free specialists.

Yet, translating the sweeps can leave space for mistake, and a little level of all mammograms either return a bogus positive — misdiagnosing a solid patient as having malignancy — or bogus negative — missing the malady as it spreads.

Presently specialists at Google Health have prepared a man-made reasoning (AI) model to identify malignant growth in bosom checks from a huge number of ladies in Britain and the United States.

The pictures had just been checked on by specialists, all things considered, however dissimilar to in a clinical setting, the machine had no patient history to advise its conclusions.

Understand more: Intel makes chip to control quantum PCs

The group found that their AI model could foresee bosom malignant growth from the outputs with a comparable precision level to master radiographers.

Further, the AI demonstrated a decrease in the extent of situations where malignant growth was inaccurately recognized — 5.7 percent in the US and 1.2 percent in Britain, individually.

It additionally decreased the level of missed determinations by 9.4 percent among US patients and by 2.7 percent in Britain.

"The previous you recognize a bosom malignant growth the better it is for the patient," Dominic King, UK lead at Google Health, told AFP.

In Britain all mammograms are surveyed by two radiologists, a vital yet work escalated process. The group at Google Health likewise led tests contrasting the PC's choice and that of the main human sweep peruser.

"We consider this innovation such that supports and empowers a specialist, or a patient at last, to get the best result from whatever diagnostics they've had." PC 'second feeling'

In the event that the two analyses concurred, the case was set apart as settled. Just with grating results was the machine at that point requested to contrast and the second peruser's choice. Understand more: China correctional facilities researcher who quality altered infants

The investigation by King and his group, distributed in Nature, indicated that utilizing AI to confirm the principal human master analyst's finding could set aside to 88 percent of the remaining task at hand for the subsequent clinician." Discover me a nation where you can discover a medical caretaker or specialist that isn't occupied," said King.

"There's the open door for this innovation to help the current brilliant assistance of the (human) commentators." Ken Young, a specialist who oversees mammogram assortment for Cancer Research UK, added to the examination.

He said it was exceptional for its utilization of genuine conclusion situations from almost 30,000 sweeps.

"We have an example that is illustrative of the considerable number of ladies that may come through bosom screening," he said. "It incorporates simple cases, troublesome cases and everything in the middle."

The group said further research was required yet they trusted that the innovation would one be able to day go about as a "second sentiment" for malignant growth analyze.

#realme x50 5g #technology #world news #pakistan #zong 4g

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drmannimal · 6 years ago

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Veterinarian vs Veterinary Technician

So you’ve decided that you want to work in the veterinary field but you’re not quite sure if you want to become a veterinarian or a veterinary technician. This post is for you.

Both veterinarians and veterinary technicians are integral parts of the veterinary team. They work very closely together, and are both involved in patient care and client communication. How do they differ?

Education

Veterinary Technician - most veterinary technicians attend a two-year college program. This program does not require any prior post-secondary schooling.

Veterinarian - veterinarians must attend veterinary school, this is often four years. This program requires prior post-secondary education in North-America. Refer to my previous post for details on veterinary schooling.

Responsibilities

Veterinary Technician Throughout certain jurisdictions, technicians are referred to as veterinary nurses. While it is certainly not as simple as nurse vs doctor, that can be broad way of looking at the positions. Veterinary technicians perform a much wider range of duties than a human nurse as they are involved in every aspect of human care. Duties include: - positioning for and taking radiographs - drawing and running blood - performing laboratory tests such as urinalysis and fecal examination - medication administration - prepping patients for surgery - recovering patients form surgery - monitoring anesthesia - dental cleaning - client communication Duties do NOT include: - diagnosing - creating treatment plans - surgery

Veterinarian As the doctor, the responsibility of diagnosing and treating falls upon you. All diagnostic interpretation and treatment plans must come form the veterinarian. Veterinarians may create diagnostic or treatment plans for their technicians to then perform. Duties include: - all duties previously mentioned under technician (depending on the clinic, these duties may be shared or placed solely under technicians) - interpreting laboratory tests (bloodwork, urinalysis, fecal examination etc) - interpreting radiographs - diagnosing patients - creating treatment plans - performing surgery - removing teeth during dentistry There are no duties that veterinarians cannot perform.

Pay

Pay will depend largely upon the area of the world that you work in. Veterinary technicians often do not make more than minimum wage, though raises and contract negotiations are possibilities. Veterinary salary ranges drastically depending upon a number of factors though median salary is approximated at $70-90,000 yearly.

Whether or not you know for sure which path to follow or you're not quite decided, spend some time in a veterinary clinic. Work with all members of the veterinary team. Ask them questions - what are their days like? do they like their job? pros and cons? Experience the running of a clinic and observe the different positions. Questions? Feel free to reply to this post or message me, I’m always here to help.

#veterinarian #vet #veterinary medicine #VetMed #vet school #vetschool #vetblr #veterinary #vet tech

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dentalinfotoday · 5 years ago

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I wrote a post in 2013 "Why are my crowns not fitting?" that was pretty clear in it's explanations, but that was 6 years ago. I don't do it much differently now but there are a few changes especially because of the different types of crowns that I am inserting. Emax (lithium disilicate) and Zirconium crowns are pretty easy to fit, assuming you start by giving the laboratory a good preparation and a clear impression that captures the entire preparation, including the full extent of the finishing line ( the crowns margin is supposed to end here). Preparations should not be too subgingival and the margin must be visible when taking an impression, whether an elastomeric or optical impression is taken. Once one of these crowns is fabricated, fitting should be relatively easy. First there can be no gingival tissue impinging on the margin and if it is than either it should be curetted off or retraction chord should be placed to keep it away from the margin. Care should be taken to carefully remove all temporary cement from the preparation to insure an intimate fit for the crown since little bits of leftover temporary cement can prevent full seating of all ceramic and zirconium restorations. The next thing to check is the tightness of the interproximal contacts on both sides. I seat the crown and then use unwaxed Johnson and Johnson floss to test my contacts. I start with the mesial contact and see if the floss goes through without breaking or shredding. I don't use waxed floss for this first step because it will often go through even overly tight contacts. This step is important because one of the common reasons even good fitting crowns won't seat is a overly tight contact. If my contact is tight , I dry the crown and place Accufilm IV liquid on the proximal contact surface of the crown. Once it drys, I reseat the crown and remove it and inspect the contact to see where the blue ink has been rubbed off. If I don't have access to this product ( when I am teaching at the dental school) I use a piece of Accuflim marking paper placed around the adjacent tooth when seating the crown. Either way I am able to visualize the place where I need to adjust my contact using a medium grit small greenstone wheel. I can do this repeatedly until my contact allows the unwaxed floss to pass through properly. At that point the contact is polished with a Brasseler grey wheel that has diamond impregnated in rubber. After the mesial contact is done I will proceed to chect the distal contact. Often a tight mesial contact will cause the distal to be tight as well, but when the mesial contact is corrected the distal will be less tight as well. The last thing to check is the occlusion. Although we dentists like to ask the patient to tell us whether the bite is good, it's not the best way to check, since they are numb and have difficulty judging the bite. Instead I try in the crown and ask them to bite. Then I remove the crown and ask them if their bite is better. I ask them to pay special attention to how the side of their mouth feels that is not numb, since this should still feel normal. Sometimes I have to run through this routine multiple times but eventually most patients can be taught to judge when the "bite" is correct using this technique. Of course I use marking paper to mark the occlusion and take care to dry the crown before doing so. Often I ask the patient to bite down and clench with moderate pressure and while they are closed I tug laterally on the paper, since this seems to ensure that the paper leave a noticeable mark. After I have checked the bite in normal occlusion, I also check it in lateral excursions, since if these contacts are high it can cause a porcelain fracture in the future since people's teeth contact in many positions when they are eating. Porcelain fused to metal crowns are often more difficult to fit since they are made with a lost wax technique and often the die can become abraded since wax will spring undercuts but the metal casting will not. When fitting a pfm crown , after I adjust my contacts I use GC fit checker to check for undesirable internal binding spots and to check for an intimate fit. If there are internal "drag" marks noticed , I relieve them using a small round bur at low speed. If I find that I need to relieve my internal casting I will repeat the application of fit checker until I am happy with the fit. An acceptable fit is one in which there is a thin uniform layer of fit checker along the margin of my casting. Ideally the thickness should be thin enough the the fit checker is translucent and allows the dentist to see the grey of the casting through the silicone fit checker. The final step, performed immediately prior to cementation, is to take a bitewing radiograph of the seated crown. I check that the crown covers my entire finish line and that there is no visible gap between the crown and the tooth. If the radiograph looks good I will then cement my patients crown. Although this process can take additional time, I find that it help ensure that my crowns fit well and once inserted, hopefully my patient will enjoy many years of service from their new restoration. from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2019/07/how-to-fit-crown-in-2019.html - http://lspindelnycdds.blogspot.com/

#Dentistry #Blog

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nurseslabs · 6 years ago

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Chest X-ray (Chest radiography, CXR) is one of the most frequently performed radiological examination. A chest x-ray is a painless, non-invasive test uses electromagnetic waves to produce visual images of the heart, lungs, bones, and blood vessels of the chest. Air spaces normally seen in the lungs appear dark on the chest films. A basic chest x-ray includes posteroanterior (PA) view, in which x-rays pass from the back to the front of the body, and a left lateral view. Other projections such as lateral decubitus, lordotic views, or oblique view can be requested also. For critically ill patients who cannot leave the nursing unit, a portable x-ray machine is performed at the bedside using anteroposterior (AP) projections with an addition of a lateral decubitus view if a free flow fluid or air is suspected.

Chest images should be examined in full inspiration and erect if feasible to reduce cardiac magnification and demonstrate fluid levels. Expiration images may be needed to identify a pneumothorax or locate foreign materials. Rib detail images may be taken to delineate bone pathology, helpful when chest radiographs illustrate metastatic lesions or fractures. In the onset of the disease process of asthma, tuberculosis, and chronic obstructive pulmonary disease, chest x-ray results may not correlate with the patient’s clinical status and may even be normal.

Nurses are responsible for ensuring the comfort of the patient while at the x-ray room since some may experience pain from injury or symptoms from a disease condition as well as the apprehension about what the result may show. In addition, producing a good quality image relies on the ability of the patient to cooperate such as holding breath for a period of time. Providing a calm and relaxed environment for the patient is indeed vital.

This diagnostic and laboratory procedure study guide can help nurses understand their tasks and responsibilities during a chest x-ray.

[toc]

Indications of Chest X-ray

Here are some of the reasons why a Chest x-ray is performed:

Assist in the diagnosis of diaphragmatic hernia, lung tumors, and metastasis

Detect known or suspected pulmonary, cardiovascular, and skeletal disorders

Identify the presence of chest trauma

Confirm correct placement and position of the endotracheal tube, tracheostomy tube, chest tubes, central venous catheters, nasogastric feeding tube, pacemaker wires, intraortic balloon pump, Swan-Ganz catheters, and automatic implantable cardioverter defibrillator

Evaluate positive purified protein derivative (PPD) or Mantoux test for pulmonary tuberculosis.

Monitor progressions, resolutions, or maintenance of disease

Evaluate the patient’s response to a therapeutic regimen (antibiotic, chemotherapy)

Contraindication

Chest X-ray is not advisable for:

Patients who are pregnant or suspected of being pregnant unless the potential benefits of a procedure using radiation outweigh the risk of maternal and fetal damage

Interfering Factors

These are factors or conditions that may alter the outcome of Chest X-ray:

Presence of metallic objects within the area of examination

Excessive or unnecessary movements made by the patient during the procedure

Incorrect position of the patient, which may produce poor exposure of the area to be examined

Inability of the patient to take full inspiration

Improper adjustment of the radiographic equipment to serve thin or obese patients, which can result in underexposure or overexposure of the films

Procedure

The procedure for chest x-rays is as follows:

Items are removed Patients will be asked to remove any clothing, jewelry, or other articles that may interfere with the study.

Appropriate clothing is given Patients will be provided by an X-ray gown to wear.

Positioning the patient The patient in a standing or sitting position will face the cassette or image detector with hands on hips, inhale deeply, hold one’s breath until the X-ray image is made. For a lateral view, the chest is position on the left side against the image holder with hands raised above the head.

Images are taken The x-ray technician will stand behind a protective shield while the films are being developed within a few minutes.

Nursing Responsibilities for Chest X-ray

The following are the nursing interventions and nursing care considerations for the patient

Before Chest X-ray

The following are the nursing interventions prior to chest x-ray:

Remove all metallic objects. Items such as jewelry, pins, buttons etc can hinder the visualization of the chest.

No preparation is required. Fasting or medication restriction is not needed unless directed by the health care provider.

Ensure the patient is not pregnant or suspected to be pregnant. X-rays are usually not recommended for pregnant women unless the benefit outweighs the risk of damage to the mother and fetus.

Assess the patient’s ability to hold his or her breath. Holding one’s breath after inhaling enables the lungs and heart to be seen more clearly in the x-ray.

Provide appropriate clothing. Patients are instructed to remove clothing from the waist up and put on an X-ray gown to wear during the procedure.

Instruct patient to cooperate during the procedure. The patient is asked to remain still because any movement will affect the clarity of the image.

After Chest X-ray

The nurse should note of the following nursing interventions after chest x-ray:

No special care. Note that no special care is required following the procedure

Provide comfort. If the test is facilitated at the bedside, reposition the patient properly.

Normal Results

Normal findings in a chest x-ray will show a:

Normal lung fields, cardiac size, mediastinal structures, thoracic spine, ribs, and diaphragm

Abnormal Results

The following abnormalities can be seen on a chest x-ray test. These includes:

Atelectasis (collapse or incomplete expansion of pulmonary parenchyma)

Bronchitis (inflammation of the bronchial tube)

Cardiomegaly (enlargement of the heart)

Flattened diaphragm associated with hyperinflation of the lung (indicator for COPD)

Foreign bodies lodged in the pulmonary system as seen by a radiopaque object

Irregular patchy infiltrates in the lung fields (suggestive of pneumonia)

Lung tumors (irregular and abnormal white shadow on the lung fields)

Malposition of tubes or wires

Misalignment or break of bones (indicating fracture)

Pericardial effusion (fluid accumulation around the heart)

Pericarditis (inflammation of the pericardium)

Pleural effusion (fluid accumulation within the pleural space)

Pneumothorax (presence of air within the pleural space)

Pulmonary bases, infiltrates, fibrosis,

Scoliosis (curvature of the spinal column)

Swollen lymph nodes

Tuberculosis (patchy, nodular infiltrates usually located on the upper lobe lung fields; cavities in the lung)

Widened mediastinum (suggesting neoplasm or aortic aneurysm)

Gallery

Images and photographs related to chest x-ray:

This slideshow requires JavaScript.

References and Sources

Additional resources and references for this Chest X-ray nursing study guide:

Suzanne C. Smeltzer. Brunner & Suddarth’s Handbook of Laboratory and Diagnostic Tests: Lippincott Williams & Wilkins

Dan L. Hobbs, M.S.R.S., R.T.(R)(CT)(MR): Chest Radiography for Radiologic Technologists

Anne M. Van Leeuwen, Mickey Lynn Bladh. Laboratory & Diagnostic Tests with Nursing Implications: Davis’s

Swingler, G. H., & Zwarenstein, M. (2008). Chest radiograph in acute respiratory infections. Cochrane Database of Systematic Reviews, (1). [Link]

Chest X-ray (Chest Radiography) Nursing Care Management and Responsibilities

Chest X-ray (Chest Radiography) Chest X-ray (Chest radiography, CXR) is one of the most frequently performed radiological examination. A chest x-ray is a painless, non-invasive test uses electromagnetic waves to produce visual images of the heart, lungs, bones, and blood vessels of the chest.

#chest x-ray #Diagnostic Procedure #emphysema #expiration #Idiopathic scoliosis #inspiration #Nasogastric Tube #pericardial effusion #Pneumonia #pneumothorax #radiation #tuberculosis

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