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Objective Malnutrition is a common problem in patients with liver cirrhosis and tools for nutritional assessment are under debate. We conducted this study to assess prevalence of malnutrition in cirrhotic patients using PCM score and BIA. Additionally we compared BIA to PCM score for detecting malnutrition in this patient population. Results This was a cross sectional study conducted in two tertiary care hospitals of Karachi Pakistan on adults with liver cirrhosis. Malnutrition was assessed by PCM score using anthropometric measurements and biological specimens and (ii) Body cell mass was assessed using BIA. Malnutrition as estimated by the PCM score was present in 122 (73%) of patients in which most patients had mild malnutrition (n = 72 (45%)), followed by 34 (21%) with moderate malnutrition and 3 (1.9%) with severe malnutrition. Malnutrition according to BIA estimated through body cell mass could detect it in 98 (61%) of patients. There was optimal correlation of PCM score with body call mass (Pearson correlation coefficient = 0.3 (p value 0.001)). We conclude that majority of the patients with liver cirrhosis had malnutrition as determined by PCM score. BIA underscored the malnutrition in this patient population.

The photoelectric effects on the instability of the current-driven dust ion-acoustic (DIA) waves in a collisional and streaming dusty plasmas are theoretically investigated using fluid model with dust charge fluctuation considering dust grains as negatively charged. It is found that the photoelectric effects through dust charge fluctuation give the growth of the DIA waves beside the damping effects of collision and streaming of the plasma species. Growth rate of the DIA waves are numerically investigated using the values of appropriate plasma parameters.

Malnutrition is a common problem in patients with liver cirrhosis and tools for nutritional assessment are under debate. We conducted this study to assess prevalence of malnutrition in cirrhotic patients using PCM score and BIA. Additionally we compared BIA to PCM score for detecting malnutrition in this patient population. This was a cross sectional study conducted in two tertiary care hospitals of Karachi Pakistan on adults with liver cirrhosis. Malnutrition was assessed by PCM score using anthropometric measurements and biological specimens and (ii) Body cell mass was assessed using BIA. Malnutrition as estimated by the PCM score was present in 122 (73%) of patients in which most patients had mild malnutrition (n = 72 (45%)), followed by 34 (21%) with moderate malnutrition and 3 (1.9%) with severe malnutrition. Malnutrition according to BIA estimated through body cell mass could detect it in 98 (61%) of patients. There was optimal correlation of PCM score with body call mass (Pearson correlation coefficient = 0.3 (p value 0.001)). We conclude that majority of the patients with liver cirrhosis had malnutrition as determined by PCM score. BIA underscored the malnutrition in this patient population.

A steady, two-dimensional natural convection flow of a viscous, incompressible fluid having temperature-dependent viscosity and thermal conductivity about a truncated cone is considered. We use suitable transformations to obtain the equations governing the flow in convenient form and integrate them by using an implicit finite difference method. Perturbation solutions are employed to obtain the solution in the regimes near and far away from the point of truncation. The results are obtained in terms of the local skin friction and the local Nusselt number. Perturbation solutions are compared with the finite difference solutions and found to be in excellent agreement. The dimensionless velocity, viscosity and thermal conductivity distributions are also displayed graphically, showing the effects of various values of the pertinent parameter for smaller values of Prandtl number.

The effect of uniform suction on the steady two-dimensional laminar forced flow of a viscous incompressible fluid of temperature dependent viscosity past a wedge with uniform surface heat flux is considered. The governing equations for the flow are obtained by using suitable transformations and are solved by using an implicit finite difference method. Perturbation solutions are also obtained near the leading edge and in the downstream regime. The results are obtained in terms of the local skin friction coefficient and the rate of heat transfer for various values of the pertinent parameters, such as the Prandtl number, Pr, the velocity gradient parameter, m, the local suction parameter, ξ, and the viscosity variation parameter, ɛ. Perturbation solutions are compared with the finite difference solutions and are found to be in excellent agreement. The effect of ξ, m and ɛ on the dimensionless velocity profiles and viscosity distribution are also presented graphically for Pr = 0.7 and 7.0, which are the appropriate values for gases and water respectively.

In a trial comparing total hip replacement with resistance training in patients with severe hip osteoarthritis and an indication for surgery, hip replacement led to greater pain reduction and improved function at 6 months.

This study refers to the general reproductive biology of Osteochillus waandersii, and provides information about the sex ratio, gonad development stages, gonado-somatic index (GSI), length at maturity, fecundity, and growth pattern. The fish samples were collected monthly, between March and August 2018, from the Landak River, Kalimantan Province, Indonesia. A total of 234 specimens were collected using gillnets and dipnets, 136 males and 98 females, resulting in a 1.39:1 sex ratio, which is significantly different from the expected ratio of 1:1 (P<0.05). Males reached sexual maturity at a lower size than females, with a length at first maturity estimated at 137.9 mm for males and 140.3 mm for females. Analysis of the macroscopic and histological observations showed that testicles could be classified into four stages: immature, maturing, mature and spent. The GSI ranged between 1% and 9.54% and 1% and 11.67% for males and females, respectively. The ovaries were classified into five stages: immature or resting, maturing, mature, ripe, and spawned-recovering. The absolute fecundity varied from a minimum of 2130 to a maximum of 13640 eggs and a mean of 7165 eggs, corresponding to fish with total length between 145 to 177 mm and a weight between 30 to 67 g.

IntroductionExercise reduces systolic augmentation in the peripheral pulse wave, an effect similar to that produced by the nitric oxide (NO) donor nitroglycerin (NTG). The changes produced by exercise persist into the recovery period for >30 min. The aim of this study was to investigate if the exercise induced changes are dependent on endothelium-derived NO. We used the NO synthase inhibitor NG-monomethyl-L-arginine (L-NMMA) to test this.MethodsHealthy volunteers (n = 10, 5 female, aged 19 to 33 years) participated in a 2-phase randomised controlled cross-over study. L-NMMA (6 mg/kg i.v. over 5 min) and saline placebo were given immediately before exercise on two occasions separated by at least 5 days. Mean arterial blood pressure (MAP by Finopress), radial augmentation index (RAIx by SphgymoCor) and cardiac output (Innocor) measurements were made at baseline, during infusion of L-NMMA/saline immediately before exercise, during exercise (except for radial artery measurements) and during recovery. Peripheral vascular resistance (PVR) was calculated from MAP and cardiac output. During exercise, workload increased from 25 W to 150W by increments of 25W at 2min intervals.ResultsBefore exercise, L-NMMA increased mean arterial blood pressure (85.1±3.8 vs. 101.2±4.3 mmHg, P < 0.01), peripheral vascular resistance (16.4±0.7 vs. 24.7±1.7 mmHg/ml/min, P < 0.01) and RAIx (50.2±4.5 vs. 70.2±6.5%, P < 0.01) and decreased heart rate (65.6±5.7 vs. 49.1±2.8 bpm, P < 0.01). During and after exercise, heart rate, MAP and PVR were similar after L-NMMA and saline. However, L-NMMA attenuated the exercise induced fall in RAIx so that RAIx was higher after L-NMMA compared to saline at 15 min in recovery (49.5±5.3 vs. 36.0±4.4%, P < 0.02).ConclusionThese data suggest that, although endothelium derived NO has little effect in regulating PVR during/after exercise, it may have a role in mediating exercise induced changes in the pulse waveform.

IntroductionCentral and peripheral blood pressure and waveforms differ due to effects of wave reflection and amplification. Use of a mathematical transform function to predict central pressure remains controversial. It may be possible to estimate central systolic pressure directly from a peripheral waveform. We investigated this during cardiac catheterisation, examining the effects of pacing and nitroglycerin (NTG) on estimation of central systolic pressure from the peripheral pulse.MethodsPatients undergoing coronary angioplasty (n = 11, aged 48 to 72 years) participated. A Millar SPC-454D or fluid filled catheter was placed in the aortic root and a pacing wire in the right atrium. Peripheral digital arterial waveforms (Finometer) and aortic waveforms were obtained at baseline, during pacing at 20 bpm above resting heart rate and during administration of NTG (10 and 100 mg/min, i.v.).ResultsPacing and NTG produced marked changes in central and peripheral waveforms, reducing central augmentation index from 40.4±6.2 to 22.6±8.9% and from 40.4±6.2 to 12.7±7.0% for pacing and NTG 100 mg/min respectively (each P < 0.01). At baseline and during all interventions, there was a close correlation between central systolic blood pressure and absolute finger systolic pressure at the point of late systolic augmentation (R = 0.95, P < 0.0001). The mean difference between measured central aortic systolic BP and that estimated from digital pressure was 2.2 mmHg SD 6.2 mmHg.ConclusionsThese data suggest that central systolic blood pressure can be estimated directly from non-invasive finger pressure waveforms even during interventions such as pacing and NTG that produce a marked change in pressure waveforms.

This book provides new and seasoned users with step-by-step procedures on creating and modifying 3D models, working with cameras and lights, assigning materials to objects, rendering, and printing. Unlike many AutoCAD competitors, it uses both metric and imperial units to illustrate the myriad tools for this popular application. Use the companion CD to set up drawing exercises and projects and see all of the book's figures including color. This book includes 50 \"mini-workshops,\" that complete small projects from concept through actual plotting. Solving all of the workshops will simulate the creation of full projects (architectural and mechanical) from beginning to end, without overlooking any of the basic commands and functions in AutoCAD 2017.