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Purpose: To assess the significance of neutrophil-lymphocyte ratio (NLR) as an inflammatory indicator in patients with dry age-related macular degeneration (AMD). Study design: A retrospective case-control study.Methods: Clinical diagnosis along with complete blood count (CBC) results were extracted from hospital and laboratory information systems for patients with dry-AMD and age/gender-matched controls attending the ophthalmology clinic at King Abdulaziz medical city, Jeddah, Saudi Arabia, between 2018-2020. NLR was calculated by dividing the neutrophil by the lymphocyte count. Results: This study captured 90 patients diagnosed with dry-AMD and 270 control subjects without AMD. The mean of ages 70 and 71 years old for cases and controls, respectively. In univariate analysis, there were no significant differences in CBC results between cases and control. In NLR, dry-AMD patients have a slightly higher mean than the control group; however, this increase was not statistically significant (P-value 0.8). In the NLR model, age and gender were statistically significant factors affecting the NLR values in dry-AMD (P-value 0.03, 0.01 respectively). Conclusion: as a systemic inflammatory biomarker, NLR alone could not predict dry-AMD. However, the slight increase in the NLR values may be helpful if augmented with other laboratory measurements to aid in early disease prediction.

This paper summarises PhD research into wearable health devices and outlines three planned studies 1) a study of user and stakeholder opinions of updates, 2) a performance comparison of different device models from the same device ‘family’ and 3) a survey of clinical trial applications with an investigation of repeatability.

Background: Colonoscopy is considered the gold standard for most currently established screening programs for colorectal carcinoma (CRC), but due to its invasive nature, there were several emerging needs for the use of a substitutive, sensitive, non-invasive triaging modalities, such as utilizing immunochromatographic fecal occult blood tests (IFOBT) or molecular stool based tests such as Glycolytic M2-Pyruvate Kinase (M2-PK). Objectives: Firstly, to evaluate the sensitivity of a molecular stool based (M2PK) test, as a non-invasive, screening modality for detecting CRC and other colorectal disease (CRD). Secondary, to insight the current prevalence of CRC precursors in the Kingdom of Bahrain and recommend a customized age of enrollment in National Screening Program for CRC, once established and Thirdly, to compare the sensitivity of this fecal tumor marker based M2-PK test, as a potential replacement for the currently used IFOB test, in an attempt to promote for the need to establish a National Screening Program for Colorectal Cancer (NSPCC) based on such molecular based test or a similar platform in the kingdom, much comparable to the currently established international screening programs. Design: Prospective, cross sectional study. Duration and Place of Study: July 2012-December 2016, King Hamad University Hospital (KHUH), Bahrain. Sample Size: 2,100 (Based on Bahrain Population statistics: 1,248.348. Materials and Methods: The stool samples were collected shortly after launching a nationwide public awareness campaign against CRD in all major governmental and private sector hospitals and clinics. Out of the intended 2100 target samples, 1074 individuals managed to go through the well-structured distributed questioner and have been selected according to the inclusion/exclusion criteria and submitted their stools' samples for the detection of any CRD. A combined (molecular M2-PK and IFOBT) stool tests were used to detect any CRD in all examined stool samples. A total of 105 M2-PK' positive and 85 M2-PK'negative individuals underwent a subsequent specialist consultation and a fast track colonoscopy. Results: Out of the intended 2100 study sample, 1552 Participants were obtained during the study period and out of those, 1199 have been selected based on the inclusion and exclusion criteria. The no-show selected participants were 624 and only 575 individuals have submitted their Stool samples along with fully completed questioners. Out of those 575, only 287 stool samples were positive with M2-PK test, while 197 of the same stool samples were positive with IFOBT. Among these positive cases, only 105 of participants agreed after their medical consultation to undergo for full colonoscopies and biopsies for microscopic examination. These 105 successful full colonoscopies reveled 85 (81%) individuals negative for any neoplastic lesion and only 20 individuals (19%) showed neoplastic lesion. These 20 neoplastic findings included, 17 (85%) adenomatous polyps, 02 (10%), adenocarcinomas, and 01 (5%) was neuroendocrine carcinoma. The 17 adenomatous polyps were 09 tubular adenomas, 01 villous adenoma, and 07 tubulovillous adenomas. The colonoscopy findings in those (85) negative cases for neoplastic lesion were (6) hemorrhoids, (13) hyperplastic polyps, (10) normal mucosae with normal biopsies, (9) diverticulosis, (1) angiodysplasia, (1) inflammatory bowel disease and (1) solitary rectal ulcer. Conclusion: The screening of CRC by Stool Based molecular test such M2-PK showed high sensitivity for the detection of neoplastic Colorectal lesions compared to IFOBT. The study also found that stool based molecular (M2-PK) test, is a rapid, non-invasive, and convenient technique, which can be used as a platform for a forthcoming CRC National Screening Program in the Kingdom of Bahrain.

In the context of the need for an increasing share of renewables in electricity mixes, the paper presents the existing RES mix, PV and wind, for partially covering the electricity consumption of a research institute, ICSTM, and proposes a solution for completion with a third form of RES, a small hydropower plant. Moreover, it is envisaged to include the proposed small hydropower plant as a new real-scale laboratory attached to ICSTM. The method includes the presentation of an existing proposal for increasing installed capacity in new PV panels and propose to install an SHPP to a weir situated a few hundred meters from the institute. The hydropower potential for two possible arrangements is assessed and some types of turbines suitable for this location are presented. The main results demonstrate that building an SHPP is a better solution for completion of PV and wind as source of electricity for ICSTM. The main conclusion of the paper is that by installing new RES capacities, ICSTM can build a real-scale laboratory for new technologies, at the same time fully covering its own electricity consumption and even supplying a green electricity mix into the national power system.

Background: the joint replacement surgery is a great advance in the orthopedic medicine with a longlife promise of knee or hip reconstructive surgery which may exceeds 20 years old. Objectives: this study aimed to evaluate the knowledge of community Saudi adults regarding the joint replacement surgery in Jeddah City, Saudi Arabia (KSA), 2017. Methods: this was across sectional community based survey and it was conducted from May to August 2017 in Jeddah city among 670 adult Saudi subjects who were interviewed at shopping malls and community pharmacies. All the respondents answered a self-administrated questionnaire that considered the knowledge of respondents toward joint replacement therapy. Results: all the subjects heard before the term joint replacement therapy and the major source of information was from friends and relatives. Only nine subjects (1.3%) have undergone hip or knee replacement surgery. The level of awareness about joint replacement surgery was adequate in only 30.9% of subjects and insufficient among 69.1% of subjects. The higher level of awareness was significantly associated with old age. Conclusion: the level of awareness was inadequate among most of Saudi participants about the causes and effects of the joint replacement surgery. There is urgent need for public education about the joint replacement surgery to address the concerns and advantages of the surgery through media, internet and health educational campaigns.

Kurdistan, Iraq, has a huge hydropower potential. Even if large hydropower developments are already in use, there is enough space for new developments. The paper presents the state of the art of hydropower in Iraq with emphasis on Kurdistan, the place in national power grid and further possible developments issued from a damsmaster plan accomplished this year.

Wild vegetables can contribute to people’s food security and health. In northwest Pakistan, almost 40% of the households are classified as food insecure, due to increasing population and natural and man-made catastrophes. There is an urgent need to get an overview of still existing practices of wild vegetable use and to incorporate such knowledge into agricultural policies. The present study, therefore, aims to collect and analyze information on the most widely and commonly used wild vegetables in northwest Pakistan. Semistructured interviews were performed with 126 informants (26–78-year old) from all 24 districts of the Khyber Pakhtunkhwa Province. Information on culinary and medicinal use, cooking methods, and growing and harvest season were collected. A rating scale was used to get the opinion on quality, abundance, and use frequency of wild vegetables. Information on trading was gathered on local and regional markets. Transect walks were done with key informants for specimen collection. A total of 25 wild vegetable species (21 genera, 13 families) were documented. Most of them are herbs (22 spp.). One third of the species needs processing or detoxification prior to cooking. Taste and food quality as perceived by the local people are the main driver for use frequency and commercialization. Length of availability varies from 2 to 7 months with Rumex dentatus and Vicia faba also available during the winter season. Overall, 21 spp. are also used medicinally, mainly for gastrointestinal diseases. Leaves are the preferred plant part for both vegetables and medicines. Nine species are sold in markets, Bauhinia variegata and Caralluma tuberculata throughout the whole province. Local communities in northwest Pakistan have a broad knowledge of local plant use, especially on wild vegetables and their adequate processing. The present study suggests that the most commonly used wild vegetables should be promoted to reinforce food safety and most of them may also be commercialized. Conservation priority has to be given to the commercially harvested Caralluma tuberculata, which is presently overexploited.

Objectives: To examine the effects on bone tissues of immediate implant-supported mandibular overdentures with cusped or cuspless teeth. Methods: A randomized controlled trial was conducted at the Dental Clinic, Faculty of Dentistry, Al-Azhar University, Assiut Branch, Egypt, over a 12-month period from September 2013 to September 2014. Twenty patients were treated with immediate implant-supported overdentures: one group received overdentures with cusped teeth, and the other group received overdentures with cuspless teeth. The rate of implant success was assessed clinically and radiographically at 3, 6, 9, and 12 months. The data were collected by a questionnaire, an observation checklist, and radiography. The data were then analyzed using computerized methods. Results: Overdentures with cusped teeth showed a significant improvement in the clinical criteria, including the absence of clinical implant mobility, pain, and bone resorption, while the clinical criteria for the absence of peri-implant radiolucency were insignificantly different between the 2 groups ( p more than 0.05). There were no significant differences in the clinical evaluations for bone levels at the time of insertion or 3 months after insertions, while significant differences were found at 6, 9, and 12 months after insertion. Conclusion: Overdentures with cusped teeth supported by immediate implants were found superior regarding many clinical criteria than those cuspless counterparts. Saudi Med J 2016; Vol. 37 (1): 79-83 doi: 10.15537/smj.2016.1.12097 How to cite this article: Arafa KA. The impact on bone tissues of immediate implant-supported mandibular overdentures with cusped and cuspless teeth . Saudi Med J 2016; 37: 79-83.

Objective: This study aimed to examine the effect of overdenture over vital and nonvital abutment teeth on teeth stability (teeth mobility and attachment loss). Materials and Methods: An experimental, parallel design was used and the study was conducted over a 12-month period (December 2013 to November 2014). Thirty patients who voluntarily opted to participate in this study were recruited; the first group received overdenture over vital abutment teeth while the second group received overdenture over nonvital abutment teeth. Attachment loss and teeth mobility were periodically evaluated after 3 months, 6 months, and 12 months. The data were then analyzed by a computerized method [Statistical Package for Social Sciences (SPSS) version 20]. Results: Overdenture over vital abutment teeth showed lower attachment loss and teeth mobility, compared to the overdenture over nonvital abutment teeth. These differences were statistically significant. Conclusion: It was concluded that the overdenture over vital abutment teeth was more stable, with a lower incidence of tooth mobility and less attachment loss than overdentures placed on nonvital teeth.

Free gas along with heavy oil production affects the progressive cavity pump (PCP) performance. This necessitates the strategy to perforate away from the free gas zone. To be able to do this, it requires an integrated approach to evaluate and map the spread of the free gas accumulation in the field. The paper shall present how this resulted in improved well performance with less free gas interference. The methodology included the understanding of the production data, sub-surface geology and petrophysics; reservoir heterogeneity and free gas presence from wireline logs, core data and isotope analysis of gas collected during mud-logging and creation of maps and cross-sections showing both vertical and aerial spread of free gas accumulation. This was then integrated with existing production and well management practices, along with numerical simulation results. Such in-depth analysis helps to bring significant changes in well completion strategy and is a vital contribution to the WRFM strategy. Unlike in conventional fields where depth is more and buoyancy pressures are large, gas can easily displace oil to accumulate in structural highs, in shallow heavy oil fields, free gas accumulation is a result of combination of structural and stratigraphic entrapment process. Vertical migration and lateral migration of gas is likely restricted by non-reservoir facies. As a result a consistent gas-oil contact (GOC) may not be present across large distances. Gas oil contact separates heavy oil by possible structural spill point and lithological boundary, dipping from south to north. Structurally higher areas are prone to localized gas accumulation. The completion stand-off from the gas base has a direct correlation with gas production. So the well management and production practice is to increase the stand-off from gas base to top perforations in future wells and to perform gas shut-off job in current wells to avoid free gas production. The novelty of the current approach is that it will proactively help in completion strategy to reduce future free gas production, subsequent loss in natural reservoir energy and maintain the oil production target.

Objective : To assess the level of evidence that supports the quality of fit for removable partial denture (RPD) fabricated by computer-aided designing/computer aided manufacturing (CAD/CAM) and rapid prototyping (RP) technology. Methods : An electronic search was performed in Google Scholar, PubMed, and Cochrane library search engines, using Boolean operators. All articles published in English and published in the period from 1950 until April 2017 were eligible to be included in this review. The total number of articles contained the search terms in any part of the article (including titles, abstracts, or article texts) were screened, which resulted in 214 articles. After exclusion of irrelevant and duplicated articles, 12 papers were included in this systematic review. Results : All the included studies were case reports, except one study, which was a case series that recruited 10 study participants. The visual and tactile examination in the cast or clinically in the patient’s mouth was the most-used method for assessment of the fit of RPDs. From all included studies, only one has assessed the internal fit between RPDs and oral tissues using silicone registration material. The vast majority of included studies found that the fit of RPDs ranged from satisfactory to excellent fit. Conclusion : Despite the lack of clinical trials that provide strong evidence, the available evidence supported the claim of good fit of RPDs fabricated by new technologies using CAD/CAM. Saudi Med J 2018; Vol. 39 (1): 17-22 doi: 10.15537/smj.2018.1.20796 How to cite this article: Arafa KAO. Assessment of the fit of removable partial denture fabricated by computer-aided designing/computer aided manufacturing technology. Saudi Med J . 2018 Jan;39(1):17-22. doi: 10.15537/smj.2018.1.20796.

Background: Nutritional status of mothers is considered one of the major problems facing mothers in the world. The nutrition plays a major role in mothers and child health. Objective: This study aims to assess mothers’ nutritional status and its determinants in Alemtidad area, Khartoum. Methods: A descriptive community based survey was conducted in the Alemtidad area of Khartoum between November 2012 and December 2012. One hundred and eighty mothers were selected by simple randomization. Data were collected by using structured designed questionnaire which was then analyzed by (SPSS) program version 20. Results: The study conducted among mothers in Alemtidad area; their age ranged between 19 and 86 years with the mean age 38 ± 12 years. From those mothers about half were unemployed, and having mainly primary and secondary educational level. 81.1% of mothers were not able to select the proper food according to age and nutrients and about 71.1% of mothers took two meals per day and 23.3% one meals per day, and only 5.6 take three meals per day. The Body Mass Index (BMI) was calculated to measure the nutrition status of mothers; this study shows that mothers in Alemtidad are mainly overweight and obese, 45.6% and 18% respectively and only 35% within normal range of Body Mass Index (BMI). Conclusion: The study concludes that mothers are either overweight or obese (45.6%, 17.7% respectively). Compared to national and international statistics the findings of this study reflect high Body Mass Index (BMI) of mothers in Alemtidad.

The aim of this study was to see the usefulness of fine needle aspiration by “theBethesdasystem for reporting Thyroid Cytopathology” (TBS- RTC) for non palpable thyroid nodules through ultrasound-guidance for the evaluation and treatment planning of nonpalpable thyroid lesions. This study was conducted on 200 patients with non palpable thyroid nodules which are very low lying or felt on swallowing; in Department of Pathology and Radiology since January 2011 to June 2012. The patients were scanned and USG- FNAC was performed and reporting was done by “TBSRTC”. Of the 200 specimens 17 samples were nondiagnostic or unsatisfactory (Class I), 145 samples were benign (Class II), 20 samples were showing Atypical of Undetermined Significance (AUS) or Follicular Lesion of Undetermined Significance (FLUS); (Class III), 6 were showing follicular neoplasm or suspicious for a follicular neoplasm (Class IV), 7 samples were suspicious for malignancy (Class V) and 5 samples were positive for malignancy (Class VI). On comparison of ultrasound guided FNAC with histopathology the sensitivity for correct diagnosis was 93%, specificity was 86%, positive predictive value was 37%, negative predictive value was 99% and accuracy was 86%. USG-FNAC is a useful modality for the evaluation and treatment planning of nonpalpable thyroid lesions smaller than5 mmin the maximum diameter. TBSRTC is the best method of reporting but class III and IV are the main pitfall of this system for reporting Thyroid Cytopathology and show high sensitivity, specificity and accuracy.

This paper traces theatrically and statistically the evolution and popularity of science play from 1604, the publication of Marlowe’s Dr Faustus, to 2005 revealing reasons behind this popularity in particular within the last few decades. It also presents a brief classification of playwrights employed science in their works, and does analysis for major works that contributed much not only in the development and popularity of science drama, but also in the drastic change they have brought to this genre. Actually, from Marlowe to now, scientists and science have held a fascination for writers and audience on equal terms. In our genetic, atomic and tech-savvy climate, drama contains science of any kind will head directly to spotlight. The pivotal year of 1998, when Copenhagen was first premiered, has led to unprecedented wave of science plays. Science has become the vogue and science play has gone beyond using science as a sort of ornament to integrate it into the fabric of drama. Everything from Newton's Principia to Greene's books on String Theory has passed across the stage. Consequently, this wave of science plays has not only softened the earth for a permanent shift in our perception of science as a fundamental part of our culture and a legitimate and compelling subject for theatre, but also has brought the vision of ‘‘a third culture’’ into reality.

The buck converter and the Z-source converter for emulating the photovoltaic (PV) system is compared in this paper. First, a detail analysis and requirement of the PV emulator is discussed and then the effectiveness of the buck converter and the Z-source converter is studied. The reason of selecting buck converter over the Z-source converter is also explained. The Z-source converter is not an ideal PV emulator as explained by the theoretical and simulation approach presented in the paper. The modeling is done in MATLAB® Simulink SimPowerSystem software package. The Simulation results obtained from the MATLAB® Simulink SimPowerSystem software package for different topologies under steady state and dynamic conditions are analyzed and presented. Two different control techniques (current and voltage based) are implemented for the buck converter and based on the simulation analysis the current control technique is selected for the buck converter.

Background. Type of materials used in fabrication of denture base has an effect on dimension during denture base material processing and other factors related to clinical use.Objective. The study aims were to assess the dimensional stability including thermal changes of three different denture base materials.Methods. Ninety patients were selected to construct complete dentures with different denture base materials. They were randomly divided into three groups: group 1, patients with cobalt chrome metallic base; group 2, patients with heat curing acrylic resin fabricated by injection moulding technique; and group 3, patients with denture bases fabricated by conventional heat curing acrylic resin. The dimensional changes were assessed using digital caliper.Results. After the twelfth month, injection moulding acrylic resin had significantly the highest dimensional change followed by the conventional heat curing acrylic resin. There were no significant differences in the dimensions between the three types of denture base materials at normal mouth temperature, while, after hot tea drinking at 45°C, the dimensional change was significantly the highest in cobalt chrome metallic denture base group.Conclusion. Cobalt chrome metallic denture base has stable dimension compared to denture bases fabricated of acrylic resin but it was more affected by altered mouth temperature. The study was registered in the International Standard Randomized Controlled Trials Number (ISRCTN) registry with study ID (ISRCTN94238244).

Ethnopharmacological relevance Pastoralist tribal communities inhabit Thakht-e-Sulaiman hills since centuries. In this remote and geographically isolated area, local people mainly rely on their natural environment for ethnoveterinary care. The area is therefore of special interest for the documentation and analysis of ethnoveterinary plant use and efficacy. Materials and methods Field work was conducted from 2010–2012 and 86 informants were interviewed. First, detailed unstructured interviews and group discussions were done with key informants, and second, successive oral freelisting and semi-structured interviews were performed. The veterinary diseases as described by the informants were categorized according to the symptoms they cause and the organs they affect. Information on the cited plants, informant consensus factor (ICF) and fidelity level (FL) were calculated based on use reports. Results A total of 22 ethnoveterinary medicinal plant species, belonging to 21 genera and 20 families with 559 use reports were recorded from two different ecological zones. More species were documented from the foothills but total use reports were higher for mountain species. Mainly leaves are used to prepare decoctions which are administered orally. Most use reports concerned skeleto-muscular problems followed by gastrointestinal ailments, but ritual uses and dermatological illnesses got highest ICF. Most often cited species were Pinus gerardina, P. wallichiana and Daphne papyracea while highest FL was obtained for Salix tetrasperma, Berberis calliobotrys and Litsea monopetala. Interestingly, 50% of the species have the same or similar use for humans. Conclusion According to the local people, the most often mentioned species have high medicinal potential. They show a wide acceptance, broad application, multiple ways of preparation and administration. There is a need to conserve the knowledge of medicinal plant use in the Thakht-e-Sulaiman hills for future generations and to incorporate it into existing livestock health care services.

We report 2 cases of tuberculous otitis media that were diagnosed at Stony Brook University Hospital in New York since 1999. Both patients were women, aged 30 and 31 years. One patient had grown up in Russia, the other was a native-born American who had never left the East Coast region of the United States. Both patients had been symptomatic for many months; one complained of chronic otorrhea, and the other reported otorrhea, hearing loss, and discomfort. Neither patient responded to medical management, and both ultimately underwent surgery. One was diagnosed after surgical pathology revealed acid-fast bacilli on frozen-section analysis. In the other, pathology revealed chronic inflammation and granulomata, but stains were negative and her diagnosis was delayed for almost 2 years. We also review 9 other cases of tuberculous otitis media in the United States that have been reported in the literature since 1990. Our review suggests that the number of cases is rising in areas where tuberculosis is most common—that is, in major U.S. cities. Although 3 of these 9 cases occurred as reactivation disease in immigrants, most might have occurred as a result of local transmission. Clinicians should maintain a high degree of suspicion for tuberculosis in patients with chronic otitis symptoms, particularly those who are at higher risk of exposure to tuberculosis.

Signet ringcarcinoma (SRC), a variant of gastric adenocarcinoma, is known to have a poor prognosis, especially when arising in the young population. In this report, two cases of gastric SRC carcinomas with different outcomes are described. The first case is a 49 years old Bahraini lady who presented with abdominal pain and was found to have a gastric ulcerover the lesser curvature on endoscopy and her biopsy showed features ofa poorly differentiated signet ring adenocarcinoma. This patient was managed by a timelysubtotal gastrectomy with adjuvant chemoradiotherapy. The second caseis ofa 34 years old Bahraini male whom presented withmild dyspepsia and in whomSRCwas an incidental finding on initial endoscopic biopsy that was later confirmed by targeted biopsy.This patientwas advised total gastrectomybut died due to delay in appropriate and timely interventions primarily due to his multiple consultations regarding the same matter.

Background: Although there are a diversity of methods proposed for cleaning complete dentures, there is still no consensus in the literature about which method is most effective for removing biofilm from acrylic resin denture base surfaces. Although chlorhexidine is mostly used, benzoic acid has emerged as an effective method of denture cleansing. This study aimed to examine the efficacy of denture soaks by benzoic acid against the colonization of Candida albicans compared to zordyl (chlorhexidine gluconate 0.2%). Materials and Methods: This is a randomized controlled trial conducted in Al-Azhar University, Assiut Branch, Faculty of Dentistry, in Egypt during a 4-month period. One hundred edentulous patients with complete dentures were assigned into two equal groups, group (1): Fifty patients given instructions to use benzoic acid for immersion of their dentures and they were given the prepared solution for free to be used, while group (2): Fifty patients used zordyl (chlorhexidine gluconate 0.2%) for denture immersion. The dentures were examined four times; before delivery of instructions, 1, 2, and 4 months after initial session of instructions. Results: It was found that household benzoic acid has inhibition effect against C. albicans. The differences in means of C. albicans counts between two groups were nonsignificant before the application of denture soaks, but they begin to be significant after 1 month of the application. The mean differences of C. albicans counts continue to be significant in the 2 nd and 4 th months of follow-up. Conclusion: This study showed that using benzoic acid for denture soak has an inhibition effects against the colonization of C. albicans on the surfaces of dentures more than using zordyl (chlorhexidine gluconate 0.2%).

While executing a workover operation, one of the wells in Dukhan oil field experienced a well control problem. Water, Oil and gas from underground started to flow to surface through the production tubing. The BOP shear rams where activated to stop the flow. During the attempts to bring the well under control, an uncontrolled flow of oil, water and gas with considerable H2S concentration occurred from the ground. A relief well, which was the first relief well in the State of Qatar, was drilled to intersect the blowout well and stop the flow. A considerable amount of engineering and planning was involved to bring the well under control, along with stringent operational and safety controls. The operation was implemented in a safe and professional manner in 46 days, and resulted in an effective and long-term isolation of the blowout well. The objective of this paper is to discuss the blowout well, the relief well, and the intersecting and killing operation.

Eman M Khedr1, Sherifa A Hamed1, Hala K El-Shereef2, Ola A Shawky1, Khalid A Mohamed1, Effat M Awad3, Mohamed A Ahmed2, Ghaydaa A Shehata1, Mahmoud A Eltahtawy41Department of Neurology and Psychiatry, 2Department of Internal Medicine, 3Department of Physiology, 4Department of Clinical Pathology, Assiut University, Faculty of Medicine, Assiut, EgyptBackground: Cognitive decline after cerebrovascular stroke has adverse outcome consequences. Since some vascular causes can be prevented and treated, the identification of stroke-related cognitive impairment is a challenge. Patients with cognitive impairment and vascular diseases exhibit higher homocysteine (Hcy) concentrations. Whether Hcy is an independent risk factor for cognitive impairment after stoke is still in question. The objectives of this study were to determine: 1) the relative frequency of first-ever post-stroke dementia (PSD) (three months after onset) in a consecutive sample of our population, 2) the risk factors associated with PSD, and 3) the relationship between Hcy levels and PSD.Methods: Eighty-one inpatients with first-ever stroke were prospectively evaluated with a neuropsychological battery and event-related evoked potentials (P300) at onset and then after three months. A wide range of demographic, clinical, radiological and laboratory variables were examined. PSD was diagnosed if the clinical presentation fulfilled DSM-IV criteria of vascular dementia, the patient scored ≤21 on Mini Mental State Examination (MMSE) and ≤67 points on Cognitive Abilities Screening Instruments (CASI).Results: PSD was diagnosed in 21%. PSD was significantly associated with increasing age, low levels of education, large sized and lacunar infarctions, severity of stroke, prolonged P300 latency, smoking, hypertension, and elevated Hcy levels. High Hcy levels increased the odds ratio of PSD after adjustment of significantly relevant variables including age, smoking, size of infarction, and carotid stenosis.Conclusions: Cognitive decline is common after stroke. The results of this study indicate that PSD may result from stroke and its related risk factors including possible direct association with high Hcy levels. Better knowledge of the risk factors for PSD should increase the effectiveness of preventive strategies in patients with this condition.Keywords: post-stroke dementia, vascular risk factors, homocysteine

Introduction LAN Emulation over ATM (LANE) IP Switching Multiprotocol over ATM (MPOA) MPOA Functional Overview and Data Transfer Procedures Flow Characterization and Connection Management in MPOA Multiprotocol Label Switching (MPLS) MPLS Architecture and Functions The Label Distribution Protocol (LDP) Explicit and Constrained Routed LDP (CR-LDP) The Generic MPLS Encapsulation Structure

Virtual Path and Virtual Channel Identifiers Relation between VPC, VCC and VPL, VCL Preassigned Header Values The Payload Type Field The Cell Loss Priority (CLP) Field Generic Flow Control (GFC) Function Primitives and Service Access Points

Introduction OAM Principles and General Network Management Architecture OAM Flows ATM Layer OAM Flows and Functions Fault Management Functions??????-??????AIS/RDI Fault Management Functions??????-??????Continuity Check (CC) Fault Management Functions??????-??????Loopback (LB) Performance Management OAM Function Activation and Deactivation Procedures OAM Cell Formats and Codings Functions Specific to the AIS/RDI and CC OAM Cell Loopback OAM Cell Format and Functions Functions and Formats of PM OAM Cells Functions and Format of Activation/Deactivation OAM Cell Overview of the OAM Cell Types Relationship between OAM Functions and Connection Availability Protection Switching at the ATM Layer ]]>

Introduction Basic PNNI Signaling and Routing Concepts PNNI Signaling Protocols Source Routing in PNNI Signaling PNNI Crankback Function PNNI "Soft" Permanent Virtual Circuit (SPVC) Function PNNI Routing Functions PNNI Routing Hierarchy Addresses and Identifiers in PNNI PNNI Routing Packet Structure and Functions General Comments on PNNI Routing and Signaling

The General AAL Functional Model and AAL Types AAL Type 1??????-??????Functions and Format AAL Type 3/4 Functions and Format AAL Type 5 Functions and Format AAL Type 2 Functions and Format AAL Type 2 Switching and Signaling The Service-Specific Convergence Sublayer (SSCS) Interworking

Background Reports of natural disasters and injuries have increased in recent years in both low and high-income regions. Household emergency preparedness can limit the effects of not only natural disasters but also simple injuries. Little is known regarding the level of emergency preparedness in Sudan households. Method A cross sectional community based survey was conducted in the Alemtidad region of Sudan between September 2012 and December 2012. A random selection of 89 households was done from 3200 in the region as per power calculation. Data were collected using a structured designed questionnaire and analysed using the statistical package for social science (SPSS) program version 20 and demographics were presented accordingly. Result Less than half of households surveyed had any first aid supplies and most of these supplies were incomplete. Only 66% of housewives demonstrated knowledge about first aid for burns and falls, 88% took preventive measures against burns and falls and 51% had an action plan in case serious injury occurred. Knowledge levels of housewives reflect unacceptable levels of preparedness. Education is a significant predictor of preparedness. Conclusion Household emergency preparedness is poor. It can be encouraged by community based outreach and education programmes focused on prevention and treatment of common injuries.

Silicon photodetectors arelwidely used in the electro-optics industry for a variety of light detection and measurement applications. They offer the advantages of low cost, relatively high speed detection of light with usefully high quantum efficiency in the 0.3 to 1.1 micron wavelength region. In this review, we discuss the various trade-offs that are available to the silicon photodiode manufacturer in optimising the performance of a device for a particular application. This should enable the optical system designer to obtain a clearer understanding of the device parameters relevant to his particular needs, thereby obtaining a better match between device and system engineering constraints.© (1982) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Objective: To study the frequency of known risk factors for stroke in poor patients of Swat district. Design: prospective, descriptive hospital based study. Setting: Saidu teaching Hospital Saidu Sharif district Swat. Subjects and Methods: All poor patients admitted to the general medical ward of Saidu teaching Hospitalduring June 2005 to May 2007 were included in the study.Type of stroke was identified by C.T.scan. Risk factors for stroke and other relevant information wasrecorded on properly designed proforma. The data was analyzed on SPSS Results: Data of 134 patients, 75 male and 59 females was collected. 92 patients (70%) had cerebralinfarction, 30 patients (23%) had cerebral haemorrhage. 12 patients had normal C.T scan (non enhanced).Most patients had more than one risk factor. Hypertension was present in 61%, smoking 50%, sedentaryhabits 38%, diabetes 33%, dyslipidemia 32 %, coronary artery disease 22 %, obesity 11%, alcoholism 2%and carotid artery stenosis 5%. In hospital mortality was 20%. Eighty eight percent of patients weredependent at the time of discharge for their daily activities. Conclusion: Hypertension, smoking and diabetes are major risk factors for the development of stroke ingeneral poor population. All aims of primary and secondary prevention should address these major riskfactors. Most of the patients become dependent and it is very important to develop stroke units,physiotherapy programs and rehabilitation centers to reduce morbidity due to stroke in a poor community. Key Worlds: Stroke, Risk factors,Swat District.