Current and future funding streams for paediatric postmortem imaging: European Society of Paediatric Radiology survey results.

BACKGROUND: Perinatal and childhood postmortem imaging has been accepted as a noninvasive alternative or adjunct to autopsy. However, the variation in funding models from institution to institution is a major factor prohibiting uniform provision of this service. OBJECTIVE: To describe current funding models employed in European and non-European institutions offering paediatric postmortem imaging services and to discuss the perceived barriers to future postmortem imaging service provision. MATERIALS AND METHODS: A web-based 16-question survey was distributed to members of the European Society of Paediatric Radiology (ESPR) and ESPR postmortem imaging task force over a 6-month period (March-August 2021). Survey questions related to the radiologic and autopsy services being offered and how each was funded within the respondent's institute. RESULTS: Eighteen individual responses were received (13/18, 72.2% from Europe). Only one-third of the institutions (6/18, 33.3%) have fully funded postmortem imaging services, with the remainder receiving partial (6/18, 33.3%) or no funding (5/18, 27.8%). Funding (full or partial) was more commonly available for forensic work (13/18, 72%), particularly where this was nationally provided. Where funding was not provided, the imaging and reporting costs were absorbed by the institute. CONCLUSION: Increased access is required for the expansion of postmortem imaging into routine clinical use. This can only be achieved with formal funding on a national level, potentially through health care commissioning and acknowledgement by health care policy makers and pathology services of the value the service provides following the death of a fetus or child. Funding should include the costs involved in training, equipment, reporting and image acquisition.

Assessment of Prescribing Practices and Factors Related to Antibiotic Prescribing in Community Pharmacies.

Background and Objectives: Overprescribing of antibiotics is one of the important contributors of antimicrobial resistance globally. A high proportion of antibiotics prescribed in community settings are unnecessary or inappropriate. This study assesses the prescribing practices and factors related to antibiotic prescribing in community pharmacies in United Arab Emirates (UAE). Materials and Methods: A cross-sectional study utilizing a quantitative approach was carried out in the community pharmacies of Ras Al Khaimah (RAK), UAE. Six hundred and thirty prescription encounters from 21 randomly selected community pharmacies were investigated using World Health Organization (WHO) core prescribing indicators. Factors related to antibiotic prescribing were identified using logistic regression analyses. Results: In 630 prescription encounters, a total of 1814 drugs were prescribed. Out of these, the most commonly prescribed drug class was antibiotics (43.8% prescriptions) and the antibiotic was amoxicillin/clavulanic-acid (22.4%). The average number of drugs per prescription was 2.88, which was higher than the WHO recommended value of 1.6-1.8. In addition, more than half of the prescriptions (58.6%) had drugs by generic names and the majority of the drugs prescribed (83.8%) were from the essential drug list, which were lower than the optimal values of 100%. The majority of the antibiotics prescribed in the study were from the WHO's Access group antibiotics. Multivariable logistic regression analysis identified patient age (children-OR: 7.40, 95% CI: 2.32-23.62, p = 0.001 and adolescent-OR: 5.86, 95% CI: 1.57-21.86, p = 0.008), prescriber qualification as general practitioner (OR: 1.84, 95% CI:1.30-2.60, p = 0.001), and number of drugs per prescription (OR: 3.51, 95% CI: 1.98-6.21, p < 0.001) as independent factors associated with antibiotic prescribing. Conclusions: This study reveals considerable variations from the WHO recommendations for the different prescribing indicators in the community pharmacies of RAK, UAE. In addition, the study reports overprescribing of antibiotics in the community setting, indicating the need for interventions to promote rational use of antibiotics in a community setting.

Low-Field MRI of Stroke: Challenges and Opportunities.

Stroke is a leading cause of death and disability worldwide. The reasons for increased stroke burden in developing countries are inadequately controlled risk factors resulting from poor public awareness and inadequate infrastructure. Computed tomography and MRI are common neuroimaging modalities used to assess stroke with diffusion-weighted MRI, in particular, being the recommended choice for acute stroke imaging. However, access to these imaging modalities is primarily restricted to major cities and high-income groups. In the case of stroke, the time-window of treatment to limit the damage is of a few hours and needs a point-of-care diagnosis. A low-cost MR system typically achieved at the ultra-low- and very-low-field would meet the need for a geographically accessible and portable solution. We review studies focused on accessible stroke imaging and recent developments in MR methodologies, including hardware, to image at low fields. We hypothesize that in the absence of a formal, rapid stroke triaging system, the value of timely on-site delivery of the scanner to the stroke patient can be significant. To this end, we discuss multiple recent hardware and methods developments in the low-field regime. Our review suggests a compelling need to explore further the trade-offs between high signal, contrast, and accessibility at low fields in low-income communities. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY STAGE: 6.

Therapeutic Potential of Rhododendron arboreum Polysaccharides in an Animal Model of Lipopolysaccharide-Inflicted Oxidative Stress and Systemic Inflammation.

Systemic inflammation results in physiological changes, largely mediated by inflammatory cytokines. The present investigation was performed to determine the effect of Rhododendron arboreum (RAP) on inflammatory parameters in the animal model. The RAP (100 and 200 mg/kg) were pre-treated for animals, given orally for one week, followed by lipopolysaccharide (LPS) injection. Body temperature, burrowing, and open field behavioral changes were assessed. Biochemical parameters (AST, ALT, LDH, BIL, CK, Cr, BUN, and albumin) were done in the plasma after 6 h of LPS challenge. Oxidative stress markers SOD, CAT, and MDA were measured in different organs. Levels of inflammatory markers like tumor necrosis factor-alpha (TNF-α), interleukin-1-beta (IL-1ß) and, interleukin-6 (IL-6) as well as VEGF, a specific sepsis marker in plasma, were quantified. The plasma enzymes, antioxidant markers and plasma pro-inflammatory cytokines were significantly restored (p < 0.5) by RAP treatment, thus preventing the multi-organ and tissue damage in LPS induced rats. The protective effect of RAP may be due to its potent antioxidant potential. Thus, RAP can prevent LPS induced oxidative stress, as well as inflammatory and multi-organ damage as reported in histopathological studies in rats when administered to the LPS treated animals. These findings indicate that RAP can benefit in the management of systemic inflammation from LPS and may have implications for a new treatment or preventive therapeutic strategies with an inflammatory component.

Zingerone [4-(3-Methoxy-4-hydroxyphenyl)-butan-2] Attenuates Lipopolysaccharide-Induced Inflammation and Protects Rats from Sepsis Associated Multi Organ Damage.

The present investigation aimed to evaluate the protective effect of Zingerone (ZIN) against lipopolysaccharide-induced oxidative stress, DNA damage, and cytokine storm in rats. For survival study the rats were divided into four groups (n = 10). The control group was treated with normal saline; Group II received an intraperitoneal (i.p) injection (10 mg/kg) of LPS as disease control. Rats in Group III were treated with ZIN 150 mg/kg (p.o) 2 h before LPS challenge and rats in Group IV were given ZIN only. Survival of the rats was monitored up to 96 h post LPS treatment. In another set, the animals were divided into four groups of six rats. Animals in Group I served as normal control and were treated with normal saline. Animals in Group II were treated with lipopolysaccharide (LPS) and served as disease control. Group III animals were treated with ZIN 2 h before LPS challenge. Group IV served as positive control and were treated with ZIN (150 mg/kg orally). The blood samples were collected and used for the analysis of biochemical parameters like alanine transaminase (ALT), alkaline phosphatase (ALP), aspartate transaminase (AST), blood urea nitrogen (BUN), Cr, Urea, lactate dehydrogenase (LDH), albumin, bilirubin (BIL), and total protein. Oxidative stress markers malondialdehyde (MDA), glutathione peroxidase (GSH), myeloperoxidase (MPO), and (DNA damage marker) 8-OHdG levels were measured in different organs. Level of nitric oxide (NO) and inflammatory markers like TNF-α, IL-1ß, IL-1α, IL-2, IL-6, and IL-10 were also quantified in plasma. Procalcitonin (PCT), a sepsis biomarker, was also measured. ZIN treatment had shown significant (p < 0.5) restoration of plasma enzymes, antioxidant markers and attenuated plasma proinflammatory cytokines and sepsis biomarker (PCT), thereby preventing the multi-organ and tissue damage in LPS-induced rats also confirmed by histopathological studies of different organs. The protective effect of ZIN may be due to its potent antioxidant potential. Thus ZIN can prevent LPS-induced oxidative stress as well as inflammatory and multi-organ damage in rats when administered to the LPS treated animals.

Joint European Society of Paediatric Radiology (ESPR) and International Society for Forensic Radiology and Imaging (ISFRI) guidelines: paediatric postmortem computed tomography imaging protocol.

Postmortem CT for investigating childhood deaths is increasingly utilised as a noninvasive adjunct or alternative to standard autopsy; however there are no standardised published imaging protocols. This article describes a standardised imaging protocol that has been developed based on current practices of international postmortem imaging practitioners and experts. This recommendation is expected to be useful for postmortem imaging centres wishing to update their existing practices and for those starting paediatric postmortem CT as a new service.

Developmental Hip Dysplasia Diagnosis at Three-dimensional US: A Multicenter Study.

Purpose To validate accuracy of diagnosis of developmental dysplasia of the hip (DDH) from geometric properties of acetabular shape extracted from three-dimensional (3D) ultrasonography (US). Materials and Methods In this retrospective multi-institutional study, 3D US was added to conventional two-dimensional (2D) US of 1728 infants (mean age, 67 days; age range, 3-238 days) evaluated for DDH from January 2013 to December 2016. Clinical diagnosis after more than 6 months follow-up was normal (n = 1347), borderline (Graf IIa, later normalizing spontaneously; n = 140) or dysplastic (Graf IIb or higher, n = 241). Custom software accessible through the institution's research portal automatically calculated indexes including 3D posterior and anterior alpha angle and osculating circle radius from hip surface models generated with less than 1 minute of user input. Logistic regression predicted clinical diagnosis (normal = 0, dysplastic = 1) from 3D indexes (ie, age and sex). Output represented probability of hip dysplasia from 0 to 1 (output: >0.9, dysplastic; 0.11-0.89, borderline; <0.1, normal). Software can be accessed through the research portal. Results Area under the receiver operating characteristic curve was equivalently high for 3D US indexes and 2D US alpha angle (0.996 vs 0.987). Three-dimensional US helped to correctly categorize 97.5% (235 of 241) dysplastic and 99.4% (1339 of 1347) normal hips. No dysplastic hips were categorized as normal. Correct diagnosis was provided at initial 3D US scan in 69.3% (97 of 140) of the studies diagnosed as borderline at initial 2D US scans. Conclusion Automatically calculated 3D indexes of acetabular shape performed equivalently to high-quality 2D US scans at tertiary medical centers to help diagnose DDH. Three-dimensional US reduced the number of borderline studies requiring follow-up imaging by over two-thirds.

Knowledge of Safety, Training, and Practice of Neonatal Cranial Ultrasound: A Survey of Operators.

OBJECTIVES: Ultrasound can lead to thermal and mechanical effects in interrogated tissues. This possibility suggests a potential risk during neonatal cranial ultrasound examinations. The aim of this study was to explore safety knowledge and training of neonatal cranial ultrasound among Australian operators who routinely perform these scans. METHODS: An online survey was administered on biosafety and training in neonatal cranial ultrasound, targeting all relevant professionals who can perform neonatal cranial ultrasound examinations in Australia: namely, radiologists, neonatologists, sonographers, and pediatricians. The survey was conducted between November 2013 and May 2014. RESULTS: A total of 282 responses were received. Twenty of 208 (10%) answered all ultrasound biosafety questions correctly, and 49 of 169 (29%) correctly defined the thermal index. Two-thirds (134 of 214 [63%]) of respondents failed to recognize that reducing the overall scanning time is the most effective method of reducing the total power exposure. Only 13% (31 of 237) indicated that a predetermined fixed period of training or that a specified minimum number of supervised scans was used during training. The reported number of supervised scans during training was highly variable. Almost half of the participants (82 of 181 [45%]) stated that they had received supervision for 10 to 50 scans (median, 20 scans). CONCLUSIONS: There is a need to educate operators on biosafety issues and approaches to minimize power outputs and reduce the overall duration of cranial ultrasound scans. Development of standardized training requirements may be warranted.

Retraction Note to: Environmental impact of plantations in and around the petroleum refinery: a case study.

This article [1] has been retracted at the request of the Editor-in-Chief. Significant sections of the article show a similarity with the author's own article published previously [2]. All the authors agree with the retraction.

Inter-seasonal and spatial distribution of ground-level greenhouse gases (CO2, CH4, N2O) over Nagpur in India and their management roadmap.

Ground-level concentrations of carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O) were monitored over three seasons, i.e., post-monsoon (September-October), winter (January-February), and summer (May-June) for 1 year during 2013-2014 in Nagpur City in India. The selected gases had moderate to high variation both spatially (residential, commercial, traffic intersections, residential cum commercial sites) and temporally (at 7:00, 13:00, 18:00, and 23:00 hours in all three seasons). Concentrations of gases were randomly distributed diurnally over city in all seasons, and there was no specific increasing or decreasing trend with time in a day. Average CO2 and N2O concentrations in winter were higher over post-monsoon and summer while CH4 had highest average concentration in summer. Observed concentrations of CO2 were predominantly above global average of 400 ppmv while N2O and CH4 concentrations frequently dropped down below global average of 327 ppbv and 1.8 ppmv, respectively. Two-tailed Student's t test indicated that post-monsoon CO2 concentrations were statistically different from summer but not so from winter, while difference between summer and winter concentrations was statistically significant (P < 0.05). CH4 concentrations in all seasons were statistically at par to each other. In case of N2O, concentrations in post-monsoon were statistically different from summer but not so from winter, while difference between summer and winter concentrations was statistically significant (P < 0.05). Average ground-level concentrations of the gases calculated for three seasons together were higher in commercial areas. Environmental management priorities vis a vis greenhouse gas emissions in the city are also discussed.

Effects of unregulated anthropogenic activities on mixing ratios of volatile organic air pollutants--A case study.

UNLABELLED: During the months of October to November, many important festivals are celebrated in India. Celebration of these festivals are marked by extensive use of fireworks or pyrotechnics, bonfire, incense burning, open air community cooking, and temporary eateries using crude fuel such as coal, wood, kerosene, cow dung, burning of raw/semiwood, and coconut shells. The present study deals with the influence of these unregulated anthropogenic activities on ambient mixing level of volatile organic compounds (VOCs), especially some carbonyl compounds. The study was undertaken in the metropolitan city of Kolkata, India, with very high population density, which is even higher during festival period. The average total carbonyl level at different sites in Kolkata varied from 134.8 to 516.5 µg m(-3) in pre-festival season, whereas in post-festival season the same varied from 252.2 to 589.3 µg m(-3). Formaldehyde to acetaldehyde ratio altered from 0.62 in pre-festival season to 1.78 in post-festival season. Diurnal variation also altered, indicating variation in source composition of carbonyls. The total ozone forming potential calculated for all 14 carbonyls in pre-festival season increased by 35% in post-festival season. The effect of anthropogenic activities typical to the event of Diwali night characterized by intense execution of pyrotechnics resulted in significantly high level of carbonyl VOCs. Principal component analysis study for the event of Diwali shows clear contribution of the event on certain carbonyl VOCs. The results indicate elevated primary emissions of these pollutants and also their effect on formation of secondary pollutants. The study emphasizes the need of generating awareness among the communities in society as well as need for regulations to minimize the emissions and related hazards to the extent possible. IMPLICATIONS: Altered anthropogenic activities typical of festival season including extensive use of pyrotechnics affect ambient level of volatile organic compounds, especially some carbonyls. Such activities have considerable effect on interspecies ratio and diurnal variation. They also affect formation of secondary pollutants such as tropospheric ozone. Principal component analysis (PCA) study shows clear contribution of the pyrotechnics execution on certain carbonyl VOCs. The findings emphasize the need of generating awareness in society and need for regulations to minimize the emissions.

Emission, speciation, and evaluation of impacts of non-methane volatile organic compounds from open dump site.

Surface emission from Dhapa, the only garbage disposal ground in Kolkata, is a matter of concern to the local environment and also fuels the issues of occupational and environmental health. Surface emission of the Dhapa landfill site was studied using a flux chamber measurement for nonmethane volatile organic compounds (NMVOCs). Eighteen noncarbonyl volatile organic compounds (VOCs) and 14 carbonyl VOCs, including suspected and known carcinogens, were found in appreciable concentrations. The concentrations of the target species in the flux chamber were found to be significantly higher for most of the species in summer than winter. Surface emission rate of landfill gas was estimated by using two different approaches to assess the applicability for an open landfill site. It was found that the emissions predicted using the model Land GEM version 3.02 is one to two orders less than the emission rate calculated from flux chamber measurement for the target species. Tropospheric ozone formation has a serious impact for NMVOC emission. The total ozone-forming potential (OFP) of the Dhapa dumping ground considering all target NMVOCs was estimated to be 4.9E+04 and 1.2E+05 g/day in winter and summer, respectively. Also, it was found that carbonyl VOCs play a more important role than noncarbonyl VOCs for tropospheric ozone formation. Cumulative cancer risk estimated for all the carcinogenic species was found to be 2792 for 1 million population, while the total noncancer hazard index (HI) was estimated to be 246 for the occupational exposure to different compounds from surface emission to the dump-site workers at Dhapa. Implications: This paper describes the real-time surface emission of NMVOCs from an open municipal solid waste (MSW) dump site studied using a flux chamber. Our study findings indicate that while planning for new landfill site in tropical meteorology, real-time emission data must be considered, rather than relying on modeled data. The formation of tropospheric ozone from emitted NMVOC has also been studied. Our result shows how an open landfill site acts as a source and adds to the tropospheric ozone for the airshed of a metropolitan city.

Population pharmacokinetics of lamotrigine in Indian epileptic patients.

PURPOSE: The aim of this analysis was to describe the pharmacokinetics of oral lamotrigine (LTG) in Indian epileptic patients using a population pharmacokinetic (PPK) modeling approach to confirm that the PK is similar to that of the Caucasian population, and to evaluate and confirm the impact of covariates predictive of inter-individual variability using a simulation platform. METHODS: Blood samples were obtained from 95 patients, and LTG plasma concentrations were determined. Population PK modeling was performed using NONMEM. A one-compartment PK model with first-order absorption and elimination was used to describe the LTG PK. Log-likelihood profiling and normalized prediction distribution errors (NPDE) were used for model evaluation. A simulation study was performed to investigate dose regimens. RESULTS: Clearance (CL) was estimated to be 2.27 L/h with inter-individual variability (IIV) of 29 CV%. Volume of distribution (V) was estimated to be 53.6 L (31 CV% IIV). Body weight and concurrent use of carbamazepine and valproate were identified as significant covariates on clearance. Log-likelihood profiling indicated that parameters could be estimated with adequate precision, and NPDE indicated that the model adequately described the data observed. The simulation study illustrated the impact of carbamazepine and valproate on LTG PK, and negligible differences in PK between Indian and Caucasian patients. CONCLUSIONS: This is the first PK analysis of LTG in Indian patients. The population PK model developed adequately described the data observed. Comparison of identified PK parameters with previous PK analyses in Caucasian patients indicates that CL of LTG is similar, while V is somewhat lower compared with Caucasian patients, but this is not expected to lead to relevant differences in PK profiles during steady state.

Atlantooccipital septic arthritis complicating recurrent otitis media.

Otitis media is known to have a number of complications. We present the first reported case of atlantooccipital septic arthritis as a complication of Streptococcus pneumoniae otitis media in an 8-month-old boy.

Assessment of drug utilization pattern of antimicrobial agents in hospitalized patients with Infectious Diseases: A cross-sectional study in the United Arab Emirates.

Efficacious use of antimicrobial agents (AMAs) is paramount to combat a wide range of infections, ensure patient safety, and reduce antimicrobial resistance. To assess the drug utilization patterns of AMAs in hospitalized patients with infectious diseases in a secondary care hospital. A prospective observational study was conducted for 6 months in the internal medicine department. Data were collected, antimicrobial prescription patterns were screened, and drug utilization was assessed using the anatomical therapeutic chemical/defined daily dose methodology. Furthermore, predictors of the prescription of multiple AMAs were also analyzed. A total of 146 patient case records were reviewed and 285 AMAs were prescribed during the study period with a mean patient age of 54.2 ± 24.4 years. The average number of antimicrobials administered per patient was 1.94 ± 0.94. Respiratory tract infection and urinary tract infection were the common indications, and penicillins were the most prescribed class of AMAs. Multivariate analysis showed that the presence of comorbidities (P < 0.05) and longer hospital stays (P < 0.0001) increased the likelihood of prescribing multiple AMAs. The study provides insight into the pattern of prescribing of AMAs which help to improve the quality of care. Prescribing AMAs by generics and from the hospital formulary list according to the recommendations of the World Health Organization is a good sign of clinical practice. The study signifies the need to continuously monitor AMAs to optimize drug therapy and enhance the quality of drug use in clinical practice.

Substrate-dependent metabolomic signatures of myeloperoxidase activity in airway epithelial cells: Implications for early cystic fibrosis lung disease.

Myeloperoxidase (MPO) is released by neutrophils in inflamed tissues. MPO oxidizes chloride, bromide, and thiocyanate to produce hypochlorous acid (HOCl), hypobromous acid (HOBr), and hypothiocyanous acid (HOSCN), respectively. These oxidants are toxic to pathogens, but may also react with host cells to elicit biological activity and potential toxicity. In cystic fibrosis (CF) and related diseases, increased neutrophil inflammation leads to increased airway MPO and airway epithelial cell (AEC) exposure to its oxidants. In this study, we investigated how equal dose-rate exposures of MPO-derived oxidants differentially impact the metabolome of human AECs (BEAS-2B cells). We utilized enzymatic oxidant production with rate-limiting glucose oxidase (GOX) coupled to MPO, and chloride, bromide (Br-), or thiocyanate (SCN-) as substrates. AECs exposed to GOX/MPO/SCN- (favoring HOSCN) were viable after 24 h, while exposure to GOX/MPO (favoring HOCl) or GOX/MPO/Br- (favoring HOBr) developed cytotoxicity after 6 h. Cell glutathione and peroxiredoxin-3 oxidation were insufficient to explain these differences. However, untargeted metabolomics revealed GOX/MPO and GOX/MPO/Br- diverged significantly from GOX/MPO/SCN- for dozens of metabolites. We noted methionine sulfoxide and dehydromethionine were significantly increased in GOX/MPO- or GOX/MPO/Br--treated cells, and analyzed them as potential biomarkers of lung damage in bronchoalveolar lavage fluid from 5-year-olds with CF (n = 27). Both metabolites were associated with increasing bronchiectasis, neutrophils, and MPO activity. This suggests MPO production of HOCl and/or HOBr may contribute to inflammatory lung damage in early CF. In summary, our in vitro model enabled unbiased identification of exposure-specific metabolite products which may serve as biomarkers of lung damage in vivo. Continued research with this exposure model may yield additional oxidant-specific biomarkers and reveal explicit mechanisms of oxidant byproduct formation and cellular redox signaling.

Air quality status during Diwali festival of India: a case study.

The PM(2.5) and PM(10) samples were collected during Diwali celebration from study area and characterized for ionic concentration of four anions (NO(3) (-), NO(2) (-), Cl(-), SO(4) (2-)) and five cations (K(+), Mg(2+), NH(4) (+), Ca(2+), Na(+)). The results showed that the ionic concentrations were three times compared to those on pre and post Diwali days. Predominant ions for PM(2.5) were K(+) 33.7 µg/m(3), Mg(+) 31.6 µg/m(3), SO(4) (2-) 22.1 µg/m(3), NH(4) (+) 17.5 µg/m(3) and NO(3) (-) 18 µg/m(3) and for PM(10) the ionic concentrations were Mg(+) 29.6 µg/m(3), K(+) 26 µg/m(3), SO(4) (2-) 19.9 µg/m(3), NH(4) (+) 16.8 µg/m(3) and NO(3) (-) 16 µg/m(3). While concentration of SO(2) and NO(2) were 17.23, 70.33 µg/m(3) respectively.

Do carers and comforters require lead aprons during general radiographic examinations?

INTRODUCTION: Carers and comforters frequently remain with children during paediatric general radiographic examinations. As well as improving the likelihood of overall success of the procedure, this can be important for minimising stress and anxiety of the child. Wearing lead aprons can contribute to additional stress and anxiety about the procedure for both carer and child, specifically due to radiation risk. It also introduces some practical challenges for radiographers. This study quantified a carers exposure to scattered radiation for general radiographic examinations when remaining with a child to assist in positioning or to comfort them. METHODS: Scattered radiation was measured at four common locations where a carer may stand, with a range of tube potentials (40 kVp to 100 kVp ) and PMMA thicknesses of 2.5-22.5 cm. This was then matched to our clinical protocols to estimate the radiation dose a carer could be exposed to while assisting a patient during general radiographic examinations. RESULTS: The effective dose received by a carer standing 20 cm from the centre of the patient varies from 11 min of Australian natural BERT for a finger radiograph on a patient <3 kg and up to 62 h for a swimmers view radiograph performed on a patient >70 kg. CONCLUSION: This dosimetric data allowed an evidence-based assessment of radiation protection requirements for the carer using the ALARA principle. At our institution, it was decided that a lead apron is not required if the carer is unlikely to receive more than 2 µSv. A new policy, presented here, was developed to implement this decision.

Environmental impact of plantations in and around the petroleum refinery: a case study.

Plantation or green belt (GB) grown around the factories and industrial premises improves the condition of land, mitigates air pollution (as the plants serve as a sink for pollutants and check the flow of dust, etc.), and reduces the level of noise pollution. The software developed by NEERI for the determination of the optimal width of GB in and around an industry is based on the pollution attenuation coefficient of selected plant species of deciduous trees existing in the region. The assessment of the impact of these plantations/green belts of 500-m width in and around a petroleum refinery in the west coast of India is evaluated for reducing/managing various waste generated, and it is observed that the overall efficiency is more than 60%.

Prevalence and associations of moderately increased albuminuria in patients with type 2 diabetes in United Arab Emirates.

BACKGROUND AND AIMS: Our study sought to investigate the prevalence of moderately increased albuminuria in United Arab Emirates (UAE) nationals with type 2 diabetes, and to identify the associated factors. METHODS: This prospective cross-sectional study was conducted in two hundred and seven UAE nationals with type 2 diabetes mellitus attending the internal medicine department of a secondary care hospital. Moderately increased albuminuria was estimated in random spot urine samples and was defined as urinary albumin-to-creatinine ratio (UACR) of 3-30 mg/mmoL. Prevalence and associations of moderately increased albuminuria were evaluated. RESULTS: The study population had a mean UACR of 7.2 ± 10.2 mg/mmoL with mean eGFR of 94.5 ± 11.7 mL/min/1.73 m2. Prevalence of moderately increased albuminuria in our study population was found to be 44.0%. Multivariate logistic regression analysis showed that duration of diabetes (OR:1.72, 95% CI:1.34-2.19; p<0.001), presence of hypertension (OR:3.42, 95% CI:0.96-12.20; p=0.050) and neuropathy (OR:2.85, 95% CI:1.03-7.84; p=0.042), BMI (OR:1.08, 95% CI:1.01-1.16; p=0.019), HbA1c (OR:1.39, 95% CI:1.00-1.93; p=0.045), CRP (OR:1.10, 95% CI:1.00-1.22; p=0.035), serum creatinine (OR:1.04, 95% CI:1.02-1.06; p<0.001) and HDL-C (OR:0.10, 95% CI:0.01-0.28; p<0.001) were independently correlated with moderately increased albuminuria. Stepwise multiple linear regression analysis demonstrated that duration of diabetes, HbA1c, CRP and serum creatinine were independent predictors of UACR. CONCLUSION: We report a high prevalence of moderately increased albuminuria in UAE nationals with type 2 diabetes in a secondary care setting. Routine screening and timely management of moderately increased albuminuria in type 2 diabetes mellitus can lead to better patient outcomes.