Search results for: outflow tract obstruction

Authors: Anupalli Roja Rani, Saraswathi Jaggali

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Rose-scented geranium (Pelargonium graveolens L’Hér.) is an erect, much-branched shrub. It is indigenous to various parts of southern Africa, and it is often called Geranium. Pelargonium species are widely used by traditional healers in the areas of Southern Africa by Sotho, Xhosa, Khoi-San and Zulus for its curative and palliative effects in the treatment of diarrhea, dysentery, fever, respiratory tract infections, liver complaints, wounds, gastroenteritis, haemorrhage, kidney and bladder disorders. We have used Plant materials for extracting active compounds from analytical grades of solvents methanol, ethyl acetate, chloroform and water by a soxhlet apparatus. The phytochemical screening reveals that extracts of Pelargonium graveolens contains alkaloids, glycosides, steroids, tannins, saponins and phenols in ethyl acetate solvent. The antioxidant activity was determined using 1, 1-diphenyl-2-picrylhydrazyl (DPPH) bleaching method and the total phenolic content in the extracts was determined by the Folin–Ciocalteu method. Due to the presence of different phytochemical compounds in Pelargonium the anti-microbial activity against different micro-organisms like E.coli, Streptococcus, Klebsiella and Bacillus. Fractionation of plant extract was performed by column chromatography and was confirmed with HPLC analysis, NMR and FTIR spectroscopy for the compound identification in different organic solvent extracts.

Keywords: Pelargonium graveolens L’Hér, DPPH, micro-organisms, HPLC analysis, NMR, FTIR spectroscopy

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Authors: Richard Nyanzi, Maupi E. Letsoalo, Jacobus N. Eloff, Piet J. Jooste

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Candida albicans naturally occurs in the gastrointestinal tract (GIT) of more than 50% of humans. Overgrowth of the fungus causes several forms of candidiasis including oral thrush. Overgrowth tends to occur in immunocompromised humans such as diabetic, cancer and HIV patients. Antifungal treatment is available, but not without shortcomings. In this study, inhibitory activity of five probiotic Lactobacillus strains was demonstrated against the growth of seven clinical strains of Candida albicans by co-culturing of the organisms in a maize gruel (MG) medium. Phenotypic tests, molecular techniques and phylogenetic analysis have enabled precise identification of the organisms used in the study. The quantitative pour plate technique was used to enumerate colonies of the yeasts and the lactobacilli and the Kruskal-Wallis test and ANOVA tests were employed to compare the distributions of the colonies of the organisms. The cereal medium, containing added carbon sources, was inoculated with a Candida and a Lactobacillus strain in combination and incubated at 37 °C for 168 h. Aliquots were regularly taken and subjected to pH determination and colony enumeration. Certain Lactobacillus strains proved to be inhibitory and also lethal to some Candida albicans strains. A low pH due to Lactobacillus acid production resulted in significant low Candida colony counts. Higher Lactobacillus colony counts did not necessarily result in lower Candida counts suggesting that inhibitory factors besides low pH and competitive growth by lactobacilli contributed to the reduction in Candida counts. Such anti-Candida efficacy however needs to be confirmed by in vivo studies.

Keywords: candida albicans, oral thrush, candidiasis, lactobacillus, probiotics

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Authors: S. V. Patil, P. S. Dounde, S. S. Patil

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Emulgels have emerged as one of the most interesting topical delivery system as it has dual release control system that is gel and emulsion. The major objective behind this formulation is delivery of hydrophobic drugs to systemic circulation via skin. In fact presence of a gelling agent in water phase converts a classical emulsion in to emulgel. The emulgel for dermatological use has several favorable properties such as being thixotropic, greaseless, easily spreadable, easily removable, emollient, non-staining, water-soluble, longer shelf life, bio-friendly, transparent and pleasing appearance. Various penetration enhancers can potentiate the effect. So this can be used as better topical drug delivery systems over present conventional systems available in market. Piroxicam is a non-steroidal anti-inflammatory drug that has major problems when administered orally; it is an insoluble drug and has irritant effect on gastro intestinal tract lead to ulceration and bleeding. The aim of this study was to overcoming these problems through preparation of topical emulgel of this drug. Emulgel of Piroxicam was prepared using Carbopol 940 along with mentha oil and clove oil as permeation enhancer. The prepared emulgel were evaluated for their physical appearance, pH determination, viscosity, spreadability, in vitro drug release, ex vivo permeation studies. All the prepared formulations showed acceptable physical properties, homogeneity, consistency, spreadability, viscosity and pH value. The emulgel was found to be stable with respect to physical appearance, pH, rheological properties and drug content at all temperature and conditions for three month.

Keywords: emulgel, piroxicam, menthe oil, clove oil

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Authors: Ching-Yi Yiu, Hui-Chen Hsu

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Objectives: Obstructive sleep apnea syndrome (OSAS) is a popular problem in the modern society. It usually leads to sleep disorder, excessive daytime sleepiness and associated with cardiovascular diseases, cognitive dysfunction and even death. The nonsurgical therapies include continuous positive airway pressure (CPAP), diet and oral appliances. The surgical approaches have nasal surgery, tonsillectomy, adenoidectomy, uvulopalatopharyngoplasty (UPPP) and transoral robotic surgery (TORS).We compare the impact of surgical treatments on these kinds of patients. Methods: Between January 2018 to September 2022, We have enrolled 125 OSAS patients including 82 male and 43 female in Chi Mei Medical Center, Liouying, Taiwan. The age distribution from 6 to 71 years old (y/o) with mean age 36.1 y/o. The averaged body mass index (BMI) is 25 kg/m2 in male and 25.5 kg/m2 in female. In this cohort, we evaluated their upper airway obstruction sites with nasopharyngoscopy and scheduled a planned surgery. Some of cases received polysomnography (PSG) preoperatively, the averaged apnea-hypopnea index (AHI) is 37.7 events/hour. We have 68 patients received tonsillectomy, 9 received UPPP, 42 received UPPP and septomeatoplasty (SMP) and 6 received adenoidectomy and tonsillectomy (A and T). The subjective daytime sleepiness was evaluated with the Epworth sleepiness scale (ESS). Results: In the 68 tonsillectomy group, the averaged BMI is 24.9 kg/m2. In the UPPP group, the averaged BMI is 28.9 kg/m2. In UPPP and SMP group, the averaged BMI is 27.9 kg/m2. In the A and T group, the averaged BMI is 17.2 kg/m2. The reduction of AHI less than 20 is 58% postoperatively. The ESS reduced from 10.9 to 4.9 after surgery. Conclusion: Obstructive sleep apnea syndrome is a common upper airway disturbance in the general population. The prevalence rate is ranging high depending on different regions, age, sex and race. It leads to severe morbidity and mortality including car accident, stroke, nocturnal desaand sudden death and should be considered to be a major public health problem. The CPAP is effective to improve daytime sleepiness but the long-term compliance is low. The surgical treatment with different modalities can produce 50% decrease in AHI and ESS after surgery in the 6 to 12 months short-term period.

Keywords: apnea-hypopnea index, obstructive sleep apnea syndrome, polysomnography, uvulopalatopharyngoplasty

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Authors: Atinderpal Kaur, Shweta Dang

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Our aim is to develop a nanoemulsion-based delivery system containing polyphenon 60 (P60) and ciprofloxacin (Cipro) for intravaginal delivery to treat urinary tract infection. In the present study Polyphenon 60 (P60) and ciprofloxacin (Cipro) were loaded in a single nano emulsion (NE) system via ultra-sonication technique and characterized for particle size, in vitro release and antibacterial efficacy against Bcl-2 level Escherichia coli bacteria. To determine in vivo pharmacokinetic parameters and intravaginal transportation of NE, gamma scintigraphy and biodistribution study was conducted by radiolabelling NE with technetium pertechnetate (99mTc). The preliminary antibacterial investigation showed synergy between these compounds with FICindex of 0.42. The developed formulation showed zeta potential +55.3 and particle size of 151.7 nm, with PDI of 0.196. The in vitro release percentage of P60 at the end of 7th hours was 94.8 ± 0.9 % whereas the release for Cipro was 75.1± 0.15 % in simulated vaginal media. MBC was identified and the findings demonstrated that in both ESBL (Extended Spectrum β- lactamase) and MBL (Metallo β- lactamase) cultures the P60+Cipro NE showed inhibition of growth of all the isolates at 2 mg/ml dilutions. The percentage per gram of radiolabelled drug was found (3.50±0.26) and (3.81±0.30) in kidney and urinary bladder, respectively at 3 h. From the findings, it was concluded that the developed P60+Cipro NE was transported efficiently throughout the target organs, had long duration of action and high biocompatibility via intravaginal administration as compared to oral administration.

Keywords: ciprofloxacin, gamma scintigraphy, intravaginal drug delivery, Polyphenon 60

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Authors: Ewa Rusak, Sebastian Seget, Aleksandra Mroskowiak, Mirosław Partyka, Ewa Samulska, Julia Strózik, Anna Wilk, Przemysława Jarosz-Chobot

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Introduction: Various infections can affect children suffering from Type 1 Diabetes (T1D) because of dysfunctions of the immune system. The urinary tract and urethra of these children can be easily infected areas because of glycosuria. Aim: The microflora assessment of the urethra area of children with newly diagnosed T1D. Methods: The materials of the study were swabs taken prospectively from the urethral area of 63 children at the time of diagnosis of T1D (37 boys), then the results were correlated to the clinical parameters. In the statistical analysis, there were T student, Chi square, and U Mann-Whitney tests used. Results: The mean age was 9.4 years (6 months-17.4 years). The mean HbA1c value was 12.1% (5,6% - 20.1%). The mean value of glycosuria was 4463.2 mg/dl (0 - 9770 mg/dl). Ketoacidosis was diagnosed in 29 children (49%). The following microbial species were isolated in the collected materials: Staphylococcus epidermidis in 18 children (28.6%), Enterococcus faecalis in 17 children (27%), Candida albicans in 15 children (23.8%), coagulase-negative staphylococciin 11 children (17.5%), group B Streptococcus beta-hemolysis in 10 children (15.9%), S. aureus, E. coli, S. anginosus, C. glucuronolyticum, and A. urinae in 7 children each (11.1%), group B Streptococcus beta-hemolysis and S. hominis in 6 children each (9.5%), L. gasseri in 5 children (7.5%), C. dubliniensis in 4 children (6.3) and other, isolated cases. 2 of diagnosed patients were cultured negatively (3.2%). There were statistical correlations between the type of colonisation and patients’ sex and HbA1C value. Conclusions: It is extremely important to examine the urethral area at the time of diagnosis of T1D in order to detect inflammation and to undertake the appropriate and effective intervention.

Keywords: diabetology, skin disorders, microbiology, microflora

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Authors: Adam Majczak, Grzegorz Barański, Marcin Szlachetka

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Environmental considerations necessitate the search for new energy sources. One of the available solutions is a partial replacement of diesel fuel by compressed natural gas (CNG) in the compression ignition engines. This type of the engines is used mainly in vans and trucks. These units are also gaining more and more popularity in the passenger car market. In Europe, this part of the market share reaches 50%. Diesel engines are also used in industry in such vehicles as ship or locomotives. Diesel engines have higher emissions of nitrogen oxides in comparison to spark ignition engines. This can be currently limited by optimizing the combustion process and the use of additional systems such as exhaust gas recirculation or AdBlue technology. As a result of the combustion process of diesel fuel also particulate matter (PM) that are harmful to the human health are emitted. Their emission is limited by the use of a particulate filter. One of the method for toxic components emission reduction may be the use of liquid gas fuel such as propane and butane (LPG) or compressed natural gas (CNG). In addition to the environmental aspects, there are also economic reasons for the use of gaseous fuels to power diesel engines. A total or partial replacement of diesel gas is possible. Depending on the used technology and the percentage of diesel fuel replacement, it is possible to reduce the content of nitrogen oxides in the exhaust gas even by 30%, particulate matter (PM) by 95 % carbon monoxide and by 20%, in relation to original diesel fuel. The research object is prototype gas injector designed for direct injection of compressed natural gas (CNG) in compression ignition engines. The construction of the injector allows for it positioning in the glow plug socket, so that the gas is injected directly into the combustion chamber. The cycle analysis of the four-cylinder Andoria ADCR engine with a capacity of 2.6 dm3 for different crankshaft rotational speeds allowed to determine the necessary time for fuel injection. Because of that, it was possible to determine the required mass flow rate of the injector, for replacing as much of the original fuel by gaseous fuel. To ensure a high value of flow inside the injector, supply pressure equal to 1 MPa was applied. High gas supply pressure requires high value of valve opening forces. For this purpose, an injector with hydraulic control system, using a liquid under pressure for the opening process was designed. On the basis of air pressure measurements in the flow line after the injector, the analysis of opening and closing of the valve was made. Measurements of outflow mass of the injector were also carried out. The results showed that the designed injector meets the requirements necessary to supply ADCR engine by the CNG fuel.

Keywords: CNG, diesel engine, gas flow, gas injector

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Authors: Kalpana Rajouriya, Ajay Taneja

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Particulates are ubiquitous in the air environment and cause serious threats to human beings, such as lung cancer, COPD, and Asthma. Particulates mainly arise from industrial effluent, vehicular emission, and other anthropogenic activities. In the glass industrial city Firozabad, real-time monitoring of size segregated Particulate Matter (PM) and black carbon was done by Aerosol Black Carbon Detector (ABCD) and GRIMM portable aerosol Spectrometer at two different sites in which one site is urban and another is rural. The average mass concentration of size segregated PM during the study period (March & April 2022) was recorded as PM10 (223.73 g/m⁻³), PM5.0 (44.955 g/m⁻³), PM2.5 (59.275 g/m⁻³), PM1.0 (33.02 g/m⁻³), PM0.5 (2.05 g/m⁻³), and PM0.25 (2.99 g/m⁻³). The highest concentration of BC was found in Urban due to the emissions from diesel engines and wood burning, while NO2 was highest at the rural sites. The average concentrations of PM10 (6.08 and 2.73 times) PM2.5 exceeded the NAAQS and WHO guidelines. Particulate Matter deposition and health risk assessment was done by MPPD and USEPA model to know about the particulate matter toxicity in industrial residents. Health risk assessment results showed that Children are most likely to be affected by exposure of PM10 and PM2.5 and may have various non-carcinogenic and carcinogenic diseases. Deposition results inferred that the sensitive exposed population, especially 9 years old children, have high PM deposition as well as visualization and may be at risk of developing health-related problems from exposure to size-segregated PM. They will be discussed during presentation.

Keywords: particulate matter, black carbon, NO2, deposition of PM, health risk

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Authors: Paolo Grasso, Sai Kalyan Yelike, Federico Benzi, Mathieu Le Cam

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The cabin air quality (CAQ) in commercial aircraft is of prime interest, especially in the context of the COVID-19 pandemic. Current Environmental Control Systems (ECS) rely on a prescribed fresh airflow per passenger to dilute contaminants. An adaptive ECS strategy is proposed, leveraging air sensing and filtration technologies to ensure a better CAQ. This paper investigates the CAQ level achieved in commercial aircraft’s cabin during various flight scenarios. The modeling and simulation analysis is performed in a Modelica-based environment describing the dynamic behavior of the system. The model includes the following three main systems: cabin, recirculation loop and air-conditioning pack. The cabin model evaluates the thermo-hygrometric conditions and the air quality in the cabin depending on the number of passengers and crew members, the outdoor conditions and the conditions of the air supplied to the cabin. The recirculation loop includes models of the recirculation fan, ordinary and novel filtration technology, mixing chamber and outflow valve. The air-conditioning pack includes models of heat exchangers and turbomachinery needed to condition the hot pressurized air bled from the engine, as well as selected contaminants originated from the outside or bled from the engine. Different ventilation control strategies are modeled and simulated. Currently, a limited understanding of contaminant concentrations in the cabin and the lack of standardized and systematic methods to collect and record data constitute a challenge in establishing a causal relationship between CAQ and passengers' comfort. As a result, contaminants are neither measured nor filtered during flight, and the current sub-optimal way to avoid their accumulation is their dilution with the fresh air flow. However, the use of a prescribed amount of fresh air comes with a cost, making the ECS the most energy-demanding non-propulsive system within an aircraft. In such a context, this study shows that an ECS based on a reduced and adaptive fresh air flow, and relying on air sensing and filtration technologies, provides promising results in terms of CAQ control. The comparative simulation results demonstrate that the proposed adaptive ECS brings substantial improvements to the CAQ in terms of both controlling the asymptotic values of the concentration of the contaminant and in mitigating hazardous scenarios, such as fume events. Original architectures allowing for adaptive control of the inlet air flow rate based on monitored CAQ will change the requirements for filtration systems and redefine the ECS operation.

Keywords: cabin air quality, commercial aircraft, environmental control system, ventilation

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Authors: Deepika Biswas

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Acinetobacter baumannii, a hospital-acquired pathogen, causes nosocomial infections including pneumonia, urinary tract infection, and secondary meningitis. Carbapenem is most effective antibiotics against it. Its increased resistance to carbapenems has been a rising global concern. Antibiotics such as carbapenem are unable to use on hospital setups to eradicate A. baumannii, hence different concentrations of disinfectants including phenol; sodium hypochlorite and ethanol are increasingly being used. The objective of the present study is to find an effective concentration of above disinfectants against carbapenem-resistant strain RS307 of A. baumannii. Growth kinetics of RS307 has been determined using UV-Vis spectrophotometer in the presence and absence of disinfectants in triplicate and its standard deviation has also been calculated which make the results more reliable. Differential growth curves were plotted, which showed the effective concentration among all the concentrations of phenol, sodium hypochlorite and ethanol. On disc diffusion assay, antimicrobial effect was observed by comparing all the concentrations of disinfectants to check its synergy with imipenem, most effective carbapenem. All the results collectively revealed that 0.5% phenol, 0.5% sodium hypochlorite, and 70% ethanol could preferably be used as disinfectant for hospital setup against the carbapenem-resistant strain of A. baumannii. SDS PAGE analysis showed differential expression in the protein profile of A. baumannii after treatment. The present study highlighted that few disinfectants even in low concentration had shown better antimicrobial activity hence may be recommended for regular use in the hospitals, which will be cost effective and less harmful.

Keywords: Acenatobacter bomunii, phenol, sodium hypoclirite, ethanol, carbapenem resistance, disinfectant

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Authors: Olanrewaju O. Adeojo

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The constitutional system of government provides for the federating units of the Federal Republic of Nigeria, the States and the Local Councils under a governing structure of the Executive, the Legislature and the Judiciary with attendant distinct powers and spheres of influence. The legislative powers of the Federal Republic of Nigeria and of a State are vested in the National Assembly and House of Assembly of the State respectively. The Local council exercises legislative powers in clearly defined matters as provided by the Constitution. Though, the executive as constituted by the President and the Governor are charged with the powers of execution and administration, the legislature is empowered to ensure that such powers are duly exercised in accordance with the provisions of the Constitution. The vast areas do not make oversight functions indefinite and more importantly the purpose for the exercise of the powers are circumscribed. It include, among others, any matter with respect to which it has power to make laws. Indeed, the law provides for the competence of the legislature to procure evidence, examine all persons as witnesses, to summon any person to give evidence and to issue a warrant to compel attendance in matters relevant to the subject matter of its investigation. The exercise of functions envisaged by the Constitution seem to an extent to be literal because it lacks power of enforcing the outcome. Furthermore, the docility of the legislature is apparent in a situation where the agency or authority being called in to question is part of the branch of government to enforce sanctions. The process allows for cover up and obstruction of justice. The oversight functions are not functional in a situation where the executive is overbearing. The friction, that ensues, between the Legislature and the Executive in an attempt by the former to project the spirit of a constitutional mandate calls for concern. It is needless to state a power that can easily be frustrated. To an extent, the arm of government with coercive authority seems to have over shadowy effect over the laid down functions of the legislature. Recourse to adjudication by the Judiciary had not proved to be of any serious utility especially in a clime where the wheels of justice grinds slowly, as in Nigeria, due to the nature of the legal system. Consequently, the law and the Constitution, drawing lessons from other jurisdiction, need to insulate the legislative oversight from the vagaries of the executive. A strong and virile Constitutional Court that determines, within specific time line, issues pertaining to the oversight functions of the legislative power, is apposite.

Keywords: constitution, legislative, oversight, power

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Authors: Umme Hani, Mohammed Rahmatulla, Mohammed Ghazwani, Ali Alqahtani, Yahya Alhamhoom

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Background and introduction: Neratinib is a potent anticancer drug used for the treatment of breast cancer. It is poorly soluble at higher pH, which tends to minimize the therapeutic effects in the lower gastrointestinal tract (GIT) leading to poor bioavailability. An attempt has been made to prepare and develop a gastro-retentive system of Neratinib to improve the drug bioavailability in the GIT by enhancing the gastric retention time. Materials and methods: In the present study a three-factor at two-level (23) factorial design based optimization was used to inspect the effects of three independent variables (factors) such as sodium alginate (A), sodium bicarbonate (B) and sodium citrate (C) on the dependent variables like in vitro gelation, in vitro floating, water uptake and percentage drug release. Results: All the formulations showed pH in the range 6.7 ±0.25 to 7.4 ±0.24, percentage drug content was observed to be 96.3±0.27 to 99.5 ±0.28%, in vitro gelation observed as gelation immediate remains for an extended period. Percentage of water uptake was in the range between 9.01±0.15 to 31.01±0.25%, floating lag time was estimated form 7±0.39 to 57±0.36 sec. F4 and F5 showed floating even after 12hrs. All formulations showed a release of around 90% drug release within 12hr. It was observed that the selected independent variables affect the dependent variables. Conclusion: The developed system may be a promising and alternative approach to augment gastric retention of drugs and enhances the therapeutic efficacy of the drug.

Keywords: neratinib, 2³ factorial design, sodium alginate, floating, in situ gelling system

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Authors: Tejinder Pal Singh, Ravinder Kumar Malik, Gurpreet Kaur

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Adhesion is key factor for colonization of the gastrointestinal tract and the ability of probiotic strains to inhibit pathogens. Therefore, the adhesion ability is considered as a suitable biomarker for the selection of potential probiotic. In the present study, eight probiotic Lactobacillus reuteri strains were evaluated as viable, LiCl treated or heat-killed forms and compared with probiotic reference strains (L. reuteri ATCC55730). All strains investigated were able to adhere to Caco-2 cells. All probiotic L. reuteri strains tested were able to inhibit and displace (P < 0.05) the adhesion of Escherichia coli ATCC25922, Salmonella typhi NCDC113, Listeria monocytogenes ATCC53135 and Enterococcus faecalis NCDC115. The probiotic strain L. reuteri LR6 showed the strongest adhesion and pathogen inhibition ability among the eight L. reuteri strains tested. In addition, the abilities to inhibit and to displace adhered pathogens depended on both the probiotic and the pathogen strains tested suggesting the involvement of various mechanisms. The adhesion and antagonistic potential of the probiotic strains were significantly decreased upon exposure to 5M LiCl, showing that surface molecules, proteinaceous in nature, are involved. The heat-killed forms of the probiotic L. reuteri strains also inhibited the attachment of selected pathogens to Caco-2 cells. In conclusion, in vitro assays showed that L. reuteri strains, as viable or heat-killed forms, are adherent to Caco-2 cell line model and are highly antagonistic to selected pathogens in which surface molecules, proteinaceous molecules in particular, plays an important role.

Keywords: probiotics, Lactobacillus reuteri, adhesion, Caco-2 cells

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Authors: Emanuela Chiarella, Clelia Nisticò, Nicola Lombardo, Giovanna Lucia Piazzetta, Nadia Lobello, Maria Mesuraca

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Killian’s Antrochoanal Polyp is a benign lesion of the maxillary sinus characterized by unilateral nasal obstruction, pus discharge, and headache. It affects, more commonly children and young adults. Although its etiology still remains unclear, chronic inflammation, autoreactivity, allergies, and viral infections are strongly associated with its formation and development, resulting in nasal tissue remodeling. We aimed to investigate the stem cells components which reside in this pathological tissue. In particular, we adopted a protocol for the isolation and culturing of mesenchymal stem cells from surgical biopsies of three Killian nasal polyp patients (KNP-MSCs) as well as from their healthy nasal tissue (HNT-MSCs) that were used as controls. The immunophenotype profile of HNT-MSCs and KNP-MSCs was more similar, with a marked positivity for CD73, CD90, and CD105 expression, while being negative for CD34 and CD14 haematopoietic genes. Cell proliferation assay showed that KNP-MSCs had a replicative disadvantage compared to HNT-MSCs, as evidenced by the significantly lower number of cells in the S-phase of the cell cycle. KNP-MSCs also took longer to close a wound than HNT-MSCs, indicating a partial epithelial phenotype in which low levels of ICAM-1 mRNA and a significant increase in E-CAD transcript were detectable. Subsequently, the differentiation potential of both MSCs populations was analyzed by inducing osteoblastic or adipocyte differentiation for up to 20 days. KNP-MSCs showed the ability to differentiate into osteoblasts, although ALP activity as well as the number and size of calcium deposits were lower than osteogenic induced-HNT-MSCs. Also, mRNA levels of osteoblastic marker genes (OCN, OPN, OSX, RUNX2) resulted lower compared to control cell population. Instead, the analysis of the adipogenic differentiation potential showed a similar behavior between KNP-MSCs and HNT-MSCs considering that the amount of lipid droplets, the expression of adipocyte-specific genes (FABP4, AdipoQ, PPARγ2, LPL) and the content of triacylglycerols were almost overlapping. Taken together, these results first demonstrated that Killian's nasal polyp is a source of mesenchymal stem cells with self-renewal and multi-differentiative capabilities.

Keywords: Mesenchymal stem cells, adipogenic differentiation, osteogenic differentiation, EMT

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Authors: Klytaimnistra Katsara, George Kenanakis, Eleftherios Alissandrakis, Vassilis M. Papadakis

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In recent decades, microplastics (MPs) attracted the interest of the research community as the level of environmental plastic pollution has increased over the years. Through air inhalation and food consumption, MPs enter the human body, creating a series of possible health issues. The majority of MPs enter through the digestive tract; they migrate from the plastic packaging of the foodstuffs. Several plastics, such as Polyethylene (PE), are commonly used as food packaging material due to their preservation and storage capabilities. In this work, the surfaces of three different cured meat products with varied fat compositions were studied (bacon, mortadella, and salami) to determine the migration of MPs from plastic packaging. Micro-Raman spectroscopic measurements were performed in an experimental set lasting 28 days, where the meat samples were stored in vacuum-sealed low-density polyethylene (LDPE) pouches under refrigeration conditions at 4°C. Specific measurement days (0, 3, 9, 12, 15, and 28 days of storage) were chosen to obtain comparative results. Raman micro-spectroscopy was used to monitor the MPs migration, where the Raman spectral profile of LDPE first appeared on day 9 in Bacon, day 15 in Salami, and finally, on day 28 in Mortadella. All the meat samples on day 28 were tainted because a layer of bacterial outgrowth had developed on their surface. In conclusion, MP migration from food packaging to the surface of the cured meat samples was proven. To minimize the consumption of MPs in cured meat products that are stored in plastic packaging, a short period of storage time under refrigeration conditions is advised.

Keywords: cured meat, food packaging, low-density polyethylene, microplastic migration, micro-Raman spectroscopy

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Authors: Joshua Russell, Omar Zubair, Reuben Ndegwa

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Introduction: Mesenteric ischemia is an uncommon condition that can be challenging to diagnose in the acute setting, with the potential for significant morbidity and mortality. Very rarely has acute acalculous cholecystitis been described in the setting of mesenteric ischemia. Case: This was the case in a 78-year-old male, who initially presented with clinical and radiological evidence of small bowel obstruction, thought likely secondary to malignancy. The patient had a 6-week history of anorexia, worsening lower abdominal pain, and ~30kg of unintentional weight loss over a 12-month period and a CT- scan demonstrated a transition point in the distal ileum. The patient became increasingly hemodynamically unstable and peritonitic, and an emergency laparotomy was performed. Intra-operatively, however, no obvious transition point was identified, and instead, the gallbladder was markedly gangrenous and oedematous, consistent with acalculous cholecystitis. An open total cholecystectomy was subsequently performed. The patient was admitted to the Intensive Care Unit post-operatively and continued to deteriorate over the proceeding 48 hours, with two re-look laparotomies demonstrating progressively worsening bowel ischemia, initially in the distribution of the superior mesenteric artery and then the coeliac trunk. On review, the patient was found to have an aberrant right hepatic artery arising from the superior mesenteric artery. The extent of ischemia was considered non-survivable, and the patient was palliated. Discussion: Multiple theories currently exist for the underlying pathophysiology of acalculous cholecystitis, including biliary stasis, sepsis, and ischemia. This case lends further support to ischemia as the underlying etiology of acalculous cholecystitis. This is particularly the case when considered in the context of the patient’s aberrant right hepatic artery arising from the superior mesenteric artery, which occurs in 11-14% of patients. Conclusion: This case report adds further insight to the debate surrounding the pathophysiology of acalculous cholecystitis. It also presents acalculous cholecystitis as a complication of mesenteric ischemia that should always be considered, especially in the elderly patient and in the context of relatively common anatomical variations. Furthermore, the case brings to attention the importance of maintaining dynamic working diagnoses in the setting of evolving pathophysiology and clinical presentations.

Keywords: acalculous cholecystitis, anatomical variation, general surgery, mesenteric ischemia

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Authors: Alazar Nebyou, Sujata Pandit

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Lactic acid bacteria (LAB) are essential ingredients in probiotic foods, intestinal microflora, and dairy products that are capable of coping up with harsh gastrointestinal tract conditions and are available in a variety of environments. The objective of this study is to evaluate the probiotic property of LAB isolated from bovine milk. Milk samples were collected from local dairy farms. Samples were obtained using sterile test tubes and transported to a laboratory in the icebox for further biochemical characterization. Preliminary physiological and biochemical identification of LAB isolates was conducted by growing on MRS agar after ten-fold serial dilution. Seven of the best isolates were selected for the evaluation of the probiotic property. The LAB isolates were checked for resistance to antibiotics and their antimicrobial activity by disc diffusion assay and agar well diffusion assay respectively. Bile salt hydrolase activity of isolates was studied by growing isolates in a BSH medium with bile salt. Cell surface property of isolates was assayed by studying their autoaggregation and coaggregation percentage with S. aerues. All isolates were found BSH positive. In addition, BCM2 and BGM1 were susceptible to all antibiotic disks except BBM1 which was resistant to all antibiotic disks. BCM1 and BGM1 had the highest autoaggregation and coaggregation potential respectively. Since all LAB isolates showed gastrointestinal tolerance and good cell surface property they could be considered as good potential probiotic candidates for treatment and probiotic starter culture preparation.

Keywords: probiotic, aggregation, lactic acid bacteria, antimicrobial activity

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Authors: Eda Yakit Ak, Ergül Aslan

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The study was conducted using the quasi-experimental design to determine the influence of the nursing support program prepared according to the Health Belief Model on reproductive health behaviors of orthopedically disabled women in the physical therapy and rehabilitation clinic at a university hospital between August 2019-October, 2020. The research sample included 50 women (35 in the control group and 15 in the experimental group with orthopedic disability). A 3-week nursing support program was applied to the experimental group of women. To collect the data, Introductory Information Form and Scale for Determining the Protective Attitudes of Married Women towards Reproductive Health (SDPAMW) were applied. The evaluation was made with a follow-up form for four months. In the first evaluation, the total SDPAMW scores were 119.93±20.59 for the experimental group and 122.20±16.71 for the control group. In the final evaluation, the total SDPAMW scores were 144.27±11.95 for the experimental group and 118.00±16.43 for the control group. The difference between the groups regarding the first and final evaluations for the total SDPAMW scores was statistically significant (p<0.01). In the experimental group, between the first and final evaluations regarding the sub-dimensions of SDPAMW, an increase was found in the behavior of seeing the doctor on reproductive health issues, protection from reproductive organ and breast cancer, general health behaviors to protect reproductive health, and protection from genital tract infections (p<0.05). Consequently, the nursing support program based on the Health Belief Model applied to orthopedically disabled women positively affected reproductive health behaviors.

Keywords: orthopedically disabled, woman, reproductive health, nursing support program, health belief model

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Authors: Hannah Nagel, Hayley Lang, Albert Sole Guitart, Natasha Lean, Rachel Allavena, Cleide Sprohnie-Barrera, Alex Young

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Aggressive neoplasia of the hoof is a rare occurrence in horses and has been only sporadically described in the literature. In the few cases reported intra-hoof wall, aggressive neoplasia has been documented radiographically and has been described with variable imaging characteristics. These include a well-defined osteolytic area, a smoothly outlined semi-circular defect, an extensive draining tract beneath the hoof wall, as well as an additional large area of osteolysis or an extensive central lytic region. A 20-year-old Quarterhorse gelding and a 10-year-old Thoroughbred gelding were both presented for chronic reoccurring lameness in the left forelimb and left hindlimb, respectively. Both of the cases displayed radiographic lesions that have been previously described but also displayed osteoproliferative expansile regions of additional bone formation. Changes associated with hoof neoplasia are often non-specific due to the nature and capacity of bone to react to pathological insult, which is either to proliferate or be absorbed. Both cases depict and describe imaging findings seen on radiography, contrast radiography, computed tomography, and magnetic resonance imaging before reaching a histological diagnosis of malignant melanoma and squamous cell carcinoma. Although aggressive hoof wall neoplasia is rare, there are some imaging features which may raise our index of suspicion for an aggressive hoof wall lesion. This case report documents two horses with similar imaging findings who underwent multiple assessments, surgical interventions, and imaging modalities with a final diagnosis of malignant neoplasia.

Keywords: horse, hoof, imaging, radiography, neoplasia

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Authors: Vinay A. Sharma, Shiva Prasad H. C.

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The initial stages of any project are often observed to be in a mixed set of conditions. Setting up the project is a tough task, but taking the initial decisions is rather not complex, as some of the critical factors are yet to be introduced into the scenario. These simple initial decisions potentially shape the timeline and subsequent events that might later be plotted on it. Proceeding towards the solution for a problem is the primary objective in the initial stages. The optimization in the solutions can come later, and hence, the resources deployed towards attaining the solution are higher than what they would have been in the optimized versions. A ‘logic’ that counters the problem is essentially the core of the desired solution. Thus, if the problem is solved, the deployment of resources has led to the required logic being attained. As the project proceeds along, the individuals working on the project face fresh challenges as a team and are better accustomed to their surroundings. The developed, optimized solutions are then considered for implementation, as the individuals are now experienced, and know better of the consequences and causes of possible failure, and thus integrate the adequate tolerances wherever required. Furthermore, as the team graduates in terms of strength, acquires prodigious knowledge, and begins its efficient transfer, the individuals in charge of the project along with the managers focus more on the optimized solutions rather than the traditional ones to minimize the required resources. Hence, as time progresses, the authorities prioritize attainment of the required logic, at a lower amount of dedicated resources. For empirical analysis of the stated theory, leaders and key figures in organizations are surveyed for their ideas on appropriate logic required for tackling a problem. Key-pointers spotted in successfully implemented solutions are noted from the analysis of the responses and a metric for measuring logic is developed. A graph is plotted with the quantifiable logic on the Y-axis, and the dedicated resources for the solutions to various problems on the X-axis. The dedicated resources are plotted over time, and hence the X-axis is also a measure of time. In the initial stages of the project, the graph is rather linear, as the required logic will be attained, but the consumed resources are also high. With time, the authorities begin focusing on optimized solutions, since the logic attained through them is higher, but the resources deployed are comparatively lower. Hence, the difference between consecutive plotted ‘resources’ reduces and as a result, the slope of the graph gradually increases. On an overview, the graph takes a parabolic shape (beginning on the origin), as with each resource investment, ideally, the difference keeps on decreasing, and the logic attained through the solution keeps increasing. Even if the resource investment is higher, the managers and authorities, ideally make sure that the investment is being made on a proportionally high logic for a larger problem, that is, ideally the slope of the graph increases with the plotting of each point.

Keywords: decision-making, leadership, logic, strategic management

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Authors: Surbhi Aggarwal, Jaishree Paul

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Background: Role of GABA has been implicated in autoimmune diseases like multiple sclerosis, type1 diabetes and rheumatoid arthritis where they modulate the immune response but role in gut inflammation has not been defined. Ulcerative colitis (UC) and diarrhoeal predominant irritable bowel syndrome (IBS-D) both involve inflammation of gastrointestinal tract. UC is a chronic, relapsing and idiopathic inflammation of gut. IBS is a common functional gastrointestinal disorder characterised by abdominal pain, discomfort and alternating bowel habits. Mild inflammation is known to occur in IBS-D. Aim: Aim of this study was to investigate the role of GABA in UC as well as in IBS-D. Materials and methods: Blood and biopsy samples from UC, IBS-D and controls were collected. ELISA was used for measuring level of GABA in serum of UC, IBS-D and controls. RT-PCR analysis was done to determine GABAergic signal system in colon biopsy of UC, IBS-D and controls. RT-PCR was done to check the expression of proinflammatory cytokines. CurveExpert 1.4, Graphpad prism-6 software were used for data analysis. Statistical analysis was done by unpaired, two-way student`s t-test. All sets of data were represented as mean± SEM. A probability level of p < 0.05 was considered statistically significant. Results and conclusion: Significantly decreased level of GABA and altered GABAergic signal system was detected in UC and IBS-D as compared to controls. Significantly increased expression of proinflammatory cytokines was also determined in UC and IBS-D as compared to controls. Hence we conclude that insufficient level of GABA in UC and IBS-D leads to overproduction of proinflammatory cytokines which further contributes to inflammation. GABA may be used as a promising therapeutic target for treatment of gut inflammation or other inflammatory diseases.

Keywords: diarrheal predominant irritable bowel syndrome, γ-aminobutyric acid (GABA), inflammation, ulcerative colitis

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Authors: Maatouk Mohamed, Nouira Mariem

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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Authors: Firas Rashad Al-Samarai

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Introduction: Benign prostatic hyperplasia (BPH) is a common condition as men get older. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder. It can also cause bladder, urinary tract, or kidney problems. Objective: to evaluate the efficacy and interaction of tamsulosin with finasteride treatment on induced benign prostate hyperplasia (BPH) in mice. Methods: BPH was induced by subcutaneous injection of testosterone propionate (20 mg/kg) for 30 days. Eighty-five mice were divided into five groups. The first group (G1): twenty-five mice induced BPH treated with tamsulosin orally and divided into five equal subgroups with doses (0.017, 0.052, 0.087, 0. 123, and 0.158) mg/kg, the second group (G2): twenty-five mice induced BPH treated with finasteride orally and divided into five equal subgroups with doses (0.175, 0.527, 0.878, 1.23, and 1.580) mg/kg. the third group (G3): twenty-five mice induced BPH treated with a combination of tamsulosin with finasteride orally, and divided into five equal subgroups with doses (0.0085, 0.0875), (0.026, 0.2635), (0.0435, 0.439) , (0.0615, 0.615) and ( 0.079 , 0.790 ) mg/kg respectively. Fourth group (G4): five mice induced BPH and treated distilled water. Fifth group (G5): five mice were not inducing BPH and without any treatment. Results: The results showed a gradual significant increase in prostate weight % and prostate index % Inhibitions until reached saturation in the last two doses of tamsulosin, finasteride, and combination groups, the maximum effective dose of tamsulosin and finasteride were (0.156) and (1.495) mg/kg respectively. Moreover, the effective dose of the combination (tamsulosin and finasteride) was estimated (0.06876, 0.6876) mg/kg, respectively, as well as the type of interaction was synergism and the value of the combination index was 0.046. Conclusions: We concluded that the combination of tamsulosin with finasteride showed a synergistic effect in BPH treatment by minimizing the side effect of each drug as s result of decreasing the dose of each one.

Keywords: Tamsulosin, Finasteride, combination, BPH

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Authors: S. Thaiudom, W. Toommuangpak

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Yoghurt ice cream (YIC) containing prebiotics and probiotics seems to be much more recognized among consumers who concern for their health. Not only can it be a benefit on consumers’ health but also its taste and freshness provide people easily accept. However, the survival of such probiotic especially Bifidobacterium longum, found in human gastrointestinal tract and to be benefit to human gut, was still needed to study in the severe condition as whipping and freezing in ice cream process. Low and full-fat yoghurt ice cream containing 2 and 10% (w/w) fat content (LYIC and FYIC), respectively was produced by mixing 20% yoghurt containing B. longum into milk ice cream mix. Fructo-oligosaccharides (FOS) or galacto-oligosaccharides (GOS) at 0, 1, and 2% (w/w) were separately used as prebiotic in order to improve the survival of B. longum. Survival of this bacteria as a function of ice cream storage time and ice cream properties were investigated. The results showed that prebiotic; especially FOS could improve viable count of B. longum. The more concentration of prebiotic used, the more is the survival of B. Longum. These prebiotics could prolong the survival of B. longum up to 60 days, and the amount of survival number was still in the recommended level (106 cfu per gram). Fat content and prebiotic did not significantly affect the total acidity and the overrun of all samples, but an increase of fat content significantly increased the fat particle size which might be because of partial coalescence found in FYIC rather than in LYIC. However, addition of GOS or FOS could reduce the fat particle size, especially in FYIC. GOS seemed to reduce the hardness of YIC rather than FOS. High fat content (10% fat) significantly influenced on lowering the melting rate of YIC better than 2% fat content due to the 3-dimension networks of fat partial coalescence theoretically occurring more in FYIC than in LYIC. However, FOS seemed to retard the melting rate of ice cream better than GOS. In conclusion, GOS and FOS in YIC with different fat content can enhance the survival of B. longum and affect physical and chemical properties of such yoghurt ice cream.

Keywords: Bifidobacterium longum, prebiotic, survival, yoghurt ice cream

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Authors: Rahul Jarariya

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The textile industry uses various types of dyes and discharges a lot of highly coloured wastewater. It impacts the environment like allergic reaction, respiratory, skin problems, irritation to a mucous membrane, the upper respiratory tract has to the fore, Intoxicated dye discharges 40 to 50,000 tons with great concern. Spinel ferrites gained a lot of attention due to their wide application area from biomedical to wastewater treatment. Generally, spinel ferrite is known as M-Fe2O4. Spinel type nanoparticles possess high suspension stability. The synthesis method of Microwave solution combustion (MC) method is effective for nanoscale materials, including oxides, metals, alloys, and sulfides, works as fast and energy-efficient during the process. The review focuses on controlling, nanostructure and doping. The influence of the fuel concentration and the post-treatment temperature on the structural and magnetic properties. The effects of amounts of fuel and phase changes, particle size and shape, and magnetic properties can be characterized by various techniques. Urea is the most commonly used fuel. Ethanol or n-butanol is apt for removing impurities. As a result of the materials gives fine purity. Photocatalysis phenomena act with catalyst dosage to degrade dye from wastewater. Visible light responsive produces a large amount of hydroxyl (•OH) radical made the degradation efficiency of Rh21 type dye. It develops a narrow bandgap to make it suitable for enhanced photocatalytic activity.

Keywords: microwave solution combustion method, normal spinel, doped spinels, magnetic property, Rb21

Procedia PDF Downloads 181

Authors: S. Chuenchooklin, S. Taweepong, U. Pangnakorn

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This research was conducted in the Mae Sot Watershed whereas located in the Moei River Basin at the Upper Salween River Basin in Tak Province, Thailand. The Mae Sot Municipality is the largest urbanized in Tak Province and situated in the midstream of the Mae Sot Watershed. It usually faces flash flood problem after heavy rain due to poor flood management has been reported since economic rapidly bloom up in recently years. Its catchment can be classified as ungauged basin with lack of rainfall data and no any stream gaging station was reported. It was attached by most severely flood event in 2013 as the worst studied case for those all communities in this municipality. Moreover, other problems are also faced in this watershed such shortage water supply for domestic consumption and agriculture utilizations including deterioration of water quality and landslide as well. The research aimed to increase capability building and strengthening the participation of those local community leaders and related agencies to conduct better water management in urban area was started by mean of the data collection and illustration of appropriated application of some short period rainfall forecasting model as the aim for better flood relief plan and management through the hydrologic model system and river analysis system programs. The authors intended to apply the global rainfall data via the integrated data viewer (IDV) program from the Unidata with the aim for rainfall forecasting in short period of 7 - 10 days in advance during rainy season instead of real time record. The IDV product can be present in advance period of rainfall with time step of 3 - 6 hours was introduced to the communities. The result can be used to input to either the hydrologic modeling system model (HEC-HMS) or the soil water assessment tool model (SWAT) for synthesizing flood hydrographs and use for flood forecasting as well. The authors applied the river analysis system model (HEC-RAS) to present flood flow behaviors in the reach of the Mae Sot stream via the downtown of the Mae Sot City as flood extents as water surface level at every cross-sectional profiles of the stream. Both models of HMS and RAS were tested in 2013 with observed rainfall and inflow-outflow data from the Mae Sot Dam. The result of HMS showed fit to the observed data at dam and applied at upstream boundary discharge to RAS in order to simulate flood extents and tested in the field, and the result found satisfied. The result of IDV’s rainfall forecast data was compared to observed data and found fair. However, it is an appropriate tool to use in the ungauged catchment to use with flood hydrograph and river analysis models for future efficient flood relief plan and management.

Keywords: global rainfall, flood forecast, hydrologic modeling system, river analysis system

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Authors: Seyed Ali Hossein Zahraei, Iman Dianat

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The role of midwives and healthcare providers in applying pain relief methods to female patients is very important. different therapies like hydropathy, flavorer remedies, and respiratory techniques for pain relief do not work properly as what we expected. Lack of recognition of the physiological property of birth, despite findings that coming will attenuate the consequences of hurting, suggests the necessity for bigger awareness among expectant oldsters, educators, and health professionals of the potential of coming as a way of pain relief. Method: In our method we have 5 steps to achieve activation of oxytocin and dopamine pathways in order to reduce pain in all possible fields and reasons instead of using other treatments such as chemical painkillers. Step 1: First of all the patient should start by rubbing the clitoris up and down till occurring first clitoral orgasm. Step 2: Without stop rubing clitoris the patient must continue stimulate the clitoris in different way like circular motion in clock pathway until occurring second clitoral orgasm. Step 3: Immedietly the patient can change the position from clitoris to urethral opening where vestibular glands located. In this step the patient nock the urethral area very slowly without pressure and just like touching the area till feeling want to pee. But because of activation of sympathic nerves the gi tract is inactive. Step 4: In this step the patient should apply more pressure and change the motion to circular on urethral area in which the pee sensation increase but actually it is vestibular gland fluid. The patient should release it in small amount in this step. Step 5: The last step is combination of clitoral and urethral stimulation in up and down motion that cause more pee feeling and after clitoral orgasm occurred the amount of released fluid can be about 400ml.

Keywords: female, natural, method, pain

Procedia PDF Downloads 254

Authors: Ana Lucia Molina

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Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique for the investigation and modulation of cortical excitability in humans. The modulation of the processing of different cortical areas can result in several areas for rehabilitation, showing great potential in the treatment of motor disorders. In the human brain, the supplementary motor area (SMA) is involved in the control of the pelvic floor muscles (MAP), where dysfunctions of these muscles can lead to urinary incontinence. Peripheral magnetic stimulation, specifically sacral magnetic stimulation, has been used as a safe and effective treatment option for patients with lower urinary tract dysfunction. A systematic literature review was carried out (Pubmed, Medline and Google academic database) without a time limit using the keywords: "transcranial magnetic stimulation", "sacral neuromodulation", and "urinary incontinence", where 11 articles attended to the inclusion criteria. Results: Thirteen articles were selected. Magnetic stimulation is a non-invasive neuromodulation technique widely used in the evaluation of cortical areas and their respective peripheral areas, as well as in the treatment of lesions of brain origin. With regard to pelvic-perineal disorders, repetitive transcranial stimulation showed significant effects in controlling urinary incontinence, as well as sacral peripheral magnetic stimulation, in addition to exerting the potential to restore bladder sphincter function. Conclusion: Data from the literature suggest that both transcranial stimulation and peripheral stimulation are non-invasive references that can be promising and effective means of treatment in pelvic and perineal disorders. More prospective and randomized studies on a larger scale are needed, adapting the most appropriate and resolving parameters.

Keywords: urinary incontinence, non-invasive neuromodulation, sacral neuromodulation, transcranial magnetic stimulation.

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Authors: Huidan Yu, Anurag Deb, Rou Chen, I-Wen Wang

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The use of left ventricle assist devices (LVADs) in patients with heart failure has been a proven and effective therapy for patients with severe end-stage heart failure. Due to the limited availability of suitable donor hearts, LVADs will probably become the alternative solution for patient with heart failure in the near future. While the LVAD is being continuously improved toward enhanced performance, increased device durability, reduced size, a better understanding of implantation management becomes critical in order to achieve better long-term blood supplies and less post-surgical complications such as thrombi generation. Important issues related to the LVAD implantation include the location of outflow grafting (OG), the angle of the OG, the combination between LVAD and native heart pumping, uniform or pulsatile flow at OG, etc. We have hypothesized that an optimal implantation of LVAD is patient specific. To test this hypothesis, we employ a novel in-house computational modeling technique, named InVascular, to conduct a systematic evaluation of cardiac output at aortic arch together with other pertinent hemodynamic quantities for each patient under various implantation scenarios aiming to get an optimal implantation strategy. InVacular is a powerful computational modeling technique that integrates unified mesoscale modeling for both image segmentation and fluid dynamics with the cutting-edge GPU parallel computing. It first segments the aortic artery from patient’s CT image, then seamlessly feeds extracted morphology, together with the velocity wave from Echo Ultrasound image of the same patient, to the computation model to quantify 4-D (time+space) velocity and pressure fields. Using one NVIDIA Tesla K40 GPU card, InVascular completes a computation from CT image to 4-D hemodynamics within 30 minutes. Thus it has the great potential to conduct massive numerical simulation and analysis. The systematic evaluation for one patient includes three OG anastomosis (ascending aorta, descending thoracic aorta, and subclavian artery), three combinations of LVAD and native heart pumping (1:1, 1:2, and 1:3), three angles of OG anastomosis (inclined upward, perpendicular, and inclined downward), and two LVAD inflow conditions (uniform and pulsatile). The optimal LVAD implantation is suggested through a comprehensive analysis of the cardiac output and related hemodynamics from the simulations over the fifty-four scenarios. To confirm the hypothesis, 5 random patient cases will be evaluated.

Keywords: graphic processing unit (GPU) parallel computing, left ventricle assist device (LVAD), lumped-parameter model, patient-specific computational hemodynamics

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Authors: Angelis P. Barlampas

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PURPOSE: Presentation of an interesting finding in an asymptomatic patient. MATERIAL: A patient came at hospital because of dysuric complaints and after a urologist’s prescription of a US exam of the urogenital system. The simple ultrasound examination of the lower abdomen revealed a moderate hypertrophy of the prostate and a solitary large bladder stone. The kidneys were normal. Then, the patient underwent a CT scan, which depicted the bladder stone and, as an incidental finding, a cystic lesion in contact with the upper anterior right surface of the bladder, with mural calcifications. METHOD: Abdominal ultrasound and abdominal computed tomography before and after intravenous contrast administration. RESULTS: The repeated US exam showed a cylindrical cystic lesion with a double wall and two mural hyperechoic foci, with partial posterior shadowing. Blood flow was not recognized on color doppler. The CT exam confirmed the cystic-like anechoic lesion, in the right iliac fossa, with the presence of two foci of mural calcifications. The differential diagnosis includes cases of enteric cyst, intestinal duplication cyst, chronic abscess, urachal cyst, Meckel's diverticulum, bladder diverticulum, old hematoma, thrombosed vascular aneurysm, diverticular abscess, etc. The patient refused surgical removal and is being monitored by ultrasound. CONCLUSIONS: The careful examination of the wider peri-abdominal area, especially during the routine ultrasound examination, can contribute to the identification of important asymptomatic findings. The radiologist must not be solely focused in a certain area of examination, even if the clinical doctor asks so, but should give attention to the neighboring areas, too.

Keywords: enteric cyst, US, CT, urogenital tract, miscellaneous findings

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