Search results for: suprapubic prostatic ultrasound

Authors: E. Tan, O. McKay, T. Clarnette T., D. Croagh

Abstract:

Background: Historically with pancreatic trauma, complete disruption of the main pancreatic duct (MPD), classified as Grade IV-V by the American Association for the Surgery of Trauma (AAST), necessitated a damage-control laparotomy. This was to avoid mortality, shorten diet upgrade timeframe, and hence shorter length of stay. However, acute pancreatic resection entailed complications of pancreatic fistulas and leaks. With the advance of imaging-guided interventions, non-operative management such as percutaneous and transpapillary drainage of traumatic peripancreatic collections have been trialled favourably. The aim of this case series is to evaluate the efficacy of endoscopic ultrasound-guided (EUS) transmural drainage in managing traumatic peripancreatic collections as a less invasive alternative to traditional approaches. This study also highlights the importance of anatomical knowledge regarding peripancreatic collection’s common location in the lesser sac, the pancreas relationship to adjacent organs, and the formation of the main pancreatic duct in regards to the feasibility of therapeutic internal drainage. Methodology: A retrospective case series was conducted at a single tertiary endoscopy unit, analysing patient data over a 5-year period. Inclusion criteria outlined patients age 5 to 80-years-old, traumatic pancreatic injury of at least Grade IV and haemodynamic stability. Exclusion criteria involved previous episodes of pancreatitis or abdominal trauma. Patient demographics and clinicopathological characteristics were retrospectively collected. Results: The study identified 7 patients with traumatic pancreatic injuries that were managed from 2018-2022; age ranging from 5 to 34 years old, with majority being female (n=5). Majority of the mechanisms of trauma were a handlebar injury (n=4). Diagnosis was confirmed with an elevated lipase and computerized tomotography (CT) confirmation of proximal pancreatic transection with MPD disruption. All patients sustained an isolated single organ grade IV pancreatic injury, except case 4 and 5 with other intra-abdominal visceral Grade 1 injuries. 6 patients underwent early ERCP-guided transpapillary drainage with 1 being unsuccessful for pancreatic duct stent insertion (case 1) and 1 complication of stent migration (case 2). Surveillance imaging post ERCP showed the stents were unable to bridge the disrupted duct and development of symptomatic collections with an average size of 9.9cm. Hence, all patients proceeded to EUS-guided transmural drainage, with 2/7 patients requiring repeat drainages (case 6 and 7). Majority (n=6) had a cystogastrostomy, whilst 1 (case 6) had a cystoenterostomy due to feasibility of the peripancreatic collection being adjacent to duodenum rather than stomach. However, case 6 subsequently required repeat EUS-guided drainage with cystogastrostomy for ongoing collections. Hence all patients avoided initial laparotomy with an average index length of stay of 11.7 days. Successful transmural drainage was demonstrated, with no long-term complications of pancreatic insufficiency; except for 1 patient requiring a distal pancreatectomy at 2 year follow-up due to chronic pain. Conclusion: The early results of this series support EUS-guided transmural drainage as a viable management option for traumatic peripancreatic collections, showcasing successful outcomes, minimal complications, and long-term efficacy in avoiding surgical interventions. More studies are required before the adoption of this procedure as a less invasive and complication-prone management approach for traumatic peripancreatic collections.

Keywords: endoscopic ultrasound, cystogastrostomy, pancreatic trauma, traumatic peripancreatic collection, transmural drainage

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Authors: Dharshini Selvarajah, Nicula Lui, Karen Kong

Abstract:

Background: Uterine fibroids are a common benign gynaecologic neoplasm in reproductive-aged women. Fibroids may become symptomatic in a vast majority of nulliparous women. Their diagnosis and management is often coordinated between gyneacologists, radiologists and urologists depending on the anatomical location, growth, size and the fibroids sarcomatous evolvement. Some patients may develop obstructive uropathy symptoms, either uni or bilateral secondary urethral obstruction causing hydronephrosis. Uterine artery emoblisation (UAE) has previously shown to effectively resolve symptoms as well as relieve urethral obstruction and resolve the hydronephrosis. UAE has now established itself as an organ preserving and minimally invasive procedure in the management of symptomatic uterine fibroids. It is a safe and effective alternative to hysterectomy for resolving fibroid related pressure symptoms. The case presented examines the clinical manifestations and impact of uterine fibroids on the urinary tract system. The therapeutic options to relieve the urological symptoms as well as preserve fertility are explored and presented. Case: The case is a 29-year-old Nepalese female admitted to hospital with recurrent urosepsis with multiresistant organisms. This was on a background of an enlarged uterus (measuring 17cm x11cm) with multiple subserosal, intramural and exophytic fibroids- causing external ureteric compression. She had bilateral ureteric stents insitu and required bilateral right and left nephrostomies during repeated episodes of urosepsis and bilateral ureteric obstruction. The left nephrostomy was removed a month prior to admission and her most recent CT KUB demonstrated hypofunctioning ureteric stents with bilateral hydronephrosis. Options of hysterectomy versus uterine artery emoblisation (UAE) were extensively explored. The patient was keen to preserve fertility. Risks associated with UAE such as expulsion of the submucosal component of the fibroids and the possibilities of sepsis in the setting of ongoing ureteric colonisation were particularly high. The patient opted to trial UAE even though the risks of recurrent hospital admissions with urosepsis were going to be particularly high. In the event, the uterus fails to shrink adequately enough to relieve the obstructed ureters a hysterectomy would inevitably be required in future. Day 3 post UAE the patient developed fevers, was hypotensive and tachycardic post-receiving prophylactic meropenem and fluconazole pre emoblisation. She was noted to have a CRP of 293 with the most recent urine culture during this time growing Candida albicans. The patient was recommenced on oral fluconazole and IV meropenem, with good effect. Her repeat renal tract ultrasound post-UAE showed ongoing marked left hydronephrosis relatively unchanged from the scan one month prior to the procedure, however the right-sided hydronephrosis had resolved. The patient was discharged on a 2-week course of antibiotics. The patient will have a repeat renal tract ultrasound and MRI of the ureters to re-evaluate the degree of hydronephrosis and progress- this was unavailable at the time of abstract submission and will be presented at the conference. Conclusion: Fibroids are a common benign tumour of the uterus and can frequently impact the lower urinary system resulting in significant uropathy. They often enlarge and compress the urinary bladder, urethra and lower end of the ureters. The effectiveness of UAE as a fertility preserving option is described.

Keywords: Uterine leiomyomas and urological complications, uterine artery embolisation for fibroids, Uterine fibroids and complications, Management of uterine fibroids

Procedia PDF Downloads 225

Authors: Dharshini Selvarajah, Karen Kong

Abstract:

Background: Uterine fibroids are a common benign gynaecologic neoplasm in reproductive-aged women. Fibroids may become symptomatic in a vast majority of nulliparous women. Their diagnosis and management are often coordinated between gyneacologists, radiologists and urologists depending on the anatomical location, growth, size and the fibroids' sarcomatous evolvement. Some patients may develop obstructive uropathy symptoms, either uni or bilateral secondary urethral obstruction causing hydronephrosis. Uterine artery embolization (UAE) has previously been shown to effectively resolve symptoms as well as relieve urethral obstruction and resolve hydronephrosis. UAE has now established itself as an organ-preserving and minimally invasive procedure in the management of symptomatic uterine fibroids. It is a safe and effective alternative to hysterectomy for resolving fibroid-related pressure symptoms. The case presented examines the clinical manifestations and impact of uterine fibroids on the urinary tract system. The therapeutic options to relieve the urological symptoms as well as preserve fertility are explored and presented. Case: The case is a 29-year-old Nepalese female admitted to the hospital with recurrent urosepsis with multiresistant organisms. This was on a background of an enlarged uterus (measuring 17cm x11cm) with multiple subserosal, intramural and exophytic fibroids- causing external ureteric compression. She had bilateral ureteric stents in situ and required bilateral right and left nephrostomies during repeated episodes of urosepsis and bilateral ureteric obstruction. The left nephrostomy was removed a month prior to admission, and her most recent CT KUB demonstrated hypofunctioning ureteric stents with bilateral hydronephrosis. Options of hysterectomy versus uterine artery embolization (UAE) were extensively explored. The patient was keen to preserve fertility. Risks associated with UAE, such as the expulsion of the submucosal component of the fibroids and the possibilities of sepsis in the setting of ongoing ureteric colonisation were particularly high. The patient opted to trial UAE even though the risks of recurrent hospital admissions with urosepsis were going to be particularly high. In the event, the uterus fails to shrink adequately enough to relieve the obstructed ureters, a hysterectomy would inevitably be required in the future. Day 3 post-UAE the patient developed fevers, was hypotensive and tachycardic post-receiving prophylactic meropenem and fluconazole pre emoblisation. She was noted to have a CRP of 293 with the most recent urine culture during this time growing Candida albicans. The patient was recommenced on oral fluconazole and IV meropenum, with good effect. Her repeat renal tract ultrasound post-UAE showed ongoing marked left hydronephrosis relatively unchanged from the scan one month prior to the procedure; however, the right-sided hydronephrosis had resolved. The patient was discharged on a 2-week course of antibiotics. The patient will have a repeat renal tract ultrasound and MRI of the ureters to re-evaluate the degree of hydronephrosis and progress- this was unavailable at the time of abstract submission and will be presented at the conference. Conclusion: Fibroids are a common benign tumor of the uterus and can frequently impact the lower urinary system resulting in significant uropathy. They often enlarge and compress the urinary bladder, urethra and lower end of the ureters. The effectiveness of the UAE as a fertility-preserving option is described.

Keywords: uterine artery embolisation for fibroids, urological complications from fibroids, uropathy of fibroids, obstructive fibroid management

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Authors: Santosh Tummidi, Pragati Sathe, Kanchan Kothari, Prachi Gholap, Mona Agnihotri, Gwendolyn Fernandes, Leena Naik, Rachana Chaturvedi

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Introduction: EUS-Guided Fine Needle Aspiration/Brush (EUS-FNA/Brush) has become increasingly popular for the diagnosis and staging of gastrointestinal and peri-gastrointestinal lesions. Objective: To evaluate the diagnostic accuracy and spectrum of lesions in gastrointestinal EUS-FNA. Material and Methods: A total of 124 EUS-FNA during the period from Aug 2015-Nov 2016 were studied. Results: Age ranged from 13-80 years with a slight female predominance. CBD was the most common site with 47 cases amongst which were 9 adenocarcinoma, and 7 cases were suspicious for malignancy. Pancreatic EUS-FNA showed 5 adenocarcinoma, 2 SPEN, 1 case each of neuroendocrine tumor, anaplastic carcinoma and NHL. Amongst oesophageal lesions, 3 cases were suspicious for malignancy, and 4 were inflammatory, 4 showed SCC, 1case each adenocarcinoma and leiomyoma. Stomach- 1 case each of adenocarcinoma, granulomatous inflammation, and GIST. Periportal lymph nodes were the commonest nodes, and there were 11 necrotising granulomatous inflammations, 3 metastatic adenocarcinoma, 2 cases of atypical cells and 1 case of NHL. 17 cases were unsatisfactory, 41 cases had histopathology follow up with 85% cases being concordant. Conclusion: EUS-FNA is reliable, sensitive and specific. It can be utilized for better management of intra-abdominal lesions.

Keywords: EUS-FNA, brush, cytology, histopathology

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Authors: Eunhwa Jun

Abstract:

This case report describes the misdiagnosis of a patient who presented with right arm pain as cervical disc herniation. The patient had several underlying conditions, including hypertension, diabetes mellitus, liver cirrhosis, a history of lung cancer with left lower lobe lobectomy, and adjuvant chemoradiotherapy. An external cervical spine MRI revealed central protruding discs at the C4-5-6-7 levels. Despite treatment with medication and epidural blocks, the patient's pain persisted. A C-RACZ procedure was planned, but the patient's pain had worsened before admission. Using ultrasound, a brachial plexus block was attempted, but the brachial plexus eluded clear visualization, hinting at underlying neurological complexities. Chest CT revealed a new, large soft tissue mass in the right supraclavicular region with adjacent right axillary lymphadenopathy, leading to the diagnosis of metastatic squamous cell carcinoma. Palliative radiation therapy and chemotherapy were initiated as part of the treatment plan, and the patient's pain score decreased to 3 out of 10 on the Numeric Rating Scale (NRS), revealing the pain was due to metastatic lung cancer.

Keywords: supraclavicula brachial plexus metastasis, cervical disc herniation, brachial plexus block, metastatic lung cancer

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Authors: Mohamed K. Metwally, Sherif H. El-Gohary, Kyung Min Byun, Seung Moo Han, Soo Yeol Lee, Min Hyoung Cho, Gon Khang, Jinsung Cho, Tae-Seong Kim

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Photoacoustic imaging (PAI) is a non-invasive and non-ionizing imaging modality that combines the absorption contrast of light with ultrasound resolution. Laser is used to deposit optical energy into a target (i.e., optical fluence). Consequently, the target temperature rises, and then thermal expansion occurs that leads to generating a PA signal. In general, most image reconstruction algorithms for PAI assume uniform fluence within an imaging object. However, it is known that optical fluence distribution within the object is non-uniform. This could affect the reconstruction of PA images. In this study, we have investigated the influence of optical fluence distribution on PA back-propagation imaging using finite element method. The uniform fluence was simulated as a triangular waveform within the object of interest. The non-uniform fluence distribution was estimated by solving light propagation within a tissue model via Monte Carlo method. The results show that the PA signal in the case of non-uniform fluence is wider than the uniform case by 23%. The frequency spectrum of the PA signal due to the non-uniform fluence has missed some high frequency components in comparison to the uniform case. Consequently, the reconstructed image with the non-uniform fluence exhibits a strong smoothing effect.

Keywords: finite element method, fluence distribution, Monte Carlo method, photoacoustic imaging

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Authors: Lindani Mbatha, Suvendi Rimer, Mpho Gololo

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Image segmentation is the process of dividing an image into several sections, such as the object's background and the foreground. It is a critical technique in both image-processing tasks and computer vision. Most of the image segmentation algorithms have been developed for gray-scale images and little research and algorithms have been developed for the color images. Most image segmentation algorithms or techniques vary based on the input data and the application. Nearly all of the techniques are not suitable for noisy environments. Most of the work that has been done uses the Markov Random Field (MRF), which involves the computations and is said to be robust to noise. In the past recent years' image segmentation has been brought to tackle problems such as easy processing of an image, interpretation of the contents of an image, and easy analysing of an image. This article reviews and summarizes some of the image segmentation techniques and algorithms that have been developed in the past years. The techniques include neural networks (CNN), edge-based techniques, region growing, clustering, and thresholding techniques and so on. The advantages and disadvantages of medical ultrasound image segmentation techniques are also discussed. The article also addresses the applications and potential future developments that can be done around image segmentation. This review article concludes with the fact that no technique is perfectly suitable for the segmentation of all different types of images, but the use of hybrid techniques yields more accurate and efficient results.

Keywords: clustering-based, convolution-network, edge-based, region-growing

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Authors: Grygorii Kostromin, Vladyslav Povoroznyuk

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Chronic venous diseases (CVD) are one of the common, though controversial problems in medicine. It is generally accepted that this pathology predominantly occurs in women. The issue of excessive weight as a risk factor for CVD is still considered debatable. To the author's best knowledge, today in Ukraine, there are barely any studies that describe the relationship between CVD and obesity. Our study aims to determine the association between age, body composition, obesity and CVD in postmenopausal women. The study was conducted in D. F. Chebotarev Institute of Gerontology, National Academy of Medical Sciences of Ukraine. We have examined 96 postmenopausal women aged 46-85 years (mean age – 66.19 ± 0.96 years), who were divided into two groups depending on the presence of CVD. The women were examined by vascular surgeons. For the diagnosis of CVD, we used clinical, anatomic and pathophysiologic classifications. We also performed clinical, ultrasound and densitometry examinations. We found that the CVD frequency in postmenopausal women increased with age (from 72% in those aged 45-59 years to 84% in those aged 75-89 years). A significant correlation between the total fat mass and age was determined in postmenopausal women with CVD. We also observed a significant correlation between the lower extremities’ fat mass and age in both examined groups. A significant correlation between body mass index and age was determined only in postmenopausal women without CVD.

Keywords: chronic venous disease, risk factors, age, obesity, postmenopausal women

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Authors: Paul G. Bolz, Paul G. Lindner, Frohmut Wellner, Christian Schulze, Joern Huebelt

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Concrete, as a result of its use as a construction material, is not only subject to static loads but is also exposed to variables, time-variant, and oscillating stresses. In order to ensure the suitability of construction materials for resisting these cyclic stresses, different test methods are used for the systematic fatiguing of specimens, like the cyclic indirect tensile test. A procedure is presented that allows the estimation of the degradation of cylindrical concrete specimens during the cyclic indirect tensile test by measuring the dynamic modulus of elasticity in different states of the specimens’ fatigue process. Two methods are used in addition to the cyclic indirect tensile test in order to examine the dynamic modulus of elasticity of cylindrical concrete specimens. One of the methods is based on the analysis of eigenfrequencies, whilst the other one uses ultrasonic pulse measurements to estimate the material properties. A comparison between the dynamic moduli obtained using the three methods that operate in different frequency ranges shows good agreement. The concrete specimens’ fatigue process can therefore be monitored effectively and reliably.

Keywords: concrete, cyclic indirect tensile test, degradation, dynamic modulus of elasticity, eigenfrequency, fatigue, natural frequency, ultrasonic, ultrasound, Young’s modulus

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Authors: Veera J. Allu, Shreya Pal, Anang Pangeni

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Introduction: Adhesive small bowel obstruction (ASBO) is usually managed conservatively. Failed conservative management leads to operative intervention by an open approach. However, laparoscopic management of ASBO is increasingly being reported in the literature. We report an unusual case of ASBO secondary to a band from the appendicular tip which was managed laparoscopically. Case Description: This patient was a 61-year-old female, otherwise fit and healthy, presenting with abdominal pain and mild distension with vomiting of 3 days duration. She had undergone ultrasound-guided drainage of an appendicular abscess three months ago and laparoscopic right inguinal hernia repair (TEP) in the past. CTAP showed small bowel obstruction with a transition point in the pelvis and the possible cause being adhesions. She was initially managed conservatively; however, as she was not improving for two days, she was consented to diagnostic laparoscopy. Intraoperatively, an adhesive band was found between the appendicular tip and distal ileum around 100cm proximal to the ileocolic junction, resulting in mechanical bowel obstruction. Laparoscopic division of band was performed, followed by appendicectomy, and the patient had an uneventful recovery and was discharged on postoperative day 1. Conclusion: In highly selected patients and with appropriate expertise, laparoscopic management of ASBO is feasible and safe.

Keywords: bowel obstruction, adhesions, laparoscopy, open procedure

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Authors: S. V. Vasilenkov, O. N. Demina

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Chernobyl NPP accident is the biggest in history of nuclear energetic. Bryansk region of Russia was exposed by the most intensive radiation pollution. For that, we made some researches in order to find the methods of soil rehabilitation on territories, polluted by radionuclides with the means of Cesium 137 leaching by watering. For experiments we took the soil from the upper more polluted 10 cm layer of different species. Cesium 137 leaching was made by different methods in washing columns. Washout of Cesium was made by periodical cycles in terms of 4-6 days. In experiments with easy argillaceous soil with start specific radioactivity 4158 bk/kg through 17 cycles the effective reducing was achieved and contained 1512 bk/kg. Besides, results of researches showed, that in the first 6-10 cycles we can see reducing of washing rate but after application of intensificators: ultrasound water processing, aerification, application of fertilizers (KCl), lime, freezing, we can see increasing of Cesium 137 leaching. The experimental investigations in washout of Cesium (Cs) – 137 from the soil were carried out in the field and laboratorial conditions during its freezing and melting. The experiments showed, that washout of Cesium (Cs) – 137 from the soil is rather high after freezing, than non-frozen soil is. And it conforms to washout of Cesium, made under the influence of the intensificaters. This fact allows to recommend chip and easy to construct technically arrangement for regulation of the snow-melt runoff for rehabilitation of the radioactive impoundment.

Keywords: pollution, radiation, Cesium 137 leaching, agriculture

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Authors: Berrak Yildiz, Hinal Shah, Justine Fernandez, Nazje James, Anna Brown

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Cervical ectopic pregnancy, a rare type of ectopic pregnancies, is defined by blastocyst implantation within the cervical canal rather than the endometrium. Its rarity and potential for severe hemorrhage make cervical ectopic pregnancy a diagnostic and therapeutic challenge. A 39-year-old woman, G5P2022, with a history of two cesarean sections and two elective terminations, presented to the emergency department with vaginal bleeding and pelvic pain. Initial assessment showed a beta-hCG level of 2,853 mIU/mL, and transvaginal ultrasound revealed a small, irregular gestational sac at the level of the internal cervical os. Serial betahCG measurements over subsequent visits showed a declining trend, consistent with a nonviable pregnancy. The patient was ultimately treated with methotrexate at a dose of 50 mg/m² (total 100 mg), following which she reported no further symptoms. On follow-up, her beta-hCG level returned to the normal non-pregnant range, with no additional intervention needed. This case highlights the importance of early diagnosis in cervical ectopic pregnancy to avoid complications like hysterectomy. Methotrexate is an effective first-line treatment in hemodynamically stable patients, offering a conservative approach that can preserve fertility. The success in this patient underscores the role of prompt diagnosis and careful management in achieving resolution while minimizing invasive procedures.

Keywords: beta-hCG, cervical, ectopic, methotrexate

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Authors: M. D. H. Beg, John O. Akindoyo, Suriati Ghazali, Nitthiyah Jeyaratnam

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Over the period of time, several approaches have been undertaken to mitigate the challenges associated with bone regeneration. This includes but not limited to xenografts, allografts, autografts as well as artificial substitutions like bioceramics, synthetic cements and metals. The former three techniques often come along with peculiar limitation and problems such as morbidity, availability, disease transmission, collateral site damage or absolute rejection by the body as the case may be. Synthetic routes remain the only feasible alternative option for treatment of bone defects. Hydroxyapatite (HA) is very compatible and suitable for this application. However, most of the common methods for HA synthesis are either expensive, complicated or environmentally unfriendly. Interestingly, extraction of HA from bio-wastes have been perceived not only to be cost effective, but also environment friendly. In this research, HA was synthesized from bio-waste: namely bovine bones through three different methods which are hydrothermal chemical processes, ultrasound assisted synthesis and ordinary calcination techniques. Structure and property analysis of the HA was carried out through different characterization techniques such as TGA, FTIR, and XRD. All the methods applied were able to produce HA with similar compositional properties to biomaterials found in human calcified tissues. Calcination process was however observed to be more efficient as it eliminated all the organic components from the produced HA. The HA synthesized is unique for its minimal cost and environmental friendliness. It is also perceived to be suitable for tissue and bone engineering applications.

Keywords: hydroxyapatite, bone, calcination, biowaste

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Authors: Weerinda Appamana, Jirapong Keawkoon, Yamonporn Pacthong, Jirathiti Chitsanguansuk, Yanyong Sookklay

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In the present work, spinning disc reactor has been used for the intensification of synthesis of biodiesel from refined palm oil (RPO) based on the transesterification reaction. Experiments have been performed using different spinning disc surface and under varying operating parameters viz. molar ratio of oil to methanol (over the range of 1:4.5–1:9), rotational speed (over the range of 500–2,000 rpm), total flow rate (over the range of 260-520 ml/min), and KOH catalyst loading of 1.50% by weight of oil. Maximum FAME (fatty acid methyl esters) yield (97.5 %) of biodiesel from RPO was obtained at oil to methanol ratio of 1:6, temperature of 60 °C, and rotational speed of 1500 rpm and flow rate of 520 mL/min using groove disc at KOH catalyst loading of 1.5 wt%. Also, higher yield efficiency (biodiesel produced per unit energy consumed) was obtained for using the spinning disc reactor based approach as compared to the ultrasound hydrodynamic cavitation and conventional mechanical stirrer reactors. It obviously offers a significant reduction in the reaction time for the transesterification, especially when compared with the reaction time of 90 minutes required for the conventional mechanical stirrer. It can be concluded that the spinning disk reactor is a promising alternative method for continuous biodiesel production.

Keywords: spinning disc reactor, biodiesel, process intensification, yield efficiency

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Authors: M. K. Yusuf, W. O. Hamman, U. E. Umana, S. B. Oladele

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Background: Dilatation of the inferior vena cava (IVC) is used as the ultrasonic diagnostic feature in patients suspected of congestive heart failure. The IVC diameter has been reported to vary among the various body mass indexes (BMI) and body shape indexes (ABSI). Knowledge of these variations is useful in precision diagnoses of CHF by imaging scientists. Aim: The study aimed to establish an equation for predicting the ultrasonic mean diameter of the IVC among the various BMI/ABSI of inhabitants of Azare, Bauchi State-Nigeria. Methodology: Two hundred physically healthy adult subjects of both sexes were classified into under, normal, over, and obese weights using their BMIs after selection using a structured questionnaire following their informed consent for an abdominal ultrasound scan. The probe was placed on the midline of the body, halfway between the xiphoid process and the umbilicus, with the marker on the probe directed towards the patient's head to obtain a longitudinal view of the IVC. The maximum IVC diameter was measured from the subcostal view using the electronic caliper of the scan machine. The mean value of each group was obtained, and the results were analysed. Results: A novel equation {(IVC Diameter = 1.04 +0.01(X) where X= BMI} has been generated for determining the IVC diameter among the populace. Conclusion: An equation for predicting the IVC diameter from individual BMI values in apparently healthy subjects has been established.

Keywords: equation, ultrasonic, IVC diameter, body adiposities

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Authors: Shachi Joshi

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Purpose: The primary aim of this study was to determine the prevalence of pelvic dysfunction symptoms following OASI. The secondary aim was to assess the scope of a dedicated perineal trauma clinic in identifying and investigating women that have experienced faecal incontinence after OASI and if a transitional clinic arrangement to colorectal surgeons would be useful. Methods: The clinical database was used to identify and obtain information about 118 women who sustained an OASI (3rd/ 4th degree tear) between August 2016 and July 2017. A questionnaire was designed to assess symptoms of pelvic dysfunction; this was sent via the post in November 2018. Results: The questionnaire was completed by 45 women (38%). Faecal incontinence was experienced by 42% (N=19), flatus incontinence by 47% (N=21), urinary incontinence by 76% (N=34), dyspareunia by 49% (N=22) and pelvic pain by 33% (N=15). Of the questionnaire respondents, only 62% (N=28) had attended a perineal trauma clinic appointment. 46% (N=13) of these women reported having experienced difficulty controlling flatus or faeces in the questionnaire, however, only 23% (N=3) of these reported ongoing symptoms at the time of clinic attendance and underwent an endoanal ultrasound scan. Conclusion: Pelvic dysfunction symptoms are highly prevalent following an OASI. Perineal trauma clinic attendance alone is not sufficient for identification and follow up of symptoms. Transitional care is needed between obstetric and colorectal teams, to recognize and treat women with ongoing faecal incontinence.

Keywords: incontinence, obstetric anal sphincter, injury, repair

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Authors: S. Mezghani, E. Perrin, J. L. Bodnar, J. Marthe, B. Cauwe, V. Vrabie

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Non contact evaluation of the thickness of paint coatings can be attempted by different destructive and nondestructive methods such as cross-section microscopy, gravimetric mass measurement, magnetic gauges, Eddy current, ultrasound or terahertz. Infrared thermography is a nondestructive and non-invasive method that can be envisaged as a useful tool to measure the surface thickness variations by analyzing the temperature response. In this paper, the thermal quadrupole method for two layered samples heated up with a pulsed excitation is firstly used. By analyzing the thermal responses as a function of thermal properties and thicknesses of both layers, optimal parameters for the excitation source can be identified. Simulations show that a pulsed excitation with duration of ten milliseconds allows to obtain a substrate-independent thermal response. Based on this result, an experimental setup consisting of a near-infrared laser diode and an Infrared camera was next used to evaluate the variation of paint coating thickness between 60 µm and 130 µm on two samples. Results show that the parameters extracted for thermal images are correlated with the estimated thicknesses by the Eddy current methods. The laser pulsed thermography is thus an interesting alternative nondestructive method that can be moreover used for non conductive substrates.

Keywords: non destructive, paint coating, thickness, infrared thermography, laser, heterogeneity

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Authors: Yash Bingi, Yiqiao Yin

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Reduction of child mortality is an ongoing struggle and a commonly used factor in determining progress in the medical field. The under-5 mortality number is around 5 million around the world, with many of the deaths being preventable. In light of this issue, Cardiotocograms (CTGs) have emerged as a leading tool to determine fetal health. By using ultrasound pulses and reading the responses, CTGs help healthcare professionals assess the overall health of the fetus to determine the risk of child mortality. However, interpreting the results of the CTGs is time-consuming and inefficient, especially in underdeveloped areas where an expert obstetrician is hard to come by. Using a support vector machine (SVM) and oversampling, this paper proposed a model that classifies fetal health with an accuracy of 99.59%. To further explain the CTG measurements, an algorithm based on Randomized Input Sampling for Explanation ((RISE) of Black-box Models was created, called Feature Alteration for explanation of Black Box Models (FAB), and compared the findings to Shapley Additive Explanations (SHAP) and Local Interpretable Model Agnostic Explanations (LIME). This allows doctors and medical professionals to classify fetal health with high accuracy and determine which features were most influential in the process.

Keywords: machine learning, fetal health, gradient boosting, support vector machine, Shapley values, local interpretable model agnostic explanations

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Authors: Rebecca Dunne, Cormac Small, Geraldine O'Boyle, Nazir Ibrahim, Anisha

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Prostate cancer is the most common cancer among men, excluding non-melanoma skin cancers. It is estimated that approximately 12% of men will develop prostate cancer during their lifetime. Patients with intermediate, high risk, and very-high risk prostate cancer often undergo a combination of radiation treatments. These treatments include external beam radiotherapy with a low-dose rate or high-dose rate brachytherapy boost, often with concomitant androgen deprivation therapy. The literature on follow-up of patients that receive brachytherapy is scarce, particularly follow-up of patients that undergo high-dose rate brachytherapy. This retrospective study aims to investigate the biochemical failure and toxicities associated with triple therapy and external beam radiotherapy given in combination with brachytherapy. Reported toxicities and prostate specific antigen (PSA) were retrospectively evaluated in eighty patients that previously underwent external beam radiotherapy with a low-dose rate or high dose-rate brachytherapy boost. The severity of toxicities were correlated with intra-operative dosing during brachytherapy on ultrasound and CT scan. The results of this study will provide further information for clinicians and patients when considering treatment options.

Keywords: toxicities, combination, brachytherapy, intra-operative dosing, biochemical failure

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Authors: Nadia A. Mohamed, Zakaria El-Khayat, Wagdy K. B. Khalil, Mehrez E. El-Naggar

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Drug nephrotoxicity is still a problem for patients who have taken drugs for elongated periods or permanently. Ultrasound-assisted sol−gel method was used to prepare hollow structured poroussilica nanoemulsion loaded with sodium salicylate as a model drug. The work was extended to achieve the target of the current work via investigating the protective role of this nanoemulsion model as anti-inflammatory drug or ginger for its antioxidant effect against cisplatin-induced nephrotoxicity in male albino rats. The results clarify that the nanoemulsion model was synthesized using ultrasonic assisted with small size and well stabilization as proved by TEM and DLS analysis. Additionally, blood urea nitrogen (BUN), Serum creatinine (SC) and Urinary total protein (UTP) were increased, and the level of creatinine clearance (Crcl) was decreased. All those were met with disorders in oxidative stress and downregulation in the expression of the nephrin gene. Also, histopathological changes of the kidney tissue were observed. These changes back to normal by treatment with silica nanoparticles loaded sodium salicylate (Si-Sc-NPs), ginger or both. Conclusions oil/water nanoemulsion of (Si-Sc NPs) and ginger showed a protective and promising preventive strategy against nephrotoxicity due to their antioxidant and anti-inflammatory effects, and that offers a new approach in attenuating drug induced nephrotoxicity.

Keywords: sodium salicylate nanoencapsulation, nephrin mRNA, drug nephrotoxicity, cisplatin, experimental rats

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Authors: S. Cobos-Guzman

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This paper presents the results of a mechatronic design based on a 4-wheel omnidirectional mobile robot that can be used in indoor logistic applications. The low-level control has been selected using two open-source hardware (Raspberry Pi 3 Model B+ and Arduino Mega 2560) that control four industrial motors, four ultrasound sensors, four optical encoders, a vision system of two cameras, and a Hokuyo URG-04LX-UG01 laser scanner. Moreover, the system is powered with a lithium battery that can supply 24 V DC and a maximum current-hour of 20Ah.The Robot Operating System (ROS) has been implemented in the Raspberry Pi and the performance is evaluated with the selection of the sensors and hardware selected. The mechatronic system is evaluated and proposed safe modes of power distribution for controlling all the electronic devices based on different tests. Therefore, based on different performance results, some recommendations are indicated for using the Raspberry Pi and Arduino in terms of power, communication, and distribution of control for different devices. According to these recommendations, the selection of sensors is distributed in both real-time controllers (Arduino and Raspberry Pi). On the other hand, the drivers of the cameras have been implemented in Linux and a python program has been implemented to access the cameras. These cameras will be used for implementing a deep learning algorithm to recognize people and objects. In this way, the level of intelligence can be increased in combination with the maps that can be obtained from the laser scanner.

Keywords: autonomous, indoor robot, mechatronic, omnidirectional robot

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Authors: Komal Verma, V. S. Moholkar

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This paper reports investigations in the mineralization of industrial wastewater (COD = 3246 mg/L, TOC = 2500 mg/L) using a ternary (ultrasound + Fenton + adsorption) hybrid advanced oxidation process. Fe3O4 decorated activated charcoal (Fe3O4@AC) nanocomposites (surface area = 538.88 m2/g; adsorption capacity = 294.31 mg/g) were synthesized using co-precipitation. The wastewater treatment process was optimized using central composite statistical design. At optimum conditions, viz. pH = 4.2, H2O2 loading = 0.71 M, adsorbent dose = 0.34 g/L, reduction in COD and TOC of wastewater were 94.75% and 89%, respectively. This result is essentially a consequence of synergistic interactions among the adsorption of pollutants onto activated charcoal and surface Fenton reactions induced due to the leaching of Fe2+/Fe3+ ions from the Fe3O4 nanoparticles. Microconvection generated due to sonication assisted faster mass transport (adsorption/desorption) of pollutants between Fe₃O₄@AC nanocomposite and the solution. The net result of this synergism was high interactions and reactions among and radicals and pollutants that resulted in the effective mineralization of wastewater The Fe₃O₄@AC showed excellent recovery (> 90 wt%) and reusability (> 90% COD removal) in 5 successive cycles of treatment. LC-MS analysis revealed effective (> 50%) degradation of more than 25 significant contaminants (in the form of herbicides and pesticides) after the treatment with ternary hybrid AOP. Similarly, the toxicity analysis test using the seed germination technique revealed ~ 60% reduction in the toxicity of the wastewater after treatment.

Keywords: Fe₃O₄@AC nanocomposite, RSM, COD;, LC-MS, Toxicity

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Authors: Lila Boulekbache-Makhlouf, Kahina Djaoud, Myriam Tazarourte, Samir Hadjal, Khodir Madani

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In Algeria, important quantities of secondary date variety (Phoenix dactylifera L.) are generated in each campaign; their chemical composition is similar to that of commercial dates. The present work aims to valorize this common date variety (Degla-Beida) which is often poorly exploited. In this context, we tried to prepare syrup from the secondary date variety and to evaluate the effect of conventional extraction (CE) or water bath extraction (WBE) and alternative extraction (microwaves assisted extraction (MAE), and ultrasounds assisted extraction (UAE)) on its total sugar content (TSC), using response surface methodology (RSM). Then, the analysis of individual sugars was performed by high-performance liquid chromatography (HPLC). Maximum predicted TSC recoveries under the optimized conditions for MAE, UAE and CE were 233.248 ± 3.594 g/l, 202.889 ± 5.797 g/l, and 233.535 ± 5.412 g/l, respectively, which were close to the experimental values: 233.796 ± 1.898 g/l; 202.037 ± 3.401 g/l and 234.380 ± 2.425 g/l. HPLC analysis revealed high similarity in the sugar composition of date juices obtained by MAE (60.11% sucrose, 16.64% glucose and 23.25% fructose) and CE (50.78% sucrose, 20.67% glucose and 28.55% fructose), although a large difference was detected for that obtained by UAE (0.00% sucrose, 46.94% glucose and 53.06% fructose). Microwave-assisted extraction was the best method for the preparation of date syrup with an optimal recovery of total sugar content. However, ultrasound-assisted extraction was the best one for the preparation of date syrup with high content of reducing sugars.

Keywords: dates, extraction, RSM, sugars, syrup

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Authors: Venus Pagare, Amit Kharat, Dhaval K. Thakkar, Tushar J. Palekar

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Introduction: Chronic low back pain (CLBP) is a major public health problem and is the leading musculoskeletal cause of disability. Altered neuromuscular control of core muscles, particulary transverses abdominis (TrA) is thought to be a contributing factor for the development of CLBP. Therefore, various exercises targeting the TrA are commonly incorporated into the rehabilitation. Objectives: To investigate the effects of 3 different core exercises on activation capacity of TrA muscle in individuals with CLBP as compared with healthy controls. Methodology: Thickness of TrA muscle was measured by ultrasound imaging in 30 patients with CLBP and 30 healthy controls. Measurements were taken during 3 different TrA activation exercises i.e Abdominal drawing in maneuver (ADIM), Abdominal drawing in with straight leg raise (ADSLR) and breathe hold at maximum expiration (ME). Thickness of the muscle at rest (at the end of normal tidal expiration) was taken as a baseline measure. Results: There was a significant difference between the healthy subjects and patients with low back pain with regard to the thickness of TrA at rest and thickness during contraction. ADIM produced a significant increase in the thickness of TrA compared to ADSLR and ME (p<0.001). Also, increase in thickness of TrA was more in the control group than patients with low back pain. Conclusion: CLBP patients exhibited atrophy of TrA muscle with delayed activation. Also, of the various core exercises, ADIM can be an effective method for activation of TrA.

Keywords: LBP, CLBP, ADSLR, ADIM

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Authors: Amal Abo El-Maaty, Amira Mohamed, Nashwa Abu-Aita, Hisham Morgan

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For estimating markers of overweight or obesity of brood mares used for riding and training, 17 mares of different body conditions were subjected to blood sampling and ultrasound examination to measure rump fat thickness and monitor ovulation for six consecutive weeks. Also length (L), heart girth (G) and withers height (H) were measured to estimate body weight (BW), body fat %, body fat mass (BFM) and body mass index (BMI). Mares were classified into three groups according to both body condition score (BCS) and rump back fat (BF). Overweight mares (O) were having BCS > 7 and BF thickness >7mm, moderate body condition (M) mares were having BCS >3and ≤7and BF <3and <7mm, and emaciated mares (E) were having BCS ≤3 and BF ≤3mm. glucose, triglycerides, nitric oxide, ovarian, thyroid, insulin, insulin like growth factor-I (IGF-1), and leptin hormones were measured. Results revealed that BCS, G, L, L*G*H, BW, BF, fat %, BFM were significantly (P<0.0001) decreasing linearly from O to E. T4 concentrations of E were significantly high (P=0.04) compared to M and O but T3 concentrations tended to decrease in E (P>0.05). Insulin and IGF-1 concentrations tended to be high in O (P>0.05) and decrease with the decrease of body condition. M had (P=0.007) the highest leptin, but E mares had the lowest P4 concentrations (P=0.01). Concentrations of glucose and NO decreased with the decrease of BCS and BF but triglycerides of O were insignificantly high. In conclusion, exercise could prevent the development of metabolic syndrome in horses and back fat and morphometric measurements were the easiest and simple assessment of overweight and deviation to obesity.

Keywords: body condition score, insulin, leptin, mares, rump fat

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Authors: Ahmad Shahin, Walid Moudani, Ali Bekraki

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This research aims at presenting a predictive data mining model to handle an accurate diagnosis of acute appendicitis with patients for the purpose of maximizing the health service quality, minimizing morbidity/mortality, and reducing cost. However, acute appendicitis is the most common disease which requires timely accurate diagnosis and needs surgical intervention. Although the treatment of acute appendicitis is simple and straightforward, its diagnosis is still difficult because no single sign, symptom, laboratory or image examination accurately confirms the diagnosis of acute appendicitis in all cases. This contributes in increasing morbidity and negative appendectomy. In this study, the authors propose to generate an accurate model in prediction of patients with acute appendicitis which is based, firstly, on the segmentation technique associated to ABC algorithm to segment the patients; secondly, on applying fuzzy logic to process the massive volume of heterogeneous and noisy data (age, sex, fever, white blood cell, neutrophilia, CRP, urine, ultrasound, CT, appendectomy, etc.) in order to express knowledge and analyze the relationships among data in a comprehensive manner; and thirdly, on applying dynamic programming technique to reduce the number of data attributes. The proposed model is evaluated based on a set of benchmark techniques and even on a set of benchmark classification problems of osteoporosis, diabetes and heart obtained from the UCI data and other data sources.

Keywords: healthcare management, acute appendicitis, data mining, classification, decision tree

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Authors: Chung-Hyeon Ryu, Do-Hyoung Kim, Hak-Sung Kim

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As the use of the composites was increased, the detecting method of hidden damages which have an effect on performance of the composite was important. Terahertz (THz) spectroscopy was assessed as one of the new powerful nondestructive evaluation (NDE) techniques for fiber reinforced composite structures because it has many advantages which can overcome the limitations of conventional NDE techniques such as x-rays or ultrasound. The THz wave offers noninvasive, noncontact and nonionizing methods evaluating composite damages, also it gives a broad range of information about the material properties. In additions, it enables to detect the multiple-delaminations of various nonmetallic materials. In this study, the pulse type THz spectroscopy imaging system was devised and used for detecting and evaluating the hidden delamination in the glass fiber reinforced plastic (GFRP) composite laminates. The interaction between THz and the GFRP composite was analyzed respect to the type of delamination, including their thickness, size and numbers of overlaps among multiple-delaminations in through-thickness direction. Both of transmission and reflection configurations were used for evaluation of hidden delaminations and THz wave propagations through the delaminations were also discussed. From these results, various hidden delaminations inside of the GFRP composite were successfully detected using time-domain THz spectroscopy imaging system and also compared to the results of C-scan inspection. It is expected that THz NDE technique will be widely used to evaluate the reliability of composite structures.

Keywords: terahertz, delamination, glass fiber reinforced plastic composites, terahertz spectroscopy

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Authors: Stefanos Karanasios, Charkleia Koutri, Maria Moutzouri, Sofia A. Xergia, Vasiliki Sakellari, George Gioftsos

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The precise calculation of arterial occlusive pressure (AOP) is a critical step to accurately prescribe individualized pressures during blood flow restriction training (BFRT). AOP is usually measured in a supine position before training; however, previous reports suggested a significant influence in lower limb AOP across different body positions. The aim of the study was to investigate the effect of three different body positions on upper limb AOP and the reliability of the method for its standardization in clinical practice. Forty-two healthy participants (Mean age: 28.1, SD: ±7.7) underwent measurements of upper limb AOP in supine, seated, and standing positions by three blinded raters. A cuff with a manual pump and a pocket doppler ultrasound were used. A significantly higher upper limb AOP was found in seated compared with supine position (p < 0.031) and in supine compared with standing position (p < 0.031) by all raters. An excellent intraclass correlation coefficient (0.858- 0.984, p < 0.001) was found in all positions. Upper limb AOP is strongly dependent on body position changes. The appropriate measurement position should be selected to accurately calculate AOP before BFRT. The excellent inter-rater reliability and repeatability of the method suggest reliable and consistent results across repeated measurements.

Keywords: Kaatsu training, blood flow restriction training, arterial occlusion, reliability

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Authors: Adrian Ionut Nicoara, Denisa Ionela Ene, Alina Maria Holban, Cristina Busuioc

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At present, the development of materials with biomedical applications is a domain of interest that will produce a full series of benefits in engineering and medicine. In this sense, it is required to use a natural material, and this paper is focused on the development of a composite material based on bacterial cellulose – hydroxyapatite and silver nanoparticles with applications in hard tissue. Bacterial cellulose own features like biocompatibility, non-toxicity character and flexibility. Moreover, the bacterial cellulose can be conjugated with different forms of active silver to possess antimicrobial activity. Hydroxyapatite is well known that can mimic at a significant level the activity of the initial bone. The material was synthesized by using an ultrasound probe and finally characterized by several methods. Thereby, the morphological properties were analyzed by using Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM). Because the synthesized material has medical application in restore the tissue and to fight against microbial invasion, the samples were tested from the biological point of view by evaluating the biodegradability in phosphate-buffered saline (PBS) and simulated body fluid (SBF) and moreover the antimicrobial effect was performed on Gram-positive bacterium Staphylococcus aureus, Gram-negative bacterium Escherichia coli, and fungi Candida albicans. The results reveal that the obtained material has specific characteristics for bone regeneration.

Keywords: bacterial cellulose, biomaterials, hydroxyapatite, scaffolds materials

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Authors: Angelis P. Barlampas

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PURPOSE: The purpose of this paper is to demonstrate the important role of taking an appropriate and detailed history, in order to reach the best possible diagnostic conclusion. MATERIAL: A patient presented to the emergency department due to the sudden onset of continuous abdominal pain, during the last hour and with the clinical symptoms of an acute abdomen. During the clinical examination, signs of peritoneal irritation and diffuse abdominal tenderness were found. The rest of the clinical and laboratory tests did not reveal anything important. From the reported medical history, nothing of note was found, except for the report of a large liver cyst, for which he was advised not to take any further action, except from regular ultrasound examination . METHOD: A computed tomography examination was performed after per os administration of gastrografin, which revealed a hyperdense ascitic effusion, similar in density to that of gastrografin within the intestinal tract. The presence of a large cyst of the left hepatic lobe was confirmed, contacting and pushing against the stomach. In the area of the contact between the liver cyst and the pylorus, there were extraluminal air bubbles and local opacity of the peritoneal fat, with a small hyperdense effusion. Result : The above, as well as the absence of a history of stomach ulcer or recent trauma, or other pathology, argue in favor of acute pyloric perforation, due to mural necrosis, in response to chronic external pressure from the pre-existing large liver cyst.

Keywords: perforation, stomach, large liver cyst, CT abdomen, acute abdominal pain, intraperitoneal leakage, constrast leakage

Procedia PDF Downloads 97