Search results for: runoff discharge

Authors: S. Jamshidi, E. Feizi Ashtiani, M. Ardestani, A. Feizi Ashtiani

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Waste load allocation (WLA) strategies usually intend to find economical policies for water resource management. Water quality trading (WQT) is an approach that uses discharge permit market to reduce total environmental protection costs. This primarily requires assigning discharge limits known as total maximum daily loads (TMDLs). These are determined by monitoring organizations with respect to the receiving water quality and remediation capabilities. The purpose of this study is to compare two approaches of TMDL assignment for WQT policy in small catchment area of Haraz River, in north of Iran. At first, TMDLs are assigned uniformly for the whole point sources to keep the concentrations of BOD and dissolved oxygen (DO) at the standard level at checkpoint (terminus point). This was simply simulated and controlled by Qual2kw software. In the second scenario, TMDLs are assigned using multi objective particle swarm optimization (MOPSO) method in which the environmental violation at river basin and total treatment costs are minimized simultaneously. In both scenarios, the equity index and the WLA based on trading discharge permits (TDP) are calculated. The comparative results showed that using economically optimized TMDLs (2nd scenario) has slightly more cost savings rather than uniform TMDL approach (1st scenario). The former annually costs about 1 M$ while the latter is 1.15 M$. WQT can decrease these annual costs to 0.9 and 1.1 M$, respectively. In other word, these approaches may save 35 and 45% economically in comparison with command and control policy. It means that using multi objective decision support systems (DSS) may find more economical WLA, however its outcome is not necessarily significant in comparison with uniform TMDLs. This may be due to the similar impact factors of dischargers in small catchments. Conversely, using uniform TMDLs for WQT brings more equity that makes stakeholders not feel that much envious of difference between TMDL and WQT allocation. In addition, for this case, determination of TMDLs uniformly would be much easier for monitoring. Consequently, uniform TMDL for TDP market is recommended as a sustainable approach. However, economical TMDLs can be used for larger watersheds.

Keywords: waste load allocation (WLA), water quality trading (WQT), total maximum daily loads (TMDLs), Haraz River, multi objective particle swarm optimization (MOPSO), equity

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Authors: Victor Au, Khin Maung Than, Zaw Win Aung, Linawati Jumat

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Background & Objectives: Cardiac arrests can occur anywhere or anytime, and most of the cases will be brought to the emergency department except the cases that happened in at in-patient setting. Raja IsteriPangiran Anak Saleha (RIPAS) Hospital is the only tertiary government hospital which located in Brunei Muara district and received all referral from other Brunei districts. Data of cardiac arrests in Brunei Darussalam scattered between Emergency Medical Ambulance Services (EMAS), Emergency Department (ED), general inpatient wards, and Intensive Care Unit (ICU). In this audit, we only focused on cardiac arrest cases which had happened or presented to the emergency department RIPAS Hospital. Theobjectives of this audit were to look at demographic of cardiac arrest cases and the survival to discharge rate of In-Hospital Cardiac Arrest (IHCA) and Out-Hospital Cardiac Arrest (OHCA). Methodology: This audit retrospective study was conducted on all cardiac arrest cases that underwent Cardiopulmonary Resuscitation (CPR) in ED RIPAS Hospital, Brunei Muara, in the year 2019-2020. All cardiac arrest cases that happened or were brought in to emergency department were included. All the relevant data were retrieved from ED visit registry book and electronic medical record “Bru-HIMS” with keyword diagnosis of “cardiac arrest”. Data were analyzed and tabulated using Excel software. Result: 313 cardiac arrests were recorded in the emergency department in year 2019-2020. 92% cases were categorized as OHCA, and the remaining 8% as IHCA. Majority of the cases were male with age between 50-60 years old. In OHCA subgroup, only 12.4% received bystander CPR, and 0.4% received Automatic External Defibrillator (AED) before emergency medical personnel arrived. Initial shockable rhythm in IHCA group accounted for 12% compare to 4.9% in OHCA group. Outcome of ED resuscitation, 32% of IHCA group achieved return of spontaneous circulation (ROSC) with a survival to discharge rate was 16%. For OHCA group, 12.35% achieved ROSC, but unfortunately, none of them survive till discharge. Conclusion: Standardized registry for cardiac arrest in the emergency department is required to provide valid baseline data to measure the quality and outcome of cardiac arrest. Zero survival rate for out hospital cardiac arrest is very concerning, and it might represent the significant breach in cardiac arrest chains of survival. Systematic prospective data collection is needed to identify contributing factors and to improve resuscitation outcome.

Keywords: cardiac arrest, OHCA, IHCA, resuscitation, emergency department

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Authors: Sebai Amal, Massuel Sylvain

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Groundwater is the key element of the development of most of the semi-arid areas where water resources are increasingly scarce due to an irregularity of precipitation, on the one hand, and an increasing demand on the other hand. This is the case of the watershed of the Central Tunisia Merguellil, object of the present study, which focuses on an implementation of an underground flows hydrodynamic model to understand the recharge processes of the Kairouan’s plain groundwater by aquifers boundary through the hydraulic threshold of El Haouareb. The construction of a conceptual geological 3D model by the Hydro GeoBuilder software has led to a definition of the aquifers geometry in the studied area thanks to the data acquired by the analysis of geologic sections of drilling and piezometers crossed shells partially or in full. Overall analyses of the piezometric Chronicles of different piezometers located at the level of the dam indicate that the influence of the dam is felt especially in the aquifer carbonate which confirms that the dynamics of this aquifer are highly correlated to the dam’s dynamic. Groundwater maps, high and low-water dam, show a flow that moves towards the threshold of El Haouareb to the discharge of the waters of Ain El Beidha discharge towards the plain of Kairouan. Software FEFLOW 5.2 steady hydrodynamic modeling to simulate the hydraulic threshold at the level of the dam El Haouareb in a satisfactory manner. However, the sensitivity study to the different parameters shows equivalence problems and a fix to calibrate the limestones’ permeability. This work could be improved by refining the timing steady and amending the representation of limestones in the model.

Keywords: Hydrodynamic modeling, lithological modeling, hydraulic, semi-arid, merguellil, central Tunisia

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Authors: Muhammad Saleem Akhtar, Mushtaq Hussain Lashari, Ejaz Ahmad, Tanveer Ahmad, Laeeq Akbar Lodhi, Ijaz Ahmad, Masood Akhtar

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The objective of this study was to determine the effect of bull exposure continuously or intermittently or its excretory products after calving on postpartum interval to estrus, in Nili-Ravi buffalo. Forty-eight buffaloes of Nili-Ravi breed were allocated one of the four treatments in a totally randomized plan using a 4 x 1 factorial design. The four treatment groups were BEC (Bull Exposed Continuously), BEI (Bull Exposed Intermittently), EPB (Excretory Products of Bull) and BNE (Bull Not Exposed). BEC; buffaloes (n = 12) were exposed continuously to the physical presence of a bull whereas in BEI; buffaloes (n = 12) were exposed intermittently to the physical presence of bull. EPB; buffaloes (n = 12) were exposed to discharge waste (urine and feces) of bull and BNE buffaloes (n = 12) were not exposed to a bull or discharge waste of bulls. Buffaloes were exposed on day 15 after parturition. Day 15 postpartum represented d 0 for each treatment. The postpartum interval from calving to first behavioural estrus was 66.88 days in BEC, 75.12 days in BEI, 77.28 days in EPB and 76.5 days in BNE treatments. Postpartum interval to first behavioural estrus was shorter in BEC than BEI, EPB, and BNE treatments. There was no significant difference in postpartum interval to estrus between BEI, EPB and BNE treatments. In present study, the percentage of buffaloes showing estrus during experimental period was 75.0%, 66.66%, 66.66% and 58.33% in BEC, BEI, EPB and BNE treatments, respectively. The mean serum progesterone concentration did not differ significantly between BEC and other (BEI, EPB, and BNE) treatments. It was concluded that presence of bull has positive effect in reducing calving interval in Nili Ravi buffalo.

Keywords: calving interval, biostimulation, buffalo, bull exposure

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Authors: Yi-Chuan Cheng, Li-Chi Huang, Yu-Shan Chang

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Introduction: The main purpose of this study was to explore the relationship between the learning number, care knowledge, care skills and maternal confidence in preterm infant care in Taiwan. Background: Preterm infants care has been stressful for mother caring at home. Many programs have been applied for improving the infant care maternal confident. But less to know the learning behavior in mothers of preterm infant. Methods: The sample consisted of 55 mothers with preterm infants were recruited in a neonatal intermediate unit at a medical center in central Taiwan. The self-reported questionnaires including knowledge and skills of preterm infant care scales and maternal confidence scale were used to evaluation, which were conducted during hospitalization, before hospital discharge, and one month after discharge. We performed by using Pearson correlation of the collected data using SPSS 18. Results: The study showed that the learning number and knowledge in preterm infant care was a significant positive correlation (r = .40), and the skills and confidence preterm infant care was positively correlated (r = .89). Conclusions: Study results showed the mother had more learning number in preterm infant care will be stronger knowledge, and the skills and confidence in preterm infant care were also positively correlated. Thus, we found the learning behavior change significant care knowledge. And the maternal confidence change significant with skill on preterm infant’s care. But bondage still needs further study and develop the participation in hospital-based instructional programs, which could lead to greater long-term retention of learning.

Keywords: learning behavior, care knowledge, care skills, maternal confidence

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Authors: Gurkirandeep Kaur, Rana Pratap Yadav

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This experimental study is aimed to examine the radiation characteristics of different plasma structures of a surface wave-driven plasma antenna by an automated measuring system. In this study, a 30 cm long plasma column of argon gas with a diameter of 3 cm is excited by surface wave discharge mechanism operating at 13.56 MHz with RF power level up to 100 Watts and gas pressure between 0.01 to 0.05 mb. The study reveals that a single structured plasma monopole can be modified into an array of plasma antenna elements by forming multiple striations or plasma blobs inside the discharge tube by altering the values of plasma properties such as working pressure, operating frequency, input RF power, discharge tube dimensions, i.e., length, radius, and thickness. It is also reported that plasma length, electron density, and conductivity are functions of operating plasma parameters and controlled by changing working pressure and input power. To investigate the antenna radiation efficiency for the far-field region, an automation-based radiation measuring system has been fabricated and presented in detail. This developed automated system involves a combined setup of controller, dc servo motors, vector network analyzer, and computing device to evaluate the radiation intensity, directivity, gain and efficiency of plasma antenna. In this system, the controller is connected to multiple motors for moving aluminum shafts in both elevation and azimuthal plane whereas radiation from plasma monopole antenna is measured by a Vector Network Analyser (VNA) which is further wired up with the computing device to display radiations in polar plot forms. Here, the radiation characteristics of both continuous and array plasma monopole antenna have been studied for various working plasma parameters. The experimental results clearly indicate that the plasma antenna is as efficient as a metallic antenna. The radiation from plasma monopole antenna is significantly influenced by plasma properties which provides a wider range in radiation pattern where desired radiation parameters like beam-width, the direction of radiation, radiation intensity, antenna efficiency, etc. can be achieved in a single monopole. Due to its wide range of selectivity in radiation pattern; this can meet the demands of wider bandwidth to get high data speed in communication systems. Moreover, this developed system provides an efficient and cost-effective solution for measuring the radiation pattern in far-field zone for any kind of antenna system.

Keywords: antenna radiation characteristics, dynamically reconfigurable, plasma antenna, plasma column, plasma striations, surface wave

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Authors: Hacer Kobya Bulut, Ilknur Kahriman, Birsel C. Demirbag

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Introduction and Purpose: The lives of children with cancer are affected by long term hospitalizations in a negative way due to complications arising from diagnosis or treatment. However, the children's parents are known to have difficulties in meeting their children’s needs and providing home care after cancer treatment or during remission process. Supporting these children and their parents by giving a planned discharge training starting from the hospital and home care leads to reducing hospital applications, hospitalizations, hospital costs, shortening the length of hospital stay and increasing the satisfaction of the children with cancer and their families. This study was conducted to investigate the status of children and their parents' unplanned application to hospital and re-hospitalization. Methods: The study was carried out with 65 children with hematological malignancy in 0-17 age group and their families in a hematology clinic and polyclinic of a university hospital in Trabzon. Data were collected with survey methodology between August-November, 2015 through face to face interview using numbers, percentage and chi-square test in the evaluation. Findings: Most of the children were leukemia (90.8%) and 49.2% had been ill over 13 months. Few of the parents (32.3%) stated that they had received discharge and home care training (24.6%) but most of them (69.2%) found themselves enough in providing home care. Very few parents (6.2%) received home care training after their children being discharged and the majority of parents (61.5%) faced difficulties in home care and had no one to call around them. The parents expressed that in providing care to their children with hematological malignance, they faced difficulty in feeding them (74.6%), explaining their disease (50.0%), giving their oral medication (47.5%), providing hygiene (43.5%) and providing oral care (39.3%). The question ‘What are the emergency situations in which you have to bring your children to a doctor immediately?' was replied as fever (89.2%), severe nausea and vomiting (87.7%), hemorrhage (86.2%) and pain (81.5%). The study showed that 50.8% of the children had unplanned applications to hospitals and 33.8% of them identified as unplanned hospitalization and the first causes of this were fever and pain. The study showed that the frequency of applications (%78.8) and hospitalizations (%81.8) was higher for boys and a statistically significant difference was found between gender and unplanned applications (X=4.779; p=0.02). Applications (48.5%) and hospitalizations (40.9%) were found lower for the parents who had received hospital discharge training, and a significant difference was determined between receiving training and unplanned hospitalizations (X=8.021; p=0.00). Similarly, applications (30.3%) and hospitalizations (40.9%) was found lower for the ones who had received home care training, and a significant difference was determined between receiving home care training and unplanned hospitalizations (X=4.758; p=0.02). Conclusion: It was found out that caregivers of children with cancer did not receive training related to home care and complications about treatment after discharging from hospital, so they faced difficulties in providing home care and this led to an increase in unplanned hospital applications and hospitalizations.

Keywords: cancer, children, unplanned application, unplanned hospitalization

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Authors: Fabio N. Moreno, Letícia B. Marinho, Beatriz D. Ruiz, Maria Helena R. B. Martins

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Brazil is a top consumer of pesticides worldwide, and the São Paulo State is one of the highest consumers among the Brazilian federative states. However, representative data about the occurrence of pesticides in surface waters of the São Paulo State is scarce. This paper aims to present the results of pesticides monitoring executed within the Water Quality Monitoring Network of CETESB (The Environmental Agency of the São Paulo State) between the 2018-2022 period. Surface water sampling points (21 to 25) were selected within basins of predominantly agricultural land-use (5 to 85% of cultivated areas). The samples were collected throughout the year, including high-flow and low-flow conditions. The frequency of sampling varied between 6 to 4 times per year. Selection of pesticide molecules for monitoring followed a prioritizing process from EMBRAPA (Brazilian Agricultural Research Corporation) databases of pesticide use. Pesticides extractions in aqueous samples were performed according to USEPA 3510C and 3546 methods following quality assurance and quality control procedures. Determination of pesticides in water (ng L-1) extracts were performed by high-performance liquid chromatography coupled with mass spectrometry (HPLC-MS) and by gas chromatography with nitrogen phosphorus (GC-NPD) and electron capture detectors (GC-ECD). The results showed higher frequencies (20- 65%) in surface water samples for Carbendazim (fungicide), Diuron/Tebuthiuron (herbicides) and Fipronil/Imidaclopride (insecticides). The frequency of observations for these pesticides were generally higher in monitoring points located in sugarcane cultivated areas. The following pesticides were most frequently quantified above the Aquatic life benchmarks for freshwater (USEPA Office of Pesticide Programs, 2023) or Brazilian Federal Regulatory Standards (CONAMA Resolution no. 357/2005): Atrazine, Imidaclopride, Carbendazim, 2,4D, Fipronil, and Chlorpiryfos. Higher median concentrations for Diuron and Tebuthiuron in the rainy months (october to march) indicated pesticide transport through surface runoff. However, measurable concentrations in the dry season (april to september) for Fipronil and Imidaclopride also indicates pathways related to subsurface or base flow discharge after pesticide soil infiltration and leaching or dry deposition following pesticide air spraying. With exception to Diuron, no temporal trends related to median concentrations of the most frequently quantified pesticides were observed. These results are important to assist policymakers in the development of strategies aiming at reducing pesticides migration to surface waters from agricultural areas. Further studies will be carried out in selected points to investigate potential risks as a result of pesticides exposure on aquatic biota.

Keywords: pesticides monitoring, são paulo state, water quality, surface waters

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Authors: Vignesh Ratnaraj, Jaewon Chang

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Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

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Authors: Sonu Khanal, Mandira Shrestha

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Snow and Glaciers are the largest dependable reserved sources of water for the river system originating from the Himalayas so an accurate estimate of the volume of water contained in the snowpack and the rate of release of water from snow and glaciers are, therefore, needed for efficient management of the water resources. This research assess the fusion of energy exchanges between the snowpack, air above and soil below according to mass and energy balance which makes it apposite than the models using simple temperature index for the snow and glacier melt computation. UEBGrid a Distributed energy based model is used to calculate the melt which is then routed by Geo-SFM. The model robustness is maintained by incorporating the albedo generated from the Landsat-7 ETM images on a seasonal basis for the year 2002-2003 and substrate map derived from TM. The Substrate file includes predominantly the 4 major thematic layers viz Snow, clean ice, Glaciers and Barren land. This approach makes use of CPC RFE-2 and MERRA gridded data sets as the source of precipitation and climatic variables. The subsequent model run for the year between 2002-2008 shows a total annual melt of 17.15 meter is generate from the Marshyangdi Basin of which 71% is contributed by the glaciers , 18% by the rain and rest being from the snow melt. The albedo file is decisive in governing the melt dynamics as 30% increase in the generated surface albedo results in the 10% decrease in the simulated discharge. The melt routed with the land cover and soil variables using Geo-SFM shows Nash-Sutcliffe Efficiency of 0.60 with observed discharge for the study period.

Keywords: Glacier, Glacier melt, Snowmelt, Energy balance

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Authors: S. Shafiee Ardestani, A. Najafi, N. Valizadeh, E. Payani, H. Karimian

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Objectives: Treatment of mild traumatic brain injury in emergency ward patients with any type of traumatic intracranial hemorrhage is flexible. The aim of this study is to assess the clinical outcomes of mild traumatic brain injury patients who had acute traumatic intracranial hemorrhage on initial emergency ward neuroimaging. Materials-Methods: From March 2011 to November 2012 in a retrospective cohort study we enrolled emergency ward patients with mild traumatic brain injury with Glasgow Coma Scale (GCS) scores of 14 or 15 and who had stable vital signs. Patients who had any type of intracranial hemorrhage on first head CT and repeat head CT within 24 hours were included. Patients with initial GCS < 14, injury > 24 hours old, pregnancy, concomitant non-minor injuries, and coagulopathy were excluded. Primary endpoints were neurosurgical procedures and/or death and for discharged patients, return to the emergency ward during one week. Results: Among 755 patients who were referred to the emergency ward and underwent two head CTs during first 24 hours, 302 (40%) were included. The median interval between CT scans was 6 hours (ranging 4 to 8 hours). Consequently, 135 (45%) patients had subarachnoid hemorrhage, 124 (41%) patients had subdural hemorrhage, 15 (5%) patients had epidural hemorrhage, 28 (9%) patients had cerebral contusions, and 54 (18%) patients had intra-parenchymal hemorrhage. Six of 302 patients died within 15 days of injury. 200 patients (66%) have been discharged from the emergency ward, 25 (12%) of whom returned to the emergency ward after one week. Conclusion: Discharge of the head trauma patients after a repeat head CT and brief period of observation in the emergency ward lead to early discharge of mild traumatic brain injury patients with traumatic ICH without adverse events.

Keywords: clinical outcomes, emergency ward, mild traumatic intracranial hemorrhage, Glasgow Coma Scale (GCS)

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Authors: Mohammad H. Fattahi

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Chaotic analysis has been performed on the river flow time series before and after applying the wavelet based de-noising techniques in order to investigate the noise content effects on chaotic nature of flow series. In this study, 38 years of monthly runoff data of three gauging stations were used. Gauging stations were located in Ghar-e-Aghaj river basin, Fars province, Iran. The noise level of time series was estimated with the aid of Gaussian kernel algorithm. This step was found to be crucial in preventing removal of the vital data such as memory, correlation and trend from the time series in addition to the noise during de-noising process.

Keywords: chaotic behavior, wavelet, noise reduction, river flow

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Authors: Ranjith Menon, Abathar Aladi, Hans-Christean Nahser, Maneesh Bhojak, Sacha Nevin, Paul Eldridge

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Background: Spontaneous subarachnoid haemorrhage (SAH) accounts for approximately 5% of all strokes. Patients with spontaneous SAH (as shown by CT or lumbar puncture) undergo investigations to identify or exclude an underlying structural cause, typically cerebral aneurysm. However in 10 - 20% of cases, no structural cause is found. This includes more than one imaging modality (intracranial MRA, CTA, 4DCTA and/or DSA) and in some spinal MRI. Objective: To determine; 1) If an underlying structural or vascular cause can be identified in non-aneurysmal SAH patients by comparing different imaging modalities at presentation and at follow-up. 2) If MRI spine in patients with non-aneurysmal SAH reveals an underlying SAH cause. 3)The functional outcome at discharge. Results: We performed a retrospective analysis of all non-traumatic SAH patients admitted to the Walton centre from January 2009 to December 2015. There were 1457 patients with non-traumatic SAH admitted to the Walton centre of whom 21.8% (n=300) patients were diagnosed with non-aneurysmal SAH. Males were 65.6% and females were 43.3%. The presenting symptoms were sudden onset headache (93.6%), the focal neurological deficit (12%), loss of consciousness (10.6%) and others (6%). About 285 patients received 2 modalities of imaging (CTA & DSA), 192 received 3 modalities of imaging (CTA, MRA & DSA) and 137 received MRI spine (51/137 whole spine). The modified Rankin Score at discharge were: mRS 0 = 292 (97.33%), mRS 1-2 = 6, mRS 6 = 1 (cardiac arrest in IHD patient) and unknown in 1. Follow-up imaging at 3 to 6 months in 190 (63.3%) patients did not identify an underlying cause. Conclusion: This retrospective analysis concludes that non-aneurysmal SAH has a good functional outcome. A single imaging modality (CTA (4DCTA) or MRA or DSA) was adequate to exclude an underlying cause of SAH and a delayed imaging failed to identify a cause. Routinely performing MRI spine in this group of patients appears not to be necessary according to this evidence.

Keywords: stroke, non-aneurysmal subarachnoid haemorrhage, neuroimaging, modified rankin score

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Authors: Devika Nair, Sean Bellairs, Ken Evans

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Flow and erosion modeling provides an avenue for simulating the fine suspended sediment in surface water systems like streams and creeks. Fine suspended sediment is highly mobile, and many contaminants that may have been released by any sort of catchment disturbance attach themselves to these sediments. Therefore, a knowledge of fine suspended sediment transport is important in assessing contaminant transport. The CAESAR-Lisflood Landform Evolution Model, which includes a hydrologic model (TOPMODEL) and a hydraulic model (Lisflood), is being used to assess the sediment movement in tropical streams on account of a disturbance in the catchment of the creek and to determine the dynamics of sediment quantity in the creek through the years by simulating the model for future years. The accuracy of future simulations depends on the calibration and validation of the model to the past and present events. Calibration and validation of the model involve finding a combination of parameters of the model, which, when applied and simulated, gives model outputs similar to those observed for the real site scenario for corresponding input data. Calibrating the sediment output of the CAESAR-Lisflood model at the catchment level and using it for studying the equilibrium conditions of the landform is an area yet to be explored. Therefore, the aim of the study was to calibrate the CAESAR-Lisflood model and then validate it so that it could be run for future simulations to study how the landform evolves over time. To achieve this, the model was run for a rainfall event with a set of parameters, plus discharge and sediment data for the input point of the catchment, to analyze how similar the model output would behave when compared with the discharge and sediment data for the output point of the catchment. The model parameters were then adjusted until the model closely approximated the real site values of the catchment. It was then validated by running the model for a different set of events and checking that the model gave similar results to the real site values. The outcomes demonstrated that while the model can be calibrated to a greater extent for hydrology (discharge output) throughout the year, the sediment output calibration may be slightly improved by having the ability to change parameters to take into account the seasonal vegetation growth during the start and end of the wet season. This study is important to assess hydrology and sediment movement in seasonal biomes. The understanding of sediment-associated metal dispersion processes in rivers can be used in a practical way to help river basin managers more effectively control and remediate catchments affected by present and historical metal mining.

Keywords: erosion modelling, fine suspended sediments, hydrology, surface water systems

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Authors: Tiao Chang, Ivan Caballero, Hong Zhou

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Streams carry water and sediment naturally by maintaining channel dimensions, pattern, and profile over time. Watershed erosion as a natural process has occurred to contribute sediment to streams over time. The formation of channel dimensions is complex. This study is to relate quantifiable and consistent channel dimensions at the bankfull stage to the corresponding watershed erosion estimation by the Revised Universal Soil Loss Equation (RUSLE). Twelve sites of which drainage areas range from 7 to 100 square miles in the Hocking River Basin of Ohio were selected for the bankfull geometry determinations including width, depth, cross-section area, bed slope, and drainage area. The twelve sub-watersheds were chosen to obtain a good overall representation of the Hocking River Basin. It is of interest to determine how these bankfull channel dimensions are related to the soil erosion of corresponding sub-watersheds. Soil erosion is a natural process that has occurred in a watershed over time. The RUSLE was applied to estimate erosions of the twelve selected sub-watersheds where the bankfull geometry measurements were conducted. These quantified erosions of sub-watersheds are used to investigate correlations with bankfull channel dimensions including discharge, channel width, channel depth, cross-sectional area, and pebble distribution. It is found that drainage area, bankfull discharge and cross-sectional area correlates strongly with watershed erosion well. Furthermore, bankfull width and depth are moderately correlated with watershed erosion while the particle size, D50, of channel bed sediment is not well correlated with watershed erosion.

Keywords: watershed, stream, sediment, channel

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Authors: Mohamed K. Khalil, Mohamed S. Ragab

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Atomizers are used in many engineering applications including diesel engines, petrol engines and spray combustion in furnaces as well as gas turbine engines. These atomizers are used to increase the specific surface area of the fuel, which achieve a high rate of fuel mixing and evaporation. In all combustion systems reduction in mean drop size is a challenge which has many advantages since it leads to rapid and easier ignition, higher volumetric heat release rate, wider burning range and lower exhaust concentrations of the pollutant emissions. Pressure atomizers have a different configuration for design such as swirl atomizer (simplex), dual orifice, spill return, plain orifice, duplex and fan spray. Simplex pressure atomizers are the most common type of all. Among all types of atomizers, pressure swirl types resemble a special category since they differ in quality of atomization, the reliability of operation, simplicity of construction and low expenditure of energy. But, the disadvantages of these atomizers are that they require very high injection pressure and have low discharge coefficient owing to the fact that the air core covers the majority of the atomizer orifice. To overcome these problems, dual orifice atomizer was designed. This paper proposes a detailed mathematical model design procedure for both pressure swirl atomizer (Simplex) and dual orifice atomizer, examines the effects of varying fuel type and makes a clear comparison between the two types. Using five types of fuel (JP-5, JA1, JP-4, Diesel and Bio-Diesel) as a case study, reveal the effect of changing fuel type and its properties on atomizers design and spray characteristics. Which effect on combustion process parameters; Sauter Mean Diameter (SMD), spray cone angle and sheet thickness with varying the discharge coefficient from 0.27 to 0.35 during takeoff for high bypass turbofan engines. The spray atomizer performance of the pressure swirl fuel injector was compared to the dual orifice fuel injector at the same differential pressure and discharge coefficient using Excel. The results are analyzed and handled to form the final reliability results for fuel injectors in high bypass turbofan engines. The results show that the Sauter Mean Diameter (SMD) in dual orifice atomizer is larger than Sauter Mean Diameter (SMD) in pressure swirl atomizer, the film thickness (h) in dual orifice atomizer is less than the film thickness (h) in pressure swirl atomizer. The Spray Cone Angle (α) in pressure swirl atomizer is larger than Spray Cone Angle (α) in dual orifice atomizer.

Keywords: gas turbine engines, atomization process, Sauter mean diameter, JP-5

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Authors: Stepan Kuchar, Martin Golasowski, Radim Vavrik, Michal Podhoranyi, Boris Sir, Jan Martinovic

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The main goal of this article is to describe the online flood monitoring and prediction system Floreon+ primarily developed for the Moravian-Silesian region in the Czech Republic and the basic process it uses for running automatic rainfall-runoff and hydrodynamic simulations along with their calibration and uncertainty modeling. It takes a long time to execute such process sequentially, which is not acceptable in the online scenario, so the use of high-performance computing environment is proposed for all parts of the process to shorten their duration. Finally, a case study on the Ostravice river catchment is presented that shows actual durations and their gain from the parallel implementation.

Keywords: flood prediction process, high performance computing, online flood prediction system, parallelization

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Authors: Mirko Ante, Şeniz Sörgel, Andreas Bund

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Li-S- (Lithium-Sulfur-) battery systems provide very high specific gravimetric energy (2600 Wh/kg) and volumetric energy density (2800Wh/l). Hence, Li-S batteries are one of the key technologies for both the upcoming electromobility and stationary applications. Furthermore, the Li-S battery system is potentially cheap and environmentally benign. However, the technical implementation suffers from cycling stability, low charge and discharge rates and incomplete understanding of the complex polysulfide reaction mechanism. The aim of this work is to develop an effective electrocatalyst for the polysulfide reactions so that the electrode kinetics of the sulfur half-cell will be improved. Accordingly, the overvoltage will be decreased, and the efficiency of the cell will be increased. An enhanced electroactive surface additionally improves the charge and discharge rates. To reach this goal, functionalized electrocatalytic coatings are investigated to accelerate the kinetics of the polysulfide reactions. In order to determine a suitable electrocatalyst, apparent exchange current densities of a variety of materials (Ni, Co, Pt, Cr, Al, Cu, ITO, stainless steel) have been evaluated in a polysulfide containing electrolyte by potentiodynamic measurements and a Butler-Volmer fit including diffusion limitation. The samples have been examined by Scanning Electron Microscopy (SEM) after the potentiodynamic measurements. Up to now, our work shows that cobalt is a promising material with good electrocatalytic properties for the polysulfide reactions and good chemical stability in the system. Furthermore, an electrodeposition from a modified Watt’s nickel electrolyte with a sulfur source seems to provide an autocatalytic effect, but the electrocatalytic behavior decreases after several cycles of the current-potential-curve.

Keywords: electrocatalyst, energy storage, lithium sulfur battery, sulfur electrode materials

Procedia PDF Downloads 349

Authors: Jamal Radaideh

Abstract:

Al-Asfar Lake is located about 14 km east of Al-Ahsa and is one of the most important wetland lakes in the Al Ahsa/Eastern Province of Saudi Arabia. Al-Ahsa is may be the largest oasis in the world, having an area of 20,000 hectares, in addition, it is of the largest and oldest agricultural centers in the region. The surplus farm irrigation water beside additional water supplied by treated wastewater from Al-Hofuf sewage station is collected by a drainage network and discharged into Al-Asfar Lake. The lake has good wetlands, sand dunes as well as large expanses of open and shallow water. Salt tolerant vegetation is present in some of the shallow areas around the lake, and huge stands of Phragmites reeds occur around the lake. The lake presents an important habitat for wildlife and birds, something not expected to find in a large desert. Although high evaporation rates in the range of 3250 mm are common, the water remains in the evaporation lakes during all seasons of the year is used to supply cattle with drinking water and for aquifer recharge. Investigations showed that high concentrations of nitrogen (N), phosphorus (P), biological oxygen demand (BOD), chemical oxygen demand (COD) and salinity discharge to Al Asfar Lake from the D2 drain exist. It is expected that the majority of BOD, COD and N originates from wastewater discharge and leachate from surplus irrigation water which also contribute to the majority of P and salinity. The significant content of nutrients and biological oxygen demand reduces available oxygen in the water. The present project aimed to improve the water quality of the lake using constructed wetland trains which will be built around the lake. Phragmites reeds, which already occur around the lake, will be used.

Keywords: Al Asfar lake, constructed wetland, water quality, water treatment

Procedia PDF Downloads 421

Authors: Kazuki Kohama, Hiroko Ono

Abstract:

The rainfall in Japan is gradually increasing every year according to Japan Meteorological Agency and Intergovernmental Panel on Climate Change Fifth Assessment Report. It means that the rainfall difference between rainy season and non-rainfall is increasing. In addition, the increasing trend of strong rain for a short time clearly appears. In recent years, natural disasters have caused enormous human injuries in various parts of Japan. Regarding water disaster, local heavy rain and floods of large rivers occur frequently, and it was decided on a policy to promote hard and soft sides as emergency disaster prevention measures with water disaster prevention awareness social reconstruction vision. Okinawa prefecture in subtropical region has torrential rain and water disaster several times a year such as river flood, in which is caused in specific rivers from all 97 rivers. Also, the shortage of capacity and narrow width are characteristic of river in Okinawa and easily cause river flood in heavy rain. This study focuses on Kohatu River that is one of the specific rivers. In fact, the water level greatly rises over the river levee almost once a year but non-damage of buildings around. On the other hand in some case, the water level reaches to ground floor height of house and has happed nine times until today. The purpose of this research is to figure out relationship between precipitation, surface outflow and total treatment water quantity of Kohatu River. For the purpose, we perform hydrological analysis although is complicated and needs specific details or data so that, the method is mainly using Geographic Information System software and outflow analysis system. At first, we extract watershed and then divided to 23 catchment areas to understand how much surface outflow flows to runoff point in each 10 minutes. On second, we create Unit Hydrograph indicating the area of surface outflow with flow area and time. This index shows the maximum amount of surface outflow at 2400 to 3000 seconds. Lastly, we compare an estimated value from Unit Hydrograph to a measured value. However, we found that measure value is usually lower than measured value because of evaporation and transpiration. In this study, hydrograph analysis was performed using GIS software and outflow analysis system. Based on these, we could clarify the flood time and amount of surface outflow.

Keywords: disaster prevention, water disaster, river flood, GIS software

Procedia PDF Downloads 121

Authors: Mohamed Ahmed Abdelmawla

Abstract:

Calling to achieve Millennium Development Goals (MDGs) engaged with agriculture, i.e. poverty alleviation targets, human resources involved in agricultural sectors with special emphasis on irrigation must receive wealth of practical experience and training. Increased food production, including staple food, is needed to overcome the present and future threats to food security. This should happen within a framework of sustainable management of natural resources, elimination of unsustainable methods of production and poverty reduction (i.e. axes of modernization). A didactic tool to confirm the task of wise and maximum utility is the best management and accurate measurement, as major requisites for modernization process. The key component to modernization as a warranted goal is adhering great attention to management and measurement issues via capacity building. As such, this paper stressed the issues of discharge management and measurement by Field Outlet Pipes (FOP) for selected ones within the Gezira Scheme, where randomly nine FOPs were selected as representative locations. These FOPs extended along the Gezira Main Canal at Kilo 57 areas in the South up to Kilo 194 in the North. The following steps were followed during the field data collection and measurements: For each selected FOP, a 90 v- notch thin plate weir was placed in such away that the water was directed to pass only through the notch. An optical survey level was used to measure the water head of the notch and FOP. Both calculated discharge rates as measured by the v – notch, denoted as [Qc], and the adopted discharges given by (MOIWR), denoted as [Qa], are tackled for the average of three replicated readings undertaken at each location. The study revealed that the FOP overestimates and sometimes underestimates the discharges. This is attributed to the fact that the original design specifications were not fulfilled or met at present conditions where water is allowed to flow day and night with high head fluctuation, knowing that the FOP is non modular structure, i.e. the flow depends on both levels upstream and downstream and confirmed by the results of this study. It is convenient and formative to quantify the discharge in FOP with weirs or Parshall flumes. Cropping calendar should be clearly determined and agreed upon before the beginning of the season in accordance and consistency with the Sudan Gezira Board (SGB) and Ministry of Irrigation and Water Resources. As such, the water indenting should be based on actual Crop Water Requirements (CWRs), not on rules of thumb (420 m3/feddan, irrespective of crop or time of season).

Keywords: management, measurement, MDGs, modernization

Procedia PDF Downloads 238

Authors: Ahmed Abbas

Abstract:

Land degradation in the Lower Cheliff region leads to loss of their fertility, physical and chemical properties by secondary salinization and film forming surface or surface crust. The main factor related to runoff and soil erosion is their susceptibility to crusting caused by the impact of raindrops, which causes the reduction of the filterability of the soil. The present study aims to investigate the hydrodynamic behavior of five types of soil taken from the plain of low Cheliff under simulated rainfall by using two intensities, one moderate, and others correspond to heavy rains at low kinetic energies. Experimental results demonstrate the influence of chemical and mechanical physical properties of soils on their hydrodynamic behavior and the influence of heavy rain on the modality of the reduction in the filterability and the amount of transported sediment.

Keywords: erosion, hydrodynamic behavior, rain simulation, soil

Procedia PDF Downloads 263

Authors: Nannapus Saramad, Rewwadee Petsirasan, Jom Suwanno

Abstract:

Background: This retrospective study design was to describe average blood pressure, blood pressure level, target blood pressure control rate post-stroke BP control in the year following discharge from Sichon hospital, Sichon District, Nakhon Si Thammarat province. The secondary data analysis was employed from the patient’s health records with patient or caregiver interview. A total of 232 eligible post-acute ischemic strokes in the year following discharge (2017-2018) were recruited. Methods: Data analyses were applied to identify the relationship values of single variables were determined through univariate analyses: The Chi-square test, Fisher exact test, the variables found to have a p-value < 0.2 were analyzed by the binary logistic regression Results: Most of the patients in this study were men 61.6%, an average age of 65.4 ± 14.8 years. Systolic blood pressure levels were in the grade 1-2 hypertension and diastolic pressure at optimal and normal at all times during the initial treatment through the present. The results revealed 25% among the groups under the age of 60 achieved BP control; 36.3% for older than 60 years group; and 27.9% for diabetic group. The multivariate analysis revealed the final relationship of four significant variables: 1) receiving calcium-channel blocker (p =.027); 2) medication adherence of antihypertensive (p = .024) 3) medication adherence of antiplatelet ( p = .020); and 4) medication behavior ( p = . 010) . Conclusion: The medical nurse and health care provider should promote their adherence to behavior to improve their blood pressure control.

Keywords: acute ischemic stroke, target blood pressure control, medication adherence, recurrence stroke

Procedia PDF Downloads 109

Authors: Sara Bahariderakhshan, Morteza Ahmadifar

Abstract:

Leakage is one of the most important problems that water distribution networks face which first reason is high-pressure existence. There are many approaches to control this excess pressure, which using pressure reducing valves (PRVs) or reducing pipe diameter are ones. In the other hand, Pumps are using electricity or fossil fuels to supply needed pressure in distribution networks but excess pressure are made in some branches due to topology problems and water networks’ variables therefore using pressure valves will be inevitable. Although using PRVs is inevitable but it leads to waste electricity or fuels used by pumps because PRVs just waste excess hydraulic pressure to lower it. Pumps working in reverse or Pumps as Turbine (called PaT in this article) are easily available and also effective sources of reducing the equipment cost in small hydropower plants. Urban areas of developing countries are facing increasing in area and maybe water scarcity in near future. These cities need wider water networks which make it hard to predict, control and have a better operation in the urban water cycle. Using more energy and, therefore, more pollution, slower repairing services, more user dissatisfaction and more leakage are these networks’ serious problems. Therefore, more effective systems are needed to monitor and act in these complicated networks than what is used now. In this article a new approach is proposed and evaluated: Using PAT to produce enough energy for remote valves and sensors in the water network. These sensors can be used to determine the discharge, pressure, water quality and other important network characteristics. With the help of remote valves pipeline discharge can be controlled so Instead of wasting excess hydraulic pressure which may be destructive in some cases, obtaining extra pressure from pipeline and producing clean electricity used by remote instruments is this articles’ goal. Furthermore due to increasing the area of the network there is unwanted high pressure in some critical points which is not destructive but lowering the pressure results to longer lifetime for pipeline networks without users’ dissatisfaction. This strategy proposed in this article, leads to use PaT widely for pressure containment and producing energy needed for remote valves and sensors like what happens in supervisory control and data acquisition (SCADA) systems which make it easy for us to monitor, receive data from urban water cycle and make any needed changes in discharge and pressure of pipelines easily and remotely. This is a clean project of energy production without significant environmental impacts and can be used in urban drinking water networks, without any problem for consumers which leads to a stable and dynamic network which lowers leakage and pollution.

Keywords: new energies, pump as turbine, drinking water, distribution network, remote control equipments

Procedia PDF Downloads 442

Authors: Morteza Ahmadifar, Sarah Bahari Derakhshan

Abstract:

Leakage is one of the most important problems that water distribution networks face which first reason is high-pressure existence. There are many approaches to control this excess pressure, which using pressure reducing valves (PRVs) or reducing pipe diameter are ones. On the other hand, Pumps are using electricity or fossil fuels to supply needed pressure in distribution networks but excess pressure are made in some branches due to topology problems and water networks’ variables, therefore using pressure valves will be inevitable. Although using PRVs is inevitable but it leads to waste electricity or fuels used by pumps because PRVs just waste excess hydraulic pressure to lower it. Pumps working in reverse or Pumps as Turbine (called PAT in this article) are easily available and also effective sources of reducing the equipment cost in small hydropower plants. Urban areas of developing countries are facing increasing in area and maybe water scarcity in near future. These cities need wider water networks which make it hard to predict, control and have a better operation in the urban water cycle. Using more energy and therefore more pollution, slower repairing services, more user dissatisfaction and more leakage are these networks’ serious problems. Therefore, more effective systems are needed to monitor and act in these complicated networks than what is used now. In this article a new approach is proposed and evaluated: Using PAT to produce enough energy for remote valves and sensors in the water network. These sensors can be used to determine the discharge, pressure, water quality and other important network characteristics. With the help of remote valves pipeline discharge can be controlled so Instead of wasting excess hydraulic pressure which may be destructive in some cases, obtaining extra pressure from pipeline and producing clean electricity used by remote instruments is this articles’ goal. Furthermore, due to increasing the area of network there is unwanted high pressure in some critical points which is not destructive but lowering the pressure results to longer lifetime for pipeline networks without users’ dissatisfaction. This strategy proposed in this article, leads to use PAT widely for pressure containment and producing energy needed for remote valves and sensors like what happens in supervisory control and data acquisition (SCADA) systems which make it easy for us to monitor, receive data from urban water cycle and make any needed changes in discharge and pressure of pipelines easily and remotely. This is a clean project of energy production without significant environmental impacts and can be used in urban drinking water networks, without any problem for consumers which leads to a stable and dynamic network which lowers leakage and pollution.

Keywords: clean energies, pump as turbine, remote control, urban water distribution network

Procedia PDF Downloads 374

Authors: Raja Umer Sajjad, Chang Hee Lee

Abstract:

Stormwater runoff is the leading contributor to pollution of receiving waters. In response, an efficient stormwater monitoring program is required to quantify and eventually reduce stormwater pollution. The overall goals of stormwater monitoring programs primarily include the identification of high-risk dischargers and the development of total maximum daily loads (TMDLs). The challenge in developing better monitoring program is to reduce the variability in flux estimates due to sampling errors; however, the success of monitoring program mainly depends on the accuracy of the estimates. Apart from sampling errors, manpower and budgetary constraints also influence the quality of the estimates. This study attempted to develop optimum stormwater monitoring design considering both cost and the quality of the estimated pollutants flux. Three years stormwater monitoring data (2012 – 2014) from a mix land use located within Geumhak watershed South Korea was evaluated. The regional climate is humid and precipitation is usually well distributed through the year. The investigation of a large number of water quality parameters is time-consuming and resource intensive. In order to identify a suite of easy-to-measure parameters to act as a surrogate, Principal Component Analysis (PCA) was applied. Means, standard deviations, coefficient of variation (CV) and other simple statistics were performed using multivariate statistical analysis software SPSS 22.0. The implication of sampling time on monitoring results, number of samples required during the storm event and impact of seasonal first flush were also identified. Based on the observations derived from the PCA biplot and the correlation matrix, total suspended solids (TSS) was identified as a potential surrogate for turbidity, total phosphorus and for heavy metals like lead, chromium, and copper whereas, Chemical Oxygen Demand (COD) was identified as surrogate for organic matter. The CV among different monitored water quality parameters were found higher (ranged from 3.8 to 15.5). It suggests that use of grab sampling design to estimate the mass emission rates in the study area can lead to errors due to large variability. TSS discharge load calculation error was found only 2 % with two different sample size approaches; i.e. 17 samples per storm event and equally distributed 6 samples per storm event. Both seasonal first flush and event first flush phenomena for most water quality parameters were observed in the study area. Samples taken at the initial stage of storm event generally overestimate the mass emissions; however, it was found that collecting a grab sample after initial hour of storm event more closely approximates the mean concentration of the event. It was concluded that site and regional climate specific interventions can be made to optimize the stormwater monitoring program in order to make it more effective and economical.

Keywords: first flush, pollutant load, stormwater monitoring, surrogate parameters

Procedia PDF Downloads 227

Authors: A. Moussouni, L. Mouzai, M. Bouhadef

Abstract:

Soil erosion is a very complex phenomenon, resulting from detachment and transport of soil particles by erosion agents. The kinetic energy of raindrop is the energy available for detachment and transport by splashing rain. The soil erodibility is defined as the ability of soil to resist to erosion. For this purpose, an experimental study was conducted in the laboratory using rainfall simulator to study the effect of the kinetic energy of rain (Ec) on the soil erodibility (K). The soil used was a sandy agricultural soil of 62.08% coarse sand, 19.14% fine sand, 6.39% fine silt, 5.18% coarse silt and 7.21% clay. The obtained results show that the kinetic energy of raindrops evolves as a power law with soil erodibility.

Keywords: erosion, runoff, raindrop kinetic energy, soil erodibility, rainfall intensity, raindrop fall velocity

Procedia PDF Downloads 481

Authors: Alilu Getahun Sulito

Abstract:

Exceptional floods are now prevalent in many places in Ethiopia, resulting in a large number of human deaths and property destruction. Lake Boyo watershed, in particular, had also traditionally been vulnerable to flash floods throughout the Boyo watershed. The goal of this research is to create flood and inundation maps for the Boyo Catchment. The integration of Geographic information system(GIS) technology and the hydraulic model (HEC-RAS) were utilized as methods to attain the objective. The peak discharge was determined using Fuller empirical methodology for intervals of 5, 10, 15, and 25 years, and the results were 103.2 m3/s, 158 m3/s, 222 m3/s, and 252 m3/s, respectively. River geometry, boundary conditions, manning's n value of varying land cover, and peak discharge at various return periods were all entered into HEC-RAS, and then an unsteady flow study was performed. The results of the unsteady flow study demonstrate that the water surface elevation in the longitudinal profile rises as the different periods increase. The flood inundation charts clearly show that regions on the right and left sides of the river with the greatest flood coverage were 15.418 km2 and 5.29 km2, respectively, flooded by 10,20,30, and 50 years. High water depths typically occur along the main channel and progressively spread to the floodplains. The latest study also found that flood-prone areas were disproportionately affected on the river's right bank. As a result, combining GIS with hydraulic modelling to create a flood inundation map is a viable solution. The findings of this study can be used to care again for the right bank of a Boyo River catchment near the Boyo Lake kebeles, according to the conclusion. Furthermore, it is critical to promote an early warning system in the kebeles so that people can be evacuated before a flood calamity happens. Keywords: Flood, Weira River, Boyo, GIS, HEC- GEORAS, HEC- RAS, Inundation Mapping

Keywords: Weira River, Boyo, GIS, HEC- GEORAS, HEC- RAS, Inundation Mapping

Procedia PDF Downloads 36

Authors: Diab Z., Hamad A., Dixit A., Al-Rikabi M., Keshaverzi F.

Abstract:

Introduction: According to the NICE guidelines, 2020Prasugrel is the recommended first line treatment in adults with acute coronary syndromes (ACS) in patients with ST-segment-elevation myocardial infarction (STEMI), defined as ST elevation or new left bundle branch block on ECG , that cardiologists intend to treat with primary percutaneous coronary intervention (PCI). The current literature suggests that this is largely due to safety and efficacy, and cost effectiveness. We wanted to do an audit to examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI. AIM: To examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI Methods: We looked at the patients presented to MRI during1^st of January 2022 to 28th February 2022. We included all the people who were above 18 and were brought to the hospital through the PPCI pathway and diagnosed as ACS and underwent PPCI. We excluded Patients who were brought to the hospital through the PPCI pathway and underwent coronary angiography and their diagnosis was found other than STEMI or if the outcome was death before discharge or they were above age >75 (as per guideline increase bleeding risk of prasugrel in a person aged 75 or older). Results: The total number of patients was 100. There were a total of seventy patients who had STEMI and fit the criteria for inclusion. Out of these, only 72.9% (51) were given Prasugrel as a first line. Seventeen (17) 24.3% STEMI patients were candidates for prasugrel as first-line therapy but were instead offered (clopidogrel/ticagrelor). Two 2 (2.9%) STEMI patients were not given prasugrel as first-line therapy because of C/I (CVA) or the use of anticoagulant Nine 9 (9%) of them died before discharge. Eleven 11 (11%) were above the age of 75. Ten 10 (10%) of patients had a diagnosis other than STEMI. Conclusions and recommendations: Our audit has shown the need to increase awareness amongst staff re: the first line use of Prasugrel as per NICE guidelines. We aim to arrange awareness sessions for staff and increase visibility of the guidelines for the staff to encourage them to adhere to the guideline. Further research is needed to find the optimum treatment in patients above 75.

Keywords: pasurgrel, PCI, NICE, STEMI

Procedia PDF Downloads 60

Authors: Darshana Rathod, Kirtikumar Rathod, Kamlesh Kumari, Abhilasha Motghare

Abstract:

Background and Aims: Hypospadias is one of the common congenital anomalies in males. Various modalities are used for pain management, including caudal, penile, pudendal, ring blocks, and systemic analgesics. There has yet to be a consensus regarding the most effective and safe analgesic method for controlling pain in these children. We planned this study to determine our institute's pain management practices for hypospadias surgeries. Material and Methods: This retrospective cohort study reviewed 150 children with hypospadias undergoing surgery from January 2020 to December 2023. Data regarding the mode of pain management, postoperative opioid requirement, PACU discharge, and complications was collected from the records. Results: For postoperative pain, 33 (22%) children received caudal block, 60 (40%) penile block, and 57 (38%) were managed by intravenous analgesics. A significant difference was found in the three groups, with the IV analgesic group requiring significantly higher opioid boluses in PACU [43 (75.4%) required two boluses (p < 0.05)]. The difference in PACU discharge time among the three groups was statistically significant (p< 0.05), with IV analgesics groups having the highest (55 mins [47, 60]), the Caudal group at 35mins (30, 40), and the dorsal penile block group at 35mins (25, 40). There was no significant difference in complications like edema, meatal stenosis, urethra-cutaneous fistula, or wound dehiscence among all three groups. Conclusion: Intravenous analgesics and regional blocks like caudal and penile blocks are the common pain management modalities in our institute. The regional blocks are effective in managing pain in the postoperative period and are not significantly associated with complications.

Keywords: caudal block, hypospadias, pain management, penile block

Procedia PDF Downloads 28