Search results for: wound contraction

Authors: Madhav Khadilkar

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Construction of a large standby reservoir was required to provide secure water supply. The new reservoir was required to be constructed at the same location of an abandoned old open pond due to space constraints. Some investigations were carried out earlier to improvise and re-commission the existing pond. But due to a lack of quantified risk of settlement from voids in the underlying limestone, the shallow foundations were not found feasible. Since the reservoir was resting on hard strata for about three-quarter of plan area and one quarter was resting on soil underlying with limestone and considerably low subgrade modulus. Further investigations were carried out to ascertain the locations and extent of voids within the limestone. It was concluded that the risk due to lime dissolution was acceptably low, and the site was found geotechnically feasible. The hazard posed by limestone dissolution was addressed through the integrated structural and geotechnical analysis and design approach. Finite Element Analysis was carried out to quantify the stresses and differential settlement due to various probable loads and soil-structure interaction. Walls behaving as cantilever under operational loads were found undergoing in-plane bending and tensile forces due to soil-structure interaction. Sensitivity analysis for varying soil subgrade modulus was carried out to check the variation in the response of the structure and magnitude of stresses developed. The base slab was additionally checked for the loss of soil contact due to lime pocket formations at random locations. The expansion and contraction joints were planned to receive minimal additional forces due to differential settlement. The reservoir was designed to sustain the actions corresponding to allowable deformation limits per code, and geotechnical measures were proposed to achieve the soil parameters set in structural analysis.

Keywords: differential settlement, limestone dissolution, reservoir, soil structure interaction

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Authors: Zewdneh Zana Zate

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The study focuses on the evolutionary and ecological genomics of both wild and cultivated Coffea arabica L. at its center of origin, Ethiopia, aiming to uncover how this vital species may withstand future climate changes. Utilizing bioclimatic models, we project the future distribution of Arabica under varied climate scenarios for 2050 and 2080, identifying potential conservation zones and immediate risk areas. Through whole-genome resequencing of accessions from Ethiopian gene banks, this research assesses genetic diversity and divergence between wild and cultivated populations. It explores relationships, demographic histories, and potential hybridization events among Coffea arabica accessions to better understand the species' origins and its connection to parental species. This genomic analysis also seeks to detect signs of natural or artificial selection across populations. Integrating these genomic discoveries with ecological data, the study evaluates the current and future ecological and genomic vulnerabilities of wild Coffea arabica, emphasizing necessary adaptations for survival. We have identified key genomic regions linked to environmental stress tolerance, which could be crucial for breeding more resilient Arabica varieties. Additionally, our ecological modeling predicted a contraction of suitable habitats, urging immediate conservation actions in identified key areas. This research not only elucidates the evolutionary history and adaptive strategies of Arabica but also informs conservation priorities and breeding strategies to enhance resilience to climate change. By synthesizing genomic and ecological insights, we provide a robust framework for developing effective management strategies aimed at sustaining Coffea arabica, a species of profound global importance, in its native habitat under evolving climatic conditions.

Keywords: coffea arabica, climate change adaptation, conservation strategies, genomic resilience

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Authors: Luksanaporn Krungkraipetch

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One hundred cataract patients with phacoemulsification were enrolled in the study to compare of visual acuity outcome and complication after phacoemulsification between diabetic and non-diabetic patients at Burapha University Hospital, Chonburi, Thailand. Fifty patients were diabetic (type II) group and 50 patients were non-diabetic group. All cases were operated by one doctor with the same pre-operative care, operation (phacoemulsification), and post-operative care. Visual acuity and complication after surgery were assessed after the operation for two years. There were no significant differences in demographic data between the two groups. The visual outcome values ≥ 2 lines and ≥ 20/40 had no significant differences between two groups after two years of surgery. The complication rate in diabetic group had cystoid macular edema 16%, rupture posterior capsule 8%, posterior capsule opacity 2%, uveitis 2 %, and 2% endophthalmitis. The non-diabetic group had cystoid macular edema 12%, rupture posterior capsule 8%, uveitis 2%, posterior capsule opacity 2%, and 2% wound leak. Comparison of visual acuity outcome and complication after phacoemulsification between diabetic and non-diabetic patients had no statistical significant differences between these two groups. It was found that cystoid macular edema was the most common complication in both groups and 10% of retinopathy progression was seen.

Keywords: cataract, visual acuity, cataract extraction, phacoemulsification, diabetic retinopathy

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Authors: Shivankar Agrawal, Sunil Kumar Deshmukh, Colin Barrow, Alok Adholeya

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Millions of people worldwide are affected by infectious diseases caused by bacteria and fungi. Skin and skin structure infections (SSSI) represent a significant category of infectious disease. Unexpectedly, many pathogens have developed resistance towards current antibiotics and over the time this problem has become more and more serious. All these new problems necessitate the continuous search for novel and alternative antibiotics and antifungals. The aim of our research is the screening of extracts of marine fungi for their antibacterial activity against bacteria causing skin and wound infection in humans. A total of 40 marine samples were collected from west coast and Andaman Island of India and 35 morphologically different marine fungi were isolated using natural sea water medium. Among 35 marine fungi, eight isolates exhibited significant antimicrobial activity against human pathogens. In the course of systematic screening program for bioactive marine fungi, strain 'D5' was found to be most potent strain with MIC value of 1 mg/mL, which was morphologically identified as Simplicillium lamellicola. The effects of the most active crude extracts against their susceptible test microorganisms were also investigated by SEM analysis. Purification and characterization of crude extracts for identification of active lead molecule is under process. The results of diversity and antimicrobial activity have increased the scope of finding industrially important marine fungi from Indian marine environments and these organisms could be vital sources for the discovery of pharmaceutically useful molecules.

Keywords: antimicrobial activity, antibiotic, marine fungi, skin infections

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Authors: M. Varmaziar

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Magnesium (Mg) is an essential mineral that plays a crucial role in the human body. Certain types of foods, including nuts, grains, fruits, vegetables, and whole grains, are rich sources of magnesium. Mg serves as an essential cofactor for numerous enzymatic reactions, including energy metabolism, cellular growth, glycolysis, and protein synthesis. The Mg-ATP complex serves as an energy source and is vital for many physiological functions, including nerve conduction, muscle contraction, and blood pressure regulation. Despite the vital role of magnesium in energy metabolism, maintaining adequate magnesium intake is often overlooked among the general population and athletes. The aim of this study was to investigate the effect of magnesium supplementation on the physical activities of field athletes. Field athletes were divided into two groups: those who consumed magnesium supplements and those who received a placebo. These two groups received either 500 mg of magnesium oxide or a placebo daily for 8 weeks. At the beginning and end of the study, athletes completed ISI questionnaires and physical activity assessments. Nutritional analyses were performed using N4 software, and statistical analyses were conducted using SPSS19 software. The results of this study revealed a significant difference between the two study groups. Athletes who received magnesium supplements experienced less fatigue related to field athletic activities and muscle soreness. In contrast, athletes who received the placebo reported more significant fatigue and muscle soreness. A concerning finding in these results is that the performance of athletic activities may be at risk with low magnesium levels. Therefore, magnesium is essential for maintaining health and plays a crucial role in athletic performance. Consuming a variety of magnesium-rich foods ensures that individuals receive an adequate amount of this essential nutrient in their diet. The consumption of these foods improves performance parameters in athletic exercises.

Keywords: athletic performance, effect, field athletes, magnesium supplement

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Authors: Mallikarjunachari Gangapuram

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The design of stimuli-responsive hydrogel nanocomposite thin films is gaining significant attention in these days due to its wide variety of applications. Soft microrobots, drug delivery, biosensors, regenerative medicine, bacterial adhesion, energy storage and wound dressing are few advanced applications in different fields. In this research work, the nanomechanical properties of composite thin films of 20 microns were tuned by applying homogeneous external DC, and AC magnetic fields of magnitudes 0.05 T and 0.1 T. Polyvinyl alcohol (PVA) used as a matrix material and elliptical hematite nanoparticles (ratio of the length of the major axis to the length of the minor axis is 140.59 ± 1.072 nm/52.84 ± 1.072 nm) used as filler materials to prepare the nanocomposite thin films. Both quasi-static nanoindentation, Nano Dynamic Mechanical Analysis (Nano-DMA) tests were performed to characterize the viscoelastic properties of PVA, PVA+Hematite (0.1% wt, 2% wt and 4% wt) nanocomposites. Different properties such as storage modulus, loss modulus, hardness, and Er/H were carefully analyzed. The increase in storage modulus, hardness, Er/H and a decrease in loss modulus were observed with increasing concentration and DC magnetic field followed by AC magnetic field. Contact angle and ATR-FTIR experiments were conducted to understand the molecular mechanisms such as hydrogen bond formation, crosslinking density, and particle-particle interactions. This systematic study is helpful in design and modeling of magnetic responsive hydrogel nanocomposite thin films for biomedical applications.

Keywords: hematite, hydrogel, nanoindentation, nano-DMA

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Authors: Kriyapa lairungruang, Arunporn Itharat

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Limonia acidissima L. (LA) (Common name: wood apple, Thai name: ma-khwit) is a medicinal plant which has long been used in Thai traditional medicine. Its bark is used for treatment of diarrhea, abscess, wound healing and inflammation and it is also used in oral cancer. Thus, this research aimed to investigate antioxidant and cytotoxic activities of the LA bark extracts produced by various extraction methods. Different extraction procedures were used to extract LA bark for biological activity testing: boiling in water, maceration with 95% ethanol, maceration with 50% ethanol and water boiling of each the 95% and the 50% ethanolic residues. All extracts were tested for antioxidant activity using DPPH radical scavenging assay, cytotoxic activity against human laryngeal epidermoid carcinoma (HEp-2) cells and human oral epidermoid carcinoma (KB) cells using sulforhodamine B (SRB) assay. The results found that the 95% ethanolic extract of LA bark showed the highest antioxidant activity with EC50 values of 29.76±1.88 µg/ml. For cytotoxic activity, the 50% ethanolic extract showed the best cytotoxic activity against HEp-2 and KB cells with IC50 values of 9.55±1.68 and 18.90±0.86 µg/ml, respectively. This study demonstrated that the 95% ethanolic extract of LA bark showed moderate antioxidant activity and the 50% ethanolic extract provided potent cytotoxic activity against HEp-2 and KB cells. These results confirm the traditional use of LA for the treatment of oral cancer and laryngeal cancer, and also support its ongoing use.

Keywords: antioxidant activity, cytotoxic activity, Laryngeal epidermoid carcinoma, Limonia acidissima L., oral epidermoid carcinoma

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Authors: Stephanie Cheng, Benjamin Poh, Vivyan Tay, Sachin Mathur

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Aim: Diabetes mellitus (DM) is a worldwide pandemic affecting 500 million people. It is known to be associated with increased susceptibility to soft tissue infections (STI). Despite being a major public health burden, the literature relating the effects of DM and the presentation, severity and healing of STIs in general surgical patients remain limited. Methods: We conducted a retrospective review of all patients admitted with STI in a tertiary teaching hospital over a 12-month period. Patient demographics and surgical outcomes were collected and analyzed. Results: During the study period, 1059 patients were admitted for STIs, of which 936 (88%) required surgical intervention. Diabetic patients were presented with a higher body-mass index (BMI) (28 vs 26), larger abscess size (24 vs 14 cm²) and a longer length of stay (LOS)(4.4 days vs 2.9 days). They also underwent a higher proportion of wide debridement as well as application of negative pressure wound therapy (NPWT) (42% vs 35%). More diabetic patients underwent subsequent re-operation within the same sitting (8 vs 4). There were no differences in re-admission rates within 30 days nor subsequent abscess formation in those followed for 6 months. Conclusion: The incidence of STIs among DM patients represents a significant disease burden; surgeons should consider intensive patient counseling and partnering with primary care providers in order to help reduce the incidence of future STI admissions based on lifestyle modification and glucose control.

Keywords: general surgery, emergency general surgery, acute care surgery, soft tissue infections, diabetes mellitus

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Authors: Olajumoke A. Ojeleye

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The study assessed the patterns and extent of self-medication practice among adolescents in selected public senior secondary schools in Ife Central Local Government Area of Osun State. The objectives of the study were to find out the patterns of self-medication among adolescents, to elucidate whether age or gender has any effect on the self-medication patterns of adolescent, to ascertain to what extent adolescents indulge in self-medication, to examine the sources of drug information of these adolescents and also to examine the sources of these drugs. A cross-sectional design was employed for the study. A self-administered questionnaire tested for validity was used to collect data. Multistage sampling technique was used and 238 adolescents participated in the study. Data collection took two weeks and was analysed using Statistical Package for Social Sciences version 17. Results were presented using descriptive (e.g. frequency counts) and inferential statistics (e.g. chi-square). Results showed that more females (55.9%) than males (44.1%) practiced self-medication. Although the results showed that there is a low prevalence rate (33.6%) of self-medication among adolescents, chemists served as both the source of information on how to use the drug as well as the source of the drugs. Also, adolescents under study will only self-medicate in medical conditions such as malaria or wound/injuries but will prefer to see a doctor for conditions such as abdominal pain, infections or allergic reactions. It was recommended that government officials responsible for regulating and controlling of drugs should be more active in ensuring that safe drugs are made available over the counter and the consumer be given adequate information about the use of drugs and when to consult the doctor.

Keywords: adolescents, drugs, patterns, self-medication

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Authors: Milena Trevisan Pelegrino, Bruna De Araujo Lima, Mônica H. M. Do Nascimento, Christiane B. Lombello, Marcelo Brocchi, Amedea B. Seabra

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Nitric oxide (NO) is a small molecule involved in a wide range of physiological and pathophysiological processes, including vasodilatation, control of inflammatory pain, wound healing, and antibacterial activities. As NO is a free radical, the design of drugs that generates therapeutic amounts of NO in controlled spatial and time manners is still a challenge. In this study, the NO donor S-nitrosoglutathione (GSNO) was incorporated into the thermoresponsive Pluronic F-127 (PL) - chitosan (CS) hydrogel, in an easy and economically feasible methodology. CS is a polysaccharide with known antimicrobial and biocompatibility properties. Scanning electron microscopy, rheology and differential scanning calorimetry techniques were used for hydrogel characterization. The results demonstrated that the hydrogel has a smooth surface, thermoresponsive behavior, and good mechanical stability. The kinetics of NO release and GSNO diffusion from GSNO-containing PL/CS hydrogel demonstrated a sustained NO/GSNO release, in concentrations suitable for biomedical applications, at physiological and skin temperatures. The GSNO-PL/CS hydrogel demonstrated a concentration-dependent toxicity to Vero cells, and antimicrobial activity to Pseudomonas aeruginosa (minimum inhibitory concentration and minimum bactericidal concentration values of 0.5 µg·mL-1 of hydrogel, which correspondents to 1 mmol·L-1 of GSNO). Interesting, the concentration range in which the NO-releasing hydrogel demonstrated antibacterial effect was not found toxic to Vero mammalian cell. Thus, GSNO-PL/CS hydrogel is suitable biomaterial for topical NO delivery applications.

Keywords: antimicrobial, chitosan, biocompatibility, S-nitrosothiols

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Authors: P. Y. Chiang, Y. H. Chen, Y. J. Lin, C. C. Chang, W. C. Hsu

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The number of the elderly in the world population and the rate of falls in this increasing numbers of older people are increasing. Decreasing muscle strength and an increasing risk of falling are associated with the ageing process. Because the effects of seated stepping training on the walking performance in the elderly remain unclear, the main purpose of the proposed study is to perform electromyography analysis during walking and seated stepping in the elderly. Four surface EMG electrodes were sticked on the surface of lower limbs muscles, including vastus lateralis (VL), and gastrocnemius (GT) of both sides. Before test, maximal voluntary contraction (MVC) of the respective muscle was obtained using manual muscle testing. The analog raw data of EMG signals were digitized with a sampling frequency of 2000 Hz. The signals were fully rectified and the linear envelope were calculated. Stepping motion cycle was separated into two phases by stepping timing (ST) and pedal return timing (PRT). ST refer to the time when the pedal marker reached the highest height, representing the contra-lateral leg was going to release the pedal. PRT refer to the time when the pedal marker reached the lowest height, representing the contra-lateral leg was going to step the pedal. We assumed that ST acted the same role in initial contact during walking, and PRT for toe-off. The period from ST to next PRT was called pushing phase (PP), during which the leg would start to step with resistance, and we compare this phase with the stance phase in level walking. The period from PRT to next ST was called returning phase (RP), during which leg would not have any resistance in this phase, and we compare this phase with the swing phase in level walking. VL and Gastro muscular activation had similar patterns in both side. The ability may transfer to those needed during loading response, mid-stance and terminal swing phase. User needed to make more effort in stepping compared with walking with similar timing; thus the strengthening of the VL and Gastro may be helpful to improve the walking endurance and efficiency for the elderly.

Keywords: elderly, electromyography, seated stepping, walking

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Authors: Kebron Abich Asnake

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The outbreak of COVID-19 has had far-reaching socio-economic consequences globally, and Ethiopia is no exception. This abstract provides a summary of a research study on the socio-economic impact of COVID-19 in Ethiopia. The study analyzes the health impact, economic repercussions, social consequences, government response measures, and opportunities for post-crisis recovery. In terms of health impact, the research explores the spread and transmission of the virus, the capacity and response of the healthcare system, and the mortality rate, with a focus on vulnerable populations. The economic impact analysis entails investigating the contraction of the GDP, employment and income loss, disruption in key sectors such as agriculture, tourism, and manufacturing, and the specific implications for small and medium-sized enterprises (SMEs), foreign direct investment, and remittances. The social impact section looks at the disruptions in education and the digital divide, food security and nutrition challenges, increased poverty and inequality, gender-based violence, and mental health issues. The research also examines the measures taken by the Ethiopian government, including health and safety regulations, economic stimulus packages, social protection programs, and support for vulnerable populations. Furthermore, the study outlines long-term recovery prospects, social cohesion, and community resilience challenges. It highlights the need to strengthen the healthcare system and finds a balance between health and economic priorities. The research concludes by presenting recommendations for policy-makers and stakeholders, emphasizing opportunities for post-crisis recovery such as diversification of the economy, enhanced healthcare infrastructure, investment in digital infrastructure and technology, and support for domestic tourism and local industries. This research provides valuable insights into the socio-economic impact of COVID-19 in Ethiopia, offering a comprehensive analysis of the challenges faced and potential pathways towards recovery.

Keywords: impact, covid, ethiopia, health

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Authors: Adriana C. Panayi, Riaz A. Agha, Brady A. Sieber, Dennis P. Orgill

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Background: Increased rates of both breast cancer and obesity have resulted in more women seeking breast reconstruction. These women may be at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who have undergone breast reconstruction following mastectomy. Methods: Cochrane, PUBMED and EMBASE electronic databases were screened and data was extracted from included studies. The clinical outcomes assessed were surgical complications, medical complications, length of postoperative hospital stay, reoperation rate and patient satisfaction. Results: 33 studies met the inclusion criteria for the review and 29 provided enough data to be included in the meta-analysis (71368 patients, 20061 of which were obese). Obese women were 2.3 times more likely to experience surgical complications (95 percent CI 2.19 to 2.39; P < 0.00001), 2.8 times more likely to have medical complications (95 percent CI 2.41 to 3.26; P < 0.00001) and had a 1.9 times higher risk of reoperation (95 percent CI 1.75 to 2.07; P < 0.00001). The most common complication, wound dehiscence, was 2.5 times more likely in obese women (95 percent CI 1.80 to 3.52; P < 0.00001). Sensitivity analysis confirmed that obese women were more likely to experience surgical complications (RR 2.36, 95% CI 2.22–2.52; P < 0.00001). Conclusions: This study provides evidence that obesity increases the risk of complications in both implant and autologous reconstruction. Additional prospective and observational studies are needed to determine if weight reduction prior to reconstruction reduces the perioperative risks associated with obesity.

Keywords: autologous reconstruction, breast cancer, breast reconstruction, literature review, obesity, oncology, prosthetic reconstruction

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Authors: E. Bennion, A. Acharya, S. Barnes, D. Ferrell, S. Luckett-Cole, G. Mower, J. Nelson, Y. Nguyen

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Objective: This study aimed to evaluate the validity of a firearm injury query in the Early Notification of Community-based Epidemics syndromic surveillance system. Syndromic surveillance data are used at the Utah Department of Health for early detection of and rapid response to unusually high rates of violence and injury, among other health outcomes. The query of interest was defined by the Centers for Disease Control and Prevention and used chief complaint and discharge diagnosis codes to capture initial emergency department encounters for firearm injury of all intents. Design: Two epidemiologists manually reviewed electronic health records of emergency department visits captured by the query from April-May 2020, compared results, and sent conflicting determinations to two arbiters. Results: Of the 85 unique records captured, 67 were deemed probable, 19 were ruled out, and two were undetermined, resulting in a positive predictive value of 75.3%. Common reasons for false positives included non-initial encounters and misleading keywords. Conclusion: Improving the validity of syndromic surveillance data would better inform outbreak response decisions made by state and local health departments. The firearm injury definition could be refined to exclude non-initial encounters by negating words such as “last month,” “last week,” and “aftercare”; and to exclude non-firearm injury by negating words such as “pellet gun,” “air gun,” “nail gun,” “bullet bike,” and “exit wound” when a firearm is not mentioned.

Keywords: evaluation, health information system, firearm injury, syndromic surveillance

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Authors: Abdullah Saeidi, Aydin Gülses, Christan Flörke

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Skin cancer of the face region is the most common type of malignancy and surgical excision is the preferred approach. However, the clinical long term results reported in the literature are still controversial. Objectives: To describe; 1. Demographical characteristics 2. Affected site, distribution and TNM classification regarding tumor type 3. Surgical aspects • Surgical removal: excision principles, safety margins, the need for secondary resection, primary reconstruction/ defect closure, anesthesia protocol, duration of hospital stay (if any) • Secondary intervention for defect closure/reconstruction: Flap technique, anesthesia protocol, duration of hospital stay (if any), postoperative wound management etc. 4. Tumor recurrences 5. Clinical outcomes 6. Studying the possible therapy approach throw Biostatistical relation and correlation between multiple Histological, diagnostics and clinical Faktors. following surgical ablation of the skin cancer of the head and neck region. Methods: Selection and statistical analysis of medical records of patients who had admitted to the Department of Oral and Maxillofacial Surgery, Universitätsklinikum Schleswig Holstein, Campus Kiel during the period of 2015-2019 will be retrospectively evaluated. Data will be collected via ORBIS Information-Management-System (ORBIS AG, Saarbrücken, Germany).

Keywords: non melanoma skin cancer, face skin cancer, skin reconstruction, non melanoma skin cancer recurrence, non melanoma skin cancer metastases

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Authors: Waqas Ashraf, Yasir Nawab, Haritham Khan, Habib Awais, Shahbaz Ahmad

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Seersucker is a popular lightweight fabric widely used in men’s and women’s suiting, casual wear, children’s clothing, house robes, bed spreads and for spring and summer wear. The puckered effect generates air spaces between body and the fabric, keeping the wearer cool in hot conditions. The aim of this work was to develop knitted seersucker fabric on single cylinder weft knitting machine using plain jersey structure. Core spun cotton yarn and cotton spun yarn of same linear density were used. Core spun cotton yarn, contains cotton fiber in the sheath and elastase filament in the core. The both yarn were fed at regular interval to feeders on the machine. The loop length and yarn tension were kept constant at each feeder. The samples were then scoured and bleached. After wet processing, the fabric samples were washed and tumble dried. Parameters like loop length, stitch density and areal density were measured after conditioning these samples for 24 hours in Standard atmospheric condition. Produced sample has a regular puckering stripe along the width of the fabric with same height. The stitch density of both the flat and puckered area of relaxed fabric was found to be different .Air permeability and moisture management tests were performed. The results indicated that the knitted seersucker fabric has better wicking and moisture management properties as the flat area contact, whereas puckered area held away from the skin. Seersucker effect in knitted fabric was achieved by the difference of contraction of both sets of courses produced from different types of yarns. The seer sucker fabric produce by knitting technique is less expensive as compared to woven seer sucker fabric as there is no need of yarn preparation. The knitted seersucker fabric is more practicable for summer dresses, skirts, blouses, shirts, trousers and shorts.

Keywords: air permeability, knitted structure, moisture management, seersucker

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Authors: Allyne Topaz

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Intraoral dehiscence compromises free fibula flaps following mandibular reconstruction. Salivary contamination risks thrombosis of microvascular anastomosis and hardware infection. The superficial temporal artery islandized flap (STAIF) offers an efficient, non-microsurgical reconstructive option for regaining intraoral competency for a time sensitive complication. Methods: The STAIF flap is based on the superficial temporal artery coursing along the anterior hairline. The flap is mapped with assistance of the doppler probe. The width of the skin paddle is taken based on the ability to close the donor site. The flap is taken down to the level of the zygomatic arch and tunneled into the mouth. Results: We present a case of a patient who underwent mandibular reconstruction with a free fibula flap after a traumatic shotgun wound. The patient developed repeated intraoral dehiscence following failed local buccal and floor of mouth flaps leading to salivary contamination of the flap and hardware. The intraoral dehiscence was successfully salvaged on the third attempt with a STAIF flap. Conclusions: Intraoral dehiscence creates a complication requiring urgent attention to prevent loss of free fibula flap after mandibular reconstruction. The STAIF is a non-microsurgical option for restoring intraoral competency. This robust, axially vascularized skin paddle may be split for intra- and extra-oral coverage, as needed and can be an important tool in the reconstructive armamentarium.

Keywords: free fibula flap, intraoral dehiscence, mandibular reconstruction, superficial temporal artery islandized flap

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Authors: Paolo Ragazzi, Olivier Peillon, Paul Fauris, Mathias Simon, Raul Navarro, Juan Carlos Martin, Oriol Casasayas, Laura Pacheco, Albert Perez-Bellmunt

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Introduction: The use of stretching techniques in the sports world is frequent and widely used for its many effects. One of the main benefits is the gain in flexibility, range of motion and facilitation of the sporting performance. Recently the use of Roller-Foam (RF) has spread in sports practice both at elite and recreational level for its benefits being similar to those observed in stretching. The objective of the following study is to compare the results of the Roller-Foam with the proprioceptive neuromuscular facilitation stretching (PNF) (one of the stretchings with more evidence) on the hamstring muscles. Study design: The design of the study is a single-blind, randomized controlled trial and the participants are 40 healthy volunteers. Intervention: The subjects are distributed randomly in one of the following groups; stretching (PNF) intervention group: 4 repetitions of PNF stretching (5seconds of contraction, 5 second of relaxation, 20 second stretch), Roller-Foam intervention group: 2 minutes of Roller-Foam was realized on the hamstring muscles. Main outcome measures: hamstring muscles flexibility was assessed at the beginning, during (30’’ of intervention) and the end of the session by using the Modified Sit and Reach test (MSR). Results: The baseline results data given in both groups are comparable to each other. The PNF group obtained an increase in flexibility of 3,1 cm at 30 seconds (first series) and of 5,1 cm at 2 minutes (the last of all series). The RF group obtained a 0,6 cm difference at 30 seconds and 2,4 cm after 2 minutes of application of roller foam. The results were statistically significant when comparing intragroups but not intergroups. Conclusions: Despite the fact that the use of roller foam is spreading in the sports and rehabilitation field, the results of the present study suggest that the gain of flexibility on the hamstrings is greater if PNF type stretches are used instead of RF. These results may be due to the fact that the use of roller foam intervened more in the fascial tissue, while the stretches intervene more in the myotendinous unit. Future studies are needed, increasing the sample number and diversifying the types of stretching.

Keywords: hamstring muscle, stretching, neuromuscular facilitation stretching, roller foam

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Authors: Yanqun Li, Hong Geng

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The rapid urbanization process taking big cities as the main body leads to the unequal configuration of urban and rural areas in the aspects of land supply, industrial division of labor, service supply and space allocation, and induces the shrinking characterization of service energy, industrial system and population vitality in small towns. As an important spatial unit in the spectrum of urbanization that serves, connects and couples urban and rural areas, the shrinking phenomenon faced by small towns has an important influence on the healthy development of urbanization. Based on the census of small towns in Wuhan metropolitan area, we have found that the shrinking of small towns is a passive contraction of elastic tension under the squeeze in cities. Once affected by the external forces such as policy regulation, planning guidance, and population return, small towns will achieve expansion and growth. Based on the theory of complex adaptive systems, this paper comprehensively constructs the development index evaluation system of small towns from five aspects of population, economy, space, society and ecology, measures the shrinking level of small towns, further analyzes the shrinking characteristics of small towns, and identifies whether the shrinking is elastic or not. And then this paper measures the resilience ability index of small town contract from the above-mentioned five aspects. Finally, this paper proposes an adaptive mechanism of urban-rural interaction evolution under fine division of labor to response the passive shrinking in small towns of Wuhan. Based on the above, the paper creatively puts forward the planning response measures of the small towns on the aspects of spatial layout, function orientation and service support, which can provide reference for other regions.

Keywords: complex adaptive systems, resiliency shrinking, adaptation mechanism, planning response

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Authors: Mona Afifi, Yara Al Qahtani, Afnan Al Dosari, Amnah Hamdi

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Background: First aid is the care provided outside the hospital. It is important in saving lives. Delay in helping the victims may result in serious complication or even death. Many people die in Saudi Arabia because they don’t get proper first aid interventions. According to Traffic Safety council in KSA (2012), in the year of 2011 there was 7153 deaths from car accident in KAS. Subjects and method: Quasi-experimental research design was utilized to assess the effect of a structured 45-minute educational session on 82 undergraduate nursing students’ knowledge about first aid. Two tools were developed for the purpose of the current study. First tool containing the sociodemographic data including age, gender, level, and previous participation in a first aid course, and 55 statements specific to different situations that requires first aid. Concept and Knowledge of First Aid has 9 questions, cardiopulmonary resuscitation has 12 questions, Bleeding and Shock have 7 questions, Road Traffic Accidents has 5 questions, Fracture and Trauma have 4 questions, wound has 5 questions, sunstroke has 4 questions, bits and stings has 4 questions and burn has 5 questions. The second tool was to evaluate the campaign session. Result: The overall knowledge score showed significant difference between the pre and post awareness session (59.58 and 93.00 respectively, p=.000). Mean score shows significant difference in pre-tests between third and fourth year nursing students indicating that knowledge of fourth year students is higher compared to third year students with the mean knowledge scores of 69.56 and 60.88 respectively (p=0.006). Conclusion: Results of the current study indicate that the level of the knowledge in the post test session was higher than in the pre session. Also results showed that the fourth year student`s knowledge in pre-test was better compared to previous year.

Keywords: first aid, awareness campaign, undergraduate nursing students, knowledge

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Authors: Konstans Ruseva, Kristina Ivanova, Katerina Todorova, Margarita Gabrashanska, Tzanko Tzanov, Elena Vassileva

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Zwitterionic polymers (ZP) are well-known with their ultralow biofouling. They are successfully competing with poly(ethylene glycols) (PEG), which are considered as the “golden standard” in this respect. These unique properties are attributed to their strong hydration capacity, defined by the dipole-dipole interactions, arising between the ZP pendant groups as well as to the dipoles interaction with water molecules. Beside, ZP are highly resistant to bacterial adhesion thus ensuring an excellent anti-biofilm formation ability. Moreover, ZP are able to respond upon external stimuli such as temperature, pH, salt concentration changes which in combination with their anti-biofouling effect render this type of polymers as materials with a high potential in biomedical applications. The present work is focused on the development of zwitterionic hydrogels for efficient treatment of highly exudating and hard-to-heal chronic wounds. To this purpose, two types of ZP networks with different crosslinking degree were synthesized - polysulfobetaine (PSB) and polycarboxybetaine (PCB) ones. They were characterized in terms of their physico-mechanical properties, e.g. microhardness, swelling ability, smart behaviour. Furthermore, the potential of ZP networks to resist biofilm formation towards Staphylococcus aureus and Escherichia coli was studied. Their ability to reduce the high levels of myeloperoxidase and metalloproteinase, two enzymes that are part of the chronic wounds enviroenment, was revealed. Moreover, the in vitro cytotoxic assessment of PSB and PCB networks along with their in vivo performance in rats was also studied to reveal their high biocompatibility.

Keywords: absorption properties, biocompatibility, enzymatic inhibition activity, wound healing, zwitterionic polymers

Procedia PDF Downloads 177

Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

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Bile spillage occurs frequently during laparoscopic cholecystectomy yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact, might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visits, with subsequent readmission and additional procedures. While some authors found no increase in SSI following bile spillage (BS) compared to non-bile spillage cases, others found bile spillage to be associated with SSI. Therefore we sought to examine whether bile spillage is indeed associated with an increased risk of postoperative wound infections after laparoscopic cholecystectomy. I hypothesize that patients who experience BS during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing Laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per CDC-defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non-bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and was absent in the rest i.e.92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in nonbile spillage cases, SSI was found in 8 cases (8.7%). However, it was statistically not significant (p-value>0.05). Eleven (92%) cases were superficial SSI and one was an organ-space infection. No mortality or 30-day readmission. Spillage of Gallbladder content does not lead to an increase in SSIs. However as the rate of SSI is still higher, Surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage thorough peritoneal irrigation with normal saline should be done.

Keywords: organ space infection, Laparoscopic cholecystectomy, biliary spillage, surgical site infection

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Authors: Hager Elsheikh, Matthias Sendler, Juliana Glaubnitz

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In pancreatitis, an inflammatory reaction occurs in the pancreatic secretory cells due to premature activation of proteases, leading to pancreatic self-digestion and necrotic cell death of acinar cells. Acute pancreatitis in patients is characterized by a severe immune reaction that could lead to serious complications, such as organ failure or septic shock, if left untreated. Chronic pancreatitis is a recurrence of episodes of acute pancreatitis resulting in a fibro-inflammatory immune response, in which the type 2 immune response is primarily driven by AAMs in the pancreas. One of the most important signaling pathways for M2 macrophage activation is the IL-4/STAT6 pathway. Pancreatic fibrosis is induced by the hyperactivation of pancreatic stellate cells by dysregulation in the inflammatory response, leading to further damage, autodigestion and possibly necrosis of pancreatic acinar cells. The aim of this research is to investigate the effect of STAT6 knockout in disease severity and development of fibrosis wound healing in the presence of different macrophage populations, regulated by the type 2 immune response, after inducing chronic and/or acute pancreatitis in mice models via cerulean injection. We further investigate the influence of the JAK/STAT6 signaling pathway on the balance of fibrosis and regeneration in STAT6 deficient and wild-type mice. The characterization of resident and recruited macrophages will provide insight into the influence of the JAK/STAT6 signaling pathway on infiltrating cells and, ultimately, tissue fibrosis and disease severity.

Keywords: acute and chronic pancreatitis, tissue regeneration, macrophage polarization, Gastroenterology

Procedia PDF Downloads 47

Authors: Galit Truman Zinman

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The 'Islamic State' (IS) is one of the most successful jihadist groups in the modern history. The 'Islamic State' strives to realize the idea of erasing the borders between Muslim countries and establishing a wide Islamic caliphate. The 'Islamic State' is based on religious unity and opposition to existing political order. In this paper, the main argument is that the 'Islamic State' is characterized by two significant tendencies of state-building: preservation and change. The methodology of this study is based on the process tracing method and the analysis of primary sources: decisions, announcements and speeches of religious leaders of the Islamic State, slogans, rituals and symbols, audio and video clips produced by the Al-Hayat Media Center, films distributed on YouTube, as well as the content analysis of Dabiq`s articles (IS official Journal) and nasheeds (jihadi songs). The major findings of this study indicate that in practice the 'Islamic State' uses the same socio-political functions typical to the modern state (preservation), but introduces a different religious-ideological content (change). On the one hand, there is a preservation of the principles of existing modern state. Even with the rejection of secularization, globalization, and nationalism, there is an establishment of typical modern nation-state patterns. It is still a state entity, which has an ideological infrastructure, territory, population, governance and a monopoly on the use of violence, security services, justice system, tax collection, etc. All these functions characterize the modern state, and despite the desire of the 'Islamic State' to create a new kind of state, it reminds patterns of the typical modern nation-state. As for the religious-ideological content of the new state, here we can see a tendency of great change. The 'Islamic State' aims to create an Islamic caliphate which would allow the establishment of religious law and order, under a big commitment to return civilization to a seventh-century environment. The 'Islamic State' favors the fight against Western culture and its liberal ideology. It supports the struggle for global jihad against the unbelievers. Today, despite the territorial 'contraction' and the undermining of the organization's governance in Iraq and Syria, the 'Islamic State' continues to maintain its brand among jihadist activists around the world.

Keywords: Islamic State, Islamic caliphate, modern nation-state, religious law and order

Procedia PDF Downloads 169

Authors: Christina Hagen, Pragathi Kamale Gurmurthy, Thorsten M. Buzug

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CFD simulations are performed in the upper airway of a patient suffering from obstructive sleep apnea (OSA) that is a sleep related breathing disorder characterized by repetitive partial or complete closures of the upper airways. The simulations are aimed at getting a better understanding of the pathophysiological flow patterns in an OSA patient. The simulation is compared to medical data of a sleep endoscopic examination under sedation. A digital model consisting of surface triangles of the upper airway is extracted from the MR images by a region growing segmentation process and is followed by a careful manual refinement. The computational domain includes the nasal cavity with the nostrils as the inlet areas and the pharyngeal volume with an outlet underneath the larynx. At the nostrils a flat inflow velocity profile is prescribed by choosing the velocity such that a volume flow rate of 150 ml/s is reached. Behind the larynx at the outlet a pressure of -10 Pa is prescribed. The stationary incompressible Navier-Stokes equations are numerically solved using finite elements. A grid convergence study has been performed. The results show an amplification of the maximal velocity of about 2.5 times the inlet velocity at a constriction of the pharyngeal volume in the area of the tongue. It is the same region that also shows the highest pressure drop from about 5 Pa. This is in agreement with the sleep endoscopic examinations of the same patient under sedation showing complete contractions in the area of the tongue. CFD simulations can become a useful tool in the diagnosis and therapy of obstructive sleep apnea by giving insight into the patient’s individual fluid dynamical situation in the upper airways giving a better understanding of the disease where experimental measurements are not feasible. Within this study, it could been shown on one hand that constriction areas within the upper airway lead to a significant pressure drop and on the other hand a good agreement of the area of pressure drop and the area of contraction could be shown.

Keywords: biomedical engineering, obstructive sleep apnea, pharynx, upper airways

Procedia PDF Downloads 289

Authors: Mamatha Hosapatna, Anne D. Souza, Vrinda Hari Ankolekar, Antony Sylvan D. Souza

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Introduction: The lower extremity of the femur is characterized by an anterior groove in which patella is held during motion. This groove separates the two lips of the trochlea (medial and lateral), prolongation of the two condyles. In humans, the lateral trochlear lip is more developed than the medial one, creating an asymmetric groove that is also specific to the human body. Because of femoral obliquity, contraction of quadriceps leads to a lateral dislocation stress on the patella, and the more elevated lateral side of the patellar groove helps the patella stays in its correct place, acting as a wall against lateral dislocation. This specific shape fits an oblique femur. It is known that femoral obliquity is not genetically determined but comes with orthostatism and biped walking. Material and Methodology: To measure the various dimensions of the Femoropatellar groove (FPG) and femoral condyle using digital image analyser. 37 dried adult femora (22 right,15 left) were used for the study. End on images of the lower end of the femur was taken. Various dimensions of the Femoropatellar groove and FP angle were measured using image J software. Results were analyzed statistically. Results: Maximum of the altitude of medial condyle of the right femur is 4.98± 0.35 cm and of the left femur is 5.20±.16 cm. Maximum altitude of lateral condyle is 5.44±0.4 and 5.50±0.14 on the right and left side respectively. Medial length of the groove is 1.30±0.38 cm on the right side and on the left side is 1.88±0.16 cm. The lateral length of the groove on the right side is 1.900±.16 cm and left side is 1.88±0.16 cm. Femoropatellar angle is 136.38◦±2.59 on the right side and on the left side it is 142.38◦±7.0 Angle and dimensions of the femoropatellar groove on the medial and lateral sides were measured. Asymmetry in the patellar groove was observed. The lateral lip was found to be wider and bigger which correlated with the previous studies. An asymmetrical patellar groove with a protruding lateral side associated with an oblique femur is a specific mark of bipedal locomotion. Conclusion: Dimensions of FPG are important in maintaining the stability of patella and also in knee replacement surgeries. The implants used in to replace the patellofemoral compartment consist of a metal groove to fit on the femoral end and a plastic disc that attaches to the undersurface of the patella. The location and configuration of the patellofemoral groove of the distal femur are clinically significant in the mechanics and pathomechanics of the patellofemoral articulation.

Keywords: femoral patellar groove, femoro patellar angle, lateral condyle, medial condyle

Procedia PDF Downloads 378

Authors: Meltem Koray, Arda Ozgon, Duygu Ofluoglu, Mehmet Yaltirik

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Oral ulcerations can be seen as a side effect of different drugs. These ulcers usually appear within a few weeks following drug treatment. In most of cases, these ulcers resist to conventional treatments, such as anesthetics, antiseptics, anti-inflammatory agents, cauterization, topical tetracycline and corticosteroid treatment. The diagnosis is usually difficult, especially in patients receiving multiple drug therapies. Hyaluronan or hyaluronic acid (HA) is a biomaterial that has been introduced as an alternative approach to enhance wound healing and also used for oral ulcer treatment. The aim of this report is to present the treatment of drug-induced oral ulceration on maxillary mucosa with HA gel. 60-year-old male patient was referred to Department of Oral and Maxillofacial Surgery complaining of oral ulcerations during few weeks. He had received chemotherapy and radiotherapy in 2014 with the diagnosis of nasopharyngeal carcinoma, and he has accompanying systemic diseases such as; cardiological, neurological diseases and gout. He is medicated with Escitalopram (Cipralex® 20mg), Quetiapine (Seroquel® 100mg), Mirtazapine (Zestat® 15mg), Acetylsalicylic acid (Coraspin® 100mg), Ramipril-hydrochlorothiazide (Delix® 2.5mg), Theophylline anhydrous (Teokap Sr® 200mg), Colchicine (Colchicum Dispert® 0.5mg), Spironolactone (Aldactone® 100mg), Levothyroxine sodium (Levotiron® 50mg). He had painful oral ulceration on the right side of maxillary mucosa. The diagnosis was 'drug-induced oral ulceration' and HA oral gel (Aftamed® Oral gel) was prescribed 3 times a day for 2 weeks. Complete healing was achieved within 3 weeks without any side effect and discomfort. We suggest that HA oral gel is a potentially useful local drug which can be an alternative for management of drug-induced oral ulcerations.

Keywords: drug-induced, hyaluronic acid, oral ulceration, maxillary mucosa

Procedia PDF Downloads 253

Authors: Eman Ahmed Ahmed, Ghada Abdelmoneim Mohamed, Hamada Ahmed Hamada, Nagui Sobhi Nassif

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Impaired skeletal muscle endurance may be an important causal factor in the development of patellofemoral pain syndrome (PFPS). However, there is lack of information regarding the effect of hip versus knee muscle fatigue on isokinetic parameters, and myoelectric activity of hip and knee muscles in these patients. Purpose: The study was conducted to investigate the effect of hip abductors versus knee extensors fatigue protocol on knee proprioception, hip and knee muscle strength and their myoelectric activity in patients with PFPS. Methods: Fifteen female patients with PFPS participated in the study. They were tested randomly under two fatiguing conditions; hip abductors and knee extensors fatigue protocols. Isolated muscle fatigue of two muscles was induced isokinetically on the affected side in a two separate sessions with a rest interval of at least three days. After determining peak torque, patients performed continuous maximal concentric-eccentric contraction of the selected muscle until the torque output dropped below 50% of peak torque value for 3 consecutive repetitions. Knee proprioception, eccentric hip abductors' peak torque, eccentric knee extensors' peak torque, EMG ratio of vastus medialis obliquus (VMO) / vastus lateralis (VL), and EMG activity of gluteus medius (GM) muscle, were recorded before and immediately after each fatigue protocol using the Biodex Isokinetic system and EMG Myosystem. Results: Two-way within subject MANOVA revealed that eccentric knee extensors’ peak torque decreased significantly after hip abductors fatigue protocol compared to pre fatigue condition (p<0.05). On the other hand, there was no statistically significant difference in the eccentric hip abductors’ peak torque after admitting knee extensors fatigue protocol (p > 0.05). Moreover, no significant difference was found in knee proprioception, EMG ratio of VMO/VL, and EMG activity of GM muscle, after either hip or knee fatigue protocol (p>0.05). Conclusion: A hip focused rehabilitation program may be beneficial in improving knee function through correcting faulty kinematics and hence decrease knee loading in patients with PFPS.

Keywords: electromyography, knee proprioception, mechanical responses, muscle fatigue, patellofemoral pain syndrome

Procedia PDF Downloads 290

Authors: Wei-Chia Huang, Jane Wang

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Damage to nerves is considered one of the most irreversible injuries. The regeneration of nerves has always been an important topic in regenerative medicine. In general, damage to human tissue will naturally repair overtime. However, when the nerves are damaged, healed flesh wound cannot guarantee full restoration to its original function, as truncated nerves are often irreversible. Therefore, the development of treatment methods to successfully guide and accelerate the regeneration of nerves has been highly sought after. In order to induce nerve tissue growth, nerve conduits are commonly used to help reconnect broken nerve bundles to provide protection to the location of the fracture while guiding the growth of the nerve bundles. To prevent the protected tissue from becoming necrotic and to ensure the growth rate, the conduits used are often modified with microstructures or blended with neuron growth factors that may facilitate nerve regeneration. Electrical stimulation is another attempted treatment for medical rehabilitation. With appropriate range of voltages and stimulation frequencies, it has been demonstrated to promote cell proliferation and migration. Biodegradability are critical for medical devices like nerve conduits, while conductive polymers pose great potential toward the differentiation and growth of nerve cells. In this work, biodegradability and conductivity were combined into a novel biodegradable, photocurable, conductive polymer composite materials by embedding conductive nanoparticles in poly(glycerol sebacate) acrylate (PGSA) and 3D-printed into nerve conduits. Rat pheochromocytoma cells and rat neuronal Schwann cells were chosen for the in vitro tests of the conduits and had demonstrate selective growth upon culture in the conductive conduits with built-in microchannels and electrical stimulation.

Keywords: biodegradable polymer, 3d printing, neural regeneration, electrical stimulation

Procedia PDF Downloads 91

Authors: Avani Jain, S. Shelley, M. Indirani, Shilpa Kalal, Jaykanth Amalachandran

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Aim: To evaluate the prevalence of gall bladder dysfunction in patients with dyspepsia using In-House fatty meal cholescintigraphy. Materials & Methods: This study is a prospective cohort study. 59 healthy volunteers with no dyspeptic complaints and negative ultrasound and endoscopy were recruited in study. 61 patients having complaint of dyspepsia for duration of more than 6 months were included. All of them underwent 99mTc-Mebrofenin fatty meal cholescintigraphy following a standard protocol. Dynamic acquisitions were acquired for 120 minutes with an In-House fatty meal being given at 45th minute. Gall bladder emptying kinetics was determined with gall bladder ejection fractions (GBEF) calculated at 30minutes, 45minutes and at 60 minutes (30min, 45min & 60 min). Standardization of fatty meal was done for volunteers. Receiver operating characteristic (ROC) analysis was used assess the diagnostic accuracy of 3 time points (30min, 45min & 60 min) used for measuring gall bladder emptying. On the basis of cut off derived from volunteers, the patients were assessed for gall bladder dysfunction. Results: In volunteers, the GBEF at 30 min was 74.42±8.26 % (mean ±SD), at 45 min was 82.61 ± 6.5 % and at 60 min was 89.37±4.48%, compared to patients where at 30min it was 33.73±22.87%, at 45 min it was 43.03±26.97% and at 60 min it was 51.85±29.60%. The lower limit of GBEF in volunteers at 30 min was 60%, 45 min was 69% and at 60 min was 81%. ROC analysis showed that area under curve was largest for 30 min GBEF (0.952; 95% CI = 0.914-0.989) and that all the 3 measures were statistically significant (p < 0.005). Majority of the volunteers had 74% of gall bladder emptying by 30 minutes; hence it was taken as an optimum cutoff time to assess gall bladder contraction. > 60% GBEF at 30 min post fatty meal was considered as normal and < 60% GBEF as indicative of gall bladder dysfunction. In patients, various causes for dyspepsia were identified: GB dysfunction (63.93%), Peptic ulcer (8.19 %), Gastroesophageal reflux disease (8.19%), Gastritis (4.91%). In 18.03% of cases GB dysfunction coexisted with other gastrointestinal conditions. The diagnosis of functional dyspepsia was made in 14.75% of cases. Conclusions: Gall bladder dysfunction contributes significantly to the causation of dyspepsia. It could coexist with various other gastrointestinal diseases. Fatty meal was well tolerated and devoid of any side effects. Many patients who are labeled as functional dyspeptics could actually have gall bladder dysfunction. Hence as an adjunct to ultrasound and endoscopy, fatty meal cholescintigraphy can also be used as a screening modality in characterization of dyspepsia.

Keywords: in-house fatty meal, choescintigraphy, dyspepsia, gall bladder ejection fraction, functional dyspepsia

Procedia PDF Downloads 488