Search results for: gastric outlet obstruction
172 Power Recovery in Egyptian Natural Gas Pressure Reduction Stations Using Turboexpander Systems
Authors: Kamel A. Elshorbagy, Mohamed A. Hussein, Rola S. Afify
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Natural gas pressure reduction is typically achieved using pressure reducing valves, where isenthalpic expansion takes place with considerable amount of wasted energy in an irreversible throttling process of the gas. Replacing gas-throttling process by an expansion process in a turbo expander (TE) converts the pressure of natural gas into mechanical energy transmitted to a loading device (i.e. an electric generator). This paper investigates the performance of a turboexpander system for power recovery at natural gas pressure reduction stations. There is a considerable temperature drop associated with the turboexpander process. Essential preheating is required, using gas fired boilers, to avoid undesirable effects of a low outlet temperature. Various system configurations were simulated by the general flow sheet simulator HYSYS and factors affecting the overall performance of the systems were investigated. Power outputs and fuel requirements were found using typical gas flow variation data. The simulation was performed for two case studies in which real input data are used. These case studies involve a domestic (commercial) and an industrial natural gas pressure reduction stations in Egypt. Economic studies of using the turboexpander system in both of the two natural gas pressure reduction stations are conducted using precise data obtained through communication with several companies working in this field. The results of economic analysis, for the two case studies, prove that using turboexpander systems in Egyptian natural gas reduction stations can be a successful project for energy conservation.Keywords: natural gas, power recovery, reduction stations, turboexpander systems
Procedia PDF Downloads 323171 Multiparametric Optimization of Water Treatment Process for Thermal Power Plants
Authors: Balgaisha Mukanova, Natalya Glazyrina, Sergey Glazyrin
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The formulated problem of optimization of the technological process of water treatment for thermal power plants is considered in this article. The problem is of multiparametric nature. To optimize the process, namely, reduce the amount of waste water, a new technology was developed to reuse such water. A mathematical model of the technology of wastewater reuse was developed. Optimization parameters were determined. The model consists of a material balance equation, an equation describing the kinetics of ion exchange for the non-equilibrium case and an equation for the ion exchange isotherm. The material balance equation includes a nonlinear term that depends on the kinetics of ion exchange. A direct problem of calculating the impurity concentration at the outlet of the water treatment plant was numerically solved. The direct problem was approximated by an implicit point-to-point computation difference scheme. The inverse problem was formulated as relates to determination of the parameters of the mathematical model of the water treatment plant operating in non-equilibrium conditions. The formulated inverse problem was solved. Following the results of calculation the time of start of the filter regeneration process was determined, as well as the period of regeneration process and the amount of regeneration and wash water. Multi-parameter optimization of water treatment process for thermal power plants allowed decreasing the amount of wastewater by 15%.Keywords: direct problem, multiparametric optimization, optimization parameters, water treatment
Procedia PDF Downloads 387170 Triose Phosphate Utilisation at the (Sub)Foliar Scale Is Modulated by Whole-plant Source-sink Ratios and Nitrogen Budgets in Rice
Authors: Zhenxiang Zhou
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The triose phosphate utilisation (TPU) limitation to leaf photosynthesis is a biochemical process concerning the sub-foliar carbon sink-source (im)balance, in which photorespiration-associated amino acids exports provide an additional outlet for carbon and increases leaf photosynthetic rate. However, whether this process is regulated by whole-plant sink-source relations and nitrogen budgets remains unclear. We address this question by model analyses of gas-exchange data measured on leaves at three growth stages of rice plants grown at two-nitrogen levels, where three means (leaf-colour modification, adaxial vs abaxial measurements, and panicle pruning) were explored to alter source-sink ratios. Higher specific leaf nitrogen (SLN) resulted in higher rates of TPU and also led to the TPU limitation occurring at a lower intercellular CO2 concentration. Photorespiratory nitrogen assimilation was greater in higher-nitrogen leaves but became smaller in cases associated with yellower-leaf modification, abaxial measurement, or panicle pruning. The feedback inhibition of panicle pruning on rates of TPU was not always observed because panicle pruning blocked nitrogen remobilisation from leaves to grains, and the increased SLN masked the feedback inhibition. The (sub)foliar TPU limitation can be modulated by whole-plant source-sink ratios and nitrogen budgets during rice grain filling, suggesting a close link between sub-foliar and whole-plant sink limitations.Keywords: triose phosphate utilization, sink limitation, panicle pruning, oryza sativa
Procedia PDF Downloads 90169 Parametric Investigation of Aircraft Door’s Emergency Power Assist System (EPAS)
Authors: Marshal D. Kafle, Jun H. Kim, Hyun W. Been, Kyoung M. Min
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Fluid viscous damping systems are well suited for many air vehicles subjected to shock and vibration. These damping system work with the principle of viscous fluid throttling through the orifice to create huge pressure difference between compression and rebound chamber and obtain the required damping force. One application of such systems is its use in aircraft door system to counteract the door’s velocity and safely stop it. In exigency situations like crash or emergency landing where the door doesn’t open easily, possibly due to unusually tilting of fuselage or some obstacles or intrusion of debris obstruction to move the parts of the door, such system can be combined with other systems to provide needed force to forcefully open the door and also securely stop it simultaneously within the required time i.e.less than 8seconds. In the present study, a hydraulic system called snubber along with other systems like actuator, gas bottle assembly which together known as emergency power assist system (EPAS) is designed, built and experimentally studied to check the magnitude of angular velocity, damping force and time required to effectively open the door. Whenever needed, the gas pressure from the bottle is released to actuate the actuator and at the same time pull the snubber’s piston to operate the emergency opening of the door. Such EPAS installed in the suspension arm of the aircraft door is studied explicitly changing parameters like orifice size, oil level, oil viscosity and bypass valve gap and its spring of the snubber at varying temperature to generate the optimum design case. Comparative analysis of the EPAS at several cases is done and conclusions are made. It is found that during emergency condition, the systemopening time and angular velocity, when snubber with 0.3mm piston and shaft orifice and bypass valve gap of 0.5 mm with its original spring is used,shows significant improvement over the old ones.Keywords: aircraft door damper, bypass valve, emergency power assist system, hydraulic damper, oil viscosity
Procedia PDF Downloads 423168 Emerging Issues of Non-Communicable Diseases among Older Persons in India
Authors: Dhananjay W. Bansod, Santosh Phad
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Non-Communicable Diseases (NCD) are major contributing factors to the disease burden in the world as well as in India. With a growing proportion of older persons in India gives rise to several challenges. With the advancement of age, elderly is exposed to various kinds of health problems more specifically NCDs. Therefore, an effort has been made to examine the prevalence of NCDs among older persons and its treatment-seeking behaviour, also it is tried to explore the association between the NCDs and its effect on the overall wellbeing of older persons. Data used from “Building Knowledge Base of Population Ageing Survey” conducted in 2011 in seven states of India. Six chronic diseases used (non-communicable diseases) namely Arthritis, Hypertension, Cataract, Diabetes, Asthma and Heart diseases to understand the issues related to NCDs. Also seen the effect of NCDs on the wellbeing of the elderly, the subjective well-being consists of nine questions from which SUBI score generated for mental health status, which ranges from 9 to 27. This Index indicates that lower the score better is the mental health status. Further, this index modified and generated three categories of Better (9-15), Average (16-20) and Worse (21-27). The reliability analysis is carried out with the coefficient (Cronbach’s alpha) of the scale was 0.8884. The result shows that Orthopedic / musculoskeletal ailments involving arthritis, rheumatism and osteoarthritis are the most common type of ailment followed by hypertension. Two-thirds of the elderly reported suffering from at least one chronic ailment. Most chronic illness conditions received some form of treatment and mainly depend on public health facilities. Financial insecurity is the primary obstruction in seeking treatment for most of the chronic ailments which typically require a longer duration of medication and repeated medical consultations, both having significant economic implications. According to SUBI index, only 15 per cent of the elderly are in Better mental health status, and one-third of the elderly are with the worse score. Elderly with the ailments like Cataract, Asthma and Arthritis have worse mental health. It depicts that the burden of disease is more among the elderly and it is directly affecting the overall wellbeing of older persons.Keywords: NCD, well-being, older person, India
Procedia PDF Downloads 147167 Numerical Study on Response of Polymer Electrolyte Fuel Cell (PEFCs) with Defects under Different Load Conditions
Authors: Muhammad Faizan Chinannai, Jaeseung Lee, Mohamed Hassan Gundu, Hyunchul Ju
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Fuel cell is known to be an effective renewable energy resource which is commercializing in the present era. It is really important to know about the improvement in performance even when the system faces some defects. This study was carried out to analyze the performance of the Polymer electrolyte fuel cell (PEFCs) under different operating conditions such as current density, relative humidity and Pt loadings considering defects with load changes. The purpose of this study is to analyze the response of the fuel cell system with defects in Balance of Plants (BOPs) and catalyst layer (CL) degradation by maintaining the coolant flow rate as such to preserve the cell temperature at the required level. Multi-Scale Simulation of 3D two-phase PEFC model with coolant was carried out under different load conditions. For detailed analysis and performance comparison, extensive contours of temperature, current density, water content, and relative humidity are provided. The simulation results of the different cases are compared with the reference data. Hence the response of the fuel cell stack with defects in BOP and CL degradations can be analyzed by the temperature difference between the coolant outlet and membrane electrode assembly. The results showed that the Failure of the humidifier increases High-Frequency Resistance (HFR), air flow defects and CL degradation results in the non-uniformity of current density distribution and high cathode activation overpotential, respectively.Keywords: PEM fuel cell, fuel cell modeling, performance analysis, BOP components, current density distribution, degradation
Procedia PDF Downloads 214166 Investigation of the Operational Principle and Flow Analysis of a Newly Developed Dry Separator
Authors: Sung Uk Park, Young Su Kang, Sangmo Kang, Young Kweon Suh
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Mineral product, waste concrete (fine aggregates), waste in the optical field, industry, and construction employ separators to separate solids and classify them according to their size. Various sorting machines are used in the industrial field such as those operating under electrical properties, centrifugal force, wind power, vibration, and magnetic force. Study on separators has been carried out to contribute to the environmental industry. In this study, we perform CFD analysis for understanding the basic mechanism of the separation of waste concrete (fine aggregate) particles from air with a machine built with a rotor with blades. In CFD, we first performed two-dimensional particle tracking for various particle sizes for the model with 1 degree, 1.5 degree, and 2 degree angle between each blade to verify the boundary conditions and the method of rotating domain method to be used in 3D. Then we developed 3D numerical model with ANSYS CFX to calculate the air flow and track the particles. We judged the capability of particle separation for given size by counting the number of particles escaping from the domain toward the exit among 10 particles issued at the inlet. We confirm that particles experience stagnant behavior near the exit of the rotating blades where the centrifugal force acting on the particles is in balance with the air drag force. It was also found that the minimum particle size that can be separated by the machine with the rotor is determined by its capability to stay at the outlet of the rotor channels.Keywords: environmental industry, separator, CFD, fine aggregate
Procedia PDF Downloads 595165 Exploring Factors Related to Unplanning Readmission of Elderly Patients in Taiwan
Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee
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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis
Procedia PDF Downloads 130164 Optimal Design of Storm Water Networks Using Simulation-Optimization Technique
Authors: Dibakar Chakrabarty, Mebada Suiting
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Rapid urbanization coupled with changes in land use pattern results in increasing peak discharge and shortening of catchment time of concentration. The consequence is floods, which often inundate roads and inhabited areas of cities and towns. Management of storm water resulting from rainfall has, therefore, become an important issue for the municipal bodies. Proper management of storm water obviously includes adequate design of storm water drainage networks. The design of storm water network is a costly exercise. Least cost design of storm water networks assumes significance, particularly when the fund available is limited. Optimal design of a storm water system is a difficult task as it involves the design of various components, like, open or closed conduits, storage units, pumps etc. In this paper, a methodology for least cost design of storm water drainage systems is proposed. The methodology proposed in this study consists of coupling a storm water simulator with an optimization method. The simulator used in this study is EPA’s storm water management model (SWMM), which is linked with Genetic Algorithm (GA) optimization method. The model proposed here is a mixed integer nonlinear optimization formulation, which takes care of minimizing the sectional areas of the open conduits of storm water networks, while satisfactorily conveying the runoff resulting from rainfall to the network outlet. Performance evaluations of the developed model show that the proposed method can be used for cost effective design of open conduit based storm water networks.Keywords: genetic algorithm (GA), optimal design, simulation-optimization, storm water network, SWMM
Procedia PDF Downloads 248163 Quantification of Hydrogen Sulfide and Methyl Mercaptan in Air Samples from a Waste Management Facilities
Authors: R. F. Vieira, S. A. Figueiredo, O. M. Freitas, V. F. Domingues, C. Delerue-Matos
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The presence of sulphur compounds like hydrogen sulphide and mercaptans is one of the reasons for waste-water treatment and waste management being associated with odour emissions. In this context having a quantifying method for these compounds helps in the optimization of treatment with the goal of their elimination, namely biofiltration processes. The aim of this study was the development of a method for quantification of odorous gases in waste treatment plants air samples. A method based on head space solid phase microextraction (HS-SPME) coupled with gas chromatography - flame photometric detector (GC-FPD) was used to analyse H2S and Metil Mercaptan (MM). The extraction was carried out with a 75-μm Carboxen-polydimethylsiloxane fiber coating at 22 ºC for 20 min, and analysed by a GC 2010 Plus A from Shimadzu with a sulphur filter detector: splitless mode (0.3 min), the column temperature program was from 60 ºC, increased by 15 ºC/min to 100 ºC (2 min). The injector temperature was held at 250 ºC, and the detector at 260 ºC. For calibration curve a gas diluter equipment (digital Hovagas G2 - Multi Component Gas Mixer) was used to do the standards. This unit had two input connections, one for a stream of the dilute gas and another for a stream of nitrogen and an output connected to a glass bulb. A 40 ppm H2S and a 50 ppm MM cylinders were used. The equipment was programmed to the selected concentration, and it automatically carried out the dilution to the glass bulb. The mixture was left flowing through the glass bulb for 5 min and then the extremities were closed. This method allowed the calibration between 1-20 ppm for H2S and 0.02-0.1 ppm and 1-3.5 ppm for MM. Several quantifications of air samples from inlet and outlet of a biofilter operating in a waste management facility in the north of Portugal allowed the evaluation the biofilters performance.Keywords: biofiltration, hydrogen sulphide, mercaptans, quantification
Procedia PDF Downloads 476162 Spontaneous Pneumothorax in Mixed Poisoning Presented as Daisley Barton Syndrome
Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam
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Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.Keywords: pneumothorax, suicide, dithionate, OPC, herbicide
Procedia PDF Downloads 99161 Real World Cancer Pain Incidence and Treatment in Daily Hospital
Authors: Alexandru Grigorescu, Alexandra Protesanu
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Background: Approximately 34-67 percent of cancer patients experience an episode of uncontrolled pain during the course of their disease, depending on the stage. The aim is to provide evidence-based data for pain prevalence, diagnosis and treatment recommendations on an integrative model of medical oncology and palliative care for patients with cancer diagnostic in a day hospital. Patients and method: Consultation registers and electronic records of 166 Patients (Pts) were studied from April 2022 to March 2023. Pts with pain syndrome were selected. The pain was objectified by the visual pain scale. To elucidate the causes of the pain, investigations were carried out: bone scintigraphy, CT scan, and PET-CT. The analgesic treatments were represented by weak and strong morphine, radiotherapy, and bisphosphonates. Result: During the mentioned period, 166 oncological patients (74 women and 92 men) were treated in the oncology day hospitalization service. There were 1,500 consultations, 40 of which were only for pain. The neoplastic locations were: gynecological, malignant melanoma, breast, gastric, bronchopulmonary, colorectal, liver, pancreatic, bladder, and kidney. 70 Pts presented pain syndrome. The causes of the pain were represented by bone metastases, compressive tumors, and post-surgical status. Drug treatment: Tramadol 47 Pts, of which 10 switched to a major opioid (Oxycodonum, Morphine sulfate), 20 Pts were treated with Oxycodonum as the first intention. In 5 patients ry to rotated morphine, 20 Pts received palliative radiotherapy, 10 Pts were treated with bisphosphonates. 2 Pts required neurosurgery consultation for an antalgic intervention. 5 Pts had important adverse reactions to morphine. All patients and their families were advised by a medical oncologist and psychologist for a lifestyle change. Conclusions: The prevalence of pain was similar to that described in the literature. In most cases, the pain could be managed in the day hospital. Weak and strong morphine represented the main pain therapy. Palliative radiotherapy was the second most effective therapy. Treatment with bisphosphonates was useful. Surgical interventions were rarely indicated. Discussions with patients and their families regarding the lifestyle change were important.Keywords: cancer pain, opioids, medical oncology, palliative care
Procedia PDF Downloads 66160 Effects of Exhaust Gas Emitted by the Fleet on Public Health in the Region of Annaba (Algeria): Ecotoxicological Test on Durum Wheat (Triticum durum Desf.)
Authors: Aouissi Nora, Meksem Leila
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This work focused on the study of air pollution generated by the transport sector in the region of Annaba. Our study is based on two parts: the first one concerns an epidemiological investigation in the area of Annaba situated in the east Algerian coast, which deals with the development of the fleet and its impact on public health. To get a more precise idea of the impact of road traffic on public health, we consulted the computing center office of the National Social Insurance Fund. The information we were given by this office refers to the number of reported asthma and heart disease after medical examination during the period 2006-2010. The second part was devoted to the study of the toxicity of exhaust gases on some physical and biochemical parameters of durum wheat (Triticum durum Desf.). After germination and three-leaf stage, the pots are placed in a box of volume (0,096 m3) having an input which is linked directly to the exhaust pipe of a truck, and an outlet to prevent asphyxiation plant. The experience deals with 30 pots: 10 pots are exposed for 5 minutes to exhaust smoke; the other 10 are exposed for 15 minutes, and the remaining 10 for 30 minutes. The epidemiological study shows that the levels of pollutants emitted by the fleet are responsible for the increase of people respiratory and cardiovascular diseases. As for biochemical analyses of vegetation, they clearly show the toxicity of pollutants emitted by the exhaust gases, with an increase in total protein, proline and stimulation of detoxification enzyme (catalase).Keywords: air pollution, toxicity, epidemiology, biochemistry
Procedia PDF Downloads 334159 Fluid Prescribing Post Laparotomies
Authors: Gusa Hall, Barrie Keeler, Achal Khanna
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Introduction: NICE guidelines have highlighted the consequences of IV fluid mismanagement. The main aim of this study was to audit fluid prescribing post laparotomies to identify if fluids were prescribed in accordance to NICE guidelines. Methodology: Retrospective database search of eight specific laparotomy procedures (colectomy right and left, Hartmann’s procedure, small bowel resection, perforated ulcer, abdominal perineal resection, anterior resection, pan proctocolectomy, subtotal colectomy) highlighted 29 laparotomies between April 2019 and May 2019. Two of 29 patients had secondary procedures during the same admission, n=27 (patients). Database case notes were reviewed for date of procedure, length of admission, fluid prescribed and amount, nasal gastric tube output, daily bloods results for electrolytes sodium and potassium and operational losses. Results: n=27 based on 27 identified patients between April 2019 – May 2019, 93% (25/27) received IV fluids, only 19% (5/27) received the correct IV fluids in accordance to NICE guidelines, 93% (25/27) who received IV fluids had the correct electrolytes levels (sodium & potassium), 100% (27/27) patients received blood tests (U&E’s) for correct electrolytes levels. 0% (0/27) no documentation on operational losses. IV fluids matched nasogastric tube output in 100% (3/3) of the number of patients that had a nasogastric tube in situ. Conclusion: A PubMed database literature review on barriers to safer IV prescribing highlighted educational interventions focused on prescriber knowledge rather than how to execute the prescribing task. This audit suggests IV fluids post laparotomies are not being prescribed consistently in accordance to NICE guidelines. Surgical management plans should be clearer on IV fluids and electrolytes requirements for the following 24 hours after the plan has been initiated. In addition, further teaching and training around IV prescribing is needed together with frequent surgical audits on IV fluid prescribing post-surgery to evaluate improvements.Keywords: audit, IV Fluid prescribing, laparotomy, NICE guidelines
Procedia PDF Downloads 120158 A Rare Case of Synchronous Colon Adenocarcinoma
Authors: Mohamed Shafi Bin Mahboob Ali
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Introduction: Synchronous tumor is defined as the presence of more than one primary malignant lesion in the same patient at the indexed diagnosis. It is a rare occurrence, especially in the spectrum of colorectal cancer, which accounts for less than 4%. The underlying pathology of a synchronous tumor is thought to be due to a genomic factor, which is microsatellite instability (MIS) with the involvement of BRAF, KRAS, and the GSRM1 gene. There are no specific sites of occurrence for the synchronous colorectal tumor, but many studies have shown that a synchronous tumor has about 43% predominance in the ascending colon with rarity in the sigmoid colon. Case Report: We reported a case of a young lady in the middle of her 30's with no family history of colorectal cancer that was diagnosed with a synchronous adenocarcinoma at the descending colon and rectosigmoid region. The lady's presentation was quite perplexing as she presented to the district hospital initially with simple, uncomplicated hemorrhoids and constipation. She was then referred to our center for further management as she developed a 'football' sized right gluteal swelling with a complete intestinal obstruction and bilateral lower-limb paralysis. We performed a CT scan and biopsy of the lesion, which found that the tumor engulfed the sacrococcygeal region with more than one primary lesion in the colon as well as secondaries in the liver. The patient was operated on after a multidisciplinary meeting was held. Pelvic exenteration with tumor debulking and anterior resection were performed. Postoperatively, she was referred to the oncology team for chemotherapy. She had a tremendous recovery in eight months' time with a partial regain of her lower limb power. The patient is still under our follow-up with an improved quality of life post-intervention. Discussion: Synchronous colon cancer is rare, with an incidence of 2.4% to 12.4%. It has male predominance and is pathologically more advanced compared to a single colon lesion. Down staging the disease by means of chemoradiotherapy has shown to be effective in managing this tumor. It is seen commonly on the right colon, but in our case, we found it on the left colon and the rectosigmoid. Conclusion: Managing a synchronous colon tumor could be challenging to surgeons, especially in deciding the extent of resection and postoperative functional outcomes of the bowel; thus, individual treatment strategies are needed to tackle this pathology.Keywords: synchronous, colon, tumor, adenocarcinoma
Procedia PDF Downloads 108157 Exploring the Prebiotic Potential of Glucosamine
Authors: Shilpi Malik, Ramneek Kaur, Archita Gupta, Deepshikha Yadav, Ashwani Mathur, Manisha Singh
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Glucosamine (GS) is the most abundant naturally occurring amino monosaccharide and is normally produced in human body via cellular glucose metabolism. It is regarded as the building block of cartilage matrix and is also an essential component of cartilage matrix repair mechanism. Besides that, it can also be explored for its prebiotic potential as many bacterial species are known to utilize the amino sugar by acquiring them to form peptidoglycans and lipopolysaccharides in the bacterial cell wall. Glucosamine can therefore be considered for its fermentation by bacterial species present in the gut. Current study is focused on exploring the potential of glucosamine as prebiotic. The studies were done to optimize considerable concentration of GS to reach GI tract and being fermented by the complex gut microbiota and food grade GS was added to various Simulated Fluids of Gastro-Intestinal Tract (GIT) such as Simulated Saliva, Gastric Fluid (Fast and Fed State), Colonic fluid, etc. to detect its degradation. Since it was showing increase in microbial growth (CFU) with time, GS was Further, encapsulated to increase its residential time in the gut, which exhibited improved resistance to the simulated Gut conditions. Moreover, prepared microspehres were optimized and characterized for their encapsulation efficiency and toxicity. To further substantiate the prebiotic activity of Glucosamine, studies were also performed to determine the effect of Glucosamine on the known probiotic bacterial species, i.e. Lactobacillus delbrueckii (MTCC 911) and Bifidobacteriumbifidum (MTCC 5398). Culture conditions for glucosamine will be added in MRS media in anaerobic tube at 0.20%, 0.40%, 0.60%, 0.80%, and 1.0%, respectively. MRS media without GS was included in this experiment as the control. All samples were autoclaved at 118° C for 15 min. Active culture was added at 5% (v/v) to each anaerobic tube after cooling to room temperature and incubated at 37° C then determined biomass and pH and viable count at incubation 18h. The experiment was completed in triplicate and the results were presented as Mean ± SE (Standard error).The experimental results are conclusive and suggest Glucosamine to hold prebiotic properties.Keywords: gastro intestinal tract, microspheres, peptidoglycans, simulated fluid
Procedia PDF Downloads 333156 The Mainspring of Controlling of Low Pressure Steam Drum at Lower Pressure than Its Design for Adjusting the Urea Synthesis Pressure
Authors: Reza Behtash, Enayat Enayati
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The pool condenser is in principal a horizontal reactor, containing a bundle of U-tubes for heat exchange, coupling to low pressure steam drum. Condensation of gas takes place in a condensed pool around the tubes of the condenser. The heat of condensation is removed by the generation of low pressure steam on the inner tube side of the bundle. A circulation pump transfers ample boiler feed water to these tubes. The pressure of the steam generated influenced the heat flux. Changing the steam pressure means changing the steam condensate temperature and therefore the temperature difference between the tube side and the shell side. 2NH3 + CO2 ↔ NH2COONH4 + Heat. This reaction is exothermic and according to Le Chatelier's Principle if the heat is not removed enough, it will come back to left side and generate of the gas and so the Urea synthesis pressure will rise. The most principal reasons for high Urea synthesis pressure are non proportional of Ammonia/Dioxide Carbon ratio and too high a pressure in low pressure steam drum. Proportional of Ammonia/Dioxide Carbon ratio is 3.0 and normal pressure for low pressure steam drum is 4.5 bar. As regards these conditions were proportional but we could not control the synthesis pressure the plant endangered, therefore we had to control the steam drum pressure at about 3.5 bar. While we opened the pool condenser, we found the partition plate used to divide inlet and outlet boiler feed water to tubes, was broken partially and so amount of boiler feed water bypass the tubes and the heat was not removed totally and it resulted in the generation of gases and high pressure in synthesis.Keywords: boiler, pressure, pool condenser, partition plate
Procedia PDF Downloads 383155 Study of the Effect of the Contra-Rotating Component on the Performance of the Centrifugal Compressor
Authors: Van Thang Nguyen, Amelie Danlos, Richard Paridaens, Farid Bakir
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This article presents a study of the effect of a contra-rotating component on the efficiency of centrifugal compressors. A contra-rotating centrifugal compressor (CRCC) is constructed using two independent rotors, rotating in the opposite direction and replacing the single rotor of a conventional centrifugal compressor (REF). To respect the geometrical parameters of the REF one, two rotors of the CRCC are designed, based on a single rotor geometry, using the hub and shroud length ratio parameter of the meridional contour. Firstly, the first rotor is designed by choosing a value of length ratio. Then, the second rotor is calculated to be adapted to the fluid flow of the first rotor according aerodynamics principles. In this study, four values of length ratios 0.3, 0.4, 0.5, and 0.6 are used to create four configurations CF1, CF2, CF3, and CF4 respectively. For comparison purpose, the circumferential velocity at the outlet of the REF and the CRCC are preserved, which means that the single rotor of the REF and the second rotor of the CRCC rotate with the same speed of 16000rpm. The speed of the first rotor in this case is chosen to be equal to the speed of the second rotor. The CFD simulation is conducted to compare the performance of the CRCC and the REF with the same boundary conditions. The results show that the configuration with a higher length ratio gives higher pressure rise. However, its efficiency is lower. An investigation over the entire operating range shows that the CF1 is the best configuration in this case. In addition, the CRCC can improve the pressure rise as well as the efficiency by changing the speed of each rotor independently. The results of changing the first rotor speed show with a 130% speed increase, the pressure ratio rises of 8.7% while the efficiency remains stable at the flow rate of the design operating point.Keywords: centrifugal compressor, contra-rotating, interaction rotor, vacuum
Procedia PDF Downloads 134154 New Coating Materials Based on Mixtures of Shellac and Pectin for Pharmaceutical Products
Authors: M. Kumpugdee-Vollrath, M. Tabatabaeifar, M. Helmis
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Shellac is a natural polyester resin secreted by insects. Pectins are natural, non-toxic and water-soluble polysaccharides extracted from the peels of citrus fruits or the leftovers of apples. Both polymers are allowed for the use in the pharmaceutical industry and as a food additive. SSB Aquagold® is the aqueous solution of shellac and can be used for a coating process as an enteric or controlled drug release polymer. In this study, tablets containing 10 mg methylene blue as a model drug were prepared with a rotary press. Those tablets were coated with mixtures of shellac and one of the pectin different types (i.e. CU 201, CU 501, CU 701 and CU 020) mostly in a 2:1 ratio or with pure shellac in a small scale fluidized bed apparatus. A stable, simple and reproducible three-stage coating process was successfully developed. The drug contents of the coated tablets were determined using UV-VIS spectrophotometer. The characterization of the surface and the film thickness were performed with the scanning electron microscopy (SEM) and the light microscopy. Release studies were performed in a dissolution apparatus with a basket. Most of the formulations were enteric coated. The dissolution profiles showed a delayed or sustained release with a lagtime of at least 4 h. Dissolution profiles of coated tablets with pure shellac had a very long lagtime ranging from 13 to 17.5 h and the slopes were quite high. The duration of the lagtime and the slope of the dissolution profiles could be adjusted by adding the proper type of pectin to the shellac formulation and by variation of the coating amount. In order to apply a coating formulation as a colon delivery system, the prepared film should be resistant against gastric fluid for at least 2 h and against intestinal fluid for 4-6 h. The required delay time was gained with most of the shellac-pectin polymer mixtures. The release profiles were fitted with the modified model of the Korsmeyer-Peppas equation and the Hixson-Crowell model. A correlation coefficient (R²) > 0.99 was obtained by Korsmeyer-Peppas equation.Keywords: shellac, pectin, coating, fluidized bed, release, colon delivery system, kinetic, SEM, methylene blue
Procedia PDF Downloads 407153 Computed Tomography Myocardial Perfusion on a Patient with Hypertrophic Cardiomyopathy
Authors: Jitendra Pratap, Daphne Prybyszcuk, Luke Elliott, Arnold Ng
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Introduction: Coronary CT angiography is a non-invasive imaging technique for the assessment of coronary artery disease and has high sensitivity and negative predictive value. However, the correlation between the degree of CT coronary stenosis and the significance of hemodynamic obstruction is poor. The assessment of myocardial perfusion has mostly been undertaken by Nuclear Medicine (SPECT), but it is now possible to perform stress myocardial CT perfusion (CTP) scans quickly and effectively using CT scanners with high temporal resolution. Myocardial CTP is in many ways similar to neuro perfusion imaging technique, where radiopaque iodinated contrast is injected intravenously, transits the pulmonary and cardiac structures, and then perfuses through the coronary arteries into the myocardium. On the Siemens Force CT scanner, a myocardial perfusion scan is performed using a dynamic axial acquisition, where the scanner shuffles in and out every 1-3 seconds (heart rate dependent) to be able to cover the heart in the z plane. This is usually performed over 38 seconds. Report: A CT myocardial perfusion scan can be utilised to complement the findings of a CT Coronary Angiogram. Implementing a CT Myocardial Perfusion study as part of a routine CT Coronary Angiogram procedure provides a ‘One Stop Shop’ for diagnosis of coronary artery disease. This case study demonstrates that although the CT Coronary Angiogram was within normal limits, the perfusion scan provided additional, clinically significant information in regards to the haemodynamics within the myocardium of a patient with Hypertrophic Obstructive Cardio Myopathy (HOCM). This negated the need for further diagnostics studies such as cardiac ECHO or Nuclear Medicine Stress tests. Conclusion: CT coronary angiography with adenosine stress myocardial CTP was utilised in this case to specifically exclude coronary artery disease in conjunction with accessing perfusion within the hypertrophic myocardium. Adenosine stress myocardial CTP demonstrated the reduced myocardial blood flow within the hypertrophic myocardium, but the coronary arteries did not show any obstructive disease. A CT coronary angiogram scan protocol that incorporates myocardial perfusion can provide diagnostic information on the haemodynamic significance of any coronary artery stenosis and has the potential to be a “One Stop Shop” for cardiac imaging.Keywords: CT, cardiac, myocardium, perfusion
Procedia PDF Downloads 132152 Polymeric Micelles Based on Block Copolymer α-Tocopherol Succinate-g-Carboxymethyl Chitosan for Tamoxifen Delivery
Authors: Sunil K. Jena, Sanjaya K. Samal, Mahesh Chand, Abhay T. Sangamwar
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Tamoxifen (TMX) and its analogues are approved as a first line therapy for the treatment of estrogen receptor-positive tumors. However, clinical development of TMX has been hampered by its low bioavailability and severe hepatotoxicity. Herein, we attempt to design a new drug delivery vehicle that could enhance the pharmacokinetic performance of TMX. Initially, high-molecular weight carboxymethyl chitosan was hydrolyzed to low-molecular weight carboxymethyl chitosan (LMW CMC) with hydrogen peroxide under the catalysis of phosphotungstic acid. Amphiphilic block copolymers of LMW CMC were synthesized via amidation reaction between the carboxyl group of α-tocopherol succinate (TS) and an amine group of LMW CMC. These amphiphilic block copolymers were self-assembled to nanosize core-shell-structural micelles in the aqueous medium. The critical micelle concentration (CMC) decreased with the increasing substitution of TS on LMW CMC, which ranged from 1.58 × 10-6 to 7.94 × 10-8 g/mL. Maximum TMX loading up to 8.08 ± 0.98% was achieved with Cmc-TS4.5 (TMX/Cmc-TS4.5 with 1:8 weight ratio). Both blank and TMX-loaded polymeric micelles (TMX-PM) of Cmc-TS4.5 exhibits spherical shape with the particle size below 200 nm. TMX-PM has been found to be stable in the gastrointestinal conditions and released only 44.5% of the total drug content by the first 72 h in simulated gastric fluid (SGF), pH 1.2. However, the presence of pepsin does not significantly increased the TMX release in SGF, pH 1.2, released only about 46.2% by the first 72 h suggesting its inability to cleave the peptide bond. In contrast, the release of TMX from TMX-PM4.5 in SIF, pH 6.8 (without pancreatin) was slow and sustained, released only about 10.43% of the total drug content within the first 30 min and nearly about 12.41% by the first 72 h. The presence of pancreatin in SIF, pH 6.8 led to an improvement in drug release. About 28.09% of incorporated TMX was released in the presence of pancreatin in 72 h. A cytotoxicity study demonstrated that TMX-PM exhibited time-delayed cytotoxicity in human MCF-7 breast cancer cells. Pharmacokinetic studies on Sprague-Dawley rats revealed a remarkable increase in oral bioavailability (1.87-fold) with significant (p < 0.0001) enhancement in AUC0-72 h, t1/2 and MRT of TMX-PM4.5 than that of TMX-suspension. Thus, the results suggested that CMC-TS micelles are a promising carrier for TMX delivery.Keywords: carboxymethyl chitosan, d-α-tocopherol succinate, pharmacokinetic, polymeric micelles, tamoxifen
Procedia PDF Downloads 329151 Microfluidic Impedimetric Biochip and Related Methods for Measurement Chip Manufacture and Counting Cells
Authors: Amina Farooq, Nauman Zafar Butt
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This paper is about methods and tools for counting particles of interest, such as cells. A microfluidic system with interconnected electronics on a flexible substrate, inlet-outlet ports and interface schemes, sensitive and selective detection of cells specificity, and processing of cell counting at polymer interfaces in a microscale biosensor for use in the detection of target biological and non-biological cells. The development of fluidic channels, planar fluidic contact ports, integrated metal electrodes on a flexible substrate for impedance measurements, and a surface modification plasma treatment as an intermediate bonding layer are all part of the fabrication process. Magnetron DC sputtering is used to deposit a double metal layer (Ti/Pt) over the polypropylene film. Using a photoresist layer, specified and etched zones are established. Small fluid volumes, a reduced detection region, and electrical impedance measurements over a range of frequencies for cell counts improve detection sensitivity and specificity. The procedure involves continuous flow of fluid samples that contain particles of interest through the microfluidic channels, counting all types of particles in a portion of the sample using the electrical differential counter to generate a bipolar pulse for each passing cell—calculating the total number of particles of interest originally in the fluid sample by using MATLAB program and signal processing. It's indeed potential to develop a robust and economical kit for cell counting in whole-blood samples using these methods and similar devices.Keywords: impedance, biochip, cell counting, microfluidics
Procedia PDF Downloads 162150 Performance Evaluation of Conical Solar Concentrator System with Different Flow Rate
Authors: Gwi Hyun Lee, Mun Soo Na
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Solar energy has many advantages of infinite and clean source, and also it can be used for reduction of greenhouse gases and environment pollution. Concentrated solar system is a very useful to achieve reasonably high thermal efficiency. Different types of solar concentrating systems have been developed such as parabolic trough and parabolic dish. Conical solar concentrator is one of the most reliable and promising renewable energy systems for higher temperature applications. The objectives of this study were to investigate the influence of flow rate affecting the thermal efficiency of a conical solar collector, which has a double tube absorber placed at focal axis for collecting solar radiation. A conical solar concentrator consists of a conical reflector, which reflects direct solar radiation into an absorber. A double tube absorber was placed at the center of focal axis for collecting the solar radiation reflected from a conical reflector. A dual tracking system consists of a linear actuator and slew drive with driving cycle of 6 seconds. Water was used as circulating fluid, which flows from inlet to outlet of an absorber for collecting solar radiation. Three identical conical solar concentrator systems were installed side by side at the same place for the accurate performance analysis under the same environmental conditions. Performance evaluations were carried out with different volumetric flow rate of 2, 4 and 6 L/min to find the influence of flow rate affecting on thermal efficiency. The results indicated that average thermal efficiency was 73.24%, 81.96%, and 79.78% for each flow rate of 2 L/min, 4 L/min, and 6 L/min. It shows that the flow rate of circulating water has a significant effect on the thermal efficiency of the conical solar concentrator. It is concluded that an optimum flow rate of conical solar concentrator is 6 L/min.Keywords: conical solar concentrator, performance evaluation, solar energy, solar energy system
Procedia PDF Downloads 279149 Phytochemical Content and Bioactive Properties of Wheat Sprouts
Authors: Jasna Čanadanović-Brunet, Lidija Jevrić, Gordana Ćetković, Vesna Tumbas Šaponjac, Jelena Vulić, Slađana Stajčić
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Wheat contains high amount of nutrients such as dietary fiber, resistant starch, vitamins, minerals and microconstituents, which are building blocks of body tissues, but also help in the prevention of diseases such as cardiovascular disease, cancer and diabetes. Sprouting enhances the nutritional value of whole wheat through biosynthesis of tocopherols, polyphenols and other valuable phytochemicals. Since the nutritional and sensory benefits of germination have been extensively documented, using of sprouted grains in food formulations is becoming a trend in healthy foods. The present work addressed the possibility of using freeze-dried sprouted wheat powder, obtained from spelt-wheat cv. ‘Nirvana’ (Triticum spelta L.) and winter wheat cv. ‘Simonida’ (Triticum aestivum L. ssp. vulgare var. lutescens), as a source of phytochemicals, to improve the functional status of the consumer. The phytochemicals' content (total polyphenols, flavonoids, chlorophylls and carotenoids) and biological activities (antioxidant activity on DPPH radicals and antiinflammatory activity) of sprouted wheat powders were assessed spectrophotometrically. The content of flavonoids (216.52 mg RE/100 g), carotenoids (22.84 mg β-carotene/100 g) and chlorophylls (131.23 mg/100 g), as well as antiinflammatory activity (EC50=3.70 mg/ml) was found to be higher in sprouted spelt-wheat powder, while total polyphenols (607.21 mg GAE/100 g) and antioxidant activity on DDPPH radicals (EC50=0.27 mmol TE/100 g) was found to be higher in sprouted winter wheat powders. Simulation of gastro-intestinal digestion of sprouted wheat powders clearly shows that intestinal digestion caused a higher release of polyphenols than gastric digestion for both samples, which indicates their higher bioavailability in the colon. The results of the current study have shown that wheat sprouts can provide a high content of phytochemicals and considerable bioactivities. Moreover, data reported show that they contain a unique pattern of bioactive molecules, which make these cereal sprouts attractive functional foods for a health-promoting diet.Keywords: wheat, sprouts, phytochemicals, bioactivity
Procedia PDF Downloads 466148 Clinical Empathy: The Opportunity to Offer Optimal Treatment to People with Serious Illness
Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno
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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.Keywords: clinical empathy, determinants, healthcare, psychological wellbeing
Procedia PDF Downloads 122147 Environmental Degradation and Globalization with Special Reference to Developing Economics
Authors: Indira Sinha
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According to the Oxford Advanced Learner's English Dictionary of Current English, environment is the complex of physical, chemical and biotic factors that act upon an organism or an ecological community and ultimately determines its form and survival. It is defined as conditions and circumstances which are affecting people's lives. The meaning of environmental degradation is the degradation of the environment through depletion of resources such as air, water and soil and the destruction of ecosystems and extinction of wildlife. Globalization is a significant feature of recent world history. The aim of this phenomenon is to integrate societies, economies and cultures through a common link of trading policies, technology and communication. Undoubtedly it has opened up the world economy at a very high speed but at the same time it has an adverse impact on the environment. The purpose of the present study is to investigate the impact of globalization on the environmental conditions. An overview of what the forces of globalization have in store for the environment with constructing large number of industries and destroying large forests lands will be given in this paper. The forces of globalization have created many serious environmental problems like high temperature, extinction of many species of plant and animal and outlet of poisonous chemicals from industries. The revelation of this study is that in case of developing economics these problems are more critical. In developing countries like India many factories are built with less environmental regulations, while developed economies maintain positive environmental practices. The present study is a micro level study which aims to employ a combination of theoretical, descriptive, empirical and analytical approach in addition to the time tested case method.Keywords: globalization, trade policies, environmental degradation, developing economies, large industries
Procedia PDF Downloads 239146 The Effect of Surgical Intervention on Pediatric and Adolescent Obstructive Sleep Apnea Syndrome
Authors: Ching-Yi Yiu, Hui-Chen Hsu
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Objectives: Obstructive sleep apnea syndrome (OSAS) is a popular problem in the modern society. It usually leads to sleep disorder, excessive daytime sleepiness and associated with cardiovascular diseases, cognitive dysfunction and even death. The nonsurgical therapies include continuous positive airway pressure (CPAP), diet and oral appliances. The surgical approaches have nasal surgery, tonsillectomy, adenoidectomy, uvulopalatopharyngoplasty (UPPP) and transoral robotic surgery (TORS).We compare the impact of surgical treatments on these kinds of patients. Methods: Between January 2018 to September 2022, We have enrolled 125 OSAS patients including 82 male and 43 female in Chi Mei Medical Center, Liouying, Taiwan. The age distribution from 6 to 71 years old (y/o) with mean age 36.1 y/o. The averaged body mass index (BMI) is 25 kg/m2 in male and 25.5 kg/m2 in female. In this cohort, we evaluated their upper airway obstruction sites with nasopharyngoscopy and scheduled a planned surgery. Some of cases received polysomnography (PSG) preoperatively, the averaged apnea-hypopnea index (AHI) is 37.7 events/hour. We have 68 patients received tonsillectomy, 9 received UPPP, 42 received UPPP and septomeatoplasty (SMP) and 6 received adenoidectomy and tonsillectomy (A and T). The subjective daytime sleepiness was evaluated with the Epworth sleepiness scale (ESS). Results: In the 68 tonsillectomy group, the averaged BMI is 24.9 kg/m2. In the UPPP group, the averaged BMI is 28.9 kg/m2. In UPPP and SMP group, the averaged BMI is 27.9 kg/m2. In the A and T group, the averaged BMI is 17.2 kg/m2. The reduction of AHI less than 20 is 58% postoperatively. The ESS reduced from 10.9 to 4.9 after surgery. Conclusion: Obstructive sleep apnea syndrome is a common upper airway disturbance in the general population. The prevalence rate is ranging high depending on different regions, age, sex and race. It leads to severe morbidity and mortality including car accident, stroke, nocturnal desaand sudden death and should be considered to be a major public health problem. The CPAP is effective to improve daytime sleepiness but the long-term compliance is low. The surgical treatment with different modalities can produce 50% decrease in AHI and ESS after surgery in the 6 to 12 months short-term period.Keywords: apnea-hypopnea index, obstructive sleep apnea syndrome, polysomnography, uvulopalatopharyngoplasty
Procedia PDF Downloads 95145 Assessment of Estrogenic Contamination and Potential Risk in Taihu Lake, China
Authors: Guanghua Lu, Zhenhua Yan
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To investigate the estrogenic contamination and potential risk of Taihu Lake, eight active biomonitoring points in the northern section of Taihu Lake were set up and located in Wangyuhe River outlet (P1), Gonghu Bay (P2 and P3), Meiliang Bay (P4 and P5), Zhushan Bay (P6 and P7) and Lake Centre (P8). A suite of biomarkers in caged fish after in situ exposure for 28 days, coupled with six selected exogenous estrogens in water, were determined in May and December 2011. Six target estrogens, namely estrone (E1), 17b-estradiol (E2), ethinylestradiol (EE2), estriol (E3), diethylstilbestrol (DES) and bisphenol A (BPA), were quantified using UPLC/MS/MS. The concentrations of E1, E2, E3, EE2, DES and BPA ranged from ND to 3.61 ng/L, ND to 17.3 ng/L, ND to 1.65 ng/L, ND to 10.2 ng/L, ND to 34.6 ng/L, and 3.95 to 207 ng/L, respectively. BPA was detected at all sampling points at all test periods, E2 was detected at 95% of samples, E1 and EE2 was detected at 75% of samples, and E3 was detected only in December 2011 with quite low concentrations. Each individual estrogen concentration measured at each sampling point was multiplied by its relative potency to gain the estradiol equivalent (EEQ). The total EEQ values in all the monitoring points ranged from 5.69 to 17.8 ng/L in May 2011, and from 4.46 to 21.1 ng/L in December 2011. E2 and EE2 were thought to be the major causal agents responsible for the estrogenic activities. Serum vitellogenin and E2 levels, gonadal DNA damage, and gonadosomatic index were measured in the in situ exposed fish. An enhanced integrated biomarker response (EIBR) was calculated and used to evaluate potential feminization risk of fish in the polluted area of Taihu Lake. EIBR index showed good agreement with the observed total EEQ levels in water. Our results indicated that Gong bay and the lake center had a low estrogenic risk, whereas Wangyuhe River, Meiliang Bay, and Zhushan Bay might present a higher risk to fish.Keywords: active biomonitoring, estrogen, feminization risk, Taihu Lake
Procedia PDF Downloads 277144 Importance of CT and Timed Barium Esophagogram in the Contemporary Treatment of Patients with Achalasia
Authors: Sanja Jovanovic, Aleksandar Simic, Ognjan Skrobic, Dragan Masulovic, Aleksandra Djuric-Stefanovic
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Introduction: Achalasia is an idiopathic primary esophageal motility disorder characterized by esophageal peristalsis and impaired swallow-induced relaxation of the lower esophageal sphincter (LES). It is a rare disease that affects both genders with an incidence of 1/100.000 and a prevalence rate of 10/100,000 per year. Objective: Laparoscopic Heller myotomy (LHM) represents a therapy of choice for patients with achalasia, providing excellent outcomes. The aim of this study was to evaluate the significance of computed tomography (CT) in analyzing achalasia subtypes and timed barium esophagogram (TBE) in evaluation of LHM success, as a part of standardized diagnostic protocol. Method: Fifty-one patients with achalasia, confirmed by manometric studies, in addition to standardized diagnostic methods, underwent CT and TBE. CT was done with multiplanar reconstruction, measuring the wall thickness above the esophago-gastric junction in the axial plane. TBE was performed preoperatively and two days postoperatively swallowing low-density barium sulfate, and plane upright frontal films were performed 1, 2 and 5 minutes after the ingestion. In all patients, LHM was done, and pre and postoperative height and weight of the barium column were compared. Results: According to CT findings we divided patients into 3 subtypes of achalasia according to wall thickness: < 4mm as subtype one, between 4 - 9mm as II, and > 10 mm as subtype 3. Correlation of manometric results, as a reference values, and CT findings indicated CT sensitivity of 90% and specificity of 70 % in establishing subtypes of achalasia. The preoperative values of TBE at 1, 2 and 5 minutes were: median barium column height 17.4 ± 7.4, 15.9 ± 6.2 and 13.9 ± 6.2 cm; median column width 5 ± 1.5, 4.7 ± 1.6 and 4.5 ± 1.8 cm respectively. LHM significantly reduced these values (height 7 ± 4.6, 5.8 ± 4.2, 3.7 ± 3.4 cm; width 2.9 ± 1.3, 2.6 ± 1.3 and 2.4 ± 1.4 cm), indicating the quantitative estimates of emptying as excellent (p value < 0.01). Conclusion: CT has high sensitivity and specificity in evaluation of achalasia subtypes, and can be introduced as an additional method for standardized evaluation of these patients. The quantitative assessment of TBE based on measurements of the barium column is an accurate and beneficial method, which adequately estimates esophageal emptying success of LHM.Keywords: achalasia, computed tomography, esophagography, myotomy
Procedia PDF Downloads 235143 Insights into The Oversight Functions of The Legislative Power Under The Nigerian Constitution
Authors: Olanrewaju O. Adeojo
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The constitutional system of government provides for the federating units of the Federal Republic of Nigeria, the States and the Local Councils under a governing structure of the Executive, the Legislature and the Judiciary with attendant distinct powers and spheres of influence. The legislative powers of the Federal Republic of Nigeria and of a State are vested in the National Assembly and House of Assembly of the State respectively. The Local council exercises legislative powers in clearly defined matters as provided by the Constitution. Though, the executive as constituted by the President and the Governor are charged with the powers of execution and administration, the legislature is empowered to ensure that such powers are duly exercised in accordance with the provisions of the Constitution. The vast areas do not make oversight functions indefinite and more importantly the purpose for the exercise of the powers are circumscribed. It include, among others, any matter with respect to which it has power to make laws. Indeed, the law provides for the competence of the legislature to procure evidence, examine all persons as witnesses, to summon any person to give evidence and to issue a warrant to compel attendance in matters relevant to the subject matter of its investigation. The exercise of functions envisaged by the Constitution seem to an extent to be literal because it lacks power of enforcing the outcome. Furthermore, the docility of the legislature is apparent in a situation where the agency or authority being called in to question is part of the branch of government to enforce sanctions. The process allows for cover up and obstruction of justice. The oversight functions are not functional in a situation where the executive is overbearing. The friction, that ensues, between the Legislature and the Executive in an attempt by the former to project the spirit of a constitutional mandate calls for concern. It is needless to state a power that can easily be frustrated. To an extent, the arm of government with coercive authority seems to have over shadowy effect over the laid down functions of the legislature. Recourse to adjudication by the Judiciary had not proved to be of any serious utility especially in a clime where the wheels of justice grinds slowly, as in Nigeria, due to the nature of the legal system. Consequently, the law and the Constitution, drawing lessons from other jurisdiction, need to insulate the legislative oversight from the vagaries of the executive. A strong and virile Constitutional Court that determines, within specific time line, issues pertaining to the oversight functions of the legislative power, is apposite.Keywords: constitution, legislative, oversight, power
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