Search results for: pain scale
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6856

Search results for: pain scale

6466 Eco Scale: A Tool for Assessing the Greenness of Pharmaceuticals Analysis

Authors: Heba M. Mohamed

Abstract:

Owing to scientific and public concern about health and environment and seeking for a better quality of life; “Green”, “Environmentally” and “Eco” friendly practices have been presented and implemented in different research areas. Subsequently, researchers’ attention is drawn in the direction of greening the analytical methodologies and taking the Green Analytical Chemistry principles (GAC) into consideration. It is of high importance to appraise the environmental impact of each of the implemented green approaches. Compared to the other traditional green metrics (E-factor, Atom economy and the process profile), the eco scale is the optimum choice to assess the environmental impact of the analytical procedures used for pharmaceuticals analysis. For analytical methodologies, Eco-Scale is calculated by allotting penalty points to any factor of the used analytical procedure which disagree and not match with the model green analysis, where the perfect green analysis has its Eco-Scale value of 100. In this work, calculation and comparison of the Eco-Scale for some of the reported green analytical methods was done, to accentuate their greening potentials. Where the different scores can reveal how green the method is, compared to the ideal value. The study emphasizes that greenness measurement is not only about the waste quantity determination but also dictates a holistic scheme, considering all factors.

Keywords: eco scale, green analysis, environmentally friendly, pharmaceuticals analysis

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6465 Expression of Somatostatin and Neuropeptide Y in Dorsal Root Ganglia Following Hind Paw Incision in Rats

Authors: Anshu Bahl, Saroj Kaler, Shivani Gupta, S B Ray

Abstract:

Background: Somatostatin is an endogenous regulatory neuropeptide. Somatostatin and its analogues play an important role in neuropathic and inflammatory pain. Neuropeptide Y is extensively distributed in the mammalian nervous system. NPY has an important role in blood pressure, circadian rhythm, obesity, appetite and memory. The purpose was to investigate somatostatin and NPY expression in dorsal root ganglia during pain. The plantar incision model in rats is similar to postoperative pain in humans. Methods: 24 adult male Sprague dawley rats were distributed randomly into two groups – Control (n=6) and incision (n=18) groups. Using Hargreaves apparatus, thermal hyperalgesia behavioural test for nociception was done under basal condition and after surgical incision in right hind paw at different time periods (day 1, 3 and 5). The plantar incision was performed as per standard protocol. Perfusion was done using 4% paraformaldehyde followed by extraction of dorsal root ganglia at L4 level. The tissue was processed for immunohistochemical localisation for somatostatin and neuropeptide Y. Results: Post incisional groups (day 1, 3 and 5) exhibited significant decrease of paw withdrawal latency as compared to control groups. Somatostatin expression was noted under basal conditions. It decreased on day 1, but again gradually increased on day 3 and further on day five post incision. The expression of Neuropeptide Y was noted in the cytoplasm of dorsal root ganglia under basal conditions. Compared to control group, expression of neuropeptide Y decreased on day one after incision, but again gradually increased on day 3. Maximum expression was noted on day five post incision. Conclusion: Decrease in paw withdrawal latency indicated nociception, particularly on day 1. In comparison to control, somatostatin and NPY expression was decreased on day one post incision. This could be correlated with increased axoplasmic flow towards the spinal cord. Somatostatin and NPY expression was maximum on day five post incision. This could be due to decreased migration from the site of synthesis towards the spinal cord.

Keywords: dorsal root ganglia, neuropeptide y, postoperative pain, somatostatin

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6464 Adolescent Sleep Hygiene Scale and Adolescent Sleep Wake Scale: Factorial Analysis and Validation for Indian Population

Authors: Sataroopa Mishra, Mona Basker, Sneha Varkki, Ram Kumar Pandian, Grace Rebekah

Abstract:

Background: Sleep deprivation is a matter of public health importance among adolescents. We used adolescent sleep wake scale and adolescent sleep hygiene scale to determine the sleep quality and sleep hygiene respectively of school going adolescents in Vellore city of India. The objective of the study was to do factorial analysis of the scales and validate it for use in local population. Methods: Observational questionnaire based cross sectional study. Setting: Community based school survey in a semi-urban setting in three schools in Vellore city. Data collection: Non probability sample was collected form students studying in standard 9 and 11. Students filled Adolescent Sleep Wake scale (ASWS) and Adolescent Sleep Hygiene Scale (ASHS) translated into vernacular language. Data Analysis: Exploratory Factorial Analysis was used to see the factor loading of various components of the two scales. Confirmatory factorial analysis is subsequently planned for assessing the internal validity of the scales.Results: 557 adolescents were included in the study of 12 – 17 years old. Exploratory factorial analysis of adolescent sleep hygiene scale indicated significant factor loading for 18 items from 28 items originally devised by the authors and has been reconstructed to four domains instead of 9 domains in the original scale namely sleep stability, cognitive – emotional, Physiological - bed time routine - behavioural arousal factor (activites before bedtime and during bed time), Sleep environment (lighting and bed sharing). Factorial analysis of Adolescent sleep wake scale showed factor loading of 18 items out of 28 items in original scale reconstructed into 5 aspects of sleep quality. Conclusions: The factorial analysis gives a reconstructed scale useful for the local population. Further a confirmatory factorial analysis has been subsequently planned to determine the internal consistency of the scale for local population.

Keywords: factorial analysis, sleep hygiene, sleep quality, adolescent sleep scale

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6463 A Clustering Algorithm for Massive Texts

Authors: Ming Liu, Chong Wu, Bingquan Liu, Lei Chen

Abstract:

Internet users have to face the massive amount of textual data every day. Organizing texts into categories can help users dig the useful information from large-scale text collection. Clustering, in fact, is one of the most promising tools for categorizing texts due to its unsupervised characteristic. Unfortunately, most of traditional clustering algorithms lose their high qualities on large-scale text collection. This situation mainly attributes to the high- dimensional vectors generated from texts. To effectively and efficiently cluster large-scale text collection, this paper proposes a vector reconstruction based clustering algorithm. Only the features that can represent the cluster are preserved in cluster’s representative vector. This algorithm alternately repeats two sub-processes until it converges. One process is partial tuning sub-process, where feature’s weight is fine-tuned by iterative process. To accelerate clustering velocity, an intersection based similarity measurement and its corresponding neuron adjustment function are proposed and implemented in this sub-process. The other process is overall tuning sub-process, where the features are reallocated among different clusters. In this sub-process, the features useless to represent the cluster are removed from cluster’s representative vector. Experimental results on the three text collections (including two small-scale and one large-scale text collections) demonstrate that our algorithm obtains high quality on both small-scale and large-scale text collections.

Keywords: vector reconstruction, large-scale text clustering, partial tuning sub-process, overall tuning sub-process

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6462 Need for Standardization of Manual Inspection in Small and Medium-Scale Manufacturing Industries

Authors: Adithya Nadig

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In the field of production, characterization of surface roughness plays a vital role in assessing the quality of a manufactured product. The defined parameters for this assessment, each, have their own drawbacks in describing a profile surface. From the purview of small-scale and medium-scale industries, an increase in time spent for manual inspection of a product for various parameters adds to the cost of the product. In order to reduce this, a uniform and established standard is necessary for quantifying a profile of a manufactured product. The inspection procedure in the small and medium-scale manufacturing units at Jigani Industrial area, Bangalore, was observed. The parameters currently in use in those industries are described in the paper and a change in the inspection method is proposed.

Keywords: efficiency of quality assessment, manual areal profiling technique, manufacturing in small and medium-scale industries product-oriented inspection, standardization of manual inspection, surface roughness characterization

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6461 A Rare Case of Endometriosis Lesion in Caecum Causing Acute Small Bowel Obstruction

Authors: Freda Halim

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Endometriosis in bowel is rare condition, about 3-37% of endometriosis cases. Most of bowel endometriosis rising in the rectosigmoid (90% of bowel endometriosis). The incidence of caecal endometriosis is very low ( < 5% of bowel endometriosis) and almost never causing acute small bowel obstruction. The aim of this paper is to show that although bowel obstruction caused by caecal endometriosis is difficult to diagnose as it is rare, and may require laparotomy to make definite diagnosis, but it should be considered in infertile female patient. The case is 37 years old woman infertile woman with intestinal obstruction with pre-operative diagnosis total acute small bowel obstruction caused by right colonic mass, with sepsis as the complication. Before the acute small bowel obstruction, she complained of chronic right lower quadrant pain with chronic constipation alternate with chronic diarrhea, symptoms that happened both in bowel endometriosis and colorectal malignancy. She also complained of chronic pelvic pain and dysmenorrhea. She was married for 10 years with no child. The patient was never diagnosed with endometriosis and never seek medical attention for infertility and the chronic pelvic pain. The patient underwent Abdominal CT Scan, with results: massive small bowel obstruction, and caecal mass that causing acute small bowel obstruction. Diagnosis of acute small bowel obstruction due to right colonic mass was made, and exploratory laparotomy was performed in the patient. During the laparotomy, mass at caecum and ileocaecal that causing massive small bowel obstruction was found and standard right hemicolectomy and temporary ileostomy were performed. The pathology examination showed ectopic endometriosis lesions in caecum and ileocaecal valve. The histopathology also confirmed with the immunohistochemistry, in which positive ER, PR, CD 10 and CD7 was found the ileocaecal and caecal mass. In the second operation, reanastomosis of the ileum was done 3 months after the first operation. The chronic pelvic pain is decreasing dramatically after the first and second operation. In conclusion, although bowel obstruction caused by caecal endometriosis is a rare cause of intestinal obstruction, but it can be considered as a cause in infertile female patient

Keywords: acute, bowel obstruction, caecum, endometriosis

Procedia PDF Downloads 146
6460 Endodontics Flare-Up

Authors: Khalid Mohammed Idrees

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Endodontic treatment aims to reverse the disease process and thereby eliminate the associated signs of symptoms. When the treatment itself appears to initiate the onset of pain and /or swelling (endodontic flare-up), the result can be distressing to both the patient and the operator. Patient might even consider postoperative symptoms as a bench mark against which the clinician’s skills are measured. Obviously the treatment with the lowest prevalence of postoperative pain is usually the treatment of choice as long as effectiveness and cost are not compromised. Knowledge of the cause and mechanism behind intra appointment flare-up is of utmost importance for the clinician to properly prevent or manage this undesirable condition. This review lecture will discuss the causative factors of flare-up with special attention to the microorganism role, various modalities of preventive measures would be discussed. Those measures are based on scientific evidence combined with the long clinical experience of the lecturer.

Keywords: endodontic flare-up, causative factors, inflammatory mediators, preventive measures

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6459 Prevalence of the Musculoskeletal Disorder amongst School Teachers

Authors: Nirav Vaghela, Sanket Parekh

Abstract:

Objective: Musculoskeletal disorders (MSD) represent one of the most common and important occupational health problems in working populations, being responsible for a substantial impact on quality of life and incurring a major economic burden in compensation cost and lost wages. School teachers represent an occupational group among which there appears to be a high prevalence of MSD. Design: Three hundred and fourteen teachers were enrolled in this study. Teachers were interview with the Modified Nordic Questionnaire. Result: In current study total 314 participants have been recruited in that minimum age of participants is 22 and maximum age is 59 with mean 40.5± 9.88. Total prevalence of the MSD is 71.95% among the teachers. In that Female were more affected with 72% than the males with 28%. Conclusion: The teachers here in reported a high prevalence of musculoskeletal pain in the shoulder, knee and back.

Keywords: repetitive stress injury, pain, occupational hazards, disability, abneetism, physical health, quality of life

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6458 Results of Twenty Years of Laparoscopic Hernia Repair Surgeries

Authors: Arun Prasad

Abstract:

Introduction: Laparoscopic surgery of hernia started in early 1990 and has had a mixed acceptance across the world, unlike laparoscopic cholecystectomy that has become a gold standard. Laparoscopic hernia repair claims to have less pain, less recurrence, and less wound infection compared to open hernia repair leading to early recovery and return to work. Materials and Methods: Laparoscopic hernia repair has been done in 2100 patients from 1995 till now with a follow-up data of 1350 patients. Data was analysed for results and satisfaction. Results: There is a recurrence rate of 0.1%. Early complications include bleeding, trocar injury and nerve pain. Late complications were rare. Conclusion: Laparoscopic inguinal hernia repair has a steep learning curve but after that the results and patient satisfaction are very good. It should be the procedure of choice in all bilateral and recurrent hernias.

Keywords: laparoscopy, hernia, mesh, surgery

Procedia PDF Downloads 251
6457 Assessment of Politeness Behavior on Communicating: Validation of Scale through Exploratory Factor Analysis and Confirmatory Factor Analysis

Authors: Abdullah Pandang, Mantasiah Rivai, Nur Fadhilah Umar, Azam Arifyadi

Abstract:

This study aims to measure the validity of the politeness behaviour scale and obtain a model that fits the scale. The researcher developed the Politeness Behavior on Communicating (PBC) scale. The research method uses descriptive quantitative by developing the PBC scale. The population in this study were students in three provinces, namely South Sulawesi, West Sulawesi, and Central Sulawesi, recorded in the 2022/2023 academic year. The sampling technique used stratified random sampling by determining the number of samples using the Slovin formula. The sample of this research is 1200 students. This research instrument uses the PBC scale, which consists of 5 (five) indicators: self-regulation of compensation behaviour, self-efficacy of compensation behaviour, fulfilment of social expectations, positive feedback, and no strings attached. The PBC scale consists of 34 statement items. The data analysis technique is divided into two types: the validity test on the correlated item values and the item reliability test referring to Cronbach's and McDonald's alpha standards using the JASP application. Furthermore, the data were analyzed using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). The results showed that the adaptation of the Politeness Behavior on Communicating (PBC) scale was on the Fit Index with a chi-square value (711,800/375), RMSEA (0.53), GFI (0.990), CFI (0.987), GFI (0.985).

Keywords: polite behavior in communicating, positive communication, exploration factor analysis, confirmatory factor analysis

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6456 Multi-Scale Urban Spatial Evolution Analysis Based on Space Syntax: A Case Study in Modern Yangzhou, China

Authors: Dai Zhimei, Hua Chen

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The exploration of urban spatial evolution is an important part of urban development research. Therefore, the evolutionary modern Yangzhou urban spatial texture was taken as the research object, and Spatial Syntax was used as the main research tool, this paper explored Yangzhou spatial evolution law and its driving factors from the urban street network scale, district scale and street scale. The study has concluded that at the urban scale, Yangzhou urban spatial evolution is the result of a variety of causes, including physical and geographical condition, policy and planning factors, and traffic conditions, and the evolution of space also has an impact on social, economic, environmental and cultural factors. At the district and street scales, changes in space will have a profound influence on the history of the city and the activities of people. At the end of the article, the matters needing attention during the evolution of urban space were summarized.

Keywords: block, space syntax and methodology, street, urban space, Yangzhou

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6455 Assessing an Instrument Usability: Response Interpolation and Scale Sensitivity

Authors: Betsy Ng, Seng Chee Tan, Choon Lang Quek, Peter Looker, Jaime Koh

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The purpose of the present study was to determine the particular scale rating that stands out for an instrument. The instrument was designed to assess student perceptions of various learning environments, namely face-to-face, online and blended. The original instrument had a 5-point Likert items (1 = strongly disagree and 5 = strongly agree). Alternate versions were modified with a 6-point Likert scale and a bar scale rating. Participants consisted of undergraduates in a local university were involved in the usability testing of the instrument in an electronic setting. They were presented with the 5-point, 6-point and percentage-bar (100-point) scale ratings, in response to their perceptions of learning environments. The 5-point and 6-point Likert scales were presented in the form of radio button controls for each number, while the percentage-bar scale was presented with a sliding selection. Among these responses, 6-point Likert scale emerged to be the best overall. When participants were confronted with the 5-point items, they either chose 3 or 4, suggesting that data loss could occur due to the insensitivity of instrument. The insensitivity of instrument could be due to the discreet options, as evidenced by response interpolation. To avoid the constraint of discreet options, the percentage-bar scale rating was tested, but the participant responses were not well-interpolated. The bar scale might have provided a variety of responses without a constraint of a set of categorical options, but it seemed to reflect a lack of perceived and objective accuracy. The 6-point Likert scale was more likely to reflect a respondent’s perceived and objective accuracy as well as higher sensitivity. This finding supported the conclusion that 6-point Likert items provided a more accurate measure of the participant’s evaluation. The 5-point and bar scale ratings might not be accurately measuring the participants’ responses. This study highlighted the importance of the respondent’s perception of accuracy, respondent’s true evaluation, and the scale’s ease of use. Implications and limitations of this study were also discussed.

Keywords: usability, interpolation, sensitivity, Likert scales, accuracy

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6454 Effect of Residential Block Scale Envelope in Buildings Energy Consumption: A Vernacular Case Study in an Iranian Urban Context

Authors: M. Panahian

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A global challenge which is of paramount significance today is the issue of devising innovative solutions to tackle the environmental issues, as well as more intelligent and foresightful consumption of and management of natural resources. Changes in global climate resulting from the burning of fossil fuel and the rise in the level of energy consumption are a few examples of environmental issues detrimental to any form of life on earth, which are aggravated year by year. Overall, energy-efficient designs and construction strategies can be studied at three scales: building, block, and city. Nevertheless, as the available literature suggests, the greatest emphasis has been on building and city scales, and little has been done as to the energy-efficient designs at block scale. Therefore, the aim of the current research is to investigate the influences of residential block scale envelope on the energy consumption in buildings. To this end, a case study of residential block scale has been selected in the city of Isfahan, in Iran, situated in a hot and dry climate with cold winters. Eventually, the most effective variables in energy consumption, concerning the block scale envelope, will be concluded.

Keywords: sustainability, passive energy saving solutions, residential block scale, energy efficiency

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6453 Rutin C Improve Osseointegration of Dental Implant and Healing of Soft Tissue

Authors: Noha Mohammed Ismael Awad Eladal, Aala Shoukry Emara

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Background: Wound healing after dental implant surgery is critical to the procedure's success. The aim of this study was to explore the effects of rutin+vitamin C supplementation in wound healing following the placement of dental implants. Methodology: There were 20 participants in this randomized controlled clinical trial who needed dental implants to replace missing teeth. Patients were divided into two groups, and group A received dental implants. Group B received dental implants with vitamin C administration. Follow-up appointments were performed on day 3, day 7, and day 14 post-surgery, during which soft tissue healing and pain response scores were evaluated using the visual analog scale. Postoperative digital panoramas were taken immediately after surgery, 3 months and 6 months postoperatively. Changes in bone density along with the bone-implant interface at the mesial, distal and apical sides were assessed using the digora software. Results: An independent t-test was used to compare the means of variables between the two groups. At the same time, repeated measures were employed to compare the means of variables between two groups. ANOVA was used to compare bone density for the same group at different dates. Significant increased differences were observed at the mesial, distal and apical sides Surrounding the implants of both groups per time. However, the rate of increase was significantly higher in group B The mean difference at the mesial side after 6 months was 21.99 ± 5.48 in the group B and 14.21 ± 4.95 in group A, while it read 21.74 ± 3.56 in the group B and 10.78 ± 3.90 in group A at the distal side and was 18.90 ± 5.91 in the group B and 10.39 ± 3.49 group A at the apical side. Significance was recorded at P = 0.004, P = 0.0001, and 0.001 at the mesial, distal and apical sides respectively. The mean pain score and wound healing were significantly higher in group A as compared to group B, respectively. Conclusion: The rutin c + vitamin c group significantly promoted bone healing and speeded up the osseointegration process and improved soft tissue healing.

Keywords: osseointegration, soft tissue, rutin c, dental implant

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6452 An Engineered Epidemic: Big Pharma's Role in the Opioid Crisis

Authors: Donna L. Roberts

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2019 marked 23 years since Purdue Pharma launched its flagship drug, OxyContin, that unleashed an unprecedented epidemic touching both celebrities and common citizens, metropolitan, suburbia and rural areas and all levels of socioeconomic status. From rural Appalachia to East LA individuals, families and communities have been devastated by a trajectory of addiction that often began with the legitimate prescription of a pain killer for anything from a tooth extraction to a sports injury to recovery from surgery or chronic arthritis. Far from being a serendipitous progression of events, the proliferation of this new breed of 'miracle drug' was instead a carefully crafted marketing program aimed at both the medical community and common citizens. This research represents and in-depth investigation of the evolution of the marketing, distribution and promotion of prescription opioids by pharmaceutical companies and its relationship to the propagation of the opioid crisis. Specifically, key components of Purdue Pharma’s aggressive marketing campaign, including its bonus system and sales incentives, were analyzed in the context of the sociopolitical environment that essential created the proverbial 'perfect storm' for the changing manner in which pain is treated in the U.S. The analyses of these series of events clearly indicate their role in first, the increase in prescription of opioids for non-terminal pain relief and subsequently, the incidence of related addiction, overdose, and death. Through this examination of the conditions that facilitated and maintained this drug crisis, perhaps we can begin to chart a course toward its resolution.

Keywords: addiction, opioid, opioid crisis, Purdue Pharma

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6451 The Analysis of Questionnaires about the Health Condition of Students Involved in the Korean Medicine Doctors` Visiting School Program-Cohort Study: Middle and High School Participator of Seong-Nam-

Authors: Narae Yang, Hyun Kyung Sung, Seon Mi Shin, Hee Jung, Yong Ji Kim, Tae-Yong Park, Ho Yeon Go

Abstract:

The aim of this study was to build base-line data for the Korean Medicine Doctors` Visiting School Program (KMDVSP) by analyzing a student health survey filled out by the students. Korean medicine doctors assigned to 20 middle and high schools in Seong-nam visited these schools eight times in five months. During each visit, the assigned doctors performed health consultations and Korean medicine treatment, and taught health education classes. 12115 students answered self-reported questionnaires about their own physical condition at the beginning of the program. In a question about pain, 7080(58%) reported having a headache, while 4048(33%) said they had a backache, nuchal pain/shoulder pain was reported by 5993(49%), dyspepsia was present in 2736(23%), rhinitis/sinusitis was reported by 4176(34%), coughing/dyspnea by 7102(59%), itching/skin rash by 2840(23%), and constipation was reported by 1091(9%), while 2264(18%) said they had diarrhea. Increased urinary frequency/feeling of residual urine was reported by 569 students (5%), and 3324(27%) said they had insomnia/fitful sleep/morning fatigue. When asked about menstruation, 4450(83%) of the female students reported irregular menstruation or said they experienced menstrual pain. Understanding the health condition of adolescent students is the starting point to determining national health policy to prevent various diseases in the future. We have developed the pilot project of KMDVSP and collected research about students’ health. Based on this data, further studies should be performed in order to develop a cooperative program between schools and the Korean medical center.

Keywords: korean medicine doctors` visiting school program(kmdvsp), student`s health condition, questionnaires, cohort study

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6450 Antioxidant Potential of Pomegranate Rind Extract Attenuates Pain, Inflammation and Bone Damage in Experimental Rats

Authors: Ritu Karwasra, Surender Singh

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Inflammation is an important physiological response of the body’s self-defense system that helps in eliminating and protecting organism from harmful stimuli and in tissue repair. It is a highly regulated protective response which helps in eliminating the initial cause of cell injury, and initiates the process of repair. The present study was designed to evaluate the ameliorative effect of pomegranate rind extract on pain and inflammation. Hydroalcoholic standardized rind extract of pomegranate at doses 50, 100 and 200 mg/kg and indomethacin (3 mg/kg) was tested against eddy’s hot plate induced thermal algesia, carrageenan (acute inflammation) and Complete Freund’s Adjuvant (chronic inflammation) induced models in Wistar rats. Parameters analyzed were inhibition of paw edema, measurement of joint diameter, levels of GSH, TBARS, SOD, TNF-α, radiographic imaging, tissue histology and synovial expression of pro-inflammatory cytokine receptor (TNF-R1). Radiological and light microscopical analysis were carried out to find out the bone damage in CFA-induced chronic inflammatory model. Findings of the present study revealed that pomegranate rind extract at a dose of 200 mg/kg caused a significant (p<0.05) reduction in paw swelling in both the inflammatory models. Nociceptive threshold was also significantly (p<0.05) improved. Immunohistochemical analysis of TNF-R1 in CFA-induced group showed elevated level, whereas reduction in level of TNF-R1 was observed in pomegranate (200 mg/kg). Henceforth, we might say that pomegranate produced a dose-dependent reduction in inflammation and pain along with the reduction in levels of oxidative stress markers and tissue histology, and the effect was found to be comparable to that of indomethacin. Thus, it can be concluded that pomegranate is a potential therapeutic target in the pathogenesis of inflammation and pain, and punicalagin is the major constituents found in rind extract might be responsible for the activity.

Keywords: carrageenan, inflammation, nociceptive-threshold, pomegranate, histopathology

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6449 Quantitative Texture Analysis of Shoulder Sonography for Rotator Cuff Lesion Classification

Authors: Chung-Ming Lo, Chung-Chien Lee

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In many countries, the lifetime prevalence of shoulder pain is up to 70%. In America, the health care system spends 7 billion per year about the healthy issues of shoulder pain. With respect to the origin, up to 70% of shoulder pain is attributed to rotator cuff lesions This study proposed a computer-aided diagnosis (CAD) system to assist radiologists classifying rotator cuff lesions with less operator dependence. Quantitative features were extracted from the shoulder ultrasound images acquired using an ALOKA alpha-6 US scanner (Hitachi-Aloka Medical, Tokyo, Japan) with linear array probe (scan width: 36mm) ranging from 5 to 13 MHz. During examination, the postures of the examined patients are standard sitting position and are followed by the regular routine. After acquisition, the shoulder US images were drawn out from the scanner and stored as 8-bit images with pixel value ranging from 0 to 255. Upon the sonographic appearance, the boundary of each lesion was delineated by a physician to indicate the specific pattern for analysis. The three lesion categories for classification were composed of 20 cases of tendon inflammation, 18 cases of calcific tendonitis, and 18 cases of supraspinatus tear. For each lesion, second-order statistics were quantified in the feature extraction. The second-order statistics were the texture features describing the correlations between adjacent pixels in a lesion. Because echogenicity patterns were expressed via grey-scale. The grey-scale co-occurrence matrixes with four angles of adjacent pixels were used. The texture metrics included the mean and standard deviation of energy, entropy, correlation, inverse different moment, inertia, cluster shade, cluster prominence, and Haralick correlation. Then, the quantitative features were combined in a multinomial logistic regression classifier to generate a prediction model of rotator cuff lesions. Multinomial logistic regression classifier is widely used in the classification of more than two categories such as the three lesion types used in this study. In the classifier, backward elimination was used to select a feature subset which is the most relevant. They were selected from the trained classifier with the lowest error rate. Leave-one-out cross-validation was used to evaluate the performance of the classifier. Each case was left out of the total cases and used to test the trained result by the remaining cases. According to the physician’s assessment, the performance of the proposed CAD system was shown by the accuracy. As a result, the proposed system achieved an accuracy of 86%. A CAD system based on the statistical texture features to interpret echogenicity values in shoulder musculoskeletal ultrasound was established to generate a prediction model for rotator cuff lesions. Clinically, it is difficult to distinguish some kinds of rotator cuff lesions, especially partial-thickness tear of rotator cuff. The shoulder orthopaedic surgeon and musculoskeletal radiologist reported greater diagnostic test accuracy than general radiologist or ultrasonographers based on the available literature. Consequently, the proposed CAD system which was developed according to the experiment of the shoulder orthopaedic surgeon can provide reliable suggestions to general radiologists or ultrasonographers. More quantitative features related to the specific patterns of different lesion types would be investigated in the further study to improve the prediction.

Keywords: shoulder ultrasound, rotator cuff lesions, texture, computer-aided diagnosis

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6448 Efficacy of Cool's and Rhythmic Stabilization Exercises on Scapular up Ward Rotation and Ut/Sa Ratio in Patients with Shoulder Impingement Syndrome

Authors: Mohammed Moustafa, Khaled Ayad, Waleed Reda

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Shoulder impingement syndrome is the most common disorder of the shoulder, resulting in functional loss and disability. Objective: This study was designed to compare between the effects of scapular muscle training versus rhythmic stabilization exercises in treatment of shoulder impingement syndrome. Methods: Thirty patients participated in this study; they were assigned randomly into two experimental groups. The first experimental group (A) consisted of 15 patients with a mean age (21.87±2.72) years; they received graduated rhythmic stabilization exercises and stretching of the posterior capsule. The second experimental group (B) consisted of 15 patients with a mean age (22.27±2.94) years; they received scapular muscle training exercises in addition to stretching of the posterior capsule. Treatment was given three times per week, every other day, for four consecutive weeks. Patients have been evaluated pretreatment and post treatment for shoulder pain severity and functional disability. Results: Both groups showed highly statistical significant reduction in pain severity and functional disability measured post-treatment when compared with their corresponding values in pretreatment assessment. Conclusion: Both of rhythmic stabilization exercises and scapular muscle training are effective interventions to reduce shoulder pain severity and functional disability.

Keywords: impingement syndrome, scapular exercises, rhythmic stabilization exercises, posterior capsule stretch

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6447 Uncommon Causes of Acute Abdominal Pain: A Pictorial Essay

Authors: Mahesh Hariharan, Rajan Balasubramaniam, Sharath Kumar Shetty, Shanthala Yadavalli, Mohammed Ahetasham, Sravya Devarapalli

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Acute abdomen is one of the most common clinical conditions requiring a radiological investigation. Ultrasound is the primary modality of choice which can diagnose some of the common causes of acute abdomen. However, sometimes the underlying cause for the pain is far more complicated than expected to mandate a high degree of suspicion to suggest further investigation with contrast-enhanced computed tomography or magnetic resonance imaging. Here, we have compiled a comprehensive series of selected cases to highlight the conditions which can be easily overlooked unless carefully sought for. This also emphasizes the importance of multimodality approach to arrive at the final diagnosis with an increased overall diagnostic accuracy which in turn improves patient management and prognosis.

Keywords: acute abdomen, contrast-enhanced computed tomography scan, magnetic resonance imaging, plain radiographs, ultrasound

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6446 Comparison of Trunk and Hip Muscle Activities and Anterior Pelvic Tilt Angle during Three Different Bridging Exercises in Subjects with Chronic Low Back Pain

Authors: Da-Eun Kim, Heon-Seock Cynn, Sil-Ah Choi, A-Reum Shin

Abstract:

Bridging exercise in supine position with the hips and knees flexed have been commonly performed as one of the therapeutic exercises and is a comfortable and pain-free position to most individuals with chronic low back pain (CLBP). Many previous studies have investigated the beneficial way of performing bridging exercises to improve activation of abdominal and gluteal muscle and reduce muscle activity of hamstrings (HAM) and erector spinae (ES) and compensatory lumbopelvic motion. The purpose of this study was to compare the effects of three different bridging exercises on the HAM, ES, gluteus maximus (Gmax), gluteus medius (Gmed), and transverse abdominis/internal abdominis oblique (TrA/IO) activities and anterior pelvic tilt angle in subjects with CLBP. Seventeen subjects with CLBP participated in this study. They performed bridging under three different conditions (with 30° hip abduction, isometric hip abduction, and isometric hip adduction). Surface electromyography was used to measure muscle activity, and the ImageJ software was used to calculate anterior pelvic tilt angle. One-way repeated-measures analysis of variance was used to assess the statistical significance of the measured variables. HAM activity was significantly lower in bridging with 30° hip abduction and isometric hip abduction than in bridging with isometric hip adduction. Gmax and Gmed activities were significantly greater in bridging with isometric hip abduction than in bridging with 30° hip abduction and isometric hip adduction. TrA/IO muscle activity was significantly greater and anterior pelvic tilt angle was significantly lower in bridging with isometric hip adduction than in bridging with 30° hip abduction and isometric hip abduction. Bridging with isometric hip abduction using Thera-Band can effectively reduce HAM activity, and increase Gmax and Gmed activities in subjects with CLBP. Bridging with isometric hip adduction using a pressure biofeedback unit can be a beneficial exercise to improve TrA/IO activity and minimize anterior pelvic tilt in subjects with CLBP.

Keywords: bridging exercise, electromyography, low back pain, lower limb exercise

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6445 Identification of Workplace Hazards of Underground Coal Mines

Authors: Madiha Ijaz, Muhammad Akram, Sima Mir

Abstract:

Underground mining of coal is carried out manually in Pakistan. Exposure to ergonomic hazards (musculoskeletal disorders) are very common among the coal cutters of these mines. Cutting coal in narrow spaces poses a great threat to both upper and lower limbs of these workers. To observe the prevalence of such hazards, a thorough study was conducted on 600 workers from 30 mines (20 workers from 1 mine), located in two districts of province Punjab, Pakistan. Rapid Upper Limb Assessment sheet and Rapid Entire Body Assessment sheet were used for the study along with a standard Nordic Musculoskeleton disorder questionnaire. SPSS, 25, software was used for data analysis on upper and lower limb disorders, and regression analysis models were run for upper and lower back pain. According to the results obtained, it was found that work stages (drilling & blasting, coal cutting, timbering & supporting, etc.), wok experience and number of repetitions performed/minute were significant (with p-value 0.00,0.004 and 0.009, respectively) for discomfort in upper and lower limb. Age got p vale 0.00 for upper limb and 0.012 for lower limb disorder. The task of coal cutting was strongly associated with the pain in upper back (with odd ratios13.21, 95% confidence interval (CI)14.0-21.64)) and lower back pain (3.7, 95% confidence interval 1.3-4.2). scored on RULA and REBA sheets, every work-stage was ranked at 7-highest level of risk involved. Workers were young (mean value of age= 28.7 years) with mean BMI 28.1 kg/m2

Keywords: workplace hazards, ergonomic disorders, limb disorders, MSDs.

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6444 Socio-Economic Effects of Micro-Credit on Small-Scale Poultry Farmers’ Livelihood in Ado Odo-Ota Local Government Area of Ogun State, Nigeria

Authors: E. O. Fakoya, B. G. Abiona, W. O. Oyediran, A. M. Omoare

Abstract:

This study examined the socio-economic effects of micro-credit on small scale poultry farmers’ livelihood in Ado Odo-Ota Local Government area of Ogun State. Purposive sampling method was used to select eighty (80) small scale poultry farmers that benefited in micro credit. Interview guide was used to obtain information on the respondents’ socio-economic characteristic, sources of micro-credit and the effects of micro-credit on their livelihood. The results revealed that most of the respondents (77.50 %) were males while half (40.00%) of the respondents were between the ages of 31-40 years. A high proportion (72.50%) of the respondents had formal education. The major sources of micro credit to small scale poultry farmers were cooperative society (47.50%) and personal savings (20.00%). The findings also revealed that micro-credit had positive effect on the assets and livelihoods of small scale poultry farmers’ livelihood. Results of t-test analysis showed a significant difference between the effects before and after micro-credit on small-scale poultry farmers’ Livelihood at p < 0.05. The study recommends that formal lending institution should be given necessary support by government to enable poultry farmers have access to credit facilities in the study area.

Keywords: micro-credit, effects, livelihood, poultry farmers, socio-economic, small scale

Procedia PDF Downloads 437
6443 Evaluate the Possibility of Using ArcGIS Basemaps as GCP for Large Scale Maps

Authors: Jali Octariady, Ida Herliningsih, Ade K. Mulyana, Annisa Fitria, Diaz C. K. Yuwana

Abstract:

Awareness of the importance large-scale maps for development of a country is growing in all walks of life, especially for governments in Indonesia. Various parties, especially local governments throughout Indonesia demanded for immediate availability the large-scale maps of 1:5000 for regional development. But in fact, the large-scale maps of 1:5000 is only available less than 5% of the entire territory of Indonesia. Unavailability precise GCP at the entire territory of Indonesia is one of causes of slow availability the large scale maps of 1:5000. This research was conducted to find an alternative solution to this problem. This study was conducted to assess the accuracy of ArcGIS base maps coordinate when it shall be used as GCP for creating a map scale of 1:5000. The study was conducted by comparing the GCP coordinate from Field survey using GPS Geodetic than the coordinate from ArcGIS basemaps in various locations in Indonesia. Some areas are used as a study area are Lombok Island, Kupang City, Surabaya City and Kediri District. The differences value of the coordinates serve as the basis for assessing the accuracy of ArcGIS basemaps coordinates. The results of the study at various study area show the variation of the amount of the coordinates value given. Differences coordinate value in the range of millimeters (mm) to meters (m) in the entire study area. This is shown the inconsistency quality of ArcGIS base maps coordinates. This inconsistency shows that the coordinate value from ArcGIS Basemaps is careless. The Careless coordinate from ArcGIS Basemaps indicates that its cannot be used as GCP for large-scale mapping on the entire territory of Indonesia.

Keywords: accuracy, ArcGIS base maps, GCP, large scale maps

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6442 Scale-Up Process for Phyllanthus niruri Enriched Extract by Supercritical Fluid Extraction

Authors: Norsyamimi Hassim, Masturah Markom

Abstract:

Supercritical fluid extraction (SFE) has been known as a sustainable and safe extraction technique for plant extraction due to the minimal usage of organic solvent. In this study, a scale-up process for the selected herbal plant (Phyllanthus niruri) was investigated by using supercritical carbon dioxide (SC-CO2) with food-grade (ethanol-water) cosolvent. The quantification of excess ethanol content in the final dry extracts was conducted to determine the safety of enriched extracts. The extraction yields obtained by scale-up SFE unit were not much different compared to the predicted extraction yields with an error of 2.92%. For component contents, the scale-up extracts showed comparable quality with laboratory-scale experiments. The final dry extract showed that the excess ethanol content was 1.56% g/g extract. The fish embryo toxicity test (FETT) on the zebrafish embryos showed no toxicity effects by the extract, where the LD50 value was found to be 505.71 µg/mL. Thus, it has been proven that SFE with food-grade cosolvent is a safe extraction technique for the production of bioactive compounds from P. niruri.

Keywords: scale-up, supercritical fluid extraction, enriched extract, toxicity, ethanol content

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6441 The Effectiveness of Laughing Qigong for Women with Breast Cancer in Community

Authors: Chueh Chang, Chia-jung Hsieh, Fu-yu Yu, Yu-Hwa Lin

Abstract:

Background:The majority of women diagnosed with breast cancer undergo treatment involving surgery and radiotherapy or chemotherapy, or both. With these major advances in breast cancer management, many patients still have to deal with short or long-term side effects and psychological distress related to the disease and treatment, which have a substantial impact on their quality of life. The Laughing Qigong Program (LQP) is an interactive laughter program that combines the physical and physiological benefits of laughter with the mental benefits of Chinese qigong. Purpose: In order to improve the quality of life for breast cancer women in the community as well as echoing the WHO 2004 “Promoting Mental Health” for every one. This study focused on how to promote the positive mental health for women of breast cancer through the “laughter program” in Taiwan. During the presentation, how to practice Laughing Qigong will be demonstrated. Method: Using nonequivalent pretest-posttest design, ix-one breast cancer patients were volunteered to enroll in this study from the Taiwan Breast Cancer Alliance (TBCA). Thirty patients were assigned to the experimental group and the other 31 patients were assigned to the control group. The women who were assigned to the experimental group received laughter program one hour per session, once a week, totally 12 sessions. All subjects were tested before and after the intervention on the following: Self-Esteem scale (RSE), Face Scale (FS), Anxiety and pain experience were measured as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR),and heart rate variability (HRV) as physiological markers of the body’s response to stress. Results: After comparing the experimental and control groups, the results revealed that those breast cancer women with “laughing program” their sense of humor were improved, less uncomfortable on self report physical conditions, more positive attitudes toward stress management by using laughter, and had emotional improvement according to the face scale.

Keywords: mental health promotion, breast cancer, laughing Qigong, women

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6440 Difficulties in Providing Palliative Care in Rural India, West Bengal: Experience of an NGO

Authors: Aditya Manna

Abstract:

Introduction: As in any developing countries state of West Bengal in India has a huge burden of cancer patients in advanced stage coming from rural area where awareness regarding the usefulness of palliative care in rather poor. Objective: Our goal is to give a pain free good quality of life in these advanced stage cancer patients. Objective of this study is to identify the main difficulties in achieving the above goal in a rural village setting in India. Method: Advanced cancer patients in need of palliative care in various villages in of rural India were selected for this study. Their symptoms and managements in that rural surroundings were evaluated by an NGO (under the guidance of a senior palliative care specialist) working in that area. An attempt was made to identify the main obstacles in getting proper palliative care in a rural setting. Results: Pain, fatigue are the main symptoms effecting these patients. In most patients pain and other symptoms control were grossly inadequate due to lack of properly trained manpower in the rural India. However regular homecare visits by a group of social workers were of immense help in the last few months of life. NGO team was well guided by a palliative care specialist. Conclusion: There is a wide gap of trained manpower in this filled in rural areas of India. Dedicated groups from rural area itself need encouragement and proper training, so that difficult symptoms can be managed locally along with necessary social and psychological support to these patients.

Keywords: palliative care, NGO, rural India, home care

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6439 Randomized Controlled Trial of Ultrasound Guided Bilateral Intermediate Cervical Plexus Block in Thyroid Surgery

Authors: Neerja Bharti, Drishya P.

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Introduction: Thyroidectomies are extensive surgeries involving a significant degree of tissue handling and dissection and are associated with considerable postoperative pain. Regional anaesthesia techniques have immerged as possible inexpensive and safe alternatives to opioids in the management of pain after thyroidectomy. The front of the neck is innervated by branches from the cervical plexus, and hence, several approaches for superficial and deep cervical plexus block (CPB) have been described to provide postoperative analgesia after neck surgery. However, very few studies have explored the analgesic efficacy of intermediate CPB for thyroid surgery. In this study, we have evaluated the effects of ultrasound-guided bilateral intermediate CPB on perioperative opioid consumption in patients undergoing thyroidectomy under general anesthesia. Methods: In this prospective randomized controlled study, fifty ASA grade I-II adult patients undergoing thyroidectomy were randomly divided into two groups: the study group received ultrasound-guided bilateral intermediate CPB with 10 ml 0.5% ropivacaine on each side, while the control group received the same block with 10 ml normal saline on each side just after induction of anesthesia. Anesthesia was induced with propofol, fentanyl, and vecuronium and maintained with propofol infusion titrated to maintain the BIS between 40 and 60. During the postoperative period, rescue analgesia was provided with PCA fentanyl, and the pain scores, total fentanyl consumption, and incidence of nausea and vomiting during 24 hours were recorded, and overall patient satisfaction was assessed. Results: The groups were well-matched with respect to age, gender, BMI, and duration of surgery. The difference in intraoperative propofol and fentanyl consumption was not statistically significant between groups. However, the intraoperative haemodynamic parameters were better maintained in the study group than in the control group. The postoperative pain scores, as measured by VAS at rest and during movement, were lower, and the total fentanyl consumption during 24 hours was significantly less in the study group as compared to the control group. Patients in the study group reported better satisfaction scores than those in the control group. No adverse effects of ultrasound-guided intermediate CPB block were reported. Conclusion: We concluded that ultrasound-guided intermediate cervical plexus block is a safe and effective method for providing perioperative analgesia during thyroid surgery.

Keywords: thyroidectomy, cervical plexus block, pain relief, opioid consumption

Procedia PDF Downloads 93
6438 Identification of Potential Large Scale Floating Solar Sites in Peninsular Malaysia

Authors: Nur Iffika Ruslan, Ahmad Rosly Abbas, Munirah Stapah@Salleh, Nurfaziera Rahim

Abstract:

Increased concerns and awareness of environmental hazards by fossil fuels burning for energy have become the major factor driving the transition toward green energy. It is expected that an additional of 2,000 MW of renewable energy is to be recorded from the renewable sources by 2025 following the implementation of Large Scale Solar projects in Peninsular Malaysia, including Large Scale Floating Solar projects. Floating Solar has better advantages over its landed counterparts such as the requirement for land acquisition is relatively insignificant. As part of the site selection process established by TNB Research Sdn. Bhd., a set of mandatory and rejection criteria has been developed in order to identify only sites that are feasible for the future development of Large Scale Floating Solar power plant. There are a total of 85 lakes and reservoirs identified within Peninsular Malaysia. Only lakes and reservoirs with a minimum surface area of 120 acres will be considered as potential sites for the development of Large Scale Floating Solar power plant. The result indicates a total of 10 potential Large Scale Floating Solar sites identified which are located in Selangor, Johor, Perak, Pulau Pinang, Perlis and Pahang. This paper will elaborate on the various mandatory and rejection criteria, as well as on the various site selection process required to identify potential (suitable) Large Scale Floating Solar sites in Peninsular Malaysia.

Keywords: Large Scale Floating Solar, Peninsular Malaysia, Potential Sites, Renewable Energy

Procedia PDF Downloads 174
6437 Development and Evaluation of a Psychological Adjustment and Adaptation Status Scale for Breast Cancer Survivors

Authors: Jing Chen, Jun-E Liu, Peng Yue

Abstract:

Objective: The objective of this study was to develop a psychological adjustment and adaptation status scale for breast cancer survivors, and to examine the reliability and validity of the scale. Method: 37 breast cancer survivors were recruited in qualitative research; a five-subject theoretical framework and an item pool of 150 items of the scale were derived from the interview data. In order to evaluate and select items and reach a preliminary validity and reliability for the original scale, the suggestions of study group members, experts and breast cancer survivors were taken, and statistical methods were used step by step in a sample of 457 breast cancer survivors. Results: An original 24-item scale was developed. The five dimensions “domestic affections”, “interpersonal relationship”, “attitude of life”, “health awareness”, “self-control/self-efficacy” explained 58.053% of the total variance. The content validity was assessed by experts, the CVI was 0.92. The construct validity was examined in a sample of 264 breast cancer survivors. The fitting indexes of confirmatory factor analysis (CFA) showed good fitting of the five dimensions model. The criterion-related validity of the total scale with PTGI was satisfactory (r=0.564, p<0.001). The internal consistency reliability and test-retest reliability were tested. Cronbach’s alpha value (0.911) showed a good internal consistency reliability, and the intraclass correlation coefficient (ICC=0.925, p<0.001) showed a satisfactory test-retest reliability. Conclusions: The scale was brief and easy to understand, was suitable for breast cancer patients whose physical strength and energy were limited.

Keywords: breast cancer survivors, rehabilitation, psychological adaption and adjustment, development of scale

Procedia PDF Downloads 509