Search results for: pain intensity

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

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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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Authors: Mohammad Alshawaf, Rahmat Poudineh, Nawaf Alhajeri

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The power generated from photovoltaic (PV) modules is non-dispatchable on demand due to the stochastic nature of solar radiation. The random variations in the measured intensity of solar irradiance are due to clouds and, in the case of arid regions, dust storms which decrease the intensity of intensity of solar irradiance. Therefore, modeling PV power output using average, maximum, or minimum solar irradiance values is inefficient to predict power generation reliably. The overall objective of this paper is to predict the power output of PV modules using Monte Carlo approach based the weather and solar conditions measured in Kuwait. Given the 250 Wp PV module used in study, the average daily power output is 1021 Wh/day. The maximum power was generated in April and the minimum power was generated in January 1187 Wh/day and 823 Wh/day respectively. The certainty of the daily predictions varies seasonally and according to the weather conditions. The output predictions were far more certain in the summer months, for example, the 80% certainty range for August is 89 Wh/day, whereas the 80% certainty range for April is 250 Wh/day.

Keywords: Monte Carlo, solar energy, variable renewable energy, Kuwait

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Authors: Evan W. Krieger, Vijayan K. Asari, Saibabu Arigela

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Video imagery captured for real-time security and surveillance applications is typically captured in complex lighting conditions. These less than ideal conditions can result in imagery that can have underexposed or overexposed regions. It is also typical that the video is too low in resolution for certain applications. The purpose of security and surveillance video is that we should be able to make accurate conclusions based on the images seen in the video. Therefore, if poor lighting and low resolution conditions occur in the captured video, the ability to make accurate conclusions based on the received information will be reduced. We propose a solution to this problem by using image preprocessing to improve these images before use in a particular application. The proposed algorithm will integrate an intensity enhancement algorithm with a super resolution technique. The intensity enhancement portion consists of a nonlinear inverse sign transformation and an adaptive contrast enhancement. The super resolution section is a single image super resolution technique is a Fourier phase feature based method that uses a machine learning approach with kernel regression. The proposed technique intelligently integrates these algorithms to be able to produce a high quality output while also being more efficient than the sequential use of these algorithms. This integration is accomplished by performing the proposed algorithm on the intensity image produced from the original color image. After enhancement and super resolution, a color restoration technique is employed to obtain an improved visibility color image.

Keywords: dynamic range compression, multi-level Fourier features, nonlinear enhancement, super resolution

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Authors: Moohyun Lee, Soojung Hur, Yongwan Park

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In this paper is proposed a method uses only LIDAR system to classification an obstacle and determine its type by establishing database for classifying obstacles based on LIDAR. The existing LIDAR system, in determining the recognition of obstruction in an autonomous vehicle, has an advantage in terms of accuracy and shorter recognition time. However, it was difficult to determine the type of obstacle and therefore accurate path planning based on the type of obstacle was not possible. In order to overcome this problem, a method of classifying obstacle type based on existing LIDAR and using the width of obstacle materials was proposed. However, width measurement was not sufficient to improve accuracy. In this research, the width data was used to do the first classification; database for LIDAR intensity data by four major obstacle materials on the road were created; comparison is made to the LIDAR intensity data of actual obstacle materials; and determine the obstacle type by finding the one with highest similarity values. An experiment using an actual autonomous vehicle under real environment shows that data declined in quality in comparison to 3D LIDAR and it was possible to classify obstacle materials using 2D LIDAR.

Keywords: obstacle, classification, database, LIDAR, segmentation, intensity

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Authors: Nirav Vaghela, Sanket Parekh

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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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Authors: Arun Prasad

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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

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Authors: Mayesha Tahsin, A.S. Mollah

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Recently, a 1.5x1.5 inch NaI(Tl) detector based gamma-ray spectroscopy system has been installed in the laboratory of the Nuclear Science and Engineering Department of the Military Institute of Science and Technology for radioactivity detection purposes. The newly installed NaI(Tl) detector has a circular lead shield of 22 mm width. An important consideration of any gamma-ray spectroscopy is the minimization of natural background radiation not originating from the radioactive sample that is being measured. Natural background gamma-ray radiation comes from naturally occurring or man-made radionuclides in the environment or from cosmic sources. Moreover, the main problem with this system is that it is not suitable for measurements of radioactivity with a large sample container like Petridish or Marinelli beaker geometry. When any laboratory installs a new detector or/and new shield, it “must” first carry out quality and performance tests for the detector and shield. This paper describes a new portable shielding system with lead that can reduce the background radiation. Intensity of gamma radiation after passing the shielding will be calculated using shielding equation I=Ioe-µx where Io is initial intensity of the gamma source, I is intensity after passing through the shield, µ is linear attenuation coefficient of the shielding material, and x is the thickness of the shielding material. The height and width of the shielding will be selected in order to accommodate the large sample container. The detector will be surrounded by a 4π-geometry low activity lead shield. An additional 1.5 mm thick shield of tin and 1 mm thick shield of copper covering the inner part of the lead shielding will be added in order to remove the presence of characteristic X-rays from the lead shield.

Keywords: shield, NaI (Tl) detector, gamma radiation, intensity, linear attenuation coefficient

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Authors: R. Karmouch

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A thin gold metal layer was deposited on the top of silicon oxide films containing embedded Si nanocrystals (Si-nc). The sample was annealed in gas containing nitrogen, and subsequently characterized by photoluminescence. We obtained 3-fold enhancement of photon emission from the Si-nc embedded in silicon dioxide covered with a Gold layer as compared with an uncovered sample. We attribute this enhancement to the increase of the spontaneous emission rate caused by the coupling of the Si-nc emitters with the surface plasmons (SP). The evolution of PL emission with laser irradiated time was also collected from covered samples, and compared to that from uncovered samples. In an uncovered sample, the PL intensity decreases with time, approximately with two decay constants. Although the decrease of the initial PL intensity associated with the increase of sample temperature under CW pumping is still observed in samples covered with a gold layer, this film significantly contributes to reduce the permanent deterioration of the PL intensity. The resistance to degradation of light-emitting silicon nanocrystals can be increased by SP coupling to suppress the permanent deterioration. Controlling the permanent photodeterioration can allow to perform a reliable optical gain measurement.

Keywords: photodeterioration, silicon nanocrystals, ion implantation, photoluminescence, surface plasmons

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Authors: Johnson C. Y. Pang, Bo Peng, Kara K. L. Reeves, Allan C. L. Fud

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Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding is potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26 ± 5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms, and quality of life (QOL), were analyzed by repeated measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: ultrasound-guided dry needling, dry needling, knee osteoarthritis, physiotheraphy

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Authors: Dana El-Mughayyar, Neil Manson, Erin Bigney, Eden Richardson, Dean Tripp, Edward Abraham

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Use of narcotics to treat pain has increased over the past two decades and is a contributing factor to the current public health crisis. Understanding the pre-operative risks of chronic narcotic use may be aided through investigation of psychological measures. The objective of the reported study is to determine predictors of narcotic use two years post-surgery in a thoracolumbar spine surgery population, including an array of psychological factors. A prospective observational study of 191 consecutively enrolled adult patients having undergone thoracolumbar spine surgery is presented. Baseline measures of interest included the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia, Multidimensional Scale for Perceived Social Support (MSPSS), Chronic Pain Acceptance Questionnaire (CPAQ-8), Oswestry Disability Index (ODI), Numeric Rating Scales for back and leg pain (NRS-B/L), SF-12’s Mental Component Summary (MCS), narcotic use and demographic variables. The post-operative measure of interest is narcotic use at 2-year follow-up. Narcotic use is collapsed into binary categories of use and no use. Descriptive statistics are run. Chi Square analysis is used for categorical variables and an ANOVA for continuous variables. Significant variables are built into a hierarchical logistic regression to determine predictors of post-operative narcotic use. Significance is set at α < 0.05. Results: A total of 27.23% of the sample were using narcotics two years after surgery. The regression model included ODI, NRS-Leg, time with condition, chief complaint, pre-operative drug use, gender, MCS, PCS subscale helplessness, and CPAQ subscale pain willingness and was significant χ² (13, N=191)= 54.99; p = .000. The model accounted for 39.6% of the variance in narcotic use and correctly predicted in 79.7% of cases. Psychological variables accounted for 9.6% of the variance over and above the other predictors. Conclusions: Managing chronic narcotic usage is central to the patient’s overall health and quality of life. Psychological factors in the preoperative period are significant predictors of narcotic use 2 years post-operatively. The psychological variables are malleable, potentially allowing surgeons to direct their patients to preventative resources prior to surgery.

Keywords: narcotics, psychological factors, quality of life, spine surgery

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Authors: Liyang Yue, Bing Yan, James N. Monks, Rakesh Dhama, Zengbo Wang, Oleg V. Minin, Igor V. Minin

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A particle can function as a refractive lens to focus a plane wave, generating a narrow, high intensive, weak-diverging beam within a sub-wavelength volume, known as the ‘photonic jet’. Refractive index contrast (particle to background media) and scaling effect of the dielectric particle (relative-to-wavelength size) play key roles in photonic jet formation, rather than the shape of particle-lens. Waist (full width of half maximum, FWHM) of a photonic jet could be beyond the diffraction limit and smaller than the Airy disk, which defines the minimum distance between two objects to be imaged as two instead of one. Many important applications for imaging and sensing have been afforded based upon the super-resolution characteristic of the photonic jet. It is known that apodization method, in the form of an amplitude pupil-mask centrally situated on a particle-lens, can further reduce the waist of a photonic nanojet, however, usually lower its intensity at the focus due to blocking of the incident light. In this paper, the anomalously intensity-enhanced apodization effect was discovered in the near-field via numerical simulation. It was also experimentally verified by a scale model using a copper-masked Teflon cuboid solid immersion lens (SIL) with 22 mm side length under radiation of a plane wave with 8 mm wavelength. Peak intensity enhancement and the lateral resolution of the produced photonic jet increased by about 36.0 % and 36.4 % in this approach, respectively. This phenomenon may possess the scale effect and would be valid in multiple frequency bands.

Keywords: apodization, particle-lens, scattering, near-field optics

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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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Authors: Vu Hoang Thu Huong

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Background: Surface electrical stimulation (SES) is a popular non-invasive approach that offers a wide range of treatments for many diseases of physical therapy. It involves applying electrical stimulation to the skin via surface electrodes to stimulate nerve fibers. SES was regularly used to treat the back and upper or lower extremities, but it was rarely used to treat the chest and abdomen. SES on the thorax and abdomen should be administered with more attention because crucial organs are under those areas (i.e., heart, lungs, liver, etc.). In these areas, safety precautions are suggested, and some SES applications might even be a contraindication. The fact that physical therapists have less experience with SES in these situations can also be attributed to these. Although a few earlier studies applied it to these settings and discovered hopeful results, none of them highlight the relationship between the intensity of SES and its depth of impact for safety considerations. Objective: To assure feasibility when using SES in these areas, the purpose of this study is to summarize the common location and intensity of those areas that have been conducted in previous studies. Method: A thorough systematic review was conducted to determine the common surface electrode position for the thorax and abdomen areas. The studies with the randomized controlled design were systematically searched using inclusion and exclusion criteria through nine electronic databases, including Pubmed, Scopus, etc., between 1975 and Dec 2021. Results: Thirty-three studies with over 1800 participants and 4 types of SES (TENS, IFC, NMES, and FES) with various categories of department hospitals were found. Following an anterior, lateral, and posterior observation, the particular SES positions found that it concentrated on 6 regions (the thoracic, abdomen, upper lateral, lower lateral, upper back, and lower back regions), and its intensity for each region was also summarized. Conclusion: This systematic review figured out the popular locations of SES in the thorax and abdominal areas as well as a summarized maximum of intensity that was found in previous studies with outstanding outcomes.

Keywords: surface electrical stimulation, electrical stimulation, thoracic, abdomen, abdominal.

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

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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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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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Authors: A. A. Abid

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The magnetospheric multiscale (MMS) satellite observations in the inner magnetosphere were used to detect the proton band of the electromagnetic ion cyclotron (EMIC) waves on December 14, 2015, which have been significantly contributing to the dynamics of the magnetosphere. It has been examined that the intensity of EMIC waves gradually increases by decreasing the L shell. The waves are triggered by hot proton thermal anisotropy. The low-energy cold protons (ions) can be activated by the EMIC waves when the EMIC wave intensity is high. As a result, these previously invisible protons are now visible. As a result, the EMC waves also excite the helium ions. The EMIC waves, whose frequency in the magnetosphere of the Earth ranges from 0.001 Hz to 5 Hz, have drawn a lot of attention for their ability to carry energy. Since these waves act as a mechanism for the loss of energetic electrons from the Van Allen radiation belt to the atmosphere, therefore, it is necessary to understand how and where they can be produced, as well as the direction of waves along the magnetic field lines. This work examines how the excitation of EMIC waves is affected by the energy of hot proton temperature anisotropy, and It has a minimum resonance energy of 6.9 keV and a range of 7 to 26 keV. On the hot protons, however, the reverse effect can be seen for energies below the minimum resonance energy. It is demonstrated that throughout the energy range of 1 eV to 100 eV, the number density and temperature anisotropy of the protons likewise rise as the intensity of the EMIC waves increases. Key Points: 1. The analysis of EMIC waves produced by hot proton temperature anisotropy using MMS data. 2. The number density and temperature anisotropy of the cold protons increases owing to high-intensity EMIC waves. 3. The cold protons with an energy range of 1-100eV are energized by EMIC waves using the Magnetospheric Multiscale (MMS) satellite not been discussed before

Keywords: EMIC waves, temperature anisotropy of hot protons, energization of the cold proton, magnetospheric multiscale (MMS) satellite observations

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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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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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Authors: Mariola Głowacka

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Aim: The aim of this study was to present the assessment of dyspnea and anxiety in seniors staying in the hospice in the context of the nurse's tasks. Materials and methods: The presented research was carried out at the "Hospicjum Płockie" Association of St. Urszula Ledóchowska in Płock, in a stationary ward, for adults. The research group consisted of 100 people, women, and men. In the study described in this paper, the method of diagnostic survey, the method of estimation and analysis of patient records were used, and the research tools were the numerical scale of the NRS assessment, the modified Borg scale to assess dyspnea, the Trait Anxiety scale to test the intensity of anxiety and the sociodemographic assessment of the respondent. Results: Among the patients, the greatest number were people without dyspnoea (38 people) and with average levels of dyspnoea (26 people). People with lung cancer had a higher level of breathlessness than people with other cancers. Half of the patients included in the study felt anxiety at a low level. On average, men had a higher level of anxiety than women. Conclusion: 1) Patients staying in the hospice require comprehensive nursing care due to the underlying disease, comorbidities, and a wide range of medications taken, which aggravate the feeling of dyspnea and anxiety. 2) The study showed that in patients staying in the hospice, the level of dyspnea was of varying severity. The greatest number of people were without dyspnea (38) and patients with a low level of dyspnea (34). There were 12 people experiencing an average level of dyspnea and a high level of dyspnea 15. 3) The main factor influencing the severity of dyspnea in patients was the location of cancer. There was no significant relationship between the intensity of dyspnea and the age, gender of the patient, and time from diagnosis. 4) The study showed that in patients staying in the hospice, the level of anxiety was of varying severity. Most people experience a low level of anxiety (51). There were 16 people with a high level of anxiety, while there were 33 people experiencing anxiety at an average level. 5) The patient's gender was the main factor influencing the increase in anxiety intensity. Men had higher levels of anxiety than women. There was no significant correlation between the intensity of anxiety and the age of the respondents, as well as the type of cancer and time since diagnosis. 6) The intensity of dyspnea depended on the type of cancer the subjects had. People with lung cancer had a higher level of breathlessness than those with breast cancer and bowel cancer. It was not found that the anxiety increased depending on the type of cancer and comorbidities of the examined person.

Keywords: cancer, shortness of breath, anxiety, senior, hospice

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

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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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Authors: Madiha Ijaz, Muhammad Akram, Sima Mir

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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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Authors: Johnson C. Y. Pang, Bo Pengb, Kara K. L. Reevesc, Allan C. L. Fud

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Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding are potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26±5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms and quality of life (QOL), were analyzed by repeated-measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: reliability, jumping, 3D motion analysis, anterior crucial ligament reconstruction

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Authors: Tanit Daniel Jodar Vecina, Adriane Prisco Petry

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The shape of the wind velocity profile changes according to local features of terrain shape and roughness, which are parameters responsible for defining the Atmospheric Boundary Layer (ABL) profile. Air flow characteristics over and around landforms, such as hills, are of considerable importance for applications related to Wind Farm and Turbine Engineering. The air flow is accelerated on top of hills, which can represent a decisive factor for Wind Turbine placement choices. The present work focuses on the study of ABL behavior as a function of slope and surface roughness of hill-shaped landforms, using the Computational Fluid Dynamics (CFD) to build wind velocity and turbulent intensity profiles. Reynolds-Averaged Navier-Stokes (RANS) equations are closed using the SST k-ω turbulence model; numerical results are compared to experimental data measured in wind tunnel over scale models of the hills under consideration. Eight hill models with slopes varying from 25° to 68° were tested for two types of terrain categories in 2D and 3D, and two analytical codes are used to represent the inlet velocity profiles. Numerical results for the velocity profiles show differences under 4% when compared to their respective experimental data. Turbulent intensity profiles show maximum differences around 7% when compared to experimental data; this can be explained by not being possible to insert inlet turbulent intensity profiles in the simulations. Alternatively, constant values based on the averages of the turbulent intensity at the wind tunnel inlet were used.

Keywords: Atmospheric Boundary Layer, Computational Fluid Dynamic (CFD), Numerical Modeling, Wind Tunnel

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Authors: Ngo Thi Thu, Kazuo Tanaka, Masahiro Tanaka, Dao Ngoc Chien

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Nanometric superfocusing of optical intensity near the tip of partially metal- coated dielectric conical probe of the convergent surface plasmon polariton wave is investigated by the volume integral equation method. It is possible to perform nanofocusing using this probe by using both linearly and radially polarized Gaussian beams as the incident waves. Strongly localized and enhanced optical near-fields can be created on the tip of this probe for the cases of both incident Gaussian beams. However the intensity distribution near the probe tip was found to be very sensitive to the shape of the probe tip.

Keywords: waveguide, surface plasmons, electromagnetic theory

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Authors: Deepti Kumari, Upamanyu Hore

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Cities are an example of a human-modified environment with few fragments of urban green spaces, which are widely considered for urban biodiversity. The study aims to address the avifaunal diversity in urban parks based on the park size and their urbanization intensity. Also, understanding the key factors affecting species composition and structure as birds are a good indicator of a healthy ecosystem, and they are sensitive to changes in the environment. A 50 m-long line-transect method is used to survey birds in 39 urban parks in Delhi, India. Habitat variables, including vegetation (percentage of non-native trees, percentage of native trees, top canopy cover, sub-canopy cover, diameter at breast height, ground vegetation cover, shrub height) were measured using the quadrat method along the transect, and disturbance variables (distance from water, distance from road, distance from settlement, park area, visitor rate, and urbanization intensity) were measured using ArcGIS and google earth. We analyzed species data for diversity and richness. We explored the relation of species diversity and richness to habitat variables using the multi-model inference approach. Diversity and richness are found significant in different park sizes and their urbanization intensity. Medium size park supports more diversity, whereas large size park has more richness. However, diversity and richness both declined with increasing urbanization intensity. The result of CCA revealed that species composition in urban parks was positively associated with tree diameter at breast height and distance from the settlement. On the model selection approach, disturbance variables, especially distance from road, urbanization intensity, and visitors are the best predictors for the species richness of birds in urban parks. In comparison, multiple regression analysis between habitat variables and bird diversity suggested that native tree species in the park may explain the diversity pattern of birds in urban parks. Feeding guilds such as insectivores, omnivores, carnivores, granivores, and frugivores showed a significant relation with vegetation variables, while carnivores and scavenger bird species mainly responded with disturbance variables. The study highlights the importance of park size in urban areas and their urbanization intensity. It also indicates that distance from the settlement, distance from the road, urbanization intensity, visitors, diameter at breast height, and native tree species can be important determining factors for bird richness and diversity in urban parks. The study also concludes that the response of feeding guilds to vegetation and disturbance in urban parks varies. Therefore, we recommend that park size and surrounding urban matrix should be considered in order to increase bird diversity and richness in urban areas for designing and planning.

Keywords: diversity, feeding guild, urban park, urbanization intensity

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Authors: Aditya Manna

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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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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

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Authors: Kiran Bala Das

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This paper examines the Ukraine wheat export condition after Russian-Ukrainian military confrontation. The political conflict in Ukraine and the recent military intervention of Russia in Crimea is raising concern full effect of the events there is still uncertain, but some hints can be seen in the wheat market by analyzing the trend and pattern of Ukraine wheat export. Crimea is extremely important as it is where most of Ukraine grain exported by ship from its ports of the black sea. Ukraine is again seeking to establish itself a significant exporter of agricultural product with its rich black soil, it is chornozem the top soil layer that makes the country soil so fertile and become one of the major exporter of wheat in the world, its generous supplier of wheat make Ukraine 'Bread basket of Europe'. Ukraine possesses 30% of the world’s richest black soil; its agricultural industry has huge potential especially in grains. European Union (EU) is a significant trading partner of Ukraine but geopolitical tension adversely affects the wheat trade from black sea, which threatens Europe breadbasket. This study also highlights an index of export intensity to analyze the intensity of existing trade for the period 2011-2014 between Ukraine and EU countries. The result show export has intensified over the years, but this year low trade intensity. The overall consequence is hard to determine but if the situation deteriorates and Ukraine cutoff export, international wheat price will hike and grain prices (wheat) also come under the current circumstances and the recent development indicates how the grain market get affected and Agri future now in danger in Ukraine, and its forecast that Ukraine harvest low wheat crop this year and projected decline in export of wheat.

Keywords: breadbasket of Europe, export intensity index, growth rate, wheat export

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Authors: Tausif A. Ishtiaque, Zarrin T. Tasin, Kazi S. Akter

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Current trend of urban expansion, especially in the developing countries has caused significant changes in land cover, which is generating great concern due to its widespread environmental degradation. Energy consumption of the cities is also increasing with the aggravated heat island effect. Distribution of land surface temperature (LST) is one of the most significant climatic parameters affected by urban land cover change. Recent increasing trend of LST is causing elevated temperature profile of the built up area with less vegetative cover. Gradual change in land cover, especially decrease in vegetative cover is enhancing the Urban Heat Island (UHI) effect in the developing cities around the world. Increase in the amount of urban vegetation cover can be a useful solution for the reduction of UHI intensity. LST and Normalized Difference Vegetation Index (NDVI) have widely been accepted as reliable indicators of UHI and vegetation abundance respectively. Chittagong, the second largest city of Bangladesh, has been a growth center due to rapid urbanization over the last several decades. This study assesses the intensity of UHI in Chittagong city by analyzing the relationship between LST and NDVI based on the type of land use/land cover (LULC) in the study area applying an integrated approach of Geographic Information System (GIS), remote sensing (RS), and regression analysis. Land cover map is prepared through an interactive supervised classification using remotely sensed data from Landsat ETM+ image along with NDVI differencing using ArcGIS. LST and NDVI values are extracted from the same image. The regression analysis between LST and NDVI indicates that within the study area, UHI is directly correlated with LST while negatively correlated with NDVI. It interprets that surface temperature reduces with increase in vegetation cover along with reduction in UHI intensity. Moreover, there are noticeable differences in the relationship between LST and NDVI based on the type of LULC. In other words, depending on the type of land usage, increase in vegetation cover has a varying impact on the UHI intensity. This analysis will contribute to the formulation of sustainable urban land use planning decisions as well as suggesting suitable actions for mitigation of UHI intensity within the study area.

Keywords: land cover change, land surface temperature, normalized difference vegetation index, urban heat island

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