Search results for: plastic surgery

Authors: S. A. Hashemi, A. Khoshraftar

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This paper presents the influence of the vertical seismic component on the non-linear dynamics analysis of three different structures. The subject structures were analyzed and designed according to recent codes. This paper considers three types of buildings: 5-, 10-, and 15-story buildings. The non-linear dynamics analysis of the structures with assuming elastic-perfectly-plastic behavior was performed using Ram Perform-3D software; the horizontal component was taken into consideration with and without the incorporation of the corresponding vertical component. Dynamic responses obtained for the horizontal component acting alone were compared with those obtained from the simultaneous application of both seismic components. The results show that the effect of the vertical component of the ground motion may increase the axial load significantly in the interior columns and consequently, the stories. The plastic mechanisms would be changed. The P-Delta effect is expected to increase. The punching base plate shear of the columns should be considered. Moreover, the vertical component increases the input energy when the structures exhibit inelastic behavior and are taller.

Keywords: inelastic behavior, non-linear dynamic analysis, steel structure, vertical component

Procedia PDF Downloads 289

Authors: Y. Teterin, S. Suleymanova, I. Dmitriev, P. Yartcev

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Introduction: One of the most common complications after pancreas transplantation are pancreatic fluid collections (PFCs), which are often complicated not only by infection and subsequent disfunction of the pancreatoduodenal graft (PDG), but also with a rather high mortality rate of recipients. Drainage is not always effective and often requires repeated open surgical interventions, which worsens the outcome of the surgery. Percutaneous drainage of PFCs combined with endoscopic stenting of the main pancreatic duct of the pancreatoduodenal graft (MPDPDG) showed high efficiency in the treatment of PFCs. Aims & Methods: From 01.01.2012 to 31.12.2021 at the Sklifosovsky Research Institute for Emergency Medicine were performed 64 transplantations of PDG. In 11 cases (17.2%), the early postoperative period was complicated by the formation of PFCs. Of these, 7 patients underwent percutaneous drainage of pancreonecrosis with high efficiency and did not required additional methods of treatment. In the remaining 4 patients, drainage was ineffective and was an indication for endoscopic stenting of the MPDPDG. They were the ones who made up the study group. Among them were 3 men and 1 woman. The mean age of the patients was 36,4 years.PFCs in these patients formed on days 1, 12, 18, and 47 after PDG transplantation. We used a gastroscope to stent the MPDPDG, due to anatomical features of the location of the duodenoduodenal anastomosis after PDG transplantation. Through the endoscope channel was performed selective catheterization of the MPDPDG, using a catheter and a guidewire, followed by its contrasting with a water-soluble contrast agent. Due to the extravasation of the contrast, was determined the localization of the defect in the PDG duct system. After that, a plastic pancreatic stent with a diameter of 7 Fr. and a length of 7 cm. was installed along guidewire. The stent was installed in such a way that its proximal edge completely covered the defect zone, and the distal one was determined in the intestinal lumen. Results: In all patients PDG pancreaticography revealed extravasation of a contrast in the area of the isthmus and body of the pancreas, which required stenting of the MPDPDG. In 1 (25%) case, the patient had a dislocation of the stent into the intestinal lumen (III degree according to Clavien-Dindo (2009)). This patient underwent repeated endoscopic stenting of the MPDPDG. On average 23 days after endoscopic stenting of the MPDPDG, the drainage tubes were removed and after approximately 40 days all patients were discharged in a satisfactory condition with follow-up endocrinologist and surgeon consultation. Pancreatic stents were removed after 6 months ± 7 days. Conclusion: Endoscopic stenting of the main pancreatic duct of the donor pancreas is by far the most highly effective and minimally invasive method in the treatment of PFCs after transplantation of the pancreatoduodenal complex.

Keywords: pancreas transplantation, endoscopy surgery, diabetes, stenting, main pancreatic duct

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Authors: Davender Kumar, Virender Singh, Rekha Sharma

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Correction of skeletal deformities in adult patients with orthodontics is limited. In adult severe cases, the combined approach, orthodontic and orthognathic surgery, is always the treatment of choice, and the results obtained usually ensure a better esthetic, functional, and stable results Orthognathic surgery is the best option for cases when camouflage treatment is questionable and growth modulation is not possible. This case report illustrates the benefit of the team approach in correcting mandible retrusion along with class II skeletal deformity with 100% deep bite. Correction was achieved by anterior repositioning of mandible osteotomy along with orthodontic treatment. The patient's facial appearance was markedly improved along with functional and stable occlusion.

Keywords: camouflage, skeletal, orthognathic, dental

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Authors: Fatma Ahmed, Heba Mostafa, Bassem Ramdan, Azza El-Soussi

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Background: World Health Organization stated that by 2020 cardiac disease will be the number one cause of death worldwide and estimates that 25 million people per year will suffer from heart disease. Cardiac surgery is considered an effective treatment for severe forms of cardiovascular diseases that cannot be treated by medical treatment or cardiac interventions. In spite of the benefits of cardiac surgery, it is considered a major stressful experience for patients who are candidate for surgery. Prehabilitation can decrease incidences of postoperative complications as it prepares patients for surgical stress through enhancing their defenses to meet the demands of surgery. When patients anticipate the postoperative sequence of events, they will prepare themselves to act certain behaviors, identify their roles and actively participate in their own recovery, therefore, anxiety levels are decreased and functional capacity is enhanced. Prehabilitation programs can comprise interventions that include physical exercise, psychological prehabilitation, nutritional optimization and risk factor modification. Physical exercises are associated with improvements in the functioning of the various physiological systems, reflected in increased functional capacity, improved cardiac and respiratory functions and make patients fit for surgical intervention. Prehabilitation programs should also prepare patients psychologically in order to cope with stress, anxiety and depression associated with postoperative pain, fatigue, limited ability to perform the usual activities of daily living through acting in a healthy manner. Notwithstanding the benefits of psychological preparations, there are limited studies which investigated the effect of psychological prehabilitation to confirm its effect on psychological, quality of life and physiological outcomes of patients who had undergone cardiac surgery. Aim of the study: The study aims to determine the effect of prehabilitation interventions on outcomes of patients undergoing cardiac surgeries. Methods: Quasi experimental study design was used to conduct this study. Sixty eligible and consenting patients were recruited and divided into two groups: control and intervention group (30 participants in each). One tool namely emotional, physiological, clinical, cognitive and functional capacity outcomes of prehabilitation intervention assessment tool was utilized to collect the data of this study. Results: Data analysis showed significant improvement in patients' emotional state, physiological and clinical outcomes (P < 0.000) with the use of prehabilitation interventions. Conclusions: Cardiac prehabilitation in the form of providing information about surgery, circulation exercise, deep breathing exercise, incentive spirometer training and nutritional education implemented daily by patients scheduled for elective open heart surgery one week before surgery have been shown to improve patients' emotional state, physiological and clinical outcomes.

Keywords: emotional recovery, clinical recovery, coronary artery bypass grafting patients, prehabilitation

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Authors: Salman Ahmad, Muhammad Aown Sammar Raza, Muhammad Farrukh Saleem, Rashid Iqbal, Muhammad Saqlain Zaheer, Muhammad Usman Aslam, Imran Haider, Muhammad Adnan Nazar, Muhammad Ali

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Among the various abiotic stresses, drought stress is one of the most challenging for field crops. Wheat is one of the major staple food of the world, which is highly affected by water deficit stress in the current scenario of climate change. In order to ensure food security by depleting water resources, there is an urgent need to adopt technologies which result in sufficient crop yield with less water consumption. Mulching and partial rootzone drying (PRD) are two important management techniques used for water conservation and to mitigate the negative impacts of drought. The experiment was conducted to screen out the best-suited mulch for wheat under PRD system. Two water application techniques (I1= full irrigation I2= PRD irrigation) and four mulch treatments (M0= un-mulched, M1= black plastic mulch, M2= wheat straw mulch and M4= cotton sticks mulch) were conducted in completely randomized design with four replications. The treatment, black plastic mulch was performed the best than other mulch treatments. For irrigation levels, higher values of growth, physiological and water-related parameters were recorded in control treatment while, quality traits and enzymatic activities were higher under partial root zone drying. The current study concluded that adverse effects of drought on wheat can be significantly mitigated by using mulches but black plastic mulch was best suited for partial rootzone drying irrigation system in wheat.

Keywords: antioxidants, leaf water relations, Mulches, osmolytes, partial root zone drying, photosynthesis

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Authors: Ana Claudia Muniz Rennó, Karina Nogueira

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This study aimed to investigate the in vivo tissue response of the introduction of the bioactive mesh (BM) scaffolds using a model of tibial bone defect implants in rats. Although a previous in vivo study demonstrated a highly positive response of particulate bioactive materials in the morphological and biomechanical properties of the bone callus, the effects of material with superior bioactivity, present in form of meshes have not been studied yet. Eighty male Wistar rats with 3 mm tibial defects were used. Animals were divided into four groups: intact group (IG) – tibia without any injury; bone defect day zero (0dD) – bone defects, sacrificed immediately after injury; bone defect control group (CG) – bone defects without any filler and bone defect filled with BM scaffold. The animals of BM and CG groups were sacrificed 15, 30 and 45 days post-injury to compare the temporal-special effects of the scaffolds on bone healing. The histological analysis revealed an organized newly formed bone at 30 and 45 days post-surgery in the BM. Also, this group presented an increased COX-2 expression on days 15 and 30 post-surgery. Furthermore, the immunohistochemistry analysis revealed that, BM presented a positive immunoexpression of RUNX-2 during all periods evaluated. The biomechanical analysis revealed that at 15 day after surgery, no significant statistically difference was observed between BM and CG and both groups had significantly higher values of maximal load compared to 0dG and significantly lower values than IG. On days 30 and 45 post-surgery, BM presented statistically lower values of maximal load compared to the CG. Nevertheless, at the same periods, BM did not show statistically significant difference compared to the IG maximal load values (p > 0, 05). Our results revealed that the implantation of the BM scaffolds was effective in stimulating newly bone formation.

Keywords: bone, biomaterials, scaffolds, cartilage

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Authors: M. Sulieman, H. Arabiyat, H. Ali, K. Potiszil, I. Abbas, R. English, P. King, I. Brown, P. Drew

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Introduction: The incidence of breast ductal Carcinoma in Situ (DCIS) has been increasing; it currently represents up 20-25% of all breast carcinomas. Some aspects of DCIS management are still controversial, mainly due to the heterogeneity of its clinical presentation and of its biological and pathological characteristics. In DCIS, histological diagnosis obtained preoperatively, carries the risk of sampling error if the presence of invasive cancer is subsequently diagnosed. The mammographic extent over than 4–5 cm and the presence of architectural distortion, focal asymmetric density or mass on mammography are proven important risk factors of preoperative histological under staging. Intracystic papillary cancer (IPC) is a rare form of breast carcinoma. Despite being previously compared to DCIS it has been shown to present histologically with invasion of the basement membrane and even metastasis. SLNB – Carries the risk of associated comorbidity that should be considered when planning surgery for DCIS and IPC. Objectives: The aim of this Audit was to better define a ‘high risk’ group of patients with pre-op diagnosis of non-invasive cancer undergoing breast conserving surgery, who would benefit from sentinel node biopsy. Method: Retrospective data collection of all patients with ductal carcinoma in situ over 5 years. 636 patients identified, and after exclusion criteria applied: 394 patients were included. High risk defined as: Extensive micro-calcification >40mm OR any mass forming DCIS. IPC: Winpath search from for the term ‘papillary carcinoma’ in any breast specimen for 5 years duration;.29 patients were included in this group. Results: DCIS: 188 deemed high risk due to >40mm calcification or a mass forming (radiological or palpable) 61% of those had a mastectomy and 32% BCS. Overall, in that high-risk group - the number with invasive disease was 38%. Of those high-risk DCIS pts 85% had a SLN - 80% at the time of surgery and 5% at a second operation. For the BCS patients - 42% had SLN at time of surgery and 13% (8 patients) at a second operation. 15 (7.9%) pts in the high-risk group had a positive SLNB, 11 having a mastectomy and 4 having BCS. IPC: The provisional diagnosis of encysted papillary carcinoma is upgraded to an invasive carcinoma on final histology in around a third of cases. This has may have implications when deciding whether to offer sentinel node removal at the time of therapeutic surgery. Conclusions: We have defined a ‘high risk’ group of pts with pre-op diagnosis of non-invasive cancer undergoing BCS, who would benefit from SLNB at the time of the surgery. In patients with high-risk features; the risk of invasive disease is up to 40% but the risk of nodal involvement is approximately 8%. The risk of morbidity from SLN is up to about 5% especially the risk of lymphedema.

Keywords: breast ductal carcinoma in Situ (DCIS), intracystic papillary carcinoma (IPC), sentinel node biopsy (SLNB), high-risk, non-invasive, cancer disease

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Authors: Anek Apipatkul, Paphakorn Pitayachaval

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Preventive maintenance is a standardized procedure to control and prevent risky problems affecting production in order to increase work efficiency. Machine monitoring also routinely works to collect data for a scheduling maintenance period. This paper is to present the application of machine monitoring by using the internet of things (IOTs) and a lean technique in order to manage with complex maintenance tasks of an automated plastic granule packing machine. To organize the preventive maintenance, there are several processes that the machine monitoring was applied, starting with defining a clear scope of the machine, establishing standards in maintenance work, applying a just-in-time (JIT) technique for timely delivery in the maintenance work, solving problems on the floor, and also improving the inspection process. The result has shown that wasted time was reduced, and machines have been operated as scheduled. Furthermore, the efficiency of the scheduled maintenance period was increased by 95%.

Keywords: internet of things, preventive maintenance, machine monitoring, lean technique

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Authors: Rassoli Aisa, Abrishami Movahhed Arezu, Faturaee Nasser, Seddighi Amir Saeed, Shafigh Mohammad

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Cardiovascular diseases are one of the most common causes of mortality in developed countries. Coronary artery abnormalities and carotid artery stenosis, also known as silent death, are among these diseases. One of the treatment methods for these diseases is to create a deviatory pathway to conduct blood into the heart through a bypass surgery. The saphenous vein is usually used in this surgery to create the deviatory pathway. Unfortunately, a re-surgery will be necessary after some years due to ignoring the disagreement of mechanical properties of graft tissue and/or applied prostheses with those of host tissue. The objective of the present study is to clarify the viscoelastic behavior of human saphenous tissue. The stress relaxation tests in circumferential and longitudinal direction were done in this vein by exerting 20% and 50% strains. Considering the stress relaxation curves obtained from stress relaxation tests and the coefficients of the standard solid model, it was demonstrated that the saphenous vein has a non-linear viscoelastic behavior. Thereafter, the fitting with Fung’s quasilinear viscoelastic (QLV) model was performed based on stress relaxation time curves. Finally, the coefficients of Fung’s QLV model, which models the behavior of saphenous tissue very well, were presented.

Keywords: Viscoelastic behavior, stress relaxation test, uniaxial tensile test, Fung’s quasilinear viscoelastic (QLV) model, strain rate

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Authors: Waseem Akram, Hafiz Azhar Ali Khan

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Unplanned urbanization together with change in life from simple to more technologically advanced style with flow of rural masses to urban areas has played a vital role in pilling loads of solid wastes in our environment. The cities and towns have expanded beyond boundaries. Even the uncontrolled population expansion has caused the overall environmental burden. Thus, today the indifference remains as one of the biggest trash that has come up due to the non-responsive behavior of the people. Everyday huge amount of solid waste is thrown in the streets, on the roads, parks, and in all those places that are frequently and often visited by the human beings. This behavior based response in many countries of the world has led to serious health concerns and environmental issues. Over 80% of our products that are sold in the market are packed in plastic bags. None of the bags are later recycled but simply become a permanent environment concern that flies, choke lines or are burnt and release toxic gases in the environment or form dumps of heaps. Lack of classification of the daily waste generated from houses and other places lead to worst clogging of the sewerage lines and formation of ponding areas which ultimately favor vector borne disease and sometimes become a cause of transmission of polio virus. Solid waste heaps were checked at different places of the cities. All of the wastes on visual assessments were classified into plastic bags, papers, broken plastic pots, clay pots, steel boxes, wrappers etc. All solid waste dumping sites in the cities and wastes that were thrown outside of the trash containers usually contained wrappers, plastic bags, and unconsumed food products. Insect populations seen in these sites included the house flies, bugs, cockroaches and mosquito larvae breeding in water filled wrappers, containers or plastic bags. The population of the mosquitoes, cockroaches and houseflies were relatively very high in dumping sites close to human population. This population has been associated with cases like dengue, malaria, dysentery, gastro and also to skin allergies during the monsoon and summer season. Thus, dumping of the huge amount of solid wastes in and near the residential areas results into serious environmental concerns, bad smell circulation, and health related issues. In some places, the same waste is burnt to get rid of mosquitoes through smoke which ultimately releases toxic material in the atmosphere. Therefore, a proper environmental strategy is needed to minimize environmental burden and promote concepts of recycled products and thus, reduce the disease burden.

Keywords: solid waste accumulation, disease burden, mosquitoes, vector borne diseases

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Authors: Devina Jain

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The choice between single-use drinking glasses and reusable glasses is of major concern to our lifestyles, and hence, the environment. This study is aimed at comparing three systems - a disposable paper cup, a disposable cup and a reusable stainless steel cup or glass - with respect to their effect on the environment to find out which one is more advantageous for reducing the impact on the environment. Life Cycle Assessment was conducted using modeling software, Umberto NXT Universal (Version 7.1). For the purpose of this study, the cradle to grave approach was considered. Results showed that cleaning is of a very strong influence on the environmental burden by these drinking systems, with a contribution of up to 90 to 100%. Thus, the burden is determined by the way in which the utensils are washed, and how much water is consumed. It maybe seems like a small, insignificant daily practice. In the short term, it would seem that paper and plastic cups are a better idea, since they are easy to acquire and do not need to be stored, but in the long run, we can say that steel cups will have less of an environmental impact. However, if the frequency of use and the number of glasses employed per use are of significance to decide the appropriateness of the usage, it is better to use disposable cups and glasses.

Keywords: disposable glass, life cycle assessment, paper, plastic, reusable glass, stainless steel

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Authors: Keiko Yamauchi, Motoyuki Nakao, Yoko Ishihara

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The increase in the number of women with breast cancer in Japan has required hospitals to provide a higher quality of medicine so that patients are satisfied with the treatment they receive. However, patients’ satisfaction following breast cancer treatment has not been sufficiently studied. Hence, we investigated the factors influencing patient satisfaction following breast cancer treatment among Japanese women. These women underwent either breast-conserving surgery (BCS) (n = 380) or total mastectomy (TM) (n = 247). In March 2016, we conducted a cross-sectional internet survey of Japanese women with breast cancer in Japan. We assessed the following factors: socioeconomic status, cancer-related information, the role of medical decision-making, the degree of satisfaction regarding the treatments received, and the regret arising from the medical decision-making processes. We performed logistic regression analyses with the following dependent variables: extreme satisfaction with the treatments received, and regret regarding the medical decision-making process. For both types of surgery, the odds ratio (OR) of being extremely satisfied with the cancer treatment was significantly higher among patients who did not have any regrets compared to patients who had. Also, the OR tended to be higher among patients who chose to play a wanted role in the medical decision-making process, compared with patients who did not. In the BCS group, the OR of being extremely satisfied with the treatment was higher if, at diagnosis, the patient’s youngest child was older than 19 years, compared with patients with no children. The OR was also higher if patient considered the stage and characteristics of their cancer significant. The OR of being extremely satisfied with the treatments was lower among patients who were not employed on full-time basis, and among patients who considered the second medical opinions and medical expenses to be significant. These associations were not observed in the TM group. The OR of having regrets regarding the medical decision-making process was higher among patients who chose to play a role in the decision-making process as they preferred, and was also higher in patients who were employed on either a part-time or contractual basis. For both types of surgery, the OR was higher among patients who considered a second medical opinion to be significant. Regardless of surgical type, regret regarding the medical decision-making process decreases treatment satisfaction. Patients who received breast-conserving surgery were more likely to have regrets concerning the medical decision-making process if they could not play a role in the process as they preferred. In addition, factors associated with the satisfaction with treatment in BCS group but not TM group included the second medical opinion, medical expenses, employment status, and age of the youngest child at diagnosis.

Keywords: medical decision making, breast-conserving surgery, total mastectomy, Japanese

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Authors: Derin Ureten

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Plastic pollution does not disappear, it gets smaller and smaller through photolysis which are caused mainly by sun’s radiation, thermal oxidation, thermal degradation, and biodegradation which is the action of organisms digesting larger plastics. All plastic pollutants have exceedingly harmful effects on the environment. Together with the COVID-19 pandemic, the number of plastic products such as masks and gloves flowing into the environment has increased more than ever. However, microplastics are not the only pollutants in water, one of the most tenacious and toxic pollutants are heavy metals. Heavy metal solutions are also capable of causing varieties of health problems in organisms such as cancer, organ damage, nervous system damage, and even death. The aim of this research is to prove that microplastics can be used in wastewater treatment systems by proving that they could adsorb heavy metals in solutions. Experiment for this research will include two heavy metal solutions; one including microplastics in a heavy metal contaminated water solution, and one that just includes heavy metal solution. After being sieved, absorbance of both mediums will be measured with the help of a spectrometer. Iron (III) chloride (FeCl3) will be used as the heavy metal solution since the solution becomes darker as the presence of this substance increases. The experiment will be supported by Pure Nile Red powder in order to observe if there are any visible differences under the microscope. Pure Nile Red powder is a chemical that binds to hydrophobic materials such as plastics and lipids. If proof of adsorbance could be observed by the rates of the solutions' final absorbance rates and visuals ensured by the Pure Nile Red powder, the experiment will be conducted with different temperature levels in order to analyze the most accurate temperature level to proceed with removal of heavy metals from water. New wastewater treatment systems could be generated with the help of microplastics, for water contaminated with heavy metals.

Keywords: microplastics, heavy metal, pollution, adsorbance, wastewater treatment

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Authors: M. Benachour, N. Benachour, M. Benguediab

Abstract:

In this investigation, variation of cyclic loading effect on fatigue crack growth is studied. This study is performed on 2024 T351 and 7050-T74 aluminum alloys, used in aeronautical structures. The propagation model used in this study is NASGRO model. In constant amplitude loading (CA), the effect of stress ratio has been investigated. Fatigue life and fatigue crack growth rate were affected by this factor. Results showed an increasing in fatigue crack growth rates (FCGRs) with increasing stress ratio. Variable amplitude loading (VAL) can take many forms i.e with a single overload, overload band etc. The shape of these loads affects strongly the fracture life and FCGRs. The application of a single overload (ORL) decrease the FCGR and increase the delay crack length caused by the formation of a larger plastic zone compared to the plastic zone due without VAL. The fatigue behavior of the both material under single overload has been compared.

Keywords: fatigue crack growth, overload ratio, stress ratio, generalized willenborg model, retardation, al-alloys

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Authors: R. M. S. Sachini Amararathne

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This research is striving to develop a thermo degradable starch plastic compound/ masterbatch for industrial packaging applications. A native corn starch-modified with an esterification reaction of lauric acid is melt blent with an unsaturated elastomer (styrene-butadiene-rubber/styrene-butadiene-styrene). A trace amount of metal salt is added into the internal mixer to study the effect of pro-oxidants in a thermo oxidative environment. Then the granulated polymer composite which is consisted with 80-86% of polyolefin (LLDP/LDPE/PP) as the pivotal agent; is extruded with processing aids, antioxidants and some other additives in a co-rotating twin-screw extruder. The pelletized composite is subjected to compression molding/ Injection molding or blown film extrusion processes to acquire the samples/specimen for tests. The degradation process is explicated by analyzing the results of fourier transform infrared spectroscopy (FTIR) measurements, thermo oxidative aging studies (placing the dumb-bell specimen in an air oven at 70 °C for four weeks of exposure.) governed by tensile and impact strength test reports. Furthermore, the samples were elicited into manifold outdoors to inspect the degradation process. This industrial process is implemented to reduce the volume of fossil-based garbage by achieving the biodegradability and compostability in the natural cycle. Hence the research leads to manufacturing a degradable plastic packaging compound which is now available in the Sri Lankan market.

Keywords: blown film extrusion, compression moulding, polyolefin, pro-oxidant, styrene-butadine-rubber, styrene-butadiene-styrene, thermo oxidative aging, unsaturated elastomer

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Authors: Perry Ayi Mankattah

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Introduction: Africa, which should lead the world in honey production, is importing three times the honey it produces even though it has a healthy, industrious and large population of bees. This is due to the mechanism of honey harvesting that destroys the combs and thereby reducing honey production and rate of harvesting. For Africa to take its place in the world of honey production, Africa should adopt a method that enables a higher rate of honey harvesting. The Advance Top Bar is, therefore, a simplified framework that provides that answer. It can be made of wood, plastic and metal that can be fabricated by tin/metal smiths, wielders and carpenters at the village level without any very sophisticated machines. Material and Methods: ATB is a top bar-like hollow framework of dimension 3.2*48 cm that can be made of wood, plastic and metal. It is made up of three parts of a constant hollow top bar, a variable grooved bottom bar with both bars being joined through synchronized holes (that align both the top and bottom bars ) by either metal or plastic rods of length 22cm and diameter of 5 mm with rounded balls at both ends It could be used with foundation combs or without and also other accessories to have about ten (10) function which includes commercial propolis harvesting queen rearing etc. The variable bottom bar length depends on the width of the hive, as most African beehives are somehow not standardized. Results: Foundation combs are placed within the Advance Top Bar for the bees to form their combs over its mesh to prevent comb breakage during honey harvesting. Similarly, honeycombs on top bars will produce natural foundation combs when also placed in the Advance top bar system just as they are re-used in the Langstroth Frames. Discussions and Conclusions: Any modification that will promote non-comb destruction during honey harvesting in Top bars shall cause Africa to increase honey production by over 100% as beekeepers adopt the mechanism. Honey-laden combs from the current normal top bars could be placed in the Advance Top Bar to harvest without comb destruction; hence the same system could be used as a transition to the adoption of the Advance Top Bar with less cost.

Keywords: honey, harvest, increase, production

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Authors: Rajib Husain, Munirujzaman Osmani, Mohammad Shamsal Islam

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Purpose: To compare the safety, efficacy and visual outcome of phacoemulsification vs. manual small-incision cataract surgery (SICS) for the treatment of cataract in Bangladesh. Objectives: 1. To assess the Visual outcome after cataract surgery 2. To understand the post-operative complications and early rehabilitation 3. To identified which surgical procedure more attractive to the patients 4. To identify which surgical procedure is occurred fewer complications. 5. To find out the socio-economic and demographic characteristics of study patients Setting: Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh. Design: Retrospective, randomised comparison of 300 patients with visually significant cataracts. Method: The present study was designed as a retrospective hospital-based research. The sample size was 300 and study period was from July, 2012 to July, 2013 and assigned randomly to receive either phacoemulsification or manual small-incision cataract surgery (SICS). Preoperative and post-operative data were collected through a well designed collection format. Three follow-up were done; i) during discharge ii) 1-3 weeks & iii) 4-11 weeks post operatively. All preoperative and surgical complications, uncorrected and best-corrected visual acuity (BCVA) and astigmatism were taken into consideration for comparison of outcome Result: Nearly 95% patients were more than 40 years of age. About 52% patients were female, and 48% were male. 52% (N=157) patients came to operate their first eye where 48% (N=143) patients were visited again to operate their second eye. Postoperatively, five eyes (3.33%) developed corneal oedema with >10 Descemets folds, and six eyes (4%) had corneal oedema with <10 Descemets folds for Phacoemulsification surgeries. For SICS surgeries, seven eyes (4.66%) developed corneal oedema with >10 Descemets folds and eight eyes (5.33%) had corneal oedema with < 10 descemets folds. However, both the uncorrected and corrected (4-11 weeks) visual acuities were better in the eyes that had phacoemulsification (p=0.02 and p=0.03), and there was less astigmatism (p=0.001) at 4-11 weeks in the eye that had phacoemulsification. Best-corrected visual acuity (BCVA) of final follow-up 95% (N=253) had a good outcome, borderline 3.10% (N=40) and poor outcome was 1.6% (N=7). The individual surgeon outcome were closer, 95% (BCVA) in SICS and 96% (BCVA) in Phacoemulsification at 4-11 weeks follow-up respectively. Conclusion: outcome of cataract surgery both Phacoemulsification and SICS in CEITC was more satisfactory according to who norms. Both Phacoemulsification and manual small-incision cataract surgery (SICS) shows excellent visual outcomes with low complication rates and good rehabilitation. Phacoemulsification is significantly faster, and modern technology based surgical procedure for cataract treatment.

Keywords: phacoemulsification, SICS, cataract, Bangladesh, visual outcome of SICS

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Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao

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The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.

Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery

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Authors: Khosro Barkhordari, Fateme Sadr, Mina Pashang

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Back ground: Blood transfusion is one of the major issues in cardiac surgery patients. Transfusing patients based on fixed cut-off points of hemoglobin is the current protocol in most institutions. The hemoglobin level of 7- 10 has been suggested for blood transfusion in cardiac surgery patients. We aimed to evaluate if blood transfusion based on change in percentage of hematocrit has different outcomes. Methods: In this retrospective cohort study, we investigated the early postoperative outcome of cardiac surgery patients who received blood transfusions at Tehran Heart Center Hospital, IRAN. We reviewed and analyzed the basic characteristics and clinical data of 700 patients who met our exclusion and inclusion criteria. The two groups of blood transfused patients were compared, those who have 30-50 percent decrease in basal hematocrit versus those with 10 -29 percent decrease. Results: This is ongoing study, and the results would be completed in two weeks after analysis of the date. Conclusion: Early analysis has shown no difference in early post-operative outcomes between the two groups, but final analysis will be completed in two weeks. 1-Department of Anesthesiology and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IRAN 2- Department of Research, Tehran Heart Center, Tehran, IRAN Quantitative variables were compared using the Student t-test or the Mann‐Whitney U test, as appropriate, while categorical variables were compared using the χ2 or the Fisher exact test, as required. Our intention was to compare the early postoperative outcomes between the two groups, which include 30 days mortality, Length of ICU stay, Length of hospital stay, Intubation time, Infection rate, acute kidney injury, and respiratory complications. The main goal was to find if transfusing blood based on changes in hematocrit from a basal level was better than to fixed cut-off point regarding early post-operative outcomes. This has not been studied enough and may need randomized control trials.

Keywords: post-operative, cardiac surgery, outcomes, blood transfusion

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Authors: Rafael Ricieri, Rogerio Barros

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Objective: This study is to report a case of massive necrotizing enterocolitis in a six-month-old patient, requiring ileostomy and protective jejunostomy as a damage control measure in the first exploratory laparotomy surgery in massive enterocolitis without a previous diagnosis. Methods: This study is a case report of success in making and closing a protective jejunostomy. However, the low number of publications on this staged and risky measure of surgical resolution encouraged the team to study the indication and especially the correct time for closing the patient's protective jejunostomy. The main study instrument will be the six-month-old patient's medical record. Results: Based on the observation of the case described, it was observed that the time for the closure of the described procedure (protective jejunostomy) varies according to the level of compromise of the health status of your patient and of an individual of each person. Early closure, or failure to close, can lead to a favorable problem for the patient since several problems can result from this closure, such as new intestinal perforations, hydroelectrolyte disturbances. Despite the risk of new perforations, we suggest closing the protective jejunostomy around the 14th day of the procedure, thus keeping the patient on broad-spectrum antibiotic therapy and absolute fasting, thus reducing the chances of new intestinal perforations. Associated with the closure of the jejunostomy, a gastric tube for decompression is necessary, and care in an intensive care unit and electrolyte replacement is necessary to maintain the stability of the case.

Keywords: jejunostomy, ileostomy, enterocolitis, pediatric surgery, gastric surgery

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Authors: C. Kuoh, C. Lucas, T. Lopes, I. Mechie, J. Yoong, W. Yoong

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For all surgeons, there is one preventable but still highly occurring complication – wrong site surgeries. They can have potentially catastrophic, irreversible, or even fatal consequences on patients. With the exponential development of microsurgery and the use of advanced technological tools, the consequences of operating on the wrong side, anatomical part, or even person is seen as the most visible and destructive of all surgical errors and perhaps the error that is dreaded by most clinicians as it threatens their licenses and arouses feelings of guilt. Despite the implementation of the WHO surgical safety checklist more than a decade ago, the incidence of wrong-site surgeries remains relatively high, leading to tremendous physical and psychological repercussions for the clinicians involved, as well as a financial burden for the healthcare institution. In this presentation, the authors explore various factors which can lead to wrong site surgery – a combination of environmental and human factors and evaluate their impact amongst patients, practitioners, their families, and the medical industry. Major contributing factors to these “never events” include deviations from checklists, excessive workload, and poor communication. Two real-life cases are discussed, and systems that can be implemented to prevent these errors are highlighted alongside lessons learnt from other industries. The authors suggest that reinforcing speaking-up, implementing medical professional trainings, and higher patient’s involvements can potentially improve safety in surgeries and electrosurgeries.

Keywords: wrong side surgery, never events, checklist, workload, communication

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Authors: Muna Al-Tarshi

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The distribution and accumulation dynamics of anthropogenic marine debris (AMD) and microplastic particles in mangrove habitats in the region are poorly understood. The abundance, sorting, and diversity aspects of AMD and microplastics were investigated in three types of mangroves creeks ( Natural mangrove, afforested mangrove, and non-planted). Abundance, concentration, and particles form of microplastics have been illustrated in three substrate in mangrove habitats e.g. sediment, water, and aquatic organisms. Density separation method by using highly saturated solution was implemented to extract the plastic particles from the sediment samples. The average size of particles in each transect was done using image software, and the polymer type was determined via FTIR. There was variability in abundance of microplastics and marine debris between the habitats and within the substrates in the habitats.Biomonitoring program was developed to detect the pollution of microplastics in mangrove habitats in Sultanate of Oman. Sediment dwelling species were the best choice. Testing whether the zooplankton (Artemia) eating the microplastics via FlowCam technique have been studied. The zooplanktons (Artemia) were eating the microplastics as mistaken food.

Keywords: microplastics, marine debris, flowcam, FTIR, polymer, artemia

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Authors: Rona Lee Suelo-Calanao, Mahmoud Loubani

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Objective: Sternal wound infection (SWI) following cardiac operation has a significant impact on patient morbidity and mortality. It also contributes to longer hospital stays and increased treatment costs. SWI management is mainly focused on treatment rather than prevention. This study looks at the effect of closed incision negative pressure therapy (ciNPT) dressing to help reduce the incidence of superficial SWI in high-risk patients after cardiac surgery. The ciNPT dressing was evaluated at 3 cardiac hospitals in the United Kingdom". Methods: All patients who had cardiac surgery from 2013 to 2021 were included in the study. The patients were classed as high risk if they have two or more of the recognised risk factors: obesity, age above 80 years old, diabetes, and chronic obstructive pulmonary disease. Patients receiving standard dressing (SD) and patients using ciNPT were propensity matched, and the Fisher’s exact test (two-tailed) and unpaired T-test were used to analyse categorical and continuous data, respectively. Results: There were 766 matched cases in each group. Total SWI incidences are lower in the ciNPT group compared to the SD group (43 (5.6%) vs 119 (15.5%), P=0.0001). There are fewer deep sternal wound infections (14(1.8%) vs. 31(4.04%), p=0.0149) and fewer superficial infections (29(3.7%) vs. 88 (11.4%), p=0.0001) in the ciNPT group compared to the SD group. However, the ciNPT group showed a longer average length of stay (11.23 ± 13 days versus 9.66 ± 10 days; p=0.0083) and higher mean logistic EuroSCORE (11.143 ± 13 versus 8.094 ± 11; p=0.0001). Conclusion: Utilization of ciNPT as an approach to help reduce the incidence of superficial and deep SWI may be effective in high-risk patients requiring cardiac surgery.

Keywords: closed incision negative pressure therapy, surgical wound infection, cardiac surgery complication, high risk cardiac patients

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Authors: Mehrdad Taghipour, Mina Rostami, Mahdi Eskandarlou

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Partial-thickness skin graft is the cornerstone for scalp defect repair. Given the potential side effects following harvesting from these sites, this study aimed to compare the outcomes of graft harvesting from scalp and lower limb. This clinical trial was conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to Plastic Surgery Clinic at Besat Hospital, Hamadan, Iran during 2018-2019. Sampling was done by simple randomization using random digit table. The donor site in case group and control group was scalp and lower limb respectively. Overall, 28 patients (70%) were male and 12 (30%) were female. Basal cell carcinoma (BCC) and trauma were the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The mean diameter of defect was 24.28±45.37 mm for all of the patients. The difference between diameters of defect in both groups were statistically meaningful while no such difference between graft diameters was seen. The graft “Take” was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale and the satisfaction was higher in them per Likert scale. Scalp can safely be used as donor site for skin graft to be used for scalp defects associated with better results and lower complication rates compared to other donor sites.

Keywords: donor site, graft, scalp, partial thickness

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Authors: Amit K. Mishra, Jaswant Singh

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The menace of plastic, which significantly pollutes the aquatic environment, has emerged as a global problem. There is an emerging concern about microplastics (MPs) accumulation in aquatic ecosystems. It is familiar to everyone that the ultimate end for most of the plastic debris is the ocean. Rivers are the efficient carriers for transferring MPs from terrestrial to aquatic, further from upstream to downstream areas, and ultimately to oceans. The root cause study can provide an effective solution to a problem; hence, tracing of MPs in the riverine system can illustrate the long-term microplastic pollution. This study aimed to investigate the occurrence and distribution of microplastic contamination in surface water and sediment of the two major river systems of Uttar Pradesh, India. One is the Gomti River, Lucknow, a tributary of the Ganga, and the second is the Saryu River, the lower part of the Ghagra River, which flows through the city of Ayodhya. In this study, the distribution and abundance of MPs in surface water and sediments of two rivers were compared. Samples of water and sediment were collected from different (four from each river) sampling stations in the river catchment of two rivers. Plastic particles were classified according to type, shape, and color. In this study, 1523 (average abundance 254) and 143 (average abundance 26) microplastics were identified in all studied sites in the Gomati River and Saryu River, respectively. Observations on samples of water showed that the average MPs concentration was 392 (±69.6) and 63 ((±18.9) particles per 50l of water, whereas the sediment sample showed that the average MPs concentration was 116 (±42.9) and 46 (±12.5) particles per 250gm of dry sediment in the Gomati River and Saryu River, respectively. The high concentration of microplastics in the Lucknow area can be attributed to human activities, population density, and the entry of various effluents into the river. Microplastics with fibrous shapes were dominated, followed by fragment shapes in all the samples. The present study is a pioneering effort to count MPs in the Gomati and Saryu River systems.

Keywords: freshwater, Gomati, microplastics, Saryu, sediment

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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: Saman Namvarrechi, Armin A. Dormeny, Javad Dargahi, Mojtaba Kahrizi

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Since last two decades, minimally invasive surgery (MIS) has grown significantly due to its advantages compared to the traditional open surgery like less physical pain, faster recovery time and better healing condition around incision regions; however, one of the important challenges in MIS is getting an effective sensing feedback within the patient’s body during operations. Therefore, surgeons need efficient tactile sensing like determining the hardness of contact tissue for investigating the patient’s health condition. In such a case, MIS tactile sensors are preferred to be able to provide force/pressure sensing, force position, lump detection, and softness sensing. Among different pressure sensor technologies, the piezoelectric operating principle is the fittest for MIS’s instruments, such as catheters. Using PVDF with its copolymer, TrFE, as a piezoelectric material, is a common method of design and fabrication of a tactile sensor due to its ease of implantation and biocompatibility. In this research, PVDF-TrFE polymer is deposited via spin-coating method and treated with various post-deposition processes to investigate its piezoelectricity and amount of electroactive β phase. These processes include different post thermal annealing, the effect of spin-coating speed, different layer of deposition, and the presence of additional hydrate salt. According to FTIR spectroscopy and SEM images, the amount of the β phase and porosity of each sample is determined. In addition, the optimum experimental study is established by considering every aspect of the fabrication process. This study clearly shows the effective way of deposition and fabrication of a tactile PVDF-TrFE based sensor and an enhancement methodology to have a higher β phase and piezoelectric constant in order to have a better sense of touch at the end effector of biomedical devices.

Keywords: β phase, minimally invasive surgery, piezoelectricity, PVDF-TrFE, tactile sensor

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Authors: Hasan Atakan Sengul, Nergis Canturk, Bahar Erbas

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Drinking water is indispensable for life. With increasing awareness of communities, the content of drinking water and tap water has been a matter of curiosity. The presence of Bisphenol-A is the top one when content curiosity is concerned. The most used chemical worldwide for production of polycarbonate plastics and epoxy resins is Bisphenol-A. People are exposed to Bisphenol-A chemical, which disrupts the endocrine system, almost every day. Each year it is manufactured an average of 5.4 billion kilograms of Bisphenol-A. Linear formula of Bisphenol-A is (CH₃)₂C(C₆H₄OH)₂, its molecular weight is 228.29 and CAS number is 80-05-7. Bisphenol-A is known to be used in the manufacturing of plastics, along with various chemicals. Bisphenol-A, an industrial chemical, is used in the raw materials of packaging mate-rials in the monomers of polycarbonate and epoxy resins. The pass through the nutrients of Bisphenol-A substance happens by packaging. This substance contaminates with nutrition and penetrates into body by consuming. International researches show that BPA is transported through body fluids, leading to hormonal disorders in animals. Experimental studies on animals report that BPA exposure also affects the gender of the newborn and its time to reach adolescence. The extent to what similar endocrine disrupting effects are on humans is a debate topic in many researches. In our country, detailed studies on BPA have not been done. However, it is observed that 'BPA-free' phrases are beginning to appear on plastic packaging such as baby products and water carboys. Accordingly, this situation increases the interest of the society about the subject; yet it causes information pollution. In our country, all national and international studies on exposure to BPA have been examined and Ankara province has been designated as testing region. To assess the effects of plastic use in daily habits of people and the plastic amounts removed out of the body, the results of the survey conducted with volunteers who live in Ankara has been analyzed with Sciex appliance by means of LC-MS/MS in the laboratory and the amount of exposure and BPA removal have been detected by comparing the results elicited before. The results have been compared with similar studies done in international arena and the relation between them has been exhibited. Consequently, there has been found no linear correlation between the amount of BPA in drinking water and the amount of BPA in urine. This has also revealed that environmental exposure and the habits of daily plastic use have also direct effects a human body. When the amount of BPA in drinking water is considered; minimum 0.028 µg/L, maximum 1.136 µg/L, mean 0.29194 µg/L and SD(standard deviation)= 0.199 have been detected. When the amount of BPA in urine is considered; minimum 0.028 µg/L, maximum 0.48 µg/L, mean 0.19181 µg/L and SD= 0.099 have been detected. In conclusion, there has been found no linear correlation between the amount of BPA in drinking water and the amount of BPA in urine (r= -0.151). The p value of the comparison between drinking water’s and urine’s BPA amounts is 0.004 which shows that there is a significant change and the amounts of BPA in urine is dependent on the amounts in drinking waters (p < 0.05). This has revealed that environmental exposure and daily plastic habits have also direct effects on the human body.

Keywords: analyze of bisphenol-A, BPA, BPA in drinking water, BPA in urine

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Authors: Alok Madan, Arshad K. Hashmi

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The paper presents a plastic analysis procedure based on the energy balance concept for performance based seismic retrofit of multi-story multi-bay masonry infilled reinforced concrete (R/C) frames with a ‘soft’ ground story using passive energy dissipation (PED) devices with the objective of achieving a target performance level of the retrofitted R/C frame for a given seismic hazard level at the building site. The proposed energy based plastic analysis procedure was employed for developing performance based design (PBD) formulations for PED devices for a simulated application in seismic retrofit of existing frame structures designed in compliance with the prevalent standard codes of practice. The PBD formulations developed for PED devices were implemented for simulated seismic retrofit of a representative code-compliant masonry infilled R/C frame with a ‘soft’ ground story using friction dampers as the PED device. Non-linear dynamic analyses of the retrofitted masonry infilled R/C frames is performed to investigate the efficacy and accuracy of the proposed energy based plastic analysis procedure in achieving the target performance level under design level earthquakes. Results of non-linear dynamic analyses demonstrate that the maximum inter-story drifts in the masonry infilled R/C frames with a ‘soft’ ground story that is retrofitted with the friction dampers designed using the proposed PBD formulations are controlled within the target drifts under near-field as well far-field earthquakes.

Keywords: energy methods, masonry infilled frame, near-field earthquakes, seismic protection, supplemental damping devices

Procedia PDF Downloads 275

Authors: Pavel Zabrodin

Abstract:

The drawback of magnesium alloys is poor plasticity, which complicates the forming. Effective way of improving the properties of the cast magnesium alloy AZ31 (3 wt. % Al, 0.8 wt. % Zn, 0.2 wt. % Mn)) is to combine hot extrusion at 350°C and equal-channel angular pressing (ECAP) at 180°C. Because of reduced grain sizes, changes in the nature of the grain boundaries, and enhancement of a texture that favors basal dislocation glide, after this kind of processing, increase yield stress and ductility. For study of the effect of microstructure on the mechanisms for plastic deformation, there is some interest in investigating the mechanical properties of the ultrafinegrained (UFG) Mg alloy at low temperatures, before and after annealing. It found that the amplitude and statistics at the low-temperature jump-like deformation the Mg alloy of dependent on microstructure. Reduction of the average density of dislocations and grain growth during annealing causing a reduction in the amplitude of the jump-like deformation and changes in the distribution of surges in amplitude. It found that the amplitude and statistics at the low-temperature jump-like deformation UFG alloy dependent on temperature of deformation. Plastic deformation of UFG alloy at a temperature of 10 K occurs uniformly - peculiarities is not observed. Increasing of the temperature of deformation from 4,2 to 0,5 K is causing a reduction in the amplitude and increasing the frequency of the jump-like deformation.

Keywords: jump-like deformation, low temperature, plasticity, magnesium alloy

Procedia PDF Downloads 437