Search results for: modified radical mastectomy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1710

Search results for: modified radical mastectomy

1230 Link Between Intensity-trajectories Of Acute Postoperative Pain And Risk Of Chronicization After Breast And Thoracopulmonary Surgery

Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila

Abstract:

Introduction: The risk factors for the chronicization of postoperative pain are numerous and often intricately intertwined. Among these, the severity of acute postoperative pain is currently recognized as one of the most determining factors. Mastectomy and thoracotomy are described as among the most painful surgeries and the most likely to lead to chronic post-surgical pain (CPSP). Objective: To examine the aspects of acute postoperative pain potentially involved in the development of chronic pain following breast and thoracic surgery. Patients and Methods: A prospective study involving 164 patients was conducted over a six-month period. Postoperative pain (during mobilization) was assessed using a Visual Analog Scale (VAS) at various time points after surgery: Day 0, 1st, 2nd, 5th days, 1st and 6th months. Moderate to severe pain was defined as a VAS score ≥ 4. A comparative analysis (univariate analysis) of postoperative pain intensities at different evaluation phases was performed on patients with and without CPSP to identify potential associations with the risk of chronicization six months after surgery. Results: At the 6th month post-surgery, the incidence of CPSP was 43.0%. Moderate to severe acute postoperative pain (in the first five days) was observed in 64% of patients. The highest pain scores were reported among thoracic surgery patients. Comparative measures revealed a highly significant association between the presence of moderate to severe acute pain, especially lasting for ≥ 48 hours, and the occurrence of CPSP (p-value <0.0001). Likewise, the persistence of subacute pain (up to 4 to 6 weeks after surgery), especially of moderate to severe intensity, was significantly associated with the risk of chronicization at six months (p-value <0.0001). Conclusion: CPSP after breast and thoracic surgery remains a fairly common morbidity that profoundly affects the quality of life. Severe acute postoperative pain, especially if it is prolonged and/or with a slow decline in intensity, can be an important predictive factor for the risk of chronicization. Therefore, more effective and intensive management of acute postoperative pain, as well as longitudinal monitoring of its trajectory over time, should be an essential component of strategies for preventing chronic pain after surgery.

Keywords: chronic post-surgical pain, acute postoperative pain, breast and thoracic surgery, subacute postoperative pain, pain trajectory, predictive factor

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1229 Speciation, Preconcentration, and Determination of Iron(II) and (III) Using 1,10-Phenanthroline Immobilized on Alumina-Coated Magnetite Nanoparticles as a Solid Phase Extraction Sorbent in Pharmaceutical Products

Authors: Hossein Tavallali, Mohammad Ali Karimi, Gohar Deilamy-Rad

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The proposed method for speciation, preconcentration and determination of Fe(II) and Fe(III) in pharmaceutical products was developed using of alumina-coated magnetite nanoparticles (Fe3O4/Al2O3 NPs) as solid phase extraction (SPE) sorbent in magnetic mixed hemimicell solid phase extraction (MMHSPE) technique followed by flame atomic absorption spectrometry analysis. The procedure is based on complexation of Fe(II) with 1, 10-phenanthroline (OP) as complexing reagent for Fe(II) that immobilized on the modified Fe3O4/Al2O3 NPs. The extraction and concentration process for pharmaceutical sample was carried out in a single step by mixing the extraction solvent, magnetic adsorbents under ultrasonic action. Then, the adsorbents were isolated from the complicated matrix easily with an external magnetic field. Fe(III) ions determined after facility reduced to Fe(II) by added a proper reduction agent to sample solutions. Compared with traditional methods, the MMHSPE method simplified the operation procedure and reduced the analysis time. Various influencing parameters on the speciation and preconcentration of trace iron, such as pH, sample volume, amount of sorbent, type and concentration of eluent, were studied. Under the optimized operating conditions, the preconcentration factor of the modified nano magnetite for Fe(II) 167 sample was obtained. The detection limits and linear range of this method for iron were 1.0 and 9.0 - 175 ng.mL−1, respectively. Also the relative standard deviation for five replicate determinations of 30.00 ng.mL-1 Fe2+ was 2.3%.

Keywords: Alumina-Coated magnetite nanoparticles, Magnetic Mixed Hemimicell Solid-Phase Extraction, Fe(ΙΙ) and Fe(ΙΙΙ), pharmaceutical sample

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1228 Factors Affecting of Musculoskeletal Disorders in Nurses from a Taiwan Hospital

Authors: Hsien Hua Kuo, Wen Chun Lin, Chia Chi Hsu, Hsien Wen Kuo

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Objective: Despite the high prevalence of musculoskeletal disorders (MSDs) among nurses, which has been consistently observed in the studies of Western countries, very little information regarding intensity of workload and work-related quality of life (WRQOL) related to MSDs among nurses is available in Taiwan. The objective of this study is to investigate the factors affecting musculoskeletal disorders in nurses from a hospital. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire which contained the demographic information, workplace condition and musculoskeletal disorders. Results: Response rate of nurses were 92.5% from a teaching hospital. Based on medical diagnosis by physician, neck of musculoskeletal disorders had the highest percentage in nine body portions. The higher percentage of musculoskeletal disorders in nurses found from wards of internal and surgery. Severity and symptoms of musculoskeletal disorders diagnosed by self-reported questionnaire significantly correlated with WRQOL, job satisfaction and intensity of workload among nurses based on the logistic regression model. Conclusion: The severity and symptoms of musculoskeletal disorders among nurses showed a dose-dependent with WRQOL and workload. When work characteristics in hospital were modified, the severity of musculoskeletal disorders among nurses will be decreased and alleviated. Comment: Multifaceted ergonomic intervention programme to reduce the prevalence of MSDs among nurses was by encouraging nurses to do more physical activity which will make them more flexible and increase their strength. Therefore, the head nurse should encourage nurses to regularly physical activity and to modify unfitting ergonomic environment in order to reduce the prevalence of MSDs.

Keywords: musculoskeletal disorders, nurse, WRQOL, job satisfaction

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1227 Earthquake Forecasting Procedure Due to Diurnal Stress Transfer by the Core to the Crust

Authors: Hassan Gholibeigian, Kazem Gholibeigian

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In this paper, our goal is determination of loading versus time in crust. For this goal, we present a computational procedure to propose a cumulative strain energy time profile which can be used to predict the approximate location and time of the next major earthquake (M > 4.5) along a specific fault, which we believe, is more accurate than many of the methods presently in use. In the coming pages, after a short review of the research works presently going on in the area of earthquake analysis and prediction, earthquake mechanisms in both the jerk and sequence earthquake direction is discussed, then our computational procedure is presented using differential equations of equilibrium which govern the nonlinear dynamic response of a system of finite elements, modified with an extra term to account for the jerk produced during the quake. We then employ Von Mises developed model for the stress strain relationship in our calculations, modified with the addition of an extra term to account for thermal effects. For calculation of the strain energy the idea of Pulsating Mantle Hypothesis (PMH) is used. This hypothesis, in brief, states that the mantle is under diurnal cyclic pulsating loads due to unbalanced gravitational attraction of the sun and the moon. A brief discussion is done on the Denali fault as a case study. The cumulative strain energy is then graphically represented versus time. At the end, based on some hypothetic earthquake data, the final results are verified.

Keywords: pulsating mantle hypothesis, inner core’s dislocation, outer core’s bulge, constitutive model, transient hydro-magneto-thermo-mechanical load, diurnal stress, jerk, fault behaviour

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1226 Arbuscular Mycorrhizal Symbiosis Modulates Antioxidant Capacity of in vitro Propagated Hyssop, Hyssopus officinalis L.

Authors: Maria P. Geneva, Ira V. Stancheva, Marieta G. Hristozkova, Roumiana D. Vasilevska-Ivanova, Mariana T. Sichanova, Janet R. Mincheva

Abstract:

Hyssopus officinalis L., Lamiaceae, commonly called hyssop, is an aromatic, semi-evergreen, woody-based, shrubby perennial plant. Hyssop is a good expectorant and antiviral herb commonly used to treat respiratory conditions such as influenza, sinus infections, colds, and bronchitis. Most of its medicinal properties are attributed to the essential oil of hyssop. The study was conducted to evaluate the influence of inoculation with arbuscular mycorrhizal fungi of in vitro propagated hyssop plants on the: activities of antioxidant enzymes superoxide dismutase, catalase, guaiacol peroxidase and ascorbate peroxidase; accumulation of non-enzymatic antioxidants total phenols and flavonoid, water-soluble soluble antioxidant metabolites expressed as ascorbic acid; the antioxidant potential of hyssop methanol extracts assessed by two common methods: free radical scavenging activity using free stable radical (2,2-diphenyl-1-picrylhydrazyl, DPPH• and ferric reducing antioxidant power FRAP in flowers and leaves. The successfully adapted to field conditions in vitro plants (survival rate 95%) were inoculated with arbuscular mycorrhizal fungi (Claroideoglomus claroideum, ref. EEZ 54). It was established that the activities of enzymes with antioxidant capacity (superoxide dismutase, catalase, guaiacol peroxidase and ascorbate peroxidase) were significantly higher in leaves than in flowers in both control and mycorrhized plants. In flowers and leaves of inoculated plants, the antioxidant enzymes activity were lower than in non-inoculated plants, only in SOD activity, there was no difference. The content of low molecular metabolites with antioxidant capacity as total phenols, total flavonoids, and water soluble antioxidants was higher in inoculated plants. There were no significant differences between control and inoculated plants both for FRAP and DPPH antioxidant activity. According to plant essential oil content, there was no difference between non-inoculated and inoculated plants. Based on our results we could suggest that antioxidant capacity of in vitro propagated hyssop plant under conditions of cultivation is determined by the phenolic compounds-total phenols and flavonoids as well as by the levels of water-soluble metabolites with antioxidant potential. Acknowledgments: This study was conducted with financial support from National Science Fund at the Bulgarian Ministry of Education and Science, Project DN06/7 17.12.16.

Keywords: antioxidant enzymes, antioxidant metabolites, arbuscular mycorrhizal fungi, Hyssopus officinalis L.

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1225 Investigation of the Use of Surface-Modified Waste Orange Pulp for the Adsorption of Remazol Black B

Authors: Ceren Karaman, Onur Karaman

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The adsorption of Remazol Black B (RBB), an anionic dye, onto dried orange pulp (DOP) adsorbent prepared by only drying and by treating with cetyltrimetylammonium bromide (CTAB), a cationic surfactant, surface-modified orange pulp (SMOP) was studied in a stirred batch experiments system at 25°C. The adsorption of RBB on each adsorbent as a function of surfactant dosage, initial pH of the solution and initial dye concentration was investigated. The optimum amount of CTAB was found to be 25g/l. For RBB adsorption studies, while working pH value for the DOP adsorbent system was determined as 2.0, it was observed that this value shifted to 8.0 when the 25 g/l CTAB treated-orange pulp (SMOP) adsorbent was used. It was obtained that the adsorption rate and capacity increased to a certain value, and the adsorption efficiency decreased with increasing initial RBB concentration for both DOP and SMOP adsorbents at pH 2.0 and pH 8.0. While the highest adsorption capacity for DOP was determined as 62.4 mg/g at pH 2.0, and as 325.0 mg/g for SMOP at pH 8.0. As a result, it can be said that permanent cationic coating of the adsorbent surface by CTAB surfactant shifted the working pH from 2.0 to 8.0 and it increased the dye adsorption rate and capacity of orange pulp much more significantly at pH 8.0. The equilibrium RBB adsorption data on each adsorbent were best described by the Langmuir isotherm model. The adsorption kinetics of RBB on each adsorbent followed a pseudo-second-order model. Moreover, the intraparticle diffusion model was used to describe the kinetic data. It was found that diffusion is not the only rate controlling step. The adsorbent was characterized by the Brunauer–Emmett–Teller (BET) analysis, Fourier-transform-infrared (FTIR) spectroscopy, and scanning-electron-microscopy (SEM). The mechanism for the adsorption of RBB on the SMOP may include hydrophobic interaction, van der Waals interaction, stacking and electrostatic interaction.

Keywords: adsorption, Cetyltrimethylammonium Bromide (CTAB), orange pulp, Remazol Black B (RBB), surface modification

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1224 Competing Risks Modeling Using within Node Homogeneity Classification Tree

Authors: Kazeem Adesina Dauda, Waheed Babatunde Yahya

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To design a tree that maximizes within-node homogeneity, there is a need for a homogeneity measure that is appropriate for event history data with multiple risks. We consider the use of Deviance and Modified Cox-Snell residuals as a measure of impurity in Classification Regression Tree (CART) and compare our results with the results of Fiona (2008) in which homogeneity measures were based on Martingale Residual. Data structure approach was used to validate the performance of our proposed techniques via simulation and real life data. The results of univariate competing risk revealed that: using Deviance and Cox-Snell residuals as a response in within node homogeneity classification tree perform better than using other residuals irrespective of performance techniques. Bone marrow transplant data and double-blinded randomized clinical trial, conducted in other to compare two treatments for patients with prostate cancer were used to demonstrate the efficiency of our proposed method vis-à-vis the existing ones. Results from empirical studies of the bone marrow transplant data showed that the proposed model with Cox-Snell residual (Deviance=16.6498) performs better than both the Martingale residual (deviance=160.3592) and Deviance residual (Deviance=556.8822) in both event of interest and competing risks. Additionally, results from prostate cancer also reveal the performance of proposed model over the existing one in both causes, interestingly, Cox-Snell residual (MSE=0.01783563) outfit both the Martingale residual (MSE=0.1853148) and Deviance residual (MSE=0.8043366). Moreover, these results validate those obtained from the Monte-Carlo studies.

Keywords: within-node homogeneity, Martingale residual, modified Cox-Snell residual, classification and regression tree

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1223 Usy-Cui Zeolite: An Efficient and Reusable Catalyst for Derivatives Indole Synthesis

Authors: Hassina Harkat, Samiha Taybe, Salima Loucif, Valérie Beneteau, Patrick Pale

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Indole and its derivatives have attracted great interest because of their importance in the synthetic organic and medicinal chemistry. They are widely used as anti hypertension, anti tubercular, anticancer activity, antiviral, Alzheimer's disease, antioxidant properties, and free radical induced lipid peroxidation. Many drugs and natural products contain indole moiety, such as the vinca alkaloids, fungal metabolites and marine natural products. Generally applicable synthetic methods for indole moiety involve ring closure to form the pyrrole. Indole derivatives can also be accessed by further functionalization of the indole nucleus. Therefore we report a mild and efficient protocol for the synthesis of analogues of indole catalyzed via zeolithe USY doped with CuI under solvent-free conditions.

Keywords: indole, zeolithe, USY-CuI, heterogeneous catalysis

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1222 Adsorption of Heavy Metals Using Chemically-Modified Tea Leaves

Authors: Phillip Ahn, Bryan Kim

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Copper is perhaps the most prevalent heavy metal used in the manufacturing industries, from food additives to metal-mechanic factories. Common methodologies to remove copper are expensive and produce undesired by-products. A good decontaminating candidate should be environment-friendly, inexpensive, and capable of eliminating low concentrations of the metal. This work suggests chemically modified spent tea leaves of chamomile, peppermint and green tea in their thiolated, sulfonated and carboxylated forms as candidates for the removal of copper from solutions. Batch experiments were conducted to maximize the adsorption of copper (II) ions. Effects such as acidity, salinity, adsorbent dose, metal concentration, and presence of surfactant were explored. Experimental data show that maximum adsorption is reached at neutral pH. The results indicate that Cu(II) can be removed up to 53%, 22% and 19% with the thiolated, carboxylated and sulfonated adsorbents, respectively. Maximum adsorption of copper on TPM (53%) is achieved with 150 mg and decreases with the presence of salts and surfactants. Conversely, sulfonated and carboxylated adsorbents show better adsorption in the presence of surfactants. Time-dependent experiments show that adsorption is reached in less than 25 min for TCM and 5 min for SCM. Instrumental analyses determined the presence of active functional groups, thermal resistance, and scanning electron microscopy, indicating that both adsorbents are promising materials for the selective recovery and treatment of metal ions from wastewaters. Finally, columns were prepared with these adsorbents to explore their application in scaled-up processes, with very positive results. A long-term goal involves the recycling of the exhausted adsorbent and/or their use in the preparation of biofuels due to changes in materials’ structures.

Keywords: heavy metal removal, adsorption, wastewaters, water remediation

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1221 Synergistic Effect of Doxorubicin-Loaded Silver Nanoparticles – Polymeric Conjugates on Breast Cancer Cells

Authors: Nancy M. El-Baz, Laila Ziko, Rania Siam, Wael Mamdouh

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Cancer is one of the most devastating diseases, and has over than 10 million new cases annually worldwide. Despite the effectiveness of chemotherapeutic agents, their systemic toxicity and non-selective anticancer actions represent the main obstacles facing cancer curability. Due to the effective enhanced permeability and retention (EPR) effect of nanomaterials, nanoparticles (NPs) have been used as drug nanocarriers providing targeted cancer drug delivery systems. In addition, several inorganic nanoparticles such as silver (AgNPs) nanoparticles demonstrated a potent anticancer activity against different cancers. The present study aimed at formulating core-shell inorganic NPs-based combinatorial therapy based on combining the anticancer activity of AgNPs along with doxorubicin (DOX) and evaluating their cytotoxicity on MCF-7 breast cancer cells. These inorganic NPs-based combinatorial therapies were designed to (i) Target and kill cancer cells with high selectivity, (ii) Have an improved efficacy/toxicity balance, and (iii) Have an enhanced therapeutic index when compared to the original non-modified DOX with much lower dosage The in-vitro cytotoxicity studies demonstrated that the NPs-based combinatorial therapy achieved the same efficacy of non-modified DOX on breast cancer cell line, but with 96% reduced dose. Such reduction in DOX dose revealed that the combination between DOX and NPs possess a synergic anticancer activity against breast cancer. We believe that this is the first report on a synergic anticancer effect at very low dose of DOX against MCF-7 cells. Future studies on NPs-based combinatorial therapy may aid in formulating novel and significantly more effective cancer therapeutics.

Keywords: nanoparticles-based combinatorial therapy, silver nanoparticles, doxorubicin, breast cancer

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1220 Prediction of Antibacterial Peptides against Propionibacterium acnes from the Peptidomes of Achatina fulica Mucus Fractions

Authors: Suwapitch Chalongkulasak, Teerasak E-Kobon, Pramote Chumnanpuen

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Acne vulgaris is a common skin disease mainly caused by the Gram–positive pathogenic bacterium, Propionibacterium acnes. This bacterium stimulates inflammation process in human sebaceous glands. Giant African snail (Achatina fulica) is alien species that rapidly reproduces and seriously damages agricultural products in Thailand. There were several research reports on the medical and pharmaceutical benefits of this snail mucus peptides and proteins. This study aimed to in silico predict multifunctional bioactive peptides from A. fulica mucus peptidome using several bioinformatic tools for determination of antimicrobial (iAMPpred), anti–biofilm (dPABBs), cytotoxic (Toxinpred), cell membrane penetrating (CPPpred) and anti–quorum sensing (QSPpred) peptides. Three candidate peptides with the highest predictive score were selected and re-designed/modified to improve the required activities. Structural and physicochemical properties of six anti–P. acnes (APA) peptide candidates were performed by PEP–FOLD3 program and the five aforementioned tools. All candidates had random coiled structure and were named as APA1–ori, APA2–ori, APA3–ori, APA1–mod, APA2–mod and APA3–mod. To validate the APA activity, these peptide candidates were synthesized and tested against six isolates of P. acnes. The modified APA peptides showed high APA activity on some isolates. Therefore, our biomimetic mucus peptides could be useful for preventing acne vulgaris and further examined on other activities important to medical and pharmaceutical applications.

Keywords: Propionibacterium acnes, Achatina fulica, peptidomes, antibacterial peptides, snail mucus

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1219 Permeability Prediction Based on Hydraulic Flow Unit Identification and Artificial Neural Networks

Authors: Emad A. Mohammed

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The concept of hydraulic flow units (HFU) has been used for decades in the petroleum industry to improve the prediction of permeability. This concept is strongly related to the flow zone indicator (FZI) which is a function of the reservoir rock quality index (RQI). Both indices are based on reservoir porosity and permeability of core samples. It is assumed that core samples with similar FZI values belong to the same HFU. Thus, after dividing the porosity-permeability data based on the HFU, transformations can be done in order to estimate the permeability from the porosity. The conventional practice is to use the power law transformation using conventional HFU where percentage of error is considerably high. In this paper, neural network technique is employed as a soft computing transformation method to predict permeability instead of power law method to avoid higher percentage of error. This technique is based on HFU identification where Amaefule et al. (1993) method is utilized. In this regard, Kozeny and Carman (K–C) model, and modified K–C model by Hasan and Hossain (2011) are employed. A comparison is made between the two transformation techniques for the two porosity-permeability models. Results show that the modified K-C model helps in getting better results with lower percentage of error in predicting permeability. The results also show that the use of artificial intelligence techniques give more accurate prediction than power law method. This study was conducted on a heterogeneous complex carbonate reservoir in Oman. Data were collected from seven wells to obtain the permeability correlations for the whole field. The findings of this study will help in getting better estimation of permeability of a complex reservoir.

Keywords: permeability, hydraulic flow units, artificial intelligence, correlation

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1218 Evaluation of the Skid Resistance of Asphalt Concrete Made of Local Low-Performance Aggregates Based on New Accelerated Polishing Machine

Authors: Saci Abdelhakim Ferkous, Khedoudja Soudani, Smail Haddadi

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This paper presents the results of a laboratory experimental study that explores the skid resistance of asphalt concrete mixtures made of local low-performance aggregates by partially replacing sand with olive mill waste (OMW). OMW was mixed with aggregates using a dry process by replacing sand with contents of 5%, 7%, 10% and 15%. The mechanical performances of the mixtures were evaluated using the Marshall and Duriez tests. A modified accelerated polishing machine was used as polishing equipment, and a British pendulum tester (BPT) was used to test the skid resistance of the samples. Finally, texture parameter analysis was performed using scanning electron microscopy (SEM) and Mountains Map software to assess the effect of OMW on the friction coefficient evolution. Using a distinct road wheel for a modified version of an accelerated polishing machine, which is normally used to determine the polished stone value of aggregates, the results showed that the addition of OMW up to 10% conferred a better skid resistance in comparison to normal asphalt concrete. The presence of olive mill waste in the mixture until 15% guarantees a gain of 22%-29% in skid resistance after polishing compared with the reference mix. Indeed, from texture parameter analysis, it was observed that there was differential wear of the lightweight aggregates (OMW) compared to the other aggregates during the polishing process, which created a new surface microtexture that had new peaks and led to a good level of friction compared to the mixtures without OMW. In general, it was found that OMW is a promising modifier for asphalt mixtures with both engineering and economic merits.

Keywords: skid resistance, olive mill waste, polishing resistance, accelerated polishing machine, local materials, sustainable development.

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1217 3D Printing of Dual Tablets: Modified Multiple Release Profiles for Personalized Medicine

Authors: Veronika Lesáková, Silvia Slezáková, František Štěpánek

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Additive manufacturing technologies producing drug dosage forms aimed at personalized medicine applications are promising strategies with several advantages over the conventional production methods. One of the emerging technologies is 3D printing which reduces manufacturing steps and thus allows a significant drop in expenses. A decrease in material consumption is also a highly impactful benefit as the tested drugs are frequently expensive substances. In addition, 3D printed dosage forms enable increased patient compliance and prevent misdosing as the dosage forms are carefully designed according to the patient’s needs. The incorporation of multiple drugs into a single dosage form further increases the degree of personalization. Our research focuses on the development of 3D printed tablets incorporating multiple drugs (candesartan, losartan) and thermoplastic polymers (e.g., KlucelTM HPC EF). The filaments, an essential feed material for 3D printing,wereproduced via hot-melt extrusion. Subsequently, the extruded filaments of various formulations were 3D printed into tablets using an FDM 3D printer. Then, we have assessed the influence of the internal structure of 3D printed tablets and formulation on dissolution behaviour by obtaining the dissolution profiles of drugs present in the 3D printed tablets. In conclusion, we have developed tablets containing multiple drugs providing modified release profiles. The 3D printing experiments demonstrate the high tunability of 3D printing as each tablet compartment is constructed with a different formulation. Overall, the results suggest that the 3D printing technology is a promising manufacturing approach to dual tablet preparation for personalized medicine.

Keywords: 3D printing, drug delivery, hot-melt extrusion, dissolution kinetics

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1216 The Effects of Irregular Immigration Originating from Syria on Turkey's Security Issues

Authors: Muzaffer Topgul, Hasan Atac

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After the September 11 attacks, fight against terrorism has risen to higher levels in security concepts of the countries. The following reactions of some nation states have led to the formation of unstable areas in different parts of the World. Especially, in Iraq and Syria, the influences of radical groups have risen with the weakening of the central governments. Turkey (with the geographical proximity to the current crisis) has become a stop on the movement of people who were displaced because of terrorism. In the process, the policies of the Syrian regime resulted in a civil war which is still going on since 2011, and remain as an unresolved crisis. With the extension of the problem, changes occurred in foreign policies of the World Powers; moreover, the ongoing effects of the riots, conflicts of interests of foreign powers, conflicts in the region because of the activities of radical groups increased instability within the country. This case continues to affect the security of Turkey, particularly illegal immigration. It has exceeded the number of two million Syrians who took refuge in Turkey due to the civil war, while continuing uncertainty about the legal status of asylum seekers, besides the security problems of asylum-seekers themselves, there are problems in education, health and communication (language) as well. In this study, we will evaluate the term of immigration through the eyes of national and international law, place the disorganized and illegal immigration in security sphere, and define the elements/components of irregular migration within the changing security concept. Ultimately, this article will assess the effects of the Syrian refuges to Turkey’s short-term, mid-term, and long-term security in the light of the national and international data flows and solutions will be presented to the ongoing problem. While explaining the security problems the data and the donnees obtained from the nation and international corporations will be examined thorough the human security dimensions such as living conditions of the immigrants, the ratio of the genders, especially birth rate occasions, the education circumstances of the immigrant children, the effects of the illegal passing on the public order. In addition, the demographic change caused by the immigrants will be analyzed, the changing economical conditions where the immigrants mostly accumulate, and their participation in public life will be worked on and the economical obstacles sourcing due to irregular immigration will be clarified. By the entire datum gathered from the educational, cultural, social, economic, demographical extents, the regional factors affecting the migration and the role of irregular migration in Turkey’s future security will be revealed by implication to current knowledge sources.

Keywords: displaced people, human security, irregular migration, refugees

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1215 Clinical and Radiological Outcome in 300 Patients with Non-Aneurysmal Sah

Authors: Ranjith Menon, Abathar Aladi, Hans-Christean Nahser, Maneesh Bhojak, Sacha Nevin, Paul Eldridge

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Background: Spontaneous subarachnoid haemorrhage (SAH) accounts for approximately 5% of all strokes. Patients with spontaneous SAH (as shown by CT or lumbar puncture) undergo investigations to identify or exclude an underlying structural cause, typically cerebral aneurysm. However in 10 - 20% of cases, no structural cause is found. This includes more than one imaging modality (intracranial MRA, CTA, 4DCTA and/or DSA) and in some spinal MRI. Objective: To determine; 1) If an underlying structural or vascular cause can be identified in non-aneurysmal SAH patients by comparing different imaging modalities at presentation and at follow-up. 2) If MRI spine in patients with non-aneurysmal SAH reveals an underlying SAH cause. 3)The functional outcome at discharge. Results: We performed a retrospective analysis of all non-traumatic SAH patients admitted to the Walton centre from January 2009 to December 2015. There were 1457 patients with non-traumatic SAH admitted to the Walton centre of whom 21.8% (n=300) patients were diagnosed with non-aneurysmal SAH. Males were 65.6% and females were 43.3%. The presenting symptoms were sudden onset headache (93.6%), the focal neurological deficit (12%), loss of consciousness (10.6%) and others (6%). About 285 patients received 2 modalities of imaging (CTA & DSA), 192 received 3 modalities of imaging (CTA, MRA & DSA) and 137 received MRI spine (51/137 whole spine). The modified Rankin Score at discharge were: mRS 0 = 292 (97.33%), mRS 1-2 = 6, mRS 6 = 1 (cardiac arrest in IHD patient) and unknown in 1. Follow-up imaging at 3 to 6 months in 190 (63.3%) patients did not identify an underlying cause. Conclusion: This retrospective analysis concludes that non-aneurysmal SAH has a good functional outcome. A single imaging modality (CTA (4DCTA) or MRA or DSA) was adequate to exclude an underlying cause of SAH and a delayed imaging failed to identify a cause. Routinely performing MRI spine in this group of patients appears not to be necessary according to this evidence.

Keywords: stroke, non-aneurysmal subarachnoid haemorrhage, neuroimaging, modified rankin score

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1214 Thermolysin Entrapment in a Gold Nanoparticles/Polymer Composite: Construction of an Efficient Biosensor for Ochratoxin a Detection

Authors: Fatma Dridi, Mouna Marrakchi, Mohammed Gargouri, Alvaro Garcia Cruz, Sergei V. Dzyadevych, Francis Vocanson, Joëlle Saulnier, Nicole Jaffrezic-Renault, Florence Lagarde

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An original method has been successfully developed for the immobilization of thermolysin onto gold interdigitated electrodes for the detection of ochratoxin A (OTA) in olive oil samples. A mix of polyvinyl alcohol (PVA), polyethylenimine (PEI) and gold nanoparticles (AuNPs) was used. Cross-linking sensors chip was made by using a saturated glutaraldehyde (GA) vapor atmosphere in order to render the two polymers water stable. Performance of AuNPs/ (PVA/PEI) modified electrode was compared to a traditional immobilized enzymatic method using bovine serum albumin (BSA). Atomic force microscopy (AFM) experiments were employed to provide a useful insight into the structure and morphology of the immobilized thermolysin composite membranes. The enzyme immobilization method influence the topography and the texture of the deposited layer. Biosensors optimization and analytical characteristics properties were studied. Under optimal conditions AuNPs/ (PVA/PEI) modified electrode showed a higher increment in sensitivity. A 700 enhancement factor could be achieved with a detection limit of 1 nM. The newly designed OTA biosensors showed a long-term stability and good reproducibility. The relevance of the method was evaluated using commercial doped olive oil samples. No pretreatment of the sample was needed for testing and no matrix effect was observed. Recovery values were close to 100% demonstrating the suitability of the proposed method for OTA screening in olive oil.

Keywords: thermolysin, A. ochratoxin , polyvinyl alcohol, polyethylenimine, gold nanoparticles, olive oil

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1213 2D Convolutional Networks for Automatic Segmentation of Knee Cartilage in 3D MRI

Authors: Ananya Ananya, Karthik Rao

Abstract:

Accurate segmentation of knee cartilage in 3-D magnetic resonance (MR) images for quantitative assessment of volume is crucial for studying and diagnosing osteoarthritis (OA) of the knee, one of the major causes of disability in elderly people. Radiologists generally perform this task in slice-by-slice manner taking 15-20 minutes per 3D image, and lead to high inter and intra observer variability. Hence automatic methods for knee cartilage segmentation are desirable and are an active field of research. This paper presents design and experimental evaluation of 2D convolutional neural networks based fully automated methods for knee cartilage segmentation in 3D MRI. The architectures are validated based on 40 test images and 60 training images from SKI10 dataset. The proposed methods segment 2D slices one by one, which are then combined to give segmentation for whole 3D images. Proposed methods are modified versions of U-net and dilated convolutions, consisting of a single step that segments the given image to 5 labels: background, femoral cartilage, tibia cartilage, femoral bone and tibia bone; cartilages being the primary components of interest. U-net consists of a contracting path and an expanding path, to capture context and localization respectively. Dilated convolutions lead to an exponential expansion of receptive field with only a linear increase in a number of parameters. A combination of modified U-net and dilated convolutions has also been explored. These architectures segment one 3D image in 8 – 10 seconds giving average volumetric Dice Score Coefficients (DSC) of 0.950 - 0.962 for femoral cartilage and 0.951 - 0.966 for tibia cartilage, reference being the manual segmentation.

Keywords: convolutional neural networks, dilated convolutions, 3 dimensional, fully automated, knee cartilage, MRI, segmentation, U-net

Procedia PDF Downloads 241
1212 The Effectiveness of the Repositioning Campaign of PKO BP Brand on the Basis of Questionnaire Research

Authors: Danuta Szwajca

Abstract:

Image is a very important intangible asset of a contemporary enterprise, especially, in case of a bank as a public trust institution. A positive, demanded image may effectively distinguish the bank among the competition and build the customer confidence and loyalty. PKO BP is the biggest and largest bank functioning on the Polish financial market. Within the years not a very nice image of the bank has been embedded in the customers’ minds as an old-fashioned, stagnant, resistant to changes institution, what result in the customer loss, and ageing. For this reason, in 2010, the bank launched a campaign of radical image change along with a strategy of branches modernization and improvement of the product offer. The objective of the article is to make an attempt of effectiveness assessment of the brand repositioning campaign that lasted three years. The foundations of the assessment are the results of the questionnaire research concerning the way of bank’s perception before and after the campaign.

Keywords: advertising campaign, brand repositioning, image of the bank, repositioning

Procedia PDF Downloads 398
1211 Statistical Analysis and Optimization of a Process for CO2 Capture

Authors: Muftah H. El-Naas, Ameera F. Mohammad, Mabruk I. Suleiman, Mohamed Al Musharfy, Ali H. Al-Marzouqi

Abstract:

CO2 capture and storage technologies play a significant role in contributing to the control of climate change through the reduction of carbon dioxide emissions into the atmosphere. The present study evaluates and optimizes CO2 capture through a process, where carbon dioxide is passed into pH adjusted high salinity water and reacted with sodium chloride to form a precipitate of sodium bicarbonate. This process is based on a modified Solvay process with higher CO2 capture efficiency, higher sodium removal, and higher pH level without the use of ammonia. The process was tested in a bubble column semi-batch reactor and was optimized using response surface methodology (RSM). CO2 capture efficiency and sodium removal were optimized in terms of major operating parameters based on four levels and variables in Central Composite Design (CCD). The operating parameters were gas flow rate (0.5–1.5 L/min), reactor temperature (10 to 50 oC), buffer concentration (0.2-2.6%) and water salinity (25-197 g NaCl/L). The experimental data were fitted to a second-order polynomial using multiple regression and analyzed using analysis of variance (ANOVA). The optimum values of the selected variables were obtained using response optimizer. The optimum conditions were tested experimentally using desalination reject brine with salinity ranging from 65,000 to 75,000 mg/L. The CO2 capture efficiency in 180 min was 99% and the maximum sodium removal was 35%. The experimental and predicted values were within 95% confidence interval, which demonstrates that the developed model can successfully predict the capture efficiency and sodium removal using the modified Solvay method.

Keywords: CO2 capture, water desalination, Response Surface Methodology, bubble column reactor

Procedia PDF Downloads 268
1210 Emergence of Vancomycin Resistant and Methcillin Resistant Staphylococus aureus in Patients with Different Clinical Manifestations in Khartoum State, Sudan

Authors: Maimona A. E. Elimam, Suhair Rehan, Miskelyemen A. Elmekki, Mogahid M. Elhassan

Abstract:

Staphylococcus aureus (Staph. aureus), a major cause of potentially life-threatening infections acquired in healthcare and community settings, has developed resistance to most classes of antimicrobial agents as determined by the dramatic increase. The present study aimed to determine the prevalence of MRSA, and VRSA in patients with different clinical manifestations in Khartoum state. The study population (n, 426) were males and females with different age categories, suffering either from wound infections (105), ear infections (121), or UTI (101), in addition to nasal carriers of medical staff (100). Cultures, Gram staining, and other biochemical tests were performed for conventional identification. Modified Kirby-Bauer disk diffusion method was applied and DNA was extracted from MRSA and VRSA isolates and PCR was then performed for amplification of arc, mecA, VanA, and VanB genes. The results confirmed the existence of Staph. aureus in 49/426 (11.5%) cases among which MRSA were isolated from 34/49 (69.4%) when modified Kirby-Bauer disk diffusion method was applied. Ten out of these 34 MRSA were confirmed as VRSA by cultures on BHI agar containing 6μg/ml vancomycin according to NCCLS criteria. PCR revealed that out of the 34 MRSA isolates, 26 were mecA positive (76.5%) while 8 (23.5%) were arcC positive. No vanA or VanB genes were detected. Molecular method confirmed the results for MRSA through the presence of either arcC or mecA genes while it failed to approve the occurrence of VRSA since neither VanA or VanB genes were detected. Thus, VRSA may be attributed to other factors.

Keywords: antibiotic resistance, Staphylococcus aureus, VRSA, MRSA, Khartoum, Sudan

Procedia PDF Downloads 422
1209 Characterization of Biocomposites Based on Mussel Shell Wastes

Authors: Suheyla Kocaman, Gulnare Ahmetli, Alaaddin Cerit, Alize Yucel, Merve Gozukucuk

Abstract:

Shell wastes represent a considerable quantity of byproducts in the shellfish aquaculture. From the viewpoint of ecofriendly and economical disposal, it is highly desirable to convert these residues into high value-added products for industrial applications. So far, the utilization of shell wastes was confined at relatively lower levels, e.g. wastewater decontaminant, soil conditioner, fertilizer constituent, feed additive and liming agent. Shell wastes consist of calcium carbonate and organic matrices, with the former accounting for 95-99% by weight. Being the richest source of biogenic CaCO3, shell wastes are suitable to prepare high purity CaCO3 powders, which have been extensively applied in various industrial products, such as paper, rubber, paints and pharmaceuticals. Furthermore, the shell waste could be further processed to be the filler of polymer composites. This paper presents a study on the potential use of mussel shell waste as biofiller to produce the composite materials with different epoxy matrices, such as bisphenol-A type, CTBN modified and polyurethane modified epoxy resins. Morphology and mechanical properties of shell particles reinforced epoxy composites were evaluated to assess the possibility of using it as a new material. The effects of shell particle content on the mechanical properties of the composites were investigated. It was shown that in all composites, the tensile strength and Young’s modulus values increase with the increase of mussel shell particles content from 10 wt% to 50 wt%, while the elongation at break decreased, compared to pure epoxy resin. The highest Young’s modulus values were determined for bisphenol-A type epoxy composites.

Keywords: biocomposite, epoxy resin, mussel shell, mechanical properties

Procedia PDF Downloads 299
1208 Development of a New Polymeric Material with Controlled Surface Micro-Morphology Aimed for Biosensors Applications

Authors: Elham Farahmand, Fatimah Ibrahim, Samira Hosseini, Ivan Djordjevic, Leo. H. Koole

Abstract:

Compositions of different molar ratios of polymethylmethacrylate-co-methacrylic acid (PMMA-co-MAA) were synthesized via free- radical polymerization. Polymer coated surfaces have been produced on silicon wafers. Coated samples were analyzed by atomic force microscopy (AFM). The results have shown that the roughness of the surfaces have increased by increasing the molar ratio of monomer methacrylic acid (MAA). This study reveals that the gradual increase in surface roughness is due to the fact that carboxylic functional groups have been generated by MAA segments. Such surfaces can be desirable platforms for fabrication of the biosensors for detection of the viruses and diseases.

Keywords: polymethylmethacrylate-co-methacrylic acid (PMMA-co-MAA), polymeric material, atomic force microscopy, roughness, carboxylic functional groups

Procedia PDF Downloads 573
1207 Consequences of Some Remediative Techniques Used in Sewaged Soil Bioremediation on Indigenous Microbial Activity

Authors: E. M. Hoballah, M. Saber, A. Turky, N. Awad, A. M. Zaghloul

Abstract:

Remediation of cultivated sewage soils in Egypt become an important aspect in last decade for having healthy crops and saving the human health. In this respect, a greenhouse experiment was conducted where contaminated sewage soil was treated with modified forms of 2% bentonite (T1), 2% kaolinite (T2), 1% bentonite+1% kaolinite (T3), 2% probentonite (T4), 2% prokaolinite (T5), 1% bentonite + 0.5% kaolinite + 0.5% rock phosphate (RP) (T6), 2% iron oxide (T7) and 1% iron oxide + 1% RP (T8). These materials were applied as remediative materials. Untreated soil was also used as a control. All soil samples were incubated for 2 months at 25°C at field capacity throughout the whole experiment. Carbon dioxide (CO2) efflux from both treated and untreated soils as a biomass indicator was measured through the incubation time and kinetic parameters of the best fitted models used to describe the phenomena were taken to evaluate the succession of sewaged soils remediation. The obtained results indicated that according to the kinetic parameters of used models, CO2 effluxes from remediated soils was significantly decreased compared to control treatment with variation in rate values according to type of remediation material applied. In addition, analyzed microbial biomass parameter showed that Ni and Zn were the most potential toxic elements (PTEs) that influenced the decreasing order of microbial activity in untreated soil. Meanwhile, Ni was the only influenced pollutant in treated soils. Although all applied materials significantly decreased the hazards of PTEs in treated soil, modified bentonite was the best treatment compared to other used materials. This work discussed different mechanisms taking place between applied materials and PTEs founded in the studied sewage soil.

Keywords: remediation, potential toxic elements, soil biomass, sewage

Procedia PDF Downloads 212
1206 Evaluation of Polyphenolics Compounds in Cold Brewed Indian Tea

Authors: Chandrima Das, Sirshendu Chatterjee

Abstract:

Tea (Camellia sinensis) is known as nature's low calorie wonder drink. Since ancient times hot consumptions of tea is very much popular. We have observed that many heat sensitive secondary metabolites which get destroyed on heating, moreover by people, who are permanently live at higher altitude or the members of high altitude expedition team, are deprived of various tea brewing facilities like electricity, fuel, etc. and the hence cold decoction of tea might be a good alternative. In this backdrop present study aims at the analysis of antioxidants like polyphenols, flavonoids and free radical scavenging activity as well as the l-theanine concentration of different types of cold brewed teas like black, green, white and oolong and compared with its hot decoction. Further, we also analysed in details about the bioactive components by using HPLC followed by green synthesis of nanoparticles. The study highlighted that the difference between the concentration of antioxidant in cold and hot brewed tea is insignificant and hence intake of cold decoction will be beneficial to health.

Keywords: antioxidants, flavanoid, polyphenols, HPLC, nanoparticles

Procedia PDF Downloads 286
1205 The Effects of High Velocity Low Amplitude Thrust Manipulation versus Low Velocity Low Amplitude Mobilization in Treatment of Chronic Mechanical Low Back Pain

Authors: Ahmed R. Z. Baghdadi, Ibrahim M. I. Hamoda,  Mona H. Gamal Eldein, Ibrahim Magdy Elnaggar

Abstract:

Background: High-velocity low amplitude thrust (HVLAT) manipulation and low-velocity low amplitude (LVLA) mobilization are an effective treatment for low back pain (LBP). Purpose: This study compared the effects of HVLAT versus LVLA on pain, functional deficits and segmental mobility in treatment of chronic mechanical LBP. Methods: Ninety patients suffering from chronic mechanical LBP are classified to three groups; Thirty patients treated by HVLAT (group I), thirty patients treated by LVLA (group II) and thirty patients as control group (group III) participated in the study. The mean age was 28.00±2.92, 27.83±2.28 and 28.07±3.05 years and BMI 27.98±2.60, 28.80±2.40 and 28.70±2.53 kg/m2 for group I, II and III respectively. The Visual Analogue Scale (VAS), the Oswestry low back pain disability questionnaire and modified schoper test were used for assessment. Assessments were conducted two weeks before and after treatment with the control group being assessed at the same time intervals. The treatment program group one was two weeks single session per week, and for group II two sessions per week for two weeks. Results: The One-way ANOVA revealed that group I had significantly lower pain scores and Oswestry score compared with group II two weeks after treatment. Moreover, the mobility in modified schoper increased significantly and the pain scores and Oswestry scores decreased significantly after treatment in group I and II compared with control group. Interpretation/Conclusion: HVLAT is preferable to LVLA mobilization, possibly due to a beneficial neurophysiological effect by Stimulating mechanically sensitive neurons in the lumbar facet joint capsule.

Keywords: low back pain, manipulation, mobilization, low velocity

Procedia PDF Downloads 577
1204 Preventive Impact of Regional Analgesia on Chronic Neuropathic Pain After General Surgery

Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila, Lamara Abdelhak

Abstract:

Introduction: Post-surgical chronic pain (PSCP) is a pathological condition with a rather complex etiopathogenesis that extensively involves sensitization processes and neuronal damage. The neuropathic component of these pains is almost always present, with variable expression depending on the type of surgery. Objective: To assess the presumed beneficial effect of Regional Anesthesia-Analgesia Techniques (RAAT) on the development of post-surgical chronic neuropathic pain (PSCNP) in various surgical procedures. Patients and Methods: A comparative study involving 510 patients distributed across five surgical models (mastectomy, thoracotomy, hernioplasty, cholecystectomy, and major abdominal-pelvic surgery) and randomized into two groups: Group A (240) receiving conventional postoperative analgesia and Group B (270) receiving balanced analgesia, including the implementation of a Regional Anesthesia-Analgesia Technique (RAAT). These patients were longitudinally followed over a 6-month period, with postsurgical chronic neuropathic pain (PSCNP) defined by a Neuropathic Pain Score DN2≥ 3. Comparative measurements through univariate and multivariable analyses were performed to identify associations between the development of PSCNP and certain predictive factors, including the presumed preventive impact (protective effect) of RAAT. Results: At the 6th month post-surgery, 419 patients were analyzed (Group A= 196 and Group B= 223). The incidence of PSCNP was 32.2% (n=135). Among these patients with chronic pain, the prevalence of neuropathic pain was 37.8% (95% CI: [29.6; 46.5]), with n=51/135. It was significantly lower in Group B compared to Group A, with respective percentages of 31.4% vs. 48.8% (p-value = 0.035). The most significant differences were observed in breast and thoracopulmonary surgeries. In a multiple regression analysis, two predictors of PSCNP were identified: the presence of preoperative pain at the surgical site as a risk factor (OR: 3.198; 95% CI [1.326; 7.714]) and RAAT as a protective factor (OR: 0.408; 95% CI [0.173; 0.961]). Conclusion: The neuropathic component of PSCNP can be observed in different types of surgeries. Regional analgesia included in a multimodal approach to postoperative pain management has proven to be effective for acute pain and seems to have a preventive impact on the development of PSCNP and its neuropathic nature, particularly in surgeries that are more prone to chronicization.

Keywords: post-surgical chronic pain, post-surgical chronic neuropathic pain, regional anesthesia-analgesia techniques, neuropathic pain score DN2, preventive impact

Procedia PDF Downloads 57
1203 Performance Analysis of Modified Solar Water Heating System for Climatic Condition of Allahabad, India

Authors: Kirti Tewari, Rahul Dev

Abstract:

Solar water heating is a thermodynamic process of heating water using sunlight with the help of solar water heater. Thus, solar water heater is a device used to harness solar energy. In this paper, a modified solar water heating system (MSWHS) has been proposed over flat plate collector (FPC) and Evacuated tube collector (ETC). The modifications include selection of materials other than glass, and glass wool which are conventionally used for fabricating FPC and ETC. Some modifications in design have also been proposed. Its collector is made of double layer of semi-cylindrical acrylic tubes and fibre reinforced plastic (FRP) insulation base. Water tank is made of double layer of acrylic sheet except base and north wall. FRP is used in base and north wall of the water tank. A concept of equivalent thickness has been utilised for calculating the dimensions of collector plate, acrylic tube and tank. A thermal model for the proposed design of MSWHS is developed and simulation is carried out on MATLAB for the capacity of 200L MSWHS having collector area of 1.6 m2, length of acrylic tubes of 2m at an inclination angle 25° which is taken nearly equal to the latitude of the given location. Latitude of Allahabad is 24.45° N. The results show that the maximum temperature of water in tank and tube has been found to be 71.2°C and 73.3°C at 17:00hr and 16:00hr respectively in March for the climatic data of Allahabad. Theoretical performance analysis has been carried out by varying number of tubes of collector, the tank capacity and climatic data for given months of winter and summer.

Keywords: acrylic, fibre reinforced plastic, solar water heating, thermal model, conventional water heaters

Procedia PDF Downloads 322
1202 Some Studies on Endometritis in Pure Arabian Mares

Authors: Khairi El Battawy, Monika Skalicki

Abstract:

The present investigation has been done on pure Egyptian Arabian mares that reared in private horse studs. Fifty non-pregnant mares were selected and examined to classify them as either being reproductively healthy or subfertile mares including clinical endometritis, early embryonic death, granulosa cell tumor, repeat breeder (post-breeding endometritis), and anoestrus mares. The purpose of the study was to assess oxidative/antioxidant biochemical metabolites, lipogram, trace elements and reproductive hormones throughout reproductive conditions in mares during regular estrous, anestrum, early pregnancy, granulose cell tumor, ovulation failure, and endometritis. Results showed intensification of the free radical-dependent process in the blood of infertile mare, especially mares with endometritis. Ultrasonography as a diagnostic tool diagnosis of endometritis in mares was an important step as it revealed much information concerning infertility problem.

Keywords: endometritis, ovulation, oxidative, mare

Procedia PDF Downloads 163
1201 Synchronous Carcinoma Cervix with Vulvar Carcinoma in situ: A Case Report

Authors: Bhushan Bhalgat, Suresh Singh, Phanindra Swain, Kamal Kishore Lakhera

Abstract:

Carcinoma of cervix and carcinoma of vulva have been associated with common predisposing factors like human papillomavirus and smoking. Skip metastases and metachronous appearance of both these tumours have been reported. There is no case report showing synchronous appearance of these tumours in English literature. We herewith report a case report of a middle aged female patient who presented with per vaginal bleeding, and on examination, a cervical mass was palpable. Also, a proliferative growth was seen over her left vulva. Biopsy of both lesions came out to be squamous cell carcinoma and carcinoma in situ, respectively. A radical hysterectomy and bilateral pelvic and paraaortic lymph nodal dissection was performed along with left simple vulvectomy. This thereby underscores that any lesion over vulva appearing during or after treatment of cervical carcinoma should be biopsied to rule out vulvar carcinoma.

Keywords: carcinoma of cervix, carcinoma of vulva, synchronous tumours, gynecological oncology

Procedia PDF Downloads 147