Search results for: spinal injuries
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 680

Search results for: spinal injuries

200 Immediate Life Support to a Wild Barn Owl (Tyto alba)

Authors: Bilge Kaan Tekelioglu, Mehmet Celik, Mahmut Ali Gokce, Ladine Celik, Yusuf Uzun

Abstract:

A male mature barn owl (Tyto alba) was brought to Cukurova University Ceyhan Veterinary Medicine Faculty at the beginning of January 2017. The bird was found at a local state elementary school’s garden where had been terribly damaged by metal wires. On the clinical examination, the animal was in shock and atonic position at arrival and seems to have feather problems and severe injuries. The ears, eyes, claws and wounded areas were checked and no signs of viral, microbial or ecto-parasitic infection were observed. The bird has been declared by U.S. wild life Office as endangered species. At first, the owl was kept in silent, warm and darkened cabinet against shock and warmed fluid replacement was started by % 5 dextrose solution per orally. On the second day, we started per oral forced feeding with chicken flesh meat dipped into the dextrose solution. On the third day, the bird was continued to be fed with fresh meat. At the fourth day, the owl was started to be fed with chicks during the next 3 days died by natural means which has been supplied by a local breeder. At the first 3 days 1 chick per day and the following days 2 chicks per day has been given per orally. The tenth day we started flying exercises in a small and non-windowed room safely. The saved owl was kept in this room for 10 more days. Finally, the owl was released at the habitation where it had been found injured. This study has one more time proved that, if you save one, you can save more. Wild life is in danger all over the world. Every living creature has right and deserves a chance to live.

Keywords: wild life, barn owl, Tyto alba, rescue, life support, feeding

Procedia PDF Downloads 356
199 Apparent Temperature Distribution on Scaffoldings during Construction Works

Authors: I. Szer, J. Szer, K. Czarnocki, E. Błazik-Borowa

Abstract:

People on construction scaffoldings work in dynamically changing, often unfavourable climate. Additionally, this kind of work is performed on low stiffness structures at high altitude, which increases the risk of accidents. It is therefore desirable to define the parameters of the work environment that contribute to increasing the construction worker occupational safety level. The aim of this article is to present how changes in microclimate parameters on scaffolding can impact the development of dangerous situations and accidents. For this purpose, indicators based on the human thermal balance were used. However, use of this model under construction conditions is often burdened by significant errors or even impossible to implement due to the lack of precise data. Thus, in the target model, the modified parameter was used – apparent environmental temperature. Apparent temperature in the proposed Scaffold Use Risk Assessment Model has been a perceived outdoor temperature, caused by the combined effects of air temperature, radiative temperature, relative humidity and wind speed (wind chill index, heat index). In the paper, correlations between component factors and apparent temperature for facade scaffolding with a width of 24.5 m and a height of 42.3 m, located at south-west side of building are presented. The distribution of factors on the scaffolding has been used to evaluate fitting of the microclimate model. The results of the studies indicate that observed ranges of apparent temperature on the scaffolds frequently results in a worker’s inability to adapt. This leads to reduced concentration and increased fatigue, adversely affects health, and consequently increases the risk of dangerous situations and accidental injuries

Keywords: apparent temperature, health, safety work, scaffoldings

Procedia PDF Downloads 180
198 Labor Productivity and Organization Performance in Specialty Trade Construction: The Moderating Effect of Safety

Authors: Shalini Priyadarshini

Abstract:

The notion of performance measurement has held great appeal for the industry and research communities alike. This idea is also true for the construction sector, and some propose that performance measurement and productivity analysis are two separate management functions, where productivity is a subset of performance, the latter requiring comprehensive analysis of comparable factors. Labor productivity is considered one of the best indicators of production efficiency. The construction industry continues to account for a disproportionate share of injuries and illnesses despite adopting several technological and organizational interventions that promote worker safety. Specialty trades contractors typically complete a large fraction of work on any construction project, but insufficient body of work exists that address subcontractor safety and productivity issues. Literature review has revealed the possibility of a relation between productivity, safety and other factors and their links to project, organizational, task and industry performance. This research posits that there is an association between productivity and performance at project as well as organizational levels in the construction industry. Moreover, prior exploration of the importance of safety within the performance-productivity framework has been anecdotal at best. Using structured questionnaire survey and organization- and project level data, this study, which is a combination of cross-sectional and longitudinal research designs, addresses the identified research gap and models the relationship between productivity, safety, and performance with a focus on specialty trades in the construction sector. Statistical analysis is used to establish a correlation between the variables of interest. This research identifies the need for developing and maintaining productivity and safety logs for smaller businesses. Future studies can design and develop research to establish causal relationships between these variables.

Keywords: construction, safety, productivity, performance, specialty trades

Procedia PDF Downloads 277
197 Clinical Outcomes of Mild Traumatic Brain Injury with Acute Traumatic Intracranial Hemorrhage on Initial Emergency Ward Neuroimaging

Authors: S. Shafiee Ardestani, A. Najafi, N. Valizadeh, E. Payani, H. Karimian

Abstract:

Objectives: Treatment of mild traumatic brain injury in emergency ward patients with any type of traumatic intracranial hemorrhage is flexible. The aim of this study is to assess the clinical outcomes of mild traumatic brain injury patients who had acute traumatic intracranial hemorrhage on initial emergency ward neuroimaging. Materials-Methods: From March 2011 to November 2012 in a retrospective cohort study we enrolled emergency ward patients with mild traumatic brain injury with Glasgow Coma Scale (GCS) scores of 14 or 15 and who had stable vital signs. Patients who had any type of intracranial hemorrhage on first head CT and repeat head CT within 24 hours were included. Patients with initial GCS < 14, injury > 24 hours old, pregnancy, concomitant non-minor injuries, and coagulopathy were excluded. Primary endpoints were neurosurgical procedures and/or death and for discharged patients, return to the emergency ward during one week. Results: Among 755 patients who were referred to the emergency ward and underwent two head CTs during first 24 hours, 302 (40%) were included. The median interval between CT scans was 6 hours (ranging 4 to 8 hours). Consequently, 135 (45%) patients had subarachnoid hemorrhage, 124 (41%) patients had subdural hemorrhage, 15 (5%) patients had epidural hemorrhage, 28 (9%) patients had cerebral contusions, and 54 (18%) patients had intra-parenchymal hemorrhage. Six of 302 patients died within 15 days of injury. 200 patients (66%) have been discharged from the emergency ward, 25 (12%) of whom returned to the emergency ward after one week. Conclusion: Discharge of the head trauma patients after a repeat head CT and brief period of observation in the emergency ward lead to early discharge of mild traumatic brain injury patients with traumatic ICH without adverse events.

Keywords: clinical outcomes, emergency ward, mild traumatic intracranial hemorrhage, Glasgow Coma Scale (GCS)

Procedia PDF Downloads 336
196 Development of a System for Measuring the Three-axis Pedal Force in Cycling and Its Applications

Authors: Joo-Hack Lee, Jin-Seung Choi, Dong-Won Kang, Jeong-Woo Seo, Ju-Young Kim, Dae-Hyeok Kim, Seung-Tae Yang, Gye-Rae Tack

Abstract:

For cycling, the analysis of the pedal force is one of the important factors in the study of exercise ability assessment and overuse injuries. In past studies, a two-axis measurement sensor was used at the sagittal plane to measure the force only in the anterior, posterior, and vertical directions and to analyze the loss of force and the injury on the frontal plane due to the forces in the right and left directions. In this study, which is a basic study on diverse analyses of the pedal force that consider the forces on the sagittal plane and the frontal plane, a three-axis pedal force measurement sensor was developed to measure the anterior-posterior (Fx), medio-lateral (Fz), and vertical (Fy) forces. The sensor was fabricated with a size and shape similar to those of the general flat pedal, and had a 550g weight that allowed smooth pedaling. Its measurement range was ±1000 N for Fx and Fz and ±2000 N for Fy, and its non-linearity, hysteresis, and repeatability were approximately 0.5%. The data were sampled at 1000 Hz using a signal collector. To use the developed sensor, the pedaling efficiency (index of efficiency, IE) and the range of left and right (medio-lateral, ML) forces were measured with two seat heights (low and high). The results of the measurement showed that the IE was higher and the force range in the ML direction was lower with the high position than with the low position. The developed measurement sensor and its application results will be useful in understanding and explaining the complicated pedaling technique, and will enable diverse kinematic analyses of the pedal force on the sagittal plane and the frontal plane.

Keywords: cycling, pedal force, index of effectiveness, measuring

Procedia PDF Downloads 658
195 A Parking Demand Forecasting Method for Making Parking Policy in the Center of Kabul City

Authors: Roien Qiam, Shoshi Mizokami

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Parking demand in the Central Business District (CBD) has enlarged with the increase of the number of private vehicles due to rapid economic growth, lack of an efficient public transport and traffic management system. This has resulted in low mobility, poor accessibility, serious congestion, high rates of traffic accident fatalities and injuries and air pollution, mainly because people have to drive slowly around to find a vacant spot. With parking pricing and enforcement policy, considerable advancement could be found, and on-street parking spaces could be managed efficiently and effectively. To evaluate parking demand and making parking policy, it is required to understand the current parking condition and driver’s behavior, understand how drivers choose their parking type and location as well as their behavior toward finding a vacant parking spot under parking charges and search times. This study illustrates the result from an observational, revealed and stated preference surveys and experiment. Attained data shows that there is a gap between supply and demand in parking and it has maximized. For the modeling of the parking decision, a choice model was constructed based on discrete choice modeling theory and multinomial logit model estimated by using SP survey data; the model represents the choice of an alternative among different alternatives which are priced on-street, off-street, and illegal parking. Individuals choose a parking type based on their preference concerning parking charges, searching times, access times and waiting times. The parking assignment model was obtained directly from behavioral model and is used in parking simulation. The study concludes with an evaluation of parking policy.

Keywords: CBD, parking demand forecast, parking policy, parking choice model

Procedia PDF Downloads 193
194 Investigating the Feasibility of Promoting Safety in Civil Projects by BIM System Using Fuzzy Logic

Authors: Mohammad Reza Zamanian

Abstract:

The construction industry has always been recognized as one of the most dangerous available industries, and the statistics of accidents and injuries resulting from it say that the safety category needs more attention and the arrival of up-to-date technologies in this field. Building information modeling (BIM) is one of the relatively new and applicable technologies in Iran, that the necessity of using it is increasingly evident. The main purposes of this research are to evaluate the feasibility of using this technology in the safety sector of construction projects and to evaluate the effectiveness and operationality of its various applications in this sector. These applications were collected and categorized after reviewing past studies and researches then a questionnaire based on Delphi method criteria was presented to 30 experts who were thoroughly familiar with modeling software and safety guidelines. After receiving and exporting the answers to SPSS software, the validity and reliability of the questionnaire were assessed to evaluate the measuring tools. Fuzzy logic is a good way to analyze data because of its flexibility in dealing with ambiguity and uncertainty issues, and the implementation of the Delphi method in the fuzzy environment overcomes the uncertainties in decision making. Therefore, this method was used for data analysis, and the results indicate the usefulness and effectiveness of BIM in projects and improvement of safety status at different stages of construction. Finally, the applications and the sections discussed were ranked in order of priority for efficiency and effectiveness. Safety planning is considered as the most influential part of the safety of BIM among the four sectors discussed, and planning for the installation of protective fences and barriers to prevent falls and site layout planning with a safety approach based on a 3D model are the most important applications of BIM among the 18 applications to improve the safety of construction projects.

Keywords: building information modeling, safety of construction projects, Delphi method, fuzzy logic

Procedia PDF Downloads 166
193 A Virtual Reality Simulation Tool for Reducing the Risk of Building Content during Earthquakes

Authors: Ali Asgary, Haopeng Zhou, Ghassem Tofighi

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Use of virtual (VR), augmented reality (AR), and extended reality technologies for training and education has increased in recent years as more hardware and software tools have become available and accessible to larger groups of users. Similarly, the applications of these technologies in earthquake related training and education are on the rise. Several studies have reported promising results for the use of VR and AR for evacuation behaviour and training under earthquake situations. They simulate the impacts that earthquake has on buildings, buildings’ contents, and how building occupants and users can find safe spots or open paths to outside. Considering that considerable number of earthquake injuries and fatalities are linked to the behaviour, our goal is to use these technologies to reduce the impacts of building contents on people. Building on our artificial intelligence (AI) based indoor earthquake risk assessment application that enables users to use their mobile device to assess the risks associated with building contents during earthquakes, we develop a virtual reality application to demonstrate the behavior of different building contents during earthquakes, their associate moving, spreading, falling, and collapsing risks, and their risk mitigation methods. We integrate realistic seismic models, building contents behavior with and without risk mitigation measures in virtual reality environment. The application can be used for training of architects, interior design experts, and building users to enhance indoor safety of the buildings that can sustain earthquakes. This paper describes and demonstrates the application development background, structure, components, and usage.

Keywords: virtual reality, earthquake damage, building content, indoor risks, earthquake risk mitigation, interior design, unity game engine, oculus

Procedia PDF Downloads 102
192 Disparities in Suicide and Mental Health among Student Athletes of Ethnic and Racial Minorities Compared to Their White Non-latinx Counterparts

Authors: Elizabeth Russo, Angelica Terepka

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The present paper reviews literature examining trends among suicide, suicidal ideation, and mental illness rates in ethnic and racial minority student-athletes. While the rates of suicide amongst student athlete populations is lower than rates of suicide seen in the general student populations, there is a discrepancy amongst rates of suicide in student athletes; specifically, those identifying with racial and ethnic minority backgrounds endorse higher rates of suicidal ideation. The samples from the existing literature consisted of White, Black, Hispanic/Latinx, Asian/ Pacific Islander, Multiracial, and Native American student-athletes. Studies suggest that ethnic and racial minority students are more susceptible to suicide, depression, and other mental health concerns compared to their white counterparts. Across the literature, White student athletes appeared to have more social and academic support from fellow classmates, university administration and professors, and staff within their athletic departments. Student athletes who did not identify as White endorsed higher rates of loneliness, felt ethnically and racially underrepresented within their athletic department, and endorsed lack of appropriate medical treatment for injuries by athletic department medical staff. Additionally, non-White student athletes receive less peer support and must balance additional stressors such as discrimination in contrast to their White/non-Latinx peers. Recommendations for athletic departments and mental health providers supporting student athletes who identify as racial and ethnic minorities are discussed.

Keywords: racial and ethnic minority, suicide, student-athlete, suicidal ideation

Procedia PDF Downloads 81
191 A Study of Influence of Freezing on Mechanical Properties of Tendon Fascicles

Authors: Martyna Ekiert, Andrzej Mlyniec

Abstract:

Tendons are the biological structures, which primary function is to transfer force generated by muscles to the bones. Unfortunately, damages of tendons are also one of the most common injuries of the human musculoskeletal system. For the most severe cases of tendon rupture, such as the tear of calcaneus tendon or anterior cruciate ligament of the knee, a surgical procedure is the only possible way of full recovery. Tendons used as biological grafts are usually subjected to the process of deep freezing and subsequent thawing. This, in particular for multiple freezing/thawing cycles, may result in changes of tendon internal structure causing deterioration of mechanical properties of the tissue. Therefore, studies on the influence of freezing on tendons biomechanics, including internal water content in soft tissue, seems to be greatly needed. An experimental study of the influence of freezing on mechanical properties of the tendon was performed on fascicles samples dissected form bovine flexor tendons. The preparation procedure was performed with the presence of 0.9% saline solution in order to prevent an excessive tissue drying. All prepared samples were subjected to the different number of freezing/thawing cycles. For freezing part of the protocol we used -80°C temperature while for slow thawing we used fridge temperature (4°C) combined with equalizing temperatures in the standard state (25°C). After final thawing, the mechanical properties of each sample was examined using cyclic loading test. Our results may contribute for better understanding of negative effects of soft tissues freezing, resulting from abnormal thermal expansion of water. This also may help to determine the limit of freezing/thawing cycles disqualifying tissue for surgical purposes and thus help optimize tissues storage conditions.

Keywords: freezing, soft tissue, tendon, bovine fascicles

Procedia PDF Downloads 218
190 Monitor Vehicle Speed Using Internet of Things Based Wireless Sensor Network System

Authors: Akber Oumer Abdurezak

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Road traffic accident is a major problem in Ethiopia, resulting in the deaths of many people and potential injuries and crash every year and loss of properties. According to the Federal Transport Authority, one of the main causes of traffic accident and crash in Ethiopia is over speeding. Implementation of different technologies is used to monitor the speed of vehicles in order to minimize accidents and crashes. This research aimed at designing a speed monitoring system to monitor the speed of travelling vehicles and movements, reporting illegal speeds or overspeeding vehicles to the concerned bodies. The implementation of the system is through a wireless sensor network. The proposed system can sense and detect the movement of vehicles, process, and analysis the data obtained from the sensor and the cloud system. The data is sent to the central controlling server. The system contains accelerometer and gyroscope sensors to sense and collect the data of the vehicle. Arduino to process the data and Global System for Mobile Communication (GSM) module for communication purposes to send the data to the concerned body. When the speed of the vehicle exceeds the allowable speed limit, the system sends a message to database as “over speeding”. Both accelerometer and gyroscope sensors are used to collect acceleration data. The acceleration data then convert to speed, and the corresponding speed is checked with the speed limit, and those above the speed limit are reported to the concerned authorities to avoid frequent accidents. The proposed system decreases the occurrence of accidents and crashes due to overspeeding and can be used as an eye opener for the implementation of other intelligent transport system technologies. This system can also integrate with other technologies like GPS and Google Maps to obtain better output.

Keywords: accelerometer, IOT, GSM, gyroscope

Procedia PDF Downloads 74
189 Development of 3D Printed, Conductive, Biodegradable Nerve Conduits for Neural Regeneration

Authors: Wei-Chia Huang, Jane Wang

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Damage to nerves is considered one of the most irreversible injuries. The regeneration of nerves has always been an important topic in regenerative medicine. In general, damage to human tissue will naturally repair overtime. However, when the nerves are damaged, healed flesh wound cannot guarantee full restoration to its original function, as truncated nerves are often irreversible. Therefore, the development of treatment methods to successfully guide and accelerate the regeneration of nerves has been highly sought after. In order to induce nerve tissue growth, nerve conduits are commonly used to help reconnect broken nerve bundles to provide protection to the location of the fracture while guiding the growth of the nerve bundles. To prevent the protected tissue from becoming necrotic and to ensure the growth rate, the conduits used are often modified with microstructures or blended with neuron growth factors that may facilitate nerve regeneration. Electrical stimulation is another attempted treatment for medical rehabilitation. With appropriate range of voltages and stimulation frequencies, it has been demonstrated to promote cell proliferation and migration. Biodegradability are critical for medical devices like nerve conduits, while conductive polymers pose great potential toward the differentiation and growth of nerve cells. In this work, biodegradability and conductivity were combined into a novel biodegradable, photocurable, conductive polymer composite materials by embedding conductive nanoparticles in poly(glycerol sebacate) acrylate (PGSA) and 3D-printed into nerve conduits. Rat pheochromocytoma cells and rat neuronal Schwann cells were chosen for the in vitro tests of the conduits and had demonstrate selective growth upon culture in the conductive conduits with built-in microchannels and electrical stimulation.

Keywords: biodegradable polymer, 3d printing, neural regeneration, electrical stimulation

Procedia PDF Downloads 103
188 Effect of Saffron Extract and Aerobic Exercises on Troponin T and Heart-Type Fatty Acid Binding Protein in Men with Type 2 Diabetes

Authors: Ahmad Abdi, M. Golzadeh Gangeraj, Alireza Barari, S. Shirali, S. Amini

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Aims: Diabetes is one of the common metabolic diseases in the world that has the dire adverse effects such as nephropathy, retinopathy and cardiovascular problems. Pharmaceutical and non-pharmaceutical strategies for control and treatment of diabetes are provided. Exercise and nutrition as non-drug strategies for the prevention and control of diabetes are considered. Exercises may increase oxidative stress and myocardium injury, thus it is necessary to take nutrition strategies to help diabetic athletes. Methods: This study was a semi-experimental research. Therefore, 24 men with type 2 diabetes were selected and randomly divided in four groups (1. control, 2. saffron extract, 3. aerobic exercises, 4. compound aerobic exercises and saffron extract). Saffron extract with 100 mg/day was used. Aerobic exercises, three days a week, for eight weeks, with 55-70% of maximum heart rate were performed. At the end, levels of Heart-type fatty acid-binding protein (HFABP) and Troponin T were measured. Data were analyzed by Paired t, One-way ANOVA and Tukey tests. Results: The serum Troponin T increased significantly in saffron extract, aerobic exercises and compound saffron extract -aerobic exercises in type 2 diabetic men(P=0.024, P =0.013, P=0.005 respectively). Saffron extract consumption (100 mg/day) and aerobic exercises did not significantly influence the serum HFABP (P =0.365, P =0.188 respectively). But serum HFABP decreased significantly in compound saffron extract -aerobic exercises group (P =0.003). Conclusions: Raised cardiac Troponin T and HFABP concentration accepted as the standard biochemical markers for the diagnosis of cardiac injury. Saffron intake may beneficially protect the myocardium from injuries. Compound saffron extract -aerobic exercises can decrease levels of Troponin T and HFABP in men with type 2 diabetes.

Keywords: Saffron, aerobic exercises, type 2 diabetes, HFABP, troponin T

Procedia PDF Downloads 266
187 Studies on Tolerance of Chickpea to Some Pre and Post Emergence Herbicides

Authors: Rahamdad Khan, Ijaz Ahmad Khan

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In modern agriculture the herbicides application are considered the most effective and fast in action against all types of weeds. But it’s a fact that the herbicide applicator cannot totally secure the crop plants from the possible herbicide injuries that further leads to several destructive changes in plant biochemistry. For the purpose pots studies were undertaken to test the tolerance order of chickpea against pre- emergence herbicides (Stomp 330 EC- Dual Gold 960 EC) and post- emergence herbicides (Topik 15 WP- Puma Super 75 EW- Isoproturon 500 EW) during 2012-13 and 2013-14. The experimental design was CRD with three replications. Plant height, number of branches plant-1, number of seeds plant-1, nodulation, seed protein contents and other growth related parameters in chickpea were examined during the investigations. The results indicate that all the enquire herbicides gave a significant variation to all recorded parameter of chick pea except nodule fresh and dray weight. Moreover the toxic effect of pre-emergence herbicide on chickpea was found higher as compared to post-emergence herbicides. Minimum chickpea plant height (50.50 cm), number of nodule plant-1 (17.83) and lowest seed protein (14.13 %) was recorded in Stomp 330 EC. Similarly the outmost seeds plant-1 (29.66) and number of nodule plant-1 (21) were found for Puma Super 75 EW. The results further showed that the highest seed protein content (21.75 and 21.15 %) was recorded for control/ untreated and Puma Super 75EW. Taking under concentration the possible negative impact of the herbicides the chemical application must be minimized up to certain extent at which the crop is mostly secure. However chemical weed control has many advantages so we should train our farmer regarding the proper use of agro chemical to minimize the loses in crops while using herbicides.

Keywords: chickpea, herbicides, protein, stomp 330 EC, weed

Procedia PDF Downloads 488
186 Functionalized Spherical Aluminosilicates in Biomedically Grade Composites

Authors: Damian Stanislaw Nakonieczny, Grazyna Simha Martynkova, Marianna Hundakova, G. Kratosová, Karla Cech Barabaszova

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The main aim of the research was to functionalize the surface of spherical aluminum silicates in the form of so-called cenospheres. Cenospheres are light ceramic particles with a density between 0.45 and 0.85 kgm-3 hat can be obtained as a result of separation from fly ash from coal combustion. However, their occurrence is limited to about 1% by weight of dry ash mainly derived from anthracite. Hence they are very rare and desirable material. Cenospheres are characterized by complete chemical inertness. Mohs hardness in range of 6 and completely smooth surface. Main idea was to prepare the surface by chemical etching, among others hydrofluoric acid (HF) and hydrogen peroxide, caro acid, silanization using (3-aminopropyl) triethoxysilane (APTES) and tetraethyl orthosilicate (TEOS) to obtain the maximum development and functionalization of the surface to improve chemical and mechanical connection with biomedically used polymers, i.e., polyacrylic methacrylate (PMMA) and polyetheretherketone (PEEK). These polymers are used medically mainly as a material for fixed and removable dental prostheses and PEEK spinal implants. The problem with their use is the decrease in mechanical properties over time and bacterial infections fungal during implantation and use of dentures. Hence, the use of a ceramic filler that will significantly improve the mechanical properties, improve the fluidity of the polymer during shape formation, and in the future, will be able to support bacteriostatic substances such as silver and zinc ions seem promising. In order to evaluate our laboratory work, several instrumental studies were performed: chemical composition and morphology with scanning electron microscopy with Energy-Dispersive X-Ray Probe (SEM/EDX), determination of characteristic functional groups of Fourier Transform Infrared Spectroscopy (FTIR), phase composition of X-ray Diffraction (XRD) and thermal analysis of Thermo Gravimetric Analysis/differentia thermal analysis (TGA/DTA), as well as assessment of isotherm of adsorption with Brunauer-Emmett-Teller (BET) surface development. The surface was evaluated for the future application of additional bacteria and static fungus layers. Based on the experimental work, it was found that orated methods can be suitable for the functionalization of the surface of cenosphere ceramics, and in the future it can be suitable as a bacteriostatic filler for biomedical polymers, i.e., PEEK or PMMA.

Keywords: bioceramics, composites, functionalization, surface development

Procedia PDF Downloads 119
185 Patient Tracking Challenges During Disasters and Emergencies

Authors: Mohammad H. Yarmohammadian, Reza Safdari, Mahmoud Keyvanara, Nahid Tavakoli

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One of the greatest challenges in disaster and emergencies is patient tracking. The concept of tracking has different denotations. One of the meanings refers to tracking patients’ physical locations and the other meaning refers to tracking patients ‘medical needs during emergency services. The main goal of patient tracking is to provide patient safety during disaster and emergencies and manage the flow of patient and information in different locations. In most of cases, there are not sufficient and accurate data regarding the number of injuries, medical conditions and their accommodation and transference. The objective of the present study is to survey on patient tracking issue in natural disaster and emergencies. Methods: This was a narrative study in which the population was E-Journals and the electronic database such as PubMed, Proquest, Science direct, Elsevier, etc. Data was gathered by Extraction Form. All data were analyzed via content analysis. Results: In many countries there is no appropriate and rapid method for tracking patients and transferring victims after the occurrence of incidents. The absence of reliable data of patients’ transference and accommodation, even in the initial hours and days after the occurrence of disasters, and coordination for appropriate resource allocation, have faced challenges for evaluating needs and services challenges. Currently, most of emergency services are based on paper systems, while these systems do not act appropriately in great disasters and incidents and this issue causes information loss. Conclusion: Patient tracking system should update the location of patients or evacuees and information related to their states. Patients’ information should be accessible for authorized users to continue their treatment, accommodation and transference. Also it should include timely information of patients’ location as soon as they arrive somewhere and leave therein such a way that health care professionals can be able to provide patients’ proper medical treatment.

Keywords: patient tracking, challenges, disaster, emergency

Procedia PDF Downloads 304
184 Simulated Mechanical Analysis on Hydroxyapatite Coated Porous Polylactic Acid Scaffold for Bone Grafting

Authors: Ala Abobakr Abdulhafidh Al-Dubai

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Bone loss has risen due to fractures, surgeries, and traumatic injuries. Scientists and engineers have worked over the years to find solutions to heal and accelerate bone regeneration. The bone grafting technique has been utilized, which projects significant improvement in the bone regeneration area. An extensive study is essential on the relation between the mechanical properties of bone scaffolds and the pore size of the scaffolds, as well as the relation between the mechanical properties of bone scaffolds with the development of bioactive coating on the scaffolds. In reducing the cost and time, a mechanical simulation analysis is beneficial to simulate both relations. Therefore, this study highlights the simulated mechanical analyses on three-dimensional (3D) polylactic acid (PLA) scaffolds at two different pore sizes (P: 400 and 600 μm) and two different internals distances of (D: 600 and 900 μm), with and without the presence of hydroxyapatite (HA) coating. The 3D scaffold models were designed using SOLIDWORKS software. The respective material properties were assigned with the fixation of boundary conditions on the meshed 3D models. Two different loads were applied on the PLA scaffolds, including side loads of 200 N and vertical loads of 2 kN. While only vertical loads of 2 kN were applied on the HA coated PLA scaffolds. The PLA scaffold P600D900, which has the largest pore size and maximum internal distance, generated the minimum stress under the applied vertical load. However, that same scaffold became weaker under the applied side load due to the high construction gap between the pores. The development of HA coating on top of the PLA scaffolds induced greater stress generation compared to the non-coated scaffolds which is tailorable for bone implantation. This study concludes that the pore size and the construction of HA coating on bone scaffolds affect the mechanical strength of the bone scaffolds.

Keywords: hydroxyapatite coating, bone scaffold, mechanical simulation, three-dimensional (3D), polylactic acid (PLA).

Procedia PDF Downloads 56
183 A Preliminary Investigation on Factors that Influence Road Users Speeding Behaviors in Selected Roads of Peninsular Malaysia

Authors: Farah Fazlinda Binti Mohamad, Siti Hikmah Binti Musthar, Ahmad Saifizul Bin Abdullah, Jamilah Mohamad, Mohamed Rehan Karim

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Road safety is intolerable issue. It affects and impinges on everyone's life as the roads shared by everyone. The most vulnerable victims were the road users who cater the roads every day. It is an appalling when World Health Organization reported that Malaysian road users were ranked worst in Asian countries with 23 deaths for every 100,000 of population over the span of 12 years (World Health Organization, 2009). From this report, it is found that speeding has contributed to 60% of all accidents in the country. Therefore, this study aims to elucidate on speeding matter that occur among road users in selected roads of Peninsular Malaysia. This study on the other hand, provides an insight understanding on the factors affecting behaviour of road users to speeding in selected roads of Peninsular Malaysia. To answer the study aims, 500 sets of questionnaires were distributed among 500 respondents in selected roads of Peninsular Malaysia to obtain their opinions on the matter. The respondents were from different demographics backgrounds to have fair explanation on the issue. The answers have been analysed using descriptive analysis. The results indicated psychological factors of road users appeared to be prominent in explaining road users’ behaviour to speeding. Male road users were also found dominant in speeding compared to female. Thus, this has increased their vulnerability to road injuries and deaths. These findings are very useful in order for us to improve our driving behaviour. Relevant authorities should also revise the existing countermeasures as well as designing the new countermeasures for the road users. It is nevertheless important to comprehend this speeding issue and factors associating it. This matter should be taken seriously and responsibly by each road users as road safety is a responsible of all.

Keywords: road safety, speeding, countermeasures, accidents

Procedia PDF Downloads 485
182 Potentials and Challenges of Adventure Tourism Development: A Case Study of Kashmir Valley, India

Authors: Abdul Hamid Mir

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Tourism which is considered as the economic bonanza of Jammu and Kashmir plays an important role in the socio-economic development of Jammu and Kashmir. It is considered as a multi-segmented industry which provides different type of jobs like hotel managers, receptionists, guides, tour operators, travel agents, photographers, etc. Kashmir Valley which is one of the three meso regions (Jammu, Kashmir and Ladakh) of Jammu and Kashmir State is famous all over the world due to its natural beauty. It attracts tourists from the every corner of the globe that is why it has earned name as ‘Paradise on Earth’ and ‘Switzerland of Asia’. It is full of natural treasure and gratifies the several types of tourists. The tourists are experiences fun, thrilling events and safe experience in Kashmir valley, but on the other hand, the adventure tourists are experiencing the physical risks, dangers and losses (injuries, death etc) too. Kashmir valley has greater potential to become one of the best adventure tourism destinations in the world. It offers immense opportunities to the adventurists to explore the wonderful exotic Himalayan ranges and landscapes, in addition, to facing the challenges of fast flowing rivers. Adventure tourism is at the initial stage of development in Kashmir valley and virgin areas needs to be explored and develop which in result will increase not only tourist arrivals but also enhance the business opportunities and economy of local people in Kashmir. Thus the exploitation of virginity of adventure tourism potentials in Kashmir valley is need of the hour. Therefore the present study highlights the potentials of adventure tourism in Kashmir valley and also focuses on the problems in the development of adventure tourism. Furthermore, the study extends to give various recommendations and suggestions in order to develop adventure tourism and broaden the base of tourist arrivals on one hand and sustained the growth on the other hand.

Keywords: adventure, Kashmir, tourism, tourists, potential, rafting, skiing

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181 Comparative Study in Treatment of Distal Humerus Fracture with Lateral Column Plate Percutaneous Medial Screw and Intercondylar Screw

Authors: Sameer Gupta, Prant Gupta

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Context: Fractures in the distal humerus are complex and challenging injuries for orthopaedic surgeons that can be effectively treated with open reduction and internal fixation. Aims: The study analyses clinical outcomes in patients with intra-articular distal humerus fractures (AO type 13 C3 excluded) treated using a different method of fixation ( LCPMS). Subject and Methods: A study was performed, and the author's personal experiences were reported. Thirty patients were treated using an intercondylar screw with lateral column plating and percutaneous medial column screw fixation. Detailed analysis was done for functional outcomes (average arc of motion, union rate, and complications). Statistical Analysis Used: SPSS software version 22.0 was used for statistical analysis. Results: In our study, at the end of 6 months, Overall good to excellent results were achieved in 28 patients out of 30 after analysis on the basis of MEP score. The majority of patients regained full arc of motion, achieved fracture union without any major complications, and were able to perform almost all activities of daily living (which required good elbow joint movements and functions). Conclusion: We concluded that this novel method provides adequate stability and anatomical reconstruction with an early union rate observed at the end of 6 months. Excellent functional outcome was observed in almost all the patients because of less operating time and initiation of early physiotherapy, as most of the patients experienced mild nature of pain post-surgery.

Keywords: intra arricular distal humerus fracture, percutaneous medial screw, lateral column plate, arc of motion

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180 Acute Cartilage Defects of the Knee Treated With Chondral Restoration Procedures and Patellofemoral Stabilisation

Authors: John Scanlon, Antony Raymond, Randeep Aujla, Peter D’Alessandro, Satyen Gohil

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Background: The incidence of significant acute chondral injuries with patella dislocation is around 10-15%. It is accepted that chondral procedures should only be performed in the presence of joint stability Methods:Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging, and complications were recorded. PROMs and patient satisfaction was obtained. Results:20 knees (18 patients) were included. Mean age was 18.6 years (range; 11-39), and the mean follow-up was 16.6 months (range; 2-70). The defect locations were the lateral femoral condyle (9/20; 45%), patella (9/20; 45%), medial femoral condyle (1/20; 5%) and the trochlea (1/20; 5%). The mean defect size was 2.6cm2. Twelve knees were treated with cartilage fixation, 5 with microfracture, and 3 with OATS. At follow up, the overall mean Lysholm score was 77.4 (± 17.1), with no chondral regenerative procedure being statistically superior. There was no difference in Lysholm scores between those patients having acute medial patellofemoral ligament reconstruction versus medial soft tissue plication (p=0.59). Five (25%) knees required re-operation (one arthroscopic arthrolysis; one patella chondroplasty; two removal of loose bodies; one implant adjustment). Overall, 90% responded as being satisfied with surgery. Conclusion: Our aggressive pathway to identify and treat acute cartilage defects with early operative intervention and patella stabilisation has shown high rates of satisfaction and Lysholm scores. The full range of chondral restoration options should be considered by surgeons managing these patients.

Keywords: patella dislocation, chondral restoration, knee, patella stabilisation

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179 Gender Estimation by Means of Quantitative Measurements of Foramen Magnum: An Analysis of CT Head Images

Authors: Thilini Hathurusinghe, Uthpalie Siriwardhana, W. M. Ediri Arachchi, Ranga Thudugala, Indeewari Herath, Gayani Senanayake

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The foramen magnum is more prone to protect than other skeletal remains during high impact and severe disruptive injuries. Therefore, it is worthwhile to explore whether these measurements can be used to determine the human gender which is vital in forensic and anthropological studies. The idea was to find out the ability to use quantitative measurements of foramen magnum as an anatomical indicator for human gender estimation and to evaluate the gender-dependent variations of foramen magnum using quantitative measurements. Randomly selected 113 subjects who underwent CT head scans at Sri Jayawardhanapura General Hospital of Sri Lanka within a period of six months, were included in the study. The sample contained 58 males (48.76 ± 14.7 years old) and 55 females (47.04 ±15.9 years old). Maximum length of the foramen magnum (LFM), maximum width of the foramen magnum (WFM), minimum distance between occipital condyles (MnD) and maximum interior distance between occipital condyles (MxID) were measured. Further, AreaT and AreaR were also calculated. The gender was estimated using binomial logistic regression. The mean values of all explanatory variables (LFM, WFM, MnD, MxID, AreaT, and AreaR) were greater among male than female. All explanatory variables except MnD (p=0.669) were statistically significant (p < 0.05). Significant bivariate correlations were demonstrated by AreaT and AreaR with the explanatory variables. The results evidenced that WFM and MxID were the best measurements in predicting gender according to binomial logistic regression. The estimated model was: log (p/1-p) =10.391-0.136×MxID-0.231×WFM, where p is the probability of being a female. The classification accuracy given by the above model was 65.5%. The quantitative measurements of foramen magnum can be used as a reliable anatomical marker for human gender estimation in the Sri Lankan context.

Keywords: foramen magnum, forensic and anthropological studies, gender estimation, logistic regression

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178 Assessment of Vehicular Accidents and Possible Mitigation Measures: A Case of Ahmedabad, Gujarat, India

Authors: K. Omkar, D. Nayan

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Rapid urbanization is one of the consequences of rapid population explosion, which has also led to massive increase in number of motorized vehicles essential for carrying out all activities needed for sustaining urban livelihood. With this increased use of motorized vehicles over the time there has also been an increase in number of accidents. Study of road network and geometric features are essential to tackle problems of road accidents in any district or town. The increase in road accidents is one of the burning issues in the present society. Records show that there is one death at every 3.7 minutes because of road accident. It has been found from the research that, accidents occur due to, mistakes of the driver (86%) followed by bad street condition (5%), mistake of pedestrian (4%), as well as technical and maintenance defects (1%). Here, case study of Ahmedabad, Gujarat is taken up where first road safety level is assessed considering various parameters. The study confined to accident characteristics of all types of vehicles. For deeper analysis, road safety index for various stretches in Ahmedabad was found out. Crash rate for same stretches was found out. Based on various parameters priority was decided so that which stretch should be look out first to minimize road accidents on that stretch and which stretch should look out last. The major findings of the study are that accident severity of Ahmedabad has increased, but accident fatality risk has decreased; thus there is need to undertake some traffic engineering measures or make some traffic rules that are strictly followed by traffic. From the above study and literature studied it is found that Ahmedabad is suffering from similar problem of accidents and injuries and deaths caused by them, after properly investigating the issue short-term and long-term solutions to minimize road accidents have been presented in this paper.

Keywords: accident severity index, accident fatality rate, accident fatality risk, accident risk, road safety index

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177 Distributed Leadership and Emergency Response: A Study on Seafarers

Authors: Delna Shroff

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Merchant shipping is an occupation with a high rate of fatal injuries caused by organizational accidents and maritime disasters. In most accident investigations, the leader’s actions are under scrutiny and point out the necessity to investigate the leader’s decisions in critical conditions. While several leadership studies have been carried out in the past, there is a tendency for most research to focus on holders of formal positions. The unit of analysis in most studies has been the ‘individual.’ A need is, therefore, felt to adopt a practice-based perspective of leadership, understand how leadership emerges to affect maritime safety. This paper explores the phenomenon of distributed leadership among seafarers more holistically. It further examines the role of one form of distributed leadership, that is, planfully aligned leadership in the emergency response of the team. A mixed design will be applied. In the first phase, the data gathered by way of semi-structured interviews will be used to explore the seafarer’s implicit understanding of leadership. The data will be used to develop a conceptual framework of distributed leadership, specific to the maritime context. This framework will be used to develop a simulation. Experimental design will be used to examine the relationship between planfully aligned leadership and emergency response of the team members during navigation. Findings show that planfully aligned leadership significantly and positively predicts the emergency response of team members. Planfully aligned leadership leads to a better emergency response of the team members as compared to authoritarian leadership. In the third qualitative phase, additional data will be gathered through semi-structured interviews to further validate the findings to gain a more complete understanding of distributed leadership and its relation to emergency response. Above are the predictive results; the study expects to be a cornerstone of safety leadership research and has important implications for leadership development and training within the maritime industry.

Keywords: authoritarian leadership, distributed leadership, emergency response , planfully aligned leadership

Procedia PDF Downloads 173
176 Exploring the Stressors Faced by Sportspersons: A Qualitative Study on Young Indian Sportspersons and Their Coping Strategies to Stress

Authors: Moyera Sanganeria

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In the highly competitive landscape of contemporary sports, sportspersons worldwide encounter formidable challenges, often practicing for extensive hours while contending with limited social and physical resources. A growing number of sportspersons globally are sharing their struggles with depression, anxiety, and stress arising from the complex journey and identity associated with being a sportsperson. This qualitative study aims to investigate the challenges faced by sportspersons in individual versus team sports and explore potential gender-based variations in coping strategies. It attempts to do so by recognizing the imperative to comprehend the root causes and coping mechanisms for these stressors. By employing purposive sampling, MMA and Kabaddi players from training academies across Mumbai were selected for the study. Twelve participants were interviewed through semi-structured interviews guided by an interview guide. Reflective thematic analysis was employed to discern diverse stressors and coping strategies. Key stressors encountered by young Indian sportspersons encompass injuries, socio-economic challenges, financial constraints, escalating competition, and performance anxiety. Notably, individuals engaged in team sports tended to adopt emotion-focused coping mechanisms, while those in individual sports leaned more towards problem-focused coping strategies in response to these stressors. There were no prominent gender differences found in coping strategies employed by sportspersons. This study underscores the critical issue of declining mental health among sportspersons in India, emphasizing the necessity for a structured and customized mental health intervention strategy tailored to the unique needs of this population.

Keywords: stressors, coping strategies, sports psychology, sportspersons, mental health

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175 The Gray Dance - An Analysis of Ageism in Dance

Authors: Paula Higa

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This paper briefly examines age and its impact on a dancer’s performance career. An investigation into the possible reasons why audiences don’t regularly see veteran dancers on stage (termed as the Gray Dancer) supports the research. This analysis reflects some of the social dynamics that shape perceptions of the aging body in the U.S., as well as the correlation between the meaning of old and decay in Western culture. The primary question addressed in this research asks, who has the prerogative to determine when a dancer should stop dancing - society or the dancer themselves The aging process can significantly shorten a performer's professional career. The body has less endurance and is more susceptible to injuries, fatigue, etc. It also becomes less flexible and loses muscular strength and tone. A reduction in physical skills may usher gray dancers to embrace an ideology of shorter careers. However, in today’s age of diversity, equity, and inclusion, the realm of dance performance should reflect the times in which it is rooted; a multi-generational environment where people interact and participate in all of life's events. Overall, this study champions the inclusion of gray dancers as representations of mastery and wisdom akin to those traits associated with age and experience across various professions. Dance is an art form that transcends the assumptions of youthful beauty and physical ability. It serves as a conduit for conveying a lifetime of experiences, emotions, and ideas through the expressive vehicle of the body. Furthermore, it presents audiences with a medium to perceive and comprehend both themselves and life itself, echoing Noverre's insightful contemplation. The essay underscores the importance of valuing, sensing, and appreciating the richness that gray dancers bring to the stage by delving into segments of dance history and analyzing the possible influence of curators, directors, audiences, and society in general on ageism in dance.

Keywords: dance, ageism, politics in dance, curatorial process

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174 Sirt1 Activators Promote Skin Cell Regeneration and Cutaneous Wound Healing

Authors: Hussain Mustatab Wahedi, Sun You Kim

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Skin acts as a barrier against the harmful environmental factors. Integrity and timely recovery of the skin from injuries and harmful effects of radiations is thus very important. This study aimed to investigate the importance of Sirt1 in the recovery of skin from UVB-induced damage and cutaneous wounds by using natural and synthetic novel Sirt1 activators. Juglone, known as a natural Pin1 inhibitor, and NED416 a novel synthetic Sirt1 activator were checked for their ability to regulate the expression and activity of Sirt1 and hence photo-damage and wound healing in cultured skin cells (NHDF and HaCaT cells) and mouse model by using Sirt1 siRNA knockdown, cell migration assay, GST-Pulldown assay, western blot analysis, tube formation assay, and immunohistochemistry. Interestingly, Sirt1 knockdown inhibited skin cell migration in vitro. Juglone up regulated the expression of Sirt1 in both the cell lines under normal and UVB irradiated conditions, enhanced Sirt1 activity and increased the cell viability by reducing reactive oxygen species synthesis and apoptosis. Juglone promoted wound healing by increasing cell migration and angiogenesis through Cdc42/Rac1/PAK, MAPKs and Smad pathways in skin cells. NED416 upregulated Sirt1 expression in HaCaT and NHDF cells as well as increased Sirt1 activity. NED416 promoted the process of wound healing in early as well as later stages by increasing macrophage recruitment, skin cell migration, and angiogenesis through Cdc42/Rac1 and MAPKs pathways. So, both these compounds activated Sirt1 and promoted the process of wound healing thus pointing towards the possible role of Sirt1 in skin regeneration and wound healing.

Keywords: skin regeneration, wound healing, Sirt1, UVB light

Procedia PDF Downloads 187
173 Keratin Fiber Fabrication from Biowaste for Biomedical Application

Authors: Ashmita Mukherjee, Yogesh Harishchandra Kabutare, Suritra Bandyopadhyay, Paulomi Ghosh

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Uncontrolled bleeding in the battlefield and the operation rooms can lead to serious injuries, trauma and even be lethal. Keratin was reported to be a haemostatic material which rapidly activates thrombin followed by activation of fibrinogen leading to the formation of insoluble fibrin. Also platelets, the main initiator of haemostasis are reported to adhere to keratin. However, the major limitation of pure keratin as a biomaterial is its poor physical property and corresponding low mechanical strength. To overcome this problem, keratin was cross-linked with alginate to increase its mechanical stability. In our study, Keratin extracted from feather waste showed yield of 80.5% and protein content of 8.05 ± 0.43 mg/mL (n=3). FTIR and CD spectroscopy confirmed the presence of the essential functional groups and preservation of the secondary structures of keratin. The keratin was then cross-linked with alginate to make a dope. The dope was used to draw fibers of desired diameters in a suitable coagulation bath using a customized wet spinning setup. The resultant morphology of keratin fibers was observed under a brightfield microscope. The FT-IR analysis implied that there was a presence of both keratin and alginate peaks in the fibers. The cross-linking was confirmed in the keratin alginate fibers by a shift of the amide A and amide B peaks towards the right and disappearance of the peak for N-H stretching (1534.68 cm-1). Blood was drawn in citrate vacutainers for whole blood clotting test and blood clotting kinetics, which showed that the keratin fibers could accelerate blood coagulation compared to that of alginate fibers and tissue culture plate. Additionally, cross-linked keratin-alginate fiber was found to have lower haemolytic potential compared to alginate fiber. Thus, keratin cross-linked fibers can have potential applications to combat unrestrained bleeding.

Keywords: biomaterial, biowaste, fiber, keratin

Procedia PDF Downloads 191
172 Neuromyelitis Optica area Postrema Syndrome(NMOSD-APS) in a Fifteen-year-old Girl: A Case Report

Authors: Merilin Ivanova Ivanova, Kalin Dimitrov Atanasov, Stefan Petrov Enchev

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Backgroud: Neuromyelitis optica spectrum disorder, also known as Devic’s disease, is a relapsing demyelinating autoimmune inflammatory disorder of the central nervous system associated with anti-aquaporin 4 (AQP4) antibodies that can manifest with devastating secondary neurological deficits. Most commonly affected are the optic nerves and the spinal cord-clinically this is often presented with optic neuritis (loss of vision), transverse myelitis(weakness or paralysis of extremities),lack of bladder and bowel control, numbness. APS is a core clinical entity of NMOSD and adds to the clinical representation the following symptoms: intractable nausea, vomiting and hiccup, it usually occurs isolated at onset, and can lead to a significant delay in the diagnosis. The condition may have features similar to multiple sclerosis (MS) but the episodes are worse in NMO and it is treated differently. It could be relapsing or monophasic. Possible complications are visual field defects and motor impairment, with potential blindness and irreversible motor deficits. In severe cases, myogenic respiratory failure ensues. The incidence of reported cases is approximately 0.3–4.4 per 100,000. Paediatric cases of NMOSD are rare but have been reported occasionally, comprising less than 5% of the reported cases. Objective: The case serves to show the difficulty when it comes to the diagnostic processes regarding a rare autoimmune disease with non- specific symptoms, taking large interval of rimes to reveal as complete clinical manifestation of the aforementioned syndrome, as well as the necessity of multidisciplinary approach in the setting of а general paediatric department in аn emergency hospital. Methods: itpatient's history, clinical presentation, and information from the used diagnostic tools(MRI with contrast of the central nervous system) lead us to the conclusion .This was later on confirmed by the positive results from the anti-aquaporin 4 (AQP4) antibody serology test. Conclusion: APS is a common symptom of NMOSD and is considered a challenge in a differential-diagnostic plan. Gaining an increased awareness of this disease/syndrome, obtaining a detailed patient history, and performing thorough physical examinations are essential if we are to reduce and avoid misdiagnosis.

Keywords: neuromyelitis, devic's disease, hiccup, autoimmune, MRI

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171 Role of Endotherapy vs Surgery in the Management of Traumatic Pancreatic Injury: A Tertiary Center Experience

Authors: Thinakar Mani Balusamy, Ratnakar S. Kini, Bharat Narasimhan, Venkateswaran A. R, Pugazhendi Thangavelu, Mohammed Ali, Prem Kumar K., Kani Sheikh M., Sibi Thooran Karmegam, Radhakrishnan N., Mohammed Noufal

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Introduction: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic pancreatic injury in a tertiary care center. Methods: All consecutive patients hospitalized at our center with traumatic pancreatic injury between 2013 and 2017 were included. The American Association for Surgery of Trauma (AAST) classification was used to stratify patients into five grades of severity. Outcome parameters were then analyzed based on the treatment modality employed. Results: Of the 35 patients analyzed, 26 had an underlying blunt trauma with the remaining nine presenting due to penetrating injury. Overall in-hospital mortality was 28%. 19 of these patients underwent exploratory laparotomy with the remaining 16 managed nonoperatively. Nine patients had a severe injury ( > grade 3) – of which four underwent endotherapy, three had stents placed and one underwent an endoscopic pseudocyst drainage. Among those managed nonoperatively, three underwent a radiological drainage procedure. Conclusion: Mortality rates were clearly higher in patients managed operatively. This is likely a result of significantly higher degrees of major associated non-pancreatic injuries and not just a reflection of surgical morbidity. Despite this, surgical management remains the mainstay of therapy, especially in higher grades of pancreatic injury. However we would like to emphasize that endoscopic intervention definitely remains the preferred treatment modality when the clinical setting permits. This is especially applicable in cases of main pancreatic duct injury with ascites as well as pseudocysts.

Keywords: endotherapy, non-operative management, surgery, traumatic pancreatic injury

Procedia PDF Downloads 206