Search results for: post facial syndrome

Authors: Darma Putra Sitepu, Dewi Larasati, Yohanes Wolter Hendrik George

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Sepsis is a life-threatening medical emergency frequently observed in intensive care unit (ICU). Surviving Sepsis Campaign in 2018 has recommended the administration of early vasopressor in the first hour of sepsis or septic shock but has not yet included de-resuscitation protocol. De-resuscitation in acute management of septic shock is where patient received active removal of accumulated fluid. It has been proposed by some studies and ongoing clinical trials. Here we present a case with early vasopressor and de-resuscitation. Male, 27 years old presenting to the emergency room with shortness of breath, altered mental status, and widespread blisters on his body and lips started a few hours prior, after receiving non-steroidal anti-inflammatory drug through intravenous injection. Patient was hypotensive, tachycardic, and tachypneic at admission, diagnosed with Steven Johnson Syndrome with Septic Shock. Patient received fluid resuscitation, early vasopressor, and diuresis agent aimed to actively remove fluid after the initial phase of resuscitation. Patient was admitted to ICU and progressively recovering. At day-10, patient was stabilized and was transferred to general ward. Early vasopressor and de-resuscitation are beneficial for the patient.

Keywords: sepsis, shock, de-resuscitation, vasopressor, fluid, case report

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Authors: Priyanka R. Sagar

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Social economic status (SES) is a variable that denotes the social standing of a person in society, and quality of life is a measure of health, happiness, and comfort of an individual. During early 2020, the world was stuck by the blow of the COVID-19 pandemic resulting in minimal or no economic activities to takes place. The present research paper is an attempt to analyze the socioeconomic status and quality of life of construction workers dwelling in the sub-urban areas of Hoskote located in the Bengaluru rural district pre and post-COVID-19. It also tries to analyze the difference in these variables pre and post-COVID-19. The study uses a retrospective design and data collected through a questionnaire survey from the respondents of Hoskote. A total of 100 samples were collected, out of which 73% were men and 27% were women. The mean age group of the participants is 41.04 ± 6.97 years. The overall analysis of the study shows that there is a significant difference in the socioeconomic status of construction workers pre and post-COVID-19. The study shows SES of the workers pre-pandemic is higher than post-pandemic. The other variable is quality of life which consists of physical health, psychological health, social relationships, and environmental domains. The study depicts that the psychological domain alone has been impacted by the pandemic; workers had better mental health pre-COVID-19. The other domains, i.e., physical health, social relationship, and environment, remain unaffected.

Keywords: socio-economic status, quality of life, construction workers, COVID-19

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Authors: Soudeh Tabashi, Mohammadreza Moshari, Parisa Sezari

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Introduction: Postoperative analgesia in Orthotopic Liver Transplantation (OLT) surgery is challenging for anesthesiologists. Although OLT is one of the most extensive abdominal operations, it seems that patients don’t suffer from severe post operative pain. On the other hands drug metabolism is unpredictable due to unknown graft function. The aim of this study was to compare intraoperative infusion of remifentanil versus fentanyl in postoperative opioid demand in patients with OLT and evaluating the complications in two groups. Method: In this double-blind clinical trial 34 patients who had OLT were included. They divided randomly in two groups of Remifentanil (R) and Fentanyl (F). Patients in group R and F received infusion of Remifentanil 0.3-1 µg/Kg/min and Fentanyl 0.3-1 µg/Kg/min during maintenance of anesthesia. Post operative pain were measured in 6, 12, 18, 24 hours and second and third days after surgery with Numeric Rate Scale (NRS). Patients had received intravenous acetaminophen as rescue therapy with NRS of 3 or more. In addition to demographic information, post operative opioid consumption were recorded as the primary outcome. Intraoperative blood transfusion, intraoperative inotropic drugs consumption, weaning time and intensive care unit stay were also evaluated. Results: Total dose of acetaminophen consumption in first 3 days after surgery did not have significant difference between two groups (Pvalue=0.716). intraoperative inotrope consumption, blood transfusion and post operative weaning time and ICU stay were also similar in both groups. Conclusion: This study demonstrates that intraoperative infusion of remifentanil in OLT have the same effect on post operative pain management as fentanyl. Despite the complications of operation were not increased by remifentanil.

Keywords: liver transplantation, postoperative pain, remifentanil, fentanyl

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Authors: Murat Mert, Yusuf Ozer, Fatih Kolay

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Behaviour of giving harm to the body in literature has been named as “self-injury”, “self-mutilation” ve “self-harm”. “Self-injury”, or “self-mutilation” is generally used for the same meaning and mentioned as an action which is committed to the body itself directly. As is seen that alcohol and drug users have injured their bodies because of deprivation, whereas behaviour of self-injury in some societies is accepted as religious and cultural, it has nevertheless been diagnosed in people who have a borderline personality disorder, histrionic personality disorder, psychotic personality disorder and mood disorder. There has not been any direct self-murder tendency in people having self-harmed. However, death cases can be seen together with loss of consciousness depending on loss of blood by exceeding the limit in the course of injury action. 34- year old – male person who was alcohol addicted, having had a psycological treatment beforehand, had mutilated his small intestine together with fatty tissue by cutting his body with a razor-blade at the thought of insects strolling around the body (delirium tremens) due to deprivation attack and had died in the result of various cuts. In this study, crime scene investigation and death mechanism of the person having had self-harmed in a result of abstinence syndrome will be explained. Relevant criteria which differentiate this case from homicide will be examined.

Keywords: self-injury, autopsy, abstinence syndrome, CSI

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Authors: Phatu William Mashela, Pontsho Edmund Tseke, Kgabo Martha Pofu

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‘Inconsistent results’ in nematode suppression post-application of botanical-based products created credibility concerns. Relative to untreated control, sampling for nematodes post-application of botanical-based products suggested significant increases in nematode population densities. ‘Inconsistent results’ were confirmed in Tylenchulus semipenetrans on Citrus jambhiri seedlings when sampling was carried out at 120 days post-application of a granular Nemarioc-AG phytonematicide. The objective of this study was to determine post-application effects of untreated control, Nemarioc-AG phytonematicide and aldicarb to T. semipenetrans population densities on C. jambhiri seedlings. Two hundred and ten seedlings were each inoculated with 10000 T. semipenetrans eggs and second-stage juveniles (J2) in plastic pots containing 2700 ml growing mixture. A week after inoculation, seedlings were equally split and subjected to once-off treatment of 2 g aldicarb, 2 g Nemarioc-AG phytonematicide and untreated control. Five seedlings from each group were randomly placed on greenhouse benches to serve as a sampling block, with a total of 14 blocks. The entire block was sampled weekly and assessed for final nematode population density (Pf). After the final assessment, post-regression of untreated Pf to increasing sampling intervals exhibited positive quadratic relations, with the model explaining 90% associations, with optimum Pf of 13804 eggs and J2 at six weeks post-application. In contrast, treated Pf and increasing sampling interval exhibited negative quadratic relations, with the model explaining 95% and 92% associations in phytonematicide and aldicarb, respectively. In the phytonematicide, Pf was 974 eggs and J2, whereas that in aldicarb was 2205 eggs and J2 at six weeks. In conclusion, temporal cyclic nematode population growth provided an empirically-based explanation of ‘inconsistent results’ in nematode suppression post-application of the two nematode management strategies.

Keywords: nematode management, residual effect, slow decline of citrus, the citrus nematode

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Authors: Muhammad Shakeel Rehman Hissam

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This study aims at analyzing gender in Othello by applying Judith Butler’s Post-Structural theory of gender and gender performance. The analysis of the play provides us context by which we can examine what kinds of effects the drama have on understanding of the researchers regarding gender identity. The study sets out to examine that, is there any evidence or ground in Shakespearean selected work which leads to challenge the patriarchal taken for granted prescribed roles of gender? This would be the focal point in study of Othello that actions and performances of characters determine their gender identity rather than their sexuality. It argues that gender of Shakespearean characters has no constant, fixed and structural impression. On the contrary, they undergo consistent variations in their behavior and performance which impart fluidity and volatility to them. The focal point of the present study is Butler’s prominent work; Gender Trouble: Feminism and subversion of Identity and her post structural theory of Gender performativity as the theoretical underpinning of the text. It analyzes the selected play in Post-Structural gender perspective. The gender-centric plot of the play is riddled with fluidity of gender. The most fascinating aspect of the play is the transformations of genders on the basis of performances by different characters and through these transformations; gender identity is revealed and determined. The study reconstructs the accepted gender norms by challenging the traditional concept of gender that is based on sexual differences of characters.

Keywords: post structural, gender, performativity, socio-cultural gender norms, binaries, Othello, Butler, identity

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Authors: Eman Ahmed Ahmed, Ghada Abdelmoneim Mohamed, Hamada Ahmed Hamada, Nagui Sobhi Nassif

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Impaired skeletal muscle endurance may be an important causal factor in the development of patellofemoral pain syndrome (PFPS). However, there is lack of information regarding the effect of hip versus knee muscle fatigue on isokinetic parameters, and myoelectric activity of hip and knee muscles in these patients. Purpose: The study was conducted to investigate the effect of hip abductors versus knee extensors fatigue protocol on knee proprioception, hip and knee muscle strength and their myoelectric activity in patients with PFPS. Methods: Fifteen female patients with PFPS participated in the study. They were tested randomly under two fatiguing conditions; hip abductors and knee extensors fatigue protocols. Isolated muscle fatigue of two muscles was induced isokinetically on the affected side in a two separate sessions with a rest interval of at least three days. After determining peak torque, patients performed continuous maximal concentric-eccentric contraction of the selected muscle until the torque output dropped below 50% of peak torque value for 3 consecutive repetitions. Knee proprioception, eccentric hip abductors' peak torque, eccentric knee extensors' peak torque, EMG ratio of vastus medialis obliquus (VMO) / vastus lateralis (VL), and EMG activity of gluteus medius (GM) muscle, were recorded before and immediately after each fatigue protocol using the Biodex Isokinetic system and EMG Myosystem. Results: Two-way within subject MANOVA revealed that eccentric knee extensors’ peak torque decreased significantly after hip abductors fatigue protocol compared to pre fatigue condition (p<0.05). On the other hand, there was no statistically significant difference in the eccentric hip abductors’ peak torque after admitting knee extensors fatigue protocol (p > 0.05). Moreover, no significant difference was found in knee proprioception, EMG ratio of VMO/VL, and EMG activity of GM muscle, after either hip or knee fatigue protocol (p>0.05). Conclusion: A hip focused rehabilitation program may be beneficial in improving knee function through correcting faulty kinematics and hence decrease knee loading in patients with PFPS.

Keywords: electromyography, knee proprioception, mechanical responses, muscle fatigue, patellofemoral pain syndrome

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Authors: Andrea Gatti, Federica Coppotelli, Ma Primavera, Laura Palmieri, Umberto Tarantino

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Aim of study: Scientific literature is scarce of studies and reviews valuing the pros and cons of the paratricipital approach for the treatment of humeral shaft fractures; the lateral paratricipital approach is a valid alternative to the classical posterior approach to the humeral shaft as it preserves both the triceps muscle and the elbow extensor mechanisms; based on our experience, this retrospective analysis aims at analyzing outcome, risks and benefits of the lateral paratricipital approach for humeral shaft fractures. Methods: Our study includes 14 patients treated between 2018 and 2019 for unilateral humeral shaft fractures: 13 with a B1 or B2 and a patient with a C fracture type (according to the AO/ATO Classification); 6 of our patients identified as male while 8 as female; age average was 57.8 years old (range 21-73 years old). A lateral paratricipital approach was performed on all 14 patients, sparing the triceps muscle by avoiding the olecranon osteotomy and by assessing the integrity and the preservation of the radial nerve; the humeral shaft fracture osteosynthesis was performed by means of plates and screws. After surgery all patients have started elbow functional rehabilitation with acceptable pain management. Post-operative follow-up has been carried out by assessing radiographs, MEPS (Mayo Elbow Performance Score) and DASH (Disability of Arm Shoulder and Hand) functional assessment and ROM of the affected joint. Results: All 14 patients had an optimal post-operative follow-up with an adequate osteosynthesis and functional rehabilitations by entirely preserving the operated elbow joint; the mean elbow ROM was 0-118.6 degree (range of 0-130) while the average MEPS score was 86 (range75-100) and 79.9 for the DASH (range 21.7-86.1). Just 2 patients suffered of temporary radial nerve apraxia, healed in the subsequent follow-ups. CONCLUSION: The lateral paratricipital approach preserve both the integrity of the triceps muscle and the elbow biomechanism but we do strongly recommend additional studies to be carried out to highlight differences between it and the classical posterior approach in treating humeral shaft fractures.

Keywords: paratricepital approach, humerus shaft fracture, posterior approach humeral shaft, paratricipital postero-lateral approach

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Authors: Mustafa M. Donma, Orkide Donma

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Metabolic syndrome (MetS) is a disease associated with obesity. It is a complicated clinical problem possibly affecting body composition as well as macrominerals. These parameters gain further attention, particularly in the pediatric population. The aim of this study is to investigate the amount of discrete body composition fractions in groups that differ in the severity of obesity. Also, the possible associations with calcium (Ca), phosphorus (P), magnesium (Mg) will be examined. The study population was divided into four groups. Twenty-eight, 29, 34, and 34 children were involved in Group 1 (healthy), 2 (obese), 3 (morbid obese), and 4 (MetS), respectively. Institutional Ethical Committee approved the study protocol. Informed consent forms were obtained from the participants. The classification of obese groups was performed based upon the recommendations of the World Health Organization. Metabolic syndrome components were defined. Serum Ca, P, Mg concentrations were measured. Within the scope of body composition, fat mass, fat-free mass, protein mass, mineral mass were determined by a body composition monitor using bioelectrical impedance analysis technology. Weight, height, waist circumference, hip circumference, head circumference, and neck circumference values were recorded. Body mass index, diagnostic obesity notation model assessment index, fat mass index, and fat-free mass index values were calculated. Data were statistically evaluated and interpreted. There was no statistically significant difference among the groups in terms of Ca and P concentrations. Magnesium concentrations differed between Group 1 and Group 4. Strong negative correlations were detected between P as well as Mg and fat mass index as well as diagnostic obesity notation model assessment index in Group 4, the group, which comprised morbid obese children with MetS. This study emphasized unique associations of P and Mg minerals with diagnostic obesity notation model assessment index and fat mass index during the evaluation of morbid obese children with MetS. It was also concluded that diagnostic obesity notation model assessment index and fat mass index were more proper indices in comparison with body mass index and fat-free mass index for the purpose of defining body composition in children.

Keywords: children, fat mass, fat-free mass, macrominerals, obesity

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is known to be associated with many clinically important diseases including metabolic syndrome (MetS). Vitamin B₁₂ plays essential roles in fat and protein metabolisms and its cooperation with vitamin B₉ is well-known. The aim of this study is to investigate the possible contributions as well as associations of these micronutrients upon obesity and MetS during childhood. A total of 128 children admitted to Namik Kemal University, Medical Faculty, Department of Pediatrics Outpatient Clinics were included into the scope of this study. The mean age±SEM of 92 morbid obese (MO) children and 36 with MetS were 118.3±3.8 months and 129.5±6.4 months, respectively (p > 0.05). The study was approved by Namık Kemal University, Medical Faculty Ethics Committee. Written informed consent forms were obtained from the parents. Demographic features and anthropometric measurements were recorded. WHO BMI-for age percentiles were used. The values above 99 percentile were defined as MO. Components of MetS [waist circumference (WC), fasting blood glucose (FBG), triacylglycerol (TRG), high density lipoprotein cholesterol (HDL-Chol), systolic pressure (SP), diastolic pressure (DP)] were determined. Routine laboratory tests were performed. Serum vitamin B₁₂ concentrations were measured using electrochemiluminescence immunoassay. Vitamin B₉ was analyzed by an immunoassay analyzer. Values for vitamin B₁₂ < 148 pmol/L, 148-221 pmol/L, > 221 pmol/L were accepted as low, borderline and normal, respectively. Vitamin B₉ levels ≤ 4 mcg/L defined deficiency state. Statistical evaluations were performed by SPSSx Version 16.0. p≤0.05 was accepted as statistical significance level. Statistically higher body mass index (BMI), WC, hip circumference (C) and neck C were calculated in MetS group compared to children with MO. No difference was noted for head C. All MetS components differed between the groups (SP, DP p < 0.001; WC, FBG, TRG p < 0.01; HDL-Chol p < 0.05). Significantly decreased vitamin B₉ and vitamin B₁₂ levels were detected (p < 0.05) in children with MetS. In both groups percentage of folate deficiency was 5.5%. No cases were below < 148 pmol/L. However, in MO group 14.3% and in MetS group 22.2% of the cases were of borderline status. In MO group B₁₂ levels were negatively correlated with BMI, WC, hip C and head C, but not with neck C. WC, hip C, head C and neck C were all negatively correlated with HDL-Chol. None of these correlations were observed in the group of children with MetS. Strong positive correlation between FBG and insulin as well as strong negative correlation between TRG and HDL-Chol detected in MO children were lost in MetS group. Deficiency state end-products of both B₉ and B₁₂ may interfere with the expected profiles of MetS components. In this study, the alterations in MetS components affected vitamin B₁₂ metabolism and also its associations with anthropometric body measurements. Further increases in vitamin B₁₂ and vitamin B₉ deficiency in MetS associated with the increased vitamin B₁₂ as well as vitamin B₉ deficiency metabolites may add to MetS parameters.

Keywords: children, cobalamin, folate, metabolic syndrome, obesity

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Authors: Emily Toon

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Nurses play a critical role in the prevention of ventilator-associated pneumonia through the maintenance of endotracheal tubes and use of subglottic secretion drainage via subglottic suctioning endotracheal tubes. The purpose of this evidence based practice project is to develop a staff education program on subglottic suctioning endotracheal tubes for critical care nurses at Middlesex Health with the aim of determining and documenting increased knowledge and/or practice change. The setting included registered nurses within Middlesex Health’s critical care unit who were recruited to complete a pre-test (n=14), view a presentation, and complete a post-test (n=10). Average pre-test scores were compared to average post-test scores to determine an increase in knowledge and/or practice change. The overall mean pre-test score was 59.7 percent, compared with the mean post-test score of 88.1 percent. Pre- and post-test scores were unmatched, so statistical significance could not be determined. The hypothesis that a staff education program on subglottic suctioning endotracheal tubes would demonstrate an increase in knowledge was supported, but not statistically. By integrating a pre-test/post-test design into educational presentations to evaluate increased knowledge, data generated may be used to improve methods and practices of delivering education and enhance staff learning.

Keywords: endotracheal tubes, staff education, subglottic secretion drainage, ventilator-associated pneumonia

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Authors: Man-Ching Yu

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In Chinese music, pentatonic collection is central in constituting all the harmonic and melodic elements; most of the traditional Chinese musicians particularly emphasize the importance of the smoothness between pentatonic collections when one collection modulates to another collection, articulating the roles of the pentatonic common tones. On the contrary, in post-tonal Chinese music the central features of the pentatonic modulations tend to reflect a larger number of semitonal relationships with a lesser number of common tones. This paper offers an analytical account of the transformations between pentatonic collections that arise in post-tonal Chinese music by adopting the methodology of the Tonnetz, in particular, Dual Interval Space (DIS), to elaborate and reexamine pentatonicism by focusing on the transformations between pentatonic elements, especially semitonal motion and common tones. In the essay, various pentatonic passages will be analyzed by means of DIS for highlighting the transformation of the collections. It will be shown that the pentatonic collections that are in semitonal, third, and augmented fourth relationships exhibit the maximum number of semitonal shifts.

Keywords: tonnetz, pentatonicism, post-tonal Chinese music, dual interval space, transformation

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Authors: Xing Ping Hu, Yuexun Tian, Jerome Hogsette

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Housefly, Musca domestica L., is a serious urban nuisance and public health/food safety concern. This study evaluated the topical toxicity of 17 essential oil components and 3 plant essential oils against permethrin-resistant adult females and insecticide-susceptible house fly strains. Results show that thymol had the lowest LD₅₀ values against permethrin-resistant strain (43.77 and 41.10 ug per fly) and permethrin-susceptible strain (35.19 and 29.16 ug per fly) at both 24- and 48-hours post treatments; (+)-Pulegone had the lowest LD₉₅ values against the permethrin-resistant strain (0.15 and 0.10 mg per fly) at 24- and 48-hours post treatments, whereas plant thyme oil had the lowest LD₉₅ value of 0.17 mg per fly at post-24h and post-48h against the permethrin-susceptible strain. Additionally, the LD₅₀s was slightly but not significantly negatively correlated with the boiling points of the compounds tested; but showed no correlation with the density and LogP. These results indicate that specific essential oils and compounds have topical insecticidal properties against house flies with low dose. They may have the potential for development as botanical insecticides.

Keywords: urban pest, public health, pest management, botanical chemical

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Authors: Joseph Carl Macalintal, Erlinda Armovit

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Magnesium sulfate has been a mainstay in the management of preeclampsia and is associated with a decreased incidence of morbidity and mortality. The syndrome has an unpredictable course, sometimes rapidly evolving to full-blown disease. In patients with deteriorating status, it is indicated to terminate the pregnancy via cesarean section. The anesthesiologists would prefer to have the procedure done under regional anesthesia; however, there may be cases when neuraxial anesthesia is contraindicated, or a general anesthesia would permit prompt delivery of the fetus. A patient with severe preeclampsia was given magnesium sulfate intrapartum, wherein a primary cesarean section was indicated for arrest in cervical dilatation, and was performed under general anesthesia. The patient developed acute respiratory failure and the causes of this occurrence were investigated in this report. It was later found out that neither the hypermagnesemia nor the muscle relaxant alone caused the patient’s condition but the interaction between the two. The patient was managed expectantly at the intensive care unit (ICU) and was eventually extubated during the 1st post-operative day. Knowledge of this drug interaction would allow obstetricians to advise their patients and their family about the possibility of prolonged intubation and ICU admission. This would also bring to the anesthesiologists’ attention the need to decrease the dose of muscle relaxant and to prepare drugs for immediate decurarisation.

Keywords: eclampsia, magnesium sulfate, preeclampsia, rocuronium bromide

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Authors: Abubakar Maikudi

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Contrastive analysis is the method of analyzing the structure of any two languages with a view to determining the possible differential aspects of their systems irrespective of their genetic affinity or level of development. Contrastive analysis of two languages becomes useful when it is adequately describing the sound structure and grammatical structure of two languages, with comparative statements giving emphasis to the compatible items in the two systems. This research work uses comparative analysis theory to analyze adjective and adjectival phrases in Hausa and Yorùbá languages. The Hausa language belongs to the Chadic family of the Afro-Asiatic phylum, while the Yorùbá language belongs to the Benue-Congo family of the Niger-Congo phylum. The findings of the research clearly demonstrated that there are significant similarities in the adjectival phrase constructions of the two languages, i.e., nominal (Head) and post-nominal (Post-Head) use of the adjective, predicative function of an adjective, use of the reduplicative adjective, use of the comparative and superlative adjective, etc. However, there are dissimilarities in the adjectival phrase of the two languages in gender/number agreement and pre-nominal (Post-Head) use of adjectives.

Keywords: genetic affinity, contrastive analysis, phylum, pre-head, post-head

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Authors: T. C. Ng, R. Radzi, T. K. Ng, H. C. Chen

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The analgesic effects of lidocaine-bupivacaine block in cats undergoing routine orchiectomy were determined in this controlled, randomized, and blinded study. Twelve cats were randomly assigned to two groups. Cats in local block group received subcutaneous infiltration of 1 mg/kg of 2% lidocaine and 1 mg/kg of 0.5% bupivacaine into the scrotal sac. Cats in control group received equivolume of saline. Both groups were induced with mixture of ketamine (15 mg/kg) and acepromazine (0.1 mg/kg) intramuscularly and maintained on sevoflurane via facemask. Non-invasive blood pressures (BP), heart (HR), and respiratory rate (RR) were measured intra-operatively at specific events. Post-operatively, all cats received meloxicam, 0.2 mg/kg subcutaneously. Pain scores were determined at 4, 8, and 24 hours postoperatively. Mechanical pressure thresholds (MPT) at the perineum and metatarsus were determined at 2, 4, 8, and 24 hours postoperatively. Intra-operatively, the BP and HR tended to be higher in the control group. The increment in HR peaked during traction and autoligation of the spermatic cord in the control group. There was no treatment difference in RR. Post-operatively, pain scores in the group given local blocks were lower than the control group at 4 hour post-operation. There was no treatment difference in the post-operative HR, RR, BP and MPT values. In conclusion, subcutaneous infiltration of lidocaine-bupivacaine into the scrotal sac before orchiectomy improved intra-operative hemodynamic stability and provided better analgesia up to 4 hours post-surgery.

Keywords: analgesia, bupivacaine, cat, lidocaine, local block, orchiectomy

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Authors: Mustafa Kaya

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After the 1999 Marmara earthquake in Turkey research by the Turkish Precast Union stated that 24.50% of the precast structures were damaged with some of this damage being observed in the beam to column connections of the structures. Since it is essential to provide those rendered homeless by the earthquake with safe, habitable accommodation repairing medium and slight levels of damage at the connection parts should be undertaken. In order to prove that a repaired connection was sufficiently strong, a precast beam to column post tensioned connection was tested in three phases. In phase one, the middle level damage was observed at 6% drift at these connections. As a result of the extra loads applied, little damage was observed. In the last phase, the four connections tested in the first phase were repaired using epoxy resin and then retested. The results from the tests on the repaired precast and the undamaged specimens showed that the repaired specimens were sufficiently strong, thus proving that repair to damaged precast beam to column post tensioned connections can be undertaken.

Keywords: precast beam to column connection, moment-resisting connection, post-tensioned connections, repair of precast connections

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Authors: Uwonkunda Jeanne, J. Godwin Prem Singh, Anjaneyalu Subbiah

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HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole.

Keywords: People living with HIV, social dysfunction, stigma, and Social support.

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Authors: Se-Hwa Park, En-Kyung Han, Jae-Young Lim, Hye-Jung Ahn

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Purpose: The objective of this study is to provide basic data for understanding the substance of inpatient life with CRPS (Complex Regional Pain Syndrome) and developing efficient and effective nursing intervention. Methods: From September 2018 to November, we have interviewed 10 CRPS patients about inpatient experiences. To understand the implication of inpatient life experiences with CRPS and intrinsic structure, we have used the question: 'How about the inpatient experiences with CRPS'. For data analysis, the method suggested by Colaizzi was applied as a phenomenological method. Results: According to the analysis, the study participants' inpatient life process was structured in six categories: (a) breakthrough pain experience (b) the limitation of pain treatment, (c) worsen factors of pain during inpatient period, (d) treat method for pain, (e) positive experience for inpatient period, (f) requirements for medical team, family and people in hospital room. Conclusion: Inpatient with CRPS have experienced the breakthrough pain. They had expected immediate treatment for breakthrough pain, but they experienced severe pain because immediate treatment was not implemented. Pain-worsening factors which patients with CRPS are as follows: personal factors from negative emotions such as insomnia, stress, sensitive character, pain part touch or vibration stimulus on the bed, physical factors from high threshold or rapid speed during fast transfer, conflict with other people, climate factors such as humidity or low temperature, noise, smell, lack of space because of many visitors. Patients actively manage the pain committing into another tasks or diversion. And also, patients passively manage the pain, just suppress, give-up. They think positively about rehabilitation treatment. And they require the understanding and sympathy for other people, and emotional support, immediate intervention for medical team. Based on the results of this study, we suppose the guideline of systematic breakthrough pain management for the relaxation of sudden pain, using notice of informing caution for touch or vibration. And we need to develop non-medicine pain management nursing intervention.

Keywords: breakthrough pain, CRPS, complex regional pain syndrome, inpatient life experiences, phenomenological method

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Authors: Thaer Khaleel Swaid, Maryam Al Ahmad, Ishtiaq Ahmad

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47-year-old female, known to have a liver cyst and hemangiomas, presented to the gastroenterology clinic for chronic moderate postprandial epigastric pain, which is aggravated by food, leaning forward and relieved on lying flat. The pain was associated with nausea, vomiting, heartburn and excessive burping. She opened her bowel daily, having well-formed stools without blood or mucus. The patient denied NSAID intake, smoking or alcohol. On physical examination during the episode of pain abdomen revealed a soft, lax abdomen and mild tenderness in the epigastric region without organomegaly. Bowel sounds were audible. Her routine hematological and biochemical parameters were within normal, including CBC, Celiac serology, Lipase, Metabolic profile and H pylori stool antigen. The patient underwent an Ultrasound of the abdomen which showed multiple liver cysts, hemangioma, normal GB and biliary tree. Based on the clinical picture and to narrow our differential diagnosis, an ultrasound Doppler for the abdomen was ordered, and it showed celiac artery peak systolic velocity in expiration is 270cm/s, suggestive of median arcuate ligament syndrome. She Had computerized tomography abdomen done and showed a Narrowing of the celiac artery at the origin, likely secondary to low insertion of the median arcuate ligament. Furthermore, Gastroscopy and, later on colonoscopy were done, which was unremarkable. A laparoscopic decompression of the celiac trunk was indicated, for which the patient was referred to vascular surgery. This case confirms that Median Arcuate Ligament syndrome is an unusual diagnosis and is always challenging. Usually, patients undergo extensive workups before a final diagnosis is achieved. Our case highlights the challenge of diagnosing MALS since this entity is rare. It is a good choice to perform abdominal ultrasound with Doppler imaging on a patient with symptoms such as postprandial angina.

Keywords: Unveiling the Mystery, MALS, rare entity, Rare vascular phenomenon

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Authors: Jyotismita Talukdar

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In this paper, a study has been made on the possibility and accuracy of early prediction of several Heart Disease using Artificial Neural Network. (ANN). The study has been made in both noise free environment and noisy environment. The data collected for this analysis are from five Hospitals. Around 1500 heart patient’s data has been collected and studied. The data is analysed and the results have been compared with the Doctor’s diagnosis. It is found that, in noise free environment, the accuracy varies from 74% to 92%and in noisy environment (2dB), the results of accuracy varies from 62% to 82%. In the present study, four basic attributes considered are Blood Pressure (BP), Fasting Blood Sugar (FBS), Thalach (THAL) and Cholesterol (CHOL.). It has been found that highest accuracy(93%), has been achieved in case of PPI( Post-Permanent-Pacemaker Implementation ), around 79% in case of CAD(Coronary Artery disease), 87% in DCM (Dilated Cardiomyopathy), 89% in case of RHD&MS(Rheumatic heart disease with Mitral Stenosis), 75 % in case of RBBB +LAFB (Right Bundle Branch Block + Left Anterior Fascicular Block), 72% for CHB(Complete Heart Block) etc. The lowest accuracy has been obtained in case of ICMP (Ischemic Cardiomyopathy), about 38% and AF( Atrial Fibrillation), about 60 to 62%.

Keywords: coronary heart disease, chronic stable angina, sick sinus syndrome, cardiovascular disease, cholesterol, Thalach

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is defined as a severe chronic disease characterized by a low-grade inflammatory state. Therefore, inflammatory markers gained utmost importance during the evaluation of obesity and metabolic syndrome (MetS), a disease characterized by central obesity, elevated blood pressure, increased fasting blood glucose and elevated triglycerides or reduced high density lipoprotein cholesterol (HDL-C) values. Some inflammatory markers based upon complete blood cell count (CBC) are available. In this study, it was questioned which inflammatory marker was the best to evaluate the differences between various obesity groups. 514 pediatric individuals were recruited. 132 children with MetS, 155 morbid obese (MO), 90 obese (OB), 38 overweight (OW) and 99 children with normal BMI (N-BMI) were included into the scope of this study. Obesity groups were constituted using age- and sex-dependent body mass index (BMI) percentiles tabulated by World Health Organization. MetS components were determined to be able to specify children with MetS. CBC were determined using automated hematology analyzer. HDL-C analysis was performed. Using CBC parameters and HDL-C values, ratio markers of inflammation, which cover neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), monocyte-to-HDL-C ratio (MHR) were calculated. Statistical analyses were performed. The statistical significance degree was considered as p < 0.05. There was no statistically significant difference among the groups in terms of platelet count, neutrophil count, lymphocyte count, monocyte count, and NLR. PLR differed significantly between OW and N-BMI as well as MetS. Monocyte-to HDL-C value exhibited statistical significance between MetS and N-BMI, OB, and MO groups. HDL-C value differed between MetS and N-BMI, OW, OB, MO groups. MHR was the ratio, which exhibits the best performance among the other CBC-based inflammatory markers. On the other hand, when MHR was compared to HDL-C only, it was suggested that HDL-C has given much more valuable information. Therefore, this parameter still keeps its value from the diagnostic point of view. Our results suggest that MHR can be an inflammatory marker during the evaluation of pediatric MetS, but the predictive value of this parameter was not superior to HDL-C during the evaluation of obesity.

Keywords: children, complete blood cell count, high density lipoprotein cholesterol, metabolic syndrome, obesity

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Authors: Mitchell Stanton

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Background: Endovascular management is well established as a mainstay treatment option for cerebral aneurysms. It is also well established that immediate post procedural imaging can be difficult to interpret due to the presence of contrast material. However, through the use of Dual-Energy computed tomography, it has become possible to differentiate contrast extravasation and intracranial haemorrhage. This case illustrates the importance of this technology following endovascular treatment of an unruptured cerebral aneurysm. Case Presentation: A 79-year-old female was found to have an unruptured large intracavernous ICA fusiform aneurysm on CT Brain Angiogram after presenting with acute ophthalmoplegia. This ophthalmoplegia was caused by mass effect from the aneurysm and subsequently the aneurysm was treated with an endovascular flow diverting stent. CT brain was performed post operatively due to a reduced level of consciousness and this showed diffuse subarachnoid hyperdensity of the left hemisphere. The use of Dual-Energy CT allowed accurate differentiation and illustrated diffuse contrast material extravasation, allowing patient to continue on dual-antiplatelets and therapeutic anticoagulation to reduce the risk of ischaemic injury post endovascular stent. Conclusion: Endovascular treatment options for management of intracranial aneurysms are constantly evolving. The use of Dual-Energy CT therefore has an integral role in accurately diagnosing any post-operative complications. Specifically, differentiating between subarachnoid haemorrhage and contrast extravasation is vital in these patients due to the significant consequences to their ongoing management in regards to continuation or cessation of antiplatelets or anticoagulation. With increasing access to this technology, its use should become standard practice in the post-operative investigation of these patients undergoing endovascular treatment.

Keywords: aneurysm, computed tomography, contrast extravasation, dual-energy CT, endovascular, subarachnoid haemorrhage

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Authors: Caroline Hoorn

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Post-matriculants in disadvantaged communities such as Douglas encounter a number of career challenges. The transition to the democratic dispensation in 1994, coupled with the rapid changes in the information domain that are characteristic of post-industrial life, complicate the career development trajectories of disadvantaged youth. The career development stories and experiences of disadvantaged youth in provinces such as the Northern Cape have not been told, leading to their marginalisation. It is against this background that the study explored the gendered dimensions of career development narratives, experiences, and choices of post-matriculants in the Douglas community in the Northern Cape. Using a qualitative, narrative approach, the researcher elicited career development stories from 23 participants in Douglas using semi-structured interviews. Two main themes were highlighted through the narratives; (1) willingness to challenge the traditional male dominated career script (2) breaking gender barriers. The study showed that gender did not have any influence on the career choices of the post-matriculants. The perceptions around career choices and gender were being challenged partly by the urge to affirm equality and the constant reminder of the poverty-stricken conditions prevalent in the households. A preferred gender is not required to be attached to the fulfilment of outcomes in a knowledge-based economy. Thus, it is not an issue of gender or masculinity but knowledge and skills. Furthermore, the study revealed that the career choices being considered are still the traditionally stereotypical careers like nursing, teaching, and social work, which demonstrates a lack of information to a broader pool of career options to select from.

Keywords: career development, gender, narratives, post-matriculants

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Authors: Gigih Supriyatno

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SQL injection is one of the most common types of attacks and has a very critical impact on web servers. In the worst case, an attacker can perform post-exploitation after a successful SQL injection attack. In the case of forensics web servers, web server analysis is closely related to log file analysis. But sometimes large file sizes and different log types make it difficult for investigators to look for traces of attackers on the server. The purpose of this paper is to help investigator take appropriate steps to investigate when the web server gets attacked. We use attack scenarios using SQL injection attacks including PHP backdoor injection as post-exploitation. We perform post-mortem analysis of web server logs based on Hypertext Transfer Protocol (HTTP) POST and HTTP GET method approaches that are characteristic of SQL injection attacks. In addition, we also propose structured analysis method between the web server application log file, database application, and other additional logs that exist on the webserver. This method makes the investigator more structured to analyze the log file so as to produce evidence of attack with acceptable time. There is also the possibility that other attack techniques can be detected with this method. On the other side, it can help web administrators to prepare their systems for the forensic readiness.

Keywords: web forensic, SQL injection, investigation, web shell

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Authors: George D. Ranis, Valasia Iakovoglou, George N. Zaimes

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Fires are one of the main types of disturbances that shape ecosystems in the Mediterranean region. However nowadays, climate alterations towards higher temperature regimes results on the increased levels of the intensity, frequency and the spread of fires inducing obstacles for the natural regeneration. Thasos Island is one of the Greek islands that have experienced those problems. Since 1984, a series of wildfires led to the reduction of forest cover from 61.6% to almost 20%. The negative impacts were devastating in many different aspects for the island. The absence of plant cover, post-wildfire precipitation and steep slopes were the major factors that induced severe soil erosion and intense flooding events. That also resulted to serious economic problems to the local communities and the ability of the burnt areas to regenerate naturally. Despite the substantial amount of published work regarding Thasos wildfires, there is no information related to post-wildfire effects on the hydrology and soil erosion. More research related to post-fire effects should help to an overall assessment of the negative impacts of wildfires on land degradation through processes such as soil erosion and flooding.

Keywords: erosion, land degradation, Mediterranean islands, regeneration, Thasos, wildfires

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Authors: Scott A. Abbott

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This paper examines the increase in the occurrence of natural disasters worldwide and the need to support vulnerable communities in post-disaster recovery. Preparation and implementation of post-disaster recovery projects need to be improved to allow communities to recover infrastructure, housing, economically and socially following a catastrophe. With the continual rise in catastrophic events worldwide due to climate change, impacts on construction resources affect the ability for post-disaster recovery to be undertaken. This research focuses on case studies of catastrophic events in Queensland, Australia, to contribute to the body of knowledge and gain valuable insights on lessons learned from past events and how they have been managed. The aim of this research is to adopt qualitative data using semi-structured interviews from participants predominantly from the insurance sector to understand barriers that have previously and currently exist in post-disaster recovery. Existing literature was reviewed to reveal gaps in knowledge that needed to be tested. Qualitative data was collected and summarised from field research with the results analysed and discussed. Barriers that impacted post-disaster recovery included time, cost, and resource capability and capacity. Causal themes that impacted time and cost were identified as decision making, pre-planning, and preparedness, as well as effective communication across stakeholders. The research study applied a qualitative approach to the existing literature and case studies across Queensland, Australia, to identify existing and new barriers that impact post-disaster recovery. It was recommended to implement effective procurement strategies to assist in cost control; implement pre-planning and preparedness strategies across funder, contractor, and local governments; more effective and timely decision making to reduce time and cost impacts.

Keywords: construction recovery, cost, disaster recovery, resources, time

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Authors: Awe Ayodeji Samson, Adeuja Yetunde Omowunmi

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Corruption is a ‘monster’ that can consume a whole nation, continent and even the world if it is not destroyed while it is still immature; It grows in the mind of the people, takes over their thinking and guides their decision-making process. Corruption snowballs into socio-economic catastrophe that might be difficult to deal with. Corruption which is a disease of the mind can be alleviated in Africa and the world at large by transforming a Corruption-Prone Mind to a Corruption-Immune Mind and to achieve this, we have to change our value system because the use of anti-graft agencies alone is not enough. Therefore, we have to fight corruption from the inside and the outside. Value System is the principle of right and wrong that are accepted by an individual or a social group; the reviewing and reordering of our value system is the solution to the problem of corruption as proposed by this research because the African society has become a ‘Money and Power Driven Society’ where the ‘I am worth concept’ which is a problematic concept has created an ‘Aggressive Society’ with grasping and money-grabbing individuals. We place more priority on money and the display of opulence. Hence, this has led to a ‘Triangular Society’ where minority is lavishing in plenty and majority is gasping for little. The get rich quick syndrome, the ethnicity syndrome, weakened educational system are signs of the prevalence of corruption in Africa This research has analyzed role and impact of the change in our value system in the fight against corruption in Africa and has therefore proposed the change in our value system as the way forward in the fight against corruption in Africa.

Keywords: corruption-prone mind, corruption-immune mind, triangular society, aggressive society, money and power-driven society

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Authors: Chizzoniti Domenico, Beggiora Klizia, Cattani Letizia, Moscatelli Monica

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This paper concerns the study of sustainable construction materials applied on the "Health Post", a prototype for the primary health care situated in alienated areas of the world. It's suitable for social and climatic Sub-Saharan context; however, it could be moved in other countries of the world with similar urgent needs. The idea is to create a Health Post with local construction materials that have a low environmental impact and promote the local workforce allowing reuse of traditional building techniques lowering production costs and transport. The aim of Primary Health Care Centre is to be a flexible and expandable structure identifying a modular form that can be repeated several times to expand its existing functions. In this way it could be not only a health care centre but also a socio-cultural facility.

Keywords: low costs building, sustainable construction materials, green construction system, prototype, health care, emergency

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Authors: Chia-Ching Tsai

Abstract:

In the literature, the positive effect of service co-recovery has been evidenced, and which customers’ attribution is the key successful factor has also been indicated. There is also literature investigating on initiation of co-recovery for finding out the superior way to co-recovery, and indicating co-recovery initiated by employees causes better effect of co-recovery. This research postulates the consequences of co-recovery by different initiators affect customers’ attribution and the resultant results. Thus, this research uses a 3x2 factorial design to investigate the impact of initiator of co-recovery and consequence of co-recovery on customers’ attribution and post-recovery satisfaction. The results show initiation of co-recovery has a significant influence on internal attribution, and the employee initiator causes the highest internal attribution. The consequences of co-recovery interact with initiators of co-recovery on internal attribution significantly. Moreover, internal attribution significantly affects post-recovery satisfaction.

Keywords: service co-recovery, initiation of co-recovery, attribution, post-recovery satisfaction

Procedia PDF Downloads 263