Search results for: fracture clinic
516 Revising Our Ideas on Revisions: Non-Contact Bridging Plate Fixation of Vancouver B1 and B2 Periprosthetic Femoral Fractures
Authors: S. Ayeko, J. Milton, C. Hughes, K. Anderson, R. G. Middleton
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Background: Periprosthetic femoral fractures (PFF) in association with hip hemiarthroplasty or total hip arthroplasty is a common and serious complication. In the Vancouver Classification system algorithm, B1 fractures should be treated with Open Reduction and Internal Fixation (ORIF) and preferentially revised in combination with ORIF if B2 or B3. This study aims to assess patient outcomes after plate osteosynthesis alone for Vancouver B1 and B2 fractures. The main outcome is the 1-year re-revision rate, and secondary outcomes are 30-day and 1-year mortality. Method: This is a retrospective single-centre case-series review from January 2016 to June 2021. Vancouver B1 and B2, non-malignancy fractures in adults over 18 years of age treated with polyaxial Non-Contact Bridging plate osteosynthesis, have been included. Outcomes were gathered from electronic notes and radiographs. Results: There were 50 B1 and 64 B2 fractures. 26 B2 fractures were managed with ORIF and revision, 39 ORIF alone. Of the revision group, one died within 30 days (3.8%), one at one year (3.8%), and two were revised within one year (7.7). Of the B2 ORIF group, three died within 30-day mortality (7.96%), eight at one year (21.1%), and 0 were revised in 1 year. Conclusion: This study has demonstrated that satisfactory outcomes can be achieved with ORIF, excluding revision in the management of B2 fractures.Keywords: arthroplasty, bridging plate, periprosthetic fracture, revision surgery
Procedia PDF Downloads 94515 Music in the Early Stages of Life: Considerations from Working with Groups of Mothers and Babies
Authors: Ana Paula Melchiors Stahlschmidt
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This paper discusses the role of music as a ludic activity and constituent element of voice in the construction and consolidation of the relationship of the baby and his/her mother or caretaker, evaluating its implications in his/her psychic structure and constitution as a subject. The work was based on the research developed as part of the author’s doctoral activities carried out from her insertion in a project of the Music Department of Federal University of Rio Grande do Sul - UFRGS, which objective was the development of musical activities with groups of babies from 0 to 24 months old and their caretakers. Observations, video recordings of the meetings, audio testemonies, and evaluation tools applied to group participants were used as instruments for this research. Information was collected on the participation of 195 babies, among which 8 were more focused on through interviews with their mothers or caretakers. These interviews were analyzed based on the referential of French Discourse Analysis, Psychoanalysis, Psychology of Development and Musical Education. The results of the research were complemented by other posterior experiences that the author developed with similar groups, in a context of a private clinic. The information collected allowed the observation of the ludic and structural functions of musical activities, when developed in a structured environment, as well as the importance of the musicality of the mother’s voice to the psychical structuring of the baby, allowing his/her insertion in the language and his/her constituition as a subject.Keywords: music and babies, maternal voice, Psychoanalysis and music, psychology and music
Procedia PDF Downloads 443514 Response of Selected Echocardiographic Features to Aerobic Training in Obese Hypertensive Males
Authors: Abeer Ahmed Abdelhameed
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The aim of this study was to investigate the effect of aerobic exercises on LV parameters, lipid profile, and anthropometric measurements in hypertensive middle aged male subjects. Thirty obese patients were recruited for the study from the outpatient clinic of National Heart Institute, Egypt. Their ages ranges from 40 to 60 years. All participants underwent an aerobic training program including regular aerobic sub-maximal exercises in the form of treadmill walking and abdominal exercises 3/week for four months, the exercise were individually tailored for each participant depending on the result of cardiopulmonary exercise test. The result showed no significant difference observed in both LVPWT and LVSWT data from pre-test values to post-test values in all subjects after 4 months, with a significant reduction in WHR, systolic blood pressure, TAG and LDL records. Result also revealed a significant increase in HDL, Eƒ, LVEDD and FS records for all participants. The significant improvement in ventricular functions in form of ejection fraction of electrical group more than exercise group after 4 months at the end of the study may be due to the beneficial effect of faradic stimulation in lipolysis of storage adipose tissues, stimulation of lean body mass and muscles and/or thermal effect that improves vascularization.Keywords: left ventricular parameters, aerobic training, electrical stimulation, lipid profile
Procedia PDF Downloads 245513 Factors Associated with Women’s Participation in Osteoporosis Health-Related Behaviors: An Analysis of Two Ethno-Cultural Groups
Authors: Offer E. Edelstein, Iris Vered, Orly Sarid
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Background: Physical activity (PA) is considered as a major factor in bone density preservation and fracture prevention. Yet, gaps in understanding exist regarding how ethnocultural backgrounds might shape attitudes, intentions, and actual PA participation. Based on the theory of planned behavior (TPB) for predicting PA, the aims of the current study were: i) to compare attitudes, subjective norms, perceived control, intentions and knowledge, across two ethnocultural groups; ii) to evaluate the fit of the model across two ethnocultural groups of women: Israeli-born Jews and Ethiopian immigrants. Methods: Two hundred women (one hundred from each group), aged > 65, completed valid and reliable questionnaires assessing knowledge, TPB components, and actual PA. Results: The level of knowledge on osteoporosis was relatively low in both groups. Intention to participate in PA was the only variable that directly predicted actual PA. Intention to participate in PA served as a mediator among attitudes, subjective norms, perceived control, and actual PA. The TPB components mediated the link between knowledge and intention to participate in PA. Conclusion: It is important to understand and augment interventions that enhance PA, in the community, and with sensitivity concerning each ethnocultural group.Keywords: attitudes, ethnocultural groups, knowledge, physical activity
Procedia PDF Downloads 126512 Prevalence of Tobacco Use and Practice among Patients Attending Dental Institution: A Cross-Sectional Study
Authors: Vinay Gupta, Seema Malhotra
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Background: Patients who usually consume tobacco are unaware of its ill effects completely therefore it becomes necessary to educate and counselling them after obtaining their knowledge about tobacco. Aim: To measure prevalence of tobacco use among dental outpatients and to evaluation of tobacco user attending dental outpatients (OPD) prepared to quit. Methods: A cross-sectional survey, which was carried out on patients attending Outside Patient Department (OPD) of dental college of King Georges Medical University, Lucknow, India. All the patients who consumed tobacco attending the Dental College were asked to participate in the study. The questionnaire was written in English/ Hindi (local language). Participation in this study was voluntary and the questionnaire was anonymous and self-administered. The proposal of this survey had been approved by the ethical committee of institution. Informed consent was obtained from all the participants. Results: Prevalence of tobacco user attending the Dental OPD was 46.4%. Male tobacco user represented 85.9%. Smokeless tobacco (57%) user were more than smoking (1.4%) and 18.9% were using both smokeless and smoking tobacco. 40.7% start using tobacco since less than 5 years. 55.3% uses tobacco after get up in the morning. 87.1% tobacco user knows that it cause cancer. 54.8% respond that warning sign on packet/pouch effect on mind but due to addiction, it would not work out. 54.8% attempted for quitting but not successful. 90.0% willing to quit in future if facility provide. Conclusion: Higher prevalence of tobacco usage among study population and will to quit in future shows need of cessation clinic in every dental institution in India.Keywords: tobacco, knowledge, practice, counselling
Procedia PDF Downloads 330511 Effectiveness of an Early Intensive Behavioral Intervention Program on Infants with Autism Spectrum Disorder
Authors: Dongjoo Chin
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The purpose of this study was to investigate the effectiveness of an Early Intensive Behavioral Intervention (EIBI) program on infants with autism spectrum disorder (ASD) and to explore the factors predicting the effectiveness of the program, focusing on the infant's age, language ability, problem behaviors, and parental stress. 19 pairs of infants aged between 2 and 5 years who have had been diagnosed with ASD, and their parents participated in an EIBI program at a clinic providing evidence-based treatment based on applied behavior analysis. The measurement tools which were administered before and after the EIBI program and compared, included PEP-R, a curriculum evaluation, K-SIB-R, K-Vineland-II, K-CBCL, and PedsQL for the infants, and included PSI-SF and BDI-II for the parents. Statistical analysis was performed using a sample t-test and multiple regression analysis and the results were as follows. The EIBI program showed significant improvements in overall developmental age, curriculum assessment, and quality of life for infants. There was no difference in parenting stress or depression. Furthermore, measures for both children and parents at the start of the program predicted neither PEP-R nor the degree of improvement in curriculum evaluation measured six months later at the end of the program. Based on these results, the authors suggest future directions for developing an effective intensive early intervention (EIBI) program for infants with ASD in Korea, and discuss the implications and limitations of this study.Keywords: applied behavior analysis, autism spectrum disorder, early intensive behavioral intervention, parental stress
Procedia PDF Downloads 166510 Correlating Musical Subject and Dialectical Subject to Develop a Critical Approach to Ideology in Musical Analysis and Composition
Authors: James Waide
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In music, subject typically denotes the initial idea to which the entire composition refers—a concept congruous with Aristotle's notion of subject as primary substance, in the sense of an irreducible this particular. Gioseffo Zarlino, who established subject (soggetto) as a musical term, insisted the composer as “rediscovering” the subject within their music in order to “[bring] it to perfection” and, furthermore, that if the composer had not rediscovered the subject already, then one would simply take the first part of the composition to be the subject. Meanwhile, Žižek reads the Hegelian subject (as negativity set against positive object) through Lacanian Psychoanalysis (in which the subject is a kind of fictive entity of the clinic: a mere appearance which sits atop the objects of analysis) in the concept of Absolute Recoil. For Žižek, subject exists retroactively in Absolute Recoil from object, meaning subject is a void which only has meaning because of the object it is seen through. Following the work of theorists such as Adorno and Althusser, one can understand the ideological construction of such a subject. It may be argued that in Zarlino, musical subject can be similarly read as retroactively constructed, either by the composer or the listener. Furthermore, in recent work, Samuel Wilson identifies different kinds of subjects in music which can be psychoanalytically examined, including the fictive subject: a purely musical entity raised to the level of psychoanalytic subject. On which basis if, as Adorno insisted, 'authentic' music constitutes 'cognition without concepts', where and what is this subject without concept?.Keywords: absolute recoil, critical theory, ideology, music analysis, psychoanalysis, retroactivity, subject
Procedia PDF Downloads 61509 Sexual Health and Sexual Risk Behavior of the Youth with HIV Positive in Northeastern Part, Thailand
Authors: Orathai Srithongtham, Ubonsri Thabuddha
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The youth with HIV positive is not difference from the general youth in term of sexual needs. Sexual health is crucial the most to support the youth with HIV positive to be sexual well-being. This study aims to elucidate the sexual health on protection from STDs (Sexual Transmitted Diseases) and HIV transmission and to explain sexual risk behavior of the youth with HIV positive. The target group was the youth with HIV positive about 23 cases from two provinces in northeastern part of Thailand. Qualitative method was applied for collecting data by in-depth interview. Content analysis was use for data analysis. The youth with HIV positive was protection from STDs and HIV transmission by using the condom during sexual activity. The reason to deny the condom use were ashamed, condom is not a part of life, no have fit size, and the youth fear to stigmatized as a mental disorder and fear to stigmatized as going to fuck someone. The youth who trust with nurse in clinic was dare to request the condom by face. Sexual activity without condom use is sexual risk behavior. The major causes were couple trust and the sexual enjoyment first and sexual active competition with friend without condom use. The concern on HIV was the boyfriend or girlfriend not accepts the HIV positive people, worry about the HIV transmutation, and finally not compliance to ARV drug. The youth with HIV positive was lacking of the knowledge on sexual health on the issues of access to condom and the concern to keep on relationship with the boyfriend or girlfriend. This concern issues was led to the non-adherence of ARV drug and HIV distribution. To provide the sexual health service is more essential to the youth with HIV positive.Keywords: sexual health, sexual risk behavior, youth, HIV
Procedia PDF Downloads 463508 Gingival Tissue Appearance Changes According Hormonal Oscillations at Female Patients
Authors: Ilma Robo, Saimir Heta, Vera Ostreni, Elsaida Agrushi, Eduart Kapaj
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Introduction: Cyclic hormonal fluctuations are known from literature to have a clinically visible effects on gingival tissue reactions, to the diagnosed processes of gingival inflammation. Materials and methods: At a total of 47 female patients, ad-hock presented at the University Clinic, were recorded data on effect of hormonal oscillations at periodontal treatment protocol. Oral examination was performed on soft tissue of gingiva and the oral mucous membrane, always respecting the air-drying procedure and then checking with free eye differences in oral mucosal relief. After the patients were informed about the study protocol, the purpose of the study and the ongoing procedure, verbal consensus was required. Results: The study was conducted in a total of 47 patients, out of which 13 patients were under the gingivitis classification, and 24 patients under the periodontal classification. Patients included in the study are divided by age, cycle week respectively 1,2,3 and 4.The younger age of female patients is more prone to the appearance of gingivitis, which is further aggravated by the effects of sexual hormones and the effect of the controlled or non-regulated fluctuations of the latter. Conclusions: The healing process is more fuel-intensive in the absence of high hormone levels, as they are these pro-inflammatory hormones, both in or near the ho Younger women are more open to volunteering in studies that record individual and study data that may last in time.Keywords: gingiva, hormonal oscillations, female patients, mucosa, periodontal non-surgical treatment
Procedia PDF Downloads 74507 The Effectiveness of High-Frequency Repetitive Transcranial Magnetic Stimulation in Persistent Somatic Symptoms Disorder: A Case Report Study
Authors: Mohammed Khamis Albalushi
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Background: Somatic symptoms disorders are usually comorbid with depressive disorders despite the fact that there is little evidence for effective treatment for it. Repetitive transcranial magnetic stimulation (rTMS) has been approved by the FDA for mildly resistant depression. From this point, we hypothesized that rTMS delivered over the prefrontal cortex (PFC) may be useful in somatic symptoms disorder. Therefore, in our case report, we want to shed light on the potential effectiveness of rTMS in somatic symptoms disorder. Case Report: A 65-year-old Omani female with multiple medical comorbidities on multiple medications. She presented complaining of multiple somatic complaints in the last 2 years after visiting multiple clinics and underwent several specialists’ examinations, investigations and procedures for somatic treatments; all of them were normal. Then patient was seen by a different psychiatric clinic; multiple anti-depressant and adjuvant anti-psychotic medications were tried, patient still did not improve. The patient was admitted to the hospital for observation and management. Initially, she was preoccupied with her somatic complaint and kept on Fluoxetine and Olanzapine along with that, topiramate was added, but still with minimal improvement. Then rTMS was added to her management plan following Intermittent theta burst (iTBS) rTMS protocol. After completing all sessions of rTMS, the patient was recovering from all her symptoms, and no complaints were reported from her. Conclusion: Our case highlights the importance of investigating more thoroughly in rTMS as a treatment option for Persistent Somatic symptoms Disorder.Keywords: rTMS, somatic symptoms disorder, resistive cases, TMS
Procedia PDF Downloads 53506 Effect of Multi Walled Carbon Nanotubes on Pyrolysis Behavior of Unsaturated Polyester Resin
Authors: Rosli Mohd Yunus, A. K. M. Moshiul Alam, Mohammad Dalour Beg
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In the case of advance polymeric materials reinforcement and thermal stability of matrix is a focused arena of researchers. The distribution of carbon nanotubes (CNTs) in polymer matrix influences material properties. In this study, multi-walled carbon nanotubes (MWCNTs) have been dispersed in unsaturated polyester resin (UPR) through solution mixing and sonication techniques using tetra hydro furan (THF) solvent. Nanocomposites have been fabricated with solution mixing and without solution mixing. Viscosity, Fourier-transform infrared spectroscopy, Field emission scanning electron microscopy (FESEM) investigations have been conducted to study the distribution as well as interaction between matrix and MWCNT. The differential scanning calorimetry (DSC), thermogravimetric analyses (TGA) and pyrolysis behavior have been conducted to study the thermal degradation and stability of nanocomposites. In addition, the SEM micrographs of nanocomposite residual chars were exhibited more packed together. Incorporation of CNT enhances crystallinity and mechanical and thermal properties of the nanocomposites. Correlations among MWCNTs dispersion, nucleation, fracture morphology and various properties have been made.Keywords: char, multiwall carbon nanotubes, nano composite, pyrolysis
Procedia PDF Downloads 346505 Mineralisation and Fluid Inclusions Studies of the Fluorite Deposit at Jebel Mecella, North Eastern Tunisia
Authors: Miladi Yasmine, Bouhlel Salah, Garnit Hechmi, David Banks
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The Jebel Mecella F (Ba-Pb-Zn) ore deposits of the Zaghouan district are located in northeastern Tunisia, 60 km south of Tunis. The host rocks belong to the Ressas Formation of Kimmeridgian-Tithonian age and lower Cretaceous layers. Mineralisations occur as stratiform lenses and fracture fillings. The ore mineral assemblage is composed of fluorite, barite, sphalerite galena, and quartz. Primary fluid inclusions in sphalerite have homogenization temperatures ranging from 129 to 145°C final melting temperature range from -14.9 to -10.0, corresponding to salinities of 14.0 to 17.7 wt% NaCl equivalent. Fluid inclusions in fluorite homogenize to the liquid phase between 116 and 160°C. The final ice melting temperature ranges from -23 to -15 °C, corresponding to salinities between 17 and 24 wt% NaCl equivalent. The LAICP-MS analyses of the fluid inclusions in fluorite show that these fluids are dominated by Na>K>Mg. Furthermore, the high K/Na values from fluid inclusions suggest the brine interacted with K-rich rocks in the basement or in siliciclastic sediments in the basins. The ore fluids in Jebel Mecella are highly saline and Na-K dominated with lower Mg concentrations, and come from the leaching of the dolomitic host rocks. These results are compatible with Mississippi-Valley-type mineralizing fluids.Keywords: Jebel Mecella, fluid inclusions, micro thermometry, LA-ICP-MS
Procedia PDF Downloads 185504 Failure and Stress Analysis of Super Heater Tubes of a 67 TPH Coke Dry Quenching Boiler
Authors: Subodh N. Patel, Abhijit Pusty, Manashi Adhikary, Sandip Bhattacharyya
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The steam superheater (SH) is a coil type heat exchanger which is used to produce superheated steam or to convert the wet steam to dry steam (69.6 kg/cm² and 495°C), generated by a boiler. There were two superheaters in the system, SH I and SH II. SH II is a set of tubes that faces the initial interaction with flue gas at high temperature followed by SH I tubes. After a service life of 2100 hours, a tube in the SH II found to be punctured. Dye penetrant test revealed that out of 50 such tubes, 14 more tubes had severe cracks at a similar location. The failure was investigated in detail. The materials and scale were characterized by optical microscope and advance characterization technique. Scale, observed on fracture surface, was characterized under scanning electron microscope and Raman spectroscopy. Stresses acting on the tubes in working condition were analyzed by finite element method software, ANSYS. Cyclic stresses were observed in the simulation at the same prone location due to restriction in expansion of tubes. Based on scale characterization and stress analysis, it was concluded that the tube failed in thermo-mechanical fatigue. Finally, prevention and control measures were taken to avoid such failure in the future.Keywords: finite element analysis, oxide scale, superheater tube, thermomechanical fatigue
Procedia PDF Downloads 114503 Determination of Inflow Performance Relationship for Naturally Fractured Reservoirs: Numerical Simulation Study
Authors: Melissa Ramirez, Mohammad Awal
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The Inflow Performance Relationship (IPR) of a well is a relation between the oil production rate and flowing bottom-hole pressure. This relationship is an important tool for petroleum engineers to understand and predict the well performance. In the petroleum industry, IPR correlations are used to design and evaluate well completion, optimizing well production, and designing artificial lift. The most commonly used IPR correlations models are Vogel and Wiggins, these models are applicable to homogeneous and isotropic reservoir data. In this work, a new IPR model is developed to determine inflow performance relationship of oil wells in a naturally fracture reservoir. A 3D black-oil reservoir simulator is used to develop the oil mobility function for the studied reservoir. Based on simulation runs, four flow rates are run to record the oil saturation and calculate the relative permeability for a naturally fractured reservoir. The new method uses the result of a well test analysis along with permeability and pressure-volume-temperature data in the fluid flow equations to obtain the oil mobility function. Comparisons between the new method and two popular correlations for non-fractured reservoirs indicate the necessity for developing and using an IPR correlation specifically developed for a fractured reservoir.Keywords: inflow performance relationship, mobility function, naturally fractured reservoir, well test analysis
Procedia PDF Downloads 260502 Mechanical Investigation Approach to Optimize the High-Velocity Oxygen Fuel Fe-Based Amorphous Coatings Reinforced by B4C Nanoparticles
Authors: Behrooz Movahedi
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Fe-based amorphous feedstock powders are used as the matrix into which various ratios of hard B4C nanoparticles (0, 5, 10, 15, 20 vol.%) as reinforcing agents were prepared using a planetary high-energy mechanical milling. The ball-milled nanocomposite feedstock powders were also sprayed by means of high-velocity oxygen fuel (HVOF) technique. The characteristics of the powder particles and the prepared coating depending on their microstructures and nanohardness were examined in detail using nanoindentation tester. The results showed that the formation of the Fe-based amorphous phase was noticed over the course of high-energy ball milling. It is interesting to note that the nanocomposite coating is divided into two regions, namely, a full amorphous phase region and homogeneous dispersion of B4C nanoparticles with a scale of 10–50 nm in a residual amorphous matrix. As the B4C content increases, the nanohardness of the composite coatings increases, but the fracture toughness begins to decrease at the B4C content higher than 20 vol.%. The optimal mechanical properties are obtained with 15 vol.% B4C due to the suitable content and uniform distribution of nanoparticles. Consequently, the changes in mechanical properties of the coatings were attributed to the changes in the brittle to ductile transition by adding B4C nanoparticles.Keywords: Fe-based amorphous, B₄C nanoparticles, nanocomposite coating, HVOF
Procedia PDF Downloads 127501 Failure Analysis of Laminated Veneer Bamboo Dowel Connections
Authors: Niloufar Khoshbakht, Peggi L. Clouston, Sanjay R. Arwade, Alexander C. Schreyer
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Laminated veneer bamboo (LVB) is a structural engineered composite made from glued layers of bamboo. A relatively new building product, LVB is currently employed in similar sizes and applications as dimensional lumber. This study describes the results of a 3D elastic Finite Element model for halfhole specimens when loaded in compression parallel-to-grain per ASTM 5764. The model simulates LVB fracture initiation due to shear stresses in the dowel joint and predicts displacement at failure validated through comparison with experimental results. The material fails at 1mm displacement due to in-plane shear stresses. The paper clarifies the complex interactive state of in-plane shear, tension perpendicular-to-grain, and compression parallel-to-grain stresses that form different distributions in the critical zone beneath the bolt hole for half-hole specimens. These findings are instrumental in understanding key factors and fundamental failure mechanisms that occur in LVB dowel connections to help devise safe standards and further LVB product adoption and design.Keywords: composite, dowel connection, embedment strength, failure behavior, finite element analysis, Moso bamboo
Procedia PDF Downloads 260500 Pore Pressure and In-situ Stress Magnitudes with Image Log Processing and Geological Interpretation in the Haoud Berkaoui Hydrocarbon Field, Northeastern Algerian Sahara
Authors: Rafik Baouche, Rabah Chaouchi
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This work reports the first comprehensive stress field interpretation from the eleven recently drilled wells in the Berkaoui Basin, Algerian Sahara. A cumulative length of 7000+m acoustic image logs from 06 vertical wells were investigated, and a mean NW-SE (128°-145° N) maximum horizontal stress (SHMax) orientation is inferred from the B-D quality wellbore breakouts. The study integrates log-based approach with the downhole measurements to infer pore pressure, in-situ stress magnitudes. Vertical stress (Sv), interpreted from the bulk-density profiles, has an average gradient of 22.36 MPa/km. The Ordovician and Cambrian reservoirs have a pore pressure gradient of 13.47-13.77 MPa/km, which is more than the hydrostatic pressure regime. A 17.2-18.3 MPa/km gradient of minimum horizontal stress (Shmin) is inferred from the fracture closure pressure in the reservoirs. Breakout widths constrained the SHMax magnitude in the 23.8-26.5 MPa/km range. Subsurface stress distribution in the central Saharan Algeria indicates that the present-day stress field in the Berkaoui Basin is principally strike-slip faulting (SHMax > Sv > Shmin). Inferences are drawn on the regional stress pattern and drilling and reservoir development.Keywords: stress, imagery, breakouts, sahara
Procedia PDF Downloads 68499 Pregnancy Rhinitis Prevalence among Saudi Women
Authors: Mohammed G. Alotaibi, Sameer Albahkaly, Salwa M. Bahkali, Abdullah M. Alghamdi, Raseel S. Alswidan, Maha Bin Shafi, Sarah Almaiman
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Introduction: Rhinitis is common in Saudi Arabia. Therefore, our study was designed to evaluate the prevalence, triggering factors, severity and progression of rhinitis during pregnancy. Methods: Prospective cross-sectional study was conducted in eight governmental and private medical centers in Riyadh, Saudi Arabia, during June and July 2014. Validated Arabic language self-administered questionnaire was used. Sample size of 260 Saudi pregnant women was calculated by Raosoft sample size calculator. Random sampling was achieved by choosing one and skipping every five patients in the clinic list. Data were coded and entered manually into spreadsheets then transferred to SPSS statistical package version 16.0 for Windows. Consent, Privacy and confidentiality of information were assured. Results: Pregnancy rhinitis was reported 31.2% (CI 25.6 - 37.2%). Symptoms arising in first trimester appeared in 79.2% of PR cases and mostly worsen. The most prevalent symptoms were nasal pruritis (67.5%), followed by sneezing (57.1%), congestion (50.6%), and post nasal drip (46.7%). The major triggering factor was dust (71.4%), followed by Tobacco/Shisha smoke (57.6%) and perfume(47%). Preexisting allergic diseases were markedly associated with developing pregnancy rhinitis. Conclusion: Rhinitis during pregnancy manifested in one third of Saudi pregnant ladies. Nasal pruritus was the most common symptom and dust was the widespread triggering factor.Keywords: allergy, pregnancy, Rhinitis, sneezing
Procedia PDF Downloads 243498 Comparison of Early Silicon Oil Removal and Late Silicon Oil Removal in Patients With Rhegmatogenous Retinal Detachment
Authors: Hamidreza Torabi, Mohsen Moghtaderi
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Introduction: Currently, deep vitrectomy with silicone oil tamponade is the standard treatment method for patients with Rhegmatogenous Retinal Detachment (RRD). After retinal repair, it is necessary to remove silicone oil from the eye, but the appropriate time to remove the oil and complications related to that time has been less studied. The aim of this study was to compare the results of the early removal of silicone oil with the delayed removal of silicone oil in patients with RRD. Method & material: Patients who were referred to the Ophthalmology Clinic of Baqiyatallah Hospital, Tehran, Iran, due to RRD with detached macula in 2021 & 2022 were evaluated. These patients were treated with deep vitrectomy and silicone oil tamponade. Patients whose retinas were attached after the passage of time were candidates for silicone oil removal (SOR) surgery. For patients in the early SOR group, SOR surgery was performed 3-6 months after the initial vitrectomy surgery, and for the late SOR group, SOR was performed after 6 months after the initial vitrectomy surgery. Results: In this study, 60 patients with RRD were evaluated. 23 (38.3%) patients were in the early group, and 37 (61.7%) patients were in the late group. Based on our findings, it was seen that the mean visual acuity of patients based on the Snellen chart in the early group (0.48 ± 0.23 Decimal) was better than the late group (0.33 ± 0.18 Decimal) (P-value=0.009). Retinal re-detachment has happened only in one patient with early SOR. Conclusion: Early removal of silicone oil (less than 6 months) from the eyes of patients undergoing RRD surgery has been associated with better vision results compared to late removal.Keywords: retinal detachment, vitrectomy, silicone oil, silicone oil removal, visual acuity
Procedia PDF Downloads 71497 Effect of Serum Electrolytes on a QTc Interval and Mortality in Patients admitted to Coronary Care Unit
Authors: Thoetchai Peeraphatdit, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham, Niyada Naksuk
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Background: Serum electrolyte abnormalities are a common cause of an acquired prolonged QT syndrome, especially, in the coronary care unit (CCU) setting. Optimal electrolyte ranges among the CCU patients have not been sufficiently investigated. Methods: We identified 8,498 consecutive CCU patients who were admitted to the CCU at Mayo Clinic, Rochester, the USA, from 2004 through 2013. Association between first serum electrolytes and baseline corrected QT intervals (QTc), as well as in-hospital mortality, was tested using multivariate linear regression and logistic regression, respectively. Serum potassium 4.0- < 4.5 mEq/L, ionized calcium (iCa) 4.6-4.8 mg/dL, and magnesium 2.0- < 2.2 mg/dL were used as the reference levels. Results: There was a modest level-dependent relationship between hypokalemia ( < 4.0 mEq/L), hypocalcemia ( < 4.4 mg/dL), and a prolonged QTc interval; serum magnesium did not affect the QTc interval. Association between the serum electrolytes and in-hospital mortality included a U-shaped relationship for serum potassium (adjusted odds ratio (OR) 1.53 and OR 1.91for serum potassium 4.5- < 5.0 and ≥ 5.0 mEq/L, respectively) and an inverted J-shaped relationship for iCa (adjusted OR 2.79 and OR 2.03 for calcium < 4.4 and 4.4- < 4.6 mg/dL, respectively). For serum magnesium, the mortality was greater only among patients with levels ≥ 2.4 mg/dL (adjusted OR 1.40), compared to the reference level. Findings were similar in sensitivity analyses examining the association between mean serum electrolytes and mean QTc intervals, as well as in-hospital mortality. Conclusions: Serum potassium 4.0- < 4.5 mEq/L, iCa ≥ 4.6 mg/dL, and magnesium < 2.4 mg/dL had a neutral effect on QTc intervals and were associated with the lowest in-hospital mortality among the CCU patients.Keywords: calcium, electrocardiography, long-QT syndrome, magnesium, mortality, potassium
Procedia PDF Downloads 383496 Simultaneous Improvement of Wear Performance and Toughness of Ledeburitic Tool Steels by Sub-Zero Treatment
Authors: Peter Jurči, Jana Ptačinová, Mária Hudáková, Mária Dománková, Martin Kusý, Martin Sahul
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The strength, hardness, and toughness (ductility) are in strong conflict for the metallic materials. The only possibility how to make their simultaneous improvement is to provide the microstructural refinement, by cold deformation, and subsequent recrystallization. However, application of this kind of treatment is impossible for high-carbon high-alloyed ledeburitic tool steels. Alternatively, it has been demonstrated over the last few years that sub-zero treatment induces some microstructural changes in these materials, which might favourably influence their complex of mechanical properties. Commercially available PM ledeburitic steel Vanadis 6 has been used for the current investigations. The paper demonstrates that sub-zero treatment induces clear refinement of the martensite, reduces the amount of retained austenite, enhances the population density of fine carbides, and makes alterations in microstructural development that take place during tempering. As a consequence, the steel manifests improved wear resistance at higher toughness and fracture toughness. Based on the obtained results, the key question “can the wear performance be improved by sub-zero treatment simultaneously with toughness” can be answered by “definitely yes”.Keywords: ledeburitic tool steels, microstructure, sub-zero treatment, mechanical properties
Procedia PDF Downloads 306495 Nurse's Professional Space: Psychiatric Outpatient Clinic of Ottawa's Montfort Hospital 1976-2002
Authors: Silvia Maria Moya
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After the Great Depression, the number of admissions to psychiatric facilities saw a significant increase. This increase, coupled with the arrival of new antipsychotic drugs, prepared the ground to the psychiatric deinstitutionalization movement in North America. Community services became an essential part of care where the role of the nurse also became crucial in the management of patients. Looking through the archives of the Department of Psychiatry at the Ottawa Montfort Hospital, this project aims to assess the role of the nurse in a multidisciplinary team in a period of psychiatric deinstitutionalization. This research focuses on the different roles of the mental health nurse during the second half of the twentieth century. The case study, used as a methodological approach allows in-depth analysis of the journey of a female patient with long hospital course. The analysis of the document ‘psychiatric evaluation’ on the medical records of outpatient Montfort Hospital – where, on a regular basis, different health professionals of the multidisciplinary team write their notes – allow us to better understand the difficulties of the patient, their problems, their family and work relationships and the evolution of their self-esteem, but most importantly, it allows us to identify the importance of the different nurse`s roles in the team and in the mental health setting. This project therefore reveals that the nurse occupies a larger professional space than the other professionals in the multidisciplinary team and highlights the role of mental health nurses with patients and their families and their leadership role within a multidisciplinary team.Keywords: mental health, nursing, deinstitutionalization, professional space
Procedia PDF Downloads 355494 A Survey of Chronic Pain Patients’ Experiences in the Emergency Department
Authors: G. Fitzpatrick, S. O. Chonghaile, D. Harmon
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Objective: Chronic pain patients represent a unique challenge in the Emergency Department. Very little literature has been published regarding this group of patients. Our aim was to determine the attitude of patients with chronic pain to the Emergency Department in order to improve and streamline their future visits. Methods: A two-year survey was carried out on Chronic Pain Patients regarding their Emergency Department Attendances. Patients attending the Pain Clinic in Croom Hospital, Co. Limerick were asked to complete a 20-part questionnaire regarding their experiences of visiting the Emergency Department in the preceding year. 46 questionnaires were completed. Results: Unbearable breakthrough pain was the main reason for visiting the Emergency Department. More than half (54%) of those surveyed were not satisfied with the treatment received. Problems indicated included under-treatment of pain (59%), a sense of being under undue suspicion of drug-seeking behaviour (33%) and a perception that the patient themselves understood their condition better than the treating doctor (76%). Paracetamol, NSAIDs, or time off work comprised 72% of the treatments offered – all of which could have been provided by their General Practitioner. Only 4% were offered a nerve block. 67% felt that the creation of personalised Patient Plans, consisting of an agreed plan between the patient, their pain specialist, and the Emergency Department, would expedite their trip through the Emergency Department. Conclusions: Chronic pain patients generally have a negative experience in the ED. Possible future solutions include increasing our empathy and levels of knowledge, provision of nerve blocks in the ED, and use of personalised “Patient Plans” to streamline the treatment pathway for this group of patients.Keywords: chronic pain, survey, patients, emergency department
Procedia PDF Downloads 364493 Modeling Anisotropic Damage Algorithms of Metallic Structures
Authors: Bahar Ayhan
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The present paper is concerned with the numerical modeling of the inelastic behavior of the anisotropically damaged ductile materials, which are based on a generalized macroscopic theory within the framework of continuum damage mechanics. Kinematic decomposition of the strain rates into elastic, plastic and damage parts is basis for accomplishing the structure of continuum theory. The evolution of the damage strain rate tensor is detailed with the consideration of anisotropic effects. Helmholtz free energy functions are constructed separately for the elastic and inelastic behaviors in order to be able to address the plastic and damage process. Additionally, the constitutive structure, which is based on the standard dissipative material approach, is elaborated with stress tensor, a yield criterion for plasticity and a fracture criterion for damage besides the potential functions of each inelastic phenomenon. The finite element method is used to approximate the linearized variational problem. Stress and strain outcomes are solved by using the numerical integration algorithm based on operator split methodology with a plastic and damage (multiplicator) variable separately. Numerical simulations are proposed in order to demonstrate the efficiency of the formulation by comparing the examples in the literature.Keywords: anisotropic damage, finite element method, plasticity, coupling
Procedia PDF Downloads 195492 Anxiety Sensitivity and Coping Motives Predict Substance Use Craving and Relapse
Authors: Ruhollah Heydari Sheikh Ahmad, Sara Alaie Khoraem
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Introduction: Substance use disorder is conceptualized as a chronic relapsing condition where relapse is usually defined as the return to problematic substance use following treatment. An issue of great importance is the identification of the predictors of relapse and the development of treatments that may help prevent relapse. One of the strongest predictors of relapse is craving. The purpose of the present study was to study the effect of anxiety, anxiety sensitivity, and coping motives on craving. Materials and method: Participants (n=74) were male opiate users recruited from a semi-private clinic providing de-toxification and treatment services for substance users. Anxiety, anxiety sensitivity, coping motives and craving were assessed using relevant questionnaires. The addiction severity index was used to assess addiction severity. Results: All patients were methadone maintained and one year after detoxification, 36 patients (48.64%) relapsed. Stress and anxiety, anxiety sensitivity, addiction severity and coping motives predicted craving and relapse. Anxiety sensitivity specifically predicted early relapse. Conclusion: Substance use is a severe mental disorder, with high relapse rates. Substance users high in anxiety sensitivity are particularly prone to relapse during the first six months of treatment. Addiction severity and coping motives need to be taken into account when providing interventional services for substance users. Findings imply the significance of additional psychological attention to methadone maintained patients to prevent craving and relapse.Keywords: anxiety sensitivity, coping motives, relapse, substance use craving
Procedia PDF Downloads 284491 Experimental and Numerical Investigations of Impact Response on High-Speed Train Windshield
Authors: Wen Ma, Yong Peng, Zhixiang Li
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Security journey is a vital focus on the field of Rail Transportation. Accidents caused by the damage of the high-speed train windshield have occurred many times and have given rise to terrible consequences. Train windshield consists of tempered glass and polyvinyl butyral (PVB) film. In this work, the quasi-static tests and the split Hopkinson pressure bar (SHPB) tests were carried out first to obtain the mechanical properties and constitutive model for the tempered glass and PVB film. These tests results revealed that stress and Young’s modulus of tempered glass were wake-sensitive to strain rate, but stress and Young’s modulus of PVB film were strong-sensitive to strain rate. Then impact experiment of the windshield was carried out to investigate dynamic response and failure characteristics of train windshield. In addition, a finite element model based on the combined finite element method was proposed to investigate fracture and fragmentation responses of train windshield under different-velocity impact. The results can be used for further design and optimization of the windshield for high-speed train application.Keywords: constitutive model, impact response, mechanism properties, PVB film, tempered glass
Procedia PDF Downloads 137490 A Study of Ocular Morbidity in Road Traffic Accidents
Authors: Nikhat Iqbal Tamboli
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INTRODUCTION: road traffic accidents (RTAs) are one of the leading and common causes of ocular injuries especially in developing countries like India which are preventable with certain measures and so it is of public health importance. AIM: To study incidence and clinical presentation of ocular morbidity in road traffic accidents. METHOD: Prospective cross-sectional study was conducted on 360 patients reported in department of ophthalmology. Detailed ocular examination and relevant investigations done. RESULTS: Incidence of ocular injuries is 23%. male:female ratio is 4.5:1.Cases having Sub conjunctival haemorrhage [74].eccymosis[217]. lid lcerations [164]orbital fracture[12] corneal tear [7]corneal abrasion[2] sclera tear[6] hyphaema[4] traumatic mydriasis [7]traumatic cataract [2]vitreous haemorrhage [1]traumatic optic neuropathy[1].Maximum cases in age group 20-40 years, with two wheeler vehicles 94.7% .Under influence of alcohol 13.3%. CONCLUSION: Younger age group with male preponderance is involved in ocular trauma due to road traffic accidents .maximum cases reported are with anterior segment injuries. Alcohol and two wheeler vehicles are common risk factors. Injuries involving cornea had bad prognosis and involving retina had worst prognosis.Keywords: ocular morbidity, eye trauma, RTA, eye injury
Procedia PDF Downloads 61489 Degradation of Mechanical Properties of Offshoring Polymer Composite Pipes in Thermal Environment
Authors: Hamza Benyahia, Mostapha Tarfaoui, Ahmed El-Moumen, Djamel Ouinas
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Composite pipes are commonly used in the oil industry, and extreme flow of hot and cold gas fluid can cause degradation of their mechanical performance and properties. Therefore, it is necessary to consider thermomechanical behavior as an important parameter in designing these tubular structures. In this paper, an experimental study is conducted on composite glass/epoxy tubes, with a thickness of 6.2 mm and 86 mm internal diameter made by filament winding of (Փ = ± 55°), to investigate the effects of extreme thermal condition on their mechanical properties b over a temperature range from -40 to 80°C. The climatic chamber is used for the thermal aging and then, combine split disk system is used to perform tensile tests on these composite pies. Thermal aging is carried out for 8hr but each specimen was subjected to various temperature ranges and then, uniaxial tensile test is conducted to evaluate their mechanical performance. Experimental results show degradation in the mechanical properties of composite pipes with an increase in temperature. The rigidity of pipes increases progressively with a decrease in thermal load and results in a radical decrease in their elongation before fracture, thus, decreasing their ductility. However, with an increase in the temperature, there is a decrease in the yield strength and an increase in yield strain, which confirmed an increase in the plasticity of composite pipes.Keywords: composite pipes, thermal-mechanical properties, filament winding, thermal degradation
Procedia PDF Downloads 129488 Anti-Osteoporotic Effect of Deer Antler in Ovariectomized Rats
Authors: Hye Kyung Kim, Myung-Gyou Kim, Kang-Hyun Leem
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The deer velvet antler is well known for its traditional medicinal value and is widely used in the clinic. It has been considered to possess bone-strengthening activity. The goal of this study was to investigate the anti-osteoporotic effect of deer antler velvet on ovariectomized rats (OVX), and their possible mechanism of the action. In the first step, the in vitro effects of DAE on bone loss were determined. The proliferation, collagen content and alkaline phosphatase (ALP) activity of human osteoblastic MG-63 cells and osteoclastogenesis from bone marrow-derived precursor cells were measured. The in vivo experiment confirmed the positive effect of DAE on bone tissue. 3-month old female Sparague-Dawley rats were either sham operated or OVX, and administered DAE (20 and 100 mg/kg) for 4 weeks. DAE increased MG-63 cell proliferation and ALP activity in a dose-dependent manner. Collagen content was also increased by DAE treatment. However, the effect of DAE on bone resorption was not observed. OVX rats supplemented with DAE showed osteoprotective effects as the bone ALP level was increased and c-terminal telopeptide level was decreased by 100 mg/kg DAE treatment compared with OVX controls. Moreover, the tartrate-resistant acid phosphatase-5b level was also decreased by DAE treatment. The present study suggests that DAE is effective in preventing bone loss in OVX rats, and may be potential therapeutic agents for the treatment of postmenopausal osteoporosis.Keywords: bone ALP, c-terminal telopeptide, deer antler, osteoporosis, ovariectomy, tartrate-resistant acid phosphatase-5b
Procedia PDF Downloads 237487 Lessons Learned in Developing a Clinical Information System and Electronic Health Record (EHR) System That Meet the End User Needs and State of Qatar's Emerging Regulations
Authors: Darshani Premaratne, Afshin Kandampath Puthiyadath
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The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly, the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned. The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned.Keywords: clinical information system, electronic health record, state regulations, integrated referral network of clinics
Procedia PDF Downloads 354