Search results for: lower limb rehabilitation

Authors: Hardisiswo Soedjana, Inne Caroline

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Deep dermal or full thickness burns are inevitably lead to post-burn contractures. These contractures remain to be one of the most concerning late complications of burn injuries. Surgical management includes releasing the contracture followed by resurfacing the defect accompanied by post-operative rehabilitation. Optimal treatment of post-burn contractures depends on the characteristics of the contractures. This study is aimed to describe clinical characteristics, problems, and management of post-burn contractures in adults and children. A retrospective analysis was conducted from medical records of patients suffered from contractures after burn injuries admitted to Hasan Sadikin general hospital between January 2016 and January 2018. A total of 50 patients with post burn contractures were included in the study. There were 17 adults and 33 children. Most patients were male, whose age range within 15-59 years old and 5-9 years old. Educational background was mostly senior high school among adults, while there was only one third of children who have entered school. Etiology of burns was predominantly flame in adults (82.3%); whereas flame and scald were the leading cause of burn injury in children (11%). Based on anatomical regions, hands were the most common affected both in adults (35.2%) and children (48.5%). Contractures were identified in 6-12 months since the initial burns. Most post-burn hand contractures were resurfaced with full-thickness skin graft (FTSG) both in adults and children. There were 11 patients who presented with recurrent contracture after previous history of contracture release. Post-operative rehabilitation was conducted for all patients; however, it is important to highlight that it is still challenging to control splinting and exercise when patients are discharged and especially the compliance in children. In order to improve quality of life in patients with history of deep burn injuries, prevention of contractures should begin right after acute care has been established. Education for the importance of splinting and exercise should be administered as comprehensible as possible for adult patients and parents of pediatric patients.

Keywords: burn, contracture, education, exercise, splinting

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Authors: Muhammad Adeel Arshad, Shaukat Ali Bhatti

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The study aimed to investigate the effect of bile acids and lipase supplementation in low-energy diets on growth performance and meat quality of broilers. Seven hundred day-old Cobb-500 broiler chicks with an average initial body weight of 45.9 ± 0.3 g were assigned to 5 dietary treatments, with five replications of 28 birds each in a completely randomized design. The five treatments were as follows: (i) HE: broilers received a diet with high energy content; (ii) LE: broilers received a diet with low energy content and energy content reduced by 100 kcal/kg as compared to HE; (iii) LEB: broilers received a diet similar to the LE group supplemented with 300 g/ton bile acids; (iv) LEL: broilers received a diet similar to the LE group supplemented with 180 g/ton lipase enzyme and (v) LEBL: broilers received a diet similar to the LE group supplemented with both 300 g/ton bile acids and 180 g/ton lipase enzyme. The experimental period lasted for 35 days. Broilers fed HE had a lower (P < 0.05) body weight (BW) gain and lower feed intake (1-35 d), but during finisher period (21-35 d), BW gain was similar with other treatments. Feed conversion ratio (FCR) was lower in HE and higher in LEBL group (P < 0.05), while the LE, LEB, and LEL had intermediate values. At 35 d no difference occurred between treatment for water holding capacity and pH of breast and thigh muscles (P > 0.05). The relative weight of pancreas was higher (P < 0.05) in LEB treatment but lower (P < 0.05) in LEL treatment. In conclusion, bile acids and lipase supplementation at 300 g/ton and 150g/ton of feed in low-energy diets respectively had no effect on broiler performance and meat quality. However, FCR was improved in HE treatment.

Keywords: bile acids, energy, enzyme, growth

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Authors: Julia Hoefer Martí

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While research has consistently found a significant motherhood wage penalty for heterosexual women, where homosexual women are concerned, evidence has appeared to suggest no effect, or possibly even a wage bonus. This paper presents a model of the household with a public good that requires both a monetary expense and a labour investment, and where the household budget is shared between partners. Lower-wage partners will do relatively more of the household labour while higher-wage partners will specialise in market labour, and the arrival of a child exacerbates this split, resulting in the lower-wage partner taking on even more of the household labour in relative terms. Employers take this gender-sexuality dyad as a signal for employees’ commitment to the labour market after having a child, and use the information when setting wages after employees become parents. Given that women empirically earn lower wages than men, in a heterosexual couple the female partner will often do more of the household labour. However, as not every female partner has a lower wage, this results in an over-adjustment of wages that manifests as an unexplained motherhood wage penalty. On the other hand, in homosexual couples wage distributions are ex ante identical, and gender is no longer a useful signal to employers as to whether the partner is likely to specialise in household labour or market labour. This model is then tested using longitudinal data from the EU Standards of Income and Living Conditions (EU-SILC) to investigate the hypothesis that women experience different wage effects of motherhood depending on their sexual orientation. While heterosexual women receive a significant motherhood wage penalty of 8-10%, homosexual mothers do not receive any significant wage bonus or penalty of motherhood, consistent with the hypothesis presented above.

Keywords: discrimination, gender, motherhood, sexual orientation, labor economics

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Authors: Maris Klavins, Valery Rodinov

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The aim of this study was to analyze long term changes of surface water quality in Latvia, spatial variability of water chemical composition, possible impacts of different pollution sources as well as to analyze the measures to protect national water resources - river basin management. Within this study, the concentrations of major water ingredients and microelements in major rivers and lakes of Latvia have been determined. Metal concentrations in river and lake waters were compared with water chemical composition. The mean concentrations of trace metals in inland waters of Latvia are appreciably lower than the estimated world averages for river waters and close to or lower than background values, unless regional impacts determined by local geochemistry. This may be explained by a comparatively lower level of anthropogenic load. In the same time in several places, direct anthropogenic impacts are evident, regarding influences of point sources both transboundary transport impacts. Also, different processes related to pollution of surface waters in Latvia have been analyzed. At first the analysis of changes and composition of pollutant emissions in Latvia has been realized, and the obtained results were compared with actual composition of atmospheric precipitation and their changes in time.

Keywords: water quality, trend analysis, pollution, human impact

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Authors: Nisha James, Shubha Ranganathan

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Sex trafficking is a type of human trafficking involving prostitution of individuals for sexual exploitation. The stigma and social isolation they face in the society often makes it difficult for them to become rehabilitated from trafficking, due to which many of them continue in prostitution for years after being sex trafficked. Victims are subjected to violations of their fundamental human rights, deprived of basic medical facilities and undergo long-term abuse. This paper focuses on the role of Non-Governmental Organizations (NGOs) in the rescue and rehabilitation of victims of sex trafficking. Semi-structured interviews were conducted with 26 survivors of sex trafficking, five sex workers and 14 non-community staff members of a project running NGO in the city of Chennai in South India. Chennai has a number of NGOs that are involved in HIV/AIDS awareness and prevention programs. In many cases, rehabilitation of sex trafficking victims is also a mandate of these NGOs. This particular NGO was also involved in development activities towards the eradication of HIV/AIDS. For instance, they were engaged in inculcating safe sex practices among high-risk groups such as sex workers or in fighting for sex worker rights. The study found that the NGO’s role in combatting sex trafficking is overrun by the way it approaches these issue related to HIV/AIDS. Further, their activities are dependent solely on funding. Given that gradually, international funding for HIV/AIDS has slowly been withdrawn, there have been problems such as reduction in the salary of the project staff, the outreach workers and peer educators, many of whom were survivors of sex trafficking who have been able to survive on their wages instead of continuing in prostitution. Therefore, till date, the project funding has helped in making them aware of the health and social consequences of continuing in prostitution, and in supporting them socioeconomically, but the lack of funding may also lead the NGO workers into a state of unemployment, poverty and eventually into being re-trafficked. The study concludes by pointing to the need for disengaging anti-trafficking efforts from the HIV/AIDS related programs.

Keywords: non-governmental organization role, non-governmental organization staff, sex trafficking survivors, sex workers

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Authors: Pintu Modak

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The core strength is essential not only for athletes but also for everyone to perform everyday's household chores with ease and efficiency. Core strength means to strengthen the muscles deep within the abdomen which connect to the spine and pelvis which control the position and movement of the central portion of the body. Strengthening of core muscles is important for injury prevention (lower back pain) and performance enhancement in sports. The purpose of the study was to review the literature and findings on the effects of Yoga exercise as a part of sports training method and fitness programs. Fifteen papers were found to be relevant for this review. There are five simple yoga poses: Ardha Phalakasana (Low plank), Vasisthasana (side plank), Purvottanasana (inclined plane), Sarvangasana (shoulder stand), and Virabhadrasana (Warrior) are found to be very effective for strengthening core muscles. They are the most effective poses to build core strength and flexibility to the core muscles. The study suggests that sports and fitness trainers should include these yoga exercises in their programs to strengthen core muscles.

Keywords: core strength, yoga, injuries, lower back

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Authors: Sanjeewa Seneviratne, Ian Campbell, Nina Scott, Ross Lawrenson

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Introduction: Indigenous Māori women experience a 60% higher breast cancer mortality rate compared with European women in New Zealand. We explored the impact of difference in the rate of screen detected breast cancer between Māori and European women on more advanced disease at diagnosis and lower survival in Māori women. Methods: All primary in-situ and invasive breast cancers diagnosed in screening age women (as defined by the New Zealand National Breast Cancer Screening Programme) between 1999 and 2012 in the Waikato area were identified from the Waikato Breast Cancer Register and the national screening database. Association between screen versus non-screen detection and cancer stage at diagnosis and survival were compared by ethnicity and socioeconomic deprivation. Results: Māori women had 50% higher odds of being diagnosed with more advance staged cancer compared with NZ European women, a half of which was explained by the lower rate of screen detected cancer in Māori women. Significantly lower breast cancer survival rates were observed for Māori compared with NZ European and most deprived compared with most affluent socioeconomic groups for symptomatically detected breast cancer. No significant survival differences by ethnicity or socioeconomic deprivation were observed for screen detected breast cancer. Conclusions: Low rate of screen detected breast cancer appears to be a major contributor for more advanced stage disease at diagnosis and lower breast cancer survival in Māori compared with NZ European women. Increasing screening participation for Māori has the potential to substantially reduce breast cancer mortality inequity between Māori and NZ European women.

Keywords: breast cancer, screening, ethnicity, inequity

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Authors: Rizalyn Gonzales, Harold Monteclaro

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This study determined the effects of net height on the capture performance of crab entangling nets. Fishing trials were conducted using nets with the following net heights: 1) 12 meshes down (MD), 2) 24 MD and 3) 50 MD. A total of 1,290 individuals comprising of 87 species belonging to 53 families were caught. One-way ANOVA showed that net height significantly affects various catch parameters such as catch per unit effort (CPUE) of the total and target catch, amount of non-target catch, sizes and species richness. The use of appropriate net height is a potential technical measure for a selective but still efficient crab entangling net fishery. Lower net height significantly reduced non-target catch up to 70%. While lower nets decreased the CPUE of target catch such as blue swimming crab Portunus pelagicus and christian crab Charybdis feriatus up to 65% in 12 MD, catch in 24 MD was not significantly different with that in 50 MD. The use of 24 MD also resulted in capturing larger-sized Portunus pelagicus. Catch species richness decreased up to 58% in lower nets. These results are useful to fisheries managers and government institutions to develop or improve existing regulations towards a sustainable crab fishery particularly blue swimming crabs.

Keywords: blue swimming crabs, catch per unit effort, crab entangling nets, net height

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Authors: Hatice Kahyaoglu Sut, Serap Unsar, Seda Kurt

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The aim of this study is to investigate sexual quality of life in women with gynecological cancer. This cross-sectional study was conducted on 37 women with gynecological cancer and 39 control women (in menopausal term) at the Gynecooncology and Menopause Clinics of Trakya University Medical Faculty between January and July 2015. Women who had sexual active and willing to participate in the study filled an information form inquiring socio-demographic characteristics and Sexual Quality of Life Questionnaire-Female (SQLQ-F). Data were analyzed by Mann-Whitney-U test and Kruskal-Wallis test. The average age of the women was 52.7 ± 7.6 (51.2 ± 8.7 in women with gynecological cancer, 54.3 ± 6.0 in controls). The SQOL-F scores in women with gynecologic cancer (60.8 ± 22.4) was lower than controls (63.5 ± 20.7), however, there was no statistically significant difference (p = 0.759). Women with gynecological cancer who had vaginal dryness and pain during sexual intercourse (45.7 ± 21.3) were lower SQOL-F total score than control group (66.0 ± 21.7) (p = 0.014). The SQOL-F scores in women who took chemotherapy treatment (55.7 ± 17.8) were lower than in women who had not chemotherapy treatment (86.8 ± 16.6) (p = 0.005). In conclusion, taking chemotherapy treatment and occurring vaginal dryness and pain complaints during sexual intercourse in women with gynecological cancer reduces sexual quality of life. Therefore, sexual quality of life in women with gynecological cancer should be evaluated, and they should be supported in order to improve their sexual quality of life.

Keywords: gynecological cancer, quality of life, sexuality, women

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Authors: Ezeddin Kolaib

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Paracetamol tablets and cimetidine tablets were prepared by single-step granulation/tabletting and by compression after high shear granulation. The addition of PVP (polyvinylpyrrolidone) was essential for single-step granulation/tabletting of formulation containing high concentrations of paracetamol or cimetidine. Paracetamol tablets without and with PVP obtained by single-step granulation/tabletting exhibited a significantly higher tensile strength, a significantly lower disintegration time, a lower friability and a faster dissolution compared to those prepared by compression after high shear granulation. Cimetidine tablets with PVP obtained by single-step granulation/tabletting exhibited a significantly lower tensile strength, a significantly lower disintegration time and a faster dissolution compared to those prepared by compression after high shear granulation. Single-step granulation/tabletting allowed to produce tablets containing up to 80% paracetamol or cimetidine with a dissolution profile complying with the USP requirements. For pure paracetamol or pure cimetidine the addition of crospovidone as a disintegrant was required to obtain a dissolution profile that complied with the pharmacopoeial requirements. Long term and accelerated stability studies of paracetamol tablets produced by single-step granulation/tabletting over a period of one year showed no significant influence on the tablet tensile strength, friability and dissolution. Although a significant increase of the disintegration time was observed, it remained below 10 min. These results indicated that single-step granulation/tabletting could be an efficient technique for the production of highly dosed drugs such as paracetamol and cimetidine.

Keywords: single-step granulation/tabletting, twin screw extrusion, high shear granulation, high dosage drugs, paracetamol, cimetidine

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Authors: Abdolrasoul Daneshjoo

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Soccer is a game which draws more attention in different countries especially in Brazil. Kicking among different skills in soccer and soccer players is an excellent role for the success and preference of a team. The way of point gaining in this game is passing the ball over the goal lines which are gained by shoot skill in attack time and or during the penalty kicks.Regarding the above assumption, identifying the effective factors in instep kicking in different distances shoot with maximum force and high accuracy or pass and penalty kick, may assist the coaches and players in raising qualitative level of performing the skill.The aim of the present study was to study of a few kinematical parameters in instep kicking from 5 and 7 meter distance among the male and female elite soccer players.24 right dominant lower limb subjects (12 males and 12 females) among Tehran elite soccer players with average and the standard deviation (22.5 ± 1.5) & (22.08± 1.31) years, height of (179.5 ± 5.81) & (164.3 ± 4.09) cm, weight of (69.66 ± 4.09) & (53.16 ± 3.51) kg, %BMI (21.06 ± .731) & (19.67 ± .709), having playing history of (4 ± .73) & (3.08 ± .66) years respectively participated in this study. They had at least two years of continuous playing experience in Tehran soccer league.For sampling player's kick; Kinemetrix Motion analysis with three cameras with 1000 Hz was used. Five reflective markers were placed laterally on the kicking leg over anatomical points (the iliac crest, major trochanter, lateral epicondyle of femur, lateral malleolus, and lateral aspect of distal head of the fifth metatarsus). Instep kick was filmed, with one step approach and 30 to 45 degrees angle from stationary ball. Three kicks were filmed, one kick selected for further analyses. Using Kinemetrix 3D motion analysis software, the position of the markers was analyzed. Descriptive statistics were used to describe the mean and standard deviation, while the analysis of variance, and independent t-test (P < 0.05) were used to compare the kinematic parameters between two genders.Among the evaluated parameters, the knee acceleration, the thigh angular velocity, the angle of knee proportionately showed significant relationship with consequence of kick. While company performance on 5m in 2 genders, significant differences were observed in internal – external displacement of toe, ankle, hip and the velocity of toe, ankle and the acceleration of toe and the angular velocity of pelvic, thigh and before time contact . Significant differences showed the internal – external displacement of toe, the ankle, the knee and the hip, the iliac crest and the velocity of toe, the ankle and acceleration of ankle and angular velocity of the pelvic and the knee.

Keywords: biomechanics, kinematics, instep kicking, soccer

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Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

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Background: Obesity, particularly abdominal type, lead to accelerated progress of atherosclerosis and thus affects the functioning of various human organs. Non-HDL cholesterol includes residual risk of the cardiovascular diseases which persists in patients after achieved recommended level of LDL cholesterol. The maintenance of normal body mass index plays a particularly important role in both the prevention and treatment of chronic diseases. Materials and Methods: The study covered 96 patients (55 females, 42 males, age 66,9 +/-10,2 years). The nutritional status was determined with the Waist to Height Ratio (WHtR) and the Waist to Hip Ratio (WHR). A function of the kidney was evaluated by calculating the estimated glomerular filtration rate (eGFR) using the MDRD formula. Non-high-density lipoprotein cholesterol (non-HDL) is simply the difference between the total cholesterol concentration and the HDL cholesterol concentration. Results: The higher was level of non-HDL cholesterol, the lower eGFR had studied subjects (p<0.001). Significant correlation was found between higher WHtR and lower the eGFR (p=0.002). Also underweight (30% of patient) led to obtaining lower values of eGFR in subjects over 65 years old. The poorer nutrition the lower was glomerular filtration rate. Conclusions: Nutritional statuses of patients have a significant impact on the level of kidney function. Not only accumulated excess fat in the abdominal area, but also its deficiency affects the deterioration in renal filtration. Higher level of non-HDL not only raises the residual risk of the heart disease but also influences on kidney by worsening eGFR. Proper diet in connection with physical activity should lead to achieving good nutrition in these patients and protect their kidney function.

Keywords: nutrition, non-HDL cholesterol, glomerular filtration rate, lifestyle

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Authors: ChunLoon Cha, HoYeon Lee, SangSoon Hwang

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Mild combustion is characterized with its distinguished features, such as suppressed pollutant emission, homogeneous temperature distribution, reduced noise and thermal stress. However, most studies for MILD combustion have been focused on gas phase fuel. Therefore further study on MILD combustion using liquid fuel is needed for the application to liquid fueled gas turbine especially. In this work, we will focus on numerical simulation of the effects of diluent gas velocity on the formation of liquid fuel MILD combustion used in gas turbine area. A series of numerical simulations using Ansys fluent 18.2 have been carried out in order to investigate the detail effect of the flow field in the furnace on the formation of MILD combustion. The operating conditions were fixed at relatively lower heat intensity of 1.28 MW/m³ atm and various global equivalence ratios were changed. The results show that the local high temperature region was decreased and the flame temperature was uniformly distributed due to high velocity of diluted burnt gas. The increasing of diluted burnt gas velocity can be controlled by open ratio of adapter size. It was found that the maximum temperature became lower than 1800K and the average temperature was lower than 1500K that thermal NO formation was suppressed.

Keywords: MILD combustion, spray combustion, liquid fuel, diluent gas velocity, low NOx emission

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Authors: Ceri McIntosh

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A 25-year-old male was referred to the Maxillofacial department by his general dental practitioner with a complaint of mobile teeth. Medically he was well though he took mirtazapine for anxiety. He was found to have had previous extractions of the lower right second premolar and first molar, with grade 2 mobility of the upper right first and second molars and lower right lateral incisor. Radiographically there was significant external root resorption of these teeth, which were subsequently extracted. Over the next 18 months, the resorption continued around multiple teeth on the right side, and when the mobile teeth were removed, they showed no remaining root, including loss of coronal dentine, leaving only an enamel shell. No cause has been identified either histologically or in the patient’s blood work. A review of relevant literature will be included in this case report.

Keywords: case report, idiopathic resorption, idiopathic root resorption, external resorption

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Authors: John Yahng, Riteesh Bookun

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Popliteal artery aneurysms (PAAs) are the most common arterial aneurysm of the periphery. It is defined as focal dilation of the artery more than 50% of the normal vessel diameter which usually varies between 7 mm to 11 mm. The most common presentation for PAAs is claudication due to luminal stenmosis secondary to mural thrombus or acute limb ischaemia due to occlusive thrombosis or distal thromboembolism. It is less common for patients to present with non-ischaemic symptoms secondary to mass effect and compression of adjacent structures, and of these, presentation with common peroneal nerve compression is particularly uncommon. We present a rare case of a 92-year-old female patient presenting with 4-month history of left foot drop with radiological evidence of common peroneal nerve compression secondary to PAA of 22 mm by21mm in size. To the best of our knowledge, this is the smallest reported popliteal aneurysm presenting with foot drop. We also present the endovascular treatment option taken in our case.

Keywords: aneurysm, foot drop, peroneal nerve, popliteal

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Authors: Eman Merza, Stephen Pearson, Glen Lichtwark, Peter Malliaras

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The Achilles tendon (AT) exhibits volume changes related to fluid flow under acute load which may be linked to changes in stiffness. Fluid flow provides a mechanical signal for cellular activity and may be one mechanism that facilitates tendon adaptation. This study aimed to investigate whether isometric intervention involving a high level of load duration and intensity could maximize the immediate reduction in AT volume and stiffness compared to interventions involving a lower level of load duration and intensity. Sixteen healthy participants (12 males, 4 females; age= 24.4 ± 9.4 years; body mass= 70.9 ± 16.1 kg; height= 1.7 ± 0.1 m) performed three isometric interventions of varying levels of load duration (2 s and 8 s) and intensity (35% and 75% maximal voluntary isometric contraction) over a 3 week period. Freehand 3D ultrasound was used to measure free AT volume (at rest) and length (at 35%, 55%, and 75% of maximum plantarflexion force) pre- and post-interventions. The slope of the force-elongation curve over these force levels represented individual stiffness (N/mm). Large reductions in free AT volume and stiffness resulted in response to long-duration high-intensity loading whilst less reduction was produced with a lower load intensity. In contrast, no change in free AT volume and a small increase in AT stiffness occurred with lower load duration. These findings suggest that the applied load on the AT must be heavy and sustained for a long duration to maximize immediate volume reduction, which might be an acute response that enables optimal long-term tendon adaptation via mechanotransduction pathways.

Keywords: Achilles tendon, volume, stiffness, free tendon, 3d ultrasound

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Authors: Pascale Brasseur, Binu Gurung, Nicholas Halfpenny, James Eaton

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Development of minimally invasive treatments in recent years provides a potential alternative to invasive surgical interventions which are of limited value to patients with spinal metastases due to short life expectancy. A systematic review was conducted to explore the efficacy and safety of radiofrequency ablation (RFA), a minimally invasive treatment in patients with spinal metastases. EMBASE, Medline and CENTRAL were searched from database inception to March 2017 for randomised controlled trials (RCTs) and non-randomised studies. Conference proceedings for ASCO and ESMO published in 2015 and 2016 were also searched. Fourteen studies were included: three prospective interventional studies, four prospective case series and seven retrospective case series. No RCTs or studies comparing RFA with another treatment were identified. RFA was followed by cement augmentation in all patients in seven studies and some patients (40-96%) in the remaining seven studies. Efficacy was assessed as pain relief in 13/14 studies with the use of a numerical rating scale (NRS) or a visual analogue scale (VAS) at various time points. Ten of the 13 studies reported a significant decrease in pain outcome, post-RFA compared to baseline. NRS scores improved significantly at 1 week (5.9 to 3.5, p < 0.0001; 8 to 4.3, p < 0.02 and 8 to 3.9, p < 0.0001) and this improvement was maintained at 1 month post-RFA compared to baseline (5.9 to 2.6, p < 0.0001; 8 to 2.9, p < 0.0003; 8 to 2.9, p < 0.0001). Similarly, VAS scores decreased significantly at 1 week (7.5 to 2.7, p=0.00005; 7.51 to 1.73, p < 0.0001; 7.82 to 2.82, p < 0.001) and this pattern was maintained at 1 month post-RFA compared to baseline (7.51 to 2.25, p < 0.0001; 7.82 to 3.3; p < 0.001). A significant pain relief was achieved regardless of whether patients had cement augmentation in two studies assessing the impact of RFA with or without cement augmentation on VAS pain scores. In these two studies, a significant decrease in pain scores was reported for patients receiving RFA alone and RFA+cement at 1 week (4.3 to 1.7. p=0.0004 and 6.6 to 1.7, p=0.003 respectively) and 15-36 months (7.9 to 4, p=0.008 and 7.6 to 3.5, p=0.005 respectively) after therapy. Few minor complications were reported and these included neural damage, radicular pain, vertebroplasty leakage and lower limb pain/numbness. In conclusion, the efficacy and safety of RFA were consistently positive between prospective and retrospective studies with reductions in pain and few procedural complications. However, the lack of control groups in the identified studies indicates the possibility of selection bias inherent in single arm studies. Controlled trials exploring efficacy and safety of RFA in patients with spinal metastases are warranted to provide robust evidence. The identified studies provide an initial foundation for such future trials.

Keywords: pain relief, radiofrequency ablation, spinal metastases, systematic review

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Authors: Fouzia Arif, Arif S. Mohammad, Hifsa Altaf, Lubna Raees

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Introduction: The term "disability", refers to any condition that impedes the completion of daily tasks using traditional methods. In developing countries like Pakistan, disable population is usually excluded from the mainstream. In squatter settlements the situation is more critical. Sultanabad is one of the squatter settlements of Karachi. Purpose of case study is to improve the health of disabled children’s, and create awareness among the parents and community. Through a household visit, Shiraz, a young disabled boy of 15.5 years old was identified. Her mother articulated that her son was living normally and happily with his parents two years back. When he was 13 years old and student of class 8th, both his legs were traumatized in a Railway Train Accident while playing cricket. He got both femoral shaft fractured severely. He was taken to Jinnah Post Graduate Medical Centre (JPMC) where his left leg was amputated at above knee level and right leg was opened & fixed by reduction internally, luckily bone healed moderately with the passage of time. Methods: In Squatter settlements of Karachi Sultanabad, a survey was conducted in two sectors. Disability screening questionnaire was developed, collaboration with community through household visits, outreach sessions 23cases of disabled were identified who were socialized through sports, Musical program and get-together was organized with stockholder for creating awareness among community and parent’s. Collaboration was established with different NGOs, Government, stakeholders and community support for establishment of Physiotherapy Center. During home visit it was identified that Shiraz was on bed since last 1 year, his family could not afforded cost of physiotherapist and medical consultation due to poverty. Parents counseling was done mentioning that Shiraz needed to take treatment. After motivation his parents agreed for treatment. He was consulted by an orthopedic surgeon in AKUH, Who referred to DMC University of Health Science for rehabilitation service. There he was assessed and referred for Community Based Physiotherapy Centre Sultanabad. Physiotherapist visited home along with Coordinator for Special children and assessed him regularly, planned Physiotherapy treatment for abdominal, high muscles strutting exercise foot muscles strengthening exercise, knee mobilization weight bearing from partial to full weight gradually, also strengthen exercise were given for residual limb as the boy was dependent on it. He was also provided by an artificial leg and training was done. Result: Shiraz is now fully mobile, he can walk independently even out of home, functional ability progress improved and dependency factors reduced. It was difficult but not impossible. We all have sympathy but if we have empathy then we can rehabilitate the community in a better way. His parents are very happy and also the community is surprised to see him in such better condition. Conclusion: Combined efforts of physiotherapist, Coordinator of special children, community and parents made a drastic change in Shiraz’s case by continuously motivating him for better outcome. He is going to school regularly without support. Since he belongs to a poor family he faces financial constraints for education and clinical follow ups regularly.

Keywords: femoral shaft fracture, trauma, orthopedic surgeon, physiotherapy treatment

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Authors: Jeounghee Kim

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Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.

Keywords: spinal cord injury, complication, nursing, rehabilitation

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Authors: Salem Alsanusi, Abdulla Alakad

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An experimental investigation to study the behaviour of under flexure reinforced concrete T-Beams. Those Beams were loaded to pre-designated stress levels as percentage of calculated collapse loads. Repairing these beans by either reinforced concrete jacket, or by externally bolted steel plates were utilized. Twelve full scale beams were tested in this experimental program scheme. Eight out of the twelve beams were loaded under different loading levels. Tests were performed for the beams before and after repair with Reinforced Concrete Jacket (RCJ). The applied Load levels were 60%, 77% and 100% of the calculated collapse loads. The remaining four beams were tested before and after repair with Bolted Steel Plate (BSP). Furthermore, out previously mentioned four beams two beams were loaded to the calculated failure load 100% and the remaining two beams were not subjected to any load. The eight beams recorded for the RCJ test were repaired using reinforced concrete jacket. The four beams recorded for the BSP test were all repaired using steel plate at the bottom. All the strengthened beams were gradually loaded until failure occurs. However, in each loading case, the beams behaviour, before and after strengthening, were studied through close inspection of the cracking propagation, and by carrying out an extensive measurement of deformations and strength. The stress-strain curve for reinforcing steel and the failure strains measured in the tests were utilized in the calculation of failure load for the beams before and after strengthening. As a result, the calculated failure loads were close to the actual failure tests in case of beams before repair, ranging from 85% to 90% and also in case of beams repaired by reinforced concrete jacket ranging from 70% to 85%. The results were in case of beams repaired by bolted steel plates ranging from (50% to 85%). It was observed that both jacketing and bolted steel plate methods could effectively restore the full flexure capacity of the damaged beams. However, the reinforced jacket has increased the failure load by about 67%, whereas the bolted steel plates recovered the failure load.

Keywords: rehabilitation, strengthening, reinforced concrete, beams deflection, bending stresses

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Authors: Rajani Bogati, Gopini Pathak

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Women living in husband’s home (second home) after getting married is a common culture in Nepalese society. Most of the marriages are arranged between the mutual understandings of their parents as per their cultural practice. Culturally, arranged marriage system protects women in the society. Even though, women domestic violence is also still alive in the society. It depends upon the family class, ethnicity, caste, religion etc. Lower class (poor) family always try to get marriage from the higher class (rich) family of girl and also try to send their girl in higher class family. This study analysis the freedom of women of Armala Village Development Committee, Kaski district on the base of the family class of girl where she born (First home). 88% women are getting more respect in their second home if their family class of first home and second homes are same. They feel more comfortable and freedom in their second home. 79% of Women are suffering from domestic violence while the marriage between the boys from higher class and the girls from lower class. But less than 10% women are getting distress from violence if the marriage is accompanied between the girls from higher class and the boys from lower class. Less domestic violence is seem where the both families are educated, even though they are from different class. This study recommends that the society should be educated first to reduce women domestic violence.

Keywords: arranged marriage, women, family class, domestic violence

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Authors: Virginia Martin Torrejon, Binjie Wu

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Gelatine is a protein biopolymer obtained from the partial hydrolysis of animal tissues which contain collagen, the primary structural component in connective tissue. Gelatine hydrogels have attracted considerable research in recent years as an alternative to synthetic materials due to their outstanding gelling properties, biocompatibility and compostability. Surfactants, such as sodium dodecyl sulfate (SDS), are often used in hydrogels solutions as surface modifiers or solubility enhancers, and their incorporation can influence the hydrogel’s viscoelastic properties and, in turn, its processing and applications. Literature usually focuses on studying the impact of formulation parameters (e.g., gelatine content, gelatine strength, additives incorporation) on gelatine hydrogels properties, but processing parameters, such as curing temperature, are commonly overlooked. For example, some authors have reported a decrease in gel strength at lower curing temperatures, but there is a lack of research on systematic viscoelastic characterisation of high strength gelatine and gelatine-SDS systems at a wide range of curing temperatures. This knowledge is essential to meet and adjust the technological requirements for different applications (e.g., viscosity, setting time, gel strength or melting/gelling temperature). This work investigated the effect of curing temperature (10, 15, 20, 23 and 25 and 30°C) on the elastic modulus (G’) and melting temperature of high strength gelatine-SDS hydrogels, at 10 wt% and 20 wt% gelatine contents, by small-amplitude oscillatory shear rheology coupled with Fourier Transform Infrared Spectroscopy. It also correlates the gel strength obtained by rheological measurements with the gel strength measured by texture analysis. Gelatine and gelatine-SDS hydrogels’ rheological behaviour strongly depended on the curing temperature, and its gel strength and melting temperature can be slightly modified to adjust it to given processing and applications needs. Lower curing temperatures led to gelatine and gelatine-SDS hydrogels with considerably higher storage modulus. However, their melting temperature was lower than those gels cured at higher temperatures and lower gel strength. This effect was more considerable at longer timescales. This behaviour is attributed to the development of thermal-resistant structures in the lower strength gels cured at higher temperatures.

Keywords: gelatine gelation kinetics, gelatine-SDS interactions, gelatine-surfactant hydrogels, melting and gelling temperature of gelatine gels, rheology of gelatine hydrogels

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Authors: Kotomi Yamashita, Hiromi Kawasaki, Satoko Yamasaki, Susumu Fukita, Risako Sakai

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Lifestyle-related diseases develop from the long-term accumulation of health consequences from a poor lifestyle. Thus, schoolchildren, who have not accumulated long-term lifestyle habits, are believed to be at a lower risk for lifestyle-related diseases. However, schoolchildren rarely receive blood tests unless they are under treatment for a serious disease; without such data on their blood, the impacts of their young lifestyle could not be known. Blood data from physical measurements can help in the implementation of more effective health education. Therefore, we examined the correlation between body mass index (BMI) and blood sugar/serum lipid (BS/SL) levels. From 2014 to 2016, we measured the blood data of fourth-grade students living in a city in Japan. The present study reported on the results of 281 fourth-grade boys only (80.3% of total). We analyzed their BS/SL levels by comparing the blood data against the criteria of the National Center for Child Health and Development in Japan. Next, we examined the correlation between BMI and BS/SL levels. IBM SPSS Statistics for Windows, Version 25 was used for analysis. A total of 69 boys (24.6%) were within the normal range for BMI (18.5–24), whereas 193 (71.5%) and 8 boys (2.8%) had lower and higher BMI, respectively. Regarding BS levels, 280 boys were within the normal range (70–90 mg/dl); 1 boy reported a higher value. All the boys were within the normal range for glycated Hemoglobin (HbA1c) (4.6–6.2%). Regarding SL levels, 271 boys were within the normal range (125–230 mg/dl) for total cholesterol (TC), whereas 5 boys (1.8%) had lower and 5 boys (1.8%) had higher levels. A total of 243 boys (92.7%) were within the normal range (36-138mg/dL) for triglycerides (TG), whereas 19 boys (7.3%) had lower and 19 boys (7.3%) had higher levels. Regarding high-density lipoprotein cholesterol (HDL-C), 276 boys (98.2%) were within the normal range (40-mg/dl), whereas 5 boys (1.8%) reported lower values. All but one boy (280, 99.6%) were within the normal range (-170 mg/dl) for low-density lipoprotein cholesterol (LDL-C); the exception (0.4%) had a higher level. BMI and BS didn’t show a correlation. BMI and HbA1c were moderately positively correlated (r = 0.139, ｐ＝0.019). We also observed moderate positive correlations between BMI and TG (r = 0.328, p < 0.01), TC (r=0.239, p< 0.01), LDL-C (r = 0.324, p < 0.01), respectively. BMI and HDL-C were low correlated (r = -0.185, p = 0.002). Most of the boys were within the normal range for BS/SL levels. However, some boys exceeded the normal TG range. Fourth graders with a high TG may develop a lifestyle-related disease in the future. Given its relation to TG, food habits should be improved in this group. Our findings suggested a positive correlation between BMI and BS/SL levels. Fourth-grade schoolboys with a high BMI may be at high risk for developing lifestyle-related diseases. Lifestyle improvement may be recommended to lower the BS/SL levels in this group.

Keywords: blood sugar level, lifestyle-related diseases, school students, serum lipid level

Procedia PDF Downloads 138

Authors: Nayeon, Lee, Won-Young, Cho, Hyun Joo, Jang, Chi-Ho, Lee

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This study investigated the effects of the dietary supplementation of the Allium hookeri root, and processed sulfur, on the growth performance of guinea pigs. The guinea pigs were fed a control diet (CON), as well as the control diet including 1% freeze-dried Allium hookeri root (AH), or 0.1% processed sulfur (S), or including both the freeze-dried Allium hookeri root and the processed sulfur (AHS). The weight of perirenal adipose tissue (PAT) and the epididymal adipose tissue (EAT) in the AH were significantly lower than CON (p < 0.05). The serum cholesterols levels of the AH and the AHS were significantly lower than the S (p < 0.05). While the total saturated fatty acid content in the serum of the AH and AHS groups showed a tendency to decrease, the total monounsaturated fatty acid increased. The results of this study suggested that dietary consumption of Allium hookeri root may help to decrease fat accumulation, lower serum cholesterol levels, and control serum free fatty acid contents in the guinea pigs.

Keywords: Allium hookeri, dietary supplementation, growth performance, processed sulfur, Guinea pig

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Authors: John Yahng, Hansraj Riteesh Bookun

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Popliteal artery aneurysms (PAAs) are the most common arterial aneurysm of the periphery. It is defined as focal dilation of the artery more than 50% of the normal vessel diameter which usually varies between 7 mm to 11 mm. The most common presentation for PAAs is claudication due to luminal stenosis secondary to mural thrombus or acute limb ischaemia due to occlusive thrombosis or distal thromboembolism. It is less common for patients to present with non-ischaemic symptoms secondary to mass effect and compression of adjacent structures, and of these, presentation with common peroneal nerve compression is particularly uncommon. We present a rare case of a 92-year-old female patient presenting with 4-month history of left foot drop with radiological evidence of common peroneal nerve compression secondary to PAA of 22 mm by 21mm in size. To the best of our knowledge, this is the smallest reported popliteal aneurysm presenting with foot drop. We also present the endovascular treatment option taken in our case.

Keywords: aneurysm, foot drop, peroneal nerve, popliteal

Procedia PDF Downloads 404

Authors: Scott M. Black, Craig Maclean, Pauline Hall Barrientos, Konstantinos Ritos, Asimina Kazakidi

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Aortic aneurysms and dissections are leading causes of death in cardiovascular disease. Both inevitably lead to hemodynamic instability without surgical intervention in the form of vascular stent-graft deployment. An accurate description of the aortic geometry and blood flow in patient-specific cases is vital for treatment planning and long-term success of such grafts, as they must generate physiological branch perfusion and in-stent hemodynamics. The aim of this study was to create patient-specific computational fluid dynamics (CFD) models through a multi-modality, multi-dimensional approach with boundary condition optimization to predict branch flow rates and in-stent hemodynamics in custom stent-graft configurations. Three-dimensional (3D) thoracoabdominal aortae were reconstructed from four-dimensional flow-magnetic resonance imaging (4D Flow-MRI) and computed tomography (CT) medical images. The former employed a novel approach to generate and enhance vessel lumen contrast via through-plane velocity at discrete, user defined cardiac time steps post-hoc. To produce patient-specific boundary conditions (BCs), the aortic geometry was reduced to a one-dimensional (1D) model. Thereafter, a zero-dimensional (0D) 3-Element Windkessel model (3EWM) was coupled to each terminal branch to represent the distal vasculature. In this coupled 0D-1D model, the 3EWM parameters were optimized to yield branch flow waveforms which are representative of the 4D Flow-MRI-derived in-vivo data. Thereafter, a 0D-3D CFD model was created, utilizing the optimized 3EWM BCs and a 4D Flow-MRI-obtained inlet velocity profile. A sensitivity analysis on the effects of stent-graft configuration and BC parameters was then undertaken using multiple stent-graft configurations and a range of distal vasculature conditions. 4D Flow-MRI granted unparalleled visualization of blood flow throughout the cardiac cycle in both the pre- and postsurgical states. Segmentation and reconstruction of healthy and stented regions from retrospective 4D Flow-MRI images also generated 3D models with geometries which were successfully validated against their CT-derived counterparts. 0D-1D coupling efficiently captured branch flow and pressure waveforms, while 0D-3D models also enabled 3D flow visualization and quantification of clinically relevant hemodynamic parameters for in-stent thrombosis and graft limb occlusion. It was apparent that changes in 3EWM BC parameters had a pronounced effect on perfusion distribution and near-wall hemodynamics. Results show that the 3EWM parameters could be iteratively changed to simulate a range of graft limb diameters and distal vasculature conditions for a given stent-graft to determine the optimal configuration prior to surgery. To conclude, this study outlined a methodology to aid in the prediction post-surgical branch perfusion and in-stent hemodynamics in patient specific cases for the implementation of custom stent-grafts.

Keywords: 4D flow-MRI, computational fluid dynamics, vascular stent-grafts, windkessel

Procedia PDF Downloads 181

Authors: Vered Shenaar-Golan, Nava Wald, Uri Yatzkar

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Background: Parenting children with mental health problems poses multiple challenges, including coping with difficult behavior and negative child emotions. The impact on parents includes financial strain, negative social stigma, and negative feelings of guilt or blame, resulting in significant stress and lower levels of well-being. Given findings that self-compassion plays a significant role in reducing stress and improving well-being, the current study examined the role of self-compassion in the experience of parents raising a child with mental health problems. The study tested (1) whether child behavioral/emotional problem severity is associated with higher parental stress and lower parental well-being; (2) whether self-compassion is associated with lower parental stress and higher parental well-being; and (3) whether self-compassion is a stronger predictor of parental stress and well-being than child behavioral/emotional problem severity. Methods: Three hundred and six mothers and two hundred and fifty-six fathers of children attending a hospital child and adolescent psychiatric center were assessed at admission. Consenting parents completed four questionnaires: Child Strength and Difficulty – parent version, Self-compassion, Parent Feeling Inventory, and Well-Being. Results: Child behavioral/emotional problem severity was associated with higher parental stress and lower parental well-being, and self-compassion was a stronger predictor of parental stress and well-being levels than child behavioral/emotional problem severity. For children with internalizing but not externalizing behavioral/emotional problems, parental self-compassion was the only predictor of parental well-being beyond the severity of child behavioral/emotional problems. Conclusions: Cultivating self-compassion is important in reducing parental stress and increasing parental well-being, particularly with internalizing presentations, and should be considered when designing therapeutic interventions for parents.

Keywords: parenting children with mental health problems, self-compassion, parental stress, feelings, well-being

Procedia PDF Downloads 79

Authors: F. Bringby, A. Nordin, L. Björnådal, E. Svenungsson, C. Boström, H Alexanderson

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Patients with systemic sclerosis (SSc) have reduced hand function and self-reported limitations in daily activities. Few studies have explored limitations in shoulder-arm mobility and muscle function, or if there are differences in physical function between diffuse cutaneous (dcSSc) and limited cutaneous (lcSSc) SSc. The purpose of this study was to describe objectively assessed shoulder-arm mobility, lower extremity muscle function and muscle endurance in SSc and evaluate possible differences between lcSSc and dcSSc. 121 patients with SSc were included in this cross sectional study. Shoulder-arm mobility were examined using the Shoulder Function Assessment Scale (SFA) including 5 tasks ,lower extremity muscle function was measured by Timed stands test (TST) and muscle endurance in shoulder- and hip flexors were assessed by the Functional Index 2 (FI-2). Patients with dcSSc had median SFA hand to back score 5 (4-6) and median “hand to seat” score of 5 (4-6) compared to patients with lcSSc with corresponding median values of 6 (4-6) and 6 (5-6) respectively (p<0.01-p<0.05). 50% of both patientsgroups had lower muscle function assessed by the TST compared to age- and gender matched reference values but there were no differences in TST between the two patient groups. There was no difference in FI-2 scores between dcSSc and lcSSc. The whole group had 40 (28-83) % and 38 (32-72) % of maximal FI-2 shoulder flexion score on the right and left sides, and 40 (23-63) % and 37 (23-62) % of maximal FI-2 hip flexion score on the right and left sides. Reference values for the FI-2 indicate that healthy individuals perform in mean 100 % of maximal score. Patients with dcSSc were more limited than patients with lcSSc. Patients with SSc have reduced muscle function compared to reference values. These results highlights the importance of assessing shoulder-arm mobility and muscle function as well as a need for further research to identify exercise interventions to target these limitations.

Keywords: diffuse, limited, mobility, muscle function, physical therapy, systemic sclerosis

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Authors: Gaurav D. Sonawane, Vikas G. Sargade

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The present investigation is a study of the effect of advanced Physical Vapor Deposition (PVD) coatings on cutting temperature residual stresses and surface roughness during Duplex Stainless Steel (DSS) 2205 turning. Austenite stabilizers like nickel, manganese, and molybdenum reduced the cost of DSS. Surface Integrity (SI) plays an important role in determining corrosion resistance and fatigue life. Resistance to various types of corrosion makes DSS suitable for applications with critical environments like Heat exchangers, Desalination plants, Seawater pipes and Marine components. However, lower thermal conductivity, poor chip control and non-uniform tool wear make DSS very difficult to machine. Cemented carbide tools (M grade) were used to turn DSS in a dry environment. AlTiN and AlTiCrN coatings were deposited using advanced PVD High Pulse Impulse Magnetron Sputtering (HiPIMS) technique. Experiments were conducted with cutting speed of 100 m/min, 140 m/min and 180 m/min. A constant feed and depth of cut of 0.18 mm/rev and 0.8 mm were used, respectively. AlTiCrN coated tools followed by AlTiN coated tools outperformed uncoated tools due to properties like lower thermal conductivity, higher adhesion strength and hardness. Residual stresses were found to be compressive for all the tools used for dry turning, increasing the fatigue life of the machined component. Higher cutting temperatures were observed for coated tools due to its lower thermal conductivity, which results in very less tool wear than uncoated tools. Surface roughness with uncoated tools was found to be three times higher than coated tools due to lower coefficient of friction of coating used.

Keywords: cutting temperature, DSS2205, dry turning, HiPIMS, surface integrity

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Authors: Sibel Ecemiş Kılıç, Muhammed Aydoğan

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The rapid development of culture tourism has drawn attention to conserving cultural values especially by developing countries that would like to benefit from the economic contribution this type of tourism attracts. Tourism can have both positive and negative outcomes for historical settlements and their residents. The accommodation-purposed rehabilitation and revitalization project in “Sigacik Old City Zone” are to be discussed with spatial, economic, social and organizational dimensions. It is aimed to evaluate the relationship between the development of tourism and sustainable heritage conservation.

Keywords: Sığacık, urban conservation, sustainable tourism, Seferihisar

Procedia PDF Downloads 505