Search results for: dengue cases
4000 Sexual Satifaction in Women with Polycystic Ovarian Syndrome
Authors: Nashi Khan, Amina Khalid
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Aim: The purpose of this research was to find the psychiatric morbidity and level of sexual satisfaction among women with polycystic ovarian syndrome and their comparison with women with general medical conditions and to examine the correlation between psychiatric morbidity and sexual satisfaction among these women. Design: Cross sectional research design was used. Method: A total of 176 (M age = 30, SD = 5.83) women were recruited from both private and public sector hospitals in Pakistan. About 88 (50%) of the participants were diagnosed with polycystic ovarian syndrome (cases), whereas other 50% belonged to control group. Data were collected using semi structured interview. Sexual satisfaction scale for women (SSS-W) was administered to measure sexual satisfaction level and psychiatric morbidity was assessed by Symptom Checklist-Revised. Results: Results showed that participant’s depression and anxiety level had significant negative correlation with their sexual satisfaction level, whereas, anxiety and depression shared a significant positive correlation. There was a significant difference in the scores for sexual satisfaction, depression and anxiety for both cases and controls. These results suggested that women suffering from polycystic ovarian syndrome tend to be less sexually satisfied and experienced relatively more symptoms of depression and anxiety as compared to controls.Keywords: level of sexual satisfaction, psychiatric morbidity, polycystic ovarian syndrome
Procedia PDF Downloads 4623999 Risk Factors Associated with Outbreak of Cerebrospinal Meningitis in Kano State- Nigeria, March-May 2017
Authors: Visa I. Tyakaray, M. Abdulaziz, O. Badmus, N. Karaye, M. Dalhat, A. Shehu, I. Bello, T. Hussaini, S. Akar, G. Effah, P. Nguku
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Introduction: Nigeria has recorded outbreaks of meningitis in the past, being in the meningitis belt. A multi-state outbreak of Cerebrospinal Meningitis (CSM) from Neisseria meningitides occurred in 2017 involving 24 states, and Kano State reported its first two confirmed CSM cases on 22nd March, 2017. We conducted the outbreak investigation to characterize the outbreak, determine its associated risk factors and institute appropriate control measures. Method: We conducted an unmatched Case-control study with ratio 1:2. A case was defined as any person with sudden onset of fever (>38.5˚C rectal or 38.0˚C axillary) and one of the following: neck stiffness, altered consciousness or bulging fontanelle in toddlers while a control was defined as any person who resides around the case such as family members, caregivers, neighbors, and healthcare personnel. We reviewed and validated line list and conducted active case search in health facilities and neighboring communities. Descriptive, bivariate, stratified and multivariate analysis were performed. Laboratory confirmation was by Latex agglutination and/or Culture. Results: We recruited 48 cases with median age of 11 years (1 month – 65 years), attack rate was 2.4/100,000 population with case fatality rate of 8%; 34 of 44 local government areas were affected.On stratification, age was found to be a confounder. Independent factors associated with the outbreak were age (Adjusted Odds Ratio, AOR =6.58; 95% Confidence Interval (CI) =2.85-15.180, history of Vaccination (AOR=0.37; 95% CI=0.13-0.99) and history of travel (AOR=10.16; (1.99-51.85). Laboratory results showed 22 positive cases for Neisseria meningitides types C and A/Y. Conclusion: Major risk factors associated with this outbreak were age (>14years), not being vaccinated and history of travel. We sensitized communities and strengthened case management. We recommended immediate reactive vaccination and enhanced surveillance in bordering communities.Keywords: cerebrospinal, factors, Kano-Nigeria, meningitis, risk
Procedia PDF Downloads 2153998 Consumption of Animal and Vegetable Protein on Muscle Power in Road Cyclists from 18 to 20 Years in Bogota, Colombia
Authors: Oscar Rubiano, Oscar Ortiz, Natalia Morales, Lida Alfonso, Johana Alvarado, Adriana Gutierrez, Daniel Botero
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Athletes who usually use protein supplements, are those who practice strength and power sports, whose goal is to achieve a large muscle mass. However, it has also been explored in sports or endurance activities such as cycling, and where despite requiring high power, prominent muscle development can impede good competitive performance due to the determinant of body mass for good performance of the athlete body. This research shows, the effect with protein supplements establishes a protein - muscle mass ratio, although in a lesser proportion the relationship between protein types and muscle power. Thus, we intend to explore as a first approximation, the behavior of muscle power in lower limbs after the intake of two protein supplements from different sources. The aim of the study was to describe the behavior of muscle power in lower limbs after the consumption of animal protein (AP) and vegetable protein (VP) in four route cyclists from 18 to 20 years of the Bogota cycling league. The methodological design of this study is quantitative, with a non-probabilistic sampling, based on a pre-experimental model. The jumping power was evaluated before and after the intervention by means of the squat jump test (SJ), Counter movement jump (CMJ) and Abalacov (AB). Cyclists consumed a drink with whey protein and a soy isolate after training four times a week for three months. The amount of protein in each cyclist, was calculated according to body weight (0.5 g / kg of muscle mass). The results show that subjects who consumed PV improved muscle strength and landing strength. In contrast, the power and landing force decreased for subjects who consumed PA. For the group that consumed PV, the increase was positive at 164.26 watts, 135.70 watts and 33.96 watts for the AB, SJ and CMJ jumps respectively. While for PA, the differences of the medians were negative at -32.29 watts, -82.79 watts and -143.86 watts for the AB, SJ and CMJ jumps respectively. The differences of the medians in the AB jump were positive for both the PV (121.61 Newton) and PA (454.34 Newton) cases, however, the difference was greater for PA. For the SJ jump, the difference for the PA cases was 371.52 Newton, while for the PV cases the difference was negative -448.56 Newton, so the difference was greater in the SJ jump for PA. In jump CMJ, the differences of the medians were negative for the cases of PA and PV, being -7.05 for PA and - 958.2 for PV. So the difference was greater for PA. The conclusion of this study shows that serum protein supplementation showed no improvement in muscle power in the lower limbs of the cyclists studied, which could suggest that whey protein does not have a beneficial effect on performance in terms of power, either, showed an impact on body composition. In contrast, supplementation with soy isolate showed positive effects on muscle power, body.Keywords: animal protein (AP), muscle power, supplements, vegetable protein (VP)
Procedia PDF Downloads 1773997 Timing of Ileostomy Closure Following Rectal Cancer Surgery at an Australian Regional Hospital
Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen
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Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer
Procedia PDF Downloads 953996 Acoustic Analysis for Comparison and Identification of Normal and Disguised Speech of Individuals
Authors: Surbhi Mathur, J. M. Vyas
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Although the rapid development of forensic speaker recognition technology has been conducted, there are still many problems to be solved. The biggest problem arises when the cases involving disguised voice samples come across for the purpose of examination and identification. Such type of voice samples of anonymous callers is frequently encountered in crimes involving kidnapping, blackmailing, hoax extortion and many more, where the speaker makes a deliberate effort to manipulate their natural voice in order to conceal their identity due to the fear of being caught. Voice disguise causes serious damage to the natural vocal parameters of the speakers and thus complicates the process of identification. The sole objective of this doctoral project is to find out the possibility of rendering definite opinions in cases involving disguised speech by experimentally determining the effects of different disguise forms on personal identification and percentage rate of speaker recognition for various voice disguise techniques such as raised pitch, lower pitch, increased nasality, covering the mouth, constricting tract, obstacle in mouth etc by analyzing and comparing the amount of phonetic and acoustic variation in of artificial (disguised) and natural sample of an individual, by auditory as well as spectrographic analysis.Keywords: forensic, speaker recognition, voice, speech, disguise, identification
Procedia PDF Downloads 3683995 Epidemiological, Clinical, Histopathological Profile and Management of Breast Cancer at Kinshasa University Clinics
Authors: Eddy K. Mukadi
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This work is a documentary and descriptive study devoted to the epidemiological, clinical, histopathological and therapeutic profile of breast cancer deals with the department of gynecology and obstetrics of the university clinics of Kinshasa during the period from 1 January 2014 to 31 December 2014. We have identified 56 cases of breast cancer. These cancers accounted for 45.2% of gynecological mammary cancers. The youngest in our series was 18 years old while the oldest was 74 years old; And the mean age of these patients was 43.4 years and mostly multiparous (35.7%). Brides (60.7%) and bachelors (26.8%) were the most affected by breast cancer. The reasons for consultation were dominated by nodules in the breast (48.2%) followed by pain (35.7%) and nipple discharge (14.3%). In 89.2% of the cases, it was the advanced clinical stage (stage 3 and 4) and the infiltrating ductal carcinoma was the most frequent histological type (75%) The malignant tumor was mainly in the left breast (55.3%), and chemotherapy with hormone therapy and patey was the most convenient treatment (42.8%), while patey mastectomy was performed in 12.5% of patients. Because of the high incidence of breast cancer identified in our study, some preventive measures must be taken into account to address this public health problem, including breast autopalpation once a month, Early detection system development of a national breast cancer policy and the implementation of a national breast cancer control program.Keywords: breast cancer, histopathological profile, epidemiological profile, Kinshasa
Procedia PDF Downloads 2163994 Lessons from Patients Expired due to Severe Head Injuries Treated in Intensive Care Unit of Lady Reading Hospital Peshawar
Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir
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Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar
Procedia PDF Downloads 3503993 Epidemiology of Healthcare-Associated Infections among Hematology/Oncology Patients: Results of a Prospective Incidence Survey in a Tunisian University Hospital
Authors: Ezzi Olfa, Bouafia Nabiha, Ammar Asma, Ben Cheikh Asma, Mahjoub Mohamed, Bannour Wadiaa, Achour Bechir, Khelif Abderrahim, Njah Mansour
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Background: In hematology/oncology, health care improvement has allowed increasingly aggressive management in diagnostic and therapeutic procedures. Nevertheless, these intensified procedures have been associated with higher risk of healthcare associated infections (HAIs). We undertook this study to estimate the burden of HAIs in the cancer patients in an onco -hematology unit in a Tunisian university hospital. Materials/Methods: A prospective, observational study, based on active surveillance for a period of 06 months from Mars through September 2016, was undertaken in the department of onco-hematology in a university hospital in Tunisia. Patients, who stayed in the unit for ≥ 48 h, were followed until hospital discharge. The Centers for Disease Control and Prevention criteria (CDC) for site-specific infections were used as standard definitions for HAIs. Results: One hundred fifty patients were included in the study. The gender distribution was 33.3% for girls and 66.6% boys. They have a mean age of 23.12 years (SD = 18.36 years). The main patient’s diagnosis is: Acute Lymphoblastic Leukemia (ALL): 48.7 %( n=73). The mean length of stay was 21 days +/- 18 days. Almost 8% of patients had an implantable port (n= 12), 34.9 % (n=52) had a lumber puncture and 42.7 % (n= 64) had a medullary puncture. Chemotherapy was instituted in 88% of patients (n=132). Eighty (53.3%) patients had neutropenia at admission. The incidence rate of HAIs was 32.66 % per patient; the incidence density was 15.73 per 1000 patient-days in the unit. Mortality rate was 9.3% (n= 14), and 50% of cases of death were caused by HAIs. The most frequent episodes of infection were: infection of skin and superficial mucosa (5.3%), pulmonary aspergillosis (4.6%), Healthcare associated pneumonia (HAP) (4%), Central venous catheter associated infection (4%), digestive infection (5%), and primary bloodstream infection (2.6%). Finally, fever of unknown origin (FUO) incidence rate was 14%. In case of skin and superficial infection (n= 8), 4 episodes were documented, and organisms implicated were Escherichia.coli, Geotricum capitatum and Proteus mirabilis. For pulmonary aspergillosis, 6 cases were diagnosed clinically and radiologically, and one was proved by positive aspergillus antigen in bronchial aspiration. Only one patient died due this infection. In HAP (6 cases), four episodes were diagnosed clinically and radiologically. No bacterial etiology was established in these cases. Two patients died due to HAP. For primary bloodstream infection (4 cases), implicated germs were Enterobacter cloacae, Geotricum capitatum, klebsiella pneumoniae, and Streptococcus pneumoniae. Conclusion: This type of prospective study is an indispensable tool for internal quality control. It is necessary to evaluate preventive measures and design control guides and strategies aimed to reduce the HAI’s rate and the morbidity and mortality associated with infection in a hematology/oncology unit.Keywords: cohort prospective studies, healthcare associated infections, hematology oncology department, incidence
Procedia PDF Downloads 3903992 Association of MIR146A rs2910164 Variation with a Predisposition to Sporadic Breast Cancer in a Pakistani Cohort
Authors: Mushtaq Ahmad, Bashir Rahman, Taqweem-ul-Haq, Fazal Jalil, Aftab Ali Shah
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Single nucleotide polymorphisms (SNPs) in genes coding for microRNAs (miRNAs) play a pivotal role in the progression of breast cancer (BC). We investigated the association of miR-146a rs2910164 G/C polymorphism with the risk of BC in the Pakistani population. The miR-146a rs2910164 polymorphism was genotyped in 300 BC-cases and 300 age- and gender-matched healthy controls using T-ARMS-PCR. Genotype and allele frequencies were calculated, and the association between genotypes and the risk of BC was calculated by odds ratios (OR) and confidence intervals (95%). A significant difference in genotypic frequencies (χ2=63.10; p ≤ 0.0001) and allelic frequencies (OR=0.3955 (0.3132-0.4993); p ≤ 0.0001) was observed between cases and controls. Furthermore, we also found that miR-146 rs2910164 CC homozygote increased the risk of breast cancer in the dominant (OR=0.2397 (0.1629-0.3526); p=0.0001; GG vs GC+CC) and recessive (OR=2.803 (1.865- 4.213); P ≤ 0.0001; CC vs GC+GG) inheritance models. In summary, miR-146a rs2910164 G/C is significantly associated with BC in the Pakistani population. To our knowledge, this is the first study that assessed MIR146a rs2910164 G > C SNP in Pakistani population. By analyzing the secondary structure of MIR146A variant, a significant structural modification was noted. Study with a larger sample size is needed to further confirm these findings.Keywords: breast cancer, MIR146A, microRNA, SNP
Procedia PDF Downloads 1363991 The Origin Variability of the Iliolumbar Artery
Authors: Raid Hommady, Waseem Al-Talalwah, Shorok Al Dorazi, Roger Soames
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The iliolumbar artery is a regular branch of posterior division of the internal iliac artery. The present study investigate 82 specimens to identify the origin of iliolumbar artery. The present study targets the sciatic nerve root supply from iliolumbar artery based on its origin and course. In present study, the ililumbar artery arose from the posterior division of internal iliac artery in 52.2%. In few cases, it arose from dorsomedial aspect of the internal iliac artery in 28.8%. In few cases, the iliolumbar artery arose from the dorsal aspects of the internal iliac artery as well as from the common and external iliac artery 1.7%. Also, the iliolumbar artery arose from the sciatic artery as well as from superior and inferior gluteal arteries in 5.1%. Conversely, it found to be congenital absent in 8.5%. Therefore, the posterior trunk of the internal iliac artery is the most common origin of the iliolumbar artery. With the origin variability of the iliolumbar artery, there is a vascular supply variability of the lumbosacral trunk and sacral root of sciatic nerve. The iliolumbar artery provides vascular supply for lumbosacral trunk 57.3% in whereas the sacral root in 5.1%. As a result, surgeons should pay attention to these variations to decrease iatrogenic fault.Keywords: iliolumbar, sciatic artery, internal iliac, external iliac, posterior division
Procedia PDF Downloads 3093990 Multi-Objective Optimization of Electric Discharge Machining for Inconel 718
Authors: Pushpendra S. Bharti, S. Maheshwari
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Electric discharge machining (EDM) is one of the most widely used non-conventional manufacturing process to shape difficult-to-cut materials. The process yield, in terms of material removal rate, surface roughness and tool wear rate, of EDM may considerably be improved by selecting the optimal combination(s) of process parameters. This paper employs Multi-response signal-to-noise (MRSN) ratio technique to find the optimal combination(s) of the process parameters during EDM of Inconel 718. Three cases v.i.z. high cutting efficiency, high surface finish, and normal machining have been taken and the optimal combinations of input parameters have been obtained for each case. Analysis of variance (ANOVA) has been employed to find the dominant parameter(s) in all three cases. The experimental verification of the obtained results has also been made. MRSN ratio technique found to be a simple and effective multi-objective optimization technique.Keywords: electric discharge machining, material removal rate, surface roughness, too wear rate, multi-response signal-to-noise ratio, multi response signal-to-noise ratio, optimization
Procedia PDF Downloads 3543989 Bcl-2: A Molecule to Detect Oral Cancer and Precancer
Authors: Vandana Singh, Subash Singh
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Introduction: Oral squamous cell carcinoma is the most common malignant tumor of the oral cavity. Normally the death of cell and the growth are active processes and depend not only on external factors but also on the expression of genes like Bcl-2, which activate and inhibit apoptosis. The term Bcl-2 is an acronym for B-cell lymphoma/ leukemia -2 genes. Objectives: An attempt was made to evaluate Bcl-2 oncoprotein expression in patients with oral precancer and cancer and to assess possible correlation between Bcl-2 oncoprotein expression and clinicopathological features of oral precancer and cancer. Material and Methods: This is a selective prospective clinical and immunohistochemical study. Clinicopathological examination is correlated with immunohistochemical findings. The immunolocalization of Bcl-2 protein is performed using the labeled streptavidin biotin (LSAB) method. To visualize the reaction, 3, 3-diaminobenzidine (DAB) is used. Results: Bcl-2 expression was positive in 11 [36.66 %, low Bcl-2 expression 3 (10.00 %), moderate Bcl-2 expression 7 (23.33 %), and high Bcl-2 expression 1 (3.33 %)] oral cancer cases and in 14 [87.50 %, low expression 8 (50 %), moderate expression 6 (37.50 %)] precancer cases. Conclusion: On the basis of the results of our study we conclude that positive Bcl-2 expression may be an indicator of poor prognosis in oral cancer and precancer. Relevance: It has been reported that there is deregulation of Bcl-2 expression during progression from oral epithelial dysplasia to squamous cell carcinoma. It can be used for revealing progression of epithelial dysplasia to malignancy and as a prognostic marker in oral precancer and cancer.Keywords: BcL-2, immunohistochemistry, oral cancer, oral precancer
Procedia PDF Downloads 2693988 Convention Refugees in New Zealand: Being Trapped in Immigration Limbo without the Right to Obtain a Visa
Authors: Saska Alexandria Hayes
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Multiple Convention Refugees in New Zealand are stuck in a state of immigration limbo due to a lack of defined immigration policies. The Refugee Convention of 1951 does not give the right to be issued a permanent right to live and work in the country of asylum. A gap in New Zealand's immigration law and policy has left Convention Refugees without the right to obtain a resident or temporary entry visa. The significant lack of literature on this topic suggests that the lack of visa options for Convention Refugees in New Zealand is a widely unknown or unacknowledged issue. Refugees in New Zealand enjoy the right of non-refoulement contained in Article 33 of the Refugee Convention 1951, whether lawful or unlawful. However, a number of rights contained in the Refugee Convention 1951, such as the right to gainful employment and social security, are limited to refugees who maintain lawful immigration status. If a Convention Refugee is denied a resident visa, the only temporary entry visa a Convention Refugee can apply for in New Zealand is discretionary. The appeal cases heard at the Immigration Protection Tribunal establish that Immigration New Zealand has declined resident and discretionary temporary entry visa applications by Convention Refugees for failing to meet the health or character immigration instructions. The inability of a Convention Refugee to gain residency in New Zealand creates a dependence on the issue of discretionary temporary entry visas to maintain lawful status. The appeal cases record that this reliance has led to Convention Refugees' lawful immigration status being in question, temporarily depriving them of the rights contained in the Refugee Convention 1951 of lawful refugees. In one case, the process of applying for a discretionary temporary entry visa led to a lawful Convention Refugee being temporarily deprived of the right to social security, breaching Article 24 of the Refugee Convention 1951. The judiciary has stated a constant reliance on the issue of discretionary temporary entry visas for Convention Refugees can lead to a breach of New Zealand's international obligations under Article 7 of the International Covenant on Civil and Political Rights. The appeal cases suggest that, despite successful judicial proceedings, at least three persons have been made to rely on the issue of discretionary temporary entry visas potentially indefinitely. The appeal cases establish that a Convention Refugee can be denied a discretionary temporary entry visa and become unlawful. Unlawful status could ultimately breach New Zealand's obligations under Article 33 of the Refugee Convention 1951 as it would procedurally deny Convention Refugees asylum. It would force them to choose between the right of non-refoulement or leaving New Zealand to seek the ability to access all the human rights contained in the Universal Declaration of Human Rights elsewhere. This paper discusses how the current system has given rise to these breaches and emphasizes a need to create a designated temporary entry visa category for Convention Refugees.Keywords: domestic policy, immigration, migration, New Zealand
Procedia PDF Downloads 1023987 Investigation of Possible Precancerous Viral Markers in Dental Follicles of Asymptomatic Impacted Teeth
Authors: Serap Keskin Tunç, Cennet Neslihan Eroğlu, Sevinç Şahin, Selda Seçkin
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It has been suggested that various viruses may play a role in the pathogenesis of cancerous oral lesions in the literature. The aim of this study was to investigate the presence of both possible precancerous viral markers (HPV, HHV8, HSV1, HSV2, and EBV), and p53 and Ki-67 in the dental follicles of asymptomatic impacted teeth. A hundred healthy volunteers, older than 18 years old, included in the study. Dental follicles of extracted impacted teeth were excised and fixated in 10% formaldehyde. Histopathological and immunohistochemical examinations using HPV (containing HPV 8 and HPV 11), p16 (containing HPV 16), HHV8, HSV1, HSV2, EBV, p53 and Ki-67 antibodies were carried out. Also, the immunohistochemical results were correlated with the clinicopathological feature by Chi-square test statistically No dysplasia or neoplasm was observed. 62% of the cases were positive for p16, 32% were positive for EBV, 26% were positive for HSV1, immunohistochemically. All cases were immunonegative for HPV, HSV2, and HHV8. There was statistically significant correlation between overexpression of p53 with both EBV and p16 positivity (p<0.05). Direct correlation between higher expression of Ki-67 between EBV immunopositivity was detected (p<0.05). Thus, these viruses may be suggested to show trophism to the dental follicles acting as a reservoir. In conclusion, all dental follicles of extracted impacted teeth should be examined histopathologically in order to detect and prevent possible viral oncogenesis.Keywords: dental follicles, Ki67, p53, precancerous markers viral markers
Procedia PDF Downloads 2903986 Tax Criminal Case Settlement Through Obligative Justice Approach to Increase the State Revenue
Authors: Pujiyono, Reda Manthovani, Deny Tri Ardianto, Rabani Halawa, Isharyanto
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This research has background that the taxpayer (defendant) who has paid off the tax payable and the tax penalty payable after the tax case file has been transferred to the court, while the legality of stopping the prosecution of tax cases on the grounds that in the interest of state revenue is not regulated in the provisions of Law Number 8 of 1981 concerning The Criminal Procedure Code and Law Number 28 of 2007 concerning the Third Amendment to Law Number 6 of 1983 concerning General Provisions and Tax Procedures as amended several times, most recently by Law Number 16 of 2009 concerning Stipulation of Government Regulation in Lieu of Law Number 5 of 2008 concerning Fourth Amendment to Law Number 6 0f 1983 concerning General Provisions and Tax Procedures to become Law, even though at the investigation stage it regulates the mechanism for stopping the investigation for the sake of the interest of acceptance ne this is because before the case file is transferred to the court where at the request of the Minister of Finance of The Republic of Indonesia can stop the investigation in the interest of state revenue so that based on this phenomenon a legal vacuum is found. Therefore, a non-penal policy is needed from the public prosecutor to resolve tax crime cases without going through litigation in court through the penal mediation method using the Plea Bargaining System which adheres to the principles of restorative justice and obligative justice based on the ultimum remedium principle and the principle of opportunity in order to realize the principle of fast, simple and low cost justice (content principle). This research is a normative legal research, using a statutory approach, conceptual approach, and comparative law approach. Regulations that is used in many countries, include America, The Netherlands and Singapore. The results of this study indicate that there is a reformulation of the tax criminal justice system which regulates the mechanism, qualifications and authority to terminate the prosecution of tax cases in the interest of state revenues in order to achieve legal goals which are not only for legal certainty but more that, namely providing benefits and legal justice for people seeking justice.Keywords: obligative justice, regulation, state reveneus, tax criminal
Procedia PDF Downloads 833985 Exergetic and Sustainability Evaluation of a Building Heating System in Izmir, Turkey
Authors: Nurdan Yildirim, Arif Hepbasli
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Heating, cooling and lighting appliances in buildings account for more than one third of the world’s primary energy demand. Therefore, main components of the building heating systems play an essential role in terms of energy consumption. In this context, efficient energy and exergy utilization in HVAC-R systems has been very essential, especially in developing energy policies towards increasing efficiencies. The main objective of the present study is to assess the performance of a family house with a volume of 326.7 m3 and a net floor area of 121 m2, located in the city of Izmir, Turkey in terms of energetic, exergetic and sustainability aspects. The indoor and exterior air temperatures are taken as 20°C and 1°C, respectively. In the analysis and assessment, various metrics (indices or indicators) such as exergetic efficiency, exergy flexibility ratio and sustainability index are utilized. Two heating options (Case 1: condensing boiler and Case 2: air heat pump) are considered for comparison purposes. The total heat loss rate of the family house is determined to be 3770.72 W. The overall energy efficiencies of the studied cases are calculated to be 49.4% for Case 1 and 54.7% for Case 2. The overall exergy efficiencies, the flexibility factor and the sustainability index of Cases 1 and 2 are computed to be around 3.3%, 0.17 and 1.034, respectively.Keywords: buildings, exergy, low exergy, sustainability, efficiency, heating, renewable energy
Procedia PDF Downloads 3423984 Study of Dermatoglyphics Pattern in Patient with Hypertension
Authors: Ajeevan Gautam, Gulam Anwer Khan, Pratibha Pokhrel
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Introduction: Dermatoglyphics is the science which deals with the study of dermal ridge configuration on the digits, palms and soles. It is grooved by ridges and forms variety of configurations. The aim of the study was to identify dermal ridge patterns on fingertip of hypertensive patients and in normal population and to compare patterns among them. Methods: The subjects of the study were 130 hypertensives and 130 non-hypertensives cases of Kathmandu Valley aged between 40 to 80 years. Case history was recorded after consent finger prints were taken. Different parameters as whorl, loop, arch and composite patterns were studied and analysed. Result: It revealed, increased whorl pattern in hypertensive. It showed 65.69% whorl, 29.23% loop and 5.07% arch patterns in right hand of hypertensive people. In control, it was found to be 34.46% whorl, 58.15% loop and 5.38% arch patterns respectively. Similarly in left hand 63.69% whorl, 32% loop and 4.30% arch in hypertensive group. In control group it was 60.15% as loop, 35.69% as whorl and 15% as arch. Discussion: Based on findings of the result, it was concluded that the whorl, loop and arch patterns observed as 65.69%, 29.23% and 5.07% respectively in hypertensive cases in right hand. Similarly in left hand, it was found to be 4.30% as arch, 32% as loop and 63.69% as whorl patterns, but in normotensive subjects these patterns were recorded as 36.43%, 58.15%, 5.38% in right hand and 35.69%, 60.15%, 4.15% in left hand as whorl, loop and arch respectively.Keywords: arch, dermatoglyphics, hypertension, loop, whorl
Procedia PDF Downloads 2943983 Scope, Relevance and Sustainability of Decentralized Renewable Energy Systems in Developing Economies: Imperatives from Indian Case Studies
Authors: Harshit Vallecha, Prabha Bhola
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‘Energy for all’, is a global issue of concern for the past many years. Despite the number of technological advancements and innovations, significant numbers of people are living without access to electricity around the world. India, an emerging economy, tops the list of nations having the maximum number of residents living off the grid, thus raising global attention in past few years to provide clean and sustainable energy access solutions to all of its residents. It is evident from developed economies that centralized planning and electrification alone is not sufficient for meeting energy security. Implementation of off-grid and consumer-driven energy models like Decentralized Renewable Energy (DRE) systems have played a significant role in meeting the national energy demand in developed nations. Cases of DRE systems have been reported in developing countries like India for the past few years. This paper attempts to profile the status of DRE projects in the Indian context with their scope and relevance to ensure universal electrification. Diversified cases of DRE projects, particularly solar, biomass and micro hydro are identified in different Indian states. Critical factors affecting the sustainability of DRE projects are extracted with their interlinkages in the context of developers, beneficiaries and promoters involved in such projects. Socio-techno-economic indicators are identified through similar cases in the context of DRE projects. Exploratory factor analysis is performed to evaluate the critical sustainability factors followed by regression analysis to establish the relationship between the dependent and independent factors. The generated EFA-Regression model provides a basis to develop the sustainability and replicability framework for broader coverage of DRE projects in developing nations in order to attain the goal of universal electrification with least carbon emissions.Keywords: climate change, decentralized generation, electricity access, renewable energy
Procedia PDF Downloads 1243982 The Effect of Electric Field Distributions on Grains and Insect for Dielectric Heating Applications
Authors: S. Santalunai, T. Thosdeekoraphat, C. Thongsopa
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This paper presents the effect of electric field distribution which is an electric field intensity analysis. Consideration of the dielectric heating of grains and insects, the rice and rice weevils are utilized for dielectric heating analysis. Furthermore, this analysis compares the effect of electric field distribution in rice and rice weevil. In this simulation, two copper plates are used to generate the electric field for dielectric heating system and put the rice materials between the copper plates. The simulation is classified in two cases, which are case I one rice weevil is placed in the rice and case II two rice weevils are placed at different position in the rice. Moreover, the probes are located in various different positions on plate. The power feeding on this plate is optimized by using CST EM studio program of 1000 watt electrical power at 39 MHz resonance frequency. The results of two cases are indicated that the most electric field distribution and intensity are occurred on the rice and rice weevils at the near point of the probes. Moreover, the heat is directed to the rice weevils more than the rice. When the temperature of rice and rice weevils are calculated and compared, the rice weevils has the temperature more than rice is about 41.62 Celsius degrees. These results can be applied for the dielectric heating applications to eliminate insect.Keywords: capacitor copper plates, electric field distribution, dielectric heating, grains
Procedia PDF Downloads 4083981 Vitamin D Status in Relation to Body Mass Index: Population of Carpathian Region
Authors: Vladyslav Povoroznyuk, Ivan Pankiv
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The present research has attempted to link a higher body weight with a lower vitamin D status. Objective: Vitamin D status of Carpathian region population in Ukraine was studied to examine whether serum levels of 25-hydroxyvitamin D [25(OH)D] are associated with body mass index (BMI). Methods: Data collected from 302 adults (18–84 years) were analyzed. Variables measured included serum 25(OH)D, weight and height used to determine BMI status. Results: Mean 25(OH)D level was 23.2 ± 8.1 ng/mL for the group; 26.3 ± 8.4 ng/mL and 22.8 ± 9.1 ng/mL for males and females, respectively. Based on BMI, 3.6% were underweight, 21.2% had a normal weight, 46.4% were overweight and 28.8% obese. Only in 28 cases (9.3%), content of 25(ОН)D in the serum of blood was within the normal limits, and there were vitamin D deficiency and insufficiency observed in other cases (90.7%). Thus, severe vitamin D deficiency was revealed in 1.7% of the inspected. A significant interrelation between levels of 25(OH)D in blood and BMI was found among persons with BMI 25-29.9 kg/m2. Mean value of 25(OH)D levels among persons with obesity did not differ to a significant extent from indexes in persons with normal body weight. Conclusion: Status of vitamin D among the population of Carpathian region remains far from optimal and requires urgent measures in correction and prevention. Results confirmed a poor inverse relationship between vitamin D status and BMI. Intercommunication between maintenance of vitamin D and BMI requires further investigations.Keywords: body mass index, Carpathian region, obesity, vitamin D
Procedia PDF Downloads 3903980 Transient Freshwater-Saltwater Transition-Zone Dynamics in Heterogeneous Coastal Aquifers
Authors: Antoifi Abdoulhalik, Ashraf Ahmed
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The ever growing threat of saltwater intrusion has prompted the need to further advance the understanding of underlying processes related to SWI for effective water resource management. While research efforts have mainly been focused on steady state analysis, studies on the transience of saltwater intrusion mechanism remain very scarce and studies considering transient SWI in heterogeneous medium are, as per our knowledge, simply inexistent. This study provides for the first time a quantitative analysis of the effect of both inland and coastal water level changes on the transition zone under transient conditions in layered coastal aquifer. In all, two sets of four experiments were completed, including a homogeneous case, and four layered cases: case LH and case HL presented were two bi-layered scenarios where a low K layer was set at the top and the bottom, respectively; case HLH and case LHL presented two stratified aquifers with High K–Low K–High K and Low K–High K– Low K pattern, respectively. Experimental automated image analysis technique was used here to quantify the main SWI parameters under high spatial and temporal resolution. The findings of this study provide an invaluable insight on the underlying processes responsible of transition zone dynamics in coastal aquifers. The results show that in all the investigated cases, the width of the transition zone remains almost unchanged throughout the saltwater intrusion process regardless of where the boundary change occurs. However, the results demonstrate that the width of the transition zone considerably increases during the retreat, with largest amplitude observed in cases LH and LHL, where a low K was set at the top of the system. In all the scenarios, the amplitude of widening was slightly smaller when the retreat was prompted by instantaneous drop of the saltwater level than when caused by inland freshwater rise, despite equivalent absolute head change magnitude. The magnitude of head change significantly caused larger widening during the saltwater wedge retreat, while having no impact during the intrusion phase.Keywords: freshwater-saltwater transition-zone dynamics, heterogeneous coastal aquifers, laboratory experiments, transience seawater intrusion
Procedia PDF Downloads 2413979 Diagnosing and Treating Breast Cancer during Pregnancy: Neonatal Outcomes after Chemotherapy
Authors: Elyce Cardonick, Shistri Dhar, Linsdey Seidman
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Background: When breast cancer is diagnosed during pregnancy, the prognosis is comparable to non-pregnant women matched for prognostic indicators when pregnant women receive treatment without delay. Chemotherapy, including taxanes, can be given during pregnancy with normal neonatal development in exposed fetuses. Methods: Cases of primary breast cancer were extracted from the Cancer and Pregnancy Registry and longitudinal study at Cooper Medical School, which collects cases of pregnant women diagnosed and treated for cancer into a single database. Obstetrical, oncology and pediatric records were reviewed, including annual neonatal developmental, behavioral and medical assessments. Results: 270 pregnant women were diagnosed with primary breast cancer at a mean gestational age of 14.7+9weeks. Mean maternal age at diagnosis 34.5+4.5 years. Receptor status is comparable to non-pregnant women of reproductive age. Forty-nine women were advised to terminate. Two hundred two women underwent surgery;244 women received chemotherapy in pregnancy after the first trimester; the majority of Doxorubucin/Cytoxan; 81 of the cases included a taxane. At a mean of 90 months, follow up obtained on 255 newborns.192/255 newborns are meeting developmental milestones. Respiratory illnesses, including asthma, and bronchiolitis, were reported in 64 newborns, the most common medical condition reported. Thirty-one children are undergoing treatment for GERD, 11 for urinary tract infections, and 7 are undergoing treatment for anemia. Twenty-six children with expressive or articulation language delays, 21/26 are mild. Eleven children with gross/ 7 with fine motor delays. Eight children are treated for ADHD, 4 for anxiety and 4 have social skill impairment. The majority of children with developmental, language or motor delays were born preterm. Conclusion: After chemotherapy exposure in utero for breast cancer, the majority of newborns are meeting developmental milestones and are medically healthy. The goal for treating pregnant women with breast cancer is to aim for delivery close to the term.Keywords: breast cancer, pregnancy, chemotherapy, newborn
Procedia PDF Downloads 1173978 Numerical Simulation of Heating Characteristics in a Microwave T-Prong Antenna for Cancer Therapy
Authors: M. Chaichanyut, S. Tungjitkusolmun
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This research is presented with microwave (MW) ablation by using the T-Prong monopole antennas. In the study, three-dimensional (3D) finite-element methods (FEM) were utilized to analyse: the tissue heat flux, temperature distributions (heating pattern) and volume destruction during MW ablation in liver cancer tissue. The configurations of T-Prong monopole antennas were considered: Three T-prong antenna, Expand T-Prong antenna and Arrow T-Prong antenna. The 3D FEMs solutions were based on Maxwell and bio-heat equations. The microwave power deliveries were 10 W; the duration of ablation in all cases was 300s. Our numerical result, heat flux and the hotspot occurred at the tip of the T-prong antenna for all cases. The temperature distribution pattern of all antennas was teardrop. The Arrow T-Prong antenna can induce the highest temperature within cancer tissue. The microwave ablation was successful when the region where the temperatures exceed 50°C (i.e. complete destruction). The Expand T-Prong antenna could complete destruction the liver cancer tissue was maximized (6.05 cm³). The ablation pattern or axial ratio (Widest/length) of Expand T-Prong antenna and Arrow T-Prong antenna was 1, but the axial ratio of Three T-prong antenna of about 1.15.Keywords: liver cancer, T-Prong antenna, finite element, microwave ablation
Procedia PDF Downloads 3293977 The Correlation between Clostridium Difficile Infection and Bronchial Lung Cancer Occurrence
Authors: Molnar Catalina, Lexi Frankel, Amalia Ardeljan, Enoch Kim, Marissa Dallara, Omar Rashid
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Introduction: Clostridium difficile (C. diff) is a toxin-producing bacteria that can cause diarrhea and colitis. U.S. Center for Disease Control and Prevention revealed that C. difficile infection (CDI) has increased from 31 cases per 100,000 persons per year in 1996 to 61 per 100,000 in 2003. Approximately 500,000 cases per year occur in the United States. After exposure, the bacteria colonize the colon, where it adheres to the intestinal epithelium where it produces two toxins: TcdA and TcdB. TcdA affects the intestinal epithelium, causing fluid secretion, inflammation, and tissue necrosis, while TcdB acts as a cytotoxin purpose of this study was to evaluate the association between C diff infection and bronchial lung cancer development. Methods: Using ICD- 9 and ICD-10 codes, the data was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to assess the patients infected with C diff as opposed to the non-infected patients. The Holy Cross Health, Fort Lauderdale, granted access to the database for the purpose of academic research. Patients were matched for age and Charlson Comorbidity Index (CCI). Standard statistical methods were used. Results: Bronchial lung cancer occurrence in the population not infected with C diff infection was 4741, as opposed to the population infected with C. diff, where 2039 cases of lung cancer were observed. The difference was statistically significant (p-value < 2.2x10^e-16), which reveals that C diff might be protective against bronchial lung cancer. The data was then matched by treatment to create to minimize the effect of treatment bias. Bronchial cancer incidence was 422 and 861 in infected vs. non-infected (p-value of < 2.2x10^e-16), which once more indicates that C diff infection could be beneficial in diminishing bronchial cancer development. Conclusion: This retrospective study conveys a statistical correlation between C diff infection and decreased incidence of lung bronchial cancer. Further studies are needed to comprehend the protective mechanisms of C. Diff infection on lung cancer.Keywords: C. diff, lung cancer, protective, microbiology
Procedia PDF Downloads 2353976 Diagnosis of Rotavirus Infection among Egyptian Children by Using Different Laboratory Techniques
Authors: Mohamed A. Alhammad, Hadia A. Abou-Donia, Mona H. Hashish, Mohamed N. Massoud
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Background: Rotavirus is the leading etiologic agent of severe diarrheal disease in infants and young children worldwide. The present study was aimed 1) to detect rotavirus infection as a cause of diarrhoea among children under 5 years of age using the two serological methods (ELISA and LA) and the PCR technique (2) to evaluate the three methodologies used for human RV detection in stool samples. Materials and Methods: This study was carried out on 247 children less than 5 years old, diagnosed clinically as acute gastroenteritis and attending Alexandria University Children Hospital at EL-Shatby. Rotavirus antigen was screened by ELISA and LA tests in all stool samples, whereas only 100 samples were subjected to RT-PCR method for detection of rotavirus RNA. Results: Out of the 247 studied cases with diarrhoea, rotavirus antigen was detected in 83 (33.6%) by ELISA and 73 (29.6%) by LA, while the 100 cases tested by RT-PCR showed that 44% of them had rotavirus RNA. Rotavirus diarrhoea was significantly presented with a marked seasonal peak during autumn and winter (61.4%). Conclusion: The present study confirms the huge burden of rotavirus as a major cause of acute diarrhoea in Egyptian infants and young children. It was concluded that; LA is equal in sensitivity to ELISA, ELISA is more specific than LA, and RT-PCR is more specific than ELISA and LA in diagnosis of rotavirus infection.Keywords: rotavirus, diarrhea, immunoenzyme techniques, latex fixation tests, RT-PCR
Procedia PDF Downloads 3703975 Physical Exam-Indicated Cerclage with Mesh Cap Prolonged Gestation on Average for 9 Weeks and 4 Days: 11 Years of Experience
Authors: M. Keršič, M. Lužnik, J. Lužnik
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Cervical dilatation and membrane herniation before 26th week of gestation poses very high risk for extremely and very premature childbirth. Cerclage with mesh cap (mesh cerclage, MC) can greatly diminish this risk and provide additional positive effects. Between 2005 and 2014, MC has been performed in 9 patients with singleton pregnancies who had prolapsed membranes beyond external cervical/uterine os before 25th week of pregnancy (one in 29th). With patients in general anaesthesia, lithotomy and Trendelenburg position (about 25°) prolapsed membranes were repositioned in the uterine cavity, using tampon soaked in antiseptic solution (Skinsept mucosa). A circular, a type of purse-string suture (main band) with double string Ethilon 1 was applied at about 1 to 1.5 cm from the border of the external uterine os - 6 to 8 stitches were placed, so the whole external uterine os was encircled (modified McDonald). In the next step additional Ethilon 0 sutures were placed around all exposed parts of the main double circular suture and loosely tightened. On those sutures, round tailored (diameter around 6 cm) mesh (Prolene® or Gynemesh* PS) was attached. In all 9 cases, gestation was prolonged on average for 9 weeks and 4 days (67 days). In four cases maturity was achieved. Mesh was removed in 37th–38th week of pregnancy or if spontaneous labour began. In two cases, a caesarean section was performed because of breech presentation. In the first week after birth in 22nd week one new born died because of immaturity (premature birth was threatening in 18th week and then MC was placed). Ten years after first MC, 8 of 9 women with singleton pregnancy and MC performed have 8 healthy children from these pregnancies. Mesh cerclage successfully closed the opened cervical canal or uterine orifice and prevented further membrane herniation and membrane rupture. MC also provides a similar effect as with occluding the external os with suturing but without interrupting the way for excretion of abundant cervical mucus. The mesh also pulls the main circular band outwards and thus lowers the chance of suture cutting through the remaining cervix. MC prolonged gestation very successfully (mean for 9 weeks and 4 days) and thus increased possibility for survival and diminished the risk for complications in very early preterm delivered survivors in cases with cervical dilatation and membrane herniation before 26th week of gestation. Without action possibility to achieve at least 28th or 32nd week of gestation would be poor.Keywords: cervical insufficiency, mesh cerclage, membrane protrusion, premature birth prevention, physical exam-indicated cerclage, rescue cerclage
Procedia PDF Downloads 1903974 Leveraging Natural Language Processing for Legal Artificial Intelligence: A Longformer Approach for Taiwanese Legal Cases
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Legal artificial intelligence (LegalAI) has been increasing applications within legal systems, propelled by advancements in natural language processing (NLP). Compared with general documents, legal case documents are typically long text sequences with intrinsic logical structures. Most existing language models have difficulty understanding the long-distance dependencies between different structures. Another unique challenge is that while the Judiciary of Taiwan has released legal judgments from various levels of courts over the years, there remains a significant obstacle in the lack of labeled datasets. This deficiency makes it difficult to train models with strong generalization capabilities, as well as accurately evaluate model performance. To date, models in Taiwan have yet to be specifically trained on judgment data. Given these challenges, this research proposes a Longformer-based pre-trained language model explicitly devised for retrieving similar judgments in Taiwanese legal documents. This model is trained on a self-constructed dataset, which this research has independently labeled to measure judgment similarities, thereby addressing a void left by the lack of an existing labeled dataset for Taiwanese judgments. This research adopts strategies such as early stopping and gradient clipping to prevent overfitting and manage gradient explosion, respectively, thereby enhancing the model's performance. The model in this research is evaluated using both the dataset and the Average Entropy of Offense-charged Clustering (AEOC) metric, which utilizes the notion of similar case scenarios within the same type of legal cases. Our experimental results illustrate our model's significant advancements in handling similarity comparisons within extensive legal judgments. By enabling more efficient retrieval and analysis of legal case documents, our model holds the potential to facilitate legal research, aid legal decision-making, and contribute to the further development of LegalAI in Taiwan.Keywords: legal artificial intelligence, computation and language, language model, Taiwanese legal cases
Procedia PDF Downloads 723973 Superficial Temporal Artery Pseudoaneurysm Post Blepharoplasty: Case Report
Authors: Asaad Alhabsi, Alyaqdan Algafri
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Aim: Reporting 83 years old man with history of left upper eyelid swelling post 4-lids blepharoplasty diagnosed based on clinical presentation and Radiological imaging with pseudoaneurysm of frontal branch of Superficial Temporal Artery post blepharoplasty. METHODS: 83 years old who presented to a Tertiary ophthalmic center with painless left upper eyelids swelling for 2 months post 4-lids blepharoplasty. Left subcutaneous, sub-brow lesion, in the supertemporal pre-septal area, large mass found and excised surgically. Then he developed recurrent larger mass twice first time treated with aspiration of blood, second time diagnosed with superficial temporal artery (STA) pseudoaneurysm of frontal branch treated with endovascular embolization. RESULTS: Pseudoaneurysm of superficial temporal artery (STA) is a rare, presenting usual post head or face trauma .literature reported few cases of such conditions post operatively, and no reported cases post blepharoplasty. CONCLUSIONS: Surgical intervention is the gold standard of treatment either directly by dissecting the aneurysmal sac and ligate both ends, or endovascular method of injecting thrombin or embolization which was done in this patient by interventional radiologist.Keywords: superficial temporal artery, pseudoaneurysm, blepharoplasty, Oculoplasty
Procedia PDF Downloads 773972 Recurrent Neural Networks for Classifying Outliers in Electronic Health Record Clinical Text
Authors: Duncan Wallace, M-Tahar Kechadi
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In recent years, Machine Learning (ML) approaches have been successfully applied to an analysis of patient symptom data in the context of disease diagnosis, at least where such data is well codified. However, much of the data present in Electronic Health Records (EHR) are unlikely to prove suitable for classic ML approaches. Furthermore, as scores of data are widely spread across both hospitals and individuals, a decentralized, computationally scalable methodology is a priority. The focus of this paper is to develop a method to predict outliers in an out-of-hours healthcare provision center (OOHC). In particular, our research is based upon the early identification of patients who have underlying conditions which will cause them to repeatedly require medical attention. OOHC act as an ad-hoc delivery of triage and treatment, where interactions occur without recourse to a full medical history of the patient in question. Medical histories, relating to patients contacting an OOHC, may reside in several distinct EHR systems in multiple hospitals or surgeries, which are unavailable to the OOHC in question. As such, although a local solution is optimal for this problem, it follows that the data under investigation is incomplete, heterogeneous, and comprised mostly of noisy textual notes compiled during routine OOHC activities. Through the use of Deep Learning methodologies, the aim of this paper is to provide the means to identify patient cases, upon initial contact, which are likely to relate to such outliers. To this end, we compare the performance of Long Short-Term Memory, Gated Recurrent Units, and combinations of both with Convolutional Neural Networks. A further aim of this paper is to elucidate the discovery of such outliers by examining the exact terms which provide a strong indication of positive and negative case entries. While free-text is the principal data extracted from EHRs for classification, EHRs also contain normalized features. Although the specific demographical features treated within our corpus are relatively limited in scope, we examine whether it is beneficial to include such features among the inputs to our neural network, or whether these features are more successfully exploited in conjunction with a different form of a classifier. In this section, we compare the performance of randomly generated regression trees and support vector machines and determine the extent to which our classification program can be improved upon by using either of these machine learning approaches in conjunction with the output of our Recurrent Neural Network application. The output of our neural network is also used to help determine the most significant lexemes present within the corpus for determining high-risk patients. By combining the confidence of our classification program in relation to lexemes within true positive and true negative cases, with an inverse document frequency of the lexemes related to these cases, we can determine what features act as the primary indicators of frequent-attender and non-frequent-attender cases, providing a human interpretable appreciation of how our program classifies cases.Keywords: artificial neural networks, data-mining, machine learning, medical informatics
Procedia PDF Downloads 1313971 Antibiotic Treatment of Apical Periodontitis
Authors: Ilma Robo, Saimir Heta, Gerhard Nokaj
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Introduction: The method of treatment and the treatment protocols of apical periodontitis are now known, but the ongoing debate remains on whether or not prescription antibiotics should be given to patients suffering from this type of pathology. In fact, as an indication for prescribing antibiotics, this type of pathology remains between clinical indication and contraindication. Material and Methods: This article is of the short-communication type and has the sole purpose of analyzing the clinical picture of apical periodontitis and the fact that the appearance and extent of this pathology in the periapex area passes the stage when the host or the immune cells of the organism of the affected individual, react against bacterial factors. Results: Determining whether or not to prescribe systemic antibiotics according to literature sources can be avoided. In some cases, research in this field about this pathology even indicates endodontic rinsers or irrigants, such as chlorhexidine, in typical cases, mainly in persistent apical periodontitis. Conclusions: In times when bacterial resistance is a hot topic in some fields of scientific research, it is important to divide dental pathologies of bacterial origin into those when systemic antibiotic prescriptions must be given and those when every clinical issue is resolved only with endodontic root canal treatment. Even certain sources of published literature show the specifics of the most effective antibiotics against the bacterial flora causing the pathology of apical periodontitis.Keywords: endodontic treatment, apical periodontitis, antibiotics, chlorhexidine
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