Search results for: back pain
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2508

Search results for: back pain

1818 Effect of Perioperative Multimodal Analgesia on Postoperative Opioid Consumption and Complications in Elderly Traumatic Hip Fracture Patients: A Systematic Review of Randomised Controlled Trials

Authors: Raheel Shakoor Siddiqui, Shahbaz Malik, Manikandar Srinivas Cheruvu, Sanjay Narayana Murthy, Livio DiMascio

Abstract:

Background: elderly traumatic hip fracture patients frequently present to trauma services globally. Rising low energy falls amongst an osteoporotic aging population is the commonest cause for injury. Hip fractures in this population are a major cause for severe pain, morbidity and mortality. The term hip fracture is interchangeable with neck of femur fracture, fractured neck of femur or proximal femur fracture. Hip fracture pain management protocols and guidelines suggest conventional analgesia, nerve block and opioid based treatment as rescue analgesia. There is a current global opioid crisis with overuse, abuse and dependence. Adverse opioid related complications in vulnerable elderly patients further adds to morbidity and mortality. Systematic reviews in literature have evidenced superiority of multimodal analgesia in osteoarthritic primary joint replacements compared to opioids however, this has not yet been conducted for elderly traumatic hip fracture patients. Aims: The primary aim of this systematic review is to provide standardised evidence following Cochrane and PRISMA guidance in determining advantages of perioperative multimodal analgesia over conventional opioid based treatments in elderly traumatic hip fractures. Methods: 5 databases were searched from January 2000-2023 which identified 8 randomised controlled trials and 446 total participants. These trials met defined PICOS eligibility criteria of patient mean age ≥ 65 years presenting with a unilateral traumatic fractured neck of femur for operative intervention. Analgesic intervention with perioperative multimodal analgesia has been compared to conventional opioid based analgesia. Outcomes of interest include, primarily, the change in postoperative opioid consumption within a 0-30 postoperative period and secondarily, the change in postoperative adverse events and complications. A qualitative synthesis has been performed due to clinical heterogenicity and variance amongst trials. Results: GRADE evidence of moderate quality supports perioperative multimodal analgesia leads to a reduction in postoperative opioid consumption however, low quality evidence supports a reduction of adverse effects and complications. Conclusion: Perioperative multimodal analgesia whether used preoperative, intraoperative and/or postoperative leads to a reduction in postoperative opioid consumption for elderly traumatic hip fracture patients. This review recommends the use of perioperative multimodal analgesia as part of hip fracture pain protocols however, caution and clinical judgement should be used as the risk of adverse effects may not be lower.

Keywords: trauma, orthopaedics, hip, fracture, neck of femur fracture, analgesia, multimodal analgesia, opioid

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1817 Estimation of Geotechnical Parameters by Comparing Monitoring Data with Numerical Results: Case Study of Arash–Esfandiar-Niayesh Under-Passing Tunnel, Africa Tunnel, Tehran, Iran

Authors: Aliakbar Golshani, Seyyed Mehdi Poorhashemi, Mahsa Gharizadeh

Abstract:

The under passing tunnels are strongly influenced by the soils around. There are some complexities in the specification of real soil behavior, owing to the fact that lots of uncertainties exist in soil properties, and additionally, inappropriate soil constitutive models. Such mentioned factors may cause incompatible settlements in numerical analysis with the obtained values in actual construction. This paper aims to report a case study on a specific tunnel constructed by NATM. The tunnel has a depth of 11.4 m, height of 12.2 m, and width of 14.4 m with 2.5 lanes. The numerical modeling was based on a 2D finite element program. The soil material behavior was modeled by hardening soil model. According to the field observations, the numerical estimated settlement at the ground surface was approximately four times more than the measured one, after the entire installation of the initial lining, indicating that some unknown factors affect the values. Consequently, the geotechnical parameters are accurately revised by a numerical back-analysis using laboratory and field test data and based on the obtained monitoring data. The obtained result confirms that typically, the soil parameters are conservatively low-estimated. And additionally, the constitutive models cannot be applied properly for all soil conditions.

Keywords: NATM tunnel, initial lining, laboratory test data, numerical back-analysis

Procedia PDF Downloads 358
1816 Force Distribution and Muscles Activation for Ankle Instability Patients with Rigid and Kinesiotape while Standing

Authors: Norazlin Mohamad, Saiful Adli Bukry, Zarina Zahari, Haidzir Manaf, Hanafi Sawalludin

Abstract:

Background: Deficit in neuromuscular recruitment and decrease force distribution were the common problems among ankle instability patients due to altered joint kinematics that lead to recurrent ankle injuries. Rigid Tape and KT Tape had widely been used as therapeutic and performance enhancement tools in ankle stability. However the difference effect between this two tapes is still controversial. Objective: To investigate the different effect between Rigid Tape and KT Tape on force distribution and muscle activation among ankle instability patients while standing. Study design: Crossover trial. Participants: 27 patients, age between 18 to 30 years old participated in this study. All the subjects were applied with KT Tape & Rigid Tape on their affected ankle with 3 days of interval for each intervention. The subjects were tested with their barefoot (without tape) first to act as a baseline before proceeding with KT Tape, and then with Rigid Tape. Result: There were no significant difference on force distribution at forefoot and back-foot for both tapes while standing. However the mean data shows that Rigid Tape has the highest force distribution at back-foot rather than forefoot when compared with KT Tape that had more force distribution at forefoot while standing. Regarding muscle activation (Peroneus Longus), results showed significant difference between Rigid Tape and KT Tape (p= 0.048). However, there was no significant difference on Tibialis Anterior muscle activation between both tapes while standing. Conclusion: The results indicated that Peroneus longus muscle was more active when applied Rigid Tape rather than KT Tape in ankle instability patients while standing.

Keywords: ankle instability, kinematic, muscle activation, force distribution, Rigid Tape, KT tape

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1815 Fibromyalgia and Personality: A Review of the Different Personality Types Identified

Authors: Lize Tibiriçá, Ronnie Lee, Samantha Behbahani

Abstract:

Fibromyalgia (FM) is a musculoskeletal disorder affecting men and women of different ages and cultures. The cause of this disorder is unknown; however, studies suggest an etiology that involves biological and psychosocial factors. Few studies have shown that a personality type such as neuroticism is associated with chronic pain conditions. Past research has explored whether patients with FM present with a specific personality trait. However, studies have used different methods (i.e. Minnesota Multiphasic Personality Inventory (MMPI), Sociotropy and Autonomy Scale (SAS) and Dysfunctional Attitude Scale (DAS), Tridimensional Personality Questionnaire or Temperament and Character Inventory (TCI), Karolinska scale of personality, Big Five Inventory or NEO Personality Inventory) to explore the connection between FM and a personality type. They have identified personality types that present similar characteristics but vary in the name (i.e. high harm avoidance and low novelty seeking, psychasthenia/muscular tension/somatic anxiety, neuroticism). Although Zuckerman-Kuhlman Personality Questionnaire and the Big Five Inventory differ in terms of content and structure, both of them identify neuroticism as the personality type of FM patients, and the former also identifies these patients as having a low sociability personality trait. Previous research also shows a trend of sociotropic personality style with FM patients that also suffer from Major Depressive Disorder. Participants in these studies were, for the most part, adult female and researchers have recognized that as a limitation and whether their findings can be generalized to men and younger patients with FM. Furthermore, most studies reviewed were conducted in Europe (i.e. Spain) and had a cross-sectional design. Future research should replicate past studies in different countries and consider conducting a longitudinal study. Although it is suspected that FM course is modulated by FM patients’ personality, it is not known whether individuals with similar personalities will develop FM. This review sought to explain the differences and similarities between the personality types identified. Limitations in the studies reviewed were addressed, and considerations for future research and treatment were discussed.

Keywords: chronic pain, fibromyalgia, neuroticism, personality type

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1814 Efficient Depolymerization of Polyethylene terephthalate (PET) Using Bimetallic Catalysts

Authors: Akmuhammet Karayev, Hassam Mazhar, Mamdouh Al Harthi

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Polyethylene terephthalate (PET) recycling stands as a pivotal solution in combating plastic pollution and fostering a circular economy. This study addresses the catalytic glycolysis of PET, a key step in its recycling process, using synthesized catalysts. Our focus lies in elucidating the catalytic mechanism, optimizing reaction kinetics, and enhancing reactor design for efficient PET conversion. We synthesized anionic clays tailored for PET glycolysis and comprehensively characterized them using XRD, FT-IR, BET, DSC, and TGA techniques, confirming their suitability as catalysts. Through systematic parametric studies, we optimized reaction conditions to achieve complete PET conversion to bis hydroxy ethylene terephthalate (BHET) with over 75% yield within 2 hours at 200°C, employing a minimal catalyst concentration of 0.5%. These results underscore the catalysts' exceptional efficiency and sustainability, positioning them as frontrunners in catalyzing PET recycling processes. Furthermore, we demonstrated the recyclability of the obtained BHETs by repolymerizing them back to PET without the need for a catalyst. Heating the BHETs in a distillation unit facilitated their conversion back to PET, highlighting the closed-loop potential of our recycling approach. Our work embodies a significant leap in catalytic glycolysis kinetics, driven by sustainable catalysts, offering rapid and high-impact PET conversion while minimizing environmental footprint. This breakthrough not only sets new benchmarks for efficiency in PET recycling but also exemplifies the pivotal role of catalysis and reaction engineering in advancing sustainable materials management.

Keywords: polymer recycling, catalysis, circular economy, glycolysis

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1813 Numerical Investigation of Material Behavior During Non-Equal Channel Multi Angular Extrusion

Authors: Mohamed S. El-Asfoury, Ahmed Abdel-Moneim, Mohamed N. A. Nasr

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The current study uses finite element modeling to investigate and analyze a modified form of the from the conventional equal channel multi-angular pressing (ECMAP), using non-equal channels, on the workpiece material plastic deformation. The modified process non-equal channel multi-angular extrusion (NECMAE) is modeled using two-dimensional plane strain finite element model built using the commercial software ABAQUS. The workpiece material used is pure aluminum. The model was first validated by comparing its results to analytical solutions for single-pass equal channel angular extrusion (ECAP), as well as previously published data. After that, the model was used to examine the effects of different % of reductions of the area (for the second stage) on material plastic deformation, corner gap, and required the load. Three levels of reduction in the area were modeled; 10%, 30%, and 50%, and compared to single-pass and double-pass ECAP. Cases with a higher reduction in the area were found to have smaller corner gaps, higher and much uniform plastic deformation, as well as higher required loads. The current results are mainly attributed to the back pressure effects exerted by the second stage, as well as strain hardening effects experienced during the first stage.

Keywords: non-equal channel angular extrusion, multi-pass, sever plastic deformation, back pressure, Finite Element Modelling (FEM)

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1812 The Environmental Influence on Slow Learners' Learning Achievement

Authors: Niphattha Hannapha

Abstract:

This paper examines how the classroom environment influences slow learners’ learning achievement; it focuses on how seating patterns affect students’ behaviours and which patterns best contribute to students’ learning performance. The researcher studied how slow learners’ characteristics and seating patterns influenced their behaviours and performance at Ban Hin Lad School. As a nonparticipant observation, the target groups included 15 slow learners from Prathomsueksa (Grades) 4 and 5. Students’ behaviours were recorded during their learning activities in order to minimize their reading and written expression disorder in Thai language tutorials. The result showed four seating patterns and two behaviors which obstructed students’ learning. The average of both behaviours mostly occurred when students were seated with patterns 1 (the seat facing the door, with the corridor alongside) and 3 (the seat alongside the door, facing the aisle) respectively. Seating patterns 1 and 3 demonstrated visibility (the front and side) of a walking path with two-way movement. However, seating patterns 2 (seating with the door alongside and the aisle at the back) and 4 (sitting with the door at the back and the aisle alongside) demonstrated visibility (the side) of a walking path with one-way movement. In Summary, environmental design is important to enhance concentration in slow learners who have reading and writing disabilities. This study suggests that students should be seated where they can have the least visibility of movement to help them increase continuous learning. That means they can have a better chance of developing reading and writing abilities in comparison with other patterns of seating.

Keywords: slow learning, interior design, interior environment, classroom

Procedia PDF Downloads 210
1811 Radiofrequency Ablation: A Technique in the Management of Low Anal Fistula

Authors: R. Suresh, C. B. Singh, A. K. Sarda

Abstract:

Background: Over the decades, several surgical techniques have been developed to treat anal fistulas with variable success rates and complications. Large amount of work has been done in radiofrequency excision of the fistula for several years but no work has been done for ablating the tract. Therefore one can consider for obliteration ofanal fistula by Radiofrequency ablation (RFA). Material and Methods: A randomized controlled clinical trial was conducted at Lok Nayak Hospital, where a total of 40 patients were enrolled in the study and they were randomly assigned to Group I (fistulectomy)(n=20) and Group II (RFA) (n=20). Aim of the study was to compare the efficacy of RFA of fistula versus fistulectomy in the treatment of a low anal fistula and to evaluate RFA as an effective alternative to fistulectomy with respect to time taken for wound healing as primary outcome and post-operative pain, time taken to return to work as secondary outcomes. Patients with simple low anal fistulas, single internal and external opening, not more than two secondary tracts were included. Patients with high complex fistula, fistulas communicating with cavity, fistula due to condition like tuberculosis, Crohn's, malignancy were excluded from the study. Results: Both groups were comparable with respect to age, sex ratio, type of fistula. Themean healing time was significantly shorter in group II (41.02 days) than in group I(62.68 days).The mean operative time was significantly shorter in groupII (21.40 min) than in group I(28.50 min). The mean time taken to return to work was significantly shorter in group II(8.30 days)than in group I(12.01 days).There was no significant difference in the post operative hospital stay, mean postoperative pain score, wound infection and recurrence between the two groups. Conclusion: The patients who underwent RFA of fistula had shorter wound healing time, operative time and time taken to return to work when compared to those who underwent fistulectomy and therefore RFA shows outcome comparable to fistulectomy in the treatment of low anal fistula.

Keywords: fistulectomy, low anal fistula, radio frequency ablation, wound healing

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1810 Imaging of Underground Targets with an Improved Back-Projection Algorithm

Authors: Alireza Akbari, Gelareh Babaee Khou

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Ground Penetrating Radar (GPR) is an important nondestructive remote sensing tool that has been used in both military and civilian fields. Recently, GPR imaging has attracted lots of attention in detection of subsurface shallow small targets such as landmines and unexploded ordnance and also imaging behind the wall for security applications. For the monostatic arrangement in the space-time GPR image, a single point target appears as a hyperbolic curve because of the different trip times of the EM wave when the radar moves along a synthetic aperture and collects reflectivity of the subsurface targets. With this hyperbolic curve, the resolution along the synthetic aperture direction shows undesired low resolution features owing to the tails of hyperbola. However, highly accurate information about the size, electromagnetic (EM) reflectivity, and depth of the buried objects is essential in most GPR applications. Therefore hyperbolic curve behavior in the space-time GPR image is often willing to be transformed to a focused pattern showing the object's true location and size together with its EM scattering. The common goal in a typical GPR image is to display the information of the spatial location and the reflectivity of an underground object. Therefore, the main challenge of GPR imaging technique is to devise an image reconstruction algorithm that provides high resolution and good suppression of strong artifacts and noise. In this paper, at first, the standard back-projection (BP) algorithm that was adapted to GPR imaging applications used for the image reconstruction. The standard BP algorithm was limited with against strong noise and a lot of artifacts, which have adverse effects on the following work like detection targets. Thus, an improved BP is based on cross-correlation between the receiving signals proposed for decreasing noises and suppression artifacts. To improve the quality of the results of proposed BP imaging algorithm, a weight factor was designed for each point in region imaging. Compared to a standard BP algorithm scheme, the improved algorithm produces images of higher quality and resolution. This proposed improved BP algorithm was applied on the simulation and the real GPR data and the results showed that the proposed improved BP imaging algorithm has a superior suppression artifacts and produces images with high quality and resolution. In order to quantitatively describe the imaging results on the effect of artifact suppression, focusing parameter was evaluated.

Keywords: algorithm, back-projection, GPR, remote sensing

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1809 Using Multi-Specialist Team to Care for a Breast Cancer Patient Who Received Total Mastectomy during Pregnancy

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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1808 An Extensible Software Infrastructure for Computer Aided Custom Monitoring of Patients in Smart Homes

Authors: Ritwik Dutta, Marylin Wolf

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This paper describes the trade-offs and the design from scratch of a self-contained, easy-to-use health dashboard software system that provides customizable data tracking for patients in smart homes. The system is made up of different software modules and comprises a front-end and a back-end component. Built with HTML, CSS, and JavaScript, the front-end allows adding users, logging into the system, selecting metrics, and specifying health goals. The back-end consists of a NoSQL Mongo database, a Python script, and a SimpleHTTPServer written in Python. The database stores user profiles and health data in JSON format. The Python script makes use of the PyMongo driver library to query the database and displays formatted data as a daily snapshot of user health metrics against target goals. Any number of standard and custom metrics can be added to the system, and corresponding health data can be fed automatically, via sensor APIs or manually, as text or picture data files. A real-time METAR request API permits correlating weather data with patient health, and an advanced query system is implemented to allow trend analysis of selected health metrics over custom time intervals. Available on the GitHub repository system, the project is free to use for academic purposes of learning and experimenting, or practical purposes by building on it.

Keywords: flask, Java, JavaScript, health monitoring, long-term care, Mongo, Python, smart home, software engineering, webserver

Procedia PDF Downloads 384
1807 Electrochemical Synthesis of ZnTe and Cu-ZnTe Thin Films for Low Resistive Ohmic Back Contact for CdS/CdTe Solar Cells

Authors: Shivaji M. Sonawane, N. B. Chaure

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ZnTe is direct band gap, the P-type semiconductor with the high absorption coefficient of the order of 104cm-1 is suitable for solar cell development. It can be used as a low resistive ohmic contact to CdS/CdTe or tandem solar cell application. ZnTe and Cu-ZnTe thin film have been electrochemically synthesized on to fluorine-doped tin oxide coated glass substrates using three electrode systems containing Ag/AgCl, graphite and FTO as reference, counter and working electrode respectively were used to deposit the thin films. The aqueous electrolytic solution consist of 0.5M TeO2, 0.2M ZnSO4, and 0.1M Na3C6H5O7:2H2O, 0.1MC6H8O7:H2O and 0.1mMCuSO4 with PH 2.5 at room temperature was used. The reaction mechanism is studied in the cyclic voltammetry to identify the deposition potentials of ZnTe and Cu-ZnTe.The potential was optimized in the range -0,9 to -1,1 V. Vs Ag/AgCl reference electrode. The effect of deposition potential on the structural properties was studied by using X-ray diffraction. The X-ray diffraction result reveled cubic crystal structure of ZnTe with preferential (111) orientation with cubic structure. The surface morphology and film composition were analyzed by means of Scanning electron microscopy (SEM) and Energy Dispersive Analysis of X- Rays (EDAX). The optical absorption measurement has been analyzed for the band gap determination of deposited layers about 2.26 eV by UV-Visible spectroscopy. The drastic change in resistivity has been observed due to incorporation of copper probably due to the diffusion of Cu into grain boundaries.

Keywords: ohmic back contact, zinc telluride, electrodeposition, photovoltaic devices

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1806 Osteoarticular Manifestations and Abnormalities of Bone Metabolism in Celiac Disease

Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia

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Introduction: Celiac disease (CD) is a chronic autoimmune inflammatory enteropathy caused by gluten. The clinical presentation is very variable. Malabsorption in the MC is responsible for an alteration of the bone metabolism. Our purpose is to study the osteoarticular manifestations related to this condition. Material and methods: It is a retrospective study of 41 cases of CD diagnosed on clinical, immunological, endoscopic and histological arguments, in the Internal Medicine and Gastroenterology Department of Farhat Hached Hospital between September 2005 and January 2016. Results: Osteoarticular manifestations were found in 9 patients (22%) among 41 patients presenting CD. These were 7 women and 2 men with an average age of 35.7 years (25 to 67 years). These manifestations were revelatory of CD in 3 cases. Abdominal pain and diarrhea were present in 6 cases. Inflammatory polyarthralgia of wrists and knees has been reported in 7 patients. Mechanical mono arthralgia was noted in 2 patients. Biological tests revealed microcytic anemia by iron deficiency in 7 cases, hypocalcemia in 5 cases, Hypophosphatemia in 3 cases and elevated alkaline phosphatases in 3 cases. Upper gastrointestinal endoscopy with duodenal biopsy found villous atrophy in all cases. In immunology, Anti-transglutaminase antibodies were positive in all patients, Anti-endomysium in 7 cases. Measurement of bone mineral density (BMD) by biphotonic X-ray absorptiometer with evaluation of the T-score and the Z-score was performed in Twenty patients (48.8%). It was normal in 7 cases (33%) and showed osteopenia in 5 patients (25%) and osteoporosis in 2 patients (10%). All patients were treated with a Gluten-free diet associated with vitamin D and calcium substitution in 5 cases. The evolution was favorable in all cases with reduction of bone pain and normalization of the phosphocalcic balance. Conclusion: The bone impact of CD is frequent but often asymptomatic. Patients with CD should be evaluated by the measurement of bone mineral density and monitored for calcium and vitamin D deficiencies.

Keywords: bone mineral density, celiac disease, osteoarticular manifestations, vitamin D and calcium

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1805 The Role of a Specialized Diet for Management of Fibromyalgia Symptoms: A Systematic Review

Authors: Siddhant Yadav, Rylea Ranum, Hannah Alberts, Abdul Kalaiger, Brent Bauer, Ryan Hurt, Ann Vincent, Loren Toussaint, Sanjeev Nanda

Abstract:

Background and significance: Fibromyalgia (FM) is a chronic pain disorder also characterized by chronic fatigue, morning stiffness, sleep, and cognitive symptoms, psychological disturbances (anxiety, depression), and is comorbid with multiple medical and psychiatric conditions. It has an incidence of 2-4% in the general population and is reported more commonly in women. Oxidative stress and inflammation are thought to contribute to pain in patients with FM, and the adoption of an antioxidant/anti-inflammatory diet has been suggested as a modality to alleviate symptoms. The aim of this systematic review was to evaluate the efficacy of specialized diets (ketogenic, gluten free, Mediterranean, and low carbohydrate) in improving FM symptoms. Methodology: A comprehensive search of the following databases from inception to July 15th, 2021, was conducted: Ovid MEDLINE and Epub ahead of print, in-process and other non-indexed citations and daily, Ovid Embase, Ovid EBM reviews, Cochrane central register of controlled trials, EBSCO host CINAHL with full text, Elsevier Scopus, website and citation index, web of science emerging sources citation and clinicaltrials.gov. We included randomized controlled trials, non-randomized experimental studies, cross-sectional studies, cohort studies, case series, and case reports in adults with fibromyalgia. The risk of bias was assessed with the Agency for Health Care Research and Quality designed, specific recommended criteria (AHRQ). Results: Thirteen studies were eligible for inclusion. This included a total of 761 participants. Twelve out of the 13 studies reported improvement in widespread body pain, joint stiffness, sleeping pattern, mood, and gastrointestinal symptoms, and one study reported no changes in symptomatology in patients with FM on specialized diets. None of the studies showed the worsening of symptoms associated with a specific diet. Most of the patient population was female, with the mean age at which fibromyalgia was diagnosed being 48.12 years. Improvement in symptoms was reported by the patient's adhering to a gluten-free diet, raw vegan diet, tryptophan- and magnesium-enriched Mediterranean diet, aspartame- and msg- elimination diet, and specifically a Khorasan wheat diet. Risk of bias assessment noted that 6 studies had a low risk of bias (5 clinical trials and 1 case series), four studies had a moderate risk of bias, and 3 had a high risk of bias. In many of the studies, the allocation of treatment (diets) was not adequately concealed, and the researchers did not rule out any potential impact from a concurrent intervention or an unintended exposure that might have biased the results. On the other hand, there was a low risk of attrition bias in all the trials; all were conducted with an intention-to-treat, and the inclusion/exclusion criteria, exposures/interventions, and primary outcomes were valid, reliable, and implemented consistently across all study participants. Concluding statement: Patients with fibromyalgia who followed specialized diets experienced a variable degree of improvement in their widespread body pain. Improvement was also seen in stiffness, fatigue, moods, sleeping patterns, and gastrointestinal symptoms. Additionally, the majority of the patients also reported improvement in overall quality of life.

Keywords: fibromyalgia, specialized diet, vegan, gluten free, Mediterranean, systematic review

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1804 Rutin C Improve Osseointegration of Dental Implant and Healing of Soft Tissue

Authors: Noha Mohammed Ismael Awad Eladal, Aala Shoukry Emara

Abstract:

Background: Wound healing after dental implant surgery is critical to the procedure's success. The aim of this study was to explore the effects of rutin+vitamin C supplementation in wound healing following the placement of dental implants. Methodology: There were 20 participants in this randomized controlled clinical trial who needed dental implants to replace missing teeth. Patients were divided into two groups, and group A received dental implants. Group B received dental implants with vitamin C administration. Follow-up appointments were performed on day 3, day 7, and day 14 post-surgery, during which soft tissue healing and pain response scores were evaluated using the visual analog scale. Postoperative digital panoramas were taken immediately after surgery, 3 months and 6 months postoperatively. Changes in bone density along with the bone-implant interface at the mesial, distal and apical sides were assessed using the digora software. Results: An independent t-test was used to compare the means of variables between the two groups. At the same time, repeated measures were employed to compare the means of variables between two groups. ANOVA was used to compare bone density for the same group at different dates. Significant increased differences were observed at the mesial, distal and apical sides Surrounding the implants of both groups per time. However, the rate of increase was significantly higher in group B The mean difference at the mesial side after 6 months was 21.99 ± 5.48 in the group B and 14.21 ± 4.95 in group A, while it read 21.74 ± 3.56 in the group B and 10.78 ± 3.90 in group A at the distal side and was 18.90 ± 5.91 in the group B and 10.39 ± 3.49 group A at the apical side. Significance was recorded at P = 0.004, P = 0.0001, and 0.001 at the mesial, distal and apical sides respectively. The mean pain score and wound healing were significantly higher in group A as compared to group B, respectively. Conclusion: The rutin c + vitamin c group significantly promoted bone healing and speeded up the osseointegration process and improved soft tissue healing.

Keywords: osseointegration, soft tissue, rutin c, dental implant

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1803 Work Related Musculoskeletal Disorder: A Case Study of Office Computer Users in Nigerian Content Development and Monitoring Board, Yenagoa, Bayelsa State, Nigeria

Authors: Tamadu Perry Egedegu

Abstract:

Rapid growth in the use of electronic data has affected both the employee and work place. Our experience shows that jobs that have multiple risk factors have a greater likelihood of causing Work Related Musculoskeletal Disorder (WRMSDs), depending on the duration, frequency and/or magnitude of exposure to each. The study investigated musculoskeletal disorder among office workers. Thus, it is important that ergonomic risk factors be considered in light of their combined effect in causing or contributing to WRMSDs. Fast technological growth in the use of electronic system; have affected both workers and the work environment. Awkward posture and long hours in front of these visual display terminals can result in work-related musculoskeletal disorders (WRMSD). The study shall contribute to the awareness creation on the causes and consequences of WRMSDs due to lack of ergonomics training. The study was conducted using an observational cross-sectional design. A sample of 109 respondents was drawn from the target population through purposive sampling method. The sources of data were both primary and secondary. Primary data were collected through questionnaires and secondary data were sourced from journals, textbooks, and internet materials. Questionnaires were the main instrument for data collection and were designed in a YES or NO format according to the study objectives. Content validity approval was used to ensure that the variables were adequately covered. The reliability of the instrument was done through test-retest method, yielding a reliability index at 0.84. The data collected from the field were analyzed with a descriptive statistics of chart, percentage and mean. The study found that the most affected body regions were the upper back, followed by the lower back, neck, wrist, shoulder and eyes, while the least affected body parts were the knee calf and the ankle. Furthermore, the prevalence of work-related 'musculoskeletal' malfunctioning was linked with long working hours (6 - 8 hrs.) per day, lack of back support on their seats, glare on the monitor, inadequate regular break, repetitive motion of the upper limbs, and wrist when using the computer. Finally, based on these findings some recommendations were made to reduce the prevalent of WRMSDs among office workers.

Keywords: work related musculoskeletal disorder, Nigeria, office computer users, ergonomic risk factor

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1802 Medical Dressing Induced Digital Ischemia in Patient with Congenital Insensitivity to Pain and Anhidrosis

Authors: Abdulwhab Alotaibi, Abdullah Alzahrani, Ziyad Bokhari, Abdulelah Alghamdi

Abstract:

First described in 1975 by Dr. Miller, Medical dressings are uncommon but possible cause of hand digital ischemia due the tourniquet-like effect. The incident of this complication has been reported across wide range of age-groups, yet it seems like that the pediatric population are specifically vulnerable. Multiple dressing types were reported to have caused ischemic injury, such as elastic wrap, tubular gauze, and self-adherent dressings. We present a case of medical dressing induced digital ischemia in patient with Congenital insensitivity to pain and anhidrosis (CIPA), which further challenge the discovery of the condition. An 8-year-old girl known case of CIPA. Brought by her mother to the ER after nail bed injury, which she managed by application of elastic wrap that was left for 24 hours. When the mother found out she immediately removed the elastic band, and noticed the fingertip was black and cold with tense bullae. The color then changed later when she arrived to the ER to dark purple with bluish discoloration on the tip. On examination there was well demarcated tense bullae on the distal right fifth finger. Neurovascular intact, pulse oximetry on distal digit 100%, capillary refill time was delayed. She was seen under Plastic surgery and conservative management recommended, and patient was discharged with safety netting. Two days later the patient came as follow-up visit at which her condition demonstrated significant improvement, the bullae has since ruptured leaving behind sloughed skin, capillary refill and pulse oximetry were both within normal limits, sensory function couldn’t be assessed but her motor function and ROM were normal, topical bacitracin and bandage dressings were applied for the eroded skin. Patient was scheduled for a follow-up in 2 weeks. Preventatively it’s advisable to avoid the commonly implicated dressings such as elastic, tubular gauze or self-adherent wraps in hand or digital injuries when possible, but in cases where the use of these dressings is of necessity the appropriate precautions must be taken, Dr. Makarewich proposed the following 5 measures to help minimize the incidence of the injury: 1-Unwrapping 12 inches of the dressing before rolling the injured finger. 2-Wrapping from distal to proximal with minimal tension to avoid vascular embarrassment. 3-The use of 5-25 inch to overlap the entire wrap. 4-Maintaining light pressure over the wrap to allow adherence of the dressing. 5-Minimization of the number of layers used to wrap the affected digit. Also assessing the capillary refill after the application can help in determining the patency of the supplying blood vessels. It’s also important to selectively determine if the patient is a candidate for conservative management, as tailored approach can help in maximizing the positive outcomes for our patients.

Keywords: congenital insensitivity to pain, digital ischemia, medical dressing, conservative management

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1801 Covid-19 Frontliners Survey: Assessing Complications and Quality of Life in Health Care Workers in District Swat, Khyber Pakhtunkhwa, Pakistan

Authors: Mohsin Shahab, Shagufta Rehmat, Faisal F. Khan

Abstract:

Background: The global COVID-19 pandemic has generated health problems worldwide. Health care workers are the front-line warriors against the pandemic. The aim of this study was to find out the prevalence of COVID-19 (7th May 2021 to 3rd August 2021) amongst Health Care Workers (HCWs) and to assess the complications associated with it and its effects on their quality of life. Material and Method: The study was conducted in healthcare facilities which serve as pandemic hospitals in district Swat. A total of 140 healthcare workers, who were employed in the COVID-19 health care facilities, including the department of Pulmonology, Intensive Care Unit (ICU), and COVID-19 wards. Participants were tested for COVIID-19 using RT PCR test. A Case Report Form (CRF) for conditions during and post COVID-19 was filled to assess the complications and quality of life of health care workers. Results: A total of 140 Health Care Workers were studied, out of which 40% were doctors, 22% nursing staff, 17% paramedic staff, 9% cleaning staff, lab technologist 6%, 2% operation theater staff, administration staff, and pharmacist. The respondents were also investigated for pre-existing illness prior to SARS-CoV-2 infection, hypertension was the most prevalent, followed by chronic heart diseases and neurological disorders. Fever was the most common symptom, recorded 76.42% in the participants, while 55.71% of participants had dry cough, 55% had a sore throat, following by chest pain 43.56%. Reinfection rate was 10%, with chest pain being recorded in 85.71%. Post disease complication analysis showed that 47.14% of the participants were diagnosed with a new diagnosis after the COVID-19 recovery. Pulmonological diseases were recorded the most as a new diagnosis in, followed by gastrointestinal and psychological problems. Conclusions: The results of the study illustrates how COVID-19 has affected the overall health and quality of life of HCWs in District Swat of Khyber Pakhtunkhwa, Pakistan.

Keywords: SARS-CoV-2, COVID-19, HCW's, symptoms, questionnaire, post COVID-19

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1800 A Prospective Review of Axillary Drainage in Axillary Lymph Node Dissection in Breast Conservation Cancer Surgery

Authors: Ruqayya Naheed Khan, Romaisa Shamim, Awais Amjad Malik, Awais Naeem, Amina Iqbal Khan, Asad Parvaiz

Abstract:

Objective: Patients undergoing axillary lymph node dissection (ALND) for metastatic lymph nodes in our hospital usually have drains placed in their axilla for a period of 6-10 days. We evaluated the post-op course of patients who underwent breast conservation surgery (BCS) along with ALND. Methods: A prospective cohort study was conducted at Shaukat Khanam Memorial Cancer Hospital from April 2017 to August 2017 including all lymph node positive breast cancer patients undergoing BCS with ALND. Patients were divided into two groups. Group A had no axillary drain while in Group B a drain was placed in axilla. Results: A total of 76 patients were included. 41 patients were included in group A and 35 patients in Group B. Median number of LNs dissected in group A was 17 and in group B was 15 (p value 0.443). Median operative time in group A was 84 min and in group B was 79 min (p value 0.223). Median hospital stay in both groups was 1 day (p value 0.78). At 2 weeks all patients in group A developed seroma as compared to none in group B (p value < 0.001). 3 of these patients in group A required aspiration of seroma due to pressure effects. Rest were managed conservatively. At 6 weeks only 50% patients had a seroma radiologically in Group A as compared to 33% in group B (p value 0.023). No intervention was required in any patients at week 6. QOL at 2 weeks was much better in Group A (7/41 patients had unsatisfactory response) as compared to group B (10/31 had unsatisfactory response). Results were statistically significant (p value 0.045). However, there wasn’t much difference in QOL at 6 weeks. Only 1 patient in group A had an unsatisfactory response. Average pain score at 2 weeks was similar in both groups (4.2 v/s 4.1 p value 0.73). Infection was seen in 1 patient in each group at 2 weeks (p value 0.668) and in only 1 patient in group A at 6 weeks (p value 0.067). Conclusion: We conclude from our study that there isn’t much difference in drain and no drain group in terms of wound infection and pain scores. No drain group is however associated with a better QOL in early post-op period.

Keywords: axillary drainage, axillary lymph node dissection, breast cancer, no drain in axilla

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1799 Early Return to Play in Football Player after ACL Injury: A Case Report

Authors: Nicola Milani, Carla Bellissimo, Davide Pogliana, Davide Panzin, Luca Garlaschelli, Giulia Facchinetti, Claudia Casson, Luca Marazzina, Andrea Sartori, Simone Rivaroli, Jeff Konin

Abstract:

The patient is a 26 year-old male amateur football player from Milan, Italy; (81kg; 185cm; BMI 23.6 kg/m²). He sustained a non-contact anterior cruciate ligament tear to his right knee in June 2021. In September 2021, his right knee ligament was reconstructed using a semitendinosus graft. The injury occurred during a football match on natural grass with typical shoes on a warm day (32 degrees celsius). Playing as a defender he sustained the injury during a change of direction, where the foot was fixated on the grass. He felt pain and was unable to continue playing the match. The surgeon approved his rehabilitation to begin two weeks post-operative. The initial physiotherapist assessment determined performing two training sessions per day within the first three months. In the first three weeks, the pain was 4/10 on Numerical Rating Scale (NRS), no swelling, a range of motion was 0-110°, with difficulty fully extending his knee and minimal quadriceps activation. Crutches were discontinued at four weeks with improved walking. Active exercise, electrostimulator, physical therapy, massages, osteopathy, and passive motion were initiated. At week 6, he completed his first functional movement screen; the score was 16/21 with no pain and no swelling. At week 8, the isokinetic test showed a 23% differential deficit between the two legs in maximum strength (at 90°/s). At week 10, he improved to 15% of injury-induced deficit which suggested he was ready to start running. At week 12, the athlete sustained his first threshold test. At week 16, he performed his first return to sports movement assessment, which revealed a 10% stronger difference between the legs. At week 16, he had his second threshold test. At week 17, his first on-field test revealed a 5% differential deficit between the two legs in the hop test. At week 18, isokinetic test demonstrates that the uninjured leg was 7% stronger than the recovering leg in maximum strength (at 90°/s). At week 20, his second on-field test revealed a 2% difference in hop test; at week 21, his third isokinetic test demonstrated a difference of 5% in maximum strength (at 90°/s). At week 21, he performed his second return to sports movement assessment which revealed a 2% difference between the limbs. Since it was the end of the championship, the team asked him to partake in the playoffs; moreover the player was very motivated to participate in the playoffs also because he was the captain of the team. Together with the player and the team, we decided to let him play even though we were aware of a heightened risk of injury than what is reported in the literature because of two factors: biological recovery times and the results of the tests we performed. In the decision making process about the athlete’s recovery time, it is important to balance the information available from the literature with the desires of the patient to avoid frustration.

Keywords: ACL, football, rehabilitation, return to play

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1798 Artificial Intelligence Based Predictive Models for Short Term Global Horizontal Irradiation Prediction

Authors: Kudzanayi Chiteka, Wellington Makondo

Abstract:

The whole world is on the drive to go green owing to the negative effects of burning fossil fuels. Therefore, there is immediate need to identify and utilise alternative renewable energy sources. Among these energy sources solar energy is one of the most dominant in Zimbabwe. Solar power plants used to generate electricity are entirely dependent on solar radiation. For planning purposes, solar radiation values should be known in advance to make necessary arrangements to minimise the negative effects of the absence of solar radiation due to cloud cover and other naturally occurring phenomena. This research focused on the prediction of Global Horizontal Irradiation values for the sixth day given values for the past five days. Artificial intelligence techniques were used in this research. Three models were developed based on Support Vector Machines, Radial Basis Function, and Feed Forward Back-Propagation Artificial neural network. Results revealed that Support Vector Machines gives the best results compared to the other two with a mean absolute percentage error (MAPE) of 2%, Mean Absolute Error (MAE) of 0.05kWh/m²/day root mean square (RMS) error of 0.15kWh/m²/day and a coefficient of determination of 0.990. The other predictive models had prediction accuracies of MAPEs of 4.5% and 6% respectively for Radial Basis Function and Feed Forward Back-propagation Artificial neural network. These two models also had coefficients of determination of 0.975 and 0.970 respectively. It was found that prediction of GHI values for the future days is possible using artificial intelligence-based predictive models.

Keywords: solar energy, global horizontal irradiation, artificial intelligence, predictive models

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1797 Comparing Field Displacement History with Numerical Results to Estimate Geotechnical Parameters: Case Study of Arash-Esfandiar-Niayesh under Passing Tunnel, 2.5 Traffic Lane Tunnel, Tehran, Iran

Authors: A. Golshani, M. Gharizade Varnusefaderani, S. Majidian

Abstract:

Underground structures are of those structures that have uncertainty in design procedures. That is due to the complexity of soil condition around. Under passing tunnels are also such affected structures. Despite geotechnical site investigations, lots of uncertainties exist in soil properties due to unknown events. As results, it possibly causes conflicting settlements in numerical analysis with recorded values in the project. This paper aims to report a case study on a specific under passing tunnel constructed by New Austrian Tunnelling Method in Iran. The intended tunnel has an overburden of about 11.3m, the height of 12.2m and, the width of 14.4m with 2.5 traffic lane. The numerical modeling was developed by a 2D finite element program (PLAXIS Version 8). Comparing displacement histories at the ground surface during the entire installation of initial lining, the estimated surface settlement was about four times the field recorded one, which indicates that some local unknown events affect that value. Also, the displacement ratios were in a big difference between the numerical and field data. Consequently, running several numerical back analyses using laboratory and field tests data, the geotechnical parameters were accurately revised to match with the obtained monitoring data. Finally, it was found that usually the values of soil parameters are conservatively low-estimated up to 40 percent by typical engineering judgment. Additionally, it could be attributed to inappropriate constitutive models applied for the specific soil condition.

Keywords: NATM, surface displacement history, numerical back-analysis, geotechnical parameters

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1796 Impacts of Hydrologic and Topographic Changes on Water Regime Evolution of Poyang Lake, China

Authors: Feng Huang, Carlos G. Ochoa, Haitao Zhao

Abstract:

Poyang Lake, the largest freshwater lake in China, is located at the middle-lower reaches of the Yangtze River basin. It has great value in socioeconomic development and is internationally recognized as an important lacustrine and wetland ecosystem with abundant biodiversity. Impacted by ongoing climate change and anthropogenic activities, especially the regulation of the Three Gorges Reservoir since 2003, Poyang Lake has experienced significant water regime evolution, resulting in challenges for the management of water resources and the environment. Quantifying the contribution of hydrologic and topographic changes to water regime alteration is necessary for policymakers to design effective adaption strategies. Long term hydrologic data were collected and the back-propagation neural networks were constructed to simulate the lake water level. The impacts of hydrologic and topographic changes were differentiated through scenario analysis that considered pre-impact and post-impact hydrologic and topographic scenarios. The lake water regime was characterized by hydrologic indicators that describe monthly water level fluctuations, hydrologic features during flood and drought seasons, and frequency and rate of hydrologic variations. The results revealed different contributions of hydrologic and topographic changes to different features of the lake water regime.Noticeable changes were that the water level declined dramatically during the period of reservoir impoundment, and the drought was enhanced during the dry season. The hydrologic and topographic changes exerted a synergistic effect or antagonistic effect on different lake water regime features. The findings provide scientific reference for lacustrine and wetland ecological protection associated with water regime alterations.

Keywords: back-propagation neural network, scenario analysis, water regime, Poyang Lake

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1795 Combined Effect of Therapeutic Exercises and Shock Wave versus Therapeutic Exercises and Phonophoresis in Treatment of Shoulder Impingement Syndrome: A Randomized Controlled Trial

Authors: Mohamed M. Mashaly, Ahmed M. F. El Shiwi

Abstract:

Background: Shoulder impingement syndrome is an encroachment of subacromial tissues, rotator cuff, subacromial bursa, and the long head of the biceps tendon, as a result of narrowing of the subacromial space. Activities requiring repetitive or sustained use of the arms over head often predispose the rotator cuff tendon to injury. Purpose: To compare between Combined effect therapeutic exercises and Shockwave therapy versus therapeutic exercises and phonophoresis in the treatment of shoulder impingement syndrome. Methods: Thirty patients diagnosed as shoulder impingement syndrome stage II Neer classification due to mechanical causes. Patients were randomly distributed into two equal groups. The first group consisted of 15 patients with a mean age of (45.46+8.64) received therapeutic exercises (stretching exercise of posterior shoulder capsule and strengthening exercises of shoulder muscles) and shockwave therapy (6000 shocks, 2000/session, 3 sessions, 2 weeks apart, 0.22mJ/mm^2) years. The second group consisted of 15 patients with a mean age of 46.26 (+ 8.05) received same therapeutic exercises and phonophoresis (3 times per week, each other day, for 4 consecutive weeks). Patients were evaluated pretreatment and post treatment for shoulder pain severity, shoulder functional disability, shoulder flexion, abduction and internal rotation motions. Results: Patients of both groups showed significant improvement in all the measured variables. In between groups difference the shock wave group showed a significant improvement in all measured variables than phonophoresis group. Interpretation/Conclusion: Combined effect of therapeutic exercises and shock wave were more effective than therapeutic exercises and phonophoresis on decreasing shoulder pain severity, shoulder functional disability, increasing in shoulder flexion, abduction, internal rotation in patients with shoulder impingement syndrome.

Keywords: shoulder impingement syndrome, therapeutic exercises, shockwave, phonophoresis

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1794 Current Trends in the Arabic Linguistics Development: Between National Tradition and Global Tendencies

Authors: Olga Bernikova, Oleg Redkin

Abstract:

Globalization is a process of worldwide economic, political and cultural integration. Obviously, this phenomenon has both positive and negative issues. This article analyzes the impact of the modern process of globalization on the national traditions of language teaching and research. In this context, the problem of the ratio of local to global can be viewed from several sides. Firstly, since English is the language of over 80 percent of scientific and technical research worldwide, what should be the language of science in certain region? Secondly, language 'globality' is not always associated with English, because intercultural communications may have their regional peculiarities. For example, in the Arab world, Modern Standard Arabic can also be regarded as 'global' phenomenon, since the mother-tongue languages of the population are local Arabic dialects. In addition, the correlation 'local' versus 'global' is manifested not only in the linguistic sphere but also in the methodology used in language acquisition and research. Thus, the major principles of the Arabic philological tradition, which goes back to the 7th century, are still spread in the modern Arab world. At the same time, the terminology and methods of language research that are peculiar to this tradition are quite far from the issues of general linguistics that underlies the description of all the languages of the world. The present research relies on a comparative analysis of sources in Arabic linguistics, including original works in Arabic dating back to the 12th-13th centuries. As a case study, interaction of local and global is also considered on the example of the Arabic teaching and research in Russia. Speaking about the correlation between local and global it is possible to forecast development of two parallel tendencies: the spread of the phenomena of globalization on one hand, and local implementation of a language policy aimed at preserving native languages, including Arabic, on the other.

Keywords: Arabic, global, language, local, tradition

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1793 Female Masochism, Jouissance, and (Re)workings of Trauma: An Ethnographic Study of the Bondage, Discipline, Dominance, Submission, Sadism, and Masochism Scene in Post-WWII Japan

Authors: Maari Sugawara

Abstract:

This ethnographic research interrogates female masochism within contemporary Japan, focusing on fifteen female BDSM (Bondage, Discipline, Dominance, Submission, Sadism, and Masochism) practitioners who identify as masochists, bottoms, and/or submissives. The study employs semi-structured interviews with these practitioners, representing diverse backgrounds and ages, to explore the intersection of sexuality and individual and/or collective trauma. The study focuses on a specific group of sadomasochists who, as survivors of gender and sexual violence, reenact their trauma through BDSM practices. This exploration draws on feminist performance studies, postcolonial studies, psychoanalysis, and affect analysis to highlight the complexities of female masochism. In a cultural milieu that often reduces female masochism to mere compliance with heteropatriarchy, this study argues that specific masochistic practices transcend submission, serving as vital strategies for confronting trauma and dismantling entrenched cultural narratives. Engaging with Lacan’s concept of feminine jouissance and the notion of "creative masochism" in the context of Japan's proximity to the imperial US, the study facilitates a nuanced exploration of female masochistic enjoyment. The study shows that these practices can act as both a means of survival and a mode of resilience, challenging dominant narratives that portray masochism solely as a form of subjugation, drawing on feminist performance studies, postcolonial studies, psychoanalysis, and affect analysis. It interprets masochism as a complex terrain of affective engagement, where shared suffering and consensual pain foster transformative possibilities. By analyzing BDSM as a cultural site, this research reframes masochism not only as a personal negotiation of pain but also as a broader allegory for Japan’s ongoing geopolitical self-positioning. Central to this analysis is the concept of "creative masochism," which positions masochism as both a metaphor and a practice through which Japan addresses its historical subordination to the United States. This framework allows for a deeper understanding of how participants' lived desires intersect with national narratives, illuminating the relationship between personal experiences and larger socio-political dynamics. It incorporates sadomasochistic metaphors into Japan-U.S. interactions, reflecting underlying patterns of submission, resistance, and cultural negotiation. Additionally, this research examines the effects, affects, and limitations of masochism within the post-WWII Japanese context, providing insights into how masochism can reshape one's relationship with their surroundings. This study challenges the notion that female masochism is entirely subsumed by hegemonic structures, revealing instead that subjects can assert their autonomy within their experiences of pleasure and pain. The consensual enactment of violence within these encounters emerges as a complex and ambivalent process, wherein pain transforms into a generative force for reimagining alternative forms of sociality and belonging. Additionally, the research identifies contradictions and connections between the personal and political, examining how kink practices shape participants' daily lives and identities, and vice versa, highlighting the profound impact of these practices on their sense of self and community. Ultimately, it reaffirms agency in the face of pervasive heteronormative power dynamics, suggesting that masochism can serve as a site of both resistance and redefinition.

Keywords: female masochism, BDSM, Japan, masochism, trauma, sexual violence

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1792 Primary Fallopian Tube Carcinoma: A Case Report

Authors: Mary Abigail T. Ty, Mary Jocelyn Yu-Laygo, Jocelyn Z. Mariano

Abstract:

This is a case of L.S.T., a 61 year old, G6P4 (3124) who presented with a one month history of intermittent, brownish, watery, non foul smelling vaginal discharge. There were no other accompanying symptoms. On rectovaginal examination, a palpable adnexal mass on the left was appreciated, with the lower border measuring 3 cm. The mass was non-tender, had irregular borders and solid areas. On transvaginal sonography, it revealed a left pelvic mass measuring 3 x 4 x 2 cm, with a Sassone score of 9. It had vascularization. The primary consideration was Ovarian Newgrowth, probably malignant in nature. CA-125 results were slightly elevated at 43.2 u/ml (NV: 0-35 u/ml). After intraoperative evaluation, the left fallopian tube was converted into a 9 x 4.5 x 3 cm bulbous cystic mass with solid areas. On cut section, the ampullary portion of the fallopian tube contained necrotic and friable looking tissues. Specimen was sent for frozen section and results revealed adenocarcinoma of the left fallopian tube. Patient subsequently underwent complete surgical staging with unremarkable post-operative course. The Surg Ico pathologic diagnosis was G6P4 (3124) Fallopian tube serous cystadenocarcinoma stage 1. The mean incidence of PFTC is 3.6 per million women yearly. This is associated with a generally low survival rate. The primary diagnosis is very difficult to establish because only 0–10% of patients suffering from PFTC are diagnosed pre-operatively. Symptoms play a very important role in the discovery of this disease, because there will be no presentation to the hospital without symptoms. The most common of which may be vaginal bleeding, abdominal pain, a palpable mass and ascites. A conglomerate of manifestations may be encountered, but not at all times. This is termed hydrops tubae profluens where there is presence of colicky pain with relief from intermittent passage of serosanguinous vaginal discharge. The significance of this report is to emphasize the rarity of the case and how the dilemma in the diagnosis is almost always present despite ancillary procedures.

Keywords: fallopian tube carcinoma, prognosis, rare, risk factors

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1791 Back Extraction and Isolation of Alkaloids from Ionic Liquid-Based Extracts

Authors: Rozalina Keremedchieva, Ivan Svinyarov, Milen G. Bogdanov

Abstract:

In continuation of a research project on the application of ionic liquids (ILs) as an alternative to the conventional organic solvents used in the recovery of value added chemicals of industrial interest1-3 we developed a procedure for back extraction and isolation in pure form of the biologically active alkaloid glaucine from IL-based aqueous solutions. One of the approaches applied was the formation of two-phase systems (IL-ATPS) by the addition of kosmotropic salts to the plant extract. The ability of the salts (Na2CO3, MgSO4, (NH4)2SO4, NaH2PO4) to induce the formation of two-phase systems and the influence of pH value on the partition coefficients of glaucine was comprehensively studied. As a result, it was found that the target alkaloid is preferably partitioned into the IL-rich phase regardless of the pH value of the medium and thus shows the inapplicability of the approach used for the isolation of the target compound from the ionic liquid. However, the results obtained can be used as a platform for the development of an analytical method for the quantitative determination of low concentrations of glaucine in biological samples. We further examined the ability of a series of organic solvents such as diethyl ether, Tert-butylmethyl ether, ethyl acetate, butyl acetate, toluene, chloroform, dichloromethane to recover glaucine form raw IL-based aqueous extracts. Optimal conditions for quantitative extraction of glaucine into chloroform were found from which, after removal of the solvent and subsequent recrystallization from ethanol, the target compound was isolated in a high purity as a hydrobromide salt – The form in which it entrance as an active ingredient in various medicines.

Keywords: natural products, ionic liquids, solid-liquid extraction, liquid-liquid extraction

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1790 The Democracy of Love and Suffering in the Erotic Epigrams of Meleager

Authors: Carlos A. Martins de Jesus

Abstract:

The Greek anthology, first put together in the tenth century AD, gathers in two separate books a large number of epigrams devoted to love and its consequences, both of hetero (book V) and homosexual (book XII) nature. While some poets wrote epigrams of only one genre –that is the case of Strato (II cent. BC), the organizer of a wide-spread garland of homosexual epigrams –, several others composed within both categories, often using the same topics of love and suffering. Using Plato’s theorization of two different kinds of Eros (Symp. 180d-182a), the popular (pandemos) and the celestial (ouranios), homoerotic epigrammatic love is more often associated with the first one, while heterosexual poetry tends to be connected to a higher form of love. This paper focuses on the epigrammatic production of a single first-century BC poet, Meleager, aiming to look for the similarities and differences on singing both kinds of love. From Meleager, the Greek Anthology –a garland whose origins have been traced back to the poet’s garland itself– preserves more than sixty heterosexual and 48 homosexual epigrams, an important and unprecedented amount of poems that are able to trace a complete profile of his way of singing love. Meleager’s poetry deals with personal experience and emotions, frequently with love and the unhappiness that usually comes from it. Most times he describes himself not as an active and engaged lover, but as one struck by the beauty of a woman or boy, i.e., in a stage prior to erotic consummation. His epigrams represent the unreal and fantastic (literally speaking) world of the lover, in which the imagery and wordplays are used to convey emotion in the epigrams of both genres. Elsewhere Meleager surprises the reader by offering a surrealist or dreamlike landscape where everyday adventures are transcribed into elaborate metaphors for erotic feeling. For instance, in 12.81, the lovers are shipwrecked, and as soon as they have disembarked, they are promptly kidnapped by a figure who is both Eros and a beautiful boy. Particularly –and worth-to-know why significant – in the homosexual poems collected in Book XII, mythology also plays an important role, namely in the figure and the scene of Ganimedes’ kidnap by Zeus for his royal court (12. 70, 94). While mostly refusing the Hellenistic model of dramatic love epigram, in which a small everyday scene is portrayed –and 5. 182 is a clear exception to this almost rule –, Meleager actually focuses on the tumultuous inside of his (poetic) lovers, in the realm of a subject that feels love and pain far beyond his/her erotic preferences. In relation to loving and suffering –mostly suffering, it has to be said –, Meleager’s love is therefore completely democratic. There is no real place in his epigrams for the traditional association mentioned before between homoeroticism and a carnal-erotic-pornographic love, while the heterosexual one being more evenly and pure, so to speak.

Keywords: epigram, erotic epigram, Greek Anthology, Meleager

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1789 Comparative Efficacy of Prolene and Polyester Mesh for the Repair of Abdominal Wall Defect in Pigeons (Columba livia)

Authors: Muhammad Naveed Ali, Hamad Bin Rashid, Muhammad Arif Khan, Abdul Basit, Hafiz Muhammad Arshad

Abstract:

Abdominal defects are very common in pigeons. A new technique is known as intraabdominal mesh transplant that give better protection for herniorrhaphy. The aim of this study was to determine the performance of hernia mesh. In this study, an efficacy of two synthetic hernia mesh implants viz. conventional Prolene and a lightweight mesh monofilament polyester were assessed for the abdominal wall repair in pigeons. Twenty four healthy pigeons were selected and randomly distributed into three groups, A, B and C (n=8). In all groups, experimental laparotomy was performed; thereafter, abdominal muscles and peritoneum were sutured together, while, a 2 x 2 cm defect was created in the abdominal muscles. For onlay hernioplasty, the hernia mesh (Prolene mesh: group A; Polyester mesh: group B) was implanted over the external oblique muscles of the abdomen. In group C (control), the mesh was not implanted; instead, the laparotomy incision was closed after a herniorrhaphy. Post-operative pain wound healing, adhesion formation, histopathological findings and formation of hematoma, abscess and seroma were assessed as short-term complications. Post-operatively, pain at surgical site was significantly less (P < 0.001) in group B (Polyester mesh); wound healing was also significantly better and rapid in group B (P < 0.05) than in group A (Prolene mesh). Group B (Polyester mesh) also depicted less than 25% adhesions when assessed on the basis of a Quantitative Modified Diamond scale; a Qualitative Adhesion Tenacity scale also depicted either no adhesions or flimsy adhesions (n=2) in group B (Polyester mesh), in contrast to group A (Prolene), which manifested greater adhesion formation and presence of dense adhesions requiring blunt dissection. There were observed hematoma, seroma and abscess formations in birds treated by Prolene mesh only. Conclusively, the polyester mesh proved superior to the Prolene mesh regarding lesser adhesion, better in wound healing, and no short-term follow-up complications.

Keywords: adhesion, mesh, polyester, prolene

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