Search results for: cardiovascular disease risk

Authors: Joshua Loiselle

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This paper discusses the challenges engineering teams face in conducting Failure Modes and Effects Analysis (FMEA) studies. This paper focuses on the specific topic of improving the efficiency and effectiveness of FMEA studies. Modern economic needs and increased business competition require engineers to constantly develop newer and better solutions within shorter timeframes and tighter margins. In addition, documentation requirements for meeting standards/regulatory compliance and customer needs are becoming increasingly complex and verbose. Managing open actions and continuous improvement activities across all projects, product variations, and processes in addition to daily engineering tasks is cumbersome, time consuming, and is susceptible to errors, omissions, and non-conformances. FMEA studies are proven methods for improving products and processes while subsequently reducing engineering workload and improving machine and resource availability through a pre-emptive, systematic approach of identifying, analyzing, and improving high-risk components. If implemented correctly, FMEA studies significantly reduce costs and improve productivity. However, the value of an effective FMEA is often shrouded by a lack of clarity and structure, misconceptions, and previous experiences and, as such, FMEA studies are frequently grouped with the other required information and documented retrospectively in preparation of customer requirements or audits. Performing studies in this way only adds cost to a project and perpetuates the misnomer that FMEA studies are not value-added activities. This paper discusses the benefits of effective FMEA studies, the challenges related to conducting FMEA studies, best practices for efficiently overcoming challenges via structure and automation, and the benefits of implementing those practices.

Keywords: FMEA, quality, APQP, PPAP

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Authors: Sayed Ali Garossi, Azar Heidarizadi, Shahla Mohammad Ganji

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Context: Colorectal cancer is the second type of cancer-related mortality globally. Expression of cas8 (caspase 8) is closely connected to growth and metastasis of colorectal cancer.Cas8/Rip1 plays a vital role in the apoptosis pathway and resistance to chemotherapy. The aim of the present study is to investigate the pattern of gene expression in colorectal cancer and compare the differences using Real-Time PCR to find a potential biomarker candidate for colorectal cancer. Methodology: This study conducted real-time PCR to evaluate gene expression of Cas8 in colorectal cancer patients. The gene-specific primer sequences exon–exon junction was designed by OLIGO7 software for the expression of the gene under investigation. Forty-six patient samples without any chemotherapy were selected, including tumoral tissue and adjacent normal tissue samples. The age of the patients was 50 and the size of the tumors was 5.5 cm. The categories were before and after age 50. Findings: Here, we found that Caspase 8 was overexpressed in CRC tissues compared to corresponding adjacent colon tissues (Cas8: 5.2 vs. 1 ratio); high expression of Cas8 was associated with poor overall survival and independent risk factors for the prognosis of CRC patients. Conclusion: In conclusion, our study pioneered the reporting of high Casp8 expression as a predictor of poor prognosis and chemical resistance in CRC patients.Cas8 overexpression suppressed Cas 8 / Rip1-dependent apoptosis and activated the proliferation of tumor cells by activating necroptosis. The necroptosis pathway has also emerged as a new approach to anti-tumor in cancer treatment.

Keywords: Cas8, necroptosis, apoptosis, Real-Time PCR

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Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi

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Purpose: Advanced Glaucoma with Failed trab is not an uncommon sight in glaucoma clinic, and such cases usually tend to present with high intraocular pressure (IOP) and advanced cupping, or even glaucomatous atrophy stage. Re-surgery is needed for such cases, and wound modulation poses a major challenge in these cases. We share our experience in this case series with the use of Ologen (collagen matrix implant) along with MMC 0.04% used in surgery. The purpose of the study was to evaluate the efficacy and outcome of collagen matrix implant in re-trabeculectomy in advanced glaucoma cases. Methodology: Eleven eyes of 11 patients (one eye of one patient) underwent re-trabeculectomy surgery with MMC and Ologen. Ologen implant was used in sub scleral and subconjunctival space, as a spacer and wound modulator. In five cases, triple modulation with implant soaked in anti-VEGF was used. Results: All patients had cupping more than 0.9, and one case was GOA. All cases were on maximal medication at presentation and majority were on systemic anti-glaucoma therapy also. Post-surgery, follow-up ranged from 13 – 34 months, and all cases had a follow longer than the gap between previous surgery (which was failed) and re-trab. One case needed AC reformation and one needling was done. Phaco was done at same sitting in four cases. All cases had their IOP lowered post surgery, and vision was maintained in all, however one case was considered as failed re-surgery case. Topical medication was needed in seven cases post-surgery also. Conclusion: Ologen as adjuvant should be considered in all re-trab cases and all high risk and advanced cases, and triple modulation can be next step in these cases. Aggressive IOP control and non- reluctance to continue topical medications post second surgery should be considered in such cases, to give them best possible vision.

Keywords: failed trabeculectomy, ologen, trabeculectomy, advanced glaucoma

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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People with diabetes mellitus are more susceptible to developing infections, as high blood sugar levels can weaken the patient's immune system defences. People with diabetes are more adversely affected when they get an infection than someone without the disease, because you have weakened immune defences in diabetes. People who have minimally elevated blood sugar levels experience worse outcomes with infections. Diabetic patients in hospitals do not necessarily have a higher mortality rate due to infections, but they do face longer hospitalisation and recovery times. A study was done in a tertiary care unit in eastern India. Patients with type 2 diabetes mellitus infection were recruited in the study. A total of 520 cases of Type 2 Diabetes Mellitus were recorded out of which 200 infectious cases was included in the study. All subjects underwent detailed history & clinical examination. Microbiological samples were collected from respective site of the infection for microbial culture and antibiotic sensitivity test. Out of the 200 infectious cases urinary tract infection(UTI) was found in majority of the cases followed by diabetic foot ulcer (DFU), respiratory tract infection(RTI) and sepsis. It was observed that Escherichia coli was the most commonest pathogen isolated from UTI cases and Staphylococcus aureus was predominant in foot ulcers followed by other organisms. Klebsiella pneumonia was the major organism isolated from RTI and Enterobacter aerogenes was commonly observed in patients with sepsis. Isolated bacteria showed differential sensitivity pattern against commonly used antibiotics. The majority of the isolates were resistant to several antibiotics that are usually prescribed on an empirical basis. These observations are important, especially for patient management and the development of antibiotic treatment guidelines. It is recommended that diabetic patients receive pneumococcal and influenza vaccine annually to reduce morbidity and mortality. Appropriate usage of antibiotics based on local antibiogram pattern can certainly help the clinician in reducing the burden of infections.

Keywords: antimicrobial resistance, diabetic foot ulcer, respiratory tract infection, urinary tract infection

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Authors: Michael P. Mannino, Gerald W. Hart

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The majority of glucose metabolism proceeds through glycolytic pathways such as glycolysis or pentose phosphate pathway, however, about 5% is shunted through the hexosamine biosynthetic pathway, producing uridine diphosphate N-acetyl glucosamine (UDP-GlcNAc). This precursor can then be incorporated into complex oligosaccharides decorating the cell surface or remain as an intracellular post-translational-modification (PTM) of serine/threonine residues (O-GlcNAcylation, OGN), which has been identified on over 4,000 cytosolic or nuclear proteins. Intracellular OGN has major implications on cellularprocesses, typically by modulating protein localization, protein-protein interactions, protein degradation, and gene expression. Additionally, OGN is known to have an extensive cross-talk with phosphorylation, be in a competitive or cooperative manner. Unlike other PTMs there are only two cycling enzymes that are capable of adding or removing the GlcNAc moiety, O-linked N-aceytl glucosamine Transferase (OGT) and O-linked N-acetyl glucoamidase (OGA), respectively. The activity of OGT has been shown to be sensitive to cellular UDP-GlcNAc levels, even changing substrate affinity. Owing to this and that the concentration of UDP-GlcNAc is related to the metabolisms of glucose, amino acid, fatty acid, and nucleotides, O-GlcNAc is often referred to as a nutrient sensing rheostat. Indeed OGN is known to regulate several signaling pathways as a result of nutrient levels, such as insulin signaling. Dysregulation of OGN is associated with several disease states such as cancer, diabetes, and neurodegeneration. Improvements in glycomics over the past 10-15 years has significantly increased the OGT substrate pool, suggesting O-GlcNAc’s involvement in a wide variety of signaling pathways. However, O-GlcNAc’s role at the receptor level has only been identified in a case-by-case basis of known pathways. Examining the OGN of the plasma membrane (PM) may better focus our understanding of O-GlcNAc-effected signaling pathways. In this current study, PM fractions were isolated from several cell types via ultracentrifugation, followed by purification and MS/MS analysis in several cell lines. This process was repeated with or without OGT/OGA inhibitors or with increased/decreased glucose levels in media to ascertain the importance of OGN. Various pathways are followed up on in more detailed studies employing methods to localize OGN at the PM specifically.

Keywords: GlcNAc, nutrient sensitive, post-translational-modification, receptor

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Authors: Vincenzo Piemonte

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The liver is a complex, large-scale biochemical reactor which plays a unique role in the human physiology. When liver ceases to perform its physiological activity, a functional replacement is required. Actually, liver transplantation is the only clinically effective method of treating severe liver disease. Anyway, the aforementioned therapeutic approach is hampered by the disparity between organ availability and the number of patients on the waiting list. In order to overcome this critical issue, research activities focused on liver support device systems (LSDs) designed to bridging patients to transplantation or to keep them alive until the recovery of native liver function. In recirculating albumin dialysis devices, such as MARS (Molecular Adsorbed Recirculating System), adsorption is one of the fundamental steps in albumin-dialysate regeneration. Among the albumin-bound toxins that must be removed from blood during liver-failure therapy, bilirubin and tryptophan can be considered as representative of two different toxin classes. The first one, not water soluble at physiological blood pH and strongly bounded to albumin, the second one, loosely albumin bound and partially water soluble at pH 7.4. Fixed bed units are normally used for this task, and the design of such units requires information both on toxin adsorption equilibrium and kinetics. The most common adsorptive media used in LSDs are activated carbon, non-ionic polymeric resins and anionic resins. In this paper, bilirubin adsorption isotherms on different adsorptive media, such as polymeric resin, albumin-coated resin, anionic resin, activated carbon and alginate beads with entrapped albumin are presented. By comparing all the results, it can be stated that the adsorption capacity for bilirubin of the five different media increases in the following order: Alginate beads < Polymeric resin < Albumin-coated resin < Activated carbon < Anionic resin. The main focus of this paper is to provide useful guidelines for the optimization of liver support devices which implement adsorption columns to remove albumin-bound toxins from albumin dialysate solutions.

Keywords: adsorptive media, adsorption equilibrium, artificial liver devices, bilirubin, mathematical modelling

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Authors: Odey Moses Ogah, Felix Terhemba Ikyereve

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The study was carried out to analyzed risks in financing agriculture by agricultural cooperatives in Benue State, Nigeria. The study made use of research questionnaires for data collection. A multistage sampling technique was used to select a sample of 210 respondents from 21 agricultural cooperatives. Both descriptive and inferential statistics were employed in data analysis. Loan defaulting (66.7%) and reduction in savings by members (51.4%) were the major causes of risks faced by agricultural cooperatives in financing agriculture in the study area. Other causes include adverse changes in commodity prices (48.6%), disaster (45.7%), among others. It was found that risks adversely influence the profitability and competition of agricultural cooperatives (82.9%). Multiple regression analysis results showed that the coefficient of multiple determinations was 0.67, implying that the explanatory variables included in the model accounted for 67% of the variation in the level of profitability of agricultural cooperatives. The number of loans, average amount of loan and the interest rate were significant and important determinants of profitability of the cooperatives. The majority of the respondents (88.6%) made use of loan guarantors as a strategy of managing loan default/no repayment. It was found that the majority (70%) of the respondents were faced with the challenge of lack of insurance cover. The study recommends that agricultural cooperative officials should be encouraged to undergo formal training and education to easily acquire administrative skills in the management of agricultural loans; Farmer's loan size should be increased and released on time to enable them to use it effectively. Policies that enhance insuring farm activities should be put in place to discourage farmers from risk aversion.

Keywords: agriculture, analysis, cooperative, finance, risks

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Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

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Authors: Ghada M. El-Kassas, Maged A. El Wakeel, Salwa R. El-Zayat

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Background: Environmental enteric dysfunction (EED) is asymptomatic villous atrophy of the small bowel that is prevalent in the developing world and is associated with altered intestinal function and integrity. Evidence has suggested that supplementary omega-3 might ameliorate this damage by reducing gastrointestinal inflammation and may also benefit cognitive development. Objective: We tested whether omega-3 supplementation improves intestinal integrity, growth, and cognitive function in stunted children predicted to have EED. Methodology: 100 Egyptian stunted children aged 1-5 years and 100 age and gender-matched normal children as controls. At the primary phase of the study, we assessed anthropometric measures and fecal markers such as myeloperoxidase (MPO), neopterin (NEO), and alpha-1-anti-trypsin (AAT) (as predictors of EED). Cognitive development was assessed (Bayley or Wechsler scores). Oral n-3 (omega-3) LC-PUFA at a dosage of 500 mg/d was supplemented to all cases and followed up for 6 months after which the 2ry phase of the study included the previous clinical, laboratory and cognitive assessment. Results: Fecal inflammatory markers were significantly higher in cases compared to controls. (MPO), (NEO) and (AAT) showed a significant decline in cases at the end of the 2ry phase (P < 0.001 for all). Omega-3 supplementation resulted also in a significant increase in mid-upper arm circumference (MUAC) (P < 0.01), weight for age z-score, and skinfold thicknesses (P< 0.05 for both). Cases showed significant improvement of cognitive function at phase 2 of the study. Conclusions: Omega-3 supplementation successfully improved intestinal inflammatory state related to EED. Also, some improvement of anthropometric and cognitive parameters showed obvious improvement with omega-3 supplementation.

Keywords: cognitive functions, EED, omega-3, stunting

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Authors: Zhaopeng Zhu, Xianzhi Song, Gensheng Li, Shuo Zhu, Shiming Duan, Xuezhe Yao

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Accurate calculation of wellbore pressure is of great significance to prevent wellbore risk during drilling. The traditional mechanism model needs a lot of iterative solving procedures in the calculation process, which reduces the calculation efficiency and is difficult to meet the demand of dynamic control of wellbore pressure. In recent years, many scholars have introduced artificial intelligence algorithms into wellbore pressure calculation, which significantly improves the calculation efficiency and accuracy of wellbore pressure. However, due to the ‘black box’ property of intelligent algorithm, the existing intelligent calculation model of wellbore pressure is difficult to play a role outside the scope of training data and overreacts to data noise, often resulting in abnormal calculation results. In this study, the multi-phase flow mechanism is embedded into the objective function of the neural network model as a constraint condition, and an intelligent prediction model of wellbore pressure under the constraint condition is established based on more than 400,000 sets of pressure measurement while drilling (MPD) data. The constraint of the multi-phase flow mechanism makes the prediction results of the neural network model more consistent with the distribution law of wellbore pressure, which overcomes the black-box attribute of the neural network model to some extent. The main performance is that the accuracy of the independent test data set is further improved, and the abnormal calculation values basically disappear. This method is a prediction method driven by MPD data and multi-phase flow mechanism, and it is the main way to predict wellbore pressure accurately and efficiently in the future.

Keywords: multiphase flow mechanism, pressure while drilling data, wellbore pressure, mechanism constraints, combined drive

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Authors: Abeer Mohammed, Nevein Mustafa Elashery, Mona Hassan Abdel Aal, Ereny Wilson Nagib

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The Aim of the current study is to investigate nutrition role in the management of psychiatric disorders. Research Design: A quasi- experimental research design was utilized for this study. Setting The study was conducted at outpatient clinic at Institute of Psychiatry affiliated to Ain Shams University hospitals, using a convenient sample of 50 psychiatric patients with depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders. Tools: data were collected through; first, an interview questionnaire covering socio-demographic characteristics, second, nutrition assessment tools Third, nutrition risk assessment. Fourth, nutrition management program Results showed that there were highly statistically significant improvements in modified nutritional supplements for patients with depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders' patients after conducting the nutrition management program. Regarding psychiatric patients’ knowledge about healthy food, healthy nutritional habits, and patients’ awareness & readiness for change, there were highly statistically significant improvements. Concerning signs and symptoms of psychiatric disorders, there were highly statistically significant improvements for depression, schizophrenia, bipolar disorders, and obsessive-compulsive patients after conducting the management program. In conclusion, the nutrition management program was effective in improving symptoms associated with, depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders. The study recommended that nurses should have more contribution in counseling psychiatric patients, and their families about healthy diet and healthy habits. Further research should recommend studying the effectiveness of herbs on enhancing mental health for psychiatric patients.

Keywords: nutrition, role, management, psychiatric disorders

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Authors: Maia Kukhaleishvili, Ekaterine Bulauri, Iveta Megrelishvili, Tamar Shamatava, Tamar Chipashvili

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Plant viruses can cause loss of yield and quality in a lot of important crops. Symptoms of pathogens are variable depending on the cultivars and virus strain. Selection of resistant potato varieties would reduce the risk of virus transmission and significant economic impact. Other way to avoid reduced harvest yields is regular potato seed production sampling and testing for viral infection. The aim of this study was to determine the occurrence and distribution of viral diseases according potato cultivars for further selection of virus-free material in Georgia. During the summer 2015- 2016, 5 potato cultivars (Sante, Laura, Jelly, Red Sonia, Anushka) at 5 different farms located in Akhalkalaki were tested for 6 different potato viruses: Potato virus A (PVA), Potato virus M (PVM), Potato virus S (PVS), Potato virus X (PVX), Potato virus Y (PVY) and potato leaf roll virus (PLRV). A serological method, Double Antibody Sandwich-Enzyme linked Immunosorbent Assay (DASELISA) was used at the laboratory to analyze the results. The result showed that PVY (21.4%) and PLRV (19.7%) virus presence in collected samples was relatively high compared to others. Researched potato cultivars except Jelly and Laura were infected by PVY with different concentrations. PLRV was found only in three potato cultivars (Sante, Jelly, Red Sonia) and PVM virus (3.12%) was characterized with low prevalence. PVX, PVA and PVS virus infection was not reported. It would be noted that 7.9% of samples were containing PVY/PLRV mix infection. Based on the results it can be concluded that PVY and PLRV infections are dominant in all research cultivars. Therefore significant yield losses are expected. Systematic, long-term control of potato viral infection, especially seed-potatoes, must be regarded as the most important factor to increase seed productivity.

Keywords: virus, potato, infection, diseases

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Authors: Ana Maria Carmen Ilie, Carmela Vaccaro

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Gas migration through wellbore failure, in particular from abandoned wells, is repeatedly identified as the highest risk mechanism. The vadose zone was subject to monitoring system close to the wellbore in Minerbio, methane storage site. The new technology has been well-developed and used with the purpose to provide reliable estimates of leakage parameters. Of these techniques, soil flux sampling at the soil surface, via the accumulation chamber method and soil flux sampling at the depths of 100cm below the ground surface, have been an important technique for characterizing the gas concentrations at the gas storage site. We present results of soil Radon Bq/m3, CO2%, CH4% and O2% concentration gases. Measurements have been taken for radon concentrations with an Durridge RAD7 Company, Inc., USA, instrument. We used for air and soil quality an Biogas ETG instrument monitoring system, with NDIR CO2, CH4 gas sensor and electrochemical O2 gas sensor. The measurements started in September-October 2015, where no outliers have been identified. The measurements have continued in March-April-July-August-September 2016, almost at the same time in the same place around the gas storage site, values measured 15 minutes for each sampling, to determine their concentration, their distribution and to understand the relationship among gases and atmospheric conditions. At a depth of 100 cm, the maximum soil radon gas concentrations were found to be 1770 ±±582 Bq/m3, the soil consists of 64.31% sand, 20.75% silt and 14.94% clay, and with 0.526 ppm of Uranium. The maximum concentration (September 2016), in soil at 100cm below the ground surface, with 83% sand, 8.96% silt and 7.89% clay, was about 0.06% CH4, and in atmosphere 0.06% CH4 at 40°C (T). In the other months the values have been on the range of 0.01% to 0.03% CH4. Since we did not have outliers in the gas storage site, soil-gas samples for isotopic analysis have not been done.

Keywords: leakage gas monitoring, lithology, soil gas, methane

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Authors: Massimiliano Frezza, Sergio Bianchi, Augusto Pianese

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Introduced by Shannon in 1948 in the field of information theory as the average rate at which information is produced by a stochastic set of data, the concept of entropy has gained much attention as a measure of uncertainty and unpredictability associated with a dynamical system, eventually depicted by a stochastic process. In particular, the Shannon entropy measures the degree of order/disorder of a given signal and provides useful information about the underlying dynamical process. It has found widespread application in a variety of fields, such as, for example, cryptography, statistical physics and finance. In this regard, many contributions have employed different measures of entropy in an attempt to characterize the financial time series in terms of market efficiency, market crashes and/or financial crises. The Shannon entropy has also been considered as a measure of the risk of a portfolio or as a tool in asset pricing. This work investigates the theoretical link between the Shannon entropy and the multifractional Brownian motion (mBm), stochastic process which recently is the focus of a renewed interest in finance as a driving model of stochastic volatility. In particular, after exploring the current state of research in this area and highlighting some of the key results and open questions that remain, we show a well-defined relationship between the Shannon (log)entropy and the memory function H(t) of the mBm. In details, we allow both the length of time series and time scale to change over analysis to study how the relation modify itself. On the one hand, applications are developed after generating surrogates of mBm trajectories based on different memory functions; on the other hand, an empirical analysis of several international stock indexes, which confirms the previous results, concludes the work.

Keywords: Shannon entropy, multifractional Brownian motion, Hurst–Holder exponent, stock indexes

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Authors: Worku Dejene Bekele, András Marczika Csilla Sörös

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Silver nanoparticles are silver metal with a size of 1-100nm. The most common source of silver nanoparticles is inorganic salts. Nanoparticles can be ingested through our foods and constitute nanoparticles and silver ions, whether as an additive or by migrants and, in some cases, as a pollutant. Silver nanoparticles are the most widely applicable engineered nanomaterials, especially for antimicrobial function. Ag nanoparticles give different advantages in the case of food safety, quality, and overall acceptability; however, they affect the health of humans and animals, putting them at risk of health problems and environmental pollution. Silver nanoparticles have been used widely in food packaging technologies, especially in water treatments, meat and meat products, fruit, and many other food products. This is for bio-preservation from food products. The primary goal of this review is to determine the safety and health impact of Ag nanoparticles application in food packaging and analysis of the human organs more affected by this preservative technology, to assess the implications of a nanoparticle on food safety, to determine the effects of nanoparticles on consumers health and to determine the impact of nanotechnology on product acceptability. But currently, much research has demonstrated that there is cause to believe that silver nanoparticles may have toxicological effects on biological organs and systems. The silver nanoparticles affect DNA expression, gastrointestinal barriers, lungs, and other breathing organs illness. Silver particles and molecules are very toxic. During its application in food packaging, food industries used the thinnest particle. This particle can potentially affect the gastrointestinal tracts-it suffers from mucus production, DNA, lungs, and other breezing organs. This review is targeted to demonstrate the knowledge gap that industrials use in the application of silver nanoparticles in food packaging and preservation and its health effects on the consumer.

Keywords: food preservatives, health impact, nanoparticle, silver nanoparticle

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Authors: Ian Omung'a

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Breast cancer remains to be one of the deadliest cancers for women worldwide, with the risk of developing tumors being as high as 50 percent in Sub-Saharan African countries like Kenya. With as many as 42 percent of these cases set to be diagnosed late when cancer has metastasized and or the prognosis has become terminal, Full Field Digital [FFD] Mammography remains an effective screening technique that leads to early detection where in most cases, successful interventions can be made to control or eliminate the tumors altogether. FFD Mammograms have been proven to multiply more effective when used together with Computer-Aided Detection and Diagnosis [CADe] systems, relying on algorithmic implementations of Deep Learning techniques in Computer Vision to carry out deep pattern recognition that is comparable to the level of a human radiologist and decipher whether specific areas of interest in the mammogram scan image portray abnormalities if any and whether these abnormalities are indicative of a benign or malignant tumor. Within this paper, we review emergent Deep Learning techniques that will prove relevant to the development of State-of-The-Art FFD Mammogram CADe systems. These techniques will span self-supervised learning for context-encoded occlusion, self-supervised learning for pre-processing and labeling automation, as well as the creation of a standardized large-scale mammography dataset as a benchmark for CADe systems' evaluation. Finally, comparisons are drawn between existing practices that pre-date these techniques and how the development of CADe systems that incorporate them will be different.

Keywords: breast cancer diagnosis, computer aided detection and diagnosis, deep learning, whole mammogram classfication, ultrasound classification, computer vision

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Authors: S. Kershaw, P. J. Barry, K. Webb

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Background: Cystic Fibrosis (CF) is a chronic lung disease where patients have chronic lung infection punctuated by acute exacerbations that require intermittent intravenous (IV) antibiotics during their lives. With time, peripheral venous access can become difficult and limited. Accessing these veins can become arduous, traumatic, painful and unworkable. A permanent intravascular access device or Port is a small device that is inserted into the central venous system that allows the delivery of medicine eliminating the need for peripheral venous access. Ports represent a convenient and efficient method when venous access is required on a permanent basis however they are also associated with significant vascular complications. Superior Vena Cava Obstruction (SVCO) is a rare but significant vascular complication of ports in this setting. Objective: We aimed to look at a single CF centre’s experience of port-related SVCO over a thirty year period. Methods: Retrospective data was extracted using patient’s notes, electronic radiological reports and local databases over a period in excess of 30 years from 1982 to 2014. Results: 13 patients were identified with SVCO as a result of their port. 11 patients had CF (9 female, 2 male), one male patient had Primary Ciliary Dyskinesia and one female patient had severe Asthma. The mean port function was 1532 days (range 110 – 4049) and the mean age at SVCO was 24 years (range 11.1 to 36.5 years). The most common symptoms were facial oedema (n=8, 61.5%) and dilated veins (n=6, 46.2%). 7 patients had their Ports removed after SVCO. 6 patients underwent attempted stenting (46.2%) and 6 did not. 4 out of the 6 who underwent stenting required/had re-intervention. 3 of the 6 patients who underwent stenting had symptom resolution, however, 4 of the 6 patients who were not stented had symptom resolution also. Symptom resolution was not guaranteed with stenting and required re-intervention in two-thirds. Conclusion: This case series represents the experience of one of the longest established CF units in the UK and represents the largest cohort ever reported in the literature.

Keywords: ports, Superior Vena Cava Obstruction, cystic fibrosis, access devices

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Authors: Mike T. Wei, Douglas N. Mintz, Lisa A. Mandl, Arielle W. Fein, Jayme C. Burket, Yuo-Yu Lee, Wei-Ti Huang, Vivian P. Bykerk, Mark P. Figgie, Edward F. Di Carlo, Bruce N. Cronstein, Susan M. Goodman

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Background/Purpose: Rheumatoid arthritis (RA) patients have excellent total hip arthroplasty (THA) survival, and methotrexate (MTX), an anti-inflammatory disease modifying drug which may affect bone reabsorption, may play a role. The purpose of this study is to determine the diagnosis leading to revision THA (rTHA) in RA patients and to assess the association of radiographic lucency with MTX use. Methods: All patients with validated diagnosis of RA in the institution’s THA registry undergoing rTHA from May 2007 - February 2011 were eligible. Diagnosis leading to rTHA and medication use was determined by chart review. Osteolysis was evaluated on available radiographs by measuring maximum lucency in each Gruen zone. Differences within RA patients with/without MTX in osteolysis, demographics, and medications were assessed with chi-squared, Fisher's exact tests or Mann-Whitney U tests as appropriate. The error rate for multiple comparisons of lucency in the different Gruen zones was corrected via false discovery rate methods. A secondary analysis was performed to determine differences in diagnoses leading to revision between RA and matched OA controls (2:1 match by sex age +/- 5 years). OA exclusion criteria included presence of rheumatic diseases, use of MTX, and lack of records. Results: 51 RA rTHA were identified and compared with 103 OA. Mean age for RA was 57.7 v 59.4 years for OA (p = 0.240). 82.4% RA were female v 83.5% OA (p = 0.859). RA had lower BMI than OA (25.5 v 28.2; p = 0.166). There was no difference in diagnosis leading to rTHA, including infection (RA 3.9 v OA 6.8%; p = 0.719) or dislocation (RA 23.5 v OA 23.3%; p = 0.975). There was no significant difference in the length of time the implant was in before revision: RA 11.0 v OA 8.8 years (p = 0.060). Among RA with/without MTX, there was no difference in use of biologics (30.0 v 43.3%, p = 0.283), steroids (47.6 v 50.0%, p = 0.867) or bisphosphonates (23.8 v 33.3%, p = 0.543). There was no difference in rTHA diagnosis with/without MTX, including loosening (52.4 v 56.7%, p = 0.762). There was no significant difference in lucencies with MTX use in any Gruen zone. Patients with MTX had femoral stem subsidence of 3.7mm v no subsidence without MTX (p = 0.006). Conclusion: There was no difference in the diagnosis leading to rTHR in RA and OA, although RA trended longer prior to rTHA. In this small retrospective study, there were no significant differences associated with MTX exposure or radiographic lucency among RA patients. The significance of subsidence is not clear. Further study of arthroplasty survival in RA patients is warranted.

Keywords: hip arthroplasty, methotrexate, revision arthroplasty, rheumatoid arthritis

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Authors: Jaishree Ellis

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The United States Centers for Disease Control tells us that many women with disabilities will not receive regular health screenings, including Pap Smears and mammograms. This article was comprised and written to recognize the barriers to care, gaps in existing healthcare implementation, and viable methodologies for the provision of comprehensive and robust gynecologic care for women with disabilities. According to the World Health Organization, 15% of the world's population, or approximately 1 billion people, have disabilities, most of whom are identified as women. Women with disabilities are described as being multi-disabled, as in some places, they suffer exclusion because of their disabilities as well as their gender. The paucity of information regarding how to create a healthcare system that is inclusive of every woman, regardless of her type of disability (physical, mental, intellectual or medical), has made it challenging to establish an environment that makes it possible for individuals to access care in an equitable, respectful and comprehensive way. A review of the current literature, institutional websites within the United States and American resource guides was implemented to determine where comprehensive models of care for women with disabilities exist, as well as the modalities that are being employed to meet their healthcare needs. The many barriers to care that women with disabilities face were also extracted from various sources within the literature to provide an exhaustive list that can be tackled, one by one. Of the 637 Hospital Systems in the United States, only 7 provide website documentation of health care services that address the unique needs of women with disabilities. The presumption is that if institutions have not marketed such interventions to the community, then it is likely that they do not have a robust suite of services with which to make gynecologic care available to patients with disabilities. Through this review, 7 main barriers to comprehensive gynecologic care were identified, with more than 20 sub-categories existing within those. As with many other areas of community life, inclusion remains lacking in the delivery of healthcare for women with disabilities. There are at least 7 barriers that must be overcome in order to provide equity in the medical office, the exam room, the hospital and the operating room. While few institutions have prioritized this, those few have provided blueprints that can easily be adopted by others. However, as the general population lives longer and ages, the incidence of disabilities increases, as do the healthcare disparities surrounding them. Further compounded by this is a lack of formal education for medical providers in the United States.

Keywords: health equity, inclusion, healthcare disparities, education

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Authors: Ahmad Baghdadi, Mohammed Kishk

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Construction projects are unique and involve different level of complexity. Airports projects, among other construction projects, are considered to be very complex as they face a number of challenges which make them inevitably exposed to risks. However, in Saudi Arabia, the sector of aviation is considered an important sector owing to the fact that it is the first destination for Muslims on an annual basis. As a result the Saudi government has allocated a huge amount of their general budget to this sector through the General Authority of Civil Aviation (GACA). However, it has been found that the projects are still delivered with a significant number of time and cost overruns. These consequences are typically generated from the risks involved in the projects. Thus, there is a need to identify the number of risks thought to cause such overruns in project times and costs, as well as to assess their significances in terms of their likelihoods of occurrence and their impacts. Accordingly, this paper aims to identify risks associated with aviation construction projects in Saudi Arabia, as well as to assess their likelihoods of occurrence and impacts on such projects. In total, forty four risks have been identified through a critical literature review of common risks in similar projects, as well as thirteen semi-structured interviews with expert project managers involved in GACA’s projects. However, the assessment of the identified risks in term of their likelihoods of occurrence and impacts was obtained through the analysis of forty five questionnaires. Respondents of questionnaires include clients, contractors and consultants. The results show the risks of design changes by the client, labour issue, and setting a tight schedule by the client have the highest likelihoods of occurrence in GACA projects, while the risks of earthquakes, design constructability, and corruption have the greatest impacts.

Keywords: aviation construction projects, GACA, risks, risk assessment, Saudi Arabia

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Authors: Zainab Bibi, Afsheen Aman, Shah Ali Ul Qader

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Endo-β-1,4-xylanases [EC 3.2.1.8] are one of the major groups of enzymes that are involved in degradation process of xylan and have several applications in food, textile and paper processing industries. Due to broad utility of endo-β-1,4-xylanase, researchers are focusing to increase the productivity of this hydrolase from various microbial species. Harsh industrial condition, faster reaction rate and efficient hydrolysis of xylan with low risk of contamination are critical requirements of industry that can be fulfilled by synthesizing the enzyme with efficient properties. In the current study, a newly isolated thermophile Geobacillus stearothermophilus KIBGE-IB29 was used in order to attain the maximum production of endo-1,4-β-xylanase. Bacterial culture was isolated from soil, collected around the blast furnace site of a steel processing mill, Karachi. Optimization of various nutritional and physical factors resulted the maximum synthesis of endo-1,4-β-xylanase from a thermophile. High production yield was achieved at 60°C and pH-6.0 after 24 hours of incubation period. Various nitrogen sources viz. peptone, yeast extract and meat extract improved the enzyme synthesis with 0.5%, 0.2% and 0.1% optimum concentrations. Dipotassium hydrogen phosphate (0.25%), potassium dihydrogen phosphate (0.05%), ammonium sulfate (0.05%) and calcium chloride (0.01%) were noticed as valuable salts to improve the production of enzyme. The thermophilic nature of isolate, with its broad pH stability profile and reduced fermentation time indicates its importance for effective xylan saccharification and for large scale production of endo-1,4-β-xylanase.

Keywords: geobacillus, optimization, production, xylanase

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Authors: Arundhuti Devi, Gitumani Devi, Krishna G. Bhattacharyya

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The goal of this study was to assess the characteristics of the airborne dust created by opencast coal mining and its relation to population hospitalization risk for skin and lung diseases in Margherita Coalfield, Assam, India. Air samples were collected for 24 h in three 8-h periods. For the collection of particulate matter (PM10) and total suspended particulate matter (SPM) samples, respiratory dust samplers with glass microfiber filter papers were used. PM10 was analyzed for Cu, Cd, Cr, Mn, Zn, Ni, Fe and Pb with Flame Atomic Absorption Spectrophotometer (FAAS). SPM and PM10 concentrations were respectively found to be as high as 1,035 and 265.85 μg/m³ in work zone air. The concentration of metals associated with PM10 showed values higher than the permissible limits. It was observed that the average concentrations of the metals Fe, Pb, Ni, Zn, and Cu were very high during the winter month of December, those of Cd and Cr were high during the month of May and Mn was high during February. The morphology of the particles studied with scanning electron microscopy (SEM) gave significant results. Due to opencast coal mining, the air in the work zone, as well as the general ambient air, was found to be highly polluted with respect to dust. More than 8000 patient records maintained by the hospital authority were collected from three hospitals in the area. The highest percentage of people suffering from lung diseases are found in Margherita Civil Hospital (~26.77%) whereas most people suffering from skin diseases reported for treatment in the ESIC hospital (47.47%). Both PM10 and SPM were alarmingly high, and the results were in conformity with the high incidence of lung and other respiratory diseases in the study area.

Keywords: heavy metals, open cast coal mining, PM10, respiratory diseases

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Authors: Abdulfatah Al-Jaradi, Marzoq Ali Odhah, Abdulnasser A. Haza’a

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Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of ANC include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding antenatal care. Methodology: A descriptive KAP study was conducting in public hospitals in Sana'a City-Yemen. The study population was included all pregnant women that intended to the prenatal department and clinical outpatient department, the final sample size was 371 pregnant women, a self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women were had correct answers in total knowledge regarding antenatal care, and about two-thirds (67%) of pregnant women were had performance practice regarding antenatal care and two-third (68%) of pregnant women were had a positive attitude. Conclusions & Recommendations: We concluded that a significant association between overall knowledge and practice level toward antenatal care and demographic characteristics of pregnant women, women (residence place, level of education, did your husband support you in attending antenatal care and place of delivery of the last baby), at (P-value ≤ 0.05). We recommended more education and training courses, lecturers and education sessions in clinical facilitators focused ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.

Keywords: antenatal care, knowledge, practice, attitude, pregnant women

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Authors: Shittu Bashirat, Shittu Mujeeb, Oluremi Adeolu, Orisadare Olayiwola, Jikeme Osameke, Bello Lateef

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Septicemia in neonates refers to generalized bacterial infection documented by positive blood culture in the first 28 days of life and is one of the leading causes of neonatal mortality in sub-Sahara Africa. Thrombocytopenia in newborns is a result of increased platelet consumption; sepsis was found to be the most common risk factor. The objective of the study was to determine if there are organism-specific platelet responses among the 2 groups of bacterial agents: Gram-positive and Gram-negative bacteria, and also to examine the association of platelet count and prothrombin time with neonatal septicemia. 232 blood samples were collected for this study. The blood culture was performed using Bactec 9050, an instrumented blood culture system. The platelet count and prothrombin time were performed using Abacus Junior 5 hematology analyzer and i-STAT 1 analyzer respectively. Of the 231 neonates hospitalized with clinical sepsis, blood culture reports were positive in 51 cases (21.4%). Klebsiella spp. (35.3%) and Staphylococcus aureus (27.5%) were the most common Gram-negative and Gram-positive isolates respectively. Thrombocytopenia was observed in 30 (58.8%) of the neonates with septicemia. Of the 9 (17.6%) patients with severe thrombocytopenia, seven (77.8%) had Klebsiella spp. septicemia. Out of the 21(63.6%) of thrombocytopenia produced by Gram-negative isolate, 17 (80.9) had increased prothrombin time. In conclusion, Gram-negative organisms showed the highest cases of severe thrombocytopenia and prolonged PT. This study has helped to establish a disturbance in hemostatic systems in neonates with septicemia. Further studies, however, may be required to assess other hemostasis parameters in order to understand their interaction with the infectious organisms in neonates.

Keywords: neonates, septicemia, thrombocytopenia, prolonged prothrombin time, platelet count

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Authors: Shu-Pin Huang, Pai-Chi Teng, Hao-Han Chang, Chia-Hsin Liu, Yung-Lun Lin, Shu-Chi Wang, Hsin-Chih Yeh, Chih-Pin Chuu, Jiun-Hung Geng, Li-Hsin Chang, Wei-Chung Cheng, Chia-Yang Li

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The emergence of immune checkpoint inhibitors (ICIs) targeting proteins like PD-1 and PD-L1 has changed the treatment paradigm of bladder cancer. However, not all patients benefit from ICIs, with some experiencing early death. There's a significant need for biomarkers associated with the PD-1 pathway in bladder cancer. Current biomarkers focus on tumor PD-L1 expression, but a more comprehensive understanding of PD-1-related biology is needed. Our study has developed a seven-gene risk score panel, employing a comprehensive bioinformatics strategy, which could serve as a potential prognostic and predictive biomarker for bladder cancer. This panel incorporates the FYN, GRAP2, TRIB3, MAP3K8, AKT3, CD274, and CD80 genes. Additionally, we examined the relationship between this panel and immune cell function, utilizing validated tools such as ESTIMATE, TIDE, and CIBERSORT. Our seven-genes panel has been found to be significantly associated with bladder cancer survival in two independent cohorts. The panel was also significantly correlated with tumor infiltration lymphocytes, immune scores, and tumor purity. These factors have been previously reported to have clinical implications on ICIs. The findings suggest the potential of a PD-1 pathway-based transcriptomic panel as a prognostic and predictive biomarker in bladder cancer, which could help optimize treatment strategies and improve patient outcomes.

Keywords: bladder cancer, programmed cell death protein 1, prognostic biomarker, immune checkpoint inhibitors, predictive biomarker

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Authors: Damaris Estrella Castillo, Zacil ha Vilchis Zapata, Leydi Peraza Gómez

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Hearing loss is an etiologically heterogeneous condition, where almost 60% is genetic in origin, 20% is due to environmental factors, and 20% have unknown causes. However, it is now known that the gene, GJB2, which encodes the connexin 26 protein, accounts for a large percentage of non-syndromic genetic hearing loss, and variants in this gene have been identified to be a common cause of hereditary hearing loss in many populations. The literature reports that the etiology in deafness helps improve family functioning but low-income countries this is difficult. Therefore, it is difficult to contribute the right of families to know about the genetic risk in future pregnancies as well as determining the certainty of being a carrier or affected. In order to assess the impact of genetic counseling and the functionality, 100 families with at least one child with profound hearing loss, were evaluated by specialists in audiology, clinical genetics and psychology. Targeted mutation analysis for one of the two known large deletions of upstream of GJB2/GJB6 gene (35delG; and including GJB2 regulatory sequences and GJB6) were performed in patients with diagnosis of non-syndromic hearing loss. Genetic counseling was given to all parents and primary caregivers, and APGAR family test was applied before and after the counseling. We analyzed a total of 300 members (children, parents) to determine the presence of the GJB2 gene mutation. Twelve patients (carriers and affected) were positive for the mutation, from 5 different families. The subsequent family APGAR testing and genetic counseling, showed that 14% perceived their families as functional, 62 % and 24 % moderately functional dysfunctional. This shows the importance of genetic counseling in the perception of family function that can directly impact the quality of life of these families.

Keywords: family dynamics, deafness, APGAR, counseling

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Authors: C. Sridawruang

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Young people today has sexual activities differing from those of earlier generations, in that teenagers are likely to have multiple partners, and are frequently in short-term relationships or with partners that are not well known to them. The proportion of teenage mothers in Thailand has increased. Young people were not specifically addressed during the overall very successful HIV-prevention campaigns. Because of this missed opportunity, they are still unaware of the risk of unsafe sexual behavior. Aims: To describe the reproductive health care services in perspectives of rural Thai teenagers Methods: This survey was one part of a mixed method approach taken using survey and focus groups with 439 teenagers aged 12-18 years in 5 villages, Udon Thani, Thailand. The standard questionnaire survey had been used for collecting data. The numeric data was checked and analyzed by using descriptive statistics. Results: Most teenager respondents stated that they do not know where sexual reproductive health services provided for them. Most teenagers felt difficult to access and talk with health staff about sexual related issues. They stated that discussing, or consulting with health providers might not be safe. Teenagers might lose opportunities to access and get advice from health care services. The mean knowledge score of contraception and condom reproductive was 6.34 from a total score 11. Most teenagers especially girls expressed a need for counseling services and reported a need for telephone services. Conclusions: The need of appropriate information focusing on sexual relationships and contraception should be designed to help young people make wise decisions and there should be set health care services for Thai teenagers to make sure that teenagers could access easily. Health care providers need to be trained to improve their knowledge, attitudes and skills in reproductive health care practices for Thai teenagers.

Keywords: youth friendly health services, rural, Thai, teenagers

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Authors: Moez Elsaadani, Noel Durand, Brice Sorli, Didier Montet

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Governments and international instances are trying to improve the food safety system to prevent, reduce or avoid the increase of food borne diseases. This food risk is one of the major concerns for the humanity. The contamination by mycotoxins is a threat to the health and life of humans and animals. One of the most common mycotoxin contaminating feed and foodstuffs is Ochratoxin A (OTA), which is a secondary metabolite, produced by Aspergillus and Penicillium strains. OTA has a chronic toxic effect and proved to be mutagenic, nephrotoxic, teratogenic, immunosuppressive, and carcinogenic. On the other side, because of their high stability, specificity, affinity, and their easy chemical synthesis, aptamer based methods are applied to OTA biosensing as alternative to traditional analytical technique. In this work, five aptamers have been tested to confirm qualitatively and quantitatively their binding with OTA. In the same time, three different analytical methods were tested and compared based on their ability to detect and quantify the OTA. The best protocol that was established to quantify free OTA from linked OTA involved an ultrafiltration method in green coffee solution with. OTA was quantified by HPLC-FLD to calculate the binding percentage of all five aptamers. One aptamer (The most effective with 87% binding with OTA) has been selected to be our biorecognition element to study its electrical response (variation of electrical properties) in the presence of OTA in order to be able to make a pairing with a radio frequency identification (RFID). This device, which is characterized by its low cost, speed, and a simple wireless information transmission, will implement the knowledge on the mycotoxins molecular sensors (aptamers), an electronic device that will link the information, the quantification and make it available to operators.

Keywords: aptamer, aptasensor, detection, Ochratoxin A

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Authors: Sila K. Sari, Betty J.L. Laglbauer, Muhammad G. Salim, Irianies C. Gozali, Iqbal Herwata, Fahmi Fahmi, Selvia Oktaviyani, Isabel Ender, Sarah Lewis, Abraham Sianipar, Mark Erdmann

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Taking strides towards the sustainable use of marine stocks requires science-based management of target fish populations and reduction of bycatch in non-selective fisheries. Among elasmobranchs, mobulid rays are faced with high extinction risk due to intrinsic vulnerability to fishing and their conservation has been recognized as a strong priority both in Indonesia and worldwide. Despite their common vulnerabilities to fishing pressure due to slow growth, late maturation and low fecundity, only manta rays, but not devil rays, are protected in Indonesian waters. However, both manta and devil rays are captured in non-selective fisheries, in particular drift gillnets, since their habitat overlaps with fishing grounds for primary target species (e.g. marlin, swordfish and bullet tuna off the coast of Muncar). For this reason, mobulid populations are being heavily impacted, and while national-level protections are crucial to help conservation, they may not suffice alone to insure populations sustainability. In order to assess the potential of applying live-release management measures to conserve mobulids captured as bycatch in drift gillnets, we deployed pop-up survival archival transmitters to assess post-release mortality in Indonesian mobulid rays. We also assessed which fishing practices, in particular, soak duration, affected post-release mortality in order to draw relevant conclusions for management.

Keywords: Mobulid, Devil ray, Manta ray, Bycatch

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Authors: Mohamed Ahmed Madkour, Haitham Magdy Hamad

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This research aims to study of the surgery science and imaging in ancient Egypt, and how to diagnose the surgical cases, whether due to injuries or disease that requires surgical intervention, Medical diagnosis and how to treat it. The ancient Egyptian physician tried to change over from magic and theological thinking to become a stand-alone experimental science, they were able to distinguish between diseases and they divide them into internal and external diseases even this division exists to date in modern medicine. There is no evidence to recognize the amount of human knowledge in the prehistoric knowledge of medicine and surgery except skeleton. It is not far from the human being in those times familiar with some means of treatment, Surgery in the Stone age was rudimentary, Flint stone was used after trimming in a certain way as a lancet to slit and open the skin. Wooden tree branches were used to make splints to treat bone fractures. Surgery developed further when copper was discovered, it led to the advancement of Egyptian civilization, then modern and advanced tools appeared in the operating theater like a knife or a scalpel. The climate and environmental conditions have preserved medical papyri and human remains that have confirmed their knowledge of surgical methods including sedation. The ancient Egyptians reached a great importance in surgery, evidenced by the scenes that depict the pathological image and the surgical process, but the image alone is not sufficient to prove the pathology, its presence in ancient Egypt and its treatment method. As there are a number of medical papyri, especially Edwin Smith and Ebris, which prove the ancient Egyptian surgeon's knowledge of the pathological condition that It requires a surgical intervention, otherwise its diagnosis and the method of treatment will not be described with such accuracy through these texts. Some surgeries are described in the department of surgery at Ebris papyrus. The level of surgery in ancient Egypt was high, and they performed surgery such as hernias and Aneurysm, however we have not received a lengthy explanation of the various surgeries and the surgeon has usually only said “treated surgically”. It is evident in the Ebris papyrus that they used sharp surgical tools and cautery in operations where bleeding is expected, such as hernias, arterial sacs and tumors.

Keywords: ancient Egypt, archaeology, Egyptian history, ancient asurgical imaging, Egyptian civilization, civilization

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