Search results for: forensic cases
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4787

Search results for: forensic cases

4037 Integration of Best Practices and Requirements for Preliminary E-Learning Courses

Authors: Sophie Huck, Knut Linke

Abstract:

This study will examine how IT practitioners can be motivated for IT studies and which kind of support they need during their occupational studies. Within this research project, the challenge of supporting students being engaged in business for several years arose. Here, it is especially important to successfully guide them through their studies. The problem of this group is that they finished their school education years ago. In order to gather first experiences, preliminary e-learning courses were introduced and tested with a group of users studying General Management. They had to work with these courses and have been questioned later on about their approach to the different methods. Moreover, a second group of potential students was interviewed with the help of online questionnaires to give information about their expectations regarding extra occupational studies. We also want to present best practices and cases in e-education in the subarea of mathematics and distance learning. Within these cases and practices, we use state of the art systems and technologies in e-education to find a way to increase teaching quality and the success of students. Our research indicated that the first group of enrolled students appreciated the new preliminary e-learning courses. The second group of potential students was convinced of this way of learning as a significant component of extra occupational studies. It can be concluded that this part of the project clarified the acceptance of the e-learning strategy by both groups and led to satisfactory results with the enrolled students.

Keywords: e-learning evaluation, self-learning, virtual classroom, virtual learning environments

Procedia PDF Downloads 325
4036 Temperature-Dependent Post-Mortem Changes in Human Cardiac Troponin-T (cTnT): An Approach in Determining Postmortem Interval

Authors: Sachil Kumar, Anoop Kumar Verma, Wahid Ali, Uma Shankar Singh

Abstract:

Globally approximately 55.3 million people die each year. In the India there were 95 lakh annual deaths in 2013. The number of deaths resulted from homicides, suicides and unintentional injuries in the same period was about 5.7 lakh. The ever-increasing crime rate necessitated the development of methods for determining time since death. An erroneous time of death window can lead investigators down the wrong path or possibly focus a case on an innocent suspect. In this regard a research was carried out by analyzing the temperature dependent degradation of a Cardiac Troponin-T protein (cTnT) in the myocardium postmortem as a marker for time since death. Cardiac tissue samples were collected from (n=6) medico-legal autopsies, (in the Department of Forensic Medicine and Toxicology, King George’s Medical University, Lucknow India) after informed consent from the relatives and studied post-mortem degradation by incubation of the cardiac tissue at room temperature (20±2 OC), 12 0C, 25 0C and 37 0C for different time periods ((~5, 26, 50, 84, 132, 157, 180, 205, and 230 hours). The cases included were the subjects of road traffic accidents (RTA) without any prior history of disease who died in the hospital and their exact time of death was known. The analysis involved extraction of the protein, separation by denaturing gel electrophoresis (SDS-PAGE) and visualization by Western blot using cTnT specific monoclonal antibodies. The area of the bands within a lane was quantified by scanning and digitizing the image using Gel Doc. The data shows a distinct temporal profile corresponding to the degradation of cTnT by proteases found in cardiac muscle. The disappearance of intact cTnT and the appearance of lower molecular weight bands are easily observed. Western blot data clearly showed the intact protein at 42 kDa, two major (27 kDa, 10kDa) fragments, two additional minor fragments (32 kDa) and formation of low molecular weight fragments as time increases. At 12 0C the intensity of band (intact cTnT) decreased steadily as compared to RT, 25 0C and 37 0C. Overall, both PMI and temperature had a statistically significant effect where the greatest amount of protein breakdown was observed within the first 38 h and at the highest temperature, 37 0C. The combination of high temperature (37 0C) and long Postmortem interval (105.15 hrs) had the most drastic effect on the breakdown of cTnT. If the percent intact cTnT is calculated from the total area integrated within a Western blot lane, then the percent intact cTnT shows a pseudo-first order relationship when plotted against the log of the time postmortem. These plots show a good coefficient of correlation of r = 0.95 (p=0.003) for the regression of the human heart at different temperature conditions. The data presented demonstrates that this technique can provide an extended time range during which Postmortem interval can be more accurately estimated.

Keywords: degradation, postmortem interval, proteolysis, temperature, troponin

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4035 Elasto-Plastic Analysis of Structures Using Adaptive Gaussian Springs Based Applied Element Method

Authors: Mai Abdul Latif, Yuntian Feng

Abstract:

Applied Element Method (AEM) is a method that was developed to aid in the analysis of the collapse of structures. Current available methods cannot deal with structural collapse accurately; however, AEM can simulate the behavior of a structure from an initial state of no loading until collapse of the structure. The elements in AEM are connected with sets of normal and shear springs along the edges of the elements, that represent the stresses and strains of the element in that region. The elements are rigid, and the material properties are introduced through the spring stiffness. Nonlinear dynamic analysis has been widely modelled using the finite element method for analysis of progressive collapse of structures; however, difficulties in the analysis were found at the presence of excessively deformed elements with cracking or crushing, as well as having a high computational cost, and difficulties on choosing the appropriate material models for analysis. The Applied Element method is developed and coded to significantly improve the accuracy and also reduce the computational costs of the method. The scheme works for both linear elastic, and nonlinear cases, including elasto-plastic materials. This paper will focus on elastic and elasto-plastic material behaviour, where the number of springs required for an accurate analysis is tested. A steel cantilever beam is used as the structural element for the analysis. The first modification of the method is based on the Gaussian Quadrature to distribute the springs. Usually, the springs are equally distributed along the face of the element, but it was found that using Gaussian springs, only up to 2 springs were required for perfectly elastic cases, while with equal springs at least 5 springs were required. The method runs on a Newton-Raphson iteration scheme, and quadratic convergence was obtained. The second modification is based on adapting the number of springs required depending on the elasticity of the material. After the first Newton Raphson iteration, Von Mises stress conditions were used to calculate the stresses in the springs, and the springs are classified as elastic or plastic. Then transition springs, springs located exactly between the elastic and plastic region, are interpolated between regions to strictly identify the elastic and plastic regions in the cross section. Since a rectangular cross-section was analyzed, there were two plastic regions (top and bottom), and one elastic region (middle). The results of the present study show that elasto-plastic cases require only 2 springs for the elastic region, and 2 springs for the plastic region. This showed to improve the computational cost, reducing the minimum number of springs in elasto-plastic cases to only 6 springs. All the work is done using MATLAB and the results will be compared to models of structural elements using the finite element method in ANSYS.

Keywords: applied element method, elasto-plastic, Gaussian springs, nonlinear

Procedia PDF Downloads 226
4034 Traumatic Spinal Cord Injury; Incidence, Prognosis and the Time-Course of Clinical Outcomes: A 12 Year Review from a Tertiary Hospital in Korea

Authors: Jeounghee Kim

Abstract:

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

Keywords: spinal cord injury, complication, nursing, rehabilitation

Procedia PDF Downloads 212
4033 Using Power Flow Analysis for Understanding UPQC’s Behaviors

Authors: O. Abdelkhalek, A. Naimi, M. Rami, M. N. Tandjaoui, A. Kechich

Abstract:

This paper deals with the active and reactive power flow analysis inside the unified power quality conditioner (UPQC) during several cases. The UPQC is a combination of shunt and series active power filter (APF). It is one of the best solutions towards the mitigation of voltage sags and swells problems on distribution network. This analysis can provide the helpful information to well understanding the interaction between the series filter, the shunt filter, the DC bus link and electrical network. The mathematical analysis is based on active and reactive power flow through the shunt and series active power filter. Wherein series APF can absorb or deliver the active power to mitigate a swell or sage voltage where in the both cases it absorbs a small reactive power quantity whereas the shunt active power absorbs or releases the active power for stabilizing the storage capacitor’s voltage as well as the power factor correction. The voltage sag and voltage swell are usually interpreted through the DC bus voltage curves. These two phenomena are introduced in this paper with a new interpretation based on the active and reactive power flow analysis inside the UPQC. For simplifying this study, a linear load is supposed in this digital simulation. The simulation results are carried out to confirm the analysis done.

Keywords: UPQC, Power flow analysis, shunt filter, series filter.

Procedia PDF Downloads 577
4032 Estimation of Implicit Colebrook White Equation by Preferable Explicit Approximations in the Practical Turbulent Pipe Flow

Authors: Itissam Abuiziah

Abstract:

In several hydraulic systems, it is necessary to calculate the head losses which depend on the resistance flow friction factor in Darcy equation. Computing the resistance friction is based on implicit Colebrook-White equation which is considered as the standard for the friction calculation, but it needs high computational cost, therefore; several explicit approximation methods are used for solving an implicit equation to overcome this issue. It follows that the relative error is used to determine the most accurate method among the approximated used ones. Steel, cast iron and polyethylene pipe materials investigated with practical diameters ranged from 0.1m to 2.5m and velocities between 0.6m/s to 3m/s. In short, the results obtained show that the suitable method for some cases may not be accurate for other cases. For example, when using steel pipe materials, Zigrang and Silvester's method has revealed as the most precise in terms of low velocities 0.6 m/s to 1.3m/s. Comparatively, Halland method showed a less relative error with the gradual increase in velocity. Accordingly, the simulation results of this study might be employed by the hydraulic engineers, so they can take advantage to decide which is the most applicable method according to their practical pipe system expectations.

Keywords: Colebrook–White, explicit equation, friction factor, hydraulic resistance, implicit equation, Reynolds numbers

Procedia PDF Downloads 191
4031 Mycobacterium Genome Extraction from Lymph Nodes of Sarcoidosis Cases Using Transbronchial Needle Aspiration: A Cross-Sectional Descriptive Essay On 1223 Patients

Authors: Atefeh Abedini, Pegah Soltani, Arda Kiani

Abstract:

Background: Sarcoidosis and Tuberculosis are both considered granulomatous chronic diseases with some similar pulmonary and extra-pulmonary manifestations. It is hypothesized that given these morphological similarities, the genome of mycobacterium could have an impact on the development of Sarcoidosis. Identifying the potential correlation of these diseases may assist in the management of sarcoidosis. Herein, we aimed to inspect the lymph node biopsy of sarcoidosis patients for the existence of the HSP-65 mycobacterium DNA sequence. Methods: This cross-sectional survey was conducted on 1188 Sarcoidosis patients without active/latent tuberculosis infection who were diagnosed in Masih Daneshvari Hospital in Tehran, Iran, from January 2020 to January 2022. Trans-bronchial needle aspiration (TBNA) was performed due to bilateral hilar lymphadenopathy to take a specimen. Results: The under-evaluated patients were mainly women (N=815 (68.6%)), none-smoker (N=1016 (85.5%)), and middle-aged (50.1 (SD=4.22)) with average angiotensin-converting enzyme (ACE) index of 75.6 (SD=6.42). Dyslipidemias (n=314 (26.4%), Hypertension (n=295 (24.8%)), Diabetes mellitus (n=131 (11.0%)), and chronic heart diseases (n=97 (8.2%)) had the highest prevalence between comorbidities. Skin lesions (n= 655 (55.1%)), ophthalmic (n=341 (28.7%)), and cardiac involvement (n=229 (19.3%)) were obtained as the most common extra-pulmonary characteristics of the patients. Amongst 1188 enrolled patients who were not afflicted with Mycobacterium tuberculosis based on smear/culture essay, clinical symptoms, and Chest x-ray screening, 121 (10.2%) cases had detectable amplified DNA for Mycobacterium Tuberculosis extracted from mediastinal lung lymph nodes. Conclusion: In this survey, the mycobacterium genome was detected in almost 1 per 10 case biopsies of sarcoidosis. The remarkable number of cases (n=1188) evaluated in this study was the strength of this study which supported the hypothesis regarding sarcoidosis and mycobacterium genome correlation. Further investigation, such as case-control surveys, is required to better clarify this association.

Keywords: mycobacterium tuberculosis, sarcoidosis, genome, DNA, trans-bronchial needle aspiration

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4030 MR Enterography Findings in Pediatric and Adult Patients with Crohn's Disease

Authors: Karolina Siejka, Monika Piekarska, Monika Zbroja, Weronika Cyranka, Maryla Kuczynska, Magdalena Grzegorczyk, Malgorzata Nowakowska, Agnieszka Brodzisz, Magdalena Maria Wozniak

Abstract:

Crohn’s disease is one of chronic inflammatory bowel diseases. It is increasing in prevalence worldwide, especially with young people. The disease usually occurs in the second to the fourth decade of life. Traditionally is diagnosed by clinical indicates, endoscopic, and histological findings. Magnetic Resonance Enterography (MRE) can demonstrate mural and extramural inflammatory signs and complications, which make it a valuable diagnostic modality. The study included 76 adults and 36 children diagnosed with Crohn’s disease. Each patient underwent MRE with intravenous administration of a contrast agent. All the studies were performed using Siemens Aera 1.5T scanner according to a local study protocol. Whenever applicable, MR Enterography findings were verified with endoscopy. Forty adults and all 36 children had an active phase of Crohn’s disease; five adults had a chronic phase of the disease; one adult had both chronic and active inflammatory features. Thirty adults have no sings of pathology. In both adult and pediatric groups the most commonly observed manifestation of active disease was thickened edematous ileum wall (26 adults and 36 children). Adults had Bauhin’s valve edema in 58% cases (n=23) and mesenteric changes in 34% cases (n=9). To compare, 32 children had Bauhin’s valve edema (89%) and, in 23 cases, was found inflammatory infiltration of the peri-intestinal fat (64%). The involvement of the large intestine was more common among children (100%). Complications of Crohn’s disease were found commonly in adults (40% of adults, 22% of children). There were observed 18 fistulas (14 adults, four children) and six abscesses (2 adults, four children). MRE is a reliable method in the evaluation of Crohn’s disease activity, especially of its complications. The lack of radiations makes MRE well-tolerated modality, which can be often repeated, particularly in young patients. The disease had different medical sings depending on age – children often had a more active inflammatory process, but there were more complications in the adult group.

Keywords: Crohn's disease, diagnostics, inflammatory bowel disease, magnetic resonance enterography, MRE

Procedia PDF Downloads 189
4029 Fake News During COVID-19 Pandemic: An Overview from A Legal Perspective

Authors: Ida Shafinaz Mohamed Kamil, Mohd Dahlan Abdul Malek

Abstract:

Today, the whole world is facing a catastrophe called the novel coronavirus disease known as COVID-19. As of October 2021, it has been reported that more than 248 million cases and 5 million deaths have been recorded worldwide. In Malaysia, 2,466,663 cases were reported, with 28,876 deaths recorded on 30 October 2021. Unfortunately, the world is not only facing the COVID-19 pandemic but the COVID-19 infodemic as well, where fake news about COVID-19 disease is spreading faster and more widely than from the virus itself. The spread of fake news is amplified through various social media platforms, which is causing concern among the community. The uncertainty in understanding what fake news really is has caused difficulties and challenges in providing a solution to the hazards that it creates. This article discusses what constitutes fake news and examines the current legal framework put in place to combat fake news in Malaysia. Employing a doctrinal research methodology, this article thoroughly analyzes the relevant legal provisions under the Communications and Multimedia Act 1998, the Penal Code and the Emergency (Essential Powers) Ordinance (No.2) 2021, which came into force on 12 March 2021 as well as related case laws, for offenses and punishments with regards to fake news. The findings from the analysis indicate that there is still room for improvement in regulating fake news, in particular concerning COVID-19.

Keywords: fake news, legal pespective, covid 19, pendemic

Procedia PDF Downloads 86
4028 Integrated Safety Net Program for High-Risk Families in New Taipei City

Authors: Peifang Hsieh

Abstract:

New Taipei city faces increasing number of migrant families, in which the needs of children are sometimes neglected due to insufficient support from communities. Moreover, the traditional mindset of disengagement discourages citizens from preemptively identifying families in need in their communities, resulting in delay of prompt intervention from authorities concerned. To safeguard these vulnerable families, New Taipei city develops the 'Integrated Safety-Net Program for High-Risk Families' from 2011 by implementing the following measures: (A) New attitude and action: Instead of passively receiving reported case of high-risk families, the program takes proactive and preemptive approach to detect and respond at early stage, so the cases are prevented from worsening. In addition, cross-departmental integration mechanism is established to meet multiple needs of high-risk families. The children number added to the government care network is greatly increased to over 10,000, which is around 4.4 times the original number before the program. (B) New service points: 2000 city-wide convenience stores are added as service stations so that children in less privileged families can go to any of 24-hour convenience stores across the city to pick up free meals. This greatly increases the approachability to high-risk families. Moreover, the social welfare institutes will be notified with information left in convenience stores by children and follow up with further assistance, greatly enhancing chances of less privileged families being identified. (C) New Key Figures: Mobilize community officers and volunteers to detect and offer on-site assistance. Volunteer organizations within communities are connected to report and offer follow-up services in a more active manner. In total, from 2011 to 2015, 54,789 cases are identified through active care, benefiting 82,124 children. In addition, 87.49% family-cases in the program receiving comprehensive social assistance are no longer at high risk.

Keywords: cross department, high-risk families, public-private partnership, integrated safety net

Procedia PDF Downloads 304
4027 Liquefaction Resistance Using Shear Wave Velocity

Authors: Filali Kamel, Sbartai Badreddine

Abstract:

The cyclic resistance curves developed by Andrus and Stokoe related to shear wave velocity case history databases are frequently used in accordance with the assumption of the Seed and Idriss simplified procedure. These cyclic resistance curves were deduced using a database according to the cyclic stress ratio (CSR) proposed by Seed and Idriss. Their approach is founded on the hypothesis that the dynamic cyclic shear stress (τd) is always less than that given by the simplified procedure (τr), as deduced by Seed and Idriss through their simplifying assumptions (rd= τd / τr <1). In 2017, Filali and Sbartai demonstrated that rd can often exceed 1, and they proposed a correction for the CSR in cases where rd > 1. Therefore, the correction of CSR implies that the cyclic resistance ratio (CRR) must also be corrected because it is defined by the boundary curve, which separates the liquefied and nonliqueified cases plotted using the original CSR of Seed and Idriss on which values of CRR are equal to CSR. For this purpose, in the context of this study, we have proposed in the range when the peak ground acceleration is ≤0.30g, which corresponds to rd>1, a modified boundary curve in accordance with the corrected version of the simplified method, which provides the safest case, generalize its use for any used earthquakes and allows the simplified method to be the more conservative.

Keywords: liquefaction, soil, earthquake, simplified method, cyclic stress ratio, cyclique resistance ratio

Procedia PDF Downloads 31
4026 Thermomechanical Coupled Analysis of Fiber Reinforced Polymer Composite Square Tube: A Finite Element Study

Authors: M. Ali, K. Alam, E. Ohioma

Abstract:

This paper presents a numerical investigation on the behavior of fiber reinforced polymer composite tubes (FRP) under thermomechanical coupled loading using finite element software ABAQUS and a special add-on subroutine, CZone. Three cases were explored; pure mechanical loading, pure thermal loading, and coupled thermomechanical loading. The failure index (Tsai-Wu) under all three loading cases was assessed for all plies in the tube walls. The simulation results under pure mechanical loading showed that composite tube failed at a tensile load of 3.1 kN. However, with the superposition of thermal load on mechanical load on the composite tube, the failure index of the previously failed plies in tube walls reduced significantly causing the tube to fail at 6 kN. This showed 93% improvement in the load carrying capacity of the composite tube in present study. The increase in load carrying capacity was attributed to the stress effects of the coefficients of thermal expansion (CTE) on the laminate as well as the inter-lamina stresses induced due to the composite stack layup.

Keywords: thermal, mechanical, composites, square tubes

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4025 Recurrence of Pterygium after Surgery and the Effect of Surgical Technique on the Recurrence of Pterygium in Patients with Pterygium

Authors: Luksanaporn Krungkraipetch

Abstract:

A pterygium is an eye surface lesion that begins in the limbal conjunctiva and progresses to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a distinctive wing-like aspect. Indications for surgery, in decreasing order of significance, are grown over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and aesthetic concerns. Recurrent pterygium results in the loss of time, the expense of therapy, and the potential for vision impairment. The objective of this study is to find out how often the recurrence of pterygium after surgery occurs, what effect the surgery technique has, and what causes them to come back in people with pterygium. Materials and Methods: Observational case control in retrospect: the study involves a retrospective analysis of 164 patient samples. Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium. For factor analysis, the inferential statistics odds ratio (OR) and 95% confidence interval (CI) ANOVA are utilized. A p-value of 0.05 was deemed statistically important. Results: The majority of patients, according to the results, were female (60.4%). Twenty-four of the 164 (14.6%) patients who underwent surgery exhibited recurrent pterygium. The average age is 55.33 years old. Postoperative recurrence was reported in 19 cases (79.3%) of bare sclera techniques and five cases (20.8%) of conjunctival autograft techniques. The recurrence interval is 10.25 months, with the most common (54.17 percent) being 12 months. In 91.67 percent of cases, all follow-ups are successful. The most common recurrence level is 1 (25%). A surgical complication is a subconjunctival hemorrhage (33.33 percent). Comparing the surgeries done on people with recurrent pterygium didn't show anything important (F = 1.13, p = 0.339). Age significantly affected the recurrence of pterygium (95% CI, 6.79-63.56; OR = 20.78, P 0.001). Conclusion: This study discovered a 14.6% rate of pterygium recurrence after pterygium surgery. Across all surgeries and patients, the rate of recurrence was four times higher with the bare sclera method than with conjunctival autograft. The researchers advise selecting a more conventional surgical technique to avoid a recurrence.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

Procedia PDF Downloads 94
4024 Tuberculosis in Patients with HIV-Infection in Russia: Cohort Study over the Period of 2015-2016 Years

Authors: Marina Nosik, Irina Rymanova, Konstantin Ryzhov, Joan Yarovaya, Alexander Sobkin

Abstract:

Tuberculosis (TB) associated with HIV is one of the top causes of death worldwide. However, early detection and treatment of TB in HIV-infected individuals significantly reduces the risk of developing severe forms of TB and mortality. The goal of the study was to analyze the peculiarities of TB associated with HIV infection. Over the period of 2015-2016 a retrospective cohort study was conducted among 377 patients with TB/HIV co-infection who attended the Moscow Tuberculosis Clinic. The majority of the patients was male (64,5%). The median age was: men 37,9 (24÷62) and women 35,4 (22÷72) years. The most prevalent age group was 30-39 years both for men and women (73,3% and 54,7%, respectively). The ratio of patients in age group 50-59 and senior was 3,9%. Socioeconomic status of patients was rather low: only 2.3% of patients had a university degree; 76,1% was unemployed (of whom 21,7% were disabled). Most patients had disseminated pulmonary tuberculosis in the phase of infiltration/ decay (41,5%). The infiltrative TB was detected in 18,9% of patients; 20,1% patients had tuberculosis of intrathoracic lymph nodes. The occurrence of MDR-TB was 16,8% and XDR-TB – 17,9%. The number of HIV-positive patients with newly diagnosed TB was n=261(69,2%). The active TB-form (MbT+) among new TB/HIV cases was 44,7 %. The severe clinical forms of TB and a high TB incidence rate among HIV-infected individuals alongside with a large number of cases of newly diagnosed tuberculosis, indicate the need for more intense interaction with TB services for timely diagnosis of TB which will optimize treatment outcomes.

Keywords: HIV, tuberculosis (TB), TB associated with HIV, multidrug-resistant TB (MDR-TB)

Procedia PDF Downloads 246
4023 An Appraisal of the Utilization of the New International Academy of Cytology Yokohama Standardized Reporting System: A Study of Diagnostic Accuracy and Calculation of the Risk of Malignancy Along with Histopathological Correlation in Fine-Needle Aspiratio

Authors: Deepika Gupta, Namita Bhutani, Mithlesh Bhargav

Abstract:

Objective: Breast cancer is the most commonly encountered lesion in females after non-melanoma skin malignancies. The triple assessment is an important approach in pre-operative lesions in developing countries. The objectives of the present study were to determine diagnostic accuracy and calculation of ROM along with cyto-histopathological correlation with the incorporation of a new IAC reporting system. Material and Methods: A total of 940 FNAC slides were retrieved from December 2019 to December 2020 and categorized according to the new IAC system. The diagnostic accuracy and calculation of ROM, along with cyto-histopathological correlation, were determined. Results: All the breast FNAC lesions were categorized from C1 to C5. Of the 940 cases, 358 cases had cyto-histopathological correlation. The ROM was ranging from 0% to 99%. All the statistical parameters were calculated along with diagnostic accuracy which was 97%. Conclusion: The new IAC standardized reporting system of breast FNAC evoked the utilization of rapid, accurate, and low-cost diagnostic tests and broadened the understanding and application of breast FNAC.

Keywords: accuracy, fine needle aspiration cytology, IAC, risk of malignancy, Yokohama system

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4022 Xenografts: Successful Penetrating Keratoplasty Between Two Species

Authors: Francisco Alvarado, Luz Ramírez

Abstract:

Corneal diseases are one of the main causes of visual impairment and affect almost 4 million, and this study assesses the effects of deep anterior lamellar keratoplasty (DALK) with porcine corneal stroma and postoperative topical treatment with tacrolimus in patients with infectious keratitis. No patient was observed with clinical graft rejection. Among the cases: 2 were positive to fungal culture, 2 with Aspergillus and the other 8 cases were confirmed by bacteriological culture. Corneal diseases are one of the main causes of visual impairment and affect almost 4 million. This study assesses the effects of deep anterior lamellar keratoplasty (DALK) with porcine corneal stroma and postoperative topical treatment with tacrolimus in patients with infectious keratitis. Receiver bed diameters ranged from 7.00 to 9.00 mm. No incidents of Descemet's membrane perforation were observed during surgery. During the follow-up period, no corneal graft splitting, IOP increase, or intolerance to tacrolimus were observed. Deep anterior lamellar keratoplasty seems to be the best option to avoid xenograft rejection, and it could help new surgical techniques in humans.

Keywords: ophthalmology, cornea, corneal transplant, xenografts, surgical innovations

Procedia PDF Downloads 88
4021 A Theoretical Approach on Electoral Competition, Lobby Formation and Equilibrium Policy Platforms

Authors: Deepti Kohli, Meeta Keswani Mehra

Abstract:

The paper develops a theoretical model of electoral competition with purely opportunistic candidates and a uni-dimensional policy using the probability voting approach while focusing on the aspect of lobby formation to analyze the inherent complex interactions between centripetal and centrifugal forces and their effects on equilibrium policy platforms. There exist three types of agents, namely, Left-wing, Moderate and Right-wing who comprise of the total voting population. Also, it is assumed that the Left and Right agents are free to initiate a lobby of their choice. If initiated, these lobbies generate donations which in turn can be contributed to one (or both) electoral candidates in order to influence them to implement the lobby’s preferred policy. Four different lobby formation scenarios have been considered: no lobby formation, only Left, only Right and both Left and Right. The equilibrium policy platforms, amount of individual donations by agents to their respective lobbies and the contributions offered to the electoral candidates have been solved for under each of the above four cases. Since it is assumed that the agents cannot coordinate each other’s actions during the lobby formation stage, there exists a probability with which a lobby would be formed, which is also solved for in the model. The results indicate that the policy platforms of the two electoral candidates converge completely under the cases of no lobby and both (extreme) formations but diverge under the cases of only one (Left or Right) lobby formation. This is because in the case of no lobby being formed, only the centripetal forces (emerging from the election-winning aspect) are present while in the case of both extreme (Left-wing and Right-wing) lobbies being formed, centrifugal forces (emerging from the lobby formation aspect) also arise but cancel each other out, again resulting in a pure policy convergence phenomenon. In contrast, in case of only one lobby being formed, both centripetal and centrifugal forces interact strategically, leading the two electoral candidates to choose completely different policy platforms in equilibrium. Additionally, it is found that in equilibrium, while the donation by a specific agent type increases with the formation of both lobbies in comparison to when only one lobby is formed, the probability of implementation of the policy being advocated by that lobby group falls.

Keywords: electoral competition, equilibrium policy platforms, lobby formation, opportunistic candidates

Procedia PDF Downloads 337
4020 Inverse Heat Conduction Analysis of Cooling on Run-Out Tables

Authors: M. S. Gadala, Khaled Ahmed, Elasadig Mahdi

Abstract:

In this paper, we introduced a gradient-based inverse solver to obtain the missing boundary conditions based on the readings of internal thermocouples. The results show that the method is very sensitive to measurement errors, and becomes unstable when small time steps are used. The artificial neural networks are shown to be capable of capturing the whole thermal history on the run-out table, but are not very effective in restoring the detailed behavior of the boundary conditions. Also, they behave poorly in nonlinear cases and where the boundary condition profile is different. GA and PSO are more effective in finding a detailed representation of the time-varying boundary conditions, as well as in nonlinear cases. However, their convergence takes longer. A variation of the basic PSO, called CRPSO, showed the best performance among the three versions. Also, PSO proved to be effective in handling noisy data, especially when its performance parameters were tuned. An increase in the self-confidence parameter was also found to be effective, as it increased the global search capabilities of the algorithm. RPSO was the most effective variation in dealing with noise, closely followed by CRPSO. The latter variation is recommended for inverse heat conduction problems, as it combines the efficiency and effectiveness required by these problems.

Keywords: inverse analysis, function specification, neural net works, particle swarm, run-out table

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4019 Uncertainty in Building Energy Performance Analysis at Different Stages of the Building’s Lifecycle

Authors: Elham Delzendeh, Song Wu, Mustafa Al-Adhami, Rima Alaaeddine

Abstract:

Over the last 15 years, prediction of energy consumption has become a common practice and necessity at different stages of the building’s lifecycle, particularly, at the design and post-occupancy stages for planning and maintenance purposes. This is due to the ever-growing response of governments to address sustainability and reduction of CO₂ emission in the building sector. However, there is a level of uncertainty in the estimation of energy consumption in buildings. The accuracy of energy consumption predictions is directly related to the precision of the initial inputs used in the energy assessment process. In this study, multiple cases of large non-residential buildings at design, construction, and post-occupancy stages are investigated. The energy consumption process and inputs, and the actual and predicted energy consumption of the cases are analysed. The findings of this study have pointed out and evidenced various parameters that cause uncertainty in the prediction of energy consumption in buildings such as modelling, location data, and occupant behaviour. In addition, unavailability and insufficiency of energy-consumption-related inputs at different stages of the building’s lifecycle are classified and categorized. Understanding the roots of uncertainty in building energy analysis will help energy modellers and energy simulation software developers reach more accurate energy consumption predictions in buildings.

Keywords: building lifecycle, efficiency, energy analysis, energy performance, uncertainty

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4018 O.MG- It’s a Cyber-Enabled Fraud

Authors: Damola O. Lawal, David W. Gresty, Diane E. Gan, Louise Hewitt

Abstract:

This paper investigates the feasibility of using a programmable USB such as the O.MG Cable to perform a file tampering attack. Here, the O.MG Cable, an apparently harmless mobile device charger, is used in an unauthorized way to alter the content of a file (accounts record-January_Contributions.xlsx). The aim is to determine if a forensics analyst can reliably determine who has altered the target file; the O.MG Cable or the user of the machine. This work highlights some of the traces of the O.MG Cable left behind on the target computer itself, such as the Product ID (PID) and Vendor ID (ID). Also discussed is the O.MG Cable’s behavior during the experiments. We determine if a forensics analyst could identify if any evidence has been left behind by the programmable device on the target file once it has been removed from the computer to establish if the analyst would be able to link the traces left by the O.MG Cable to the file tampering. It was discovered that the forensic analyst might mistake the actions of the O.MG Cable for the computer users. Experiments carried out in this work could further the discussion as to whether an innocent user could be punished for the unauthorized changes made by a programmable device.

Keywords: O.MG cable, programmable USB, file tampering attack, digital evidence credibility, miscarriage of justice, cyber fraud

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4017 Sexual Satifaction in Women with Polycystic Ovarian Syndrome

Authors: Nashi Khan, Amina Khalid

Abstract:

Aim: The purpose of this research was to find the psychiatric morbidity and level of sexual satisfaction among women with polycystic ovarian syndrome and their comparison with women with general medical conditions and to examine the correlation between psychiatric morbidity and sexual satisfaction among these women. Design: Cross sectional research design was used. Method: A total of 176 (M age = 30, SD = 5.83) women were recruited from both private and public sector hospitals in Pakistan. About 88 (50%) of the participants were diagnosed with polycystic ovarian syndrome (cases), whereas other 50% belonged to control group. Data were collected using semi structured interview. Sexual satisfaction scale for women (SSS-W) was administered to measure sexual satisfaction level and psychiatric morbidity was assessed by Symptom Checklist-Revised. Results: Results showed that participant’s depression and anxiety level had significant negative correlation with their sexual satisfaction level, whereas, anxiety and depression shared a significant positive correlation. There was a significant difference in the scores for sexual satisfaction, depression and anxiety for both cases and controls. These results suggested that women suffering from polycystic ovarian syndrome tend to be less sexually satisfied and experienced relatively more symptoms of depression and anxiety as compared to controls.

Keywords: level of sexual satisfaction, psychiatric morbidity, polycystic ovarian syndrome

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4016 Risk Factors Associated with Outbreak of Cerebrospinal Meningitis in Kano State- Nigeria, March-May 2017

Authors: Visa I. Tyakaray, M. Abdulaziz, O. Badmus, N. Karaye, M. Dalhat, A. Shehu, I. Bello, T. Hussaini, S. Akar, G. Effah, P. Nguku

Abstract:

Introduction: Nigeria has recorded outbreaks of meningitis in the past, being in the meningitis belt. A multi-state outbreak of Cerebrospinal Meningitis (CSM) from Neisseria meningitides occurred in 2017 involving 24 states, and Kano State reported its first two confirmed CSM cases on 22nd March, 2017. We conducted the outbreak investigation to characterize the outbreak, determine its associated risk factors and institute appropriate control measures. Method: We conducted an unmatched Case-control study with ratio 1:2. A case was defined as any person with sudden onset of fever (>38.5˚C rectal or 38.0˚C axillary) and one of the following: neck stiffness, altered consciousness or bulging fontanelle in toddlers while a control was defined as any person who resides around the case such as family members, caregivers, neighbors, and healthcare personnel. We reviewed and validated line list and conducted active case search in health facilities and neighboring communities. Descriptive, bivariate, stratified and multivariate analysis were performed. Laboratory confirmation was by Latex agglutination and/or Culture. Results: We recruited 48 cases with median age of 11 years (1 month – 65 years), attack rate was 2.4/100,000 population with case fatality rate of 8%; 34 of 44 local government areas were affected.On stratification, age was found to be a confounder. Independent factors associated with the outbreak were age (Adjusted Odds Ratio, AOR =6.58; 95% Confidence Interval (CI) =2.85-15.180, history of Vaccination (AOR=0.37; 95% CI=0.13-0.99) and history of travel (AOR=10.16; (1.99-51.85). Laboratory results showed 22 positive cases for Neisseria meningitides types C and A/Y. Conclusion: Major risk factors associated with this outbreak were age (>14years), not being vaccinated and history of travel. We sensitized communities and strengthened case management. We recommended immediate reactive vaccination and enhanced surveillance in bordering communities.

Keywords: cerebrospinal, factors, Kano-Nigeria, meningitis, risk

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4015 Incidence of and Risk Factors for Post-Operative Cognitive Dysfunction (POCD) in Neurosurgical Patients: A Prospective Cohort Study

Authors: Suparna Bharadwaj, Sriganesh Kamath, Gopalakrishna K. N., Subhas Konar

Abstract:

Introduction: Post-operative cognitive dysfunction (POCD) is a spectrum of clinical syndrome presenting as emergence delirium (ED) and/or post-operative delirium (POD). ED is a transient state (minutes to hours) of marked agitation after the discontinuation of general anesthesia, which does not respond to consoling measures. On the other hand, POD without identifiable etiology is not temporally related to emergence from anesthesia. These patients often emerge smoothly and may be lucid in the post-anesthesia care unit (PACU), but may develop fluctuating mental status, most commonly between postoperative days one and three. General anesthesia (GA) has been identified as a risk factor for POCD. Cranial surgeries involve brain handling in addition to exposure to GA. We hypothesize that the incidence of postoperative delirium after cranial surgery is twice that of spinal surgery. The primary objective of this study was to evaluate the incidence of emergence delirium and postoperative delirium in patients undergoing cranial and spinal neurosurgeries. The secondary objective was to identify the perioperative risk factors of ED and POD. Methods: This was a prospective cohort observation study conducted from March 2020 to September 2023 conducted at a tertiary neurocentre. After obtaining institutional ethics committee approval, adult patients undergoing cranial or spinal surgery with a Glasgow coma scale of 15 were included in the study. Patients undergoing cranial surgery are considered exposed to risk factors, while patients undergoing spinal surgery are considered unexposed. All study subjects received standard general anesthesia. About twenty perioperative parameters were identified as risk factors for POCD. ED was assessed using the Riker sedation agitation scale, and POD was assessed using the confusion assessment method. A sample size of 2000 patients was planned with 1000 each cranial and spinal cases. However, around 700 spinal patients could be recruited for this study. Results: In this study, about two thousand patients were screened for inclusion. However, 1185 cranial cases and 742 spinal cases were considered for final analysis. Both the groups were similar in terms of demographics. Incidence of ED was 25.8% after cranial surgery vs 10.24% after spinal surgery (relative risk 2.5). The incidence of POD after cranial surgery is 20.25% vs 2.15% after cranial surgery (relative risk 9.3). All the proposed risk factors were assessed using binomial logistic regression. Conclusion: Cranial cases expose patients to a nine times higher risk for the development of postoperative delirium. The presence of ED predisposes to POD representing a spectrum.

Keywords: post operative cognitive dysfunction, Neurosurgical patients cohort study, cohort study, emergence delirium

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4014 Consumption of Animal and Vegetable Protein on Muscle Power in Road Cyclists from 18 to 20 Years in Bogota, Colombia

Authors: Oscar Rubiano, Oscar Ortiz, Natalia Morales, Lida Alfonso, Johana Alvarado, Adriana Gutierrez, Daniel Botero

Abstract:

Athletes who usually use protein supplements, are those who practice strength and power sports, whose goal is to achieve a large muscle mass. However, it has also been explored in sports or endurance activities such as cycling, and where despite requiring high power, prominent muscle development can impede good competitive performance due to the determinant of body mass for good performance of the athlete body. This research shows, the effect with protein supplements establishes a protein - muscle mass ratio, although in a lesser proportion the relationship between protein types and muscle power. Thus, we intend to explore as a first approximation, the behavior of muscle power in lower limbs after the intake of two protein supplements from different sources. The aim of the study was to describe the behavior of muscle power in lower limbs after the consumption of animal protein (AP) and vegetable protein (VP) in four route cyclists from 18 to 20 years of the Bogota cycling league. The methodological design of this study is quantitative, with a non-probabilistic sampling, based on a pre-experimental model. The jumping power was evaluated before and after the intervention by means of the squat jump test (SJ), Counter movement jump (CMJ) and Abalacov (AB). Cyclists consumed a drink with whey protein and a soy isolate after training four times a week for three months. The amount of protein in each cyclist, was calculated according to body weight (0.5 g / kg of muscle mass). The results show that subjects who consumed PV improved muscle strength and landing strength. In contrast, the power and landing force decreased for subjects who consumed PA. For the group that consumed PV, the increase was positive at 164.26 watts, 135.70 watts and 33.96 watts for the AB, SJ and CMJ jumps respectively. While for PA, the differences of the medians were negative at -32.29 watts, -82.79 watts and -143.86 watts for the AB, SJ and CMJ jumps respectively. The differences of the medians in the AB jump were positive for both the PV (121.61 Newton) and PA (454.34 Newton) cases, however, the difference was greater for PA. For the SJ jump, the difference for the PA cases was 371.52 Newton, while for the PV cases the difference was negative -448.56 Newton, so the difference was greater in the SJ jump for PA. In jump CMJ, the differences of the medians were negative for the cases of PA and PV, being -7.05 for PA and - 958.2 for PV. So the difference was greater for PA. The conclusion of this study shows that serum protein supplementation showed no improvement in muscle power in the lower limbs of the cyclists studied, which could suggest that whey protein does not have a beneficial effect on performance in terms of power, either, showed an impact on body composition. In contrast, supplementation with soy isolate showed positive effects on muscle power, body.

Keywords: animal protein (AP), muscle power, supplements, vegetable protein (VP)

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4013 Timing of Ileostomy Closure Following Rectal Cancer Surgery at an Australian Regional Hospital

Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen

Abstract:

Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.

Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer

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4012 Epidemiological, Clinical, Histopathological Profile and Management of Breast Cancer at Kinshasa University Clinics

Authors: Eddy K. Mukadi

Abstract:

This work is a documentary and descriptive study devoted to the epidemiological, clinical, histopathological and therapeutic profile of breast cancer deals with the department of gynecology and obstetrics of the university clinics of Kinshasa during the period from 1 January 2014 to 31 December 2014. We have identified 56 cases of breast cancer. These cancers accounted for 45.2% of gynecological mammary cancers. The youngest in our series was 18 years old while the oldest was 74 years old; And the mean age of these patients was 43.4 years and mostly multiparous (35.7%). Brides (60.7%) and bachelors (26.8%) were the most affected by breast cancer. The reasons for consultation were dominated by nodules in the breast (48.2%) followed by pain (35.7%) and nipple discharge (14.3%). In 89.2% of the cases, it was the advanced clinical stage (stage 3 and 4) and the infiltrating ductal carcinoma was the most frequent histological type (75%) The malignant tumor was mainly in the left breast (55.3%), and chemotherapy with hormone therapy and patey was the most convenient treatment (42.8%), while patey mastectomy was performed in 12.5% of patients. Because of the high incidence of breast cancer identified in our study, some preventive measures must be taken into account to address this public health problem, including breast autopalpation once a month, Early detection system development of a national breast cancer policy and the implementation of a national breast cancer control program.

Keywords: breast cancer, histopathological profile, epidemiological profile, Kinshasa

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4011 Lessons from Patients Expired due to Severe Head Injuries Treated in Intensive Care Unit of Lady Reading Hospital Peshawar

Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir

Abstract:

Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.

Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar

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4010 Epidemiology of Healthcare-Associated Infections among Hematology/Oncology Patients: Results of a Prospective Incidence Survey in a Tunisian University Hospital

Authors: Ezzi Olfa, Bouafia Nabiha, Ammar Asma, Ben Cheikh Asma, Mahjoub Mohamed, Bannour Wadiaa, Achour Bechir, Khelif Abderrahim, Njah Mansour

Abstract:

Background: In hematology/oncology, health care improvement has allowed increasingly aggressive management in diagnostic and therapeutic procedures. Nevertheless, these intensified procedures have been associated with higher risk of healthcare associated infections (HAIs). We undertook this study to estimate the burden of HAIs in the cancer patients in an onco -hematology unit in a Tunisian university hospital. Materials/Methods: A prospective, observational study, based on active surveillance for a period of 06 months from Mars through September 2016, was undertaken in the department of onco-hematology in a university hospital in Tunisia. Patients, who stayed in the unit for ≥ 48 h, were followed until hospital discharge. The Centers for Disease Control and Prevention criteria (CDC) for site-specific infections were used as standard definitions for HAIs. Results: One hundred fifty patients were included in the study. The gender distribution was 33.3% for girls and 66.6% boys. They have a mean age of 23.12 years (SD = 18.36 years). The main patient’s diagnosis is: Acute Lymphoblastic Leukemia (ALL): 48.7 %( n=73). The mean length of stay was 21 days +/- 18 days. Almost 8% of patients had an implantable port (n= 12), 34.9 % (n=52) had a lumber puncture and 42.7 % (n= 64) had a medullary puncture. Chemotherapy was instituted in 88% of patients (n=132). Eighty (53.3%) patients had neutropenia at admission. The incidence rate of HAIs was 32.66 % per patient; the incidence density was 15.73 per 1000 patient-days in the unit. Mortality rate was 9.3% (n= 14), and 50% of cases of death were caused by HAIs. The most frequent episodes of infection were: infection of skin and superficial mucosa (5.3%), pulmonary aspergillosis (4.6%), Healthcare associated pneumonia (HAP) (4%), Central venous catheter associated infection (4%), digestive infection (5%), and primary bloodstream infection (2.6%). Finally, fever of unknown origin (FUO) incidence rate was 14%. In case of skin and superficial infection (n= 8), 4 episodes were documented, and organisms implicated were Escherichia.coli, Geotricum capitatum and Proteus mirabilis. For pulmonary aspergillosis, 6 cases were diagnosed clinically and radiologically, and one was proved by positive aspergillus antigen in bronchial aspiration. Only one patient died due this infection. In HAP (6 cases), four episodes were diagnosed clinically and radiologically. No bacterial etiology was established in these cases. Two patients died due to HAP. For primary bloodstream infection (4 cases), implicated germs were Enterobacter cloacae, Geotricum capitatum, klebsiella pneumoniae, and Streptococcus pneumoniae. Conclusion: This type of prospective study is an indispensable tool for internal quality control. It is necessary to evaluate preventive measures and design control guides and strategies aimed to reduce the HAI’s rate and the morbidity and mortality associated with infection in a hematology/oncology unit.

Keywords: cohort prospective studies, healthcare associated infections, hematology oncology department, incidence

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4009 Association of MIR146A rs2910164 Variation with a Predisposition to Sporadic Breast Cancer in a Pakistani Cohort

Authors: Mushtaq Ahmad, Bashir Rahman, Taqweem-ul-Haq, Fazal Jalil, Aftab Ali Shah

Abstract:

Single nucleotide polymorphisms (SNPs) in genes coding for microRNAs (miRNAs) play a pivotal role in the progression of breast cancer (BC). We investigated the association of miR-146a rs2910164 G/C polymorphism with the risk of BC in the Pakistani population. The miR-146a rs2910164 polymorphism was genotyped in 300 BC-cases and 300 age- and gender-matched healthy controls using T-ARMS-PCR. Genotype and allele frequencies were calculated, and the association between genotypes and the risk of BC was calculated by odds ratios (OR) and confidence intervals (95%). A significant difference in genotypic frequencies (χ2=63.10; p ≤ 0.0001) and allelic frequencies (OR=0.3955 (0.3132-0.4993); p ≤ 0.0001) was observed between cases and controls. Furthermore, we also found that miR-146 rs2910164 CC homozygote increased the risk of breast cancer in the dominant (OR=0.2397 (0.1629-0.3526); p=0.0001; GG vs GC+CC) and recessive (OR=2.803 (1.865- 4.213); P ≤ 0.0001; CC vs GC+GG) inheritance models. In summary, miR-146a rs2910164 G/C is significantly associated with BC in the Pakistani population. To our knowledge, this is the first study that assessed MIR146a rs2910164 G > C SNP in Pakistani population. By analyzing the secondary structure of MIR146A variant, a significant structural modification was noted. Study with a larger sample size is needed to further confirm these findings.

Keywords: breast cancer, MIR146A, microRNA, SNP

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4008 The Origin Variability of the Iliolumbar Artery

Authors: Raid Hommady, Waseem Al-Talalwah, Shorok Al Dorazi, Roger Soames

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The iliolumbar artery is a regular branch of posterior division of the internal iliac artery. The present study investigate 82 specimens to identify the origin of iliolumbar artery. The present study targets the sciatic nerve root supply from iliolumbar artery based on its origin and course. In present study, the ililumbar artery arose from the posterior division of internal iliac artery in 52.2%. In few cases, it arose from dorsomedial aspect of the internal iliac artery in 28.8%. In few cases, the iliolumbar artery arose from the dorsal aspects of the internal iliac artery as well as from the common and external iliac artery 1.7%. Also, the iliolumbar artery arose from the sciatic artery as well as from superior and inferior gluteal arteries in 5.1%. Conversely, it found to be congenital absent in 8.5%. Therefore, the posterior trunk of the internal iliac artery is the most common origin of the iliolumbar artery. With the origin variability of the iliolumbar artery, there is a vascular supply variability of the lumbosacral trunk and sacral root of sciatic nerve. The iliolumbar artery provides vascular supply for lumbosacral trunk 57.3% in whereas the sacral root in 5.1%. As a result, surgeons should pay attention to these variations to decrease iatrogenic fault.

Keywords: iliolumbar, sciatic artery, internal iliac, external iliac, posterior division

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