Search results for: left subclavian artery

Authors: Sabiha Sahin, Kursad Bora Carman, Coskun Yarar

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Introduction: Measuring the diameter of the optic nerve sheath is a noninvasive and easy to use imaging technique to predict intracranial pressure in children and adults. The aim was to measure the diameter of the optic nerve sheath in pediatric head trauma. Methods: The study group consisted of 40 children with healthy and 40 patients with head trauma. Transorbital sonographic measurement of the optic nerve sheath diameter was performed. Conclusion: The mean diameters of the optic nerve sheath of right and left eyes were 0.408 ± 0.064 mm and 0.417 ± 0.065 mm, respectively, in the trauma group. These results were higher in patients than in control group. There was a negative correlation between optic nerve sheath diameters and Glasgow Coma Scales in patients with head trauma (p < 0.05). There was a positive correlation between optic nerve sheath diameters and positive CT findings, systolic blood pressure in patients with head trauma. The clinical status of the patients at admission, blood pH and lactate level were related to the optic nerve sheath diameter. Conclusion: Measuring the diameter of the optic nerve sheath is not an invasive technique and can be easily used to predict increased intracranial pressure and to prevent secondary brain injury.

Keywords: head trauma, intracranial pressure, optic nerve, sonography

Procedia PDF Downloads 141

Authors: Joaquim de Almeida Dultra, Daiana Cristina Pereira Santana, Fátima Karoline Alves Araújo Dultra, Liliane Akemi Kawano Shibasaki, Mariana Machado Mendes de Carvalho, Ieda Margarida Crusoé Rocha Rebello

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Defects originating from mandibular resections can cause significant functional impairment and facial disharmony, and they have complex rehabilitation. The aim of this report is to demonstrate the authors' experience facing challenging rehabilitation after mandibular resection in a patient with ameloblastoma. Clinical and surgical steps are described simultaneously, highlighting the adaptation of the final fixed prosthesis, reported in an unprecedented way in the literature. A 37-year-old male patient was seen after a sports accident, where a pathological fracture in the symphysis and left mandibular body was identified, where a large radiolucent lesion was found. The patient underwent resection, bone graft, distraction osteogenesis, rehabilitation with dental implants, prosthesis, and finally, orofacial harmonization, in an interval of six years. Rehabilitation should consider the patient's needs individually and should have as the main objective to provide similar aesthetics and function to that present before the disease. We also emphasize the importance of interdisciplinary work during the course of rehabilitation.

Keywords: ameloblastoma, mandibular reconstruction, distraction osteogenesis, dental implants. dental prosthesis, implant-supported, treatment outcome

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Authors: Yetunde I. Bulu, Moses B. Adewole, Julius O. Faluyi

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This study investigates the effect of aggressive application of herbicide on weed succession in an urban environment in Ile-Ife, Osun State. An inspection of the communities was carried out to identify sites maintained by herbicides (test plots) and those without herbicide history (control plots). Four different experimental plots located at Olasode, Eleweran, Ife City and Parakin within Ile-Ife town were monitored during the study. Comprehensive enumeration and identification of plant populations to species level was carried out on each of the plots and at every visit to determine the direction of succession. Index of similarities was used to determine the relationship in plant species composition between plots treated with herbicide and the untreated plots. The trend of increasing plant species was observed in all the study plots. Low Similarity Index between the treated plots and the control vegetation was observed at all visitations. Low similarity was also observed between the above-ground vegetation and the seed bank in all the plots. The study concluded that the weed population observed from the experimental plots showed an increase in species richness and diversity when the plots were left to recover compared to the control plots.

Keywords: herbicide, index of similarity, population, soil seed bank, succession

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Authors: Azmi Ilmi Aziz, Wisnu Sadasih, Rizal Fanany

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Purpose: This study describes systemic factors, intraocular lens (IOL), and ocular abnormalities in patients with IOL glistening at a tertiary hospital in Semarang. Methods: A retrospective, with a descriptive approach on patients with IOL glistening who visited the eye clinic between August 2019 to June 2023. Results: Twenty-five patients were examined; 11 patients (44%) had IOL glistening in their right eye, 4 patients (16%) in their left eye, and 10 patients (40%) in both eyes. The gender of patients consisted of 12 male patients (48%) and 13 female patients (52%). The median age of the patients was 68 years. The mean onset was 4.44 years after the first cataract surgery. Hypertension was found in 13 patients (52%), and diabetes was found in 9 patients (36%). Nine patients (36%) were identified with a foldable IOL with a closed loop design, and 1 patient (4%) with a PMMA IOL with an iris-fixated IOL design, while 15 other patients’ IOL were unrecorded. Glaucoma was found in 3 patients (12%). Conclusions: The result of this study showed that more than half of the patients were hypertensive, and some were glaucomatous, which had been discussed relevant in previous studies. Most IOL that could be identified was foldable IOL with a closed loop design. To our knowledge, the design of an IOL to glistening had never been explored. A longer study involving larger subjects is needed to better describe the systemic factors, IOL, and ocular abnormalities in patients with IOL glistening.

Keywords: glistening, intraocular lens, foldable IOL, PMMA IOL

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Authors: Hansraj Bookun, Angela Tan, Rachel Xuan, Linheng Zhao, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos

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Introduction: Incisional wound complications in vascular surgery patients represent a significant clinical and econometric burden of morbidity and mortality. The objective of this study was to trial the feasibility of applying the Prevena negative pressure incision management system as a routine dressing in patients who had undergone arterial surgery. Conventionally, Prevena has been applied to groin incisions, but this study features applications on multiple wound sites such as the thigh or major amputation stumps. Method: This was a cross-sectional observational, single-centre case series of 12 patients who had undergone major vascular surgery. Their wounds were managed with the Prevena system being applied either intra-operatively or on the first post-operative day. Demographic and operative details were collated as well as the length of stay and complication rates. Results: There were 9 males (75%) with mean age of 66 years and the comorbid burden was as follows: ischaemic heart disease (92%), diabetes (42%), hypertension (100%), stage 4 or greater kidney impairment (17%) and current or ex-smoking (83%). The main indications were acute ischaemia (33%), claudication (25%), and gangrene (17%). There were single instances of an occluded popliteal artery aneurysm, diabetic foot infection, and rest pain. The majority of patients (50%) had hybrid operations with iliofemoral endarterectomies, patch arterioplasties, and further peripheral endovascular treatment. There were 4 complex arterial bypass operations and 2 major amputations. The mean length of stay was 17 ± 10 days, with a range of 4 to 35 days. A single complication, in the form of a lymphocoele, was encountered in the context of an iliofemoral endarterectomy and patch arterioplasty. This was managed conservatively. There were no deaths. Discussion: The Prevena wound management system shows that in conjunction with safe vascular surgery, absolute wound complication rates remain low and that it remains a valuable adjunct in the treatment of vasculopaths.

Keywords: wound care, negative pressure, vascular surgery, closed incision

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Authors: Elena Parmentier, Henrik Endeman

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Introduction: Large mediastinal masses often present with diagnostic and clinical challenges due to compression of the respiratory and hemodynamic system. We present a case of a mediastinal mass with symptomatic mechanical compression of the trachea, resulting in challenging airway management. Methods: We present a case of 66-year-old male, complaining of progressive dysphagia. Initial esophagogastroscopy revealed a stenosis secondary to external compression, biopsies were inconclusive. Additional CT scan showed a large mediastinal mass of unknown origin, situated between the vertebrae and esophagus. Symptoms progressed and patient developed dyspnea and stridor. A new CT showed quick growth of the mass with compression of the trachea, subglottic to just above the carina. A tracheal covered stent was successfully placed. Endobronchial ultrasound revealed a large irregular mass without tracheal invasion, biopsies were taken. 4 days after stent placement, the patients’ condition deteriorated with worsening of stridor, dyspnea and desaturation. Migration of the tracheal stent into the right main bronchus was seen on chest X ray, with obstruction of the left main bronchus and secondary atelectasis. Different methods have been described in the literature for tracheobronchial stent removal (surgical, endoscopic, fluoroscopyguided), our first choice in this case was flexible bronchoscopy. However, this revealed tracheal compression above the migrated stent and passage of the scope occurred impossible. Patient was admitted to the ICU, high-flow nasal oxygen therapy was started and the situation stabilized, giving time for extensive assessment and preparation of the airway management approach. Close cooperation between the intensivist, pulmonologist, anesthesiologist and otorhinolaryngologist was essential. Results: In case of sudden deterioration, a protocol for emergency situations was made. Given the increased risk of additional tracheal compression after administration of neuromuscular blocking agents, an approach with awake fiberoptic intubation maintaining spontaneous ventilation was proposed. However, intubation without retrieval of the tracheal stent was found undesirable due to expected massive shunting over the left atelectatic lung. As rescue option, assistance of extracorporeal circulation was considered and perfusionist was kept on standby. The patient stayed stable and was transferred to the operating theatre. High frequency jet ventilation under general anesthesia resulted in desaturations up to 50%, making rigid bronchoscopy impossible. Subsequently an endotracheal tube size 8 could be placed successfully and the stent could be retrieved via bronchoscopy over (and with) the tube, after which the patient was reintubated. Finally, a tracheostomy (Shiley™ Tracheostomy Tube With Cuff, size 8) was placed, fiberoptic control showed a patent airway. Patient was readmitted to the ICU and could be quickly weaned of the ventilator. Pathology was positive for rhabdomyosarcoma, without indication for systemic therapy. Extensive surgery (laryngectomy, esophagectomy) was suggested, but patient refused and palliative care was started. Conclusion: Due to meticulous planning in an interdisciplinary team, we showed a successful airway management approach in this complicated case of critical airway compression secondary to a rare rhabdomyosarcoma, complicated by tracheal stent migration. Besides presenting our thoughts and considerations, we support exploring other possible approaches of this specific clinical problem.

Keywords: airway management, rhabdomyosarcoma, stent displacement, tracheal stenosis

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Authors: Amal Alatar

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The architectural legacy is considered a significant factor, which left its features on the shape of buildings and historical and archaeological sites all over the world. In this framework, this paper focuses on Umm Qais town, located in Northern Jordan, which includes archaeological remains of the ancient Decapolis city of Gadara, still the witness of the originality and architectural identity of the city. 3D modeling is a public asset and a valuable resource for cultural heritage. This technique allows the possibility to make accurate representations of objects, structures, and surfaces. Hence, these representations increase valuable assets when thinking about cultural heritage. The Heritage Building Information Modeling (HBIM) is considered an effective tool to represent information on Cultural Heritage (CH) which can be used for documentation, restoration, conservation, presentation, and research purposes. Therefore, this paper focus on the interdisciplinary project of the virtualization of the West Theater in Gadara (Umm Qais) for 3D documentation and structural studies. The derived 3D model of the cultural heritage is the basis for further archaeological studies; the challenges of the work stay in the acquisition, processing, and integration of the multi-resolution data as well as their interactive visualization.

Keywords: archaeology, 3D modeling, Umm Qais, culture heritage, Jordan

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Authors: Angelis P. Barlampas

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The purpose of this study is to inform the reader, about the various applications of artificial intelligence (AI), in cardiac imaging. AI grows fast and its role is crucial in medical specialties, which use large amounts of digital data, that are very difficult or even impossible to be managed by human beings and especially doctors.Artificial intelligence (AI) refers to the ability of computers to mimic human cognitive function, performing tasks such as learning, problem-solving, and autonomous decision making based on digital data. Whereas AI describes the concept of using computers to mimic human cognitive tasks, machine learning (ML) describes the category of algorithms that enable most current applications described as AI. Some of the current applications of AI in cardiac imaging are the follows: Ultrasound: Automated segmentation of cardiac chambers across five common views and consequently quantify chamber volumes/mass, ascertain ejection fraction and determine longitudinal strain through speckle tracking. Determine the severity of mitral regurgitation (accuracy > 99% for every degree of severity). Identify myocardial infarction. Distinguish between Athlete’s heart and hypertrophic cardiomyopathy, as well as restrictive cardiomyopathy and constrictive pericarditis. Predict all-cause mortality. CT Reduce radiation doses. Calculate the calcium score. Diagnose coronary artery disease (CAD). Predict all-cause 5-year mortality. Predict major cardiovascular events in patients with suspected CAD. MRI Segment of cardiac structures and infarct tissue. Calculate cardiac mass and function parameters. Distinguish between patients with myocardial infarction and control subjects. It could potentially reduce costs since it would preclude the need for gadolinium-enhanced CMR. Predict 4-year survival in patients with pulmonary hypertension. Nuclear Imaging Classify normal and abnormal myocardium in CAD. Detect locations with abnormal myocardium. Predict cardiac death. ML was comparable to or better than two experienced readers in predicting the need for revascularization. AI emerge as a helpful tool in cardiac imaging and for the doctors who can not manage the overall increasing demand, in examinations such as ultrasound, computed tomography, MRI, or nuclear imaging studies.

Keywords: artificial intelligence, cardiac imaging, ultrasound, MRI, CT, nuclear medicine

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Authors: Yekta Ülgen, Fırat Matur

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Cole-Cole parameters of 40 post-menopausal women are compared with their DEXA bone mineral density measurements. Impedance characteristics of four extremities are compared; left and right extremities are statistically same, but lower extremities are statistically different than upper ones due to their different fat content. The correlation of Cole-Cole impedance parameters to bone mineral density (BMD) is observed to be higher for a dominant arm. With the post menopausal population, ANOVA tests of the dominant arm characteristic frequency, as a predictor for DEXA classified osteopenic and osteoporotic population around the lumbar spine, is statistically very significant. When used for total lumbar spine osteoporosis diagnosis, the area under the Receiver Operating Curve of the characteristic frequency is 0.875, suggesting that the Cole-Cole plot characteristic frequency could be a useful diagnostic parameter when integrated into standard screening methods for osteoporosis. Moreover, the characteristic frequency can be directly measured by monitoring frequency driven the angular behavior of the dominant arm without performing any complex calculation.

Keywords: bioimpedance spectroscopy, bone mineral density, osteoporosis, characteristic frequency, receiver operating curve

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Authors: Ammar Alsabery, Habibis Saleh, Norazam Arbin, Ishak Hashim

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Unsteady natural convection and heat transfer in a square cavity partially filled with porous media using a thermal non-equilibrium model is studied in this paper. The left vertical wall is maintained at a constant hot temperature and the right vertical wall is maintained at a constant cold temperature, while the horizontal walls are adiabatic. The governing equations are obtained by applying the Darcy model and Boussinesq approximation. COMSOL's finite element method is used to solve the non-dimensional governing equations together with specified boundary conditions. The governing parameters of this study are the Rayleigh number, the modified thermal conductivity ratio, the inter-phase heat transfer coefficien and the time independent. The results presented for values of the governing parameters in terms of streamlines in both fluid/porous layer, isotherms of fluid and solid porous layer, isotherms of fluid layer, and average Nusselt number.

Keywords: unsteady natural convection, thermal non-equilibrium model, Darcy model

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Authors: Sarah Beaver, Renee Bryce

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Audiograms detect hearing impairment, but missing values pose problems. This work explores imputations in an attempt to improve accuracy. This work implements Linear Regression, Lasso, Linear Support Vector Regression, Bayesian Ridge, K Nearest Neighbors (KNN), and Random Forest machine learning techniques to impute audiogram frequencies ranging from 125Hz to 8000Hz. The data contains patients who had or were candidates for cochlear implants. Accuracy is compared across two different Nested Cross-Validation k values. Over 4000 audiograms were used from 800 unique patients. Additionally, training on data combines and compares left and right ear audiograms versus single ear side audiograms. The accuracy achieved using Root Mean Square Error (RMSE) values for the best models for Random Forest ranges from 4.74 to 6.37. The R\textsuperscript{2} values for the best models for Random Forest ranges from .91 to .96. The accuracy achieved using RMSE values for the best models for KNN ranges from 5.00 to 7.72. The R\textsuperscript{2} values for the best models for KNN ranges from .89 to .95. The best imputation models received R\textsuperscript{2} between .89 to .96 and RMSE values less than 8dB. We also show that the accuracy of classification predictive models performed better with our best imputation models versus constant imputations by a two percent increase.

Keywords: machine learning, audiograms, data imputations, single imputations

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Authors: Talip Turkmen

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From the moment the first beats, the first step into the world mankind finds him in a struggle to survive. Most important case to win this fight is power. Power is one of the most common concepts which we encounter in our life. Mainly power is ability to reach desired results on someone else or ability to penetrate into the behavior of others. Throughout history merging technology and changing political trade-offs caused the change of concept of power. Receiving a state of multipolar new world order in the 21st century and increasing impacts of media have narrowed the limits of military power. With increasing globalization and peaceful diplomacy this gap, left by military power, has filled by soft power which has ability to persuade and attract. As concepts of power soft power also has not compromised yet. For that reason it is important to specify, sources of soft power, soft power strategies and limits of soft power. The purpose of this study was to analyze concept of soft power and importance of soft power in foreign relations. This project focuses on power, hard power and soft power relations, sources of soft power and strategies to gain soft power. Datas in this project was acquired from other studies on soft power and foreign relations. This paper was prepared in terms of concept and research techniques. As a result of data gained in this study the one of important topics in international relations is balance between soft power.

Keywords: soft power, foreign policy, national power, hard power

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Authors: Sadeq Al Yaari, Muhammad Alkhunayn, Ayman Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Adham Al Yaari, Sajedah Al Yaari, Fatehi Eissa

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Stuttering is a multidimensional disorder that is influenced by different factors. As a result of their un-understanding of the genuine reasons behind stuttering, psychiatrists and Speech and Language Pathologists/Therapists (SLP/Ts) are often unfamiliar with the psychoneurolinguistic characteristics, support needs, and the disability measurement impacting requested rehabilitation of the stuttering population. PubMed, PsycInfo, Web of Science, Scopus, and Google scholar searches, in addition to some unpublished literature, were conducted in this Systematic Literature Review and Meta-analysis (SLR and Meta-analysis) to identify whether stuttering is caused by psychological or neurological reasons. The study concluded that psychological, not neurolinguistic factors were identified as most significant for the causality of childhood stuttering. Stutterers have intact language skills, but impaired ability more to communicate with others than to form letters in the brain or to articulate them. The study recommends research in the future that sheds light on the adult stuttering population often left out of the focus of diagnosis and in need of further exploration vis-a-vis issues they encounter, as well as the possible ways to deal with them psychoneurolinguistically.

Keywords: causality, childhood stuttering, psychology, neurolinguistics, systematic literature review, meta-analysis

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Authors: Margareta Rahayuningsih, Siti Alimah, Novita Hermayani, Misbahul Munir

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Wreathed Hornbill (Rhycticeros undulatus) was a protected bird that we can found in Mount Ungaran. It is known that the bird have been breeding and nesting on the mountain. The objective of the research was to analysis the materials composition of the Wreathed Hornbill nest wall plaster. The study was carried out in Curug Lawe and Gunung Gentong, Mount Ungaran Central Java. Nest wall plaster samples were collected from nest cavities were used by hornbill but after they left from the nest. The nest tree species on Gunung Gentong was Syzygium antisepticum and Syzigium glabratum on Curug Lawe. Materials analysis used proximate analysis and have been done on Chemistry Laboratory of Semarang State University. The result of proximate analysis showed that the material composition of nest wall plaster such as water, proteins. lipid, carbohydrate, and ash between Curug Lawe and Gunung Gentong was different. Except Carbohidrate, the highest componen showed in the nest wall plaster on Gunung Gentong.

Keywords: Mount Ungaran, nest cover entrance, Rhyticeros undulatus, proximate analysis

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Authors: Raphael C. Zero, Thiago A. S. S. Rocha, Marita V. Cardozo, Caio C. C. Santos, Alisson D. S. Fechis, Antonio C. Shimano, FabríCio S. Oliveira

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Biomechanical analysis is an important factor in tissue studies. The objective of this study was to determine the feasibility of a new anatomical technique and quantify the changes in skin and the jejunum resistance of cats’ corpses throughout the process. Eight adult cat cadavers were used. For every kilogram of weight, 120ml of fixative solution (95% 96GL ethyl alcohol and 5% pure glycerin) was applied via the external common carotid artery. Next, the carcasses were placed in a container with 96 GL ethyl alcohol for 60 days. After fixing, all carcasses were preserved in a 30% sodium chloride solution for 60 days. Before fixation, control samples were collected from fresh cadavers and after fixation, three skin and jejunum fragments from each cadaver were tested monthly for strength and displacement until complete rupture in a universal testing machine. All results were analyzed by F-test (P <0.05). In the jejunum, the force required to rupture the fresh samples and the samples fixed in alcohol for 60 days was 31.27±19.14N and 29.25±11.69N, respectively. For the samples preserved in the sodium chloride solution for 30 and 60 days, the strength was 26.17±16.18N and 30.57±13.77N, respectively. In relation to the displacement required for the rupture of the samples, the values of fresh specimens and those fixed in alcohol for 60 days was 2.79±0.73mm and 2.80±1.13mm, respectively. For the samples preserved for 30 and 60 days with sodium chloride solution, the displacement was 2.53±1.03mm and 2.83±1.27mm, respectively. There was no statistical difference between the samples (P=0.68 with respect to strength, and P=0.75 with respect to displacement). In the skin, the force needed to rupture the fresh samples and the samples fixed for 60 days in alcohol was 223.86±131.5N and 211.86±137.53N respectively. For the samples preserved in sodium chloride solution for 30 and 60 days, the force was 227.73±129.06 and 224.78±143.83N, respectively. In relation to the displacement required for the rupture of the samples, the values of fresh specimens and those fixed in alcohol for 60 days were 3.67±1.03mm and 4.11±0.87mm, respectively. For the samples preserved for 30 and 60 days with sodium chloride solution, the displacement was 4.21±0.93mm and 3.93±0.71mm, respectively. There was no statistical difference between the samples (P=0.65 with respect to strength, and P=0.98 with respect to displacement). The resistance of the skin and intestines of the cat carcasses suffered little change when subjected to alcohol fixation and preservation in sodium chloride solution, each for 60 days, which is promising for use in surgery training. All experimental procedures were approved by the Municipal Legal Department (protocol 02.2014.000027-1). The project was funded by FAPESP (protocol 2015-08259-9).

Keywords: anatomy, conservation, fixation, small animal

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Authors: Eddy K. Mukadi

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

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

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Authors: Rinku Maji, Joydeep Chakrabortty, Stephen F. King

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The grand unified theory (GUT) rationales the arbitrariness of the standard model (SM) and explains many enigmas of nature at the outset of a single gauge group. The GUTs predict the proton decay and, the spontaneous symmetry breaking (SSB) of the higher symmetry group may lead to the formation of topological defects, which are indispensable in the context of the cosmological observations. The Super-Kamiokande (Super-K) experiment sets sacrosanct bounds on the partial lifetime (τ) of the proton decay for different channels, e.g., τ(p → e+ π0) > 1.6×10³⁴ years which is the most relevant channel to test the viability of the nonsupersymmetric GUTs. The GUTs based on the gauge groups SO(10) and E(6) are broken to the SM spontaneously through one and two intermediate gauge symmetries with the manifestation of the left-right symmetry at least at a single intermediate stage and the proton lifetime for these breaking chains has been computed. The impact of the threshold corrections, as a consequence of integrating out the heavy fields at the breaking scale alter the running of the gauge couplings, which eventually, are found to keep many GUTs off the Super-K bound. The possible topological defects arising in the course of SSB at different breaking scales for all breaking chains have been studied.

Keywords: grand unified theories, proton decay, threshold correction, topological defects

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Authors: Ledi Neçaj

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Introduction: Cardio-respiratory rehabilitation is the set of coordinated interventions needed to provide the best physical, psychological, and social conditions so that patients with chronic or post-acute cardiopulmonary disease, with their efforts, maintain or resume optimal functioning in society through improved health behaviors. Purpose: To study the effectiveness of the application of Cardio-Respiratory Rehabilitation in the typology of patients with chronic or post-acute cardiomyopathy and chronic respiratory diseases in order to facilitate their therapeutic use and to improve the overall quality of life. Material and Method: This is a prospective study including patients with COPD and cardiac disease who were included in the rehabilitation program during the period January 2019 - November 2021. The study was conducted at the University Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of Good Counsel, Tirana". An individual chart was used to collect sociodemographic, physical, clinical, and functional examinations for each patient. Results: The study included 253 patients, with a mean age of 62.1 (± 7.9) years, ranging from 48 to 82 years. (67.6%) of the patients were males, and (32.4%) female. Male patients predominated in all age groups, with a statistically significant difference with females (p<0.01). The most common cardiac pathologies are coronary artery bypass (24%), cerebral stroke (9%), myocardial infarction (17%), Stent placement (8%) (p<0.01). Correlation matrix of risk factors found a significant correlation of alcohol consumption with diabetes, smoking, dyslipidemia, sedentary life, obesity, AVC, and hypertension. Functional capacity estimated by change in metabolic equivalents (MET) improved by 46% from 4. ±2.2 to 7.2± .8 METs (p<0.01). Duration of exercise after rehabilitation was increased by 21% compared to baseline (p<0.01). The mean score of all three subscales of the questionnaire: symptoms (p=0.03), activity (p<0.01), and impact (p<0.01) after rehabilitation, was lower compared to pre-rehabilitation. Conclusions: The rehabilitation program has impacted on improving the quality of life, reducing symptoms, reducing the impact of negative factors on daily life, and reducing dyspnea during daily activities.

Keywords: cardio-respiratory rehabilitation, physical exercise, quality of life, diseases

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Authors: Deepak Chaudhary

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The main objective of the study is to explore the genesis and achievements of the Madhesh movement. Madhesh Movement is a social movement that brought massive political changes and contributed a lot to the nation-building process in the modern history of Nepal. This movement erupted in January 2007 in the Tarai/Madhesh region following the promulgation of the Interim Constitution that left the incorporation of federalism and proportional representation in the Constitution. The most excluded community in Nepal- Madheshi community, seemed to have angered against state-sponsored discrimination and exclusion that have been occurred for centuries. Since Madheshis were treated as non-Nepali, though the history of Nepal’s Tarai/Madhesh has been ancient. In the beginning, this movement was against Maoist, but later, it went against the state's prejudices and discriminations. It extended across the Tarai/Madhesh region of Nepal for a month. The movement was spontaneous to a large extent. A researcher himself is a witness to the movement. Key Informant Interviews with participants, including politicians, journalists, and activists, have mainly carried out for the study. This movement ensured Madheshi identity first. Secondly, the number of electoral constituencies was increased as it reached 120 in Tarai/Madhesh while it was 80 only. As a result, Madheshi representation in the Constitution Assembly reached 35 %, while it was 20% only. The main thing that this movement played a major role in ensuring the federalism as a political system in Nepal.

Keywords: dignity, exclusion, federalism, inclusion, Madhesh movement, nation-building

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Authors: Aboozar Dehghan, S. Sharifi, A. Ardeshiri, F. Jafari, F. Samani

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Ultrasonography is a safe, particular, available and easy to use method to evaluate soft tissues. Tendons play the main role to body locomotors system. Ultrasonography performed in tarsus and metatarsus region of rare limb of eight adult, Dromedary camels (camelus dromedaries) in both sex. Clinical examination and gate analysis was performed before slaughtering. From the tarsus to the 1st phalanx was divided to 4 equal region include 1a, 2a, 1b and 2b. Flexor surface was clipped and covered by enough ultrasonography gel. Ultrasonography was performed by linear phased array 8-12 Mhz transducer in transverse and longitudinal section and Superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT) and suspensory ligament (SL) were imaged. Echogenicity and diameter of these structures were recorded. Size of tendons and SL measured after necropsy too. statistical analysis obtained that SDFT diameter larger than others in all described regions and mean of DDFT diameter larger than suspensory ligament. Echogenicity of SL more than SDFT and DDFT. No Significant relationship was seen between left and right rare limb structures size. Between sex and tendons and SL diameter, significant relationship not seen.

Keywords: dromedary camel, tars and metatars, ultrasonography

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Authors: Usha N. Murthy, H. B. Rekha, Mahaveer Devoor

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The introduction of more stringent pollution regulations, in relation to financial and social pressures for sustainable development, has pressed toward limiting the volumes of industrial and domestic effluents discharged into the environment-as well as to increase the efforts within research and development of new or more efficient wastewater treatment technologies. Considering both discharge volume and effluent composition, wastewater generated by the textile industry is rated as the most polluting among all industrial sectors. The pollution load is mainly due to spent dye baths, which are composed of unreacted dyes, dispersing agents, surfactants, salts and organics. In the present investigation, the textile dye wastewater was characterized by high colour, chemical oxygen demand (COD), total dissolved solids (TDS) and pH. Electrochemical oxidation process for four plate electrodes was carried out at five different current intensities, out of which 0.14A has achieved maximum percentage removal of COD with 75% and 83% of colour. The COD removal rate in kg COD/h/m2 decreases with increase in the current intensity. The energy consumption increases with increase in the current intensity. Hence, textile dye wastewater can be effectively pre-treated by electrochemical oxidation method where the process limits objectionable colour while leaving the COD associated with organics left for natural degradation thus causing a sustainable reduction in pollution load.

Keywords: electrochemical treatment, COD, colour, environmental engineering

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Authors: Dipti Yadav, Latha Rangan, Pinakeswar Mahanta

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Recent fuel-development strategies to reduce oil dependency, mitigate greenhouse gas emissions, and utilize domestic resources have generated interest in the search for alternative sources of fuel supplies. Bioenergy production from lignocellulosic biomass has a great potential. Cellulose, hemicellulose and Lignin are main constituent of woods or agrowaste. In all the industries there are always left over or waste products mainly lignin, due to the heterogeneous nature of wood and pulp fibers and the heterogeneity that exists between individual fibers, no method is currently available for the quantitative isolation of native or residual lignin without the risk of structural changes during the isolation. The potential benefits from finding alternative uses of lignin are extensive, and with a double effect. Lignin can be used to replace fossil-based raw materials in a wide range of products, from plastics to individual chemical products, activated carbon, motor fuels and carbon fibers. Furthermore, if there is a market for lignin for such value-added products, the mills will also have an additional economic incentive to take measures for higher energy efficiency. In this study residual lignin were isolated from areca nut shells by acid hydrolysis and were analyzed and characterized by Fourier Transform Infrared (FTIR), LCMS and complexity of its structure investigated by NMR.

Keywords: Areca nut, Lignin, wood, bioenergy

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Authors: Nadeem H. Meikha , Nazad H. Qader, Basheer M. Hasafa

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The trial was conducted to examine the effect of He-Ne laser therapy on the testis and serum testosterone level in adult rats. Thirty five albino Western adult male rats aged 3-4 months and weighing approximately 250-300 g were used and divided into three treatments. Testicular tissue of rats in the first and second treatments were exposed once daily for three successively days to a dose of irradiation 1.02 j/cm2 (40 second), and to 2.03 j/cm2 (80 second) respectively, while the third group left without any treatments (control). The results showed that the process of irradiation adversely affected on the level of serum testosterone concentration of the irradiated rats in the first and second treatment comparing to the normal level in the control group. While the histological examination showed that decrease in number of germ cells with 40 second of irradiation at day three, with 80 second of irradiation the decreased started at day two and three. The spermatids number decreased in rate low, medium, high respectively for three days of 40 second of irradiation, while the spermatids number were adversely affected by dropping in a rate of medium, large and very large for three days of 80 second of irradiation, respectively. In conclusion our study revealed that any reduction in sertoli cells causes adverse affect on both spermatids and germinal cells which increase with the increasing of duration and repetition of irradiation.

Keywords: He-Ne laser, rats, testosterone, spermatids

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Authors: Subal Kar, Amitesh Kumar, A. Majumder, S. K. Ghosh, S. Saha, S. S. Sikdar, T. K. Saha

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CRLH (composite right/left-handed) based and SRR (split-ring resonator) based filters have been designed at microwave frequency which can provide better performance compared to conventional edge-coupled band-pass filter designed around the same frequency, 2.45 GHz. Both CRLH and SRR are unit cells used in metamaterial design. The primary aim of designing filters with such structures is to realize size reduction and also to realize novel filter performance. The CRLH based filter has been designed in microstrip transmission line, while the SRR based filter is designed with SRR loading in waveguide. The CRLH based filter designed at 2.45 GHz provides an insertion loss of 1.6 dB with harmonic suppression up to 10 GHz with 67 % size reduction when compared with a conventional edge-coupled band-pass filter designed around the same frequency. One dimensional (1-D) SRR matrix loaded in a waveguide shows the possibility of realizing a stop-band with sharp skirts in the pass-band while a stop-band in the pass-band of normal rectangular waveguide with tailoring of the dimensions of SRR unit cells. Such filters are expected to be very useful for communication systems at microwave frequency.

Keywords: BPF, CRLH, harmonic, metamaterial, SRR and waveguide

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Authors: Wellemans Isabelle, Remmelink Myriam, Foucart Annick, Rusu Stefan, Compère Christophe

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Primary pulmonary meningioma (PPM) is a very rare tumor, and its occurrence has been reported only sporadically. Multiple PPMs are even more exceptional, and herein, we report, to the best of our knowledge, the fourth case, focusing on the clinicopathological features of the tumor. Moreover, the possible relationship between the use of progesterone–only contraceptives and the development of these neoplasms will be discussed. Case Report: We report a case of a 51-year-old female presenting three solid pulmonary nodules, with the following localizations: right upper lobe, middle lobe, and left lower lobe, described as incidental findings on computed tomography (CT) during a pre-bariatric surgery check-up. The patient revealed no drinking or smoking history. The physical exam was unremarkable except for the obesity. The lesions ranged in size between 6 and 24 mm and presented as solid nodules with lobulated contours. The largest lesion situated in the middle lobe had mild fluorodeoxyglucose (FDG) uptake on F-18 FDG positron emission tomography (PET)/CT, highly suggestive of primary lung neoplasm. For pathological assessment, video-assisted thoracoscopic middle lobectomy and wedge resection of the right upper nodule was performed. Histological examination revealed relatively well-circumscribed solid proliferation of bland meningothelial cells growing in whorls and lobular nests, presenting intranuclear pseudo-inclusions and psammoma bodies. No signs of anaplasia were observed. The meningothelial cells expressed diffusely Vimentin, focally Progesterone receptors and were negative for epithelial (cytokeratin (CK) AE1/AE3, CK7, CK20, Epithelial Membrane Antigen (EMA)), neuroendocrine markers (Synaptophysin, Chromogranin, CD56) and Estrogenic receptors. The proliferation labelling index Ki-67 was low (<5%). Metastatic meningioma was ruled out by brain and spine magnetic resonance imaging (MRI) scans. The third lesion localized in the left lower lobe was followed-up and resected three years later because of its slow but significant growth (14 mm to 16 mm), alongside two new infra centimetric lesions. Those three lesions showed a morphological and immunohistochemical profile similar to previously resected lesions. The patient was disease-free one year post-last surgery. Discussion: Although PPMs are mostly benign and slow-growing tumors with an excellent prognosis, they do not present specific radiological characteristics, and it is difficult to differentiate it from other lung tumors, histopathologic examination being essential. Aggressive behavior is associated with atypical or anaplastic features (WHO grades II–III) The etiology is still uncertain and different mechanisms have been proposed. A causal connection between sexual hormones and meningothelial proliferation has long been suspected and few studies examining progesterone only contraception and meningioma risk have all suggested an association. In line with this, our patient was treated with Levonorgestrel, a progesterone agonist, intra-uterine device (IUD). Conclusions: PPM, defined by the typical histological and immunohistochemical features of meningioma in the lungs and the absence of central nervous system lesions, is an extremely rare neoplasm, mainly solitary and associating, and indolent growth. Because of the unspecific radiologic findings, it should always be considered in the differential diagnosis of lung neoplasms. Regarding multiple PPM, only three cases are reported in the literature, and this is the first described in a woman treated by a progesterone-only IUD to the best of our knowledge.

Keywords: pulmonary meningioma, multiple meningioma, meningioma, pulmonary nodules

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Authors: Taikchan Lildar, Ayesha Samad, Suraj Sookhu

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Atrial fibrillation with rapid ventricular response results in the loss of atrial kick and shortened ventricular filling time, which often leads to decompensated heart failure. Pharmacologic rhythm control is the treatment of choice, and patients frequently benefit from the restoration of sinus rhythm. When pharmacologic treatment is unsuccessful or a patient declines hemodynamically, direct cardioversion is the treatment of choice. Torsades de pointes or “twisting of the points'' in French, is a rare but under-appreciated risk of cardioversion therapy and accounts for a significant number of sudden cardiac death each year. A 61-year-old female with no significant past medical history presented to the Emergency Department with worsening dyspnea. An electrocardiogram showed atrial fibrillation with rapid ventricular response, and a chest X-ray was significant for bilateral pulmonary vascular congestion. Full-dose anticoagulation and diuresis were initiated with moderate improvement in symptoms. A transthoracic echocardiogram revealed biventricular systolic dysfunction with a left ventricular ejection fraction of 30%. After consultation with an electrophysiologist, the consensus was to proceed with the restoration of sinus rhythm, which would likely improve the patient’s heart failure symptoms and possibly the ejection fraction. A transesophageal echocardiogram was negative for left atrial appendage thrombus; the patient was treated with a loading dose of amiodarone and underwent successful direct current cardioversion with 200 Joules. The patient was placed on telemetry monitoring for 24 hours and was noted to have frequent premature ventricular contractions with subsequent degeneration to torsades de pointes. The patient was found unresponsive and pulseless; cardiopulmonary resuscitation was initiated with cardioversion, and return of spontaneous circulation was achieved after four minutes to normal sinus rhythm. Post-cardiac arrest electrocardiogram showed sinus bradycardia with heart-rate corrected QT interval of 592 milliseconds. The patient continued to have frequent premature ventricular contractions and required two additional cardioversions to achieve a return of spontaneous circulation with intravenous magnesium and lidocaine. An automatic implantable cardioverter-defibrillator was subsequently implanted for secondary prevention of sudden cardiac death. The backup pacing rate of the automatic implantable cardioverter-defibrillator was set higher than usual in an attempt to prevent premature ventricular contractions-induced torsades de pointes. The patient did not have any further ventricular arrhythmias after implantation of the automatic implantable cardioverter-defibrillator. Overdrive pacing is a method utilized to treat premature ventricular contractions-induced torsades de pointes by preventing a patient’s susceptibility to R on T-wave-induced ventricular arrhythmias. Pacing at a rate of 90 beats per minute succeeded in controlling the arrhythmia without the need for traumatic cardiac defibrillation. In our patient, conversion of atrial fibrillation with rapid ventricular response to normal sinus rhythm resulted in a slower heart rate and an increased probability of premature ventricular contraction occurring on the T-wave and ensuing ventricular arrhythmia. This case highlights direct current cardioversion for atrial fibrillation with rapid ventricular response resulting in persistent ventricular arrhythmia requiring an automatic implantable cardioverter-defibrillator placement with overdrive pacing to prevent a recurrence.

Keywords: refractory atrial fibrillation, atrial fibrillation, overdrive pacing, torsades de pointes

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Authors: Nikita Mahajani

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The Bene Israel is the oldest Jewish community on the subcontinent, and their shipwreck off the coast of Navgaon (a coastal settlement south of Alibaug), in which only seven men and women survived, anticipated the first millennia of their residence in the Konkan. The community was cut off from mainstream Judaism for decades as a result of its poverty. Almost all of the Bene Israel people in the northern Konkan region have relocated to Israel. The few who remained have settled down in Mumbai and Thane. Despite this, they have left a rich cultural legacy, as seen by their houses, cemeteries and synagogues. Even though the population has reduced owing to outside migration, much of this built legacy has survived. This paper attempts to examine the Jewish architectural heritage in Raigad with an aim to recreate their cultural, social and economic history. Oral histories by interviews of the Bene Israel community from Revdanda helped gain information about naming customs, migrations, professions, religious customs and funeral practices. The findings of this research reveal that most synagogues in Raigad district are shut due to a lack of Bene Israelis coming for prayers. The cemeteries are in a dilapidated condition. The little-known Bene Israeli community of Raigad is a seamless blend of Maharashtrian and Jew culture and feels more homely in India.

Keywords: Konkan, Alibag, Revdanda, Pen, Bene Israeli, Indian jews, synagogue, cemetry

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Authors: Naser Safdarian, Nader Jafarnia Dabanloo

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In this paper we used four features i.e. Q-wave integral, QRS complex integral, T-wave integral and total integral as extracted feature from normal and patient ECG signals to detection and localization of myocardial infarction (MI) in left ventricle of heart. In our research we focused on detection and localization of MI in standard ECG. We use the Q-wave integral and T-wave integral because this feature is important impression in detection of MI. We used some pattern recognition method such as Artificial Neural Network (ANN) to detect and localize the MI. Because these methods have good accuracy for classification of normal and abnormal signals. We used one type of Radial Basis Function (RBF) that called Probabilistic Neural Network (PNN) because of its nonlinearity property, and used other classifier such as k-Nearest Neighbors (KNN), Multilayer Perceptron (MLP) and Naive Bayes Classification. We used PhysioNet database as our training and test data. We reached over 80% for accuracy in test data for localization and over 95% for detection of MI. Main advantages of our method are simplicity and its good accuracy. Also we can improve accuracy of classification by adding more features in this method. A simple method based on using only four features which extracted from standard ECG is presented which has good accuracy in MI localization.

Keywords: ECG signal processing, myocardial infarction, features extraction, pattern recognition

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Authors: Nizar Abu-Jaber

Abstract:

Late Pleistocene and Holocene carbonate crusts in the south of Jordan were studied using a combination of field documentation, petrography, geochemical and isotopic techniques. These surficial crusts and vein deposits appear to have formed as a result of interaction between near-surface groundwater, surficial soil and sediments and rising carbon dioxide. Rising mantle CO2 dissolves in the water to create carbonic acid, which in turn dissolves the calcite in the soil in the sediments. When the pH rises later due to degassing, the carbonate crusts are left in the places where the water was flowing in veins, channels and interfaces between high and low permeability materials. The crusts have the potential for being important records of natural and human agencies on the landscape of the area. They reflect the isotopic composition of the waters in which they precipitated in, and also contain isotopic information about the aeolian calcium fluxes affecting the area (using strontium isotopes). Moreover, changing stream valley base levels can be identified and measured, which can help quantify the rates of tectonic movement. Finally, human activities such and channel construction and terrace building can be identified and traced temporally and spatially using these deposits.

Keywords: anthropogenic change, carbonate crusts, environmental change, Jordan

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Authors: Mandlenkosi G. R. Mahlobo, Peter A. Olubambi, Philippe Refait

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The aim of this study was to use voltammetry as a method to understand the behaviour of steel in unsaturated soil in the presence of cathodic protection (CP). Three carbon steel coupons were buried in artificial soil wetted at 65-70% of saturation for 37 days. All three coupons were left at open circuit potential (OCP) for the first seven days in the unsaturated soil before CP, which was only applied on two of the three coupons at the protection potential -0.8 V vs Cu/CuSO₄ for the remaining 30 days of the experiment. Voltammetry was performed weekly on the coupon without CP, while electrochemical impedance spectroscopy (EIS) was performed daily to monitor and correct the applied CP potential from the ohmic drop. Voltammetry was finally performed on the last day on the coupons under CP. All the voltammograms were modeled with mathematical equations in order to compute the electrochemical parameters and subsequently deduced the corrosion rate of the steel coupons. For the coupon without CP, the corrosion rate was determined at 300 µm/y. For the coupons under CP, the residual corrosion rate under CP was estimated at 12 µm/y while the corrosion rate of the coupons, after interruption of CP, was estimated at 25 µm/y. This showed that CP was efficient due to two effects: a direct effect from the decreased potential and an induced effect associated with the increased interfacial pH that promoted the formation of a protective layer on the steel surface.

Keywords: carbon steel, cathodic protection, voltammetry, unsaturated soil, Raman spectroscopy

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