Search results for: general medical

Authors: Haruna Abdu Usman, Bashir Usman Mohammed, Mohammed Umar Jamil

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Municipal solid waste management constitutes a serious problem bedeviling environmental protection agencies in many cities of developing countries. Most agencies do not collect the totality of the waste generated in their cities. This study presents the current solid waste management practices and problems in Bauchi metropolis, Bauchi state Nigeria. The general feature is characterized by inefficient, insufficient and irrational collection and improper disposal alternatives. The consequent environmental effects of these problems depict clogged city drains, uncollected heap of waste on road sides of residential areas, vacant plots and uncompleted buildings and highways. This contributes immensely to flooding in the city. The major challenges facing the state environmental protection agency includes; lack of collection and disposal points, technical and institutional arrangements, financial resources and general attitude of the serving public among others. The study suggested a comprehensive and integrated approach to the solid waste management which recognizes and incorporates the interventionist role of the state government, the private formal and informal waste management operators and the serving public.

Keywords: municipal solid waste, bauchi metropolitan area, environmental protection agency, solid waste management, waste disposal

Procedia PDF Downloads 742

Authors: Ali Showail Ali Alasmari

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Introduction: Cataract is the loss of transparency of the lens inside the eye. It is the most common cause of visual loss and blindness worldwide. This study provides a systemic review of the recent findings on the association of vitamin D, and vitamin B12, and their possible role in preventing cataracts in senile (S) and diabetic mellitus (DM) patient groups. Objective: This study was intended to establish and investigate if there is any role between vitamin D and vitamin B12? Secondly, the connection between serum level of vitamin D and vitamin B12 in cataract incidence senile (s) vs. diabetic mellitus (DM) cataract patient groups. Furthermore, to evaluate and analyze cataract occurrence regarding vitamin D and vitamin B12 levels with other risk factors. Finally, to evaluate lens opacities pre and post treatment with vitamin D and vitaminB12 linked to age and visual acuity loss in both senile(S) and diabetic mellitus (DM) cataract patients’ groups. Methods: This study conducted at the ophthalmology clinic at Muhyail General Hospital. Select a prospective case-control to study the effect of vitamin D and Vit B12 on senile(S) cataracts that caused by age and diabetic mellitus (DM)cataract patients; then we compare these two groups. This study prospectively enrolled a total of 50 samples, 25 with senile cataract and 25 with diabetic cataract, from ophthalmology clinic at Muhyail General Hospital. Measuring 25-hydroxy vitamin D and vitamin B12 level concentrations in the assigned samples. Analyses were performed using SAS (statistical analysis software) program. Results: The most important finding in this study was that the senile(s) cataract patients’ group greatly benefited by the combination therapy of vitamin D, and Vitamin B12 reached (28.5±1.50 and 521.1±21.10) respectively; on the contrary, the diabetic cataract patient group hardly shows any significant improvement (21.5 ± 1.00 and 197.2 ± 7.20) respectively. This is because of the Metformin, the first line drug for treating diabetes, has been reported to potentially decrease vitamin B-12 status. This epigenetic modification was correlated with the diabetic mellitus (DM) cataract patients’ group not responding. Vitamin B12 deficiency also leads to an impairment of the conversion of methylmalonyl-CoA to succinyl-CoA, which has been associated with insulin resistance. There was no significant difference between the age, body mass index (BMI), the mean of Vit-D pre-treatments, and the mean values of Hemoglobin A1C of both senile (S) and diabetic mellitus (DM) cataract patient groups. On other hand, there was a highly significant difference between the mean values of glucose levels in both senile (S) and diabetic mellitus (DM) cataract patient groups. Conclusion: Here we conclude that diabetic mellitus (DM) cataract patient group hardly benefited from this combination therapy vitamin D and vitamin B12; on the other hand senile patient group (s) benefited a lot from the therapy.

Keywords: cataract patients, senile, diabetes mellitus, vitamin B12, vitamin D, Muhyail General Hospital, Saudi Arabia

Procedia PDF Downloads 104

Authors: Jerzy Slowik, Elzbieta Grochowska-Niedworok

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The analysis of the market needs and trends in both treatment and prophylaxis shows the growing need to implement comprehensive solutions that would enable safe contact of the beneficiaries with the therapeutic and diagnostic support group. Based on the evaluation of the medical and sports industry services market, projects co-financed by the EFRR in the form of comprehensive care systems using IT tools for patients under treatment in the field of obesity and metabolism using the system were implemented under the Regional Operational Program of the Silesian Voivodeship for 2014-2020. SFAO 1.0 (Support for the Fight Against Obesity) number of the WND-RPSL project. 01.02.00-24-06EA / 16) as well as for competitors in qualified sports SK system (qualified sports) project number WND-RPSL. 01.02.00-24-0630 / 17-002. The service provided in accordance with SFAO 1.0 has shown a wide range of therapy possibilities - from monitoring the body's reactions during sports activities of healthy people to remote care for sick patients. As a result of the introduction of an innovative service, it was possible to increase the effectiveness of the therapy, which was manifested in the reduction of the starting doses of drugs by 10%, improvement of the efficiency of the respiratory and blood circulation system, and a 10% increase in bone density. Innovation in the provision of medical services in the field of qualified sports SK was a response to the needs of the athletes and their parents, coaches, physiotherapists, dieticians, and doctors who take care of people actively practicing qualified sports. The creation of the platform made it possible to constantly monitor the trainers necessary for both the proper training process and the control over the health of patients. Monitoring the patient's health by a specialized team in the field of various specialties allows for the proper targeting of the treatment and training process due to the increase in the availability of medical counseling. Specialists taking care of the patient can provide additional advice and modify the medical treatment of the patient on an ongoing basis, which is why we are dealing with a holistic approach.

Keywords: innovation of medical services, sport, obesity, innovation

Procedia PDF Downloads 127

Authors: Omar Bobes, Abeer Al-Attar, Mohammad Hassan Kharita, Huda Al-Naemi

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The number of radiological examinations has increased steadily in recent years. As a result, the risk of possible radiation-induced consequential damage also increases through continuous, lifelong, and increasing exposure to ionizing radiation. Therefore, radiation dose monitoring in medicine became an essential element of medical practice. In this study, the occupational cumulative doses for radiation workers in Hamad medical corporation in Qatar have been assessed for a period of five years. The number of monitored workers selected for this study was 555 (out of a total of 1250 monitored workers) who have been working continuously -with no interruption- with ionizing radiation over the past five years from 2015 to 2019. The aim of this work is to examine the occupational groups and the activities where the higher radiation exposure occurred and in what order of magnitude. The most exposed group was the nuclear medicine technologist staff, with an average cumulative dose of 8.4 mSv. The highest individual cumulative dose was 9.8 mSv recorded for the PET-CT technologist category.

Keywords: cumulative dose, effective dose, monitoring, occupational exposure, dosimetry

Procedia PDF Downloads 243

Authors: Ashlesha Khanapure, Harsh Kashyap, Abhinav Anand, Sanjana Habib, Anupama Bidargaddi

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Technologies that are developing quickly are being developed daily in a variety of disciplines, particularly the medical field. For the purpose of detecting bone fractures in X-ray pictures of different body segments, our work compares the ResNet-50 and MobileNetV3 architectures. It evaluates accuracy and computing efficiency with X-rays of the elbow, hand, and shoulder from the MURA dataset. Through training and validation, the models are evaluated on normal and fractured images. While ResNet-50 showcases superior accuracy in fracture identification, MobileNetV3 showcases superior speed and resource optimization. Despite ResNet-50’s accuracy, MobileNetV3’s swifter inference makes it a viable choice for real-time clinical applications, emphasizing the importance of balancing computational efficiency and accuracy in medical imaging. We created a graphical user interface (GUI) for MobileNet V3 model bone fracture detection. This research underscores MobileNetV3’s potential to streamline bone fracture diagnoses, potentially revolutionizing orthopedic medical procedures and enhancing patient care.

Keywords: CNN, MobileNet V3, ResNet-50, healthcare, MURA, X-ray, fracture detection

Procedia PDF Downloads 63

Authors: Ahmed Khalil

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Increased energy demands around the world have led to the raise in power production which has resulted with more greenhouse gas emissions through fossil sources. These fossil sources and emissions cause deterioration in echo-system. Therefore, renewable energy sources come to the scene as echo-friendly and clean energy sourcing, whereas the electrical devices and energy needs decrease in the timeline. Each of these renewable energy sources contribute to the reduction of greenhouse gases and mitigate environmental deterioration. However, there are also some general and source-specific challenges, which influence the choice of the investors. The most prominent general challenge that effects end-users’ comfort and reliability is usually determined as the intermittence which derives from the diversions of source conditions, due to nature dynamics and uncontrolled periodic changes. Research and development professionals strive to mitigate intermittence challenge through material improvement for each renewable source whereas hybrid source mix stand as a solution. This solution prevails well, when single renewable technologies are upgraded further. On the other hand, integration of energy efficient devices and systems, raise the affirmative effect of such solution in means of less energy requirement in sustainability composition or scenario. This paper provides a glimpse on the advantages of composing renewable source mix versus single usage, with contribution of sampled e-efficient systems and devices. Accordingly it demonstrates the extended benefits, through planning and predictive estimation stages of Ahmadi Town Projects in Kuwait.

Keywords: e-efficient systems, hybrid source, intermittence challenge, renewable energy

Procedia PDF Downloads 136

Authors: Wu Liching

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Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

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Authors: Michael Dolgin, Oz Hamtzani, Talma Kushnir

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A literature review has shown that while parents of children with cancer experience increased levels of psychological distress associated with their child's medical condition, considerable variability in parental adjustment is evident. Of the factors that may account for this variability, little attention has been devoted to the simultaneous interaction of three coping constructs and their role in parental adjustment: (1) Coping techniques employed, (2) Repertoire of coping techniques, and (3) Flexibility in applying coping techniques. While these constructs have been studied individually in relation to adjustment in general, studies to date have not included them together within a single conceptual model and research design and evaluated them in a clinical population. The objective of the current study was to determine how these three coping technique constructs interact to impact parental adjustment to pediatric cancer. A cross-sectional sample of 145 parents of children in active cancer treatment completed standardized measures of coping techniques, repertoire, flexibility, and parental distress. A hierarchical multiple regression analysis demonstrated that 37% of the variance in parental distress was predicted by the use of avoidance-focused coping techniques [F(1,118)=69.843, p<.001], with an additional 3% predicted by coping repertoire [F(2,117)=7.63, p=.00] for a total of 40% variance explained. Coping flexibility was found to mediate the relationship between coping repertoire and parental distress. These findings suggest that coping techniques employed by parents (problem/emotion-focused vs. avoidance-focused), as well as coping repertoire, significantly impact parental adjustment. Flexibility in applying coping techniques within one’s coping repertoire further contributes to parental adjustment. Implications for further study and clinical intervention will be presented.

Keywords: coping techniques, repertoire, flexibility, adjustment

Procedia PDF Downloads 42

Authors: Ssembatya Joseph Mary

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Introduction: Omphalocele, an abdominal wall defect, occurs in 1 out of 4,000 to 6,000 live births. It is characterized by visceral herniation of small and large intestines, liver, and sometimes spleen and gonads are involved. The viscera is always covered by a three-layered sac. The defect in the mesoderm is mainly due to the failure of lateral abdominal wall folds to unite. About 350,000 ventral hernia repairs are done annually in the united states of America. Surgical repair with a mesh is the gold standard surgical method. With conservative management of Omphalocele, children are eventually closed between the age of 1 and 5 years. Herein, we present a late manifestation of ventral hernia following Omphalocele in a female Ugandan. Case presentation: A 56-year-old female with no known chronic illnesses and normal perinatal history presented with an umbilical swelling since birth with no associated symptoms. She is a married woman to one husband and has five children, and all of them are in good general condition with no such symptoms. She had normal vitals with an umbilical defect measuring about 20cm from the xiphoid process and 10 cm from the symphysis pubis. Surgery was done (component separation) on the second inpatient day, and it was uneventful. The patient was discharged on the 4th postoperative day in good general condition with a dry and clean surgical site. Conclusion: Despite adequate literature about Omphalocele and clear management guidelines, there have been reported cases of adult presentation of ventral hernias secondary to Omphalocele.

Keywords: omphalocele, ventral hernia, uganda, late presentation

Procedia PDF Downloads 68

Authors: H. Jalahi, A. Yazdanpanah Nozari

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Background and Purpose: Assessment of learners’ performance is an important factors in teaching-learning process. When a factor is sensitive and has high influence on life, their assessment should be done precisely. Thinking dispositions are very important factors in medical education because of its specific condition. In this study a model is designed for fostering thinking dispositions of learners in which authentic assessment is an important element. Materials and Methods: Objective based research is developmental, and such a model was not designed for curricula. Data collection and comparing approaches about assessment and analyzing current assessments offered applied proposals. Results: Based on research findings, the current assessments are response-based, that is students instead of product of response, only offers the specific response which the teachers expects; but authentic assessment is a form of assessment in which students are asked to perform real-word tasks that demonstrate meaningful application of essential knowledge and skills. Conclusion: Because of the difficulties and unexpected problems in life and individuals needs to lifelong learning and conditions in medical course that require decision making in specific times, we must pay attention to reach thinking dispositions and it should be included in curriculum. Authentic assessment as an important aspect of curriculum can help fostering thinking dispositions of learners. Using this kind of assessments which focus on application of information and skills to solve real-word tasks have more important role in medical courses.

Keywords: assessment, authentic, medical courses, developmental

Procedia PDF Downloads 365

Authors: Konysbek Aksaule

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The purpose of this work is to explore new and effective ways of teaching English to students who are studying a foreign language since the timeliness of the problem disclosed in this article is due to the high level of English proficiency that potential specialists must have due to high competition in the context of global globalization. The article presents an analysis of the feasibility and effectiveness of using an authentic feature film in teaching English to students. The methodological basis of the study includes an assessment of the level of students' proficiency in a foreign language, the stage of evaluating the film, and the method of selecting the film for certain categories of students. The study also contains a list of practical tasks that can be applied in the process of viewing and perception of an original feature film in a foreign language, and which are aimed at developing language skills such as speaking and listening. The results of this study proved that teaching English to students through watching an original film is one of the most effective methods because it improves speech perception, speech reproduction ability, and also expands the vocabulary of students and makes their speech fluent. In addition, learning English through watching foreign films has a huge impact on the cultural views and knowledge of students about the country of the language being studied and the world in general. Thus, this study demonstrates the high potential of using authentic feature film in English lessons for pedagogical science and methods of teaching English in general.

Keywords: university, education, students, foreign language, feature film

Procedia PDF Downloads 148

Authors: Sadia Suri Kashif, Raheeda Fatima, Maqsood Ahmed Khan

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Purpose of the study: The objective of this research was to determine the perception of Pakistani physicians (whether primary care, specialists or residents) in Karachi, being one of the largest and highly populated cities of Pakistan, regarding clinical approaches towards diet, exercise, and therapy in obese patients. This research determines their understanding of obesity and employability of obesity management in their daily practices. Research methodology: This is a questionnaire-based survey. A minimum of 300 questionnaires (N=300) were distributed and filled by practicing physicians in a random selection of medical setups in Karachi. Randomly 246 physicians responded to the survey. The survey tested their views regarding weight management, importance of general awareness and their strategies to control weight. Results: In the first part of survey the physicians responded to almost 66% regarding the seriousness of obesity management with advising diet modification, physical exercise and decreasing calorie intake; 57% failed to employ Body Mass Index and Waist Hip Ratio as weight measurement tools in their daily practice; 50% disagreed on using pharmacotherapy as an option; 67% were not sure about the proper dosage and indication of anti-obesity medication while almost same disagreed on using surgical options for management of obesity; 83.3% physicians agreed on the increased obesity pandemic in Pakistan. Conclusion: The findings indicate that there is a gap between awareness and knowledge among Pakistani practicing physicians regarding pharmacotherapy for obesity. There is a need to frequently update latest guidelines to help manage this condition, which is becoming more prevalent in our country day by day. Physicians should be obligated to use updated knowledge for managing obesity.

Keywords: obesity, physicians, BMI, weight management, obesity awareness

Procedia PDF Downloads 170

Authors: Julia Wimmers-Klick

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In the contemporary study of anatomy, medical students utilize a diverse array of resources, including lab handouts, lectures, and, increasingly, digital media such as interactive anatomy apps and digital images. Notably, a significant shift has occurred, with fewer students possessing traditional anatomy atlases or books, reflecting a broader trend towards digital approaches like Virtual Reality, Augmented Reality, and web-based programs. This paper seeks to explore the evolution of anatomy education by contrasting current digital tools with historical resources, such as classical anatomical illustrations and atlases, to assess their relevance and potential benefits in modern medical education. Through a comprehensive literature review, the development of anatomical illustrations is traced from the textual descriptions of Galen to the detailed and artistic representations of Da Vinci, Vesalius, and later anatomists. The examination includes how the printing press facilitated the dissemination of anatomical knowledge, transforming covert dissections into public spectacles and formalized teaching practices. Historical illustrations, often influenced by societal, religious, and aesthetic contexts, not only served educational purposes but also reflected the prevailing medical knowledge and ethical standards of their times. Critical questions are raised about the place of historical illustrations in today's anatomy curriculum. Specifically, their potential to teach critical thinking, highlight the history of medicine, and offer unique insights into past societal conditions are explored. These resources are viewed in their context, including the lack of diversity and the presence of ethical concerns, such as the use of illustrations from unethical sources like Pernkopf’s atlas. In conclusion, while digital tools offer innovative ways to visualize and interact with anatomical structures, historical illustrations provide irreplaceable value in understanding the evolution of medical knowledge and practice. The study advocates for a balanced approach that integrates traditional and modern resources to enrich medical education, promote critical thinking, and provide a comprehensive understanding of anatomy. Future research should investigate the optimal combination of these resources to meet the evolving needs of medical learners and the implications of the digital shift in anatomy education.

Keywords: human anatomy, historical illustrations, historical context, medical education

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Authors: Elizaveta S. Prokofyeva, Svetlana V. Maltseva, Roman D. Zaitsev

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Rapidly evolving modern data analysis technologies in healthcare play a large role in understanding the operation of the system and its characteristics. Nowadays, one of the key tasks in urban healthcare is to optimize the resource allocation. Thus, the application of data analysis in medical institutions to solve optimization problems determines the significance of this study. The purpose of this research was to establish the dependence between the indicators of the effectiveness of the medical institution and its resources. Hospital discharges by diagnosis; hospital days of in-patients and in-patient average length of stay were selected as the performance indicators and the demand of the medical facility. The hospital beds by type of care, medical technology (magnetic resonance tomography, gamma cameras, angiographic complexes and lithotripters) and physicians characterized the resource provision of medical institutions for the developed models. The data source for the research was an open database of the statistical service Eurostat. The choice of the source is due to the fact that the databases contain complete and open information necessary for research tasks in the field of public health. In addition, the statistical database has a user-friendly interface that allows you to quickly build analytical reports. The study provides information on 28 European for the period from 2007 to 2016. For all countries included in the study, with the most accurate and complete data for the period under review, predictive models were developed based on historical panel data. An attempt to improve the quality and the interpretation of the models was made by cluster analysis of the investigated set of countries. The main idea was to assess the similarity of the joint behavior of the variables throughout the time period under consideration to identify groups of similar countries and to construct the separate regression models for them. Therefore, the original time series were used as the objects of clustering. The hierarchical agglomerate algorithm k-medoids was used. The sampled objects were used as the centers of the clusters obtained, since determining the centroid when working with time series involves additional difficulties. The number of clusters used the silhouette coefficient. After the cluster analysis it was possible to significantly improve the predictive power of the models: for example, in the one of the clusters, MAPE error was only 0,82%, which makes it possible to conclude that this forecast is highly reliable in the short term. The obtained predicted values of the developed models have a relatively low level of error and can be used to make decisions on the resource provision of the hospital by medical personnel. The research displays the strong dependencies between the demand for the medical services and the modern medical equipment variable, which highlights the importance of the technological component for the successful development of the medical facility. Currently, data analysis has a huge potential, which allows to significantly improving health services. Medical institutions that are the first to introduce these technologies will certainly have a competitive advantage.

Keywords: data analysis, demand modeling, healthcare, medical facilities

Procedia PDF Downloads 144

Authors: Shang Yee Chong

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Perioperative pain is a complex mechanism activated by various nociceptive, neuropathic, and inflammatory pathways. Opioids have long been a mainstay for analgesia in this period, even as we are continuously moving towards a multimodal model to improve pain control while minimising side effects. Dexmedetomidine, a potent alpha-2 agonist, is a useful sedative and hypnotic agent. Its use in the intensive care unit has been well described, and it is increasingly an adjunct intraoperatively for its opioid sparing effects and to decrease pain scores. We describe a case of a general surgical patient in whom minimal opioids was required with dexmedetomidine use. The patient was a 61-year-old Indian gentleman with a history of hyperlipidaemia and type 2 diabetes mellitus, presenting with rectal adenocarcinoma detected on colonoscopy. He was scheduled for a robotic ultra-low anterior resection. The patient was induced with intravenous fentanyl 75mcg, propofol 160mg and atracurium 40mg. He was intubated conventionally and mechanically ventilated. Anaesthesia was maintained with inhalational desflurane and anaesthetic depth was measured with the Masimo EEG Sedline brain function monitor. An initial intravenous dexmedetomidine dose (bolus) of 1ug/kg for 10 minutes was given prior to anaesthetic induction and thereafter, an infusion of 0.2-0.4ug/kg/hr to the end of surgery. In addition, a bolus dose of intravenous lignocaine 1.5mg/kg followed by an infusion at 1mg/kg/hr throughout the surgery was administered. A total of 10mmol of magnesium sulphate and intravenous paracetamol 1000mg were also given for analgesia. There were no significant episodes of bradycardia or hypotension. A total of intravenous phenylephrine 650mcg was given throughout to maintain the patient’s mean arterial pressure within 10-15mmHg of baseline. The surgical time lasted for 5 hours and 40minutes. Postoperatively the patient was reversed and extubated successfully. He was alert and comfortable and pain scores were minimal in the immediate post op period in the postoperative recovery unit. Time to first analgesia was 4 hours postoperatively – with paracetamol 1g administered. This was given at 6 hourly intervals strictly for 5 days post surgery, along with celecoxib 200mg BD as prescribed by the surgeon regardless of pain scores. Oral oxycodone was prescribed as a rescue analgesic for pain scores > 3/10, but the patient did not require any dose. Neither was there nausea or vomiting. The patient was discharged on postoperative day 5. This case has reinforced the use of dexmedetomidine as an adjunct in general surgery cases, highlighting its excellent opioid-sparing effects. In the entire patient’s hospital stay, the only dose of opioid he received was 75mcg of fentanyl at the time of anaesthetic induction. The patient suffered no opioid adverse effects such as nausea, vomiting or postoperative ileus, and pain scores varied from 0-2/10. However, intravenous lignocaine infusion was also used in this instance, which would have helped improve pain scores. Paracetamol, lignocaine, and dexmedetomidine is thus an effective, opioid-sparing combination of multi-modal analgesia for major abdominal surgery cases.

Keywords: analgesia, dexmedetomidine, general surgery, opioid sparing

Procedia PDF Downloads 135

Authors: Devita Wardani, Pratiwi Gusti Wahyu, Andreas Infianto, Raden Dicky Wirawan Listiandoko, Descahirul, Yunnica

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Flexible fiberoptic bronchoscopy (FFB) is the essential method for both the diagnosis and staging of central lung cancer. Concerning central lesions, the sensitivity of endobronchial forceps biopsy of a visible endobronchial lesion is 74%. The aim is to determine the distribution of lung cancer types of patients diagnosed with and who underwent bronchoscopy at General Ahmad Yani Metro Hospital. Methods: This study is a cross-sectional descriptive study. Data are obtained from histopathological results of lung malignancy through bronchoscopy either from forceps biopsy, washing and brushing. Results: Lung cancer is more found in men (72.2%) than women (27.8%). The average age for men ranges 57 years old for Non-Small Cell and 56 years old for Small Cell case. Most histopathology found in non-small cell lung cancer (87.7%), with adenocarcinoma as the most common type (68.4%), followed by squamous cell carcinoma (29.1%). Findings for adenocarcinoma showed that men had an incidence of 64.8% and women had an incidence of 35.2%. Like NSCLC, men can have up to 90% of cases of SCLC compared to 10% in women. In addition to non-small cell and small cell types, other types, such as large cells and renal carcinoma metastases, were obtained. Conclusions: Adenocarcinoma lung cancer is the most widely obtained type with predominantly male patients.

Keywords: bronchoscopy, forceps biopsy, washing, brushing

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Authors: Julia Wimmers-Klick

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At the Canadian University of British Columbia's Faculty of Medicine, anatomy has traditionally been taught through a combination of lectures and dissection labs in the first two years, with radiology taught separately through lectures and online modules. However, this separation may leave students underprepared for medical practice, as medical imaging is essential for diagnosing anatomical and pathological conditions. To address this, a pilot project was initiated aimed at integrating radiological imaging into anatomy dissection labs from day one of medical school. The incorporated radiological images correlated with the current dissection areas. Additional stations were added within the lab, tailored to the specific content being covered. These stations focused on bones, and quiz questions, along with light-box exercises using radiographs, CT scans, and MRIs provided by the radiology department. The images used were free of pathologies. Examples of these will be presented in the poster. Feedback from short interviews with students and instructors has been positive, particularly among second-year students who appreciated the integration compared to their first-year experience. This low-budget approach was easy to implement but faced challenges, as lab instructors were not radiologists and occasionally struggled to answer students' questions. Instructors expressed a desire for basic training or a refresher course in radiology image reading, particularly focused on identifying healthy landmarks. Overall, all participants agreed that integrating radiology with anatomy reinforces learning during dissection, enhancing students' understanding and preparation for clinical practice.

Keywords: quality improvement, radiology education, anatomy education, integration

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Authors: Felicitas Pielsticker, Christoph Pielsticker, Ingo Witzke

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Neurological findings provide foundational results for many different disciplines. In this article we want to discuss these with a special focus on mathematics education. The intention is to make neuroscience research useful for the description of cognitive mathematical learning processes. A key issue of mathematics education is that students often behave as if their mathematical knowledge is constructed in isolated compartments with respect to the specific context of the original learning situation; supporting students to link these compartments to form a coherent mathematical society of mind is a fundamental task not only for mathematics teachers. This aspect goes hand in hand with the question if there is such a thing as abstract general mathematical knowledge detached from concrete reality. Educational Neuroscience may give answers to the question why students develop their mathematical knowledge in isolated subjective domains of experience and if it is generally possible to think in abstract terms. To address these questions, we will provide examples from different fields of mathematics education e.g. students’ development and understanding of the general concept of variables or the mathematical notion of universal proofs. We want to discuss these aspects in the reflection of functional studies which elucidate the role of specific brain regions in mathematical learning processes. In doing this the paper addresses concept formation processes of students in the mathematics classroom and how to support them adequately considering the results of (educational) neuroscience.

Keywords: brain regions, concept formation processes in mathematics education, proofs, teaching-learning processes

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Authors: Kiurski S. Jelena, Aksentijević M. Snežana, Kecić S. Vesna, Oros B. Ivana

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The prosperity of electronic equipment in photocopying environment not only has improved work efficiency, but also has changed indoor air quality. Considering the number of photocopying employed, indoor air quality might be worse than in general office environments. Determining the contribution from any type of equipment to indoor air pollution is a complex matter. Non-methane hydrocarbons are known to have an important role of air quality due to their high reactivity. The presence of hazardous pollutants in indoor air has been detected in one photocopying shop in Novi Sad, Serbia. Air samples were collected and analyzed for five days, during 8-hr working time in three-time intervals, whereas three different sampling points were determined. Using multiple linear regression model and software package STATISTICA 10 the concentrations of occupational hazards and micro-climates parameters were mutually correlated. Based on the obtained multiple coefficients of determination (0.3751, 0.2389, and 0.1975), a weak positive correlation between the observed variables was determined. Small values of parameter F indicated that there was no statistically significant difference between the concentration levels of non-methane hydrocarbons and micro-climates parameters. The results showed that variable could be presented by the general regression model: y = b0 + b1xi1+ b2xi2. Obtained regression equations allow to measure the quantitative agreement between the variation of variables and thus obtain more accurate knowledge of their mutual relations.

Keywords: non-methane hydrocarbons, photocopying process, multiple regression analysis, indoor air quality, pollutant emission

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Authors: Ahmad Afif, Teuku Yuri M. Zagloel

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Sustainable supply chain management is a new pattern that has emerged recently in industry and companies. The procurement process is one of the key factors for efficiency in supply chain management practices. Partnership is one of the procurement strategies for strategic items. The success factors of the partnership must be determined to avoid things that endanger the financial and operational status of the company. The current supplier partnership research focuses on the selection of general criteria and sustainable supplier selection. Currently, there is still limited research on the success factors of supplier partnerships that focus on strategic items in the coal mining industry. Meanwhile, the procurement of coal mining has its own characteristics, and there are regulations related to the procurement of goods. Therefore, this research was conducted to determine the categories of goods that are included in the strategic items and to design the success factors of supplier partnerships. The main factors studied are general, financial, production, reputation, synergies, and sustainable. The research was conducted using the Kraljic method to determine the categories of goods that are included in the strategic items. To design a supplier partnership success factor using the Hybrid Multi Criteria Decision Making method. Integrated Fuzzy AHP-Fuzzy TOPSIS is used to determine the weight of the success factors of supplier partnerships and to rank suppliers on the factors used.

Keywords: supplier, partnership, strategic item, success factors, and coal mining industry

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Authors: Mohammad Al-Mousawi

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This academic article explores the indispensable role of critical thinking in the process of diagnosing diseases. Employing a multidisciplinary approach, we delve into the cognitive skills and analytical mindset that clinicians, researchers, and healthcare professionals must employ to navigate the complexities of disease identification. By examining the integration of critical thinking within the realms of medical education, diagnostic decision-making, and technological advancements, this article aims to underscore the significance of cultivating and applying critical thinking skills in the ever-evolving landscape of healthcare.

Keywords: critical thinking, medical education, diagnostic decision-making, fostering critical thinking

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Authors: Dilsad Akal

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Aim: Companies communicate with each other and with their costumers via call centers. Call centers are defined as stressful because of their uncertain working hours, inadequate relief time, performance based system and heavy workload. In literature, this sector is defined as risky as mining sector by means of health and safety. The aim of this research is to enlight the relatively dark area. Subject and Methods: The collection of data for this study completed during April-May 2015 for the two selected call centers in different parts of Turkey. The applied question mostly investigated the health conditions of call center workers. Electromagnetic field measurements were completed at the same time with applying the question poll. The ratio of employee accessibility noted as 73% for the first call center and 87% for the second. Results: The results of electromagnetic field measurements were as between 371 V/m-32 V/m for the first location and between 370 V/m-61 V/m for the second. The general complaints of the employees for both workplaces can be counted as; inadequate relief time, inadequate air conditioning, disturbance, poor thermal conditions, inadequate or extreme lighting. Furthermore, musculoskeletal discomfort, stress, ear and eye discomfort are main health problems of employees. Conclusion: The measured values and the responses to the question poll were found parallel with the other similar research results in literature. At the end of this survey, a risk map of workplace was prepared in terms of safety and health at work in general and some suggestions for resolution were provided.

Keywords: call center, health and safety, electromagnetic field, risk map

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Authors: Raheel Shakoor Siddiqui, Calvin Mathias, Manikandar Srinivas Cheruvu, Bobin Varghese

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A 58 year old gentleman presented to accident and emergency at the district general hospital with worsening shortness of breath and a non-productive cough over a period of five days. He was initially admitted under the medical team for suspicion of SARS-CoV-2 (COVID-19) pneumonitis. Subsequently, upon deterioration of observations and a positive COVID-19 PCR, he was taken to intensive care for invasive mechanical ventilation. He required frequent proning, inotropic support and was intubated for thirty-three days. After successful extubation, he developed myopathy with a limited range of motion to his right knee and right shoulder. Plain film imaging of these limbs demonstrated an unusual formation of heterotopic ossification without any precipitating trauma or surgery. Current literature demonstrates limited case series portraying heterotopic ossification post-COVID-19. There has been negligible evidence of heterotopic ossification in the ipsilateral knee and shoulder post-prolonged immobility secondary to a critical illness. Physiotherapy and rehabilitation are post-intensive care can be prolonged due to the formation of heterotopic ossification around joints. Prolonged hospital stays may lead to a higher risk of developing infections of the chest, urine and pressure sores. This raises the question of whether a severe systemic inflammatory immune response from the SARS-CoV-2 virus results in histopathological processes leading to the formation of heterotopic ossification not previously seen, requiring prolonged physiotherapy.

Keywords: orthopaedics, rehabilitation, physiotherapy, heterotopic ossification, COVID-19

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Authors: Natalia Kalinowska

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The adoption of the General Data Protection Regulation, (GDPR) finished the four-year work of the European Commission in this area in the European Union. Considering far-reaching changes, which will be applied by GDPR, the European legislator envisaged two-year transitional period. Member states and companies have to prepare for a new regulation until 25 of May 2018. The idea, which becomes a new look at an attitude to data protection in the European Union is risk-based approach. So far, as a result of implementation of Directive 95/46/WE, in many European countries (including Poland) there have been adopted very particular regulations, specifying technical and organisational security measures e.g. Polish implementing rules indicate even how long password should be. According to the new approach from May 2018, controllers and processors will be obliged to apply security measures adequate to level of risk associated with specific data processing. The risk in GDPR should be interpreted as the likelihood of a breach of the rights and freedoms of the data subject. According to Recital 76, the likelihood and severity of the risk to the rights and freedoms of the data subject should be determined by reference to the nature, scope, context and purposes of the processing. GDPR does not indicate security measures which should be applied – in recitals there are only examples such as anonymization or encryption. It depends on a controller’s decision what type of security measures controller considered as sufficient and he will be responsible if these measures are not sufficient or if his identification of risk level is incorrect. Data protection regulation indicates few levels of risk. Recital 76 indicates risk and high risk, but some lawyers think, that there is one more category – low risk/now risk. Low risk/now risk data processing is a situation when it is unlikely to result in a risk to the rights and freedoms of natural persons. GDPR mentions types of data processing when a controller does not have to evaluate level of risk because it has been classified as „high risk” processing e.g. processing on a large scale of special categories of data, processing with using new technologies. The methodology will include analysis of legal regulations e.g. GDPR, the Polish Act on the Protection of personal data. Moreover: ICO Guidelines and articles concerning risk based approach in GDPR. The main conclusion is that an appropriate risk assessment is a key to keeping data safe and avoiding financial penalties. On the one hand, this approach seems to be more equitable, not only for controllers or processors but also for data subjects, but on the other hand, it increases controllers’ uncertainties in the assessment which could have a direct impact on incorrect data protection and potential responsibility for infringement of regulation.

Keywords: general data protection regulation, personal data protection, privacy protection, risk based approach

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Authors: Muhammad Ajmair

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This empirical study followed structural vector auto regression (SVAR) approach proposed by the so-called AB-model of Amisano and Giannini (1997) to check the impact of relevant macroeconomic determinants on economic growth in Pakistan. Before that auto regressive distributive lag (ARDL) bound testing technique and time varying parametric approach along with general to specific approach was employed to find out relevant significant determinants of economic growth. To our best knowledge, no author made such a study that employed auto regressive distributive lag (ARDL) bound testing and time varying parametric approach with general to specific approach in empirical literature, but current study will bridge this gap. Annual data was taken from World Development Indicators (2014) during period 1976-2014. The widely-used Schwarz information criterion and Akaike information criterion were considered for the lag length in each estimated equation. Main findings of the study are that remittances received, gross national expenditures and inflation are found to be the best relevant positive and significant determinants of economic growth. Based on these empirical findings, we conclude that government should focus on overall economic growth augmenting factors while formulating any policy relevant to the concerned sector.

Keywords: economic growth, gross national expenditures, inflation, remittances

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Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper, we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: mobile health, data integration, expert systems, disease-related malnutrition

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Authors: Goitom Molalign Takele, Tsegalem Hailemariam Ballo, Kiros Belay Gebrekidan, Birhan Gebresilassie Gebregiorgis

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Background: Emergency medical services (EMS) are services that provide out-of-hospital emergency medical care to injured or ill peoples, and transporting to definitive care. EMS is an integral part of the emergency medical system and has been associated with decreased morbidity and mortality related to emergency cases. The aim of this study was to assess the utilization, barriers, and determinants of EMS in Mekelle, Ethiopia. Methods: A community-based cross-sectional study was conducted in selected sub-cities of Mekelle. A multistage sampling method was employed to recruit study participants, and data were collected by trained data collectors using an interviewer-administered questionnaire. Multivariate logistic regression analysis was used to examine the statistical association of the determinants of EMS utilization. Results: Half (50.5%) of the respondents had experienced or witnessed an emergency incident in the past year. The common means of transportations used were Bajaj’s (39.2%) and ambulances (22.7%). Majority (88.1%) of the respondents did not knew the EMS access phone number of an ambulance. As their preferred mode of transportation in case of emergency conditions, 42.2% of the participants reported an ambulance, followed by Bajaj 33.7%. Where participants who had gynecologic emergencies were 9.4 times (AOR=9.4, 95% CI: 1.04, 85, p=0.046), and those who knew any ambulance numbers were 3.6 times (AOR=3.6, 95% CI: 1.22, 10.8, p=0.02) more likely to use ambulance services in case of emergencies. Conclusion: The ambulance utilization level in Mekelle city was low and victims of emergency conditions were being transported mainly using public transports such as Bajaj’s and taxis. Even though the perception of the public towards EMS services is favorable, lack of awareness of EMS access, and lack of integrated EMS system in the city are the barriers that may have contributed to the low utilization. Actions to improve EMS access and integrating the system are warranted to promote the services utilization.

Keywords: emergency medical services, utilization, Mekelle, barriers

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Authors: A.L. Tamm, N. Šott, J. Jürimäe, E. Lätt, A. Orav, Ü. Parm

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Coffee is one of the most frequently consumed beverages in the world but still its effects on human organism are not completely understood. Coffee has also been used as a method for weight loss, but its effectiveness has not been proved. There is also not similar comprehension in classifying overweight in choosing between body mass index (BMI) and fat percentage (fat%). The aim of the study was to determine associations between coffee consumption and body composition. Secondly, to detect which measure (BMI or fat%) is more accurate to use describing overweight. Altogether 103 persons enrolled the study and divided into three groups: coffee non-consumers (n=39), average coffee drinkers, who consumed 1 to 4 cups (1 cup = ca 200ml) of coffee per day (n=40) and excessive coffee consumers, who drank at least five cups of coffee per day (n=24). Body mass (medical electronic scale, A&D Instruments, Abingdon, UK) and height (Martin metal anthropometer to the nearest 0.1 cm) were measured and BMI calculated (kg/m2). Participants´ body composition was detected with dual energy X-ray absorptiometry (DXA, Hologic) and general data (history of chronic diseases included) and information about coffee consumption, and physical activity level was collected with questionnaires. Results of the study showed that excessive coffee consumption was associated with increased fat-free mass. It could be foremost due to greater physical activity level in school time or greater (not significant) male proportion in excessive coffee consumers group. For estimating the overweight the fat% in comparison to BMI recommended, as it gives more accurate results evaluating chronical disease risks. In conclusion coffee consumption probably does not affect body composition and for estimating the body composition fat% seems to be more accurate compared with BMI.

Keywords: body composition, body fat percentage, body mass index, coffee consumption

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Authors: Mojtaba Aghajari, Alireza Aghasi

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The first challenge which the current research faced has been the identification or determination of the level of knowledge in Isfahan public transportation corporation, and the second challenge has been the recognition and choice of a proper approach for the instructional system design. Responding these two challenges will present an appropriate model of instructional system design. In order to respond the first challenge or question, Nonaka and Takeuchi KM model has been utilized due to its universality among the 26 models proposed so far. The statistical population of this research included 2200 people, among which 200 persons were chosen as the sample of the research by the use of Morgan’s method. The data gathering has been carried out by the means of a questionnaire based on Nonaka and Takeuchi KM model, analysis of which has been done by SPSS program. The output of this questionnaire, yielding the point of 1.96 (out of 5 points), revealed that the general condition of Isfahan public transportation corporation is weak concerning its being knowledge-centered. After placing this output on Jonassen’s continuum, it was revealed that the appropriate approach for instructional system design is the system (or behavioral) approach. Accordingly, different steps of the general model of ADDIE, which covers all of the ISO10015 standards, were adopted in the act of designing. Such process in Isfahan public transportation corporation was designed and divided into three main steps, including: instructional designing and planning, instructional course planning, determination of the evaluation and the effectiveness of the instructional courses.

Keywords: instructional system design, system approach, knowledge management, employees

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Authors: Julius Steinkopf, Eric Rost, Aike Hessel, Sonia Lippke

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Objective: This study examined possible determinants of return to work (RTW) in individuals who participated in a medical rehabilitation program longitudinally over a time period of six months. Design/methodology/approach: N=1,044 rehabilitants were included in the baseline measurement in terms of completing a questionnaire during their medical rehabilitation. About 30% (n=350) have remained in the study in terms of participating in computer-assisted telephone interviewing (CATI) six months later. Frequency analyses and Regression analyses were run. Findings: About 70% of the rehabilitants returned to work six months after rehabilitation. Regression analyses revealed that the RTW rates were significantly predicted by gender (OR=0.12, men were more likely to return), perceived social support (OR=3.01) and current physical functioning (OR=1.25). Furthermore RTW motives, like expected monetary rewards (OR=25.2) and feelings of being needed (OR=0.18) same as motives for not returning to work (nRTW), like the wish to stop working in order to spend time with the spouse (OR=0.13) or a lack of enjoyment of work (OR=3.81), significantly predicted return to work rates. Life satisfaction, self-efficacy beliefs, mental health, current income, educational background or age did not significantly increase explained variance (all ps > .05). Practical implications: Taking theses predictors into account provides options to increase the effectiveness of interventions aiming at increasing RTW: Medical rehabilitations should not only aim at improving the physical functioning but also to enhance beneficial motives and social support as well as support women specifically in order to improve the effectiveness of medical rehabilitation and public health interventions. Originality/value: Illness-caused work absences are related to high financial costs and individual burden. Despite of the public health and societal implications, this is one of the very few studies investigating systematically fitness and health for the return to work.

Keywords: gender, fitness, health, physical functioning

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