Search results for: Duration of Hemodialysis

Authors: Michał Lidner, Zbigniew SzcześNiak

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The ability to estimate blast load overpressure properly plays an important role in safety design of buildings. The issue of studying of blast loading on structural elements has been explored for many years. However, in many literature reports shock wave overpressure is estimated with simplified triangular or exponential distribution in time. This indicates some errors when comparing real and numerical reaction of elements. Nonetheless, it is possible to further improve setting similar to the real blast load overpressure function versus time. The paper presents a method of numerical analysis of the phenomenon of the air shock wave propagation. It uses Finite Volume Method and takes into account energy losses due to a heat transfer with respect to an adiabatic process rule. A system of three equations (conservation of mass, momentum and energy) describes the flow of a volume of gaseous medium in the area remote from building compartments, which can inhibit the movement of gas. For validation three cases of a shock wave flow were analyzed: a free field explosion, an explosion inside a steel insusceptible tube (the 1D case) and an explosion inside insusceptible cube (the 3D case). The results of numerical analysis were compared with the literature reports. Values of impulse, pressure, and its duration were studied. Finally, an overall good convergence of numerical results with experiments was achieved. Also the most important parameters were well reflected. Additionally analyses of dynamic response of one of considered structural element were made.

Keywords: adiabatic process, air shock wave, explosive, finite volume method

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Authors: Yahaya Abdullahi, Ben Coetzee, Linda Van Den Berg

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The study aimed at establishing the global positioning system (GPS) determined singles match characteristics that act as predictors of successful and less-successful male singles badminton players’ group classification. Twenty-two (22) male single players (aged: 23.39 ± 3.92 years; body stature: 177.11 ± 3.06cm; body mass: 83.46 ± 14.59kg) who represented 10 African countries participated in the study. Players were categorised as successful and less-successful players according to the results of five championships’ of the 2014/2015 season. GPS units (MinimaxX V4.0), Polar Heart Rate Transmitter Belts and digital video cameras were used to collect match data. GPS-related variables were corrected for match duration and independent t-tests, a cluster analysis and a binary forward stepwise logistic regression were calculated. A Receiver Operating Characteristic Curve (ROC) was used to determine the validity of the group classification model. High-intensity accelerations per second were identified as the only GPS-determined variable that showed a significant difference between groups. Furthermore, only high-intensity accelerations per second (p=0.03) and low-intensity efforts per second (p=0.04) were identified as significant predictors of group classification with 76.88% of players that could be classified back into their original groups by making use of the GPS-based logistic regression formula. The ROC showed a value of 0.87. The identification of the last-mentioned GPS-related variables for the attainment of badminton performances, emphasizes the importance of using badminton drills and conditioning techniques to not only improve players’ physical fitness levels but also their abilities to accelerate at high intensities.

Keywords: badminton, global positioning system, match analysis, inertial movement analysis, intensity, effort

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Authors: K. M. Pratap Shankar, Dattatreya Rao, Sai Prasad

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Background: Skin diseases are among the most common health problems worldwide and are associated with a considerable burden. Eczema is such a skin ailment which cause psychological, social and financial burden on the patient and their families. Management of eczema with antibiotics, antihistamines, steroids etc., are available but even after their use relapses, recurrences and other complications are very common. Aim: The aim of this study was to assess the efficacy of leech application in the management of vicarcikā (Eczema) with Histopathological study. Methods: For the present study 10 patients having the classical symptoms of Vicarcikā, were randomly selected as per the inclusion and exclusion criteria from O.P.D. & I.P.D. sections of Śalya department, S.V. Āyurvedic Hospital, Tirupati. Minimum 4 sittings of Leech application was carried out with seven days interval. Total duration of treatment was 6 weeks. Biopsy samples were collected from the lesion site before and after treatment. Histopathological examination was done by the pathologist. Results: In eczema (dermatitis) the leech application therapy gives excellent response by reducing the inflammatory component, hyperkeratosis, spongiosis, irregular acanthosis and by evoking a granulation tissue response in the dermis and in most of the cases with complete recovery from the lesion. Most of the cases in the study were chronic dermatitis and sebhoric keratosis, almost all local/focal pigmented lesions is totally relieved by leech therapy especially in cases of sebhoric keratosis. Conclusion: In the present study it was found that, leech application evokes significant changes at histological level specifically in reduction of inflammatory component, hyperkeratosis, spongiosis and irregular acanthosis. It was also found that there was a considerable formation of granulation tissue, which helps in formation of healthy new tissues.

Keywords: acanthosis, eczema, hyperkeratosis, leech application, spongiosis

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Authors: Jeanne Grace, Melkamu D. Kassa

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Background: Despite the recognized benefits of physical exercise, including a reduction of health risk factor indicators, illness and deaths related to Non-Communicable Diseases (NCDs) like cardiovascular disease, diabetes, hypertension, and cancer, the extent of its recognition and use as a prevention strategy by healthcare professionals working in Ethiopian referral hospitals is unknown. Objective: This study explored healthcare professionals’ use of physical exercise as a non-communicable disease prevention strategy in the Ethiopian public sector healthcare system. Methods: In this cross-sectional study, a self-administered questionnaire was conducted after being piloted to ensure validity and reliability. For the study, 312 participants were selected from 13 purposively selected Ethiopian referral hospitals, these being 99 physicians who were purposively selected and 213 nurses who were proportionately and randomly selected. Results: The results indicated that three-quarters (78%) of healthcare professionals working in Ethiopian hospitals are not using physical exercise as a strategy to prevent NCDs. Increased specialization (AOR = 20.203, p < 0.001), longer service years (AOR = 0.041, p = 0.014), young age (AOR = 19.871, p < 0.001), and being male (AOR = 0.269, p < 0.001), were predictors of using physical exercise as a strategy for the prevention of NCDs. Conclusion: Healthcare professionals’ utilization of physical exercise as a strategy for NCDs prevention was inadequate in Ethiopia. Given the increasing burden of NCD disease in Ethiopia, training nurses, physicians and medical managers have to acknowledge the use of physical exercise as an NCD prevention strategy. The results of this study highlight the importance of formulating physical exercise intervention strategies for NCDs patients, and the need to incorporate training for healthcare professionals on the type, intensity, duration, and frequency of physical exercise to prevent NCDs in the Ethiopian healthcare system.

Keywords: exercise, medical managers, nurses, physicians

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Authors: Korpapa Srisamai, Pawee Siriruk

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The purpose of this study is to forecast product demands and develop appropriate and adequate procurement plans to meet customer needs and reduce costs. When the product exceeds customer demands or does not move, it requires the company to support insufficient storage spaces. Moreover, some items, when stored for a long period of time, cause deterioration to dead stock. A case study of the wholesale company of electronic equipment and components, which has uncertain customer demands, is considered. The actual purchasing orders of customers are not equal to the forecast provided by the customers. In some cases, customers have higher product demands, resulting in the product being insufficient to meet the customer's needs. However, some customers have lower demands for products than estimates, causing insufficient storage spaces and dead stock. This study aims to reduce the loss of sales opportunities and the number of remaining goods in the warehouse, citing 30 product samples of the company's most popular products. The data were collected during the duration of the study from January to October 2022. The methods used to forecast are simple moving averages, weighted moving average, and exponential smoothing methods. The economic ordering quantity and reorder point are used to calculate to meet customer needs and track results. The research results are very beneficial to the company. The company can reduce the loss of sales opportunities by 20% so that the company has enough products to meet customer needs and can reduce unused products by up to 10% dead stock. This enables the company to order products more accurately, increasing profits and storage space.

Keywords: demand forecast, reorder point, lost sale, dead stock

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Authors: Anthropometric, Physical Fitness Ability Profile of Elite, Non-Elite Boxers of Manipur

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Background: Boxing is one of the oldest combat sports where different anthropological and fitness ability parameters determine performance. It is characterized by short duration, high intensity bursts of activity. The purpose of this research was to determine anthropometric and physical fitness profile of male elite and non-elite boxers of Manipur and to compare the two groups. Materials and Methods: Nineteen subjects were selected as elite boxers and twenty-four were non-elite boxers of Manipur. A cross-sectional study was conducted on anthropometric measurements and physical fitness ability tests on 33 subjects (elite and non-elite boxers). Statistical analysis was done using descriptive statistics, t-test and logistic regression with the help of SPSS version 15 software. Results: Results showed elite boxers have significantly reduced neck girth and calf girth as compare to non-elite boxers. Elite boxers have significantly lower sub scapular skin fold (SSF) and supra iliac skin fold (SISF) than their counterparts. Higher stature, larger BTB and lower percent fat are associated with higher performance in boxing. Sit ups (SU), standing Broad Jump (SBJ), Plat taping (PT), Sit and reach (SAR) and Harvard Step Test (HST) are predicted as most contributing factors enhancing performance level among the physical fitness components. Elite boxers are found to have more functional strength (sit ups), higher explosive strength (SBJ), more agility (PT), cardio-vascular endurance and flexibility (SAR) than non-elite boxers. Conclusion: In conclusion, lower fat, higher lean body mass, larger bi-trochantric breadth, high explosive strength, agility and flexibility are significantly associated with higher performance and chance of becoming elite boxers.

Keywords: anthropometry, elite and non-elite boxers, Manipur, physical fitness

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Authors: Ming-Hong Chen

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In the study, the mechanical and financial feasibility for the compressed air energy storage (CAES) system in the porous media reservoir in Taiwan is evaluated. In 2035, Taiwan aims to install 16.7 GW of wind power and 40 GW of photovoltaic (PV) capacity. However, renewable energy sources often generate more electricity than needed, particularly during winter. Consequently, Taiwan requires long-term, large-scale energy storage systems to ensure the security and stability of its power grid. Currently, the primary large-scale energy storage options are Pumped Hydro Storage (PHS) and Compressed Air Energy Storage (CAES). Taiwan has not ventured into CAES-related technologies due to geological and cost constraints. However, with the imperative of achieving net-zero carbon emissions by 2050, there's a substantial need for the development of a considerable amount of renewable energy. PHS has matured, boasting an overall installed capacity of 4.68 GW. CAES, presenting a similar scale and power generation duration to PHS, is now under consideration. Taiwan's geological composition, being a porous medium unlike salt caves, introduces flow field resistance affecting gas injection and extraction. This study employs a program analysis model to establish the system performance analysis capabilities of CAES. The finite volume model is then used to assess the impact of porous media, and the findings are fed back into the system performance analysis for correction. Subsequently, the financial implications are calculated and compared with existing literature. For Taiwan, the strategic development of CAES technology is crucial, not only for meeting energy needs but also for decentralizing energy allocation, a feature of great significance in regions lacking alternative natural resources.

Keywords: compressed-air energy storage, efficiency, porous media, financial feasibility

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Authors: Samuel Asrat

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Infusion pumps have become indispensable tools in modern healthcare, allowing for precise and controlled delivery of fluids, medications, and nutrients to patients. This paper provides an overview of the historical development, measurement, and parts of infusion pumps. The historical development of infusion pumps can be traced back to the early 1960s when the first rudimentary models were introduced. These early pumps were large, cumbersome, and often unreliable. However, advancements in technology and engineering over the years have led to the development of smaller, more accurate, and user-friendly infusion pumps. Measurement of infusion pumps involves assessing various parameters such as flow rate, volume delivered, and infusion duration. Flow rate, typically measured in milliliters per hour (mL/hr), is a critical parameter that determines the rate at which fluids or medications are delivered to the patient. Accurate measurement of flow rate is essential to ensure the proper administration of therapy and prevent adverse effects. Infusion pumps consist of several key parts, including the pump mechanism, fluid reservoir, tubing, and control interface. The pump mechanism is responsible for generating the necessary pressure to push fluids through the tubing and into the patient's bloodstream. The fluid reservoir holds the medication or solution to be infused, while the tubing serves as the conduit through which the fluid travels from the reservoir to the patient. The control interface allows healthcare providers to program and adjust the infusion parameters, such as flow rate and volume. In conclusion, infusion pumps have evolved significantly since their inception, offering healthcare providers unprecedented control and precision in delivering fluids and medications to patients. Understanding the historical development, measurement, and parts of infusion pumps is essential for ensuring their safe and effective use in clinical practice.

Keywords: dip, ip, sp, is

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Authors: Farzad Danaei, Yilmaz Akkaya

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In many civil engineering applications, especially in the construction of large concrete structures, the early age behavior of concrete has shown to be a crucial problem. The uneven rise in temperature within the concrete in these constructions is the fundamental issue for quality control. Therefore, developing accurate and fast temperature prediction models is essential. The thermal properties of concrete fluctuate over time as it hardens, but taking into account all of these fluctuations makes numerical models more complex. Experimental measurement of the thermal properties at the laboratory conditions also can not accurately predict the variance of these properties at site conditions. Therefore, specific heat capacity and the heat conductivity coefficient are two variables that are considered constant values in many of the models previously recommended. The proposed equations demonstrate that these two quantities are linearly decreasing as cement hydrates, and their value are related to the degree of hydration. The effects of changing the thermal conductivity and specific heat capacity values on the maximum temperature and the time it takes for concrete to reach that temperature are examined in this study using numerical sensibility analysis, and the results are compared to models that take a fixed value for these two thermal properties. The current study is conducted in 7 different mix designs of concrete with varying amounts of supplementary cementitious materials (fly ash and ground granulated blast furnace slag). It is concluded that the maximum temperature will not change as a result of the constant conductivity coefficient, but variable specific heat capacity must be taken into account, also about duration when a concrete's central node reaches its max value again variable specific heat capacity can have a considerable effect on the final result. Also, the usage of GGBFS has more influence compared to fly ash.

Keywords: early-age concrete, mass concrete, specific heat capacity, thermal conductivity coefficient

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Authors: Timo Miebach, Kirsten Hoeper, Carolin Felix

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In times of competitive pressures and demographic change, hospitals have to reconsider their strategies as a company. Due to the fact, that operations are one of the main income and one of the primary cost drivers otherwise, a process-oriented approach and an efficient use of resources seems to be the right way for getting a consistent market position. Thus, the efficient operation room occupancy planning is an important cause variable for the success and continued the existence of these institutions. A high utilization of resources is essential. This means a very high, but nevertheless sensible capacity-oriented utilization of working systems that can be realized by avoiding downtimes and a thoughtful occupancy planning. This engineering approach should help hospitals to reach her break-even point. Firstly, the aim is to establish a strategy point, which can be used for the generation of a planned throughput time. Secondly, the operation planning and control should be facilitated and implemented accurately by the generation of time modules. More than 100,000 data records of the Hannover Medical School were analyzed. The data records contain information about the type of conducted operation, the duration of the individual process steps, and all other organizational-specific data such as an operating room. Based on the aforementioned data base, a generally valid model was developed by an analysis to define a strategy point which takes the conflict of capacity utilization and low overtime into account. Furthermore, time modules were generated in this work, which allows a simplified and flexible operation planning and control for the operation manager. By the time modules, it is possible to reduce a high average value of the idle times of the operation rooms. Furthermore, the potential is used to minimize the idle time spread.

Keywords: capacity, operating room, surgery planning and control, utilization

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Authors: Hazel Ann Gianelli Cu, Stephanie Co, Radcliff Cobankiat

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Objectives: TRC101/Veverimer is an orally administered, non absorbed, sodium- and counterion-free hydrochloric acid binder for the treatment of metabolic acidosis associated with chronic kidney disease. The main objective of this study is to determine the efficacy of TRC 101/ Veverimer 6g/day in increasing serum bicarbonate levels of chronic kidney disease patients with metabolic acidosis. In this meta analysis, we also aim to look at safety outcomes, adverse effects and if the level of serum bicarbonate reached metabolic alkalosis when given TRC101/Veverimer. Methodology: Pubmed, Cochrane, Google Scholar and Science direct were used to search for randomized controlled trials about TRC101/Veverimer use in Chronic kidney disease patients with metabolic acidosis. Search strategy according to the Prisma checklist was done with evaluation of biases and synthesis of results using the Cochrane Review Manager software 5.4. Results: Two randomized controlled trials involving 371 chronic kidney disease patients were included in this study. Results show there was a significant increase in the serum bicarbonate level when given TRC101/Veverimer compared to the placebo. Both studies had a significant number of participants who completed the studies until the end. P value of <0.00001 was used in both studies with a confidence interval of 95%. Conclusion: TRC101/Veverimer 6g/day was shown to effectively and safely increase serum bicarbonate or achieve normalization in chronic kidney disease patients with metabolic acidosis as compared with a placebo. This was associated with delayed progression of kidney disease with improvement of physical functioning, however longer duration of future studies is ideal in order to assess further the long advantages and consequences of TRC 101/Veverimer.

Keywords: chronic kidney disease, metabolic acidosis, Veverimer, TRC101

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Authors: Ali Alshahrani, Adel Almaai, Saad Garni

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Aim of the study: To explore duration and determinants of consultation time at a family medicine center. Methodology: This study was conducted at the Family Medicine Center in Ahad Rafidah City, at the southwestern part of Saudi Arabia. It was conducted on the working days of March 2013. Trained nurses helped in filling in the checklist. A total of 459 patients were included. A checklist was designed and used in this study. It included patient’s age, sex, diagnosis, type of visit, referral and its type, psychological problems and additional work-up. In addition, number of daily bookings, physician`s experience and consultation time. Results: More than half of patients (58.39%) had less than 10 minutes’ consultation (Mean+SD: 12.73+9.22 minutes). Patients treated by physicians with shortest experience (i.e., ≤5 years) had the longest consultation time while those who were treated with physicians with the longest experience (i.e., > 10 years) had the shortest consultation time (13.94±10.99 versus 10.79±7.28, p=0.011). Regarding patients’ diagnosis, those with chronic diseases had the longest consultation time (p<0.001). Patients who did not need referral had significantly shorter consultation time compared with those who had routine or urgent referral (11.91±8.42,14.60±9.03 and 22.42±14.81 minutes, respectively, p<0.001). Patients with associated psychological problems needed significantly longer consultation time than those without associated psychological problems (20.06±13.32 versus 12.45±8.93, p<0.001). Conclusions: The average length of consultation time at Ahad Rafidah Family Medicine Center is approximately 13 minutes. Less-experienced physicians tend to spend longer consultation times with patients. Referred patients, those with psychological problems, those with chronic diseases tend to have longer consultation time. Recommendations: Family physicians should be encouraged to keep their optimal consultation time. Booking an adequate number of patients per shift would allow the family physician to provide enough consultation time for each patient.

Keywords: consultation, quality, medicine, clinics

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Authors: Maryam Nazari, Atefeh Ghanbari, Saghar Noorinia

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Obesity, as an abnormal or excessive accumulation of fat, is caused by genetic, behavioral and environmental factors. Recently, obesity surgeries, such as bariatric surgery, as the last measure to control obesity, have attracted experts and society, especially women, attention, so knowing the possible complications of this major surgery and their control in reproductive age is of particular importance due to its effects on pregnancy outcomes. Bariatric surgery reduces the risk of diabetes and high blood pressure associated with pregnancy, premature birth, macrosomia, stillbirth and dumping syndrome. Although in the first months after surgery, nausea and vomiting caused by changes in intra-abdominal pressure are associated with an increased risk of malabsorption of micronutrients such as folic acid, iron, vitamin B1, D, calcium, selenium and phosphorus and finally, fetal growth disorder. Moreover, serum levels of micronutrients such as vitamin D, calcium, and iron in mothers who used to have bariatric surgery and their babies have been shown to be lower than in mothers without a history of bariatric surgery. Moreover, vitamin A deficiency is shown to be more widespread in pregnancies after bariatric surgery, which leads to visual problems in newborns and premature delivery. However, complications such as the duration of hospitalization of newborns in the NICU, disease rate in the first 28 days of life and congenital anomalies are not significantly different in babies born to mothers undergoing bariatric surgery compared to the control group. In spite of the vast advantages following obesity surgeries, due to the catabolic conditions and severe weight loss followed by such major intervention and the probability of nutrients malnutrition in a pregnant woman and her baby, after having surgery, at least 12 to 18 months should be considered to get pregnant as a recovery period. In addition, taking essential supplements before and at least 6 months after this approach is recommended.

Keywords: bariatric surgery, pregnancy, malnutrition, vitamin and mineral deficiency

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Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

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Authors: Camelia Porey, Binaya Kumar Jaiswal

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BACKGROUND: Antiphospholipid antibody (APLA) syndrome is an autoimmune disorder predisposing to thrombotic complications affecting CNS either by arterial vasooclusion or venous thrombosis. Cerebral venous sinus thrombosis (CVST) secondarily causes raised intracranial pressure (ICP). However, intracranial hypertension without evidence of CVST is a rare entity. Here we present two cases of elevated ICP with absence of identifiable CVST. CASE SUMMARY: Case 1, 28-year female had a 2 months history of holocranial headache followed by bilateral painless vision loss reaching lack of light perception over 20 days. CSF opening pressure was elevated. Fundoscopy showed bilateral grade 4 papilledema. MRI revealed a partially empty sella with bilateral optic nerve tortuosity. Idiopathic intracranial hypertension (IIH) was diagnosed. With acetazolamide, there was complete resolution of the clinical and radiological abnormalities. 5 months later she presented with acute onset right-sided hemiparesis. MRI was suggestive of acute left MCA infarct.MR venogram was normal. APLA came positive with high titres of Anticardiolipin and Beta 2 glycoprotein both IgG and IgM. Case 2, 23-year female, presented with headache and diplopia of 2 months duration. CSF pressure was elevated and Grade 3 papilledema was seen. MRI showed bilateral optic nerve hyperintensities with nerve head protrusion with normal MRV. APLA profile showed elevated beta 2 glycoprotein IgG and IgA. CONCLUSION: This is an important non thrombotic complication of APLA syndrome and requires further large-scale study for insight into the pathogenesis and early recognition to avoid future complications.

Keywords: APLA syndrome, idiopathic intracranial hypertension, MR venogram, papilledema

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Authors: Saeed Abbasi, Davood Farsi, Soudabeh Shafiee Ardestani, Neda Valizadeh

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Objectives: Peripheral vertigo is a common complaint of patients who are visited in emergency departments. In our study, we wanted to evaluate the effect of betahistine as an oral drug vs. intravenous diazepam for the treatment of acute peripheral vertigo. We also wanted to see the possibility of substitution of parenteral drug with an oral one with fewer side effects. Materials and Methods: In this randomized, double-blind study, 101 patients were enrolled in the study. The patients were divided in two groups in a double-blind randomized manner. Group A took oral placebo and 10 mg of intravenous diazepam. Group B received 8mg of oral betahistine and intravenous placebo. Patients’ symptoms and signs (Vertigo severity, Nausea, Vomiting, Nistagmus and Gate) were evaluated after 0, 2, 4, 6 hours by emergency physicians and data were collected by a questionnaire. Results: In both groups, there was significant improvement in vertigo (betahistine group P=0.02 and Diazepam group P=0.03). Analysis showed more improvement in vertigo severity after 4 hours of treatment in betahistine group comparing to diazepam group (P=0.02). Nausea and vomiting were significantly lower in patients receiving diazepam after 2 and 6 hours (P=0.02 & P=0.03).No statistically significant differences were found between the groups in nistagmus, equilibrium & vertigo duration. Conclusion: The results of this randomized trial showed that both drugs had acceptable therapeutic effects in peripheral vertigo, although betahistine was significantly more efficacious after 4 hours of drug intake. As for higher nausea and vomiting in betahistine group, physician should consider these side effects before drug prescription.

Keywords: acute peripheral vertigo, betahistine, diazepam, emergency department

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Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston

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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.

Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience

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Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova, Anna Khelkovskaya-Sergeeva

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Objectives. There is very few data on changes of the musculoskeletal manifestations (artritis, arthralgia, muscle weakness, etc.) in systemic sclerosis (SSc) on rituximab (RTX) therapy. The aim of our study was to assess the severity of the musculoskeletal involvement in SSc patients (pts) and its changes during RTX therapy. Methods. Our study included 103 pts with SSc. The mean followup period was 12.6±10.7 months. The mean age was 47±12.9 years, female-87 pts (84%), the diffuse cutaneous subset of the disease had 55 pts (53%). The mean disease duration was 6.2±5.5 years. All pts had interstitial lung disease (ILD) and were positive for ANA, 67% of them were positive for antitopoisomerase-1. All patients received prednisolone at a dose of 11.3±4.5 mg/day, immunosuppressants at inclusion received 47% of them. Pts received RTX due to the ineffectiveness of previous therapy for ILD. The cumulative mean dose of RTX was 1.7±0.6 grams. Arthritis was observed in 22 pts (21%), arthralgias in 47 pts (46%). Muscle weakness was observed in 17 pts (17%). Tendon friction rubs was established in 7 pts (7%). The results at baseline and at the end of the follow up are presented in the form of mean values. Results. There was an improvement of all outcome parameters and musculoskeletal manifestations on RTX therapy. There was a decrease in the number of pts with arthritis from 22 (21%) to 10 (9%), a decrease in the number of pts with arthralgias from 47 (46%) to 31 (30%). The number of pts with muscle weakness decreased from 17 (17%) to 7 (7%). The number of pts with tendon friction rubs decreased from 7 (7%) to 3 (3%). The creatine phosphokinase decreased from 365.5±186 to 70.8±50.4 (p=0.00006). The C-reactive protein (CRP) decreased from 23.2±31.3 to 8.62±7.4 (p=0.001). The dose of prednisolone was reduced from 11.3±4.5 to 9.8±3.5 mg/day (p=0.0004). Conclusion. In our study, musculoskeletal involvement was detected in almost half of the patients with SSc-ILD. There was an improvement of musculoskeletal manifestations despite a small cumulative dose of RTX. We also managed to reduce the dose of glucocorticosteroids. The improvement of musculoskeletal manifestations was accompanied by a decrease in laboratory parameters - creatine phosphokinase and CRP. RTX is effective option for treatment of musculoskeletal manifestations in SSc.

Keywords: arthritis, musculoskeletal involvement, systemic sclerosis, rituximab

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Authors: Lior Rake, Shmulik Pinkert

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Methane hydrate has been found in significant quantities in soils offshore within continental margins and in permafrost within arctic regions where low temperature and high pressure are present. The mechanical parameters for geotechnical engineering are commonly evaluated in geomechanical laboratories adapted to simulate the environmental conditions of methane hydrate-bearing sediments (MHBS). Due to the complexity and high cost of natural MHBS sampling, most laboratory investigations are conducted on artificially formed samples. MHBS artificial samples can be formed using different hydrate formation methods in the laboratory, where methane gas and water are supplied into the soil pore space under the methane hydrate phase conditions. The most commonly used formation method is the excess gas method which is considered a relatively simple, time-saving, and repeatable testing method. However, there are several differences in the procedures and techniques used to produce the hydrate using the excess gas method. As a result of the difference between the test facilities and the experimental approaches that were carried out in previous studies, different measurement criteria and analyses were proposed for MHBS geomechanics. The lack of uniformity among the various experimental investigations may adversely impact the reliability of integrating different data sets for unified mechanical model development. In this work, we address some fundamental aspects relevant to reliable MHBS geomechanical investigations, such as hydrate homogeneity in the sample, the hydrate formation duration criterion, the hydrate-saturation evaluation method, and the effect of temperature measurement accuracy. Finally, a set of recommendations for repeatable and reliable MHBS formation will be suggested for future standardization of MHBS geomechanical investigation.

Keywords: experimental study, laboratory investigation, excess gas, hydrate formation, standardization, methane hydrate-bearing sediment

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Authors: Lia Matchavariani

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Water reservoir construction on the rivers flowing into the sea complicates the coast protection, seashore starts to degrade causing coast erosion and disaster on the backdrop of current climate change. The instruments of the impact of a water reservoir on the climate and coastal areas are its contact surface with the atmosphere and the area irrigated with its water or humidified with infiltrated waters. The Black Sea coastline is characterized by the highest ecological vulnerability. The type and intensity of the water reservoir impact are determined by its morphometry, type of regulation, level regime, and geomorphological and geological characteristics of the adjoining area. Studies showed the impact of the water reservoir on the climate, on its comfort parameters is positive if it is located in the zone of insufficient humidity and vice versa, is negative if the water reservoir is found in the zone with abundant humidity. There are many natural and anthropogenic factors determining the peculiarities of the impact of the water reservoir on the climate, which can be assessed with maximum accuracy by the so-called “long series” method, which operates on the meteorological elements (temperature, wind, precipitations, etc.) with the long series formed with the stationary observation data. This is the time series, which consists of two periods with statistically sufficient duration. The first period covers the observations up to the formation of the water reservoir and another period covers the observations accomplished during its operation. If no such data are available, or their series is statistically short, “an analog” method is used. Such an analog water reservoir is selected based on the similarity of the environmental conditions. It must be located within the zone of the designed water reservoir, under similar environmental conditions, and besides, a sufficient number of observations accomplished in its coastal zone.

Keywords: coast-constituent sediment, eustasy, meteorological parameters, seashore degradation, water reservoirs impact

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Authors: Fathia Ehmouda Zaid, Reim Abudelnbi

Abstract:

Cardiovascular disease is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Patients and method: Cross-section study (68) patients diagnosed as systemic lupus erythematosus (SLE), who visited the outpatient clinic of rheumatology, these patients were interviewed with a structured questionnaire about their past and current clinically for presence of Cardiovascular disease in systemic lupus and use SLEDAI, specific tests [ECG –ECHO –CXRAY] the data are analyzed statistically by Pearson's correlation coefficient was calculated and statistical significance was defined as P< 0.05,during period (2013-2014). Objective: Estimation Cardiovascular disease manifestation of systemic lupus erythematosus, correlation with disease activity, morbidity, and mortality. Result: (68) Patients diagnosed as systemic lupus erythematosus' age range from (18-48 years), M=(13±29Y), Sex were female 66/68 (97.1%), male 2/68 (2.9%),duration of disease range[1-15year], M =[7±8y], we found Cardiovascular disease manifestation of systemic lupus erythematosus 32/68 (47.1%), correlation with disease activity use SLEDAI,(r= 476** p=0.000),Morbidity,(r= .554**; p=0.000) and mortality (r=.181; p=.139), Cardiovascular disease manifestations of systemic lupus erythematosus are pericarditis 8/68 (11.8%), pericardial effusion 6/68 (8.8%), myocarditis 4/68 (5.9 %), valvular lesions (endocarditis) 1/68 (1.5%), pulmonary hypertension (PAH) 12/68 (17.6%), coronary artery disease 1/68 (1.5%), none of patients have conduction abnormalities involvement. Correlation with disease activity use SLEDAI, pericarditis (r= .210, p=.086), pericardial effusion (r= 0.079, p=.520), myocarditis (r= 272*, p=.027), valvular lesions (endocarditis) (r= .112, p= .362), pulmonary hypertension (PAH) (r= .257*, p=.035) and coronary artery disease (r=.075, p=.544) correlation between cardiovascular disease manifestations of systemic lupus erythematosus and specific organ involvement we found Mucocutaneous (r=.091 p= .459), musculoskeletal (MSK) (r=.110 p=.373), Renal disease (r=.278*, p=.022), neurologic disease (r=.085, p=.489) and Hematologic disease (r=-.264*, p=.030). Conclusion: Cardiovascular manifestation is more frequent symptoms with systemic lupus erythematosus (SLE) is 47 % correlation with disease activity and morbidity but not with mortality. Recommendations: Focus research to evaluation and an adequate assessment of cardiovascular complications on the morbidity and mortality of the patients with SLE are still required.

Keywords: cardiovascular disease, systemic lupus erythematosus, disease activity, mortality

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Authors: Sutinon Yuchomsuk, Satchachon Changthom, Pruet Areesawangvong, Monsiri Jinapen

Abstract:

Background: Esophageal squamous cell carcinoma can be presented with many symptoms, such as dysphagia or weight loss. However, in some circumstances, rare presentations can be found, e.g., dyspnea, which is more common in pulmonary malignancy. And dyspnea is also one of the most common presentations of COVID-19 infection. So, in this case, we can learn from many points in patient symptoms and findings leading to the diagnosis of esophageal squamous cell carcinoma. Method: This research is a case-report study including one patient from Mahasarakham Hospital, Thailand. Data were collected during December 2021. Result: A 55-year-old Thai male patient with an unknown past medical history presented with dyspnea and shortness of breath for the duration of three days prior to admission. His symptom also included cough, fever, and sore throat. Laboratory results indicated that the patient had COVID-19 pneumonia. Further investigation showed that he had cardiac tamponade and suspected pulmonary/esophageal cancer. Lung biopsy and pericardiocentesis were done, which were positive for carcinoma from pericardial effusion but negative for malignancy from the lung biopsy. Later esophagogastroduodenoscopy was done with endoscopic tissue biopsy; the result was positive for squamous cell carcinoma of the esophagus. Conclusion: Most commonly, esophageal cancer is presented with dysphagia or weight loss. However, in some rare cases, patients can also be presented with dyspnea due to cardiac tamponade. And in recent years, COVID-19 has become a pandemic all over the world, sometimes masking symptoms of other diseases. Such as in this case, the patient didn’t improve after the pneumonia was resolved, which led to the final diagnosis of metastatic esophageal cancer.

Keywords: esophageal cancer, cardiac tamponade, metastatic squamous cell carcinoma, COVID-19 infection

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Authors: Hsien Hwa Kuo, Lin Wen Chun, Lin Wen Chun, Hsien Wen Kuo

Abstract:

Objective: Nurses represent an important occupational group frequently affected by wrist musculoskeletal disorders (WMSDs) due to a heavy workload, working shifts, poor posture, giving shots, making beds, lifting patients, bending their waist and insufficient rest time every day. However, lack of research reported nurses whether workload in household correlated with the severity of WMSDs. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire including the demographic information, workplace condition and nine body parts of musculoskeletal disorders. Results: 17.9% and 23.9% of severity and symptoms in WMSDs among nurses with children were significant higher than among nurses without children (1​2.4% and 15.9%). Based on multiple logistic regression models adjusted for age, work duration, job title and body mass index (BMI), we found that heavy workload in hospital had higher odds ratio (OR) of the severity and symptoms of WMSD among nurses with children (OR= 8.67 and OR= 4.30, p<0.05) compared to nurses without children (OR= 1.94 and OR= 1.70). Conclusion: The severity and symptoms of WMSDs among nurses significantly correlated with workload in hospital among nurses with children. If women are at greater risk because of the combination of their work and family demands, synergistic effect of WMSDs was found among nurses. Comment: Women's domestic work, especially once they become mothers, they invest more time and energy caring for children, helping others, and doing housework. Thus domestic work, per se, may be a risk factor for wrist musculoskeletal problems, and, more importantly, it may constrain women's ability to protect themselves from the effects of their paid work. If nurses with more domestic work periodically make efforts to physical activity or modify inappropriate posture, their WMSDs symptoms will be alleviated.

Keywords: musculoskeletal disorders, nurse, NMQ, WMSDs

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Authors: Jiahui Song

Abstract:

The use of very high electric fields (~ 100kV/cm or higher) with pulse durations in the nanosecond range has been a recent development. The electric pulses have been used as tools to generate electroporation which has many biomedical applications. Most of the studies of electroporation have ignored possible thermal effects because of the small duration of the applied voltage pulses. However, it has been predicted membrane temperature gradients ranging from 0.2×109 to 109 K/m. This research focuses on thermal gradients that drives for electroporative enhancements, even though the actual temperature values might not have changed appreciably from their equilibrium levels. The dynamics of pore formation with the application of an externally applied electric field is studied on the basis of molecular dynamics (MD) simulations using the GROMACS package. Different temperatures are assigned to various regions to simulate the appropriate temperature gradients. The GROMACS provides the force fields for the lipid membranes, which is taken to comprise of dipalmitoyl-phosphatidyl-choline (DPPC) molecules. The water model mimicks the aqueous environment surrounding the membrane. Velocities of water and membrane molecules are generated randomly at each simulation run according to a Maxwellian distribution. For statistical significance, a total of eight MD simulations are carried out with different starting molecular velocities for each simulation. MD simulation shows no pore is formed in a 10-ns snapshot for a DPPC membrane set at a uniform temperature of 295 K after a 0.4 V/nm electric field is applied. A nano-sized pore is clearly seen in a 10-ns snapshot on the same geometry but with the top and bottom membrane surfaces kept at temperatures of 300 and 295 K, respectively. For the same applied electric field, the formation of nanopores is clearly demonstrated, but only in the presence of a temperature gradient. MD simulation results show enhanced electroporative effects arising from thermal gradients. The study suggests the temperature gradient is a secondary driver, with the electric field being the primary cause for electroporation.

Keywords: nanosecond, electroporation, thermal effects, molecular dynamics

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Authors: Ivy Chumo, Sheillah Simiyu, Hellen Gitau, Isaac Kisiangani, Caroline Kabaria Kanyiva Muindi, Blessing Mberu

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The global sanitation workforce bridges the gap between sanitation infrastructure and the provision of sanitation services through essential public service work. Manual pit emptiers often perform the work at the cost of their dignity, safety, and health as their work requires repeated heavy physical activities such as lifting, carrying, pulling, and pushing. This exposes them to occupational and environmental health hazards and risking illness, injury, and death. The study will extend the studies by presenting occupational health risks and suggestions for improvement in informal settlements of Nairobi, Kenya. This is a qualitative study conducted among sanitation stakeholders in Korogocho, Mukuru and Kibera informal settlements in Nairobi. Data were captured using digital voice recorders, transcribed and thematically analysed. The discussion notes were further supported by observational notes made during the interviews. These formed the basis for a robust picture of occupational health of manual pit emptiers; a lack or inappropriate use of protective clothing, and prolonged duration of working hours were described to contribute to the occupational health hazard. To continue working, manual pit emptiers had devised coping strategies which include working in groups, improvised protective clothing, sharing the available protective clothing, working at night and consuming alcohol drinks while at work. Many of these strategies are detrimental to their health. Occupational health hazards among pit emptiers are key for effective working and is as a result of a lack of collaboration amongst stakeholders linked to health, safety and lack of PPE of pit emptiers. Collaborations amongst sanitation stakeholders is paramount for health, safety, and in ensuring the provision and use of personal protective devices.

Keywords: sanitation, occupational health, manual emptiers, informal settlements

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Authors: Nermeen Elbeltagy, Sara Hassan, Tamer Hosny, Mostafa Abdelaziz

Abstract:

Introduction: Adequate postoperative analgesia after caesarean section (CS) is crucial as it impacts the distinct surgical recovery needs of the parturient. Over recent years, there has been increased interest in regional nerve block techniques with promising results on efficacy. These techniques reduce the need for additional analgesia, thereby lowering the incidence of drug-related side effects. As postoperative pain after cesarean is mainly due to abdominal incision, the transverses abdomenis plane ( TAP ) block is a relatively new abdominal nerve block with excellent efficacy after different abdominal surgeries, including cesarean section. Objective: The main objective is to compare ultrasound-guided TAP block provided by the anesthesiologist with TAP provided by the surgeon through a caesarean incision regarding the duration of postoperative analgesia, intensity of analgesia, timing of mobilization, and easiness of the procedure. Method: Ninety pregnant females at term who were scheduled for delivery by elective cesarean section were randomly distributed into two groups. The first group (45) received spinal anesthesia and postoperative ultrasound guided TAP block using 20ml on each side of 0.25% bupivacaine which was provided by the anesthesiologist. The second group (45) received spinal anesthesia plus a TAP block using 20ml on each side of 0.25% bupivacaine, which was provided by the surgeon through the cesarean incision. Visual Analogue Scale (VAS) was used for the comparison between the two groups. Results: VAS score after four hours was higher among the TAP block group provided by the surgeon through the surgical incision than the postoperative analgesic profile using ultrasound-guided TAP block provided by the anesthesiologist (P=0.011). On the contrary, there was no statistical difference in the patient’s dose of analgesia after four hours of the TAP block (P=0.228). Conclusion: TAP block provided through the surgical incision is safe and enhances early patient’s mobilization.

Keywords: TAP block, CS, VAS, analgesia

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Authors: Kyosuke Kamada, Christoph Kapeller, Michael Jordan, Mostafa Mohammadpour, Christy Li, Christoph Guger

Abstract:

Cortico-cortical evoked potentials (CCEP) refer to responses generated by cortical electrical stimulation at distant brain sites. These responses provide insights into the functional networks associated with language or motor functions, and in the context of epilepsy, they can reveal pathological networks. Locating the origin and spread of seizures within the cortex is crucial for pre-surgical planning. This process can be enhanced by employing cortical stimulation at the seizure onset zone (SOZ), leading to the generation of CCEPs in remote brain regions that may be targeted for disconnection. In the case of a 24-year-old male patient suffering from intractable epilepsy, corpus callosotomy was performed as part of the treatment. DTI-MRI imaging, conducted using a 3T MRI scanner for fiber tracking, along with CCEP, is used as part of an assessment for surgical planning. Stimulation of the SOZ, with alternating monophasic pulses of 300µs duration and 15mA current intensity, resulted in CCEPs on the contralateral frontal cortex, reaching a peak amplitude of 206µV with a latency of 31ms, specifically in the left pars triangularis. The related fiber tracts were identified with a two-tensor unscented Kalman filter (UKF) technique, showing transversal fibers through the corpus callosum. The CCEPs were monitored through the progress of the surgery. Notably, the SOZ-associated CCEPs exhibited a reduction following the resection of the anterior portion of the corpus callosum, reaching the identified connecting fibers. This intervention demonstrated a potential strategy for mitigating the impact of intractable epilepsy through targeted disconnection of identified cortical regions.

Keywords: CCEP, SOZ, Corpus callosotomy, DTI

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Authors: G. Kaushik, A. Gupta, S. Lalwani, K. D. Soni, S. Kumar, S. Sagar

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Objective: Alcohol is a leading risk factor associated with the disability and death due to RTI. Present study aims to demonstrate the demographic profile, injury pattern, physiological parameters of victims of trauma following alcohol consumption arriving in the emergency department (ED) and mortality in alcohol intoxicated trauma patients admitted to Apex Trauma Center in Delhi. Design and Methods: Present study was performed in randomly selected 182 alcohol breath analyzer tested RTI patients from the emergency department of Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences, New Delhi for over a period of 3 months started from September 2013 to November 2013. Results: A total 182 RTI patients with blunt injury were selected between 30-40 years of age and equally distributed to male and female group. Of these, 93 (51%) were alcohol negative and 89 (49%) were alcohol positive. In 89 alcohol positive patients, 47 (53%) had Artificial Airway as compared to 17 (18%), (p < 0.001) in the other group. The Glasgow Coma Scale (GCS) score was lower (p < 0.001) and higher Injury Severity Score (ISS) was observed in alcohol positive group as compared to other group (p < 0.03). Increased number of patients (58%) were admitted to Intensive Care Unit (ICU), in alcohol positive group (p < 0.001) and they were in ICU for longer time compare to other group (p < 0.001). The alcohol positive patients were on ventilator support for longer duration as compared to non-alcoholic group (p < 0.001). Mortality rate was higher in alcohol intoxicated patients as compared to non-alcoholic RTI patients, however, the difference was not statistically significant. Conclusion: This study revealed that GCS, mean ISS, ICU stay, ventilation time etc. might have considerable impact on mortality in alcohol intoxicated patients as compared to non-alcoholic group.

Keywords: road traffic injuries, alcohol, trauma, emergency department

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Authors: Xi Quan Cheng, Yan Chao Xu, Xu Jiang, Lu Shao, Cher Hon Lau

Abstract:

A hydrophilic thin-film-composite (TFC) nanofiltration (NF) membrane has been developed through the interfacial polymerization (IP) of amino-functional polyethylene glycol (PEG) and trimesoyl chloride. The selective layer is formed on a polyethersulfone (PES) support that is characterized using FTIR, XPS and SEM, and is dependent on monomer immersion duration, and the concentration of monomers and additives. The higher hydrophilicity alongside the larger pore size of the PEG-based selective layer is the key to a high water flux of 66.0 L m-2 h-1 at 5.0 bar. With mean pore radius of 0.42 nm and narrow pore size distribution, the MgSO4 rejections of the PEG based PA TFC NF membranes can reach up to 80.2 %. The hydrophilic PEG based membranes shows positive charged since the isoelectric points range from pH=8.9 to pH=9.1 and the rejection rates for different salts of the novel membranes are in the order of R(MgCl2)>R(MgSO4)>R(NaCl)>R(Na2SO4). The pore sizes and water permeability of these membranes are tailored by varying the molecular weight and molecular architecture of amino-functional PEG. Due to the unique structure of the selective layer of the PEG based membranes consisting of saturated aliphatic construction unit (CH2-CH2-O), the membranes demonstrate dual resistance to fouling and chlorine. The membranes maintain good salt rejections and high water flux of PEG based membranes after treatment by 2000 ppm NaClO for 24 hours. Interestingly, the PEG based membranes exhibit excellent fouling resistance with a water flux recovery of 90.2 % using BSA as a model molecule. More importantly, the hydrophilic PEG based NF membranes have been exploited to separate several water soluble antibiotics (such as tobramycin, an aminoglycoside antibiotic applied in the treatment of various types of bacterial infections), showing excellent performance in concentration or removal of antibioics.

Keywords: nanofiltration, antibiotic separation, hydrophilic membrane, high flux

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Authors: Mads Kirk Larsen

Abstract:

Strict air pollution control is today high on the agenda world-wide. By reducing the particular emission, not only the mg/Nm3 will be reduced – also parts of mercury and other hazardous matters attached to the particles will be reduced. Furthermore, it is possible to catch the fine particles (PM2.5). For particulate control, the precipitators are still the preferred choice and much efforts have been done to improve the efficiencies. Many ESP’s have seen electrical upgrading by changing the traditional 1 phase power system into either 3 phase or SMPS (High Frequency) units. However, there exist a 4th type of power supply – the pulse type. This is unfortunately widely unknown, but may be of great benefit to power plants. The FLSmidth type is called COROMAX® and it is a high voltage pulse generator for precipitators using a semiconductor switch operating at medium potential. The generated high voltage pulses have rated amplitude of 80 kV and duration of 75 μs and are superimposed on a variable base voltage of 60 kV rated voltage. Hereby, achieving a peak voltage of 140 kV. COROMAX® has the ability to increase the voltage beyond the natural spark limit inside the precipitator. Voltage levels may often be twice as high after installation of COROMAX®. Hereby also the migration velocity increases and thereby the efficiency. As the collection efficiency is proportional to the voltage peak and mean values, this also increases the collection efficiency of the fine particles where test has shown 80% removal of particles less than 0.07 micron. Another great advantage is the indifference to back-corona. Simultaneously with emission reduction, the power consumption will also be reduced. Another great advantage of the COROMAX® system is that the emission can be improved without the need to change the internal parts or enlarge the ESP. Recently, more than 150 units have been installed in China, where emissions have been reduced to ultra-low levels.

Keywords: eleectrostatic precipitator, high resistivity dust, micropulse energization, particulate removal

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