Search results for: Total Knee Replacement Surgery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10447

Search results for: Total Knee Replacement Surgery

9487 Peat Soil Stabilization by Using Sugarcane Bagasse Ash (SCBA)

Authors: Mohd. Khaidir Abu Talib, Noriyuki Yasufuku, Ryohei Ishikura

Abstract:

It is well recognized that peat can impede the proper hydration of cement because of high organic content, presence of humic acid and less solid particles. That means the large amount of cement is required in order to neutralize the acids or otherwise the process of the peat stabilization remains retarded. Nevertheless, adding a great quantity of cement into the peat is absolutely an unfriendly and uneconomical solution. Sugarcane production is world number one commodities and produced a lot of bagasse. Bagasse is burnt to generate power required for diverse activities in the factory and leave bagasse ash as a waste. Increasing concern of disposal of bagasse residual creates interest to explore the potential application of this material. The objective of this study is to develop alternative binders that are environment friendly and contribute towards sustainable management by utilizing sugarcane bagasse ash (SCBA) in the stabilization of peat soil. Alongside SCBA, Ordinary Portland Cement (OPC), calcium chloride (CaCl2) and silica sand (K7) were used as additives to stabilize the peat that sampled from Hokkaido, Japan. In obtaining the optimal mix design, specimens of stabilized peat were tested in unconfined compression. It was found that stabilized peat comprising 20% and 5% (PCB1-20 and PCB2-5) partial replacement of OPC with SCBA 1 and SCBA 2 attain the maximum unconfined compressive strength (UCS) and discovered greater than untreated soil (P) and UCS of peat-cement (PC) specimen. At the optimal mix design, the UCS of the stabilized peat specimens increased with increasing of curing time, preloading during curing, OPC dosage and K7 dosage. For PCB1-20 mixture, inclusion of a minimum OPC dosage of 300 kg/m3 and K7 dosage of 500 kg/m3 along with curing under 20kPa pressure is recommendable for the peat stabilization to be effective. However for PCB2-5 mixture, it suggested to use more OPC and K7 dosage or alternatively increase the preloading during curing to 40kPa in order to achieve minimum strength target. It can be concluded that SCBA 1 has better quality than SCBA 2 in peat stabilization especially the contribution made by its fine particle size.

Keywords: peat stabilization, sugarcane bagasse ash utilization, partial cement replacement, unconfined strength

Procedia PDF Downloads 531
9486 Vermicomposting of Textile Industries’ Dyeing Sludge by Using Eisenia foetida

Authors: Kunwar D. Yadav, Dayanand Sharma

Abstract:

Surat City in India is famous for textile and dyeing industries which generate textile sludge in huge quantity. Textile sludge contains harmful chemicals which are poisonous and carcinogenic. The safe disposal and reuse of textile dyeing sludge are challenging for owner of textile industries and government of the state. The aim of present study was the vermicomposting of textile industries dyeing sludge with cow dung and Eisenia foetida as earthworm spices. The vermicompost reactor of 0.3 m3 capacity was used for vermicomposting. Textile dyeing sludge was mixed with cow dung in different proportion, i.e., 0:100 (C1), 10:90 (C2), 20:80 (C3), 30:70 (C4). Vermicomposting duration was 120 days. All the combinations of the feed mixture, the pH was increased to a range 7.45-7.78, percentage of total organic carbon was decreased to a range of 31-33.3%, total nitrogen was decreased to a range of 1.15-1.32%, total phosphorus was increased in the range of 6.2-7.9 (g/kg).

Keywords: cow dung, Eisenia foetida, textile sludge, vermicompost

Procedia PDF Downloads 210
9485 The Effects of Nanoemulsions Based on Commercial Oils: Sunflower, Canola, Corn, Olive, Soybean, and Hazelnut Oils for the Quality of Farmed Sea Bass at 2±2°C

Authors: Yesim Ozogul, Mustafa Durmuş, Fatih Ozogul, Esmeray Kuley Boğa, Yılmaz Uçar, Hatice Yazgan

Abstract:

The effects of oil-in-water nanoemulsions on the sensory, chemical (total volatile basic nitrogen (TVB-N), thiobarbituric acid (TBA), peroxide value (PV) and free fatty acids (FFA), and microbiological qualities (total viable count (TVC), total psychrophilic bacteria, and total Enterbactericaea bacteria) of sea bream fillets stored at 2 ± 2°C were investigated. Physical properties of emulsions (viscosity, the particle size of droplet, thermodynamic stability, refractive index and surface tension) were determined. The results showed that the use of nanoemulsion extended the shelf life of fish 2 days when compared with the control. Treatment with nanoemulsions significantly (p<0.05) decreased the values of biochemical parameters during storage period. Bacterial growth was inhibited by the use of nanoemulsions. Based on the results, it can be concluded that nanoemulsions based on commercial oils extended the shelf life and improved the quality of sea bass fillets during storage period.

Keywords: lipid oxidation, nanoemulsion, sea bass, quality parameters

Procedia PDF Downloads 477
9484 Preparation and Biological Evaluation of 186/188Re-Chitosan for Radiosynovectomy

Authors: N. Ahmadi, H. Yousefnia, A. Bahrami-Samani

Abstract:

Chitosan is a natural and biodegradable polysaccharide with special characteristic for application in intracavital therapy. 166Ho-chitosan has been reported for the treatment of hepatocellular carcinoma and RSV with promising results. The aim of this study was to prepare 186/188Re-chitosan for radiosynovectomy purposes and investigate the probability of its leakage from the knee joint. 186/188Re was produced by neutron irradiation of the natural rhenium in a research reactor. Chemical processing was performed to obtain (186/188Re)-NaReO4- according to the IAEA manual. A stock solution of chitosan was prepared by dissolving in 1 % acetic acid aqueous solution (10 mg/mL). 1.5 mL of this stock solution was added to the vial containing the activity and the mixture was stirred for 5 min in the room temperature. The radiochemical purity of the complex was checked by the ITLC method, showing the purity of higher than 98%. Distribution of the radiolabeled complex was determined after intra-articular injection into the knees of rats. Excellent retention was observed in the joint with approximately no activity in the other organs.

Keywords: chitosan, leakage, radiosynovectomy, rhenium

Procedia PDF Downloads 336
9483 Follicular Thyroid Carcinoma in a Developing Country: A Retrospective Study of 10 Years

Authors: Abdul Aziz, Muhammad Qamar Masood, Saadia Sattar, Saira Fatima, Najmul Islam

Abstract:

Introduction: The most common endocrine tumor is thyroid cancer. Follicular Thyroid Carcinoma (FTC) accounts for 5%–10% of all thyroid cancers. Patients with FTC frequently present with more advanced stage diseases and a higher occurrence of distant metastases because of the propensity of vascular invasion. FTC is mainly treated with surgery, while radioactive iodine therapy is the main adjuvant therapy as per ATA guidelines. In many developing countries, surgical facilities and radioactive iodine are in short supply; therefore, understanding follicular thyroid cancer trends may help developing countries plan and use resources more effectively. Methodology: It was a retrospective observational study of FTC patients of age 18 years and above conducted at Aga Khan University Hospital, Karachi, from 1st January 2010 to 31st December 2019. Results: There were 404 patients with thyroid carcinoma, out of which forty (10.1%) were FTC. 50% of the patients were in the 41-60 years age group, and the female to male ratio was 1.5: 1. Twenty-four patients (60%) presented with complain of neck swelling followed by metastasis (20%) and compressive symptoms (20%). The most common site of metastasis was bone (87.5%), followed by lung (12.5%). The pre-operative thyroglobulin level was done in six out of eight metastatic patients (75%) in which it was elevated. This emphasizes the importance of checking thyroglobulin level in unusual presentation (bone pain, fractures) of a patient having neck swelling also to help in establishing the primary source of tumor. There was no complete documentation of ultrasound features of the thyroid gland in all the patients, which is an important investigation done in the initial evaluation of thyroid nodule. On FNAC, 50% (20 patients) had Bethesda category III-IV nodules, while 10% ( 4 patients ) had Bethesda category II. In sixteen patients, FNAC was not done as they presented with compressive symptoms or metastasis. Fifty percent had a total thyroidectomy and 50% had subtotal followed by completion thyroidectomy, plus ten patients had lymph node dissection, out of which seven had histopathological lymph node involvement. On histopathology, twenty-three patients (57.5%) had minimally invasive, while seventeen (42.5%) had widely invasive follicular thyroid carcinoma. The capsular invasion was present in thirty-three patients (82.5%); one patient had no capsular invasion, but there was a vascular invasion. Six patients' histopathology had no record of capsular invasion. In contrast, the lymphovascular invasion was present in twenty-six patients (65%). In this study, 65 % of the patients had clinical stage 1 disease, while 25% had stage 2 and 10% had clinical stage 4. Seventeen patients (42.5%) had received RAI 30-100 mCi, while ten patients (25%) received more than 100 mCi. Conclusion: FTC demographic and clinicopathological presentation are the same in Pakistan as compared to other countries. Surgery followed by RAI is the mainstay of treatment. Thus understanding the trend of FTC and proper planning and utilization of the resources will help the developing countries in effectively treating the FTC.

Keywords: thyroid carcinoma, follicular thyroid carcinoma, clinicopathological features, developing countries

Procedia PDF Downloads 187
9482 Full Fat Soybean Meal as a Substitute for Soybean Meal in Broiler Rations

Authors: R. M. K. S. Chandana, A. P. D. G. Pathirana, N. Priyankarage, W. A. D. Nayananjalie, S. S. P. Silva

Abstract:

Full fat soybean meal (FFSBM) has been used in many parts of the world together with solvent-extracted soybean meal (SBM) in livestock feeds. Although some local FFSBM is available, their use has not been assessed experimentally. This study was carried out to evaluate the use of local extruded FFSBM in broiler rations. Four treatment diets were formulated by incorporating locally produced FFSBM (0, 10, 20, and 30%) as a replacement for soybean meal (SBM) in a two-phase (starter and finisher) feeding program. Two hundred Hubbard F 15 day old broiler chicks were randomly assigned into four treatments with five replicates per each. Bodyweight gain (BWG), feed intakes (FI), and feed conversion ratio (FCR) were calculated for a period of 42 days. Nutrient utilization in the form of dry matter (DM), energy, nitrogen, and fat retention were estimated by the total collection method in three weeks old broilers. At the end of the experiment, carcass weight was measured, and the dressing percentage was calculated. Data were analyzed using one way analysis of variance (ANOVA) in SAS. There was no significant effect of FFSBM on feed intakes of chicks fed different diets (p > 0.05). Birds fed the control diet, and FF10 (10% FFSBM diet) gained significantly more than that of birds fed FF20 or FF30 diets (p > 0.05). In the finisher period, control birds gained more than all the other treatment birds. FCR was poorer in bird fed higher levels of FFSBM compared to the control or FF10 birds during their early life, but that was not evident in the latter part of the experiment. Treatments did not alter (p > 0.05) the retention of DM and nitrogen, but energy utilization was lowest (p < 0.05) in birds fed with 0% FFSBM, and the highest fat digestibility was observed in birds fed with 30% FFSBM diets. Thus, it can be concluded that FFSBM can be used as a substitute for SBM in broiler rations and could be incorporated up to 10% of the diet safely with no adverse effects on broiler performances.

Keywords: body weight, broiler, digestibility, full fat soybean meal, soybean meal

Procedia PDF Downloads 144
9481 The Incidence of Inferior Alveolar Nerve Dysfunction Following Bilateral Sagittal Split Osteotomies: A Single Centre Retrospective Audit in the United Kingdom

Authors: Krupali Mukeshkumar, Jinesh Shah

Abstract:

Background: Bilateral Sagittal Split Osteotomy (BSSO), used for the correction of mandibular deformities, is a common oral and maxillofacial surgical procedure. Inferior alveolar nerve dysfunction is commonly reported post-operatively by patients as paresthesia or anesthesia. The current literature lacks a consensus on the incidence of inferior alveolar nerve dysfunction as patients are not routinely assessed pre and post-operatively with an objective assessment. The range of incidence varies from 9% to 85% of patients, with some authors arguing that 100% of patients experience nerve dysfunction immediately post-surgery. Systematic reviews have shown a difference between incidence rates at different follow-up periods using objective and subjective methods. Aim: To identify the incidence of inferior alveolar nerve dysfunction following BSSO. Gold standard: Nerve dysfunction incidence rates similar or lower than current literature of 83% day one post-operatively and 18.4% at one year follow up. Setting: A retrospective cross-sectional audit of patients treated between 2017-2019 at the Royal Stoke University Hospital, Maxillofacial and Orthodontic departments. Sample: All patients who underwent a BSSO (with or without le fort one osteotomy) between 2017–2019 were identified from the database. Patients with pre-existing neurosensory disturbance, those who had a genioplasty at the same time and those with no follow-up were excluded. The sample consisted of 121 patients, 37 males and 84 females between the ages of 17-50 years at the time of surgery. Methods: Clinical records of 121 cases were reviewed to assess the age, sex, type of mandibular osteotomy, status of the nerve during the surgical procedure, type of bony split and incidence of nerve dysfunction at follow-up appointments. The surgical procedure was carried out by three Maxillo-facial surgeons and follow-up appointments were carried out in the Orthodontic and Oral and Maxillo-facial departments. Results: 120 patients were treated to correct the mandibular facial deformity and 1 patient was treated for sleep apnoea. Seventeen patients had a mandibular setback and 104 patients had mandibular advancement. 68 patients reported inferior alveolar nerve dysfunction at one week following their surgery. Seventy-six patients had temporary paresthesia present between 2 weeks and 12 months post-surgery. 13 patients had persistent nerve dysfunction at 12 months, of which 1 had a bad bony split during the BSSO. The incidence of nerve dysfunction postoperatively was 6.6% after 1 day, 56.1% at 1 week, 62.8% at 2 weeks, 59.5% between 3-6 weeks, 43.0% between 8-16 weeks and 10.7% at 1 year. Conclusions: The results of this audit show a similar incidence rate to the research gold standard at the one-year follow-up. Future Recommendations: No changes to surgical procedure or technique are indicated, but a need for improved documentation and a standardized approach for assessment of post-operative nerve dysfunction would be beneficial.

Keywords: bilateral sagittal split osteotomy, inferior alveolar nerve, mandible, nerve dysfunction

Procedia PDF Downloads 234
9480 Comparison Between Tension Band Wiring Using K-Wires and Cannulated Screws in Transverse Patella Fracture Fixation

Authors: Daniel Francis, Mo Yassin

Abstract:

Transverse patella fractures are routinely fixed using tension band wiring (TBW) using Kirschner wires and a wire in the shape of a figure of 8. The idea of the study was to compare the outcomes of the traditional technique against the more recently used cannulated screws and fiber tape in the shape of a figure of 8. We performed a retrospective cohort study of all the surgically fixed patella fractures from the year 2019 to 2022. The patients were divided into two groups TBW group and cannulated screws group. The primary outcome measure was the failure of fixation and the need for the removal of metalwork. Twenty-six patellar fractures were studied. TBW was used in 14 (53.8%), and cannulated screws were used for fixation in 12 (46.2%). There was one incident of metalwork failure in the TBW and one incident in the cannulated screws group. Five (35.7%) of patients in the TBW needed symptomatic metal work removed and One (8.3%) in the cannulated screw group. In both groups, the rate of fixation failure was low. Symptomatic implants, the most common complication observed, were higher in the TBW group in our practice. Although the small numbers in both groups, the hope of this study is to shine the light on the use of cannulated screws for patella fractures as it would reduce the need for a second operation and reduce the load on the already stretched services as well as improving the patient experience by not requiring further surgery. Although this is not a brand-new technique, it is not commonly used as there have not yet been any studies that demonstrate the lower rates of second surgery needed.

Keywords: patella, tension band wiring, randomised, new technique

Procedia PDF Downloads 72
9479 Implementing Total Quality Management in Higher Education

Authors: Abbos Utkirov

Abstract:

Total Quality Management (TQM) in the context of educational institutions requires careful planning and the implementation of an annual quality program to achieve its vision effectively. By applying TQM concepts, the higher education system can experience significant improvements. This study aims to examine TQM in higher education, focusing on Critical Success Factors (CSF) and their implementation across all areas. The study ultimately concludes that CSF and their execution play a crucial role in higher education institutions. Some institutions have already benefited from TQM methods by dedicating themselves to the system and using it to achieve their objectives. Through this review, recent studies shed light on how the TQM system can employ various strategies and hypotheses to empower employees, foster a positive and supportive environment, and emphasize the importance of enabling students to unleash their full potential.

Keywords: total quality management (TQM), critical success factor (CSF), organizational performance, quality management practices

Procedia PDF Downloads 87
9478 Analysis of the Outcome of the Treatment of Osteoradionecrosis in Patients after Radiotherapy for Head and Neck Cancer

Authors: Petr Daniel Kovarik, Matt Kennedy, James Adams, Ajay Wilson, Andy Burns, Charles Kelly, Malcolm Jackson, Rahul Patil, Shahid Iqbal

Abstract:

Introduction: Osteoradionecrosis (ORN) is a recognised toxicity of radiotherapy (RT) for head and neck cancer (HNC). Existing literature lacks any generally accepted definition and staging system for this toxicity. Objective: The objective is to analyse the outcome of the surgical and nonsurgical treatments of ORN. Material and Method: Data on 2303 patients treated for HNC with radical or adjuvant RT or RT-chemotherapy from January 2010 - December 2021 were retrospectively analysed. Median follow-up to the whole group of patients was 37 months (range 0–148 months). Results: ORN developed in 185 patients (8.1%). The location of ORN was as follows; mandible=170, maxilla=10, and extra oral cavity=5. Multiple ORNs developed in 7 patients. 5 patients with extra oral cavity ORN were excluded from treatment analysis as the management is different. In 180 patients with oral cavity ORN, median follow-up was 59 months (range 5–148 months). ORN healed in 106 patients, treatment failed in 74 patients (improving=10, stable=43, and deteriorating=21). Median healing time was 14 months (range 3-86 months). Notani staging is available in 158 patients with jaw ORN with no previous surgery to the mandible (Notani class I=56, Notani class II=27, and Notani class III=76). 28 ORN (mandible=27, maxilla=1; Notani class I=23, Notani II=3, Notani III=1) healed spontaneously with a median healing time 7 months (range 3–46 months). In 20 patients, ORN developed after dental extraction, in 1 patient in the neomandible after radical surgery as a part of the primary treatment. In 7 patients, ORN developed and spontaneously healed in irradiated bone with no previous surgical/dental intervention. Radical resection of the ORN (segmentectomy, hemi-mandibulectomy with fibula flap) was performed in 43 patients (all mandible; Notani II=1, Notani III=39, Notani class was not established in 3 patients as ORN developed in the neomandible). 27 patients healed (63%); 15 patients failed (improving=2, stable=5, deteriorating=8). The median time from resection to healing was 6 months (range 2–30 months). 109 patients (mandible=100, maxilla=9; Notani I=3, Notani II=23, Notani III=35, Notani class was not established in 9 patients as ORN developed in the maxilla/neomandible) were treated conservatively using a combination of debridement, antibiotics and Pentoclo. 50 patients healed (46%) with a median healing time 14 months (range 3–70 months), 59 patients are recorded with persistent ORN (improving=8, stable=38, deteriorating=13). Out of 109 patients treated conservatively, 13 patients were treated with Pentoclo only (all mandible; Notani I=6, Notani II=3, Notani III=3, 1 patient with neomandible). In total, 8 patients healed (61.5%), treatment failed in 5 patients (stable=4, deteriorating=1). Median healing time was 14 months (range 4–24 months). Extra orally (n=5), 3 cases of ORN were in the auditory canal and 2 in mastoid. ORN healed in one patient (auditory canal after 32 months. Treatment failed in 4 patients (improving=3, stable=1). Conclusion: The outcome of the treatment of ORN remains in general, poor. Every effort should therefore be made to minimise the risk of development of this devastating toxicity.

Keywords: head and neck cancer, radiotherapy, osteoradionecrosis, treatment outcome

Procedia PDF Downloads 91
9477 Effect of Two Entomopathogenic Fungi Beauveria bassiana and Metarhizium anisopliae var. acridum on the Haemolymph of the Desert Locust Schistocerca gregaria

Authors: Fatima Zohra Bissaad, Farid Bounaceur, Nassima Behidj, Nadjiba Chebouti, Fatma Halouane, Bahia Doumandji-Mitiche

Abstract:

Effect of Beauveria bassiana and Metarhizium anisopliae var. acridum on the 5th instar nymphs of Schistocerca gregaria was studied in the laboratory. Infection by these both entomopathogenic fungi caused reduction in the hemolymph total protein. The average amounts of total proteins were 2.3, 2.07, 2.09 µg/100 ml of haemolymph in the control and M. anisopliae var. acridum, and B. bassiana based-treatments, respectively. Three types of haemocytes were recognized and identified as prohaemocytes, plasmatocytes and granulocytes. The treatment caused significant reduction in the total haemocyte count and in each haemocyte type on the 9th day after its application.

Keywords: Beauveria bassiana, haemolymph picture, haemolymph protein, Metarhizium anisopliae var. acridum, Schistocerca gregaria

Procedia PDF Downloads 472
9476 Molecularly Imprinted Nanoparticles (MIP NPs) as Non-Animal Antibodies Substitutes for Detection of Viruses

Authors: Alessandro Poma, Kal Karim, Sergey Piletsky, Giuseppe Battaglia

Abstract:

The recent increasing emergency threat to public health of infectious influenza diseases has prompted interest in the detection of avian influenza virus (AIV) H5N1 in humans as well as animals. A variety of technologies for diagnosing AIV infection have been developed. However, various disadvantages (costs, lengthy analyses, and need for high-containment facilities) make these methods less than ideal in their practical application. Molecularly Imprinted Polymeric Nanoparticles (MIP NPs) are suitable to overcome these limitations by having high affinity, selectivity, versatility, scalability and cost-effectiveness with the versatility of post-modification (labeling – fluorescent, magnetic, optical) opening the way to the potential introduction of improved diagnostic tests capable of providing rapid differential diagnosis. Here we present our first results in the production and testing of MIP NPs for the detection of AIV H5N1. Recent developments in the solid-phase synthesis of MIP NPs mean that for the first time a reliable supply of ‘soluble’ synthetic antibodies can be made available for testing as potential biological or diagnostic active molecules. The MIP NPs have the potential to detect viruses that are widely circulating in farm animals and indeed humans. Early and accurate identification of the infectious agent will expedite appropriate control measures. Thus, diagnosis at an early stage of infection of a herd or flock or individual maximizes the efficiency with which containment, prevention and possibly treatment strategies can be implemented. More importantly, substantiating the practicability’s of these novel reagents should lead to an initial reduction and eventually to a potential total replacement of animals, both large and small, to raise such specific serological materials.

Keywords: influenza virus, molecular imprinting, nanoparticles, polymers

Procedia PDF Downloads 354
9475 Factors Contributing to Sports Injuries among Senior High Schools in Ghana

Authors: Mawuli M. Sedegah, Emmanuel O. Sarpong, Ernest Y. Acheampong

Abstract:

Sports injuries among student-athletes in high schools have become prevalent in most developing countries. The study explores the risk factors influencing sports injuries and identify those sustained among high schools’ competitions in the Akuapem Municipality. Drawing on literature from sports injuries, 610 student-athletes were used to understand how they sustained various injuries during schools’ sports and games. Using a cross-sectional survey, the study reveals how wounds, knee injury, muscle cramps, and thigh injury are common injuries in the municipality. The physiological factor was rampant, resulting from the number of games played by student-athletes, which significantly influenced sprain, strain, dislocation, and nose bleeding injuries among them. Results recorded a low correlation accounting for 9% occurrence of sports injuries in the Akuapem Municipality. Further study can be done in the other districts to have a general approach to remedy some of these sports injuries.

Keywords: common injuries, physiological factors, sports injuries, student-athletes

Procedia PDF Downloads 168
9474 Prevalence of Gestational Diabetes Mellitus in Western Australia from 2015 until 2020

Authors: Kumaressan Ragunathan, Arisudhan Anantharachagan

Abstract:

Gestational diabetes mellitus (GDM) is the subtype of diabetes that has been rapidly increasing in numbers in Australia. The annual percentage of GDM has increased more than 50 percent in the last decade. According to Diabetes Australia, more than five hundred thousand women in Australia will be diagnosed with GDM. Globally, the prevalence of GDM ranges from single-digit to more than 45%. The prevalence of GDM has increased significantly last five years after the introduction of new diagnostic criteria. Hence, we have decided to investigate the trend in GDM prevalence in a tertiary maternity unit at Western Australia and compare it to national prevalence. Data is derived from STORK Perinatal Database which has been used by Maternity services in Western Australia to populate information on pregnancy and labour. We have selected data from 2015 until 2020, which includes 17508 women. Among 17508 women, 3850 women were diagnosed with GDM. In 2015, we had a total of 2213 deliveries with 345 of them were complicated by GDM. GDM prevalence was 15.6% compared to the Australian national prevalence of 12%. In 2016, total deliveries increased to 2759 with 590 of were with GDM. GDM prevalence was 21.4% compared to the Australian national prevalence of 12%. In 2017, total deliveries further increased to 3049 with 675 with GDM. GDM prevalence was 22.1%, with an Australian national prevalence of 13%. In 2018, total deliveries continued to increase, with numbers reaching 3231 with 749 with GDM. GDM prevalence was 23.2%, with an Australian National prevalence of 14%. In 2019, total deliveries were 3110, with 712 complicated by GDM. GDM prevalence was 22.9%, with Australian national prevalence 14%. In 2020, total deliveries 3146 with 819 complicated by GDM. GDM prevalence increased to 26% and we were unable to compare this to national standard as national prevalence has not been released. Among 3890 women with GDM, 2482 (64%) of them required insulin. Apart from that, a total 1642(42%) from the GDM group were delivered via the Caesarean section. 2121 (55%) women with GDM required induction of labour. Overall, we demonstrated an increase in the prevalence of GDM in our unit from 2015 until 2020. Our prevalence is also higher compared to national prevalence. This could be contributed by the increasing number of obesity and in addition, our unit accepts referrals of women with a body mass index (BMI) of more than 40. Hence, further studies are required to look at other risk factors like ethnicity, socio-economic status, health literacy and age, which could contribute to this high prevalence.

Keywords: gestational diabetes mellitus, prevalence, Western Australia, Australia

Procedia PDF Downloads 159
9473 A Study of Anoxic - Oxic Microbiological Technology for Treatment of Heavy Oily Refinery Wastewater

Authors: Di Wang, Li Fang, Shengyu Fang, Jianhua Li, Honghong Dong, Zhongzhi Zhang

Abstract:

Heavy oily refinery wastewater with the characteristics of high concentration of toxic organic pollutant, poor biodegradability and complicated dissolved recalcitrant compounds is intractable to be degraded. In order to reduce the concentrations of COD and total nitrogen pollutants which are the major pollutants in heavy oily refinery wastewater, the Anoxic - Oxic microbiological technology relies mainly on anaerobic microbial reactor which works with methanogenic archaea mainly that can convert organic pollutants to methane gas, and supplemented by aerobic treatment. The results of continuous operation for 2 months with a hydraulic retention time (HRT) of 60h showed that, the COD concentration from influent water of anaerobic reactor and effluent water from aerobic reactor were 547.8mg/L and 93.85mg/L, respectively. The total removal rate of COD was up to 84.9%. Compared with the 46.71mg/L of total nitrogen pollutants in influent water of anaerobic reactor, the concentration of effluent water of aerobic reactor decreased to 14.11mg/L. In addition, the average removal rate of total nitrogen pollutants reached as high as 69.8%. Based on the data displayed, Anoxic - Oxic microbial technology shows a great potential to dispose heavy oil sewage in energy saving and high-efficiency of biodegradation.

Keywords: anoxic - oxic microbiological technology, COD, heavy oily refinery wastewater, total nitrogen pollutant

Procedia PDF Downloads 488
9472 Management of Dysphagia after Supra Glottic Laryngectomy

Authors: Premalatha B. S., Shenoy A. M.

Abstract:

Background: Rehabilitation of swallowing is as vital as speech in surgically treated head and neck cancer patients to maintain nutritional support, enhance wound healing and improve quality of life. Aspiration following supraglottic laryngectomy is very common, and rehabilitation of the same is crucial which requires involvement of speech therapist in close contact with head and neck surgeon. Objectives: To examine the functions of swallowing outcomes after intensive therapy in supraglottic laryngectomy. Materials: Thirty-nine supra glottic laryngectomees were participated in the study. Of them, 36 subjects were males and 3 were females, in the age range of 32-68 years. Eighteen subjects had undergone standard supra glottis laryngectomy (Group1) for supraglottic lesions where as 21 of them for extended supraglottic laryngectomy (Group 2) for base tongue and lateral pharyngeal wall lesion. Prior to surgery visit by speech pathologist was mandatory to assess the sutability for surgery and rehabilitation. Dysphagia rehabilitation started after decannulation of tracheostoma by focusing on orientation about anatomy, physiological variation before and after surgery, which was tailor made for each individual based on their type and extent of surgery. Supraglottic diet - Soft solid with supraglottic swallow method was advocated to prevent aspiration. The success of intervention was documented as number of sessions taken to swallow different food consistency and also percentage of subjects who achieved satisfactory swallow in terms of number of weeks in both the groups. Results: Statistical data was computed in two ways in both the groups 1) to calculate percentage (%) of subjects who swallowed satisfactorily in the time frame of less than 3 weeks to more than 6 weeks, 2) number of sessions taken to swallow without aspiration as far as food consistency was concerned. The study indicated that in group 1 subjects of standard supraglottic laryngectomy, 61% (n=11) of them were successfully rehabilitated but their swallowing normalcy was delayed by an average 29th post operative day (3-6 weeks). Thirty three percentages (33%) (n=6) of the subjects could swallow satisfactorily without aspiration even before 3 weeks and only 5 % (n=1) of the needed more than 6 weeks to achieve normal swallowing ability. Group 2 subjects of extended SGL only 47 %( n=10) of them could achieved satisfactory swallow by 3-6 weeks and 24% (n=5) of them of them achieved normal swallowing ability before 3 weeks. Around 4% (n=1) needed more than 6 weeks and as high as 24 % (n=5) of them continued to be supplemented with naso gastric feeding even after 8-10 months post operative as they exhibited severe aspiration. As far as type of food consistencies were concerned group 1 subject could able to swallow all types without aspiration much earlier than group 2 subjects. Group 1 needed only 8 swallowing therapy sessions for thickened soft solid and 15 sessions for liquids whereas group 2 required 14 sessions for soft solid and 17 sessions for liquids to achieve swallowing normalcy without aspiration. Conclusion: The study highlights the importance of dysphagia intervention in supraglottic laryngectomees by speech pathologist.

Keywords: dysphagia management, supraglotic diet, supraglottic laryngectomy, supraglottic swallow

Procedia PDF Downloads 228
9471 An Environmental Method for Renovation of Sewer Systems in Building Structures

Authors: Parastou Kharazmi

Abstract:

Degradation of building materials particularly pipelines causes environmental damage during the renovation or replacement, disturbance for people living in the buildings, is time-consuming and last but not least is very costly. Rehabilitation by composite materials is a solution for renovation of degraded pipeline in residential buildings and any other structures which is less costly, faster and causes less damage to the environment. This study provides a brief state of technology, methods, and materials which are being used in Nordic and some other European countries and an investigation on the performance of the relined pipes after they have been in working condition. The investigation was carried by different analyses in laboratory as well as numerous field inspections.

Keywords: buildings, pipeline, rehabilitation, polymer materials

Procedia PDF Downloads 237
9470 Beta Titanium Alloys: The Lowest Elastic Modulus for Biomedical Applications: A Review

Authors: Mohsin Talib Mohammed, Zahid A. Khan, Arshad N. Siddiquee

Abstract:

Biometallic materials are the most important materials for use in biomedical applications especially in manufacturing a variety of biological artificial replacements in a modern worlds, e.g. hip, knee or shoulder joints, due to their advanced characteristics. Titanium (Ti) and its alloys are used extensively in biomedical applications based on their high specific strength and excellent corrosion resistance. Beta-Ti alloys containing completely biocompatible elements are exceptionally prospective materials for manufacturing of bioimplants. They have superior mechanical, chemical and electrochemical properties for use as biomaterials. These biomaterials have the ability to introduce the most important property of biochemical compatibility which is low elastic modulus. This review examines current information on the recent developments in alloying elements leading to improvements of beta Ti alloys for use as biomaterials. Moreover, this paper focuses mainly on the evolution, evaluation and development of the modulus of elasticity as an effective factor on the performance of beta alloys.

Keywords: beta alloys, biomedical applications, titanium alloys, Young's modulus

Procedia PDF Downloads 319
9469 The Effectivity of Lime Juice on the Cooked Rice's Shelf-Life

Authors: Novriyanti Lubis, Riska Prasetiawati, Nuriani Rahayu

Abstract:

The effectivity of lime juice on the cooked rice’s shelf-life was investigated. This research was proposed to get the optimal condition, such as concentration lime juice as the preservatives, and shelf-life cooked rice’s container to store using rice warmer. The effectivity was analysed total colony bacteriology, and physically. The variation of lime juice’s concentration that have been used were 0%, 0,46%, 0,93%, 1,40%, and 1,87%. The observation of cooked rice’s quality was done every 12 hours, including colour, smell, flavour, and total colony every 24 hours. Based on the result of the research considered from the cooked rice’s quality through observing the total of the colony bacteriology and physically, it showed the optimum concentrate which is effective preserve the cooked rise’s level concentrate was 0.93%.

Keywords: bacteriology, cooked rice's, lime juice, preservative

Procedia PDF Downloads 332
9468 M-Machine Assembly Scheduling Problem to Minimize Total Tardiness with Non-Zero Setup Times

Authors: Harun Aydilek, Asiye Aydilek, Ali Allahverdi

Abstract:

Our objective is to minimize the total tardiness in an m-machine two-stage assembly flowshop scheduling problem. The objective is an important performance measure because of the fact that the fulfillment of due dates of customers has to be taken into account while making scheduling decisions. In the literature, the problem is considered with zero setup times which may not be realistic and appropriate for some scheduling environments. Considering separate setup times from processing times increases machine utilization by decreasing the idle time and reduces total tardiness. We propose two new algorithms and adapt four existing algorithms in the literature which are different versions of simulated annealing and genetic algorithms. Moreover, a dominance relation is developed based on the mathematical formulation of the problem. The developed dominance relation is incorporated in our proposed algorithms. Computational experiments are conducted to investigate the performance of the newly proposed algorithms. We find that one of the proposed algorithms performs significantly better than the others, i.e., the error of the best algorithm is less than those of the other algorithms by minimum 50%. The newly proposed algorithm is also efficient for the case of zero setup times and performs better than the best existing algorithm in the literature.

Keywords: algorithm, assembly flowshop, scheduling, simulation, total tardiness

Procedia PDF Downloads 325
9467 Comparison of Two Strategies in Thoracoscopic Ablation of Atrial Fibrillation

Authors: Alexander Zotov, Ilkin Osmanov, Emil Sakharov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

Abstract:

Objective: Thoracoscopic surgical ablation of atrial fibrillation (AF) includes two technologies in performing of operation. 1st strategy used is the AtriCure device (bipolar, nonirrigated, non clamping), 2nd strategy is- the Medtronic device (bipolar, irrigated, clamping). The study presents a comparative analysis of clinical outcomes of two strategies in thoracoscopic ablation of AF using AtriCure vs. Medtronic devices. Methods: In 2 center study, 123 patients underwent thoracoscopic ablation of AF for the period from 2016 to 2020. Patients were divided into two groups. The first group is represented by patients who applied the AtriCure device (N=63), and the second group is - the Medtronic device (N=60), respectively. Patients were comparable in age, gender, and initial severity of the condition. Among the patients, in group 1 were 65% males with a median age of 57 years, while in group 2 – 75% and 60 years, respectively. Group 1 included patients with paroxysmal form -14,3%, persistent form - 68,3%, long-standing persistent form – 17,5%, group 2 – 13,3%, 13,3% and 73,3% respectively. Median ejection fraction and indexed left atrial volume amounted in group 1 – 63% and 40,6 ml/m2, in group 2 - 56% and 40,5 ml/m2. In addition, group 1 consisted of 39,7% patients with chronic heart failure (NYHA Class II) and 4,8% with chronic heart failure (NYHA Class III), when in group 2 – 45% and 6,7%, respectively. Follow-up consisted of laboratory tests, chest Х-ray, ECG, 24-hour Holter monitor, and cardiopulmonary exercise test. Duration of freedom from AF, distant mortality rate, and prevalence of cerebrovascular events were compared between the two groups. Results: Exit block was achieved in all patients. According to the Clavien-Dindo classification of surgical complications fraction of adverse events was 14,3% and 16,7% (1st group and 2nd group, respectively). Mean follow-up period in the 1st group was 50,4 (31,8; 64,8) months, in 2nd group - 30,5 (14,1; 37,5) months (P=0,0001). In group 1 - total freedom of AF was in 73,3% of patients, among which 25% had additional antiarrhythmic drugs (AADs) therapy or catheter ablation (CA), in group 2 – 90% and 18,3%, respectively (for total freedom of AF P<0,02). At follow-up, the distant mortality rate in the 1st group was – 4,8%, and in the 2nd – no fatal events. Prevalence of cerebrovascular events was higher in the 1st group than in the 2nd (6,7% vs. 1,7% respectively). Conclusions: Despite the relatively shorter follow-up of the 2nd group in the study, applying the strategy using the Medtronic device showed quite encouraging results. Further research is needed to evaluate the effectiveness of this strategy in the long-term period.

Keywords: atrial fibrillation, clamping, ablation, thoracoscopic surgery

Procedia PDF Downloads 106
9466 An Assessment of Sexual Informational Needs of Breast Cancer Patients in Radiation Oncology

Authors: Li Hoon Lim, Nur Farhanah Said, Katie Simmons, Eric Pei Ping Pang, Sharon Mei Mei Wong

Abstract:

Background and Purpose: Research regarding the sexual impact of breast cancer treatment on Asian women is both sensitive and scarce. This study aims to assess and evaluate the sexual health needs and concerns of breast cancer radiotherapy patients. It is hoped that awareness will be increased and an appropriate intervention can be developed to address the needs of future breast cancer patients. Methods: 110 consecutive unselected breast cancer patients were recruited prospectively. Questionnaires were administered once for patient undergoing radiotherapy to the breast. This study employed an anonymous questionnaire; any breast radiotherapy patient who can read English can voluntarily receive and complete the survey. The questionnaire consisted of items addressing demographics, potential informational needs, and educational preferences. Results: Patients’ interest to address sexual concerns decreases with age (p=0.024). Coherently, sexual concerns of patients are reported to decrease with age (p=0.015) where 70% of all respondents below age 50 [age 20-29 (60%); 30-39 (56.3%); 40-49(55.1%)] have started to have sexual concerns regarding their treatment effects on their sexual health. Patients who underwent breast conservation surgery (42.2%) and reconstruction surgery (83.3%) were more likely to have concerns about sexual health versus patients who underwent mastectomy (36.7%) (p=0.032). 74.2% of patients with sexual concern regardless of age would initiate conversation with their healthcare providers (p < 0.001). Conclusions: The results showed a staggering interest of female patients wanting information on this area which would not only boost their confidence and body image but also address concerns of the effect of breast radiotherapy on sexual health during their treatment.

Keywords: breast cancer, breast radiotherapy, sexual health, sexual impact

Procedia PDF Downloads 202
9465 Evaluation of Antioxidants in Medicinal plant Limoniastrum guyonianum

Authors: Assia Belfar, Mohamed Hadjadj, Messaouda Dakmouche, Zineb Ghiaba

Abstract:

Introduction: This study aims to phytochemical screening; Extracting the active compounds and estimate the effectiveness of antioxidant in Medicinal plants desert Limoniastrum guyonianum (Zeïta) from South Algeria. Methods: Total phenolic content and total flavonoid content using Folin-Ciocalteu and aluminum chloride colorimetric methods, respectively. The total antioxidant capacity was estimated by the following methods: DPPH (1.1-diphenyl-2-picrylhydrazyl radical) and reducing power assay. Results: Phytochemical screening of the plant part reveals the presence of phenols, saponins, flavonoids and tannins. While alkaloids and Terpenoids were absent. The acetonic extract of L. guyonianum was extracted successively with ethyl acetate and butanol. Extraction of yield varied widely in the L. guyonianum ranging from (0.9425 %to 11.131%). The total phenolic content ranged from 53.33 mg GAE/g DW to 672.79 mg GAE/g DW. The total flavonoid concentrations varied from 5.45 to 21.71 mg/100g. IC50 values ranged from 0.02 ± 0.0004 to 0.13 ± 0.002 mg/ml. All extracts showed very good activity of ferric reducing power, the higher power was in butanol fraction (23.91 mM) more effective than BHA, BHT and VC. Conclusions: Demonstrated this study that the acetonic extract of L. guyonianum contain a considerable quantity of phenolic compounds and possess a good antioxidant activity. Can be used as an easily accessible source of Natural Antioxidants and as a possible food supplement and in the pharmaceutical industry.

Keywords: limoniastrum guyonianum, phenolics compounds, flavonoid compound, antioxidant activity

Procedia PDF Downloads 341
9464 In vitro Evaluation of the Anti-Methanogenic Properties of Australian Native and Some Exotic Plants with a View of Their Potential Role in Management of Ruminant Livestock Emissions

Authors: Philip Vercoe, Ali Hardan

Abstract:

Samples of 29 Australian wild natives and exotic plants were tested in vitro batch rumen culture system for their methanogenic characteristics and potential usage as feed or antimicrobial to enhance sustainable livestock ruminant production system. The plants were tested for their in vitro rumen fermentation end products properties which include: methane production, total gas pressure, concentrations of total volatile fatty acids, ammonia, and acetate to propionate ratio. All of the plants were produced less methane than the positive control (i.e., oaten chaff) in vitro. Nearly 50 % of plants inhibiting methane by over 50% in comparison to the control. Eremophila granitica had the strongest inhibitory effect about 92 % on methane production comparing with oaten chaff. The exotic weed Arctotheca calendula (Capeweed) had the highest concentration of volatile fatty acids production as well as the highest in total gas pressure among all plants and the control. Some of the acacia species have the lowest production of total gas pressure. The majority of the plants produced more ammonia than the oaten chaff control. The plant species that produced the most ammonia was Codonocarpus cotinifolius, producing over 3 times as much methane as oaten chaff control while the lowest was Eremophila galeata. There was strong positive correlation between methane production and total gas production as well as between total gas production and the concentration of VFA produced with R² = 0.74, R² = 0.84, respectively. While there was weak positive correlation between methane production and the acetate to propionate ratio as well as between the concentration of VFA produced and methane production with R² = 0.41, R² = 0.52, respectively.

Keywords: in vitro Rumen Fermentation, methane, wild Australian native plants, forages

Procedia PDF Downloads 341
9463 A Numerical Study on the Influence of CO2 Dilution on Combustion Characteristics of a Turbulent Diffusion Flame

Authors: Yasaman Tohidi, Rouzbeh Riazi, Shidvash Vakilipour, Masoud Mohammadi

Abstract:

The objective of the present study is to numerically investigate the effect of CO2 replacement of N2 in air stream on the flame characteristics of the CH4 turbulent diffusion flame. The Open source Field Operation and Manipulation (OpenFOAM) has been used as the computational tool. In this regard, laminar flamelet and modified k-ε models have been utilized as combustion and turbulence models, respectively. Results reveal that the presence of CO2 in air stream changes the flame shape and maximum flame temperature. Also, CO2 dilution causes an increment in CO mass fraction.

Keywords: CH4 diffusion flame, CO2 dilution, OpenFOAM, turbulent flame

Procedia PDF Downloads 272
9462 A Straightforward Method for Determining Inorganic Selenium Speciations by Graphite Furnace Atomic Absorption Spectroscopy in Water Samples

Authors: Sahar Ehsani, David James, Vernon Hodge

Abstract:

In this experimental study, total selenium in solution was measured with Graphite Furnace Atomic Absorption Spectroscopy, GFAAS, then chemical reactions with sodium borohydride were used to reduce selenite to hydrogen selenide. Hydrogen selenide was then stripped from the solution by purging the solution with nitrogen gas. Since the two main speciations in oxic waters are usually selenite, Se(IV) and selenate, Se(VI), it was assumed that after Se(IV) is removed, the remaining total selenium was Se(VI). Total selenium measured after stripping gave Se(VI) concentration, and the difference of total selenium measured before and after stripping gave Se(IV) concentration. An additional step of reducing Se(VI) to Se(IV) was performed by boiling the stripped solution under acidic conditions, then removing Se(IV) by a chemical reaction with sodium borohydride. This additional procedure of removing Se(VI) from the solution is useful in rare cases where the water sample is reducing and contains selenide speciation. In this study, once Se(IV) and Se(VI) were both removed from the water sample, the remaining total selenium concentration was zero. The method was tested to determine Se(IV) and Se(VI) in both purified water and synthetic irrigation water spiked with Se(IV) and Se(VI). Average recovery of spiked samples of diluted synthetic irrigation water was 99% for Se(IV) and 97% for Se(VI). Detection limits of the method were 0.11 µg L⁻¹ and 0.32 µg L⁻¹ for Se(IV) and Se(VI), respectively.

Keywords: Analytical Method, Graphite Furnace Atomic Absorption Spectroscopy, Selenate, Selenite, Selenium Speciations

Procedia PDF Downloads 138
9461 Stability of Total Phenolic Concentration and Antioxidant Capacity of Extracts from Pomegranate Co-Products Subjected to In vitro Digestion

Authors: Olaniyi Fawole, Umezuruike Opara

Abstract:

Co-products obtained from pomegranate juice processing contain high levels of polyphenols with potential high added values. From value-addition viewpoint, the aim of this study was to evaluate the stability of polyphenolic concentrations in pomegranate fruit co-products in different solvent extracts and assess the effect on the total antioxidant capacity using the FRAP, DPPH˙ and ABTS˙+ assays during simulated in vitro digestion. Pomegranate juice, marc and peel were extracted in water, 50% ethanol (50%EtOH) and absolute ethanol (100%EtOH) and analysed for total phenolic concentration (TPC), total flavonoids concentration (TFC) and total antioxidant capacity in DPPH˙, ABST˙+ and FRAP assays before and after in vitro digestion. Total phenolic concentration (TPC) and total flavonoid concentration (TFC) were in the order of peel > marc > juice throughout the in vitro digestion irrespective of the extraction solvents used. However, 50% ethanol extracted 1.1 to 12-fold more polyphenols than water and ethanol solvents depending on co-products. TPC and TFC increased significantly in gastric digests. In contrast, after the duodenal, polyphenolic concentrations decreased significantly (p < 0.05) compared to those obtained in gastric digests. Undigested samples and gastric digests showed strong and positive relationships between polyphenols and the antioxidant activities measured in DPPH, ABTS and FRAP assays, with correlation coefficients (r2) ranging between 0.930 – 0.990 whereas, the correlation between polyphenols (TPC and TFC) and radical cation scavenging activity (in ABTS) were moderately positive in duodenal digests. Findings from this study also showed that the concentration of pomegranate polyphenols and antioxidant thereof during in vitro gastro-intestinal digestion may not reflect the pre-digested phenolic concentration. Thus, this study highlights the need to provide biologically relevant information on antioxidants by providing data reflecting their stability and activity after in vitro digestion.

Keywords: by-product, DPPH, polyphenols, value addition

Procedia PDF Downloads 325
9460 Numerical Simulation on Bacteria-Carrying Particles Transport and Deposition in an Open Surgical Wound

Authors: Xiuguo Zhao, He Li, Alireza Yazdani, Xiaoning Zheng, Xinxi Xu

Abstract:

Wound infected poses a serious threat to the surgery on the patient during the process of surgery. Understanding the bacteria-carrying particles (BCPs) transportation and deposition in the open surgical wound model play essential role in protecting wound against being infected. Therefore BCPs transportation and deposition in the surgical wound model were investigated using force-coupling method (FCM) based computational fluid dynamics. The BCPs deposition in the wound was strongly associated with BCPs diameter and concentration. The results showed that the rise on the BCPs deposition was increasing not only with the increase of BCPs diameters but also with the increase of the BCPs concentration. BCPs deposition morphology was impacted by the combination of size distribution, airflow patterns and model geometry. The deposition morphology exhibited the characteristic with BCPs deposition on the sidewall in wound model and no BCPs deposition on the bottom of the wound model mainly because the airflow movement in one direction from up to down and then side created by laminar system constructing airflow patterns and then made BCPs hard deposit in the bottom of the wound model due to wound geometry limit. It was also observed that inertial impact becomes a main mechanism of the BCPs deposition. This work may contribute to next study in BCPs deposition limit, as well as wound infected estimation in surgical-site infections.

Keywords: BCPs deposition, computational fluid dynamics, force-coupling method (FCM), numerical simulation, open surgical wound model

Procedia PDF Downloads 284
9459 The Incidence of Maxillary Canine Ankylosis: A Single-Centre Analysis of 206 Canines Following Surgical Exposure and Orthodontic Alignment

Authors: Sidra Suleman, Maliha Suleman, Jinesh Shah

Abstract:

Maxillary canines play a crucial role in occlusion and aesthetics. Successful management of impacted canines requires early identification and intervention to prevent complications such as resorption of adjacent teeth and cystic changes. Although removal of the deciduous canine can encourage normal eruption of its successor, this is not always successful. Some patients may require surgical exposure and bonding of a gold chain to mobilise and align the canine, which can take up to 3 years. As this procedure has various risks, patients need to be appropriately consented to. Failure of such treatment commonly occurs due to inadequate anchorage or failure of the gold chain attachment, but in some cases, this is due to ankylosis. Aim: The aim of this study was to determine the incidence of ankylosis of unerupted maxillary ectopic canines following surgical exposure and orthodontic alignment at the Maxillofacial and Orthodontic Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: Patients treated from January 1, 2017, to December 31, 2019, were retrospectively studied. Electronic records with post-treatment follow-up at 3-6 months and 12-15 months were extracted and analysed. Patients were excluded based on three criteria, non-compliance with orthodontic treatment post-surgery, presence of canine transposition, and external orthodontic treatment. Sample: Overall, 159 suitable patients were selected from the 171 patients identified. Surgical exposure and gold chain bonding was carried out for a total of 206 maxillary canines, with the pattern of impaction being 159 (77.2 %) palatal, 46 (22.3%) buccal, and 1 (0.49%) in line of the arch. The sample consisted of 57 (35.8%) males and 102 (64.2%) females between the age range of 10 to 32 years, with the mean age being 15 years. The procedures were carried out under general anaesthesia for all but three patients, with two cases being repeats. Closed exposure was carried out for 189 (91.7%) canines. Results: The incidence of ankylosis from this study was 0.97%. In total, two patients had upper left canine ankylosis, which was identified at their 12-15 months orthodontic follow-up. Both patients were males, one having closed exposure at age 15 and the other having open exposure at age 19. Conclusions: Although this data shows that there is a low risk of ankylosis (0.97%), it highlights the difficulty in predicting which patients may be affected, and thus, a thorough pre-treatment assessment and careful observation during treatment is necessary. Future studies involving larger cohorts are warranted to further analyse factors affecting outcomes.

Keywords: ankylosis, ectopic, maxillary canines, orthodontics

Procedia PDF Downloads 206
9458 Increasing Access to Upper Limb Reconstruction in Cervical Spinal Cord Injury

Authors: Michelle Jennett, Jana Dengler, Maytal Perlman

Abstract:

Background: Cervical spinal cord injury (SCI) is a devastating event that results in upper limb paralysis, loss of independence, and disability. People living with cervical SCI have identified improvement of upper limb function as a top priority. Nerve and tendon transfer surgery has successfully restored upper limb function in cervical SCI but is not universally used or available to all eligible individuals. This exploratory mixed-methods study used an implementation science approach to better understand these factors that influence access to upper limb reconstruction in the Canadian context and design an intervention to increase access to care. Methods: Data from the Canadian Institute for Health Information’s Discharge Abstracts Database (CIHI-DAD) and the National Ambulatory Care Reporting System (NACRS) were used to determine the annual rate of nerve transfer and tendon transfer surgeries performed in cervical SCI in Canada over the last 15 years. Semi-structured interviews informed by the consolidated framework for implementation research (CFIR) were used to explore Ontario healthcare provider knowledge and practices around upper limb reconstruction. An inductive, iterative constant comparative process involving descriptive and interpretive analyses was used to identify themes that emerged from the data. Results: Healthcare providers (n = 10 upper extremity surgeons, n = 10 SCI physiatrists, n = 12 physical and occupational therapists working with individuals with SCI) were interviewed about their knowledge and perceptions of upper limb reconstruction and their current practices and discussions around upper limb reconstruction. Data analysis is currently underway and will be presented. Regional variation in rates of upper limb reconstruction and trends over time are also currently being analyzed. Conclusions: Utilization of nerve and tendon transfer surgery to improve upper limb reconstruction in Canada remains low. There are a complex array of interrelated individual-, provider- and system-level barriers that prevent individuals with cervical SCI from accessing upper limb reconstruction. In order to offer equitable access to care, a multi-modal approach addressing current barriers is required.

Keywords: cervical spinal cord injury, nerve and tendon transfer surgery, spinal cord injury, upper extremity reconstruction

Procedia PDF Downloads 95