Search results for: late surgery

Authors: Mohammad Ghandehari Motlagh

Abstract:

Purpose: Comparing anterior chamber depth (ACD) measured with Orbscan II and Pentacam HR compared with the Smith method results. Methods: Smith method (1979) is a reliable method of measuring ACD only with help of slit lamp. In this study 102 phakic eyes as PRK candidates were imaged with both OrbScan and Pentacam and finally ACD was measured thru Smith method with slit lamp. ACD measured with Smith method was presumed as the gold standard and was compared with ACD of the 2 imaging devices. Contraindication cases for PRK and pseudophakic eyes have been excluded from the study. Results: Mean age of the patients was 35.2 ±14.8 yrs/old including 56 M(54.9%)and 46 F(45.09%).Acceptable correlation of ACD measured thru Smith method with Orbscan and Pentacam are R=0.958 and R=0.942 respectively and so Orbscan results can be used in procedures relying on ACD. Conclusion: ACDs measured with OrbScan is more precise than Pentacam and so can be more useful in some surgery procedures relying ACD results such as phakic IOLs and in cycloplegia contraindications.

Keywords: orbscan, pentacam, anterior chamber depth, slit lamp

Procedia PDF Downloads 366

Authors: Sokol Isaraj, Lorela Bendo

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Scars resulting from surgery, injury, or burns have a physical and psychological impact on the affected patient. Although a number of treatments are available, nano fat grafting is an effective treatment for scars. Nano fat is a liquid suspension rich in stem cells obtained by mechanical emulsification. Nano fat grafting was performed in 10 cases to correct rhytides, surgical scars, and post-burn scars between January 2022 and April 2022. Fat was aspirated from the lower abdomen or trochanteric region. After emulsification and filtration protocol, the resulting nano fat liquid was injected intradermally and subdermally. All patients filled out a questionnaire at three months post-treatment, which consisted of questions regarding the grade of improvement of skin and recommendation of the procedure. The clinical results were apparent between 2 and 3 weeks after the treatment. All patients confirmed an improvement in skin texture and quality. The most significant improvement was seen in pigmentation and pliability. No complications were reported. Nano fat seems to be a safe and effective treatment in scar treatment and skin rejuvenation.

Keywords: fat grafting, fat transfer, micro fat, nano fat

Procedia PDF Downloads 82

Authors: Aminu Alhaji Bala

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The Jama’atu Izalatil Bid’ah Wa-Iqamatis Sunnah is a Da’wah organization and reform movement launched in Jos - Nigeria in 1978 as a purely reform movement under the leadership of late Shaykh Ismai’la Idris. The organization started a full fledge preaching sessions at National, State and Local Government levels immediately after its formation. The contributions of this organization to da'wah activities in Nigeria are paramount. The organization conducted its preaching under the council of preaching with the help of the executives, elders and patrons of the movement. Teaching and preaching have been recognized as the major programs of the society. Its preaching activities are conducted from ward, local, state and national levels throughout the states of Nigeria and beyond. It also engaged itself in establishing Mosques, schools and offers sermons during Friday congregation and Eid days throughout its mosques where its sermon is translated into vernacular language, this attracted many Muslims who don’t understand Arabic to patronize the its activities. The organization however split into two faction due to different approaches to Da’wah methodology and some seemingly selfish interests among its leaders. It is upon this background that this research was conducted using analytical method to compare and contrast the da’wah methodology applied by the two factions of the organization. The research discussed about the formation, Da’wah activities of the organization. It also compared and contrast the Da’wah approach and methodology of the two factions. The research finding reveals that different approach and methods applied by these factions is one of the main reason of their split in addition to other selfish interest among its leaders.

Keywords: activities, Da’wah, methodology, organization

Procedia PDF Downloads 219

Authors: Zety Shakila Binti Mohd Yusof, Muhammad Adib Bin Ishak, Hajah Fatimah Binti Hussein

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The international shipping business is related to numerous controls or regulations of export and import shipments. It is costly and time consuming, and when something goes wrong or when the buyer or seller fails to comply with the regulations, it can result in penalties, delays, and unexpected costs etc. For the focus of this study, the researchers have selected a local forwarder that provides forwarding and clearance services, Nexus Zone Logistics. It was identified that this company currently has many extra costs to be paid including local and detention charges, which negatively impacts the flow of income and reduces overall stability. Two variables have been identified as factors of extra charges; loaded containers entering the port by exceeded closing time and late delivery of empty containers to the container yard. This study is a qualitative in nature and the secondary data collected was analyzed using self-administered observation. The findings of this study were covered by one selected case for each export and import shipment between July and December 2014. The data were analyzed using frequency analysis based on tables and graphs. The researcher recommends Nexus Zone Logistics impose a 1% deposit payment per container for each shipment (export and import) to its customers.

Keywords: international shipping, export and import, detention charges, container shipment

Procedia PDF Downloads 381

Authors: Gulnara Azizova, Naila Hasanova, Nazenin Hasanzade

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The aim of study is to investigate the role of osteoactivin as a more sensitive and modern diagnostic biomarker that has a prognostic value in metabolic and repair processes occurring in bone and cartilage tissue in osteoporosis and osteoporotic fractures. Osteoactivin (OA) is a new glycoprotein that is highly expressed during osteoblast differentiation. It was first discovered in an osteopetrotic rat model using mRNA . This study was carried out on patients between the ages of 45-83 from the Department of Traumatology and placed in 3 groups: group I - 14 patients with osteoporosis, group II - 15 patients with non-osteoporotic fractures, group III - 25 patients with osteoporotic fractures. The control group consisted of 14 healthy people. To monitor changes in osteoactivin, blood samples were taken at 3 stages: on day 1 before treatment, on day 10 of treatment, and 1 month after treatment. The concentration of OA in the blood serum was determined by ELISA method on the immunoassay analyzer “Mindray MR- 96A” using a set of reagents from the company Boster ( ELISA Kit PicoKine, USA). The statistical evaluation was performed by using SPSS 22.0 program (IBM SPSS Inc., USA). Compared to the control, osteoactivin concentration increased by 66.2% in patients with osteoporosis, 54.1% in patients with non-osteoporotic fractures, and 80.2% in patients with osteoporotic fractures, indicating that it plays an important role in the pathogenesis of osteoporotic fractures. At 1 month after treatment, osteoactivin concentration increased by 81.6% in patients with non-osteoporotic fractures. The lack of a significant change in osteoporotic fractures is explained by the late healing of these fractures. Based on the sensitivity and specificity indicators, the ROC curve was created and it was determined that osteoactivin is a test with high general diagnostic value, specificity and informativeness in the prognosis of osteoporosis and osteoporotic fractures, and can be used throughout the treatment period.

Keywords: osteoactivin, bone, osteoporosis., cartilage

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Authors: Ahmad Tijani Surajudeen, Muhammad Zahiri Awang Mat, Aliy Abdulwahid Adebisi

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With arrival of Islam in the South-Western Nigeria in the late fifteenth and early sixteenth centuries, various masājid established in different parts of the area played vital roles towards the betterment and unity of the Muslims. However, despite the fact that the masājid in the South-Western part of Nigeria contributed immensely to the spiritual and educational enhancement of the Muslims, it has not fully captured the holistic educational roles as a unique model used by the Prophet (S.A.W). Therefore, the primary objective of this paper is to investigate and broaden the roles of masjid towards its compartmentalized and holistic contributions among the Muslims in the south-western Nigeria. The findings from the paper have identified five holistic roles of masjid, namely, spiritual, intellectual, physical, social and emotional contributions which have been exemplified in the prophetic model of masjid. The paper has argued that the five factors must be unreservedly unified towards the betterment of the Muslims and enhancement of Islamic education and Arabic Language in the South-Western Nigeria. However, the challenges of masjid management in the South-Western Nigeria are the main hindrance in achieving the holistic roles of masjid. It is thereby suggested that, the management of masjid should take the identified prophetic model of masjid into account in order to positively improve the affairs of Muslims as well as promoting the teaching and learning of Islamic education and Arabic language among the Muslims in the South-Western Nigeria.

Keywords: worship, Islamic education, Arabic language, prophetic holistic model

Procedia PDF Downloads 330

Authors: Nitin Dwivedi, Jigna Shah

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Brain tumor is metastatic neoplasm of central nervous system, in most of cases it is life threatening disease with low survival rate. Despite of enormous efforts in the development of therapeutics and diagnostic tools, the treatment of brain tumors and gliomas remain a considerable challenge in the area of neuro-oncology. The most reason behind of this the presence of physiological barriers including blood brain barrier and blood brain tumor barrier, lead to insufficient reach ability of therapeutic agents at the site of tumor, result of inadequate destruction of gliomas. So there is an indeed need empowerment of brain tumor imaging for better characterization and delineation of tumors, visualization of malignant tissue during surgery, and tracking of response to chemotherapy and radiotherapy. Multifunctional different generations of dendrimer offer an improved effort for potentiate drug delivery at the site of brain tumor and gliomas. So this article emphasizes the innovative dendrimer approaches in tumor targeting, tumor imaging and delivery of therapeutic agent.

Keywords: blood brain barrier, dendrimer, gliomas, nanotechnology

Procedia PDF Downloads 559

Authors: Mohammed Abdelsabour-Khalaf, F. Yusuf , B Brand-Saberi

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Purpose: Applications of nanotechnology nowadays extended to include a wide range of scientific areas such electron micrscopy and gene expression. The aim of the current study was to investigate the developmental expression pattern of genes involved in human glomerulo-nephropathies associated with massive proteinuria and podocyte differentiation using the chicken mesonephros as a model system. Method: We performed in situ hybridization using chicken specific mRNA probes for genes expressed in the early nephron and slit diaphragm genes. The probes used were cNeph1, cNeph2, cSim1, cLmx1b, and cAtoh8. Chicken embryos from Hamburger Hamilton developmental stage HH19 (E3) to HH 34 (E9) were used for the in situ hybridization (ISH). ISH was performed on whole mount embryos which were sectioned by vibratome. Results: Our result show that Neph1, Neph2, Sim1. Lmx1b and Atoh8 genes are dynamically expressed during nephron morphogenesis and Neph1 and Atoh8 are also specifically expressed in the podocytes during late stages of differentiation. Conclusion: We conclude from our results that the genes implicated in congenital and acquired glomerulo-nephropathies like Neph1 and Neph2 are dynamically expressed during mesonephros development pointing towards a role in the formation of the filtration barrier and the differentiation of the mesonephric podocytes. Thus the avian mesonephros could serve as a model to study human kidney diseases.

Keywords: mesonephros, chicken embryo, gene expression, immunohistochemistry

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Authors: Christine Ivy A. Nogot

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Under the colony of Spain for more than three centuries, the Philippines has a deep-rooted structure of Western ideologies and colonialism. The late 19th century, the period of Enlightenment, created a significant impact on our history when a group of middle-class Filipino men were sent to Europe to study. They were called Ilustrados, a Spanish word for erudite. They were the enlightened; the well-educated, intellectual scholars. Their writings provide intellectual grounds for the awakening of national consciousness that eventually prompted national movements and revolutions. They helped to establish a postcolonial society. In the modern era, Miguel Syjuco, a Filipino expatriate, wrote a novel and titled it Ilustrado. It is a representation of the liberal mind of the diasporic author in contemporary discourse. It provides a critical examination of the ilustrado in transition through the character of Miguel, who is also an expatriate writer. Using Syjuco’s award-winning novel as the primary text and anchored on Said’s concept of Orientalism, this paper examines how the depiction of features of the Eastern world is presented in the literary discourse. This paper looks into Said’s concept of orientalism as a hegemonic discursive structure and shows how Western superiority influences the Eastern culture in literary discourse. It explores Gramsci’s theory of cultural hegemony to explore Said’s argument that Western powers conquer the orient through culture and ideology. This paper presents how dominant ideologies and the social context redefine the ilustrado in the contemporary era.

Keywords: cultural hegemony, ilustrado, orientalism, postcolonial

Procedia PDF Downloads 76

Authors: Kathleen Joy Hingan, Jessiraye Luienne Catubigan, Carlo Mercado, Janisse RañEses

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In this research, the researchers wanted to explore how specialists and resident doctors in the fields of surgery, and obstetrics and gynecology handle their medical errors. They are interested in understanding the factors that contributed to the disclosure of medical error, the feelings after the occurrence of an error, and the way they coped with it given the power relations in place. The researchers conducted semi-structured interviews, transcribed the recordings, and analyzed the transcripts using thematic analysis. They found that doctors disclosed to their superiors and co-residents to cope with and to learn from the errors. In terms of disclosure to patients, the participants told them about the adverse event, but not about the error because of fear for themselves, their colleagues, their institution, and their patient. Doctors also performed compensatory actions to make up for the error and the nondisclosure of its occurrence. These actions functioned as a form of damage control too. Resident doctors and specialists receive different sanctions because of the power structures in the system.

Keywords: coping, disclosure, doctors, interviews, medical errors, thematic analysis

Procedia PDF Downloads 288

Authors: Sokol Isaraj, Lorela Bendo

Abstract:

Scars resulting from surgery, injury, or burns have a physical and psychological impact on the affected patient. Although a number of treatments are available, nano fat grafting is an effective treatment for scars. Nano fat is a liquid suspension rich in stem cells obtained by mechanical emulsification. Nano fat grafting was performed in 10 cases to correct rhytides, surgical scars and post-burn scars between January 2022 and April 2022. Fat was aspirated from the lower abdomen or trochanteric region. After emulsification and filtration protocol, the resulting nano fat liquid was injected intradermally and subdermally. All patients filled out a questionnaire at 3 months post-treatment which consisted of questions regarding the grade of improvement of skin and recommendation of the procedure. The clinical results were apparent between 2 and 3 weeks after the treatment. All patients confirmed an improvement in skin texture and quality. The most significant improvement was seen in pigmentation and pliability. No complications were reported. Nano fat seems to be a safe and effective treatment for scar treatment and skin rejuvenation.

Keywords: fat grafting, fat transfer, microfat, nanofat

Procedia PDF Downloads 81

Authors: Saima Hirani, Emmanuela Ojukwu, Nilanga Aki Bandara

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Background: Mental health challenges that begin during the youth age period may continue across the entire life course. One way to support youth mental health is to encourage youth engagement in prosocial activities. This study aimed to explore youth’s perceptions about helping others and mental well-being, barriers, and enablers for youth to initiate and continue prosocial activities, and strategies for developing the attribute of helping others in youth. Methods: We conducted a qualitative study using semi-structured, virtual interviews with 18 young individuals (aged 16-24 years) living in Vancouver, British Columbia, Canada. Results: Youth perceived helping others as a source of feeling peace and calm, finding meaning in life, experiencing social connection and promoting self-care, and relieving stress. Participants reported opportunities to learn new skills, the role of religion, social connections, previous positive experiences, and role modeling as enablers for their prosocial behaviour. Heavy time commitment, negative behaviour from others, self-doubt, and late exposure to such activities were considered barriers by youth when participating in prosocial activities. Youth also brought forward key recommendations for engaging youth in helping others. Conclusions: The findings of this study support the notion that youth have positive experiences when engaging in helping others and that involving young people in prosocial activities could be used as a protective intervention for promoting youth mental health and overall well-being.

Keywords: helping others, prosocial behaviour, youth, mental well-being

Procedia PDF Downloads 65

Authors: Bankole Wright

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The late 20th to the early 21st century has been predominantly characterized by the movement of individuals from one country to another country or countries. The chief reasons for migration have always been premised on socio-cultural, socio-political and socio-economic factors, with influences of migration finding expression through various ways. Indeed, migration experiences have formed points of subjectivity which functions as agencies that propel migrants to strongly quest for migrating from their home space to other socio-cultural space that performs the role of escape for them. This paper interrogates the discourse of migration, agency and subjectivity in Helon Habila’s Travellers. The essay explores the interconnectedness between migration which is the physical [as deployed in this paper] movement from one location to another, agency as seen in the ability to act based on various ideological frameworks within which the action is taken, and subjectivity which identifies with the predominant factors that influence human actions; and how these connections are responsible for defining the diaspora individual. The discourse of what makes migrants desire to move from their various spaces is as critical as the experiences they face in their various host land. Hence, this paper demonstrates, through the analysis of an African diasporic novel, that the quest for migration is mostly determined by certain agencies in the diaspora home space, which characters have been subjects of and desire to escape. Traveller is a novel which chronicles the various experiences of migrants who journey from their various home space to another land as a result of different agencies that precipitated their migration. This paper engages these agencies as impediments to human survival.

Keywords: migration, agency, subjectivity, Helon Habila, diaspora, home, space

Procedia PDF Downloads 269

Authors: Seren Sevim Öğmen, Ömer Özyiğit

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Vouni Palace is a Persian palace built on a rocky hill in the Lefke district of Cyprus. The palace is one of the limited number of architectures identified, which prove the existence of a Persian period on the island. Since the excavations on the palace were held a very long time ago, there is a need to re-date the cultural layers within the palace using new archaeological evidence and recent studies. The existing chronology has been reviewed and a new chronology has been created according to its architectural structure, floor findings such as ceramics and sculptures and the stratigraphic layer of Room 59 where the Vouni Treasure was found. This work dates the palace in Vouni between the periods of c. 520 BC, deduced from the early period sculptures, and c. 330 BC by the late period floor ceramics. Some earlier dated archaic sculptures are identified in Room 122 – which takes part in the temenos area of the palace, and correspondingly the construction of the palace is dated c. 520 BC. The comparison between Vouni Palace and Persian palaces built in Iran, shows similarities with palaces built during the rule of Darius. It is evident that two main building periods of the palace which are previously identified, represent Persian influence according to its architectural structure and findings. Several floor potteries show that there must be other layer or layers after Vouni Treasure dated 390/380 BC, which was considered as the destruction date of the palace. At this point the forenamed date can indicate the end of a stage, not the end of the period because the palace was still in use until c. 330 BC. The results of the study, in addition to dating the layers of Vouni Palace, enlightens the administrative function of the Palace within the Persian rule in Cyprus.

Keywords: administrative, chronology, cyprus, persian rule, vouni palace

Procedia PDF Downloads 116

Authors: Arash Sepehri bonab

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One of the regions of critical development in medical devices has been the part of the software - as an indispensable component of a therapeutic device, as a standalone device, and more as of late, as applications on portable gadgets. The chance related to a breakdown of the standalone computer program utilized inside healthcare is in itself not a model for its capability or not as a medical device. It is, subsequently, fundamental to clarify a few criteria for the capability of a stand-alone computer program as a medical device. The number of computer program items and therapeutic apps is persistently expanding and so as well is used in wellbeing education (e. g., in clinics and doctors' surgeries) for determination and treatment. Within the last decade, the use of information innovation in healthcare has taken a developing part. In reality, the appropriation of an expanding number of computer devices has driven several benefits related to the method of quiet care and permitted simpler get to social and health care assets. At the same time, this drift gave rise to modern challenges related to the usage of these modern innovations. The program utilized in healthcare can be classified as therapeutic gadgets depending on the way they are utilized and on their useful characteristics. In the event that they are classified as therapeutic gadgets, they must fulfill particular directions. The point of this work is to show a computer program improvement system that can permit the generation of secure and tall, quality restorative gadget computer programs and to highlight the correspondence between each program advancement stage and the fitting standard and/or regulation.

Keywords: medical devices, regulation, software, development, healthcare

Procedia PDF Downloads 106

Authors: Cecilia Fagerstrom, Solve Elmstahl, Lena S. Wranker

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The conditions of increased morbidity in an aging population cause the need for family care to become more common at an advanced age. The role of family caregivers may well last for a long time but may also change over time, from being caregivers to being non-caregivers or vice versa. Although demands associated with family caring change as individuals enter into, engage with, and exit from this role, the evidence regarding the impact of family caregiving transitions on the health of older carers is still limited. This study comprised individuals (n=2294, 60+years) from the southern part of Sweden included in the project Swedish National study of Aging and Care. Caregiving transitions are discussed in the categories: enter, exit, and continuing during a six-year period. Individuals who exited caregiving during the time were older than those who continued or entered into the role of caregiving. At the six-year follow-up, caregivers who were continuing or had exited caregiving were more often worried about their own health compared to baseline. Resembling findings were not found in those who entered caregiving. Family caregiving transitions of exiting, entering or continuing had no effect on the individuals’ functional, physical and mental health expect for participants who entered in caregiving. For them, entering the role of family caregiving was associated with an improvement in physical health during the six years follow up period. Conclusion: Although the health impact of different caregiving transitions in late life does not differ, individual conditions and health at baseline are important parameters to take into consideration to improve long-term health in family caregivers.

Keywords: family caregiving, health, old age, transition

Procedia PDF Downloads 218

Authors: Sarah Pasala, Elizabeth Zacharias

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Vital sign monitoring is crucial for both everyday health and medical diagnosis. A significant factor in assessing a human's health is their vital signs, which include heart rate, breathing rate, blood pressure, and electrocardiogram (ECG) readings. Vital sign monitoring has been the focus of many system and method innovations recently. Piezoelectrics are materials that convert mechanical energy into electrical energy and can be used for vital sign monitoring. Piezoelectric energy harvesters that are stretchable and flexible can detect very low frequencies like airflow, heartbeat, etc. Current advancements in piezoelectric materials and flexible sensors have made it possible to create wearable and implantable medical devices that can continuously monitor physiological signals in humans. But because of their non-biocompatible nature, they also produce a large amount of e-waste and require another surgery to remove the implant. This paper presents a biocompatible and flexible piezoelectric composite material for wearable and implantable devices that offers a high-performance platform for seamless and continuous monitoring of human physiological signals and tactile stimuli. It also addresses the issue of e-waste and secondary surgery. A Lead-free piezoelectric, SrBi4Ti4O15, is found to be suitable for this application because the properties can be tailored by suitable substitutions and also by varying the synthesis temperature protocols. In the present work, SrBi4Ti4O15 modified by rare-earth has been synthesized and studied. Coupling factors are calculated from resonant (fr) and anti-resonant frequencies (fa). It is observed that Samarium substitution in SBT has increased the Curie temperature, dielectric and piezoelectric properties. From impedance spectroscopy studies, relaxation, and non-Debye type behaviour are observed. The composite of bioresorbable poly(l-lactide) and Lead-free rare earth modified Bismuth Layered Ferroelectrics leads to a flexible piezoelectric device for non-invasive measurement of vital signs, such as heart rate, breathing rate, blood pressure, and electrocardiogram (ECG) readings and also artery pulse signals in near-surface arteries. These composites are suitable to detect slight movement of the muscles and joints. This Lead-free rare earth modified Bismuth Layered Ferroelectrics – polymer composite is synthesized using a ball mill and the solid-state double sintering method. XRD studies indicated the two phases in the composite. SEM studies revealed the grain size to be uniform and in the range of 100 nm. The electromechanical coupling factor is improved. The elastic constants are calculated and the mechanical flexibility is found to be improved as compared to the single-phase rare earth modified Bismuth Latered piezoelectric. The results indicate that this composite is suitable for the non-invasive detection of multiple vital signs of humans.

Keywords: composites, flexible, non-invasive, piezoelectric

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Authors: Jatinder Pal Singh, Harpreet Singh, Gagandeep Singh Digra, Mandeep Kaur Sidhu, Pawan Kumar

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Introduction: Ganglion cyst is a benign condition in which there is a cystic lesion in relation to a joint or a tendon sheath arising from myxoid degeneration of fibrous connective tissue. These can be unilocular or multilocular. In rare cases, there may be multiple ganglion cysts, known as cystic ganglionosis. They can occur at any age but are commonly seen in adults. Clinically they may be asymptomatic or present as swelling or mass effect in adjacent structures. These are common in extremities such as hands and feet. Case Presentation: 11-year-old female child presented with slowly progressive painless swelling of her right hand since the age of 4. Antenatal and perinatal history was unremarkable. Her family history was negative. She denies fever, malaise, morning stiffness, weight loss, fatigue, restriction of joint movements, or any sensory and motor deficit. Lab parameters were negative for inflammatory or infectious etiology. No other joint or extremity involvement was present. On physical examination, the swelling was present on the dorsum and palmer aspect of the right hand and wrist. They were non-tender on palpation without any motor or sensory deficit. MRI hand revealed multiple well-defined fluid signal intensity cystic appearing lesions in periarticular/intraarticular locations in relation to distal radio-ulnar, radio-carpal, intercarpal, carpometacarpal, metacarpophalangeal and interphalangeal joints as well as peritendinous location around flexor tendons more so in the region of wrist, palm, 1st and 5th digit and along extensor tendons in the region of wrist, largest one noted along flexor pollicis longus tendon in thenar region and along 1st digit measuring approx. 4.6 x 1.2 x 1.2 centimeter. Pressure erosions and bone remodelling were noted in the bases of the 2nd to 5th metacarpals, capitate, trapezoid, the distal shaft of 1st metacarpal, and proximal phalanx of 1st digit. Marrow edema was noted in the base and proximal shaft of the 4th metacarpal and proximal shaft of the 3rd metacarpal – likely stress or pressure related. The patient was advised of aspiration, but the family refused the procedure. Therefore the patient was kept on conservative treatment. Conclusion: Cystic ganglionosis is a rare condition with very few cases reported in the medical literature. Its prevalence and association are not known because of the rarity of this condition. It should be considered as an important differential in patients presenting with soft tissue swelling in extremities. Treatment option includes conservative management, aspiration, and surgery. Aspiration has a high recurrence rate. Although surgery has a low recurrence rate, it carries a high rate of complications. Imaging with MRI is essential for confirmation of the cystic nature of lesions and their relation with the joint capsules or tendons. This helps in differentiating from other soft tissue lesions and presurgical planning.

Keywords: radiology, rare, cystic ganglionosis, child

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Authors: Michael W. Markowitz, Jeffrey Gingerich

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The landscape of higher education in the United States has undergone significant changes in the last 25 years. What was once a domain of competition among prospective students for a limited number of college and university seats has become a marketplace in which institutions vie for the enrollment of educational consumers. A central figure in this paradigm shift has been the Chief Academic Officer (CAO), whose institutional role has also evolved beyond academics to include such disparate responsibilities as strategic planning, fiscal oversight, student recruitment, fundraising and personnel management. This paper explores the scope and impact of this transition by, first, explaining its context: the intersection of key social, economic and political factors in neo-conservative, late 20th Century America that redefined the value and accountability of institutions of higher learning. This context, in turn, is shown to have redefined the role and function of the CAO from a traditional academic leader to one centered on the successful application of corporate principles of organizational and fiscal management. Information gathered from a number of sitting Provosts, Vice-Presidents of Academic Affairs and Deans of Faculty is presented to illustrate the parameters of this change, as well as the extent to which today’s academic officers feel prepared and equipped to fulfill this broader institutional role. The paper concludes with a discussion of the impact of this transition on the American academy and whether it serves as a portend of change to come in higher education systems around the globe.

Keywords: academic administration, higher education, leadership, organizational management

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Authors: Pamela Chia, Tay Yoong Chuan

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Introduction: Severe pulmonary hypertension (PH) patients requiring non-cardiac surgery risk have increased mortality rates ranging. These patients are plagued with cardiorespiratory failure, dysrhythmias and anticoagulation potentially with concurrent sepsis and renal insufficiency, perioperative morbidity. We present a deaf-mute patient with severe idiopathic PH emergently prepared for ruptured ectopic laparotomy. Case Report: A 20 year-old female, 62kg (BMI 25 kg/m2) with severe idiopathic PH (2DE Ejection Fraction was 41%, Pulmonary Artery Systolic Pressure (PASP) 105 mmHg, Right ventricle strain and hypertrophy) and selective mutism was rushed in for emergency laparotomy after presenting to the emergency department for abdominal pain. The patient had an NYHA Class II with room air SpO2 93-95%. While awaiting lung transplant, the patient takes warfarin, Sildanefil, Macitentan and even Selexipag for rising PASP. At presentation, vital signs: BP 95/63, HR 119 SpO2 88% (room air). Despite decreasing haemoglobin 14 to 10g/dL, INR 2.59 was reversed with prothrombin concentrate, and Vitamin K. ECG revealed Right Bundle Branch Block with right ventricular strain and x-ray showed cardiomegaly, dilated Right Ventricle, Pulmonary Arteries, basal atelectasis. Arterial blood gas showed compensated metabolic acidosis pH 7.4 pCO2 32 pO2 53 HCO3 20 BE -4 SaO2 88%. The cardiothoracic surgeon concluded no role for Extracorporeal Membrane Oxygenation (ECMO). We inserted invasive arterial and central venous lines with blood transfusion via an 18G cannula before the patient underwent a midline laparotomy, haemostasis of ruptured ovarian cyst with 2.4L of clots under general anesthesia and FloTrac cardiac output monitoring. Rapid sequence induction was done with Midazolam/Propofol, remifentanil infusion, and rocuronium. The patient was maintained on Desflurane. Blood products and colloids were transfused for further 1.5L blood loss. Postoperatively, the patient was transferred to the intensive care unit and was extubated uneventfully 7hours later. The patient went home a week later. Discussion: Emergency hemostasis laparotomy in anticoagulated WHO Class I PH patient awaiting lung transplant with no ECMO backup poses tremendous stress on the deaf-mute patient and the anesthesiologist. Balancing hemodynamics avoiding hypotension while awaiting hemostasis in the presence of pulmonary arterial dilators and anticoagulation requires close titration of volatiles, which decreases RV contractility. We review the contraindicated anesthetic agents (ketamine, N2O), choice of vasopressors in hypotension to maintain Aortic-right ventricular pressure gradients and nitric oxide use perioperatively. Conclusion: Interdisciplinary communication with a deaf-mute moribund patient and anesthesia considerations pose many rare challenges worth sharing.

Keywords: pulmonary hypertension, case report, warfarin reversal, emergency surgery

Procedia PDF Downloads 218

Authors: Minjung Park, Jimin Park, Youngwoon Kim, Hyungseop Han, Myoungryul Ok, Hojeong Jeon, Hyunkwang Seok, Yuchan Kim

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Magnesium is an essential element in human body and has unique characteristics such as bioabsorbable and biodegradable properties. Therefore, there has been much attention on studies on the implants based on magnesium to avoid subsequent surgery. However, high amount of hydrogen gas is generated by relatively severe corrosion of magnesium especially in aqueous condition with chloride ions. And it contributes to the causes of swelling of skin and causes consequent inflammation of soft tissue where is directly in contact with implants. Therefore, there is still concern about the safety of the using biodegradable magnesium alloys, which is limited to various applications. In this study, we analyzed the influence of coenzyme on corrosion behavior of magnesium. The analysis of corrosion rate was held by using Hanks’ balanced salt solution (HBSS) as a body stimulated fluid and in condition of 37°C. Thus, with deferring the concentration of the coenzyme used in this study, corrosion rates from 0.0654ml/ cm² to 0.0438ml/cm² were observed in immersion tests. Also, comparable results were obtained in electrochemical tests. Results showed that hydrogen gas produced from corrosion of magnesium can be controlled.

Keywords: biodegradable magnesium, biomaterials, coenzyme, corrosion

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Authors: Sanele E. Nene L., Lia M. Hewitt

Abstract:

Background: Artificial intelligence (AI) has a high value in healthcare, various applications have been developed for the efficiency of clinical operations, such as appointment/surgery scheduling, diagnostic image analysis, prognosis, prediction and management of specific ailments. Purpose: The purpose of this study was to explore, describe, contrast, evaluate, and develop the various leadership strategies as a conceptual framework, applied by public health Operational Managers (OMs) to embrace AI benefits, with the aim to improve the healthcare system in a public hospital. Design and Method: A qualitative, exploratory, descriptive and contextual research design was followed and a descriptive phenomenological approach. Five phases were followed to conduct this study. Phenomenological individual interviews and focus groups were used to collect data and a phenomenological thematic data analysis method was used. Findings and conclusion: Three themes surfaced as the experiences of AI by the OMs; Positive experiences related to AI, Management and leadership processes in AI facilitation, and Challenges related to AI.

Keywords: ambivalence, embracing, Artificial intelligence, public hospital

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Authors: Sneha Noble, Rahul Krishnan, Uma G., D. K. Vijaykumar

Abstract:

Breast-Cancer related Lymphedema is a major problem that affects many women. Lymphedema is the swelling that generally occurs in the arms or legs caused by the removal of or damage to lymph nodes as a part of cancer treatment. Treating it at the earliest possible stage is the best way to manage the condition and prevent it from leading to pain, recurrent infection, reduced mobility, and impaired function. So, this project aims to focus on the multi-modal approaches to identify the risks of Lymphedema in post-surgical oncology patients and prevent it at the earliest. The Kinect IR Sensor is utilized to capture the images of the body and after image processing techniques, the region of interest is obtained. Then, performing the voxelization method will provide volume measurements in pre-operative and post-operative periods in patients. The formation of a mathematical model will help in the comparison of values. Clinical pathological data of patients will be investigated to assess the factors responsible for the development of lymphedema and its risks.

Keywords: Kinect IR sensor, Lymphedema, voxelization, lymph nodes

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Authors: Rosa Hendijani, Mohammadhesam Hajighasemi

Abstract:

As of late, the sharing economy has become an important type of business model. Online taxi services are one example that has grown rapidly around the world. This study examines the factors influencing the use of online taxis as one form of IT-enabled sharing services based on the theory of planned behavior (TPB). Based on the theory of planned behavior, these factors can be divided into three categories, including the ones related to attitude (e.g., image and perceived usefulness), normative believes (e.g., subjective norms), and behavioral control (e.g., technology facilitating conditions and self-efficacy). Three other factors were also considered based on the literature, including perceived economic benefits, openness towards using shared services, and perceived availability. The effect of all these variables was tested both directly and indirectly through intention as the mediating variable. A survey method was used to test the research hypotheses. In total, 361 individuals partook in the study. The results of a multiple regression analysis on behavior showed that perceived economic benefits, compatibility, and subjective norms were important factors influencing behavior among online taxi users. In addition, intention partially mediated the effect of perceived economic benefits and compatibility on behavior. It can be concluded that perceived economic benefits, compatibility, and subjective norms are the three main factors that influence behavior among online taxi users.

Keywords: collaborative consumption, IT-enabled sharing services model, online taxi, sharing economy, theory of planned behavior

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Authors: Esmaeil Biazar

Abstract:

A nanofibrous PHBV nerve conduit has been used to evaluate its efficiency based on the promotion of nerve regeneration in rats. The designed conduits were investigated by physical, mechanical and microscopic analyses. The conduits were implanted into a 30-mm gap in the sciatic nerves of the rats. Four months after surgery, the regenerated nerves were evaluated by macroscopic assessments and histology. This polymeric conduit had sufficiently high mechanical properties to serve as a nerve guide. The results demonstrated that in the nanofibrous graft with cells, the sciatic nerve trunk had been reconstructed with restoration of nerve continuity and formatted nerve fibers with myelination. For the grafts especially the nanofibrous conduits with cells, muscle cells of gastrocnemius on the operated side were uniform in their size and structures. This study proves the feasibility of artificial conduit with Schwann cells for nerve regeneration by bridging a longer defect in a rat model.

Keywords: sciatic regeneration, Schwann cell, artificial conduit, nanofibrous PHBV, histological assessments

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Authors: Dae Kyung Choi, Won Man Park, Kyungsoo Kim, Yoon Hyuk Kim

Abstract:

The interspinous process devices have been recently used due to its advantages such as minimal invasiveness and less subsidence of the implant to the osteoporotic bone. In this paper, we have analyzed the influences of ligature tightening of several interspinous process devices using finite element analysis. Four types of interspinous process implants were inserted to the L3-4 spinal motion segment based on their surgical protocols. Inferior plane of L4 vertebra was fixed and 7.5 Nm of extension moment were applied on superior plane of L3 vertebra with 400N of compressive load along follower load direction and pretension of the ligature. The stability of the spinal unit was high enough than that of intact model. The higher value of pretension in the ligature led the decrease of dynamic stabilization effect in cases of the WallisTM, DiamTM, Viking, and Spear®. The results of present study could be used to evaluate surgical option and validate the biomechanical characteristics of the spinal implants.

Keywords: interspinous process device, bone fracture risk, lumbar spine, finite element analysis

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Authors: T. R. Hidayat, G. Irawan, F. Kurniawan, E. H. I. Prasetya, Suharto, T. F. Ridwan, A. Pitoyo, A. Juniantoro, R. T. Hidayat

Abstract:

Swab activities is an activity to lift fluid from inside the well with the use of a sand line that aims to find out fluid influx after conducting perforation or to reduce the level of fluid as an effort to get the difference between formation pressure with hydrostatic pressure in the well for underbalanced perforation. During the swab activity, problems occur frequent problems occur with the rubber swab. The rubber swab often breaks and becomes a fish inside the well. This rubber swab fishing activity caused the rig operation takes longer, the swab result data becomes too late and create potential losses of well operation for the company. The average time needed for fishing the fractions of rubber swab plus swab work is 42 hours. Innovation made for such problems is to modify the rubber swab tool. The rubber swab tool is modified by provided a series of brushes at the end part of the tool with a thread of connection in order to improve work safety, so when the rubber swab breaks, the broken swab will be lifted by the brush underneath; therefore, it reduces the loss time for rubber swab fishing. This tool has been applied, it and is proven that with this rubber swab tool modification, the rig operation becomes more efficient because it does not carry out the rubber swab fishing activity. The fish fractions of the rubber swab are lifted up to the surface. Therefore, it saves the fuel cost, and well production potentials are obtained. The average time to do swab work after the application of this modified tool is 8 hours.

Keywords: rubber swab, modifikasi swab, brush, fishing rubber swab, saving cost

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Authors: Prabhu Thangaraju, Manoj Deepak, A. Sivakumar

Abstract:

Removal of inter vertebral disc along with spinal fusion has many disadvantages such as causing stress fractures. If it is possible regenerate the spine it would be possible avoid the complications of the surgery and achieve better results. Our study involves the use of mesenchymal stem cells in regenerating the discs. Our study involved 10 patients who presented with degenerative disc disease between 2008-2011 in our hospital. After adequate pre-operative check prepared mesenchymal stem cells were injected into the disc spaces. These patients were subjected to conservative therapy for a minimum of six weeks before they were accepted into the study. They were followed up regularly for a minimum of 2years with serial radiographs and MRI. 8 out of the 10 patients had completed reduction in the pain. The T2 weighted MRI images in 9 out of the 10 patients showed a bright signal compared the previous Images which indicated that there was improvement in the hydration levels. From the case study of 10 patients who were subjected to mesenchymal cell therapy in our hospital, we can conclude that the use of mesenchymal cells in treatment of intervertebral disc degeneration in a safe and effective option.

Keywords: mesenchymal stem cells, intervertebral disc, the spine, disc degeneration

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Authors: Katie Jerram, Jacqui Nevols, Rebecca Howes, Hayley Richardson, Debbie Suso, Thomas Batten, Reny Mathai

Abstract:

Pyomyositis is an uncommon acute purulent skeletal muscle infection, usually caused by Staphylococcus aureus, occurring either spontaneously or following local trauma. Immunocompromise is a risk factor. It presents with pyrexia, pain, and tenderness of the affected muscle, which may have a firm ‘woody’ feel. Management usually involves surgery and prolonged courses of antibiotics, but alongside these active treatments, palliation of symptoms such as pain is also a priority. A short case series of diabetic inpatients under the care of the Renal Medicine team with pyomyositis is presented, demonstrating that Hospital Palliative Care Teams may be well placed to provide symptom management advice by working jointly with the patient’s medical or surgical team. A review of the literature on the management of pain in pyomyositis is also presented, and there was no clear consensus on the best strategy. It may be that a combination of analgesics and adjuncts is the most effective strategy, perhaps combined with the holistic approach used within palliative care.

Keywords: pyomyositis, pain, palliation, analgesia

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Authors: Chao Fang

Abstract:

Due to the Confucian emphasis on filial piety and an undeveloped social welfare system in mainland China, adult children are both socially and legally obliged to care for their parents, including financial assistance and physical care as well as emotional and social support. Thus a family-centred care pattern for elderly people has been firmly established in China. However, because of the nationwide ‘One Child Policy’, over one million parents are excluded from such care because of the death of their only child and, therefore, their primary caregiver. Without their child’s support, these parents must manage the day to day challenges of growing old alone, with little support from society. By overturning established expectations of a ‘good’ elderly life, the loss of an only child may be accompanied by social and self-stigmatization, pushing these bereaved parents to the margin of society and threatening their economic, physical, emotional and social well-being. More importantly, since the One Child Policy was implemented from the late 1970s and early 1980s, the first generation of bereaved or ‘Shidu’ parents has reached an age at which those parents need elderly care. However, their predicament has been largely ignored. This paper reports on a qualitative interview study that found elderly care to be the main concern for Shidu parents’ everyday life. The paper identifies and discusses the concerns these bereaved parents raised about the prospect of having nowhere to turn at a time of increased need for financial, physical, social and emotional support in old age. The paper also identifies how Shidu parents have been coming together in grief and negotiate to make their predicament known to the government and wider society and to re-define their elderly life by rebuilding a sense of ‘family’.

Keywords: culture, bereavement, China, elderly care

Procedia PDF Downloads 272