Search results for: fault diagnosis

Authors: Tewelde Gebreslassie Gebreanenia, Frie Ayalew Yimam, Seada Hussen Adem

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Patient safety and quality of care are essential goals of health care delivery, but they are often compromised by human errors, system failures, or resource constraints. In a variety of healthcare contexts, artificial intelligence (AI), a quickly developing field, can provide fresh approaches to enhancing patient safety and treatment quality. Artificial Intelligence (AI) has the potential to decrease errors and enhance patient outcomes by carrying out tasks that would typically require human intelligence. These tasks include the detection and prevention of adverse events, monitoring and warning patients and clinicians about changes in vital signs, symptoms, or risks, offering individualized and evidence-based recommendations for diagnosis, treatment, or prevention, and assessing and enhancing the effectiveness of health care systems and services. This study examines the state-of-the-art and potential future applications of AI-based technologies for enhancing patient safety and care quality, as well as the opportunities and problems they present for patients, policymakers, researchers, and healthcare providers. In order to ensure the safe, efficient, and responsible application of AI in healthcare, the paper also addresses the ethical, legal, social, and technical challenges that must be addressed and regulated.

Keywords: artificial intelligence, health care, human intelligence, patient safty, quality of care

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Authors: Ahmed AlNouss, Salim Ahmed

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Process control refers to the techniques to control the variables in a process in order to maintain them at their desired values. Advanced process control (APC) is a broad term within the domain of control where it refers to different kinds of process control and control related tools, for example, model predictive control (MPC), statistical process control (SPC), fault detection and classification (FDC) and performance assessment. APC is often used for solving multivariable control problems and model predictive control (MPC) is one of only a few advanced control methods used successfully in industrial control applications. Advanced control is expected to bring many benefits to the plant operation; however, the extent of the benefits is plant specific and the application needs a large investment. This requires an analysis of the expected benefits before the implementation of the control. In a real plant simulation studies are carried out along with some experimentation to determine the improvement in the performance of the plant due to advanced control. In this research, such an exercise is undertaken to realize the needs of APC application. The main objectives of the paper are as follows: (1) To apply MPC to a number of simulations set up to realize the need of MPC by comparing its performance with that of proportional integral derivatives (PID) controllers. (2) To study the effect of controller parameters on control performance. (3) To develop appropriate performance index (PI) to compare the performance of different controller and develop novel idea to present tuning map of a controller. These objectives were achieved by applying PID controller and a special type of MPC which is dynamic matrix control (DMC) on the multi-tanks process simulated in loop-pro. Then the controller performance has been evaluated by changing the controller parameters. This performance was based on special indices related to the difference between set point and process variable in order to compare the both controllers. The same principle was applied for continuous stirred tank heater (CSTH) and continuous stirred tank reactor (CSTR) processes simulated in Matlab. However, in these processes some developed programs were written to evaluate the performance of the PID and MPC controllers. Finally these performance indices along with their controller parameters were plotted using special program called Sigmaplot. As a result, the improvement in the performance of the control loops was quantified using relevant indices to justify the need and importance of advanced process control. Also, it has been approved that, by using appropriate indices, predictive controller can improve the performance of the control loop significantly.

Keywords: advanced process control (APC), control loop, model predictive control (MPC), proportional integral derivatives (PID), performance indices (PI)

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Authors: Ahmad Lutfi, Nikolas Dhega

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The Malala deposit in northwest Sulawesi is the only known porphyry molybdenum and the only source for rhenium, occurrence in Indonesia. The neural network method produces results that correspond very closely to those of the knowledge-based fuzzy logic method and weights of evidence method. This method required data of solid geology, regional faults, airborne magnetic, gamma-ray survey data and GIS data. This interpretation of the network output fits with the intuitive notion that a prospective area has characteristics that closely resemble areas known to contain mineral deposits. Contrasts with the weights of evidence and fuzzy logic methods, where, for a given grid location, each input-parameter value automatically results in an increase in the prospective estimated. Malala District indicated molybdenum anomalies in stream sediments from in excess of 15 km2 were obtained, including the Takudan Fault as most prominent structure with striking 40̊ to 60̊ over a distance of about 30 km and in most places weakly at anomaly B, developed over an area of 4 km2, with a ‘shell’ up to 50 m thick at the intrusive contact with minor mineralization occurring in the Tinombo Formation. Series of NW trending, steeply dipping fracture zones, named the East Zone has an estimated resource of 100 Mt at 0.14% MoS2 and minimum target of 150 Mt 0.25%. The Malala porphyries occur as stocks and dykes with predominantly granitic, with fluorine-poor class of molybdenum deposits and belongs to the plutonic sub-type. Unidirectional solidification textures consisting of subparallel, crenulated layers of quartz that area separated by layers of intrusive material textures. The deuteric nature of the molybdenum mineralization and the dominance of carbonate alteration.The nature of the Stage I with alteration barren quartz K‐feldspar; and Stage II with alteration quartz‐K‐feldspar‐apatite-molybdenite veins combined with the presence of disseminated molybdenite with primary biotite in the host intrusive.

Keywords: molybdenite, Malala, porphyries, anomaly B

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Authors: Christopher Leung, Tony Kim, Rebecca Lendzion, Scott Mackenzie

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Retroperitoneal abscesses are a rare but serious condition with often delayed diagnosis, non-specific symptoms, multiple causes and high morbidity/mortality. With the advent of more readily available cross-sectional imaging, retroperitoneal abscesses are treated earlier and better outcomes are achieved. Occasionally, a retroperitoneal abscess is present as a huge retroperitoneal abscess, as evident in this 53-year-old male. With a background of chronic renal disease and left partial nephrectomy, this gentleman presented with a one-month history of left flank pain without any other symptoms, including fevers or abdominal pain. CT abdomen and pelvis demonstrated a huge retroperitoneal abscess spanning from the diaphragm, abutting the spleen, down to the iliopsoas muscle and abutting the iliac vessels at the pelvic brim. This large retroperitoneal abscess required open drainage as well as drainage by interventional radiology. A long course of intravenous antibiotics and multiple drainages was required to drain the abscess. His blood culture and fluid culture grew Proteus species suggesting a urinary source, likely from his non-functioning kidney, which had a partial nephrectomy. Such a huge retroperitoneal abscess has rarely been described in the literature. The learning point here is that the basic principle of source control and antibiotics is paramount in treating retroperitoneal abscesses regardless of the size of the abscess.

Keywords: retroperitoneal abscess, retroperitoneal mass, sepsis, genitourinary infection

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Authors: Maria Trimintziou, Michael Sakellariou, Prodromos Psarropoulos

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Nowadays, the exploitation of hydrocarbons reserves in deep seas and oceans, in combination with the need to transport hydrocarbons among countries, has made the design, construction and operation of offshore pipelines very significant. Under this perspective, it is evident that many more offshore pipelines are expected to be constructed in the near future. Since offshore pipelines are usually crossing extended areas, they may face a variety of geohazards that impose substantial permanent ground deformations (PGDs) to the pipeline and potentially threaten its integrity. In case of a geohazard area, there exist three options to proceed. The first option is to avoid the problematic area through rerouting, which is usually regarded as an unfavorable solution due to its high cost. The second is to apply (if possible) mitigation/protection measures in order to eliminate the geohazard itself. Finally, the last appealing option is to allow the pipeline crossing through the geohazard area, provided that the pipeline will have been verified against the expected PGDs. In areas with moderate or high seismicity the design of an offshore pipeline is more demanding due to the earthquake-related geohazards, such as landslides, soil liquefaction phenomena, and active faults. It is worthy to mention that although worldwide there is a great experience in offshore geotechnics and pipeline design, the experience in seismic design of offshore pipelines is rather limited due to the fact that most of the pipelines have been constructed in non-seismic regions (e.g. North Sea, West Australia, Gulf of Mexico, etc.). The current study focuses on the seismic design of offshore pipelines against active faults. After an extensive literature review of the provisions of the seismic norms worldwide and of the available analytical methods, the study simulates numerically (through finite-element modeling and strain-based criteria) the distress of offshore pipelines subjected to PGDs induced by active seismic faults at the seabed. Factors, such as the geometrical properties of the fault, the mechanical properties of the ruptured soil formations, and the pipeline characteristics, are examined. After some interesting conclusions regarding the seismic vulnerability of offshore pipelines, potential cost-effective mitigation measures are proposed taking into account constructability issues.

Keywords: offhore pipelines, seismic design, active faults, permanent ground deformations (PGDs)

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Authors: Argaw Amare, Abbuna Fuffa, Stringer Andy

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Improving public knowledge and changing their attitudes towards antibiotic use will be a crucial early strategy to contain Antibiotic resistance. The current study was undertaken from November 2015 to June 2016. A cross-sectional survey using a pretested questionnaire was conducted on 392 residents (330 male and 62 female) aged 18 and above. Participants were selected randomly. Data was analyzed using simple descriptive statistics; the Chi-square test was used to determine any significant difference. The majority of participants (81%) were farmers in their occupation. Most of the respondents (76%) were not able to define the difference between antimicrobials and antibiotics. Furthermore, (61%) of participants were not able to define what antibiotics and for what purpose they are used. Thirty-four percent of participants do not know the names of antibiotics they have used for their animals and for themselves. Nearly 68% have no knowledge about the disease they have been treated for. The majority of participants (73.5%) agree to complete their course of treatment even if they feel better. About 72.5% of participants disagree that antibiotics are safe and can be used to treat different diseases, without prescription. Most of the participants (95%) treat their animals after diagnosis; more than 80% of them agree to not purchase veterinary drugs from local traders. This study showed that the participants have poor knowledge and good attitude, with an average score of 41.3±16.1% and 79.6±16, respectively. Knowledge and attitude are significantly correlated (p<0.01). The participants in this study had a good attitude toward the rational use of antibiotics. Whereas they lack knowledge with regard to the kinds of antibiotics and the diseases they are prescribed for. Therefore, further educational interventions are necessary to improve their understanding of the antibiotics currently available and the major bacterial diseases they are prescribed.

Keywords: AMR, knoweledge, attitude, perception

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Authors: Arturo S. Daag, Ira Karrel D. L. San Jose, Mike Gabriel G. Pedrosa, Ken Adrian C. Villarias, Rayfred P. Ingeniero, Cyrah Gale H. Rocamora, Margarita P. Dizon, Roland Joseph B. De Leon, Teresito C. Bacolcol

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The province of Leyte consists of various geomorphological landforms: These are: a) landforms of tectonic origin transect large part of the volcanic centers in upper Ormoc area; b) landforms of volcanic origin, several inactive volcanic centers located in Upper Ormoc are transected by Philippine Fault; c) landforms of volcano-denudational and denudational slopes dominates the area where most of the earthquake-induced landslide occurred; and d) Colluvium and alluvial deposits dominate the foot slope of Ormoc and Jaro-Pastrana plain. Earthquake ground acceleration and geotechnical properties of various landforms are crucial for landslide studies. To generate the landslide critical acceleration model of sliding block, various data were considered, these are: geotechnical data (i.e., soil and rock strength parameters), slope, topographic wetness index (TWI), landslide inventory, soil map, geologic maps for the calculation of the factor of safety. Horizontal-to-vertical spectral ratio (HVSR) surveying methods, refraction microtremor (ReMi), and three-component microtremor (3CMT) were conducted to measure site period and surface wave velocity as well as to create a soil thickness model. Critical acceleration model of various geomorphological unit using Remote Sensing, field geotechnical, geophysical, and geospatial data collected from the areas affected by the 06 July 2017 M6.5 Leyte earthquake. Spatial analysis of earthquake-induced landslide from the 06 July 2017, were then performed to assess the relationship between the calculated critical acceleration and peak ground acceleration. The observed trends proved helpful in establishing the role of critical acceleration as a determining factor in the distribution of co-seismic landslides.

Keywords: earthquake-induced landslide, remote sensing, geomorphology, seismic response

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Authors: Gajendra Kumar Mourya, Dinesh Bhatia, Akash Handique, Sunita Warjri, Syed Achaab Amir

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Nowadays, Medical imaging has become an integral part of modern healthcare. Abdominal CT images are an invaluable mean for abdominal organ investigation and have been widely studied in the recent years. Diagnosis of liver pathologies is one of the major areas of current interests in the field of medical image processing and is still an open problem. To deeply study and diagnose the liver, segmentation of liver is done to identify which part of the liver is mostly affected. Manual segmentation of the liver in CT images is time-consuming and suffers from inter- and intra-observer differences. However, automatic or semi-automatic computer aided segmentation of the Liver is a challenging task due to inter-patient Liver shape and size variability. In this paper, we present a technique for automatic segmenting the liver from CT images using Random Forest Classifier. Random forests or random decision forests are an ensemble learning method for classification that operate by constructing a multitude of decision trees at training time and outputting the class that is the mode of the classes of the individual trees. After comparing with various other techniques, it was found that Random Forest Classifier provide a better segmentation results with respect to accuracy and speed. We have done the validation of our results using various techniques and it shows above 89% accuracy in all the cases.

Keywords: CT images, image validation, random forest, segmentation

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Authors: Shadrack Mambo, Karim Djouani, Yskandar Hamam, Barend van Wyk, Patrick Siarry

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This paper discusses the current trends in medical image registration techniques and addresses the need to provide a solid theoretical foundation for research endeavours. Methodological analysis and synthesis of quality literature was done, providing a platform for developing a good foundation for research study in this field which is crucial in understanding the existing levels of knowledge. Research on medical image registration techniques assists clinical and medical practitioners in diagnosis of tumours and lesion in anatomical organs, thereby enhancing fast and accurate curative treatment of patients. Literature review aims to provide a solid theoretical foundation for research endeavours in image registration techniques. Developing a solid foundation for a research study is possible through a methodological analysis and synthesis of existing contributions. Out of these considerations, the aim of this paper is to enhance the scientific community’s understanding of the current status of research in medical image registration techniques and also communicate to them, the contribution of this research in the field of image processing. The gaps identified in current techniques can be closed by use of artificial neural networks that form learning systems designed to minimise error function. The paper also suggests several areas of future research in the image registration.

Keywords: image registration techniques, medical images, neural networks, optimisaztion, transformation

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Authors: Behnam Shakerian, Negin Razavi

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The pathogenesis of coronary artery disease is multifactorial. The epicardial fat pad is a localized fat depot lying between the myocardium and the visceral layer of the pericardium. The mechanisms through which epicardial fat pad can cause atherosclerosis are complex. The epicardial fat pad can surround the coronary arteries and contributes to the development and progression of coronary artery disease. Methods: we selected 50 patients who underwent coronary artery angiography for the evaluation of coronary artery disease that results were positive for coronary artery disease. All patients underwent an echocardiographic examination after coronary angiography to measure epicardial fat pad thickness. The epicardial fat pad was defined as an echo-free space between the myocardium's outer wall and the pericardium's visceral layer. Results: The epicardial fat pad was measured on the right ventricle apex in 46 patients. Sixty- five percent of the studied patients were male. The most common vessel with stenosis was the left anterior descending artery. A significant correlation was observed between epicardial fat pad thickness and the severity of coronary artery disease. Discussions: The epicardial fat pad provides a horizon on the pathophysiology of cardiovascular diseases. It directly contributes to the development and progression of coronary artery disease by causing inflammation and endothelial damage. Further investigations are needed to determine whether medical treatment can reduce the mass of epicardial fat pad and can help to improve atherosclerosis. Conclusion: The epicardial fat pad measurement could be used as an indicator of coronary arteries’ atherosclerosis. Therefore, thickness measurement of the epicardial fat pad in the clinical practice could be of assistance in identifying patients at risk and if required, undergoing supplementary diagnosis with coronary angiography.

Keywords: epicardial, fat pad, coronary artery disease, echocardiography

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Authors: Chariya Laohavich

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At the current, the trends in the lung disease at a university hospital are the treat and diagnosis by bronchoscopy. Bronchoscopic cryotherapy is a long time procedure 1-4 hours. The cryo probe is sensitive and easy to be damaged and expensive. We have this study management for protection the cryo probe, user satisfaction and qualities work. This study conducted in 4 stages: stage 1 for a survey of problems and assessment of user’s needs; stage 2 for designing and developing the Rama-chest cryo arm for a bronchoscopy process; stage 3 for test-implementing the Rama-chest cryo arm in real situations, studying its problems and obstacles, and evaluating the user satisfaction; and stage 4 for an overall assessment and improvement. The sample used in this study consisted of a total of 15 Ramathipbodi Hospital’s Bronchoscopist and bronchoscopist’s nurse who had used the Rama-chest cryo arm for bronchoscopic cryotherapy from January to June 2016. Objective: To study efficacy and user satisfaction on the Rama-chest cryo arm innovation for bronchoscopic cryotherapy. Data were collected using a Rama-chest cryo arm satisfaction assessment form and analysed based on mean and standard deviation. Result is the Rama-chest cryo arm was an innovation that accommodated during bronchoscopic cryotherapy. The subjects rated this the cryo arm as being most satisfactory (M = 4.86 ± , SD 0.48. Therefore we have developed a cryo arm that uses local material, practical and economic. Our innovation is not only flexible and sustainable development but also lean and seamless. This produced device can be used as effectively as the imported one, and thus can be eventually substituted.

Keywords: efficacy, satisfaction, Rama-chest cryo arm, innovation, bronchoscopic cryotherapy

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Authors: Thomas P. Jones

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Overview: Drowning is an important cause of accidental death, particularly in children and young people. Although many survive drowning incidents, it is a relatively rare presenting complaint in Emergency Departments. When cases do present, they can be complex and unpredictable. For patients to receive the best care, it is important that their management is standardized and evidence based, however this can be difficult in a topic area with limited studies and inconsistencies in case reporting. Objectives: To review recent cases to assess the performance of Manchester Royal Infirmary Emergency Department in the management of near drowning. To produce evidence based guideline on the management of drowning victims in the ED. Methods: Emergency department records were searched for patients with the diagnosis of ‘fatal drowning’ or ‘nearly drowning’ and two relevant case notes reviewed. To produce the guideline a literature review was conducted and a series of structured short cut systematic reviews known as Best BETs carried out. This information was used to produce a clear treatment pathway. Results: The case studies emphasized the variety in presentation of drowning victims whilst highlighting inconsistencies in management and documentation. An evidence-based guideline is presented as a flowchart, which illustrates the relevant investigations and treatment that victims of a drowning incident should receive, based on the best available evidence. Conclusion: It is hoped that when put into practice, the guideline will improve and standardize patient care in cases of near drowning. An audit is recommended to assess its effectiveness.

Keywords: drowning, near drowning, non fatal drowning, fatal drowning

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Authors: Morteza Gharibi, Abdolghader Pakniat, Somayeh Bahrampouri

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Introduction: Emergency department (E.R.) crowding is a serious widespread problem in hospitals that leads to irregularities, a slower rate of delivery of services to patients, and a long-term stay. In addition, the long-term stay in the E.D. reduces the possibility of providing services with appropriate quality to other patients who are undergoing medical emergencies, which leads to dissatisfaction among patients. This study aimed to determine the relationship between ED-crowding and the mortality rate of the patients referred to the E.D. In a retrospective cohort study, all patients who expired in first 24 hours of admission were enrolled in the study. Crowding index at the moment of admission was calculated using Edwin Score. The data including history and physical examination, time of arrival in the E.D., diagnosis (using ICD 10 code), time of death, cause of death, demographic information was recoded based on triage forms on admission and patients’ medical files. Data analysis was performed by using descriptive statistics and chi square test, ANOVA tests using SPSS ver. 19. The time of arrival in E.D. to death in crowded E.D. conditions, with an average of five hours and 25 minutes, was significantly higher than the average admission Time of arrival in E.D. to death in active and crowded E.D. conditions. More physicians and nurses can be employed during crowded times to reduce staff fatigue and improve their performance during these hours.

Keywords: mortality, emergency, department, crowding

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Authors: Santos Cabrera, Halbert Yesid, Moncada Nino, Alvaro Fernando, Rincon Cuta, Yeisson Alexis

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The present work evaluates the feasibility of implementing a health and use monitoring system (HUMS), based on vibration analysis as a condition-based maintenance program for the UH60L 'Blackhawk' helicopters. The mixed approach used consists of contributions from national and international experts, the analysis of data extracted from the software (Meridium), the correlation of variables derived from the diagnosis of availability, the development, and application of the HUMS system, the evaluation of the latter through of the use of instruments designed for the collection of information using the DELPHI method and data capture with the device installed in the helicopter studied. The results obtained in the investigation reflect the context of maintenance in aerial operations, a reduction of operation and maintenance costs of over 2%, better use of human resources, improvement in availability (5%), and fulfillment of the aircraft’s security standards, enabling the implementation of the monitoring system (HUMS) in the condition-based maintenance program. New elements are added to the study of maintenance based on condition -specifically, in the determination of viability based on qualitative and quantitative data according to the methodology. The use of condition-based maintenance will allow organizations to adjust and reconfigure their strategic, logistical, and maintenance capabilities, aligning them with their strategic objectives of responding quickly and adequately to changes in the environment and operational requirements.

Keywords: air transportation sustainability, HUMS, maintenance based condition, maintenance blackhawk capability

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Authors: Taleb L., Benarbia M., Brahmi M., Belmiloud H., Boukerche A.

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Introduction and purpose of the study: Cavum cancer in children and adolescents is rare and represents 8% of all nasopharyngeal cancers treated in our department. Our objective is to study its epidemiological, clinical, therapeutic, and evolutionary particularities. Material and methods: Retrospective study of 39 patients under 20 years old, treated for undifferentiated non-metastatic carcinoma of the nasopharynx at the Emir Abdelkader Cancer Center between 2014 and 2020. Results and statistical analysis: Median age was 14 years [7-19 years], with a sex ratio of 2.9. The median time to diagnosis was 5.6 months [1 to 14 months], the circumstances of the discovery of which were dominated by lymph node syndrome in 43.6% of cases (n=17) followed by a rhinological syndrome in 30.8% of cases (n=13). The tumor stage was T1 for two patients (5.1%), T2 for 8 (20.5%), T3 for 9 (23.1%), T4 for 20 (51.3%), N0 for 2 (5 .1%) N1 for 4 (10.3%), N2 for 28 (71.8%) and N3 for 5 (12.8%). All patients received induction chemotherapy followed by concomitant radiotherapy with cisplatin. The dose of irradiation delivered to the cavum and adenopathies was 66 Gy with fractionation of 2 Gy per session in 69.2% of cases (n=27) and 1.8 Gy in 30.8% of cases (n=12). With a median follow-up of 51 months (15 to 97 months), the locoregional, metastatic, specific, and overall relapse-free survival rates at five years were 91.1%, 73.5%, 66.1%, and 68.4, respectively. Conclusion: Chemotherapy and radiotherapy treatment of cavum cancer in children and adolescents has allowed excellent locoregional control despite the advanced stage of the disease. However, the frequency of metastatic relapses could justify the possible use of systemic maintenance treatment.

Keywords: cancer, nasopharynx, radiotherapy, chemotherapy, survival

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Authors: Rajkumar Ghosh

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This paper focuses on the structural analysis of Chaura Thrust in Himachal Pradesh, India. It investigates mylonitised zones under microscopic observation, characterizes the box fold and its signature in the regional geology of Himachal Himalaya, and documents the Higher Himalayan Out-of-Sequence Thrust (OOST) in the region. The study aims to provide field evidence and documentation for Chaura Thrust (CT), which was previously considered a blind thrust. The research methodology involves geological field observation, microscopic studies, and strain analysis of oriented samples collected along the Jhakri-Chaura transect. The study presents findings such as the activation ages of MCT and STDS, the identification of mylonitised zones and various types of crenulated schistosity, and the manifestation of box folds and OOST. The presence of meso- and micro-scale box folds around Chaura suggests structural upliftment, while kink folds and shear sense indicators were identified. The research highlights the importance of microscopic studies and contributes to the understanding of the structural analysis of CT and its implications in the regional geology of the Himachal Himalaya. Mylonitised zones with S-C fabric were observed under the microscope, along with dynamic and bulging recrystallization and sub-grain formation. Various types of crenulated schistosity were documented, including a rare case of crenulation cleavage and sigmoid Muscovite occurring together. The conclusions emphasize the non-blind nature of Chaura Thrust, the characterization of box folds, the activation timing of different thrusts, and the significance of microscopic observations. Jhakri/Chaura/Sarahan thrusts are the zone of tectonic imbrication that transport Higher Himalayan gneissic rock on Rampur Quartzite. The evidence of frequent earthquakes and landslides in the Jhakri region confirm the study of morphometric conclusion that there is considerable neo-tectonic activity along an active fault in the Sutlej river basin. The study also documents the presence of OOST in Himachal Pradesh and its potential impact on strain accumulation.

Keywords: Main Central Thrust, Jhakri Thrust, Chaura Thrust, Higher Himalaya, Out-of-Sequence Thrust, Sarahan Thrust

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Authors: Titap Yazicioglu

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To examine the results of two different surgery in patients with severe ptosis and poor levator function. The records of 10 bilateral congenital ptosis patients, who underwent Whitnall’s sling surgery on one eyelid and frontalis sling surgery on the other were analyzed retrospectively. All patients had severe congenital ptosis(>4mm) and poor levator function (LF<4mm). Data regarding eyelid position, cosmetic outcomes, and postoperative complications were evaluated. All patients were assessed for a minimum of one year with regard to the amount of correction, residual ptosis and lagophthalmos. The study consisted of 10 patients, with an average age of 9.2±2.4 years. Preoperative diagnosis for all patients was noted as, the average LF was 3.4±0.51mm, vertical lid height was 3.5±0.52 mm and margin reflex distance-1 (MRD-1) was 0.4±0.51mm. The mean vertical lid height was measured as 7.1±0.73 mm in the frontalis sling group and 7.2±0.63 mm in the Whitnall’s sling group at the postoperative 1st month control. However, in patients with Whitnall’s sling, revision was performed with frontalis sling surgery due to failure in vertical lid height in the late postoperative period, and an average of 7.5±0.52 mm was achieved. Satisfactory results were obtained in all patients. Although postoperative lagophthalmitis developed in the frontalis sling group, none of them developed exposure keratitis. Granuloma was observed as sling infection in 2(20%) of the patients. Although Whitnall’s sling technique provides a natural look appearance without interfering with the functional result, we did not find it as successful as frontalis sling surgery in severe ptosis.

Keywords: congenital ptosis, frontalis suspension, Whitnall ligament, complications

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Authors: Qurat-ul-Ain, Humaira Mehmood

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Background: HIV infection (a global pandemic) in pregnant women has turn out to be an emerging aspect of public health because of its role in the spread of HIV infection, predominantly among children. Aim: The aim was to analyze the trends of diagnosis with respect to gestational age and an overview of the mode of delivery over ten years. Methods: A retrospective data collection from clinical records of diagnosed HIV infected pregnant females attended at HIV antenatal clinic (special clinic), at Pakistan Institute of Medical Sciences, Islamabad, for various complaints during the period of 10 years from February 2007 to December 2016 was done. Results: A total of 113 pregnancies were reported with HIV infection in 10 years. Cases diagnosed at the 1st trimester (1-12 weeks) of pregnancy were (50.4%, 57/113), at the 2nd trimester (13-26 weeks) were (24.8%, 28/113), at the 3rd trimester (27-40+ weeks) were (24.7%, 28/113). Most deliveries were by caesarean section (53.1%, 60/113), elective caesarean sections were (58.3%, 35/60) and emergency caesarean sections were (41.6%,25/60). Vaginal deliveries were (26.5%, 30/113). Reported miscarriages were (17.7%, 20/113). Conclusion: At 1st trimester, 50% of the females were diagnosed with HIV infection, and 50% remained undiagnosed at their 1st trimester. Routine antenatal HIV testing throughout the country is vastly needed for timely diagnoses and prompt treatment(antiretroviral therapy), to suppress the virus, to reduce the risk of spread of HIV infection, to plan elective caesarean section delivery and to prevent mother-to-child transmission.

Keywords: gestational age, HIV infection, mode of delivery, pregnancy

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Authors: Osama Shakeel

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The objective of the paper is to study the clinic-pathological factors, survival analyses, recurrence rate, metastatic rate, risk factors and the management of cutaneous malignant melanoma at Shaukat Khanum Memorial Cancer Hospital and Research Center. Methodology: From 2014 to 2017, all patients with a diagnosis of cutaneous malignant melanoma (CMM) were included in the study. Demographic variables were collected. Short and long term oncological outcomes were recorded. All data were entered and analyzed in SPSS version 21. Results: A total of 28 patients were included in the study. Median age was 46.5 +/-15.9 years. There were 16 male and 12 female patients. The family history of melanoma was present in 7.1% (n=2) of the patients. All patients had a mean survival of 13.43+/- 9.09 months. Lower limb was the commonest site among all which constitutes 46.4%(n=13). On histopathological analyses, ulceration was seen in 53.6% (n=15) patients. Unclassified tumor type was present in 75%(n=21) of the patients followed by nodular 21.4% (n=6) and superficial spreading 3.5%(n=1). Clark level IV was the commonest presentation constituting 46.4%(n=13). Metastases were seen in 50%(n=14) of the patients. Local recurrence was observed in 60.7%(n=17). 64.3%(n=18) lived after one year of treatment. Conclusion: CMM is a fatal disease. Although its disease of fair skin individuals, however, the incidence of CMM is also rising in this part of the world. Management includes early diagnoses and prompt management. However, mortality associated with this disease is still not favorable.

Keywords: malignant cancer of skin, cutaneous malignant melanoma, skin cancer, survival analyses

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Authors: Rujijan Vichivanives

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This research aims to create a knowledge-based system as a database for self-healthcare analysis, diagnosis of simple illnesses, and the use of Thai herbs instead of modern medicine by using principles of Thai traditional medication theory. These were disseminated by website network programs within Suan Sunandha Rajabhat University. The population used in this study was divided into two groups: the first group consisted of four experts of Thai traditional medication and the second group was 300 website users. The methods used for collecting data were paper questionnaires and poll questionnaires on the website. The statistics used for analyzing data was at an average level. The results were divided into three parts: the first part was the development of a knowledge-based system and the second part was applied programs on website. Both parts could be fulfilled and achieved according to the set goal. The third part was the evaluation of the study: The evaluation of the viewpoints of the experts towards website designs were evaluated at a good level of 4.20. The satisfaction evaluation of the users was found at a good level of average satisfactory level at 4.24. It was found that the young population of those under the age of 16 had less cares about their health than the population of other teenagers, working age adults and those of older age. The research findings should be extended in order to encourage the lifestyle modifications to people of all ages by using the self-healthcare principles.

Keywords: developing, herbs, knowledge-based system, medical treatment

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Authors: Sana Ilyas, Kishalaya Mukherjee, Suresh Shetty

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Lip Augmentation has become more common in recent years. Patients do not expect to experience facial palsy after having lip augmentation. This poster will present the findings of such a presentation and will discuss the possible pathophysiology and management. (This poster has been published as a paper in the dental update, June 2022) Aim: The aim of the study was to explore the link between facial nerve palsy and lip fillers, to explore the literature surrounding facial nerve palsy, and to discuss the case of a patient who presented with facial nerve palsy with seemingly unknown cause. Methodology: There was a thorough assessment of the current literature surrounding the topic. This included published papers in journals through PubMed database searches and printed books on the topic. A case presentation was discussed in detail of a patient presenting with peripheral facial nerve palsy and associating it with lip augmentation that she had a day prior. Results and Conclusion: Even though the pathophysiology may not be clear for this presentation, it is important to highlight uncommon presentations or complications that may occur after treatment. This can help with understanding and managing similar cases, should they arise.It is also important to differentiate cause and association in order to make an accurate diagnosis. This may be difficult if there is little scientific literature. Therefore, further research can help to improve the understanding of the pathophysiology of similar presentations. This poster has been published as a paper in dental update, June 2022, and therefore shares a similar conclusiom.

Keywords: facial palsy, lip augmentation, causation and correlation, dental cosmetics

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Authors: David Jurado, Carlos Ávila

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Detection of early signs of breast cancer development is crucial to quickly diagnose the disease and to define adequate treatment to increase the survival probability of the patient. Computer Aided Detection systems (CADs), along with modern data techniques such as Machine Learning (ML) and Neural Networks (NN), have shown an overall improvement in digital mammography cancer diagnosis, reducing the false positive and false negative rates becoming important tools for the diagnostic evaluations performed by specialized radiologists. However, ML and NN-based algorithms rely on datasets that might bring issues to the segmentation tasks. In the present work, an automatic segmentation and detection algorithm is described. This algorithm uses image processing techniques along with the Hough transform to automatically identify microcalcifications that are highly correlated with breast cancer development in the early stages. Along with image processing, automatic segmentation of high-contrast objects is done using edge extraction and circle Hough transform. This provides the geometrical features needed for an automatic mask design which extracts statistical features of the regions of interest. The results shown in this study prove the potential of this tool for further diagnostics and classification of mammographic images due to the low sensitivity to noisy images and low contrast mammographies.

Keywords: breast cancer, segmentation, X-ray imaging, hough transform, image analysis

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Authors: W. Ling, Mohamed Saufi Bin Awang

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Introduction: Mycobacterium tuberculosis post a major health problem worldwide. Central nervous system (CNS) infection by mycobacterium tuberculosis is one of the most devastating complications of tuberculosis. Although with advancement in medical fields, we are yet to understand the pathophysiology of how mycobacterium tuberculosis was able to cross the blood-brain barrier (BBB) and infect the CNS. CNS TB may present with nonspecific clinical symptoms which can mimic other diseases/conditions; this is what makes the diagnosis relatively difficult and challenging. Public health has to be informed and educated about the spread of TB, and early identification of TB is important as it is a curable disease. Case Report: A young 21-year-old Malay gentleman was initially presented to us with symptoms of ear discharge, tinnitus, and right-sided headache for the past one year. Further history reveals that the symptoms have been mismanaged and neglected over the period of 1 year. Initial investigation reveals features of inflammation of the ear. Further imaging showed the feature of chronic inflammation of the otitis media and atypical right cerebral abscess, which has the same characteristic features and consistency. He further underwent a biopsy, and results reveal positive Mycobacterium tuberculosis of the otitis media. With the results and the available imaging, we were certain that this is likely a case of disseminated tuberculosis causing CNS TB. Conclusion: We aim to highlight the challenge and difficult face in our health care system and public health in early identification and treatment.

Keywords: central nervous system tuberculosis, intracranial tuberculosis, tuberculous encephalopathy, tuberculous meningitis

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Authors: Afolabi Joseph Fasoranti

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Tuberculosis (TB) is an infectious disease caused by mycobacterium tuberculosis. Tuberculosis is a major public health problem in Nigeria, being one of the ten leading causes of hospital admissions and a leading cause of death in adults, especially among the economically productive age group. This paper critically examined the importance of health education towards the eradication and prevention of tuberculosis in Nigeria. It was reviewed and discussed under the following subheadings; Global burden of tuberculosis in Nigeria, concept, definition and etiology of tuberculosis, Signs and symptoms of tuberculosis, diagnosis of tuberculosis, causative agent, modes of infection and incubation period, risk factors of pulmonary tuberculosis Dots and stop TB programmes in Nigeria Treatment and prevention of tuberculosis TB treatment strategies, Dealing with treatment problems in Nigeria Stigmatization against Tuberculosis Patients Health education as a tool for achieving free tuberculosis country. Emphasis for Tb control has been placed on the development of improved vaccines, diagnostic and treatment courses but less on health education and awareness. Although the need for these tools is indisputable, the obstacle facing the spread of TB go beyond technological. The findings of this study may stimulate health system policy makers, Government and non- governmental organizations, donor agencies and other stakeholders in planning and designing health education intervention programs on the control and eradication of tuberculosis. It therefore recommended that Government should implement health education as part of the DOTs, this will thus empower the tuberculosis patients on ways to live healthy, lifestyle, in doing this, they will recover fast and prevent them from spreading the disease.

Keywords: tuberculosis, health education, panacea, Nigeria, prevention

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Authors: Stephanie Aguirre Moreno, Jesús Everardo Olguín Tiznado, Claudia Camargo Wilson, Juan Andrés López Barreras

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This research work presents a proposal to evaluate the environmental performance of a Higher Education Institution (HEI) in Mexico in order to minimize their environmental impact. Given that public education has limited financial resources, it is necessary to conduct studies that support priorities in decision-making situations and thus obtain the best cost-benefit ratio of continuous improvement programs as part of the environmental management system implemented. The methodology employed, adapted from the Environmental Effect Analysis (EEA), weighs the environmental aspects identified in the environmental diagnosis by two characteristics. Number one, environmental priority through the perception of the stakeholders, compliance of legal requirements, and environmental impact of operations. Number two, the possibility of improvement, which depends of factors such as the exchange rate that will be made, the level of investment and the return time of it. The highest environmental priorities, or hot spots, identified in this evaluation were: electricity consumption, water consumption and recycling, and disposal of municipal solid waste. However, the possibility of improvement for the disposal of municipal solid waste is higher, followed by water consumption and recycling, in spite of having an equal possibility of improvement to the energy consumption, time of return and cost-benefit is much greater.

Keywords: environmental performance, environmental priority, possibility of improvement, continuous improvement programs

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Authors: Prince Suka Neekia Momta, Rita Iheoma Achonyeulo

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Ant Tracking seismic attribute applied over 4-seconds seismic volume revealed structural features triggered by clay diapirism, growth fault development, rapid deltaic sedimentation and intense drilling. The attribute was extracted on vertical seismic sections and time slices. Mega tectonic structures such as growth faults and clay diapirs are visible on vertical sections with obscured minor lineaments or fractures. Fractures are distinctively visible on time slices yielding recognizable patterns corroborating established geologic models. This model seismic attribute enabled the understanding of fluid flow characteristics and production responses. Three structural patterns recognized in the field include: major growth faults, minor faults or lineaments and network of fractures. Three growth faults mapped on seismic section form major deformation bands delimiting the area into three blocks or depocenters. The growth faults trend E-W, dip down-to-south in the basin direction, and cut across the study area. The faults initiating from about 2000ms extended up to 500ms, and tend to progress parallel and opposite to the growth direction of an upsurging diapiric structure. The diapiric structures form the major deformational bands originating from great depths (below 2000ms) and rising to about 1200ms where series of sedimentary layers onlapped and pinchout stratigraphically against the diapir. Several other secondary faults or lineaments that form parallel streaks to one another also accompanied the growth faults. The fracture networks have no particular trend but form a network surrounding the well area. Faults identified in the study area have potentials for structural hydrocarbon traps whereas the presence of fractures created a fractured-reservoir condition that enhanced rapid fluid flow especially water. High aquifer flow potential aided by possible fracture permeability resulted in rapid decline in oil rate. Through the application of Ant Tracking attribute, it is possible to obtain detailed interpretation of structures that can have direct influence on oil and gas production.

Keywords: seismic, attributes, production, structural

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Authors: M. Sunitha, B. Nithyavani, Mathew Yohannan, S. Thiruvieni Balajji, M. A. Rathi, C. Arul Raj, P. Ragavendran, V. K. Gopalkrishnan

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Establishment of an early and reliable biomarker for ovarian carcinogenesis whose expression can be monitored through noninvasive techniques will enable early diagnosis of cancer. Carbonic anhydrases (CA) isozymes IX and XII have been suggested to play a role in oncogenic processes. In von Hippel-Lindau (VHL)-defective tumors, the cell surface transmembrane carbonic anhydrase (CA) CA XI and CA XII genes are overexpressed because of the absence of pVHL. These enzymes are involved in causing a hypoxia condition, thereby providing an environment for metastasis. Aberrant expression of the facilitative glucose transporter GLUT I is found in a wide spectrum of epithelial malignancies. Studying the mRNA expression of CA IX, CA XII and Glut I isozymes in ovarian cancer cell lines (OAW-42 and PA-1) revealed the expression of these hypoxia genes. Immunohistochemical staining of carbonic anhydrases was also performed in 40 ovarian cancer tissues. CA IX and CA XII were expressed at 540 bp and 520 bp in OAW42, PA1 in ovarian cancer cell lines. GLUT-1 was expressed at 325bp in OAW 42, PA1 genes in ovarian cancer cell lines. Immunohistochemistry revealed high to moderate levels of expression of these enzymes. The immuostaining was seen predominantly on the cell surface membrane. The study concluded that these genes CA IX, CA XII and Glut I are expressed under hypoxic condition in tumor cells. From the present results expression of CA IX, XII and Glut I may represent potential targets in ovarian cancer therapy.

Keywords: ovarian cancer, carbonic anhydrase IX, XII, Glut I, tumor markers

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Authors: Horesh Reinman Netta

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Objectives: To examine the relationship between stressful life events and recurrent major depressive disorders Methods: Three groups of 50 subjects were assessed. One group had a recurrent major depressive disorder with melancholic features; the second group met the criteria for borderline personality disorder, and the third consisted of healthy controls. The Structured Clinical Interview for AXIS I DSM-IV Disorders sand the Structured Clinical Interview for AXIS II DSM-IV Disorders were used for diagnosis. The Israel Psychiatric Epidemiology Research Interview (IPERI) Life Event Scale and the Coddington Life Events Schedule (CLES) were used to measure life events which were confirmed with a confirmatory semi-structured interview. The Beck Depression Inventory and the Satisfaction from Life scales were also administered. Results : The total number of loss-related events in childhood and in the year preceding the first episode was significantly higher in the affective disorder group than in the two control groups. Total number of LE, uncontrolled and independent events were also more common in the depressed patients in the year preceding the first episode. No category of SLE was differentiated among any of the three groups during any period of time following the first depressive episode. Conclusions: SLE play an important role in the onset of affective disorders. There appear to be specific kinds of SLE occurring in childhood and in the year preceding a first episode that have particular significance. SLE may have a lesser role in the maintenance of this illness.

Keywords: modd dosorders, recurrent depression, stress, life events

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Authors: Sadie Khorramnia, Asha Bonney, Kate Galloway, Andrew Kyoong

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Sleep plays a pivotal role in the registration and consolidation of memory. Multiple observational studies have demonstrated that self-reported sleep duration and sleep quality are associated with cognitive performance. Montreal Cognitive Assessment questionnaire is a screening tool to assess mild cognitive (MCI) impairment with a 90% diagnostic sensitivity. In our current study, we used MOCA to identify MCI in patients who underwent sleep study in our sleep department. We then looked at the clinical risk factors and sleep-related parameters in subjects found to have mild cognitive impairment but without a diagnosis of sleep-disordered breathing. Clinical risk factors, including physician, diagnosed hypertension, diabetes, and depression and sleep-related parameters, measured during sleep study, including percentage time of each sleep stage, total sleep time, awakenings, sleep efficiency, apnoea hypopnoea index, and oxygen saturation, were evaluated. A total of 90 subjects who underwent sleep study between March 2019 and October 2019 were included. Currently, there is no pharmacotherapy available for MCI; therefore, identifying the risk factors and attempting to reverse or mitigate their effect is pivotal in slowing down the rate of cognitive deterioration. Further characterization of sleep parameters in this group of patients could open up opportunities for potentially beneficial interventions.

Keywords: apnoea hypopnea index, mild cognitive impairment, sleep architecture, sleep study

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Authors: Noel Busch-Armendariz, Caitlin Sulley

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Introduction: This study investigated the development of college experiences, COVID-19 pandemic experiences, alcohol use, and sexual violence. The longitudinal study includes 656 college students living in the same dormitory. Students' alcohol use and social network structure were investigated to better understand the relationship with sexual violence risk. Basic Methodologies: Over two years, students repeated five web-based surveys, including a pre-college survey and surveys during four consecutive semesters. Questions were added in the fourth wave to assess students’ experiences of the COVID-19 pandemic, administered from November-January 2021, including mental and behavioral health. Analyses include the impact of COVID on living arrangements, drinking behaviors, and daily life; experiences of COVID symptoms, testing, and diagnosis, responses to COVID such as social distancing, quarantining, not working, increased health care needs; experience of fear, worry, stigma, emotional well-being, loneliness, and mental health; experiences of financial loss, lack of basic supplies, receiving emotional and financial support, and comparison with academic disengagement. Concluding Statement: Findings and discussion will include strategies to strengthen mental and behavioral health programs and policies.

Keywords: COVID, mental health, substance abuse, college students, sexual misconducts

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