Search results for: medical equipment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4861

Search results for: medical equipment

3061 The Nursing Experience in a Stroke Patient after Lumbar Surgery at Surgical Intensive Care Unit

Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao

Abstract:

The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.

Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery

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3060 Addressing Head Transplantation and Its Legal, Social and Neuroethical Implications

Authors: Joseph P. Mandala

Abstract:

This paper examines the legal and medical ethics concerns, which proponents of human head transplantation continue to defy since the procedure was first attempted on dogs in 1908. Despite recent bioethical objections, proponents have proceeded with radical experimentation, claiming transplantation would treat incurable diseases and improve patients’ quality of life. In 2018, Italian neurosurgeon, Sergio Canavero, and Dr. Xiaoping Ren claimed to have performed a head transplant on a corpse in China. Content analysis of literature shows that the procedure failed to satisfy scientific, legal, and bioethical elements because, unlike humans, corpses cannot coordinate function. Putting a severed head onto a body that has been dead for several days is not equivalent to a transplant which would require successfully reconnecting and restoring function to a spinal cord. While reconnection without restoration of bodily function is not transplantation, the publicized procedure on animals and corpses could leapfrog to humans, sparking excitement in society likely to affect organ donors and recipients from territorial jurisdictions with varying legal and ethical regimes. As neurodiscoveries generate further excitement, the need to preemptively address the legal and medical ethics impact of head transplantation in our society cannot be overstated. A preemptive development of methods to address the impact of head transplantation will help harmonizing national and international laws on organ donations, advance directives, and laws affecting end of life.

Keywords:

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3059 Impact of Leadership Styles on Work Motivation and Organizational Commitment among Faculty Members of Public Sector Universities in Punjab

Authors: Wajeeha Shahid

Abstract:

The study was designed to assess the impact of transformational and transactional leadership styles on work motivation and organizational commitment among faculty members of universities of Punjab. 713 faculty members were selected as sample through convenient random sampling technique. Three self-constructed questionnaires namely Leadership Styles Questionnaire (LSQ), Work Motivation Questionnaire (WMQ) and Organizational Commitment Questionnaire (OCMQ) were used as research instruments. Major objectives of the study included assessing the effect and impact of transformational and transactional leadership styles on work motivation and organizational commitment. Theoretical frame work of the study included Idealized Influence, Inspirational Motivation, Intellectual Stimulation, Individualized Consideration, Contingent Rewards and Management by Exception as independent variables and Extrinsic motivation, Intrinsic motivation, Affective commitment, Continuance commitment and Normative commitment as dependent variables. SPSS Version 21 was used to analyze and tabulate data. Cronbach's Alpha reliability, Pearson Correlation and Multiple regression analysis were applied as statistical treatments for the analysis. Results revealed that Idealized Influence correlated significantly with intrinsic motivation and Affective commitment whereas Contingent rewards had a strong positive correlation with extrinsic motivation and affective commitment. Multiple regression models revealed a variance of 85% for transformational leadership style over work motivation and organizational commitment. Whereas transactional style as a predictor manifested a variance of 79% for work motivation and 76% for organizational commitment. It was suggested that changing organizational cultures are demanding more from their leadership. All organizations need to consider transformational leadership style as an important part of their equipment in leveraging both soft and hard organizational targets.

Keywords: leadership styles, work motivation, organizational commitment, faculty member

Procedia PDF Downloads 308
3058 Wrong Site Surgery Should Not Occur In This Day And Age!

Authors: C. Kuoh, C. Lucas, T. Lopes, I. Mechie, J. Yoong, W. Yoong

Abstract:

For all surgeons, there is one preventable but still highly occurring complication – wrong site surgeries. They can have potentially catastrophic, irreversible, or even fatal consequences on patients. With the exponential development of microsurgery and the use of advanced technological tools, the consequences of operating on the wrong side, anatomical part, or even person is seen as the most visible and destructive of all surgical errors and perhaps the error that is dreaded by most clinicians as it threatens their licenses and arouses feelings of guilt. Despite the implementation of the WHO surgical safety checklist more than a decade ago, the incidence of wrong-site surgeries remains relatively high, leading to tremendous physical and psychological repercussions for the clinicians involved, as well as a financial burden for the healthcare institution. In this presentation, the authors explore various factors which can lead to wrong site surgery – a combination of environmental and human factors and evaluate their impact amongst patients, practitioners, their families, and the medical industry. Major contributing factors to these “never events” include deviations from checklists, excessive workload, and poor communication. Two real-life cases are discussed, and systems that can be implemented to prevent these errors are highlighted alongside lessons learnt from other industries. The authors suggest that reinforcing speaking-up, implementing medical professional trainings, and higher patient’s involvements can potentially improve safety in surgeries and electrosurgeries.

Keywords: wrong side surgery, never events, checklist, workload, communication

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3057 Prostatic Cyst in Suprapubic Ultrasound Examination

Authors: Angelis P. Barlampas, Ghita Bianca-Andreea

Abstract:

A case of a prostatic midline cyst is presented, which was found during a routine general ultrasound examination in an otherwise healthy young man. The incidence of prostatic cysts discovered in suprapubic ultrasound examination has constantly been rising over the previous decades. Despite the fact that the majority of them are benign, a significant amount is related to symptoms, such as pain, dysuria, infertility, and even cancer. The wide use of ultrasound examination and the increasing availability of high-resolution ultrasound systems have rendered new diagnostic challenges. Once upon a time a suprapubic ultrasound was only useful for measuring only the size and the dimensions of the prostatic gland. It did not have the ability to analyze and resolve structures such as cystic or solid nodules. The current machine equipment has managed to depict the imaging characteristics of lesions with high acuity that compares of an intrarectal ultrasound. But the last one is a specialized examination, which demands expertise and good knowledge. Maybe the time has come for the general radiologist and, especially the one who uses suprapubic ultrasound, to pay more attention to the examination of the prostate gland and to take advantage of the superb abilities and the high resolution of the new ultrasound systems. That is exactly, what this case is emphasizing. The incidental discovery of prostatic cysts, and the relatively little available literature about managing them turns them into an interesting theme for exploring and studying. The prostatic cysts are further divided into midline and paramidline cysts, with the first being usually utricle cysts. A more precise categorization is as follows: A midline cystic lesion usually regards a Mullerian duct cyst, a prostatic utricle cyst, an ejaculatory duct cyst, a prostatic cystadenoma, a ductus deferens cyst, and a TURP. On the other hand, a lateral cystic lesion usually refers to a cystic degeneration of benign prostatic hyperplasia, a prostatic retention cyst, a seminal vesicle cyst, diverticular prostatitis, a prostatic abscess, cavitatory prostatitis from chronic prostatitis, a parasitic prostatic cyst, a cystic prostatic carcinoma, e.t.c.

Keywords: prostatic cyst, radiology, benign prostatic lesions, prostatic cancer, suprapubic prostatic ultrasound

Procedia PDF Downloads 58
3056 Development of a Large-Scale Cyclic Shear Testing Machine Under Constant Normal Stiffness

Authors: S. M. Mahdi Niktabara, K. Seshagiri Raob, Amit Kumar Shrivastavac, Jiří Ščučkaa

Abstract:

The presence of the discontinuity in the form of joints is one of the most significant factors causing instability in the rock mass. On the other hand, dynamic loads, including earthquake and blasting induce cyclic shear loads along the joints in rock masses; therefore, failure of rock mass exacerbates along the joints due to changing shear resistance. Joints are under constant normal load (CNL) and constant normal stiffness (CNS) conditions. Normal stiffness increases on the joints with increasing depth, and it can affect shear resistance. For correct assessment of joint shear resistance under varying normal stiffness and number of cycles, advanced laboratory shear machine is essential for the shear test. Conventional direct shear equipment has limitations such as boundary conditions, working under monotonic movements only, or cyclic shear loads with constant frequency and amplitude of shear loads. Hence, a large-scale servo-controlled direct shear testing machine was designed and fabricated to perform shear test under the both CNL and CNS conditions with varying normal stiffness at different frequencies and amplitudes of shear loads. In this study, laboratory cyclic shear tests were conducted on non-planar joints under varying normal stiffness. In addition, the effects of different frequencies and amplitudes of shear loads were investigated. The test results indicate that shear resistance increases with increasing normal stiffness at the first cycle, but the influence of normal stiffness significantly decreases with an increase in the number of shear cycles. The frequency of shear load influences on shear resistance, i.e. shear resistance increases with increasing frequency. However, at low shear amplitude the number of cycles does not affect shear resistance on the joints, but it decreases with higher amplitude.

Keywords: cyclic shear load, frequency of load, amplitude of displacement, normal stiffness

Procedia PDF Downloads 151
3055 A Dynamic Solution Approach for Heart Disease Prediction

Authors: Walid Moudani

Abstract:

The healthcare environment is generally perceived as being information rich yet knowledge poor. However, there is a lack of effective analysis tools to discover hidden relationships and trends in data. In fact, valuable knowledge can be discovered from application of data mining techniques in healthcare system. In this study, a proficient methodology for the extraction of significant patterns from the coronary heart disease warehouses for heart attack prediction, which unfortunately continues to be a leading cause of mortality in the whole world, has been presented. For this purpose, we propose to enumerate dynamically the optimal subsets of the reduced features of high interest by using rough sets technique associated to dynamic programming. Therefore, we propose to validate the classification using Random Forest (RF) decision tree to identify the risky heart disease cases. This work is based on a large amount of data collected from several clinical institutions based on the medical profile of patient. Moreover, the experts’ knowledge in this field has been taken into consideration in order to define the disease, its risk factors, and to establish significant knowledge relationships among the medical factors. A computer-aided system is developed for this purpose based on a population of 525 adults. The performance of the proposed model is analyzed and evaluated based on set of benchmark techniques applied in this classification problem.

Keywords: multi-classifier decisions tree, features reduction, dynamic programming, rough sets

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3054 Optimisation Model for Maximising Social Sustainability in Construction Scheduling

Authors: Laura Florez

Abstract:

The construction industry is labour intensive, and the behaviour and management of workers have a direct impact on the performance of construction projects. One of the issues it currently faces is how to recruit and maintain its workers. Construction is known as an industry where workers face the problem of short employment durations, frequent layoffs, and periods of unemployment between jobs. These challenges not only creates pressures on the workers but also project managers have to constantly train new workers, face skills shortage, and uncertainty on the quality of the workers it will attract. To consider worker’s needs and project managers expectations, one practice that can be implemented is to schedule construction projects to maintain a stable workforce. This paper proposes a mixed integer programming (MIP) model to schedule projects with the objective of maximising social sustainability of construction projects, that is, maximise labour stability. Aside from the social objective, the model accounts for equipment and financial resources required by the projects during the construction phase. To illustrate how the solution strategy works, a construction programme comprised of ten projects is considered. The projects are scheduled to maximise labour stability while simultaneously minimising time and minimising cost. The tradeoff between the values in terms of time, cost, and labour stability allows project managers to consider their preferences and identify which solution best suits their needs. Additionally, the model determines the optimal starting times for each of the projects, working patterns for the workers, and labour costs. This model shows that construction projects can be scheduled to not only benefit the project manager, but also benefit current workers and help attract new workers to the industry. Due to its practicality, it can be a valuable tool to support decision making and assist construction stakeholders when developing schedules that include social sustainability factors.

Keywords: labour stability, mixed-integer programming (MIP), scheduling, workforce management

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3053 Review on Future Economic Potential Stems from Global Electronic Waste Generation and Sustainable Recycling Practices.

Authors: Shamim Ahsan

Abstract:

Abstract Global digital advances associated with consumer’s strong inclination for the state of art digital technologies is causing overwhelming social and environmental challenges for global community. During recent years not only economic advances of electronic industries has taken place at steadfast rate, also the generation of e-waste outshined the growth of any other types of wastes. The estimated global e-waste volume is expected to reach 65.4 million tons annually by 2017. Formal recycling practices in developed countries are stemming economic liability, opening paths for illegal trafficking to developing countries. Informal crude management of large volume of e-waste is transforming into an emergent environmental and health challenge in. Contrariwise, in several studies formal and informal recycling of e-waste has also exhibited potentials for economic returns both in developed and developing countries. Some research on China illustrated that from large volume of e-wastes generation there are recycling potential in evolving from ∼16 (10−22) billion US$ in 2010, to an anticipated ∼73.4 (44.5−103.4) billion US$ by 2030. While in another study, researcher found from an economic analysis of 14 common categories of waste electric and electronic equipment (WEEE) the overall worth is calculated as €2.15 billion to European markets, with a potential rise to €3.67 billion as volumes increase. These economic returns and environmental protection approaches are feasible only when sustainable policy options are embraced with stricter regulatory mechanism. This study will critically review current researches to stipulate how global e-waste generation and sustainable e-waste recycling practices demonstrate future economic development potential in terms of both quantity and processing capacity, also triggering complex some environmental challenges.

Keywords: E-Waste, , Generation, , Economic Potential, Recycling

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3052 Dietary Patterns and Adherence to the Mediterranean Diet among Breast Cancer Female Patients in Lebanon: A Cross-Sectional Study

Authors: Yasmine Aridi, Lara Nasreddine, Maya Khalil, Arafat Tfayli, Anas Mugharbel, Farah Naja

Abstract:

Breast cancer is the most commonly diagnosed cancer site among women worldwide and the second most common cause of cancer mortality. Breast cancer rates differ vastly between geographical areas, countries, and within the same country. In Lebanon, the proportion of breast cancer to all other sites of tumor is 38.2%; these rates are still lower than those observed worldwide, but remain the highest among Arab countries. Studies and evidence based reviews show a strong association between breast cancer development and prognosis and dietary habits, specifically the Mediterranean diet (MD). As such, the aim of this study is to examine dietary patterns and adherence to the MD among a sample of 182 breast cancer female patients in Beirut, Lebanon. Subjects were recruited from two major hospitals; a private medical center and a public hospital. All subjects were administered two questionnaires: socio- demographics and Mediterranean diet adherence. Five Mediterranean scores were calculated: MS, MSDPS, PMDI, PREDIMED and DDS. The mean age of the participants was 53.78 years. The overall adherence to the Mediterranean diet (MD) was low since the sample means of 3 out of the 5 calculated scores were less than the scores’ medians. Given that 4 out of the 5 Mediterranean scores significantly varied between the recruitment sites, women in the private medical center were found to adhere more to the MD. Our results also show that the majority of the sample population’s intakes are exceeding the recommendations for total and saturated fat, while meeting the requirements for fiber, EPA, DHA and Linolenic Acid. Participants in the private medical center were consuming significantly more calories, carbohydrates, fiber, sugar, Lycopene, Calcium, Iron and Folate and less fat. After conducting multivariate linear regression analyses, the following significant results were observed: positive associations between MD (CPMDI, PREDIMED) and monthly income & current state of health, while negative associations between MD (MSDPS, PREDIMED) and age & employment status. Our findings indicated a low overall adherence to the MD and identified factors associated with it; which suggests a need to address dietary habits among BC patients in Lebanon, specifically encouraging them to adhere to their traditional Mediterranean diet.

Keywords: Adherence, Breast cancer, Dietary patterns, Mediterranean diet, Nutrition

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3051 Investigations on the Influence of Web Openings on the Load Bearing Behavior of Steel Beams

Authors: Felix Eyben, Simon Schaffrath, Markus Feldmann

Abstract:

A building should maximize the potential for use through its design. Therefore, flexible use is always important when designing a steel structure. To create flexibility, steel beams with web openings are increasingly used, because these offer the advantage that cables, pipes and other technical equipment can easily be routed through without detours, allowing for more space-saving and aesthetically pleasing construction. This can also significantly reduce the height of ceiling systems. Until now, beams with web openings were not explicitly considered in the European standard. However, this is to be done with the new EN 1993-1-13, in which design rules for different opening forms are defined. In order to further develop the design concepts, beams with web openings under bending are therefore to be investigated in terms of damage mechanics as part of a German national research project aiming to optimize the verifications for steel structures based on a wider database and a validated damage prediction. For this purpose, first, fundamental factors influencing the load-bearing behavior of girders with web openings under bending load were investigated numerically without taking material damage into account. Various parameter studies were carried out for this purpose. For example, the factors under study were the opening shape, size and position as well as structural aspects as the span length, arrangement of stiffeners and loading situation. The load-bearing behavior is evaluated using resulting load-deformation curves. These results are compared with the design rules and critically analyzed. Experimental tests are also planned based on these results. Moreover, the implementation of damage mechanics in the form of the modified Bai-Wierzbicki model was examined. After the experimental tests will have been carried out, the numerical models are validated and further influencing factors will be investigated on the basis of parametric studies.

Keywords: damage mechanics, finite element, steel structures, web openings

Procedia PDF Downloads 174
3050 The Role of Artificial Intelligence in Creating Personalized Health Content for Elderly People: A Systematic Review Study

Authors: Mahnaz Khalafehnilsaz, Rozina Rahnama

Abstract:

Introduction: The elderly population is growing rapidly, and with this growth comes an increased demand for healthcare services. Artificial intelligence (AI) has the potential to revolutionize the delivery of healthcare services to the elderly population. In this study, the various ways in which AI is used to create health content for elderly people and its transformative impact on the healthcare industry will be explored. Method: A systematic review of the literature was conducted to identify studies that have investigated the role of AI in creating health content specifically for elderly people. Several databases, including PubMed, Scopus, and Web of Science, were searched for relevant articles published between 2000 and 2022. The search strategy employed a combination of keywords related to AI, personalized health content, and the elderly. Studies that utilized AI to create health content for elderly individuals were included, while those that did not meet the inclusion criteria were excluded. A total of 20 articles that met the inclusion criteria were identified. Finding: The findings of this review highlight the diverse applications of AI in creating health content for elderly people. One significant application is the use of natural language processing (NLP), which involves the creation of chatbots and virtual assistants capable of providing personalized health information and advice to elderly patients. AI is also utilized in the field of medical imaging, where algorithms analyze medical images such as X-rays, CT scans, and MRIs to detect diseases and abnormalities. Additionally, AI enables the development of personalized health content for elderly patients by analyzing large amounts of patient data to identify patterns and trends that can inform healthcare providers in developing tailored treatment plans. Conclusion: AI is transforming the healthcare industry by providing a wide range of applications that can improve patient outcomes and reduce healthcare costs. From creating chatbots and virtual assistants to analyzing medical images and developing personalized treatment plans, AI is revolutionizing the way healthcare is delivered to elderly patients. Continued investment in this field is essential to ensure that elderly patients receive the best possible care.

Keywords: artificial intelligence, health content, older adult, healthcare

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3049 Effect of Cardio-Specific Overexpression of MUL1, a Mitochondrial Protein on Myocardial Function

Authors: Ximena Calle, Plinio Cantero-López, Felipe Muñoz-Córdova, Mayarling-Francisca Troncoso, Sergio Lavandero, Valentina Parra

Abstract:

MUL1, a mitochondrial E3 ubiquitin ligase anchored to the outer mitochondrial membrane, is highly expressed in the heart. MUL1 is involved in multiple biological pathways associated with mitochondrial dynamics. Increased MUL1 affects the balance between fission and fusion, affecting mitochondrial function, which plays a crucial role in myocardial function. Therefore, it is interesting to evaluate the effect of cardiac-specific overexpression of MUL1 on myocardial function. Aim: To determine heart functionality in a mouse model with cardio-specific overexpression MUL1 protein. Methods and Results: Male C57BL/Tg transgenic mice with cardiomyocyte-specific overexpression of MUL1 (n=10) and control (n=4) were evaluated at 12, 27, and 35 weeks of age. Glucose tolerance curve determination was performed after a 6-hours fast to assess metabolic capacity, treadmill test, and systolic, and diastolic pressure was evaluated by the mouse tail-cuff blood pressure system equipment. The result showed no glucose tolerance curve, and the treadmill test demonstrated no significant changes between groups. However, substantial changes in diastolic function were observed by ultrasound and determination of cardiac hypertrophy proteins by western blot. Conclusions: Cardio-specific overexpression of MUL1 in mice without any treatment affects diastolic cardiac function, thus showing the important role contributed by MUL1 in the heart. Future research should evaluate the effect of cardiomyocyte-specific overexpression of MUL1 in pathological conditions such as a high-fat diet is one of the main risk factors for cardiovascular disease.

Keywords: diastolic dysfunction, hypertrophy cardiac, mitochondrial E3 ubiquitin ligase 1, MUL1

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3048 Awareness about Work-Related Hazards Causing Musculoskeletal Disorders

Authors: Bintou Jobe

Abstract:

Musculo-skeletal disorders (MSDs) are injuries or disorders of the spine disc, muscle strains, and low back injuries. It remains a major cause of occupational illness. Findings: Due to poor grips during handling, it is possible for neck, shoulder, arm, knees, ankle, fingers, waist, lower back injuries, and other muscle joints to be affected. Pregnant women are more prone to physical and hormonal changes, which lead to the relaxation of supporting ligaments. MSD continues to pose a global concern due to its impact on workers worldwide. The prevalence of the disorder is high, according to research into the workforce in Europe and developing countries. The causes are characterized by long working hours, insufficient rest breaks, poor posture, repetitive motion, poor manual handling techniques, psychological stress, and poor nutrition. To prevent MSD, the design mainly involves avoiding and assessing the risk. However, clinical solutions, policy governance, and minimizing manual labour are also an alternative. In addition, eating a balanced diet and teamwork force are key to elements in minimising the risk. This review aims to raise awareness and promote cost effectiveness prevention and understanding of MSD through research and identify proposed solutions to recognise the underlying causes of MSDs in the construction sectors. The methodology involves a literature review approach, engaging with the policy landscape of MSD, synthesising publications on MSD and a wider range of academic publications. In conclusion, training on effective manual handling techniques should be considered, and Personal Protective Equipment should be a last resort. The implementation of training guidelines has yielded significant benefits.

Keywords: musculoskeletal disorder work related, MSD, manual handling, work hazards

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3047 Web-Based Alcohol Prevention among Iranian Medical University Students: A Randomized Control Trail

Authors: Farzad Jalilian, Mehdi Mirzaei Alavijeh

Abstract:

Background: E-interventions as a universal approach to prevent a high-risk behavior, such as alcohol drinking. This study was conducted to evaluate web-based alcohol drinking preventative intervention efficiency among medical university students in Iran. Methods: Overall, 150 freshman and sophomore male student’s college students participated in this study as intervention and control group. This was a longitudinal randomized pre- and post-test series control group design panel study to implement a behavior modification based intervention to alcohol drinking prevention among college students. Cross-tabulation, t-test, repeated measures, and GEE by using SPSS statistical package, version 21 was used for the statistical analysis. The participants were followed up for 6 months with data collection scheduled at baseline, 3 and 6 months. The primary outcomes are attitude, self-control, and sensation seeking. Furthermore, the secondary outcome is comparing alcohol drinking among the study groups. Results: It was found significant reduce in average response for an attitude towards alcohol drinking and sensation seeking among intervention group (P < 0.05). But after intervention not significant difference between intervention and control group of improve self-control and reduce alcohol drinking (P > 0.05). Conclusion: Our intervention has been accompanied with reducing alcohol use rate. These findings indicate that e-intervention may be effectiveness approach to address the alcohol prevention among college students.

Keywords: e-interventions, alcohol drinking, students, Iran

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3046 A Retrospective Study of Suicidal Deaths in Madinah for Ten Years

Authors: Radah Yousuf, Ashraf Shebl

Abstract:

Suicide is a tragic event with strong emotional repercussions for its survivors and for families of its victims. There were thousands of cases all over the world. There are many risk factors include mental disorders such as depression, and substance abuse, including alcoholism and use of benzodiazepines. Other suicides are impulsive acts due to stress such as from financial difficulties, troubles with relationships, or from bullying. The aim of work in this study is making a survey from archives of the suicidal cases, which had a medicolegal examination, in forensic medicine center in Al Madinah Almunawarah-KSA, for ten years in the period between 1428-1438h. In each case, some data are collected such as age, sex, time and place of an act, method of suicide, the presence of the witness, medical history. This study demonstrates that suicide is more common in male than female, and the 4th decade was the most period of age. The most common method of suicide was hanging followed by falling from the height. These results indicated that cultural and religious beliefs that discourage suicide and support self-preservation instinct, and suicide education programs provide information to students in high school, builds awareness, one of the most important issues in solving that problem. From the forensic view, circumstantial evidence of every forensic case must take and record, full history about the social, medical and psychological problems, attend the scene of death is a very important, complete medicolegal investigation for every case, and full autopsy with very skilled techniques and facilities can help in diagnosing what type of crimes.

Keywords: suicide, age, sex, hanging

Procedia PDF Downloads 148
3045 Multi-Atlas Segmentation Based on Dynamic Energy Model: Application to Brain MR Images

Authors: Jie Huo, Jonathan Wu

Abstract:

Segmentation of anatomical structures in medical images is essential for scientific inquiry into the complex relationships between biological structure and clinical diagnosis, treatment and assessment. As a method of incorporating the prior knowledge and the anatomical structure similarity between a target image and atlases, multi-atlas segmentation has been successfully applied in segmenting a variety of medical images, including the brain, cardiac, and abdominal images. The basic idea of multi-atlas segmentation is to transfer the labels in atlases to the coordinate of the target image by matching the target patch to the atlas patch in the neighborhood. However, this technique is limited by the pairwise registration between target image and atlases. In this paper, a novel multi-atlas segmentation approach is proposed by introducing a dynamic energy model. First, the target is mapped to each atlas image by minimizing the dynamic energy function, then the segmentation of target image is generated by weighted fusion based on the energy. The method is tested on MICCAI 2012 Multi-Atlas Labeling Challenge dataset which includes 20 target images and 15 atlases images. The paper also analyzes the influence of different parameters of the dynamic energy model on the segmentation accuracy and measures the dice coefficient by using different feature terms with the energy model. The highest mean dice coefficient obtained with the proposed method is 0.861, which is competitive compared with the recently published method.

Keywords: brain MRI segmentation, dynamic energy model, multi-atlas segmentation, energy minimization

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3044 The Influence of Applying Mechanical Chest Compression Systems on the Effectiveness of Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest

Authors: Slawomir Pilip, Michal Wasilewski, Daniel Celinski, Leszek Szpakowski, Grzegorz Michalak

Abstract:

The aim of the study was to evaluate the effectiveness of cardiopulmonary resuscitation taken by Medical Emergency Teams (MET) at the place of an accident including the usage of mechanical chest compression systems. In the period of January-May 2017, there were 137 cases of a sudden cardiac arrest in a chosen region of Eastern Poland with 360.000 inhabitants. Medical records and questionnaires filled by METs were analysed to prove the effectiveness of cardiopulmonary resuscitations that were considered to be effective when an early indication of spontaneous circulation was provided and the patient was taken to hospital. A chest compression system used by METs was applied in 60 cases (Lucas3 - 34 patients; Auto Pulse - 24 patients). The effectiveness of cardiopulmonary resuscitation among patients who were employed a chest compression system was much higher (43,3%) than the manual cardiac massage (36,4%). Thus, the usage of Lucas3 chest compression system resulted in 47% while Auto Pulse was 33,3%. The average ambulance arrival time could have had a significant impact on the subsequent effectiveness of cardiopulmonary resuscitation in these cases. Ambulances equipped with Lucas3 reached the destination within 8 minutes, and those with Auto Pulse needed 12,1 minutes. Moreover, taking effective basic life support (BLS) by bystanders before the ambulance arrival was much more frequent for ambulances with Lucas3 than Auto Pulse. Therefore, the percentage of BLS among the group of patients who were employed Lucas3 by METs was 26,5%, and 20,8% for Auto Pulse. The total percentage of taking BLS by bystanders before the ambulance arrival resulted in 25% of patients who were later applied a chest compression system by METs. Not only was shockable cardiac rhythm obtained in 47% of these cases, but an early indication of spontaneous circulation was also provided in all these patients. Both Lucas3 and Auto Pulse were evaluated to be significantly useful in improving the effectiveness of cardiopulmonary resuscitation by 97% of Medical Emergency Teams. Therefore, implementation of chest compression systems essentially makes the cardiopulmonary resuscitation even more effective. The ambulance arrival time, taking successful BLS by bystanders before the ambulance arrival and the presence of shockable cardiac rhythm determine an early indication of spontaneous circulation among patients after a sudden cardiac arrest.

Keywords: cardiac arrest, effectiveness, mechanical chest compression systems, resuscitation

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3043 Return to Work after a Mental Health Problem: Analysis of Two Different Management Models

Authors: Lucie Cote, Sonia McFadden

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Mental health problems in the workplace are currently one of the main causes of absences. Research work has highlighted the importance of a collaborative process involving the stakeholders in the return-to-work process and has established the best management practices to ensure a successful return-to-work. However, very few studies have specifically explored the combination of various management models and determined whether they could satisfy the needs of the stakeholders. The objective of this study is to analyze two models for managing the return to work: the ‘medical-administrative’ and the ‘support of the worker’ in order to understand the actions and actors involved in these models. The study also aims to explore whether these models meet the needs of the actors involved in the management of the return to work. A qualitative case study was conducted in a Canadian federal organization. An abundant internal documentation and semi-directed interviews with six managers, six workers and four human resources professionals involved in the management of records of employees returning to work after a mental health problem resulted in a complete picture of the return to work management practices used in this organization. The triangulation of this data facilitated the examination of the benefits and limitations of each approach. The results suggest that the actions of management for employee return to work from both models of management ‘support of the worker’ and ‘medical-administrative’ are compatible and can meet the needs of the actors involved in the return to work. More research is needed to develop a structured model integrating best practices of the two approaches to ensure the success of the return to work.

Keywords: return to work, mental health, management models, organizations

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3042 Discrete-Event Modeling and Simulation Methodologies: Past, Present and Future

Authors: Gabriel Wainer

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Modeling and Simulation methods have been used to better analyze the behavior of complex physical systems, and it is now common to use simulation as a part of the scientific and technological discovery process. M&S advanced thanks to the improvements in computer technology, which, in many cases, resulted in the development of simulation software using ad-hoc techniques. Formal M&S appeared in order to try to improve the development task of very complex simulation systems. Some of these techniques proved to be successful in providing a sound base for the development of discrete-event simulation models, improving the ease of model definition and enhancing the application development tasks; reducing costs and favoring reuse. The DEVS formalism is one of these techniques, which proved to be successful in providing means for modeling while reducing development complexity and costs. DEVS model development is based on a sound theoretical framework. The independence of M&S tasks made possible to run DEVS models on different environments (personal computers, parallel computers, real-time equipment, and distributed simulators) and middleware. We will present a historical perspective of discrete-event M&S methodologies, showing different modeling techniques. We will introduce DEVS origins and general ideas, and compare it with some of these techniques. We will then show the current status of DEVS M&S, and we will discuss a technological perspective to solve current M&S problems (including real-time simulation, interoperability, and model-centered development techniques). We will show some examples of the current use of DEVS, including applications in different fields. We will finally show current open topics in the area, which include advanced methods for centralized, parallel or distributed simulation, the need for real-time modeling techniques, and our view in these fields.

Keywords: modeling and simulation, discrete-event simulation, hybrid systems modeling, parallel and distributed simulation

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3041 Misophonia and Its Relationship with Obsessive-compulsive Disorder, Anxiety, and Depression

Authors: Shahrzad Yektatalab, Agrin Mohammadi, Ladan Zarshenas

Abstract:

Background: Misophonia is a severe emotional response to repetitive sounds. This disorder may limit a person's communication, reduce their ability, or disrupt their social and personal life. This study aims to determine the prevalence of Misophonia and its relationship with obsessive-compulsive disorder, anxiety, and depression in undergraduate students of XXX University of Medical Sciences. Methods: The present study is an analytical descriptive study conducted in October 2020. The study samples are 390 undergraduate students of XXX University of medical sciences. A relative and systematic sampling method was used. In this study, a demographic questionnaire, misophonia questionnaire (A score of 7 or higher is considered as misophonia), Beck anxiety questionnaire, Beck depression questionnaire, and Maudsley questionnaire were used, and the data were analyzed using SPSS 24 software. Due to the non-normality of the data, the Spearman correlation coefficient was used for analyzing data. The significance level was considered less than 0.05. Results: 23.8% of students have misophonia. Of the 390 participants in the study, 93 had experienced misophonia. Among these 93 students, 37 (39.8%) had obsessive-compulsive disorder, 8 (8.6%) had anxiety and 9 (9.7%) had depression. There was a significant and direct relationship between all variables (p <0.001), which means that with the increase of each disorder, the probability of an increase in other disorders increases. Conclusion: Due to the high prevalence of misophonia in students and its direct relationship with obsessive-compulsive disorder, anxiety, and depression, It is recommended that future studies be conducted to identify ways to prevent and reduce the incidence of misophonia.

Keywords: misophonia, obsessive-compulsive disorder, anxiety, depression

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3040 The Arts in Medicine and Health: A Necessity for Evidence-Based Health Systems

Authors: Alan S. Weber

Abstract:

This contribution reviews the current biomedical and qualitative arts research on arts-in-health interventions to improve both individual and population health outcomes. Arts therapies–for example, music therapy with roots in Aristoxenus’s Ἁρμονικὰ στοιχεῖα and the Pythagorean sect–have long been employed in therapeutic contexts. However, the 20th century witnessed the increasing use of the visual and plastic arts (drawing, painting, sculpting), performing arts (drama and dance), and other expressive arts modalities into occupational therapy, well-being medicine, and psychological and psychiatric counselling, diagnosis, and treatment. A significant body of peer-reviewed evidence in the medical and neurological sciences on the role of arts-in-health has developed, and specifically, research on music and art therapy has led to their inclusion within the current biomedical paradigm of evidence-based practice. The arts cannot only aid in public and population health promotion (promoting healthy behaviors and lifestyles, preventing disease onset) but also in addressing psychological issues (regulation of emotion; stress, anxiety, and depression reduction), behavioural issues (basic life skills, coping), and physiological response (immune system function, hormonal regulation, homeostatis). Working as a cross-disciplinary researcher in the arts in an American medical college, the author has developed several successful arts-in-health programs at the national and international level.

Keywords: arts-in-health, evidence based medicine, arts for health, expressive arts therapies

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3039 Study of Mobile Game Addiction Using Electroencephalography Data Analysis

Authors: Arsalan Ansari, Muhammad Dawood Idrees, Maria Hafeez

Abstract:

Use of mobile phones has been increasing considerably over the past decade. Currently, it is one of the main sources of communication and information. Initially, mobile phones were limited to calls and messages, but with the advent of new technology smart phones were being used for many other purposes including video games. Despite of positive outcomes, addiction to video games on mobile phone has become a leading cause of psychological and physiological problems among many people. Several researchers examined the different aspects of behavior addiction with the use of different scales. Objective of this study is to examine any distinction between mobile game addicted and non-addicted players with the use of electroencephalography (EEG), based upon psycho-physiological indicators. The mobile players were asked to play a mobile game and EEG signals were recorded by BIOPAC equipment with AcqKnowledge as data acquisition software. Electrodes were places, following the 10-20 system. EEG was recorded at sampling rate of 200 samples/sec (12,000samples/min). EEG recordings were obtained from the frontal (Fp1, Fp2), parietal (P3, P4), and occipital (O1, O2) lobes of the brain. The frontal lobe is associated with behavioral control, personality, and emotions. The parietal lobe is involved in perception, understanding logic, and arithmetic. The occipital lobe plays a role in visual tasks. For this study, a 60 second time window was chosen for analysis. Preliminary analysis of the signals was carried out with Acqknowledge software of BIOPAC Systems. From the survey based on CGS manual study 2010, it was concluded that five participants out of fifteen were in addictive category. This was used as prior information to group the addicted and non-addicted by physiological analysis. Statistical analysis showed that by applying clustering analysis technique authors were able to categorize the addicted and non-addicted players specifically on theta frequency range of occipital area.

Keywords: mobile game, addiction, psycho-physiology, EEG analysis

Procedia PDF Downloads 165
3038 Carbon Footprint of Road Project for Sustainable Development: Lessons Learnt from Traffic Management of a Developing Urban Centre

Authors: Sajjad Shukur Ullah, Syed Shujaa Safdar Gardezi

Abstract:

Road infrastructure plays a vital role in the economic activities of any economy. Besides derived benefits from these facilities, the utilization of extensive energy resources, fuels, and materials results in a negative impact on the environment in terms of carbon footprint; carbon footprint is the overall amount of greenhouse gas (GHG) generated from any action. However, this aspect of environmental impact from road structure is not seriously considered during such developments, thus undermining a critical factor of sustainable development, which usually remains unaddressed, especially in developing countries. The current work investigates the carbon footprint impact of a small road project (0.8 km, dual carriageway) initiated for traffic management in an urban centre. Life cycle assessment (LCA) with boundary conditions of cradle to the site has been adopted. The only construction phase of the life cycle has been assessed at this stage. An impact of 10 ktons-CO2 (6260 ton-CO2/km) has been assessed. The rigid pavement dominated the contributions as compared to a flexible component. Among the structural elements, the underpass works shared the major portion. Among the materials, the concrete and steel utilized for various structural elements resulted in more than 90% of the impact. The earth-moving equipment was dominant in operational carbon. The results have highlighted that road infrastructure projects pose serious threats to the environment during their construction and which need to be considered during the approval stages. This work provides a guideline for supporting sustainable development that could only be ensured when such endeavours are properly assessed by industry professionals and decide various alternative environmental conscious solutions for the future.

Keywords: construction waste management, kiloton, life cycle assessment, rigid pavement

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3037 Men’s Attendance in Labour and Birth Room: A Choice and Coercion in Childbirth

Authors: A/Prof Marjan Khajehei

Abstract:

In the last century, the role of fathers in the birth has changed exponentially. Before the 1970s, the principal view was that birth was a female business and not a man’s place. Changing cultural and professional attitudes around the emotional bond between a man and a woman, family structure and the more proactive involved role of men in the family have encouraged fathers’ attendance at birth. There is evidence that fathers’ support can make birthing less traumatic for some women and can make couples closer. This has made some clinicians to believe the fathers should be more involved throughout the birth process. Some clinicians even go further and ask the fathers to watch the medical procedures, such as inserting vaginal speculum, forceps or vacuum, episiotomy and stitches. Although birth can unfold like a beautiful picture captured by birth photographers, with fathers massaging women’s backs by candle light and the miraculous moment of birth, it can be overshadowed by less attractive images of cervical mucous, emptying bowels and the invasive medical procedures. What happens in the birth room and the fathers’ reaction to the graphic experience of birthing can be unpredictable. Despite the fact that most men are absolutely thrilled to be in the delivery room, for some men, a very intimate body part can become completely desexualised, and they can experience psychological and sexual scarring. They see someone they cherish dramatically sliced open and can then associate their partners with a disturbing scene, and it can dramatically affect their relationships. While most women want the expectant fathers by their side for this life-changing event, not all of them may be happy for their partners to watch the perineum to be cut or stitched or when large blades of forceps are inserted inside the vagina. Anecdotal reports have shown that consent is not sought from the labouring women as to whether they want their partners to watch these procedures. The majority of research1, 2, 3 focuses on men’s and women’s retrospective attitudes towards their birth experience. However, the effect of witnessing invasive procedures during childbirth on a man's attraction to his partner, while she is most vulnerable, and also an increased risk of post-traumatic stress disorder in fathers have not been widely investigated. There is a lack of sufficient research investigating whether women need to be asked for their consent before inviting their partners to closely watch medical procedures during childbirth. Future research is required to provide a basis for better awareness and involve the consumers to understanding the men’s and women’s experience and their expectations for labour and birth.

Keywords: birth, childbirth, father, labour, men, women

Procedia PDF Downloads 127
3036 LTE Performance Analysis in the City of Bogota Northern Zone for Two Different Mobile Broadband Operators over Qualipoc

Authors: Víctor D. Rodríguez, Edith P. Estupiñán, Juan C. Martínez

Abstract:

The evolution in mobile broadband technologies has allowed to increase the download rates in users considering the current services. The evaluation of technical parameters at the link level is of vital importance to validate the quality and veracity of the connection, thus avoiding large losses of data, time and productivity. Some of these failures may occur between the eNodeB (Evolved Node B) and the user equipment (UE), so the link between the end device and the base station can be observed. LTE (Long Term Evolution) is considered one of the IP-oriented mobile broadband technologies that work stably for data and VoIP (Voice Over IP) for those devices that have that feature. This research presents a technical analysis of the connection and channeling processes between UE and eNodeB with the TAC (Tracking Area Code) variables, and analysis of performance variables (Throughput, Signal to Interference and Noise Ratio (SINR)). Three measurement scenarios were proposed in the city of Bogotá using QualiPoc, where two operators were evaluated (Operator 1 and Operator 2). Once the data were obtained, an analysis of the variables was performed determining that the data obtained in transmission modes vary depending on the parameters BLER (Block Error Rate), performance and SNR (Signal-to-Noise Ratio). In the case of both operators, differences in transmission modes are detected and this is reflected in the quality of the signal. In addition, due to the fact that both operators work in different frequencies, it can be seen that Operator 1, despite having spectrum in Band 7 (2600 MHz), together with Operator 2, is reassigning to another frequency, a lower band, which is AWS (1700 MHz), but the difference in signal quality with respect to the establishment with data by the provider Operator 2 and the difference found in the transmission modes determined by the eNodeB in Operator 1 is remarkable.

Keywords: BLER, LTE, network, qualipoc, SNR.

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3035 Groundwater Investigation Using Resistivity Method and Drilling for Irrigation during the Dry Season in Lwantonde District, Uganda

Authors: Tamale Vincent

Abstract:

Groundwater investigation is the investigation of underground formations to understand the hydrologic cycle, known groundwater occurrences, and identify the nature and types of aquifers. There are different groundwater investigation methods and surface geophysical method is one of the groundwater investigation more especially the Geoelectrical resistivity Schlumberger configuration method which provides valuable information regarding the lateral and vertical successions of subsurface geomaterials in terms of their individual thickness and corresponding resistivity values besides using surface geophysical method, hydrogeological and geological investigation methods are also incorporated to aid in preliminary groundwater investigation. Investigation for groundwater in lwantonde district has been implemented. The area project is located cattle corridor and the dry seasonal troubles the communities in lwantonde district of which 99% of people living there are farmers, thus making agriculture difficult and local government to provide social services to its people. The investigation was done using the Geoelectrical resistivity Schlumberger configuration method. The measurement point is located in the three sub-counties, with a total of 17 measurement points. The study location is at 0025S, 3110E, and covers an area of 160 square kilometers. Based on the results of the Geoelectrical information data, it was found two types of aquifers, which are open aquifers in depth ranging from six meters to twenty-two meters and a confined aquifer in depth ranging from forty-five meters to eighty meters. In addition to the Geoelectrical information data, drilling was done at an accessible point by heavy equipment in the Lwakagura village, Kabura sub-county. At the drilling point, artesian wells were obtained at a depth of eighty meters and can rise to two meters above the soil surface. The discovery of artesian well is then used by residents to meet the needs of clean water and for irrigation considering that in this area most wells contain iron content.

Keywords: artesian well, geoelectrical, lwantonde, Schlumberger

Procedia PDF Downloads 124
3034 An Analysis of the Impact of Immunosuppression upon the Prevalence and Risk of Cancer

Authors: Aruha Khan, Brynn E. Kankel, Paraskevi Papadopoulou

Abstract:

In recent years, extensive research upon ‘stress’ has provided insight into its two distinct guises, namely the short–term (fight–or–flight) response versus the long–term (chronic) response. Specifically, the long–term or chronic response is associated with the suppression or dysregulation of immune function. It is also widely noted that the occurrence of cancer is greatly correlated to the suppression of the immune system. It is thus necessary to explore the impact of long–term or chronic stress upon the prevalence and risk of cancer. To what extent can the dysregulation of immune function caused by long–term exposure to stress be controlled or minimized? This study focuses explicitly upon immunosuppression due to its ability to increase disease susceptibility, including cancer itself. Based upon an analysis of the literature relating to the fundamental structure of the immune system alongside the prospective linkage of chronic stress and the development of cancer, immunosuppression may not necessarily correlate directly to the acquisition of cancer—although it remains a contributing factor. A cross-sectional analysis of the survey data from the University of Tennessee Medical Center (UTMC) and Harvard Medical School (HMS) will provide additional supporting evidence (or otherwise) for the hypothesis of the study about whether immunosuppression (caused by the chronic stress response) notably impacts the prevalence of cancer. Finally, a multidimensional framework related to education on chronic stress and its effects is proposed.

Keywords: immune system, immunosuppression, long–term (chronic) stress, risk of cancer

Procedia PDF Downloads 134
3033 Bridging the Gaping Levels of Information Entree for Visually Impaired Students in the Sri Lankan University Libraries

Authors: Wilfred Jeyatheese Jeyaraj

Abstract:

Education is a key determinant of future success, and every person deserves non-discriminant access to information for educational inevitabilities in any case. Analysing and understanding complex information is a crucial learning tool, especially for students. In order to compete equally with sighted students, visually impaired students require the unhinged access to access to all the available information resources. When the education of visually impaired students comes to a focal point, it can be stated that visually impaired students encounter several obstacles and barriers before they enter the university and during their time there as students. These obstacles and barriers are spread across technical, organizational and social arenas. This study reveals the possible approaches to absorb and benefit from the information provided by the Sri Lankan University Libraries for visually impaired students. Purposive sampling technique was used to select sample visually impaired students attached to the Sri Lankan National universities. There are 07 National universities which accommodate the visually impaired students and with the identified data, they were selected for this study and 80 visually impaired students were selected as the sample group. Descriptive type survey method was used to collect data. Structured questionnaires, interviews and direct observation were used as research instruments. As far as the Sri Lankan context spread is concerned, visually impaired students are able to finish their courses through their own determination to overcome the barriers they encounter on their way to graduation, through moral and practical support from their own friends and very often through a high level of creativity. According to the findings there are no specially trained university librarians to serve visually impaired users and less number of assistive technology equipment are available at present. This paper enables all university libraries in Sri Lanka to be informed about the social isolation of visually compromised students at the Sri Lankan universities and focuses on the rectification issues by considering their distinct case for interaction.

Keywords: information access, Sri Lanka, university libraries, visual impairment

Procedia PDF Downloads 235
3032 Medical Dressing Induced Digital Ischemia in Patient with Congenital Insensitivity to Pain and Anhidrosis

Authors: Abdulwhab Alotaibi, Abdullah Alzahrani, Ziyad Bokhari, Abdulelah Alghamdi

Abstract:

First described in 1975 by Dr. Miller, Medical dressings are uncommon but possible cause of hand digital ischemia due the tourniquet-like effect. The incident of this complication has been reported across wide range of age-groups, yet it seems like that the pediatric population are specifically vulnerable. Multiple dressing types were reported to have caused ischemic injury, such as elastic wrap, tubular gauze, and self-adherent dressings. We present a case of medical dressing induced digital ischemia in patient with Congenital insensitivity to pain and anhidrosis (CIPA), which further challenge the discovery of the condition. An 8-year-old girl known case of CIPA. Brought by her mother to the ER after nail bed injury, which she managed by application of elastic wrap that was left for 24 hours. When the mother found out she immediately removed the elastic band, and noticed the fingertip was black and cold with tense bullae. The color then changed later when she arrived to the ER to dark purple with bluish discoloration on the tip. On examination there was well demarcated tense bullae on the distal right fifth finger. Neurovascular intact, pulse oximetry on distal digit 100%, capillary refill time was delayed. She was seen under Plastic surgery and conservative management recommended, and patient was discharged with safety netting. Two days later the patient came as follow-up visit at which her condition demonstrated significant improvement, the bullae has since ruptured leaving behind sloughed skin, capillary refill and pulse oximetry were both within normal limits, sensory function couldn’t be assessed but her motor function and ROM were normal, topical bacitracin and bandage dressings were applied for the eroded skin. Patient was scheduled for a follow-up in 2 weeks. Preventatively it’s advisable to avoid the commonly implicated dressings such as elastic, tubular gauze or self-adherent wraps in hand or digital injuries when possible, but in cases where the use of these dressings is of necessity the appropriate precautions must be taken, Dr. Makarewich proposed the following 5 measures to help minimize the incidence of the injury: 1-Unwrapping 12 inches of the dressing before rolling the injured finger. 2-Wrapping from distal to proximal with minimal tension to avoid vascular embarrassment. 3-The use of 5-25 inch to overlap the entire wrap. 4-Maintaining light pressure over the wrap to allow adherence of the dressing. 5-Minimization of the number of layers used to wrap the affected digit. Also assessing the capillary refill after the application can help in determining the patency of the supplying blood vessels. It’s also important to selectively determine if the patient is a candidate for conservative management, as tailored approach can help in maximizing the positive outcomes for our patients.

Keywords: congenital insensitivity to pain, digital ischemia, medical dressing, conservative management

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