Search results for: endotracheal tubes
131 Correlation to Predict Thermal Performance According to Working Fluids of Vertical Closed-Loop Pulsating Heat Pipe
Authors: Niti Kammuang-lue, Kritsada On-ai, Phrut Sakulchangsatjatai, Pradit Terdtoon
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The objectives of this paper are to investigate effects of dimensionless numbers on thermal performance of the vertical closed-loop pulsating heat pipe (VCLPHP) and to establish a correlation to predict the thermal performance of the VCLPHP. The CLPHPs were made of long copper capillary tubes with inner diameters of 1.50, 1.78, and 2.16mm and bent into 26 turns. Then, both ends were connected together to form a loop. The evaporator, adiabatic, and condenser sections length were equal to 50 and 150 mm. R123, R141b, acetone, ethanol, and water were chosen as variable working fluids with constant filling ratio of 50% by total volume. Inlet temperature of heating medium and adiabatic section temperature was constantly controlled at 80 and 50oC, respectively. Thermal performance was represented in a term of Kutateladze number (Ku). It can be concluded that when Prandtl number of liquid working fluid (Prl), and Karman number (Ka) increases, thermal performance increases. On contrary, when Bond number (Bo), Jacob number (Ja), and Aspect ratio (Le/Di) increases, thermal performance decreases. Moreover, the correlation to predict more precise thermal performance has been successfully established by analyzing on all dimensionless numbers that have effect on the thermal performance of the VCLPHP.Keywords: vertical closed-loop pulsating heat pipe, working fluid, thermal performance, dimensionless parameter
Procedia PDF Downloads 414130 Extracting the Atmospheric Carbon Dioxide and Convert It into Useful Minerals at the Room Conditions
Authors: Muthana A. M. Jamel Al-Gburi
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Elimination of carbon dioxide (CO2) gas from our atmosphere is very important but complicated, and since there is always an increase in the gas amounts of the other greenhouse ones in our atmosphere, causes by both some of the human activities and the burning of the fossil fuels, which leads to the Global Warming phenomena i.e., increasing the earth temperature to a higher level, creates desertification, tornadoes and storms. In our present research project, we constructed our own system to extract carbon dioxide directly from the atmospheric air at the room conditions and investigated how to convert the gas into a useful mineral or Nano scale fibers made of carbon by using several chemical processes and chemical reactions leading to a valuable building material and also to mitigate the environmental negative change. In the present water pool system (Carbone Dioxide Domestic Extractor), the ocean-sea water was used to dissolve the CO2 gas from the room and converted into carbonate minerals by using a number of additives like shampoo, clay and MgO. Note that the atmospheric air includes CO2 gas has circulated within the sea water by air pump connected to a perforated tubes fixed deep on the pool base. Those chemical agents were mixed with the ocean-sea water to convert the formed acid from the water-CO2 reaction into a useful mineral. After we successfully constructed the system, we did intense experiments and investigations on the CO2 gas reduction level and found which is the optimum active chemical agent to work in the atmospheric conditions.Keywords: global warming, CO₂ gas, ocean-sea water, additives, solubility level
Procedia PDF Downloads 80129 The Utilization of Rain Water to Ground Water with Tube in the Area of Tourism in Yogyakarta
Authors: Kurniawan Agung Pambudi, Alfian Deo Pradipta
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Yogyakarta is the famous tourism city in Indonesia. The Tugu Jogja is a tourism center located in Jetis. To support the tourism activities required facilities such as tourist hotel and guest house. The existence of tourism also has an impact on the environment. The surface of the land is covered by cement and a local company dealing in ceramics, then an infiltration process is not running. The existence of the building in layers resulting in the amount of water resource in Jetis decreases. The purpose of this research is to know the impact of the construction of the building in layers in Jetis. To obtain the data done by observation, measurements and taking the land profile, along with the interview to people in Jetis. The results of the study showed that the number of water sources in Jetis, Yogyakarta start decreases as a result of the construction of the building on stilts as a result, the height of the surface of the groundwater decreases and digging a pit must be in to get the source of the waters. Based on the results of research it can be concluded that the height of the surface of the groundwater decreases. To resolve the issue required a method to rainwater can seep into the ground for maximum. The rain that fell upon the precarious houses or other buildings is channeled toward the ground through the tubes with the depth of 1-2 meters. Rainwater will be absorbed into the land and increase the amount of ground water.Keywords: rain water, tube, water resource, groundwater
Procedia PDF Downloads 223128 Production of Amorphous Boron Powder via Chemical Vapor Deposition (CVD)
Authors: Meltem Bolluk, Ismail Duman
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Boron exhibits the properties of high melting temperature (2273K to 2573 K), high hardness (Mohs: 9,5), low density (2,340 g/cm3), high chemical resistance, high strength, and semiconductivity (band gap:1,6-2,1 eV). These superior properties enable to use it in several high-tech areas from electronics to nuclear industry and especially in high temperature metallurgy. Amorphous boron and crystalline boron have different application areas. Amorphous boron powder (directly amorphous and/or α-rhombohedral) is preferred in rocket firing, airbag inflating and in fabrication of superconducting MgB2 wires. The conventional ways to produce elemental boron with a purity of 85 pct to 95 prc are metallothermic reduction, fused salt electrolysis and mechanochemical synthesis; but the only way to produce high-purity boron powders is Chemical Vapour Deposition (Hot Surface CVD). In this study; amorphous boron powders with a minimum purity of 99,9 prc were synthesized in quartz tubes using BCl3-H2 gas mixture by CVD. Process conditions based on temperature and gas flow rate were determined. Thermodynamical interpretation of BCl3-H2 system for different temperatures and molar rates were performed using Fact Sage software. The characterization of powders was examined by using Xray diffraction (XRD), Scanning Electron Microscope (SEM) and Transmission Electron Microscope (TEM), Stereo Microscope (SM), Helium gas pycnometer analysis. The purities of final products were determined by titration after lime fusion.Keywords: amorphous boron, CVD, powder production, powder characterization
Procedia PDF Downloads 217127 Effect of Constant and Variable Temperature on the Morphology of TiO₂ Nanotubes Prepared by Two-Step Anodization Method
Authors: Tayyaba Ghani, Mazhar Mehmood, Mohammad Mujahid
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TiO₂ nanotubes are receiving immense attraction in the field of dye-sensitized solar cells due to their well-defined nanostructures, efficient electron transport and large surface area as compared to other one dimensional structures. In the present work, we have investigated the influence of temperature on the morphology of anodically produced self-organized Titanium oxide nanotubes (TiNTs). TiNTs are synthesized by two-step anodization method in an ethylene glycol based electrolytes containing ammonium fluoride. Experiments are performed at constant anodization voltage for two hours. An investigation by the SEM images reveals that if the temperature is kept constant during the anodizing experiment, variation in the average tube diameter is significantly reduced. However, if the temperature is not controlled then due to the exothermic nature of reactions for the formation of TiNTs, the temperature of electrolyte keep on increasing. This variation in electrolyte bath temperature introduced strong variations in tube diameter (20 nm to 160 nm) along the length of tubes. Current profiles, recorded during the anodization experiment, predict the effect of constant and varying experimental temperatures as well. In both cases, XRD results show the complete anatase crystal structure of nanotube upon annealing at 450 °C. Present work highlights the importance of constant temperature during the anodization experiments in order to develop an ordered array of nanotubes with a uniform tube diameter.Keywords: anodization, ordering, temperature, TiO₂ nanotubes
Procedia PDF Downloads 171126 Screening Deformed Red Blood Cells Irradiated by Ionizing Radiations Using Windowed Fourier Transform
Authors: Dahi Ghareab Abdelsalam Ibrahim, R. H. Bakr
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Ionizing radiation, such as gamma radiation and X-rays, has many applications in medical diagnoses and cancer treatment. In this paper, we used the windowed Fourier transform to extract the complex image of the deformed red blood cells. The real values of the complex image are used to extract the best fitting of the deformed cell boundary. Male albino rats are irradiated by γ-rays from ⁶⁰Co. The male albino rats are anesthetized with ether, and then blood samples are collected from the eye vein by heparinized capillary tubes for studying the radiation-damaging effect in-vivo by the proposed windowed Fourier transform. The peripheral blood films are prepared according to the Brown method. The peripheral blood film is photographed by using an Automatic Image Contour Analysis system (SAMICA) from ELBEK-Bildanalyse GmbH, Siegen, Germany. The SAMICA system is provided with an electronic camera connected to a computer through a built-in interface card, and the image can be magnified up to 1200 times and displayed by the computer. The images of the peripheral blood films are then analyzed by the windowed Fourier transform method to extract the precise deformation from the best fitting. Based on accurate deformation evaluation of the red blood cells, diseases can be diagnosed in their primary stages.Keywords: windowed Fourier transform, red blood cells, phase wrapping, Image processing
Procedia PDF Downloads 85125 The Design Optimization for Sound Absorption Material of Multi-Layer Structure
Authors: Un-Hwan Park, Jun-Hyeok Heo, In-Sung Lee, Tae-Hyeon Oh, Dae-Kyu Park
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Sound absorbing material is used as automotive interior material. Sound absorption coefficient should be predicted to design it. But it is difficult to predict sound absorbing coefficient because it is comprised of several material layers. So, its targets are achieved through many experimental tunings. It causes a lot of cost and time. In this paper, we propose the process to estimate the sound absorption coefficient with multi-layer structure. In order to estimate the coefficient, physical properties of each material are used. These properties also use predicted values by Foam-X software using the sound absorption coefficient data measured by impedance tube. Since there are many physical properties and the measurement equipment is expensive, the values predicted by software are used. Through the measurement of the sound absorption coefficient of each material, its physical properties are calculated inversely. The properties of each material are used to calculate the sound absorption coefficient of the multi-layer material. Since the absorption coefficient of multi-layer can be calculated, optimization design is possible through simulation. Then, we will compare and analyze the calculated sound absorption coefficient with the data measured by scaled reverberation chamber and impedance tubes for a prototype. If this method is used when developing automotive interior materials with multi-layer structure, the development effort can be reduced because it can be optimized by simulation. So, cost and time can be saved.Keywords: sound absorption material, sound impedance tube, sound absorption coefficient, optimization design
Procedia PDF Downloads 289124 Healthcare Waste Management Practices in Bangladesh: A Case Study in Dhaka City, Bangladesh
Authors: H. M. Nuralam, Z. Xiao-lan, B. K. Dubey, D. Wen-Chuan
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Healthcare waste (HCW) is one of the major concerns in environmental issues due to its infectious and hazardous nature that is requires specific treatment and systematic management prior to final disposal. This study aimed to assess HCW management system in Dhaka City (DC), Bangladesh, by investigating the present practices implemented by the city. In this study, five different healthcare establishments were selected in DC. Field visits and interviews with health personnel and staff who are concerned with the waste management were conducted. The information was gathered through questionnaire focus on the different aspect of HCW management like, waste segregation and collection, storage and transport, awareness as well. The results showed that a total of 7,215 kg/day (7.2 ton/day) of waste were generated, of which 79.36% (5.6 ton/day) was non-hazardous waste and 20.6% (1.5 ton/day) was hazardous waste. The rate of waste generation in these healthcare establishments (HCEs) was 2.6 kg/bed/day. There was no appropriate and systematic management of HCWs except at few private HCEs that segregate their hazardous waste. All the surveyed HCEs dumped their HCW together with the municipal waste, and some staff members were also found to be engaged in improper handling of the generated waste. Furthermore, the used sharp instruments, saline bags, blood bags and test tubes were collected for resale or reuse. Nevertheless, the lack of awareness, appropriate policy, regulation and willingness to act, were responsible for the improper management of HCW in DC. There was lack of practical training of concerned healthcare to handle the waste properly, while the nurses and staff were found to be aware of the health impacts of HCW.Keywords: awareness, disposal, Dhaka city, healthcare waste management, waste generation
Procedia PDF Downloads 325123 Study the Effects of Increasing Unsaturation in Palm Oil and Incorporation of Carbon Nanotubes on Resinous Properties
Authors: Muhammad R. Islam, Mohammad Dalour H. Beg, Saidatul S. Jamari
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Considering palm oil as non-drying oil owing to its low iodine value, an attempt was taken to increase the unsaturation in the fatty acid chains of palm oil for the preparation of alkyds. To increase the unsaturation in the palm oil, sulphuric acid (SA) and para-toluene sulphonic acid (PTSA) was used prior to alcoholysis for the dehydration process. The iodine number of the oil samples was checked for the unsaturation measurement by Wijs method. Alkyd resin was prepared using the dehydrated palm oil by following alcoholysis and esterification reaction. To improve the film properties 0.5 wt% multi-wall carbon nano tubes (MWCNTs) were used to manufacture polymeric film. The properties of the resins were characterized by various physico-chemical properties such as density, viscosity, iodine value, acid value, saponification value, etc. Structural elucidation was confirmed by Fourier transform of infrared spectroscopy and proton nuclear magnetic resonance; surfaces of the cured films were observed by scanning electron microscopy. In addition, pencil hardness and chemical resistivity was also measured by using standard methods. The effect of enhancement of the unsaturation in the fatty acid chain found significant and motivational. The resin prepared with dehydrated palm oil showed improved properties regarding hardness and chemical resistivity testing. The incorporation of MWCNTs enhanced the thermal stability and hardness of the films as well.Keywords: alkyd resin, nano-coatings, dehydration, palm oil
Procedia PDF Downloads 310122 Getting Out of the Box: Tangible Music Production in the Age of Virtual Technological Abundance
Authors: Tim Nikolsky
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This paper seeks to explore the different ways in which music producers choose to embrace various levels of technology based on musical values, objectives, affordability, access and workflow benefits. Current digital audio production workflow is questioned. Engineers and music producers of today are increasingly divorced from the tangibility of music production. Making music no longer requires you to reach over and turn a knob. Ideas of authenticity in music production are being redefined. Calculations from the mathematical algorithm with the pretty pictures are increasingly being chosen over hardware containing transformers and tubes. Are mouse clicks and movements equivalent or inferior to the master brush strokes we are seeking to conjure? We are making audio production decisions visually by constantly looking at a screen rather than listening. Have we compromised our music objectives and values by removing the ‘hands-on’ nature of music making? DAW interfaces are making our musical decisions for us not necessarily in our best interests. Technological innovation has presented opportunities as well as challenges for education. What do music production students actually need to learn in a formalised education environment, and to what extent do they need to know it? In this brave new world of omnipresent music creation tools, do we still need tangibility in music production? Interviews with prominent Australian music producers that work in a variety of fields will be featured in this paper, and will provide insight in answering these questions and move towards developing an understanding how tangibility can be rediscovered in the next generation of music production.Keywords: analogue, digital, digital audio workstation, music production, plugins, tangibility, technology, workflow
Procedia PDF Downloads 271121 Rising Velocity of a Non-Newtonian Liquids in Capillary Tubes
Authors: Reza Sabbagh, Linda Hasanovich, Aleksey Baldygin, David S. Nobes, Prashant R. Waghmare
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The capillary filling process is significantly important to study for numerous applications such as the under filling of the material in electronic packaging or liquid hydrocarbons seepage through porous structure. The approximation of the fluid being Newtonian, i.e., linear relationship between the shear stress and deformation rate cannot be justified in cases where the extent of non-Newtonian behavior of liquid governs the surface driven transport, i.e., capillarity action. In this study, the capillary action of a non-Newtonian fluid is not only analyzed, but also the modified generalized theoretical analysis for the capillary transport is proposed. The commonly observed three regimes: surface forces dominant (travelling air-liquid interface), developing flow (viscous force dominant), and developed regimes (interfacial, inertial and viscous forces are comparable) are identified. The velocity field along each regime is quantified with Newtonian and non-Newtonian fluid in square shaped vertically oriented channel. Theoretical understanding of capillary imbibition process, particularly in the case of Newtonian fluids, is relied on the simplified assumption of a fully developed velocity profile which has been revisited for developing a modified theory for the capillary transport of non-Newtonian fluids. Furthermore, the development of the velocity profile from the entrance regime to the developed regime, for different power law fluids, is also investigated theoretically and experimentally.Keywords: capillary, non-Newtonian flow, shadowgraphy, rising velocity
Procedia PDF Downloads 204120 Modeling of Full Range Flow Boiling Phenomenon in 23m Long Vertical Steam Generator Tube
Authors: Chaitanya R. Mali, V. Vinod, Ashwin W. Patwardhan
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Design of long vertical steam generator (SG) tubes in nuclear power plant involves an understanding of different aspects of flow boiling phenomenon such as flow instabilities, flow regimes, dry out, critical heat flux, pressure drop, etc. The knowledge of the prediction of local thermal hydraulic characteristics is necessary to understand these aspects. For this purpose, the methodology has been developed which covers all the flow boiling regimes to model full range flow boiling phenomenon. In this methodology, the vertical tube is divided into four sections based on vapor fraction value at the end of each section. Different modeling strategies have been applied to the different sections of the vertical tube. Computational fluid dynamics simulations have been performed on a vertical SG tube of 0.0126 m inner diameter and 23 m length. The thermal hydraulic parameters such as vapor fraction, liquid temperature, heat transfer coefficient, pressure drop, heat flux distribution have been analyzed for different designed heat duties (1.1 MW (20%) to 3.3 MW (60%)) and flow conditions (10 % to 80 %). The sensitivity of different boiling parameters such as bubble departure diameter, nucleation site density, bubble departure frequency on the thermal hydraulic parameters was also studied. Flow instability has been observed at 20 % designed heat duty and 20 % flow conditions.Keywords: thermal hydraulics, boiling, vapor fraction, sensitivity
Procedia PDF Downloads 147119 Fiberoptic Intubation Skills Training Improves Emergency Medicine Resident Comfort Using Modality
Authors: Nicholus M. Warstadt, Andres D. Mallipudi, Oluwadamilola Idowu, Joshua Rodriguez, Madison M. Hunt, Soma Pathak, Laura P. Weber
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Endotracheal intubation is a core procedure performed by emergency physicians. This procedure is a high risk, and failure results in substantial morbidity and mortality. Fiberoptic intubation (FOI) is the standard of care in difficult airway protocols, yet no widespread practice exists for training emergency medicine (EM) residents in the technical acquisition of FOI skills. Simulation on mannequins is commonly utilized to teach advanced airway techniques. As part of a program to introduce FOI into our ED, residents received hands-on training in FOI as part of our weekly resident education conference. We hypothesized that prior to the hands-on training, residents had little experience with FOI and were uncomfortable with using fiberoptic as a modality. We further hypothesized that resident comfort with FOI would increase following the training. The education intervention consisted of two hours of focused airway teaching and skills acquisition for PGY 1-4 residents. One hour was dedicated to four case-based learning stations focusing on standard, pediatric, facial trauma, and burn airways. Direct, video, and fiberoptic airway equipment were available to use at the residents’ discretion to intubate mannequins at each station. The second hour involved direct instructor supervision and immediate feedback during deliberate practice for FOI of a mannequin. Prior to the hands-on training, a pre-survey was sent via email to all EM residents at NYU Grossman School of Medicine. The pre-survey asked how many FOI residents have performed in the ED, OR, and on a mannequin. The pre-survey and a post-survey asked residents to rate their comfort with FOI on a 5-point Likert scale ("extremely uncomfortable", "somewhat uncomfortable", "neither comfortable nor uncomfortable", "somewhat comfortable", and "extremely comfortable"). The post-survey was administered on site immediately following the training. A two-sample chi-square test of independence was calculated comparing self-reported resident comfort on the pre- and post-survey (α ≤ 0.05). Thirty-six of a total of 70 residents (51.4%) completed the pre-survey. Of pre-survey respondents, 34 residents (94.4%) had performed 0, 1 resident (2.8%) had performed 1, and 1 resident (2.8%) had performed 2 FOI in the ED. Twenty-five residents (69.4%) had performed 0, 6 residents (16.7%) had performed 1, 2 residents (5.6%) had performed 2, 1 resident (2.8%) had performed 3, and 2 residents (5.6%) had performed 4 FOI in the OR. Seven residents (19.4%) had performed 0, and 16 residents (44.4%) had performed 5 or greater FOI on a mannequin. 29 residents (41.4%) attended the hands-on training, and 27 out of 29 residents (93.1%) completed the post-survey. Self-reported resident comfort with FOI significantly increased in post-survey compared to pre-survey questionnaire responses (p = 0.00034). Twenty-one of 27 residents (77.8%) report being “somewhat comfortable” or “extremely comfortable” with FOI on the post-survey, compared to 9 of 35 residents (25.8%) on the pre-survey. We show that dedicated FOI training is associated with increased learner comfort with such techniques. Further direction includes studying technical competency, skill retention, translation to direct patient care, and optimal frequency and methodology of future FOI education.Keywords: airway, emergency medicine, fiberoptic intubation, medical simulation, skill acquisition
Procedia PDF Downloads 180118 Analysis of Rectangular Concrete-Filled Double Skin Tubular Short Columns with External Stainless Steel Tubes
Authors: Omnia F. Kharoob, Nashwa M. Yossef
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Concrete-filled double skin steel tubular (CFDST) columns could be utilized in structures such as bridges, high-rise buildings, viaducts, and electricity transmission towers due to its great structural performance. Alternatively, lean duplex stainless steel has recently gained significant interest for its high structural performance, similar corrosion resistance and lower cost compared to the austenitic steel grade. Hence, this paper presents the nonlinear finite element (FE) analysis, behaviour and design of rectangular outer lean duplex stainless steel (EN 1.4162) CFDST short columns under compression. All classes of the outer rectangular hollow section according to the depth-to-thickness (D/t) ratios were considered. The results showed that the axial ultimate strength of rectangular CFDST short columns increased linearly by increasing the concrete compressive strength, while it does not influence when changing the hollow ratios. Finally, the axial capacities were compared with the available design methods, and recommendations were conducted for the design strength of this type of column.Keywords: concrete-filled double skin columns, compressive strength, finite element analysis, lean duplex stainless steel, ultimate axial strength, short columns
Procedia PDF Downloads 303117 Comparative Study on Structural Behaviour of Circular Hollow Steel Tubular, Concrete Filled Steel Tubular, and Reinforced Cement Concrete Stub Columns under Pure Axial Compression
Authors: Niladri Roy, M. Longshithung Patton
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This paper is aimed at studying the structural response of circular hollow steel tubular (HST), concrete filled steel tubular (CFST), and reinforced cement concrete (RCC) stub columns when subjected to only axial compressive forces and also examining their comparative nature using finite element (FE) models. These results are further compared with the respective experimental results. FE software package ABAQUS 6.14 has been used for further parametric studies where a total of 108 FE models were modelled. The diameters of the HST, CFST, and RCC stub columns are kept as 100, 140, 180, and 220, with length to diameter ratio fixed at 3 to avoid end effects and flexural failure. To keep the same percentage of steel (by volume), the thicknesses of steel tubes in HST and CFST columns were varied in response to the change in diameter of the main reinforcement bar in RCC columns. M25 grade of concrete was used throughout. The objective is to compare the structural behaviour of HST, CFST, and RCC stub columns on the basis of their axial compressive load carrying capacity and failure modes. The studies show that filling the circular HST columns with concrete increases the Pu of the CCFST columns by 2.97 times. It was also observed that the Pu (HST) is about 0.72 times Pu (RCC) on average, and the Pu (CFST) is about 2.08 times Pu (RCC) on average. After the analysis and comparison, it has been proved that CFST has much more load carrying capacity than HST and RCC and also provides the same strength at a very less sectional size.Keywords: HST columns, stub columns, CFST columns, RCC columns, finite element modeling, ABAQUS
Procedia PDF Downloads 100116 Evaluation of Non-Staggered Body-Fitted Grid Based Solution Method in Application to Supercritical Fluid Flows
Authors: Suresh Sahu, Abhijeet M. Vaidya, Naresh K. Maheshwari
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The efforts to understand the heat transfer behavior of supercritical water in supercritical water cooled reactor (SCWR) are ongoing worldwide to fulfill the future energy demand. The higher thermal efficiency of these reactors compared to a conventional nuclear reactor is one of the driving forces for attracting the attention of nuclear scientists. In this work, a solution procedure has been described for solving supercritical fluid flow problems in complex geometries. The solution procedure is based on non-staggered grid. All governing equations are discretized by finite volume method (FVM) in curvilinear coordinate system. Convective terms are discretized by first-order upwind scheme and central difference approximation has been used to discretize the diffusive parts. k-ε turbulence model with standard wall function has been employed. SIMPLE solution procedure has been implemented for the curvilinear coordinate system. Based on this solution method, 3-D Computational Fluid Dynamics (CFD) code has been developed. In order to demonstrate the capability of this CFD code in supercritical fluid flows, heat transfer to supercritical water in circular tubes has been considered as a test problem. Results obtained by code have been compared with experimental results reported in literature.Keywords: curvilinear coordinate, body-fitted mesh, momentum interpolation, non-staggered grid, supercritical fluids
Procedia PDF Downloads 130115 Report of Candida Auris: An Emerging Fungal Pathogen in a Tertiary Healthcare Facility in Ekiti State, Nigeria
Authors: David Oluwole Moses, Odeyemi Adebowale Toba, Olawale Adetunji Kola
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Candida auris, an emerging fungus, has been reported in more than 30 countries around the world since its first detection in 2009. Due to its several virulence factors, resistance to antifungals, and persistence in hospital settings, Candida auris has been reported to cause treatment-failure infections. This study was therefore carried out to determine the incidence of Candida auris in a tertiary hospital in Ekiti State, Nigeria. In this study, a total of 115 samples were screened for Candida species using cultural and molecular methods. The carriage of virulence factors and antifungal resistance among C. auris was detected using standard microbiological methods. Candida species isolated from the samples were 15 (30.0%) in clinical samples and 22 (33.85%) in hospital equipment screened. Non-albicans Candida accounted for 3 (20%) and 8 (36.36%) among the isolates from the clinical samples and equipment, respectively. Only five of the non-albicans Candida isolates were C. auris. All the isolates produced biofilm, gelatinase, and hemolysin, while none produced germ tubes. Two of the isolates were resistant to all the antifungals tested. Also, all the isolates were resistant to fluconazole and itraconazole. Nystatin appeared to be the most effective among the tested antifungals. The isolation of Candida auris is being reported for the second time in Nigeria, further confirming that the fungus has spread beyond Lagos and Ibadan, where it was first reported. The extent of the spread of the nosocomial fungus needed to be further investigated and curtailed in Nigeria before its outbreak in healthcare facilities.Keywords: candida auris, virulence factors, antifungals, pathogen, hospital, infection
Procedia PDF Downloads 46114 Cost Effective Intraoperative Mri for Cranial and Spinal Cases Using Pre-Existing Three Side Open Mri-Adjacent to Operation Theater = Since-2005
Authors: V. K. Tewari, M. Hussain, H. K. D.Gupta
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Aims/Background: The existing Intraoperative-MRI(IMRI) of developed countries is too costly to be utilized in any developing country. We have used the preexisting 3-side open 0.2-tesla MRI for IMRI in India so that the maximum benefit of the goal of IMRI is attained with cost effective state of the art surgeries. Material/Methods: We have operated 36-cases since 13thNov2005 via IMRI to till date. The table of MRI is used as an operating table which can be taken to the P3 level and as and when we require MRI to be done then the table can slide to P1 level so that the intraoperative monitoring can be done. The oxygen/nitrous tubes were taken out from vent made in the wall of the MRI room to outside. The small handy Boyel’s trolley was taken inside the MRI room with a small monitor. Anesthesia is been given in the MRI room itself. Usual skin markings were given with the help of scout MRI fields so the preciseness is increased. Craniotomy flap raised or the laminectomy and the dura opened in the similar fashion by same instruments as for the non IMRI case. Now corticectomy is planned after the T1 contrast image to localize and minimize the cortical resection. Staged and multiple P3 to P1 position and vice versa is planned respectively so that the resection is optimized to around 0.5 mm for radiotherapy. Immediate preclosure hematoma and edemas can be differentiated and cared for it. Results: Same MRI images as compared to highly expensive MRI of western world are achieved. Conclusion: 0.2 tesla Intraoperative MRI can be used for operative work for cranial and spinal cases easily with highly cost effectiveness.Keywords: intraoperative MRI, 0.2 tesla intraoperative MRI, cost effective intraoperative MRI, medical and health sciences
Procedia PDF Downloads 454113 Subcutan Isosulfan Blue Administration May Interfere with Pulse Oximetry
Authors: Esra Yuksel, Dilek Duman, Levent Yeniay, Sezgin Ulukaya
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Sentinel lymph node biopsy (SLNB) is a minimal invasive technique with lower morbidity in axillary staging of breast cancer. Isosulfan blue stain is frequently used in SLNB and regarded as safe. The present case report aimed to report severe decrement in SpO2 following isosulfan blue administration, as well as skin and urine signs and inconsistency with clinical picture in a 67-year-old ,77 kg, ASA II female case that underwent SLNB under general anesthesia. Ten minutes after subcutaneous administration of 10 ml 1% isosulfan blue by the surgeons into the patient, who were hemodynamically stable, SpO2 first reduced to 87% from 99%, and then to 75% in minutes despite 100% oxygen support. Meanwhile, blood pressure and EtCO2 monitoring was unremarkable. After specifying that anesthesia device worked normally, airway pressure did not increase and the endotracheal tube has been placed accurately, the blood sample was taken from the patient for arterial gas analysis. A severe increase was thought in MetHb concentration since SpO2 persisted to be 75% although the concentration of inspired oxygen was 100%, and solution of 2500 mg ascorbic acid in 500 ml 5% Dextrose was given to the patient via intravenous route until the results of arterial blood gas were obtained. However, arterial blood gas results were as follows: pH: 7.54, PaCO2: 23.3 mmHg, PaO2: 281 mmHg, SaO2: %99, and MetHb: %2.7. Biochemical analysis revealed a blood MetHb concentration of 2%.However, since arterial blood gas parameters were good, hemodynamics of the patient was stable and methemoglobin concentration was not so high, the patient was extubated after surgery when she was relaxed, cooperated and had adequate respiration. Despite the absence of respiratory or neurological distress, SpO2 value was increased only up to 85% within 2 hours with 5 L/min oxygen support via face mask in the surgery room as the patient was extubated. At that time, the skin of particularly the upper part of her body has turned into blue, more remarkable on the face. The color of plasma of the blood taken from the patient for biochemical analysis was blue. The color of urine coming throughout the urinary catheter placed in intensive care unit was also blue. Twelve hours after 5 L/min. oxygen inhalation via a mask, the SpO2 reached to 90%. During monitoring in intensive care unit on the postoperative 1st day, facial color and urine color of the patient was still blue, SpO2 was 92%, and arterial blood gas levels were as follows: pH: 7.44, PaO2: 76.1 mmHg, PaCO2: 38.2 mmHg, SaO2: 99%, and MetHb 1%. During monitoring in clinic on the postoperative 2nd day, SpO2 was 95% without oxygen support and her facial and urine color turned into normal. The patient was discharged on the 3rd day without any problem.In conclusion, SLNB is a less invasive alternative to axillary dissection. However, false pulse oximeter reading due to pigment interference is a rare complication of this procedure. Arterial blood gas analysis should be used to confirm any fall in SpO2 reading during monitoring.Keywords: isosulfan blue, pulse oximetry, SLNB, methemoglobinemia
Procedia PDF Downloads 315112 Comparison of Methods for the Synthesis of Eu+++, Tb+++, and Tm+++ Doped Y2O3 Nanophosphors by Sol-Gel and Hydrothermal Methods for Bioconjugation
Authors: Ravindra P. Singh, Drupad Ram, Dinesh K. Gupta
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Rare earth ions doped metal oxides are a class of luminescent materials which have been proved to be excellent for applications in field emission displays and cathode ray tubes, plasma display panels. Under UV irradiation Eu+++ doped Y2O3 is a red phosphor and Tb+++ doped Y 2O3 is a green phosphor. It is possible that, due to their high quantum efficiency, they might serve as improved luminescent markers for identification of biomolecules, as already reported for CdSe and CdSe/ZnS nanocrystals. However, for any biological applications these particle powders must be suspended in water while retaining their phosphorescence. We hereby report synthesis and characterization of Eu+++ and Tb+++ doped yttrium oxide nanoparticles by sol-gel and hydrothermal processes. Eu+++ and Tb+++ doped Y2O3 nanoparticles have been synthesized by hydrothermal process using yttrium oxo isopropoxide [Y5O(OPri)13] (crystallized twice) and it’s acetyl acetone modified product [Y(O)(acac)] as precursors. Generally the sol-gel derived metal oxides are required to be annealed to the temperature ranging from 400°C-800°C in order to develop crystalline phases. However, this annealing also results in the development of aggregates which are undesirable for bio-conjugation experiments. In the hydrothermal process, we have achieved crystallinity of the nanoparticles at 300°C and the development of crystalline phases has been found to be proportional to the time of heating of the reactor. The average particle sizes as calculated from XRD were found to be 28 nm, 32 nm, and 34 nm by hydrothermal process. The particles were successfully suspended in chloroform in the presence of trioctyl phosphene oxide and TEM investigations showed the presence of single particles along with agglomerates.Keywords: nanophosphors, Y2O3:Eu+3, Y2O3:Tb+3, sol-gel, hydrothermal method, TEM, XRD
Procedia PDF Downloads 402111 Monitoring the Responses to Nociceptive Stimuli During General Anesthesia Based on Electroencephalographic Signals in Surgical Patients Undergoing General Anesthesia with Laryngeal Mask Airway (LMA)
Authors: Ofelia Loani Elvir Lazo, Roya Yumul, Sevan Komshian, Ruby Wang, Jun Tang
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Background: Monitoring the anti-nociceptive drug effect is useful because a sudden and strong nociceptive stimulus may result in untoward autonomic responses and muscular reflex movements. Monitoring the anti-nociceptive effects of perioperative medications has long been desiredas a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively.To this end, electroencephalogram (EEG) based tools includingBIS and qCON were designed to provide information about the depth of sedation whileqNOXwas produced to informon the degree of antinociception.The goal of this study was to compare the reliability of qCON/qNOX to BIS asspecific indicators of response to nociceptive stimulation. Methods: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board(IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed o62n all patientsprior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. Results: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from74±13 mm Hg at baseline to 84± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76±12 BPM at baseline to 80±13BPM during noxious stimuli[p=0.078] respectively). Conclusion: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices.Keywords: antinociception, bispectral index (BIS), general anesthesia, laryngeal mask airway, qCON/qNOX
Procedia PDF Downloads 92110 Liesegang Phenomena: Experimental and Simulation Studies
Authors: Vemula Amalakrishna, S. Pushpavanam
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Change and motion characterize and persistently reshape the world around us, on scales from molecular to global. The subtle interplay between change (Reaction) and motion (Diffusion) gives rise to an astonishing intricate spatial or temporal pattern. These pattern formation in nature has been intellectually appealing for many scientists since antiquity. Periodic precipitation patterns, also known as Liesegang patterns (LP), are one of the stimulating examples of such self-assembling reaction-diffusion (RD) systems. LP formation has a great potential in micro and nanotechnology. So far, the research on LPs has been concentrated mostly on how these patterns are forming, retrieving information to build a universal mathematical model for them. Researchers have developed various theoretical models to comprehensively construct the geometrical diversity of LPs. To the best of our knowledge, simulation studies of LPs assume an arbitrary value of RD parameters to explain experimental observation qualitatively. In this work, existing models were studied to understand the mechanism behind this phenomenon and challenges pertaining to models were understood and explained. These models are not computationally effective due to the presence of discontinuous precipitation rate in RD equations. To overcome the computational challenges, smoothened Heaviside functions have been introduced, which downsizes the computational time as well. Experiments were performed using a conventional LP system (AgNO₃-K₂Cr₂O₇) to understand the effects of different gels and temperatures on formed LPs. The model is extended for real parameter values to compare the simulated results with experimental data for both 1-D (Cartesian test tubes) and 2-D(cylindrical and Petri dish).Keywords: reaction-diffusion, spatio-temporal patterns, nucleation and growth, supersaturation
Procedia PDF Downloads 152109 Effect of Seasonal Variation on Two Introduced Columbiformes in Awba Dam Tourism Centre, University of Ibadan, Ibadan
Authors: Kolawole F. Farinloye, Samson O. Ojo
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Two Columbiformes species were recently introduced to the newly established Awba Dam Tourism Centre [ADTC], hence there is need to investigate the effect of seasonal variation on these species with respect to hematological composition. Blood samples were obtained from superficial ulna vein of the 128 apparently healthy C. livia and C. guinea into tubes containing EDTA as anticoagulant. Thin blood smears (TBS) were prepared, stained and viewed under microscope. Values of Red Blood Cell (RBC) count, White Blood Cell (WBC) count, cholesterol (CH), Uric Acid (UA), Protein (PR), Mean Corpuscular Volume (MCV), Haemoglobin Content (HB), Blood Volume (BV), Plasma Glucose (PG) and Length/Width (L/W) ratio of red blood cells were assessed. The procedure was carried out on a seasonal basis (wet and dry seasons of 2013-2014). Data was analyzed using descriptive and inferential statistics. Lymphocyte count for C. livia was F3, 161 = 13.15, while for C. guinea was F3, 178 = 13.15. Heterophil, H/L ratio and Muscle score values for both species were (rs = -0.38, rs = -0.44), (rs = 0.51, rs = 0.31) (4, 3) respectively. Analyses also demonstrated a low WBC to RBC ratio (0.004: 25.3) in both species during the wet season compared to dry season, respectively. L/W varied significantly among sampling seasons i.e. wet (19.1% of BV, 12.6% of BV, 0.1% of BV) and dry (18.9% of BV, 12.7% of BV, 0.08% of BV). The level of HB in wet season (19.20±8.46108) is lower compared to dry season (19.70±8.48762). T-test also showed (wet=15.625, 0.111), (dry=12.125, 0.146) respectively, hence there is no association between species and haematological parameters. Species introduced were found to be haematologically stable. Although there were slight differences in seasonal composition, however this can be attributed to seasonal variation; suggesting little or no effect of seasons on their blood composition.Keywords: seasonal variation, Columbiformes, Awba Dam tourism centre, University of Ibadan, Ibadan
Procedia PDF Downloads 341108 Extracting the Coupled Dynamics in Thin-Walled Beams from Numerical Data Bases
Authors: Mohammad A. Bani-Khaled
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In this work we use the Discrete Proper Orthogonal Decomposition transform to characterize the properties of coupled dynamics in thin-walled beams by exploiting numerical simulations obtained from finite element simulations. The outcomes of the will improve our understanding of the linear and nonlinear coupled behavior of thin-walled beams structures. Thin-walled beams have widespread usage in modern engineering application in both large scale structures (aeronautical structures), as well as in nano-structures (nano-tubes). Therefore, detailed knowledge in regard to the properties of coupled vibrations and buckling in these structures are of great interest in the research community. Due to the geometric complexity in the overall structure and in particular in the cross-sections it is necessary to involve computational mechanics to numerically simulate the dynamics. In using numerical computational techniques, it is not necessary to over simplify a model in order to solve the equations of motions. Computational dynamics methods produce databases of controlled resolution in time and space. These numerical databases contain information on the properties of the coupled dynamics. In order to extract the system dynamic properties and strength of coupling among the various fields of the motion, processing techniques are required. Time- Proper Orthogonal Decomposition transform is a powerful tool for processing databases for the dynamics. It will be used to study the coupled dynamics of thin-walled basic structures. These structures are ideal to form a basis for a systematic study of coupled dynamics in structures of complex geometry.Keywords: coupled dynamics, geometric complexity, proper orthogonal decomposition (POD), thin walled beams
Procedia PDF Downloads 418107 Finite Element Analysis of Cold Formed Steel Screwed Connections
Authors: Jikhil Joseph, S. R. Satish Kumar
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Steel Structures are commonly used for rapid erections and multistory constructions due to its inherent advantages. However, the high accuracy required in detailing and heavier sections, make it difficult to erect in place and transport. Cold Formed steel which are specially made by reducing carbon and other alloys are used nowadays to make thin-walled structures. Various types of connections are being reported as well as practiced for the thin-walled members such as bolting, riveting, welding and other mechanical connections. Commonly self-drilling screw connections are used for cold-formed purlin sheeting connection. In this paper an attempt is made to develop a moment resting frame which can be rapidly and remotely constructed with thin walled sections and self-drilling screws. Semi-rigid Moment connections are developed with Rectangular thin-walled tubes and the screws. The Finite Element Analysis programme ABAQUS is used for modelling the screwed connections. The various modelling procedures for simulating the connection behavior such as tie-constraint model, oriented spring model and solid interaction modelling are compared and are critically reviewed. From the experimental validations the solid-interaction modelling identified to be the most accurate one and are used for predicting the connection behaviors. From the finite element analysis, hysteresis curves and the modes of failure were identified. Parametric studies were done on the connection model to optimize the connection configurations to get desired connection characteristics.Keywords: buckling, cold formed steel, finite element analysis, screwed connections
Procedia PDF Downloads 187106 Influences of Separation of the Boundary Layer in the Reservoir Pressure in the Shock Tube
Authors: Bruno Coelho Lima, Joao F.A. Martos, Paulo G. P. Toro, Israel S. Rego
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The shock tube is a ground-facility widely used in aerospace and aeronautics science and technology for studies on gas dynamic and chemical-physical processes in gases at high-temperature, explosions and dynamic calibration of pressure sensors. A shock tube in its simplest form is comprised of two separate tubes of equal cross-section by a diaphragm. The diaphragm function is to separate the two reservoirs at different pressures. The reservoir containing high pressure is called the Driver, the low pressure reservoir is called Driven. When the diaphragm is broken by pressure difference, a normal shock wave and non-stationary (named Incident Shock Wave) will be formed in the same place of diaphragm and will get around toward the closed end of Driven. When this shock wave reaches the closer end of the Driven section will be completely reflected. Now, the shock wave will interact with the boundary layer that was created by the induced flow by incident shock wave passage. The interaction between boundary layer and shock wave force the separation of the boundary layer. The aim of this paper is to make an analysis of influences of separation of the boundary layer in the reservoir pressure in the shock tube. A comparison among CDF (Computational Fluids Dynamics), experiments test and analytical analysis were performed. For the analytical analysis, some routines in Python was created, in the numerical simulations (Computational Fluids Dynamics) was used the Ansys Fluent, and the experimental tests were used T1 shock tube located in IEAv (Institute of Advanced Studies).Keywords: boundary layer separation, moving shock wave, shock tube, transient simulation
Procedia PDF Downloads 315105 Numerical Modelling of Immiscible Fluids Flow in Oil Reservoir Rocks during Enhanced Oil Recovery Processes
Authors: Zahreddine Hafsi, Manoranjan Mishra , Sami Elaoud
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Ensuring the maximum recovery rate of oil from reservoir rocks is a challenging task that requires preliminary numerical analysis of different techniques used to enhance the recovery process. After conventional oil recovery processes and in order to retrieve oil left behind after the primary recovery phase, water flooding in one of several techniques used for enhanced oil recovery (EOR). In this research work, EOR via water flooding is numerically modeled, and hydrodynamic instabilities resulted from immiscible oil-water flow in reservoir rocks are investigated. An oil reservoir is a porous medium consisted of many fractures of tiny dimensions. For modeling purposes, the oil reservoir is considered as a collection of capillary tubes which provides useful insights into how fluids behave in the reservoir pore spaces. Equations governing oil-water flow in oil reservoir rocks are developed and numerically solved following a finite element scheme. Numerical results are obtained using Comsol Multiphysics software. The two phase Darcy module of COMSOL Multiphysics allows modelling the imbibition process by the injection of water (as wetting phase) into an oil reservoir. Van Genuchten, Brooks Corey and Levrett models were considered as retention models and obtained flow configurations are compared, and the governing parameters are discussed. For the considered retention models it was found that onset of instabilities viz. fingering phenomenon is highly dependent on the capillary pressure as well as the boundary conditions, i.e., the inlet pressure and the injection velocity.Keywords: capillary pressure, EOR process, immiscible flow, numerical modelling
Procedia PDF Downloads 131104 Evaluation of Synthesis and Structure Elucidation of Some Benzimidazoles as Antimicrobial Agents
Authors: Ozlem Temiz Arpaci, Meryem Tasci, Hakan Goker
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Benzimidazole, a structural isostere of indol and purine nuclei that can interact with biopolymers, can be identified as master key. So that benzimidazole compounds are important fragments in medicinal chemistry because of their wide range of biological activities including antimicrobial activity. We planned to synthesize some benzimidazole compounds for developing new antimicrobial drug candidates. In this study, we put some heterocyclic rings on second position and an amidine group on the fifth position of benzimidazole ring and synthesized them using a multiple step procedure. For the synthesis of the compounds, as the first step, 4-chloro-3-nitrobenzonitrile was reacted with cyclohexylamine in dimethyl formamide. Imidate esters (compound 2) were then prepared with absolute ethanol saturated with dry HCl gas. These imidate esters which were not too stable were converted to compound 3 by passing ammonia gas through ethanol. At the Pd / C catalyst, the nitro group is reduced to the amine group (compound 4). Finally, various aldehyde derivatives were reacted with sodium metabisulfite addition products to give compound 5-20. Melting points were determined on a Buchi B-540 melting point apparatus in open capillary tubes and are uncorrected. Elemental analyses were done a Leco CHNS 932 elemental analyzer. 1H-NMR and 13C-NMR spectra were recorded on a Varian Mercury 400 MHz spectrometer using DMSO-d6. Mass spectra were acquired on a Waters Micromass ZQ using the ESI(+) method. The structures of them were supported by spectral data. The 1H-NMR, 13C NMR and mass spectra and elemental analysis results agree with those of the proposed structures. Antimicrobial activity studies of the synthesized compounds are under the investigation.Keywords: benzimidazoles, synthesis, structure elucidation, antimicrobial
Procedia PDF Downloads 156103 Evaluation of Antagonistic and Aggregation Property of Probiotic Lactic Acid Bacteria Isolated from Bovine Milk
Authors: Alazar Nebyou, Sujata Pandit
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Lactic acid bacteria (LAB) are essential ingredients in probiotic foods, intestinal microflora, and dairy products that are capable of coping up with harsh gastrointestinal tract conditions and are available in a variety of environments. The objective of this study is to evaluate the probiotic property of LAB isolated from bovine milk. Milk samples were collected from local dairy farms. Samples were obtained using sterile test tubes and transported to a laboratory in the icebox for further biochemical characterization. Preliminary physiological and biochemical identification of LAB isolates was conducted by growing on MRS agar after ten-fold serial dilution. Seven of the best isolates were selected for the evaluation of the probiotic property. The LAB isolates were checked for resistance to antibiotics and their antimicrobial activity by disc diffusion assay and agar well diffusion assay respectively. Bile salt hydrolase activity of isolates was studied by growing isolates in a BSH medium with bile salt. Cell surface property of isolates was assayed by studying their autoaggregation and coaggregation percentage with S. aerues. All isolates were found BSH positive. In addition, BCM2 and BGM1 were susceptible to all antibiotic disks except BBM1 which was resistant to all antibiotic disks. BCM1 and BGM1 had the highest autoaggregation and coaggregation potential respectively. Since all LAB isolates showed gastrointestinal tolerance and good cell surface property they could be considered as good potential probiotic candidates for treatment and probiotic starter culture preparation.Keywords: probiotic, aggregation, lactic acid bacteria, antimicrobial activity
Procedia PDF Downloads 215102 Impact of a Novel Technique of S-Shaped Tracheostoma in Pediatric Tracheostomy in Intensive Care Unit on Success and Procedure Related Complications
Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh
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Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.Keywords: peatrics, tracheostomy, ICU, tracheostoma
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