Search results for: open surgical wound model

Authors: Robin Singh, Mayank Nautiyal, Priyank Jain, Vatasta Koul, Vaibhav Sharma

Abstract:

The curiosity to investigate the space and its mysteries was dependably the main impetus of human interest, as the particle of livings exists from the "debut de l'Univers" (beginning of the Universe) typified with its few other living things. The sharp drive to uncover the secrets of stars and their unusual deportment was dependably an ignitor of stars investigation. As humankind lives in civilizations and states, stars likewise live in provinces named ‘clusters’. Clusters are separates into 2 composes i.e. open clusters and globular clusters. An open cluster is a gathering of thousand stars that were moulded from a comparable goliath sub-nuclear cloud and for the most part; contain Propulsion I (extremely metal-rich) and Propulsion II (mild metal-rich), where globular clusters are around gathering of more than thirty thousand stars that circles a galactic focus and basically contain Propulsion III (to a great degree metal-poor) stars. Futurology of this paper lies in the spectroscopic investigation of globular clusters like M92 and NGC419 and open clusters like M34 and IC2391 in different color bands by using software like VIREO virtual observatory, Aladin, CMUNIWIN, and MS-Excel. Assessing the outcome Hertzsprung-Russel (HR) diagram with exemplary cosmological models like Einstein model, De Sitter and Planck survey demonstrate for a superior age estimation of respective clusters. Colour-Magnitude Diagram of these clusters was obtained by photometric analysis in g and r bands which further transformed into BV bands which will unravel the idea of stars exhibit in the individual clusters.

Keywords: color magnitude diagram, globular clusters, open clusters, Einstein model

Procedia PDF Downloads 202

Authors: Seyed Reza Aghili, Tahereh Shokohi, Lotfollah Davoodi, Zahra Kashi, Azam Moslemi, Mahdi Abastabar, Iman Haghani, Sabah Mayahi, Asoudeh A.

Abstract:

Introduction: In diabetic foot ulcers, if fungal agents such as Candida species penetrate into the cutaneous or depth of ulcer, can increase the degree of the wound and cause Candia infection and make it more difficult to heal. Material & Methods: A cross-sectional study was performed on 100 diabetic foot ulcer patients in 2020 in Sari, Iran. patient's data and wound grade were recorded in a questionnaire. Candida infection was diagnosed with direct microscopic examination and culture of samples. Colony-PCR molecular method was used for ITS region of DNA and then PCR-RFLP with Msp1 enzyme and using HWP1 specific gene to determine species of Candida agent. Results: Of 100 patients, the mean age 62.1 ± 10.8 years, 95% type 2 diabetes, 83%>10 years duration diabetes, 59% male, 66%> poor education level, 99% married, 52% rural, 95% neuropathic symptoms, 88% using antibiotics, 69%HbA1C >9%, and mean ulcer degree 2.6±1.05 were. Candida infection was seen in 13% of the deep tissue of the wound and 7% cutaneous around the wound. The predominant Candida isolated was C. parapsilosis (71.5%), C .albicans (14.3%). Fungal infections caused by mold fungi were not detected. There was a statistically significant relationship between yeast infection and gender, rural, HbA1C and ulcer degree. Conclusion: Mycological evaluations often are ignored. Candida parapsilosis is the most common infectious agent in these patients and may require specific treatment. Therefore, more attention of physicians to Candida infections particularly, early diagnosis and effective treatment can help faster recovery and prevent amputation.

Keywords: diabetic foot ulcer, candida infection, risk factors, c. parapsilosis

Procedia PDF Downloads 166

Authors: Abhit Kumar

Abstract:

The world is full of master slave Telemanipulator where the doctor’s masters the console and the surgical arm perform the operations, i.e. these robots are passive robots, what the world needs to focus is that in use of these passive robots we are acquiring doctors for operating these console hence the utilization of the concept of robotics is still not fully utilized ,hence the focus should be on active robots, Auto Surgical-Emissive Hand use the similar concept of active robotics where this anthropomorphic hand focuses on the autonomous surgical, emissive and scanning operation, enabled with the vision of 3 way emission of Laser Beam/-5°C < ICY Steam < 5°C/ TIC embedded in palm of the anthropomorphic hand and structured in a form of 3 way disc. Fingers of AS-EH (Auto Surgical-Emissive Hand) as called, will have tactile, force, pressure sensor rooted to it so that the mechanical mechanism of force, pressure and physical presence on the external subject can be maintained, conversely our main focus is on the concept of “emission” the question arises how all the 3 non related methods will work together that to merged in a single programmed hand, all the 3 methods will be utilized according to the need of the external subject, the laser if considered will be emitted via a pin sized outlet, this radiation is channelized via a thin channel which further connect to the palm of the surgical hand internally leading to the pin sized outlet, here the laser is used to emit radiation enough to cut open the skin for removal of metal scrap or any other foreign material while the patient is in under anesthesia, keeping the complexity of the operation very low, at the same time the TIC fitted with accurate temperature compensator will be providing us the real time feed of the surgery in the form of heat image, this gives us the chance to analyze the level, also ATC will help us to determine the elevated body temperature while the operation is being proceeded, the thermal imaging camera in rooted internally in the AS-EH while also being connected to the real time software externally to provide us live feedback. The ICY steam will provide the cooling effect before and after the operation, however for more utilization of this concept we can understand the working of simple procedure in which If a finger remain in icy water for a long time it freezes the blood flow stops and the portion become numb and isolated hence even if you try to pinch it will not provide any sensation as the nerve impulse did not coordinated with the brain hence sensory receptor did not got active which means no sense of touch was observed utilizing the same concept we can use the icy stem to be emitted via a pin sized hole on the area of concern ,temperature below 273K which will frost the area after which operation can be done, this steam can also be use to desensitized the pain while the operation in under process. The mathematical calculation, algorithm, programming of working and movement of this hand will be installed in the system prior to the procedure, since this AS-EH is a programmable hand it comes with the limitation hence this AS-EH robot will perform surgical process of low complexity only.

Keywords: active robots, algorithm, emission, icy steam, TIC, laser

Procedia PDF Downloads 334

Authors: S. Mazifah, A. Azahan, A. Kadir

Abstract:

This paper aims to examine the relationship between the needs of ex-landfill redevelopment and the adequacy of open space provision in the context of sustainable urban development planning in Malaysia as seen from the perspective of the National Urban Policy. With a specific focus on the Action Plan DPN6 and DPN9, ex-landfill redevelopment needs and provision of open space are detailed to identify their potential and constraints in the development of sustainable cities. As a result, this paper found a link between the needs of urban ex-landfill redevelopment and approach to provide adequate urban open space. Through the proposal of the development of public park at urban ex-landfill sites, the needs of ex-landfill redevelopment and the adequacy of urban open space provision is being 'united' and translated as an approach to create a sustainable urban development in Malaysia.

Keywords: ex-landfill redevelopment, open spaces, National Urban Policy, sustainable urban development

Procedia PDF Downloads 423

Authors: Scott Cavinder

Abstract:

Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.

Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery

Procedia PDF Downloads 60

Authors: Hakim Derradji, Abdelkader Yahi, Abdelmalek Sabrou, Nacer Tabet

Abstract:

Introduction: Cystic lesions located in the sellar and suprasellar region cause a diagnostic and therapeutic problem, given their location and their impact on neighboring structures. The patient's symptomatology varies from a simple headache to serious visual and endocrine disorders, involving the functional prognosis, sometimes even the vital prognosis. Surgery in this region remains a therapeutic challenge, and several surgical techniques have been described and used. Material and Methods: We treated 15 patients during the period from 2015 to 2022, whose clinical, biological, radiological, and therapeutic characteristics will be presented in detail in this work, and in whom the surgical technique differs from one case to another. Conclusion: We will discuss in this work the different techniques used to treat these lesions and the different objectives to be achieved for each case, as well as the complications and our conduct to be taken per and post-operative.

Keywords: cystic lesions, adenomas, sellar and suprasellar region, neuroendoscopy

Procedia PDF Downloads 74

Authors: Douglas Yeboah, Monishka Narayan, Jai Singh

Abstract:

One of the key parameters in determining the power conversion efficiency (PCE) of organic solar cells (OSCs) is the open-circuit voltage, however, it is still not well understood. In order to examine the performance of OSCs, it is necessary to understand the losses associated with the open-circuit voltage and how best it can be improved. Here, an analytical expression for the open-circuit voltage of bulk heterojunction (BHJ) OSCs is derived from the charge carrier densities without considering the drift-diffusion current. The open-circuit voltage thus obtained is dependent on the donor-acceptor band gap, the energy difference between the highest occupied molecular orbital (HOMO) and the hole quasi-Fermi level of the donor material, temperature, the carrier density (electrons), the generation rate of free charge carriers and the bimolecular recombination coefficient. It is found that open-circuit voltage increases when the carrier density increases and when the temperature decreases. The calculated results are discussed in view of experimental results and agree with them reasonably well. Overall, this work proposes an alternative pathway for improving the open-circuit voltage in BHJ OSCs.

Keywords: charge carrier density, open-circuit voltage, organic solar cells, temperature

Procedia PDF Downloads 337

Authors: Wael Elkholy, Ashraf Sakr, Mahmoud Qandeel, Adam Elkholy

Abstract:

Lumbar disc herniation is a common pathology that may cause significant low back pain and radicular pain that could profoundly impair daily life activities of individuals. Patients who undergo surgical treatment for lumbar disc herniation usually present with radiculopathy along with low back pain (LBP) instead of radiculopathy alone. When discectomy is performed, improvement in leg radiating pain is observed due to spinal nerve irritation. However, long-term LBP due to degenerative changes in the disc may occur postoperatively. In addition, limited research has been reported on the short-term (within 1 year) improvement in LBP after discectomy. In this study we would like to share our minimally invasive open technique for lumbar discectomy with annuloplasty and nuceloplasty as a technique for effective reduction of both axial and radicular pain.

Keywords: nucleoplasty, sinuvertebral nerve cauterization, annuloplasty, discogenic low back pain, axial pain, radicular pain, minimally invasive lumbar discectomy

Procedia PDF Downloads 45

Authors: Vangelis Papadimitropoulos

Abstract:

This paper is part of the research program “Techno-Social Innovation in the Collaborative Economy”, funded by the Hellenic Foundation for Research and Innovation (H.F.R.I.) for the years 2022-2024. The paper showcases the Open Food Network (OFN) as an open-sourced digital platform supporting short food supply chains in local agricultural production and consumption. The paper outlines the research hypothesis, the theoretical framework, and the methodology of research as well as the findings and conclusions. Research hypothesis: The model of open cooperativism as a vehicle for systemic change in the agricultural sector. Theoretical framework: The research reviews the OFN as an illustrative case study of the three-zoned model of open cooperativism. The OFN is considered a paradigmatic case of the model of open cooperativism inasmuch as it produces commons, it consists of multiple stakeholders including ethical market entities, and it is variously supported by local authorities across the globe, the latter prefiguring the mini role of a partner state. Methodology: Research employs Ernesto Laclau and Chantal Mouffe’s discourse analysis -elements, floating signifiers, nodal points, discourses, logics of equivalence and difference- to analyse the breadth of empirical data gathered through literature review, digital ethnography, a survey, and in-depth interviews with core OFN members. Discourse analysis classifies OFN floating signifiers, nodal points, and discourses into four themes: value proposition, governance, economic policy, and legal policy. Findings: OFN floating signifiers align around the following nodal points and discourses: “digital commons”, “short food supply chains”, “sustainability”, “local”, “the elimination of intermediaries” and “systemic change”. The current research identifies a lack of common ground of what the discourse of “systemic change” signifies on the premises of the OFN’s value proposition. The lack of a common mission may be detrimental to the formation of a common strategy that would be perhaps deemed necessary to bring about systemic change in agriculture. Conclusions: Drawing on Laclau and Mouffe’s discourse theory of hegemony, research introduces a chain of equivalence by aligning discourses such as “agro-ecology”, “commons-based peer production”, “partner state” and “ethical market entities” under the model of open cooperativism, juxtaposed against the current hegemony of neoliberalism, which articulates discourses such as “market fundamentalism”, “privatization”, “green growth” and “the capitalist state” to promote corporatism and entrepreneurship. Research makes the case that for OFN to further agroecology and challenge the current hegemony of industrial agriculture, it is vital that it opens up its supply chains into equivalent sectors of the economy, civil society, and politics to form a chain of equivalence linking together ethical market entities, the commons and a partner state around the model of open cooperativism.

Keywords: sustainability, the digital commons, open cooperativism, innovation

Procedia PDF Downloads 45

Authors: M. Ashaque Meah, Md. Fazlul Karim, M. Shah Noor, Nazmun Nahar Papri, M. Khalid Hossen, M. Ismoen

Abstract:

Tsunami and inundation modelling due to far field tsunami propagation in a limited area is a very challenging numerical task because it involves many aspects such as the formation of various types of waves and the irregularities of coastal boundaries. To compute the effect of far field tsunami and extent of inland inundation due to far field tsunami along the coastal belts of west coast of Malaysia and Southern Thailand, a formulated boundary condition and a moving boundary condition are simultaneously used. In this study, a boundary fitted curvilinear grid system is used in order to incorporate the coastal and island boundaries accurately as the boundaries of the model domain are curvilinear in nature and the bending is high. The tsunami response of the event 26 December 2004 along the west open boundary of the model domain is computed to simulate the effect of far field tsunami. Based on the data of the tsunami source at the west open boundary of the model domain, a boundary condition is formulated and applied to simulate the tsunami response along the coastal and island boundaries. During the simulation process, a moving boundary condition is initiated instead of fixed vertical seaside wall. The extent of inland inundation and tsunami propagation pattern are computed. Some comparisons are carried out to test the validation of the simultaneous use of the two boundary conditions. All simulations show excellent agreement with the data of observation.

Keywords: open boundary condition, moving boundary condition, boundary-fitted curvilinear grids, far-field tsunami, shallow water equations, tsunami source, Indonesian tsunami of 2004

Procedia PDF Downloads 420

Authors: Dimitra V. Peristeri, Hussameldin M. Nour, Amiya Ahsan, Sameh Abogabal, Krishna K. Singh, Muhammad Shafique Sajid

Abstract:

Introduction: The use of optimal skin antiseptic agents for the prevention of surgical site infection (SSI) is of critical importance, especially during abdominal surgical procedures. Alcohol-based chlorhexidine gluconate (CHG) and aqueous-based povidone-iodine (PVI) are the two most common skin antiseptics used nowadays. The objective of this article is to evaluate the effectiveness of alcohol-based CHG versus aqueous-based PVI used for skin preparation before abdominal surgery to reduce SSIs. Methods: Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomised, controlled trials (RCTs) comparing alcohol-based CHG skin preparation versus aqueous-based PVI in patients undergoing abdominal surgery. The combined outcomes of SSIs were calculated using an odds ratio (OR) with 95% confidence intervals (95% CI). All data were analysed using Review Manager (RevMan) Software 5.4, and the meta-analysis was performed with a random effect model analysis. Results: A total of 11 studies, all RCTs, were included (n= 12072 participants), recruiting adult patients undergoing abdominal surgery. In the random effect model analysis, the use of alcohol-based CHG in patients undergoing abdominal surgery was associated with a reduced risk of SSI compared to aqueous-based PVI (OR: 0.84; 95% CI [0.74, 0.96], z= 2.61, p= 0.009). Conclusion: Alcohol-based CHG may be more effective for preventing the risk of SSI compared to aqueous-based PVI agents in abdominal surgery. The conclusion of this meta-analysis may add a guiding value to reinforce current clinical practice guidelines.

Keywords: skin preparation, surgical site infection, chlorhexidine, skin antiseptics

Procedia PDF Downloads 78

Authors: Yanuarti Retnaningrum, Cendrawasih A. Farmasyanti, Kuswahyuning

Abstract:

Orthodontists find challenges in treating patients who have cases of macroglossia and multiple tooth agenesis because difficulties in determining the causes, formulating a diagnosis and the potential for relapse after treatment. Definition of macroglossia is a tongue enlargement due to muscle hypertrophy, tumor or an endocrine disturbance. Macroglossia may cause many problems such as anterior proclination of upper and lower incisors, development of general diastema and anterior and/ or posterior open bite. Treatment for such patients with multiple tooth agenesis and macroglossia can be complex and must consider orthodontic and/or surgical interventions. This article discusses an orthodontic non surgical approach to a patient with a general diastema in both maxilla and mandible associated with multiple tooth agenesis and macroglossia. Fixed orthodontic therapy with straightwire appliance was used for space closure in anterior region of maxilla and mandible, also to create a space suitable for future prosthetic restoration. After 12 months treatment, stable and functional occlusal relationships was achieved, although still have edentulous area in both maxilla and mandible. At the end of the orthodontic treatment was obtained with correct overbite and overjet values. After removal of the brackets, a maxillary and mandibular removable retainer combine with artificial tooth were placed for retention.

Keywords: general diastema, macroglossia, space closure, tooth agenesis

Procedia PDF Downloads 157

Authors: Farnoosh Faal

Abstract:

The excessive reliance on private cars has led to a range of problems, such as traffic congestion, air pollution, and carbon emissions, which have significant impacts on public health and the environment. Public open spaces have the potential to promote sustainable transportation and reduce dependence on cars by providing alternative mobility options, including walking, cycling, and public transit. This paper examines the existing research on the relationship between public open spaces and sustainable transportation. It discusses the key design principles and planning strategies that can enhance the accessibility and safety of public open spaces, particularly for pedestrians and cyclists. The paper also explores the role of public open spaces in promoting active mobility and reducing car use in urban and suburban contexts. Finally, the paper highlights the policy and institutional barriers that hinder the integration of public open spaces with sustainable transportation systems and suggests some potential solutions to overcome these barriers. Overall, the paper argues that public open spaces have immense potential to facilitate sustainable transportation and reduce car dependence, and therefore, it is important to prioritize the development and maintenance of public open spaces as a key component of sustainable urban and regional planning.

Keywords: public open space, sustainable transportation, active mobility, car dependence, urban and regional planning, traffic congestion

Procedia PDF Downloads 125

Authors: Saeed Khandan Siar, Stefan Tenbohlen, Christian Breuer, Raphael Lebreton

Abstract:

The goal of this article is to investigate the detailed temperature distribution and the fluid flow of an oil cooled winding of a power transformer by means of computational fluid dynamics (CFD). The experimental setup consists of three passes of a zig-zag cooled disc type winding, in which losses are modeled by heating cartridges in each winding segment. A precise temperature sensor measures the temperature of each turn. The laboratory setup allows the exact control of the boundary conditions, e.g. the oil flow rate and the inlet temperature. Furthermore, a simulation model is solved using the open source computational fluid dynamics solver OpenFOAM and validated with the experimental results. The model utilizes the laminar and turbulent flow for the different mass flow rate of the oil. The good agreement of the simulation results with experimental measurements validates the model.

Keywords: CFD, conjugated heat transfer, power transformers, temperature distribution

Procedia PDF Downloads 394

Authors: Ahmed Gendia, Waseem Kamran

Abstract:

Objective: Total Laparoscopic hysterectomy (TLH) remains a common approach among laparoscopic surgeons. However, this approach depends on the use of uterine manipulator to facilitate the surgery. Although many studies reported the effectiveness of TLH with uterine manipulator, only few reported TLH without the use of any uterine or vaginal manipulation. the aim of this report is to demonstrate our Technique (kamran's TLH) in performing TLH without the use of any uterine or vaginal manipulation in benign conditions and report our intra- and post-operative outcomes. Methodology : surgical technique will be demonstrated through a short video highlighting the easy and safe to learn surgical steps. Additionally, the data of 86 patients who underwent KTLH for benign condition were retrospectively analyzed. the data included intra- and postoperative finding and complications. Results : A total of 86 hysterectomies were performed utilizing the Kamran's TLH ( KTHL). Mean age was 52.2 (±11) years old and BMI was 28.2(±7). Mean operative time was 64.7(±27.9) minutes and estimated bloods loss was 46.2(±54.6) ml. No intraoperative complications were recorded and there was no conversion to open surgery. Only one patient required readmission and surgery for vaginal vault dehiscence. Conclusion & Significance: Uterine manipulator is a key component in performing laparoscopic hysterectomy. However, our approach demonstrated that TLH can be safely performed without the use of any uterine or vaginal manipulation.

Keywords: laparoscopic hystrectomy, TLH, uterine manipulator, surgery

Procedia PDF Downloads 129

Authors: M. Khaledi Pour, P. Akbartehrani, M. Amini, M. Khani, M. Mohajeri Tehrani, R. Radi, B. Shokri

Abstract:

Diabetic Foot Ulcer (DFU) is one of the costly severe complications of diabetes. Neuropathy and Peripheral Arterial Disease (PAD) due to diabetes are significant causes of this complication. In 10 years the patients with DFUs are twice as likely to die as patients without DFUs. Cold Atmospheric Plasma (CAP) is a promising tool for medical purposes. CAP generate reactive species at room temperature and are effective in killing bacteria and fibroblast proliferation. These CAP-based tools produce NO, which has bactericidal and angiogenesis properties. It also showed promising effects in the DFUs surface reduction and the time to wound closure. In this paper, we evaluated the effect of the Argon Plasma Jet (APJ) on the healing process of the Wagner Grade 2 DFUs in a randomized clinical trial. The 20 kHz sinusoidal voltage frequency derives the APJ. Patients (n=20) were randomly double-blinded assigned into two groups. These groups receive the standard care (SC, n=10) and the standard care with APJ treatment (SC+APJ, n=10) for five sessions in four weeks. The results showed that the APJ treatment along standard care could reduce the wound surface by 20 percent more than the standard care. Also, It showed a more influential role in controlling wound infection.

Keywords: argon plasma jet, cold atmospheric plasma, diabetes, diabetic foot ulcer

Procedia PDF Downloads 174

Authors: Patrícia Severino, Luciana Nalone, Daniele Martins, Marco Chaud, Classius Ferreira, Cristiane Bani, Ricardo Albuquerque

Abstract:

Hydrogels produced with polymers have been used in the development of dressings for wound treatment and tissue revitalization. Our study on polymer nanocomposites containing silver nanoparticles shows antimicrobial activity and applications in wound healing. The effects are linked with the slow oxidation and Ag⁺ liberation to the biological environment. Furthermore, bacterial cell membrane penetration and metabolic disruption through cell cycle disarrangement also contribute to microbial cell death. The silver antimicrobial activity has been known for many years, and previous reports show that low silver concentrations are safe for human use. This work aims to develop a hydrogel using natural polymers (sodium alginate and gelatin) combined with silver nanoparticles for wound healing and with antimicrobial properties in cutaneous lesions. The hydrogel development utilized different sodium alginate and gelatin proportions (20:80, 50:50 and 80:20). The silver nanoparticles incorporation was evaluated at the concentrations of 1.0, 2.0 and 4.0 mM. The physico-chemical properties of the formulation were evaluated using ultraviolet-visible (UV-Vis) absorption spectroscopy, Fourier transform infrared (FTIR) spectroscopy, differential scanning calorimetry (DSC), and thermogravimetric (TG) analysis. The morphological characterization was made using transmission electron microscopy (TEM). Human fibroblast (L2929) viability assay was performed with a minimum inhibitory concentration (MIC) assessment as well as an in vivo cicatrizant test. The results suggested that sodium alginate and gelatin in the (80:20) proportion with 4 mM of AgNO₃ in the (UV-Vis) exhibited a better hydrogel formulation. The nanoparticle absorption spectra of this analysis showed a maximum band around 430 - 450 nm, which suggests a spheroidal form. The TG curve exhibited two weight loss events. DSC indicated one endothermic peak at 230-250 °C, due to sample fusion. The polymers acted as stabilizers of a nanoparticle, defining their size and shape. Human fibroblast viability assay L929 gave 105 % cell viability with a negative control, while gelatin presented 96% viability, alginate: gelatin (80:20) 96.66 %, and alginate 100.33 % viability. The sodium alginate:gelatin (80:20) exhibited significant antimicrobial activity, with minimal bacterial growth at a ratio of 1.06 mg.mL⁻¹ in Pseudomonas aeruginosa and 0.53 mg.mL⁻¹ in Staphylococcus aureus. The in vivo results showed a significant reduction in wound surface area. On the seventh day, the hydrogel-nanoparticle formulation reduced the total area of injury by 81.14 %, while control reached a 45.66 % reduction. The results suggest that silver-hydrogel nanoformulation exhibits potential for wound dressing therapeutics.

Keywords: nanocomposite, wound healing, hydrogel, silver nanoparticle

Procedia PDF Downloads 81

Authors: Estelle Arbellay, Lori D. Daniels, Shawn D. Mansfield, Alice S. Chang

Abstract:

Mountain pine beetle (MPB) outbreaks are currently devastating lodgepole pine forests in western North America, which are also widely disturbed by frequent wildfires. Both MPB and fire can leave scars on lodgepole pine trees, thereby diminishing their commercial value and possibly compromising their utilization in solid wood products. In order to fully exploit the affected resource, it is crucial to understand how wounding from these two disturbance agents impact wood properties. Moreover, previous research on lodgepole pine has focused solely on sound wood and stained wood resulting from the MPB-transmitted blue fungi. By means of a quantitative multi-proxy approach, we tested the hypotheses that (i) wounding (of either MPB or fire origin) caused significant changes in wood properties of lodgepole pine and that (ii) MPB-induced wound effects could differ from those induced by fire in type and magnitude. Pith-to-bark strips were extracted from 30 MPB scars and 30 fire scars. Strips were cut immediately adjacent to the wound margin and encompassed 12 rings from normal wood formed prior to wounding and 12 rings from wound wood formed after wounding. Wood properties evaluated within this 24-year window included ring width, relative wood density, cellulose crystallinity, fibre dimensions, and carbon and nitrogen concentrations. Methods used to measure these proxies at a (sub-)annual resolution included X-ray densitometry, X-ray diffraction, fibre quality analysis, and elemental analysis. Results showed a substantial growth release in wound wood compared to normal wood, as both earlywood and latewood width increased over a decade following wounding. Wound wood was also shown to have a significantly different latewood density than normal wood 4 years after wounding. Latewood density decreased in MPB scars while the opposite was true in fire scars. By contrast, earlywood density was presented only minor variations following wounding. Cellulose crystallinity decreased in wound wood compared to normal wood, being especially diminished in MPB scars the first year after wounding. Fibre dimensions also decreased following wounding. However, carbon and nitrogen concentrations did not substantially differ between wound wood and normal wood. Nevertheless, insect-feeding and fire-heating wounding were shown to significantly alter most wood properties of lodgepole pine, as demonstrated by the existence of several morphological anomalies in wound wood. MPB and fire generally elicited similar anomalies, with the major exception of latewood density. In addition to providing quantitative criteria for differentiating between biotic (MPB) and abiotic (fire) disturbances, this study provides the wood industry with fundamental information on the physiological response of lodgepole pine to wounding in order to evaluate the utilization of scarred trees in solid wood products.

Keywords: elemental analysis, fibre quality analysis, lodgepole pine, wood properties, wounding, X-ray densitometry, X-ray diffraction

Procedia PDF Downloads 297

Authors: Tahra AlMahmoud, Sameeha Mohamed Al Hadhrami, Mohamed Elhanan, Hanan Naser Alshamsi, Fikri Abu-Zidan

Abstract:

Background: To the best of the author(s)’ knowledge there are no epidemiological studies for traumatic eye injuries in UAE, neither data on groups at risk or mechanisms for ocular trauma. Purpose: To report the epidemiology of eye injuries that required hospital admission and surgery at a referral center at the eastern part of Abu Dhabi. Method: Retrospective charts review of all patients who had suffered an eye injury that required surgical intervention between 2012 and 2017 at Al Ain Hospital. Demographic data, place of occurrence, the cause of injury, visual acuity (VA) before and after treatment, number of admission days and follow up were extracted. Data were tabulated and presented as number (%), mean (SD), or median (range) as appropriate. Wilcoxon signed rank test was used for VA outcome. Results: One hundred forty-one patients were identified, 96 eyes with open-globe and 48 other types of injuries. The mean age of the patients was 26±15.5 years, and 89% were male. Majority of injuries occurred at the workplace (50.4%) followed by home (31.2%). Trauma with a sharp object (24.1%), blunt object (16.3%), nail (11.3%), and hammer on metal (7.8%) were the most common etiologies of injury. Corneas injuries (48.2%) was the most frequent cause for visual acuity limitation followed by lens/cataract (23.4%). Among the traumatized eyes, 30 eyes (21.3%) retained intraocular foreign body, Mean admission days was 3.16± 2.81days (1-16) and a number of follow up visit was 3.17± 4.11times (0-26). Conclusion: Ocular trauma requiring surgical intervention is an area of concern in particular for occupations involving work with metals. This work may give insight into the value and necessity of implementing preventive measures.

Keywords: epidemiology, Middle Eastern area, occupational injury, ocular traumas

Procedia PDF Downloads 107

Authors: Robnier Reyes, Andrew J. P. Marques, Joel Ramjist, Chris R. Pasarikovski, Victor X. D. Yang

Abstract:

Over the past three decades, surgical robotic systems have demonstrated their ability to improve surgical outcomes. The LBR Med is a collaborative robotic arm that is meant to work with a surgeon to streamline surgical workflow. It has 7 degrees of freedom and thus can be easily oriented. Position and torque sensors at each joint allow it to maintain a position accuracy of 150 µm with real-time force and torque feedback, making it ideal for complex surgical procedures. Spinal fusion procedures involve the placement of as many as 20 pedicle screws, requiring a great deal of accuracy due to proximity to the spinal canal and surrounding vessels. Any deviation from intended path can lead to major surgical complications. Assistive surgical robotic systems are meant to serve as collaborative devices easing the workload of the surgeon, thereby improving pedicle screw placement by mitigating fatigue related inaccuracies. Moreover, robotic spinal systems have shown marked improvements over conventional freehanded techniques in both screw placement accuracy and fusion quality and have greatly reduced the need for screw revision, intraoperatively and post-operatively. However, current assistive spinal fusion robots, such as the ROSA Spine, are limited in functionality to positioning surgical instruments. While they offer a small degree of improvement in pedicle screw placement accuracy, they do not alleviate surgeon fatigue, nor do they provide real-time force and torque feedback during screw insertion. We propose a semi-autonomous surgical robot workflow for spinal fusion where the surgeon guides the robot to its initial position and orientation, and the robot drives the pedicle screw accurately into the vertebra. Here, we demonstrate feasibility by inserting pedicle screws into ex-vivo bovine rib bone. The robot monitors position, force and torque with respect to predefined values selected by the surgeon to ensure the highest possible spinal fusion quality. The workflow alleviates the strain on the surgeon by having the robot perform the screw placement while the ability to monitor the process in real-time keeps the surgeon in the system loop. The approach we have taken in terms of level autonomy for the robot reflects its ability to safely collaborate with the surgeon in the operating room without external navigation systems.

Keywords: ex vivo bovine bone, pedicle screw, surgical robot, surgical workflow

Procedia PDF Downloads 135

Authors: Thammanoon Charmjuree, Yuosre F. Badir, Umar Safdar

Abstract:

There is a consensus among innovation scholars that knowledge is a vital antecedent for firm’s innovation; e.g., process innovation. Recently, there has been an increasing amount of attention to more open approaches to innovation. This open model emphasizes the use of purposive flows of knowledge across the organization boundaries. Firms adopt open innovation strategy to improve their innovation performance by bringing knowledge into the organization (inbound open innovation) to accelerate internal innovation or transferring knowledge outside (outbound open innovation) to expand the markets for external use of innovation. Reviewing open innovation research reveals the following. First, the majority of existing studies have focused on inbound open innovation and less on outbound open innovation. Second, limited research has considered the possible interaction between both and how this interaction may impact the firm’s innovation performance. Third, scholars have focused mainly on the impact of open innovation strategy on product innovation and less on process innovation. Therefore, our knowledge of the relationship between firms’ inbound and outbound open innovation and how these two impact process innovation is still limited. This study focuses on the firm’s external technology acquisition (ETA) and external technology exploitation (ETE) and the firm’s process innovation performance. The ETA represents inbound openness in which firms rely on the acquisition and absorption of external technologies to complement their technology portfolios. The ETE, on the other hand, refers to commercializing technology assets exclusively or in addition to their internal application. This study hypothesized that both ETA and ETE have a positive relationship with process innovation performance and that ETE fully mediates the relationship between ETA and process innovation performance, i.e., ETA has a positive impact on ETE, and turn, ETE has a positive impact on process innovation performance. This study empirically explored these hypotheses in software development firms in Thailand. These firms were randomly selected from a list of Software firms registered with the Department of Business Development, Ministry of Commerce of Thailand. The questionnaires were sent to 1689 firms. After follow-ups and periodic reminders, we obtained 329 (19.48%) completed usable questionnaires. The structure question modeling (SEM) has been used to analyze the data. An analysis of the outcome of 329 firms provides support for our three hypotheses: First, the firm’s ETA has a positive impact on its process innovation performance. Second, the firm’s ETA has a positive impact its ETE. Third, the firm’s ETE fully mediates the relationship between the firm’s ETA and its process innovation performance. This study fills up the gap in open innovation literature by examining the relationship between inbound (ETA) and outbound (ETE) open innovation and suggest that in order to benefits from the promises of openness, firms must engage in both. The study went one step further by explaining the mechanism through which ETA influence process innovation performance.

Keywords: process innovation performance, external technology acquisition, external technology exploitation, open innovation

Procedia PDF Downloads 177

Authors: Chatchaval Pornpatkul, Wipawan Suksathid

Abstract:

This paper is to study and control the pressure of the water inside the open tank using a cascade control with the communication in the process by fieldbus system for the pressure calibration. The plant model is to be used in experiments to control the level and flow process of the water by using Syscon program to create functions. We used to control by Intouch runtime program to create the graphic display on the screen. In this case we used PI control the level and the flow process of water in the open tank in the range of 0 – 10 L/m. The output signal of the level and the flow transmitter are the digital standard signal by fieldbus system. And all information displayed on the computer with the communication between the computer and plant model can be communication to each other through just one cable pair. And in this paper, the PI tuning, we used calculate by Ziegler-Nichols reaction curve method to control the plant model by PI controller.

Keywords: cascade control, fieldbus system, pressure calibration, microelectronics systems

Procedia PDF Downloads 437

Authors: Young-Su Ryu, Won-Gi Jeon, Byoung-Chul Song, Jae-Hong Park, Ki-Won Kwon

Abstract:

In this paper, an open framework based smart energy storage system (ESS) profile for photovoltaic (PV)-ESS and uninterruptible power supply (UPS)-ESS is proposed and designed. An open framework based smart ESS is designed and developed for unifying the different interfaces among manufacturers. The smart ESS operates under the profile which provides the specifications of peripheral devices such as different interfaces and to the open framework. The profile requires well systemicity and expandability for addible peripheral devices. Especially, the smart ESS should provide the expansion with existing systems such as UPS and the linkage with new renewable energy technology such as PV. This paper proposes and designs an open framework based smart ESS profile for PV-ESS and UPS-ESS. The designed profile provides the existing smart ESS and also the expandability of additional peripheral devices on smart ESS such as PV and UPS.

Keywords: energy storage system (ESS), open framework, profile, photovoltaic (PV), uninterruptible power supply (UPS)

Procedia PDF Downloads 448

Authors: Edu Marcelina, Sule Sheidu A., Nsor Eunice

Abstract:

As open and distance education is gradually becoming an acceptable means of solving the problem of access in higher education, quality has now become one of the main concerns among institutions and stakeholders of open and distance learning (ODL) and the education sector in general. This study assessed the challenges of academic quality in the open and distance learning (ODL) education in Nigeria using Distance Learning Institute (DLI), University of Lagos and National Open University of Nigeria as a case. In carrying out the study, a descriptive survey research design was employed. A researcher-designed and validated questionnaire was used to elicit responses that translated to the quantitative data for this study. The sample comprised 665 students of the Distance Learning Institute (DLI), and National Open University of Nigeria (NOUN), carefully selected through the method of simple random sampling. Data collected from the study were analyzed using Chi-Square (X2) at 0.05 Level of significance. The results of the analysis revealed that; the use of ICT tools is a factor in ensuring quality in the Open and Distance Learning (ODL) operations; the quality of the materials made available to ODL students will determine the quality of education that will be received by the students; and the time scheduled for students for self-study, online lecturing/interaction and face to face study and the quality of education in Open and Distance Learning Institutions has a lot of impact on the quality of education the students receive. Based on the findings, a number of recommendations were made.

Keywords: open and distance learning, quality, ICT, face-to-face interaction

Procedia PDF Downloads 346

Authors: Soorya Vennila

Abstract:

A comprehensive study of malaria in 165 villages (hamlets) in Harur block, Dharmapuri district, has revealed the fact that there are distinct episodes of malaria due to An. culicifacies, the vector, causes persistent transmission in the revenue village called Vedakatamaduvu. A total of 300 household adult samples are randomly selected to study both quantitatively and qualitatively the vulnerability of malaria. On the basis of the response, the problem uncommon with groups was identified as the outdoor routine, particularly open defecation, with which the samples needed to be stratified into two major groups; users of toilets 21 and those who practice open defecation 279. Open defecation, as the habit-based vulnerability, is measured with the Pearson correlation coefficient to estimate the relationship between malaria and open defecation. It is also verified from the literature that plant fluids provide mosquitoes not only with energy but also with nutrition, to the extent that they can develop fertile eggs. In the endemic areas, the bushy Presopis Juliflora, which naturally serves as a feeding and resting spot for mosquitoes, serves as a cover to practice open defecation as well. Eventually, those who get resort to Presopis for open defecation have a higher chance of getting exposed to mosquito bites and being infected with malaria. The study concludes that the combination of bushy Prosopis Juliflora and open defecation leaves the place perpetually vulnerable to malaria.

Keywords: Malaria, open defecation, endemic, presopis juliflora

Procedia PDF Downloads 69

Authors: Hansraj Bookun, Angela Tan, Rachel Xuan, Linheng Zhao, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos

Abstract:

Introduction: Incisional wound complications in vascular surgery patients represent a significant clinical and econometric burden of morbidity and mortality. The objective of this study was to trial the feasibility of applying the Prevena negative pressure incision management system as a routine dressing in patients who had undergone arterial surgery. Conventionally, Prevena has been applied to groin incisions, but this study features applications on multiple wound sites such as the thigh or major amputation stumps. Method: This was a cross-sectional observational, single-centre case series of 12 patients who had undergone major vascular surgery. Their wounds were managed with the Prevena system being applied either intra-operatively or on the first post-operative day. Demographic and operative details were collated as well as the length of stay and complication rates. Results: There were 9 males (75%) with mean age of 66 years and the comorbid burden was as follows: ischaemic heart disease (92%), diabetes (42%), hypertension (100%), stage 4 or greater kidney impairment (17%) and current or ex-smoking (83%). The main indications were acute ischaemia (33%), claudication (25%), and gangrene (17%). There were single instances of an occluded popliteal artery aneurysm, diabetic foot infection, and rest pain. The majority of patients (50%) had hybrid operations with iliofemoral endarterectomies, patch arterioplasties, and further peripheral endovascular treatment. There were 4 complex arterial bypass operations and 2 major amputations. The mean length of stay was 17 ± 10 days, with a range of 4 to 35 days. A single complication, in the form of a lymphocoele, was encountered in the context of an iliofemoral endarterectomy and patch arterioplasty. This was managed conservatively. There were no deaths. Discussion: The Prevena wound management system shows that in conjunction with safe vascular surgery, absolute wound complication rates remain low and that it remains a valuable adjunct in the treatment of vasculopaths.

Keywords: wound care, negative pressure, vascular surgery, closed incision

Procedia PDF Downloads 105

Authors: Fossarello Maurizio, Mattana Giorgio, Tatti Filippo.

Abstract:

The most widely performed surgical procedure in Open-Angle Glaucoma (OAG) is trabeculectomy. Although this filtering procedure is extremely effective, surgical failure and postoperative complications are reported. Due to the its invasive nature and possible complications, trabeculectomy is usually reserved, in practice, for patients who are refractory to medical and laser therapy. Recently, a number of micro-invasive surgical techniques (MIGS: Micro-Invasive Glaucoma Surgery), have been introduced in clinical practice. They meet the criteria of micro-incisional approach, minimal tissue damage, short surgical time, reliable IOP reduction, extremely high safety profile and rapid post-operative recovery. Xen45 Gel Implant (Allergan, Dublin, Ireland) is one of the MIGS alternatives, and consists in a porcine gelatin tube designed to create an aqueous flow from the anterior chamber to the subconjunctival space, bypassing the resistance of the trabecular meshwork. In this study we report the results of this technique as a favorable option in the treatment of OAG for its benefits in term of efficacy and safety, either alone or in combination with cataract surgery. This is a retrospective, single-center study conducted in consecutive OAG patients, who underwent Xen45 Gel Stent implantation alone or in combination with phacoemulsification, from October 2018 to June 2019. The primary endpoint of the study was to evaluate the reduction of both IOP and number of antiglaucoma medications at 12 months. The secondary endpoint was to correlate filtering bleb morphology evaluated by means of anterior segment OCT with efficacy in IOP lowering and eventual further procedures requirement. Data were recorded on Microsoft Excel and study analysis was performed using Microsoft Excel and SPSS (IBM). Mean values with standard deviations were calculated for IOPs and number of antiglaucoma medications at all points. Kolmogorov-Smirnov test showed that IOP followed a normal distribution at all time, therefore the paired Student’s T test was used to compare baseline and postoperative mean IOP. Correlation between postoperative Day 1 IOP and Month 12 IOP was evaluated using Pearson coefficient. Thirty-six eyes of 36 patients were evaluated. As compared to baseline, mean IOP and the mean number of antiglaucoma medications significantly decreased from 27,33 ± 7,67 mmHg to 16,3 ± 2,89 mmHg (38,8% reduction) and from 2,64 ± 1,39 to 0,42 ± 0,8 (84% reduction), respectively, at 12 months after surgery (both p < 0,001). According to bleb morphology, eyes were divided in uniform group (n=8, 22,2%), subconjunctival separation group (n=5, 13,9%), microcystic multiform group (n=9, 25%) and multiple internal layer group (n=14, 38,9%). Comparing to baseline, there was no significative difference in IOP between the 4 groups at month 12 follow-up visit. Adverse events included bleb function decrease (n=14, 38,9%), hypotony (n=8, 22,2%) and choroidal detachment (n=2, 5,6%). All eyes presenting bleb flattening underwent needling and MMC injection. The higher percentage of patients that required secondary needling was in the uniform group (75%), with a significant difference between the groups (p=0,03). Xen45 gel stent, either alone or in combination with phacoemulsification, provided a significant lowering in both IOP and medical antiglaucoma treatment and an elevated safety profile.

Keywords: anterior segment OCT, bleb morphology, micro-invasive glaucoma surgery, open angle glaucoma, Xen45 gel implant

Procedia PDF Downloads 109

Authors: Kwei Huan Liw, Sashi B. Darshan

Abstract:

Background: Double eyelid surgery has become one of the most sought-after aesthetic procedures among Asians. Many surgeons perform surgical blepharoplasty and various other methods of non-incisional blepharoplasty. Face-Q is a validated method of measuring patient satisfaction for facial aesthetic procedures. Here we have analyzed the overall eye satisfaction score, the upper eyelid appraisal score and the adverse effect on eyes score Methods: 274 patients (548 eyes), aged between 18 to 40 years old, were recruited from 2015-2018. Each patient underwent a non-incisional double-eyelid blepharoplasty using a single-knotted continuous buried suture. 3 – 5 stab incisions were made depending on the upper eyelid size. A needle loaded with 7-0 nylon is passed from the lateral most wound through the dermis and the conjunctiva in an alternate fashion into the remaining stab wounds. The suture is then tunneled back laterally in the deeper dermis and knotted securely with the suture end. The knot is then buried within the orbicularis oculi muscle. Each patient was required to fill the Face-Q questionnaire before the procedure and 2 weeks post procedure. The results are described based on the percentage of the maximum achievable score. Patients were reviewed after 12 to 18 months to assess the long-term outcome. Results: The overall eye satisfaction score demonstrated a high level of post-operative satisfaction (97.85%), compared to 27.32% pre-operatively. The appraisal of upper eyelid scores showed drastic improvement in perception post-operatively (95.31%) compared to 21.44% pre-operatively. Adverse effect on eyes score showed a very low post-operative complication rate (0.4%) The long-term follow-up showed 6 cases that had developed asymmetrical folds. Only 1 patient agreed for revision surgery. The other 5 patients were still satisfied with the outcome and were not keen for revision surgery. None of the cases had loosening of knots. Conclusion: Modified single-knot continuous buried suture technique is a simple and non-invasive method to create aesthetically pleasing non-surgical double-eyelids, which has long-term effects. Proper patient selection is crucial and good surgical technique is required to achieve a desirable outcome.

Keywords: blepharoplasty, double-eyelid, face-Q, non-incisional

Procedia PDF Downloads 100

Authors: T. Nozu, K. Hibi, T. Nishiie

Abstract:

This paper discusses the applicability of the numerical model for a damage prediction method of the accidental hydrogen explosion occurring in a hydrogen facility. The numerical model was based on an unstructured finite volume method (FVM) code “NuFD/FrontFlowRed”. For simulating unsteady turbulent combustion of leaked hydrogen gas, a combination of Large Eddy Simulation (LES) and a combustion model were used. The combustion model was based on a two scalar flamelet approach, where a G-equation model and a conserved scalar model expressed a propagation of premixed flame surface and a diffusion combustion process, respectively. For validation of this numerical model, we have simulated the previous two types of hydrogen explosion tests. One is open-space explosion test, and the source was a prismatic 5.27 m3 volume with 30% of hydrogen-air mixture. A reinforced concrete wall was set 4 m away from the front surface of the source. The source was ignited at the bottom center by a spark. The other is vented enclosure explosion test, and the chamber was 4.6 m × 4.6 m × 3.0 m with a vent opening on one side. Vent area of 5.4 m2 was used. Test was performed with ignition at the center of the wall opposite the vent. Hydrogen-air mixtures with hydrogen concentrations close to 18% vol. were used in the tests. The results from the numerical simulations are compared with the previous experimental data for the accuracy of the numerical model, and we have verified that the simulated overpressures and flame time-of-arrival data were in good agreement with the results of the previous two explosion tests.

Keywords: deflagration, large eddy simulation, turbulent combustion, vented enclosure

Procedia PDF Downloads 222

Authors: Mujahid Ali, Wasif Mohammed Ali, Meraj Ahmad

Abstract:

Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well as in India. The etiology of perforation peritonitis in India continues to be different from its western counterparts. The aim of this study is to evaluate the spectrum of cases of perforation peritonitis at our hospital. Methods: A prospective study conducted includes three hundred thirtysix patients of perforation peritonitis at J. N. Medical College from October 2015 to July 2017. The patients were admitted, resuscitated and underwent emergency laparotomy. Data were collected in terms of demographic profile, clinical presentations, site of perforations, causes and surgical outcomes. Results: In this study, the most common cause of perforation peritonitis was peptic ulcer disease (43%), followed by enteric perforation (12.8%), tubercular perforation (12.5%), traumatic perforation (11.9%), appendicular perforation (9.8%), amoebic caecal perforation (3%), malignant perforation (1.5%), etc. The sites of perforations were stomach in majority (38.3%), ileum (31%), appendix (8%), duodenum (5.%), caecum (4.4%) ,colon (3%), jejunum (8.5%) and gall bladder (2%). The overall mortality was 21% in our study. Age >50 years (p= <0.0001, OR= 3.9260, CI= 2.2 to 6.9), organ failure (p= <0.0001, OR= 29.2, CI= 14.8 to 57.6), shock (p=<0.0001, OR=20.20, CI= 10.56 to 38.6), diffuse peritonitis (p<0.0015, OR= 6.8810, CI= 2.09 to 22.57) and faecal exudates (p<0.0001) were found to be significant factors affecting mortality. The most common complication associated was superficial wound infection (40%), followed by burst abdomen seen in 21% cases, intra-abdominal sepsis in 18% cases, electrolyte imbalances in 15% cases, anastomotic leak in 6% cases. Conclusion: In this study, stomach is the most common site of perforation with peptic ulcer disease being the most common etiology. Older age, presence of shock, organ failure and faecal peritonitis were the risk factors affecting the mortality of the patients. Early recognition, adequate resuscitation and referral of patients can influence outcome and reduces mortality as well as morbidity.

Keywords: etiology, mortality, perforation, spectrum

Procedia PDF Downloads 236