Search results for: high blood pressure

Authors: Chong Hu, Tiantian Wang, Zhe Li, Ourui Huang, Yichen Pan

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When the train is running in a high geothermal tunnel, changes in the temperature field will cause disturbances in the propagation and superposition of pressure waves in the tunnel, which in turn have an effect on the aerodynamic resistance of the train. The aim of this paper is to investigate the effect of the changes in the lengths of the high-temperature zone of the tunnel on the aerodynamic resistance of the train, clarifying the evolution mechanism of aerodynamic resistance of trains in tunnels with high ground temperatures. Firstly, moving model tests of trains passing through wall-heated tunnels were conducted to verify the reliability of the numerical method in this paper. Subsequently, based on the three-dimensional unsteady compressible RANS method and the standard k-ε two-equation turbulence model, the change laws of the average aerodynamic resistance under different high-temperature zone lengths were analyzed, and the influence of frictional resistance and pressure difference resistance on total resistance at different times was discussed. The results show that as the length of the high-temperature zone LH increases, the average aerodynamic resistance of a train running in a tunnel gradually decreases; when LH = 330 m, the aerodynamic resistance can be reduced by 5.7%. At the moment of maximum resistance, the total resistance, differential pressure resistance, and friction resistance all decrease gradually with the increase of LH and then remain basically unchanged. At the moment of the minimum value of resistance, with the increase of LH, the total resistance first increases and then slowly decreases; the differential pressure resistance first increases and then remains unchanged, while the friction resistance first remains unchanged and then gradually decreases, and the ratio of the differential pressure resistance to the total resistance gradually increases with the increase of LH. The results of this paper can provide guidance for scholars who need to investigate the mechanism of aerodynamic resistance change of trains in high geothermal environments, as well as provide a new way of thinking for resistance reduction in non-high geothermal tunnels.

Keywords: high-speed trains, aerodynamic resistance, high-ground temperature, tunnel

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Authors: Alua Massalimova

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Situation analysis of Blood Service revealed that the strengths dominated over the weak 1.4 times. The possibilities dominate over the threats by 1.1 times. It follows that by using timely the possibility the Service, it is possible to strengthen its strengths and avoid threats. Priority directions of the resulting analysis are the use of subjective factors, such as personal management capacity managers of the Blood Center in the field of possibilities of legal activity of administrative decisions and the mobilization of stable staff in general market conditions. We have studied for the period 2011-2015 retrospectively indicators of Blood Service of Kazakhstan. Strengths of Blood Service of RK(Ps4,5): 1) indicators of donations for 1000 people is higher than in some countries of the CIS (in Russia 14, Kazakhstan - 17); 2) the functioning science centre of transfusiology; 3) the legal possibility of additional financing blood centers in the form of paid services; 4) the absence of competitors; 5) training on specialty Transfusiology; 6) the stable management staff of blood centers, a high level of competence; 7) increase in the incidence requiring transfusion therapy (oncohematology); 8) equipment upgrades; 9) the opening of a reference laboratory; 10) growth of the proportion of issued high-quality blood components; 11) governmental organization 'Drop of Life'; 12) the functioning bone marrow register; 13) equipped with modern equipment HLA-laboratory; 14) High categorization of average medical workers; 15) availability of own specialized scientific journal; 16) vivarium. The weaknesses (Ps = 3.5): 1) the incomplete equipping of blood centers and blood transfusion cabinets according to standards; 2) low specific weight of paid services of the CC; 3) low categorization of doctors; 4) high staff turnover; 5) the low scientific potential of industrial and clinical of transfusiology; 6) the low wages paid; 7) slight growth of harvested donor blood; 8) the weak continuity with offices blood transfusion; 9) lack of agitation work; 10) the formally functioning of Transfusion Association; 11) the absence of scientific laboratories; 12) high standard deviation from the average for donations in the republic. The possibilities (Ps = 2,7): 1): international grants; 2) organization of international seminars on clinical of transfusiology; 3) cross-sectoral cooperation; 4) to increase scientific research in the field of clinical of transfusiology; 5) reduce the share of donation unsuitable for transfusion and processing; 6) strengthening marketing management in the development of fee-based services; 7) advertising paid services; 8) strengthening the publishing of teaching aids; 9) team-building staff. The threats (Ps = 2.1): 1) an increase of staff turnover; 2) the risk of litigation; 3) reduction gemoprodukts based on evidence-based medicine; 4) regression of scientific capacity; 5) organization of marketing; 6) transfusiologist marketing; 7) reduction in the quality of the evidence base transfusions.

Keywords: blood service, healthcare, Kazakhstan, quantative swot analysis

Procedia PDF Downloads 215

Authors: Mehdi Behbahani, Sebastian Rible, Charles Moulinec, Yvan Fournier, Mike Nicolai, Paolo Crosetto

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Computational Fluid Dynamics blood-flow simulations are increasingly used to develop and validate blood-contacting medical devices. This study shows that numerical simulations can provide additional and accurate estimates of relevant hemodynamic indicators (e.g., recirculation zones or wall shear stresses), which may be difficult and expensive to obtain from in-vivo or in-vitro experiments. The most recent FDA (Food and Drug Administration) benchmark consisted of a simplified centrifugal blood pump model that contains fluid flow features as they are commonly found in these devices with a clear focus on highly turbulent phenomena. The FDA centrifugal blood pump study is composed of six test cases with different volumetric flow rates ranging from 2.5 to 7.0 liters per minute, pump speeds, and Reynolds numbers ranging from 210,000 to 293,000. Within the frame of this study different turbulence models were tested including RANS models, e.g. k-omega, k-epsilon and a Reynolds Stress Model (RSM) and, LES. The partitioners Hilbert, METIS, ParMETIS and SCOTCH were used to create an unstructured mesh of 76 million elements and compared in their efficiency. Computations were performed on the JUQUEEN BG/Q architecture applying the highly parallel flow solver Code SATURNE and typically using 32768 or more processors in parallel. Visualisations were performed by means of PARAVIEW. Different turbulence models including all six flow situations could be successfully analysed and validated against analytical considerations and from comparison to other data-bases. It showed that an RSM represents an appropriate choice with respect to modeling high-Reynolds number flow cases. Especially, the Rij-SSG (Speziale, Sarkar, Gatzki) variant turned out to be a good approach. Visualisation of complex flow features could be obtained and the flow situation inside the pump could be characterized.

Keywords: blood flow, centrifugal blood pump, high performance computing, scalability, turbulence

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Authors: Nalan Hakime Nogay

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Childhood obesity is a significant health issue that is currently on the rise all over the world. In recent years, the relationship between childhood obesity and cardiovascular disease risk has been pointed out. The purpose of this study is to evaluate the relationship between some of the anthropometric indicators and blood lipid levels in adolescents. The present study has been conducted on a total of 252 adolescents -200 girls and 52 boys- within an age group of 12 to 18 years. Blood was drawn from each participant in the morning -after having fasted for 10 hours from the day before- to analyze their total cholesterol, HDL, LDL and triglyceride levels. Their body weight, height, waist circumference, subscapular skinfold thicknesses and triceps skinfold thicknesses measurements were taken and their individual waist/height ratios, BMI and body fat ratios were calculated. The blood lipid levels of the participants were categorized as acceptable, borderline and high in accordance with the 2011 Expert Panel Integrated Guidelines. The body fat ratios, total blood cholesterol and HDL levels of the girls were significantly higher than the boys whereas their waist circumference values were lower. The triglyceride levels, total cholesterol/HDL, LDL/HDL, triglyceride/HDL ratios of the group with the BMI ≥ 95 percentile ratio (the obese group) were higher than the groups that were considered to be overweight and normal weight as per their respective BMI values, while the HDL level of the obese group was lower; a fact that was found to be statistically significant. No significant relationship could be established, however, between the total blood cholesterol and LDL levels with their anthropometric measurements. The BMI, waist circumference, waist/height ratio, body fat ratio and triglyceride level of the group with the higher triglyceride level ( ≥ 130mg/dl) were found to be significantly higher compared to borderline (90-129 mg/dl) and the normal group (< 90 mg/dl). The BMI, waist circumference, waist/height ratio values of the group with the lower HDL level ( < 40 mg/dl) were significantly higher than the normal ( > 45 mg/dl) and borderline (40-45 mg/dl) groups. All of the anthropometric measurements of the group with the higher triglyceride/HDL ratio ( ≥ 3) were found to be significantly higher than that of the group with the lower ratio (< 3). Having a high BMI, waist/height ratio and waist circumference is related to low HDL and high blood triglyceride and triglyceride/HDL ratio. A high body fat ratio, on the other hand, is associated with a low HDL and high triglyceride/HDL ratio. Tackling childhood and adolescent obesity are important in terms of preventing cardiovascular diseases.

Keywords: adolescent, body fat, body mass index, lipid profile

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Authors: J. Al-Dmour, A. Sagahyroon, A. Al-Ali, S. Abusnana

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Radio Frequency Based Identification Systems have emerged as one of the possible valuable solutions that can be utilized in healthcare systems. Nowadays, RFID tags are available with built-in human vital signs sensors such as Body Temperature, Blood Pressure, Heart Rate, Blood Sugar level and Oxygen Saturation in Blood. This work proposes the design, implementation, and testing of an integrated mobile RFID-based health care system. The system consists of a wireless mobile vital signs data acquisition unit (RFID-DAQ) integrated with a fuzzy-logic–based software algorithm to monitor and assess patients conditions. The system is implemented and tested in ‘Rashid Center for Diabetes and Research’, Ajman, UAE. System testing results are compared with the Modified Early Warning System (MEWS) that is currently used in practice. We demonstrate that the proposed and implemented system exhibits an accuracy level that is comparable and sometimes better than the widely adopted MEWS system.

Keywords: healthcare, fuzzy logic, MEWS, RFID

Procedia PDF Downloads 331

Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

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Diabetes in India is growing at an alarming rate and the complications caused by it need to be controlled. Coronary heart disease (CHD) is one of the complications that will be discussed for prediction in this study. India has the second most number of diabetes patients in the world. To the best of our knowledge, there is no CHD risk score for Indian type 2 diabetes patients. Any form of CHD has been taken as the event of interest. A sample of 750 was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of CHD. Predictive risk scores of CHD events are designed by cox proportional hazard regression. Model calibration and discrimination is assessed from Hosmer Lemeshow and area under receiver operating characteristic (ROC) curve. Overfitting and underfitting of the model is checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Youden’s index is used to choose the optimal cut off point from the scores. Five year probability of CHD is predicted by both survival function and Markov chain two state model and the better technique is concluded. The risk scores for CHD developed can be calculated by doctors and patients for self-control of diabetes. Furthermore, the five-year probabilities can be implemented as well to forecast and maintain the condition of patients.

Keywords: coronary heart disease, cox proportional hazard regression, ROC curve, type 2 diabetes Mellitus

Procedia PDF Downloads 206

Authors: Karuna Sutthibenjakul, Sunisa Chatmongkolchart

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Background: Postinduction hypotension is common and occurs more often in elderly patients. We aimed to determine risk factors for hypotension after induction among elderly patients (aged 65 years and older) who underwent elective non-cardiac surgery under general anesthesia. Methods: This cohort study analyzed from 580 data between December 2017 and July 2018 at a tertiary university hospital in south of Thailand. Hypotension is defined as more than 30% decrease mean arterial pressure from baseline after induction within 20 minutes or the use of vasopressive agent to treat low blood pressure. Intraoperative parameters were blood pressure and heart rate at T0, TEI, T5, T10, T15 and T20 (immediately after arrival at operating room, time after intubation, 5, 10, 15 and 20 minutes after intubation) respectively. Results: The median age was 72.5 (68, 78) years. A prevalence of post-induction hypotension was 64.8%. The highest prevalence (39.7%) was at 15 minutes after intubation. The association of post-induction hypotension is rising with diuretic drug as preoperative medication (P-value=0.016), hematocrit level (P-value=0.031) and the degree of hypertension immediately after arrival at operating room (P-value<0.001). Increasing fentanyl dosage during induction was associated with hypotension at intubation time (P-value<0.01) and 5 minutes after intubation (P-value<0.001). There was no statistically significant difference in the increasing propofol dosage. Conclusion: The degree of hypertension immediately after arrival at operating room and increasing fentanyl dosage were a significant risk factors for postinduction hypotension in elderly patients.

Keywords: risk factors, post-induction, hypotension, elderly

Procedia PDF Downloads 118

Authors: S. M. Golgoun, S. M. Taheri

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Investigation of radioactive contamination of personnel working in radiation centers to identify radioactive materials and then measure the potential contamination and eliminate it has always been considered. For this purpose, various ways have been proposed so far and different devices have been designed and built. Gas sealed proportional counter has special working conditions. In this research, a gas sealed detector of proportional counter type was made and then its various parameters were investigated. Some parameters are influential on their working conditions and one of these most important parameters is the internal pressure of the proportional gas-filled detector. In this experimental research, we produced software for examination and altering high voltage, registering data, and calculating efficiency. By this, we investigated different gas pressure effects on detector efficiency and proposed optimizing working conditions of this detector. After reviewing the results, we suggested a range between 20-30 mbar pressure for this gas sealed detector.

Keywords: gas sealed, proportional detector, pressure, counter

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Authors: Osama Zayed

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Aim of the work: The aim of this study is to assess the predictors of pelvic vascular injuries in patients with pelvic fractures from major blunt trauma. Methods: This study was conducted as a tool-assessment study. Forty six patients with pelvic fractures from major blunt trauma will be recruited to the study arriving to department of emergency, Suez Canal University Hospital. Data were collected from questionnaire including; personal data of the studied patients and full medical history, clinical examinations, outcome measures (The Physiological and Operative Severity Score for enumeration of Mortality and morbidity (POSSUM), laboratory and imaging studies. Patients underwent surgical interventions or further investigations based on the conventional standards for interventions. All patients were followed up during conservative, operative and post-operative periods in the hospital for interpretation the predictive scores of vascular injuries. Results: Significant predictors of vascular injuries according to computed tomography (CT) scan include age, male gender, lower Glasgow coma (GCS) scores, occurrence of hypotension, mortality rate, higher physical POSSUM scores, presence of ultrasound collection, type of management, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) POSSUM scores, presence of abdominal injuries, and poor outcome. Conclusions: There was higher frequency of males than females in the studied patients. There were high probability of morbidity and low probability of mortality among patients. Our study demonstrates that POSSUM score can be used as a predictor of vascular injury in pelvis fracture patients.

Keywords: predictors, pelvic vascular injuries, pelvic fractures, major blunt trauma, POSSUM

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Authors: Sihyun Chae, Ryoto Arai, Waldo Concepcion, Paula Popescu

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The kidneys perform an important role in the human hormones that regulate the blood pressure, produce an active form of vitamin D and control the production of red blood cells. Kidney disease can cause health problems, such as heart disease. Also, increase the chance of having a stroke or heart attack. There are mainly to types of treatments for kidney disease, dialysis, and kidney transplant. For a better quality of life, the kidney transplant is desirable. However, kidney transplant can cause antibody reaction and patients’ body would be attacked by immune system of their own. For solving that issue, patients with transplanted kidney always take immunosuppressive drugs which can hurt kidney as side effects. Patients willing to do a kidney transplant have a waiting time of 3.6 years in average searching to find an appropriate kidney, considering there are almost 96,380 patients waiting for kidney transplant. There is a promising method to solve these issues: bioartificial kidney. Our membrane is specially designed with unique perforations capable to filter the blood cells separating the white blood cells from red blood cells. White blood cells will not pass through the encapsulated kidney preventing the immune system to attack the new organ and eliminating the need of a matching donor. It is possible to construct life-time long encapsulation without needing pumps or a power supply on the cell’s separation method preventing futures surgeries due the Cross-Channel Flow inside the device. This technology allows the possibility to use an animal kidney, prevent cancer cells to spread through the body, arm and leg transplants in the future. This project aims to improve the quality of life of patients with kidney disease.

Keywords: kidney encapsulation, immunosuppression filter, leukocyte filter, leukocyte

Procedia PDF Downloads 188

Authors: Siddig H. Hamad, Salah M. Al-Eid, Fahad M. Al-Jassas

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Composite samples of minced chicken were vacuum-packaged and pressure treated at 300, 400, 450 and 500 MPa in a Stansted 'FOOD-LAB' model S-FL-850-9-W high hydrostatic pressure research apparatus (Stansted Fluid Power Ltd., Stansted, UK). Treated and untreated samples were then stored at 3°C, and microbial content as well as some chemical and physical properties monitored. The microbial load of the untreated samples reached the spoilage level of 107 cfu/g in about one week, resulting in bad smell and dark brown color. The pressure treatments reduced total bacterial counts by about 1.8 to 3.2 log10 cycles and reduced counts of Enterobacteriaceae and Salmonella to non-detectable levels. The color of meat was slightly affected, but pH, moisture content and the oxidation products of lipids were not substantially changed. The treatment killed mainly gram negative bacteria but also caused sub-lethal injury to part of the population resulting in prolonged lag phase. The population not killed by the 350 to 450 MPa treatments grew relatively slowly during storage, and its loads reached spoilage level in 4 to 6 weeks, while the load of the population treated at 500 MPa did not reach this level till the end of a storage period of 9 weeks.

Keywords: chicken, cold storage, microbial spoilage, high hydrostatic pressure

Procedia PDF Downloads 226

Authors: Nazim Uddin, Yohiko Nakaura, Kazutaka Yamamoto

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Compote (fruit in syrup) of pineapple (Ananas comosus L. Merrill) is expected to have a high market potential as one of convenient ready-to-eat (RTE) foods worldwide. High hydrostatic pressure (HHP) in combination with low temperature (LT) was applied to the processing of pineapple compote as well as medium HHP (MHHP) in combination with medium-high temperature (MHT) since both processes can enhance liquid impregnation and inactivate microbes. MHHP+MHT (55 or 65 °C) process, as well as the HHP+LT process, has successfully inactivated the microbes in the compote to a non-detectable level. Although the compotes processed by MHHP+MHT or HHP+LT have lost the fresh texture as in a similar manner as those processed solely by heat, it was indicated that the texture degradations by heat were suppressed under MHHP. Degassing process reduced the hardness, while calcium (Ca) contributed to be retained hardness in MHT and MHHP+MHT processes. Electrical impedance measurement supported the damage due to degassing and heat. The color, Brix, and appearance were not affected by the processing methods significantly. MHHP+MHT and HHP+LT processes may be applicable to produce high-quality, safe RTE pineapple compotes. Further studies on the optimization of packaging and storage condition will be indispensable for commercialization.

Keywords: compote of pineapple, RTE, medium high hydrostatic pressure, postharvest loss, texture

Procedia PDF Downloads 123

Authors: Sih-Li Chen, Chih-Hao Chen, Chi-Tong Chan

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Poor ventilation and high carbon dioxide (CO2) concentrations lead to the formation of sick buildings. This problem cannot simply be resolved by introducing fresh air from outdoor environments because this creates extra loads on indoor air-conditioning systems. Desiccants are widely used in air conditioning systems in tropical and subtropical regions with high humidity to reduce the latent heat load from fresh air. Desiccants are usually used as a packed-bed type, which is low cost, to combine with air-conditioning systems. Nevertheless, the pressure drop of a packed bed is too high, and the heat of adsorption caused by the adsorption process lets the temperature of the outlet air increase, bringing about an extra heat load, so the high pressure drop and the increased temperature of the outlet air are energy consumption sources needing to be resolved. For this reason, the gas-solid fluidised beds that have high heat and mass transfer rates, uniform properties and low pressure drops are very suitable for use in air-conditioning systems.This study experimentally investigates the performance of silica gel fluidized bed device which applying to an air conditioning system. In the experiments, commercial silica gel particles were filled in the two beds and to form a fixed packed bed and a fluidized bed. The results indicated that compared to the fixed packed bed device, the total adsorption and desorption by amounts of fluidized bed for 40 minutes increased 20.6% and 19.9% respectively when the bed height was 10 cm and superficial velocity was set to 2 m/s. In addition, under this condition, the pressure drop and outlet air temperature raise were reduced by 36.0% and 30.0%. Given the above results, application of the silica gel fluidized bed to air conditioning systems has great energy-saving potential.

Keywords: fluidized bed, packed bed, silica gel, adsorption, desorption, pressure drop

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Authors: Siamak Yaghoubi, Mohammad Reza Abootorabi, Hamid Kayalha

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Objective: The study was aimed to evaluate the applicability of the Cobra Perilaryngeal Airway (Cobra PLATM) for patients under general anesthesia and also compare result with the Laryngeal Mask Airway (LMA). Methods: Seventy three obese and overweight patients were included in the study. The patients were randomly assigned to either LMA or Cobra PLATM. Time required for intubation, successful intubation attempt, airway sealing pressure, the incidences of complications including blood staining, sore throat and dysphagia were assessed and noted. Results: Thirty six and thirty seven patients were allocated randomly to either LMA or Cobra PLATM, respectively. Most of the patients were male and were in Mallampati Class II airway in both groups. The first attempt and overall insertion success for the Cobra PLATM was significantly more frequent compared to the LMA (p<0.05). Tube insertion was more successful (Cobra PLATM, 94%; LMA™, 77%; P = 0.027) with the Cobra PLATM. The insertion times were similar with the Cobra PLATM and LMA™ (Cobra PLATM, 29.94±16.35s; LMA™, 27.00±7.88s). The airway sealing pressure in the Cobra PLATM (24.80±0.90 H2O) was significantly more than LMA™ (19.13 ±0.58 H2O, p<0.001). Sore throat was more frequent in the LMA™ groups that did not reach statistical significance (Fisher’s exact test, P = 0.33). Incidences of blood staining on airway tube were seen for both groups that was higher in the Cobra PLATM group (Fisher’s exact test, P = 0.02). Incidence of dysphagia was not different between the two groups. Conclusion: The CobraPLA™ was found to be safe and low complications, better airway sealing and high rate of the first insertion success for suing in obese and overweight patients. The study recommended using the CobraPLA™ as a rescue device in an emergency situation among obese and overweight patients.

Keywords: CobraPLA™, flexible laryngeal mask airway, obese patients, perilaryngeal airway

Procedia PDF Downloads 366

Authors: Marzieh Yassin, Azizeh Parandnia, Javad Sarrafzadeh, Reza Salehi

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Background: Myofascial trigger points (MTrPs) are one of the main causes of musculoskeletal pain syndromes and are associated with pain, tenderness, and limited range of motion (ROM). This study compared the effectiveness of high-intensity laser therapy (HILT) and dry needling (DN) on pain intensity, pain pressure threshold, cervical range of motion and disability in people with chronic neck pain. Method and Material: 30 patients with chronic neck pain were randomly divided into two groups: a HILT group (n=15) and a DN group (n=15). Treatment sessions were performed for three weeks, and all participants received related intervention twice a week (5 sessions). The pain level was measured using a Visual Analog Scale (VAS); the pain pressure threshold (PPT) was measured using a digital algometer; perceived disability was measured using the neck disability index (NDI); and cervical range of movements (CROMs) were measured using an iPhone app (lateral flexion) and a goniometer (Rotation). Results: In both the dry needling and high-intensity laser therapy groups, the pain and neck disability were significantly decreased (P < 0.05). Also, the pain pressure threshold and cervical range of motions were significantly increased in both groups. However, there was no significant difference between the two groups (P > 0.05). Conclusion: Both high-intensity laser therapy and dry needling can be used to treat chronic neck pain.

Keywords: chronic neck pain, dry needling, high intensity laser therapy (HILT), pain, pain pressure threshold

Procedia PDF Downloads 60

Authors: Salima Taleb, Kafila Boulaba, Ahlem Yousfi, Nada Taleb, Difallah Basma

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Introduction: Obesity is recognized as a cardiovascular risk factor. It is associated with cardio-metabolic diseases. Its prevalence is increasing significantly in both rich and poor countries. However, there are obese people who have no metabolic disturbance. So we think obesity is not always a risk factor for an abnormal metabolic profile that increases the risk of cardiometabolic problems. However, there is no definition that allows us to identify the individual group Metabolically Healthy but Obese (MHO). Objective: The objective of this study is to evaluate the relationship between MHO and some factors associated with it. Methods: A longitudinal study is a prospective cohort study of 600 participants aged ≥18 years. Metabolic status was assessed by the following parameters: blood pressure, fasting glucose, total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. Body Mass Index (BMI) was calculated as weight (in kg) divided by height (m2), BMI = Weight/(Height)². According to the BMI value, our population was divided into four groups: underweight subjects with BMI <18.5 kg/m2, normal weight subjects with BMI = 18.5–24.9 kg/m², overweight subjects with BMI=25–29.9 kg/m², and obese subjects who have (BMI ≥ 30 kg/m²). A value of P < 0.05 was considered significant. Statistical processing was done using the SPSS 25 software. Results: During this study, 194 (32.33%) were identified as MHO among 416 (37%) obese individuals. The prevalence of the metabolically unhealthy phenotype among normal-weight individuals was (13.83%) vs. (37%) in obese individuals. Compared with metabolically healthy normal-weight individuals (10.93%), the prevalence of diabetes was (30.60%) in MHO, (20.59%) in metabolically unhealthy normal weight, and (52.29%) for metabolically unhealthy obese (p = 0.032). Blood pressure was significantly higher in MHO individuals than in metabolically healthy normal-weight individuals and in metabolically unhealthy obese than in metabolically unhealthy normal weight (P < 0.0001). Familial coronary artery disease does not appear to have an effect on the metabolic status of obese and normal-weight patients (P = 0.544). However, waist circumference appears to have an effect on the metabolic status of individuals (P < 0.0001). Conclusion: This study showed a high prevalence of metabolic profile disruption in normal-weight subjects and a high rate of overweight and/or obese people who are metabolically healthy. To understand the physiological mechanism related to these metabolic statuses, a thorough study is needed.

Keywords: metabolically health, obesity, factors associated, cardiovascular diseases

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Authors: P. Meethum, C. Suvanjumrat

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Many aluminum motorcycle parts produced by a high pressure die casting. Some parts such as fuel caps were a thin and complex shape. This part risked for porosities and blisters on surface if it only depended on an experience of mold makers for mold design. This research attempted to use CAST-DESIGNER software simulated the high pressure die casting process with the same process parameters of a motorcycle fuel cap production. The simulated results were compared with fuel cap products and expressed the same porosity and blister locations on cap surface. An average of absolute difference of simulated results was obtained 0.094 mm when compared the simulated porosity and blister defect sizes on the fuel cap surfaces with the experimental micro photography. This comparison confirmed an accuracy of software and will use the setting parameters to improve fuel cap molds in the further work.

Keywords: aluminum, die casting, fuel cap, motorcycle

Procedia PDF Downloads 352

Authors: Ahmed Banda, Alaa Maghrabi, Aiman Fakieh

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Terahertz (THz) range lies in the area between 0.1 to 10 THz. The process of generating and detecting THz can be done through different techniques. One of the most familiar techniques is done through a photoconductive antenna (PCA). The process of generating THz radiation at PCA includes applying a laser pump in femtosecond and DC voltage difference. However, photocurrent is generated at PCA, which its value is affected by different parameters (e.g., dielectric properties, DC voltage difference and incident power of laser pump). THz radiation is used for biomedical applications. However, different biomedical fields need new technologies to meet patients’ needs (e.g. blood-related conditions). In this work, a novel method to check the red blood cells (RBCs) concentration of a blood sample using PCA is presented. RBCs constitute 44% of total blood volume. RBCs contain Hemoglobin that transfers oxygen from lungs to body organs. Then it returns to the lungs carrying carbon dioxide, which the body then gets rid of in the process of exhalation. The configuration has been simulated and optimized using COMSOL Multiphysics. The differentiation of RBCs concentration affects its dielectric properties (e.g., the relative permittivity of RBCs in the blood sample). However, the effects of four blood samples (with different concentrations of RBCs) on photocurrent value have been tested. Photocurrent peak value and RBCs concentration are inversely proportional to each other due to the change of dielectric properties of RBCs. It was noticed that photocurrent peak value has dropped from 162.99 nA to 108.66 nA when RBCs concentration has risen from 0% to 100% of a blood sample. The optimization of this method helps to launch new products for diagnosing blood-related conditions (e.g., anemia and leukemia). The resultant electric field from DC components can not be used to count the RBCs of the blood sample.

Keywords: biomedical applications, photoconductive antenna, photocurrent, red blood cells, THz radiation

Procedia PDF Downloads 192

Authors: K. AlJimaz, A. Abdullah, A. Abdulsalam, K. Ebdah, A. Abdalrasheed

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Understanding flow distribution and head losses is essential to design and calculate Thermo fluid parameters in order to reduce the pressure to a certain required pressure. This paper discusses the ways acquired in design and simulation to create and design an impedance box that reduces pressure. It's controlled by specific scientific principles such as Bernoulli’s principle and conservation of mass. In this paper, the design is made using SOLIDWORKS, and the simulation is done using ANSYS software to solve differential equations and study the parameters in the 3D model, also to understand how the design of this box reduced the pressure. The design was made so that fluid enters at a certain pressure of 3000 Pa in a single inlet; then, it exits from six outlets at a pressure of 300 Pa with respect to the conservation of mass principle. The effect of the distribution of flow and the head losses has been noticed that it has an impact on reducing the pressure since other factors, such as friction, were neglected and also the temperature, which was constant. The design showed that the increase in length and diameter of the pipe helped to reduce the pressure, and the head losses contributed significantly to reduce the pressure to 10% of the original pressure (from 3000 Pa to 300 Pa) at the outlets.

Keywords: box, pressure, thermodynamics, 3D

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Authors: Masuma Novak, Daniel Novak

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Background: Sweden along with other Nordic countries has the highest incidence of type 1 diabetes mellitus (T1DM) worldwide. The trend is increasing globally. The diagnosis is often given at the emergency clinic when children arrive with cardinal symptom of T1DM. Children with T1DM are known to have an increased risk of microvascular- and macrovascular complications. A family history of cardiovascular complications may further increase their risk. Clinically evident diabetes-related vascular complications are however rarely visible in childhood and adolescence, whereby an intensive diabetes treatment and normoglycemic control is a goal for every child. This study is a risk evaluation of children with T1DM based on their family’s cardiovascular history. Method: Since 2005 the Better Diabetes Diagnosis (BDD) study is a nationwide Swedish prospective cohort study that recruits new-onset T1DM who are less than 18 years old at time of diagnosis. For each newly diagnosed child, blood samples are collected for specific HLA genotyping and islet autoantibody assays and their family’s cardiovascular history is evaluated. As part of the BDD study, during the years 2010-2013 all children diagnosed with T1DM at the Queen Silvia’s Children’s Hospital in Sweden were asked about their family’s cardiovascular history. Questions regarded maternal and paternal high blood pressure, stroke, and myocardial infarction before the age of 55 years, and hyperlipidemia were answered. A maximum risk score of eight was possible. All children are clinically observed prospectively for early functional and structural abnormalities such as protein uremia, blood pressure, and retinopathy. Results: A total of 275 children aged 0 to 18 years were diagnosed with T1DM at the Queen Silvia’s Children’s Hospital emergency clinic during this four year period. The participation rate was 99.7%. 26.4% of the children had no hereditary cardiovascular risk factors. 22.7 % had one risk factor and 18.8% had two risk factors. 14.8% had three risk factors. 9.7% had four risk factors and 7.5% had five risk factors or more. Conclusion: Among children with T1DM in Sweden there is a difference in hereditary cardiovascular risk factors. These results indicate that children with T1DM who also have increased hereditary cardiovascular risk factors should be monitored closely with early screening for functional and structural cardiovascular abnormalities. This is a very preliminary and ongoing study which will be complemented with the cardiovascular risk analysis among children without T1DM.

Keywords: children, type I diabetes, emergency clinic, CVD risk

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Authors: Khaled Ayfi

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In industrial oxygen systems at high temperature and high pressure, contamination by solid particles is one of the principal causes of ignition hazards. Indeed, gas can sweep away particles, generated by corrosion inside the pipes or during maintenance operations (welding residues, careless disassembly, etc.) and produce accumulations at places where the gas velocity decrease. Moreover, in such an environment rich in oxygen (oxidant), particles are highly reactive and can ignite system walls more actively and at higher temperatures. Oxidation based thermal effects are responsible for mechanical properties lost, leading to the destruction of the pressure equipment wall. To deal with this problem, a numerical analysis is done regarding a sample representative of a wall subjected to pressure and temperature. The validation and analysis are done comparing the numerical simulations results to experimental measurements. More precisely, in this work, we propose a numerical model that describes the thermomechanical behavior of thin metal disks under pressure and subjected to laser heating. This model takes into account the geometric and material nonlinearity and has been validated by the comparison of simulation results with experimental measurements.

Keywords: ignition, oxygen, numerical simulation, thermomechanical behavior

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Authors: Nirali Sanghavi, Julia Ash, Amy Wasserman

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Introduction: To the best of our knowledge, there is only one case report that found an association between leuprolide and scleroderma renal crisis (SRC). Leuprolide has been noted to cause acute renal failure in some patients. Given the close timing of the leuprolide injection and the worsening renal function in our patient, leuprolide likely caused exacerbation of lupus nephritis and SRC. Interestingly, our patient on long-term hydroxychloroquine (HCQ) with normal baseline cardiac function was found to have HCQ cardiomyopathy highlighting the need for close monitoring of HCQ toxicity. We know that some of the risk factors that are involved in HCQ induced cardiomyopathy are older age, females, increased dose and >10 years of HCQ use, and pre-existing cardiac and renal insufficiency. Case presentation: A 34-year-old African American woman with a history of overlap of systemic lupus erythematosus (SLE) and scleroderma features and class III lupus nephritis presented with severe headaches, elevated blood pressure (180/120 mmHg) and worsening creatinine levels (2.07 mg/dL). The headaches started 1 month ago after she started leuprolide injections for fibroids. She was being treated with mycophenolate mofetil 1 gm twice a day, belimumab weekly, HCQ 200mg, and prednisone 5 mg daily. She has been on HCQ since her teenage years. The examination was unremarkable except for proximal interphalangeal joint contractures in the right hand and sclerodactyly of bilateral hands, unchanged from baseline. Laboratory findings include urinalysis, which showed 3+ protein, 1+ blood, 6 red blood cells, and 14 white blood cells ruling out thrombotic microangiopathy. C3 was 32 mg/dL, C4 <5 mg/dL, and +dsDNA increased >1000. She was started on captopril and discharged once creatinine and blood pressure was controlled. She was readmitted with hypertension, hyperkalemia, worsening creatinine, nephrotic range proteinuria, complaints of chest pressure, and shortness of breath with pleuritic chest pain. Physical examination and lab findings were unchanged. She was treated with pulse dose methyl prednisone followed by taper and multiple anti-hypertensive agents, including captopril, for presumed lupus nephritis flare versus SRC. Renal biopsy was consistent with SRC and class IV lupus nephritis and was started on cyclophosphamide. While cardiac biopsy showed borderline myocarditis without necrosis and cytoplasmic vacuolization consistent with HCQ cardiomyopathy, hence HCQ was discontinued. Summary: It highlights a rare association of leuprolide causing exacerbation of lupus nephritis or SRC. Although rare, the current case reinforces the importance of close monitoring for HCQ toxicity in patients with renal insufficiency.

Keywords: leuprolide, lupus nephritis, scleroderma, SLE

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Authors: P. Serpytis, K. Azukaitis, U. Gargalskaite, R. Navickas, J. Badariene, V. Dzenkeviciute

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Purpose: Total longitudinal displacement (tLoD) of the common carotid artery (CCA) wall is a novel ultrasound marker of vascular function that can be evaluated using modified speckle tracking techniques. Decreased CCA tLoD has already been shown to be associated with diabetes and was shown to predict one year cardiovascular outcome in patients with suspected coronary artery disease (CAD) . The aim of our study was to evaluate if CCA tLoD differ between patients with moderate or high cardiovascular (CV) risk and patients after recent acute myocardial infarction (AMI). Methods: 49 patients (54±6 years) with moderate or high CV risk and 42 patients (58±7 years) after recent AMI were included. All patients were non-diabetic. CCA tLoD was evaluated using GE EchoPAC speckle tracking software and expressed as mean of both sides. Data on systolic blood pressure, total and high density lipoprotein (HDL) cholesterol levels, high sensitivity C-reactive protein (hsCRP) level, smoking status and family history of early CV events was evaluated and assessed for association with CCA tLoD. Results: tLoD of CCA did not differ between patients with moderate or high CV risk and patients with very high CV risk after MI (0.265±0.128 mm vs. 0.237±0.103 mm, p>0.05). Lower tLoD was associated with lower HDL cholesterol levels (r=0.211, p=0.04) and male sex (0.228±0.1 vs. 0.297±0.134, p=0.01). Conclusions: tLoD of CCA did not differ between patients with moderate or high CV risk and patients with very high CV risk after AMI. However, lower CCA tLoD was significantly associated with low HDL cholesterol levels and male sex.

Keywords: total longitudinal displacement, carotid artery, cardiovascular risk, acute myocardial infarction

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Authors: Fatima M. Kabbashi, Abdalla M. Abdalla, Hussam K. Hamad, Elias S. Hassan

Abstract:

This study investigates the production of renewable energy (biogas) from biomedical hazard waste (blood) and eco-friendly disposal. Biogas is produced by the bacterial anaerobic digestion of biomaterial (blood). During digestion process bacterial feeding result in breaking down chemical bonds of the biomaterial and changing its features, by the end of the digestion (biogas production) the remains become manure as known. That has led to the economic and eco-friendly disposal of hazard biomedical waste (blood). The samples (Whole blood, Red blood cells 'RBCs', Blood platelet and Fresh Frozen Plasma ‘FFP’) are collected and measured in terms of carbon to nitrogen C/N ratio and total solid, then filled in connected flasks (three flasks) using water displacement method. The results of trails showed that the platelet and FFP failed to produce flammable gas, but via a gas analyzer, it showed the presence of the following gases: CO, HC, CO₂, and NOX. Otherwise, the blood and RBCs produced flammable gases: Methane-nitrous CH₃NO (99.45%), which has a blue color flame and carbon dioxide CO₂ (0.55%), which has red/yellow color flame. Methane-nitrous is sometimes used as fuel for rockets, some aircraft and racing cars.

Keywords: renewable energy, biogas, biomedical waste, blood, anaerobic digestion, eco-friendly disposal

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Authors: Kotomi Yamashita, Hiromi Kawasaki, Satoko Yamasaki, Susumu Fukita, Risako Sakai

Abstract:

Lifestyle-related diseases develop from the long-term accumulation of health consequences from a poor lifestyle. Thus, schoolchildren, who have not accumulated long-term lifestyle habits, are believed to be at a lower risk for lifestyle-related diseases. However, schoolchildren rarely receive blood tests unless they are under treatment for a serious disease; without such data on their blood, the impacts of their young lifestyle could not be known. Blood data from physical measurements can help in the implementation of more effective health education. Therefore, we examined the correlation between body mass index (BMI) and blood sugar/serum lipid (BS/SL) levels. From 2014 to 2016, we measured the blood data of fourth-grade students living in a city in Japan. The present study reported on the results of 281 fourth-grade boys only (80.3% of total). We analyzed their BS/SL levels by comparing the blood data against the criteria of the National Center for Child Health and Development in Japan. Next, we examined the correlation between BMI and BS/SL levels. IBM SPSS Statistics for Windows, Version 25 was used for analysis. A total of 69 boys (24.6%) were within the normal range for BMI (18.5–24), whereas 193 (71.5%) and 8 boys (2.8%) had lower and higher BMI, respectively. Regarding BS levels, 280 boys were within the normal range (70–90 mg/dl); 1 boy reported a higher value. All the boys were within the normal range for glycated Hemoglobin (HbA1c) (4.6–6.2%). Regarding SL levels, 271 boys were within the normal range (125–230 mg/dl) for total cholesterol (TC), whereas 5 boys (1.8%) had lower and 5 boys (1.8%) had higher levels. A total of 243 boys (92.7%) were within the normal range (36-138mg/dL) for triglycerides (TG), whereas 19 boys (7.3%) had lower and 19 boys (7.3%) had higher levels. Regarding high-density lipoprotein cholesterol (HDL-C), 276 boys (98.2%) were within the normal range (40-mg/dl), whereas 5 boys (1.8%) reported lower values. All but one boy (280, 99.6%) were within the normal range (-170 mg/dl) for low-density lipoprotein cholesterol (LDL-C); the exception (0.4%) had a higher level. BMI and BS didn’t show a correlation. BMI and HbA1c were moderately positively correlated (r = 0.139, ｐ＝0.019). We also observed moderate positive correlations between BMI and TG (r = 0.328, p < 0.01), TC (r=0.239, p< 0.01), LDL-C (r = 0.324, p < 0.01), respectively. BMI and HDL-C were low correlated (r = -0.185, p = 0.002). Most of the boys were within the normal range for BS/SL levels. However, some boys exceeded the normal TG range. Fourth graders with a high TG may develop a lifestyle-related disease in the future. Given its relation to TG, food habits should be improved in this group. Our findings suggested a positive correlation between BMI and BS/SL levels. Fourth-grade schoolboys with a high BMI may be at high risk for developing lifestyle-related diseases. Lifestyle improvement may be recommended to lower the BS/SL levels in this group.

Keywords: blood sugar level, lifestyle-related diseases, school students, serum lipid level

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Authors: Takuya Suzuki, Atsushi Shirai, Takashi Seki

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Acupuncture therapy is one of the treatments in traditional Chinese medicine. Recently, some reports have shown the effectiveness of acupuncture. However, its full acceptance has been hindered by the lack of understanding on mechanism of the therapy. Acupuncture applied to Zusanli (ST-36) enhances blood flow volume in superior mesenteric artery (SMA), yielding peripheral vascular resistance – regulated blood flow of SMA dominated by the parasympathetic system and inhibition of sympathetic system. In this study, a lumped-parameter approximation model of blood flow in the systemic arteries was developed. This model was extremely simple, consisting of the aorta, carotid arteries, arteries of the four limbs and SMA, and their peripheral vascular resistances. Here, the individual artery was simplified to a tapered tube and the resistances were modelled by a linear resistance. We numerically investigated contribution of the peripheral vascular resistance of SMA to the systemic blood distribution using this model. In addition to the upstream end of the model, which correlates with the left ventricle, two types of boundary condition were applied; mean left ventricular pressure which correlates with blood pressure (BP) and mean cardiac output which corresponds to cardiac index (CI). We examined it to reproduce the experimentally obtained hemodynamic change, in terms of the ratio of the aforementioned hemodynamic parameters from their initial values before the acupuncture, by regulating the peripheral vascular resistances and the upstream boundary condition. First, only the peripheral vascular resistance of SMA was changed to show contribution of the resistance to the change in blood flow volume in SMA, expecting reproduction of the experimentally obtained change. It was found, however, this was not enough to reproduce the experimental result. Then, we also changed the resistances of the other arteries together with the value given at upstream boundary. Here, the resistances of the other arteries were changed simultaneously in the same amount. Consequently, we successfully reproduced the hemodynamic change to find that regulation of the upstream boundary condition to the value experimentally obtained after the stimulation is necessary for the reproduction, though statistically significant changes in BP and CI were not observed in the experiment. It is generally known that sympathetic and parasympathetic tones take part in regulation of whole the systemic circulation including the cardiac function. The present result indicates that stimulation to ST-36 could induce vasodilation of peripheral circulation of SMA and vasoconstriction of that of other arteries. In addition, it implies that experimentally obtained small changes in BP and CI induced by the acupuncture may be involved in the therapeutic response.

Keywords: acupuncture, hemodynamics, lumped-parameter approximation, modeling, systemic vascular resistance

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Authors: F. S. Alavi, D. Mowla, F. Esmaeilzadeh

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In this paper, the Eclipse 300 simulator was used to perform compositional modeling of gas injection process for enhanced condensate recovery of a real gas condensate well in south of Iran here referred to as SA4. Some experimental data were used to tune the Peng-Robinson equation of state for this case. Different scenarios of gas injection at current reservoir pressure and at abandonment reservoir pressure had been considered with different gas compositions. Methane, carbon dioxide, nitrogen and two other gases with specified compositions were considered as potential gases for injection. According to the obtained results, nitrogen leads to highest pressure maintenance in the reservoir but methane results in highest condensate recovery among the selected injection gases. At low injection rates, condensate recovery percent is strongly affected by gas injection rate but this dependency shifts to zero at high injection rates. Condensate recovery is higher in all cases of injection at current reservoir pressure than injection at abandonment pressure. Using a constant injection rate, increasing the production well bottom hole pressure results in increasing the condensate recovery percent and time of gas breakthrough.

Keywords: gas-condensate reservoir, case-study, compositional modelling, enhanced condensate recovery, gas injection

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Authors: Zakaria Hamdi, Mariyamni Awang

Abstract:

For the past decades, CO₂ flooding has been used as a successful method for enhanced oil recovery (EOR). However, high mobility ratio and fingering effect are considered as important drawbacka of this process. Low temperature injection of CO₂ into high temperature reservoirs may improve the oil recovery, but simulating multiphase flow in the non-isothermal medium is difficult, and commercial simulators are very unstable in these conditions. Furthermore, to best of authors’ knowledge, no experimental work was done to verify the results of the simulations and to understand the pore-scale process. In this paper, we present results of investigations on injection of low temperature CO₂ into a high-pressure high-temperature micromodel with injection temperature range from 34 to 75 °F. Effect of temperature and saturation changes of different fluids are measured in each case. The results prove the proposed method. The injection of CO₂ at low temperatures increased the oil recovery in high temperature reservoirs significantly. Also, CO₂ rich phases available in the high temperature system can affect the oil recovery through the better sweep of the oil which is initially caused by penetration of LCO₂ inside the system. Furthermore, no unfavorable effect was detected using this method. Low temperature CO₂ is proposed to be used as early as secondary recovery.

Keywords: enhanced oil recovery, CO₂ flooding, micromodel studies, miscible flooding

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Authors: Irna Farikhah

Abstract:

Converting low-grade waste heat into useful energy such as sound energy which can then be used to generate acoustic power in a thermoacoustic engine has become an attracting issue for researchers. The generated power in thermoacoustic engine can be used for driving a thermoacoustic cooler when they are installed in a tube. This cooler system can be called as a heat-driven thermoacoustic cooler. In this study, low heating temperature of the engine is discussed. In addition, having high efficiency of the whole cooler is also essential. To design a thermoacoustic cooler having high efficiency with using low-grade waste heat for the engine, the effect of mean pressure is investigated. By increasing the mean pressure, the heating temperature to generate acoustic power can be decreased from 557 °C to 300 °C. Moreover, the efficiency of the engine and cooler regenerators attain 67% and 47% of the upper limit values, respectively and 49% of the acoustical work generated by the engine regenerator is utilized in the cooler regenerator. As a result, the efficiency of the whole cooler becomes 15% of the upper limit value.

Keywords: cooler, mean pressure, performance, thermoacoustic

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Authors: Aly Kassem, Eman Sapet, Eman Abdelbaset, Hosam Mahmoud

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Objective: Hypertension is an important public health challenge being one of the most common worldwide disease-affecting human. Our aim is to study the clinical characteristics, therapeutic regimens, treatment compliance, and risk factors in a sector of of hypertensive patients at Sohag City. Subject and Methods: A cross sectional study; conducted in Sohag city; it involved 520 patients; males (45.7 %) and females (54.3 %). Their ages ranged between 35-85 years. BP measurements, BMI, blood glucose, Serum creatinine, urine analysis, serum Lipids, blood picture and ECG were done all the studied patients. Results: Hypertension presented more between non-smokers (72.55%), females (54.3%), educated patients (50.99%) and patients with low SES (54.9%). CAD presented in (51.63%) of patients, while laboratory investigations showed hyperglycaemia in (28.7%), anemia in (18.3%), high serum creatinine level in (8.49%) and proteinuria in (10.45%) of patient. Adequate BP control was achieved in (49.67%); older patients had lower adequacy of BP control in spite of the extensive use of multiple-drug therapy. Most hypertensive patients had more than one coexistent CV risk factor. Aging, being a female (54.3%), DM (32.3%), family history of hypertension (28.7%), family history of CAD (25.4%), and obesity (10%) were the common contributing risk factors. ACE-inhibitors were prescribed in (58.16%), Beta-blockers in (34.64%) of the patients. Monotherapy was prescribed for (41.17%) of the patients. (75.81%) of patients had regular use of their drug regimens. (49.67%) only of patients had their condition under control, the number of drugs was inversely related to BP control. Conclusion: Hypertensive patients in Sohag city had a profile of high CV risks, and poor blood pressure control particularly in the elderly. A multidisciplinary approach for routine clinical check-up, follow-up, physicians and patients training, prescribing simple once-daily regimens and encouraging life style modifications are recommended. Anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance.

Keywords: anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance

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