Search results for: cubic normal distribution

Authors: Fedili Benamar, Belloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Introduction: Perioperative blood loss is a frequent cause of complications in total hip replacement (THR). The present prospective study assessed the efficacy of tranexamic acid (Exacyl(®)) in reducing blood loss in primary THR. Hypothesis: Tranexamic acid reduces blood loss in THR. Material and method: -This is a prospective randomized study on the effectiveness of Exacyl (tranexamic acid) in total hip replacement surgery performed on a standardized technique between 2019 and September 2022. -It involved 154 patients, of which 84 received a single injection of Exacyl (group 1) at a dosage of 10 mg/kg over 20 minutes during the perioperative period. -All patients received postoperative thromboprophylaxis with enoxaparin 0.4 ml subcutaneously. -All patients were admitted to the post-interventional intensive care unit for a duration of 24 hours for monitoring and pain management as per the service protocol. Results: 154 patients, of which 84 received a single injection of Exacyl (group 1) and 70 patients patients who did not receive Exacyl perioperatively : (Group 2 ) The average age is 57 +/- 15 years The distribution by gender was nearly equal with 56% male and 44% female; "The distribution according to the ASA score was as follows: 20.2% ASA1, 82.3% ASA2, and 17.5% ASA3. "There was a significant difference in the average volume of intraoperative and postoperative bleeding during the 48 hours." The average bleeding volume for group 1 (received Exacyl) was 614 ml +/- 228, while the average bleeding volume for group 2 was 729 +/- 300, with a chi-square test of 6.35 and a p-value < 0.01, which is highly significant. The ANOVA test showed an F-statistic of 7.11 and a p-value of 0.008. A Bartlett test revealed a chi-square of 6.35 and a p-value < 0.01." "In Group 1 (patients who received Exacyl), 73% had bleeding less than 750 ml (Group A), and 26% had bleeding exceeding 750 ml (Group B). In Group 2 (patients who did not receive Exacyl perioperatively), 52% had bleeding less than 750 ml (Group A), and 47% had bleeding exceeding 750 ml (Group B). "Thus, the use of Exacyl reduced perioperative bleeding and specifically decreased the risk of severe bleeding exceeding 750 ml by 43% with a relative risk (RR) of 1.37 and a p-value < 0.01. The transfusion rate was 1.19% in the population of Group 1 (Exacyl), whereas it was 10% in the population of Group 2 (no Exacyl). It can be stated that the use of Exacyl resulted in a reduction in perioperative blood transfusion with an RR of 0.1 and a p-value of 0.02. Conclusions: The use of Exacyl significantly reduced perioperative bleeding in this type of surgery.

Keywords: acid tranexamic, blood loss, anesthesia, total hip replacement, surgery

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Authors: Nadia Warmilee

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This study is s descriptive-analytical research and it aims at studying sound intensity in individuals with antisocial personality disorder and ordinary persons. Data were collected from experimental and control groups by interviews and a field research. Population was all male Iranian with antisocial personality disorder that three of them (a murderer and two individuals with antisocial personality disorder (APD) who have not committed any crimes yet) were selected purposefully. They were compared to three non-affected people. PRAAT software has been used to analyze the data. Results of this study show that there is a significant relationship between dysthymia and sound intensity values. Antisocial personality disorder also affects sound intensity fluctuations. The values of sound intensity are higher in non-affected people than affected one whilst these values are more monotonous. T-test was used to study significance or in significance of sound intensity difference in producing vowels.

Keywords: Acoustics, Sound Intensity, Antisocial Personality Disorder, Psycholinguistics

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Authors: Masoud Swalehe, Semra Günay

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Developed countries are losing many lives to non-communicable diseases as compared to their developing counterparts. The effects of these diseases are mostly sudden and manifest at a very short time prior to death or a dangerous attack and this has consolidated the significance of emergency medical system (EMS) as one of the vital areas of healthcare service delivery. The primary objective of this research is to reduce ambulance response times (RT) of Eskişehir province EMS since a number of studies have established a relationship between ambulance response times and survival chances of patients especially out of hospital cardiac arrest (OHCA) victims. It has been found out that patients who receive out of hospital medical attention in few (4) minutes after cardiac arrest because of low ambulance response times stand higher chances of survival than their counterparts who take longer times (more than 12 minutes) to receive out of hospital medical care because of higher ambulance response times. The study will make use of geographic information systems (GIS) technology to dynamically reallocate ambulance resources according to demand and time so as to reduce ambulance response times. Geospatial-time distribution of ambulance calls (demand) will be used as a basis for optimal ambulance deployment using system status management (SSM) strategy to achieve much demand coverage with the same number of ambulance resources to cause response time reduction. Drive-time polygons will be used to come up with time specific facility coverage areas and suggesting additional facility candidate sites where ambulance resources can be moved to serve higher demands making use of network analysis techniques. Emergency Ambulance calls’ data from 1st January 2014 to 31st December 2014 obtained from Eskişehir province health directorate will be used in this study. This study will focus on the reduction of ambulance response times which is a key Emergency Medical Services performance indicator.

Keywords: emergency medical services, system status management, ambulance response times, geographic information system, geospatial-time distribution, out of hospital cardiac arrest

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Authors: Kirti Hira, A. Sajeli Begum, S. Mahibalan, Poorna Chandra Rao

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Introduction: Cancer is one of the leading causes of death worldwide. Although existing therapy effectively kills cancer cells, they do affect normal growing cells leading to many undesirable side effects. Hence there is need to develop effective as well as safe drug molecules to combat cancer, which is possible through phyto-research. The currently available plant-derived blockbuster drugs are the example for this. In view of this, an investigation was done to identify cytotoxic lead molecules from Hedyotis umbellata (Family Rubiaceae), a widely distributed weed in India. Materials and Methods: The methanolic extract of the whole plant of H. umbellata (MHU), prepared through Soxhlet extraction method was further fractionated with diethyl ether and n-butanol, successively. MHU, ether fraction (EMHU) and butanol fraction (BMHU) were lyophilized and were tested for the cytotoxic effect using 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay against non-small cell lung cancer (NSCLC) A549 cell lines. The potentially active EMHU was subjected to chromatographic purification using normal-phase silica columns, in order to isolate the responsible bioactive compounds. The isolated pure compounds were tested for their cytotoxic effect by MTT assay against A549 cells. Compound-3, which was found to be most active, was characterized using IR, 1H- and 13C-NMR and MS analysis. The study was further extended to decipher the mechanism of action of cytotoxicity of compound-3 against A549 cells through various in vitro cellular models. Cell cycle analysis was done using flow cytometry following PI (Propidium Iodide) staining. Protein analysis was done using Western blot technique. Results: Among MHU, EMHU, and BMHU, the non-polar fraction EMHU demonstrated a significant dose-dependent cytotoxic effect with IC50 of 67.7μg/ml. Chromatography of EMHU yielded seven compounds. MTT assay of isolated compounds explored compound-3 as potentially active one, which inhibited the growth of A549 cells with IC50value of 14.2μM. Further, compound-3 was identified as cedrelopsin, a coumarin derivative having molecular weight of 260. Results of in vitro mechanistic studies explained that cedrelopsin induced cell cycle arrest at G2/M phase and down-regulated the expression of G2/M regulatory proteins such as cyclin B1, cdc2, and cdc25C, dose dependently. This is the first report that explores the cytotoxic mechanism of cedrelopsin. Conclusion: Thus a potential small lead molecule, cedrelopsin isolated from H. umbellata, showing antiproliferative effect mediated by G2/M arrest in A549 cells was discovered. The effect of cedrelopsin against other cancer cell lines followed by in vivo studies can be performed in future to develop a new drug candidate.

Keywords: A549, cedrelopsin, G2/M phase, Hedyotis umbellata

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Authors: Katy Eleanor Addinall

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Women’s body image dissatisfaction is a widespread problem, and it is present in all age groups, on every socioeconomic level, in all occupations, all cultures, and religions. Body image dissatisfaction is a broad term that is used to vary from normal discontent of a woman about one or more of her physical attributes to extreme negative causes, for example, an eating disorder. South African women were examined, and an empirical qualitative study was done to evaluate the women’s thoughts and feelings regarding their bodies. The causes and effects of body image dissatisfaction were examined, and social science literature was used to determine the etiology of body image dissatisfaction, which confirmed that it is multifactorial. A variety of therapeutic aids were studied, and cognitive behavioural therapy appeared to be the most effective. Every woman is an individual with an individual body image and must be approached as an individual holistic being. Thus, a holistic pragmatic model was developed as a possible aid in the woman’s healing process.

Keywords: body, body image, females, woman, therapy, dissatisfaction, holistic, cognitive behavioural therapy

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Authors: Sospeter P. Maganga, Alphonce Wikedzi, Mussa D. Budeba, Samwel V. Manyele

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This study characterizes complex gold ores (elemental and mineralogical composition, gold distribution, ore grindability, and mineral liberation) for preliminary process selection. About 200 kg of ore samples were collected from each location using systematic sampling by mass interval. Ores were dried, crushed, milled, and split into representative sub-samples (about 1 kg) for elemental and mineralogical composition analyses using X-ray fluorescence (XRF), fire assay finished with Atomic Absorption Spectrometer (AAS), and X-ray Diffraction (XRD) methods, respectively. The gold distribution was studied on size-by-size fractions, while ore grindability was determined using the standard Bond test. The mineral liberation analysis was conducted using ThermoFisher Scientific Mineral Liberation Analyzer (MLA) 650, where unsieved polished grain mounts (80% passing 700 µm) were used as MLA feed. Two MLA measurement modes, X-ray modal analysis (XMOD) and sparse phase liberation-grain X-ray mapping analysis (SPL-GXMAP), were employed. At least two cyanide consumers (Cu, Fe, Pb, and Zn) and kinetics impeders (Mn, S, As, and Bi) were present in all locations investigated. Copper content at Kapanda (0.77% Cu) and Ibindi (7.48% Cu) exceeded the recommended threshold of 0.5% Cu for direct cyanidation. The gold ore at Ibindi indicated a higher rate of grinding compared to other locations. This could be explained by the highest grindability (2.119 g/rev.) and lowest Bond work index (10.213 kWh/t) values. The pyrite-marcasite, chalcopyrite, galena, and siderite were identified as major gold, copper, lead, and iron-bearing minerals, respectively, with potential for economic extraction. However, only gold and copper can be recovered under conventional milling because of grain size issues (galena is exposed by 10%) and process complexity (difficult to concentrate and smelt iron from siderite). Therefore, the preliminary process selection is copper flotation followed by gold cyanidation for Kapanda and Ibindi ores, whereas gold cyanidation with additives such as glycine or ammonia is selected for Mawemeru and Itumbi ores because of low concentrations of Cu, Pb, Fe, and Zn minerals.

Keywords: complex gold ores, mineral liberation, ore characterization, ore grindability

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Authors: Salete Martins Alves, José Josemar de Oliveira Junior

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The current efforts on design of lubricants are based in attending the new requirement of modern equipment with the focus on the choice of base oil and additives. Nowadays, there are different types of lubricant oils’ bases, such as mineral oils, synthetic oils, re-refined oils and vegetable oils. The lubrication in the boundary condition is controlled mainly by EP additives that interact with the surface forming very thin films. Therefore, the study’s goal is to evaluate the action of three EP additives, with different percentage of sulfur, on friction and wear reduction. They were evaluated in mineral and synthetic oils. Lubricants were prepared with synthetic and mineral oils and added 3 % and 5 % of EP additives. The friction and wear characteristics were studied using HFRR test. In this test, a normal load of 10 N was applied at a frequency of 20 Hz. The analysis of results has appointed that the percentage of sulfur in mineral oil has influenced on wear reduction. However, synthetic oil had good performance with low sulfur content.

Keywords: boundary lubrication, EP additives, sulfur, wear

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Authors: T. K. Dutta, K. K. Das, N. Dutta

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The salient feature of this paper is primarily concerned with Ricker’s population model: f(x)=x e^(r(1-x/k)), where r is the control parameter and k is the carrying capacity, and some fruitful results are obtained with the following objectives: 1) Determination of bifurcation values leading to a chaotic region, 2) Development of Statistical Methods and Analysis required for the measure of Fractal dimensions, 3) Calculation of various fractal dimensions. These results also help that the invariant probability distribution on the attractor, when it exists, provides detailed information about the long-term behavior of a dynamical system. At the end, some open problems are posed for further research.

Keywords: Feigenbaum universality, chaos, Lyapunov exponent, fractal dimensions

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Authors: Victor Pena Ribeiro, Caroline Arruda, Jennyfer Andrea Aldana Mejia, Jairo Kenupp Bastos

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Leishmaniasis is a serious health problem around the world. The treatment of infected individuals with pentavalent antimonial drugs is the main therapeutic strategy. However, they present high toxicity and persistence side effects. Therefore, the discovery of new and safe natural-derived therapeutic agents against leishmaniasis is important. Propolis is a resin of viscous consistency produced by Apis mellifera bees from parts of plants. The main types of Brazilian propolis are green, red, yellow and brown. Thus, the aim of this work was to investigate the chemical composition and leishmanicidal properties of a brown propolis (BP). For this purpose, the hydroalcoholic crude extract of BP was obtained and was fractionated by liquid-liquid chromatography. The chemical profile of the extract and its fractions were obtained by HPLC-UV-DAD. The fractions were submitted to preparative HPLC chromatography for isolation of the major compounds of each fraction. They were analyzed by NMR for structural determination. The volatile compounds were obtained by hydrodistillation and identified by GC/MS. Promastigote forms of Leishmania amazonensis were cultivated in M199 medium and then 2×106 parasites.mL-1 were incubated in 96-well microtiter plates with the samples. The BP was dissolved in dimethyl sulfoxide (DMSO) and diluted into the medium, to give final concentrations of 1.56, 3.12, 6.25, 12.5, 25 and 50 µg.mL⁻¹. The plates were incubated at 25ºC for 24 h, and the lysis percentage was determined by using a Neubauer chamber. The bioassays were performed in triplicate, using a medium with 0.5% DMSO as a negative control and amphotericin B as a positive control. The leishimnicidal effect against promastigote forms was also evaluated at the same concentrations. Cytotoxicity experiments also were performed in 96-well plates against normal (CHO-k1) and tumor cell lines (AGP01 and HeLa) using XTT colorimetric method. Phenolic compounds, flavonoids, and terpenoids were identified in brown propolis. The major compounds were identified as follows: p-coumaric acid (24.6%) for a methanolic fraction, Artepelin-C (29.2%) for ethyl acetate fraction and the compounds of hexane fraction are in the process of structural elucidation. The major volatile compounds identified were β-caryophyllene (10.9%), germacrene D (9.7%), nerolidol (10.8%) and spathulenol (8.5%). The propolis did not show cytotoxicity against normal cell lines (CHO) with IC₅₀ > 100 μg.mL⁻¹, whereas the IC₅₀ < 10 μg.mL⁻¹ showed a potential against the AGP01 cell line, propolis did not demonstrate cytotoxicity against HeLa cell lines IC₅₀ > 100 μg.mL⁻¹. In the determination of the leishmanicidal activity, the highest (50 μg.mL⁻¹) and lowest (1.56 μg.mL⁻¹) concentrations of the crude extract caused the lysis of 76% and 45% of promastigote forms of L. amazonensis, respectively. To the amastigote form, the highest (50 μg.mL⁻¹) and lowest (1.56 μg.mL⁻¹) concentrations caused the mortality of 89% and 75% of L. amazonensis, respectively. The IC₅₀ was 2.8 μg.mL⁻¹ to amastigote form and 3.9 μg.mL⁻¹ to promastigote form, showing a promising activity against Leishmania amazonensis.

Keywords: amastigote, brown propolis, cytotoxicity, promastigote

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Authors: Alemayehu Muluneh, Saskia Keesstra, Leo Stroosnijder, Woldeamlak Bewket, Ashenafi Burka

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There are some scientific evidences and a belief by many that forests attract rain and deforestation contributes to a decline of rainfall. However, there is still a lack of concrete scientific evidence on the role of forests in rainfall amount. In this paper, we investigate the forest-rainfall relationships in the environmentally hot spot area of the Central Rift Valley (CRV) of Ethiopia. Specifically, we evaluate long term (1970-2009) rainfall variability and its relationship with historical forest cover and the relationship between existing forest cover and topographical variables and rainfall distribution. The study used 16 long term and 15 short term rainfall stations. The Mann-Kendall test, bi variate and multiple regression models were used. The results show forest and wood land cover continuously declined over the 40 years period (1970-2009), but annual rainfall in the rift valley floor increased by 6.42 mm/year. But, on the escarpment and highlands, annual rainfall decreased by 2.48 mm/year. The increase in annual rainfall in the rift valley floor is partly attributable to the increase in evaporation as a result of increasing temperatures from the 4 existing lakes in the rift valley floor. Though, annual rainfall is decreasing on the escarpment and highlands, there was no significant correlation between this rainfall decrease and forest and wood land decline and also rainfall variability in the region was not explained by forest cover. Hence, the decrease in annual rainfall on the escarpment and highlands is likely related to the global warming of the atmosphere and the surface waters of the Indian Ocean. Spatial variability of number of rainy days from systematically observed two-year’s rainfall data (2012-2013) was significantly (R2=-0.63) explained by forest cover (distance from forest). But, forest cover was not a significant variable (R2=-0.40) in explaining annual rainfall amount. Generally, past deforestation and existing forest cover showed very little effect on long term and short term rainfall distribution, but a significant effect on number of rainy days in the CRV of Ethiopia.

Keywords: elevation, forest cover, rainfall, slope

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Authors: Ehsan Kadkhodaie, Shahin Parvar, Soroush Senemar, Mostafa Shriat, Abdolrasoul Malekpour

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The role of oil in supra distribution transformers is so critical and, several standards in determining the quality of oil have been offered. So far, moisture, viscosity and insulation protection of the oil have been measured based on mechanical and chemical methods and systems such as kart fisher, falling ball and TDM 4000 that most of these techniques are destructive and have many problems such as pollution. In this study, due to the properties of oil and also physical behavior of ultrasound wave new method was designed to in the determination of oil indicators including viscosity and moisture. The results show the oil viscosity can be found from the relationship μ = 42.086/√EE and moisture from (PLUS+) = −15.65 (PPM) + 26040 relationship.

Keywords: oil, viscosity, moisture, ultrasonic waves

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Authors: Samira-Sadat JamaliDinan, Haidar Almohri, Mohammad-Reza Nazem-Zadeh

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Lateralization of temporal lobe epilepsy (TLE) is very important for positive surgical outcomes. We propose a machine learning framework to ultimately identify the epileptogenic hemisphere for temporal lobe epilepsy (TLE) cases using magnetoencephalography (MEG) coherence source imaging (CSI) and diffusion tensor imaging (DTI). Unlike most studies that use classification algorithms, we propose an effective clustering approach to distinguish between normal and TLE cases. We apply the famous Minkowski weighted K-Means (MWK-Means) technique as the clustering framework. To overcome the problem of poor initialization of K-Means, we use particle swarm optimization (PSO) to effectively select the initial centroids of clusters prior to applying MWK-Means. We demonstrate that compared to K-means and MWK-means independently, this approach is able to improve the result of a benchmark data set.

Keywords: temporal lobe epilepsy, machine learning, clustering, magnetoencephalography

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Authors: Merzak Laribi, Abdelmadjid Kasser

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Thermal spraying processes are widely used to produce coatings on original constructions as well as in repair and maintenance of long standing structures. A lot of efforts forwarding to develop thermal spray coatings technology have been focused on improving mechanical characteristics, minimizing residual stress level and reducing porosity of the coatings. The specific aim of this paper is to determine either residual stresses distribution or wear resistance of stainless steel coating thermally sprayed on a carbon steel substrate. Internal stresses determination was performed using an extensometric method in combination with a simultaneous progressive electrolytic polishing. The procedure consists of measuring micro-deformations using a bi-directional extensometric gauges glued on the substrate side of the materials. Very thin layers of the deposits are removed by electrochemical polishing across the sample surface. Micro-deformations are instantaneously measured, leading to residual stresses calculation after each removal. Wear resistance of the coating has been determined using a ball-on-plate tribometer. Friction coefficient is instantaneously measured during the tribological test. Attention was particularly focused on the influence of a post-annealing at 850 °C for one hour in vacuum either on the residual stresses distribution or on the wear resistance behavior under specific wear and lubrication conditions. The obtained results showed that the microstructure of the obtained arc sprayed stainless steel coating is classical. It is homogeneous and contains un-melted particles, metallic oxides and also pores and micro-cracks. The internal stresses are in compression in the coating. They are more or less scattered between -50 and -270 MPa on the surface and decreased more at the interface. The value at the surface of the substrate is about –700 MPa, partially due to the molten particles impact with the substrate. The post annealing has reduced the residual stresses in both coating and surface of the steel substrate so that the hole material becomes more relaxed. Friction coefficient has an average value of 0.3 and 0.4 respectively for non annealed and annealed specimen. It is rather oil lubrication which is really benefit so that friction coefficient is decreased to about 0.06.

Keywords: residual stresses, wear resistance, stainless steel, coating, thermal spraying, annealing, lubrication

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Authors: Suman Chaudhary, Rupinder K. Kanwar, Jagat R. Kanwar

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Azadirachta indica, also known as Neem belonging to the mahogany family is actively gaining interest in the era of modern day medicine due to its extensive applications in homeopathic medicine such as Ayurveda and Unani. More than 140 phytochemicals have been extracted from neem leaves, seed, bark and flowers for agro-medicinal applications. Among the various components, neem leaf protein (NLP) is currently the most investigated active ingredient, due to its immunomodulatory activities against tumor growth. However, these therapeutic ingredients of neem are susceptible to degradation and cannot withstand the drastic pH changes under physiological environment, and therefore, there is an urgent need of an alternative strategy such as a nano-delivery system to exploit its medicinal benefits. This study hypothesizes that guar gum (GG) derived biodegradable nano-carrier based encapsulation of NLP will improve its stability, specificity and sensitivity, thus facilitating targeted anti-cancer therapeutics. GG is a galactomannan derived from the endosperm of the guar beans seeds. Synthesis of guar nanocapsules (NCs) was performed using nanoprecipitation technique where the GG was encapsulated with NLP. Preliminary experiments conducted to characterize the NCs confirmed spherical morphology with a narrow size distribution of 30-40 nm. Differential scanning colorimetric analysis (DSC) validated the stability of these NCs even at a temperature range of 50-60°C which was well within the physiological and storage conditions. Thermogravimetric (TGA) analysis indicated high decomposition temperature of these NCs ranging upto 350°C. Additionally, Fourier Transform Infrared spectroscopy (FTIR) and the SDS-PAGE data acquired confirmed the successful encapsulation of NLP in the NCs. The anti-cancerous therapeutic property of this NC was tested on colon cancer cells (caco-2) as they are one of the most prevalent form of cancer. These NCs (both NLP loaded and void) were also tested on human intestinal epithelial cells (FHs 74) cells to evaluate their effect on normal cells. Cytotoxicity evaluation of the NCs in the cell lines confirmed that the IC50 for NLP in FHs 74 cells was ~2 fold higher than in caco-2 cells, indicating that this nanoformulation system possessed biocompatible anti-cancerous properties Immunoconfocal microscopy analysis confirmed the time dependent internalization of the NCs within 6h. Recent findings performed using Annexin V and PI staining indicated a significant increase (p ≤ 0.001) in the early and late apoptotic cell population when treated with the NCs signifying the role of NLP in inducing apoptosis in caco-2 cells. This was further validated using Western blot, Polymerase chain reaction (PCR) and Fluorescence activated cell sorter (FACS) aided protein expressional analysis which presented a downregulation of survivin, an anti-apoptotic cell marker and upregulation of Bax/Bcl-2 ratio (pro-apoptotic indicator). Further, both the NLP NC and unencapsulated NLP treatment destabilized the mitochondrial membrane potential subsequently facilitating the release of the pro-apoptotic caspase cascade initiator, cytochrome-c. Future studies will be focused towards granting specificity to these NCs towards cancer cells, along with a comprehensive analysis of the anti-cancer potential of this naturally occurring compound in different cancer and in vivo animal models, will validate the clinical application of this unprecedented protein therapeutic.

Keywords: anti-tumor, guar gum, nanocapsules, neem leaf protein

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Authors: Elisha Didam Markus, Thapelo Maqame

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This paper focuses on studying the effects of magnetism on water and their impact to plant growth. Magnetic fields are known to induce higher rate of biochemical reaction and therefore can be used for growth related reactions in plants. For the purpose of this study, two 2 litres bottles were taken, one with two opposite poles magnets (500 mT) one on top and one at the bottom of the bottle. Another bottle was not altered in any way (used as control). Each bottle contained tap water stored up for 24 hours. Plants planted into different pots were watered using water from these bottles. Four pots with soil and manure equally mixed were used and equal volume of radish berry seeds were planted. Two pots were watered with magnetised water and the other two with normal tap water. The developments of plants were monitored in terms of their lengths for a period of 21 days. After 21 days, the lengths of plants watered with magnetised water were found to be 5.6% longer than those watered with tap water.

Keywords: magnetised water, radish berry, growth percentage, magnetic fields

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Authors: Enrique Castañeda, Tomas Hernadez, Mario Ulloa

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Recent studies related to submarine pipelines under high pressure, temperature and buried, forces us to make bibliographical and documentary research to make us of references applicable to our problem. This paper presents an experimental methodology to the implementation of results obtained in a scale model, bibliography soil mechanics and finite element simulation. The model consists of a tank of 0.60 x 0.90 x 0.60 basis equipped high side windows, tires and digital hardware devices for measuring different variables to be applied to the model, where the mechanical properties of the soil are determined, simulation of drag a pipeline buried in a non-cohesive seafloor of the Gulf of Mexico, estimate the failure surface and application of each of the variables for the determination of mechanical elements.

Keywords: static friction coefficient, maximum passive force resistant soil, normal, tangential stress

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Authors: Premalatha B. S., Shenoy A. M.

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Background: Rehabilitation of swallowing is as vital as speech in surgically treated head and neck cancer patients to maintain nutritional support, enhance wound healing and improve quality of life. Aspiration following supraglottic laryngectomy is very common, and rehabilitation of the same is crucial which requires involvement of speech therapist in close contact with head and neck surgeon. Objectives: To examine the functions of swallowing outcomes after intensive therapy in supraglottic laryngectomy. Materials: Thirty-nine supra glottic laryngectomees were participated in the study. Of them, 36 subjects were males and 3 were females, in the age range of 32-68 years. Eighteen subjects had undergone standard supra glottis laryngectomy (Group1) for supraglottic lesions where as 21 of them for extended supraglottic laryngectomy (Group 2) for base tongue and lateral pharyngeal wall lesion. Prior to surgery visit by speech pathologist was mandatory to assess the sutability for surgery and rehabilitation. Dysphagia rehabilitation started after decannulation of tracheostoma by focusing on orientation about anatomy, physiological variation before and after surgery, which was tailor made for each individual based on their type and extent of surgery. Supraglottic diet - Soft solid with supraglottic swallow method was advocated to prevent aspiration. The success of intervention was documented as number of sessions taken to swallow different food consistency and also percentage of subjects who achieved satisfactory swallow in terms of number of weeks in both the groups. Results: Statistical data was computed in two ways in both the groups 1) to calculate percentage (%) of subjects who swallowed satisfactorily in the time frame of less than 3 weeks to more than 6 weeks, 2) number of sessions taken to swallow without aspiration as far as food consistency was concerned. The study indicated that in group 1 subjects of standard supraglottic laryngectomy, 61% (n=11) of them were successfully rehabilitated but their swallowing normalcy was delayed by an average 29th post operative day (3-6 weeks). Thirty three percentages (33%) (n=6) of the subjects could swallow satisfactorily without aspiration even before 3 weeks and only 5 % (n=1) of the needed more than 6 weeks to achieve normal swallowing ability. Group 2 subjects of extended SGL only 47 %( n=10) of them could achieved satisfactory swallow by 3-6 weeks and 24% (n=5) of them of them achieved normal swallowing ability before 3 weeks. Around 4% (n=1) needed more than 6 weeks and as high as 24 % (n=5) of them continued to be supplemented with naso gastric feeding even after 8-10 months post operative as they exhibited severe aspiration. As far as type of food consistencies were concerned group 1 subject could able to swallow all types without aspiration much earlier than group 2 subjects. Group 1 needed only 8 swallowing therapy sessions for thickened soft solid and 15 sessions for liquids whereas group 2 required 14 sessions for soft solid and 17 sessions for liquids to achieve swallowing normalcy without aspiration. Conclusion: The study highlights the importance of dysphagia intervention in supraglottic laryngectomees by speech pathologist.

Keywords: dysphagia management, supraglotic diet, supraglottic laryngectomy, supraglottic swallow

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Authors: Esmaeil Abbaszadeh Molaei, Zongyan Zhou, Aibing Yu

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The applications of liquid fluidizations have been increased in many parts of industries such as particle classification, backwashing of granular filters, crystal growth, leaching and washing, and bioreactors due to high-efficient liquid–solid contact, favorable mass and heat transfer, high operation flexibilities, and reduced back mixing of phases. In most of these multiphase operations the particles properties, i.e. size, density, and shape, may change during the process because of attrition, coalescence or chemical reactions. Previous studies, either experimentally or numerically, mainly have focused on studies of liquid-solid fluidized beds containing spherical particles; however, the role of particle shape on the hydrodynamics of liquid fluidized beds is still not well-known. A three-dimensional Discrete Element Model (DEM) and Computational Fluid Dynamics (CFD) are coupled to study the influence of particles shape on particles and liquid flow patterns in liquid-solid fluidized beds. In the simulations, ellipsoid particles are used to study the shape factor since they can represent a wide range of particles shape from oblate and sphere to prolate shape particles. Different particle shapes from oblate (disk shape) to elongated particles (rod shape) are selected to investigate the effect of aspect ratio on different flow characteristics such as general particles and liquid flow pattern, pressure drop, and particles orientation. First, the model is verified based on experimental observations, then further detail analyses are made. It was found that spherical particles showed a uniform particle distribution in the bed, which resulted in uniform pressure drop along the bed height. However for particles with aspect ratios less than one (disk-shape), some particles were carried into the freeboard region, and the interface between the bed and freeboard was not easy to be determined. A few particle also intended to leave the bed. On the other hand, prolate particles showed different behaviour in the bed. They caused unstable interface and some flow channeling was observed for low liquid velocities. Because of the non-uniform particles flow pattern for particles with aspect ratios lower (oblate) and more (prolate) than one, the pressure drop distribution in the bed was not observed as uniform as what was found for spherical particles.

Keywords: CFD, DEM, ellipsoid, fluidization, multiphase flow, non-spherical, simulation

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Authors: Paola Millare, Nelinda Catherine Pangilinan

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Background and Aim: Cervical cancer is the most commonly diagnosed gynecological malignancy during pregnancy. Owing to the rarity of the disease, and the complexity of all factors that have to be taken into consideration, standardization of treatment is very difficult. Cervical cancer is the second most common malignancy among women. The treatment of cancer during pregnancy is most challenging in the case of cervical cancer, since the pregnant uterus itself is affected. This report aims to present a case of cervical cancer in a pregnant woman and how to manage this case and several issues accompanied with it. Methods: This is a case of a 28 year-old, Gravida 4 Para 2 (1111), who presented with watery to mucoid, whitish, non-foul smelling and increasing in amount. Internal examination revealed normal external genitalia, parous outlet, cervix was transformed into a fungating mass measuring 5x4 cm, with left parametrial involvement, body of uterus was enlarged to 24 weeks size, no adnexal mass or tenderness. She had cervical punch biopsy, which revealed, adenocarcinoma, well-differentiated cervical tissue. Standard management for cases with stage 2B cervical carcinoma was to start radiation or radical hysterectomy. In the case of patients diagnosed with cervical cancer and currently pregnant, these kind of management will result to fetal loss. The patient still declined the said management and opted to delay the treatment and wait for her baby to reach at least term and proceed to cesarean section as route of delivery. Results: The patient underwent an elective cesarean section at 37th weeks age of gestation, with an outcome of a term, live baby boy APGAR score 7,9 birthweight 2600 grams. One month postpartum, the patient followed up and completed radiotherapy, chemotherapy and brachytherapy. She was advised to go back after 6 months for monitoring. On her last check up, an internal examination was done which revealed normal external genitalia, vagina admits 2 fingers with ease, there is a palpable fungating mass at the cervix measuring 2x2 cm. A repeat gynecologic oncologic ultrasound was done revealing cervical mass, endophytic, grade 1 color score with stromal invasion 35% post radiation reactive lymph nodes with intact paracolpium, pericervical, and parametrial involvement. The patient was then advised to undergo pelvic boost and for close monitoring of the cervical mass. Conclusion: Cervical cancer in pregnancy is rare but is a dilemma for women and their physicians. Treatment should be multidisciplinary and individualized following careful counseling. In this case, the treatment was clearly on the side of preventing the progression of cervical cancer while she is pregnant, however due to ethical reasons, the management deviates on the right of the patient to decide for her own health and her unborn child. The collaborative collection of data relating to treatment and outcome is strongly encouraged.

Keywords: cancer, cervical, ethical, pregnancy

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Authors: Y. Kourd, D. Lefebvre

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The monitoring of industrial processes is required to ensure operating conditions of industrial systems through automatic detection and isolation of faults. This paper proposes a method of fault diagnosis based on a neuro-fuzzy hybrid structure. This hybrid structure combines the selection of threshold and decision tree. The validation of this method is obtained with the DAMADICS benchmark. In the first phase of the method, a model will be constructed that represents the normal state of the system to fault detection. Signatures of the faults are obtained with residuals analysis and selection of appropriate thresholds. These signatures provide groups of non-separable faults. In the second phase, we build faulty models to see the flaws in the system that cannot be isolated in the first phase. In the latest phase we construct the tree that isolates these faults.

Keywords: decision tree, residuals analysis, ANFIS, fault diagnosis

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Authors: Fayez Hanna, Viet Tran

Abstract:

A 20 years old lady- primigravida 6 weeks pregnant with unremarkable past history, presented to the emergency department at the Royal Hobart Hospital, Tasmania, Australia, with hyperemesis gravidarum associated with, dehydration and complicated with hematemesis and chest pain resistant. Accordingly, we conducted laboratory investigations which revealed: FBC: WBC 23.9, unremarkable U&E, LFT, lipase and her VBG showed a pH 7.4, pCo2 36.7, cK+ 3.2, cNa+ 142. The decision was made to do a chest X-ray (CXR) after explaining the risks/benefit of performing radiographic investigations during pregnancy and considering the patient's plan for the termination of the pregnancy as she was not ready for motherhood for shared decision-making and consent to look for pneumoperitoneum to suggest perforated viscus that might cause the hematemesis. However, the CXR showed pneumomediastinum but no evidence of pneumoperitoneum or pneumothorax. Consequently, a decision was made to proceed with CT oesophagography with imaging pre and post oral contrast administration to identify a potential oesophageal tear since it could not be excluded using a plain film of the CXR. The CT oesophagography could not find a leak for the administered oral contrast and thus, no oesophageal tear could be confirmed but could not exclude the Mallory-Weiss tear (lower oesophageal tear). Further, the CT oesophagography showed an extensive pneumomediastinum that could not be confirmed to be pulmonary in origin noting the presence of bilateral pulmonary interstitial emphysema and pneumothorax in the apex of the right lung that was small. The patient was admitted to the Emergency Department Inpatient Unit for monitoring, supportive therapy, and symptomatic management. Her hyperemesis was well controlled with ondansetron 8mg IV, metoclopramide 10mg IV, doxylamine 25mg PO, pyridoxine 25mg PO, esomeprazole 40mg IV and oxycodone 5mg PO was given for pain control and 2 litter of IV fluid. The patient was stabilized after 24 hours and discharged home on ondansetron 8mg every 8 hours whereas the patient had a plan for medical termination of pregnancy. Three weeks later, the patient represented with nausea and vomiting complicated by a frank hematemesis. Her observation chart showed HR 117- other vital signs were normal. Pathology showed WBC 14.3 with normal U&E and Hb. The patient was managed in the Emergency Department with the same previous regimen and was discharged home on same previous regimes. Five days later, she presented again with nausea, vomiting and hematemesis and was admitted under obstetrics and gynaecology for stabilization then discharged home with a plan for surgical termination of pregnancy after 3-days rather than the previously planned medical termination of pregnancy to avoid extension of potential oesophageal tear. The surgical termination and follow up period were uneventful. The case is considered rare as pneumomediastinum is a very rare complication of hyperemesis gravidarum where vomiting-induced barotrauma leads to a ruptured oesophagus and air leak into the mediastinum. However no rupture oesophagus in our case. Although the combination of pneumothorax and pneumomediastinum without oesophageal tear was reported only 8 times in the literature, but none of them was due to hyperemesis gravidarum.

Keywords: Pneumothorax, pneumomediastinum, hyperemesis gravidarum, pneumopericardium

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Authors: Ana Marie T. Acevedo

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This study was conducted to describe variations in the shapes of the elytra, head and pronotum of populations of adult Brontispa longissima (Gestro) infesting coconut farms from selected areas in the Philippines using Cluster Analysis, Relative Warp Analysis coupled with box plot and histograms and Procustean analysis. The data used in this study included shape residuals captured using the method of landmark based geometric morphometrics. Results: The results of the cluster analyses based on the average shapes of the elytra, head and pronotum shows no consistent pattern of similarity between and among five populations of B. longissima. When localized variations using Relative Warp Analysis coupled with box plot and histograms was done, the findings revealed that RWA was only successful in summarizing variations using two relative warps in the shape of the elytra where the first two warps contained 86.29% of the variations of the female and 85.48% for the males. For the head and pronotum, the first two relative warps captured less than 50% of the overall variation. Looking at the shapes of the frequency histograms, all were found to follow a unimodal distribution. The box plots reveal no consistent results. Among the three characters studied only the elytra were more robust and reliable compared to head and pronotum and then Tandag differ from the rest of the other over-lapping populations. On the other hand, Procustean Analyses revealed that elytra were more spread in the posterior region both in male and female. The coordinates in head and pronotum were evenly distributed. In the overlapping consensus configurations show that variability was exaggerated in the right side of the elytra and the posterior parts of the head and pronotum. Results also showed expansion among females while compression among males in elytra. For males, expansion are localized in the posterior part of the elytra, For the head, results showed asymmetry in the distribution of expansion areas where expansion are observed in the right postero-lateral aspect of the female head. Conclusion: The overall results may imply that they might belong to one operational taxonomic unit or ecotype or biotype. Geography might not be the factor responsible for the differentiation of the populations of B. longissima.

Keywords: cluster analysis, relative warp analysis, procrustean analysis, environmental parameters

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Authors: Masood Otarod, Ronald M. Supkowski

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This abstract discusses a method that reduces the general dispersion model in cylindrical coordinates to a second order linear ordinary differential equation with constant coefficients so that it can be utilized to conduct kinetic studies in packed bed tubular catalytic reactors at a broad range of Reynolds numbers. The model was tested by 13CO isotope transient tracing of the CO adsorption of Boudouard reaction in a differential reactor at an average Reynolds number of 0.2 over Pd-Al2O3 catalyst. Detailed experimental results have provided evidence for the validity of the theoretical framing of the model and the estimated parameters are consistent with the literature. The solution of the general dispersion model requires the knowledge of the radial distribution of axial velocity. This is not always known. Hence, up until now, the implementation of the dispersion model has been largely restricted to the plug-flow regime. But, ideal plug-flow is impossible to achieve and flow regimes approximating plug-flow leave much room for debate as to the validity of the results. The reduction of the general dispersion model transpires as a result of the application of a factorization theorem. Factorization theorem is derived from the observation that a cross section of a catalytic bed consists of a solid phase across which the reaction takes place and a void or porous phase across which no significant measure of reaction occurs. The disparity in flow and the heterogeneity of the catalytic bed cause the concentration of reacting compounds to fluctuate radially. These variabilities signify the existence of radial positions at which the radial gradient of concentration is zero. Succinctly, factorization theorem states that a concentration function of axial and radial coordinates in a catalytic bed is factorable as the product of the mean radial cup-mixing function and a contingent dimensionless function. The concentration of adsorbed compounds are also factorable since they are piecewise continuous functions and suffer the same variability but in the reverse order of the concentration of mobile phase compounds. Factorability is a property of packed beds which transforms the general dispersion model to an equation in terms of the measurable mean radial cup-mixing concentration of the mobile phase compounds and mean cross-sectional concentration of adsorbed species. The reduced model does not require the knowledge of the radial distribution of the axial velocity. Instead, it is characterized by new transport parameters so denoted by Ωc, Ωa, Ωc, and which are respectively denominated convection coefficient cofactor, axial dispersion coefficient cofactor, and radial dispersion coefficient cofactor. These cofactors adjust the dispersion equation as compensation for the unavailability of the radial distribution of the axial velocity. Together with the rest of the kinetic parameters they can be determined from experimental data via an optimization procedure. Our data showed that the estimated parameters Ωc, Ωa Ωr, are monotonically correlated with the Reynolds number. This is expected to be the case based on the theoretical construct of the model. Computer generated simulations of methanation reaction on nickel provide additional support for the utility of the newly conceptualized dispersion model.

Keywords: factorization, general dispersion model, isotope transient kinetic, partial differential equations

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Authors: Safwan Mawlood Hussien

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Internet of Things (IoT) is a promising technology has received considerable attention in different fields such as health, industry, defence, and agro, etc. Due to the limitation capacity of computing, storage, and communication, IoT objects are more vulnerable to attacks. Many solutions have been proposed to solve security issues, such as key management using symmetric-key ciphers. This study provides a scalable group distribution key management based on ECcryptography; with less transmitted messages The method has been validated through simulations in OMNeT++.

Keywords: elliptic curves, Diffie–Hellman, discrete logarithm problem, secure key exchange, WSN security, IoT security, smart-agro

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Authors: Yutae Lee

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This paper considers a discrete-time bulk-arrival bulkservice queueing system, where service capacity varies depending on the previous service time. By using the generating function technique and the supplementary variable method, we compute the distributions of the queue length at an arbitrary slot boundary and a departure time.

Keywords: discrete-time queue, bulk queue, variable service capacity, queue length distribution

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Authors: Saeed Farhadypour, Majid Azadi, Habibolla Sayyari, Mahmood Mosavi, Shahram Irani, Aliakbar Bidokhti, Omid Alizadeh Choobari, Ziba Hamidi

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In the recent decades, frequencies of dust events have increased significantly in west and south west of Iran. First, a survey on the dust events during the period (1990-2013) is investigated using historical dust data collected at 6 weather stations scattered over west and south-west of Iran. After statistical analysis of the observational data, one of the most severe dust storm event that occurred in the region from 3rd to 6th July 2009, is selected and analyzed. WRF-Chem model is used to simulate the amount of PM10 and how to transport it to the areas. The initial and lateral boundary conditions for model obtained from GFS data with 0.5°×0.5° spatial resolution. In the simulation, two aerosol schemas (GOCART and MADE/SORGAM) with 3 options (chem_opt=106,300 and 303) were evaluated. Results of the statistical analysis of the historical data showed that south west of Iran has high frequency of dust events, so that Bushehr station has the highest frequency between stations and Urmia station has the lowest frequency. Also in the period of 1990 to 2013, the years 2009 and 1998 with the amounts of 3221 and 100 respectively had the highest and lowest dust events and according to the monthly variation, June and July had the highest frequency of dust events and December had the lowest frequency. Besides, model results showed that the MADE / SORGAM scheme has predicted values and trends of PM10 better than the other schemes and has showed the better performance in comparison with the observations. Finally, distribution of PM10 and the wind surface maps obtained from numerical modeling showed that the formation of dust plums formed in Iraq and Syria and also transportation of them to the West and Southwest of Iran. In addition, comparing the MODIS satellite image acquired on 4th July 2009 with model output at the same time showed the good ability of WRF-Chem in simulating spatial distribution of dust.

Keywords: dust storm, MADE/SORGAM scheme, PM10, WRF-Chem

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Authors: Koo-Yeon Kim, Eun-Hye Kim, Tae-Il Son

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Epidermal Growth Factor (EGF, Mw=6,045) has been reported to have high efficiency of wound repair and anti-wrinkle effect. However, the half-life of EGF in the body is too short to exert the biological activity effectively when applied in free form. Growth Factors can be stabilized by immobilization with carbohydrates from thermal and proteolytic degradation. Low molecular weight chitosan (LMCS) and its derivate prepared by hydrogen peroxide has high solubility. LM6A6DC was successfully prepared as a reactive carbohydrate for the stabilization of EGF by the reactions of LMCS with alkalization, tosylation, azidation and reduction. The structure of LM6A6DC was confirmed by FT-IR, 1H NMR and elementary analysis. For enhancing the stability of free EGF, EGF was attached with LM6A6DC by using water-soluble carbodiimide. EGF-LM6A6DC conjugates did not show any cytotoxicity on the Normal Human Dermal Fibroblast(NHDF) 3T3 proliferation at least under 100 ㎍/㎖. In the result, it was considered that LM6A6DC is suitable to immobilize of growth factor.

Keywords: epidermal growth factor (EGF), low-molecular-weight chitosan, immobilization

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Authors: A. Abdouni, C. Thieulin, M. Djaghloul, R. Vargiolu, H. Zahouani

Abstract:

A decline in the main sensory modalities (vision, hearing, taste, and smell) is well reported to occur with advancing age, it is expected a similar change to occur with touch sensation and perception. In this study, we have focused on the touch sensations highlighting ageing and gender influences with in vivo systems. The touch process can be divided into two main phases: The first phase is the first contact between the finger and the object, during this contact, an adhesive force has been created which is the needed force to permit an initial movement of the finger. In the second phase, the finger mechanical properties with their surface topography play an important role in the obtained sensation. In order to understand the age and gender effects on the touch sense, we develop different ideas and systems for each phase. To better characterize the contact, the mechanical properties and the surface topography of human finger, in vivo studies on the pulp of 40 subjects (20 of each gender) of four age groups of 26±3, 35+-3, 45+-2 and 58±6 have been performed. To understand the first touch phase a classical indentation system has been adapted to measure the finger contact properties. The normal force load, the indentation speed, the contact time, the penetration depth and the indenter geometry have been optimized. The penetration depth of a glass indenter is recorded as a function of the applied normal force. Main assessed parameter is the adhesive force F_ad. For the second phase, first, an innovative approach is proposed to characterize the dynamic finger mechanical properties. A contactless indentation test inspired from the techniques used in ophthalmology has been used. The test principle is to blow an air blast to the finger and measure the caused deformation by a linear laser. The advantage of this test is the real observation of the skin free return without any outside influence. Main obtained parameters are the wave propagation speed and the Young's modulus E. Second, negative silicon replicas of subject’s fingerprint have been analyzed by a probe laser defocusing. A laser diode transmits a light beam on the surface to be measured, and the reflected signal is returned to a set of four photodiodes. This technology allows reconstructing three-dimensional images. In order to study the age and gender effects on the roughness properties, a multi-scale characterization of roughness has been realized by applying continuous wavelet transform. After determining the decomposition of the surface, the method consists of quantifying the arithmetic mean of surface topographic at each scale SMA. Significant differences of the main parameters are shown with ageing and gender. The comparison between men and women groups reveals that the adhesive force is higher for women. The results of mechanical properties show a Young’s modulus higher for women and also increasing with age. The roughness analysis shows a significant difference in function of age and gender.

Keywords: ageing, finger, gender, touch

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Authors: Juan Li, Jiawen Qiu, Yuchuan Chu, Tianping Zhang, Wei Meng, Yanhui Jia, Xiaohui Liu

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This article developed an ion thruster optic system sputter erosion depth numerical 3D model by IFE-PIC (Immersed Finite Element-Particle-in-Cell) and Mont Carlo method, and calculated the downstream surface sputter erosion rate of accelerator grid; Compared with LIPS-200 life test data, the results of the numerical model are in reasonable agreement with the measured data. Finally, we predict the lifetime of the 20cm diameter ion thruster via the erosion data obtained with the model. The ultimate result demonstrates that under normal operating condition, the erosion rate of the grooves wears on the downstream surface of the accelerator grid is 34.6μm⁄1000h, which means the conservative lifetime until structural failure occurring on the accelerator grid is 11500 hours.

Keywords: ion thruster, accelerator gird, sputter erosion, lifetime assessment

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

Abstract:

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

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

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