Search results for: Diep The Tai
6 A Case Report of Aberrant Vascular Anatomy of the Deep Inferior Epigastric Artery Flap
Authors: Karissa Graham, Andrew Campbell-Lloyd
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The deep inferior epigastric artery perforator flap (DIEP) is used to reconstruct large volumes of tissue. The DIEP flap is based on the deep inferior epigastric artery (DIEA) and vein. Accurate knowledge of the anatomy of these vessels allows for efficient dissection of the flap, minimal damage to surrounding tissue, and a well vascularized flap. A 54 year old lady was assessed for bilateral delayed autologous reconstruction with DIEP free flaps. The right DIEA was consistent with the described anatomy. The left DIEA had a vessel branching shortly after leaving the external iliac artery and before entering the muscle. This independent branch entered the muscle and had a long intramuscular course to the largest perforator. The main DIEA vessel demonstrated a type II branching pattern but had perforators that were too small to have a viable DIEP flap. There were no communicating arterial branches between the independent vessel and DIEA, however, there was one venous communication between them. A muscle sparing transverse rectus abdominis muscle flap was raised using the main periumbilical perforator from the independent vessel. Our case report demonstrated an unreported anatomical variant of the DIEA. A few anatomical variants have been described in the literature, including a unilateral absent DIEA and peritoneal-cutaneous perforators that had no connection to the DIEA. Doing a pre-operative CTA helps to identify these rare anatomical variations, which leads to safer, more efficient, and effective operating.Keywords: aberrant anatomy, CT angiography, DIEP anatomy, free flap
Procedia PDF Downloads 1345 The Impact of COVID-19 on Reconstructive Breast Surgery and Future Prospective
Authors: Amenah Galo, Mohammed Farid, Kareem Alsharkawy, Robert Warner, Karthikeyan Srinivasan, Haitham Khalil, Ruth Waters
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Introduction: The cessation of elective surgery, particularly breast reconstruction, continue to be affected by the COVID-19 pandemic. The restructuring of medical services and staff redeployment severely affected the ability to return to normality for surgical specialties. The aim of this study is to determine the decline in breast reconstruction affected by the COVID-19 pandemic in a tertiary center. Methods: A retrospective review of breast reconstruction cases (autologous, non-autologous) or mastectomies Pre- COVID (March 2019-March 2020) and during COVID (March 2020- March 2021) at Queen Elizabeth Hospital, Birmingham, were collated. Data included patient demographics, BMI, previous and recent reconstruction, length of hospital stay, and mastectomies, including risk-reducing. Results: The number of patients who had breast reconstruction was significantly lower during COVID (n=62) compared to pre-COVID (n=199). The mean age (pre-COVID 51, COVID 59 years), BMI (Pre-COVID and COVID = 27), previous reconstruction (pre-COVID n=101, 51%, COVID n=33, 53%) and length hospital stay was less during COVID (3 days) compared to Pre-COVID (4 days). The proportion of risk-reducing mastectomies and reconstruction during COVID (32%, n=20) were higher than pre-COVID (21%, n=41). A higher proportion rate of autologous reconstruction (DIEP 56, TRAM 17) Pre-COVID compared to COVID (DIEP 22, TRAM 7). Implant reconstructions were higher during COVID (n=19, 31%) than pre-COVID (n=31, 16%). Conclusion: The lack of regular provision for breast reconstruction continues to decline during the pandemic. This will have a tremendous impact on waiting lists without a timeline for reconstruction to offer patients. An international survey highlights the disparities in offering breast reconstruction and strategies to rectify this issue.Keywords: breast reconstruction, COVID-19 pandemic, mastectomy, autologous, implant
Procedia PDF Downloads 2214 Livestock Production in Vietnam: Technical Efficiency and Productivity Performance Based on Regional Differences
Authors: Diep Thanh Tung
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This study aims to measure technical efficiency and examine productivity performance of livestock production in regions of Vietnam based on a panel data of 2008–2012. After four years, although there are improvements in efficiency of some regions, low technical efficiency, poor performance of productivity and its compositions are dominant features in almost regions. Households which much depend on livestock income in agricultural income or agricultural income in total income are more vulnerable than the others in term of livestock production.Keywords: data envelopment analysis, meta-frontier, Malmquist, technical efficiency, livestock production
Procedia PDF Downloads 7063 On-Farm Diversification in Vietnam: Determinants and Trends
Authors: Diep Thanh Tung, Joachim Aurbacher
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This study aims to measure the level of on-farm diversification in Vietnam. The empirical results of the research carried out reflect regional differences in terms of on-farm diversification and its determinants. Households in the northern regions have adapted to the fragmented and small-sized parcels of land held by diversifying their on-farm activities. In contrast, the Mekong delta region in the south of Vietnam is characterized by larger agricultural parcels and a specialization in rice production. Land use fragmentation, as reflected by a large number of plots in a given area, is one of the most important reasons for the high levels of on-farm diversification seen, while the higher share of non-farm income in total income is the reason of lower levels of on-farm diversification. Households have reacted to natural and economic shocks by diversifying their on-farm activities. The non-stationary Markov chain model used here shows various diversification scenarios and trends. In most cases, on-farm diversification generally tends to reduce over the next few years.Keywords: diversification, simpson index, fixed effects, non-stationary markov chain
Procedia PDF Downloads 4852 Antimicrobial Peptide Produced by Lactococcus garvieae with a Broad Inhibition Spectrum
Authors: Hai Chi, Ibrahim Mehmeti, Kirill Ovchinnikov, Hegle Holo, Ingolf F. Nes, Dzung B. Diep
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By using a panel of multiple indicator strains of different bacterial species and genera, we screened a large collection of bacterial isolates (over 1800 isolates) derived from raw milk, for bacteriocin producers with broad inhibition spectra (BIS). Fourteen isolates with BIS were identified, and by 16S rDNA sequencing they were found to belong to Lactococcus garvieae (10 isolates) and Enterococcus feacalis (4 isolates). Further analysis of the ten L. garvieae isolates revealed that they were very similar, if not identical, to each other in metabolic and genetic terms: they had the same fermentation profile on different types of sugars, repetitive sequence-based PCR (rep-PCR) DNA pattern as well as they all had the same inhibition profile towards over 50 isolates of different species. The bacteriocin activity from one of the L. garvieae isolates was assessed further. The bacteriocin which was termed garvicin KS, was found to be heatstable and proteinase-labile and its inhibition spectrum contained many distantly related genera of Firmicutes, comprising most lactic acid bacteria (LAB) as well as problematic species of Bacillus, Listeria, Streptococcus and Staphylococcus and their antibiotic resistant derivatives (e.g. VRE, MRSA). Taken together, the results indicate that this is a potent bacteriocin from L. garvieae and that its very broad inhibition spectrum can be a very useful property for use in food preservation as well as in infection treatments caused by gram-positive pathogens and their antibiotic-derivatives.Keywords: bacteriocin, lactic acid bacteria, Lactococcus garvieae, antibiotics resistance
Procedia PDF Downloads 2441 Factors Associated with Depression: Insights from a Cross-Sectional Study among University Students in Vietnam
Authors: Diep The Tai, Huynh Phuong Thao, Tran Cong Luan, Nguyen Thi Hong Huong, Truong Thi Xuan Lien
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Backgrounds: Depression is a prevalent mental health concern among university students. This cross-sectional study explores the factors associated with depression among university students in Vietnam. Methods: In 2022, a web-based survey was conducted among 2,304 students from different universities across North, Central, and South Vietnam. The Pearson chi-squared test was used to analyze the statistical associations between socio-demographic factors, depression levels, and social media addiction. Results: The results showed that 33,9% of freshmen experienced severe depression, with higher rates among females (69,8%) than males (30,2%). Health field students had the highest proportion of severe depression (52%). Social media addiction was prevalent among freshmen (29%) and health students (54,4%). Factors such as family infections, study pressure, hometown, studying in public places, and social media addiction were strongly linked to higher depression levels. However, spending more time communicating with friends and studying at home had a protective effect against depression. Notably, social media addiction was significantly associated with increased depression levels. Conclusion: The study highlights the influence of family COVID-19 infections, academic pressures, studying in public places, hometown, social media addiction, and lack of social interactions on depression levels. It underscores the importance of comprehensive approaches to address depression, promote resilience, and provide support to students during future outbreaks.Keywords: Depression, social media addiction, mental health, university students, Vietnam
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