Search results for: bleeding

Authors: Abhishekkumar Ramasamy, Parameshwari

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Chitosan is the deacyelitated derivative of chitin, the second most abundant biopolymer just after cellulose. Without doubt, its biomedical usages have gained more importance among the vast variety of chitosan applications owing to its good biocompatibility and biodegradability. In recent years, particular interest has been devoted to chitosan hydrogels as a promising alternative in competition with conventional sutures or bioadhesives. Different parameters such as acid type and concentration, and degree of deacetylation (DD%) of chitosan, were altered to modify hydrogel properties including viscosity, pH, cohesive strength, and tissue bioadhesiveness. In the current work, we have investigated the effectiveness of chitosan hydrogel encapsulated with tanexamic acid to stop bleeding. Chitosan film was obtained with solubilization of chitosan powder in aqueous acidic media. In vivo experiments have been conducted on rat and rabbit models that provide a convenient way to evaluate the efficacy of prepared samples. The arteries vein was punctured on the hind limb of the rat and the gauze was been applied on the punchered area. Bioadhesive strength as well as irritant effects were discussed. Samples with higher degree of deacetylation, including Chs-16 and Chs-19 that were dissolved in lactic media showed best sealing effect.

Keywords: chitosan, biocomaptibility, biodegradability, bioadhersive, deacetylation

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Authors: Adel Yasky, Waseem Al-Talalwah, Shorok Al Dorazi, Roger Soames

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The internal pudendal artery is a standard branch of the anterior division of the internal iliac artery. The current study includes 41 cadavers to investigate the origin and branches of the internal pudendal artery and its clinical significances. The internal pudendal artery arose directly from the anterior division of the internal iliac artery in 48.3% while it arose indirectly in 48.5%. However, the internal pudendal artery arose from the posterior division of internal iliac artery in 1.6%. Moreover, it arose internal iliac artery bifurcation site in 1.6%. Further, the internal pudendal artery supplied the urinary bladder in 17.1%. Also, the internal pudendal artery supplied the rectum 33.5% respectively. It gave uterine and vaginal arteries in 9.4% and 7.8% respectively. Finally, it supplied the sciatic nerve via giving lateral sacral branch in 1.6%. Internists, surgeons and radiologists have to be aware of the variability to decrease iatrogenic injury. Therefore, unnecessary proximal ligation should be avoided at the site of indirect origin of the internal pudendal artery to prevent sciatic neuropathy. Further, intrapelvic bleeding as result of laceration of internal pudendal branches during hysterectomy, prostatectomy or proctectomy should be expected. Therefore, this study increases the awareness of surgeons leading to minimize iatrogenic faults,

Keywords: internal pudendal artery, inferior gluteal artery, superior gluteal artery, internal iliac artery, impotence, decreased libido

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Authors: Thampi Rawther, Sean O’Brien, Kamala Kanta Das

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Background: Intussusception in the adult is rarely from a benign cause and is almost always pathological. Causes include carcinomas, polyps, Meckel's diverticulum, or colonic diverticulum. Common symptoms include abdominal pain, intestinal obstruction, palpable abdominal mass, GI bleeding, and anemia. Sarcomatoid carcinoma is a rare type of small intestinal malignancy exhibiting carcinomatous and sarcomatous features. It primarily affects older patients, mean age 57, and is 1.5 times more prevalent in men. Method: This is an interesting case report of a patient presenting with intussusception secondary to a sarcomatoid tumor of the small bowel. Conclusion: Surgery is the treatment of choice in adults with intussusception due to the high malignancy potential. Furthermore, surgical resection of the affected bowel is the definitive form of therapy as small bowel sarcomatoid tumors are not responsive to chemotherapy and radiotherapy. Early surgical intervention helps reduce mortality as it allows for early staging, treatment, and monitoring of the tumor. The patient was fortunate to have presented with intussusception, facilitating early surgical intervention, and was found to have a low disease stage.

Keywords: general surgery, small bowel tumour, imaging, unique

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Authors: Ashok D. Satpute

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Ayurveda, the ancient Indian Medical system is practiced all over India and abroad, is rich in natural source of medicines, including marine products. The marine drugs which prominently used are pravala (coral), mukta (pearl), kapardika (cowry).Shukti (oyster shell), shankha (conch), agnijara (amber) etc. Except agnijara (amber) all are rich in calcium. Interestingly they are not used as supplements in calcium deficiency as done in conventional medical practice. They are used as medicines in the disease like fever, tuberculosis, bleeding disorders, eye problems, digestive complaints etc. Many scientific studies have shown their potent medicinal value. Each has its own properties and used therapeutically after subjecting them to various purificatory processes which are called shodhana in which several medicinal plants are used which also help in enhancing therapeutical activity. Then these purified marine products are subjected to marana (incineration) process and obtained in the form of Bhasma (a finest form of medicine). Agnijara, a derivative of whale is useful as aphrodisiac and prescribed in neuromuscular disorders and tetanus. The ancient scriptures written in Sanskrit language thousands of years back have rich information about all these natural marine products and their medicinal usage.

Keywords: Ayurveda, bhasma, marana, shodhana

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Authors: Daniel C. Bonzo

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Practical considerations lead to the use of unit of analysis within subjects, e.g., bleeding episodes or treatment-related adverse events, in rare disease settings. This is coupled with data augmentation techniques such as extrapolation to enlarge the subject base. In general, one can think about extrapolation of data as extending information and conclusions from one estimand to another estimand. This approach induces hierarchichal clustered data with varying cluster sizes. Extrapolation of clinical trial data is being accepted increasingly by regulatory agencies as a means of generating data in diverse situations during drug development process. Under certain circumstances, data can be extrapolated to a different population, a different but related indication, and different but similar product. We consider here the problem of estimation (point and interval) using a mixed-models approach under an extrapolation. It is proposed that estimators (point and interval) be constructed using weighting schemes for the clusters, e.g., equally weighted and with weights proportional to cluster size. Simulated data generated under varying scenarios are then used to evaluate the performance of this approach. In conclusion, the evaluation result showed that the approach is a useful means for improving statistical inference in rare disease settings and thus aids not only signal detection but risk-benefit evaluation as well.

Keywords: clustered data, estimand, extrapolation, mixed model

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Authors: Zahra Ghasemi, Fatemeh Babaei

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Plasma-derived medicinal products are vital categories of biological therapies. These products are used to treat rare, chronic, severe, and life-threatening conditions, such as bleeding disorders (Hemophilia A and B), hemolytic disease of the fetus and newborn, severe infections, burns and liver diseases, and other diseases caused by the absence or malfunction of certain proteins. In addition, they improve the patient’s quality of life. The process of producing plasma-derived medicinal products begins with the collection of human plasma from healthy donors. This initial stage is complex and is monitored with high precision and sensitivity by global authorities to maintain the quality and safety of the final products as well as the health of the donors. The amount of manufactured plasma-derived medicinal products depends on the availability of its raw material, human plasma, so collecting enough plasma for fractionation is essential. Therefore, adopting a suitable national policy regarding plasma donation, establishing collection centers, and increasing public awareness of the importance of plasma donation will improve any country’s conditions regarding the timely and sufficient supply of these medicines. In this study, we tried to briefly examine the importance of sustainability of the plasma industry and its situation in our beloved country of Iran.

Keywords: plasma, source plasma, plasma-derived medicinal products, fractionation

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Authors: Amandeep Kaur, Manmeet Gill

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The climacteric is a wide phenomenon. Women of the entire world go through it at their own level. It’s a topic on which women hesitate to talk openly. It includes breast tenderness, uterine bleeding, arthralgia, hemorrhage, changes in emotional level such as facing depression, emotional breakdown, irritability and others. Other than such emotional breakdown nausea, vomiting, headache, gaining or losing weight is common problem associated with the climacteric disorder. The purpose of the present study is to assess the Climacteric disorders among women such as during menopause whatever a woman or girl faces mentally or physically. This is mainly done in women when they reached the age of 12 to 48 worldwide. For completing the study two objectives have been taken. The first objective of the study is to analyze the symptoms which lead to Climacteric among women such as Vaginal problems, Breast changes, Behavioral problems, Weight gain, Problems in the urinary tract etc. and the second Objective is to identify the variables which affect Climacteric these are Physical variables (lack of energy, joint soreness, stiffness, back pain etc.), Psychological variables (anxiety, poor memory, inability to concentrate) and Vasomotor variables (hormone estrogen fall, etc). The secondary source of method or data is used to deal with the theme of paper. Sometimes the word climacteric is interchanged with the term menopause and all these changes are high during the period of menopause among women.

Keywords: climacteric and their symposiums, disorder, reviews, in middle age

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Authors: Mai Ashraf Talaat

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Background: Vitamin C (ascorbic acid) is an essential nutrient for the development and repair of all body tissues. It can be obtained from a healthy diet or through supplementation. Due to its importance, vitamin C has become a mainstay in the treatment and prevention of many diseases and in maintaining immune, skin, bone and overall health. This review article aims to discuss the studies and case reports conducted to evaluate the effect of Vitamin C on oral health and the recent advances in oral medicine that involve the use of vitamin C. Data/Sources: The review was conducted for clinical studies, case reports and published literature in the English language that addresses this topic. An extensive search in the electronic databases of PubMed, PubMed Central, Web of Science, National Library of Medicine and ResearchGate was performed. Conclusion: Vitamin C is thought to treat periodontal diseases and gingival enlargement. It also affects biofilm formation and therefore, it helps in reducing caries incidence. Recently, vitamin C mesotherapy has been used to treat inflamed gingiva, bleeding gums and gingival hyperpigmentation. More research and randomized controlled trials are needed on this specific topic for more accurate judgment. Clinical significance: A minimally invasive approach - the usage of vitamin C in dental care could drastically reduce the need for surgical intervention.

Keywords: oral health, periodontology, vitamin C, Gingivitis

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Authors: Ezeh Chukwunonso Peter Excel, Akruti Vg

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Aim/Background: To show that even after undergoing 1-5 courses of chemotherapy for Gestational Trophoblastic Disease (GTD) reproductive health of women is intact and they conceive successfully after it. Method: Retrospective cohort analysis using data from the Lugansk regional maternity hospital database of years 1993-2013, which shows n=18 females had GTD and underwent 1-5 courses of chemotherapy. Results and Discussion: Frequency of GTD was rare. All 18 patients (pts) belong to age group of 17-39 years, covering wide range of reproductive age. Out of 18 pts, 15 had hydatidiform mole (HM) while other 3 had choriocarcinoma (CC). In anamnesis, among CC pts, 1 had early pre-eclampsia at 24 weeks and 1 had 4th week of late postpartum (PP) bleeding, while all HM pts had genital inflammatory diseases, 1 pt of HM during follow-up had High hCG and 3 times curettage in 5 months. 18 women became pregnant for 25 times after chemotherapy. Chemotherapy was given under indication of either high level of HCG, luteal cyst >6cm or path-morphological results of curettage. CC 3 pts had (2 spontaneous abortions (SA), 2 term cesarean section (CS), 1 preterm CS). HM 15 pts had (3 artificial abortion, 2 SA, 7CS (5 term and 2 preterm), 8 vaginal deliveries (7 term and 1 preterm)). Conclusion: During our research we got 22.2% preterm deliveries and 55.6% CS which is higher than the normal cases, but still all the 18 women were able to have kids successfully after chemotherapy. So we can conclude that chemotherapy for GTD was successful in keeping the reproductive health of women intact.

Keywords: reproductive health, chemotherapy, gestational trophoblastic disease, women

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Authors: Pármenas Costa Macedo do Nascimento

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Periodontal disease is the most common disease in the oral cavity of felines. It starts with the accumulation of bacteria on the tooth surface supporting the tissues of the periodontal tissue, namely gums, alveolar bone, cementum, and periodontal ligament. The main clinical symptom observed by the owner is bad breath, which may lead to local and systemic consequences depending on the stage of periodontal disease, such as bleeding and bone loss. Therefore, the study is important to educate tutors to take better care of the felines oral health in order to try to prevent the disease. For this epidemiological study, the target population has been felines, located on the outskirts of Manaus, in the state of Amazonas, with a geographic area of 155.68 km², with no defined breed, from October 1st to 10th, 2021, whose samples has been randomly selected, with a detailed profile. The variables of interest for this study have been: absence or presence of periodontal disease, gender, age (delimited by age group), and condition (domiciled or homeless). Using a sample of 40 felines from 4 districts of the east side of Manaus chosen at random, an oral exam has been made to identify the studied disease. The animal's apparent age, condition, sex, and presence or absence of periodontal disease has been noted. It has been observed that 70% (28/40) of them had periodontal disease, mostly females, aged between 0 and 5 years and domiciled, totaling 30% (12/40).

Keywords: felines, oral cavity, oral exam, periodontal disease

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Authors: I. L. Ibrahim, A. Mann, A. Ndanaimi

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The research involved phytochemical screening, antibacterial activities and mineral determination by flame photometry of the crude extract of Brysocarpus coccineus schum indeed were carried out. The result of Phytochemical screening reveal tha saponins, alkaloids, cardiac glycosides, and anthraquinones were present. This suggests that the plant extract could be used as anti-inflammatory and anti-bleeding agents. Estimation of mineral content shows that the crude extract of B. coccineus contains 0.73 (Na+), 1.06 (K+) and 1.98 (Ca+) which justifies its use to be safe for hypertensive patients and could be used to lower blood pressure. The antibacterial properties of aqueous and ethanol extract were studied against some bacteria; pseudomonas aeruginosa, Escherichia coli, Bacilus subtilis, Klebsilla penmuoniae by disc diffusion method. The aqueous extract showed significant activity against the organisms while the ethanol at concentrations 5-10mg/ml ethanol extract showed significant zone of inhibition against the organisms, E. coli, (19 mm), B. cereus (12 mm), P. aeruginosa (11 mm), K. pnemuoniae (11 mm). Minimum inhibitory concentration (MIC) was carried with considerable effect of inhibition on the organisms. The MIC values observed were 1, 24, 16 and 19 mm against E. coli, B. cereus, P. aeruginosa and K. pnemuoniae respectively. Therefore, the plant could be a potential source of antibacterial agent although more pharmacological and clinical study may be recommended.

Keywords: phytochemicals, microorganisms, screenings, mineral ions

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Authors: I. L. Ibrahim, A. Mann, B. A. Adam

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This project involved screening for antibacterial activity, phytochemical and mineral properties of Leptadenia hastata by flame photometry. The result of phytochemical screening reveals that the presence of flavonoids, tannins, saponins, alkaloids, steroidal, and anthraquinones while the cardiac glycoside was absent. This justifies the plant been used as anti-bleeding and anti-inflammatory agents. The result of flame photometry revealed that 1.85 % (Na), 0.65% (K) and 1.85 % (Ca) which indicates the safe nature of the plant extract as such could be used to lower high blood pressure. The antibacterial properties of both the aqueous and ethanolic extract were studied against some bacteria, Escherichia coli, Bacillus Cercus, Pseudomonas aeruginas, and Enterobacter aerogegens, by disc diffusion method and the result reveals that there are very good activities against the organism while the ethanolic extract at concentration 1.0 – 1.2 mg/ml. the ethanolic extract showed in considerable zone inhibition against bacteria’s; Escherichia coli, Bacillus Cercus, pseudomonas aeruginosa andklebsellapnemuoniae. Minimum inhibitory concentration (MIC) and minimum Bacterial concentration (MBC) were conducted with fairly good significant effect of inhibition on the organism, therefore, plant extract could be a potential source of antibacterial agent.

Keywords: antibacterial activity, Leptadenia hastata, infectious diseases, phytochemical screening

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Authors: Satoshi Furukawa, Satomu Morita, Katsuji Nishi, Masahito Hitosugi

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We experience the autopsy cases that the deceased was alive in emergency room on arrival. Bleeding is the leading cause of preventable death after injury. This retrospective study aimed to characterize opportunities for performance improvement identified in patients who died from traffic trauma and were considered by the quality improvement of education system. The Japan Advanced Trauma Evaluation and Care (JATEC) education program was introduced in 2002. We focused the abdominal traffic trauma injury. An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 41 post-mortems of road traffic accident between April 1999 and March 2014 subjected to medico-legal autopsy at the department of Forensic Medicine, Shiga University of Medical Science. 16 patients (39.0%) were abdominal trauma injury. The mean period of survival after meet with accident was 13.5 hours, compared abdominal trauma death was 27.4 hours longer. In road traffic accidents, the most injured abdominal organs were liver followed by mesentery. We thought delayed treatment was associated with immediate diagnostic imaging, and so expected to expand trauma management examination.

Keywords: abdominal traffic trauma, preventable death, autopsy, emergency medicine

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Authors: Israr Ahmad, Sehrish Sabir

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Present study deals with the taxonomic and ethno medicinal uses of some Pteridophytes species present in District Bagh AJK, Pakistan. The people of District Bagh extensively use Pteridophytes for different purposes. Ethno botanical evidence and Ornamental Potential of the taxa of wild pteridophytes was documented through field trips during 2017-2018, and data was collected through a structured questionnaire, and in-depth interviews were conducted from the natives in the hilly regions. Total of 22 Pteridophytes belonging to 13 genera 9 families were collected. Out of 22 species, one species (Cystoathyriumchinense ) newly record from Pakistan. The most leading family is Pteridaceae, having 9species, followed by Dryopteridaceae, having 4species, and Aspleniaceae having 3species. The remaining families are represented by single species of each. Inhabitants of mountainous and rural zones regularly used these taxa for different remedy, which are not discussed in the previous available literature. The novel remedies reported in this research areCystoathyriumchinense decoction used for irregular menstruation, Cyclosorusopulentus crushed leaves and stem are used for the treatment of stomach disorder.Onychiumlucidumused to treatJaundice, injury, pain dysentery, common cold, and arresting bleeding. Based on these findings, it is further recommended that phytochemical studies should be conducted to explore active chemical constituents for the cure of various diseases. Conservation efforts must be done to conserve many threatened species of the research area.

Keywords: adiantum, cancer, pakistan, pteridophytes

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Authors: Zengmin Tian, Bin Lv, Rui Hui, Yupeng Liu, Chuan Wang, Qing Liu, Hongyu Li, Yan Qi, Li Song

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Objective Robot was used for replacement of the frame in recent years. The paper is to investigate the safety and effectiveness of frameless stereotactic surgery in the treatment of children with cerebral palsy. Methods Clinical data of 425 children with spastic cerebral palsy were retrospectively analyzed. The patients were treated with robot-assistant frameless stereotactic surgery of nuclear mass destruction. The motor function was evaluated by gross motor function measure-88 (GMFM-88) before the operation, 1 week and 3 months after the operation respectively. The statistical analysis was performed. Results The postoperative CT showed that the destruction area covered the predetermined target in all the patients. Minimal bleeding of puncture channel occurred in 2 patient, and mild fever in 3 cases. Otherwise, there was no severe surgical complication occurred. The GMFM-88 scores were 49.1±22.5 before the operation, 52.8±24.2 and 64.2±21.4 at the time of 1 week and 3 months after the operation, respectively. There was statistical difference between before and after the operation (P<0.01). After 3 months, the total effective rate was 98.1%, and the average improvement rate of motor function was 24.3% . Conclusion Replaced the traditional frame, the robot-assistant frameless stereotactic surgery is safe and reliable for children with spastic cerebral palsy, which has positive significance in improving patients’ motor function.

Keywords: cerebral palsy, robotics, stereotactic techniques, frameless operation

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Authors: Dhara Shah, Chandrakant Shah

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As everyone knows, fly ash is a residual material we get upon energy production using coal. It has found numerous advantages for use in the concrete industry like improved workability, increased ultimate strength, reduced bleeding, reduced permeability, better finish and reduced heat of hydration. Types of fly ash depend on the type of coal and the coal combustion process. It is a pozzolanic material and has mainly two classes, F and C, based on the chemical composition. The fly ash used for this experimental work contains significant amount of lime and would be categorized as type F fly ash. Generally all types of fly ash have particle size less than 0.075mm. The fineness and lime content of fly ash are very important as they will affect the air content and water demand of the concrete, thereby affecting the durability and strength of the concrete. The present work has been done to optimize the use of fly ash to produce concrete with improved results and added benefits. A series of tests are carried out, analyzed and compared with concrete manufactured using only Portland cement as a binder. The present study is carried out for concrete mix with replacement of cement with different proportions of fly ash. Two concrete mixes M25 and M30 were studied with six replacements of cement with fly ash i.e. 40%, 45%, 50%, 55%, 60% and 65% for 7-day, 14-day, 28-day, 56-day and 90-day. Study focused on compressive strength, split tensile strength, modulus of elasticity and modulus of rupture of concrete. Study clearly revealed that cement replacement by any proportion of fly ash failed to achieve early strength. Replacement of 40% and 45% succeeded in achieving required flexural strength for M25 and M30 grade of concrete.

Keywords: processed fly ash, engineering properties of concrete, pozzolanic, lime content

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Authors: A. Umar, A. Tamimi

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Development of new types of concrete with improved performance is a very important issue for the whole building industry. The development is based on the optimization of the concrete mix design, with an emphasis not only on the workability and mechanical properties but also to the durability and the reliability of the concrete structure in general. Self-compacting concrete (SCC) is a high-performance material designed to flow into formwork under its own weight and without the aid of mechanical vibration. At the same time it is cohesive enough to fill spaces of almost any size and shape without segregation or bleeding. Construction time is shorter and production of SCC is environmentally friendly (no noise, no vibration). Furthermore, SCC produces a good surface finish. Despite these advantages, SCC has not gained much local acceptance though it has been promoted in the Middle East for the last ten to twelve years. The reluctance in utilizing the advantages of SCC, in Bahrain, may be due to lack of research or published data pertaining to locally produced SCC. Therefore, there is a need to conduct studies on SCC using locally available material supplies. From the literature, it has been observed that the use of viscosity modifying admixtures (VMA), micro silica and glass fibers have proved to be very effective in stabilizing the rheological properties and the strength of fresh and hardened properties of self-compacting concrete (SCC). Therefore, in the present study, it is proposed to carry out investigations of SCC with combinations of various dosages of VMAs with and without micro silica and glass fibers and to study their influence on the properties of fresh and hardened concrete.

Keywords: self-compacting concrete, viscosity modifying admixture, micro silica, glass fibers

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Authors: Muhammad Munir, Riffat Mehboob, Samina Naeem, Muhammad Salman, Shehryar Ahmed, Irshad Hussain Qureshi, Tahira Murtaza Cheema, Ashraf Sultan, Akmal Laeeq, Nakhshab Choudhry, Asad Aslam Khan, Fridoon Jawad Ahmad

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A dengue outbreak in Lahore, Pakistan during 2011 was unprecedented in terms of severity and magnitude. This research aims to determine the serotype distribution of dengue virus during this outbreak and classify the patients demographically. 5ml of venous blood was drawn aseptically from 166 patients with dengue-like signs to test for the virus between the months of August to November 2011. The samples were sent to the CDC, Atlanta, Georgia for the purpose of molecular assays to determine their serotype. RT-PCR protocol was performed targeting at the 4 dengue serotypes. Out of 166 cases, dengue infection was detected with RT-PCR in 95 cases, all infected with same serotype DEN-2. 75% of positive cases were males while 25% were females. Most positive patients were in the age range of 16-30 years. 33% positive cases had accompanying bleeding. This is first study during the 2011 dengue epidemic in Lahore that reports DEN-2 as the only prevalent serotype. It also indicates that more infected patients were males, adults, within age range of 16-30 years, peaked in the month of November, Dengue hemorrhagic fever (DHF) is manifested more in females, Ravi town was heavily hit by dengue virus infection.

Keywords: dengue, serotypes, Pakistan, DEN 2, Lahore, demography, serotype distrbution, 2011 epidemic

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Authors: H. N. S. Silva, S. N. Silva

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Introduction: The latest WHO data published in 2014 states that Sri Lanka has reached 2,773 of total deaths and over 14000 individuals’ sustained injuries due to RTAs each year. It was noticed in previous studies that policemen, three wheel drivers and also pedestrians were the first to respond to RTAs but the victim’s condition was aggravated due to unskilled attempts made by the responders while management of the victim’s wounds, moving and positioning of the victims and also mainly while transportation of the victims. Objective: To observe the practices of the urban public in Sri Lanka who are encountered with RTAs. Methods: A qualitative study was done to analyze public behavior seen on video recordings of scenes of accidents purposefully selected from social media, news websites, YouTube and Google. Results: The results showed that all individuals who tried to help during the RTA were middle aged men, who were mainly pedestrians, motorcyclists and policemen during that moment. Vast majority were very keen to actively help the victims to get to hospital as soon as possible and actively participated in providing 'aid'. But main problem was the first aid attempts were disorganized and uncoordinated. Even though all individuals knew how to control external bleeding, none of them was aware of spinal prevention techniques or management of limb injuries. Most of the transportation methods and transfer techniques used were inappropriate and more injury prone. Conclusions: The public actively engages in providing aid despite their inappropriate practices in giving first aid.

Keywords: encountered, pedestrians, road traffic accidents, urban public

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Authors: Priyanka Sharma, Tarkewshwar Dubey, Hemalatha Siva

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Hemorrhoids are one of the most common anorectal diseases around the world. Severalfactors are involved in causing hemorrhoids including irregularbowel function (constipation, diarrhea), exercise, gravity, low fiberdiet, pregnancy, obesity, high abdominal pressure, prolongedsitting, genetic factors, and aging. Pain, bleeding, itching,swelling and anal discharge are the symptoms of the disease. Due to limitedmodern pharmacotherapeutic options available for treatment, theherbal medicines remain the choice of therapy. Blumea lacera (Burm f.) DC. belonging to the Asteraceae family is a common plain land weed of Bangladesh. Traditionally it has been used for treatment of hemorrhoids.Considering the above fact, present study was aimed to validate the ethnomedicinal use of B. lacera leaves on experimental hemorrhoids in rats. The anti-hemorrhoid activity was performed by using croton oil induced rat models. The parameters studied were assessment of TNF-α and IL-6, Evans blue exudation, macroscopic severity score, recto-anal coefficient, histomorphological scores. Also, in vivo antioxidant parameters and histopathological studies were also performed. All paramaters exhibited significant anti-hemorrhoid activity. Moreover ethanolic extract of B. lacera (EBL) leaves 400mg/kg showed ameliorative effect oncroton oil induced hemorrhoids.In conclusion, EBL exhibitedbeneficial effect on croton oil- induced hemorrhoids and validates its ethnomedicinal use in treatment of piles.

Keywords: haemorrhoids, IL-6, piles, TNF-α

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Authors: M. Elder, L. Beech, A. Mackie

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Heterotopic pregnancy is an uncommon and potentially life-threatening condition in which there is simultaneous occurrence of intrauterine and ectopic pregnancies. It has an incidence of approximately 1:3900 pregnancies, occurring in only 1:30000 spontaneous pregnancies. This study presents a rare case of spontaneous heterotopic pregnancy in a 34-year-old primiparous woman who was brought in by ambulance to the emergency department following collapse at 20+1 weeks gestation after normal first trimester screening and morphology scan. She was hemodynamically unstable and fetal heart rate was 60bpm. Initial resuscitation included transfusion of 2 units packed red blood cells and 1g intravenous tranexamic acid. Bedside ultrasound revealed evidence of approximately 1000ml clot in the right upper quadrant. She underwent a diagnostic laparoscopy and washout, which proceeded to a midline exploratory laparotomy. This revealed a 2.6L hemoperitoneum and query right ectopic pregnancy with calcified areas and clot, with no other cause of bleeding identified. Right salpingectomy was performed, and pathology later confirmed ectopic pregnancy. The intrauterine pregnancy had no complications, and she delivered a healthy full-term baby. This case demonstrates that ultrasound confirmation of intrauterine pregnancy does not exclude coexisting ectopic pregnancy. Heterotopic pregnancy should be considered in any pregnant woman presenting with abdominal pain or signs of hemorrhagic shock, as prompt diagnosis and treatment is essential to minimize foetal and maternal morbidity and mortality.

Keywords: ectopic pregnancy, hemorrhagic shock, salpingectomy, spontaneous heterotopic pregnancy

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Authors: Nawaf Al-Kharashi, Waseem Al-Talalwah, Shorok Al Dorazi, Roger Soames

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Superior gluteal artery is one of the largest branches of posterior division of the internal iliac artery. It passes between the lumbosacral and first sacral root to escape from the pelvic cavity through the grater sciatic foramen just above the piriformis. The current study includes 41 cadaver investigates the origin and branch of the superior gluteal artery and clarify the clinical significance. In present study, the superior gluteal artery arises from the posterior division of the internal iliac artery directly in 82.5% whereas it arises indirectly as from the sciatic artery in 15.9%. However, it is congenital absence in 1.6% which is compensated by sciatic artery. The sciatic nerve gains vascular supply from superior gluteal artery in two ways either during its course or giving lateral sacral artery in 27% and lumbar branches in 1.6%. It also supplies the adductors group and iliacus via giving obturator artery in 14.3% and in 1.6% respectively. The superior gluteal artery usually passes between lumbosacral trunk and first sacral root in 82.5% whereas it does not passes the sciatic roots as it arises behind them in 15.9%. With a variability of the superior gluteal artery origin, there is a variability of sciatic nerve roots supply. Further, the superior gluteal artery arising from sciatic artery behind the sciatic roots carries a high risk of intra-pelvic bleeding in case of posterior pelvic fracture. Prolonged ligation of the superior gluteal artery which gives lateral sacral artery may result in sciatic neuropathy. Therefore, surgeons have to be aware of the superior gluteal artery variation in origin, course and branches to reduce the iatrogenic faults.

Keywords: internal pudendal artery, inferior gluteal artery, superior gluteal artery, internal iliac artery. sciatic neuropathy, sciatic nerve

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Authors: Pitchaporn Purngpiputtrakul, Suttasinee Petsakul, Sunisa Chatmongkolchart

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Nasogastric tube (NGT) insertion in anaesthetized and intubated patients can be challenging even for experienced anesthesiologists. Various techniques have been proposed to facilitate NGT insertion in these patients. This study aimed to compare the success rate and time required for NGT insertion between the GlideScope visualization and neck flexion with lateral neck pressure techniques. This randomized clinical trial was performed at a teaching hospital on 86 adult patients undergoing abdominal surgery under relaxant general anaesthesia who required intraoperative NGT insertion. The patients were randomized into two groups, the GlideScope group (group G) and the neck flexion with lateral neck pressure group (group F). The success rate of first and second attempts, duration of insertion, and complications were recorded. The total success rate was 79.1% in Group G compared with 76.7% in Group F (P=1) The median time required for NGT insertion was significantly longer in Group G, for both first and second attempts (97 vs 42 seconds P<0.001) and (70 vs 48.5 seconds P=0.015), respectively. Complications were reported in 23 patients (53.5%) in group G and 13 patients (30.2%) in group F. Bleeding and kinking were the most common complications in both techniques. Using GlideScope visualization to facilitate NGT insertion was comparable to neck flexion with lateral neck pressure technique in degree of success rate of insertion, while neck flexion with lateral neck pressure technique had fewer complications and was less time-consuming.

Keywords: anaesthesia, nasogastric tube, GlideScope, intubation

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Authors: Bang Haeyong

Abstract:

Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative fever after lumbar fusion. Methods: This study was a retrospective chart review of 291 patients who underwent lumbar fusion between March 2015 and February 2016 at the Asan Medical Center. Information was extracted from electronic medical records. Postoperative fever was measured at Tmax > 37.7 ℃ and Tmax > 38.3 ℃. The presence of postoperative fever, blood culture, urinary excretion, and/or chest x-ray were evaluated. Patients were evaluated for infection after lumbar fusion. Results: We found 222 patients (76.3%) had a postoperative temperature of 37.7 ℃, and 162 patients (55.7%) had a postoperative temperature of 38.3 ℃ or higher. The percentage of febrile patients trended down following the mean 1.8days (from the first postoperative day to seventh postoperative day). Infection rate was 9 patients (3.1%), respiratory virus (1.7%), urinary tract infection (0.3%), phlebitis (0.3%), and surgical site infection (1.4%). There was no correlation between Tmax > 37.7℃ or Tmax > 38.3℃, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection. Risk factors for increased postoperative fever following surgery were confirmed to be delay of defecation (OR=1.37, p=.046), and shorten of remove drainage (OR=0.66, p=.037). Conclusions: The incidence of fever was 76.3% after lumbar fusion and the drainage time was faster in the case of fever. It was thought that the bleeding was absorbed at the operation site and fever occurred. The prevalence of febrile septicemia was higher in patients with long bowel movements before surgery than after surgery. Clinical symptoms should be considered because postoperative fever cannot be determined by fever alone because fever and infection are not significant.

Keywords: lumbar surgery, fever, postoperative, risk factor

Procedia PDF Downloads 221

Authors: Mathew Nyashanu, George K. Kiggundu, Mandu S. Ekpenyong

Abstract:

There is an increased number of young people engaging in early sexual relationships worldwide. Furthermore, statistics for early pregnancy among young people have also increased, especially in low and middle-income countries. This has health implications for both the parents and the baby. High uptake in family planning contraception among young people can reduce early pregnancy and subsequent negative health outcomes on the young parents and the baby. This study was set to explore the factors influencing the uptake of family planning contraceptive services among young people (18-24 years) at a community level in rural Budaka district, Uganda. The study utilised an explorative qualitative approach. The study found out that religion, partner resistance; perceived loss of libido, perceived barren, long waiting time and distance from the health facility, lack of privacy/confidentiality, excessive menstrual bleeding, cancer, and fear of having disabled babies, limited the utilisation of family planning contraceptive services while contraception as HIV prevention and child spacing encouraged young people to use family planning contraceptive services. There is a need for a culturally orientated community-based contraceptive health promotion approach to increase the uptake of family planning contraception services among young people.

Keywords: Young people, Family Planning, Contraceptives, Black sub-Sahara African

Procedia PDF Downloads 104

Authors: Enock E. Goler, Emmanuel H. Kwon-Ndung, Gbenga F. Akomolafe, Terna T. Paul, Markus Musa, Joshua I. Waya, James H. Okogbaa

Abstract:

An ethno-medicinal survey of plants used in treating various diseases and ailments was carried out in the study area of Nasarawa State, North Central Nigeria to obtain information on their uses and potentials. The ethno-medicinal survey was administered through structured questionnaires among local inhabitants from areas with high plant density and diversity within the various Local Government Areas of the State. A total of 84 (Eighty four) plant species belonging to 45 (Forty five) families were found to be useful in treatment of various ailments such as diabetes, measles, fever, asthma, jaundice, pneumonia, sexually transmitted diseases (STDs), aches, diarrhea, cough, arthritis, yellow fever, typhoid, erectile dysfunction and excessive bleeding. Different parts of the plant such as the roots, leaves and stems are used in preparing herbal remedies which could be from dry or freshly collected plants. The main methods of preparation are decoction or infusion, while in some cases the plant parts used are consumed directly. Residents in the study areas find the herbal remedy cheaper and more accessible and claimed that there are no side effects compared to orthodox medicine. This study has confirmed the need towards the conscious conservation of plant genetic resources in order to ensure sustained access to these ethno-medicinal plant materials.

Keywords: ethno-medicinal, Nasarawa, plants, survey

Procedia PDF Downloads 245

Authors: B.S. Roopa

Abstract:

Objectives: To investigate the prevalence of concomitant use of GPDs in patients treated with NSAIDs and GPDs in recommended dose and frequency as prophylaxis. And also to know the association between risk factors and prescription of GPDs in patients treated with NSAIDs. Methods: Study was a prospective, observational, cross-sectional survey. Data from patients with prescription of NSAIDs at the out-patient departments of secondary care Hospital, Nilgiris, India were collected in a specially designed proforma for a period of 45 days. Analysis using χ2 tests for discrete variables. Factors that might be associated with prescription of GPD with NSIADs were assessed in multiple logistic regression models. Results: Three hundred and three patients were included in this study, and the rate of GPD prescription was 89.1%. Most of the patients received H2-receptor antagonist, and, to a lesser degree, antacid and proton pump inhibitor. Patients with history of GI ulcer/bleeding were much more likely to be co-prescribed GPD than those who had no history of GI disorders .Compared with patients who were managed in general outpatient clinic, those managed in Secondary care hospital in Nilgrisis, India were more likely to receive GPD. Conclusions: The prescription rate of GPD with NSAIDs is high. Patients were prescribed with H2RA with dose of 150mg twice daily, which are not effective in reducing the risk of NSAIDs induced gastric ulcer. Only the frequency of NSAIDs prescription was considered significant determinant for the co-prescription with GPAs in patients who are < 65 years and ≥ 65 years old.

Keywords: gastro protective agents, non steridol anti inlfammatory agents

Procedia PDF Downloads 268

Authors: S. V. Patil, P. S. Dounde, S. S. Patil

Abstract:

Emulgels have emerged as one of the most interesting topical delivery system as it has dual release control system that is gel and emulsion. The major objective behind this formulation is delivery of hydrophobic drugs to systemic circulation via skin. In fact presence of a gelling agent in water phase converts a classical emulsion in to emulgel. The emulgel for dermatological use has several favorable properties such as being thixotropic, greaseless, easily spreadable, easily removable, emollient, non-staining, water-soluble, longer shelf life, bio-friendly, transparent and pleasing appearance. Various penetration enhancers can potentiate the effect. So this can be used as better topical drug delivery systems over present conventional systems available in market. Piroxicam is a non-steroidal anti-inflammatory drug that has major problems when administered orally; it is an insoluble drug and has irritant effect on gastro intestinal tract lead to ulceration and bleeding. The aim of this study was to overcoming these problems through preparation of topical emulgel of this drug. Emulgel of Piroxicam was prepared using Carbopol 940 along with mentha oil and clove oil as permeation enhancer. The prepared emulgel were evaluated for their physical appearance, pH determination, viscosity, spreadability, in vitro drug release, ex vivo permeation studies. All the prepared formulations showed acceptable physical properties, homogeneity, consistency, spreadability, viscosity and pH value. The emulgel was found to be stable with respect to physical appearance, pH, rheological properties and drug content at all temperature and conditions for three month.

Keywords: emulgel, piroxicam, menthe oil, clove oil

Procedia PDF Downloads 431

Authors: Hansraj Riteesh Bookun, Emily Maree Stevens, Jarryd Leigh Solomon, Anthony Chan

Abstract:

Objective: This was a retrospective cross-sectional study evaluating the safety and efficacy of femoral endarterectomy using the eversion technique with transection as opposed to the conventional endarterectomy technique with either vein or synthetic patch arterioplasty. Methods: Between 2010 to mid 2017, 19 patients with mean age of 75.4 years, underwent eversion femoral endarterectomy with transection by a single surgeon. There were 13 males (68.4%), and the comorbid burden was as follows: ischaemic heart disease (53.3%), diabetes (43.8%), stage 4 kidney impairment (13.3%) and current or ex-smoking (73.3%). The indications were claudication (45.5%), rest pain (18.2%) and tissue loss (36.3%). Results: The technical success rate was 100%. One patient required a blood transfusion following bleeding from intraoperative losses. Two patients required blood transfusions from low post operative haemogloblin concentrations – one of them in the context of myelodysplastic syndrome. There were no unexpected returns to theatre. The mean length of stay was 11.5 days with two patients having inpatient stays of 36 and 50 days respectively due to the need for rehabilitation. There was one death unrelated to the operation. Conclusion: The eversion technique with transection is safe and effective with low complication rates and a normally expected length of stay. It poses the advantage of not requiring a synthetic patch. This technique features minimal extraneous dissection as there is no need to harvest vein for a patch. Additionally, future endovascular interventions can be performed by puncturing the native vessel. There is no change to the femoral bifurcation anatomy after this technique. We posit that this is a useful adjunct to the surgeon’s panoply of vascular surgical techniques.

Keywords: endarterectomy, eversion, femoral, vascular

Procedia PDF Downloads 166

Authors: Carolyn Whyte, Tina Halai, Sonita Koshal

Abstract:

Aim: There are many methods available to assess the potential difficulty of third molar surgery. This study investigated various factors to assess whether they had a bearing on the difficulties encountered. Study design: A retrospective study was completed of 62 single mandibular third molar teeth removed under day case general anaesthesia between May 2016 and August 2016 by 3 consultant oral surgeons. Method: Data collection was by examining the OPG radiographs of each tooth and recording the necessary data. This was depth of impaction, angulation, bony impaction, point of application in relation to second molar, root morphology, Pell and Gregory classification and Winters Lines. This was completed by one assessor and verified by another. Information on medical history, anxiety, ethnicity and age were recorded. Case notes and surgical entries were examined for any difficulties encountered. Results: There were 5 cases which encountered surgical difficulties which included fracture of root apices (3) which were left in situ, prolonged bleeding (1) and post-operative numbness >6 months(1). Four of the 5 cases had Pell and Gregory classification as (B) where the occlusal plane of the impacted tooth is between the occlusal plane and the cervical line of the adjacent tooth. 80% of cases had the point of application as either coronal or apical one third (1/3) in relation to the second molar. However, there was variability in all other aspects of assessment in predicting difficulty of removal. Conclusions: Of the cases which encountered difficulties they all had at least one predictor of potential complexity but these varied case by case.

Keywords: impaction, mandibular third molar, radiographic assessment, surgical removal

Procedia PDF Downloads 154