Search results for: endoscopic treatment of carpal tunnel syndrome

Authors: Rajendra Roul

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The main objective of the project is to bring attention towards the performance of an aerofoil when exposed to the fluid medium inside the wind tunnel. This project aims at involvement of civil as well as mechanical engineering thereby making itself as a multidisciplinary project. The airfoil of desired size is taken into consideration for the project to carry out effectively. An aerofoil is the shape of the wing or blade of propeller, rotor or turbine. Lot of experiment have been carried out through wind-tunnel keeping aerofoil as a reference object to make a future forecast regarding the design of turbine blade, car and aircraft. Lift and drag now become the major identification factor for any design industry which shows that wind tunnel testing along with software analysis (ANSYS) becomes the mandatory task for any researchers to forecast an aerodynamics design. This project is an initiative towards the mitigation of drag, better lift and analysis of wake surface profile by investigating the surface pressure distribution. The readings has been taken on airfoil model in Wind Tunnel Testing Machine (WTTM) at different air velocity 20m/sec, 25m/sec, 30m/sec and different angle of attack 00,50,100,150,200. Air velocity and pressures are measured in several ways in wind tunnel testing machine by use to measuring instruments like Anemometer and Multi tube manometer. Moreover to make the analysis more accurate Ansys fluent contribution become substantial and subsequently the CFD simulation results. Analysis on an Aerofoil have a wide spectrum of application other than aerodynamics including wind loads in the design of buildings and bridges for structural engineers.

Keywords: wind-tunnel, aerofoil, Ansys, multitube manometer

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Authors: Parul Garg

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Bouveret Syndrome is a rare presentation described as Gastric Outlet Obstruction secondary to Gallstone Ileus. Here we describe the 3-year progression of disease from cholelithiasis to gallstone ileus with relevant imaging findings. The patient was treated under an Upper Gastrointestinal Surgery service with surgical intervention in the form of a laparoscopic assisted procedure with midline laparotomy. She recovered well and was discharged 1 week post operatively. No complications occurred.

Keywords: Cholelithiasis, Bouveret syndrome, Gallstone Ileus, gastric outlet obstruction

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Authors: Jyoti Agrawal

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Introduction: Renal diseases in children and young adult can be difficult to diagnose early as it may present only with few symptoms, tends to have different course than adult and respond variously to different treatment. The pattern of renal disease in children is different from developing countries as compared to developed countries. Methods: This study was a hospital based prospective observational study carried from March, 2014 to February 2015 at BP Koirala institute of health sciences. Patients with renal disease, both inpatient and outpatient from birth to 14 years of age were enrolled in the study. The diagnosis of renal disease was be made on clinical and laboratory criteria. Results: Total of 120 patients were enrolled in our study which contributed to 3.74% % of total admission. The commonest feature of presentation was edema (75%), followed by fever (65%), hypertension (60%), decreased urine output (45%) and hematuria (25%). Most common diagnosis was acute glomerulonephritis (40%) followed by Nephrotic syndrome (25%) and urinary tract infection (25%). Renal biopsy was done for 10% of cases and most of them were steroid dependent nephrotic syndrome. 5% of our cases expired because of multiorgan dysfunction syndrome, sepsis and acute kidney injury. Conclusion: Renal disease contributes to a large part of hospital pediatric admission as well as mortality and morbidity to the children.

Keywords: glomerulonephritis, nephrotic syndrome, renal disease, urinary tract infection

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Authors: James M. Geidner

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Objective: The purpose of this meta-analysis was to examine the evidence for the effectiveness of exercise interventions on reducing metabolic components in children and/or adolescents diagnosed with Paediatric Metabolic Syndrome. Methods: A computerized search was made from four databases: PubMed, PsycInfo, SPORTDiscus, Cochrane Central Register. The analysis was restricted to children and adolescents with metabolic syndrome examining the effect of exercise interventions on metabolic components. Effect size and 95% confidence interval were calculated and the heterogeneity of the studies was estimated using Cochran’s Q-statistic and I2. Bias was assessed using multiple tools and statistical analyses. Results: Thirteen studies, consisting of 19 separate trials, were selected for the meta-analysis as they fulfilled the inclusion criteria (n=908). Exercise interventions resulted in decreased waist circumference, systolic blood pressure, diastolic blood pressure, fasting glucose, insulin resistance, triglycerides, and High-Density Lipoprotein Cholesterol (HDL-C). Conclusions: This meta-analysis provides insights into the effectiveness of exercise interventions on markers of Paediatric Metabolic Syndrome in children and adolescents.

Keywords: metabolic syndrome, syndrome x, pediatric, meta-analysis

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Authors: Siti Khadijah Che Osmi, Syed Mohd Ahmad

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This paper presents a methodology to develop fragility curves for shallow tunnels so as to describe a relationship between seismic hazard and tunnel vulnerability. Emphasis is given to the influence of surrounding soil material properties because the dynamic behaviour of the tunnel mostly depends on it. Four ground properties of soils ranging from stiff to soft soils are selected. A 3D nonlinear time history analysis is used to evaluate the seismic response of the tunnel when subjected to five real earthquake ground intensities. The derived curves show the future probabilistic performance of the tunnels based on the predicted level of damage states corresponding to the peak ground acceleration. A comparison of the obtained results with the previous literature is provided to validate the reliability of the proposed fragility curves. Results show the significant role of soil properties and input motions in evaluating the seismic performance and response of shallow tunnels.

Keywords: fragility analysis, seismic performance, tunnel lining, vulnerability

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Authors: Siti Khadijah Che Osmi, Mohammed Ahmad Syed

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Underground tunnels are one of the most popular public facilities for various applications such as transportation, water transfer, network utilities and etc. Experience from the past earthquake reveals that the underground tunnels also become vulnerable components and may damage at certain percentage depending on the level of ground shaking and induced phenomena. In this paper a numerical analysis is conducted in evaluating the sensitivity of two types of circular shallow tunnel lining models to wide ranging changes in the geotechnical design parameter. Critical analysis has been presented about the current methods of analysis, structural typology, ground motion characteristics, effect of soil conditions and associated uncertainties on the tunnel integrity. The response of the tunnel is evaluated through 2D non-linear finite element analysis, which critically assesses the impact of increasing levels of seismic loads. The finding from this study offer significant information on improving methods to assess the vulnerability of underground structures.

Keywords: geotechnical design parameter, seismic response, sensitivity analysis, shallow tunnel

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Authors: Abdelhakam A. Noreldien, Sakhr B. Abudarag, Muslim S. Eltoum, Salih O. Osman

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This paper presents an analytical study of Small Unmanned Aerial Vehicle (SUAV) dynamic stability derivatives. Simulating SUAV dynamics and analyzing its behavior at the earliest design stages is too important and more efficient design aspect. The approach suggested in this paper is using the wind tunnel experiment to collect the aerodynamic data and get the dynamic stability derivatives. AutoCAD Software was used to draw the case study (wildlife surveillance SUAV). The SUAV is scaled down to be 0.25% of the real SUAV dimensions and converted to a wind tunnel model. The model was tested in three different speeds for three different attitudes which are; pitch, roll and yaw. The wind tunnel results were then used to determine the case study stability derivative values, and hence it used to calculate the roots of the characteristic equation for both longitudinal and lateral motions. Finally, the characteristic equation roots were found and discussed in all possible cases.

Keywords: model, simulating, SUAV, wind tunnel

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Authors: Rakan Hassan M. Alzahrani, Ziyad Alzahrani, Bader Bashrahil, Abdulrahman Elyasi, Abdullah a Ghaddaf, Rayan Alzahrani, Mohammed Alkathlan, Nawaf Alghamdi, Dakheelallah Almutairi

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Background: Corticosteroid irrigations, which regularly involve the off-label use of budesonide mixed with normal saline in high volume Sino-nasal irrigations, have been more commonly used in the management of post-operative chronic rhinosinusitis (CRS). Objective: This article attempted to measure the efficacy of post-operative budesonide nasal irrigation compared to normal saline-alone nasal irrigation in the management of chronic rhinosinusitis (CRS) through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The databases PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched by two independent authors. Only RCTs comparing budesonide irrigation to normal saline alone irrigation for CRS with or without polyposis after functional endoscopic sinus surgery (FESS) were eligible. A random effect analysis model of the reported CRS-related quality of life (QOL) measures and the objective endoscopic assessment scales of the disease was done. Results: Only 6 RCTs met the eligibility criteria, with a total number of participants of 356. Compared to normal saline irrigation, budesonide nasal irrigation showed statically significant improvements in both the CRS-related quality of life (QOL) and the endoscopic findings (MD= -4.22 confidence interval [CI]: -5.63, -2.82 [P < 0.00001]), (SMD= -0.50 confidence interval [CI]: -0.93, -0.06 [P < 0.03]) respectively. Conclusion: Both intervention arms showed improvements in CRS-related QOL and endoscopic findings in post-FESS chronic rhinosinusitis with or without polyposis. However, budesonide irrigation seems to have a slight edge over conventional normal saline irrigation with no reported serious side effects, including hypothalamic-pituitary-adrenal (HPA) axis suppression.

Keywords: Budesonide, chronic rhinosinusitis, corticosteroids, nasal irrigation, normal saline

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Authors: Krzysztof Skiba, Zdzislaw Kaminski

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Wind power is based on a variety of construction solutions to convert wind energy into electrical energy. These constructions are constrained by the correlation between their energy conversion efficiency and the area they occupy. Their energy conversion efficiency can be improved by wind tunnel tests of a rotor as a diffuser to optimize shapes of aerodynamic elements, to adapt these elements to changing conditions and to increase airflow intensity. This paper discusses the results of computer simulations and aerodynamic analyzes of this innovative diffuser design. The research aims at determining the aerodynamic phenomena triggered by the airflow inside this construction, and developing a design to improve the efficiency of the wind turbine. The research results enable us to design a diffuser with a double Venturi nozzle and specially shaped blades. The design of this type uses Bernoulli’s law on the behavior of the flowing medium in the tunnel of a decreasing diameter. The air flowing along the tunnel changes its velocity so the rotor inside such a decreased tunnel diameter rotates faster in this airflow than does the wind outside this tunnel, which makes the turbine more efficient. Additionally, airflow velocity is improved by applying aerodynamic rings with extended trailing edges to achieve controlled turbulent vortices.

Keywords: wind turbine, renewable energy, cfd, numerical analysis

Procedia PDF Downloads 278

Authors: Gichun Cha, Dongwan Lee, Junkyeong Kim, Aoqi Zhang, Seunghee Park

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All the world are studying the construction technology of double deck tunnel in order to respond to the increasing urban traffic demands and environmental changes. Advanced countries have the construction technology of the double deck tunnel structure. but the domestic country began research on it. Construction technologies are important. But Safety evaluation of structure is necessary to prevent possible accidents during construction. Thus, the double deck tunnel was required the shape management of middle slabs. The domestic country is preparing the construction of double deck tunnel for an alternate route and a pleasant urban environment. Shape management of double deck tunnel has been no research because it is a new attempted technology. The present, a similar study is bridge structure for the shape management. Bridge is implemented shape model using terrestrial laser scanning(TLS). Therefore, we proceed research on the bridge slabs because there is a similar structure of double deck tunnel. In the study, we develop shape management method of bridge slabs using TLS. We select the Test-bed for measurement site. This site is bridge located on Sungkyunkwan University Natural Sciences Campus. This bridge has a total length of 34m, the vertical height of 8.7m from the ground. It connects Engineering Building #1 and Engineering Building #2. Point cloud data for shape management is acquired the TLS and We utilized the Leica ScanStation C10/C5 model. We will confirm the Maximum displacement area of middle slabs using Least-Squares Fitting. We expect to raise stability for double deck tunnel through shape management for middle slabs.

Keywords: bridge slabs, least squares, safety evaluation, shape management method, terrestrial laser scanning

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Authors: Seyed Abolhasan Naeini, Saeideh Mohammadi

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Site response has a profound effect on earthquake damages. Seismic interaction of urban tunnels with surface structures could also affect seismic site response. Here, we use FLAC 2D to investigate the interaction of a single tunnel and twin tunnels-surface structures on the site response. Soil stratification and properties are selected based on Line. No 7 of the Tehran subway. The effect of surface structure is considered in two ways: Equivalent surcharge and geometrical modeling of the structure. Comparison of the results shows that consideration of the structure geometry is vital in dynamic analysis and leads to the changes in the magnitude of displacements, accelerations and response spectrum. Therefore it is necessary for the surface structures to be wholly modeled and not just considered as a surcharge in dynamic analysis. The use of twin tunnel also leads to the reduction of dynamic residual settlement.

Keywords: superstructure, tunnel, site response, surcharge, interaction

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Authors: Nancy Wilson

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In utero, fetal drug exposure is prevalent amongst birthing facilities. Assessment tools for neonatal abstinence syndrome (NAS) are often cumbersome and ill-fitting, harboring immense subjectivity. This paradox often leads the clinical assessor to be hypervigilant when assessing the newborn for subtle symptoms of NAS, often mistaken for normal newborn behaviors. As a quality improvement initiative, this project led to a more adaptable NAS tool termed eat, sleep, console (ESC). This function-based NAS assessment scores the infant based on the ability to accomplish three basic newborn necessities- to sleep, to eat, and to be consoled. Literature supports that ESC methodology improves patient and family outcomes while providing more cost-effective care.

Keywords: neonatal abstinence syndrome, neonatal opioid withdrawal, maternal substance abuse, pregnancy, and addiction, Finnegan neonatal abstinence syndrome tool, eat, sleep, console

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Authors: Yong-Il Lee, Do-Yeon Hwang, Won-Seog Jeong, Duckshin Park

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Recently, because of the high-speed trains forced ventilation, it is important to control the ventilation. The ventilation is for controlling various contaminants, temperature, and humidity. The high-speed train route is straight to a destination having a high speed. And there are many mountainous areas in Korea. So, tunnel rate is higher then other country. KTX HVAC block off the outdoor air, when entering tunnel. So the high tunnel rate is an effect of ventilation in the KTX cabin. It is important to reduction rate in CO2 concentration prediction. To meet the air quality of the public transport vehicles recommend standards, the KTX cabin of CO2 concentration should be managed. In this study, the concentration change was predicted by CO2 prediction simulation in route to be opened.

Keywords: CO2 prediction, KTX, ventilation, infrastructure and transportation engineering

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Authors: Han Run-Sheng, Li Wen-Yao, Wang Feng, Liu Fei, Qiu Wen-Long, Lei Li

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Accurately positioning detection of concealed deposits or ore-bodies is one of the difficult problems in mineral exploration field. Theory calculation and exploration practices for tunnel gravity indicate that 3D high-precision Tunnel Gravity Exploration Method (TGEM) can find concealed high-density three-dimensional ore-bodies in the depth. The ore-finding breakthroughs at the depth of the Zhaotong Maoping carbonate-hosted Zn–Pb–(Ag–Ge) deposit in Northeastern Yunnan have proved that the exploration method in combination with MEAHFZ method is effective to detect concealed high-density ore-bodies. TGEM may overcome anomalous ambiguity of other geophysical methods for 3D positioning of concealed ore-bodies.

Keywords: 3D tunnel gravity exploration method, concealed high-density Ore-bodies, Zn–Pb–(Ag–Ge) deposit, Zaotong mapping, Northeastern Yunnan

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Authors: Hassan Shahmiri Barzoki

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Background: Posttraumatic stress disorder (PTSD) is an abnormal physiologic and psychological reaction in person with severe traumatic history. In recent studies, the relationship between PTSD and some other disease apparently unrelated to psychological situations, such as cardiovascular diseases, diabetes, and metabolic syndrome, has been revealed. Thus, the aim of this study was to survey the prevalence of metabolic syndrome and mental health in PTSD patients. Methods: The research design was retrospective cohort study. Subjects were consisted of 142 Iran-Iraq war veterans with PTSD (age: 40-60 years), and the control group was consisted of 153 veterans without PTSD. Data was collected using questionnaires, physical exams and laboratory tests. Results: Prevalence of metabolic syndrome was 45.1%in PTSD group and 17% in control group. In addition, blood pressure, triglyceride and fasting blood sugar in PTSD group were significantly higher than control group (p<0.05). Also, PTSD patients had significant high rates of psychiatric disorders. Conclusion: PTSD patients are more prone to metabolic syndrome and psychiatric disorders than control group.

Keywords: mental health, metabolic syndrome, post traumatic stress disorder, patient

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Authors: Olivia Rachel Hwang, Yu-Hsuan Joni Shao

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Androgen Deprivation Therapy (ADT) has been a primary treatment for patients with advanced prostate cancer. However, it is associated with numerous adverse effects related to Metabolic Syndrome (MetS), including hypertension, diabetes, hyperlipidaemia, heart diseases and ischemic strokes. However, complications associated with ADT for prostate cancer in Taiwan is not well documented. The purpose of this study is to utilize the data from NHIRD (National Health Insurance Research Database) to examine the trajectory changes of MetS-related complications in men receiving ADT. The risks of developing complications after the treatment were analyzed with multivariate Cox regression model. Covariates including in the model were the complications before the diagnosis of prostate cancer, the age, and the year at cancer diagnosis. A total number of 17268 patients from 1997-2013 were included in this study. The exclusion criteria were patients with any other types of cancer or with the existing MetS-related complications. Changes in MetS-related complications were observed among two treatment groups: 1) ADT (n=9042), and 2) non-ADT (n=8226). The ADT group appeared to have an increased risk in hypertension (hazard ratio 1.08, 95% confidence interval 1.03-1.13, P = 0.001) and hyperlipidemia (hazard ratio 1.09, 95% confidence interval 1.01-1.17, P = 0.02) when compared with non-ADT group in the multivariate Cox regression analyses. In the risk of diabetes, heart diseases, and ischemic strokes, ADT group appeared to have an increased but not significant hazard ratio. In conclusion, ADT was associated with an increased risk in hypertension and hyperlipidemia in prostate cancer patients in Taiwan. The risk of hypertension and hyperlipidemia should be considered while deciding on ADT, especially those with the known history of hypertension and hyperlipidemia.

Keywords: androgen deprivation therapy, ADT, complications, metabolic syndrome, MetS, prostate cancer

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Authors: Hadj Miloua, Abbes Azzi

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The objective of the present paper is to understand, predict and modeled the fire behavior in confined and open area in different conditions and diverse fuels such as liquid pool fire and the vegetative materials. The distinctive problems are a ventilated road tunnel used for urban transport, by the characterization installations of ventilation and his influence in the mode of smoke dispersion and the flame shape. A general investigation is relatively traditional, based on the modeling and simulation the scenario of the pool fire interacted with wind ventilation by the use of numerical software fire dynamic simulator FDS ver.5 to simulate the fire in ventilated tunnel. The second simulation by WFDS.5 is Wildland fire which is always occurs in forest and rangeland fire environments and will thus have an impact on people, property and resources.

Keywords: fire, road tunnel, simulation, vegetation, wildland

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Authors: Rania F. Ahmed, Sally A. El Awdan, Gehad A. Abdel Jaleel, Dalia O. Saleh, Omar A. H. Ahmed-Farid

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The metabolic syndrome is an important public health concern often related to obesity, improper diet, and sedentary lifestyles and can predispose individuals to the development of many dangerous health conditions, disability and early death. This research aimed to investigate the efficacy of resveratrol (RSV) to reverse the neuro-complications associated with metabolic syndrome experimentally-induced in rats using an eight weeks high fat, high fructose diet (HFHF) model. The corresponding drug treatments were administered orally during the last 10 days of the diet. Behavioural tests namely the open field test (OFT) and the forced swimming test (FST) were conducted. Brain levels of monoamines viz. serotonin, norepinephrine and dopamine as well as their metabolites were assessed. 8-hydroxyguanosine (8-OHDG) as an indicative of DNA-fragmentation, nitric oxide (NOx) and tumor necrosis factor-α (TNF- α) were estimated. Finally, brain antioxidant parameters namely malondialdehyde (MDA), reduced and oxidized glutathione (GSH, GSSG) were evaluated. HFHF-induced metabolic syndrome resulted in decreased activity in the OFT and increased immobility duration in the FST. Furthermore, HFHF-induced metabolic syndrome lead to a significant increase in brain monoamines turn over as well as elevation in 8-OHDG, NOx, TNF- α, MDA and GSSG; and reduction in GSH. Ten days daily treatment with RSV (20 and 40 mg/kg p.o) dose dependently increased activity in the OFT and decreased immobility duration in the FST. Moreover, RSV normalized brain monoamines contents, reduced 8-OHDG, NOx, TNF- α, MDA and GSSG; and elevated GSH. In conclusion, we can say that RSV showed neuro-protective properties against HFHF-induced metabolic syndrome represented by monoamines preservation, prevention of neurodegeneration, anti-inflammatory and antioxidant potentials and could be recommended as a beneficial daily dietary supplement to treat the neuronal side effects associated with HFHF-induced metabolic syndrome.

Keywords: antioxidants, DNA-fragmentation, forced swimming test, HFHF-induced metabolic syndrome, monoamines, nitric oxide (NOx), open field, resveratrol, tumor necrosis factor-α (TNF- α), 8-hydroxyguanosine (8-OHDG)

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Authors: Shai Gabay

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The tunnel effect describes the phenomenon where a moving object seems to persist even when temporarily hidden from view. Numerous studies indicate that humans, infants, and nonhuman primates possess object persistence, relying on spatiotemporal cues to track objects that are dynamically occluded. While this ability is associated with neural activity in the cerebral neocortex of humans and mammals, the role of subcortical mechanisms remains ambiguous. In our current investigation, we explore the functional contribution of monocular aspects of the visual system, predominantly subcortical, to the representation of occluded objects. This is achieved by manipulating whether the reappearance of an object occurs in the same or different eye from its disappearance. Additionally, we employ Archerfish, renowned for their precision in dislodging insect prey with water jets, as a phylogenetic model to probe the evolutionary origins of the tunnel effect. Our findings reveal the active involvement of subcortical structures in the mental representation of occluded objects, a process evident even in species that do not possess cortical tissue.

Keywords: archerfish, tunnel effect, mental representations, monocular channels, subcortical structures

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Authors: Can Mungan, Gokhan Kilic

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Structural engineers and tunnel owners have good reason to attach importance to the assessment and inspection of tunnels. Regular inspection is necessary to maintain and monitor the health of the structure not only at the present time but throughout its life cycle. Detection of flaws within the structure, such as corrosion and the formation of cracks within the internal elements of the structure, can go a long way to ensuring that the structure maintains its integrity over the course of its life. Other issues that may be detected earlier through regular assessment include tunnel surface delamination and the corrosion of the rebar. One advantage of new technology such as the ground penetrating radar (GPR) is the early detection of imperfections. This study will aim to discuss and present the effectiveness of GPR as a tool for assessing the structural integrity of the heavily used tunnel. GPR is used with various antennae in frequency and application method (2 GHz and 500 MHz GPR antennae). The paper will attempt to produce a greater understanding of structural defects and identify the correct tool for such purposes. Conquest View with 3D scanning capabilities was involved throughout the analysis, reporting, and interpretation of the results. This study will illustrate GPR mapping and its effectiveness in providing information of value when it comes to rebar position (lower and upper reinforcement). It will also show how such techniques can detect structural features that would otherwise remain unseen, as well as moisture ingress.

Keywords: tunnel, GPR, health monitoring, moisture ingress, rebar position

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Authors: Mina Hojat Ansari, Kamran Bagheri Lankarani, Mohammad Reza Fattahi, Ali Reza Safarpour

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Irritable bowel syndrome (IBS) is a common bowel disorder which is usually diagnosed through the abdominal pain, fecal irregularities and bloating. Alteration in the intestinal microbial composition is implicating to inflammatory and functional bowel disorders which is recently also noted as an IBS feature. Owing to the potential importance of microbiota implication in both efficiencies of the treatment and prevention of the diseases, we examined the association between the intestinal microbiota and different bowel patterns in a cohort of subjects with IBS and healthy controls. Fresh fecal samples were collected from a total of 50 subjects, 30 of whom met the Rome IV criteria for IBS and 20 Healthy control. Total DNA was extracted and library preparation was conducted following the standard protocol for small whole genome sequencing. The pooled libraries sequenced on an Illumina Nextseq platform with a 2 × 150 paired-end read length and obtained sequences were analyzed using several bioinformatics programs. The majority of sequences obtained in the current study assigned to bacteria. However, our finding highlighted the significant microbial taxa variation among the studied groups. The result, therefore, suggests a significant association of the microbiota with symptoms and bowel characteristics in patients with IBS. These alterations in fecal microbiota could be exploited as a biomarker for IBS or its subtypes and suggest the modification of the microbiota might be integrated into prevention and treatment strategies for IBS.

Keywords: irritable bowel syndrome, intestinal microbiota, small whole genome sequencing, fecal samples, Illumina

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Authors: Jumanah S. Alawfi

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Polycystic ovary syndrome (PCOS) is a common endocrinopathy among females in their reproductive years. The incidence cases are nearly 1.55 million among females across the globe, with 0.43 million associated disability-adjusted life-years (DALYs). This syndrome is associated with intricate mechanisms typically characterized by insulin resistance (IR), infertility, overweight and/or obesity. Lifestyle interventions are often prescribed as an adjective treatment. Nonetheless, obesity is a complex disease that encompasses multiple dimensions, such as excessive energy intake and genetics. The melanocortin 4 receptor mutation (MC4R) is an important mediator in appetite. There is emerging evidence that suggests its role in the Body Mass Index (BMI) among PCOS subjects, which poses the question of obesity and/or overweight among the PCOS patients who carry the MC4R variants may be caused by overconsumption. Thereby, using other satiety techniques may be beneficial as a part of personalized nutrition. Therefore, the aim of the current mini-review is to discuss the effect of the vegan low glycemic diet on reducing appetite among PCOS patients. The review shows that there is a gap in the knowledge of the effect of the vegan diet on PCOS patients who carry MC4R variants which need further research.

Keywords: polycystic ovarian syndrome (PCOS), Appetite, Melanocortin 4 Receptor Mutation (MC4R)., Obesity

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Authors: S. H. Jang

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Posterior reversible encephalopathy syndrome (PRES) is characterized by acute neurologic symptoms (visual loss, headache, altered mentality and seizures) and by typical imaging findings (bilateral subcortical and cortical edema with predominatly posterior distribution). Nephrotic syndrome is a syndrome comprising signs of proteinuria, hypoalbuminemia, and edema. It is well known that hypertension predispose patient with nephrotic syndrome to PRES. A 45-year old male was referred for suddenly developed vertigo, disequilibrium. He had previous history of nephrotic syndrome. His medical history included diabetes controlled with medication. He was hospitalized because of generalized edema a few days ago. His vital signs were stable. On neurologic examination, his mental state was alert. Horizontal nystagmus to right side on return to primary position was observed. He showed good grade motor weakness and ataxia in right upper and lower limbs without other sensory abnormality. Brain MRI showed increased signal intensity in FLAIR image, decreased signal intensity in T1 image and focal enhanced lesion in T1 contrast image at whole midbrain, pons and cerebellar peduncle symmetrically, which was compatible with vasogenic edema. Laboratory findings showed severe proteinuria and hypoalbuminemia. He was given intravenous dexamethasone and diuretics to reduce vasogenic edema and raise the intra-vascular osmotic pressure. Nystagmus, motor weakness and limb ataxia improved gradually over 2 weeks; He recovered without any neurologic symptom and sign. Follow-up MRI showed decreased vasogenic edema fairly. We report a case of brain stem PRES in normotensive, nephrotic syndrome patient.

Keywords: posterior reversible encephalopathy syndrome, MRI, nephrotic syndrome, vasogenic brain edema

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Authors: Myoung-Jin Lee, Sung-Jin Lee, Young-Kon Park, Jin-Wook Kim, Bo-Kyoung Kim, Song-Hun Chong, Sun-Il Kim

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Currently, sinkholes may occur due to natural or unknown causes. When the sinkhole is an instantaneous phenomenon, most accidents occur because of significant damage. Thus, methods of monitoring are being actively researched, such that the impact of the accident can be mitigated. A sinkhole can severely affect and wreak havoc in community-based facilities such as a city railway construction. Therefore, the development of a laser / scanning system and an image-based tunnel is one method of pre-monitoring that it stops the accidents. The laser scanning is being used but this has shortcomings as it involves the development of expensive equipment. A laser / videobased scanning tunnel is being developed at Korea Railroad Research Institute. This is designed to automatically operate the railway. The purpose of the scanning is to obtain an image of the city such as of railway structures (stations, tunnel). At the railway structures, it has developed 3D laser scanning that can find a micro-crack can not be distinguished by the eye. An additional aim is to develop technology to monitor the status of the railway structure without the need for expensive post-processing of 3D laser scanning equipment, by developing corresponding software.

Keywords: 3D laser scanning, sinkhole, tunnel, city railway construction

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Authors: Viyango Pandian, Kumaresh Athiyappan

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Pelvic congestion Syndrome (PCS) is usually seen in multiparous women who give history of chronic dull-aching pelvic pain. We report a case of a 17 year old unmarried female, who presented with acute onset of chronic dull-aching abdominal pain in the left iliac fossa, which particularly increased during menstruation and was finally diagnosed to be pelvic congestion syndrome. On ultrasonography, multiple tortuous and dilated veins were observed in the left adnexa. Both ovaries appeared normal in size, volume and echotexture. Computed tomography (CT) angiography was performed to precisely delineate the venous pathway and to assess any associated abnormality; which showed a dilated and tortuous left ovarian vein with an anomalous course around the left kidney and draining into the left renal vein. Clinical parameters and hormonal levels were within normal limits. This is a rare case of anomalous course of left ovarian vein associated with pelvic congestion syndrome.

Keywords: anomalous course of ovarian vein, computed tomography, pelvic congestion syndrome, ultrasonography

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Authors: Kartik Gupta, Umar Khan, Mayur Parab, Dhiraj Chaudhari, Afzal Ansari

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The report focuses on the study related to the Design and Simulation of a stabilator (an all-movable horizontal stabilizer) for a fixed-wing aircraft. The project involves the development of a computerized direct optimization procedure for designing an aircraft all-movable stabilator. This procedure evaluates various design variables to synthesize an optimal stabilator that meets specific requirements, including performance, control, stability, strength, and flutter velocity constraints. The work signifies the CFD (Computational Fluid Dynamics) analysis of the airfoils used in the stabilator along with the CFD analysis of the Stabilizer and Stabilator of an aircraft named Thorp- T18 in software like XFLR5 and ANSYS-Fluent. A comparative analysis between a Stabilizer and Stabilator of equal surface area and under the same environmental conditions was done, and the percentage of drag reduced by the Stabilator for the same amount of lift generated as the Stabilizer was also calculated lastly, Wind tunnel testing was performed on a scale down model of the Stabilizer and Stabilator and the results of the Wind tunnel testing were compared with the results of CFD.

Keywords: wind tunnel testing, CFD, stabilizer, stabilator

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Authors: Alex Atanaw Alebachew

Abstract:

The outcomes of a numerical research study conducted using the PLAXIS software to analyze surface settlements and moments generated in tunnel linings. The investigation focuses on both circular and rectangular twin tunnels. The study suggests that rectangular tunnels, although considered unconventional in modern tunneling practices, may be a viable option for shallow-depth tunneling in weak ground. The recommendation for engineers in the tunneling industry is to consider the use of rectangular tunnel boring machines (TBMs) based on the findings of this analysis. The research emphasizes the importance of evaluating various tunneling methods to optimize performance and address specific challenges in different ground conditions. These findings provide valuable insights into the behavior of rectangular tunnels compared to circular tunnels, emphasizing factors such as burial depth, relative positioning, tunnel size, and critical distance that influence surface settlements and bending moments. This research explores the feasibility of utilizing rectangular Tunnel Boring Machines (TBMs) as an alternative to conventional circular TBMs. The research findings indicate that rectangular tunnels exhibit slightly lower settlement than circular tunnels at shallow depths, especially in a narrower range directly above the twin tunnels. This difference could be attributed to maintaining a consistent tunnel-lining thickness across all depths. In deeper tunnel scenarios, circular tunnels experience less settlement compared to rectangular tunnels. Additionally, parallel rectangular tunnels settle more gradually than piggyback configurations, while piggyback tunnels show increased moments in the tunnel built second at the same level. Both settlement and moment coefficients increase with the diameter of twin tunnels, irrespective of their shape. The critical distance for both circular and rectangular tunnels is around 2.5 times the tunnel diameter, and distances closer than this result in a notable increase in moments. Rectangular tunnels spaced closer than 5 times the diameter led to higher settlement, and circular tunnels spaced closer than 2.5 to 3 times the diameter experience increased settlement as well.

Keywords: alternative, rectangular, tunnel, twin bored circular, weak ground

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Authors: Wei Qu, Cassandra Agius, Nikki Varvazovsky, Angela Meade

Abstract:

The goals of the case study are to address the importance of early diagnosis of osmotic demyelination syndrome (ODS) and to analyse the types, duration, and intensities of the rehabilitation program to promote neurological and functional recovery. It can be associated with biphasic course of disease and severe neurological and neuropsychiatric symptoms. Although a few treatment modalities, such as plasmapheresis, immunoglobulin therapy, steroid, and thyrotrophin-releasing hormone, have been suggested, there is no effective treatment for ODS. The overall prognosis of established ODS is generally poor. A high proportion of patients have a severe permanent disability, which has led to social, economic, and emotional burdens to carers and societies. In this case, a 69-year-old retired pensioner with chronic alcoholism was admitted to the hospital with a reduced level of consciousness and tonic-clonic seizure. He had severe hyponatraemia (serum sodium 118 mmol/L) and hypokalemia (serum potassium 2.8 mmol/L). He was treated with anticonvulsants, 150ml 3% hypertonic saline over one hour, and 40 mmol potassium chloride over one hour, and his sodium was increased by 11 mmol/L in the first 24 hours. However, he had worsened neurological symptoms with quadriplegia, dysphagia, anarthria, and confusion, and the radiological features suggested the diagnosis of ODS. He had minimal neurological recovery during the first four weeks of hospital admission. He was treated with seven weeks of a multi-disciplinary intensive rehabilitation program. On discharge, he had made a significant cognitive and functional recovery and could mobilize independently without a walking aid. In conclusion, ODS can still occur despite correcting sodium following the current clinical guidelines. Patients with severe neurological deficits in the context of osmotic demyelination syndrome would benefit from intensive rehabilitation to facilitate their functional improvement and to promote their quality of life.

Keywords: osmotic demyelination syndrome, hyponatremia, central pontine and extrapontine myelinolysis, rehabilitation

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Authors: Jiri Kysucan, Dusan Klos, Katherine Vomackova, Pavel Koranda, Martin Lovecek, Cestmir Neoral, Roman Havlik

Abstract:

Aim: The prognosis of patients with pancreatic cancer is poor. The median of survival after establishing diagnosis is 3-11 months without surgical treatment, 13-20 months with surgical treatment depending on the disease stage, 5-year survival is less than 5%. Radical surgical resection remains the only hope of curing the disease. Early diagnosis with valid establishment of tumor resectability is, therefore, the most important aim for patients with pancreatic cancer. The aim of the work is to evaluate the contribution and define the role of 18F-FDG PET/CT in preoperative staging. Material and Methods: In 195 patients (103 males, 92 females, median age 66,7 years, 32-88 years) with a suspect pancreatic lesion, as part of the standard preoperative staging, in addition to standard examination methods (ultrasonography, contrast spiral CT, endoscopic ultrasonography, endoscopic ultrasonographic biopsy), a hybrid 18F-FDG PET/CT was performed. All PET/CT findings were subsequently compared with standard staging (CT, EUS, EUS FNA), with peroperative findings and definitive histology in the operated patients as reference standards. Interpretation defined the extent of the tumor according to TNM classification. Limitations of resectability were local advancement (T4) and presence of distant metastases (M1). Results: PET/CT was performed in a total of 195 patients with a suspect pancreatic lesion. In 153 patients, pancreatic carcinoma was confirmed and of these patients, 72 were not indicated for radical surgical procedure due to local inoperability or generalization of the disease. The sensitivity of PET/CT in detecting the primary lesion was 92.2%, specificity was 90.5%. A false negative finding in 12 patients, a false positive finding was seen in 4 cases, positive predictive value (PPV) 97.2%, negative predictive value (NPV) 76,0%. In evaluating regional lymph nodes, sensitivity was 51.9%, specificity 58.3%, PPV 58,3%, NPV 51.9%. In detecting distant metastases, PET/CT reached a sensitivity of 82.8%, specificity was 97.8%, PPV 96.9%, NPV 87.0%. PET/CT found distant metastases in 12 patients, which were not detected by standard methods. In 15 patients (15.6%) with potentially radically resectable findings, the procedure was contraindicated based on PET/CT findings and the treatment strategy was changed. Conclusion: PET/CT is a highly sensitive and specific method useful in preoperative staging of pancreatic cancer. It improves the selection of patients for radical surgical procedures, who can benefit from it and decreases the number of incorrectly indicated operations.

Keywords: cancer, PET/CT, staging, surgery

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Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia

Abstract:

Introduction: Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease of unknown cause. Concomitant autoimmune disorders have been described in 30–50% of patients with AIH. The aim of our study is to determine the prevalence and the type of autoimmune disorders associated with AIH. Material and Methods: It is a retrospective study over a period of 16 years (2000-2015) including all patients followed for AIH. The diagnosis of AHI was based on the criteria of the revised International AIH group scoring system (IAIHG). Results: Twenty-for patients (21 women and 3 men) followed for AIH were collected. The mean age was 39 years (17-65 years). Among these patients, 11 patients(45.8%) had at least one autoimmune disease associated to AIH. These diseases were Hashimoto's thyroiditis (n = 5), Gougerot Sjogren syndrome (n=5), Primary biliary cirrhosis (n=2), Primitive sclerosant Cholangitis (n=1), Addison disease (n = 1) and systemic sclerosis (n=1). Patients were treated with corticosteroids alone or with azathioprine associated to the specific treatment of associated diseases with complete remission of AIH in 90% of cases and clinical improvement of other diseases. Conclusion: In our study, the prevalence of autoimmune diseases in AIH patients was 45.8%. These diseases were dominated by autoimmune thyroiditis and Gougerot Sjogren syndrome. The investigation of autoimmune diseases in autoimmune hepatitis must be systematic because of their frequency and the importance of adequate management.

Keywords: autoimmune diseases, autoimmune hepatitis, autoimmune thyroiditis, gougerot sjogren syndrome

Procedia PDF Downloads 237