Search results for: knee replacement surgery

Authors: Charles A. Khamala

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In 2003, constrained by an absent “rule of law culture” and negative economic growth, the new Kenyan government chose to pursue incremental judicial reforms rather than comprehensive constitutional reforms. President Mwai Kibaki’s first administration’s judicial reform strategy was two pronged. First, to implement unprecedented “radical surgery,” he appointed a new Chief Justice who instrumentally recommended that half the purportedly-corrupt judiciary should be removed by Presidential tribunals of inquiry. Second, the replacement High Court judges, initially, instrumentally-endorsed the “radical surgery’s” administrative decisions removing their corrupt predecessors. Meanwhile, retention of the welfare-reducing Constitution perpetuated declining public confidence in judicial institutions culminating in refusal by the dissatisfied opposition party to petition the disputed 2007 presidential election results, alleging biased and corrupt courts. Fatefully, widespread post-election violence ensued. Consequently, the international community prompted the second Kibaki administration to concede to a new Constitution. Suddenly, the High Court then adopted a non-instrumental interpretation to reject the 2003 “radical surgery.” This paper therefore critically analyzes whether the Kenyan court’s inconsistent interpretations–pertaining to the constitutionality of the 2003 “radical surgery” removing corruption from Kenya’s courts–was predicated on political expediency or human rights principles. If justice “must also seen to be done,” then pursuit of the CJ’s, Judicial Service Commission’s and president’s political or economic interests must be limited by respect for the suspected judges and magistrates’ due process rights. The separation of powers doctrine demands that the dismissed judges should have a right of appeal which entails impartial review by a special independent oversight mechanism. Instead, ignoring fundamental rights, Kenya’s new Supreme Court’s interpretation of another round of vetting under the new 2010 Constitution, ousts the High Court’s judicial review jurisdiction altogether, since removal of judicial corruption is “a constitutional imperative, akin to a national duty upon every judicial officer to pave way for judicial realignment and reformulation.”

Keywords: administrative decisions, corruption, fair hearing, judicial review, (non) instrumental

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Authors: T. B. Anil Kumar, Mallikarjun Hiremath, V. Ramachandra

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The present experimental investigation deals with the quality performance analysis of cement concrete with 0, 15 and 25% fly ash and 0, 0.2, 0.4 and 0.6% of polypropylene fibers by weight of cement. The various test parameters like workability, unit weight, compressive strength, flexural strength, split tensile strength and abrasion resistance are detailed in the analysis. The compressive strength of M40 grade concrete attains higher value by the replacement of cement by 15% fly ash and at 0.4% PP after 28 and 56 days of curing. Higher flexural strength of concrete was observed by the replacement of cement by 15% fly ash with 0.2% PP after 28 and 56 days of curing. Similarly, split tensile strength value also increases and attains higher value by the replacement of cement by 15% fly ash with 0.4% PP after 28 and 56 days of curing. The percentage of wear gets reduced to 30 to 33% by the addition of fibers at 0.2%, 0.4% and 0.6% in cement concrete replaced by 15 and 25% fly ash. Hence, it is found that the pavement thickness gets reduced up to 20% when compared with plain concrete slab by the 15% fly ash treated with 0.2% PP fibers and also reduced up to 27% of surface course cost.

Keywords: cement, fly ash, polypropylene fiber, pavement design, cost analysis

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Authors: Asis Kumar Khan, Rajeev Kumar Goel

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Recent infrastructure growth all around the world lead to increase in demand for concrete day by day. Cement being binding material for concrete the usage of cement also gone up significantly. Cement manufacturing utilizes abundant natural resources and causes environment pollution by releasing a huge quantity of CO₂ into the atmosphere. So, it is high time to look for alternates to reduce the cement consumption in concrete. Geopolymer concrete is one such material which utilizes the industrial waste such as fly ash, ground granulated blast furnace slag and low-cost alkaline liquids such as sodium hydroxide and sodium silicate to produce the concrete. On the other side, river sand is becoming very expensive due to its large-scale depletion at source and the high cost of transportation. In this view, river sand is replaced by crushed sand in this study. In this work, an attempt has been made to understand the durability parameters of geopolymer concrete by partially replacing fly ash with cement. Fly ash is replaced by cement at various levels e.g., from 0 to 50%. Concrete cubes of 100x100x100mm were used for investigating different durability parameters. The various parameters studied includes compressive strength, split tensile strength, drying shrinkage, sodium sulphate attack resistance, sulphuric acid attack resistance and chloride permeability. Highest compressive strength & highest split tensile strength is observed in 30% replacement level. Least drying is observed with 30% replacement level. Very good resistance for sulphuric acid & sodium sulphate is found with 30% replacement. However, it was not possible to find out the chloride permeability due to the high conductivity of geopolymer samples of all replacement levels.

Keywords: crushed sand, compressive strength, drying shrinkage, geopolymer concrete, split tensile strength, sodium sulphate attack resistance, sulphuric acid attack resistance

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Authors: Sukhee Park, Gaab Soo Kim

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Purpose: We aimed to evaluate the adequacy of second-generation laryngeal mask airway use during prolonged abdominal surgery in respect of ventilation, oxygenation, postoperative pulmonary complications (PPC), and postoperative non-pulmonary complications on living donor kidney transplant (LDKT) surgery. Methods: In total, 257 recipients who underwent LDKT using either laryngeal mask airway-ProSeal (LMA-P) or endotracheal tube (ETT) were retrospectively analyzed. Arterial partial pressure of carbon dioxide (PaCO2 and ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PFR) during surgery were compared between two groups. In addition, PPC including pulmonary aspiration and postoperative non-pulmonary complications including nausea, vomiting, hoarseness, vocal cord palsy, delirium, and atrial fibrillation were also compared. Results: PaCO2 and PFR during surgery were not significantly different between the two groups. PPC was also not significantly different between the two groups. Interestingly, the incidence of delirium was significantly lower in the LMA-P group than the ETT group (3.0% vs. 10.3%, P = 0.029). Conclusions: During prolonged abdominal surgery such as LDKT, second-generation laryngeal mask airway offers adequate ventilation and oxygenation and can be considered a suitable alternative to ETT.

Keywords: laryngeal mask airway, prolonged abdominal surgery, kidney transplantation, postoperative pulmonary complication

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Authors: Prachi Abhishek Dave, Manisha Singh

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Purpose: The purpose is to study the microbiological profile, prognostic factors, and outcomes of surgery for microbial keratitis (MK) associated endophthalmitis. Methods: It is a retrospective analysis of 39 MK associated endophthalmitis cases which underwent combined PKP with VR surgery. Results: The majority (84.6%) of patients had a history of previous ocular surgery, cataract surgery being the most common (51.2%). Six patients had a history of trauma and 8 patients had corneal graft infection. The culture positivity rate was 92.3%. Organisms isolated were Streptococcal sp (20.5%), Pseudomonas (15.3%), Staphylococcal sp (12.8%) and Fungus (35.8%). Final visual acuities ranged from NPL to 20/120. Poor anatomic success was seen in 15(38.46%) eyes (9-phthisis, 6-eviscerated). Fungal cases had a poor success rate (P-0.02). Conclusion: MK associated endophthalmitis is a sight threatening ocular condition. Fungal etiology carries a poorer prognosis. Timely surgical intervention can achieve favourable anatomical and functional results.

Keywords: endophthalmitis, microbial keratitis, penetrating keratoplasty, vitreo retinal surgery

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Authors: Mohamed T. El-Hawary, Carsten Koenke, Amr M. El-Nemr, Nagy F. Hanna

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Sustainable construction materials using solid construction wastes are of great environmental and economic significance. Construction wastes, demolishing wastes, and wastes coming out from the preparation of traditional materials could be used in sustainable concrete manufacture, which is the main scope of this paper. Ceramics, clay bricks, marble, recycled concrete, and many other materials should be tested and validated for use in the manufacture of green concrete. Introducing waste materials in concrete helps in reducing the required landfills, leaving more space for land investments, and decrease the environmental impact of the concrete buildings industry in both stages -construction and demolition-. In this paper, marble aggregate is used as a replacement for the natural aggregate in sustainable green concrete production. The results showed that marble aggregates can be used as a full replacement for the natural aggregates in eco-friendly green concrete.

Keywords: coarse aggregate replacement, economical designs, green concrete, marble aggregates, sustainability, waste management

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Authors: Nursyafiq Ali Shibramulisi, Nor Farah Fauzi, Nur Azniza Zawin Anuar, Nurul Atikah Azmi, Janice Hew Pei Fang

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Background: Work related musculoskeletal disorders (WRMD) among dental personnel have been underestimated and under-reported worldwide and specifically in Malaysia. The problem will arise and progress slowly over time, as it results from accumulated injury throughout the period of work. Several risk factors, such as repetitive movement, static posture, vibration, and adapting poor working postures, have been identified to be contributing to WRMSD in dental practices. Dental personnel is at higher risk of getting this problem as it is their working nature and core business. This would cause pain and dysfunction syndrome among them and result in absence from work and substandard services to their patients. Methodology: A cross-sectional study involving 19 government dental clinics in Perak was done over the period of 3 months. Those who met the criteria were selected to participate in this study. Malay version of the Self-Reported Nordic Musculoskeletal Discomfort Form was used to identify the prevalence of WRMSD, while the intensity of pain in the respective regions was evaluated using a 10-point scale according to ‘Pain as The 5ᵗʰ Vital Sign’ by MOH Malaysia and later on were analyzed using SPSS version 25. Descriptive statistics, including mean and SD and median and IQR, were used for numerical data. Categorical data were described by percentage. Pearson’s Chi-Square Test and Spearman’s Correlation were used to find the association between the prevalence of WRMSD and other socio-demographic data. Results: 159 dentists, 73 dental therapists, 26 dental lab technicians, 81 dental surgery assistants, and 23 dental attendants participated in this study. The mean age for the participants was 34.9±7.4 and their mean years of service was 9.97±7.5. Most of them were female (78.5%), Malay (71.3%), married (69.6%) and right-handed (90.1%). The highest prevalence of WRMSD was neck (58.0%), followed by shoulder (48.1%), upper back (42.0%), lower back (40.6%), hand/wrist (31.5%), feet (21.3%), knee (12.2%), thigh 7.7%) and lastly elbow (6.9%). Most of those who reported having neck pain scaled their pain experiences at 2 out of 10 (19.5%), while for those who suffered upper back discomfort, most of them scaled their pain experience at 6 out of 10 (17.8%). It was found that there was a significant relationship between age and pain at neck (p=0.007), elbow (p=0.027), lower back (p=0.032), thigh (p=0.039), knee (p=0.001) and feet (p=0.000) regions. Job position also had been found to be having a significant relationship with pain experienced at the lower back (p=0.018), thigh (p=0.011), knee, and feet (p=0.000). Conclusion: The prevalence of WRMSD among dental personnel in Perak was found to be high. Age and job position were found to be having a significant relationship with pain experienced in several regions. Intervention programs should be planned and conducted to prevent and reduce the occurrence of WRMSD, as all harmful or unergonomic practices should be avoided at all costs.

Keywords: WRMSD, ergonomic, dentistry, dental

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Authors: Jake Hindmarch, Edward Farley, Norman Eizenberg, Mark Midwinter

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There is a need to bring the anatomical knowledge of medical students up to the standards required by surgical specialties. Contention exists amongst anatomists, clinicians, and surgeons about the standard of anatomical knowledge medical students need. The aim of this study was to explore the standards which the Royal Australasian College of Surgeons are applying knowledge of anatomy. Furthermore, to align medical school teaching to what the surgical profession requires from graduates.: The 2018 volume of the ANZ Journal of Surgery was narrowed down to 254 articles by applying the search term “Anatomy”. The main topic was then extracted from each paper. The content of the paper was assessed for ‘novel description’ or ‘application’ of anatomical knowledge’ and classified accordingly. The majority of papers with an anatomical focus was from the general surgery specialty, which focused on surgical techniques, outcomes and management. Vascular surgery had the highest percentage of papers with a novel description and application of anatomy. Cardiothoracic and paediatric surgery had no papers with a novel description of anatomy. Finally, a novel application of anatomy was the main focus of each speciality. Firstly, a high proportion of novel applications and descriptions of anatomy are in general surgery. Secondly, vascular surgery had the largest proportion of novel application and description of anatomy, namely due to the rise of therapeutic imaging and endovascular techniques. Finally, all disciplines demonstrated a trend towards having a higher proportion of novel application of anatomical knowledge

Keywords: anatomical knowledge, anatomy, surgery, novel anatomy

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Authors: Kalyan Kumar Moulick

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In this paper the author studied the possibilities of using Rice Husk Ash (RHA) available in India; to produce concrete. The effect of RHA on concrete discussed. Traditional uses of Rice Husk in India pointed out and the advantages of using RHA in making concrete highlighted. Suggestion provided regarding prospective application of RHA concrete in India which in turn will definitely reduce the cost of concrete and environmental friendly due to utilization of waste and replacement of Cement.

Keywords: cement replacement, concrete, environmental friendly, rice husk ash

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Authors: Ravande Kishore

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The paper present the results of experimental investigation carried out to understand the mechanical properties of concrete containing marble dust. Two grades of concrete viz. M25 and M35 have been considered for investigation. For each grade of concrete five replacement percentages of sand viz. 5%, 10%, 15%, 20% and 25% by marble dust have been considered. In all, 12 concrete mix cases including two control concrete mixtures have been studied to understand the key properties such as Compressive strength, Modulus of elasticity, Modulus of rupture and Split tensile strength. Development of Compressive strength is also investigated. In general, the results of investigation indicated improved performance of concrete mixture containing marble dust. About 21% increase in Compressive strength is noticed for concrete mixtures containing 20% marble dust and 80% river sand. An overall assessment of investigation results pointed towards high potential for marble dust as alternative construction material coming from waste generated in marble industry.

Keywords: construction material, partial replacement, marble dust, compressive strength

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Authors: Martin Dupuy, Solange Grunenwald, Pierre-Louis Colombo, Laurence Mahieu, Pomone Richard, Philippe Bartoli

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Endonasal endoscopic trans-sphenoidal surgery for pituitary tumours has become a mainstay of treatment over the last two decades. Although it is generally accepted that there is no significant difference between endoscopic versus microscopic approach for surgical outcomes (endocrine and ophthalmologic status), nasal morbidity seems to the benefit of endoscopic procedures. Minimally invasive endoscopic surgery needs an operative learning curve to achieve surgeon’s efficiency. This learning curve is now well known for surgical outcomes and complications rate, however, few data are available for nasal morbidity. The aim of our series is to document operative experience and nasal quality of life after (NQOL) endoscopic trans-sphenoidal surgery. The prospective pituitary surgical cohort consisted of 525 consecutives patients referred to our Skull Base Diseases Department. Endoscopic procedures were performed by a single neurosurgeon using an uninostril approach. NQOL was evaluated using the Sino-Nasal Test (SNOT-22), the Anterior Base Nasal Inventory (ASBNI) and the Skull Base Inventory Score (SBIS). Data were collected before surgery during hospital stay and 3 months after the surgery. The seventy first patients were compared to the latest 70 patients. There was no significant difference between comparison score before versus after surgery for SNOT-22, ASBNI and SBIS during the single surgeon’s learning curve. Our series demonstrates that in our institution there is no statistically significant learning curve for NQOL after uninostril endoscopic pituitary surgery. A careful progression through sinonasal structures with very limited mucosal incision is associated with minimal morbidity and preserves nasal function. Conservative and minimal invasive approach could be achieved early during learning curve.

Keywords: pituitary surgery, quality of life, minimal invasive surgery, learning curve, pituitary tumours, skull base surgery, endoscopic surgery

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Authors: Abhishek Dave, Manisha Singh

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Purpose: The study aims to evaluate the outcomes of combined Penetrating keratoplasty (PKP) and Vitreo-Retinal (VR) surgery in patients having endophthalmitis with poor corneal clarity. Methods: PKP with VR Surgery was performed in 43 eyes. This is a retrospective analysis of their preoperative, intraoperative and microbiological characteristics and anatomical and functional outcomes. Results: Corneal opacification was due to corneal ulcer in 30 (69.7%), graft infection in 8 (18.6%), bullous keratopathy in 4 and corneal scar in 1 eye. Postoperative visual acuity improved in 20 (46.5%), not changed in 14 (32.5%) and deteriorated in 9 eyes (20.9%). Poor anatomic success was seen in 15 (34.88%) eyes (9-phthisis bulbi, 6-eviscerated). Graft remained clear in 24 eyes (1 year). Microbiology revealed bacteria in 26, fungus in 14 and no growth in 3 eyes. Six out of 11 patients having poor vision in the fellow eye, too, achieved functional success. Conclusion: PKP with VR surgery is a complex but globe-salvaging procedure for poor prognosis eyes, which otherwise would need evisceration.

Keywords: penetrating keratoplasty, VR surgery, endophthalmitis, corneal ulcer

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Authors: Ramon Sancibrian, Carlos Redondo-Figuero, Maria C. Gutierrez-Diez, Esther G. Sarabia, Maria A. Benito-Gonzalez, Jose C. Manuel-Palazuelos

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In this paper, the design and evaluation of a handle for laparoscopic surgery is presented. The design of the handle is based on ergonomic principles and tries to avoid awkward postures for surgeons. The handle combines the so-called power-grip and accurate-grip in order to provide strength and accuracy in the performance of surgery. The handle is tested using both objective and subjective approaches. The objective approach uses motion capture techniques to obtain the angles of forearm, arm, wrist and hand. The muscular effort is obtained with electromyography electrodes. On the other hand, a subjective survey has been carried out using questionnaires. Results confirm that the handle is preferred by the majority of the surgeons.

Keywords: laparoscopic surgery, ergonomics, mechanical design, biomechanics

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Authors: Aliyu Usman, Muhaammed Bello Ibrahim, Yusuf D. Amartey, Jibrin M. Kaura

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This research is aimed at investigating the effect of using amorphous silica ash (ASA) obtained from rice husk as a partial replacement of ordinary Portland cement (OPC) on the mechanical and microstructure properties of cement paste and mortar. ASA was used in partial replacement of ordinary Portland cement in the following percentages 3 percent, 5 percent, 8 percent and 10 percent. These partial replacements were used to produce Cement-ASA paste and Cement-ASA mortar. ASA was found to contain all the major chemical compounds found in cement with the exception of alumina, which are SiO2 (91.5%), CaO (2.84%), Fe2O3 (1.96%), and loss on ignition (LOI) was found to be 9.18%. It also contains other minor oxides found in cement. Consistency of Cement-ASA paste was found to increase with increase in ASA replacement. Likewise, the setting time and soundness of the Cement-ASA paste also increases with increase in ASA replacements. The test on hardened mortar were destructive in nature which include flexural strength test on prismatic beam (40mm x 40mm x 160mm) at 2, 7, 14 and 28 days curing and compressive strength test on the cube size (40mm x 40mm, by using the auxiliary steel platens) at 2,7,14 and 28 days curing. The Cement-ASA mortar flexural and compressive strengths were found to be increasing with curing time and decreases with cement replacement by ASA. It was observed that 5 percent replacement of cement with ASA attained the highest strength for all the curing ages and all the percentage replacements attained the targeted compressive strength of 6N/mm2 for 28 days. There is an increase in the drying shrinkage of Cement-ASA mortar with curing time, it was also observed that the drying shrinkages for all the curing ages were greater than the control specimen all of which were greater than the code recommendation of less than 0.03%. The scanning electron microscope (SEM) was used to study the Cement-ASA mortar microstructure and to also look for hydration product and morphology.

Keywords: amorphous silica ash, cement mortar, cement paste, scanning electron microscope

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Authors: Suprihatin Soewarto

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The background of writing this paper is to assess the truth of rejection of some Muslim scholars who develop Islamic economics on the concept of consumer satisfaction and replace it with the concept of maslahah. In the perspective of Islamic law, this rejection attitude needs to be verified in order to know the accuracy of the replacement of this concept of satisfaction with maslahah as part of consumer behavior. This is done so that replacement of rejection of the term satisfaction with maslahah is objective. This objective replacement of the term will surely be more enlightening and more just than the subjective substitution. Therefore the writing of this paper aims to get an answer whether the concept of satisfaction needs to be replaced? is it possible for Islamic law to confirm the theory of consumer satisfaction? The method of writing this paper using the method of literature with a critical analysis approach. The results of this study is an explanation of the similarities and differences of consumer satisfaction theory and consumer theory maslahah according to Islamic law. disclosure of the concept of consumer gratitude according to Islamic law and its implementation in Muslim consumer demand theory.

Keywords: consumer's gratitude, islamic law, confirmation, satisfaction consumer's

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Authors: Amichai Ben ari, Daniella Margalit

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Medical procedures, such as surgery, may have traumatic significance for some children. This study examines the relationship between maltreatment in children and the development Pediatric Medical Traumatic Stress (PMTS). To this end, differences in the level of distress of children after surgery were examined between two groups: children who were maltreated ("children at risk") and children from the control group ("children who are not at risk"). The study involved 230 parents of children who came to the hospital to undergo surgery. Parents filled out demographic questionnaires to measure socioeconomic variables and psychological questionnaires to measure the distress of the child and parent before surgery. After 6 months from the time of surgery, the parents again filled in the questionnaire measuring the child's distress. The results of the study showed that the level of distress experienced by children at risk after surgery was significantly higher relative to children who are not at risk. It was also found that the level of distress experienced by parents of children at risk in relation to their child’s surgery is significantly higher compared to parents of children who are not at risk. Finally, it was found that the variables: (1) pre-morbid psychological functioning of the child. (2) Parental and family functioning in daily life. (3) Exposure of the child to traumatic events. (4) Support factors for the family. Are variables that predict the development of PMTS in children after surgery, but only for children at risk and not for children who are not at risk. The significance of the findings in relation to the need to identify at-risk populations in the hospitals and the policies derived from them were discussed, and several directions were raised for further research.

Keywords: children at risk, pediatric medical traumatic stress (PMTS), PTSD, medical procedures

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Authors: Fiona Lourenco, William Allen

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Dentofacial deformities are primarily surgically treated via orthognathic surgery. Health-related quality of life is concerned with aspects of quality of life that relate specifically to an individual’s health. Design and Setting: Retrospective analysis of patients who had orthognathic surgery from January 2018 - December 2022 at the trust using the previously validated Orthognathic Quality of Life questionnaire (OQoL). Materials and Methods: 32 Patient questionnaires (which included pre-operative and post-operative separate sections) were obtained via telephone survey. The data was analysed using the two-tailed paired t-test and Wilcoxon signed-rank test. Results: The change in perception post-surgery was highly significant (both tests resulted in p<0.001 for overall analysis as well as for each domain). Overall, a 74% improvement in QoL was seen following orthognathic surgery. Reports of improvement in each domain were as follows: 71% in the social aspect of the deformity domain, 76% in facial aesthetics, 60% in function, and 57% improvement in awareness of facial deformity. Conclusion: The assessment of QoL is becoming progressively imperative in clinical research. The above data shows that orthognathic surgery has a significant improvement in the QoL of patients post-operatively. The results demonstrate improvement in all domains, with perceptions in facial aesthetics seeing the highest change post-operatively.

Keywords: dentofacial, oral, facial asymmetry, orthognathic surgery, quality of life

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Authors: Kevin Syam, Devendra K. Chauhan, Mandeep Singh Dhillon

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Background: The posterior horn of medial meniscus (PHMM) is a secondary stabilizer against anterior translation of tibia. Cadaveric studies have revealed increased strain on the ACL graft and greater instrumented laxity in Posterior horn deficient knees. Clinical studies have shown higher prevalence of radiological OA after ACL reconstruction combined with menisectomy. However, functional outcomes in ACL reconstructed knee in the absence of Posterior horn is less discussed, and specific role of posterior horn is ill-documented. This study evaluated functional and radiological outcomes in posterior horn preserved and posterior horn sacrificed ACL reconstructed knees. Materials: Of the 457 patients who had ACL reconstruction done over a 6 year period, 77 cases with minimum follow up of 18 months were included in the study after strict exclusion criteria (associated lateral meniscus injury, other ligamentous injuries, significant cartilage degeneration, repeat injury and contralateral knee injuries were excluded). 41 patients with intact menisci were compared with 36 patients with absent posterior horn of medial meniscus. Radiological and clinical tests for instability were conducted, and knees were evaluated using subjective International Knee Documentation Committee (IKDC) score and the Orthopadische Arbeitsgruppe Knie score (OAK). Results: We found a trend towards significantly better overall outcome (OAK) in cases with intact PHMM at average follow-up of 43.03 months (p value 0.082). Cases with intact PHMM had significantly better objective stability (p value 0.004). No significant differences were noted in the subjective IKDC score (p value 0.526) and the functional OAK outcome (category D) (p value 0.363). More cases with absent posterior horn had evidence of radiological OA (p value 0.022) even at mid-term follow-up. Conclusion: Even though the overall OAK and subjective IKDC scores did not show significant difference between the two subsets, the poorer outcomes in terms of objective stability and radiological OA noted in the absence of PHMM, indicates the importance of preserving this important part of the meniscus.

Keywords: ACL, functional outcome, knee, posterior of medial meniscus

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Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi

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Purpose: Advanced Glaucoma with Failed trab is not an uncommon sight in glaucoma clinic, and such cases usually tend to present with high intraocular pressure (IOP) and advanced cupping, or even glaucomatous atrophy stage. Re-surgery is needed for such cases, and wound modulation poses a major challenge in these cases. We share our experience in this case series with the use of Ologen (collagen matrix implant) along with MMC 0.04% used in surgery. The purpose of the study was to evaluate the efficacy and outcome of collagen matrix implant in re-trabeculectomy in advanced glaucoma cases. Methodology: Eleven eyes of 11 patients (one eye of one patient) underwent re-trabeculectomy surgery with MMC and Ologen. Ologen implant was used in sub scleral and subconjunctival space, as a spacer and wound modulator. In five cases, triple modulation with implant soaked in anti-VEGF was used. Results: All patients had cupping more than 0.9, and one case was GOA. All cases were on maximal medication at presentation and majority were on systemic anti-glaucoma therapy also. Post-surgery, follow-up ranged from 13 – 34 months, and all cases had a follow longer than the gap between previous surgery (which was failed) and re-trab. One case needed AC reformation and one needling was done. Phaco was done at same sitting in four cases. All cases had their IOP lowered post surgery, and vision was maintained in all, however one case was considered as failed re-surgery case. Topical medication was needed in seven cases post-surgery also. Conclusion: Ologen as adjuvant should be considered in all re-trab cases and all high risk and advanced cases, and triple modulation can be next step in these cases. Aggressive IOP control and non- reluctance to continue topical medications post second surgery should be considered in such cases, to give them best possible vision.

Keywords: failed trabeculectomy, ologen, trabeculectomy, advanced glaucoma

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Authors: K. Bensafia, A. Mansour, G. Le Maillot, B. Clement, O. Reynet, P. Ariès, S. Haddab

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This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.

Keywords: electrocardiography, monitoring, surgery, wireless system

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Authors: Farhad Fakoursevom

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Heart disease is one of the diseases which is found in abundance today. Various types of surgeries, such as bypasses, angiography, angioplasty, etc., are used to treat patients. People may receive such surgeries, some of which are invasive and some non-invasive, throughout their lives. People might cope with pre-surgery anxiety and stress, which can disrupt their normal life and even reduce the effects of the surgery, so the desired result can not be achieved in surgery. Considering this issue, the present study aimed to do a comparative assessment of people who received sedatives before surgery and people who did not receive sedatives. In terms of the purpose, this is an applied research and descriptive survey in terms of method. The statistical population included patients who underwent surgeries in the specialist heart hospitals of Mashhad, Iran; 60 people were considered as a statistical population, 30 of them received sedatives before surgery, and 30 others had not received sedatives before surgery. Valid and up-to-date articles were systematically used to collect theoretical bases, and a researcher-made questionnaire was used to examine the level of stress and anxiety of people. The questionnaire content validity was assessed by a panel of experts in psychology and medicine. The construct validity was tested using the software. Cronbach's alpha and composite reliability were used for reliability, which shows the appropriate reliability of the questionnaire. SPSS software was used to compare the research results between two groups, and the research findings showed that there is no significant association between the people who received sedatives and those who did not receive sedatives in terms of the amount of stress and anxiety. The longer the time of taking the drugs before the surgery, the more the mental peace of the patients will be. According to the results, it can be said that if we don't need to have an emergency operation and need more time, we have to use sedative drugs with different doses compared to the severity of the surgery, and also in case of a medical emergency such as heart surgery due to a stroke, we have to take advantage of psychological services during and before the operation and sedative drugs so that the patients can control their stress and anxiety and achieve better outcomes.

Keywords: sedative drugs, stress, anxiety, surgery

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Authors: Gavin Gengan, Hsein Kew

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Glass from varying recycling processes is considered a material that can be used as aggregate. Waste glass is available from different sources and has been used in the construction industry over the last decades. This current study aims to use recycled glass as a partial replacement for conventional aggregate materials. The experimental programme was designed to optimise the mechanical properties of structural concrete made with recycled glass aggregates (GA). NA (natural aggregates) was partially substituted by GA in a mix design of concrete of 30N/mm2 in proportions of 10%, 20%, and 25% 30%, 40%, and 50%. It was found that with an increasing proportion of GA, there is a decline in compressive strength. The optimum percentage replacement of NA by GA is 25%. The heat of hydration was also investigated with thermocouples placed in the concrete. This revealed an early acceleration of hydration heat in glass concrete, resulting from the thermal properties of glass. The gain in the heat of hydration and the better bonding of glass aggregates together with the pozzolanic activity of the finest glass particles caused the concrete to develop early age and long-term strength higher than that of control concrete

Keywords: concrete, compressive strength, glass aggregates, heat of hydration, pozzolanic

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Authors: Luksanaporn Krungkraipetch

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Currently, surgery is the only known effective treatment for pterygium. In certain groups, the probability of recurrence after basic sclera excision is very significant. Tissue grafting is substantially more time-consuming and challenging than keeping the sclera uncovered, but it reduces the chance of recurrence. Conjunctival autograft surgery is older than amniotic membrane graft surgery. The purpose of this study was to compare pterygium surgery with conjunctival autograft against an amniotic membrane transplant. In the study, a randomized controlled trial was used. Four cases were ruled out (two for failing to meet inclusion criteria and the other for refusing to participate). Group I (n = 40) received the intervention, whereas Group II (n = 40) served as the control. Both descriptive and inferential statistical approaches were used, including data analysis and data analysis statistics. The descriptive statistics analysis covered basic pterygium surgery information as well as the risk of recurrent pterygium. As an inferential statistic, the chi-square was used. A p-value of 0.05 is statistically significant. The findings of this investigation were the majority of patients in Group I were female (70.0%), aged 41–60 years, had no underlying disease (95.0%), and had nasal pterygium (97.5%). The majority of Group II patients were female (60.0%), aged 41–60 years, had no underlying disease (97.5%) and had nasal pterygium (97.5%). Group I had no recurrence of pterygium after surgery, but Group II had a 7.5% recurrence rate. Typically, the recurrence time is twelve months. The majority of pterygium recurrences occur in females (83.3%), between the ages of 41 and 60 (66.7%), with no underlying disease. The recurrence period is typically six months (60%) and a nasal pterygium site (83.3%). Pterygium recurrence after surgery is associated with nasal location (p =.002). 16.7% of pterygium surgeries result in complications; one woman with nasal pterygium underwent autograft surgery six months later. The presence of granulation tissue at the surgical site is a mild complication. A pterygium surgery recurrence rate comparison of conjunctival autograft and amniotic membrane transplantation revealed that conjunctival autograft had a higher recurrence rate than amniotic membrane transplantation (p =.013).

Keywords: pterygium, pterygium surgery, conjunctival autograft, amniotic membrane transplantation

Procedia PDF Downloads 43

Authors: Samiha Ramdani, Abdelhamid Geuttala

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There is no doubt that the batteries increasingly used tires create environmental concerns. Algeria generates large amounts of by industrial and household waste, such as used tires and colored glass bottles and dishes, whose valuation in cementitious materials could be an interesting ecological and economical alternative for broadening eliminating cumbersome landfills. This work is a contribution to the promotion of local materials with the use of waste tires and glass bottle in the development of a new cementitious composite having the acceptable compressive strength and a capacity of improved strains. For this purpose, rubber crumb (GC) from shredding used tires were used as partial replacement of quarry sand with 10%, 20%, 40, 60%. In addition, some mixtures also contain glass powder at15% cement replacement by volume. The compressive strength, tensile strength, deformability, the water permeability and penetration Inions chlorides are studied. As results; an acceptable compressive strength was obtained with the substitution rate of 10% and 20% by volume, the deformability of the composite increases with increased replacement rate. The addition of finely ground glass as a partial replacement of cement concrete increases the resistance to penetration of Inions chloride and reduce the water permeability thereof; then increases their durability.

Keywords: crumb rubber, deformability, compressive strength, finely ground glass, durability, behavior law

Procedia PDF Downloads 295

Authors: Piotr-Robert Lazik, Harald Garrecht

Abstract:

Many concrete technologists are looking for a solution to replace Fly Ashes that would be unavailable in a few years as an element that occurs as a major component of many types of concrete. The importance of such component is clear - it saves cement and reduces the amount of CO₂ in the atmosphere that occurs during cement production. Wood Ashes from electrostatic filter can be used as a valuable substitute in concrete. The laboratory investigations showed that the wood ash concrete had a compressive strength comparable to coal fly ash concrete. These results indicate that wood ash can be used to manufacture normal concrete.

Keywords: wood ashes, fly ashes, electric filter, replacement, concrete technology

Procedia PDF Downloads 104

Authors: Fadzel Wong Chee Ping, Chee Keong Chen, Foong Kiew Ooi, Mahaneem Mohamed

Abstract:

Introduction: To date, information on the effects of bee bread supplementation on isokinetic muscular performance are lacking. Therefore, this study was carried out to investigate the effects of 8-week bee bread supplementation on isokinetic muscular strength and power in young athletes. Methodology: Twelve male athletes (age: 24.0±1.8 years; BMI: 22.3 ± 1.3 kg.m-2; VO2max: 52.0 ± 2.8 mL.kg-1.min-1) were recruited in this randomised double blind, placebo-controlled crossover study. Participants consumed either bee bread at a dosage of 20 g.d-1 or placebo for 8 weeks. An isokinetic dynamometer was used to measure participants’ lower limb muscular strength and power prior (pre-test) and post (post-test) 8 weeks of experimental period. Testing angular velocities were set at 180o.s-1 and 300o.s-1 to determine knee flexion and extension muscular peak torque (an indicator of muscular strength) and average power of the participants. Statistical analyses were performed using ANOVA with repeated measures. Results: Isokinetic knee extension peak torque and average power at 180o.s-1, and isokinetic knee flexion peak torque and average power at 180o.s-1 were significantly (p<0.05) higher at post-test compared to pre-test with bee bread supplementation. However, significant differences were not observed in the measured parameters between pre- and post-test with placebo supplementation. Conclusion: Supplementation of bee bread for 8 weeks at a dosage of 20 g daily increased some of the measured isokinetic muscular strength and power parameters in young athletes.

Keywords: bee bread, isokinetic, power, strength

Procedia PDF Downloads 231

Authors: Wen-Yu Chen, Chia-Yuan Hsu, Sasinee Vongsrikul

Abstract:

The present study is to explore the perception of Taiwanese females towards medical tourism in Thailand for the development of applicable marketing strategy, integrating travel motivation and cosmetic surgery trend to attract potential medical tourists from Taiwan. Since previous studies relevant to this research issue are limited, qualitative study is firstly employed by using one focus group interview and in-depth interviews with Taiwanese females. Moreover, the present research collected questionnaires from 290 Taiwanese females to provide greater understanding of research results. The top three factors that affect Taiwanese females’ decision for not going to Thailand for medical tourism are “physicians and nurses cannot speak Chinese”, “low quality of the cosmetic surgery product that I want to do”, and “the county does not have laws to protect medical tourists’ right”. The finding of the empirical part would suggest the area in medical tourism industry which Thailand should promote and emphasizes in order to increase its presence as a hub for cosmetic surgery and attract Taiwanese female market. Therefore, the study contributes to the potential development of marketing strategy for medical tourism, specifically in the area of cosmetic surgery in Thailand while targeting Taiwan market.

Keywords: Thailand, Taiwanese female tourists, medical tourism, cosmetic surgery

Procedia PDF Downloads 395

Authors: Débora C. G. Oliveira, Julio D. Salles, Bruna A. Moriy, João A. Rossignolo, Holmer Savastano Jr.

Abstract:

The objective of this study was to identify the optimal level of partial replacement of Portland cement by the ashes originating from burning straw and bagasse from sugar cane (ASB). Order to this end, were made five series of flat plates and cylindrical bodies: control and others with the partial replacement in 20, 30, 40, and 50% of ASB in relation to the mass of the Ordinary Portland cement, and conducted a mechanical testing of simple axial compression (cylindrical bodies) and the four-point bending (flat plates) and determined water absorption (WA), bulk density (BD) and apparent void volume (AVV) on both types of specimens. Based on the data obtained, it may be noted that the control treatment containing only Portland cement, obtained the best results. However, the cylindrical bodies with 20% ashes showed better results compared to the other treatments. And in the formulations plates, the treatment which showed the best results was 30% cement replacement by ashes.

Keywords: modulus of rupture, simple axial compression, waste, bagasse sugarcane

Procedia PDF Downloads 397

Authors: Bruno Di Pace, Roxanne H. Padley

Abstract:

Aims: The recent increase in remote video interaction has increased the number of requests for teleconsultations with plastic surgeons in private practice (70% in the UK and 64% in the USA). This study investigated the motivations for such an increase and the underlying psychological impact on patients. Method: An anonymous web-based poll of 8 questions was designed and distributed to patients seeking cosmetic surgery through social networks in both Italy and the UK. The questions gathered responses regarding 1. Reasons for pursuing cosmetic surgery; 2. The effects of delays caused by the SARS-COV-2 pandemic; 3. The effects on mood; 4. The influence of video conferencing on body-image perception. Results: 85 respondents completed the online poll. Overall, 68% of respondents stated that seeing themselves more frequently online had influenced their decision to seek cosmetic surgery. The types of surgeries indicated were predominantly to the upper body and face (82%). Delays and access to surgeons during the pandemic were perceived as negatively impacting patients' moods (95%). Body-image perception and self-esteem were lower than in the pre-pandemic, particularly during lockdown (72%). Patients were more inclined to undergo cosmetic surgery during the pandemic, both due to the wish to improve their “lockdown face” for video conferencing (77%) and also due to the benefits of home recovery while in smart working (58%). Conclusions: Overall, findings suggest that video conferencing has led to a significant increase in requests for cosmetic surgery and the so-called “Zoom Boom” effect.

Keywords: cosmetic surgery, remote communication, telehealth, zoom boom

Procedia PDF Downloads 150

Authors: Camila Parodi, Viviana Letelier, Giacomo Moriconi

Abstract:

The cement industry is responsible for around a 5% of the CO2 emissions worldwide and considering that concrete is one of the most used materials in construction its total effect is important. An alternative to reduce the environmental impact of concrete production is to incorporate certain amount of residues in the dosing, limiting the replacement percentages to avoid significant losses in the mechanical properties of the final material. Previous researches demonstrate the feasibility of using brick and rust residues, separately, as a cement replacement. This study analyses the variation in the mechanical properties of mortars by incorporating masonry residue composed of clay bricks and cement mortar. In order to improve the mechanical properties of masonry residue, this was subjected to a heat treatment of 650 ° C for four hours and its effect is analyzed in this study. Masonry residue was obtained from a demolition of masonry perimetral walls. The residues were crushed and sieved and the maximum size of particles used was 75 microns. The percentages of cement replaced by masonry residue were 0%, 10%, 20% and 30%. The effect of masonry residue addition and its heat treatment in the mechanical properties of mortars is evaluated through compressive and flexural strength tests after 7, 14 and 28 curing days. Results show that increasing the amount of masonry residue used increases the losses in compressive strength and flexural strength. However, the use of up to a 20% of masonry residue, when a heat treatment is applied, allows obtaining mortars with similar compressive strength to the control mortar. Masonry residues mortars without a heat treatment show losses in compressive strengths between 15% and 27% with respect to masonry residues with heat treatment, which demonstrates the effectiveness of the heat treatment. From this analysis it can be conclude that it is possible to use up to 20% of masonry residue with heat treatment as cement replacement without significant losses in mortars mechanical properties, reducing considerably the environmental impact of the final material.

Keywords: cement replacement, environmental impact, masonry residue, mechanical properties of recycled mortars

Procedia PDF Downloads 350