Search results for: nasolacrimal duct obstruction

Authors: Chandra Shekhar Majumder, Orin Sultana Jamie

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Background: Dacryocystorhinostomy (DCR) has been a widely accepted surgical intervention for nasolacrimal duct obstructions. Some previous studies demonstrated the potential benefits of the peroperative application of agents like Mitomycin-C (MMC) with DCR to improve surgical outcomes. Relevant studies are rare in Bangladesh, and there are controversies about the dose, duration of MMC, and outcome. Therefore, the present study aimed to investigate the comparative efficacy of DCR with and without MMC in a tertiary hospital in Bangladesh. Objective: The study aims to determine the outcome of a dacryocystorhinostomy with preoperative local use of mitomycin–C. Methods: An analytical study was conducted in the Department of Ophthalmology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, from January 2023 to September 2023. Seventy patients who were admitted for DCR operation were included according to the inclusion and exclusion criteria. Patients were divided into two groups: those who underwent DCR with peroperative administration of 0.2 mg/ml Mitomycin-C for 5 minutes (Group I) and those who underwent DCR alone (Group II). All patients were subjected to detailed history taking, clinical examination, and relevant investigations. All patients underwent DCR according to standard guidelines and ensured the highest peroperative and postoperative care. Then, patients were followed up at 7th POD, 1-month POD, 3 months POD, and 6 months POD to observe the success rate between the two groups by assessing tearing condition, irrigation, height of tear meniscus, and FDDT- test. Data was recorded using a pre-structured questionnaire, and collected data were analyzed using SPSS 23. Results: The mean age of the study patients was 42.17±6.7 (SD) years and 42.29±7.1 (SD) years in Groups I and II, respectively, with no significant difference (p=0.945). At the 6th month’s follow-up, group I patients were observed with 94.3% frequency of symptom-free, 85.6% patency of lacrimal drainage system, 68.6% had tear meniscus <0.1mm and 88.6% had positive Fluorescence Dye Disappearance Test (FDDT test). In group II, 91.4% were symptom-free, 68.6% showed patency, 57.1% had a height of tear meniscus < 0.1 mm, and 85.6% had FDDT test positive. But no statistically significant difference was observed (p<.05). Conclusion: The use of Mitomycin-C preoperatively during DCR offers better postoperative outcomes, particularly in maintaining patency and achieving symptom resolution with more FDDT test positive and improvement of tear meniscus in the MMC group than the control group. However, this study didn’t demonstrate a statistically significant difference between the two groups. Further research with larger sample sizes and longer follow-up periods would be beneficial to corroborate these findings.

Keywords: dacryocystorhinostomy, mitomycin-c, dacryocystitis, nasolacrimal duct obstruction

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Authors: B. Rajesh Kamath, J. Sundara Rajan, M. K. Veeraiah, M. Z. Kurian

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Insulation performance of a gas insulated system is severely affected by particle contaminants. These metallic particles adversely affect the characteristics of insulating system. These particles can produce surface charges due to partial discharge activities. These particles which are free to move enhance the local electric fields. This paper deals with the influence of conducting particle placed in a co-axial duct on the discharge characteristics of gas mixtures. Co-axial duct placed in a high pressure chamber is used for the purpose. A gas pressure of 0.1, 0.2 and 0.3 MPa have been considered with a 10:90 SF₆ and N₂ gas mixtures. The 2D and 3D histograms of clean duct and duct with copper particle are discussed in this paper.

Keywords: coaxial duct, gas insulated system, gas mixtures, metallic particle, partial discharges, histograms

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Authors: Heidar Jafarizadeh, Hossein Keshtkar, Ahmad Sohankar

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Heat transfer and turbulent flow structure have been studied in a divergent ribbed duct with a varying duct geometry with Reynolds numbers of 7000 to 90000 using numerical methods. In this study, we confirmed our numerical results of a ribbed duct with an Initial slope of zero to 3 degree by comparing them to experimental data we had and investigated the impact of the ducts divergence on heat transfer and flow pattern in the 2-dimensional flow. Then we investigated the effect of tilting the ribs, on heat transfer and flow behavior. We achieved this by changing the ribs angles from a range of 40 to 75 degrees in a divergent duct and simulated the flow in 3-dimensions. Our results show that with an increase in duct divergence, heat transfer increases linearly and the coefficient of friction increases exponentially. As the results show, a duct with a divergence angle of 1.5 degree presents better thermal performance in comparison with all the angle range’s we studied. Besides, a ribbed duct with 40 degree rib orientation had the best thermal performance considering the simultaneous effects of pressure drop and heat transfer which were imposed on it.

Keywords: divergent ribbed duct, heat transfer, thermal performance, turbulent flow structure

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Authors: Joshua Teo, Leo Phan

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Signet cell carcinoma of the appendix is the rarest and the most aggressive subtype of appendiceal malignancy, typically with non-specific presentations. We describe a case of a 62-year-old male with large bowel obstruction and CT demonstrating dilated large bowels from caecum to proximal sigmoid colon with pneumoperitoneum. Intra-operatively, closed-loop obstruction caused by dense adherence of sigmoid colon to caecum was noted, which had resulted in caecal perforation. Histopathology study indicated primary appendiceal malignancy of signet cell morphology with intra-peritoneal spread to the sigmoid colon. Large bowel obstruction from appendiceal malignancy has rarely been reported, and a similar presentation has not been described in the existing literature. When left-sided large bowel obstruction is suspected to be caused by a malignant stricture, it is essential to consider transperitoneal spread of appendiceal malignancy as potential aetiology, particularly in the elderly.

Keywords: appendiceal carcinoma, large bowel obstruction, signet ring cell cancer, caecal perforation

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Authors: M. H. Alhajeri, Hamad M. Alhajeri, A. H. Alenezi

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Computational fluid dynamics (CFD) investigation of heat transfer in U-duct with turbulators is presented in this paper. The duct passages used to cool internally the blades in gas turbine. The study is focused in the flow behavior and the Nusselt number (Nu) distributions. The model of the u-duct contains two square legs that are connected by 180* turn. Four turbulators are located in each surface of the leg and distributed in a staggered arrangement. The turbulator height and width are equal to 0.1 of the duct width, and the turbulator height is 0.1 of the distance between the turbulators. The Reynolds number (Re) used in this study is 95000 and the inlet velocity is 10 m/s. It was noticed that, after the flow resettles from the interruptions generated by the first turbulator or the turn, the flow construct two eddies, one large and the other is small after and before the turbulator, respectively. The maximum values of the Nu are found at a distance of approximately one turbulator width w before of the flow reattachment point.

Keywords: computational fluid dynamics, CFD, rib, heat transfer, blade

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Authors: Freda Halim

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Endometriosis in bowel is rare condition, about 3-37% of endometriosis cases. Most of bowel endometriosis rising in the rectosigmoid (90% of bowel endometriosis). The incidence of caecal endometriosis is very low ( < 5% of bowel endometriosis) and almost never causing acute small bowel obstruction. The aim of this paper is to show that although bowel obstruction caused by caecal endometriosis is difficult to diagnose as it is rare, and may require laparotomy to make definite diagnosis, but it should be considered in infertile female patient. The case is 37 years old woman infertile woman with intestinal obstruction with pre-operative diagnosis total acute small bowel obstruction caused by right colonic mass, with sepsis as the complication. Before the acute small bowel obstruction, she complained of chronic right lower quadrant pain with chronic constipation alternate with chronic diarrhea, symptoms that happened both in bowel endometriosis and colorectal malignancy. She also complained of chronic pelvic pain and dysmenorrhea. She was married for 10 years with no child. The patient was never diagnosed with endometriosis and never seek medical attention for infertility and the chronic pelvic pain. The patient underwent Abdominal CT Scan, with results: massive small bowel obstruction, and caecal mass that causing acute small bowel obstruction. Diagnosis of acute small bowel obstruction due to right colonic mass was made, and exploratory laparotomy was performed in the patient. During the laparotomy, mass at caecum and ileocaecal that causing massive small bowel obstruction was found and standard right hemicolectomy and temporary ileostomy were performed. The pathology examination showed ectopic endometriosis lesions in caecum and ileocaecal valve. The histopathology also confirmed with the immunohistochemistry, in which positive ER, PR, CD 10 and CD7 was found the ileocaecal and caecal mass. In the second operation, reanastomosis of the ileum was done 3 months after the first operation. The chronic pelvic pain is decreasing dramatically after the first and second operation. In conclusion, although bowel obstruction caused by caecal endometriosis is a rare cause of intestinal obstruction, but it can be considered as a cause in infertile female patient

Keywords: acute, bowel obstruction, caecum, endometriosis

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Authors: Sofia Baldelli, Aman More

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Milk curd obstruction is commonly reported as being misdiagnosed for NEC, and they predominantly mimic each other in clinical presentation, including abdominal distension, vomiting, constipation, feeding intolerance and frank or occult blood PR. Using the case of a pre-term neonate misdiagnosed with necrotising enterocolitis when in fact, they had milk curd obstruction, we compare the two diagnoses and why they are hard to differentiate, the risk factors for clinicians to consider and the different management options. The main diagnostic tool for these conditions remains the plain radiograph and here we present the original radiograph of the neonate and discuss the classical radiological features of both diagnoses. We conclude that further imaging techniques such as ultrasound might be used to improve diagnosis when X-ray is inconclusive.

Keywords: milk curd obstruction, Necrotising Enterocolitis, radiology, pediatric surgery

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Authors: Sanjay Agrawal, Trapti Varshney, G. N. Tiwari

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In this paper, thermal modeling has been developed for photovoltaic PV modules, namely; Case A: semitransparent PV module without duct, Case B: semitransparent PV module with duct, Case C: opaque PV module without duct, Case D: opaque PV module with duct for Delhi, India climatic condition. MATLAB 7.0 software has been used to solve mathematical models of the proposed system. For validation of proposed system, the experimental study has also been carried out for all above four cases, and then comparative analysis of all different type of PV module has been presented. The hybrid PVT module air collectors presented in this study are self sustaining the system and can be used for the electricity generation in remote areas where access of electricity is not economical due to high transmission and distribution losses. It has been found that overall annual thermal energy and exergy gain of semitransparent PV module is higher by 11.6% and7.32% in summer condition and 16.39% and 18% in winter condition respectively as compared to opaque PV module considering same area (0.61 m2) of PV module.

Keywords: semitransparent PV module, overall exergy, overall thermal energy, opaque

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Authors: Mengqi Zhu, Chang Nyung Kim

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This study numerically investigates three-dimensional liquid-metal (LM) magnetohydrodynamic (MHD) flows in a misaligned duct under a uniform magnetic field. The duct consists of two misaligned horizontal channels (one is inflow channel, the other is outflow channel) and one central vertical channel. Computational fluid dynamics simulations are performed to predict the behavior of the MHD flows, using commercial code CFX. In the current study, a case with Hartmann number 1000 is considered. The electromagnetic features of LM MHD flows are elucidated to examine the interdependency of the flow velocity, current density, electric potential, pressure drop and Lorentz force. The results show that pressure decreases linearly along the main flow direction.

Keywords: CFX, liquid-metal magnetohydrodynamic flows, misaligned duct, pressure drop

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Authors: Yue Yan, Chang Nyung Kim

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The numerical investigation of the three-dimensional liquid-metal (LM) magnetohydrodynamic (MHD) flows in a curved duct with flow channel insert (FCI) is presented in this paper, based on the computational fluid dynamics (CFD) method. A uniform magnetic field is applied perpendicular to the duct. The interdependency of the flow variables is examined in terms of the flow velocity, current density, electric potential and pressure. The electromagnetic characteristics of the LM MHD flows are reviewed with an introduction of the electric-field component and electro-motive component of the current. The influence of the existence of the FCI on the fluid flow is investigated in detail. The case with FCI slit located near the side layer yields smaller pressure gradient with stable flow field.

Keywords: curved duct, flow channel insert, liquid-metal, magnetohydrodynamic

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Authors: David Armany, Matthew Allaway, Preet Gosal, Senarath Edirimanne

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A potentially devastating complication of routine laparoscopic cholecystectomy includes iatrogenic bile duct injuries, which represent a stable incidence rate of 0.3% over the past three decades. Whilst related to several relative risks such as surgeon experience and patient factors (older age, male sex), misinterpretation of biliary tree anatomy remains the most common cause, accounting for 80% of iatrogenic Common Bile Duct injuries. Whilst extremely rare, a duplicate common bile duct anomaly remains a potential variation to encounter during biliary surgery, with 30 recognised cases in the worldwide literature, of which type Vb accounts for 4. We report the case of a rare type Vb variation encountered during intra-operative laparoscopic cholecystectomy and confirmed on cholangiogram. To our knowledge, this is the first documented Type Vb case encountered in an Australian population. Given these anomalies are asymptomatic and can perpetuate iatrogenic common bile duct injuries, awareness of all subtypes is crucial. Irrevocably, preoperative Magnetic Resonance Cholangiopancreatography can help recognise these anomalies before the operating theatre; however, their widespread adoption is limited by expensive and availability.

Keywords: duplicated common bile duct, type Vb, cholecystitis, MRCP, cholangiogram, iatrogenic CBD

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Authors: Marlon M. Hernández Cely, Victor E. C. Baptistella, Oscar M. H. Rodríguez

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Particle Image Velocimetry (PIV) is a well-established technique in the field of fluid flow measurement and provides instantaneous velocity fields over global domains. It has been applied to external and internal flows and in single and two-phase flows. Regarding internal flow, works about the application of PIV in annular ducts are scanty. An experimental work is presented, where flow of water is studied in an annular duct of inner diameter of 60 mm and outer diameter of 155 mm and 10.5-m length, with the goal of obtaining detailed velocity measurements. Depending on the flow rates of water, it can be laminar, transitional or turbulent. In this study, the water flow rate was kept at three different values for the annular duct, allowing the analysis of one laminar and two turbulent flows. Velocity fields and statistic quantities of the turbulent flow were calculated.

Keywords: PIV, annular duct, laminar, turbulence, velocity profile

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

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Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

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Authors: Veera J. Allu, Shreya Pal, Anang Pangeni

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Introduction: Adhesive small bowel obstruction (ASBO) is usually managed conservatively. Failed conservative management leads to operative intervention by an open approach. However, laparoscopic management of ASBO is increasingly being reported in the literature. We report an unusual case of ASBO secondary to a band from the appendicular tip which was managed laparoscopically. Case Description: This patient was a 61-year-old female, otherwise fit and healthy, presenting with abdominal pain and mild distension with vomiting of 3 days duration. She had undergone ultrasound-guided drainage of an appendicular abscess three months ago and laparoscopic right inguinal hernia repair (TEP) in the past. CTAP showed small bowel obstruction with a transition point in the pelvis and the possible cause being adhesions. She was initially managed conservatively; however, as she was not improving for two days, she was consented to diagnostic laparoscopy. Intraoperatively, an adhesive band was found between the appendicular tip and distal ileum around 100cm proximal to the ileocolic junction, resulting in mechanical bowel obstruction. Laparoscopic division of band was performed, followed by appendicectomy, and the patient had an uneventful recovery and was discharged on postoperative day 1. Conclusion: In highly selected patients and with appropriate expertise, laparoscopic management of ASBO is feasible and safe.

Keywords: bowel obstruction, adhesions, laparoscopy, open procedure

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Authors: Chul H. Jo, Do Y. Kim, Bong K. Cho, Myeong J. Kim

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The exhaustion of oil and the environmental pollution from the use of fossil fuel are increasing. Tidal current power (TCP) has been proposed as an alternative energy source because of its predictability and reliability. By applying a duct and single point mooring (SPM) system, a TCP device can amplify the generating power and keep its position properly. Because the generating power is proportional to cube of the current stream velocity, amplifying the current speed by applying a duct to a TCP system is an effective way to improve the efficiency of the power device. An SPM system can be applied at any water depth and is highly cost effective. Simple installation and maintenance procedures are also merits of an SPM system. In this study, we designed an SPM system for a duct-type TCP device for use in shallow water. Motions of the duct are investigated to obtain the response amplitude operator (RAO) as the magnitude of the transfer function. Parameters affecting the stability of the SPM system such as the fairlead departure angle, current velocity, and the number of clamp weights are analyzed and/or optimized. Wadam and OrcaFlex commercial software is used to design the mooring line.

Keywords: mooring design, parametric analysis, RAO (Response Amplitude Operator), SPM (Single Point Mooring)

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Authors: Nur Irmawati, H. A. Mohammed

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In the present study, mixed convection in a horizontal rectangular duct using Al2O3 is numerically investigated. The effects of different Rayleigh number, Reynolds number and radiation on flow and heat transfer characteristics were studied in detail. This study covers Rayleigh number in the range of 2×106≤Ra≤2×107 and Reynolds number in the range of 100≤Re≤1100. Results reveal that the Nusselt number increases as Reynolds and Rayleigh numbers increase. It was also found that the dimensionless temperature distribution increases as Rayleigh number increases.

Keywords: numerical simulation, mixed convection, horizontal rectangular duct, nanofluids

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Authors: Pakawhat Khumkhreung, Yottana Khunatorn

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The flow pattern inside rectangular intake air duct of 300 MW lignite coal-fired power plant is investigated in order to analyze and reduce overall inlet system pressure drop. The system consists of the 45-degree inlet elbow, the flow instrument, the 90-degree mitered elbow and fans, respectively. The energy loss in each section can be determined by Bernoulli’s equation and ASHRAE standard table. Hence, computational fluid dynamics (CFD) is used in this study based on Navier-Stroke equation and the standard k-epsilon turbulence modeling. Input boundary condition is 175 kg/s mass flow rate inside the 11-m² cross sectional duct. According to the inlet air flow rate, the Reynolds number of airstream is 2.7x10⁶ (based on the hydraulic duct diameter), thus the flow behavior is turbulence. The numerical results are validated with the real operation data. It is found that the numerical result agrees well with the operating data, and dominant loss occurs at the flow rate measurement device. Normally, the air flow rate is measured by the airfoil and it gets high pressure drop inside the duct. To overcome this problem, the airfoil is planned to be replaced with the other type measuring instrument, such as the average pitot tube which generates low pressure drop of airstream. The numerical result in case of average pitot tube shows that the pressure drop inside the inlet airstream duct is decreased significantly. It should be noted that the energy consumption of inlet air system is reduced too.

Keywords: airfoil, average pitot tube, combustion air, CFD, pressure drop, rectangular duct

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Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

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Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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Authors: D. Kumar, S. Kumar, A. G. Memon, R. A. Memon, K. Harijan

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A considerable amount of energy is usually lost due to compression of insulation in Heating, ventilation, and air conditioning (HVAC) duct. In this paper, the economic impact of compression of insulation is estimated. Relevant mathematical models were used to estimate the optimal thickness at the points of compression. Furthermore, the payback period is calculated for the optimal thickness at the critical parts of supply air duct (SAD) and return air duct (RAD) considering natural gas (NG) and liquefied petroleum gas (LPG) as fuels for chillier operation. The mathematical model is developed using preliminary data obtained for an HVAC system of a pharmaceutical company. The higher heat gain and cooling loss, due to compression of thermal insulation, is estimated using relevant heat transfer equations. The results reveal that maximum energy savings (ES) in SAD is 34.5 and 40%, while in RAD is 22.9% and 29% for NG and LPG, respectively. Moreover, the minimum payback period (PP) for SAD is 2 and 1.6years, while in RAD is 4.3 and 2.7years for NG and LPG, respectively. The optimum insulation thickness (OIT) corresponding to maximum ES and minimum PP is estimated to be 35 and 42mm for SAD, while 30 and 38mm for RAD in case of NG and LPG, respectively.

Keywords: optimum insulation thickness, life cycle cost analysis, payback period, HVAC system

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Authors: Y. S. Mohamed, L. A. Ahmed, H. A. Salem, A. M. Agha

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Liver Fibrosis is one of the most serious conditions that affect the Egyptian society. In the present study, the effect of nicorandil was investigated in experimentally-induced liver fibrosis by bile duct ligation in rats. Nicorandil (3mg/kg/day) was given orally 24 h after bile duct ligation for 14 days till the end of the experiment. Nicorandil group showed a significant improvement in liver function tests (ALT and ALP) as well as a significant decrease in oxidative stress biomarkers (TBARS and GSH), area of fibrosis and activity of hepatic stellate cells as indicated by decreased expression of alpha smooth muscle actin.Moreover, nicorandil treatment decreased HSCs proliferation due to its inhibitory effects on protein kinase C(PKC) and Platelet derived growth factor (PDGF) . Oral administration of either glibenclamide (10 mg/kg/day)(a KATP channel blocker) or L-NAME (30 mg/kg/day) (an inhibitor of nitric oxide synthase) blocked the protective effects of nicorandil. However, nicorandil and L-NAME treated group showed more or less results similar to that of untreated bile duct ligated group. In conclusion, nicorandil was effective against the development of bile duct ligated-induced liver fibrosis in rats where activation of the NO pathway plays an important role in the protective effect nicorandil.

Keywords: hepatic stellate cells, nicorandil, nitric oxide donor, liver fibrosis

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Authors: Nishitha Chowdary, Prabhav Dwivedi

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Solar radiation (or insolation) is responsible for 174 petawatts (PW) of energy reaching the Earth's atmosphere. About one-third of this is reflected in space. Solar energy is by far the most abundant source of energy on Earth. In this study to use solar energy to the fullest in a solar air heater, An analysis of a solar air heater duct roughened with fixed cylindrical ribs in 3-D has been done using CFD. These fixed cylindrical ribs have a uniform circular cross-section and are placed in transverse in-line and staggered arrangements. The orientation of ribs has been fixed and is perpendicular to the in-flow direction. Cylindrical ribs are arranged periodically with fixed pitch; therefore, one pitch length is only considered in the present study. Validation has been done with smooth as well as with roughened duct and is matched perfectly with the developed correlations. Geometric parameters, namely rib height (e), ranges from 1 to 2 mm and pitch ranges from 10 to 40 mm are used in the present investigation. Thermo-hydraulic performance parameters in terms of average Nusselt number and friction factor have been extracted for Reynolds number ranging 5000—18000 to optimize the performance of roughened duct.

Keywords: cylindrical ribs, solar air heater, thermo-hydraulic performance factor, roughened duct

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Authors: Deok Hyun Han

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Objective: To explore outcomes of UventaTM metallic ureteral stent between malignant and benign ureteral obstruction. Methods: We reviewed the medical records of 90 consecutive patients who underwent Uventa stent placement for benign or malignant ureteral obstruction from December 2009 to June 2013. We evaluated the clinical outcomes, complications, and reasons and results for unexpected stent removals. Results: The median follow-up was 10.7 (0.9 – 41) months. From a total of 125 ureter units, there were 24 units with benign obstructions and 101 units with malignant obstructions. Initial technical successes were achieved in all patients. The overall success rate was 70.8% with benign obstructions and 84.2% with malignant obstructions. The major reasons for treatment failure were stent migration (12.5%) in benign and tumor progression (11.9%) in malignant obstructions. The overall complication rate was similar between benign and malignant obstructions (58.3% and 42.6%), but severe complications, which are Clavien grade 3 or more, occurred in 41.7% of benign and 6.9% of malignant obstructions. The most common complications were stent migration (25.0%) in benign obstructions and persistent pain (14.9%) in malignant obstructions. The stent removal was done in 16 units; nine units that were removed by endoscopy and seven units were by open surgery. Conclusions: In malignant ureteral obstructions, the Uventa stent showed favorable outcomes with high success rate and acceptable complication rate. However, in benign ureteral obstructions, overall success rate and complication rate were less favorable. Malignant ureteral obstruction seems to be appropriate indication of Uventa stent placement. However, in chronic diffuse benign ureteral obstructions the decision of placement of Uventa stent has to be careful.

Keywords: cause, complication, ureteral obstruction, metal stent

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Authors: Varun Goel

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Solar energy is a good option among renewable energy resources due to its easy availability and abundance. The simplest and most efficient way to utilize solar energy is to convert it into thermal energy and this can be done with the help of solar collectors. The thermal performance of such collectors is poor due to less heat transfer from the collector surface to air. In this work, experimental investigations of single pass solar air heater having triangular duct and provided with roughness element on the underside of the absorber plate. V-shaped ribs are used for investigation having three different values of relative roughness pitch (p/e) ranges from 4-16 for a fixed value of angle of attack (α), relative roughness height (e/Dh) and a relative gap distance (d/x) values are 60°, 0.044 and 0.60 respectively. Result shows that considerable augmentation in heat transfer has been obtained by providing roughness.

Keywords: artificial roughness, solar air heater, triangular duct, V-shaped ribs

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Authors: Mohammad Mahdi Doustdar, Mohammad Mojtahedpoor

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The effects of flame-holder position, the ratio of flame holder diameter to combustion chamber diameter and injection angle on fuel propulsive droplets sizing and effective mass fraction have been studied by a cold flow. We named the mass of fuel vapor inside the flammability limit as the effective mass fraction. An empty cylinder as well as a flame-holder which are as a simulator for duct combustion has been considered. The airflow comes into the cylinder from one side and injection operation will be done by four nozzles which are located on the entrance of cylinder. To fulfill the calculations a modified version of KIVA-3V code which is a transient, three-dimensional, multi phase, multi component code for the analysis of chemically reacting flows with sprays, is used.

Keywords: KIVA-3V, flame-holder, duct combustion, effective mass fraction, mean diameter of droplets

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Authors: K. S. Sivakumaran, T. Thanga, B. Halabieh

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The end panels of a large rectangular industrial duct, which experience significant internal pressures, also experience considerable transverse shear due to transfer of gravity loads to the supports. The current design practice of such thin plate panels for shear load is based on methods used for the design of plate girder webs. The structural arrangements, the loadings and the resulting behavior associated with the industrial duct end panels are, however, significantly different than those of the web of a plate girder. The large aspect ratio of the end panels gives rise to multiple bands of tension fields, whereas the plate girder web design is based on one tension field. In addition to shear, the industrial end panels are subjected to internal pressure which in turn produces significant membrane action. This paper reports a study which was undertaken to review the current industrial analysis and design methods and to propose a comprehensive method of designing industrial duct end panels for shear resistance. In this investigation, a nonlinear finite element model was developed to simulate the behavior of industrial duct end panel subjected to transverse shear and internal pressures. The model considered the geometric imperfections and constitutive relations for steels. Six scale independent dimensionless parameters that govern the behavior of such end panel were identified and were then used in an extensive parametric study. It was concluded that the plate slenderness dominates the shear strength of stockier end panels, and whereas, the aspect ratio and plate slenderness influence the shear strength of slender end panels. Based on these studies, this paper proposes design aids for estimating the shear strength of rectangular duct end panels.

Keywords: thin plate, transverse shear, tension field, finite element analysis, parametric study, design

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Authors: Mustafa Sengul, Enes Sahin, Sertac Arslan

Abstract:

Pumpjets are one of the marine propulsion systems frequently used in underwater vehicles nowadays. The reasons for frequent use of pumpjet as a propulsion system are that it has higher relative efficiency at high speeds, better cavitation, and acoustic performance than its rivals. Pumpjets are composed of rotor, stator, and duct, and there are two different types of pumpjet configurations depending on the desired hydrodynamic characteristic, which are with accelerating and decelerating duct. Pumpjet with an accelerating channel is used at cargo ships where it works at low speeds and high loading conditions. The working principle of this type of pumpjet is to maximize the thrust by reducing the pressure of the fluid through the channel and throwing the fluid out from the channel with high momentum. On the other hand, for decelerating ducted pumpjets, the main consideration is to prevent the occurrence of the cavitation phenomenon by increasing the pressure of the fluid about the rotor region. By postponing the cavitation, acoustic noise naturally falls down, so decelerating ducted systems are used at noise-sensitive vehicle systems where acoustic performance is vital. Therefore, duct design becomes a crucial step during pumpjet design. This study, it is aimed to optimize the duct geometry of a decelerating ducted pumpjet for a highly speed underwater vehicle by using proper optimization tools. The target output of this optimization process is to obtain a duct design that maximizes fluid pressure around the rotor region to prevent from cavitation and minimizes drag force. There are two main optimization techniques that could be utilized for this process which are parameter-based optimization and gradient-based optimization. While parameter-based algorithm offers more major changes in interested geometry, which makes user to get close desired geometry, gradient-based algorithm deals with minor local changes in geometry. In parameter-based optimization, the geometry should be parameterized first. Then, by defining upper and lower limits for these parameters, design space is created. Finally, by proper optimization code and analysis, optimum geometry is obtained from this design space. For this duct optimization study, a commercial codedparameter-based optimization algorithm is used. To parameterize the geometry, duct is represented with b-spline curves and control points. These control points have x and y coordinates limits. By regarding these limits, design space is generated.

Keywords: pumpjet, decelerating duct design, optimization, underwater vehicles, cavitation, drag minimization

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Authors: Parul Garg

Abstract:

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: Kaczmarzyk Piotr, Anna Dziechciarz, Wojciech Klapsa

Abstract:

The purpose of this paper is demonstration the test results of research influence of temperature on the velocity of flame propagation using gas and air mixtures for selected gas mixtures. The research was conducted on the test apparatus in the form of duct 2 m long. The test apparatus was funded from the project: “Development of methods to neutralize threats of explosion for determined tanks contained technical gases, including alternative sources of supply in the fire environment, taking into account needs of rescuers” number: DOB-BIO6/02/50/2014. The Project is funded by The National Centre for Research and Development. This paper presents the results of measurement of rate of pressure rise and rate in flame propagation, using test apparatus for mixtures air and methane or air and propane. This paper presents the results performed using the test apparatus in the form of duct measuring the rate of flame and overpressure wave. Studies were performed using three gas mixtures with different concentrations: Methane (3% to 8% vol), Propane (3% to 6% vol). As regard to the above concentrations, tests were carried out at temperatures 20 and 30 ̊C. The gas mixture was supplied to the inside of the duct by the partial pressure molecules. Data acquisition was made using 5 dynamic pressure transducers and 5 ionization probes, arranged along of the duct. Temperature conditions changes were performed using heater which was mounted on the duct’s bottom. During the tests, following parameters were recorded: maximum explosion pressure, maximum pressure recorded by sensors and voltage recorded by ionization probes. Performed tests, for flammable gas and air mixtures, indicate that temperature changes have an influence on overpressure velocity. It should be noted, that temperature changes do not have a major impact on the flame front velocity. In the case of propane and air mixtures (temperature 30 ̊C) was observed DDT (Deflagration to Detonation) phenomena. The velocity increased from 2 to 20 m/s. This kind of explosion could turn into a detonation, but the duct length is too short (2 m).

Keywords: flame propagation, flame propagation velocity, explosion, propane, methane

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Authors: Shivani Kuttuva, Bridget Fergie, Andrew Mishreki, Shovkat Mir, Fintan Bergin

Abstract:

Diaphragm disease (DD) of the small bowel is a condition wherein the bowel lumen is divided into a series of short compartments by multiple circumferential membranes of mucosa and submucosa, leading to pinhole lumen and subsequent obstruction. It is a rare condition commonly attributed to non-steroidal anti-inflammatory drugs (NSAIDs) usage. Herein we present a 31-yr-old-female with a history of NSAIDs usage for one year following neurosurgery, who presented with recurrent idiopathic small bowel obstruction, recalcitrant anaemia, and impaction of capsule endoscope on investigating for anaemia. The capsule endoscopy images demonstrated multiple circumferential strictures with ulcers at its tip and villous atrophy in the proximal bowel, suggestive of NSAIDs related damage. However, due to the lack of awareness of the detrimental effects of NSAIDs on bowel mucosa distal to the duodenum, the underlying aetiology of this clinical presentation remained a mystery for a significant duration. The patient had to undergo repeated laparotomies in order to relieve the symptoms of recurring acute small bowel obstruction. Upon examining the resected specimen under microscopy, the histopathological hallmark of expanded, fibrotic, and congested submucosa was picked up, leading to the confirmation of diaphragm disease. Thus, this case report aims to widen the awareness among clinicians and aid surgeons in devising a management plan for young individuals presenting with recurring episodes of obstruction due to Diaphragm disease.

Keywords: capsule endoscopy, diaphragm disease, NSAIDs, recurrent small bowel obstruction

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Authors: Christine Ysabelle G. Roman, Pauline Torres

Abstract:

Background: Hypertrophic cardiomyopathy is a disease of marked heterogeneity. It is a genetically determined heart disease characterized by significant myocardium hypertrophy that results in diastolic dysfunction, left ventricular outflow tract obstruction, and an increased risk of arrhythmias. The primary treatment in patients with such conditions is negative inotropic drugs, such as beta-blockers, calcium channel antagonists, and disopyramide. However, for those who remain symptomatic and need septal reduction therapy, surgical septal myectomy or alcohol septal ablation are options. Case Summary: A 19 – year old female presented in the authors’ institution with easy fatigability. The consult was done a year prior, and 2D echocardiography was requested which showed concentric left ventricular hypertrophy, asymmetrically hypertrophied interventricular septum (IVS) with the largest diameter of 3.3cm & subaortic dynamic obstruction with a maximum gradient of 47 mmHg. A repeat echo a year later showed asymmetric septal hypertrophy (IVS measuring at 3cm) with the systolic anterior motion of anterior mitral valve leaflet and left ventricular outflow tract obstruction (peak gradient of 50mmHg). The patient then underwent alcohol septal ablation and was discharged stable after four days of admission. Conclusion: Hypertrophic obstructive cardiomyopathy, a cardiovascular genetic disease, results in various patterns of left ventricular hypertrophy and abnormality of mitral valve apparatus. The patient is managed medically initially. However, despite optimal drug therapy and significant left ventricular outflow tract obstruction, significant heart failure symptoms or syncope require invasive treatment.

Keywords: hypertrophic obstructive cardiomyopathy, left ventricular outflow tract obstruction, alcohol septal ablation, alcohol

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