Search results for: orthopaedic in-training examination
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1692

Search results for: orthopaedic in-training examination

1662 Establishment of Virtual Fracture Clinic in Princess Royal Hospital Telford: Experience and Recommendations during the First 9 Months

Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed

Abstract:

Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19

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1661 Studies on Some Aspects of Sub Clinical Mastitis in Cattle

Authors: Kavita Jaidiya, Anju Chahar, Chitra Jaidiya

Abstract:

The present study was conducted on 200 quarters from 50 apparently healthy cows. Samples are subjected to California Mastitis Test (CMT), cultural examination, and mPCR. Milk samples were also subjected to changes in composition Viz. fat, protein, and lactose. The prevalence of subclinical mastitis based on culture examination was 30(60/200), 36 (72/200), and 40 percent (93/200) based on CMT, culture examination, and mPCR on a quarterly basis. The prevalence of subclinical mastitis on animal basis was 40 (20/50), 46 (23/50), and 52 percent (26/50) based on CMT, Culture examination, and mPCR. The highest prevalence was observed in IVth parity on a quarterly basis and in Vth parity on cow basis. On culture examination, Staphylococcus aureus was the most prevalent organism (50.56%), followed by Streptococcus dysaglactiae (11.33%), E. coli (7.8 %), Staphylococcus agalactiae (13.48 %), Staphylococcus epidermidis (2.2 %), Streptococcus hyicus (6.94%), Streptococcus uberis (5.16%), Klebsiella pneumonia (6.74%). On isolation by bacterial mPCR, Staphylococcus spp. (42%) was the major pathogen. Organisms isolated in mixed infections are Streptococcus spp., Klebsiella pneumonia, E.coli and Pseudomonas aeruginous. The average mean value of fat, protein, and lactose content in subclinically affected milk samples were 3.40 ± 0.101, 3.009 ± 0.033, and 4.48 ± 0.03, and the mean value of fat, protein, and lactose content in normal milk were 4.13 ± 0.035, 3.39 ± 0.021, and 5.10 ± 0.016. The mean blood level of reduced glutathione in subclinical mastitis (30.44 ± 1.87 ng/ml) was lower than healthy cows (47.98 ± 4.04ng/ml). The concentration of malondialdehyde (10.026 ± 0.21mmol/L) in subclinical mastitis was significantly higher as compared to healthy group cows (2.19 ± 0.23mmol/L).

Keywords: cow, subclinical mastitis, mPCR, California Mastitis test

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1660 The Differences between Direct Examination and ELISA Test during the Diagnosis of Fasciolosis in Jaundiced Slaughtered Sheep in Iraq

Authors: Azad A. Meerkhan, Alaa Hani Razak, Bayan M. S. Younis

Abstract:

The efficiency of enzyme-linked immunosorbent assay (ELISA) in sheep infected with Fasciola hepatica was studied. 232 jaundiced sheep among 5208 sheep slaughter in the Duhok abattoir (regardless of the age and gender) between the period of May. 2012 to Oct. 2012 were examined by direct examination (Searching of adult flukes in the bile duct) and by Enzyme-linked immunosorbent assay (ELISA) to detect the prevalence of fascioliasis in the studied population which showed a high observed infection ratio in Sep. 2012 (12.2%) with the high (ELISA) result of infection in May. 2012 (25.36%). Significant differences were found between the two ways in all of the months with the highest difference in May. 2012 and the net deference between the both ways was 6.91%.

Keywords: fascioliasis, Fasciola hepatica, layers, liver fluk, ELISA, direct examination

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1659 Using Multi-Level Analysis to Identify Future Trends in Small Device Digital Communication Examinations

Authors: Mark A. Spooner

Abstract:

The growth of technological advances in the digital communications industry has dictated the way forensic examination laboratories receive, analyze, and report on digital evidence. This study looks at the trends in a medium sized digital forensics lab that examines small communications devices (i.e., cellular telephones, tablets, thumb drives, etc.) over the past five years. As law enforcement and homeland security organizations budgets shrink, many agencies are being asked to perform more examinations with less resources available. Using multi-level statistical analysis using five years of examination data, this research shows the increasing technological demand trend. The research then extrapolates the current data into the model created and finds a continued exponential growth curve of said demands is well within the parameters defined earlier on in the research.

Keywords: digital forensics, forensic examination, small device, trends

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1658 Sensitivity and Specificity of Clinical Testing for Digital Nerve Injury

Authors: Guy Rubin, Ravit Shay, Nimrod Rozen

Abstract:

The accuracy of a diagnostic test used to classify a patient as having disease or being disease-free is a valuable piece of information to be used by the physician when making treatment decisions. Finger laceration, suspected to have nerve injury is a challenging decision for the treating surgeon. The purpose of this study was to evaluate the sensitivity, specificity and predictive values of six clinical tests in the diagnosis of digital nerve injury. The six clinical tests included light touch, pin prick, static and dynamic 2-point discrimination, Semmes Weinstein monofilament and wrinkle test. Data comparing pre-surgery examination with post-surgery results of 42 patients with 52 digital nerve injury was evaluated. The subjective examinations, light touch, pin prick, static and dynamic 2-point discrimination and Semmes-Weinstein monofilament were not sensitive (57.6, 69.7, 42.4, 40 and 66.8% respectively) and specific (36.8, 36.8, 47.4, 42.1 and 31.6% respectively). Wrinkle test, the only objective examination, was the most sensitive (78.1%) and specific (55.6%). This result gives no pre-operative examination the ability to predict the result of explorative surgery.

Keywords: digital nerve, injury, nerve examination, Semmes-Weinstein monofilamen, sensitivity, specificity, two point discrimination, wrinkle test

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1657 Prostatic Cyst in Suprapubic Ultrasound Examination

Authors: Angelis P. Barlampas, Ghita Bianca-Andreea

Abstract:

A case of a prostatic midline cyst is presented, which was found during a routine general ultrasound examination in an otherwise healthy young man. The incidence of prostatic cysts discovered in suprapubic ultrasound examination has constantly been rising over the previous decades. Despite the fact that the majority of them are benign, a significant amount is related to symptoms, such as pain, dysuria, infertility, and even cancer. The wide use of ultrasound examination and the increasing availability of high-resolution ultrasound systems have rendered new diagnostic challenges. Once upon a time a suprapubic ultrasound was only useful for measuring only the size and the dimensions of the prostatic gland. It did not have the ability to analyze and resolve structures such as cystic or solid nodules. The current machine equipment has managed to depict the imaging characteristics of lesions with high acuity that compares of an intrarectal ultrasound. But the last one is a specialized examination, which demands expertise and good knowledge. Maybe the time has come for the general radiologist and, especially the one who uses suprapubic ultrasound, to pay more attention to the examination of the prostate gland and to take advantage of the superb abilities and the high resolution of the new ultrasound systems. That is exactly, what this case is emphasizing. The incidental discovery of prostatic cysts, and the relatively little available literature about managing them turns them into an interesting theme for exploring and studying. The prostatic cysts are further divided into midline and paramidline cysts, with the first being usually utricle cysts. A more precise categorization is as follows: A midline cystic lesion usually regards a Mullerian duct cyst, a prostatic utricle cyst, an ejaculatory duct cyst, a prostatic cystadenoma, a ductus deferens cyst, and a TURP. On the other hand, a lateral cystic lesion usually refers to a cystic degeneration of benign prostatic hyperplasia, a prostatic retention cyst, a seminal vesicle cyst, diverticular prostatitis, a prostatic abscess, cavitatory prostatitis from chronic prostatitis, a parasitic prostatic cyst, a cystic prostatic carcinoma, e.t.c.

Keywords: prostatic cyst, radiology, benign prostatic lesions, prostatic cancer, suprapubic prostatic ultrasound

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1656 Retrospective Audit of Antibiotic Prophylaxis in Spinal Patient at Mater Private Network Cork 2019 vs 2021

Authors: Ciaran Smiddy, Fergus Nugent, Karen Fitzmaurice

Abstract:

A measure of prescribing and administration of Antimicrobial Prophylaxis before and during Covid-19(2019 vs. 2021) was desired to assess how these were affected by Covid-19. Antimicrobial Prophylaxis was assessed for 60 patients, under 3 Orthopaedic Consultants, against local guidelines. The study found that compliance with guidelines improved significantly, from 60% to 83%, but Appropriate use of Vancomycin reduced from 37% to 29%.

Keywords: antimicrobial stewardship, prescribing, spinal surgery, vancomycin

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1655 Service Evaluation of Consent for Hand and Wrist Surgery and Formulation of Evidence-Based Guidelines

Authors: Parsa Keyvani, Alistair Phillips, David Warwick

Abstract:

Background: The current process for gaining patient consent for hand and wrist surgery at University Hospital Southampton (UHS) is paper-based and makes use of generic forms provided by the NHS and no patient information leaflet is available relating to hand and wrist surgery. Aims: To evaluate the process of obtaining clinical consent and suggest ways in which the service can be improved. Methods: A log-book review of four orthopaedic surgeons at UHS was carried out over a three-month period in order to identify the 10 most common types of elective hand and wrist surgeries performed. A literature review was carried out to identify the complications of these surgeries. The surgeries were then divided into 6 types: nerve, bone, ligament, joint, tendon and dupuytren’s surgery. A digitised consent form was created covering the complications of all 6 surgery types. Finally, the surgeons at the orthopaedic department of UHS were asked whether they prefer the old paper-based or the digitised consent form. Results: All of the surgeons felt that the procedure type-based form was easier to read, use and understand. Conclusion: This research highlights a number of problems related to the use of current NHS consent forms. The proposed solution is to use a set of digitised, procedure type-based consent forms. Digital consent forms can be filled in in advance and sent to the patient electronically along with any relevant information leaflets, thus giving them time to absorb the information and come up with any questions before they have their pre-procedure discussion with their doctor. This would allow the doctor to focus the consultation on the patient rather than writing out the consent form and would ultimately be a step forward in making the NHS a global digital leader and fully embrace the opportunity offered by technology.

Keywords: digitised consent form, elective surgery, hand surgery complications, informed consent, procedure type-based consent form

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1654 Quantitative Texture Analysis of Shoulder Sonography for Rotator Cuff Lesion Classification

Authors: Chung-Ming Lo, Chung-Chien Lee

Abstract:

In many countries, the lifetime prevalence of shoulder pain is up to 70%. In America, the health care system spends 7 billion per year about the healthy issues of shoulder pain. With respect to the origin, up to 70% of shoulder pain is attributed to rotator cuff lesions This study proposed a computer-aided diagnosis (CAD) system to assist radiologists classifying rotator cuff lesions with less operator dependence. Quantitative features were extracted from the shoulder ultrasound images acquired using an ALOKA alpha-6 US scanner (Hitachi-Aloka Medical, Tokyo, Japan) with linear array probe (scan width: 36mm) ranging from 5 to 13 MHz. During examination, the postures of the examined patients are standard sitting position and are followed by the regular routine. After acquisition, the shoulder US images were drawn out from the scanner and stored as 8-bit images with pixel value ranging from 0 to 255. Upon the sonographic appearance, the boundary of each lesion was delineated by a physician to indicate the specific pattern for analysis. The three lesion categories for classification were composed of 20 cases of tendon inflammation, 18 cases of calcific tendonitis, and 18 cases of supraspinatus tear. For each lesion, second-order statistics were quantified in the feature extraction. The second-order statistics were the texture features describing the correlations between adjacent pixels in a lesion. Because echogenicity patterns were expressed via grey-scale. The grey-scale co-occurrence matrixes with four angles of adjacent pixels were used. The texture metrics included the mean and standard deviation of energy, entropy, correlation, inverse different moment, inertia, cluster shade, cluster prominence, and Haralick correlation. Then, the quantitative features were combined in a multinomial logistic regression classifier to generate a prediction model of rotator cuff lesions. Multinomial logistic regression classifier is widely used in the classification of more than two categories such as the three lesion types used in this study. In the classifier, backward elimination was used to select a feature subset which is the most relevant. They were selected from the trained classifier with the lowest error rate. Leave-one-out cross-validation was used to evaluate the performance of the classifier. Each case was left out of the total cases and used to test the trained result by the remaining cases. According to the physician’s assessment, the performance of the proposed CAD system was shown by the accuracy. As a result, the proposed system achieved an accuracy of 86%. A CAD system based on the statistical texture features to interpret echogenicity values in shoulder musculoskeletal ultrasound was established to generate a prediction model for rotator cuff lesions. Clinically, it is difficult to distinguish some kinds of rotator cuff lesions, especially partial-thickness tear of rotator cuff. The shoulder orthopaedic surgeon and musculoskeletal radiologist reported greater diagnostic test accuracy than general radiologist or ultrasonographers based on the available literature. Consequently, the proposed CAD system which was developed according to the experiment of the shoulder orthopaedic surgeon can provide reliable suggestions to general radiologists or ultrasonographers. More quantitative features related to the specific patterns of different lesion types would be investigated in the further study to improve the prediction.

Keywords: shoulder ultrasound, rotator cuff lesions, texture, computer-aided diagnosis

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1653 An Investigation of Item Bias in Free Boarding and Scholarship Examination in Turkey

Authors: Yeşim Özer Özkan, Fatma Büşra Fincan

Abstract:

Biased sample is a regression of an observation, design process and all of the specifications lead to tendency of a side or the situation of leaving from the objectivity. It is expected that, test items are answered by the students who come from different social groups and the same ability not to be different from each other. The importance of the expectation increases especially during student selection and placement examinations. For example, all of the test items should not be beneficial for just a male or female group. The aim of the research is an investigation of item bias whether or not the exam included in 2014 free boarding and scholarship examination in terms of gender variable. Data which belong to 5th, 6th, and 7th grade the secondary education students were obtained by the General Directorate of Measurement, Evaluation and Examination Services in Turkey. 20% students were selected randomly within 192090 students. Based on 38418 students’ exam paper were examined for determination item bias. Winsteps 3.8.1 package program was used to determine bias in analysis of data, according to Rasch Model in respect to gender variable. Mathematics items tests were examined in terms of gender bias. Firstly, confirmatory factor analysis was applied twenty-five math questions. After that, NFI, TLI, CFI, IFI, RFI, GFI, RMSEA, and SRMR were examined in order to be validity and values of goodness of fit. Modification index values of confirmatory factor analysis were examined and then some of the items were omitted because these items gave an error in terms of model conformity and conceptual. The analysis shows that in 2014 free boarding and scholarship examination exam does not include bias. This is an indication of the gender of the examination to be made in favor of or against different groups of students.

Keywords: gender, item bias, placement test, Rasch model

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1652 Smartphone Based Wound Assessment System for Diabetes Patients

Authors: Vaibhav V. Dixit, Shubham Ajay Karwa

Abstract:

Diabetic foot ulcers speak to a critical medical problem. Right now, clinicians and medical caretakers primarily construct their injury evaluation in light of visual examination of wound size and mending status, while the patients themselves rarely have a chance to play a dynamic part. Henceforth, love quantitative and practical examination technique that empowers the patients and their parental figures to take a more dynamic part in every day wound care possibly can quicken wound recuperating, spare travel cost and diminish human services costs. Considering the commonness of cell phones with a high-determination computerized camera, evaluating wounds by breaking down pictures of ceaseless foot ulcers is an alluring choice. In this paper, we propose a novel injury picture examination framework actualized using feature extraction and color segmentation. Here we are using the Normalized minimum distance classifier for classifying the output.

Keywords: diabetic, Gabor wavelet, normalized minimum distance classifier, quantiable parameters

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1651 The Relationship between Class Attendance and Performance of Industrial Engineering Students Enrolled for a Statistics Subject at the University of Technology

Authors: Tshaudi Motsima

Abstract:

Class attendance is key at all levels of education. At tertiary level many students develop a tendency of not attending all classes without being aware of the repercussions of not attending all classes. It is important for all students to attend all classes as they can receive first-hand information and they can benefit more. The student who attends classes is likely to perform better academically than the student who does not. The aim of this paper is to assess the relationship between class attendance and academic performance of industrial engineering students. The data for this study were collected through the attendance register of students and the other data were accessed from the Integrated Tertiary Software and the Higher Education Data Analyzer Portal. Data analysis was conducted on a sample of 93 students. The results revealed that students with medium predicate scores (OR = 3.8; p = 0.027) and students with low predicate scores (OR = 21.4, p < 0.001) were significantly likely to attend less than 80% of the classes as compared to students with high predicate scores. Students with examination performance of less than 50% were likely to attend less than 80% of classes than students with examination performance of 50% and above, but the differences were not statistically significant (OR = 1.3; p = 0.750).

Keywords: class attendance, examination performance, final outcome, logistic regression

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1650 Examining Criminology via Diverse Philosophical Paradigms: Considering the Nomological-Deductive Model of Science versus the Humanistic Tradition

Authors: William R. Crawley

Abstract:

The current paper provides an examination of the primary conceptual and historical foundations leading to contemporary perspectives in criminological theory. This subject area involves the examination of theory that is vast and highly interdisciplinary but must, at its core, consider several postulates. The following areas of consideration will be the focus of this examination: presentation of various definitions of criminology as a discipline and attention to a dialogue which inquires as to whether criminological modes of explanation can be regarded as scientific with respect to focus, methods, and findings – e.g., conceptualization, operationalization, measurement strategies, analytical techniques, etc. Specifically, two opposing philosophical frameworks—naturalistic and anti-naturalistic philosophy—are examined by means of conceptual analysis for their necessary and sufficient conditions. Like all academic disciplines, for practitioners and students of criminology to understand and effectively use insights and discoveries, it is imperative that disciplinary axioms and methodologies are critically scrutinized. This paper provides a primer to this critique.

Keywords: anti-naturalistic philosophy, humanistic tradition, is criminology a science, naturalistic philosophy, nomological-deductive model

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1649 Restoration of Railway Turnout Frog with FCAW

Authors: D. Sergejevs, A. Tipainis, P. Gavrilovs

Abstract:

Railway turnout frogs restored with MMA often have such defects as infusions, pores, a.o., which under the influence of dynamic forces cause premature destruction of the restored surfaces. To prolong the operational time of turnout frog, i.e. operational time of the restored surface, turnout frog was restored using FCAW and afterwards matallographic examination was performed. Experimental study revealed that railway turnout frog restored with FCAW had better quality than elements restored with MMA, furthermore it provided considerable time economy.

Keywords: elements of railway turnout, FCAW, metallographic examination, quality of build-up welding

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1648 Microscopic Examination of the Pre-Hatching Development of the Chicken Ovary

Authors: Mohamed Alsafy, Samir El-Gendy, Ashraf Karkoura, Doha Shokry

Abstract:

The purpose of the current study was to investigate the development of the chicken ovary. One hundred fertilized egg of Alexandria breed of chicken used. The whole embryo has undergone the light microscopic examination at HH20 (E.3), HH21 (E.3.5), HH23 (E.4), HH29 (E.6) and HH34 (E.8). The ovary has undergone the light microscopic examination at HH38 (E.12) and HH42 (E.16), SEM at HH26 (E.5), HH29 (E.6), HH36 (E.10), HH38 (E.12), HH39 (E.13) and HH42 (E.16), TEM at HH38 (E.12) and HH42 (E.16). The genital ridge appeared by a thickening of the coelomic epithelium medioventral surface of the developing mesonephroi at HH20 (E.3). The boundaries of the undifferentiating gonads defined clearly separated from the mesonephroi. The undifferentiated gonads bulged as a distinct organ in the coelomic cavity at HH23 (E.4). At the initial stages of the gonadogenesis, the germinal epithelium was stratified squamous epithelium. The PGCs appeared at the genital ridge at HH21 (E.3.5). The PGCs observed at the dorsal mesentery with few microvilli and showed positive PAS reaction due to the glycogen content in their cytoplasm. The left-right gonadal asymmetry firstly detected by the number of PGCs migrating toward the left gonadal ridge more than the right at HH20 (E.3) and the macroscopic examination of gonadal asymmetry began at HH34 (E.8). The left ovary appeared a smooth rod-shape, its stroma showed lipid droplets, and its parenchyma showed an extensive arrangement of interstitial cords at HH42 (E.16).

Keywords: ovary, Alexandria chicken, light microscopy, SEM, TEM

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1647 Association of Ankle Brachial Index with Diabetic Score Neuropathy Examination in Type 2 Diabetes Melitus Patients

Authors: A. K. Putri, A.Fitri, C. A. Batubara

Abstract:

Diabetes Mellitus (DM) is a chronic disease that could cause complications. The complication can be Peripheral Arterial Disease (PAD) or Diabetic Neuropathy (DN). Peripheral Arterial Disease is checked by Ankle Brachial Index (ABI), DN is checked by Diabetic Neuropathy Examination (DNE) score. To determine the association of ABI and DNE score in DM type 2. This study uses a cross-sectional design. The subjects were DM patients at the neurology and endocrinology polyclinic at Haji Adam Malik Hospital Medan and its network hospital and this study subjects were examined for ABI and DNE scores. The data were analysed using the Fisher Exact statistics test. Demographics characteristic showed most of subject are female (51,6%), age range ≥ 60 (45.2% ; average 57,6 ± 9,8 years ), and history of DM 5-10 years (45,2%). The most patient ABI characteristics were mild PAD (42%) and moderate PAD (29%). The most patient DNE Score characteristics were≥ 3 (51,6%). There’s a significant relationship between ABI and DNE score in DM type 2 (p =0.016). Conclusion: There is a significant association between ABI and DNE scores in DM type 2 patients

Keywords: diabetic neuropathy, diabetes mellitus, ankle-brachial index, diabetic neuropathy examination

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1646 Automated Video Surveillance System for Detection of Suspicious Activities during Academic Offline Examination

Authors: G. Sandhya Devi, G. Suvarna Kumar, S. Chandini

Abstract:

This research work aims to develop a system that will analyze and identify students who indulge in malpractices/suspicious activities during the course of an academic offline examination. Automated Video Surveillance provides an optimal solution which helps in monitoring the students and identifying the malpractice event immediately. This work is organized into three modules. The first module deals with performing an impersonation check using a PCA-based face recognition method which is done by cross checking his profile with the database. The presence or absence of the student is even determined in this module by implementing an image registration technique wherein a grid is formed by considering all the images registered using the frontal camera at the determined positions. Second, detecting such facial malpractices in which a student gets involved in conversation with another, trying to obtain unauthorized information etc., based on the threshold range evaluated by considering his/her mouth state whether open or closed. The third module deals with identification of unauthorized material or gadgets used in the examination hall by training the positive samples of the object through various stages. Here, a top view camera feed is analyzed to detect the suspicious activities. The system automatically alerts the administration when any suspicious activities are identified, thereby reducing the error rate caused due to manual monitoring. This work is an improvement over our previous work published in identifying suspicious activities done by examinees in an offline examination.

Keywords: impersonation, image registration, incrimination, object detection, threshold evaluation

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1645 Dizziness in the Emergency: A 1 Year Prospective Study

Authors: Nouini Adrâa

Abstract:

Background: The management of dizziness and vertigo can be challenging in the emergency department (ED). It is important to rapidly diagnose vertebrobasilar stroke (VBS), as therapeutic options such as thrombolysis and anticoagulation require prompt decisions. Objective: This study aims to assess the rate of misdiagnosis in patients with dizziness caused by VBS in the ED. Methods and Results: The cohort was comprised of 82 patients with a mean age of 55 years; 51% were women and 49% were men. Among dizzy patients, 15% had VBS. We used Cohen’s kappa test to quantify the agreement between two raters – namely, emergency physicians and neurologists – regarding the causes of dizziness in the ED. The agreement between emergency physicians and neurologists is low for the final diagnosis of central vertigo disorders and moderate for the final diagnosis of VBS. The sensitivity of ED clinal examination for benign conditions such as BPPV was low at 56%. The positive predictive value of the ED clinical examination for VBS was also low at 50%. Conclusion: There is a substantial rate of misdiagnosis in patients with dizziness caused by VBS in the ED. To reduce the number of missing diagnoses of VBS in the future, there is a need to train emergency physicians in neuro vestibular examinations, including the HINTS examination for acute vestibular syndrome (AVS) and the Dix-Hallpike (DH) maneuver for episodic vestibular syndrome. Using video head impulse tests could help reduce the rate of misdiagnosis of VBS in the ED.

Keywords: dizziness, vertigo, vestibular disease, emergency

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1644 Infrared Thermography Applications for Building Investigation

Authors: Hamid Yazdani, Raheleh Akbar

Abstract:

Infrared thermography is a modern non-destructive measuring method for the examination of redeveloped and non-renovated buildings. Infrared cameras provide a means for temperature measurement in building constructions from the inside, as well as from the outside. Thus, heat bridges can be detected. It has been shown that infrared thermography is applicable for insulation inspection, identifying air leakage and heat losses sources, finding the exact position of heating tubes or for discovering the reasons why mold, moisture is growing in a particular area, and it is also used in conservation field to detect hidden characteristics, degradations of building structures. The paper gives a brief description of the theoretical background of infrared thermography.

Keywords: infrared thermography, examination of buildings, emissivity, heat losses sources

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1643 Sudden Death of a Cocaine Body Packer: An Autopsy Examination Findings

Authors: Parthasarathi Pramanik

Abstract:

Body packing is a way of transfer drugs across the international border or any drug prohibited area. The drugs are usually hidden in body packets inside the anatomical body cavities like mouth, intestines, rectum, ear, vagina etc. Cocaine is a very common drug for body packing across the world. A 48 year old male was reported dead in his hotel after complaining of chest pain and vomiting. At autopsy, there were eighty-two white cylindrical body packs in the stomach, small and large intestines. Seals of few of the packets were opened. Toxicological examination revealed presence of cocaine in the stomach, liver, kidney and hair samples. Microscopically, presence of myocardial necrosis with interstitial oedema along with hypertrophy and fibrosis of the myocardial fibre suggested heart failure due to cocaine cardio toxicity. However, focal lymphocyte infiltration and perivascular fibrosis in the myocardium also indicated chronic cocaine toxicity of the deceased. After careful autopsy examination it was considered the victim was died due congestive heart failure secondary to acute and chronic cocaine poisoning.

Keywords: cardiac failure, cocaine, body packer, sudden death

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1642 Assessment of Exposure Dose Rate from Scattered X-Radiation during Diagnostic Examination in Nigerian University Teaching Hospital

Authors: Martins Gbenga., Orosun M. M., Olowookere C. J., Bamidele Lateef

Abstract:

Radiation exposures from diagnostic medical examinations are almost always justified by the benefits of accurate diagnosis of possible disease conditions. The aim is to assess the influence of selected exposure parameters on scattered dose rates. The research was carried out using Gamma Scout software installation on the Computer system (Laptop) to record the radiation counts, pulse rate, and dose rate for 136 patients. Seventy-three patients participated in the male category with 53.7%, while 63 females participated with 46.3%. The mean and standard deviation value for each parameter is recorded, and tube potential is within 69.50±11.75 ranges between 52.00 and 100.00, tube current is within 23.20±17.55 ranges between 4.00 and 100.00, focus skin distance is within 73.195±33.99 and ranges between 52.00 and 100.00. Dose Rate (DRate in µSv/hr) is significant at an interval of 0.582 and 0.587 for tube potential and body thickness (cm). Tube potential is significant at an interval of 0.582 and 0.842 of DRate (µSv/hr) and body thickness (cm). The study was compared with other studies. The exposure parameters selected during each examination contributed to scattered radiation. A quality assurance program (QAP) is advised for the center.

Keywords: x-radiation, exposure rate, dose rate, tube potentials, scattered radiation, diagnostic examination

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1641 Factors Affecting Students' Performance in the Examination

Authors: Amylyn F. Labasano

Abstract:

A significant number of empirical studies are carried out to investigate factors affecting college students’ performance in the academic examination. With a wide-array of literature-and studies-supported findings, this study is limited only on the students’ probability of passing periodical exams which is associated with students’ gender, absences in the class, use of reference book, and hours of study. Binary logistic regression was the technique used in the analysis. The research is based on the students’ record and data collected through survey. The result reveals that gender, use of reference book and hours of study are significant predictors of passing an examination while students’ absenteeism is an insignificant predictor. Females have 45% likelihood of passing the exam than their male classmates. Students who use and read their reference book are 38 times more likely pass the exam than those who do not use and read their reference book. Those who spent more than 3 hours in studying are four (4) times more likely pass the exam than those who spent only 3 hours or less in studying.

Keywords: absences, binary logistic regression, gender, hours of study prediction-causation method, periodical exams, random sampling, reference book

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1640 Forensic Methods Used for the Verification of the Authenticity of Prints

Authors: Olivia Rybak-Karkosz

Abstract:

This paper aims to present the results of scientific research on methods of forging art prints and their elements, such as signature or provenance and forensic science methods that might be used to verify their authenticity. In the last decades, the art market has observed significant interest in purchasing prints. They are considered an economical alternative to paintings and a considerable investment. However, the authenticity of an art print is difficult to establish as similar visual effects might be achieved with drawings or xerox. The latter is easy to make using a home printer. They are then offered on flea markets or internet auctions as genuine prints. This probable ease of forgery and, at the same time, the difficulty of distinguishing art print techniques were the main reasons why this research was undertaken. A lack of scientific methods dedicated to disclosing a forgery encouraged the author to verify the possibility of using forensic science's methods known and used in other fields of expertise. This research methodology consisted of completing representative forgery samples collected in selected museums based in Poland and a few in Germany and Austria. That allowed the author to present a typology of methods used to forge art prints. Given that one of the most famous graphic design examples is bills and securities, it seems only appropriate to propose in print verification the usage of methods of detecting counterfeit currency. These methods contain an examination of ink, paper, and watermarks. On prints, additionally, signatures and imprints of stamps, etc., are forged as well. So the examination should be completed with handwriting examination and forensic sphragistics. The paper contains a stipulation to conduct a complex analysis of authenticity with the participation of an art restorer, art historian, and forensic expert as head of this team.

Keywords: art forgery, examination of an artwork, handwriting analysis, prints

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1639 A Case of Apocrine Sweat Gland Adenocarcinoma in a Tabby Cat

Authors: Funda Terzi, Elif Dogan, Ayse B. Kapcak

Abstract:

In this report, clinical, radiological, macroscopic, and histopathological findings of apocrine sweat gland adenocarcinoma are presented in a 13-year-old male tabby cat. In clinical examination, soft tissue masses were detected in the caudal abdomen and left tuber coxae. On radiological examination, subcutaneous masses with soft tissue contrast appearance were detected, and the masses were surgically removed under general anesthesia. The sizes of the masses were approximately 2x2x3 cm in the caudal abdomen and approximately 1x1x2 cm in the tuber coxae region. The cross-section of the mass was whitish-yellow in color. After the masses were fixed in 10% formaldehyde solution, a routine histopathology procedure was applied. In histopathological examination, apocrine sweat glands in a cystic structure and extensions from the center of the cyst to the lumen were determined, and anisonucleosis, anisocytosis, and anaplastic cells with giant nuclei were observed in the epithelial cells of the gland facing the lumen. A diagnosis of papillary-cystic type apocrine sweat gland adenocarcinoma was made with these findings.

Keywords: apocrine sweat gland, carcinoma, cat, histopathology

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1638 Factors Affecting the Readiness in the License Examination Testing of Nursing Students

Authors: Suwannee Sroisong, Angkhana Ruenkon, Ronnaphop Eimtab

Abstract:

The purpose of this study was twofold: First, to examine the relationship of the Readiness on the License Examination Testing (RLET) with factors namely achieved motivation, attitude on testing, self-perception, perception in testing among the nursing students at Baromarajonani College of Nursing, Buddhachinaraj, Thailand (BCNB); and secondly, to investigate the factors affecting the RLET of the nursing students. All data were collected from a set of 214 questionnaires of nursing students, second semester and in academic year 2010, at BCNB. As a set of variables in the questionnaire, it consisted of factors of readiness in testing, achieved motivation, attitude on testing, self-perception, and perception in testing. The following statistics were analyzed: frequency, percentage, means, standard deviation, and Stepwise-multiple regression correlation. Research results were as follows: 1) For the relationship among following factors, namely achieved motivation, attitude on testing, self-perception, perception in testing, there were positive correlation coefficients between .324 to .560 at the .05 level of significance; and 2) One crucial factor affecting the RLET of nursing students, namely achieved motivation, was found. The achieved motivation factor could explain the variance or predict the RLET of nursing students at 31.40 percent and at the .05 level of significance.

Keywords: readiness, nursing, license examination testing, Thailand

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1637 Effect of Povidone Iodine in Treatment of Epidemic Keratoconjunctivitis: Clinical Trail Study

Authors: Mohammad Hossain Validad

Abstract:

Background and Aim: Epidemic keratoconjunctivitis is a type of conjunctivitis caused by adenoviruses that can spread rapidly through direct and indirect contact. The aim of this study was to evaluate the therapeutic effects of Povidone-Iodine 0.4% and 0.2% in improving the symptoms and signs of patients with epidemic keratoconjunctivitis. Materials and Methods: In this clinical trial study, 60 patients with a mean age of 27.8±8.4 years who were eligible for inclusion criteria were randomly divided into three groups. The first group received eye drops of Povidone-Iodine 0.4% and betamethasone 0.1%, the second group received PovidoneIodine 0.2% and betamethasone 0.1% and the third group received betamethasone 0.1%. Follow-ups were on the first, fourth, seventh and tenth days after starting treatment. Parameters examined at each examination were hyperaemia, mucopurulent discharge, eyelid edema, hemorrhage, and subepithelial infiltration. Results: The results showed that mucopurulent discharge on the fourth day of the examination (P = 0.005) and the seventh day of the examination (P = 0.001) were significantly different in the three treatment groups. Sub-epithelial infiltration on the tenth day after treatment did not show a significant difference in the 3 groups (P = 0.287). Conclusion: Based on the results of this study, Povidone-Iodine is more effective in relieving some of signs of EKC, such as reduced mucopurulent discharge than steroids alone.

Keywords: EKC, topical bethadine, adenovirus, sub epithelial opacity

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1636 Differential Diagnosis of an Asymptomatic Lesion in Contact with the Bladder

Authors: Angelis P. Barlampas

Abstract:

PURPOSE: Presentation of an interesting finding in an asymptomatic patient. MATERIAL: A patient came at hospital because of dysuric complaints and after a urologist’s prescription of a US exam of the urogenital system. The simple ultrasound examination of the lower abdomen revealed a moderate hypertrophy of the prostate and a solitary large bladder stone. The kidneys were normal. Then, the patient underwent a CT scan, which depicted the bladder stone and, as an incidental finding, a cystic lesion in contact with the upper anterior right surface of the bladder, with mural calcifications. METHOD: Abdominal ultrasound and abdominal computed tomography before and after intravenous contrast administration. RESULTS: The repeated US exam showed a cylindrical cystic lesion with a double wall and two mural hyperechoic foci, with partial posterior shadowing. Blood flow was not recognized on color doppler. The CT exam confirmed the cystic-like anechoic lesion, in the right iliac fossa, with the presence of two foci of mural calcifications. The differential diagnosis includes cases of enteric cyst, intestinal duplication cyst, chronic abscess, urachal cyst, Meckel's diverticulum, bladder diverticulum, old hematoma, thrombosed vascular aneurysm, diverticular abscess, etc. The patient refused surgical removal and is being monitored by ultrasound. CONCLUSIONS: The careful examination of the wider peri-abdominal area, especially during the routine ultrasound examination, can contribute to the identification of important asymptomatic findings. The radiologist must not be solely focused in a certain area of examination, even if the clinical doctor asks so, but should give attention to the neighboring areas, too.

Keywords: enteric cyst, US, CT, urogenital tract, miscellaneous findings

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1635 Ophthalmic Ultrasound in the Diagnosis of Retinoblastoma

Authors: Abdulrahman Algaeed

Abstract:

The Ophthalmic Ultrasound is the easiest method of early diagnosing Retinoblastoma after clinical examination. It can be done with ease without sedation. King Khaled Eye Specialist Hospital is a tertiary care center where Retinoblastoma patients are often seen and treated there. The first modality to rule out the disease is Ophthalmic Ultrasound. Classic Retinoblastoma is easily diagnosed by using the conventional 10MHz Ophthalmic Ultrasound probe in the regular clinic setup. Retinal lesion with multiple, very highly reflective surfaces within lesion typical of Calcium deposits. The use of Standardized A-scan is very useful where internal reflectivity is classified as very highly reflective. Color Doppler is extremely useful as well to show the blood flow within lesion/s. In conclusion: Ophthalmic Ultrasound should be the first tool to be used to diagnose Retinoblastoma after clinical examination. The accuracy of the Exam is very high.

Keywords: doppler, retinoblastoma, reflectivity, ultrasound

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1634 Measurement and Analysis of Radiation Doses to Radiosensitive Organs from CT Examination of the Cervical Spine Using Radiochromic Films and Monte Carlo Simulation Based Software

Authors: Khaled Soliman, Abdullah Alrushoud, Abdulrahman Alkhalifah, Raed Albathi, Salman Altymiat

Abstract:

Radiation dose received by patients undergoing Computed Tomography (CT) examination of the cervical spine was evaluated using Gafchromic XR-QA2 films and CT-EXPO software (ver. 2.3), in order to document our clinical dose values and to compare our results with other benchmarks reported in the current literature. Radiochromic films were recently used as practical dosimetry tool that provides dose profile information not available using the standard ionisation chamber routinely used in CT dosimetry. We have developed an in-house program to use the films in order to calculate the Entrance Dose Length Product (EDLP) in (mGy.cm) and to relate the EDLP to various organ doses calculated using the CT-EXPO software. We also calculated conversion factor in (mSv/mGy.cm) relating the EDLP to the effective dose (ED) from the examination using CT-EXPO software. Variability among different types of CT scanners and dose modulation methods are reported from at least three major CT brands available at our medical institution. Our work describes the dosimetry method and results are reported. The method can be used as in-vivo dosimetry method. But this work only reports results obtained from adult female anthropomorphic Phantom studies.

Keywords: CT dosimetry, gafchromic films, XR-QA2, CT-Expo software

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1633 Gingival Myiasis of Dog Caused by Wohlfahrtia magnifica, Garmsar, Iran

Authors: Keivan Jamshidi

Abstract:

Myiasis is defined as the infestation of living tissues of vertebrates by larvae of flies. Gingival myiasis is an uncommon type of myiasis. In oral inspection of a death dog (Garmsar, Iran) for routine training postmortem investigation, gingival myiasis was found. Only one larva was removed from the lesions and sent to a parasitology laboratory for identification. For histopathological studies, affected area of the gingiva was cut and placed in 10% formalin, and then sent to pathology laboratory. On parasitological examination the causative agent of this condition was found as larva of Wohlfahrtia magnifica. Histopathological examination of the injured gingiva showed hyperplasia of squamous epithelial tissue and acanthosis in mucosal membrane, hyperemia and infiltration of mononuclear cells and eosinophils into lamina propria. The present report seems to be the first report of gingival myiasis in dog in Iran.

Keywords: Wohlfahrtia magnifica, gingiva, myiasis, dog

Procedia PDF Downloads 538