Search results for: premature menopause
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 237

Search results for: premature menopause

177 Prevalence, Median Time, and Associated Factors with the Likelihood of Initial Antidepressant Change: A Cross-Sectional Study

Authors: Nervana Elbakary, Sami Ouanes, Sadaf Riaz, Oraib Abdallah, Islam Mahran, Noriya Al-Khuzaei, Yassin Eltorki

Abstract:

Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Most patients with MDD in the mental health setting have been labeled incorrectly as treatment-resistant where in fact they have not been subjected to an adequate trial of guideline-recommended therapy. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. Avoiding irrational practices such as subtherapeutic doses of IAD, premature switching between the ADs, and refraining from unjustified polypharmacy can help the disease to go into a remission phase We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. This was a retrospective cross- sectional study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using two unadjusted and adjusted cox regression models. A total of 487 patients met the inclusion criteria of the study. The average age for participants was 39.1 ± 12.3 years. Patients with first experience MDD episode 255 (52%) constituted a major part of our sample comparing to the relapse group 206(42%). About 431 (88%) of the patients had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. Switching was consistently more common than combination or augmentation at any timepoint. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. Five independent variables (age, bothersome side effects, un-optimization of the dose before any change, comorbid anxiety, first onset episode) were significantly associated with the likelihood of IAD change in the unadjusted analysis. The factors statistically associated with higher hazard of IAD change in the adjusted analysis were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. The findings of this study can have direct clinical guidance for health care professionals since an optimized, evidence-based use of AD medication can improve the clinical outcomes of patients with MDD; and also, to identify high-risk factors that could worsen the survival time on IAD such as young age and comorbid anxiety

Keywords: initial antidepressant, dose optimization, major depressive disorder, comorbid anxiety, combination, augmentation, switching, premature discontinuation

Procedia PDF Downloads 145
176 Methods Used to Perform Requirements Elicitation for Healthcare Software Development

Authors: Tang Jiacheng, Fang Tianyu, Liu Yicen, Xiang Xingzhou

Abstract:

The proportion of healthcare services is increasing throughout the globe. The convergence of mobile technology is driving new business opportunities, innovations in healthcare service delivery and the promise of a better life tomorrow for different populations with various healthcare needs. One of the most important phases for the combination of health care and mobile applications is to elicit requirements correctly. In this paper, four articles from different research directions with four topics on healthcare were detailed analyzed and summarized. We identified the underlying problems in guidance to develop mobile applications to provide healthcare service for Older adults, Women in menopause, Patients undergoing covid. These case studies cover several elicitation methods: survey, prototyping, focus group interview and questionnaire. And the effectiveness of these methods was analyzed along with the advantages and limitations of these methods, which is beneficial to adapt the elicitation methods for future software development process.

Keywords: healthcare, software requirement elicitation, mobile applications, prototyping, focus group interview

Procedia PDF Downloads 143
175 Skin-to-Skin Contact Simulation: Improving Health Outcomes for Medically Fragile Newborns in the Neonatal Intensive Care Unit

Authors: Gabriella Zarlenga, Martha L. Hall

Abstract:

Introduction: Premature infants are at risk for neurodevelopmental deficits and hospital readmissions, which can increase the financial burden on the health care system and families. Kangaroo care (skin-to-skin contact) is a practice that can improve preterm infant health outcomes. Preterm infants can acquire adequate body temperature, heartbeat, and breathing regulation through lying directly on the mother’s abdomen and in between her breasts. Due to some infant’s condition, kangaroo care is not a feasible intervention. The purpose of this proof-of-concept research project is to create a device which simulates skin-to-skin contact for pre-term infants not eligible for kangaroo care, with the aim of promoting baby’s health outcomes, reducing the incidence of serious neonatal and early childhood illnesses, and/or improving cognitive, social and emotional aspects of development. Methods: The study design is a proof-of-concept based on a three-phase approach; (1) observational study and data analysis of the standard of care for 2 groups of pre-term infants, (2) design and concept development of a novel device for pre-term infants not currently eligible for standard kangaroo care, and (3) prototyping, laboratory testing, and evaluation of the novel device in comparison to current assessment parameters of kangaroo care. A single center study will be conducted in an area hospital offering Level III neonatal intensive care. Eligible participants include newborns born premature (28-30 weeks of age) admitted to the NICU. The study design includes 2 groups: a control group receiving standard kangaroo care and an experimental group not eligible for kangaroo care. Based on behavioral analysis of observational video data collected in the NICU, the device will be created to simulate mother’s body using electrical components in a thermoplastic polymer housing covered in silicone. It will be designed with a microprocessor that controls simulated respiration, heartbeat, and body temperature of the 'simulated caregiver' by using a pneumatic lung, vibration sensors (heartbeat), pressure sensors (weight/position), and resistive film to measure temperature. A slight contour of the simulator surface may be integrated to help position the infant correctly. Control and monitoring of the skin-to-skin contact simulator would be performed locally by an integrated touchscreen. The unit would have built-in Wi-Fi connectivity as well as an optional Bluetooth connection in which the respiration and heart rate could be synced with a parent or caregiver. A camera would be integrated, allowing a video stream of the infant in the simulator to be streamed to a monitoring location. Findings: Expected outcomes are stabilization of respiratory and cardiac rates, thermoregulation of those infants not eligible for skin to skin contact with their mothers, and real time mother Bluetooth to the device to mimic the experience in the womb. Results of this study will benefit clinical practice by creating a new standard of care for premature neonates in the NICU that are deprived of skin to skin contact due to various health restrictions.

Keywords: kangaroo care, wearable technology, pre-term infants, medical design

Procedia PDF Downloads 153
174 Impact of COVID-19 Disease on Reproductive Health in Women

Authors: Mikailzade Parvin, Gurbanova Jamila, Alizade Samaya, Hasanova Afat

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It is known that in March 2020, the World Health Organization (WHO) declared a global pandemic of the 2019 coronovirus disease COVID-19, caused by the severe acute respiratory syndrome coronovirus (SARS-CoV-2). In this period, ensuring the safety of pregnancy and childbirth has become one of the necessary issues. The measures taken in this direction naturally consisted of strengthening and improving preventive measures among pregnant women. It should be noted that the lethality of SARS-CoV-2 infection among women reached 25%. The relevance of studying the effect of COVID-19 on reproductive health in women is due to its wide spread worldwide, severe clinical course, and the occurrence of numerous complications or lethality. It is of urgent importance to study the impact of the mentioned coronavirus infection on the health of pregnant women and the serious complications caused by it.Taking these into account, 230 pregnant women infected with the COVID-19 virus infection were registered. The average age of the pregnant women included in the study was: 29.24±6.0. The diagnosis of corona virus infection was made on the basis of polymerase chain reaction (PCR), serological tests (IgG, IgM). In 57.4% of cases, bilateral pneumonia was recorded in pregnant women and confirmed on the basis of radiological (RH) examination. RH examination revealed pneumonia with infiltrate in the lungs. Among clinical symptoms in pregnant women infected with COVID-19 virus infection: in 86 (37.4%) cases, symptoms such as high fever (t-39.0oC), shortness of breath, fatigue, and hypoxia were noted in pregnant women. A decrease in SpO2 to a minimal level was recorded. Laboratory-instrumental examinations were carried out. The obtained results showed: the average limit of D-dimer was 0.8±0.5; prothrombin time 13.2±1.1 seconds; INR 0.98±0.08, prothrombin index 104.3±19.5%, EHS - 34.8±13.6 mm/s. It should be noted that respiratory distress syndrome (RDS), premature birth, malformed and extremely malformed newborns, asphyxia or hypoxia have been reported in infants born to pregnant women infected with the coronavirus disease.Thus, from the obtained indicators, it is known that pregnant women infected with the virus have a high risk of serious illness and death for both themselves and their babies. It has been proven that the majority of babies born to SARS-CoV-2 positive mothers have a negative impact on their health.

Keywords: Covid 19, reproductive health, preqnancy, premature birth

Procedia PDF Downloads 81
173 A Hybrid Multi-Objective Firefly-Sine Cosine Algorithm for Multi-Objective Optimization Problem

Authors: Gaohuizi Guo, Ning Zhang

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Firefly algorithm (FA) and Sine Cosine algorithm (SCA) are two very popular and advanced metaheuristic algorithms. However, these algorithms applied to multi-objective optimization problems have some shortcomings, respectively, such as premature convergence and limited exploration capability. Combining the privileges of FA and SCA while avoiding their deficiencies may improve the accuracy and efficiency of the algorithm. This paper proposes a hybridization of FA and SCA algorithms, named multi-objective firefly-sine cosine algorithm (MFA-SCA), to develop a more efficient meta-heuristic algorithm than FA and SCA.

Keywords: firefly algorithm, hybrid algorithm, multi-objective optimization, sine cosine algorithm

Procedia PDF Downloads 158
172 Novel Low-cost Bubble CPAP as an Alternative Non-invasive Oxygen Therapy for Newborn Infants with Respiratory Distress Syndrome in a Tertiary Level Neonatal Intensive Care Unit in the Philippines: A Single Blind Randomized Controlled Trial

Authors: Navid P Roodaki, Rochelle Abila, Daisy Evangeline Garcia

Abstract:

Background and Objective: Respiratory Distress Syndrome (RDS) among premature infants is a major causes of neonatal death. The use of Continuous Positive Airway Pressure (CPAP) has become a standard of care for preterm newborns with RDS hence cost-effective innovations are needed. This study compared a novel low-cost Bubble CPAP (bCPAP) device to ventilator driven CPAP in the treatment of RDS. Methods: This is a single-blind, randomized controlled trial done on May 2022 to October 2022 in a Level III Neonatal Intensive Care Unit in the Philippines. Preterm newborns (<36 weeks) with RDS were randomized to receive Vayu bCPAP device or Ventilator-derived CPAP. Arterial Blood Gases, Oxygen Saturation, administration of surfactant, and CPAP failure rates were measured. Results: Seventy preterm newborns were included. No differences were observed between the Ventilator driven CPAP and Vayu bCPAP on the PaO2 (97.51mmHg vs 97.37mmHg), So2 (97.08% vs 95.60%) levels, amount of surfactant administered between groups. There were no observed differences in CPAP failure rates between Vayu bPCAP (x̄ 3.23 days) and ventilator-driven CPAP (x̄ 2.98 days). However, a significant difference was noted on the CO2 level (40.32mmHg vs 50.70mmHg), which was higher among those hooked to Ventilator-driven CPAP (p 0.004). Conclusion: This study has shown that the novel low-cost bubble CPAP (Vayu bCPAP) can be used as an efficacious alternate non invasive oxygen therapy among preterm neonates with RDS, although the CO2 levels were higher among those hooked to ventilator driven CPAP, other outcome parameters measured showed that both devices are comparable. Recommendation: A multi-center or national study to account for geographic region, which may alter the outcomes of patients connected to different ventilatory support. Cost comparison between devices is also suggested. A mixed-method research assessing the experiences of health care professionals in assembling and utilizing the gadget is a second consideration.

Keywords: bubble CPAP, ventilator-derived CPAP; infant, premature, respiratory distress syndrome

Procedia PDF Downloads 74
171 Early Metastatic Cancer: A Review of Its Management and Outcomes

Authors: Diwei Lin, Amanda Jia Hui Tan

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In 2012, testicular cancer was estimated to account for 940 disability adjusted life years in Australia; of these, 450 were years lost due to premature death and 500 were years of healthy life lost due to disease, disability or injury. Testicular choriocarcinoma is one of the rarest variants of testicular germ cell tumours, accounting for less than 1% of testicular germ cell tumours and only about 0.19% of all testicular tumours. Management involves radical orchiectomy followed by chemotherapy. Even then, the prognosis is extremely poor. This case report describes a 20-year-old male with pure testicular choriocarcinoma with pulmonary metastases.

Keywords: testicular cancer, choriocarcinoma, cryptorchidism, chemotherapy, metastatic testicular cancer

Procedia PDF Downloads 357
170 Precocious Puberty Due to an Autonomous Ovarian Cyst in a 3-Year-Old Girl: Case Report

Authors: Aleksandra Chałupnik, Zuzanna Chilimoniuk, Joanna Borowik, Aleksandra Borkowska, Anna Torres

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Background: Precocious puberty is the occurrence of secondary sexual characteristics in girls before the age of 8. The diverse etiology of premature puberty is crucial to determine whether it is true precocious puberty, depending on the activation of the hypothalamic-pituitary-gonadal axis, or pseudo-precocious, which is independent of the activation of this axis. Whatever the cause, premature action of the sex hormones leads to the common symptoms of various forms of puberty. These include the development of sexual characteristics, acne, acceleration of growth rate and acceleration of skeletal maturation. Due to the possible genetic basis of the disorders, an interdisciplinary search for the cause is needed. Case report: The case report concerns a patient of a pediatric gynecology clinic who, at the age of two years, developed advanced thelarhe (M3) and started recurrent vaginal bleeding. In August 2019, gonadotropin suppression initially and after LHRH stimulation and high estradiol levels were reported at the Endocrinology Department. Imaging examinations showed a cyst in the right ovary projection. The bone age was six years. The entire clinical picture indicated pseudo- (peripheral) precocious in the course of ovarian autonomic cyst. In the follow-up ultrasound performed in September, the image of the cyst was stationary and normalization of estradiol levels and clinical symptoms was noted. In December 2019, cyst regression and normal gonadotropin and estradiol concentrations were found. In June 2020, white mucus tinged with blood on the underwear, without any other disturbing symptoms, was observed for several days. Two consecutive USG examinations carried out in the same month confirmed the change in the right ovary, the diameter of which was 25 mm with a very high level of estradiol. Germinal tumor markers were normal. On the Tanner scale, the patient scored M2P1. The labia and hymen had puberty features. The correct vaginal entrance was visible. Another active vaginal bleeding occurred in the first week of July 2020. The considered laparoscopic treatment was abandoned due to the lack of oncological indications. Treatment with Tamoxifen was recommended in July 2020. In the initiating period of treatment, no maturation progression, and even reduction of symptoms, no acceleration of growth and a marked reduction in the size of the cysts were noted. There was no bleeding. After the size of the cyst and hormonal activity increased again, the treatment was changed to Anastrozole, the effect of which led to a reduction in the size of the cyst. Conclusions: The entire clinical picture indicates alleged (peripheral) puberty. Premature puberty in girls, which is manifested as enlarged mammary glands with high levels of estrogens secreted by autonomic ovarian cysts and prepubertal levels of gonadotropins, may indicate McCune-Albright syndrome. Vaginal bleeding may also occur in this syndrome. Cancellation of surgical treatment of the cyst made it impossible to perform a molecular test that would allow to confirm the diagnosis. Taking into account the fact that cysts are often one of the first symptoms of McCune-Albrigt syndrome, it is important to remember about multidisciplinary care for the patient and careful search for skin and bone changes or other hormonal disorders.

Keywords: McCune Albrigth's syndrome, ovarian cyst, pediatric gynaecology, precocious puberty

Procedia PDF Downloads 185
169 Menstrual Hygiene Management among Young Unmarried Women in India

Authors: Enu Anand, Jayakant Singh

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Menstruation among women is an integral part and a natural process that starts with menarche and stops at menopause. Women use sanitary pad, clothes and other methods to prevent blood stain from becoming evident. This paper examines the prevalence and discrepancies in use of hygienic method during menstruation among unmarried women in India using nationally representative District Level Household and facility Survey data (2007-08). The findings suggest that only one-third of the study population used hygienic method during menstruation. Rural-urban and poor-non poor disparity persists across all background characteristics in use of hygienic method. Women with high school and above education (OR=8.8, p<0.001), from richest wealth quintile (OR=5.2, p<0.001) and women following Christian religion (OR=3.6, p<0.001) are more likely to use hygienic method as compared to women with no education, poor household and Hindu women respectively. Locally prepared, low-cost sanitary pads can be promoted across the country for easy accessibility and affordability. Efforts should be made to produce locally prepared low-cost sanitary napkins in bulk and supply it through female health workers such as ANM and Anganwadi worker across the country.

Keywords: menstrual hygiene, sanitary pad, unmarried women, India

Procedia PDF Downloads 481
168 Investigating the Abolishment of Virginity Testing in South Africa

Authors: Nqobizwe Mvelo Ngema

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This paper argues that the custom of virginity testing has been revived in order to combat against social ills such as unwanted pregnancies, immorality, promiscuity and the spread of HIV/AIDS. However, virginity testing is not free from challenges such as the belief that having sexual intercourse with a virgin can cure men from AIDS, virginity testing is not accurate because there is scientific evidence supporting the fact that there many ways of losing virginity other than sexual intercourse, for example, the usage of tampons and participation in physical activities may tear the hymen. South African parliament took some positive steps in combatting against harm associated with virginity testing by regulating it in the Children’s Act. It is argued, in this paper, that the abolition of virginity testing may lead to paper law and it would be premature to abolish virginity testing in South Africa.

Keywords: equality rights, virginity testing, human rights, interdisciplinary law and legal studies

Procedia PDF Downloads 520
167 An Improved Many Worlds Quantum Genetic Algorithm

Authors: Li Dan, Zhao Junsuo, Zhang Wenjun

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Aiming at the shortcomings of the Quantum Genetic Algorithm such as the multimodal function optimization problems easily falling into the local optimum, and vulnerable to premature convergence due to no closely relationship between individuals, the paper presents an Improved Many Worlds Quantum Genetic Algorithm (IMWQGA). The paper using the concept of Many Worlds; using the derivative way of parallel worlds’ parallel evolution; putting forward the thought which updating the population according to the main body; adopting the transition methods such as parallel transition, backtracking, travel forth. In addition, the algorithm in the paper also proposes the quantum training operator and the combinatorial optimization operator as new operators of quantum genetic algorithm.

Keywords: quantum genetic algorithm, many worlds, quantum training operator, combinatorial optimization operator

Procedia PDF Downloads 735
166 Access the Knowledge, Awareness, and Factors Associated With Hypertension Among the Residents of Modeca District of Tiko, South West Region of Cameroon, in the Middle of a Separatist Violence Since 2017

Authors: Franck Kem Acho

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The trends of diseases have been changed from the last few years, now the burden of non-communicable diseases is increasing day by day. In all the non-communicable diseases, Hypertension is one of the leading causes of premature death and morbidity worldwide. This disease is a silent killer, it mostly affects the people with no obvious symptoms. Not only the heart it also increases the risk of brain, kidney and other diseases, now a days it is a serious medical problem. Over a billion people near about 1 in 4 men and 1 in 5 women having hypertension. In this case study men and women of ages between 30-80 years with Hypertension were identified in community remote area with their Health status being checked and monitored for one week and Health Education was provided for the importance of regular Health checkup alongside the continuous taking of medications.

Keywords: hypertension, health status, health check up, health education

Procedia PDF Downloads 58
165 An Enhanced Digital Forensic Model for Internet of Things Forensic

Authors: Tina Wu, Andrew Martin

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The expansion of the Internet of Things (IoT) brings a new level of threat. Attacks on IoT are already being used by criminals to form botnets, launch Distributed Denial of Service (DDoS) and distribute malware. This opens a whole new digital forensic arena to develop forensic methodologies in order to have the capability to investigate IoT related crimes. However, existing proposed IoT forensic models are still premature requiring further improvement and validation, many lack details on the acquisition and analysis phase. This paper proposes an enhanced theoretical IoT digital forensic model focused on identifying and acquiring the main sources of evidence in a methodical way. In addition, this paper presents a theoretical acquisition framework of the different stages required in order to be capable of acquiring evidence from IoT devices.

Keywords: acquisition, Internet of Things, model, zoning

Procedia PDF Downloads 262
164 Influence and Interaction of Temperature, H2S and pH on Concrete Sewer Pipe Corrosion

Authors: Anna Romanova, Mojtaba Mahmoodian, Morteza A. Alani

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Concrete sewer pipes are known to suffer from a process of hydrogen sulfide gas induced sulfuric acid corrosion. This leads to premature pipe degradation, performance failure and collapses which in turn may lead to property and health damage. The above work reports on a field study undertaken in working sewer manholes where the parameters of effluent temperature and pH as well as ambient temperature and concentration of hydrogen sulfide were continuously measured over a period of two months. Early results suggest that effluent pH has no direct effect on hydrogen sulfide build up; on average the effluent temperature is 3.5°C greater than the ambient temperature inside the manhole and also it was observed that hydrogen sulfate concentration increases with increasing temperature.

Keywords: concrete corrosion, hydrogen sulfide gas, temperature, sewer pipe

Procedia PDF Downloads 566
163 An Exact Algorithm for Location–Transportation Problems in Humanitarian Relief

Authors: Chansiri Singhtaun

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This paper proposes a mathematical model and examines the performance of an exact algorithm for a location–transportation problems in humanitarian relief. The model determines the number and location of distribution centers in a relief network, the amount of relief supplies to be stocked at each distribution center and the vehicles to take the supplies to meet the needs of disaster victims under capacity restriction, transportation and budgetary constraints. The computational experiments are conducted on the various sizes of problems that are generated. Branch and bound algorithm is applied for these problems. The results show that this algorithm can solve problem sizes of up to three candidate locations with five demand points and one candidate location with up to twenty demand points without premature termination.

Keywords: disaster response, facility location, humanitarian relief, transportation

Procedia PDF Downloads 442
162 Optimization of Flexible Job Shop Scheduling Problem with Sequence-Dependent Setup Times Using Genetic Algorithm Approach

Authors: Sanjay Kumar Parjapati, Ajai Jain

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This paper presents optimization of makespan for ‘n’ jobs and ‘m’ machines flexible job shop scheduling problem with sequence dependent setup time using genetic algorithm (GA) approach. A restart scheme has also been applied to prevent the premature convergence. Two case studies are taken into consideration. Results are obtained by considering crossover probability (pc = 0.85) and mutation probability (pm = 0.15). Five simulation runs for each case study are taken and minimum value among them is taken as optimal makespan. Results indicate that optimal makespan can be achieved with more than one sequence of jobs in a production order.

Keywords: flexible job shop, genetic algorithm, makespan, sequence dependent setup times

Procedia PDF Downloads 325
161 The Effectiveness of Scalp Cooling Therapy on Reducing Chemotherapy Induced Alopecia: A Critical Literature Review

Authors: M. Krishna

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The study was intended to identify if scalp cooling therapy is effective on preventing chemotherapy-induced hair loss among cancer patients. Critical literature of non-randomized controlled trials was used to investigate whether scalp cooling therapy is effective on preventing chemotherapy-induced alopecia. The review identified that scalp cooling therapy is effective on preventing chemotherapy-induced alopecia. Most of the patients receiving chemotherapy experience alopecia. It is also perceived as the worst effect of chemotherapy. This may be severe and lead the patients to withdraw the chemo treatment. The image disturbance caused by alopecia will make the patient depressed and will lead to declined immunity. With the knowledge on effectiveness of scalp cooling therapy on preventing chemotherapy-induced alopecia, patient undergoing chemotherapy will not be hesitant to undergo the treatment. Patients are recommended to go through scalp cooling therapy every chemo cycle and the proper therapy duration is 30 minutes before, during chemo. The suggested duration of the scalp cooling therapy is 45-90 minutes for an effective and positive outcome. This finding is excluding other factors of alopecia such as menopause, therapeutic drugs, poor hair density, liver function problems, and drug regimes.

Keywords: alopecia, cancer, chemotherapy, scalp cooling therapy

Procedia PDF Downloads 199
160 Metastatic Ovarian Tumor Discovered Accidentally during Cesarean Section in a 34 Year Old Woman: A Case Report

Authors: Ghada E. Esheba, Ghufran Kheshaifaty, Kholoud Al-Harbi, Wafa'a Al-Harbi, Ala'a Al-Orabi, Moayad Turkistani

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Krukenberg tumor is a rare metastatic ovarian carcinoma that usually occurs in female between 30 - 40 year old and rarely seen after menopause. Stomach is the most common primary site. Histopathological features of krukenberg tumors appear as diffuse stromal proliferation, mucus-production, and numerous signet-cells and these tumors spread mostly by lymphatic route. Treatment and prognostic factors are not well established. This study describes a 34 year old female with a unilateral ovarian mass discovered accidentally during cesarean section delivery and it was misdiagnosed as luteoma of pregnancy, but histopathological examination showed a diffuse infiltration of the ovary and omentum by signet ring cells. These findings were not correlated with luteoma of pregnancy or any other types of primary ovarian tumors like surface epithelial tumor, sex cord stromal tumor or germ cell tumor. However, after the analysis of immunohistochemical results (negative CK7, positive CK20 and CDX-2), the finding was the diagnostic of metastatic krukenberg tumor. Two weeks later, the patient was evaluated and a large gastric tumor was found in her stomach and she underwent gastrectomy.

Keywords: CK7, CK20, CDX-2, Krukenburg tumor, metastatic ovarian tumor

Procedia PDF Downloads 311
159 Sexual Quality of Life in Women with Gynecological Cancer

Authors: Hatice Kahyaoglu Sut, Serap Unsar, Seda Kurt

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The aim of this study is to investigate sexual quality of life in women with gynecological cancer. This cross-sectional study was conducted on 37 women with gynecological cancer and 39 control women (in menopausal term) at the Gynecooncology and Menopause Clinics of Trakya University Medical Faculty between January and July 2015. Women who had sexual active and willing to participate in the study filled an information form inquiring socio-demographic characteristics and Sexual Quality of Life Questionnaire-Female (SQLQ-F). Data were analyzed by Mann-Whitney-U test and Kruskal-Wallis test. The average age of the women was 52.7 ± 7.6 (51.2 ± 8.7 in women with gynecological cancer, 54.3 ± 6.0 in controls). The SQOL-F scores in women with gynecologic cancer (60.8 ± 22.4) was lower than controls (63.5 ± 20.7), however, there was no statistically significant difference (p = 0.759). Women with gynecological cancer who had vaginal dryness and pain during sexual intercourse (45.7 ± 21.3) were lower SQOL-F total score than control group (66.0 ± 21.7) (p = 0.014). The SQOL-F scores in women who took chemotherapy treatment (55.7 ± 17.8) were lower than in women who had not chemotherapy treatment (86.8 ± 16.6) (p = 0.005). In conclusion, taking chemotherapy treatment and occurring vaginal dryness and pain complaints during sexual intercourse in women with gynecological cancer reduces sexual quality of life. Therefore, sexual quality of life in women with gynecological cancer should be evaluated, and they should be supported in order to improve their sexual quality of life.

Keywords: gynecological cancer, quality of life, sexuality, women

Procedia PDF Downloads 338
158 Association of Serum Uric Acid Level and Bone Mineral Density of Menopausal Women

Authors: Soyeon Kang, Youn-Jee Chung, Jung Namkung

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Objective: This retrospective study investigated the association between uric acid level and bone mineral density (BMD) in the postmenopausal period. Methods: The study included 328 menopausal women (mean age, 57.3 ± 6.5 years; mean serum uric acid level, 4.6 ± 1.0 mg/dL). Patients were divided into three groups by tertile of serum uric acid level. Patients who used hormone treatment (HT), bisphosphonates, or lipid-lowering agents were included. Results: Blood urea nitrogen, serum creatinine, and serum triglyceride levels were significantly higher in the upper uric acid tertiles. No significant difference was found in the mean uric acid levels between medication users and non-users. Distinct HT regimens showed different mean serum uric acid levels. In a cross-sectional analysis, higher serum uric acid levels showed a tendency toward increased BMD in the spine and femoral neck. Longitudinal analysis of 186 women who underwent follow-up examination at a mean interval of 14.6 months revealed a trend toward a smaller reduction in femoral neck BMD in women in the upper serum uric acid tertiles. Conclusion: A positive correlation exists between serum uric acid levels and BMD in menopausal women.

Keywords: menopause, antioxidant, uric acid, bone mineral density

Procedia PDF Downloads 123
157 Modelling the Effects of External Factors Affecting Concrete Carbonation

Authors: Abhishek Mangal, Kunal Tongaria, S. Mandal, Devendra Mohan

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Carbonation of reinforced concrete structures has emerged as one of the major challenges for Civil engineers across the world. With increasing emissions from various activities, carbon dioxide concentration in the atmosphere has been eve rising, enhancing its penetration in porous concrete, reaching steel bars and ultimately leading to premature failure. Several literatures have been published dealing with the various interdependent variables related to carbonation. However, with innumerable variability a generalization of these data proves to be a troublesome task. This paper looks into this carbonation anomaly in concrete structures caused by various external variables such as relative humidity, concentration of CO2, curing period and ambient temperature. Significant discussions and comparisons have been presented on the basis of various studies conducted with an aim to predict the depth of carbonation as a function of these multidimensional parameters using various numerical and statistical modelling techniques.

Keywords: carbonation, curing, exposure conditions, relative humidity

Procedia PDF Downloads 249
156 An Enhanced Particle Swarm Optimization Algorithm for Multiobjective Problems

Authors: Houda Abadlia, Nadia Smairi, Khaled Ghedira

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Multiobjective Particle Swarm Optimization (MOPSO) has shown an effective performance for solving test functions and real-world optimization problems. However, this method has a premature convergence problem, which may lead to lack of diversity. In order to improve its performance, this paper presents a hybrid approach which embedded the MOPSO into the island model and integrated a local search technique, Variable Neighborhood Search, to enhance the diversity into the swarm. Experiments on two series of test functions have shown the effectiveness of the proposed approach. A comparison with other evolutionary algorithms shows that the proposed approach presented a good performance in solving multiobjective optimization problems.

Keywords: particle swarm optimization, migration, variable neighborhood search, multiobjective optimization

Procedia PDF Downloads 165
155 Optimal MPPT Charging Battery System for Photovoltaic Standalone Applications

Authors: Kelaiaia Mounia Samira, Labar Hocine, Mesbah Tarek, Kelaiaia samia

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The photovoltaic panel produces green power, and because of its availability across the globe, it can supply isolated loads (site away of the electrical network or difficult of access). Unfortunately this energy remains very expensive. The most application of these types of power needs storage devices, the Lithium batteries are commonly used because of its powerful storage capability. Using a solar panel or an array of panels without a controller that can perform MPPT will often result in wasted power, which results in the need to install more panels for the same power requirement. For devices that have the battery connected directly to the panel, this will also result in premature battery failure or capacity loss. In this paper it is proposed a modified P&O algorithm for the MPPT which takes in account the battery’s internal resistance vs temperature and stage of charging. Of course the temperature variation and irradiation of the PV panel are also introduced.

Keywords: modeling, battery, MPPT, charging, PV Panel

Procedia PDF Downloads 519
154 Reinforcement of Calcium Phosphate Cement with E-Glass Fibre

Authors: Kanchan Maji, Debasmita Pani, Sudip Dasgupta

Abstract:

Calcium phosphate cement (CPC) due to its high bioactivity and optimum bioresorbability shows excellent bone regeneration capability. Despite it has limited applications as bone implant due to its macro-porous microstructure causing its poor mechanical strength. The reinforcement of apatitic CPCs with biocompatible fibre glass phase is an attractive area of research to improve its mechanical strength. Here we study the setting behaviour of Si-doped and un-doped alpha tri-calcium phosphate (α-TCP) based CPC and its reinforcement with the addition of E-glass fibre. Alpha tri-calcium phosphate powders were prepared by solid state sintering of CaCO3, CaHPO4 and tetra ethyl ortho silicate (TEOS) was used as silicon source to synthesise Si doped α-TCP powders. Alpha tri-calcium phosphate based CPC hydrolyzes to form hydroxyapatite (HA) crystals having excellent osteoconductivity and bone-replacement capability thus self-hardens through the entanglement of HA crystals. Setting time, phase composition, hydrolysis conversion rate, microstructure, and diametral tensile strength (DTS) of un-doped CPC and Si-doped CPC were studied and compared. Both initial and final setting time of the developed cement was delayed because of Si addition. Crystalline phases of HA (JCPDS 9-432), α-TCP (JCPDS 29-359) and β-TCP (JCPDS 9-169) were detected in the X-ray diffraction (XRD) pattern after immersion of CPC in simulated body fluid (SBF) for 0 hours to 10 days. The intensities of the α-TCP peaks of (201) and (161) at 2θ of 22.2°and 24.1° decreased when the time of immersion of CPC in SBF increased from 0 hours to 10 days, due to its transformation into HA. As Si incorporation in the crystal lattice stabilised the TCP phase, Si doped CPC showed a little slower rate of conversion into HA phase as compared to un-doped CPC. The SEM image of the microstructure of hardened CPC showed lower grain size of HA in un-doped CPC because of premature setting and faster hydrolysis of un-doped CPC in SBF as compared that in Si-doped CPC. Premature setting caused generation of micro and macro porosity in un-doped CPC structure which resulted in its lower mechanical strength as compared to that in Si-doped CPC. This lower porosity and greater compactness in the microstructure attributes to greater DTS values observed in Si-doped CPC. E-glass fibres of the average diameter of 12 μm were cut into approximately 1 mm in length and immersed in SBF to deposit carbonated apatite on its surface. This was performed to promote HA crystal growth and entanglement along the fibre surface to promote stronger interface between dispersed E-glass fibre and CPC matrix. It was found that addition of 10 wt% of E-glass fibre into Si-doped α-TCP increased the average DTS of CPC from 8 MPa to 15 MPa as the fibres could resist the propagation of crack by deflecting the crack tip. Our study shows that biocompatible E-glass fibre in optimum proportion in CPC matrix can enhance the mechanical strength of CPC without affecting its bioactivity.

Keywords: Calcium phosphate cement, biocompatibility, e-glass fibre, diametral tensile strength

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153 Hysterectomy and Symbolic Damage: When the Desire for Motherhood is Reactivated in a Nun

Authors: Ndje Ndje Mireille

Abstract:

The improvement in the physical aspects of hysterectomy has tended to make us forget the psychological burden of this operation for many women. African women closely associate fertility and femininity, and they fear that their desire will diminish, that they will be less desirable after having undergone a hysterectomy. Medicine may be tempted to trivialize this surgical intervention by relying on the evolution of current surgery that leaves little or no marks. It is possible to think that the uterus is useless for a nun who has decided to freely disregard her motherhood. We used the clinical research method for this study. Through a semi-directive interview guide, we collected the verbatims of an hysterectomized catholic nun. The verbatims were transcribed and analyzed with the thematic content analysis. This analysis shows that the medical reality does not always correspond to the subjective experience of women, for whom hysterectomy can imply strong symbolic damage. The uterus is not essential to life, but it is essential to give life, and this lack can reactivate a desire for motherhood. The experience of hysterectomy is unique for each woman in relation to her history. This operation will eliminate all hope of pregnancy; it will be felt as intimate mutilation and an attack on femininity, it will bring up concerns about sexuality. Even if a woman has past the age of having children, has gone through menopause, or has freely decided not to have children, she still find it difficult to accept this procedure. The lack of uterus make a woman feel useless.

Keywords: hysterectomy, symbolic damage, desire for motherhood, feminity, nun

Procedia PDF Downloads 152
152 A Hybrid Distributed Algorithm for Solving Job Shop Scheduling Problem

Authors: Aydin Teymourifar, Gurkan Ozturk

Abstract:

In this paper, a distributed hybrid algorithm is proposed for solving the job shop scheduling problem. The suggested method executes different artificial neural networks, heuristics and meta-heuristics simultaneously on more than one machine. The neural networks are used to control the constraints of the problem while the meta-heuristics search the global space and the heuristics are used to prevent the premature convergence. To attain an efficient distributed intelligent method for solving big and distributed job shop scheduling problems, Apache Spark and Hadoop frameworks are used. In the algorithm implementation and design steps, new approaches are applied. Comparison between the proposed algorithm and other efficient algorithms from the literature shows its efficiency, which is able to solve large size problems in short time.

Keywords: distributed algorithms, Apache Spark, Hadoop, job shop scheduling, neural network

Procedia PDF Downloads 382
151 Breast Cancer and BRCA Gene: A Study on Genetic and Environmental Interaction

Authors: Abhishikta Ghosh Roy

Abstract:

Breast cancer is the most common malignancy among women globally, including India. Human breast cancer results from the genetic and environmental interaction. The present study attempts to understand the molecular heterogeneity of BRCA1 and BRCA2 genes, as well as to understand the association of various lifestyle and reproductive variables for the Breast Cancer risk. The study was conducted amongst 110 patients and 128 controls with total DNA sequencing of flanking and coding regions of BRCA1 BRCA2 genes that revealed ten Single Nucleotide Polymorphisms (SNPs) (6 novels). The controls selected for the study were age, sex and ethnic group matched. After written and informed consent biological samples were collected from the subjects. After detailed molecular analysis, significant (p < 0.005) molecular heterogeneity is revealed in terms of SNPs in BRCA1 (4 Exonic & 1 Intronic) and BRCA2 (2exonic and 3 Intronic) genes. The augmentation study investigated significant (p < 0.05) association with positive family history, early age at menarche, irregular menstrual periods, menopause, prolong contraceptive use, nulliparity, history of abortions, consumption of alcohol and smoking for breast cancer risk. To the best of authors knowledge, this study is the first of its kind, envisaged that the identification of the SNPs and modification of the lifestyle factors might aid to minimize the risk among the Bengalee Hindu females.

Keywords: breast cancer, BRCA, lifestyle, India

Procedia PDF Downloads 109
150 Extremely Large Sinus Pericranii with Involvement of the Torcular and Associated with Crouzon’s Syndrome

Authors: Felipe H. Sanders, Bryan A. Edwards, Matthew Fusco, Rod J. Oskouian, R. Shane Tubbs

Abstract:

Introduction: Sinus pericranii is a rare vascular malformation that connects the intracranial dural sinuses to the extracranial venous drainage system and is caused by either trauma or congenital defects. Although the majority of these vascular structures are due to trauma, some are congenital. Case report: Herein, we report a 5-month-old patient with a very large and fluctuating subcutaneous mass over the occiput and the diagnosis of Crouzon’s syndrome. The child presented with a large midline mass that on imaging, connected to the underlying torcular and was diagnosed as a sinus pericranii. At long-term follow up and without operative intervention, the sinus pericranii resolved. This uncommon relationship is reviewed. Conclusion: Premature closure of posterior fossa sutures as part of Crouzon syndrome can present with large sinus pericranii. Such subcutaneous swellings might resolve spontaneously.

Keywords: congenital, craniosynostosis, pediatric, vascular malformation

Procedia PDF Downloads 198
149 Piezo-Extracted Model Based Chloride/ Carbonation Induced Corrosion Assessment in Reinforced Concrete Structures

Authors: Gupta. Ashok, V. talakokula, S. bhalla

Abstract:

Rebar corrosion is one of the main causes of damage and premature failure of the reinforced concrete (RC) structures worldwide, causing enormous costs for inspection, maintenance, restoration and replacement. Therefore, early detection of corrosion and timely remedial action on the affected portion can facilitate an optimum utilization of the structure, imparting longevity to it. The recent advent of the electro-mechanical impedance (EMI) technique using piezo sensors (PZT) for structural health monitoring (SHM) has provided a new paradigm to the maintenance engineers to diagnose the onset of the damage at the incipient stage itself. This paper presents a model based approach for corrosion assessment based on the equivalent parameters extracted from the impedance spectrum of concrete-rebar system using the EMI technique via the PZT sensors.

Keywords: impedance, electro-mechanical, stiffness, mass, damping, equivalent parameters

Procedia PDF Downloads 539
148 Pattern of Valvular Involvement and Demographic Features of Patients on Benzathine Penicillin at Dhulikhel Hospital

Authors: Sanjaya Humagain, Rajendra Koju

Abstract:

Background: Rheumatic heart disease (RHD) is the most common cardiovascular disease in children and young adults. Though declined and almost non-existent in developed nations, RHD is still one of the leading cause for premature death and disability in developing countries. Prevalence of RHD is high in both rural as well as urban area of Nepal. Present study is designed to look at the pattern of valvular involvement and demographic features in RHD. Methods: 326 patients indicated for inj. Benzathine penicillin were selected and echocardiograph performed to see the pattern of vavular involvement. Data analysis was done using SPSS 17. Result: The most common type of lesion was mixed type with mitral valve involvement. MR was the most common isolated lesion. MS was more commonly seen in females whereas AS was more common in males. Secondary prophylaxis was more common than primary prophylaxis. Conclusion: RHD still being a major problem and a preventable disease so extensive screening program is required to identify them early and prevent the complication.

Keywords: acute rheumatic fever, RHD, MS, MR, AS, AR, Inj benzathine penicillin

Procedia PDF Downloads 312