Search results for: preoperative biliary drainage
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 523

Search results for: preoperative biliary drainage

343 Comparison of Agree Method and Shortest Path Method for Determining the Flow Direction in Basin Morphometric Analysis: Case Study of Lower Tapi Basin, Western India

Authors: Jaypalsinh Parmar, Pintu Nakrani, Bhaumik Shah

Abstract:

Digital Elevation Model (DEM) is elevation data of the virtual grid on the ground. DEM can be used in application in GIS such as hydrological modelling, flood forecasting, morphometrical analysis and surveying etc.. For morphometrical analysis the stream flow network plays a very important role. DEM lacks accuracy and cannot match field data as it should for accurate results of morphometrical analysis. The present study focuses on comparing the Agree method and the conventional Shortest path method for finding out morphometric parameters in the flat region of the Lower Tapi Basin which is located in the western India. For the present study, open source SRTM (Shuttle Radar Topography Mission with 1 arc resolution) and toposheets issued by Survey of India (SOI) were used to determine the morphometric linear aspect such as stream order, number of stream, stream length, bifurcation ratio, mean stream length, mean bifurcation ratio, stream length ratio, length of overland flow, constant of channel maintenance and aerial aspect such as drainage density, stream frequency, drainage texture, form factor, circularity ratio, elongation ratio, shape factor and relief aspect such as relief ratio, gradient ratio and basin relief for 53 catchments of Lower Tapi Basin. Stream network was digitized from the available toposheets. Agree DEM was created by using the SRTM and stream network from the toposheets. The results obtained were used to demonstrate a comparison between the two methods in the flat areas.

Keywords: agree method, morphometric analysis, lower Tapi basin, shortest path method

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342 The Issues of Irrigation and Drainage in Kebbi State and Their Effective Solution for a Sustainable Agriculture in Kebbi State, Nigeria

Authors: Mumtaz Ahmed Sohag, Ishaq Ahmed Sohag

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Kebbi State, located in the Nort-West of Nigeria, is rich in water resources as the major rivers viz. Niger and Rima irrigate a vast majority of land. Besides, there is significant amount of groundwater, which farmers use for agriculture purpose. The groundwater is also a major source of agricultural and domestic water as wells are installed in almost all parts of the region. Although Kebbi State is rich in water, however, there are some pertinent issues which are hampering its agricultural productivity. The low lands (locally called Fadama), has spread out to a vast area. It is inundated every year during the rainy season which lasts from June to September every year. The farmers grow rice during the rainy season when water is standing. They cannot do further agricultural activity for almost two months due to high standing water. This has resulted in widespread waterlogging problem. Besides, the impact of climate change is resulting in rapid variation in river/stream flows. The information about water bodies regarding the availability of water for agricultural and other uses and the behavior of rivers at different flows is seldom available. Furthermore, sediment load (suspended and bedload) is not measured due to which land erosion cannot be countered effectively. This study, carried out in seven different irrigation regions of Kebbi state, found that diversion structures need to be constructed at some strategic locations for the supply of surface water to the farmers. The water table needs to be lowered through an effective drainage system. The monitoring of water bodies is crucial for sound data to help efficient regulation and management of water. Construction of embankments is necessary to control frequent floods in the rivers of Niger and Rima. Furthermore, farmers need capacity and awareness for participatory irrigation management.

Keywords: water bodies, floods, agriculture, waterlogging

Procedia PDF Downloads 214
341 Practices of Waterwise Circular Economy in Water Protection: A Case Study on Pyhäjärvi, SW Finland

Authors: Jari Koskiaho, Teija Kirkkala, Jani Salminen, Sarianne Tikkanen, Sirkka Tattari

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Here, phosphorus (P) loading to the lake Pyhäjärvi (SW Finland) was reviewed, load reduction targets were determined, and different measures of waterwise circular economy to reach the targets were evaluated. In addition to the P loading from the lake’s catchment, there is a significant amount of internal P loading occurring in the lake. There are no point source emissions into the lake. Thus, the most important source of external nutrient loading is agriculture. According to the simulations made with LLR-model, the chemical state of the lake is at the border of the classes ‘Satisfactory’ and ‘Good’. The LLR simulations suggest that a reduction of some hundreds of kilograms in annual P loading would be needed to reach an unquestionably ‘Good’ state. Evaluation of the measures of the waterwise circular economy suggested that they possess great potential in reaching the target P load reduction. If they were applied extensively and in a versatile, targeted manner in the catchment, their combined effect would reach the target reduction. In terms of cost-effectiveness, the waterwise measures were ranked as follows: The best: Fishing, 2nd best: Recycling of vegetation of reed beds, wetlands and buffer zones, 3rd best: Recycling field drainage waters stored in wetlands and ponds for irrigation, 4th best: Controlled drainage and irrigation, and 5th best: Recycling of the sediments of wetlands and ponds for soil enrichment. We also identified various waterwise nutrient recycling measures to decrease the P content of arable land. The cost-effectiveness of such measures may be very good. Solutions are needed to Finnish water protection in general, and particularly for regions like lake Pyhäjärvi catchment with intensive domestic animal production, of which the ‘P-hotspots’ are a crucial issue.

Keywords: circular economy, lake protection, mitigation measures, phosphorus

Procedia PDF Downloads 86
340 Hydro Geochemistry and Water Quality in a River Affected by Lead Mining in Southern Spain

Authors: Rosendo Mendoza, María Carmen Hidalgo, María José Campos-Suñol, Julián Martínez, Javier Rey

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The impact of mining environmental liabilities and mine drainage on surface water quality has been investigated in the hydrographic basin of the La Carolina mining district (southern Spain). This abandoned mining district is characterized by the existence of important mineralizations of sulfoantimonides of Pb - Ag, and sulfides of Cu - Fe. All surface waters reach the main river of this mining area, the Grande River, which ends its course in the Rumblar reservoir. This waterbody is intended to supply 89,000 inhabitants, as well as irrigation and livestock. Therefore, the analysis and control of the metal(loid) concentration that exists in these surface waters is an important issue because of the potential pollution derived from metallic mining. A hydrogeochemical campaign consisting of 20 water sampling points was carried out in the hydrographic network of the Grande River, as well as two sampling points in the Rumbler reservoir and at the main tailings impoundment draining to the river. Although acid mine drainage (pH below 4) is discharged into the Grande river from some mine adits, the pH values in the river water are always neutral or slightly alkaline. This is mainly the result of a dilution process of the small volumes of mine waters by net alkaline waters of the river. However, during the dry season, the surface waters present high mineralization due to a constant discharge from the abandoned flooded mines and a decrease in the contribution of surface runoff. The concentrations of dissolved Cd and Pb in the water reach values of 2 and 81 µg/l, respectively, exceeding the limit established by the Environmental Quality Standard for surface water. In addition, the concentrations of dissolved As, Cu, and Pb in the waters of the Rumblar reservoir reached values of 10, 20, and 11 µg/l, respectively. These values are higher than the maximum allowable concentration for human consumption, a circumstance that is especially alarming.

Keywords: environmental quality, hydrogeochemistry, metal mining, surface water

Procedia PDF Downloads 117
339 MR-Implantology: Exploring the Use for Mixed Reality in Dentistry Education

Authors: Areej R. Banjar, Abraham G. Campbell

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The use of Mixed Reality (MR) in teaching and training is growing popular and can improve students’ ability to perform technical procedures. This short paper outlines the creation of an interactive educational MR 3D application that aims to improve the quality of instruction for dentistry students. This application is called MRImplantology and aims to teach the fundamentals and preoperative planning of dental implant placement. MRImplantology uses cone-beam computed tomography (CBCT) images as the source for 3D dental models that dentistry students will be able to freely manipulate within a 3D MR world to aid their learning process.

Keywords: augmented reality, education, dentistry, cone-beam computed tomography CBCT, head mounted display HMD, mixed reality

Procedia PDF Downloads 158
338 Application of 2D Electrical Resistivity Tomographic Imaging Technique to Study Climate Induced Landslide and Slope Stability through the Analysis of Factor of Safety: A Case Study in Ooty Area, Tamil Nadu, India

Authors: S. Maniruzzaman, N. Ramanujam, Qazi Akhter Rasool, Swapan Kumar Biswas, P. Prasad, Chandrakanta Ojha

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Landslide is one of the major natural disasters in South Asian countries. Applying 2D Electrical Resistivity Tomographic Imaging estimation of geometry, thickness, and depth of failure zone of the landslide can be made. Landslide is a pertinent problem in Nilgris plateau next to Himalaya. Nilgris range consists of hard Archean metamorphic rocks. Intense weathering prevailed during the Pre-Cambrian time had deformed the rocks up to 45m depth. The landslides are dominant in the southern and eastern part of plateau of is comparatively smaller than the northern drainage basins, as it has low density of drainage; coarse texture permitted the more of infiltration of rainwater, whereas in the northern part of the plateau entombed with high density of drainage pattern and fine texture with less infiltration than run off, and low to the susceptible to landslide. To get comprehensive information about the landslide zone 2D Electrical Resistivity Tomographic imaging study with CRM 500 Resistivity meter are used in Coonoor– Mettupalyam sector of Nilgiris plateau. To calculate Factor of Safety the infinite slope model of Brunsden and Prior is used. Factor of Safety can be expressed (FS) as the ratio of resisting forces to disturbing forces. If FS < 1 disturbing forces are larger than resisting forces and failure may occur. The geotechnical parameters of soil samples are calculated on the basis upon the apparent resistivity values for litho units of measured from 2D ERT image of the landslide zone. Relationship between friction angles for various soil properties is established by simple regression analysis from apparent resistivity data. Increase of water content in slide zone reduces the effectiveness of the shearing resistance and increase the sliding movement. Time-lapse resistivity changes to slope failure is determined through geophysical Factor of Safety which depends on resistivity and site topography. This ERT technique infers soil property at variable depths in wider areas. This approach to retrieve the soil property and overcomes the limit of the point of information provided by rain gauges and porous probes. Monitoring of slope stability without altering soil structure through the ERT technique is non-invasive with low cost. In landslide prone area an automated Electrical Resistivity Tomographic Imaging system should be installed permanently with electrode networks to monitor the hydraulic precursors to monitor landslide movement.

Keywords: 2D ERT, landslide, safety factor, slope stability

Procedia PDF Downloads 286
337 Predictive Spectral Lithological Mapping, Geomorphology and Geospatial Correlation of Structural Lineaments in Bornu Basin, Northeast Nigeria

Authors: Aminu Abdullahi Isyaku

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Semi-arid Bornu basin in northeast Nigeria is characterised with flat topography, thick cover sediments and lack of continuous bedrock outcrops discernible for field geology. This paper presents the methodology for the characterisation of neotectonic surface structures and surface lithology in the north-eastern Bornu basin in northeast Nigeria as an alternative approach to field geological mapping using free multispectral Landsat 7 ETM+, SRTM DEM and ASAR Earth Observation datasets. Spectral lithological mapping herein developed utilised spectral discrimination of the surface features identified on Landsat 7 ETM+ images to infer on the lithology using four steps including; computations of band combination images; band ratio images; supervised image classification and inferences of the lithological compositions. Two complementary approaches to lineament mapping are carried out in this study involving manual digitization and automatic lineament extraction to validate the structural lineaments extracted from the Landsat 7 ETM+ image mosaic covering the study. A comparison between the mapped surface lineaments and lineament zones show good geospatial correlation and identified the predominant NE-SW and NW-SE structural trends in the basin. Topographic profiles across different parts of the Bama Beach Ridge palaeoshorelines in the basin appear to show different elevations across the feature. It is determined that most of the drainage systems in the northeastern Bornu basin are structurally controlled with drainage lines terminating against the paleo-lake border and emptying into the Lake Chad mainly arising from the extensive topographic high-stand Bama Beach Ridge palaeoshoreline.

Keywords: Bornu Basin, lineaments, spectral lithology, tectonics

Procedia PDF Downloads 117
336 To Compare the Visual Outcome, Safety and Efficacy of Phacoemulsification and Small-Incision Cataract Surgery (SICS) at CEITC, Bangladesh

Authors: Rajib Husain, Munirujzaman Osmani, Mohammad Shamsal Islam

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Purpose: To compare the safety, efficacy and visual outcome of phacoemulsification vs. manual small-incision cataract surgery (SICS) for the treatment of cataract in Bangladesh. Objectives: 1. To assess the Visual outcome after cataract surgery 2. To understand the post-operative complications and early rehabilitation 3. To identified which surgical procedure more attractive to the patients 4. To identify which surgical procedure is occurred fewer complications. 5. To find out the socio-economic and demographic characteristics of study patients Setting: Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh. Design: Retrospective, randomised comparison of 300 patients with visually significant cataracts. Method: The present study was designed as a retrospective hospital-based research. The sample size was 300 and study period was from July, 2012 to July, 2013 and assigned randomly to receive either phacoemulsification or manual small-incision cataract surgery (SICS). Preoperative and post-operative data were collected through a well designed collection format. Three follow-up were done; i) during discharge ii) 1-3 weeks & iii) 4-11 weeks post operatively. All preoperative and surgical complications, uncorrected and best-corrected visual acuity (BCVA) and astigmatism were taken into consideration for comparison of outcome Result: Nearly 95% patients were more than 40 years of age. About 52% patients were female, and 48% were male. 52% (N=157) patients came to operate their first eye where 48% (N=143) patients were visited again to operate their second eye. Postoperatively, five eyes (3.33%) developed corneal oedema with >10 Descemets folds, and six eyes (4%) had corneal oedema with <10 Descemets folds for Phacoemulsification surgeries. For SICS surgeries, seven eyes (4.66%) developed corneal oedema with >10 Descemets folds and eight eyes (5.33%) had corneal oedema with < 10 descemets folds. However, both the uncorrected and corrected (4-11 weeks) visual acuities were better in the eyes that had phacoemulsification (p=0.02 and p=0.03), and there was less astigmatism (p=0.001) at 4-11 weeks in the eye that had phacoemulsification. Best-corrected visual acuity (BCVA) of final follow-up 95% (N=253) had a good outcome, borderline 3.10% (N=40) and poor outcome was 1.6% (N=7). The individual surgeon outcome were closer, 95% (BCVA) in SICS and 96% (BCVA) in Phacoemulsification at 4-11 weeks follow-up respectively. Conclusion: outcome of cataract surgery both Phacoemulsification and SICS in CEITC was more satisfactory according to who norms. Both Phacoemulsification and manual small-incision cataract surgery (SICS) shows excellent visual outcomes with low complication rates and good rehabilitation. Phacoemulsification is significantly faster, and modern technology based surgical procedure for cataract treatment.

Keywords: phacoemulsification, SICS, cataract, Bangladesh, visual outcome of SICS

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335 Solids and Nutrient Loads Exported by Preserved and Impacted Low-Order Streams: A Comparison among Water Bodies in Different Latitudes in Brazil

Authors: Nicolas R. Finkler, Wesley A. Saltarelli, Taison A. Bortolin, Vania E. Schneider, Davi G. F. Cunha

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Estimating the relative contribution of nonpoint or point sources of pollution in low-orders streams is an important tool for the water resources management. The location of headwaters in areas with anthropogenic impacts from urbanization and agriculture is a common scenario in developing countries. This condition can lead to conflicts among different water users and compromise ecosystem services. Water pollution also contributes to exporting organic loads to downstream areas, including higher order rivers. The purpose of this research is to preliminarily assess nutrients and solids loads exported by water bodies located in watersheds with different types of land uses in São Carlos - SP (Latitude. -22.0087; Longitude. -47.8909) and Caxias do Sul - RS (Latitude. -29.1634, Longitude. -51.1796), Brazil, using regression analysis. The variables analyzed in this study were Total Kjeldahl Nitrogen (TKN), Nitrate (NO3-), Total Phosphorus (TP) and Total Suspended Solids (TSS). Data were obtained in October and December 2015 for São Carlos (SC) and in November 2012 and March 2013 for Caxias do Sul (CXS). Such periods had similar weather patterns regarding precipitation and temperature. Altogether, 11 sites were divided into two groups, some classified as more pristine (SC1, SC4, SC5, SC6 and CXS2), with predominance of native forest; and others considered as impacted (SC2, SC3, CXS1, CXS3, CXS4 and CXS5), presenting larger urban and/or agricultural areas. Previous linear regression was applied for data on flow and drainage area of each site (R² = 0.9741), suggesting that the loads to be assessed had a significant relationship with the drainage areas. Thereafter, regression analysis was conducted between the drainage areas and the total loads for the two land use groups. The R² values were 0.070, 0.830, 0.752 e 0.455 respectively for SST, TKN, NO3- and TP loads in the more preserved areas, suggesting that the loads generated by runoff are significant in these locations. However, the respective R² values for sites located in impacted areas were respectively 0.488, 0.054, 0.519 e 0.059 for SST, TKN, NO3- and P loads, indicating a less important relationship between total loads and runoff as compared to the previous scenario. This study suggests three possible conclusions that will be further explored in the full-text article, with more sampling sites and periods: a) In preserved areas, nonpoint sources of pollution are more significant in determining water quality in relation to the studied variables; b) The nutrient (TKN and P) loads in impacted areas may be associated with point sources such as domestic wastewater discharges with inadequate treatment levels; and c) The presence of NO3- in impacted areas can be associated to the runoff, particularly in agricultural areas, where the application of fertilizers is common at certain times of the year.

Keywords: land use, linear regression, point and non-point pollution sources, streams, water resources management

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334 Surgical Treatment Tumors and Cysts of the Pancreas in Children

Authors: Trunov V.O., Ryabov A. B., Poddubny I.V

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Introduction: cystic and solid pancreatic tumors have a relevant and disruptive position in many positions. The results of the treatment of children with tumors and pancreatic cysts aged 3 to 17 years for the period from 2008 to 2019 on the basis of the Morozov State Children's Clinical Hospital in Moscow were analyzed. The total number of children with solid tumors was 17, and 31 with cysts. In all children, the diagnosis was made on the basis of ultrasound, followed by CT and MRI. In most patients with solid tumors, they were located in the area of the pancreas tail - 58%, in the body area - 14%, in the area of the pancreatic head - 28%. In patients with pancreatic cysts, the distribution of patients by topography was as follows: head of the pancreas - 10%, body of the pancreas - 16%, tail of the pancreas - 68%, total cystic transformation of the Wirsung duct - 6%. In pancreatic cysts, the method of surgical treatment was based on the results of MRCP, the level of amylase in the contents of the cyst, and the localization of the cyst. Thus, pathogenetically substantiated treatment included: excision of cysts, internal drainage on an isolated loop according to Ru, the formation of pancreatojejunoanastomosis in a child with the total cystic transformation of the Wirsung duct. In patients with solid pancreatic lesions, pancretoduodenalresection, central resection of the pancreas, and distal resection from laparotomy and laparoscopic access were performed. In the postoperative period, in order to prevent pancreatitis, all children underwent antisecretory therapy, parenteral nutrition, and drainage of the omental bursa. Results: hospital stay ranged from 7 to 12 days. The duration of postoperative fermentemia in patients with solid formations lasted from 3 to 6 days. In all cases, according to the histological examination, a pseudopapillary tumor of the pancreas was revealed. In the group of children with pancreatic cysts, fermentemia was observed from 2 to 4 days, recurrence of cysts in the long term was detected in 3 children (10%). Conclusions: the treatment of cystic and solid pancreatic neoplasms is a difficult task in connection with the anatomical and functional features of the organ.

Keywords: pancreas, tumors, cysts, resection, laparoscopy, children

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333 Assessment of Alternative Water Resources and Growing Media in Green Roofs

Authors: Hamideh Nouri, Sattar Chavoshi Borujeni

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Grey infrastructure is an unavoidable part of urbanisation that is threatening the local microclimates. Sustainable urbanisation requires more green infrastructure in cities such as green roofs to minimise urbanisation impacts. The environmental, social and economic benefits of green roofs are widely deliberated. However, there is still a lack of assessment of the water management for green roofs. This paper aimed to assess the irrigation management of green roofs in a semi-arid region where blue water scarcity is one of the primary challenges in urban water management. To determine the appropriate water source and growing media for green roofs, an experiment was established at the University of South Australia, Australia. This study compared the performance of two growing media and three water sources on the drainage quality, medium weight and survival rate of potted Tussock grass (Poa labillardieral), an endemic plant to Australia and recommended for green roofs. Three irrigation sources were tap water, mixed of wastewater-stormwater, and rainwater. The growing media were natural sandy loam soil and Scoria - one of the most used commercial growing media for green roofs. The drainage quality of these media was tested by analysing leachate samples. Medium weight was measured before and after watering, and all pots were monitored for their survival rates. Results showed that although plant growing development was significantly higher in Scoria, the survival rate was lower. For all three water sources, EC and pH of the leachate were significantly lower from Scoria than the sandy loam soil. However, the mixed of wastewater-stormwater had the highest EC, and rainwater had the lowest EC. Results did not present a significant difference between pH of different water resources in the same media. Our experimental results found the scoria and rainwater as the best sources of medium and water for green roofs.

Keywords: green smart cities, urban water, green roofs, green walls, wastewater, stormwater

Procedia PDF Downloads 134
332 Influence of Recycled Polymer-Based Aggregates on Mechanical Properties of Polymer Concrete

Authors: Ahmet Kurklu, Abdussamed Sarp, Gokmen Arikan, Akin Eren, Arif Ulu, Ferit Cakir

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Our natural resources are diminishing day by day with the needs of the growing world population. There is a danger that these resources will be depleted if they are not used in a controlled manner. As a result of the rapid increase in the consumption of limited natural resources, one of the issues where studies have gained importance is recycling. Many countries have carried out various research and development activities on recycling and reuse to prevent wastage of resources. For sustainable and healthy living, the limited amount of raw material resources in nature should be consumed consciously, and the necessary awareness should be given for recycling activities. One of the sectors where the consumption of raw materials is high is the construction sector. With the changing consumption habits of the evolving technology in the construction sector, the need to use special concrete along with the normal concrete has arisen. With the increasing need for specialty concretes, polymer concrete, which was discovered in the early 1900s, has evolved to the present day. Polymer concretes are special concretes with high strength, water impermeability, resistance to chemical action, and low surface roughness. Thanks to these properties, they find wide applications in many fields such as swimming pools, drainage systems, repair works. In the study, the effect of using recycled aggregates instead of natural aggregates in the production of polymer concrete on the performance of polymer concrete is investigated. In the experiments conducted for this purpose, the use of natural aggregate is reduced at certain rates, and instead, recycled aggregate is added at the same rate. The recycled aggregate to be used in the study is obtained from the polymer concrete drainage channel production facility of Mert Casting Co., Istanbul, Turkey. In order to clearly observe the effect of recycled materials on the product in the study, the other components (resin, hardener, accelerator, and additive) are kept constant in the concrete mix. In the study, fresh and hardened concrete tests are to be carried out on the mixes to be prepared.

Keywords: concrete, mechanical properties, polymer concrete, recycle aggregate

Procedia PDF Downloads 113
331 Impact of Glaucoma Surgery on Corneal Endothelium

Authors: Majid Moshirfar, Kyle Margulies, Yasmyne C. Ronquillo, Phillip Hoopes

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A total of 66 articles were reviewed to compare glaucoma and its associated surgeries' effect on central corneal endothelium cell density (CECD). The paper reports the average reported central CECD loss at 3-, 6-, 12-, 24-, 36-, 48-, and 60-month post-operation for each glaucoma surgery. ALT, MLT, SLT, CS AGV, VC BGI, Hydrus + phaco, XEN gel + phaco, PRESERFLO, Dual iStent, or Trabectome had no significant impact on postoperative CECD compared to either preoperative CECD or control group CECD. The highest CECD loss was found to be EXPRESS-phaco, AC AGV, CS BGI, CS BGI, AC BGI, and AC BGI at the 3-, 6-, 12-, 24-, 36-, 48-, and 60-month follow-ups, respectively. AC AGV, Trab + MMC, Trab, AC BGI, Trab + MMC, Cypass, and Cypass showed the smallest reduction of CECD at the 3-, 6-, 12-, 24-, 36-, 48-, and 60-month follow-ups.

Keywords: glaucoma, corneal endothelium, cell density, surgery outcome

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330 A Prospective Review of Axillary Drainage in Axillary Lymph Node Dissection in Breast Conservation Cancer Surgery

Authors: Ruqayya Naheed Khan, Romaisa Shamim, Awais Amjad Malik, Awais Naeem, Amina Iqbal Khan, Asad Parvaiz

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Objective: Patients undergoing axillary lymph node dissection (ALND) for metastatic lymph nodes in our hospital usually have drains placed in their axilla for a period of 6-10 days. We evaluated the post-op course of patients who underwent breast conservation surgery (BCS) along with ALND. Methods: A prospective cohort study was conducted at Shaukat Khanam Memorial Cancer Hospital from April 2017 to August 2017 including all lymph node positive breast cancer patients undergoing BCS with ALND. Patients were divided into two groups. Group A had no axillary drain while in Group B a drain was placed in axilla. Results: A total of 76 patients were included. 41 patients were included in group A and 35 patients in Group B. Median number of LNs dissected in group A was 17 and in group B was 15 (p value 0.443). Median operative time in group A was 84 min and in group B was 79 min (p value 0.223). Median hospital stay in both groups was 1 day (p value 0.78). At 2 weeks all patients in group A developed seroma as compared to none in group B (p value < 0.001). 3 of these patients in group A required aspiration of seroma due to pressure effects. Rest were managed conservatively. At 6 weeks only 50% patients had a seroma radiologically in Group A as compared to 33% in group B (p value 0.023). No intervention was required in any patients at week 6. QOL at 2 weeks was much better in Group A (7/41 patients had unsatisfactory response) as compared to group B (10/31 had unsatisfactory response). Results were statistically significant (p value 0.045). However, there wasn’t much difference in QOL at 6 weeks. Only 1 patient in group A had an unsatisfactory response. Average pain score at 2 weeks was similar in both groups (4.2 v/s 4.1 p value 0.73). Infection was seen in 1 patient in each group at 2 weeks (p value 0.668) and in only 1 patient in group A at 6 weeks (p value 0.067). Conclusion: We conclude from our study that there isn’t much difference in drain and no drain group in terms of wound infection and pain scores. No drain group is however associated with a better QOL in early post-op period.

Keywords: axillary drainage, axillary lymph node dissection, breast cancer, no drain in axilla

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329 Land Degradation Assessment through Spatial Data Integration in Eastern Chotanagpur Plateau, India

Authors: Avijit Mahala

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Present study is primarily concerned with the physical processes and status of land degradation in a tropical plateau fringe. Chotanagpur plateau is one of the most water erosion related degraded areas of India. The granite gneiss geological formation, low to medium developed soil cover, undulating lateritic uplands, high drainage density, low to medium rainfall (100-140cm), dry tropical deciduous forest cover makes the Silabati River basin a truly representative of the tropical environment. The different physical factors have been taken for land degradation study includes- physiographic formations, hydrologic characteristics, and vegetation cover. Water erosion, vegetal degradation, soil quality decline are the major processes of land degradation in study area. Granite-gneiss geological formation is responsible for developing undulating landforms. Less developed soil profile, low organic matter, poor structure of soil causes high soil erosion. High relief and sloppy areas cause unstable environment. The dissected highland causes topographic hindrance in productivity. High drainage density and frequency in rugged upland and intense erosion in sloppy areas causes high soil erosion of the basin. Decreasing rainfall and increasing aridity (low P/PET) threats water stress condition. Green biomass cover area is also continuously declining. Through overlaying the different physical factors (geological formation, soil characteristics, geomorphological characteristics, etc.) of considerable importance in GIS environment the varying intensities of land degradation areas has been identified. Middle reaches of Silabati basin with highly eroded laterite soil cover areas are more prone to land degradation.

Keywords: land degradation, tropical environment, lateritic upland, undulating landform, aridity, GIS environment

Procedia PDF Downloads 111
328 Determining Optimum Locations for Runoff Water Harvesting in W. Watir, South Sinai, Using RS, GIS, and WMS Techniques

Authors: H. H. Elewa, E. M. Ramadan, A. M. Nosair

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Rainfall water harvesting is considered as an important tool for overcoming water scarcity in arid and semi-arid region. Wadi Watir in the southeastern part of Sinai Peninsula is considered as one of the main and active basins in the Gulf of Aqaba drainage system. It is characterized by steep hills mainly consist of impermeable rocks, whereas the streambeds are covered by a highly permeable mixture of gravel and sand. A comprehensive approach involving the integration of geographic information systems, remote sensing and watershed modeling was followed to identify the RWH capability in this area. Eight thematic layers, viz volume of annual flood, overland flow distance, maximum flow distance, rock or soil infiltration, drainage frequency density, basin area, basin slope and basin length were used as a multi-parametric decision support system for conducting weighted spatial probability models (WSPMs) to determine the potential areas for the RWH. The WSPMs maps classified the area into five RWH potentiality classes ranging from the very low to very high. Three performed WSPMs' scenarios for W. Watir reflected identical results among their maps for the high and very high RWH potentiality classes, which are the most suitable ones for conducting surface water harvesting techniques. There is also a reasonable match with respect to the potentiality of runoff harvesting areas with a probability of moderate, low and very low among the three scenarios. WSPM results have shown that the high and very high classes, which are the most suitable for the RWH are representing approximately 40.23% of the total area of the basin. Accordingly, several locations were decided for the establishment of water harvesting dams and cisterns to improve the water conditions and living environment in the study area.

Keywords: Sinai, Wadi Watir, remote sensing, geographic information systems, watershed modeling, runoff water harvesting

Procedia PDF Downloads 335
327 Maxillofacial Trauma: A Case of Diacapitular Condylar Fracture

Authors: Krishna Prasad Regmi, Jun-Bo Tu, Cheng-Qun Hou, Li-Feng Li

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Maxillofacial trauma in a pediatric group of patients is particularly challenging, as these patients have significant differences from adults as far as the facial skeleton is concerned. Mandibular condylar fractures are common presentations to hospitals across the globe and remain the most important cause of temporomandibular joint (TMJ) ankylosis. The etiology and epidemiology of pediatric trauma involving the diacapitular condylar fractures (DFs) have been reported in a large series of patients. Nevertheless, little is known about treatment protocols for DFs in children. Accordingly, the treatment modalities for the management of pediatric fractures also differ. We suggest following the PDA and intracapsular ABC classification of condylar fracture to increase the overall postoperative satisfaction level that bypasses the change of subjective feelings of patients’ from preoperative to the postoperative condition. At the same time, use of 3-D technology and surgical navigation may also increase treatment accuracy.

Keywords: maxillofacial trauma, diacapitular fracture, condylar fracture, PDA classification

Procedia PDF Downloads 245
326 Identification of Suitable Rainwater Harvesting Sites Using Geospatial Techniques with AHP in Chacha Watershed, Jemma Sub-Basin Upper Blue Nile, Ethiopia

Authors: Abrha Ybeyn Gebremedhn, Yitea Seneshaw Getahun, Alebachew Shumye Moges, Fikrey Tesfay

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Rainfed agriculture in Ethiopia has failed to produce enough food, to achieve the increasing demand for food. Pinpointing the appropriate site for rainwater harvesting (RWH) have a substantial contribution to increasing the available water and enhancing agricultural productivity. The current study related to the identification of the potential RWH sites was conducted at the Chacha watershed central highlands of Ethiopia which is endowed with rugged topography. The Geographic Information System with Analytical Hierarchy Process was used to generate the different maps for identifying appropriate sites for RWH. In this study, 11 factors that determine the RWH locations including slope, soil texture, runoff depth, land cover type, annual average rainfall, drainage density, lineament intensity, hydrologic soil group, antecedent moisture content, and distance to the roads were considered. The overall analyzed result shows that 10.50%, 71.10%, 17.90%, and 0.50% of the areas were found under highly, moderately, marginally suitable, and unsuitable areas for RWH, respectively. The RWH site selection was found highly dependent on a slope, soil texture, and runoff depth; moderately dependent on drainage density, annual average rainfall, and land use land cover; but less dependent on the other factors. The highly suitable areas for rainwater harvesting expansion are lands having a flat topography with a soil textural class of high-water holding capacity that can produce high runoff depth. The application of this study could be a baseline for planners and decision-makers and support any strategy adoption for appropriate RWH site selection.

Keywords: runoff depth, antecedent moisture condition, AHP, weighted overlay, water resource

Procedia PDF Downloads 21
325 Application of Pedicled Perforator Flaps in Large Cavities of the Breast

Authors: Neerja Gupta

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Objective-Reconstruction of large cavities of the breast without contralateral symmetrisation Background- Reconstruction of breast includes a wide spectrum of procedures from displacement to regional and distant flaps. The pedicled Perforator flaps cover a wide spectrum of reconstruction surgery for all quadrants of the breast, especially in patients with comorbidities. These axial flaps singly or adjunct are based on a near constant perforator vessel, a ratio of 2:1 at its entry in a flap is good to maintain vascularity. The perforators of lateral chest wall viz LICAP, LTAP have overlapping perfurosomes without clear demarcation. LTAP is localized in the narrow zone between the lateral breast fold and anterior axillary line,2.5-3.8cm from the fold. MICAP are localized at 1-2 cm from sternum. Being 1-2mm in diameter, a Single perforator is good to maintain the flap. LICAP has a dominant perforator in 6th-11th spaces, while LTAP has higher placed dominant perforators in 4th and 5th spaces. Methodology-Six consecutive patients who underwent reconstruction of the breast with pedicled perforator flaps were retrospectively analysed. Selections of the flap was done based on the size and locations of the tumour, anticipated volume loss, willingness to undergo contralateral symmetrisation, cosmetic expectations, and finances available.3 patients underwent vertical LTAP, the distal limit of the flap being the inframammary crease. 3 patients underwent MICAP, oriented along the axis of rib, the distal limit being the anterior axillary line. Preoperative identification was done using a unidirectional hand held doppler. The flap was raised caudal to cranial, the pivot point of rotation being the vessel entry into the skin. The donor area is determined by the skin pinch. Flap harvest time was 20-25 minutes. Intra operative vascularity was assessed with dermal bleed. The patient immediate pre, post-operative and follow up pics were compared independently by two breast surgeons. Patients were given a breast Q questionnaire (licensed) for scoring. Results-The median age of six patients was 46. Each patient had a hospital stay of 24 hours. None of the patients was willing for contralateral symmetrisation. The specimen dimensions were from 8x6.8x4 cm to 19x16x9 cm. The breast volume reconstructed range was 30 percent to 45 percent. All wide excision had free margins on frozen. The mean flap dimensions were 12x5x4.5 cm. One LTAP underwent marginal necrosis and delayed wound healing due to seroma. Three patients were phyllodes, of which one was borderline, and 2 were benign on final histopathology. All other 3 patients were invasive ductal cancer and have completed their radiation. The median follow up is 7 months the satisfaction scores at median follow of 7 months are 90 for physical wellbeing and 85 for surgical results. Surgeons scored fair to good in Harvard score. Conclusion- Pedicled perforator flaps are a valuable option for 3/8th volume of breast defects. LTAP is preferred for tumours at the Central, upper, and outer quadrants of the breast and MICAP for the inner and lower quadrant. The vascularity of the flap is dependent on the angiosomalterritories; adequate venous and cavity drainage.

Keywords: breast, oncoplasty, pedicled, perforator

Procedia PDF Downloads 164
324 Arthroscopic Superior Capsular Reconstruction Using the Long Head of the Biceps Tendon (LHBT)

Authors: Ho Sy Nam, Tang Ha Nam Anh

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Background: Rotator cuff tears are a common problem in the aging population. The prevalence of massive rotator cuff tears varies in some studies from 10% to 40%. Of irreparable rotator cuff tears (IRCTs), which are mostly associated with massive tear size, 79% are estimated to have recurrent tears after surgical repair. Recent studies have shown that superior capsule reconstruction (SCR) in massive rotator cuff tears can be an efficient technique with optimistic clinical scores and preservation of stable glenohumeral stability. Superior capsule reconstruction techniques most commonly use either fascia lata autograft or dermal allograft, both of which have their own benefits and drawbacks (such as the potential for donor site issues, allergic reactions, and high cost). We propose a simple technique for superior capsule reconstruction that involves using the long head of the biceps tendon as a local autograft; therefore, the comorbidities related to graft harvesting are eliminated. The long head of the biceps tendon proximal portion is relocated to the footprint and secured as the SCR, serving to both stabilize the glenohumeral joint and maintain vascular supply to aid healing. Objective: The purpose of this study is to assess the clinical outcomes of patients with large to massive RCTs treated by SCR using LHBT. Materials and methods: A study was performed of consecutive patients with large to massive RCTs who were treated by SCR using LHBT between January 2022 and December 2022. We use one double-loaded suture anchor to secure the long head of the biceps to the middle of the footprint. Two more anchors are used to repair the rotator cuff using a single-row technique, which is placed anteriorly and posteriorly on the lateral side of the previously transposed LHBT. Results: The 3 men and 5 women had an average age of 61.25 years (range 48 to 76 years) at the time of surgery. The average follow-up was 8.2 months (6 to 10 months) after surgery. The average preoperative ASES was 45.8, and the average postoperative ASES was 85.83. The average postoperative UCLA score was 29.12. VAS score was improved from 5.9 to 1.12. The mean preoperative ROM of forward flexion and external rotation of the shoulder was 720 ± 160 and 280 ± 80, respectively. The mean postoperative ROM of forward flexion and external rotation were 1310 ± 220 and 630 ± 60, respectively. There were no cases of progression of osteoarthritis or rotator cuff muscle atrophy. Conclusion: SCR using LHBT is considered a treatment option for patients with large or massive RC tears. It can restore superior glenohumeral stability and function of the shoulder joint and can be an effective procedure for selected patients, helping to avoid progression to cuff tear arthropathy.

Keywords: superior capsule reconstruction, large or massive rotator cuff tears, the long head of the biceps, stabilize the glenohumeral joint

Procedia PDF Downloads 55
323 Aerodynamic Analysis of Vehicles

Authors: E. T. L. Cöuras Ford, V. A. C. Vale, J. U. L. Mendes

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Two of the objective principal in the study of the aerodynamics of vehicles are the safety and the acting. Those objectives can be reached through the development of devices modify the drainage of air about of the vehicle and also through alterations in the way of the external surfaces. The front lowest profile of the vehicle, for instance, has great influence on the coefficient of aerodynamic penetration (Cx) and later on great part of the pressure distribution along the surface of the vehicle. The objective of this work was of analyzing the aerodynamic behavior that it happens on some types the trucks of vehicles, based on experimentation in aerodynamic tunnel, seeking to determine the aerodynamic efficiency of each one of them.

Keywords: aerodynamic, vehicles, wind tunnel, safety, acting

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322 Artificial Neural Networks and Hidden Markov Model in Landslides Prediction

Authors: C. S. Subhashini, H. L. Premaratne

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Landslides are the most recurrent and prominent disaster in Sri Lanka. Sri Lanka has been subjected to a number of extreme landslide disasters that resulted in a significant loss of life, material damage, and distress. It is required to explore a solution towards preparedness and mitigation to reduce recurrent losses associated with landslides. Artificial Neural Networks (ANNs) and Hidden Markov Model (HMMs) are now widely used in many computer applications spanning multiple domains. This research examines the effectiveness of using Artificial Neural Networks and Hidden Markov Model in landslides predictions and the possibility of applying the modern technology to predict landslides in a prominent geographical area in Sri Lanka. A thorough survey was conducted with the participation of resource persons from several national universities in Sri Lanka to identify and rank the influencing factors for landslides. A landslide database was created using existing topographic; soil, drainage, land cover maps and historical data. The landslide related factors which include external factors (Rainfall and Number of Previous Occurrences) and internal factors (Soil Material, Geology, Land Use, Curvature, Soil Texture, Slope, Aspect, Soil Drainage, and Soil Effective Thickness) are extracted from the landslide database. These factors are used to recognize the possibility to occur landslides by using an ANN and HMM. The model acquires the relationship between the factors of landslide and its hazard index during the training session. These models with landslide related factors as the inputs will be trained to predict three classes namely, ‘landslide occurs’, ‘landslide does not occur’ and ‘landslide likely to occur’. Once trained, the models will be able to predict the most likely class for the prevailing data. Finally compared two models with regards to prediction accuracy, False Acceptance Rates and False Rejection rates and This research indicates that the Artificial Neural Network could be used as a strong decision support system to predict landslides efficiently and effectively than Hidden Markov Model.

Keywords: landslides, influencing factors, neural network model, hidden markov model

Procedia PDF Downloads 361
321 Semiconductor Supported Gold Nanoparticles for Photodegradation of Rhodamine B

Authors: Ahmad Alshammari, Abdulaziz Bagabas, Muhamad Assulami

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Rhodamine B (RB) is a toxic dye used extensively in textile industry, which must be remediated before its drainage to the environment. In the present study, supported gold nanoparticles on commercially available titania and zincite were successfully prepared and then their activity on the photodegradation of RB under UV-A light irradiation were evaluated. The synthesized photocatalysts were characterized by ICP, BET, XRD, and TEM. Kinetic results showed that Au/TiO2 was an inferior photocatalyst to Au/ZnO. This observation could be attributed to the strong reflection of UV irradiation by gold nanoparticles over TiO2 support.

Keywords: supported AuNPs, semiconductor photocatalyst, photodegradation, rhodamine B

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320 The Admitting Hemogram as a Predictor for Severity and in-Hospital Mortality in Acute Pancreatitis

Authors: Florge Francis A. Sy

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Acute pancreatitis (AP) is an inflammatory condition of the pancreas with local and systemic complications. Severe acute pancreatitis (SAP) has a higher mortality rate. Laboratory parameters like the neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), and mean platelet volume (MPV) have been associated with SAP but with conflicting results. This study aims to determine the predictive value of these parameters on the severity and in-hospital mortality of AP. This retrospective, cross-sectional study was done in a private hospital in Cebu City, Philippines. One-hundred five patients were classified according to severity based on the modified Marshall scoring. The admitting hemogram, including the NLR, RDW, and MPV, was obtained from the complete blood count (CBC). Cut-off values for severity and in-hospital mortality were derived from the ROC. Association between NLR, RDW, and MPV with SAP and mortality were determined with a p-value of < 0.05 considered significant. The mean age for AP was 47.6 years, with 50.5% being male. Most had an unknown cause (49.5%), followed by a biliary cause (37.1%). Of the 105 patients, 23 patients had SAP, and 4 died. Older age, longer in-hospital duration, congestive heart failure, elevated creatinine, urea nitrogen, and white blood cell count were seen in SAP. The NLR was associated with in-hospital mortality using a cut-off of > 10.6 (OR 1.133, 95% CI, p-value 0.003) with 100% sensitivity, 70.3% specificity, 11.76% PPV and 100% NPV (AUC 0.855). The NLR was not associated with SAP. The RDW and MPV were not associated with SAP and mortality. The admitting NLR is, therefore, an easily accessible parameter that can predict in-hospital mortality in acute pancreatitis. Although the present study did not show an association of NLR with SAP nor RDW and MPV with both SAP and mortality, further studies are suggested to establish their clinical value.

Keywords: acute pancreatitis, mean platelet volume, neutrophil-lymphocyte ratio, red cell distribution width

Procedia PDF Downloads 100
319 Ultrasonography of Low Extremities Veins Before and After Replacement of Knee Joint by Endoprosthesis

Authors: A. V. Alabut, V. D. Sikilinda, N. J. Nelasov, O. L. Eroshenko, M. N. Morgunov, I. V. Koroleva

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We have analyzed the results of treatment of 204 patients with knee prosthetic arthroplasty. For the purpose of active delineation of vascular pathology triplex sonography of arterial and venous vessels of low extremities was performed in all cases in the preoperative period. When it was necessary, reconstructive vascular surgery was implemented to improve peripheral circulation and reduce the hazard of thrombosis after knee replacement. The combination of specific and nonspecific methods of thromboprophylaxis was used in perioperative period. On 7-10 day and 2.5-3 month after prosthetic arthroplasty, all patients iteratively underwent triple sonography. In case of detection of floating thrombus, urgent venous ligation was performed. Active diagnostics of venous thrombosis gave the opportunity to avoid fatal pulmonary embolism.

Keywords: knee replacement, venous thrombosis, pulmonary embolism, vascular surgery

Procedia PDF Downloads 336
318 Characterization and Optimization of Culture Conditions for Sulphur Oxidizing Bacteria after Isolation from Rhizospheric Mustard Soil, Decomposing Sites and Pit House

Authors: Suman Chaudhary, Rinku Dhanker, Tanvi, Sneh Goyal

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Sulphur oxidizing bacteria (SOB) have marked their significant role in perspectives of maintaining healthy environment as researchers from all over the world tested and apply these in waste water treatment plants, bioleaching of heavy metals, deterioration of bridge structures, concrete and for bioremediation purposes, etc. Also, these SOB are well adapted in all kinds of environment ranging from normal soil, water habitats to extreme natural sources like geothermal areas, volcanic eruptions, black shale and acid rock drainage (ARD). SOB have been isolated from low pH environment of anthropogenic origin like acid mine drainage (AMD) and bioleaching heaps, hence these can work efficiently in different environmental conditions. Besides having many applications in field of environment science, they may be proven to be very beneficial in area of agriculture as sulphur is the fourth major macronutrients required for the growth of plants. More amount of sulphur is needed by pulses and oilseed crops with respect to the cereal grains. Due to continuous use of land for overproduction of more demanding sulphur utilizing crops and without application of sulphur fertilizers, its concentration is decreasing day by day, and thus, sulphur deficiency is becoming a great problem as it affects the crop productivity and quality. Sulphur is generally found in soils in many forms which are unavailable for plants (cannot be use by plants) like elemental sulphur, thiosulphate which can be taken up by bacteria and converted into simpler forms usable by plants by undergoing a series of transformations. So, keeping the importance of sulphur in view for various soil types, oilseed crops and role of microorganisms in making them available to plants, we made an effort to isolate, optimize, and characterize SOB. Three potential strains of bacteria were isolated, namely SSF7, SSA21, and SSS6, showing sulphate production of concentration, i.e. 2.268, 3.102, and 2.785 mM, respectively. Also, these were optimized for various culture conditions like carbon, nitrogen source, pH, temperature, and incubation time, and characterization was also done.

Keywords: sulphur oxidizing bacteria, isolation, optimization, characterization, sulphate production

Procedia PDF Downloads 315
317 Evaluation of the Risk Factors on the Incidence of Adjacent Segment Degeneration After Anterior Neck Discectomy and Fusion

Authors: Sayyed Mostafa Ahmadi, Neda Raeesi

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Background and Objectives: Cervical spondylosis is a common problem that affects the adult spine and is the most common cause of radiculopathy and myelopathy in older patients. Anterior discectomy and fusion is a well-known technique in degenerative cervical disc disease. However, one of the late undesirable complications is adjacent disc degeneration, which affects about 91% of patients in ten years. Many factors can be effective in causing this complication, but some are still debatable. Discovering these risk factors and eliminating them can improve the quality of life. Methods: This is a retrospective cohort study. All patients who underwent anterior discectomy and fusion surgery in the neurosurgery ward of Imam Khomeini Hospital between 2013 and 2016 were evaluated. Their demographic information was collected. All patients were visited and examined for radiculopathy, myelopathy, and muscular force. At the same visit, all patients were asked to have a facelift, and neck profile, as well as a neck MRI(General Tesla 3). Preoperative graphs were used to measure the diameter of the cervical canal(Pavlov ratio) and to evaluate sagittal alignment(Cobb Angle). Preoperative MRI of patients was reviewed for anterior and posterior longitudinal ligament calcification. Result: In this study, 57 patients were studied. The mean age of patients was 50.63 years, and 49.1% were male. Only 3.5% of patients had anterior and posterior longitudinal ligament calcification. Symptomatic ASD was observed in 26.6%. The X-rays and MRIs showed evidence of 80.7% radiological ASD. Among patients who underwent one-level surgery, 20% had symptomatic ASD, but among patients who underwent two-level surgery, the rate of ASD was 50%.In other words, the higher the number of surfaces that are operated and fused, the higher the probability of symptomatic ASD(P-value <0.05). The X-rays and MRIs showed 80.7% of radiological ASD. Among patients who underwent surgery at one level, 78% had radiological ASD, and this number was 92% among patients who underwent two-level surgery(P-value> 0.05). Demographic variables such as age, sex, height, weight, and BMI did not have a significant effect on the incidence of radiological ASD(P-value> 0.05), but sex and height were two influential factors on symptomatic ASD(P-value <0.05). Other related variables such as family history, smoking and exercise also have no significant effect(P-value> 0.05). Radiographic variables such as Pavlov ratio and sagittal alignment were also unaffected by the incidence of radiological and symptomatic ASD(P-value> 0.05). The number of surgical surfaces and the incidence of anterior and posterior longitudinal ligament calcification before surgery also had no statistically significant effect(P-value> 0.05). In the study of the ability of the neck to move in different directions, none of these variables are statistically significant in the two groups with radiological and symptomatic ASD and the non-affected group(P-value> 0.05). Conclusion: According to the findings of this study, this disease is considered to be a multifactorial disease. The incidence of radiological ASD is much higher than symptomatic ASD (80.7% vs. 26.3%) and sex, height and number of fused surfaces are the only factors influencing the incidence of symptomatic ASD and no variable influences radiological ASD.

Keywords: risk factors, anterior neck disectomy and fusion, adjucent segment degeneration, complication

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316 Hybrid versus Cemented Fixation in Total Knee Arthroplasty: Mid-Term Follow-Up

Authors: Pedro Gomes, Luís Sá Castelo, António Lopes, Marta Maio, Pedro Mota, Adélia Avelar, António Marques Dias

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Introduction: Total Knee Arthroplasty (TKA) has contributed to improvement of patient`s quality of life, although it has been associated with some complications including component loosening and polyethylene wear. To prevent these complications various fixation techniques have been employed. Hybrid TKA with cemented tibial and cementless femoral components have shown favourable outcomes, although it still lack of consensus in the literature. Objectives: To evaluate the clinical and radiographic results of hybrid versus cemented TKA with an average 5 years follow-up and analyse the survival rates. Methods: A retrospective study of 125 TKAs performed in 92 patients at our institution, between 2006 to 2008, with a minimum follow-up of 2 years. The same prosthesis was used in all knees. Hybrid TKA fixation was performed in 96 knees, with a mean follow-up of 4,8±1,7 years (range, 2–8,3 years) and 29 TKAs received fully cemented fixation with a mean follow-up of 4,9±1,9 years (range, 2-8,3 years). Selection for hybrid fixation was nonrandomized and based on femoral component fit. The Oxford Knee Score (OKS 0-48) was evaluated for clinical assessment and Knee Society Roentgenographic Evaluation Scoring System was used for radiographic outcome. The survival rate was calculated using the Kaplan-Meier method, with failures defined as revision of either the tibial or femoral component for aseptic failures and all-causes (aseptic and infection). Analysis of survivorship data was performed using the log-rank test. SPSS (v22) was the computer program used for statistical analysis. Results: The hybrid group consisted of 72 females (75%) and 24 males (25%), with mean age 64±7 years (range, 50-78 years). The preoperative diagnosis was osteoarthritis (OA) in 94 knees (98%), rheumatoid arthritis (RA) in 1 knee (1%) and Posttraumatic arthritis (PTA) in 1 Knee (1%). The fully cemented group consisted of 23 females (79%) and 6 males (21%), with mean age 65±7 years (range, 47-78 years). The preoperative diagnosis was OA in 27 knees (93%), PTA in 2 knees (7%). The Oxford Knee Scores were similar between the 2 groups (hybrid 40,3±2,8 versus cemented 40,2±3). The percentage of radiolucencies seen on the femoral side was slightly higher in the cemented group 20,7% than the hybrid group 11,5% p0.223. In the cemented group there were significantly more Zone 4 radiolucencies compared to the hybrid group (13,8% versus 2,1% p0,026). Revisions for all causes were performed in 4 of the 96 hybrid TKAs (4,2%) and 1 of the 29 cemented TKAs (3,5%). The reason for revision was aseptic loosening in 3 hybrid TKAs and 1 of the cemented TKAs. Revision was performed for infection in 1 hybrid TKA. The hybrid group demonstrated a 7 years survival rate of 93% for all-cause failures and 94% for aseptic loosening. No significant difference in survivorship was seen between the groups for all-cause failures or aseptic failures. Conclusions: Hybrid TKA yields similar intermediate-term results and survival rates as fully cemented total knee arthroplasty and remains a viable option in knee joint replacement surgery.

Keywords: hybrid, survival rate, total knee arthroplasty, orthopaedic surgery

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315 Neutralization of Sulphurous Waste (AMD) Using Recycled Waste Concrete

Authors: Ercument Koc, Banu Yaylali, Gulsen Tozsin, Haci Deveci

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Re-using of concrete waste materials for the neutralization of acid mine drainage (AMD) can protect the environment and contribute the national economy. The aim of this study was to investigate the prevention of AMD formation and heavy metal release using concrete wastes which are alkaline and generated by demolition of buildings within the urban renewal process. Shake flask test was conducted to determine the neutralization effects. Concrete wastes are rich in CaCO3 and they are used as a pH regulator for AMD neutralization. The results showed that pH of the AMD increased from 3.33 to 6.84 with the application of concrete waste materials.

Keywords: AMD, neutralization, sulphurous waste, urban renewal

Procedia PDF Downloads 274
314 Safe Disposal of Pyrite Rich Waste Rock Using Alkali Phosphate Treatment

Authors: Jae Gon Kim, Yongchan Cho, Jungwha Lee

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Acid rock drainage (ARD) is generated by the oxidation of pyrite (FeS₂) contained in the excavated rocks upon its exposure to atmosphere and is an environmental concern at construction site due to its high acidity and high concentration of toxic elements. We developed the safe disposal method with the reduction of ARD generation by an alkali phosphate treatment. A pyrite rich andesite was collected from a railway construction site. The collected rock sample was crushed to be less than 3/8 inches in diameter using a jaw crusher. The crushed rock was filled in an acryl tube with 20 cm in diameter and 40 cm in height. Two treatments for the ARD reduction were conducted with duplicates: 1) the addition of 10mM KH₂PO₄_3% NaHCO₃ and 2) the addition of 10mM KH₂PO₄_3% NaHCO₃ and ordinary portland cement (OPC) on the top of the column. After the treatments, 500 ml of distilled water added to each column for every week for 3 weeks and then the column was flushed with 1,500 ml of distilled water in the 4th week. The pH, electrical conductivity (EC), concentrations of anions and cations of the leachates were monitored for 10 months. The pH of the leachates from the untreated column showed 2.1-3.7, but the leachates from the columns treated with the alkali phosphate solution with or without the OPC addition showed pH 6.7–8.9. The leachates from the treated columns had much lower concentrations of SO₄²⁻ and toxic elements such as Al, Mn, Fe and heavy metals than those from the untreated columns. However, the leachates from the treated columns had a higher As concentration than those from the untreated columns. There was no significant difference in chemical property between the leachates from the treated columns with and without the OPC addition. The chemistry of leachates indicates that the alkali phosphate treatment decreased the oxidation of sulfide and neutralized the acidic pore water. No significant effect of the OPC addition on the leachate chemistry has shown during 10-month experiment. However, we expect a positive effect of the OPC addition on the reduction of ARD generation in terms of long period. According to the results of this experiment, the alkali phosphate treatment of sulfide rich rock can be a promising technology for the safe disposal method with the ARD reduction.

Keywords: acid rock drainage, alkali phosphate treatment, pyrite rich rock, safe disposal

Procedia PDF Downloads 121