Search results for: prosthetic venous valve

Authors: Ouassila Bekkal Brikci Benhabib, Zahia Boucherit Otmani, Kebir Boucherit, A. Seghir

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The establishment of intravenous catheters in hospitalized patient is an act common in many clinical situations. These therapeutic tools, from their insertion in the body, represent gateways including fungal germs prone. The latter can generate the growth of biofilms, which can be the cause of fungal infection. Faced with this problem, we conducted a study at the University Hospital of Tlemcen in the neurosurgery unit and aims to isolate and identify Candida yeasts from intravenous catheters. Then test their ability to form biofilms. Materials and methods: 256 patient hospitalized in surgery of the hospital in west Algeria were submitted to this study. All samples were taken from peripheral venous catheters implanted for 72 hours or more days. A total of 31 isolates of Candida species were isolated. MIC and SMIC are determined at 80% inhibition by the test XTT tetrazolium measured at 490 nm. The final concentrations of antifungal agent being between 0.03 and 16 mg / ml for amphotericin B and from 0.015 to 8 mg / mL caspofungin. Results: 31 Candida species isolates from catheters including 14 Candida albicans and 17 Candida non albicans . 21 strains of all the isolates were able to form biofilms. In their form of Planktonic cells, all isolates are 100% susceptible to antifungal agents tested. However, in their state of biofilms, more isolates have become tolerant to the tested antifungals. Conclusion: Candida yeasts isolated from intravascular catheters are considered an important virulence factor in the pathogenesis of infections. Their involvement in catheter-related infections can be disastrous for their potential to generate biofilms. They survive high concentrations of antifungal where treatment failure. Pending the development of a therapeutic approach antibiofilm related to catheters, their mastery is going through: -The risk of infection prevention based on the training and awareness of medical staff, -Strict hygiene and maximum asepsis, and -The choice of material limiting microbial colonization.

Keywords: candida, biofilm, hospital, infection, amphotericin B, caspofungin

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Authors: Siamak Yaghoubi, Vahideh Rashtchi, Marzieh Khezri, Hamid Kayalha, Monadi Hamidfar

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Background and objectives: Effective postoperative pain management in abdominal surgeries, which are painful procedures, plays an important role in reducing postoperative complications and increasing patient’s satisfaction. There are many techniques for pain control, one of which is Patient-Controlled Analgesia (PCA). The aim of this study was to compare the analgesic effects of morphine, paracetamol and ketorolac in the patients undergoing open cholecystectomy, using PCA method. Material and Methods: This randomized controlled trial was performed on 330 ASA (American Society of Anesthesiology) I-II patients ( three equal groups, n=110) who were scheduled for elective open cholecystectomy in Shahid Rjaee hospital of Qazvin, Iran from August 2013 until September 2015. All patients were managed by general anesthesia with TIVA (Total Intra Venous Anesthesia) technique. The control group received morphine with maximum dose of 0.02mg/kg/h, the paracetamol group received paracetamol with maximum dose of 1mg/kg/h, and the ketorolac group received ketorolac with maximum daily dose of 60mg using IV-PCA method. The parameters of pain, nausea, hemodynamic variables (BP and HR), pruritus, arterial oxygen desaturation, patient’s satisfaction and pain score were measured every two hours for 8 hours following operation in all groups. Results: There were no significant differences in demographic data between the three groups. there was a statistically significant difference with regard to the mean pain score at all times between morphine and paracetamol, morphine and ketorolac, and paracetamol and ketorolac groups (P<0.001). Results indicated a reduction with time in the mean level of postoperative pain in all three groups. At all times the mean level of pain in ketorolac group was less than that in the other two groups (p<0.001). Conclusion: According to the results of this study ketorolac is more effective than morphine and paracetamol in postoperative pain control in the patients undergoing open cholecystectomy, using PCA method.

Keywords: analgesia, cholecystectomy, ketorolac, morphine, paracetamol

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Authors: Anis Eloud, Sayed Chehaibi

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Compaction of agricultural soils as a result of the passage of heavy machinery on the fields is a problem that affects many agronomists and farmers since it results in a loss of yield of most crops. To remedy this, and raise the overall future of the food security challenge, we must study and understand the process of soil degradation. The present review is devoted to understanding the effect of repeated passages on agricultural land. The experiments were performed on a plot of the area of the ESIER, characterized by a clay texture in order to quantify the soil compaction caused by the wheels of the tractor during repeated passages on agricultural land. The test tractor CASE type puissance 110 hp and 5470 kg total mass of 3500 kg including the two rear axles and 1970 kg on the front axle. The state of soil compaction has been characterized by measuring its resistance to penetration by means of a penetrometer and direct manual reading, the density and permeability of the soil. Soil moisture was taken jointly. The measurements are made in the initial state before passing the tractor and after each pass varies from 1 to 7 on the track wheel inflated to 1.5 bar for the rear wheel and broke water to the level of valve and 4 bar for the front wheels. The passages are spaced to the average of one week. The results show that the passage of wheels on a farm tilled soil leads to compaction and the latter increases with the number of passages, especially for the upper 15 cm depth horizons. The first passage is characterized by the greatest effect. However, the effect of other passages do not follow a definite law for the complex behavior of granular media and the history of labor and the constraints it suffers from its formation.

Keywords: wheel traffic, tractor, soil compaction, wheel

Procedia PDF Downloads 449

Authors: Manas Kotepui, Kwuntida Uthaisar, Phiman Thirarattanasunthon, Bhukdee PhunPhuech, Nuoil Phiwklam

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Introduction: Malaria due to Plasmodium vivax has placed huge burdens on the health, longevity, and general prosperity of large sections of the human population. This study aimed at prospectively collecting information on the clinical profile of Plasmodium vivax from subjects acutely infected with P. vivax residing in some of the highest malaria transmission regions in Thailand. Methods: A retrospective study of malaria cases, hospitalized between 2013 and 2015 was performed. Clinical characteristics, diagnosis, and parasitological results on admission, age, and gender were mined from medical records at Phop Phra Hospital located in endemic areas of Tak Province, Thailand. Venous blood samples were collected at the time of admission to the hospital to determine the present of parasite and also parasite count by thick and thin film examination, and also Complete blood count (CBC) parameters. Results: Results showed that patients infected with Plasmodium vivax (276 cases) had a high monocyte count (mean=390 cells/µL) during initial stage of infection and continuously lower during later stage (any stage with gametocyte, mean=230 cells/µL) of infection (P value=0.021) whereas, patients infected with Plasmodium vivax had a low basophil count (mean=20 cells/µL) during initial stage of infection and continuously higher during later stage of infection (mean at stage with gametocyte=70 cells/µL) (P value=0.033). In addition, patients with more than one stage infection tend to have lower lymphocyte count (mean=1180 cells/µL) than patients with only one stage infection (mean=1350 cells/µL)(P value=0.011) whereas, patients with more than one stage infection tend to have lower basophil count (mean=60 cells/µL) than patients with only one stage infection (mean=80 cells/µL) (P value=0.01). Conclusion: This study indicated that patients infected with Plasmodium vivax had high monocyte count and low basophil count during initial stage of infection which was continuously lower during later stage of infection. Patients with more than one stage infection tend to have lower lymphocyte count than patients with only one stage infection whereas, patients with more than one stage infection tend to have lower basophil count than patients with only one stage infection. This information contributes to better understanding of pathological characteristic of Plasmodium vivax infection.

Keywords: plasmodium vivax, Thailand, asexual erythrocytic stages, hematological parameters

Procedia PDF Downloads 180

Authors: H. J. Liu, Y. A. Chan, C. K. Pai, K. C. Tseng, Y. H. Chen, Y. L. Chan, T. C. Kuo

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To satisfy the mission requirement of the FORMOSAT-7 project, NSPO has initialized a self-reliant development on satellite propulsion technology. A trade-off study on different types of on-board propulsion system has been done. A green propellant, high-concentration hydrogen peroxide (H2O2 hereafter), is chosen in this research because it is ITAR-free, nontoxic and easy to produce. As the components designed for either cold gas or hydrazine propulsion system are not suitable for H2O2 propulsion system, the primary objective of the research is to develop the components compatible with H2O2. By cooperating with domestic research institutes and manufacturing vendors, several prototype components, including a diaphragm-type tank, pressure transducer, ball latching valve, and one-Newton thruster with catalyst bed, were manufactured, and the functional tests were performed successfully according to the mission requirements. The requisite environmental tests, including hot firing test, thermal vaccum test, vibration test and compatibility test, are prepared and will be to completed in the near future. To demonstrate the subsystem function, an Air-Bearing Thrust Stand (ABTS) and a real-time Data Acquisition & Control System (DACS) were implemented to assess the performance of the proposed H2O2 propulsion system. By measuring the distance that the thrust stand has traveled in a given time, the thrust force can be derived from the kinematics equation. To validate the feasibility of the approach, it is scheduled to assess the performance of a cold gas (N2) propulsion system prior to the H2O2 propulsion system.

Keywords: FORMOSAT-7, green propellant, Hydrogen peroxide, thruster

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Authors: Daehyun Baek, Seungmin Lee, Minju Kim Jangik Park, Hyeong-Soon Moon

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SPM (Single Point Mooring) is one of the mooring buoy facilities installed on a coast near oil and gas terminal which is not able to berth FPSO or large oil tankers under the condition of high draft due to geometrical limitation. Loading and unloading of crude oil and gas through a subsea pipeline can be carried out between the mooring buoy, ships and onshore facilities. SPM is an offshore-standalone system which has to withstand the harsh marine environment with harsh conditions such as high wind, current and so on. Therefore, SPM is required to have high stability, reliability and durability. Also, SPM is comprised to be integrated systems which consist of power management, high pressure valve control, sophisticated hardware/software and a long distance communication system. In order to secure required functions of SPM system, a simulation model for the integrated system of SPM using MATLAB Simulink and State flow tool has been developed. The developed model consists of configuration of hydraulic system for opening and closing of PLEM (Pipeline End Manifold) valves and control system logic. To verify functions of the model, an integrated simulation model for overall systems of SPM was also developed by considering handshaking variables between individual systems. In addition to the dynamic model, a self-diagnostic function to determine failure of the system was configured, which enables the SPM system itself to alert users about the failure once a failure signal comes to arise. Controlling and monitoring the SPM system is able to be done by a HMI system which is capable of managing the SPM system remotely, which was carried out by building a communication environment between the SPM system and the HMI system.

Keywords: HMI system, mooring buoy, simulink simulation model, single point mooring, stateflow

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Authors: A. Kherraf, S. Ouarrak, L. Azzouzi, R. Habbal

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Introduction: Preserved LVEF heart failure is an important cause of mortality and morbidity in hypertensive patients. A strong correlation between impaired diastolic function and longitudinal systolic dysfunction. could have several explanations, first, the diastole is an energy dependent process, especially during its first phase, it also includes active systolic components during the phase of iso volumetric relaxation, in addition, the impairment of the intrinsic myocytic function is part of hypertensive pathology as evidenced by recent studies. METHODS AND MATERIALS: This work consists of performing in a series of 333 hypertensive patients (aged 25 to 75 years) a complete echocardiographic study, including LVEF by Simpson biplane method, the calculation of the indexed left ventricular mass, the analysis of the diastolic function, and finally, the study of the longitudinal deformation of the LV by the technique of speckletracking (calculation of the GLS). Patients with secondary hypertension, leaky or stenosing valve disease, arrhythmia, and a history of coronary insufficiency were excluded from this study. RESULTS: Of the 333 hypertensive patients, 225 patients (67.5%) had impaired diastolic function, of which 60 patients (18%) had high filling pressures. 49.39% had echocardigraphic HVG, Almost all of these patients (60 patients) had low GLS. There is a statistically very significant relationship between lower GLS and increased left ventricular filling pressures in hypertensive patients. These results suggest that increased filling pressures are closely associated with atrioventricular interaction in patients with hypertension, with a strong correlation with impairment of longitudinal systolic function and diastolic function CONCLUSION: Overall, a linear relationship is established between increased left ventricular mass, diastolic dysfunction, and longitudinal LV systolic dysfunction

Keywords: hypertension, diastolic function, left ventricle, heart failure

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Authors: Samar Saadeldin Abdelmotalab Omer, Ikram Mohammed Eltayeb Elsiddig, Amna Beshir Medani Ahmed, Saad Mohammed Hussein Ayoub

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Many herbal medicinal products are considered as potential hypocholesterolemic agents with encouraging safety profiles, however, only a limited amount of clinical research exists to support their efficacy. The present study was designed to compare the antihypercholesterolaemic and antioxidant activities of the crude ethanolic extracts of Citrus reticulata peel, Zingiber officinale rhizome, and Sesamum indicum seeds. Forty-five rats were used throughout the experiment, which were divided into nine groups, five rats in each as follows; normal control group (normal rats fed with standard normal diet), rats fed hypercholesterolemic diet consisting of 1% cholesterol and 10% saturated animal fat, which were further divided into eight groups; hypercholesterolemic control group (rats only fed hypercholesterolemic diet), groups 3,4,5,6,7, and 8 were given Citrus reticulata, Zingiber officinale, and Sesamum indicum ethanolic extracts at doses of (250mg/kg and 500mg/kg, respectively) orally; and group 9 rats were given atorvastatin (0.18mg/kg) orally as a reference antihypercholesterolaemic drug. Blood samples were obtained four weeks following treatment from the retro-orbital venous plexus after fasting overnight from all groups and the lipid profile (serum total cholesterol (TC), high-density-lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and triglycerides levels) was measured and the risk ratio (TC/HDL-C) was assessed. The antioxidant activity of the three plant extracts was determined using DPPH free-radical assay. Results of in vivo and in vitro antihypercholesterolaemic and antioxidant assay, respectively, revealed that the three extracts possess comparable antioxidant and anti-hypercholesterolaemic activities.

Keywords: anti hypercholesterolemic effects, antioxidant activity, HDL, LDL, TC, TGs, citrus reticulata, sesamum indicum, zingiber officinale

Procedia PDF Downloads 436

Authors: Aymen Laadhari

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The cardiovascular system is centered on the heart and is characterized by a very complex structure with different physical scales in space (e.g. micrometers for erythrocytes and centimeters for organs) and time (e.g. milliseconds for human brain activity and several years for development of some pathologies). The development and numerical implementation of mathematical models of the cardiovascular system is a tremendously challenging topic at the theoretical and computational levels, inducing consequently a growing interest over the past decade. The accurate computational investigations in both healthy and pathological cases of processes related to the functioning of the human cardiovascular system can be of great potential in tackling several problems of clinical relevance and in improving the diagnosis of specific diseases. In this talk, we focus on the specific task of simulating three particular phenomena related to the cardiovascular system on the macroscopic, mesoscopic and microscopic scales, respectively. Namely, we develop numerical methodologies tailored for the simulation of (i) the haemodynamics (i.e., fluid mechanics of blood) in the aorta and sinus of Valsalva interacting with highly deformable thin leaflets, (ii) the hyperelastic anisotropic behaviour of cardiomyocytes and the influence of calcium concentrations on the contraction of single cells, and (iii) the dynamics of red blood cells in microvasculature. For each problem, we present an appropriate fully Eulerian finite element methodology. We report several numerical examples to address in detail the relevance of the mathematical models in terms of physiological meaning and to illustrate the accuracy and efficiency of the numerical methods.

Keywords: finite element method, cardiovascular system, Eulerian framework, haemodynamics, heart valve, cardiomyocyte, red blood cell

Procedia PDF Downloads 228

Authors: Teng lin, Li Yuxing, Han Hui, Zhao Pengfei, Zhang Datong

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With the development of carbon capture and storage (CCS), the flow assurance of CO2 transportation becomes more important, particularly for supercritical CO2 pipelines. The relieving system using the choke valve is applied to control the pressure in CO2 pipeline. However, the temperature of fluid would drop rapidly because of Joule-Thomson cooling (JTC), which may cause solid CO2 form and block the pipe. In this paper, a Computational Fluid Dynamic (CFD) model, using the modified Lagrangian method, Reynold's Stress Transport model (RSM) for turbulence and stochastic tracking model (STM) for particle trajectory, was developed to predict the deposition characteristic of solid carbon dioxide. The model predictions were in good agreement with the experiment data published in the literature. It can be observed that the particle distribution affected the deposition behavior. In the region of the sudden expansion, the smaller particles accumulated tightly on the wall were dominant for pipe blockage. On the contrary, the size of solid CO2 particles deposited near the outlet usually was bigger and the stacked structure was looser. According to the calculation results, the movement of the particles can be regarded as the main four types: turbulent motion close to the sudden expansion structure, balanced motion at sudden expansion-middle region, inertial motion near the outlet and the escape. Furthermore the particle deposits accumulated primarily in the sudden expansion region, reattachment region and outlet region because of the four type of motion. Also the Stokes number had an effect on the deposition ratio and it is recommended for Stokes number to avoid 3-8St.

Keywords: carbon capture and storage, carbon dioxide pipeline, gas-particle flow, deposition

Procedia PDF Downloads 343

Authors: Chun-Fang Hsueh, Chen-Kang Chang

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Introduction: Branched-chain amino acids (BCAA) could reduce cerebral uptake of tryptophan, leading to decreased synthesis of serotonin in the brain. Arginine and citrulline could reduce exercise-induced hyperammonemia by increasing nitric oxide synthesis and the urea cycle. The combination of these supplements could reduce exercise-induced central fatigue. The purpose of this study was to examine the effect of BCAA, arginine, and citrulline supplementation on repeated swimming performance in teenage athletes. Methods: Eight male and eight female high school swimmers ingested 0.085 g/kg BCAA, 0.05 g/kg arginine and 0.05 g/kg citrulline (AA trial) or placebo (PL trial) in a randomized cross-over design. One hour after the ingestion, the subjects performed a 50 m sprint with their best style every 2 min for 8 times in an indoor 25 m pool. The subjects were asked to swim with their maximal effort each time. The time, stroke frequency and stroke length in each sprint were recorded. Venous blood samples were collected before and after the exercise. The time for each sprint was analyzed by 2-way analysis of variance with repeated measurement. Results: When all subjects were pooled together, total time for the AA trial was significantly faster than the PL trial (AA: 244.02 ± 22.94 s; PL: 247.55 ± 24.17 s, p < .001). Individual sprint time showed significant trial (p= .001) and trial x time (p= .004) effects. The post-hoc analysis revealed that the AA trial was significantly faster than the PL trial in the 2nd, 5th, and 6th sprint. In female subjects, there is a significant trial effect (p= .004) with the AA trial being faster in the 1st, 2nd, and 5th sprint. On the other hand, the trial effect was not significant (p= .072) in male subjects. Conclusions: The combined supplementation could improve 8 x 50 m performance in high school swimmers. The blood parameters including BCAA, tryptophan, NH₃, nitric oxide, and urea, as well as the stroke frequency and length in each sprint, are being analyzed. The results will be presented in the conference.

Keywords: central fatigue, hyperammonemia, tryptophan, urea

Procedia PDF Downloads 160

Authors: Joseph L. Mathew, Shourjendra N. Banerjee, R. K. Ratho, Sourabh Dutta, Vanita Suri

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Background: In India and many other developing countries, a single dose of measles vaccine is administered to infants at 9 months of age. This is based on the assumption that maternal transplacentally transferred antibodies will protect infants until that age. However, our previous data showed that most infants lose maternal anti-measles antibodies before 6 months of age, making them susceptible to measles before vaccination at 9 months. Objective: This prospective study was designed to compare susceptibility in pre-term vs term infants, at different time points. Material and Methods: Following Institutional Ethics Committee approval and a formal informed consent process, venous blood was drawn from a cohort of 45 consecutive term infants and 45 consecutive pre-term infants (both groups delivered by the vaginal route); at birth, 3 months, 6 months and 9 months (prior to measles vaccination). Serum was separated and anti-measles IgG antibody levels were measured by quantitative ELISA kits (with sensitivity and specificity > 95%). Susceptibility to measles was defined as antibody titre < 200mIU/ml. The mean antibody levels were compared between the two groups at the four time points. Results: The mean gestation of term babies was 38.5±1.2 weeks; and pre-term babies 34.7±2.8 weeks. The respective mean birth weights were 2655±215g and 1985±175g. Reliable maternal vaccination record was available in only 7 of the 90 mothers. Mean anti-measles IgG antibody (±SD) in terms babies was 3165±533 IU/ml at birth, 1074±272 IU/ml at 3 months, 314±153 IU/ml at 6 months, and 68±21 IU/ml at 9 months. The corresponding levels in pre-term babies were 2875±612 IU/ml, 948±377 IU/ml, 265±98 IU/ml, and 72±33 IU/ml at 9 months (p > 0.05 for all inter-group comparisons). The proportion of susceptible term infants at birth, 3months, 6months and 9months was 0%, 16%, 67% and 96%. The corresponding proportions in the pre-term infants were 0%, 29%, 82%, and 100% (p > 0.05 for all inter-group comparisons). Conclusion: Majority of infants are susceptible to measles before 9 months of age suggesting the need to anticipate measles vaccination, but there was no statistically significant difference between the proportion of susceptible term and pre-term infants, at any of the four-time points. A larger study is required to confirm these findings and compare sero-protection if vaccination is anticipated to be administered between 6 and 9 months.

Keywords: measles, preterm, susceptibility, term infant

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Authors: R. Alramyan, S. Alsalamah, R. Alrashed, R. Alakel, F. Altheyeb, M. Alessa

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Background: Nutritional support with total parenteral nutrition (TPN) is usually commenced with hematopoietic stem cell transplantation (HSCT) patients. However, it has its benefits and risks. Complications related to central venous catheter such as infections, and metabolic disturbances, including abnormal liver function, is usually of concern in such patients. Methods: A retrospective charts review of all pediatric patients who underwent HSCT between the period 2015-2018 in a tertiary hospital in Riyadh, Saudi Arabia. Patients' demographics, types of conditioning, type of nutrition, and patients' outcomes were collected. Statistical analysis was conducted using SPSS version 22. Frequencies and percentages were used to describe categorical variables. Mean, and standard deviation were used for continuous variables. A P value of less than 0.05 was considered as statically significant. Results: a total of 162 HSCTs were identified during the period mentioned. Indication of allogenic transplant included hemoglobinopathy in 50 patients (31%), acute lymphoblastic leukemia in 21 patients (13%). TPN was used in 96 patients (59.30%) for a median of 14 days, nasogastric tube feeding (NGT) in 16 (9.90%) patients for a median of 11 days, and 71 of patients (43.80%) were able to tolerate oral feeding. Out of the 96 patients (59.30%) who were dependent on TPN, 64 patients (66.7%) had severe mucositis in comparison to 17 patients (25.8%) who were either on NGT or tolerated oral intake. (P-value= 0.00). Sinusoidal obstruction syndrome (SOS) was seen in 14 patients (14.6%) who were receiving TPN compared to none in non-TPN patients (P=value 0.001). Moreover, majority of patients who had SOS received myeloablative conditioning therapy for non-malignant disease (hemoglobinopathy). However, there were no statistically significant differences in Graft-vs-Host Disease (both acute and chronic), bacteremia, and patient outcome between both groups. Conclusions: Nutritional support using TPN is used in majority of patients, especially post-myeloablative conditioning associated with severe mucositis. TPN was associated with VOD, especially in hemoglobinopathy patients who received myeloablative therapy. This may emphasize on use of preventative measures such as fluid restriction, use of diuretics, or defibrotide in high-risk patients.

Keywords: hematopoeitic stem cell transplant, HSCT, stem cell transplant, sinusoidal obstruction syndrome, total parenteral nutrition

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Authors: K. N. Dinesh Babu, P. K. Gargava

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Energization of a transformer results in sudden flow of current which is an effect of core magnetization. This current will be dominated by the presence of second harmonic, which in turn is used to segregate fault and inrush current, thus guaranteeing proper operation of the relay. This additional security in the relay sometimes obstructs or delays differential protection in a specific scenario, when the 2^nd harmonic content was present during a genuine fault. This kind of scenario can result in isolation of the transformer by Buchholz and pressure release valve (PRV) protection, which is acted when fault creates more damage in transformer. Such delays involve a huge impact on the insulation failure, and chances of repairing or rectifying fault of problem at site become very dismal. Sometimes this delay can cause fire in the transformer, and this situation becomes havoc for a sub-station. Such occurrences have been observed in field also when differential relay operation was delayed by 10-15 ms by second harmonic blocking in some specific conditions. These incidences have led to the need for an alternative solution to eradicate such unwarranted delay in operation in future. Modern numerical relay, called as intelligent electronic device (IED), is embedded with advanced protection features which permit higher flexibility and better provisions for tuning of protection logic and settings. Such flexibility in transformer protection IEDs, enables incorporation of alternative methods such as dynamic switching of second harmonic feature for blocking the differential protection with additional security. The analysis and precautionary measures carried out in this case, have been simulated and discussed in this paper to ensure that similar solutions can be adopted to inhibit analogous issues in future.

Keywords: differential protection, intelligent electronic device (IED), 2nd harmonic inhibit, inrush inhibit

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Authors: A. Kherraf, M. Bouziane, A. Drighil, L. Azzouzi, R. Habbal

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Objective: Myxomas are rare heart tumors most commonly found in the left atrium. The purpose of this observation is to report a rare case of myxoma of the right atrium revealed by pulmonary embolism. Observation: A 34-year-old patient with no history presented to the emergency room with sudden onset dyspnea. Clinical examination showed arterial pressure at 110/70mmHg, tachycardia at 110bpm, and 90% oxygen saturation. The ECG enrolled in incomplete right bundle branch block. The radio-thorax was normal. Echocardiography revealed the presence of a large homogeneous intra-OD mass, contiguous to the inter-atrial septum, prolapsing through the tricuspid valve, and causing mild tricuspid insufficiency, with dilation of the right ventricle and retained systolic function with PAPs estimated at 45mmHg. A chest scan was performed, revealing the presence of right segmental pulmonary embolism. The patient was put under anticoagulant and underwent surgical resection of the mass; its pathological examination concluded to a myxoma. The post-operative consequences were simple, without recurrence of the mass after one year follow-up. Discussion: Myxomas represent 50% of heart tumors. Most often, they originate in the left atrium, and more rarely in the right atrium or the ventricles. Myxoma of the right atrium can be responsible for life-threatening pulmonary embolism. The most predictive factor for embolization remains the morphology of the myxomas; papillary or villous myxomas are the most friable. Surgery is the standard treatment, with regular postoperative follow-up to detect recurrence. Conclusion: Myxomas of the right atrium are a rare location for these tumors. Pulmonary embolism is the main complication and should routinely involve careful study of the right chambers on echocardiography.

Keywords: pulmonary embolism, myxoma, right atrium, heart tumors

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Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

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Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

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Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

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Authors: K. Tesfamariam, S. Gebreyesus, C. Lachat, P. Kolsteren, S. De Saeger, M. De Boevre, A. Argaw

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Aflatoxins are toxic secondary metabolites produced by Aspergillus fungi, which are ubiquitously present in the food supplies of low- and middle-income countries. Studies of maternal aflatoxin exposure and fetal outcomes are mainly focused on size at birth and the effect on intrauterine fetal growth has not been assessed using repeated longitudinal fetal biometry across gestation. Therefore, this study intends to assess the association between chronic aflatoxin exposure during pregnancy and fetal growth trajectories in a rural Ethiopian setting. In a prospective cohort study, we enrolled 492 pregnant women. A phlebotomist collected 5 mL of a venous blood sample from eligible women before 28 completed weeks of gestation and aflatoxin B1-lysine concentration was determined using liquid chromatography-tandem mass spectrometry. The mean (±SD) gestational age was 19.1 (3.71) weeks at enrollment, and 28.5 (3.51) and 34.5 (2.44) weeks of gestation at the second and third rounds of ultrasound measurements, respectively. Estimated fetal weight was expressed in centiles using the INTERGROWTH-21st reference. We fitted a multivariable linear mixed-effects model to estimate the rate of fetal growth between aflatoxin-exposed (i.e., aflatoxin B1-lysine concentration above or equal to the limit of detection) and non-exposed mothers in the study. Mothers had a mean (±SD) age of 26.0 (4.58) years. The median (P25, P75) serum AFB1-lysine concentration was 12.6 (0.93, 96.9) pg/mg albumin, and aflatoxin exposure was observed in 86.6% of maternal blood samples. Eighty-five percent of the women enrolled provided at least two ultrasound measurements for analysis. On average, the aflatoxin-exposed group had a significantly lower change over time in fetal weight-for-gestational age centile than the unexposed group (ß = -1.01 centiles/week, 95% CI: -1.87, -0.15, p = 0.02). Chronic maternal AF exposure is associated with lower fetal weight gain over time. Our findings emphasize the importance of nutrition-sensitive strategies to mitigate dietary aflatoxin exposure as well as adopting food safety measures in low-income settings, particularly during the fetal period of development.

Keywords: aflatoxin, fetal growth, low-income setting, mycotoxins

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Authors: Ji-Hoon Byeon, Kwon-Hee Lee

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Strainer filter serves to block the inflow of impurities while mixed fluid is entering or exiting the piping. The filter of the strainer has a perforated structure, so that the pressure drop and the velocity change necessarily occur when the mixed fluid passes through the filter. It is possible to predict the pressure drop and velocity change of the strainer by numerical analysis by implementing all the perforated plates. However, if the size of the perforated plate exceeds a certain size, it is difficult to perform the numerical analysis, and sometimes we cannot guarantee its accuracy. In this study, we tried to predict the pressure drop and velocity change by using the porous media technique to obtain the equivalent resistance without actual implementation of the perforation shape of the strainer. Ansys-CFX, a commercial software, is used to perform the numerical analysis. The analysis procedure is as follows. Firstly, the unit pattern of the perforated plate is modeled, and the pressure drop is analyzed by varying the velocity by symmetry of the wall surface. Secondly, since the equation for obtaining resistance is a quadratic equation of pressure having unknown velocity, the viscous resistance and the inertia resistance of the perforated plate are obtained from the relationship between pressure and speed. Thirdly, by using the calculated resistance values, the values are substituted into the flat plate implemented as a two-dimensional porous media, and the accuracy is verified by comparing the pressure drop and the velocity change. Fourthly, the pressure drop and velocity change in the whole strainer are analyzed by using the resistance values obtained on the perforated plate in the actual whole strainer model. Using the porous media technique, it is found that pressure drop and velocity change can be predicted in relatively short time without modeling the overall shape of the filter. Acknowledgements: This work was supported by the Valve Center from the Regional Innovation Center(RIC) Program of Ministry of Trade, Industry & Energy (MOTIE).

Keywords: strainer, porous media, CFD, numerical analysis

Procedia PDF Downloads 338

Authors: Charles Bijjah Nkhata, Memory Nekati Mvula, Milton Masautso Kalongonda, Martha Masamba, Isaac Thom Shawa

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Viral Hepatitis is a serious public health concern globally with deaths estimated at 1.4 million annually due to liver fibrosis, cirrhosis, and hepatocellular carcinoma. Hepatitis B and C are the most common viruses that cause liver damage. However, the majority of infected individuals are unaware of their serostatus. Viral Hepatitis has contributed to maternal and neonatal morbidity and mortality. There is no updated data on the Epidemiology of hepatitis B and C among pregnant mothers in Malawi. To assess the epidemiology of Hepatitis B and C viruses among pregnant women at Queen Elizabeth Central Hospital. Specific Objectives • To determine sero-prevalence of HBsAg and Anti-HCV in pregnant women at QECH. • To investigate risk factors associated with HBV and HCV infection in pregnant women. • To determine the distribution of HBsAg and Anti-HCV infection among pregnant women of different age group. A descriptive cross-sectional study was conducted among pregnant women at QECH in last quarter of 2021. Of the 114 pregnant women, 96 participants were consented and enrolled using a convenient sampling technique. 12 participants were dropped due to various reasons; therefore 84 completed the study. A semi-structured questionnaire was used to collect socio-demographic and behavior characteristics to assess the risk of exposure. Serum was processed from venous blood samples and tested for HBsAg and Anti-HCV markers utilizing Rapid screening assays for screening and Enzyme Linked Immunosorbent Assay for confirmatory. A total of 84 pregnant consenting pregnant women participated in the study, with 1.2% (n=1/84) testing positive for HBsAg and nobody had detectable anti-HCV antibodies. There was no significant link between HBV and HCV in any of the socio-demographic data or putative risk variables. The findings indicate a viral hepatitis prevalence lower than the set range by the WHO. This suggests that HBV and HCV are rare in pregnant women at QECH. Nevertheless, accessible screening for all pregnant women should be provided. The prevention of MTCT is key for reduction and prevention of the global burden of chronic viral Hepatitis.

Keywords: viral hepatitis, hepatitis B, hepatitis C, pregnancy, malawi, liver disease, mother to child transmission

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Authors: Phakamani Xaba, Robert Huberts, Bilainu Oboirien

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The present study was aimed at developing & comparing two neural-network-based predictive models to predict shelf-life/product age of South African margarine using free fatty acid (FFA), water droplet size (D3.3), water droplet distribution (e-sigma), moisture content, peroxide value (PV), anisidine valve (AnV) and total oxidation (totox) value as input variables to the model. Brick margarine products which had varying ages ranging from fresh i.e. week 0 to week 47 were sourced. The brick margarine products which had been stored at 10 & 25 °C and were characterized. JMP and MATLAB models to predict shelf-life/ margarine age were developed and their performances were compared. The key performance indicators to evaluate the model performances were correlation coefficient (CC), root mean square error (RMSE), and mean absolute percentage error (MAPE) relative to the actual data. The MATLAB-developed model showed a better performance in all three performance indicators. The correlation coefficient of the MATLAB model was 99.86% versus 99.74% for the JMP model, the RMSE was 0.720 compared to 1.005 and the MAPE was 7.4% compared to 8.571%. The MATLAB model was selected to be the most accurate, and then, the number of hidden neurons/ nodes was optimized to develop a single predictive model. The optimized MATLAB with 10 neurons showed a better performance compared to the models with 1 & 5 hidden neurons. The developed models can be used by margarine manufacturers, food research institutions, researchers etc, to predict shelf-life/ margarine product age, optimize addition of antioxidants, extend shelf-life of products and proactively troubleshoot for problems related to changes which have an impact on shelf-life of margarine without conducting expensive trials.

Keywords: margarine shelf-life, predictive modelling, neural networks, oil oxidation

Procedia PDF Downloads 168

Authors: Marian Agbugui

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The West African Lung fishes are fishes rich in protein and serve as an important source of food supply for man. The kind of food ingested by this group of fishes is dependent on the alimentary canal as well as the fish’s digestive processes which provide suitable modifications for maximum utilization of food taken. A study of the alimentary canal of P. annectens will expose the best information on the anatomy and histology of the fish. Samples of P. annectens were dissected to reveal the liver, pancreas and entire gut wall. Digital pictures of the mouth, jaws and the Gastrointestinal Tract (GIT) were taken. The entire gut was identified, sectioned and micro graphed. P. annectens was observed to possess a terminal mouth that opens up to 10% of its total body length, an adaptive feature to enable the fish to swallow the whole of its pry. Its dentition is made up of incisors- scissor-like teeth which also help to firmly grip, seize and tear through the skin of prey before swallowing. A short, straight and longitudinal GIT was observed in P. annectens which is known to be common feature in lungfishes, though it is thought to be a primitive characteristic similar to the lamprey. The oesophagus is short and distensible similar to other predatory and carnivorous species. Food is temporarily stored in the stomach before it is passed down into the intestine. A pyloric aperture is seen at the end of the double folded pyloric valve which leads into an intestine that makes up 75% of the whole GIT. The intestine begins at the posterior end of the pyloric aperture and winds down in six coils through the whole length intestine and ends at the cloaca. From this study it is concluded that P. annectens possess a composite GIT with organs similar to other lung fishes; it is a detritor with carnivorous abilities.

Keywords: gastrointestinal tract, incisors scissor-like teeth, intestine, mucus, Protopterus annectens, serosa

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Authors: Changyeop Lee, Sewon Kim, Jongho Lee

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Reburning technology has been developed to adopt various commercial combustion systems. Fuel lean reburning is an advanced reburning method to reduce NOx economically without using burnout air, however it is not easy to get high NOx reduction efficiency. In the fuel lean reburning system, the localized fuel rich eddies are used to establish partial fuel rich regions so that the NOx can react with hydrocarbon radical restrictively. In this paper, a new advanced reburning method which supplies reburn fuel with oscillatory motion is introduced to increase NOx reduction rate effectively. To clarify whether forced oscillating injection of reburn fuel can effectively reduce NOx emission, experimental tests were conducted in vertical combustion furnace. Experiments were performed in flames stabilized by a gas burner, which was mounted at the bottom of the furnace. The natural gas is used as both main and reburn fuel and total thermal input is about 40kW. The forced oscillating injection of reburn fuel is realized by electronic solenoid valve, so that fuel rich region and fuel lean region is established alternately. In the fuel rich region, NOx is converted to N2 by reburning reaction, however unburned hydrocarbon and CO is oxidized in fuel lean zone and mixing zone at downstream where slightly fuel lean region is formed by mixing of two regions. This paper reports data on flue gas emissions and temperature distribution in the furnace for a wide range of experimental conditions. All experimental data has been measured at steady state. The NOx reduction rate increases up to 41% by forced oscillating reburn motion. The CO emissions were shown to be kept at very low level. And this paper makes clear that in order to decrease NOx concentration in the exhaust when oscillating reburn fuel injection system is adopted, the control of factors such as frequency and duty ratio is very important.

Keywords: NOx, CO, reburning, pollutant

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Authors: Mateus Silva Mendonça, Wender Pereira de Oliveira, Gabriel Heleno de Paula Araújo, Hiago Tenório Teixeira Santana Rocha, Augusto César Teixeira Malaquias, José Guilherme Coelho Baeta

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The stricter legislation and the greater demand of the population regard to gas emissions and their effects on the environment as well as on human health make the automotive industry reinforce research focused on reducing levels of contamination. This reduction can be achieved through the implementation of improvements in internal combustion engines in such a way that they promote the reduction of both specific fuel consumption and air pollutant emissions. These improvements can be obtained through numerical simulation, which is a technique that works together with experimental tests. The aim of this paper is to build, with support of the GT-Suite software, a one-dimensional model of a single-cylinder research engine to analyze the impact of the variation of swirl and tumble coefficients on the performance and on the air pollutant emissions of an engine. Initially, the discharge coefficient is calculated through the software Converge CFD 3D, given that it is an input parameter in GT-Power. Mesh sensitivity tests are made in 3D geometry built for this purpose, using the mass flow rate in the valve as a reference. In the one-dimensional simulation is adopted the non-predictive combustion model called Three Pressure Analysis (TPA) is, and then data such as mass trapped in cylinder, heat release rate, and accumulated released energy are calculated, aiming that the validation can be performed by comparing these data with those obtained experimentally. Finally, the swirl and tumble coefficients are introduced in their corresponding objects so that their influences can be observed when compared to the results obtained previously.

Keywords: 1D simulation, single-cylinder research engine, swirl coefficient, three pressure analysis, tumble coefficient

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Authors: Jonnalagadda Naveen, M. P. S. Tomar, Putluru Satish, Palanisamy Dharani

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Present investigation was carried out on a single specimen of the heart of yellow-bellied sea snake, which accidentally came to the seashore with the fisherman’s net. After the death, these specimens was preserved in 10% neutral buffered formalin and observe for its morphology. The literature cited revealed that meager information was available on the anatomy of the heart of this species of snake thus present study was planned on the gross anatomy of the heart of yellow-bellied sea snake. The heart of yellow-bellied sea snake was located between 28-35th rib in an oblique direction in the pericardial sac. It was three chambered with the complete division of atria but the ventricular cavity was incompletely divided. The apex did not show any gubernaculum cordis. The sinus venosus was the common cavity for confluence of anterior and posterior vana cava and the jugular vein was opened with anterior vena cava. The opening of posterior vena cava was slit-like and it was guarded by membranous valves whereas no valve could be observed at the opening of anterior vana cava and the jugular vein. Both the caval veins ran along the right border of the heart. Pulmonary vein was single which later divided into two branches. The length-width index for the atria was 1.33 whereas it was 1.67 for the ventricle. The atrioventricular canal was situated slightly towards the left of the midline of the heart and was divided into a right cavum pulmonale and left cavum arteriosum of which the right one was slightly larger and longer than the left. The cavum venosum was present in between the cavum pulmonale and the cavum arteriosum. The Ventricle was elongated triangle muscular compartment with ventrally located apex. Internally the cavity of ventricle was divided into two partial chambers dorsally by a muscular ridge and ventrally by an incomplete inter ventricular septum.

Keywords: aorta, atrium, heart, sea snake, sinus venosus, ventricle

Procedia PDF Downloads 177

Authors: Marcin Jakiel, Maria Kurek, Karolina Gutkowska, Sylwia Sanakiewicz, Dominika Stolarczyk, Jakub Batko, Rafał Jakiel, Mateusz K. Hołda

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The geometry of RVOT is extremely complicated. It is an irregular block with an ellipsoidal cross-section, whose dimensions decrease toward the pulmonary valve and measure 33.82 (IQR 30,51-39,36), 28.82 (IQR 26,11-32,22), 27.95 ± 4,11 for width [mm] and 33.41 ± 6,14, 26.99 ± 4,41, 26.91 ± 4,00 [mm] for depth, in the basal, middle and subpulmonary parts, respectively. In a sagittal section view, the RVOT heads upward and slightly backward. Its anterior perimeter has an average length of 41.96 mm and inclines to the transverse plane at an angle of 50.77° (IQR 46,53°-58,70°). In the posterior region, the RVOT is shorter (18.17mm) and flexes anteriorly. Therefore, the slope of the upper part of the rear wall to the transverse plane is an acute angle (open toward the rear) of 44,58° (IQR 37,30°-51,25°), while in the lower part it is an angle close to a right angle of 94,30°±15,44°. In addition, the thickness of the RVOT wall in the diastolic phase, at the posterior perimeter at the base, in the middle of the length and subpulmonary measure 3,80 mm ± 0,88 mm, 3,56 mm ± 0,73 mm, 3,56 mm ± 0,65 mm, respectively. In frontal cross-section, the RVOT rises on the interventricular septum, which makes it possible to distinguish the septal and supraseptal parts on its left periphery. The angles (facing the vertices to the right) of the inclination of these parts to the transverse plane are 75.5° (IQR 66,44°-81,11°) and 107.01° (IQR 99,09 – 115,23°), respectively, which allows us to conclude that the direction of the RVOT long axis changes from left to right. The above analysis shows that there is no single RVOT axis. Two axes can be distinguished, the one for the upper RVOT being more backward and leftward. The aforementioned forward deflection of the posterior wall and the RVOT's elevation over the interventricular septum, suggest that access to the subpulmonary region may be difficult. It should be emphasized that this area is often the target for ablation of ventricular arrhythmias. The small thickness of the RVOT posterior wall, with its difficult geometry, may favor its perforation into the pericardium or ascending aorta.

Keywords: angle, geometry, operation access, position, RVOT, shape

Procedia PDF Downloads 81

Authors: Tadele Araya, Tsehaye Asmelash, Girmatsion Fiseha

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Background: Hepatitis B virus (HBV), Hepatitis C virus (HCV) and Human Immunodeficiency Virus (HIV) constitute serious healthcare problems worldwide. Blood-borne pathogens HBV, HCV and HIV are commonly associated with infections among substance or Injection Drug Users (IDUs). The objective of this study was to determine the prevalence of HBV, HCV, and HIV infections among substance users in Mekelle Substance users Treatment and Rehabilitation Centers. Methods: A cross-sectional study design was used from Dec 2020 to Sep / 2021 to conduct the study. A total of 600 substance users were included. Data regarding the socio-demographic, clinical and sexual behaviors of the substance users were collected using a structured questionnaire. For laboratory analysis, 5-10 ml of venous blood was taken from the substance users. The laboratory analysis was performed by Enzyme-Linked Immunosorbent Assay (ELISA) at Mekelle University, Department of Medical Microbiology and Immunology Research Laboratory. The Data was analyzed using SPSS and Epi-data. The association of variables with HBV, HCV and HIV infections was determined using multivariate analysis and a P value < 0.05 was considered statistically significant. Result: The overall prevalence rate of HBV, HCV and HIV infections were 10%, 6.6%, and 7.5%, respectively. The mean age of the study participants was 28.12 ± 6.9. A higher prevalence of HBV infection was seen in participants who were users of drug injections and in those who were infected with HIV. HCV was comparatively higher in those who had a previous history of unsafe surgical procedures than their counterparts. Homeless participants were highly exposed to HCV and HIV infections than their counterparts. The HBV/HIV Co-infection prevalence was 3.5%. Those doing unprotected sexual practices [P= 0.03], Injection Drug users [P= 0.03], those who had an HBV-infected person in their family [P=0.02], infected with HIV [P= 0.025] were statistically associated with HBV infection. HCV was significantly associated with Substance users and previous history of unsafe surgical procedures [p=0.03, p=0.04), respectively. HIV was significantly associated with unprotected sexual practices and being homeless [p=0.045, p=0.05) respectively. Conclusion-The highly prevalent viral infection was HBV compared to others. There was a High prevalence of HBV/HIV co-infection. The presence of HBV-infected persons in a family, unprotected sexual practices and sharing of needles for drug injection were the risk factors associated with HBV, HIV, and HCV. Continuous health education and screening of the viral infection coupled with medical and psychological treatment is mandatory for the prevention and control of the infections.

Keywords: hepatitis b virus, hepatitis c virus, HIV, substance users

Procedia PDF Downloads 57

Authors: Freda Halim

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

Keywords: acute, bowel obstruction, caecum, endometriosis

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Authors: Ana Bermudez de Castro Muela, Xiomara Santos Salas, Silvia Cayon Somacarrera

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The aim of this review is to explain what is the intracranial hypotension and its main causes, and also to approach to the diagnostic management in the different clinical situations, understanding radiological findings, and physiopathological substrate. An approach to the diagnostic management is presented: what are the guidelines to follow, the different tests available, and the typical findings. We review the myelo-CT and myelo-RM studies in patients with suspected CSF fistula or hypotension of unknown cause during the last 10 years in three centers. Signs of intracranial hypotension (subdural hygromas/hematomas, pachymeningeal enhancement, venous sinus engorgement, pituitary hyperemia, and lowering of the brain) that are evident in baseline CT and MRI are also sought. The intracranial hypotension is defined as a lower opening pressure of 6 cmH₂O. It is a relatively rare disorder with an annual incidence of 5 per 100.000, with a female to male ratio 2:1. The clinical features it’s an orthostatic headache, which is defined as development or aggravation of headache when patients move from a supine to an upright position and disappear or typically relieve after lay down. The etiology is a decrease in the amount of cerebrospinal fluid (CSF), usually by loss of it, either spontaneous or secondary (post-traumatic, post-surgical, systemic disease, post-lumbar puncture etc.) and rhinorrhea and/or otorrhea may exist. The pathophysiological mechanisms of hypotension and CSF hypertension are interrelated, as a situation of hypertension may lead to hypotension secondary to spontaneous CSF leakage. The diagnostic management of intracranial hypotension in our center includes, in the case of being spontaneous and without rhinorrhea and/or otorrhea and according to necessity, a range of available tests, which will be performed from less to more complex: cerebral CT, cerebral MRI and spine without contrast and CT/MRI with intrathecal contrast. If we are in a situation of intracranial hypotension with the presence of rhinorrhea/otorrhea, a sample can be obtained for the detection of b2-transferrin, which is found in the CSF physiologically, as well as sinus CT and cerebral MRI including constructive interference steady state (CISS) sequences. If necessary, cisternography studies are performed to locate the exact point of leakage. It is important to emphasize the significance of myelo-CT / MRI to establish the diagnosis and location of CSF leak, which is indispensable for therapeutic planning (whether surgical or not) in patients with more than one lesion or doubts in the baseline tests.

Keywords: cerebrospinal fluid, neuroradiology brain, magnetic resonance imaging, fistula

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Authors: M. Mortas, H. Asar, P. Dursun Cebi

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The visionary works of architectural representation in the 21st century's present situation, are practiced through the methodologies which try to expose the intellectual and theoretical essences of futurologist positions that are revealed with this era's interactions. Expansions of conceptual and contextual inputs related to one architectural design representation, depend on its deepness of critical attitudes, its interactions with the concepts such as experience, meaning, affection, psychology, perception and aura, as well as its communication with spatial, cultural and environmental factors. The purpose of this research study is to be able to offer methodological application areas for the design dimensions of experiential practices into architectural design studios, by focusing on the architectural representative narrations of 'transformation,' 'metamorphosis,' 'morphogenesis,' 'in-betweenness', 'superposition' and 'intertwine’ in which they affect and are affected by the today’s spatiotemporal hybridizations of architecture. The narrative representations and the visual theory paradigms of the designers are chosen under the main title of 'transformation' for the investigation of these visionary and critical representations' dismantlings and decodings. Case studies of this research area are chosen from Neil Spiller, Bryan Cantley, Perry Kulper and Dan Slavinsky’s transformative, morphogenetic representations. The theoretical dismantlings and decodings which are obtained from these artists’ contemporary architectural representations are tried to utilize and practice in the structural design studios as alternative methodologies when to approach architectural design processes, for enriching, differentiating, diversifying and 'transforming' the applications of so far used design process precedents. The research aims to indicate architectural students about how they can reproduce, rethink and reimagine their own representative lexicons and so languages of their architectural imaginations, regarding the newly perceived tectonics of prosthetic, biotechnology, synchronicity, nanotechnology or machinery into various experiential design workshops. The methodology of this work can be thought as revealing the technical and theoretical tools, lexicons and meanings of contemporary-visionary architectural representations of our decade, with the essential contents and components of hermeneutics, etymology, existentialism, post-humanism, phenomenology and avant-gardism disciplines to re-give meanings the architectural visual theorists’ transformative representations of our decade. The value of this study may be to emerge the superposed and overlapped atmospheres of futurologist architectural representations for the students who need to rethink on the transcultural, deterritorialized and post-humanist critical theories to create and use the representative visual lexicons of themselves for their architectural soft machines and beings by criticizing the now, to be imaginative for the future of architecture.

Keywords: architectural design studio, visionary lexicon, narrative architecture, transformative representation

Procedia PDF Downloads 116