Search results for: shunt surgery

Authors: M. M. Akhmediev, J. R. Ashrapov, T. M. Akhmediev

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Hydrocephalus frequently occurs with spina bifida, and up to 80% of such patients need to be shunted. Objective: It’s sought to improve the results of the surgical treatment of hydrocephalus in children with spina bifida. Methods: We have analyzed the results of the surgical treatment of 80 patients aged between 1 month and 1,5-year-old with hydrocephalus and myelomeningocele. All patients underwent surgery in the period of 2013-2018. Results: In all patients, spina bifida was associated with hydrocephalus with a predominant extension of the posterior horns of the lateral ventricles in the form of colpocephaly, Chiari malformation type 2. Based on the method “Choose right shunt” the determination of the point of critical deformation of the ventricular system was established, 47 (58.8%) patients for the 1st stage underwent ventriculoperitoneal (VP) shunt surgery with a low-pressure valve, 28 (35.0%) patients with medium pressure and 5 (6.2%) with high-pressure valve. Under or over drainage complications were not observed in the postoperative period. The 2nd stage of surgery for myelomeningocele repair was planned in 1-2 months with the follow-up head ultrasonography and electromyography study. Conclusion: The implantable shunt systems parameters chosen before surgery in the surgical management of hydrocephalus in children with myelomeningocele are important in the causes of under or over drainage states, cerebrospinal fluid leakage from the myelomeningocele sac. Management of hydrocephalus should be performed by considering myelomeningocele affecting craniospinal compliance.

Keywords: hydrocephalus, spina bifida, myelomeningocele, ventriculoperitoneal (VP) shunt

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Authors: Sandrieli Afornali, Adriano Keijiro Maeda, Renato Fedatto Beraldo, Carlos Alberto Mattozo, Ricardo Nascimento Brito

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BACKGROUND: The most used variety in hydrocephalus treatment is the ventriculoperitoneal shunt (VPS). However, it may fails in 20 to 70% of cases. It makes necessary to have alternative cavities for the implantation of the distal catheter. Ventriculo-atrial shunting (VAS) is described as the second option. To our knowledge, there are 121 reported cases of VGB shunt in children until 2020 and a highly variable success rate, from 25 to 100%, with an average of 63% of patients presenting good long-term results. Our goal is to evaluate the epidemiological profile of patients submitted to ventriculo-gallbladder (VGB) shunt and, through a review of literature, to compare our results with others series. METHODS: a retrospective cross-sectional observational study of a case series of nine patients. The medical records of all patients were reviewed, who underwent VGB shunt at the Hospital Pequeno Príncipe from Curitiba, Paraná, Brazil, from January 2014 to October 2022. The inclusion criteria were: patients under 17 years of age with hydrocephalus of any etiology, currently using or prior to VGB shunt. RESULTS: There were 6 (66,7%) male and 3 (33,3%) female. The average age of 73.6 months or 6.1 years at the time of surgery. They were submitted on average 5.1 VPS reviews previous to VGB shunt. Five (55,5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage due to kinking the distal catheter in the solution (11.1%) and ventriculoenteric fistula (22.2%); all these patients were cured at surgical reapproach, and in 2 of them the VGB shunt was reimplanted. Two patients died (22.2%), and five (55,5%) patients maintained the use of VGB shunt in the follow-up period; and in 4 (44.4%) there was never need for review. CONCLUSION: VGB shunt tends to be underestimated because it is still unconventional and little publicized in literature. Our article shows a lower risk of death and similar risk of complications when compared to others altenatives shunts. We emphasize VGB shunt as a safe procedure to be the second option when VPS fails or has contraindications.

Keywords: hydrocephalus, ventricular-gallbladder shunt, VGB shunt, VPS, ventriculoperitoneal shunt, ventriculoatrial shunt

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Authors: Waleed Jarjoura

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In various cases of visual impairments, the individuals are referred to expert Ophthalmologists in order to establish a correct diagnosis. Children with visual-impairments confront various challenging experiences in life since early childhood throughout lifespan. In some cases, blind infants, especially due to congenital hydrocephalus, suffer from high intra-cranial pressure and, consequently, go through a ventriculo-peritoneal shunt surgery in order to limit the neurological symptoms or decrease the cognitive impairments. In this article, a detailed description of numerous crucial implications of the V/P shunt surgery, through the right posterior-inferior parieto-temporal cortex, on the observed preliminary capabilities that are pre-requisites for the acquisition of literacy skills in braille, basic Math competencies, braille printing which suggest Gerstmann syndrome in the blind. In addition, significant difficultiesorientation and mobility skills using the Cane, in general, organizational skills, and social interactions were observed. The primary conclusion of this report focuses on raising awareness among neuro-surgeons towards the need for alternative intracranial routes for V/P shunt implantation in blind infants that preserve the right posterior-inferior parieto-temporal cortex that is hypothesized to modulate the tactual-spatial cues in braille discrimination. A second conclusion targets educators and therapists that address the acquired dysfunctionsin blind individuals due to V/P shunt surgeries.

Keywords: congenital blindness, hydrocephalus, shunt surgery, spatial orientation

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Authors: O. Abdelkhalek, A. Naimi, M. Rami, M. N. Tandjaoui, A. Kechich

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This paper deals with the active and reactive power flow analysis inside the unified power quality conditioner (UPQC) during several cases. The UPQC is a combination of shunt and series active power filter (APF). It is one of the best solutions towards the mitigation of voltage sags and swells problems on distribution network. This analysis can provide the helpful information to well understanding the interaction between the series filter, the shunt filter, the DC bus link and electrical network. The mathematical analysis is based on active and reactive power flow through the shunt and series active power filter. Wherein series APF can absorb or deliver the active power to mitigate a swell or sage voltage where in the both cases it absorbs a small reactive power quantity whereas the shunt active power absorbs or releases the active power for stabilizing the storage capacitor’s voltage as well as the power factor correction. The voltage sag and voltage swell are usually interpreted through the DC bus voltage curves. These two phenomena are introduced in this paper with a new interpretation based on the active and reactive power flow analysis inside the UPQC. For simplifying this study, a linear load is supposed in this digital simulation. The simulation results are carried out to confirm the analysis done.

Keywords: UPQC, Power flow analysis, shunt filter, series filter.

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Authors: Benalia Nadia, Bensiali Nadia, Zerzouri Noura

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This paper presents an analysis of the effects of parameters np and nq for exponential load on the transmission line voltage profile, transferred power and transmission losses for different shunt compensation size. For different values for np and nq in which active and reactive power vary with it is terminal voltages as in exponential form, variations of the load voltage for different sizes of shunt capacitors are simulated with a simple two-bus power system using Matlab SimPowerSystems Toolbox. It is observed that the compensation level is significantly affected by the voltage sensitivities of loads.

Keywords: static load model, shunt compensation, transmission system, exponentiel load model

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Authors: Diala Bitar, Emmanuel Gourdon, Claude H. Lamarque, Manuel Collet

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Acoustic absorber devices play an important role reducing the noise at the propagation and reception paths. An electroacoustic absorber consists of a loudspeaker coupled to an electric shunt circuit, where the membrane is playing the role of an absorber/reflector of sound. Although the use of linear shunt resistors at the transducer terminals, has shown to improve the performances of the dynamical absorbers, it is nearly efficient in a narrow frequency band. Therefore, and since nonlinear phenomena are promising for their ability to absorb the vibrations and sound on a larger frequency range, we propose to couple a nonlinear electric shunt circuit at the loudspeaker terminals. Then, the equivalent model can be described by a 2 degrees of freedom system, consisting of a primary linear oscillator describing the dynamics of the loudspeaker membrane, linearly coupled to a cubic nonlinear energy sink (NES). The system is analytically treated for the case of 1:1 resonance, using an invariant manifold approach at different time scales. The proposed methodology enables us to detect the equilibrium points and fold singularities at the first slow time scales, providing a predictive tool to design the nonlinear circuit shunt during the energy exchange process. The preliminary results are promising; a significant improvement of acoustic absorption performances are obtained.

Keywords: electroacoustic absorber, multiple-time-scale with small finite parameter, nonlinear energy sink, nonlinear passive shunt

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Authors: Ali Ravangard, S. Mohammadi

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Shunt Capacitors have several uses in the electric power systems. They are utilized as sources of reactive power by connecting them in line-to-neutral. Electric utilities have also connected capacitors in series with long lines in order to reduce its impedance. This is particularly common in the transmission level, where the lines have length in several hundreds of kilometers. However, this post will generally discuss shunt capacitors. In distribution systems, shunt capacitors are used to reduce power losses, to improve voltage profile, and to increase the maximum flow through cables and transformers. This paper presents a new method to determine the optimal locations and economical sizing of fixed and/or switched shunt capacitors with a view to power losses reduction and voltage stability enhancement. For solving the problem, a new enhanced cuckoo optimization algorithm is presented.The proposed method is tested on distribution test system and the results show that the algorithm suitable for practical implementation on real systems with any size.

Keywords: capacitor placement, power losses, voltage stability, radial distribution systems

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Authors: Yousfi Abdelkader, Chaker Abdelkader, Bot Youcef

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This article proposes a five-level shunt active power filter for power quality improvement using a interval type-2 fuzzy logic controller (IT2 FLC). The reference compensating current is extracted using the P-Q theory. The majority of works previously reported are based on two-level inverters with a conventional Proportional integral (PI) controller, which requires rigorous mathematical modeling of the system. In this paper, a IT2 FLC controlled five-level active power filter is proposed to overcome the problem associated with PI controller. The IT2 FLC algorithm is applied for controlling the DC-side capacitor voltage as well as the harmonic currents of the five-level active power filter. The active power filter with a IT2 FLC is simulated in MATLAB Simulink environment. The simulated response shows that the proposed shunt active power filter controller has produced a sinusoidal supply current with low harmonic distortion and in phase with the source voltage.

Keywords: power quality, shunt active power filter, interval type-2 fuzzy logic controller (T2FL), multilevel inverter

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Authors: Issa M. Hweidi, Saba W. Al-Ibraheem

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This study aimed to assess the increased hospital length of stay and healthcare costs associated with SSIs among ventriculoperitoneal shunting surgery patients in Jordan. This study adopted a retrospective and nested 1:1 matched case-control design. A non-probability convenient sample of 48 VP shunt patients was recruited for the purpose of the study. The targeted groups of the study basically used to cross-match the variables investigated to minimize the risk of confounding. Information was extracted from the text of patients' electronic health records. As compared to the non-SSI group, the SSI group had an extra mean healthcare cost of $13,696.53 (p=0.001) and longer hospital length of stay (22.64 mean additional days). Furthermore, Acinetobacter baumannii and Klebsiella pneumonia were identified as being the most predominant causative agents of SSIs. The results of this study may provide baseline data for national and regional benchmarking to evaluate the quality of care provided to likewise patients. Adherence to infection control strategies and protocols considering new surveillance methods of SSIs is encouraged.

Keywords: ventriculoperitoneal shunt, health care cost, length of stay, neurosurgery, surgical site infections

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Authors: Abdelhalim Kessal, Ali Chebabhi

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In this paper, a controller based on fuzzy logic control (FLC) associated to Three Dimensional Space Vector Modulation (3DSVM) is applied for shunt active filter in αβo axes domain. The main goals are to improve power quality under disturbed loads, minimize source currents harmonics and reduce neutral current magnitude in the four-wire structure. FLC is used to obtain the reference current and control the DC-bus voltage at the inverter output. The switching signals of the four-leg inverter are generating through a Three Dimensional Space Vector Modulation (3DSVM). Selected simulation results have been shown to validate the proposed system.

Keywords: flc, 3dsvm, sapf, harmonic, inverter

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Authors: Kaddari Faiza, Mazari Benyounes, Mihoub Youcef, Safa Ahmed

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Active filtering of electric power has now become a mature technology for reactive power and harmonic compensation caused by the proliferation of power electronics devices used for industrial, commercial and residential purposes. The aim of this study is to enhance the power quality by improving the performances of shunt active power filter in harmonic mitigation to obtain sinusoidal source currents with very weak ripples. A power circuit configuration and control scheme for shunt active power filter are described with an improved method for harmonics compensation using self-tuning-filter for harmonics identification and fuzzy logic control to generate reference current. Simulation results (using MATLAB/SIMULINK) illustrates the compensation characteristics of the proposed control strategy. Analysis of these results proves the feasibility and effectiveness of this method to improve the power quality and also show the performances of fuzzy logic control which provides flexibility, high precision and fast response. The total harmonic distortion (THD %) for the simulations found to be within the recommended imposed IEEE 519-1992 harmonic standard.

Keywords: Active Powers Filter (APF), Self-Tuning-Filter (STF), fuzzy logic control, hysteresis-band control

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Authors: Saeed A. AlGhamdi, Nabil Habli, Vinoj Somasanran

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This paper presents an application of 230 kV Variable Shunt Reactors (VSR) used to compensate reactive power of dual 90 KM subsea cables. VSR integrates an on-load tap changer (OLTC) that adjusts reactive power compensation to maintain acceptable bus voltages under variable load profile and network configuration. An automatic voltage regulator (AVR) or a power management system (PMS) that allows VSR rating to be changed in discrete steps typically controls the OLTC. Typical regulation range start as minimum as 20% up to 100% and are available for systems up to 550kV. The regulation speed is normally in the order of seconds per step and approximately a minute from maximum to minimum rating. VSR can be bus or line connected depending on line/cable length and compensation requirements. The flexible reactive compensation ranges achieved by recent VSR technologies have enabled newer facilities design to deploy line connected VSR through either disconnect switches, which saves space and cost, or through circuit breakers. Lines with VSR are typically energized with lower taps (reduced reactive compensation) to minimize or remove the presence of delayed zero crossing.

Keywords: power management, reactive power, subsea cables, variable shunt reactors

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Authors: Amar Omeiri

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This paper presents a three-phase shunt active power filter for current harmonics suppression and reactive power compensation using the supply current as reference. The proposed APF has a simple control circuit; it consists of detecting the supply current instead of the load current. The advantages of this APF are simplicity of control circuits and low implementation cost. The simulation results show that the proposed APF can compensate the reactive power and suppress current harmonics with two types of non-linear loads.

Keywords: active power filter, current harmonics and reactive power compensation, PWM inverter, Total Harmonic Distortion, power quality

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Authors: Sana Ansari, Sirus Mohammadi

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In distribution systems, shunt capacitors are used to reduce power losses, to improve voltage profile, and to increase the maximum flow through cables and transformers. This paper presents a new method to determine the optimal locations and economical sizing of fixed and/or switched shunt capacitors with a view to power losses reduction and voltage stability enhancement. General Algebraic Modeling System (GAMS) has been used to solve the maximization modules using the MINOS optimization software with Linear Programming (LP). The proposed method is tested on 33 node distribution system and the results show that the algorithm suitable for practical implementation on real systems with any size.

Keywords: power losses, voltage stability, radial distribution systems, capacitor

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Authors: Abderrahmane El Kachani, El Mahjoub Chakir, Anass Ait Laachir, Abdelhamid Niaaniaa, Jamal Zerouaoui, Tarik Jarou

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This paper presents a wind turbine based on the doubly fed induction generator (DFIG) connected to the utility grid through a shunt active power filter (SAPF). The whole system is controlled by a double nonlinear predictive controller (DNPC). A Taylor series expansion is used to predict the outputs of the system. The control law is calculated by optimization of the cost function. The first nonlinear predictive controller (NPC) is designed to ensure the high performance tracking of the rotor speed and regulate the rotor current of the DFIG, while the second one is designed to control the SAPF in order to compensate the harmonic produces by the three-phase diode bridge supplied by a passive circuit (rd, Ld). As a result, we obtain sinusoidal waveforms of the stator voltage and stator current. The proposed nonlinear predictive controllers (NPCs) are validated via simulation on a 1.5 MW DFIG-based wind turbine connected to an SAPF. The results obtained appear to be satisfactory and promising.

Keywords: wind power, doubly fed induction generator, shunt active power filter, double nonlinear predictive controller

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Authors: Brahim Berbaoui

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In this paper, a new particle swarm optimization (PSO) based method is proposed for the implantation of optimal harmonic power flow in power systems. In this algorithm approach, proportional integral controller for reference compensating currents of active power filter is performed in order to minimize the total harmonic distortion (THD). The simulation results show that the new control method using PSO approach is not only easy to be implanted, but also very effective in reducing the unwanted harmonics and compensating reactive power. The studies carried out have been accomplished using the MATLAB Simulink Power System Toolbox.

Keywords: shunt active power filter, power quality, current control, proportional integral controller, particle swarm optimization

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Authors: John Yahng, Hansraj Riteesh Bookun

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Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

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Authors: A. Morsli, A. Tlemçani, N. Ould Cherchali, M. S. Boucherit

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This article presents two methods for the compensation of harmonics generated by a nonlinear load. The first is the classic method P-Q. The second is the controller by modern method of artificial intelligence specifically fuzzy logic. Both methods are applied to an Active Power Filter shunt (APFs) based on a three-phase voltage converter at five levels NPC topology. In calculating the harmonic currents of reference, we use the algorithm P-Q and pulse generation, we use the intersective PWM. For flexibility and dynamics, we use fuzzy logic. The results give us clear that the rate of Harmonic Distortion issued by fuzzy logic is better than P-Q.

Keywords: fuzzy logic controller, P-Q method, pulse width modulation (PWM), shunt active power filter (sAPF), total harmonic distortion (THD)

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Authors: Mehmet Ali Kisaçam, P. Sema Temizer Ozan, Ayşe Doğan, Gonca Ozan, F. Sarper Türker

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Cardiovascular disease which is one of the most common health problems worldwide has crucial importance because of its’ morbidity and mortality rates. Nitric oxide synthase and arginase use L-arginine as a substrate and produce nitric oxide (NO), citrulline and urea, ornithine respectively. Endothelial dysfunction is characterized by reduced bioavailability of vasodilator and anti-inflammatory molecule NO. The purpose of the study to assess endothelial function via arginase activity and NO levels in patients undergoing coronary artery bypass grafting (CABG) surgery. The study was conducted on 26 patients (14 male, 12 female) undergoing CABG surgery. Blood samples were collected from the subjects before surgery, after the termination and after 24 hours of the surgery. Arginase activity and NO levels measured in collected samples spectrophotometrically. Arginase activity decreased significantly in subjects after the termination of the surgery compared to before surgery data. 24 hours after the surgery there wasn’t any significance in arginase activity as it compared to before surgery and after the termination of the surgery. On the other hand, NO levels increased significantly in the subject after the termination of the surgery. However there was no significant increase in NO levels after 24 hours of the surgery, but there was an insignificant increase compared to before surgery data. The results indicate that after the termination of the surgery vascular and endothelial function improved and after 24 hours of the surgery arginase activity and NO levels returned to normal.

Keywords: arginase, bypass, cordiopulmonary, nitric oxide

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Authors: M. R. Bengourina, M. Rahli, L. Hassaine, S. Saadi

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In this study, we present a control method entitled virtual flux direct power control of a grid connected photovoltaic system associated with an active power filter. The virtual flux direct control of power (VF-DPC) is employed for the calculation of reference current generation. In this technique, the switches states of inverter are selected from a table of switching based on the immediate errors between the active and reactive powers and their reference values. The objectives of this paper are the reduction of Total Harmonic Distortion (THD) of source current, compensating reactive power and injecting the maximum active power available from the PV array into the load and/or grid. MATLAB/SIMULINK simulations are provided to demonstrate the performance of the proposed approach.

Keywords: shunt active power filter, VF-DPC, photovoltaic, MPPT

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Authors: Kouider Bendine, Zouaoui Satla, Boukhoulda Farouk Benallel, Shun-Qi Zhang

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Turbine blades are subjected to a variety of loads, lead to an undesirable vibration. Such vibration can cause serious damages or even lead to a total failure of the blade. The present paper addresses the vibration control of turbine blade. The study aims to propose a passive vibration control using piezoelectric material. the passive control is effectuated by shunting an RL circuit to the piezoelectric patch in a parallel configuration. To this end, a Finite element model for the blade with the piezoelectric patch is implemented in ANSYS APDL. The model is then subjected to a harmonic frequency-based analysis for the case of control on and off. The results show that the proposed methodology was able to reduce blade vibration by 18%.

Keywords: blade, active piezoelectric vibration control, finite element., shunt circuit

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Authors: Vishal V. Choudhari, Gaurao A. Dongre, S. P. Diwan

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A number of reference current generation have been developed for analysis of shunt active power filter to mitigate the load compensation. Depending upon the type of load the technique has to be chosen. In this paper, six reference current generation techniques viz. instantaneous reactive power theory(IRP), Synchronous reference frame theory(SRF), Perfect harmonic cancellation(PHC), Unity power factor method(UPF), Self-tuning filter method(STF), Predictive filtering method(PFM) are compared for different operating conditions. The harmonics are introduced because of non-linear loads in the system. These harmonics are eliminated using above techniques. The results and performance of system simulated on MATLAB/Simulink platform. The system is experimentally implemented using DS1104 card of dSPACE system.

Keywords: SAPF, power quality, THD, IRP, SRF, dSPACE module DS1104

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Authors: Devieta Romadhon Saendardy

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Introduction: The case of aneurysmal subarachnoid hemorrhage (SAH) associated with intraventricular hemorrhage (IVH) in many way. In general, the anterior communicating artery and posterior circulation aneurysms cause Intraventricular Hemorrhage. The development of intraventricular hemorrhage (IVH) in aneurysmal subarachnoid hemorrhage (aSAH) is linked with higher mortality and poor neurological recovery. Case: This case report presents a 51-year-old female patient who developed IVH following SAH. The patient's Glasgow Coma Scale score was 14, the patient has a severe headache, and there were right extremity hemipharese neurological deficits. A non-contrast head CT scan revealed a massive intraventricular haemorrhage. In an hour, the patient got her headache and pharese worse. Discussion: Intraventricular hemorrhage is a serious complication of subarachnoid hemorrhage, necessitating prompt recognition and management. This case highlights the importance of a time management, medical management and surgical intervention to optimize outcomes in patients with intraventricular hemorrhage caused by subarachnoid hemorrhage. Placement of a shunt system improves clinical outcome in intraventricular hemorrhage.

Keywords: Intraventricular hemorrhage, subarachnoid hemorrhage, shunt, time

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Authors: Ayeshmanthe Rathnayake, Siew Goh, Carmel Fenton, Ashutosh Hardikar

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Post-Operative Atrial Fibrillation (POAF) is the most frequent complication of cardiac surgery and is associated with reduced survival, increased rates of cognitive changes and cerebrovascular accident, heart failure, renal dysfunction, infection and length of stay, and hospital costs. Cardiac tamponade, although less common, carries high morbidity and mortality. Shed mediastinal blood in the pericardial space is a major source of intrapericardial oxidative stress and inflammation that triggers POAF. The utilisation of a left posterior pericardiotomy aims to shunt blood from the pericardium into the pleural space and have a role in the prevention of POAF as well as cardiac tamponade. 2118 patients had undergone isolated Coronary Artery Bypass Graft (CABG) at Royal Hobart Hospital from 2008-2021. They were divided into pericardiotomy vs control group. Patient baseline demographics, intraoperative data, and post-operative outcomes were reviewed retrospectively. Total incidence of new POAF and cardiac tamponade was 26.1% and 0.75%, respectively. Primary outcome of both the incidence of POAF(22.9% vs27.8%OR 0.77 p<0.05) and Cardiac Tamponade (0% vs 1.1% OR 0.85 p<0.05) were less in the pericardiotomy group.Increasing age, BMI, poor left ventricular function (EF <30%), and return to theatre were independent predictors of developing POAF. There were similar rates of return to theatre for bleeding however, no cases of tamponade in the pericardiotomy group. There were no complications attributable to left posterior pericardiotomy and the time added to the duration of surgery was minimal. Left posterior pericardiotomy is associated with a significant reduction in the incidence of POAFand cardiac tamponade and issafe and efficient.

Keywords: cardiac surgery, pericardiotomy, post-operative atrial fibrillation, cardiac tamponade

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Authors: Babak Masoomian, Masoud Khorrami Nejad, Hamid Riazi Esfahani

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Purpose: To report the result of strabismus surgery in eye-salvaged retinoblastoma (Rb) patients. Methods: A retrospective case series including 18 patients with Rb and strabismus who underwent strabismus surgery after completing tumor treatment by a single pediatric ophthalmologist. Results: A total of 18 patients (10 females and 8 males) were included with a mean age of 13.3 ± 3.0 (range, 2-39) months at the time tumor presentation and 6.0 ± 1.5 (range, 4-9) years at the time of strabismus surgery. Ten (56%) patients had unilateral, and 8(44%) had bilateral involvement, and the most common worse eye tumor’s group was D (n=11), C (n=4), B (n=2) and E (n=1). Macula was involved by the tumors in 12 (67%) patients. The tumors were managed by intravenous chemotherapy (n=8, 47%), intra-arterial chemotherapy (n=7, 41%) and both (n=3, 17%). After complete treatment, the average time to strabismus surgery was 29.9 ± 20.5 (range, 12-84) months. Except for one, visual acuity was equal or less than 1.0 logMAR (≤ 20/200) in the affected eye. Seven (39%) patients had exotropia, 11(61%) had esotropia (P=0.346) and vertical deviation was found in 8 (48%) cases. The angle of deviation was 42.0 ± 10.4 (range, 30-60) prism diopter (PD) for esotropic and 35.7± 7.9 (range, 25-50) PD for exotropic patients (P=0.32) that after surgery significantly decreased to 8.5 ± 5.3 PD in esotropic cases and 5.9±6.7 PD in exotropic cases (P<0.001). The mean follow-up after surgery was 15.2 ± 2.0 (range, 10-24) months, in which 3 (17%) patients needed a second surgery. Conclusion: Strabismus surgery in treated Rb is safe, and results of the surgeries are acceptable and close to the general population. There was not associated with tumor recurrence or metastasis.

Keywords: retinoblastoma, strabismus, chemotherapy, surgery

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Authors: Dehini Rachid, Ferdi Brahim

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The shunt active power filter (SAPF) is not destined only to improve the power factor, but also to compensate the unwanted harmonic currents produced by nonlinear loads. This paper presents a SAPF with identification and control method based on artificial neural network (ANN). To identify harmonics, many techniques are used, among them the conventional p-q theory and the relatively recent one the artificial neural network method. It is difficult to get satisfied identification and control characteristics by using a normal (ANN) due to the nonlinearity of the system (SAPF + fast nonlinear load variations). This work is an attempt to undertake a systematic study of the problem to equip the (SAPF) with the harmonics identification and DC link voltage control method based on (ANN). The latter has been applied to the (SAPF) with fast nonlinear load variations. The results of computer simulations and experiments are given, which can confirm the feasibility of the proposed active power filter.

Keywords: artificial neural networks (ANN), p-q theory, harmonics, total harmonic distortion

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Authors: Minna Salim, James Brady

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Postoperative nausea and pain (PONV) are adverse effects following surgical procedures. It is especially pronounced in patients undergoing orthognathic surgery, as their mouth is closed postoperatively using wires or rubber bands. Postoperative mouth closure increases the discomfort and risk of complications associated with nausea and vomiting. Many surgeons and institutions apply gastric decompression in hopes of aspirating stomach contents and, therefore, decreasing PONV incidence. This review observed that PONV incidence was not affected by gastric decompression overall. However, the effect of gastric decompression on PONV in orthognathic surgery was variable. This paper aims to summarize the findings of gastric decompression on PONV and to determine the need for it in orthognathic surgery.

Keywords: gastric decompression, nasogastric tube, orthognathic surgery, postoperative nausea, vomiting

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Authors: Ayu Nabila Kusuma Pradana, Aprinaldi Jasa Mantau, Tomohiko Akahoshi

Abstract:

The incidence of Disseminated intravascular coagulation (DIC) following gastrointestinal surgery has a poor prognosis. Therefore, it is important to determine the factors that can predict the prognosis of DIC. This study will investigate the factors that may influence the outcome of DIC in patients after gastrointestinal surgery. Eighty-one patients were admitted to the intensive care unit after gastrointestinal surgery in Kyushu University Hospital from 2003 to 2021. Acute DIC scores were estimated using the new Japanese Association for Acute Medicine (JAAM) score from before and after surgery from day 1, day 3, and day 7. Acute DIC scores will be compared with The Sequential Organ Failure Assessment (SOFA) score, platelet count, lactate level, and a variety of biochemical parameters. This study applied machine learning algorithms to predict the prognosis of DIC after gastrointestinal surgery. The results of this study are expected to be used as an indicator for evaluating patient prognosis so that it can increase life expectancy and reduce mortality from cases of DIC patients after gastrointestinal surgery.

Keywords: the survival rate, gastrointestinal surgery, JAAM score, neural network, machine learning, disseminated intravascular coagulation (DIC)

Procedia PDF Downloads 216

Authors: R. Litt, A. Kana, K. House

Abstract:

The primary aim of this patient-related experience questionnaire was to gain a better understanding of our patients' experience as inpatients when they undergo orthognathic surgery. The secondary aim of this study was to identify ways in which we can improve the orthognathic inpatient experience and to share this with other units. All patients who received orthognathic surgery at an NHS hospital - Bristol Royal Infirmary, England, over the course of 6 months were asked to complete a questionnaire regarding their care. This data was then analysed and compared to the same questionnaire given to patients treated in a private hospital where orthognathic surgery was completed. All treatment was completed by the same surgeon. The design of the questions took into account NICE (National Institute for Health and Care Excellence) guidance on improving the experience of patient care. Particularly taking into account patients' essential requirements of care, for example, assessing and managing pain, ensuring adequate and appropriate nutrition, and ensuring the patients' personal needs are regularly reviewed and addressed. Overall the patient-related experience after orthognathic surgery was comparable in both the NHS and private hospitals. However, the questionnaire highlighted aspects of inpatient care after orthognathic surgery that can easily be improved in order to provide our patients with the best possible care.

Keywords: orthognathic surgery, patient feedback, jaw surgery, inpatient experience

Procedia PDF Downloads 117

Authors: Sangram A. Sathe, Neha A. Madgulkar, Shruti S. Raut, S. P. Wadkar

Abstract:

Transforaminal lumbar interbody fusion (TLIF) surgeries have nowadays became popular for treatment of degenerated spinal disorders. The interbody fusion technique like TLIF maintains load bearing capacity of the spine and a suitable disc height. Currently many techniques have been introduced to cure Spondylolisthesis. This surgery provides greater rehabilitation of degenerative spines. While performing this TLIF surgery existing methods use guideway, which is a troublesome surgery technique as the use of two separate instruments is required to perform this surgery. This paper presents a concept which eliminates the use of guideway. This concept also eliminates problems that occur like reverting the cage. The concept discussed in this paper also gives high accuracy while performing surgery.

Keywords: TLIF, spondylolisthesis, spine, instruments

Procedia PDF Downloads 304