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Oct 2023 DOI 10.14302/issn.2769-2264.jw-23-4633
Adeba DerejeCorresponding author
Dams are built to produce electricity, store water for irrigation, control flood hazards and other uses. The operation of dam has a complicated problem, which includes multiple decision variables, several conflicting and contradictory objectives together with significant uncertainty and risk. The objective of this study was to make an impact assessment that Fincha’a-Amarti dam operation can bring on the downstream activity. Fincha’a-Amarti dam downstream irrigation water requirement was done by using CROPWAT software. The SWAT model was also used to model the watershed and simulate the flow. Meteorological data and spatial data of the study area were used as an input of the model. The meteorological stations considered were Shambu, Fincha’a, Homi, Nashe and Harato. The study shows that downstream water requirement greater than the existing downstream water release during the months of: January, February, March, April, May, September, October, November and December; but existing water release is greater than downstream water requirement during wet season only. Therefore, the study concludes that there is downstream water stress except during wet season.
Feb 2023 DOI 10.14302/issn.2643-2811.jmbr-22-4302
Edeowede Abhulimen AbelCorresponding author
The Gas Turbine operation was investigated with a view to evolving a system designed to provide a realistic imitation of the controls and operation of a Gas Turbine, used for training purposes. Operator Training Simulator has been widely adopted by many industries being a computer simulation which attempts to model a real-life plant so that it can be studied. A well trained and skilled operator is key in increasing power plant safety and productivity. Therefore, enabling quality training for operators is becoming more important as they need to handle increased load of information and duties whereas the lack of training is a major reason for inadequate performance. By changing variables in the simulator, predictions are made about the behaviour of the engine. It is a tool to virtually investigate the behaviour of the system while in operation. This work becomes indispensable because it is prohibitively expensive or simply too dangerous to allow trainees use the real equipment in a power plant. The Gas Turbine operation’s simulator is born from Object Oriented Programming, employing key programming languages. The simulator design focused on specific tasks in the operation of the Gas Turbine which include; startup, synchronization and monitoring of vital parameters like vibration, temperature, pressure, and angle of the Inlet Guide Vane. The statuses of various valves, pumps and motors as well as the Performance of actuators and the response of concatenated components are also being tracked. The simulator was found to effectively mimic a real plant life. With this simulator, trainee operators in Gas Turbine can spend time learning valuable lessons in a "safe" virtual environment yet living a lifelike experience. This will go a long way in minimizing operators’ error in GT power plants, thereby curtailing power outages and conserving power plant components.
May 2019 DOI 10.14302/issn.2690-4837.ijip-19-2842
A.S. Sardenberg RodrigoCorresponding author
Head of Thoracic Surgery/ Hospital Paulistano, Americas Serviços Médicos São Paulo, United Health Group, Rua Martiniano de Carvalho
Cesarean sections (CS) are one of the most commonly performed surgical procedures worldwide. There is great variability in the percentage of cesarean sections between countries, varying from 3% to 42.9%5. In the US, approximately 32% of deliveries occur through a cesarean section. Overall, a drastic increase in cesarean section rate has been reported reaching its highest level at the present time. In Brazil, considering the types of births by live births from 2006 to 2016, the national percentage of cesarean section was 52.37%. The variability in this percentage can still be perceived within Brazilian territory. The highest cesarean rate occurred in the Southern region, representing 58.33% of births, while the lowest rate occurred in the Northern region, with 41.79%. It is possible to see the steady increase in the percentage of CS over time, from 45.01% in 2006 to 55.39% in 2016.
Sep 2018 DOI 10.14302/issn.2641-9181.ijnr-18-2226
V.I.PetukhovCorresponding author
Vladimir State University, Vladimir, Russia
The authors analyze the results of atomic emission spectrometry of hair samples for Al, Cd, Fe, Cr, Cu, Li, Pb, V, and Zn in 952 healthy subjects and 952 liquidators of the Chernobyl nuclear power plant accident. Using correlation analysis (Pearson) of the obtained data, the authors have found pair correlations between metal concentration values. According to the authors, criticality or synchronization (as a particular case of the critical state of the system) can be inherent in all ATP-dependent membrane pumps (P-type) controlling metal-ligand homeostasis in epidermal cells. A quantitative criterion (synchronization index) is proposed to measure the level of criticality (synchronization) in the functioning of membrane ATPases.
Feb 2017 DOI 10.14302/issn.2474-3585.jpmc-16-1103
M. Chaudhary SanjeevCorresponding author
Associate Professor, Government Medical College,Gondia
Background : DOTS is the current international strategy for tuberculosis control endorsed by the World Health Organization and the International Union against Tuberculosis and Lung Diseases. Maharashtra achieved full coverage under RNTCP in October 2003. The programme was launched in Nagpur in the last quarter of 2002. Three years after its launch, it is the ideal time to assess the performance of programme to identify the operational challenges. Methods: This is a cross sectional study carried out in 'Sadar Tuberculosis Unit' of Nagpur Municipal Corporation with the objective to study performance of some aspects of RNTCP. Programme performance was explored through laboratory records review and non participant observations of all four designated microscopy centres. DOT centres were observed for accessibility, identifiability and the facilities provided to patients visiting for treatment. Performance of some operational aspects of RNTCP was assessed using standards, norms, procedures etc described in programme guidelines. Results: It was observed that the TB unit was manned with RNTCP- trained supervisory team. Three of four microscopy centres were established in multispecialty health facilities. Adequate space for sputum microscopy was available at two centres. Laboratory technician was available at three centres. Separate tables for smearing and staining were available at three centres. Sink, staining racks, spirit lamp, binocular microscope and drugs in patient - wise boxes were available in all four centres. Laboratory registers were completely and correctly filled in all centres. No false positive or false negative error was found in rereading of AFB smears. Conclusions: It is concluded that the performance of the programme at the unit is satisfactory. Still some aspects of the programme components need to be strengthened at microscopy centres for better performance of RNTCP.
Oct 2025 DOI 10.14302/issn.2641-4538.jphi-25-5661
Rashwan NaglaaCorresponding author
The World Health Organization emphasizes the importance of international collaboration to save lives and improve health at national and global levels. However, significant challenges face those engaged in international collaborations such as language barriers, cultural differences, different rules and regulations, and limited resources. This paper discusses the use of cultural humility theory to support an international collaboration between stakeholders from different countries with diverse cultural backgrounds working together to optimize a novel middle and high school curriculum intended to promote peaceful coexistence in the Kingdom of Bahrain. We use the attributes of cultural humility as a framework to reflect on lessons learned while navigating cultural differences, conclude by recommending the use of this framework during international collaborations, and provide practical examples about how to operationalize the attributes of cultural humility to inform international collaborations attempting to promote global public health.
Jul 2024 DOI 10.14302/oap.jc-23-4781
S. Kadandale JayaramaCorresponding author
As a first step towards clarifying the basis of the cooperation and conflict seen in chimeric binary mixes of Dictyostelium giganteum, we examined the karyotype of six natural isolates. All six had 5 haploid chromosomes. No meiotic figures were seen. Fluorescence in-situ hybridization was carried out using conserved D. discoideum centromeric DNA sequences as probes. From it, we infer that two chromosomes are sub-metacentric, one is metacentric and two are telocentric.
Feb 2024 DOI 10.14302/issn.2997-2248.jwl-23-4791
Sahile AtinafaCorresponding author
The Trans boundary protection of migratory species is a common argument for international cooperation. Ecotourism supports these activities through long-term commitment from international conservation organizations, all interest groups and various political entities. However, due to anthropogenic influences and inadequate understanding of species ecology, sustainable conservation of migratory species is often challenging. Therefore, this review article evaluates the migration status, potential anthropogenic threats, and conservation directives from the perspective of ecotourism of the white-eared kob (Kobuskobleucotis, Lichtenstein and Peters, 1854). Ethiopia. Kobus kobleucotis migrate through the Boma-Gambella border ecosystems of Ethiopia and South Sudan at certain times of the year. This migration is anonymous and requires an understanding of the overall ecology of the species. Currently, the white-eared Kob population exceeds half a million, making it the second largest migration in Africa, after the wildebeest migration in the Serengeti, Tanzania. Kobs occur in groups of five to forty depending on sex and age and are nocturnal but inactive on the hottest days. Rich grasslands and permanent water sources are the preferred habitats for the species. However, the decline in grassland potential, frequent hunting, expanding settlements, changes in land use and land cover are potential threats to the white-eared kob in Gambella National Parks. Therefore, understanding the total ecological, anthropogenic and behavioral variables that influence the movement and status of the species is the ultimate parameter for conservation activity. Furthermore, entire migration corridors require sustainable management by balancing stakeholder interests and rural community development through nature-based tourism. It is also noted that solid economic and environmental incentives through nature-based tourism require adequate protection in Gambella and the surrounding regions.
Jan 2024 DOI 10.14302/issn.2641-4538.jphi-23-4856
Rashid AlKalbani SalmaCorresponding author
Colorectal cancer (CRC) is a major public health problem worldwide, as it is the third most common disease and the second leading cause of cancer-related fatalities. In recent years, Oman, like many other countries, has seen an epidemiological shift from communicable diseases to noncommunicable diseases, including colorectal cancer, necessitating comprehensive planning to address the root cause of the problem as well as a comprehensive screening program to detect diseases at an early stage and thus improve health outcomes. Colorectal cancer is the second most frequent cancer in Oman, with the highest mortality rate, inflicting considerable public health and economic consequences; nevertheless, there is no population-based CRC screening programme in place to minimise the disease's incidence, mortality, and severe health outcomes. This review highlights the epidemiology of colorectal cancer in Oman, the Wilson and Junger criteria, operational readiness, and recommendations for implementing a population-based colorectal cancer screening program.
Dec 2023
Fazlul Islam MuhammadCorresponding author
Cosmic surgery is a non-invasive operation developed by applying modern astronomical discoveries to surgical science. Scientific cosmology is the study of the universe through physics and astronomy. Religious cosmology explains the universe based on religious scriptures. According to religious cosmology, the universe consists of hell, heaven, and earth. Earth is surrounded by hell, and hell is surrounded by heaven. Astronomers explored the universe and found billions of galaxies of stars all around the earth made of hellish fire. The location of the stars and hells in the universe and their characteristics are identical. Comparative study shows that all the stars in the visible galaxies of the universe are religious hells. The discovery of hells in the lower universe confirms the existence of heavens in the inaccessible upper universe that has been predicted in the Holy Scriptures. This astronomical discovery is not only a message to mankind but also a recombinant cosmic signal all over the world, which is generated for the exploration of the cosmos by prophets and astronomers. According to the supernatural theory of disease, supernatural virus infects the prefrontal cortex of the human brain and disrupts the normal spirit of executive functions including reasoning, planning, motivation, and problem solving that leads people to a delusional lifestyle and behavior and alters the dynamic equilibrium between man and environment, and causes all physical, mental, social, and spiritual disorders, national, international, and inter-religious conflicts and wars in the world. Cosmic surgery is a non-invasive operation applying above mentioned cosmic signal to the human brain to sterilize the whole world from the supernatural virus that can change our sick world into a healthier, happier, and prosperous world like a terrestrial paradise.
Dec 2023 DOI 10.14302/issn.2766-8681.jcsr-23-4811
Isea RaúlCorresponding author
Biotechnology has changed our relationships and perspectives of the world, influencing industry and serving as a catalyst for scientific discoveries. With this change, biotechnology enters a new age known as Biotechnology 2.0. "Modern Biotechnology" and "Artificial Intelligence" are getting married. In order to lessen food poverty, this idea incorporates the most recent advancements in genetic engineering, medicine, environmental preservation, and agricultural productivity and loss reduction strategies. The importance of openness and public involvement in addressing public concerns and advancing moral behavior in biotechnology's future, fostering cooperation among diverse stakeholders, and accomplishing this in a sustainable way for the good of society and humanity cannot be overstated, especially with the backing of biotechnology governance.
Dec 2023 DOI 10.14302/issn.2690-4829.jen-23-4799
Gartner PatriziaCorresponding author
Polymer electrolyte membrane (PEM) technologies hold promise for sustainable energy solutions, yet pinhole-related challenges persist. Our research introduces a novel biohybrid approach to self-healing, enhancing multiple healing cycles with minimal membrane disruption. Initial steps involve immobilizing enzymes on a polymeric membrane. This study establishes the immobilization process and analytical framework through enzyme immobilization on polypropylene. Applicability and stability are investigated, laying groundwork for potential Nafion™ applications and advancing climate neutral energy. Qualitative analysis employs colorimetric p-NPA assay on polypropylene-immobilized lipase from Candida rugosa (CRL) and Lipase B from Candida antarctica (CALB). Both enzymes hold their temperature optimum at 50°C which is increased by 10°C via immobilization. Diisopropylcarbodiimide (DIC) is optimal for immobilization. Synchronous enzyme and DIC addition is advantageous. After 8 reuse cycles, immobilized enzymes retain 54.3% residual activity. Immobilizates exposed to PEM fuel cell conditions show better stability due to covalent immobilization than free CRL. Yet, declines occur under stressors like 60 °C and concentrated alcohol. Immobilizates remain resilient at pH 3 and under oxidizing as well as reducing conditions constituted by varied gas atmospheres. Considering PEM fuel cells' operational range, in-depth investigations across conditions are vital. Future studies target long-term PEM fuel cell lifespans, focusing on extremophilic enzymes or modifications for high-temperature stability. Subsequently, the transferability of the immobilization method to Nafion™ shall be deliberated based on the outcomes.
Aug 2023 DOI 10.14302/issn.2641-5518.jcci-23-4646
Issa Abdulhamid SayedCorresponding author
Introduction The idea of HLSSM2 is to get the least easy surgical intervention, as arthroscopic surgery begins with examining the shoulder joint, and the location and size of the lesion are determined, then open over the lesion with an open surgical approach that is very limited for surgical repair; not using arthroscopic instruments but conventional surgical instruments in the second step. Figure 1 Figure 1. Methods Clinical experience with this technique consists of 44 cases over a period of thirty-one months, this study was from September 2020 to May 2023. All cases were done as outpatients and under general anesthesia. Results The mean duration of the operation was 35 minutes, and the minimum duration was 25 minutes. There was no major nerve or vascular injury in all cases. This technique is simple, safe, and good cosmetically satisfactory for all patients after full recovery about three months after the procedure, and it is cost-effective. One 43-year-old female patient suffered pain and stiffness during the first six months after surgery and was not very satisfied, she did not stop visiting us till now, she was not happy because of shoulder pain and tenderness. Conclusion It can be used by experienced hand surgeons in shoulder arthroscopy and in Mini Lateral Shoulder Approach (MLSA)3, especially in countries where shoulder arthroscopic release and repair with suture anchors are expensive4 or not available. This technique is not very simple but is available, safe, cosmetically satisfactory, and cost-effective.
Mar 2023 DOI 10.14302/issn.2690-0904.ijoe-21-3884
Keshaverz VajiheCorresponding author
Background and Purpose Public health problems are caused by the emergence of environmental pollution and infectious diseases, which have caused concern around the world. The public health threat affects the relationship between people. Population growth and associated pressures increase difficulties associated with effective means of maintaining public health. The diseases transmitted from human and livestock communication, water pollution, air pollution, and environmental pollutants urge us to find new solutions to address these problems. Understanding the environmental and environmental health is a prerequisite for protecting public health. In Iran, like other countries in the world, the issue of environmental protection and its compliance with the first program of economic, social and cultural development of the Islamic Republic has begun and expanded in the future. In this regard, new perspectives are being introduced that will bring about dramatic changes at various levels of planning, processes and specialized sectors such as civil, industrial and educational sectors. The training of engineers in this regard can play a very important role in refining the attitudes of young engineers and using these bases in their specialized activities. One of the important tasks of universities is to provide a suitable platform for such training. In this regard, it is essential that the major industrial universities of the country develop various programs in this field. Materials and Methods The present study is a review of the type of validity that is performed through search of authoritative scientific databases such as PubMed and Scopus, Google scholar, PubMed using the key words of building safety and health, HSE, and prevention methods are the latest information. Results Implementing the principles of HSE in various construction, industrial and other projects requires time, because any change that is considered in the system requires a change of attitude, which in turn requires time to adapt and adapt to the new conditions. The conditions for the projects in this research are their current conditions, and the next research, after a while, can determine the percentage of project progress in terms of HSE. Conclusion In order to comply with the principle of HSE cases, there is a need for training. These trainings should be executed at different levels and levels of contracting and monitoring so that the level of awareness of the risks involved in the development of civil operations between the personnel reaches a common frontier.
Dec 2022 DOI 10.14302/issn.2766-8681.jcsr-22-4400
Hayashi TomoyaCorresponding author
Tactile information plays an important role in human manipulation of objects; however, prosthetic limb placement or teleoperation requires the manipulation of alternative bodies in the absence of tactile sensations. To provide an alternative to tactile sensation, this study proposes and assesses a continuous feedback scheme with temporally coded vibration. This scheme was designed to provide discrete intended tactile information in response to changing object-controlled situations by repetitively presenting time-coded vibration patterns. The effects of the proposed scheme on an object with acatch-and-hold task in virtual reality were confirmed. Compared to the control feedback scheme that provides vibration only when the balance of the virtual grip force and object position is changed, the proposed feedback scheme has a better effect in terms of the success rate of holding on to the object with an appropriate holding force during the task. The effect is larger, especially in the invisible task condition, suggesting that the increased amount of information with coded vibration patterns can be used without any special training, especially without visual information. Considering the existing studies that show the effect of a feedback scheme in response to motion events, the continuous feedback scheme proposed in this study may be more suitable for movements that require sequential coordination and passive responses than stimulation methods based on motion events. This feedback scheme has potential applications not only in tele-technology but also in healthcare, such as rehabilitation.
Apr 2022 DOI 10.14302/issn.2831-8846.j3dpa-22-4066
Geremew TemesgenCorresponding author
Debark University, Department of physics, Debark, Ethiopia
Thin films are everywhere in the modern world, with many of the technologies we depend upon in daily life being, in turn, dependent upon thin film technology. Chemical bath deposition includes principles of chemical bath deposition (CBD) and concept of solubility product, nucleation and film growth, thin film deposition mechanism in chemical bath deposition. The non-metallic ion source (anions) and metal ion source (cations) then react to form the compound. The nucleation process plays an important role in determining the crystallinity and microstructure of the resultant film. From the discussion of deposition techniques which are physical and chemical deposition methods. Physical deposition techniques contains sputtering deposition, electron beam evaporation and physical vapour deposition (PVD) process have been known for over 100 years and also fabrication films on the substrate, as well as the increasement of the pressure in the chamber due to operation of the sources indicates directly that gases or vapors are desorbed. Chemical deposition process is economically effective and has been industrially exploited to large scale. It can be summarized that thin film characterization techniques include X-ray diffraction (XRD), UV-Vis spectrophotometer, scanning electron microscopy, energy dispersive x-ray diffraction, transmission electron microscopy (TEM). X-rays diffraction (XRD) is a rapid and a powerful technique used to study the phase of a crystalline material, information on unit cell lattice parameters, crystal structure, crystal orientation and crystalline size.
Oct 2021 DOI 10.14302/issn.2639-3166.jar-21-3872
Hassan Dahab MohamedCorresponding author
Department of Agric Eng. – College of Agriculture- University of Khartoum.
Sugar cane production requires a number of operations to be carried out in the field through number of implements and machines. Therefore, time consuming and required large amount of energy. A combined field cultivator was designed in Kenana agricultural implements factory (KAIF) to carry out at one time multi operations (cultivation, furrow-reforming and Fertilizer placement). This is to increase field productivity, reduce farm power and lower operation time and cost. The combined implement was evaluated in Kenana cultivation fields and compared with three individual implements, rigid tine cultivator, furrow-reformer and fertilizer applicator. The measured parameters were drawbar pull, power requirements, field capacity, fuel consumption and total time in the field. The results showed highly significant differences at 1% level between the different implements for the field capacity, fuel consumption and significant differences at 5% for the drawbar pull. A power requirement in (kW) for the combined cultivator was 77% of those individual implements. Total time per feddan to accomplish the required operations by the combined cultivator was 57% of that required by the individual implements. Fuel consumption was reduced to 57% when combined implement was used compared to that consumed by individual implements. It was concluded that the combined cultivator was effective in increasing field productivity and reducing power and cost of operation.
Aug 2021 DOI 10.14302/issn.2692-5915.jafs-21-3930
Donald L. BureshCorresponding author
The purpose of this essay is to compare and contrast the cyber-attacks on Estonia, Georgia, and Ukraine, including tactics, techniques, procedures, and effects. The paper states that none of the models will probably be repeated. The thesis is that cyber-attacks will change as technology changes. In other words, past cyber-attacks operations, particularly in Estonia, Georgia, and Ukraine, are not good predictors of future cyber-attack activity.
Aug 2021 DOI 10.14302/issn.2639-3166.jar-21-3883
Haroun Mohamed Adam AbubakerCorresponding author
Department of Crop Science, College of Agriculture, University of Bahri- Sudan.
Despite the existing several Sugar manufacturing companies in Sudan, there is an acute shortage in sugar supply, therefore the government imports Sugar to bridge the gap. One of the strategies to be followed is the introduction of Sugar beet (Beta vulgaris) crop, mainly for sugar production. This crop has several advantages over Sugarcane such as short duration, less water requirement, in addition to other uses like animal feed. Therefore it became necessary to have good understanding of agricultural operations, cultural practices and adaptation. However, the main objective of this study was to assess the effect of Nitrogen fertilizer and plant spacing on vegetative growth of Sugar beet. This study was conducted at the farm of the College of Agriculture, University of Bahri, Alkadro, Khartoum State-Sudan; during the season 2016/2017. The experiment was arranged in Split plot in Randomized Complete Block Design with six treatments and four replications. Two plant spacing (15 and 20 cm.) were used as main plot, referred as (S1, S2) along with three levels of Nitrogen fertilizer (40, 80 and 120 kg/ha.), as subplot; referred as (N1, N2 and N3) and the control (0). Data regarding leaf number, leaf area index (LAI), leaf dry weight (g) (LDW), root diameter (mm.) and root fresh weight were recorded and statistically analyzed. The results showed S2 (20 cm) increased all the studied plant characters, namely the leaf number (29.139), leaf area index by (7.54), leaf dry weight (g) to (89.870), root diameter (mm) (94,992), root fresh weight (g) (695.80) compared to S1(1015 cm). On the other hand; the application of N3 (120 kg/ha.) increased the lead number (30.956), leaf Area Index (8.841), Leaf dry weight (102.47), root diameter (97.955) and root fresh weight (851.77) compared to S2 and S1 as presented in (table 4, table 5 and table 6).
May 2021 DOI 10.14302/issn.2641-4538.jphi-21-3824
Munharo StevenCorresponding author
University of Suffolk, Ipswich, UK
Zimbabwe like many other sub-Saharan African states has been struggling to provide a quality health service delivery system. Nations with rampant corruption and ineffective bureaucracy made worse, the response towards the fight against COVID-19, Coronavirus Disease 2019. Despite the Zimbabwean government setting out protocols with international agencies such as WHO, World Health Organization to mount an effective response against COVID-19, the health system has been overstretched with lack of personal protective equipment, shortage of drugs and essential equipment and wanton corruption practices coupled with shortage of staff. Timely delivery of orders is still a challenge due to strict bureaucratic measures when transporting goods and the existing competition between countries. Manufacturers and donors are shifting their focus to their countries leaving the Zimbabwean health service underfunded and under-resourced. However, among the challenges experienced the country has been given a chance to revisit its priorities and strategize how best the government and organizations can move essential medical goods, utilize current trade agreements such as ACFTA, African Continental Free Trade Area and local drug manufacturers to produce essential medicines. Launching an efficient mechanism to end corrupt practices in procurement and supply as well as improve interagency cooperation and communication may help improve efforts to end COVID-19 in Zimbabwe.
Mar 2021 DOI 10.14302/issn.2329-9487.jhc-21-3742
Sisay TesfayeCorresponding author
Associate Professor
Cardiovascular disease is actually a major cause of mortality, illness and hospitalization worldwide. Several risk factors have been identified that are strongly associated with the development of cardiovascular disease. Public prevention strategies have relied predominately on managing environmental factors that contribute to cardiovascular disease, such as obesity, smoking and lack of exercise. The understanding of the role of genetics in cardiovascular disease development has become much more important to link genetics with the onset of disease and response to therapy. This seeks to examine how genes can predispose individuals to cardiovascular disease and how this knowledge might be applied to more comprehensive preventive strategies in the future. In addition, the review explores possibilities for genetics in cardiovascular disease treatment, particularly through the use of identified driver genes and gene therapy. To fully understand the biological implications of these associations, there is a need to relate them to the exquisite, multilayered regulation of protein expression and regulatory elements, mutation, microRNAs and epigenetics. Understanding how the information contained in the DNA relates to the operation of these regulatory layers will allow us not only to better predict the development of cardiovascular disease but also to develop more effective therapies.
Mar 2021 DOI 10.14302/issn.2641-4538.jphi-21-3765
A. Weber SimonCorresponding author
Cellogic GmbH, Niedstrasse 21, 12159 Berlin, Germany
Acute post-operative delirium (POD) and long-term post-operative cognitive dysfunction (POCD) are frequent and associated with increased mortality, dependency on care giving and institutionalization rates. The POCD-related cost burden on the German long-term care insurance provides an indication for the savings potential from risk-adapted treatment schemes. Comprehensive estimates have not been assessed or published so far. A model-based cost-analysis was designed to estimate POCD-related costs in the long-term care insurance. Comprehensive analysis of inpatient operations and procedures (OPS-codes) served as the base for case number calculations, which were then used as input to the actual cost model. POCD-incidence rates were obtained from the BioCog study. Various sensitivity analyses were performed to assess uncertainty of the model results. Total POCD related annual costs in the German long-term care insurance account for approximately 1.6 billion EUR according to the base case of our analysis. Total annual costs for all POCD cases depend on surgery numbers, incidence rates, other assumptions, and uncertain input parameters. The financial burden to the long-term care insurance is substantial, even in a conservative scenario of the cost model. Variability of results stems from uncertain assumptions, POCD-incidence rates and from uncertain patient numbers who are undergoing surgery and are therefore at risk to develop POCD.
Jan 2021
Vladimir Leonidovich MartynovCorresponding author
Doctor of Medical Sciences, Associate Professor, National Research Nizhny Novgorod State University named after N.I. Lobachevsky (UNN), Russia
Annotation On the basis of 40 years of work on the treatment of 415 patients with gastroenterocolitis clinic, the author revealed the presence of refluxes due to anatomical defects of the Bauhinia valve (its failure) and the duodenum (chronic duodenal obstruction) at all levels of the gastrointestinal tract. After surgical correction of these anatomical breakdowns, the author states a significant improvement in all indicators of the state of both the digestive system and some extraintestinal manifestations, possibly the onset of precancer. The results obtained allowed the author to conclude that there are no "functional" disorders, this is only the level of our knowledge. Operations have been developed to correct the failure of the Bauhinia flap, intraoperative prevention of refluxes, and indications for methods of correcting chronic disorders of duodenal patency.
Dec 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3670
K. Ceesay EbrimaCorresponding author
University of Gambia, Banjul, Gambia
Purpose This paper assess the impact of COVID-19 pandemic on Education, Staff development and Training in Africa. Online Research Methodology/Approach The data use in this paper was generated from online survey questionnaire, in which the participants were asked about certain questions in which covid-19 affect their social-economic situation. The questionnaire was design to help Africa to understand covid-19 impacts on their social and economic live. Results The results of this study reveal that coronavirus pandemic affected Africa in a number of ways; 1) 52.2 percent of the respondents said they should open school now in Africa, while 47.8 percent fear they should not open schools 2) 81 percent said before educational institution are closed there is public or official announcement that institutions must be closed due to pandemic—may be 3 months, ……,,…,, one week it depends on the severity of how covid-19 is spreading across the regions in Africa, 10.7 percent of the respondent said it may be and only 8.3 percent said it is not official announced.3) 65.4 percent of the respondents said government implemented an education response for continue of learning in Africa while educational institutions are closed 4) 61.5 percent said use of online/digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes provided by government, while 50 percent said television, radio, or podcast broadcast and 17.9 percent said assigning reading and exercises for home study. 5) 45.3 percent out of 100 percent said use of online or digital learning platform are the proportion of children affected by education institution closure. 38.7 percent said the proportion of children affect are the one that concentrate of using television, radio or podcast broadcasts to get academic content. 14.7 percent of the respondents are the proportion of the children affected by educational institute closure if they are assigning reading and exercises for home study. 6) 52.6 percent of the respondents from non-government organization, private schools said use of online or digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes, while 61.5 percent said use of online/digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes provided by government. The same thing government said as well. Similar respondents from government as do the non-government or private schools and 35.9 percent respondent said television, radio and podcast broadcast are method for continuity of learning is currently available for children affected by closures of educational institutes-provided by non-governmental organization, private schools etc, whereas 50 percent of the respondents said assigning reading and exercises for home study is the method for continuity of learning is currently available for children affected by closures of educational institutes-provided by government.7) 48.1 percent of the respondents said for the impact of covid-19 pandemic on staff development and training that their enterprise or organization partially suspended operation due to the pandemic and 34.2 percent of the responded said they completely suspended operation because of coronavirus pandemic and 16.5 percent said no closures on in operation for staff development and training because of pandemic. 8)According to the results of this question of the online survey, 49.3 percent said the challenges their enterprise face in delivery staff training programmes and activities using online learning or offline learning during covid-19 was due to infrastructure issues such the problem associated with internet and the like. The survey of the study also confirmed that 32.9 percent twice said limited digital skills of trainers and cost of staff training was a major setback to train staff in their enterprise or organization or department or establishment while 30.1 percent said it is due to limited digital literacy of users are the main challenges face by their department in order to train staff. Policy Implications The implication of the results from this online survey is that it has serious impacts on education closure and staff development and training. As educations are closed due to covid-19 pandemic, it will affect already problems of human capital that are hampering the development of Africa. Due to covid-19 pandemic, the achievement of sustainable development goals on quality education will be seriously halted. The government and the ministry in Africa should work hand in hand to solve the problems of children affected by schools closure after the pandemic by either additional hours or provide more study hours for schools to catch-up with what happened during the pandemic, the study noted. Originality/value The impact of covid-19 on education, staff development and training.
Dec 2020 DOI 10.14302/issn.2470-5020.jnrt-20-3629
K QuenumCorresponding author
Neurosurgery Departement of Parakou University Chud/Ba, Republic of Benin
Introduction The extra dural hematoma is a blood collection between the cranial vault and the dura mater. It is a neurosurgical emergency whose statistical data are poorly known in the Republic of Benin. Objective The aims of this study are to assess epidemiology, therapeutic and outcome of traumatic extra dural hematomas for children admitted to the surgical department of CHUD-B/A from 2012 to 2017. Methods This was a cross-sectional, descriptive and retrospective study over a period from January 1st, 2012 to December 31st, 2017. Results One hundred and seventy-eight cases of children aged between 0-15 years were examined for brain traumatic injury. Twenty-seven 27 (15.2%) cases of extra dural hematomas were retained. The most represented age group was between 11-15 years with a frequency of 42.1%. The male sex was more represented (78.9%). Road traffic accidents were the main aetiology (57.9%). 52.6% had a mild head injury, 26.3% had a moderate head injury and 21.1% had a severe head injury. On brain scan the frequently observed location was temporo-parietal (31.6%). Acute anemia was observed in 16 children. Seventeen children were operated on. The operation involved evacuation of extra dural hematoma by cranial bone flap with suspension of the dura mater. There were no deaths. Conclusion The availability of brain CT makes the diagnosis of extra dural hematoma easier. Its management is neurosurgical with a favourable post-operative evolution in all cases in this series.
May 2020 DOI 10.14302/issn.2642-3146.jec-20-3359
K.G. Palmer WilliamCorresponding author
Independent Researcher, TRI-LEA-EM, 76 Sideroad 33-34, RR 5, Paisley, ON N0G 2N0, Canada.
For 5 years, since the start-up of an array of 140 wind turbines, residents have filed complaints with the Ontario Ministry of the Environment (the regulator), and K2 Wind (the operator). Residents complained that the turbines produce a tonal sound, and that the irritation this produced impacted their sleep, their health, and the enjoyment of their property. To confirm tonality from the wind turbines, this research examined over 200 data examples from two families. These families collected data by two independent methods, a continuously recording system, and by making selected audio recordings. The recorded data was correlated with the wind turbine operational performance, and local weather conditions. The correlated data was analyzed for tonality using international standard evaluation methods. The analysis confirmed over 84% correlation between complaints of irritating conditions, and tonality from 5 dB to over 20 dB. Finally, the results showed that the assumption of the regulator to only require assessment of compliance when the resident was downwind of the nearest wind turbine was incorrect. Most complaints arose from other wind directions. Neither was the regulator’s assumption correct that curtailing the wind turbine operation to continue operating at only partially reduced outputs would give remediation. The research concludes that tonality arises consistent with the wind turbine operation, identifying a critical need to revise the practices to prevent chronic irritation. In the original issuance of this paper, the author inadvertently erred by stating that there was a difference between the method for assessing wind turbine tonality of an expert group panel and the method now prescribed by regulations. That statement was incorrect, and the author apologizes for the error and for any confusion it may have caused. The error, miscalculations resulting from the error, where necessary conclusions drawn from erroneous calculations are corrected.
Apr 2020 DOI 10.14302/issn.2691-8862.jvat-20-3314
M. Motawei ShimaaCorresponding author
Associate Professors of Forensic Medicine &Clinical Toxicology, Faculty of Medicine, Mansoura University, Egypt
This article reviews toxicology practice challenges during COVID‑19, including laboratory safety, chemical exposures, therapeutics, and public health messaging. It identifies research needs and operational adaptations to support preparedness for future events.
Nov 2019 DOI 10.14302/issn.2379-7835.ijn-19-3083
Ververs MijaCorresponding author
Senior Nutritionist/Health Scientist, Emergency Response and Recovery Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Background In November 2014, the World health Organization (WHO), in collaboration with United Nations Children's Fund (UNICEF), and the World Food Programme, produced interim guidelines (iGL) on providing nutritional support to patients in Ebola treatment units (ETUs). They have been translated into French and issued by the Ministry of Health, UNICEF and WHO in adapted versions to be used in the current outbreak in the Democratic Republic of the Congo (DRC). This paper evaluates the use and usefulness of the 2014 iGL in the West Africa and current DRC Ebola virus disease (EVD) outbreaks and identifies experiences and lessons learned from practitioners on the operational aspects of nutritional care and support in ETUs. Methods Key-informants (n=26), from 12 organizations (Non-Governmental Organizations, United Nations, Red Cross Red Crescent Movement) were interviewed who were actively engaged in the nutritional and/or clinical care of EVD patients. Results There was a consensus among key-informants that the 2014 iGL initially served a guiding purpose. However, the vast amount of learning from the 2014-2016 and current EVD outbreaks indicates that the interim guidelines need to be revised. Practitioners struggled to find operational solutions for nutritional care, and the challenges were plentiful, especially regarding 1) the different perceptions of the importance of nutritional care among ETU staff; 2) the difficulties around food preparation and distribution for EVD patients; 3) how to take into account the patients’ dietary preferences; 4) the nutritional care needed in relation to specific EVD symptoms; 5) who assumed roles in nutritional care in ETUs; 6) if and how feeding support was organized; 7) whether malnutrition needed to be addressed and how; and 8) whether the intake of specific nutrients could contribute to improved treatment outcomes. Information from the key-informants interviews resulted in numerous lessons learned and recommendations for nutritional support during current and future outbreaks. Conclusions This investigation underscored the importance of documenting experiences of practitioners on nutritional care in emerging infectious diseases for which limited scientific evidence exists and for which interim guidelines are produced to fill in knowledge gaps. It also emphasized the importance of nutritional care in ETUs during treatment.
Jul 2019 DOI 10.14302/issn.2694-2283.jsem-19-2938
Hinzpeter C JaimeCorresponding author
Medical Doctor, University of Chile, Clinical Hospital, Santiago Chile.
An anterior cruciate ligament (ACL) injury is an important cause of rest in athletes. In most cases, ACL injuries do not require external contact and they are associated with biomechanical risk factors that increase ACL tension. The increase of the hip flexion angle (HF) is included within these. The ACL requires cooperation of the periarticular musculature of the knee, muscle groups, hip stabilizers and CORE muscles; consequently, fatigue caused by exercise would alter the balance and put this ligament at risk. The objective of the study is to determine the angular behavior for HF before and after a physical load (a standardized training) in children between 11 and 12 years old. A non-randomized clinical study was carried out. The sample consisted of 50 soccer school students born between 11 and 12 years old. The angular behavior of HF was compared before and after performing a training session. The angular behavior was measured through the Drop Jump test (DJ), with data obtained by inertial sensors. After the exercise, there was a significant increase in HF. It was concluded that the angular behavior of HF increases significantly in both extremities after training and that preventive measures must be applied for neuromuscular control of the hip.
Jul 2019 DOI 10.14302/issn.2694-2283.jsem-19-2949
Hinzpeter JaimeCorresponding author
Department of Orthopaedic Surgery, Clinical Hospital, University of Chile, Santos Dumontt # 999, Independencia, Zip Code: 8380456, Santiago, Chile.
Background The Anterior Cruciate Ligament (ACL) injury is uncommon, but constitutes an important percentage of the lesions requiring more than 8 weeks of recovery in sports. Most ACL injuries do not require external contact and are associated with biomechanical risk factors that stress this ligament ACL: like an increase in knee valgus angle (KV) and hip flexion (HF) and a decreased in knee flexion (KF). The ACL requires muscle cooperation to resist the load; however, when there is fatigue, the protective capacity of the musculature would decrease. The objective of the study is to analyze the angular behavior before and after a physical load for HF in children of 14-15 years old. Hypothesis The physical load applied in a single training session is enough to change some biomechanical risk factors of ACL injury. Study Design Experimental study Level of Evidence 2b Methods The sample consisted of 50 students from different soccer schools between 14-15 years old. We analyzed the hip angular behavior of hip flexion before and after a training session. The angles where obtained from inertioal sensor while the students performed a Drop Jump test from a 30 centimeters drawer. Results Statistically significant differences were found in the differences between pre physical load HF / post-load HF (p = 0.00053), right pre physical load HF / right post- load HF (p = 0.0086) and left post- load (p = 0.0248206). Conclusions It was concluded that the angular behavior of HF increases significantly in both post-training limbs, after performing a physical load. Clinical Relevance This study analyzed the importance of using prevention injury programs since early stages, and give importance to the eccentric role of hamstring, gluteus and core exercises.
Feb 2019
P Dargan DallanCorresponding author
Mersey Regional Burns and Plastic Surgery Centre, Whiston Hospital, Warrington Road, Prescot, Merseyside, L35 5DR, United Kingdom
Background: Chest wall deformities may be managed with skeletal manipulation, which risks life-threatening complications. Custom-made prostheses are a less invasive surgical option, manufactured from silicone elastomer using 3D computed tomographic reconstruction and 3D-printed thoracic models. Methods: All patients undergoing custom-made implants between January 2010 and March 2017 were identified from the prosthetic department records. A retrospective review of the clinical records was performed. Mean follow up period was 1.8 years. A comparison was made with our earlier results from 1995 to 2009. Results: Twenty-six patients underwent insertion of custom-made implants for chest wall deformity. Pectus excavatum was present in 50% (n=13), and Poland syndrome 42% (n=11). All 11 female patients underwent 3D reconstruction and 3D printed models, and 3 of 15 males. Four underwent simultaneous bilateral breast augmentation, and three had staged breast augmentation. Seroma occurred in 27% (n=7), and hypertrophic scar in 12% (n=3). The reoperation rate was 23% (n=6), including autologous fat graft in two patients. Surgical suction drains were used in 42% (n=11) patients, of whom 36% (n=4) developed seroma, compared with 17% (n=2) of those without drains (p=0.08). Conclusions: Custom-made prostheses are an effective and safe option for patients with chest wall deformities. The majority have a short postoperative inpatient stay (81%) and are satisfied with the outcome (77%). Seroma was the commonest complication (27%), and drains did not reduce seroma risk. Single dose intravenous antibiotic prophylaxis is adequate. A minority of patients opt for further aesthetic procedures.
Jan 2019 DOI 10.14302/issn.2474-7785.jarh-19-2608
W. Harvey PeterCorresponding author
Conjoint Clinical Professor, Deakin University, School of Medicine, Faculty of Health
In the light of various complaints about the quality of care provided by and operation of aged care facilities across Australia, the Commonwealth Government has announced a Royal Commission into the activities of the sector. As the proportion of Australians over 65 continues to grow with the ageing of the ‘Baby Boomer’ generation, more Australians are seeking secure aged care arrangements to meet their increasingly complex living and healthcare needs. We hear much comment today about the concept of healthy ageing and the importance of older people staying connected to and active in their communities. Not only does this ongoing connectivity support better lifestyles and health status, it provides an avenue for older people to contribute to the support of others once their more formal working lives are concluded. Unfortunately, the gap between the rhetoric and the reality of ageing in Australia is strained and it appears that much about the operations of the aged care sector today is less than satisfactory. While some well-funded retirees can afford comfortable and fulfilling living arrangements, many others are left in less ideal circumstances. With aged care organisations currently building the next generation of ‘hotel’ style living arrangements for cashed up self-funded retirees, others are being left behind financially and in terms of the quality of their care. At the same time, maltreatment and abuse of residents is coming to light, as in the ‘Oakden Nursing Home’ situation in South Australia, for example. Consequently, the Federal Government has now launched a formal inquiry into the activities of organisations running aged care facilities in Australia. The inquiry is designed to assess the operation of this industry with a focus on the economics of aged care centres, the quality of care, the food and recreational activities provided and the challenge of staffing these facilities to keep residents safe and well as they age in dignity.
Nov 2018 DOI 10.14302/issn.2642-3146.jec-18-2416
K.G. Palmer WilliamCorresponding author
Independent Researcher, TRI-LEA-EM, 76 Sideroad 33-34, RR 5, Paisley, ON N0G 2N0, Canada.
Wind turbines are often perceived as benign. This can be attributed to the population majority dwelling in urban locations distant from most wind turbines. Society may understate the risk to individuals living near turbines due to an overstatement of the perceived benefits of turbines, and an understatement of the risk of injury from falling turbine parts, or shed ice. Flaws in risk calculation may be attributed to a less than fully developed safety culture. Indications of this are the lack of a comprehensive industry failure database, and safety limits enabling the industry growth, but not protective of the public. A comprehensive study of wind turbine failures and risks in the Canadian province of Ontario gives data to enable validation of existing failure models. Failure probabilities are calculated, to show risk on personal property, or in public spaces. Repeated failures, and inadequate safety separation show public safety is not currently assured. A method of calculating setbacks from wind turbines to mitigate public risk is shown. Wind turbines with inadequate setbacks can adversely impact public health both directly from physical risk and indirectly by irritation from loss of safe use of property. Physical public safety setbacks are separate from larger setbacks required to prevent irritation from noise and other stressors, particularly when applied to areas of learning, rest and recuperation. The insights provided by this paper can assist the industry to enhance its image and improve its operation, as well as helping regulators set safety guidelines assuring protection of the public.
Sep 2018 DOI 10.14302/issn.2377-2549.jndc-18-2224
Ono KatsutoshiCorresponding author
Department of Energy Science and Technology, Kyoto University, Japan.
This paper describes the theoretical foundations for the electric power and hydrogen generator that functions with zero energy input without violating the laws of thermodynamics. This generation system is a combined energy cycle consisting of the H2O=H2+1/2O2 reduction reaction performed by the water electrolytic cell and the H2+1/2O2=H2O oxidation reaction performed by the fuel cell. This electrolytic method differs from the conventional electrolytic scheme in that if a quasi-static process is assumed, so that the theoretical power requirement is only 17% of the total energy required. This method performs electrostatic-to-chemical energy conversion by electrostatic-induction potential-superposed electrolytic scheme. If this electrolytic cell that delivers the pure stoichiometric H2-O2 mixture is combined with a fuel cell to form an energy cycle, then this may lead to the concepts of a hydrogen redox electric power generator and a hydrogen redox hydrogen generator that use alkaline water electrolyte or solid polymer electrolyte membrane (PEM) for both electrolytic cell and fuel cell. In the power generator, part of power delivered by the fuel cell is returned to the electrolytic cell, and the remainder represents the net power output. According to calculations based on data from the operational conditions for commercially available electrolytic cell and fuel cell, more than 70% of the power delivered from the fuel cell can be extracted outside the cycle as net power output without the use of any external source of energy.
Aug 2018 DOI 10.14302/issn.2641-4538.jphi-18-2190
Hamdy OmniaCorresponding author
Department of Engineering Applications of Laser, National Institute of Laser Enhanced Sciences (NILES), Cairo University, Giza Governorate 12613, Egypt
Optical imaging method provides safe and encouraging tool in many medical applications. In this editorial, principle operation, instrumentation, medical applications and advantages of diffuse optical imaging technique are presented and discussed.
Jan 2018 DOI 10.14302/issn.2474-3585.jpmc-17-1836
Róbert PókaCorresponding author
University of Debrecen, Faculty of Medicine, Department of Obstetrics and Gynecology.
Objective: Demographic analysis of intrauterine deaths in North-Eastern Hungary with national and international comparison. Materials and Methods: The authors collected data from the National Bureau of Statistics’ 1996-2014 database to assess frequency, gestational age, maternal age and education for six counties of the region. 722 individual cases were analyzed. A regional survey was initiated to collect more detailed data on living environment in the region between 2010 and 2014 through community midwifery services records. Results: Data over 20 years showed most intrauterine deaths (Perinatal mortality, Late fetal death, Stillbirth] occurred between 24th and 36th weeks of which 35% occurred in the North-Eastern region of Hungary. The causes of intrauterine deaths were placental abruption, cord accident, placental insufficiency, malformations and intrauterine infection. Detailed analysis regarding attendance at either the Obstetricians or the community midwifery services, the patient’s medical history and the patients’ compliance were reported, compliance in 1% completely lacked. Gravidity and multiparity were associated risk factors. A significant proportion was associated with teenage pregnancy, low maternal education, smoking risks, unemployment, dependence on social support, unhygienic environment and smaller accommodations. Lack of cooperation during antenatal care was significant. Conclusion: Frequency and distribution of intrauterine deaths in North-Eastern Hungary show a similar picture as those of socio-economic indices. The unfavorable trend came to an end in 2015, however the national statistics did not show any improvement. The solution to the problem seems to be independent of the service provision, therefore, socio-economic development of affected counties is warranted, and financial incentives and/or government aid provided during pregnancy may improve future perinatal outcomes.
Sep 2017 DOI 10.14302/issn.2574-4526.jddd-17-1776
Augoulea AretiCorresponding author
Department of Obstetrics and Gynecology, National and Kapodestrian University of Athens, Medical School,, Aretaieio Hospital, 76 Vas. Sofias Ave, GR-11528, Athens, Greece
Objectives: The rate of morbid obesity among women of reproductive age continues to rise worldwide. Surgical treatment remains the most effective mean to face it. Anatomical, physiological and nutritional modifications lead to several challenges for pregnancy after bariatric procedures. In spite of routine supplementation after bariatric surgery, vitamin and mineral deficiency frequently appear in bariatric pregnancies. The aim of this review is to summarize the existing data on the prevalence and management of nutritional deficiencies in pregnancy after bariatric surgery. Methodology: A comprehensive search of Pubmed Database was conducted for English-language studies using a list of key words. Results: The most common post-operative deficiencies in pregnancy include iron, vitamin B12, folate, vitamin D and magnesium deficiency. Less common are selenium, vitamin A, vitamin B6 and vitamin C deficiency. Finally, copper, vitamin K, vitamin B1, vitamin E and albumin deficiencies are considered to be relatively rare. Conclusions: Pregnancy after bariatric surgery has been proven to be safe for both the mother and the fetus. However, there is still the risk of significant nutritional deficiencies with adverse effects on pregnancy and lactation. As a result, a thorough customized nutritional assessment is mandatory for every woman in reproductive age who has undergone a bariatric operation, with strict regular follow-up during pregnancy and lactation.
Aug 2017 DOI 10.14302/issn.2997-2086.jfs-17-1663
Knezevich MichelleCorresponding author
Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.
Fetal surgery is the newest surgical specialty with a compelling history. The development of fetal surgery began in primates and lambs and, in its most basic form, was first performed in humans in 1965. Since its introduction, the field has expanded and changed dramatically. Several of these changes have involved the ethical aspect of fetal surgery. This field conflicts with the Hippocratic oath mantra of “first do no harm” as one of the patients, the mother, receives no benefit from these procedures. The ethical dilemma resulted in stringent inclusion and exclusion criteria for fetal operations. Initially, fetal surgery was only indicated for life-threatening conditions of the fetus but is now offered in some disease processes to improve quality of life for the child. As the field has matured, it has grown to encompass numerous different types of fetal interventions. Similar to other areas of surgery, the trend has been to migrate from more invasive to less invasive procedures. Currently, some of these therapies are performed entirely percutaneously. Theoretically, this trend would improve outcomes for both the mother and fetus. While this has generally proven true, there are some important exceptions to this rule. Finally, as the field continues to evolve, much research is being performed looking at possible new types of fetal interventions. Some of these procedures, such as fetal stem cell therapy and fetal gene therapy, could change the face of modern medicine.
Jul 2017 DOI 10.14302/issn.2474-7785.jarh-16-1067
Nanavati NikhilCorresponding author
Specialist Registrar Orthopedics, Sheffield Teaching Hospitals, Sheffield, UK
Aim Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in hospital with orthopaedic surgery already an established risk factor. This study aims to establish the length of time that a patient is at risk of sustaining a VTE post orthopaedic surgery. Method A retrospective case series of all patients who underwent orthopaedic surgery between 2010 and 2014 whom re-presented with a VTE within one year of their initial operation. Demographic, operative and clinical information was obtained in order to identify potential risk factors. Results 53 patients were identified as having a VTE within one year of discharge. The majority (63.4%) underwent lower limb arthroplasty. 29% of the cohort had either a family or personal history of VTE, 79% had ischaemic heart disease (IHD), hypertension or both. The average body mass index (BMI) of the cohort was 31.4; above the UK national average. 56.6% of the cohort developed a pulmonary embolism (PE) and 49% developed a deep vein thrombosis (DVT). Co-occurring DVT and PE was diagnosed in 5.6% of patients. The average length of time for readmission for patients to re-present at hospital with a PE was 122 days (range 4-361) and 107 days (range 7 – 360) with a DVT. Conclusion This study confirms the existence of pre-established risk factors for developing VTE including obesity, personal and family history of DVT, cardiovascular disease and lower limb arthroplasty. These risk factors are recognised despite patients receiving post-operative thromboprophylaxis. The findings of this study extend the current research by suggesting that patients presenting with known risk factors of developing VTE may be at risk for longer than the current guidelines cover for the administration of thromboprophylaxis. We propose further studies are needed to identify any potential requirements for more extensive VTE prophylaxis in this population.
Jun 2017 DOI 10.14302/issn.2474-3585.jpmc-17-1540
Mwanakasale VictorCorresponding author
Copperbelt University, School of Medicine, Ndola, Zambia.
Introduction Schistosoma haematobium infection is acquired early in life with the peak prevalence and intensity of infection occurring in the second decade of life in endemic areas. The aim of this study was to establish any association between S. haematobium infection and development of inguinal hernia in school age children in a S. haematobium highly endemic area in Zambia. Methodology An analytical study was conducted at St Paul’s Mission Hospital, Nchelenge, Luapula province, Zambia. Hospital operating theatre records were reviewed for inguinal hernia repair operations in school age children. Results There were 45 inguinal hernia repair operations conducted in male school age children presumed to be infected with S. haematobium between July 2010 and July 2015. The mean age of these children was 9.6 years while the age range was from 6 years to 14 years. The overall prevalence of S. haematobium in school age children in the area ranged from 89.5% to 95.5% during this period. Conclusion Inguinal hernia is a probable complication of S. haematobium infection in school age male children.
Jun 2017 DOI 10.14302/issn.2474-7785.jarh-17-1578
Wilson DaisyCorresponding author
Institute of Ageing and Inflammation, University of Birmingham, Edgbaston, Birmingham, UK, B15 2GW
Frailty describes a medical syndrome that confers increased vulnerability to disproportionate changes in health status following minor stressors. With loss of homeostatic reserve in multiple physiological systems, frailty conveys an increased risk of adverse health outcomes. Despite the lack of a clear universal definition, the utilisation of two landmark operational models has allowed a rapid expansion in frailty-centred research. The pathophysiology of frailty is yet to be elucidated in the literature, but a critical role for a heightened inflammatory state is hypothesised. Raised levels of pro-inflammatory cytokines are associated with frailty, with emerging evidence relating their biochemical action with development of the frailty phenotype. Dysregulation of both the innate and adaptive immune system are key components of the frailty syndrome. Remodelling of the T cell compartment and upregulated inflammatory pathways are theorised to propagate the heightened inflammatory state critical in the frailty syndrome. Increased neutrophil counts, in conjunction with ineffective neutrophil migration associated with age, is theorised to produce tissue damage and secondary inflammation conducive of the inflammatory picture in frailty. Beyond the gold standard of the comprehensive geriatric assessment, management of frailty is a fast-evolving area of research. Exercise interventions have shown promising results, improving functional ability and showing beneficial immunomodulation. Vitamin D supplementation, with proposed anti-inflammatory effects, nutritional support and pharmacological treatments all provide promising areas for future therapeutic intervention.
Nov 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1304
Fagorala AfolamiCorresponding author
Trinity School of Medicine
Objective The psychosocial aspect of drug use is seldom researched in Caribbean nations. Drug use in the Caribbean has been on the rise since the 1990s. Statistical indicators have established evidence for the increased rates of illegal drug use. This study briefly reviewed these indicators and explored factors that influenced the state of drug affairs in Grenada from 2001 to 2009. Methods Interviews conducted in a semi-structured form were carried out on key stakeholders involved in drug prevention in Grenada. Literary review of pertinent articles from search engines was used to buttress results. Further search through statistical records provided by the Drug Control Secretariat and Grenada Drug Information Network/National Observatory on Drugs (GRENDIN/NOD) was used to obtain information on recent developments surrounding drug related activities in Grenada. Results Trends show marijuana as the drug of choice and males being primarily involved in illegal drug activities. Additionally, cultural, and psychological factors play major roles in the proliferation of the drug problem in Grenada. Conclusion Despite preventive measures used to raise awareness on the dangers of drug use, drug use/abuse/activities are still at an all-time high in Grenada. Focusing on the social, cultural, psychological factors influencing illicit drug activities, and increased cooperation between anti-drug organizations may be effective in curbing illegal drug use in Grenada.
Jul 2016 DOI 10.14302/issn.2474-3585.jpmc-16-1118
Shelli Stephens-StidhamCorresponding author
We used the five dimensions of the RE-AIM model to evaluate a smoke alarm (SA) installation program called Operation Installation (OI), which was implemented in 36 high risk census tracts in Dallas, TX, from 2001-2011. More than 20,000 SAs were installed in 8,134 houses through OI. The RE-AIM model showed that the program had a modest reach into the target population (26.5%), and a relatively high effectiveness (63%) at preventing deaths and injuries in program houses. Adoption and implementation remained high throughout the time period. Individual level maintenance of SAs was high initially (91.8%), but rapidly declined and was only 20% after 10 years. Application of the RE-AIM model to evaluate this long-term SA installation program highlighted areas that warranted improvement, especially for the dimensions of Reach and individual-level Maintenance. The model may be useful for evaluating the impact of other injury prevention programs.
Jul 2016 DOI 10.14302/issn.2471-7061.jcrc-14-575
V. Roig JoséCorresponding author
Consorcio Hospital General Universitario de Valencia, Department of General and Digestive Surgery.
Aim: To analyze the factors involved in and the results of stoma reversal after an emergency Hartmann's operation. Methods: A multicenter retrospective study from the Valencian Society of Surgery of patients who had undergone an emergent Hartmann’s operation from 2004 to 2008. An analysis of the reversal rate and related factors, delay, and morbidity of reconstruction was performed. Results: Three hundred sixty-two patients were studied. The most frequent initial diagnosis was colorectal cancer, followed by complicated acute diverticulitis; the primary surgical indication was acute peritonitis. After a median follow-up of 52 months, 151 patients (41.7%) underwent surgery to reverse the stoma at a median of 10 months after initial surgery. Diagnosis of diverticulitis or trauma, peritonitis as the surgical indication, and non-advanced tumors were associated with reversal. Multivariate analysis showed that only age and tumor stage were predictive of reversal. Postoperative complications occurred in 44% of the cases, and wound infection was the most common. There were 9 (6%) anastomotic leaks. Thirteen patients (8.6%) retained a permanent or temporary stoma after the attempted reconstruction. Conclusion: Hartmann’s reversal after emergency surgery is performed in less than half of all such patients and has significant morbidity.
Mar 2016 DOI 10.14302/issn.2577-137X.ji-15-834
Z Kompithra RajeevCorresponding author
Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, 632004, India
The Expanded Program on Immunization (EPI) in India delivers vaccines under its policy, through government hospitals, health centers and outreach clinics. However, the national average full immunization coverage is stagnating at about 70%. The days and times of clinics are not always convenient for mothers working at home or employed outside. Moreover, vaccines not under EPI, but recommended by the Indian Academy of Pediatrics (IAP), are unavailable there, forcing mothers to go to private sector immunization clinics to get them. Recognizing the local need for user-friendly immunization clinic, we designed one in the Department of Child Health. The impetus came from local demand by a civil society organization (Rotary Club of Vellore). Our immunization clinic is open every working day (8.30 am to 4.00 pm) offering both groups of vaccines. Its success is illustrated by the fact that over 7000 children per month receive immunization in this clinic. We describe its design and operation so that this model may be replicated in other urban hospitals with pediatric sections.
Dec 2015 DOI 10.14302/issn.2470-0436.jos-15-818
Arlappa NimmathotaCorresponding author
National Institute of Nutrition (Indian Council of Medical Research), Hyderabad, India.
Purpose: Vitamin A deficiency (VAD) is still a major nutritional problem of public health importance among the rural pre-school children in India, even after the implementation national vitamin A prophylaxis programme for prevention of nutritional blindness and ICDS have been in operation for more than three decades. The purpose of this communication is to assess the prevalence of ocular manifestations of vitamin A deficiency among rural pre-school children of north India. Methods: A community based cross-section study; adopting multi-stage random sampling procedure was carried out by NNMB among rural pre-school children of four north Indian states viz. Maharashtra, Madhya Pradesh, Orissa and West Bengal. A total of 36,111 rural pre-school children of 1-5years (Boys: 18408; Girls: 17703) were covered for this study. Results: The prevalence of conjunctival xerosis (2.5%), the first ocular sign of VAD and Bitot’s spot (0.9%), an objective ocular sign of VAD was higher than the cut-off values suggestive of public health nutritional problem among the rural children. While, the prevalence of night blindness, the first symptom VAD was reported among 0.5% of rural children. Similarly, the proportion of rural pre-school children with sub-clinical VAD was 64%, suggestive of severe public health importance. Conclusion: The prevalence of ocular manifestation and sub-clinical vitamin A deficiency was high among the rural children of north India. Therefore, rural communities are encouraged to consume diets rich in vitamin A and administer massive dose vitamin A solution to the children of under five for the prevention and control of vitamin A deficiency and its adverse impact on child morbidity and mortality.
Dec 2015 DOI 10.14302/issn.2471-7061.jcrc-15-661
Zoucas EvitaCorresponding author
Colorectal Section, Division of Surgery and Urology, Skane University Healthcare, SE-205 02 Malmö, Sweden.
Following multivisceral pelvic resections, the pelvis and perineum are often reconstructed using myocutaneous flaps. Abdominal wall defects after harvesting rectus abdominis flaps can be reinforced with mesh. Primary reconstruction using synthetic mesh was presently evaluated. Fifty-eight patients who underwent multivisceral pelvic resection and perineal reconstruction with a vertical rectus abdominis myocutaneous (VRAM) flap, January 2004 to February 2014, were retrospectively reviewed. The abdominal wall was reinforced in 26. Demographics, treatment procedures, surgical procedures, length of hospital and ICU stay, early and late morbidity at the recipient and donor sites were recorded. Patients with mesh reinforcement were significantly younger than those without. There were no further significant differences in patient demographics or treatment procedures between the two groups. In 31% of the patients with mesh, surgery was performed on two consecutive days, although total operating time did not differ significantly. Patients without mesh bled more. Surgery was associated with considerable morbidity, without significant differences in overall complication rate between the two groups. At the recipient site, wound infection/dehiscence was the most common early complication. The group with mesh had higher rate of total flap necrosis necessitating re-operation. At the donor site, wound infection /dehiscence, hernia, or bulge were recorded. Patients with mesh had lower rates of donor site morbidity. Perineal reconstruction with VRAM flap and primary abdominal wall reinforcement with mesh is feasible after multivisceral resection. Our study indicates that primary use of mesh can be applied in potentially contaminated surgical fields in oncologic patients without increasing morbidity and with improved long-term cosmetic results.
Nov 2015 DOI 10.14302/issn.2471-2175.jdrt-15-698
Xiang Wen-ZhongCorresponding author
Department of Dermatology, Third Hospital of Hangzhou, Affiliated Hangzhou Clinical College, Anhui Medical University.
Bullous pemphigoid (BP) is one of the most common autoimmune blistering diseases. Here, we report an old woman presented with a 2-month history of bullous lesions located just over the skin of the right thigh and buttock where the orthopedics operation was performed using artificial hip made of titanium alloy and a twenty days history of similar lesions involving the rest of the body gradually.
Aug 2015 DOI 10.14302/issn.2372-6601.jhor-15-666
Zaichick VladimirCorresponding author
Radionuclide Diagnostics Department, Medical Radiological Research Centre, Obninsk 249036, Russia
Objectives: To clarify the role of trace elements in the etiology and the pathogenesis of the chondrosarcoma, a non-destructive neutron activation analysis with high resolution spectrometry of long-lived radionuclides were performed. Methodology: The silver (Ag), cobalt (Co), chromium (Cr), iron (Fe), mercury (Hg), rubidium (Rb), antimony (Sb), selenium (Se), and zinc (Zn)mass fractions and Co/Zn, Cr/Zn, Fe/Zn, Hg/Zn, Sb/Zn, Co/Rb, Cr/Rb, Fe/Rb, Hg/Rb, Sb/Rb, and Se/Rb mass fraction ratios were estimated in normal bone samples from 27 patients with intact bone (12 females and 15 males, aged from 16 to 49 years), who had died from various non bone related causes, mainly unexpected from trauma, and in tumor samples, obtained from open biopsies or after operation of 16 patients with chondrosarcoma ((3 females and 13 males, 8 to 65 years old). The reliability of difference in the results between intact bone and chondrosarcoma tissues was evaluated by Student’s t-test. Key Results: In the chondrosarcoma tissue the mass fractions of Co, Fe, and Se are significantly higher while the mass fraction of Rb is lower than in normal bone tissues. Moreover, significantly higher Co/Zn, Fe/Zn, Co/Rb, Cr/Rb, Fe/Rb, Sb/Rb, and Se/Rb mass fraction ratios are typical of the chondrosarcoma tissue compared to intact bone. In the chondrosarcoma tissue many correlations between trace elements found in the control group was no longer evident. Major Conclusions: In chondrosarcoma transformed bone tissues the trace element homeostasis is significantly disturbed.
Nov 2014 DOI 10.14302/issn.2379-8572.joa-14-429
Ver Halen JonCorresponding author
Background: We reviewed the 2005-2011 ACS-NSQIP database to evaluate factors associated with adverse events (AE) after total laryngectomy (TL). Methods: All total laryngectomies performed from 2006 to 2011 were identified for analysis. The cohort was characterized with respect to preoperative and demographic characteristics, complications, reoperation, and mortality. Results: 493 cases were identified. Complications of any category occurred in 189 cases (38.3%). Factors that were found to confer significant risk for medical complications were increased age (dds Ratio (OR) 1.03), prior PCI (OR 2.84), disseminated cancer (OR 2.47), chronic steroid/immunosuppresion use (OR 2.87), unintended weight loss > 10% over 6 months prior to surgery (OR 2.02), increasing work RVU total (OR 1.02), and increased anesthesia Z-score (OR 1.31). Only increased anesthesia Z-score (OR 1.27) was found to be a statistically significant risk factor for surgical complications. Chronic steroid/immunosuppression use (OR 3.16) and increased anesthesia Z-score (OR 1.29) were both found to be statistically significant risk factors of reoperation within 30 days. Conclusions: NSQIP is the only dataset that correctly discerns between minimally invasive and wide excision in laryngectomy. The use of the NSQIP dataset may be imperfect, as pertinent details of chemotherapy and radiation, and procedure-specific complications, including fistula formation, are not tracked. In spite of this, our findings suggest avenues for improvement in the care of TL patients, and suggest directions for a laryngectomy-specific outcomes database.