184 research outputs found
Effects of HH education program on HH compliance among empolyess working in a tertiary care setting in Saudi Arabia
Smart Algorithms for Hierarchical Clustering in Optical Network
Network design process is a very important in order to balance between the investment in the network and the supervises offered to the network user, taking into consideration, both minimizing the network investment cost, on the other hand, maximizing the quality of service offered to the customers as well.Partitioning the network to smaller sub-networks called clusters is required during the design process inorder to ease studying the whole network and achieve the design process as a trade-off between several atrtributes such as quality of service, reliability,cost, and management. Under CANON, a large scale optical network is partitioned into a number of geographically limited areas taking into account many different criteria like administrative domains, topological characteristics, traffic patterns, legacy infrastructure etc. An important consideration is that each of these clusters is comprised of a group of nodes in geographical proximity. The clusters can coincide with administrative domains but there could be many cases where two or more clusters belong to the same administrative domain. Therefore, in the most general case the partitioning into specific clusters can be either a off-line or a on-line process. In this work only the off-line case is considered. In this Study, we look at the problem of designing efficient 2- level Hierarchical Optical Networks (HON), in the context of network costs optimization. 2-level HON paradigm only have local rings to connect disjoint sets of nodes and a global sub mesh to interconnect all the local rings. We present an Hierarchical algorithm that is based on two phases. We present results for scenarios containing a set of real optical topologies
Cut-edge mucoperiosteal flap for anterior fixation of palatal flap in palatoplasty
Introduction: This study was done at Mansoura University Children Hospital, Egypt from the period of June 2013 to June 2015 on 80 patients with incomplete intramaxillary cleft palate.Patients and methods: After oral layer closure of the cleft palate, anterior fixation of the flap is obtained by raising the anterior cut-edge of mucoperiosteal flap for about 0.5 cm then suturing the flap to the elevated cut-edge with two stitches. We divided the patients into two groups and evaluated the time needed for fixation the palatal flap anddifficulty of fixation and evaluated the incidence of anterior palatal fistula between the two groups.Results: The time used for elevation of the flap and taking the two stitches in group A ranged from 2.5 to 6 min. However, the time used for taking the two stitches without elevation of the flap in group B ranged from 2.8 to 9 min.Conclusion: We found that cut-edge mucoperiosteal flap for anterior fixation of two-flap palatoplasty is a simple step at the end of cleft palate repair procedure which allows easy fixation of the palatal flap with short time and good opposition of the tissue edges, allowing better healing.Keywords: anterior fixation palatal flap, cut-edge, palatoplast
Spontaneous spinal cord infarction secondary to embolism from an aortic aneurysm mimicking as cauda equina due to disc prolapse: a case report
Spinal “stroke” is an uncommon cause of paraplegia. Spinal cord infarction from unruptured aortic aneurysm is rare. When encountered it poses diagnostic challenge to the clinician due to its rarity, which may lead to incorrect or delayed diagnosis. We report a case of 62-year-old man presenting to casualty as caudaequina syndrome due to spinal cord infarction secondary to emboli from an infra renal abdominal aortic aneurysm. To the authors knowledge this is first case of its kind and has not been reported in literature. Patient had improvement in proximal motor function following repair of the aneurysm, although he remained doubly incontinent in six months follow up
Decreasing but differential trends of adverse events among dialysis outpatient following re-enforcement of infection control measures; 20-month surveillance study
Understanding Key Bidding Factors Considered by Top Jordanian Contractors
One of the most crucial decisions that is regularly exercised by construction contractors is to determine whether to bid or not to bid on a certain project. The purpose of this paper is to understand key factors that are considered by top Jordanian contractors in their bid/no-bid decision making. Previous research in the Jordanian construction market reported the importance weights of 53 bid/no-bid factors (El-Mashaleh, 2013). Based on that work, this paper discusses the top bidding factors and compares them with international related work. Additionally, the paper examines the reliability of El-Mashaleh’s (2013) study based on Cronbach's alpha reliability test. Furthermore, the paper tests the degree of consensus among the respondents of El-Mashaleh’s (2013) work regarding the ranking of the 53 bid/no-bid decision factors based on Kendall's coefficient of concordance. Finally, analysis of variance (ANOVA) is conducted to test statistical significant differences in the importance weights of the 53 bidding factors between public and private bidders. Cronbach's alpha reliability test proves that the adopted scale of measurement for the importance of the bid/no-bid factors has excellent internal consistency reliability. Kendall's coefficient of concordance reveals a significant degree of consensus among the respondents regarding the ranking of the bid/no-bid decision factors. Analysis of variance (ANOVA) indicates statistical significant differences in importance weights between public and private bidders for 6 factors out of the 53 factors considered
Upper lip myomucosal flap for the repair of anterior oronasal fistula
Anterior oronasal fistula after cleft palatal repair is difficult to correct and it is consider challenging to many surgeons. Many techniques were used to repair this type of fistula without guarantee for success. Upper lip myomucosal flap is an alternative technique for the repair of this type of fistula. This is a retrospective descriptive case series study which included 10 patients diagnosed with anterior oronasal fistula after cleft palatal repair. They presented to Pediatric Surgery Department at the Faculty of Medicine, Mansoura University Children Hospital from the period between November 2013 and August 2014. In this technique, we do harvesting of the flap with measurement of its length and width, then baring the edge of the fistula with trying of its closure with local flaps. After that we suture the flap to the edge of the fistula and then evaluate the success rate. This study included 10 patients with age ranging from 15 to 72 months. The size of the fistula was less than 1 cm in six patients and more than 1 cm in four patients. The flap was used as an additional layer repair in seven patients and as the only layer for the repair in three patients. This technique was found to be successful in 70% of the patients with good healing without any recurrent fistula. We concluded that the use of this technique is feasible; however, its efficacy should be tested in larger number of patients to be considered as an option for the treatment of anterior oronasal fistula.Keywords: oronasal fistula, upper lip myomucosal flap, lip fla
Ectopic cardiovascular fat in middle-aged men: effects of race/ethnicity, overall and central adiposity. The ERA JUMP study.
Background/objectivesHigher volumes of ectopic cardiovascular fat (ECF) are associated with greater risk of coronary heart disease (CHD). Identifying factors that are associated with ECF volumes may lead to new preventive efforts to reduce risk of CHD. Significant racial/ethnic differences exist for overall and central adiposity measures, which are known to be associated with ECF volumes. Whether racial/ethnic differences also exist for ECF volumes and their associations with these adiposity measures remain unclear.Subjects/methodsBody mass index (BMI), computerized tomography-measured ECF volumes (epicardial, pericardial and their summation) and visceral adipose tissue (VAT) were examined in a community-based sample of 1199 middle-aged men (24.2% Caucasians, 7.0% African-Americans, 23.6% Japanese-Americans, 22.0% Japanese, 23.2% Koreans).ResultsSignificant racial/ethnic differences existed in ECF volumes and their relationships with BMI and VAT. ECF volumes were the highest among Japanese-Americans and the lowest among African-Americans. The associations of BMI and VAT with ECF differed by racial/ethnic groups. Compared with Caucasians, for each 1-unit increase in BMI, African-Americans had lower, whereas Koreans had higher increases in ECF volumes (P-values<0.05 for both). Meanwhile, compared with Caucasians, for each 1-unit increase in log-transformed VAT, African-Americans, Japanese-Americans and Japanese had similar increases, whereas Koreans had a lower increase in ECF volumes (P-value<0.05).ConclusionsRacial/ethnic groups differed in their propensity to accumulate ECF at increasing level of overall and central adiposity. Future studies should evaluate whether reducing central adiposity or overall weight will decrease ECF volumes more in certain racial/ethnic groups. Evaluating these questions might help in designing race-specific prevention strategy of CHD risk associated with higher ECF
Epidemiology of the first outbreak of carbapenem-resistant Klebsiella pneumoniae in Saudi Arabia
Post-Traumatic Intra-Cocoon Mesenteric Tear: A Case Report
Sclerosing peritonitis, more commonly called abdominal cocoon, is a rare intra-peritoneal disease that is characterized by complete or partial encapsulation of the small intestine by a thick collagenous membrane. This disease mostly presents in the form of small bowel obstruction, however in our case the patient presented with intra-cocoon bleeding following a motor vehicle accident
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