Rapid pleurodesis using small bore pigtail catheter and bleomycin in malignant pleural effusions: a case series

Pleural drainage is the treatment of choice for patients presented with symptomatic malignant pleural effusion. The conventional method of treatment is insertion of large bore thoracostomy tube (chest tube) before proceeding to chemical pleurodesis. The aim of this preliminary prospective study was to investigate the success rate of performing pleurodesis using a small bore pigtail catheter (Mar Flow® CH12) in patients with malignant pleural effusion. Pleurodesis was performed within twenty four hours after insertion of pigtail catheter with bleomycin as sclerosing agent. Patients were follow-up at four weeks post pleurodesis with chest radiography. The intervention was scored as “successful” if no radiographic evidence of fluid reaccumulation was noted at four weeks. A “partial success” score indicated accumulation of fluid that did not produce symptoms and did not require repeat pleural drainage of any sort. All other outcomes were scored as “unsuccessful”. Five patients with malignant pleural effusion from Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II were included in this study with mean age of 53.6 year old. The primary diseases include breast, lung, ovarian and colon cancers. The mean time of pleurodesis was 9.5 hours. Of the five pleurodesis performed, a complete response (“successful”) was seen in three patients (60%), a partial response (“partial success”) was seen in one patient (20%) and one patient (20%) did not respond to rapid pleurodesis. In conclusion, pleurodesis in patients with malignant pleurodesis can be achieved rapidly using small bore pigtail catheter and bleomycin

Effective communication skills for information professionals / Mohd Nizam Yunus ... [et al.]

An effective and good communication abilities are central to accomplishment in numerous parts of life. Numerous occupations require solid communication abilities and socially individuals with enhanced communication abilities more often than not appreciate better interpersonal associations with other parties. Effective communication provides useful benefits to a person especially if he or she is working in an organization that requires a good relation with clients and customers. In the field of records management, we do not only manage records but with the current situation, this area requires us to deal with external parties such as government departments and private sector and also from the members of the public. For example, some information institutions centers require external customers or clients for income generation. Clients and customers should be treated well and this requires an effective form of communication from information professionals. Imagine if the clients had to deal with staffs who do not know how to communicate effectively, the client may run away to other information institutions and they will lose their financial resources. This makes the information professionals should have the skills to communicate well in order to maintain the reputation of their records. An information professional also deals with government officials and also members of the public during their daily task. All of this requires good personal communication skills. Information institutions often received visitors such as libraries, archives, record centers and museums and one such way to handle visitors effectively is by using a good communication skills

Obturator hernia: A rare condition with common surgical symptoms

Hernia is a common surgical problem. However, worldwide incidence of obturator hernia is <1% of all hernia cases, occurring more commonly in thin, elderly and multiparous female. An 82 years old lady presented with bowel obstruction sign and symptoms for 4 days duration. Imaging study, computed tomography with enhanced contrast (CECT) of abdomen and pelvis showed small bowel obstruction secondary to left obturator hernia. Emergency abdominal exploration with left transverse transperitoneal approach was performed. Intraoperatively, anti mesenteric part of ileal wall was incarcerated through the left obturator foramen causing small bowel obstruction and it was resected with end to end anastomosis. She recovered well and was discharged on postoperative day 7. The signs and symptoms of obturator hernia are non-specific. Most cases are presented with symptoms of intestinal obstruction, resulting in diagnostic difficulty for this rare condition. Delay in diagnosis and surgical intervention contribute to poorer outcomes

Predictive Modeling of TiN Coating Roughness

In this paper, an approach in modeling surface roughness of Titanium Nitrite (TiN) coating using Response Surface Method (RSM) is implemented. The TiN coatings were formed using Physical Vapor Deposition (PVD) sputtering process. N2 pressure, Argon pressure and turntable speed were selected as process variables. Coating surface roughness as an important coating characteristic was characterized using Atomic Force Microscopy (AFM) equipment. Analysis of variance (ANOVA) is used to determine the significant factors influencing resultant TiN coating roughness. Based on that, a quadratic polynomial model equation represented the process variables and coating roughness was developed. The result indicated that the actual coating roughness of validation runs data fell within the 90% prediction interval (PI) and the residual errors were very low. The findings from this study suggested that Argon pressure, quadratic term of N2 pressure, quadratic term of turntable speed, interaction between N2 pressure and turntable speed, and interaction between Argon pressure and turntable speed influenced the TiN coating surface roughness

Characterization of measured lightning electric fields observed in Malaysia

This paper presents a characteristic of lightning electric fields. The lightning electric fields captured by two parallel plats sensor and the characterization for preliminary breakdown pulse (PBP) and first return stroke (RS) were studied. A total of 207 data were recorded and 10 data are selected and been utilized in this paper accordingly. In PBP signal data, time before return stroke, ending time and maximum peak of PBP were analyzed. The time duration between the PBP and the occurrence of RS was obtained as 0.64 ms and 2.61 ms and then compared with results from other researchers. For RS signal data, slow front time, deviation time, RS peak, time to peak, zero crossing time and 10% to 90% rise time were evaluated meticulously and the results were discussed accordingly. Moreover, the statistical correlation between electric field zero times and corresponding rise times was studied

The electric field effect on angles of copper-type down-conductor

This paper is to study the effect of electric field on an angle variation of copper down-conductor due to voltage and current transient. Down-conductor which informs of numerous material, shape and dimension are mandatory for diverting the lightning current from air termination system to the grounding system in sheltered building. Hence, a numerical analysis method is applied emulating the comprehensible and particular model according to ordinarily used in the manufacturer’s datasheet specification. A rigorous assessment in term of electric fields was reviewed in comparison with the critical breakdown value of air for a crucial study. Later, a foremost angle is proposed for the installation of down-conductor in order to achieve a reliable protection system

Copper Layer Sheet Resistance Evolution As A Function Of Post-Seed Process Self-Annealing Time

Copper layer metallization is one of the important processes in integrated circuit manufacturing. One of the issues faced in this process is the proneness of Cu interface diffusion as well as surface oxidation which degrade some of the Cu thin film properties. Due to this concern, most integrated circuit manufacturing facility imposed 12 hours maximum delay time between the Cu seed deposition and Cu electroplating step. However, there is lack of study and data to justify support this time restriction. This study investigated the effect of self-annealing time between Cu seeding process and Cu electroplating process to the sheet resistance, reflectance, and stress of the deposited film. The data indicated that the there is no significant deterioration or fluctuation in sheet resistance, reflectance, and stress beyond 12 hours delay time. This suggested that the imposed 12 hours maximum delay time between Cu seed and Cu electroplating process can be further extended, which will give greater flexibility for the manufacturing scheduling

Application of ANFIS in Predicting of TiAlN Coatings Hardness

In this paper, a new approach in predicting the hardness of Titanium Aluminum Nitrite (TiAlN) coatings using Adaptive Neuro-Fuzzy Inference System (ANFIS) is implemented. TiAlN coated cutting tool is widely used in machining due to its excellent properties. The TiAlN coatings were formed using Physical Vapor Deposition (PVD) magnetron sputtering process. The substrate sputtering power, bias voltage and temperature were selected as the input parameters and the hardness as an output of the process. A statistical design of experiment called Response Surface Methodology (RSM) was used in collecting optimized data. The ANFIS model was trained using the limited experimental data. The triangular, trapezoidal, bell and Gaussian shapes of membership functions were used for inputs as well as output. The results of ANFIS model were validated with the testing data and compared with fuzzy and nonlinear RSM hardness models in terms of the root mean square error (RMSE) and model prediction accuracy. The result indicated that the ANFIS model using 3-3-3 triangular shapes membership function obtained better result compared to the fuzzy and nonlinear RSM hardness models. The result also indicated that the ANFIS model could predict the output response in high prediction accuracy even using limited training data

Modeling of TiN Coating Thickness Using RSM Approach

In this paper, modeling of Titanium Nitrite (TiN) coating thickness using Response Surface Method (RSM) is implemented. Insert cutting tools were coated with TiN using Physical Vapor Deposition (PVD) sputtering process. N2 pressure, Argon pressure and turntable speed were selected as process variables while the coating thickness as output response. The coating thickness as an important coating characteristic was measured using surface profilometer equipment. Analysis of variance (ANOVA) was used to determine the significant factors influencing TiN coating thickness. Then, a polynomial linear model represented the process variables and coating thickness was developed. The result indicated that the actual validation data fell within the 90% prediction interval(PI) and the percentage of the residual errors were low. Findings from this study suggested that Argon pressure, N2 pressure and turntable speed influenced the TiN coating thicknes

On the behavior of lightning return stroke current incidence to tall towers

The return stroke current in the case of a lightning strike on a tall structure is affected by different tower and channel parameters such as the velocity of the return stroke current, the height of the observation point along the structure, the lightning channel and the reflection coefficients at the top and bottom of the structure. This paper will consider all these factors in the behaviour of the return stroke. The current wave shapes at different heights along tower and channel were modeled and the simulated current at tower top was compared to the corresponding measured current. Moreover, the effects of reflection factors and other important parameters on the values of current peak were considered and the results were discussed accordingly