Justification of Urgent Brain CT Examinations at Medium Size Hospital, Jerusalem

We studied requested urgent Brain CT Scan procedures justification. In addition, we addressed referrer’s (physician’s) awareness of radiation risks. In doing so, we considered two aspects to the issue. First, we reviewed the records of the requested urgent CT scan procedures for a sample of 339 patients at Al-Maqassed Hospital, a major hospital in Palestine. Secondly, we surveyed a sample of forty-two referrer’s from the same hospital to test their awareness of radiation risks. Our study shows that out of the 339 urgent brain CT requests, 69.6% were justified requests and 30.4% were unjustified. Statistically, these observations implied the following general statement: At least, 25% of the CT requests at this Hospital are unjustified with a p-value of 0.011. On the other hand, our survey on referrers shows that 42% of respondents knew the effective dose of a brain CT scan, 24% of respondents knew the radiation risks and 14% of respondents knew about radiation protection. Although the study is limited, yet it shows the need to reduce the number of brain CT examinations and the need to improve their justification. Consequently, the need for regular education and guideline implementation at least in this country is of paramount importance

Multimodal Imaging of Hepatocellular Carcinoma Using Dynamic Liver Phantom

Liver phantom is used at various medical levels, such as detecting hepatocellular carcinoma (HCC) in the early stages, training medical staff to deal with HCC by taking biopsies, developing new sequences on medical imaging devices, confirming the image quality, applying treatments to HCC, and others. All of the trials should be applied before entering the real human body. The phantom includes properties very similar to those of the human body, as well as the properties of liver cancer and how it is treated within the body through its biological form. Therefore, the present chapter aims to provide comprehensive information to consider when fabricating HCC-containing phantoms and the characteristics of those phantoms in proportion to multimodal medical imaging to aid in understanding the main target of dynamic phantom for HCC

Current Status Regarding Tumour Progression, Surveillance, Diagnosis, Staging, and Treatment Of HCC: A Literature Review

Hepatocellular carcinoma (HCC) is the most common primary malignant tumour of the liver, and is globally considered to be a major causes of cancer-associated mortality. The early diagnosis of HCC improves overall survival through the application of suitable treatment options. This article presents some of the techniques for the surveillance of HCC like ultrasonography and the use of tumour biomarkers such as α-fetoprotein (AFP), DesGamma-Carboxy Prothrombin (DCP) and others. Included in the discussion will be diagnostic methods like computed tomography (CT), magnetic resonance imaging (MRI), contrast enhancement ultrasound (CEUS), and fluorodeoxyglucose positron emission tomography hybrid with computed tomography (FDG PET/CT). Current molecular pathogenesis related to HCC and the molecular steps that determine the transition from benign to malignancy are also analysed. The HCC stages which depends on the Barcelona Clinic Liver Cancer (BCLC) algorithm are also discussed. Finally, this review article discusses the present therapeutic and treatment options for HCC such as resection, transplantation, or ablation used to treat early stage cancer. Also included will be trans-arterial chemoembolization (TACE) and Sorafenib for patients with intermediate and advanced-stage cancer, respectively

Characterization and Construction of a Robust and Elastic Wall-Less Flow Phantom for High Pressure Flow Rate Using Doppler Ultrasound Applications

A Doppler ultrasound is a noninvasive test that can be used to estimate the blood flow through the vessels. Presently, few flow phantoms are being used to be qualified for long-term utilize and storage with high physiological flow rate Doppler ultrasound. The main drawback of the two hydrogel materials items (Konjac (K) and carrageenan (C) (KC)) that it is not fit for long-term storage and easy to deteriorate. Thus, this research study focuses on the characterization and construction of a robust and elastic wall-less flow phantom with suitable acoustical properties of TMM. The mechanisms for the fabrication of a wall-less flow phantom utilizing a physically strong material such as K, C, and gelatin (bovine skin)-based TMM were explained. In addition, the clinical ultrasound (Hitachi Avius (HI)) system was used as the main instrument for data acquisition. Vessel mimicking material (VMM) with dimensions of 15.0 mm depth equal to those of human common carotid arteries (CCA) were obtained with pulsatile flow. The acoustical properties (speed of sound and attenuation were 1533±2 m/s and 0.2 dB/cm. MHz, respectively) of a new TMM were agreed with the IEC 61685 standards. Furthermore, the velocity percentages error were decreased with increase in the Doppler angle (the lowest % error (3%) it was at 53◦). The gelatin from bovine skin was a proper material to be added to KC to enhance the strength of TMM during for long-term utilize and storage of high-flow of blood mimicking Fluid (BMF). This wall-less flow phantom will be a suitable instrument for examining in-vitro research studies

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Effectiveness of therapeutic ultrasound and kinesio tape in treatment of tennis elbow

Objective: To investigate the effect of kinesio tape and therapeutic ultrasound on pain and hand grip strength associated with tennis elbow. Material and Methods: Twenty male and female patients with age from 20-50 years suffering from lateral epicondylitis were participated in this study. All patients were randomly selected from orthopaedic surgeon. They were dividing into two groups. Group (A) (ultrasound and exercises group). Group (B) (kinesio tape and exercises group). The hand-held dynamometer was used to provide a detailed and objective measurement of wrist joint strength throughout its range of motion, the pressure being registered in kilogram (Kg) and Visual Analogue Scale (VAS) was used to record the degree of pain intensity. Result: The result shows no significant difference between group A and B in their ages, weights, heights, and BMI where their t and P-values were (0.8, 0.43), (0.03, 0.97), (0.98, 0.33), and (0.9, 0.37) respectively. In Group A the significant differences in hand grip strength between pre and post-test which shows 31.59), compared to the pre-test (27.35), while in group B (33.17) compared to the pre-test (23.88). According the pain scale for group A and group B there are significant differences where the results were (2.50), compared to the pre-test (5.90) and (2.00), compared to the pre-test (7.30), retrospectively. Conclusions: The treatment was improvement between both groups. However, the kinesio tape is better than therapeutic ultrasound

Physical activity and health-related quality of life among physiotherapists in Hebron/West Bank

Introduction: Physical activity (PA) directly affects Health-related quality of life. The aim of the study was to establish the relationship between physical activity levels of physiotherapists and their physical activity promotion strategies. in Hebron/West Bank. Method: The study relied on cross-section, which included 150 PTs distributed over 42 centers of Hebron areas in Palestine country. The questionnaire is based on Likert scale items pentagonal level, which included several aspects of Health-related quality of life. Statistical analysis was used to test the associations between different categorical variables (p < 0.05). Results: of total 150 participants, most of them were male 56%, their ages ranged from 25-30 years (46%), and holding bachelor’s degrees 78%. About 60% of them are in good physical health. Most participants feel vitality, depression, quit, have energy, and are happy in the most of the time. In addition, most of them believe their health is similar to that of the members of the surrounding community. The study showed there is no relationship between general health and age except in the age group over 40 years, and females are the most exposed group. In addition, there is an influence relationship between physical and psychological with age, and this effect also includes females more than males. Conclusion: Physical functioning of most of the participants was good, while most of the participants had problems with their work and the major effect was on the female category

Chemical items used for preparing tissue-mimicking material of wall-less flow phantom for doppler ultrasound imaging

The wall-less flow phantoms with recognized acoustic features (attenuation and speed of sound), interior properties, and dimensions of tissue were prepared, calibrated, and characterized of Doppler ultrasound scanning demands tissue-mimicking materials (TMMs). TMM phantoms are commercially available and ready-made for medical ultrasound applications. Furthermore, the commercial TMM phantoms are proper for ultrasound purpose or estimation of diagnostic imaging techniques according to the chemical materials used for its preparation. However, preparing a desirable TMM for wall-less flow phantom using a specific chemical material according to the specific applications is required for different flow. In this review, TMM and wall-less flow phantoms prepared using different chemical materials and methods were described. The chemical materials used in Doppler ultrasound TMM and wall-less flow phantoms fabricated over the previous decades were of high interest in this review

The emergence of Y-chromosome haplogroup J1e among Arabic-speaking populations

Haplogroup J1 is a prevalent Y-chromosome lineage within the Near East. We report the frequency and YSTR diversity data for its major sub-clade (J1e). The overall expansion time estimated from 453 chromosomes is 10 000 years. Moreover, the previously described J1 (DYS388=13) chromosomes, frequently found in the Caucasus and eastern Anatolian populations, were ancestral to J1e and displayed an expansion time of 9000 years. For J1e, the Zagros/Taurus mountain region displays the highest haplotype diversity, although the J1e frequency increases toward the peripheral Arabian Peninsula. The southerly pattern of decreasing expansion time estimates is consistent with the serial drift and founder effect processes. The first such migration is predicted to have occurred at the onset of the Neolithic, and accordingly J1e parallels the establishment of rain-fed agriculture and semi-nomadic herders throughout the Fertile Crescent. Subsequently, J1e lineages might have been involved in episodes of the expansion of pastoralists into arid habitats coinciding with the spread of Arabic and other Semitic-speaking populations

Genome-wide and fine-resolution association analysis of malaria in West Africa

We report a genome-wide association (GWA) study of severe malaria in The Gambia. The initial GWA scan included 2,500 children genotyped on the Affymetrix 500K GeneChip, and a replication study included 3,400 children. We used this to examine the performance of GWA methods in Africa. We found considerable population stratification, and also that signals of association at known malaria resistance loci were greatly attenuated owing to weak linkage disequilibrium (LD). To investigate possible solutions to the problem of low LD, we focused on the HbS locus, sequencing this region of the genome in 62 Gambian individuals and then using these data to conduct multipoint imputation in the GWA samples. This increased the signal of association, from P = 4 × 10(-7) to P = 4 × 10(-14), with the peak of the signal located precisely at the HbS causal variant. Our findings provide proof of principle that fine-resolution multipoint imputation, based on population-specific sequencing data, can substantially boost authentic GWA signals and enable fine mapping of causal variants in African populations