Changing pattern and etiology of maxillofacial fractures during the civil uprising in Western Libya

The purpose of the present study was to evaluate changing pattern in characteristics of maxillofacial fractures and concomitant injuries in Western Libya During revolution and to assess the association between mechanism of injury and fracture patterns. A retrospective review of medical records and radiographs of 187 patients treated for maxillofacial fractures from January 2010 to December 2012 was performed, there were 326 fractures in 187 patients. The male: female ratio was 6:1. Most fractures occurred in patients aged 11 to 40 years, and few injuries occurred in patients aged > 50 years. Most fractures occurred from motor vehicle accidents, and other most frequent causes included assault, gunshot, and fall injuries. Most maxillofacial fractures involved the mandible, zygomatic complex, or maxilla. Most mandibular fractures occurred at the parasymphysis, angle, or condyle. Associated injuries most frequently involved the head, chest, and extremities. Most patients were treated with open reduction (132 patients [71%]), and 26 patients (14%) were treated nonoperatively. There were 21 complications (11%). In summary, motor vehicle accidents were the most frequent cause of maxillofacial fracture in western Libya, possibly because of the lack of seat belt legislation. Interpersonal violence was a less frequent cause of maxillofacial fracture, possibly because of the religious restriction on alcohol consumption

Cost-effectiveness of malaria diagnosis using rapid diagnostic tests compared to microscopy or clinical symptoms alone in Afghanistan

Background Improving access to parasitological diagnosis of malaria is a central strategy for control and elimination of the disease. Malaria rapid diagnostic tests (RDTs) are relatively easy to perform and could be used in primary level clinics to increase coverage of diagnostics and improve treatment of malaria.<p></p> Methods A cost-effectiveness analysis was undertaken of RDT-based diagnosis in public health sector facilities in Afghanistan comparing the societal and health sector costs of RDTs versus microscopy and RDTs versus clinical diagnosis in low and moderate transmission areas. The effect measure was ‘appropriate treatment for malaria’ defined using a reference diagnosis. Effects were obtained from a recent trial of RDTs in 22 public health centres with cost data collected directly from health centres and from patients enrolled in the trial. Decision models were used to compare the cost of RDT diagnosis versus the current diagnostic method in use at the clinic per appropriately treated case (incremental cost-effectiveness ratio, ICER).<p></p> Results RDT diagnosis of Plasmodium vivax and Plasmodium falciparum malaria in patients with uncomplicated febrile illness had higher effectiveness and lower cost compared to microscopy and was cost-effective across the moderate and low transmission settings. RDTs remained cost-effective when microscopy was used for other clinical purposes. In the low transmission setting, RDTs were much more effective than clinical diagnosis (65.2% (212/325) vs 12.5% (40/321)) but at an additional cost (ICER) of US$4.5 per appropriately treated patient including a health sector cost (ICER) of US$2.5 and household cost of US$2.0. Sensitivity analysis, which varied drug costs, indicated that RDTs would remain cost-effective if artemisinin combination therapy was used for treating both P. vivax and P. falciparum. Cost-effectiveness of microscopy relative to RDT is further reduced if the former is used exclusively for malaria diagnosis. In the health service setting of Afghanistan, RDTs are a cost-effective intervention compared to microscopy.<p></p> Conclusions RDTs remain cost-effective across a range of drug costs and if microscopy is used for a range of diagnostic services. RDTs have significant advantages over clinical diagnosis with minor increases in the cost of service provision.<p></p&gt

Saudi SCD patients’ symptoms and quality of life relative to the number of ED visits

Background Individuals living with sickle cell disease (SCD) have significantly increased emergency department (ED) use compared to the general population. In Saudi Arabia, health care is free for all individuals and therefore has no bearing on increased ED visits. However, little is known about the relationship between quality of life (QoL) and frequency of acute care utilization in this patient population. Methods A cross-sectional study was conducted on 366 patients with SCD who attended the outpatient department at King Fahad Hospital, Hofuf, Saudi Arabia. Data were collected through self-administered surveys, which included: demographics, SCD-related ED visits, clinical issues, and QoL levels. We assessed the ED use by asking for the number of SCD-related ED visits within a 6-month period. Results The self-report survey of ED visits was completed by 308 SCD patients. The median number of SCD-related ED visits within a 6-month time period (IQR) was four (2-7 visits). According to the unadjusted negative binomial model, the rate of SCD-related ED visits increased by (46, 39.3, 40, and 53.5 %) for patients with fever, skin redness with itching, swelling, and blood transfusion, respectively. Poor QoL tends to increase the rate of SCD-related ED visits. Well education and poor general health positively influenced the rate of SCD-related ED visits. Well education tends to increase the rate of SCD-related ED visits by 50.2 %. The rate of SCD-related ED visits decreased by 1.4 % for every point increase in general health. Conclusion Saudi patients with sickle cell disease reported a wide range of SCD-related ED visits. It was estimated that six of 10 SCD patients had at least three ED visits within a 6-month period. Well education and poor general health resulted in an increase in the rate of SCD-related ED visits

Early functional outcome of two surgical protocols used in the repair of complete unilateral cleft lip palate: a comparative study

Background and objective The outcome of different treatment protocols for primary management of patients with complete unilateral cleft lip palate (UCLP) may vary considerably. This study aimed to compare the results of quality of speech and velopharyngeal sphincter mechanism between two surgical protocols used in the repair of complete UCLP.Patients and methods This study was conducted in Zagazig University Hospitals from February 2009 to April 2012 on 30 patients. The patients were categorized into two groups: group A, which consisted of 15 patients who underwent cleft lip repair and cleft hard palate repair with a vomer flap in same sitting; and group B, which consisted of 15 patients who underwent only cleft lip repair at first sitting. At the age of 12 months in both groups, repair of the remaining cleft palate was performed.Results A significant difference between groups A and B at all postoperative comparisons was found in terms of grade of nasality, grade of closure of the velopharyngeal valve, and nasal emission of air.Conclusion Early repair of the hard palate with simultaneous cleft lip repair can be considered as a reliable alternative procedure to one-stage palatoplasty and appeared to have better early functional results in the treatment of complete UCLP

The changes in various hydroxyproline fractions in aortic tissue of rabbits are closely related to the progression of atherosclerosis

<p>Abstract</p> <p>Background</p> <p>The most important function of collagen and elastin is to induce several mechanical parameters which are known to play a dominant role in governing mechanical properties of the blood vessels. The aortic tissue of rabbit is one of the important sources of collagen and elastin. The effects of high fat diet (HFD) on the hydroxyproline (Hyp) fractions in serum and aortic tissues of rabbits and collagen content in the aortic tissues of rabbits have not been documented before. The present study was undertaken to investigate the changes in Hyp fractions in serum and aortic tissues of rabbits and collagen content in the aortic tissues of rabbits during the progression of atherosclerosis. The atherosclerotic model used in this study was the New Zealand white rabbit (male; 12 weeks old). Twenty five rabbits were individually caged, and divided into control group (NOR; n = 10) and HFD group (CHO; n = 15). The control group was fed (100 g/day) of normal (NOR) diet for a period of 15 weeks. The HFD group was fed normal diet supplemented with 1.0% cholesterol plus 1.0% olive oil (100 g/day) for the same period of time.</p> <p>Results</p> <p>We found that the TC, LDLC, and TG (mg/dl) were significantly (p < 0.001) increased in HFD rabbits compared with control rabbits with percentage normalized changes of 1198%, 1591%, and 710%, respectively. The peptide-bound Hyp in the serum was significantly (P < 0.05) increased in HFD rabbits compared with control rabbits with percentage normalized change of 517% while it significantly (P < 0.01) decreased in aortic tissues of HFD rabbits compared with control rabbits with percentage normalized change of 65%. The protein-bound Hyp in the serum was significantly (P < 0.01) increased in HFD rabbits compared with control rabbits with percentage normalized change of 100%; the protein-bound Hyp in the aortic tissues of control rabbits was 235.30 ± 55.14 (Mean ± SD) while it was not detectable (ND) in HFD rabbits. Total serum Hyp showed no significant (P < 0.05) change in HFD rabbits compared with control rabbits while it was significantly (P < 0.05) decreased in aortic tissues of HFD rabbits compared with control rabbits with percentage normalized change of 73%. The total collagen was significantly (p < 0.01) decreased in aortic tissues of HFD rabbits compared with control rabbits with percentage normalized change of 73% which was supported by histological study.</p> <p>Conclusions</p> <p>These results suggest that percentage decrease in various Hyp fractions in aortic tissue of HFD rabbits are closely related to percentage decrease of collagen content in aortic tissues of HFD rabbits. These results also suggest that it may be possible to use the changes in various Hyp fractions in aortic tissues of rabbits as an important risk factor during the progression of atherosclerosis.</p

Multi Criteria Optimization Approach for Dressing of Vitrified Grinding Wheel

Rotary diamond dressers are widely used for the dressing to improve the efficiency of vitrified grinding wheel. The paper focuses on the process parameters, i.e., feed speed of dresser, depth of cut, grinding wheel velocity, velocity ratio between grinding wheel and rotary dresser, number of pass and dressing method (up-cut or down-cut) in rotary diamond dressing. The objective is to investigate the effect of these process parameters with their interactions for two response parameters, dressing ratio and overlapped dressed area. As far as the response parameters are concerned, the goal is to maximize dressing ratio and minimize overlapped dressed area simultaneously. Thirty-six experiments were designed and performed. Analysis of variance and multi-criteria optimization approach are opted to find out significant process parameters and optimal parameter setting. Finally, the significant process parameters, dressing method and number of pass are identified as well and the optimal parameter setting is also determined

Desa Mengembangkan Penghidupan Berkelanjutan

Buku ini mengingatkan lagi kepada kita bahwa desa bukan hanya lokasi kemiskinan dan ketertinggalan. Desa tidak boleh lagi dijadikan obyek program kementerian hingga SKPD kabupaten. Desa adalah sumber produksi yang harus bisa dinikmati dan digunakan untuk warga desa. Hal ini jelas memerlukan kerja keras semua pihak untuk memetakan potensi dan aset yang dimiliki agar bisa dioptimalkan sebagai sumber penghidupan bagi warga desa. Jika desa sudah bisa menjadi sumber penghidupan bagi warganya, maka kami yakin arus kepergian warga desa usia produktif ke kota akan semakin berkurang dan orang kembali nyaman untuk tetap tinggal di desa. Buku ini dengan baik menyinggung dan memberi contoh tentang bagaimana aset yang ada di desa dimaksimalkan sehingga bisa menjadi alternatif sumber penghidupan bagi warga desa sekaligus berkontribusi memberi tambahan pendapatan ke pemerintah desa

Image Retrieval Based on Edge Histogram Descriptor of MPEG-7

A major research area in computer vision is content-based image retrieval. MPEG-7 sets up a list of descriptions of the structured image content. We examine the weakness and lack of retrieval approaches based on global characteristics in this study by incorporating the commonly used feature descriptors of MPEG-7. In the meantime, to satisfy user requirements for assessing spatial information similarities, an image retrieval approach based on texture region features for MPEG-7 is recommended. Retrieval tests show the validity and efficiency of our approach. This paper also defines our approach to color quantization, extraction, and matching processes of features and so on in depth