A Comparative Policy Analysis of the United Kingdom and India Regarding the Reuse of Medical Devices.

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Factors Contributing To Therapeutic Compliance Of Epileptic Patients And The Suggestive Solutions

Epileptic seizures are only one manifestation of neurologic or metabolic diseases. Epileptic seizures have many causes, including a genetic predisposition for certain seizures, head trauma, stroke, brain tumors, alcohol or drug withdrawal, and other conditions. . Several factors affect patient's level of adherence. These factors include type of therapy, patient's own condition, health team, social and financial support patient's psychological condition . The aim; of  this work is to detect the factors  affecting  compliance to therapeutic regimen among adult patients with epilepsy and the suggestive solutions for the main factors of noncompliance. Methodology; two tools were used in the study; epilepsy self-adherence scale and interviewing questionnaire to identify factors affecting compliance. Setting; Epilepsy outpatient clinic, Ain Shams University hospital Sample: A convenience sample of (50) adult female and male patients with epilepsy were included Results: (32%) of the patients with epilepsy had unsatisfactory level of compliance to therapeutic regimen & followed instructions .Furthermore, the most common factors affecting patients` compliance negatively were therapy related factors, health care team, and financial burden (41.5%,39%&38.5%) respectively . Conclusion; more than two thirds of the patients with epilepsy had unsatisfactory compliance level. Furthermore, many factors were affecting patients` compliance such as therapy related factors, health care team ,financial factors, condition related factors, and social support. .Recommendation;. Health care providers should be oriented with the importance of patient's compliance and suitable strategies to plan and implement individualized care for each patient to improve adherence. Patients and their families should be provided with adequate knowledge about epilepsy and the importance of proper adherence to necessary self-management practices including adequate safety  precautions, diet and exercise regimens ,  follow up schedules, stress management and  avoidance of precipitating  factors that may contribute to province a seizure activity. Keywords: patient compliance, therapeutic regimen, adherence, factor.

The Effect of Mechanical Combined Contact Stress with Buckling Load on the Stress Distribution in the Ball and SocketJoint Mechanism

The design of components subjected to contact stress as local compressive stress is important in engineering application especially in ball and socket Joining. Two kinds of contact stress are introduced in the ball and socket joint, the first is from normal contact while the other is from sliding contact. Although joining two long links (drive shaft in steering cars) will cause the effect of flexural and tensional buckling stress in hollow columns through the ball and socket ends on the failure condition of the joining mechanism. In this paper the consideration of the combined effect of buckling Load and contact stress on the ball and socket joints have been taken, epically on the stress distribution in the contact area. Different parameters have been taken in the design of joint. This is done by changing the angles for applied loads with the principle axis, the angle of contact between ball and socket and using different applied loads. <br />The problem has been solved using analytical solution for computing the critical loads and using these loads for calculating the stress distribution with finite element method using ANSYS 10. The numerical results have been compared with the experimental method using photo elasticity pattern which shows good agreement between experimental and simulation results

Influence of limestone filler and of the size of the aggregates on DEF

This experimental study aims to determine the effect of limestone filler on concrete expansion due to delayed ettringite formation (DEF). Different mortars made with different sizes and percentages of limestone filler and Portland cement CEM I 52.5N are conserved in water. The expansion of the specimens is measured. Results show that DEF is not inhibited by limestone filler. The kinetics and the amplitude of the swelling depend on the size of the limestone filler. The volume fraction of aggregates changes only the kinetics: the relation between swelling and water uptake depends only on the size of the aggregates.Comment: 16 pages, 9 figures, 4 table

Factors Contributing To Therapeutic Compliance Of Epileptic Patients And The Suggestive Solutions

Epileptic seizures are only one manifestation of neurologic or metabolic diseases. Epileptic seizures have many causes, including a genetic predisposition for certain seizures, head trauma, stroke, brain tumors, alcohol or drug withdrawal, and other conditions. . Several factors affect patient's level of adherence. These factors include type of therapy, patient's own condition, health team, social and financial support patient's psychological condition . The aim; of  this work is to detect the factors  affecting  compliance to therapeutic regimen among adult patients with epilepsy and the suggestive solutions for the main factors of noncompliance. Methodology; two tools were used in the study; epilepsy self-adherence scale and interviewing questionnaire to identify factors affecting compliance. Setting; Epilepsy outpatient clinic, Ain Shams University hospital Sample: A convenience sample of (50) adult female and male patients with epilepsy were included Results: (32%) of the patients with epilepsy had unsatisfactory level of compliance to therapeutic regimen &amp; followed instructions .Furthermore, the most common factors affecting patients` compliance negatively were therapy related factors, health care team, and financial burden (41.5%,39%&amp;38.5%) respectively . Conclusion; more than two thirds of the patients with epilepsy had unsatisfactory compliance level. Furthermore, many factors were affecting patients` compliance such as therapy related factors, health care team ,financial factors, condition related factors, and social support. .Recommendation;. Health care providers should be oriented with the importance of patient's compliance and suitable strategies to plan and implement individualized care for each patient to improve adherence. Patients and their families should be provided with adequate knowledge about epilepsy and the importance of proper adherence to necessary self-management practices including adequate safety  precautions, diet and exercise regimens ,  follow up schedules, stress management and  avoidance of precipitating  factors that may contribute to province a seizure activity. Keywords: patient compliance, therapeutic regimen, adherence, factor

Is collagenase-3 (MMP-13) expression in chondrosarcoma of the jaws a true marker for tumor aggressiveness?

<p>Abstract</p> <p>Background</p> <p>Matrix metalloproteinases (MMPs) play an important role in the modeling and remodeling of the extracellular matrix in both physiologic and pathologic states and thus plays an important role in tumor progression. Human collagenase-3 (MMP-13) is a member of matrix metalloproteinase family of enzymes that was originally identified in breast carcinomas and subsequently detected during fetal ossification and in arthritic processes.</p> <p>Aim</p> <p>The present study was designed to investigate the expression MMP-13 and to correlate its expression with clinicopathological parameters in chondrosarcoma of the jaws.</p> <p>Methods</p> <p>Archival tumor tissues from 11 patients with chondrosarcoma of the jaws were analyzed by immunohistochemistry for the expression of MMP-13. Clinical information was obtained through the computerized retrospective database from the tumor registry between 1998 to 2006.</p> <p>Results</p> <p>Eight of 11 cases (72.8 %) of chondrosarcomas showed a positive reaction for MMP-13, whereas two cases of normal cartilage were negative for this collagenase. As regard the clinicopathological parameters, there was no correlation between MMP-13 expression and sex, age and tumor site. While, there were significant associations between MMP-13 expression and both of mitotic counts and necrosis. On the other hand, there was a significant difference between low and high grade tumors (P < 0.05) regarding MMP-13 expression. Also, there was no significant correlation between MMP-13 expression in primary lesions and their local recurrence.</p> <p>Conclusion</p> <p>MMP-13 is expressed in the majority of chondrosarcoma of the jaws. It is also noteworthy that the expression of MMP-13 may be related to tumor biological aggressiveness and used to aid in predicting patient's poor prognosis.</p

PHYTOCHEMICAL ANALYSIS AND ANTIBACTERIAL EFFICACY OF EXTRACTS OF DIPTEROCARPUS ZEYLANICUS

The overuse of antibiotics has resulted in microorganisms developing resistance to commercially available antibiotics. The present research aims to study the presence, properties, and distribution of bioactive compounds within several plant parts of Dipterocarpus zeylanicus which has been used in traditional medicine to treat various infectious diseases. &nbsp;The secondary metabolites were extracted from the leaf, seed, heartwood, and resin through sequential extraction. A qualitative phytochemical investigation was performed to determine the presence of secondary metabolites in the extracts. Antioxidant activity was determined using DPPH radical scavenging assay and Folin-Ciocalteu assay was used to measure the Total polyphenolic content (TPC). The antimicrobial assay was performed using EUCAST disc diffusion assay with Escherichia coli, MRSA, and Staphylococcus aureus as microbial strains. The phytochemical study indicated ubieties of alkaloids, steroids, saponins, flavonoids, cardiac glycosides, phenols, tannins, and terpenoids. Heartwood extracted using ethyl acetate showed the highest antioxidant activity (IC50 0.484 µg/ml). The highest amount of phenols (56.3±4.6 mg GAE/g) was present in the methanol extract of seed. A large inhibition zone (10.7±0.6 mm) by ethyl acetate extract of seed against E. coli demonstrated effective antibacterial activity. Therefore, these crude extracts can be used to isolate novel biologically active secondary metabolites exhibiting antimicrobial and antioxidant properties

Transcatheter Aortic Valve Replacement Restoring Candidacy for Liver Transplant in Patients With Cirrhosis

Guidelines for preoperative workup for an orthotopic liver transplant often rule out patients with severe aortic stenosis as transplant candidates. This case illustrates the potential of transcatheter aortic valve replacement (TAVR) as a bridge for liver transplants in cirrhotic patients with severe aortic stenosis. The 1-year and 2-year post-liver transplant follow-ups showed no complications in the patient\u27s prosthetic aortic valves, and graft survival was 100% with no evidence of rejection. Notable post-transplant recovery involved medical complications that were not related to the liver function or surgical procedure

Behavior of High Strength Hybrid Reinforcement Concrete Beams

Six proposed simply supported high strength-steel fiber reinforced concrete (HS-SFRC) beams reinforced with FRP (fiber reinforced polymer) rebars were numerically tested by finite element method using ABAQUS software to investigate their behavior under the flexural failure. The beams were divided into two groups depending on their cross sectional shape. Group A consisted of four trapezoidal beams with dimensions of (height 200 mm, top width 250 mm, and bottom width 125 mm), while group B consisted of two rectangular beams with dimensions of (125 ×200) mm. All specimens have same total length of 1500 mm, and they were also considered to be made of same high strength concrete designed material with 1% volume fraction of steel fiber. Different types and ratios of FRP rebar were used to reinforce these test beams. The study’s principle variables were the amount and type of flexural reinforcement (glass FRP and basalt FRP) and beam cross-sectional shape (rectangular and trapezoidal). The load-deflection behavior and ultimate load capacity of the beams were studied and compared with one another under flexural test with symmetrical two-point loading. The results show that increasing the reinforcement ratio resulted in higher post cracking flexural stiffness, and higher residual strength, as well as caused an increase in the first cracking load and ultimate load capacity ranged from 3 to 16.9%, and 4.6 to 7.3% respectively. When the GFRP rebars replaced by BFRP, the overall beams flexural performance showed outstanding improvements. Moreover the results indicate that increasing the top width of the beam cross section led to a significant enhancement in the first crack load ranged from 16 to 32.4%, also a remarkable increases in the ultimate load capacity in the range of 35.5 to 35.8% were indicated in the trapezoidal beams compared to rectangular beams. However the results show that the deflections were similar and were approximately 1.07–1.54 mm for all test beams. It is worth noting that the general flexural behavior of all the test beams indicated a ductile behavior with a gradual reduction in strength and high residual strength pre to failure due to proposing steel fiber presence

Asymmetric Cascaded Multilevel Inverter with Unequal Dc Sources using SPWM and MSVPWM Topologies

This paper introduces the modeling design and simulation of seven and thirteen levels cascaded asymmetric multilevel inverter (MLI) with reduced number of switches.  MLI is the most efficient energy converters which are essentially appropriated for high power applications with decrease total harmonics distortion (THD). MLI doesn't only get high power in the output but it is also utilized in renewable energy resources such as fuel cells, wind and photovoltaic cells. This paper principally focuses on a hybrid cascaded MLI with two and three unequal dc supplies which decreases the number of semiconductor power switches. Sinusoidal PWM (SPWM) and modified space vector PWM (MSVPWM) techniques are used to improve an ac output with reduced THD. The gating pulses for seven and thirteen level hybrid cascaded converter using SPWM and MSVPWM techniques are introduced. The results of these proposed modulation strategies reduce the percentage magnitude of THD. The performance of the proposed SPWM and MSVPWM topologies are verified using seven and thirteen levels cascaded asymmetric MLI via simulink/matlab. Keywords: Sinusoidal Pulse Width Modulation (SPWM), Modified Space Vector Pulse Width Modulation (MSVPWM), Multilevel Inverter (MLI), Total Harmonics Distortion (THD)