44 research outputs found
Transverse colon volvulus in a 15 year old boy and the review of the literature
We report a rare case of transverse colon volvulus in a fifteen year old boy with a review of the literature. This brings the total number of pediatric cases reported in the English literature to fifteen. This case is unusual in that no aetiological factor has been found, in contrast to the majority of the pediatric cases. Diagnosis can be challenging and the effective management remains controversial. The various radiological imaging modalities are presented. The epidemiology, aetiology, diagnosis and management of transverse colon volvulus are discussed. It is important to highlight this case and those in the literature, as many surgeons may never have seen a single case of transverse colon volvulus. It may therefore not be considered in the differential diagnosis of recurrent intermittent abdominal pain or acute intestinal obstruction
Comparative analysis of optimal power flow in renewable energy sources based microgrids
Adaptation of renewable energy is inevitable. The idea of microgrid offers integration of renewable energy sources with conventional power generation sources. In this research, an operative approach was proposed for microgrids comprising of four different power generation sources. The microgrid is a way that mixes energy locally and empowers the end-users to add useful power to the network. IEEE-14 bus system-based microgrid was developed in MATLAB/Simulink to demonstrate the optimal power flow. Two cases of battery charging and discharging were also simulated to evaluate its realization. The solution of power flow analysis was obtained from the Newton–Raphson method and particle swarm optimization method. A comparison was drawn between these methods for the proposed model of the microgrid on the basis of transmission line losses and voltage profile. Transmission line losses are reduced to about 17% in the case of battery charging and 19 to 20% in the case of battery discharging when system was analyzed with the particle swarm optimization. Particle swarm optimization was found more promising for the deliverance of optimal power flow in the renewable energy sources-based microgrid
Recent advances in information-centric networking based internet of things (ICN-IoT)
Information-Centric Networking (ICN) is being realized as a promising approach to accomplish the shortcomings of current IP-address based networking. ICN models are based on naming the content to get rid of address-space scarcity, accessing the content via name-based-routing, caching the content at intermediate nodes to provide reliable, efficient data delivery and self-certifying contents to ensure better security. Obvious benefits of ICN in terms of fast and efficient data delivery and improved reliability raises ICN as highly promising networking model for Internet of Things (IoTs) like environments. IoT aims to connect anyone and/or anything at any time by any path on any place. From last decade, IoTs attracts both industry and research communities. IoTs is an emerging research field and still in its infancy. Thus, this paper presents the potential of ICN for IoTs by providing state-of-the-art literature survey. We discuss briefly the feasibility of ICN features and their models (and architectures) in the context of IoT. Subsequently, we present a comprehensive survey on ICN based caching, naming, security and mobility approaches for IoTs with appropriate classification. Furthermore, we present operating systems (OS) and simulation tools for ICN-IoT. Finally, we provide important research challenges and issues faced by ICN for IoTs
Life satisfaction, disease management attitudes and nutritional status of diabetes mellitus patients in Azad Kashmir, Pakistan: a hospital based cross-sectional study
BACKGROUND: The life satisfaction of diabetes mellitus patients in association with the disease management attitudes and nutritional status have never been investigated yet in Pakistani administered Azad Jammu & Kashmir. AIM: The purpose of this study is to analyze the patient satisfaction about life with diabetes mellitus in association with disease management and nutritional status. METHODS: A cross sectional survey was conducted among 496 patients in DHQ hospital, Mirpur Azad Jammu & Kashmir. The questionnaire comprised of two sections: 1) Diabetes Attitude Scale (DAS-3); 2) Patient profile, DM history, nutritional status and dietary habits. The findings are generated by binary logistic regression and multivariate regression analyses. RESULTS: Overall, 64% of the patients interviewed reported dissatisfaction with their life with DM. Majority of the patients were females (66%), BMI value above 25.0 (56%). Gender male (AOR=1.82; 95%CI=1.15-2.88) and low income (AOR=3.16; 95%CI= 1.13-8.80) and middle income (AOR=4.70; 95%CI=1.52-15.5) were significantly associated with life dissatisfaction. There was higher likelihood of life dissatisfaction among patients with low food intake (AOR=1.82; 95%CI= 1.20-2.76); patients’ belief on: no need of taking insulin to treat their diabetes have a mild disease (AOR=1.56; 95%CI= 1.01-2.41); not much use in trying to have good blood sugar control because complications of diabetes happen anyway (AOR= 1.63; 95%CI= 1.18-2.23); emotional effects of diabetes are small (AOR=1.47; 95%CI= 1.02-2.14); decisions regarding daily diabetes care should be made by the patient (AOR= 2.15; 95%CI= 1.19-3.88). CONCLUSION: Findings implied the need of organizing counselling sessions for DM patients that promote regular physical activity to improve health and disease management. The consultation and regular visits of a nutritionist may help the patients in achieving better health outcomes
The photometric stereo approach and the visualization of 3D face reconstruction
The 3D Morphable models of the human face have prepared myriad of applications in computer vision, human computer interaction and security surveillances. However, due to the variation in size, complexity of training data set, the landmark mapping, the representation in real time and rendering or synthesis of images in three dimensional is limited. In this paper, we extend the approach of the photometric stereo and provide the human face reconstruction in three dimensional. The proposed method consists of two steps. First it automatically detects the face and segment the iris along with statistical features of pupil location in it. Secondly it provides the selection of minimum six features and where iris process to generate the 3D face. In compare with existing methods our approach provides the automation which produces more better and efficient results in contrast to the manual methods
Ectopic hyperprolactinaemia due to a malignant Uterine Tumor Resembling Ovarian Sex Cord Tumors (UTROCST)
Purpose
Moderate hyperprolactinaemia (2–5 times upper limit of normal) occurring in a patient with a normal pituitary MRI is generally considered to be due to a lesion below the level of detection of the MRI scanner assuming macroprolactin and stress have been excluded. Most patients with mild-to-moderate hyperprolactinaemia and a normal MRI respond to dopamine agonist therapy. We present the rare case of a patient who had prolactin elevation typical of a prolactin-secreting pituitary macroadenoma,with a normal cranial MRI, and in whom the prolactin rose further with dopamine agonist treatment. Subsequent investigations revealed ectopic hyperprolactinaemia to a uterine tumor resembling ovarian sex cord tumor (UTROSCT) which resolved following tumor resection. Although mostly considered to be benign, the UTROSCT recurred with recurrent hyperprolactinaemia and intraabdominal metastases.
Methods
We have systematically and critically reviewed existing literature relating to ectopic hyperprolactinaemia in general and UTROCST specifically.
Results
Fewer than 80 cases of UTROSCTs have been reported globally of which about 23% have shown malignant behaviour. There are fewer than 10 cases of paraneoplastic hyperprolactinaemia originating from uterine neoplasms including one other case of ectopic hyperprolactinaemia to a UTROSCT.
Conclusions
Our case demonstrates the importance of screening for extracranial hyperprolactinaemia in the context of: (1) substantially raised prolactin (10× ULN) and (2) normal cranial MRI assuming macroprolactin has been excluded. The majority of extracranial ectopic prolactin-secreting tumors occur in the reproductive organs.Methods: We have systematically and critically reviewed existing literature relating to ectopic hyperprolactinaemia in general and UTROCST specifically.
Results: Fewer than 80 cases of UTROSCTs have been reported globally of which about 23% have shown malignant behaviour. There are fewer than 10 cases of paraneoplastic hyperprolactinaemia originating from uterine neoplasms including one other case of ectopic hyperprolactinaemia to a UTROSCT.
Conclusions: Our case demonstrates the importance of screening for extracranial hyperprolactinaemia in the context of: (1) substantially raised prolactin (10xULN) and (2) normal cranial MRI assuming macroprolactin has been excluded. The majority of extracranial ectopic prolactin-secreting tumors occur in the reproductive organs
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