Strategies to cope claustrophobia during magnetic resonance imaging examination

Background: Claustrophobia associated with MRI scan is a well-recognized problem all over the world. The unpleasant psychological experience during MRI can lead to premature cancellation of the study resulting in non-interpretable data. In addition, performing future studies on the claustrophobic patient may not be possible leading to non-utilization of an important diagnostic modality. This study was conducted with the aim to determine a cheap and short intervention which can be applicable to small radiology set up as well.Methods: A prospective study was conducted at a tertiary care hospital from October 2016 to December 2016. Accompanying someone was the first strategy used to coped MR imaging claustrophobia followed by placebo (multivitamin), listening Quran and closed eye (blindfold). All those patients who failed to respond in these strategies were finally labeled as an unsuccessful candidate. Listening of Quran was selected as one of the tools as all the patients were Muslims in present study.Results: Among 84 claustrophobic patients, a closed eye was the most successful strategy found effective in (13) 81.2%, followed by placebo 66.7% patients, listening Quran (7) 30.4%, accompanying someone (15) 17.85% while 4% patients remained claustrophobic after application of all strategies. Significant association of accompanying someone and placebo was observed with education (p-value 0.037) and age of the patients (0.016) respectively.Conclusions: In general, placebo, being accompanied by someone and blindfold were found to be the most effective strategies to cope with MRI related claustrophobia. However, the success of these strategies is also dependent on certain factors like age, education status and socioeconomic status of the patients

To Evaluate the Outcome of Endoscopic Removal of 3rd Ventricle Colloid Cyst

Objective: To analyze the outcome of 3rd ventricle colloid cyst removal by endoscopic approach. Material and Methods: It is a prospective observational case series study. About 11 patients of third ventricle colloid cyst were included. Site of the study was Neurosurgery B department, Lady Reading Hospital, Peshawar. Study duration was from July 2015 to June 2017. All routine investigations were done including CT brain and MRI .The clinical presentation, radiological findings, post-surgery outcome was analyzed. Endoscopic approach was applied in all cases using a rigid endoscope through right pre-coronal burr hole. Results: our study consisted of total 11 patients. Headache and giddiness were the most common presentations (n = 9). 5 patients had change in vision. 2 patients suffered ataxia. One patient presented with urinary incontinence. Post-operative hydrocephalus was observed in only one patient.no recurrence was noted on follow-up visits, Conclusions: Endoscopic approach to colloid cyst treatment is safe and effective with low complications rate

Facture of the Pars Interarticularis with or without Spondylolisthesis in an Adult Population in a Developing Country: Evaluation by Multidetector Computed Tomography

Study DesignDescriptive cross-sectional study.PurposeTo determine the prevalence of lumbar spondylolysis and spondylolisthesis in a general adult population unrelated to lower back pain as evaluated by multidetector computed tomography.Overview of LiteratureThere is a significant paucity of information related to the prevalence of spondylolysis and spondylolisthesis and its degenerative changes in a general adult population unrelated to lower back pain in developing countries.MethodsA retrospective study was conducted on abdominopelvic computed tomography (CT) scans performed between January 1st 2015 and December 31st 2015 for various clinical indications. Patients with lower back pain, with a history of trauma or road traffic accident, or referred from orthopedic or neurosurgery departments were excluded to avoid any bias. CT scans were reviewed in axial, sagittal, and coronal planes using bone window settings for evaluating spondylolysis and spondylolisthesis.ResultsOf 4,348 patients recruited, spondylolysis and spondylolisthesis were identified in 266 (6.1%) and 142 (3.3%) patients, respectively. Age was significantly higher in both spondylolysis and spondylolisthesis patients than in those without spondylolysis and spondylolisthesis (47.19±15.45 vs. 42.5±15.96, p60 years old, both spondylolysis (p=0.018) and spondylolisthesis (p=0.025) were significantly more prevalent in females.ConclusionsThe prevalence of pars interarticularis fracture observed higher with gradual increase in the prevalence with advancing age. In particular, preponderance was significantly higher among older females

Prevalence of Lumbosacral Transitional Vertebra in Individuals with Low Back Pain: Evaluation Using Plain Radiography and Magnetic Resonance Imaging

Study DesignDescriptive cross-sectional study.PurposeTo determine the frequency of lumbosacral transitional vertebrae (LSTV) in patients with low back pain (LBP) and the role of iliolumbar ligament (ILL) origin from L5 in LSTV cases.Overview of LiteratureTransitional vertebrae are developmental variants of the spine. LSTV is a common congenital abnormality, and failure to recognize this anomaly may result in serious consequences during surgery.MethodsAll patients aged 11–90 years of either gender with LBP for any duration, who presented for X-ray and magnetic resonance imaging (MRI) of the lumbosacral spine, were included. X-rays of the lumbosacral spine in anteroposterior and lateral views were acquired. In addition, T1- and T2-weighted sagittal and axial MRI was performed. Images were evaluated on a workstation.ResultsOf 504 patients, transitional vertebrae were observed in 75 patients (15%). Among them, 39 (52%) patients had Castellvi type III and 36 (48%) patients had Castellvi type II. However, on MRI, 42 (56%) patients had O'Driscoll type II, 18 (24%) patients had O'Driscoll type IV, and 15 patients (20%) had O'Driscoll type III. ILL origin from L5 was significantly higher (n=429, 100%) among patients with a normal lumbosacral junction than among patients with a transitional lumbosacral junction (n=22, 29.3%) (p<0.001).ConclusionsLSTV occurs at a high frequency in patients with LBP. Furthermore, in the presence of LSTV, the ILL is not a reliable marker for the identification of L5

Ride Sharing application for Aviapolis Business region

This thesis proposes a flexible platform to help improve employees' mobility through ridesharing applications. Since ridesharing is a familiar adopted but complex taxonomy. The topic provides a solution to an existing common requirement: commuting from point A to point B via shared rides. Some areas lack frequent public transportation, which means that the time interval between transport is very high or varies. It results in long waiting hours, long traveling time, and higher cost. Ride-sharing may be one of the most useful solutions when there are no other means of transportation to a specific location but generally, it is not the only option. This study was carried out using Action research methodology to develop solutions to a problem. The study began by asking the employees to share their viewpoints and envisage suggestions to tackle the problem. The purpose was to hear it from the participants, detect the core factors considered for the service design, and compare it with the public transport during the town hall sessions. After the brainstorming part, the study turned to the development of the actual ride sharing service and mobile application. As part of PiggyBaggy's transition from crowdsourced delivery to ridesharing, the software team performed a comprehensive code update. The outcome of the thesis is a tested, sustainable ride-sharing web application with backend servers for users to access the ride-sharing service through their smartphones or computers. Additionally, the application includes some characteristics that are essential to the service. Using Web Development Tools and Libraries and dynamic backend solutions that was developed to make the application simple and easy to use. The solution tested in this Thesis on a trial basis opens up an alley to further elaboration, refining the service design, and a real-life service that will most likely be launched in the near future

Development of Eco-Friendly Nanomembranes of Aloe vera/PVA/ZnO for Potential Applications in Medical Devices

Due to the current COVID-19 pandemic, there is a crucial need for the development of antimicrobial and antiviral personal protective equipment such as facemasks and gowns. Therefore, in this research we fabricated electrospun nanofibers composite with polyvinyl alcohol, aloe vera, and zinc oxide nanoparticles for end application in medical devices. Electrospun nanofibers were made with varying concentrations of aloe vera (1%, 2%, 3%, 4%) having a constant concentration of ZnO (0.5%) with varying concentrations of ZnO nanoparticles (1%, 2%, 3%, 4%) having a constant concentration of aloe vera (0.5%). To check the morphology and composition, all prepared nanofibers were subjected to different characterization techniques, such as Scanning Electron Microscopy (SEM), and Fourier Transform Infrared Spectroscopy (FTIR). In addition, its antimicrobial activity was checked both with qualitative and quantitative approaches against gram-positive (Staphylococcus aureus) bacteria and gram-negative (Escherichia coli) bacteria. The results suggest that increasing ZnO concentration kills and inhibits bacterial growth more proficiently compared to increasing aloe vera concentration in electrospun nanofibers; the highest antimicrobial was found with 4% ZnO, killing almost 100% of gram-positive (Staphylococcus aureus) bacteria and 99.2% of gram-negative (Escherichia coli) bacteria. These fabricated nanofibers have potential applications in medical devices and would help control the spread of many diseases

Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan

Purpose: In patients with erectile dysfunction, it is important to differentiate psychogenic from organic causes. Penile Doppler ultrasonography is a relatively inexpensive and minimally invasive tool for this purpose. This study was conducted to evaluate the causes of erectile dysfunction in an adult male population, using penile Doppler ultrasonography. Materials and Methods: A retrospective study was conducted in a single center. All patients who presented with complaints of erectile dysfunction and underwent penile Doppler ultrasonography between July 2014 and June 2016 were included in this study. All examinations were performed using GE Voluson S6 and GE Logiq P5 devices. Following baseline scans, an intracavernosal injection of 20 μg of prostaglandin E1 was given. Peak systolic and end diastolic velocities were measured in each cavernosal artery. Patients with a peak systolic velocity of ＜25 cm/s were considered to have arterial insufficiency, while an end diastolic velocity of ＞5 cm/s was considered to indicate venous incompetence. Results: Out of 97 patients (mean age, 37.09±11.59 years; range, 19∼69 years), 50 patients (51.5%) had normal findings, 24 patients (24.7%) had arterial insufficiency, 15 patients (15.5%) had a venous leak, and 8 patients (8.2%) patients had arterial insufficiency with a venous leak. Psychogenic erectile dysfunction was significantly higher among patients aged ≤40 years, while arterial insufficiency with or without a venous leak was significantly higher among patients aged ＞40 years (p=0.022). Conclusions: A majority of the studied individuals demonstrated no organic cause of erectile dysfunction, thus confirming a high prevalence of the psychogenic etiology, particularly in relatively young individuals

Apparel Consumer Behavior and Circular Economy: Towards a Decision-Tree Framework for Mindful Clothing Consumption

The apparel consumer, one of the vital stakeholders in the apparel supply chain, has a significant role to play in moving the clothing industry in a sustainable direction. From purchasing and care practice to donation and disposal, every step of their decisions impacts the environment. Various internal and external variables influence those decisions, including culture, customs, values, beliefs, norms, assumptions, economy, gender, education and others. Therefore, we believe having a scientific understanding is very important, because consumers need to be aware of what makes eco-conscious apparel behavior; only then will the circular transition be eased. However, the key concern is whether the apparel consumers are aware of this knowledge or not. Therefore, we formulated a prospective study from a life cycle thinking point of view with a key focus on synthesizing apparel consumer behavior concerning clothing acquisition, maintenance and disposal through the circular economy lens. Hence, a circular economy lens framework is proposed, followed by three research questions&rsquo; (RQ) formulation: RQ1. What is the current norm of clothing acquisition, maintenance and disposal behavior?; RQ2. Is apparel consumer clothing acquisition, maintenance and disposal behavior circular-driven?; RQ3. What is the sustainable way of clothing acquisition, maintenance and disposal? These questions are followed by circular economy lens framework development for apparel consumers. Second, following the research questions, state-of-the-art literature-driven decisions were gathered to form constructive consumer-centric decisions over the apparel lifecycle. Third, building on this synthesis, a critical discussion is offered, following the decision-tree approach to inform relevant behavioral guidelines for consumers and other stakeholders in the apparel supply chain. Overall, our findings on apparel consumer behavior through the circular economy lens could serve as new guidelines for consumers to exercise mindful clothing consumption behavior

Development of Carbon-Nanodot-Loaded PLA Nanofibers and Study of Their Barrier Performance for Medical Applications

The COVID-19 pandemic has increased the usage of personal protective equipment (PPE) all round the world and, in turn, it has also increased the waste caused by disposable PPE. This has exerted a severe environmental impact, so in our work, we propose the utilization of a sustainable electrospun nanofiber based on poly lactic acid (PLA), as it is biobased and conditionally degradable. We optimized the weight percentage of the PLA-precursor solution and found that 19% PLA produces fine nanofibers with good morphology. We also introduced carbon nanodots (CNDs) in the nanofibers and evaluated their antibacterial efficiency. We used 1, 2, 3, and 4% CNDs with 19% PLA and found increased antibacterial activity with increased concentrations of CNDs. Additionally, we also applied a spunbond-nanofiber layered assembly for the medical face masks and found that with the addition of only 0.45 mg/cm2 on the nonwoven sheet, excellent particle filtration efficiency of 96.5% and a differential pressure of 39 Pa/cm2 were achieved, meeting the basic requirements for Type I medical face masks (ASTM-F2100)