Episiotomy is the commonest obstetrics intervention in the world to reduce severe perineal injuries. Its prevalence is 43% to 100% in primiparous women in Asia. Further, worldwide approximately 10-95% of pregnant women undergo episiotomy incision during birth. Delay in wound healing probably increases the risk of wound infection, changes the muscular structure, and ultimately causes muscle tone loss. So, wound care is of specific significance to postnatal maternal outcomes. Hence, this case study aimed to evaluate the effect of Marham-i-Raal in episiotomy wound healing and pain relief. The study was conducted in eleven postpartum primi or multipara pregnant women aged between group 19 and 35 years with term gestational age, singleton pregnancy in a cephalic presentation who had a normal vaginal delivery with mediolateral episiotomy, without a perineal tear, and perineal hematoma. Externally, application of Marham-i-Raal 2g on episiotomy incisional wound, twice a day for 10 days was advised. Wound healing of episiotomy and pain intensity was assessed with REEDA ["redness, oedema, ecchymosis, discharge and approximation of the edges"] scoring and VAS scoring for pain intensity respectively. At one hour (baseline), the REEDA mean score of eleven patients was 3.90±1.04 whereas on day 7-10 it was 0.18±0.40 with statistically significant difference (p<0.001). The VAS mean score at one hour was 6.90±1.22 whereas on day 7-10 it was 0.72±0.78 with a statistically significant difference (p<0.001). Marham-i-Raal would be effective in episiotomy wound healing and reducing pain intensity. Further, randomized double-blind controlled trials in large sample size are recommended.
da Costa, Joao Cordeiro;Manso, Maria Conceicao;Gregorio Susana;Leite, Marcia;Pinto, Joao Moreira
Tuberculosis and Respiratory Diseases
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v.85
no.4
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pp.349-357
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2022
Background: The most consistently identified mortality determinants for the new coronavirus 2019 (COVID-19) infection are aging, male sex, cardiovascular/respiratory diseases, and cancer. They were determined from heterogeneous cohorts that included patients with different disease severity and previous conditions. The main goal of this study was to determine if activities of daily living (ADL) dependence measured by Barthel's index could be a predictor for COVID-19 mortality. Methods: A prospective cohort study was performed with a consecutive sample of 340 COVID-19 patients representing patients from all over the northern region of Portugal from October 2020 to March 2021. Mortality risk factors were determined after controlling for demographics, ADL dependence, admission time, comorbidities, clinical manifestations, and delay-time for diagnosis. Central tendency measures were used to analyze continuous variables and absolute numbers (proportions) for categorical variables. For univariable analysis, we used t test, chi-square test, or Fisher exact test as appropriate (α=0.05). Multivariable analysis was performed using logistic regression. IBM SPSS version 27 statistical software was used for data analysis. Results: The cohort included 340 patients (55.3% females) with a mean age of 80.6±11.0 years. The mortality rate was 19.7%. Univariate analysis revealed that aging, ADL dependence, pneumonia, and dementia were associated with mortality and that dyslipidemia and obesity were associated with survival. In multivariable analysis, dyslipidemia (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.17-0.71) was independently associated with survival. Age ≥86 years (pooled OR, 2.239; 95% CI, 1.100-4.559), pneumonia (pooled OR, 3.00; 95% CI, 1.362-6.606), and ADL dependence (pooled OR, 6.296; 95% CI, 1.795-22.088) were significantly related to mortality (receiver operating characteristic area under the curve, 82.1%; p<0.001). Conclusion: ADL dependence, aging, and pneumonia are three main predictors for COVID-19 mortality in an elderly population.
The liver progenitor cells could form a potential target cell population fore both tumor-initiating and -promoting chemicals. Induction of drug-metabolizing and antioxidant enzymes, including AhR-dependent CYP1A1, NQO-1 and AKR1C9, was detected in the rat liver epithelial WB-F344 "stem-like" cells. Additionally, WB-F344 cells express a functional, wild-type form of p53 protein, a biomarker of genotoxic events, and connexin 43, a basic structural unit of gap junctions forming an important type of intercellular communication. In this cellular model, two complementary assays have been established for detection of the modes of action associated with tumor promotion: inhibition of gap junctional intercellular communication (GJIC) and proliferative activity in confluent cells. We found that the PAHs and PCBs, which are AhR agonists, released WB-F344 cells from contact inhibition, increasing both DNA synthesis and cell numbers. Genotoxic effects of some PAHs that lead to apoptosis and cell cycle delay might interfere with the proliferative activity of PAHs. Contrary to that, the nongenotoxic low-molecular-weight PAHs and non-dioxin-like PCB congeners, abundant in the environment, did not significantly affect cell cycle and cell proliferation; however both groups of compounds inhibited GJIC in WB-F344 cells. The release from contact inhibiton by a mechanism that possibly involves the AhR activation, inhibition of GJIC and genotoxic events induced by environmental contaminants are three important modes of action that could play an important role in carcinogenic effects of toxic compounds. The relative potencies to inhibit GJIC, to induce AhR-mediated activity, and to release cells from contact inhibition were determined for a large series of PAHs and PCBs and their metabolites. In vitro bioassays based on detection of events on cellular level (deregulation of GJIC and/or proliferation) or determination of receptor-mediated activities in both ?$stem-like^{\circ}{\times}$ and hepatocyte-like liver cellular models are valuable tools for detection of modes of action of polyaromatic hydrocarbons. They may serve, together with concentration data, as a first step in their risk assessment.
In response to the COVID-19 pandemic, the logistics industry in Korea has rapidly been expanding, with offline demand concentrating on online platforms owing to the development of digital infrastructure. This has increased the workload of courier drivers considerably, along with labor intensity. A delivery driver died recently from overwork due to the continuous increase in delivery volume, which raises social concerns. Delivery drivers work long hours, (over 12 hours) and are greatly affected by weather conditions, such as snow, rain, heat waves, and cold waves. In addition, they lack a fixed workplace; perform atypical work handling workpieces of various sizes, weights, and shapes; and spend a large amount of time driving as part of their work. This work involves a high level of tension and requires attention and concentration. Despite the frequency of industrial accidents in the courier industry, studies on safety and health to quantitatively analyze and systematize the work of courier workers are very scarce. Therefore, to define the work process necessary for investigating the harmful factors in delivery service and the work analysis, this study conducted interviews and on-site surveys to analyze the unit work of the delivery service by targeting delivery workers. In other words, a framework of unit work for work analysis was presented to enable research and analysis by considering the aforementioned characteristics of the courier industry. The process was broadly divided into work, transport, storage, delay, and inspection. Work was divided into loading, sorting, unloading, and door subcategories, and transportation was divided into vehicle, cart, and walking subcategories as well as 10 small processes. Moreover, 22 unit works were again drawn by conducting field surveys and interviews. The risk of unit work derived from this study was ergonomically evaluated, and the ergonomic analysis revealed that uploading and transportation were the most dangerous. The results of this study could be used as basic data for preventing industrial accidents among courier workers, whose work has increased with the logistics volume and the development of the logistics industry.
Ha-ram Jo;Seongyong Yoon;Jinseok Kim;Seong-yong Cho;Jong-min An;Gayoung Kim
Annals of Occupational and Environmental Medicine
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v.34
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pp.16.1-16.11
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2022
Background: Antimony is used in catalysts, pesticides, brake systems, pharmaceuticals, and synthetic fire retardants in the plastic, paint, and rubber industries. Accumulation of trivalent antimony compounds in the body can cause cardiotoxic effects and increase the risk of electrocardiogram (ECG) abnormalities and sudden death. Antimony exposure can result in action potential prolongation, causing a cardiac repolarization delay, which appears as QTc prolongation and T-wave abnormalities on the ECG. There are no studies on antimony-associated cardiac toxicity in Korea. Case presentation: Accordingly, the present study reports cases of ECG abnormalities in workers handling antimony trisulfide at a company located in the Gyeongsangbuk-do region. Nineteen workers employed at an automobile brake lining manufacturer were exposed to antimony trisulfide dust through thermoforming, grinding, and drilling processes. In 2020, the workers were reported to work 12-hour shifts, 5 days a week. The time-weighted average (TWA) of antimony trisulfide exposure measured in workers was 0.0028 mg/m3. Two workers were excluded from the analysis due to pre-existing medical conditions (cardiovascular disease). Of the remaining 17 workers, ECG abnormalities were found in 41% (seven out of 17: four with QTc prolongation and T-wave abnormalities; two with only T-wave abnormalities; and one with only QTc prolongation). Conclusions: This case report outlines the first few cases in Korea in which potential cardiac toxicity caused by occupational exposure to antimony was identified. However, data regarding cardiac toxicity caused by antimony exposure are still lacking in Korea; thus, additional studies are needed to identify causal relationships.
Journal of the Institute of Convergence Signal Processing
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v.25
no.1
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pp.1-6
/
2024
The main function of intercept array sonar is to detect pulses radiated from enemy surface ships, submarines, and torpedoes. When a pulse is detected, it is a high risk situation for the own ship, so it is very important to find the target's location for the ship's maneuverability and survival. The target's location is calculated by finding the starting point of the pulse received form each sensor and calculating the time delay between sensors. In order to find starting point, the envelope of the signal is calculated and differential filtering is performed. However, since intercept array sonar has a high sampling frequency of the signal, the number of samples to be processed is large, so this process has a problem with a large computational amount. In this paper, we propose a pulse starting point calculation method using decimation for reducing computational amount. Simulations were performed while changing the decimation factor, and it was confirmed that computational amount was reduced. The proposed method is expected to be effective in real-time processing system and have advantages in resource utilization.
International conference on construction engineering and project management
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2024.07a
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pp.1112-1119
/
2024
Addis Ababa, the capital of Ethiopia, has been lacking an adequate road network to ensure community access to social, political, and economic resources and to facilitate economic development. The road network coverage was about 22.5% in 2022, which is below the minimum international standard of 25%. To improve accessibility and mobility, the Addis Ababa City Roads Authority(AACRA) has engaged its own force crew (contractor), as well as local and foreign road contractors, in the construction of urban roads. However, these road construction projects are rarely completed within the estimated time and cost, along with a variety of other issues that also need to be addressed. This study aims to explore the application of lean construction for improving the performance of urban road construction projects in Addis Ababa City. A survey of road construction stakeholders was carried out to evaluate their perspectives on the importance of project performance indicators, with the goal of identifying key factors affecting road construction project performance. First, a list of performance indicators was prepared based on a review of lean construction literature, and a total of 38 identified factors were grouped into six performance indicator categories. Cross-tabulation analysis of the stakeholder perspectives was then carried out, and it was found that the indicators that affect the performance of urban road infrastructure projects (in descending order of importance) were: time, quality, cost, risk, safety, and sustainability. Through this analysis it was concluded that right-of-way issues, delay to finish, inflation, contractor capacity, and scope change with change order are also major factors that affect the performance of urban roads construction projects. Clarification of these factors will provide AACRA with useful information on what aspects of lean construction should be prioritized when evaluating future construction projects.
Background: Esophageal perforation is an emergency that. requires early diagnosis and effective treatment. A delay in diagnosis and treatment. significantly increases morbidity and mortality. Material and Method: Thirty-seven patients with esophageal perforation were surgically treated at our institutions between January 1990 and December 2006. We retrospectively reviewed the results of surgical treatment for esophageal perforation to understand the risk factors affecting survival inpatients. Result: Patients ranged in age from 21 to 87 years, with an average age of $52.7{\pm}16.98$ years. Thirty-one of the patients were men and six were women. There were 23 patients (62%) with spontaneous perforations, 10 patients (27%) with a traumatic perforation, and 4 patients (11%) with an iatrogenic perforation. The site of esophageal perforation was the cervical esophagus in 5 patients, the thoracic esophagus in 31 patients, and the abdominal esophagus in one patient. Twenty-nine patients underwent primary closure of the perforation and five patients had T-tube drainage. Exclusion-diversion procedures were performed in two patients and an esophagectomy was performed in one patient. There were six cases of mortality (16.22%) and 25 cases of postoperative complications in 15 patients (40.5%). Patients that were treated later than 24 hours after detection of the perforation showed a statistically significant high morbidity and mortality rate (p<0.05). Conclusion: The most important risk factor of esophageal perforation was the time interval between detection of the perforation and the initiation of treatment. A prompt diagnosis and effective treatment are necessary to decrease morbidity and mortality.
Kim, Kwang Myung;Park, Hyoung June;Goo, Tae Hun;Kim, Hyung Chan
The Journal of Engineering Geology
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v.30
no.4
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pp.457-468
/
2020
Problems arising during pile design works for plant construction, civil and architecture work are mostly come from uncertainty of geotechnical characteristics. In particular, obtaining the N-value measured through the Standard Penetration Test (SPT) is the most important data. However, it is difficult to obtain N-value by drilling investigation throughout the all target area. There are many constraints such as licensing, time, cost, equipment access and residential complaints etc. it is impossible to obtain geotechnical characteristics through drilling investigation within a short bidding period in overseas. The geotechnical characteristics at non-drilling investigation points are usually determined by the engineer's empirical judgment, which can leads to errors in pile design and quantity calculation causing construction delay and cost increase. It would be possible to overcome this problem if N-value could be predicted at the non-drilling investigation points using limited minimum drilling investigation data. This study was conducted to predicted the N-value using an Artificial Neural Network (ANN) which one of the Artificial intelligence (AI) method. An Artificial Neural Network treats a limited amount of geotechnical characteristics as a biological logic process, providing more reliable results for input variables. The purpose of this study is to predict N-value at the non-drilling investigation points through patterns which is studied by multi-layer perceptron and error back-propagation algorithms using the minimum geotechnical data. It has been reviewed the reliability of the values that predicted by AI method compared to the measured values, and we were able to confirm the high reliability as a result. To solving geotechnical uncertainty, we will perform sensitivity analysis of input variables to increase learning effect in next steps and it may need some technical update of program. We hope that our study will be helpful to design works in the future.
Purpose: The aim of this study was to investigate the effect of perinatal risk factors on brain maturation and the relationship of brain maturation and neurodevelopmental outcomes with brain maturation scoring system in brain MRI. Methods: ELBWI infants born at the Seoul National University Children's Hospital from January 2006 to December 2010 were included. A retrospective analysis was performed with their medical record and brain MR images acquired at near full term. We read brain MRI and measured maturity with total maturation score (TMS). TMS is a previously developed anatomic scoring system to assess brain maturity. The total maturation score was used to evaluate the four parameters of maturity: (1) myelination, (2) cortical infolding, (3) involution of glial cell migration bands, and (4) presence of germinal matrix tissue. Results: Images from 124 infants were evaluated. Their mean gestational age at birth was 27.1${\pm}$2.1 weeks, and mean birth weight was 781.5${\pm}$143.9 g. The mean TMS was 10.8${\pm}$2.0. TMS was significantly related to the postmenstrual age (PMA) of the infant, increasing with advancing postmenstrual age (P<0.001). TMS showed no significance with neurodevelopmental delay, and with brain injury, respectively. Conclusion: TMS was developed for evaluating brain maturation in conventional brain MRI. The results of this study suggest that TMS was not useful for predicting neurodevelopmental delay, but further studies are needed to make standard score for each PMA and to re-evaluate the relationship between brain maturation and neurodevelopmental delay.
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