Asthma is one of the chronic and long-term diseases of the airways. It is characterized by reversible airflow obstruction, chest tightness, and dyspnea with decreased work of breathing. The inside airway’s walls are swollen or inflamed. The aim of this study was to determine the effectiveness of active cycle of breathing technique as an airway clearance technique in patients with asthma. The health-related quality of life and functional capacity of patients was measured using a standardized airway questionnaire (AQ20) and six-minute walk test. The study was cohort design included 38 patients (mean age 41.131±14.711) of both genders with mild to moderate asthma. Each patient received multiple sessions (3 times/week for one month) of active cycle of breathing technique. Pre and post-treatment measures were recorded for functional capacity and health-related quality of life in the form of six-minute walk test and standardized airway questionnaire. All 38 patients were stable during the study period. The health-related quality of life and functional capacity of patient significantly improved post-treatment sessions with means [205.375±93.594 for week 1, 1248.719±112.187 for week 2, 306.429±140.5554 for week 3, 337.245±134.389 for week 4], for six-minute wall test and mean difference 4.13± 2.3 SD for standardized airway questionnaire with p-value (0.00) significant upon paired t-test. It is concluded that the active cycle of breathing technique is very beneficial intervention for improving quality of life and functional capacity of patients with mild to moderate asthma. Further, investigations are required to explore efficiency of ABCT as a tool for cardio-pulmonary rehabilitation.
Introduction: Ankle arthrodesis using the Ilizarov technique provides high union rate with the added benefits of early weight-bearing, and the unique advantage of its ability to promote regeneration of soft tissue around the bone, including skin, muscle and neuro-vascular structures, and its versatility to allow correction of the position of the foot by adjusting the frame post-operatively as needed. We describe our experience with this technique and the functional outcomes in our patients. Materials and Methods: This retrospective study was conducted in 20 ankle fusion cases using the Ilizarov method between the years 2007 and 2017. We defined success in treatment by loss of preoperative symptoms and radiological union on plain radiographs of the ankle. Results: Fusion was achieved in all patients (100%). Immediate post-operative ambulation was with full weight bearing (FWB) in 16 (83%) of the participants and non-weight bearing (NWB) in 3 patients (17%). Post-procedure 11 patients (67%) of the participants who were full weight bearing required some form of support for walking for 2-3 weeks. Post-operatively three patients had pin tract infection requiring intravenous antibiotics. Radiological union took range of 6-12 weeks, mean union time was 8 weeks. Only one patient required bone grafting due to bone loss. Average follow-up period was 10-45 months. Conclusion: The Ilizarov technique has a high union rate and leads to general favourable clinical outcome and may be considered for any ankle arthrodesis but is especially useful in complex cases such as for revisions, soft-tissue compromise, infection and in patients with risk for non-union. Early weight bearing is an extra benefit.
Introduction: Tibia is the most common long bone fractured due its vulnerable subcutaneous location and most often associated with acquired complications of delayed union or non-union due to infection. Amongst the various treatment options to treat them, the Ilizarov external fixator application is considered superior due to its multiple advantages. The objective of this study was to analyse the role of Ilizarov fixation in infected tibial non-union, as well as to assess bony union and associated functional outcomes. Materials and Methods: A retrospective review was conducted for the duration between 1st January 2005 to 31st December 2016. Total of fifty-one patients with tibial non-union associated with infection who treated with the Ilizarov fixator were included in the study. Patient records were reviewed for union of bone, bone and functional outcomes and complications. Results: The most common organism for infection was identified to be Staphylococcus Aureus. At the time of final follow-up all patients had achieved union except two, one of whom had to undergo amputation due to non-union and sepsis. Majority of the patients had an excellent score as per ASAMI grading system for bone and function results. The most common complication noted was pin track infections. Conclusion: In our experience, Ilizarov external fixator is better suited for infected non-union of tibia because it can provide a stable mechanical environment, bone transport, correct deformities, and enable weight bearing and hence we recommend its use for the same.
The inherent biological hazards associated with ionizing radiation necessitate the implementation of effective shielding measures, particularly in medical applications. Interventional radiology, in particular, poses a unique challenge as it often exposes medical personnel to prolonged periods of high x-ray doses. Historically, lead and lead-based compounds have been the primary materials employed for shielding against photons. However, the drawbacks of lead, including its substantial weight causing personnel's inflexibility and its toxicity, have raised concerns regarding its long-term impact on both human health and the environment. Barium tantalate has emerged as a promising alternative, due to its unique attenuation properties against low-energy x-rays, specifically targeting the weak absorption area of lead. In the present study, we employ the Geant4 Monte Carlo simulation tool to investigate various formulations of barium tantalate doped with rare earth elements. The aim is to identify the optimal composition for shielding x-rays in the context of interventional radiology. To achieve this, we employ a reference x-ray spectrum typical of interventional radiology procedures, with energies extending up to 90 keV, within a carefully designed simulation setup. Our primary performance indicator is the reduction in air kerma transmission. Furthermore, we assess the absorbed doses to critical organs at risk within a standard human body phantom protected by the shield. Our results demonstrate that specific concentrations of the examined rare earth impurities can enhance the shielding performance of barium tantalate. To mitigate x-ray exposure in interventional radiology, our analysis reveals that the most effective shielding performance is achieved when using barium tantalate compositions containing 15% Erbium or 10% Samarium by weight. These findings suggest the possibility of developing lead-free shielding solutions or apron for interventional radiology personnel, offering a remarkable reduction in weight (exceeding 30%) while maintaining shielding performance at levels comparable to traditional lead-based materials.
A method for improving the thermoluminescence (TL) yield of silica-based optical fibres is demonstrated. Using silica obtained from a single manufacturer, three forms of pure (undoped) fibre (capillary-, flat-, and photonic crystal fibre (PCF)) and two forms of Ge-doped fibre (capillary- and flat-fibre) were fabricated. The pure fibre samples were exposed to 6 and 21MeV electrons, the doped fibres to 6MV photons. The consistent observation of large TL yield enhancement is strongly suggestive of surface-strain defects generation. For 6MeV irradiations of flat-fibre and PCF, respective TL yields per unit mass of about 12.0 and 17.5 times that of the undoped capillary-fibre have been observed. Similarly, by making a Ge-doped capillary-fibre into flat-fibre, the TL response is found to increase by some 6.0 times. Thus, in addition to TL from the presence of a dopant, the increase in fused surface areas of flat-fibres and PCF is seen to be a further important source of TL. The glow-curves of the undoped fibres have been analysed by computational deconvolution. Trap centre energies have been estimated and compared for the various fibre samples. Two trap centre types observed in capillary-fibre are also observed in flat-fibre and PCF. An additional trap centre in flat-fibre and one further trap centre in PCF are observed when compared to capillary fibre. These elevated-energy trap centres are linked with strain-generated defects in the collapsed regions of the flat fibre and PCF.
A new approach for filtering an optical band-pass in optical amplifier is proposed using a macro bending. The proposed filter leverages the bending loss of higher order modes at shorter wavelengths. At longer wavelengths, the filter increases fiber's bending loss as the fundamental mode 'tail' is leak out from the cladding. The combination of wavelength dependent loss at longer and shorter wavelength gives rise to the optical band-pass filter characteristic inside the fiber. The simulated spectral response of the filter is found to be in good agreement with the experimental results. Subsequently, the proposed optical band-pass filter is applied in Thulium-doped fiber amplifiers (TDFA) system for gain and noise figure enhancements. The filter functions to suppress both the amplified spontaneous emission (ASE) at 800 nm and 1800 nm wavelength regions and thus improves both gain and noise figure performances in S-band region. By bending of the gain medium, gain and noise figure of the TDFA are improved by about 2 dB and 0.5 dB respectively, within a wavelength region from 1440 and 1500 nm when the 1050 nm pump power is fixed at 250 mW.
We experimentally demonstrate a simple method for generating a multiwavelength Brillouin comb by utilizing a linear cavity of hybrid Brillouin-erbium fiber lasers (BEFLs). The optimization of Brillouin pump wavelength, power, and erbium gain played a significant role in determining the maximum number of Brillouin Stokes signals generated. Simultaneous and stable multiple-wavelength laser output of 22 lines with 10.88-GHz channel spacing has been obtained with good flatness. Various parameters such as 980-nm pump power, Brillouin pump wavelength, and Brillouin pump power that affect the performance of a multiwavelength BEFL system have been investigated. An analysis of the tuning range of the system is presented.
Hypertension is a major risk factor for a number of cardiovascular diseases. Proper management of hypertension may require both pharmacological and non-pharmacological interventions. Non-pharmacological interventions help reduce the daily dose of antihypertensive medication and delay the progression from prehypertension to hypertension stage. Non-pharmacological interventions include lifestyle modifications like dietary modifications, exercise, avoiding stress, and minimizing alcohol consumption. Nutritional requirements of hypertensive individuals can be addressed through adopting either the DASH diet or through traditional Mediterranean diet. These dietary guidelines promote the consumption of fruits, vegetables, grains, dairy products, and food rich in K+, Mg+2, Ca+2, and phosphorus. Restriction of Na+ intake has the greatest role in lowering the blood pressure. The DASH diet alone has the effect equal to that of a single drug therapy. After dietary modifications, exercise and weight loss are the second major intervention for hypertension management. Avoiding stressful lifestyle, depression, and anxiety also help to reduce elevated blood pressure. Minimizing alcohol intake also favors the blood pressure reduction. However, lifestyle modification is a dynamic process and requires continuous adherence. It is a multi-factorial approach targeting more than one intervention. However, 6-12-month lifestyle modifications can be attempted in stage-1 hypertensive patients without any cardiovascular complication, in the hope that they may be sufficiently effective to make it unnecessary to use medicines.
This work investigates the suitability of locally fabricated 6 mol% Ge-doped optical fibres as dosimeters for small-field output ratio measurements. Two fabrications of fibre, cylindrical (CF) and flat (FF) fibres, were used to measure doses in small photon fields, from 4 to 15 mm. The findings were compared to those of commercial Ge-doped fibre (COMM), EBT3 film and an IBA CC01 ionization chamber. Irradiations were carried out using a 6 MV SRS photon beam operating at a dose rate of 1000 cGy min-1, delivering a dose of 16 Gy. To minimise the possibility of the fibres failing to be exposed to the intended dose in small fields, the fibres were accommodated in a custom-made Perspex phantom. For the 4 mm cone the CF and FF measured output ratios were found to be smaller than obtained with EBT3 film by 32% and 13% respectively. Conversely, while for the 6 to 15 mm cone fields the FF output ratios were consistently greater than those obtained using EBT3 film, the CF output ratios differed from those of EBT3 film by at most 3.2%, at 6 mm, otherwise essentially agreeing with EBT3 values at the other field sizes. For the 4 to 7.5 mm cones, all output ratios obtained from Ge-doped optical fibre measurements were greater than those of IBA CC01 ionization chamber. The measured FF and CF output ratios for the 7.5 to 15 mm cones agreed with published MC estimates to within 15% and 13%, respectively. Down to 6 mm cone field, present measurements point to the potential of CF as a small-field dosimeter, its use recommended to be complemented by the use of EBT3 film for small-field dosimetry.
Important thermoluminescence (TL) properties of five (5) different core sizes Ge-doped optical fibers have been studied to develop new TL material with better response. These are drawn from same preform applying different speed and tension during drawing phase to produce Ge-doped optical fibers with five (5) different core sizes. The results of the investigations are also compared with most commonly used standard TLD-100 chips (LiF:Mg,Ti) and commercial multimode Ge-doped optical fiber (Yangtze Optical Fiber, China). Scanning Electron Microscope (SEM) and EDX analysis of the fibers are also performed to map Ge distribution across the deposited region. Standard Gamma radiation source in Secondary Standard Dosimetry Lab (SSDL) was used for irradiation covering dose range from 1Gy to 10Gy. The essential dosimetric parameters that have been studied are TL linearity, reproducibility and fading. Prior to irradiation all samples ∼0.5cm length are annealed at temperature of 400°C for 1h period to standardize their sensitivities and background. Standard TLD-100 chips are also annealed for 1h at 400°C and subsequently 2h at 100°C to yield the highest sensitivity. TL responses of these fibers show linearity over a wide gamma radiation dose that is an important property for radiation dosimetry. Among all fibers used in this study, 100μm core diameter fiber provides highest response that is 2.6 times than that of smallest core (20μm core) optical fiber. These fiber-samples demonstrate better response than commercial multi-mode optical fiber and also provide low degree of fading about 20% over a period of fifteen days for gamma radiation. Effective atomic number (Zeff) is found in the range (13.25-13.69) which is higher than soft tissue (7.5) however within the range of human-bone (11.6-13.8). All the fibers can also be re-used several times as a detector after annealing. TL properties of the Ge-doped optical fibers indicate promising applications in ionizing radiation dosimetry.
The thermoluminescence (TL) glow curves and kinetics parameters of Thulium (Tm) doped silica cylindrical fibers (CF) are presented. A linear accelerator (LINAC) was used to deliver high-energy radiation of 21MeV electrons and 10MV photons. The CFs were irradiated in the dose range of 0.2-10Gy. The experimental glow curve data was reconstructed by using WinREMS. The WinGCF software was used for the kinetic parameters evaluation. The TL sensitivity of Tm-doped silica CF is about 2 times higher as compared to pure silica CF. Tm-doped silica CF seems to be more sensitive to 21MeV electrons than to 10MV photons. Surprisingly, no supralinearity was displayed and a sub-linear response of Tm-doped silica CF was observed within the analyzed dose range for both 21MeV electrons and 10MV photons. The Tm-doped silica CF glow curve consists of 5 individual glow peaks. The Ea of peak 4 and peak 5 was highly dependent on dose when irradiated with photons. We also noticed that the electron radiation (21MeV) caused a shift of glow peak by 7-13°C to the higher temperature region compared with photons radiation (10MV). Our Tm-doped fibers seem to give high TL response after 21MeV electrons, which gives around 2 times higher peak integral as compared with 10MV photon radiation. We concluded that peak 4 is the first-order kinetic peak and can be used as the main dosimetric peak of Tm-doped silica CF.
Influenza is an important health hazard among Hajj pilgrims. For the last ten years, pilgrims are being recommended to take influenza vaccine before attending Hajj. Vaccination coverage has increased in recent years, but whether there has been any change in the prevalence of influenza-like illness (ILI) is not known. In this analysis, we examined the changes in the rate of ILI against seasonal influenza vaccine uptake among Hajj pilgrims over the last decade.
Oral drug delivery is natural, most acceptable and desirable route for nearly all drugs, but many drugs like NSAIDs when delivered by this route cause gastrointestinal irritation, gastric bleeding, ulcers, and many undesirable effects which limits their usage by oral delivery. Moreover, it is almost impossible to control the release of a drug in a targeted location in body. We developed thermo-responsive chitosan-co-poly(N-isopropyl-acrylamide) injectable hydrogel as an alternative for the gastro-protective and controlled delivery of loxoprofen sodium as a model drug. A free radical polymerization technique was used to synthesize thermo-responsive hydrogel by cross-linking chitosan HCl with NIPAAM using glutaraldehyde as cross-linker. Confirmation of crosslinked hydrogel structure was done by Fourier transform infrared spectra (FTIR). The thermal stability of hydrogel was confirmed through thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The scanning electron microscopy (SEM) was performed to evaluate the structural morphology of cross-linked hydrogel. To evaluate the rheological behavior of hydrogel with increasing temperature, rheological study was performed. Swelling and in vitro drug release studies were carried out under various temperature and pH conditions. The swelling study revealed that maximum swelling was observed at low pH (pH 1.2) and low temperature (25 °C) compared to the high range of pH and temperature and it resulted in quick release of the drug. The high range of pH (7.4) and temperature (37 °C) however caused controlled release of the drug. The in vivo evaluation of the developed hydrogel in rabbits demonstrated the controlled release behavior of fabricated system.
Rhenium Disulfide (ReS2) has evolved as a novel 2D transition-metal dichalcogenide (TMD) material which has promising applications in optoelectronics and photonics because of its distinctive anisotropic optical properties. Saturable absorption property of ReS2 has been utilized to fabricate saturable absorber (SA) devices to generate short pulses in lasers systems. The results were outstanding, including high-repetition-rate pulses, large modulation depth, multi-wavelength pulses, broadband operation and low saturation intensity. In this review, we emphasize on formulating SAs based on ReS2 to produce pulsed lasers in the visible, near-infrared and mid-infrared wavelength regions with pulse durations down to femtosecond using mode-locking or Q-switching technique. We outline ReS2 synthesis techniques and integration platforms concerning solid-state and fiber-type lasers. We discuss the laser performance based on SAs attributes. Lastly, we draw conclusions and discuss challenges and future directions that will help to advance the domain of ultrafast photonic technology.
Using tailor-made sub-mm dimension doped-silica fibres, thermoluminescent dosimetric studies have been performed for α-emitting sources of 223RaCl2 (the basis of the Bayer Healthcare product Xofigo®). The use of 223RaCl2 in the palliative treatment of bone metastases resulting from late-stage castration-resistant prostate cancer focuses on its favourable uptake in metabolically active bone metastases. Such treatment benefits from the high linear energy transfer (LET) and associated short path length (<100µm) of the α-particles emitted by 223Ra and its decay progeny. In seeking to provide for in vitro dosimetry of the α-particles originating from the 223Ra decay series, investigation has been made of the TL yield of various forms of Ge-doped SiO2 fibres, including photonic crystal fibre (PCF) collapsed, PCF uncollapsed, flat and single-mode fibres. Irradiations of the fibres were performed at the UK National Physical Laboratory (NPL). Notable features are the considerable sensitivity of the dosimeters and an effective atomic number Zeff approaching that of bone, the glass fibres offering the added advantage of being able to be placed directly into liquid. The outcome of present research is expected to inform development of doped fibre dosimeters of versatile utility, including for applications as detailed herein.
In previous work we investigated the real-time radioluminescence (RL) yield of Ge-doped silica fibres and Al2O3 nanodot media, sensing electron- and x-ray energies and intensities at values familiarly obtained in external beam radiotherapy. The observation of an appreciable low-dose sensitivity has given rise to the realisation that there is strong potential for use of RL dosimetry in diagnostic radiology. Herein use has been made of P-doped silica optical fibre, 2 mm diameter, also including a 271 µm cylindrical doped core. With developing needs for versatile x-ray imaging dosimetry, preliminary investigations have been made covering the range of diagnostic x-ray tube potentials 30 kVp to 120 kVp, demonstrating linearity of RL with kVp as well as in terms of the current-time (mAs) product. RL yields also accord with the inverse-square law. Given typical radiographic-examination exposure durations from tens- to a few hundred milliseconds, particular value is found in the ability to record the influence of x-ray generator performance on the growth and decay of beam intensity, from initiation to termination.
The key purpose of this experiment was to evaluate the thrombolytic, antioxidant, membrane stabilizing and antimicrobial potentials of crude ethanol extracts (CEE) of whole plant, organic and aqueous soluble fractions (OF & AQSF). CEE showed the highest (44.63%) clot lysis activity compared to streptokinase (64.35%). In DPPH study, petroleum ether soluble fraction (PSF) has exhibited IC50 of 18.83 μg/mL while the standard ascorbic acid was 2.48 µg/mL. AQSF profoundly inhibited the lysis of erythrocytes (66.20%) which was insignificantly different (p > 0.05) to acetylsalicylic acid (71.98%), the reference. However, AQSF showed a significantly stronger level of protection against heat-induced hemolysis (64.80%) as compared with the acetylsalicylic acid (78.90%). CEE, OF and AQSF have displayed reasonable growth of inhibition of tested bacteria compared to negative control and standard drug (77.50 mg of GAE/g).
Present study concerns the key thermoluminescence (TL) properties of photonic crystal fibres (PCFs), seeking development of alternatively structured TL materials that are able to offer a advantages over existing passive dosimeters. In terms of their internal structure and light guiding properties the PCFs, collapsed and structured, differ significantly from that of conventional optical fibres. To investigate the dosimetric parameters of the PCFs use was made of a linear accelerator producing a 6 MV photon beam, delivering doses ranging from 0.5 Gy to 8 Gy. The parameters studied included TL response, linearity index, glow curves, relative sensitivity and TL signal fading, the results being compared against those obtained using TLD-100 chips. At 4 Gy photon dose the Ge-doped collapsed PCFs were found to provide a response 27 × that of structured PCF, also giving a TL yield similar to that of standard TLD-100 chips. Over post-irradiation periods of 15 and 30 days collapsed PCF TL signal fading were 8% and 17% respectively, with corresponding values of 37% and 64% for the structured PCF. Trapping parameters including the order of kinetics (b), activation energy (E) and frequency factor (s-1) were assessed with Chen's peak shape method. Lifetime of trapping centre was found to be (2.36 E+03) s and (9.03 E +01) s regarding the collapsed and structured PCF respectively with 6 Gy of photon beam. For the Ge-doped collapsed PCF, the high TL yield, sensitivity and low fading provide the basis of a highly promising system of TLD for radiotherapy applications.