This paper proposes an emergency Traffic Adaptive MAC (eTA-MAC) protocol for WBANs based on Prioritization. The main advantage of the protocol is to provide traffic ranking through a Traffic Class Prioritization-based slotted-Carrier Sense Multiple Access/Collision Avoidance (TCP-CSMA/CA) scheme. The emergency traffic is handled through Emergency Traffic Class Provisioning-based slotted-CSMA/CA (ETCP-CSMA/CA) scheme. The emergency-based traffic adaptivity is provided through Emergency-based Traffic Adaptive slotted-CSMA/CA (ETA-CSMA/CA) scheme. The TCP-CSMA/CA scheme assigns a distinct, minimized and prioritized backoff period range to each traffic class in every backoff during channel access in Contention Access Period (CAP). The ETCP-CSMA/CA scheme delivers the sporadic emergency traffic that occurs at a single or multiple BMSN(s) instantaneously, with minimum delay and packet loss. It does this while being aware of normal traffic in the CAP. Then, the ETA-CSMA/CA scheme creates a balance between throughput and energy in the sporadic emergency situation with energy preservation of normal traffic BMSNs. The proposed protocol is evaluated using NS-2 simulator. The results indicate that the proposed protocol is better than the existing Medium Access Control (MAC) protocols by 86% decrease in packet delivery delay, 61% increase in throughput, and a 76% decrease in energy consumption.
Epistaxis is a common clinical condition and perhaps the most common ENT cause for emergency hospital admission. Commonly epistaxis originates from the anterior septum and is easily controlled with caurterization and packing. Posterior epistaxis is less common, but more difficult to treat. It usually occurs in the elderly and is frequently associated with hypertension, artherosclerosis and conditions that decrease platelets and clotting function. In the elderly and hypertensive patient the source of bleeding is likely from the sphenopalatine area in lateral posterior nasal wall. Intractable posterior epistaxis that persists despite repeated use of nasal packing has been treated in many different ways. Conventional methods of arterial ligation in intractable epistaxis often involve surgical morbidity as well as failure due to arterial anastomosis. Embolization is most effective in hands of an experience radiologist, in patients with epistaxis refractory to arterial ligation, bleeding site difficult to reach surgically or epistaxis due to general bleeding disorder. Endoscopic ligation or clipping of sphenopalatine artery is a relatively simple and effective procedure for control of intractable posterior epistaxis.
From January 1980 to December 1982, there were 222 MEDEVAC patients admitted to Mid Hospital, out of whom 206 had their case notes available for this study. The median age of the 206 patients MEDEVAC was 24.5 years and the male to female ratio was 1.2 : 1. The Kenyah, Iban, Punans, Kelabit, Kayan and Murut ethnic groups contributed most of the cases. There was some seasonal variation in the number of MEDEVAC done, the high months being July and December and the low periods in May/June and October/November. Most of the MEDEVAC were requested by ground staff at the remote rural clinics and also district hospitals. The median duration of stay of the patients was 9.7 days. The top five causes for MEDEVAC were: bronchopneumonia; accidental falls; gastroenteritis; peptic ulcers; and appendicitis. 7.8% of the MEDEVAC died in hospital. The management of cases ranged from conservative management to blood transfusions to surgical interventions. Based on the criteria set, 63.6% of the MEDEVAC were considered justified.
Gurayat General Hospital is a 350 bed secondary referral hospital of Kingdom of Saudi Arabia. This is one of the busiest hospitals in Al-Jouf region. Trauma is very common in this city and the ER department is mostly overwhelmed by Neurosurgical emergency patients. The aim the study was to evaluate the age sex,
types of injuries and causes of injuries of the neurosurgical emergency patients. This was a cross-sectional descriptive observational study. Ethical approval was achieved from proper authority. Good Clinical Practice (GCP) ICH E6 protocol was followed in order to ensure safety and efficacy. Data was collected from the log book of the ER department. Data were transferred to a spreadsheet to make a master sheet. Valuables of individual columns were analyzed and tabulated. Comparison was performed between the result of this study and other international studies. About 7.3% of all ER admissions were for the Neurosurgical cases. Among the Neurosurgical cases (n=3588) there was clear predominance of male
gender (81%). Majority (45%) of the Neurosurgical patients were from children and teen age group. Nearly 50% of the patients reported to ER with the history of Road Traffic Accident (RTA). Head injury was the commonest (61%) type of injury. Approximately 45% patients were admitted in to general ward whereas 42% patients were discharged from ER after providing primary treatment. When the results of this study were compared to the results of the other international studies fair similarities were observed.