Response of Diaphragmatic Excursion to Inspiratory Muscle Trainer Post Thoracotomy

Thoracotomy is a great surgery that has serious pulmonary complications, so purpose of this study was to determine the response of diaphragmatic excursion to inspiratory muscle trainer post thoracotomy. Thirty patients of both sexes (16 men and 14 women) with age ranged from 20 to 40 years old had done thoracotomy participated in this study. The practical work was done in cardiothoracic department, Kasr-El-Aini hospital at faculty of medicine for individuals 3 days Post operatively. Patients were assigned into two groups: group A (study group) included 15 patients (8 men and 7 women) who received inspiratory muscle training by using inspiratory muscle trainer for 20 minutes and routine chest physiotherapy (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Group B (control group) included 15 patients (8 men and 7 women) who received the routine chest physiotherapy only (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Ultrasonography was used to evaluate the changes in diaphragmatic excursion before and after training program. Statistical analysis revealed a significant increase in diaphragmatic excursion in the study group (59.52%) more than control group (18.66%) after using inspiratory muscle trainer post operatively in patients post thoracotomy. It was concluded that the inspiratory muscle training device increases diaphragmatic excursion in patients post thoracotomy through improving inspiratory muscle strength and improving mechanics of breathing and using of inspiratory muscle trainer as a method of physical therapy rehabilitation to reduce post-operative pulmonary complications post thoracotomy.

Clinical Comparative Study Comparing Efficacy of Intrathecal Fentanyl and Magnesium as an Adjuvant to Hyperbaric Bupivacaine in Mild Pre-Eclamptic Patients Undergoing Caesarean Section

Adequate analgesia following caesarean section decreases morbidity, hastens ambulation, improves patient outcome and facilitates care of the newborn. Intrathecal magnesium, an NMDA antagonist, has been shown to prolong analgesia without significant side effects in healthy parturients. The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of magnesium or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine in patients with mild preeclampsia undergoing caesarean section. Sixty women with mild preeclampsia undergoing elective caesarean section were included in a prospective, double blind, controlled trial. Patients were randomly assigned to receive spinal anesthesia with 2 mL 0.5% hyperbaric bupivacaine with 12.5 μg fentanyl (group F) or 0.1 ml of 50% magnesium sulphate (50 mg) (group M) with 0.15ml preservative free distilled water. Onset, duration and recovery of sensory and motor block, time to maximum sensory block, duration of spinal anaesthesia and postoperative analgesic requirements were studied. Statistical comparison was carried out using the Chi-square or Fisher’s exact tests and Independent Student’s t-test where appropriate. The onset of both sensory and motor block was slower in the magnesium group. The duration of spinal anaesthesia (246 vs. 284) and motor block (186.3 vs. 210) were significantly longer in the magnesium group. Total analgesic top up requirement was less in group M. Hemodynamic parameters were similar in both the groups. Intrathecal magnesium caused minimal side effects. Since Fentanyl and other opioid congeners are not available throughout the country easily, magnesium with its easy availability and less side effect profile can be a cost effective alternative to fentanyl in managing pregnancy induced hypertension (PIH) patients given along with Bupivacaine intrathecally in caesarean section.

Evaluation of a Bio-Mechanism by Graphed Static Equilibrium Forces

The unique structural configuration found in human foot allows easy walking. Similar movement is hard to imitate even for an ape. It is obvious that human ambulation relates to the foot structure itself. Suppose the bones are represented as vertices and the joints as edges. This leads to the development of a special graph that represents human foot. On a footprint there are point-ofcontacts which have contact with the ground. It involves specific vertices. Theoretically, for an ideal ambulation, these points provide reactions onto the ground or the static equilibrium forces. They are arranged in sequence in form of a path. The ambulating footprint follows this path. Having the human foot graph and the path crossbred, it results in a representation that describes the profile of an ideal ambulation. This profile cites the locations where the point-of-contact experience normal reaction forces. It highlights the significant of these points.

Simulation of the Pedestrian Flow in the Tawaf Area Using the Social Force Model

In today-s modern world, the number of vehicles is increasing on the road. This causes more people to choose walking instead of traveling using vehicles. Thus, proper planning of pedestrians- paths is important to ensure the safety of pedestrians in a walking area. Crowd dynamics study the pedestrians- behavior and modeling pedestrians- movement to ensure safety in their walking paths. To date, many models have been designed to ease pedestrians- movement. The Social Force Model is widely used among researchers as it is simpler and provides better simulation results. We will discuss the problem regarding the ritual of circumambulating the Ka-aba (Tawaf) where the entrances to this area are usually congested which worsens during the Hajj season. We will use the computer simulation model SimWalk which is based on the Social Force Model to simulate the movement of pilgrims in the Tawaf area. We will first discuss the effect of uni and bi-directional flows at the gates. We will then restrict certain gates to the area as the entrances only and others as exits only. From the simulations, we will study the effect of the distance of other entrances from the beginning line and their effects on the duration of pilgrims circumambulate Ka-aba. We will distribute the pilgrims at the different entrances evenly so that the congestion at the entrances can be reduced. We would also discuss the various locations and designs of barriers at the exits and its effect on the time taken for the pilgrims to exit the Tawaf area.

Development and Assessment of Measuring/Rehabilitation Device for Myelopathy Patients with Lower Extremity Function

Disordered function of maniphalanx and difficulty with ambulation will occur insofar as a human has a failure in the spinal marrow. Cervical spondylotic myelopathy as one of the myelopathy emanates from not only external factors but also increased age. In addition, the diacrisis is difficult since cervical spondylotic myelopathy is evaluated by a doctor-s neurological remark and imaging findings. As a quantitative method for measuring the degree of disability, hand-operated triangle step test (for short, TST) has formulated. In this research, a full automatic triangle step counter apparatus is designed and developed to measure the degree of disability in an accurate fashion according to the principle of TST. The step counter apparatus whose shape is a low triangle pole displays the number of stepping upon each corner. Furthermore, the apparatus has two modes of operation. Namely, one is for measuring the degree of disability and the other for rehabilitation exercise. In terms of usefulness, clinical practice should be executed before too long.