bluuebunny/crossref_metadata_2025 huggingface dataset:
Recovery of Excavated Materials as an Alternative Solution to Earth Building Materials
Authors: Nouali Mohammed , Saillio Mickael , Ghorbel Elhem
Published: January 2022

The tunnel excavation works generate huge quantities of earth. These excavated materials are primarily stored in landfills. This paper proposes an alternative solution for valorizing excavated earth in earthen constructions. Firstly, the excavated earth was characterized using differential and gravimetric thermal analysis (DTA / TGA), infrared spectra (FTIR), and X-ray diffraction. Hence, sand, fine particles, and water extracted from excavated earth are used to elaborate mortars’ stabilized with cement, lime, and slag. Short hemp fibers were also used to diminish shrinkage cracks. The quantity of stabilizers was fixed to 5% by weight of the excavated earth while the water/solid ratio was maintained constant and equal to 0.45. Five different mortar formulations were performed using excavated earth and were cured for 28 days in a controlled environment before testing. Compressive and three-point flexural tests were carried out to determine specimens’ mechanical properties. The characterization results show that the excavated earth are mainly composed of dolomite, calcite, quartz, and clay. While, the mechanical results show that the stabilized excavated earth with cement additive presents higher mechanical properties relative to the other additives.
What Makes Cow-Dung Stabilised Earthen Block Water-Resistant
Authors: Kulshreshtha Yask , Vardon Philip J. , Meesters Gabrie , van Loosdrecht Mark C.M. , Mota Nelson J.A. , Jonkers Henk M.
Published: January 2022

The water-resistance of cow-dung has made it a widely used stabiliser in traditional earthen structures in several Asian and African countries. Multiple studies have shown an improvement in water-resistance with the addition of cow-dung, but none provides insight into this behaviour. The present study investigates the water-resistance behaviour of cow-dung stabilised earthen blocks through an extensive experimental programme to identify and characterise the components of cow-dung responsible for its water-resistance. Fresh cow-dung was collected and separated into fibres (>63 μm), medium-sized microbial aggregates (1-63 μm) and small-sized microbial aggregates (0.5-7 μm). Each component was mixed with soil and samples were prepared at different water contents (optimum water content corresponding to the highest dry density and water content higher than optimum) and compacted with 2.5 MPa force to prepare compressed blocks. The water-resistance of these blocks was evaluated through the immersion and modified drip/rain test. It was found that the small-sized microbial aggregates are almost entirely responsible for water-resistance behaviour of cow-dung stabilised earthen blocks. Small-sized microbial aggregates were further characterised by gas chromatography, mercury intrusion porosimetry, N2- BET surface area, zeta potential measurement and electron microscopy. The results indicate that the small-sized microbial aggregates are composed of clay-sized negatively charged particles that are rich in fatty acids. The hydrophobicity of these particles is hypothesised to be responsible for water-resistance behaviour. These insights are further used to produce stabilised blocks that performed at least 30 times better than the unstabilised blocks in both water-resistance tests. The study concludes with practical recommendations for the use of wet cow-dung over dry cow-dung and a reduction of fibre content to increase the water-resistance of earthen blocks.
Interactions of Biobased Rheology Modifying Agents with Superplasticizer in Cement Paste
Authors: Mezhov Alexander , Zhang Kun , Schmidt Wolfram
Published: January 2022

Organic admixtures are an indispensable component of modern concrete. Thus, their purposeful application is not only technically and economically viable but in addition an inevitable tool to make concrete more environmentally friendly. In this context, the use of polysaccharides has increasingly gained interest in the built environment as sustainable resource for performance enhancement. However, due to its origin, biopolymers possess a vast variety of molecular structures which can result in incompatibilities with other polymers present in concrete, such as superplasticizers. The present study highlights effects of the joint application of different types of starches and polycarboxylates with respect to their influence on cement hydration and structural build-up of cement pastes.
Traditional Gypsum Pavements with Natural Aditives
Authors: González Sánchez Belén , Navarro Antonia , Ramírez-Casas Judith , Rosell Joan Ramon
Published: January 2022

In traditional architecture, the construction systems used have always been linked to the material resources of the environment. In the areas of extraction of gypsum in the Iberian Peninsula, the use of this material as a conglomerant was not limited to the interior lining of vertical and/or horizontal walls or to interior decorations, as is the case today, but proved to be a very versatile material, which could be used both in structural elements and in finishing elements and decorations. This study shows the preliminary results of an ongoing research on the recovery of traditional gypsum pavements, where three types of traditional gypsum plasters with natural products such as collagen, coconut soap, potassium soap, vegetable oil and marshmallow root were tested. The hygroscopic behaviour of the treated samples has been evaluated from the capillarity water absorption and the contact angle, due to their high hygroscopicity. On the other hand, the density and porosity, surface hardness and thermal conductivity of the samples have also been determined.
A Dual-Scale Numerical Model for the Diffusive Behaviour Prediction of Biocomposites Based on Randomly Oriented Fibres
Authors: Nouri Mustapha , Tahlaiti Mahfoud
Published: January 2022

This work aims to present a multi-scale numerical approach based on a 2D finite element model to simulate the diffusive behaviour of biocomposites based on randomly dispersed Diss fibres during ageing in water. So, first of all, the diffusive behaviour of each phase (fibres/matrix) as well as of the biocomposite was determined experimentally. Secondly, the microstructure of the biocomposite was observed by optical microscope and scanning electron microscope (SEM), and then regenerated in a Digimat finite element calculation software thanks to its own fibre generator: "Random fibre placement". Finally, the diffusion problem based on Fick's law was solved on the Abaqus finite element calculation software. The results showed an excellent agreement between the experiment and the numerical model. The numerical model has enabled a better understanding of the diffusive behaviour of water within the biocomposite, in particular the effect of the fibre/matrix interface. In terms of durability, the layered structure of this biocomposite has proven to be effective in protecting the plant fibres from hydrothermal transfer, which preserves the durability of the material.
Influence of High Temperatures on the Mechanical Properties of Wood Bio-Concretes
Authors: Aguiar Amanda Lorena Dantas , da Gloria M’hamed Yassin Rajiv , Toledo Filho Romildo Dias
Published: January 2022

The use of wood wastes in the production of bio-concrete shows high potential for the development of sustainable civil construction, since this material, in addition to having low density, increases the energy efficiency of buildings in terms of thermal insulation. However, a concern arising from the production of bio-concretes with high amounts of plant biomass is how this material behaves when subjected to high temperatures. Therefore, this work aims to evaluate the influence of high temperatures on the mechanical properties of wood bio-concretes. The mixtures were produced with wood shavings volumetric fractions of 40, 50 and 60% and cementitious matrix composed of a combination of cement, fly ash and metakaolin. Uniaxial compression tests and scanning electron microscopy (SEM) were performed, with bio-concrete at age of 28 days, at room temperature (reference) and after exposure to temperatures of 100, 150, 200 and 250 °C. The density and compressive strength of the bio-concrete gradually decreased with increasing biomass content. Up to 200 °C, reductions in strength and densities less than 19% and 13%, respectively, were observed. At 250 °C, reductions of compressive strength reached 87%. Analysis performed by SEM showed an increase in the number of cracks in the wood-cementitious matrix interface and wood degradation by increasing the temperature.
Mycelium Composites and their Biodegradability: An Exploration on the Disintegration of Mycelium-Based Materials in Soil
Authors: Van Wylick Aurélie , Elsacker Elise , Yap Li Li , Peeters Eveline , de Laet Lars
Published: January 2022

In the search for environmentally friendly materials, mycelium composites have been labelled as high potential bio-based alternatives to fossil-based and synthetic materials in various fields. Mycelium-based materials are praised for their biodegradability, however no scientific research nor standard protocols exist to substantiate this claim. This research therefore aims to develop an appropriate experimental methodology as well as to deliver a novel proof of concept of the material’s biodegradability. The applied methodology was adapted from a soil burial test under predefined laboratory conditions and hands-on preliminary experiments. The mycelium composite samples were placed in a nylon netting and then buried in potting soil with a grain size of 2 mm for different time-intervals ranging between one and sixteen weeks. Results showed that mycelium, which acted as the binder, had the tendency to decompose first. A weight loss of 43% was witnessed for inert samples made of the fungal strain Ganoderma resinaceum and hemp fibres after sixteen weeks. The disintegration rate in this method however depended on various parameters which were related to the material’s composition, its production method and the degradation process which involved the used equipment, materials and environmental properties.
Investigation of Thermal, Mechanical and Acoustic Performance of Bio-Materials Based on Plaster-Gypsum and Cork
Authors: Bouzit Said , Merli Francesca , Sonebi Mohammed , Amziane Sofiane , Buratti Cinzia , Taha Mohammed
Published: January 2022

The building sector is one of the biggest consumers of energy in the world and it is pushing the scientific community to find various alternative solutions to solve the problem of thermal insulation of buildings. Therefore, the selection of appropriate building materials is a major challenge for improving the thermal comfort and energy performance of buildings. In this scenario, the interest of plaster-based composites as insulating materials increases, in particular for new applications, as insulators for the building envelope, and this deserves to be studied. In this investigation, new plaster-based composites with cork were produced and tested at lab scale, in order to obtain cheap solutions with improved thermo-physical and acoustic performance. The results show that it is possible to improve the thermal, mechanical, and acoustic performance of construction biomaterials by using plaster as a binder and cork as a natural reinforcement: thermal conductivity was equal to 0.097 W/m.K, the compressive strength to about 2.30 MPa, and the transmission loss to about 40 dB.
Keywords:
Plaster-Gypsum; Cork; Thermal, Mechanical and Acoustic Properties.
Hydro-Mechanics Coupling on Rammed Earth Material: Drying Experiment at Structural Scale
Authors: Chitimbo Taini , Abdul-Samad Feras , Prime Noémie , Plé Olivier
Published: January 2022

Rammed earth structures are very sensitive to hydric conditions. Experimental studies have been undertaken to understand the link between liquid water transfer and mechanical behavior at structural scale. This study was done on a prismatic rammed earth sample of 15cm x 15cm x 45cm, structured as a wall element with several layers. Samples were subjected to one dimensional drying in an indoor environment. Humidity and temperature sensors were placed on each layer inside the sample. The kinetic of drying was monitored by continuous weighing the sample and humidity measurement at a regular interval. Results of water content evolution suggest that samples dry in two stages; the first stage is associated with relatively high evaporation flux of 13.88 g m-2h-1 while the second stage has very low flux of moisture evaporation. Unconfined compressive strength was performed in drying samples after 0, 2, 6 and 8 weeks of drying. In parallel, digital image correlation was used to determine the stiffness of samples. Results show an increase in compressive strength by the rate of 98 kPa per week in the first two weeks, then this rate reduces to 23 KPa per weeks after 8 weeks. These experimental results will allow to enhance the 3D hydro mechanical numerical model developed in the laboratory.
Flexural Behavior of Six Species of Italian Bamboo
Authors: Greco Silvia , Molari Luisa
Published: January 2022

The good mechanical performance of bamboo, coupled with its sustainability, has boosted the idea to use it as a structural material. In some areas of the world it is regularly used in constructions but there are still countries in which there is a lack of knowledge of the mechanical properties of the locally-grown bamboo, which limits the spread of this material. Bamboo is optimized to resist to flexural actions with its peculiar micro structure along the thickness in which the amount of fibers intensifies towards the outer layer and the inner part is composed mostly of parenchyma. The flexural strength depends on the amount of fibers, whereas the flexural ductility is correlated to the parenchyma content. This study focuses on the flexural strength and ductility of six different species of untreated bamboo grown in Italy. A four-point bending test was carried out on bamboo strips in two different loading configurations relating to its microstructure. Deformation data are acquired from two strain gauges in the upper and lower part of the bamboo beam. Difference in shape and size of Italian bamboo species compared to the ones traditionally used results in added complexity when performing the tests. Such difficulties and the found solutions are also described in this work. The main goal is to reveal the flexural behavior of Italian bamboo as a functionally graded material and to expand the knowledge of European bamboo species toward its use as a structural material not only as culm but also as laminated material.
3D Modelling of Hydric Transfers in Spruce Wood with Consideration of Sorption Hysteresis
Authors: Maaroufi Maroua , Abahri Kamilia , Bourdot Alexandra , El Hachem Chady
Published: January 2022

Buildings are responsible for a large portion of the total energy consumption, and have a heavy environmental impact. Wood is one of the most used bio-based building materials, as it helps reducing the environmental footprint of the construction sector. Spruce wood is widely available in France and therefore massively used in buildings. It has interesting thermal and acoustic insulation performances and a good hydric regulation property. Spruce wood microstructure is highly heterogeneous and multiphasic, which makes it harder to apprehend. On the other hand, sorption hysteresis phenomenon is responsible for the moisture accumulation in porous building materials. It is often neglected in hygrothermal transfers modelling, which leads to incorrect water content values. The aim of this work is to investigate the influence of the sorption hysteresis phenomenon on the hydric transfers of spruce wood. The heterogeneity of the microstructure is also considered through 3D tomographic reconstructions included in the modelling.
Development of Airlaid Non-Woven Panels for Building’s Thermal Insulation
Authors: Ayadi Melek , Zouari Riadh , Ségovia César , Baffoun Ayda , Msahli Slah , Brosse Nicolas
Published: January 2022

As the need to ensure thermal comfort in buildings is constantly evolving, new technologies continue to emerge with the aim to develop efficient thermal insulation materials. This study aims to explore a textile technology using Airlaid process to develop non-woven fabrics made of natural fibers extracted from Posidonia Oceanica’s waste for assessing their suitability for insulation products in construction field. This technology offers the feature to develop isotropic non-woven structures by orienting randomly the fibers on the fabric surface. The web composed of a mixture of Posidonia Oceanica fibers and a proportion of thermoplastic fibers is then thermally bonded in an oven followed by cooling in order to ensure the solidification of the bonding areas. The prepared panels are then analyzed for the thermal conductivity. It was found that their thermal conductivity is close to commonly used thermal insulation materials, ranging between 0.03515 W/m.K and 0.03957 W/m.K, which allows the non-woven panels to compete with widely-used insulation materials for building’s field. The second part of this work aims to determinate the Posidonia panel's resistance to five common mold types in buildings (Aspergillus niger, Penicilumfuniculosum, Trichoderma viride, Chaetomium globosum, Paecilomycesvariotii). In fact, at high moisture content, molds are likely to develop on cellulosic materials affecting indoor air quality and eventually causing a variety of health risks to occupants. However, optic microscope results showed no growth of molds on the Posidonia samples which allows conceiving reliable thermal insulation materials.
Valorization of Vegetal Fibers in Anti-Fissuration Screed Mortar Formulation
Authors: Pons Ribera Sergio , Hamzaoui Rabah , Colin Johan , Vasseur Benitha , Bessette Laetitia , Bernardeau Fabien , Bredy Tuffe Patricia , Bono Pierre , Gasparutto Antoine , Audouin Marie
Published: January 2022

This work, which is part of the FIBRABETON project, aims to anti-fissuration screed formulations proposition based on natural fibers and comparing these formulations to a synthetic fiber-screed formulation. Different natural fiber (hemp, flax, miscanthus and bamboo) with contents rangingfrom 0.4% to 0.8% were tested. The spread (slump), the shrinkage and mechanical strength (flexural and compressive) studies were carried out. SEM images of natural fibers and natural fibers screed formulation were analyzed. Overall, it is found that all natural fibers screed formulations tested, have shown better behaviour than the synthetic fibers screed formulation in point of view workability, shrinkage and mechanical properties. The lowest shrinkage value is found in the case of the H5 (5 mm long hemp fibers) screed formulation. Generally speaking, the mechanical strength values (flexural and compressive) are more or less similar between natural soft fibers (hemp and flax) and rigid fibers (miscanthus and bamboo). Taking in account slump, shrinkage and mechanical behavior, the proposed good compromise in this work is the H5 screed formulation.
Experimental Investigation on Evaporation Rate for Enhancing Evaporative Cooling of Pervious Pavement Containing Recycled Rubber
Authors: Seifeddine Khaled , Toussaint Evelyne , Amziane Sofiane
Published: January 2022

Traditional impermeable pavements such as asphalt have dark surfaces and high thermal inertia. During hot weather, they tend to absorb and store solar radiation, which promotes the development of urban heat islands (UHI). Furthermore, permeable pavements are effective in mitigating the urban heat island effect via evaporative cooling. There are many studies in the literature on the hydraulic and mechanical characteristics of permeable pavements, but a few studies focus on the impact of evaporative cooling of these pavements. In this study, 3 types of permeable pavements based on pozzolan, recycled rubber and polyurethane resin were studied during 3 hot days. The objective was to quantify the cooling effect in these innovative permeable pavements compared to a traditional impermeable asphalt pavement. The results of this experiment show that the cooling effect in the new types of draining pavements can last up to two days in the weather conditions of this experiment compared to the traditional asphalt pavement. The evaporation rate and surface temperature of permeable pavements vary in opposite directions. In addition, evaporation in pervious pavements is controlled by the availability of water near the surface. This study is a preliminary step in the design of pavements that contribute to the valorization of rubber waste, to the stormwater management and to the reduction of the effects of urban heat islands during heat waves.
Experimental Study on Restoration of Deteriorated Timber due to Termites by Resin Filling
Authors: Yajima Takashi , Imamoto Kei-ichi , Kiyohara Chizuru , Yamada Mikako
Published: January 2022

There are many valuable wooden buildings in the world, because timber has been used all over the world as a building material for a long time. However, there is an issue that timber deteriorates due to various factors. Therefore, in order to preserve these valuable wooden buildings, it is necessary to appropriately repair or reinforce treatment. One of the treatments is the resin filling method. In this method, filling the resin in order to restore the strength into an internal cavity caused by deterioration. It has become clear that it is possible to recover the strength using this method, however, we are still conducting construction based on the rule of thumb. Therefore, authors examined the resin characteristics in order to inject the resin in stable manner and ensure strength recovery. Authors focused on deteriorated timber due to termites, because Japan has a very high amount of such type of timber. Authors reports the following four aspects of the characteristics of resin filling into timber. 1. The Area velocity is determined by the injection pressure, width of the gap, and viscosity of the resin. 2. The resin spreads concentrically in the gap of wood, but there is no regularity in the random gap like deteriorated timber due to termites. 3. Authors proposed a new coefficient for the application, of a theoretical formula to deteriorated timber due to termites. 4. Authors proposed a flowchart of resin filling method to perform stable construction.
A Model for Assessment of Heat and Moisture Transfer Hollow a Hemp Concerte Wall Using Finite Element Method
Authors: Ouldboukhitine Salah , Amziane Sofiane , Benkhaled Maroua
Published: January 2022

The energy performance of buildings represents a major challenge in terms of sustainable development. The buildings and buildings construction sectors combined are responsible for over one-third of global final energy consumption and nearly 40% of total direct and indirect CO2 emissions. In order to reduce the energy consumption of buildings and their harmful impact on the environment, special attention has been paid in recent years to the use of bio-based materials. In the present paper, a model of heat and moisture transfer hollow hemp concrete wall is proposed using finite element method. The energy and mass balances are expressed using measurable transfer drivers as temperature water content and vapor pressure and coefficients related explicitly to the macroscopic properties of material as thermal conductivity, specific heat, and water vapor permeability. The proposed model is implemented in MATLAB code and validated through experimental measurements.
Humanitarian Action: A De Facto Durable Solution of Refugee Crisis?
Authors: Roy Sodip , Barua Hrithika
Published: January 2022

Humanitarian action tends to save lives of millions of forcibly displaced people around the globe during emergencies. In principle, it is temporary, but it continues for an extended period in the case of refugee crises. Among the three available durable solutions, the UN agencies can hardly implement them. Eventually, those solutions do not work in most of the twenty-first century refugee crisis. This study raises the question whether humanitarian action is likely to be another durable solution or not, and why it is preferred to other durable solutions to refugee crises. To that end, this study investigates the dynamics of ranges of solutions to protracted refugee situations (PRS) in different corners of the world. After an exploration of relevant secondary resources in qualitative setting, it concludes that statism causes many unavoidable politico-economic challenges to the traditional durable solutions while many self-devised comfort zones encourage the overuse of humanitarian action like a long-term solution to the problems. Addressing this incongruity of durable solutions to refugee crisis, the study urges that refugee regime reduce the dependency on humanitarian action and thus reinforce truly for alternative, less statist or transnational, and sustainable solutions.
Effectiveness and Safety of Moxibustion for Poststroke Insomnia
Authors: Ren Jia-Jun , Tian Hui-Chuan , Wang Yun-Fan , Li Yun-Ting , Xu Qian , Tian Lu
Published: January 2022

Objective:

This study aimed to systematically evaluate the clinical efficiency and safety of moxibustion for the treatment of poststroke insomnia (PSI).

Methods:

We searched PubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service platform (Wanfang Data), Chinese Scientific Journal Database (VIP), and clinical rial for trandomized controlled trials on moxibustion as a treatment for PSI, including results from the creation of all databases until December 12, 2020. The functional languages used were Chinese and English. Two reviewers independently performed the literature search, data extraction, and quality evaluation. The primary and secondary outcome measures were the effective rate and adverse events, respectively. The meta-analysis was carried out using RevMan5.4 software and Stata15.

Results:

Of the 11 trials, 996 patients in mainland China were included. Compared to the control group, the combination of single moxibustion therapy or moxibustion combined with acupuncture in the treatment of DN could reduce the sleep quality score (SQS) (mean difference [MD] = −0.50, 95% confidence interval [CI] [ − 0.89, −0.11], Z = 2.51, P = 0.01), time to falling asleep score (MD = −0.39, 95% CI [−0.49, −0.29], Z = 7.79, P < 0.00001), sleep time score (MD = −0.34, 95% CI [−0.59, −0.09], Z = 2.64, P = 0.008), sleep efficiency score (MD = −0.30, 95% CI [−0.52, −0.08], Z = 2.69, P = 0.007), sleep disorder score (MD = −0.29, 95% CI [−0.49, −0.09], Z = 2.85, P = 0.004), daily function disturbance score (MD = −0.54, 95% CI [−0.82, −0.26], Z = 3.78, P = 0.0002), Pittsburgh Sleep Quality Index aggregate score (MD = −2.30, 95% CI [−2.97, −1.63], Z = 6.71, P < 0.00001), SPIEGEL aggregate score (MD = −7.62, 95% CI [−8.12, −7.12], Z = 29.75, P < 0.00001), and stroke-specific quality of life aggregate score (MD = 12.68, 95% CI [0.92, 24.44], Z = 2.11, P = 0.03).

Conclusion:

This study indicates that moxibustion contributes to the treatment of PSI. Nevertheless, more extensive trials are required to validate the results due to the small sample sizes, few reports on adverse effects, and high risk of bias in the included studies.
The Spectrum of Mucocutaneous Manifestation during Pregnancy: An Observational Study of 170 Pregnant Women Visiting a Tertiary Care Hospital
Authors: Bedi Aishwarya , Khatu Swapna S. , Poulkar Chandrakant B. , Palaskar Nachiket , Chaudhari Nitin D. , Patokar Abhishek S.
Published: January 2022

ABSTRACT

Background:

Pregnancy is characterized by myriad of temporary alteration in endocrine, metabolic, and immunological factors. These alterations result in multiple mucocutaneous manifestations. The various skin changes may be either physiological or changes in preexisting skin diseases, or development of new pregnancy-specific dermatoses. Pregnancy-specific skin dermatoses include atopic eruption of pregnancy (AEP), polymorphic eruption of pregnancy, pemphigoid gestationalis, and intrahepatic cholestasis of pregnancy.

Aims:

The aim of the study was to study the frequency and pattern of mucocutaneous manifestations in pregnant women attending the tertiary care hospital.

Settings and Design:

A descriptive observational study.

Subjects and Methods:

A total number of 170 pregnant women attending antenatal outpatient department from October 2017 to March 2019 were included in the study. Detailed history, clinical examination, and relevant investigations were done. Patients not willing to give informed consent were only excluded from the study.

Results:

In this study, 58.23% (99) were primigravida and 41.77% (71) were multigravida. Most of the cases presented during third trimester (73%). In this study among the 170 pregnant women, the incidence of skin changes observed was 790 physiological entities, nonspecific dermatoses of pregnancy were 95, and 42 cases of specific dermatoses of pregnancy. The most common physiological changes noted were pigmentary changes 46.96% out of all physiological changes. All pregnant women showed pigmentary changes. Most common pigmentary change was linea nigra and melasma. Other changes were striae distensae 14.55%, vascular changes 10.37%, mucous membrane changes 5.19%, pruritus 17%, hair changes 1.51%, and nail changes 1.13%. Tinea corporis was most common infection 48.6% out of all infections, followed by candidal vaginitis 10.8%. Acne vulgaris was most common inflammatory disorder seen in 12.35%, followed by urticaria and psoriasis, seen in 7.05% and 1.76%, respectively. Polymorphic eruption of pregnancy and AEP was seen in 14.70% and 10%, respectively. No cases of intrahepatic cholestasis of pregnancy and pemphigoid gestationalis were noted.

Conclusions:

This study brings into focus prevalence of various mucocutaneous changes during pregnancy. Thorough knowledge about pregnancy dermatoses is essential to arrive at a specific diagnosis which is a mandate for counseling and management.
Assessment of Clinical, Biochemical, and Hormonal Profile of Lean Versus Overweight Polycystic Ovarian Syndrome Patients
Authors: Ghatnatti Vikrant , Patil Shwetha , Kour Harpreet
Published: January 2022

Background:

Polycystic ovary syndrome (PCOS) is a common endocrine disorder having escalation in its prevalence. This study was planned to understand the clinical, biochemical, and hormonal profile of lean versus overweight patients diagnosed newly with PCOS.

Materials and Methods:

A cross-sectional study was conducted for 1 year in the Department of Endocrinology of a tertiary care hospital. A total of 50 female patients newly diagnosed to have PCOS by the Rotterdam criteria 2003 were enrolled for the study. Assessment of clinical characteristics, biochemical, and hormonal profile was done.

Results:

Fasting serum insulin levels and homeostasis model assessment-insulin resistance signifying insulin resistance were higher in overweight compared to the lean PCOS. Insulin resistance was present in 50% of lean PCOS and 82% of overweight PCOS. Glucose abnormalities were noted in 13.7% of lean PCOS and 32.2% of overweight PCOS.

Conclusion:

Obese women with PCOS have a higher risk of increased obesity, impaired glucose tolerance, and insulin resistance as compared to lean PCOS women.
A Clinical Profile of Adverse Drug Reaction in HIV Patients on Highly Active Antiretroviral Therapy
Authors: Gurav Nitish Ashok , Ravi K. , Sumana B. , Rajanna Avinash Hannabe , Rajalbandi Rakesh Shetty
Published: January 2022

Background:

The expansion of antiretroviral therapy has increased the life expectancy of patients living with HIV (PLHIV). However, the Highly Active Antiretroviral Therapy (HAART) has a wide range of toxicity ranging from low grade intolerance to life threatening adverse drug reactions (ADR). Mild toxicity does not require any change in therapy. Moderate to severe toxicity may require substitution with an alternate class of drug while life threatening side effects need discontinuation of HAART till the condition of patient is stabilized and toxicity is resolved.

Aim and Objective:

To estimating the frequency of occurrence of ADRs in PLHIV on HAART. To estimate the clinical profile and severity of ADRs.

Materials and Methods:

The data of the patient who were registered at Centre of Excellence, Bowring and Lady Curzon Hospital, Bangalore Medical Collage & Research Institution, Bangalore, from May 2015 to April 2017, were retrospectively reviewed. Demographic data, routine blood investigations, ADRs and CD4 count at that time were noted.

Results:

In our study conducted from May 2015 to April 2017, 1834 PLHIV were included. Out of these patients, 1554 PLHIV were on HAART. 601 patients showed ADRs secondary to HAART. The age distribution was between 18 to 75 years and the mean age was 43.19+9.18. M: F:: 62:38. 409 patients had hypertriglyceridemia, 472 patients had hypercholesterolemia, 84 had hyperbilirubinemia, 48 developed anemia, 17 patients developed hepatotoxicity, 25 developed drug induced skin rash. Significant association was found between the above reactions and the causative drug. Other reactions like hyperglycemia, night mares, Steven Johnson syndrome (SJS) observed in the study did not show statistical significance.

Conclusion:

The commonly observed adverse drug reactions of HAART were hypertriglyceridemia, hypercholesterolemia, hyperbilirubinemia, anemia, hepatotoxicity and skin rashes. However hyperglycemia, SJS, night mares were rarely seen.
Challenges of Managing Viper Envenomation
Authors: Agrawal Purvesh , Khandelwal Nidhi
Published: January 2022

The signs and symptoms following snakebite envenomation vary according to the type of snake encountered. Typically, Viperidae (vipers) envenomates with a hemotoxin causing coagulopathy and muscle breakdown, while elapids envenomate with a neurotoxin. However, these are not exclusive; the venom from elapids can have a hemotoxic effect and that of the Viperidae can be neurotoxic. We present a case series of viper envenomation presenting to the emergency department at a secondary care Indian Navy Hospital during 2019–2020. These cases highlight the clinical challenges involved in presentation of viper envenomation.
Adverse Drug Reaction Monitoring Through Active Surveillance in the Inpatients of General Medicine Ward of a Tertiary Care Hospital
Authors: Roy Pooja , Nadig Pratibha , Jayashankar C. A.
Published: January 2022

Objective:

To monitor and analyze the adverse drug reactions (ADRs) by active surveillance in the inpatients of the department of general medicine of a tertiary care hospital.

Materials and Methods:

This was a cross-sectional study on the patients aged 18–70 years conducted for a period of 6 months. Patients' medical history, any new symptoms after commencing treatment, and their details were obtained after direct interviews. The case report forms were also reviewed. Suspected ADRs were documented in consultation with the attending physicians. Descriptive statistics was used to analyze the data for the occurrence, relatedness to the drug, seriousness, preventability, severity, intensity, and predictability of ADRs.

Results:

Fifty-three women and 47 men consented to participate, the majority of whom were between the ages of 20 and 30 years. Thirty suspected ADRs were detected in 24 out of 100 patients. The most common indications for which the drugs were prescribed were depression, psychosis, bipolar disorder, atopic dermatitis, and cervical spondylitis. Of the 30 ADRs, 28 were probably related, and 2 were possibly due to the prescribed drugs. Seven ADRs were serious in nature. Four ADRs were definitely preventable, seven were probably preventable, and nineteen were not preventable. Maximum ADRs were caused by immunosuppressants including steroids. Dermatological reactions were the most common manifestations of ADRs followed by that of central nervous system. There were four rare ADRs, namely, escitalopram-induced duodenitis, phenobarbitone-induced pancytopenia, quetiapine-induced thrombocytopenia, and aripiprazole-induced ocular gyrus syndrome. ADRs were mostly mild to moderate in intensity.

Conclusion:

Monitoring the ADRs through active surveillance is helpful to get a detailed information and to detect rare ADRs.
Trace element and magnesium in patients with bronchial asthma
Authors: Ali Ahmed Abd Al-Rahman , El-Wahsh Rabab Abd Elrazek , Afia Hoda F. , Abdelaal Gehan A.
Published: January 2022

Background

Bronchial asthma is a chronic inflammatory disease of the respiratory system. Trace elements play roles in inflammation and may affect bronchial asthma.

Aim

This study aimed to determine the concentrations of copper (Cu), zinc (Zn), iron (Fe), and magnesium (Mg) in the sera of patients and to evaluate their value in asthma severity and control.

Participants and methods

This study was carried out on 71 asthmatic adult patients and 20 healthy control participants. Patients were diagnosed with bronchial asthma based on clinical history and the presence of reversible airway obstruction in spirometry. Levels of serum trace elements (Cu, Zn, Fe, and Mg) were determined in all participants.

Results

The serum levels of Zn and Mg were lower in patients with asthma in comparison with the controls, while the serum levels of Fe and Cu were higher in patients with asthma in comparison with the healthy controls. The P value was significant for Zn (P<0.008) and Fe (P<0.016). There was no difference between serum levels of trace elements in different grades of asthma severity or control.

Conclusion

Asthmatic patients had abnormal serum trace element levels such as lower serum Zn and higher serum Fe levels than the controls, but without a significant relation to the degree of asthma severity or its level of control.
Role of intrapleural instillation of MESNA in the management of pleural adhesions
Authors: Omar Amany , Abo Elfadl Abd-Elazim , Ahmed Yousef , Elkhayat Hussein , Gamal Montaser
Published: January 2022

Context

Intrapleural adhesions and pleural fluid loculation is a common clinical problem. Several options are available to manage the intrapleural adhesions. MESNA has recently been used as a fibrinolytic agent and due to its efficacy and safety it is an option in treating intrapleural adhesions instead of other intrapleural fibrinolytics.

Aims

To assess the efficacy and safety of MESNA as a fibrinolytic agent in the management of loculated pleural effusions.

Settings and design

A prospective case series study at the Chest Department, Assiut University Hospital from October 2017 to March 2020.

Patients and methods

A prospective case series study has been conducted on 25 patients, who were admitted at the Chest Department, Assiut University Hospital. Patients presented with complex septated pleural effusion and their symptoms were anticipated to improve by pleural fluid drainage . MESNA was given daily for 3 consecutive days at a dose of 1800 mg diluted with 20 ml of normal saline and injected into the pleural cavity through the chest tube. The amount of drained fluid, chest ultrasound, and chest radiograph were used to evaluate the improvement of patients, assess the safety of MESNA, and detect any adverse effects.

Results

After installation of MESNA there is an increase in the amount of the fluid drained through the intercostal tube with significant difference before and after installation of MESNA (P<0.001) with a success rate of 64% in the studied patients.

Conclusions

Intrapleural installation of MESNA is a safe and effective therapy in the treatment of loculated plural effusions.
Lung transplantation from past to future
Authors: Mehfooz Nazia , Kaul Parvaiz A.
Published: January 2022

Lung transplantation is performed on patients with terminal lung diseases and is generally done in two scenarios: when a patient with terminal stage lung disease is predicted to have 50% or less chances of survival in the next 2–3 years and/or advancement of lung disease to such a stage that clear survival advantage of lung transplantation is evident. It was first done in humans in 1963 by Dr James Hardy. Proper timing of transplant is important. It should be neither too late nor too early. Listing of patients for lung transplantation was initially a problem but subsequently with the introduction of lung allocation scores (LAS) by the United Network for Organ Sharing in 2005, the waiting list mortality has decreased significantly. LAS is a concept to prioritize organ allocation based on the expected survival advantage of transplantation. The LAS is aimed to pick up the best-suited candidates for transplant and to decrease waiting list mortality.

The decision to do single or double lung transplantation is multifactorial. It depends on transplant indications, recipient factors, and donor availability.

As with any other transplant, lung transplantation needs posttransplant immunosuppression. Postlung transplant immunosuppression generally consists of a regimen consisting of calcineurin inhibitors, purine synthesis antagonists, and prednisolone.

Immunosuppression and drug toxicity are the main cause of early complications. Complications vary with time postoperatively. Primary graft dysfunction is the major concern in the first month after transplant. Acute rejection infections predominate in the subsequent posttransplant period. Neoplasia and chronic lung allograft dysfunction predominate after the first year. The initial attempts resulted in a poor outcome but is now routinely performed as the results have been much more promising in this era due to advances in surgical techniques and immunosuppression regimens.

Lung transplantation no doubt offers better survival but is still unfortunately only 50% at 5 years.

There is somewhat unawareness among the clinicians about lung transplantation. Our primary aim of this review is to aware young clinicians about the possible role of lung transplantation in terminal lung diseases.

Thus, keeping in mind our primary aim, this review provides an overview of lung transplantation in terms of historical background, candidate selection criteria, concept of LAS, methods of bridging to transplantation, single versus bilateral transplantation, post-lung immunosuppression, outcome, and complications.
Registry of cases of pulmonary hypertension in army hospitals
Authors: Elwahab Koraa Emad E.A. , Farghaly Ayman A.E. , Wagih Khaled M. , Ali Eman R. , Abdelrady Marwa M. , Zaki Ahmed M.R.
Published: January 2022

Background

Pulmonary hypertension (PH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation, which results, over time, from extensive vascular remodeling and increased pulmonary vascular resistance. Registries conducted since the National Institutes of Health study have enhanced our understanding of select aspects of pulmonary arterial hypertension (PAH). A network of 17 French university hospitals reported observations from a registry of 674 adults with PAH and described the minimum prevalence and incidence, as well as the clinical and hemodynamic characteristics, of this group.

Objective

To record all the cases of PH in all Egyptian army hospitals in the period between January 2015 and December 2019.

Patients and methods

This study was conducted on 150 patients with PH. They were recruited from the outpatient clinic and Department of Chest at specialized hospitals of Kobry Elkobba Armed Forces, as well as Air Force specialized and international medical center of the armed forces. This study was carried out on all patients diagnosed as having PH, as a retrospective and prospective study, starting from January 2015 till December 2019. The patients were subjected to the diagnostic algorithm of PH suggested by the 2015 European Cardiology Society/European Respiratory Society guidelines for the diagnosis and treatment of PH.

Results

The study was conducted on 150 patients with PH, including group 1 [88 (58.6%) patients], group 2 [16 (10.6%) patients], group 3 [eight (5.3%) patients], group 4 [34 (22.6%) patients], and group 5 [four (2.6%) patients], and there were seven patients of multigroups. The detailed data of different therapies were shown as important numbers. The diuretic therapies were given to 120 patients, 12 patients were on oxygen therapy, calcium channel blockers were only given to the five vasoreactive patients in our study, and 34 patients received oral anticoagulant, whereas specific drugs were given to 93 patients.

Conclusion

This was a preliminary study establishing patient characteristics in Egypt in the form of a registry. The most frequent PH etiologies were PAH and chronic thromboembolic PH, and patients were substantially younger at diagnosis compared with other international cohorts. Most patients with PAH received targeted therapy and showed significant improvement in disease severity (WHO Function Class). One of the most important limitation was the lack of the of the follow-up and survival data of many patients; however, many patients who were in the follow-up programs made a great survival but not to count on it as a result in the registry.
Serum uric acid level as a prognostic factor in sepsis outcome
Authors: El-Shebiny Emad , Daif Shymaa , Shoeib Sabry , Fathi Yasser , Zahran Enas
Published: January 2022

Background

Uric acid (UA) is the final product of metabolism of purine base, with either an antioxidant or a pro-oxidant according to the metabolic state. It was found that UA can give information about outcomes in multiple diseases. Depending on this view, research studies focused on UA to act as a biomarker of seriousness of illness in patients suffering from sepsis.

Objective

This study was targeted to evaluate if serum UA level can reflect the severity of sepsis state in critically ill patients and the prognosis of these patients.

Materials and methods

This prospective study using data extracted from patients of the ward, ICU of Internal Medicine Department and critical care unit from May 2019 to November 2019. The outcome was reported after 28 day from the date of admission to hospital regarding patient’s survival or not. Characteristics of the included patients were: age greater than 18 years, first time to admit to hospital, and patients who were diagnosed to have gout, chronic renal failure, malignancy, and those on diuretics were excluded.

Results

Variable levels of serum UA on admission did not reflect the rate of survival between patients with sepsis according to statistical results. So UA cannot act a predictor for mortality from sepsis.

Conclusion

UA level at the time of hospitalization cannot predict the survival rate of patients with sepsis.
Assessment of noninvasive ventilation in patients with acute severe asthma
Authors: El Shinnawy Olfat M. , Metwally Mohamed , Abdel Aleem Nermeen A. , Eid Walaa M.
Published: January 2022

Background

Despite improvements in asthma medication, intubation is deemed necessary in severe asthma with its complications. Noninvasive ventilation (NIV) is an evolving method to manage acute respiratory failure in those patients. However, the effect of NIV is unclear, and there are debates regarding its safety.

Aims

To evaluate the role of NIV in patients with acute severe asthma and to assess predictors for its use in those patients.

Patients and methods

In a prospective interventional study, 90 patients with acute asthma were divided into two groups: medical one and NIV group. The outcomes were the improvement in forced expiratory volume in the first second, as well as clinical and respiratory parameters.

Results

The respiratory rate showed a significant improvement after 6 h (16.6±3.7 breath/min), and also the heart rate (95.8±11.3 beat/min) and arterial partial pressure of oxygen (88.09±20.2). The time needed to alleviate accessory muscle use was shorter in the NIV group (1.93±0.3 vs. 3.07±0.4 h in the other group). The need for endotracheal intubation and invasive mechanical ventilation was more with group 1. There was no mortality in any group of our study.

Conclusion

NIV group demonstrated clinical improvement regarding the grade of dyspnea and accelerating the time needed for the absence of accessory muscle usage in acute severe asthma. NIV also has a significant benefit in improving oxygenation, lowering the intubation rate, and shortening the length of hospital and ICU stay in comparison with conventional medical therapy.