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Cost saving by reloading the multiband ligator in endoscopic esophageal variceal ligation: A proposal for developing countries

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World Journal of Gastroenterology 2008年第14期14卷 2222-2225页

作者： Zaigham Abbas Lubna Rizvi Umair Syed Ahmed Khalid Mumtaz Wasim Jafri Department of Medicine The Aga Khan University Hospital Karachi 74800 Pakistan

AIM:To assess the cost savings of reloading the multiband ligator in endoscopic esophageal variceal ligation (EVL) used on the same patient for subsequent sessions. METHODS:This single centre retrospective descriptive study analysed patients undergoing variceal ligation at a tertiary care centre between 1st January, 2003 and 30th June, 2006. The multiband ligator was reloaded with six hemorrhoidal bands using hemorrhoidal ligator for the second and subsequent sessions. Analysis of cost saving was done for the number of follow-up sessions for the variceal eradication. RESULTS:A total of 261 patients underwent at least one session of endoscopic esophageal variceal ligation between January 2003 and June 2006. Out of 261, 108 patients (males 67) agreed to follow the eradication program and underwent repeated sessions. A total of 304 sessions was performed with 2.81 sessions per patient on average. Thirty-two patients could not complete the programm. In 76 patients (70%), variceal obliteration was achieved. The ratio of the costs for the session with reloaded ligator versus a session with a new ligator was 1:2.37. Among the patients who completed esophageal varices eradication, cost saving with reloaded ligator was 58%. CONCLUSION:EVL using reloaded multiband ligators for the follow-up sessions on patients undergoing variceal eradication is a cost saving procedure. reloading the ligator thus is recommended especially for developing countries where most of the patients are not health insured.

关键词： Esophageal varices reloading Multiband ligator Eradication Cost saving

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Analysis of Structural State of 60/40 Brass Cartridge Case (BCC) after Being Exposed to High Pressure and Temperature of Firing

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Open Journal of Applied Sciences 2019年第9期9卷 710-724页

作者： Abdalla Saif Eldin Mohammed Giad Group Khartoum Sudan

This research presents an experimental and analytical study of the structural state of the 60/40 brass cartridge case, (BCC) after being fired. The oral section of the BCC has the function of confining the gases of firing by expanding against the chamber and sealing the gases. Firing conditions, namely, high pressure and temperature, 3000 bar and 2727°C, respectively, affect performance properties of the (BCC). These are confining and crack strengths. Experimental study was done on the oral section to address these effects on the structural and mechanical properties of this brass. This alloy is a 60% copper (Cu) and 40% zinc (Zn) alloy and has a two-phase structure, alpha, (α) and beta, (β). Using “before and after” comparison approach;performance properties were tested in cartridge cases prepared before and after firing. These properties are hardness, tensile strength, micro-structural and chemical composition. Comparing the tests’ results, after firing demonstrated considerable degrading in performance properties, micro-structural disorder and a remarkable deficiency in the zinc element in the brass structure. This deficiency affects the percentage of beta phase in the alloy which governs the strength of the brass. According to the required properties before firing, it was found that after firing, the brass cartridge case is not qualified for reloading.

关键词： Structural State Brass Cartridge Case (BCC) Deficiency of Zinc reloading

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