Rohit Singh

CH11B088

1.)
Fecal Incontinence (FI) is a ubiquitous condition in care facilities worldwide. Despite advances in
stool management, FI still remains a challenge for patients and care providers alike.
Traditional management of FI includes absorbent pads and inflatable drainage catheters.
Though inexpensive, these methods are time consuming and labor intensive. More importantly,
these management options manifest costly complications, such as incontinence associated
dermatitis (IAD), facility acquired pressure ulcers (FAPU), and nosocomial infections.
Mismanaged FI can lead to an increased length of stay (4-11 days) and up to $40,000 in
avoidable healthcare expenditure.
Consure developed an internal catheter that was almost like a short-term implant that could be
inserted and managed by a family member after one or two observations in the hospital
.Consures device offered numerous advantages over existing FI solutions. The device
is odor-proof, leak proof, and can contain stool regardless of consistency. It also has a slick
insertion mechanism that is easier on the caregiver and helps preserve the dignity of the
patient. Additionally, the Consure device was the first solution for FI that diverted fecal material
without interrupting the normal physiological functioning of the body. Existing indwelling
solutions force the rectum to remain open, which is not its natural position. Given the various
medications patients with FI can be on, it is difficult to know whether the stool will be liquid or
formed, and this creates anxiety in terms of how to best care for the family member. The only
solutions currently available that could manage both liquid and formed stool were absorbent
pads, so Consure initially concentrated on a next-generation diaper with multiple layers that
could help maintain cleanliness and minimize contact with moisture or other skin irritants.
Consure also spent time reviewing available catheter/collection bag solutions. In doing
so, they grew convinced that the latter type of treatment could offer superior benefits to
patients and caregivers alike if Consure could come up with a better design.
In addition to being limited to use for liquid or semi-liquid stool, the other challenge with
existing indwelling catheters was that they had to be inserted and supervised by medical
professionals. In medical facilities, one of the earliest issues that the team observed was the
reluctance of doctors to participate in managing FI. There are certain diseases or health
situations where that doctor does not want to be involved, and fecal incontinence is one of
them. So the doctor delegates or avoids the condition, and the nurse takes on that
responsibility. While the patient was hospitalized, if an indwelling catheter was called for, it was

the nurse who had to manually insert it into the rectum. And this is a significant pain pointits
unpleasant and the nurses dislike doing it. So Consure set out to solve that as well, by designing
an insertion device that would allow the device to be placed in a clean, hygienic manner. As
team further considered the needs of its target audience, they realized that, at least in this
particular case, cost was not the primary concern. So coming up with a cheaper solution was
not as important as creating a better solution for the patient that was more effective and easier
to use. By eliminating the need for imaging, the pre insertion exam, and the need for a nurse to
insert the device, Consure could build a solution that could not only be implemented by a
family member, but was well-suited to cost- and resource-constrained settings such as
community hospitals or psychiatric care facilities in smaller cities. Ideally, the device would also
mitigate the discomfort of the patients, who see FI care as a humiliating invasion of their
privacy.
The core technology resulted in the development of device which was:
SAFE

Indwelling component designed to avoid mucosal erythema or necrosis.

Positioning of indwelling component prevents sphincter injuries.

Unique collapsing mechanism avoids trauma during device removal.

HYGIENIC

Applicator minimizes exposure and cross contamination to effluents during insertion.

Proprietary lattice technology seals to rectal wall and diverts fecal exudate without

leakage.

Discreet odor proof bags with integrated unidirectional valve prevent accidental soiling.
SIMPLE

Intuitive 3-step procedure requires minimal training for use.

Built-in sampling, irrigation, and fluid delivery ports allow for easy and accessible clinical

care.

Low device maintenance significantly reduces nursing time compared to traditional

methods.

3.)
The bones in your fingers are called phalanges. Each finger has three phalanges, except the
thumb, which has two phalanges. A broken, or fractured, finger occurs when one or more of
these bones breaks. Fingers have the highest risk of injury of all the parts of the hand.
The shear strength of a typical bone is 65-71 MPa. I'll assume that finger bone isn't too much
different. So let's say P = 70 MPa.
If a finger bone was assumed to be circular , it's radius would be a approximately 1/4 cm .
So, F = P * ( r2 )
= 70 x 106 * (0.0025)^2 N
= 1400 N
= 140 kg (weight)
So according to my method, which is undoubtedly oversimplifies everything , the force required
to break should be around 1400 N.
This can be achieved when your finger gets hit by a rapid moving body ( like while catching a
ball).

4.)
Mechanism of flatulence
Sensory nerve endings present in the rectum and anal canal can detect pressure exerted by the
bulk of a stool. As this pressure mounts, a person feels the urgency to pass the stool. The flatus
that gathers in the lower intestine and colon also exerts pressure and triggers a need to pass
wind.
Flatulence often makes a sound, as the flatus passes through the tight anal sphincter. The
speed the gas is passed at, the tightness of the sphincter and other factors such as water and
body fat content, determine the type and pitch of the sound.
Flatulence can occur accidentally when pressure within the abdomen is suddenly raised due to
coughing, sneezing, sexual intercourse or laughing.

Mechanism of eructation ( belching )

Belching is the audible escape of air from the esophagus into the pharynx. The medical term for
belching is eructation. There are 2 types of belches: the gastric belch and supragastric belch.
Gastric belching is the escape of swallowed intragastric air that enters the esophagus during a
transient lower-esophageal sphincter relaxation (TLESR). TLESRs are triggered by distention of
the proximal stomach and allow venting of air from the stomach, thereby serving as a gastric
decompression mechanism and preventing passage of large volumes of gas through the pylorus
into the intestines. TLESRs therefore sometimes are referred to as the belch reflex. Once in the
esophagus, esophageal distention caused by the refluxed air initiates reflexogenic relaxation of
the upper-esophageal sphincter (UES) through which the air can escape the esophagus. Gastric
belches occur 25 to 30 times per day and are physiological. Gastric belches are involuntary and
are controlled entirely by reflexes.
In supragastric belches the air does not originate from the stomach but is ingested immediately
before it is expelled again. Supragastric belches are not a reflex but instead are the result of
human behavior. Studies with simultaneous impedance monitoring and high-resolution
manometry reveal the underlying mechanism of this behavior. A contraction of the diaphragm
creates a negative pressure in the thoracic cavity and the esophagus, subsequent relaxation of
the UES, resulting in inflow of air into the esophagus .The air thus is suctioned into the
esophagus where it is expelled again immediately in a pharyngeal direction using straining. A
minority of subjects that express supragastric belching use a different technique. They inject air
into the esophagus by a simultaneous contraction of the muscles of the base of the tongue and
the pharynx. The subsequent expulsion of air out of the esophagus in retrograde direction is
induced by straining and goes through a similar mechanism as in patients who apply suction to
move the air into the esophagus.

5. To Choose from Nylon, Polypropylene, Polyether Block Amide, Polyvinyl Chloride and
Polytetrafluoroethylene
Ill probably choose the following :
a.) Polyether Block Amide :
Characteristic properties are its flexibility, its good mechanical properties at low and high
temperatures, and its softness.
b.) Polytetrafluoroethylene ( Teflon ): PTFE should especially be used . It can be used for long
term monitoring of a catheter (for more than 48 hours), because its used biocompatible Teflon
materials help avoid deposition of any kind of blood ingredient, such as fibrin, erythrocytes,
and leucocytes.