Proposed Management Algorithm Research Articles

Management of Cerebrospinal Fluid Leakage by Pump-Regulated Volumetric Continuous Lumbar Drainage Following Anterior Cervical Decompression and Fusion for Ossification of the Posterior Longitudinal Ligament.

Cerebrospinal fluid (CSF) leakage is a major concern related to anterior cervical decompression and fusion for ossification of the posterior longitudinal ligament (OPLL). We propose a management algorithm for CSF leakage following anterior cervical decompression and fusion for OPLL involving the use of pump-regulated volumetric continuous lumbar drainage. We retrospectively reviewed patients who underwent anterior cervical decompression and fusion for OPLL and were managed with the proposed algorithm between March 2018 and July 2022. The proposed management algorithm for CSF leakage by pump-regulated volumetric continuous lumbar drainage was as follows. On exposure of the arachnoid membrane with or without CSF leakage, a dural sealant patch was applied to manage the dural defect. In case of persistent CSF leakage despite application of the dural sealant patch, patients underwent pump-regulated volumetric continuous lumbar drainage. Fifty-one patients were included in the study. CSF leakage occurred in 14 patients. Of these 14 patients, 9 patients underwent lumbar drain insertion according to the proposed management algorithm. Successful resolution of CSF leakage was observed in 8 of the 9 patients who underwent lumbar drainage. All patients were encouraged to ambulate without concern of CSF overdrainage due to gravity, because it could be avoided with pump-regulated volumetric continuous CSF drainage. Therefore, complications associated with absolute bed rest or CSF overdrainage were not observed. The proposed management algorithm with pump-regulated volumetric continuous lumbar drainage showed safety and efficacy for management of CSF leakage following anterior decompression and fusion for OPLL.

Clinically significant bleeding complications of percutaneous breast biopsy: 10-year analysis and a proposed management algorithm

PurposeBleeding is a well-known risk of percutaneous breast biopsy, frequently controlled with manual pressure. However, significant bleeding complications may require further evaluation or intervention. Our objectives were to assess the rate, type, and periprocedural management of significant bleeding following percutaneous breast biopsy and to evaluate the success of any interventions. MethodsWe retrospectively reviewed percutaneous breast biopsies at our institution over a 10-year period with documented post-biopsy bleeding complications in radiology reports. Patients were included if bleeding required intervention (interventional radiology [IR], surgery, or other), imaging follow-up, or clinical evaluation for symptoms. Additional data included patient demographics, anticoagulation, history of bleeding diathesis, biopsy details, bleeding symptoms, histopathology, and intervention details, if applicable. ResultsOf 5820 unique patients who underwent percutaneous biopsy, 66 patients (66/5820; 1.1%) comprising 71 biopsy cases met inclusion for clinically significant bleeding with 5/71(7.0%) requiring surgery, 9/71(12.7%) requiring IR intervention, and 57/71(80.3%) requiring lower-acuity intervention including prolonged observation (5/57;7.0%), overnight admission (4/57;5.6%), aspiration (4/57;5.6%), lidocaine and suture (2/57;2.8%), primary care visit (7/57;10.0%), blood transfusion (1/57;1.4%), emergency room visit (6/57;8.5%), surgery consult (8/57;11.3%), IR consult (2/57;2.8%), and follow-up imaging (22/57;31.0%). Most patients requiring intervention by surgery or IR had acute signs of bleeding immediately after biopsy while most patients with delayed signs of bleeding required lower-acuity interventions. ConclusionClinically significant bleeding is extremely rare after percutaneous breast biopsy and is most often managed non-surgically. Developing an institutional algorithm for management of bleeding complications that consults IR before surgery may help decrease the number of patients managed surgically.

Edge assisted, forecast integrated ensemble learning based service management scheme for delay minimization in smart cities applications

As the Internet of Things (IoT) is maturing as a technology, innovative and cross-domain IoT applications have seen smart cities being conceived and designed across the globe, though with data and resource management challenges, Quality of Service (QoS) fulfilment challenges among others. These could also be addressed by means of context-aware fog computing at the edge of the network and also by incorporating intelligence at the network edge. Since workload at fog nodes can anytime see sudden changes in demand, hence load migration among fog nodes becomes viable. However, improper migration can lead to further migrations, eventually decreasing performance. In this paper, we present a multi-channel queuing model based smart distributed service management approach and an intelligent resource-aware forecasting technique to predict the required context and resource management. The scheme accomplishes live migration by a resource-aware ensemble forecast method that used current and predicted resource utilization and their context availabilities to address the delay requirement for cross-domain IoT applications. The proposed management algorithms are simulated using CloudSim simulator and the efficacy of the obtained results confirm the superiority of the proposed methods.

Optimized Power Management Approach for Photovoltaic Systems with Hybrid Battery-Supercapacitor Storage

The paper addresses the ongoing and continuous interest in photovoltaic energy systems (PESs). In this context, the study focuses on an isolated photovoltaic system with hybrid battery-supercapacitor storage (HBSS). The integration of supercapacitors (SCs) in this system is particularly important because of their high specific power density. In photovoltaic (PV) systems, multi-storage systems use two or more energy storage technologies to enhance system performance and flexibility. When batteries and supercapacitors are combined in a PV system, their benefits are maximized and offer a more reliable, efficient, cost-effective energy storage option. In addition, effective multi-storage power management in a PV system needs a solid grasp of the energy storage technologies, load power demand profiles, and the whole system architecture. This work establishes a battery-supercapacitor storage system (HBSS) by combining batteries and supercapacitors. The primary objective is to devise a novel management algorithm that effectively controls the different power sources. The algorithm is designed to manage the charge and discharge cycles of the hybrid battery-supercapacitor energy storage system (HBSS), thereby guaranteeing that the state of charge (SOC) for both batteries and supercapacitors is maintained within the specified range. The proposed management algorithm is designed to be simple, efficient, and light on computational resources. It efficiently handles the energy flow within the HBSS, optimizing the usage of both batteries and supercapacitors based on real-time conditions and energy demands. The proposed method ensures their longevity and maximizes their performance by maintaining the SOC of these energy storage components within the specified limits. Simulation results obtained from applying the management strategy are found to be satisfactory. These results show that the proposed algorithm maintains the SOC of batteries and supercapacitors within the desired range, leading to improved energy management and enhanced system efficiency.

Endoscopic retrograde cholangiopancreatography (ERCP) approach for patients with Roux-en-Y gastric bypass: a comparative study between four ERCP techniques with proposed management algorithm

BackgroundEndoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in patients with Roux-en-Y gastric bypass (RYGB) due to altered anatomy. ObjectiveTo compare the procedural and clinical outcomes of 4 different ERCP techniques in RYGB patients. SettingAcademic tertiary referral center in the United States. MethodsA retrospective cohort study including patients with RYGB anatomy who underwent an ERCP between January 2015 and September 2020. We compared procedural success and adverse events (AEs) rates of balloon-assisted enteroscopy (BAE), gastrostomy-assisted ERCP (GAE), endoscopic ultrasound (EUS)-directed transgastric ERCP (EDGE), and rendezvous guidewire-assisted ERCP (RGA). ResultsSeventy-eight RYGB patients underwent a total of 132 ERCPs. The mean age was 60 ± 11.8 years, with female predominance (85.7%). The ERCP procedures performed were BAE (n = 64; 48.5%), GAE (n = 18; 13.7%), EDGE (n = 25; 18.9%), and RGA (n = 25; 18.9%), with overall procedure success rates of 64.1%, 100%, 89.5%, and 91.7%, respectively. All approaches were superior to BAE (GAE versus BAE, P = .003; EDGE versus BAE, P = .034; RGA versus BAE, P = .011). The overall AE rates were 10.9%, 11.1%, 15.8 %, and 25.0%, respectively. There was no statistical difference in AEs. There were also no differences in bleeding, post-ERCP pancreatitis, and perforation rates between the 4 approaches. ConclusionProcedure success was similar between GAE, RGA, and EDGE, but superior to BAE. AE rates were similar between approaches.

Non-Interventional Management of Advanced Pancreatic Neuroendocrine Neoplasms in Patients with von Hippel-Lindau Disease

Von Hippel-Lindau (VHL) is a rare autosomal dominant hereditary cancer predisposition syndrome. Patients with VHL have a high risk for developing retinal and central nervous system hemangioblastoma, pheochromocytoma, renal cell carcinoma, and pancreatic neuroendocrine neoplasms (PNEN). About a fifth of patients with VHL will develop PNEN, and only a tenth of them will develop metastatic or unresectable (advanced) PNEN requiring medical intervention. In this review, we performed a literature search for studies, written in English, on the medical interventions for VHL-related localized and advanced PNENs and their clinical outcomes. We detail the various medical interventions for this rare group of patients, including their mode of action and potential efficacy and toxicity. Finally, based on the current literature, we delineate a possible management algorithm for patients with VHL and advanced PNEN. We can conclude that data on the efficacy of various vascular endothelial growth factor (VEGF) receptor inhibitors, and on the efficacy of belzutifan, a novel hypoxia-inducible factor 2 inhibitor, for the management of advanced PNEN in VHL, are scarce. Hence, deduction from the management of sporadic PNEN is required, and is implemented in the proposed management algorithm provided within this review.

How We Manage Gastrointestinal Symptoms During Oral Immunotherapy Through a Shared Decision-Making Process—A Practical Guide for the Community Practitioner

Allergists addressing gastrointestinal (GI) symptoms during oral immunotherapy (OIT) may be biased toward diagnoses related to OIT; however, non-OIT causes may occur. Although there is currently a lack of robust data for evidence-based treatment recommendations, we provide 3 real-world illustrative cases along with a proposed management algorithm for GI symptoms encountered during OIT. This algorithm was developed because of a significant clinical need, given the number of new-to-OIT providers that include practicing allergists, trainees transitioning into practice, and allied health care providers who manage GI symptoms in OIT patients. We developed the algorithm based on the opinions of community and academic allergy clinics across Canada with significant clinical experience offering infant, preschool, and school-aged OIT patients, with gastroenterologist input. Further research is needed to fill the knowledge gaps in the management of GI symptoms during OIT before formal recommendations can be suggested.

Oral 24 - Indeterminate Lesions of the Testis: A Systematic Review and Proposed Management Algorithm

Oral 24 - Indeterminate Lesions of the Testis: A Systematic Review and Proposed Management Algorithm

A Review of the Prevention of Mother-to-Child Transmission of Human T-Cell Lymphotrophic Virus Type 1 (HTLV-1) With a Proposed Management Algorithm.

Human T cell lymphotropic virus type 1 (HTLV-1) is a human retrovirus that is endemic in a number of regions across the world. There are an estimated 5–10 million people infected worldwide. Japan is currently the only country with a national antenatal screening programme in place. HTLV-1 is primarily transmitted sexually in adulthood, however it can be transmitted from mother-to-child perinatally. This can occur transplacentally, during the birth process or via breastmilk. If HTLV-1 is transmitted perinatally then the lifetime risk of adult T cell leukemia/lymphoma rises from 5 to 20%, therefore prevention of mother-to-child transmission of HTLV-1 is a public health priority. There are reliable immunological and molecular tests available for HTLV-1 diagnosis during pregnancy and screening should be considered on a country by country basis. Further research on best management is needed particularly for pregnancies in women with high HTLV-1 viral load. A first step would be to establish an international registry of cases and to monitor outcomes for neonates and mothers. We have summarized key risk factors for mother-to-child transmission of HTLV-1 and subsequently propose a pragmatic guideline for management of mothers and infants in pregnancy and the perinatal period to reduce the risk of transmission. This is clinically relevant in order to reduce mother-to-child transmission of HTLV-1 and it's complications.

Exenterate or Not: A Simple Proposed Management Algorithm for Mucormycosis During the Era of COVID-19 in a Tertiary Eye Care Center in Egypt.

PurposeTo construct a simple management algorithm for cases with orbital mucormycosis during the COVID-19 era.MethodsRetrospective study included records of 30 Egyptian patients with post COVID-19 orbital mucormycosis. They underwent full clinical examination, laboratory investigations, Computed tomography (CT)/magnetic resonance imaging (MRI) of the paranasal sinuses and pathological specimen examination. The proposed algorithm was based on all the available data of the included patients.ResultsThe mean age of the studied patients was 62.47±11.13 years; 56.6% were females and 63.3% had uncontrolled diabetes mellitus. The main presentation was Orbital apex syndrome (OAS) in 43.3% of the cases. Twenty-six patients (86.6%) received systemic liposomal amphotericin B, while 4 patients (13.3%) received posaconazole. Orbital exenteration was done in 6 patients (20.0%), 4 of them died (66.7%). Twenty-four patients (80%) survived with clinical but not with visual improvement.ConclusionSystemic antifungal treatment and functional endoscopic sinus surgery (FESS) with extensive debridement of involved necrotic tissues were the main steps to control ROCM. Orbital exenteration should be kept for cases with periorbital tissue affection as it did not increase the final cure rate. The proposed management algorithm is supposed to be simple and easy to follow.

Stochastic energy management for a renewable energy based microgrid considering battery, hydrogen storage, and demand response

This paper presents a stochastic management algorithm to address the optimal operation of smart microgrids (MGs) in the high presence of stochastic renewable energy resources. The proposed management algorithm aims to find a day-ahead optimal operation of the renewable energy resources, including wind turbine, photovoltaic (PV) unit, Fuel Cell (FC), electrolyzer, microturbine, and energy storage that simultaneously considers the participation of the smart homes in demand response programs. The presented stochastic management is formulated as a mixed-integer linear programming (MILP) problem solved through a stochastic programming approach. Two different energy storage devices, i.e., battery and hydrogen storage tank, are modeled, and their operations are compared. Various uncertainties (e.g., wind speed, solar irradiance, demand, and electricity price) are modeled, where the scenario-based approach is applied to find a finite number of scenarios. The efficiency of the presented algorithm is verified in four scenarios to evaluate the effect of hydrogen storage and demand response program. Finally, it is shown that applying both hydrogen storage and demand response program can benefit the MG from the economic perspective and results in a significant reduction in the total cost.

P284 Prophylactic medication for the prevention of endoscopic recurrence after ileocolonic resection in Crohn’s disease: a prospective study based on clinical risk stratification

Abstract Background In patients with Crohn’s disease (CD), postoperative prophylactic medication based on clinical risk stratification is recommended in international guidelines to prevent recurrence after ileocolonic resection (ICR). This study aimed to evaluate the risk of endoscopic recurrence after implementation of a predefined management algorithm after ICR incorporating clinical risk stratification. Methods In this multicenter, prospective clinical cohort study, CD patients (≥16 years) were included who were scheduled for ICR and gave informed consent. Endoscopy-guided treatment (no prophylactic medication directly after ICR) was recommended in patients at low risk (LR) of postoperative recurrence, and prophylactic medication (immunosuppressant/biological) in high risk (HR). HR was defined as ≥1 risk factor: smoking, penetrating disease, re-resection. Clinical and histologic risk factors for endoscopic recurrence (Rutgeerts’ score ≥i2) were assessed using logistic regression models and ROC curves based on predicted probabilities. Results In total 213 CD patients were included (median age 34.5 years, 65.3% women): 93 (43.7%) at LR and 120 (56.3%) at HR (smoking 45 (21.3%); penetrating disease 51 (23.9%); re-resection 51 (23.9%)). Adherence to the proposed management algorithm was 65%; 76/93 (81.7%) in the LR (no prophylaxis) and 61/120 (50.8%) in the HR population (prophylaxis). Endoscopic recurrence in LR patients was 69% without prophylaxis versus 48% with prophylaxis (p=0.070); in HR 78% without prophylaxis versus 55% with prophylaxis (p=0.019). Clinical risk stratification corresponded with an area under the curve (AUC) of 0.64 (95%CI 0.55–0.73) (Figure 1). Clinical factors combined with histology (active inflammation, granulomas, plexitis in resection margins) increased the AUC to 0.69 (95% CI 0.61–0.88) (Figure 1). Conclusion This prophylactic medication algorithm in CD patients based on clinical risk stratification after ICR, results in an absolute risk reduction of endoscopic recurrence of 23% in HR versus 21% increase in LR patients in whom medication is omitted. For this latter population, further refinement of risk stratification is required, and may include histologic assessment.

Chronic kidney disease and anticoagulation - Quick overview and practical guide

Clinicians managing patients with chronic/end-stage renal disease often are challenged when it comes to anticoagulation in this subset. Unfractioned heparin and warfarin have been in use, and most multidisciplinary teams are comfortable with the drug/s either as prophylaxis or for full anticoagulation. Over the past decade, there has been an increase in the use of low-molecular-weight heparin and more recently of direct oral anticoagulants for anticoagulation. However, there is a reluctance to use these drugs for concern of increased bleeding and management of this complication in patients with renal disease. This paper shares a quick overview of coagulation in chronic/end-stage kidney disease and drugs used for anticoagulation, societal recommendations for their use, with clinical case scenarios, and a proposed management algorithm when patients have a bleed while on anticoagulation.

EXPERIENCE OF THE TREATMENT OF PATIENTS WITH ACUTE PANCREATITIS.

The aim: To improve the results of treatment of patients diagnosed with acute pancreatitis. Materials and methods: The materials of the work are based on the clinical examination and treatment of 301 patients with acute pancreatitis, in the treatment of which, along with classical treatment, a therapeutic and diagnostic complex was used, which allows predicting and preventing the development of abdominal compartment syndrome (ACS). Results: Managed to reduce the number of cases of infected pancreatic necrosis, effectively predict and prevent the development of abdominal compartment syndrome (ACS), reduce the average length of stay of patients in the hospital. Conclusions: The use of the proposed management algorithm for patients with acute pancreatitis allows to shorten the treatment period by effectively predicting and preventing the development of pancreatic necrosis, its septic complications and abdominal compartment syndrome.

An Algorithmic Approach to Managing Parotid Duct Injury Following Buccal Fat Pad Removal.

The principles of achieving an aesthetically pleasing and harmonious facial appearance are influenced by our evolving understanding of the three-dimensional topography of the face coupled with novel approaches to midface volumization and contouring. In parallel with the evolving landscape of facial aesthetic surgery, an increasing number of publications have emerged focusing on the role of intraoral buccal fat pad removal (BFPR) for the purposes of aesthetic midface contouring. The authors sought to emphasize an underreported and potentially preventable and untoward complication involving iatrogenic parotid duct injury following BFPR. The purpose of this publication is 3-fold: (1) to review the relevant anatomy and literature on intraoral BFPR, (2) to present a case example of this complication, and (3) to discuss treatment options as part of a proposed management algorithm. The authors detail the surgical indications for performing BFPR and review the relevant anatomic considerations. Complication prevention strategies are outlined, and details regarding avoidance of parotid duct injury are reviewed. The diagnostic criteria and clinical presentation of parotid duct injuries following BFPR are comprehensively outlined. The authors present a clinically actionable algorithm for managing a suspected or diagnosed parotid duct injury following BFPR. A clinical case example is discussed to highlight this complication, the diagnostic criteria, and the systematic and algorithmic approach to management. Intraoral BFPR is an incredibly valuable and powerful procedure that can improve facial contour in patients with buccal lipodystrophy or buccal fat pad pseudoherniation. The authors propose a proper diagnostic approach and treatment algorithm to manage this untoward complication.Level of Evidence: 5

Long-term complications of COVID-19.

SARS-CoV-2 has rapidly spread across the globe and infected hundreds of millions of people worldwide. As our experience with this virus continues to grow, our understanding of both short-term and long-term complications of infection with SARS-CoV-2 continues to grow as well. Just as there is heterogeneity in the acute infectious phase, there is heterogeneity in the long-term complications seen following COVID-19 illness. The purpose of this review article is to present the current literature with regards to the epidemiology, pathophysiology, and proposed management algorithms for the various long-term sequelae that have been observed in each organ system following infection with SARS-CoV-2. We will also consider future directions, with regards to newer variants of the virus and their potential impact on the long-term complications observed.

Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers

Background: Finger epiphyseal growth plate stress injuries are the most frequent sport-specific injuries in adolescent climbers. Definitive diagnostic and therapeutic guidelines are pending. Purpose: To evaluate a diagnostic-therapeutic algorithm for finger epiphyseal growth plate stress injuries in adolescent climbers. Study Design: Case series; Level of evidence, 4. Methods: On the basis of previous work on diagnostics and treatment of finger epiphyseal growth plate stress injuries (EGPIs) in adolescent climbers, we developed a new algorithm for management of these injuries, which was implemented into our clinical work. During a 4-year period, we performed a prospective multicentered analysis of our patients treated according to the algorithm. Climbing-specific background was evaluated (training years, climbing level, training methods, etc); injuries were analyzed (Salter-Harris classification and UIAA MedCom score [Union Internationale des Associations d’Alpinisme]); and treatments and outcomes were recorded: union, time to return to climbing, VAS (visual analog scale), QuickDASH (shortened version of the Disabilities of the Arm, Shoulder, and Hand), and a climbing-specific outcome score. Results: Within the observation period, 27 patients with 37 independent EGPIs of the fingers were recorded (mean ± SD age, 14.7 ± 1.5 years; 19 male, 8 female; 66.7% competitive athletes). Regarding maturity at time of injury, the mean age at injury did not differ by sex. Average UIAA climbing level was 9.5 ± 0.8, with 6 ± 4.6 years of climbing or bouldering and 14 ± 9.1 hours of weekly climbing-specific training volume. Among the 37 injuries there were 7 epiphyseal strains, 2 Salter-Harris I fractures, and 28 Salter-Harris III fractures (UIAA 1, n = 7; UIAA 2, n = 30). Thirty-six injuries developed through repetitive stress, while 1 had an acute onset. Twenty-eight injuries were treated nonoperatively and 9 surgically. Osseous union was achieved in all cases, and there were no recurrences. The time between the start of treatment and the return to sport was 40.1 ± 65.2 days. The climbing-specific outcome score was excellent in 34 patients and good in 3. VAS decreased from 2.3 ± 0.6 to 0.1 ± 0.4 after treatment and QuickDASH from 48.1 ± 7.9 to 28.5 ± 3.3. Conclusion: The proposed management algorithm led to osseous union in all cases. Effective treatment of EGPIs of the fingers may include nonsurgical or surgical intervention, depending on the time course and severity of the injury. Further awareness of EGPI is important to help prevent these injuries in the future.

CAR T-cell therapy and critical care

Chimeric antigen receptor (CAR) T‑cells are genetically engineered to give T‑cells the ability to attack specific cancer cells, and to improve outcome of patients with refractory/relapsed aggressive B‑cell malignancies. To date, several CAR T‑cell products are approved and additional products with similar indication or extended to other malignancies are currently being evaluated. Side effects of CAR T‑cell treatment are potentially severe or even life-threatening immune-related toxicities, specifically cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Consequently, medical emergency teams (MET) are increasingly involved in the assessment and management of CAR T‑cell recipients. This article describes the principles of CAR T‑cell therapy and summarizes the main complications and subsequent therapeutic interventions aiming to provide a survival guide for METs with a proposed management algorithm.

Predictive Management Algorithm for Controlling PV-Battery Off-Grid Energy System.

This paper introduces an energy management strategy for an off-grid hybrid energy system. The hybrid system consists of a photovoltaic (PV) module, a LiFePO4 battery pack coupled with a Battery Management System (BMS), a hybrid solar inverter, and a load management control unit. A Long Short-Term Memory network (LSTM)-based forecasting strategy is implemented to predict the available PV and battery power. The learning data are extracted from an African country with a tropical climate, which is very suitable for PV power applications. Using LSTM as a prediction method significantly increases the efficiency of the forecasting. The main objective of the proposed strategy is to control the different loads according to the forecasted energy availability of the system and the forecasted battery state of charge (SOC). The proposed management algorithm and the system are tested using Matlab/Simulink software. A comparative study demonstrates that the reduction in the energy deficit of the system is approximately 53% compared to the system without load management. In addition to this, the reliability of the system is improved as the loss of power supply probability (LPSP) decreases from 5% to 3%.

Fuzzy Logic Energy Management between Stand-alone PV Systems

Because of its environmental benefits, PV technology is widely used in several applications. It presents an alternative solution for isolated sites that does not dispose a grid connection. However, it has drawbacks, its intermittent character, due to its dependency on meteorological parameters such as the outside temperature and solar irradiation. The produced energy can be more or less than the load requirement. This paper presents an intelligent strategy management between photovoltaic station owners. It can be involved as follow between two customers: the photovoltaic installation production of the first customer is higher than its load requirement; however, the neighboring station has a lack of energy to cover its load. In this case, it brings energy from station 1 to cover the insufficiency and vice versa. The batteries intervene neither, if the required energy cannot be provided by the local and the neighbored stations, nor, to store the excess power. The dual standalone photovoltaic system was created using MATLAB Simulink environment. The proposed management algorithm is based on FLC. The Mamdani is one of the widely known fuzzy inference system. It ensures continuous energy delivery to the load while minimizing wasted power. The outcomes of the simulation demonstrate the previously mentioned controller effectiveness between standalone PV systems.