Search results for: Bile Mohamed
1654 Evaluation of Surgical Site Infection in Bile Spillage Cases Compared to Non Bile Spillage Cases Following Laparoscopic Cholecystectomy
Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai
Abstract:
Bile spillage occurs frequently during laparoscopic cholecystectomy yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact, might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visits, with subsequent readmission and additional procedures. While some authors found no increase in SSI following bile spillage (BS) compared to non-bile spillage cases, others found bile spillage to be associated with SSI. Therefore we sought to examine whether bile spillage is indeed associated with an increased risk of postoperative wound infections after laparoscopic cholecystectomy. I hypothesize that patients who experience BS during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing Laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per CDC-defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non-bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and was absent in the rest i.e.92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in nonbile spillage cases, SSI was found in 8 cases (8.7%). However, it was statistically not significant (p-value>0.05). Eleven (92%) cases were superficial SSI and one was an organ-space infection. No mortality or 30-day readmission. Spillage of Gallbladder content does not lead to an increase in SSIs. However as the rate of SSI is still higher, Surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage thorough peritoneal irrigation with normal saline should be done.Keywords: organ space infection, Laparoscopic cholecystectomy, biliary spillage, surgical site infection
Procedia PDF Downloads 761653 Bile Salt Induced Microstructural Changes of Gemini Surfactant Micelles
Authors: Vijaykumar Patel, P. Bahadur
Abstract:
Microstructural evolution of a cationic gemini surfactant 12-4-12 micelles in the presence of bile salts has been investigated using different techniques. A negative value of interaction parameter evaluated from surface tension measurements is a signature of strong synergistic interaction between oppositely charged surfactants. Both the bile salts compete with each other in inducing the micellar transition of 12-4-12 micelles depending on their hydrophobicity. Viscosity measurements disclose that loading of bile salts induces morphological changes in 12-4-12 micelles; sodium deoxycholate is more efficient in altering the aggregation behaviour of 12-4-12 micelles compared to sodium cholate and presents pronounced increase in viscosity and micellar growth which is suppressed at elevated temperatures. A remarkable growth of 12-4-12 micelles in the presence of sodium deoxycholate at low pH has been ascribed to the solubilization of bile acids formed in acidic medium. Small angle neutron scattering experiments provided size and shape of 12-4-12/bile salt mixed micelles are explicated on the basis of hydrophobicity of bile salts. The location of bile salts in micelle was determined from nuclear overhauser effect spectroscopy. The present study characterizes 12-4-12 gemini-bile salt mixed systems which significantly enriches our knowledge, and such a structural transition provides an opportunity to use these bioamphiphiles as delivery vehicles and in some pharmaceutical formulations.Keywords: gemini surfactants, bile salts, SANS (small angle neutron scattering), NOESY (nuclear overhauser effect spectroscopy)
Procedia PDF Downloads 1491652 Effect of Nicorandil in Bile Duct Ligation-Induced Liver Fibrosis in Rats: Role of Hepatic Stellate Cells
Authors: Y. S. Mohamed, L. A. Ahmed, H. A. Salem, A. M. Agha
Abstract:
Liver Fibrosis is one of the most serious conditions that affect the Egyptian society. In the present study, the effect of nicorandil was investigated in experimentally-induced liver fibrosis by bile duct ligation in rats. Nicorandil (3mg/kg/day) was given orally 24 h after bile duct ligation for 14 days till the end of the experiment. Nicorandil group showed a significant improvement in liver function tests (ALT and ALP) as well as a significant decrease in oxidative stress biomarkers (TBARS and GSH), area of fibrosis and activity of hepatic stellate cells as indicated by decreased expression of alpha smooth muscle actin.Moreover, nicorandil treatment decreased HSCs proliferation due to its inhibitory effects on protein kinase C(PKC) and Platelet derived growth factor (PDGF) . Oral administration of either glibenclamide (10 mg/kg/day)(a KATP channel blocker) or L-NAME (30 mg/kg/day) (an inhibitor of nitric oxide synthase) blocked the protective effects of nicorandil. However, nicorandil and L-NAME treated group showed more or less results similar to that of untreated bile duct ligated group. In conclusion, nicorandil was effective against the development of bile duct ligated-induced liver fibrosis in rats where activation of the NO pathway plays an important role in the protective effect nicorandil.Keywords: hepatic stellate cells, nicorandil, nitric oxide donor, liver fibrosis
Procedia PDF Downloads 6101651 Some Probiotic Traits of Lactobacillus Strains Isolated from Pollen
Authors: Hani Belhadj, Daoud Harzallah, Seddik Khennouf, Saliha Dahamna, Mouloud Ghadbane
Abstract:
In this study, Lactobacillus strains isolated from pollen were identified by means of phenotypic and genotypic methods, At pH 2, most strains proved to be acid resistants, with losses in cell viability ranging from 0.77 to 4.04 Log orders. In addition, at pH 3 all strains could grew and resist the acidic conditions, with losses in cell viability ranging from 0.40 to 3.61 Log orders. It seems that, 0.3% and 0.5% of bile salts does not affect greatly the survival of most strains, excluding Lactobacillus sp. BH1398. Survival ranged from 81.0±3.5 to 93.5±3.9%. In contrast, in the presence of 1.0% bile salts, survival of five strains was decreased by more than 50%. Lactobacillus fermentum BH1509 was considered the most tolerant strain (77.5% for 1% bile) followed by Lactobacillus plantarum BH1541 (59.9% for 1% bile). Furthermore, all strains were resistant to colistine, clindamycine, chloramphenicol, and ciprofloxacine, but most of the strains were susceptible to Peniciline, Oxacillin, Oxytetracyclin, and Amoxicillin. Functionally interesting Lactobacillus isolates may be used in the future as probiotic cultures for manufacturing fermented foods and as bioactive delivery systems.Keywords: probiotics, lactobacillus, pollen, bile, acid tolerance
Procedia PDF Downloads 4191650 Duplicated Common Bile Duct: A Recipe for Injury
Authors: David Armany, Matthew Allaway, Preet Gosal, Senarath Edirimanne
Abstract:
A potentially devastating complication of routine laparoscopic cholecystectomy includes iatrogenic bile duct injuries, which represent a stable incidence rate of 0.3% over the past three decades. Whilst related to several relative risks such as surgeon experience and patient factors (older age, male sex), misinterpretation of biliary tree anatomy remains the most common cause, accounting for 80% of iatrogenic Common Bile Duct injuries. Whilst extremely rare, a duplicate common bile duct anomaly remains a potential variation to encounter during biliary surgery, with 30 recognised cases in the worldwide literature, of which type Vb accounts for 4. We report the case of a rare type Vb variation encountered during intra-operative laparoscopic cholecystectomy and confirmed on cholangiogram. To our knowledge, this is the first documented Type Vb case encountered in an Australian population. Given these anomalies are asymptomatic and can perpetuate iatrogenic common bile duct injuries, awareness of all subtypes is crucial. Irrevocably, preoperative Magnetic Resonance Cholangiopancreatography can help recognise these anomalies before the operating theatre; however, their widespread adoption is limited by expensive and availability.Keywords: duplicated common bile duct, type Vb, cholecystitis, MRCP, cholangiogram, iatrogenic CBD
Procedia PDF Downloads 881649 Survival of Four Probiotic Strains in Acid, Bile Salt and After Spray Drying
Authors: Rawichar Chaipojjana, Suttipong Phosuksirikul, Arunsri Leejeerajumnean
Abstract:
The objective of the study was to select the survival of probiotic strains when exposed to acidic and bile salts condition. Four probiotic strains (Lactobacillus casei subsp. rhamnosus TISTR 047, Lactobacillus casei TISTR 1500, Lactobacillus acidophilus TISTR 1338 and Lactobacillus plantarum TISTR 1465) were cultured in MRS broth and incubated at 35ºC for 15 hours before being inoculated into acidic condition (5 M HCl, pH 2) for 2 hours and bile salt (0.3%, pH 5.8) for 8 hour. The survived probiotics were counted in MRS agar. Among four stains, Lactobacillus casei subsp. rhamnosus TISTR 047 was the highest tolerance specie. Lactobacillus casei subsp. rhamnosus TISTR 047 reduced 6.74±0.07 log CFU/ml after growing in acid and 5.52±0.05 log CFU/ml after growing in bile salt. Then, double emulsion of microorganisms was chosen to encapsulate before spray drying. Spray drying was done with the inlet temperature 170ºC and outlet temperature 80ºC. The results showed that the survival of encapsulated Lactobacillus casei subsp. rhamnosus TISTR 047 after spray drying decreased from 9.63 ± 0.32 to 8.31 ± 0.11 log CFU/ml comparing with non-encapsulated, 9.63 ± 0.32 to 4.06 ± 0.08 log CFU/ml. Therefore, Lactobacillus casei subsp. rhamnosus TISTR 047 would be able to survive in gastrointestinal and spray drying condition.Keywords: probiotic, acid, bile salt, spray drying
Procedia PDF Downloads 3551648 Cholesterol-Lowering Effects of Lactobacillus plantarum Isolated from Northeastern Thai Fermented Vegetable Brassica juncea (L.)
Authors: T. Warinpramote, J. Sanguanjeen, P. Pholphakwaen, S. Kittisorayut, J. Kerdtubtim, S. Palachote, M. Taweechotipatr
Abstract:
Cholesterol is a type of lipid molecule which is the significant risk factor for coronary heart disease. Currently, there are many cholesterol-lowering alternative treatments especially bile salt hydrolase positive lactobacilli. BSH can cleave the peptide linkage of bile salt, which results in removal of the amino acid group from the steroid core and increases production of the new bile acid by using more cholesterol. The purpose of this study was to isolate, and screen probiotic characteristics of lactobacilli from fermented Thai foods and further investigated for their comparative BSH activity. The result showed that 2 of 81 Lactobacillus strains, JPK2-2 and JPK3-2, isolated from Brassica juncea (L.) had significantly exhibited high BSH activity. In addition, these Lactobacillus strains showed their results that the ability to tolerate acid and bile salt. Furthermore, the using of 16S rDNA sequencing for definitive microbial identifications showed that these 2 strains belong to Lactobacillus plantarum. In the future, the L. plantarum with BSH activity strains JPK2-2 and JPK3-2 may be the candidate probiotics for application in functional foods and dairy products to improve in the patient with cardiovascular diseases.Keywords: Lactobacillus plantarum, probiotics, bile salt hydrolase, cholesterol-lowering, fermented Thai food
Procedia PDF Downloads 1551647 Effects of Bile Acids and Lipase Supplementation in Low-Energy Diets on Growth Performance and Meat Quality in Broiler Chickens
Authors: Muhammad Adeel Arshad, Shaukat Ali Bhatti
Abstract:
The study aimed to investigate the effect of bile acids and lipase supplementation in low-energy diets on growth performance and meat quality of broilers. Seven hundred day-old Cobb-500 broiler chicks with an average initial body weight of 45.9 ± 0.3 g were assigned to 5 dietary treatments, with five replications of 28 birds each in a completely randomized design. The five treatments were as follows: (i) HE: broilers received a diet with high energy content; (ii) LE: broilers received a diet with low energy content and energy content reduced by 100 kcal/kg as compared to HE; (iii) LEB: broilers received a diet similar to the LE group supplemented with 300 g/ton bile acids; (iv) LEL: broilers received a diet similar to the LE group supplemented with 180 g/ton lipase enzyme and (v) LEBL: broilers received a diet similar to the LE group supplemented with both 300 g/ton bile acids and 180 g/ton lipase enzyme. The experimental period lasted for 35 days. Broilers fed HE had a lower (P < 0.05) body weight (BW) gain and lower feed intake (1-35 d), but during finisher period (21-35 d), BW gain was similar with other treatments. Feed conversion ratio (FCR) was lower in HE and higher in LEBL group (P < 0.05), while the LE, LEB, and LEL had intermediate values. At 35 d no difference occurred between treatment for water holding capacity and pH of breast and thigh muscles (P > 0.05). The relative weight of pancreas was higher (P < 0.05) in LEB treatment but lower (P < 0.05) in LEL treatment. In conclusion, bile acids and lipase supplementation at 300 g/ton and 150g/ton of feed in low-energy diets respectively had no effect on broiler performance and meat quality. However, FCR was improved in HE treatment.Keywords: bile acids, energy, enzyme, growth
Procedia PDF Downloads 1171646 Antidiabetic Evaluation of Pig (Sus scrofa) Bile on Alloxan-Induced BALB/c Mice
Authors: John Lyndon C. Lunnay
Abstract:
This study discerns to evaluate the antidiabetic efficacy of pig bile on alloxan-induced BALB/c mice. The experimental animals were divided and selected using RCBD into 5 groups (n= 4): T1 (negative control), T2 (1ml/kg), T3 (2ml/kg), T4 (3ml/kg) and T5 (Glibenclamide). Hyperglycemia was induced by injecting 1% alloxan monohydrate intraperitoneally. A glucose tolerance test was performed using a 2g/kg glucose solution, and blood glucose levels were measured at different time intervals. 14 days of monitoring was also done to ensure effectivity and efficacy of the different treatments. Bodyweight was also determined. Results show that administration of treatments on test animals significantly reverted the blood glucose levels of mice in 60 minutes and 120 minutes using an oral glucose tolerance test. After 14 days of monitoring, normal blood glucose levels were seen significantly on T2 (1ml/kg), T3 (2ml/kg), T4 (3ml/kg), and T5 (Glibenclamide), which only suggests the efficacy of pig bile on lowering glucose levels on alloxan-induced diabetic mice. Bodyweight analysis shows no significant difference. Duncan’s multiple range test (DMRT) shows comparable efficacy and effectivity between T4 (3ml/kg) and T5 (Glibenclamide) on lowering BGL at different day and time intervals.Keywords: pig bile, BALB/c mice, blood glucose, Gllibenclamide
Procedia PDF Downloads 1461645 Fibrin Glue Reinforcement of Choledochotomy Closure Suture Line for Prevention of Bile Leak in Patients Undergoing Laparoscopic Common Bile Duct Exploration with Primary Closure: A Pilot Study
Authors: Rahul Jain, Jagdish Chander, Anish Gupta
Abstract:
Introduction: Laparoscopic common bile duct exploration (LCBDE) allows cholecystectomy and the removal of common bile duct (CBD) stones to be performed during the same sitting, thereby decreasing hospital stay. CBD exploration through choledochotomy can be closed primarily with an absorbable suture material, but can lead to biliary leakage postoperatively. In this study we tried to find a solution to further lower the incidence of bile leakage by using fibrin glue to reinforce the sutures put on choledochotomy suture line. It has haemostatic and sealing action, through strengthening the last step of the physiological coagulation and biostimulation, which favours the formation of new tissue matrix. Methodology: This study was conducted at a tertiary care teaching hospital in New Delhi, India, from 2011 to 2013. 20 patients with CBD stones documented on MRCP with CBD diameter of 9 mm or more were included in this study. Patients were randomized into two groups namely Group A in which choledochotomy was closed with polyglactin 4-0 suture and suture line reinforced with fibrin glue, and Group ‘B’ in which choledochotomy was closed with polyglactin 4-0 suture alone. Both the groups were evaluated and compared on clinical parameters such as operative time, drain content, drain output, no. of days drain was required, blood loss & transfusion requirements, length of postoperative hospital stay and conversion to open surgery. Results: The operative time for Group A ranged from 60 to 210 min (mean 131.50 min) and Group B 65 to 300 min (mean 140 minutes). The blood loss in group A ranged from 10 to 120 ml (mean 51.50 ml), in group B it ranged from 10 to 200 ml (mean 53.50 ml). In Group A, there was no case of bile leak but there was bile leak in 2 cases in Group B, minimum 0 and maximum 900 ml with a mean of 97 ml and p value of 0.147 with no statistically significant difference in bile leak in test and control groups. The minimum and maximum serous drainage in Group A was nil & 80 ml (mean 11 ml) and in Group B was nil & 270 ml (mean 72.50 ml). The p value came as 0.028 which is statistically significant. Thus serous leakage in Group A was significantly less than in Group B. The drains in Group A were removed from 2 to 4 days (mean: 3 days) while in Group B from 2 to 9 days (mean: 3.9 days). The patients in Group A stayed in hospital post operatively from 3 to 8 days (mean: 5.30) while in Group B it ranged from 3 to 10 days with a mean of 5 days. Conclusion: Fibrin glue application on CBD decreases bile leakage but in statistically insignificant manner. Fibrin glue application on CBD can significantly decrease post operative serous drainage after LCBDE. Fibrin glue application on CBD is safe and easy technique without any significant adverse effects and can help less experienced surgeons performing LCBDE.Keywords: bile leak, fibrin glue, LCBDE, serous leak
Procedia PDF Downloads 2141644 The Role of Glyceryl Trinitrate (GTN) in 99mTc-HIDA with Morphine Provocation Scan for the Investigation of Type III Sphincter of Oddi Dysfunction (SOD)
Authors: Ibrahim M Hassan, Lorna Que, Michael Rutland
Abstract:
Type I SOD is usually diagnosed by anatomical imaging such as ultrasound, CT and MRCP. However, the types II and III SOD yield negative results despite the presence of significant symptoms. In particular, the type III is difficult to diagnose due to the absence of significant biochemical or anatomical abnormalities. Nuclear Medicine can aid in this diagnostic dilemma by demonstrating functional changes in the bile flow. Low dose Morphine (0.04mg/Kg) stimulates the tone of the sphincter of Oddi (SO) and its usefulness has been shown in diagnosing SOD by causing a delay in bile flow when compared to a non morphine provoked - baseline scan. This work expands on that process by using sublingual GTN at 60 minutes post tracer and morphine injection to relax the SO and induce an improvement in bile outflow, and in some cases show immediate relief of morphine induced abdominal pain. The criteria for positive SOD are as follows: if during the first hour of the morphine provocation showed (1) delayed intrahepatic biliary ducts tracer accumulation; plus (2) delayed appearance but persistent retention of activity in the common bile duct, and (3) delayed bile flow into the duodenum. In addition, patients who required GTN within the first hour to relieve abdominal pain were regarded as highly supportive of the diagnosis. Retrospective analysis of 85 patients (pts) (78F and 6M) referred for suspected SOD (type III) who had been intensively investigated because of recurrent right upper quadrant or abdominal pain post cholecystectomy. 99mTc-HIDA scan with morphine-provocation is performed followed by GTN at 60 minutes post tracer injection and a further thirty minutes of dynamic imaging are acquired. 30 pts were negative. 55 pts were regarded as positive for SOD and 38/55 (60%) of these patients with an abnormal result were further evaluated with a baseline 99mTc-HIDA. As expected, all 38 pts showed better bile flow characteristics than during the morphine provocation. 20/55 (36%) patients were treated by ERCP sphincterotomy and the rest were managed conservatively by medical therapy. In all cases regarded as positive for SOD, the sublingual GTN at 60 minutes showed immediate improvement in bile flow. 11/55(20%) who developed severe post-morphine abdominal pain were relieved by GTN almost instantaneously. We propose that GTN is a useful agent in the diagnosis of SOD when performing 99mTc-HIDA scan and that the satisfactory response to the sublingual GTN could offer additional information in patients who have severe pain at the time the procedure or when presenting to the emergency unit because of biliary pain. And also in determining whether a trial of medical therapy may be used before considering surgery.Keywords: GTN, HIDA, MORPHINE, SOD
Procedia PDF Downloads 3031643 Isolation and Identification of Probiotic Lactic Acid Bacteria with Cholesterol Lowering Potential and Their Use in Fermented Milk Product
Authors: Preeyarach Whisetkhan, Malai Taweechotipatr, Ulisa Pachekrepapol
Abstract:
Elevated level of blood cholesterol or hypercholesterolemia may lead to atherosclerosis and poses a major risk for cardiovascular diseases. Probiotics play a crucial role in human health, and probiotic bacteria that possesses bile salt hydrolase (BSH) activity can be used to lower cholesterol level of the host. The aim of this study was to investigate whether lactic acid bacteria (LAB) isolated from traditional Thai fermented foods were able to exhibit bile salt hydrolase activity and their use in fermented milk. A total of 28 isolates were tested for BSH activity by plate method on MRS agar supplemented with 0.5% sodium salt of taurodeoxycholic acid and incubated at 37°C for 48 h under anaerobic condition. The results showed that FN1-1 and FN23-3 isolates possessed strong BSH activity. FN1-1 and FN23-3 isolates were then identified for phenotype, biochemical characteristics, and genotype (16S rRNA sequencing). FN1-1 isolate showed 99.92% similarity to Lactobacillus pentosus DSM 20314(T), while FN23-3 isolate showed 99.94% similarity to Enterococcus faecium CGMCC1.2136 (T). Lactobacillus pentosus FN1-1 and Enterococcus faecium FN23-3 were tolerant of pH 3-4 and 0.3 and 0.8% bile. Bacterial count and pH of milk fermented with Lactobacillus pentosus FN1-1 at 37°C and 43°C were investigated. The results revealed that Lactobacillus pentosus FN1-1 was able to grow in milk, which led to decrease in pH level. Fermentation at 37°C resulted in faster growth rate than at 43 °C. Lactobacillus pentosus FN1-1 was a candidate probiotic to be used in fermented milk products to reduce the risk of high-cholesterol diseases.Keywords: probiotics, lactic acid bacteria, bile salt hydrolase, cholesterol
Procedia PDF Downloads 1481642 Cost-Effectiveness of Laparoscopic Common Bile Duct Exploration vs. Endoscopic Retrograde Cholangiopancreatography in the Emergency Management of Common Bile Duct Stones
Authors: Tess Howard, Lily Owens, Maneesha De Silva, Russell Hodgson
Abstract:
Purpose: This study aims to evaluate the cost-effectiveness of laparoscopic common bile duct exploration (CBDE) compared to endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy for the emergency management of common bile duct (CBD) stones. Methodology: A retrospective case note review was conducted on consecutive patients undergoing emergency management of CBD stones using either CBDE, or ERCP and cholecystectomy at a single centre between January 2014-October 2014. Data on admission and procedural costs, length of hospital stay, postoperative complications and further stone related interventions were analysed. Results: A total of 350 patients were analysed. Among them, 299 patients underwent CBDE at the time of cholecystectomy, while the remaining 51 underwent ERCP either pre-, intra- or post cholecystectomy. CBDE was associated with lower overall costs compared to ERCP with an average hospital stay cost of $13,093 vs $22,930 respectively. This was largely attributed to shorter hospital stays (6.5 vs 10.3 days), decreased need for intensive care unit admission and fewer postoperative interventions within the CBDE group. Notably, single procedure laparoscopic cholecystectomy with CBDE demonstrated decreased operative costs compared to laparoscopic cholecystectomy combined with ERCP pre-/intra- or post-operatively ($3,747 vs. $4,641). Conclusion: Emergent CBDE is a cost-effective alternative to ERCP for managing CBD stones when combined with cholecystectomy. The upfront investment in equipment for CBDE and increased cholecystectomy procedural time is counterbalanced by reduced hospital stay, fewer procedures and subsequent cost savings. Economic considerations, in conjunction with clinical outcomes, should inform the selection of the optimal approach for CBD stone management in emergency settings.Keywords: choledocolithiasis, management, cost-effectiveness, endoscopic retrograde cholangiopancreatography, ERCP, CBDE, common bile duct exploration
Procedia PDF Downloads 171641 Endoscopic Treatment of Patients with Large Bile Duct Stones
Authors: Yuri Teterin, Lomali Generdukaev, Dmitry Blagovestnov, Peter Yartcev
Abstract:
Introduction: Under the definition "large biliary stones," we referred to stones over 1.5 cm, in which standard transpapillary litho extraction techniques were unsuccessful. Electrohydraulic and laser contact lithotripsy under SpyGlass control have been actively applied for the last decade in order to improve endoscopic treatment results. Aims and Methods: Between January 2019 and July 2022, the N.V. Sklifosovsky Research Institute of Emergency Care treated 706 patients diagnosed with choledocholithiasis who underwent biliary stones removed from the common bile duct. Of them, in 57 (8, 1%) patients, the use of a Dormia basket or Biliary stone extraction balloon was technically unsuccessful due to the size of the stones (more than 15 mm in diameter), which required their destruction. Mechanical lithotripsy was used in 35 patients, and electrohydraulic and laser lithotripsy under SpyGlass direct visualization system - in 26 patients. Results: The efficiency of mechanical lithotripsy was 72%. Complications in this group were observed in 2 patients. In both cases, on day one after lithotripsy, acute pancreatitis developed, which resolved on day three with conservative therapy (Clavin-Dindo type 2). The efficiency of contact lithotripsy was in 100% of patients. Complications were not observed in this group. Bilirubin level in this group normalized on the 3rd-4th day. Conclusion: Our study showed the efficacy and safety of electrohydraulic and laser lithotripsy under SpyGlass control in a well-defined group of patients with large bile duct stones.Keywords: contact lithotripsy, choledocholithiasis, SpyGlass, cholangioscopy, laser, electrohydraulic system, ERCP
Procedia PDF Downloads 781640 Genome Analysis of Lactobacillus Plantarum and Lactobacillus Brevis Isolated From Traditionally Fermented Ethiopian Kocho and Their Probiotic Properties
Authors: Guesh Mulaw, Haile Beruhulay, Anteneh Tesfaye, Tesfaye Sisay Diriba Muleta
Abstract:
Probiotics are live microorganisms that, when administered in adequate amounts, promote the health of a consumer. The present work aims to study the whole genome sequence of probiotic strains of lactic acid bacteria (LAB) isolated from traditional Ethiopian fermented kocho for bacteriocin production and to evaluate their probiotic properties. LAB were isolated from traditionally fermented kocho samples and characterized following standard methods. Accordingly, a total of 150 LAB were isolated, of which 7 (4.67%) isolates showed 50.52-74.05% and 33.33-62.40% survival rates at pH 2 for 3 and 6 h, respectively. The 7 acid-tolerant isolates were also tolerated 0.3% bile salt for 24 h with 88.96 to 98.10% survival. The acid and bile salt-tolerant LAB isolates also inhibited some reference foodborne pathogenic bacteria to varying degrees. All 7 acid- and bile salt-tolerant isolates were susceptible to ampicillin, tetracycline and erythromycin. However, the potent isolates showed remarkable resistance to kanamycin. Likewise, four of the 7 isolates were resistant to streptomycin, but three of the 7 isolates were sensitive to streptomycin. The identification of the seven selected probiotic LAB isolates and their genetic relatedness was performed based on whole-genome sequence comparisons. Consequently, these isolates belonged to Lactobacillus species, including 6 Lb. plantarum, 1 Lb. brevis. Among the 7 potential probiotic LAB strains, BAGEL predicted 2 bacteriocin for class II in the genome of 7 strains. The 7 Lactobacillus strains were found to be potentially useful for producing functional products and could be suitable probiotic candidates for food processing industriesKeywords: ferneted foods, kocho, probiotics, lactic acid bacteria
Procedia PDF Downloads 281639 Preliminary Evaluation of the Probiotic Potential of Leuconostoc mesonteroides Strain Isolated from Goat's Milk
Authors: Benyoucef Amel, Benmechernene Zineb, Kihal Mebrouk
Abstract:
One strain (V1) of Leuconostoc mesonteroides was isolated from goat’s milk collected from El Bayadh which is located in the west of Algeria and was characterized by phenotypic and biochemical methods. This strain was tested for their antimicrobial activity against indicator bacteria (Staphylococcus aureus ATCC 43300, Listeria innocua ATCC 33090, Listeria ivanovii ATCC 19119) and was evaluated for certain properties relevant to probiotic including acid resistance (pH 2 ; 3and 4), bile tolerance at 0.5%, 1% and 2%, pepsin resistance 3mg/ml at pH 2 and 3, hemolytic activity and antibiotics sensitivity. Our results revealed the strain V1 showed antagonistic activity against Staphylococcus aureus, Listeria innocua and Listeria ivanovii, due to a production of proteinous nature substances. The strain was resistant to pH 3 and 4, bile salts at 0.5%, 1% and 2% and pepsin at pH 3; and was γ-hemolytic and susceptible to four antibiotics: Chloramphenicol, pristinamycin, Clindamycin and Lincomycin. These results may be considered the strain V1 as suitable probiotic candidate.Keywords: antimicrobial, goat‘s milk, Leuconostoc, probiotic
Procedia PDF Downloads 2401638 Diagnosis of Choledocholithiasis with Endosonography
Authors: A. Kachmazova, A. Shadiev, Y. Teterin, P. Yartcev
Abstract:
Introduction: Biliary calculi disease (LCS) still occupies the leading position among urgent diseases of the abdominal cavity, manifesting itself from asymptomatic course to life-threatening states. Nowadays arsenal of diagnostic methods for choledocholithiasis is quite wide: ultrasound, hepatobiliscintigraphy (HBSG), magnetic resonance imaging (MRI), endoscopic retrograde cholangiography (ERCP). Among them, transabdominal ultrasound (TA ultrasound) is the most accessible and routine diagnostic method. Nowadays ERCG is the "gold" standard in diagnosis and one-stage treatment of biliary tract obstruction. However, transpapillary techniques are accompanied by serious postoperative complications (postmanipulative pancreatitis (3-5%), endoscopic papillosphincterotomy bleeding (2%), cholangitis (1%)), the lethality being 0.4%. GBSG and MRI are also quite informative methods in the diagnosis of choledocholithiasis. Small size of concrements, their localization in intrapancreatic and retroduodenal part of common bile duct significantly reduces informativity of all diagnostic methods described above, that demands additional studying of this problem. Materials and Methods: 890 patients with the diagnosis of cholelithiasis (calculous cholecystitis) were admitted to the Sklifosovsky Scientific Research Institute of Hospital Medicine in the period from August, 2020 to June, 2021. Of them 115 people with mechanical jaundice caused by concrements in bile ducts. Results: Final EUS diagnosis was made in all patients (100,0%). In all patients in whom choledocholithiasis diagnosis was revealed or confirmed after EUS, ERCP was performed urgently (within two days from the moment of its detection) as the X-ray operation room was provided; it confirmed the presence of concrements. All stones were removed by lithoextraction using Dormia basket. The postoperative period in these patients had no complications. Conclusions: EUS is the most informative and safe diagnostic method, which allows to detect choledocholithiasis in patients with discrepancies between clinical-laboratory and instrumental methods of diagnosis in shortest time, that in its turn will help to decide promptly on the further tactics of patient treatment. We consider it reasonable to include EUS in the diagnostic algorithm for choledocholithiasis. Disclosure: Nothing to disclose.Keywords: endoscopic ultrasonography, choledocholithiasis, common bile duct, concrement, ERCP
Procedia PDF Downloads 841637 Non Chemical-Based Natural Products in the Treatment and Control of Disease in Fish
Authors: Albert P. Ekanem, Austin I. Obiekezie, Elizabeth X. Ntia
Abstract:
Introduction: Some African plants and bile from animals have shown efficacies in the treatment and control of diseases in farmed fish. The background of the study is based on the fact the African rain forest is blessed with the abundance of medicinal plants that should be investigated for their use in the treatment of diseases. The significance of the study is informed by the fact that chemical-based substances accumulate in the tissues of food fish, thereby reducing the food values of such products and moreover, the continuous use of chemotherapeutics in the aquatic environments tends to degrade the affected environment. Methodology: Plants and animal products were extracted, purified and applied under in vitro and in vivo conditions to the affected organisms. Effective plants and bills were analyzed for biologically active substances responsible for the activities by both qualitative and HPLC methods. Results: Extracts of Carica papaya and Mucuna pruriens were effective in the treatment of Ichthyophthiriasis in goldfish (Carassius auratus auratus) with high host tolerance. Similarly, ectoparasitic monogeneans were effectively dislodged from the gills and skin of goldfish by the application of extracts of Piper guineense at therapeutic concentrations. Artemesia annua with known antimalarial activities in human was also effective against fish monogenean parasites of Clarias gariepinus in a concentration-related manner without detriments to the host. Effective antibacterial activities against Aeromonas and Pseudomonas diseases of the African catfish (Heterobranchus longifilis) were demonstrated in some plants such as Phylanthus amarus, Allium sativum, A. annua, and Citrus lemon. Bile from some animals (fish, goat, chicken, cow, and pig) showed great antibacterial activities against some gastrointestinal bacterial pathogens of fish. Conclusions: African plants and some animal bile have shown potential promise in the treatment of diseases in fish and other aquatic animals. The use of chemical-based substances for control of diseases in the aquatic environments should be restricted.Keywords: control, diseases, fish, treatment
Procedia PDF Downloads 4481636 Non Chemical-Based Natural Products in the Treatment and Control of Fish Diseases
Authors: Albert P. Ekanem, Austin I. Obiekezie, Elizabeth X. Ntia
Abstract:
Introduction: Some African plants and bile from animals have shown efficacies in the treatment and control of diseases in farmed fish. The background of the study is based on the fact the African rain forest is blessed with abundance of medicinal plants that should be investigated for their use in the treatment of diseases. The significance of the study is informed by the fact that chemical-based substances accumulates in the tissues of food fish, thereby reducing the food values of such products and moreover, the continuous use of chemotherapeutants in the aquatic environments tends to degrades the affected environment. Methodology: Plants and animal products were extracted, purified and applied under in vitro and in vivo conditions to the affected organisms. Effective plants and biles were analyzed for active biological substances responsible for the activities by both qualitative and HPLC methods. Results: Extracts of Carica papaya and Mucuna pruriens were effective in the treatment of Ichthyophthiriasis in goldfish (Carassius auratus auratus) with high host tolerance. Similarly, ectoparasitic monogeneans were effectively dislodged from the gills and skin of goldfish by the application of extracts of Piper guineense at therapeutic concentrations. Artemesia annua with known antimalarial activities in human was also effective against fish monogenean parasites of Clarias gariepinus in a concentration related manner without detriments to the host. Effective antibacterial activities against Aeromonas and Pseudomonas diseases of the African catfish (Heterobranchus longifilis) were demonstrated in some plants such as Phylanthus amarus, Allium sativum, A. annua, and Citrus lemon. Bile from some animals (fish, goat, chicken, cow, and pig) showed great antibacterial activities against some gastrointestinal bacterial pathogens of fish. Conclusions: African plants and some animal bile have shown potential promise in the treatment of diseases in fish and other aquatic animals. The use of chemical-based substances for control of diseases in the aquatic environments should be restricted.Keywords: control, diseases, fish, natural products, treatment
Procedia PDF Downloads 5211635 Growth and Some Physiological Properties of Three Selected Species of Bifidobacteria in Admixture of Soy Milk and Goat Milk
Authors: Ahmed Zahran
Abstract:
Bifidobacterium breve ATCC 15700, Bifidobacterium adolescents ATCC 15704 and Bifidobacterium longum ATCC 15707 were tested for their growth, acid production, bile tolerance, antibiotic resistance and adherence to columnar epithelial cells of the small intestine of goat. The growth of all studied species was determined in the MRSL medium. B.longum 15707 was the most active species in comparison with the other two species; it was also more resistant to bile acids. The adhesion of the studied species to the columnar epithelial cells was studied. All the studied species showed some degree of adhesion; however, B.longum adhered more than the other two species. This species was resistant to four types of antibiotics and was sensitive to chloramphenicol 30 µg. The activity of Bifidobacterium species in soymilk was evaluated by measuring the development of titratalle acidity. B.longum 15707 was the most active species in terms of growth and activity of soymilk. So, soymilk containing bifidobacteria could be added to goat milk to produce acceptable functional soy yogurt, using the ratio of (1:4) soy milk to goat milk. This product could be of unique health benefits, especially in the case of high cholesterol levels and replenishment of intestinal flora after antibiotic therapy.Keywords: bifidobacteria physiological properties, soy milk, goat milk, attachment epithelial cells, columnar tissues, probiotic food
Procedia PDF Downloads 821634 Sizing of Drying Processes to Optimize Conservation of the Nuclear Power Plants on Stationary
Authors: Assabo Mohamed, Bile Mohamed, Ali Farah, Isman Souleiman, Olga Alos Ramos, Marie Cadet
Abstract:
The life of a nuclear power plant is regularly punctuated by short or long period outages to carry out maintenance operations and/or nuclear fuel reloading. During these stops periods, it is essential to conserve all the secondary circuit equipment to avoid corrosion priming. This kind of circuit is one of the main components of a nuclear reactor. Indeed, the conservation materials on shutdown of a nuclear unit improve circuit performance and reduce the maintenance cost considerably. This study is a part of the optimization of the dry preservation of equipment from the water station of the nuclear reactor. The main objective is to provide tools to guide Electricity Production Nuclear Centre (EPNC) in order to achieve the criteria required by the chemical specifications of conservation materials. A theoretical model of drying exchangers of water station is developed by the software Engineering Equation Solver (EES). It used to size requirements and air quality needed for dry conservation of equipment. This model is based on heat transfer and mass transfer governing the drying operation. A parametric study is conducted to know the influence of aerothermal factor taking part in the drying operation. The results show that the success of dry conservation of equipment of the secondary circuit of nuclear reactor depends strongly on the draining, the quality of drying air and the flow of air injecting in the secondary circuit. Finally, theoretical case study performed on EES highlights the importance of mastering the entire system to balance the air system to provide each exchanger optimum flow depending on its characteristics. From these results, recommendations to nuclear power plants can be formulated to optimize drying practices and achieve good performance in the conservation of material from the water at the stop position.Keywords: dry conservation, optimization, sizing, water station
Procedia PDF Downloads 2611633 Evaluation of Antagonistic and Aggregation Property of Probiotic Lactic Acid Bacteria Isolated from Bovine Milk
Authors: Alazar Nebyou, Sujata Pandit
Abstract:
Lactic acid bacteria (LAB) are essential ingredients in probiotic foods, intestinal microflora, and dairy products that are capable of coping up with harsh gastrointestinal tract conditions and are available in a variety of environments. The objective of this study is to evaluate the probiotic property of LAB isolated from bovine milk. Milk samples were collected from local dairy farms. Samples were obtained using sterile test tubes and transported to a laboratory in the icebox for further biochemical characterization. Preliminary physiological and biochemical identification of LAB isolates was conducted by growing on MRS agar after ten-fold serial dilution. Seven of the best isolates were selected for the evaluation of the probiotic property. The LAB isolates were checked for resistance to antibiotics and their antimicrobial activity by disc diffusion assay and agar well diffusion assay respectively. Bile salt hydrolase activity of isolates was studied by growing isolates in a BSH medium with bile salt. Cell surface property of isolates was assayed by studying their autoaggregation and coaggregation percentage with S. aerues. All isolates were found BSH positive. In addition, BCM2 and BGM1 were susceptible to all antibiotic disks except BBM1 which was resistant to all antibiotic disks. BCM1 and BGM1 had the highest autoaggregation and coaggregation potential respectively. Since all LAB isolates showed gastrointestinal tolerance and good cell surface property they could be considered as good potential probiotic candidates for treatment and probiotic starter culture preparation.Keywords: probiotic, aggregation, lactic acid bacteria, antimicrobial activity
Procedia PDF Downloads 2101632 From Dog to Dog: Potential Probiotic and Immunomodulatory Strains Isolated from Canine Milk
Authors: Paula Buldres, Jorge Toledo
Abstract:
Objectives: This study aimed to characterize potential probiotic strains isolated from canine breast milk for use in dogs with enteropathies. Methodology: Six canine breast milk strains, one canine colostrum strain, and one control porcine breast milk strain were characterized. According to its functional properties of resistance to acids, different concentrations of bile salts, and pancreatin, its presumptive properties of safety and inhibitory effect on pathogens, non-cytotoxic characteristics, and adhesion to the intestine. The immunomodulatory effect of formulations with better probiotic characterization in vitro and in vivo was also analyzed. Results: Two strains characterized as potential probiotics were obtained, which corresponded to the canine strains (TUCO-16 and TUCO-17), presenting resistance to acidic pH, bile salts, and pancreatin, as well as an inhibitory effect on pathogenic Escherichia coli, Salmonella sp., and Clostridium perfringens. Strains TUCO-16 and TUCO-17 induced a significant increase in the expression of TNF-α and IL-8 in canine macrophages, respectively. Expression analyses of pattern recognition receptors in DH82 cells suggest that TUCO-16 and TUCO-17 might increase the TLR2 expression marker, and porcine strain (TUCO-4) increases the NOD2 expression marker. Based on the count obtained and the encapsulation yield, the best formulations correspond to FOS-Inulin for the TUCO-17 and TUCO-4 strains; Maltodextrin-Inulin for TUCO-16. All the strains are non-cytotoxic. The strain that showed the highest adhesion to intestinal epithelial cells was TUCO-17 with the FOS-Inulin formulation. On the other hand, the probiotics decreased the expression of pro-inflammatory markers in vivo, both in the intestine and in the spleen of mice. Conclusion: The combination of these three strains under study (TUCO-16, TUCO-17, and TUCO-4) would cover the probiotic properties in formulation and immunomodulation of all the markers under study.Keywords: probiotics, gastrointestinal infec, dog, probiotic formulation, immunomodulatory probiotics
Procedia PDF Downloads 661631 Sudan’s Approach to Knowledge Management in Disaster Management
Authors: Mohamed Abdalla Elamein Boshara, Peter Charles Woods, Nour Eldin Mohamed Elshaiekh
Abstract:
Knowledge Management has become very important for Disaster Management response and planning. This paper proposes the implementation of a Knowledge Management System with a sustainable data collection mechanism for reliable and timely information management to support decision makers in making the right decisions in the timely manner.Keywords: knowledge management, disaster management, incident tracking, web application
Procedia PDF Downloads 7781630 Probiotic Potential and Antimicrobial Activity of Enterococcus faecium Isolated from Chicken Caecal and Fecal Samples
Authors: Salma H. Abu Hafsa, A. Mendonca, B. Brehm-Stecher, A. A. Hassan, S. A. Ibrahim
Abstract:
Enterococci are important inhabitants of the animal intestine and are widely used in probiotic products. A probiotic strain is expected to possess several desirable properties in order to exert beneficial effects. Therefore, the objective of this study was to isolate and characterize strains of Enterococcus sp. from chicken cecal and fecal samples to determine potential probiotic properties. Enterococci were isolated from thirty one chicken cecal and fecal samples collected from a local farm. In vitro studies were performed to assess antibacterial activity (using agar well diffusion and cell free supernatant broth technique against Salmonella enterica serotype Enteritidis), susceptibility to antibiotics (amoxycillin, cotrimoxazole, chloramphenicol, cefuroxime, ceftriaxone, ciprofloxacin, and nalidixic acid), survival in acidic conditions, resistance to bile salts, and their survival during simulated gastric juice conditions at pH 2.5. Isolates were identified using biochemical and molecular assays (API 50 CHL, and API ZYM kits followed by 16S rDNA gene sequence analysis). Two strains were identified, of which, Enteroccocus faecium was capable of inhibiting the growth of S. enteritidis and was susceptible to a wide range of antibiotics. In addition, the isolated strain exhibited significant resistance under highly acidic conditions (pH=2.5) for 8 hours and survived well in bile salt at 0.2% for 24 hours and showing ability to survive in the presence of simulated gastric juice at pH 2.5. Based on these results, the E. faecium isolate fulfills some of the criteria to be considered as a probiotic strain and therefore, could be used as a feed additive with good potential for controlling S. enteritidis in chickens. However, in vivo studies are needed to determine the safety of the strain.Keywords: acid tolerance, antimicrobial activity, Enterococcus faecium, probiotic
Procedia PDF Downloads 3961629 Isolation and Molecular Identification of Two Fungal Strains Capable of Degrading hydrocarbon Contaminants on Saudi Arabian Environment
Authors: Amr A. EL Hanafy, Yasir Anwar, Saleh A. Mohamed, Saleh Mohamed Saleh Al-Garni, Jamal S. M. Sabir , Osama A. H. Abu Zinadah, Mohamed Morsi Ahmed
Abstract:
In the vicinity of the red sea about 15 fungi species were isolated from oil contaminated sites. On the basis of aptitude to degrade the crude oil and DCPIP assay, two fungal isolates were selected amongst 15 oil degrading strains. Analysis of ITS-1, ITS-2 and amplicon pyrosequencing studies of fungal diversity revealed that these strains belong to Penicillium and Aspergillus species. Two strains that proved to be the most efficient in degrading crude oil was Aspergillus niger (54 %) and Penicillium commune (48 %) Subsequent to two weeks of cultivation in BHS medium the degradation rate were recorded by using spectrophotometer and GC-MS. Hence, it is cleared that these fungal strains has the capability of degradation and can be utilized for cleaning the Saudi Arabian environment.Keywords: fungal strains, hydrocarbon contaminants, molecular identification, biodegradation, GC-MS
Procedia PDF Downloads 5201628 Experimental Study on Friction Factor of Oscillating Flow Through a Regenerator
Authors: Mohamed Saïd Kahaleras, François Lanzetta, Mohamed Khan, Guillaume Layes, Philippe Nika
Abstract:
This paper presents an experimental work to characterize the dynamic operation of a metal regenerator crossed by dry compressible air alternating flow. Unsteady dynamic measurements concern the pressure, velocity and temperature of the gas at the ends and inside the channels of the regenerator. The regenerators are tested under isothermal conditions and thermal axial temperature gradient.Keywords: friction factor, oscillating flow, regenerator, stirling machine
Procedia PDF Downloads 5061627 Effects of Flexible Flat Feet on Electromyographic Activity of Erector Spinae and Multifidus
Authors: Abdallah Mohamed Kamel Mohamed Ali, Samah Saad Zahran, Mohamed Hamed Rashad
Abstract:
Background: Flexible flatfoot (FFF) has been considered as a risk factor for several lower limb injuries and mechanical low back pain. This was attributed to the dysfunction of the lumbopelvic-hip complex musculature. Objective: To investigate the influence of FFF on electromyographic activities of erector spinae and multifidus. Methods: A cross-section study was held between an FFF group (20 subjects) and a normal foot group (20 subjects). A surface electromyography was used to assess the electromyographic activity of erector spinae and multifidus. Group differences were assessed by the T-test. Results: There was a significant increase in EMG activities of erector spinae and multifidus in the FFF group compared with the normal group. Conclusion: There is an increase in EMG activities in erector spinae and multifidus in FFF subjects compared with normal subjects.Keywords: electromyography, flatfoot, low back pain, paraspinal muscles
Procedia PDF Downloads 2111626 Static Relaxation of Glass Fiber Reinforced Pipes
Authors: Mohammed Y. Abdellah, Mohamed K. Hassan, A. F. Mohamed, Shadi M. Munshi, A. M. Hashem
Abstract:
Pips made from glass fiber reinforced polymer has competitive role in petroleum industry. The need of evaluating the mechanical behavior of (GRP) pipes is essential objects. Stress relaxation illustrates how polymers relieve stress under constant strain. Static relaxation test is carried out at room temperature. The material gives poor static relaxation strength, two loading cycles have been observed for the tested specimen.Keywords: GRP, sandwich composite material, static relaxation, stress relief
Procedia PDF Downloads 6221625 Study on the Effect of Coupling Fluid Compressible-Deformable Wall on the Flow of Molten Polymers
Authors: Mohamed Driouich, Kamal Gueraoui, Mohamed Sammouda
Abstract:
The main objective of this work is to establish a numerical code for studying the flow of molten polymers in deformable pipes. Using an iterative numerical method based on finite differences, we determine the profiles of the fluid velocity, the temperature and the apparent viscosity of the fluid. The numerical code presented can also be applied to other industrial applications.Keywords: numerical code, molten polymers, deformable pipes, finite differences
Procedia PDF Downloads 573