Search results for: adverse effect
15307 Pregnancy Outcome in Women with HIV Infection from a Tertiary Care Centre of India
Authors: Kavita Khoiwal, Vatsla Dadhwal, K. Aparna Sharma, Dipika Deka, Plabani Sarkar
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Introduction: About 2.4 million (1.93 - 3.04 million) people are living with HIV/AIDS in India. Of all HIV infections, 39% (9,30,000) are among women. 5.4% of infections are from mother to child transmission (MTCT), 25,000 infected children are born every year. Besides the risk of mother to child transmission of HIV, these women are at risk of the higher adverse pregnancy outcome. The objectives of the study were to compare the obstetric and neonatal outcome in women who are HIV positive with low-risk HIV negative women and effect of antiretroviral drugs on preterm birth and IUGR. Materials and Methods: This is a retrospective case record analysis of 212 HIV-positive women delivering between 2002 to 2015, in a tertiary health care centre which was compared with 238 HIV-negative controls. Women who underwent medical termination of pregnancy and abortion were excluded from the study. Obstetric outcome analyzed were pregnancy induced hypertension, HIV positive intrauterine growth restriction, preterm birth, anemia, gestational diabetes and intrahepatic cholestasis of pregnancy. Neonatal outcome analysed were birth weight, apgar score, NICU admission and perinatal transmission.HIV-positiveOut of 212 women, 204 received antiretroviral therapy (ART) to prevent MTCT, 27 women received single dose nevirapine (sdNVP) or sdNVP tailed with 7 days of zidovudine and lamivudine (ZDV + 3TC), 15 received ZDV, 82 women received duovir and 80 women received triple drug therapy depending upon the time period of presentation. Results: Mean age of 212 HIV positive women was 25.72+3.6 years, 101 women (47.6 %) were primigravida. HIV positive status was diagnosed during pregnancy in 200 women while 12 women were diagnosed prior to conception. Among 212 HIV positive women, 20 (9.4 %) women had preterm delivery (< 37 weeks), 194 women (91.5 %) delivered by cesarean section and 18 women (8.5 %) delivered vaginally. 178 neonates (83.9 %) received exclusive top feeding and 34 neonates (16.03 %) received exclusive breast feeding. When compared to low risk HIV negative women (n=238), HIV positive women were more likely to deliver preterm (OR 1.27), have anemia (OR 1.39) and intrauterine growth restriction (OR 2.07). Incidence of pregnancy induced hypertension, diabetes mellitus and ICP was not increased. Mean birth weight was significantly lower in HIV positive women (2593.60+499 gm) when compared to HIV negative women (2919+459 gm). Complete follow up is available for 148 neonates till date, rest are under evaluation. Out of these 7 neonates found to have HIV positive status. Risk of preterm birth (P value = 0.039) and IUGR (P value = 0.739) was higher in HIV positive women who did not receive any ART during pregnancy than women who received ART. Conclusion: HIV positive pregnant women are at increased risk of adverse pregnancy outcome. Multidisciplinary team approach and use of highly active antiretroviral therapy can optimize the maternal and perinatal outcome.Keywords: antiretroviral therapy, HIV infection, IUGR, preterm birth
Procedia PDF Downloads 25915306 Emotional Disclosure as Mediator Between Marital Satisfaction and Mental Health Problems in Women with Infertility
Authors: Sadia Saleem
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Infertility is a global health concern that may have a long-lasting effect on the psychosocial functioning of an individual. Rich research evidence has shown that women with infertility are at greater risk of adverse psychological experiences than men. The culture plays a risk factor when it comes to infertility. Family is considered as a central focus of a collectivistic culture like Pakistan and having children is the key factor that determines the quality of a marital relationship, individual well-being and overall standing in the society. In this collectivistic cultural context, women usually get the blame and experience more psychological distress and social isolation. A total sample of 121 (M 28.17, SD 4.73) women with primary infertility selected through purposive sampling were tested using Emotional Disclosure Questionnaire, Couple Satisfaction Index and Depression Anxiety Stress Scale. The results indicate that negative emotional disclosure positively mediates the relationship between marital satisfaction and mental health problems (p < .001) in women with primary infertility. The results are discussed in terms of psychosocial counseling and family psychoeducation in Pakistani collectivistic cultural context.Keywords: infertility, couple satisfaction, emotional disclosure, mental health
Procedia PDF Downloads 16115305 Anti-Obesity Activity of Garcinia xanthochymus: Biochemical Characterization and In vivo Studies in High Fat Diet-Rat Model
Authors: Mahesh M. Patil, K. A. Anu-Appaiah
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Overweight and obesity is a serious medical problem, increasing in prevalence, and affecting millions worldwide. Investigators have been trying from decades to articulate the burden of obesity and related risk factors. To answer this problem, we suggest a new therapeutic anti-obesity compounds from Garcinia xanthochymus fruit. However, there is little published scientific information on non-hydroxycitric acid Garcinia species. Our findings include biochemical characterization of the fruit; in vivo toxicity and bio-efficacy study of G. xanthochymus in high fat diet wistar rat model. We observed that Garcinia pericarp is a rich source of organic acids, polyphenols, mono- (40.63%) and poly-unsaturated fatty acids (16.45%; omega-3: 10.02%). Toxicological studies have showed that Garcinia is safe and had no observed adverse effect level up to 400 mg/kg/day. Body weight and food intake was significantly (P<0.05) reduced in oral gavage treated rats (sonicated Garcinia powder) in 13 weeks. Subcutaneous fat was significantly (P<0.05) reduced in Garcinia treated rats. Hepatocytes significantly (p<0.05) overexpressed sterol regulatory element binding protein 2, liver X receptor- α, liver X receptor- β, lipoprotein lipase and monoacylglycerol lipase. Fatty acid binding protein 1 and peroxisome proliferator activated receptor- α were down regulated as assessed by real time qPCR. Currently our research is focused on the adipocyte obesity related gene expressions, effect of Garcinia on 3T3-adipocyte cell lines and high fat diet induced mice model. This in vivo pre-clinical data suggests that G. xanthochymus may have clinical utility for the treatment of obesity. However, further studies are required to establish its potency.Keywords: Garcinia xanthochymus, anti-obesity, high fat diet, real time qPCR
Procedia PDF Downloads 25015304 Haematological and Internal Organs Characteristics of Rabbit Bucks Fed Boiled Pigeon Pea (Cajanus Cajan) Seed Meal
Authors: Nnennaya Samuel Okoro
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An experiment was conducted to determine the growth performance, blood parameters and reproductive characteristics of 8-week old male weaner rabbits fed 20% boiled pigeon pea seed meal (PPSM). The study lasted for 16 weeks. Results showed that haematological parameters of the two groups of rabbit bucks were not significantly affected (P>0.05) by the treatment, meaning that the PPSM was adequate for maintaining the blood parameters at the normal levels. The 20% boiled PPSM significantly affected (P<0.05) serum Alanine Aminotransferase (ALT) (67.72±2.5 I.U/I) more than the ALT (57.50±2.02 I.U/I) of the control, which is an indication of liver problem. The globulin level (3.00 ± 0.23 g/d) of the 20% boiled PPSM group was significantly higher than that of the control (2.60±0.06 g/dl), indicating that the test diet did not alter protein metabolism in the rabbits. Boiled pigeon pea seed meal supported organ weight and testicular development in rabbit bucks, suggesting that boiling reduced the level of the anti-nutritional factors in pigeon pea seed meal. Thus, 20% boiled pigeon pea can be included in diets of rabbits without adverse effect on blood parameters and internal organs characteristics.Keywords: haematology, internal organs, pigeon pea, rabbits, serum biochemistry
Procedia PDF Downloads 24815303 Quality of Care of Medical Male Circumcisions: A Non-Negotiable for Right to Care
Authors: Nelson Igaba, C. Onaga, S. Hlongwane
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Background: Medical Male Circumcision (MMC) is part of a comprehensive HIV prevention strategy. The quality of MMC done at Right To Care (RtC) sites is maintained by Continuous Quality Improvement (CQI) based on findings of assessments by internal and independent external assessors who evaluate such parameters as the quality of the surgical procedure, infection control, etc. There are 12 RtC MMC teams in Mpumalanga, two of which are headed by Medical Officers and 10 by Clinical Associates (Clin A). Objectives: To compare the quality (i) of care rendered at doctor headed sites (DHS) versus Clin A headed sites (CHS); (ii) of CQI assessments (external versus internal). Methodology: A retrospective review of data from RightMax™ (a novel RtC data management system) and CQI reports (external and internal) was done. CQI assessment scores of October 2015 and October 2016 were taken as the baseline and latest respectively. Four sites with 745-810 circumcisions per annum were purposively selected; the two DHS (group A) and two CHS (group B). Statistical analyses were conducted using R (2017 version). Results: There were no significant difference in latest CQI scores between the two groups (DHS and CHS) (Anova, F = 1.97, df = 1, P = 0.165); between internal and external CQI assessment scores (Anova, F = 2.251, df = 1, P = 0.139) or among the individual sites (Anova, F = 1.095, df = 2, P = 0.341). Of the total of 16 adverse events reported by the four sites in the 12 months reviewed (all were infections), there was no statistical evidence that the documented severity of the infection was different for DHS and CHS (Fisher’s exact test, p-value = 0.269). Conclusion: At RtC VMMC sites in Mpumalanga, internal and external/independent CQI assessments are comparable, and quality of care of VMMC is standardized with the performance of well-supervised clinical associates comparing well with those of medical officers.Keywords: adverse events, Right to Care, male medical circumcision, continuous quality improvement
Procedia PDF Downloads 17515302 The Influence of Thomson Effect on the Performance of N-Type Skutterudite Thermoelement
Authors: Anbang Liu, Huaqing Xie, Zihua Wu, Xiaoxiao Yu, Yuanyuan Wang
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Due to the temperature-dependence and mutual coupling of thermoelectric parameters, the Thomson effect always exists, which is derived from temperature gradients during thermoelectric conversion. The synergistic effect between the Thomson effect and non-equilibrium heat transport of charge carriers leads to local heat absorption or release in thermoelements, thereby affecting its power generation performance and conversion efficiency. This study verified and analyzed the influence and mechanism of the Thomson effect on N-type skutterudite thermoelement through quasi-steady state testing under approximate vacuum conditions. The results indicate the temperature rise/fall of N-type thermoelement at any position is affected by Thomson heat release/absorption. Correspondingly, the Thomson effect also contributes advantageously/disadvantageously to the output power of N-type skutterudite thermoelement when the Thomson coefficients are positive/negative. In this work, the output power can be promoted or decreased maximally by more than 27% due to the presence of Thomson heat when the absolute value of the Thomson coefficient is around 36 μV/℃.Keywords: Thomson effect, heat transport, thermoelectric conversion, numerical simulation
Procedia PDF Downloads 6415301 Improving Health Care and Patient Safety at the ICU by Using Innovative Medical Devices and ICT Tools: Examples from Bangladesh
Authors: Mannan Mridha, Mohammad S. Islam
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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.Keywords: intensive care units, medical errors, medical devices, patient care and safety
Procedia PDF Downloads 14815300 Analysis of Transformer Reactive Power Fluctuations during Adverse Space Weather
Authors: Patience Muchini, Electdom Matandiroya, Emmanuel Mashonjowa
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A ground-end manifestation of space weather phenomena is known as geomagnetically induced currents (GICs). GICs flow along the electric power transmission cables connecting the transformers and between the grounding points of power transformers during significant geomagnetic storms. Geomagnetically induced currents have been studied in other regions and have been noted to affect the power grid network. In Zimbabwe, grid failures have been experienced, but it is yet to be proven if these failures have been due to GICs. The purpose of this paper is to characterize geomagnetically induced currents with a power grid network. This paper analyses data collected, which is geomagnetic data, which includes the Kp index, DST index, and the G-Scale from geomagnetic storms and also analyses power grid data, which includes reactive power, relay tripping, and alarms from high voltage substations and then correlates the data. This research analysis was first theoretically analyzed by studying geomagnetic parameters and then experimented upon. To correlate, MATLAB was used as the basic software to analyze the data. Latitudes of the substations were also brought into scrutiny to note if they were an impact due to the location as low latitudes areas like most parts of Zimbabwe, there are less severe geomagnetic variations. Based on theoretical and graphical analysis, it has been proven that there is a slight relationship between power system failures and GICs. Further analyses can be done by implementing measuring instruments to measure any currents in the grounding of high-voltage transformers when geomagnetic storms occur. Mitigation measures can then be developed to minimize the susceptibility of the power network to GICs.Keywords: adverse space weather, DST index, geomagnetically induced currents, KP index, reactive power
Procedia PDF Downloads 11315299 Diet-Induced Epigenetic Transgenerational Inheritance
Authors: Gaby Fahmy
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The last decades have seen a rise in metabolic disorders like diabetes, obesity, and fatty liver disease around the world. Environmental factors, especially nutrition, have contributed to this increase. Additionally, pre-conceptional parental nutritional choices have been shown to result in epigenetic modifications affecting gene expression during the developmental process in-utero. These epigenetic modifications have also been seen to extend to the following offspring in a trans-generational effect. This further highlights the significance and relevance of epigenetics and epigenetic tags, which were previously thought to be stripped in newly formed embryos. Suitable prenatal nutrition may partially counteract adverse outcomes caused by exposures to environmental contaminants, ultimately resulting in improved metabolic profiles like body weight and glucose homeostasis. This was seen in patients who were given dietary interventions like restrictive caloric intake, intermittent fasting, and time-restricted feeding. Changes in nutrition are pivotal in the regulation of epigenetic modifications that are transgenerational. For example, dietary choices such as fatty foods vs. vegetables and nuts in fathers were shown to significantly affect sperm motility and volume. This was pivotal in understanding the importance of paternal inheritance. Further research in the field is needed as it remains unclear how many generations are affected by these changes.Keywords: epigenetics, transgenerational, diet, fasting
Procedia PDF Downloads 9415298 Reliability of Clinical Coding in Accurately Estimating the Actual Prevalence of Adverse Drug Event Admissions
Authors: Nisa Mohan
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Adverse drug event (ADE) related hospital admissions are common among older people. The first step in prevention is accurately estimating the prevalence of ADE admissions. Clinical coding is an efficient method to estimate the prevalence of ADE admissions. The objective of the study is to estimate the rate of under-coding of ADE admissions in older people in New Zealand and to explore how clinical coders decide whether or not to code an admission as an ADE. There has not been any research in New Zealand to explore these areas. This study is done using a mixed-methods approach. Two common and serious ADEs in older people, namely bleeding and hypoglycaemia were selected for the study. In study 1, eight hundred medical records of people aged 65 years and above who are admitted to hospital due to bleeding and hypoglycemia during the years 2015 – 2016 were selected for quantitative retrospective medical records review. This selection was made to estimate the proportion of ADE-related bleeding and hypoglycemia admissions that are not coded as ADEs. These files were reviewed and recorded as to whether the admission was caused by an ADE. The hospital discharge data were reviewed to check whether all the ADE admissions identified in the records review were coded as ADEs, and the proportion of under-coding of ADE admissions was estimated. In study 2, thirteen clinical coders were selected to conduct qualitative semi-structured interviews using a general inductive approach. Participants were selected purposively based on their experience in clinical coding. Interview questions were designed in a way to investigate the reasons for the under-coding of ADE admissions. The records review study showed that 35% (Cl 28% - 44%) of the ADE-related bleeding admissions and 22% of the ADE-related hypoglycemia admissions were not coded as ADEs. Although the quality of clinical coding is high across New Zealand, a substantial proportion of ADE admissions were under-coded. This shows that clinical coding might under-estimate the actual prevalence of ADE related hospital admissions in New Zealand. The interviews with the clinical coders added that lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing might be the potential reasons for the under-coding of the ADE admissions. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. These results highlight that further work is needed on interventions to improve the clinical coding of ADE admissions, such as providing education to coders about the importance of ADEs, education to clinicians about the importance of clear and confirmed medical records entries, availing pharmacist service to improve the detection and clear documentation of ADE admissions and including a mandatory field in the discharge summary about external causes of diseases.Keywords: adverse drug events, bleeding, clinical coders, clinical coding, hypoglycemia
Procedia PDF Downloads 13015297 Scanning Electronic Microscopy for Analysis of the Effects of Surfactants on De-Wrinkling and Dispersion of Graphene
Authors: Kostandinos Katsamangas, Fawad Inam
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Graphene was dispersed using a tip sonicator and the effect of surfactants were analysed. Sodium Dodecyl Sulphate (SDS) and Polyvinyl Alcohol (PVA) were compared to observe whether or not they had any effect on any de-wrinkling, and secondly whether they aided to achieve better dispersions. There is a huge demand for wrinkle free graphene as this will greatly increase its usefulness in various engineering applications. A comprehensive literature on de-wrinkling graphene has been discussed. Low magnification Scanning Electronic Microscopy (SEM) was conducted to assess the quality of graphene de-wrinkling. The utilization of the PVA has a significant effect on de-wrinkling whereas SDS had minimal effect on the de-wrinkling of graphene.Keywords: Graphene, de-wrinkling, dispersion, surfactants, scanning electronic microscopy
Procedia PDF Downloads 47015296 Premature Menopause among Women in India: Evidence from National Family Health Survey-IV
Authors: Trupti Meher, Harihar Sahoo
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Premature menopause refers to the occurrence of menopause before the age of 40 years. Women who experience premature menopause either due to biological or induced reasons have a longer duration of exposure to severe symptoms and adverse health consequences when compared to those who undergo menopause at a later age, despite the fact that premature menopause has a profound effect on the health of women. This study attempted to determine the prevalence and predictors of premature menopause among women aged 25-39 years, using data from the National Family Health Survey (NFHS-4) conducted during 2015–16 in India. Descriptive statistics and multinomial logistic regression were used to carry out the result. The results revealed that the prevalence of premature menopause in India was 3.7 percent. Out of which, 2.1 percent of women had experienced natural premature menopause, whereas 1.7 percent had premature surgical menopause. The prevalence of premature menopause was highest in the southern region of India. Further, results of the multivariate model indicated that rural women, women with higher parity, early age at childbearing and women with smoking habits were at a greater risk of premature menopause. A sizeable proportion of women in India are attaining menopause prematurely. Unless due attention is given to this matter, it will emerge as a major problem in India in the future. The study also emphasized the need for further research to enhance knowledge on the problems of premature menopausal women in different socio-cultural settings in India.Keywords: India, natural menopause, premature menopause, surgical menopause
Procedia PDF Downloads 20415295 Synthesis of New Anti-Tuberculosis Drugs
Authors: M. S. Deshpande, Snehal D. Bomble
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Tuberculosis (TB) is a deadly contagious disease that is caused by a bacterium called Mycobacterium tuberculosis. More than sixty years ago, the introduction of the first anti-TB drugs for the treatment of TB (streptomycin (STR), p-aminosalcylic acid (PAS), isoniazid (INH), and then later ethambutol (EMB) and rifampicin (RIF)) gave optimism to the medical community, and it was believed that the disease would be completely eradicated soon. Worldwide, the number of TB cases has continued to increase, but the incidence rate has decreased since 2003. Recently, highly drug-resistant forms of TB have emerged worldwide. The prolonged use of classical drugs developed a growing resistance and these drugs have gradually become less effective and incapable to meet the challenges, especially those of multi drug resistant (MDR)-TB, extensively drug resistant (XDR)-TB, and HIV-TB co-infections. There is an unmet medical need to discover newer synthetic molecules and new generation of potent drugs for the treatment of tuberculosis which will shorten the time of treatment, be potent and safe while effective facing resistant strains and non-replicative, latent forms, reduce adverse side effect and not interfere in the antiretroviral therapy. This paper attempts to bring out the review of anti-TB drugs, and presents a novel method of synthesizing new anti-tuberculosis drugs and potential compounds to overcome the bacterial resistance and combat the re-emergence of tuberculosis.Keywords: tuberculosis, mycobacterium, multi-drug resistant (MDR)-TB, extensively drug resistant (XDR)-TB
Procedia PDF Downloads 37915294 Enhanced Anti-Inflammatory and Antioxidant Activities of Perna canaliculus Oil Extract and Low Molecular Weight Fucoidan from Undaria pinnatifida
Authors: Belgheis Ebrahimi, Jun Lu
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In recent years, there has been a growing recognition of the potential of marine-based functional foods and combination therapies in promoting a healthy lifestyle and exploring their effectiveness in preventing or treating diseases. The combination of marine bioactive compounds or extracts offers synergistic or enhancement effects through various mechanisms, including multi-target actions, improved bioavailability, enhanced bioactivity, and mitigation of potential adverse effects. Both the green-lipped mussel (GLM) and fucoidan derived from brown seaweed are rich in bioactivities. These two, mussel and fucoidan, have not been previously formulated together. This study aims to combine GLM oil from Perna canaliculus with low molecular weight fucoidan (LMWF) extracted from Undaria pinnatifida to investigate the unique mixture’s anti-inflammatory and antioxidant properties. The cytotoxicity of individual compounds and combinations was assessed using the MTT assay in (THP-1 and RAW264.7) cell lines. The anti-inflammatory activity of mussel-fucoidan was evaluated by treating LPS-stimulated human monocyte and macrophage (THP1-1) cells. Subsequently, the inflammatory cytokines released into the supernatant of these cell lines were quantified via ELISA. Antioxidant activity was determined by using the free radical scavenging assay (DPPH). DPPH assay demonstrated that the radical scavenging activity of the combinations, particularly at concentrations exceeding 1 mg/ml, showed a significantly higher percentage of inhibition when compared to the individual component. This suggests an enhancement effect when the two compounds are combined, leading to increased antioxidant activity. In terms of immunomodulatory activity, the individual compounds exhibited distinct behaviors. GLM oil displayed a higher ability to suppress the cytokine TNF- compared to LMWF. Interestingly, the LMWF fraction, when used individually, did not demonstrate TNF- suppression. However, when combined with GLM, the TNF- suppression (anti-inflammatory) activity of the combination was better than GLM or LWMF alone. This observation underscores the potential for enhancement interactions between the two components in terms of anti-inflammatory properties. This study revealed that each individual compound, LMWF, and GLM, possesses unique and notable bioactivity. The combination of these two individual compounds results in an enhancement effect, where the bioactivity of each is enhanced, creating a superior combination. This suggests that the combination of LMWF and GLM has the potential to offer a more potent and multifaceted therapeutic effect, particularly in the context of antioxidant and anti-inflammatory activities. These findings hold promise for the development of novel therapeutic interventions or supplements that harness the enhancement effects.Keywords: combination, enhancement effect, perna canaliculus, undaria pinnatifida
Procedia PDF Downloads 7915293 Thiopental-Fentanyl versus Midazolam-Fentanyl for Emergency Department Procedural Sedation and Analgesia in Patients with Shoulder Dislocation and Distal Radial Fracture-Dislocation: A Randomized Double-Blind Controlled Trial
Authors: D. Farsi, G. Dokhtvasi, S. Abbasi, S. Shafiee Ardestani, E. Payani
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Background and aim:It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FTversusfentanyl-midazolam (FM)in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods:In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccess rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P<0.001). The occurrence of adverse effects was low in both groups (p=0.31). Conclusion: PSA using FT is effective and appears to be safe for orthopedic procedures in the ED. Therefore, regarding the prompt onset of action, short recovery period of thiopental, it seems that this combination can be considered more for performing PSA in orthopedic procedures in ED.Keywords: procedural sedation and analgesia, thiopental, fentanyl, midazolam, orthopedic procedure, emergency department, pain
Procedia PDF Downloads 25115292 Application of Arbuscular Mycorrhizal Fungi as Biologically Based Strategy for Mitigation of Adverse Impact of Salt Stress on Wheat
Authors: Abeer Hashem, Khalid F. Almutairi, Ulkar Ibrahimova, Elsayed Fathi Abdallah
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Salinity poses a significant challenge to wheat production, necessitating the exploration of strategies to mitigate its adverse effects. The present investigation aims to study the impact of arbuscular mycorrhizal fungi (AMF) application to improve plant tolerance in terms of growth, carbohydrate, photosynthetic characteristics, and antioxidant enzyme activities under salt stress conditions. So, a randomized complete block design with five replications was employed comprising various treatments of AMF application under salinity stress (200mM), and control samples were used for each treatment. The obtained results demonstrated significantly that AMF used in this study showed beneficial impacts in all parameters used as sensitive monitor for relation of plant-salt microbe interaction. The root colonization by AMF showed the highest plant growth criteria, relative water content, soluble sugar, starch, and total non-structural carbohydrates under both control and salinity stress conditions. Moreover, the application of AMF-treated plants showed the highest soluble protein concentration and activity in leaves and antioxidant enzymes (catalase, superoxide dismutase, guaiacol peroxidase). These findings highlight the potential impact of AMF application as a biologically based strategy to manage the mitigation of salt stress on wheat, which increases the availability of many salt marsh habitats for sustainable agriculture of such strategy crops.Keywords: arbuscular mycorrhizal fungi, salt stress, plant growth criteria, soluble protein, antioxidant enzymes, wheat plant
Procedia PDF Downloads 4515291 Effect of Urban Informal Settlements and Outdoor Advertisement on the Quality of Built Environment and Urban Upgrading in Nigeria
Authors: Amao Funmilayo Lanrewaju, T. Ogunlade
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The paper examines the causes and characteristics of informal settlements and outdoor advertisement in the evaluation of quality of environment. The paper identifies the problems that have aided informal settlements to: Urbanization, poverty, growth of informal sector, non-affordability of land and housing shortage. The paper asserts that the informal settlements have serious adverse effects on the people’s health, their built environment and quality of life. The secondary data was obtained from books, journals and seminar papers. The paper argues that, although the urban upgrading possesses great potential for improving quality of built environment in informal settlements, there is a need to repackage the upgrading exercise so that majority can benefit from it. It is necessary to incorporate community participation into the urban upgrading in order to assist the very poor that cannot take care of their housing consumption needs. Therefore, government is encouraged to see informal settlements as a solution to new city planning rather than problem to the urban areas. This paper suggests the implementation of policies and planning, physical infrastructural development, social economic improvement, environment and health improvement. Government, private and communities interventions on informal settlements are required in order to prevent further decay for sustainable development.Keywords: quality of environment, informal settlements, urban upgrading, outdoor advertisement
Procedia PDF Downloads 48315290 Externalised Migration Controls and the Deportation of Minors and Potential Refugees from Mexico
Authors: Vickie Knox
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Since the ‘urgent humanitarian crisis’ of the arrival of tens of thousands of Central American minors at the Mexico-US border in early 2014, the USA has increasingly externalised migration controls to Mexico. Although the resulting policy ‘Plan Frontera Sur’ claimed to protect migrants’ human rights, it has manifested as harshly delivered in-country controls and an alarming increase in deportations, particularly of minors. This is of particular concern given the ongoing situation of forced migration caused by criminal violence in Central America because these deportations do not all comply with Mexico’s international obligations and with its own legal framework for international protection that allows inter alia verbal asylum claims and grants minors additional protection against deportation. Notably, the volume of deportations, the speed with which they are carried out and the lack of adequate screening indicate non-compliance with the principle of non-refoulement and the right to claim asylum or other forms of protection. Based on qualitative data gathered in fieldwork in 2015 and quantitative data covering the period 2014-2016, this research details three types of adverse outcome resulting from these externalised controls: human rights violations perpetrated in order to deliver the policy–namely, deportations that may not comply with the principle of non-refoulement or the protection of minors; human rights violations perpetrated in the execution of policy–such as violations by state actors during apprehension and detention; and adverse consequences of the policy – such as increased risk during transit. This research has particular resonance as the Trump era brings tighter enforcement in the region, and has broader relevance for the study of externalisation tools on a global level.Keywords: deportation, externalisation, forced migration, non-refoulement
Procedia PDF Downloads 15015289 Identifying Reforms Required in Construction Contracts from Resolved Disputed Cases
Authors: K. C. Iyer, Yogita Manan Bindal, Sumit Kumar Bakshi
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The construction industry is plagued with disputes and litigation in India with many stalled projects seeking dispute resolution. This has an adverse effect on the performance and overall project delivery and impacts future investments within the industry. While construction industry is the major driver of growth, there has not been major reforms in the government construction contracts. The study is aimed at identifying the proactive means of dispute avoidance, focusing on reforms required within the construction contracts, by studying 49 arbitration awards of construction disputes. The claims presented in the awards are aggregated to study the causes linked to the contract document and are referred against the prospective recommendation and practices as surveyed from literature review of research papers. Within contract administration, record keeping has been a major concern as they are required by the parties to substantiate the claims or the counterclaims and therefore are essential in any dispute redressal process. The study also observes that the right judgment is inhibited when the record keeping is improper and due to lack of coherence between documents, the dispute resolution period is also prolonged. The finding of the research will be relevant to industry practitioners in contract drafting with a view to avoid disputes.Keywords: construction contract, contract administration, contract management, dispute avoidance
Procedia PDF Downloads 26415288 Improved Multi–Objective Firefly Algorithms to Find Optimal Golomb Ruler Sequences for Optimal Golomb Ruler Channel Allocation
Authors: Shonak Bansal, Prince Jain, Arun Kumar Singh, Neena Gupta
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Recently nature–inspired algorithms have widespread use throughout the tough and time consuming multi–objective scientific and engineering design optimization problems. In this paper, we present extended forms of firefly algorithm to find optimal Golomb ruler (OGR) sequences. The OGRs have their one of the major application as unequally spaced channel–allocation algorithm in optical wavelength division multiplexing (WDM) systems in order to minimize the adverse four–wave mixing (FWM) crosstalk effect. The simulation results conclude that the proposed optimization algorithm has superior performance compared to the existing conventional computing and nature–inspired optimization algorithms to find OGRs in terms of ruler length, total optical channel bandwidth and computation time.Keywords: channel allocation, conventional computing, four–wave mixing, nature–inspired algorithm, optimal Golomb ruler, lévy flight distribution, optimization, improved multi–objective firefly algorithms, Pareto optimal
Procedia PDF Downloads 31815287 Ocular Complications, Adverse Effects of the Procedure, Side-effects of Medications Used for Graft Survival, and Preventable Vision Loss in Live-related Renal Transplant Recipients: Experience at a Transplant Centre in Pakistan
Authors: Fatema Ali Lanewala, Akhtar Jamal Khan
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The ocular complications in renal transplant recipients at the biggest transplant center in Pakistan were seen to be diverse, multiple, and sight-threatening. These complications could mainly be due to the primary disease causing renal failure, the process of transplantation, and/or the medications used pre and post-transplantation. A retrospective case series recently published in the Journal of Pakistan Medical Association highlights the common ocular pathologies encountered in renal transplant population. Majority of the patients suffered from cataract, which is a known side-effect of long-term steroids routinely used for graft survival. There was a unique finding in Pakistani population, never reported before from any other transplant centre world over; a large number of recipients was reported to be suffering from night blindness, which significantly improved on vitamin A supplementation. There were a variety of other ocular complications seen which emphasizes the necessity of ocular care and routine examination of transplant recipient’s eyes by an ophthalmologist in order to avoid visual compromise and improve the quality of life of the transplant recipient.Keywords: cataract, night blindness, ocular complications, renal transplantation
Procedia PDF Downloads 10415286 Role of Numerical Simulation as a Tool to Enhance Climate Change Adaptation and Resilient Societies: A Case Study from the Philippines
Authors: Pankaj Kumar
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Rapid global changes resulted in unfavorable hydrological, ecological, and environmental changes and cumulatively affected natural resources. As a result, the local communities become vulnerable to water stress, poor hygiene, the spread of diseases, food security, etc.. However, the central point for this vulnerability revolves around water resources and the way people interrelate with the hydrological system. Also, most of the efforts to minimize the adverse effect of global changes are centered on the mitigation side. Hence, countries with poor adaptive capacities and poor governance suffer most in case of disasters. However, several transdisciplinary numerical tools are well designed and are capable of answering “what-if questions” through scenario analysis using a system approach. This study has predicted the future water environment in Marikina River in the National Capital Region, Metro Manila of Philippines, using Water Evaluation and Planning (WEAP), an integrated water resource management tool. Obtained results can answer possible adaptation measures along with their associated uncertainties. It also highlighted various challenges for the policy planners to design adaptation countermeasures as well as to track the progress of achieving SDG 6.0.Keywords: water quality, Philippines, climate change adaptation, hydrological simulation, wastewater management, weap
Procedia PDF Downloads 10215285 Bridging the Gap and Widening the Divide
Authors: Lerato Dixon, Thorsten Chmura
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This paper explores whether ethnic identity in Zimbabwe leads to discriminatory behaviour and the degree to which a norm-based intervention can shift this discriminatory behaviour. Social Identity Theory suggests that group identity can lead to favouritism towards the in-group and discriminatory behaviour towards the out-group. Agents yield higher utility from maintaining positive self-esteem by confirming with group behaviour. This paper focuses on the two majority ethnic groups in Zimbabwe – the Ndebele and Shona. Racial identities are synonymous with the language spoken. Zimbabwe’s history highlights how identity formation took place. As following independence, political parties became recognised as either Ndebele or Shona-speaking. It is against this backdrop that this study investigates the degree to which norm-based nudge can alter behaviour. This paper uses experimental methods to analyse discriminatory behaviour between two naturally occurring ethnic groups in Zimbabwe. In addition, we investigate if social norm-based interventions can shift discriminatory behaviour to understand if the divide between these two identity groups can be further divided or healed. Participants are randomly assigned into three groups to receive information regarding a social norm. We compare the effect of a proscriptive social norm-based intervention, stating what shouldn't be done and prescriptive social norms as interventions, stating what should be done. Specifically, participants are either shown the socially appropriate (Heal) norm, the socially inappropriateness (Divide) norm regarding interethnic marriages or no norm-based intervention. Following the random assignment into intervention groups, participants take part in the Trust Game. We conjecture that discrimination will shift in accordance with the prevailing social norm. Instead, we find evidence of interethnic discriminatory behaviour. We also find that trust increases when interacting with Ndebele, Shona and Zimbabwean participants following the Heal intervention. However, if the participant is Shona, the Heal intervention decreases trust toward in-groups and Zimbabwean co-players. On the other hand, if the participant is Shona, the Divide treatment significantly increases trust toward Ndebele participants. In summary, we find evidence that norm-based interventions significantly change behaviour. However, the prescriptive norm-based intervention (Heal) decreases trust toward the in-group, out-group and national identity group if the participant is Shona – therefore having an adverse effect. In contrast, the proscriptive Divide treatment increases trust if the participant is Shona towards Ndebele co-players. We conclude that norm-based interventions have a ‘rebound’ effect by altering behaviour in the opposite direction.Keywords: discrimination, social identity, social norm-based intervention, zimbabwe
Procedia PDF Downloads 24815284 Clinical Comparative Study Comparing Efficacy of Intrathecal Fentanyl and Magnesium as an Adjuvant to Hyperbaric Bupivacaine in Mild Pre-Eclamptic Patients Undergoing Caesarean Section
Authors: Sanchita B. Sarma, M. P. Nath
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Adequate analgesia following caesarean section decreases morbidity, hastens ambulation, improves patient outcome and facilitates care of the newborn. Intrathecal magnesium, an NMDA antagonist, has been shown to prolong analgesia without significant side effects in healthy parturients. The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of magnesium or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine in patients with mild preeclampsia undergoing caesarean section. Sixty women with mild preeclampsia undergoing elective caesarean section were included in a prospective, double blind, controlled trial. Patients were randomly assigned to receive spinal anesthesia with 2 mL 0.5% hyperbaric bupivacaine with 12.5 µg fentanyl (group F) or 0.1 ml of 50% magnesium sulphate (50 mg) (group M) with 0.15ml preservative free distilled water. Onset, duration and recovery of sensory and motor block, time to maximum sensory block, duration of spinal anaesthesia and postoperative analgesic requirements were studied. Statistical comparison was carried out using the Chi-square or Fisher’s exact tests and Independent Student’s t-test where appropriate. The onset of both sensory and motor block was slower in the magnesium group. The duration of spinal anaesthesia (246 vs. 284) and motor block (186.3 vs. 210) were significantly longer in the magnesium group. Total analgesic top up requirement was less in group M. Hemodynamic parameters were similar in both the groups. Intrathecal magnesium caused minimal side effects. Since Fentanyl and other opioid congeners are not available throughout the country easily, magnesium with its easy availability and less side effect profile can be a cost effective alternative to fentanyl in managing pregnancy induced hypertension (PIH) patients given along with Bupivacaine intrathecally in caesarean section.Keywords: analgesia, magnesium, pre eclampsia, spinal anaesthesia
Procedia PDF Downloads 32015283 Effect of Large English Studies Classes on Linguistic Achievement and Classroom Discourse at Junior Secondary Level in Yobe State
Authors: Clifford Irikefe Gbeyonron
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Applied linguists concur that there is low-level achievement in English language use among Nigerian secondary school students. One of the factors that exacerbate this is classroom feature of which large class size is obvious. This study investigated the impact of large classes on learning English as a second language (ESL) at junior secondary school (JSS) in Yobe State. To achieve this, Solomon four-group experimental design was used. 382 subjects were divided into four groups and taught ESL for thirteen weeks. 356 subjects wrote the post-test. Data from the systematic observation and post-test were analyzed via chi square and ANOVA. Results indicated that learners in large classes (LLC) attain lower linguistic progress than learners in small classes (LSC). Furthermore, LSC have more chances to access teacher evaluation and participate actively in classroom discourse than LLC. In consequence, large classes have adverse effects on learning ESL in Yobe State. This is inimical to English language education given that each learner of ESL has their individual peculiarity within each class. It is recommended that strategies that prioritize individualization, grouping, use of language teaching aides, and theorization of innovative models in respect of large classes be considered.Keywords: large classes, achievement, classroom discourse
Procedia PDF Downloads 40815282 The Effect of Circuit Training on Aerobic Fitness and Body Fat Percentage
Authors: Presto Tri Sambodo, Suharjana, Galih Yoga Santiko
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Having an ideal body shape healthy body are the desire of everyone, both young and old. The purpose of this study was to determine: (1) the effect of block circuit training on aerobic fitness and body fat percentage, (2) the effect of non-block circuit training on aerobic fitness and body fat percentage, and (3) differences in the effect of exercise on block and non-circuit training block against aerobic fitness and body fat percentage. This research is an experimental research with the prestest posttest design Two groups design. The population in this study were 57 members of fat loss at GOR UNY Fitness Center. The retrieval technique uses purposive random sampling with a sample of 20 people. The instruments with rockport test (1.6 KM) and body fat percentage with a scale of bioelectrical impedance analysis omron (BIA). So it can be concluded the circuit training between block and non-block has a significant effect on aerobic fitness and body fat percentage. And for differences in the effect of circuit training between blocks and non-blocks, it is more influential on aerobic fitness than the percentage of body fat.Keywords: circuit training, aerobic fitness, body fat percentage, healthy body
Procedia PDF Downloads 25115281 The Effects of Copper and Cadmium on Germination and Seedling Growth of Oriental Beech (Fagus orientalis Lipsky) Seeds
Authors: Handan Ucun Özel, Halil Barış Özel
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The toxic effects of copper and cadmium on seed germination, seedling, root, shoot length, and seedling dry biomass of oriental beech (Fagus orientalis Lipsky) was evaluated under laboratory conditions compared to control values. Copper and cadmium treatments at 50, 100, 150, and 200 mg/l affect seed germination and seedling growth of oriental beech as compared to control. Copper treatments at 50, 100, 150, and 200 mg/l concentrations produced significant (p < 0.01) effects on seed germination and seedling length of oriental beech while copper treatment at 150 mg/l significantly affected root growth and seedling dry biomass as compared to control. Similarly, cadmium treatments from 50 to 200 mg/l affected the seed germination, root, shoot length, and seedling dry biomass of oriental beech as compared to control. Cadmium treatments showed an adverse effect on seedlings of oriental beech as compared to copper, copper and cadmium treatments at 200mg/l exhibited the lowest percentage of tolerance in seedlings of oriental beech as compared to control.Keywords: copper, cadmium, toxicity, oriental beech
Procedia PDF Downloads 29415280 Dealing the Disruptive Behaviour amongst Students with Autism through Circus
Authors: K. A. Razhiyah
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Disruptive behavior is a problem that is usually associated with those with autism. There is a need to overcome this behavioral problem because the negative impact of this problem does not only effect the social relation of the students but also can cause uneasiness to those around them. This condition will be worse if the techniques used failed to motivate students to change the behaviour. The purpose of this study was to determine the effect of the circus games technique on the disruptive behavior amongst students with autism. The positive results of the intervention that was carried out for three months show the reduction in disruptive behaviour, and also improvement in the turn-taking and focusing ability aspect. Positive changes shown by the students had an encouraging effect and in a way are helping them in the teaching and learning process.Keywords: autism, desruptive behaviour, circus, effect
Procedia PDF Downloads 24715279 Cultural Studies: The Effect of Western Culture on Muslim Lifestyle
Authors: Farah Wahida Binti Mohamad Said
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Islamic culture is the way of life a Muslim is defined by the Qur’an and Sunnah. On the other hand, Western culture is fashioned by a host of people; Capitalists, atheists, people who believe in same-gender marriages and others of a similar nature. The main issue that faced by the Muslim in Malaysia is the effect of western culture on Muslim lifestyle. This is because of the influence from western culture that dominates mind of the Muslim and also impressed on their lifestyle. Practically, majority all things have connected with western culture. However, the main objective for this project is to develop the effect of western culture on Muslim lifestyle. This project also focuses on a few aspects that relate with cultural of Muslim and western culture nowadays. This paper will include a few method .The methods for this project are a video, interview etc. Another methodology we will put on next paper for more detail information. As a result, this research found that western cultural will be effect on Muslim lifestyle.Keywords: effect of western culture, Muslim lifestyle, western culture, western and Muslim culture
Procedia PDF Downloads 51515278 Evaluation of the Analytic for Hemodynamic Instability as a Prediction Tool for Early Identification of Patient Deterioration
Authors: Bryce Benson, Sooin Lee, Ashwin Belle
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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.Keywords: clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring
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