Search results for: kidney stone
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 646

Search results for: kidney stone

376 Review of the Safety of Discharge on the First Postoperative Day Following Carotid Surgery: A Retrospective Analysis

Authors: John Yahng, Hansraj Riteesh Bookun

Abstract:

Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

Procedia PDF Downloads 147
375 Semi-automatic Design and Fabrication of Ring-Bell Control by IoT

Authors: Samart Rungjarean, Benchalak Muangmeesri, Dechrit Maneetham

Abstract:

Monks' and Novices' chimes may have some restrictions, such as during the rain when a structure or location chimes or at a certain period. Alternately, certain temple bells may be found atop a tall, difficult-to-reach bell tower. As a result, the concept of designing a brass bell for use with a mobile phone over great distances was proposed. The Internet of Things (IoT) system will be used to regulate the bell by testing each of the three beatings with a wooden head. A stone-beating head and a steel beater. The sound resonates nicely, with the distance and rhythm of the hit contributing to this. An ESP8266 microcontroller is used by the control system to manage its operations and will communicate with the pneumatic system to convey a signal. Additionally, a mobile phone will be used to operate the entire system. In order to precisely direct and regulate the rhythm, There is a resonance of roughly 50 dB for this test, and the operating distance can be adjusted. Timing and accuracy were both good.

Keywords: automatic ring-bell, microcontroller, ring-bell, iot

Procedia PDF Downloads 85
374 An Overview of Sludge Utilization into Fired Clay Brick

Authors: Aeslina Binti Abdul Kadir, Ahmad Shayuti Bin Abdul Rahim

Abstract:

Brick is one of the most common masonry units used as building material. Due to the demand, different types of waste have been investigated to be incorporated into the bricks. Many types of sludge have been incorporated in fired clay brick for example marble sludge, stone sludge, water sludge, sewage sludge, and ceramic sludge. The utilization of these waste materials in fired clay bricks usually has positive effects on the properties such as lightweight bricks with improved shrinkage, porosity, and strength. This paper reviews on utilization of different types of sludge wastes into fired clay bricks. Previous investigations have demonstrated positive effects on the physical and mechanical properties as well as less impact towards the environment. Thus, the utilizations of sludge waste could produce a good quality of brick and could be one of alternative disposal methods for the sludge wastes.

Keywords: fired clay brick, sludge waste, compressive strength, shrinkage, water absorption

Procedia PDF Downloads 419
373 The Engineering Properties of Jordanian Marble

Authors: Mousa Bani Baker, Raed Abendeh, Zaidoon Abu Salem, Hesham Ahmad

Abstract:

This research paper was commissioned to discuss the Jordanian marble, which is a non-foliated metamorphic rock composed of recrystallized carbonate minerals, most commonly calcite or dolomite. Geologists use the term "marble" to refer to metamorphosed limestone; however, stonemasons use the term more broadly to encompass unmetamorphised limestone. Marble is commonly used for sculpture and as a building material. The marble has many uses; one of them is using the white marble that has been prized for its use in sculptures since classical times. This preference has to do with its softness, relative isotropy and homogeneity, and a relative resistance to shattering. Another use of it is the construction marble which is “a stone which is composed of calcite, dolomite or serpentine which is capable of taking a polish” Marble Institute of America. This report focuses most about the marble in Jordan and its properties: rock definition, physical properties, the marble occurrences in Jordan, types of Jordanian marble and their prices and test done on this marble.

Keywords: marble, metamorphic, non-foliated, compressive strength, recrystallized, Moh’s hardness, abrasion, absorption, modulus of rupture, porosity

Procedia PDF Downloads 347
372 Self-Efficacy Psychoeducational Programme for Patients With End-Stage Renal Disease

Authors: H.C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

Abstract:

Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological wellbeing, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes. Hopefully it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

Procedia PDF Downloads 285
371 Treatment of Simulated Textile Wastewater Containing Reactive Azo Dyes Using Laboratory Scale Trickling Filter

Authors: Ayesha Irum, Sadia Mumtaz, Abdul Rehman, Iffat Naz, Safia Ahmed

Abstract:

The present study was conducted to evaluate the potential applicability of biological trickling filter system for the treatment of simulated textile wastewater containing reactive azo dyes with bacterial consortium under non-sterile conditions. The percentage decolorization for the treatment of wastewater containing structurally different dyes was found to be higher than 95% in all trials. The stable bacterial count of the biofilm on stone media of the trickling filter during the treatment confirmed the presence, proliferation, dominance and involvement of the added microbial consortium in the treatment of textile wastewater. Results of physicochemical parameters revealed the reduction in chemical oxygen demand (58.5-75.1%), sulphates (18.9-36.5%), and phosphates (63.6-73.0%). UV-Visible and FTIR spectroscopy confirmed decolorization of dye containing wastewater was the ultimate consequence of biodegradation. Toxicological studies revealed the nontoxic nature of degradative metabolites.

Keywords: biodegradation, textile dyes, waste water, trickling filters

Procedia PDF Downloads 409
370 The Effectiveness of a Self-Efficacy Psychoeducational Programme to Enhance Outcomes of Patients with End-Stage Renal Disease

Authors: H. C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

Abstract:

Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological well-being, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes and it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

Procedia PDF Downloads 291
369 Cultural References in Jean-François Menard's French Translation of Harry Potter a L'ecole Des Sorciers: An Analysis of the Translated Catchphrases and Spells and Cultural Elements

Authors: Brynn Patrice Fader

Abstract:

The objective of this research project is to assess the ways in which Jean-Francois Menards French translation Harry Potter a l'ecole des sorciers translates the cultural references from the original text JK Rowlings' Harry Potter and the Philosophers Stone. The method of this analysis is to focus on analyzing the reasons for and the ways in which Menard translates the spells and catchphrases throughout the novel and the effects that these choices have on the reader. While at times Menard resorts to the omission or manipulation and borrowing he also contrasts these techniques by transferring the cultural references using the direct translational approach. It appears that the translator resorts to techniques other than direct translation when it is necessary to ensure that the target audience will understand the events and conversations taking place.

Keywords: cultural elements, direct translation, manipulation, omission

Procedia PDF Downloads 293
368 Researching International PhD Algerian Students’ Communication Challenges in Speaking When Discussing and Interacting with Their British Peers: A Researcher’s Interpretive Perspective through the Use of Semi-Structured Interview

Authors: H. Maita

Abstract:

This paper addresses the issue of the speaking challenges that the Algerian PhD students experience during their studies abroad, particularly in UK territory; more specifically, this study describes how these students may deal with such challenges and whether the cultural differences is one core reason in such dilemma or not. To this end, an understanding and interpretation of what actually encompasses both linguistic interference and cultural differences are required. Throughout the paper there is an attempt to explain the theoretical basis of the interpretive research and to theoretically discuss the pivotal use of the interview, as a data collection tool, in interpretive research. Thus, the central issue of this study is to frame the theoretical perspective of the interpretive research through the discussion of PhD Algerian’s communication and interaction challenges in the EFL context. This study is a corner stone for other research studies to further investigate the issue related to communication challenges because no specific findings will be pointed out in this research.

Keywords: communication, EFL, interaction, linguistic interference

Procedia PDF Downloads 109
367 Improving the Utilization of Telfairia occidentalis Leaf Meal with Cellulase-Glucanase-Xylanase Combination and Selected Probiotic in Broiler Diets

Authors: Ayodeji Fasuyi

Abstract:

Telfairia occidentalis is a leafy vegetable commonly grown in the tropics for nutritional benefits. The use of enzymes and probiotics is becoming prominent due to the ban on antibiotics as growth promoters in many parts of the world. It is conceived that with enzymes and probiotics additives, fibrous leafy vegetables can be incorporated into poultry feeds as protein source. However, certain antinutrients were also found in the leaves of Telfairia occidentalis. Four broiler starter and finisher diets were formulated for the two phases of the broiler experiments. A mixture of fiber degrading enzymes, Roxazyme G2 (combination of cellulase, glucanase and xylanase) and probiotics (Turbotox), a growth promoter, were used in broiler diets at 1:1. The Roxazyme G2/Turbotox mixtures were used in diets containing four varying levels of Telfairia occidentalis leaf meal (TOLM) at 0, 10, 20 and 30%. Diets 1 were standard broiler diets without TOLM and Roxazyme G2 and Turbotox additives. Diets 2, 3 and 4 had enzymes and probiotics additives. Certain mineral elements such as Ca, P, K, Na, Mg, Fe, Mn, Cu and Zn were found in notable quantities viz. 2.6 g/100 g, 1.2 g/100 g, 6.2 g/100 g, 5.1 g/100 g, 4.7 g/100 g, 5875 ppm, 182 ppm, 136 ppm and 1036 ppm, respectively. Phytin, phytin-P, oxalate, tannin and HCN were also found in ample quantities viz. 189.2 mg/100 g, 120.1 mg/100 g, 80.7 mg/100 g, 43.1 mg/100 g and 61.2 mg/100 g, respectively. The average weight gain was highest at 46.3 g/bird/day for birds on 10% TOLM diet but similar (P > 0.05) to 46.2 g/bird/day for birds on 20% TOLM. The feed conversion ratio (FCR) of 2.27 was the lowest and optimum for birds on 10% TOLM although similar (P > 0.05) to 2.29 obtained for birds on 20% TOLM. FCR of 2.61 was the highest at 2.61 for birds on 30% TOLM diet. The lowest FCR of 2.27 was obtained for birds on 10% TOLM diet although similar (P > 0.05) to 2.29 for birds on 20% TOLM diet. Most carcass characteristics and organ weights were similar (P > 0.05) for the experimental birds on the different diets except for kidney, gizzard and intestinal length. The values for kidney, gizzard and intestinal length were significantly higher (P < 0.05) for birds on the TOLM diets. The nitrogen retention had the highest value of 72.37 ± 0.10% for birds on 10% TOLM diet although similar (P > 0.05) to 71.54 ± 1.89 obtained for birds on the control diet without TOLM and enzymes/probiotics mixture. There was evidence of a better utilization of TOLM as a plant protein source. The carcass characteristics and organ weights all showed evidence of uniform tissue buildup and muscles development particularly in diets containing 10% of TOLM level. There was also better nitrogen utilization in birds on the 10% TOLM diet. Considering the cheap cost of TOLM, it is envisaged that its introduction into poultry feeds as a plant protein source will ultimately reduce the cost of poultry feeds.

Keywords: Telfairia occidentalis leaf meal, enzymes, probiotics, additives

Procedia PDF Downloads 111
366 Effect of Local Steel Slag as a Coarse Aggregate in the Properties of Fly Ash Based-Geopolymer Concrete

Authors: O. M. Omar, A. M. Heniegal, G. D. Abd Elhameed, H. A. Mohamadien

Abstract:

Local steel slag is produced as a by-product during the oxidation of steel pellets in an electric arc furnace. Using local steel slag waste as a hundred substitute of crushed stone in construction materials would resolve the environmental problems caused by the large-scale depletion of the natural sources of dolomite. This paper reports the experimental study to investigate the influence of a hundred replacement of dolomite as a coarse aggregate with local steel slag, on the fresh and hardened geopolymer concrete properties. The investigation includes traditional testing of hardening concrete, for selected mixes of cement and geopolymer concrete. It was found that local steel slag as a coarse aggregate enhanced the slump test of the fresh state of cement and geopolymer concretes. Nevertheless the unit weight of concretes was affected. Meanwhile, the good performance was observed when fly ash used as geopolymer concrete based.

Keywords: geopolymer, molarity, steel slag, sodium hydroxide, sodium silicate

Procedia PDF Downloads 281
365 Evaluating Gallein Dye as a Beryllium Indicator

Authors: Elise M. Shauf

Abstract:

Beryllium can be found naturally in some fruits and vegetables (carrots, garden peas, kidney beans, pears) at very low concentrations, but is typically not clinically significant due to the low-level exposure and limited absorption of beryllium by the stomach and intestines. However, acute or chronic beryllium exposure can result in harmful toxic and carcinogenic biological effects. Beryllium can be both a workplace hazard and an environmental pollutant, therefore determining the presence of beryllium at trace levels can be essential to protect workers as well as the environment. Analysis of gallein, C₂₀H₁₂O₇, to determine if it is usable as a fluorescent dye for beryllium detection. The primary detection method currently in use includes hydroxybenzoquinoline sulfonates (HBQS), for which alternative indicators are desired. Unfortunately, gallein does not have the desired aspects needed as a dye for beryllium detection due to the peak shift properties.

Keywords: beryllium detection, fluorescent, gallein dye, indicator, spectroscopy

Procedia PDF Downloads 124
364 Jarcho-Levin Syndrome: A Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

Abstract:

Introduction: Spondylothoracic dysostosis, also known as Jarcho-Levin syndrome, is defined by a shortened neck and thorax, a protruding abdomen, inguinal and umbilical hernias, atypical spinal structure and rib fusion, leading to restricted chest movement or difficulty in breathing, along with urinary tract abnormalities and, potentially severe scoliosis. Aim: This is the case of a patient diagnosed with Jarcho-Levin syndrome, aiming to detail the range of abnormalities observed in this syndrome, the observed complications, and the therapeutic approaches employed. Results: A three-month-old male infant, born of a consanguineous marriage, delivered at full term by cesarean section, was admitted to the pediatric department for severe acute bronchiolitis. In his prenatal history, morphological ultrasound revealed macrosomia, a shortened spine, irregular vertebrae with thickened skin, normal fetal cardiac ultrasound, and the absence of the right kidney. His perinatal history included respiratory distress, requiring ventilatory support for five days. Upon physical examination, he had stunted growth, scoliosis, a short neck and trunk, longer upper limbs compared to lower limbs, varus equinus in the right foot, a neural tube defect, a low hairline, and low-set ears. Spondylothoracic dysostosis was suspected, leading to further investigations, including a normal transfontaneous ultrasound, a spinal cord ultrasound revealing a lipomyelocele-type closed dysraphism with a low-attached cord, an abdominal ultrasound indicating a single left kidney, and a cardiac ultrasound identifying Kommerell syndrome. Due to a lack of resources, genetic testing could not be performed, and the diagnosis was based on clinical criteria. Conclusion: Jarcho-Levin syndrome can result in a mortality rate of about 50%, primarily due to respiratory complications associated with thoracic insufficiency syndrome. Other complications, like heart and neural tube defects, can also lead to premature mortality. Therefore, early diagnosis and comprehensive treatment involving various specialists are essential.

Keywords: Jarcho-Levin syndrome, congenital disorder, scoliosis, spondylothoracic dysostosis, neural tube defect

Procedia PDF Downloads 34
363 Investigation of Thermal Comfort Conditions of Vernacular Buildings Taking into Consideration Various Use Patterns: A Case Study

Authors: Christina Kalogirou

Abstract:

The main goal of this paper is to explore the thermal comfort conditions in traditional buildings during all seasons of the year taking into consideration various use patterns. For this purpose a dwelling of vernacular architecture is selected and data regarding the indoor and outdoor air and surface temperature as well as the relative humidity are collected. These measurements are conducted in situ during the period of a year. Also, this building is occupied periodically and a calendar of occupancy was kept (duration of residence, hours of heating system operation, hours of natural ventilation, etc.) in order to correlate the indoor conditions recorded with the use patterns via statistical analysis. Furthermore, the effect of the high thermal inertia of the stone masonry walls and the different orientation of the rooms is addressed. Thus, this paper concludes in some interesting results on the effect of the users in the indoor climate conditions in the case of buildings with high thermal inertia envelops.

Keywords: thermal comfort, in situ measurements, occupant behaviour, vernacular architecture

Procedia PDF Downloads 421
362 Renal Amyloidosis in Domestic Iranian Sheep

Authors: Keivan Jamshidi, Fateme Behbahani, Sara Omidi, Nadia Shahi, Alireza Farkhonde

Abstract:

Amyloidosis represents a heterogenous group of diseases that have in common the deposition of fibrils composed of proteins of beta-pleated sheet structure, which can be specifically identified by histochemistry using the Congo red or similar stains. Between October 2013 to April 2014 (6 months) different patterns of renal amyloidosis was diagnosed on histopathological examination of kidneys belong to 196 out of 7065 slaughtered sheep subjected to postmortem examination. Microscopic examination of renal tissue sections stained with H&E and CR staining techniques revealed 3 patterns of renal amyloid deposition; including glomerular (22.72%), medullary (68.18%), and vascular (9.09%) were recognized. Renal medullary amyloidosis (RMA) was detected as the most prevalence pattern of renal amyloidosis in domestic sheep.

Keywords: sheep, amyloidosis, kidney, slaughterhouse

Procedia PDF Downloads 349
361 Examples from a Traditional Sismo-Resistant Architecture

Authors: Amira Zatir, Abderahmane Mokhtari, Amina Foufa, Sara Zatir

Abstract:

It exists in several regions in the world, of numerous historic monuments, buildings and housing environment, built in traditional ways which survive for earthquakes, even in zones where the seismic risk is particularly raised. These constructions, stemming from vernacular architecture, allow, through their resistances in the time earthquakes, to identify the various sismo-resistant "local" techniques. Through the examples and the experiences presented, the remark which can be made, is that in the traditional built, two major principles in a way opposite, govern the constructions in earthquake-resistant. It is about the very big flexibility, whom answer very light constructions, like the Japanese wooden constructions, Turkish and even Chinese; that of the very big rigidity to which correspond constructions in masonry in particular stone, more or less heavy and massive, which we meet in particular in the Mediterranean Basin, and in the historic sanctuary of Machu Pacchu. In it sensible and well-reflected techniques of construction are added, of which the use of the humble materials such as the earth and the adobe. The ancient communities were able to face the seismic risks, thanks to them know-how reflected in their intelligently designed constructions, testifying of a local seismic culture.

Keywords: earthquake, architecture, traditional, construction, resistance

Procedia PDF Downloads 393
360 Drug Reaction with Eosinophilia and Systemic Symptoms (Dress) Syndrome Presenting as Multi-Organ Failure

Authors: Keshari Shrestha, Philip Vatterott

Abstract:

Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal drug-related syndrome. DRESS classically presents with a diffuse maculopapular rash, fevers, and eosinophilia more than three weeks after drug exposure. DRESS can present with multi-organ involvement, with liver damage being the most common and severe. Pulmonary involvement is a less common manifestation and is associated with poor clinical outcomes. Chest imaging is often nonspecific, and symptoms can range from mild cough to acute respiratory distress syndrome (ARDS) . This is a case of a 49-year-old female with a history of recent clostridium difficile colitis status post treatment with oral vancomycin who presented with rash, acute liver and kidney failure, as well as diffuse nodular alveolar lung opacities concerning for DRESS syndrome with multi-organ involvement. Clinical Course: This patient initially presented to an outside hospital with clostridium difficile colitis, acute liver injury, and acute kidney injury. She developed a desquamating maculopapular rash in the setting of recent oral vancomycin, meloxicam, and furosemide initiation. She was hospitalized on two additional occasions with worsening altered mental status, liver injury, and acute kidney injury and was initiated on intermittent hemodialysis. Notably, she was found to have systemic eosinophilia (4100 cells/microliter) several weeks prior. She was transferred to this institution for further management where she was found to have encephalopathy, jaundice, lower extremity edema, and diffuse bilateral rhonchorous breath sounds on pulmonary examination. The patient was started on methylprednisolone for suspected DRESS syndrome. She underwent an evaluation for alternative causes of her organ failure. Her workup included a negative infectious, autoimmune, metabolic, toxic, and malignant work-up. Abdominal computed tomography (CT) and ultrasound were remarkable for evidence of hepatic steatosis and possible cirrhotic morphology. Additionally, a chest CT demonstrated diffuse and symmetric nodular alveolar lung opacities with peripheral sparing not consistent with acute respiratory distress syndrome or edema. Ultimately, her condition continued to decline, and she required intubation on several occasions. On hospital day 25 she succumbed to distributive shock in the setting of probable sepsis and multi-organ failure. Discussion: DRESS syndrome occurs in 1 in 1,000 to 10,000 patients with a mortality rate of around 10%. Anti-convulsant, anti-bacterial, anti-viral, and sulfonamide drugs are the most common drugs implicated in the development of DRESS syndrome; however, the list of offending agents is extensive . The diagnosis of DRESS syndrome is made after excluding other causes of disease such as infectious and autoimmune etiologies. The RegiSCAR scoring system is used to diagnose DRESS syndrome with 2-3 points indicating possible disease, 4-5 probable disease, and >5 definite disease. This patient scored a 7 on the RegiSCAR scale for eosinophilia, rash, organ involvement, and exclusion of other causes (infectious and autoimmune). While the pharmacologic trigger in this case is unknown, it is speculated to be caused by vancomycin, meloxicam, or furosemide due to the favorable timeline of initiation. Despite aggressive treatment, DRESS syndrome can often be fatal. Because of this, early diagnosis and treatment of patients with suspected DRESS syndrome is imperative.

Keywords: drug reaction with eosinophilia and systemic symptoms, multi-organ failure, pulmonary involvement, renal failure

Procedia PDF Downloads 146
359 Mobile Application Set to Empower SME Farmers in Peri-Urban Sydney Region

Authors: A. Hol

Abstract:

Even in the well developed countries like Australia, Small to Medium Farmers do not often have the power over the market prices as they are more often than not set by the farming agents. This in turn creates problems as farmers only get to know for how much their produce has been sold for by the agents three to four weeks after the sale has taken the place. To see and identify if and how peri-urban Sydney farmers could be assisted, carefully selected group of peri-urban Sydney farmers of the stone fruit has been interviewed. Following the case based interviews collected data was analyzed in detail using the Scenario Based Transformation principles. Analyzed data was then used to create a most common transformation case. The case identified that a mobile web based system could be develop so that framers can monitor agent earnings and in turn gain more power over the markets. It is expected that after the system has been in action for six months to a year, farmers will become empowered and they will gain means to monitor the market and negotiate agent prices.

Keywords: mobile applications, farming, scenario-based analysis, scenario-based transformation, user empowerment

Procedia PDF Downloads 363
358 Contrast Enhanced Magnetic Resonance Angiography in Rats with Gadobenate Dimeglumine at 3T

Authors: Jao Jo-Chi, Chen Yen-Ku, Jaw Twei-Shiun, Chen Po-Chou

Abstract:

This study aimed to investigate the magnetic resonance (MR) signal enhancement ratio (ER) of contrast-enhanced MR angiography (CE-MRA) in normal rats with gadobenate dimeglumine (Gd-BOPTA) using a clinical 3T scanner and an extremity coil. The relaxivities of Gd-BOPTA with saline only and with 4.5 % human serum albumin (HSA) were also measured. Compared with Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA), Gd-BOPTA had higher relaxivities. The maximum ER of Aorta (ERa), kidney, liver and muscle with Gd-BOPTA were higher than those with Gd-DTPA. The maximum ERa appeared at 1.2 min and decayed to half at 10 min after Gd-BOPTA injection. This information is helpful for the design of CE-MRA study of rats.

Keywords: contrast-enhanced magnetic resonance angiography, Gd-BOPTA, Gd-DTPA, rat

Procedia PDF Downloads 600
357 Access the Knowledge, Awareness, and Factors Associated With Hypertension Among the Residents of Modeca District of Tiko, South West Region of Cameroon, in the Middle of a Separatist Violence Since 2017

Authors: Franck Kem Acho

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The trends of diseases have been changed from the last few years, now the burden of non-communicable diseases is increasing day by day. In all the non-communicable diseases, Hypertension is one of the leading causes of premature death and morbidity worldwide. This disease is a silent killer, it mostly affects the people with no obvious symptoms. Not only the heart it also increases the risk of brain, kidney and other diseases, now a days it is a serious medical problem. Over a billion people near about 1 in 4 men and 1 in 5 women having hypertension. In this case study men and women of ages between 30-80 years with Hypertension were identified in community remote area with their Health status being checked and monitored for one week and Health Education was provided for the importance of regular Health checkup alongside the continuous taking of medications.

Keywords: hypertension, health status, health check up, health education

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356 Evaluation of Antidiabetic Activity of a Combination Extract of Nigella Sativa & Cinnamomum Cassia in Streptozotocin Induced Type-I Diabetic Rats

Authors: Ginpreet Kaur, Mohammad Yasir Usmani, Mohammed Kamil Khan

Abstract:

Diabetes mellitus is a disease with a high global burden and results in significant morbidity and mortality. In India, the number of people suffering with diabetes is expected to rise from 19 to 57 million in 2025. At present, interest in herbal remedies is growing to reduce the side effects associated with conventional dosage form like oral hypoglycemic agents and insulin for the treatment of diabetes mellitus. Our aim was to investigate the antidiabetic activities of combinatorial extract of N. sativa & C. cassia in Streptozotocin induced type-I Diabetic Rats. Thus, the present study was undertaken to screen postprandial glucose excursion potential through α- glucosidase inhibitory activity (In Vitro) and effect of combinatorial extract of N. sativa & C. cassia in Streptozotocin induced type-I Diabetic Rats (In Vivo). In addition changes in body weight, plasma glucose, lipid profile and kidney profile were also determined. The IC50 values for both extract and Acarbose was calculated by extrapolation method. Combinatorial extract of N. sativa & C. cassia at different dosages (100 and 200 mg/kg orally) and Metformin (50 mg/kg orally) as the standard drug was administered for 28 days and then biochemical estimation, body weights and OGTT (Oral glucose tolerance test) were determined. Histopathological studies were also performed on kidney and pancreatic tissue. In In-Vitro the combinatorial extract shows much more inhibiting effect than the individual extracts. The results reveals that combinatorial extract of N. sativa & C. cassia has shown significant decrease in plasma glucose (p<0.0001), total cholesterol and LDL levels when compared with the STZ group The decreasing level of BUN and creatinine revealed the protection of N. sativa & C. cassia extracts against nephropathy associated with diabetes. Combination of N. sativa & C. cassia significantly improved glucose tolerance to exogenously administered glucose (2 g/kg) after 60, 90 and 120 min interval on OGTT in high dose streptozotocin induced diabetic rats compared with the untreated control group. Histopathological studies shown that treatment with N. sativa & C. cassia extract alone and in combination restored pancreatic tissue integrity and was able to regenerate the STZ damaged pancreatic β cells. Thus, the present study reveals that combination of N. sativa & C. cassia extract has significant α- glucosidase inhibitory activity and thus has great potential as a new source for diabetes treatment.

Keywords: lipid levels, OGTT, diabetes, herbs, glucosidase

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355 Evaluation of the Radiolabelled 68GA-DOTATOC Complex in Adenocarcinoma Breast Cancer

Authors: S. Zolghadri, M. Naderi, H. Yousefnia, B. Alirzapour, A. R. Jalilian, A. Ramazani

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Nowadays, 68Ga-DOTATOC has been known as a potential agent for the detection of neuroendocrine tumours and it has indicated higher sensitivity compared with the 111In-Octeroetide. The aim of this study was to evaluate the effectiveness of this new agent in the diagnosis of adenocarcinoma breast cancer. 68Ga-DOTATOC was prepared with the radiochemical purity of higher than 98% and by the specific activity of 39.6 TBq/mmol. 37 MBq of the complex was injected intravenously into the BULB/c mice with adenocarcinoma breast cancer. PET/CT images were acquired after 30, 60 and 90 min post injection demonstrated significant accumulation in the tumour sites. Also, considerable activity was observed in the kidney and bladder as the main routs of excretion. Generally, the results showed that 68Ga-DOTATOC can be considered as a suitable complex for diagnosis of the adenocarcinoma breast cancer using PET procedure.

Keywords: adenocarcinoma breast cancer, 68Ga, octreotide, imaging

Procedia PDF Downloads 317
354 Effect of Crashed Stone on Properties of Fly Ash Based-Geopolymer Concrete with Local Alkaline Activator in Egypt

Authors: O. M. Omar, G. D. Abd Elhameed, A. M. Heniegal, H. A. Mohamadien

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Green concrete are generally composed of recycling materials as hundred or partial percent substitutes for aggregate, cement, and admixture in concrete. To reduce greenhouse gas emissions, efforts are needed to develop environmentally friendly construction materials. Using of fly ash based geopolymer as an alternative binder can help reduce CO2 emission of concrete. The binder of geopolymer concrete is different from the ordinary Portland cement concrete. Geopolymer Concrete specimens were prepared with different concentration of NaOH solution M10, M14, and, M16 and cured at 60 ºC in duration of 24 hours and 8 hours, in addition to the curing in direct sunlight. Thus, it is necessary to study the effects of the geopolymer binder on the behavior of concrete. Concrete is made by using geopolymer technology is environmental friendly and could be considered as part of the sustainable development. In this study the Local Alkaline Activator in Egypt and dolomite as coarse aggregate in fly ash based-geopolymer concrete was investigated. This paper illustrates the development of mechanical properties. Since the gained compressive strength for geopolymer concrete at 28 days was in the range of 22.5MPa – 43.9MPa.

Keywords: geopolymer, molarity, sodium hydroxide, sodium silicate

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353 Flexible Ureterorenoscopy as a New Possibility of Treating Nephrolithiasis in Children – Preliminary Reports

Authors: Adam Haliński, Andrzej Haliński

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Introduction: Flexible ureterorenoscopy is a surgery technique used for the treatment of the upper urinary tract. It is very often used in adult patients; however, due to the advancing miniaturization of the equipment as well as its precision, this technique has also become possible in the treatment process in children. Material and method: We would like to present 26 cases of flexible ureterorenoscopy carried out in children with nephrolithiasis of the upper urinary tract aged 6 to 17 years. The average age was 9.5 years and the children were treated in our department from June 2013 to January 2015. The first surgery in Poland took place in our Department on 06.06.2013. Because of nephrolithiasis all the children had been subjected earlier to ESWL treatment, which was unsuccessful. Results: 14 children had deposits in the lower calyx, 9 children had deposits in the middle and lower calyx and in 3 children a stone was located in the initial ureter. An efficiency of 88 % was achieved. Conclusions: Flexible ureterorenoscopy is effective and minimally invasive tool both for the diagnosis and treatment of upper urinary tract. We believe that the advancing miniaturization of the equipment and gaining experience will enable carrying out of this procedure in smaller children with high efficiency.

Keywords: flexible ureterorenoscopy, urolithisis, endourology, nephrolithiasis

Procedia PDF Downloads 358
352 Improvement of Bearing Capacity of Soft Clay Using Geo-Cells

Authors: Siddhartha Paul, Aman Harlalka, Ashim K. Dey

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Soft clayey soil possesses poor bearing capacity and high compressibility because of which foundations cannot be directly placed over soft clay. Normally pile foundations are constructed to carry the load through the soft soil up to the hard stratum below. Pile construction is costly and time consuming. In order to increase the properties of soft clay, many ground improvement techniques like stone column, preloading with and without sand drains/band drains, etc. are in vogue. Time is a constraint for successful application of these improvement techniques. Another way to improve the bearing capacity of soft clay and to reduce the settlement possibility is to apply geocells below the foundation. The geocells impart rigidity to the foundation soil, reduce the net load intensity on soil and thus reduce the compressibility. A well designed geocell reinforced soil may replace the pile foundation. The present paper deals with the applicability of geocells on improvement of the bearing capacity. It is observed that a properly designed geocell may increase the bearing capacity of soft clay up to two and a half times.

Keywords: bearing capacity, geo-cell, ground improvement, soft clay

Procedia PDF Downloads 294
351 A Review of Masonry Buildings Restrengthening Methods

Authors: Negar Sartipzadeh

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The historic buildings are generally the ones which have been built by materials like brick, mud, stone, and wood. Some phenomena such as severe earthquakes can be tremendously detrimental to the structures, imposing serious effects and losses on such structures. Hence, it matters a lot to ascertain safety and reliability of the structures under such circumstances. It has been asserted that the major reason for the collapse of Unreinforced Masonry (URM) in various earthquakes is the incapability of resisting the forces and vice versa because such URMs are meant for the gravity load and they fail to withstand the shear forces inside the plate and the bending forces outside the plate. For this reason, restrengthening such structures is a key factor in lowering the seismic loss in developing countries. Seismic reinforcement of the historic buildings with regard to their cultural value on one hand, and exhaustion and damage of many of the structural elements on the other hand, have brought in restricting factors which necessitate the seismic reinforcement methods meant for such buildings to be maximally safe, non-destructive, effective, and non-obvious. Henceforth, it is pinpointed that making use of diverse technologies such as active controlling, Energy dampers, and seismic separators besides the current popular methods would be justifiable for such buildings, notwithstanding their high imposed costs.

Keywords: masonry buildings, seismic reinforcement, Unreinforced Masonry (URM), earthquake

Procedia PDF Downloads 258
350 A Kunitz-Type Serine Protease Inhibitor from Rock Bream, Oplegnathus fasciatus Involved in Immune Responses

Authors: S. D. N. K. Bathige, G. I. Godahewa, Navaneethaiyer Umasuthan, Jehee Lee

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Kunitz-type serine protease inhibitors (KTIs) are identified in various organisms including animals, plants and microbes. These proteins shared single or multiple Kunitz inhibitory domains link together or associated with other types of domains. Characteristic Kunitz type domain composed of around 60 amino acid residues with six conserved cysteine residues to stabilize by three disulfide bridges. KTIs are involved in various physiological processes, such as ion channel blocking, blood coagulation, fibrinolysis and inflammation. In this study, two Kunitz-type domain containing protein was identified from rock bream database and designated as RbKunitz. The coding sequence of RbKunitz encoded for 507 amino acids with 56.2 kDa theoretical molecular mass and 5.7 isoelectric point (pI). There are several functional domains including MANEC superfamily domain, PKD superfamily domain, and LDLa domain were predicted in addition to the two characteristic Kunitz domain. Moreover, trypsin interaction sites were also identified in Kunitz domain. Homology analysis revealed that RbKunitz shared highest identity (77.6%) with Takifugu rubripes. Completely conserved 28 cysteine residues were recognized, when comparison of RbKunitz with other orthologs from different taxonomical groups. These structural evidences indicate the rigidity of RbKunitz folding structure to achieve the proper function. The phylogenetic tree was constructed using neighbor-joining method and exhibited that the KTIs from fish and non-fish has been evolved in separately. Rock bream was clustered with Takifugu rubripes. The SYBR Green qPCR was performed to quantify the RbKunitz transcripts in different tissues and challenged tissues. The mRNA transcripts of RbKunitz were detected in all tissues (muscle, spleen, head kidney, blood, heart, skin, liver, intestine, kidney and gills) analyzed and highest transcripts level was detected in gill tissues. Temporal transcription profile of RbKunitz in rock bream blood tissues was analyzed upon LPS (lipopolysaccharide), Poly I:C (Polyinosinic:polycytidylic acid) and Edwardsiella tarda challenge to understand the immune responses of this gene. Compare to the unchallenged control RbKunitz exhibited strong up-regulation at 24 h post injection (p.i.) after LPS and E. tarda injection. Comparatively robust expression of RbKunits was observed at 3 h p.i. upon Poly I:C challenge. Taken together all these data indicate that RbKunitz may involve into to immune responses upon pathogenic stress, in order to protect the rock bream.

Keywords: Kunitz-type, rock bream, immune response, serine protease inhibitor

Procedia PDF Downloads 351
349 Getting to Know the Types of Concrete and its Production Methods

Authors: Mokhtar Nikgoo

Abstract:

Definition of Concrete and Concreting: Concrete (in French: Béton) in a broad sense is any substance or combination that consists of a sticky substance with the property of cementation. In general, concrete refers to concrete made by Portland cement, which is produced by mixing fine and coarse aggregates, Portland cement and water. After enough time, this mixture turns into a stone-like substance. During the hardening or processing of the concrete, cement is chemically combined with water to form strong crystals that bind the aggregates together, a process called hydration. During this process, significant heat is released called hydration heat. Additionally, concrete shrinks slightly, especially as excess water evaporates, a phenomenon known as drying shrinkage. The process of hardening and the gradual increase in concrete strength that occurs with it does not end suddenly unless it is artificially interrupted. Instead, it decreases more over long periods of time, although, in practical applications, concrete is usually set after 28 days and is considered at full design strength. Concrete may be made from different types of cement as well as pozzolans, furnace slag, additives, additives, polymers, fibers, etc. It may also be used in the way it is made, heating, water vapor, autoclave, vacuum, hydraulic pressures and various condensers.

Keywords: concrete, RCC, batching, cement, Pozzolan, mixing plan

Procedia PDF Downloads 68
348 Wave Interaction with Single and Twin Vertical and Sloped Porous Walls

Authors: Mohamad Alkhalidi, S. Neelamani, Noor Alanjari

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The main purpose of harbors and marinas is to create a calm and safe docking space for marine vessels. Standard rubble mound breakwaters, although widely used, occupy port space and require large amounts of stones or rocks. Kuwait does not have good quality stone, so they are imported at a very high cost. Therefore, there is a need for a new wave energy dissipating structure where stones and rocks are scarce. While permeable slotted vertical walls have been proved to be a suitable alternative to rubble mound breakwaters, the introduction of sloped slotted walls may be more efficient in dissipating wave energy. For example, two slotted barriers with 60degree inclination may be equivalent to three vertical slotted barriers from wave energy dissipation point of view. A detailed physical model study is carried out to determine the effects of slope angle, porosity, and a number of walls on wave energy dissipation for a wide range of random and regular waves. The results of this study can be used to improve and optimize energy dissipation and reduce construction cost.

Keywords: porosity, slope, wave reflection, wave transmission

Procedia PDF Downloads 270
347 The Influence of Zeolitic Spent Refinery Admixture on the Rheological and Technological Properties of Steel Fiber Reinforced Self- Compacting Concrete

Authors: Žymantas Rudžionis, Paulius Grigaliūnas, Danutė Vaičiukynienė

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By planning this experimental work to investigate the effect of zeolitic waste on rheological and technological properties of self-compacting fiber reinforced concrete, we had an intention to draw attention to the environmental factor. Large amount of zeolitic waste, as a secondary raw materials are not in use properly and large amount of it is collected without a clear view of it’s usage in future. The principal aim of this work is to assure, that zeolitic waste admixture takes positive effect to the self-compacting fiber reinforced concrete mixes stability, flowability and other properties by using the experimental research methods. In addition to that a research on cement and zeolitic waste mortars were implemented to clarify the effect of zeolitic waste on properties of cement paste and stone. Primary studies indicates that zeolitic waste characterizes clear puzzolanic behavior, do not deteriorate and in some cases ensure positive rheological and mechanical characteristics of self-compacting concrete mixes.

Keywords: self compacting concrete, steel fiber reinforced concrete, zeolitic waste, rheological, properties of concrete, slump flow

Procedia PDF Downloads 343