Search results for: wastewater treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8539

Search results for: wastewater treatment

5509 Clinical Characteristics of Retinal Detachment Associated with Atopic Dermatitis

Authors: Hyoung Seok Kim

Abstract:

Purpose: To evaluate the clinical characteristics and surgical outcomes of retinal detachment associated with atopic dermatitis. Methods: A retrospective investigation of clinical notes of 37 patients with retinal detachment associated with atopic dermatitis was conducted from January 2019 to December 2023. Initial visual acuity, medical history, type of retinal detachment, number of tears, types of treatment, success rate of treatment, and presence of cataract were investigated. To evaluate the relationship with cataract, the patients were classified into three groups according to lens status: group A (eyes with clear lens), group B (eyes with cataract), and group C (pseudophakic eyes). Results: Of the 37 patients, 29 were male and 8 were female; 10 patients had bilateral retinal detachment (27.0%). The retinal breaks were often located temporally (89.4%), with only 5 cases (10.6%) involving nasal-side retinal breaks. No significant differ ences were noted in the ratio of males to females, age distribution, visual acuity before and after treatments, axial length, and lo cation of retina breaks among the three groups. After primary surgery, retinal detachment recurred in 12 patients (14 eyes), 5 of whom were initially diagnosed with bilateral retinal detachment. In addition, 12 of 14 eyes underwent a second operation, in which detachment recurred in 3 eyes. Conclusions: Incidence of bilateral retinal detachment was high in patients with atopic dermatitis, and the retinal breaks were of ten found on the temporal side. Retinal re-detachment was statistically high in patients with cataract or pseudophakic eyes com pared to patients with clear lens (p = 0.024).

Keywords: retinal detachment, atopic dermatitis, cataract, retina surgery

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5508 Removal Efficiency of Some Heavy Metals from Aqueous Solution on Magnetic Nanoparticles

Authors: Gehan El-Sayed Sharaf El-Deen

Abstract:

In this study, super paramagnetic iron-oxide nano- materials (SPMIN) were investigated for removal of toxic heavy metals from aqueous solution. The magnetic nanoparticles of 12 nm were synthesized using a co-precipitation method and characterized by transmission electron microscopy (TEM), transform infrared spectroscopy (FTIR), x-ray diffraction (XRD) and vibrating sample magnetometer (VSM). Batch experiments carried out to investigate the influence of different parameters such as contact time, initial concentration of metal ions, the dosage of SPMIN, desorption,pH value of solutions. The adsorption process was found to be highly pH dependent, which made the nanoparticles selectively adsorb these three metals from wastewater. Maximum sorption for all the studies cations obtained at the first half hour and reached equilibrium at one hour. The adsorption data of heavy metals studied were well fitted with the Langmuir isotherm and the equilibrium data show the percent removal of Ni2+, Zn2+ and Cd2+ were 96.5%, 80% and 75%, respectively. Desorption studies in acidic medium indicate that Zn2+, Ni2+ and Cd2+ were removed by 89%, 2% and 18% from the first cycle. Regeneration studies indicated that SPMIN nanoparticles undergoing successive adsorption–desorption processes for Zn2+ ions retained original metal removal capacity. The results revealed that the most prominent advantage of the prepared SPMIN adsorbent consisted in their separation convenience compared to the other adsorbents and SPMIN has high efficiency for removal the investigated metals from aqueous solution.

Keywords: heavy metals, magnetic nanoparticles, removal efficiency, Batch technique

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5507 The Design of Fire in Tube Boiler

Authors: Yoftahe Nigussie

Abstract:

This report presents a final year project pertaining to the design of Fire tube boiler for the purpose of producing saturated steam. The objective of the project is to produce saturated steam for different purpose with a capacity of 2000kg/h at 12bar design pressure by performing a design of a higher performance fire tube boiler that considered the requirements of cost minimization and parameters improvement. This is mostly done in selection of appropriate material for component parts, construction materials and production methods in different steps of analysis. In the analysis process, most of the design parameters are obtained by iterating with related formulas like selection of diameter of tubes with overall heat transfer coefficient optimization, and the other selections are also as like considered. The number of passes is two because of the size and area of the tubes and shell. As the analysis express by using heavy oil fuel no6 with a higher heating value of 44000kJ/kg and lower heating value of 41300kJ/kg and the amount of fuel consumed 140.37kg/hr. and produce 1610kw of heat with efficiency of 85.25%. The flow of the fluid is a cross flow because of its own advantage and the arrangement of the tube in-side the shell is welded with the tube sheet, and the tube sheet is attached with the shell and the end by using a gasket and weld. The design of the shell, using European Standard code section, is as like pressure vessel by considering the weight, including content and the supplementary accessories such as lifting lugs, openings, ends, man hole and supports with detail and assembly drawing.

Keywords: steam generation, external treatment, internal treatment, steam velocity

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5506 Effects of Fatty Acid Salts and Spices on Dermatophagoides farinae

Authors: Yumeho Obata, Mariko Era, Takayoshi Kawahara, Takahide Kanyama, Hiroshi Morita

Abstract:

Dermatophagoides farinae is major mite allergens in indoors. D. farinae is often swarm over powder products (e.g. wheat flour), because it feeds on starch or protein that are included in them. Eating powder products which are mixed D.farinae causes various allergic symptoms. Therefore, the creation of food additive agents with high safety and control of mite effect is required. Fatty acid salts and spices are known that have pesticidal activities. This study describes the effects of fatty acid salts and spices against Dermatophagoides farinae. Materials and Methods: Potassium salts of 9 fatty acids (C4:0, C6:0, C8:0, C10:0, C12:0, C14:0, C18:1, C18:2, C18:3) were prepared by mixing the fatty acid with the appropriate amount of KOH solution to a concentration of 175 mM and pH 10.5. C12Cu and C12Zn were selected as other fatty acid salts. Cayenne pepper, habanero, Japanese pepper, mustard, jalapeno pepper, curry aroma and cinnamon were selected as spices. D. farina, have been cultured in laboratory. To rear the mites, double-soled dishes containing of sterilized food were put on the big plastic container (30.0 × 20.0 × 20.0cm) which had 100% ammonium nitrate solution in the bottom. Plastic container was placed on incubator at 25 °C and 64 % relative humidity (RH) under dark condition. Sterilized food composed of dried bonito flakes and dried yeast (Ebios), 1:1 by weight. The antiproliferative method, sample and medium culture were mixed in double-soled dish and kept at 25 °C and 64 % RH. Decrease rates were determined 1 week and 4 week after treatment under microscope. D. farina was considered to be dead if appendages did not move when prodded with a pin. Results and Conclusions: The results show that the fatty acids potassium showed no antiproliferative effects against D. farinae. On the other hand, Japanese pepper, mustard, curry aroma and cinnamon were effective to decrease propagative rate (over 80 %) after treatment for 1 week against D. farina. Japanese pepper, curry aroma and cinnamon were effective to decrease propagative rate (approximately 100 %) after treatment for 4 weeks against D. farina. Especially, Japanese pepper and cinnamon showed the fasted and the most consecutive antiproliferative effects. These results indicate that Japanese pepper and cinnamon have high antiproliferative effects against D. farina and suggest spices will be used as a food additive agent.

Keywords: fatty acid salts, spices, antiproliferative effects, dermatophagoides farinae

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5505 Chronic Hepatitis C Virus Screening: The Role, Strategies and Challenging of Primary Healthcare Faced to Augment and Identify Asymptomatic Infected Patients

Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

Abstract:

Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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5504 Characteristics of Female Offenders: Using Childhood Victimization Model for Treatment

Authors: Jane E. Hill

Abstract:

Sexual, physical, or emotional abuses are behaviors used by one person in a relationship or within a family unit to control the other person. Physical abuse can consist of, but not limited to hitting, pushing, and shoving. Sexual abuse is unwanted or forced sexual activity on a person without their consent. Abusive behaviors include intimidation, manipulation, humiliation, isolation, frightening, terrorizing, coercing, threatening, blaming, hurting, injuring, or wounding another individual. Although emotional, psychological and financial abuses are not criminal behaviors, they are forms of abuse and can leave emotional scars on their victim. The purpose of this literature review research was to examine characteristics of female offenders, past abuse, and pathways to offending. The question that guided this research: does past abuse influence recidivism? The theoretical foundation used was relational theory by Jean Baker Miller. One common feature of female offenders is abuse (sexual, physical, or verbal). Abuse can cause mental illnesses and substance abuse. The abuse does not directly affect the women's recidivism. However, results indicated the psychological and maladaptive behaviors as a result of the abuse did contribute to indirect pathways to continue offending. The female offenders’ symptoms of ongoing depression, anxiety, and engaging in substance abuse (self medicating) did lead to the women's incarceration. Using the childhood victimization model as the treatment approach for women's mental illness and substance abuse disorders that were a result from history of child abuse have shown success. With that in mind, if issues surrounding early victimization are not addressed, then the women offenders may not recover from their mental illness or addiction and are at a higher risk of reoffending. However, if the women are not emotionally ready to engage in the treatment process, then it should not be forced onto them because it may cause harm (targeting prior traumatic experiences). Social capital is family support and sources that assist in helping the individual with education, employment opportunities that can lead to success. Human capital refers to internal knowledge, skills, and capacities that help the individual act in new and appropriate ways. The lack of human and social capital is common among female offenders, which leads to extreme poverty and economic marginalization, more often in frequent numbers than men. In addition, the changes in welfare reform have exacerbated women’s difficulties in gaining adequate-paying jobs to support themselves and their children that have contributed to female offenders reoffending. With that in mind, one way to lower the risk factor of female offenders from reoffending is to provide them with educational and vocational training, enhance their self-efficacy, and teach them appropriate coping skills and life skills. Furthermore, it is important to strengthen family bonds and support. Having a supportive family relationship was a statistically significant protective factor for women offenders.

Keywords: characteristics, childhood victimization model, female offenders, treatment

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5503 Prevalence of Complement Factor H (Y402H) Gene Polymorphism and Its Impact on the Predisposition of Syrians to Age-Related Macular Degeneration (AMD) and Response to Bevacizumab Intravitreal Injection

Authors: Loubna Safar, Lama Youssef, Majd Aljamali

Abstract:

Age-related macular degeneration (AMD) is one of the leading causes of blindness worldwide. Complement factor H polymorphism (Y402H) is thought to play a potential role in the predisposition to AMD and response of patients with exudative AMD to treatment with anti-Vascular Endothelial Growth Factor (anti-VEGF). This study aimed to investigate the frequency of Y402H among Syrians, its impact on their susceptibility to AMD, and the hypothesized role of Y402H in patients' response to intravitreal anti-VEGF (i.e.,, bevacizumab). Our case-control study encompassed unrelated 54 AMD cases and 44 controls. Genotyping was determined by standard sequencing of PCR products. Frequency was compared between patients and controls, and correlation between genotype and response to treatment was assessed in 20 patients with wet AMD who received a therapeutic course of three intravitreal bevacizumab injections (once monthly). Our results revealed a significantly higher prevalence of the risk allele C among AMD cases (51.9%) in comparison with controls (37.5%) (P= 0.04, OR= 1.386, CI= 0.999- 1.923). Patients with the TT genotype (no risk allele) exhibited a significantly better primary response rate, reached 87.5% compared to only 41.7% in patients carrying the risk allele C (TC + CC), (P= 0.04, OR= 9.8, CI=0.899- 106.84). The findings of this study prove the importance of investigating Y402H polymorphism as a prognostic marker for predicting response to bevacizumab in AMD patients.

Keywords: age-related macular degeneration, bevacizumab, complement factor H gene, polymorphism, Y402H

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5502 Effects of Nanoencapsulated Echinacea purpurea Ethanol Extract on the Male Reproductive Function in Streptozotocin-Induced Diabetic Rats

Authors: Jia-Ling Ho, Xiu-Ru Zhang, Zwe-Ling Kong

Abstract:

Diabetes mellitus (DM) is a major health problem that affects patients’ life quality throughout the world due to its many complications. It characterized by chronic hyperglycemia with oxidative stress, which impaired male reproductive function. Fibroblast growth factor 21 (FGF21) is a metabolic regulator that is required for normal spermatogenesis and protects against diabetes-induced germ cell apoptosis. Echinacea purpurea ethanol extract (EE), which contain phenolic acid and isobutylamide, had been proven to have antidiabetic property. Silica-chitosan nanoparticles (Nano-CS) has drug delivery and controlled release properties. This study aims to investigate whether silica-chitosan nanoparticles encapsulated EE (Nano-EE) had more ameliorating male infertility by analyzing the effect of testicular FGF21. The Nano-EE was characterized before used to treatment the diabetic rat model. Male Sprague-Dawley (SD) rats were obtained and divided into seven groups. A group was no induced Streptozotocin (STZ), marked as normal group. Diabetic rats were induced into diabetes by STZ (33 mg/kg). A diabetic group was no treatment with sample (diabetic control group), and other groups were treatment by Nano-CS (465 mg/kg), Nano-EE (93, 279, 465 mg/kg), and metformin (Met) (200 mg/kg) used as reference drug for 7 weeks. Our results indicated that the average nanoparticle size and zeta potential of Nano-EE were 2630 nm and -21.3 mV, respectively. The encapsulation ratio of Nano-EE was about 70%. It also confirmed the antioxidative activity was unchanged by comparing the DPPH and ABTS scavenging of Nano-EE and EE. In vivo test, Nano-EE can improve the STZ induced hyperglycemia, insulin resistance, and plasma FGF21 levels. Nano-EE has increased sperm motility, mitochondria membrane potential (MMP), plasma testosterone level, and reduction of abnormal sperm, nitric oxide (NO), superoxide production as well as reactive oxygen species (ROS). In addition, in plasma antioxidant enzymes glutathione peroxidase (GPx) and superoxide dismutase (SOD) was increased whereas pro-inflammatory cytokines TNF-α, and IL-1β were decreased. Further, in testis, protein content of FGF21, PGC-1α, and SIRT1 were improved. Nano-EE might improve diabetes-induced down-regulation of testicular FGF21 and SIRT1/PGC-1α signaling hence maintain spermatogenesis.

Keywords: diabetes mellitus, Echinacea purpurea, reproductive dysfunction, silica-chitosan nanoparticles

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5501 The Inattentional Blindness Paradigm: A Breaking Wave for Attentional Biases in Test Anxiety

Authors: Kritika Kulhari, Aparna Sahu

Abstract:

Test anxiety results from concerns about failure in examinations or evaluative situations. Attentional biases are known to pronounce the symptomatic expression of test anxiety. In recent times, the inattentional blindness (IB) paradigm has shown promise as an attention bias modification treatment (ABMT) for anxiety by overcoming practice and expectancy effects which preexisting paradigms fail to counter. The IB paradigm assesses the inability of an individual to attend to a stimulus that appears suddenly while indulging in a perceptual discrimination task. The present study incorporated an IB task with three critical items (book, face, and triangle) appearing randomly in the perceptual discrimination task. Attentional biases were assessed as detection and identification of the critical item. The sample (N = 50) consisted of low test anxiety (LTA) and high test anxiety (HTA) groups based on the reactions to tests scale scores. Test threat manipulation was done with pre- and post-test assessment of test anxiety using the State Test Anxiety Inventory. A mixed factorial design with gender, test anxiety, presence or absence of test threat, and critical items was conducted to assess their effects on attentional biases. Results showed only a significant main effect for test anxiety on detection with higher accuracy of detection of the critical item for the LTA group. The study presents promising results in the realm of ABMT for test anxiety.

Keywords: attentional bias, attentional bias modification treatment, inattentional blindness, test anxiety

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5500 Sensitivity of Steindachneridion parahybae Mature Oocytes versus Embryos at Low Temperature

Authors: Tais Silva Lopes, Danilo Caneppele, Elizabeth Romagosa

Abstract:

Surubim-do-Paraíba, Steindachneridion parahybae is a species of South American fish in critical conditions of extinction. Researches have been developed with the objective of conserving the biological material of this species. We evaluated the cooling of mature oocytes in the cryoprotective solutions containing the following alcohols: methanol, Propylene glycol and DMSO, each at concentrations of 1M, 2M and 4M, totaling nine treatments. After being submitted to treatments, the oocytes were maintained for 120 minutes in cooling to -5.52±2.58⁰C. A sample of oocytes was submitted to negative control (NC), kept in 90% L-15 solution, and positive control (PC), fertilized and taken directly to the incubator. Fertilization and hatching rates were evaluated. In order to compare the sensitivity of oocytes to embryos of the same species, the embryos maintained as CP in the previous assay were used in the free-flow stage (about 22 hours post fertilization) and submitted to the same treatments (prepared in distilled water) and also cooled for 120 min. The evaluation was done by the hatch rate. There was no fertilization rate of the oocytes submitted to the cooling with propylene glycol; the other cryoprotectants presented values of at most 3.7% of fertilization (Methanol 1M), and no treatment completed development until hatching. The cooled embryos had a significant percentage of normal larvae in all treatments, but inversely proportional to the increase in the concentration of the alcohols. DMSO 1M was the most promising treatment for embryo cooling, with 41.7% ± 20.2 of normal larvae, while mature oocytes were highly sensitive to cold.

Keywords: cryoconservation, cooling, embryos, freezing, oocytes, south American fish

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5499 Attention Treatment for People With Aphasia: Language-Specific vs. Domain-General Neurofeedback

Authors: Yael Neumann

Abstract:

Attention deficits are common in people with aphasia (PWA). Two treatment approaches address these deficits: domain-general methods like Play Attention, which focus on cognitive functioning, and domain-specific methods like Language-Specific Attention Treatment (L-SAT), which use linguistically based tasks. Research indicates that L-SAT can improve both attentional deficits and functional language skills, while Play Attention has shown success in enhancing attentional capabilities among school-aged children with attention issues compared to standard cognitive training. This study employed a randomized controlled cross-over single-subject design to evaluate the effectiveness of these two attention treatments over 25 weeks. Four PWA participated, undergoing a battery of eight standardized tests measuring language and cognitive skills. The treatments were counterbalanced. Play Attention used EEG sensors to detect brainwaves, enabling participants to manipulate items in a computer game while learning to suppress theta activity and increase beta activity. An algorithm tracked changes in the theta-to-beta ratio, allowing points to be earned during the games. L-SAT, on the other hand, involved hierarchical language tasks that increased in complexity, requiring greater attention from participants. Results showed that for language tests, Participant 1 (moderate aphasia) aligned with existing literature, showing L-SAT was more effective than Play Attention. However, Participants 2 (very severe) and 3 and 4 (mild) did not conform to this pattern; both treatments yielded similar outcomes. This may be due to the extremes of aphasia severity: the very severe participant faced significant overall deficits, making both approaches equally challenging, while the mild participant performed well initially, leaving limited room for improvement. In attention tests, Participants 1 and 4 exhibited results consistent with prior research, indicating Play Attention was superior to L-SAT. Participant 2, however, showed no significant improvement with either program, although L-SAT had a slight edge on the Visual Elevator task, measuring switching and mental flexibility. This advantage was not sustained at the one-month follow-up, likely due to the participant’s struggles with complex attention tasks. Participant 3's results similarly did not align with prior studies, revealing no difference between the two treatments, possibly due to the challenging nature of the attention measures used. Regarding participation and ecological tests, all participants showed similar mild improvements with both treatments. This limited progress could stem from the short study duration, with only five weeks allocated for each treatment, which may not have been enough time to achieve meaningful changes affecting life participation. In conclusion, the performance of participants appeared influenced by their level of aphasia severity. The moderate PWA’s results were most aligned with existing literature, indicating better attention improvement from the domain-general approach (Play Attention) and better language improvement from the domain-specific approach (L-SAT).

Keywords: attention, language, cognitive rehabilitation, neurofeedback

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5498 Altering the Solid Phase Speciation of Arsenic in Paddy Soil: An Approach to Reduce Rice Grain Arsenic Uptake

Authors: Supriya Majumder, Pabitra Banik

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Fates of Arsenic (As) on the soil-plant environment belong to the critical emerging issue, which in turn to appraises the threatening implications of a human health risk — assessing the dynamics of As in soil solid components are likely to impose its potential availability towards plant uptake. In the present context, we introduced an improved Sequential Extraction Procedure (SEP) questioning to identify solid-phase speciation of As in paddy soil under variable soil environmental conditions during two consecutive seasons of rice cultivation practices. We coupled gradients of water management practices with the addition of fertilizer amendments to assess the changes in a partition of As through a field experimental study during monsoon and post-monsoon season using two rice cultivars. Water management regimes were varied based on the methods of cultivation of rice by Conventional (waterlogged) vis-a-vis System of Rice Intensification-SRI (saturated). Fertilizer amendment through the nutrient treatment of absolute control, NPK-RD, NPK-RD + Calcium silicate, NPK-RD + Ferrous sulfate, Farmyard manure (FYM), FYM + Calcium silicate, FYM + Ferrous sulfate, Vermicompost (VC), VC + Calcium silicate, VC + Ferrous sulfate were selected to construct the study. After harvest, soil samples were sequentially extracted to estimate partition of As among the different fractions such as: exchangeable (F1), specifically sorbed (F2), As bound to amorphous Fe oxides (F3), crystalline Fe oxides (F4), organic matter (F5) and residual phase (F6). Results showed that the major proportions of As were found in F3, F4 and F6, whereas F1 exhibited the lowest proportion of total soil As. Among the nutrient treatment mediated changes on As fractions, the application of organic manure and ferrous sulfate were significantly found to restrict the release of As from exchangeable phase. Meanwhile, conventional practice produced much higher release of As from F1 as compared to SRI, which may substantially increase the environmental risk. In contrast, SRI practice was found to retain a significantly higher proportion of As in F2, F3, and F4 phase resulting restricted mobilization of As. This was critically reflected towards rice grain As bioavailability where the reduction in grain As concentration of 33% and 55% in SRI concerning conventional treatment (p <0.05) during monsoon and post-monsoon season respectively. Also, prediction assay for rice grain As bioavailability based on the linear regression model was performed. Results demonstrated that rice grain As concentration was positively correlated with As concentration in F1 and negatively correlated with F2, F3, and F4 with a satisfactory level of variation being explained (p <0.001). Finally, we conclude that F1, F2, F3 and F4 are the major soil. As fractions critically may govern the potential availability of As in soil and suggest that rice cultivation with the SRI treatment is particularly at less risk of As availability in soil. Such exhaustive information may be useful for adopting certain management practices for rice grown in contaminated soil concerning to the environmental issues in particular.

Keywords: arsenic, fractionation, paddy soil, potential availability

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5497 Clinical Signs of River Blindness and the Efficacy of Ivermectin Therapy in Idogun, Ondo State-Nigeria

Authors: Afolabi O.J, Simon-Oke I.A., Oniya M.O., Okaka C.E.

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River blindness is a skin, and an eye disease caused by Onchocerca volvulus and vectored by a female hematophagous blackfly. The study aims to evaluate the distribution of the clinical signs of river blindness and the efficacy of ivermectin in the treatment of river blindness in Idogun. Observational studies in epidemiology that involve the use of a structured questionnaire to obtain useful epidemiological information from the respondents, physical assessment via palpation from head to ankle was used to assess clinical signs from the respondents and skin snip test was used to evaluate the prevalence of the disease. The efficacy of the drug was evaluated and expressed in percentages. One hundred and ninety-two (192) out of the 384 respondents examined, showed various signs of river blindness. However, it was only 108 (28.1%) respondents with the clinical signs that demonstrated Onchocerca volvulus microfilariae in their skin snips. The clinical signs observed among the respondents include skin depigmentation such as dermatitis, leopard skin, papules, pruritus and self-inflicted injury, while ocular symptoms include cataract, ocular lesion and partial blindness. Among these clinical signs, papules, and pruritus were the most dominant in the community. The prevalence of the clinical signs was observed to vary significantly among the age groups and gender (P<0.05). The efficacy of the drug after 6 and 12 months of treatments shows that the drug is more effective at age groups 10-50 years than the age groups 51-90 years. Ivermectin is observed to be efficacious in the treatment of the disease. However, to achieve eradication of the disease, the drug may be administered at 0.15mg/kg twice a year.

Keywords: riverblindness, clinical signs, ivermectin, Idogun

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5496 Effects of Beeswax Coating on the Properties of Cocoa Bean Shell Based Papers

Authors: Sri Rejeki, Tamrin Tamrin, RH. F. Faradilla, Muhammad N. Ibrahim, Mariana M., Irnawati Irnawati

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Cocoa bean shells, despite their antioxidant and antimicrobial properties, are still considered as an underutilized agricultural waste. The functional properties and their lignocelluloses content make cocoa bean shells a potential material for paper-based food packaging. In our previous research, we have successfully produced papers from cocoa bean shells that had antioxidant and antibacterial activities. However, the hydrophilic nature of the lignocelluloses of cocoa bean shells hinders the application of the paper to be used as a food packaging. In this research, we aimed to study the effects of beeswax coating on the wettability and mechanical properties of the paper. The coating was done by dipping the papers in beeswax solution several times and in three different beeswax concentrations. The number of dipping and beeswax concentration significantly (p<0.05) affected the water contact angle of the papers. Results show that the water contact angle increases dramatically due to the coating treatment. The control paper or uncoated paper had a contact angle of 40.50o, while the contact angle of the best-coated paper (D3B3: 3x dipping, 3g/10mL beeswax) reached 96.93o. Both tensile strength and percent elongation were not significantly (p>0.05) affected by the coating treatment. This showed that beeswax was a potential organic material to improve the hydrophobicity of paper from cocoa bean shells without any undesirable effects on the mechanical properties of the paper.

Keywords: cocoa bean shell, paper, beeswax, coating, contact angle

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5495 The Effect of Crack Size, Orientation and Number on the Elastic Modulus of a Cracked Body

Authors: Mark T. Hanson, Alan T. Varughese

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Osteoporosis is a disease affecting bone quality which in turn can increase the risk of low energy fractures. Treatment of osteoporosis using Bisphosphonates has the beneficial effect of increasing bone mass while at the same time has been linked to the formation of atypical femoral fractures. This has led to the increased study of micro-fractures in bones of patients using Bisphosphonate treatment. One of the mechanics related issues which have been identified in this regard is the loss in stiffness of bones containing one or many micro-fractures. Different theories have been put forth using fracture mechanics to determine the effect of crack presence on elastic properties such as modulus. However, validation of these results in a deterministic way has not been forthcoming. The present analysis seeks to provide this deterministic evaluation of fracture’s effect on the elastic modulus. In particular, the effect of crack size, crack orientation and crack number on elastic modulus is investigated. In particular, the Finite Element method is used to explicitly determine the elastic modulus reduction caused by the presence of cracks in a representative volume element. Single cracks of various lengths and orientations are examined as well as cases of multiple cracks. Cracks in tension as well as under shear stress are considered. Although the focus is predominantly two-dimensional, some three-dimensional results are also presented. The results obtained show the explicit reduction in modulus caused by the parameters of crack size, orientation and number noted above. The present results allow the interpretation of the various theories which currently exist in the literature.

Keywords: cracks, elastic, fracture, modulus

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5494 Polyphenol-Rich Aronia Melanocarpa Juice Consumption and Line-1 Dna Methylation in a Cohort at Cardiovascular Risk

Authors: Ljiljana Stojković, Manja Zec, Maja Zivkovic, Maja Bundalo, Marija Glibetić, Dragan Alavantić, Aleksandra Stankovic

Abstract:

Cardiovascular disease (CVD) is associated with alterations in DNA methylation, the latter modulated by dietary polyphenols. The present pilot study (part of the original clinical study registered as NCT02800967 at www.clinicaltrials.gov) aimed to investigate the impact of 4-week daily consumption of polyphenol-rich Aronia melanocarpa juice on Long Interspersed Nucleotide Element-1 (LINE-1) methylation in peripheral blood leukocytes, in subjects (n=34, age of 41.1±6.6 years) at moderate CVD risk, including an increased body mass index, central obesity, high normal blood pressure and/or dyslipidemia. The goal was also to examine whether factors known to affect DNA methylation, such as folate intake levels, MTHFR C677T gene variant, as well as the anthropometric and metabolic parameters, modulated the LINE-1 methylation levels upon consumption of polyphenol-rich Aronia juice. The experimental analysis of LINE-1 methylation was done by the MethyLight method. MTHFR C677T genotypes were determined by the polymerase chain reaction-restriction fragment length polymorphism method. Folate intake was assessed by processing the data from the food frequency questionnaire and repeated 24-hour dietary recalls. Serum lipid profile was determined by using Roche Diagnostics kits. The statistical analyses were performed using the Statistica software package. In women, after vs. before the treatment period, a significant decrease in LINE-1 methylation levels was observed (97.54±1.50% vs. 98.39±0.86%, respectively; P=0.01). The change (after vs. before treatment) in LINE-1 methylation correlated directly with MTHFR 677T allele presence, average daily folate intake and the change in serum low-density lipoprotein cholesterol, while inversely with the change in serum triacylglycerols (R=0.72, R2=0.52, adjusted R2=0.36, P=0.03). The current results imply potential cardioprotective effects of habitual polyphenol-rich Aronia juice consumption achieved through the modifications of DNA methylation pattern in subjects at CVD risk, which should be further confirmed. Hence, the precision nutrition-driven modulations of DNA methylation may become targets for new approaches in the prevention and treatment of CVD.

Keywords: Aronia melanocarpa, cardiovascular risk, LINE-1, methylation, peripheral blood leukocytes, polyphenol

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5493 The Anti-Obesity Effects of the Aqueous and Ethanolic Leaf Extracts of Blumea balsamifera on Diet-Induced Obese Sprague-Dawley Rats

Authors: Mae Genevieve G. Cheung, Michael G. Cuevas, Lovely Fe L. Cuison, Elijin P. Dai, Katrina Marie S. Duron, Azalea Damaris E. Encarnacion, May T. Magtoto, Gina C. Castro

Abstract:

The present study aims to evaluate the effectiveness of aqueous and ethanolic leaf extracts of Blumea balsamifera in reducing obesity on diet-induced obese Sprague-Dawley rats. Aqueous and ethanolic leaf extracts were obtained by maceration and percolation, respectively, of air-dried, grinded leaves. The test animals were given a high fat diet (HFD) for 21 days, except for one negative control group fed with a standard diet (SD). The Blumea balsamifera extracts were given at doses of 300 mg/Kg and 600 mg/Kg for BBAE and BBEE groups, and the positive control group, Orlistat, was given at 21.6 mg/Kg dose. After 24 days of treatment, the statistical difference of parameters such as Lee’s index and lipid profile of each group before and after the treatment period were determined separately using Tukey’s test of two-way Analysis of Variance (ANOVA). The statistical results showed that the600mg/kg dose of BBAE and BBEE had greatly lowered the Lee’s index among the other doses while the 300 mg/Kg dose BBEE, 600 mg/Kg BBAE, and 300 mg/kg BBAE lowered the total cholesterol level, LDL level, and VLDL and total triglyceride level respectively. The extracts, however, lowered the HDL level which was also exhibited by the standard drug, Orlistat.

Keywords: adipocytes, adipogenesis, Blumea balsamifera, Lee’s index, obesity, Sambong

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5492 Medicinal and Aromatic Plants of Borcka (Artvin)

Authors: Özgür Emi̇nağaoğlu, Hayal Akyildirim Beğen, Şevval Sali̇oğlu

Abstract:

In this study, the plant used for purification and aromatic purposes by the public in Adagül, Akpınar, Alaca, Ambarlı, Arkaköy, Avcılar, Balcı, Civan, Demirciler, Düzköy, İbrikli, Kale, Kaynarca and Taraklı villages in Borcka (Artvin) district between 2020-2022. The purpose of the study, determining the surgical common and local names, regions, botanical features, used parts of plants, purpose of use, local usage intensive, and giving literature data. The research area is located on the A8 square according to Davis's grid system; its phytogeographic extensions are in the Holarctic regions, and the Euro-Siberian flora settlement is in the Colchic subsection of the Euxine region. In the research area, 71 personal questionnaires were applied. As a result of the surveys, it was determined that 93 plant species belonging to 44 families were used by the local people for purification and aromatic purposes. The families that contain the most taxa in the research area are, respectively, Rosaceae (15 taxa), Astericaeae (9 taxa), Lamiaceae (7 taxa), Crassulaceae (4 taxa). As a result of the survey studies, Plantago major L. is known by almost all participants. The most used plants were Allium scorodoprasum, Helichrysum arenarium, Alnus glutinosa subsp. barbata, Juglans regia, Tilia rubra subsp. caucasica, Picea orientalis, Urtica dioica. These plants are used in the treatment of many diseases. Some of these plants that grow in Borçka are used in different countries for the treatment of the same diseases.

Keywords: artvin, borçka, medicinal, aromatic, plant

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5491 Knowledge Based Software Model for the Management and Treatment of Malaria Patients: A Case of Kalisizo General Hospital

Authors: Mbonigaba Swale

Abstract:

Malaria is an infection or disease caused by parasites (Plasmodium Falciparum — causes severe Malaria, plasmodium Vivax, Plasmodium Ovale, and Plasmodium Malariae), transmitted by bites of infected anopheles (female) mosquitoes to humans. These vectors comprise of two types in Africa, particularly in Uganda, i.e. anopheles fenestus and Anopheles gambaie (‘example Anopheles arabiensis,,); feeds on man inside the house mainly at dusk, mid-night and dawn and rests indoors and makes them effective transmitters (vectors) of the disease. People in both urban and rural areas have consistently become prone to repetitive attacks of malaria, causing a lot of deaths and significantly increasing the poverty levels of the rural poor. Malaria is a national problem; it causes a lot of maternal pre-natal and antenatal disorders, anemia in pregnant mothers, low birth weights for the newly born, convulsions and epilepsy among the infants. Cumulatively, it kills about one million children every year in sub-Saharan Africa. It has been estimated to account for 25-35% of all outpatient visits, 20-45% of acute hospital admissions and 15-35% of hospital deaths. Uganda is the leading victim country, for which Rakai and Masaka districts are the most affected. So, it is not clear whether these abhorrent situations and episodes of recurrences and failure to cure from the disease are a result of poor diagnosis, prescription and dosing, treatment habits and compliance of the patients to the drugs or the ethical domain of the stake holders in relation to the main stream methodology of malaria management. The research is aimed at offering an alternative approach to manage and deal absolutely with problem by using a knowledge based software model of Artificial Intelligence (Al) that is capable of performing common-sense and cognitive reasoning so as to take decisions like the human brain would do to provide instantaneous expert solutions so as to avoid speculative simulation of the problem during differential diagnosis in the most accurate and literal inferential aspect. This system will assist physicians in many kinds of medical diagnosis, prescribing treatments and doses, and in monitoring patient responses, basing on the body weight and age group of the patient, it will be able to provide instantaneous and timely information options, alternative ways and approaches to influence decision making during case analysis. The computerized system approach, a new model in Uganda termed as “Software Aided Treatment” (SAT) will try to change the moral and ethical approach and influence conduct so as to improve the skills, experience and values (social and ethical) in the administration and management of the disease and drugs (combination therapy and generics) by both the patient and the health worker.

Keywords: knowledge based software, management, treatment, diagnosis

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5490 Implementing Mindfulness into Wellness Plans: Assisting Individuals with Substance Abuse and Addiction

Authors: Michele M. Mahr

Abstract:

The purpose of this study is to educate, inform, and facilitate scholarly conversation and discussion regarding the implementation of mindfulness techniques when working with individuals with substance use disorder (SUD) or addictive behaviors in mental health. Mindfulness can be recognized as the present moment, non-judgmental awareness, initiated by concentrated attention that is non-reactive and as openheartedly as possible. Individuals with SUD or addiction typically are challenged with triggers, environmental situations, cravings, or social pressures which may deter them from remaining abstinent from their drug of choice or addictive behavior. Also, mindfulness is recognized as one of the cognitive and behavioral treatment approaches and is both a physical and mental practice that encompasses individuals to become aware of internal situations and experiences with undivided attention. That said, mindfulness may be an effective strategy for individuals to employ during these experiences. This study will reveal how mental health practitioners and addiction counselors may find mindfulness to be an essential component of increasing wellness when working with individuals seeking mental health treatment. To this end, mindfulness is simply the ability individuals have to know what is actually happening as it is occurring and what they are experiencing at the moment. In the context of substance abuse and addiction, individuals may employ breathing techniques, meditation, and cognitive restructuring of the mind to become aware of present moment experiences. Furthermore, the notion of mindfulness has been directly connected to the development of neuropathways. The creation of the neural pathways then leads to creating thoughts which leads to developing new coping strategies and adaptive behaviors. Mindfulness strategies can assist individuals in connecting the mind with the body, allowing the individual to remain centered and focused. All of these mentioned above are vital components to recovery during substance abuse and addiction treatment. There are a variety of therapeutic modalities applying the key components of mindfulness, such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy for depression (MBCT). This study will provide an overview of both MBSR and MBCT in relation to treating individuals with substance abuse and addiction. The author will also provide strategies for readers to employ when working with clients. Lastly, the author will create and foster a safe space for discussion and engaging conversation among participants to ask questions, share perspectives, and be educated on the numerous benefits of mindfulness within wellness.

Keywords: mindfulness, wellness, substance abuse, mental health

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5489 Assessment of Escherichia coli along Nakibiso Stream in Mbale Municipality, Uganda

Authors: Abdul Walusansa

Abstract:

The aim of this study was to assess the level of microbial pollution along Nakibiso stream. The study was carried out in polluted waters of Nakibiso stream, originating from Mbale municipality and running through ADRA Estates to Namatala Wetlands in Eastern Uganda. Four sites along the stream were selected basing on the activities of their vicinity. A total of 120 samples were collected in sterile bottles from the four sampling locations of the stream during the wet and dry seasons of the year 2011. The samples were taken to the National water and Sewerage Cooperation Laboratory for Analysis. Membrane filter technique was used to test for Erischerichia coli. Nitrogen, Phosphorus, pH, dissolved oxygen, electrical conductivity, total suspended solids, turbidity and temperature were also measured. Results for Nitrogen and Phosphorus for sites; 1, 2, 3 and 4 were 1.8, 8.8, 7.7 and 13.8 NH4-N mg/L; and 1.8, 2.1, 1.8 and 2.3 PO4-P mg/L respectively. Basing on these results, it was estimated that farmers use 115 and 24 Kg/acre of Nitrogen and Phosphorus respectively per month. Taking results for Nitrogen, the same amount of Nutrients in artificial fertilizers would cost $ 88. This shows that reuse of wastewater has a potential in terms of nutrients. The results for E. coli for sites 1, 2, 3 and 4 were 1.1 X 107, 9.1 X 105, 7.4 X 105, and 3.4 X 105 respectively. E. coli hence decreased downstream with statistically significant variations between sites 1 and 4. Site 1 had the highest mean E.coli counts. The bacterial contamination was significantly higher during the dry season when more water was needed for irrigation. Although the water had the potential for reuse in farming, bacterial contamination during both seasons was higher than 103 FC/100ml recommended by WHO for unrestricted Agriculture.

Keywords: E. coli, nitrogen, phosphorus, water reuse, waste water

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5488 Effects of Sole and Integrated Application of Cocoa Pod Ash and Poultry Manure on Soil Properties and Leaf Nutrient Composition and Performance of White Yam

Authors: T. M. Agbede, A. O. Adekiya

Abstract:

Field experiments were conducted during 2013, 2014 and 2015 cropping seasons at Rufus Giwa Polytechnic, Owo, Ondo State, southwest Nigeria. The objective of the investigation was to determine the effect of Cocoa Pod Ash (CPA) and Poultry Manure (PM) applied solely and their combined form, as sources of fertilizers on soil properties, leaf nutrient composition, growth and yield of yam. Three soil amendments: CPA, PM (sole forms), CPA and PM (mixture), were applied at 20 t ha-1 with an inorganic fertilizer (NPK 15-15-15) at 400 kg ha-1 as a reference and a natural soil fertility, NSF (control). The five treatments were arranged in a randomized complete block design with three replications. The test soil was slightly acidic, low in organic carbon (OC), N, P, K, Ca and Mg. Results showed that soil amendments significantly increased (p = 0.05) tuber weights and growth of yam, soil and leaf N, P, K, Ca and Mg, soil pH and OC concentrations compared with the NSF (control). The mixture of CPA+PM treatment increased tuber weights of yam by 36%, compared with inorganic fertilizer (NPK) and 19%, compared with PM alone. Sole PM increased tuber weight of yam by 15%, compared with NPK. Sole or mixed forms of soil amendments showed remarkable improvement in soil physical properties, nutrient availability, compared with NPK and the NSF (control). Integrated application of CPA at 10 t ha-1 + PM at 10 t ha-1 was the most effective treatment in improving soil physical properties, increasing nutrient availability and yam performance than sole application of any of the fertilizer materials.

Keywords: cocoa pod ash, leaf nutrient composition, poultry manure, soil properties, yam

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5487 The Importance of Mental Health Literacy: Interventions in a Psychiatry Service of Hospital José Joaquim Fernandes, Portugal

Authors: Mariana Mangas, Yaroslava Martins, Ana Charraz, Ana Matos Pires

Abstract:

Introduction: Health literacy empowers people of knowledge, motivation and skills to access, understand, evaluate and mobilize information relating to health. Although the benefits of public knowledge of physical disease are widely accepted, knowledge about mental disorder has been compatibly neglected. Nowadays there is considerably evidence that literacy is of great importance for the promotion of health and prevention of mental illness. Objective: Disclosure the concept and importance of mental health literacy and introduce the literacy program of Psychiatry Service of Hospital José Joaquim Fernandes. Methodology: A search was conducted on PubMed, using keywords “literacy” and “mental health”. A description of mental health literacy interventions implemented on Psychiatry Service of Hospital José Joaquim Fernandes was performed, namely, psychoeducation programs for depression and bipolar disorder. Results and discussion: Health literacy enables patient to be able to actively participate in his treatment. The improving of mental health literacy can promote early identification of mental disorders, improve treatment results, increase the use of health services and allow the community to take action to achieve better mental health. Psychoeducation is very useful in improving the course of disease and in reducing the number of episodes and hospitalizations. Bipolar patients who received psychoeducation and pharmacotherapy have no relapses during the program and last year. Conclusion: Mental health literacy is not simply a matter of having knowledge, rather, it is knowledge linked to action which can benefit mental health.

Keywords: mental health, literacy, psychoeducation, knowledge, empowerment

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5486 Human Immunodeficiency Virus Infection/AIDS Abandoned Children in Kenya

Authors: Ruth Muturi Wanjiku

Abstract:

HIV/AIDS in Kenya for unborn and young kids. HIV/AIDS is a significant health concern in Kenya, with an estimated 1.5 million people living with the disease. Unfortunately, many of these individuals are unaware of their HIV status, and the disease continues to spread among the population or unborn kids. HIV/AIDS can be transmitted from an infected mother during pregnancy, childbirth, or breastfeeding. However, with early testing and treatment, the risk of mother-to-child transmission can be significantly reduced. Therefore, it is crucial for pregnant women to get tested and receive appropriate medical care. For young kids, HIV/AIDS education is critical to preventing the spread of the disease. It is essential to teach children about the importance of safe sex practices, avoiding risky behaviors such as sharing needles and getting tested regularly. Additionally, children should be taught about the stigma surrounding HIV/AIDS and encouraged to treat individuals living with the disease with compassion and respect. In conclusion, HIV/AIDS is a significant health concern in Kenya that affects individuals of all ages. For unborn kids, early testing and treatment are critical to reducing the risk of mother-to-child transmission. For young kids, education about HIV/AIDS and safe sex practices is essential to preventing the spread of the disease and reducing stigma. It is essential to promote awareness and encourage individuals to get tested and seek medical care if they believe they may be infected with HIV/AIDS.

Keywords: AIDS, HIV, children, pregnant

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5485 Anti-inflammatory and Antioxidant Activity of Heliotropium indicum Linn. Used for Cancer Patients Treatment

Authors: Jitpisute Chunthorng-Orn, Thana Juckmeta, Onmanee Prajuabjinda, Arunporn Itharat

Abstract:

Inflammation and oxidative stress work together to produce symptoms in cancer patients. The whole part of it is used as a preparation to treat cancer patients in Khampramong temple which has been a place of treatment and palliative care for cancer patients since 2005. Thus, the objective of this study was to investigate anti-inflammatory and antioxidant activities of Heliotropium indicum extracts. Dried plant materials were extracted in a similar manner to those practiced by the Khampramong Temple i.e. maceration in 95% ethanol and boiling in water. For anti-inflammation activity, both extracts were tested for suppression of nitric oxide (NO) production in LPS-induced RAW 264.7 cells. They were also tested for antioxidant activity by DPPH radical scavenging assay. This study found that the ethanolic extract of Heliotropium indicum exhibited higher inhibitory activity of NO release than Indomethacin as a positive control (IC50 value of 24.17±2.12 and 34.67±6.23 μg/mL, respectively). For DPPH radical scavenging assay, the ethanolic extract also exhibited antioxidant activity but less than BHT as a antioxidant compound (EC50 values = 28.91±4.26 and 13.08±0.29 μg/mL, respectively). In contrast, its water extract had no inhibitory activity on NO release (IC50 > 100 μg/mL) and no inhibitory activity on DPPH radicals (EC50 values > 100 μg/mL). The results showed correlation between anti-inflammation and antioxidant activity and these results also support using this plant to treat cancer patients.

Keywords: Heliotropium indicum, RAW 264.7, DPPH, Khampramong Temple

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5484 Characterization of the Intestinal Microbiota: A Signature in Fecal Samples from Patients with Irritable Bowel Syndrome

Authors: Mina Hojat Ansari, Kamran Bagheri Lankarani, Mohammad Reza Fattahi, Ali Reza Safarpour

Abstract:

Irritable bowel syndrome (IBS) is a common bowel disorder which is usually diagnosed through the abdominal pain, fecal irregularities and bloating. Alteration in the intestinal microbial composition is implicating to inflammatory and functional bowel disorders which is recently also noted as an IBS feature. Owing to the potential importance of microbiota implication in both efficiencies of the treatment and prevention of the diseases, we examined the association between the intestinal microbiota and different bowel patterns in a cohort of subjects with IBS and healthy controls. Fresh fecal samples were collected from a total of 50 subjects, 30 of whom met the Rome IV criteria for IBS and 20 Healthy control. Total DNA was extracted and library preparation was conducted following the standard protocol for small whole genome sequencing. The pooled libraries sequenced on an Illumina Nextseq platform with a 2 × 150 paired-end read length and obtained sequences were analyzed using several bioinformatics programs. The majority of sequences obtained in the current study assigned to bacteria. However, our finding highlighted the significant microbial taxa variation among the studied groups. The result, therefore, suggests a significant association of the microbiota with symptoms and bowel characteristics in patients with IBS. These alterations in fecal microbiota could be exploited as a biomarker for IBS or its subtypes and suggest the modification of the microbiota might be integrated into prevention and treatment strategies for IBS.

Keywords: irritable bowel syndrome, intestinal microbiota, small whole genome sequencing, fecal samples, Illumina

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5483 Management of Pressure Ulcer with a Locally Constructed Negative Pressure Device (NPD) in Traumatic Paraplegia Patients: A Randomized Controlled Clinical Trial

Authors: Mukesh K. Dwivedi, Rajeshwar N. Srivastava, Amit K. Bhagat, Saloni Raj

Abstract:

Introduction: Management of Pressure Ulcer (PU) is an ongoing clinical challenge particularly in traumatic paraplegia patients in developing countries where socio economic conditions often dictate treatment modalities. When negative pressure wound therapy (NPWT) was introduced, there were a series of devices (V.A.C., KCI, San Antonio, TX) manufactured. These devices for NPWT are costly and hard to afford by patients in developing countries like India. Considering this limitation, this study was planned to design an RCT to compare NPWT by an indigenized locally constructed NPD and conventional gauze dressing for the treatment of PU. Material and Methods: This RCT (CTRI/2014/09/0050) was conducted in the Department of Orthopaedic Surgery at King George’s Medical University (KGMU), India. Thirty-four (34) subjects of traumatic paraplegia having PU of stage 3 or 4, were enrolled and randomized in two treatment groups (NPWT Group & Conventional dressing group). The outcome measures of this study were surface area and depth of PU, exudates, microorganisms and matrix metalloproteinase-8 (MMP-8) during 0 to 9 weeks follow-ups. Levels of MMP-8 were analyzed in the tissues of PU at week 0, 3, 6 and week 9 by Enzyme Linked Immuno Sorbent Assay (ELISA). Results: Significantly reduced length of PU in NPWT group was observed at week 6 (p=0.04) which further reduced at week 9 (p=0.001) as compared to conventionally treated group. Similarly significant reduction of width and depth of PU was observed in NPWT at week 9 (p<0.05). The exudate became significantly (p=0.001) lower in NPWT group as compared with conventionally treated group from 6th to 9th week. Clearance and conversion of slough into red granulation tissue was significantly higher in NPWT group (p=0.001). At week 9, the wound culture was negative in all the subjects of NPWT group, while it was positive in 10 (41⋅6%) subjects of conventional group. Significantly lower level of MMP-8 was observed in subjects of NPWT group at week 6 (0.006**), and continually more reduction was observed at week 9 (<0.0001**) as compared to the conventional group. Conclusion: NPWT by locally constructed NPD is better wound care procedure for management of PU. Our device gave similar results as commercially available devices. Reduction of level of MMP-8 and increased rate of healing was achieved by negative pressure wound therapy (NPWT) as compared to conventional dressing.

Keywords: NPWT, NPD, MMP8, ELISA

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5482 Associated Factors of Hypercholesterolemia, Hyperuricemia and Double Burden of Hypercuricémia-Hypercholesterolemia in Gout Patients: Hospital Based Study

Authors: Pierre Mintom, Armel Assiene Agamou, Leslie Toukem, William Dakam, Christine Fernande Nyangono Biyegue

Abstract:

Context: Hyperuricemia, the presence of high levels of uric acid in the blood, is a known precursor to the development of gout. Recent studies have suggested a strong association between hyperuricemia and disorders of lipoprotein metabolism, specifically hypercholesterolemia. Understanding the factors associated with these conditions in gout patients is essential for effective treatment and management. Research Aim: The objective of this study was to determine the prevalence of hyperuricemia, hypercholesterolemia, and the double burden of hyperuricemia-hypercholesterolemia in the gouty population. Additionally, the study aimed to identify the factors associated with these conditions. Methodology: The study utilized a database from a survey of 150 gouty patients recruited at the Laquintinie Hospital in Douala between August 2017 and February 2018. The database contained information on anthropometric parameters, biochemical markers, and the food and drugs consumed by the patients. Hyperuricemia and hypercholesterolemia were defined based on specific serum uric acid and total cholesterol thresholds, and the double burden was defined as the co-occurrence of hyperuricemia and hypercholesterolemia. Findings: The study found that the prevalence rates for hyperuricemia, hypercholesterolemia, and the double burden were 61.3%, 76%, and 50.7% respectively. Factors associated with these conditions included hypertriglyceridemia, atherogenicity index TC/HDL ratio, atherogenicity index LDL/HDL ratio, family history, and the consumption of specific foods and drinks. Theoretical Importance: The study highlights the strong association between hyperuricemia and dyslipidemia, providing important insights for guiding treatment strategies in gout patients. Additionally, it emphasizes the significance of nutritional education in managing these metabolic disorders, suggesting the need to address eating habits in gout patients. Data Collection and Analysis Procedures: Data was collected through surveys and medical records of gouty patients. Information on anthropometric parameters, biochemical markers, and dietary habits was recorded. Prevalence rates and associated factors were determined through statistical analysis, employing odds ratios to assess the risks. Question Addressed: The study aimed to address the prevalence rates and associated factors of hyperuricemia, hypercholesterolemia, and the double burden in gouty patients. It sought to understand the relationships between these conditions and determine their implications for treatment and nutritional education. Conclusion: Findings show that it’s exists an association between hyperuricemia and hypercholesterolemia in gout patients, thus creating a double burden. The findings underscore the importance of considering family history and eating habits in addressing the double burden of hyperuricemia-hypercholesterolemia. This study provides valuable insights for guiding treatment approaches and emphasizes the need for nutritional education in gout patients. This study specifically focussed on the sick population. A case–control study between gouty and non-gouty populations would be interesting to better compare and explain the results observed.

Keywords: gout, hyperuricemia, hypercholesterolemia, double burden

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5481 Clonal Dissemination of Pseudomonas aeruginosa Isolates in Kermanshah Hospitals, West of Iran

Authors: Alisha Akya, Afsaneh salami

Abstract:

Background and Objective: Pseudomonas aeruginosa is an opportunistic pathogen associated with nosocomial infections. One of the major concerns for the treatment of P. aeruginosa infections is its resistant to a variety of antibiotics. The purpose of this study was to assess the dissemination of p. aeruginosa isolates obtained from major hospitals in Kermanshah, west of Iran. Materials and Methods: Antibiotic susceptibility testing was performed using the minimal inhibitory concentrations. Mettalo-beta-lactamase was investigated using the double disk diffusion (DDST) test and PCR. Molecular typing was performed by pulsed-field gel electrophoresis (PFGE). Results: The 60 P. aeruginosa isolates, 30 (50%) were resistant to gentamicin, 38 (63/3%) to piperacilin, 42 (70%) to ceftazidime, and 45 (75%) to cefepime. Twenty-nine (48/3%) isolates were MBLs producer based on the DDST test. Five (8/3%) isolates were positive for VIM gene and 4 of them were from burn specimens. PFGE analysis among MBLs producers revealed 12 distinct genotype patterns. A pattern covering the highest number of strains was determined as the dominant clone. Conclusions: Our study showed that P. aeruginosa strains can be spread between patients in hospitals or acquired from different environmental sources. P. aeruginosa isolates were highly resistant to antibiotics and, therefore, the susceptibility of isolates to antibiotics should be tested before treatment. Given the clinical significance of MBLs producing isolates, identification of these organisms is essential in the hospitals in order to get a better therapeutic response and control of bacterial dissemination.

Keywords: clonal dissemination, mettalo-beta-lactamase, Pseudomonas aeruginosa, PFGE

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5480 Dental Ethics versus Malpractice, as Phenomenon with a Growing Trend

Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

Abstract:

Dealing with emerging cases of dental malpractice with justifications that stem from the clear rules of dental ethics is a phenomenon with an increasing trend in today's dental practice. Dentists should clearly understand how far the limit of malpractice goes, with or without minimal or major consequences, for the affected patient, which can be justified as a complication of dental treatment, in support of the rules of dental ethics in the dental office. Indeed, malpractice can occur in cases of lack of professionalism, but it can also come as a consequence of anatomical and physiological limitations in the implementation of the dental protocols, predetermined and indicated by the patient in the paragraph of the treatment plan in his personal card. This study is of the review type with the aim of the latest findings published in the literature about the problem of dealing with these phenomena. The combination of keywords is done in such a way with the aim to give the necessary space for collecting the right information in the networks of publications about this field, always first from the point of view of the dentist and not from that of the lawyer or jurist. From the findings included in this article, it was noticed the diversity of approaches towards the phenomenon depends on the different countries based on the legal basis that these countries have. There is a lack of or a small number of articles that touch on this topic, and these articles are presented with a limited number of data on the same topic. Conclusions: Dental malpractice should not be hidden under the guise of various dental complications that we justify with the strict rules of ethics for patients treated in the dental chair. The individual experience of dental malpractice must be published with the aim of serving as a source of experience for future generations of dentists.

Keywords: dental ethics, malpractice, professional protocol, random deviation

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