Search results for: rabies treatment
Commenced in January 2007
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Edition: International
Paper Count: 8270

Search results for: rabies treatment

5120 Pregnant Individuals in Rural Areas Benefit from Cognitive Behavioral Therapy: A Literature Review

Authors: Kushal Patel, Manasa Dittakavi, Cyrus Falsafi, Gretchen Lovett

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Rural America has seen a surge in opioid addiction rates and overdose deaths in recent years, becoming a significant public health crisis. This may be due to a variety of factors, such as lack of access to healthcare or other economic and social factors that can contribute to addiction such as poverty, unemployment, and social isolation. As the opioid epidemic has disproportionately affected rural communities, pregnant women in these areas may be highly susceptible and face additional difficulties in facing the appropriate care they need. Opioid use disorder has many negative effects on prenatal infants. These include changes in their microbiome, mental health, neurodevelopment and cognition. These can affect how the child performs in various activities in life and how they interact with others. It has been demonstrated that using cognitive behavioral therapy improves not just pain-related results but also mobility, quality of life, disability, and mood outcomes. This indicates that cognitive behavioral therapy (CBT) may be a useful therapeutic strategy for enhancing general health and wellbeing in people with opioid use problems. In terms of treating psychiatric diseases, CBT carries fewer dangers than opioids. One study that illustrates the potential for CBT to promote a reduction in opioid use disorder used self-reported drug use patterns 6 months prior to and during their pregnancy. At the beginning of the study, participants reported an average of 3.78 drug or alcohol use days in the previous 28 days, which decreased to 1.63 days after treatment. The study also found a decrease in depression scores, as measured by IDS scores, from 23.9 to 17.1 at the end of treatment. These and other results show that CBT can have meaningful impacts on pregnant women in Rural America who struggle with an opioid use disorder. This project has been approved by the West Virginia School of Osteopathic Medicine- Office of Research and Sponsored Programs and deemed non-research scholarly work.

Keywords: appalachia, CBT, opiods, pregnancy

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5119 The Efficacy of Video Education to Improve Treatment or Illness-Related Knowledge in Patients with a Long-Term Physical Health Condition: A Systematic Review

Authors: Megan Glyde, Louise Dye, David Keane, Ed Sutherland

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Background: Typically patient education is provided either verbally, in the form of written material, or with a multimedia-based tool such as videos, CD-ROMs, DVDs, or via the internet. By providing patients with effective educational tools, this can help to meet their information needs and subsequently empower these patients and allow them to participate within medical-decision making. Video education may have some distinct advantages compared to other modalities. For instance, whilst eHealth is emerging as a promising modality of patient education, an individual’s ability to access, read, and navigate through websites or online modules varies dramatically in relation to health literacy levels. Literacy levels may also limit patients’ ability to understand written education, whereas video education can be watched passively by patients and does not require high literacy skills. Other benefits of video education include that the same information is provided consistently to each patient, it can be a cost-effective method after the initial cost of producing the video, patients can choose to watch the videos by themselves or in the presence of others, and they can pause and re-watch videos to suit their needs. Health information videos are not only viewed by patients in formal educational sessions, but are increasingly being viewed on websites such as YouTube. Whilst there is a lot of anecdotal and sometimes misleading information on YouTube, videos from government organisations and professional associations contain trustworthy and high-quality information and could enable YouTube to become a powerful information dissemination platform for patients and carers. This systematic review will examine the efficacy of video education to improve treatment or illness-related knowledge in patients with various long-term conditions, in comparison to other modalities of education. Methods: Only studies which match the following criteria will be included: participants will have a long-term physical health condition, video education will aim to improve treatment or illness related knowledge and will be tested in isolation, and the study must be a randomised controlled trial. Knowledge will be the primary outcome measure, with modality preference, anxiety, and behaviour change as secondary measures. The searches have been conducted in the following databases: OVID Medline, OVID PsycInfo, OVID Embase, CENTRAL and ProQuest, and hand searching for relevant published and unpublished studies has also been carried out. Screening and data extraction will be conducted independently by 2 researchers. Included studies will be assessed for their risk of bias in accordance with Cochrane guidelines, and heterogeneity will also be assessed before deciding whether a meta-analysis is appropriate or not. Results and Conclusions: Appropriate synthesis of the studies in relation to each outcome measure will be reported, along with the conclusions and implications.

Keywords: long-term condition, patient education, systematic review, video

Procedia PDF Downloads 116
5118 Case Study Hyperbaric Oxygen Therapy for Idiopathic Sudden Sensorineural Hearing Loss

Authors: Magdy I. A. Alshourbagi

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Background: The National Institute for Deafness and Communication Disorders defines idiopathic sudden sensorineural hearing loss as the idiopathic loss of hearing of at least 30 dB across 3 contiguous frequencies occurring within 3 days.The most common clinical presentation involves an individual experiencing a sudden unilateral hearing loss, tinnitus, a sensation of aural fullness and vertigo. The etiologies and pathologies of ISSNHL remain unclear. Several pathophysiological mechanisms have been described including: vascular occlusion, viral infections, labyrinthine membrane breaks, immune associated disease, abnormal cochlear stress response, trauma, abnormal tissue growth, toxins, ototoxic drugs and cochlear membrane damage. The rationale for the use of hyperbaric oxygen to treat ISSHL is supported by an understanding of the high metabolism and paucity of vascularity to the cochlea. The cochlea and the structures within it require a high oxygen supply. The direct vascular supply, particularly to the organ of Corti, is minimal. Tissue oxygenation to the structures within the cochlea occurs via oxygen diffusion from cochlear capillary networks into the perilymph and the cortilymph. . The perilymph is the primary oxygen source for these intracochlear structures. Unfortunately, perilymph oxygen tension is decreased significantly in patients with ISSHL. To achieve a consistent rise of perilymph oxygen content, the arterial-perilymphatic oxygen concentration difference must be extremely high. This can be restored with hyperbaric oxygen therapy. Subject and Methods: A 37 year old man was presented at the clinic with a five days history of muffled hearing and tinnitus of the right ear. Symptoms were sudden onset, with no associated pain, dizziness or otorrhea and no past history of hearing problems or medical illness. Family history was negative. Physical examination was normal. Otologic examination revealed normal tympanic membranes bilaterally, with no evidence of cerumen or middle ear effusion. Tuning fork examination showed positive Rinne test bilaterally but with lateralization of Weber test to the left side, indicating right ear sensorineural hearing loss. Audiometric analysis confirmed sensorineural hearing loss across all frequencies of about 70- dB in the right ear. Routine lab work were all within normal limits. Clinical diagnosis of idiopathic sudden sensorineural hearing loss of the right ear was made and the patient began a medical treatment (corticosteroid, vasodilator and HBO therapy). The recommended treatment profile consists of 100% O2 at 2.5 atmospheres absolute for 60 minutes daily (six days per week) for 40 treatments .The optimal number of HBOT treatments will vary, depending on the severity and duration of symptomatology and the response to treatment. Results: As HBOT is not yet a standard for idiopathic sudden sensorineural hearing loss, it was introduced to this patient as an adjuvant therapy. The HBOT program was scheduled for 40 sessions, we used a 12-seat multi place chamber for the HBOT, which was started at day seven after the hearing loss onset. After the tenth session of HBOT, improvement of both hearing (by audiogram) and tinnitus was obtained in the affected ear (right). Conclusions: In conclusion, HBOT may be used for idiopathic sudden sensorineural hearing loss as an adjuvant therapy. It may promote oxygenation to the inner ear apparatus and revive hearing ability. Patients who fail to respond to oral and intratympanic steroids may benefit from this treatment. Further investigation is warranted, including animal studies to understand the molecular and histopathological aspects of HBOT and randomized control clinical studies.

Keywords: idiopathic sudden sensorineural hearing loss (issnhl), hyperbaric oxygen therapy (hbot), the decibel (db), oxygen (o2)

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5117 Evaluation of Stress Relief using Ultrasonic Peening in GTAW Welding and Stress Corrosion Cracking (SCC) in Stainless Steel, and Comparison with the Thermal Method

Authors: Hamidreza Mansouri

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In the construction industry, the lifespan of a metal structure is directly related to the quality of welding. In most metal structures, the welded area is considered critical and is one of the most important factors in design. To date, many fracture incidents caused by these types of cracks have occurred. Various methods exist to increase the lifespan of welds to prevent failure in the welded area. Among these methods, the application of ultrasonic peening, in addition to the stress relief process, can manually and more precisely adjust the geometry of the weld toe and prevent stress concentration in this part. This research examined Gas Tungsten Arc Welding (GTAW) on common structural steels and 316 stainless steel, which require precise welding, to predict the optimal condition. The GTAW method was used to create residual stress; two samples underwent ultrasonic stress relief, and for comparison, two samples underwent thermal stress relief. Also, no treatment was considered for two samples. The residual stress of all six pieces was measured by X-Ray Diffraction (XRD) method. Then, the two ultrasonically stress-relieved samples and two untreated samples were exposed to a corrosive environment to initiate cracking and determine the effectiveness of the ultrasonic stress relief method. Thus, the residual stress caused by GTAW in the samples decreased by 3.42% with thermal treatment and by 7.69% with ultrasonic peening. Furthermore, the results show that the untreated sample developed cracks after 740 hours, while the ultrasonically stress-relieved piece showed no cracks. Given the high costs of welding and post-welding zone modification processes, finding an economical, effective, and comprehensive method that has the least limitations alongside a broad spectrum of usage is of great importance. Therefore, the impact of various ultrasonic peening stress relief parameters and the selection of the best stress relief parameter to achieve the longest lifespan for the weld area is highly significant.

Keywords: GTAW welding, stress corrosion cracking(SCC), thermal method, ultrasonic peening.

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5116 Use of Radiation Chemistry Instrumental Neutron Activation Analysis (INAA) and Atomic Absorption Spectroscopy (AAS) for the Elemental Analysis Medicinal Plants from India Used in the Treatment of Heart Diseases

Authors: B. M. Pardeshi

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Introduction: Minerals and trace elements are chemical elements required by our bodies for numerous biological and physiological processes that are necessary for the maintenance of health. Medicinal plants are highly beneficial for the maintenance of good health and prevention of diseases. They are known as potential sources of minerals and vitamins. 30 to 40% of today’s conventional drugs used in the medicinal and curative properties of various plants are employed in herbal supplement botanicals, nutraceuticals and drug. Aim: The authors explored the mineral element content of some herbs, because mineral elements may have significant role in the development and treatment of gastrointestinal diseases, and a close connection between the presence or absence of mineral elements and inflammatory mediators was noted. Methods: Present study deals with the elemental analysis of medicinal plants by Instrumental Neutron activation Analysis and Atomic Absorption Spectroscopy. Medicinal herbals prescribed for skin diseases were purchased from markets and were analyzed by Instrumental Neutron Activation Analysis (INAA) using 252Cf Californium spontaneous fission neutron source (flux * 109 n s-1) and the induced activities were counted by γ-ray spectrometry and Atomic Absorption Spectroscopy (AAS) techniques (Perkin Elmer 3100 Model) available at Department of Chemistry University of Pune, INDIA, was used for the measurement of major, minor and trace elements. Results: 15 elements viz. Al, K, Cl, Na, Mn by INAA and Cu, Co, Pb, Ni, Cr, Ca, Fe, Zn, Hg and Cd by AAS were analyzed from different medicinal plants from India. A critical examination of the data shows that the elements Ca , K, Cl, Al, and Fe are found to be present at major levels in most of the samples while the other elements Na, Mn, Cu, Co, Pb, Ni, Cr, Ca, Zn, Hg and Cd are present in minor or trace levels. Conclusion: The beneficial therapeutic effect of the studied herbs may be related to their mineral element content. The elemental concentration in different medicinal plants is discussed.

Keywords: instrumental neutron activation analysis, atomic absorption spectroscopy, medicinal plants, trace elemental analysis, mineral contents

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5115 Exploring the Role of Immune-Modulators in Pathogen Recognition Receptor NOD2 Mediated Protection against Visceral Leishmaniasis

Authors: Junaid Jibran Jawed, Prasanta Saini, Subrata Majumdar

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Background: Leishmania donovani infection causes severe host immune-suppression through the modulation of pathogen recognition receptors. Apart from TLRs (Toll Like Receptor), recent studies focus on the important contribution of NLR (NOD-Like Receptor) family member NOD1 and NOD2 as these receptors are capable of triggering host innate immunity. The aim of this study was to decipher the role of NOD1/NOD2 receptors during experimental visceral leishmaniasis (VL) and the important link between host failure and parasite evasion strategy. Method: The status of NOD1 and NOD2 receptors were analysed in uninfected and infected cells through western blotting and RT-PCR. The active contributions of these receptors in reducing parasite burden were confirmed by siRNA mediated silencing, and over-expression studies and the parasite numbers were calculated through microscopic examination of the Giemsa-stained slides. In-vivo studies were done by using non-toxic dose of Mw (Mycobacterium indicus pranii), Ara-LAM(Arabinoasylated lipoarabinomannan) along with MDP (Muramyl dipeptide) administration. Result: Leishmania donovani infection of the macrophages reduced the expression of NOD2 receptors whereas NOD1 remain unaffected. MDP, a NOD2-ligand, treatment during over-expression of NOD2, reduced the parasite burden effectively which was associated with increased pro-inflammatory cytokine generation and NO production. In experimental mouse model, Ara-LAM treatment increased the expression of NOD2 and in combination with MDP it showed active therapeutic potential against VL and found to be more effective than Mw which was already reported to be involved in NOD2 modulation. Conclusion: This work explores the essential contribution of NOD2 during experimental VL and mechanistic understanding of Ara-LAM + MDP combination therapy to work against this disease and highlighted NOD2 as an essential therapeutic target.

Keywords: Ara-LAM (Arabinoacylated Lipoarabinomannan), NOD2 (nucleotide binding oligomerization receptor 2), MDP (muramyl di peptide), visceral Leishmaniasis

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5114 Utilizing Quick Response (QR) Codes and Uniform Resource Locator (URL) links in Printed Discharge Instructions for Chronic Pain Patients

Authors: Jawad Arshad

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Back and neck pain result in more than 3 million Emergency Department (ED) visits per year. Approximately 10-20% of patients with acute low back pain will continue to have moderate to severe pain after 3 months and 30% will develop chronic functional impairment. Strategies for analgesia for musculoskeletal pain upon ED discharge have been shown to be highly variable and provider dependent. The American College of Physicians, United Kingdom and Danish treatment guidelines all recommend exercise as the first line treatment for low back pain present >12 weeks and as an adjunctive treatment to education and encouraging continued mobility in acute low back pain. URL links and QR codes were embedded in Epic’s Electronic Medical Record (EMR) for seamless integration into discharge instructions. To our knowledge, this is the first time QR codes have been embedded and used as an adjunct to computer generated discharge instructions into an EMR nationwide. Materials and Methods: Eleven two-minute physical therapy (PT) videos treating a variety of common painful musculoskeletal conditions were prepared in collaboration between the Pain Management and Physical Therapy departments of a large academic center. The videos were hosted and made available on Vimeo for free public access. Dynamic QR codes and URL links were created for each video and integrated into the EPIC Electronic Medical Record discharge instructions. Both data from physician prescribed PT videos and results of public searches are included. As the case report is devoid of patient identifiable information, it is exempt from IRB review requirements as per IRB policy. Results/Case Report: From 2/6/2021 to 5/19/21, the videos were prescribed on Epic a total of 76 times, the dynamic QR codes were scanned a total of 84 times. Low back (n=32) followed by neck (n=8), shoulder (n=7) and radicular low back pain (n=7) were the most common painful complaints prescribed a PT video. The videos were played on Vimeo 790 times with 83% (n=656) being unique views and 17% returning users. Shoulder pain (n=489) followed by neck (n=36) and low back pain (n=37) were the most commonly played videos. Discussion: Patients are viewing their physical therapy videos via QR codes provided by their physicians. The large number of public views of the physical therapy videos are either from patients sharing the link/QR code or patients not affiliated with our institution are searching for videos to treat their painful complaints. The data suggests there is a need for reputable home PT videos to treat commonly encountered painful complaints with 17% of viewers returning for repeat view. The shoulder pain video was played significantly more than the others despite not being given to patients more frequently, which raised suspicion it may have received increased traffic via an outside affiliate, website or influencer. When eliminating shoulder pain from the data, individuals watched 67% of the entire video on average, indicating high engagement.

Keywords: pain, EMR, emergency medicine, discharge

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5113 Absolute Lymphocyte Count as Predictor of Pneumocystis Pneumonia in Patients With Unknown HIV Status at a Private Tertiary Hospital

Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura

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Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.

Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP

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5112 Addressing Factors Associated with Vertical HIV Transmission among Pregnant Women in Rwanda

Authors: Murorunkwere Marie Claire

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Introduction: In Sub-Saharan Africa and specifically in Rwandan rural areas, mother-to-Child human immunodeficiency virus transmission remains a big challenge. This is mainly due to lack of awareness and ignorance among pregnant rural women, leading to neglect regular taking of prophylactic antiretroviral treatment and to persistently beliefs in traditional healers and home deliveries. This paper explores the factors associated with stagnant reduction in human immunodeficiency virus vertical transmission among pregnant rural women and provides solutions to tackle it. Methodology: The first phase of this research will be a qualitative survey was conducted to assess the knowledge, attitudes and practices towards vertical human immunodeficiency virus transmission among pregnant women in one rural district in Rwanda. The data generated from phase one of this research will be used to address the main factors revealed through community mobilization and motivation on attending required antenatal consultations and hospital deliveries, proper and regular antiretroviral treatment taking, and discouraging beliefs in traditional healers and home deliveries. Refresher training seminars will also be organized for healthcare providers qualified on conducting deliveries about current measures to maximize the reduction of chances that can lead to mother -child contamination (to avoid early rupture of membranes and to prevent any source of contamination). Results: This paper is expected to contribute in a significant reduction of the vertical human immunodeficiency virus transmission burden among pregnant rural women. Conclusion: Strong campaigns on prevention of mother- to-child human immunodeficiency virus transmission and community mobilization of pregnant rural women, and house to house education and continuous reminders as well as training seminars to health care personnel on updated measures is, key in addressing vertical human immunodeficiency virus transmission.

Keywords: attitudes transformation, community mobilisation, pregnant rural women, vertical HIV transmission

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5111 Increased Seedling Vigor Through Phytohomeopathy

Authors: Jasper Jose Zanco

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Plants are affected by substances diluted below certain limits. In seeds subjected to ultra-high dilutions (UHD), according to phytohomeopathic methods, it is possible to reduce the concentrations to infinitesimal levels and the effects persist. This research aimed to test different potencies of UHD to modify the vigor of Eruca versicaria (L) Cav. seedlings. The research was carried out at the Plant Production Laboratory of UNISUL University in Santa Catarina, Brazil. Eight UHD treatments were tested, four drops for every 30 mL of distilled water: Control (70% alcohol - A70); Sulphur (S9), Acidum fluoridricum (A30), Calcarea carbonica (C200), Graphies naturalis (G200), Kali carbonicum (K100) Belladonna (B12), diluted and succussed in Hahnemannian centesimal standards. Succussion is a standard pharmaceutical method found in worldwide pharmaceuticals. The statistical design consisted of 50 seeds every 4 replicates per treatment, completely randomized, followed by ANOVA and Tukey's test. Succussion may integrate the high dilution of water treatments, even after successive dilutions, and the product of this process acts through physical-chemical and bioelectric stimuli, causing physiological responses at the cellular level, such as the activation of antioxidant systems, increased resistance to environmental stress or growth modulation. According to some researchers, these responses could be mediated by genetic expression changes or the plants' cellular signaling systems. The results showed significant differences between the control (A70) and the other treatments. Conductivity measurements were made in the seed germination water and impedance; the seedlings were measured for dry weight and total area. The highest conductivity occurred in the control treatment (27.8 μS/cm) and the lowest in K100 (21.3 μS/cm). After germination, on germitest paper, A70 was significantly different from G200 (<1%) and S9 (5%). Both homeopathies differed from the other treatments, with S9 obtaining the best germination (87.1%) and vigor index (IV=7.98) in relation to the other treatments. The control, A70, presented the lowest germination (63.9%) and vigor (IV=4.93).

Keywords: ultra high dilution, impedance, condutivity, eruca versicaria

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5110 Comparative Effects of Dietary Ocimum Gratissimum and Antibiotic Growth Promoter on Body Weight and Gut Morphometry of Broiler Starters

Authors: Victor U. Odoemelam, Ihemdirim C. Unamba-Opara, Martins C. Anyanwuocha

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Antibiotics used as growth promoters in animal feeds have been criticized and banned in many nations due to possible development of both drug resistance, cross resistance and multiple resistances by consumers. Numerous additives are now being used or proposed as alternatives. A study to compare the effects of Ocimum gratissimum (Scent leaf) and antibiotic growth promoter (Oxytetracycline HCl) on growth performance and intestinal morphology of starter broiler birds was conducted using ninety six (96) days old broiler birds. The birds were randomly assigned to four treatments with each treatment comprising 24 birds replicated three times with 8 birds per replicate in a completely randomized design experiment. Four diets (T1 control diet without Oxytetracycline HCl and Ocimum gratissimum; T2 had Oxytetracycline HCl; T3 had 1% Ocimum gratissimum; T4 had 1.5% Ocimum gratissimum) were formulated and offered ad libitum to the respective birds. Data was collected on feed intake, body weight gain and feed conversion ratio (FCR) also Jejenal sections of the intestine were collected for examination of Villi length and Crypt depth at the end of starter phase. Results show that there were no significant difference (P>0.05) observed in feed intake and final body weight. However, feed conversion ratio (FCR) and daily weight gain significantly differed (P<0.05). T1, T2, and T4 were similar, however T2 differed (P<0.05) from T3. FCR followed the same pattern. Dietary treatment significantly (P<0.05) affected Villi length, Crypt depth and Villi length/crypt depth ratio. Birds fed OG containing diets, had significantly higher (P<0.05) villi length/crypt depth ratio. However, this did not translate to a significantly higher body weight gain or feed conversion ratio. It can be concluded that O. gratissimum can replace antibiotic growth promoter (Oxytetracycline HCl) since their effect on performance were similar.

Keywords: antibiotics, body weight, feed additives, intestinal morphology, phytogenics

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5109 Prevalence and Predictors of Metabolic Syndrome among Diabetic Clinic Attendees in Sokoto, Nigeria

Authors: Kehinde Joseph Awosan, Balarabe Adami Isah, Edzu Usman Yunusa, Sarafadeen Adeniyi Arisegi, Izuchukwu Obasi, Oluchi Solomon-Anucha

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Background: Metabolic syndrome (MetS) is prevalent in patients with diabetes mellitus and a significant risk for major cardiovascular events. Identifying its burden and peculiarities is crucial to preventing complications among those at risk. Aim: This study was conducted to determine the prevalence and predictors of metabolic syndrome among diabetes clinic attendees in Sokoto, Nigeria. Materials and Methods: A cross-sectional study was conducted among 365 patients with type 2 diabetes attending the diabetes clinic of Specialist Hospital, Sokoto, Nigeria. A structured questionnaire was used to obtain data on the respondents’ socio-demographic variables, treatment history, and lifestyle. Blood pressure and anthropometric measurements (including weight, height, and waist circumference) were done for the patients. Likewise, biochemical assessment (including fasting plasma glucose, high-density lipoprotein cholesterol (HDL-c), and triglyceride (TG) was done. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Data were analyzed using the IBM Statistical Package for Social Sciences (SPSS) version 25. Results: The ages of the patients ranged from 30 to 78 (mean = 50.9 ±11.7) years. The overall prevalence of MetS was 57.3%, with a higher prevalence in females (68.1%) than males (43.0%). The most common components of MetS observed were hypertension (69.2%), and elevated fasting plasma glucose (65.7%); while the predictors of MetS were age > 50 years (OR 6.960, 95% CI: 3.836-12.628, p < 0.001), female sex (OR 2.300, 95% CI: 1.355-3.903, p = 0.002), physical activity (OR 0.214, 95% CI: 0.126-0.363, p < 0.001), and overweight/obesity (OR 3.356, 95% CI: 1.838-6.127, p < 0.001). Conclusion: Metabolic syndrome is prevalent among patients with type 2 diabetes in Sokoto, Nigeria, and the predictors were age > 50 years, female sex, physical activity, and overweight/obesity. Diabetes care providers should screen their patients for MetS to prevent adverse cardiovascular events.

Keywords: prevalence, predictors, metabolic syndrome, diabetes

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5108 Gut Microbial Dynamics in a Mouse Model of Inflammation-Linked Carcinogenesis as a Result of Diet Supplementation with Specific Mushroom Extracts

Authors: Alvarez M., Chapela M. J., Balboa E., Rubianes D., Sinde E., Fernandez de Ana C., Rodríguez-Blanco A.

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The gut microbiota plays an important role as gut inflammation could contribute to colorectal cancer development; however, this role is still not fully understood, and tools able to prevent this progression are yet to be developed. The main objective of this study was to monitor the effects of a mushroom extracts formulation in gut microbial community composition of an Azoxymethane (AOM)/Dextran sodium sulfate (DSS) mice model of inflammation-linked carcinogenesis. For the in vivo study, 41 adult male mice of the C57BL / 6 strain were obtained. 36 of them have been induced in a state of colon carcinogenesis by a single intraperitoneal administration of AOM at a dose of 12.5 mg/kg; the control group animals received instead of the same volume of 0.9% saline. DSS is an extremely toxic polysaccharide sulfate that causes chronic inflammation of the colon mucosa, favoring the appearance of severe colitis and the production of tumors induced by AOM. Induction by AOM/DSS is an interesting platform for chemopreventive intervention studies. This time the model was used to monitor gut microbiota changes as a result of supplementation with a specific mushroom extracts formulation previously shown to have prebiotic activity. The animals have been divided into three groups: (i) Cancer + mushroom extracts formulation experimental group: to which the MicoDigest2.0 mushroom extracts formulation developed by Hifas da Terra S.L has been administered dissolved in drinking water at an estimated concentration of 100 mg / ml. (ii) Control group of animals with Cancer: to which normal water has been administered without any type of treatment. (iii) Control group of healthy animals: these are the animals that have not been induced cancer or have not received any treatment in drinking water. This treatment has been maintained for a period of 3 months, after which the animals were sacrificed to obtain tissues that were subsequently analyzed to verify the effects of the mushroom extract formulation. A microbiological analysis has been carried out to compare the microbial communities present in the intestines of the mice belonging to each of the study groups. For this, the methodology of massive sequencing by molecular analysis of the 16S gene has been used (Ion Torrent technology). Initially, DNA extraction and metagenomics libraries were prepared using the 16S Metagenomics kit, always following the manufacturer's instructions. This kit amplifies 7 of the 9 hypervariable regions of the 16S gene that will then be sequenced. Finally, the data obtained will be compared with a database that makes it possible to determine the degree of similarity of the sequences obtained with a wide range of bacterial genomes. Results obtained showed that, similarly to certain natural compounds preventing colorectal tumorigenesis, a mushroom formulation enriched the Firmicutes and Proteobacteria phyla and depleted Bacteroidetes. Therefore, it was demonstrated that the consumption of the mushroom extracts’ formulation developed could promote the recovery of the microbial balance that is disrupted in the mice model of carcinogenesis. More preclinical and clinical studies are needed to validate this promising approach.

Keywords: carcinogenesis, microbiota, mushroom extracts, inflammation

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5107 Rheological and Crystallization Properties of Dark Chocolate Formulated with Essential Oil of Orange and Carotene Extracted from Pineapple Peels

Authors: Mayra Pilamunga, Edwin Vera

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The consumption of dark chocolate is beneficial due to its high content of flavonoids, catechins, and procyanidins. To improve its properties, fortification of chocolate with polyphenols, anthocyanins, soy milk powder and other compounds has been evaluated in several studies. However, to our best knowledge, the addition of carotenes to chocolate has not been tested. Carotenoids, especially ß-carotene and lutein, are widely distributed in fruits and vegetables so that they could be extracted from agro-industrial waste, such as fruit processing. On the other hand, limonene produces crystalline changes of cocoa butter and improves its consistency and viscosity. This study aimed to evaluate the production of dark chocolate with the addition of carotenes extracted from an agro industrial waste and to improve its rheological properties and crystallization, with orange essential oil. The dried and fermented cocoa beans were purchased in Puerto Quito, Ecuador, and had a fat content of 51%. Six types of chocolates were formulated, and two formulations were chosen, one at 65% cocoa and other at 70% cocoa, both with a solid: fat ratio of 1.4:1. With the formulations selected, the influence of the addition of 0.75% and 1.5% orange essential oil was evaluated, and analysis to measure the viscosity, crystallization and sensory analysis were done. It was found that essential oil does not generate significant changes in the properties of chocolate, but has an important effect on aroma and coloration, which changed from auburn to brown. The best scores on sensory analysis were obtained for the samples formulated with 0.75% essential oil. Prior to the formulation with carotenes, the extraction of these compounds from pineapple peels were performed. The process was done with and without a previous enzymatic treatment, with three solid-solvent ratios. The best treatment was using enzymes in a solids-solvent ratio of 1:12.5; the extract obtained under these conditions had 4.503 ± 0.214 μg Eq. β-carotene/mL. This extract was encapsulated with gum arabic and maltodextrin, and the solution was dried using a freeze dryer. The encapsulated carotenes were added to the chocolate in an amount of 1.7% however 60,8 % of them were lost in the final product.

Keywords: cocoa, fat crystallization, limonene, carotenoids, pineapple peels

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5106 Random Variation of Treated Volumes in Fractionated 2D Image Based HDR Brachytherapy for Cervical Cancer

Authors: R. Tudugala, B. M. A. I. Balasooriya, W. M. Ediri Arachchi, R. W. M. W. K. Rathnayake, T. D. Premaratna

Abstract:

Brachytherapy involves placing a source of radiation near the cancer site which gives promising prognosis for cervical cancer treatments. The purpose of this study was to evaluate the effect of random variation of treated volumes in between fractions in the 2D image based fractionated high dose rate brachytherapy for cervical cancer at National Cancer Institute Maharagama, Sri Lanka. Dose plans were analyzed for 150 cervical cancer patients with orthogonal radiographs (2D) based brachytherapy. ICRU treated volumes was modeled by translating the applicators with the help of “Multisource HDR plus software”. The difference of treated volumes with respect to the applicator geometry was analyzed by using SPSS 18 software; to derived patient population based estimates of delivered treated volumes relative to ideally treated volumes. Packing was evaluated according to bladder dose, rectum dose and geometry of the dose distribution by three consultant radiation oncologist. The difference of treated volumes depends on types of the applicators, which was used in fractionated brachytherapy. The means of the “Difference of Treated Volume” (DTV) for “Evenly activated tandem (ET)” length” group was ((X_1)) -0.48 cm3 and ((X_2)) 11.85 cm3 for “Unevenly activated tandem length (UET) group. The range of the DTV for ET group was 35.80 cm3 whereas UET group 104.80 cm3. One sample T test was performed to compare the DTV with “Ideal treatment volume difference (0.00cm3)”. It is evident that P value was 0.732 for ET group and for UET it was 0.00 moreover independent two sample T test was performed to compare ET and UET groups and calculated P value was 0.005. Packing was evaluated under three categories 59.38% used “Convenient Packing Technique”, 33.33% used “Fairly Packing Technique” and 7.29% used “Not Convenient Packing” in their fractionated brachytherapy treatments. Random variation of treated volume in ET group is much lower than UET group and there is a significant difference (p<0.05) in between ET and UET groups which affects the dose distribution of the treatment. Furthermore, it can be concluded nearly 92.71% patient’s packing were used acceptable packing technique at NCIM, Sri Lanka.

Keywords: brachytherapy, cervical cancer, high dose rate, tandem, treated volumes

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5105 Investigation of Performance of Organic Acids on Carbonate Rocks (Experimental Study in Ahwaz Oilfield)

Authors: Azad Jarrahian, Ehsan Heidaryan

Abstract:

Matrix acidizing treatments can yield impressive production increase if properly applied. In this study, carbonate samples taken from Ahwaz Oilfield have undergone static solubility, sludge, emulsion, and core flooding tests. In each test interaction of acid and rock is reported and at the end it has been shown that how initial permeability and type of acid affects the overall treatment efficiency.

Keywords: carbonate acidizing, organic acids, spending rate, acid penetration, incomplete spending.

Procedia PDF Downloads 438
5104 The Impact of Environmental Corporate Social Responsibility (ECSR) and the Perceived Moral Intensity on the Intention of Ethical Investment

Authors: Chiung-Yao Huang, Yu-Cheng Lin, Chiung-Hui Chen

Abstract:

This study seeks to examine perceived environmental corporate social responsibility (ECSR) with a focus on negative environmental questions, related to intention of ethical investment intention after a environmental failure recovery. An empirical test was employed to test the hypotheses. We manipulated the information on negative ECSR activities of a hypothetical firm in a experimental design with a failure recovery treatment. The company’s negative ECSR recovery was depicted in a positive perspective (depicting a follow-up strong social action), whereas in the negative ECSR treatment it was described in a negative perspective (depicting a follow-up non social action). In both treatments, information about other key characteristics of the focal company were kept constant. Investors’ intentions to invest in the company’s stock were evaluated by multi-item scales. Results indicate that positive ECSR recovery information about a firm enhances investors’ intentions to invest in the company’s stock. In addition, perceived moral intensity has a significant impact on the intention of ethical investment and that perceived moral intensity also serves as a key moderating variable in the relationship between negative ECSR and the intention of ethical investment. Finally, theoretical and managerial implications of the findings are discussed. Practical implications: The results suggest that managers may need to be aware of perceived moral intensity as a key variable in restoring the intention of ethical investment. The results further suggest that perceived moral intensity has a direct, and it also has an moderating influence between ECSR and the intention of ethical investment. Originality/value: In an attempt to deepen the understanding of how investors perceptions of firm environmental CSR are connected with other investor‐related outcomes through ECSR recovery, the present research proposes a comprehensive model which encompasses ECSR and other key relationship constructs after a ECSR failure and recovery.

Keywords: ethical investment, Environmental Corporate Social Responsibility(ECSR), ECSR recovery, moral intensity

Procedia PDF Downloads 352
5103 Palliative Orthovoltage Radiotherapy and Subcutaneous Infusion of Carboplatin for Treatment of Appendicular Osteosarcoma in Dogs

Authors: Kathryn L. Duncan, Charles A. Kuntz, Alessandra C. Santamaria, James O. Simcock

Abstract:

Access to megavoltage radiation therapy for small animals is limited in many locations around the world. This can preclude the use of palliative radiation therapy for the treatment of appendicular osteosarcoma in dogs. The objective of this study was to retrospectively assess the adverse effects and survival times of dogs with appendicular osteosarcoma that were treated with hypofractionated orthovoltage radiation therapy and adjunctive carboplatin chemotherapy administered via a single subcutaneous infusion. Medical records were reviewed retrospectively to identify client-owned dogs with spontaneously occurring appendicular osteosarcoma that was treated with palliative orthovoltage radiation therapy and a single subcutaneous infusion of carboplatin. Data recorded included signalment, tumour location, results of diagnostic imaging, haematologic and serum biochemical analyses, adverse effects of radiation therapy and chemotherapy, and survival times. Kaplan-Meier survival analysis was performed, and log-rank analysis was used to determine the impact of specific patient variables on survival time. Twenty-three dogs were identified that met the inclusion criteria. Median survival time for dogs was 182 days. Eleven dogs had adverse haematologic effects, 3 had adverse gastrointestinal effects, 6 had adverse effects at the radiation site and 7 developed infections at the carboplatin infusion site. No statistically significant differences were identified in survival times based on sex, tumour location, development of infection, or pretreatment serum alkaline phosphatase. Median survival time and incidence of adverse effects were comparable to those previously reported in dogs undergoing palliative radiation therapy with megavoltage or cobalt radiation sources and conventional intravenous carboplatin chemotherapy. The use of orthovoltage palliative radiation therapy may be a reasonable alternative to megavoltage radiation in locations where access is limited.

Keywords: radiotherapy, veterinary oncology, chemotherapy, osteosarcoma

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5102 ICAM1 Expression is Enhanced by TNFa through Histone Methylation in Human Brain Microvessel Cells

Authors: Ji-Young Choi, Jungjin Kim, Sang-Sun Yun, Sangmee Ahn Jo

Abstract:

Intracellular adhesion molecule1 (ICAM1) is a mediator of inflammation and involved in adhesion and transmigration of leukocytes to endothelial cells, resulting in enhancement of brain inflammation. We hypothesized that increase of ICAM1 expression in endothelial cells is an early step in the pathogenesis of brain diseases such as Alzheimer’s disease. Here, we report that ICAM1 expression is regulated by pro-inflammatory cytokine TNFa in human microvascular endothelial cell (HBMVEC). TNFa significantly increased ICAM1 mRNA and protein levels at the concentrations showing no cell toxicity. This increase was also shown in micro vessels of mouse brain 24 hours after treatment with TNFa (8 mg/kg, i.v). We then investigated the epigenetic mechanism involved in the induction of ICAM1 expression. Chromatin immunoprecipitation assay revealed that TNFa reduced methylation of histone3K9 (H3K9-2me) and histone3K27 (H3K27-3me), well-known modification as gene suppression, with in the ICAM1 promoter region. However, acetylation of H3K9 and H3K14, well-known modification as gene activation, was not changed by TNFa. Treatment of BIX01294, a specific inhibitor of histone methyltransferase G9a responsible for H3K9-2me, dramatically increased in ICAM1 mRNA and protein levels and overexpression of G9a gene suppressed TNFa-induced ICAM1 expression. In contrast, GSK126, an inhibitor of histone methyltransferase EZH2 responsible for H3K27-3me and valproic acid, an inhibitor of histone deacetylase (HDAC) did not affect ICAM1 expression. These results suggested that histone3 methylation is involved in ICAM1 repression. Moreover, TNFa or BIX01294-induced ICAM induction resulted in both enhancements in adhesion and transmigration of leukocyte on endothelial cell. This study demonstrates that TNFa upregulates ICAM1 expression through H3K9-2me and H3K27-3me within the ICAM1 promoter region, in which G9a is likely to play a pivotal role in ICAM1 transcription. Our study provides a novel mechanism for ICAM1 transcription regulation in HBMVEC.

Keywords: ICAM1, TNFa, HBMVEC, H3K9-2me

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5101 Study of Syntactic Errors for Deep Parsing at Machine Translation

Authors: Yukiko Sasaki Alam, Shahid Alam

Abstract:

Syntactic parsing is vital for semantic treatment by many applications related to natural language processing (NLP), because form and content coincide in many cases. However, it has not yet reached the levels of reliable performance. By manually examining and analyzing individual machine translation output errors that involve syntax as well as semantics, this study attempts to discover what is required for improving syntactic and semantic parsing.

Keywords: syntactic parsing, error analysis, machine translation, deep parsing

Procedia PDF Downloads 560
5100 The Experiences and Needs of Mothers’ of Children With Cancer in Coping With the Child's Disease

Authors: Maarja Karbus, Elsbet Lippmaa, Kadri Kööp, Mare Tupits

Abstract:

Aim: The aim is to describe the experiences and needs of mothers of children with cancer in coping with the child's illness. Background: Cancer affects different life areas. Especially if it is a child, in this case the whole family is involved. Loved ones are mentally affected, there are limitations, and life changes need to be made to make the whole treatment regimen and recovery as comfortable as possible. Also, the whole process is expensive and time consuming. The research is part of a larger project that covers the experiences and needs of parents of children with chronic illness and coping strategies related to the child's illness. Design: Qualitative, empirical, descriptive research. Method: Semi-structured interviews were used to collect data and inductive content analysis was used to analyze the data. The interviews were conducted in the autumn of 2020, 5 respondents participated in the research. Results and Conclusions: The research revealed that the mothers' experiences of coping with a child's disease included health-related experiences, material aspects, changes in lifestyle, support systems and contact with professionals. Regarding the organizational and material aspects of life, the subjects presented experiences with economic problems, adaptation of changes in lifestyle, access to information and changes in the treatment process. With regard to health, the respondents identified experiences with the mother's physical and mental health and experiences with the health of an ill child. The experience of different support systems was related to the support of family, friends, acquaintances, various organizations and specialists. Experiences with specialist support included experiences with family relationships and positive and negatiive experiences with staff. The mothers' needs in dealing with the child's disease included the mother's emotional needs, the support of other family members, and the need for various support systems and services. The needs of coping with the child were the need for understanding, support, confidence, the need to be strong and courageous, the need to ignore one's own needs, and the need for personal time and rest. The needs of other family members included the needs of an ill child and the need to pay attention to other children in the family. The needs of different supporters and services were related to different helpers and different services.

Keywords: cancer, mother, coping, child, need, experience, illness

Procedia PDF Downloads 151
5099 A Five-Year Experience of Intensity Modulated Radiotherapy in Nasopharyngeal Carcinomas in Tunisia

Authors: Omar Nouri, Wafa Mnejja, Fatma Dhouib, Syrine Zouari, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Leila Farhat, Nejla Fourati, Jamel Daoud

Abstract:

Purpose and Objective: Intensity modulated radiation (IMRT) technique, associated with induction chemotherapy (IC) and/or concomitant chemotherapy (CC), is actually the recommended treatment modality for nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the therapeutic results and the patterns of relapse with this treatment protocol. Material and methods: A retrospective monocentric study of 145 patients with NPC treated between June 2016 and July 2021. All patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. The high-risk volume dose was 66.5 Gy in children. Survival analysis was performed according to the Kaplan-Meier method, and the Log-rank test was used to compare factors that may influence survival. Results: Median age was 48 years (11-80) with a sex ratio of 2.9. One hundred-twenty tumors (82.7%) were classified as stages III-IV according to the 2017 UICC TNM classification. Ten patients (6.9%) were metastatic at diagnosis. One hundred-thirty-five patient (93.1%) received IC, 104 of which (77%) were TPF-based (taxanes, cisplatin and 5 fluoro-uracil). One hundred-thirty-eight patient (95.2%) received CC, mostly cisplatin in 134 cases (97%). After a median follow-up of 50 months [22-82], 46 patients (31.7%) had a relapse: 12 (8.2%) experienced local and/or regional relapse after a median of 18 months [6-43], 29 (20%) experienced distant relapse after a median of 9 months [2-24] and 5 patients (3.4%) had both. Thirty-five patients (24.1%) died, including 5 (3.4%) from a cause other than their cancer. Three-year overall survival (OS), cancer specific survival, disease free survival, metastasis free survival and loco-regional free survival were respectively 78.1%, 81.3%, 67.8%, 74.5% and 88.1%. Anatomo-clinic factors predicting OS were age > 50 years (88.7 vs. 70.5%; p=0.004), diabetes history (81.2 vs. 66.7%; p=0.027), UICC N classification (100 vs. 95 vs. 77.5 vs. 68.8% respectively for N0, N1, N2 and N3; p=0.008), the practice of a lymph node biopsy (84.2 vs. 57%; p=0.05), and UICC TNM stages III-IV (93.8 vs. 73.6% respectively for stage I-II vs. III-IV; p=0.044). Therapeutic factors predicting OS were a number of CC courses (less than 4 courses: 65.8 vs. 86%; p=0.03, less than 5 courses: 71.5 vs. 89%; p=0.041), a weight loss > 10% during treatment (84.1 vs. 60.9%; p=0.021) and a total cumulative cisplatin dose, including IC and CC, < 380 mg/m² (64.4 vs. 87.6%; p=0.003). Radiotherapy delay and total duration did not significantly affect OS. No grade 3-4 late side effects were noted in the evaluable 127 patients (87.6%). The most common toxicity was dry mouth which was grade 2 in 47 cases (37%) and grade 1 in 55 cases (43.3%).Conclusion: IMRT for nasopharyngeal carcinoma granted a high loco-regional control rate for patients during the last five years. However, distant relapses remain frequent and conditionate the prognosis. We identified many anatomo-clinic and therapeutic prognosis factors. Therefore, high-risk patients require a more aggressive therapeutic approach, such as radiotherapy dose escalation or adding adjuvant chemotherapy.

Keywords: therapeutic results, prognostic factors, intensity-modulated radiotherapy, nasopharyngeal carcinoma

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5098 Implementation of A Treatment Escalation Plan During The Covid 19 Outbreak in Aneurin Bevan University Health Board

Authors: Peter Collett, Mike Pynn, Haseeb Ur Rahman

Abstract:

For the last few years across the UK there has been a push towards implementing treatment escalation plans (TEP) for every patient admitted to hospital. This is a paper form which is completed by a junior doctor then countersigned by the consultant responsible for the patient's care. It is designed to address what level of care is appropriate for the patient in question at point of entry to hospital. It helps decide whether the patient would benefit for ward based, high dependency or intensive care. They are completed to ensure the patient's best interests are maintained and aim to facilitate difficult decisions which may be required at a later date. For example, a frail patient with significant co-morbidities, unlikely to survive a pathology requiring an intensive care admission is admitted to hospital the decision can be made early to state the patient would not benefit from an ICU admission. This decision can be reversed depending on the clinical course of the patient's admission. It promotes discussions with the patient regarding their wishes to receive certain levels of healthcare. This poster describes the steps taken in the Aneurin Bevan University Health Board (ABUHB) when implementing the TEP form. The team implementing the TEP form campaigned for it's use to the board of directors. The directors were eager to hear of experiences of other health boards who had implemented the TEP form. The team presented the data produced in a number of health boards and demonstrated the proposed form. Concern was raised regarding the legalities of the form and that it could upset patients and relatives if the form was not explained properly. This delayed the effectuation of the TEP form and further research and discussion would be required. When COVID 19 reached the UK the National Institute for Health and Clinical Excellence issued guidance stating every patient admitted to hospital should be issued a TEP form. The TEP form was accelerated through the vetting process and was approved with immediate effect. The TEP form in ABUHB has now been in circulation for a month. An audit investigating it's uptake and a survey gathering opinions have been conducted.

Keywords: acute medicine, clinical governance, intensive care, patient centered decision making

Procedia PDF Downloads 179
5097 Fuzzy Inference System for Diagnosis of Malaria

Authors: Purnima Pandit

Abstract:

Malaria remains one of the world’s most deadly infectious disease and arguably, the greatest menace to modern society in terms of morbidity and mortality. To choose the right treatment and to ensure a quality of life suitable for a specific patient condition, early and accurate diagnosis of malaria is essential. It reduces transmission of disease and prevents deaths. Our work focuses on designing an efficient, accurate fuzzy inference system for malaria diagnosis.

Keywords: fuzzy inference system, fuzzy logic, malaria disease, triangular fuzzy number

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5096 A Study on Pattern of Acute Poisoning in Patients Admitted to Emergency Wards in a Tertiary Care Hospital

Authors: Sathvika Reddy, Devi Revathi

Abstract:

Background: In India, deliberate self-harm (DSH) with poisoning agents carries a significant impact on morbidity and mortality. Changes in the patterns of poisoning vary across various geographical locations. It is important to know the patterns in a given region in order to facilitate rapid clinical diagnosis, appropriate treatment to reduce associated morbidity and mortality. Aim and Objective: To study the patterns, treatment outcomes of acute poisoning in patients admitted to emergency wards in a tertiary care hospital and to provide poison information services. Materials and Methods: This study was conducted at M.S Ramaiah Memorial and Teaching Hospital from November 2016 to March 2017. The patient’s data was obtained from patient case sheet, interaction with health care professionals, interviewing patients and their caretakers (if possible), and were documented in a suitably designed form. Results: The study involved 131 patients with a mean age of 27.76 ± 15.5 years. Majority of the patients were in the age group 21-30 years, literates (n=53) dwelling in urban (n=113) areas belonging to upper middle class (n=50). Analgesics and antipyretics were commonly utilized in intentional drug overdosage (n=49). Envenomation constituted n=21(16.03%). Furthermore, a significant relationship was observed between marital status and self-poisoning (n=64) (P < 0.001) which commonly occurred through oral ingestion. The outcomes were correlated with the GCS and PSS system and n=85 recovered, n=17 were discharged against medical advice, and n=4 died, and n=4 were lost to follow up respectively. The poison information queries include drug overdose (n=29) and management related queries (n=22) provided majorly by residents (n=45) to update knowledge (n=11) and for better patient care (n=40). Conclusion: The trend in poisoning is dynamic. Medications were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.

Keywords: poisoning, suicides, clinical pharmacist, envenomation, poison information services

Procedia PDF Downloads 165
5095 Microstructure Dependent Fatigue Crack Growth in Aluminum Alloy

Authors: M. S. Nandana, K. Udaya Bhat, C. M. Manjunatha

Abstract:

In this study aluminum alloy 7010 was subjected to three different ageing treatments i.e., peak ageing (T6), over-ageing (T7451) and retrogression and re ageing (RRA) to study the influence of precipitate microstructure on the fatigue crack growth rate behavior. The microstructural modification was studied by using transmission electron microscope (TEM) to examine the change in the size and morphology of precipitates in the matrix and on the grain boundaries. The standard compact tension (CT) specimens were fabricated and tested under constant amplitude fatigue crack growth tests to evaluate the influence of heat treatment on the fatigue crack growth rate properties. The tests were performed in a computer-controlled servo-hydraulic test machine applying a load ratio, R = 0.1 at a loading frequency of 10 Hz as per ASTM E647. The fatigue crack growth was measured by adopting compliance technique using a CMOD gauge attached to the CT specimen. The average size of the matrix precipitates were found to be of 16-20 nm in T7451, 5-6 nm in RRA and 2-3 nm in T6 conditions respectively. The grain boundary precipitate which was continuous in T6, was disintegrated in RRA and T7451 condition. The PFZ width was lower in RRA compared to T7451 condition. The crack growth rate was higher in T7451 and lowest in RRA treated alloy. The RRA treated alloy also exhibits an increase in threshold stress intensity factor range (∆Kₜₕ). The ∆Kₜₕ measured was 11.1, 10.3 and 5.7 MPam¹/² in RRA, T6 and T7451 alloys respectively. The fatigue crack growth rate in RRA treated alloy was nearly 2-3 times lower than that in T6 and was one order lower than that observed in T7451 condition. The surface roughness of RRA treated alloy was more pronounced when compared to the other conditions. The reduction in fatigue crack growth rate in RRA alloy was majorly due to the increase in roughness and partially due to increase in spacing between the matrix precipitates. The reduction in crack growth rate and increase in threshold stress intensity range is expected to benefit the damage tolerant capability of aircraft structural components under service loads.

Keywords: damage tolerance, fatigue, heat treatment, PFZ, RRA

Procedia PDF Downloads 155
5094 Synthesis of Silver Nanoparticles Adsorbent from Phytolacca Dodecandra ‘Endod’ Leaf to Water Treatment, at Almeda Textile Factory, Tigray Ethiopia

Authors: Letemariam Gebreslassie Gebrekidan

Abstract:

Water pollution is one of the most feared problems in modern societies, especially in developing countries like Ethiopia. Nanoparticles with controlled size and composition are of fundamental and technological interest as they provide solutions to technological and environmental challenges in the areas of solar energy conversion, catalysis, medicine, and water treatment. The synthesis of metallic nanoparticles is an active area of academic and, more importantly, application research in nanotechnology. Adsorption is a process in which pollutants are absorbed on a solid surface. A molecule (pollutant) adhered to the solid surface is called an adsorbate, and the solid surface is an adsorbent. Adsorption is controlled by various parameters such as temperature, the nature of the adsorbate and adsorbent, and the presence of other pollutants along with the experimental conditions (pH, concentration of pollutants, contact time, particle size, and temperature). Depending on the main problem of water pollution, this research is available on the adsorption of wastewater using silver nanoparticles extracted from phytolacca Dodecandra leaf. AgNP was synthesized from a 1mM aqueous solution of silver nitrate (AgNO3) and Phytolacca Dodecandra leaf extract at room temperature. The synthesized nanoparticles were characterized using UV/visible Spectrometer, FTIR and XRD. In the UV-Vis spectrum, The Surface Plasmon resonance (SPR) peak was observed at 414 nm, which confirmed the synthesis of AgNPs. FTIR spectroscopy, recorded from 4000 cm-1 to 400 cm-1, indicated the presence of a capping agent with the nanoparticles. From the XRD results, the average crystalline size was estimated to be 20 nm Confirming the nanoparticle nature of the obtained sample. Thus, the present method leads to the formation of silver nanoparticles with well-defined dimensions. The effects of different parameters like solution pH, adsorbent dose, contact time and initial concentration of dye were studied. The concentration of MB is 0.01 mg/L and 0.002 mg/L before and after adsorption, respectively. The wastewater containing MB was well purified using AgNP adsorbent.

Keywords: wastewater, silver nanoparticle, Characterization, adsorption, parameter

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5093 Liver Transplantation after Downstaging with Electrochemotherapy of Large Hepatocellular Carcinoma and Portal Vein Tumor Thrombosis: A Case Report

Authors: Luciano Tarantino, Emanuele Balzano, Aurelio Nasto

Abstract:

S.R. 53 years. January 2009: HCV-related cirrhosis, Child-Pugh A5 class, EGDS no aesophageal Varices. No important comorbidities. Treated with PEG-IFN+Ribavirin (march-november 2009) with subsequent sustained virologic response. HCVRNA absent overtime. October 2016 :CT detected small HCC nodule in the VIII segment (diam.=12 mm). Treated with US guided RF-ablation. November 2016 CT: complete necrosis. Unfortunately, the patient dropped out US and CT follow-up controls.September 2018: asthenia and weight loss. CT showed a large tumor infiltrating V-VII-VI segments and complete PVTT of right portal vein and its branches . Surgical Consultation excluded indication to Liver resection and OLT . 23 october 2018: ECT of a large peri-hilar area of the tumor including the PVTT. 1 and 3 months post-treatment CT showed complete necrosis and retraction of the thrombus and residual viable tumor in the peripheral portion of the right lobe . Therefor, the patient was reevaluated for OLT and considered eligible in waiting list . March 2019: CT showed no perihilar or portal vein recurrence and distant progression in the right lobe . March 2019 : Trans-arterial-Radio-therapy (TARE) of the right lobe. Post-treatment CT demonstrated no perihilar or portal vein recurrence and extensive necrosis of the residual tumor . December 2019: CT demonstrated several recurrences of HCC infiltrating the VI and VII segment . Howewer no recurrence was observed at hepatic hilum and in portal vessels . Therefore, on February 2020 the patient received OLT. At 44 months follow-up, no complication or recurrence or liver disfunction have been observed.

Keywords: hepatocellular carcinoma, portal vein tumor thrombosis, interventional ultrasound, liver tumor ablation, liver transplantation

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5092 The Efficacy of Psychological Interventions for Psychosis: A Systematic Review and Network Meta-Analysis

Authors: Radu Soflau, Lia-Ecaterina Oltean

Abstract:

Background: Increasing evidence supports the efficacy of psychological interventions for psychosis. However, it is unclear which one of these interventions is most likely to address negative psychotic symptoms and related outcomes. We aimed to determine the relative efficacy of psychological and psychosocial interventions for negative symptoms, overall psychotic symptoms, and related outcomes. Methods: To attain this goal, we conducted a systematic review and network meta-analysis. We searched for potentially eligible trials in PubMed, EMBASE, PsycInfo, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases up until February 08, 2022. We included randomized controlled trials that investigated the efficacy of psychological for adults with psychosis. We excluded interventions for prodromal or “at risk” individuals, as well as patients with serious co-morbid medical or psychiatric conditions (others than depressive and/or anxiety disorders). Two researchers conducted study selection and performed data extraction independently. Analyses were run using STATA network and mvmeta packages, applying a random effect model under a frequentist framework in order to compute standardized mean differences or risk ratio. Findings: We identified 47844 records and screened 29466 records for eligibility. The majority of eligible interventions were delivered in addition to pharmacological treatment. Treatment as usual (TAU) was the most frequent common comparator. Theoretically driven psychological interventions generally outperformed TAU at post-test and follow-up, displaying small and small-to-medium effect sizes. A similar pattern of results emerged in sensitivity analyses focused on studies that employed an inclusion criterion for relevant negative symptom severity. Conclusion: While the efficacy of some psychological interventions is promising, there is a need for more high-quality studies, as well as more trials directly comparing psychological treatments for negative psychotic symptoms.

Keywords: psychosis, network meta-analysis, psychological interventions, efficacy, negative symptoms

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5091 Investigating a Crack in Care: Assessing Long-Term Impacts of Child Abuse and Neglect

Authors: Remya Radhakrishnan, Hema Perinbanathan, Anukriti Rath, Reshmi Ramachandran, Rohith Thazhathuvetil Sasindrababu, Maria Karizhenskaia

Abstract:

Childhood adversities have lasting effects on health and well-being. This abstract explores the connection between adverse childhood experiences (ACEs) and health consequences, including substance abuse and obesity. Understanding the impact of childhood trauma and emphasizing the importance of culturally sensitive treatments and focused interventions help to mitigate these effects. Research consistently shows a strong link between ACEs and poor health outcomes. Our team conducted a comprehensive literature review of depression and anxiety in Canadian children and youth, exploring diverse treatment methods, including medical, psychotherapy, and alternative therapies like art and music therapy. We searched Medline, Google Scholar, and St. Lawrence College Library. Only original research papers, published between 2012 and 2023, peer-reviewed, and reporting on childhood adversities on health and its treatment methods in children and youth in Canada were considered. We focused on their significance in treating depression and anxiety. According to the study's findings, the prevalence of adverse childhood experiences (ACEs) is still a significant concern. In Canada, 40% of people report having had multiple ACEs, and 78% report having had at least one ACE, highlighting the persistence of childhood adversity and indicating that the issue is unlikely to fade off in the near future. Likewise, findings revealed that individuals who experienced abuse, neglect, or violence during childhood are likelier to engage in harmful behaviors like polydrug use, suicidal ideation, and victimization and suffer from mental health problems such as depression and post-traumatic stress disorder (PTSD).

Keywords: adverse childhood experiences (ACEs), obesity, post-traumatic stress disorder (PTSD), resilience, substance abuse, trauma-informed care

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