Search results for: treatment resistant schizophrenia
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9056

Search results for: treatment resistant schizophrenia

8756 Determination of Metalaxyl Efficacy in Controlling Phytophthora palmivora Infection of Durian Using Bioassay

Authors: Supawadee Phetkhajone, Wisuwat Songnuan

Abstract:

Metalaxyl is one of the most common and effective fungicides used to control Phytophthora palmivora infection in durian (Durio zibethinus L.). The efficacy of metalaxyl residue in durian under greenhouse condition was evaluated using bioassay. Durian seedlings were treated with 2 methods of application, spraying, and soil drenching of metalaxyl, at recommended concentration (1000 mg/L). Mock treated samples were treated with 0.1% Tween20 and water for spraying and soil drenching methods, respectively. The experiment was performed in triplicates. Leaves were detached from treated plants at 0, 1, 7, 15, 20, 30, and 60 days after application, inoculated with metalaxyl-resistant and metalaxyl-sensitive isolates of P. palmivora, and incubated in a high humidity chamber for 5 days at room temperature. Metalaxyl efficacy was determined by measuring the lesion size on metalaxyl treated and mock treated samples. The results showed that metalaxyl can control metalaxyl-sensitive isolate of P. palmivora for at least 30 days after application in both methods of application. The metalaxyl-resistant isolate was not inhibited in all treatments. Leaf samples from spraying method showed larger lesions compared to soil drench method. These results demonstrated that metalaxyl applications, especially soil drenching methods showed high efficacy to control metalaxyl-sensitive isolates of P. palmivora, although it cannot control metalaxyl-resistant isolates of P. palmivora in all treatments. These qualitative data indicate that metalaxyl may suitable to control metalaxyl-sensitive isolates of P. palmivora infection.

Keywords: bioassay, degradation, durian, metalaxyl

Procedia PDF Downloads 125
8755 Advances in Natural Fiber Surface Treatment Methodologies for Upgradation in Properties of Their Reinforced Composites

Authors: G. L. Devnani, Shishir Sinha

Abstract:

Natural fiber reinforced polymer composite is a very attractive area among the scientific community because of their low cost, eco-friendly and sustainable in nature. Among all advantages there are few issues which need to be addressed, those issues are the poor adhesion and compatibility between two opposite nature materials that is fiber and matrix and their relatively high water absorption. Therefore, natural fiber modifications are necessary to improve their adhesion with different matrices. Excellent properties could be achieved with the surface treatment of these natural fibers ultimately leads to property up-gradation of their reinforced composites with different polymer matrices. Lot of work is going on to improve the adhesion between reinforced fiber phase and polymer matrix phase to improve the properties of composites. Researchers have suggested various methods for natural fiber treatment like silane treatment, treatment with alkali, acetylation, acrylation, maleate coupling, etc. In this study a review is done on the different methods used for the surface treatment of natural fibers and what are the advance treatment methodologies for natural fiber surface treatment for property improvement of natural fiber reinforced polymer composites.

Keywords: composites, acetylation, natural fiber, surface treatment

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8754 Studies on Corrosion Resistant Composite Coating for Metallic Surfaces

Authors: Navneetinder Singh, Harprabhjot Singh, Harpreet Singh, Supreet Singh

Abstract:

Many materials are known to mankind that is widely used for synthesis of corrosion resistant hydrophobic coatings. In the current work, novel hydrophobic composite was synthesized by mixing polytetrafluoroethylene (PTFE) and 20 weight% ceria particles followed by sintering. This composite had same hydrophobic behavior as PTFE. Moreover, composite showed better scratch resistance than virgin PTFE. Pits of plasma sprayed Ni₃Al coating were exploited to hold PTFE composite on the substrate as Superni-75 alloy surface through sintering process. Plasma sprayed surface showed good adhesion with the composite coating during scratch test. Potentiodynamic corrosion test showed 100 fold decreases in corrosion rate of coated sample this may be attributed to inert and hydrophobic nature of PTFE and ceria.

Keywords: polytetrafluoroethylene, PTFE, ceria, coating, corrosion

Procedia PDF Downloads 383
8753 The Confluence between Autism Spectrum Disorder and the Schizoid Personality

Authors: Murray David Schane

Abstract:

Though years of clinical encounters with patients with autism spectrum disorders and those with a schizoid personality the many defining diagnostic features shared between these conditions have been explored and current neurobiological differences have been reviewed; and, critical and different treatment strategies for each have been devised. The paper compares and contrasts the apparent similarities between autism spectrum disorders and the schizoid personality are found in these DSM descriptive categories: restricted range of social-emotional reciprocity; poor non-verbal communicative behavior in social interactions; difficulty developing and maintaining relationships; detachment from social relationships; lack of the desire for or enjoyment of close relationships; and preference for solitary activities. In this paper autism, fundamentally a communicative disorder, is revealed to present clinically as a pervasive aversive response to efforts to engage with or be engaged by others. Autists with the Asperger presentation typically have language but have difficulty understanding humor, irony, sarcasm, metaphoric speech, and even narratives about social relationships. They also tend to seek sameness, possibly to avoid problems of social interpretation. Repetitive behaviors engage many autists as a screen against ambient noise, social activity, and challenging interactions. Also in this paper, the schizoid personality is revealed as a pattern of social avoidance, self-sufficiency and apparent indifference to others as a complex psychological defense against a deep, long-abiding fear of appropriation and perverse manipulation. Neither genetic nor MRI studies have yet located the explanatory data that identifies the cause or the neurobiology of autism. Similarly, studies of the schizoid have yet to group that condition with those found in schizophrenia. Through presentations of clinical examples, the treatment of autists of the Asperger type is revealed to address the autist’s extreme social aversion which also precludes the experience of empathy. Autists will be revealed as forming social attachments but without the capacity to interact with mutual concern. Empathy will be shown be teachable and, as social avoidance relents, understanding of the meaning and signs of empathic needs that autists can recognize and acknowledge. Treatment of schizoids will be shown to revolve around joining empathically with the schizoid’s apprehensions about interpersonal, interactive proximity. Models of both autism and schizoid personality traits have yet to be replicated in animals, thereby eliminating the role of translational research in providing the kind of clues to behavioral patterns that can be related to genetic, epigenetic and neurobiological measures. But as these clinical examples will attest, treatment strategies have significant impact.

Keywords: autism spectrum, schizoid personality traits, neurobiological implications, critical diagnostic distinctions

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8752 Diversities, Antibiogram and Antibiotic Resistance Genes in Staphylococcus Species in Raw Meat from a Research Farm

Authors: Anthony Ayodeji Adegoke, Olayinka Ayobami Aiyegoro, Thor Axel Stenstrom

Abstract:

A study to investigate the species diversities, antibiogram and antibiotic resistance genes in Staphylococcus species from raw meat and dairy products collected from an abattoir and a farm shop of a research institute in Irene, South Africa over a six-month period was conducted. Polymerase Chain Reaction was used to speciate the bacteria and to detect the presence and otherwise of resistance genes. Antibiotic susceptibility testing was performed by disk diffusion method on Mueller-Hinton agar according to the Clinical Laboratory Standards Institute standards. A total of twenty-six (26) antibiotics were used to determine the antibiotic susceptibility. S. xylosus was the predominant isolate with 30% total occurrence, followed by S. epidermis, S. aureus, S. saprophyticus and S. haemolyticus with 25%, 15%, 15%, and 10% abundance respectively. The isolates were resistant to ceftezidime, gentamycin, nalidixic acid, nortrafuration, ampicillin, penicillin, oxytetracycline, tetracycline, doxycycline, clindamycin and lincomycin. mecA genes was detected among the methicillin resistant Staphylococcus species (MRSS) but no vancomycin resistance genes (van A and van B) were detected in these isolates. The presence of MRSS and multidrug resistant Staphylococcus species in meat affirms the need to avoid consumption of partially cooked meat currently rampant in South Africa, to avoid the spread of difficult to control pathogens in epidemiological proportion.

Keywords: Staphylococcus species, antibiotics, antibiotic resistance genes, food products, methicillin resistance, mecA gene

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8751 Open Trial of Group Schema Therapy for the Treatment of Eating Disorders

Authors: Evelyn Smith, Susan Simpson

Abstract:

Background: Eating disorder (ED) treatment is complicated by high rates of chronicity, comorbidity, complex personality traits and client dropout. Given these complexities, Schema Therapy (ST) has been identified as a suitable treatment option. The study primarily aims to evaluate the efficacy of group ST for the treatment of EDs. The study further evaluated the effectiveness of ST in reducing schemas and improving quality of life. Method: Participant suitability was ascertained using the Eating Disorder Examination. Following this, participants attended 90-minute weekly group sessions over 25 weeks. Groups consisted of six to eight participants and were facilitated by two psychologists, at least one of who is trained in ST. Measures were completed at pre, mid and post-treatment. Measures assessed ED symptoms, cognitive schemas, schema mode presentations, quality of life, self-compassion and psychological distress. Results: As predicted, measures of ED symptoms were significantly reduced following treatment. No significant changes were observed in early maladaptive schema severity; however, reductions in schema modes were observed. Participants did not report improvements in general quality of life measures following treatment, though improvement in psychological well-being was observed. Discussion: Overall, the findings from the current study support the use of group ST for the treatment of EDs. It is expected that lengthier treatment is needed for the reduction in schema severity. Given participant dropout was considerably low, this has important treatment implications for the suitability of ST for the treatment of EDs.

Keywords: eating disorders, schema therapy, treatment, quality of life

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8750 Biomimetic Strategies to Design Non-Toxic Antimicrobial Textiles

Authors: Isabel Gouveia

Abstract:

Antimicrobial textile materials may significantly reduce the risk of infections and because they are able to absorb substances from the skin and release therapeutic compounds to the skin, they can also find applications as complementary therapy of skin-diseases as part of standard management. Although functional textiles may be a promising area in skin disease/injury management, as part of standard management, few offer complementary treatment even though they are well known to reduce scratching and aiding emollient absorption, reducing infection, and alleviating pruritus. The reason for this may rely on the low quality of supporting evidence and negative effect that antimicrobial agents may exert on skin microbiome, as for example additional irritation of the vulnerable skin, and by causing resistant bacteria. Several antimicrobial agents have been tested in textiles: quaternary ammonium compounds, silver, polyhexamethylene-biguanides and triclosan have been used, with success. They have powerful bactericidal activity but the majority have a reduce spectrum of microbial inhibition and may cause skin irritation, ecotoxicity and bacteria resistance. Furthermore, the rising flow of strains resistant to last-resort antibiotics rekindles interest in alternative strategies. In this regard, new functional textiles incorporating highly specific antimicrobial agents towards pathogenic bacteria, are required. Recent research has been conducted on naturally occurring antimicrobials as novel alternatives to antibiotics. Conscious of this need our team firstly reported new approaches using L-cysteine and antimicrobial peptides (AMP). Briefly, we were able to develop different immobilization processes towards 6 Log Reduction against bacteria such as S. aureus and K. pneumoniae. Therefore, here we present several innovative antimicrobial textiles incorporating AMP and L-Cysteine which may open new avenues for the medical textiles market and biomaterials in general. Team references will be discussed as an overview and for comparison purposes in terms of potential therapeutic applications.

Keywords: Antimicrobials, Antimicrobial Textiles, Biomedical Textiles, Biomimetic surface functionalization

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8749 Prevalence of Extended Spectrum of Beta Lactamase Producers among Gram Negative Uropathogens

Authors: Y. V. S. Annapurna, V. V. Lakshmi

Abstract:

Urinary tract infection (UTI) is one of the most common infectious diseases at the community level with a high rate of morbidity . This is further augmented by increase in the number of resistant and multi resistant strains of bacteria particularly by those producing Extended spectrum of beta lactamases. The present study was aimed at analysis of antibiograms of E.coli and Klebsiella sp causing urinary tract infections. Between November 2011 and April 2013, a total of 1120 urine samples were analyzed,. Antibiotic sensitivity testing was done with 542(48%) isolates of E.coli and 446(39%) of Klebsiella sp using the standard disc diffusion method against eleven commonly used antibiotics .Organisms showed high susceptibility to Amikacin and Netilimicin and low susceptibility to Cephalosporins. MAR index was calculated for the multidrug resistant strains. Maximum MAR index detected among the isolates was 0.9. Phenotypic identification for ESBL production was confirmed by double disk synergy test (DDST) according to CLSI guidelines. Plasmid profile of the isolates was carried out using alkaline hydrolysis method. Agarose-gel electrophoresis showed presence of high-molecular weight plasmid DNA among the ESBL strains. This study emphasizes the importance of indiscriminate use of antibiotics which if discontinued, in turn would prevent further development of bacterial drug resistance. For this, a proper knowledge of susceptibility pattern of uropathogens is necessary before prescribing empirical antibiotic therapy and it should be made mandatory.

Keywords: escherichia coli, extended spectrum of beta lactamase, Klebsiella spp, Uropathogens

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8748 Understanding the Mechanisms of Salmonella typhimurium Resistance to Cannabidiol

Authors: Iddrisu Ibrahim, Joseph Atia Ayariga, Junhuan Xu, Daniel Abugri, Boakai Robertson, Olufemi S. Ajayi

Abstract:

The emergence of multidrug resistance poses a huge risk to public health globally. Yet these recalcitrant pathogens continue to rise in incidence rate, with resistance rates significantly outpacing the speed of antibiotic development. This, therefore, presents an aura of related health issues such as untreatable nosocomial infections arising from organ transplants and surgeries, as well as community-acquired infections that are related to people with compromised immunity, e.g., diabetic and HIV patients, etc. There is a global effort to fight multidrug-resistant pathogens spearheaded by the World Health Organization, thus calling for research into novel antimicrobial agents to fight multiple drug resistance. Previously, our laboratory demonstrated that Cannabidiol (CBD) was an effective antimicrobial against Salmonella typhimurium (S. typhimurium). However, we observed resistance development over time. To understand the mechanisms S. typhimurium uses to develop resistance to Cannabidiol (CBD), we studied the abundance of bacteria lipopolysaccharide (LPS) and membrane sterols of both susceptible and resistant S. typhimurium. Using real-time quantitative polymerase chain reaction (RT-qPCR), we also analyzed the expression of selected genes known for aiding resistance development in S. typhimurium. We discovered that there was a significantly higher expression of blaTEM, fimA, fimZ, and integrons in the CBD-resistant bacteria, and these were also accompanied by a shift in abundance in cell surface molecules such as lipopolysaccharide (LPS) and sterols.

Keywords: antimicrobials, resistance, cannabidiol, gram-negative bacteria, integrons, blaTEM, Fim, LPS, ergosterols

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8747 Wastewater Treatment Using Microalgae

Authors: Chigbo Ikechukwu Emmanuel

Abstract:

Microalgae can be used for tertiary treatment of wastewater due to their capacity to assimilate nutrients. The pH increase which is mediated by the growing algae also induces phosphorus precipitation and ammonia stripping to the air, and may in addition act disinfecting on the wastewater. Domestic wastewater is ideal for algal growth since it contains high concentrations of all necessary nutrients. The growth limiting factor is rather light, especially at higher latitudes. The most important operational factors for successful wastewater treatment with microalgae are depth, turbulence and hydraulic retention time.

Keywords: microalgae, wastewater treatment, phosphorus, nitrogen, light, operation, ponds, growth

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8746 Prevalence and Antimicrobial Resistance of Salmonella spp. Isolated from Pigs at Slaughterhouses in Northeast of Thailand

Authors: Sunpetch Angkititrakul, Seree Klaengair, Dusadee Phongaran, Arunee Ritthipanun

Abstract:

The objective of this study is to determine the prevalence and antimicrobial resistance pattern of Salmonella spp. isolated from pigs at slaughterhouses in the northeast of Thailand. During 2015-2016, all samples were isolated and identified by ISO 6579:2002. A total of 699 samples of rectal swab were collected and isolated for the presence of Salmonella. Salmonella was detected in 275 of 699 (39.34%) samples. 24 serovars were identified in the 275 isolates. The most prevalent serovars were rissen (36.97%), S. enterica ser.4,5,12:i: (25.35%) and typhimurium (21.33%). In this study, 76.30% of the isolates were resistant to at least one antimicrobial drug and 38.39% were multidrug resistant. The highest resistances were found in ampicillin (69.20%), tetracycline (66.35%), sulfamethoxazole/trimethoprim (35.55%) and chloramphenicol (9.00%) The results showed high prevalence of Salmonella spp. in pigs and high antimicrobial resistance among the isolates, and indicated the need for monitoring program to control Salmonella contamination and reduce the dissemination of antimicrobial resistance in pig supply chain.

Keywords: prevalence, antimicrobial resistance, Salmonella spp., pig

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8745 Mercury Removal Using Pseudomonas putida (ATTC 49128): Effect of Acclimatization Time, Speed, and Temperature of Incubator Shaker

Authors: A. A. M. Azoddein, R. M. Yunus, N. M. Sulaiman, A. B. Bustary, K. Sabar

Abstract:

Microbes have been used to solve environmental problems for many years. The use microorganism to sequester, precipitate or alter the oxidation state of various heavy metals has been extensively studied. Processes by which microorganism interacts with toxic metal are very diverse. The purpose of this research is to remove the mercury using Pseudomonas putida, pure culture ATTC 49128 at optimum growth parameters such as techniques of culture, acclimatization time and speed of incubator shaker. Thus, in this study, the optimum growth parameters of P.putida were obtained to achieve the maximum of mercury removal. Based on the optimum parameters of Pseudomonas putida for specific growth rate, the removal of two different mercury concentration, 1 ppm and 4 ppm were studied. A mercury-resistant bacterial strain which is able to reduce ionic mercury to metallic mercury was used to reduce ionic mercury from mercury nitrate solution. The overall levels of mercury removal in this study were between 80% and 90%. The information obtained in this study is of fundamental for understanding of the survival of P.putida ATTC 49128 in mercury solution. Thus, microbial mercury environmental pollutants removal is a potential biological treatment for waste water treatment especially in petrochemical industries in Malaysia.

Keywords: Pseudomonas putida, growth kinetic, biosorption, mercury, petrochemical waste water

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8744 The Effect of Pozzolan Addition on the Physico-Chemical and Mechanical Properties of Mortars Based on Cement Resistant to Sulfate (CRS)

Authors: L. Belagraa, A. Belguendouz, Y. Rouabah, A. Bouzid, A. Noui, O. Kessal

Abstract:

The use of cements CRS in aggressive environments showed a lot of benefits as like good mechanical responses and therefore better durability, however, their manufacturing consume a lot of clinker, which leads to the random hazardous deposits, the shortage of natural resources and the gas and the dust emissions mainly; (CO2) with its ecological negative impact on the environment. Technical, economic and environmental benefits by the use of blended cements have been reported and being considered as a research area of great interest. The purpose of this study is to evaluate the influence of the substitution of natural pozzolan on the physico-chemical properties of the new formulated binder and the mechanical behavior of mortar containing this binary cement. Hence, the pozzolan replacement is composed with different proportions (0%, 2.5%, 5%, 7.5% and 10%). The physico-chemical properties of cement resistant to sulfate (CRS) alternative composition were investigated. Further, the behavior of the mortars based on this binder is studied. These characteristics includes chemical composition, density and fineness, consistency, setting time, shrinkage, absorption and the mechanical response. The results obtained showed that the substitution of pozzolan at the optimal ratio of 5% has a positive effect on the resulting cement, greater specific surface area, reduced water demand, accelerating the process of hydration, a better mechanical responses and decreased absorption. Therefore, economic and ecological cement based on mineral addition like pozzolan could be possible as well as advantageous to the formulation of environmental mortars.

Keywords: Cement Resistant to Sulfate (CRS), environmental mortars mechanical response, physico-chemical properties, pozzolan

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8743 Risk Allocation in Public-Private Partnership (PPP) Projects for Wastewater Treatment Plants

Authors: Samuel Capintero, Ole H. Petersen

Abstract:

This paper examines the utilization of public-private partnerships for the building and operation of wastewater treatment plants. Our research focuses on risk allocation in this kind of projects. Our analysis builds on more than hundred wastewater treatment plants built and operated through PPP projects in Aragon (Spain). The paper illustrates the consequences of an inadequate management of construction risk and an unsuitable transfer of demand risk in wastewater treatment plants. It also shows that the involvement of many public bodies at local, regional and national level further increases the complexity of this kind of projects and make time delays more likely.

Keywords: wastewater, treatment plants, PPP, construction

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8742 Understanding the Common Antibiotic and Heavy Metal Resistant-Bacterial Load in the Textile Industrial Effluents

Authors: Afroza Parvin, Md. Mahmudul Hasan, Md. Rokunozzaman, Papon Debnath

Abstract:

The effluents of textile industries have considerable amounts of heavy metals, causing potential microbial metal loads if discharged into the environment without treatment. Aim: In this present study, both lactose and non-lactose fermenting bacterial isolates were isolated from textile industrial effluents of a specific region of Bangladesh, named Savar, to compare and understand the load of heavy metals in these microorganisms determining the effects of heavy metal resistance properties on antibiotic resistance. Methods: Five different textile industrial canals of Savar were selected, and effluent samples were collected in 2016 between June to August. Total bacterial colony (TBC) was counted for day 1 to day 5 for 10-6 dilution of samples to 10-10 dilution. All the isolates were isolated and selected using 4 differential media, and tested for the determination of minimum inhibitory concentration (MIC) of heavy metals and antibiotic susceptibility test with plate assay method and modified Kirby-Bauer disc diffusion method, respectively. To detect the combined effect of heavy metals and antibiotics, a binary exposure experiment was performed, and to understand the plasmid profiling plasmid DNA was extracted by alkaline lysis method of some selective isolates. Results: Most of the cases, the colony forming units (CFU) per plate for 50 ul diluted sample were uncountable at 10-6 dilution, however, countable for 10-10 dilution and it didn’t vary much from canal to canal. A total of 50 Shigella, 50 Salmonella, and 100 E.coli (Escherichia coli) like bacterial isolates were selected for this study where the MIC was less than or equal to 0.6 mM for 100% Shigella and Salmonella like isolates, however, only 3% E. coli like isolates had the same MIC for nickel (Ni). The MIC for chromium (Cr) was less than or equal to 2.0 mM for 16% Shigella, 20% Salmonella, and 17% E. coli like isolates. Around 60% of both Shigella and Salmonella, but only 20% of E.coli like isolates had a MIC of less than or equal to 1.2 mM for lead (Pb). The most prevalent resistant pattern for azithromycin (AZM) for Shigella and Salmonella like isolates was found 38% and 48%, respectively; however, for E.coli like isolates, the highest pattern (36%) was found for sulfamethoxazole-trimethoprim (SXT). In the binary exposure experiment, antibiotic zone of inhibition was mostly increased in the presence of heavy metals for all types of isolates. The highest sized plasmid was found 21 Kb and 14 Kb for lactose and non-lactose fermenting isolates, respectively. Conclusion: Microbial resistance to antibiotics and metal ions, has potential health hazards because these traits are generally associated with transmissible plasmids. Microorganisms resistant to antibiotics and tolerant to metals appear as a result of exposure to metal-contaminated environments.

Keywords: antibiotics, effluents, heavy metals, minimum inhibitory concentration, resistance

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8741 Medicinal Plants: An Antiviral Depository with Complex Mode of Action

Authors: Daniel Todorov, Anton Hinkov, Petya Angelova, Kalina Shishkova, Venelin Tsvetkov, Stoyan Shishkov

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Human herpes viruses (HHV) are ubiquitous pathogens with a pandemic spread across the globe. HHV type 1 is the main causative agent of cold sores and fever blisters around the mouth and on the face, whereas HHV type 2 is generally responsible for genital herpes outbreaks. The treatment of both viruses is more or less successful with antivirals from the nucleoside analogues group. Their wide application increasingly leads to the emergence of resistant mutants In the past, medicinal plants have been used to treat a number of infectious and non-infectious diseases. Their diversity and ability to produce the vast variety of secondary metabolites according to the characteristics of the environment give them the potential to help us in our warfare with viral infections. The variable chemical characteristics and complex composition is an advantage in the treatment of herpes since the emergence of resistant mutants is significantly complicated. The screening process is difficult due to the lack of standardization. That is why it is especially important to follow the mechanism of antiviral action of plants. On the one hand, it may be expected to interact with its compounds, resulting in enhanced antiviral effects, and the most appropriate environmental conditions can be chosen to maximize the amount of active secondary metabolites. During our study, we followed the activity of various plant extracts on the viral replication cycle as well as their effect on the extracellular virion. We obtained our results following the logical sequence of the experimental settings - determining the cytotoxicity of the extracts, evaluating the overall effect on viral replication and extracellular virion.During our research, we have screened a variety of plant extracts for their antiviral activity against both virus replication and the virion itself. We investigated the effect of the extracts on the individual stages of the viral replication cycle - viral adsorption, penetration and the effect on replication depending on the time of addition. If there are positive results in the later experiments, we had studied the activity over viral adsorption, penetration and the effect of replication according to the time of addition. Our results indicate that some of the extracts from the Lamium album have several targets. The first stages of the viral life cycle are most affected. Several of our active antiviral agents have shown an effect on extracellular virion and adsorption and penetration processes. Our research over the last decade has shown several curative antiviral plants - some of which are from the Lamiacea family. The rich set of active ingredients of the plants in this family makes them a good source of antiviral preparation.

Keywords: human herpes virus, antiviral activity, Lamium album, Nepeta nuda

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8740 High Prevalence of Multi-drug Resistant Diarrheagenic Escherichia coli among Hospitalised Diarrheal Patients in Kolkata, India

Authors: Debjani Ghosh, Goutam Chowdhury, Prosenjit Samanta, Asish Kumar Mukhopadhyay

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Acute diarrhoea caused by diarrheagenic Escherichia coli (DEC) is one of the major public health problem in developing countries, mainly in Asia and Africa. DEC consists of six pathogroups, but the majority of the cases were associated with the three pathogropus, enterotoxigenic E. coli (ETEC), enteroaggregative E. coli (EAEC), and enteropathogenic E. coli (EPEC). Hence, we studied the prevalence and antimicrobial resistance of these three major DEC pathogroups in hospitalized diarrheal patients in Kolkata, India, during 2012-2019 with a large sample size. 8,891 stool samples were processed, and 7.8% of them was identified as DEC infection screened by multiplex PCR, in which ETEC was most common (47.7%) followed by EAEC (38.4%) and EPEC (13.9%). Clinical patient history suggested that children <5 years of age were mostly affected with ETEC and EAEC, whereas people within >5-14 years of age were significantly associated with EPEC and ETEC infections. Antibiogram profile showed a high prevalence of multidrug resistant (MDR) isolates among DEC (56.9%), in which 9% were resistant to antibiotics of six different antimicrobial classes. Screening of the antibiotic resistance conferring genes in DEC showed the presence of blaCTX-M (30.2%) in highest number followed by blaTEM (27.5%), tetB (18%), sul2 (12.6%), strA (11.8%), aadA1 (9.8%), blaOXA-1 (9%), dfrA1 (1.6%) and blaSHV (1.2%) which indicates the existence of mobile genetic elements in those isolates. Therefore, the presence of MDR DEC strains in higher number alarms the public health authorities to take preventive measures before the upsurge of the DEC caused diarrhea cases in near future.

Keywords: diarrheagenic escherichia coli, ETEC, EAEC, EPEC

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8739 Electrochemical and Microstructure Properties of Chromium-Graphene and SnZn-Graphene Oxide Composite Coatings

Authors: Rekha M. Y., Punith Kumar, Anshul Kamboj, Chandan Srivastava

Abstract:

Coatings plays an important role in providing protection for a substrate and in improving the surface quality. Graphene/graphene oxide (GO) using in coating systems provides an environmental friendly solution towards protection against corrosion. Issues such as, lack of scale, high cost, low quality limits the practical application of graphene/GO as corrosion resistant coating material. One other way to employ these materials for corrosion protection is to incorporate them into coatings that are conventionally used for corrosion protection. Due to the extraordinary properties of graphene/GO, it has been demonstrated that the coatings containing graphene/GO are more corrosion resistant than pure metal/alloy coatings. In the present work, Cr-graphene and SnZn-GO composite coatings were investigated in enhancing the corrosion resistant property when compared to pure Cr coating and pure SnZn coating respectively. All the coatings were electrodeposited over mild-steel substrate. Graphene and GO were synthesized by electrochemical exfoliation method and modified Hummers’ method respectively. In Cr coatings, the microstructural study revealed that the addition of formic acid in the coatings reduced the number of cracks in the coatings. Further addition of graphene in Cr coating enhanced the Cr coating’s morphology. Chemically synthesized ZnO nanoparticles were also embedded in the as-deposited Cr and Cr-graphene coatings to enhance the adhesion of the coating, to improve the surface finish and to increase the corrosion resistant property of the coatings. Diffraction analysis revealed that the addition of graphene also altered the texture of the Cr coatings. In SnZn alloy coatings, the morphological and topographical characterization revealed that the relative smoothness and compactness of the coatings increased with increase in the addition of GO in the coatings. The microstructural investigation revealed large-scale segregation of Zn-rich and Sn-rich phases in the pure SnZn coating. However, in SnZn-GO composite coating the uniform distribution of Zn phase in the Sn-rich matrix was observed. This distribution caused the early and uniform formation of ZnO, which is the corrosion product, yielding better corrosion resistance for the SnZn-GO composite coatings as compared to pure SnZn coating. A significant improvement in corrosion resistance in terms of reduction in corrosion current and corrosion rate and increase in the polarization resistance was observed in Cr coating containing graphene and in SnZn coatings containing GO.

Keywords: coatings, corrosion, electrodeposition, graphene, graphene-oxide

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8738 Preliminary Treatment in Wastewater Treatment Plants: Operation and Maintenance Aspects

Authors: Priscila M. Lima, Corine A. P. de Almeida, Muriele R. de Lima, Fernando J. C. Magalhães Filho

Abstract:

This work characterized the preliminary treatment in WWTPs in the state of Mato Grosso Do Sul (Brazil) and analyzed aspects of operation and maintenance of solid waste retained, and was evaluated the interference of this step in treatment efficiency beyond the relationship between solid waste generation with rainfall and seasonality in the region of each WTPs. The results shown that the standard setting in the preliminary treatment consists of grid along with Sand Trap, followed by Parshall that is used in 94.12% of WWTPs analyzed, and in 5.88% of WWTPs it was added the air-lift to the Sand Trap. Was concluded that the influence of rainfall, flow and seasonality associated with the rate of waste generation in the preliminary treatment, had little relation to the operation and maintenance of the primary treatment. But in some cases, precipitation data showed increased rainfall converging with increased flow and solid waste generation.

Keywords: pretreatment, sewage, solid waste, wastewater

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8737 Online Self-Help Metacognitive Therapy for OCD: A Case Series

Authors: C. Pearcy, C. Rees

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Cognitive behavioural therapy (CBT) and exposure and response prevention (ERP) are currently the most efficacious treatments for Obsessive-compulsive disorder (OCD). Many clients, however, remain symptomatic following treatment. As a result, refusal of treatment, withdrawal from treatment, and partial adherence to treatment are common amongst ERP. Such limitations have caused few professionals to actually engage in ERP therapy, which has warranted the exploration of alternative treatments. This study evaluated an online self-help treatment program for OCD (the OCD Doctor Online); a 4-week Metacognitive Therapy (MCT) program which has implemented strategies from Wells’ Metacognitive model of OCD. The aim of the present study was to investigate whether an online self-help treatment using MCT would reduce symptoms of OCD, reduce unhelpful metacognitions and improve quality of life. Treatment effectiveness was assessed using a case series methodology in 3 consecutively referred individuals. At post-treatment, all participants showed reductions in unhelpful metacognitive beliefs (MCQ-30) and improvements in quality of life (Q-LES-Q), which were maintained through to 4 week follow-up. Two of the three participants showed reductions in OCD symptomology (OCI-R), which were further reduced at 4-week follow-up. The present study suggests that internet-based self-help treatment may be an effective means of delivering MCT to adults with OCD.

Keywords: internet-based, metacognitive therapy, obsessive-compulsive disorder, self-help

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8736 Risk Factors for Severe Typhoid Fever in Children: A French Retrospective Study about 78 Cases from 2000-2017 in Six Parisian Hospitals

Authors: Jonathan Soliman, Thomas Cavasino, Virginie Pommelet, Lahouari Amor, Pierre Mornand, Simon Escoda, Nina Droz, Soraya Matczak, Julie Toubiana, François Angoulvant, Etienne Carbonnelle, Albert Faye, Loic de Pontual, Luu-Ly Pham

Abstract:

Background: Typhoid and paratyphoid fever are systemic infections caused by Salmonella enterica serovar Typhi or paratyphi (A, B, C). Children traveling to tropical areas are at risk to contract these diseases which can be complicated. Methods: Clinical, biological and bacteriological data were collected from 78 pediatric cases reported between 2000 and 2017 in six Parisian hospitals. Children aged 0 to 18 years old, with a diagnosis of typhoid or paratyphoid fever confirmed by bacteriological exams, were included. Epidemiologic, clinical, biological features and presence of multidrug-resistant (MDR) bacteria or intermediate susceptibility to ciprofloxacin (nalidixic acid resistant) were examined by univariate analysis and by logistic regression analysis to identify risk factors of severe typhoid in children. Results: 84,6% of the children were imported cases of typhoid fever (n=66/78) and 15,4% were autochthonous cases (n=12/78). 89,7% were caused by S.typhi (n=70/78) and 12,8% by S.paratyphi (n=10/78) including 2 co-infections. 19,2% were intrafamilial cases (n=15/78). Median age at diagnosis was 6,4 years-old [6 months-17,9 years]. 28,2% of the cases were complicated forms (n=22/78): digestive (n=8; 10,3%), neurological (n=7; 9%), pulmonary complications (n=4; 5,1%) and hemophagocytic syndrome (n=4; 5,1%). Only 5% of the children had prior immunization with typhoid non-conjugated vaccine (n=4/78). 28% of the cases (n=22/78) were caused by resistant bacteria. Thrombocytopenia and diagnosis delay was significantly associated with severe infection (p= 0.029 and p=0,01). Complicated forms were more common with MDR (p=0,1) and not statistically associated with a young age or sex in this study. Conclusions: Typhoid and paratyphoid fever are not rare in children back from tropical areas. This multicentric pediatric study seems to show that thrombocytopenia, diagnosis delay, and multidrug resistant bacteria are associated with severe typhoid fever and complicated forms in children.

Keywords: antimicrobial resistance, children, Salmonella enterica typhi and paratyphi, severe typhoid

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8735 The Effects of Boronizing Treatment on the Friction and Wear Behavior of 0.35 VfTiC- Ti3SiC2 Composite

Authors: M. Hadji, A. Haddad, Y. Hadji

Abstract:

The effects of boronizing treatment on the friction coefficient and wear behavior of 0.35 Vf TiC- Ti3 SiC2 composite were investigated. In order to modity the surface properties of Ti3SiC2, boronizing treatment was carried out through powder pack cementation in the 1150-1350 °C temperature range. After boronizing treatment, one mixture layer, composed of TiB2 and SiC, forms on the surface of Ti3SiC2. The growth of the coating is processed by inward diffusion of Boron and obeys a linear rule. The Boronizing treatment increases the hardness of Ti3SiC2 from 6 GPa to 13 GPa. In the pin-on-disc test, i twas found that the material undergoes a steady-state coefficient of friction of around 0.8 and 0.45 in case of Ti3SiC2/Al2O3 tribocouple under 7N load for the non treated and the boronized samples, respectively. The wear resistance of Ti3SiC2 underAl2O3 ball sliding has been significantly improved, which indicated that the boronizing treatment is a promising surface modification way of Ti3SiC2.

Keywords: MAX phase, wearing, friction, boronizing

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8734 Effect of Aging Treatment on Tensile Properties of AZ91D Mg Alloy

Authors: Ju Hyun Won, Seok Hong Min, Tae Kwon Ha

Abstract:

Phase equilibria of AZ91D Mg alloys for nonflammable use, containing Ca and Y, were carried out by using FactSage® and FTLite database, which revealed that solid solution treatment, could be performed at temperatures from 400 to 450 °C. Solid solution treatment of AZ91D Mg alloy without Ca and Y was successfully conducted at 420 °C and supersaturated microstructure with all beta phase resolved into matrix was obtained. In the case of AZ91D Mg alloy with some Ca and Y, however, a little amount of intermetallic particles were observed after solid solution treatment. After solid solution treatment, each alloy was annealed at temperatures of 180 and 200 °C for time intervals from 1 min to 48 hrs and hardness of each condition was measured by micro-Vickers method. Peak aging conditions were deduced as at the temperature of 200 °C for 10 hrs.

Keywords: Mg alloy, AZ91D, nonflammable alloy, phase equilibrium, peak aging

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8733 Bioactive Secondary Metabolites from Culturable Unusual Actinomycetes from Solomon Islands Marine Sediments: Isolation and Characterisation of Bioactive Compounds

Authors: Ahilya Singh, Brad Carte, Ramesh Subramani, William Aalbersberg

Abstract:

A total of 37 actinomycete strains were purified from 25 Solomon Islands marine sediments using four different types of isolation media. Among them, 54% of the strains had obligate requirement of seawater for growth. The ethyl acetate extract of 100 ml fermentation product of each strain was screened for antimicrobial activity against multidrug resistant human pathogens and cytotoxic activity against brine shrimps. A total of 67% of the ethyl acetate extracts showed antimicrobial and/or cytotoxic activities. A strain F-1915 was selected for isolation and evaluation of bioactive compound(s) based on its bioactive properties and chemical profile analysis using the LC-MS. The strain F-1915 was identified to have 96% sequence similarity to Streptomyces violaceusniger on the basis of 16S rDNA sequences using BLAST analysis. The 16S rDNA revealed that the strain F-1915 is a new member of MAR4 clade of actinomycetes. The MAR4 clade is an interesting clade of actinomycetes known for the production of pharmaceutically important hybrid isoprenoid compounds. The ethyl acetate extract of the fermentation product of this strain was purified by silica gel column chromatography and afforded the isolation of one bioactive pure compound. Based on the 1D and 2D NMR spectral data of compound 1 it was identified as a new mono-brominated phenazinone, Marinophenazimycin A, a structure which has already been studied by external collaborators at Scripps Institution of Oceanography but is yet to be published. Compound 1 displayed significant antimicrobial activity against drug resistant human pathogens. The minimum inhibitory concentration (MIC) of compound 1 was against Methicillin Resistant Staphylococcus aureus (MRSA) was about 1.9 μg/ml and MIC recorded against Amphotericin Resistant Candida albicans (ARCA) was about 0.24 μg/ml. The bioactivity of compound 1 against ARCA was found to be better than the standard antifungal agent amphotericin B. Compound 1 however did not show any cytotoxic activity against brine shrimps.

Keywords: actinomycetes, antimicrobial activity, brominated phenazine, MAR4 clade, marine natural products, multidrug resistent, 1D and 2D NMR

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8732 Separation of Hazardous Brominated Plastics from Waste Plastics by Froth Flotation after Surface Modification with Mild Heat-Treatment

Authors: Nguyen Thi Thanh Truc, Chi-Hyeon Lee, Srinivasa Reddy Mallampati, Byeong-Kyu Lee

Abstract:

This study evaluated to facilitate separation of ABS plastics from other waste plastics by froth flotation after surface hydrophilization of ABS with heat treatment. The mild heat treatment at 100oC for 60s could selectively increase the hydrophilicity of the ABS plastics surface (i.e., ABS contact angle decreased from 79o to 65.8o) among other plastics mixture. The SEM and XPS results of plastic samples sufficiently supported the increase in hydrophilic functional groups and decrease contact angle on ABS surface, after heat treatment. As a result of the froth flotation (at mixing speed 150 rpm and airflow rate 0.3 L/min) after heat treatment, about 85% of ABS was selectively separated from other heavy plastics with 100% of purity. The effect of optimum treatment condition and detailed mechanism onto separation efficiency in the froth floatation was also investigated. This research is successful in giving a simple, effective, and inexpensive method for ABS separation from waste plastics.

Keywords: ABS, hydrophilic, heat treatment, froth flotation, contact angle

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8731 Tuberculosis in Humans and Animals in the Eastern Part of the Sudan

Authors: Yassir Adam Shuaib, Stefan Niemann, Eltahir Awad Khalil, Ulrich Schaible, Lothar Heinz Wieler, Mohammed Ahmed Bakhiet, Abbashar Osman Mohammed, Mohamed Abdelsalam Abdalla, Elvira Richter

Abstract:

Tuberculosis (TB) is a chronic bacterial disease of humans and animals and it is characterized by the progressive development of specific granulomatous tubercle lesions in affected tissues. In a six-month study, from June to November 2014, a total of 2,304 carcasses of cattle, camel, sheep, and goats slaughtered at East and West Gaash slaughterhouses, Kassala, were investigated during postmortem, in parallel, 101 sputum samples from TB suspected patients at Kassala and El-Gadarif Teaching Hospitals were collected in order to investigate tuberculosis in animals and humans. Only 0.1% carcasses were found with suspected TB lesions in the liver and lung and peritoneal cavity of two sheep and no tuberculous lesions were found in the carcasses of cattle, goats or camels. All samples, tissue lesions and sputum, were decontaminated by the NALC-NaOH method and cultured for mycobacterial growth at the NRZ for Mycobacteria, Research Center Borstel, Germany. Genotyping and molecular characterization of the grown strains were done by line probe assay (GenoType CM and MTBC) and 16S rDNA, rpoB gene, and ITS sequencing, spoligotyping, MIRU-VNTR typing and next generation sequencing (NGS). Culture of the specimens revealed growth of organisms from 81.6% of all samples. Mycobacterium tuberculosis (76.2%), M. intracellulare (14.2%), mixed infection with M. tuberculosis and M. intracellulare (6.0%) and mixed infection with M. tuberculosis and M. fortuitum and with M. intracellulare and unknown species (1.2%) were detected in the sputum samples and unknown species (1.2%) were detected in the samples of one of the animals tissues. From the 69 M. tuberculosis strains, 25 (36.2%) were showing either mono-drug-resistant or multi-drug-resistant or poly-drug-resistant but none was extensively drug-resistant. In conclusion, the prevalence of TB in animals was very low while in humans M. tuberculosis-Delhi/CAS lineage was responsible for most cases and there was an evidence of MDR transmission and acquisition.

Keywords: animal, human, slaughterhouse, Sudan, tuberculosis

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8730 Glucose Uptake Rate of Insulin-Resistant Human Liver Carcinoma Cells (IR/HepG2) by Flavonoids from Enicostema littorale via IR/IRS1/AKT Pathway

Authors: Priyanka Mokashi, Aparna Khanna, Nancy Pandita

Abstract:

Diabetes mellitus is a chronic metabolic disorder which will be the 7th leading cause of death by 2030. The current line of treatment for the diabetes mellitus is oral antidiabetic drugs (biguanides, sulfonylureas, meglitinides, thiazolidinediones and alpha-glycosidase inhibitors) and insulin therapy depending upon the type 1 or type 2 diabetes mellitus. But, these treatments have their disadvantages, ranging from the developing of resistance to the drugs and adverse effects caused by them. Alternative to these synthetic agents, natural products provides a new insight for the development of more efficient and safe drugs due to their therapeutic values. Enicostema littorale blume (A. Raynal) is a traditional Indian plant belongs to the Gentianaceae family. It is widely distributed in Asia, Africa, and South America. There are few reports on Swrtiamarin, major component of this plant for its antidiabetic activity. However, the antidiabetic activity of flavonoids from E. littorale and their mechanism of action have not yet been elucidated. Flavonoids have a positive relationship with disease prevention and can act on various molecular targets and regulate different signaling pathways in pancreatic β-cells, adipocytes, hepatocytes and skeletal myofibers. They may exert beneficial effects in diabetes by (i) improving hyperglycemia through regulation of glucose metabolism in hepatocytes; (ii) enhancing insulin secretion and reducing apoptosis and promoting proliferation of pancreatic β-cells; (iii) increasing glucose uptake in hepatocytes, skeletal muscle and white adipose tissue (iv) reducing insulin resistance, inflammation and oxidative stress. Therefore, we have isolated four flavonoid rich fractions, Fraction A (FA), Fraction B (FB), Fraction C (FC), Fraction D (FD) from crude alcoholic hot (AH) extract from E. littorale, identified by LC/MS. Total eight flavonoids were identified on the basis of fragmentation pattern. Flavonoid FA showed the presence of swertisin, isovitexin, and saponarin; FB showed genkwanin, quercetin, isovitexin, FC showed apigenin, swertisin, quercetin, 5-O-glucosylswertisin and 5-O-glucosylisoswertisin whereas FD showed the presence of swertisin. Further, these fractions were assessed for their antidiabetic activity on stimulating glucose uptake in insulin-resistant HepG2 cell line model (IR/HepG2). The results showed that FD containing C-glycoside Swertisin has significantly increased the glucose uptake rate of IR/HepG2 cells at the concentration of 10 µg/ml as compared to positive control Metformin (0.5mM) which was determined by glucose oxidase- peroxidase method. It has been reported that enhancement of glucose uptake of cells occurs due the translocation of Glut4 vesicles to cell membrane through IR/IRS1/AKT pathway. Therefore, we have studied expressions of three genes IRS1, AKT and Glut4 by real-time PCR to evaluate whether they follow the same pathway or not. It was seen that the glucose uptake rate has increased in FD treated IR/HepG2 cells due to the activation of insulin receptor substrate-1 (IRS1) followed by protein kinase B (AKT) through phosphoinositide 3-kinase (PI3K) leading to translocation of Glut 4 vesicles to cell membrane, thereby enhancing glucose uptake and insulin sensitivity of insulin resistant HepG2 cells. Hence, the up-regulation indicated the mechanism of action through which FD (Swertisin) acts as antidiabetic candidate in the treatment of type 2 diabetes mellitus.

Keywords: E. littorale, glucose transporter, glucose uptake rate, insulin resistance

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8729 Microstructure and Mechanical Properties of Boron-Containing AZ91D Mg Alloys

Authors: Ji Chan Kim, Seok Hong Min, Tae Kwon Ha

Abstract:

Effect of boron addition on the microstructure and mechanical properties of AZ91D Mg alloy was investigated in this study. Through calculation of phase equilibria, carried out by using FactSage® and FTLite database, solution treatment temperature was decided as 420 °C where supersaturated solid solution can be obtained. Solid solution treatment was conducted at 420 °C for 24 hrs followed by hot rolling at 420 °C and the total reduction was about 60%. Recrystallization heat treatment was followed at 420 °C for 6 hrs to obtain equiaxed microstructure. After recrystallization treatment, aging heat treatment was conducted at temperature of 200 °C for time intervals from 1 min to 200 hrs and hardness of each condition was measured by micro-Vickers method. Peak hardness was observed after 20 hrs. Tensile tests were also conducted on the specimens aged for various time intervals and the results were compared with hardness.

Keywords: AZ91D Mg alloy, boron, heat treatment, microstructure, mechanical properties, hardness

Procedia PDF Downloads 316
8728 Barriers to Current Mental Health Assessment in India

Authors: Suantak Demkhosei Vaiphei

Abstract:

Mental illness is still considered as an illness not to be treated, resulting India becoming the most depressed country in the world. At present, 150 million Indians are suffering from mental illness and desperately in need of immediate care assessment for their mental health condition. However, only 0.06 per cent of India’s health budget is devoted to mental health treatment, in which the available data suggests that the state of spending the sanctioned budget in this regard is abysmal. Lack of awareness, ignorance, social stigma, and discriminations becomes the underlying factors for worsening the individual mental health conditions. Unfortunately, India becomes the most depressed country in the world, which is hugely affected by anxiety, schizophrenia, and bipolar disorder followed by China and USA as per the latest World Health Organization report. The National Care of Medical Health stated that at least 6.5 per cent of the Indian populations are under serious mental disorder both in the rural and the urban areas’Mental health is the integral part of health and can be affected by a range of psychosocial-economic factors that need comprehensive strategically approach for promotion, prevention, treatment, and recovery. In a low- and middle-income country like India, the advance progress in mental health service is visible consistently slow and minimal. Some of the major barriers can be seen in the existing public health priorities and its influence on funding; challenges to delivery of basic mental health care in the primary care settings; the minimal numbers of well-trained professionals in the area of mental health care; and lack of mental health perspective in public-health leadership. The existing barriers according to WHO (2007) are; lack of funding for mental health services is the core barrier in implementing quality mental health services, including inadequate coordinated and consensus based national mental health advocacy and plans, the absence of mental health in major donor priorities, marketing of expensive pharmaceuticals by industry, cost-effectiveness information on mental health services that is unknown to senior decision-makers and social stigma among others. Moreover, lack of strong mental health advocacy in countries to increase resources for mental health services and the role of social stigma and the view that mental health is a private responsibility are also the two barriers to mental health.

Keywords: mental health, depression, stigma, barriers

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8727 The Effectiveness of High-Frequency Repetitive Transcranial Magnetic Stimulation in Persistent Somatic Symptoms Disorder: A Case Report Study

Authors: Mohammed Khamis Albalushi

Abstract:

Background: Somatic symptoms disorders are usually comorbid with depressive disorders despite the fact that there is little evidence for effective treatment for it. Repetitive transcranial magnetic stimulation (rTMS) has been approved by the FDA for mildly resistant depression. From this point, we hypothesized that rTMS delivered over the prefrontal cortex (PFC) may be useful in somatic symptoms disorder. Therefore, in our case report, we want to shed light on the potential effectiveness of rTMS in somatic symptoms disorder. Case Report: A 65-year-old Omani female with multiple medical comorbidities on multiple medications. She presented complaining of multiple somatic complaints in the last 2 years after visiting multiple clinics and underwent several specialists’ examinations, investigations and procedures for somatic treatments; all of them were normal. Then patient was seen by a different psychiatric clinic; multiple anti-depressant and adjuvant anti-psychotic medications were tried, patient still did not improve. The patient was admitted to the hospital for observation and management. Initially, she was preoccupied with her somatic complaint and kept on Fluoxetine and Olanzapine along with that, topiramate was added, but still with minimal improvement. Then rTMS was added to her management plan following Intermittent theta burst (iTBS) rTMS protocol. After completing all sessions of rTMS, the patient was recovering from all her symptoms, and no complaints were reported from her. Conclusion: Our case highlights the importance of investigating more thoroughly in rTMS as a treatment option for Persistent Somatic symptoms Disorder.

Keywords: rTMS, somatic symptoms disorder, resistive cases, TMS

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