Search results for: disease duration
1936 Nephroblastoma at Universitas Academic Hospital Complex in the Last 20 Years
Authors: I. Iroka, L. Mgidlana, J. Willoughby, S. Dhlamini, P. Nxumalo, S. Sefadi, A. Mthembu, E. Gerber, E. Brits
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Introduction: Nephroblastoma is a common paediatric tumor with good survival rates when diagnosed and treated early. Method: This retrospective study aimed to describe the patients with nephroblastoma seen at Universitas Academic Hospital Complex between the years 2000 and 2020. Results: In the study period, there were 207 patients identified. The patient profile had slightly more male than female patients; the median age was under four years of age. The study found a median delay of one month between symptom onset and diagnosis; a common cause was a delay in seeking care. Patients diagnosed and treated more than a month after symptoms started had poorer survival rates. There was a higher rate of Stage IV disease compared to similar studies in South Africa. Good preoperative histology and no relapse had good survival rates.. Patients from Lesotho had longer delays and presented with more severe diseases than the South African cohort. Conclusion: Early identification and treatment lead to better outcomes. Health-seeking behaviour, misdiagnosis, and referral delays might contribute to the long delays. A targeted study for patients from Lesotho is recommended.Keywords: nephroblastoma, South Africa, Lesotho, developing country
Procedia PDF Downloads 1001935 Diagnostic Performance of Tumor Associated Trypsin Inhibitor in Early Detection of Hepatocellular Carcinoma in Patients with Hepatitis C Virus
Authors: Aml M. El-Sharkawy, Hossam M. Darwesh
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Abstract— Background/Aim: Hepatocellular carcinoma (HCC) is often diagnosed at advanced stage where effective therapies are lacking. Identification of new scoring system is needed to discriminate HCC patients from those with chronic liver disease. Based on the link between tumor associated trypsin inhibitor (TATI) and HCC progression, we aimed to develop a novel score based on combination of TATI and routine laboratory tests for early prediction of HCC. Methods: TATI was assayed for HCC group (123), liver cirrhosis group (210) and control group (50) by Enzyme Linked Immunosorbent Assay (ELISA). Data from all groups were retrospectively analyzed including α feto protein (AFP), international normalized ratio (INR), albumin and platelet count, transaminases, and age. Areas under ROC curve were used to develop the score. Results: A novel index named hepatocellular carcinoma-vascular endothelial growth factor score (HCC-TATI score) = 3.1 (numerical constant) + 0.09 ×AFP (U L-1) + 0.067 × TATI (ng ml-1) + 0.16 × INR – 1.17 × Albumin (g l-1) – 0.032 × Platelet count × 109 l-1 was developed. HCC-TATI score produce area under ROC curve of 0.98 for discriminating HCC patients from liver cirrhosis with sensitivity of 91% and specificity of 82% at cut-off 6.5 (ie less than 6.5 considered cirrhosis and greater than 4.4 considered HCC). Conclusion: Hepatocellular carcinoma-TATI score could replace AFP in HCC screening and follow up of cirrhotic patients.Keywords: Hepatocellular carcinoma, cirrhosis, HCV, diagnosis, TATI
Procedia PDF Downloads 3381934 The Effect of Bihemisferic Transcranial Direct Current Stimulation Therapy on Upper Extremity Motor Functions in Stroke Patients
Authors: Dilek Cetin Alisar, Oya Umit Yemisci, Selin Ozen, Seyhan Sozay
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New approaches and treatment modalities are being developed to make patients more functional and independent in stroke rehabilitation. One of these approaches is transcranial direct stimulation therapy (tDCS), which aims to improve the hemiplegic upper limb function of stroke patients. tDCS therapy is not in the routine rehabilitation program; however, the studies about tDCS therapy on stroke rehabilitation was increased in recent years. Evaluate the effect of tDCS treatment on upper extremity motor function in patients with subacute stroke was aimed in our study. 32 stroke patients (16 tDCS group, 16 sham groups) who were hospitalized for rehabilitation in Başkent University Physical Medicine and Rehabilitation Clinic between 01.08.2016-20.01-2018 were included in the study. The conventional upper limb rehabilitation program was used for both tDCS and control group patients for 3 weeks, 5 days a week, for 60-120 minutes a day. In addition to the conventional stroke rehabilitation program in the tDAS group, bihemispheric tDCS was administered for 30 minutes daily. Patients were evaluated before treatment and after 1 week of treatment. Functional independence measure self-care score (FIM), Brunnstorm Recovery Stage (BRS), and Fugl-Meyer (FM) upper extremity motor function scale were used. There was no difference in demographic characteristics between the groups. There were no significant differences between BRS and FM scores in two groups, but there was a significant difference FIM score (p=0.05. FIM, BRS, and FM scores are significantly in the tDCS group, when before therapy and after 1 week of therapy, however, no difference is found in the shame group (p < 0,001). When FBS and FM scores were compared, there were statistical significant differences in tDCS group (p < 0,001). In conclusion, this randomized double-blind study showed that bihemispheric tDCS treatment was found to be superior to upper extremity motor and functional enhancement in addition to conventional rehabilitation methods in subacute stroke patients. In order for tDCS therapy to be used routinely in stroke rehabilitation, there is a need for more comprehensive, long-termed, randomized controlled clinical trials in order to find answers to many questions, such as the duration and intensity of treatment.Keywords: cortical stimulation, motor function, rehabilitation, stroke
Procedia PDF Downloads 1291933 The Application of Transcranial Direct Current Stimulation (tDCS) Combined with Traditional Physical Therapy to Address Upper Limb Function in Chronic Stroke: A Case Study
Authors: Najmeh Hoseini
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Strokerecovery happens through neuroplasticity, which is highly influenced by the environment, including neuro-rehabilitation. Transcranial direct current stimulation (tDCS) may enhance recovery by modulating neuroplasticity. With tDCS, weak direct currents are applied noninvasively to modify excitability in the cortical areas under its electrodes. Combined with functional activities, this may facilitate motor recovery in neurologic disorders such as stroke. The purpose of this case study was to examine the effect of tDCS combined with 30 minutes of traditional physical therapy (PT)on arm function following a stroke. A 29-year-old male with chronic stroke involving the left middle cerebral artery territory went through the treatment protocol. Design The design included 5 weeks of treatment: 1 week of traditional PT, 2 weeks of sham tDCS combined with traditional PT, and 2 weeks of tDCS combined with traditional PT. PT included functional electrical stimulation (FES) of wrist extensors followed by task-specific functional training. Dual hemispheric tDCS with 1 mA intensity was applied on the sensorimotor cortices for the first 20 min of the treatment combined with FES. Assessments before and after each treatment block included Modified Ashworth Scale, ChedokeMcmaster Arm and Hand inventory, Action Research Arm Test (ARAT), and the Box and Blocks Test. Results showed reduced spasticity in elbow and wrist flexors only after tDCS combination weeks (+1 to 0). The patient demonstrated clinically meaningful improvements in gross motor and fine motor control over the duration of the study; however, components of the ARAT that require fine motor control improved the greatest during the experimental block. Average time improvement compared to baseline was26.29 s for tDCS combination weeks, 18.48 s for sham tDCS, and 6.83 for PT standard of care weeks. Combining dual hemispheric tDCS with the standard of care PT demonstrated improvements in hand dexterity greater than PT alone in this patient case.Keywords: tDCS, stroke, case study, physical therapy
Procedia PDF Downloads 981932 Vietnamese Indigenous Healing’s Implication for Vietnamese Women Counseling in Korea
Authors: Youngsub Oh, Youngsoon Kim
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As the second largest group among international marriages in Korea, Vietnamese married immigrant women have been exposed to psychological crisis like divorce and family violence. The purpose of this study is to understand how to counsel those women from the perspective of indigenous healing as their own psychological problem-solving way. To this end, this study reviewed Vietnamese cultural literatures on their mentality as well as Vietnamese medical literatures on indigenous healing. The research results are as follows: First, cultural foundations that have formed Vietnamese mentality are Confucian value system, reserved communication, and religious pluralism. These cultural backgrounds play an important role in understanding their own therapeutic tradition. Second, Vietnamese indigenous healing considers cause of mental disease as a collapse of balance between mind and body and environment. Thus, indigenous treatment deals with psychological problems through a recovery of the balance from the holistic perspective. In fact, indigenous healing has been actively practiced in everyday place as well as hospital until today. The implications of Vietnamese indigenous healing for multicultural counseling in Korea are as follows: First, Korean counselors need to interactively understand their own assumptions on indigenous healing as well as counselees’ own assumptions. Second, a variety of psychological intervention strategies can be drawn from Vietnamese indigenous healing. Third, indigenous healing needs to be integrated with modern techniques of counseling and psychotherapy, as both treatments are not mutually exclusive but complementary.Keywords: indigenous healing, Korea, multicultural counseling, Vietnamese married immigrant women
Procedia PDF Downloads 2951931 Detection and Molecular Identification of Bacteria Forming Polyhydroxyalkanoate and Polyhydroxybutyrate Isolated from Soil in Saudi Arabia
Authors: Ali Bahkali, Rayan Yousef Booq, Mohammad Khiyami
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Soil samples were collected from five different regions in the Kingdom of Saudi Arabia. Microbiological methods included dilution methods and pour plates to isolate and purify bacteria soil. The ability of isolates to develop biopolymer was investigated on petri dishes containing elements and substance concentrations stimulating developing biopolymer. Fluorescent stains, Nile red and Nile blue were used to stain the bacterial cells developing biopolymers. In addition, Sudan black was used to detect biopolymers in bacterial cells. The isolates which developed biopolymers were identified based on their gene sequence of 1 6sRNA and their ability to grow and synthesize PHAs on mineral medium supplemented with 1% dates molasses as the only carbon source under nitrogen limitation. During the study 293 bacterial isolates were isolated and detected. Through the initial survey on the petri dishes, 84 isolates showed the ability to develop biopolymers. These bacterial colonies developed a pink color due to accumulation of the biopolymers in the cells. Twenty-three isolates were able to grow on dates molasses, three strains of which showed the ability to accumulate biopolymers. These strains included Bacillus sp., Ralstonia sp. and Microbacterium sp. They were detected by Nile blue A stain with fluorescence microscopy (OLYMPUS IX 51). Among the isolated strains Ralstonia sp. was selected after its ability to grow on molasses dates in the presence of a limited nitrogen source was detected. The optimum conditions for formation of biopolymers by isolated strains were investigated. Conditions studied included, best incubation duration (2 days), temperature (30°C) and pH (7-8). The maximum PHB production was raised by 1% (v1v) when using concentrations of dates molasses 1, 2, 3, 4 and 5% in MSM. The best inoculated with 1% old inoculum (1= OD). The ideal extraction method of PHA and PHB proved to be 0.4% sodium hypochlorite solution, producing a quantity of polymer 98.79% of the cell's dry weight. The maximum PHB production was 1.79 g/L recorded by Ralstonia sp. after 48 h, while it was 1.40 g/L produced by R.eutropha ATCC 17697 after 48 h.Keywords: bacteria forming polyhydroxyalkanoate, detection, molecular, Saudi Arabia
Procedia PDF Downloads 3491930 Laboratory Evaluation of Bacillus subtilis Bioactivity on Musca domestica (Linn) (Diptera: Muscidae) Larvae from Poultry Farms in South Western Nigeria
Authors: Funmilola O. Omoya
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Muscid flies are known to be vectors of disease agents and species that annoy humans and domesticated animals. An example of these flies is Musca domestica (house fly) whose adult and immature stages occur in a variety of filthy organic substances including household garbage and animal manures. They contribute to microbial contamination of foods. It is therefore imperative to control these flies as a result of their role in Public health. The second and third instars of Musca domestica (Linn) were infected with varying cell loads of Bacillus subtilis in vitro for a period of 48 hours to evaluate its larvicidal activities. Mortality of the larvae increased with incubation period after treatment with the varying cell loads. Investigation revealed that the second instars larvae were more susceptible to treatment than the third instars treatments. Values obtained from the third instar group were significantly different (P0.05) from those obtained from the second instars group in all the treatments. Lethal concentration (LC50) at 24 hours for 2nd instars was 2.35 while LC50 at 48 hours was 4.31.This study revealed that Bacillus subtilis possess good larvicidal potential for use in the control of Musca domestica in poultry farms.Keywords: Bacillus subtilis, Musca domestica, larvicidal activities, poultry farms
Procedia PDF Downloads 4301929 Detection of Viral-Plant Interaction Using Some Pathogenesis Related Protein Genes to Identify Resistant Genes against Potato LeafRoll Virus and Potato Virus Y in Egyptian Isolates
Authors: Dalia. G. Aseel, E. E. Hafez, S. M. Hammad
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Viral RNAs of both potato leaf roll virus (PLRV) and potato virus Y (PVY) were extracted from infected potato leaves collected from different Egyptian regions. Differential Display Polymerase Chain Reaction (DD-PCR) using (Endogluconase, β-1,3-glucanases, Chitinase, Peroxidase and Polyphenol oxidase) primers (forward strand) for was performed. The obtained data revealed different banding patterns depending on the viral type and the region of infection. Regarding PLRV, a 58 up regulated and 19 down regulated genes were detected, while, 31 up regulated and 14 down regulated genes were observed in case of PVY. Based on the nucleotide sequencing, variable phylogenetic relationships were reported for the three sequenced genes coding for: Induced stolen tip protein, Disease resistance RPP-like protein and non-specific lipid-transfer protein. In a complementary approach, using the quantitative Real-time PCR, the expressions of PRs genes understudy were estimated in the infected leaves by PLRV and PVY of three potato cultivars (Spunta, Diamont and Cara). The infection with both viruses inhibited the expressions of the five PRs genes. On the contrary, infected leaves by PLRV or PVY elevated the expression of some defense genes. This interaction also may be enhanced and/or inhibited the expression of some genes responsible for the plant defense mechanisms.Keywords: PLRV, PVY, PR genes, DD-PCR, qRT-PCR, sequencing
Procedia PDF Downloads 3421928 Design, Implementation and Evaluation of Health and Social Justice Trainings in Nigeria
Authors: Juliet Sorensen, Anna Maitland
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Introduction: Characterized by lack of water and sanitation, food insecurity, and low access to hospitals and clinics, informal urban settlements in Lagos, Nigeria have very poor health outcomes. With little education and a general inability to demand basic rights, these communities are often disempowered and isolated from understanding, claiming, or owning their health needs. Utilizing community-based participatory research characterized by interdisciplinary, cross-cultural partnerships, evidence-based assessments, and both primary and secondary source research, a holistic health education and advocacy program was developed in Lagos to address health barriers for targeted communities. This includes a first of its kind guide formulated to teach community-based health educators how to transmit health information to low-literacy Nigerian audiences while supporting behavior change models and social support mechanisms. This paper discusses the interdisciplinary contributions to developing a health education program while also looking at the need for greater beneficiary ownership and implementation of health justice and access. Methods: In March 2016, an interdisciplinary group of medical, legal, and business graduate students and faculty from Northwestern University conduced a Health Needs Assessment (HNA) in Lagos with a partner and a local non-governmental organization. The HNA revealed that members of informal urban communities in Lagos were lacking basic health literacy, but desired to remedy this lacuna. Further, the HNA revealed that even where the government mandates specific services, many vulnerable populations are unable to access these services. The HNA concluded that a program focused on education, advocacy, and organizing around anatomy, maternal and sexual health, infectious disease and malaria, HIV/AIDS, emergency care, and water and sanitation would respond to stated needs while also building capacity in communities to address health barriers. Results: Based on the HNA, including both primary and secondary source research on integrated health education approaches and behavior change models and responsive, adaptive material development, a holistic program was developed for the Lagos partners and first implemented in November 2016. This program trained community-nominated health educators in adult, low-literacy, knowledge exchange approaches, utilizing information identified by communities as a priority. After a second training in March 2017, these educators will teach community-based groups and will support and facilitate behavior change models and peer-support methods around basic issues like hand washing and disease transmission. They will be supported by community paralegals who will help ensure that newly trained community groups can act on education around access, such as receiving free vaccinations, maternal health care, and HIV/AIDS medicines. Materials will continue to be updated as needs and issues arise, with a focus on identifying best practices around health improvements that can be shared across these partner communities. Conclusion: These materials are the first of their kind, and address a void of health information and understanding pervasive in informal-urban Lagos communities. Initial feedback indicates high levels of commitment and interest, as well as investment by communities in these materials, largely because they are responsive, targeted, and build community capacity. This methodology is an important step in dignity-based health justice solutions, albeit in the process of refinement.Keywords: community health educators, interdisciplinary and cross cultural partnerships, health justice and access, Nigeria
Procedia PDF Downloads 2501927 Different Sampling Schemes for Semi-Parametric Frailty Model
Authors: Nursel Koyuncu, Nihal Ata Tutkun
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Frailty model is a survival model that takes into account the unobserved heterogeneity for exploring the relationship between the survival of an individual and several covariates. In the recent years, proposed survival models become more complex and this feature causes convergence problems especially in large data sets. Therefore selection of sample from these big data sets is very important for estimation of parameters. In sampling literature, some authors have defined new sampling schemes to predict the parameters correctly. For this aim, we try to see the effect of sampling design in semi-parametric frailty model. We conducted a simulation study in R programme to estimate the parameters of semi-parametric frailty model for different sample sizes, censoring rates under classical simple random sampling and ranked set sampling schemes. In the simulation study, we used data set recording 17260 male Civil Servants aged 40–64 years with complete 10-year follow-up as population. Time to death from coronary heart disease is treated as a survival-time and age, systolic blood pressure are used as covariates. We select the 1000 samples from population using different sampling schemes and estimate the parameters. From the simulation study, we concluded that ranked set sampling design performs better than simple random sampling for each scenario.Keywords: frailty model, ranked set sampling, efficiency, simple random sampling
Procedia PDF Downloads 2131926 The Influence of Students’ Race and Socioeconomic Status on Teachers’ Assessment of ADHD: Implications for Educational Inequalities
Authors: Justine McKay
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Implicit Bias and its impact on the schooling experience of racial minorities with ADHD is significant. ADHD has become a globally diagnosed disorder. The lack of an objective diagnostic tool for ADHD has created controversy over the disease and its validity. ADHD is referred to as a social construct or a suburban problem related to active white boys who disrupt classrooms. The subjectivity of an ADHD diagnosis and the diagnostic process is based on norm-referenced checklists of behaviours completed by the student, caregiver, teachers, clinicians, and other community members. Teachers' perceptions of classroom behaviours are influenced by implicit bias related to race and socioeconomic status. The same behaviours displayed by white and marginalized or low-income students are perceived differently. The white student is perceived to be struggling academically and needing support, while the marginalized or lower-income student's behaviour is seen as disruptive or criminal. The presence of teacher implicit bias results in the inequity of diagnosis, and academic support, which has long-term implications for these students. The subjectivity of the diagnostic process socially reproduces the systemic injustice of opportunity for marginalized youth within the education system.Keywords: ADHD, education, equity, implicit bias, subjectivity
Procedia PDF Downloads 751925 The Protective Effect of Grape Seed Oil with Use of Ciprofloxacin Induced Germ Cell Toxicity in Male Albino Mice
Authors: Galawezh Obaid Othman
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The present investigation was undertaken to evaluate the germ cell toxicity induced by ciprofloxacin antibiotic and the Protective effect of grape seed oil, Ciproflaxin uses include treatment of genitor-urinary and some reproductive tract bacterial infections. One of the most attractive approaches to disease prevention involves the use of natural antioxidants to protect tissue against toxic injury, the possible protective effect of grape seed oil, against ciprofloxacin induced reproductive toxicity on mouse .the animals were randomly divided into four groups consisting of five mice. Group (1) was orally given distilled water (solvent of the used drugs) and kept as a control. Group (2) was administered 6ml/kg. b.w of grape seed oil orally 15 days .Group (3) was administered 206mg/kg. b.w of ciprofloxacin orally for 15 days.. Last group was treated orally with Grape seed oil (6mg/kg b.w. /day) prior to an orally administered ciprofloxacin (CPX) at a dose of 206 mg⁄kg. b.w. by three hours for fifteen days. Ciproflaxin have ability to induce various types of sperm abnormalities such as (Sperm without head, sperm without tail, defective head spearm,swollen head sperm ), The results explored that Grape seed oil possesses statistically significant (p<0.05) protective potential against Ciproflaxin by decreasing sperm abnormalities frequency in mouse.Keywords: antimutagen, ciprofloxacin, grape seed oil, germ cell
Procedia PDF Downloads 4431924 Urbanization and House Water Supply in Nigeria
Authors: Oluronke Odunjo
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The world is becoming increasingly urbanized and Nigeria is not left out. One of the indicators of human developments is housing and as such, water is needed by households for survival. This Paper assesses sources of water being used by residents in the newly urbanized areas of Ogbomoso, Southwest, Nigeria. Multistage sampling technique was used and Oke-Adunin Community was purposively selected for the study as it has large concentration of staff and students of Ladoke Akintola University of Technology. The area was captured with Google earth and two hundred and twenty two inhabited houses were found. Questionnaire was the instrument for data collection which was administered using total enumeration technique. Data obtained however, were analyzed with descriptive and inferential statistical analyses. Findings revealed that most of the respondents were male, while 36.03% house owners were between the ages of 46 and 55 years. Sources of water used by residents include well (56.94%), water vendors (17.77%), rain (15.29%) and borehole (3.72%). Distance travelled by house owners to sources of water was as high as 5.06 metres, resulting into stress (30.00 %), depression (25.00%) and aggressiveness (18.75%). Result of correlation analysis between the sources of water of respondents and disease prevalence showed that both rain water and water vendor had very strong positive correlation with typhoid, diarrhea and dysentery, while well water only had positive correlation with dysentery. Recommendations were therefore, proffered towards solving the problems associated with water in the area.Keywords: newly urbanized area, Ogbomoso, sources of water, residents
Procedia PDF Downloads 1971923 Evaluation of the Efficacy and Tolerance of Gabapentin in the Treatment of Neuropathic Pain
Authors: A. Ibovi Mouondayi, S. Zaher, R. Assadi, K. Erraoui, S. Sboul, J. Daoudim, S. Bousselham, K. Nassar, S. Janani
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INTRODUCTION: Neuropathic pain (NP) caused by damage to the somatosensory nervous system has a significant impact on quality of life and is associated with a high economic burden on the individual and society. The treatment of neuropathic pain consists of the use of a wide range of therapeutic agents, including gabapentin, which is used in the treatment of neuropathic pain. OBJECTIF: The objective of this study was to evaluate the efficacy and tolerance of gabapentin in the treatment of neuropathic pain. MATERIAL AND METHOD: This is a monocentric, cross-sectional, descriptive, retrospective study conducted in our department over a period of 19 months from October 2020 to April 2022. The missing parameters were collected during phone calls of the patients concerned. The diagnostic tool adopted was the DN4 questionnaire in the dialectal Arabic version. The impact of NP was assessed by the visual analog scale (VAS) on pain, sleep, and function. The impact of PN on mood was assessed by the "Hospital anxiety, and depression scale HAD" score in the validated Arabic version. The exclusion criteria were patients followed up for depression and other psychiatric pathologies. RESULTS: A total of 67 patients' data were collected. The average age was 64 years (+/- 15 years), with extremes ranging from 26 years to 94 years. 58 women and 9 men with an M/F sex ratio of 0.15. Cervical radiculopathy was found in 21% of this population, and lumbosacral radiculopathy in 61%. Gabapentin was introduced in doses ranging from 300 to 1800 mg per day with an average dose of 864 mg (+/- 346) per day for an average duration of 12.6 months. Before treatment, 93% of patients had a non-restorative sleep quality (VAS>3). 54% of patients had a pain VAS greater than 5. The function was normal in only 9% of patients. The mean anxiety score was 3.25 (standard deviation: 2.70), and the mean HAD depression score was 3.79 (standard deviation: 1.79). After treatment, all patients had improved the quality of their sleep (p<0.0001). A significant difference was noted in pain VAS, function, as well as anxiety and depression, and HAD score. Gabapentin was stopped for side effects (dizziness and drowsiness) and/or unsatisfactory response. CONCLUSION: Our data demonstrate a favorable effect of gabapentin on the management of neuropathic pain with a significant difference before and after treatment on the quality of life of patients associated with an acceptable tolerance profile.Keywords: neuropathic pain, chronic pain, treatment, gabapentin
Procedia PDF Downloads 961922 Improving the Growth Performance of Beetal Goat Kids Weaned at Various Stages with Various Levels of Dietary Protein in Starter Ration under High Input Feeding System
Authors: Ishaq Kashif, Muhammad Younas, Muhammad Riaz, Mubarak Ali
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Poor feeding management during pre-weaning period is one of the factors resulting in compromised growth of Beetal kids fattened for meat purpose. The main reason for this anomaly may be less milk offered to kids and non-serious efforts for its management. This study was planned to find the most appropriate protein level suiting the age of the weaning while shifting animals to high input feeding system. Total of 42 Beetal male kids having 30 (±10), 60 (±10) and 90 (±10) days of age were selected with 16 in each age group. They were designated as G30, G60 and G90, respectively. The weights of animals were; 8±2 kg (G30), 12±2 kg (G60) and 16±2 kg (G90), respectively. All animals were weaned by introducing the total mix feed gradually and withdrawing the milk during the adjustment period of two weeks. The pelleted starter ration (total mix feed) with three various dietary protein levels designated as R1 (16% CP), R2 (20% CP) and R3 (26% CP) were introduced. The control group was reared on the fodder (Maize). The starter rations were iso-caloric and were offered for six-week duration. All animals were exposed to treatment using two-factor factorial (3×3) plus control treatment arrangement under completely randomized design. The data were collected on average daily feed intake (ADFI), average daily gain (ADG), gain to intake ratio, Klieber ratio (KR), body measurements and blood metabolites of kids. The data was analyzed using aov function of R-software. The statistical analysis showed that starter feed protein levels and age of weaning had significant interaction for ADG (P < 0.001), KR (P < 0.001), ADFI (P < 0.05) and blood urea nitrogen (P < 0.05) while serum creatinine and feed conversion had non-significant interaction. The trend analysis revealed that ADG had significant quadratic interaction (P < 0.05) within protein levels and age of weaning. It was found that animals weaned at 30 or 60 days, on R2 diet had better ADG (46.8 gm/day and 87.06 gm/day, respectively) weaned at 60 days of age. The animals weaned at 90 days had best ADG (127 gm/day) with R1. It is concluded that animal weaned at 30 or 40 days required 20% CP for better growth performance while animal at 90 days showed better performance with 16% CP.Keywords: average daily gain, starter protein levels, weaning age, gain to intake ratio
Procedia PDF Downloads 2501921 Same-Day Detection Method of Salmonella Spp., Shigella Spp. and Listeria Monocytogenes with Fluorescence-Based Triplex Real-Time PCR
Authors: Ergun Sakalar, Kubra Bilgic
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Faster detection and characterization of pathogens are the basis of the evoid from foodborne pathogens. Salmonella spp., Shigella spp. and Listeria monocytogenes are common foodborne bacteria that are among the most life-threatining. It is important to rapid and accurate detection of these pathogens to prevent food poisoning and outbreaks or to manage food chains. The present work promise to develop a sensitive, species specific and reliable PCR based detection system for simultaneous detection of Salmonella spp., Shigella spp. and Listeria monocytogenes. For this purpose, three genes were picked out, ompC for Salmonella spp., ipaH for Shigella spp. and hlyA for L. monocytogenes. After short pre-enrichment of milk was passed through a vacuum filter and bacterial DNA was exracted using commercially available kit GIDAGEN®(Turkey, İstanbul). Detection of amplicons was verified by examination of the melting temperature (Tm) that are 72° C, 78° C, 82° C for Salmonella spp., Shigella spp. and L. monocytogenes, respectively. The method specificity was checked against a group of bacteria strains, and also carried out sensitivity test resulting in under 10² CFU mL⁻¹ of milk for each bacteria strain. Our results show that the flourescence based triplex qPCR method can be used routinely to detect Salmonella spp., Shigella spp. and L. monocytogenes during the milk processing procedures in order to reduce cost, time of analysis and the risk of foodborne disease outbreaks.Keywords: evagreen, food-born bacteria, pathogen detection, real-time pcr
Procedia PDF Downloads 2441920 Intimate Partner Violence Concerns during COVID-19 Pandemic
Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami
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Background: In March 2020, the World Health Organization (WHO) declared the outbreak of a new coronavirus disease, COVID-19, as a public health concern and pandemic. This situation is generating psychological consequences such as stress, anxiety, depression, and intimate partner violence (IPV) throughout the population. This is a brief note on the magnitude of this threat and different ways for abused women to minimize the effects of it in their daily life. Methods: A literature review was conducted using the MEDLINE, PSYCHINFO, and SCIENCE DIRECT databases. The keywords used included intimate partner violence, abuse, victims, pandemic, quarantine, coronavirus, and COVID-19. A Google search was also conducted using these words to identify reports published in non-indexed health care and social science journals. The literature search was restricted to English language studies. Results: The prevalence of IPV and its consequences are rising during such a pandemic. Having sufficient support from healthcare workers and acquaintances is critical for women in such circumstances. Conclusion: Community members, healthcare providers, governments, and policymakers should be informed of the increased risk of IPV during such a pandemic. They should provide a supporting structure for abused women. Social networking is also a good approach that could help abusive women during this situation.Keywords: covid-19, intimate partner violence, pandemic, women
Procedia PDF Downloads 681919 Additional Usage of Remdesivir with the Standard of Care in Patients with Moderate And Severe COVID-19: A Tertiary Hospital’s Experience
Authors: Pugazhenthan Thangaraju
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Background: Since the pandemic began, more than millions of people have become infected with COVID-19. Globally, researchers are working for safe and effective treatments for this disease. Remdesivir is a drug that has been approved for the treatment of COVID-19. Many aspects are still being considered that may influence the future use of remdesivir. Aim: To assess the safety and efficacy of Remdesivir in hospitalized adult patients diagnosed with moderate and severe COVID-19. Methods: It was a record-based retrospective cohort study conducted between April 1st, 2020 and June 30th, 2021 at the tertiary care teaching hospital All India Institutes of Medical Sciences (AIIMS), Raipur Results: There were a total of 10,559 medical records of COVID-19 patients of which 1034 records were included in this study. Overall, irrespective of the survival status, there was statistical significant difference observed between the WHO score at the time of admission and discharge. Clinical improvement among the survivors was found to be statistically significant. Conclusion: Remdesivir's potential efficacy against coronaviruses has so far been limited to in vitro studies and animal models. However, information about COVID-19 is rapidly expanding. Several clinical trials for the treatment of COVID-19 with remdesivir are now underway. However, the findings of this study support remdesivir as a promising agent in the fight against SARS-CoV-2.Keywords: Remdesivir, COVID-19, SARS-CoV-2, antiviral, RNA-dependent RNA polymerase, viral pneumonia
Procedia PDF Downloads 661918 The Impact of Childhood Cancer on the Quality of Life of Survivor: A Qualitative Analysis of Functionality and Participation
Authors: Catarina Grande, Barbara Mota
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The main goal of the present study was to understand the impact of childhood cancer on the quality of life of survivors and the extent to which oncologic disease affects the functionality and participation of survivors at the present time, compared to the time of diagnosis. Six survivors of pediatric cancer participated in the study. Participants were interviewed using a semi-structured interview, adapted from two instruments present in the literature - QALY and QLACS - and piloted through a previous study. This study is based on a qualitative approach using content analysis, allowing the identification of categories and subcategories. Subsequently, the correspondence between the units of meaning and the codes in the International Classification of Functioning, Disability, and Health for Children and Young, which contributed to a more detailed analysis of the impact on the quality of life of survivors in relation to the domains under study. The results showed significant changes between the moment of diagnosis and the present moment, concretely at the microsystem of the survivor. Regarding functionality and participation, the results show that the functions of the body are the most affected domain, emphasizing the emotional component that currently has a greater impact on the quality of life of survivors. The present study allowed identifying a set of codes for the development of a CIF-CJ core set for pediatric cancer survivors. He also indicated the need for future studies to validate and deepen these issues.Keywords: cancer, participation, quality of life, survivor
Procedia PDF Downloads 2401917 Thatsana Nataya Chatri Dance: A Creative Conservation Process of Cultural Performing Arts for Competition
Authors: Dusittorn Ngamying
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The research on Thatsana Nataya Chatri Dance: A Creative Conservation Process of Cultural Performing Arts for Competition was aimed at 1) studying the creative conservation process of cultural performing arts; 2) creating conservation process of cultural performing arts of Thatsana Nataya Chatri dance; and 3) utilizing the created performing arts for the competition. The study was conducted using the qualitative research method in the Central region provinces of Thailand through documentary study and data from field observations, interviews and focus group meetings. Data were collected from 50 informants consisting of 10 experts on the subject, 30 practitioners and 10 general information providers. The data collection instruments consisted of participatory and non-participatory forms, structured and non-structured interview schedules and focus group note forms. The data were verified by the triangulation technique and presented using the descriptive analysis. The results of the study reveal that the creative conservation process of cultural performing arts should be initiated by those who have experienced using a prior knowledge in the pursuit of new knowledge. The new knowledge is combined to generate creative work with the conservation process in 9 aspects: acquiring the related knowledge, creating theme and inspiration, designing the music and melody, designing costumes, inventing dance postures, selecting dancers, transferring the dance postures, preparing the stage and performance equipment, planning the performance event. Inventing the conservation process of cultural performing arts Thatsana Nataya Chatri dance consists of 33 dance postures and 14 transformed patterns. The performance requires 6 dancers, 3 males and 3 females. Costume features both male and female classical and modified dancer’s costumes. The duration of the show takes 5 minutes. As for the application for the competition, this creative work has been selected by Dramatic Works Association (Thailand) to represent Thailand at the Lombok International Dance Sports Festival 2015 held at Lombok, Indonesia. The team has been awarded the Second Place in the Traditional Dance category.Keywords: creative conservation process, cultural performing arts, Thatsana Nataya Chatri dance, competition
Procedia PDF Downloads 2241916 Aspectual Verbs in Modern Standard Arabic
Authors: Yasir Alotaibi
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The aim of this paper is to discuss the syntactic analysis of aspectual or phasal verbs in Modern Standard Arabic (MSA). Aspectual or phasal verbs refer to a class of verbs that require a verbal complement and denote the inception, duration, termination ...etc. of a state or event. This paper will discuss two groups of aspectual verbs in MSA. The first group includes verbs such as ̆gacala, tafiqa, ?akhatha, ?ansha?a, sharaca and bada?a and these verbs are used to denote the inception of an event. The second group includes verbs such as ?awshaka, kaada and karaba and the meaning of these verbs is equivalent to be near/almost . The following examples illustrate the use of the verb bada?a ‘begin’ which is from the first group: a. saalim-un bada?a yuthaakiru. Salem-NOM begin.PFV.3SGM study.IPFV.3SGM ‘Salem began to study’ b.*saalim-un bada?a ?an yuthaakiru. Salem-NOM begin.PFV.3SGM COMP study.IPFV.3SGM ‘Salem began to study’ The example in (1a) is grammatical because the aspectual verb is used with a verbal complement that is not introduced by a complementizer. In contrast, example (1b) is not grammatical because the verbal complement is introduced by the complementizer ?an ‘that’. In contrast, the following examples illustrate the use of the verb kaada ‘be almost’ which is from the second group. However, the two examples are grammatical and this means that the verbal complement of this verb can be without (as in example (2a)) or with ( as in example (2b)) a complementizer. (2) a. saalim-un kaada yuthaakiru. Salem-NOM be.almost.PFV.3SGM study.IPFV.3SGM ‘Salem was almost to study’ b. saalim-un kaada ?an yuthaakiru. Salem-NOM be.almost.PFV.3SGM COMP study.IPFV.3SGM ‘Salem was almost to study’ The salient properties of this class of verbs are that they require a verbal complement, there is no a complementizer that can introduce the complement with the first group while it is possible with the second and the aspectual verb and the embedded verb share and agree with the same subject. To the best of knowledge, aspectual verbs in MSA are discussed in traditional grammar only and have not been studied in modern syntactic theories. This paper will consider the analysis of aspectual verbs in MSA within the Lexical Functional Grammar (LFG) framework. It will use some evidence such as modifier or negation to find out whether these verbs have PRED values and head their f-structures or they form complex predicates with their complements. If aspectual verbs show the properties of heads, then the paper will explore what kind of heads they are. In particular, they should be raising or control verbs. The paper will use some tests such as agreement, selectional restrictions...etc. to find out what kind of verbs they are.Keywords: aspectual verbs, biclausal, monoclausal, raising
Procedia PDF Downloads 571915 Accessibility of Youth-Friendly Sexual and Reproductive Health Services to Secondary School Adolescents in Southern Cross River, Nigeria
Authors: Rosemary I. Eneji, Stephen Adi Odey, Edem Carole, Eucharia Nwagbara
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Sexual and reproductive health behaviors are the main causes of death, disability, and disease among adolescents in Nigeria. In this study, we determined the accessibility of youth-friendly sexual and reproductive health services to secondary school adolescents in southern Cross River state, Nigeria. Nineteen randomly selected public secondary schools across the seven local government areas in the zone were used. The respondents were four hundred senior secondary (classes SSI - SS3) students aged 15-19 years, comprising 63.7% females and 36.3% males. A 50-item structured questionnaire was used for the study. There was a strong influence of age and sex of adolescents, income and occupation of parents, knowledge and awareness of adolescents, and tradition on the accessibility and use of youth-friendly sexual and reproductive health services (YFSRHS) to the adolescents. The attitude of health workers towards accessibility was of little effect. Overall, youth-friendly sexual and reproductive health services were not easily accessible to adolescents in the study area. Thus, there is need to enforce adolescent reproductive health policies in the area. Training and use of trained caregivers and peer educators to attend to adolescents and the inclusion of adolescent reproductive health as a subject in the curriculum are strongly recommended.Keywords: youth, reproductive health, cross river state, secondary schools, Nigeria
Procedia PDF Downloads 741914 Evaluation of Percutaneous Tube Thoracostomy Performed by Trainee in Both Trauma and Non-Trauma Patients
Authors: Kulsum Maula, Md Kamrul Alam, Md Ibrahim Khalil, Md Nazmul Hasan, Mohammad Omar Faruq
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Background: Percutaneous Tube Thoracostomy (PTT) is an invasive procedure that can save a life now and then in different traumatic and non-traumatic conditions. But still, it is an enigma; how our trainee surgeons are at home in this procedure. Objectives: To evaluate the outcome of the percutaneous tube thoracostomy performed by trainees in both trauma and non-trauma patients. Study design: Prospective, Observational Study. The duration of the study was September 2018 to February 2019. Methods: All patients who need PTT in traumatic and non-traumatic conditions were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 96 patients were finalized. A pre-tested, observation-based, peer-reviewed data collection sheet was prepared before the study. Data regarding clinical and surgical outcome profiles were recorded. Data were compiled, edited, and analyzed. Results: Among 96 patients, the highest 32.29% belonged to age group 31-40 years and the lowest 9.37% belonged to the age group ≤20. The mean age of the respondents was 29.19±9.81. We found out of 96 patients, 70(72.91%) were indicated PTT for traumatic conditions and the rest 26(27.08%) were indicated PTT for non-traumatic chest conditions, where 36(37.5%) had simple penumothorax, 21(21.87%) haemothorax, 14(14.58%) massive pleural effusion, 13(13.54%) tension pneumothorax, 10(10.41%) haemopneumothorax, and 2(2.08%) had pyothorax respectively. In 53.12% of patients had right-sided intercostal chest tube (ICT) insertion, whereas 46.87% had left-sided ICT insertion. In our study, 89.55 % of the tube was placed at the normal anatomical position. Besides, 10.41% of tube thoracostomy were performed deviated from anatomical site. Among 96 patients 62.5% patients had length of incision 2-3cm, 35.41% had >3cm and 2.08% had <2cm respectively. Out of 96 patients, 75(78.13%) showed uneventful outcomes, whereas 21(21.87%) had complications, including 11.15%(11) each had wound infection, 4.46%(4) subcutaneous emphysema, 4.28%(3) drain auto expulsion, 2.85%(2) hemorrhage, 1.45%(1) had a non-functioning drain and empyema with ascending infection respectively (p=<0.05). Conclusion: PTT is a life-saving procedure that is most frequently implemented in chest trauma patients in our country. In the majority of cases, the outcome of PTT was uneventful (78.13). Besides this, more than one-third of patients had a length of incision more than 3 cm that needed extra stitches and 10.41% of cases of PTT were placed other than the normal anatomical site. Trainees of Dhaka Medical College Hospitals are doing well in their performance of PTT insertion, but still, some anatomical orientations are necessary to avoid operative and post-operative complications.Keywords: PTT, trainee, trauma, non-chest trauma patients
Procedia PDF Downloads 1211913 Developing Biocompatible Iridium Oxide Electrodes for Bone-Guided Extra-Cochlear Implant
Authors: Yung-Shan Lu, Chia-Fone Lee, Shang-Hsuan Li, Chien-Hao Liu
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Recently, various bioelectronic devices have been developed for neurologic disease treatments via electro-stimulations such as cochlear implants and retinal prosthesis. Since the electric signal needs electrodes to be transmitted to an organism, electrodes play an important role of stimulations. The materials of stimulation electrodes affect the efficiency of the delivered currents. The higher the efficiency of the electrodes, the lower the threshold current can be used to stimulate the organism which minimizes the potential damages to the adjacent tissues. In this study, we proposed a biocompatible composite electrode composed of high-charge-capacity iridium oxide (IrOₓ) film for a bone-guide extra-cochlear implant. IrOₓ was exploited to decrease the threshold current due to its high capacitance and low impedance. The IrOₓ electrode was fabricated via microelectromechanical systems (MEMS) photolithography and examined with in-vivo tests with guinea pigs. Based on the measured responses of brain waves to sound, the results demonstrated that IrOₓ electrodes have a lower threshold current compared with the Platinum (Pt) electrodes. The research results are expected to be beneficial for implantable and biocompatible electrodes for electrical stimulations.Keywords: cochlear implants, electrode, electrical stimulation, iridium oxide
Procedia PDF Downloads 1901912 Simultaneous Analysis of 25 Trace Elements in Micro Volume of Human Serum by Inductively Coupled Plasma–Mass Spectrometry
Authors: Azmawati Mohammed Nawi, Siok-Fong Chin, Shamsul Azhar Shah, Rahman Jamal
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In recent years, trace elements have gained importance as biomarkers in many chronic diseases. Unfortunately, the requirement for sample volume increases according to the extent of investigation for diagnosis or elucidating the mechanism of the disease. Here, we describe the method development and validation for simultaneous determination of 25 trace elements (lithium (Li), beryllium (Be), magnesium (Mg), aluminium (Al), vanadium (V), chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), gallium (Ga), arsenic (As), selenium (Se), rubidium (Rb), strontium (Sr), silver (Ag), cadmium (Cd), caesium (Cs), barium (Ba), mercury (Hg), thallium (Tl), lead (Pb), uranium (U)) using just 20 µL of human serum. Serum samples were digested with nitric acid and hydrochloric acid (ratio 1:1, v/v) and analysed using inductively coupled plasma–mass spectrometry (ICP-MS). Seronorm®, a human-derived serum control material was used as quality control samples. The intra-day and inter-day precisions were consistently < 15% for all elements. The validated method was later applied to 30 human serum samples to evaluate its suitability. In conclusion, we have successfully developed and validated a precise and accurate analytical method for determining 25 trace elements requiring very low volume of human serum.Keywords: acid digestion, ICP-MS, trace element, serum
Procedia PDF Downloads 1861911 Cholesterol-Lowering Effects of Lactobacillus plantarum Isolated from Northeastern Thai Fermented Vegetable Brassica juncea (L.)
Authors: T. Warinpramote, J. Sanguanjeen, P. Pholphakwaen, S. Kittisorayut, J. Kerdtubtim, S. Palachote, M. Taweechotipatr
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Cholesterol is a type of lipid molecule which is the significant risk factor for coronary heart disease. Currently, there are many cholesterol-lowering alternative treatments especially bile salt hydrolase positive lactobacilli. BSH can cleave the peptide linkage of bile salt, which results in removal of the amino acid group from the steroid core and increases production of the new bile acid by using more cholesterol. The purpose of this study was to isolate, and screen probiotic characteristics of lactobacilli from fermented Thai foods and further investigated for their comparative BSH activity. The result showed that 2 of 81 Lactobacillus strains, JPK2-2 and JPK3-2, isolated from Brassica juncea (L.) had significantly exhibited high BSH activity. In addition, these Lactobacillus strains showed their results that the ability to tolerate acid and bile salt. Furthermore, the using of 16S rDNA sequencing for definitive microbial identifications showed that these 2 strains belong to Lactobacillus plantarum. In the future, the L. plantarum with BSH activity strains JPK2-2 and JPK3-2 may be the candidate probiotics for application in functional foods and dairy products to improve in the patient with cardiovascular diseases.Keywords: Lactobacillus plantarum, probiotics, bile salt hydrolase, cholesterol-lowering, fermented Thai food
Procedia PDF Downloads 1571910 Rising Prevalence of Diabetes among Elderly People in Kerala: Evidence from NSS Data
Authors: Narendra Kumar
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In developing countries, the majority of people with diabetes are in the age range of 45-64 years and more women than men. As in many areas of the India, non-insulin dependent diabetes mellitus has become major problems. Now it is spreading among the middle class and poor at an alarming stage in India and Kerala is turning to be the world capital of diabetes. This study uses two round NSS data from the ‘National Sample Survey Organization, India’ to investigate the predictors of diabetes in Kerala. The overall estimates for diabetes prevalence among elderly show that higher in men than women, but there are more women with diabetes than men. Education of respondent has been found a significant characteristics, further respondent working status, caste/tribe have substantial impact on diabetes in Kerala. The disease is more common for people who are mostly physically inactive. This whole picture is very much prominent in the urban areas compared with the rural ones. Not working elderly have significantly higher with diabetes than for those working in elderly. Socioeconomic status was inversely associated with diabetes prevalence. For men and women, the prevalence of diabetes and hypertension were significantly higher in the urban population while smoking, smokeless tobacco consumption was more prevalent in the rural population. High alcohol intake increases diabetes risk among elderly. Finally these findings specified that an increase improve health care services and changing life style of elderly which should in turn raise diabetes patient survival and should decrease comorbidities due to diabetes in Kerala.Keywords: elderly, diabetes, prevalence, Kerala
Procedia PDF Downloads 3111909 An Information Matrix Goodness-of-Fit Test of the Conditional Logistic Model for Matched Case-Control Studies
Authors: Li-Ching Chen
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The case-control design has been widely applied in clinical and epidemiological studies to investigate the association between risk factors and a given disease. The retrospective design can be easily implemented and is more economical over prospective studies. To adjust effects for confounding factors, methods such as stratification at the design stage and may be adopted. When some major confounding factors are difficult to be quantified, a matching design provides an opportunity for researchers to control the confounding effects. The matching effects can be parameterized by the intercepts of logistic models and the conditional logistic regression analysis is then adopted. This study demonstrates an information-matrix-based goodness-of-fit statistic to test the validity of the logistic regression model for matched case-control data. The asymptotic null distribution of this proposed test statistic is inferred. It needs neither to employ a simulation to evaluate its critical values nor to partition covariate space. The asymptotic power of this test statistic is also derived. The performance of the proposed method is assessed through simulation studies. An example of the real data set is applied to illustrate the implementation of the proposed method as well.Keywords: conditional logistic model, goodness-of-fit, information matrix, matched case-control studies
Procedia PDF Downloads 2931908 The Indebtedness of Men and Women: A Study of Personal Bankruptcies in the Czech Republic
Authors: Zuzana Fišerová, Marie Paseková
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Debt relief (also labelled personal bankruptcy) is a bankruptcy settlement method which was implemented into Czech legislation by the Insolvency Act (Act No. 182/2006 Coll. on Insolvency and its Resolution) on 1 January 2008. The need to implement the institute of personal bankruptcy arose from the excessive over-indebtedness of many inhabitants of the Czech Republic after the crisis that arose around 2008 and 2009. The contribution analyses the development in the manner in which households approach personal bankruptcy and assesses and surveys the differences between indebtedness among men and women. The first section analyses the development in numbers of filed personal bankruptcy petitions and the successfulness thereof; it likewise analyses the impact of other economic influences (regional differences, unemployment etc.). The differences between debtors in dependency to gender are also surveyed. A survey of insolvency proceedings for 664 persons whose insolvency proceedings were commenced in 2008 was conducted, whilst the data were acquired from the publicly accessible insolvency register. The hypothesis on the equality of the average debt level of men and women was tested when comparing indebtedness in dependency to debtor gender. At a significance level of 0.05, the test confirmed that the mean value of debt level for women is lower than the mean value of debt level for men. Through analysis of further results, it was found that the average level of debt among women was CZK 537 thousand, while the average level of creditor satisfaction reached 46.2%. Men in the monitored sample had an average level of reported receivables of CZK 652 thousand, satisfaction of their creditors reached 58.8%. The main changes in the institute of personal bankruptcy are then evaluated in the closing discussion, and the impacts of these changes for households are assessed. The development of legislation in the Czech Republic and practice are shifting towards broader usage of personal bankruptcy, especially insofar as it can now also be used by entrepreneurs. Furthermore, the amendment of the Insolvency Act has enabled married couples to apply for joint debt relief, which has improved the position of the marriage partner with lower income and who would not get permission for debt relief on his/her own (mostly women are at issue). In current practice, the condition of adequate income is also solved by the fact that another person (usually a family member) undertakes to donate a certain monthly sum throughout the duration of the debt relief. Personal bankruptcy can thus be completed also by individuals to whom it would previously have been denied by the court.Keywords: debtor, households, insolvency act, over-indebtedness, personal bankruptcy
Procedia PDF Downloads 2861907 Rare Case of Pyoderma Gangrenosum of the Upper Limb
Authors: Karissa A. Graham
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Pyoderma gangrenosum (PG) is a prototypic autoinflammatory neutrophilic dermatosis that is a rare disorder. It presents a diagnostic challenge owing to its variable presentation, clinical overlap with other conditions, it is often associated with other systemic conditions, and there is no definitive histological or laboratory characteristic. The Delphai consensus for PG includes the presence of at least one ulcer on the anterior lower limb. Systemic corticosteroids and immunosuppressive therapies are the mainstay treatment for PG. We describe a case report of delayed diagnosis of ulcerative pyoderma gangrenosum in a 44-year-old male on his forearm. The patient presented with an infected ulcer on his right forearm that had been present for over three years. The patient was a Type 2 Diabetic with no personal or family history of inflammatory bowel disease or other autoimmune diseases. The patient was initially investigated for malignancy, but biopsies returned as chronic inflammatory tissue with neutrophilic infiltrate and no malignancy. The patient was commenced on systemic prednisone for the treatment of pyoderma gangrenosum. The diagnosis of ulcerative PG poses a challenge given the vast differential diagnosis for a cutaneous ulcer (i.e., malignant, vascular, autoimmune, trauma, infective, etc.). Diagnostic accuracy is important given that the treatment for PG with steroids does not go without risks and indeed may be contraindicated in other potential causes of the ulcer. Indeed, more common and more sinister causes of ulcers should be investigated first, as death from PG is quite rare.Keywords: dermatological diagnosis, dermatosis, pyoderma gangrenosum, rare presentation
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