Search results for: patient reported symptom burden

Authors: Chee Wai Ku, Pui See Chin

Abstract:

As an emerging alternative to hysterectomy, uterine artery embolization (UAE) has been widely used in the management of fibroids and in controlling postpartum hemorrhage (PPH) unresponsive to other therapies. Research has shown UAE to be a safe, minimally invasive procedure with few complications and minimal effects on future fertility. We present two cases highlighting the use of UAE in preventing PPH in a patient with a large fibroid at the time of cesarean section and in the treatment of secondary PPH refractory to other therapies in another patient. We present a 36-year primiparous woman who booked at 18+6 weeks gestation with a 13.7 cm subserosal fibroid at the lower anterior wall of the uterus near the cervix and a 10.8 cm subserosal fibroid in the left wall. Prophylactic internal iliac artery occlusion balloons were placed prior to the planned classical midline cesarean section. The balloons were inflated once the baby was delivered. Bilateral uterine arteries were embolized subsequently. The estimated blood loss (EBL) was 400 mls and hemoglobin (Hb) remained stable at 10 g/DL. Ultrasound scan 2 years postnatally showed stable uterine fibroids 10.4 and 7.1 cm, which was significantly smaller than before. We present the second case of a 40-year-old G2P1 with a previous cesarean section for failure to progress. There were no antenatal problems, and the placenta was not previa. She presented with term labour and underwent an emergency cesarean section for failed vaginal birth after cesarean. Intraoperatively extensive adhesions were noted with bladder drawn high, and EBL was 300 mls. Postpartum recovery was uneventful. She presented with secondary PPH 3 weeks later complicated by hypovolemic shock. She underwent an emergency examination under anesthesia and evacuation of the uterus, with EBL 2500mls. Histology showed decidua with chronic inflammation. She was discharged well with no further PPH. She subsequently returned one week later for secondary PPH. Bedside ultrasound showed that the endometrium was thin with no evidence of retained products of conception. Uterotonics were administered, and examination under anesthesia was performed, with uterine Bakri balloon and vaginal pack insertion after. EBL was 1000 mls. There was no definite cause of PPH with no uterine atony or products of conception. To evaluate a potential cause, pelvic angiogram and super selective left uterine arteriogram was performed which showed profuse contrast extravasation and acute bleeding from the left uterine artery. Superselective embolization of the left uterine artery was performed. No gross contrast extravasation from the right uterine artery was seen. These two cases demonstrated the superior efficacy of UAE. Firstly, the prophylactic use of intra-arterial balloon catheters in pregnant patients with large fibroids, and secondly, in the diagnosis and management of secondary PPH refractory to uterotonics and uterine tamponade. In both cases, the need for laparotomy hysterectomy was avoided, resulting in the preservation of future fertility. UAE should be a consideration for hemodynamically stable patients in centres with access to interventional radiology.

Keywords: fertility preservation, secondary postpartum hemorrhage, uterine embolization, uterine fibroids

Procedia PDF Downloads 187

Authors: George Zhou, Yunchan Chen, Candace Chien

Abstract:

Kidney replacement therapy is the current standard of care for end-stage renal diseases. In-center or home hemodialysis remains an integral component of the therapeutic regimen. Arteriovenous fistulas (AVF) make up the vascular circuit through which blood is filtered and returned. Naturally, AVF patency determines whether adequate clearance and filtration can be achieved and directly influences clinical outcomes. Our aim was to build a deep learning model for automated AVF stenosis screening based on the sound of blood flow through the AVF. A total of 311 patients with AVF were enrolled in this study. Blood flow sounds were collected using a digital stethoscope. For each patient, blood flow sounds were collected at 6 different locations along the patient’s AVF. The 6 locations are artery, anastomosis, distal vein, middle vein, proximal vein, and venous arch. A total of 1866 sounds were collected. The blood flow sounds are labeled as “patent” (normal) or “stenotic” (abnormal). The labels are validated from concurrent ultrasound. Our dataset included 1527 “patent” and 339 “stenotic” sounds. We show that blood flow sounds vary significantly along the AVF. For example, the blood flow sound is loudest at the anastomosis site and softest at the cephalic arch. Contextualizing the sound with location metadata significantly improves classification performance. How to encode and incorporate categorical metadata is an active area of research1. Herein, we study ordinal (i.e., integer) encoding schemes. The numerical representation is concatenated to the flattened feature vector. We train a vision transformer (ViT) on spectrogram image representations of the sound and demonstrate that using scalar multiples of our integer encodings improves classification performance. Models are evaluated using a 10-fold cross-validation procedure. The baseline performance of our ViT without any location metadata achieves an AuROC and AuPRC of 0.68 ± 0.05 and 0.28 ± 0.09, respectively. Using the following encodings of Artery:0; Arch: 1; Proximal: 2; Middle: 3; Distal 4: Anastomosis: 5, the ViT achieves an AuROC and AuPRC of 0.69 ± 0.06 and 0.30 ± 0.10, respectively. Using the following encodings of Artery:0; Arch: 10; Proximal: 20; Middle: 30; Distal 40: Anastomosis: 50, the ViT achieves an AuROC and AuPRC of 0.74 ± 0.06 and 0.38 ± 0.10, respectively. Using the following encodings of Artery:0; Arch: 100; Proximal: 200; Middle: 300; Distal 400: Anastomosis: 500, the ViT achieves an AuROC and AuPRC of 0.78 ± 0.06 and 0.43 ± 0.11. respectively. Interestingly, we see that using increasing scalar multiples of our integer encoding scheme (i.e., encoding “venous arch” as 1,10,100) results in progressively improved performance. In theory, the integer values do not matter since we are optimizing the same loss function; the model can learn to increase or decrease the weights associated with location encodings and converge on the same solution. However, in the setting of limited data and computation resources, increasing the importance at initialization either leads to faster convergence or helps the model escape a local minimum.

Keywords: arteriovenous fistula, blood flow sounds, metadata encoding, deep learning

Procedia PDF Downloads 89

Authors: Hernán A. Perez, Luis J. Armando, Néstor H. García

Abstract:

Background and aims Cardiovascular disease rates are very high in patients with renal failure (CRF), but the underlying mechanisms are incompletely understood. Traditional cardiovascular risk factors do not explain the increased risk, and observational studies have observed paradoxical or absent associations between classical risk factors and mortality in dialysis patients. A large randomized controlled trial, the 4D Study, the AURORA and the ALERT study found that statin therapy in CRF do not reduce cardiovascular events. These results may be the results of ‘accelerated atherosclerosis’ observed on these patients. The objective of this study was to investigate if carotid total plaque area (TPA), a measure of carotid plaque burden growth is increased at progressively lower creatinine clearance in patients with CRF. We studied a cohort of patients with CRF not on dialysis, reasoning that risk factor associations might be more easily discerned before end stage renal disease. Methods: The Blossom DMO Argentina ethics committee approved the study and informed consent from each participant was obtained. We performed a cohort study in 412 patients with Stage 1, 2 and 3 CRF. Clinical and laboratory data were obtained. TPA was determined using bilateral carotid ultrasonography. Modification of Diet in Renal Disease estimation formula was used to determine renal function. ANOVA was used when appropriate. Results: Stage 1 CRF group (n= 16, 43±2yo) had a blood pressure of 123±2/78±2 mmHg, BMI 30±1, LDL col 145±10 mg/dl, HbA1c 5.8±0.4% and had the lowest TPA 25.8±6.9 mm2. Stage 2 CRF (n=231, 50±1 yo) had a blood pressure of 132±1/81±1 mmHg, LDL col 125±2 mg/dl, HbA1c 6±0.1% and TPA 48±10mm2 ( p< 0.05 vs CRF stage 1) while Stage 3 CRF (n=165, 59±1 yo) had a blood pressure of 134±1/81±1, LDL col 125±3 mg/dl, HbA1c 6±0.1% and TPA 71±6mm2 (p < 0.05 vs CRF stage 1 and 2). Conclusion: Our data indicate that TPA increases along the renal function deterioration, and it is not related with the LDL cholesterol and triglycerides levels. We suggest that mechanisms other than the classics are responsible for the observed excess of cardiovascular disease in CKD patients and finally, determination of total plaque area should be used to measure effects of antiatherosclerotic therapy.

Keywords: hypertension, chronic renal failure, atherosclerosis, cholesterol

Procedia PDF Downloads 272

Authors: Saimir Heta, Ilma Robo, Nevila Alliu, Tea Meta

Abstract:

Background: Plasma levels of inflammatory markers are the expression of the infectious wastes of existing periodontitis, as well as of existing inflammation everywhere in the body. Materials and Methods: The study consists of the clinical part of the measurement of inflammatory markers of 23 patients diagnosed with chronic periodontitis and the recording of parental periodontal parameters of patient periodontal status: hemorrhage index and probe values, before and 7-10 days after non-surgical periodontal treatment. Results: The level of fibrinogen drops according to the categorization of disease progression, active and passive, with the biggest % (18%-30%) at the fluctuation 10-20 mg/d. Fluctuations in fibrinogen level according to the age of patients in the range 0-10 mg/dL under 40 years and over 40 years was 13%-26%, in the range 10-20 mg/dL was 26%-22%, in the 20-40 mg/dL was 9%-4%. Conclusions: Non-surgical periodontal treatment significantly reduces the level of non-inflammatory markers in the blood. Oral health significantly reduces the potential source for periodontal bacteria, with the potential of promoting thromboembolism, through interaction between thrombocytes.

Keywords: chronic periodontitis, atherosclerosis, risk factor, inflammatory markers

Procedia PDF Downloads 126

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

Abstract:

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

Keywords: prevalence, predictors, metabolic syndrome, diabetes

Procedia PDF Downloads 146

Authors: Nagendra P. Luitel, Mark J. D. Jordans

Abstract:

Globally, there is a significant gap between the number of individuals in need of mental health care and those who actually receive treatment. The evidence is accumulating that mental health services can be delivered effectively by primary health care workers through community-based programs and task-sharing approaches. Changing the role of specialist mental health workers from service delivery to building clinical capacity of the primary health care (PHC) workers could help in reducing treatment gap in low and middle-income countries (LMICs). We developed a comprehensive mental health care plan in 2012 and evaluated its feasibility and effectiveness over the past three years. Initially, a mixed method formative study was conducted for the development of mental health care plan (MHCP). Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from beneficiaries (n=135) during the pilot-testing phase. Repeated community survey (N=2040); facility detection survey (N=4704) and the cohort study (N=576) were conducted for evaluation of the MHCP. The resulting MHCP consists of twelve packages divided over the community, health facility, and healthcare organization platforms. Detection of mental health problems increased significantly after introducing MHCP. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Currently, MHCP has been implemented in the entire Chitwan district where over 1400 people (438 people with depression, 406 people with psychosis, 181 people with epilepsy, 360 people with alcohol use disorder and 51 others) have received mental health services from trained health workers. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers, high drop-out rates and continue the supply of medicines. The results indicated that involvement of PHC workers in detection and management of mental health problems is an effective strategy to minimize treatment gap on mental health care in Nepal.

Keywords: mental health, Nepal, primary care, treatment gap

Procedia PDF Downloads 295

Authors: Ahuva Even-Zohar, Shoshi Werner

Abstract:

Context: Sexuality is an important aspect of overall quality of life for individuals across different age groups and health conditions. Sexual interest and activity continue to be important and play a role in people's life as they age. Despite this, there is limited research on the sexual health of older adults. Research Aim: The study aims to examine the knowledge, attitudes, and sexual activity of older adults and to explore the relationship between sexual activity and quality of life among this population. Methodology: The study involved 203 Jewish participants from Israel, with an average age of 69.59. The participants completed questionnaires administered through an Internet panel. The questionnaires measured variables such as knowledge about and attitudes towards sexuality, sexual activity, quality of life, and socio-demographic information. Findings: The study found that a majority of the participants reported engaging in sexual activity, with most of them experiencing full sexual intercourse. Approximately half of the participants expressed high levels of satisfaction with their sexual activity. The results indicated that older adults demonstrated a moderate level of knowledge and permissive attitudes towards sexuality in later life. Moreover, higher levels of knowledge and permissive attitudes were associated with increased sexual activity. The frequency of sexual activity was identified as a predictor of quality of life, with a mediating effect on the relationship between attitudes towards older adults' sexuality and quality of life. Notably, men and older adults who were married or in a relationship reported higher frequencies of sexual activity compared to women and older adults without a partner. Furthermore, a majority of participants did not seek professional help or discuss their sexual concerns with a therapist. Theoretical Importance: This research contributes to our understanding of a topic that is often considered taboo - sexuality among older adults. It highlights that older adults maintain an interest in sexual activity, and that engaging in such activity contributes to their overall quality of life. Data Collection and Analysis Procedures: The data for this study were collected using structured questionnaires administered through an Internet panel. The questionnaires included closed-ended questions, allowing for quantitative data analysis. Descriptive statistics and regression analysis were performed to examine the relationships between the variables. Questions Addressed: This study aimed to address the following questions: What is the level of knowledge and attitudes towards sexuality among older adults? How prevalent is sexual activity among older adults and what factors are associated with it? How does sexual activity impact the quality of life of older adults? Do older adults seek professional help for their sexual concerns? Conclusion: The main conclusion drawn from this research is that sexuality is a crucial aspect of older adults' lives and significantly contributes to their quality of life. The study emphasizes the need for educational programs aimed at older adults and professionals, which promote the understanding and benefits of sexuality in later life. It also suggests that professionals should actively encourage older individuals to seek help and support when experiencing difficulties related to sexuality.

Keywords: men, older adults, quality of life, sexuality, women

Procedia PDF Downloads 71

Authors: Esmat Noroozi, Elahe Sarfi, Farha Hosseinzadeh Lotfi

Abstract:

Examining the impacts of data modification is considered as sensitivity analysis. A lot of studies have considered the data modification of inputs and outputs in DEA. The issues which has not heretofore been considered in DEA sensitivity analysis is modification in the number of inputs and (or) outputs and determining the impacts of this modification in the status of efficiency of DMUs. This paper is going to present systems that show the impacts of adding one or multiple inputs or outputs on the status of efficiency of DMUs and furthermore a model is presented for recognizing the minimum number of inputs and (or) outputs from among specified inputs and outputs which can be added whereas an inefficient DMU will become efficient. Finally the presented systems and model have been utilized for a set of real data and the results have been reported.

Keywords: data envelopment analysis, efficiency, sensitivity analysis, input, out put

Procedia PDF Downloads 450

Authors: Mrabet S., Beghdadi C., Bensadok S., Benzoubara W., Bestani R. F., Djellakh H., Ahmed Fouatih N.

Abstract:

Introduction: The notion of beauty is imposed on us by philosophers as an obvious fact that would impose it on everyone, a self-proclaimed absolute truth, a clearly readable divining intuition for each of us. Beauty is often linked to rationality or moral notions. Materials and Methods: In order to evaluate and compare the perceptions of different groups of evaluators regarding changes made to the components of a smile, an analytical cross-sectional epidemiological study was conducted. Results: The selected population included 184 patients, 152 dental students, 22 general practitioners and 42 orthodontists. The criteria studied concern the smile line, gingival exposure, dental exposure, alignment of free edges, or coincidence of interincisal points. Discussion and Conclusion: A different appreciation between laypeople and professionals was observed on several criteria for judging an attractive smile. Hence the importance of listening to the patient's complaints and defining from the outset a therapeutic strategy that aims to restore aesthetics and function. On the groups of professionals, the impact of variables such as age, sex, as well as professional experience is undeniable and seems to affect the appreciation of the smile.

Keywords: smile, orthodontics, appreciation, practitioner

Procedia PDF Downloads 3

Authors: Majid Zargar, Frank Bullen, Ron Ayers

Abstract:

One of the important factors in the design of asphalt concrete mixes is the accurate measurement of air voids and their variable distribution. Both can have significant impact on long and short term fatigue and creep behaviour under traffic. While some simple methods exist for overall evaluation of air voids, measuring air void distribution in asphalt concrete is very complex, involving expensive techniques such as X-ray methodologies. The research reported in the paper investigated the use of non-destructive ultrasonic techniques as an alternative to estimate the amount of air voids and their distribution within asphalt samples. Seventy-four Standard AC–14 asphalt samples made with three types of bitumen; Multigrade, PMB and C320 were analysed using ultrasonic techniques. The results have illustrated that ultrasonic testing has the potential of being a rapid, accurate and cost-effective method of estimating air void distribution in asphalt.

Keywords: asphalt concrete, air voids, ultrasonic, mechanical behaviour

Procedia PDF Downloads 347

Authors: Geraldine Landon, Enora Clero, Jean-Rene Jourdain

Abstract:

In 2005, the Institut de Radioprotection et de Sûreté Nucléaire (IRSN, France) launched a research program named EPICE (acronym for 'Evaluation of Pathologies potentially Induced by CaEsium') to collect scientific information on non-cancer effects possibly induced by chronic exposures to low doses of ionizing radiation with the view of addressing a question raised by several French NGOs related to health consequences of the Chernobyl nuclear accident in children. The implementation of the program was preceded by a pilot phase to ensure that the project would be feasible and determine the conditions for implementing an epidemiological study on a population of several thousand children. The EPICE program focused on childhood cardiac arrhythmias started in May 2009 for 4 years, in partnership with the Russian Bryansk Diagnostic Center. The purpose of this cross-sectional study was to determine the prevalence of cardiac arrhythmias in the Bryansk oblast (depending on the contamination of the territory and the caesium-137 whole-body burden) and to assess whether caesium-137 was or not a factor associated with the onset of cardiac arrhythmias. To address these questions, a study bringing together 18 152 children aged 2 to 18 years was initiated; each child received three medical examinations (ECG, echocardiography, and caesium-137 whole-body activity measurement) and some of them were given with a 24-hour Holter monitoring and blood tests. The findings of the study, currently submitted to an international journal justifying that no results can be given at this step, allow us to answer clearly to the issue of radiation-induced childhood arrhythmia, a subject that has been debated for many years. Our results will be certainly helpful for health professionals responsible for the monitoring of population exposed to the releases from the Fukushima Dai-ichi nuclear power plant and also useful for future comparative study in children exposed to ionizing radiation in other contexts, such as cancer radiation therapies.

Keywords: Caesium-137, cardiac arrhythmia, Chernobyl, children

Procedia PDF Downloads 245

Authors: Dalibor Štys, Kryštof M. Stys, Maryia Chkalova, Petr Kouba, Aliaxandr Pautsina, Dalibor Štys Jr., Jana Pečenková, Denis Durniev, Tomáš Náhlík, Petr Císař

Abstract:

In this article, a construction and some properties of the 5iD viewer, the system recording simultaneously five views of a given experimental object is reported. Properties of the system are demonstrated on the analysis of fish schooling behavior. It is demonstrated the method of instrument calibration which allows inclusion of image distortion and it is proposed and partly tested also the method of distance assessment in the case that only two opposite cameras are available. Finally, we demonstrate how the state trajectory of the behavior of the fish school may be constructed from the entropy of the system.

Keywords: 3D positioning, school behavior, distance calibration, space vision, space distortion

Procedia PDF Downloads 390

Authors: Salim Ouchtati, Jean Sequeira, Mouldi Bedda

Abstract:

In this work we present an off line system for the recognition of the Arabic handwritten words of the Algerian departments. The study is based mainly on the evaluation of neural network performances, trained with the gradient back propagation algorithm. The used parameters to form the input vector of the neural network are extracted on the binary images of the handwritten word by several methods: the parameters of distribution, the moments centered of the different projections and the Barr features. It should be noted that these methods are applied on segments gotten after the division of the binary image of the word in six segments. The classification is achieved by a multi layers perceptron. Detailed experiments are carried and satisfactory recognition results are reported.

Keywords: handwritten word recognition, neural networks, image processing, pattern recognition, features extraction

Procedia PDF Downloads 514

Authors: Khaled M. El-Naggar

Abstract:

This paper presents a fast and efficient technique for monitoring and supervising power system disturbances generated due to dynamic performance of power systems or faults. Monitoring power system quantities involve monitoring fundamental voltage, current magnitudes, and their frequencies as well as their negative and zero sequence components under different operating conditions. The proposed technique is based on simulated annealing optimization technique (SA). The method uses digital set of measurements for the voltage or current waveforms at power system bus to perform the estimation process digitally. The algorithm is tested using different simulated data to monitor the symmetrical components of power system waveforms. Different study cases are considered in this work. Effects of number of samples, sampling frequency and the sample window size are studied. Results are reported and discussed.

Keywords: estimation, faults, measurement, symmetrical components

Procedia PDF Downloads 465

Authors: Charlotte Bach, Albrecht Jahn, Mahnaz Motamedi, Maryam Karimi-Ghahfarokhi

Abstract:

Background: Maternal and infant deaths are most prevalent in the first month after birth, emphasizing the critical need for quality healthcare services during this period. Immigrant women, who are more susceptible to adverse pregnancy outcomes, often face neglect in accessing proper healthcare. The lack of adequate postpartum care significantly contributes to mortality rates. Therefore, utilizing maternal health care services and implementing postpartum care is crucial in reducing maternal and child mortality. Aims: This study aims to evaluate the assessment of pre- and postnatal care among women with and without migration background. In addition, the study explores the impact of COVID-19 procedures on women's experiences during pregnancy, birth, and the postpartum period. Methods: This research employs a cross-sectional Mixed-Method design. Data collection was facilitated through structured questionnaires administered to participants, alongside the utilization of patient bases, including Maternity and child medical records. Following the assumption that the investigator aimed to gain comprehensive insights, qualitative sampling focused on individuals with substantial experiences related to COVID-19, regarded as rich cases. Results: our study highlighted the influence of educational level, marital status, and consensual partnerships on the likelihood of Cesarean deliveries. Regarding breastfeeding practices, migrant women exhibited higher rates of breastfeeding initiation and continuation. Contraception utilization revealed interesting patterns, with non-migrants displaying higher odds of contraceptive use. The qualitative component of our research adds depth to the exploration of women's experiences during the COVID-19 pandemic, revealing nuanced challenges related to anxiety, hospital restrictions, breastfeeding support, and postnatal ward routines. Conclusion: Dissimilarity among studies toward cesarean rate between migrants and non-migrants underscores the importance of targeted interventions considering the diverse needs of distinct population groups. It also acknowledges potential cultural, contextual, and healthcare system influences on the association between mode of delivery and infant feeding practices. Studies acknowledge the influence of contextual variables on contraceptive preferences among migrants and non-migrants, emphasizing the need for tailored healthcare policies. The findings contribute to existing research, highlighting the need for a nuanced understanding of the impact of birth preparation courses on maternal and infant outcomes. Furthermore, they emphasize the universality of certain maternity care experiences, regardless of pandemic contexts, reinforcing the importance of patient-centred approaches in healthcare delivery.

Keywords: migration background, pregnancy outcome, covid-19, postpartum

Procedia PDF Downloads 56

Authors: Srikanta Tagore Sarkar, Prasanta Kumar Mandal, Dibakar Roy

Abstract:

The association of a capitate fracture with a scaphoid fracture has been termed as the naviculocapitate syndrome. The existence of some nondisplaced fractures of scaphoid and capitate with or without the fracture of lunate or radius suggests that there is a spectrum of these injuries, and this confuses the terminology. With our case; we report an unusual variety of this naviculocapitate syndrome with distal radial Colles fracture in addition to the nondisplaced fractures of the scaphoid, capitate and the dorsal lip of radial fracture. When we looked at the literature there is no another Colles fracture reported together with undisplaced scapho-capitate syndrome. The coronal and sagittal images that obtained from the MDCT (Multidetector computed tomography) is useful and effective imaging modality to diagnose complex wrist fractures with more details that are not detected in X-rays.

Keywords: scaphoid, capitate, Colles’ fracture, syndrome, MDCT, unusual

Procedia PDF Downloads 394

Authors: Muhammad A. Ado, Intan S. Ismail, Hasanah M. Ghazali, Faridah Abas

Abstract:

In this study, we have investigated the phytochemical constituents of soluble fractions of dichloromethane (DCM) of methanolic leaves extract of the Callicarpa maingayi. The phytochemicals investigation has resulted in the isolation of three triterpenoids (euscaphic acid (1), arjunic acid (2), and ursolic acid (3)) together with two flavones apigenin (4) and acacetin (5)), two phytosterols (stigmasterol 3-O-β-glycopyranoside (6) and sitosterol 3-O-β-glycopyranoside (7)), and one fatty acid (n-hexacosanoic acid (8)). Six (6) compounds isolated from this species were isolated for the first time (1, 2, 3, 4, 5, and 8). Their structures were elucidated and identified by spectral methods of one and two-dimensional NMR techniques, gas chromatography-mass spectrometry, and comparison with the previously reported literature. The biological activity of three compounds (1-3) was carried out on acetylcholinesterase inhibition activity. Compound (3) was found to displayed good inhibition against AChE with an IC₅₀ value of 21.5 ± 0.022 μM.

Keywords: acetylcholinesterase, Callicarpa maingayi, euscaphic acid, ursolic acid

Procedia PDF Downloads 147

Authors: Shweta Shriwas, Sumeet Dwivedi, Raghvendra Dubey

Abstract:

Plumeria pudica Linn. Family Apocynaceae commonly known as Nag Chmapa is grown wildly in many parts of India. The plant is medium size shrub, grown up to height of 5-10 feet, evergreen with white flowers. In traditional system of medicine, the plant is widely used in the treatment of worms, infection, inflammation, etc. So, far no any systematic and documented study was done to revealed quality control parameters and pharmacological aspect of the selected plant species, therefore, the attempt was made in present investigation to reveal the same. The parameters such as Ash value, FOM, LOD, SI, etc. were studied using various coarsely dried plant materials of the species. Analgesic, anti-inflammatory, anthelmentic and anti-microbial activity of various extract was investigated and reported in present work.

Keywords: Plumeria pudica, quality control, pharmacology, parameters

Procedia PDF Downloads 217

Authors: Terungwa Simon Yange, Agana Moses A.

Abstract:

This paper studied steganography and designed a simplistic approach to a steganographic tool for hiding information in image files with the view of addressing the security challenges with data by hiding data from unauthorized users to improve its security. The Structured Systems Analysis and Design Method (SSADM) was used in this work. The system was developed using Java Development Kit (JDK) 1.7.0_10 and MySQL Server as its backend. The system was tested with some hypothetical health records which proved the possibility of protecting data from unauthorized users by making it secret so that its existence cannot be easily recognized by fraudulent users. It further strengthens the confidentiality of patient records kept by medical practitioners in the health setting. In conclusion, this work was able to produce a user friendly steganography software that is very fast to install and easy to operate to ensure privacy and secrecy of sensitive data. It also produced an exact copy of the original image and the one carrying the secret message when compared with each.

Keywords: steganography, cryptography, encryption, decryption, secrecy

Procedia PDF Downloads 266

Authors: Aftab Ahmed, Ghulam Mehboob

Abstract:

The object of presentation is to highlight the importance of condition which is a very rare genetic disorder although Paget’s disease is common but its juvenile type is very rare and a late presentation due to very slow onset and lack of earlier standard management. We present a case of 25 years old male with a chronic history of bone pain and a slow onset of mild swelling, later on diagnosed as juvenile Paget disease of bone. Rarity of this condition with inaccessibility for standard health treatment can lead to a significant delay in presentation and its management. There have been 50 reported cases worldwide according to Genetic Home Reference. There is increased osteoclastic activity along with osteoblastic activity related to gene alteration and osteoprotegrin deficiency. Morbidity of disease is very significant which lead children to become immobilize.

Keywords: juvenile, Paget’s disease, bone, Northern Area of Pakistan

Procedia PDF Downloads 329

Authors: Ching-Yu Liao, Ju-Joan Wong

Abstract:

Recent years have shown a trend of younger stroke patients and an increase in ischemic strokes with the rise in stroke incidence. This has led to a growing demand for telemedicine, particularly during the COVID-19 pandemic, which has made the need for telemedicine even more urgent. This shift in healthcare is also closely related to advancements in Internet of Things (IoT) technology. Stroke-induced hemiparesis is a significant issue for patients. The medical community believes that if intervention occurs within three to six months of stroke onset, 80% of the residual effects can be restored to normal, a period known as the stroke golden period. During this time, patients undergo treatment and rehabilitation, and neural plasticity is at its best. Lower limb rehabilitation for stroke generally includes exercises such as support standing and walking posture, typically involving the healthy limb to guide the affected limb to achieve rehabilitation goals. Existing gait training aids in hospitals usually involve balance gait, sitting posture training, and precise muscle control, effectively addressing issues of poor gait, insufficient muscle activity, and inability to train independently during recovery. However, home training aids, such as braced and wheeled devices, often rely on the healthy limb to pull the affected limb, leading to lower usage of the affected limb, worsening circular walking, and compensatory movement issues. IoT technology connects devices via the internet to record, receive data, provide feedback, and adjust equipment for intelligent effects. Therefore, this study aims to explore how IoT can be integrated into existing gait training aids to monitor and sensor home rehabilitation movements, improve gait training compensatory issues through real-time feedback, and enable healthcare professionals to quickly understand patient conditions and enhance medical communication. To understand the needs of hemiparetic patients, a review of relevant literature from the past decade will be conducted. From the perspective of user experience, participant observation will be used to explore the use of home training aids by stroke patients and therapists, and interviews with physical therapists will be conducted to obtain professional opinions and practical experiences. Design specifications for home training aids for hemiparetic patients will be summarized. Applying IoT technology to lower limb training aids for stroke hemiparesis can help promote walking function recovery in hemiparetic patients, reduce muscle atrophy, and allow healthcare professionals to immediately grasp patient conditions and adjust gait training plans based on collected and analyzed information. Exploring these potential development directions provides a valuable reference for the further application of IoT technology in the field of medical rehabilitation.

Keywords: stroke, hemiplegia, rehabilitation, gait training, internet of things technology

Procedia PDF Downloads 32

Authors: Hafizan Junoh, Kumaran Palanisamy, Yip Chan Heng, Pua Fei Ling

Abstract:

This study investigates the influence of low temperature thermo-chemical pretreatment of organic food waste on the performance of COD solubilisation. Both temperature and alkaline agent were reported to have an effect on solubilizing any possible biomass including organic food waste. The three independent variables considered in this pretreatment were temperature (50-90oC), pretreatment time (30-120 minutes) and alkaline concentration, sodium hydroxide, NaOH (0.7-15 g/L). The optimal condition obtained were 90oC, 15 g/L NaOH for 2 hours. Solubilisation has potential in enhancing methane production by providing a high amount of soluble components at an early stage during anaerobic digestion.

Keywords: food waste, pretreatments, respond surface methodology, ANOVA, anaerobic digestion

Procedia PDF Downloads 554

Authors: Rizwan Arshad, Alessio Panza, Nimra Inayat, Syeda Mariam Batool Kazmi, Shawana Azmat

Abstract:

The rapidly expanding use of immunotherapy for a wide range of cancers from late to early stages has, predictably, been accompanied by evidence of inequities in access to these highly effective but costly treatments. In this survey-based case study, we aimed to develop a One-window services model (OWSM) based on Anderson’s behavioral model to enhance competence in accessing cancer medications, particularly immunotherapies, through the analysis of 20 patient surveys conducted in the Armed forces bone marrow transplant center of the district, Rawalpindi from November to December 2022. The purposive sampling technique was used. Cronbach’s alpha coefficient was found to be 0.71. It was analyzed using SPSS version 26 with descriptive analysis, and results showed that the majority of the cancer patients were non-competent to access their prescribed cancer immunotherapy because of individual-level, socioeconomic, and organizational barriers.

Keywords: cancer immunotherapy, one-window services model, accessibility, competence

Procedia PDF Downloads 76

Authors: Sangeeta Girdhar, Amanat Grewal, Nahush Bansal

Abstract:

Introduction: There is an increasing burden of hypertension in India. The morbidity and mortality arising from complications are mainly due to non-adherence to medication, unhealthy dietary habits, and lack of physical activity. Non-adherence is a well-recognised factor contributing to inadequate control of high blood pressure. Adherence to pharmacotherapy for hypertension varies from 43% to 88%. Non-adherence is influenced by various socio-demographic factors. Understanding these factors is useful in managing non-adherence. Therefore, the study was planned to determine adherence among hypertensives and factors associated with non-adherence to treatment. Methodology: A cross-sectional study was conducted at Urban Health Training Centre of Dayanand Medical College and Hospital Ludhiana. Patients attending the OPD over a period of 3 months were included in the study. Prior ethical approval was obtained, and informed consent was taken from subjects. A predesigned semi-structured questionnaire was applied, which included socio-demographic profile, treatment-seeking behaviour, adherence to the antihypertensive medication, lifestyle factors (intake of alcohol, smoking, consumption of junk food, high salt intake) contributing to the development of the disease. Reasons for non-adherence to the therapy were also explored. Data was entered into excel, and SPSS 26 version was used for analysis. Results: A total of 186 individuals were interviewed. Out of these, 113 females (60.8%) and 73 males (39.2%) participated in the study. Mean age of participants was 60.9 ± 10.7 years. Adherence to anti-hypertensive treatment was found in 68.3% of the participants. It was observed that adherence was more in literate individuals as compared to illiterate (p value- 0.78). Adherence was lower among smokers (33.3%) and alcohol consumers (53.8%) as compared to non-users (69.4% and 70.6%, respectively). The predominant reasons for skipping medications were discontinuing medication when feeling well, forgetfulness and unawareness. Conclusion: There is a need to generate awareness regarding the importance of adherence to therapy among patients. Intensive health education and counselling of the patients is the need of the hour.

Keywords: hypertension, anti-hypertensive, adherence, counselling

Procedia PDF Downloads 91

Authors: Zhuang Yiwen

Abstract:

The paper examines the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. One of the major challenges identified is the lack of a standard coding system for medical devices, which makes it difficult to track them effectively. The paper suggests the use of the Unique Device Identifier (UDI) as a single standard for medical devices to improve tracking and reduce errors. The paper also explores the use of barcoding and image recognition to identify and document medical devices in nursing practices. In nursing practices, the use of barcodes for identifying medical devices is common. However, the information contained in these barcodes is often inconsistent, making it challenging to identify which segment contains the model identifier. Moreover, the use of barcodes may be improved with the use of UDI, but many subsidized accessories may still lack barcodes. The paper suggests that the readiness for UDI and barcode standardization requires standardized information, fields, and logic in electronic medical record (EMR), operating theatre (OT), and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. Nursing workflow and data flow also need to be taken into account. The paper also explores the use of image recognition, specifically the Tesseract OCR engine, to identify and document implants in public hospitals due to limitations in barcode scanning. The study found that the solution requires an implant information database and checking output against the database. The solution also requires customization of the algorithm, cropping out objects affecting text recognition, and applying adjustments. The solution requires additional resources and costs for a mobile/hardware device, which may pose space constraints and require maintenance of sterile criteria. The integration with EMR is also necessary, and the solution require changes in the user's workflow. The paper suggests that the long-term use of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) as a supporting terminology to improve clinical documentation and data exchange in healthcare. SNOMED CT provides a standardized way of documenting and sharing clinical information with respect to procedure, patient and device documentation, which can facilitate interoperability and data exchange. In conclusion, the paper highlights the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. The paper suggests the use of UDI and barcode standardization to improve tracking and reduce errors. It also explores the use of image recognition to identify and document medical devices in nursing practices. The paper emphasizes the importance of standardized information, fields, and logic in EMR, OT, and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. These recommendations could help the Singapore healthcare system to improve tracking and traceability of medical devices and ultimately enhance patient safety.

Keywords: medical device tracking, unique device identifier, barcoding and image recognition, systematized nomenclature of medicine clinical terms

Procedia PDF Downloads 79

Authors: Florence Roselle Adalin, Misha Louise Delariarte, Fabbette Laire Lagas, Sarah Emanuelle Mejia, Lika Mizukoshi, Irish Paullen Palomeno, Gibrianne Alistaire Ramos, Danica Pauline Ramos, Josefina Tuazon, Jo Leah Flores

Abstract:

Pain, often a missed and undertreated symptom, affects the quality of life of individuals. Nurses are key players in providing effective pain management to decrease morbidity and mortality of patients in pain. Nurses’ knowledge and attitude on pain greatly affect their ability on assessment and management. The Pain Society of the Philippines recognized the inadequacy and inaccessibility of data on the knowledge, skills, and attitude of nurses on pain management in the country. This study may be the first of its kind in the county, giving it the potential to contribute greatly to nursing education and practice through providing valuable baseline data. Objectives: This study aims to describe the level of knowledge and attitude, and current practices of nurses on pain assessment and management; and determine the relationship of nurses’ knowledge and attitude with years of experience, training on pain management and clinical area of practice. Methodology: A survey research design was employed. Four hospitals were selected through purposive sampling. A total of 235 Medical-Surgical Unit and Intensive Care Unit (ICU) nurses participated in the study. The tool used is a combination of demographic survey, Nurses’ Knowledge and Attitude Survey Regarding Pain (NKASRP), Acute Pain Evidence Based Practice Questionnaire (APEBPQ) with self-report questions on non-pharmacologic pain management. The data obtained was analysed using descriptive statistics, two sample T-tests for clinical areas and training; and Pearson product correlation to identify relationship of level of knowledge and attitude with years of experience. Results and Analysis: The mean knowledge and attitude score of the nurses was 47.14%. Majority answered ‘most of the time’ or ‘all the time’ on 84.12% of practice items on pain assessment, implementation of non-pharmacologic interventions, evaluation and documentation. Three of 19 practice items describing morphine and opioid administration in special populations were only done ‘a little of the time’. Most utilized non-pharmacologic interventions were deep breathing exercises (79.66%), massage therapy (27.54%), and ice therapy (26.69%). There was no significant relationship between knowledge scores and years of clinical experience (p = 0.05, r= -0.09). Moreover, there was not enough evidence to show difference in nurses’ knowledge and attitude scores in relation to presence of training (p = 0.41) or areas (Medical-Surgical or ICU) of clinical practice (p = 0.53). Conclusion and Recommendations: Findings of the study showed that the level of knowledge and attitude of nurses on pain assessment and management is suboptimal; and no relationship between nurses’ knowledge and attitude and years of experience. It is recommended that further studies look into the nursing curriculum on pain education, culture-specific pain management protocols and evidence-based practices in the country.

Keywords: knowledge and attitude, nurses, pain management, practices on pain management

Procedia PDF Downloads 349

Authors: Subodh Kumar, Sanjeev Kumar Sharma, Gaurav Kaushik, Pramod Avti, Phulen Sarma, Bikash Medhi, Krishan Lal Khanduja

Abstract:

Background: It is well known that cigarette smoke is one of the causative factors in various lung diseases especially cancer. Carcinogens and oxidant molecules present in cigarette smoke not only damage the cellular constituents (lipids, proteins, DNA) but may also regulate the molecular pathways involved in inflammation and cancer. Continuous oxidative stress caused by the constituents of cigarette smoke leads to higher PhospholipaseA₂ (PLA₂) activity, resulting in elevated levels of secondary metabolites whose role is well defined in cancer. To reduce the burden of chronic inflammation as well as oxidative stress, and higher levels of secondary metabolites, we checked the curative potential of PLA₂ inhibitor Bromoenol Lactone (BEL) during continuous exposure of cigarette smoke condensate (CSC). Aim: To check the therapeutic potential of Bromoenol Lactone (BEL), an inhibitor of PhospholipaseA₂s, in pathways of CSC-induced changes in type I and type II alveolar epithelial cells. Methods: Effect of BEL on CSC-induced PLA2 activity were checked using colorimetric assay, cellular toxicity using cell viability assay, membrane integrity using fluorescein di-acetate (FDA) uptake assay, reactive oxygen species (ROS) levels and apoptosis markers through flow cytometry, and cellular regulation using MAPKinases levels, in lung epithelium. Results: BEL significantly mimicked CSC-induced PLA₂ activity, ROS levels, apoptosis, and kinases level whereas improved cellular viability and membrane integrity. Conclusions: Current observations revealed that BEL may be a potential therapeutic agent during Cigarette smoke-induced anomalies in lung epithelium.

Keywords: cigarette smoke condensate, phospholipase A₂, oxidative stress, alveolar epithelium, bromoenol lactone

Procedia PDF Downloads 189

Authors: Prangya P. Sahoo, B. S. Murty

Abstract:

The present study deals with phase evolution of oxide dispersed CoCrFeMnNi high entropy alloy as a function of amount of added Y2O3 during mechanical alloying and analysis of grain growth kinetics of CoCrFeMnNi high entropy alloy without and with oxide dispersion. Mechanical alloying of CoCrFeMnNi resulted in a single FCC phase. However, evolution of chromium carbide was observed after heat treatment between 1073 and 1473 K. Comparison of grain growth time exponents and activation energy barrier is also reported. Micro structural investigations, using electron microscopy and EBSD techniques, were carried out to confirm the enhanced grain growth resistance which is attributed to the presence oxide dispersoids.

Keywords: grain growth kinetics, mechanical alloying, oxide dispersion, phase evolution

Procedia PDF Downloads 431

Authors: Janine Sommer, Mariana Daus, Mariana Simon, Maria Smith, Daniel Luna

Abstract:

The technologies and communication advances contributed to new tools development which allows patients to have an active role in their own health. In the light of information needs and paradigms changes about health, the patient self-manages their care. This line of care focuses on patients; specific portals come up to people with particular requirements like pregnant women. Thinking of a portal design to this sector of the population, in September 2016 a survey was made to users with the objective to knowing and understanding information’s needs at the moment to use an application for pregnant. Also, prototypes of the portal´s features were designed to try and validate with users, using the methodology of human-centered design. Investigations have made possible the identification of needs of this population and develop a tool who try to satisfy, providing timely information for each part of pregnancy and allowing the patients to make a physical check and the follow up of pregnancy seeking advice from our obstetricians.

Keywords: electronic health record, health personal record, mobile applications, pregnant women

Procedia PDF Downloads 351

Authors: Seok Hong Min, Tae Kwon Ha

Abstract:

With the increasing interest on Ti alloys, the extraction process of Ti from its typical ore, TiO₂, has long been and will be important issue. As an intermediate product for the production of pigment or titanium metal sponge, tetrachloride (TiCl₄) is produced by fluidized bed using high TiO₂ feedstock. The purity of TiCl₄ after chlorination is subjected to the quality of the titanium feedstock. Since the impurities in the TiCl₄ product are reported to final products, the purification process of the crude TiCl₄ is required. The purification process includes fractional distillation and chemical treatment, which depends on the nature of the impurities present and the required quality of the final product. In this study, thermodynamic analysis on the impurity effect in the chlorination process, which is the first step of extraction of Ti from TiO₂, has been conducted. All thermodynamic calculations were performed using the FactSage thermodynamical software.

Keywords: rutile, titanium, chlorination process, impurities, thermodynamic calculation, FactSage

Procedia PDF Downloads 308