Search results for: primary prevention
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5818

Search results for: primary prevention

2368 Effect of Jatropha curcas Leaf Extract on Castor Oil Induced Diarrhea in Albino Rats

Authors: Fatima U. Maigari, Musa Halilu, M. Maryam Umar, Rabiu Zainab

Abstract:

Plants as therapeutic agents are used as drug in many parts of the world. Medicinal plants are mostly used in developing countries due to culture acceptability, belief or due to lack of easy access to primary health care services. Jatropha curcas is a plant from the Euphorbiaceae family which is widely used in Northern Nigeria as an anti-diarrheal agent. This study was conducted to determine the anti-diarrheal effect of the leaf extract on castor oil induced diarrhea in albino rats. The leaves of J. curcas were collected from Balanga Local government in Gombe State, north-eastern Nigeria; due to its bioavailability. The leaves were air-dried at room temperature and ground to powder. Phytochemical screening was done and different concentrations of the extract was prepared and administered to the different categories of experimental animals. From the results, aqueous leaf extract of Jatropha curcas at doses of 200mg/Kg and 400mg/Kg was found to reduce the mean stool score as compared to control rats, however, maximum reduction was achieved with the standard drug of Loperamide (5mg/Kg). Treatment of diarrhea with 200mg/Kg of the extract did not produce any significant decrease in stool fluid content but was found to be significant in those rats that were treated with 400mg/Kg of the extract at 2hours (0.05±0.02) and 4hours (0.01±0.01). A significant reduction of diarrhea in the experimental animals signifies it to possess some anti-diarrheal activity.

Keywords: anti-diarrhea, diarrhea, Jatropha curcas, loperamide

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2367 Optimal Wind Based DG Placement Considering Monthly Changes Modeling in Wind Speed

Authors: Belal Mohamadi Kalesar, Raouf Hasanpour

Abstract:

Proper placement of Distributed Generation (DG) units such as wind turbine generators in distribution system are still very challenging issue for obtaining their maximum potential benefits because inappropriate placement may increase the system losses. This paper proposes Particle Swarm Optimization (PSO) technique for optimal placement of wind based DG (WDG) in the primary distribution system to reduce energy losses and voltage profile improvement with four different wind levels modeling in year duration. Also, wind turbine is modeled as a DFIG that will be operated at unity power factor and only one wind turbine tower will be considered to install at each bus of network. Finally, proposed method will be implemented on widely used 69 bus power distribution system in MATLAB software environment under four scenario (without, one, two and three WDG units) and for capability test of implemented program it is supposed that all buses of standard system can be candidate for WDG installing (large search space), though this program can consider predetermined number of candidate location in WDG placement to model financial limitation of project. Obtained results illustrate that wind speed increasing in some months will increase output power generated but this can increase / decrease power loss in some wind level, also results show that it is required about 3MW WDG capacity to install in different buses but when this is distributed in overall network (more number of WDG) it can cause better solution from point of view of power loss and voltage profile.

Keywords: wind turbine, DG placement, wind levels effect, PSO algorithm

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2366 Sustainability of Ecotourism Related Activities in the Town of Yercaud: A Modeling Study

Authors: Manoj Gupta Charan Pushparaj

Abstract:

Tourism related activities are getting popular day by day and tourism has become an integral part of everyone’s life. Ecotourism initiatives have grown enormously in the past decade, and the concept of ecotourism has shown to bring great benefits in terms of environment conservation and to improve the livelihood of local people. However, the potential of ecotourism to sustain improving the livelihood of the local population in the remote future is a topic of active debate. A primary challenge that exists in this regard is the enormous costs of limiting the impacts of tourism related activities on the environment. Here we employed systems modeling approach using computer simulations to determine if ecotourism activities in the small hill town of Yercaud (Tamil Nadu, India) can be sustained over years in improving the livelihood of the local population. Increasing damage to the natural environment as a result of tourism-related activities have plagued the pristine hill station of Yercaud. Though ecotourism efforts can help conserve the environment and enrich local population, questions remain if this can be sustained in the distant future. The vital state variables in the model are the existing tourism foundation (labor, services available to tourists, etc.,) in the town of Yercaud and its natural environment (water, flora and fauna). Another state variable is the textile industry that drives the local economy. Our results would help to understand if environment conservation efforts are sustainable in Yercaud and would also offer suggestions to make it sustainable over the course of several years.

Keywords: ecotourism, simulations, modeling, Yercaud

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2365 Balancing Act: Political Dynamics of Economic and Climatological Security in the Politics of the Middle East

Authors: Zahra Bakhtiari

Abstract:

Middle East countries confront a multitude of main environmental challenges which are inevitable. The unstable economic and political structure which dominates numerous middle East countries makes it difficult to react effectively to unfavorable climate change impacts. This study applies a qualitative methodology and relies on secondary literature aimed to investigate how countries in the Middle East are balancing economic security and climatic security in terms of budgeting, infrastructure investment, political engagement (domestically through discourses or internationally in terms of participation in international organizations or bargaining, etc.) There has been provided an outline of innovative measures in both economic and environmental fields that are in progress in the Middle East countries and what capacity they have for economic development and environmental adaptation, as well as what has already been performed. The primary outcome is that countries that rely more on infrastructure investment such as negative emissions technologies (NET) through green social capital enterprises and political engagement, especially nationally determined contributions (NDCs) commitments and United Nations Framework Convention on Climate Change (UNFCCC), experience more economic and climatological security balance in the Middle East. Since implementing these measures is not the same in all countries in the region, we see different levels of balance between climate security and economic security. The overall suggestion is that the collaboration of both the bottom-up and top-down approaches helps create strategic environmental strategies which are in line with the economic circumstances of each country and creates the desired balance.

Keywords: climate change, economic growth, sustainability, the Middle East, green economy, renewable energy

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2364 Experimental Investigation of Gas Bubble Behaviours in a Domestic Heat Pump Water Heating System

Authors: J. B. Qin, X. H. Jiang, Y. T. Ge

Abstract:

The growing awareness of global warming potential has internationally aroused interest and demand in reducing greenhouse gas emissions produced by human activity. Much national energy in the UK had been consumed in the residential sector mainly for space heating and domestic hot water production. Currently, gas boilers are mostly applied in the domestic water heating which contribute significantly to excessive CO2 emissions and consumption of primary energy resources. The issues can be solved by popularizing heat pump systems that are attributable to higher performance efficiency than those of traditional gas boilers. Even so, the heat pump system performance can be further enhanced if the dissolved gases in its hot water circuit can be efficiently discharged.  To achieve this target, the bubble behaviors in the heat pump water heating system need to be extensively investigated. In this paper, by varying different experimental conditions, the effects of various heat pump hot water side parameters on gas microbubble diameters were measured and analyzed. Correspondingly, the effect of each parameter has been investigated. These include varied system pressures, water flow rates, saturation ratios and heat outputs. The results measurement showed that the water flow rate is the most significant parameter to influence on gas microbubble productions. The research outcomes can significantly contribute to the understanding of gas bubble behaviors at domestic heat pump water heating systems and thus the efficient way for the discharging of the associated dissolved gases.  

Keywords: heat pump water heating system, microbubble formation, dissolved gases in water, effectiveness

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2363 Nonlinear Passive Shunt for Electroacoustic Absorbers Using Nonlinear Energy Sink

Authors: Diala Bitar, Emmanuel Gourdon, Claude H. Lamarque, Manuel Collet

Abstract:

Acoustic absorber devices play an important role reducing the noise at the propagation and reception paths. An electroacoustic absorber consists of a loudspeaker coupled to an electric shunt circuit, where the membrane is playing the role of an absorber/reflector of sound. Although the use of linear shunt resistors at the transducer terminals, has shown to improve the performances of the dynamical absorbers, it is nearly efficient in a narrow frequency band. Therefore, and since nonlinear phenomena are promising for their ability to absorb the vibrations and sound on a larger frequency range, we propose to couple a nonlinear electric shunt circuit at the loudspeaker terminals. Then, the equivalent model can be described by a 2 degrees of freedom system, consisting of a primary linear oscillator describing the dynamics of the loudspeaker membrane, linearly coupled to a cubic nonlinear energy sink (NES). The system is analytically treated for the case of 1:1 resonance, using an invariant manifold approach at different time scales. The proposed methodology enables us to detect the equilibrium points and fold singularities at the first slow time scales, providing a predictive tool to design the nonlinear circuit shunt during the energy exchange process. The preliminary results are promising; a significant improvement of acoustic absorption performances are obtained.

Keywords: electroacoustic absorber, multiple-time-scale with small finite parameter, nonlinear energy sink, nonlinear passive shunt

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2362 Study of Polyphenol Profile and Antioxidant Capacity in Italian Ancient Apple Varieties by Liquid Chromatography

Authors: A. M. Tarola, R. Preti, A. M. Girelli, P. Campana

Abstract:

Safeguarding, studying and enhancing biodiversity play an important and indispensable role in re-launching agriculture. The ancient local varieties are therefore a precious resource for genetic and health improvement. In order to protect biodiversity through the recovery and valorization of autochthonous varieties, in this study we analyzed 12 samples of four ancient apple cultivars representative of Friuli Venezia Giulia, selected by local farmers who work on a project for the recovery of ancient apple cultivars. The aim of this study is to evaluate the polyphenolic profile and the antioxidant capacity that characterize the organoleptic and functional qualities of this fruit species, besides having beneficial properties for health. In particular, for each variety, the following compounds were analyzed, both in the skins and in the pulp: gallic acid, catechin, chlorogenic acid, epicatechin, caffeic acid, coumaric acid, ferulic acid, rutin, phlorizin, phloretin and quercetin to highlight any differences in the edible parts of the apple. The analysis of individual phenolic compounds was performed by High Performance Liquid Chromatography (HPLC) coupled with a diode array UV detector (DAD), the antioxidant capacity was estimated using an in vitro essay based on a Free Radical Scavenging Method and the total phenolic compounds was determined using the Folin-Ciocalteau method. From the results, it is evident that the catechins are the most present polyphenols, reaching a value of 140-200 μg/g in the pulp and of 400-500 μg/g in the skin, with the prevalence of epicatechin. Catechins and phlorizin, a dihydrohalcone typical of apples, are always contained in larger quantities in the peel. Total phenolic compounds content was positively correlated with antioxidant activity in apple pulp (r2 = 0,850) and peel (r2 = 0,820). Comparing the results, differences between the varieties analyzed and between the edible parts (pulp and peel) of the apple were highlighted. In particular, apple peel is richer in polyphenolic compounds than pulp and flavonols are exclusively present in the peel. In conclusion, polyphenols, being antioxidant substances, have confirmed the benefits of fruit in the diet, especially as a prevention and treatment for degenerative diseases. They demonstrated to be also a good marker for the characterization of different apple cultivars. The importance of protecting biodiversity in agriculture was also highlighted through the exploitation of native products and ancient varieties of apples now forgotten.

Keywords: apple, biodiversity, polyphenols, antioxidant activity, HPLC-DAD, characterization

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2361 ALDH1A1 as a Cancer Stem Cell Marker: Value of Immunohistochemical Expression in Benign Prostatic Hyperplasia, Prostatic Intraepithelial Neoplasia, and Prostatic Adenocarcinoma

Authors: H. M. Abdelmoneim, N. A. Babtain, A. S. Barhamain, A. Z. Kufiah, A. S. Malibari, S. F. Munassar, R. S. Rawa

Abstract:

Introduction: Prostate cancer is one of the most common causes of morbidity and mortality in men in developed countries. Cancer Stem Cells (CSCs) could be responsible for the progression and relapse of cancer. Therefore, CSCs markers could provide a prognostic strategy for human malignancies. Aldehyde dehydrogenase 1A1 (ALDH1A1) activity has been shown to be associated with tumorigenesis and proposed to represent a functional marker for tumor initiating cells in various tumor types including prostate cancer. Material & Methods: We analyzed the immunohistochemical expression of ALDH1A1 in benign prostatic hyperplasia (BPH), prostatic intraepithelial neoplasia (PIN) and prostatic adenocarcinoma and assessed their significant correlations in 50 TURP sections. They were microscopically interpreted and the results were correlated with histopathological types and tumor grade. Results: In different prostatic histopathological lesions we found that ALDH1A1 expression was low in BPH (13.3%) and PIN (6.7%) and then its expression increased with prostatic adenocarcinoma (40%), and this was statistically highly significant (P value = 0.02). However, in different grades of prostatic adenocarcinoma we found that the higher the Gleason grade the higher the expression for ALDH1A1 and this was statistically significant (P value = 0.02). We compared the expression of ALDH1A1 in PIN and prostatic adenocarcinoma. ALDH1A1 expression was decreased in PIN and highly expressed in prostatic adenocarcinoma and this was statistically significant (P value = 0.04). Conclusion: Increasing ALDH1A1 expression is correlated with aggressive behavior of the tumor. Immunohistochemical expression of ALDH1A1 might provide a potential approach to study tumorigenesis and progression of primary prostate carcinoma.

Keywords: ALDH1A1, BPH, PIN, prostatic adenocarcinoma

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2360 Prevalence of Anaemia Amongst Antenatal Clinic Attendees at Booking: A Nigerian Study

Authors: S Eli, DGB Kalio, BOA Altraide, P Kua, DA MacPepple, FE Okonofua

Abstract:

Background: Anaemia in pregnancy is worrisome morbidity encountered by obstetricians and gynaecologist in the developing countries of the world. It is an indirect cause of maternal mortality and also a cause of perinatal mortality. Aim: The study aimed to ascertain the prevalence of anaemia amongst antenatal clinic (ANC) attendees at booking at The Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Rivers State, Nigeria. Method: The method was a cross-sectional study of ANC attendees at booking at RSUTH. The cut-off for anaemia by the WHO used for this study was packed cell volume (PCV) less than 33%. Simple randomized sampling method was used. Information was analyzed using SPSS version 25. Result: A total of 500 questionnaires were distributed, and 488 questionnaires retrieved. The mean age was of the ANC attendees was 31.44 years, and the modal parity was 0. Three hundred and fifty-seven (73.2%) of the respondents had a tertiary level of education, 126(25.8%) had a secondary level of education while 5 (1%) of the respondents had a primary level of education. Five (1%) of the respondents did not volunteer their educational status. The modal packed cell volume was 32%. Three hundred and eighty-two (78.3%) of the ANC attendees had PCV level less than 33% compared to 106 (21.7%) who had PCV equal or greater than 33%. Conclusion: The study revealed that the prevalence of anaemia in pregnancy amongst ANC attendees at the RSUTH was high, representing 73.3% of the subjects. Anaemia was common amongst multiparas (38.5%). Malaria prophylaxis, as well as encouraging pregnant women to be compliant with their routine antenatal drugs as well as counseling on the right diet, cannot be overemphasized during pregnancy. In addition, women should use family planning for child spacing for them to recover from previous pregnancies.

Keywords: anaemia, ANC attendees, Nigeria, prevalence

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2359 Efficacy of Heart Failure Reversal Treatment Followed by 90 Days Follow up in Chronic Heart Failure Patients with Low Ejection Fraction

Authors: Rohit Sane, Snehal Dongre, Pravin Ghadigaonkar, Rahul Mandole

Abstract:

The present study was designed to evaluate efficacy of heart failure reversal therapy (HFRT) that uses herbal procedure (panchakarma) and allied therapies, in chronic heart failure (CHF) patients with low ejection fraction. Methods: This efficacy study was conducted in CHF patients (aged: 25-65 years, ejection fraction (EF) < 30%) wherein HFRT (60-75 minutes) consisting of snehana (external oleation), swedana (passive heat therapy), hrudaydhara(concoction dripping treatment) and basti(enema) was administered twice daily for 7 days. During this therapy and next 30 days, patients followed the study dinarcharya and were prescribed ARJ kadha in addition to their conventional treatment. The primary endpoint of this study was evaluation of maximum aerobic capacity uptake (MAC) as assessed by 6-minute walk distance (6MWD) using Cahalins equation from baseline, at end of 7 day treatment, follow-up after 30 days and 90 days. EF was assessed by 2D Echo at baseline and after 30 days of follow-up. Results: CHF patients with < 30% EF (N=52, mean [SD] age: 58.8 [10.8], 85% men) were enrolled in the study. There was a 100% compliance to study therapy. A significant improvement was observed in MAC levels (7.11%, p =0.029), at end of 7 day therapy as compared to baseline. This improvement was maintained at two follow-up visits. Moreover, ejection fraction was observed to be increased by 6.38%, p=0,012 as compared to baseline at day 7 of the therapy. Conclusions: This 90 day follow up study highlights benefit of HFRT, as a part of maintenance treatment for CHF patients with reduced ejection fraction.

Keywords: chronic heart failure, functional capacity, heart failure reversal therapy, oxygen uptake, panchakarma

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2358 Land Art in Public Spaces Design: Remediation, Prevention of Environmental Risks and Recycling as a Consequence of the Avant-Garde Activity of Landscape Architecture

Authors: Karolina Porada

Abstract:

Over the last 40 years, there has been a trend in landscape architecture which supporters do not perceive the role of pro-ecological or postmodern solutions in the design of public green spaces as an essential goal, shifting their attention to the 'sculptural' shaping of areas with the use of slopes, hills, embankments, and other forms of terrain. This group of designers can be considered avant-garde, which in its activities refers to land art. Initial research shows that such applications are particularly frequent in places of former post-industrial sites and landfills, utilizing materials such as debris and post-mining waste in their construction. Due to the high degradation of the environment surrounding modern man, the brownfields are a challenge and a field of interest for the representatives of landscape architecture avant-garde, who through their projects try to recover lost lands by means of transformations supported by engineering and ecological knowledge to create places where nature can develop again. The analysis of a dozen or so facilities made it possible to come up with an important conclusion: apart from the cultural aspects (including artistic activities), the green areas formally referring to the land are important in the process of remediation of post-industrial sites and waste recycling (e. g. from construction sites). In these processes, there is also a potential for applying the concept of Natural Based Solutions, i.e. solutions allowing for the natural development of the site in such a way as to use it to cope with environmental problems, such as e.g.  air pollution, soil phytoremediation and climate change. The paper presents examples of modern parks, whose compositions are based on shaping the surface of the terrain in a way referring to the land art, at the same time providing an example of brownfields reuse and application of waste recycling.  For the purposes of object analysis, research methods such as historical-interpretation studies, case studies, qualitative research or the method of logical argumentation were used. The obtained results provide information about the role that landscape architecture can have in the process of remediation of degraded areas, at the same time guaranteeing the benefits, such as the shaping of landscapes attractive in terms of visual appearance, low costs of implementation, and improvement of the natural environment quality.

Keywords: brownfields, contemporary parks, landscape architecture, remediation

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2357 Comparison of Microwave-Assisted and Conventional Leaching for Extraction of Copper from Chalcopyrite Concentrate

Authors: Ayfer Kilicarslan, Kubra Onol, Sercan Basit, Muhlis Nezihi Saridede

Abstract:

Chalcopyrite (CuFeS2) is the most common primary mineral used for the commercial production of copper. The low dissolution efficiency of chalcopyrite in sulfate media has prevented an efficient industrial leaching of this mineral in sulfate media. Ferric ions, bacteria, oxygen and other oxidants have been used as oxidizing agents in the leaching of chalcopyrite in sulfate and chloride media under atmospheric or pressure leaching conditions. Two leaching methods were studied to evaluate chalcopyrite (CuFeS2) dissolution in acid media. First, the conventional oxidative acid leaching method was carried out using sulfuric acid (H2SO4) and potassium dichromate (K2Cr2O7) as oxidant at atmospheric pressure. Second, microwave-assisted acid leaching was performed using the microwave accelerated reaction system (MARS) for same reaction media. Parameters affecting the copper extraction such as leaching time, leaching temperature, concentration of H2SO4 and concentration of K2Cr2O7 were investigated. The results of conventional acid leaching experiments were compared to the microwave leaching method. It was found that the copper extraction obtained under high temperature and high concentrations of oxidant with microwave leaching is higher than those obtained conventionally. 81% copper extraction was obtained by the conventional oxidative acid leaching method in 180 min, with the concentration of 0.3 mol/L K2Cr2O7 in 0.5M H2SO4 at 50 ºC, while 93.5% copper extraction was obtained in 60 min with microwave leaching method under same conditions.

Keywords: extraction, copper, microwave-assisted leaching, chalcopyrite, potassium dichromate

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2356 Study on the Impact of Windows Location on Occupancy Thermal Comfort by Computational Fluid Dynamics (CFD) Simulation

Authors: Farhan E Shafrin, Khandaker Shabbir Ahmed

Abstract:

Natural ventilation strategies continue to be a key alternative to costly mechanical ventilation systems, especially in healthcare facilities, due to increasing energy issues in developing countries, including Bangladesh. Besides, overcrowding and insufficient ventilation strategies remain significant causes of thermal discomfort and hospital infection in Bangladesh. With the proper location of inlet and outlet windows, uniform flow is possible in the occupancy area to achieve thermal comfort. It also determines the airflow pattern of the ward that decreases the movement of the contaminated air. This paper aims to establish a relationship between the location of the windows and the thermal comfort of the occupants in a naturally ventilated hospital ward. It defines the openings and ventilation variables that are interrelated in a way that enhances or limits the health and thermal comfort of occupants. The study conducts a full-scale experiment in one of the naturally ventilated wards in a primary health care hospital in Manikganj, Dhaka. CFD simulation is used to explore the performance of various opening positions in ventilation efficiency and thermal comfort in the study area. The results indicate that the opening located in the hospital ward has a significant impact on the thermal comfort of the occupants and the airflow pattern inside the ward. The findings can contribute to design the naturally ventilated hospital wards by identifying and predicting future solutions when it comes to relationships with the occupants' thermal comforts.

Keywords: CFD simulation, hospital ward, natural ventilation, thermal comfort, window location

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2355 Prevalence of Anxiety and Depression: A Descriptive Cross-Sectional Study among Individuals with Substance-Related Disorders in Argentina

Authors: Badino Manuel, Farias María Alejandra

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Anxiety and depression are considered the main mental health issues found in people with substance-related disorders. Furthermore, substance-related disorders, anxiety-related and depressive disorders are among the leading causes of disability and are associated with increased mortality. The co-occurrence of substance-related disorders and these mental health conditions affect the accuracy in diagnosis, treatment plan, and recovery process. The aim is to describe the prevalence of anxiety and depression in patients with substance-related disorders in a mental health service in Córdoba, Argentina. A descriptive cross-sectional study was conducted among patients with substance-related disorders (N=305). Anxiety and depression were assessed using the Patient Health Questionnaire-4 (PHQ-4) during the period from December 2021 to March 2022. For a total of 305 participants, 71,8% were male, 25,6% female and 2,6% non-binary. As regards marital status, 51,5% were single, 21,6% as a couple, 5,9% married, 15,4% separated and 5,6% divorced. In relation to education status, 26,2% finished university, 56,1% high school, 16,4% only primary school and 1,3% no formal schooling. Regarding age, 10,8% were young, 84,3% were adults, and 4,9% were elderly. In-person treatment represented 64,6% of service users, and 35,4% were conducted through teleconsultation. 15,7% of service users scored 3 or higher for anxiety, and 32,1% scored 3 or higher for depression in the PHQ-4. 13,1% obtained a score of 3 or higher for both anxiety and depression. It is recommended to identify anxiety and depression among patients with substance-related disorders to improve the quality of diagnosis, treatment, and recovery. It is suggested to apply PHQ-4, PHQ-9 within the protocol of care for these patients.

Keywords: addiction, anxiety, depression, mental health

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2354 Global Emission Inventories of Air Pollutants from Combustion Sources

Authors: Shu Tao

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Based on a global fuel consumption data product (PKU-FUEL-2007) compiled recently and a series of databases for emission factors of various sources, global emission inventories of a number of greenhouse gases and air pollutants, including CO2, CO, SO2, NOx, primary particulate matter (total, PM 10, and PM 2.5), black carbon, organic carbon, mercury, volatile organic carbons, and polycyclic aromatic hydrocarbons, from combustion sources have been developed. The inventories feather high spatial and sectorial resolutions. The spatial resolution of the inventories are 0.1 by 0.1 degree, based on a sub-national disaggregation approach to reduce spatial bias due to uneven distribution of per person fuel consumption within countries. The finely resolved inventories provide critical information for chemical transport modeling and exposure modeling. Emissions from more than 60 sources in energy, industry, agriculture, residential, transportation, and wildfire sectors were quantified in this study. With the detailed sectorial information, the inventories become an important tool for policy makers. For residential sector, a set of models were developed to simulate temporal variation of fuel consumption, consequently pollutant emissions. The models can be used to characterize seasonal as well as inter-annual variations in the emissions in history and to predict future changes. The models can even be used to quantify net change of fuel consumption and pollutant emissions due to climate change. The inventories has been used for model ambient air quality, population exposure, and even health effects. A few examples of the applications are discussed.

Keywords: air pollutants, combustion, emission inventory, sectorial information

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2353 Utility of Optical Coherence Tomography (OCT) and Visual Field Assessment in Neurosurgical Patients

Authors: Ana Ferreira, Ines Costa, Patricia Polónia, Josué Pereira, Olinda Faria, Pedro Alberto Silva

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Introduction: Optical coherence tomography (OCT) and visual field tools are pivotal in evaluating neurological deficits and predicting potential visual improvement following surgical decompression in neurosurgical patients. Despite their clinical significance, a comprehensive understanding of their utility in this context is lacking in the literature. This study aims to elucidate the applications of OCT and visual field assessment, delineating distinct patterns of visual deficit presentations within the studied cohort. Methods: This retrospective analysis considered all adult patients who underwent a single surgery for pituitary adenoma or anterior skull base meningioma with optic nerve involvement, coupled with neuro-ophthalmology evaluation, between July 2020 and January 2023. A minimum follow-up period of 6 months was deemed essential. Results: A total of 24 patients, with a median age of 61, were included in the analysis. Three primary patterns emerged: 1) Low visual field involvement with compromised OCT, 2) High visual field involvement with relatively unaffected OCT, and 3) Significant compromise observed in both OCT and visual fields. Conclusion: This study delineates various findings in OCT and visual field assessments with illustrative examples. Based on the current findings, a prospective cohort will be systematically collected to further investigate and validate these patterns and their prognostic significance, enhancing our understanding of the utility of OCT and visual fields in neurosurgical patients.

Keywords: OCT, neurosurgery, visual field, optic nerve

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2352 China’s Grand Strategy and Greece

Authors: Alexandra Doga, Andreas Lioumpas, Sotiris Petropoulos

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This paper assesses China-Greece relations since 2006, examining them as part of China’s Grand Strategy and Greece’s perception of them. Τhe first aim of the paper is to provide an overview of China-Greece relations in connection with its long- and short-term goals. In essence, it focuses on understanding whether a Chinese grand strategy towards Greece exists. Secondly, it aims to examine the perception of Greeks over China’s foreign policy towards Greece. The intended contribution of the paper is to illustrate the response of national discourses over China’s increased presence in both the global sphere and specific countries in particular. This paper is based on qualitative analysis of secondary data as well as a thorough primary research scheme based on semi-structured interviews. The study made use of official Chinese government documents as well as academic journal articles and books. Local news outlets like newspapers provide data, and news surrounding Greece’s perception of China-Greece relations were also included. Moreover, a number of interviews of Greek officials, academics, journalists, and businessmen were conducted. This paper concluded that the period that began with the 2006 Joint Communiqué between China and Greece on the Establishment of Comprehensive Strategic Partnership has been one of the rapid strengthening of bilateral economic and political relations and frequent high-level visits. There are diverging/opposing views on whether China’s strategic choices towards Greece form part of a broader strategic approach and on whether this strategy is closely connected to the BRI initiative and its priorities.

Keywords: China, Greece, Grand Strategy, BRI, COSCO, Piraeus Port, Mediterranean

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2351 3G or 4G: A Predilection for Millennial Generation of Indian Society

Authors: Rishi Prajapati

Abstract:

3G is the abbreviation of third generation of wireless mobile telecommunication technologies. 3G is a mode that finds application in wireless voice telephony, mobile internet access, fixed wireless internet access, video calls and mobile TV. It also provides mobile broadband access to smartphones and mobile modems in laptops and computers. The first 3G networks were introduced in 1998, followed by 4G networks in 2008. 4G is the abbreviation of fourth generation of wireless mobile telecommunication technologies. 4G is termed to be the advanced form of 3G. 4G was firstly introduced in South Korea in 2007. Many abstracts have floated researches that depicted the diversity and similarity between the third and the fourth generation of wireless mobile telecommunications technology, whereas this abstract reflects the study that focuses on analyzing the preference between 3G versus 4G given by the elite group of the Indian society who are known as adolescents or the Millennial Generation aging from 18 years to 25 years. The Millennial Generation was chosen for this study as they have the easiest access to the latest technology. A sample size of 200 adolescents was selected and a structured survey was carried out which had several closed ended as well as open ended questions, to aggregate the result of this study. It was made sure that the effect of environmental factors on the subjects was as minimal as possible. The data analysis comprised of primary data collection reflecting it as quantitative research. The rationale behind this research is to give brief idea of how 3G and 4G are accepted by the Millennial Generation in India. The findings of this research would materialize a framework which depicts whether Millennial Generation would prefer 4G over 3G or vice versa.

Keywords: fourth generation, wireless telecommunication technology, Indian society, millennial generation, market research, third generation

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2350 Participatory Cartography for Disaster Reduction in Pogreso, Yucatan Mexico

Authors: Gustavo Cruz-Bello

Abstract:

Progreso is a coastal community in Yucatan, Mexico, highly exposed to floods produced by severe storms and tropical cyclones. A participatory cartography approach was conducted to help to reduce floods disasters and assess social vulnerability within the community. The first step was to engage local authorities in risk management to facilitate the process. Two workshop were conducted, in the first, a poster size printed high spatial resolution satellite image of the town was used to gather information from the participants: eight women and seven men, among them construction workers, students, government employees and fishermen, their ages ranged between 23 and 58 years old. For the first task, participants were asked to locate emblematic places and place them in the image to familiarize with it. Then, they were asked to locate areas that get flooded, the buildings that they use as refuges, and to list actions that they usually take to reduce vulnerability, as well as to collectively come up with others that might reduce disasters. The spatial information generated at the workshops was digitized and integrated into a GIS environment. A printed version of the map was reviewed by local risk management experts, who validated feasibility of proposed actions. For the second workshop, we retrieved the information back to the community for feedback. Additionally a survey was applied in one household per block in the community to obtain socioeconomic, prevention and adaptation data. The information generated from the workshops was contrasted, through T and Chi Squared tests, with the survey data in order to probe the hypothesis that poorer or less educated people, are less prepared to face floods (more vulnerable) and live near or among higher presence of floods. Results showed that a great majority of people in the community are aware of the hazard and are prepared to face it. However, there was not a consistent relationship between regularly flooded areas with people’s average years of education, house services, or house modifications against heavy rains to be prepared to hazards. We could say that the participatory cartography intervention made participants aware of their vulnerability and made them collectively reflect about actions that can reduce disasters produced by floods. They also considered that the final map could be used as a communication and negotiation instrument with NGO and government authorities. It was not found that poorer and less educated people are located in areas with higher presence of floods.

Keywords: climate change, floods, Mexico, participatory mapping, social vulnerability

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2349 Technological Affordances of a Mobile Fitness Application- A Role of Escapism and Social Outcome Expectation

Authors: Inje Cho

Abstract:

The leading health risks threatening the world today are associated with a modern lifestyle characterized by sedentary behavior, stress, anxiety, and an obesogenic food environment. To counter this alarming trend, the Centers for Disease Control and Prevention have proffered Physical Activity guidelines to bolster physical engagement. Concurrently, the burgeon of smartphones and mobile applications has witnessed a proliferation of fitness applications aimed at invigorating exercise adherence and real-time activity monitoring. Grounded in the Uses and gratification theory, this study delves into the technological affordances of mobile fitness applications, discerning the mediating influences of escapism and social outcome expectations on attitudes and exercise intention. The theory explains how individuals employ distinct communication mediums to satiate their exigencies and desires. Technological affordances manifest as attributes of emerging technologies that galvanize personal engagement in physical activities. Several features of mobile fitness applications include affordances for goal setting, virtual rewards, peer support, and exercise information. Escapism, denoting the inclination to disengage from normal routines, has emerged as a salient motivator for the consumption of new media. This study postulates that individual’s perceptions technological affordances within mobile fitness applications, can affect escapism and social outcome expectations, potentially influencing attitude, and behavior formation. Thus, the integrated model has been developed to empirically examine the interrelationships between technological affordances, escapism, social outcome expectations, and exercise intention. Structural Equation Modelling serves as the methodological tool, and a cohort of 400 Fitbit users shall be enlisted from the Prolific, data collection platform. A sequence of multivariate data analyses will scrutinize both the measurement and hypothesized structural models. By delving into the effects of mobile fitness applications, this study contributes to the growing of new media studies in sport management. Moreover, the novel integration of the uses and gratification theory, technological affordances, via the prism of escapism, illustrates the dynamics that underlies mobile fitness user’s attitudes and behavioral intentions. Therefore, the findings from this study contribute to theoretical understanding and provide pragmatic insights to developers and practitioners in optimizing the impact of mobile fitness applications.

Keywords: technological affordances, uses and gratification, mobile fitness apps, escapism, physical activity

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2348 Elderly Care for Bereaved Parents Following the Death of an Only Child in Mainland China

Authors: Chao Fang

Abstract:

Due to the Confucian emphasis on filial piety and an undeveloped social welfare system in mainland China, adult children are both socially and legally obliged to care for their parents, including financial assistance and physical care as well as emotional and social support. Thus a family-centred care pattern for elderly people has been firmly established in China. However, because of the nationwide ‘One Child Policy’, over one million parents are excluded from such care because of the death of their only child and, therefore, their primary caregiver. Without their child’s support, these parents must manage the day to day challenges of growing old alone, with little support from society. By overturning established expectations of a ‘good’ elderly life, the loss of an only child may be accompanied by social and self-stigmatization, pushing these bereaved parents to the margin of society and threatening their economic, physical, emotional and social well-being. More importantly, since the One Child Policy was implemented from the late 1970s and early 1980s, the first generation of bereaved or ‘Shidu’ parents has reached an age at which those parents need elderly care. However, their predicament has been largely ignored. This paper reports on a qualitative interview study that found elderly care to be the main concern for Shidu parents’ everyday life. The paper identifies and discusses the concerns these bereaved parents raised about the prospect of having nowhere to turn at a time of increased need for financial, physical, social and emotional support in old age. The paper also identifies how Shidu parents have been coming together in grief and negotiate to make their predicament known to the government and wider society and to re-define their elderly life by rebuilding a sense of ‘family’.

Keywords: culture, bereavement, China, elderly care

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2347 Risk Assessment in Construction of K-Span Buildings in United Arab Emirates (UAE)

Authors: Imtiaz Ali, Imam Mansoor

Abstract:

Investigations as a part of the academic study were undertaken to identify and evaluate the significant risks associated with the construction of K-span buildings in the region of UAE. Primary field data was collected through questionnaires obtaining specific open and close-ended questions from carefully selected construction firms, civil engineers and, construction manager regarding risks associated to K-span building construction. Historical data available for other regions of the same construction technique was available which was compared for identifying various non-critical and critical risk parameters by comparative evaluation techniques to come up with important risks and potential sources for their control and minimization in K-Span buildings that is increasing in the region. The associated risks have been determined with their Relative Importance Index (RII) values of which Risk involved in Change of Design required by Owners carries the highest value (RII=0.79) whereas, Delayed Payment by Owner to Contractor is one of the least (RII=0.42) value. The overall findings suggest that most relative risks as quantified originate or associated with the contractors. It may be concluded that project proponents undertaking K-span projects in planning and budgeting the cost and delays should take into account of risks on high account if changes in design are also required any delays in the material by the supplier would then be a major risk in K-span project delay. Since projects are, less costly, so owners have limited budgets, then they hire small contractors, which are not highly competent contractors. So study suggests that owner should be aware of these types of risks associated with the construction of K-span buildings in order to make it cost effective.

Keywords: k-span buildings, k-span construction, risk management, relative improvement index (RII)

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2346 Statistical Analysis and Impact Forecasting of Connected and Autonomous Vehicles on the Environment: Case Study in the State of Maryland

Authors: Alireza Ansariyar, Safieh Laaly

Abstract:

Over the last decades, the vehicle industry has shown increased interest in integrating autonomous, connected, and electrical technologies in vehicle design with the primary hope of improving mobility and road safety while reducing transportation’s environmental impact. Using the State of Maryland (M.D.) in the United States as a pilot study, this research investigates CAVs’ fuel consumption and air pollutants (C.O., PM, and NOx) and utilizes meaningful linear regression models to predict CAV’s environmental effects. Maryland transportation network was simulated in VISUM software, and data on a set of variables were collected through a comprehensive survey. The number of pollutants and fuel consumption were obtained for the time interval 2010 to 2021 from the macro simulation. Eventually, four linear regression models were proposed to predict the amount of C.O., NOx, PM pollutants, and fuel consumption in the future. The results highlighted that CAVs’ pollutants and fuel consumption have a significant correlation with the income, age, and race of the CAV customers. Furthermore, the reliability of four statistical models was compared with the reliability of macro simulation model outputs in the year 2030. The error of three pollutants and fuel consumption was obtained at less than 9% by statistical models in SPSS. This study is expected to assist researchers and policymakers with planning decisions to reduce CAV environmental impacts in M.D.

Keywords: connected and autonomous vehicles, statistical model, environmental effects, pollutants and fuel consumption, VISUM, linear regression models

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2345 Induction of Labor Using Misoprostol with or without Mifepristone in Intrauterine Death: A Randomized Controlled Study

Authors: Ajay Agrawal, Pritha Basnet, Achala Thakur, Pappu Rizal, Rubina Rai

Abstract:

Context: Rapid expulsion of fetus in intrauterine fetal death (IUFD) is usually requested without any medical grounds for it. So; an efficient, safe method for induction of labor (IOL) is required. Objective: To determine if pre-treatment with mifepristone followed by IOL with misoprostol in late IUFD is more efficacious. Methods: We conducted a randomized controlled trial in 100 patients. Group-A women received single oral dose of 200 mg mifepristone, followed by induction with vaginal misoprostol after 24-hour. Group-B women were induced only with vaginal misoprostol. In each group 5 dose of misoprostol was used 4 hourly. If first cycle was unsuccessful, after break of 12 hour, second course of misoprostol was started. The primary outcome was a measure of induction to delivery time and vaginal delivery within 24 hours. Secondary outcome was to measure need of oxytocin and complications. Results: Maternal age, parity and period of gestation were comparable between groups. Number of misoprostol dose needed in group A was significantly less than group B. Mann Whitney U test showed, women in group A had significantly earlier onset of labor, however total induction to delivery interval was not significant. In group-A, 85.7% delivered within 24 hours of first dose of misoprostol while in group-B 70% delivered within 24 hour (p=0.07). More women in Group B required oxytocin. Conclusion: Pretreatment with mifepristone before IOL following late IUFD is an effective and safe regimen. It appears to shorten the duration of induction to onset of labor.

Keywords: induction of labor, intrauterine fetal death, mifepristone, misoprostol

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2344 Aorta Adhesion Molecules in Cholesterol-Fed Rats Supplemented with Extra Virgin Olive Oil or Sunflower Oil, in Either Commercial or Modified Forms

Authors: Ageliki I. Katsarou, Andriana C. Kaliora, Antonia Chiou, Apostolos Papalois, Nick Kalogeropoulos, Nikolaos K. Andrikopoulos

Abstract:

Chronic inflammation plays a pivotal role in CVD development, while phytochemicals have been shown to reduce CVD risk. Several studies have correlated olive oil consumption with CVD prevention and CVD risk reduction. However, the effect of individual olive oil macro- or micro-constituents and possible synergisms among them needs to be further elucidated. Herein, extra virgin olive oil (EVOO) lipidic and polar phenolics fractions were evaluated for their effect on inflammatory markers in cholesterol-fed rats. Oils combining different characteristics as to their polar phenolic content and lipid profile were used. Male Wistar rats were fed for 9 weeks on either a high-cholesterol diet (HCD) or a HCD supplemented with oils, either commercially available, i.e. EVOO, sunflower oil (SO), or modified as to their polar phenol content, i.e. phenolics deprived-EVOO (EVOOd), SO enriched with the EVOO phenolics (SOe). Post-intervention, aorta and blood samples were collected. HCD induced dyslipidemia, manifested by serum total cholesterol and low-density lipoprotein cholesterol elevation. Additionally, HCD resulted in higher adhesion molecules’ levels in rat aorta. In the case of E-selectin, this increase was attenuated by HCD supplementation with EVOO and EVOOd, while no alterations were observed in SO and SOe groups. No differences were observed between pairs of commercial and modified oils, indicating that oleates may be the components responsible for aorta E-selectin levels lowering. The same was true for vascular adhesion molecule-1 (VCAM-1); augmentation in cholesterol-fed animals was attenuated by EVOO and EVOOd diets, highlighting oleates effect. In addition, VCAM-1 levels were higher in SO group compared to the respective SOe, indicating that in the presence of phenolic compounds linoleic acid have become less prone to oxidation. Intercellular adhesion molecule-1 (ICAM-1) levels were higher in cholesterol-fed rats, however not affected by any of the oils supplemented during the intervention. Overall, EVOO was found superior in regulating adhesion molecule levels in rat aorta compared to SO. EVOO and EVOOd exhibited analogous effects on all adhesion molecules assessed, indicating that EVOO major constituents (oleates) improve E-selectin and VCAM-1 levels in rat aorta, independently from phenolics presence. Further research is needed to elucidate the effect of phenolics and oleates in other tissues.

Keywords: extra virgin olive oil, cholesterol-fed rats, polar phenolics, adhesion molecules

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2343 Evaluation of the Benefit of Anti-Endomysial IgA and Anti-Tissue Transglutaminase IgA Antibodies for the Diagnosis of Coeliac Disease in a University Hospital, 2010-2016

Authors: Recep Keşli, Onur Türkyılmaz, Hayriye Tokay, Kasım Demir

Abstract:

Objective: Coeliac disease (CD) is a primary small intestine disorder caused by high sensitivity to gluten which is present in the crops, characterized by inflammation in the small intestine mucosa. The goal of this study was to determine and to compare the sensitivity and specificity values of anti-endomysial IgA (EMA IgA) (IFA) and anti-tissue transglutaminase IgA (anti-tTG IgA) (ELISA) antibodies in the diagnosis of patients suspected with the CD. Methods: One thousand two hundred seventy three patients, who have applied to gastroenterology and pediatric disease polyclinics of Afyon Kocatepe University ANS Research and Practice Hospital were included into the study between 23.09.2010 and 30.05.2016. Sera samples were investigated by immunofluorescence method for EMA positiveness (Euroimmun, Luebeck, Germany). In order to determine quantitative value of Anti-tTG IgA (EIA) (Orgentec Mainz, Germany) fully automated ELISA device (Alisei, Seac, Firenze, Italy) were used. Results: Out of 1273 patients, 160 were diagnosed with coeliac disease according to ESPGHAN 2012 diagnosis criteria. Out of 160 CD patients, 120 were female, 40 were male. The EMA specificity and sensitivity were calculated as 98% and 80% respectively. Specificity and sensitivity of Anti-tTG IgA were determined as 99% and 96% respectively. Conclusion: The specificity of EMA for CD was excellent because all EMA-positive patients (n = 144) were diagnosed with CD. The presence of human anti-tTG IgA was found as a reliable marker for diagnosis and follow-up the CD. Diagnosis of CD should be established on both the clinical and serologic profiles together.

Keywords: anti-endomysial antibody, anti-tTG IgA, coeliac disease, immunofluorescence assay (IFA)

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2342 The Threat Posed by Dominant Languages to Minor Languages or Dialects: The Case of isiZulu and isiBhaca in Umzimkhulu, KwaZulu-Natal

Authors: Yanga Lusanda Praiseworth Majola

Abstract:

The small town of Umzimkhulu is situated in the KwaZulu-Natal province of South Africa and was once the Bantustan of Transkei. Citizens of Umzimkulu are called amaBhaca because they speak isiBhaca, which is a non-standard language but is mutually intelligible to three standard official languages, isiXhosa, isiZulu, and siSwati. Since Umzimkhulu was under the Eastern Cape Province prior to 2006, isiXhosa is used for official purposes, particularly in schools, then isiZulu is used in other sectors; this is despite the fact that the majority of Umzimkhulu citizens regard themselves as amaBhaca. This poses a threat to both isiBhaca as a language and the identity of amaBhaca because Umzimkhulu is situated in KZN, where isiZulu is the dominant language spoken by the majority in the province. The primary objective of this study is to unveil, using the language dominance theory, how dominant languages pose a threat to minority and developing languages or dialects. The study employed a mixed-methods approach. Data was obtained from key community members and leaders who were identified as amaBhaca, who have lived in Umzimkhulu their whole lives. The main findings of the study are that although isiBhaca is classified as a dialect of isiXhosa, linguistically, it is closer to isiZulu, and thus isiZulu poses much threat to the existence of isiBhaca since it becomes easy for amaBhaca to switch from isiBhaca to isiZulu and end up not having an interest in isiBhaca. Respondents revealed that in their view, isiBhaca is a language of its own, and the continuous use and empowerment of isiZulu in Umzimkhulu, particularly in the professional settings, is detrimental to isiBhaca, and this subsequently has the potential of endangering the existence of isiBhaca and might lead to its attrition.

Keywords: language dominance, dominant languages, minority languages, language attrition

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2341 Integrated Passive Cooling Systems for Tropical Residential Buildings: A Review through the Lens of Latent Heat Assessment

Authors: O. Eso, M. Mohammadi, J. Darkwa, J. Calautit

Abstract:

Residential buildings are responsible for 22% of the global end-use energy demand and 17% of global CO₂ emissions. Tropical climates particularly present higher latent heat gains, leading to more cooling loads. However, the cooling processes are all based on conventional mechanical air conditioning systems which are energy and carbon intensive technologies. Passive cooling systems have in the past been considered as alternative technologies for minimizing energy consumption in buildings. Nevertheless, replacing mechanical cooling systems with passive ones will require a careful assessment of the passive cooling system heat transfer to determine if suitable to outperform their conventional counterparts. This is because internal heat gains, indoor-outdoor heat transfer, and heat transfer through envelope affects the performance of passive cooling systems. While many studies have investigated sensible heat transfer in passive cooling systems, not many studies have focused on their latent heat transfer capabilities. Furthermore, combining heat prevention, heat modulation and heat dissipation to passively cool indoor spaces in the tropical climates is critical to achieve thermal comfort. Since passive cooling systems use only one of these three approaches at a time, integrating more than one passive cooling system for effective indoor latent heat removal while still saving energy is studied. This study is a systematic review of recently published peer review journals on integrated passive cooling systems for tropical residential buildings. The missing links in the experimental and numerical studies with regards to latent heat reduction interventions are presented. Energy simulation studies of integrated passive cooling systems in tropical residential buildings are also discussed. The review has shown that comfortable indoor environment is attainable when two or more passive cooling systems are integrated in tropical residential buildings. Improvement occurs in the heat transfer rate and cooling performance of the passive cooling systems when thermal energy storage systems like phase change materials are included. Integrating passive cooling systems in tropical residential buildings can reduce energy consumption by 6-87% while achieving up to 17.55% reduction in indoor heat flux. The review has highlighted a lack of numerical studies regarding passive cooling system performance in tropical savannah climates. In addition, detailed studies are required to establish suitable latent heat transfer rate in passive cooling ventilation devices under this climate category. This should be considered in subsequent studies. The conclusions and outcomes of this study will help researchers understand the overall energy performance of integrated passive cooling systems in tropical climates and help them identify and design suitable climate specific options for residential buildings.

Keywords: energy savings, latent heat, passive cooling systems, residential buildings, tropical residential buildings

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2340 The Effectiveness of Using Functional Rehabilitation with Children of Cerebral Palsy

Authors: Bara Yousef

Abstract:

The development of independency and functional participation is an important therapeutic goal for many children with cerebral palsy,They was many therapeutic approach have been used for treatment those children like neurodevelopment treatment, balance training strengthening and stretching exercise. More recently, therapy for children with cerebral palsy has focused on achieving functional goals using task-oriented interventions and summer camping model, which focus on activities that relevant and meaningful to the child, to learn more efficient and effective motor skills. We explore the effectiveness of using functional rehabilitation comparing with regular rehabilitation among 40 Saudi children with cerebral palsy in pediatric unit at Sultan Bin Abdul Aziz Humanitarian City-Ksa ,where 20 children randomly assign in control group who received rehabilitation based on regular therapy approach and other 20 children assign on experiment group who received rehabilitation based on functional therapy approach with an average of 45min OT treatment and 45 min PT treatment- daily within a period of 6 week. Our finding reported that children in experiment group has improved in gross motor function with an average from 49.4 to 57.6 based on GMFM 66 as primary outcome measure and improved in WeeFIM with an average from 52 to 62 while children in control group has improved with an average from 48.4 to 53.7 in GMFM and from 53 to and 58 in WeeFIM. Consequently, there has been growing interest in determining the effects of functional training programs as promising approach for these children.

Keywords: Cerebral Palsy (CP), gross motor function measure (GMFM66), pediatric Functional Independent Measure (WeeFIM), rehabilitation, disability

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2339 Role of Pakistani Physicians in the Pharmacotherapy of Obesity

Authors: Sadia Suri Kashif, Raheeda Fatima, Maqsood Ahmed Khan

Abstract:

Purpose of the study: The objective of this research was to determine the perception of Pakistani physicians (whether primary care, specialists or residents) in Karachi, being one of the largest and highly populated cities of Pakistan, regarding clinical approaches towards diet, exercise, and therapy in obese patients. This research determines their understanding of obesity and employability of obesity management in their daily practices. Research methodology: This is a questionnaire-based survey. A minimum of 300 questionnaires (N=300) were distributed and filled by practicing physicians in a random selection of medical setups in Karachi. Randomly 246 physicians responded to the survey. The survey tested their views regarding weight management, importance of general awareness and their strategies to control weight. Results: In the first part of survey the physicians responded to almost 66% regarding the seriousness of obesity management with advising diet modification, physical exercise and decreasing calorie intake; 57% failed to employ Body Mass Index and Waist Hip Ratio as weight measurement tools in their daily practice; 50% disagreed on using pharmacotherapy as an option; 67% were not sure about the proper dosage and indication of anti-obesity medication while almost same disagreed on using surgical options for management of obesity; 83.3% physicians agreed on the increased obesity pandemic in Pakistan. Conclusion: The findings indicate that there is a gap between awareness and knowledge among Pakistani practicing physicians regarding pharmacotherapy for obesity. There is a need to frequently update latest guidelines to help manage this condition, which is becoming more prevalent in our country day by day. Physicians should be obligated to use updated knowledge for managing obesity.

Keywords: obesity, physicians, BMI, weight management, obesity awareness

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