Search results for: dengue cases
Commenced in January 2007
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Edition: International
Paper Count: 4627

Search results for: dengue cases

4267 A Cross-Sectional Study on the Nutritional Status of School Going Children From Urban and Rural Populations of Pakistan

Authors: Aftab Ahmed, Farhan Saeed, Muhammad Afzaal, Shinawar Waseem Ali, Ali Imran, Sadaf Munir

Abstract:

Malnutrition is a globally increasing public health concern among children; it affects number of school children influencing their growth, development and academic performance. The tenet of the current cross sectional study was to assess the nutritional biomarkers of school going children of age 12-15 years resulting in stunting, underweight, overweight, bone deformities and other health disparities in nutritionally deprived urban and rural populations of Pakistan. A sample size comprising of 180 school going children was stipulated from the targeted urban and rural populations. The fallouts of investigation unveiled that both rural and urban populations were experiencing nutritional challenges however; on account of awareness paucity the rustic population was nutritionally more compromised. Hematological tests elucidated 16.7% and 7.8% cases for high glucose level, 35.6% and 27.8% cases for low hemoglobin levels, 14.4% and 15.6% cases for low calcium indices, 12.2% and 4.4% high white blood cell count (WBC), 20% and 14.4% low red blood cell count, 76.7% and 74.4% low hematocrit (HCT) values, among the rural and urban populations respectively. The above mentioned outcomes can serve as a way forward for policy and law maker institutions to curb the possible barricades in the way of healthy nutritional status in these areas

Keywords: malnutrition, hematological study, child nutrition, bone mineral density, calcium, RBC

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4266 Ventilator Associated Pneumonia in a Medical Intensive Care Unit, Incidence and Risk Factors: A Case Control Study

Authors: Ammar Asma, Bouafia Nabiha, Ben Cheikh Asma, Ezzi Olfa, Mahjoub Mohamed, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

Abstract:

Background: Ventilator-associated pneumonia (VAP) is currently recognized as one of the most relevant causes of morbidity and mortality among intensive care unit (ICU) patients worldwide. Identifying modifiable risk factors for VAP could be helpful for future controlled interventional studies aiming at improving prevention of VAP. The purposes of this study were to determine the incidence and risk factors for VAP in in a Tunisian medical ICU. Materials / Methods: A retrospective case-control study design based on the prospective database collected over a 14-month period from September 15th, 2015 through November 15th, 2016 in an 8-bed medical ICU. Patients under ventilation for over 48 h were included. The number of cases was estimated by Epi-info Software with the power of statistical test equal to 90 %. Each case patient was successfully matched to two controls according to the length of mechanical ventilation (MV) before VAP for cases and the total length of MV in controls. VAP in the ICU was defined according to American Thoracic Society; Infectious Diseases Society of America guidelines. Early onset or late-onset VAP were defined whether the infectious process occurred within or after 96 h of ICU admission. Patients’ risk factors, causes of admission, comorbidities and respiratory specimens collected were reviewed. Univariate and multivariate analyses were performed to determine variables associated with VAP with a p-value < 0.05. Results: During the period study, a total of 169 patients under mechanical ventilation were considered, 34 patients (20.11%) developed at least one episode of VAP in the ICU. The incidence rate for VAP was 14.88/1000 ventilation days. Among these cases, 9 (26.5 %) were early-onset VAP and 25 (73.5 %) were late-onset VAP. It was a certain diagnosis in 66.7% of cases. Tracheal aspiration was positive in 80% of cases. Multi-drug resistant Acinerobacter baumanii was the most common species detected in cases; 67.64% (n=23). The rate of mortality out of cases was 88.23% (n= 30). In univariate analysis, the patients with VAP were statistically more likely to suffer from cardiovascular diseases (p=0.035) and prolonged duration of sedation (p=0.009) and tracheostomy (p=0.001), they also had a higher number of re-intubation (p=0.017) and a longer total time of intubation (p=0.012). Multivariate analysis showed that cardiovascular diseases (OR= 4.44; 95% IC= [1.3 - 14]; p=0.016), tracheostomy (OR= 4.2; 95% IC= [1.16 -15.12]; p= 0.028) and prolonged duration of sedation (OR=1.21; 95% IC= [1.07, 1.36]; p=0.002) were independent risk factors for the development of VAP. Conclusion: VAP constitutes a therapeutic challenge in an ICU setting, therefore; strategies that effectively prevent VAP are needed. An infection control-training program intended to all professional heath care in this unit insisting on bundles and elaboration of procedures are planned to reduce effectively incidence rate of VAP.

Keywords: case control study, intensive care unit, risk factors, ventilator associated pneumonia

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4265 Securitization of Illegal Fishing Cases in Natuna Waters by Indonesian Government: Study Case of Chinese Vessels Shootouts 2016

Authors: Ray Maximillian, Idil Syawfi

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Indonesia’s Exclusive Economic Zone and the infamous China’s nine-dash line are intersected in Natuna waters. Even though from Indonesia perspective, that line does not possess any legal basis, China treat that line as their national boundaries, therefore allowing Chinese fishermen to fish in the area. Under President Joko Widodo leadership, Indonesia which now focusing to suppress illegal fishing cases while emphasizing their maritime sovereignty is facing an imminent threat from China’s presence in Natuna. Tension between these countries spiked after three incident happened on 2016, especially after Indonesian navy shot Chinese fishermen vessel that suspected doing illegal fishing activity. This action seen as an attempt to secure Indonesia’s law enforcement in their waters after several months before such attempt was intervened by Chinese coast guard. Indonesia tries to securitize this issue to justify the shooting they done to Chinese vessels. In the process of securitization, it is imperative to identify the existential threat that leads to implementation of emergency measures which responded by units in the cases. Chinese coast guard presence in Natuna perceived as an existential threat to Indonesia, therefore, responded by shooting to Chinese vessels on the next encounter. This action then responded by Chinese government who said that there is overlapping claim between them and Indonesia in Natuna.

Keywords: China, illegal fishing, Indonesia, natuna, securitization

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4264 Nine Year Trend Analysis of Malaria in Kahsay Abera General Hospital Humera Town: Western Tigrai, Northern Ethiopia: A Retrospective Study

Authors: Getachew Belay, Getachew Kahsu, Brhane Berhe, Kebede Tesfay, Fitsum Mardu, Nigus Shishay, Hadush Negash, Aster Tsegaye

Abstract:

Background: Malaria kills million people around the world, and it is still a serious public health problem in Ethiopia. Over the past years, the disease has been consistently reported as leading cause of outpatient visits, hospitalization and death in health facilities across the country. This study assessed malaria trend in Humera Town Kahsay Abera Hospital Tigrai region, Northern Ethiopia. Method: A Health facility retrospective cross sectional study was conducted in Kahsay Abera General Hospital from January 2011 to December 2019. Data of Malaria cases were reviewed from Health Management Information System with the help of experts in the office. The nine year data were extracted and analyzed using Excel by excluding those which lack demographic data. Result: A total of 36,604 smear positive malaria cases were confirmed in last nine years in the study area. Plasmodim falcifarum was the most prevalent reported species. Higher number of malaria cases were reported during October season.Males were more infected by the disese (63.1%) than females and males aged 15 years and above were the most iffected ones. The percentage proportion of P.falcifarum and P.vivax were 61.6% to 38.4%, respectively. There was a decreasing trend over the nine years following the peak in 2013. Conclusion: Malaria smear positivity, with highest cases being recorded in October, was declined over the nine years after peaking in 2013. Males aged 15 years and above were more affected, and P falciparum was the predominat species. Strengtheing the prevention and control activities is warranted in the study area.

Keywords: trend, malaria, kahsay abera general hospital, tigray, ethiopia

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4263 The Comparison of Primary B-Cell and NKT-Cell Non-Hodgkin Lymphomas in Nasopharynx, Nasal Cavity, and Paranasal Sinuses

Authors: Jiajia Peng, Jianqing Qiu, Jianjun Ren, Yu Zhao

Abstract:

Background: We aimed to compare clinical and survival differences between B-cell (B-NHL) and NKT-cell non-Hodgkin lymphomas (NKT-NHL) located in the nasal cavity, nasopharynx and paranasal sinuses, which are always categorized as one sinonasal type. Methods: Patients diagnosed with primary B-NHL and NKT-NHL in the nasal cavity, nasopharynx, and paranasal sinuses from the SEER database were included. We identified these patients based on histological types and anatomical sites and subsequently conducted univariate and multivariate Cox regression and Kaplan–Meier analyses to examine cancer-special survival (CSS) outcomes. Results: Overall, most B-NHL cases originated from the nasopharynx, while the majority of NKT-NHL cases occurred in the nasal cavity. Notably, the CSS outcomes improved significantly in all sinonasal B-NHL cases over time, whereas no such improvement trend was observed in each sinonasal NKT-NHL type. Additionally, increasing age was linked with an elevated risk of death in B-NHL, particularly in the nasal cavity (HR:3.37), rather than in NKT-NHL. Compared with B-NHL, the adverse effect of the higher stage on CSS was more evident in NKT-NHL, particularly in its nasopharynx site (HR: 5.12). Furthermore, radiotherapy was beneficial for survival in patients with sinonasal B-NHL and NKT-NHL, except in those with NKT-NHL in the nasopharynx site. However, chemotherapy has only been beneficial for CSS in patients with B-NHL in paranasal sinuses (HR: 0.42) since 2010, rather than in other types of B-NHL or NKT-NHL. Conclusions: Although B-NHL and NKT-NHL in the nasal cavity, nasopharynx and paranasal sinuses have similar anatomical locations, their clinic demographics and prognoses are largely different and should be treated and studied as distinct diseases.

Keywords: B-cell non-Hodgkin lymphomas, NKT-cell non-Hodgkin lymphomas, nasal cavity lymphomas, nasal sinuses lymphomas, nasopharynx lymphomas

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4262 Use Cases Analysis of Free Space Optical Communication System

Authors: Kassem Saab, Fritzen Bart, Yves-Marie Seveque

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The deployment of Free Space Optical Communications (FSOC) systems requires the development of robust and reliable Optical Ground Stations (OGS) that can be easily installed and operated. To this end, the Engineering Department of Airbus Defence and Space is actively working on the development of innovative and compact OGS solutions that can be deployed in various environments and provide high-quality connectivity under different atmospheric conditions. This article presents an overview of our recent developments in this field, including an evaluation study of different use cases of the FSOC with respect to different atmospheric conditions. The goal is to provide OGS solutions that are both simple and highly effective, allowing for the deployment of high-speed communication networks in a wide range of scenarios.

Keywords: end to end optical communication, laser propagation, optical ground station, turbulence

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4261 The Utilization of Banana Leaves as a Substitute for Synthetic Mosquito Repellant

Authors: Beryl Apondi Obola

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Introduction: Mosquitoes are known to transmit various diseases such as malaria, dengue fever, and Zika virus. Mosquito repellents are commonly used to prevent mosquito bites. However, some of these repellents contain chemicals that can be harmful to human health and the environment. Therefore, there is a need to find alternative mosquito repellents that are safe and effective. Objective: The objective of this research is to investigate the effectiveness of banana leaves as an alternative mosquito repellent on Plasmodium falciparum and Plasmodium vivax. Methodology: The research will be conducted in two phases. In the first phase, the repellent properties of banana leaves will be tested in a laboratory setting. The leaves will be crushed and mixed with water to extract the active ingredients. The extract will be tested against mosquitoes in a controlled environment. The number of mosquitoes that are repelled by the extract will be recorded. In the second phase, the effectiveness of the banana leaf extract will be tested in the field. The extract will be applied to the skin of human volunteers, and the number of mosquito bites will be recorded. The results will be compared to a commercially available mosquito repellent. Expected Outcomes: The expected outcome of this research is to determine whether banana leaves can be used as an effective mosquito repellent. If the results are positive, banana leaves could be used as an alternative to chemical-based mosquito repellents. Conclusion: Banana leaves have been used for various purposes in traditional medicine. This research aims to investigate the potential of banana leaves as an alternative mosquito repellent. The results of this research could have significant implications for public health and the environment

Keywords: banana leaf extract, mosquito repellant, plasmodium falciparum, public health

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4260 Association of Glutathione S-transferase M1 and T1 Gene Polymorphisms with Vitiligo in Saudi Population

Authors: Ghaleb Bin Huraib, Fahad Al Harthi, Mohammad Mustafa, Abdulrahman Al-Asmari

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Introduction: Vitiligo is an acquired pigmentary skin disorder with the regional disappearance of melanocytes. Vitiligo affects 0.1 to 2% of the global population, and the incidence varies substantially depending on ethnicity. Glutathione S-transferase (GST) is a multigene family of enzymes that detoxify oxidative stress products. The oxidative stress-related GSTM1/GSTT1 genes deletion may cause epidermal melanocytes destruction and the development of vitiligo. Hence, the present study aimed to investigate the association of GST gene polymorphisms with vitiligo in the Saudi population, if any. Materials and Methods: The present study includes 129 vitiligo cases and 130 age-matched healthy controls. The proportion of male and female patients with vitiligo is almost equal. The multiplex polymerase chain reaction (PCR) method was used for polymorphic analysis. Results: Increased odds of generalized vitiligo was observed with the null genotypes of GSTT1- gene (OR = 1.91, 95% CI = 1.07-3.42, p = 0.019). The possible genetic combinations of GSTM1/GSTT1 and their genotypic distribution showed the frequency of GSTM1+/GSTT1+ 62/130 (47.69%) and GSTM1-/GSTT1+ 52/130 (40.00%) were higher in controls than in cases 44/129 (34.11%), 43/129 (33.34%), respectively while GSTM1+/GSTT1- and GSTM1-/GSTT1- null genotypes were higher 22/129 (17.05%) and 20/129 (15.50%) in vitiligo patients as compared to controls 11/130 (8.46%), 5/130 (3.84%), respectively. The strength of association of different genetic combinations with cases have shown GSTM1+/GSTT1- (OR = 2.81, 95% CI = 1.24-6.40, p = 0.009) and GSTM1-/GSTT1- (OR = 5.63, 95% CI = 1.96 - 16.16, p = 0.0004) were significantly higher in vitiligo cases as compared to controls. We did not observe any significant association of age and gender of patients with GST gene polymorphisms. Conclusions: The GSTT1-, GSTM1+/GSTT1- and GSTM1-/GSTT1- null genotypes were significantly associated with vitiligo. These genetic polymorphisms may be the associative genetic risk factor for vitiligo among Saudis. It could be used as a genetic marker for screening vitiligo patients among Saudis. Further studies on GSTs gene polymorphism in larger sample sizes from different geographical areas and ethnicity are needed to strengthen the present findings.

Keywords: vitiligo, GSTM1, GSTT1, gene polymorphism, oxidative stress

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4259 Intimate Femicide–Suicide in Israel: The Role of Migration and the Context

Authors: Revital Sela-Shayovitz

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The current study examined the nature, the characteristics and the extent of intimate femicide followed by suicide (femicide-suicide) in Israel between the years 2005 – 2014. Data were collected from the Israeli organization ‘No to Violence Against Women’ and from two daily and widely-read newspapers in Israel. The findings indicated that migration is a risk factor for intimate femicide-suicide: the majority of the cases occurred among immigrants (59%). Moreover, the vulnerability of Ethiopian immigrants is very high in comparison to the other groups in Israeli society. The dominant motives were the victim's desire for separation and arguments between partners. The main methods used were firearms and stabbing followed by hanging. Furthermore, a prior report about violence was documented in 37% of the cases. The paper discusses these findings in the context of the existing research, offers directions for future research, and suggests some response strategies.

Keywords: ethnicity, immigrants, intimate femicide, suicide

Procedia PDF Downloads 155
4258 Optimal Rotor Design of an 150kW-Class IPMSM through the 3D Voltage-Inductance Map Analysis Method

Authors: Eung-Seok Park, Tae-Chul Jeong, Hyun-Jong Park, Hyun-Woo Jun, Dong-Woo Kang, Ju Lee

Abstract:

This presents a methodology to determine detail design directions of an 150kW-class IPMSM (interior permanent magnet synchronous motor) and its detail design. The basic design of the stator and rotor was conducted. After dividing the designed models into the best cases and the worst cases based on rotor shape parameters, Sensitivity analysis and 3D Voltage-Inductance Map (3D EL-Map) parameters were analyzed. Then, the design direction for the final model was predicted. Based on the prediction, the final model was extracted with Trend analysis. Lastly, the final model was validated with experiments.

Keywords: PMSM, optimal design, rotor design, voltage-inductance map

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4257 Gender-Based Differences in the Social Judgment of Hungarian Politicians' Sex Scandals

Authors: Sara Dalma Galgoczi, Judith Gabriella Kengyel

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Sex scandals are quite an engaging topic to work with, especially with their judgment in society. Most people are interested in other people's lives, specifically in public figures' such as celebrities or politicians, because ordinary people feel like they have the right to know more things about the famous and notorious ones than they would probably willing to share. Intimacy and sexual acts aren't exceptions; moreover, sexuality is one of the central interests of humans ever since. Besides, knowing and having an opinion about any kind of scandal can change even whole social groups or classes estimation of anyone. This study aims to research the social judgment of some Hungarian politicians' sex scandals and asks important questions like diverse public opinions in the light of gender or delegates’ abuse of power. Considering that this study is about collecting and evaluating opinions from the public, and no one before researched and published this exact topic and cases, an online survey was created. In the survey were different sections. We collected data about party-preference, conservativism-liberalism scale; then we used the following questionnaires: from Zero-sum perspective with regard to gender equality (Ruthig, Kehn, Gamblin, Vanderzanden & Jones, 2017), Ambivalent Sexism Inventory (ASI; Glick & Fiske, 1996), Ambivalence Toward Men Inventory (AMI; Glick & Fiske, 1999). Finally, 5 short summaries were presented about five Hungarian politicians' sex scandal cases (3 males, 2 females) from the recent past. These stories were followed by questions about their opinion of the party and attitudes towards the parties' reactions to the cases. We came to the conclusion that people are more permissive with the scandals of men, and benevolent sexism and ambivalence towards men mediate this relation. Men tend to see these cases as part of politicians' private lives more than women. Party preference had a significant effect - people tend to pass a sentence the delegates of the opposing parties, and they rather release the delegates of their preferred party.

Keywords: sex scandal, sexism, social judgement, politician

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4256 Anaesthetic Management of a Huge Oropharyngeal Mass

Authors: Vasudha Govil, Suresh Singhal

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Introduction: Patients with oropharyngeal masses pose a challenge for an anaesthetist in terms of ventilation and tracheal intubation. Thus, preoperative assessment and preparation become an integral part of managing such anticipated difficult airway cases. Case report: A 45- year old female presented with growth in the oropharynx causing dysphagia and hoarseness of voice. Clinical examination and investigations predicted a difficult airway. It was managed with fibreoptic nasotracheal intubation with a successful perioperative outcome. Tracheostomy was kept as plan B in case of the CVCI situation. Conclusion: Careful preoperative examination and assessment is required to prepare oneself for difficult airway. Fibreoptic bronchoscope-guided nasotracheal intubation in a spontaneously breathing patient is a safe and successful airway management technique in difficult airway cases.

Keywords: airway, difficult, mass, oropharyngeal

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4255 Use of Digital Forensics for Sex Determination by Nasal Index

Authors: Ashwini Kumar, Vinod Nayak, Shankar M. Bakkannavar

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The identification of humans is important in forensic investigations not only in living but also in dead, especially in cases of mass disorders. The procedure followed in dead known as post-mortem identification is a challenging task for the forensic pathologist. However, it is mandatory in terms of the law to fulfill the social norms. Many times, due to mutilation of body parts, the normal methods of identification using skeletal remains cannot be used in the process of identification. In such cases, the intact components of the skeletal remains or bony parts play an important role in identification. In these situations, digital forensics can come to our rescue. The authors hereby made a study for determination of sex based on nasal index by using (Big Bore 16 Slice) Multidetector Computed Tomography 2D Scans. The results are represented as a poster.

Keywords: sex determination, multidetector computed tomography, nasal index, digital forensic

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4254 Retrospective Data Analysis of Penetrating Injuries Admitted to Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Thimphu, Bhutan, Due to Traditional Sports over a Period of 3 Years

Authors: Sonam Kelzang

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Background: Penetrating injuries as a result of traditional sports (Archery and Khuru) are commonly seen in Bhutan. To our knowledge, there is no study carried out looking into the data of penetrating injuries due to traditional sports. Aim: This is a retrospective analysis of cases of penetrating injuries as a result of traditional sports admitted to JDWNRH over the last 3 years to draw an inference on the pattern of injury and associated morbidity and mortality. Method: Data on penetrating injuries related to traditional sports (Archery and Khuru) were collected and reviewed over the period of 3 years. Assault cases were excluded. For each year we analysed age, sex, parts of the body affected, agent of injury and whether admission was required or not. Results: Out of the total 44 victims of penetrating injury by traditional sports (Archery and Khuru) between 2013 and 2015 (average of 15 cases of penetrating injuries per year). Eighty-five percent were male and 15% were female. Their age ranged from 4 yrs to 62 years. Sixty-one percent of the victims were in the working age group of 19-58 years; 30% of the victims were referred from various district hospitals; 38% of the victims needed admission; 42 % of the victims suffered injury to the head; and 54% of the injuries were caused by Khuru. Conclusion: Penetrating injuries due to traditional sports admitted to JDWNRH, Thimphu, remained same over the three years period despite safety regulations in place. Although there were no deaths during the last three years, morbidity still remains high.

Keywords: archery, Bhutan, Khuru, darts

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4253 Endometrial Thickness Cut-Off for Evacuation of Retained Product of Conception

Authors: Nambiar Ritu, Ali Ban, Munawar Farida, Israell Imelda, T. Farouk Eman Rasheeda, Jangalgi Renuka, S. Boma Nellie

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Aim: To define the ultrasonographic endometrial thickness (USG ET) cutoff for evacuation of retained pieces of conception (ERPC). Background: Studies of conservative management of 1st trimester miscarriage have questioned the need for post miscarriage curettage. Therapeutic decision making with transvaginal scan post miscarriage endometrial thickness in patients clinically thought to be incomplete miscarriage is often not clear. Method: Retrospective analysis of all 1ST trimester ERPC at Al Rahba Hospital from June 2012 to July 2013 was done. Total of 164 patients underwent ERPC. All cases were reviewed for pre-operative USG ET and post ERPC histopathological examination. TVS was done to evaluate the maximum ET of the uterine cavity along the long axis of the uterus and features of retained products was noted. All cases without preoperative USG ET measurement were excluded from the study, therefore only 62 out of 164 cases were included in the study. The patients were divided into three groups: o Group A: have retained products within endometrial cavity. o Group B: endometrial thickness equal or more than 20 mm. o Group C: endometrial thickness equal or less than 19.9 mm. o Post ERPC product was sent for HPE and the results were compared. Transvaginal sonographic findings can be used as a deciding factor in the management of patients with 1st trimester miscarriage who need ERPC. Our proposed cutoff in clinically stable patients requiring ERPC is more than 20 mm.

Keywords: ERPC, histopathological examination, long axis of the uterus, USG ET

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4252 The Culture of Extrajudicial Executions: An Investigative Study of the Philippines’ Fifth Republic

Authors: Nathalie Quinto, Danielle Solancho

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In 1986, after Marcos’ Martial Law of 1972, the Philippines revised its constitution for the fifth time, under the Aquino Administration. Extrajudicial violence was expected to be lessened, if not completely eradicated after this was passed. However, state-sponsored executions continued to persist even in the present time. There are currently identified policy gaps when it comes to extrajudicial cases, as there is no generally accepted definition of the term in the Philippines. In this paper, a triangulation method of historically published papers, key informant interviews, and focus group discussions of academics, scholars, and people who are involved in various cases found, was utilized for the methodology. This paper explores the establishment of a normalized system of state-sponsored executions in the country and why the state resorts to this kind of action. It found that due to a weak political, and social institution, a culture of extrajudicial executions was established.

Keywords: extrajudicial execution, human rights, justice, security

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4251 Investigation of the Association of Vitamin D Receptor Gene Polymorphism in Female Genital: Tuberculosis Cases

Authors: Swati Gautam, Amita Jain, Shyampyari Jaiswar

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Objective: To elucidate the role of (ApaI&TaqI) VDR gene polymorphism in the pathogenesis of female genital tuberculosis (FGTB) cases. Background: Female genital TB represents about 15-20% of total extra-pulmonary TB (EPTB). Female subjects with vitamin D deficiency have been shown to be at higher risk of pulmonary TB as well as FGTB. In same context few functional polymorphism in vitamin D receptor (VDR) gene has been considered as an important genetic risk factor that modulate the development of FGTB. Therefore we aimed, to elucidate the role of (ApaI&TaqI) VDR gene polymorphism in the pathogenesis of FGTB. Study design: Case-Control study. Sample size: Cases (60) and Controls (60). Study site: Department of Obstetrics & Gynecology & Department of Microbiology, K.G.M.U. Lucknow, (UP). Inclusion criteria: Cases: Women with age group 20-35 years, premenstrual endometrial aspiration collected and included in the study, those were positive with acid-fast bacilli (AFB)/ TB-PCR/ LJ culture/ liquid culture. Controls: Women with age group 20-35 years having no history of ATT and all test negative for TB recruited as control. Exclusion criteria: -Women with endometriosis, polycystic ovaries (PCOD), positive on Chlamydia & gonorrhea, already on anti-tubercular therapy (ATT) excluded. Materials and Methods: Blood samples were collected in EDTA tubes from cases and controls stored at -20ºC. Genomic DNA extraction was carried out by salting-out method. Genotyping of VDR gene (ApaI&TaqI) polymorphism was performed by using single amplification refractory mutation system (ARMS) PCR technique. PCR products were analyzed by electrophoresis on 2% agarose gel. Statistical analysis was done by SPSS16.3 software & computing odds ratio (OR) with 95% CI. Results: Increased risk of female genital tuberculosis was observed in AA genotype (OR =1.1419-6.212 95% CI, P*<0.036) and A allele (OR =1.255-3.518, 95% CI, P* < 0.006) in FGTB as compared to controls. Moreover A allele was found more frequent in FGTB patients. No significant difference was observed in TaqI gene polymorphism of VDR gene. Conclusion: The ApaI polymorphism is significantly associated with etiology of FGTB and plays an important role as a genetic risk factor in FGTB women.

Keywords: ARMS, ATT, EPTB, FGTB, VDR

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4250 Euthanasia in Dementia Cases: An Interview Study of Dutch Physicians' Experiences

Authors: J. E. Appel, R. N. Bouwmeester, L. Crombach, K. Georgieva, N. O’Shea, T. I. van Rijssel, L. Wingens

Abstract:

The Netherlands has a unique and progressive euthanasia law. Even people with advanced neurodegenerative diseases, like dementia, can request euthanasia when an Advanced Euthanasia Directive (AED) was written. Although the law sets some guidelines, in practice many complexities occur. Especially doctors experience difficult situations, as they have to decide whether euthanasia is justified. Research suggests that this leads to an emotional burden for them, due to feelings of isolation, fear of prosecution, as well as pressures from patient, family, or society. Existing literature, however, failed to address problems arising in dementia cases in particular, as well as possible sources of support. In order to investigate these issues, semi-structured in-depth interviews with 20 Dutch general practitioners and elderly care physicians will be conducted. Results are expected to be obtained by the end of December 2017.

Keywords: dementia, euthanasia, general practitioners, elderly care physicians, palliative care

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4249 Muslim Social Workers and Imams’ Recommendations in Marital and Child Custody Cases of Persons with Intellectual or Mental Disability

Authors: Badran Leena, Rimmerman Arie

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Arab society in Israel is undergoing modernization and secularization. However, its approach to disability and mental illness is still dominated by religious and traditional stereotypes, as well as folk remedies and community practices. The present study examines differences in Muslim social workers' and Imams' recommendations in marriage/divorce and child custody cases of persons with intellectual disabilities (ID) or mental illness. The study has two goals: (1) To examine differences in recommendations between Imams and Muslim social workers; (2) To explore variables related to their differential recommendations as observed in their responses to vignettes—a quantitative study using vignettes resembling existing Muslim religious (Sharia) court cases. Muslim social workers (138) and Imams (48) completed a background questionnaire, a religiosity questionnaire, and a questionnaire that included 25 vignettes constructed by the researcher based on court rulings adapted for the study. Muslim social workers tended to consider the religious recommendation when the family of a person with ID or mental illness was portrayed in the vignette as religious. The same applied to Imams, albeit to a greater extent. The findings call for raising awareness among social workers and academics regarding the importance of religion and tradition in formulating professional recommendations.

Keywords: child custody, intellectual and developmental disability, marriage/divorce, mental illness, sharia court, social workers

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4248 The Genetic Basis of the Lack of Impulse Control: What is Provided for the Criminal Law?

Authors: Amir Bastani

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The result of the research in the field of human behavioural genetics demonstrates a genetic contribution of behavioural differences in aggression, violence, drug and substance abuse, antisocial personality disorder and other related traits. As the field of human behavioural genetics progresses and achieves credibility, the criminal accused continue to use its types of evidence into the criminal law. One of the most important genetic factors which controls certain neurotransmitters like dopamine and serotonin is the Monoamine Oxidase Acid A (MAOA) gene, known as the 'warrior gene'. The high-profile study by Caspi and colleagues in 2002 showed that the combination between one type of variation of the MAOA gene and childhood maltreatment noticeably predisposes a person to antisocial behaviour. Moreover, further scientific research shows that individuals with the MAOA gene have to some degree difficulties in controlling their impulses. Based on the evidence of MAOA, some criminal accused claimed difficulties in self-control. In the first case – the famous case of Mobley – the court rejected the MAOA evidence on the ground of the lack of scientific support. In contrast, in other cases after the Mobley trial, courts accepted the evidence of MAOA. In this paper, the issue of lack of impulse control produced by the MAOA gene and cases which relied on the MAOA evidence and successfully being accepted will be reviewed in detail. Finally, the anticipation of the paper for the future use of the MAOA evidence in criminal cases will be presented.

Keywords: genetic defence, criminal responsibility, MAOA, self-control

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4247 Paraoxonase 1 (PON 1) Arylesterase and Lactonase Activities, Polymorphism and Conjugated Dienes in Gastroenteritis in Paediatric Population

Authors: M. R. Mogarekar, Shraddha V. More, Pankaj Kumar

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Gastroenteritis, the third leading killer of children in India today is responsible for 13% of all deaths in children <5 years of age and kills an estimated 300,000 children in India each year. We decided to investigate parameters which can help in early disease detection and prompt treatment. Serum paraoxonase is calcium dependent esterase which is widely distributed among tissues such as liver, kidney, and intestine and is located in the chromosomal region 7q21.3 22.1. Studies show the presence of excessive reactive oxygen metabolites and antioxidant imbalance in the gastrointestinal tract leading to oxidative stress in gastroenteritis. To our knowledge, this is the first ever study done. The objective of present study is to investigate the role of paraoxonase 1 (PON 1) status i.e arylesterase and lactonase activities and Q192R polymorphism and conjugated dienes, in gastroenteritis of paediatric population. The study and control group consists of 40 paediatric patients with and without gastroenteritis. Paraoxonase arylesterase and lactonase activities were assessed and phenotyping was determined. Conjugated dienes were also assessed. PON 1 arylesterase activities in cases (61.494±13.220) and controls (70.942±15.385) and lactonase activities in cases (15.702±1.036) and controls (17.434±1.176) were significantly decreased (p<0.05). There is no significant difference of phenotypic distribution in cases and controls. Conjugated dienes were found significantly increased in patients (0.086±0.024) than the control group (0.064±0.019) (p<0.05). Paraoxonase 1 activities (arylesterase and lactonase) and conjugated dienes may be useful in risk assessment and management in gastroenteritis in paediatric population.

Keywords: paraoxonase 1 polymorphism, arylesterase, lactonase, conjugated dienes, p-nitrophenylacetate, DHC

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4246 Application of Lattice Boltzmann Method to Different Boundary Conditions in a Two Dimensional Enclosure

Authors: Jean Yves Trepanier, Sami Ammar, Sagnik Banik

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Lattice Boltzmann Method has been advantageous in simulating complex boundary conditions and solving for fluid flow parameters by streaming and collision processes. This paper includes the study of three different test cases in a confined domain using the method of the Lattice Boltzmann model. 1. An SRT (Single Relaxation Time) approach in the Lattice Boltzmann model is used to simulate Lid Driven Cavity flow for different Reynolds Number (100, 400 and 1000) with a domain aspect ratio of 1, i.e., square cavity. A moment-based boundary condition is used for more accurate results. 2. A Thermal Lattice BGK (Bhatnagar-Gross-Krook) Model is developed for the Rayleigh Benard convection for both test cases - Horizontal and Vertical Temperature difference, considered separately for a Boussinesq incompressible fluid. The Rayleigh number is varied for both the test cases (10^3 ≤ Ra ≤ 10^6) keeping the Prandtl number at 0.71. A stability criteria with a precise forcing scheme is used for a greater level of accuracy. 3. The phase change problem governed by the heat-conduction equation is studied using the enthalpy based Lattice Boltzmann Model with a single iteration for each time step, thus reducing the computational time. A double distribution function approach with D2Q9 (density) model and D2Q5 (temperature) model are used for two different test cases-the conduction dominated melting and the convection dominated melting. The solidification process is also simulated using the enthalpy based method with a single distribution function using the D2Q5 model to provide a better understanding of the heat transport phenomenon. The domain for the test cases has an aspect ratio of 2 with some exceptions for a square cavity. An approximate velocity scale is chosen to ensure that the simulations are within the incompressible regime. Different parameters like velocities, temperature, Nusselt number, etc. are calculated for a comparative study with the existing works of literature. The simulated results demonstrate excellent agreement with the existing benchmark solution within an error limit of ± 0.05 implicates the viability of this method for complex fluid flow problems.

Keywords: BGK, Nusselt, Prandtl, Rayleigh, SRT

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4245 Contour Defects of Face with Hyperpigmentation

Authors: Afzaal Bashir, Sunaina Afzaal

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Background: Facial contour deformities associated with pigmentary changes are of major concern for plastic surgeons, both being important and difficult in treating such issues. No definite ideal treatment option is available to simultaneously address both the contour defect as well as related pigmentation. Objectives: The aim of the current study is to compare the long-term effects of conventional adipose tissue grafting and ex-vivo expanded Mesenchymal Stem Cells enriched adipose tissue grafting for the treatment of contour deformities with pigmentary changes on the face. Material and Methods: In this study, eighty (80) patients with contour deformities of the face with hyperpigmentation were recruited after informed consent. Two techniques i.e., conventional fat grafting (C-FG) and fat grafts enriched with expanded adipose stem cells (FG-ASCs), were used to address the pigmentation. Both techniques were explained to patients, and enrolled patients were divided into two groups i.e., C-FG and FG-ASCS, per patients’ choice and satisfaction. Patients of the FG-ASCs group were treated with fat grafts enriched with expanded adipose stem cells, while patients of the C-FGs group were treated with conventional fat grafting. Patients were followed for 12 months, and improvement in face pigmentation was assessed clinically as well as measured objectively. Patient satisfaction was also documented as highly satisfied, satisfied, and unsatisfied. Results: Mean age of patients was 24.42(±4.49), and 66 patients were females. The forehead was involved in 61.20% of cases, the cheek in 21.20% of cases, the chin in 11.20% of cases, and the nose in 6.20% of cases. In the GF-ASCs group, the integrated color density (ICD) was decreased (1.08×10⁶ ±4.64×10⁵) as compared to the C-FG group (2.80×10⁵±1.69×10⁵). Patients treated with fat grafts enriched with expanded adipose stem cells were significantly more satisfied as compared to patients treated with conventional fat grafting only. Conclusion: Mesenchymal stem cell-enriched autologous fat grafting is a preferred option for improving the contour deformities related to increased pigmentation of face skin.

Keywords: hyperpigmentation, color density, enriched adipose tissue graft, fat grafting, contour deformities, Image J

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4244 Incidence of Iron Deficiency Anemia Among the Children with Febrile Seizures

Authors: Samina Nazli, Nadia Qamar, Quratulain, Akasha, Saman Jamal

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Objective: The objective is to determine the frequency of iron deficiency anemia among children having febrile seizures. A descriptive Cross-Sectional Study was done in the Pediatric Unit of Allama Iqbal Memorial Teaching Hospital Sialkot from September 2020 to February 2021. Material & Methods: A total of 70 children were studied aged six months to 10 years, with either gender presenting with febrile seizures. All data of the patients was documented, including demographic data like age, gender, residential area, educational status, socioeconomic status and clinical findings at the time of presentation like fever, fits and duration of symptoms etc. Blood hemoglobin and ferritin levels were tested for each patient to evaluate iron deficiency anemia. Results: There were 65.7% male and 34.3% female cases in this study. The age range of the patients was 6 months to 10 years, with a mean age of 4.36 ± 2.71 years. Most of the children (60%) were below three years of age. Most children belonged to low and middle socioeconomic status with a frequency of 42.8% and 45.7%, respectively. Iron deficiency anemia was found in 38.6% of cases. The majority of the mothers were illiterate (65%). There were 44.3% cases from rural areas and 55.7% from urban areas. Conclusion: Iron deficiency anemia is a common problem among children with febrile seizures, younger than 03 years and belonging to rural areas. Illiterate mothers are an important risk factor for iron deficiency anemia in their children.

Keywords: febrile seizure, iron deficiency anemia, illetrate mother, low scioeconomic status, febrile siezure

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4243 Simulation Model of Induction Heating in COMSOL Multiphysics

Authors: K. Djellabi, M. E. H. Latreche

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The induction heating phenomenon depends on various factors, making the problem highly nonlinear. The mathematical analysis of this problem in most cases is very difficult and it is reduced to simple cases. Another knowledge of induction heating systems is generated in production environments, but these trial-error procedures are long and expensive. The numerical models of induction heating problem are another approach to reduce abovementioned drawbacks. This paper deals with the simulation model of induction heating problem. The simulation model of induction heating system in COMSOL Multiphysics is created. In this work we present results of numerical simulations of induction heating process in pieces of cylindrical shapes, in an inductor with four coils. The modeling of the inducting heating process was made with the software COMSOL Multiphysics Version 4.2a, for the study we present the temperature charts.

Keywords: induction heating, electromagnetic field, inductor, numerical simulation, finite element

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4242 Vibrational Behavior of Cylindrical Shells in Axial Magnetic Field

Authors: Sedrak Vardanyan

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The investigation of the vibrational character of magnetic cylindrical shells placed in an axial magnetic field has important practical applications. In this work, we study the vibrational behaviour of such a cylindrical shell by making use of the so-called exact space treatment, which does not assume any hypothesis. We discuss the effects of several practically important boundary conditions on the vibrations of the described setup. We find that, for some cases of boundary conditions, e.g. clamped, simply supported or peripherally earthed, as well as for some values of the wave numbers, the vibrational frequencies of the shell are approximately zero. The theoretical and numerical exploration of this fact confirms that the vibrations are absent or attenuate very rapidly. For all the considered cases, the imaginary part of the frequencies is negative, which implies stability for the vibrational process.

Keywords: bending vibrational frequencies, exact space treatment, free vibrations, magnetic cylindrical shells

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4241 Intrarenal Injection of Pentobarbital Sodium for Euthanasia in Cats: 131 Cases, 2010-2011

Authors: Kathleen Cooney, Jennifer Coates, Lesley Leach, Kristin Hrenchir

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The objective of this retrospective study was to determine whether intrarenal injection of pentobarbital sodium is a practicable method of euthanasia in client-owned cats. 131 Cats were anesthetized using a combination of tiletamine, zolazepam, and acepromazine given by of subcutaneous or intramuscular injection. Once an appropriate plane of anesthesia was reached, 6 ml of pentobarbital sodium was injected into either the left or right kidney. The patient’s age, sex, estimated weight, presenting condition, estimated dehydration level, palpable characteristics of the kidney pre and post injection, physical response of the cat, and time to cardiopulmonary arrest were recorded. Analysis of 131 records revealed that cats receiving an intrarenal injection of pentobarbital sodium had an average time to cardiopulmonary arrest of 1 minute. The great majority (79%) experienced cardiopulmonary arrest in less than one minute with the remainder experiencing cardiopulmonary arrest between 1 and 8 minutes of the injection. 95% of cats had no observable reaction to intrarenal injection other than cardiopulmonary arrest. In the 19% of cases where kidney swelling was not palpable upon injection, average time to cardiopulmonary arrest increased from 0.9 to 1.6 min. Conclusions and Clinical Relevance: Intrarenal injections of pentobarbital sodium are similar in effect to intravenous methods of euthanasia. Veterinarians who elect to use intrarenal injections can expect cardiopulmonary arrest to occur quickly in the majority of patients with few agonal reactions. Intrarenal injection of pentobarbital sodium in anesthetized cats has ideally suited for cases of owner observed euthanasia when obtaining intravenous access would difficult or disruptive.

Keywords: euthanasia, injection, intrarenal, pentobarbital sodium

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4240 A 10 Year Review of the Complications of Ingested and Aspirated Dentures

Authors: Rory Brown, Jessica Daniels, Babatunde Oremule, William Tsang, Sadie Khwaja

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Introduction: Dentures are common and are an intervention for both physical and psychological symptoms associated with tooth loss. However, the humble denture can cause morbidity and mortality if swallowed or aspirated. Numerous case reports document complications including hollow viscus perforation, fistula formation and airway compromise. The purpose of this review was to examine the literature documenting cases of swallowed or aspirated dentures over the past ten years to investigate factors that contribute to developing complications. Methods: A Medline literature search was performed to identify cases of denture ingestion or aspiration for over ten years. Data was collected to include patient, appliance and temporal factors that may contribute to developing complications including hollow viscus perforation, fistula formation, abscess, bowel obstruction, necrosis, hemorrhage and airway obstruction. The data was analyzed using observational and inferential statistics in the form of Chi-Squared and Pearson correlation tests. Results: Eighty-five cases of ingested or aspirated dentures were identified from 77 articles published between 1/10/2009 and 31/10/2019. Fourteen articles were excluded because they did not provide sufficient information on individual cases. Complications were documented in 37.6% of patients, and 2 cases resulted in death. There was no significant difference in complication risk based on patient age, hooked appliance, level of impaction, or radiolucency. However, symptoms of greater than 1-day duration are associated with an increased risk of complication (p=0.005). Increased time from ingestion or aspiration to removal is associated with an increased risk of complications, and the p-value remains significant up to and including day 4 (p=0.017). Conclusions: With denture use predicted to rise complications from the denture, ingestion and aspiration may become more frequent. We have demonstrated that increased symptom duration significantly increases the risk of developing complications. Additionally, we established the risk of developing complications is significantly reduced if the denture is removed with four days of aspiration or ingestion. By actively intervening early when presented with a case of swallowed or aspirated dentures, we may be able to reduce the morbidity associated with this unassuming device.

Keywords: aspiration, denture, ingestion, endoscopic foreign, body removal, foreign body impaction

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4239 The Clinical Manifestations of Myocardial Bridging in Patients with Coronary Artery Disease

Authors: Alexey Yu. Martynov, Sulejman Bayramov

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Introduction: The myocardial bridging is the most common anomaly of the coronary arteries (CA). Depending on the examination method, the frequency of detected myocardial bridges (MB) varies in a rather wide range. The typical clinical manifestations of MB are angina pectoris, arrhythmias, sudden cardiac death. Objective: To study the incidence of MB in patients hospitalized with coronary artery disease (CAD). To assess clinical manifestations of MB in patients admitted with CAD. Materials and methods: A retrospective analysis of 19159 case histories of patients admitted at clinical city hospital in Moscow from 01.01.2018 to 31.12 2019 with CAD was performed. 9384 patients’ coronary angiographies (CAG) were examined for MB. The localization of MB, the degree of coronary contraction by MB, the number of MB, isolated MB and combined with CAD were assessed. The clinical manifestations of MB were determined. Results: MB was detected in 52 patients all with one myocardial bridge. 20 patients with MB have intact CA, and 32 patients have MB combined with CAD. Among 20 patients with intact CA: I degree of MB contraction (up to 50%) was detected in 9 patients. Clinical manifestations in five cases were angina pectoris, in 3 myocardial infarction (MI) - 1 patients with ST segment elevation MI (STEMI), 2 without ST segment elevation MI (NSTEMI), 1 post-infarction cardiosclerosis (PICS). Stable angina II FC in 3, III FC in 1, vasospastic angina (VSA) in 1 patient. II degree of MB contraction (up to 50-70%) was determined in 9 patients: in seven cases angina pectoris was detected, 1 NSTEMI, 1 PICS. Stable angina II FC in 3, III FC in 1, VSA in 3 patients. III degree of MB contraction (> 70%) detected in 2 patients. II FC stable angina in one case, PICS in another. Among 32 patients having MB combined with CAD I degree of MB contraction was observed in 20 patients. Clinical manifestations in 12 cases were angina pectoris in 8 II FC and in 4 III FC, 7 MI 6 with STEMI and 1 NSTEMI, 1 PICS. II degree of MB contraction was detected in 7 patients, 4 of them had angina pectoris, 3 MI 2 with STEMI and 1 NSTEMI. Stable angina II FC in 3, VSA in 1 patients. III degree of MB contraction was diagnosed in five patients. In two cases, II FC and III FC stable angina were observed, 2 MI with STEMI and NSTEMI, 1 PICS. Conclusions: MB incidence is one in 368 patients with CAD. The most common involvement (68%) is MB combined with CA atherosclerotic lesions. MB with intact CA are detected in one-third (32%) of patients. The first-degree MB contraction is most frequent condition. MI is more often detected in intact CA with first degree MB than in the second degree. The degree of MB contraction was not correlated with the severity of the clinical manifestations.

Keywords: clinical manifestations, coronary angiography, coronary artery disease, myocardial bridging, myocardial infarction, stable angina

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4238 Detecting Overdispersion for Mortality AIDS in Zero-inflated Negative Binomial Death Rate (ZINBDR) Co-infection Patients in Kelantan

Authors: Mohd Asrul Affedi, Nyi Nyi Naing

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Overdispersion is present in count data, and basically when a phenomenon happened, a Negative Binomial (NB) is commonly used to replace a standard Poisson model. Analysis of count data event, such as mortality cases basically Poisson regression model is appropriate. Hence, the model is not appropriate when existing a zero values. The zero-inflated negative binomial model is appropriate. In this article, we modelled the mortality cases as a dependent variable by age categorical. The objective of this study to determine existing overdispersion in mortality data of AIDS co-infection patients in Kelantan.

Keywords: negative binomial death rate, overdispersion, zero-inflation negative binomial death rate, AIDS

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