Search results for: severe accident
1874 Strategy of Loading by Number for Commercial Vehicles
Authors: Ramalan Musa Yerima
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The paper titled “Loading by number” explained a strategy developed recently by the Zonal Commanding Officer of the Federal Road Safety Corps of Nigeria, covering Sokoto, Kebbi and Zamfara States of Northern Nigeria. The strategy is aimed at reducing competition, which will invariably lead to a reduction in speed, reduction in dangerous driving, reduction in crash rate, reduction in injuries, reduction in property damages and reduction in death through road traffic crashes (RTC). This research paper presents a study focused on enhancing the safety of commercial vehicles. The background of this study highlights the alarming statistics related to commercial vehicle crashes in Nigeria with a focus on Sokoto, Kebbi and Zamfara States, which often result in significant damage to property, loss of lives, and economic costs. The significance and aims is to investigate and propose an effective strategy to enhance the safety of commercial vehicles. The study recognizes the pressing need for heightened safety measures in commercial transportation, as it impacts not only the well-being of drivers and passengers but also the overall public safety. To achieve the objectives, an examination of accident data, including causes and contributing factors, was performed to identify critical areas for improvement. The major finding of the study reveals that when competition comes into play within the realm of commercial driving, it has detrimental effects on road safety and resource management. Commercial drivers are pushed to complete their routes quickly and deliver goods on time, or they push themselves to arrive quickly for more passengers and new contracts. This competitive environment, fuelled by internal and external pressures such as tight deadlines, poverty and greed, often leads to sad endings. The study recommends that if a strategy called loading by number is integrated with other multiple safety measures, such as driver training programs, regulatory enforcement, and infrastructure improvements, commercial vehicle safety can be significantly enhanced. "Loading by Number” approach is designed to ensure that the sequence of departure of drivers from the motor park ‘A’ would be communicated to motor park officials of park ‘B’, which would be considered sequentially when giving them returning passengers, regardless of the first to arrive. In conclusion, this paper underscores the significance of improving the safety measures of commercial vehicles, as they are often larger and heavier than other vehicles on the road. Whenever they are involved in accidents, the consequences can be more severe. Commercial vehicles are also frequently involved in long-haul or interstate transportation, which means they cover longer distances and spend more time on the road. This increased exposure to driving conditions increases the probability of accidents occurring. By implementing the suggested measures, policymakers, transportation authorities, and industry stakeholders can work collectively toward ensuring a safer commercial transportation system.Keywords: commercial, safety, strategy, transport
Procedia PDF Downloads 631873 Corrosion Response of Friction Stir Processed Mg-Zn-Zr-RE Alloy
Authors: Vasanth C. Shunmugasamy, Bilal Mansoor
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Magnesium alloys are increasingly being considered for structural systems across different industrial sectors, including precision components of biomedical devices, owing to their high specific strength, stiffness and biodegradability. However, Mg alloys exhibit a high corrosion rate that restricts their application as a biomaterial. For safe use as biomaterial, it is essential to control their corrosion rates. Mg alloy corrosion is influenced by several factors, such as grain size, precipitates and texture. In Mg alloys, microgalvanic coupling between the α-Mg matrix and secondary precipitates can exist, which results in an increased corrosion rate. The present research addresses this challenge by engineering the microstructure of a biodegradable Mg–Zn–RE–Zr alloy by friction stir processing (FSP), a severe plastic deformation process. The FSP-processed Mg alloys showed improved corrosion resistance and mechanical properties. FSPed Mg alloy showed refined grains, a strong basal texture and broken and uniformly distributed secondary precipitates in the stir zone. Mg, alloy base material, exposed to In vitro corrosion medium showed micro galvanic coupling between precipitate and matrix, resulting in the unstable passive layer. However, FS processed alloy showed uniform corrosion owing to stable surface film formation. The stable surface film is attributed to refined grains, preferred texture and distribution of precipitates. The research results show promising potential for Mg alloy to be developed as a biomaterial.Keywords: biomaterials, severe plastic deformation, magnesium alloys, corrosion
Procedia PDF Downloads 431872 Three Dimensional Computational Fluid Dynamics Simulation of Wall Condensation inside Inclined Tubes
Authors: Amirhosein Moonesi Shabestary, Eckhard Krepper, Dirk Lucas
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The current PhD project comprises CFD-modeling and simulation of condensation and heat transfer inside horizontal pipes. Condensation plays an important role in emergency cooling systems of reactors. The emergency cooling system consists of inclined horizontal pipes which are immersed in a tank of subcooled water. In the case of an accident the water level in the core is decreasing, steam comes in the emergency pipes, and due to the subcooled water around the pipe, this steam will start to condense. These horizontal pipes act as a strong heat sink which is responsible for a quick depressurization of the reactor core when any accident happens. This project is defined in order to model all these processes which happening in the emergency cooling systems. The most focus of the project is on detection of different morphologies such as annular flow, stratified flow, slug flow and plug flow. This project is an ongoing project which has been started 1 year ago in Helmholtz Zentrum Dresden Rossendorf (HZDR), Fluid Dynamics department. In HZDR most in cooperation with ANSYS different models are developed for modeling multiphase flows. Inhomogeneous MUSIG model considers the bubble size distribution and is used for modeling small-scaled dispersed gas phase. AIAD (Algebraic Interfacial Area Density Model) is developed for detection of the local morphology and corresponding switch between them. The recent model is GENTOP combines both concepts. GENTOP is able to simulate co-existing large-scaled (continuous) and small-scaled (polydispersed) structures. All these models are validated for adiabatic cases without any phase change. Therefore, the start point of the current PhD project is using the available models and trying to integrate phase transition and wall condensing models into them. In order to simplify the idea of condensation inside horizontal tubes, 3 steps have been defined. The first step is the investigation of condensation inside a horizontal tube by considering only direct contact condensation (DCC) and neglect wall condensation. Therefore, the inlet of the pipe is considered to be annular flow. In this step, AIAD model is used in order to detect the interface. The second step is the extension of the model to consider wall condensation as well which is closer to the reality. In this step, the inlet is pure steam, and due to the wall condensation, a liquid film occurs near the wall which leads to annular flow. The last step will be modeling of different morphologies which are occurring inside the tube during the condensation via using GENTOP model. By using GENTOP, the dispersed phase is able to be considered and simulated. Finally, the results of the simulations will be validated by experimental data which will be available also in HZDR.Keywords: wall condensation, direct contact condensation, AIAD model, morphology detection
Procedia PDF Downloads 3041871 Sudden Death and Chronic Disseminated Intravascular Coagulation (DIC): Two Case Reports
Authors: Saker Lilia, Youcef Mellouki, Lakhdar Sellami, Yacine Zerairia, Abdelhaid Zetili, Fatma Guahria, Fateh Kaious, Nesrine Belkhodja, Abdelhamid Mira
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Background: Sudden death is regarded as a suspicious demise necessitating autopsy, as stipulated by legal authorities. Chronic disseminated intravascular coagulation (DIC) is an acquired clinical and biological syndrome characterized by a severe and fatal prognosis, stemming from systemic, uncontrolled, diffuse coagulation activation. Irrespective of their origins, DIC is associated with a diverse spectrum of manifestations, encompassing minor biological coagulation alterations to profoundly severe conditions wherein hemorrhagic complications may take precedence. Simultaneously, microthrombi contribute to the development of multi-organ failures. Objective This study seeks to evaluate the role of autopsy in determining the causes of death. Materials and Methods: We present two instances of sudden death involving females who underwent autopsy at the Forensic Medicine Department of the University Hospital of Annaba, Algeria. These autopsies were performed at the request of the prosecutor, aiming to determine the causes of death and illuminate the exact circumstances surrounding it. Methods Utilized: Analysis of the initial information report; Findings from postmortem examinations; Histological assessments and toxicological analyses. Results: The presence of DIC was noted, affecting nearly all veins with distinct etiologies. Conclusion: For the establishment of a meaningful diagnosis: • Thorough understanding of the subject matter is imperative; • Precise alignment with medicolegal data is essential.Keywords: chronic disseminated intravascular coagulation, sudden death, autopsy, causes of death
Procedia PDF Downloads 851870 A Statistical Analysis on the Comparison of First and Second Waves of COVID-19 and Importance of Early Actions in Public Health for Third Wave in India
Authors: Maitri Dave
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Coronaviruses (CoV) is such infectious virus which has impacted globally in a more dangerous manner causing severe lung problems and leaving behind more serious diseases among the people. This pandemic has affected globally and created severe respiratory problems, and damaged the lungs. India has reported the first case of COVID-19 in January 2020. The first wave of COVID-19 took place from April to September of 2020. Soon after, a second peak is also noticed in the month of March 2021, which in turn becomes more dangerous due to a lack of supply of medical equipment. It created resource deficiency globally, specifically in India, where some necessary life-saving equipment like ventilators and oxygenators were not sufficient to cater to the demand-supply ratio effectively. Through carefully examining such a situation, India began to execute the process of vaccination in the month of January 2021 and successfully administered 25,46,71,259 doses of vaccines till now, which is only 15.5% of the total population while only 3.6% of the total population is fully vaccinated. India has authorized the British Oxford–AstraZeneca vaccine (Covishield), the Indian BBV152 (Covaxin) vaccine, and the Russian Sputnik V vaccine for emergency use. In the present study, we have collected all the data state wisely of both first and second wave and analyzed them using MS Excel Version 2019 and SPSS Statistics Version 26. Following the trends, we have predicted the characteristics of the upcoming third wave of COVID-19 and recommended some strategies, early actions, and measures that can be taken by the public health system in India to combat the third wave more effectively.Keywords: COVID-19, vaccination, Covishiled, Coronavirus
Procedia PDF Downloads 2161869 Case Report on Anaesthesia for Ruptured Ectopic with Severe Pulmonary Hypertension in a Mute Patient
Authors: Pamela Chia, Tay Yoong Chuan
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Introduction: Severe pulmonary hypertension (PH) patients requiring non-cardiac surgery risk have increased mortality rates ranging. These patients are plagued with cardiorespiratory failure, dysrhythmias and anticoagulation potentially with concurrent sepsis and renal insufficiency, perioperative morbidity. We present a deaf-mute patient with severe idiopathic PH emergently prepared for ruptured ectopic laparotomy. Case Report: A 20 year-old female, 62kg (BMI 25 kg/m2) with severe idiopathic PH (2DE Ejection Fraction was 41%, Pulmonary Artery Systolic Pressure (PASP) 105 mmHg, Right ventricle strain and hypertrophy) and selective mutism was rushed in for emergency laparotomy after presenting to the emergency department for abdominal pain. The patient had an NYHA Class II with room air SpO2 93-95%. While awaiting lung transplant, the patient takes warfarin, Sildanefil, Macitentan and even Selexipag for rising PASP. At presentation, vital signs: BP 95/63, HR 119 SpO2 88% (room air). Despite decreasing haemoglobin 14 to 10g/dL, INR 2.59 was reversed with prothrombin concentrate, and Vitamin K. ECG revealed Right Bundle Branch Block with right ventricular strain and x-ray showed cardiomegaly, dilated Right Ventricle, Pulmonary Arteries, basal atelectasis. Arterial blood gas showed compensated metabolic acidosis pH 7.4 pCO2 32 pO2 53 HCO3 20 BE -4 SaO2 88%. The cardiothoracic surgeon concluded no role for Extracorporeal Membrane Oxygenation (ECMO). We inserted invasive arterial and central venous lines with blood transfusion via an 18G cannula before the patient underwent a midline laparotomy, haemostasis of ruptured ovarian cyst with 2.4L of clots under general anesthesia and FloTrac cardiac output monitoring. Rapid sequence induction was done with Midazolam/Propofol, remifentanil infusion, and rocuronium. The patient was maintained on Desflurane. Blood products and colloids were transfused for further 1.5L blood loss. Postoperatively, the patient was transferred to the intensive care unit and was extubated uneventfully 7hours later. The patient went home a week later. Discussion: Emergency hemostasis laparotomy in anticoagulated WHO Class I PH patient awaiting lung transplant with no ECMO backup poses tremendous stress on the deaf-mute patient and the anesthesiologist. Balancing hemodynamics avoiding hypotension while awaiting hemostasis in the presence of pulmonary arterial dilators and anticoagulation requires close titration of volatiles, which decreases RV contractility. We review the contraindicated anesthetic agents (ketamine, N2O), choice of vasopressors in hypotension to maintain Aortic-right ventricular pressure gradients and nitric oxide use perioperatively. Conclusion: Interdisciplinary communication with a deaf-mute moribund patient and anesthesia considerations pose many rare challenges worth sharing.Keywords: pulmonary hypertension, case report, warfarin reversal, emergency surgery
Procedia PDF Downloads 2201868 Framing Opposition to Nuclear Power: Case of Akkuyu Nuclear Power
Authors: Pinar Temocin
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Although the Akkuyu nuclear power project has been in the planning the Akkuyu nuclear power plant in the Mersin Province of Southern Turkey, recent events have increased its visibility in the Turkish debate. The Fukushima accident, the 2010 nuclear deal with Russia followed by several consequent nuclear revelations of administrative deficiencies, and waste issues all spurted widespread protests across Turkey and have polarized the nation into two camps; supporters and detractors. Those who support a nuclear Turkey include energy entrepreneurs, local investors, and technical experts who are heavily involved in paving the way for the realization of a nuclear project. Civil society activists and environmentalists overwhelmingly oppose the nuclear program. This study focuses on the latter, analyzing how groups opposing nuclear power plants (NPPs) have framed the Akkuyu nuclear project as a dangerous, risky, disadvantageous, and irrational policy choice.Keywords: nuclear energy, anti-nuclear movements, environmentalists, civil society, Turkey
Procedia PDF Downloads 3661867 Text Mining Analysis of the Reconstruction Plans after the Great East Japan Earthquake
Authors: Minami Ito, Akihiro Iijima
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On March 11, 2011, the Great East Japan Earthquake occurred off the coast of Sanriku, Japan. It is important to build a sustainable society through the reconstruction process rather than simply restoring the infrastructure. To compare the goals of reconstruction plans of quake-stricken municipalities, Japanese language morphological analysis was performed by using text mining techniques. Frequently-used nouns were sorted into four main categories of “life”, “disaster prevention”, “economy”, and “harmony with environment”. Because Soma City is affected by nuclear accident, sentences tagged to “harmony with environment” tended to be frequent compared to the other municipalities. Results from cluster analysis and principle component analysis clearly indicated that the local government reinforces the efforts to reduce risks from radiation exposure as a top priority.Keywords: eco-friendly reconstruction, harmony with environment, decontamination, nuclear disaster
Procedia PDF Downloads 2201866 Access of Refugees in Rural Areas to Regular Medication during COVID-19 Era: International Organization for Migration, Jordan Experience
Authors: Rasha Shoumar
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Background: Since the onset of the Syria crisis in 2011, Jordan has hosted many Syrian refugees, many of which are residing in urban and rural areas. Vulnerability of refugees has increased due to the COVID-19 pandemic, adding to their already existing challenge in access to medical services, rendering them vulnerable to the complications of untreated medical conditions and amplifying their risk for severe COVID-19 disease. To improve health outcomes and access to health care services in a COVID-19 context, IOM (The International Organization for Migration) provided health services including awareness raising, direct primary health care through mobile teams and referrals to secondary services were extended to the vulnerable populations of refugees. Method: 6 community health volunteers were trained and deployed to different governorates to provide COVID-19 and non-communicable disease awareness and collect data rated to non-communicable disease and access to medical health services. Primary health care services were extended to 7 governorates through a mobile medical team, providing medical management. The collected Data was reviewed and analyzed. Results: 2150 refugees in rural areas were reached out by community health volunteers, out of which 78 received their medications through the Ministry of Health, 121 received their medications through different non-governmental organizations, 665 patients couldn’t afford buying any medications, 1286 patients were occasionally buying their medications when they were able to afford it. 853 patients received medications and follow up through IOM mobile clinics, the most common conditions were hypertension, diabetes, hyperlipidemia, anemia, heart disease, thyroid disease, asthma, seizures, and psychiatric conditions. 709 of these patients had more than 3 of the comorbidities. Multiple cases were referred for secondary and tertiary lifesaving interventions. Conclusion: Non communicable diseases are highly prevalent among refugee population in Jordan, access to medical services have proven to be a challenge in rural areas especially during the COVID-19 era, many of the patients have multiple uncontrolled medical conditions placing them at risk for complications and risk for severe COVID-19 disease. Deployment of mobile clinics to rural areas plays an essential role in managing such medical conditions, thus improving the continuum of health care approach, physical and mental wellbeing of refugees and reducing the risk for severe COVID-19 disease among this group, taking us one step forward toward universal health access.Keywords: COVID-19, refugees, mobile clinics, primary health care
Procedia PDF Downloads 1401865 Drought Risk Analysis Using Neural Networks for Agri-Businesses and Projects in Lejweleputswa District Municipality, South Africa
Authors: Bernard Moeketsi Hlalele
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Drought is a complicated natural phenomenon that creates significant economic, social, and environmental problems. An analysis of paleoclimatic data indicates that severe and extended droughts are inevitable part of natural climatic circle. This study characterised drought in Lejweleputswa using both Standardised Precipitation Index (SPI) and neural networks (NN) to quantify and predict respectively. Monthly 37-year long time series precipitation data were obtained from online NASA database. Prior to the final analysis, this dataset was checked for outliers using SPSS. Outliers were removed and replaced by Expectation Maximum algorithm from SPSS. This was followed by both homogeneity and stationarity tests to ensure non-spurious results. A non-parametric Mann Kendall's test was used to detect monotonic trends present in the dataset. Two temporal scales SPI-3 and SPI-12 corresponding to agricultural and hydrological drought events showed statistically decreasing trends with p-value = 0.0006 and 4.9 x 10⁻⁷, respectively. The study area has been plagued with severe drought events on SPI-3, while on SPI-12, it showed approximately a 20-year circle. The concluded the analyses with a seasonal analysis that showed no significant trend patterns, and as such NN was used to predict possible SPI-3 for the last season of 2018/2019 and four seasons for 2020. The predicted drought intensities ranged from mild to extreme drought events to come. It is therefore recommended that farmers, agri-business owners, and other relevant stakeholders' resort to drought resistant crops as means of adaption.Keywords: drought, risk, neural networks, agri-businesses, project, Lejweleputswa
Procedia PDF Downloads 1261864 Development of Detachable Brake System for Moving Apparatus
Authors: Bong-Keun Jung, Jung-Yeon Kim
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The aim of this study was to investigate usability of detachable brake system for moving apparatus such as baby strollers, manual wheelchairs or walkers. The current brake system was proposed to prevent that moving apparatus slip on sloping roadways when unattended as current built-in manual brake for the moving apparatus is not able to react for the matter. The developed detachable brake system enacted by force sensor on the hand grip showed the possibilities to prevent unexpected accident due to uncontrolled stroller or wheelchair use. To investigate the quality and acceptance of this new technology, standard stroller testbed was built and the use of moving apparatus which attached to the proposed brake system was analyzed through video recording. Additional usability questionnaires were given to test users for measuring usability issues.Keywords: brake system, stroller, wheelchair, usability test
Procedia PDF Downloads 7381863 Determining the Prevalence and Correlates of Depression among Transgenders of a Developing Country
Authors: Usama Bin Zubair, Muhammad Azeem
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Introduction: Depression has been one of the most commonly diagnosed mental health disorders in Pakistan. A Census conducted by the government of Pakistan in 2017 showed that more than 10000 trans-genders live in Pakistan. HIV, illicit substance use and mental health issues, including depression, have been the main health problems faced by them. Trans-gender population has been suffering from depressive illness more than normal population all over the world. Aim: To assess the prevalence of depression among the transgender population and analyze the relationship of socio-demographic factors with depression. Subjects and Methods: The sample population comprised of one hundred and forty-two transgender people of Rawalpindi and Islamabad. Beck depressive inventory II (BDI-II) was used to record the presence and severity of the depressive symptoms. Depressive symptoms were categorized as mild, moderate and severe. Relationship of the age, smoking, family income, illicit substance use and education were studied with the presence of depressive symptoms among these transgender people of twin cities of Pakistan. Results: A total of 142 transgender people were included in the final analysis. The mean age of the study participants was 39.55 ± 6.18. Out of these, 45.1% had no depressive symptoms while 31.7% had mild, 12.7% had moderate and 10.6% had severe depressive symptomatology. After applying the binary logistic regression, we found that the presence of depressive symptoms had a significant association with illicit substance use among the target population. Conclusion: This study showed a high prevalence of depressive symptoms among the transgender population in the twin cities of Pakistan. Use of illicit substances like tobacco, cannabis, opiates, and alcohol should be discouraged to prevent mental health problems.Keywords: depression, transgender, prevalence, sociodemographic factors
Procedia PDF Downloads 1211862 How Obesity Sparks the Immune System and Lessons from the COVID-19 Pandemic
Authors: Husham Bayazed
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Purpose of Presentation: Obesity and overweight are among the biggest health challenges of the 21st century, according to the WHO. Obviously, obese individuals suffer different courses of disease – from infections and allergies to cancer- and even respond differently to some treatment options. Of note, obesity often seems to predispose and triggers several secondary diseases such as diabetes, arteriosclerosis, or heart attacks. Since decades it seems that immunological signals gear inflammatory processes among obese individuals with the aforementioned conditions. This review aims to shed light how obesity sparks or rewire the immune system and predisposes to such unpleasant health outcomes. Moreover, lessons from the Covid-19 pandemic ascertain that people living with pre-existing conditions such as obesity can develop severe acute respiratory syndrome (SARS), which needs to be elucidated how obesity and its adjuvant inflammatory process distortion contribute to enhancing severe COVID-19 consequences. Recent Findings: In recent clinical studies, obesity was linked to alter and sparks the immune system in different ways. Adipose tissue (AT) is considered as a secondary immune organ, which is a reservoir of tissue-resident of different immune cells with mediator release, making it a secondary immune organ. Adipocytes per se secrete several pro-inflammatory cytokines (IL-6, IL-4, MCP-1, and TNF-α ) involved in activation of macrophages resulting in chronic low-grade inflammation. The correlation between obesity and T cells dysregulation is pivotal in rewiring the immune system. Of note, autophagy occurrence in adipose tissues further rewire the immune system due to flush and outburst of leptin and adiponectin, which are cytokines and influencing pro-inflammatory immune functions. These immune alterations among obese individuals are collectively incriminated in triggering several metabolic disorders and playing role in increasing cancers incidence and susceptibility to different infections. During COVID-19 pandemic, it was verified that patients with pre-existing obesity being at greater risk of suffering severe and fatal clinical outcomes. Beside obese people suffer from increased airway resistance and reduced lung volume, ACE2 expression in adipose tissue seems to be high and even higher than that in lungs, which spike infection incidence. In essence, obesity with pre-existence of pro-inflammatory cytokines such as LI-6 is a risk factor for cytokine storm and coagulopathy among COVID-19 patients. Summary: It is well documented that obesity is associated with chronic systemic low-grade inflammation, which sparks and alter different pillars of the immune system and triggers different metabolic disorders, and increases susceptibility of infections and cancer incidence. The pre-existing chronic inflammation in obese patients with the augmented inflammatory response against the viral infection seems to increase the susceptibility of these patients to developing severe COVID-19. Although the new weight loss drugs and bariatric surgery are considered as breakthrough news for obesity treatment, but preventing is easier than treating it once it has taken hold. However, obesity and immune system link new insights dispute the role of immunotherapy and regulating immune cells treating diet-induced obesity.Keywords: immunity, metabolic disorders, cancer, COVID-19
Procedia PDF Downloads 741861 Challenges of Management of Acute Pancreatitis in Low Resource Setting
Authors: Md. Shakhawat Hossain, Jimma Hossain, Md. Naushad Ali
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Acute pancreatitis is a dangerous medical emergency in the practice of gastroenterology. Management of acute pancreatitis needs multidisciplinary approach with support starts from emergency to ICU. So, there is a chance of mismanagement in every steps, especially in low resource settings. Other factors such as patient’s financial condition, education, social custom, transport facility, referral system from periphery may also challenge the current guidelines for management. The present study is intended to determine the clinico-pathological profile, severity assessment and challenges of management of acute pancreatitis in a government laid tertiary care hospital to image the real scenario of management in a low resource place. A total 100 patients of acute pancreatitis were studied in this prospective study, held in the Department of Gastroenterology, Rangpur medical college hospital, Bangladesh from July 2017 to July 2018 within one year. Regarding severity, 85 % of the patients were mild, whereas 13 were moderately severe, and 2 had severe acute pancreatitis according to the revised Atlanta criteria. The most common etiologies of acute pancreatitis in our study were gall stone (15%) and biliary sludge (15%), whereas 54% were idiopathic. The most common challenges we faced were delay in hospital admission (59%) and delay in hospital diagnosis (20%). Others are non-adherence of patient party, and lack of investigation facility, physician’s poor knowledge about current guidelines. We were able to give early aggressive fluid to only 18% of patients as per current guideline. Conclusion: Management of acute pancreatitis as per guideline is challenging when optimum facility is lacking. So, modified guidelines for assessment and management of acute pancreatitis should be prepared for low resource setting.Keywords: acute pancreatitis, challenges of management, severity, prognosis
Procedia PDF Downloads 1291860 Probabilistic Safety Assessment of Koeberg Spent Fuel Pool
Authors: Sibongiseni Thabethe, Ian Korir
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The effective management of spent fuel pool (SFP) safety has been raised as one of the emerging issues to further enhance nuclear installation safety after the Fukushima accident on March 11, 2011. Before then, SFP safety-related issues have been mainly focused on (a) controlling the configuration of the fuel assemblies in the pool with no loss of pool coolants and (b) ensuring adequate pool storage space to prevent fuel criticality owing to chain reactions of the fission products and the ability for neutron absorption to keep the fuel cool. A probabilistic safety (PSA) assessment was performed using the systems analysis program for hands-on integrated reliability evaluations (SAPHIRE) computer code. Event and fault tree analysis was done to develop a PSA model for the Koeberg SFP. We present preliminary PSA results of events that lead to boiling and cause fuel uncovering, resulting in possible fuel damage in the Koeberg SFP.Keywords: computer code, fuel assemblies, probabilistic risk assessment, spent fuel pool
Procedia PDF Downloads 1691859 Factors Associated with Depression: Insights from a Cross-Sectional Study among University Students in Vietnam
Authors: Diep The Tai, Huynh Phuong Thao, Tran Cong Luan, Nguyen Thi Hong Huong, Truong Thi Xuan Lien
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Backgrounds: Depression is a prevalent mental health concern among university students. This cross-sectional study explores the factors associated with depression among university students in Vietnam. Methods: In 2022, a web-based survey was conducted among 2,304 students from different universities across North, Central, and South Vietnam. The Pearson chi-squared test was used to analyze the statistical associations between socio-demographic factors, depression levels, and social media addiction. Results: The results showed that 33,9% of freshmen experienced severe depression, with higher rates among females (69,8%) than males (30,2%). Health field students had the highest proportion of severe depression (52%). Social media addiction was prevalent among freshmen (29%) and health students (54,4%). Factors such as family infections, study pressure, hometown, studying in public places, and social media addiction were strongly linked to higher depression levels. However, spending more time communicating with friends and studying at home had a protective effect against depression. Notably, social media addiction was significantly associated with increased depression levels. Conclusion: The study highlights the influence of family COVID-19 infections, academic pressures, studying in public places, hometown, social media addiction, and lack of social interactions on depression levels. It underscores the importance of comprehensive approaches to address depression, promote resilience, and provide support to students during future outbreaks.Keywords: Depression, social media addiction, mental health, university students, Vietnam
Procedia PDF Downloads 851858 Psychological Nano-Therapy: A New Method in Family Therapy
Authors: Siamak Samani, Nadereh Sohrabi
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Psychological nano-therapy is a new method based on systems theory. According to the theory, systems with severe dysfunctions are resistant to changes. Psychological nano-therapy helps the therapists to break this ice. Two key concepts in psychological nano-therapy are nano-functions and nano-behaviors. The most important step in psychological nano-therapy in family therapy is selecting the most effective nano-function and nano-behavior. The aim of this study was to check the effectiveness of psychological nano-therapy for family therapy. One group pre-test-post-test design (quasi-experimental Design) was applied for research. The sample consisted of ten families with severe marital conflict. The important character of these families was resistance for participating in family therapy. In this study, sending respectful (nano-function) text massages (nano-behavior) with cell phone were applied as a treatment. Cohesion/respect sub scale from self-report family processes scale and family readiness for therapy scale were used to assess all family members in pre-test and post-test. In this study, one of family members was asked to send a respectful text massage to other family members every day for a week. The content of the text massages were selected and checked by therapist. To compare the scores of families in pre-test and post-test paired sample t-test was used. The results of the test showed significant differences in both cohesion/respect score and family readiness for therapy between per-test and post-test. The results revealed that these families have found a better atmosphere for participation in a complete family therapy program. Indeed, this study showed that psychological nano-therapy is an effective method to make family readiness for therapy.Keywords: family therapy, family conflicts, nano-therapy, family readiness
Procedia PDF Downloads 6591857 L-Carnitine vs Extracorporeal Elimination for Acute Valproic Acid Intoxication: A Systemic Review
Authors: Byung Keun Yang, Jae Eun Ku, Young Seon Joo, Je Sung You, Sung Phil Chung, Hahn Shick Lee
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The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication. PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs. 11 days) in case of delayed extracorporeal therapy. Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.Keywords: carnitine, overdose, poisoning, renal dialysis, valproic acid
Procedia PDF Downloads 3651856 Optimized Road Lane Detection Through a Combined Canny Edge Detection, Hough Transform, and Scaleable Region Masking Toward Autonomous Driving
Authors: Samane Sharifi Monfared, Lavdie Rada
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Nowadays, autonomous vehicles are developing rapidly toward facilitating human car driving. One of the main issues is road lane detection for a suitable guidance direction and car accident prevention. This paper aims to improve and optimize road line detection based on a combination of camera calibration, the Hough transform, and Canny edge detection. The video processing is implemented using the Open CV library with the novelty of having a scale able region masking. The aim of the study is to introduce automatic road lane detection techniques with the user’s minimum manual intervention.Keywords: hough transform, canny edge detection, optimisation, scaleable masking, camera calibration, improving the quality of image, image processing, video processing
Procedia PDF Downloads 941855 Feeding Practices and Malnutrition among under Five Children in Communities of Kuje Area Council, Federal Capital Territory Abuja, Nigeria
Authors: Clementina Ebere Okoro, Olumuyiwa Adeyemi Owolabi, Doris Bola James, Aloysius Nwabugo Maduforo, Andrew Lingililani Mbewe, Christopher Osaruwanmwen Isokpunwu
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Poor dietary practices and malnutrition, including severe acute malnutrition among under-five children in Nigeria has remained a great public health concern. This study assessed infant and young child feeding practices and nutritional status of under-five children to determine the prevalence of malnutrition of under-five children in Kuje area council, Abuja. The study was a cross-sectional study. Multi-stage sampling techniques was used in selecting the population that was studied. Probability proportion by size was applied in choosing 30 clusters for the survey using ENA for SMART software 2011 version. Questionnaires were used to obtain information from the population, while appropriate equipment was used for measurements of anthropometric parameters. The data was also subjected to statistical analysis. Results were presented in tables and figures. The result showed that 96.7% of the children were breastfed, 30.6% had early initiation to breastfeeding within first hour of birth and 22.4% were breastfed exclusively up to 6 months, 69.8% fed infants’ colostrum, while 30.2% discarded colostrum. About half of the respondents (49.1%) introduced complementary feeding before six months and 23.2% introduced it after six months while 27.7% had age appropriate timely introduction of complementary feeding. The anthropometric result showed that the prevalence of global acute malnutrition (GAM) was 12.8%, severe wasting prevalence was 5.4%, moderate wasting was 7.4%, underweight was 24.4%, stunting was 40.3% and overweight was 7.0%. The result showed that there is a high prevalence of malnutrition among under-five children in KujeKeywords: malnutrition, under five children, breastfeeding, complementary feeding
Procedia PDF Downloads 2671854 Verification of the Effect of the Hazard-Perception Training Tool for Drivers Ported from a Tablet Device to a Smartphone
Authors: K. Shimazaki, M. Mishina, A. Fujii
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In a previous study, we developed a hazard-perception training tool for drivers using a tablet device and verified its effectiveness. Accident movies recorded by drive recorders were separated into scenes before and after the collision. The scene before the collision is presented to the driver. The driver then touches the screen to point out where he/she feels danger. After the screen is touched, the tool presents the collision scene and tells the driver if what he/she pointed out is correct. Various effects were observed such as this tool increased the discovery rate of collision targets and reduced the reaction time. In this study, we optimized this tool for the smartphone and verified its effectiveness. Verifying in the same way as in the previous study on tablet devices clarified that the same effect can be obtained on the smartphone screen.Keywords: hazard perception, smartphone, tablet devices, driver education
Procedia PDF Downloads 2181853 Investigating Real Ship Accidents with Descriptive Analysis in Turkey
Authors: İsmail Karaca, Ömer Söner
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The use of advanced methods has been increasing day by day in the maritime sector, which is one of the sectors least affected by the COVID-19 pandemic. It is aimed to minimize accidents, especially by using advanced methods in the investigation of marine accidents. This research aimed to conduct an exploratory statistical analysis of particular ship accidents in the Transport Safety Investigation Center of Turkey database. 46 ship accidents, which occurred between 2010-2018, have been selected from the database. In addition to the availability of a reliable and comprehensive database, taking advantage of the robust statistical models for investigation is critical to improving the safety of ships. Thus, descriptive analysis has been used in the research to identify causes and conditional factors related to different types of ship accidents. The research outcomes underline the fact that environmental factors and day and night ratio have great influence on ship safety.Keywords: descriptive analysis, maritime industry, maritime safety, ship accident statistics
Procedia PDF Downloads 1391852 Correlation between Pinch and Grip Strength with Dexterity in Adult Hemiplegic
Authors: S. Abbsi, M. R. Hadian, M. Abdolvahab, M. Jalili, S. Khafri
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Background: According to physical effects of cardiovascular accident (CVA) which is the most common disabilities in adulthood. It seems attention to treatment and rehabilitation of this patient has importance. Hemiplegic patients have been experienced of wild functional disabilities. Numerous patients have been suffered from upper limb disabilities. Aim of this study correlation of pinch and grip strength with dexterity in adult hemiplegic. Methods: 34 adult hemiplegic in range of 50-70 years participate in this study. After introduce and take a satisfaction patient, pinch and grip strength have evaluated by dynamometer and dexterity have evaluated by Minnesota manual dexterity test and correlation effects of them have studied. Result: According to result of present investigation, patients with hemiplegia have shown significant correlation between dexterity with pinch and grip strength. Conclusion: Dexterity has correlation with pinch and grip strength, but it seems, not have correlation with age and duration of CVA.Keywords: pinch strength, grip strength, dexterity, hemiplegia
Procedia PDF Downloads 2931851 Application and Limitation of Heavy Metal Pollution Indicators in Coastal Environment of Pakistan
Authors: Noor Us Saher
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Oceans and Marine areas have a great importance, mainly regarding food resources, fishery products and reliance of livelihood. Aquatic pollution is common due to the incorporation of various chemicals mainly entering from urbanization, industrial and commercial facilities, such as oil and chemical spills. Many hazardous wastes and industrial effluents contaminate the nearby areas and initiate to affect the marine environment. These contaminated conditions may become worse in those aquatic environments situated besides the world’s largest cities, which are hubs of various commercial activities. Heavy metal contamination is one of the most important predicaments for marine environments and during past decades this problem has intensified due to an increase in urbanization and industrialization. Coastal regions of Pakistan are facing severe threats from various organic and inorganic pollutants, especially the estuarine and coastal areas of Karachi city, the most populated and industrialized city situated along the coastline. Metal contamination causes severe toxicity in biota resulting the degradation of Marine environments and depletion of fishery resources and sustainability. There are several abiotic (air, water and sediment) and biotic (fauna and flora) indicators that indicate metal contamination. However, all these indicators have certain limitations and complexities, which delay their implementation for rehabilitation and conservation in the marine environment. The inadequate evidences have presented on this significant topic till the time and this study discussed metal pollution and its consequences along the marine environment of Pakistan. This study further helps in identification of possible hazards for the ecological system and allied resources for management strategies and decision making for sustainable approaches.Keywords: coastal and estuarine environment, heavy metals pollution, pollution indicators, Pakistan
Procedia PDF Downloads 2491850 Post-bladder Catheter Infection
Authors: Mahla Azimi
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Introduction: Post-bladder catheter infection is a common and significant healthcare-associated infection that affects individuals with indwelling urinary catheters. These infections can lead to various complications, including urinary tract infections (UTIs), bacteremia, sepsis, and increased morbidity and mortality rates. This article aims to provide a comprehensive review of post-bladder catheter infections, including their causes, risk factors, clinical presentation, diagnosis, treatment options, and preventive measures. Causes and Risk Factors: Post-bladder catheter infections primarily occur due to the colonization of microorganisms on the surface of the urinary catheter. The most common pathogens involved are Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus species. Several risk factors contribute to the development of these infections, such as prolonged catheterization duration, improper insertion technique, poor hygiene practices during catheter care, compromised immune system function in patients with underlying conditions or immunosuppressive therapy. Clinical Presentation: Patients with post-bladder catheter infections may present with symptoms such as fever, chills, malaise, suprapubic pain or tenderness, and cloudy or foul-smelling urine. In severe cases or when left untreated for an extended period of time, patients may develop more severe symptoms like hematuria or signs of systemic infection. Diagnosis: The diagnosis of post-bladder catheter infection involves a combination of clinical evaluation and laboratory investigations. Urinalysis is crucial in identifying pyuria (presence of white blood cells) and bacteriuria (presence of bacteria). A urine culture is performed to identify the causative organism(s) and determine its antibiotic susceptibility profile. Treatment Options: Prompt initiation of appropriate antibiotic therapy is essential in managing post-bladder catheter infections. Empirical treatment should cover common pathogens until culture results are available. The choice of antibiotics should be guided by local antibiogram data to ensure optimal therapy. In some cases, catheter removal may be necessary, especially if the infection is recurrent or associated with severe complications. Preventive Measures: Prevention plays a vital role in reducing the incidence of post-bladder catheter infections. Strategies include proper hand hygiene, aseptic technique during catheter insertion and care, regular catheter maintenance, and timely removal of unnecessary catheters. Healthcare professionals should also promote patient education regarding self-care practices and signs of infection. Conclusion: Post-bladder catheter infections are a significant healthcare concern that can lead to severe complications and increased healthcare costs. Early recognition, appropriate diagnosis, and prompt treatment are crucial in managing these infections effectively. Implementing preventive measures can significantly reduce the incidence of post-bladder catheter infections and improve patient outcomes. Further research is needed to explore novel strategies for prevention and management in this field.Keywords: post-bladder catheter infection, urinary tract infection, bacteriuria, indwelling urinary catheters, prevention
Procedia PDF Downloads 811849 Lessons from Patients Expired due to Severe Head Injuries Treated in Intensive Care Unit of Lady Reading Hospital Peshawar
Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir
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Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar
Procedia PDF Downloads 3501848 Caregivers Burden: Risk and Related Psychological Factors in Caregivers of Patients with Parkinson’s Disease
Authors: Pellecchia M. T., Savarese G., Carpinelli L., Calabrese M.
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Introduction: Parkinson's disease (PD) is characterized by a progressive loss of autonomy which undoubtedly has a significant impact on the quality of life of caregivers, and parents are the main informal caregivers. Caring for a person with PD is associated with an increased risk of psychiatric morbidity and persistent anxiety-depressive distress. The aim of the study is to investigate the burden on caregivers of patients with PD, through the use of multidimensional scales and to identify their personological and environmental determinants. Methods: The study has been approved by the Ethic Committee of the University of Salerno and informed consent for participation to the study was obtained from patients and their caregivers. The study was conducted at the Neurology Department of the A.O.U. "San Giovanni di Dio and Ruggi D’Aragona" of Salerno between September 2020 and May 2021. Materials: The questionnaires used were: a) Caregiver Burden Inventory - CBI a questionnaire of 24 items that allow identifying five sub-categories of burden (objective, psychological, physical, social, emotional); b) Depression Anxiety Stress Scales Short Version - DASS-21 questionnaire consisting of 21 items and valid in examining three distinct but interrelated areas (depression, anxiety and stress); c) Family Strain Questionnaire Short Form - FSQ-SF is a questionnaire of 30 items grouped in areas of increasing psychological risk (OK, R, SR, U); d) Zarit Caregiver Burden Inventory - ZBI, consisting of 22 items based on the analysis of two main factors: personal stress and pressure related to his role; e) Life Satisfaction, a single item that aims to evaluate the degree of life satisfaction in a global way using a 0-100 Likert scale. Findings: N ° 29 caregivers (M age = 55.14, SD = 9.859; 69% F) participated in the study. 20.6% of the sample had severe and severe burden (CBI score = M = 26.31; SD = 22.43) and 13.8% of participants had moderate to severe burden (ZBI). The FSQ-SF highlighted a minority of caregivers who need psychological support, in some cases urgent (Area SR and Area U). The DASS-21 results show a prevalence of stress-related symptoms (M = 10.90, SD = 10.712) compared to anxiety (M = 7.52, SD = 10.752) and depression (M = 8, SD = 10.876). There are significant correlations between some specific variables and mean test scores: retired caregivers report higher ZBI scores (p = 0.423) and lower Life Satisfaction levels (p = -0.460) than working caregivers; years of schooling show a negative linear correlation with the ZBI score (p = -0.491). The T-Test indicates that caregivers of patients with cognitive impairment are at greater risk than those of patients without cognitive impairment. Conclusions: It knows the factors that affect the burden the most would allow for early recognition of risky situations and caregivers who would need adequate support.Keywords: anxious-depressive axis, caregivers’ burden, Parkinson’ disease, psychological risks
Procedia PDF Downloads 2151847 Mental Health Monitoring System as an Effort for Prevention and Handling of Psychological Problems in Students
Authors: Arif Tri Setyanto, Aditya Nanda Priyatama, Nugraha Arif Karyanta, Fadjri Kirana A., Afia Fitriani, Rini Setyowati, Moh.Abdul Hakim
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The Basic Health Research Report by the Ministry of Health (2018) shows an increase in the prevalence of mental health disorders in the adolescent and early adult age ranges. Supporting this finding, data on the psychological examination of the student health service unit at one State University recorded 115 cases of moderate and severe health problems in the period 2016 - 2019. More specifically, the highest number of cases was experienced by clients in the age range of 21-23 years or equivalent, with the mid-semester stage towards the end. Based on the distribution of cases experienced and the disorder becomes a psychological problem experienced by students. A total of 29% or the equivalent of 33 students experienced anxiety disorders, 25% or 29 students experienced problems ranging from mild to severe, as well as other classifications of disorders experienced, including adjustment disorders, family problems, academics, mood disorders, self-concept disorders, personality disorders, cognitive disorders, and others such as trauma and sexual disorders. Various mental health disorders have a significant impact on the academic life of students, such as low GPA, exceeding the limit in college, dropping out, disruption of social life on campus, to suicide. Based on literature reviews and best practices from universities in various countries, one of the effective ways to prevent and treat student mental health disorders is to implement a mental health monitoring system in universities. This study uses a participatory action research approach, with a sample of 423 from a total population of 32,112 students. The scale used in this study is the Beck Depression Inventory (BDI) to measure depression and the Taylor Minnesota Anxiety Scale (TMAS) to measure anxiety levels. This study aims to (1) develop a digital-based health monitoring system for students' mental health situations in the mental health category. , dangers, or those who have mental disorders, especially indications of symptoms of depression and anxiety disorders, and (2) implementing a mental health monitoring system in universities at the beginning and end of each semester. The results of the analysis show that from 423 respondents, the main problems faced by all coursework, such as thesis and academic assignments. Based on the scoring and categorization of the Beck Depression Inventory (BDI), 191 students experienced symptoms of depression. A total of 24.35%, or 103 students experienced mild depression, 14.42% (61 students) had moderate depression, and 6.38% (27 students) experienced severe or extreme depression. Furthermore, as many as 80.38% (340 students) experienced anxiety in the high category. This article will review this review of the student mental health service system on campus.Keywords: monitoring system, mental health, psychological problems, students
Procedia PDF Downloads 1111846 The Response of the Accumulated Biomass and the Efficiency of Water Use in Five Varieties of Durum Wheat Lines under Water Stress
Authors: Fellah Sihem
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The optimal use of soil moisture by culture, is related to the leaf area index, which stood in the cycle and its modulation according to the prevailing stress intensity. For a given stock of water in the soil, cultivar adapted and saving water is one that is no luxury consumption during the preanthesis. It modulates the leaf area index to regulate sweating in the degree of its water supply. In plants water saving, avoidance of dehydration is related to the reduction of water loss by cuticular and stomatal pathways. Muchow and Sinclair reported that the test of relative water content (TRE) is considered the best indicator of leaf water status. The search for indicators of the ability of the plant to make good use of the water, under water stress is a prerequisite for progress in improving performance under water stress. This experiment aims to characterize a set of durum wheat varieties, tested jars and vegetation under different levels of water stress to the surface of the leaf, relative water content, cell integrity, the accumulated biomass and efficiency of water use. The experiment was conducted during the 2005/2006 academic year, at the Agricultural Research Station of the Field Crop Institute of Setif, under semi-controlled conditions. Five genotypes of durum wheat (Triticum durum Desf) were evaluated for their ability to tolerate moderate and severe water stress. The results showed that geno types respond differently to water stress. Dry matter accumulation and growth rate varied among geno types and were significantly reduced. At severe water stress biomass accumulated by Boussalam was the least affected.Keywords: water stress, triticum durum, biomass, cell membrane integrity, relative water content
Procedia PDF Downloads 4691845 Thrombocytopenia and Prolonged Prothrombin Time in Neonatal Septicemia
Authors: Shittu Bashirat, Shittu Mujeeb, Oluremi Adeolu, Orisadare Olayiwola, Jikeme Osameke, Bello Lateef
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Septicemia in neonates refers to generalized bacterial infection documented by positive blood culture in the first 28 days of life and is one of the leading causes of neonatal mortality in sub-Sahara Africa. Thrombocytopenia in newborns is a result of increased platelet consumption; sepsis was found to be the most common risk factor. The objective of the study was to determine if there are organism-specific platelet responses among the 2 groups of bacterial agents: Gram-positive and Gram-negative bacteria, and also to examine the association of platelet count and prothrombin time with neonatal septicemia. 232 blood samples were collected for this study. The blood culture was performed using Bactec 9050, an instrumented blood culture system. The platelet count and prothrombin time were performed using Abacus Junior 5 hematology analyzer and i-STAT 1 analyzer respectively. Of the 231 neonates hospitalized with clinical sepsis, blood culture reports were positive in 51 cases (21.4%). Klebsiella spp. (35.3%) and Staphylococcus aureus (27.5%) were the most common Gram-negative and Gram-positive isolates respectively. Thrombocytopenia was observed in 30 (58.8%) of the neonates with septicemia. Of the 9 (17.6%) patients with severe thrombocytopenia, seven (77.8%) had Klebsiella spp. septicemia. Out of the 21(63.6%) of thrombocytopenia produced by Gram-negative isolate, 17 (80.9) had increased prothrombin time. In conclusion, Gram-negative organisms showed the highest cases of severe thrombocytopenia and prolonged PT. This study has helped to establish a disturbance in hemostatic systems in neonates with septicemia. Further studies, however, may be required to assess other hemostasis parameters in order to understand their interaction with the infectious organisms in neonates.Keywords: neonates, septicemia, thrombocytopenia, prolonged prothrombin time, platelet count
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