Search results for: controlled drug delivery

Authors: Hadeer E. Eliwa, Naglaa S. Bazan, Ebtissam A. Darweesh, Nagwa A. Sabri

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Background: Generic substitution of brand ivabradine prescriptions can reduce drug expenditures and improve adherence. However, the distrust of generic medicines by practitioners and patients due to doubts regarding their quality and fear of counterfeiting compromise the acceptance of this practice. Aim: The goal of this study is to compare the therapeutic equivalence of brand product versus the generic product of ivabradine in adult patients with chronic heart failure with reduced ejection fraction (≤ 40%) (HFrEF). Methodology: Thirty-two Egyptian patients with chronic heart failure with reduced ejection fraction (HFrEF) were treated with branded ivabradine (Procrolan ©) and generic (Bradipect ©) during 24 (2x12) weeks. Primary outcomes were resting heart rate (HR), NYHA FC, Quality of life (QoL) using Minnesota Living with Heart Failure (MLWHF) and EF. Secondary outcomes were the number of hospitalizations for worsening HFrEF and adverse effects. The washout period was not allowed. Findings: At the 12th week, the reduction in HR was comparable in the two groups (90.13±7.11 to 69±11.41 vs 96.13±17.58 to 67.31±8.68 bpm in brand and generic groups, respectively). Also, the increase in EF was comparable in the two groups (27.44 ±4.59 to 33.38±5.62 vs 32±5.96 to 39.31±8.95 in brand and generic groups, respectively). The improvement in NYHA FC was comparable in both groups (87.5% in brand group vs 93.8% in the generic group). The mean value of the QOL improved from 31.63±15.8 to 19.6±14.7 vs 35.68±17.63 to 22.9±15.1 for the brand and generic groups, respectively. Similarly, at end of 24 weeks, no significant changes were observed from data observed at 12th week regarding HR, EF, QoL and NYHA FC. Only minor side effects, mainly phosphenes, and a comparable number of hospitalizations were observed in both groups. Conclusion: The study revealed no statistically significant differences in the therapeutic effect and safety between generic and branded ivabradine. We assume that practitioners can safely interchange between them for economic reasons.

Keywords: bradipect©, heart failure, ivabradine, Procrolan ©, therapeutic equivalence

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Authors: Huang Wei-Chi, Li Wei, Yu Tien-Chieh

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Medication adherence is crucial for treatment success. Adherence problem is common in patients with polypharmacy, especially in the geriatric population who are vulnerable to multiple chronic conditions but averagely less knowledgeable about diseases and medications. In order to help patients take medications appropriately and enhance the understanding of diseases or medications, a Line official account named e-Pharmacist was designed. The line is a popular freeware app with the highest penetration rate (95.7%) in Taiwan. The interface of e-Pharmacist is user-friendly for easy-to-read and convenient operating. Differ from other medication adherence apps, users just added e-Pharmacist as a LINE friend without installing any more apps and the drug lists were automatically downloaded from the personal electronic medical records with security permission. Over and above medication reminder, several additional capabilities were set up and engaged in the platform of e-Pharmacist including prescription refill reservation, laboratory examination consultation, medical appointment registration, and “Daily Health Log” where patients can record and track data of blood pressure/blood sugar and daily meals for self-health management as well as can share the important information to clinical professionals when seeking medical help. Additionally, a Line chatbot was utilized to provide tailored medicine information for the individual user. From July 2020 to March 2022, around 3000 patients added e-pharmacist as Line friends. Every day more than 1500 patients receive messages from e-pharmacist to notify them to take medicine. Thanks to the e-pharmacist alert system and Chatbot, the low-compliance patients (defined by Program on Adherence to Medication, PAM) significantly dropped from 36% to 6%, whereas the high-compliance patients dramatically increased from 13% to 77%. The user satisfaction is 98%. In brief, an e-pharmacist is not only a medication reminder but also a tailored personal assistant with value-added service for health management.

Keywords: e-pharmacist, self-health management, medication reminder, value-added service

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Authors: Mona Almanasef, Dalia Almaghaslah, Geetha Kandasamy, Rajalakshimi Vasudevan, Sadia Batool

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Background: Community pharmacists are one of the most accessible healthcare practitioners worldwide and their services are used by a large proportion of the population. Expanding the roles of community pharmacists could contribute to reducing pressure on general health practice and other areas of health services. This research aimed to evaluate the contribution of community pharmacists in the provision of public health services and to investigate the perceived barriers to the provision of these services in Saudi Arabia. Materials and Methods: This study followed a cross-sectional design using an online anonymous self-administered questionnaire. The study took place in the Asir region, Saudi Arabia, between September 2019 and February 2020. A convenience sampling strategy was used to select and recruit the study participants. The questionnaire was adapted from previous research and involved three sections: demographics, involvement in public health services and barriers to practicing public health roles. Results: The total number of respondents was 193. The proportion of respondents who reported that they were “very involved” or “involved” in each service was 61.7% for weight management, 60.6% for sexual health, 57.5% for healthy eating, 53.4% for physical activity promotion, 51.3% for dental health, 46.1% for smoking cessation, 39.4% for screening for diabetes, 35.7% for screening for hypertension, 31.1% for alcohol dependence and drug misuse counseling, 30.6% for screening for dyslipidaemia, and 21.8% for vaccination and immunization. Most of the barriers in the current research were rated as having low relevance to the provision of public health services. Conclusion: Findings in the current research suggest that community pharmacists in the Asir region have varying levels of involvement in public health roles. Further research needs to be undertaken to understand the barriers to the provision of public health services and what strategies would be beneficial for enhancing the public health role of community pharmacists in Saudi Arabia.

Keywords: community pharmacist, public health, Asir region, Saudi Arabia

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Authors: V. Konjik, J. Schwartz, R. Sandhoff, M. Mack

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The rising number of multi-resistant pathogens demands the development of new antibiotics in order to reduce the lethal risk of infections. Here, we investigate roseoflavin, a vitamin B2 analogue which is produced by Streptomyces davawensis and Streptomyces cinnabarinus. We consider roseoflavin to be a 'Trojan horse' compound. Its chemical structure is very similar to riboflavin but in fact it is a toxin. Furthermore, it is a clever strategy with regard to the delivery of an antibiotic to its site of action but also with regard to the production of this chemical: The producer cell has only to convert a vitamin (which is already present in the cytoplasm) into a vitamin analog. Roseoflavin inhibits the activity of Flavin depending proteins, which makes up to 3.5 % of predicted proteins in organisms sequenced so far. We sequentially knocked out gene clusters and later on single genes in order to find the ones which are involved in the roseoflavin biosynthesis. Consequently, we identified the gene rosB, coding for the protein carrying out the first step of roseoflavin biosynthesis, starting form Flavin mononucleotide. Here we show, that the protein RosB has so far unknown features. It is per se an oxidoreductase, a decarboxylase and an aminotransferase, all rolled into one enzyme. A screen of cofactors revealed needs of oxygen, NAD+, thiamine and glutamic acid to carry out its function. Surprisingly, thiamine is not only needed for the decaboxylation step, but also for the oxidation of 8-demethyl-8-formyl Flavin mononucleotide. We had managed to isolate three different Flavin intermediates with different oxidation states, which gave us a mechanistic insight of RosB functionality. Our work points to a so far new function of thiamine in Streptomyces davawensis. Additionally, RosB could be extremely useful for chemical synthesis. Careful engineering of RosB may allow the site-specific replacement of methyl groups by amino groups in polyaromatic compounds of commercial interest. Finally, the complete clarification of the roseoflavin biosynthesis opens the possibility of engineering cost-effective roseoflavin producing strains.

Keywords: antibiotic, flavin analogue, roseoflavin biosynthesis, vitamin B2

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Authors: Shoukat Ali, Abdul Qadir Jandga, Amjad Hussain

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Objective: The main purpose of this study is to compare the Percent Depth dose (PDD) and In-plane and cross-plane profiles of Varian Golden beam data to the measured data of 6 and 18 MV photons for the commissioning of Eclipse treatment planning system. Introduction: Commissioning of treatment planning system requires an extensive acquisition of beam data for the clinical use of linear accelerators. Accurate dose delivery require to enter the PDDs, Profiles and dose rate tables for open and wedges fields into treatment planning system, enabling to calculate the MUs and dose distribution. Varian offers a generic set of beam data as a reference data, however not recommend for clinical use. In this study, we compared the generic beam data with the measured beam data to evaluate the reliability of generic beam data to be used for the clinical purpose. Methods and Material: PDDs and Profiles of Open and Wedge fields for different field sizes and at different depths measured as per Varian’s algorithm commissioning guideline. The measurement performed with PTW 3D-scanning water phantom with semi-flex ion chamber and MEPHYSTO software. The online available Varian Golden Beam Data compared with the measured data to evaluate the accuracy of the golden beam data to be used for the commissioning of Eclipse treatment planning system. Results: The deviation between measured vs. golden beam data was in the range of 2% max. In PDDs, the deviation increases more in the deeper depths than the shallower depths. Similarly, profiles have the same trend of increasing deviation at large field sizes and increasing depths. Conclusion: Study shows that the percentage deviation between measured and golden beam data is within the acceptable tolerance and therefore can be used for the commissioning process; however, verification of small subset of acquired data with the golden beam data should be mandatory before clinical use.

Keywords: percent depth dose, flatness, symmetry, golden beam data

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Authors: Parul Johri, Mala Trivedi

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Major Intrinsic proteins (MIPs), actively involved in the passive transport of small polar molecules across the membranes of almost all living organisms. MIPs that specifically transport water molecules are named aquaporins (AQPs). The permeability of membranes is actively controlled by the regulation of the amount of different MIPs present but also in some cases by phosphorylation and dephosphorylation of the channel. Based on sequence similarity, MIPs have been classified into many categories. All of the proteins are made up of the 20 amino acids, the only difference is there in their orientations. Again all the 20 amino acids are made up of the basic five elements namely: carbon, hydrogen, oxygen, sulphur and nitrogen. These elements are responsible for giving the amino acids the properties of hydrophilicity/hydrophobicity which play an important role in protein interactions. The hydrophobic amino acids characteristically have greater number of carbon atoms as carbon is the main element which contributes to hydrophobic interactions in proteins. It is observed that the carbon level of proteins in different species is different. In the present work, we have taken a sample set of 150 aquaporins proteins from Uniprot database and a dynamic programming code was written to calculate the carbon percentage for each sequence. This carbon percentage was further used to barcode the aqauporins of animals and plants. The protein taken from Oryza sativa, Zea mays and Arabidopsis thaliana preferred to have carbon percentage of 31.8 to 35, whereas on the other hand sequences taken from Mus musculus, Saccharomyces cerevisiae, Homo sapiens, Bos Taurus, and Rattus norvegicus preferred to have carbon percentage of 31 to 33.7. This clearly demarks the carbon range in the aquaporin proteins from plant and animal origin. Hence the atom level analysis of protein sequences can provide us with better results as compared to the residue level comparison.

Keywords: aquaporins, carbon, dynamic prgramming, MIPs

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Authors: Keundong Lee, Dongha Yoo, Youngbin Tchoe, Gyu-Chul Yi

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Light emitting diode (LED) array is an ideal optical stimulation tool for optogenetics, which controls inhibition and excitation of specific neurons with light-sensitive ion channels or pumps. Although a fiber-optic cable with an external light source, either a laser or LED mechanically connected to the end of the fiber-optic cable has widely been used for illumination on neural tissue, a new approach to use micro LEDs (µLEDs) has recently been demonstrated. The LEDs can be placed directly either on the cortical surface or within the deep brain using a penetrating depth probe. Accordingly, this method would not need a permanent opening in the skull if the LEDs are integrated with miniature electrical power source and wireless communication. In addition, multiple color generation from single µLED cell would enable to excite and/or inhibit neurons in localized regions. Here, we demonstrate flexible and color tunable µLEDs for the optogenetic device applications. The flexible and color tunable LEDs was fabricated using multifaceted gallium nitride (GaN) nanorod arrays with GaN nanorods grown on InxGa1−xN/GaN single quantum well structures (SQW) anisotropically formed on the nanorod tips and sidewalls. For various electroluminescence (EL) colors, current injection paths were controlled through a continuous p-GaN layer depending on the applied bias voltage. The electric current was injected through different thickness and composition, thus changing the color of light from red to blue that the LED emits. We believe that the flexible and color tunable µLEDs enable us to control activities of the neuron by emitting various colors from the single µLED cell.

Keywords: light emitting diode, optogenetics, graphene, flexible optoelectronics

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Authors: Benjaporn Buranrat, Nootchanat Mairuae

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Cratoxylum formosum (Jack) Dyer (CF) has been used for the traditional medicines in South East Asian and Thailand. Normally, northeast Thai vegetables have proven cytotoxic to many cancer cells. Therefore, the present study aims to explore the molecular mechanisms underlying CF-induced cancer cell death and apoptosis on breast and liver cancer cells. The cytotoxicity and antiproliferative effects of CF on the human breast MCF-7 and liver HepG2 cancer cell lines were evaluated using sulforhodamine B assay and colony formation assay. Cell migration assay was measured using wound healing assay. The apoptosis induction mechanisms were investigated through reactive oxygen species formation, caspase 3 activity, and JC-1 activity. Gene expression by real-time PCR and apoptosis related protein levels by Western blot analysis. CF induced MCF-7 and HepG2 cell death by time- and dose-dependent manner. Furthermore, CF had the greater cytotoxic potency on MCF-7 more than HepG2 cells with IC50 values of 85.70+4.52 μM and 219.03±9.96 μM respectively, at 24 h. Treatment with CF also caused a dose-dependent decrease in colony forming ability and cell migration, especially on MCF-7 cells. CF induced ROS formation, increased caspase 3 activities, and decreased the mitochondrial membrane potential, and causing apoptotic body production and DNA fragmentation. CF significantly decreased expression of the cell cycle regulatory protein RAC1 and downstream proteins, cdk6. Additionally, CF enhanced p21 and reduced cyclin D1 protein levels. CF leaf extract induced cell death, apoptosis, antimigration in both of MCF-7 and HepG2 cells. CF could be useful for developing to anticancer drug candidate for breast and liver cancer therapy.

Keywords: cratoxylum formosum (jack) dyer, breast cancer, liver cancer, cell death

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Authors: Nargiza Nuralieva

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The study delves into assessing the influence of mindfulness and mental resilience training on the cognitive performance and stress management of pilots. Employing a meticulous literature search across databases such as Medline and Google Scholar, the study used specific keywords to target a wide array of studies. Inclusion criteria were stringent, focusing on peer-reviewed studies in English that utilized designs like randomized controlled trials, with a specific interest in interventions related to mindfulness or mental resilience training for pilots and measured outcomes pertaining to cognitive performance and stress management. The initial literature search identified a pool of 123 articles, with subsequent screening resulting in the exclusion of 77 based on title and abstract. The remaining 54 articles underwent a more rigorous full-text screening, leading to the exclusion of 41. Additionally, five studies were selected from the World Health Organization's clinical trials database. A total of 11 articles from meta-analyses were retained for examination, underscoring the study's dedication to a meticulous and robust inclusion process. The interventions varied widely, incorporating mixed approaches, Cognitive behavioral Therapy (CBT)-based, and mindfulness-based techniques. The analysis uncovered positive effects across these interventions. Specifically, mixed interventions demonstrated a Standardized Mean Difference (SMD) of 0.54, CBT-based interventions showed an SMD of 0.29, and mindfulness-based interventions exhibited an SMD of 0.43. Long-term effects at a 6-month follow-up suggested sustained impacts for both mindfulness-based (SMD: 0.63) and CBT-based interventions (SMD: 0.73), albeit with notable heterogeneity.

Keywords: mindfulness, mental resilience, pilots, cognitive performance, stress management

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Authors: F. Z. Tighilt, N. Belhaneche-Bensemra, S. Belhousse, S. Sam, K. Lasmi, N. Gabouze

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Recently, the gold nanoparticles (Au NPs) became an active multidisciplinary research topic. First, Au thin films fabricated by alkylthiol-functionalized Au NPs were found to have vapor sensitive conductivities, they were hence widely investigated as electrical chemiresistors for sensing different vapor analytes and even organic molecules in aqueous solutions. Second, Au thin films were demonstrated to have speciallocalized surface plasmon resonances (LSPR), so that highly ordered 2D Au superlattices showed strong collective LSPR bands due to the near-field coupling of adjacent nanoparticles and were employed to detect biomolecular binding. Particularly when alkylthiol ligands were replaced by thiol-terminated polymers, the resulting polymer-modified Au NPs could be readily assembled into 2D nanostructures on solid substrates. Monolayers of polystyrene-coated Au NPs showed typical dipolar near-field interparticle plasmon coupling of LSPR. Such polymer-modified Au nanoparticle films have an advantage that the polymer thickness can be feasibly controlled by changing the polymer molecular weight. In this article, the effect of tin-doped indium oxide (ITO) coatings on the plasmonic properties of ITO interfaces modified with gold nanostructures (Au NSs) is investigated. The interest in developing ITO overlayers is multiple. The presence of a con-ducting ITO overlayer creates a LSPR-active interface, which can serve simultaneously as a working electrode in an electro-chemical setup. The surface of ITO/ Au NPs contains hydroxyl groups that can be used to link functional groups to the interface. Here the covalent linking of nickel /Au NSs/ITO hybrid LSPR platforms will be presented.

Keywords: conducting polymer, metal nanoparticles (NPs), LSPR, poly (3-(pyrrolyl)–carboxylic acid), polypyrrole

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Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle

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Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.

Keywords: Covid-19, heart failure, national readmission database, readmission outcomes

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Authors: Iman Nezamzadeh, Ali Faghih, Behnam Oveisi

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In order to reduce earthquake hazards in urban areas, it is necessary to perform comprehensive studies to understand the dynamics of the active faults and identify potentially high risk areas. The fault slip-rates in Late Quaternary sediment are critical indicators of seismic hazard and also provide valuable data to recognize young crustal deformations. To measure slip-rates accurately, is needed to displacement of geomorphic markers and ages of quaternary sediment samples of alluvial deposit that deformed by movements on fault. In this study we produced information about Intermediate term slip rate of Sabzpushan Fault Zone (SPF) within the central part of the Zagros Mountains of Iran using OSL dating technique to make better analysis of seismic hazard and seismic risk reduction for Shiraz city. For this purpose identifiable geomorphic fluvial surfaces help us to provide a reference frame to determine differential or absolute horizontal and vertical deformation. Optically stimulated luminescence (OSL) is an alternative and independent method of determining the burial age of mineral grains in Quaternary sediments. Field observation and satellite imagery show geomorphic markers that deformed horizontally along the Sabzpoushan Fault. Here, drag folds is forming because of evaporites material of Miocen Formation. We estimate 2.8±0.5 mm/yr (mm/y) horizontal slip rate along the Sabzpushan fault zone, where ongoing deformation is involve with drug folding. The Soltan synclinal structure, close to the Sabzpushan fault, shows slight uplift rate due to active core-extrousion.

Keywords: slip rate, active tectonics, OSL, geomorphic markers, Sabzpushan Fault Zone, Zagros, Iran

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Authors: Sara Cumming, Julianne DiSanto, Leah Burton

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Homelessness in Canada is a persistent problem. It has been widely argued that the best tactic for eradicating homelessness is to approach social issues from a Housing First perspective—an approach that centers on quickly moving people into permanent and independent housing and then providing them additional support and services as needed. It is recognized that life skills training is both necessary and an effective way to reduce cyclical homelessness; however, there is a scarcity of research on effective ways to teach life skills; this problem was exacerbated in a pandemic context, where in-person delivery was severely restricted or no longer possible. Very little attention has been paid to the diverse cultural needs of clients in a multicultural context and the need to foster cultural knowledge/awareness in individuals to successfully contribute to the cultural safety of communities. This research attempts to fill these gaps in the literature and in practice by employing a community-engaged research (CER) approach. Academic, government, funders, front-line staff, and clients at 15 not-for-profits from across the Greater Toronto Area in Ontario, Canada, collaborated to co-create a virtual, client-centric, equity, diversity, and inclusion (EDI) informed life skill learning management system. We employed a triangulation methodology for this research. An environmental scan was conducted for best practices. Two separate Creative Problem Solving Sessions were held with over 100 front-line workers, managers, and executive directors who work with homeless populations. Quantitative and open-ended surveys were completed by over 200 individuals with experience with homelessness. All sections of this research aimed to discover the areas of skills that individuals need to maintain housing and to ascertain what a more client-driven EDI approach to life skills training should include. This research will showcase which life skills are deemed essential for homeless and precariously housed individuals.

Keywords: homelessness, Housing First, life skills, community engaged research

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Authors: Gabriela Macera DiFilippo

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The world watched in disbelief as George Floyd was killed by a policeman. The images from the scene were made more memorable by Mr. Floyd’s pleas and cries for his mother. In the aftermath of this tragedy, the Black Lives Matter movement gained momentum. Weeks and months after the protests, global interest in learning about tackling systemic racism erupted. One must wonder how school children of color viewed and processed this trauma. This study will examine the kinds of trauma experienced by children of color and the opportunity for school mental health providers to support these children. This study used literature searches that were previously conducted for proven and practical assessment methods that can help deal with racial trauma for children. As part of the assessment, trauma symptoms experienced by children of color were summarized and characterized in a non-imperial manner. The research was also will be done in practical ways to make adequate and effective mental health services available in schools and lessen the stigma. This research study found that there is a need to provide an analysis of the ongoing racial trauma of children of color after the death of George Floyd. Impactful and appropriate assessment methods, such as surveys, were presented to all school professionals. Lastly, this paper attempted to provide mental health professionals with the tools to screen and provide guidance based on unequivocal, unbiased methods for helping these children. There is a need for both schools and community leaders to ensure that every child has access to mental health care and is being assessed for their overall well-being. There is a need to educate the communities about racial trauma and its impact on individuals, especially children. School mental health professionals are encouraged to offer and educate schools and communities about racial trauma awareness, its importance, and ways to cope with it in different settings. The delivery of these informed services should focus on behavioral health and must be sensitive to children of color and different ways of self-care.

Keywords: trauma, children, black psychology, students

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Authors: Mohd Aslam Aslam

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Chronic renal failure is a debilitating condition responsible for high morbidity and mortality. Because of its costs and the complexity of its treatment, proper care is available to very few patients in India. According to researchers, the number of adults aged 30 or older who have chronic kidney disease is projected to increase from 13.2 percent currently, to 14.4 percent in 2020 and 16.7 percent in 2030. The aerial part of Aerva lanata (Busehri booti) have been used in kidney disorders by the Unani physicians. In the present study, the effect of extract of Aerva lanata was investigated on cisplatin-induced nephrotoxicity in rats. The renal effects of this drug was evaluated by monitoring levels of blood urea nitrogen (BUN), serum creatinine, serum uric acid in blood and histopathological examination of kidney. Aerva lanata was evaluated at two different doses (1400 mg/kg and 2800 mg/kg). The effect of higher dose was more pronounced in terms of inhibition in the rise of BUN, serum creatinine and uric acid. Higher dose show greater prevention in the rise of BUN, serum creatinine, and uric acid. The histopathological examination of the kidney tissue of the rats treated with aqueous methanolic extract of Aerva lanata (Higher dose-2800 mg/kg) showed marked inhibition of glomerular congestion, tubular casts, peritubular congestion, epithelial desquamation, blood vessel congestion, interstitial edema and inflammatory cells produced by the cisplatin-induced nephrotoxicity. This finding clearly indicates the protective role of Aerva lanata at higher dose. Present investigation validates the use of Aerva lanata in kidney disorders by Unani physicians.

Keywords: Aerva lanata, Busehri booti, nephroprotective, unani medicine

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Authors: Ali Faisal Saleem, Farheen Quadri, Mach Ondrej, Anita Zaidi

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Purpose: Pakistan is the final frontier for a polio-free world. Chronic malnutrition is associated with lack of effective gut immunity, and possibly associated with poliomyelitis in children received multiple OPV. We evaluate IPV dose administered together with OPV results in higher immunogenicity and mucosal immunity compared to OPV alone in chronically malnourished infants. Methods AND Materials: A community-based, unblinded-randomized-trial, conducted in 5 peri-urban, low-middle-income households of Karachi, in infants 9-12 months. Two study groups were non-malnourished (HAZ= -2 or more) and chronic malnourished (HAZ <-2SD), with 2-arms each i) OPV and ii) OPV and IPV. Two blood specimens (2ml) at baseline and at day 28 and two stool specimens (6 gm.) at day 29 and after 7 days. All infants received a bOPV challenge dose after first stool specimen. Calculates sample size was 210 in each arm. Serological (baseline compared to 28 days post-vaccine) and mucosal immunity after one week of bOPV challenge dose were study outcomes. Results: Baseline seroprevalence in malnourished infants were low compared to non-malnourished (P1, P2 and P3 (p=<0.001). There is significant rise in antibody titer and P1 seroprevalence in Mal A and B after receiving study vaccine; much higher in Mal B. Infants randomized to bOPV + IPV study vaccine showed incremental immune response against P1 (Mal B, 92.2%; Nor B, 98.4%), P2 (Mal B, 90.4%; Nor B, 94.7%), and P3 (Mal B, 85.6% and Nor B, 93.5%) was observed. A significant proportion of infants in malnourished (P1, 13%; P2, 24%; P3, 26%) and normally nourished group (P1, 5%; P2, 11%; P3, 14%) were found to be seronegative at baseline. Infants who received BOPV + IPV as their study vaccine showed a very high seroconversion response after vaccine (p=<0.001 for P1, P2 and P3). Majority of the specimens were negative at baseline (Mal A, 2%, Mal B, 1%; Nor A, 2%; Nor B, 1%), and remains negative after bOPV challenge dose (Mal A, 8%, Mal B, 6%; Nor A, 11%; Nor B, 10%). Conclusion: Malnourished-infants have low poliovirus-seroprevalence that increased remarkably after IPV. There is less viral shedding after IPV in infants.

Keywords: chronic malnutrition, infants, IPV, OPV

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Authors: Policarpio Jr. Joves

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Physicians in most teaching hospitals are commonly promoted into managerial roles, yet their training is mostly in clinical and scientific skills but not in leadership competencies. When they shift into roles of physician leadership, the majority hold on to their primary identity of physicians. These conflicting roles affect their identity and eventually their work. The physician leaders also face additional challenges related to academics which include incorporation of new knowledge into the existing curriculum, use of technology in the delivery of teaching, the need to train medical students outside of hospital wards, etc. The study aims to explore how physician leaders in teaching hospitals of private medical schools enact their leadership roles and how they face the challenges as physician leaders. The study setting shall be teaching hospitals of three private medical schools situated in the National Capital Region, Philippines. A multiple case study design shall be adopted in this research. Physicians shall be eligible to participate in the study if they are practicing clinicians limited to the five major clinical specialty: Internal Medicine, Pediatrics, Family Medicine, Surgery, Obstetrics and Gynecology. They must be teaching in the College of Medicine prior to their appointments as physician leaders in both medical school and teaching hospital. Semi-structured face-to-face interviews shall be utilized as a means of data collection, with open-ended questions, enabling physician leaders to present narratives about their identity, role enactment, conflicts, reaction of colleagues, and the challenges encountered in their day-to-day work as physician leaders. Interviews shall be combined with observations and review of records to gain more insights into how the physician leaders are 'doing' management. Within-case analysis shall be done initially followed by a thematic analysis across the cases, referred to as cross–case analysis or cross-case synthesis.

Keywords: academic leaders, academic managers, physician leaders, physician managers

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Authors: Kasipandi Muniyandi, Parimelazhagan Thangaraj

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Plants are important prospective wealth of a country, combination of local health care information about a specific plant together with data published by several groups of scientists, can help in deciding whether it should be considered acceptable for medicinal use. In the developed countries, too, plant-derived drugs may be of importance. The wide variety of ailments that are being treated with Plectranthus is an indication of the medicinal value of the genus. A number of species are not toxic and so may be taken orally, whilst others are used topically on the skin or as enemas. This study was designed to evaluate the different properties of Plectranthus stocksii and the aerial parts were collected and extracted with petroleum ether, chloroform, ethyl acetate, acetone and methanol by Soxhlet apparatus and finally macerated with hot water. The quantification assays revealed that, leaf methanol extract showed higher total phenolic (415.41 mg GAE/ g extract) and tannin (177.53 mg GAE/ g extract) contents whereas leaf ethyl acetate exhibited higher flavonoids (777.11 mg RE/ g extract) content. The antioxidant efficiency of the extracts was analyzed by various radical scavenging assays. Among the different antioxidant assays, leaf ethyl acetate extract showed higher free radical scavenging activities against DPPH (IC50 = 3.46 µg/mL), ABTS (27417.65 µM TE/ g extract), FRAP (152.17 mM Fe(II)E/ mg extract) NO• radical (21.46%) and Superoxide radical (IC50 = 24.16 µg/mL) assays. All the parts P. stocksii extracts showed significant protection against OH• induced DNA damage at 50 µg concentration. The HPLC analysis of leaf ethyl acetate extract revealed the presence of Quercetin (30.29 µg/mg of extract) was the major compound. Anticancer activity of leaf ethyl acetate extract showed better IC50 values were 48.87 and 36.08 µg/ mL against MCF-7 and Caco-2 respectively. From this study, P. stocksii can act as a potent antioxidant and cytotoxic antimicrobial agent. The scope for drug development from this plant is endless and there is undoubtedly a call for further research in pharmaceutical industries.

Keywords: antioxidant, cytotoxicity, phenolics, plectranthus stocksii

Procedia PDF Downloads 383

Authors: Surachart Koyadun

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Currently, Plasmodium knowlesi malaria has spread to almost all countries in Southeast Asia. This research aimed to 1) describe the epidemiology of Plasmodium knowlesi malaria, 2) examine the clinical symptoms of P. knowlesi malaria patients 3) analyze the ecology, animal reservoir and entomology of P. knowlesi malaria. 4) summarize the diagnosis, blood parasites, and treatment of P. knowlesi malaria. The study design was a case report combined with retrospective descriptive survey research. A total of 34 study subjects were patients with a confirmed diagnosis of P. knowlesi malaria who received treatment at hospitals and vector-borne disease control units in Songkhla Province during 2021 – 2022. The results of the epidemiological study unveiled the majority of the samples were male, had a history of staying overnight in the forest before becoming sick, the source of the infection was in the forest, and the season during which they were sick was mostly summer. The average length of time from the onset of illness until receiving a blood test was 3.8 days. The average length of hospital stay was 4 days. Patients were treated with Chloroquine Phosphate, Primaquine, Artesunate, Quinine, and Dihydroartemisinin-piperaquine (40 mg DHA-320 mg PPQ). One death was seen in 34 P. knowlesi malaria patients. All remaining patients recovered and responded to treatment. All symptoms improved after drug administration. No treatment failures were found. Analyses of ecological, zoonotic and entomological data revealed an association between infected patients and forested, monkey-hosted and mosquito-transmitted areas. The recommendation from this study was that the Polymerase Chain Reaction (PCR) method should be used in conjunction with the Thick/Thin Film test and blood parasite test (Parasitaemia) for the specificity of the infection, accuracy of diagnosis, leading to treatment of disease in a timely manner and be effective in disease control.

Keywords: human malaria, Plasmodium knowlesi, zoonotic disease, diagnosis and treatment, epidemiology, ecology

Procedia PDF Downloads 26

Authors: Godwin Ojochogu Adejo, Evelyn UnekwuOjo Adejo, Sunday UnenwOjo Adejo

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The mainstream contemporary approach to controlling the impact of diseases among poultry birds rely largely on curative measures through the administration of drugs to infected birds. Most times as observed in the deep liter poultry farming system, entire flocks including uninfected birds receive the treatment they do not need. As such, unguarded use of chemical drugs and antibiotics has led to wastage and accumulation of chemical residues in poultry products with associated health hazards to humans. However, wanton and frequent drug usage in poultry is avoidable if feeding and drinking equipment are designed to curb infection transmission among birds. Using toxicological assays as guide and with efficiency and simplicity in view, two newly field-tested and recently patented equipments called 'healthy liquid drinking trough (HDT)' and 'healthy feeding trough (HFT)' that systematically eliminate contamination of the feeding and drinking channels, thereby, curbing wide-spread infection and transmission of diseases in the (intensive) deep litter poultry farming system were designed. Upon combined usage, they automatically and drastically reduced both the amount and frequency of antibiotics use in poultry by over > 50%. Additionally, they conferred optimization of feed and water utilization/elimination of wastage by > 80%, reduced labour by > 70%, reduced production cost by about 15%, and reduced chemical residues in poultry meat or eggs by > 85%. These new and cheap technologies which require no energy input are likely to elevate safety of poultry products for consumers' health, increase marketability locally and for export, and increase output and profit especially among poultry farmers and poor people who keep poultry or inevitably utilize poultry products in developing countries.

Keywords: healthy, trough, toxicological, assay-guided, poultry

Procedia PDF Downloads 155

Authors: Masyitah Abd Aziz, Mohd Sabere Sulaiman, Norsiah Hassan, Jamilah Halina Abdul Halim, Mohd Saipul Asrafi Haron

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A well-defined terminology of ‘Marseilles’ clay roof tiles in conservation works will easily characterize the communication delivery between expert and layperson, which will help people effectively understand to such specific knowledge areas. While it reduces ambiguity and increases clarity, the communication will translate very fast as it encourage an important factor in quality of the preservation of cultural heritage for future generations. The experts in conservation works faces many important terms, and indeed the very basic terminology in conservation areas were misunderstood. Thus, there were such terminology that being taken for granted and just follow seriously the tradition of the common practitioner without having any precise knowledge of what it entails. This study aims to investigate on the misconception of the terminology of ‘Marseilles’ clay roof tiles that being used in Malaysia’s conservation work. To avoid confusion of the terminology of ‘Marseilles’ clay roof tiles that will be followed through by the next generation, observation, interviews, and readings from the literature reviews on the terminology of the roof tiles has been done. It shows some evidence that ‘Marseilles’ were referring specific to French type roof tiles that developed by the Gilardoni Brothers in 1851. It was also found in Mangalore as the pioneered manufacturer in the 1860s by The Common Wealth Trust Ltd (Basel Mission tile factory). The interlocking clay roof types that has been used in Malaysia have the similarity and are influenced by both Europe and India. However, ‘Marseilles’ terminology was commonly used in Malaysia’s conservation works which led to the misconception of the real interpretation of all interlocking clay roof tiles type. The future generations will found that the well-defined terminology will gives a specific impact on conservation method and techniques. These range of applications to which roof tiles terminology will direct the future experts to make realistic suggestion for a future sustainable conservation approaches. Furthermore, it should contributes value added to conservation knowledge as well as holistic references for next generation.

Keywords: interlocking roof tiles, marseilles, misconception, terminology

Procedia PDF Downloads 100

Authors: Tamer Shehata

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Recently, nanotechnology acquired a great interest in the field of pharmaceutical production. Several pharmaceutical equipment were introduced into the research field for production of nanoparticles, among them, BÜCHI’ fourth generation nano-spray dryer B-90. B-90 is specialized with single step of production and drying of nano and microparticles. Currently, our research group is investigating several pharmaceutical formulations utilizing BÜCHI Nano-Spray Dryer B-90 technology. One of our projects is the formulation and evaluation of metformin hydrochloride mucoadhesive microparticles for treatment of type 2-diabetis. Several polymers were investigated, among them, gelatin and sodium alginate. The previous polymers are natural polymers with mucoadhesive properties. Preformulation studies such as atomization head mesh size, flow rate, head temperature, polymer solution viscosity and surface tension were performed. Postformulation characters such as particle size, flowability, surface scan and dissolution profile were evaluated. Finally, the pharmacological activity of certain selected formula was evaluated in streptozotocin-induced diabetic rats. B-90’spray head was 7 µm hole heated to 120 with air flow rate 3.5 mL/min. The viscosity of the solution was less than 11.5 cP with surface tension less than 70.1 dyne/cm. Successfully, discrete, non-aggregated particles and free flowing powders with particle size was less than 2000 nm were obtained. Gelatin and Sodium alginate combination in ratio 1:3 were successfully sustained the in vitro release profile of the drug. Hypoglycemic evaluation of the previous formula showed a significant reduction of blood glucose level over 24 h. In conclusion, mucoadhesive metformin hydrochloride microparticles obtained from B-90 could offer a convenient dosage form with enhanced hypoglycemic activity.

Keywords: mucoadhesive, microparticles, metformin hydrochloride, nano-spray dryer

Procedia PDF Downloads 311

Authors: Indu ray

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In today’s digital world the internet is already flooded with information on how to master grammar in a foreign language. It is well known that one cannot master a language without grammar. Grammar is the backbone of any language. Without grammar there would be no structure to help you speak/write or listen/read. Successful communication is only possible if the form and function of linguistic utterances are firmly related to one another. Grammar has its own rules of use to formulate an easier-to-understand language. Like a tool, grammar formulates our thoughts and knowledge in a meaningful way. Every language has its own grammar. With grammar, we can quickly analyze whether there is any action in this text: (Present, past, future). Knowledge of grammar is an important prerequisite for mastering a foreign language. What’s most important is how teachers can make grammar lessons more interesting for students and thus promote grammar skills more successfully. Through this paper, we discuss a few important methods like (Interactive Grammar Exercises between students, Interactive Grammar Exercise between student to teacher, Grammar translation method, Audio -Visual Method, Deductive Method, Inductive Method). This paper is divided into two sections. In the first part, brief definitions and principles of these approaches will be provided. Then the possibility and the case of combination of this approach will be analyzed. In the last section of the paper, I would like to present a survey result conducted at my university on a few methods to quickly learn grammar in Foreign Language. We divided the Grammatical Skills in six Parts. 1.Grammatical Competence 2. Speaking Skills 3. Phonology 4. The syntax and the Semantics 5. Rule 6. Cognitive Function and conducted a survey among students. From our survey results, we can observe that phonology, speaking ability, syntax and semantics can be improved by inductive method, Audio-visual Method, and grammatical translation method, for grammar rules and cognitive functions we should choose IGE (teacher-student) method. and the IGE method (pupil-pupil). The study’s findings revealed, that the teacher delivery Methods should be blend or fusion based on the content of the Grammar.

Keywords: innovative method, grammatical skills, audio-visual, translation

Procedia PDF Downloads 77

Authors: Nurul Aqilah Mohd Zaini, Afroditi Chatzifragkou, Dimitris Charalampopoulos

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D-Lactic acid production is gaining increasing attention due to the thermostable properties of its polymer, Polylactic Acid (PLA). In this study, D-lactic acid was produced in microbial cultures using Lactobacillus coryniformis subsp. torquens as D-lactic acid producer and hydrolysates of Dried Distillers Grains with Solubles (DDGS) as fermentation substrate. Prior to fermentation, DDGS was first alkaline pretreated with 5% (w/v) NaOH, for 15 minutes (121oC/ ~16 psi). This led to the generation of DDGS solid residues, rich in carbohydrates and especially cellulose (~52%). The carbohydrate-rich solids were then subjected to enzymatic hydrolysis with Accellerase® 1500. For Separate Hydrolysis and Fermentation (SHF), enzymatic hydrolysis was carried out at 50oC for 24 hours, followed by fermentation of D-lactic acid at 37oC in controlled pH 6. The obtained hydrolysate contained 24 g/l glucose, 5.4 g/l xylose and 0.6 g/l arabinose. In the case of Simultaneous Saccharification and Fermentation (SSF), hydrolysis and fermentation were conducted in a single step process at 37oC in pH 5. The enzymatic hydrolysis of DGGS pretreated solids took place mostly during lag phase of L. coryniformis fermentation, with only a small amount of glucose consumed during the first 6 h. When exponential phase was started, glucose generation reduced as the microorganism started to consume glucose for D-lactic acid production. Higher concentrations of D-lactic acid were produced when SSF approach was applied, with 28 g/l D-lactic acid after 24 h of fermentation (84.5% yield). In contrast, 21.2 g/l D-lactic acid were produced when SHF was used. The optical pu rity of D-lactic acid produced from both experiments was 99.9%. Besides, approximately 2 g/l acetic acid was also generated due to lactic acid degradation after glucose depletion in SHF. SSF was proved an efficient towards DDGS ulilisation and D-lactic acid production, by reducing the overall processing time, yielding sufficient D-lactic acid concentrations without the generation of fermentation by-products.

Keywords: DDGS, alkaline pretreatment, SSF, D-lactic acid

Procedia PDF Downloads 340

Authors: Maad Kamal Al-Anni

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This study is about an algorithmic dependence of Artificial Neural Network on Multilayer Perceptron (MPL) pertaining to the classification and clustering presentations for Mobile Adhoc Network vulnerabilities. Moreover, mobile ad hoc network (MANET) is ubiquitous intelligent internetworking devices in which it has the ability to detect their environment using an autonomous system of mobile nodes that are connected via wireless links. Security affairs are the most important subject in MANET due to the easy penetrative scenarios occurred in such an auto configuration network. One of the powerful techniques used for inspecting the network packets is Intrusion Detection System (IDS); in this article, we are going to show the effectiveness of artificial neural networks used as a machine learning along with stochastic approach (information gain) to classify the malicious behaviors in simulated network with respect to different IDS techniques. The monitoring agent is responsible for detection inference engine, the audit data is collected from collecting agent by simulating the node attack and contrasted outputs with normal behaviors of the framework, whenever. In the event that there is any deviation from the ordinary behaviors then the monitoring agent is considered this event as an attack , in this article we are going to demonstrate the  signature-based IDS approach in a MANET by implementing the back propagation algorithm over ensemble-based Traffic Table (TT), thus the signature of malicious behaviors or undesirable activities are often significantly prognosticated and efficiently figured out, by increasing the parametric set-up of Back propagation algorithm during the experimental results which empirically shown its effectiveness  for the ratio of detection index up to 98.6 percentage. Consequently it is proved in empirical results in this article, the performance matrices are also being included in this article with Xgraph screen show by different through puts like Packet Delivery Ratio (PDR), Through Put(TP), and Average Delay(AD).

Keywords: Intrusion Detection System (IDS), Mobile Adhoc Networks (MANET), Back Propagation Algorithm (BPA), Neural Networks (NN)

Procedia PDF Downloads 194

Authors: Tebikew Yeneabat, Tefera Belachew, Muluneh Haile

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Background: Exclusive breast-feeding (EBF) is the practice of feeding only breast milk (including expressed breast milk) during the first six months and no other liquids and solid foods except medications. The time to cessation of exclusive breast-feeding, however, is different in different countries depending on different factors. Studies showed the risk of diarrhea morbidity and mortality is higher among none exclusive breast-feeding infants, common during starting other foods. However, there is no study that evaluated the time to cessation of exclusive breast-feeding in the study area. The aim of this study was to show time to cessation of EBF and its predictors among mothers of index infants less than twelve months old. Methods: We conducted a community-based cross-sectional study from February 13 to March 3, 2012 using both quantitative and qualitative methods. This study included a total of 592 mothers of index infant using multi-stage sampling method. Data were collected by using interviewer administered structured questionnaire. Bivariate and multivariate Cox regression analyses were performed. Results: Cessation of exclusive breast-feeding occurred in 392 (69.63%) cases. Among these, 224 (57.1%) happened before six months, while 145 (37.0%) and 23 (5.9%) occurred at six months and after six months of age of the index infant respectively. The median time for infants to stay on exclusive breast-feeding was 6.36 months in rural and 5.13 months in urban, and this difference was statistically significant on a Log rank (Cox-mantel) test. Maternal and paternal occupation, place of residence, postnatal counseling on exclusive breast-feeding, mode of delivery, and birth order of the index infant were significant predictors of cessation of exclusive breast-feeding. Conclusion: Providing postnatal care counseling on EBF, routine follow-up and support of those mothers having infants stressing for working mothers can bring about implementation of national strategy on infant and young child feeding.

Keywords: exclusive breastfeeding, cessation, median duration, Ankesha Guagusa Woreda

Procedia PDF Downloads 317

Authors: Mohammad Derakhshani, Saeed Reza Allahkaram, Michael Isakani-Zakaria, Masoud Samadian, Hojat Sharifi Rasaey

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Dynamic stray currents tend to change their magnitude and polarity with time at their source which will create anodic and cathodic spots on a nearby interfered structure. To date, one of the biggest known dynamic stray current sources are DC traction systems. Laboratory simulation is a suitable method to apply theoretical principles in order to identify effective parameters in dynamic stray current influenced corrosion. Simulation techniques can be utilized for various mitigation methods applied in a small scales for selection of the most efficient method with regards to field applications. In this research, laboratory simulation of potential fluctuations caused by dynamic stray current on a cathodically protected structure was investigated. A lab model capable of generating DC static and dynamic stray currents and simulating its effects on cathodically protected samples were developed based on stray current induced (contact-less) polarization technique. Stray current pick-up and discharge spots on an influenced structure were simulated by inducing fluctuations in the sample’s stationary potential. Two mitigation methods for dynamic stray current interference on buried structures namely application of sacrificial anodes as preferred discharge point for the stray current and potentially controlled cathodic protection was investigated. Results showed that the application of sacrificial anodes can be effective in reducing interference only in discharge spot. But cathodic protection through potential controlling is more suitable for mitigating dynamic stray current effects.

Keywords: simulation, dynamic stray current, fluctuating potentials, sacrificial anode

Procedia PDF Downloads 300

Authors: Fatai O. Oladoyinbo, Felix O. Sanni, Akinwunmi Fatai, Kamoli A. Amusa, Saheed A. Ganiyu, Wasiu B. Ayinde, Tajudeen A. Afolabi, Enock O. Dare

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Silver (Ag) and silica (SiO2) nanoparticles were synthesized using the chemical reduction method from silver nitrate and sodium silicate, respectively. X-ray Diffraction (XRD), High-Resolution Transmission Electron Microscopy (HRTEM), Scanning Electron Microscopy (SEM), Uv-Visible spectroscopy, Energy Dispersive X-ray (EDX) spectroscopy and N2 adsorption-desorption techniques were utilized to characterize the composition and structure of the samples. The crystallinity pattern of Ag nanoparticles was indexed as (111), (200), (220) and (311), which allowed reflections from face-centered cubic silver. XRD of SiO2 showed good porosity with a broad-spectrum band at Bragg’s angle 2θ of 22° while that of Ag-SiO2 showed distinct peaks at 2θ values of 39°, 43°, 66° and 79°. The XRD result agreed perfectly with the SEM and HRTEM images which showed Ag-SiO2 isotropic and anisotropic under the varying concentration of reactants. The elemental composition of Ag-SiO2, as displayed by EDX, confirmed Ag enrichment in the Ag-SiO2 heterostructure. The Uv-Visible peak at 421 nm confirmed the Surface Plasmon Resonance absorption peak of silver nanoparticles. N2 adsorption-desorption result showed a broad band of Ag-SiO2 from 3 to 8 nm, which indicated relatively narrow pore size distributions. Humidity sensing measurements performed in a controlled humidity chamber showed very high sensitivity with a sensitivity factor (SF) of 4.63 and high linearity with a steady decrease in resistance to humidity from 880 Ω at 10% RH to 190 Ω at 100% RH, indicating that Ag-SiO2 nanocomposite is a good sensing material with high sensitivity and linearity.

Keywords: silver, silica, nanocomposite, synthesis, heterostructure, core shell

Procedia PDF Downloads 77

Authors: Taddese Alemu Zerfu, Melaku Umeta Deressa, Kaleab Baye

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Background: Maternal and child under-nutrition is the underlying cause of 3•5 million annual deaths, globally. Anemia during pregnancy is among the leading nutritional disorders with serious short and long term consequences to both the mother and fetus. Objective: Examine the effect of dietary diversity on maternal anemia, nutritional status and key pregnancy outcomes of pregnancy. Methods: A prospective cohort study design, involving a total of 432 eligible pregnant women, in their second antenatal care visit was conducted between August 2014 to March, 2015. The individual dietary diversity status of mothers was used as the exposure variable to select, enroll and follow the mothers. All mothers were enrolled during second antenatal care visit and followed until delivery. Epi-data, SPSS and STATA software are used to enter and analyze the data. Chi-square test, independent 't'-test, and GLM are used to calculate risk, association and differences between key variables at P < 0.05. Results: Study participants did not differ in many of the basic characteristics (p < 0.05). The incidence of maternal anemia increased significantly from 28.6% to 32.1% between baseline and term. Pregnant mothers with inadequate dietary diversity groups had more (56% at baseline and 68% at term) risk of anemia than the comparison (adequate) groups, (RR, 1.56 and 1.68; 95% CI, 1.24 - 1.83 and 1.39 - 2.04). The overall incidence of still birth, low birth weight and pre-term birth was 4.5%, 9.1% and 13.6%, respectively. The variation of these outcomes was significant across study groups (P < 0.05). Conclusion and recommendations: Dietary diversity status of pregnant mothers has significant effect on the incidence of anemia and key pregnancy outcomes in resource limited settings, like rural Ethiopia. Therefore, apart from the ongoing routine IFA supplementation, special emphasis should be given to dietary diversity of mothers to improve related outcomes of pregnancy and maternal health.

Keywords: anemia, birth weight, dietary diversity, pregnancy, pregnancy outcome

Procedia PDF Downloads 363

Authors: Carri Welsby, Jessie Gunson, Pen Roe

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Currently, there is limited research examining health care professionals (HCPs) views on long-acting reversible contraception (LARC) advice and prescription, particularly outside of the general practice (GP) setting. The aim of this study is to systematically review existing evidence around the barriers and enablers of oral contraception (OC) in comparison to LARC, as perceived by HCPs in non-GP settings. Five electronic databases were searched in April 2018 using terms related to LARC, OC, HCPs, and views, but not terms related to GPs. Studies were excluded if they concerned emergency oral contraception, male contraceptives, contraceptive use in conjunction with a health condition(s), developing countries, GPs and GP settings, were non-English or was not published before 2013. A total of six studies were included for systematic reviewing. Five key areas emerged, under which themes were categorised, including (1) understanding HCP attitudes and counselling practices towards contraceptive methods; (2) assessment of HCP attitudes and beliefs about contraceptive methods; (3) misconceptions and concerns towards contraceptive methods; and (4) influences on views, attitudes, and beliefs of contraceptive methods. Limited education and training of HCPs exists around LARC provision, particularly compared to OC. The most common misconception inhibiting HCPs contraceptive information delivery to women was the belief that LARC was inappropriate for nulliparous women. In turn, by not providing the correct information on a variety of contraceptive methods, HCP counselling practices were disempowering for women and restricted them from accessing reproductive justice. Educating HCPs to be able to provide accurate and factual information to women on all contraception is vital to encourage a woman-centered approach during contraceptive counselling and promote informed choices by women.

Keywords: advice, contraceptives, health care professionals, long acting reversible contraception, oral contraception, reproductive justice

Procedia PDF Downloads 159