Search results for: background reduction
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8976

Search results for: background reduction

3996 Long-Term Cohort of Patients with Beta Thalassemia; Prevailing Role of Serum Ferritin Levels in Hypocalcemia and Growth Retardation

Authors: Shervin Rashidinia, Sara Shahmoradi, Seyyed Shahin Eftekhari, Mohsen Talebizadeh, Mohammad Saleh Sadeghi

Abstract:

Background: Beta-thalassemia Major (BTM) is a kind of hereditary hemolytic anemia which depended on regular monthly blood transfusion. However, iron deposition into the organs leads to multi-organ damage. The present study is the first study which aimed to evaluate the average of five-years serum ferritin level and compared by the prevalence of short stature and hypocalcemia. Materials/Methods: A cross-sectional retrospective study which a total of 140 patients with beta-thalassemia who were referred to Qom Thalassemia Clinic between February 2011 and July 2016 were enrolled to be reviewed. The exclusion criteria were consisting of incomplete medical records, diagnosis less than 2-years-ago and the blood transfusion less than every 4 weeks. The data including age, gender, weight, height, age of initial blood transfusion, age of initial chelation therapy, ferritin, and calcium were collected and analysis by SPSS version 24. Results: A total of 140 patients were enrolled. Of them, 75 (53.4%) were female. The mean age of the patients was 13.4±4.6 years.The mean age of initial diagnosis was 20.2±7.4 months. Hypocalcemia and short stature were occurred in 41 (29.3%) and 37 (26.4%) patients, respectively. The mean five-years serum ferritin level was significantly higher in the patients with short stature and hypocalcemia (P<0.0001). However, rise in serum ferritin level significantly increases the risk of short-stature and hypocalcemia (1.0004- and 1.0029 fold, respectively). Conclusion: We demonstrated that prevalence of short stature and hypocalcemia were significantly higher in the BTM.However, ferritin significantly increases the risk of short stature and hypocalcemia.

Keywords: beta-thalassemia, ferritin, growth retardation, hypocalcemia

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3995 Predictive Factors of Healthcare-Associated Infections and Antibiotic Use Patterns: A Cross-Sectional Survey at the Charles Nicolle Hospital of Tunis

Authors: Nouira Mariem, Ennigrou Samir

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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3994 Prevalence and Occupational Factors Associated with Low Back Pain among the Female Garment Workers: A Cross-Sectional Study in Bangladesh

Authors: Fazle Rabbi, Mashuda Khanom Tithi, Tasnim Mirza, Sanjida Rowshan Anannya, Ahmed Hossain

Abstract:

Background: Low Back Pain (LBP) is one of the common health problems among the garment workers that causes workers absenteeism from the work. The purpose of the study is to identify the association between occupational factors and LBP among the female garment workers in Bangladesh. Materials and Methods: A cross-sectional study was conducted with 487 female garment workers from three compliant garment factories of Bangladesh. Face-to-face interview on four different LBP measures along with questions on socio-demographic, occupational, and physical factors were used to collect the data. Result: The prevalence rates for LBP lasts for at least one day during the last six months, chronic pain, intense pain, and seeking medical care for LBP were found 63.04%, 38.60%, 13.76%, and 18.89%, respectively among the female garments workers. The multivariate logistic regression analysis indicates that duration of employment (>5 years), regular weight bearing and extended weekly working hours (>48 hours) are positively associated with LBP. Besides, age, BMI, family income, marital status and number of children are also found positively associated with the LBP measures. Conclusion: The prevalence of LBP among female garment workers in Bangladesh is found high. The duration of employment (>5 years), regular weight bearing and extended weekly working hours (>48 hours) play a significant role in developing LBP among the female workers. Factories need to consider training programs on the appropriate technique of weight bearing. It is also important to conduct regular screening programs to identify LBP, especially with married, overweight/obese and older age group to reduce the occurrence of LBP.

Keywords: Bangladesh, garment workers, low back pain, occupational health

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3993 Transport Medium That Prevents the Conversion of Helicobacter Pylori to the Coccoid Form

Authors: Eldar Mammadov, Konul Mammadova, Aytaj Ilyaszada

Abstract:

Background: According to many studies, it is known that H. pylori transform into the coccoid form, which cannot be cultured and has poor metabolic activity.In this study, we succeeded in preserving the spiral shape of H.pylori for a long time by preparing a biphase transport medium with a hard bottom (Muller Hinton with 7% HRBC (horse red blood cells) agar 5ml) and liquid top part (BH (brain heart) broth + HS (horse serum)+7% HRBC+antibiotics (Vancomycin 5 mg, Trimethoprim lactate 25 mg, Polymyxin B 1250 I.U.)) in cell culture flasks with filter caps. For comparison, we also used a BH broth medium with 7% HRBC used for the transport of H.pylori. Methods: Rapid urease test positive 7 biopsy specimens were also inoculated into biphasic and BH broth medium with 7% HRBC, then put in CO2 Gaspak packages and sent to the laboratory. Then both mediums were kept in the thermostat at 37 °C for 1 day. After microscopic, PCR and urease test diagnosis, they were transferred to Columbia Agar with 7% HRBC. Incubated at 37°C for 5-7 days, cultures were examined for colony characteristics and bacterial morphology. E-test antimicrobial susceptibility test was performed. Results: There were 3 growths from biphasic transport medium passed to Columbia agar with 7% HRBC and only 1 growth from BH broth medium with 7% HRBC. It was also observed that after the first 3 days in BH broth medium with 7%, H.pylori passed into coccoid form and its biochemical activity weakened, while its spiral shape did not change for 2-3 weeks in the biphase transport medium. Conclusions: By using the biphase transport medium we have prepared; we can culture the bacterium by preventing H.pylori from spiraling into the coccoid form. In our opinion, this may result in the wide use of culture method for diagnosis of H.pylori, study of antibiotic susceptibility and molecular genetic analysis.

Keywords: clinical trial, H.pylori, coccoid form, transport medium

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3992 Microgrid: An Alternative of Electricity Supply to an Island in Thailand

Authors: Pawitchaya Srijaiwong, Surin Khomfoi

Abstract:

There are several solutions to supply electricity to an island in Thailand such as diesel generation, submarine power cable, and renewable energy power generation. However, each alternative has its own limitation like fuel and pollution of diesel generation, submarine power cable length resulting in loss of cable and cost of investment, and potential of renewable energy in the local area. This paper shows microgrid system which is a new alternative for power supply to an island. It integrates local power plant from renewable energy, energy storage system, and microgrid controller. The suitable renewable energy power generation on an island is selected from geographic location and potential evaluation. Thus, photovoltaic system and hydro power plant are taken into account. The capacity of energy storage system is also estimated by transient stability study in order to supply electricity demand sufficiently under normal condition. Microgrid controller plays an important role in conducting, communicating and operating for both sources and loads on an island so that its functions are discussed in this study. The conceptual design of microgrid operation is investigated in order to analyze the reliability and power quality. The result of this study shows that microgrid is able to operate in parallel with the main grid and in case of islanding. It is applicable for electricity supply to an island and a remote area. The advantages of operating microgrid on an island include the technical aspect like improving reliability and quality of power system and social aspects like outage cost saving and CO₂ reduction.

Keywords: energy storage, islanding, microgrid, renewable energy

Procedia PDF Downloads 315
3991 Production of Kudzu Starch Gels With Superior Mechanical and Rheological Properties Through Submerged Ethanol Exposure and Implications for in Vitro Digestion

Authors: John-Nelson Ekumah, Xu Han, Qiufang Liang, Benxi Wei, Arif Rashid, Muhammad Safiullah, Abdul Qayum, Selorm Yao-Say Solomon Adade, Nana Adwoa Nkuma Johnson, Abdur Rehman, Xiaofeng Ren

Abstract:

Producing starch gels with superior mechanical attributes remains a challenging pursuit. This research sought to develop a simple method using ethanol exposure to produce robust starch gels. The gels’ mechanical properties, rheology, structural characteristics, and digestion were assessed through textural, rheological, structural, and in vitro digestion analyses. it investigation revealed an improvement in gel’s strength from 62.22 to178.82 g. The thermal transitions were accelerated when ethanol was elevated. The exposure to ethanol resulted in a reduction in syneresis from 11% to 9.5% over a period of 6 hours with noticeable change in size and color. Rheologically, the dominating storage modulus and tan delta (<0.55) emphasized the gel’s improved elasticity. X-ray analysis showed a stable B + V-type pattern after ethanol exposure, with increasing relative crystallinity to 7.9%. Digestibility revealed an ethanol induced resistance, through increased resistant starch from 1.87 to 8.73%. In general, the exposure to ethanol played a crucial role in enhancing the mechanical characteristics of kudzu starch gels, while simultaneously preserving higher levels of resistant starch fractions. These findings have wide-ranging implications in the fields of food and pharmaceuticals, underscoring the extensive academic and industrial importance of this study.

Keywords: kudzu starch gels, mechanical properties, rheological properties, submerged ethanol exposure, In vitro digestion

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3990 Changes in Secretory Products and Lipid Profile in the Epididymis and Spermatozoa of Rats Induced by Aluminium Chloride

Authors: Ramalingam Venugopal, Kalaiselvi Arumugam

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Environmental exposure to heavy metals is associated with a wide range of toxic effects. It is evident that heavy metals released in the environment affect the reproductive processes and fertility of animals. Toxic metals affect the male and female reproductive system directly or indirectly. Considering the toxic nature of aluminium and also the major role of secretory products and lipids in sperm maturation, the present study was planned to investigate the effect of aluminium chloride on secretory products like glyceryl phosphoryl choline (GPC), sialic acid, carnitine and acetyl carnitine content and also lipid profiles in the epididymis and spermatozoa of adult rats. Aluminium chloride, 50 mg/kg body weight was administered orally daily for 60 days. 24 hours after the last dose the rats were sacrificed and immediately epididymis was dissected out and spermatozoa was isolated. The weight of the epididymis decreased significantly. GPC and sialic acid content was significantly reduced in the epididymis and not much altered in spermatozoa. Carnitine and acetyl carnitine contents were markedly decreased in the spermatozoa as well as in the epididymis. Aluminium chloride administration caused a marked reduction in total lipid, cholesterol, phospholipids and cholesterol content in epididymis and no significant changes in spermatozoa. Several changes take place in the spermatozoa as they pass through the epididymis. These changes are directly related to the acquisition of fertilizing ability of spermatozoa. From the results, it is evident that aluminium chloride has definite influence on secretory products and lipid profiles in the epididymis. This may eventually have an adverse impact on the fertility of the animal.

Keywords: aluminium chloride, rat, carnitine, GPC, sialic acid, epididymis, spermatozoa

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3989 C-eXpress: A Web-Based Analysis Platform for Comparative Functional Genomics and Proteomics in Human Cancer Cell Line, NCI-60 as an Example

Authors: Chi-Ching Lee, Po-Jung Huang, Kuo-Yang Huang, Petrus Tang

Abstract:

Background: Recent advances in high-throughput research technologies such as new-generation sequencing and multi-dimensional liquid chromatography makes it possible to dissect the complete transcriptome and proteome in a single run for the first time. However, it is almost impossible for many laboratories to handle and analysis these “BIG” data without the support from a bioinformatics team. We aimed to provide a web-based analysis platform for users with only limited knowledge on bio-computing to study the functional genomics and proteomics. Method: We use NCI-60 as an example dataset to demonstrate the power of the web-based analysis platform and data delivering system: C-eXpress takes a simple text file that contain the standard NCBI gene or protein ID and expression levels (rpkm or fold) as input file to generate a distribution map of gene/protein expression levels in a heatmap diagram organized by color gradients. The diagram is hyper-linked to a dynamic html table that allows the users to filter the datasets based on various gene features. A dynamic summary chart is generated automatically after each filtering process. Results: We implemented an integrated database that contain pre-defined annotations such as gene/protein properties (ID, name, length, MW, pI); pathways based on KEGG and GO biological process; subcellular localization based on GO cellular component; functional classification based on GO molecular function, kinase, peptidase and transporter. Multiple ways of sorting of column and rows is also provided for comparative analysis and visualization of multiple samples.

Keywords: cancer, visualization, database, functional annotation

Procedia PDF Downloads 603
3988 Assessment of the Work-Related Stress and Associated Factors among Sanitation Workers in Public Hospitals during COVID-19, Addis Ababa, Ethiopia

Authors: Zerubabel Mihret

Abstract:

Background: Work-related stress is a pattern of reactions to work demands unmatched by worker’s knowledge, skills, or abilities. Healthcare institutions are considered high-risk and intensive work areas for work-related stress. However, there is the nonexistence of clear and strong data about the magnitude of work-related stress on sanitation workers in hospitals in Ethiopia. The aim of this study was to determine the magnitude of work-related stress among sanitation workers in public hospitals during COVID-19 in Addis Ababa, Ethiopia. Methods: Institution-based cross-sectional study was conducted from October 2021 to February 2022 among 494 sanitation workers who were selected from 4 hospitals. HSE (Health and Safety Executive of UK) standard data collection tool was used, and an interviewer-administered questionnaire was used to collect the data using KOBO collect application. The collected data were cleaned and analyzed using SPSS version 20.0. Both binary and multivariable logistic regression analyses were done to identify important factors having an association with work-related stress. Variables with p-value ≤ 0.25 in the bivariate analysis were entered into the multivariable logistic regression model. A statistically significant level was declared at a p-value ≤ 0.05. Results: This study revealed that the magnitude of work-related stress among sanitation workers was 49.2% (95% CI 45-54). Significant proportions (72.7%) of sanitation workers were dissatisfied with their current job. Sex, age, experience, and chewing khat were significantly associated with work-related stress. Conclusion: Work-related stress is significantly high among sanitation workers. Sex, age, experience, and chewing khat were identified as factors associated with work-related stress. Intervention program focusing on the prevention and control of stress is desired by hospitals.

Keywords: work-related stress, sanitation workers, Likert scale, public hospitals, Ethiopia

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3987 Effect of Distance Education Students Motivation with the Turkish Language and Literature Course

Authors: Meva Apaydin, Fatih Apaydin

Abstract:

Role of education in the development of society is great. Teaching and training started with the beginning of the history and different methods and techniques which have been applied as the time passed and changed everything with the aim of raising the level of learning. In addition to the traditional teaching methods, technology has been used in recent years. With the beginning of the use of internet in education, some problems which could not be soluted till that time has been dealt and it is inferred that it is possible to educate the learners by using contemporary methods as well as traditional methods. As an advantage of technological developments, distance education is a system which paves the way for the students to be educated individually wherever and whenever they like without the needs of physical school environment. Distance education has become prevalent because of the physical inadequacies in education institutions, as a result; disadvantageous circumstances such as social complexities, individual differences and especially geographical distance disappear. What’s more, the high-speed of the feedbacks between teachers and learners, improvement in student motivation because there is no limitation of time, low-cost, the objective measuring and evaluation are on foreground. In spite of the fact that there is teaching beneficences in distance education, there are also limitations. Some of the most important problems are that : Some problems which are highly possible to come across may not be solved in time, lack of eye-contact between the teacher and the learner, so trust-worthy feedback cannot be got or the problems stemming from the inadequate technological background are merely some of them. Courses are conducted via distance education in many departments of the universities in our country. In recent years, giving lectures such as Turkish Language, English, and History in the first grades of the academic departments in the universities is an application which is constantly becoming prevalent. In this study, the application of Turkish Language course via distance education system by analyzing advantages and disadvantages of the distance education system which is based on internet.

Keywords: distance education, Turkish language, motivation, benefits

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3986 Effects of in Ovo Injection of Royal Jelly on Hatchability, One-Day Old Chickens Quality, Total Antioxidant Status and Blood Lipoproteins

Authors: Amin Adeli, Maryam Zarei

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Background and purpose: Royal jelly (RJ) is a natural product with anti-hyperlipidemic and antioxidant properties. In ovo administration of RJ may improve lipid profile and antioxidant properties. This study was conducted to evaluate, for first time, the effects of in ovo injection of the RJ on hatchability, one-day old chick quality, total antioxidant status and blood lipoproteins. Methods: 400 incubating eggs produced by Ross 308 strain (52 weeks of age in first stage of production) were prepared and assigned into 4 groups (n=100) and 4 replications per group (n=25). These 4 groups were injected by the following pattern: 1) 0.1 ml normal saline (control), 2) 0.1 mg RJ+0.1 ml normal saline, 3) 0.2 mg RJ+0.1 ml normal saline, and 4) 0.3 mg RJ+0.1 ml normal saline. Injections were performed using a laminar flow system Lipid profile, antioxidant properties, hatchability, and one-day old chicken quality were assessed. Results: The administration of RJ at concentration of 0.1increased the percentage of hatchability compared to concentration of 0.2 and control, significant differences have not been observed among groups for quality scores (P>0.05). The results showed that in ovo injection of the RJ did not have any significant effects on lipid profile; but administration of the RJ only decreased High-density lipoprotein (HDL cholesterol, HDL-C) (P<0.05). The results showed that injection of the RJ at concentration of 0.3 increased total antioxidant capacity (TAC) compared to control group (p<0.05). Injection of the RJ progressively increased gluthation peroxidase (GPx) activity (p<0.05). The results showed that injection of the RJ decreased superoxide dismutase (SOD) compared to control group (p<0.05). Conclusion: In ovo injection of the RJ at the highest concentration increased TAC and GPx, but it did not have significant effects on lipid profile. Future studies are needed to investigate the effects of the RJ on the above-mentioned mechanisms.

Keywords: antioxidant enzymes, chicken quality, hatchability, royal jelly

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3985 Incidence, Risk Factors and Impact of Major Adverse Events Following Paediatric Cardiac Surgery

Authors: Sandipika Gupta

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Objective: Due to admirably low 30-day mortality rates for paediatric cardiac surgery, it is now pertinent to turn towards more intermediate-length outcomes such as morbidities closely associated with these surgeries. One such morbidity, major adverse events (MAE) comprises a group of adverse outcomes associated with paediatric cardiac surgery (e.g. cardiac arrest, major haemorrhage). Methods: This is a retrospective study that analysed the incidence and impact of MAE which was the primary outcome in the UK population. The data was collected in 5 centres between October 2015 and June 2017, amassing 3090 surgical episodes. The incidence and risk factors for MAE, were assessed through descriptive statistical analyses and multivariate logistic regression. The secondary outcomes of life status at 6 months and the length of hospital stay were also evaluated to understand the impact of MAE on patients. Results: Out of 3090 episodes, 134 (4.3%) had a postoperative MAE. The majority of the episodes were in: neonates (47%, P<0.001), high-risk cardiac diagnosis groups (20.1%, P<0.001), episodes with longer 5mes on the bypass (72.4%, P<0.001) and urgent surgeries (57.9%, P<0.001). Episodes reporting MAE also reported longer lengths of stay in hospital (29 days vs 9 days, P<0.001). Furthermore, patients experiencing MAE were at a higher risk of mortality at the 6-month life status check (mortality rates: 29.2% vs 2%, P<0.001).Conclusions: Key risk factors were identified. An important negative impact of MAE was found for patients. The identified risk factors could be used to profile and flag at-risk patients. Monitoring of MAE rates and closer investigation into the care pathway before and after individual MAEs in children’s heart units may lead to a reduction in these terrible events.

Keywords:

Procedia PDF Downloads 220
3984 Effects of Blood Pressure According to Age on End-Stage Renal Disease Development in Diabetes Mellitus Patients: A Nationwide Population-Based Cohort Study

Authors: Eun Hui Bae, Sang Yeob Lim, Bongseong Kim, Tae Ryom Oh, Su Hyun Song, Sang Heon Suh, Hong Sang Choi, Eun Mi Yang, Chang Seong Kim, Seong Kwon Ma, Kyung-Do Han, Soo Wan Kim

Abstract:

Background: Recent hypertension guidelines have recommended lower blood pressure (BP) targets in high-risk patients. However, there are no specific guidelines based on age or systolic and diastolic blood pressure (SBP and DBP, respectively). We aimed to assess the effects of age-related BP on the development of end-stage renal disease (ESRD) in patients with diabetes. Methods: A total of 2,563,870 patients with DM aged >20 years were selected from the Korean National Health Screening Program from 2009 to 2012 and followed up until the end of 2019. Participants were categorized into age and BP groups, and the hazard ratios (HRs) for ESRD were calculated. Results: During a median follow-up of 7.15 years, the incidence rates of ESRD increased with increasing SBP and DBP. The HR for ESRD was the highest in patients younger than 40 years of age with DBP ≥ 100 mmHg. The effect of SBP and DBP on ESRD development was attenuated with age (interaction p-value was <0.0001 for age and SBP and 0.0022 for age and DBP). The subgroup analysis for sex, anti-hypertension medication, and history of chronic kidney disease (CKD) showed higher HRs for ESRD among males younger than 40 years, not taking anti-hypertension medications and CKD compared to those among females older than 40 years, anti-hypertension medication and non-CKD groups. Conclusions: Higher SBP and DBP increase the risk of developing ESRD in patients with diabetes, and in particular, younger individuals face greater risk. Therefore, intensive BP management is warranted in younger patients to prevent ESRD.

Keywords: hypertension, young adult, end-stage renal disease, diabetes mellitus, chronic kidney disease, blood pressure

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3983 Opioid Administration on Patients Hospitalized in the Emergency Department

Authors: Mani Mofidi, Neda Valizadeh, Ali Hashemaghaee, Mona Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: Acute pain and its management remained the most complaint of emergency service admission. Diagnostic and therapeutic procedures add to patients’ pain. Diminishing the pain increases the quality of patient’s feeling and improves the patient-physician relationship. Aim: The aim of this study was to evaluate the outcomes and side effects of opioid administration in emergency patients. Material and Methods: patients admitted to ward II emergency service of Imam Khomeini hospital, who received one of the opioids: morphine, pethidine, methadone or fentanyl as an analgesic were evaluated. Their vital signs and general condition were examined before and after drug injection. Also, patient’s pain experience were recorded as numerical rating score (NRS) before and after analgesic administration. Results: 268 patients were studied. 34 patients were addicted to opioid drugs. Morphine had the highest rate of prescription (86.2%), followed by pethidine (8.5%), methadone (3.3%) and fentanyl (1.68). While initial NRS did not show significant difference between addicted patients and non-addicted ones, NRS decline and its score after drug injection were significantly lower in addicted patients. All patients had slight but statistically significant lower respiratory rate, heart rate, blood pressure and O2 saturation. There was no significant difference between different kind of opioid prescription and its outcomes or side effects. Conclusion: Pain management should be always in physicians’ mind during emergency admissions. It should not be assumed that an addicted patient complaining of pain is malingering to receive drug. Titration of drug and close monitoring must be in the curriculum to prevent any hazardous side effects.

Keywords: numerical rating score, opioid, pain, emergency department

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3982 The Association of Smoking and Body Mass Index with Acne Vulgaris in Adolescents and Young Adults

Authors: Almutazballlah Qablan, Jihan M. Muhaidat, Bana Abu Rajab

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Background: Acne vulgaris is the most common skin condition that general practitioners and dermatologists encounter. It represents a chronic inflammatory disease affecting the pilosebaceous unit. Although acne vulgaris is not a life-threatening condition, it has a considerable psychological impact on the affected person. Acne patients have poor body image, low self-esteem, social isolation, and restricted activities. As part of the emotional impact, increased levels of anxiety, anger, depression, and frustration have also been observed in acne patients. (1) In this study, we want to assess the association between two modifiable risk factors; BMI and smoking, regarding acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Irbid, north Jordan in 2019/2020. A total number of 163 Acne cases were collected and interviewed by the author; on the other hand, there were 162 control cases. Anthropometric measures for Acne patients and control individuals were taken, and BMI was calculated. Both groups were asked about smoking habits. Data on subjects between 14 and 33 years of age were extracted. The characteristics of people who reported acne were compared with those with no acne using univariate and multivariate analysis. The Statistical Package for Social Sciences (SPSS) was relied on to analyze the collected data. The crosstabs methods (chi-square) and odd ratios were relied on to test the study hypothesis. Results: Cigarette smoking was highly associated with no-acne, with an odds ratio of 0.4 (95% CI: 0.2–0.9), P-value = 0.018. BMI and waterpipe smoking were not significantly associated with acne in the multivariate analysis. Conclusion: Cigarette smoking was found to be protective from Acne. No significant relation between BMI nor waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, BMI, smoking, case-control

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3981 Bekaadendang: A Principles-Focused Evaluation

Authors: Erin Brands-Saliba

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In this evaluation study, we explore the efficacy and implementation of the five guiding principles of Bekaadendang “Being Peaceful,” a suite of services facilitated by our Anti-Human Trafficking Team, and a pivotal component of the Holistic Prevention Services department at NCFST. The guiding principles—trauma-informed care, cultural safety, 4-quadrant medicine wheel approach, harm reduction, and after-care peer support—are the foundation of Bekaadendang's mission to support at-risk individuals and survivors of human trafficking. This evaluation is of paramount importance given the profound impact of human trafficking on these communities and aims to ensure that Bekaadendang's principles are not only understood by staff but experienced by community members in a purposeful and meaningful manner. The issues at the heart of this evaluation are deeply entrenched in the historical and contemporary challenges faced by Indigenous communities, with a particular emphasis on Indigenous women and 2SLGBTQQIA+ individuals. Well-documented reports like the National Inquiry into Missing and Murdered Indigenous Women and Girls (MMIWG) have cast a glaring light on the disproportionately high rates of violence, exploitation, and trafficking experienced by these communities. The MMIWG report underlines the pressing need for holistic, culturally informed interventions like Bekaadendang. Furthermore, the research efforts of scholars, both Indigenous and non-Indigenous, shed light on the persistent systemic issues that make Indigenous individuals more vulnerable to trafficking and exploitation. Recognizing this broader context is crucial to truly grasp the importance of evaluating the guiding principles that underpin Bekaadendang's service model.

Keywords: human trafficking, indigenous healing, MMIWG, program evaluation

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3980 Understanding Algerian International Student Mental Health Experiences in UK (United Kingdom) Universities: Difficulties of Disclosure, Help-Seeking and Coping Strategies

Authors: Nesrine Boussaoui

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Background: International students often encounter challenges while studying in the UK, including communication and language barriers, lack of social networks, and socio-cultural differences that adversely impact on their mental health. For Algerian international students (AISs), these challenges may be heightened as English is not their first language and the culture of their homeland is substantially different from British culture, yet research has to incorporate their experiences and perspectives. Aim: The current study aimed to explore AISs’ 1) understandings of mental health; 2) issues of disclosure for mental health difficulties; and 3) mental health help-seeking and coping strategies. Method: In-depth, audio recorded semi-structured interviews (n = 20) with AISs in UK universities were conducted. An inductive, reflective thematic approach analysis was used. Finding: The following themes and associated sub-themes were developed: (1) Algerian cultural influences on mental health understanding(socio-cultural comparisons); (2) the paradox of the family (pressure vs. support); (3) stigma and fear of disclosure; (4) Barriers to formal help-seeking (informal disclosure as first step to seeking help); (5) Communication barriers (resort to mother tongue to disclose); (6) Self-reliance and religious coping. Conclusion: Recognising and understanding the challenges faced by AISs in terms of disclosure and mental health help-seeking is essential to reduce barriers to formal help-seeking. Informal disclosure among peers is often the first step to seeking help. Enhancing practitioners’ cultural competences and awareness of diverse understandings of mental health and the role of religious coping among AISs’ may have transferable benefits to a wider international student population.

Keywords: mental health, stegma, coping, disclosure

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3979 Repeated Batch Production of Biosurfactant from Pseudomonas mendocina NK41 Using Agricultural and Agro-Industrial Wastes as Substate

Authors: Natcha Ruamyat, Nichakorn Khondee

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The potential of an alkaliphilic bacteria isolated from soil in Thailand to utilized agro-industrial and agricultural wastes for the production of biosurfactants was evaluated in this study. Among five isolates, Pseudomonas mendocina NK41 used soapstock as substrate showing a high biosurfactant concentration of 7.10 g/L, oil displacement of 97.8 %, and surface tension reduction to 29.45 mN/m. Various agricultural residues were applied as mixed substrates with soapstock to enhance the synthesis of biosurfactants. The production of biosurfactant and bacterial growth was found to be the highest with coconut oil cake as compared to Sacha inchi shell, coconut kernel cake, and durian shell. The biodegradability of agro-industrial wastes was better than agricultural wastes, which allowed higher bacterial growth. The pretreatment of coconut oil cake by combined alkaline and hydrothermal method increased the production of biosurfactant from 12.69 g/L to 13.82 g/L. The higher microbial accessibility was improved by the swelling of the alkali-hydrothermal pretreated coconut oil cake, which enhanced its porosity and surface area. The pretreated coconut oil cake was reused twice in the repeated batch production, showing higher biosurfactant concentration up to 16.94 g/L from the second cycle. These results demonstrated the capability of using lignocellulosic wastes from agricultural and agro-industrial activities to produce a highly valuable biosurfactant. High biosurfactant yield with low-cost substrate reveals its potential towards further commercialization of biosurfactant on large-scale production.

Keywords: alkaliphilic bacteria, agricultural/agro-industrial wastes, biosurfactant, combined alkaline-hydrothermal pretreatment

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3978 Effect of Bi-Dispersity on Particle Clustering in Sedimentation

Authors: Ali Abbas Zaidi

Abstract:

In free settling or sedimentation, particles form clusters at high Reynolds number and dilute suspensions. It is due to the entrapment of particles in the wakes of upstream particles. In this paper, the effect of bi-dispersity of settling particles on particle clustering is investigated using particle-resolved direct numerical simulation. Immersed boundary method is used for particle fluid interactions and discrete element method is used for particle-particle interactions. The solid volume fraction used in the simulation is 1% and the Reynolds number based on Sauter mean diameter is 350. Both solid volume fraction and Reynolds number lie in the clustering regime of sedimentation. In simulations, the particle diameter ratio (i.e. diameter of larger particle to smaller particle (d₁/d₂)) is varied from 2:1, 3:1 and 4:1. For each case of particle diameter ratio, solid volume fraction for each particle size (φ₁/φ₂) is varied from 1:1, 1:2 and 2:1. For comparison, simulations are also performed for monodisperse particles. For studying particles clustering, radial distribution function and instantaneous location of particles in the computational domain are studied. It is observed that the degree of particle clustering decreases with the increase in the bi-dispersity of settling particles. The smallest degree of particle clustering or dispersion of particles is observed for particles with d₁/d₂ equal to 4:1 and φ₁/φ₂ equal to 1:2. Simulations showed that the reduction in particle clustering by increasing bi-dispersity is due to the difference in settling velocity of particles. Particles with larger size settle faster and knockout the smaller particles from clustered regions of particles in the computational domain.

Keywords: dispersion in bi-disperse settling particles, particle microstructures in bi-disperse suspensions, particle resolved direct numerical simulations, settling of bi-disperse particles

Procedia PDF Downloads 188
3977 Performance Comparison of Deep Convolutional Neural Networks for Binary Classification of Fine-Grained Leaf Images

Authors: Kamal KC, Zhendong Yin, Dasen Li, Zhilu Wu

Abstract:

Intra-plant disease classification based on leaf images is a challenging computer vision task due to similarities in texture, color, and shape of leaves with a slight variation of leaf spot; and external environmental changes such as lighting and background noises. Deep convolutional neural network (DCNN) has proven to be an effective tool for binary classification. In this paper, two methods for binary classification of diseased plant leaves using DCNN are presented; model created from scratch and transfer learning. Our main contribution is a thorough evaluation of 4 networks created from scratch and transfer learning of 5 pre-trained models. Training and testing of these models were performed on a plant leaf images dataset belonging to 16 distinct classes, containing a total of 22,265 images from 8 different plants, consisting of a pair of healthy and diseased leaves. We introduce a deep CNN model, Optimized MobileNet. This model with depthwise separable CNN as a building block attained an average test accuracy of 99.77%. We also present a fine-tuning method by introducing the concept of a convolutional block, which is a collection of different deep neural layers. Fine-tuned models proved to be efficient in terms of accuracy and computational cost. Fine-tuned MobileNet achieved an average test accuracy of 99.89% on 8 pairs of [healthy, diseased] leaf ImageSet.

Keywords: deep convolution neural network, depthwise separable convolution, fine-grained classification, MobileNet, plant disease, transfer learning

Procedia PDF Downloads 169
3976 Establishment of Reference Interval for Serum Protein Electrophoresis of Apparently Healthy Adults in Addis Ababa, Ethiopia

Authors: Demiraw Bikila, Tadesse Lejisa, Yosef Tolcha, Chala Bashea, Mehari Meles Tigist Getahun Genet Ashebir, Wossene Habtu, Feyissa Challa, Ousman Mohammed, Melkitu Kassaw, Adisu Kebede, Letebrhan G. Egzeabher, Endalkachew Befekadu, Mistire Wolde, Aster Tsegaye

Abstract:

Background: Even though several factors affect reference intervals (RIs), the company-derived values are currently in use in many laboratories worldwide. However, little or no data is available regarding serum protein RIs, mainly in resource-limited setting countries like Ethiopia. Objective: To establish a reference interval for serum protein electrophoresis of apparently healthy adults in Addis Ababa, Ethiopia. Method: A cross-sectional study was conducted on a total of 297 apparently healthy adults from April-October 2019 in four selected sub-cities (Akaki, Kirkos, Arada, Yeka) of Addis Ababa, Ethiopia. Laboratory analysis of collected samples was performed using Capillarys 2 Flex Piercing analyzer, while statistical analysis was done using SPSS version 23 and med-cal software. Mann-Whitney test was used to check Partitions. Non-parametric method of reference range establishment was performed as per CLSI guideline EP28A3C. Result: The established RIs were: Albumin 53.83-64.59%, 52.24-63.55%; Alpha-1 globulin 3.04-5.40%, 3.44-5.60%; Alpha-2 globulin 8.0-12.67%, 8.44-12.87%; and Beta-1 globulin 5.01-7.38%, 5.14-7.86%. Moreover, Albumin to globulin ratio was 1.16-1.8, 1.09-1.74 for males and females, respectively. The combined RIs for Beta-2 globulin and Gamma globulin were 2.54-4.90% and 12.40-21.66%, respectively. Conclusion: The established reference interval for serum protein fractions revealed gender-specific differences except for Beta-2 globulin and Gamma globulin.

Keywords: serum protein electrophoresis, reference interval, Addis Ababa, Ethiopia

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3975 Estimation and Removal of Chlorophenolic Compounds from Paper Mill Waste Water by Electrochemical Treatment

Authors: R. Sharma, S. Kumar, C. Sharma

Abstract:

A number of toxic chlorophenolic compounds are formed during pulp bleaching. The nature and concentration of these chlorophenolic compounds largely depends upon the amount and nature of bleaching chemicals used. These compounds are highly recalcitrant and difficult to remove but are partially removed by the biochemical treatment processes adopted by the paper industry. Identification and estimation of these chlorophenolic compounds has been carried out in the primary and secondary clarified effluents from the paper mill by GCMS. Twenty-six chorophenolic compounds have been identified and estimated in paper mill waste waters. Electrochemical treatment is an efficient method for oxidation of pollutants and has successfully been used to treat textile and oil waste water. Electrochemical treatment using less expensive anode material, stainless steel electrodes has been tried to study their removal. The electrochemical assembly comprised a DC power supply, a magnetic stirrer and stainless steel (316 L) electrode. The optimization of operating conditions has been carried out and treatment has been performed under optimized treatment conditions. Results indicate that 68.7% and 83.8% of cholorphenolic compounds are removed during 2 h of electrochemical treatment from primary and secondary clarified effluent respectively. Further, there is a reduction of 65.1, 60 and 92.6% of COD, AOX and color, respectively for primary clarified and 83.8%, 75.9% and 96.8% of COD, AOX and color, respectively for secondary clarified effluent. EC treatment has also been found to increase significantly the biodegradability index of wastewater because of conversion of non- biodegradable fraction into biodegradable fraction. Thus, electrochemical treatment is an efficient method for the degradation of cholorophenolic compounds, removal of color, AOX and other recalcitrant organic matter present in paper mill waste water.

Keywords: chlorophenolics, effluent, electrochemical treatment, wastewater

Procedia PDF Downloads 370
3974 PitMod: The Lorax Pit Lake Hydrodynamic and Water Quality Model

Authors: Silvano Salvador, Maryam Zarrinderakht, Alan Martin

Abstract:

Open pits, which are the result of mining, are filled by water over time until the water reaches the elevation of the local water table and generates mine pit lakes. There are several specific regulations about the water quality of pit lakes, and mining operations should keep the quality of groundwater above pre-defined standards. Therefore, an accurate, acceptable numerical model predicting pit lakes’ water balance and water quality is needed in advance of mine excavation. We carry on analyzing and developing the model introduced by Crusius, Dunbar, et al. (2002) for pit lakes. This model, called “PitMod”, simulates the physical and geochemical evolution of pit lakes over time scales ranging from a few months up to a century or more. Here, a lake is approximated as one-dimensional, horizontally averaged vertical layers. PitMod calculates the time-dependent vertical distribution of physical and geochemical pit lake properties, like temperature, salinity, conductivity, pH, trace metals, and dissolved oxygen, within each model layer. This model considers the effect of pit morphology, climate data, multiple surface and subsurface (groundwater) inflows/outflows, precipitation/evaporation, surface ice formation/melting, vertical mixing due to surface wind stress, convection, background turbulence and equilibrium geochemistry using PHREEQC and linking that to the geochemical reactions. PitMod, which is used and validated in over 50 mines projects since 2002, incorporates physical processes like those found in other lake models such as DYRESM (Imerito 2007). However, unlike DYRESM PitMod also includes geochemical processes, pit wall runoff, and other effects. In addition, PitMod is actively under development and can be customized as required for a particular site.

Keywords: pit lakes, mining, modeling, hydrology

Procedia PDF Downloads 129
3973 Molecular Simulation of NO, NH3 Adsorption in MFI and H-ZSM5

Authors: Z. Jamalzadeh, A. Niaei, H. Erfannia, S. G. Hosseini, A. S. Razmgir

Abstract:

Due to developing the industries, the emission of pollutants such as NOx, SOx, and CO2 are rapidly increased. Generally, NOx is attributed to the mono nitrogen oxides of NO and NO2 that is one of the most important atmospheric contaminants. Hence, controlling the emission of nitrogen oxides is urgent environmentally. Selective Catalytic Reduction of NOx is one of the most common techniques for NOx removal in which Zeolites have wide application due to their high performance. In zeolitic processes, the catalytic reaction occurs mostly in the pores. Therefore, investigation the adsorption phenomena of the molecules in order to gain an insight and understand the catalytic cycle is of important. Hence, in current study, molecular simulations is applied for studying the adsorption phenomena in nanocatalysts applied for SCR of NOx process. The effect of cation addition to the support in the catalysts’ behavior through adsorption step was explored by Mont Carlo (MC). Simulation time of 1 Ns accompanying 1 fs time step, COMPASS27 Force Field and the cut off radios of 12.5 Ȧ was applied for performed runs. It was observed that the adsorption capacity increases in the presence of cations. The sorption isotherms demonstrated the behavior of type I isotherm categories and sorption capacity diminished with increase in temperature whereas an increase was observed at high pressures. Besides, NO sorption showed higher sorption capacity than NH3 in H–ZSM5. In this respect, the Energy distributions signified that the molecules could adsorb in just one sorption site at the catalyst and the sorption energy of NO was stronger than the NH3 in H-ZSM5. Furthermore, the isosteric heat of sorption data showed nearly same values for the molecules; however, it indicated stronger interactions of NO molecules with H-ZSM5 Zeolite compared to the isosteric heat of NH3 which was low in value.

Keywords: Monte Carlo simulation, adsorption, NOx, ZSM5

Procedia PDF Downloads 351
3972 Effect of Ocimum americanum Water Extract on Antioxidant System in Rat

Authors: Pornrut Rabintossaporn, Suphaket Saenthaweesuk, Amornnat Thuppia, Nuntiya Somparn

Abstract:

Several dietary and herbal plants have been shown to possess cytoprotective and antioxidant effects with various mechanisms of action. The aim of this study was to determine the antioxidant effects and its mechanism of aqueous leaves extract of Ocimum americanum (OA), commonly known as American basil or 'hoary basil', in rat. The extract was screened for its phytochemical contents and antioxidant activity in vitro. Moreover, the extract was studied in rats to evaluate its effects in vivo. Rats were orally administered with the extract at the dose of 100, 200 and 400 mg/kg for 28 days. Phytochemical screening of plant extracts revealed the presence of alkaloid, cardiac glycosides, tannin and steroid compounds. The extract contained phenolic compounds 36.91 ± 0.66 mg of gallic acid equivalents per gram OA extract. The free radical scavenging activity assessed by DPPH assay gave IC50 of 41.27 ± 1.86 µg/mL, which is relatively lower than that of BHT with IC50 of 12.34 ± 1.14µg/mL. In the animals, the extract was well tolerated by the animals throughout the 28 days of study as shown by normal serum levels AST, ALP, ALT, BUN and Cr as well as normal histology of liver and pancreatic and kidney tissue. The protein expression of antioxidant enzymes, γ-glutamylcysteine ligase (γ-GCL) in liver was significantly increased compared with normal control. Consistent with the induction of γ-GCL protein expression significantly reduction of serum oxidative stress marker malondialdehyde (MDA) was found in rat treated with OA extract compared with control. Taken together, this study provides evidence that Ocimum americanum exhibits direct antioxidant properties and can induce cytoprotective enzyme in vivo.

Keywords: antioxidant, γ-glutamylcysteine ligase, MDA, Ocimum americanum

Procedia PDF Downloads 224
3971 An Examination of Social Isolation and Loneliness in Adults with Hearing Loss

Authors: Christine Maleesha Withanachchi, Eithne Heffernan, Derek Hoare

Abstract:

Background: Social isolation (SI} is a major consequence of hearing loss (HL}. Isolation can lead to serious health problems (e.g., dementia and depression). Hearing Aids (HA) is the primary intervention for HL. However, these are less effective in social situations. Interventions are needed for SI in adults with hearing loss (AHL). Objectives: Investigated the relationship between HL and SI. Explored the views of AHL and hearing healthcare professionals (HHP) towards interventions for isolation. Methods: Individual and group semi-structured interviews were conducted. Interviews were conducted at the Nottingham Institute of Health Research (NIHR) Biomedical Research Centre (BRC). Six AHL and seven HHP were recruited via maximum variation sampling. The interview transcripts were analyzed using inductive thematic analysis. Results: Social impacts of HL: Most participants described that HL hurt them. This was in the form of social withdrawal, strain on relationships, and identity loss. Downstream effects of HL: Most audiologists acknowledged that isolation from HL could lead to depression. HL can also lead to exhaustion and unemployment. Impact of stigma: There are negative connotations around HL and HA (e.g. old age) and there is difficulty talking about isolation. The complexity of SI: There can be difficulty separating SI due to HL from SI due to other contributing factors (e.g. comorbidities). Potential intervention for isolation: Participants were unfamiliar with interventions for isolation and few, if any, were targeted for AHL specifically. Most participants thought an intervention should be patient-centered and run by an AHL in the community. Opinions differed regarding whether it should hear specific or generic. Implementation of intervention: Challenges to the implementation of an intervention for SI exist due to the sensitivity of the subject. Conclusions: This study demonstrated that SI is a major consequence of HL and uncovered novel findings related to its interventions. Uptake of interventions offered to AHL to reduce loneliness and social isolation is expected to be better if led by AHL in the community as opposed to HHP led interventions in the hospital or clinic settings.

Keywords: adults with hearing loss, hearing aids, interventions, social isolation

Procedia PDF Downloads 123
3970 Neuron Point-of-Care Stem Cell Therapy: Intrathecal Transplant of Autologous Bone Marrow-Derived Stem Cells in Patients with Cerebral Palsy

Authors: F. Ruiz-Navarro, M. Matzner, G. Kobinia

Abstract:

Background: Cerebral palsy (CP) encompasses the largest group of childhood movement disorders, the patterns and severity varies widely. Today, the management focuses only on a rehabilitation therapy that tries to secure the functions remained and prevents complications. However the treatments are not aimed to cure the disease. Stem cells (SCs) transplant via intrathecal is a new approach to the disease. Method: Our aim was to performed a pilot study under the condition of unproven treatment on clinical practice to assessed the safety and efficacy of Neuron Point-of-care Stem cell Therapy (N-POCST), an ambulatory procedure of autologous bone marrow derived SCs (BM-SCs) harvested from the posterior superior iliac crest undergo an on-site cell separation for intrathecal infusion via lumbar puncture. Results: 82 patients were treated in a period of 28 months, with a follow-up after 6 months. They had a mean age of 6,2 years old and male predominance (65,9%). Our preliminary results show that: A. No patient had any major side effects, B. Only 20% presented mild headache due to LP, C. 53% of the patients had an improvement in spasticity, D. 61% improved the coordination abilities, 23% improved the motor function, 15% improved the speech, 23% reduced the number of convulsive events with the same doses or less doses of anti-convulsive medication and 94% of the patients report a subjective general improvement. Conclusions: These results support previous worldwide publications that described the safety and effectiveness of autologous BM-SCs transplant for patients wit CP.

Keywords: autologous transplant, cerebral palsy, point of care, childhood movement disorders

Procedia PDF Downloads 402
3969 Effect of Soaking Period of Clay on Its California Bearing Ratio Value

Authors: Robert G. Nini

Abstract:

The quality of road pavement is affected mostly by the type of sub-grade which is acting as road foundation. The roads degradation is related to many factors especially the climatic conditions, the quality, and the thickness of the base materials. The thickness of this layer depends on its California Bearing Ratio (CBR) test value which by its turn is highly affected by the quantity of water infiltrated under the road after heavy rain. The capacity of the base material to drain out its water is predominant factor because any change in moisture content causes change in sub-grade strength. This paper studies the effect of the soaking period of soil especially clay on its CBR value. For this reason, we collected many clayey samples in order to study the effect of the soaking period on its CBR value. On each soil, two groups of experiments were performed: main tests consisting of Proctor and CBR test from one side and from other side identification tests consisting of other tests such as Atterberg limits tests. Each soil sample was first subjected to Proctor test in order to find its optimum moisture content which will be used to perform the CBR test. Four CBR tests were performed on each soil with different soaking period. The first CBR was done without soaking the soil sample; the second one with two days soaking, the third one with four days soaking period and the last one was done under eight days soaking. By comparing the results of CBR tests performed with different soaking time, a more detailed understanding was given to the role of the water in reducing the CBR of soil. In fact, by extending the soaking period, the CBR was found to be reduced quickly the first two days and slower after. A precise reduction factor of the CBR in relation with soaking period was found at the end of this paper.

Keywords: California Bearing Ratio, clay, proctor test, soaking period, sub-grade

Procedia PDF Downloads 120
3968 Clinical and Radiological Features of Adenomyosis and Its Histopathological Correlation

Authors: Surabhi Agrawal Kohli, Sunita Gupta, Esha Khanuja, Parul Garg, P. Gupta

Abstract:

Background: Adenomyosis is a common gynaecological condition that affects the menstruating women. Uterine enlargement, dysmenorrhoea, and menorrhagia are regarded as the cardinal clinical symptoms of adenomyosis. Classically it was thought, compared with ultrasonography, when adenomyosis is suspected, MRI enables more accurate diagnosis of the disease. Materials and Methods: 172 subjects were enrolled after an informed consent that had complaints of HMB, dyspareunia, dysmenorrhea, and chronic pelvic pain. Detailed history of the enrolled subjects was taken, followed by a clinical examination. These patients were then subjected to TVS where myometrial echo texture, presence of myometrial cysts, blurring of endomyometrial junction was noted. MRI was followed which noted the presence of junctional zone thickness and myometrial cysts. After hysterectomy, histopathological diagnosis was obtained. Results: 78 participants were analysed. The mean age was 44.2 years. 43.5% had parity of 4 or more. heavy menstrual bleeding (HMB) was present in 97.8% and dysmenorrhea in 93.48 % of HPE positive patient. Transvaginal sonography (TVS) and MRI had a sensitivity of 89.13% and 80.43%, specificity of 90.62% and 84.37%, positive likelihood ratio of 9.51 and 5.15, negative likelihood ratio of 0.12 and 0.23, positive predictive value of 93.18% and 88.1%, negative predictive value of 85.29% and 75% and a diagnostic accuracy of 89.74% and 82.5%. Comparison of sensitivity (p=0.289) and specificity (p=0.625) showed no statistically significant difference between TVS and MRI. Conclusion: Prevalence of 30.23%. HMB with dysmenorrhoea and chronic pelvic pain helps in diagnosis. TVS (Endomyometrial junction blurring) is both sensitive and specific in diagnosing adenomyosis without need for additional diagnostic tool. Both TVS and MRI are equally efficient, however because of certain additional advantages of TVS over MRI, it may be used as the first choice of imaging. MRI may be used additionally in difficult cases as well as in patients with existing co-pathologies.

Keywords: adenomyosis, heavy menstrual bleeding, MRI, TVS

Procedia PDF Downloads 477
3967 Thiopental-Fentanyl versus Midazolam-Fentanyl for Emergency Department Procedural Sedation and Analgesia in Patients with Shoulder Dislocation and Distal Radial Fracture-Dislocation: A Randomized Double-Blind Controlled Trial

Authors: D. Farsi, G. Dokhtvasi, S. Abbasi, S. Shafiee Ardestani, E. Payani

Abstract:

Background and aim:It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FTversusfentanyl-midazolam (FM)in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods:In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccess rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P<0.001). The occurrence of adverse effects was low in both groups (p=0.31). Conclusion: PSA using FT is effective and appears to be safe for orthopedic procedures in the ED. Therefore, regarding the prompt onset of action, short recovery period of thiopental, it seems that this combination can be considered more for performing PSA in orthopedic procedures in ED.

Keywords: procedural sedation and analgesia, thiopental, fentanyl, midazolam, orthopedic procedure, emergency department, pain

Procedia PDF Downloads 242