Search results for: clinical prediction rule

Authors: Hui Ling Chen

Abstract:

This article describes the experience of caring for a 68-year-old lung cancer patient undergoing the initial stage of concurrent chemotherapy and radiation therapy during the period of October 21 to November 16. In this study, the author collected data through observation, interviews, medical examination, and the use of Roy’s adaptation model as a guide for data collection and assessment. This study confirmed that chemotherapy induced nausea and vomiting, and radiation therapy impaired skin integrity. At the same time, the patient experienced an anxious reaction to the initial cancer diagnosis and the insertion of subcutaneous infusion ports at the start of medical treatment. Similarly, the patient’s wife shares his anxiety, not to mention the feeling of inadequacy from the lack of training in cancer care. In response, the nursing intervention strategy has included keeping the patient and his family informed of his treatment progress, transfer of cancer care knowledge, and providing them with spiritual support. For example, the nursing staff has helped them draw up a mutually agreeable dietary plan that best suits the wife’s cooking skills, provided them with knowledge in pre- and post-radiation skin care, as well as means to cope with nausea and vomiting reactions. The nursing staff has also worked on building rapport with the patient and his spouse, providing them with encouragement, caring attention and companionship. After the patient was discharged from the hospital, the nursing staff followed up with caring phone calls to help the patient and his family make life-style adjustments to normalcy. The author hopes that his distinctive nursing experience can be useful as a reference for the clinical care of lung cancer patients undergoing the initial stage of concurrent chemotherapy and radiation therapy treatment.

Keywords: lung cancer, initiate diagnosis, concurrent chemotherapy and radiation therapy, nursing care

Procedia PDF Downloads 136

Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

Abstract:

Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

Procedia PDF Downloads 172

Authors: Birendra Kumar Jha, Mingma L. Sherpa, Binod Kumar Dahal

Abstract:

Background: The metabolic syndrome is emerging as a major public health concern in the world. Urbanization, surplus energy uptake, compounded by decreased physical activities, and increasing obesity are the major factors contributing to the epidemic of metabolic syndrome worldwide. However, prevalence of metabolic syndrome and its risk factors are little studied in Terai region of Nepal. The objectives of this research were to estimate the prevalence and to identify the risk factors of metabolic syndrome among adults in Terai region of Nepal. Method: We used a community based cross sectional study design. A total of 225 adults (age: 18 to 80 years) were selected from three district of Terai region of Nepal using cluster sampling by camp approach. IDF criteria (central obesity with any two of following four factors: triglycerides ≥ 150 mg/dl or specific treatment for lipid abnormality, reduced HDL, raised blood pressure and raised fasting plasma glucose or previously diagnosed type 2 diabetes) were used to assess metabolic syndrome. Interview, physical and clinical examination, measurement of fasting blood glucose and lipid profile were conducted for all participants. Chi-square test and multivariable logistic regression were employed to explore the risk factors of metabolic syndrome. Result: The overall prevalence of metabolic syndrome was 70.7%. Hypertension, increased fasting blood sugar, increased triglycerides and decreased HDL were observed in 50.7%, 32.4%, 41.8% and 79.1% of the subjects respectively. Socio-economic and behavioral risk factors significantly associated with metabolic syndrome were gender male (OR=2.56, 955 CI: 1.42-4.63; p=0.002), in service or retired from service (OR=3.72, 95% CI: 1.72-8.03; p=0.001) and smoking (OR= 4.10, 95% CI: 1.19-14.07; p=0.016). Conclusion: Higher prevalence of Metabolic syndrome along with presence of behavioral risk factors in Terai region of Nepal likely suggest lack of awareness and health promotion activities for metabolic syndrome and indicate the need to promote public health programs in this region to maintain quality of life.

Keywords: metabolic syndrome, Nepal, prevalence, risk factors, Terai

Procedia PDF Downloads 145

Authors: Lubomir Vecera, Tomas Gabrhelik, Benjamin Tolmaci, Josef Srovnal, Emil Berta, Petr Prasil, Petr Stourac

Abstract:

Cancer is the second leading cause of death worldwide and colon cancer is the second most common type of cancer. Currently, there are only a few studies evaluating the effect of postoperative analgesia on the prognosis of patients undergoing radical colon cancer surgery. Postoperative analgesia in patients undergoing colon cancer surgery is usually managed in two ways, either with strong opioids (morphine, piritramide) or epidural analgesia. In our prospective study, we evaluated the effect of postoperative analgesia on the presence of circulating tumor cells or minimal residual disease after colon cancer surgery. A total of 60 patients who underwent radical colon cancer surgery were enrolled in this prospective, randomized, two-center study. Patients were randomized into three groups, namely piritramide, morphine and postoperative epidural analgesia. We evaluated the presence of carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20) mRNA positive circulating tumor cells in peripheral blood before surgery, immediately after surgery, on postoperative day two and one month after surgery. The presence of circulating tumor cells was assessed by quantitative real-time reverse transcriptase-polymerase chain reaction (qRT-PCR). In the priritramide postoperative analgesia group, the presence of CEA mRNA positive cells was significantly lower on a postoperative day two compared to the other groups (p=0.04). The value of CK-20 mRNA positive cells was the same in all groups on all days. In all groups, both types of circulating tumor cells returned to normal levels one month after surgery. Demographic and baseline clinical characteristics were similar in all groups. Compared with morphine and epidural analgesia, piritramide significantly reduces the amount of CEA mRNA positive circulating tumor cells after radical colon cancer surgery.

Keywords: cancer progression, colon cancer, minimal residual disease, perioperative analgesia.

Procedia PDF Downloads 182

Authors: Xiaodi Su, Xin Ting Zheng, Laura Sutarlie, Nur Asinah binte Mohamed Salleh, Yong Yu

Abstract:

Wound healing is a dynamic process with multiple phases. Rapid profiling and quantitative characterization of inflammation and infection remain challenging. We have developed paper-like battery-free multiplexed sensors for holistic wound assessment via quantitative detection of multiple inflammation and infection markers. In one of the designs, the sensor patch consists of a wax-printed paper panel with five colorimetric sensor channels arranged in a pattern resembling a five-petaled flower (denoted as a ‘Petal’ sensor). The five sensors are for temperature, pH, trimethylamine, uric acid, and moisture. The sensor patch is sandwiched between a top transparent silicone layer and a bottom adhesive wound contact layer. In the second design, a palm-like-shaped paper strip is fabricated by a paper-cutter printer (denoted as ‘Palm’ sensor). This sensor strip carries five sensor regions connected by a stem sampling entrance that enables rapid colorimetric detection of multiple bacteria metabolites (aldehyde, lactate, moisture, trimethylamine, tryptophan) from wound exudate. For both the “\’ Petal’ and ‘Palm’ sensors, color images can be captured by a mobile phone. According to the color changes, one can quantify the concentration of the biomarkers and then determine wound healing status and identify/quantify bacterial species in infected wounds. The ‘Petal’ and ‘Palm’ sensors are validated with in-situ animal and ex-situ skin wound models, respectively. These sensors have the potential for integration with wound dressing to allow early warning of adverse events without frequent removal of the plasters. Such in-situ and early detection of non-healing condition can trigger immediate clinical intervention to facilitate wound care management.

Keywords: wound infection, colorimetric sensor, paper fluidic sensor, wound care

Procedia PDF Downloads 74

Authors: Jiping Cai, Ningzhi Wangyang, Jun Shao

Abstract:

Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality that leads to structural and functional damage in several parts of the brain, such as cranial nerves, optic nerve tract or other circuitry involved in vision and occipital lobe, depending on its location and severity. As a result, the function associated with vision processing and perception are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. Here two cases complaining of monocular vision loss (actually temporal hemianopia) due to traumatic chiasmal syndrome after frontal head injury were reported, and were compared the findings with individual case reports published in the literature. Reported cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. The degree of bitemporal hemianopia and visual loss acuity have a variable presentation and was not necessarily related to the severity of the craniocerebral trauma. Chiasmal injury may occur even in the absence bony chip impingement. Isolated bitemporal hemianopia is rare and clinical improvement usually may not occur. Mechanisms of damage to the optic chiasm after trauma include direct tearing, contusion haemorrhage and contusion necrosis, and secondary mechanisms such as cell death, inflammation, edema, neurogenesis impairment and axonal damage associated with TBI. Beside visual field test, MRI evaluation of optic pathways seems to the strong objective evidence to demonstrate the impairment of the integrity of visual systems following TBI. Therefore, traumatic chiasmal syndrome should be considered as a differential diagnosis by both neurosurgeons and ophthalmologists in patients presenting with visual impairment, especially bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.

Keywords: bitemporal hemianopia, brain injury, optic chiasma, traumatic chiasmal syndrome.

Procedia PDF Downloads 72

Authors: E. Menga, S. Hernandez

Abstract:

Finite Element Models (FEMs) are widely used in order to study and predict the dynamic properties of structures and usually, the prediction can be obtained with much more accuracy in the case of a single component than in the case of assemblies. Especially for structural dynamics studies, in the low and middle frequency range, most complex FEMs can be seen as assemblies made by linear components joined together at interfaces. From a modelling and computational point of view, these types of joints can be seen as localized sources of stiffness and damping and can be modelled as lumped spring/damper elements, most of time, characterized by nonlinear constitutive laws. On the other side, most of FE programs are able to run nonlinear analysis in time-domain. They treat the whole structure as nonlinear, even if there is one nonlinear degree of freedom (DOF) out of thousands of linear ones, making the analysis unnecessarily expensive from a computational point of view. In this work, a methodology in order to obtain the nonlinear frequency response of structures, whose nonlinearities can be considered as localized sources, is presented. The work extends the well-known Structural Dynamic Modification Method (SDMM) to a nonlinear set of modifications, and allows getting the Nonlinear Frequency Response Functions (NLFRFs), through an ‘updating’ process of the Linear Frequency Response Functions (LFRFs). A brief summary of the analytical concepts is given, starting from the linear formulation and understanding what the implications of the nonlinear one, are. The response of the system is formulated in both: time and frequency domain. First the Modal Database is extracted and the linear response is calculated. Secondly the nonlinear response is obtained thru the NL SDMM, by updating the underlying linear behavior of the system. The methodology, implemented in MATLAB, has been successfully applied to estimate the nonlinear frequency response of two systems. The first one is a two DOFs spring-mass-damper system, and the second example takes into account a full aircraft FE Model. In spite of the different levels of complexity, both examples show the reliability and effectiveness of the method. The results highlight a feasible and robust procedure, which allows a quick estimation of the effect of localized nonlinearities on the dynamic behavior. The method is particularly powerful when most of the FE Model can be considered as acting linearly and the nonlinear behavior is restricted to few degrees of freedom. The procedure is very attractive from a computational point of view because the FEM needs to be run just once, which allows faster nonlinear sensitivity analysis and easier implementation of optimization procedures for the calibration of nonlinear models.

Keywords: frequency response, nonlinear dynamics, structural dynamic modification, softening effect, rubber

Procedia PDF Downloads 263

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

Abstract:

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

Procedia PDF Downloads 148

Authors: Markus Rütten, Olaf Wünsch

Abstract:

Non-Newtonian fluid properties can change the flow behaviour significantly, its prediction is more difficult when thermal effects come into play. Hence, the focal point of this work is the wake flow behind a heated circular cylinder in the laminar vortex shedding regime for thermo-viscous shear thinning fluids. In the case of isothermal flows of Newtonian fluids the vortex shedding regime is characterised by a distinct Reynolds number and an associated Strouhal number. In the case of thermo-viscous shear thinning fluids the flow regime can significantly change in dependence of the temperature of the viscous wall of the cylinder. The Reynolds number alters locally and, consequentially, the Strouhal number globally. In the present CFD study the temperature dependence of the Reynolds and Strouhal number is investigated for the flow of a Carreau fluid around a heated cylinder. The temperature dependence of the fluid viscosity has been modelled by applying the standard Williams-Landel-Ferry (WLF) equation. In the present simulation campaign thermal boundary conditions have been varied over a wide range in order to derive a relation between dimensionless heat transfer, Reynolds and Strouhal number. Together with the shear thinning due to the high shear rates close to the cylinder wall this leads to a significant decrease of viscosity of three orders of magnitude in the nearfield of the cylinder and a reduction of two orders of magnitude in the wake field. Yet the shear thinning effect is able to change the flow topology: a complex K´arm´an vortex street occurs, also revealing distinct characteristic frequencies associated with the dominant and sub-dominant vortices. Heating up the cylinder wall leads to a delayed flow separation and narrower wake flow, giving lesser space for the sequence of counter-rotating vortices. This spatial limitation does not only reduce the amplitude of the oscillating wake flow it also shifts the dominant frequency to higher frequencies, furthermore it damps higher harmonics. Eventually the locally heated wake flow smears out. Eventually, the CFD simulation results of the systematically varied thermal flow parameter study have been used to describe a relation for the main characteristic order parameters.

Keywords: heat transfer, thermo-viscous fluids, shear thinning, vortex shedding

Procedia PDF Downloads 294

Authors: Modi Alsubaie, Willem Kuyken, Rebecca Abbott, Barnaby Dunn, Chris Dickens, Tina Keil, William Henley

Abstract:

Background: Recently, there has been an increased interest in studying the effects of mindfulness-based interventions for people with psychological and physical problems. However, the mechanisms of action in these interventions that lead to beneficial physical and psychological outcomes have yet to be clearly identified. Purpose: The aim of this paper is to review, systematically, the evidence to date on the mechanisms of action in mindfulness interventions in populations with physical and/or psychological conditions. Method: Searches of seven databases (PsycINFO, Medline (Ovid), Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, AMED, ClinicalTrials.gov) were undertaken in June 2014 and July 2015. We evaluated to what extent the studies we identified met the criteria suggested by Kazdin for establishing mechanisms of action within a psychological treatment (2007, 2009). Results: We identified four trials examining mechanisms of mindfulness interventions in those with comorbid psychological and physical health problems and 14 in those with psychological conditions. These studies examined a diverse range of potential mechanisms, including mindfulness and rumination. Of these candidate mechanisms, the most consistent finding was that greater self-reported change in mindfulness mediated superior clinical outcomes. However, very few studies fully met the Kazdin criteria for examining treatment mechanisms. Conclusion: There was evidence that global changes in mindfulness are linked to better outcomes. This evidence pertained more to interventions targeting psychological rather than physical health conditions. While there is promising evidence that MBCT/MBSR intervention effects are mediated by hypothesised mechanisms, there is a lack of methodological rigour in the field of testing mechanisms of action for both MBCT and MBSR, which precludes definitive conclusions.

Keywords: MBCT, MBSR, mechanisms, physical conditions, psychological conditions, systematic review

Procedia PDF Downloads 327

Authors: Louise Elizabeth Bolton

Abstract:

Statement of the problem: There are an estimated 328 million cases of COPD worldwide. It is likely to become the third biggest cause of death by 2030. The impact of living with palliative care needs arising from COPD disrupts an individual’s existential situation. Understandings of individuals' existential situations within COPD are limited within the research literature and are rarely addressed within clinical practice, yet existential suffering has been linked to poor health-related quality of life for those living with other chronic conditions. The purpose of this integrative review is to provide a synthesis of existing evidence on existential suffering for those living with palliative care needs arising from COPD. Methods: This is an integrative review undertaken in accordance with PRISMA guidelines. Nine electronic databases were searched from April 2019 to January 2021. Thirty-five empirical research papers of both qualitative and quantitative methodologies, alongside systematic literature reviews, were included. Data analysis was undertaken using an integrative thematic analysis approach. Findings: Identified themes of existential suffering when living with palliative care needs arising from COPD are as follows: Liminality, Lamented Life, Loss of Personal Liberty, Life Meaning and Existential isolation. The absence of life meaning and purpose was of most importance to patients. Conclusion and Significance: This integrative review provides a synthesis of international evidence upon the presence of existential suffering. It is present and of significant impact within the daily lives of those living with palliative care needs arising from COPD. The absence of life meaning has the most significant impact, requiring further exploration of both its physical and psychological impact. Rediscovery of life meaning diminishes feelings of worthlessness and hopelessness in daily life and facilitates feelings of inner peace. For those with COPD living with such a relentless symptom burden, a positive existential situation is desirable.

Keywords: palliative care, COPD, existential suffering, end of life care

Procedia PDF Downloads 130

Authors: Hyuk-Hoon Kim, Young Gi Min

Abstract:

Background: In carbon monoxide (CO) intoxication, the pathophysiology of delayed neurological sequelae (DNS) is very complex and remains poorly understood. And predicting whether patients who exhibit resolved acute symptoms have escaped or will experience DNS represents a very important clinical issue. Brain magnetic resonance (MR) imaging has been conducted to assess the severity of brain damage as an objective method to predict prognosis. And co-ingestion of a second poison in patients with intentional CO poisoning occurs in almost one-half of patients. Among patients with co-ingestions, 66% ingested ethanol. We assessed the effects of ethanol on neurologic sequelae prevalence in acute CO intoxication by means of abnormal lesion in brain MR. Method: This study was conducted retrospectively by collecting data for patients who visited an emergency medical center during a period of 5 years. The enrollment criteria were diagnosis of acute CO poisoning and the measurement of the serum ethanol level and history of taking a brain MR during admission period. Official readout data by radiologist are used to decide whether abnormal lesion is existed or not. The enrolled patients were divided into two groups: patients with abnormal lesion and without abnormal lesion in Brain MR. A standardized extraction using medical record was performed; Mann Whitney U test and logistic regression analysis were performed. Result: A total of 112 patients were enrolled, and 68 patients presented abnormal brain lesion on MR. The abnormal brain lesion group had lower serum ethanol level (mean, 20.14 vs 46.71 mg/dL) (p-value<0.001). In addition, univariate logistic regression analysis showed the serum ethanol level (OR, 0.99; 95% CI, 0.98 -1.00) was independently associated with the development of abnormal lesion in brain MR. Conclusion: Ethanol could have neuroprotective effect in acute CO intoxication by sedative effect in stressful situation and mitigative effect in neuro-inflammatory reaction.

Keywords: carbon monoxide, delayed neuropsychological sequelae, ethanol, intoxication, magnetic resonance

Procedia PDF Downloads 250

Authors: Taylan Kabbani, Ekrem Duman

Abstract:

The design of adaptive systems that take advantage of financial markets while reducing the risk can bring more stagnant wealth into the global market. However, most efforts made to generate successful deals in trading financial assets rely on Supervised Learning (SL), which suffered from various limitations. Deep Reinforcement Learning (DRL) offers to solve these drawbacks of SL approaches by combining the financial assets price "prediction" step and the "allocation" step of the portfolio in one unified process to produce fully autonomous systems capable of interacting with its environment to make optimal decisions through trial and error. In this paper, a continuous action space approach is adopted to give the trading agent the ability to gradually adjust the portfolio's positions with each time step (dynamically re-allocate investments), resulting in better agent-environment interaction and faster convergence of the learning process. In addition, the approach supports the managing of a portfolio with several assets instead of a single one. This work represents a novel DRL model to generate profitable trades in the stock market, effectively overcoming the limitations of supervised learning approaches. We formulate the trading problem, or what is referred to as The Agent Environment as Partially observed Markov Decision Process (POMDP) model, considering the constraints imposed by the stock market, such as liquidity and transaction costs. More specifically, we design an environment that simulates the real-world trading process by augmenting the state representation with ten different technical indicators and sentiment analysis of news articles for each stock. We then solve the formulated POMDP problem using the Twin Delayed Deep Deterministic Policy Gradient (TD3) algorithm, which can learn policies in high-dimensional and continuous action spaces like those typically found in the stock market environment. From the point of view of stock market forecasting and the intelligent decision-making mechanism, this paper demonstrates the superiority of deep reinforcement learning in financial markets over other types of machine learning such as supervised learning and proves its credibility and advantages of strategic decision-making.

Keywords: the stock market, deep reinforcement learning, MDP, twin delayed deep deterministic policy gradient, sentiment analysis, technical indicators, autonomous agent

Procedia PDF Downloads 174

Authors: Navarro C., Jahier B., Gard C.

Abstract:

Diarrhoea is a common disorder in both cats and dogs. Recent guidelines highlight the importance of gut microbiota and the use of strategies such as prebiotics, probiotics, postbiotics, and fecal transplants for modulating the microbiota. The objective of this study was to evaluate the palatability of a flavoured oral paste containing prebiotics (brewer’s yeast products, fructo-oligosaccharide), probiotics (Enterococcus faecium), and postbiotics (lactic ferment products), in dogs and cats. Material and methods: Healthy adult animals (cats and dogs) from various breeds received the tested product (Ultradiar® Biotic, MP Labo, France) at the recommended dosage over a small quantity of kibbles: animals less than 2 kg bodyweight received 2 ml per day, animals between2 and 6 kg received 4 ml per day, animals between 6 and 12 kg received 5 ml per day, animals between 12 and 30 kg received 8 ml per day, and animals weighing more than 30 kg received 10 ml per day. For each animal, the investigator noted the intake (immediate in less than 2 seconds, delayed after 2 seconds, no intake), the consumption of the product (no consumption, partial consumption ≤ 5%, < 50%, 50% ≤ x < 95%, ≥ 95%, total consumption). Acceptability was defined as the percentage of dogs having consumed more than 95% of the product. Results: Thirty-seven dogs were included: 19 small size, 11 medium size, and 7 large size dogs. Thirty-six dogs (97%) took the product, with 65% showing immediate intake. Only one small-sized dog did not take the product. Among the 36 dogs who took the product, 19 (53%) had a complete consumption, 13 (36%) consumed more than 95% of the product, 3 dogs consumed more than 50% (and less than 95%), and one dog consumed less than 50%. The acceptability rate was 86%. Thirty-seven cats were included. Twenty-eight cats (76%) took the product, with 8% showing immediate intake. Among those 28 cats, 7 (25%) consumed more than 95% of the product, 13 (47%) consumed more than 50% (and less than 95%), 6 consumed less than 50% and 2 cats consumed less than 5%. Conclusion: The flavoured oral paste, Ultradiar® Biotic, was well-accepted by both dogs and cats, with higher acceptability observed in dogs compared to cats. These results suggest that the product is palatable and can be usefully administered to support gastrointestinal health in companion animals. Further studies should explore the clinical benefits of this formulation in managing gastrointestinal disorders.

Keywords: cat, dog, palatability, prebiotic, probiotic

Procedia PDF Downloads 14

Authors: Iahtasham Khan, Vania Lucia De Assis Santana, Marcilia Maria Alves De Souza, Mabel Hanna Vance Harrop, Fernando Leandro Dos Santos, Cecília Maria Souza Leão E. Silva, Pedro Paulo Silveira, Marcelo Brasil, Marcus Vinícius, Hélio Cordeiro Manso Filho, Muhammad Younus, Aman Ullah Khan

Abstract:

Glanders ranks high on clinical lists in some regions of Brazil as a cause of respiratory and lymphatic disease in equids. Glanders is caused by Burkolderia mallei (B. mallei) Gram-negative bacterium. B. mallei was first biological agent used in World War I in 20th century. The complement fixation test (CFT) is a serodiagnostic tool prescribed by the World Organization for Animal Health (OIE)for the diagnosis of glanders in the international trade of equids. The aim of the present study was to monitor the serological responses in equines naturally infected with B. mallei using the CFT. A total of 574 equids were tested with CFT, 30 days apart in a total of 12 samplings. One hundred thirty-four sera tested negative in all samplings; 192 sera tested positive in one sampling and 125 sera tested positive in two or more samplings. Remaining 123 samples showed uncertain results. Thus, CFT results can vary over a period of time. These variations could be the consequence of the effects of the natural immune response in each animal. The findings of the present study demonstrate difficulties regarding the simultaneous implementation of CFT and test and slaughter policies to eradicate glanders. Another constraint to control this disease is the presence of carrier/transitory CFT-negative animals, which are a potential source of disease in glanders-free areas. Serodiagnostic tests of higher sensitivity and specificity like immunobloat should be implemented to achieve success in the eradication of glanders.

Keywords: glanders, equids, horses, immunological, mules

Procedia PDF Downloads 409

Authors: Hardisiswo Soedjana, Inne Caroline

Abstract:

Deep dermal or full thickness burns are inevitably lead to post-burn contractures. These contractures remain to be one of the most concerning late complications of burn injuries. Surgical management includes releasing the contracture followed by resurfacing the defect accompanied by post-operative rehabilitation. Optimal treatment of post-burn contractures depends on the characteristics of the contractures. This study is aimed to describe clinical characteristics, problems, and management of post-burn contractures in adults and children. A retrospective analysis was conducted from medical records of patients suffered from contractures after burn injuries admitted to Hasan Sadikin general hospital between January 2016 and January 2018. A total of 50 patients with post burn contractures were included in the study. There were 17 adults and 33 children. Most patients were male, whose age range within 15-59 years old and 5-9 years old. Educational background was mostly senior high school among adults, while there was only one third of children who have entered school. Etiology of burns was predominantly flame in adults (82.3%); whereas flame and scald were the leading cause of burn injury in children (11%). Based on anatomical regions, hands were the most common affected both in adults (35.2%) and children (48.5%). Contractures were identified in 6-12 months since the initial burns. Most post-burn hand contractures were resurfaced with full-thickness skin graft (FTSG) both in adults and children. There were 11 patients who presented with recurrent contracture after previous history of contracture release. Post-operative rehabilitation was conducted for all patients; however, it is important to highlight that it is still challenging to control splinting and exercise when patients are discharged and especially the compliance in children. In order to improve quality of life in patients with history of deep burn injuries, prevention of contractures should begin right after acute care has been established. Education for the importance of splinting and exercise should be administered as comprehensible as possible for adult patients and parents of pediatric patients.

Keywords: burn, contracture, education, exercise, splinting

Procedia PDF Downloads 118

Authors: Gulay Aras, Isil Kutluturk Karagoz, Z. Candan Algun

Abstract:

Background: Hypermetropia in school-age is a pathology that responds to treatment. In the literature, there has been no study of exercise practice in hypermetropia treatment. Objective: The purpose of this study was to investigate the effects of eye exercises and convergence exercise on visual acuity in school-age children with hypermetropia. Methods: Forty volunteer school-age children with hypermetropia (30 girls, 30 boys, between 7-17 years of age) were included in the study. Sociodemographic information and clinical characteristics were evaluated. 40 participants were randomly divided into two groups: eye exercises and convergence exercises. Home exercise protocols were given to all groups for six weeks, and regular phone calls were made once a week. Individuals performed eye exercises 10 times, convergence exercises 5 min. for two sessions per day for six weeks. The right and left eyes of all the subjects participating in the study were assessed separately by the eye doctor with a Snellen chart. The participants' quality of life was assessed using Pediatric Quality of Life Inventory Version 4.0. Physical health total score (PHTS) and scale total score (STS), which were obtained by evaluating Psychosocial health total score (PSHTS) school, emotional and social functioning, were calculated separately in the scores. At the end of the exercise program, the assessment tests applied at the beginning of the study were reapplied to all individuals. Results: There was no statistically significant difference between the pre- and post-Snellen chart measurements and quality of life in the eye exercises group (p > 0,05). There was a statistically significant difference in visual acuity of right and left eyes (p=0,004, p=0,014) and quality of life in PHTS, PSHTS and STS in the convergence exercise group (p=0,001, p=0,017, p=0,001). Conclusions: In school-age children, convergence exercises were found to be effective on visual acuity and health-related quality of life. Convergence exercises are recommended for the treatment of school-aged children with hypermetropia.

Keywords: convergence exercise, eye exercises, hypermetropia, school-age children

Procedia PDF Downloads 242

Authors: E. Olmos-Raya, A. Cascales Martínez, N. Minto de Sousa, M. Alcañiz Raya

Abstract:

The late detection and subjectivity of the assessment of Autism Spectrum Disorder (ASD) imposed a difficulty for the children’s clinical and familiar environment. The results showed in this paper, are part of a research project about the assessment and training of social skills in children with ASD, whose overall goal is the use of virtual environments together with physiological measures in order to find a new model of objective ASD assessment based on implicit brain processes measures. In particular, this work tries to contribute by studying the differences and changes in the Skin Conductance Response (SCR) and Eye Tracking (ET) between a typical development group (TD group) and an ASD group (ASD group) after several combined stimuli using a low cost Immersive Virtual Environment (IVE). Subjects were exposed to a virtual environment that showed natural scenes that stimulated visual, auditory and olfactory perceptual system. By exposing them to the IVE, subjects showed natural behaviors while measuring SCR and ET. This study compared measures of subjects diagnosed with ASD (N = 18) with a control group of subjects with typical development (N=10) when exposed to three different conditions: only visual (V), visual and auditory (VA) and visual, auditory and olfactory (VAO) stimulation. Correlations between SCR and ET measures were also correlated with the Autism Diagnostic Observation Schedule (ADOS) test. SCR measures showed significant differences among the experimental condition between groups. The ASD group presented higher level of SCR while we did not find significant differences between groups regarding DF. We found high significant correlations among all the experimental conditions in SCR measures and the subscale of ADOS test of imagination and symbolic thinking. Regarding the correlation between ET measures and ADOS test, the results showed significant relationship between VA condition and communication scores.

Keywords: autism, electrodermal activity, eye tracking, immersive virtual environment, virtual reality

Procedia PDF Downloads 135

Authors: Houman Tamaddon, Mehrdad Behnia, Masud Behnia

Abstract:

An accurate study of blood flow is associated with an accurate vascular pattern and geometrical properties of the organ of interest. Due to the complexity of vascular networks and poor accessibility in vivo, it is challenging to reconstruct the entire vasculature of any organ experimentally. The objective of this study is to introduce an innovative approach for the reconstruction of a full vascular tree from available morphometric data. Our method consists of implementing morphometric data on those parts of the vascular tree that are smaller than the resolution of medical imaging methods. This technique reconstructs the entire arterial tree down to the capillaries. Vessels greater than 2 mm are obtained from direct volume and surface analysis using contrast enhanced computed tomography (CT). Vessels smaller than 2mm are reconstructed from available morphometric and distensibility data and rearranged by applying Murray’s Laws. Implementation of morphometric data to reconstruct the branching pattern and applying Murray’s Laws to every vessel bifurcation simultaneously, lead to an accurate vascular tree reconstruction. The reconstruction algorithm generates full arterial tree topography down to the first capillary bifurcation. Geometry of each order of the vascular tree is generated separately to minimize the construction and simulation time. The node-to-node connectivity along with the diameter and length of every vessel segment is established and order numbers, according to the diameter-defined Strahler system, are assigned. During the simulation, we used the averaged flow rate for each order to predict the pressure drop and once the pressure drop is predicted, the flow rate is corrected to match the computed pressure drop for each vessel. The final results for 3 cardiac cycles is presented and compared to the clinical data.

Keywords: blood flow, morphometric data, vascular tree, Strahler ordering system

Procedia PDF Downloads 267

Authors: Daniel Botero, Oscar Rubiano, Pedro P. Barragan, Jaime Baron, Leonardo Rodriguez Perdomo, Jaime Rodriguez

Abstract:

In the last decade interval training (IT) has gained importance when is compare with strength training (ST). However, there are few studies analyzing the impact of these training over the autonomic nervous system (ANS). This work has aimed to compare the activity of the autonomic nervous system, when is expose to an IT or ST indoor cycling mode. After approval by the ethics committee, a cross-over clinical trial with 22 healthy participants (age 21 ± 3 years) was implemented. The selection of participants for the groups with sequence force-interval (F-I) and interval-force (I-F) was made randomly with assignation of 11 participants for each group. The temporal series of heart rate was obtained before and after each training using the POLAR TEAM® heart monitor. The evaluation of the ANS was performed with spectral analysis of the heart rate variability (HRV) using the fast Fourier transform (Kubios software). A training of 8 weeks in each sequence (4 weeks with each training) with an intermediate period of two weeks of washout was implemented for each group. The power parameter of the HRV in the low frequency band (LF = 0.04-0.15Hz related to the sympathetic nervous system), high frequency (HF = 0.15-0.4Hz, related to the parasympathetic) and LF/HF (with reference to a modulation of parasympathetic over the sympathetic), were calculated. Afterward, the difference between the parameters before and after was realized. Then, to evaluate statistical differences between each training was implemented the method of Wellek (Wellek and Blettner, 2012, Medicine, 109 (15), 276-81). To determine the difference of effect over parasympathetic when FT and IT are used, the T test is implemented obtaining a T value of 0.73 with p-value ≤ 0.1. For the sympathetic was obtained a T of 0.33 with p ≤ 0.1 and for LF/HF the T was 1.44 with a p ≥ 0.1. Then, the carry over effect was evaluated and was not present. Significant changes over autonomic activity with strength or interval training were not observed. However, a modulation of the parasympathetic over the sympathetic can be observed. Probably, these findings should be explained because the sample is little and/or the time of training was insufficient to generate changes.

Keywords: autonomic nervous, force training, indoor cycling, interval training

Procedia PDF Downloads 218

Authors: Rehana Khan

Abstract:

Background: The study investigates the experiences of Tiger Teams within the Sydney Local Health District during the COVID-19 pandemic. Aim: The aims were to understand the experiences of the Tiger Team members, to evaluate the effectiveness of Tiger Teams, and to elicit any learnings for future implementation of Tiger Teams in a similar context. Methods: Tiger Team members who worked from March 2020 to January 2022 were approached, with 23 members agreeing to participate in the study. Individual interviews were undertaken by a researcher on a virtual platform. Thematic analysis was used to analyse the data. Saturation was deemed to have been reached when no new themes or subthemes arose within the final three interviews. Results: Four themes emerged: diversity worked well in Tiger Teams; fear of the unknown and challenging conversations were the main challenges of Tiger Teams; improved use of resources and more structure around the strategy of the Tiger Team model would help in future implementations; and Sydney Local Health District’s response to the pandemic was uniformly considered effective in keeping the community safe. In relation to Sydney Local Health District’s response in future pandemics, participants suggested having a pool of staff in readiness to undertake Tiger Team duties when required; prioritise staff welfare at all levels of involvement during a pandemic; maintaining transparent communication and relationship building between Executive level, Tiger Team members and clinical floor level in relation to decision making; and improve documentation, including evaluations of the COVID-19 pandemic response. Implications: The study provides constructive insights into the experiences of Tiger Team members, and these findings will help inform future planning for surge and secondment of staff in public health emergencies.

Keywords: Tiger Team, pandemic response, future planning, COVID-19

Procedia PDF Downloads 73

Authors: Nazira B. Bekenova, Lydia A. Mukovozova, Andrej M. Grjibovski, Alma Z. Tokayeva, Yerbol M. Smail, Nurlan E. Aukenov

Abstract:

Erysipelas is an infectious disease with socio-economic significance and prone to prolonged recurrent course (30%). Contribution of genetic factors, in particular the gene polymorphism of cytokines, can be essential in disease etiology and pathogenesis. Interleukin – 17 A are produced by T helpers of 17 type and plays a key role in development of local inflammation process. Local inflammatory process is a dominant in the clinic of erysipelas. Established that the skin and mucosas are primary areas of migration (homing) Th17-cell and their cytokines are stimulate the barrier function of the epithelium. We studied associations between gene polymorphism of IL-17A (C737T) rs 8193036 and IL-17A level in patients with erysipelas Kazakh population. Altogether, 90 cases with erysipelas and 90 healthy controls from an ethnic Kazakh population comprised the sample. Cases were identified at Clinical Infectious Diseases Hospital of Semey (Kazakhstan). The IL-17A (rs8193036) polymorphism was analyzed by a real time polymerase chain reaction. Plasma levels of IL-17 A were assessed by immuneenzyme analysis method using ‘Vector-Best’ test-system (Russia). Differences in levels of IL-17 A between CC, TT, CT groups were studied using Kruskal — Wallis test. Pairwise comparisons were performed using Mann-Whitney tests with Bonferroni correction (New significance level was set to 0.025). We found, that in patients with erysipelas with CC genotype the level of IL-17 A was higher (p= 0, 010) compared to the carriers of CT genotype. When compared the level of IL – 17 A between the patients with TT genotype and patients with CC genotype, also between the patients with CT genotype and patients with TT genotype statistically significant differences are not revealed (p = 0.374 and p = 0.043, respectively). Comparisons of IL-17 A plasma levels between the CC and CT genotypes, between the CC and TT genotypes, and between the TT and CT in healthy patients did not reveal significant differences (p = 0, 291). Therefore, we are determined the associations of gene polymorphism of IL-17 A (C737T) with its level in patients erysipelas carriers CC genotype.

Keywords: erysipelas, interleukin – 17 A, Kazakh, polymorphism

Procedia PDF Downloads 428

Authors: Hsin-Yu Lin, Ching-Hsia Hung

Abstract:

Obstructive sleep apnea (OSA) is characterized by a complete or partial obstruction of the upper airway during sleep. The vulnerable sites of upper airway collapses are consequences of sleep state-dependent reductions in tone in specific pharyngeal dilators. Clinical examinations reveal multilevel collapses of the upper airway among the patients with OSA. Therefore, an anatomically-based oropharyngeal rehabilitation should comprise a multilevel approach, including retropalatal, retroglossal, hypopharyngeal, temporomandibular, and facial levels, all of which involve different muscle groups and contribute to multifunctional interaction and coordination, such as swallowing, breathing, and phonation. The purpose of the study was to exam the effects of this rehabilitation program with a multilevel approach. In this study, fifteen subjects with newly diagnosed moderate or severe OSA (Apnea-Hypopnea-Index≥15) were randomized into an intervention group and control group. The intervention group (N=8) underwent a 12-week-intervention of a hospital-based rehabilitation program, while the control group (N=7) was kept on the waiting list. The 12-week-intervention comprised an anatomically based multilevel approach. The primary outcome was Polysomnography (PSG) data, and the secondary outcome was oropharyngeal and respiratory muscle function. In the intervention group, Apnea-Hypopnea-Index significantly improved (46.96±19.45 versus 32.78±10.78 events/h, p=0.017) compared with control group (35.77±17.49 versus 42.96±17.32 events/h, p=0.043). While the control group remained no change, the intervention group demonstrated other PSG outcomes significantly improvement, including arousal index (46.04±18.9 versus 32.98±8.35/h, p=0.035), mean SpO2 (92.88±2.1 versus 94.13±1.46%, p=0.039). Besides, the intervention group demonstrated significant improvement in oropharyngeal and respiratory muscle function compared to the control group. This anatomically-based oropharyngeal rehabilitation with a multilevel approach can be proven as a non-invasive therapy for patients with OSA.

Keywords: obstructive sleep apnea, upper airway, oropharyngeal rehabilitation, multilevel approach

Procedia PDF Downloads 98

Authors: Christian Ihwiwhu, Nnamdi Obioha, Udeme John, Edward Bobade, Oghenerunor Bekibele, Adedeji Awujoola, Ibi-Ada Itotoi

Abstract:

Understanding the complexity in the distribution of hydrocarbon in a simple structure with flow baffles and connectivity issues is critical in targeting and developing the remaining pay in a mature asset. Subtle facies changes (heterogeneity) can have a drastic impact on reservoir fluids movement, and this can be crucial to identifying sweet spots in mature fields. This study aims to evaluate selected reservoirs in Ovhor Field, Niger Delta, Nigeria, with the objective of optimising production from the field by targeting undeveloped oil reserves, bypassed pay, and gaining an improved understanding of the selected reservoirs to increase the company’s reservoir limits. The task at the Ovhor field is complicated by poor stratigraphic seismic resolution over the field. 3-D geological (sedimentology and stratigraphy) interpretation, use of results from quantitative interpretation, and proper understanding of production data have been used in recognizing flow baffles and undeveloped compartments in the field. The full field 3-D model has been constructed in such a way as to capture heterogeneities and the various compartments in the field to aid the proper simulation of fluid flow in the field for future production prediction, proper history matching and design of good trajectories to adequately target undeveloped oil in the field. Reservoir property models (porosity, permeability, and net-to-gross) have been constructed by biasing log interpreted properties to a defined environment of deposition model whose interpretation captures the heterogeneities expected in the studied reservoirs. At least, two scenarios have been modelled for most of the studied reservoirs to capture the range of uncertainties we are dealing with. The total original oil in-place volume for the four reservoirs studied is 157 MMstb. The cumulative oil and gas production from the selected reservoirs are 67.64 MMstb and 9.76 Bscf respectively, with current production rate of about 7035 bopd and 4.38 MMscf/d (as at 31/08/2019). Dynamic simulation and production forecast on the 4 reservoirs gave an undeveloped reserve of about 3.82 MMstb from two (2) identified oil restoration activities. These activities include side-tracking and re-perforation of existing wells. This integrated approach led to the identification of bypassed oil in some areas of the selected reservoirs and an improved understanding of the studied reservoirs. New wells have/are being drilled now to test the results of our studies, and the results are very confirmatory and satisfying.

Keywords: facies, flow baffle, bypassed pay, heterogeneities, history matching, reservoir limit

Procedia PDF Downloads 122

Authors: Miao Zhang, Limin Liu, Feng Zhi, Panpan Niu, Mengya Yang, Xuemei Zhu, Ying Diao, Jun Wang, Ying Zhao

Abstract:

Background and Aims: Clinical studies have demonstrated that serum semicarbazide-sensitive amine oxidase (SSAO) activities positively correlate with the progression of atherosclerosis. The aim of the present study is to investigate the effect of SSAO inactivation on the development of atherosclerosis. Methods: Female LDLr knockout (KO) mice were given the Western-type diet for 6 and 9 weeks to induce the formation of early and advanced lesions, and semicarbazide (SCZ, 0.125%) was added into the drinking water to inactivate SSAO in vivo. Results: Despite no impact on plasma total cholesterol levels, abrogation of SSAO by SCZ not only resulted in the enlargement of both early (1.5-fold, p=0.0043) and advanced (1.8-fold, p=0.0013) atherosclerotic lesions, but also led to reduced/increased lesion contents of macrophages/smooth muscle cells (SMCs) (macrophage: ~0.74-fold, p=0.0002(early)/0.0016(advanced); SMC: ~1.55-fold, p=0.0003(early) /0.0001(advanced)), respectively. Moreover, SSAO inactivation inhibited the migration of circulating monocytes into peripheral tissues and reduced the amount of circulating Ly6Chigh monocytes (0.7-fold, p=0.0001), which may account for the reduced macrophage content in lesions. In contrast, the increased number of SMCs in lesions of SCZ-treated mice is attributed to an augmented synthetic vascular SMC phenotype switch as evidenced by the increased proliferation of SMCs and accumulation of collagens in vivo. Conclusion: SSAO inactivation by SCZ promotes the phenotypic switch of SMCs and the development of atherosclerosis. The enzymatic activity of SSAO may thus represent a potential target in the prevention and/or treatment of atherosclerosis.

Keywords: atherosclerosis, phenotype switch of smooth muscle cells, SSAO/VAP-1, semicarbazide

Procedia PDF Downloads 322

Authors: Mujahid Ali, Wasif Mohammed Ali, Meraj Ahmad

Abstract:

Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well as in India. The etiology of perforation peritonitis in India continues to be different from its western counterparts. The aim of this study is to evaluate the spectrum of cases of perforation peritonitis at our hospital. Methods: A prospective study conducted includes three hundred thirtysix patients of perforation peritonitis at J. N. Medical College from October 2015 to July 2017. The patients were admitted, resuscitated and underwent emergency laparotomy. Data were collected in terms of demographic profile, clinical presentations, site of perforations, causes and surgical outcomes. Results: In this study, the most common cause of perforation peritonitis was peptic ulcer disease (43%), followed by enteric perforation (12.8%), tubercular perforation (12.5%), traumatic perforation (11.9%), appendicular perforation (9.8%), amoebic caecal perforation (3%), malignant perforation (1.5%), etc. The sites of perforations were stomach in majority (38.3%), ileum (31%), appendix (8%), duodenum (5.%), caecum (4.4%) ,colon (3%), jejunum (8.5%) and gall bladder (2%). The overall mortality was 21% in our study. Age >50 years (p= <0.0001, OR= 3.9260, CI= 2.2 to 6.9), organ failure (p= <0.0001, OR= 29.2, CI= 14.8 to 57.6), shock (p=<0.0001, OR=20.20, CI= 10.56 to 38.6), diffuse peritonitis (p<0.0015, OR= 6.8810, CI= 2.09 to 22.57) and faecal exudates (p<0.0001) were found to be significant factors affecting mortality. The most common complication associated was superficial wound infection (40%), followed by burst abdomen seen in 21% cases, intra-abdominal sepsis in 18% cases, electrolyte imbalances in 15% cases, anastomotic leak in 6% cases. Conclusion: In this study, stomach is the most common site of perforation with peptic ulcer disease being the most common etiology. Older age, presence of shock, organ failure and faecal peritonitis were the risk factors affecting the mortality of the patients. Early recognition, adequate resuscitation and referral of patients can influence outcome and reduces mortality as well as morbidity.

Keywords: etiology, mortality, perforation, spectrum

Procedia PDF Downloads 252

Authors: Rohit Kothari, Muneer Mohamed, Vivekanandh K., Sunmeet Sandhu, Preema Sinha, Anuj Bhatnagar

Abstract:

Introduction: Hyper-IgE syndrome is a rare primary immunodeficiency syndrome characterised by triad of severe atopic dermatitis, recurrent pulmonary infections, and recurrent staphylococcal skin infections. The diagnosis requires a high degree of suspicion, typical clinical features, and not mere rise in serum-IgE levels, which may be seen in multiple conditions. Genetic studies are not always possible in a resource poor setting. This study highlights various presentations of Hyper-IgE syndrome in skin of color children. Case-series: Our study had six children of Hyper-IgE syndrome aged twomonths to tenyears. All had onset in first ten months of life except one with a late-onset at two years. All had recurrent eczematoid rash, which responded poorly to conventional treatment, secondary infection, multiple episodes of hospitalisation for pulmonary infection, and raised serum IgE levels. One case had occasional vesicles, bullae, and crusted plaques over both the extremities. Genetic study was possible in only one of them who was found to have pathogenic homozygous deletions of exon-15 to 18 in DOCK8 gene following which he underwent bone marrow transplant (BMT), however, succumbed to lower respiratory tract infection two months after BMT and rest of them received multiple courses of antibiotics, oral/ topical steroids, and cyclosporine intermittently with variable response. Discussion: Our study highlights various characteristics, presentation, and management of this rare syndrome in children. Knowledge of these manifestations in skin of color will facilitate early identification and contribute to optimal care of the patients as representative data on the same is limited in literature.

Keywords: absolute eosinophil count, atopic dermatitis, eczematous rash, hyper-immunoglobulin E syndrome, pulmonary infection, serum IgE, skin of color

Procedia PDF Downloads 130

Authors: Emmanuel Kamal Aziz Saba, Gihan Abd El-Lateif Younis El-Tantawi, Mohammed Hamdy Zahran, Ibrahim Khalil Ibrahim, Mohammed Abd El-Salam Shehata, Hussein Al-Moghazy Sultan, Medhat

Abstract:

Pelvic floor electrophysiological tests are essential for assessment of patients with obstructed defecation. The present study was conducted to determine the different patterns of pelvic floor electrophysiology that are associated with obstructed defecation. The present cross sectional study included 25 patients with obstructed defecation. A control group of 20 apparently healthy subjects were included. All patients were subjected to history taking, clinical examination, proctosigmoidoscopy, lateral proctography (evacuation proctography), dynamic pelvic magnetic resonance imaging, anal manometry and electrophysiological studies. Electrophysiological studies were including pudendal nerve motor conduction study, pudendo-anal reflex, needle electromyography of external anal sphincter and puborectalis muscles, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The control group was subjected to electrophysiological studies which included pudendal nerve motor conduction study, pudendo-anal reflex, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The most common pelvic floor electrodiagnostic pattern characteristics of obstructed defecation was pudendal neuropathy, denervation and anismus of external anal sphincter and puborectalis with complete interference pattern of external anal sphincter and puborectalis at squeezing and cough and no localized defect in external anal sphincter. In conclusion, there were characteristic pelvic floor electrodiagnostic patterns associated with obstructed defecation.

Keywords: obstructed defecation, pudendal nerve terminal motor latency, pudendoanal reflex, sphincter electromyography

Procedia PDF Downloads 433

Authors: Meenakshi Chaubey

Abstract:

A principle proposed in the cross-cultural adaption of behavior among Indian and Tibetan societies in which there are not any great variations between their young adults on the mindset of day-to-day marriage, Marriage plays a dominant position in constructing the society, which in large part comprises underneath the domain of lifestyle. Way of life is a social behavior and norm located in human societies where an extensive range of phenomena can be transmitted thru social studying. It acts characteristic of the individual has been the diploma day-to-day which they have got cultivated a specific stage of class in arts, science, architecture. The existing studies preliminarily on young adults of each community, wherein we carried out a comparative observe of the mindset of daily marriage among Indian and Tibetan teens. Further, we studied statistics comprehensively on the mindset closer day by day the marriage between Indian adult males and Tibetan younger males. With the extension of a complete look, we considered the mindset of an everyday marriage of Indian girls and Tibetan young ladies. Studies 1 showed that there might be no sizable distinction within the attitude of the day-to-day marriage of Indian and Tibetan teenagers. It, in addition, showed that they followed each different marriage beliefs and customs. Studies 2 showed that there might be no important difference in the attitude toward the everyday marriage of Indian and Tibetan young males. It similarly showcased that day-to-day secular schooling gadget in Tibetan society complements their clinical approach and changes their point of view on distinct social issues along with marriage. Research three confirmed that there is no substantial difference in the mindset of the daily marriage of Indian and Tibetan younger females. It similarly spread out the strict authorities' recommendations that they may no longer be allowed day-to-day comply with their marriage practices, including polygamy and polyandry. Thus, the information showed that there's a shift of lifestyle from one network every day to some other community because of social every day, which affects the conduct and results of daily past cultural adaptation.

Keywords: culture, marriage, attitude, society, young adults, Indian, Tibetan

Procedia PDF Downloads 73

Authors: Yasuyuki Takahashi, Hirotaka Shimada, Kyoko Saito

Abstract:

Bone scintigraphy is widely used as a screening tool for bone metastases. However, the 180 to 240 minutes (min) waiting time after the intravenous (i.v.) injection of the tracer is both long and tiresome. To solve this shortcoming, a bone scan with a shorter waiting time is needed. In this study, we applied the Maximum Intensity Projection (MIP) and triple energy window (TEW) scatter correction to a whole body bone SPECT (Merged SPECT) and investigated shortening the waiting time. Methods: In a preliminary phantom study, hot gels of 99mTc-HMDP were inserted into sets of rods with diameters ranging from 4 to 19 mm. Each rod set covered a sector of a cylindrical phantom. The activity concentration of all rods was 2.5 times that of the background in the cylindrical body of the phantom. In the human study, SPECT images were obtained from chest to abdomen at 30 to 180 min after 99mTc- hydroxymethylene diphosphonate (HMDP) injection of healthy volunteers. For both studies, MIP images were reconstructed. Planar whole body images of the patients were also obtained. These were acquired at 200 min. The image quality of the SPECT and the planar images was compared. Additionally, 36 patients with breast cancer were scanned in the same way. The delectability of uptake regions (metastases) was compared visually. Results: In the phantom study, a 4 mm size hot gel was difficult to depict on the conventional SPECT, but MIP images could recognize it clearly. For both the healthy volunteers and the clinical patients, the accumulation of 99mTc-HMDP in the SPECT was good as early as 90 min. All findings of both image sets were in agreement. Conclusion: In phantoms, images from MIP with TEW scatter correction could detect all rods down to those with a diameter of 4 mm. In patients, MIP reconstruction with TEW scatter correction could improve the detectability of hot lesions. In addition, the time between injection and imaging could be shortened from that conventionally used for whole body scans.

Keywords: merged SPECT, MIP, TEW scatter correction, 99mTc-HMDP

Procedia PDF Downloads 408